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PubMed1998

Touch therapies in the perioperative environment: human connecting for enhanced healing.

In today's fast-paced surgical environments, more than ever nurses are required to bring the sense of caring and human connection to their patients. Touch provides the most direct way of communicating this caring quality, provided the caregiver is centered and clear about intent. Three models of touch--the sensory-physical, the psychological-humanistic, and the energy-based--are explored in this article to give the reader creative and sensitive means of communicating the caring intent that is central to nursing practice.

Holistic Nursing↗

PubMed1998

Therapeutic touch. Nurturing the nurse leader.

As a complementary modality, therapeutic touch is gaining increasing recognition. Not only are nurses incorporating therapeutic touch into their daily patient care, but patients also are requesting this healing modality. Nurse leaders also use this nursing intervention to weave their vision of healing into their managerial role.

Clinical Nursing Research↗

PubMed1982

Intermittent touch syndrome.

Intermittent touch of a pseudophakos to the corneal endothelium is heralded by three signs: ciliary flush, (local) corneal dystrophy, and cystoid macular edema. This syndrome is often missed, and should be ruled out whenever any one of these three signs is detected. Once diagnosed, elimination of the touch should be accomplished promptly. If discovered early, the syndrome may be reversed.

Aged↗

PubMed1996

Intraoperative diagnosis of osseous eosinophilic granuloma by touch preparation: report of two cases with immunohistochemistry and electron microscopy.

We report two cases of eosinophilic granuloma (Langerhans cell histiocytosis) of bone, the diagnosis of which was made by intraoperative cytological evaluation of touch preparation. The clinical, cytologic, histologic, immunohistochemical, and electron microscopic findings are presented. Our cases demonstrate and further support that intraoperative cytologic analysis by touch preparation is a very useful method of diagnosis during intraoperative consultation on a bony specimen.

Biopsy↗

PubMed2006

Intraoperative touch imprint cytology for the diagnosis of sentinel lymph node metastases in breast cancer.

BACKGROUND: Intraoperative detection of sentinel lymph node (SLN) metastases enables the surgeon to take an immediate decision to proceed to completion axillary lymph node dissection (ALND). The aim of this study was to determine the accuracy of touch imprint cytology (TIC) for the diagnosis of SLN metastases in sentinel nodes from women with breast cancer. METHODS: Touch imprints from 235 sentinel nodes in 133 women with breast cancer were diagnosed by cytopathology and compared with definitive histopathology results. After a feasibility study, a real-time study was performed with the surgeon proceeding to ALND based on the TIC diagnosis. The clinical opinion of the operating surgeon as to whether the SLN appeared to contain metastases was recorded, as was the time taken for the result to be available. RESULTS: TIC detected metastases with a sensitivity of 81.1 per cent and a specificity of 100 per cent. False-negative TIC diagnoses were associated with micrometastases and lobular carcinoma. The majority of false-negative diagnoses were due to sampling rather than interpretation errors. Clinical assessment of sentinel nodes had a sensitivity of 64.3 per cent and a specificity of 87.6 per cent. CONCLUSION: TIC is feasible and enables the rapid diagnosis of SLN metastases with an acceptable accuracy for clinical use in ductal carcinoma of the breast.

Breast Neoplasms↗

PubMed2005

Comparison of molecular abnormalities in bronchial brushings and tumor touch preparations.

BACKGROUND: Preneoplastic lung lesions and early-stage lung carcinomas are associated with molecular abnormalities. The authors performed a pilot study to evaluate the use of DNA fluorescence in situ hybridization (FISH) probes to ascertain whether these biomarkers can predict nonsmall cell lung carcinoma (NSCLC). METHODS: Fourteen bronchial brushings ipsilateral to the tumor (BB/Ts), tumor touch imprints, and touch imprints of the bronchus adjacent to the tumor obtained from 15 patients with early-stage NSCLC were analyzed. The LAVysion multicolor probe set consisting of probes to 5p15, 6, 7p12, and 8q2 and the in-house probes 3p22.1 and 10q22 was used. Using the LAVysion multicolor probe set, 25 epithelial cells were counted and considered positive if > 5 cells were abnormal. Using 3p22.1 and 10q22, > or = 100 nuclei per slide were scored. The results were tabulated as the percentage of cells with deletions compared with the centromeric probes 3 and 10. Greater than 2% of the deletions were positive for 3p22.1 and 10q22. Bronchial washings from patients without lung tumors were used as controls. RESULTS: The BB/Ts were negative for malignant cells by cytologic evaluation and the LAVysion probe set; however, the combined in-house probes for 3p22.1 and 10q22 tested on BB/Ts predicted cancer in 100% of cancer patients. FISH positivity in the lung cancers was 100% for 3p22.1 deletions, 79% for 10q22 deletions, and 57% for LAVysion probes. When compared with the bronchial epithelium, tumor cells showed a 3.7-fold excess of 3p22.1 deletions, a 2-fold excess of 10q22 deletions, and a 12.6-fold excess of abnormal cells. CONCLUSIONS: The current study indicated that detection of molecular abnormalities in bronchial epithelial cells via FISH was very useful in identifying patients at high risk for developing lung carcinoma. The molecular abnormalities identified in the BB/Ts were detected at elevated levels in the tumor specimens.

