Boas práticas na aspiração endotraqueal em uma unidade de terapia intensiva: estudo observacional / Buenas prácticas en aspiración endotraqueal en una unidad de cuidados intensivos: estudio observacional / Good practices in endotracheal aspiration in an intensive care unit: observational study

Objetivos: descrever as boas práticas realizadas pela equipe multiprofissional durante a aspiração de vias aéreas inferiores em pacientes adultos, internados na Unidade de Terapia Intensiva. Método: estudo quantitativo, observacional, descritivo e prospectivo, norteado pela ferramenta STROBE, realizado em uma Unidade de Terapia Intensiva adulto, entre maio e agosto de 2022. A amostra foi composta por 25 observações e a coleta de dados através de checklist, incluídos os profissionais de enfermagem, fisioterapia e medicina. Os dados foram processados no Statistical Package for the Social Sciences, sendo calculadas as frequências absolutas e relativas. Resultados: a maioria das aspirações foram realizadas pela equipe de enfermagem, 20 (80%) profissionais não regularam a fração inspirada de oxigênio antes e após o procedimento, 06 (60%) profissionais não clampearam a sonda durante a sua inserção. O uso de máscara (100%), capote (92%) e luva (100%) foram as boas práticas com maior aderência entre os participantes. Conclusão: reforça-se a necessidade de incentivar os treinamentos abordando as boas práticas durante a aspiração endotraqueal.

Objetivos: describir las buenas prácticas realizadas por el equipo multiprofesional durante la aspiración de vías aéreas inferiores en pacientes adultos, ingresados en la Unidad de Cuidados Intensivos. Método: estudio cuantitativo, observacional, descriptivo y prospectivo, guiado por la herramienta STROBE, realizado en una unidad de cuidados intensivos adulta, entre mayo y agosto de 2022. La muestra fue compuesta por 25 observaciones y la recogida de datos a través de checklist, incluidos los profesionales de enfermería, fisioterapia y medicina. Los datos fueron procesados en el Statistical Package for the Social Sciences, siendo calculadas las frecuencias absolutas y relativas. Resultados: la mayoría de las aspiraciones fueron realizadas por el equipo de enfermería, 20 (80%) profesionales no regularon la fracción inspirada de oxígeno antes y después del procedimiento, 06 (60%) profesionales no clampearon la sonda durante su inserción. El uso de máscara (100%), capucha (92%) y guante (100%) fueron las mejores prácticas con mayor adherencia entre los participantes. Conclusión: se refuerza la necesidad de incentivar los entrenamientos abordando las buenas prácticas durante la aspiración endotraqueal.

Objective: to describe the good practices performed by the multiprofessional team during lower airway aspiration in adult patients admitted to the Intensive Care Unit. Method: quantitative, observational, descriptive and prospective study, guided by the STROBE tool, conducted in an adult intensive care unit, between May and August 2022. The sample consisted of 25 observations and data collection through checklist, including nursing, physiotherapy and medicine professionals. The data were processed in the Statistical Package for the Social Sciences, and the absolute and relative frequencies were calculated. Results: most aspirations were performed by the nursing team, 20 (80%) professionals did not regulate the inspired fraction of oxygen before and after the procedure, 06 (60%) professionals did not clamp the tube during its insertion. The use of mask (100%), cloak (92%) and glove (100%) were the best practices with greater adherence among participants. Conclusion: there is the need to encourage training addressing good practices during endotracheal aspiration.

Application of self-made negative pressure suction in the treatment of auricle subluxation and avulsion injury / 中国医师进修杂志

Objective:To explore the effect of self-made negative pressure suction in auricle subluxation and avulsion injury.Methods:The clinical data of 7 patients with auricle subluxation and avulsion injury from January 2017 to February 2022 in the First People′s Hospital of Lianyungang City were retrospectively analyzed. The 7 patients were treated with self-made simple negative pressure drainage device for negative pressure suction after suture.Results:Among the 7 patients, 1 patient suffered from severe contusion and local skin necrosis, and the scar healed after local application of erythromycin eye ointment, while the other patients healed in the first stage without obvious auricular deformity.Conclusions:The negative pressure drainage is the key factor to ensure the blood supply and shape of patients with auricle subluxation and avulsion injury. The application of self-made negative pressure drainage in the treatment of subtotal auricle avulsion injury has the advantages of simple operation, improved survival rate of auricle and improved satisfactory auricle shape.

