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3.
Med Sci Monit ; 27: e929111, 2021 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-33727522

RESUMO

BACKGROUND The aim of the present study was to evaluate the effects of different doses of oxycodone during endoscopic injection sclerotherapy (EIS) for esophageal varices with painless sclerosing agents. MATERIAL AND METHODS A total of 119 patients were randomly divided into 3 groups: Group A, midazolam and 0.075 mg/kg oxycodone (n=40); Group B, midazolam and 0.1 mg/kg oxycodone (n=40); and Group C, midazolam and 0.125 mg/kg oxycodone (n=39). The main observation index was the incidence of body movement during the perioperative period. The secondary indices were additional propofol usage; postoperative analgesic usage; other adverse effects, such as hypoxia, myoclonus, and cough; and satisfaction scores for surgeons and patients. RESULTS The incidence rates for body movement during the perioperative period in groups A, B, and C were 33%, 13%, and 0, respectively (P<0.001). The satisfaction scores for surgeons and patients were highest in Group C (0.125 mg/kg oxycodone). The incidence rates for hypoxia before EIS were 15%, 8%, and 33% (P=0.026) and during EIS were 23%, 3%, and 0% (P<0.001), respectively. There were no significant between-group differences with respect to other adverse effects. CONCLUSIONS The ideal dose of oxycodone for perioperative analgesia during EIS for esophageal varices is 0.125 mg/kg.


Assuntos
Varizes Esofágicas e Gástricas/tratamento farmacológico , Oxicodona/farmacologia , Escleroterapia/métodos , Adulto , China , Relação Dose-Resposta a Droga , Endoscopia/efeitos adversos , Varizes Esofágicas e Gástricas/metabolismo , Feminino , Hemorragia Gastrointestinal/etiologia , Humanos , Incidência , Injeções/efeitos adversos , Cirrose Hepática/complicações , Masculino , Midazolam/farmacologia , Pessoa de Meia-Idade , Oxicodona/uso terapêutico , Período Perioperatório , Estudos Prospectivos , Soluções Esclerosantes/administração & dosagem , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos
4.
Medicine (Baltimore) ; 100(1): e23034, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429727

RESUMO

BACKGROUND: Botulinum toxin A injection is an established method of treatment. Clinical practitioners use it widely in their practice to prevent the occurrence of facial scars. However, the effectiveness and safeness of has not been comprehensively established. The objective of the current systematic review is to evaluate the efficacy and safety of using botulinum toxin A injection to improve facial scars. METHODS AND ANALYSIS: This systematic review involves browsing a number of electronic databases to search for related articles. The search will include databases in both English (PubMed, EMBASE, Web of Science, Spocus, and Cochrane Central Register of Controlled Trials) and Chinese (WanFang database, China Nation Knowledge Infrastructure, and VIP database), the periods of searching will be from inception till the 15th of September 2020. Completing the search in databases allows to consider randomized controlled studies that compares botulinum toxin A interventions to any comparison interventions in those who have facial scars. The review will be inclusive of papers in both languages, English and Chinese. The independent screening of studies for eligibility is conducted by 2 independent authors. Discussion was used to resolve discrepancies between the authors. The Cochrane Risk of Bias Tool V.2.0 is adopted for evaluating the methodological quality of each study. Data extraction was performed by 2 independent authors. For dichotomous outcomes, the were expressed as relative risk (RR) with 95% confidence intervals (CI). For continuous outcomes the results were expressed as the mean difference (MD) or standardized mean difference (SMD) with 95% CI. The statistical analysis of the present study is carried out in RevMan 5.3 software. RESULTS: This study will output a comprehensive synthesis of existing evidence in relation to botulinum toxin A. Moreover, the results will also provide an interpretation of the effectiveness and safety of botulinum toxin A. CONCLUSION: The present review contributes to the existing body of knowledge by adding more evidence to evaluate if botulinum toxin A is effective and safe to be used as an intervention for improving facial scars. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/94TXP (https://osf.io/94TXP/).


