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At least 1,477 records · Page 82Linked to original sources
PubMed1977

[Transrectal prostate puncture biopsy in ambulatory care].

The transrectal puncture biopsy is an effective method in the histological clarification of suspicious palpation findings of the prostate. The puncture is technically simple, is to be performed in an outpatient department, can be repeated if necessary and is only of little stress for the patient. Preparation of the intestine or anaesthesia are not necessary. No severe complications were observed. The only little traumatized tissue cylinders obtained by means of the TRU-cut-needle allow the pathologist as a rule an evident assertion.

Aged↗
PubMed1996

[Speech rehabilitation following total laryngectomy with tracheo-esophageal puncture].

Speech rehabilitation after total laryngectomy has often been neglected, and traditional methods of esophageal voice production are frequently unsuccessful or disappointing. The development of the tracheoesophageal puncture (TEP) technique and the valved voice prosthesis by Singer and Blom in 1979 offered patients an alternative method for laryngeal speech rehabilitation. This technique is now used successfully in an increasing number of patients after total laryngectomy. We present our experience with TEP since 1988 in 8 men and 1 woman, aged 50-86 years, who had adequate follow-up. In 5, primary TEP was performed at the same time as the total laryngectomy; in 4, secondary puncture was performed 12-18 months after primary surgery. 1 had serious operative complications, 2 had minor complications, 1 had long-term problems which necessitated discontinuing use of the prosthesis, while 8 achieved satisfactory voice use and could communicate effectively. We hope that further experience with TEP in Israel will confirm its effectiveness for speech rehabilitation after total laryngectomy.

Aged↗
PubMed1996

[Examination of percutaneous minocycline hydrochloride injection therapy for hepatic cyst by one puncture method].

Minocycline hydrochloride (MINO) at a dose of 500 mg (in principle) was injected into each of 11 hepatic cysts/10 cases (mean maximum diameter: 12.6 cm) that exhibited symptoms or a tendency toward growth by percutaneous transhepatic one puncture method, and the relation between therapeutic efficacy and pH of cystic fluid was examined. The efficacy was evaluated by abdominal CT after 3 months, and when a shrink of 50% or more in the maximum diameter was observed, it was judged as marked response. Marked effect was observed in 9 lesions of 11 (82%). This MINO injection therapy by one puncture method is very safe, simple and useful. Reduction in intra-cystic pH was not always related to the therapeutic efficacy, so involvement of cytotoxicity of MINO was suggested in degenerating the cystic epithelial cells.

Adult↗
PubMed1996

[Chronic subdural hematoma secondary to an accidental dural puncture during lumbar epidural anesthesia].

We report the case of a 54-year-old woman with cephalea of five months duration caused by a chronic subdural hematoma that appeared after epidural anesthesia and accidental dural puncture for bilateral saphenectomy. Computed tomography of the brain revealed an intracranial hematoma. After surgical evacuation, the patient's headaches resolved and she recovered fully. The appearance of cephalea after dural puncture is a relatively frequent complication of spinal anesthesia, but its persistence over time, as well as changes in its initial characteristics, should lead to a suspicion of life-threatening subdural hematoma.

Anesthesia, Epidural↗
PubMedDate not supplied

[A kit of disposable devices for transcutaneous puncture biopsy].

A kit of disposable devices has been devised for successful and safe puncture biopsy of abnormal formations deeply located in the lung, mediastinum, liver, breast, pleura. The use of the kit provides qualitative instant diagnosis, by decreasing the cost of studies, and rules out transmission of infections (hepatitis, AIDS), implantation of tumor cells into the puncture canal tissues, and reduces the incidence of traumatic pneumothorax and bleeding.

Biopsy, Needle↗
PubMedDate not supplied

[General convulsive crisis related to pneumocephalus after inadvertant dural puncture in an obstetric patient].

