Search Results (96)

Background/Objectives: Rotator cuff calcific tendinopathy (RCCT) is one of the most common causes of non-traumatic shoulder pain. To date, there is still no consensus regarding the most effective method for its treatment. Ultrasound-guided percutaneous aspiration is suggested during the reabsorption phase of calcific metaplasia. We aimed to evaluate the effectiveness of ultrasound-guided lavage for RCCT from a clinical and radiological perspective. Methods: We involved patients affected by RCCT of the supraspinatus tendon. The approach used for the calcification lavage was the one-needle technique, consisting in inserting a 16–18 G needle on a 20 mL syringe with 0.9% saline solution, in the calcific metaplasia, under ultrasound guidance, using an in-plane approach; the repetitive action of pressing and releasing the plunger was repeated until the contents of the syringe became milky, at which point the syringe was replaced with a new one, always containing saline solution. The physiotherapy treatment began 7 days after the procedure. We assessed the Numeric Rating Scale, the Gartner classification, the Disability of the Arm, Shoulder and Hand scale, the Constant–Murley shoulder score, and the passive range of motion of flexion and abduction. Results: We included 23 subjects. The analysis of the data at baseline and t1 showed a statistically significant improvement in all the functional variables (p < 0.05). This result was mainly evident for pain, with a p-value of 0.001. Conclusions: The findings of the present prospective case series study showed an improvement in the clinical and radiological outcomes after ultrasound-guided percutaneous aspiration for rotator cuff calcific tendinopathy. Full article

Aboriginal and Torres Strait Islander people who inject drugs face persistent health inequities, highlighting the need for programs that meet the needs of these groups. This study explored how intersectional stigma and discrimination affect Aboriginal and Torres Strait Islander people’s access to quality healthcare. Aboriginal and Torres Strait Islander participants aged ≥18 years who had injected drugs within the past 12 months were recruited from two regional needle and syringe programs (NSPs) and a major city NSP in Queensland, Australia. Participants completed a structured survey and yarned with an Aboriginal researcher and non-Indigenous research assistant about their healthcare experiences. Through a process of reflexive and thematic analysis, three major qualitative themes emerged: participants’ social circumstances and mental health challenges made help-seeking difficult and complex; enacted stigma and racism diminished access to health services and the quality of care received; and injecting drug use was associated with disconnection from culture and community. Privileging the expertise and voices of those with lived/living experience is essential for the creation of culturally safe, inclusive, and destigmatising healthcare services for Aboriginal and Torres Strait Islander people who inject drugs. Full article

Chemical endodontic irritants can lead to the demineralization of the inorganic tooth structure, its loss of integrity, microhardness changes, erosion, and an increased risk of fractures. We investigated the action of iron oxide nanomagnet particles (IONPs) as an irrigant solution for improving hardness and identifying the concentration of element ions in the root canal. There were six groups in total: a control group (no treatment) and experimental groups (UN: ultrasound agitation normal saline, UI: ultrasound agitation IONPs, MSI: magnetic field and endodontic needle with syringe agitation IONPs, MUI: magnetic field and ultrasound agitation IONPs, and EDTA: ethylenediaminetetraacetic acid). We hypothesized that IONPs with magnetic agitation would preserve microhardness better than EDTA. Vickers hardness testing was used to evaluate microhardness, which was then analyzed using energy-dispersive X-ray spectroscopy (EDS) to investigate the calcium/phosphorus ratio and the presence of iron. The IONP groups exhibit a higher VHN value than the EDTA group (p < 0.05). These results support our hypothesis, indicating that utilizing an IONP irrigant solution with an external magnetic field does not change microhardness but enhances it compared to the EDTA group, suggesting that employing an external magnetic field to deliver nanoparticles to the root canal wall does not affect the properties of the tooth structure compared to conventional instrumentation techniques, which lead to unnecessary loss of root structure. Full article

