Gentle traction on the superior poles and visualization of the thymic veins

ASVIDE ◽  
2018 ◽  
Vol 5 ◽  
pp. 402-402
Author(s):  
Alper Toker ◽  
Erkan Kaba ◽  
Kemal Ayalp ◽  
Tugba Cosgun ◽  
Mazen Rasmi Alomari
Keyword(s):  
Gentle Traction

Management of Entropion and Trichiasis

2011 ◽  
Author(s):  
David H. Verity ◽  
Geoffrey E. Rose
Keyword(s):  
Ocular Surface ◽  
Lower Eyelid ◽  
Complete Loss ◽  
Secondary Effects ◽  
Orbicularis Muscle ◽  
Eyelid Margin ◽  
Ocular Irritation ◽  
Age Related ◽  
Causative Factors ◽  
Gentle Traction

Entropion is a posterior rotation of the upper or lower lid margin against the globe; the causes include involutional changes within the eyelid tissues or cicatricial shortening of the posterior lamella of the eyelid. Congenital lower lid entropion is rare and results from an excess of skin and orbicularis oculi muscle being only loosely attached to the eyelid retractors. The symptoms of entropion—which include ocular irritation, lid spasm, pain, redness, and watering—are worse in the presence of a keratinized lid margin (occurring in cicatricial disease) and where the ocular surface is compromised. Discomfort may lead to secondary blepharospasm, which exacerbates the entropion by causing the preseptal part of the orbicularis muscle to override the pretarsal component. The eyelids and globe should be examined to identify underlying causative factors—in particular the degree and position of tissue laxity, the position of the eyelid margin and lashes, and the thickness of the tarsus. Any secondary effects of entropion, both within the lid and on the ocular surface, should also be noted. 7-1-1 Tissue Laxity. Aging of collagen and the force of gravity leads to eyelid laxity and an excess of tissues, particularly the anterior lamella of the lid. Stretching of the orbicularis muscle and canthal tendons results in horizontal laxity, and eyelid stability is further compromised by enophthalmos due to age-related fat atrophy. Where there is a relative dissociation between the anterior and posterior lamellae, the preseptal orbicularis muscle overrides the pretarsal muscle, leading to eyelid inversion, and this effect is exacerbated both by laxity of the lower lid retractors and age-related tarsal atrophy. Tissue laxity in the absence of orbicularis overriding tends to cause ectropion; with complete loss of retractor action, this can result in complete eversion of the tarsus (“shelf ectropion”). Horizontal laxity of the eyelid tissues is assessed by grasping the lid skin and applying gentle traction in the appropriate direction. The overall horizontal laxity is judged by the extent to which the eyelid can be parted from the globe—greater than about 6 mm is abnormal for a lower eyelid—and by the speed with which the retracted lid returns to the surface of the globe (the “spring-back” test).

Through-and-Through Suture Technique to Stabilize a Sheath in Branched Endovascular Aortic Repair

2019 ◽  
Vol 26 (6) ◽  
pp. 805-809 ◽  
Author(s):  
Giuseppe Panuccio ◽  
Fiona Rohlffs ◽  
Vladimir Makaloski ◽  
Ahmed Eleshra ◽  
Nikolaos Tsilimparis ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Suture Technique ◽  
Endovascular Aortic Repair ◽  
Femoral Access ◽  
Helpful Tool ◽  
Polypropylene Suture ◽  
Aortic Repair ◽  
Gentle Traction ◽  
Vascular Suture

Purpose: To describe a technique to catheterize antegrade branches of a branched thoracoabdominal endograft from a femoral access with the help of standard sheaths and a vascular suture. Technique: The technique is demonstrated in a patient who underwent successful complex thoracoabdominal branched endovascular aortic repair. After the deployment of an aortic endograft with two antegrade branches for the targeted renovisceral vessels, a standard braided sheath was preloaded with a 3/0 polypropylene suture and introduced inside an additional sheath from the groin to the thoracic aorta. Simultaneous gentle traction on the suture as the preloaded sheath was advanced achieved a very stable 180° curve of the proximal end of the sheath. It was possible to selectively catheterize the antegrade branches and respective target vessels sequentially, as well as deploy the planned bridging stents for each branch. Conclusion: The through-and-through suture technique is a helpful tool in branched endovascular aortic repair. It saves time, radiation, and materials; no snare is needed, and it can be preloaded into a sheath.

