153 Audit of anaesthetic practice for incision and drainage of lower body abscesses before and after COVID-19

Abstract Aims Despite being the most common surgical procedure, there is wide variation that exists in the management of simple subcutaneous abscesses with no national guideline describing best practice. During the COVID-19 Pandemic national guidelines promoted the use of regional or local anaesthetic (LA) instead of general anaesthesia (GA) to avoid aerosol generating intubation associated with GA. This study aimed to assess the impact of anaesthetic choice in outcomes following incision and drainage of subcutaneous abscesses. Methods Two cohorts of patients undergoing abscess incision and drainage at St. James’ University Hospital Leeds were retrospectively identified over a 14-week period before and after the introduction of the new COVID-19 anaesthetic guidelines. Wound healing surrogate endpoints were used: i) total number of follow up appointments and ii) attendance to healthcare services after 30 days from I&D. Result 133 patients were included. Significantly more procedures were performed under LA after the intervention (84.1% vs 5.7%; p < 0.0001) with a significant reduction in wound packing (68.3% vs 87.1%. p=0.00473). Follow up data found no significant difference in the average number of follow-up appointments (7.46 vs 5.11; p = 0.0731) and the number of patients who required ongoing treatment after 30 days (n = 14 vs n = 14, p = 0.921). Conclusion Drainage of simple subcutaneous abscess under 5 cm is safe under local anaesthetic with no significant difference in surrogate endpoints of wound healing observed in this patient cohort. Recurrent packing may not be required. Future work should explore patient reported measures such as pain management and the health economics of this intervention.

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Increase in vagal activity during hypotensive lower-body negative pressure in humans

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1988.255.1.r149 ◽

1988 ◽

Vol 255 (1) ◽

pp. R149-R156 ◽

Cited By ~ 12

Author(s):

K. Sander-Jensen ◽

J. Mehlsen ◽

C. Stadeager ◽

N. J. Christensen ◽

J. Fahrenkrug ◽

...

Keyword(s):

Heart Rate ◽

Negative Pressure ◽

Lower Body Negative Pressure ◽

Venous Pressure ◽

Initial Increase ◽

Vagal Activity ◽

Lower Body ◽

Central Venous ◽

Subsequent Decrease ◽

Before And After

Progressive central hypovolemia is characterized by a normotensive, tachycardic stage followed by a reversible, hypotensive stage with slowing of the heart rate (HR). We investigated circulatory changes and arterial hormone concentrations in response to lower-body negative pressure (LBNP) in six volunteers before and after atropine administration. LBNP of 55 mmHg initially resulted in an increase in HR from 55 +/- 4 to 90 +/- 5 beats/min and decreases in mean arterial pressure (MAP) from 94 +/- 4 to 81 +/- 5 mmHg, in central venous pressure from 7 +/- 1 to -3 +/- 1 mmHg, and in cardiac output from 6.1 +/- 0.5 to 3.7 +/- 0.11/min. Concomitantly, epinephrine and norepinephrine levels increased. After 8.2 +/- 2.3 min of LBNP, the MAP had decreased to 41 +/- 7 mmHg and HR had decreased to 57 +/- 3 beats/min. Vasopressin increased from 1.2 +/- 0.3 to 137 +/- 45 pg/ml and renin activity increased from 1.45 +/- 4.0 to 3.80 +/- 1.0 ng.ml-1.h-1 with no further changes in epinephrine, norepinephrine, and vasoactive intestinal polypeptide. A tardy rise in pancreatic polypeptide indicated increased vagal activity. After atropine. LBNP also caused an initial increase in HR, which, however, remained elevated during the subsequent decrease in MAP to 45 +/- 6 mmHg occurring after 8.1 +/- 2.4 min.(ABSTRACT TRUNCATED AT 250 WORDS)

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Effectiveness Of Tepid Sponge Compresses And Plaster Compresses On Child Typhoid Patients with Fevers

KnE Life Sciences ◽

10.18502/kls.v6i1.8784 ◽

2021 ◽

Author(s):

