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1.
Medicine (Baltimore) ; 99(9): e19331, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118765

RESUMO

BACKGROUND: Cricothyroidotomy is the final strategy in the "cannot intubate, cannot oxygenate" scenario, but half of needle cricothyroidotomy attempts result in failure. The most frequent complication in needle cricothyroidotomy is posterior tracheal wall injury. We hypothesized that needle length is related to posterior wall injury and compared needle cricothyroidotomy with a commercial kit to a modified shorter needle to evaluate success and posterior wall injury rates. METHODS: The commercial kit has a needle stopper to prevent posterior wall injury, with a penetrating length of 25 mm. We made long stopper to shorten the length by 5 mm (net 20 mm penetrating length). Residents were recruited, received a lecture about cricothyroidotomy and practiced needle cricothyroidotomy using the commercial kit on a simulator. They then performed cricothyroidotomy using the commercial kit or the shorter needle on an ex-vivo porcine larynx covered with artificial skin. An intra-tracheal endoscope recorded the procedure. The video was evaluated for success/failure or posterior wall injury by independent evaluators. Larynxes with a distance from the outer surface to the inner lumen exceeding 13 mm were excluded. The distance in each larynx was measured by dissection after the study. Success and posterior wall injury rates were analyzed using Fisher exact test (P < .05 was statistically significant). RESULTS: Forty-seven residents participated in the study. Data for two residents were excluded. There was no statistically significant difference in success rate between the commercial kit (100%, 45/45) and the shorter needle (91%, 41/45, P = .12). Failure was defined if the needle tip did not reach the lumen in four trials. Cannulated but complicated by posterior wall injury occurred in 33% (15/45) with the commercial kit and 5% (2/43) with the shorter needle (P < .01). CONCLUSION: During needle cricothyroidotomy, force is needed for the needle to penetrate the cricothyroid ligament. The advancing needle sometimes cannot be stopped after penetrating the cricothyroid ligament. These data suggest that needle length is associated with posterior wall injury.


Assuntos
Cartilagem Cricoide/cirurgia , Agulhas/efeitos adversos , Traqueia/lesões , Animais , Estudos Cross-Over , Modelos Animais de Doenças , Desenho de Equipamento/métodos , Desenho de Equipamento/normas , Agulhas/tendências , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Suínos/lesões , Ensino
2.
Zhen Ci Yan Jiu ; 45(2): 148-51, 2020 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-32144926

RESUMO

OBJECTIVE: To observe the effect of the "head-nine-needle" therapy on tension headache. METHODS: A total of 150 patients with tension headache were divided into a head-nine-needle therapy group, a western medicine control group and an acupuncture control group according to the random number table, 50 cases in each one. In the head-nine-needle therapy group, the head-nine-needle therapy was adopted. In the western medicine control group, epiperisone hydrochloride tablets were prescribed for oral administration, 50 mg, three times a day as well as fluoguili hydrochloride capsules, 5 mg, once a day, taking orally before sleep. In the acupuncture control group, the routine acupuncture technique was used at Baihui (GV20), Taiyang (EX-HN5), Fengchi (GB20) and Ashi (extra), etc. The clinical effect was observed in each group. The scores of visual analogy scale (VAS) for headache severity and the scores of headache duration were assessed before and after treatment in the patients of each group. RESULTS: In comparison of the total effective rate among the groups, there was no significant difference between the head-nine-needle therapy group (48/50,96.0%) and the acupuncture control group (47/50,94.0%). The total effective rate of either of the two groups was higher than that of the western medicine control group (40/50,80.0%,P<0.05). The VAS score and the score of headache duration were reduced obviously as compared with those before treatment in each group (P<0.05), and the score was not different significantly between the head-nine-needle therapy group and the acupuncture control group (P>0.05). After 3 weeks and 4 weeks of treatment, the scores in the two acupuncture groups were all better than those in the western medicine control group (P<0.05). CONCLUSION: The "head-nine-needle" therapy achieves the obviously advantages in the alleviation of headache degree as compared with the simple western medicine and its effect is similar to the common acupuncture therapy in the patients with tension headache.


