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1.
Urologe A ; 59(9): 1017-1025, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32533201

RESUMO

BACKGROUND: Percutaneous access to the renal pelvis still remains the most difficult step before nephrolitholapaxy (PCNL). New imaging techniques, such as 3D imaging and various navigation instruments such as electromagnetic, sonographic, CT-controlled and marker-based/iPAD try to simplify this step and reduce complications. OBJECTIVES: In this review, various new techniques for puncturing the renal collecting system are presented and their advantages and disadvantages are evaluated. MATERIALS AND METHODS: A systematic literature search was carried out in MEDLINE, whereby only puncture techniques that have already been evaluated in clinical studies were included. RESULTS: Five different navigation methods for puncturing the renal pelvis before PCNL were found. CONCLUSION: Intraoperative navigation can be useful when puncturing the collecting system. The combination of ultrasound and fluoroscopy currently remains the gold standard. However, there is still a need for further, primarily clinical, prospective studies to determine which new imaging technology and navigation systems will prevail and thus facilitate the access route to the kidney, especially in the case of special anatomical conditions.


Assuntos
Cálculos Renais/cirurgia , Rim/diagnóstico por imagem , Rim/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Nefrostomia Percutânea/métodos , Punções/métodos , Humanos , Cálculos Renais/diagnóstico por imagem
2.
Rev Col Bras Cir ; 47: e20202558, 2020 Jun 03.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32578821

RESUMO

The coronavirus infection, also known as SARS-COV2, has proven to be potentially fatal, representing a major global health problem. Its spread after its origin in the city of Wuhan, China has resulted in a pandemic with the collapse of the health system in several countries, some with enormous social impact and expressive number of deaths as seen in Italy and Spain. Extreme intra and extra-hospital measures have been implemented to decrease the transmission and dissemination of the COVID-19. Regarding the surgical practice, a huge number of procedures considered non-essential or elective were cancelled and postponed until the pandemic is resolved. However, urgent and oncological procedures have been carried out. In this publication, we highlight and teach adaptations to be made with commonly used materials in laparoscopy to help prevent the spread and contamination of the healthcare team assisting surgical patients.


Assuntos
Aerossóis/efeitos adversos , Infecções por Coronavirus/prevenção & controle , Laparoscopia/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Procedimentos Cirúrgicos Robóticos/métodos , Procedimentos Cirúrgicos Operatórios/normas , Betacoronavirus , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Período Intraoperatório , Salas Cirúrgicas/métodos , Pneumoperitônio Artificial/normas , Equipamentos de Proteção/normas , Punções/métodos , Instrumentos Cirúrgicos/normas
3.
Anticancer Res ; 40(6): 3527-3534, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32487654

RESUMO

BACKGROUND/AIM: To compare the diagnostic reliability, accuracy and safety of ultrasound-guided biopsy (Tru-Cut biopsy) and ascites puncture in patients with a primarily inoperable malignant ovarian tumor. PATIENTS AND METHODS: This is a retrospective analysis of the studied methods in consecutively examined patients and a prospective validation of these methods. 79 women with a suspected primarily inoperable ovarian tumor underwent Tru-Cut biopsies and were included in the ultrasound-guided biopsy group. In addition, 55 patients after ascites puncture were enrolled in the comparison group. Both procedures were performed in 48 patients for the prospective validation. RESULTS: Significant differences in favour of ultrasound-guided biopsy were found in all studied variables (malignancy confirmation 72.9% vs. 95.8%, tumor origin 52.1% vs. 89.6%, histologic subtype 43.8% vs. 85.4% and accuracy, i.e. agreement of preoperative and definitive diagnosis 43.7% vs. 95.4%). CONCLUSION: Ultrasound-guided biopsy is an accurate, reliable, safe and minimally invasive method. Owing to the high reliability and accuracy, it has the capacity to replace ascites puncture with cytologic examination or a more invasive method (laparoscopy, laparotomy) for adequate tumor sampling.