Assuntos
Toxinas Botulínicas Tipo A/normas , Cicatriz/tratamento farmacológico , Protocolos Clínicos , Face/fisiopatologia , Toxinas Botulínicas Tipo A/efeitos adversos , Toxinas Botulínicas Tipo A/uso terapêutico , Cicatriz/fisiopatologia , Humanos , Injeções/efeitos adversos , Injeções/métodos , Metanálise como Assunto , Revisões Sistemáticas como Assunto
5.
Medicine (Baltimore) ; 99(45): e23086, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157977

RESUMO

BACKGROUND: Diabetic gastroparesis (DGP) is one of the common complications of diabetes. Accumulated evidences have shown that acupoint injection is beneficial for the clinical treatment of diabetic gastroparesis. However, there is currently no systematic review to assess this therapy. This program aims to evaluate the effectiveness and safety of this therapy for the patients with DGP. METHODS AND ANALYSIS: Literature search will be conducted via following electronic bibliographic databases from inception to Aug 2020: the Cochrane Library, PubMed, MEDLINE, Web of Science, EMBASE, Springer, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Chinese Scientific Journal Database (VIP), Wan-Fang Database. All randomized controlled trials published in English or Chinese related to acupoint injection for DGP will be included. The primary outcome is the total effective rate. The secondary outcomes are the change of motilin and gastrin levels before and after the treatment. Two researchers will be responsible for the selection of study, extraction of data, and assessment of study quality independently. RevMan V5.3 Software will be used for assessing the risk of bias and synthesizing data. RESULTS: This study will provide a high-quality synthesis of current available evidence for the treatment of DGP with this therapy clinically. CONCLUSION: The conclusions of our study will provide new evidence to judge whether acupoint injection is an effective intervention for patients suffered from DGP. OSF REGISTRATION NUMBER:: osf.io/ms58j.


Assuntos
Pontos de Acupuntura , Complicações do Diabetes/tratamento farmacológico , Gastroparesia/tratamento farmacológico , Metanálise como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Humanos , Injeções/efeitos adversos , Injeções/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
6.
PLoS One ; 15(9): e0239544, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32966339

RESUMO

Injection laryngoplasty (IL) has been used to treat various types of glottal insufficiency. The precise volume and location of the injected materials impact the outcomes. However, exactly how increasing volumes of material are distributed is unknown. In fact, the amount of IL material required to medialize a vocal cord tends to be determined empirically. Thus, the goal of this study was to investigate the pattern of IL material distribution by checking serial micro-computed tomography (MCT) and pressure changes during ILs. This experimental study used 10 excised canine larynges. Experimental devices included the IL syringe, pressure sensor, infusion pump, fixed frame, and monitoring system. We injected calcium hydroxyapatite in the thyroarytenoid muscle; whenever 0.1 mL of material was injected, we obtained an MCT scan while simultaneously measuring the pressure. After the experiments, we performed histologic analyses. MCT analyses showed that materials initially expanded centrifugally and then expanded in all directions within the muscle. The pressure initially increased rapidly but then remained relatively constant until the point at which the materials expanded in multiple directions. Histologic analyses showed that the IL material tended to expand within the epimysium of the thyroarytenoid muscle. However, in some cases, the MCT revealed that there were leakages to the surrounding space with a corresponding pressure drop. If the IL material passes through the epimysium, leakage can occur in the surrounding space, which can account for the reduction in resistance during ILs.


Assuntos
Laringoplastia/métodos , Animais , Materiais Biocompatíveis/administração & dosagem , Cães , Durapatita/administração & dosagem , Técnicas In Vitro , Injeções/efeitos adversos , Injeções/instrumentação , Injeções/métodos , Músculos Laríngeos/diagnóstico por imagem , Músculos Laríngeos/cirurgia , Laringe/diagnóstico por imagem , Laringe/cirurgia , Modelos Animais , Pressão , Prega Vocal/diagnóstico por imagem , Prega Vocal/cirurgia , Microtomografia por Raio-X
8.
J Int AIDS Soc ; 23(7): e25583, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32697423