Assuntos
Terapia por Acupuntura , Cefaleia do Tipo Tensional , Pontos de Acupuntura , Humanos , Agulhas , Cefaleia do Tipo Tensional/terapia , Resultado do Tratamento
4.
Medicine (Baltimore) ; 99(8): e19343, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080155

RESUMO

RATIONALE: Foreign body (FB) ingestion is a relatively common clinical situation in the emergency department. However, multiple sharply pointed foreign bodies located in different organs are rare conditions and no definite treatment guidelines has been established. PATIENT CONCERNS: A 31-year-old amateur magician visited the outpatient clinic with a chief complaint of epigastric discomfort. He might have accidentally swallowed some needles while practicing a magic trick 2 days before. DIAGNOSIS: Imaging tests revealed 1 needle was stuck in the left liver lobe through the stomach wall, 1 was in the third portion of the duodenum, 3 were in the ascending colon, and 2 were in the transverse colon. INTERVENTIONS: A needle in the duodenum and 5 in the colon were removed by endoscopy. The needle stuck in the liver from the stomach was not visible inside the stomach and was successfully removed by laparoscopy a few days later. OUTCOMES: The patient was able to tolerate an oral diet and was discharged on postoperative day 4 without any complications. LESSONS: Developing a treatment plan in cases of multiple sharp FB may be difficult. A multidisciplinary team of endoscopists and surgeons is needed to determine the best possible treatment plan. This experience illustrates the importance of the planning of the sequence and method of removal of multiple foreign bodies from the gastrointestinal tract.


Assuntos
Endoscopia do Sistema Digestório , Corpos Estranhos/cirurgia , Laparoscopia , Agulhas , Acidentes , Adulto , Colo/diagnóstico por imagem , Colo/cirurgia , Duodeno/diagnóstico por imagem , Duodeno/cirurgia , Humanos , Fígado/diagnóstico por imagem , Fígado/cirurgia , Magia , Masculino , Radiografia , Estômago/diagnóstico por imagem , Estômago/cirurgia
7.
Plast Reconstr Surg ; 145(2): 358-364, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31985622

RESUMO

BACKGROUND: In recent years, microneedling has been increasingly used to treat a number of dermatologic conditions, including scars. Although initial studies demonstrated improvement of (mostly) atrophic scars with microneedling, the number of patients evaluated was relatively small, and the devices and treatment protocols used and posttreatment follow-up varied widely. Through this prospective observational study, the results of microneedling on 20 patients with a variety of scars are described. METHODS: One hundred twenty consecutive patients (skin phototypes I through VI) with facial and nonfacial scars from a variety of etiologic sources (acne, trauma, surgery) were treated using a mechanical microneedling device. No additional treatments (topical or intralesional) were applied. Two assessors blinded to treatment protocol rated clinical improvement of scars 1, 3, 6, and 12 months after treatment on a five-point scale. Side effects were monitored and tabulated. RESULTS: Patients received one to six consecutive monthly microneedling treatments. All scars improved at least 50 percent after an average of 2.5 treatments. Over 80 percent of patients had 50 to 75 percent improvement, and 65 percent of patients demonstrated over 75 percent improvement. No significant clinical differences were observed in treatment responses of facial scars versus nonfacial scars nor between responses of atrophic acne scars and traumatic or surgical scars. CONCLUSIONS: This study supports the use of microneedling for various facial and nonfacial scars across a broad range of skin phototypes with minimal risk of adverse effects. Further studies will help to establish standardized protocols to optimize treatment outcomes for different scar types. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Assuntos
Cicatriz/terapia , Técnicas Cosméticas/instrumentação , Agulhas , Adolescente , Adulto , Idoso , Dermatoses Faciais/terapia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
8.
Pharm Res ; 37(3): 33, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31942659

