Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.043
Filtrar
1.
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
2.
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
3.
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
5.
Medicine (Baltimore) ; 98(36): e17048, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31490398

RESUMO

RATIONALE: Cosmetic hyaluronic acid injections for facial soft tissue augmentation are gaining popularity because of their convenience and favorable outcomes. Several associated complications have been described; however, ophthalmic artery occlusion (OAO) combined with superior sagittal sinus thrombosis (SSST) has been rarely reported. PATIENT CONCERNS: A 21-year-old woman presented with sudden loss of vision and severe pain in the left eye, right upper limb weakness, and headache immediately after hyaluronic acid injection on the left side of her forehead. DIAGNOSIS: Clinical manifestations and multimodal imaging, including spectral-domain optical coherence tomography, fundus fluorescein angiography, and digital subtraction angiography, indicated OAO and SSST. INTERVENTIONS: Various clinical examinations were performed, and the patient was treated by thrombolysis, corticosteroids, oxygen therapy, a formula for the nourishment of the optic nerve, and measures for improving the microcirculation. OUTCOMES: The treatment response was closely observed. The intracerebral hemorrhages were absorbed after 2 weeks of treatment, while the clinical manifestations, including ocular pain, headache, and limb dysfunction, were gradually alleviated. However, the visual acuity in the left eye remained at no light perception. LESSONS: Cosmetic hyaluronic acid injection can result in emergent and catastrophic complications that require immediate treatment. Thus, the development of appropriate prevention and management protocols for such scenarios is considered crucial.


Assuntos
Arteriopatias Oclusivas/induzido quimicamente , Ácido Hialurônico/efeitos adversos , Artéria Oftálmica , Trombose do Seio Sagital/induzido quimicamente , Viscossuplementos/efeitos adversos , Técnicas Cosméticas/efeitos adversos , Feminino , Humanos , Injeções/efeitos adversos , Adulto Jovem
6.
JAMA Facial Plast Surg ; 21(6): 480-486, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31513234

RESUMO

Importance: Vibration has been shown to decrease injection site pain in patients; however, to date, this effect has not been assessed for patients who catastrophize pain (ie, patients who anticipate a higher pain level). The anticipation of a pain score greater than 4 on the 11-point Numeric Rating Scale (NRS) has been associated with an increase in a patient's perception of procedural pain. Objective: To assess the efficacy of vibration during cutaneous anesthetic injection for dermatologic surgery for patients who catastrophize pain (NRS score >4) and patients who do not (NRS score ≤4). Design, Setting, and Participants: Randomized, parallel-group clinical trial from June 19 to September 4, 2018, at a tertiary dermatologic surgery clinic among 87 adults undergoing cutaneous cancer removal surgery. Patients completed a preprocedural questionnaire detailing their baseline pain, anticipated pain, and drug use. Analysis was performed on an intent-to-treat basis. Interventions: Use of a vibratory anesthetic device (VAD) on the treatment site prior to anesthetic injection in the on (VAD ON) or off (VAD OFF) mode. Main Outcomes and Measures: Pain was reported using the 11-point NRS (where 0 indicates no pain and 11 indicates the worst pain imaginable). A minimum clinically important difference of 22% or more and a substantial clinically important difference of 57% or more were used to assess the efficacy of vibration in patient-reported NRS score during anesthetic injection (iNRS score). Results: A total of 87 patients were included, with 101 unique events reported (among the unique events, 37 were reported in women and 64 were reported in men; mean [SD] age, 66.0 [11.3] years). The mean (confidence level [CL]) iNRS score for patients who catastrophized pain was 2.27 (0.66) compared with 1.44 (0.39) for patients who did not (P = .03). A 38.9% decrease in mean (CL) iNRS score was reported with VAD ON compared with VAD OFF in all participants (1.24 [0.38] vs 2.04 [0.54]). Patients who catastrophized pain reported a 25.5% decrease in mean (CL) iNRS score with VAD ON vs VAD OFF (1.91 [0.99] vs 2.57 [0.98]), and patients who did not reported a 79.4% decrease (1.02 [0.40] vs 1.84 [0.66]). VAD ON was the only statistically significant variable to affect iNRS score (F statistic, 2.741; P = .03). Conclusions and Relevance: This trial demonstrates that those who catastrophize pain prior to a procedure report a higher perceived level of pain. The application of vibration during local anesthetic injection resulted in a minimum clinically important difference in pain level for patients who catastrophize pain and a substantial clinically important difference in pain level for patients who do not. Level of Evidence: 2. Trial Registration: ClinicalTrials.gov identifier: NCT03467685.


