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Journal of Acupuncture and Meridian... Aug 2019The common opinion is that in Europe acupuncture was introduced in China at the end of the XVII century. However there are some publications, which describe the similar... (Comparative Study)
Comparative Study
The common opinion is that in Europe acupuncture was introduced in China at the end of the XVII century. However there are some publications, which describe the similar treatment method in the Stone Age Europe. From ancient to late middle century theoretical and practical aspects of medieval medicine in Europe were very similar to the Tradition Chinese medicine. So it is possible that historical phlebotomy in Europe (bloodletting) played the same role as the acupuncture in the Chinese therapy and they had one scientific source. In this article we are comparing the modern acupuncture with some Bohemian medical tractates (Practica medicinalis by Sigismundus Albicus from 1408-1424, De sanguinis minucione by Cristannus de Prachaticz from 1430). We can see the close relationship between localizations and indications of medieval phlebotomy and modern acupuncture points. 40% of the bloodletting points have close localization with the modern acupuncture points and 57% of their indications are common or very similar. The similarity of two methods may be explained in two ways. First is a common scientific source and intensive interaction and crosscultural transmission of knowledge during medical development in China and Europe up to the beginning of the XV century. This possibility indicates also some linguistic coincidences. On the other hand, both methods could have been developed separately based on common clinical empire and objective neuro-physiological patterns of human body.
Topics: Acupuncture Points; Acupuncture Therapy; Bloodletting; China; Culture; Europe; History, 20th Century; History, Medieval; Humans; Medicine, Chinese Traditional; Phlebotomy
PubMed: 31103712
DOI: 10.1016/j.jams.2019.05.001 -
Seminars in Perinatology Aug 2012The development of anemia after birth in very premature, critically ill newborn infants is a universal well-described phenomenon. Although preventing anemia in this... (Review)
Review
The development of anemia after birth in very premature, critically ill newborn infants is a universal well-described phenomenon. Although preventing anemia in this population, along with efforts to establish optimal red blood cell (RBC) transfusion and pharmacologic therapy continue to be actively investigated, the present review focuses exclusively on nonpharmacological approaches to the prevention and treatment of neonatal anemia. We begin with an overview of topics relevant to nonpharmacological techniques. These topics include neonatal and fetoplacental hemoglobin levels and blood volumes, clinical and laboratory practices applied in critically ill neonates, and current RBC transfusion practice guidelines. This is followed by a discussion of the most effective and promising nonpharmacological blood conservation strategies and techniques. Fortunately, many of these techniques are feasible in most neonatal intensive care units. When applied together, these techniques are more effective than existing pharmacotherapies in significantly decreasing neonatal RBC transfusions. They include increasing hemoglobin endowment and circulating blood volume at birth; removing less blood for laboratory testing; and optimizing nutrition.
Topics: Anemia, Neonatal; Blood Volume; Bloodless Medical and Surgical Procedures; Critical Illness; Erythrocyte Indices; Erythrocyte Transfusion; Fetal Blood; Hemoglobins; Humans; Infant, Extremely Premature; Infant, Newborn; Infant, Premature; Nutritional Support; Phlebotomy
PubMed: 22818543
DOI: 10.1053/j.semperi.2012.04.003 -
The Ceylon Medical Journal Mar 2018Methicillin resistant Staphylococcus aureus (MRSA) is transmitted through direct contact or fomites. The most important means of nosocomial spread is by hospital...
INTRODUCTION
Methicillin resistant Staphylococcus aureus (MRSA) is transmitted through direct contact or fomites. The most important means of nosocomial spread is by hospital personnel. However, fomites are being increasingly recognized as sources of nosocomial infection.
OBJECTIVES
Our aim was to describe the MRSA contamination rate of phlebotomy tourniquets and faucets in a tertiary care hospital and to compare the contamination of plastic tourniquets with that of fabric tourniquets.
