scholarly journals Evaluating the risks of arrhythmia following electrical injury: Two cases of electrical injuries in the upper limbs

2020 ◽  
Vol 8 ◽  
pp. 2050313X2092042
Author(s):  
Koichi Jingo ◽  
Yutaka Kondo ◽  
Yohei Hirano ◽  
Juri Inoue ◽  
Takaaki Kawasaki ◽  
...  
Keyword(s):  
Emergency Department ◽  
Ventricular Arrhythmias ◽  
Current Flow ◽  
The Other ◽  
Lower Limbs ◽  
Electrical Injury ◽  
Upper Limbs ◽  
Line Voltage ◽  
Old Men ◽  
Electrical Injuries

Electrical injuries induce ventricular arrhythmias, which are lethal. Therefore, it is important to evaluate the risk of arrhythmias at initial presentation to the emergency department in cases of electrical injuries. Here, we report two cases with electrical injuries, where current flowed between the upper limbs, requiring 24-h hospitalization for arrhythmia monitoring. The patients were 57- and 30-year-old men, who sustained separate electrical injuries (6600 V, line voltage), with current flow from one hand to the other. They did not develop any ventricular arrhythmias during hospitalization and were discharged. The risk for ventricular arrhythmias is lower for electrical injuries occurring between the upper limbs than for those occurring between the upper and lower limbs. We conclude that 24-h hospitalization for monitoring of patients with electrical injuries of the upper limbs may be sufficient.

scholarly journals O USO DA ESCALA DE OMNI-RES EM IDOSAS HIPERTENSAS

2011 ◽  
Vol 16 (1) ◽  
Author(s):  
Aline De Freitas Brito ◽  
Naiane Ferraz Bandeira Alves ◽  
Alessandra Araújo Silva ◽  
Alexandre Sergio Silva
Keyword(s):  
Heart Rate ◽  
Resistance Exercise ◽  
Perceived Exertion ◽  
Elderly Women ◽  
The Other ◽  
Lower Limbs ◽  
Subjective Perception ◽  
Upper Limbs ◽  
Resistance Exercises

