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1.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 6-11, jan.-dez. 2020. ilus
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1047826

RESUMO

Objetivo: compreender a utilização da técnica broken needle de punção venosa periférica na prática profissional de assistência a neonatos prematuros. Método: estudo qualitativo realizado por meio de entrevista a profissionais da assistência neonatal submetida à Análise de Conteúdo segundo Bardin. Resultados: foram identificadas as categorias: percepções dos profissionais quanto aos benefícios da técnica broken needle para o neonato; e aprendizado e vivência profissional da técnica broken needle. Conclusão: a transferência do conhecimento de um profissional ao outro favoreceu a incorporação da técnica na instituição. A equipe se preocupa em realizar técnicas que sejam menos agressivas ao neonato e, portanto, realizam a broken needle porque acreditam que seja mais vantajosa e benéfica e não tenha efeitos adversos ao neonato. Os profissionais decidem qual técnica utilizar, levando em consideração as características anatômicas e clínicas do neonato, a sua habilidade e a segurança na execução


Objective: to understand the use of the broken needle technique peripheral venous puncture in the professional practice of assistance to preterm infants. Method: qualitative study conducted through interviews with neonatal care professionals submitted to Content Analysis to Bardin. Results: the following categories were identified: Professional perceptions regarding the benefits of the broken needle technique for the neonate; Learning and professional experience of broken needle technique. Conclusion: the transfer of knowledge from one professional to another favored the incorporation of the technique in the institution. The team is concerned with performing techniques that are less aggressive to the newborn and therefore perform the broken needle because they believe it is more advantageous and beneficial and has no adverse effects on the neonate. The professionals decide which technique to use taking into account the anatomical and clinical characteristics of the neonate, their ability and safety in the execution


Objetivo: comprender el uso de la técnica broken needle de punción venosa periférica en la práctica profesional de asistencia a neonatos prematuros. Método: estudio cualitativo realizado por medio de entrevista a profesionales de la asistencia neonatal sometida al Análisis de Contenido según Bardin. Resultados: se identificaron las categorías: Percepciones de los profesionales en cuanto a los beneficios de la técnica broken needle para el neonato; Aprendizaje y vivencia profesional de la técnica broken needle. Conclusión: la transferencia del conocimiento de un profesional al otro favoreció la incorporación de la técnica en la institución. El equipo se preocupa de realizar técnicas que sean menos agresivas al neonato y, por lo tanto, realizan la técnica porque creen que es más ventajosa y benéfica y no tiene efectos adversos al neonato. Los profesionales deciden qué técnica utilizar teniendo en cuenta las características anatómicas y clínicas del neonato, su habilidad y seguridad en la ejecución


Assuntos
Humanos , Recém-Nascido , Recém-Nascido Prematuro , Coleta de Amostras Sanguíneas , Punções , Brasil , Enfermagem Neonatal
2.
Sud Med Ekspert ; 62(6): 58-62, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825335

RESUMO

A rare case of a lethal outcome due to iatrogenic damage to the intercostal vessel, a collateral branch of the posterior intercostal artery, is described. The little-known features of the topography of this vessel (location on the upper edge of the underlying rib), which requires further study in the context of variable anatomy, are given. The risks associated with deviations from the traditionally recommended sites of pleural puncture (below the eighth intercostal space to the scapular line) are substantiated. An analysis of the characteristics of bleeding arising from the intercostal vessels (from two ends, under high pressure, etc.) is given, which implies the extreme importance of a timely diagnosis. Differing points of view on the legal assessment of malpractice when care is delivered by a series of doctors, and the legal necessity of determining the 'point of no return' (the latest moment after the onset of bleeding, in which medical aid can still prevent an unfavorable outcome), are considered. An opinion is expressed on the need for the active participation (initiative) of an expert in the provision of expertise.