Assuntos
Biópsia Guiada por Imagem , Neoplasias Ovarianas/diagnóstico , Punções , Ultrassonografia , Ascite/patologia , Citodiagnóstico , Feminino , Histocitoquímica , Humanos , Biópsia Guiada por Imagem/métodos , Biópsia Guiada por Imagem/normas , Punções/métodos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Ultrassonografia/métodos
4.
Medicine (Baltimore) ; 99(15): e19656, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282716

RESUMO

To determine the influence of puncture site on aspiration in dealing with pneumothorax following CT-guided lung biopsy.Two hundred thirty-six pneumothorax patients after CT guided lung biopsies were retrospective analyzed from January 2013 to December 2018. Patients with minor asymptomatic pneumothorax were treated conservatively with monitoring of vital signs and follow-up CT to confirm stability. Ninety of the 236 pneumothorax patients, who underwent manual aspiration, were included in this analysis. In first manual aspiration, the needle from the lesion was retracted back into the pleural space after biopsy, and then aspiration treatment was performed. If the treatment is of unsatisfied result, a second attempt aspiration treatment, which puncture site away from initial biopsy one, was conducted. The efficacy of simple manual aspiration and the new method, changing puncture site for re-aspiration was observed.Immediate success was obtained in 62 out of the 90 patients in the first attempt. The effective rate and failure rate were 68.9% (62/90) and 31.1% (28/90), respectively. Twenty-eight patients in whom first attempt simple aspiration were unsuccessful underwent a second attempt aspiration, which puncture site away from initial biopsy one, was successful in 13 patients with 15 patients undergoing chest tube placement. The effective rate and failure rate were 46.4% (13/28) and 53.6% (15/28), respectively. Applying the modified procedure, total effective rate of aspiration elevated significantly from 68.9% (62/90) to 83.3% (75/90) (P < .05). No serious side effects were detected in the period of aspiration procedure.Manual aspiration with puncture site away from initial biopsy one is worth trying to deal with post-biopsy pneumothorax. This modified procedure improved the efficiency of treatment significantly, and reduced the rate of pneumothorax requiring chest tube placement.


Assuntos
Biópsia Guiada por Imagem/efeitos adversos , Pulmão/patologia , Pneumotórax/etiologia , Punções/efeitos adversos , Idoso , Tubos Torácicos/estatística & dados numéricos , Feminino , Humanos , Biópsia Guiada por Imagem/instrumentação , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Cavidade Pleural/patologia , Pneumotórax/terapia , Punções/métodos , Estudos Retrospectivos , Sucção/efeitos adversos , Sucção/métodos , Tomografia Computadorizada por Raios X/métodos , Falha de Tratamento
6.
Ann Thorac Surg ; 109(6): e457-e459, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32035048

RESUMO

A redo surgical approach to residual ventricular septal defect (VSD) is technically demanding. Sternum reentry has to be performed very carefully to avoid any uncontrolled bleeding, and preparation of the adhesions must be made to expose the most important structures (ascending aorta, caval veins). However, percutaneous transcatheter device closure of the residual VSD with radiation exposure can cause arrhythmia, valve injury, and vascular complications. This report presents a less invasive technique to treat residual VSD, without arterial access, radiation exposure, or cardiopulmonary bypass.


Assuntos
Cateterismo Cardíaco/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Comunicação Interventricular/cirurgia , Punções/métodos , Dispositivo para Oclusão Septal , Criança , Feminino , Comunicação Interventricular/diagnóstico , Humanos , Masculino , Reoperação
7.
Cir. Esp. (Ed. impr.) ; 98(2): 79-84, feb. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-187966

RESUMO

Introducción: Ha habido un aumento en la implantación de reservorios subcutáneos en los últimos años. El objetivo de este estudio es comparar las técnicas de punción venosa (PV) frente a la disección venosa (DV). Métodos: Estudio de cohortes retrospectivo. Incluyó a pacientes que requirieron un Port-A-Cath*. Se dividió a los pacientes en 2grupos: PV y DV. Los pacientes eran mayores de 18 años, requerían tratamiento intravenoso continuado, sin restricciones de patología. Se excluyó a quienes habían sido portadores de un reservorio previo y pacientes pediátricos. La elección de la técnica se basó en preferencias del cirujano. Se analizaron los parámetros clínicos de edad, sexo, ASA, IMC, motivo de colocación y lateralidad, y los datos referidos a las complicaciones y la tasa de retirada en cada uno de los grupos. El seguimiento medio fue de 2 años. Resultados: Fueron incluidos 386 pacientes durante 5 años: 228 en el grupo DV y 155 en el grupo PV. En 3 casos la técnica no quedó registrada. No hubo diferencias entre ambos grupos en edad, sexo, ASA, IMC y motivo de implantación (p > 0,05). La DV presentó menor cifra de complicaciones y se observó un mayor recambio y retirada de catéter en PV. A pesar de ello, no hubo diferencias estadísticamente significativas (p = 0,113). Conclusiones: Tanto la DV como la PV son técnicas seguras y eficaces. En nuestra experiencia, la DV presentó mejores resultados intraoperatorios y a largo plazo. Se recomienda realizar más estudios para discernir la técnica a utilizar con mayor seguridad