RESUMO

PURPOSE: Dissolvable microneedle arrays (MNAs) can be used to realize enhanced transdermal and intradermal drug delivery. Dissolvable MNAs are fabricated from biocompatible and water-soluble base polymers, and the biocargo to be delivered is integrated with the base polymer when forming the MNAs. The base polymer is selected to provide mechanical strength, desired dissolution characteristics, and compatibility with the biocargo. However, to satisfy regulatory requirements and be utilized in clinical applications, cytotoxicity of the base polymers should also be thoroughly characterized. This study systematically investigated the cytotoxicity of several important carbohydrate-based base polymers used for production of MNAs, including carboxymethyl cellulose (CMC), maltodextrin (MD), trehalose (Treh), glucose (Gluc), and hyaluronic acid (HA). METHODS: Each material was evaluated using in vitro cell-culture methods on relevant mouse and human cells, including MPEK-BL6 mouse keratinocytes, NIH-3T3 mouse fibroblasts, HaCaT human keratinocytes, and NHDF human fibroblasts. A common laboratory cell line, human embryonic kidney cells HEK-293, was also used to allow comparisons to various cytotoxicity studies in the literature. Dissolvable MNA materials were evaluated at concentrations ranging from 3 mg/mL to 80 mg/mL. RESULTS: Qualitative and quantitative analyses of cytotoxicity were performed using optical microscopy, confocal fluorescence microscopy, and flow cytometry-based assays for cell morphology, viability, necrosis and apoptosis. Results from different methods consistently demonstrated negligible in vitro cytotoxicity of carboxymethyl cellulose, maltodextrin, trehalose and hyaluronic acid. Glucose was observed to be toxic to cells at concentrations higher than 50 mg/mL. CONCLUSIONS: It is concluded that CMC, MD, Treh, HA, and glucose (at low concentrations) do not pose challenges in terms of cytotoxicity, and thus, are good candidates as MNA materials for creating clinically-relevant and well-tolerated biodissolvable MNAs.


Assuntos
Carboidratos/química , Carboidratos/toxicidade , Polímeros/química , Animais , Apoptose/efeitos dos fármacos , Carboximetilcelulose Sódica/química , Carboximetilcelulose Sódica/toxicidade , Linhagem Celular , Forma Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Sistemas de Liberação de Medicamentos , Glucose/química , Glucose/toxicidade , Humanos , Ácido Hialurônico/química , Ácido Hialurônico/toxicidade , Camundongos , Microinjeções , Agulhas , Preparações Farmacêuticas/química , Polissacarídeos/química , Polissacarídeos/toxicidade , Solubilidade , Trealose/química , Trealose/toxicidade
9.
Pharm Res ; 37(3): 35, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31950282

RESUMO

PURPOSE: Epicutaneous immunotherapy (EPIT) involving the skin's immune system is easy to use, painless and has a low risk of systemic side effects; it can be applied to food allergies that have a high morbidity rate in children. In this study, we evaluated the safety and efficacy of hydrophilic gel patch (HG) for EPIT. METHODS: Milk protein concentrate (MPC)-containing HG was applied to the skin that maintained a barrier function or formed puncture holes with microneedle, and MPC-specific antibodies were measured. The clinical study was conducted involving patients with severe milk allergy. RESULTS: No specific immune response was induced when immunizing to intact skin, and antibody production was observed by forming puncture holes. It was suggested that MPC contained in HG has immunogenicity and a very small amount of MPC was delivered to intact skin. In the clinical study, the symptom induction threshold increased in four of eight subjects, allowing them to consume milk and switch to oral immunotherapy. Although local skin reactions and temporary elevation of specific IgE antibodies were observed, no systemic side effects appeared throughout the study. CONCLUSIONS: EPIT using HG is a safe method to enable oral administration even in patients with severe milk allergies.