We report a case of iatrogenic pneumocephalus in an obstetric patient after accidental dural puncture during repeated attempts to locate the epidural space by the technique of loss-of-resistance to air. Analgesia was provided throughout labor. Two days after puncture, typical spinal headache developed and was treated with bed rest, oral analgesics and hydration. The patient was released four days after delivery but returned to the hospital emergency service after suffering general convulsions and loss of consciousness which resolved spontaneously. A computerized tomography (CT) scan revealed pneumocephalus, to which the convulsions were attributed. No further convulsions occurred in spite of the fact that anticonvulsives were not prescribed. A CT scan one month later was normal.

Adult↗
PubMed1998

Intraoperative non-puncture laparoscopic examination of contralateral internal inguinal rings is feasible in children with unilateral hydrocele.

BACKGROUND: Intraoperative non-puncture laparoscopic examination using the hernia sac as the scope entrance has been successfully conducted in children with unilateral inguinal hernia. This technique selects patients for contralateral inguinal exploration. In spite of the thin and narrow processus vaginalis, children with unilateral hydrocele encounter the same problem of subsequent contralateral inguinal hernia or hydrocele. In this study, we discuss the feasibility of this technique in children with unilateral hydrocele. METHODS: From July 1993 to September 1995, 91 children with unilateral hydrocele were examined during surgery at our institution. The results, including success rate, complications, patent rate of contralateral internal ring and contralateral subsequent hernia or hydrocele, at at least one year follow-up, were compared with those of 329 children with unilateral hernia undergoing the same examination during this period. RESULTS: A patent contralateral processus vaginalis was recognized in 31 children and all were confirmed by surgical exploration. The examination failed in three patients, of whom two had a tear in the processus vaginalis and one had retroperitoneal air dissection as a result of false insertion of the laparoscopic sheath. One patient had a postoperative wound infection. No patient with contralateral obliterated processus vaginalis developed inguinal hernia or hydrocele during follow-up of at least one year. The results were similar to those of the 329 children with hernia who underwent the same procedure in the same period. CONCLUSIONS: Intraoperative non-puncture laparoscopic examination is feasible in children with unilateral hydrocele.

Child↗
PubMed1998

Development of a hematoma classification tool for assessment and documentation post femoral arterial puncture.

Hematoma development following procedures involving femoral arterial puncture is a potentially serious complication, estimated to occur in 0.6% to 17% of the population undergoing these procedures. (Karfonta, 1994). A review of the current literature indicates there is a lack of consistent recording mechanisms and a lack of descriptors to document femoral site observations. Our purpose is to demonstrate the utility of a Hematoma Classification Tool (developed and piloted at the University of Ottawa Heart Institute) for post operative care management of patients following femoral arterial puncture.

Catheterization, Peripheral↗
PubMed2002

[Magnetic resonance in dural post-puncture headache in patient with cerebrospinal fluid hypotension].

Magnetic resonance imaging (MRI) has allowed us to establish a set of radiologic signs associated with intracranial hypotension syndrome. Findings are partly influenced by cerebral displacement. Intracranial hypotension syndrome is characterized by a decrease in cerebrospinal fluid (CSF) pressure to less than 60 mm H2O associated with occipital headache radiating to the frontal and temporal zones. For diagnostic purposes, the most common cause is anesthetic or therapeutic dural puncture, although spontaneous CSF leakage can occur. CSF protein and lymphocyte counts may be high, while the cranial meninges biopsy is normal. MRI images may show a descended brain, taking the start of the sylvian aqueduct and the location of the cerebellar amygdalae as points of reference; diminished size of the subarachnoidal cisterns and occasionally of the cerebral ventricles; meningeal enhancement from increased uptake of the contrast solution; subdural hygromas and hematomas; and pituitary enlargement. Paraspinal fluid and dilated epidural veins may be observed. Radiologic images and clinical signs are related. When CSF pressure is very low, there is greater meningeal enhancement, subdural collection and cerebral displacement. Findings gradually disappear as symptoms diminish. The signs and symptoms that might develop during intracranial hypotension syndrome vary according to the brain structure that might be affected during descent, repositioning and the traction of anchoring structures. MRI allows the degree of cerebral and spinal involvement to be ascertained, to predict whether resolution of the clinical picture will be early or late and to visualize the effect of approaches to reducing CSF leakage.