Assuntos
Anestésicos Locais/administração & dosagem , Injeções/efeitos adversos , Percepção da Dor , Dor/etiologia , Dor/prevenção & controle , Neoplasias Cutâneas/cirurgia , Vibração , Adulto , Idoso , Idoso de 80 Anos ou mais , Catastrofização , Procedimentos Cirúrgicos Dermatológicos , Humanos , Pessoa de Meia-Idade , Medição da Dor
7.
Zhonghua Shao Shang Za Zhi ; 35(8): 619-621, 2019 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-31474046

RESUMO

On January 1st 2018, a male 44 years old diabetic patient with subcutaneous soft tissue infection in right thigh was admitted to our hospital. The patient repeatedly used the same needle to inject insulin subcutaneously in the unsterilized right thigh, and his blood glucose was badly controlled in the long term. Severe subcutaneous soft tissue infection of the right thigh occurred after his fatigue, accompanied with ketoacidosis. Then he received conservative treatment in the local hospital for one month, but the infection persisted. After being transferred to our hospital, we highly suspected the diagnosis of necrotizing fasciitis according to previous test indicators and local B-ultrasound results, but suggestion of aggressive surgery was refused. So we treated him with conservative therapies using sensitive antibiotics and supportive remedies. The patient was basically healed after treatment of 1 month and he was recovered well during the follow-up 2 months after discharged from our hospital. This case emphasizes the importance of standard injection of insulin and early diagnosis of severe subcutaneous soft tissue infection.


Assuntos
Contaminação de Equipamentos , Fasciite Necrosante/etiologia , Agulhas/efeitos adversos , Infecções dos Tecidos Moles/etiologia , Adulto , Glicemia , Humanos , Injeções/efeitos adversos , Insulina , Masculino , Coxa da Perna
8.
Parasit Vectors ; 12(1): 433, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31492168

RESUMO

BACKGROUND: The safety of ProHeart® 12 (PH 12; extended-release injectable suspension; 10% moxidectin in glyceryl tristearate microspheres) was evaluated in four studies using Beagle dogs and one study using ivermectin-sensitive Collies. The recommended dose is 0.5 mg/kg subcutaneously once yearly. METHODS: Study 1: safety margin was evaluated as 3 treatments of PH 12 (0× (control); 1× (recommended dose); 3× (3 times recommended dose) and 5× (5 times recommended dose) in 12 months via clinical observations, body weights, food consumption, injection site observations, physical examinations, moxidectin tissue assay, pharmacokinetics, and clinical and anatomic pathology. Study 2: safety in breeding-age males was demonstrated by semen testing at 14-day intervals from Day 7 to Day 91 post-treatment (0× or 3×). Study 3: reproductive safety in females was demonstrated by monitoring dams and litters following treatments (0× or 3×) administered during breeding, gestation, or lactation. Study 4: safety in dogs surgically implanted with adult heartworms was evaluated by clinical and laboratory monitoring following treatment with 0× or 3× administered 61 days post-implantation. Study 5: safety in ivermectin-sensitive dogs (120 µg/kg SC) was by clinical monitoring for 1 week after administering 1×, 3× or 5×. RESULTS: Study 1: slight swelling clinically detectable at some 3× and 5× injection sites was characterized microscopically as granulomatous inflammation, like tissue responses to medical implants, interpreted as non-adverse. Pharmacokinetics were dose-proportional and there was little or no systemic accumulation. Residual moxidectin mean (range) at 1× injection sites after 1 year was 16.0% (0.045-37.6%) of the administered mass. Studies 2 and 3: no effects were identified in reproductive indices (females) or semen quality characteristics (males). Study 4: PH 12 produced marked reductions in circulating microfilariae and lower numbers of adult heartworms, but no adverse clinical signs were identified. Study 5: there were no abnormal clinical signs at 1×, 3× or 5× overdoses of PH 12 in ivermectin-sensitive dogs. CONCLUSIONS: PH 12 has a > 5× safety margin in both normal and ivermectin-sensitive dogs, has no effects on canine reproduction, and is well tolerated in heartworm-positive dogs. The only treatment-related finding was non-adverse, granulomatous inflammation at the injection site.