Assuntos
Doença Iatrogênica , Pleura , Punções , Humanos , Pleura/lesões
3.
Zhonghua Shao Shang Za Zhi ; 35(11): 811-813, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31775470

RESUMO

Objective: To explore the effect of tracheotomy combined with thyrocricocentesis and puncture of front tracheal wall in emergency treatment of laryngeal edema in patients with burns. Methods: From November 2000 to August 2018, 22 patients with severe burn or extremely severe burn combined with acute laryngeal edema were rescued in the author's unit, including 18 males and 4 females, aged 17 to 68 years. All patients were complicated with mild inhalation injury or above and more than deep partial-thickness burn to head, face, and neck. From November 2000 to October 2012, simple emergency tracheotomy was performed for 12 cases. From May 2013 to August 2018, tracheotomy combined with thyrocricocentesis and puncture of front tracheal wall was performed for 10 cases. Rescue effect and complication of the two kinds of tracheotomy were recorded. Data were processed with Fisher's exact probability test. Results: Among the 12 patients treated with simple emergency tracheotomy, 5 cases survived and 7 cases died of suffocation during tracheotomy. Among the 10 patients treated with tracheotomy combined with thyrocricocentesis and puncture of front tracheal wall, 9 cases survived and 1 case died of cardiac arrest caused by arrhythmia. There was statistically significant difference in successful rescue effect between the two kinds of tracheotomy (P<0.05). Among the 14 patients who were successfully rescued, symptoms of insomnia and post-traumatic stress disorder occurred in 12 cases, which were relieved after symptomatic treatment for 14 to 45 d without permanent hypoxic brain damage. Conclusions: In case of loss of the condition of preventive tracheotomy, first aid of acute laryngeal edema of burn patient is very difficult. Tracheotomy combined with thyrocricocentesis and puncture of front tracheal wall is simple and rapid with high successful rate and amelioration of hypoxia, which is an ideal plan for laryngeal edema.


Assuntos
Obstrução das Vias Respiratórias , Queimaduras/cirurgia , Tratamento de Emergência , Edema Laríngeo/cirurgia , Traqueotomia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Punções , Adulto Jovem
4.
Zhonghua Gan Zang Bing Za Zhi ; 27(10): 777-781, 2019 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-31734992

RESUMO

Objective: To investigate the safety, feasibility, and preliminary clinical experience of ultrasonic guided percutaneous portal vein punctures combined bi-directional angiography in the treatment by transjugular intrahepatic portosystemic shunt(TIPS). Methods: From January 2016 to June 2018, 15 patients with TIPS from our hospital who were treated by ultrasonic guided percutaneous portal vein punctures combined with bi-directional angiography were enrolled,and were recruited as experimental group. During the same period, 30 patients who were treated by TIPS combined with traditional methods were enrolled, and were recruited as control group. There was no statistical difference in baseline characteristics between the two groups (P > 0.05). The portal pressure difference in preoperative and postoperative, the fluoroscopy time, the number of puncture needles and complications were recorded. After treatment, the patients were followed up through outpatient service or telephone method. Results: The technical success rate was 100% in experimental group, and 96.7% in control group. In the experimental group, number of percutaneous transhepatic portal vein puncture by needle was 1-3 (average, 2.13 ± 0.74), and the number of portal vein puncture needles in the control group were 1-11 (average, 4.16 ± 2.13). The number of puncture needles in the experimental group were significantly decreased than in the control group (P < 0.001). In the experimental group, the fluoroscopy time was 18 ~ 46 (average 29.64 ± 8.79) minutes. In the control group, the fluoroscopy time was 12 ~ 150 (average 44.57 ± 26.84) minutes.The fluoroscopy time was significantly reduced in the experimental group compared with the control group(P = 0.023). Conclusion: Ultrasound-guided portal vein combined with bidirectional angiog-raphy is safe, feasible, and reliable in the treatment by TIPS. Compare with traditional TIPS, it can reduce the fluoroscopy time, the number of puncture needles and the liver injury.


Assuntos
Veia Porta/diagnóstico por imagem , Derivação Portossistêmica Transjugular Intra-Hepática , Angiografia , Fluoroscopia , Humanos , Agulhas , Pressão na Veia Porta , Punções , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia
5.
Medicine (Baltimore) ; 98(45): e17910, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702668

RESUMO

To evaluate the safety and efficacy of total percutaneous closure of the femoral artery access site after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) with the Perclose ProGlide device.This retrospective observational study during an almost 2-year period included 21 patients who underwent VA-ECMO in whom the femoral artery puncture site was closed percutaneously with Perclose ProGlide devices. Technical success was defined as successful arterial closure of the common femoral artery, without the need for additional surgical or endovascular procedures. Access site complications were recorded at 24 hours and 30 days after arterial closure, such as major bleeding requiring transfusion or surgical intervention, minor bleeding, groin infection, pseudoaneurysm, and lymphocele.Technical success was achieved in 20 patients (95.2%). One patient required surgical repair for an access site pseudoaneurysm. Eighteen femoral arteries were closed with 2 devices each, while 3 patients required the use of a third device for femoral artery access site closure to achieve adequate hemostasis. No arterial thrombosis, arterial dissection, arterial stenosis, groin infection, or arteriovenous fistula occurred during the periprocedural period (within 24 hours of arterial closure) or during 30-day follow-up.Percutaneous closure with the Perclose ProGlide device is a feasible procedure for closing femoral arterial access sites after VA-ECMO, with a low incidence of access site complications.