Application of controllable negative pressure suction sheath in flexible ureteroscopic lithotripsy in the treatment of renal calculi / 现代泌尿外科杂志

【Objective】 To compare the clinical application value of controllable negative pressure suction outer sheath and ordinary flexible endoscope outer sheath in flexible ureteroscopic lithotripsy with holmium laser in the treatment of renal calculi less than or equal to 2 cm in diameter. 【Methods】 A total of 85 patients with renal calculi were selected and randomly divided into negative pressure group (n=45) and ordinary group (n=40). The operation time, complications, infection indexes 2 h after operation, adverse reactions, treatment efficacy and stone-clearance rate were compared between the two groups. 【Results】 The sheath was successfully implanted and holmium laser lithotripsy was performed in both groups. The negative pressure group had significantly shorter operation time than the ordinary group [(43.3±4.9) min vs. (66.2±5.8) min, P0.05). The increase of infection indexes (procalcitonin and leukocyte) 2 h after operation were significantly lower in the negative pressure group than in the ordinary group (P<0.05). The efficacy in the negative pressure group was 91.11% (41/45) and the stone-clearance rate was 95.56% (43/45), which were significantly better than those in the ordinary group (72.50% (29/40) and 80% (32/40), respectively. The total incidence of adverse reactions such as renal colic, gross hematuria and ureteral stone street was higher in the ordinary group than in the negative pressure group (P<0.05). 【Conclusions】 Controllable negative pressure suction sheath in flexible ureteroscopic lithotripsy is more effective, as the circulation perfusion keeps the operation field clear, reduces the operation time and improves the stone-clearance rate, while the negative pressure suction lowers the pelvis pressure to prevent infectious urine from entering the blood.

Analysis of the efficacy of negative pressure suction and topical testosterone cream in the treatment of simple micropenis in school-aged obese children / 现代泌尿外科杂志

【Objective】 To investigate the efficacy of negative pressure suction and topical testosterone cream in the treatment of simple micropenis in school-aged obese children and the effects on blood lipids and serum sex hormones. 【Methods】 A total of 79 children aged 7 to 14 (10.50±1.62) years treated and followed up during Nov.2020 and Jul.2022 were involved. The patients were randomly enrolled in the negative pressure suction group (n=39) and the topical testosterone cream group (n=40). The negative pressure suction group was treated with negative pressure suction for 30 min/time, 1 time/day, for 30 d. The topical testosterone cream group was treated with topical testosterone cream applied to the scrotum of the penis 2 times/day for 30d. The transverse and longitudinal diameter of the glans, penile flaccidity, retraction length, serum sex hormones and blood lipids were measured before and after treatment. 【Results】 In both groups, penile flaccidity, retracted length and transverse and longitudinal diameter of the glans were significantly greater at 30 days of treatment and 2 months of follow-up than those before treatment (P0.025). In the topical testosterone cream group, at 30 days of treatment, there were significant differences in serum total cholesterol (CHOL), apolipoprotein B (Apo B), apolipoprotein A1 (Apo A1), high-density lipoprotein (HDL), low-density lipoprotein (LDL), sex hormone binding protein (SBG), estradiol (E2) and testosterone (TES) compared to those before treatment; at 2 months of follow-up, the differences in Apo A1, HDL, TES and DHS were still significant (P<0.025). 【Conclusion】 Both topical testosterone cream and negative pressure suction have significant efficacy in the treatment of micropenis in school-aged obese children, while topical testosterone cream has some side effects and retraction may occur after treatment. Negative pressure suction is safe and easy to operate, without side effects and retraction, and can be promoted for the treatment of micropenis in obese children.

Clinical efficacy of double-sheath vacuum suction microchannel percutaneous nephrolithotomy in the treatment of complex renal stones / 现代泌尿外科杂志

【Objective】 To investigate the efficacy and safety of double-sheath vacuum suction microchannel percutaneous nephrolithotomy (MPCNL) in the treatment of complex renal stones. 【Methods】 The clinical data of 139 patients with complicated renal stones who received MPCNL during Aug. 2019 and Jul.2020 were retrospectively analyzed. According to the operation modes, the patients were divided into the double-sheath vacuum suction group (dsVS group, n=72) and conventional nephrostomy sheath group (cNS group, n=67). The perioperative indexes and the first-stage stone clearance rate of the two groups were compared. 【Results】 In the dsVS group and cNS group, the mean operation time was (46.72±9.55) min and (57.22±11.31) min, respectively (P<0.05). The first-stage stone clearance rate was 83.33% and 70.15%, respectively (P<0.05). The BUN value was (5.07±1.65) mmol/L and (5.75±1.83) mmol/L, respectively (P<0.05). The WBC value was (9.45±2.46)×109/L and (10.71±3.14)×109/L, respectively (P<0.05). The incidence of postoperative fever was 1.39% and 11.94%, respectively (P<0.05). There was no significant difference in other clinical data between the two groups (P>0.05). 【Conclusion】 The double-sheath vacuum suction MPCNL is safe and effective to manage complex renal stones, which can shorten the operation time, reduce postoperative complications, and improve the stone clearance rate.