METHOD
A cross-sectional study was carried out in the general wards of a tertiary care hospital in the Colombo District. Two hundred tourniquets were collected and 100 faucets were swabbed and cultured on CHROMagar™ MRSA medium (CHROMagar Microbiology). Contamination rates of 50 plastic tourniquets and 50 fabric tourniquets were compared.
RESULTS
MRSA grew in 26% of tourniquets. Majority were plastic tubes. MRSA contamination of tourniquets did not significantly differ by ward (p>0.4). MRSA was found on 26% of faucets. Contamination rate was highest in the common wards for dermatology, dental, rheumatology, and neurology (55.6%), followed by gynaecology (45.2%), cardiology (33.3%), surgery (18.8%), psychiatry (11.1%), and medicine (5.6%). There was a significant difference in rates of contamination of faucets in the different wards (p<0.01). There was no significant difference in the colony count per surface area of the two types of tourniquets after a single use.
CONCLUSIONS
MRSA contamination rates of tourniquets and faucets were high. Single-use plastic tourniquets were much less contaminated with MRSA than reused tourniquets.
Topics: Colony Count, Microbial; Cross-Sectional Studies; Equipment Contamination; Equipment and Supplies, Hospital; Humans; Methicillin-Resistant Staphylococcus aureus; Phlebotomy; Sri Lanka; Tertiary Care Centers; Tourniquets; Water Supply
PubMed: 29754478
DOI: 10.4038/cmj.v63i1.8627 -
Systematic Reviews May 2018Needle-related procedures are the most important source of pain in children in hospital setting. Unmanaged pain could result in short- and long-term physiological,... (Review)
Review
BACKGROUND
Needle-related procedures are the most important source of pain in children in hospital setting. Unmanaged pain could result in short- and long-term physiological, psychological, and emotional consequences. Although the efficacy of numerous interventions has been evaluated, procedural pain management is often suboptimal in children undergoing needle-related procedures. The main objective of this systematic review is to examine the evidence for the efficacy of the Buzzy® device for needle-related procedural pain in children.
METHODS
An electronic search will be conducted in the following databases: CENTRAL, PubMed, MEDLINE, EMBASE, PsycInfo, and CINAHL. There will be no restriction regarding the language, date of publication, and publication status. Eligible studies will be randomized controlled trials using the Buzzy® device for pain management in children undergoing needle-related procedures. Selection of studies, data extraction and management, assessment of risk of bias and quality of evidence will be performed by two independent reviewers. A third researcher will be consulted in case of discrepancies. Depending on the availability and quality of the data as well as clinical and statistical heterogeneity, a meta-analysis will be performed. Otherwise, findings will be qualitatively reported.
DISCUSSION
This will be the first systematic review to examine the efficacy of the Buzzy® device on pain management of children during needle-related procedures. Results of this review will guide clinical practice and recommendations for further research to improve procedural pediatric pain management.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42017076531.
Topics: Child; Cold Temperature; Humans; Pain; Pain Management; Pain, Procedural; Pediatrics; Phlebotomy; Treatment Outcome; Vibration; Systematic Reviews as Topic
PubMed: 29788987
DOI: 10.1186/s13643-018-0738-1 -
Journal of Perinatology : Official... Dec 2019Characterize frequency and volume of blood draws and transfusions in extremely low birth weight infants in the first 10 weeks of life.
OBJECTIVE
Characterize frequency and volume of blood draws and transfusions in extremely low birth weight infants in the first 10 weeks of life.
STUDY DESIGN
We included infants with a birth weight <1000 g born 23 0/7-29 6/7 weeks gestational age (GA) and with a length of stay ≥10 weeks, admitted between 2014 and 2016 to a single neonatal intensive care unit.
RESULTS
Of 54 infants, median (25th, 75th percentile) GA and birth weight were 25 weeks (24, 26) and 665 g (587, 822), respectively. Median number of blood draws per infant decreased from 57 (49, 65) in week 1 to 12 (8, 22) in week 10. Median volume of blood extracted was 83 mL (70, 97), and median number of blood transfusions was 8 (5, 10).
