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4.
ACS Nano ; 18(28): 18129-18150, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-38954632

RESUMO

The advent of catheter-based minimally invasive surgical instruments has provided an effective means of diagnosing and treating human disease. However, conventional medical catheter devices are limited in functionalities, hindering their ability to gather tissue information or perform precise treatment during surgery. Recently, electronic catheters have integrated various sensing and therapeutic technologies through micro/nanoelectronics, expanding their capabilities. As micro/nanoelectronic devices become more miniaturized, flexible, and stable, electronic surgical catheters are evolving from simple tools to multiplexed sensing and theranostics for surgical applications. The review on multifunctional electronic surgical catheters is lacking and thus is not conducive to the reader's comprehensive understanding of the development trend in this field. This review covers the advances in multifunctional electronic catheters for precise and intelligent diagnosis and therapy in minimally invasive surgery. It starts with the summary of clinical minimally invasive surgical instruments, followed by the background of current clinical catheter devices for sensing and therapeutic applications. Next, intelligent electronic catheters with integrated electronic components are reviewed in terms of electronic catheters for diagnosis, therapy, and multifunctional applications. It highlights the present status and development potential of catheter-based minimally invasive surgical devices, while also illustrating several significant challenges that remain to be overcome.


Assuntos
Catéteres , Procedimentos Cirúrgicos Minimamente Invasivos , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação
5.
J Cardiothorac Surg ; 19(1): 457, 2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39026246

RESUMO

OBJECTIVES: Uniportal video-assisted thoracoscopic surgery pneumonectomy (U-VATS-P) is feasible and safe from a perioperative standpoint. How to choose the proper chest tube and drainage method is important in enhanced recovery after surgery (ERAS) protocols. In this study, we aimed to assess the safety of one 8.5-Fr (1Fr = 0.333 mm) pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P. METHODS: We retrospectively reviewed a single surgeon's experience with U-VATS-P for lung cancer from May 2016 to September 2022. Patients were managed with one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P. The clinical characteristics and perioperative outcomes of the patients were retrospectively analyzed. RESULTS: In total, 77 patients had one 8.5-Fr pigtail catheter placed for postoperative continuous open gravity drainage after U-VATS-P for lung cancer. The mean age was 60.9±7.39 (40-76) years; The mean FEV1 was 2.1±0.6 (l/s), and the mean FEV1% was 71.2±22.7. The median operative time was 191.38±59.32 min; the mean operative hemorrhage was 109.46±96.56 ml; the mean duration of postoperative chest tube drainage was 6.80±2.33 days; the mean drainage volumes in the first three days after operation were 186.31±50.97, 321.97±52.03, and 216.44±35.67 ml, respectively; and the mean postoperative hospital stay was 7.90±2.58 days. No patient experienced complications resulting from chest tube malfunction. Ten patients experienced minor complications. One patient with nonlife-threatening empyema and bronchopleural fistula required short rehospitalization for anti-inflammatory therapy and reintubation. Three patients with chylothorax were treated with intravenous nutrition. Four patients had atrial fibrillation that was controlled by antiarrhythmic therapy. Two patients had more thoracic hemorrhagic exudation after the operation, which was found in time and was cured effectively, so they were discharged from the hospital uneventfully after early hemostatic therapy and nutritional support. CONCLUSIONS: All patients in this study received early postoperative rehabilitation, and the rate of relevant complications was low. We therefore recommend a single 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage as an effective, safe and reliable drainage method for the management of U-VATS-P.


Assuntos
Drenagem , Neoplasias Pulmonares , Pneumonectomia , Cirurgia Torácica Vídeoassistida , Humanos , Pneumonectomia/métodos , Pneumonectomia/instrumentação , Pneumonectomia/efeitos adversos , Cirurgia Torácica Vídeoassistida/métodos , Masculino , Pessoa de Meia-Idade , Feminino , Estudos Retrospectivos , Drenagem/métodos , Drenagem/instrumentação , Idoso , Neoplasias Pulmonares/cirurgia , Complicações Pós-Operatórias , Adulto , Tubos Torácicos , Catéteres , Cuidados Pós-Operatórios/métodos
7.
A A Pract ; 18(7): e01822, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-39037106

RESUMO

Peripheral nerve blocks are typically avoided for high-speed tibial plateau fractures due to their ability to mask the paresthesias and pain associated with the feared complication of acute compartment syndrome (ACS). We present a case in which sciatic nerve and adductor canal catheters were placed utilizing low-volume infusions allowing for neurovascular assessment. These catheters served as a valuable portion of the multi-modal pain regimen in this patient with a Schatzker VI tibial plateau fracture.