Effects of fat suction combined with bipolar radiofrequency on facial and neck rejuvenation / 中华医学美学美容杂志

Objective:To investigate the efficacy and safety of fat suction combined with bipolar radiofrequency on face and neck rejuvenation.Methods:A total of 115 patients with face and neck fat deposits and skin laxity underwent fat suction combined with bipolar radiofrequency between December 2021 and October 2022 by the same surgeon in Changsha My Like Medical Cosmetology Hospital. There were 3 men and 112 women in this research. The mean age was 36.1 years (range, 26-55 years) and the mean body mass index was 21.4 (range, 16.8-27.7 kg/cm 2). Postoperative patient satisfaction surveys were conducted and 2 independent doctors evaluated clinical effect with preoperative and postoperative photographs at 3-6 months postoperatively. Results:The mean amount of fat aspirated was 44.5 ml (range, 10-92 ml) and the mean energy delivered was 4.5 kJ (range, 2.1-8.9 ml). 88.7% of patients were satisfied with their postoperative effect (102/115 patients). 92.2% of doctors were satisfied with the postoperative effect (106/115 patients). Four out of 115 patients (3.5%) developed irregularity by fat suction.Conclusions:Fat suction combined with bipolar radiofrequency can effectively reduce the fat accumulation of facial and neck and significantly improve skin relaxation. It is an effective method to rejuvenate facial and neck.

The evolution of approach in the resuscitation of neonates born with meconium-stained amniotic fluid: a tale of two countries, China and U.S.A., in the past 60 years / 中国当代儿科杂志

Neonates born through meconium-stained amniotic fluid (MSAF) may develop complications including meconium aspiration syndrome, persistent pulmonary hypertension of newborn and death. The approach to the resuscitation of these neonates has significantly evolved for the past few decades. Initially, under direct visualization technique, neonates with MSAF were commonly suctioned below the vocal cords soon after delivery. Since 2015, Neonatal Resuscitation Program (NRP®) of the American Academy of Pediatrics has recommended against "routine" endotracheal suctioning of non-vigorous neonates with MSAF but favored immediate resuscitation with positive pressure ventilation via face-mask bagging. However, the China neonatal resuscitation 2021 guidelines continue to recommend routine endotracheal suctioning of non-vigorous neonates born with MSAF at birth. This review article discusses the differences and the rationales in the approach in the resuscitation of neonates with MSAF between Chinese and American NRP® guidelines over the past 60 years.

Dificuldades na amamentação de lactentes com fissura labiopalatina / Difficulties in breastfeeding infants with cleft lip and palate / Dificultades en la lactancia de niños con labio leporino y paladar hendido

A partir da malformação congênita ocorrida pela 4ª semana a 12ª semana de vida uterina, com etiologia multifatorial , a fissura labiopalatina consiste em processos faciais acometidos com irregularidades o qual , dependendo da complexidade da abertura acarretará em dificuldades para a amamentação de lactantes. Neste sentido, o objetivo deste estudo é expor as principais dificuldades quanto ao processo de amamentação, trazendo referências atualizadas sobre o tema vinculado ao conhecimento científico. Para tal, realizou-se uma revisão integrativa de literatura com busca de artigos originais e revisões indexadas na base de dados da Biblioteca Virtual em Saúde (BVS), disponíveis pela seleção das plataformas LILACS, BDENF e MEDLINE, adotando critérios de inclusão e exclusão de artigos. Dentre os achados, 70% deles foram de origem internacional, e demonstram que, os lactantes encontram dificuldades para a amamentação conforme o grau da fissura labiopalatina, quanto maior a complexidade da fenda, menor a chance de se realizar o Aleitamento Materno Exclusivo (AME) e as principais dificuldades encontradas foram: desnutrição, perda de peso, sucção débil, pega inadequada da mama e deglutição prejudicada. Destaca-se, também, que, na maioria dos estudos abordados, as mães apresentam dificuldades frente ao diagnóstico não esperado. Portanto, torna-se indispensável aos profissionais da equipe de enfermagem ter o conhecimento científico e preparo assistencial para propor a família dos lactantes formas viáveis para a amamentação.

From the congenital malformation occurring in the 4th week to the 12th week of uterine life, with multifactorial etiology, cleft lip and palate consists of affected facial processes with irregularities which, depending on the complexity of the opening will cause difficulties for breastfeeding infants. In this sense, the objective of this study is to expose the main difficulties regarding the process of breastfeeding, bringing updated references on the subject linked to scientific knowledge. To this end, an integrative literature review was carried out searching for original articles and reviews indexed in the Virtual Health Library (VHL) database, available through the selection of LILACS, BDENF, and MEDLINE platforms, adopting article inclusion and exclusion criteria. Among the findings, 70% were of international origin, and showed that the lactating infants encounter difficulties in breastfeeding according to the degree of cleft lip and palate; the greater the complexity of the cleft, the lower the chance of exclusive breastfeeding (EBF), and the main difficulties found were malnutrition, weight loss, weak suction, inadequate grip on the breast, and impaired deglutition. It is also noteworthy that, in most of the studies approached, mothers have difficulties when facing an unexpected diagnosis. Therefore, it is essential for nursing professionals to have the scientific knowledge and assistance preparation to propose viable forms of breastfeeding to the infants' families.

