scholarly journals The Magnitude of Tissue Cooling During Cryotherapy With Varied Types of Compression

2010 ◽  
Vol 45 (3) ◽  
pp. 230-237 ◽  
Author(s):  
David Tomchuk ◽  
Mack D. Rubley ◽  
William R. Holcomb ◽  
Mark Guadagnoli ◽  
Jason M. Tarno
Keyword(s):  
Controlled Trial ◽  
Lower Leg ◽  
The Body ◽  
Acute Injury ◽  
Tissue Temperature ◽  
External Compression ◽  
Certified Athletic Trainers ◽  
Temperature Reduction ◽  
Surface Temperatures ◽  
Intramuscular Temperature

Abstract Context: Certified athletic trainers can choose different types of external compression (none, Flex-i-Wrap, and elastic wrap) when applying an ice bag to the body. However, which type facilitates the greatest magnitude of tissue cooling is unclear. Objective: To compare the effects of 2 common types of external compression on the magnitude of surface and intramuscular cooling during an ice-bag treatment. Design: Randomized controlled trial. Setting: University research laboratory. Patients or Other Participants: Fourteen college students (10 women, 4 men; age  =  22.4 ± 1.8 years, height  =  169.1 ± 8.2 cm, mass  =  73.3 ± 18.5 kg, skinfold  =  13.14 ± 1.61 mm) with previous cryotherapy experience and a posterior lower leg skinfold equal to or less than 15 mm. Intervention(s): On 3 different days separated by 24 to 48 hours, an ice bag was applied to the posterior lower leg surface of each participant for 30 minutes with no compression, with elastic wrap, or with Flex-i-Wrap. Main Outcome Measure(s): Posterior lower leg surface and intramuscular (2 cm) temperatures were recorded for 95 minutes. Results: At 15 minutes, the elastic wrap produced greater surface temperature reduction than no compression (P  =  .03); this difference remained throughout the protocol (P range, .03 to .04). At 30 minutes, surface temperatures were 14.95°C, 11.55°C, and 9.49°C when an ice bag was applied with no external compression, Flex-i-Wrap, and elastic wrap, respectively. Surface temperatures between Flex-i-Wrap and elastic wrap and between Flex-i-Wrap and no compression were never different. At 10 minutes, Flex-i-Wrap (P  =  .006) and elastic wrap (P < .001) produced greater intramuscular temperature reduction than no compression produced; these differences remained throughout the protocol. At 10 minutes, no compression, Flex-i-Wrap, and elastic wrap decreased intramuscular temperature by 1.34°C, 2.46°C, and 2.73°C, respectively. At 25 minutes, elastic wrap (8.03°C) produced greater temperature reduction than Flex-i-Wrap (6.65°C) (P  =  .03) or no compression (4.63°C) (P < .001 ). These differences remained throughout ice application and until 50 minutes after ice-bag removal. Conclusions: During an ice-bag application, external compression with elastic wrap was more effective than Flex-i-Wrap at reducing intramuscular tissue temperature. Elastic wraps should be used for acute injury care.

scholarly journals Does the shoe-lace technique aid direct closure of fasciotomy wounds after acute compartment syndrome of the lower leg? a retrospective case-control study

2021 ◽  
pp. 145749692110196
Author(s):  
P. Suomalainen ◽  
T.-K. Pakarinen ◽  
I. Pajamäki ◽  
M. K. Laitinen ◽  
H.-J. Laine ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Outcome Measurement ◽  
Controlled Trial ◽  
Lower Leg ◽  
Conventional Technique ◽  
Tibia Fracture ◽  
Acute Compartment Syndrome ◽  
Retrospective Case ◽  
Direct Closure ◽  
Patient Database

Background & aim: Tibia fractures are relatively common injuries that are accompanied with acute compartment syndrome in approximately 2% to 20% of cases. Although the shoe-lace technique, where vessel loops are threaded in a crisscross fashion and tightened daily, has been widely used, no studies have compared the shoe-lace technique with the conventional one. The aim of this study was to compare the shoe-lace technique with the conventional technique. Materials and Methods: We identified 359 consecutive patients with intramedullary nailed tibia fracture and complete medical records including outpatient data between April 2007 and April 2015 from electronic patient database of our institute. The use of the shoe-lace technique was compared to conventional one (in which wounds were first left open with moist dressings). Main outcome measurement is direct closure of fasciotomy wounds. Results: From 359 consecutive patients with intramedullary nailed tibia fracture, fasciotomy was performed on 68 (19%) patients. Of these, the shoe-lace technique was used in 47 (69%) patients while in 21 (31%) patients, the shoe-lace technique was not applied. Side-to-side approximation was successful in 36 patients (77%) in the shoe-lace+ group and 7 patients (33%) in the shoe-lace– group (p = 0.002). Conclusion: The main finding of our comparative study was that the shoe-lace technique seems to ease direct closure of lower leg fasciotomy wounds, and thus reduces the frequency of free skin grafts. Our finding needs to be confirmed in a high-quality randomized controlled trial.