Snare salvage technique for deformed WEB device after deployment

2020 ◽  
pp. neurintsurg-2020-016696
Author(s):  
Zaid Aljuboori ◽  
Dale Ding ◽  
Robert F James
Keyword(s):  
Lupus Erythematosus ◽  
Longitudinal Axis ◽  
Forward Movement ◽  
Content Type ◽  
Bifurcation Aneurysm ◽  
Aneurysm Embolization ◽  
Gentle Traction ◽  
Woven Endobridge ◽  
Web Device

The Woven EndoBridge (WEB) device is a new endovascular technology that allows safe and effective treatment of wide-neck bifurcation aneurysms without the need for dual antiplatelet therapy.1–4 The case is presented of a patient in their 50 s with a history of systemic lupus erythematosus and receiving warfarin for recurrent deep venous thrombosis and an unruptured right middle cerebral artery bifurcation aneurysm. The aneurysm was treated with a WEB SL aneurysm embolization device (MicroVention, Tustin, California, USA). After the final deployment, a technical error (inadvertent forward movement of the pusher) led to the deformation of the device along its longitudinal axis, leaving the aneurysm partially untreated. An Amplatz Goose Neck Microsnare was used to capture the proximal detachment marker and used gentle traction to restore the original shape of the device (video 1).5–7 A follow-up angiogram revealed a restoration of the device’s shape with a similar result during the 4- month follow-up angiogram.Video 1

scholarly journals Tracheal pseudomembrane secondary to aspiration pneumonia in a 6-year-old Ragdoll

2020 ◽  
Vol 6 (2) ◽  
pp. 205511692095997
Author(s):  
Hannah Kwong ◽  
Darren Fry ◽  
Gemma Birnie
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Bronchoalveolar Lavage ◽  
Endotracheal Intubation ◽  
Aspiration Pneumonia ◽  
Complete Blood Count ◽  
Clinical Signs ◽  
Abdominal Ultrasound ◽  
Prior History ◽  
Gentle Traction ◽  
History Of

Case summary A 6-year-old female spayed Ragdoll presented with a 4-day history of acute onset non-productive retching, coughing and anorexia. A complete blood count, serum biochemistry, thoracic radiography and abdominal ultrasound were performed. Initially, aspiration pneumonia was suspected owing to an alveolar lung pattern in the right cranial ventral lung lobes seen on radiographs. The cat did not improve with empirical antibiotic therapy. Bronchoscopy and bronchoalveolar lavage were performed. An intraluminal tracheal mass was identified and removed via endoscopic guidance and gentle traction. Histopathology results were consistent with a fibrinous tracheal pseudomembrane. The cat was concurrently diagnosed with Pseudomonas aeruginosa pneumonia, which was confirmed on bronchoalveolar lavage. Pseudomonas aeruginosa was also cultured within the pseudomembrane. The cat was received antimicrobial therapy for his Pseudomonas pneumonia. In humans, fibrinous tracheal pseudomembranes occur uncommonly as a complication following endotracheal intubation and rarely due to infectious organisms. As there was no prior history of endotracheal intubation, the development of fibrinous tracheal pseudomembrane in this cat was suspected to be secondary to Pseudonomas aeruginosa aspiration pneumonia. Relevance and novel information The present case report is the first to describe a tracheal pseudomembrane in a cat. Bronchoscopy-guided gentle traction and subsequent removal of the tracheal pseudomembrane resulted in a complete resolution of the clinical signs.