Escalas de percepção subjetiva de esforço têm sido usadas há bastante tempo para se referir à intensidade de esforço no exercício aeróbio. Somente há pouco tempo foi validada a escala de OMNI-RES para exercício resistido, de modo que sua aplicação em algumas populações ainda é escassa. Assim, o objetivo deste estudo foi avaliar a efetividade da escala de OMNI-RES em mulheres idosas hipertensas. Vinte e uma voluntárias (60.2±3,8 anos, IMC de 28,7±1,2 Kg/m2), realizaram quatro sessões de exercício resistido randomicamente ordenadas. Duas das sessões eram para membros inferiores (MI), com intensidades de 60% e 80% de 15 RM, e as outras duas, para membros superiores (MS), com as mesmas intensidades. As sessões tiveram três séries de 15 repetições e intervalos de 90 segundos. Ao final de cada série, mediu-se a frequência cardíaca e a percepção subjetiva foi referida pelas mulheres. Para a análise estatística, foi utilizado o teste de ANOVA two-way. A frequência cardíaca se apresentou significativamente mais elevada nas sessões a 80% de 15RM em relação a 60% de 15RM em todas as séries, tanto de membros superiores quanto de membros inferiores. Nos protocolos para MI, as mulheres referiram pontuações na escala de OMNI-RES sempre significativamente maiores ao final das três séries, com intensidade de 80% em relação a 60% de 15 RM (6,1±0,1 versus 3,7±0,1; 6,1±0,1 versus 3,8±0,2 e 6,1±0,1 versus 3,9±0,2 para as 1ª, 2ª e 3ª séries a 80 e 60% respectivamente). Nos protocolos para MS a pontuação na escala de OMNI-RES foi igualmente maior para os exercícios a 80% de 1RM em todas as séries (6,1±0,1 versus 3,5±0,1; 6,1±0,1 versus 3,5±0,1 e 6,1±0,1 versus 3,6±0,1 para as 1ª, 2ª e 3ª séries a 80 e 60% respectiva  mente). Os valores de pontuação foram equivalentes à classificação de razoavelmente leve e compatível com treino de endurance muscular segundo a escala de OMNI-RES nos exercícios a 60% de 15 RM e razoavelmente pesado e compatível com treinamento de hipertrofia para a intensidade de 80% de 15RM. Concluiu-se que a escala de OMNI-RES representa adequadamente a intensidade adotada em exercícios resistidos com características de Resistência Muscular Localizada (RML) e hipertrofia em mulheres idosas hipertensas. THE USE OF THE OMNI-RES SCALE IN HYPERTENSIVE ELDERLY abstract Scales of perceived exertion have been used for some time to refer to the intensity of effort in an aerobic exercise. Only recently the OMNI-RES scale has been validated for resistance exercise, as a result of that its application in some populations is still scarce. Thus, the purpose of this study was to evaluate the effectiveness of the OMNI-RES scale in elderly women with hypertension. Twenty one volunteers (60,2 ± 3,8 years, BMI 28,7 ± 1,2 Kg/m2), undertook four sessions of resistance exercise ordered randomly. Two of those sessions were for lower limbs at intensities of 60% and 80% of 15RM, and the other two were for upper limbs with the same intensity. The sessions had 3 sets of 15 repetitions and intervals of 90 seconds. At the end of each series it was measured the heart rate and the subjective perception was reported by the women. For statistical analysis, it was used the two-way ANOVA test. Heart rate was significantly higher in sessions at 80% with 15RM than at 60% with 15RM in all series, both upper limbs and lower limbs. In the protocols for lower limbs, the women always reported significantly higher scores on the OMNI-RES at the end of the three series with an intensity of 80% compared to 60% with 15 RM (6,1 ± 0,1  versus 3,7 ± 0,1; 6,1 ± 0,1 versus 3,8 ± 0,2 and 6,1 ± 0,1 versus 3,9 ± 0,2 for the 1st, 2nd and 3rd grades 80 and 60% respectively). The values in scores were equivalent to the classification of fairly mild consistent with muscle endurance training according to the OMNI-RES scale on the exercises at 60% with 15 RM and fairly heavy and consistent with hypertrophy training at an intensity of 80% with 15RM. It was concluded that the OMNI-RES scale adequately represented the adopted intensity in resistance exercises with features of RML and hypertrophy in hypertensive elderly women.

scholarly journals Rituximab Efficacy during a Refractory Polyarteritis Nodosa Flare

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Emmanuel Ribeiro ◽  
Thomas Cressend ◽  
Pierre Duffau ◽  
Marieke Grenouillet-Delacre ◽  
Marie Rouanet-Larivière ◽  
...  
Keyword(s):  
Case Report ◽  
Polyarteritis Nodosa ◽  
Systemic Vasculitis ◽  
The Other ◽  
Lower Limbs ◽  
Upper Limbs ◽  
Accelerated Atherosclerosis ◽  
The Real ◽  
Therapeutic Trials ◽  
Work Up

Polyarteritis nodosa (PAN) is a systemic vasculitis whose severe forms are treated with glucocorticoids and cyclophosphamide. Refractory patients are exposed to many complications, notably accelerated atherosclerosis. We report a case report of 71-year-old man followed for polyarteritis nodosa refractory to glucocorticoids and cyclosphosphamide. Systemic vasculitis relapses are followed to accelerated atherosclerosis: severe ischemic lesions led to amputation of lower limbs. Remission of refractory PAN is obtained with rituximab. Disappearance of biological inflammatory is allowed to regression of ischemic lesions in upper limbs. In this situation, we recommend a systematic vascular work-up for patients suffered from refractory vasculitis. On the other hand, therapeutic trials are needed to determine the real efficacy and place of rituximab in the treatment of polyarteritis nodosa.