scholarly journals Reduction of estimated fluid volumes following initiation of empagliflozin in patients with type 2 diabetes and cardiovascular disease: a secondary analysis of the placebo-controlled, randomized EMBLEM trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Atsushi Tanaka ◽  
Michio Shimabukuro ◽  
Hiroki Teragawa ◽  
Yosuke Okada ◽  
Toshinari Takamura ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Repeated Measures ◽  
Medical Information ◽  
Controlled Trial ◽  
Extracellular Volume ◽  
Cardiovascular Outcomes ◽  
Fluid Volume ◽  
The Body

Abstract Backgrounds/Aim Sodium glucose co-transporter 2 inhibitors promote osmotic/natriuretic diuresis and reduce excess fluid volume, and this improves cardiovascular outcomes, including hospitalization for heart failure. We sought to assess the effect of empagliflozin on estimated fluid volumes in patients with type 2 diabetes and cardiovascular disease (CVD). Methods The study was a post-hoc analysis of the EMBLEM trial (UMIN000024502), an investigator-initiated, multi-center, placebo-controlled, double-blinded, randomized-controlled trial designed primarily to evaluate the effect of 24 weeks of empagliflozin treatment on vascular endothelial function in patients with type 2 diabetes and established CVD. The analysis compared serial changes between empagliflozin (10 mg once daily, n = 52) and placebo (n = 53) in estimated plasma volume (ePV), calculated by the Straus formula and estimated the extracellular volume (eEV), determined by the body surface area, measured at baseline and 4, 12, and 24 weeks after initiation of treatment. Correlations were examined between the changes from baseline to week 24 in each estimated fluid volume parameter and several clinical variables of interest, including N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration. Results In an analysis using mixed-effects models for repeated measures, relative to placebo empagliflozin reduced ePV by − 2.23% (95% CI − 5.72 to 1.25) at week 4, − 8.07% (− 12.76 to − 3.37) at week 12, and − 5.60% (− 9.87 to − 1.32) at week 24; eEV by − 70.3 mL (95% CI − 136.8 to − 3.8) at week 4, − 135.9 mL (− 209.6 to − 62.3) at week 12, and − 144.4 mL (− 226.3 to − 62.4) at week 24. The effect of empagliflozin on these parameters was mostly consistent across various patient clinical characteristics. The change in log-transformed NT-proBNP was positively correlated with change in ePV (r = 0.351, p = 0.015), but not with change in eEV. Conclusions Our data demonstrated that initiation of empagliflozin treatment substantially reduced estimated fluid volume parameters in patients with type 2 diabetes and CVD, and that this effect was maintained for 24 weeks. Given the early beneficial effect of empagliflozin on cardiovascular outcomes seen in similar patient populations, our findings provide an important insight into the key mechanisms underlying the clinical benefit of the drug. Trial registration University Medical Information Network Clinical Trial Registry, number 000024502

scholarly journals The effects of nano-curcumin as a nutritional strategy on clinical and inflammatory factors in children with cystic fibrosis: the study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Saeedeh Talebi ◽  
Mahammad Safarian ◽  
Mahmood Reza Jaafari ◽  
Seyed Javad Sayedi ◽  
Zahra Abbasi ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Controlled Trial ◽  
Genetic Disorder ◽  
The Body ◽  
Inflammatory Factors ◽  
Secondary Outcome ◽  
Nasopharyngeal Swab ◽  
Nutritional Strategy ◽  
Cftr Protein ◽  
The Impact