De la malformación congénita que ocurre en la 4ª semana a la 12ª semana de vida uterina, con etiología multifactorial, el labio leporino y paladar hendido consiste en procesos faciales afectados con irregularidades que, dependiendo de la complejidad de la abertura causarán dificultades para la lactancia materna de los lactantes. En este sentido, el objetivo de este estudio es exponer las principales dificultades relativas al proceso de lactancia materna, aportando referencias actualizadas sobre el tema vinculadas al conocimiento científico. Para ello, se realizó una revisión bibliográfica integradora buscando artículos originales y revisiones indexados en la base de datos de la Biblioteca Virtual en Salud (BVS), disponibles a través de la selección de las plataformas LILACS, BDENF y MEDLINE, adoptando criterios de inclusión y exclusión de artículos. Entre los hallazgos, el 70% eran de origen internacional, y mostraron que los lactantes encuentran dificultades en la lactancia materna de acuerdo con el grado de labio leporino y paladar hendido; cuanto mayor es la complejidad de la hendidura, menor es la posibilidad de lactancia materna exclusiva (LME), y las principales dificultades encontradas fueron la desnutrición, pérdida de peso, succión débil, agarre inadecuado al pecho y deglución alterada. También cabe destacar que, en la mayoría de los estudios abordados, las madres tienen dificultades cuando se enfrentan a un diagnóstico inesperado. Por lo tanto, es fundamental que los profesionales de enfermería tengan el conocimiento científico y la preparación asistencial para proponer formas viables de amamantamiento a las familias de los lactantes.

Enhanced access and isolation by simple modifications of dental armamentarium

A good armamentarium facilitates the efficient working of the dentist which in turn improves the quality of treatment rendered to the patient. The present invention of the unit consisting of the flexible mirror attached to the suction and the dual suction tip aims at improving the clinical efficiency of dental treatments provided. This compact unit is designed to improve the visualization and isolation of the operating field. It is also easy to fabricate and alleviates the very relevant shortcomings of clinical work.

OCCURRENCE, MANAGEMENT AND OUTCOME OF MOLAR PREGNANCIES IN TERTIARY CARE CENTRE, GMCH

Molar pregnancies represent a signi?cant burden of disease on the spectrum of gestational trophoblastic disease. The incidence varies widely in different parts of the world. The objective of this study is to determine the occurrence, management, and outcome of molar pregnancies at our institution. During the study period of 1 year, a total of 36 cases were diagnosed with GTD, giving an incidence of 2.6 per 1000 pregnancies, 2.7 per 1000 deliveries and 2.8 per 1000 livebirths in the department of Obstetrics and Gynaecology, GMCH. Vaginal bleeding was the commonest symptoms (66.66%) apart from amenorrhea. Suction evacuation was the primary mode of treatment (91.66%) and only 4 patients (11.11%) underwent hysterectomy. Chemotherapy was administered in 12 patients. During the follow up period, 5 patients (13.88%) were diagnosed with GTN, 4 of them being invasive mole and 1 being choriocarcinoma. Use of routine ?rst trimester ultrasonography has led to early diagnosis and majority of cases are cured by simple surgical intervention. Longer follow up protocol attribute to poor compliance. A multi-centered study is essential in India to determine the true incidence and overall outcome of molar pregnancy that will help in the understanding of the burden of the disease.

Comparison of two types of disinfectants on the disinfection of the fixed end of the table suction pipe in the oral comprehensive treatment table / 口腔疾病防治

Objective@#To compare the disinfection effects of 500 mg/L chlorine-containing disinfectant and 3% hydrogen peroxide disinfectant applied to the threaded plastic hose at the fixed end of the saliva suction pipe of the oral comprehensive treatment table after diagnosis and treatment of patients in stomatology to provide a basis for clinical cleaning and disinfection.@* Methods @#The fixed ends of saliva suction pipes of 12 comprehensive treatment tables in the dental pulp department and maxillofacial surgery were selected as the research objects. The absorption was randomly divided into two groups and a control group: experimental group 1 with 500 mg/L chlorine disinfectants and experiment 2 group with 3% hydrogen peroxide disinfectant rinse disinfection and the control group with 0.9% sterile saline flushing pipe once a week for four weeks. Before and after washing and disinfection, samples from the inner wall of the threaded plastic hose interface were collected for bacterial culture and colony count, and colony counts within and between groups were compared before and after disinfection. Statistical analysis was conducted using SPSS 24.0 software.@*Results@#The baseline number of bacterial colonies in the first three groups was balanced, with no statistically significant difference (χ2 = 0.538, P = 0.764). The number of bacterial colonies after washing and disinfection was lower than that before washing and disinfection. The difference between 500 mg/L chlorine-containing disinfectant and 3% hydrogen peroxide disinfectant before and after disinfection was highly significant (Z = -4.801, P<0.001; Z = -4.429, P<0.001). There was no significant difference between the disinfection effect of 500 mg/L chlorine-containing disinfectant and 3% hydrogen peroxide disinfectant, but they were both better than the control group (χ2 = 18.070, P<0.001).@*Conclusion@#Disinfecting the saliva suction pipe with disinfectant between diagnosis and treatment can effectively reduce the bacterial contamination at the fixed end threaded plastic hose interface of the saliva suction pipe. The disinfection method is simple and convenient, and it is worth applying in the oral clinic.