Background/Objective: Needlestick injuries (NSIs) are a significant source of bloodborne infections among nurses. This study aimed to assess the prevalence, contributing factors, and awareness of post-exposure prophylaxis (PEP) among Estonian nurses. Methods: This prospective cross-sectional study was conducted using an electronic questionnaire in September 2024. Results: The majority of the 211 nurses participating in this study were females aged 21 to 75 years. Notably, 57.1% (n = 109, aged 43.9 ± 12.2) had experienced an NSI in the past decade. Most injuries occurred during sharps’ disposal (33%) and with syringe needles (72%). Among those injured, 84% washed the area with water and soap, 80% used alcohol-based disinfectants, and 69% reported the incident. However, 20.6% did not report due to perceived insignificance or lack of follow-up actions. Additionally, 14.7% were unaware of the reporting requirement, and 8.8% did not know who to report to. Conclusions: Improved training and reporting practices are essential to reduce NSIs among nurses. Full article

Microneedles (MNs) have emerged as a promising tool for pain-free drug delivery, offering an alternative to traditional syringe-based methods. Among various types of MNs, dissolving microneedles fabricated from hyaluronic acid (HA) have gained attention due to their biocompatibility and ability to deliver drugs with minimal discomfort. However, conventional HA MN fabrication techniques often limit needle lengths to a few hundred micrometers, which is insufficient for deeper drug penetration. This study introduces a novel fabrication method using bidirectional drawing lithography to extend the length of HA-based MNs. By adjusting the viscosity of HA solutions and employing a controlled pulling process, we demonstrate the feasibility of producing MNs with lengths ranging from millimeters to micrometers. An average height of 15 mm and tip diameters of approximately 80 μm were successfully produced. This advancement enhances the potential of HA MNs for transdermal drug delivery and interstitial fluid sampling. Full article

Background: Facial aging involves soft and hard tissues with changes that can affect an individual’s self-esteem and aesthetic appearance. Techniques used to counteract these changes include the use of solutions to be injected into the dermis, such as dermal matrix, vitamins, and antioxidants. B vitamins and choline are vital nutrition for humans and many other animals (vitamin B4), required to produce acetylcholine (ACh). It is considered a neurotransmitter universal methyl donator and of the major membrane constituent phosphatidylcholine (PC) and is crucial for the functioning of cell membranes, including those in skeletal muscle cells. The aim of this study is to evaluate the efficacy and safety of a fragment of HA amino acid and choline in a solution of phosphate buffer system used via mesotherapy. Specifically, state that the primary endpoint was the efficacy assessment using the Scientific Assessment Scale of Skin Quality (SASSQ), while secondary endpoints included safety assessments and patient-reported outcomes. Methods: Forty (40) subjects completed the study. In total, 40 subjects were screened and included in the study. The total duration of the study was 14 months. The first subject was included on 12 January 2019, and the last subject’s last visit was on 14 March 2020. All patients received the SKIN Colin^® products by mesotherapy technique for 8 weeks, providing the treatment with the use of 0.5 cc syringes and 13 mm long, 30 G diameter needles. The solution was inoculated into the deep layer of the dermis of the face with a suitable amount of at least 0.2/0.3 mL in the cutaneous points four times every 15 days. Each subject had to be followed for 168 days after the last mesotherapy session. Only enrolled subjects received the HA and choline via mesotherapy. The primary efficacy endpoint was the absolute change in the Scientific Assessment Scale of Skin Quality from Baseline (Day 0) to Day 168. A reduction of at least one point in the SASSQ was considered to reach the endpoint goal. Results: The results of the present investigation show Scientific Assessment Scale of Skin Quality (SASSQ) mean at baseline was 2463 with a standard deviation of 0.36, while at day 168, the mean was 1303 with a standard deviation of 0.36. The difference was statistically significant (p < 0.0001). Also, the GAIS was improved after treatment with Skin Colin^®. The assessment of “satisfaction with treatment” was very high by the majority of subjects. Conclusions: In conclusion, our results suggest that a course of treatment with choline via mesotherapy results in an improvement of the Scientific Assessment Scale of Skin Quality. This data is very important for possible fields of application in the treatment of skin and muscle aging. However, the present study has limitations due to the small sample size and the lack of a control group. Full article

