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1.
Zhongguo Zhen Jiu ; 41(3): 331-4, 2021 Mar 12.
Artigo em Chinês | MEDLINE | ID: mdl-33798320

RESUMO

"Treatment in accordance with time factor" is one of the key principles of acupuncture and moxibustion treatment. In clinical practice of acupuncture and moxibustion, the connotation of "timing/time factor" should be fully understood and the temporal rule on physiology and pathology affected by the changes of four seasons and day and night be grasped. Based on the change law of qi, blood, yin and yang and the rise and fall rules of pathogens and antipathogenic qi, the intervention is exerted timely. The dynamic law of acupoints should be associated with the changes in pathogenesis and illness location, thus, the acupoint selection, needle manipulation and needle withdrawal can be operated precisely. The idea of time factor should be considered in the whole process of clinical diagnosis and treatment with acupuncture and moxibustion so as to provide some guidance for clinical analysis and practice.


Assuntos
Terapia por Acupuntura , Moxibustão , Pontos de Acupuntura , Agulhas , Fatores de Tempo
2.
Zhongguo Zhen Jiu ; 41(2): 233-6, 2021 Feb 12.
Artigo em Chinês | MEDLINE | ID: mdl-33788478

RESUMO

The articles regarding needle-embedding treatment for hemifacial spasm published before September 30, 2019 were searched from SinoMed, Wanfang, CNKI, VIP and PubMed database, and were analyzed and summarized from treatment methods, acupoint selection, stage differentiation and action mechanism. As a result, 45 Chinese articles were obtained. The needle-embedding treatment was divided into intradermal needling and acupoint thread-embedding; the top five acupoints were Sibai (ST 2), Taiyang (EX-HN 5), Dicang (ST 4), Jiache (ST 6) and spasm trigger points. The basic research of needle-embedding treatment for hemifacial spasm is weak, and the literature regarding stage differentiation is insufficient, which are in need of further study.


Assuntos
Terapia por Acupuntura , Espasmo Hemifacial , Meridianos , Pontos de Acupuntura , Espasmo Hemifacial/terapia , Humanos , Agulhas
3.
AAPS PharmSciTech ; 22(3): 100, 2021 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-33709236

RESUMO

Intravitreal (IVT) administration of therapeutics is the standard of care for treatment of back-of-eye disorders. Although a common procedure performed by retinal specialists, IVT administration is associated with unique challenges related to drug product, device and the procedure, which may result in adverse events. Container closure configuration plays a crucial role in maintaining product stability, safety, and efficacy for the intended shelf-life. Careful design of primary container configuration is also important to accurately deliver small volumes (10-100 µL). Over- or under-dosing may lead to undesired adverse events or lack of efficacy resulting in unpredictable and variable clinical responses. IVT drug products have been traditionally presented in glass vials. However, pre-filled syringes offer a more convenient administration option by reducing the number of steps required for dose preparation there by potentially reducing the time demand on the healthcare providers. In addition to primary container selection, product development studies should focus on, among other things, primary container component characterization, material compatibility with the formulation, formulation stability, fill volume determination, extractables/leachables, and terminal sterilization. Ancillary components such as disposable syringes and needles must be carefully selected, and a detailed administration procedure that includes dosing instructions is required to ensure successful administration of the product. Despite significant efforts in improving the drug product and administration procedures, ocular safety concerns such as endophthalmitis, increased intraocular pressure, and presence of silicone floaters have been reported. A systematic review of available literature on container closure and devices for IVT administration can help guide successful product development.