Dwi Hastuti ◽

Dewi Ummu Kulsum ◽

Siti Rahmawati Ismuhu ◽

Oop Ropei

Keyword(s):

Body Temperature ◽

Typhoid Fever ◽

Wilcoxon Test ◽

School Age Children ◽

P Value ◽

Lower Body ◽

Lower Body Temperature ◽

Main Complaint ◽

Before And After ◽

Average Body

Background: Typhoid is infectious disease which is still encountered widely in various developing countries, especially those located in the tropic and subtropics. Fever is a clinincal manifestation that is often the main complaint of the sufferer. Action can be done to lower body temperature that is tepid sponge compress and plaster compress. Purpose: The purpose of this study is to determine the comparison of the effectiviness of tepid sponge compress and plaster compress of changes body temperature in school age children with typhoid fever in cibabat hospital in year 2017. Methods: The method used is quasy experiment research method with the approach of pretest and post test two design group. As many as 24 samples were taken at the patient ward of hospital Cibabat. Respondents divided into two groups namely tepid sponge compress and plaster compress by way concecutive sampling. This study was conducted for 20 minutes at each intervenstion. Data analysis used Wilcoxon test, dependen t test, and Mann-Withney. Results: Average body temperature before and after given tepid sponge compress are 38,75°C and 38,08°C with temperature different is 0,67°C. While average body temperature before and after given palster compress are 38,80°C and 38,57°C with temperature different is 0,23°C. Mann-Withney test result show that the p value = 0,000 < α = 0,05 which means bottom tepid sponge compress is more effective in lowering body temperature in scholl age children compared with plaster compress. Conclusion: Based on the result of the study, it can recommend tepid sponge compress in the implementation of nursing care to lower body temperature in typhoid fever patients. Keywords: Fever, Plaster compress, Tepid sponge

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Static Balancing Ability and Lower Body Kinematics Examination of Hungarian Folk Dancers: A Pilot Study Investigating the “Kalocsai Mars” Dance Sequence

Applied Sciences ◽

10.3390/app11188789 ◽

2021 ◽

Vol 11 (18) ◽

pp. 8789

Author(s):

Cecília Molnár ◽

Zsófia Pálya ◽

Rita M. Kiss

Keyword(s):

Measurement Procedure ◽

Folk Dance ◽

Lower Body ◽

Dance Movement ◽

Static Balancing ◽

Flexion Extension ◽

Before And After ◽

Posterior Direction ◽

Joint Flexion ◽

Hip Flexion

Folk dance is a collection of traditional dances that requires years of practicing to perform correctly. The aim of the present study was to develop a complex biomechanical measurement procedure that investigated Hungarian folk dancers’ balancing ability and lower body kinematics through a dance movement called “Kalocsai mars”. Therefore, 11 dancers’ motion (5 female and 6 male; age: 20.5 ± 2.5 years; height: 173.82 ± 7.82 cm; weight: 64.77 ± 8.67 kg) was recorded with an optical-based motion capture system and force platforms simultaneously. Before and after the dancing session, static balancing tests were performed, examining bipedal stance with eyes opened and closed conditions. The ANOVA results showed that the values of the range of motions of the knee joint flexion-extension angles and hip flexion averaged for sessions increased significantly (p=0.044, p=0.003, p=0.005) during the dancing sessions. The deviation in the joint angle was greater in the nondominant legs, suggesting that the nondominant side requires more attention to execute the dance steps correctly. The results of the balance tests showed that the oscillation in the posterior direction increased significantly after dancing (p=0.023). In comparison, the visual feedback had no significant effect on the dancers’ balancing ability.