Pneumatic Assist Device for Gait Restoration

1996 ◽  
Vol 118 (1) ◽  
pp. 9-14 ◽  
Author(s):  
M. Shiraishi ◽  
H. Watanabe
Keyword(s):  
Body Weight ◽  
Experimental Design ◽  
The Other ◽  
Lower Limbs ◽  
Upper Body ◽  
Design System ◽  
Upper Limbs ◽  
Assist Device ◽  
Walking Stick ◽  
Pneumatic Equipment

An assist device for gait restoration powered by body weight has been developed using pneumatic equipment. The aim of this system is to assist people who have weakened lower limbs and require rehabilitation for walking. An experimental design system based on a mechanical bracing structure demonstrates the possibility of using upper body weight to power a pneumatically operated assistive walking system for weakened lower limbs. Continuous forward stepping can be achieved by shifting the upper body weight consecutively from one walking stick to the other through the upper limbs. The main feature of the proposed device is that an individual “walks” using his own energy.

scholarly journals Efeito de duas diferentes frequências semanais de treinamento com pesos sobre a força muscular e pressão arterial em mulheres idosas normotensas

2017 ◽  
Vol 19 (1) ◽  
pp. 118 ◽  
Author(s):  
Renato Galindo da Silva ◽  
Danilo Rodrigues Pereira da Silva ◽  
Fábio Luiz Cheche Pina ◽  
Matheus Amarante do Nascimento ◽  
Alex Silva Ribeiro ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Older Women ◽  
The Other ◽  
Lower Limbs ◽  
Second Phase ◽  
Upper Limbs ◽  
Muscle Groups ◽  
Two Phases ◽  
Improve Muscle Strength ◽  
Total Muscle

DOI: http://dx.doi.org/10.5007/1980-0037.2017v19n1p118 The aim of this study was to analyze the effect of two different weekly resistance training (RT) frequencies on muscle strength and blood pressure (BP) in normotensive older women. Thirty normotensive and physically independent older women participated in the study, which were divided into two groups: RT performed in two weekly sessions (G2X, n = 17; 67.6 ± 4.6 years; 69.7 ± 13.4 kg; 156.6 ± 5.8 cm) and three weekly sessions (G3X; n = 13; 68.7 ± 5.0 years; 69.8 ± 16.1 kg, 155.2 ± 7.8 cm). The RT program was composed by eight exercises for different muscle groups (upper limbs, trunk and lower limbs), lasting 24 weeks (two phases of 12 weeks each). In the first phase, exercises were performed in one set of 10-15 maximum repetitions per exercise, while in the second phase, two sets were performed. BP and muscle strength (1RM) measures were performed at pre-training and after 12 and 24 weeks of RT. Increases in total muscle strength (P < 0.05) were observed in both groups (G2X = 16.8% and G3X = 18.9%), with no difference between groups. On the other hand, no significant changes (P > 0.05) in systolic BP and diastolic BP were found in both groups. The results suggest that 24 weeks of a supervised RT program improve muscle strength without affecting BP in normotensive older women, regardless of frequency of two or three weekly sessions. 

scholarly journals A Retrospective Review of Patients with Radiological Missed Fractures in an Emergency Department in Hong Kong

2003 ◽  
Vol 10 (4) ◽  
pp. 215-222 ◽  
Author(s):  
VCH Ng ◽  
FL Lau
Keyword(s):  
Emergency Department ◽  
Management Plan ◽  
Lower Limbs ◽  
X Rays ◽  
Accident And Emergency ◽  
Assessment And Treatment ◽  
Spinal Region ◽  
Accident And Emergency Department ◽  
Clinical Records ◽  
Christian Hospital