Introduction: There has been an increase in the implantation of subcutaneous reservoirs in recent years. The objective of this study was to compare puncture techniques against venous dissection. Methods: This retrospective cohort study included patients who required a Port-a-Cath and were divided into two groups: venous puncture (PV) and venous dissection (DV). Patients were over 18 years of age, requiring continued intravenous treatment, with no restriction of pathology. Patients with a previous reservoir and < 18 years old were excluded. The choice of the technique was based on the surgeon's preferences. We analyzed the clinical parameters of age, sex, ASA, BMI, reason for placement and laterality, and data related to the complications and withdrawal rate in each of the groups. Results: 386 patients were included for 5 years: 228 DV group and 155 PV group. In three cases, the technique was not documented. There were no differences between the two groups with respect to age, sex, ASA, BMI and reason for implantation (p > 0.05). The average follow-up was two years. The DV group was found to have a lower number of complications, while the PV group had an increased incidence of catheter replacement and removal. However, these differences were not statistically significant (p = 0.113). Conclusions: Both DV and PV are safe and effective techniques. In our experience, DV presented better intraoperative and long-term results. Further studies are recommended to discern which technique to use more safely


Assuntos
Humanos , Dispositivos de Acesso Vascular , Técnicas de Diagnóstico por Cirurgia , Dissecação/métodos , Estudos de Coortes , Punções/métodos , Cateterismo Venoso Central , Estudos Retrospectivos , Eletrocardiografia , Radiografia Torácica , Complicações Intraoperatórias , Complicações Pós-Operatórias
8.
Ann Otol Rhinol Laryngol ; 129(6): 548-555, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31910645

RESUMO

OBJECTIVE: To describe results of image guided sclerotherapy of venous malformations (VM) localized in the masseter muscle. METHODS: Retrospective review of prospectively maintained data was done to include consecutive cases treated over 5-year period, with minimum 6 months follow-up. Sclerotherapy was done using ultrasound (US) guided needle puncture(s) of the lesions percutaneously, and 3% polidocanol foam injected under image guidance. RESULTS: Seventeen cases (10 male, 7 female) with mean age 15.6 years (range 6-28 years) were identified. Clinical presentation was with facial asymmetry, becoming pronounced on jaw clenching, and three cases had mild local pain. On US, the lesions appeared as partially compressible masses with anechoic spaces, showing color filling on releasing probe pressure. Fourteen had phleboliths. Eight patients had undergone magnetic resonance imaging, lesions appearing as oval, homogenous, lobulated, T2 hyperintense masses, with heterogeneous contrast enhancement. Number of sclerotherapy sessions were-single in four cases, two in eight cases and three in five cases, for total of 35 sessions (average 2.05 session per patient). The mean dose of drug injected per session was 1.85 mL and total mean dose per patient was 2.79 mL. Post-procedure vomiting occurred in one patient while all had local swelling and mild pain, lasting between 3 to 7 days. No facial nerve palsy or sloughing/ulceration/skin necrosis was noted. On US follow-up (6-26 months, mean 15.9 months), 12 patients had small echogenic masses without any vascularity, and five had small anechoic areas <25%. All patients had complete resolution of swelling and pain. CONCLUSIONS: For VMs localized to the masseter muscle, image guided sclerotherapy is highly effective and safe, and recommended as first line treatment.