Abstract Background Cystic fibrosis (CF) is a genetic disorder, which is caused by the CFTR protein defects. Along with CFTR dysfunction, inflammation plays a key role in the disease outcomes. Inflammation may develop due to the internal dysfunction of the CFTR protein or external factors. Curcumin affects the CFTR protein function primarily as a corrector and potentiator and secondary as an anti-inflammatory and antimicrobial agent. The present study aims to assess the impact of nano-curcumin on clinical and inflammatory markers in children with CF. Methods This prospective, double blind control trial will be conducted at the Akbar Children’s Hospital in Mashhad, Iran. Children with CF will be enrolled based on the eligibility criteria. Placebo and curcumin with the maximum dose of 80 mg considering the body surface of the patients will be administrated for 3 months. The primary outcome is to evaluate inflammation based on serum interleukin-6, interleukin-10, and hs-CRP, stool calprotectin, and neutrophil count of nasopharyngeal swab. The secondary outcome involved clinical assessment via spirometry, anthropometrics, and quality of life. They will be assessed before and after 3 months. Discussion Due to the multifarious effects of curcumin on CF disease, it could be proposed as a nutritional strategy in the treatment of cystic fibrosis. Trial registration Iranian Registry of Clinical Trials IRCT20200705048018N1. Registered on July 10, 2020.

Kinematic Analysis of Olympic Hurdle Performance: Women's 100 Meters

1985 ◽  
Vol 1 (2) ◽  
pp. 163-173 ◽  
Author(s):  
Ralph Mann ◽  
John Herman
Keyword(s):  
Elite Athlete ◽  
Olympic Games ◽  
Lower Leg ◽  
The Body ◽  
Performance Variables ◽  
Body Velocity ◽  
The Difference ◽  
Foot Position ◽  
Support Time ◽  
Leg Position

Selected kinematic variables in the performance of the Gold and Silver medalists and the eighth-place finisher in the women's 100-meter hurdles final at the 1984 Summer Olympic Games were investigated. Cinematographic records were obtained for all track hurdling events at the Games, with the 100-meter hurdle performers singled out for initial analysis. In this race, sagittal view filming records (100 fps) were collected at the 9th hurdle of the performance. Computer generated analysis variables included both direct performance variables (body velocity, support time, etc.) and body kinematics (upper leg position, lower leg velocity, etc.) that have previously been utilized in the analysis of elite athlete hurdlers. The difference in place finish was related to the performance variables body horizontal velocity (direct), vertical velocity (indirect), and support time (indirect). The critical body kinematics variables related to success included upper and lower leg velocity during support into and off the hurdle (direct), relative horizontal foot position (to the body) at touchdown into and off the hurdle (indirect), and relative horizontal foot velocity (to the body) at touchdown into the hurdle.

Medicine: Experimentation, Politics, Emergent Bodies

2012 ◽  
Vol 18 (3-4) ◽  
pp. 1-17 ◽  
Author(s):  
Mike Michael ◽  
Marsha Rosengarten
Keyword(s):  
Public Health Policy ◽  
Science And Technology Studies ◽  
Controlled Trial ◽  
Judith Butler ◽  
The Body ◽  
The Political ◽  
Medical Evidence ◽  
Special Issue ◽  
Healthy Human ◽  
Randomized Controlled

In this introduction, we address some of the complexities associated with the emergence of medicine’s bodies, not least as a means to ‘working with the body’ rather than simply producing a critique of medicine. We provide a brief review of some of the recent discussions on how to conceive of medicine and its bodies, noting the increasing attention now given to medicine as a technology or series of technologies active in constituting a multiplicity of entities – bodies, diseases, experimental objects, the individualization of responsibility for health and even the precarity of life. We contrast what feminist theorists in the tradition of Judith Butler have referred to as the question of matter, and Science and Technology Studies with its focus on practice and the nature of emergence. As such we address tensions that exist in analyses of the ontological status of ‘the body’ – human and non-human – as it is enacted in the work of the laboratory, the randomized controlled trial, public health policy and, indeed, the market that is so frequently entangled with these spaces. In keeping with the recent turns toward ontology and affect, we suggest that we can regard medicine as concerned with the contraction and reconfiguration of the body’s capacities to affect and be affected, in order to allow for the subsequent proliferation of affects that, according to Bruno Latour, marks corporeal life. Treating both contraction and proliferation circumspectly, we focus on the patterns of affects wrought in particular by the abstractions of medicine that are described in the contributions to this special issue. Drawing on the work of A.N. Whitehead, we note how abstractions such as ‘medical evidence’, the ‘healthy human body’ or the ‘animal model’ are at once realized and undercut, mediated and resisted through the situated practices that eventuate medicine’s bodies. Along the way, we touch on the implications of this sort of perspective for addressing the distribution of agency and formulations of the ethical and the political in the medical eventuations of bodies.