Assuntos
Antinematódeos/efeitos adversos , Preparações de Ação Retardada/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Injeções/efeitos adversos , Macrolídeos/efeitos adversos , Suspensões/efeitos adversos , Animais , Antinematódeos/administração & dosagem , Preparações de Ação Retardada/administração & dosagem , Doenças do Cão/tratamento farmacológico , Cães , Hidropericárdio/tratamento farmacológico , Macrolídeos/administração & dosagem , Suspensões/administração & dosagem , Resultado do Tratamento
9.
Curr Opin Anaesthesiol ; 32(5): 638-642, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31415044

RESUMO

PURPOSE OF REVIEW: Summarize the current thinking concerning the clinically relevant aspects of nerve anatomy and best injection sites for nerve blocks. RECENT FINDINGS: The widespread use of ultrasound in regional anesthesia has changed the practice of regional anesthesia and created new possibilities. Among them is the ability to identify fascial planes, and this has become the basis for a new group of blocks, the fascial plane blocks. In this kind of blocks, the target for injection is the plane itself and not a nerve in particular. transversus abdominis plane, pectoralis muscles, erector spinae plane blocks are some examples of fascial blocks. Because injecting into a fascial plane is not controversial, these blocks are not included in our discussion of optimal placement of the needle.To determine optimal needle placement, it is important to have a clear definition of what constitutes intraneural. Although, there is almost universal agreement that the violation of the epineurium defines the intraneural concept, the literature include several studies where this assessment is erroneous.Although intentional intraneural injection is still considered objectionable, some literature suggests that injecting intraneurally, especially if extrafascicular, may be benign. This evidence is limited and anecdotal. SUMMARY: It is necessary to have a better understanding of what intraneural injection is when dealing with any type of nerve blocks, be that single nerve, plexuses, or the sciatic nerve. Perineural injections provide successful anesthesia without putting the nerve integrity at risk. That practice is supported by years of experience and common sense. Currently, there is no evidence to support any kind of intraneural injections, intrafascicular or extrafascicular.


Assuntos
Agulhas/efeitos adversos , Bloqueio Nervoso/métodos , Traumatismos dos Nervos Periféricos/prevenção & controle , Nervos Periféricos/anatomia & histologia , Humanos , Injeções/efeitos adversos , Injeções/instrumentação , Injeções/métodos , Bloqueio Nervoso/efeitos adversos , Bloqueio Nervoso/instrumentação , Traumatismos dos Nervos Periféricos/etiologia , Nervos Periféricos/diagnóstico por imagem , Ultrassonografia de Intervenção
10.
Best Pract Res Clin Anaesthesiol ; 33(1): 47-56, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31272653

RESUMO

Nerve injury is a relatively rare but devastating complication of peripheral nerve blockade (PNB). Monitoring injection pressure during PNB is one method advocated to prevent injury by detecting needle tip placement in a noncompliant position (intraneural or abutting the epineurium). Animal studies show that gross neural damage and clinical injury are associated with injection pressures exceeding 15-20 psi. In contrast, pressures <15 psi are associated with an extraneural needle tip position and no histologic or clinical injury. Injection pressure monitoring has been shown to prevent injection against the brachial plexus roots or femoral nerve during peripheral nerve block. Multiple methods are available to monitor injection pressure, and most of them are inexpensive and easy to use. Large-scale registry database or pragmatic trials are indicated to show that injection pressure monitoring reduces injury in a patient setting.


