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1.
Methods Mol Biol ; 2224: 147-152, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33606213

RESUMO

Colorectal cancer animal model is a very useful tool to explore the tumor initiation and development. In the past year, many methods have been used for building up the mouse model including the subcutaneous injection and cecal wall injection or implantation. But this model cannot reflect the native stromal environment of the colon mucosa. Recently, the in vivo murine endoscopy has been developed allowing high-resolution imaging of the colon. Endoscopy orthotopic injection tumor cell line becomes a low cost, fast tumor growth simple technique. In this chapter, we describe detailed protocols for rapidly and efficiently building up colon cancer tumors model by using the colonoscopy-guided mucosal injection. This model can be used to explore drug testing, gene function assessment, and cancer metastasis.


Assuntos
Neoplasias do Colo/patologia , Animais , Linhagem Celular Tumoral , Transformação Celular Neoplásica/patologia , Colo/patologia , Colonoscopia/métodos , Modelos Animais de Doenças , Feminino , Células HCT116 , Humanos , Injeções/métodos , Mucosa Intestinal/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos NOD , Camundongos Nus , Camundongos SCID
2.
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
3.
Nat Commun ; 12(1): 697, 2021 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-33514733

RESUMO

Mutations in voltage-gated potassium channel KCNE1 cause Jervell and Lange-Nielsen syndrome type 2 (JLNS2), resulting in congenital deafness and vestibular dysfunction. We conducted gene therapy by injecting viral vectors using the canalostomy approach in Kcne1-/- mice to treat both the hearing and vestibular symptoms. Results showed early treatment prevented collapse of the Reissner's membrane and vestibular wall, retained the normal size of the semicircular canals, and prevented the degeneration of inner ear cells. In a dose-dependent manner, the treatment preserved auditory (16 out of 20 mice) and vestibular (20/20) functions in mice treated with the high-dosage for at least five months. In the low-dosage group, a subgroup of mice (13/20) showed improvements only in the vestibular functions. Results supported that highly efficient transduction is one of the key factors for achieving the efficacy and maintaining the long-term therapeutic effect. Secondary outcomes of treatment included improved birth and litter survival rates. Our results demonstrated that gene therapy via the canalostomy approach, which has been considered to be one of the more feasible delivery methods for human inner ear gene therapy, preserved auditory and vestibular functions in a dose-dependent manner in a mouse model of JLNS2.


Assuntos
Terapia Genética/métodos , Vetores Genéticos/administração & dosagem , Síndrome de Jervell-Lange Nielsen/terapia , Canais de Potássio de Abertura Dependente da Tensão da Membrana/genética , Canais Semicirculares/cirurgia , Animais , Animais Recém-Nascidos , Modelos Animais de Doenças , Feminino , Vetores Genéticos/genética , Audição/genética , Humanos , Injeções/métodos , Síndrome de Jervell-Lange Nielsen/genética , Masculino , Camundongos , Camundongos Knockout , Parvovirinae/genética , Propriocepção/genética
4.
PLoS One ; 15(12): e0242704, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33351854

RESUMO

In this study we present a kinematic approach for modeling needle insertion into soft tissues. The kinematic approach allows the presentation of the problem as Dirichlet-type (i.e. driven by enforced motion of boundaries) and therefore weakly sensitive to unknown properties of the tissues and needle-tissue interaction. The parameters used in the kinematic approach are straightforward to determine from images. Our method uses Meshless Total Lagrangian Explicit Dynamics (MTLED) method to compute soft tissue deformations. The proposed scheme was validated against experiments of needle insertion into silicone gel samples. We also present a simulation of needle insertion into the brain demonstrating the method's insensitivity to assumed mechanical properties of tissue.


Assuntos
Injeções/estatística & dados numéricos , Modelos Estatísticos , Agulhas , Silicones/análise , Fenômenos Biomecânicos , Encéfalo/anatomia & histologia , Simulação por Computador , Humanos , Injeções/instrumentação , Injeções/métodos , Manequins , Modelos Anatômicos , Silicones/química , Estresse Mecânico
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.
Medicine (Baltimore) ; 99(46): e23249, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181715

RESUMO

Levodopa-carbidopa intestinal gel (LCIG) is a method of continuous administration of levodopa - the standard treatment in Parkinson disease (PD, a neurodegenerative disorder characterized by resting tremor, rigidity, gait impairment, and bradykinesia), thought to reduce the short-life and pulsatile problems of oral administration. We aimed to study the effects of Levodopa-Carbidopa therapy in 2 separate groups: one with intrajejunal administration of Levodopa-Carbidopa gel and the second with oral therapy.We performed an observational retrospective Romanian cohort study on 61 patients diagnosed with PD patients, with Hoehn and Jahr 3 and 4 stages, recruited from a single regional tertiary center in Cluj-Napoca, Romania, between 2009 and 2019.The mean adjusted UPDRS III (and similarly for UPDRS II) improved in the LCIG compared to the oral therapy group with 15.6 (95% CI 12.0-19.2, P < .001), and with 18.4 (95% CI 13.8-22.9, P < .001), stratified for the Hoehn and Jahr stages 3 and 4. There was a 41.7% (10) reduction in dyskinesia, and 29.2% reduction in wearing off/on-off at 1 year in the LCIG group compared to 0% (0) dyskinesia reduction, and 2.7% reduction in wearing off/on-off in the oral therapy group.Continuous intrajejunal infusion of LCIG ensures a significant and clinical reduction in motor fluctuations compared to oral therapy in advanced PD, even after adjustment for important confounders.


Assuntos
Carbidopa/administração & dosagem , Jejuno/efeitos dos fármacos , Levodopa/administração & dosagem , Doença de Parkinson/tratamento farmacológico , Administração Oral , Idoso , Idoso de 80 Anos ou mais , Carbidopa/uso terapêutico , Estudos de Coortes , Combinação de Medicamentos , Feminino , Humanos , Injeções/métodos , Injeções/normas , Levodopa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Romênia
7.
Medicine (Baltimore) ; 99(43): e22739, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120774

RESUMO

OBJECTIVES: It was recently proposed that a costoclavicular (CC) approach can be used in ultrasound (US)-guided infraclavicular brachial plexus block (BPB). In this study, we hypothesized that triple injections in each of the 3 cords in the CC space would result in a greater spread in the 4 major terminal nerves of the brachial plexus than a single injection in the CC space without increasing the local anesthetic (LA) volume. METHODS: Sixty-eight patients who underwent upper extremity surgery randomly received either a single injection (SI group, n = 34) or a triple injection (TI group, n = 34) using the CC approach. Ten milliliters of 2% lidocaine, 10 mL of 0.75% ropivacaine, and 5 mL of normal saline were used for BPB in each group (total 25 mL). Sensory-motor blockade of the ipsilateral median, radial, ulnar, and musculocutaneous nerves was assessed by a blinded observer at 5 minutes intervals for 30 minutes immediately after LA administration. RESULTS: Thirty minutes after the block, the blockage rate of all 4 nerves was significantly higher in the TI group than in the SI group (52.9% in the SI group vs 85.3% in the TI group, P = .004). But there was no significant difference in the anesthesia grade between the 2 groups (P = .262). The performance time was similar in the 2 groups (3.0 ±â€Š0.9 minutes in the SI group vs 3.2 ±â€Š1.2 minutes in the TI group, respectively; P = .54). DISCUSSION: The TI of CC approach increased the consistency of US-guided infraclavicular BPB in terms of the rate of blocking all 4 nerves without increasing the procedure time despite administering the same volume of the LA.


Assuntos
Anestésicos Locais/administração & dosagem , Bloqueio do Plexo Braquial/métodos , Antebraço/cirurgia , Mãos/cirurgia , Lidocaína/administração & dosagem , Ropivacaina/administração & dosagem , Adulto , Clavícula , Feminino , Humanos , Injeções/métodos , Injeções/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Resultado do Tratamento
8.
Medicine (Baltimore) ; 99(43): e22872, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120828

RESUMO

BACKGROUND: Shock is a major public health problem worldwide. At present, the morbidity and mortality of shock patients are relatively high. Vasomotor dysfunction is 1 of the key pathological aspects of shock. Shenfu injection has been widely used for the treatment of shock in China. Pharmacological studies have suggested that Shenfu injection can reduce peripheral circulation resistance and improve microcirculation. The purpose of this study is to evaluate the effect and safety of Shenfu injection on the microcirculation of patients with shock. METHODS: This review summarizes and meta-analyzes randomized controlled trials of Shenfu injection for the treatment of shock.Searched the following electronic databases: PubMed, Cochrane Library, Embase, CNKI, VIP and Wanfang Data. The Cochrane risk assessment tool was used to evaluate the methodological quality of randomized controlled trials. All tests are analyzed according to the standards of the Cochrane Handbook. Review Manager 5.3, R-3.5.1 software and Grading of Recommendations Assessment, Development, and Evaluation pro GDT web solution are used for data synthesis and analysis. RESULTS: This review focuses on the effects of Shenfu injection on the microcirculation of shock patients (blood lactic acid level, arteriovenous oxygen saturation, arteriovenous carbon dioxide partial pressure difference, sublingual microcirculation), 28-day mortality, 28-day ICU hospitalization and adverse reaction rate. CONCLUSION: This review provides a clear basis for evaluating the impact of Shenfu injection on the microcirculation of shock patients, as well as the effectiveness and safety of the treatment.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Microcirculação/efeitos dos fármacos , Choque/tratamento farmacológico , Estudos de Casos e Controles , China/epidemiologia , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Hospitalização/tendências , Humanos , Injeções/métodos , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Placebos/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Choque/mortalidade , Resultado do Tratamento
10.
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
11.
Cochrane Database Syst Rev ; 8: CD013063, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32797689

RESUMO

BACKGROUND: Despite substantial improvements in the success of assisted reproduction techniques (ART), live birth rates may remain consistently low, and practitioners may look for innovative treatments to improve the outcomes. The injection of embryo culture supernatant in the endometrial cavity can be undertaken at various time intervals before embryo transfer. It provides an altered endometrial environment through the secretion of factors considered to facilitate implantation. It is proposed that injection of the supernatant into the endometrial cavity prior to embryo transfer will stimulate the endometrium and provide better conditions for implantation to take place. An increased implantation rate would subsequently increase rates of clinical pregnancy and live birth, but current robust evidence on the efficacy of injected embryo culture supernatant is lacking. OBJECTIVES: To evaluate the effectiveness and safety of endometrial injection of embryo culture supernatant before embryo transfer in women undergoing ART. SEARCH METHODS: Our search strategies were designed with the help of the Cochrane Gynaecology and Fertility Group Information Specialist. We sought to identify all published and unpublished randomised controlled trials (RCTs) meeting inclusion criteria. Searches were performed on 2 December 2019. We searched the Cochrane Gynaecology and Fertility Group Specialised Register of controlled trials, CENTRAL, MEDLINE, Embase, CINAHL, trials registries and grey literature. We made further searches in the UK National Institute for Health and Care Excellence (NICE) fertility assessment and treatment guidelines. We handsearched reference lists of relevant systematic reviews and RCTs, together with searches of PubMed and Google for any recent trials that have not yet been indexed in the major databases. We had no language or location restrictions. SELECTION CRITERIA: We included RCTs testing the use of endometrial injection of embryo culture supernatant before embryo transfer during an ART cycle, compared with the non-use of this intervention, the use of placebo or the use of any other similar drug. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed risk of bias, extracted data from studies and attempted to contact the authors where data were missing. We pooled studies using a fixed-effect model. Our primary outcomes were live birth/ongoing pregnancy and miscarriage. We performed statistical analysis using Review Manager 5. We assessed evidence quality using GRADE methods. MAIN RESULTS: We found five RCTs suitable for inclusion in the review (526 women analysed). We made two comparisons: embryo culture supernatant use versus standard care or no intervention; and embryo culture supernatant use versus culture medium. All studies were published as full-text articles. Data derived from the reports or through direct communication with investigators were available for the final meta-analysis performed. The GRADE evidence quality of studies ranged from very low-quality to moderate-quality. Factors reducing evidence quality included high risk of bias due to lack of blinding, unclear risk of publication bias and selective outcome reporting, serious inconsistency among study outcomes, and serious imprecision due to wide confidence intervals (CIs) and low numbers of events. Comparison 1. Endometrial injection of embryo culture supernatant before embryo transfer versus standard care or no intervention: One study reported live birth only and two reported the composite outcome live birth and ongoing pregnancy. We are uncertain whether endometrial injection of embryo culture supernatant before embryo transfer during an ART cycle improves live birth/ongoing pregnancy rates compared to no intervention (odds ratio (OR) 1.11, 95% CI 0.73 to 1.70; 3 RCTs; n = 340, I2 = 84%; very low-quality evidence). Results suggest that if the chance of live birth/ongoing pregnancy following placebo or no treatment is assumed to be 42%, the chance following the endometrial injection of embryo culture supernatant before embryo transfer would vary between 22% and 81%. We are also uncertain whether the endometrial injection of embryo culture supernatant could decrease miscarriage rates, compared to no intervention (OR 0.89, 95% CI 0.44 to 1.78, 4 RCTs, n = 430, I2 = 58%, very low-quality evidence). Results suggest that if the chance of miscarriage following placebo or no treatment is assumed to be 9%, the chance following injection of embryo culture supernatant would vary between 3% and 30%. Concerning the secondary outcomes, we are uncertain whether the injection of embryo culture supernatant prior to embryo transfer could increase clinical pregnancy rates (OR 1.13, 95% CI 0.80 to 1.61; 5 RCTs; n = 526, I2 = 0%; very low-quality evidence), decrease ectopic pregnancy rates (OR 0.32, 95% CI 0.01 to 8.24; n = 250; 2 RCTs; I2 = 41%; very low-quality evidence), decrease multiple pregnancy rates (OR 0.70, 95% CI 0.26 to 1.83; 2 RCTs; n = 150; I2 = 63%; very low-quality evidence), or decrease preterm delivery rates (OR 0.63, 95% CI 0.17 to 2.42; 1 RCT; n = 90; I2 = 0%; very low-quality evidence), compared to no intervention. Finally, there may have been little or no difference in foetal abnormality rates between the two groups (OR 3.10, 95% CI 0.12 to 79.23; 1 RCT; n = 60; I2 = 0%; low-quality evidence). Comparison 2. Endometrial injection of embryo culture supernatant versus endometrial injection of culture medium before embryo transfer We are uncertain whether the use of embryo culture supernatant improves clinical pregnancy rates, compared to the use of culture medium (OR 1.09, 95% CI 0.48 to 2.46; n = 96; 1 RCT; very low-quality evidence). No study reported live birth/ongoing pregnancy, miscarriage, ectopic or multiple pregnancy, preterm delivery or foetal abnormalities. AUTHORS' CONCLUSIONS: We are uncertain whether the addition of endometrial injection of embryo culture supernatant before embryo transfer as a routine method for the treatment of women undergoing ART can improve pregnancy outcomes. This conclusion is based on current available data from five RCTs, with evidence quality ranging from very low to moderate across studies. Further large well-designed RCTs reporting on live births and adverse clinical outcomes are still required to clarify the exact role of endometrial injection of embryo culture supernatant before embryo transfer.


Assuntos
Meios de Cultura , Técnicas de Cultura Embrionária , Endométrio , Infertilidade Feminina/terapia , Técnicas de Reprodução Assistida , Aborto Espontâneo/epidemiologia , Viés , Transferência Embrionária , Feminino , Humanos , Injeções/métodos , Nascimento Vivo , Gravidez , Taxa de Gravidez , Gravidez Ectópica/epidemiologia , Gravidez Múltipla/estatística & dados numéricos , Nascimento Prematuro/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
Medicine (Baltimore) ; 99(32): e21590, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32769913

RESUMO

BACKGROUND: As one of the common cardiovascular diseases, acute myocardial infarction (AMI) is characterized by a high mortality rate, frequent complications, and a serious threat to human health and quality of life. Traditional Chinese medicine injection (TCMI) has been used clinically to treat AMI; however, there is no uniform standard for clinical treatment of AMI. The purpose of this study is to evaluate the efficacy and safety of different TCMI by using systematic review and network meta-analysis. METHODS: According to the strategy, the authors will retrieve both 4 Chinese databases and 3 English databases by June 30, 2020. After a series of screening, randomized controlled trials will be included related to TCMI for AMI. Two researchers will use Aggregate Data Drug Information System and STATA 15.0 to analyze the data. Finally, the evidence grade of the results will be evaluated. RESULTS: This study will provide a reliable evidence for the selection of TCMI therapies for AMI. CONCLUSION: The results of this study will provide references for evaluating the influence of different TCMI therapies for AMI, and provide decision-making references for clinical research. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/FYGBT.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Resultado do Tratamento , Medicamentos de Ervas Chinesas/normas , Humanos , Injeções/métodos , Metanálise como Assunto , Infarto do Miocárdio , Qualidade de Vida/psicologia , Revisões Sistemáticas como Assunto
13.
PLoS One ; 15(8): e0236624, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760093

RESUMO

PURPOSE: To compare pain during pars plana vitrectomy (PPV) following topical lidocaine jelly and sub-Tenon anesthesia versus peribulbar anesthesia. METHODS: Prospective, single-center, randomized study. Patients scheduled for PPV for macular hole (MH) or epiretinal membrane (ERM) at the Retina and Vitreous Section of the Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo were randomly assigned to one of two groups in a 1:1 allocation ratio. Patients assigned to Group ST received topical anesthesia with 2% lidocaine jelly followed by sub-Tenon anesthesia with 2-4 ml of 1% ropivacaine. Patients assigned to PB received peribulbar anesthesia with 4-6 ml of 1% ropivacaine. After PPV, patients in both groups were asked to rate the level of pain they felt during the entire procedure (including anesthesia administration and PPV) by pointing at a 0-100 Visual Analogue Pain Scale (VAS). Data regarding demographics, patient characteristics and surgical features were also collected. RESULTS: Fifty-four patients were enrolled in the study (26 in Group ST and 28 in Group PB). Baseline characteristics, including age, gender, and presence of comorbidities, were similar in both groups. The surgery performed was PPV alone in 10 and 14 patients in the ST and PB groups, respectively, and combined phacoemulsification and PPV in 16 and 14 patients in the ST and PB groups, respectively (p = 0.39, Pearson). Surgery duration (mean ± SD minutes) was similar in the two groups (62 ± 12 for ST and 70 ± 20 for PB, p = 0.09, t-Test). No patients needed supplemental topical or intravenous anesthesia during surgery. No sight- or life-threatening complication was observed in either group. VAS score was significantly lower in the ST compared to the PB group (median (interquartile range) was 1 (2.25-0) in the ST group compared to 11.5 (29.75-5) in the PB group, p< 0.0001, Wilcoxon). CONCLUSION: In this study of patients who underwent PPV for MH or ERM, topical followed by sub-Tenon anesthesia was more effective in controlling pain during the whole vitrectomy procedure than peribulbar anesthesia. Compared to peribulbar anesthesia which is administered with a sharp needle, sub-Tenon anesthesia administered with a blunt cannula may be associated with a reduced risk of such adverse events as globe perforation, retrobulbar hemorrhage, and inadvertent injection of anesthesia into the optic nerve sheath.


Assuntos
Anestesia Local , Anestésicos Locais , Injeções/métodos , Lidocaína , Ropivacaina , Vitrectomia , Idoso , Feminino , Humanos , Injeções Intraoculares/métodos , Masculino , Pessoa de Meia-Idade , Manejo da Dor/métodos , Medição da Dor/métodos , Estudos Prospectivos
14.
Medicine (Baltimore) ; 99(34): e21952, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846865

RESUMO

BACKGROUND: Sodium cantharidinate/vitamin B6 (SC/VB6) injection, a famous insect-derived traditional Chinese medicine preparation, has been widely applied as a promising adjunctive drug for hepatocellular carcinoma (HCC). However, its exact clinical efficacy and safety is still not well investigated. In this study, we aimed to summarize the efficacy of SC/VB6 injection on survival, liver function, immune function, and quality of life (QoL) in patients with HCC through the meta-analysis. METHODS: All available randomized controlled trials (RCTs) and high-quality prospective cohort studies that investigated the efficacy and safety of SC/VB6 for patients with HCC were searched from ten electronic databases including PubMed, Google Scholar, Cochrane Library, Excerpt Medica Database (Embase), Medline, Web of Science (WOS), Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), China Scientific Journal Database (CSJ), and Wanfang Database. Papers in Chinese or English published from January 2000 to July 2020 will be included without any restrictions.Study selection and data extraction will be performed independently by 2 researchers. The clinical outcomes including overall survival (OS), QoL, liver function, immune function, and adverse events, were systematically evaluated. Review Manager 5.3 and Stata 14.0 were used for data analysis, and the quality of the clinical trials was also evaluated. RESULTS: The results of this study will be published in a peer-reviewed journal, and provide a helpful evidence for clinicians to formulate the best postoperative adjuvant treatment strategy for HCC patients. CONCLUSION: Our study will draw an objective conclusion of the efficacy of SC/VB6 on survival, liver function, immune function, and QoL in patients with HCC. INPLASY REGISTRATION NUMBER: INPLASY202070121.


Assuntos
Cantaridina/análogos & derivados , Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas/patologia , Vitamina B 6/farmacologia , Complexo Vitamínico B/farmacologia , Cantaridina/administração & dosagem , Cantaridina/farmacologia , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/psicologia , China/epidemiologia , Quimioterapia Combinada/métodos , Humanos , Sistema Imunitário/efeitos dos fármacos , Injeções/métodos , Fígado/efeitos dos fármacos , Medicina Tradicional Chinesa/métodos , Estudos Prospectivos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Sobrevida , Resultado do Tratamento , Vitamina B 6/administração & dosagem , Complexo Vitamínico B/administração & dosagem
15.
Medicine (Baltimore) ; 99(27): e21155, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629751

RESUMO

BACKGROUND: Brucea javanica oil emulsion injection (BJOEI) has been widely applied as a promising adjunctive drug for colorectal carcinoma (CRC). However, the exact effects and safety of BJOEI remains controversial. In this study, we aimed to summarize the efficacy and safety of BJOEI for the treatment of advanced CRC through the meta-analysis, in order to provide scientific reference for the design of future clinical trials. METHODS: Eligible prospective controlled clinical trials were searched from PubMed, Cochrane Library, Google Scholar, Medline, Web of Science (WOS), Excerpt Medica Database (Embase), Chinese BioMedical Database (CBM), China Scientific Journal Database (VIP), China National Knowledge Infrastructure (CNKI) and Wanfang Database. Papers in English or Chinese published from January 2000 to May 2020 will be included without any restrictions. The clinical outcomes including therapeutic effects, quality of life (QoL), immune function and adverse events, were systematically evaluated.Study selection and data extraction will be performed independently by 2 reviewers. Review Manager 5.3 and Stata 14.0 were used for data analysis, and a fixed or random-effect model will be used depending upon the heterogeneity observed between trials. Subgroup and meta-regression analysis will be carried out depending on the availability of sufficient data. RESULTS: The results of this systematic review will be published in a peer-reviewed journal. CONCLUSION: Our study will draw an objective conclusion of the effects and safety of BJOEI for advanced CRC, and provide a helpful evidence for clinicians to formulate the best postoperative adjuvant treatment strategy for CRC patients.INPLASY registration number: INPLASY202060014.


Assuntos
Brucea/efeitos adversos , Quimioterapia Adjuvante/métodos , Neoplasias Colorretais/tratamento farmacológico , Emulsões/administração & dosagem , Estudos de Casos e Controles , China/epidemiologia , Neoplasias Colorretais/psicologia , Emulsões/uso terapêutico , Feminino , Humanos , Injeções/métodos , Masculino , Estudos Prospectivos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Resultado do Tratamento
16.
J Vis Exp ; (159)2020 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-32538907

RESUMO

The treatment of ARDS continues to pose major challenges for intensive care physicians in the 21st century with mortality rates still reaching up to 50% in severe cases. Further research efforts are needed to better understand the complex pathophysiology of this disease. There are different well-established animal models to induce acute lung injury but none has been able to adequately mimic the complex pathomechanisms of ARDS. The most crucial factor for the development of this condition is the damage to the alveolar capillary unit. The combination of two well-established lung injury models allow us to mimic in more detail the underlying pathomechanism. Bronchoalveolar lavage (BAL) leads to surfactant depletion as well as alveolar collapse. The repeated instillation of fluid volumes causes subsequent hypoxemia. Surfactant depletion is a key factor of ARDS in humans. BAL is often combined with other lung injury approaches, but not with a second hit followed by oleic acid injection (OAI) yet. Oleic acid injection leads to severely impaired gas exchange, a deterioration of lung mechanics and disruption of the alveolo-capillary barrier. The OAI mimics most of the expected effects of ARDS consisting of extended inflammation of lung tissue with an increase of alveolar leakage and gas exchange impairment. A disadvantage of the combination of different models is the difficulty to determine the influence to the lung injury caused by BAL alone, OAI alone or both together. The model presented in this report represents the combination of BAL and OAI as a new double-hit lung injury model. This new model is easy to implement and an alternative to study different therapeutic approaches in ARDS in the future.


Assuntos
Lavagem Broncoalveolar/métodos , Injeções/métodos , Ácido Oleico/uso terapêutico , /diagnóstico , Animais , Modelos Animais de Doenças , Humanos , Ácido Oleico/farmacologia , Suínos
17.
Medicine (Baltimore) ; 99(26): e20984, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590810

RESUMO

BACKGROUND: Esophageal carcinoma (EC) is one of the worst malignant digestive neoplasms with a strong tendency of invasion and metastasis. Despite the improvement of diagnostic and therapeutic methods in the past decades, the prognosis of EC remains unsatisfactory. Xiaoaiping injection (XAPI), a famous traditional Chinese herbal medicine, has been widely applied as a promising adjunctive drug for EC. However, the exact effects and safety of XAPI have yet to be systematically investigated. We aimed to summarize the efficacy and safety of XAPI for the treatment of advanced EC through the meta-analysis, in order to provide scientific reference for the design of future clinical trials. METHODS: Relevant randomized controlled trials (RCTs) were searched from Cochrane Library, PubMed, Google Scholar, Web of Science, Excerpt Medica Database, Medline, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, China Scientific Journal Database and Wanfang Database. Papers in English or Chinese published from January 2000 to May 2020 will be included without any restrictions.Study selection and data extraction will be performed independently by 2 investigators. The clinical outcomes including overall response rate, complete response rate, overall survival, Disease-free survival, quality of life, immune function and adverse events, were systematically evaluated. Review Manager 5.3 and Stata 14.0 were used for data analysis, and the quality of the studies was also evaluated. RESULTS: The results of this study will be published in a peer-reviewed journal, and provide more evidence-based guidance in clinical practice. CONCLUSION: Our study will draw an objective conclusion of the effects of XAPI combined with conventional treatment for advanced EC and provide a helpful evidence for clinicians to formulate the best postoperative adjuvant treatment strategy for EC patients. INPLASY REGISTRATION NUMBER: INPLASY202050094.