Assuntos
Bloqueio Nervoso , Nervo Isquiático , Fraturas da Tíbia , Humanos , Fraturas da Tíbia/cirurgia , Nervo Isquiático/lesões , Masculino , Catéteres/efeitos adversos , Pessoa de Meia-Idade , Síndromes Compartimentais/etiologia , Síndromes Compartimentais/cirurgia , Fraturas do Planalto Tibial
8.
Medicine (Baltimore) ; 103(23): e38452, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38847700

RESUMO

Percutaneous epidural adhesiolysis (PEA) is an effective treatment for patients with lumbar radiculopathy unresponsive to single steroid injections. Various approaches and instruments have been developed to access these lesions. This study aimed to evaluate the utility of a retrodiscal approach for epidural adhesiolysis using a WHIP catheter®. This retrospective study was conducted at Bundang Seoul National University Hospital, reviewing cases from January to December 2022. Forty-seven patients diagnosed with lumbar radiculopathy, aged 20 to 80 years, who underwent PEA with the WHIP catheter® were included. Outcomes assessed Numeric Rating Scale (NRS) for pain, Patients' Global Impression of Change (PGIC) scores, and the incidence of procedure-related complications. Follow-up evaluations occurred at 1, 3, and 6 months post-procedure. Among 47 patients, 41 completed the study, showing significant pain reduction at all follow-up points: 1 month (N = 41, 1.32 ±â€…1.68, P < .001), 3 months (N = 31, 1.90 ±â€…2.14, P < .001), and 6 months (N = 30, 2.50 ±â€…2.30, P < .001). PGIC scores indicated that 40% of the patients reported substantial improvement at one-month post-procedure. The complications were minimal, with only one case of intradiscal injection and 2 cases of vascular uptake. The retrodiscal approach PEA using the WHIP catheter® demonstrated significant efficacy in pain reduction with minimal safety concerns for patients with lumbar radiculopathy. These findings suggest that this procedure is a viable option for patients who are unresponsive to conservative treatment. However, the retrospective nature of this study and its small sample size necessitate further prospective controlled studies to confirm our results and establish long-term outcomes.


Assuntos
Catéteres , Radiculopatia , Humanos , Estudos Retrospectivos , Radiculopatia/terapia , Masculino , Pessoa de Meia-Idade , Feminino , Adulto , Idoso , Vértebras Lombares , Resultado do Tratamento , Idoso de 80 Anos ou mais , Medição da Dor , Espaço Epidural , Aderências Teciduais/terapia , Aderências Teciduais/cirurgia , Adulto Jovem , Injeções Epidurais/métodos
9.
Sci Rep ; 14(1): 13273, 2024 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-38858470

RESUMO

In this study, we conducted a numerical analysis on catheter sizes using computational fluid dynamics to assess urinary flow rates during intermittent catheterization (IC). The results revealed that the fluid (urine) movement within a catheter is driven by intravesical pressure, with friction against the catheter walls being the main hindrance to fluid movement. Higher-viscosity fluids experienced increased friction with increasing intravesical pressure, resulting in reduced fluid velocity, whereas lower-viscosity fluids experienced reduced friction under similar pressure, leading to increased fluid velocity. Regarding urine characteristics, the results indicated that bacteriuria, with lower viscosity, exhibited higher flow rates, whereas glucosuria exhibited the lowest flow rates. Additionally, velocity gradients decreased with increasing catheter diameters, reducing friction and enhancing fluid speed, while the friction increased with decreasing diameters, reducing fluid velocity. These findings confirm that flow rates increased with larger catheter sizes. Furthermore, in terms of specific gravity, the results showed that a 12Fr catheter did not meet the ISO-suggested average flow rate (50 cc/min). The significance of this study lies in its application of fluid dynamics to nursing, examining urinary flow characteristics in catheterization. It is expected to aid nurses in selecting appropriate catheters for intermittent catheterization based on urinary test results.