Assuntos
Reação no Local da Injeção/patologia , Monitorização Intraoperatória/métodos , Bloqueio Nervoso/efeitos adversos , Traumatismos dos Nervos Periféricos/patologia , Humanos , Reação no Local da Injeção/etiologia , Reação no Local da Injeção/prevenção & controle , Injeções/efeitos adversos , Bloqueio Nervoso/instrumentação , Traumatismos dos Nervos Periféricos/etiologia , Traumatismos dos Nervos Periféricos/prevenção & controle , Pressão/efeitos adversos , Ultrassonografia de Intervenção/efeitos adversos , Ultrassonografia de Intervenção/métodos
11.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(7): 694-696, 2019 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-31302972

RESUMO

Special diseases with hemorrhoid hemorrhage are intractable cases in clinical practice. Surgery may result in serious trauma and high risk, such as higher morbidity of postoperative complication, delayed hospital stay, and even death. These patients usually underwent conservative therapy or injection therapy. In 2017, our Professional Committee standardized the procedure of Shaobei injection and established the clinical guideline, but still lacked guidance for special diseases with hemorrhoid hemorrhage. In view of this, based on current medical conditions, combined with years of clinical practice, after repeated discussions, comprehensive multidisciplinary perspectives on patients with special diseases such as coagulopathy, hypertension, diabetes, portal hypertension, renal dysfunction, immunodeficiency, and antithrombotic therapy, the experts of this guideline-writing committee formulate the corresponding clinical management strategies, mainly emphasizing on preoperative management of underlying disease, choice of anesthesia methods, and precautions during surgery.


Assuntos
Hemorragia Gastrointestinal/terapia , Hemorroidas/terapia , Injeções/efeitos adversos , Tratamento Conservador , Hemorragia Gastrointestinal/etiologia , Hemorroidas/complicações , Humanos , Injeções/métodos , Guias de Prática Clínica como Assunto
12.
Diabetes Metab Syndr ; 13(2): 1237-1239, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336470

RESUMO

We are hereby reporting on a woman with type 1 diabetes getting insulin, 4 shots a day, and referring to us for an episode of severe hypoglycemia occurred after vigorously rubbing a lipo-hypertrophy (LH). She had always injected insulin into an abdominal LH area but had never suffered from any hypoglycemic event (Hypo) during the last period. Nevertheless her history included frequent Hypos, mostly mild-to-moderate but sometimes severe and eventually ending into unconsciousness and her glycemic control was poor (HbA1c 8.3%, mean FPG 161 ±â€¯22 mg/dl, mean PPG 218 ±â€¯51 mg/dl, glycemic variability (106 ±â€¯44 mg/dl). In fact, all of a sudden she rubbed vigorously the LH area trying to get rid of the abdominal skin thickening and soon after a severe Hypo occurred causing her to need for emergency medical assistance. When back at home, she corrected her technique and carefully refrained from inject insulin into the LH so that after six months the lesion disappeared, glycemic control improved and no Hypo occurred any more. Based on the recent publication reporting on a woman with a large LH consisting of thickened skin surrounding some fluid containing insulin at concentrations 13 fold those in blood, we hypothesize that such severe depended on massive insulin release from rubbed skin stores into the blood stream.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Hipoglicemia/etiologia , Hipoglicemiantes/efeitos adversos , Reação no Local da Injeção/complicações , Injeções/efeitos adversos , Adulto , Biomarcadores/análise , Glicemia/análise , Feminino , Hemoglobina A Glicada/análise , Humanos , Hipertrofia , Hipoglicemia/metabolismo , Hipoglicemia/patologia , Hipoglicemiantes/administração & dosagem , Prognóstico
13.
Artigo em Alemão | MEDLINE | ID: mdl-31212342