CONCLUSIONS
This cohort experienced a high number and volume of blood draws. Draw frequency and transfusions decreased over the first 10 weeks of life.
Topics: Anemia; Erythrocyte Transfusion; Female; Humans; Infant, Extremely Low Birth Weight; Infant, Extremely Premature; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Intensive Care Units, Neonatal; Male; Phlebotomy
PubMed: 31582812
DOI: 10.1038/s41372-019-0515-6 -
Optimizing outpatient phlebotomy staffing: tools to assess staffing needs and monitor effectiveness.Archives of Pathology & Laboratory... Jul 2014Short patient wait times are critical for patient satisfaction with outpatient phlebotomy services. Although increasing phlebotomy staffing is a direct way to improve...
CONTEXT
Short patient wait times are critical for patient satisfaction with outpatient phlebotomy services. Although increasing phlebotomy staffing is a direct way to improve wait times, it may not be feasible or appropriate in many settings, particularly in the context of current economic pressures in health care.
OBJECTIVE
To effect sustainable reductions in patient wait times, we created a simple, data-driven tool to systematically optimize staffing across our 14 phlebotomy sites with varying patient populations, scope of service, capacity, and process workflows.
DESIGN
We used staffing levels and patient venipuncture volumes to derive the estimated capacity, a parameter that helps predict the number of patients a location can accommodate per unit of time. We then used this parameter to determine whether a particular phlebotomy site was overstaffed, adequately staffed, or understaffed. Patient wait-time and satisfaction data were collected to assess the efficacy and accuracy of the staffing tool after implementing the staffing changes.
RESULTS
In this article, we present the applications of our approach in 1 overstaffed and 2 understaffed phlebotomy sites. After staffing changes at previously understaffed sites, the percentage of patients waiting less than 10 minutes ranged from 88% to 100%. At our previously overstaffed site, we maintained our goal of 90% of patients waiting less than 10 minutes despite staffing reductions. All staffing changes were made using existing resources.
CONCLUSIONS
Used in conjunction with patient wait-time and satisfaction data, our outpatient phlebotomy staffing tool is an accurate and flexible way to assess capacity and to improve patient wait times.
Topics: Ambulatory Care; Boston; Efficiency, Organizational; Humans; Patient Satisfaction; Personnel Staffing and Scheduling; Phlebotomy; Time Factors; Workflow; Workforce
PubMed: 24978919
DOI: 10.5858/arpa.2013-0450-OA -
Annals of Laboratory Medicine Sep 2014We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a...
We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level.
Topics: Humans; Internet; Interviews as Topic; Laboratories; Personal Satisfaction; Phlebotomy; Surveys and Questionnaires; Tertiary Healthcare; User-Computer Interface
PubMed: 25187892
DOI: 10.3343/alm.2014.34.5.380 -
Journal of Medical Case Reports Jan 2019The porphyrias are a rare group of metabolic disorders that can either be inherited or acquired. Along the heme biosynthetic pathway, porphyrias can manifest with...
BACKGROUND
The porphyrias are a rare group of metabolic disorders that can either be inherited or acquired. Along the heme biosynthetic pathway, porphyrias can manifest with neurovisceral and/or cutaneous symptoms, depending on the defective enzyme. Porphyria cutanea tarda, the most common type of porphyria worldwide, is caused by a deficiency of uroporphyrinogen decarboxylase, a crucial enzyme in heme biosynthesis, which results in an accumulation of photosensitive byproducts, such as uroporphyrinogen, which leads to the fragility and blistering of sun-exposed skin. Porphyria cutanea tarda is a condition that affects the liver and skin by reduction and inhibition of uroporphyrinogen decarboxylase enzyme in erythrocytes. Areas of skin that are exposed to the sun can generate blisters, hyperpigmentation, and, sometimes, lesions that heal leaving a scar or keratosis. Liver damage might present in a wide range of ways from liver function test abnormalities to hepatocellular carcinoma. The toxic effect of iron plays a role in liver damage pathogenesis.