Assuntos
Resinas Acrílicas/química , Imunoglobulina E/imunologia , Hipersensibilidade a Leite/imunologia , Proteínas do Leite/imunologia , Adesivo Transdérmico , Administração Cutânea , Animais , Bovinos , Criança , Pré-Escolar , Modelos Animais de Doenças , Feminino , Humanos , Interações Hidrofóbicas e Hidrofílicas , Imunoglobulina E/análise , Imunoterapia , Masculino , Camundongos , Microinjeções , Proteínas do Leite/administração & dosagem , Agulhas , Projetos Piloto , Pele/metabolismo , Resultado do Tratamento
10.
Zhongguo Zhen Jiu ; 40(1): 54-7, 2020 Jan 12.
Artigo em Chinês | MEDLINE | ID: mdl-31930900

RESUMO

The value of the "touching-bone" acupuncture technique in clinical application was explained through the investigation on the origin of the theory of the "touching-bone" acupuncture technique, the analysis on the characteristics of acupoint selection, the introduction of clinical characteristics and the discussion on the mechanism of acupuncture in treatment. The "touching-bone" acupuncture technique refers to deep needling method, originated from the short needling and shu needling of the ancient needling methodslisted in the Internal Classic. The target points are the reaction sites on meridian near to bone and the attachments of soft tissues on bone. During the needle insertion, the needle tip is thrust deeply to the bone or the needle body is closely attached to the bone so as to stimulate periosteum specifically. This needling technique contributes to the satisfactory effect on spasmodic, deep-located and intractable pain disorder, motor system diseases, mental diseases and cerebral diseases, etc. Hence, this acupuncture technique deserves to be promoted in clinical application and explored in research.


Assuntos
Terapia por Acupuntura , Meridianos , Agulhas
11.
J Vasc Access ; 21(1): 73-78, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31204556

RESUMO

BACKGROUND: Percutaneous renal biopsy can result in serious complications. The study is aimed to compare the safety and yield between the two approaches of biopsy techniques: the conventional craniocaudal and the caudocranial trajectory of the biopsy needle under real-time ultrasound guidance. METHODS: In this prospective observational study, a total of 80 serial kidney biopsies were performed, 40 with craniocaudal angulation and 40 with caudocranial angulation of the biopsy needle on the random allocation of 1:1 in each group. In the craniocaudal approach, the patient must hold the breath in deep inspiration to make a lower pole of the kidney approachable during unloading the biopsy gun, which was not required in caudocranial trajectory as the lower pole was approachable without holding the breath in deep inspiration. All kidney biopsies were performed percutaneously under real-time ultrasonogram guidance with a 16-cm-long, 16- or 18-gauge needles with a penetration depth of 22 mm and a sample notch of 18 mm. The yield and complications between the two groups were analyzed. RESULTS: Both the groups were comparable in essential demographic characteristics. The study found that the caudocranial position of renal biopsy is equally suitable concerning tissue yield without any increase in the risk of complications and a smaller number of passes to obtain adequate tissue. CONCLUSION: Caudocranial trajectory of the biopsy needle using a probe needle guide is as safe as the craniocaudal approach. Both approaches have similar yield and complications; however, the caudocranial approach provides ease to the patient during the procedure.


Assuntos
Biópsia por Agulha , Biópsia Guiada por Imagem/métodos , Nefropatias/patologia , Rim/patologia , Ultrassonografia de Intervenção , Adolescente , Adulto , Idoso , Biópsia por Agulha/instrumentação , Criança , Desenho de Equipamento , Feminino , Humanos , Biópsia Guiada por Imagem/efeitos adversos , Biópsia Guiada por Imagem/instrumentação , Rim/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Agulhas , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
14.
Dermatol Surg ; 46(1): 86-92, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31356435

RESUMO

BACKGROUND: Microneedling is a popular, minimally invasive skin rejuvenation modality for acne scarring. Recent reports have evaluated the efficacy and safety of microneedling monotherapy and combination treatment for scarring. OBJECTIVE: This review aims to systematically analyze the current literature on microneedling techniques used for acne scarring. METHODS: A PubMed search (2009-current) was used to identify literature on microneedling treatment for acne. All randomized and nonrandomized clinical trials, case cohorts, case reports, and case series were included with the exception of 2 studies, which were excluded due to unavailability. RESULTS: All 33 articles evaluated showed improvement of acne scar appearance after microneedling treatment. Evidence was inconsistent when comparing microneedling monotherapy to dual therapy or to fractional laser treatment. CONCLUSION: Microneedling improves acne scarring, and further studies are needed to compare microneedling with other minimally invasive treatments.