Assuntos
Músculo Masseter/irrigação sanguínea , Polidocanol/uso terapêutico , Soluções Esclerosantes/uso terapêutico , Escleroterapia/métodos , Malformações Vasculares/terapia , Veias/diagnóstico por imagem , Adolescente , Adulto , Criança , Estudos de Coortes , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Flebografia , Punções/métodos , Estudos Retrospectivos , Ultrassonografia/métodos , Ultrassonografia Doppler em Cores , Malformações Vasculares/diagnóstico por imagem , Adulto Jovem
9.
J Surg Res ; 245: 99-106, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31415935

RESUMO

BACKGROUND: Brainstem hemorrhage is an acute and severe neurosurgical disease. Cerebral hemorrhage is surgically treated via hematoma puncture drainage because of its minimally invasive nature. However, the placement of puncture must be extremely accurate due to the special anatomical location of the brainstem and its physiological functions. The present study aimed to evaluate whether the application of a three-dimensional (3D)-printed navigation mold achieved good outcomes in the surgical treatment of brainstem hemorrhage. MATERIAL AND METHODS: The present study included seven patients (three men and four women aged 40-56 y) who underwent 3D print-assisted hematoma puncture drainage between June 2016 and March 2018 at Binzhou Medical University Hospital. The amount of brainstem hemorrhage was 15-47 mL. We analyzed the basic surgical conditions, deviation distance, and postoperative clinical improvement. RESULTS: In all cases, the operation was completed successfully; no patient died or contracted an infection intraoperatively. The end of the puncture tube was located in the hematoma cavity in all cases. The deviation distance ranged from 2.5 to 7.2, and this distance gradually reduced with improvements in the technique. The hematoma drainage achieved satisfactory postoperative outcomes, with improvements in symptoms such as respiratory failure and hyperthermia. CONCLUSIONS: Use of a 3D-printed navigation mold for puncture drainage of brainstem hemorrhage realized the purpose of individualized and precision medicine, which is important in maintaining the vital signs of patients with severe brainstem hemorrhage.


Assuntos
Hemorragia Cerebral/cirurgia , Drenagem/instrumentação , Hematoma/cirurgia , Modelos Anatômicos , Impressão Tridimensional , Punções/instrumentação , Adulto , Tronco Encefálico/irrigação sanguínea , Tronco Encefálico/diagnóstico por imagem , Tronco Encefálico/cirurgia , Hemorragia Cerebral/complicações , Hemorragia Cerebral/diagnóstico , Drenagem/métodos , Feminino , Hematoma/diagnóstico , Hematoma/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Punções/métodos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Resultado do Tratamento
10.
J Matern Fetal Neonatal Med ; 33(1): 174-176, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30244617

RESUMO

Point of care lung ultrasound (POC-LUS) has played important roles in diagnosing neonatal lung diseases and assisting in their treatment. A newborn infant with severe respiratory distress diagnosed as pulmonary atelectasis caused by congenital massive pleural effusion, whose consolidated lung recruitment after pleural puncture drainage under POC-LUS guidance. Lung ultrasound can be performed easily and timely at bed-side with free of radiation exposure, thus it should be used extensively in the neonatal department.


Assuntos
Drenagem/métodos , Derrame Pleural/terapia , Sistemas Automatizados de Assistência Junto ao Leito , Atelectasia Pulmonar/terapia , Punções/métodos , Ultrassonografia de Intervenção/métodos , Humanos , Recém-Nascido , Doenças do Recém-Nascido/terapia , Masculino , Derrame Pleural/complicações , Derrame Pleural/congênito , Atelectasia Pulmonar/complicações , Atelectasia Pulmonar/congênito , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Resultado do Tratamento
11.
In Vivo ; 34(1): 155-161, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31882474

RESUMO

BACKGROUND/AIM: Presepsin is a useful biomarker for diagnosing sepsis. This study aimed to investigate the relationship between oxidative stress and presepsin levels in animal models. MATERIALS AND METHODS: Sprague-Dawley rats were used for cecal ligation and puncture (CLP) and to generate massive bowel resection (MBR) models. Trunk blood was collected for analysis of presepsin. Liver and intestinal tissue samples were taken to determine oxidative stress parameters. RESULTS: Presepsin levels in MBR and CLP sepsis models were higher than those in control groups. Reactive oxygen and nitrogen species (RONS) and malondialdehyde levels were increased in the liver and small intestine of rats in both models, whereas glutathione levels were decreased. CONCLUSION: Presepsin levels and RONS may be released by the same mechanism which is closely associated with the progression of sepsis and inflammation in both CLP and MBR models.