Aim To review the clinical spectrum and outcome of radiological missed fractures in the Accident and Emergency Department of United Christian Hospital (UCH) in 2002. Method In UCH, radiologists report all X-Rays taken in the Accident and Emergency Department (AED) within 48 hours. The study period was from 1st January 2002 to 31st December 2002. AED notes, relevant clinical records and all X-rays of patients with suspected missed fractures as reported by radiologists were reviewed for information on clinical features, treatments and outcomes. Results A total of 286 cases of missed fractures were found. Fourteen (4.9%) involved the skull and maxillofacial region, 83 (29.0%) involved the chest region, 53 (18.5%) involved the spinal region, 72 (25.2%) involved the upper limbs and 64 (22.4%) involved the lower limbs. Of these 286 cases, 137 (47.9%) were followed up in AED, 90 (31.5%) were referred to specialist clinics for further management, 26 (9.1%) required admission to hospital for further assessment and treatment, and 33 (11.5%) defaulted follow up. Furthermore, 87 (30.4%) of these 286 missed fractures required a change in management plan: 3 missed fractures required operative intervention (internal fixation) and 84 missed fractures required some form of external immobilisation. This group of patient did not lodge any complaint or claim. Conclusion A&E doctors missed quite a number of fractures that might result in significant morbidity. However, a reporting system by radiologists within 48 hours from discharge can pick up all these missed fractures, and may prevent complaints and litigations.

Birth Dates and Death Dates: An Examination of two Baseline Procedures and Age at Time of Death

1990 ◽  
Vol 20 (2) ◽  
pp. 127-137 ◽  
Author(s):  
Albert A. Harrison ◽  
Neal E. A. Kroll
Keyword(s):  
Young Men ◽  
The Other ◽  
Birth Date ◽  
Time Of Death ◽  
Low Frequencies ◽  
Temporal Proximity ◽  
Rectangular Distribution ◽  
Old Men ◽  
Day By Day ◽  
Death Date

The present study continues analyses of variations in the frequencies of death in the near temporal proximity of decedents' birthdays. Observed frequencies were compared with expected frequencies as ascertained from two baseline distributions. One distribution was the usual rectangular distribution, based on summing the number of deaths across all frequency categories and then dividing by the number of categories. The other distribution was constructed by pairing one person's birth date with another person's death date. This latter distribution was intended to provide a true baseline, and provide a better gauge for assessing the likelihood that any obtained relationship reflected coincidence or chance. Two weeks before and two weeks after the birthday there were more deaths, and one week after the birthday there were fewer deaths, than would be expected on the basis of either baseline distribution. Day-by-day analyses within the birthweek confirmed earlier reports of high followed by low frequencies of death. Compared to relatively old men, relatively young men were more likely to die on the eve of their birthdays or on their birthdays themselves. Compared to relatively young men, relatively old men's death dip begins at an earlier point in time. Methodological and theoretical implications are discussed.

Evaluation of Analgesic and Sedative Effects of Ketamine Infusion against Intravenous Morphine in Relieving Fracture Pain of Long or Short Bones of Upper and Lower Limbs

2021 ◽  
Vol 15 (6) ◽  
pp. 1807-1811
Author(s):  
Meysam Moezi ◽  
Hassan Motamed ◽  
Mohammad Ali Fahimi ◽  
Azam Khalighi
Keyword(s):  
Emergency Department ◽  
Lower Limbs ◽  
Ketamine Infusion ◽  
Disturbed Sleep ◽  
Limb Trauma ◽  
Level Of Consciousness ◽  
Sedative Effects ◽  
Intravenous Morphine ◽  
Minimum Age ◽  
The Mean

Introduction and Purpose: The importance of pain control in patients with limb trauma in the emergency department and its complications is the main issue in post-emergency care and plays an important role in accelerating the improvement of patients' general status. Therefore, the present study aimed to evaluate the analgesic and sedative effects of ketamine infusion against intravenous morphine in relieving fracture pain of long or short bones in the upper and lower limbs. Materials and Methods: We examined the effect of ketamine and morphine as ketamine infusion at a dose of 0.4 mg/kg/IV/10min and intravenous morphine at a dose of 0.1 mg/kg/IV in patients aged 18-65 years with limb trauma who visited the hospital emergency department. We also compared the duration of analgesia, the amount of pain relief according to the Visual Analogue Scale (VAS) in each of the drugs and complications of the above methods, including apnea, bradycardia, tachycardia, decreased level of consciousness, nausea, vomiting, hypertension and hypotension, seizures, and disturbed sleep, and mentioned the preferred method. Results: In the study, we studied 120 patients, 60 of whom received ketamine and 60 received morphine. The mean age of patients was 13.02±13.67 years with a minimum age of 19 years and a maximum age of 70 years, and 89(74.2%) patients were male. There was not any difference between ketamine and morphine in the factors at different times. Conclusion: The results indicated that the potency of low-dose ketamine in relieving pain in patients was very similar to morphine. Keywords: Bone fracture; Ketamine; Morphine.