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Decreased Serum Levels of C-Terminal Agrin in Postmenopausal Women Following Resistance Training

Journal of Aging and Physical Activity ◽

10.1123/japa.2019-0066 ◽

2020 ◽

Vol 28 (1) ◽

pp. 73-80 ◽

Cited By ~ 1

Author(s):

Darryn S. Willoughby ◽

Kaitlan N. Beretich ◽

Marcus Chen ◽

LesLee K. Funderburk

Keyword(s):

Body Composition ◽

Resistance Training ◽

Neuromuscular Junction ◽

Serum Levels ◽

Upper Body ◽

Lower Body ◽

Serum Estradiol ◽

Body Strength ◽

Before And After ◽

Lower Body Strength

Elevated circulating C-terminal agrin fragment (CAF) is a marker of neuromuscular junction degradation and sarcopenia. This study sought to determine if resistance training (RT) impacted the serum levels of CAF in perimenopausal (PERI-M) and postmenopausal (POST-M) women. A total of 35 women, either PERI-M or POST-M, participated in 10 weeks of RT. Body composition, muscle strength, and serum estradiol and CAF were determined before and after the RT. The data were analyzed with two-way analysis of variance (p ≤ .05). Upper body and lower body strength was significantly increased, by 81% and 73% and 86% and 79% for the PERI-M and POST-M participants, respectively; however, there were no significant changes in body composition. Estradiol was significantly less for the POST-M participants at pretraining compared with the PERI-M participants. CAF moderately increased by 22% for the PERI-M participants in response to RT, whereas it significantly decreased by 49% for the POST-M participants. Ten weeks of RT reduced the circulating CAF in the POST-M women and might play a role in attenuating degenerative neuromuscular junction changes.

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Lower body negative pressure exercise plus brief postexercise lower body negative pressure improve post-bed rest orthostatic tolerance

Journal of Applied Physiology ◽

10.1152/japplphysiol.00132.2007 ◽

2007 ◽

Vol 103 (6) ◽

pp. 1964-1972 ◽

Cited By ~ 32

Author(s):

Donald E. Watenpaugh ◽

Deborah D. O'Leary ◽

Suzanne M. Schneider ◽

Stuart M. C. Lee ◽

Brandon R. Macias ◽

...

Keyword(s):

Negative Pressure ◽

Acute Exercise ◽

Treadmill Exercise ◽

Orthostatic Intolerance ◽

Lower Body Negative Pressure ◽

Bed Rest ◽

Orthostatic Tolerance ◽

Lower Body ◽

Before And After ◽

Head Up Tilt

Orthostatic intolerance follows actual weightlessness and weightlessness simulated by bed rest. Orthostasis immediately after acute exercise imposes greater cardiovascular stress than orthostasis without prior exercise. We hypothesized that 5 min/day of simulated orthostasis [supine lower body negative pressure (LBNP)] immediately following LBNP exercise maintains orthostatic tolerance during bed rest. Identical twins (14 women, 16 men) underwent 30 days of 6° head-down tilt bed rest. One of each pair was randomly selected as a control, and their sibling performed 40 min/day of treadmill exercise while supine in 53 mmHg (SD 4) [7.05 kPa (SD 0.50)] LBNP. LBNP continued for 5 min after exercise stopped. Head-up tilt at 60° plus graded LBNP assessed orthostatic tolerance before and after bed rest. Hemodynamic measurements accompanied these tests. Bed rest decreased orthostatic tolerance time to a greater extent in control [34% (SD 10)] than in countermeasure subjects [13% (SD 20); P < 0.004]. Controls exhibited cardiac stroke volume reduction and relative cardioacceleration typically seen after bed rest, yet no such changes occurred in the countermeasure group. These findings demonstrate that 40 min/day of supine LBNP treadmill exercise followed immediately by 5 min of resting LBNP attenuates, but does not fully prevent, the orthostatic intolerance associated with 30 days of bed rest. We speculate that longer postexercise LBNP may improve results. Together with our earlier related studies, these ground-based results support spaceflight evaluation of postexercise orthostatic stress as a time-efficient countermeasure against postflight orthostatic intolerance.

