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1.
J Dent Educ ; 84(2): 166-175, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32043589

RESUMO

Various preclinical methodologies have been adopted by dental and oral health programs to develop student competence in administering dental local anesthetics (LA). Student-to-student practice is the most common preclinical training method. However, manikin simulation models have been introduced to avoid possible complications and ethical concerns with student-to-student injections. In 2017, the methodology was changed in the Bachelor of Oral Health program at The University of Sydney School of Dentistry in Australia from student-to-student practice to manikin simulation models. The aim of this study was to compare the students' learning experience, perceived confidence, and anxiety in giving their first injections to patients in these two preclinical training methods. A mixed-methods cohort design was used to compare the 2016 (n = 42) and 2017 (n = 32) oral health students' experiences and perceptions and evaluate students' clinical experience after commencing LA practice on patients. Students completed a questionnaire about their perceived level of confidence and anxiety before and after their first LA to a child and an adult for both infiltration and inferior alveolar nerve b lock (IANB) injections. Focus groups were conducted to further investigate the students' experience. The results showed that the perceived confidence and anxiety of the two cohorts did not differ significantly from each other. Although students found it difficult to transition into clinical practice without having experienced LA themselves, the manikin simulation practice provided a safe learning platform that avoided ethical and legal concerns. These findings support the use of manikin simulation models as an alte rnative method for dental local anesthetic preclinical training.


Assuntos
Anestésicos Locais , Estudantes de Odontologia , Adulto , Anestesia Local , Austrália , Criança , Competência Clínica , Humanos , Injeções , Ensino
2.
Medicine (Baltimore) ; 99(5): e19026, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000449

RESUMO

INTRODUCTION: Entropion and secondary trichiasis can lead to irritative symptoms and essential damage of ocular surface. There is no literature reporting the lower eyelid entropion related to thyroid-associated ophthalmopathy (TAO), let alone the treatment. Treatment based on etiology may yield effective and sustained results. We report 3 case reports of lower eyelid entropion associated with TAO, and provide an effective and persistent alternative to cure this entropion via the administration of shallow periorbital injections of triamcinolone acetonide (TA). PATIENT CONCERNS: Three patients presented irritative symptoms of ocular surface and diplopia. DIAGNOSIS: According to thyroid dysfunction, physical examination, and imaging findings of extraocular muscle involvement, TAO and unilateral or bilateral lower eyelid entropion were diagnosed. INTERVENTIONS: We administered shallow periorbital injections of TA to the affected eye at 3- to 4-week intervals depending on clinical response. OUTCOMES: All patients underwent complete correction of the lower eyelid entropion and no recurrence was found. CONCLUSION: The cause of lower eyelid entropion related to TAO might be the immunoinflammatory reaction of the lower eyelid retractors, enhancing the traction of pulling the lower eyelid inferoposteriorly. This condition can be treated with shallow periorbital injections of TA. Histopathological evidence and randomized controlled trials are expected to confirm our hypothesis.


Assuntos
Entrópio/tratamento farmacológico , Entrópio/etiologia , Glucocorticoides/administração & dosagem , Oftalmopatia de Graves/complicações , Triancinolona Acetonida/administração & dosagem , Adulto , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade
3.
Plast Reconstr Surg ; 145(2): 433-443, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31985637