Anesthesia, Spinal↗
PubMed1963

YELLOW FEVER VACCINATION IN MALAYA BY SUBCUTANEOUS INJECTION AND MULTIPLE PUNCTURE. HAEMAGGLUTININ-INHIBITING ANTIBODY RESPONSES IN PERSONS WITH AND WITHOUT PRE-EXISTING ANTIBODY.

In view of the risk of introduction of yellow fever into South-East Asia, comparative studies have been made of yellow fever vaccination in Malayan volunteers with a high prevalence of antibody to related viruses and in volunteers without related antibody. In a previous paper the neutralizing antibody responses of these volunteers were reported. The present paper describes the haemagglutinin-inhibiting (HI) antibody responses of the same groups of volunteers and discusses the relationship of these responses to the neutralizing antibody responses.The HI responses to yellow fever following vaccination closely paralleled the neutralizing antibody responses whether vaccination was subcutaneous or by multiple puncture. Volunteers with a high level of YF HI antibody due to infection with other group B viruses were found to be less likely to show a significant YF HI response than those without antibody. 90% of HI responses could be detected by the 21st day after vaccination.As with neutralizing antibody responses, volunteers given vaccine doses of 50-500 mouse intracerebral LD(50) subcutaneously gave greater responses than those given higher doses.

Animals↗
PubMed2005

[Full version of the 2005 Standards, Options and Recommendations for the management of procedure-related pain (lumbar puncture, bone marrow aspiration or biopsy, blood sampling) in adult patients with cancer].

The << Standards, Options and Recommendations >> (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centres (FNCLCC), the 20 French cancer centres, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. Objectives : To establish the Standards, Options and Recommendations clinical practice guidelines for the management of procedure related pain (lumbar puncture, bone marrow aspiration or biopsy, blood sampling) in adult oncology patients. To define, on the basis of the critical appraisal of the best available evidence and expert agreement, the clinical situations in which a pain preventive strategy should be implemented. Methods. Medline(R) was searched using specific search strategies from January 1966 to August 2003. Literature monitoring was performed to identify controlled clinical trials published between August 2003 to September 2004. In addition several Internet sites were searched in July 2003. Results. A total of 12 references, corresponding to 10 randomised clinical trials, were identified. Clinical guidelines have been defined for each invasive procedure.

Adult↗
PubMed2006

[Standards, options and recommendations for the management of procedure-related pain (lumbar puncture, bone marrow aspiration or biopsy, blood sampling) in children patients with cancer (summary report)].

CONTEXT: The Standards, Options and Recommendations (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centres (FNCLCC), the 20 French cancer centres, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. OBJECTIVES: To establish the Standards, Options and Recommendations clinical practice guidelines for the management of procedure related pain (lumbar puncture, bone marrow aspiration or biopsy, blood sampling) in children oncology patients. To define, on the basis of the critical appraisal of the best available evidence and expert agreement, the clinical situations in which a pain preventive strategy should be implemented. METHODS: MEDLINE was searched using specific search strategies from January 1966 to August 2004. Literature monitoring was performed to identify controlled clinical trials published in 2005. RESULTS: A total of 57 references were identified. Clinical guidelines have been defined for each invasive procedure.

Biopsy↗
PubMedDate not supplied

Cranial computed tomography before lumbar puncture: a prospective clinical evaluation.

