Influence of acupuncture needle physical-chemical properties on needling quality.

OBJECTIVES: This study analyzed the physical-chemical properties of three different brands of acupuncture needle, classified by acupuncturists as high (A), medium (B) and low (C) quality. METHODS: Experienced acupuncturists, rated, in terms of perceived needling quality, three acupuncture needle brands as high (A), medium (B) and low (C) quality. Next, scanning electron microscopy (SEM) images of the tip and surface finish of the needles of each brand were analyzed. A mechanical test was developed and performed to evaluate the compressive force required to insert the needles through a smooth surface (silicon). In addition, X-ray fluorescence spectroscopy (XRF) and dispersive energy spectroscopy (DES) were conducted to analyze the material composition of the needles and presence of oxidation. RESULTS: SEM images revealed that needle brands A and B presented a sharper tip and a more regular surface finish in comparison to brand C. In the insertion test, needle brands A and B had similar performance characteristics, with A requiring less force to penetrate the silicon device when compared to B, while C failed to penetrate the silicon and complete the test. The XRF analysis did not reveal any differences in material composition between the three brands. However, brand C exhibited particles embedded on the needle surface and DES confirmed oxidation. CONCLUSION: This study demonstrates that perceived needling quality by acupuncturists can be correlated with physical-chemical properties of the needles, especially those related to finishing quality of the tip and the surface of the needles.

Fístula liquórica espontânea: relato de caso / Spontaneous cerebrospinal fluid leaks: case report

As fistulas liquóricas rinogênicas são definidas como comunicações entre as fossas nasais e o espaço subaracnóideo. A origem dessas falhas pode ser de origem traumática ou não traumática, e o quadro clínico cursa com rinorréia ou otorréia citrina, geralmente unilateral. As fístulas não traumáticas espontâneas são menos comuns de ocorrer do que as traumáticas. O paciente relatado apresentava um quadro de rinoliquorreia através de fossa nasal direita, com aumento de fluxo ao se inclinar para frente e/ou realizar flexão anterior do pescoço. Realizando investigação diagnóstica por imagem a tomografia computadorizada de seios da face evidenciou a fístula localizada em recesso lateral de seio esfenoidal direito. Nesse caso o paciente foi submetido a correção cirúrgica, sendo escolhida uma abordagem endoscópica endonasal transpitrigoide para acessar a região do defeito. Realizado o fechamento da fístula o paciente evoluiu sem sinais de recidiva e sem outras sintomatologias.

Rhinogenic cerebrospinal fluid (CSF) leaks are communications between the nasal cavities and the subarachnoid space. The etiology of these leaks could be traumatic or non-traumatic, citrus rhinorrhea or otorrhea are the most common symptoms. The spontaneous non-traumatic leaks are less common to occur than the traumatic ones. The reported patient had CSF rhinorrhea through the right nostril, with an increased flow when leaning forward and/or perform anterior neck flexion. Imaging diagnostic by computed tomography cisternography showed the leak located in the lateral recess of the right sphenoid sinus. In this case the patient underwent a surgical procedure, the choice was an endoscopic endonasal traspterygoid approach to access the defect. A robust reconstruction of the defect was performed and the patient evolved without signs of recurrence or any other symptoms.