Assuntos
Acne Vulgar/complicações , Acne Vulgar/terapia , Cicatriz/etiologia , Cicatriz/terapia , Técnicas Cosméticas , Humanos , Agulhas , Resultado do Tratamento
15.
Br J Sports Med ; 54(1): 27-32, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31203198

RESUMO

OBJECTIVES: We describe compliance with the 'IOC Needle Policy' at two Winter Olympic Games (Sochi and PyeongChang) and compare these findings to those of the Summer Olympic Games of Rio de Janeiro. METHOD: All needle-use declaration(s) (NUD) received during the course of the 2014 and 2018 Olympic Games were reviewed. We recorded socio-demographic data, the nature and purpose of needle use, product(s) injected, and route of administration. Data were analysed descriptively. RESULTS: In total, doctors from 22 National Olympic Committees (NOCs) submitted 122 NUD involving 82 athletes in Sochi; in PyeongChang, doctors from 19 NOCs submitted 82 NUD involving 61 athletes. This represented approximately 2% of all athletes at both Games, and 25% and 20% of all NOCs participating in Sochi and PyeongChang, respectively. No marked differences in the NUD distribution patterns were apparent when comparing the two Winter Olympic Games. The most commonly administered substances were as follows: local anaesthetics, non-steroidal anti-inflammatory drug and glucocorticoids. Physicians submitted multiple NUD for 24% of all athletes who required a NUD. CONCLUSION: A limited number of NOCs submitted NUD suggesting a low incidence of needle use or limited compliance (approximately 2%). A key challenge for the future is to increase the rate of compliance in submitting NUD. More effective education of NOCs, team physicians and athletes regarding the NUD policy, its purpose, and the necessity for NUD submissions, in association with the enforcement of the appropriate sanctions following non-compliance are needed.


Assuntos
Injeções/estatística & dados numéricos , Notificação de Abuso , Esportes/legislação & jurisprudência , Anestésicos Locais/administração & dosagem , Aniversários e Eventos Especiais , Anti-Inflamatórios não Esteroides/administração & dosagem , China , Doping nos Esportes/prevenção & controle , Glucocorticoides/administração & dosagem , Humanos , Agulhas/estatística & dados numéricos
16.
Anaesthesia ; 75(1): 72-79, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31506918

RESUMO

Technology that facilitates performance of deep peripheral nerve blocks is of clinical interest. The Onvision™ is a new device for ultrasonographic needle tip tracking that incorporates an ultrasound sensor on the needle tip that is then represented by a green circle on the ultrasound screen. The primary aim of this study was to investigate the effect of needle tip tracking on procedural time in the first human volunteer study. Secondary outcome measures included: number of hand movements; hand movement path length; block success rate; block onset time; block duration; discomfort experienced by the volunteers; and the anaesthetists' confidence as to whether their block would be successful. Two anaesthetists performed ultrasound-guided lumbar plexus blocks with an out-of-plane technique, with and without the use of needle tip tracking. In total, data from 25 volunteers were studied. Mean (SD) procedural time was 163 (103) s with needle tip tracking and 216 (117) s without (p = 0.10). Hand motion analysis showed that needle tip tracking was associated with a significant decrease in the mean (SD) number of intended needling hand movements (39 (29) vs. 59 (36); p = 0.03) and path lengths (3.2 (3.1) m vs. 5.5 (4.5) m; p = 0.03). No differences were found for any other secondary outcomes. The use of Onvision needle tip tracking did not reduce procedural time for out-of-plane ultrasound-guided lumbar plexus block but did reduce the number of hand movements and path lengths. This may indicate improved needle control but further studies are needed to confirm this finding.