Recently, various biocompatible and biodegradable materials have garnered significant attention as cosmetic fillers for skin rejuvenation. Among these, poly ε-caprolactone (PCL), poly L-lactic acid (PLLA), poly D,L-lactic acid (PDLLA), and polydioxanone (PDO) microspheres have been developed and commercialized as a dermal filler. However, its irregularly hydrophobic microspheres pose hydration challenges, often causing syringe needle blockages and side effects such as delayed onset nodules and papules after the procedure. In this study, we synthesized a polyethylene glycol-poly D,L-lactic acid (mPEG-PDLLA) copolymer to address the limitations of conventional polymer fillers. Comprehensive characterization of the copolymer was performed using nuclear magnetic resonance spectroscopy, Fourier transform infrared spectroscopy, and differential scanning calorimetry. The mPEG-PDLLA copolymers demonstrated a unimodal size distribution of approximately 121 ± 20 nm in an aqueous solution. The in vitro cytotoxicity and collagen genesis of mPEG-PDLLA copolymers were evaluated using human dermal fibroblast cells. In this study, angiogenesis was observed over time in hairless mice injected with mPEG-PDLLA copolymers, confirming its potential role in enhancing collagen synthesis. To assess the inflammatory response, the expression levels of the genes MMP1 and IL-1β were analyzed. Additionally, gene expression levels such as transforming growth factor-β and collagen types I and III were compared with Rejuran^® in animal studies. The newly developed collagen-stimulating PEGylated PDLLA may be a safe and effective option for skin rejuvenation. Full article

The objective of this study was to determine the effect of two aspiration pressures (75 vs. 150 mmHg), the follicle flushing method (injection pump controlled by a foot pedal vs. a plastic syringe) and the twisting of the OPU needle on oocyte recovery and in vitro embryo production. OPU data from a total of 104 warmblood sport mares belonging to a commercial OPU-ICSI program were collected as part of a prospective study split into three experiments. Each mare was used only once for OPU. In Experiment 1, the mares’ follicles were aspirated using either a high aspiration pressure (flow rate of 1.33 mL/s; n = 18) or low aspiration pressure (0.75 mL/s; n = 18); in Experiment 2, follicles were flushed using either a manual method (plastic syringe, n = 18) or an automatic method (injection pump controlled by a foot pedal, n = 18); and in Experiment 3, the follicles were aspirated by scraping the follicle wall with needle rotation (needle twisting, n = 16) or without needle rotation (control, n = 16). In all the experiments, the same OPU operator and technician searching oocytes were used, and the allocation of each mare to the different treatment groups was randomized. The overall mean oocyte recovery rate of the study was 54.2 ± 17.1%, and the mean number of embryos per OPU-ICSI session was 1.9 ± 1.6. The oocyte recovery rate was not influenced by any of the parameters investigated (p > 0.05). However, high aspiration pressure (150 mmHg) tended to yield oocytes with lower maturation (51.6%; p = 0.09) and blastocyst rates (20.6%; p = 0.08) following IVM and ICSI, respectively, compared with the low aspiration group (64.4% MII rate and 31.4% blastocyst rate). In conclusion, increasing aspiration pressure does not increase oocyte recovery. Furthermore, when a single operator performs the OPU (holding the ovary and handling the needle simultaneously), needle rotation to scrape the follicle wall does not improve oocyte recovery. Full article