A retrospective cohort study of tracheal intubation for meconium suction in nonvigorous neonates / 中国当代儿科杂志

OBJECTIVES@#To study the feasibility of tracheal intubation for meconium suction immediately after birth of nonvigorous neonates born through meconium-stained amniotic fluid (MSAF).@*METHODS@#A retrospective cohort study was performed on nonvigorous neonates born through MSAF who were admitted to the Department of Neonatology, Zhecheng People's Hospital. The neonates without meconium suction who were admitted from July 1, 2017 to June 30, 2018 were enrolled as the control group. The neonates who underwent meconium suction from July 1, 2018 to June 30, 2019 were enrolled as the suction group. The two groups were compared in terms of the mortality rate and the incidence rates of neonatal meconium aspiration syndrome (MAS), persistent pulmonary hypertension of the newborn, pneumothorax, and pulmonary hemorrhage.@*RESULTS@#There were 80 neonates in the control group and 71 in the suction group. There were no significant differences between the two groups in the incidence rates of MAS (11% vs 7%), persistent pulmonary hypertension of the newborn (5% vs 4%), pneumothorax (3% vs 1%), and death (0% vs 1%). Compared with the control group, the suction group had a significantly lower proportion of neonates requiring oxygen inhalation (16% vs 33%, P<0.05), noninvasive respiratory support (25% vs 41%, P<0.05) or mechanical ventilation (10% vs 23%, P<0.05) and significantly shorter duration of noninvasive ventilation [(58±24) hours vs (83±41) hours, P<0.05] and length of hospital stay [6(4, 8) days vs 7(5, 10) days, P<0.05].@*CONCLUSIONS@#Although tracheal intubation for meconium suction immediately after birth may shorten the duration of respiratory support for mild respiratory problems, it cannot reduce the incidence rate of MAS, mortality rate, or the incidence rate of serious complications in nonvigorous infants born through MSAF.

Effects of different sputum suction pressure on intracranial pressure of severe craniocerebral injury patients / 中国实用护理杂志

Objective:To explore the best negative pressure standard of sputum aspiration in patients with severe craniocerebral injury, so as to achieve the best sputum aspiration effect and maintain relatively stable intracranial pressure.Methods:Totally 120 patients with severe craniocerebral injury admitted to the Department of Neurosurgery of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January to December 2019 were selected by convenience sampling method. According to the random number table method, patients were divided into 4 different negative pressure sputum aspiration groups: 75 mmHg (1 mmHg=0.133 kPa) group, 100 mmHg group, 150 mmHg group, 200 mmHg group, with 30 patients in each group. The levels of intracranial pressure and SpO 2, sputum cleaning time and mucosal injury were observed and compared in 4 groups: 1 min before sputum aspiration, 1 min after sputum aspiration and during sputum aspiration. Results:Comparison of intracranial pressure and SpO 2 in sputum aspiration among the four groups: intracranial pressure in 200 mmHg group was (22.23 ± 4.80) mmHg, which was higher than 75 mmHg group (16.33 ± 2.71) mmHg, 100 mmHg group (17.70 ± 2.32) mmHg, 150 mmHg group (17.20 ± 2.11) mmHg ( q=8.29, 6.58, 7.23), and SpO 2 was 0.906 ± 0.048, which was lower than 0.956 ± 0.013, 0.946 ± 0.018, 0.952 ± 0.023 in the other three groups ( q=7.81, 6.08, 6.69), with statistical significance (all P<0.01). There were statistically significant differences in intracranial pressure ( F=10.55) and SpO 2 ( F=36.57) among the four groups 1 min after sputum aspiration ( P<0.01);the 200 mmHg group had the highest intracranial pressure (15.63 ± 3.64) mmHg; the 100 mmHg group was (12.50 ± 1.48) mmHg and 150 mmHg group was (12.60 ± 1.00) mmHg, which had lower intracranial pressure than the 75 mmHg group (14.03 ± 2.86) mmHg. The sputum cleaning time was (35.53 ± 5.71) s in 75 mmHg group which was the longest and the shortest in 200 mmHg group (24.27 ± 3.22) s, with statistical significance among the four groups ( F=47.81, P<0.01). The incidence of airway mucosal injury in 200 mmHg group was 33.33% (10/30),which was higher than that in the other three groups, and the difference was statistically significant ( χ2=15.41, P<0.01). Conclusions:For patients with severe craniocerebral injury, artificial airway sputum viscosityⅠ-Ⅱ degree, suction negative pressure of 100-150 mmHg can better maintain the stability of intracranial pressure, control the decline of SpO 2 and prevent the damage of airway mucosa, and effectively reduce the adverse effects of sputum aspiration on patients with severe craniocerebral injury.