Adult↗

PubMed2002

Pelvic endometriosis diagnosed on touch imprint cytology.

A case of pelvic endometriosis on touch imprint cytology in a 34-yr-old woman is presented and discussed. Touch preparations of the core biopsies showed both epithelial and spindle cell components. Bland-appearing epithelial cells, arranged in tight clusters and sheets, contained finely granular chromatin and scant cytoplasm. Clusters of bland-appearing spindle cells with oval nuclei containing small prominent nucleoli were present. The differential diagnosis and diagnostic pitfalls are discussed.

Adult↗

PubMedDate not supplied

No-touch catheterization and infection rates in a select spinal cord injured population.

A clinical trial comparing two intermittent catheterization techniques used with spinal cord injured patients at Parkwood Hospital, a long-term care facility in London, ON, Canada, was conducted to evaluate the techniques' effect on urinary tract infections (UTIs). Charts were reviewed retrospectively for 92 patients with traumatic spinal cord injury who were on intermittent catheterization between January 1985 and December 1988. Nearly 80% of these patients had more than one UTI per admission. A convenience sample of 18 patients with traumatic spinal cord injury participated in a prospective study using a no-touch method of catheterization for 7 months. Preliminary findings at the completion of the study revealed that 44.4% of this experimental group had more than one UTI per admission--a 44.5% reduction. The no-touch method using the O'Neil Sterile Field urinary catheter was successful in reducing the total number of infections and duration of infection for the experimental group. A nurse satisfaction questionnaire revealed that nursing staff preferred this method of intermittent catheterization to the traditional method.

Adult↗

PubMedDate not supplied

Touch-screen computerized education for patients with brain injuries.

The use of computer technology for patient education has increased in recent years. This article describes a study that measures the attitudes and perceptions of healthcare professionals and laypeople regarding the effectiveness of a multimedia computer, the Brain Injury Resource Center (BIRC), as an educational tool. The study focused on three major themes: (a) usefulness of the information presented, (b) effectiveness of the multimedia touch-screen computer methodology, and (c) the appropriate time for making this resource available. This prospective study, conducted in an acute care medical center, obtained healthcare professionals' evaluations using a written survey and responses from patients with brain injury and their families during interviews. The findings have yielded excellent ratings as to the ease of understanding and usefulness of the BIRC. By using sight, sound, and touch, such a multimedia learning center has the potential to simplify patient and family education.

Attitude of Health Personnel↗

PubMed1993

Preoperative diagnosis of malignant melanoma using the touch-fluorescence method.

We have developed a touch-fluorescence method using preparations from the outer surface of elevated and ulcerative malignant melanoma lesions. This method allows the demonstration of the melanogenic activity of melanoma cells within 30 min and has made it possible to definitively diagnose a lesion as malignant melanoma at the initial examination. In 21 cases clinically diagnosed as typical melanoma, 17 were definitively diagnosed as melanoma from the touch-fluorescence microscopic findings. Of the four cases in which no fluorescent tumor cells were found, two proved not to be melanoma. There was some correlation between the morbid types of primary melanoma and the configuration of fluorescent melanoma cells, the main cellular configuration of superficial spreading melanoma being round whereas that of nodular melanoma and acral lentigenous melanoma was pleomorphic. Based on the above results, this method was concluded to be extremely reliable for the preoperative diagnosis of elevated and ulcerative lesions of malignant melanomas, which are sometimes difficult to diagnose.

Adult↗

PubMed1992

Pain, thermal sensation and cooling rates of hands while touching cold materials.

