scholarly journals Temperature Increases in the Human Achilles Tendon During Ultrasound Treatments With Commercial Ultrasound Gel and Full-Thickness and Half-Thickness Gel Pads

2010 ◽  
Vol 45 (4) ◽  
pp. 333-337 ◽  
Author(s):  
David O. Draper ◽  
Clinton G. Edvalson ◽  
Kenneth L. Knight ◽  
Dennis Eggett ◽  
Joseph Shurtz

Abstract Context: Although originally manufactured for use in diagnostic imaging of internal structures, 2-cm-thick gel pads are also used as conducting media for therapeutic ultrasound over areas with bony prominences. Research on the ability of these pads to conduct enough energy to adequately heat tissues has provided mixed results. However, this research has mainly been performed on the triceps surae muscle, an area over which gel pads are not typically used. We wondered how much heating might be produced if a thinner pad was used over a tendon. Objective: To compare temperature rises in the human Achilles tendon during ultrasound treatments using ultrasound gel, a 2-cm-thick pad, and a 1-cm-thick pad. Design: Cross-sectional study. Setting: University therapeutic modality laboratory. Patients or Other Participants: Forty-eight healthy volunteers (24 women, 24 men). Intervention(s): We inserted a rigid thermocouple 1 cm deep into the Achilles tendon. Ultrasound was delivered at the following settings: 3 MHz, continuous, 1 W/cm2, 10 minutes. Main Outcome Measure(s): Temperature was recorded every 30 seconds for 10 minutes. Results: Temperature increased the most in the ultrasound gel group (increase  =  13.3°C, peak  =  42°C). The 1-cm-thick pad resulted in higher tendon temperature (increase  =  9.3°C, peak  =  37.8°C) than the 2-cm-thick pad (increase  =  6.5°C, peak  =  4.8°C). The 1-cm pad produced approximately 30% more heating than the 2-cm pad (SE  =  0.72, P < .03). Conclusions: The thinner pad transmitted ultrasound more efficiently than the thicker pad. Thus, a gel pad of less than 1-cm thickness might be useful for superficial areas, such as the hands and ankles.

PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_3) ◽  
pp. 924-929
Author(s):  
Wendy G. Lane ◽  
Gilbert C. Liu ◽  
Elizabeth Newlin

Objective. To determine if hands-on instruction in child safety seat (CSS) installation decreases the number of errors in installation. Design. Cross-sectional study. Setting. Primary care offices, emergency department, CSS checkpoint. Participants. Parents of children <2 years old receiving medical care or attending a CSS check. Main Outcome Measure. Errors in CSS use. Results. Only 6.4% of parents had a correctly installed CSS. Hands-on instruction was associated with fewer errors in seat installation. Increased parent age, completion of college, and having private insurance were also associated with fewer errors in CSS placement. The majority of parents learned to install seats from reading the manual, from friends and relatives, and from figuring it out on their own. Conclusions. Errors in CSS installation are a significant problem. Hands-on instruction decreases the numbers of errors in CSS installation. However, few parents receive hands-on instruction from experts in CSS installation. Increases in correct CSS use could result from hands-on education by trained professionals.


2018 ◽  
Vol 53 (7) ◽  
pp. 696-702 ◽  
Author(s):  
Thomas Leggett ◽  
Jonathan Williams ◽  
Colm Daly ◽  
Courtney Kipps ◽  
Richard Twycross-Lewis

Context:  Exercise-associated hyponatremia (EAH) is a potentially fatal condition that can be prevented by avoiding excessive fluid intake. Running has become more popular in recent years, so it is important to assess the safety of runners' hydration strategies. Objective:  (1) To explore the intended hydration strategies of a sample of marathon runners before the 2014 London Marathon, (2) to examine their sources of information and knowledge about fluid intake and their understanding of EAH, and (3) to compare these findings with the results of a similar study carried out before the 2010 London Marathon. Design:  Cross-sectional study. Setting:  The 2014 London Marathon. Patients or Other Participants:  A total of 298 runners (148 males, 150 females), 0.83% of all race finishers. Main Outcome Measure(s):  Planned frequency, type, and volume of hydration; sources of information about appropriate drinking; and understanding of hyponatremia were explored. Comparisons were made with data collected from a sample of participants at the 2010 London Marathon. Data relating to the 2014 cohort are presented in descriptive form. Comparisons of the 2010 and 2014 cohorts were conducted using parametric and nonparametric methods. Results:  A total of 48.7% of the 2014 cohort listed drinking to thirst as the most important factor affecting their hydration strategy during the race. This compared with 25.3% of runners from the 2010 cohort and represented an increase (χ2 = 29.1, P = .001); 5.8% of the 2014 cohort planned on drinking more than 3.5 L, compared with 12% of the 2010 cohort (χ2 = 4.310, P = .038). Conclusions:  The number of sampled individuals using thirst to guide hydration strategies in the 2014 London Marathon increased from 2010. However, more than half of the 2014 cohort was not planning to drink to thirst. Runners still need to be educated about the risks of overdrinking as they continue to demonstrate a lack of knowledge and understanding.


BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e030088 ◽  
Author(s):  
Tanja Groten ◽  
Karola Kuenzer ◽  
Udo Moog ◽  
Beate Hermann ◽  
Katrin Maier ◽  
...  