Assuntos
Sistemas de Liberação de Medicamentos/métodos , Embalagem de Medicamentos/métodos , Injeções Intravítreas/métodos , Seringas , Humanos , Agulhas , Preparações Farmacêuticas/administração & dosagem , Esterilização
4.
Medicine (Baltimore) ; 100(9): e24401, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655914

RESUMO

BACKGROUND: Lumbar muscle strain (LMS) is the most common orthopedic syndrome, with high incidence globally and lingering disease, which seriously affects patients' work efficiency and quality of life. Warm needle acupuncture (WNA) is a treatment method combining acupuncture technology with warm and medicinal effect of moxibustion. It has outstanding curative effect and wide range of treatment, especially in the treatment of pain diseases. We aim to collect clinical evidence and demonstrate the efficacy and safety of WNA on LMS. METHODS/DESIGN: We will search the following database sources for the randomized controlled trials: PubMed, Cochrane Library, Excerpta Medica Database (EMBASE), Web of Science, WHO International Clinical Trials Registry Platform (TCTRP), Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database (CNKI), Chinese Scientific Journals Database (VIP), and the Wanfang Database.All randomized controlled trials of WNA for lumbar muscle strain (LMS) in the above database will be considered for inclusion, and high-quality articles will be screened for data extraction and analysis, to summarize the therapeutic effect of WNA on LMS patients. RESULT: This study will provide a rational synthesis of current evidences for warm needle acupuncture on lumbar muscle strain. CONCLUSION: The conclusion of this study will provide evidence to judge the effectiveness and safety of WNA on LMS. TRIAL REGISTRATION: INPLASY2020120100 (DOI number: 10.37766/inplasy2020.12.0100).


Assuntos
Terapia por Acupuntura/métodos , Músculos do Dorso/lesões , Região Lombossacral/lesões , Moxibustão/métodos , Entorses e Distensões/terapia , Temperatura Alta , Humanos , Metanálise como Assunto , Agulhas , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
5.
Medicine (Baltimore) ; 100(10): e25106, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725907

RESUMO

INTRODUCTION: Cytological study of samples obtained by Endoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) allows for recognition of clear signs of malignant transformation. However, certain neoplasms can be difficult to diagnose without histological analysis. Recently, a novel EUS-guided fine needle biopsy (EUS-FNB) needle was developed to increase tissue acquisition. This study set out to investigate the usefulness of this novel EUS-FNB needle (NEFN) in terms of obtaining a proper histology compared with a conventional EUS-FNA needle (CEFN). METHODS: This investigation was a prospective, single-blind, randomized study in a single academic hospital. Primary outcome was the acquisition rate of an appropriate and sufficient specimen for histologic assessment. Secondary outcomes were diagnostic yield of peripancreatic masses using a CEFN and a NEFN. Furthermore, we assessed the feasibility of determining K-ras mutation status according to needle type. RESULTS: The study enrolled 56 consecutive patients. Technical success rates were 96.6% (28/29) for the CEFN and 100% (27/27) for the NEFN (P = 1.000). No complications occurred during or after the procedure in either needle group. An adequate sample for cytologic diagnosis was obtained in 89.7% (26/29) of patients in the CEFN group vs 96.3% (26/27) of patients in the NEFN group (P = .612). For histologic diagnosis, a sample with a biopsy adequacy score of 2 or more was obtained in 41.4% (12/29) of CEFN-acquired samples vs 88.9% (24/27) of NEFN-acquired samples (P < .001). K-ras mutation analysis using histologic specimens was possible in 13 (44.8%) CEFN-acquired samples and 25 (92.6%) of NEFN-acquired samples. This difference was significant (P < .001). CONCLUSIONS: The present study suggests that the NEFN is an effective and reliable alternative compared to a CEFN in terms of tissue acquisition rate and quality of histologic sampling.


Assuntos
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/instrumentação , Agulhas , Pâncreas/patologia , Neoplasias Pancreáticas/diagnóstico , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Estudos Prospectivos , Reprodutibilidade dos Testes , Método Simples-Cego
6.
Lakartidningen ; 1182021 02 09.
Artigo em Sueco | MEDLINE | ID: mdl-33567094

RESUMO

Deformities such as hammer and claw toes are common in people with diabetes and neuropathy. These deformities increase pressure on the tip of toes, leading to callosity and subsequent pressure ulcers. Conventional flexor tenotomy has been shown to decrease the risk of pressure ulcers. During the first decade of the 21 century, a less traumatizing percutaneous method was introduced, and more recently a needle-based minimal flexor tenotomy method. In this paper, based on the outcome of 164 consecutive needle-based flexor tenotomies performed by diabetologists in routine clinics, we verify the simplicity and safety of this inexpensive method.


