RESUMO
OBJECTIVE: The aim of this study is to investigate the influence of local anesthetic (LA), operator experience level and needle type on patient procedural pain in relation to diagnostic lumbar puncture (LP). METHODS: LP was performed with either a 22 gauge traumatic needle (22 TN) or a 22 gauge atraumatic needle (22 ATN). Immediately after LP patients documented a procedural pain score (PPS) on a 10-point Likert scale. Use of LA, needle type, anesthetic time interval (ATI), number of needle insertions and the LP operator experience level were registered. ATI was defined as the time from administration of LA to first needle insertion. RESULTS: 104 patients had the LP procedure performed by 66 physicians (40 novices and 26 experienced physicians). Patients having the procedure performed by novices had a lower PPS of 2.56 if LA was administered compared to a higher PPS of 5.80 if LA was not administered (Pâ¯=â¯.046). Among experienced physicians there was no difference in PPS regardless of administration of LA. If novices administered LA, patient PPS was equal to patients having the procedure performed by an experienced operator. If novices performed the procedure with a 22 TN PPS decreased with increasing ATI (Pâ¯=â¯.01). No similar correlation was identified with the 22 ATN. CONCLUSION: Our study suggests that LP operator experience level, the needle type used and ATI may influence patient PPS. Further studies are necessary for final conclusions. These studies must consider these factors to avoid fault conclusions.
Assuntos
Competência Clínica , Dor Processual/etiologia , Punção Espinal , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestesia Local/métodos , Dinamarca , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Agulhas , Manejo da Dor , Medição da DorAssuntos
Vacinas Anticâncer/imunologia , Epitopos/imunologia , Antígeno HLA-A2/imunologia , Proteínas de Neoplasias/imunologia , Neoplasias/terapia , Proteínas Proto-Oncogênicas c-bcl-2/imunologia , Doença Aguda , Apresentação de Antígeno , Apoptose , Carcinoma/sangue , Carcinoma/imunologia , Citotoxicidade Imunológica , Células Dendríticas/imunologia , Humanos , Neoplasias Renais/sangue , Neoplasias Renais/imunologia , Leucemia Mieloide/imunologia , Leucemia Mieloide/patologia , Proteína de Sequência 1 de Leucemia de Células Mieloides , Neoplasias/imunologia , Fragmentos de Peptídeos/síntese química , Fragmentos de Peptídeos/imunologia , Especificidade do Receptor de Antígeno de Linfócitos T , Linfócitos T Citotóxicos/imunologia , Evasão Tumoral/imunologia , VacinaçãoAssuntos
Proteínas de Neoplasias/imunologia , Proteínas Proto-Oncogênicas c-bcl-2/imunologia , Linfócitos T Citotóxicos/imunologia , Citotoxicidade Imunológica , Antígeno HLA-A3/imunologia , Humanos , Proteína de Sequência 1 de Leucemia de Células Mieloides , Proteínas de Neoplasias/fisiologia , Neoplasias/imunologia , Neoplasias/terapia , Proteínas Proto-Oncogênicas c-bcl-2/fisiologiaRESUMO
The use of nontoxigenic strains of Aspergillus flavus and A. parasiticus in biological control effectively reduces aflatoxin in peanuts when conidium- producing inoculum is applied to the soil surface. In this study, the movement of conidia in soil was examined following natural rainfall and controlled precipitation from a sprinkler irrigation system. Conidia of nontoxigenic A. flavus and A. parasiticus remained near the soil surface despite repeated rainfall and varying amounts of applied water from irrigation. In addition, rainfall washed the conidia along the peanut furrows for up to 100 meters downstream from the experimental plot boundary. The dispersal gradient was otherwise very steep upstream along the furrows and in directions perpendicular to the peanut rows. The retention of biocontrol conidia in the upper soil layers is likely important in reducing aflatoxin contamination of peanuts and aerial crops such as corn and cottonseed.