The effect of lidocaine when used as a local anesthetic or by intravenous injection

2021 ◽  
Vol 1 (4) ◽  
pp. 234-237
Author(s):  
Hamza Khalifa , ,, , Ibrahim ◽  
Abdulfatah Saed ◽  
Naser Ramdan R. Amaizah ◽  
Aejeeliyah Yousuf ◽  
Malak Abdalh Akim Esdera
Keyword(s):  
Myocardial Infarction ◽  
Local Anesthetic ◽  
Ventricular Arrhythmias ◽  
Rapid Onset ◽  
The Other ◽  
Important Class ◽  
Onset Of Action ◽  
Digitalis Poisoning ◽  
Duration Of Efficacy ◽  
Efficacy Profile

The efficacy profile of lidocaine as a local anesthetic is characterized by a rapid onset of action and an intermediate duration of efficacy. Therefore, lidocaine is suitable for infiltration, block, and surface anesthesia. Longer-acting substances such as bupivacaine are sometimes given preference for spinal and peridural anesthesias, however, lidocaine, on the other hand, has the advantage of a rapid onset of action. Adrenaline supplements could delay the resorption and the duration of efficacy could be doubled. Lidocaine is the most important class 1B antiarrhythmic drug: it is used intravenously for the treatment of ventricular arrhythmias (for acute myocardial infarction, digitalis poisoning, cardioversion, or cardiac catheterization). However, a routine prophylactic administration is no longer recommended for acute cardiac infarction. The overall benefit of this measure is not convincing. Lidocaine has also been efficient in refractory cases of status epilepticus.

Severe Injury and Death Associated With Home Infant Cardiorespiratory Monitors

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 775-779
Author(s):  
Murray L. Katcher ◽  
Mary Melvin Shapiro ◽  
Connie Guist
Keyword(s):  
Young Children ◽  
Severe Injury ◽  
Electrical Injury ◽  
Anticipatory Guidance ◽  
Home Monitor ◽  
Injury Control ◽  
Electrical Injuries

Five cases of electrical injury to young children caused by misuse of components of home cardiorespiratory monitors are reported. The injuries, which included one electrocution, occurred when partially or completely disconnected electrode wires were inserted, by an older monitored child or preschool-aged sibling, into a live power cord or an uncovered wall outlet. Anticipatory guidance of home monitor users should emphasize potential electrical injuries and appropriate injury-control behaviors.

Carbamate Poisoning: The `Other' Insecticide

PEDIATRICS ◽  
1987 ◽  
Vol 79 (5) ◽  
pp. 734-738
Author(s):  
Mark Garber
Keyword(s):  
Emergency Department ◽  
Endotracheal Tube ◽  
Vitamin K ◽  
Venous Access ◽  
The Other ◽  
Toxic Agent ◽  
Carbamate Insecticides ◽  
Carbamate Insecticide

A 16-month-old child who ingested rat poison, according to her parents, was noted to have signs of cholinergic poisoning. In the emergency department, the child was intubated and given atropine via the endotracheal tube until venous access was established. Phytonadione (vitamin K) and pralidoxime (2-PAM) Were also administered. The child recovered after an uneventful hospital course. The toxic agent was determined to be a carbamate insecticide, for which treatment with pralidoxime is considered controversial. Treatment of cholinergic poisoning due to unknown or mixed agents and poisoning caused by known carbamate insecticides are discussed.

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