Assuntos
Pé Diabético , Tenotomia , Pé Diabético/cirurgia , Humanos , Agulhas , Dedos do Pé
7.
Zhongguo Zhen Jiu ; 41(1): 41-3, 2021 Jan 12.
Artigo em Chinês | MEDLINE | ID: mdl-33559441

RESUMO

Regarding the existing questions of the understanding and application of lateral needling technique in the Chapter 7 of Lingshu (Miraculous Pivot), after analyzing the original meaning of the lateral needling technique and its indication for "tendon bi syndrome" in literature, it is believed that lateral needling technique is the classic manipulation for tendon bi syndrome, mainly for tendon spasticity caused by obstruction of qi activity or retarded qi activity. The filiform needle is used in the operation. The puncture hand and the pressing hand should be cooperated during the manipulation, in which, after detecting the location of tendon disorder by the pressing hand, the needle is inserted from the lateral side of the affected site and is manipulated with the reinforcing technique achieved by lifting and thrusting needle. Afterwards, the needle is withdrawn. The lateral needling technique of acupuncture is one of the mass-loosening techniques in Neijing (Inner Classic). It is a reliable technique of acupuncture in clinical treatment of acute and chronic diseases, such as cervical spondylosis and tendon injury of lumber region and has a stable therapeutic effect.


Assuntos
Terapia por Acupuntura , Acupuntura , Pontos de Acupuntura , Agulhas , Punções , Procedimentos Cirúrgicos Vasculares
8.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431448

RESUMO

Embolised needles causing injury to the right heart and cardiac tamponade has been reported before in intravenous drug users, but to our knowledge, this is the first reported case of a needle migrating via the pulmonary arterial system to cause perforation of the left ventricle. Appropriate utilisation of imaging modalities such as plain X-ray and point-of-care focused cardiac ultrasound can be vital and life-saving in the emergency setting, and the value of gated multidetector CT as a powerful tool for imaging moving structures is highlighted.


Assuntos
Migração de Corpo Estranho/diagnóstico , Traumatismos Cardíacos/diagnóstico , Ventrículos do Coração/lesões , Agulhas/efeitos adversos , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Ponte Cardiopulmonar , Ecocardiografia , Migração de Corpo Estranho/complicações , Migração de Corpo Estranho/cirurgia , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/cirurgia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Humanos , Pulmão/irrigação sanguínea , Pulmão/diagnóstico por imagem , Pulmão/cirurgia , Masculino , Pericardiocentese , Artéria Pulmonar/diagnóstico por imagem , Cirurgia Torácica Vídeoassistida , Resultado do Tratamento
9.
Nat Commun ; 12(1): 658, 2021 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-33510169

RESUMO

A microneedle array is an attractive option for a minimally invasive means to break through the skin barrier for efficient transdermal drug delivery. Here, we report the applications of solid polymer-based ion-conductive porous microneedles (PMN) containing interconnected micropores for improving iontophoresis, which is a technique of enhancing transdermal molecular transport by a direct current through the skin. The PMN modified with a charged hydrogel brings three innovative advantages in iontophoresis at once: (1) lowering the transdermal resistance by low-invasive puncture of the highly resistive stratum corneum, (2) transporting of larger molecules through the interconnected micropores, and (3) generating electroosmotic flow (EOF). In particular, the PMN-generated EOF greatly enhances the transdermal molecular penetration or extraction, similarly to the flow induced by external pressure. The enhanced efficiencies of the EOF-assisted delivery of a model drug (dextran) and of the extraction of glucose are demonstrated using a pig skin sample. Furthermore, the powering of the PMN-based transdermal EOF system by a built-in enzymatic biobattery (fructose / O2 battery) is also demonstrated as a possible totally organic iontophoresis patch.