Assuntos
Protocolos Clínicos , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/fisiopatologia , Humanos , Injeções/métodos , Medicina Tradicional Chinesa/normas , Metanálise como Assunto , Revisões Sistemáticas como Assunto
18.
PLoS One ; 15(5): e0230009, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32379827

RESUMO

Safety critical events in robotic applications can often be characterized by forces between the robot end-effector and the environment. One application in which safe interaction between the robot and environment is critical is in the area of medical robots. In this paper, we propose a novel Compact Form Dynamic Linearization Model-Free Prediction (CFDL-MFP) technique to predict future values of any time-series sensor data, such as interaction forces. Existing time series forecasting methods have high computational times which motivates the development of a novel technique. Using Autoregressive Integrated Moving Average (ARIMA) forecasting as benchmark, the performance of the proposed model was evaluated in terms of accuracy, computation efficiency, and stability on various force profiles. The proposed algorithm was 11% more accurate than ARIMA and maximum computation time of CFDL-MFP was 4ms, compared to ARIMA (7390ms). Furthermore, we evaluate the model in the special case of predicting needle buckling events, before they occur, by using only axial force and needle-tip position data. The model was evaluated experimentally for robustness with steerable needle insertions into different tissues including gelatin and biological tissue. For a needle insertion velocity of 2.5mm/s, the proposed algorithm was able to predict needle buckling 2.03s sooner than human detections. In biological tissue, no false positive or false negative buckling detections occurred and the rates were low in artificial tissue. The proposed forecasting model can be used to ensure safe robot interactions with delicate environments by predicting adverse force-based events before they occur.


Assuntos
Previsões/métodos , Injeções/instrumentação , Injeções/métodos , Robótica/métodos , Robótica/tendências , Algoritmos , Animais , Fenômenos Biomecânicos , Cadáver , Confiabilidade dos Dados , Gelatina , Humanos , Fígado , Aprendizado de Máquina , Modelos Biológicos , Modelos Estatísticos , Agulhas , Suínos
19.
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
20.
Libyan J Med ; 15(1): 1753943, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32281500

RESUMO

Knee Osteoarthritis is a considerable public health concern, both in terms of life quality and treatment financial impacts. To investigate this disease, animal models are deemed a promising alternative. In fact, although a perfect model is generally farfetched, the creation of models that simulate human disease as accurately as possible remains an important research stake. This study aims to highlight the usefulness of the model induced by injected Mono-Iodo-Acetate and to standardize it for the rabbit species. Osteoarthritis was induced by an infra-patellar injection of 0.2 ml of an MIA solution in the left knee of 24 female New Zealand rabbits. The right knee served as a control by receiving an injection of physiological serum. The rabbits were divided into 4 groups of 6 individuals each according to the dose of MIA received per knee. All rabbits were euthanized 30 days after the injection. After sacrifice, the knees were carefully dissected and macroscopic and microscopic scores of cartilage, meniscal and synovial lesions were attributed to each group. Our study followed the laboratory animal care and management guideline published in 2017 by the Canadian Council of Animal Care. The control knees of all rabbits showed no macroscopic or microscopic lesions. The macroscopic lesions: osteophytes, meniscal lesions, fibrillation and erosion of the cartilage and microscopic lesions: disorganization of the chondrocytes, decrease in proteoglycans and synovial inflammation clinically diagnosed in human pathology were all detected and were similarly reproducible among the knees of the same group. Through this work, we highlighted the merits of the arthritis model induced by MIA, namely its simulation of several aspects of human pathology. Further advantages are low cost, speed, reproducibility. This model notably avoids delicate and risky surgical operations.


Assuntos
Inibidores Enzimáticos/administração & dosagem , Ácido Iodoacético/administração & dosagem , Osteoartrite do Joelho/induzido quimicamente , Animais , Bolsa Sinovial/patologia , Bolsa Sinovial/ultraestrutura , Canadá/epidemiologia , Cartilagem/patologia , Cartilagem/ultraestrutura , Condrócitos/patologia , Modelos Animais de Doenças , Inibidores Enzimáticos/efeitos adversos , Feminino , Humanos , Injeções/métodos , Ácido Iodoacético/efeitos adversos , Menisco/patologia , Menisco/ultraestrutura , Osteoartrite do Joelho/patologia , Osteoartrite do Joelho/veterinária , Proteoglicanas/metabolismo , Coelhos , Reprodutibilidade dos Testes
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