Assuntos
Fragmentos de Peptídeos/metabolismo , Sepse/metabolismo , Animais , Modelos Animais de Doenças , Feminino , Glutationa/metabolismo , Inflamação/metabolismo , Intestino Delgado/metabolismo , Ligadura/métodos , Fígado/metabolismo , Malondialdeído/metabolismo , Estresse Oxidativo/fisiologia , Punções/métodos , Ratos , Ratos Sprague-Dawley , Espécies Reativas de Nitrogênio/metabolismo
12.
BMC Urol ; 19(1): 122, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31775711

RESUMO

BACKGROUND: Accurate puncture and dilation of the target kidney calices for percutaneous nephrolithotomy (PCNL) can be difficult. This study aimed to investigate the advantages of PCNL using optical puncture (i.e. the puncture is visualized on a screen as seen through the needle) combined with balloon dilation vs. conventional puncture methods. METHODS: This was a retrospective study of 58 consecutive patients with kidney stones without hydronephrosis and treated at the Minimally Invasive Urology Center of Zhejiang Provincial People's Hospital between 10/2016 and 12/2017. Twenty-one patients underwent optical puncture combined with balloon dilation PCNL. Thirty-seven patients underwent conventional puncture instrument dilation PCNL (controls). Success rate, tubeless rate, blood loss, pain, and complications were compared between the two groups. RESULTS: The one-time puncture success rate (95.2% [20/21] vs. 67.6% [25/37], P = 0.02) and the postoperative tubeless rate (81.0% [17/21] vs. 54.1% [20/37], P = 0.04) were higher in the optical puncture group compared with controls. The average postoperative hemoglobin reduction was smaller (1.13 ± 0.63 vs. 1.56 ± 0.59 g/dL, P = 0.01), the postoperative VAS score was lower (1.6 ± 0.9 vs. 2.5 ± 1.2, P = 0.004), the rate of postoperative analgesic use was lower (14.3% [3/21] vs. 40.5% [15/37], P = 0.04), and the postoperative mean hospitalization days was shorter (3.7 ± 0.9 vs. 4.4 ± 0.8, P = 0.005) in the optical puncture group vs. controls. There was no case of urinary sepsis, blood transfusion, perirenal hematoma, pleural injury, and visceral organ damage. CONCLUSIONS: Optical puncture combined with balloon dilation PCNL could be associated with good therapeutic effect and low frequency of complications for the treatment of kidney stones without hydronephrosis.


Assuntos
Cálculos Renais/cirurgia , Nefrolitotomia Percutânea/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Dilatação , Feminino , Humanos , Hidronefrose , Masculino , Pessoa de Meia-Idade , Nefrolitotomia Percutânea/instrumentação , Punções/métodos , Estudos Retrospectivos , Adulto Jovem
13.
Int Immunopharmacol ; 77: 105973, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31677992

RESUMO

Sepsis is a syndrome of life-threatening organ dysfunction caused by dysregulated host responses to infection. Macrophage polarization is a key process involved in the pathogenesis of sepsis. Recent evidence has demonstrated that autophagy participates in the regulation of macrophage polarization in different phases of inflammation. Here, we investigated whether trichostatin A (TSA), a histone deacetylase (HDAC) inhibitor, promotes the macrophage M2 phenotype by enhancing autophagy to counteract excessive inflammation in a cecal ligation and puncture (CLP) mouse model. TSA stimulation increased the proportions of M2 marker (CD206, CD124 and CD23)-labeled RAW264.7 macrophages. Furthermore, with increasing TSA doses, autophagy was enhanced gradually. Interestingly, the autophagy activator rapamycin (Rap), also known as an mTOR inhibitor, unexpectedly decreased the proportions of M2 marker-labeled macrophages. However, TSA treatment reversed the Rap-induced decreases in CD206-labeled macrophages. Next, we stimulated different groups of RAW264.7 cells with the autophagy inhibitors MHY1485 or 3-methyladenine (3-MA). Inhibition of autophagy at any stage in the process suppressed TSA-induced macrophage M2 polarization, but the effect was not associated with mTOR activity. In vivo, TSA administration promoted peritoneal macrophage M2 polarization, increased LC3 II expression, attenuated sepsis-induced organ (lung, liver and kidney) injury, and altered systemic inflammatory cytokine secretion. However, 3-MA abolished the protective effects of TSA in CLP mice and decreased the number of M2 peritoneal macrophages. Therefore, TSA promotes the macrophage M2 phenotype by enhancing autophagy to reduce systemic inflammation and ultimately improves the survival of mice with polymicrobial sepsis.