RESUMO

BACKGROUND: This study explored the effect of a single local intraosseous application of a small dose of simvastatin on the wound healing process in type 1 diabetic rats and related mechanisms. METHODS: The authors chose the streptozotocin-induced type 1 diabetic rat to establish a full-thickness dermal wound using a 12-mm-diameter sterile disposable punch. The rats (n = 32) were divided randomly into four groups: (1) normal control rats, (2) type 1 diabetic rats with intraosseous injection of hydrogel vehicle, (3) type 1 diabetic rats with intraosseous injection of simvastatin (0.5 mg), and (4) type 1 diabetic rats with intragastric administration of simvastatin (20 mg/kg per day). Wound closure was followed by digital planimetry. Mobilization of endothelial progenitor cells into the circulatory system was studied using fluorescence-activated cell sorting. Neovascularization was analyzed with immunofluorescence histochemical staining. The relative levels of adiponectin and stromal cell-derived factor 1 (SDF-1) in serum, bone, and wound tissues were examined by enzyme-linked immunosorbent assay and Western blot. RESULTS: Diabetic rats exhibited impaired wound healing. Intraosseous administration of simvastatin accelerated wound healing beginning at day 4, and angiogenesis was more obvious than in the control group. Enzyme-linked immunosorbent assay revealed that adiponectin concentrations in the diabetic rats with intraosseous injection of hydrogel vehicle plus simvastatin 0.5-mg group were significantly higher compared with the diabetic rats with intraosseous injection of hydrogel vehicle group beginning at day 4. Intraosseous administration of simvastatin decreased the expression of adiponectin and SDF-1 in bone tissue but enhanced the expression of adiponectin in wounded skin. CONCLUSIONS: A single local intraosseous application of simvastatin promotes wound healing in type 1 diabetic rat. The underlying mechanisms may be attributed to the regulation of the adiponectin/SDF-1 pathway, which plays a pivotal role in endothelial progenitor cell mobilization and angiogenesis.


Assuntos
Indutores da Angiogênese/farmacocinética , Células Progenitoras Endoteliais/efeitos dos fármacos , Sinvastatina/farmacologia , Cicatrização/efeitos dos fármacos , Adiponectina/metabolismo , Animais , Quimiocina CXCL12/metabolismo , Diabetes Mellitus Experimental/fisiopatologia , Diabetes Mellitus Tipo 1/fisiopatologia , Combinação de Medicamentos , Hidrogéis , Injeções , Masculino , Neovascularização Fisiológica/efeitos dos fármacos , Poloxâmero/administração & dosagem , Ratos Sprague-Dawley , Sinvastatina/administração & dosagem , Pele/metabolismo
4.
Mymensingh Med J ; 29(1): 32-36, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915332

RESUMO

Bone marrow is a source of osteoprogenitor cells which are the most important factor of bone formation and healing of fracture. The aim of the study is to evaluate the outcome of bone marrow injection in the management of delayed union and non-union. This prospective study was performed in the department of Orthopaedics, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2017 to June 2019. In this study 21 patients with delayed union and non-union were treated by bone marrow injection. Bone marrow were aspirated from the anterior or posterior iliac crests then injected percutaneously into the fracture site. Full union was achieved in 15 cases, while failed in the others. No major complications were seen during or after the procedure. It is a safe, easy and a minimally invasive procedure compared to usual open bone graft especially for cases with high risk of anesthesia or risk of infection.


Assuntos
Transplante de Medula Óssea/métodos , Consolidação da Fratura/fisiologia , Fraturas não Consolidadas/terapia , Fraturas da Tíbia/terapia , Bangladesh , Fraturas Ósseas , Fraturas não Consolidadas/fisiopatologia , Humanos , Injeções , Masculino , Estudos Prospectivos , Fraturas da Tíbia/fisiopatologia , Resultado do Tratamento
5.
Medicine (Baltimore) ; 99(4): e18743, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977866

RESUMO

BACKGROUND: Acute pancreatitis (AP) is one of the common diseases with increasing incidence in clinical surgery and other gastrointestinal-digestive departments. Despite the rapid development of modern medicine, the overall mortality rate of AP is still high. Xuebijing (XBJ) injection (a traditional Chinese patent medicine) is a potentially effective drug for AP. This study is designed to assess the efficacy and safety of XBJ injection for AP. METHODS: We will extract data and assess methodological quality of included studies from 7 electronic databases from their inception to December 31, 2019. The primary outcomes include the mortality, surgical intervention, systemic inflammatory response syndrome (SIRS), local complications, systemic infections, gastrointestinal symptoms, and normal blood amylase recovery time. The statistical analysis will be performed using RevMan 5.3 software. RESULTS: This study will provide high-quality evidence for the efficacy of XBJ injection as an adjuvant therapy for AP. CONCLUSION: The study will provide the key evidence for clinical doctors and the development of clinical guidelines.