scholarly journals Catheter knotting in a neonate

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Rong Huang ◽  
◽  
Jia-ying Chen ◽  
Ying Zhang ◽  
Chang-mei Chen ◽  
...  
Keyword(s):  
Preterm Neonate ◽  
Urethral Meatus ◽  
Anal Atresia ◽  
Plain Films ◽  
Gentle Traction ◽  
Foley’S Catheter

A 36-week preterm neonate with anal atresia and rectoperineal fistula was catheterized with a size 6F Foley’s catheter when she underwent anoplasty on the second day after birth. When the patient recovered from anesthesia, it was decided to remove the catheter. While the catheter was being removed, resistance was felt halfway through the procedure. Abdominal plain films revealed a catheter coiled in the pelvis. With copious lubricant injected into the bladder through the catheter and patient sedated, it was removed by manipulation alone using gentle traction (Figure 1). The infant had no bleeding at the urethral meatus and no obvious abnormality in urination during the 3-month of follow-up.

scholarly journals Uterine Perforation & Abortion- A Case Report

KYAMC Journal ◽  
2017 ◽  
Vol 5 (1) ◽  
pp. 491-493
Author(s):  
Mst Atia Sultana ◽  
Rakib Uddin ◽  
Rubiyat Farzana Hussain ◽  
Masuma Khatun
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Vaginal Bleeding ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Lower Abdominal Pain ◽  
Placental Tissue ◽  
Uterine Perforation ◽  
Gentle Traction ◽  
Cord Prolapse

Sreemoti Ratna Sarker 30 years old lady presented to us with the complaints of amenorrhea for 5 months, lower abdominal pain for 5 days, slight per vaginal bleeding for 2-3 days, a cord like structure is coming down p/v on the day of admission. On general examination she was stable and on p/v examination there was cord prolapse. A gentle traction was given and it was expelled out along with a small piece of placental tissue without any fetal parts and bleeding. Then she was advised for USG of abdomen. USG reported a fetus like structure in the abdominal cavity and the empty uterine cavity . She was managed surgically. Now she is doing well.KYAMC Journal Vol. 5, No.-1, Jul 2014, Page 491-493

Intravascular repositioning of a ventriculoatrial shunt

1972 ◽  
Vol 36 (4) ◽  
pp. 512-514 ◽  
Author(s):  
William J. McSweeney
Keyword(s):  
Right Atrium ◽  
Superior Vena ◽  
Vena Cava ◽  
Ventriculoatrial Shunt ◽  
Content Type ◽  
Gentle Traction ◽  
Left Innominate Vein ◽  
The Right ◽  
In Infants And Children ◽  
Fine Print

✓ Intravascular repositioning of a misdirected ventriculoatrial shunt from the left innominate vein into the right atrium was accomplished using a Muller guidewire deflector system. The guidewire and its surrounding small polyethylene catheter were inserted into a left superficial saphenous vein and advanced through the right side of the heart into the superior vena cava. The deflector system was activated and easily hooked the misplaced ventriculoatrial catheter. With gentle traction it was repositioned in the right atrium. The simplicity and safety of this approach make it recommended for use in infants and children.

scholarly journals Embedded Metallic Bangle in Vagina

2014 ◽  
Vol 2 (2) ◽  
pp. 46-48
Author(s):  
T Gupta ◽  
N Gupta ◽  
P Bhatia ◽  
S Gupta ◽  
J Jain
Keyword(s):  
Vaginal Discharge ◽  
Symptomatic Relief ◽  
Uterovaginal Prolapse ◽  
Medical Sciences ◽  
Lower Abdomen ◽  
Indian Women ◽  
Speculum Examination ◽  
Vaginal Pessary ◽  
Long Duration ◽  
Gentle Traction