RESUMO

OBJECTIVE: Comparison of the effectiveness of local anaesthesia (LA) in piglet castration with the combination of scrotal and inguinal application of procaine 2 % and lidocaine 5 % to the intratesticular application of lidocaine 1 % using following parameters: adrenaline (A), noradrenaline (NA), defensive movements and coordinated movement patterns. MATERIAL AND METHODS: In 2 substudies 232 male suckling piglets (3-6 days of age) were randomly allocated to study groups. In groups L5 and group P2 lidocaine 5 % and procaine 2 % was applied inguinally and scrotally, respectively, while piglets of groups H (handling) and K (castration without local anaesthesia) were only fixated as for an injection. In group L1 lidocaine 1 % was injected intratesticularly. After 30 min piglets were were castrated, whereas animals of group H were again only fixated. In substudy 1 (n = 112) blood samples were taken to determine the concentration of catecholamines after castration. During injection and castration defensive movements were judged. In substudy 2 (n = 120) piglets completed a chute to document the individual stress level. RESULTS: Groups H and L1 demonstrated significantly less defensive movements during fixation for injection/injection compared to the other study groups (p ≤ 0.05). After the injection piglets of group P2 had significantly more difficulties in the chute and needed > 50 % more time to complete the course. In all study groups defensive movements during castration were the highest at the moment of severing the spermal cord. Group K obtained the highest possible rating of 8 and differed significantly from the other groups as well as when cutting the skin (p ≤ 0.05). Both the concentration of A and NA significantly rose in all groups. The increase in A and NA was significantly higher in group 2, as well as the increase in NA in group K, both in comparison to the other study groups (p ≤ 0.05). CONCLUSION: None of the applied techniques for local anaesthesia achieved a complete elimination of pain during castration of suckling piglets. The behaviour analysis indicated an altogether higher distress for P2. After castration, this injection led to a neuroendocrine pain reaction that was comparable to or higher than that of group K. In both lidocaine groups (L1, L5) the pain reaction after castration tended to be lower. These results provide approaches to apply longer acting LA with a higher analgesic potency in an appropriate dosage and with an appropriate method of application.


Assuntos
Anestésicos Locais , Lidocaína , Orquiectomia , Dor , Procaína , Anestésicos Locais/administração & dosagem , Anestésicos Locais/farmacologia , Anestésicos Locais/uso terapêutico , Animais , Animais Lactentes , Comportamento Animal/efeitos dos fármacos , Catecolaminas/sangue , Injeções/efeitos adversos , Lidocaína/administração & dosagem , Lidocaína/farmacologia , Lidocaína/uso terapêutico , Masculino , Orquiectomia/efeitos adversos , Orquiectomia/veterinária , Dor/tratamento farmacológico , Dor/etiologia , Dor/veterinária , Procaína/administração & dosagem , Procaína/farmacologia , Procaína/uso terapêutico , Estresse Fisiológico/efeitos dos fármacos , Suínos
14.
J Gen Virol ; 100(6): 968-974, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31090532

RESUMO

We evaluated the association between human pegivirus-2 (HPgV-2) infection and hepatitis C virus (HCV)/hepatitis B virus (HBV) co-infection in 745 plasma samples collected from HCV-positive but human immunodeficiency virus type one (HIV-1)-negative people who inject drugs in Hunan, China. The prevalence of anti-HPgV-2 was 4.43  % (33/745) and, within this, the HCV 6a genotype showed significantly higher prevalence as compared with the HCV non-6a genotypes, 6.29  % (18/286) vs. 1.69  % (4/236), respectively (P=0.009). HPgV-2 RNA was detected in 2.15  % (16/745), and was not significantly different between the HCV 6a and non-6a genotypes, 2.45  % (7/286) vs. 2.54  % (6/236), respectively (P =0.945). HBV single infection did not increase the risk of HPgV-2 infection. Compared with HCV single infection, HCV/HBV co-infection increased the risk of HPgV-2 infection by about three-fold: odds ratio (OR)=3.24 [95  % confidence interval (CI) 1.34-7.82, P=0.014] according to anti-HPgV-2 positivity or OR=3.51 (95  % CI 1.15-10.74, P=0.051) according to HPgV-2 viraemia. HPgV-2 infection did not increase the levels of liver-specific enzymes. Our study provides new findings regarding the association between HPgV-2 and HCV genotypes as well as HCV/HBV co-infection.