Hand cooling and resulting comfort and pain were studied in 12 subjects, while touching six different materials (polyurethane foam, wood, nylon, rustproof steel, aluminium, and temperature-controlled metal) which were initially at ambient temperature. This was done for three ambient temperatures (-10 degrees, 0 degree and 10 degrees C), after pre-exposure exercise or rest, with bare hands or while wearing gloves. The observed cooling curves were analysed as Newtonian cooling curves. The observed time constants appeared to be significantly related to the materials' contact coefficients, the presence of hand protection, the preceding activity, and the interaction between contact coefficient and the presence of hand protection. These parameters also allowed a good description of the time constant (r2 = 0.8) of the related cooling curves. Thermal and pain sensation could be described in terms of the local skin temperature, ambient temperature and hand protection. Equal pain and thermal levels were associated with lower temperatures of the back of the hand than of the contact side. The slightly painful condition was associated with a skin temperature of 16 degrees C for the back and 19 degrees C for the palm of the hand. The pain level appeared to be inversely related to cooling speed. Skin freezing occurred at higher skin temperatures when touching cold objects than when exposed to cold air as a result of reduced supercooling. The regression equations determined allowed calculations to be made of safety limits for hand cooling while in contact with a wide range of materials.

Adolescent↗

PubMed1992

Simulation of hand cooling due to touching cold materials.

A simple analytical model has been developed to simulate the cooling of the hands due to touching various types of cold material. The model consisted of a slab of tissue, covered on both sides with skin. The only active mechanism was the skin blood flow. The blood flow was controlled by body core temperature, mean skin temperature, and local hand temperature. The blood flowed along the palm before returning via the back of the hand. The control function was adapted from an earlier study, dealing with feet, but enhanced with a cold induced vasodilatation term. The palm of the hand was touching materials that were specified by conductivity and heat capacity. The hand was initially at a steady-state in a neutral environment and then suddenly grabbed the material. The resulting cooling curves have been compared to data from an experiment including six materials (foam, wood, nylon, steel, aluminium and metal at a constant temperature), three temperatures (-10, 0, and 10 degrees C), two thermal states of the body (neutral and 0.4 degrees C raised), and with and without gloves. There was a fair general agreement between the model and the experiment but the model failed to predict three specific effects: the unequal effect of equal 10 degrees C steps in cold surface temperature on the temperature of the palm of the hand, the cooling effect of nylon, and the rapid drop in back of the hand temperature. Nevertheless the overall regression was 0.88 with a standard deviation between model and experiment of about 2.5 degrees C.

Body Temperature↗

PubMed1999

Experimental evidence does not support use of the "no-touch" isolation technique in colorectal cancer.

PURPOSE: The benefits of the "no-touch" isolation technique usually performed to prevent the circulation of tumor cells are not evident. The aim of this study was to determine whether conventional surgical procedures for treatment of colon cancer could provoke the circulation of tumor cells detected by a genetic technology. METHODS: Sixteen patients undergoing resection for colorectal cancer and two patients with irresectable tumors were studied. No patient showed liver or lung metastasis. With specific primers for carcinoembryonic antigen, we used reverse transcriptase-polymerase chain reaction to analyze tumor biopsy specimens and blood samples obtained from the antecubital vein before and after surgery and from the main drainage vein of the tumor when the tumor had been extracted. Peritoneal fluid was also collected in irrecsectable cases. RESULTS: Amplification of cDNA with carcinoembryonic antigen-specific primers was achieved with all tumor biopsies and samples of peritoneal fluid. In two patients carcinoembryonic antigen reverse transcriptase-polymerase chain reaction products were detected in antecubital vein blood before surgery and in one of them also after surgery. Only in one patient (Dukes C) were carcinoembryonic antigen reverse transcriptase-polymerase chain reaction products detected from the main drainage vein of the tumor. In serial dilution experiments we determined that the limit of detection of this method was ten tumor cells in 2 ml of blood. CONCLUSION: Our data suggest that the use of no-touch isolation techniques in colorectal cancer is not justified, based on lack of evidence indicating the detachment of cells from the tumor at surgery.

Adult↗

PubMed1998

Control strategies for finger movement during touch-typing. The role of the extrinsic muscles during a keystroke.

A single keystroke during touch-typing is a rapid, goal-directed motion of the fingertip which consists of two single-direction movements. The neural control and the role of the finger extrinsic musculature during typing have not yet been explained. The fingertip motion and force, and the intramuscular electromyographic (EMG) activity (fine-wire) of the index finger extrinsic musculature were measured during touch-typing by ten experienced typists. The motions and forces were repeatable qualitatively across keystrokes. A three-burst EMG pattern was observed during a single keystroke. The three bursts were: (1) a burst of extensor activity lifted the finger before the keystroke; (2) a burst of flexor activity followed while the fingertip was moving downward; and (3) a second burst of extensor activity occurred as the fingertip reached the end of key travel. The timing of the third burst suggests the role of the extensors is to remove the fingertip from the keyswitch rather than stop the downward motion of the finger. The collision with the end of key travel stops the downward finger motion. The timing of the finger flexor EMG activity, burst 2, suggests that the flexor contraction principally overcomes the activation force of the keyswitch rather than accelerates the finger downward as expected.

Adult↗

PubMed2004

No-touch technique for autologous fat harvesting.