ObjectivesQ fever is a zoonosis caused by the bacteriumCoxiella burnetii. It is recognised as an occupational hazard for individuals who are in regular contact with animal birth products. Data from the literature are not comparable because different serological assays perform very differently in detecting past infections. It is therefore essential to choose the right assay for obtaining reliable data of seroprevalence. Obstetricians are another profession potentially at risk of Q fever. They can be infected from birth products of women with Q fever during pregnancy. There is little data, however, for Q fever in this occupational group. Our study therefore had two purposes. The first was to obtain reliable seroprevalence data for occupational groups in regular contact with animal birth products by using an assay with proven excellent sensitivity and specificity for detecting past infections. The second purpose was to obtain primary data for obstetricians.DesignWe carried out a cross-sectional study.SettingThe study included shepherds, cattle farmers, veterinarians and obstetricians from Thuringia.Participants77 shepherds, 74 veterinarians, 14 cattle farmers, 17 office employees and 68 obstetricians participated. The control group consisted of 92 blood donors.Primary outcome measureThe primary outcome measure wasC. burnetiiphase II specific IgG. The assay used was evaluated for this purpose in a previous study.ResultsOf the 250 blood samples we analysed, the very highest seroprevalences (64%–77%) occurred in individuals with frequent animal contact. There were no significant differences between shepherds, cattle farmers and veterinarians. The seroprevalence in people working in administration was lower but still significantly greater than the control. No obstetricians or midwives tested positive.ConclusionsShepherds, cattle farmers and veterinarians have a high risk ofC. burnetiiinfection. However, our study clearly proves that there was no increased risk for people working in an obstetric department.


2019 ◽  
Vol 57 (1) ◽  
pp. 5-13
Author(s):  
Arthur S. Yang ◽  
Bruce M. Richard ◽  
Andrew K. Wills ◽  
Osama Mahmoud ◽  
Jonathan R. Sandy ◽  
...  

Objectives: To (1) determine the prevalence of nonperialveolar palatal fistula up to age 5 following repair of unilateral cleft lip and palate (UCLP) in the United Kingdom, (2) examine the association of palatoplasty techniques with fistula occurrence, and (3) describe the frequency of fistula repairs and their success. Design: Cross-sectional study. Setting: All 11 centralized regional cleft centers in the United Kingdom. Participants: Two hundred sixty-eight children born between 2005 and 2007 recruited by Cleft Care UK, a nationwide cross-sectional study of all 5-year-old children born with nonsyndromic UCLP. Main Outcome Measure: Nonperialveolar palatal fistula prevalence up to age 5. Results: Fistulas were found in 72 children (31.3%, 95% confidence interval: 25.4%-37.7%) and had no significant association with palate repair sequences. Twenty-four fistulas were repaired by age 5, 12 of which had data showing 10 (83.3%) successful repairs. Conclusion: The prevalence of nonperialveolar fistulas following primary palatoplasty of UCLP in the United Kingdom was higher than previously reported. This information should be part of the preoperative discussion with families. Prospective collection of the presence of fistulas will be necessary before we can associate the occurrence of fistulas with a surgeon, institution, surgical technique, or protocol of care.


2017 ◽  
Vol 118 (1) ◽  
pp. 185-194 ◽  
Author(s):  
Yasuyoshi Mogi ◽  
Suguru Torii ◽  
Yasuo Kawakami ◽  
Toshimasa Yanai

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e021036 ◽  
Author(s):  
Gregory Gordon Greiner ◽  
Lars Schwettmann ◽  
Jan Goebel ◽  
Werner Maier

Objectives(1) To describe the accessibility of general practitioners (GPs) by the German population; (2) to determine factors on individual and area level, such as settlement structure and area deprivation, which are associated with the walking distance to a GP; and (3) to identify factors that may cause differences in the utilisation of any doctors.DesignCross-sectional study using individual survey data from the representative German Socio-Economic Panel (SOEP) linked with area deprivation data from the German Index of Multiple Deprivation for 2010 (GIMD 2010) and official data for settlement structure (urban/rural areas) at district level. Logistic regression models were estimated to determine the relationship of individual and area factors with the distance to a GP. Negative binomial regressions were used to analyse the association with utilisation.SettingGermany.Populationn=20 601 respondents from the SOEP survey data 2009.Primary outcome measureWalking distance to a GP.Secondary outcome measureDoctor visits.ResultsNearly 70% of the sample lives within a 20 min walk to a GP. People living in the most deprived areas have a 1.4-fold (95% CI 1.3 to 1.6) increased probability of a greater walking distance compared with the least deprived quintile, even after controlling for settlement structure and individual factors. In rural districts, people have a 3.1-fold (95% CI 2.8 to 3.4) higher probability of a greater walking distance compared with those in cities. Both area deprivation and rurality have a negative relationship with the utilisation of physicians, whereas the distance to a GP is not associated with the utilisation of physicians.ConclusionWalking distance to a GP depends on individual and area factors. In Germany, area deprivation is negatively correlated with the accessibility of GPs while controlling for settlement structure and individual factors. Both area factors are negatively associated with the utilisation of doctors. This knowledge could be used for future GP requirement plans.


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