CASE PRESENTATION
A 59-year-old Turkish man presented with hyperpigmented skin lesions, fatigue, and elevated ferritin level and liver function tests. He was diagnosed as having porphyria cutanea tarda after a clinical investigation and treated with phlebotomy.
CONCLUSION
Porphyria cutanea tarda is a rare condition of the liver but it must be remembered in a differential diagnosis of liver disease with typical skin involvement to decrease morbidity and health costs with early treatment.
Topics: Fatigue; Humans; Hyperpigmentation; Male; Middle Aged; Phlebotomy; Porphyria Cutanea Tarda; Treatment Outcome; Uroporphyrinogen Decarboxylase
PubMed: 30661508
DOI: 10.1186/s13256-018-1956-9 -
Pediatric Emergency Care Oct 2023Needle-related procedures are among the most important sources of pain in children in different health care settings. Our study was aimed to evaluate the effectiveness... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Needle-related procedures are among the most important sources of pain in children in different health care settings. Our study was aimed to evaluate the effectiveness of Buzzy (MMJ Labs, Atlanta, Ga.), a palm-sized bee/ladybug-shaped device combining vibration and cold, as a nonpharmacological strategy to manage needle-related pain in children.
METHODS
In this single-center, randomized (1:1) controlled open-label study, we enrolled patients aged from 1 month to 18 years who had to undergo a planned outpatient blood sampling in Pisa University Hospital's Department of Pediatrics and randomly allocated them to either the BUZZY group (intervention group) or NO BUZZY group (control group). Pain was estimated using proper pain scales according to age.
RESULTS
Between May 2021 and January 2022, 234 children aged 8.8 ± 5.1 years (50.8% girls) were enrolled and 117 were treated with the Buzzy device. In the study population, pain inversely correlated with age (r = -0.52, P < 0.001); the intervention group showed significantly lower pain (2.5 ± 2.4 vs 4.7 ± 2.8, P < 0.001) and no difference was found between boys and girls. Significant reduction in pain scores was confirmed when stratifying children by age (29 days to <3 years, P = 0.002; ≥3 to ≤8 years, P < 0.001; >8 years, P < 0.001).
CONCLUSIONS
The Buzzy device effectively reduces pain caused by percutaneous antecubital venipuncture in children in different age groups and represents a cheap and easy-to-use strategy to manage routine needle-related procedures.
Topics: Male; Female; Humans; Child; Animals; Infant, Newborn; Phlebotomy; Pain Management; Vibration; Pain; Needles
PubMed: 37478814
DOI: 10.1097/PEC.0000000000003011 -
Academic Emergency Medicine : Official... Feb 2016The objective was to test the hypothesis that exclusive use of butterfly needles for phlebotomy, compared with sample collection via intravenous (IV) catheter, will...
OBJECTIVES
The objective was to test the hypothesis that exclusive use of butterfly needles for phlebotomy, compared with sample collection via intravenous (IV) catheter, will reduce rates of sample hemolysis.
METHODS
This was an observational study of hemolysis rates before and after implementation of a "butterfly-only" phlebotomy protocol. Weekly hemolysis rates, generated by the central laboratory, were collected and the proportion of hemolyzed specimens before and after protocol implementation were compared.
RESULTS
Prior to institution of the butterfly-only protocol, 11.3% of specimens sent from the emergency department were reported as hemolyzed. During the postintervention period, only 4.3% of specimens were hemolyzed for a proportionate decrease of 62% and an absolute decrease of 7.0% (95% confidence interval = 6.6% to 7.3%).
CONCLUSIONS
Use of a butterfly-only phlebotomy protocol cuts hemolysis rates by more than half when compared with IV catheter phlebotomy.
Topics: Animals; Emergency Service, Hospital; Hemolysis; Humans; Needles; Phlebotomy
PubMed: 26766429
DOI: 10.1111/acem.12858