Design and application of an extension tube for ventilator pipeline / 中华危重病急救医学

At present, the extension tube of the ventilator, a long corrugated tube used in clinical practice, needs to be disconnected from the endotracheal tube when performing open sputum suction. Under positive pressure, the condensed water containing pathogenic microorganisms in the ventilator will be splashed. Some will form aerosol suspended in the air, pollute the air, increase the risk of cross-infection and operator pollution, while the ventilator will emit a corresponding alarm sound, resulting in noise pollution. Based on the above factors, a ventilator pipeline extension tube was designed by the medical staff of department of critical care medicine of the Eighth Medical Center of People's Liberation Army General Hospital and department of critical care medicine of Beijing Friendship Hospital of Capital Medical University, and was obtained the National Utility Model Patent of China (ZL 2020 2 1476518.X). The device consists of the main pipe, first pipe sleeve, second pipe sleeve, valve body, joystick, axial sleeve, etc., which can not only effectively avoid air pollution and reduce the risk of cross-infection, but also reduce noise pollution and the negative impact of loud noise on patients and medical staff.

Design and application of flushing device of a totally enclosed sputum suction tube for reducing the incidence of ventilator-associated pneumonia / 中华危重病急救医学

Ventilator-associated pneumonia (VAP) is one of the most common infectious diseases in patients undergoing mechanical ventilation in intensive care unit (ICU). Although the use of closed sputum suction tube for sputum suction is the most common nursing measure for patients with tracheal intubation in ICU, and it is also an important measure to reduce the occurrence of VAP, the existing clinical technology still needs to use external flushing solution for humidification and flushing. In the process of use, the flushing operation has the risk that the amount of flushing fluid cannot be controlled, resulting in a large amount of flushing fluid entering the patient's airway, causing the patient to suffocate. The sputum attached to the wall of the sputum suction tube cannot be completely flushed, and the prolonged retention of the sputum leads to the proliferation of colonized bacteria, aggravating the infection of patients. Repeated pipe flushing not only increases consumables, but also increases the workload of medical staff. For this reason, the author has designed a fully enclosed sputum suction tube flushing device, which has obtained the National Utility Model Patent of China (patent number: CN 2019 2 1198740.5). This device is an integrated design, and the materials used for sputum suction, humidification and flushing are fully enclosed, without air exposure, and can be operated strictly without bacteria. Pulse flushing with syringe can clean the sputum attached to the inner wall and reduce the incidence of VAP. The volume of flushing fluid can be effectively controlled during use to ensure patient safety and reduce waste. It is worth popularizing and applying in clinical practice to optimize the operation steps and reduce the workload of medical staff.

Use of Vacuum-suction in Depressed Skull Fractures ­ Case Report and Technical Nuances of Nonoperative Treatment

Up to 20% of victims from skull fractures are represented by the pediatric population, and 50% of these lesions are depressed skull fractures. The treatment is multimodal in nature, ranging from conservative treatment to open surgical repair. The last one is associated, although in a small proportion, to complications, such as infections, hematomas and even death, besides the risks of the anesthetic procedure itself. The authors of the present article present a case report of the successful treatment of a depressed skull fracture in a newborn patient, using the vacuum-suction technique. The use of vacuum-suction may be beneficial for the pediatric patients, as it is a quick, non-invasive procedure, without the need for general anesthesia.

Ventosaterapia no alívio da dor cervical em costureiras do sul catarinense / Cupping therapy in the relief of cervical pain in seamstresses from southern Santa Catarina / Terapia con ventosa para aliviar el dolor cervical en costureras del sur de Santa Catarina

Objetivo:identificar os efeitos do método de ventosaterapia no alívio da dor cervical em costureiras de uma confecção do segmento vestuário jeans, na região carbonífera do sul catarinense. Método: trata-se de um estudo quantitativo e longitudinal, realizado no segundo semestre de 2019, com a utilização da ventosaterapia durante oito semanas consecutivas em costureiras de uma empresa da linha têxtil no ramo do jeans, entre 40 e 50 anos, que apresentam cervicalgia. Foi utilizado a escala visual analógica para avaliação da dor.Resultados: aamostra foi composta por mulheres com média de 44,75 ± 3,58 anos, que 100% relataram dores antes da ventosaterapia, sendo 75% na cervical e 37,5% sentia essas dores diariamente. Após ventosaterapia, 50% não apresentou dores, 87,5% relatou não atrapalhar nas atividades diárias. Conclusão: foi observado a redução significativa na dor das costureiras, após utilização de terapia com ventosas.