Assuntos
Medicamentos de Ervas Chinesas/administração & dosagem , Pancreatite/tratamento farmacológico , Humanos , Injeções , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisão Sistemática como Assunto , Resultado do Tratamento
6.
Medicine (Baltimore) ; 99(1): e18579, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895805

RESUMO

The aim of this study was to compare major voice indicators in different sub-categories, the outcome of lipoinjection for patients might be refined and some voice prognostic factors could be more particularized in specific sub-groups. This is an observational study, and sub-grouped UVFP patients into 3 categories: male vs female, BMI ≥ 24 vs BMI < 24, Age ≥ 60 vs Age < 60 for more detailed exploring whether sub-categories affected voice diagnostic and prognostic parameters. Patients' voice data is recorded before and after the autologous fat injection laryngoplasty by a multidimensional voice program. Overall, 73 patients' voice performance were improved 12 months later by vocal fold lipoinjection. In the comparison of the male with female revealed female obtained better Jita than male by surgery (Female: 174.50 ±â€Š100.58 Hz; Male: 294.82 ±â€Š253.65 Hz; P < .05). BMI ≥ 24 vs BMI < 24 showed no statistical difference. Patients aged under 60 demonstrated better Highest F0, lowest F0, NHR and ShdB than elder ones 12 months after receiving vocal fold lipoinjection. Thus, Noise-to-harmonics ratio (NHR), voice turbulence index (VTI), and ShdB (Absolute shimmer, dB) may be the major post-operative evaluating markers of patients' age under 60. Voice parameters showed no significant correlation with BMI. Female patients performed lower Jita (Absolute jitter, µsec) than male patients 1 year after receiving treatment. The experimental results in this study showed UVFP patients' gender and age may stand as significant categories on analyzing clinical voice prognostic indicators, ShdB and Jita of autologous injection laryngoplasty.


Assuntos
Tecido Adiposo/transplante , Laringoplastia/métodos , Complicações Pós-Operatórias/cirurgia , Paralisia das Pregas Vocais/cirurgia , Adulto , Idoso , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Glândula Tireoide/cirurgia , Transplante Autólogo , Paralisia das Pregas Vocais/etiologia , Qualidade da Voz
7.
J Urol ; 203(2): 378, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31661382
8.
J Urol ; 203(2): 397, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31674864
9.
J Urol ; 203(2): 396-397, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31674866
10.
Ann Otol Rhinol Laryngol ; 129(2): 201-204, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31609127

RESUMO

OBJECTIVES: Understand the utility and technique of injection pharyngoplasty with autologous fat for the treatment of mild to moderate velopharyngeal insufficiency in adults without a history of cleft palate. METHODS: Consecutive case series of 11 patients (mean [SD] 41 ± 21 years of age) who underwent injection pharyngoplasty with autologous fat from 2012 to 2018 at a tertiary care center. Patients were followed for a mean of 8.6 ± 8 months with pre versus postoperative evaluations of improvement in rhinophonia, dysphagia, and velopharyngeal closure by nasopharyngoscopy (scored: 0, none; 1, mild; 2, moderate; 3, near-complete; 4, complete). RESULTS: Patient selection and surgical techniques are described. Mean improvements were 2.3 ± 0.86 for rhinophonia, 2.0 ± 0.89 for dysphagia, and 3.0 ± 0.95 for velopharyngeal closure by nasopharyngoscopy. Five (45%) patients underwent subsequent intervention, including four repeat fat injections and three sphincter pharyngoplasties. There were two transient complications-donor site hematoma and subjective nasal obstruction. CONCLUSIONS: Although objective assessments are lacking to date, this is among the first reports to demonstrate the effectiveness and safety of injection pharyngoplasty with autologous fat for velopharyngeal insufficiency in a population of adults without a history of cleft. We found, on average, moderate improvement in rhinophonia and dysphagia, and near-complete improvement in velopharyngeal closure by nasopharyngoscopy; however, a portion of patients required subsequent intervention.


