Pain assessment of a new bloodletting device: A study protocol for a randomized, controlled, double-blind, matched-paired clinical trial.

BACKGROUND: The bloodletting device has been used by many institutions for about 100 years. Many patients feel fear from the pain caused by applying the bloodletting device for treatment. We used bloodletting device using the principle of "prestimulation neurodisturbance," which can mask the subject undetectable for pain. In this study, we will investigate pain of bloodletting device during blood collection and will identify the safety of the device. METHODS: This study will be a randomized, controlled, double-blind, and matched-paired-designed clinical trial. Four groups, RTLC, LTRC, RCLT, and LCRT (T = test device, C = control device, L = left, R = right), will be randomly allocated. Total duration of the clinical trial will be 3 months. The subjects will be performed from 1 to 3 times only on the day of the procedure. The primary outcomes will be measured using pain visual analog scale score and the secondary outcomes will include verbal rating scale and the time at which the pain disappears after blood collection (second), the total number of "nonbleeding" cases and subjects, the number of "blood collection failure" and subjects, the presence of "delayed hemostasis," and the number of subjects. Repeated-measure analysis will be used to measure primary efficacy based on full analysis set. DISCUSSION: This study has limited inclusion and exclusion criteria and a well-controlled intervention, and it will be the first randomized controlled trial to investigate pain of bloodletting device using the principle of "prestimulation neurodisturbance." This study provides insights into the underlying mechanisms of the pain-reducing effect of the developed bloodletting device and will lay the groundwork for further studies.

The demise of bloodletting.

Bloodletting was a practice favoured by doctors and barber-surgeons for many centuries, and is now, perhaps surprisingly, still employed for a few specific indications. The effectiveness of bloodletting for treating diseases such as pneumonia was convincingly challenged in the mid-nineteenth century, but medical conservatism ensured the practice continued well into the twentieth century. As late as 1942, a famous medical textbook considered bloodletting appropriate treatment for pneumonia.

Addendum: Safety Standards for Gua sha (press-stroking) and Ba guan (cupping).

Our previous article Safety Standards for Gua sha (press-stroking) and Baguan (cupping) discussed the risk of transfer of blood-borne pathogens with Gua sha and Ba guan, identified Gua sha and Ba guan 'instrument criticality' as semi-critical and offered recommendations for safe practice based on hospital disinfection standards. Based on the article's feedback, we feel the need to clarify that Gua sha and Ba guan instruments, if intended for reuse, must undergo high level disinfection (HLD) or, in the case of 'wet-cupping', sterilization. We update our recommendations to be amenable to both private practice and education settings.

[Exploration on the application characteristics of bloodletting therapy for the diseases relevant with soft tissue infection by data mining technology].

OBJECTIVE: Using the data mining technology to analyze the application law of bloodletting therapy for the diseases relevant with soft tissue infection and explore the effect specificity of bloodletting therapy. METHODS: The variety of diseases treated with bloodletting therapy was taken as the sample data by collecting the reports from the periodical literatures. The network database of bloodletting literature was set up. The association rule of data mining technology was adopted to extract the information on the diseases relevant with soft tissue infection in the periodical literatures. The frequency item of the superiority disease category was calculated. And the deep mining was done in terms of the needle device, point selection and the bleeding amount separately. The application law of bloodletting therapy was summarized in the treatment of the diseases relevant with soft tissue infection. RESULTS: Fourteen kinds of relevant diseases of soft tissue infection treated with bloodletting therapy were included in the contemporary periodical literatures, of which, the reported case number and the reporting frequency were the highest for hordeolum and breast abscess. The three-edged needle was used the most frequently in the manipulation. The acupoints selected were the local Ashi points, combined with the symptomatic acupoints. The bleeding amount was not normalized by the ideas of different physicians. CONCLUSION: The bloodletting therapy achieves the better curative effect on some diseases relevant with soft tissue infection and this therapy deserves to be further promoted in clinical practice.

[Discussions on history of the bloodletting therapy overseas].