Assuntos
Oxigenação por Membrana Extracorpórea/efeitos adversos , Artéria Femoral/cirurgia , Hemostasia Cirúrgica/instrumentação , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Punções/efeitos adversos , Estudos Retrospectivos
6.
Yonsei Med J ; 60(11): 1112-1115, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31637895

RESUMO

Direct puncture and embolization of the transverse sinus (TS) for treatment of dural arteriovenous fistula (DAVF) is typically performed with coils with or without glue. We report a case of DAVF at the left TS that was treated with Onyx embolization via direct puncture of the TS. A 75-year-old woman presented with tremor, festinating gait, and dysarthria. A left TS-DAVF with retrograde superior sagittal sinus and cortical venous reflux (Cognard type IIa+b) was identified on cerebral angiography, and both TSs were occluded with thrombi. We considered that achieving complete cure by transvenous embolization via the femoral vein or transarterial embolization via occipital feeders would be difficult. Thus, we performed a small craniotomy at the occipital bone to puncture the TS. The midportion of the TS was directly punctured with a 21-G microneedle under fluoroscopic guidance. We inserted a 5-F sheath into the TS. A microcatheter was then navigated into the affected sinus. Coils were placed through the microcatheter to support Onyx formation by reducing the pressure of shunting flow. Onyx embolization was performed with the same microcatheter. The DAVF was almost completely occluded except for the presence of minimal shunting flow to the proximal TS. After 1 week, time-of-flight magnetic resonance angiography showed complete resolution of DAVF. The patient showed resolved tremor and markedly improved mental status at 1-month follow up. Direct puncture and embolization of the TS using coils and Onyx is effective and feasible method for the treatment of DAVF when other approaches seem difficult.


Assuntos
Malformações Vasculares do Sistema Nervoso Central/cirurgia , Embolização Terapêutica , Punções , Seios Transversos/cirurgia , Idoso , Malformações Vasculares do Sistema Nervoso Central/diagnóstico por imagem , Angiografia Cerebral , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Seios Transversos/diagnóstico por imagem , Resultado do Tratamento
7.
Arq Bras Cir Dig ; 32(3): e1454, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31644674

RESUMO

BACKGROUND: Percutaneous biliary drainage is a safe procedure. The risk of bleeding complications is acceptable. Frequently, patients with biliary obstructions usually have coagulation disorders thus increasing risk of bleeding. For this reason, patients should always fit the parameters of hemostasis. AIM: To determine whether the percentage of bleeding complications in percutaneous biliary drainage is greater in adults with corrected hemostasis prior to the procedure regarding those who did not require any. METHODS: : Prospective, observational, transversal, comparative by independent samples (unpaired comparison). Eighty-two patients with percutaneous biliary drainage were included. The average age was 64±16 years (20-92) being 38 male and 44 female. Patients who presented altered hemostasis were corrected and the presence of bleeding complications was evaluated with laboratory and ultrasound. RESULTS: Of 82 patients, 23 needed correction of hemostasis. The approaches performed were: 41 right, 30 left and 11 bilateral. The amount of punctures on average was 3±2. There were 13 (15.8%) bleeding complications, 12 (20%) in uncorrected and only one (4.34%) in the corrected group with no statistical difference. There were no differences in side, number of punctures and type of drainage, but number of passes and the size of drainage on the right side were different. There was no related mortality. CONCLUSION: Bleeding complications in patients requiring hemostasis correction for a percutaneous biliary drainage was not greater than in those who did not require any.


Assuntos
Perda Sanguínea Cirúrgica , Colestase/cirurgia , Drenagem/efeitos adversos , Hemostasia , Complicações Intraoperatórias/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cateteres , Colestase/sangue , Estudos Transversais , Drenagem/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Punções , Fatores de Risco , Adulto Jovem
9.
Zhonghua Yi Xue Za Zhi ; 99(38): 3005-3007, 2019 Oct 15.
Artigo em Chinês | MEDLINE | ID: mdl-31607033

RESUMO

Objective: To investigate the therapeutic effects of first phase renal puncture and drainage guided by B ultrasound and second phase percutaneous nephrolithotomy(PCNL) in the treatment of urinary calculi complicated with pyonephrosis. Methods: From January 2014 to April 2018, 28 patients with upper ureteral segment and kidney calculi complicated with pyonephrosis were collected. All patients received the pyonephrosis puncture under B ultrasound. After the inflammation was controlled and the clinical situation improved, the second phase was treated by PCNL. During the operation, routine in dwelling ureteral stent drainage and renal fistula wereperformed. The outcomes of the operation were observed. Results: A total of 28 cases were successfully punctured, the obstruction was relieved and the inflammation was controlled. Additionally, the second phase of PCNL surgery was successful, and there were no significant stone residues after PCNL. There were no complications such as severe systemic inflammatory response syndrome and severe hemorrhage. After 3 to 12 months of follow-up, renal function was restored to varying degrees, and there were no renal failure patients who needednephrectomy. Conclusions: Early diagnosis of urinary calculi complicated with pyonephrosis is the key to successful treatment. Active and effective B ultrasound-guided renal puncture and drainage, drainage of pus, and removal of urinary obstruction can improve the safety of the second phase of PCNL, and thus it attaches great importance to the treatment of pyonephrosis.


Assuntos
Cálculos Renais , Nefrolitotomia Percutânea , Nefrostomia Percutânea , Pionefrose , Drenagem , Humanos , Paracentese , Punções , Resultado do Tratamento
10.
Forensic Sci Int ; 304: 109965, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31610333

RESUMO

Facial soft tissue thicknesses (FSTT) form a key component of craniofacial identification methods, but as for any data, embedded measurement errors are highly pertinent. These in part dictate the effective resolution of the measurements. As herein reviewed, measurement methods are highly varied in FSTT studies and associated measurement errors have generally not been paid much attention. Less than half (44%) of 95 FSTT studies comment on measurement error and not all of these provide specific quantification. Where informative error measurement protocols are employed (5% of studies), the mean error magnitudes range from 3% to 45% rTEM and are typically in the order of 10-20%. These values demonstrate that FSTT measurement errors are similar in size to (and likely larger than) the magnitudes of many biological effects being chased. As a result, the attribution of small millimeter or submillimeter differences in FSTT to biological variables must be undertaken with caution, especially where they have not been repeated across different studies/samples. To improve the integrity of FSTT studies and the reporting of FSTT measurement errors, we propose the following standard: (1) calculate the technical error of measurement (TEM or rTEM) in any FSTT research work; (2) assess the error embedded in the full data collection procedure; and (3) conduct validation testing of FSTT means proposed for point estimation prior to publication to ensure newly calculated FSTT means provide improvements. In order to facilitate the latter, a freely available R tool TDValidator that uses the C-Table data for validation testing is provided.


Assuntos
Face/anatomia & histologia , Face/diagnóstico por imagem , Biópsia , Cefalometria , Coleta de Dados , Diagnóstico por Imagem/métodos , Medicina Legal , Humanos , Imagem Tridimensional , Punções , Caracteres Sexuais , Pele/patologia , Crânio/anatomia & histologia , Crânio/diagnóstico por imagem , Decúbito Dorsal
11.
Medicine (Baltimore) ; 98(40): e17477, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577781

RESUMO

The objective of this study was to compare clinical outcomes in patients who with unfavorable vascular anatomy underwent mechanical thrombectomy (MT) by common carotid artery access versus transfemoral approach.A retrospective review was performed in our hospital database to identify patients with challenging vascular anatomy who underwent MT for anterior circulation large vessel occlusion (LVO) between August 2015 and November 2018. Transcarotid and transfemoral cohorts were compared. Patient characteristics, procedural techniques, clinical outcomes were recorded.A total of 52 patients were included, 16 (31%) underwent MT via transcarotid access. There were no significant differences in patient characteristics, intravenously recombinant tissue plasminogen activator therapy, clot location, or carotid tortuosity and presence of aortic arch type. There were significant differences in clinical outcomes between the 2 cohorts, including mean access-to-reperfusion time (84 vs 44 minutes; P = .000), poor clinical outcome (modified Rankin scale >2) at 90 days follow-up (37.5% vs 63.9%; P = .034). But there were no significant differences in successful revascularization rates (thrombolysis in cerebral infarction score ≥2b 87.5% vs 80.6%; P = .541), post-thrombectomy symptomatic intracranial hemorrhage (12.5% vs 13.9%; P = .892), and mortality (12.5% vs 22.2%; P = .412) were similar between transcarotid and transfemoral cohorts.Our results demonstrate that transcarotid access for MT of anterior circulation LVO in patients with unfavorable vascular anatomy may be considerable. Transcarotid access may be better than transfemoral access in well-selected unfavorable vascular anatomy patients undergoing MT.


Assuntos
Artéria Carótida Primitiva/cirurgia , Procedimentos Endovasculares/métodos , Trombose Intracraniana/cirurgia , Trombectomia/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Artéria Femoral , Humanos , Trombose Intracraniana/complicações , Trombose Intracraniana/patologia , Masculino , Punções , Estudos Retrospectivos , Resultado do Tratamento
12.
Medicine (Baltimore) ; 98(41): e17553, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593138

RESUMO

RATIONALE: Intraspinal anesthesia, the most common anesthesia type of orthopedic operation, is regarded as safe and simple. Despite of the rare incidence, puncture related complication of intraspinal anesthesia is catastrophic for spinal cord. Here we present an intradural hematoma case triggered by improper anesthesia puncture. The principal reason of this tragedy was rooted in the neglect of spine deformities diagnosis before anesthesia. To the best of our knowledge, there is no specific case report focusing on the intradural hematoma triggered by improper anesthesia puncture. PATIENT CONCERNS: Hereby a case of thoracolumbar spinal massive hematoma triggered by intraspinal anesthesia puncture was reported. The presenting complaint of the patient was little neurologic function improvement after surgery at 6-month follow-up. DIAGNOSES: Emergency MRI demonstrated that massive spindle-like intradural T2-weighted image hypointense signal masses from T12 to S2 badly compressed the dural sac ventrally, and his conus medullaris was at L3/4 intervertebral level with absence of L5 vertebral lamina. Hereby, the diagnoses were congenital spinal bifida, tethered cord syndrome, spine intradural hematoma, and paraplegia. INTERVENTIONS: Urgent surgical interventions including laminectomy, spinal canal exploration hematoma removal, and pedicle fixation were performed. The patient received both medication (mannitol, mecobalamin, and steroids) and rehabilitation (neuromuscular electric stimulation, hyperbaric oxygen). OUTCOMES: Postoperation, he had regained only hip and knee flexion at II grade strength. His neurologic function was unchanged until 3 weeks postoperation. Six-month follow-up showed just little neurologic function improvement, and the American Spinal Injury Association grade was C. LESSONS: By presenting an intradural hematoma case triggered by improper anesthesia puncture, we shared the treatment experience and discussed the potential mechanism of neurologic compromise. The principal reason for this tragedy is preanesthesia examination deficiency. Necessary radiology examinations must be performed to prevent misdiagnosis for spinal malformation.


Assuntos
Anestesia/efeitos adversos , Hematoma/etiologia , Punções/efeitos adversos , Adulto , Descompressão Cirúrgica/métodos , Diagnóstico Diferencial , Hematoma/diagnóstico por imagem , Hematoma/patologia , Hematoma/cirurgia , Humanos , Doença Iatrogênica/epidemiologia , Injeções Espinhais , Laminectomia/métodos , Imagem por Ressonância Magnética/métodos , Masculino , Medula Espinal/irrigação sanguínea , Medula Espinal/patologia , Doenças da Medula Espinal/patologia , Coluna Vertebral/anormalidades , Coluna Vertebral/diagnóstico por imagem , Resultado do Tratamento
13.
Nihon Shokakibyo Gakkai Zasshi ; 116(9): 739-746, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31511460

RESUMO

A 92-year-old woman was hospitalized with upper abdominal pain. She had a history of acute biliary pancreatitis and chronic heart failure and had undergone gastrectomy with Roux-en-Y reconstruction. She was admitted with recurrent pancreatitis and an exacerbation of heart failure. Biliary drainage could not successfully be achieved endoscopically or with percutaneous transhepatic biliary drainage and EUS-guided biliary drainage because of the Roux-en-Y reconstruction and non-dilation of bile duct. We successfully accomplished biliary drainage in one session with percutaneous transhepatic puncture of the common bile duct with ultrasound guidance and the rendezvous technique. We report this case because it is rare.