Assuntos
Tecido Adiposo/transplante , Faringe/cirurgia , Insuficiência Velofaríngea/cirurgia , Adulto , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Transplante Autólogo , Resultado do Tratamento , Adulto Jovem
11.
Br J Anaesth ; 124(1): 84-91, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31591018

RESUMO

BACKGROUND: Efforts to prolong interscalene block (ISB) analgesia include the use of local anaesthetic adjuvants such as dexamethasone. Previous work showing prolonged block duration suggests that both perineural and intravenous (i.v.) routes can both prolong analgesia. The superiority of either route is controversial given the design of previous studies. As perineural dexamethasone is an off-label use, anaesthesiologists should be fully informed of the clinical differences, if any, on block duration. This study was designed to test whether perineural vs i.v. dexamethasone administration are equivalent. METHODS: We randomised 182 eligible patients scheduled for arthroscopic shoulder surgery to receive low-dose ISB (0.5% ropivacaine 5 ml) with perineural or i.v. dexamethasone 4 mg. Subjects, anaesthesiologists, and research personnel were blinded. All subjects also received a standardised general anaesthetic and multimodal analgesia. The primary outcome was duration of analgesia analysed as an equivalence outcome (2 h equivalency margin) using the two one-sided test (TOST) method. RESULTS: For the primary outcome, duration of analgesia, and perineural and i.v. administration of dexamethasone were not equivalent. The upper and lower bounds of the 90% confidence interval were 1 h (P=0.12) and -2.5 h (P=0.01), respectively. The observed difference in mean block duration was not clinically relevant (0.75 h longer for i.v. dexamethasone). There were no other clinically significant differences between groups. CONCLUSION: In the context of low-volume ISB with ropivacaine, perineural and i.v. dexamethasone were not equivalent in terms of their effects on block duration. However, there were no clinically significant differences in outcomes, and there is no advantage of perineural over intravenous dexamethasone. WWW.CLINICALTRIALS. GOV REGISTRATION: NCT02322242.


Assuntos
Adjuvantes Anestésicos/administração & dosagem , Adjuvantes Anestésicos/farmacologia , Bloqueio do Plexo Braquial/métodos , Plexo Braquial , Dexametasona/administração & dosagem , Dexametasona/farmacologia , Bloqueio Nervoso/métodos , Administração Intravenosa , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroscopia/métodos , Método Duplo-Cego , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Ombro/cirurgia , Adulto Jovem
12.
J Urol ; 203(2): 372-378, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31479396

RESUMO

PURPOSE: We evaluated whether polyacrylamide hydrogel is noninferior to tension-free vaginal tape to treat women with primary stress urinary incontinence. MATERIALS AND METHODS: In this controlled noninferiority clinical trial patients with primary stress urinary incontinence were randomized to tension-free vaginal tape or polyacrylamide hydrogel treatment. The primary outcome was patient satisfaction and secondary outcomes were effectiveness in reducing urinary leakage and complications at 1-year followup. For statistical power significance was considered at 5%, power was set at 80% and the noninferiority limit was 20% with a 10% expected dropout rate. RESULTS: A total of 224 women with primary stress urinary incontinence entered the study between September 28, 2015 and March 1, 2017. Of the women 111 were randomized to tension-free vaginal tape and 113 were randomized to polyacrylamide hydrogel. At 1 year a satisfaction score of 80 or greater on a visual analogue scale of 0 to 100 was reached in 95.0% and 59.8% of patients treated with tension-free vaginal tape and polyacrylamide hydrogel, respectively. Thus, polyacrylamide hydrogel did not meet the noninferiority criteria set in our study. As secondary outcomes, the cough stress test was negative in 95.0% of tension-free vaginal tape cases vs 66.4% of polyacrylamide hydrogel cases (difference 28.6%, 95% CI 18.4-38.5). However, most perioperative complications, including those in 19 tension-free vaginal tape cases vs 3 polyacrylamide hydrogel cases (difference 16.0%, 95% CI 7.8-24.9), and all 6 reoperations due to complications (difference 5.9%, 95% CI 1.2-12.4) were associated with tension-free vaginal tape. CONCLUSIONS: Mid urethral tension-free vaginal tape slings were associated with better satisfaction and cure rates than polyacrylamide hydrogel in women with primary stress urinary incontinence. However, complications were mainly associated with tension-free vaginal tape. Thus, tension-free vaginal tape should be offered as first line treatment in women who expect to be completely cured by the initial treatment and are willing to accept the complication risks. Since polyacrylamide hydrogel treatment also provides high satisfaction and cure rates, women with primary stress urinary incontinence can be offered polyacrylamide hydrogel as an alternative treatment.


Assuntos
Resinas Acrílicas/administração & dosagem , Slings Suburetrais , Incontinência Urinária por Estresse/terapia , Adulto , Feminino , Humanos , Injeções , Pessoa de Meia-Idade , Satisfação do Paciente , Resultado do Tratamento
13.
Vasc Endovascular Surg ; 54(1): 42-46, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31578127

RESUMO

OBJECTIVE: In clinical practice, the incidence of femoral pseudoaneurysms requiring repair is small, but at a tertiary care center, the repair rate is higher due to referrals. We sought to specifically study patients who suffered postcatheterization pseudoaneurysms requiring thrombin injection or operative repair and compare them to our routine transfemoral endovascular patients to identify predictors of clinically significant pseudoaneurysms. The underlying goal would be to identify what makes these patients that develop pseudoaneurysms different. METHODS: A search of our billing records for Current Procedural Technology (CPT) codes of these 2 procedures between January 2008 and April 2018 was combined with our institution's Peripheral Vascular Intervention Vascular Quality Initiative database spanning from January 2013 to December 2017. A comparison was then performed between patients who had the outcome of operative intervention for a pseudoaneurysm complication and those who did not, with the goal of elucidating patient demographics and periprocedural factors that would predict pseudoaneurysm formation using univariate and multivariate analyses. RESULTS: There were 77 patients who required thrombin injection or open repair for access-related pseudoaneurysms and 324 patients who did not. Complications occurred more often in patients who were older than 75 (40.2% vs 21.9%; P = .0009), female (57.1% vs 38.6%; P = .003), obese (59.7% vs 33.3%; P < .001), hypertensive (96.1% vs 79.3%; P = .0005), who received a sheath >6F (32.4% vs 13%; P < .0001), intraoperative and postoperative anticoagulation (77.3% vs 32.7% and 52.1% vs 24.2%, respectively; P < .0001), and periprocedural P2Y12 inhibitors (48.7% vs 28%; P = .0005). Less complications were observed in patients who had a closure device used (42.9% vs 8.45%; P < .0001) and protamine reversal (26.5% vs 13.3%; P = .0163). CONCLUSIONS: Our findings validate published reports that incriminate a larger sheath size, perioperative anticoagulation, and female gender as increasing the rate of access site complications, with the use of a closure device being protective.