RESUMO

INTRODUCTION: In light of the COVID-19 pandemic, considerable effort is going into identifying and protecting those at risk. Criminalization, stigmatization and the psychological, physical, behavioural and economic consequences of substance use make people who inject drugs (PWID) extremely vulnerable to many infectious diseases. While relationships between drug use and blood-borne and sexually transmitted infections are well studied, less attention has been paid to other infectious disease outbreaks among PWID. DISCUSSION: COVID-19 is likely to disproportionally affect PWID due to a high prevalence of comorbidities that make the disease more severe, unsanitary and overcrowded living conditions, stigmatization, common incarceration, homelessness and difficulties in adhering to quarantine, social distancing or self-isolation mandates. The COVID-19 pandemic also jeopardizes essential for PWID services, such as needle exchange or substitution therapy programmes, which can be affected both in a short- and a long-term perspective. Importantly, there is substantial evidence of other infectious disease outbreaks in PWID that were associated with factors that enable COVID-19 transmission, such as poor hygiene, overcrowded living conditions and communal ways of using drugs. CONCLUSIONS: The COVID-19 crisis might increase risks of homelessnes, overdoses and unsafe injecting and sexual practices for PWID. In order to address existing inequalities, consultations with PWID advocacy groups are vital when designing inclusive health response to the COVID-19 pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Surtos de Doenças , Overdose de Drogas/epidemiologia , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Pessoas em Situação de Rua/estatística & dados numéricos , Humanos , Injeções/efeitos adversos , Masculino , Pandemias , Fatores de Risco , Sexo sem Proteção/estatística & dados numéricos
9.
Medicine (Baltimore) ; 99(19): e19920, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384437

RESUMO

BACKGROUND: The outcomes of corticosteroid injection (CSI) and extracorporeal shock wave therapy (ESWT) as primary treatment of plantar fasciitis have been debated. This study was conducted to compare and evaluate the therapeutic effects of ultrasound-guided CSI versus medium frequency ESWT in the treatment of plantar fasciitis among Chinese population. METHODS: This study was a single-center, randomized, and double-blinded trial. The study protocol was approved by local ethics committee board and subsequently registered in Research Registry. Eighty patients with unilateral plantar fasciitis were randomized to receive either ESWT (3 times once per week) (n = 40) or CSI treatment (a single 1-mL dose of betamethasone sodium plus 0.5 mL of prilocaine under ultrasound guidance by injection into the plantar fascia) (n = 40). The primary outcome measures were visual analog scale and Foot Function Index scores. Secondary outcome measures included the heel tenderness index score and plantar fascia thickness as obtained by ultrasound examination. All of the assessments were performed at baseline and 1, 3, and 6 months after treatment. RESULTS: This is a randomized controlled trial evaluating the efficacy of CSI versus ESWT in the treatment of plantar fasciitis. This study has limited inclusion and exclusion criteria and a well-controlled intervention. CONCLUSIONS: The results of this trial will provide more evidence on which method can better treat plantar fasciitis. TRIAL REGISTRATION: This study protocol was registered in Research Registry (researchregistry5428).


Assuntos
Corticosteroides/uso terapêutico , Tratamento por Ondas de Choque Extracorpóreas/métodos , Fasciíte Plantar/terapia , Injeções/métodos , Adulto , Idoso , Doença Crônica , Método Duplo-Cego , Tratamento por Ondas de Choque Extracorpóreas/efeitos adversos , Feminino , Humanos , Injeções/efeitos adversos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Processual/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
10.
Eur J Cancer ; 131: 53-67, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32302949

RESUMO

BACKGROUND: Children with cancer often undergo long treatment trajectories involving repeated needle procedures that potentially cause pain and distress. As part of a comprehensive effort to develop clinical practice guidelines (CPGs) to address pain prevention and management in children with cancer, we aimed to provide recommendations on the pharmacological and psychological management of procedure-related pain and distress. METHODS: Of the international inter-disciplinary CPG development panel (44 individuals), two working groups including 13 healthcare professionals focused on procedural pain and distress. Grading of Recommendations Assessment, Development and Evaluation methodology was used, including the use of systematic literature reviews to inform recommendations and the use of evidence to decision frameworks. At an in-person meeting in February 2018, the guideline panel discussed these frameworks and formulated recommendations which were then discussed with a patient-parent panel consisting of 4 survivors and 5 parents. RESULTS: The systematic reviews led to the inclusion of 48 randomised controlled trials (total number of participants = 2271). Quality of evidence supporting the recommendations ranged from very low to moderate. Strong recommendations were made for the use of topical anesthetics in all needle procedures, for offering deep sedation (DS)/general anesthesia (GA) to all children undergoing lumbar puncture, for the use of DS/ GA in major procedures in children of all ages, for the use of hypnosis in all needle procedures and for the use of active distraction in all needle procedures. CONCLUSION: In this CPG, an evidence-based approach to manage procedure-related pain and distress in children with cancer is presented. As children with cancer often undergo repeated needle procedures during treatment, prevention and alleviation of procedure-related pain and distress is of the utmost importance to increase quality of life in these children and their families.


Assuntos
Antineoplásicos/administração & dosagem , Agulhas/efeitos adversos , Neoplasias/tratamento farmacológico , Dor Processual/prevenção & controle , Estresse Psicológico/prevenção & controle , Fatores Etários , Criança , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/normas , Humanos , Injeções/efeitos adversos , Injeções/psicologia , Oncologia/métodos , Oncologia/normas , Neoplasias/psicologia , Dor Processual/etiologia , Dor Processual/psicologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Estresse Psicológico/etiologia
11.
Infection ; 48(3): 375-383, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32100188

RESUMO

PURPOSE: The purpose of this study was to describe left-sided infective endocarditis (LSIE) in persons who inject drugs (PWID) and compare that group to PWID with non-LSIE and to non-PWID with LSIE. METHODS: Retrospective single-center study of adult IE patients from 2011 to 2018. RESULTS: Of the 333 patients in our cohort, 54 were PWID with LSIE, 75 were PWID with non-LSIE, and 204 were non-PWID with LSIE. When comparing LSIE vs non-LSIE in PWID, the LSIE group was older (median age 35 vs 28.5, p < 0.01), had fewer S. aureus infections (59% vs 92%, p < 0.01), was more likely to have cardiac surgery (31% vs 13%, p < 0.01), and had a higher 10-week mortality (22% vs 5%, p < 0.01). When comparing PWID with LSIE to non-PWID with LSIE, the PWID group were younger (median age 35 vs 46, p < 0.01); had more frequent multi-valve involvement (33% vs 19%, p = 0.04), Staphylococcus aureus infections (54% vs 27%, p < 0.01), and previous IE (24% vs 8%, p < 0.01); and experienced more strokes (54% vs 31%, p < 0.01). Ten-week mortality was similar for LSIE in both PWID and non-PWID (24% vs 20%, p = 0.47). CONCLUSIONS: LSIE in PWID is not uncommon. Compared to non-LSIE in PWID, valve surgery is more common and mortality is higher. For reasons that are unclear, stroke is more frequent in LSIE in PWID than in non-PWID with LSIE but mortality is no different.


Assuntos
Usuários de Drogas/estatística & dados numéricos , Endocardite/patologia , Hospitalização/estatística & dados numéricos , Injeções/efeitos adversos , Centros de Atenção Terciária/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Endocardite/etiologia , Feminino , Hospitais de Ensino/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , North Carolina , Estudos Retrospectivos , Adulto Jovem
12.
J Clin Neurosci ; 71: 66-69, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31771802

RESUMO

We sought to characterize the association between lumbar corticosteroid injections and postoperative infection rate for patients in the Military Health System undergoing lumbar arthrodesis. The Military Health System Data Repository was searched for all patients undergoing lumbar arthrodesis from 2009 to 2014. Current Procedural Terminology (CPT) codes were used to identify the subset of patients who also received preoperative lumbar corticosteroid injections. These patients were stratified by timing, type, and number of injections. Infection rates were compared to the control group of patients who did not receive preoperative lumbar corticosteroid injections. The search identified 3403 patients who had undergone lumbar arthrodesis from 2009 to 2014 within the Military Health System. 612 patients had received lumbar corticosteroid injections prior to surgery (348 epidural, 264 facet). The control group consisted of the remaining 2791 patients. Overall post-operative infection rate was 1.47% with an infection rate in the injection group of 1.14% versus 1.54% in the control group. When stratified by time, infection rates ranged from 0% to 1.85% in the injection groups. No differences between injection and control groups reached statistical significance in any subgroup analysis. Post-operative infection rate is not significantly increased in patients receiving lumbar corticosteroid injections (LCSIs) prior to lumbar arthrodesis. No differences were observed in infection rates based on timing, type, or number of injections prior to surgery.


Assuntos
Corticosteroides/farmacologia , Artrodese/métodos , Infecções/etiologia , Região Lombossacral/cirurgia , Complicações Pós-Operatórias/etiologia , Cuidados Pré-Operatórios/efeitos adversos , Corticosteroides/administração & dosagem , Adulto , Idoso , Feminino , Humanos , Infecções/complicações , Injeções/efeitos adversos , Vértebras Lombares/cirurgia , Região Lombossacral/microbiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/microbiologia , Estudos Retrospectivos
13.
Mayo Clin Proc ; 95(2): 243-254, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31883694

RESUMO

OBJECTIVES: To summarize patient notifications resulting from unsafe injection practices by health care personnel in the United States and describe recommended actions for prevention and response. PATIENTS AND METHODS: We examined records of events involving communications to groups of patients, conducted from January 1, 2012, through December 31, 2018, in which bloodborne pathogen testing was recommended or offered because of potential exposure to unsafe injection practices by health care personnel in the United States. Information compiled included: health care setting(s), type of unsafe injection practice(s), number of patients notified, number of outbreak-associated infections, and whether evidence suggesting bloodborne pathogen transmission prompted the notification. We compared these numbers with a similar review conducted from January 1, 2001, through December 31, 2011. RESULTS: From 2012 through 2018, more than 66,748 patients were notified as part of 38 patient notification events. Twenty-one involved exposures in non-hospital settings. Twenty-five involved syringe and/or needle reuse in the context of routine patient care; 11 involved drug tampering by a health care provider. The majority of events (n=25) were prompted by identification of unsafe injection practices alone, absent any documented infections at the time of notification. Outbreak-associated hepatitis B virus and/or hepatitis C virus infections were documented for 11 of the events; 8 involved patient-to-patient transmission, and 3 involved provider-to-patient transmission. CONCLUSIONS: Since 2001, nearly 200,000 patients in the United States were notified about potential exposure to blood-contaminated medications or injection equipment. Facility leadership has an obligation to ensure adherence to safe injection practices and to respond properly if unsafe injection practices are identified.


Assuntos
Comunicação , Infecção Hospitalar/epidemiologia , Reutilização de Equipamento/estatística & dados numéricos , Controle de Infecções/métodos , Injeções/efeitos adversos , Erros Médicos/estatística & dados numéricos , Seringas , Patógenos Transmitidos pelo Sangue , Infecção Hospitalar/etiologia , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/transmissão , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Hepatite B/epidemiologia , Hepatite B/transmissão , Hepatite C/epidemiologia , Hepatite C/transmissão , Humanos , Estados Unidos/epidemiologia
15.
Neurourol Urodyn ; 39(1): 203-210, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31578763

RESUMO

AIM: To assess the impact of asymptomatic bacteriuria (ASB) on the safety and efficacy of intradetrusor onabotulinumtoxinA injections in patients with overactive bladder and neurogenic detrusor overactivity. METHODS: We reviewed the medical records of patients who had received onabotulinumtoxinA between 2009 and 2014. Safety analysis was based on the appearance of urinary tract infections (UTIs), hematuria, and need for hospitalization because of related adverse event(s) in the month after injection. Patients who underwent urodynamic study before and 3 months after the first onabotulinumtoxinA treatment were included in efficacy analysis. Changes in maximal cystometric capacity (MCC), bladder compliance (BC), maximal detrusor pressure at maximal involuntary detrusor contraction (Pdetmax), and detrusor leak point pressure (DLPP) were assessed. RESULTS: Totally, 183 patients underwent 457 injection sessions. ASB was found in 38.8% (185) of urine cultures taken before injections. After treatment, 49 patients (with or without ASB) developed UTI. Urosepsis did not occur. The odds ratio of UTI in patients with ASB was 16.48. The efficacy cohort, consisting of 83 patients, showed that ASB had no significant effect on any of the efficacy parameters (MCC-risk ratio [RR]: 0.93, 95% confidence interval [CI]: 0.72-1.21; BC-RR: 0.88, 95% CI: 0.62-1.24; Pdetmax-RR: 0.9, 95% CI: 0.69-1.21; DLPP-RR: 1.69, 95% CI: 0.72-3.97). CONCLUSIONS: ASB is common among patients who are candidates for intradetrusor onabotulinumtoxinA treatment. ASB increases the risk of UTI, but does not heighten the risk of urosepsis, hospitalization, or therapy failure. This study should lead to the reconsideration of current recommendations.


Assuntos
Bacteriúria/complicações , Toxinas Botulínicas Tipo A/efeitos adversos , Bexiga Urinaria Neurogênica/tratamento farmacológico , Bexiga Urinária Hiperativa/tratamento farmacológico , Infecções Urinárias/etiologia , Agentes Urológicos/efeitos adversos , Adulto , Idoso , Toxinas Botulínicas Tipo A/uso terapêutico , Feminino , Humanos , Injeções/efeitos adversos , Masculino , Pessoa de Meia-Idade , Bexiga Urinaria Neurogênica/complicações , Bexiga Urinária Hiperativa/complicações , Agentes Urológicos/uso terapêutico
16.
Dermatol Surg ; 46(3): 395-401, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31453902

RESUMO

BACKGROUND: Dermal fillers for lip augmentation can be injected using various techniques. Although all seem to provide acceptable results, it is not clear which technique is safer, less painful, and provides greater patient comfort. OBJECTIVE: To compare patients' self-reported pain intensity during the injection of hyaluronic acid dermal filler for lip augmentation, with 2 different techniques, anterograde versus retrograde. METHODS AND MATERIALS: Prospective, single-center, within-subject, single-blinded, randomized controlled trial. All subjects received injections in the lip with hyaluronic acid-based filler, each side using the anterograde or retrograde injection technique. An automated motorized injection device was used to ensure a homogeneous deposition flow of the product injected and reduce operator bias. Pain intensity was self-assessed using a 100-mm visual analog scale. Presence and severity of bruising were recorded. RESULTS: Forty-four women (mean age 30.3 years) were randomized. Mean self-reported pain score was 53.1% lower with the anterograde technique than with the retrograde (p < .0001). The anterograde technique had lower rates of site reactions, showed a faster recovery time, and 68.2% of patients favored this technique. CONCLUSION: This study demonstrated that the anterograde technique was less painful, and led to fewer bruising and site reactions than the retrograde technique when using an automated device. LEVEL OF EVIDENCE: I.


Assuntos
Contusões/etiologia , Preenchedores Dérmicos/administração & dosagem , Ácido Hialurônico/administração & dosagem , Injeções/efeitos adversos , Injeções/instrumentação , Lábio , Adulto , Técnicas Cosméticas , Feminino , Humanos , Medição da Dor , Estudos Prospectivos , Método Simples-Cego
17.
J Cosmet Dermatol ; 19(2): 346-352, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31222959

RESUMO

BACKGROUND: A needle or a cannula can be safely used during filler injection procedures to correct a sunken upper eyelid. To date, there are no precise injection points recommended that are based on an anatomical study. OBJECTIVE: This study systematically investigated the vascular pattern and depth of forehead arteries at the periorbital area of upper eyelid. METHODS: Twenty cadavers were dissected in this study. Additional data were obtained from 30 healthy volunteers using Doppler ultrasound imaging with high-frequency probe. RESULTS: The ophthalmic artery divided into two opposite primary branches: the superior and inferior orbitoglabellar arteries running along the orbital rim. After the supratrochlear artery arose from the superior orbitoglabellar artery at the medial eyebrow, the supraorbital artery either divided from this artery near the supraorbital foramen or emerged as an individual artery from the supraorbital notch. The inferior orbitoglabellar artery gave off the radix artery superior to the medial canthal tendon. The radix artery divided into two opposite branches: the dorsal nasal artery going to the nose and the paracentral artery going to the glabella. Ultrasound imaging revealed a subcorrugator space that a cannula can safely pass through. At the supraorbital foramen/notch, the supraorbital artery traveled very close to the bone. Based on the anatomical data collected, the following injection points for a needle and a cannula technique are recommended. CONCLUSION: Correction of a sunken upper eyelid is a dangerous procedure which should be performed only by experienced physicians. However, with precise anatomical knowledge and correct techniques, optimal outcomes can be safely achieved.