Assuntos
Ductos Biliares , Pancreatite Crônica , Idoso de 80 Anos ou mais , Ducto Colédoco , Drenagem , Feminino , Humanos , Punções
14.
Zhonghua Xin Xue Guan Bing Za Zhi ; 47(9): 737-741, 2019 Sep 24.
Artigo em Chinês | MEDLINE | ID: mdl-31550846

RESUMO

Objective: To explore the feasibility and safety of a newly developed simple and rapid axillary vein puncture technique based on the surface landmarks for pacemaker implantation. Methods: From January to November 2018, we enrolled 110 patients who underwent pacemaker implantation in Beijing Anzhen Hospital. Basic clinical characteristics, such as gender, age, major diagnosis, type of pacemaker, and His-purkinje system pacing, were collected. The success rate of this axillary vein puncture technique, complications, and technical parameters of present puncture method were analyzed. Results: There were 58 (52.7%) male patients in this cohort and the average aged was (70.26±10.45) years old. This "blind" axillary vein puncture method was successful in 105 out of 110 patients (95.5%). The relevant puncture-related parameters included: the distance between points "a and b" was (3.89±0.40) cm, the first angle α was (25.84±5.54)° and the second angle ß was (66.18±10.26)°. There were no puncture-related complications, such as hematoma, pneumothorax and hemothorax. Conclusion: The new "blind" axillary vein puncture approach is a simple, effective and safe technique for pacemaker implantation, which is easy to learn and practice and suitable for promotion.


Assuntos
Veia Axilar , Marca-Passo Artificial , Implantação de Prótese , Punções/métodos , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Flebografia
15.
Rehabilitación (Madr., Ed. impr.) ; 53(3): 189-197, jul.-sept. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-185556

RESUMO

Objetivo: conocer la eficacia de la punción seca (PS) de los puntos gatillo miofasciales (PGM) en comparación con otras técnicas de fisioterapia en el tratamiento de la cervicalgia. Método: se realizó una búsqueda sistemática en las bases de datos MEDLINE Complete (EBSCO), Pubmed, PEDro y Scopus. La calidad de los estudios se evaluó mediante el estándar de sesgos de la Colaboración Cochrane. Resultados: once artículos cumplieron los criterios de elegibilidad. Se describen las características de los participantes y los resultados de la comparación de la aplicación de la PS frente al ultrasonido, TENS, técnicas de terapia manual (estiramiento pasivo, tensión-contratensión, presión isquémica) y vendaje con kinesiotape. Conclusión: la PS se sugiere como una técnica útil en la disminución del dolor cervical. No obstante, no es posible determinar su eficacia en el tratamiento de la cervicalgia en relación con otros abordajes de fisioterapia


Objective: to determine the efficacy of dry needling (DN) in the treatment of myofascial trigger points (MTrP) compared to other methods of physical therapy in the treatment of neck pain. Method: a systematic search was carried out in the MEDLINE Complete (EBSCO), Pubmed, PEDro and Scopus databases. The quality of the studies was assessed using the standard of biases of the Cochrane Collaboration. Results: eleven articles met the eligibility criteria. The characteristics of the participants and the results of the comparison of the application of DN with ultrasound, TENS, manual therapy techniques (passive stretching, strain-counterstrain, ischaemic pressure) and kinesiotape bandage are described. Conclusion: DN was a useful technique in reducing neck pain. However, its efficacy in the treatment of cervicalgia could not be determined in comparison with other physiotherapy approaches


Assuntos
Humanos , Punções/métodos , Cervicalgia/reabilitação , Pontos-Gatilho , Síndromes da Dor Miofascial/reabilitação , Terapia por Exercício/métodos , Manejo da Dor/métodos
16.
Medicine (Baltimore) ; 98(33): e16868, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415422

