cerebroprotein hydrolysate for injection (III)

Severe anaphylactic shock suspectedly induced by injection of recombinant humanized type III collagen lyophilized fiber for facial skin improvement: a case report.

Liu Junjie J, Yan Wenjing W, Liu Jing J, Yang Bowen B et al.

Recombinant humanized type III collagen is widely used in facial rejuvenation due to its excellent biocompatibility and overall favorable safety profile; however, severe systemic hypersensitivity reactions are exceedingly rare. We report a case of a 47-year-old woman with no prior history of allergy who received topical lidocaine to the face, followed by injection of recombinant humanized type III collagen lyophilized fibers for skin texture improvement. Immediately after the injection, she developed suspectedly severe anaphylactic shock temporally associated with the recombinant collagen injectionpresenting with confusion, respiratory distress, followed by marked bradycardia (33 beats/min), and loss of palpable arterial pulse. Emergency protocols were activated immediately, including cardiopulmonary resuscitation, intravenous adrenaline, corticosteroids, and fluid resuscitation. The patient's vital signs gradually recovered, and she was discharged after complete recovery two days later after complete recovery. This case suggests that recombinant humanized collagen, as a macromolecular protein, inherently carries the risk of triggering immediate-type anaphylactic shock despite its favorable safety profile. Clinicians should perform rigorous preoperative assessment, adhere to standardized procedures, and be proficient in the emergency management of anaphylactic shock to minimize the risk of severe adverse reactions and ensure medical safety.

Supraglottic Botulinum Toxin Injection Improves Symptoms of Laryngeal Sensory Dysfunction.

Novakovic Daniel D, Sandham Katrina K, Stewart Thomas Emslie TE, Johnston James Jordan JJ

Central/peripheral vagal hypersensitivity underpins laryngeal sensory dysfunction (LSD). Botulinum toxin type A (BoNT-A) injection has emerged as a targeted treatment for modulating laryngeal sensory pathways. This study aimed to evaluate short-term outcomes and predictors of response following supraglottic BoNT-A injection in patients with refractory LSD. Retrospective cohort study of patients undergoing supraglottic BoNT-A injection treatment between 2019 and 2025 for LSD symptoms refractory to medical/behavioral therapy. Outcome measures included the Newcastle Laryngeal Hypersensitivity Questionnaire (LHQ), Reflux Symptom Index (RSI), Cough Severity Index (CSI), and Voice Handicap Index-10 (VHI-10). Pre- and post-treatment scores were compared using paired statistical tests and effect size estimation. Treatment characteristics and follow-up duration were reported, along with attainment of minimal clinically important difference (MCID) and predictors of response. Eighty consecutive patients (mean age 58.3 years; 48 female) showed significant improvement across hypersensitivity domains: LHQ +3.1 (95% CI: 2.4-3.8, p < 0.001), RSI -7.9 points (95% CI: -9.7 to -5.8, p < 0.001), CSI -5.7 points (p < 0.001). VHI-10 was unchanged (-1.3, p = 0.20). MCID thresholds were achieved in 64% for LHQ and 56% for RSI. Overall, 71% of patients reported phenotypic and clinically relevant improvement. Patients with a positive short-term superior laryngeal nerve (SLN) block were more likely to respond to supraglottic BoNT. No serious complications occurred. Supraglottic BoNT-A injection is a safe, effective treatment for laryngeal sensory dysfunction targeting the sensory field of the SLN to provide clinically meaningful reductions in throat irritation without compromising voice function.

A decade of decline and regional disparity: Trends and associated factors in use of ritodrine hydrochloride for threatened preterm labor in Japan, a nationwide ecological study.

Yorozu Kazuma K, Hinotsu Shiro S, Matsuura Motoki M, Someya Masayuki M et al.

Ritodrine hydrochloride is a commonly used tocolytic agent for threatened preterm labor in Japan, despite its serious adverse events and limited use in many other countries. National obstetric guidelines have shifted toward restricting its use, but the evidence-practice gap remains unclear. The aim of this study is to determine usage trends for ritodrine at nationwide and prefectural levels and identify factors associated with usage. We conducted an ecological study linking nationwide aggregated medical claims data and statistical survey records across all 47 prefectures. We investigated 10-year trends in ritodrine use from fiscal year (FY) 2014 to 2023. Choropleth maps and spatial statistics illustrated geographic relationships among neighboring prefectures. We also conducted a cross-sectional study to identify factors associated with ritodrine injection use. The usage rate of ritodrine injection per 1000 deliveries decreased by more than 45% over 10 years. Joinpoint regression analysis identified FY2017 as a turning point, after which the decline accelerated. However, prefectural usage varied up to 13.58-fold, with spatial clustering of high-use regions. Factors associated with injection usage included the density of Perinatal Medical Centers (PMCs), hospital admissions for threatened preterm labor and preterm birth per 1000 deliveries, and the proportion of hospitals among delivery facilities. This study showed that nationwide use of ritodrine injection decreased by half over a decade, along with regional disparities among prefectures in Japan. These variations might reflect localized treatment policies influenced by differences in healthcare resources and geographical accessibility.

Transient intraocular lens opacification after intravitreal triamcinolone injection.

Cardoso-Teixeira Pedro P, Duarte Lilianne L, Costa Ferreira Cláudia C