OBJECTIVE: To prospectively identify which patients can safely undergo lumbar puncture (LP) without screening cranial computed tomography (CT). METHODS: Emergency department physicians examined patients before CT. Examiners recorded the presence or absence of 10 clinical findings and answered 8 additional questions. The criterion standard was noncontrast cranial CT interpreted by staff radiologists. Clinical findings were prospectively compared with those of CT. RESULTS: One hundred thirteen consecutive adults with the urgent need for LP (median age, 42 years) were studied. Fifteen percent of patients meeting entrance criteria had new CT-documented lesions, with 2.7% having lesions that contraindicated LP. Sensitivity, specificity, and likelihood ratios (LRs) were measured for the clinical findings. Three statistically significant predictors of new intracranial lesions were identified: altered mentation (positive LR, 2.2; 95% confidence interval [CI], 1.5-3.2), focal neurologic examination (positive LR, 4.3; 95% CI, 1.9-10), and papilledema (positive LR, 11.1; 95% CI, 1.1-115). No single item adequately predicted the absence of CT abnormalities, but the clinical screening items in aggregate significantly predicted the results (negative LR, 0; upper 95% confidence limit, 0.6). The overall clinical impression had the highest predictive value in identifying patients with CT-defined contraindications to LP (positive LR, 18.8; 95% CI, 4.8-43). CONCLUSIONS: Because of the low prevalence of lesions that contraindicate LP, screening cranial CT solely to establish the safety of performing an LP typically provides limited additional information. Physicians can use their overall clinical impression and 3 clinical predictors to identify patients with the greatest risk of having intracranial lesions that may contraindicate LP.

Adult↗
PubMed1984

Fatal intracranial extension of spinal hemorrhage after lumbar puncture.

Lumbar puncture (LP) is sometimes performed in addition to computed tomography (CT) to exclude hemorrhage prior to anticoagulation for suspected cerebral ischemia. The LP may be complicated by spinal hemorrhage during subsequent anticoagulation. We report such a case with an eventually fatal outcome due to intracranial extension of blood. On balance, the use of LP in addition to CT in this setting appears to be unwise.

Aged↗
PubMed1984

Aerodynamic properties of four tracheoesophageal puncture prostheses.

Airway resistance calculations were completed for two tracheoesophageal puncture prostheses (American V. Mueller Blom-Singer Voice Prosthesis and BIVONA Low Resistance Voice Prosthesis), which have recently become available on a commercial basis. These calculations were compared with those made previously for two, existing prostheses: the Blom-Singer duckbill and the Panje Voice Button. Substantial differences in airway resistance properties exist among these four devices. BIVONA Low Resistance devices exhibited the lowest resistance (less than 50 cm H2O/liters per second [LPS]); Panje Voice Buttons exhibited the highest (180 to 200 cm H2O/LPS); and Blom-Singer devices exhibited intermediate values (110 to 125 cm H2O/LPS) of opposition.

Air↗
PubMed1989

The effects of radiation on tracheoesophageal puncture. A retrospective study.

A census survey of the records of the Department of Otolaryngology. The Ohio State University, Columbus, identified 108 patients with tracheoesophageal puncture (TEP) for voice restoration. Fifty-one patients received radiation therapy in the management of the disease, 50 did not, and seven were unavailable for follow-up. The records were reviewed and chi 2 tests applied to identify possible effects of radiation therapy on the achievement of TE speech and on TEP-related complications. Results of a census indicate that, with the exception of radiotherapy, the two groups of patients were highly similar with respect to ultimate achievement of TE speech and to the frequency with which complications occurred, eg, stoma stenosis or leakage via TE fistula. These findings support the incorporation of TEP with the total laryngectomy procedure, even for patients for whom radiation therapy is indicated.

Alcoholism↗
PubMed1992

Defining and predicting tracheoesophageal puncture success.

There is considerable variability in the reported success rates of tracheoesophageal puncture due, in part, to the lack of a clear definition of success and a paucity of knowledge about factors that determine success. In this article, we define success on a continuum with the use of a 15-point rating scale that incorporates aspects of use and quality of speech and ability to care for the fistula and prosthesis. We suggest a cutoff score for functional and nonfunctional speakers. We define immediate and short- and long-term success. Variables related to the patient, clinician, surgical procedure, and extent of disease were subjected to a multiple regression analysis to determine which predicted success. Overall success was predicted by greater clinician expertise, younger patient age, and better patient health. We discuss the use of the rating scale and an equation to predict success.

Adult↗