Assuntos
Anestésicos Locais/administração & dosagem , Agulhas , Bloqueio Nervoso/instrumentação , Bloqueio Nervoso/métodos , Ultrassonografia de Intervenção/métodos , Adulto , Idoso , Estudos Cross-Over , Feminino , Humanos , Plexo Lombossacral , Masculino , Pessoa de Meia-Idade , Adulto Jovem
17.
Anaesthesia ; 75(1): 80-88, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31506921

RESUMO

Visibility of the needle tip is difficult to maintain during ultrasound-guided nerve block. A new needle has been developed that incorporates a piezo element 2-2.3 mm from the tip, activated by ultrasound. The electrical signal manifests as a coloured circle surrounding the needle tip, and allows real-time tracking. We hypothesised that novice regional anaesthetists would perform nerve block better with the tracker turned on rather than off. Our primary objective was to evaluate the new needle by measuring the performance of novice anaesthetists conducting simulated sciatic block on the soft embalmed Thiel cadaver. Training consisted of a lecture, scanning in volunteers and practice on cadavers. Testing entailed scanning the sciatic nerve of a cadaver and conducting 20 in-plane sciatic blocks in the mid-to-upper thigh region. Subjects were randomised equally, in groups of five, according to the sequence: tracker on/off/on/off; or tracker off/on/off/on. Video recordings were assessed by six raters for steps performed correctly and errors committed. Eight subjects were recruited and 160 videos were analysed. Using the tracking needle, five correct steps improved and one error reduced. The benefits included: better identification of the needle tip before advancing the needle, OR (95%CI) 3.4 (1.6-7.7; p < 0.001); better alignment of the needle to the transducer, 3.1 (1.3-8.7; p = 0.009); and better visibility of the needle tip 3.0 (1.4-7.3; p = 0.005). In conclusion, use of the tracker needle improved the sciatic block performance of novices on the soft embalmed cadaver.


Assuntos
Anestesia por Condução/instrumentação , Agulhas , Bloqueio Nervoso/instrumentação , Nervo Isquiático , Ultrassonografia de Intervenção/métodos , Anestesia por Condução/métodos , Cadáver , Humanos , Bloqueio Nervoso/métodos
18.
Br J Radiol ; 93(1108): 20190866, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-31860329

RESUMO

OBJECTIVE: This systematic review and meta-analysis investigated risk factors for pneumothorax following CT-guided percutaneous transthoracic lung biopsy. METHODS: A systematic search of nine literature databases between inception to September 2019 for eligible studies was performed. RESULTS: 36 articles were included with 23,104 patients. The overall pooled incidence for pneumothorax was 25.9% and chest drain insertion was 6.9%. Pneumothorax risk was significantly reduced in the lateral decubitus position where the biopsied lung was dependent compared to a prone or supine position [odds ratio (OR):3.15]. In contrast, pneumothorax rates were significantly increased in the lateral decubitus position where the biopsied lung was non-dependent compared to supine (OR:2.28) or prone position (OR:3.20). Other risk factors for pneumothorax included puncture site up compared to down through a purpose-built biopsy window in the CT table (OR:4.79), larger calibre guide/needles (≤18G vs >18G: OR 1.55), fissure crossed (OR:3.75), bulla crossed (OR:6.13), multiple pleural punctures (>1 vs 1: OR:2.43), multiple non-coaxial tissue sample (>1 vs 1: OR 1.99), emphysematous lungs (OR:3.33), smaller lesions (<4 cm vs 4 cm: OR:2.09), lesions without pleural contact (OR:1.73) and deeper lesions (≥3 cm vs <3cm: OR:2.38). CONCLUSION: This meta-analysis quantifies factors that alter pneumothorax rates, particularly with patient positioning, when planning and performing a CT-guided lung biopsy to reduce pneumothorax rates. ADVANCES IN KNOWLEDGE: Positioning patients in lateral decubitus with the biopsied lung dependent, puncture site down with a biopsy window in the CT table, using smaller calibre needles and using coaxial technique if multiple samples are needed are associated with a reduced incidence of pneumothorax.