The availability of highly effective direct-acting antivirals (DAAs) that cure individuals infected with HCV has changed completely the natural history of HCV infection and chronic hepatitis C. In sustained responders to DAAs, the most common clinical-pathologic outcome has become liver disease regression, cirrhosis re-compensation, and the de-listing of transplant candidates. However, careful scrutiny of liver disease cofactors and outcome predictors in treated patients is mandatory for an appropriate personalized surveillance of the residual risk for hepatocellular carcinoma. Since successful treatment with DAAs does not confer protective immunity against HCV reinfection, an effective vaccine is critically needed to control HCV infection. Meanwhile, it is mandatory to enhance universal access to DAAs, to test asymptomatic high-risk groups who are the main source of transmission, and to screen people who inject drugs (PWID), men who have sex with men (MSM), and sex workers, and to assure safe medical procedures with the provision of disposable needle and syringes. Full article

Harm Reduction (HR) was introduced in Mauritius in 2006 to mitigate the local Human Immunodeficiency Virus (HIV) epidemic mainly driven by injecting drug use. With an estimated population of 55,000 drug users and an estimated population of 6600 injecting drug users with an average of 21 years at first injection, the impact of drug use on the epidemic remains high. Those aged 15–24 years account for 20% of all new HIV cases detected annually since 2010, with known causes of incidence including both injecting drug use and unprotected sexual intercourse. Beginning with an exploration of access and barriers to needles and syringes, our study evolved to consider the dynamics between concurrent services and the effectiveness of the resulting system. Utilising snowball and purposive sampling, we conducted in-depth interviews with 27 participants, including service providers, identified by peer fieldworkers from various NGOs. Our analysis showed that HR services were connected via informal networks and displayed the same characteristics as Complex Adaptive Systems (CAS). We propose using qualitative structural analysis as a viable method to explore the complexity of HR. CAS and proper acknowledgement of peer support could guide current and future HR policy reforms. Full article

In recent years, hydrogel beads and in situ hydrogels have gained wide attention in various fields such as biomedicine. In this study, 3-(4-hydroxyphenyl) propionic acid (HP) was introduced into the side chain of poly(α,β-[N-(2-hydroxyethyl)-D,L-aspartamide]) (PHEA) to synthesize phenolic hydroxyl-functionalized poly(aspartamide) derivative PHEA-HP with enzyme-catalyzed cross-linking potential. First, the chemical structure of PHEA-HP was characterized by FT-IR, UV and ¹H NMR, and the results of in vitro cytotoxicity against L929 cell line and hemolysis experiment showed that PHEA-HP did not have toxicity to cells (viability > 90%) and had good blood compatibility. Then, rheological measurement confirmed the formation of PHEA-HP-based in situ hydrogel with a high storage modulus (G′) around 10⁴ Pa, and the vial-tilting method revealed that the gelation time of PHEA-HP aqueous solution could be tuned in the wide range of 5–260 s by varying the concentrations of hydrogen peroxide (H₂O₂) and horseradish peroxidase (HRP). Finally, hydrogel beads of different diameters containing methylene blue (for easy observation) were prepared using a coaxial needle and syringe pumps, and the effect of the flow rate of the outer phase on the diameters of the hydrogel beads was also investigated. Therefore, PHEA-HP may be a promising and safe poly(aspartamide) derivative that can be used to prepare in situ hydrogels and hydrogel beads for applications closely related to the human body. Full article

The aim of this study was to explore an improved method for extracting rat cerebrospinal fluid (CSF), observing the impact on animal health under conditions of large-scale CSF collection and evaluating the feasibility of repeated collections. A total of 20 rats were anesthetized and fixed in a stereotactic frame. A 26G scalp needle, combined with a 1 mL syringe, was used to puncture the atlanto-occipital membrane and collect approximately 170 μL of CSF. CSF was collected twice within 14 days. During the study, animals were monitored daily for food intake, body weight, and hematological parameters, and at the end of the study, histopathological examination was performed. The health of the animals remained good, and repeated CSF collections were feasible. The success rate of the procedure was 100%, with blood contamination in the CSF decreasing from 70% in the first collection to 35% in the second. This technique is convenient, accurate, and suitable for widespread applications. Full article