A new technique for autologous fat harvesting is presented. It is termed the "no-touch" technique because the concentrated fat graft is obtained with no handling of fatty tissue. With the no-touch technique, fat aspiration is performed under tourniquet. There is no need for any mechanical manipulations such as centrifugation, washing, whisking, filtering, or straining. The medial aspect of the knee is used as the donor area. Fat is aspirated through a disposable 10-ml syringe and a 14-gauge microcannula, which consists of a curved, semiblunted tip such as that of the Tuohy needle. What remains in the syringe is the concentrated fat without blood, serum, or lidocaine. The authors report their experience with 30 patients.

Adipose Tissue↗

PubMed2006

Automatized assessment of 1p36-19q13 status in gliomas by interphase FISH assay on touch imprints of frozen tumours.

Molecular genetic analyses have demonstrated that combined losses in 1p36 and 19q13 were associated with a good response to treatment and a higher survival rates in oligodendrogliomas (O). The presence of such deletions in a subset of mixed oligoastrocytomas (OA) also suggests that 1p-19q status may assist the histological classification of gliomas. Representative frozen fragments of 25 patients with a primary grade II or III glioma [2 O, 8 astrocytic tumours (A), 15 OA] were selected and a sensitive interphase fluorescent in situ hybridization (FISH) analysis was developed on serial touch preparations using two sets of probes. A positive detection threshold at 6% was reached by the use of both touch imprints and a new set of LSI 1p36/19q13 Abbott-Vysis probes. Strong and discrete hybridization signals of these probes facilitated the following FISH analysis; indeed, an automatic analysis of the hybridization patterns (Metafer 4, Metasystems, Althlussheim, Germany) was compared with visual counting. Both methods were highly correlated and combined 1p-19q losses found in five tumours with an oligodendroglial component (2 O, 3 OA). The automatic system allowed the capture and storage of hybridization patterns and the processing of several slides. A convenient checking of the nuclei gallery was done with direct recall and visual verification on the slides of nuclei with ambiguous hybridization patterns. The recently developed probes together with automatic counting may facilitate multicentric evaluation and standardization of 1p-19q assessment in gliomas.

Astrocytoma↗

PubMed2005

AtGLR3.4, a glutamate receptor channel-like gene is sensitive to touch and cold.

The Arabidopsis genome encodes for 20 members of putative ligand-gated channels, termed glutamate receptors (GLR). Despite the fact that initial studies suggested a role for GLRs in various aspects of photomorphogenesis, calcium homeostasis or aluminium toxicity, their functional properties and physiological role in plants remain elusive. Here, we have focussed on AtGLR3.4, which is ubiquitously expressed in Arabidopsis including roots, vascular bundles, mesophyll cells and guard cells. AtGLR3.4 encodes a glutamate-, touch-, and cold-sensitive member of this gene family. Abiotic stress stimuli such as touch, osmotic stress or cold stimulated AtGLR3.4 expression in an abscisic acid-independent, but calcium-dependent manner. In plants expressing the Ca(2+) -reporter apoaequorin, glutamate as well as cold elicited cytosolic calcium elevations. Upon glutamate treatment of mesophyll cells, the plasma membrane depolarised by about 120 mV. Both glutamate responses were transient in nature, sensitive to glutamate receptor antagonists, and were subject to desensitisation. One hour after eliciting the first calcium signal, a 50% recovery from desensitisation was observed, reflecting the stimulus-induced fast activation of AtGLR3.4 transcription. We thus conclude that AtGLR3.4 in particular and GLRs in general could play an important role in the Ca(2+) -based, fast transmission of environmental stress.

Arabidopsis↗

PubMed2001

Laparoscopic right hemicolectomy with radical lymph node dissection using the no-touch isolation technique for advanced colon cancer.

The treatment of advanced right-sided colon cancer presents numerous challenges for the surgeon who must aim to minimize the invasiveness of surgery, achieve curative resection, and prevent port-site recurrences. To overcome these issues, we performed a totally intra-abdominal laparoscopic right hemicolectomy with radical lymph node dissection based on a no-touch isolation technique. To perform this no-touch technique, we initially dissected the lymph nodes along the surgical trunk, then transected the transverse colon, terminal ileum, and mesentery without tumor manipulation. Finally, the right side of the colon was freed retroperitoneally. We performed this surgical technique on three patients and no intraoperative complications were encountered. Curative resection was achieved in all three patients, as curability A according to the Japanese Classification of Colorectal Carcinoma, and their postoperative courses were uneventful. Therefore, this novel technique proved to be both feasible and safe. Furthermore, it enabled us to minimize the invasiveness of surgery, while providing clear access to resect the right-sided advanced colon cancer.

Carcinoma↗