Assuntos
Autofagia/efeitos dos fármacos , Ácidos Hidroxâmicos/farmacologia , Inflamação/tratamento farmacológico , Macrófagos Peritoneais/efeitos dos fármacos , Sepse/tratamento farmacológico , Animais , Biomarcadores/metabolismo , Linhagem Celular , Citocinas/metabolismo , Modelos Animais de Doenças , Inibidores de Histona Desacetilases/farmacologia , Inflamação/metabolismo , Ligadura/métodos , Pulmão/efeitos dos fármacos , Pulmão/metabolismo , Ativação de Macrófagos/efeitos dos fármacos , Macrófagos Peritoneais/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fenótipo , Punções/métodos , Células RAW 264.7 , Sepse/metabolismo
14.
Enferm. glob ; 18(56): 1-9, oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-188264

RESUMO

En el contexto actual en el que han surgido numerosas alternativas en terapia intravenosa, se hacen necesarios estudios sobre los diferentes dispositivos disponibles para determinar cuál es el sistema más idóneo en cada caso. Las líneas medias surgen como alternativa a la utilización de catéteres venosos periféricos y catéteres centrales de inserción periférica. El objetivo de este estudio es evaluar el uso de los catéteres de línea media en pacientes hospitalizados. Método: Estudio retrospectivo de 1016 pacientes. Se analizaron variables relacionadas con el tiempo medio de utilización del catéter, la tasa de incidencias para cada una de las complicaciones, el número de catéteres retirados y sus causas. Resultados: El 40 % de los catéteres se canalizó por mal acceso venoso del paciente (406), el 42% por tratamiento intravenoso largo (427) y el 18% por tratamiento irritante (183). Respecto a la efectividad de los catéteres, el tiempo medio de utilización fue de 12.1 días (DE 9.4). Finalizaron el tratamiento 854 pacientes, 704 (69.3%) por fin de tratamiento y 150 (14.8%) por fallecimiento. Presentaron complicaciones el 7.4 % de los pacientes (75). Se retiraron por mal funcionamiento del catéter el 4.4% (45), el 1% por complicaciones del paciente (10). El 2% de los catéteres se retiró por fiebre (20). Conclusiones: El catéter de línea media es un dispositivo de acceso venoso con una baja tasa de complicaciones, presenta un tiempo medio de permanencia en torno a los 12 días. Supone una alternativa a los catéteres periféricos cortos en pacientes con mal acceso venoso y ofrece una alternativa a las rotaciones frecuentes en pacientes con tratamientos antibióticos superiores a 7 días


In the current context in which numerous alternatives have emerged in intravenous therapy, studies are needed on the different devices available to determine which is the most suitable system in each case. The midlines arise as an alternative to the use of peripheral venous catheters and central peripheral insertion catheters. The main objective of this study is to evaluate the use of midline catheters in hospitalized patients. Method: Retrospective study of 1016 patients. We analyzed variables related to the mean time of catheter use, the incidence rate for each of the complications, the number of catheters removed and their causes. Results: 46.5% of the catheters were inserted in men (472). The average age was 65 years (SD 16.8), being the youngest of 14 and the oldest of 101 years. 40% of the catheters were channeled due to poor venous access of the patient (406), 42% for long intravenous treatment (427) and 18% for irritant treatment (183). Regarding the effectiveness of the catheters, the average time of use was 12.1 days (SD 9.4). The treatment was terminated by 854 patients, 704 (69.3%) by the end of treatment and 150 (14.8%) by death. 7.4% of patients presented complications (75). 4.4% (45) were removed due to malfunction of the catheter, 1% due to patient complications (10). 2% of the catheters were removed due to fever (20). Conclusions: The middle line catheter is a venous access device with a low complication rate, it has a average residence time of around 12 days. It is an alternative to short peripheral catheters in patients with poor vein access and offers an alternative to frequent rotations in patients with antibiotic treatments longer than 7 days