BACKGROUND: Uterovaginal prolapse is a very common morbidity among Indian women. Vaginal pessaries still have role in the management of uterovaginal prolapse. Long forgotten pessaries get incarcerated in the vagina and their removal poses problems. A 65 year old postmenopausal lady presented with pain lower abdomen and thin vaginal discharge. Speculum examination revealed embedded metallic bangle in the vagina. Attempts at removal by gentle traction resulted in pain. Metallic bangle was removed under general anaesthesia and biopsy from the overlying tissue revealed no evidence of malignancy. Vaginal pessary gives symptomatic relief and does not cause any discomfort, women tend to forget it. This case report is unique as here ordinary metallic bangle was used as a vaginal pessary and in spite of long duration it did not cause much discomfort or any serious complication. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11174 Journal of Universal College of Medical Sciences (2014) Vol.2(2): 46-48

105 The Mustaq Method: Could This be The Simplest Shoulder Dislocation Reduction Method?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Eltayeb ◽  
K Ilo ◽  
A Mushtaq
Keyword(s):  
Supine Position ◽  
Shoulder Dislocation ◽  
Reduction Method ◽  
Lateral Pressure ◽  
Reduction Technique ◽  
The Other ◽  
Cohort Size ◽  
Dislocation Reduction ◽  
Gentle Traction ◽  
Successful Reduction

Abstract Introduction The Mushtaq Method is a new shoulder reduction technique. It is a simple, reliable, and less traumatic time modulated procedure. Method Patients are placed in the supine position if plausible. Fully adducting the affected arm with the elbow at right angle. The practitioner applies gentle traction above the elbow with the other hand placed deep into the axilla, palpation of the humeral head is followed by lateral pressure resulting in a successful relocation. Internal rotation and a broad arm sling complete the technique. No assistants are needed, and simple analgesia was often enough. Results 95% had a successful reduction within 5 minutes. 75% required analgesia alone, and no periprocedural complications were observed. Conclusions With so many options already, available it is essential to understand what dictates the success and failures of these methods. We have a new, safe, easy to use method requiring minimal force. We hope to increase our cohort size in the future to draw firm conclusions.

scholarly journals Treatment of displaced flexion-type pediatric supracondylar humeral fractures in the prone position

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668441 ◽  
Author(s):  
Hsuan-Kai Kao ◽  
Wei-Chun Lee ◽  
Wen-E Yang ◽  
Chia-Hsieh Chang
Keyword(s):  
Prone Position ◽  
Open Reduction ◽  
Humeral Fractures ◽  
Radiographic Evaluation ◽  
Kirschner Wires ◽  
Safe Method ◽  
Supracondylar Humeral Fractures ◽  
Gentle Traction ◽  
The Mean ◽  
K Wires

Purpose: This study is to report a new method to reduce and fix the displaced flexion-type pediatric supracondylar fracture in the prone position. Methods: Ten children with displaced flexion-type supracondylar humeral fractures treated between 2007 and 2013 were reviewed. There were three girls and seven boys, with a mean age of 9.5 years. The fracture was reduced by gentle traction of the forearm and gradual extension of the elbow in the prone position. Two or three crossed Kirschner wires (K-wires) were inserted percutaneously to secure the fracture reduction. Radiographic evaluation included the Baumann’s angle and the lateral humerocapitellar angle. Clinical outcomes were assessed using the Flynn’s criteria. Results: Eight children had closed reduction and percutaneous K-wire fixation. The other two children required open reduction through a posterior triceps splitting approach. The mean Baumann’s angle was 70.2° immediately after K-wires fixation and 69.5° after 3 months later. The mean lateral humerocapitellar angle was 38° immediately after K-wires fixation and 35.5° after 3 months later. The clinical outcome was excellent in nine children and poor in one child by the Flynn’s criteria. Conclusion: Reduction of displaced flexion-type pediatric supracondylar humeral fractures by traction and gradual extension in the prone position is an effective and safe method. When reduction is still impossible or nerve incarceration is suspected, open reduction and release of the trapped nerve through a posterior triceps splitting approach are simply accessible.

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