In some cases, if the insertion depth is shallower than expected, intramuscular (IM) injection of risperidone long-acting injectable (RLAI) may not penetrate the muscle fascia. However, if needle insertion depth is de...In some cases, if the insertion depth is shallower than expected, intramuscular (IM) injection of risperidone long-acting injectable (RLAI) may not penetrate the muscle fascia. However, if needle insertion depth is deeper than anticipated, needle penetration may cause damage to nerves, arteries and veins. Few clinical studies were done to evaluate the depth of needle length insertion reaching the intended gluteal muscle. The aim of this study was to evaluate the suitable depth of injecting RLAI. Twenty-six patients with schizophrenia were treated with RLAI, and randomly divided into two groups: 50 mm needle inserted group (Group-D, deep insertion, n = 13) and 20 mm needle insertion group (Group-S, shallow insertion, n = 13). For Group-S, the needle length was marked with a spacer at exactly 20 mm. Injections were performed by the psychiatrist or nurse, alternating between the two gluteal sites by double-cross method every two weeks. Clinical psychotic symptoms and injection site reactions were recorded throughout the study period. Experienced psychologists who were blinded from the needle-length experimental variable evaluated patients’ psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS) every two weeks. The plasma 9-hydroxyrisperidone (9-OH-RIS) concentrations were measured every two weeks;comparison data were determined on the 8th week and the 14th week. No significant difference was observed in 9-OH-RIS concentrations, psychotic symptoms, injection site skin reactions of subjects in both groups. However, in Group-D, injection site adverse reactions were confirmed in two subjects (15%). In Group-S, injection site reactions were confirmed in six subjects (46%). Although effective 9-OH-RIS concentrations were obtained with the insertion using both depth, it was concluded that the 50 mm insertion length was more suitable for dorsogluteal IM injections in adult patients with schizophrenia as demonstrated by the incidence of local adverse skin reactions.展开更多
Written by Ian McEwan,The Children Act which was published in 2014 is a novel that reflects the conflicts between religion and law,sense and sensibility.By using Freud’s theory of personality structure,what Fiona rea...Written by Ian McEwan,The Children Act which was published in 2014 is a novel that reflects the conflicts between religion and law,sense and sensibility.By using Freud’s theory of personality structure,what Fiona really want hidden behind her extreme rationality will be found and the author also intends to seek a good way to go out of the dilemma for individuals in mod?ern society.First of all,it will analyze Fiona’s dilemma,including her dilemma in the marriage crisis and occupation,in which it will analyze the contest of“Id”,“Ego”and“Superego”behind her choice.By analyzing from this perspective,the author wants to find out the reasons behind Fiona’s choice and behavior.Additionally,it will analyze Fiona’s epiphany after death of Adam,including epiphany of the children’s welfare and that of her emotion.展开更多
文摘In some cases, if the insertion depth is shallower than expected, intramuscular (IM) injection of risperidone long-acting injectable (RLAI) may not penetrate the muscle fascia. However, if needle insertion depth is deeper than anticipated, needle penetration may cause damage to nerves, arteries and veins. Few clinical studies were done to evaluate the depth of needle length insertion reaching the intended gluteal muscle. The aim of this study was to evaluate the suitable depth of injecting RLAI. Twenty-six patients with schizophrenia were treated with RLAI, and randomly divided into two groups: 50 mm needle inserted group (Group-D, deep insertion, n = 13) and 20 mm needle insertion group (Group-S, shallow insertion, n = 13). For Group-S, the needle length was marked with a spacer at exactly 20 mm. Injections were performed by the psychiatrist or nurse, alternating between the two gluteal sites by double-cross method every two weeks. Clinical psychotic symptoms and injection site reactions were recorded throughout the study period. Experienced psychologists who were blinded from the needle-length experimental variable evaluated patients’ psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS) every two weeks. The plasma 9-hydroxyrisperidone (9-OH-RIS) concentrations were measured every two weeks;comparison data were determined on the 8th week and the 14th week. No significant difference was observed in 9-OH-RIS concentrations, psychotic symptoms, injection site skin reactions of subjects in both groups. However, in Group-D, injection site adverse reactions were confirmed in two subjects (15%). In Group-S, injection site reactions were confirmed in six subjects (46%). Although effective 9-OH-RIS concentrations were obtained with the insertion using both depth, it was concluded that the 50 mm insertion length was more suitable for dorsogluteal IM injections in adult patients with schizophrenia as demonstrated by the incidence of local adverse skin reactions.
文摘Written by Ian McEwan,The Children Act which was published in 2014 is a novel that reflects the conflicts between religion and law,sense and sensibility.By using Freud’s theory of personality structure,what Fiona really want hidden behind her extreme rationality will be found and the author also intends to seek a good way to go out of the dilemma for individuals in mod?ern society.First of all,it will analyze Fiona’s dilemma,including her dilemma in the marriage crisis and occupation,in which it will analyze the contest of“Id”,“Ego”and“Superego”behind her choice.By analyzing from this perspective,the author wants to find out the reasons behind Fiona’s choice and behavior.Additionally,it will analyze Fiona’s epiphany after death of Adam,including epiphany of the children’s welfare and that of her emotion.