Objective: to identify the effects of the cupping therapy method in the relief of cervical pain in seamstresses of a clothing industry in the jeans industry, in the carboniferous region of southern Santa Catarina. Method: a quantitative and longitudinal study, carried out in the second semester of 2019, with the use of cupping therapy for eight consecutive weeks in seamstresses of a textile company in the jeans industry, between 40 and 50 years old, who have neck pain. The visual analogue scale was used to assess pain. Results: the sample consisted of women with an average of 44.75 ± 3.58 years, of which 100% reported pain before cupping therapy, 75% in the cervical and 37.5% experienced these pains daily. After cupping therapy, 50% had no pain, 87.5% reported no disturbance on their daily activities. Conclusion: a significant reduction in the pain of the seamstresses was observed, after the use of cupping therapy.

Objetivo: Identificar los efectos dela terapia comventosaen el alivio del dolor de cuello en costureras de una confección en el segmento de ropa de mezclilla, en la región carbonífera del sur de Santa Catarina.Método: se trata de un estudio cuantitativo y longitudinal, realizado en el segundo semestre de 2019, con el uso de la eólica durante ocho semanas consecutivas en costureras de una empresa de línea textil de la industria del jeans, de entre 40 y 50 años, que presentan dolor de cuello. La escala analógica visual se utilizó para evaluar el dolor. Resultados: la muestra estuvo conformada por mujeres con un promedio de 44,75 ± 3,58 años, que el 100% refirió dolor antes de la eólica, el 75% en la cervical y el 37,5% sintió estos dolores diariamente. Después de la terapia de viento, el50% no tuvo dolor, el 87,5% informó que no le molestaban las actividades diarias. Conclusión: se observó una reducción significativa del dolor de las costureras, luego del uso de la terapia con ventosa.

Sclerotherapy with 75% hypertonic glucose to treat dorsal synovial cysts of the wrist / Tratamento do cisto sinovial dorsal do punho com escleroterapia utilizando glicose hipertônica 75%

ABSTRACT Objective: To evaluate the cure rate for dorsal synovial cysts of the wrist with aspiration and percutaneous sclerotherapy using 75% hypertonic glucose. Methods: We enrolled 45 patients older than 18 years with untreated dorsal synovial cysts of the wrist. They underwent percutaneous aspiration and sclerotherapy with 75% hypertonic glucose 75%. A maximum of two procedures were conducted for each cyst at a 4-week interval. We analyzed age, sex, affected side, history of previous trauma, wrist goniometry, grip strength, wrist pain by the visual analogue scale, complications, and hand function questionnaire scores. Results: We evaluated 45 patients (30 female, 15 male, mean age 38.2 years with 47 cysts). Four weeks after the first procedure, 72.3% cysts were palpable and visible. At 24 weeks after the first procedure, 57.4% cysts evolved to cure and 42.6% persisted. Conclusion: Treatment of dorsal synovial cyst of the wrist with aspiration and percutaneous sclerotherapy using 75% hypertonic glucose achieved a 57.4% cure rate after 24 weeks. Level of Evidence IV, Case series

RESUMO Objetivo: Avaliar o índice de cura do cisto sinovial dorsal do punho, com aspiração e escleroterapia percutânea utilizando glicose hipertônica 75%. Métodos: Foram selecionados pacientes maiores de 18 anos, portadores de cisto sinovial dorsal do punho, sem tratamento prévio. Foram submetidos a aspiração e escleroterapia percutânea com glicose hipertônica 75%. Foi realizado no máximo dois procedimentos em cada cisto, em um intervalo de 4 semanas. Foram analisados idade, gênero, lado acometido, história de trauma prévio, goniometria, força de preensão, dor no punho pela escala visual analógica, complicações e os escores dos questionários funcionais. Resultados: Foram avaliados 45 pacientes com 47 cistos, houve perda de seguimento de 3 pacientes (3 cistos). A média de idade foi de 38,2 anos. Na quarta semana após o primeiro procedimento, tivemos cura em 23,4% cistos, 4,3% cistos apresentavam-se palpáveis porém não visíveis e 72,3% cistos se apresentavam palpáveis e visíveis. Os cistos visíveis e palpáveis foram submetidos ao segundo procedimento. Após 24 semanas do primeiro procedimento, 57,4% cistos foram curados e 42,6% cistos apresentaram persistência. Conclusão: O tratamento do cisto sinovial dorsal do punho com escleroterapia percutânea utilizando Glicose Hipertônica 75%, proporcionou cura de 57,4% após 24 semanas. Nível de Evidência IV, Série de casos