Assuntos
Falso Aneurisma/etiologia , Cateterismo Periférico/efeitos adversos , Artéria Femoral/lesões , Virilha/irrigação sanguínea , Lesões do Sistema Vascular/etiologia , Demandas Administrativas em Assistência à Saúde , Idoso , Falso Aneurisma/diagnóstico , Falso Aneurisma/terapia , Bases de Dados Factuais , Feminino , Artéria Femoral/diagnóstico por imagem , Humanos , Illinois , Injeções , Masculino , Estudos Retrospectivos , Fatores de Risco , Trombina/administração & dosagem , Fatores de Tempo , Procedimentos Cirúrgicos Vasculares , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/terapia
14.
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
15.
Expert Opin Drug Saf ; 19(1): 83-91, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31868020

RESUMO

Introduction: Botulinum toxin (BoNT) is a protein secreted by the anaerobic Gram-negative bacterium Clostridium botulinum. Among the seven known subtypes, type A is the most commonly used in women to treat diseases. It primarily blocks presynaptic release of acetylcholine at the neuromuscular junction, resulting in temporary muscle paralysis; thus, it is suitable for treating dystonia and other systemic diseases. BoNT is used widely for treating diseases that persist throughout, and may worsen during, pregnancy, such as cervical dystonia and achalasia. Thus, it is important to investigate whether BoNT injection during pregnancy causes side effects in pregnant women, fetuses, or newborns.Areas covered: This review highlights the efficiency and safety of BoNT injection in pregnancy. and assessed current literature with respect to the use of BoNT for disease treatment during pregnancy.Expert opinion: BoNT injection does not increase the risk of complications in pregnant women and fetuses. However, the use of BoNT to treat disease during pregnancy requires fully informed consent from patients. In addition, further research is needed to determine how to reduce the side effects of BoNT injection during pregnancy (e.g., by improving drug composition, or adjusting the amount of BoNT or the injection interval).


Assuntos
Toxinas Botulínicas/administração & dosagem , Fármacos Neuromusculares/administração & dosagem , Complicações na Gravidez/tratamento farmacológico , Inibidores da Liberação da Acetilcolina/administração & dosagem , Inibidores da Liberação da Acetilcolina/efeitos adversos , Inibidores da Liberação da Acetilcolina/farmacologia , Animais , Toxinas Botulínicas/efeitos adversos , Toxinas Botulínicas/farmacologia , Feminino , Humanos , Recém-Nascido , Injeções , Fármacos Neuromusculares/efeitos adversos , Fármacos Neuromusculares/farmacologia , Gravidez
16.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 33(12): 1547-1551, 2019 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-31823556

RESUMO

Objective: To investigate the effectiveness of local injection of autologous platelet-rich plasma (PRP) in treatment of diabetic foot ulcer. Methods: Between October 2017 and October 2018, 90 diabetic foot ulcer patients who met the selection criteria were randomly divided into 3 groups: PRP injection group (group A, PRP was injected and hydrogel dressing covered the wounds), PRP covered group (group B, PRP gel and hydrogel dressing covered the wounds), and the control group (group C, hydrogel dressing covered the wounds), 30 cases in each group. There was no significant difference in gender, age, injured side, disease duration, preoperative glycosylated hemoglobin, wound size, and Wagner grading between groups (P>0.05). The frequency of treatments and hospitalization day in all groups and the total amount of PRP application in groups A and B were recorded. The wound healing condition was recorded during the treatment, and the wound healing rate was calculated at 3 months after the first debridement. Results: The frequency of treatments in groups A, B, and C were (10.2±0.8), (11.4±0.6), (12.5±0.5) times, respectively. The total amount of PRP application of groups A and B were (306±24) and (342±18) mL, respectively. There was no significant difference in the frequency of treatments and the total amount of PRP application between groups (P>0.05). The hospitalization days of groups A, B, and C were (40.5±1.8), (62.1±2.3), and (88.6±1.4) days, respectively, showing significant differences between groups (P<0.05). In the course of treatment, the necrosis and exudation of the wounds gradually reduced, the areas of wounds gradually reduced; and the above conditions of group A were significantly better than groups B and C, and group B was better than group C. At 3 months after the first debridement, the wound healing rates of groups A, B, and C were 93.2%±0.8%, 52.1%±1.1%, and 21.3%±1.3%, respectively, with significant differences between groups (P<0.05). Conclusion: PRP can effectively promote the repair of diabetic foot ulcer. The effectiveness of local injection of PRP is superior to the local coverage.