Assuntos
Hidrodinâmica , Humanos , Cateteres Urinários , Viscosidade , Cateterismo Urinário/instrumentação , Cateterismo Urinário/métodos , Urina/química , Catéteres , Fricção
10.
Medicina (Kaunas) ; 60(6)2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38929592

RESUMO

Background and Objectives: This study evaluated the efficacy and safety of temporary ureteral occlusion combined with urinary diversion using a single-access route created by inserting a balloon catheter through a pigtail nephrostomy drainage catheter. With this approach, we aimed to offer an alternative for patients with ureteral leaks who are suboptimal surgical candidates. Materials and Methods: This retrospective study included nine patients (eight of which were bilateral cases and one was unilateral, totaling seventeen cases) who underwent the surgery between September 2023 and March 2024. The method involved gaining percutaneous access to the pelvicalyceal system, inserting a 4-French Fogarty balloon catheter through a pigtail nephrostomy catheter, and inflating the balloon at the proximal or mid-ureter. Results: All 17 cases achieved technical successful with no major complications. The procedure effectively relieved symptoms associated with urinary leakage in most patients. However, the significant deflation of the balloon catheter occurred in five cases (29.4%), with three (17.6%) experiencing complete deflation. In these five cases, the final balloon size was 5.81 mm (range: 0-8.9 mm), confirming a 25.0% decrease in size from pre- to post-procedure. Ureteral occlusion was 28.3 d long on average (range: 8-57 d). All patients experienced symptom relief during temporary ureteral occlusion. Except for two patients lost to follow-up, three patients showed symptom improvement with only PCN and four patients underwent surgical closure of the fistula tract before or after balloon catheter removal. Conclusions: This study confirms that this approach is safe and effective.


Assuntos
Ureter , Derivação Urinária , Humanos , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso , Derivação Urinária/métodos , Ureter/cirurgia , Drenagem/métodos , Drenagem/instrumentação , Adulto , Idoso de 80 Anos ou mais , Oclusão com Balão/métodos , Oclusão com Balão/instrumentação , Resultado do Tratamento , Catéteres , Nefrostomia Percutânea/métodos , Nefrostomia Percutânea/instrumentação
11.
PLoS Pathog ; 20(6): e1012319, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38885290

RESUMO

Candida albicans is a leading cause of intravascular catheter-related infections. The capacity for biofilm formation has been proposed to contribute to the persistence of this fungal pathogen on catheter surfaces. While efforts have been devoted to identifying microbial factors that modulate C. albicans biofilm formation in vitro, our understanding of the host factors that may shape C. albicans persistence in intravascular catheters is lacking. Here, we used multiphoton microscopy to characterize biofilms in intravascular catheters removed from candidiasis patients. We demonstrated that, NETosis, a type of neutrophil cell death with antimicrobial activity, was implicated in the interaction of immune cells with C. albicans in the catheters. The catheter isolates exhibited reduced filamentation and candidalysin gene expression, specifically in the total parenteral nutrition culture environment. Furthermore, we showed that the ablation of candidalysin expression in C. albicans reduced NETosis and conferred resistance to neutrophil-mediated fungal biofilm elimination. Our findings illustrate the role of neutrophil NETosis in modulating C. albicans biofilm persistence in an intravascular catheter, highlighting that C. albicans can benefit from reduced virulence expression to promote its persistence in an intravascular catheter.


Assuntos
Biofilmes , Candida albicans , Candidíase , Infecções Relacionadas a Cateter , Armadilhas Extracelulares , Proteínas Fúngicas , Neutrófilos , Humanos , Biofilmes/crescimento & desenvolvimento , Proteínas Fúngicas/metabolismo , Candidíase/microbiologia , Candidíase/imunologia , Infecções Relacionadas a Cateter/microbiologia , Neutrófilos/imunologia , Neutrófilos/metabolismo , Armadilhas Extracelulares/imunologia , Catéteres/microbiologia , Regulação Fúngica da Expressão Gênica
12.
Respir Investig ; 62(4): 732-737, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38878626