Assuntos
Sistemas de Liberação de Medicamentos/instrumentação , Sistemas de Liberação de Medicamentos/métodos , Epiderme/metabolismo , Pele/metabolismo , Administração Cutânea , Animais , Dextranos/administração & dosagem , Dextranos/metabolismo , Dextranos/farmacocinética , Eletro-Osmose , Fluoresceína-5-Isotiocianato/administração & dosagem , Fluoresceína-5-Isotiocianato/análogos & derivados , Fluoresceína-5-Isotiocianato/metabolismo , Fluoresceína-5-Isotiocianato/farmacocinética , Glucose/administração & dosagem , Glucose/metabolismo , Glucose/farmacocinética , Humanos , Iontoforese/instrumentação , Iontoforese/métodos , Masculino , Microinjeções , Agulhas , Padrões Moleculares Associados a Patógenos/administração & dosagem , Padrões Moleculares Associados a Patógenos/metabolismo , Padrões Moleculares Associados a Patógenos/farmacocinética , Porosidade , Suínos
10.
Arq Bras Cir Dig ; 33(4): e1554, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33503114

RESUMO

BACKGROUND: Fine needle biopsy (FNB) histological samples by endoscopic ultrasound. It is important to obtain representative histological samples of solid biliopancreatic lesions without a clear indication for resection. The role of new needles in such task is yet to be determined. AIM: To compare performance assessment between 20G double fine needle biopsy (FNB) and conventional 22G fine needle aspiration (FNA) needles for endoscopic ultrasound (EUS)-guided biopsy. METHODS: This prospective study examined 20 patients who underwent the random puncture of solid pancreatic lesions with both needles and the analysis of tissue samples by a single pathologist. RESULTS: The ProCore 20G FNB needle provided more adequate tissue samples (16 vs. 9, p=0.039) with better cellularity quantitative scores (11 vs. 5, p=0.002) and larger diameter of the histological sample (1.51±1.3 mm vs. 0.94±0.55 mm, p=0.032) than the 22G needle. The technical success, puncture difficulty, and sample bleeding were similar between groups. The sensitivity, specificity, and diagnostic accuracy were 88.9%, 100%, and 90% and 77.8%, 100%, and 78.9% for the 20G and 22G needles, respectively. CONCLUSIONS: The samples obtained with the ProCore 20G FNB showed better histological parameters; although there was no difference in the diagnostic performance between the two needles, these findings may improve pathologist performance.


Assuntos
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/normas , Agulhas/classificação , Pâncreas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/instrumentação , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Agulhas/efeitos adversos , Pâncreas/patologia , Neoplasias Pancreáticas/diagnóstico por imagem , Estudos Prospectivos , Sensibilidade e Especificidade , Adulto Jovem
11.
Anaesthesia ; 76 Suppl 1: 160-170, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33426657

RESUMO

The accuracy and reliability of ultrasound are still insufficient to guarantee complete and safe nerve block for all patients. Injection of local anaesthetic close to, but not touching, the nerve is key to outcomes, but the exact relationship between the needle tip and nerve epineurium is difficult to evaluate, even with ultrasound. Ultrasound has insufficient resolution, tissues are difficult to discern due to acoustic impedance and needles are more difficult to see with increased angulation. The limitations of ultrasound have shifted the focus of innovation towards bio-markers that help detect needle tip position by utilising the physical properties of tissues, (e.g. pressure, electrical, optics, acoustic and elastic). Although most are at the laboratory stage and results are as yet only available from phantom or cadaver studies, clinical trials are imminent. For example, fine optical fibres placed within the lumen of block needles can measure needle tip pressure. Electrical impedance differentiates between intraneural and perineural needle tip placement. A new tip tracker needle has a piezo element embedded at its distal end that tracks the needle tip in-plane and out-of-plane as a blue/red or green circle depending on its relative location within the beam. Micro-ultrasound at the tip of the needle is in development. Early images using 40MHz in anaesthetised pigs reveal muscle striation, distinct epineurium and 30-40 fascicles > 75 micron in diameter. The next few years will see a technological revolution in tip-tracking technology that has the potential to improve patient safety and, in doing so, change practice.