Assuntos
Coinfecção/etiologia , Infecções por Flaviviridae/etiologia , Hepatite B/etiologia , Hepatite C/etiologia , Injeções/efeitos adversos , Adulto , China , Coinfecção/virologia , Usuários de Drogas , Feminino , Flaviviridae/genética , Genótipo , Hepacivirus/genética , Vírus da Hepatite B/genética , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , RNA Viral/genética , Risco
16.
Eur J Contracept Reprod Health Care ; 24(3): 227-232, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30958043

RESUMO

Purpose: The aim of this study is to evaluate the health of oocyte donors and explain how they regard their experience in the long-term. Materials and methods: This is a cross-sectional study in a single fertility centre that consists of a telephone interview guided by a semi-structured questionnaire covering several aspects of reproductive health and personal experience. Results: At the time of interview, 84 out of 121 women (69%) had children while 64 (53%) were already mothers at the time of their donation. Of the 38 women achieving a pregnancy after donation, five reported six pregnancy complications. Two out of 121 (2%) women reported being in menopause (aged 41 and 45). Twenty-three women (19%) reported gynaecological issues and eight (7%) reported fertility problems, although only four consulted a specialist. Most of women highlighted positive feelings about their donation (113, 93%) and 155 (97%) would recommend donating. Less than half (53, 44%) mentioned some negative aspects, mainly related to physical discomfort: injections (20,17%), pain (17, 14%), and side effects of ovarian stimulation (10, 8%). Conclusion: The impact of donation on women's life was mostly favourable, with the majority of participants reporting positive aspects and recommending donation, although some negative feelings as physical discomfort also arose. Therefore, more comfortable stimulation protocols could be developed.


Assuntos
Nível de Saúde , Doação de Oócitos/estatística & dados numéricos , Satisfação do Paciente , Adulto , Estudos Transversais , Feminino , Doenças Urogenitais Femininas/epidemiologia , Seguimentos , Humanos , Infertilidade Feminina/epidemiologia , Injeções/efeitos adversos , Pessoa de Meia-Idade , Doação de Oócitos/efeitos adversos , Doação de Oócitos/psicologia , Indução da Ovulação/efeitos adversos , Dor/etiologia , Paridade , Gravidez , Complicações na Gravidez/epidemiologia , Taxa de Gravidez , Espanha/epidemiologia , Inquéritos e Questionários , Fatores de Tempo
17.
Plast Reconstr Surg ; 143(4): 1031-1037, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30730493

RESUMO

BACKGROUND: Vision loss and skin necrosis caused by an accidental intraarterial embolism or vascular compression are rare but devastating complications when injecting filler materials into the face. METHODS: The external and internal diameters and wall thicknesses of the facial artery and its branches were measured from 41 formalin-embalmed cadavers after removing connective tissues attached to the arterial wall. RESULTS: The diameter and thickness of the facial artery exhibited significant interregional differences. The external and internal diameters of the facial artery were 1.9 ± 0.4 and 1.2 ± 0.3 mm (mean ± SD), respectively, at the inferior border of the mandible; 1.7 ± 0.3 and 1.2 ± 0.3 mm in the vicinity of the inferior labial artery; 1.5 ± 0.3 and 1.0 ± 0.3 mm at the mouth corner; 1.4 ± 0.3 and 0.9 ± 0.2 mm in the vicinity of the superior labial artery; and 1.1 ± 0.2 and 0.7 ± 0.2 mm in the vicinity of the lateral nasal artery. The external and internal diameters at the proximal parts of the inferior labial artery, superior labial artery, and lateral nasal artery were 1.0 ± 0.3 and 0.6 ± 0.2 mm, 0.9 ± 0.3 and 0.6 ± 0.2 mm, and 0.8 ± 0.2 and 0.5 ± 0.2 mm, respectively. CONCLUSION: Morphometric examinations of the facial artery under stereomicroscope observation as performed in the present study are expected to be more accurate than direct measurements obtained during cadaveric dissection or conventional histologic evaluations.