Intervención educativa sobre succión digital en escolares. San Antonio de los Baños. 2019 / Educational intervention on digital suction in scholars. San Antonio de los Baños, 2019

Introducción: La succión digital se ha descrito como un hábito común en la infancia, pero su persistencia, acompañada de un patrón esqueletal desfavorable ocasiona diversas anomalías. Objetivo: Evaluar los resultados de un programa de intervención educativa en niños de 6 a 11 años con hábito de succión digital, pertenecientes a las escuelas primarias Julio Pérez y Domingo Lence del municipio San Antonio de los Baños. Material y Métodos: Se realizó un estudio cuasi-experimental. De un universo de 107 niños que practicaban hábitos deletéreos, se seleccionó una muestra de 42 teniendo en cuenta los criterios de inclusión. Las variables analizadas fueron: edad, sexo, nivel de conocimiento, anomalías dentomaxilofaciales y abandono del hábito. Los datos se tomaron de los resultados de la aplicación de un cuestionario. En el análisis de la información se utilizó el porcentaje y se confeccionaron tablas estadísticas y gráfico. Se usaron métodos teóricos, empíricos, estadísticos y el análisis documental. Resultados: Los niños entre 6 y 7 años fueron 47,6 por ciento y el sexo femenino, 73,8 por ciento. Dentro de las anomalías dentomaxilofaciales, la disfunción labial se presentó en 95,2 por ciento y el resalte aumentado en 92,8 por ciento. El 83.3 por ciento de los niños finalizaron con un conocimiento adecuado. El 78,6 por ciento abandonó el hábito. Conclusiones: Predominaron las hembras y el grupo de edad de 6 a 7 años. Las anomalías dentomaxilofaciales más frecuentes fueron la disfunción labial seguido del resalte aumentado. Aumentó el nivel de conocimientos y el abandono del hábito fue elevado(AU)

Introduction: Digital suction has been described as a common habit in childhood, but it can cause several anomalies if it is persistent and accompanied by an unfavorable skeletal pattern. Objective: To evaluate the results of an educational intervention program performed in children aged 6 -11 years with the habit of digital suction who belong to Julio Pérez and Domingo Lence elementary schools, San Antonio de los Baños municipality. Material and Methods: A quasi-experimental study was conducted. A sample of 42 children was selected from a universe that was made up of 107 children with deleterious habits, keeping in mind inclusion criteria. The variables analyzed included: age, sex, level of knowledge, dental and maxillofacial anomalies and cessation of the habit. The data were taken from the results of the application of a questionnaire. Percentages were used for the analysis of the information and statistical tables and figures were developed. Theoretical, empirical, and statistical methods were used; documentary analysis was also carried out. Results: The condition predominated in children aged 6 - 7 years (47,6 percent) and the female sex (73,8 percent). Among dental and maxillofacial anomalies, labial dysfunction was identified in 95,2 percent of children and augmentation of projection was present in 92,8 percent of the cases. Also, 83.3 percent of children developed an appropriate knowledge and 78,6 percent eradicated the habit. Conclusions: Female children and the age group between 6 and 7 years of age predominated in the study. The most frequent dental and maxillofacial anomalies were labial dysfunction followed by augmentation of projection. The level of knowledge increased and the cessation of the habit was high(AU)

Neumonía lipoidea exógena aguda por aspiración accidental de hidrocarburos / Acute exogenous lipoid pneumonia for accidental aspiration of hydrocarbons

La neumonía lipoidea es una enfermedad respiratoria poco conocida que resulta de la acumulación de lípidos de origen endógeno o exógeno a nivel del alveolo pulmonar. Suele ser subdiagnosticada ya que la presentación clínica es inespecífica, por lo que suele confundirse con otras patologías broncopulmonares. Se presentó el caso de un paciente de 18 años antecedentes de aspiración accidental de combustible que seis horas después comenzó con fiebre, hemoptisis, tos y disnea. Se realizó radiografía de tórax donde se observó una neumonía en base derecha que unido al interrogatorio y a la realización de la broncoscopía confirmaron el diagnóstico de neumonía lipoidea. El paciente evolucionó favorablemente con el tratamiento(AU)

Lipoid pneumonia is a little known respiratory disease that results from the accumulation of lipids of endogenous or exogenous origin in the pulmonary alveolus. It is usually underdiagnosed since the clinical presentation is nonspecific, which is why it is often confused with other bronchopulmonary pathologies. We report the case of an 18-year-old patient with a history of accidental fuel aspiration, who ran fever six hours later, together with hemoptysis, cough, and dyspnea. Chest X-rays showed a right base pneumonia. The questioning and the performance of the bronchoscopy confirmed the diagnosis of lipoid pneumonia. The patient evolved favorably with the treatment(AU)