Assuntos
Pé Diabético , Plasma Rico em Plaquetas , Bandagens , Pé Diabético/terapia , Humanos , Injeções , Cicatrização
17.
Medicine (Baltimore) ; 98(52): e18556, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876755

RESUMO

BACKGROUND: Chronic heart failure (CHF) is one of the most serious cardiovascular diseases. Shenqi Fuzheng injection (SQFZI), as a Chinese herbal injection, is usually used for the treatment of CHF. However, the clinical evidence of SQFZI for the treatment of CHF is unclear. METHODS: Two researchers will dependently search literatures of SQFZI for CHF from Chinese National Knowledge Infrastructure database, VIP database, Chinese Biological and Medicine database, Wangfang database, MEDLINE, EMBASE, Cochrane Library and Web of Science. These inclusive data of included studies will be conducted by RevMan 5.3 software. RESULTS: This meta-analysis and systematic review will provide a series of outcome measures to verify clinical efficacy and safety of SQFZI for treating CHF, including New York Heart Association (NYHA) function classification, left ventricular ejection fraction, left ventricular end-diastolic dimension, cardiac output, stroke volume, brain natriuretic peptide, N-terminal pro-brain natriuretic peptide, and adverse events. CONCLUSIONS: This meta-analysis and systematic review will provide up-to-date clinical evidence to assess SQFZI treatment efficacy for CHF patients.


Assuntos
Cardiotônicos/uso terapêutico , Medicamentos de Ervas Chinesas/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Cardiotônicos/efeitos adversos , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Humanos , Injeções , Resultado do Tratamento
18.
Medicine (Baltimore) ; 98(52): e18564, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876758

RESUMO

BACKGROUND: This study was designed to systematically evaluate the clinical efficacy and safety of ultrasound-guided intrathyroidal injection of glucocorticoids (GCs) versus routine oral administration of GCs for subacute thyroiditis (SAT) and to help seek evidence of evidence-based medicine (EBM) for ultrasound-guided intrathyroidal injection of GCs in the treatment of SAT. METHODS: Seven Chinese and English databases, including Chinese National Knowledge Infrastructure, Wanfang Data, VIP Information China Science and Technology Journal Database, SinoMed, PubMed, Cochrane Library, and Embase, were searched to collect randomized control trials on ultrasound-guided intrathyroidal injection of GCs in the treatment of SAT, which were published up to July 1, 2019. According to the method as described in Cochrane Reviewers' Handbook 5.1.0, the Cochrane Collaboration's tool for assessing risk of bias was employed to evaluate the quality of the literatures included. Statistical analysis was made by using Stata 12.0. The "metanif" command was used for sensitivity analysis to assess the stability of the results. Funnel diagram method, Egger linear regression method, and clipping complement method were used to evaluate publication bias. RESULTS: This study was carried out in strict accordance with the standard procedures for meta-analysis in the Cochrane Reviewers' Handbook 5.1.0. Critical data about the primary and secondary outcome measures were obtained by statistical analysis. CONCLUSION: This study would draw a definite conclusion about whether ultrasound-guided intrathyroidal injection of GCs is effective and safe in the treatment of SAT on the basis of EBM. This conclusion would provide scientific evidence for the clinical treatment of SAT.