Assuntos
Artérias/anatomia & histologia , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Face/irrigação sanguínea , Injeções/efeitos adversos , Erros Médicos/prevenção & controle , Cadáver , Humanos , Ácido Hialurônico
18.
Eur J Orthop Surg Traumatol ; 29(5): 1095-1100, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30747277

RESUMO

BACKGROUND: Periarticular multimodal drug injection (PMDI) has gained popularity as common postoperative pain protocols in knee arthroplasty. PMDI sites can vary, but posterior capsule (PC) is a common injection site because of its abundance of pain nociceptors. PURPOSE: To prove the hypothesis whether posteromedial drug injection alone is sufficient to provide enough effect covering the PC in order to reduce risks of neurovascular injury. Secondary outcomes are to find proper volume of injection and safe zone for PMDI injection. METHODS: Ten fresh cadaveric knees were allocated into two equal groups, which differed in volume of dye injection: 25 ml and 50 ml. Dyes were injected into posteromedial capsule compartment, and the limbs were stored in a freezer for 2 weeks. Then the posterior compartment was carefully dissected to examine spreading of the dye solution. RESULTS: No dye staining was seen superficially beneath subcutaneous tissue of the knees. In deeper layer, the dye mostly occupied medially along the fascia covering semimembranosus muscles. However, dispersion was limited distally by intermuscular septa and popliteal vessels. The 50-ml injection group provided wider extension in the superficial layer, but not in the deep layer. CONCLUSION: The intermuscular septa and the fascia of popliteal vessels were shown to be the boundary between posteromedial and posterolateral compartments of the knee. Separate PMDI for both compartments is necessary to occupy the entire PC. We suggest that 1.5 cm lateral to lateral border of PCL insertion, just above popliteus tendon, is the safe zone for injecting PMDI into the posterolateral capsule.


Assuntos
Artroplastia do Joelho/efeitos adversos , Injeções , Articulação do Joelho , Dor Pós-Operatória , Traumatismos dos Nervos Periféricos/prevenção & controle , Lesões do Sistema Vascular/prevenção & controle , Cadáver , Humanos , Injeções/efeitos adversos , Injeções/métodos , Articulação do Joelho/irrigação sanguínea , Articulação do Joelho/inervação , Articulação do Joelho/cirurgia , Modelos Anatômicos , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/tratamento farmacológico , Traumatismos dos Nervos Periféricos/etiologia , Lesões do Sistema Vascular/etiologia
19.
J Dairy Sci ; 102(4): 3431-3438, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30772020

RESUMO

Dairy calves are routinely administered medicines, vaccines, and anesthesia via injection. Although injections are painful, little is known about methods to alleviate this pain. The aim of this study was to determine whether lidocaine-prilocaine cream, a topical anesthetic, reduced calves' pain response to a subcutaneous injection around the cornual nerve. Calves were assigned 1 of 2 treatments: lidocaine-prilocaine cream at the sites of injection (n = 10) or no cream (n = 9). Thirty minutes after treatment, calves received a subcutaneous injection of 2% buffered lidocaine hydrochloride around the left and right cornual nerves. Contrary to our hypothesis, calves that received anesthetic cream beforehand displayed more escape behaviors during the injections than control calves. Both treatments had similarly low amounts of head-related behaviors afterward. Maximum eye temperature did not differ between the calves that received anesthetic cream and control calves, although eye temperature increased over time for both treatments. Heart rate increased during the 30 s following the first injection in both treatments. There were no treatment differences for any heart rate measures over the 5-min period after the first injection (mean heart rate, root mean square of successive differences, high-frequency power, and the ratio of low-frequency power to high-frequency power). These results suggest that cornual nerve blocks with buffered lidocaine are painful and that a lidocaine-prilocaine cream was not only ineffective in reducing this pain but that it may also worsen it.


Assuntos
Dor Aguda/veterinária , Anestésicos Locais/farmacologia , Doenças dos Bovinos/prevenção & controle , Combinação Lidocaína e Prilocaína/farmacologia , Lidocaína/farmacologia , Bloqueio Nervoso/veterinária , Dor Aguda/etiologia , Dor Aguda/prevenção & controle , Administração Tópica , Anestesia Local , Animais , Bovinos , Doenças dos Bovinos/etiologia , Feminino , Frequência Cardíaca , Humanos , Injeções/efeitos adversos , Injeções/veterinária , Masculino , Medição da Dor
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA