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Urologic Involvement
Published in Nazar N. Amso, Saikat Banerjee, Endometriosis, 2022
Jörg Keckstein, Gernot Hudelist, Simon Keckstein
In experienced hands, both ultrasound and MRI have high specificity for detecting bladder endometriosis. (4,5) (Figures 12.18 and 12.19). With respect to ultrasound, identification of the lesion is by a transvaginal approach, but transabdominal ultrasound is used to exclude hydronephrosis. Dynamic ultrasound technique evaluates organ mobility and is a soft marker for DE (56,57). This provides additional information about the infiltration type and specific conditions for planned surgery (see Chapter 3).
Peripheral Blood and Bone Marrow
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
Fermina Maria Mazzella, Gerardo Perrotta
Once the site has been selected, sterile technique must be observed. The skin over the puncture site is shaved if necessary, and cleansed with a disinfectant solution. Then the skin, subcutaneous tissue, and periosteum are infiltrated with a local anesthetic, such as 1% lidocaine. The patient may experience a burning sensation or discomfort during infiltration. After about 5 min, when the anesthetic has taken effect, the actual procedure may commence.
Tumescent Anesthesia
Published in Marwali Harahap, Adel R. Abadir, Anesthesia and Analgesia in Dermatologic Surgery, 2019
William B. Henghold, Brent R. Moody
As one would expect, certain regions of the body are much more sensitive to infiltration than others. These are primarily the more fibrous sites such as the periumbilical and costal areas. Reducing the rate of infiltration, advancing the cannula slowly and smoothly, using smaller diameter cannulas, and increasing the concentration of anesthetic solution are techniques to keep in mind when working in more sensitive areas. Warming of the tumescent solution (in a microwave oven or hot water bath) prior to infusion has been shown to significantly improve the pain associated with infiltration compared with that of a room temperature solution (55, 56). This also prevents the core body temperature from lowering as can occur if even room temperature solutions are used. Chilled solutions should never be used. Care must also be taken not to overheat the solution.
The effect of short-term cryopreservation on the properties and functionality of platelet-rich plasma
Published in Platelets, 2023
Maider Beitia, Diego Delgado, Jon Mercader, Irene Gimeno, João Espregueira-Mendes, Beatriz Aizpurua, Mikel Sánchez
In routine clinical practice PRP has an autologous nature and the whole obtention process is usually conducted immediately before its injection into the affected area. This implies that the blood is collected and processed during the patients visit for each infiltration session. This aspect, however, has a number of limitations. First, the patient’s waiting time can be prolonged as the whole process, from blood extraction to the infiltration, can be extended in time. Second, the fact that the blood is extracted immediately before its processing would limit a potential allogeneic use, since the patient and donor(s) would have to be scheduled to come along to the medical center the same day and time. Finally, this aspect could also be limiting in the case of patients who present medical difficulties or apprehension at the time of puncture for blood collection, due to the need to draw blood at every infiltration visit. Considering these limitations, PRP preservation could be a solution that solves these problems and might open new doors to new sample processing protocols that better adapt to the needs of each patient.
An unusual case of a grade I meningioma with perineural spread
Published in British Journal of Neurosurgery, 2023
Mohammed Fadelalla, Avinash Kumar Kanodia, John Brunton, Kirit Singh, Antonia Torgersen, Esther Sammler, Colin Smith, David Mowle, Paul White, Kismet Hossain-Ibrahim
The mechanism for this type of perineural infiltration is poorly understood. At the molecular level, there appears to be a possible association between Neural Cell Adhesion Molecule (N-CAM) (also known as CD56) and perineural spread. Barrett and Speight found that 89% of all ACC cases and 93% of those associated with perineural spread expressed NCAM,11 and its expression has also been demonstrated in head and neck Squamous Cell Carcinoma.12 Other molecular analyses have revealed an increased expression of matrix metalloproteinases and various growth factors but with no clear mechanism for how this promotes perineural spread. It has long been theorized that the nerves may provide the pathway of least resistance for the spreading malignancy, but more recent work suggests a more invasive process rather than diffusion alone, involving signalling pathways between the nerves and the invading tumour cells. However, further work is required to fully understand this.13
Device profile of the Orchid safety release valve for the prevention of accidental catheter dislodgement
Published in Expert Review of Medical Devices, 2023
Treatment delivered through peripheral intravenous (PIV) catheters is the mainstay of medical practices in acute care. An estimated 80% or more of patients admitted into acute care require some form of intravenous (IV) access. The primary goals of IV device care are successful IV insertion and maintenance and the prevention of catheter-related complications. When IV devices fail, become dislodged, or develop complications, medical treatment is hampered, and patients require more invasive procedures, such as re-insertion of the IV. The failure rate associated with PIV catheters is well documented at or above 46%, with dislodgement estimated at 15–69% [1–4]. Complications attributed to catheter dislodgement include infiltration, venous phlebitis, catheter occlusion, and failure. Preventing complications, dislodgement, and catheter failure is, therefore, essential to the completion of intravenous therapy and medical treatment.