Assuntos
Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Pálpebras/efeitos dos fármacos , Artéria Oftálmica/anatomia & histologia , Adulto , Cadáver , Cânula/efeitos adversos , Técnicas Cosméticas/instrumentação , Pálpebras/irrigação sanguínea , Pálpebras/diagnóstico por imagem , Voluntários Saudáveis , Humanos , Injeções/efeitos adversos , Injeções/instrumentação , Pessoa de Meia-Idade , Agulhas/efeitos adversos , Artéria Oftálmica/diagnóstico por imagem , Artéria Oftálmica/lesões , Órbita/irrigação sanguínea , Ultrassonografia Doppler em Cores , Adulto Jovem
18.
Plast Reconstr Surg ; 145(1): 51e-57e, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31881605

RESUMO

BACKGROUND: Facial proportions can be improved by means of chin augmentation in patients with a receding chin. The ascending mental artery is the main arterial supply to the top of the chin, and arterial occlusion of this artery can result in soft-tissue infarction. This study aims to measure the topographic anatomy of the ascending mental artery at the chin injection area, using a three-dimensional camera. METHODS: Thirty-one embalmed cadaveric faces were dissected at the chin. The midline of the inferior margin of the mandibular protuberance was marked with a pin. A variation in size between the two opposite ascending mental arteries was noticed. The depth of the artery from the skin surface and distance from the midline were measured using a three-dimensional camera. RESULTS: There were 19 dominant ascending mental arteries on the right and 12 on the left. The dominant ascending mental arteries enter the chin paracentrally, approximately 6 mm (mean ± SD, 5.64 ± 4.34 mm) from the midline, within the muscular plane, and at a depth of 4.15 ± 1.95 mm from the skin. Furthermore, the artery formed an anastomosis with the sublingual artery, within the floor of the mouth. CONCLUSION: Every aesthetic physician should recognize the course of the ascending mental artery and use the appropriate techniques to avoid vascular injury during chin augmentation using filler injections.


Assuntos
Artérias/anatomia & histologia , Queixo/irrigação sanguínea , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Embolia/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Cadáver , Preenchedores Dérmicos/efeitos adversos , Dissecação , Embolia/etiologia , Feminino , Humanos , Injeções/efeitos adversos , Injeções/métodos , Masculino , Pessoa de Meia-Idade
19.
Skeletal Radiol ; 49(3): 435-441, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31435716

RESUMO

PURPOSE: To investigate the role of music on subjects undergoing routine image-guided musculoskeletal corticosteroid injections and its effect on post-procedure pain and subjective overall experience. MATERIALS AND METHODS: This prospective study was IRB-approved and HIPAA-compliant. A total of 126 subjects referred for outpatient image-guided musculoskeletal corticosteroid injections were enrolled in the study and randomized into a music offered group ((+)MO) and a no music offered group ((-)MO). (+)MO subjects were given the opportunity to listen to music during their corticosteroid injection. All subjects were then given an anonymous survey on which they recorded their pre-procedural and post-procedural pain on a scale from 0 to 9 and rated their overall experience and how likely they were to recommend our department for musculoskeletal procedures on scales from 1 to 5. RESULTS: (+)MO subjects had significantly lower post-procedural pain (p = 0.013) and significantly greater decrease in pain (p = 0.031) compared to (-)MO subjects. Among the (+)MO subjects, there was no statistically significant difference in post-procedure pain (p = 0.34) or change in pain (p = 0.62) if music was accepted or declined. However, subjects who listened to music did have lower post-procedural pain compared to those who did not listen to music (p = 0.012), although the differences in the decrease of pain between the two groups did not quite reach statistical significance (p = 0.062). CONCLUSIONS: Playing music during image-guided musculoskeletal corticosteroid injections may reduce patients' post-procedure pain. Offering patients some measure of control over their procedure may be a factor that contributes to decreased post-procedure pain as well.


Assuntos
Corticosteroides/administração & dosagem , Injeções/efeitos adversos , Doenças Musculoesqueléticas/tratamento farmacológico , Música , Manejo da Dor/métodos , Medição da Dor , Feminino , Humanos , Análise de Intenção de Tratamento , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
20.
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
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