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Cateterismo Venoso Central/métodos , Dispositivos de Acesso Vascular/classificação , Antibacterianos/administração & dosagem , Estudos Retrospectivos , Hospitalização/estatística & dados numéricos , Flebite/epidemiologia , Infusões Intravenosas/métodos , Infecções Relacionadas a Cateter/epidemiologia , Reação no Local da Injeção/epidemiologia , Punções/métodos
17.
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
18.
Anim Reprod Sci ; 209: 106142, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31514932

RESUMO

Haemorrhagic anovulatory follicles (HAFs) are the most common pathological anovulatory condition in the mare. To enhance understanding of the physiopathology of HAFs, the aim of the present study was to determine the effects of an induced-follicular wave on LH concentrations and follicular fluid factors relevant to the ovulatory process. Mares were allocated to treatment or control groups (n = 7/group) in a crossed over design during 14 oestrous cycles with a period of one cycle occurring when there were no treatments between the times when treatments were administered. In the treatment group, all antral follicles ≥8 mm were ablated on Day 10 after ovulation followed by administration of a luteolytic dose of PGF2α. All mares of both groups were treated with 1500 IU of hCG when a follicle ≥32 mm was detected (Hour 0), and follicular fluid was aspirated 35 h later. Blood samples were collected every 48 h from Day 10 until Hour 0 from all mares. Follicular fluid was assayed for PGE2, estradiol and progesterone. Plasma was assayed for LH concentrations. A follicular wave followed follicle ablation in the treated mares. Concentrations of LH were greater (P = 0.05) in mares ot the treatment compared with control group. Concentrations of PGE2, estradiol and progesterone in follicular fluid did not differ between groups (P > 0.05). Treatment resulted in an earlier increase in circulating LH, however, there was no effect on concentrations of intra-follicular PGE2, estradiol or progesterone in hCG-stimulated preovulatory follicles.


Assuntos
Técnicas de Ablação , Anovulação/cirurgia , Líquido Folicular/metabolismo , Cavalos , Hormônio Luteinizante/sangue , Luteólise/efeitos dos fármacos , Folículo Ovariano/cirurgia , Técnicas de Ablação/métodos , Técnicas de Ablação/veterinária , Animais , Anovulação/complicações , Anovulação/metabolismo , Anovulação/veterinária , Gonadotropina Coriônica/farmacologia , Estudos Cross-Over , Dinoprosta/farmacologia , Ciclo Estral/efeitos dos fármacos , Ciclo Estral/metabolismo , Feminino , Líquido Folicular/química , Líquido Folicular/efeitos dos fármacos , Hemorragia/complicações , Hemorragia/cirurgia , Hemorragia/veterinária , Doenças dos Cavalos/metabolismo , Doenças dos Cavalos/cirurgia , Folículo Ovariano/diagnóstico por imagem , Folículo Ovariano/patologia , Ovulação/efeitos dos fármacos , Indução da Ovulação/métodos , Indução da Ovulação/veterinária , Punções/métodos , Punções/veterinária , Ultrassonografia de Intervenção/métodos , Ultrassonografia de Intervenção/veterinária
19.
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
20.
Rev. iberoam. fertil. reprod. hum ; 36(3): 3-7, jul.-sept. 2019.
Artigo em Espanhol | IBECS | ID: ibc-188325

RESUMO

La aspiración folicular transvaginal ecoguiada representa actualmente el método de lección para la recuperación ovocitaria, tanto por su simplicidad, seguridad como eficacia. Es una técnica que se utiliza desde el 1983 y que precisa de una curva de aprendizaje relativamente corta (1). Aunque las complicaciones asociadas a la técnica son poco frecuentes estimándose entre 0,1 -0,5 % (2) en algunos casos pueden ser graves, incluso letales (3), destacando entre ellas la hemorragia y la lesión e infección de estructuras pélvicas


Ecoguided transvaginal follicular aspiration currently represents the method of choice for ovocyte recovery, both for its simplicity, safety and efficacy. It is a technique that has been used since 1983 and requires a relatively short learning curve (1). Although complications associated with the technique are rare, estimated between 0.1 -0.5% (2)in some cases can be serious, even lethal (3), including bleeding and injury and infection of pelvic structures


Assuntos
Humanos , Feminino , Punções/efeitos adversos , Punções/métodos , Recuperação de Oócitos/efeitos adversos , Recuperação de Oócitos/métodos , Ultrassonografia de Intervenção/efeitos adversos , Ultrassonografia de Intervenção/métodos , Fatores de Risco
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