To introduce the origin, development and theoretical source of the bloodletting therapy overseas. The bloodletting therapy, which was based on Hippocrates's four fluid theories, had the therapeutical effect and therefor spread abroad. Many people not only thought this therapy was benefit, but also let out blood regularly. During the medieval Europ, the bloodletting therapy reached its top, which was caused by the part-time job of barber. It was questioned when spreading in the America. After that, as the development of the other medical method, the disadvantage was exposed. With several clinical mistherapies, it faded away from the stage of history. The recent research shows that the normative bloodletting therapy could treat some diseases.

[Comparative study of bloodletting therapy between traditional Chinese medicine and Tibetan medicine].

The comparative study of bloodletting therapy between traditional Chinese medicine and Tibetan medicine in view of history development, theoretic basis, bloodletting location, bloodletting tool, operation method, bloodletting amount, indications, contraindications and the others are conducted in this paper. It is pointed out that the bloodletting therapy could be better carried forward and developed through the interaction and integration of bloodletting therapy between traditional Chinese medicine and Tibetan medicine in term of the theoretic, practical and development patterns under the guidance of these two different medical theoretical systems.

The ancient surgical bloodletting method of arteriotomy.

Methods of bloodletting were widely known in antiquity and were used for the cure of numerous illnesses and symptoms, caused mainly by the supposed excess of blood in the body. This article presents and discusses arteriotomy, a surgical method of bloodletting, appearing after the 1st century AD in the texts of Celsus, Galen, Antyllus, and Severus. The texts were studied either in their primary language or in a translation. Secondary references were only used for comparing the ancient technique to modern surgical methods.

History of bloodletting by phlebotomy.

Bloodletting by phlebotomy has been an obsession with medical practitioners for thousands of years, causing countless suffering to patients, initially for unproven indications and more recently for diagnoses. The approach to medical evidence-based phlebotomy has been a triumph for scientifically inclined practitioners. Progress, primarily achieved since the nineteenth century, has been in spite of considerable opposition from the medical establishment. The evaluation of phlebotomy as a useful tool continues and no doubt further myths will be dispelled. The history of bloodletting remains one of the greatest stories of medical progress, not because of new discoveries but mainly by persistent unbiased audit.

Venopunción y venodisección en pacientes pediatricos del Hospital Manuel de Jesús Rivera: nov 1998 a feb 1999

El acceso vascular es un elemento esencial en la asistencia y tratamiento de casi todos los niños hospitalizados más aún aquellos que ingresan a las Unidades de Cuidados Críticos, lo que permite la necesidad de administración de tratamiento intravenoso y el monitoreo hemodinámico en estos pacientes, lo cual a pesar de los avances, no está desprovisto de riesgos, y pueden presentarse algunas complicaciones. El acceso vascular venoso mas inocuo y eficaz se logra el equipar con gran cuidado la talla del niño con sus necesidades terapéuticas, duración del tratamiento requerido, el disposivo y técnicas mas apropiadas. La presente investigación analiza de forma prospectiva las ventajas y desventajas de la venopunción en relación a la venodisección en los pacientes en edad pediátrica a quiens se les realizó dicho procedimiento en el período de noviembre 1998 a febrero 1999, en el Hospital Infantil Manuel de Jesús Rivera. Para su análisis se separaron en dos grupos: Grupo 1: 38 pacientes a los que se les realizó venopunción, Grupo 2: 38 pacientes a los que se les realizó venodisección,en el período en estudio. A ambos grupos se les dio seguimiento desde que se les coloco el catéter hasta que se le retiró; analizando la edad, peso, complicaciones, momento en que se presentaron las complicaciones, servicios de colocaciónytiempo de colocación y se obtuvo frecuencia, porcentaje, chi cuadrado y riesgo. El 63 de las venopunciones se realizarcon en menores de un año y el 23.7 en menores de un mes. El 42 de las venopunción fueron realizadas en niños con peso menor de 4 kilos, y en las venodisecciones el 73 correspondió a menores de 10 kilos...