Assuntos
Biópsia Guiada por Imagem/efeitos adversos , Pulmão/patologia , Pneumotórax/etiologia , Tomografia Computadorizada por Raios X , Humanos , Incidência , Agulhas/efeitos adversos , Posicionamento do Paciente/métodos , Punções/efeitos adversos , Radiografia Intervencionista/efeitos adversos , Fatores de Risco
19.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(10): 1246-1252, 2019 Oct 30.
Artigo em Chinês | MEDLINE | ID: mdl-31801716

RESUMO

OBJECTIVE: To compare 3 commonly used methods for drug delivery via the lumbar spinal subarachnoid space in rats. METHODS: We compared the effects of 3 methods for drug delivery via the lumbar spinal subarachnoid space in Sprague Dawley rats, namely acute needle puncture, chronic catheterization via laminectomy, and non-laminectomized catheterization. Body weight changes of the rats were measured, and their general and neurological conditions were assessed after the surgeries. The motor function of the rats was examined using rota rod test both before and after the surgeries. Nociceptive tests were performed to assess nociception of the rats. HE staining was used to examine local inflammation caused by the surgeries in the lumbar spinal cord tissue, and lidocaine paralysis detection and toluidine blue dye assay were used to confirm the precision of drug delivery using the 3 methods. RESULTS: Both needle puncture and catheterization via laminectomy resulted in a relatively low success rate of surgery and caused neurological abnormalities, severe motor dysfunction, hyperalgesia, allodynia and local inflammation. Catheterization without laminectomy had the highest success rate of surgery, and induced only mild agitation, slight cerebral spinal fluid leakage, mild sensory and motor abnormalities, and minimum pathology in the lumbar spinal cord. Catheterization without laminectomy produced less detectable effects on the behaviors in the rats and was well tolerated compared to the other two methods with also higher precision of drug delivery. CONCLUSIONS: Catheterization without laminectomy is a safe, accurate and effective approach to lumbar drug delivery in rats.


Assuntos
Sistemas de Liberação de Medicamentos/métodos , Região Lombossacral , Medula Espinal , Espaço Subaracnóideo , Animais , Cateterismo , Laminectomia , Agulhas , Ratos , Ratos Sprague-Dawley
20.
Zhongguo Zhen Jiu ; 39(12): 1262-6, 2019 Dec 12.
Artigo em Chinês | MEDLINE | ID: mdl-31820599

RESUMO

OBJECTIVE: To observe the clinical therapeutic effect of Jingu three-needle therapy combined with Xingnao Kaiqiao acupuncture on complex regional pain syndrome typeⅠ(CRPS-Ⅰ) after stroke. METHODS: A total of 96 patients with CRPS-Ⅰ after stroke were randomized into an observation group and a control group, 48 cases in each one. In the control group, based on the routine treatment, Xingnao Kaiqiao acupuncture was applied at Neiguan (PC 6), Shuigou (GV 26), Sanyinjiao (SP 6) and other supplementary acupoints, once a day, 6 times a week for 3 weeks. Based on the treatment in the control group, Jingu three-needle therapy was added at coracoid process, greater tuberosity of humerus and infraglenoid tubercle, the muscular fascia was released by fan-shaped separation technique for 3-6 times, and the treatment was given once every 2 days, 3 times a week for 3 weeks. Visual analogue scale (VAS) score, hand swelling level, Fugl-Meyer assessment (FMA) score and Barthel index score were observed to evaluate the pain and swelling severity, motor function and living ability of patients before and after treatment. RESULTS: ① Compared before treatment, the VAS score, hand swelling level, the FMA score and the Barthel index after treatment and 40 days after treatment were improved in both of the two groups (P<0.01). ② After treatment, the VAS score in the observation group was superior to the control group (P<0.01), 40 days after treatment, the VAS and FMA scores in the observation group were superior to the control group (P<0.01). ③ There were no significant differences after treatment and 40 days after treatment of the hand swelling level and the Barthel index between the two groups (P>0.05). CONCLUSION: Jingu three-needle therapy combined with Xingnao Kaiqiao acupuncture can improve the pain severity and the motor function of affected limbs in patients with CRPS-Ⅰ after stroke, and the therapeutic effect may be sustained for a long term. However, the treatment seems to be ineffectual on extremity swelling.


Assuntos
Terapia por Acupuntura , Síndromes da Dor Regional Complexa , Acidente Vascular Cerebral , Pontos de Acupuntura , Síndromes da Dor Regional Complexa/terapia , Humanos , Agulhas , Resultado do Tratamento
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