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Effect of hindlimb suspension on cardiovascular responses to sympathomimetics and lower body negative pressure

Journal of Applied Physiology ◽

10.1152/jappl.1990.68.1.355 ◽

1990 ◽

Vol 68 (1) ◽

pp. 355-362 ◽

Cited By ~ 37

Author(s):

J. M. Overton ◽

C. M. Tipton

Keyword(s):

Negative Pressure ◽

Lower Body Negative Pressure ◽

Cardiovascular Responses ◽

Male Rats ◽

Hindlimb Suspension ◽

Lower Body ◽

Baroreflex Control ◽

Cardiovascular Deconditioning ◽

Treatment Conditions ◽

Before And After

To determine whether hindlimb suspension is associated with the development of cardiovascular deconditioning, male rats were studied before and after undergoing one of three treatment conditions for 9 days: 1) cage control (n = 15, CON), 2) horizontal suspension (n = 15, HOZ), and 3) head-down suspension (n = 18, HDS). Testing included lower body negative pressure administered during chloralose-urethan anesthesia and graded doses of sympathomimetic agents (norepinephrine, phenylephrine, and tyramine) administered to conscious unrestrained animals. Both HDS and HOZ were associated with a small decrease in the hypotensive response to lower body negative pressure. The HOZ group, but not the HDS group, exhibited augmented reflex tachycardia. Furthermore, both HDS and HOZ groups manifested reduced pressor responses to phenylephrine after treatment. These reductions were associated with significantly attenuated increases in mesenteric vascular resistance. However, baroreflex control of heart rate was not altered by the treatment conditions. Collectively, these results indicate that 9 days of HDS in rats does not elicit hemodynamic response patterns generally associated with cardiovascular deconditioning induced by hypogravic conditions.

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A HOSPITAL-BASED CLINICAL STUDY ON THE MANAGEMENT OF CHRONIC MASTOIDITIS AND MASTOID ABSCESS AT VIMS, PAWAPURI, NALANDA, BIHAR

10.36106/ijsr/7821468 ◽

2021 ◽

pp. 27-29

Author(s):

Shambhu Sharan Gupta ◽

Satish Kumar ◽

Debarshi Jana

Keyword(s):

Treatment Guidelines ◽

Demographic Data ◽

Incision And Drainage ◽

Best Management ◽

Management Protocol ◽

Before And After ◽

Antibiotics Use ◽

Data History ◽

Laboratory Investigations

Background: In spite of the advent of antibiotics, the incidence of mastoiditis and mastoid abscess is not uncommon in the ENT practice. The pathogenesis is due to virulence of organism, insufcient antibiotics use, and ineffective antibiotics. Treatment consists of simple incision drainage to modied radical mastoidectomy. However, there seems to be no unanimous agreement on the best management strategy for this problem. The present study presents the outcome of patients undergoing treatment and also presents a protocol followed in VIMS, Pawapuri, Nalanda, Bihar and its prognostic value. Aim of the Study: The aim of this study is to review the available management protocols for treatment of mastoiditis and mastoid abscess and formulate our own hospital-based guidelines and protocol. Materials and Methods:Astudy was conducted on 53 patients aged between 11 and 60 years, who presented with mastoiditis or mastoid abscess. All the patients were treated according to surgical protocols available. Demographic data, history, and otoscopy ndings were recorded. Patients with mastoiditis were treated with mastoidectomy, and the patients with mastoid abscess were treated initially with incision and drainage and after 2 weeks with mastoidectomy. Laboratory investigations such as audiometry, culture, and sensitivity of pus from the ears were done. All the patients were followed for 6 months. Observations and Results:Atotal of 53 patients were enrolled in this study. Mean age was 25.45 ± 2.35 in males and 23.76 ± 1.85 in females who presented with mastoiditis. Similarly, the mean age was 23.76 ± 1.85 and 20.46 ± 2.10 years for patients of mastoid abscess. There were 39/53 (73.58%) males and 14/53 (26.41%) females. Audiometry could be done in 32/37 (86.48%) patients with mastoiditis and 8/16 (50%) patients with mastoid abscess. These 40/56 (71.42%) patients had conductive deafness with a mean pure tone average of 32.45 dB. There were no post-operative complications reported during follow-up of 6 months. Conclusions:Adenitive management protocol is a must for every hospital to avoid delay and complications before and after surgical treatment in mastoiditis and mastoid abscess. Treatment guidelines should be followed meticulously in the diagnosis, laboratory investigations, and decisionmaking of denitive surgical procedure to be adopted in mastoiditis and mastoid abscess.