RESUMO

BACKGROUND: Cryobiopsy use is anticipated to become more common in diagnosing lung diseases. In Japan, inserting a Fogarty catheter through a suction channel above the endotracheal tube's cuff for hemostasis is common practice. However, the rigid nature of the endotracheal tube poses challenges to tracheal intubation using a bronchoscope. The endotracheal tube cuff must be removed to prevent interference during Fogarty catheter insertion. To simplify the procedure and enhance safety, we devised and implemented a method of inserting a hemostatic Fogarty catheter with a suction tube externally attached to a softer endotracheal tube. This study aimed to evaluate the sustainability of this Fogarty catheter insertion method using suction tubes. METHODS: The hemostatic Fogarty catheter insertion method was retrospectively validated. We compared outcomes between 60 patients who underwent the conventional method with a suction channel above the cuff and 50 patients who underwent the novel approach with an externally attached suction tube. RESULTS: The physicians performing bronchoscopy and inserting the Fogarty catheter in the group in which the suction tube was externally attached for Fogarty catheter insertion had little experience. However, the overall bronchoscopy time was shorter; the two groups showed no significant differences in complications. CONCLUSION: Regarding cryobiopsy procedures, using an externally attached suction tube for Fogarty catheter insertion was practical and comparable to the conventional method of using a suction channel above the cuff. This method made the procedure more simple and safe.


Assuntos
Broncoscopia , Intubação Intratraqueal , Humanos , Estudos Retrospectivos , Intubação Intratraqueal/instrumentação , Intubação Intratraqueal/métodos , Sucção/instrumentação , Sucção/métodos , Broncoscopia/métodos , Masculino , Feminino , Idoso , Biópsia/métodos , Biópsia/instrumentação , Pessoa de Meia-Idade , Catéteres , Criocirurgia/métodos , Criocirurgia/instrumentação
18.
BMC Pediatr ; 24(1): 325, 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38734598

RESUMO

BACKGROUND: Cerebrospinal fluid (CSF) shunts allow children with hydrocephalus to survive and avoid brain injury (J Neurosurg 107:345-57, 2007; Childs Nerv Syst 12:192-9, 1996). The Hydrocephalus Clinical Research Network implemented non-randomized quality improvement protocols that were shown to decrease infection rates compared to pre-operative prophylactic intravenous antibiotics alone (standard care): initially with intrathecal (IT) antibiotics between 2007-2009 (J Neurosurg Pediatr 8:22-9, 2011), followed by antibiotic impregnated catheters (AIC) in 2012-2013 (J Neurosurg Pediatr 17:391-6, 2016). No large scale studies have compared infection prevention between the techniques in children. Our objectives were to compare the risk of infection following the use of IT antibiotics, AIC, and standard care during low-risk CSF shunt surgery (i.e., initial CSF shunt placement and revisions) in children. METHODS: A retrospective observational cohort study at 6 tertiary care children's hospitals was conducted using Pediatric Health Information System + (PHIS +) data augmented with manual chart review. The study population included children ≤ 18 years who underwent initial shunt placement between 01/2007 and 12/2012. Infection and subsequent CSF shunt surgery data were collected through 12/2015. Propensity score adjustment for regression analysis was developed based on site, procedure type, and year; surgeon was treated as a random effect. RESULTS: A total of 1723 children underwent initial shunt placement between 2007-2012, with 1371 subsequent shunt revisions and 138 shunt infections. Propensity adjusted regression demonstrated no statistically significant difference in odds of shunt infection between IT antibiotics (OR 1.22, 95% CI 0.82-1.81, p = 0.3) and AICs (OR 0.91, 95% CI 0.56-1.49, p = 0.7) compared to standard care. CONCLUSION: In a large, observational multicenter cohort, IT antibiotics and AICs do not confer a statistically significant risk reduction compared to standard care for pediatric patients undergoing low-risk (i.e., initial or revision) shunt surgeries.


