RESUMEN
Transcatheter arterial chemoembolization is a technique for provoking ischemia and cytotoxic activity by selectively injecting microspheres containing chemotherapy drugs into vessels supplying a tumor. An 87-year-old female patient on palliative treatment for hepatocellular carcinoma and with indications for chemoembolization underwent preparatory angiography, which revealed celiac trunk occlusion. The treatment option chosen was selective catheterization of the hepatic artery proper to release the chemotherapy agent via an alternative route through the superior mesenteric artery with communication using the pancreaticoduodenal arcade. Studies have reported evidence showing increased survival after chemoembolization and also reduced tumor growth rate. However, difficulties with accessing and catheterizing the artery feeding the tumor via the alternative access make the procedure a challenge, because of the tortuosity of the pancreaticoduodenal arcade.
RESUMEN
PURPOSE: To develop a specific device for pleural drainage in hypertensive pneumothorax. METHODS: The prototype was modeled from the free version of a 3D modeling application, printed on a 3D printer using ABS® plastic material, and tested in a pleural drainage simulator. RESULTS: Pleural drainage in the simulator using the prototype was feasible and reproducible. CONCLUSIONS: While the prototype is functional in the simulator, it requires improvement and refinement for use in humans.
Asunto(s)
Neumotórax , Drenaje , Humanos , Pleura , Neumotórax/cirugíaRESUMEN
Resumo: Introdução: A intubação orotraqueal é um procedimento importante no manejo da via aérea, principalmente quando realizada em situações de emergência. A videolaringoscopia é um artificio que facilita a visualização da glote ao auxiliar a intubação. Objetivo: Este estudo teve como objeto acoplar uma câmera de vídeo a um laringoscópio convencional do tipo Macintosh para possibilitar e orientar o treinamento da intubação orotraqueal. Método: O uso de uma câmera acoplada a um laringoscópio convencional permite a visibilização direta e indireta da glote. As imagens da câmera podem ser transmitidas por wi-fi e compartilhadas para dispositivos e plataformas eletrônicos, visando ao ensino presencial ou remoto da intubação orotraqueal. Resultado: A utilização do dispositivo artesanal como método de ensino de intubação orotraqueal permite ao docente ensinar a teoria do procedimento e orientar e corrigir a execução realizada pelo acadêmico. Esse feedback no treinamento prático pode ser realizado presencialmente ou por via remota. Conclusão: O uso do dispositivo artesanal de videolaringoscopia no ensino médico é uma ferramenta de baixo custo para aperfeiçoar o treinamento de intubação orotraqueal convencional.
Abstract: Introduction: The orotracheal intubation is an important procedure in airway management, especially when performed in emergency situations. Video-laryngoscopy is an artifice that facilitates visualization of the glottis, aiding intubation. Objective: This study aimed to attach a video camera to a conventional Macintosh-type laryngoscope to enable and train intubation or otracheal training. Method: The use of a camera coupled to a conventional laryngoscope allows direct and indirect visualization of the glottis. Camera images can be transmitted over wi-fi and shared to electronic devices and platforms, aiming at teaching in person or remotely about orotracheal intubation. Result: The use of the device as a method of teaching intubation or otracheal, allows teaching to teach the theory of procedure and training the execution performed by the artisanal method. This feedback in the practical training of orotracheal intubation in mannequins can be performed in person or remotely. Conclusion: The use of handcrafted video laryngoscopy device in medical education is a low-cost tool to improve conventional orotracheal intubation training.