scholarly journals Effects of a workplace prevention programme for problem gambling: study protocol for a cluster randomised controlled trial

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e015963 ◽  
Author(s):  
Jonas Rafi ◽  
Ekaterina Ivanova ◽  
Alexander Rozental ◽  
Per Carlbring
Keyword(s):  
Problem Gambling ◽  
Large Scale ◽  
Controlled Trial ◽  
Public Health Problem ◽  
Cluster Randomised Controlled Trial ◽  
Severity Index ◽  
The Body ◽  
Prevention Programme ◽  
Open Access Journals ◽  
Randomised Controlled

IntroductionDespite being considered a public health problem, no prevention programme for problem gambling in workplace settings has been scientifically evaluated. This study aims to fill a critical gap in the field of problem gambling by implementing and evaluating a large-scale prevention programme in organisations.Methods and analysisTen organisations, with a total of n=549 managers and n=8572 employees, will be randomised to either receiving a prevention programme or to a waitlist control condition. Measurements will be collected at the baseline and 3, 12 and 24 months after intervention. The primary outcome of interest is the managers’ inclination to act when worried or suspicious about an employee’s problem gambling or other harmful use. Additional outcomes of interest include the Problem Gambling Severity Index and gambling habits in both managers and employees. Furthermore, qualitative analyses of the responses from semistructured interviews with managers will be performed.Ethics and disseminationThis study has been approved by the regional ethics board of Stockholm, Sweden, and it will contribute to the body of knowledge concerning prevention of problem gambling. The findings will be published in peer-reviewed, open-access journals.Trial registration numberNCT02925286; Pre-results.

scholarly journals Ultrasound assessment of muscle mass in the diagnosis of sarcopenia in cardiovascular patients

2021 ◽  
Vol 20 (3) ◽  
pp. 2699
Author(s):  
A. S. Erokhina ◽  
E. D. Golovanova ◽  
M. A. Miloserdov
Keyword(s):  
Body Mass Index ◽  
Muscle Mass ◽  
Body Mass ◽  
Lower Leg ◽  
The Body ◽  
Russian Society ◽  
Speed Test ◽  
European Working ◽  
Class 1 ◽  
Artery Disease

Aim. To study the advantages of ultrasound versus anthropometric assessment of muscle mass for early diagnosis of sarcopenia in patients >45 years of age.Material and methods. The study included 79 patients aged 4589 years with coronary artery disease (CAD), hypertension, type 2 diabetes, heart failure, class 1-3 obesity. Diagnosis of hypertension was carried out according to the European (2018) and Russian (2019) guidelines; CAD — according to Russian Society of Cardiology (2020) guidelines. Sarcopenia was diagnosed according to 2010 European Working Group on Sarcopenia in Older People (EWGSOP) criteria and 2018 EWGSOP2 guidelines. Muscle mass (MM) was determined by two methods: 1 — by measuring the rectus abdominis muscle (RAM) thickness using the ultrasound; 2 — by measuring the arm and lower leg circumference. Muscle strength was determined by wrist dynamometer. Muscle function was assessed using the 4-m gait speed test.Results. The study showed that in patients aged >45 years admitted to the emergency cardiology department, the body mass index exceeded 25 kg/m2 in 88,6% of cases. The incidence of sarcopenia of varying severity was 55,7% (n=44). The differences in RAM thickness, arm and lower leg circumference between the groups of patients with/without sarcopenia were significant (p<0,001), but were less than the threshold only for RAM thickness. RAM thickness levels progressively decreased with increasing severity of sarcopenia and significantly differed at all stages compared to patients without sarcopenia (p<0,001), regardless of body mass index. A decrease in lower leg circumference below the threshold values determining a MM decrease was observed only in severe sarcopenia, and arm circumference — in both men and women only in severe sarcopenia. There were no significant differences for arm and lower leg circumference depending on sarcopenia stages in overweight and obese patients.Conclusion. MM assessment by measuring RAM thickness with ultrasound in comparison with the anthropometric method makes it possible to diagnose sarcopenia in patients >45 years of age with cardiovascular diseases and obesity at earlier stages and to promptly recommend preventive measures.

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