Assuntos
Glucocorticoides/administração & dosagem , Tireoidite Subaguda/tratamento farmacológico , Ultrassonografia de Intervenção , Administração Oral , Glucocorticoides/uso terapêutico , Humanos , Injeções/efeitos adversos , Injeções/métodos , Glândula Tireoide/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia de Intervenção/efeitos adversos , Ultrassonografia de Intervenção/métodos
19.
Zhongguo Zhong Yao Za Zhi ; 44(20): 4387-4396, 2019 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-31872623

RESUMO

To evaluate the effectiveness and safety of Xiyanping Injection in the treatment of acute bronchitis in children. The research systematically retrieved four Chinese databases( namely CNKI,VIP,Wan Fang,Sino Med) and four English databases( namely EMbase,Cochrane Library,Medline,Clinical Trail.gov). The retrieval time ranged from the commencement of each database to April2019. According to pre-set inclusion criteria and exclusion criteria,randomized controlled trials( RCTs) of Xiyanping Injection in the treatment of acute bronchitis in children were screened out. The quality assessment of the included studies was performed using the " Cochrane Bias Risk Assessment" tool,and the Meta-quantitatively analysis on the included studies was performed using Rev Man 5.3 software. A total of 648 articles were retrieved,and 10 studies were finally included. Except for one multi-arm test,the total sample size was 1 260,including 630 cases in the test group and 630 cases in the control group. The overall quality of the included study was not high. The results of Meta-analysis showed that in terms of antipyretic time,Xiyanping Injection combined with routine therapy was superior to routine therapy in the shortening of fever time in children with acute bronchitis( MD =-0.94,95%CI[-1.18,-0.70],P<0.000 01); in the overall efficacy,Xiyanping Injection combined with routine therapy was superior to routine therapy( RR = 1. 34,95% CI[1.26,1.42],P<0.000 01) and Yanhuning Injection + routine therapy( RR = 1.28,95%CI[1.19,1.38],P<0.000 01); descriptive analysis showed that Xiyanping Injection was excellent in the overall efficacy in treating acute bronchitis in children. The differences between the two groups were statistically significant( P< 0.000 1). The adverse reactions included in the study were mild adverse reactions,with no impact on treatment. Based on the results of this study,Xiyanping Injection combined with routine therapy or other Western medicine had a certain effect on acute bronchitis in children,especially in improving the overall efficacy of acute bronchitis in children. No serious adverse reactions were observed. And in the time of fever,cough and cough disappearance time,lung voice loss time,Xiyanping Injection + routine therapy or Western medicine therapy was better than routine therapy or Western medicine therapy. However,the small size of included studies,the low quality of the included studies,and the existence of publication bias and the low quality of the evidence had impacts on the reliability of the conclusion. Therefore,more large-sample,multi-center,well-designed,rigorous randomized controlled trials with best case reports are required to further verify the efficacy and safety.


Assuntos
Bronquite/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Doença Aguda , Criança , Humanos , Injeções , Masculino , Reprodutibilidade dos Testes
20.
Zhonghua Zhong Liu Za Zhi ; 41(12): 891-895, 2019 Dec 23.
Artigo em Chinês | MEDLINE | ID: mdl-31874544

RESUMO

Objective: With the development of laparoscopic surgery technique, the concept of minimally invasive surgery has gradually gained popularity. Laparoscopic minimally invasive technique applied in the treatment of gastric cancer has been recognized by surgeons. In recent years, the indocyanine green labeled near-infrared fluorescence laparoscopic technique has been gradually applied to the surgical treatment of gastric cancer. This technique overcomes the drawbacks of tactile lack of laparoscopic surgery and makes the laparoscopic surgery of gastric cancer more precise and minimally invasive. This article introduces the injection method of indocyanine green and discusses the application of fluorescent laparoscopy in gastric cancer surgery, including intraoperative tumor localization of early gastric cancer, sentinel lymph node biopsy, lymph node navigation of advanced gastric cancer, digestive tract reconstruction and gastrointestinal blood perfusion assessment during the procedure.


Assuntos
Corantes/administração & dosagem , Gastrectomia/métodos , Verde de Indocianina/administração & dosagem , Laparoscopia , Neoplasias Gástricas/cirurgia , China , Humanos , Injeções , Laparoscopia/métodos , Excisão de Linfonodo , Linfonodos/patologia , Metástase Linfática/diagnóstico , Biópsia de Linfonodo Sentinela , Neoplasias Gástricas/patologia
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