Assuntos
Antibacterianos , Antibioticoprofilaxia , Derivações do Líquido Cefalorraquidiano , Humanos , Derivações do Líquido Cefalorraquidiano/efeitos adversos , Antibacterianos/administração & dosagem , Estudos Retrospectivos , Criança , Masculino , Pré-Escolar , Feminino , Lactente , Antibioticoprofilaxia/métodos , Adolescente , Injeções Espinhais , Hidrocefalia/cirurgia , Cateteres de Demora/efeitos adversos , Infecção da Ferida Cirúrgica/prevenção & controle , Infecções Relacionadas a Cateter/prevenção & controle , Catéteres
19.
J Biol Inorg Chem ; 29(3): 353-373, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38744691

RESUMO

Investigating the application of innovative antimicrobial surface coatings on medical devices is an important field of research. Many of these coatings have significant drawbacks, including biocompatibility, coating stability and the inability to effectively combat multiple drug-resistant bacteria. In this research, we developed an antibiofilm surface coating for medical catheters using biosynthesized silver nanoparticles (b-Cs-AgNPs) developed using leaves extract of Calliandra surinamensis. Various characterization techniques were employed to thoroughly characterize the synthesized b-Cs-AgNPs and c-AgNPs. b-Cs-AgNPs were compatible with human normal kidney cells and chicken embryos. It did not trigger any skin inflammatory response in in vivo rat model. b-Cs-AgNPs demonstrated potent zone of inhibition of 19.09 mm when subjected to the disc diffusion method in E. coli confirming strong antibacterial property. Different anti-bacterial assays including liquid growth curve, colony counting assay, biofilm formation assay supported the potent antimicrobial efficacy of b-Cs-AgNPs alone and when coated to medical grade catheters. Mechanistic studies reveal the presence of ferulic acid, that was important for the synthesis of b-AgNPs along with enhanced antibacterial effects of b-Cs-AgNPs compared to c-AgNPs, supported by molecular docking analysis. These results together demonstrated the effective role b-Cs-AgNPs in combating infections and mitigating biofilm formations, highlighting their need for further study in the field of biomedical applications.


Assuntos
Antibacterianos , Biofilmes , Catéteres , Nanopartículas Metálicas , Prata , Animais , Biofilmes/efeitos dos fármacos , Prata/química , Prata/farmacologia , Nanopartículas Metálicas/química , Antibacterianos/farmacologia , Antibacterianos/química , Antibacterianos/síntese química , Catéteres/microbiologia , Galinhas , Escherichia coli/efeitos dos fármacos , Escherichia coli/fisiologia , Testes de Sensibilidade Microbiana , Humanos , Embrião de Galinha , Ratos , Extratos Vegetais/farmacologia , Extratos Vegetais/química , Folhas de Planta/química , Folhas de Planta/microbiologia
20.
Prenat Diagn ; 44(8): 971-978, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38743216

RESUMO

OBJECTIVE: We report on the 1-year outcomes of fetuses who underwent thoracoamniotic shunting (TAS) with a double-basket catheter for fetal hydrothorax (FHT) using a national post-marketing surveillance registry. METHODS: This surveillance study was conducted for cases enrolled between 2011 and 2019. Preoperative, operative, and postoperative findings and outcomes had to be reported through the national surveillance website. RESULTS: Forty-three institutes enrolled 295 patients. In 60 patients, associated abnormalities were diagnosed after birth. Among the 235 patients with isolated hydrothorax, the survival rate at 1 year of age was 70.5%. Among these patients, 89% did not require oxygen or other respiratory support. The 1-year survival rate in complicated cases was 27%. Trisomy 21 was the most common associated problem (40%). Catheter associated problems, including dislocation (25%), obstruction (24%), and preterm rupture of the membranes (6%) were observed, but there were no severe maternal complications. TAS before 29.5 weeks of gestation (odds ratio [OR] 0.16) and skin edema and ascites (OR 0.06) were risk factors for death at one year, whereas appropriate shunt location for >28 days (OR 4.2) was a protective factor. CONCLUSION: We report a favorable survival rate in fetuses with isolated FHT treated with this double-basket catheter.


Assuntos
Hidrotórax , Sistema de Registros , Humanos , Feminino , Gravidez , Sistema de Registros/estatística & dados numéricos , Hidrotórax/cirurgia , Hidrotórax/epidemiologia , Hidrotórax/etiologia , Adulto , Catéteres/efeitos adversos , Vigilância de Produtos Comercializados/estatística & dados numéricos , Terapias Fetais/métodos , Terapias Fetais/estatística & dados numéricos , Terapias Fetais/instrumentação , Terapias Fetais/efeitos adversos , Recém-Nascido , Doenças Fetais/epidemiologia , Doenças Fetais/cirurgia
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