This study investigated the survival and growth of Salmonella in onion extracts and bulbs. The inhibition or retardation of Salmonella growth by extracts of red, white, and yellow onions was tested against the onion germplasm and exposure to different light spectra during curing. Separately, survival of Salmonella Newport was tested on red, white, and yellow onion bulbs on the external and internal onion layers with a syringe and needle. Onions exposed to blue, red, and white LED light during curing produced extracts with variable antimicrobial effects (p < 0.05), with those exposed to blue light showing the strongest inhibitory effect on red and white onions only. In survival studies, Salmonella inoculated on the outer scale was reduced by 1.2, >2.7, and >2.4 logs on red, white, and yellow onions, respectively, within 3 days, whereas it grew by 2.4, 2.6, and 2.8 logs inside red, white, and yellow onion bulbs, respectively, over 18 days. In separate trials, the outer layer again did not support the survival of Salmonella Newport. The a_w increased significantly from 0.51 to 0.58 in the outer scales and 0.96 to 0.98 for the fourth inner scales. Despite being rich in antimicrobial polyphenols, tissue integrity and water content may still promote Salmonella growth in onions. Full article

Background: Bone marrow aspiration concentrate (BMAC) has garnered increasing interest due to its potential for healing musculoskeletal injuries. While the iliac crest remains a common harvest site, the aspiration technique’s efficacy in offering the highest yield and prevalence of mesenchymal stem cells (MSCs) is controversial. This study aimed to compare two different techniques of bone marrow aspiration over the anterior iliac crest from a single level versus multiple levels. Methods: Anterior iliac crests were selected in seven adult patients (aged between 31 and 59 years old). Aspiration was achieved using an 11-gauge needle (length: 100 mm; diameter: 2.3 mm) specifically manufactured for bone marrow collection (BD, Becton, Franklin Lakes, NJ, USA) connected to a 10 mL syringe. On one side, 4cc of bone marrow was aspirated at a single level to a depth of 7 cm without changing the needle direction. On the other side, over the same portion of the iliac crest, 1 cc of bone marrow was obtained from multiple levels of different depths during needle retrieval, maintaining a distance of 1 cm and changing the tip direction. The samples were blindly sent to the laboratory without indicating whether they came from an single level or multiple levels. Fluorescence-activated cell sorting (FACS) and osteoblast differentiation were analyzed and compared. Results: In the FACS analysis, the single level resulted in a higher population of MSCs that were positive for CD105, CD73, and CD90 and negative for CD34, compared to the multiple-level method. In the process of osteoblast differentiation, it was observed that MSCs exhibited more advanced features of enhanced osteoblastic abilities in the single-level method rather than the multiple-level method. Conclusions: A single-level aspiration technique at the anterior iliac crest may produce a high-quality bone marrow aspirate. This technique may help obtain specific populations of MSCs with the desired characteristics for use in regenerative therapies for musculoskeletal injuries. Full article

Diabetes is one of the most common diseases worldwide, with an increasing number of people affected. Insulin therapy is still the major treatment for both Type 1 and Type 2 diabetes and has evolved from bulky syringes to modern insulin pens introduced in 1985. An insulin pen consists of three major parts: a cartridge, a single-use pen needle (PN), and a precision dosing mechanism. Initially, PNs were long and thick, causing great discomfort and concern. Thanks to advances in design, shorter and thinner needles have appeared on the market, improving patient acceptability and pain perception. Studies highlight the influence of PN geometry and other characteristics on injection-related pain, including length, diameter, bevel design, and hub. Despite a lack of specific international regulations for PN geometry, scientific publications have focused on exploring different PNs’ characteristics to optimize patient comfort and reduce pain. To guide the selection of suitable PNs, this review provides a round-up of literature research findings on the impact of PN geometry on pain perception and patient acceptability. Specifically, it provides an overview of the PN manufacturing process, current international regulations, and the state-of-the-art research on PN geometry affecting pain perception. Full article