RESUMO

Transjugular intra-hepatic portosystemic shunts (TIPS) had been considered a standard procedure in patients suffering from portal hypertension. The most challenging step in TIPS placement is blind puncture of the portal vein. We had established a localization method by introducing an Intra-Hepatic Arterial based puncture directing Localizer (IHAL) with the assistance of the enhanced computed tomography (CT) reconstruction. This study aimed to evaluate the feasibility, efficacy, and technical success of this method.From June 2018 to August 2018, 10 consecutive patients suffering from refractory ascites or esophageal gastric bleeding by liver cirrhosis were included in this retrospective study to evaluate feasibility, efficacy, and technical success of enhanced CT assisted IHAL-guided puncture of the portal vein. As a control, 10 patients receiving TIPS placement before Jun 2018 with cone beam CT (CBCT)-guided puncture were included to compare the reduction of portal-systemic pressure gradient (PSPG), portal entry time (PET), the number of puncture, dose area product (DAP) and contrast medium consumption.Technical success was 100% in the study group (IHAL-guided group) and in 90.0% of the control group (CBCT-guided group). Appropriate IHAL point could be achieved in all patients under the enhanced CT reconstruction assistance. The median number of punctures and DAP in IHAL group were significantly less than those in CBCT group. The reduction of PSPG, PET, and contrast medium consumption in IHAL group showed no significant differences than those in CBCT group.Enhanced CT reconstruction assisted IHAL-guided portal vein puncture is technically feasible and a reliable tool for TIPS placement resulting in a significant reduction of the number of punctures and DAP.


Assuntos
Hipertensão Portal/cirurgia , Derivação Portossistêmica Transjugular Intra-Hepática/métodos , Radiografia Intervencionista/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos de Viabilidade , Feminino , Humanos , Hipertensão Portal/etiologia , Cirrose Hepática/complicações , Masculino , Pessoa de Meia-Idade , Veia Porta/diagnóstico por imagem , Veia Porta/cirurgia , Punções/métodos , Tomografia Computadorizada por Raios X
17.
World Neurosurg ; 131: e562-e569, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31400527

RESUMO

BACKGROUND: Minimally invasive surgical techniques may have beneficial effects on spontaneous intracerebral hemorrhage. Accurate localization of the hematoma and real-time guided puncture are more important in minimally invasive surgical procedures than in traditional craniotomy. Here, we introduce a novel simple puncture positioning and guidance system for intracerebral hematoma and demonstrate its utility for hematoma puncture surgery in a simulation experiment and series of patients. METHODS: We describe the device and use of the technique for hematoma puncture surgery in basal ganglia hematomas and report on the precision of the simulation experiments compared to that of freehand puncture, as well as its clinical application in 16 cases. RESULTS: The accuracy of this technique was superior to that of freehand puncture. All 16 patients underwent successful puncturing of the hematoma cavity or ventricles only once without any related complications. CONCLUSIONS: We demonstrate a novel simple puncture positioning and guidance system that has the advantages of simplicity, low-cost, device availability, and individual real-time guidance. We believe this system may be useful in resource-limited centers where navigation is not available.


Assuntos
Hemorragia dos Gânglios da Base/cirurgia , Hemorragia Cerebral Intraventricular/cirurgia , Drenagem/métodos , Hematoma/cirurgia , Procedimentos Neurocirúrgicos/métodos , Punções/métodos , Adulto , Idoso , Hemorragia Cerebral/cirurgia , Feminino , Humanos , Imagem Tridimensional , Masculino , Pessoa de Meia-Idade , Cirurgia Assistida por Computador
19.
Gastrointest Endosc ; 90(3): 535-536, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31439136
20.
Curr Med Sci ; 39(4): 638-644, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31347002

RESUMO

To evaluate the effect of triple puncture on primary trigeminal neuralgia (pTN), 64 patients with pTN were randomly assigned to two groups: treatment group and control group. The participants in the treatment group received triple puncture treatment of 6 times per week for 4 weeks, and those in control group were given carbamazepine (300-600 mg per day) for at least 1 month. Before and after treatment, the primary outcomes including the total efficiency rate and the VAS pain scores, and the secondary outcomes including the frequency of pain attack and adverse events were observed. Sixty-two participants finished the study (33 in treatment group and 29 in control group individually). After treatment, the symptoms (mainly pain) of the two groups were alleviated. The total efficiency rate in the treatment group and control group was 90.9% and 75.9% respectively. The VAS pain scores and frequency of pain attack were significantly reduced in the treatment group as compared with the control group (P<0.05). The incidence of adverse events in the treatment group and control group was 9.1% and 24.1% respectively. It can be inferred that triple puncture can effectively improve the quality of life of patients with pTN and has less side effects.


Assuntos
Punções/métodos , Nervo Trigêmeo/fisiopatologia , Neuralgia do Trigêmeo/terapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Punções/efeitos adversos , Qualidade de Vida , Resultado do Tratamento , Neuralgia do Trigêmeo/fisiopatologia
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