Assuntos
Bloqueio Nervoso/métodos , Nervos Periféricos/diagnóstico por imagem , Ultrassonografia de Intervenção/métodos , Anestésicos Locais/administração & dosagem , Animais , Agulhas
12.
Nat Biomed Eng ; 5(1): 64-76, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33483710

RESUMO

The detection and quantification of protein biomarkers in interstitial fluid is hampered by challenges in its sampling and analysis. Here we report the use of a microneedle patch for fast in vivo sampling and on-needle quantification of target protein biomarkers in interstitial fluid. We used plasmonic fluor-an ultrabright fluorescent label-to improve the limit of detection of various interstitial fluid protein biomarkers by nearly 800-fold compared with conventional fluorophores, and a magnetic backing layer to implement conventional immunoassay procedures on the patch and thus improve measurement consistency. We used the microneedle patch in mice for minimally invasive evaluation of the efficiency of a cocaine vaccine, for longitudinal monitoring of the levels of inflammatory biomarkers, and for efficient sampling of the calvarial periosteum-a challenging site for biomarker detection-and the quantification of its levels of the matricellular protein periostin, which cannot be accurately inferred from blood or other systemic biofluids. Microneedle patches for the minimally invasive collection and analysis of biomarkers in interstitial fluid might facilitate point-of-care diagnostics and longitudinal monitoring.


Assuntos
Biomarcadores/análise , Líquido Extracelular/química , Microtecnologia/instrumentação , Agulhas , Animais , Cocaína/análise , Citocinas/análise , Desenho de Equipamento , Feminino , Corantes Fluorescentes/química , Técnicas de Imunoadsorção/instrumentação , Limite de Detecção , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL
14.
J Mater Chem B ; 9(2): 421-427, 2021 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-33367393

RESUMO

Obesity is a chronic and recurrent disease with potential risks. Traditional weight-loss methods (like exercises, surgeries, oral drugs, etc.) have shown different side effects. In this experiment, the microneedle (MN) patch was selected as the drug carrier of the weight-loss drug Rosiglitazone (Rosi). Besides, melanin was added to enhance the photo-thermal effect and accelerate the release of drugs to the target fat region under near-infrared (NIR) light. Afterwards, with exterior cold stimulation, the significant and accurate effect of body slimming could be achieved. This combination of soluble MN patches and variable temperatures provides an attractive nonsurgical method for future accurate body slimming management.


Assuntos
Agulhas/normas , Obesidade/terapia , Perda de Peso/efeitos dos fármacos , Animais , Humanos , Camundongos , Temperatura
15.
Curr Opin Ophthalmol ; 32(1): 19-24, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33196545

RESUMO

PURPOSE OF REVIEW: To review variations of flanged intraocular lens fixation (Yamane technique) and their outcomes. RECENT FINDINGS: Sutureless intrascleral IOL fixation has become popular, and many techniques have been reported. Among them, the Yamane technique has been widely used in recent years, and there are many variations. However, there are no reports that systematically compare them. SUMMARY: There are variations of the Yamane technique, such as those used to create a scleral tunnel or to dock needles and haptics. Although few reports have directly compared each technique, small scleral wounds appear to be beneficial for long-term stability of the IOL. A method of fixing a capsule tension segment or iris using a flange has also been reported, demonstrating the diverse range of uses of the flange.


Assuntos
Implante de Lente Intraocular/métodos , Facoemulsificação , Técnicas de Sutura , Humanos , Iris/cirurgia , Lentes Intraoculares , Agulhas , Esclera/cirurgia
16.
Anesth Analg ; 132(2): 556-565, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33323786

RESUMO

BACKGROUND: Nerve damage can occur after peripheral nerve block (PNB). Ultrasound guidance does not eliminate the risk of intraneural injection or nerve injury. Combining nerve stimulation and injection pressure (IP) monitoring with ultrasound guidance has been suggested to optimize needle tip location in PNB. In this prospective observational study, we hypothesized that measured pairs of IP and minimum intensity of stimulation (MIS) might differentiate successive needle tip locations established by high-resolution ultrasound during PNB. METHODS: For this exploratory study, 240 observations for 40 ultrasound-guided PNBs were studied in 28 patients scheduled for orthopedic surgery. During the progression of the needle to the nerve observed by ultrasonography, the IP was measured continuously using a computerized pressure-sensing device with a low flow rate of solution. Stimulation thresholds and electrical impedance were obtained by an impedance analyzer coupled to the nerve stimulator at 6 successive needle positions. The median (quartile) or mean (95% confidence interval [CI]) was reported. A mixed model analysis was used, and the sample was also explored using a classification and regression tree (CART) algorithm. RESULTS: Specific combinations of IP and MIS were measured for subcutaneous, epimysium contact, intramuscular, nerve contact (231 mm Hg [203-259 mm Hg] and 1.70 mA [1.38-2.02 mA]), intraneural location (188 mm Hg [152-224 mm Hg] and 0.58 mA [0.46-0.70 mA]), and subparaneural location (47 mm Hg [41-53 mm Hg] and 1.35 mA [1.09-1.61 mA]). The CART algorithm shows that the optimal subparaneural needle tip position might be defined by the lowest pressure (<81.3 mm Hg) and MIS (<1.5 mA) cutoffs. CONCLUSIONS: Our exploratory study evaluated concepts to generate hypotheses. The combinations of IP and MIS might help the physician during a PNB procedure. A low IP and low MIS might confirm a subparaneural location, and a high IP and a low MIS might be an alert for the intraneural location of the needle tip.


Assuntos
Anestésicos Locais/administração & dosagem , Bloqueio Nervoso , Nervos Periféricos/diagnóstico por imagem , Ultrassonografia de Intervenção , Anestésicos Locais/efeitos adversos , Estimulação Elétrica , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Agulhas , Bloqueio Nervoso/efeitos adversos , Procedimentos Ortopédicos , Pressão , Estudos Prospectivos , Transdutores de Pressão
17.
J Vis Exp ; (166)2020 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-33346197

RESUMO

The jewel wasp, Nasonia vitripennis, has become an efficient model system to study epigenetics of haplo-diploid sex determination, B-chromosome biology, host-symbiont interactions, speciation, and venom synthesis. Despite the availability of several molecular tools, including CRISPR/Cas9, functional genetic studies are still limited in this organism. The major limitation of applying CRISPR/Cas9 technology in N. vitripennis stems from the challenges of embryonic microinjections. Injections of embryos are particularly difficult in this organism and in general in many parasitoid wasps, due to small embryo size and the requirement of a host pupa for embryonic development. To address these challenges, Cas9 ribonucleoprotein complex delivery into female ovaries by adult injection, rather than embryonic microinjection, was optimized, resulting in both somatic and heritable germline edits. The injection procedures were optimized in pupae and female wasps using either ReMOT Control (Receptor-Mediated Ovary Transduction of Cargo) or BAPC (Branched Amphiphilic Peptide Capsules). These methods are shown to be effective alternatives to embryo injection, enabling site-specific and heritable germline mutations.


Assuntos
Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas/genética , Edição de Genes , Microinjeções , Interferência de RNA , Vespas/genética , Animais , Cruzamentos Genéticos , Feminino , Testes Genéticos , Masculino , Mutação/genética , Agulhas , Pupa/genética , Análise de Sobrevida
18.
PLoS One ; 15(12): e0242704, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33351854

RESUMO

In this study we present a kinematic approach for modeling needle insertion into soft tissues. The kinematic approach allows the presentation of the problem as Dirichlet-type (i.e. driven by enforced motion of boundaries) and therefore weakly sensitive to unknown properties of the tissues and needle-tissue interaction. The parameters used in the kinematic approach are straightforward to determine from images. Our method uses Meshless Total Lagrangian Explicit Dynamics (MTLED) method to compute soft tissue deformations. The proposed scheme was validated against experiments of needle insertion into silicone gel samples. We also present a simulation of needle insertion into the brain demonstrating the method's insensitivity to assumed mechanical properties of tissue.


Assuntos
Injeções/estatística & dados numéricos , Modelos Estatísticos , Agulhas , Silicones/análise , Fenômenos Biomecânicos , Encéfalo/anatomia & histologia , Simulação por Computador , Humanos , Injeções/instrumentação , Injeções/métodos , Manequins , Modelos Anatômicos , Silicones/química , Estresse Mecânico
19.
Zhonghua Nan Ke Xue ; 26(1): 31-35, 2020 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-33345474

RESUMO

Objective: To compare the efficiency and complications of transrectal ultrasound (TRUS)-guided prostate biopsy with a 16-gauge (16G) or an 18G puncture needle in the diagnosis of PCa. METHODS: This prospective randomized controlled study included 142 male patients undergoing TRUS-guided prostate biopsy in our hospital, 71 with the 16G and the other 71 with the 18G puncture needle. We compared the post-puncture incidence rates of hematuria, bleeding and infection between the two groups of patients and classified the complications according to the Clavien-Dindo scores. RESULTS: The detection rate of PCa was significantly lower in the 18G than in the 16G group (12.68% vs 36.62%, χ2 = 10.958, P = 0.001), even with f/tPSA ≤ 0.15 (8.51% vs 44.44%, χ2 = 12.617, P = 0.001), but showed no statistically significant difference between the two groups with f/tPSA > 0.15 (P<0.05). No post-puncture infection was observed in any of the patients. There were no statistically significant differences between the 18G and 16G groups in the incidence rates of rectal bleeding (21.13% vs 15.49%, χ2 = 0.753, P = 0.385) and urethral bleeding (18.31% vs 16.90%, χ2 = 0.049, P = 0.826), nor in Clavien-Dindo grades (26 vs 20 cases of grade I; no grade II in either group; 2 vs 3 cases of grade III ; Z = -0.698, P = 0.458). CONCLUSIONS: The 16G puncture needle can achieve a higher detection rate of PCa than the 18G needle in TRUS-guided prostate biopsy without increasing the incidence of complications.


Assuntos
Biópsia/instrumentação , Agulhas , Neoplasias da Próstata , Ultrassonografia de Intervenção , Humanos , Masculino , Estudos Prospectivos , Neoplasias da Próstata/diagnóstico , Punções
20.
Medicine (Baltimore) ; 99(51): e23665, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371104

RESUMO

ABSTRACT: Caudal epidural injection (CEI) is effective for lumbar spinal pain. However, accidental intravascular injection reduces therapeutic efficacy of CEI and leads to fatal complications such as hematoma, and neurologic deficit. Whitacre needle has been reported to be effective for reducing intravascular injection during transforaminal epidural injection, compared with Quincke needle. The bevel of Chiba needle is shorter than that of Quincke needle. In this study we compared Whitacre needle and Chiba needle on incidence of intravascular injection during CEI.This was a single-blind, randomized clinical consort study. After institutional Review Board approval, a total of 164 patients underwent CEI were randomly allocated to one of 2 group (Whitacre needle or Chiba needle group). Intravascular injection was assessed with real-time fluoroscopy. In addition, total procedure time was measured. Data were compared between groups, and P < .05 was consideredstatistically significant.There were no differences between groups in terms of patient demographic and clinical characteristics. There was no significant difference on incidence of intravascular injection between Whitacre and Chiba needle group (11% vs 19.5%, P = .192). However, the procedure time is significantly longer in the Whitacre than Chiba needle group (172.8 ±â€Š53.8 sec vs 147.1 ±â€Š61.1 sec, P = .005).Based on current study, our results indicated that Whitacre needle was not effective to decrease the incidence of intravascular injection during CEI, compared to Chiba needle.


Assuntos
Injeções Epidurais/efeitos adversos , Injeções Epidurais/instrumentação , Agulhas/efeitos adversos , Idoso , Feminino , Fluoroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Agulhas/estatística & dados numéricos
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