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Quantification of Training Load During Return to Play After Upper- and Lower-Body Injury in Australian Rules Football

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2016-0300 ◽

2017 ◽

Vol 12 (5) ◽

pp. 634-641 ◽

Cited By ~ 6

Author(s):

Dean Ritchie ◽

Will G. Hopkins ◽

Martin Buchheit ◽

Justin Cordy ◽

Jonathan D. Bartlett

Keyword(s):

High Speed ◽

Training Load ◽

Return To Play ◽

Upper Body ◽

Lower Body ◽

Total Distance ◽

Australian Rules Football ◽

Before And After ◽

Point Total ◽

Indoor And Outdoor

Context:Training volume, intensity, and distribution are important factors during periods of return to play.Purpose:To quantify the effect of injury on training load (TL) before and after return to play (RTP) in professional Australian Rules football.Methods:Perceived training load (RPE-TL) for 44 players was obtained for all indoor and outdoor training sessions, while field-based training was monitored via GPS (total distance, high-speed running, mean speed). When a player sustained a competition time-loss injury, weekly TL was quantified for 3 wk before and after RTP. General linear mixed models, with inference about magnitudes standardized by between-players SDs, were used to quantify effects of lower- and upper-body injury on TL compared with the team.Results:While total RPE-TL was similar to the team 2 wk before RTP, training distribution was different, whereby skills RPE-TL was likely and most likely lower for upper- and lower-body injury, respectively, and most likely replaced with small to very large increases in running and other conditioning load. Weekly total distance and high-speed running were most likely moderately to largely reduced for lower- and upper-body injury until after RTP, at which point total RPE-TL, training distribution, total distance, and high-speed running were similar to the team. Mean speed of field-based training was similar before and after RTP compared with the team.Conclusions:Despite injured athletes’ obtaining comparable TLs to uninjured players, training distribution is different until after RTP, indicating the importance of monitoring all types of training that athletes complete.

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The Effects of Plyometric Conditioning Exercises on Volleyball Performance with Self-Selected Rest Intervals

Applied Sciences ◽

10.3390/app11188329 ◽

2021 ◽

Vol 11 (18) ◽

pp. 8329

Author(s):

Michal Krzysztofik ◽

Rafal Kalinowski ◽

Aleksandra Filip-Stachnik ◽

Michal Wilk ◽

Adam Zajac

Keyword(s):

Performance Enhancement ◽

Lower Body ◽

Mean Power ◽

Back Squat ◽

Specific Performance ◽

Volleyball Players ◽

Before And After ◽

Ball Velocity ◽

Mean Power Output ◽

Rest Intervals

Post-activation performance enhancement remains a topic of debate in sport science. The purpose of this study was to examine the effects of lower-body plyometric conditioning activity (CA) with a self-selected intra-complex rest interval on upper and lower-body volleyball specific performance. Eleven resistance-trained female volleyball players participated in the study (age: 20 ± 2 years; body mass: 67.8 ± 4.4 kg; height: 178 ± 6 cm; half back squat one-repetition maximum: 78.6 ± 10.2 kg; experience in resistance training: 5.5 ± 2.1 years and in volleyball training: 10 ± 2.3 years). Each participant performed a plyometric CA followed by two different sport-specific tests: an attack jump and a standing spike attack. The changes in jump height (JH), relative mean power output (MP) and ball velocity (BV) were analyzed before and after the CA with self-selected rest intervals. The applied plyometric CA with self-selected intra-complex rest intervals led to an insignificant decline in JH (p = 0.594; effect size [ES]: −0.27) and MP (p = 0.328; ES: −0.46) obtained during the attack jump as well as a significant decline in BV (p = 0.029; ES: −0.72) during the standing spike attack. This study showed that a plyometric CA with self-selected intra-complex rest intervals failed to elicit localized and non-localized PAPE effect in a group of sub-elite volleyball players.

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