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At least 1,207 records · Page 67Linked to original sources

Comparison of the early response to two methods of rehabilitation in adhesive capsulitis.

PRINCIPLE: A randomised, comparative prospective clinical trial was planned to compare the early response to different rehabilitation methods for adhesive capsulitis taking into consideration the clinical efficacy and the cost effectiveness of the methods. METHODS: Forty patients with adhesive capsulitis were randomised into two treatment groups. The first group (CYR) received the Cyriax approach of deep friction massage and mobilisation exercises three times weekly. The second group (PT) had daily physical therapy including hot pack and short wave diathermy application. Both groups concluded their treatments with stretching exercises and were also instructed to a daily home exercise program. The primary end point of the study was to reach 80% of the normal passive range of motion (ROM) of the shoulder in all planes within a period of two weeks. Secondary end points were the overall ROM and pain response (spontaneous pain, night pain and pain with motion) to each treatment. RESULTS: 19 patients in the CYR group (95%) and 13 patients in the PT group (65%) reached sufficient ROM at the end of the second week (p <0.05). The improvement in shoulder flexion, inner and outer rotation values and the decrease in pain with motion were significantly better in the CYR group after the first week of treatment. CONCLUSION: The Cyriax method of rehabilitation provides a faster and better response than the conventional physical therapy methods in the early phase of treatment in adhesive capsulitis. The method is non-invasive, effective and requires fewer hospital visits for a sufficient early response.

Adult↗

Provoked iris ischaemia in the rabbit: A fluorescien angiographic study.

We studied experimental anterior segment ischaemia in rabbits by fluorescein angiography of the iris. Nine rabbits were subjected to diathermy occlusion of one or both long posterior ciliary arteries or to disinsertion and reattachment of up to 4 rectus muscles. Occlusion of one LPCA or up to 3 recti had only a minor ischaemic effect on the iris vessels. Occlusion of both LPCAs produced necrosis of the anterior segment or ischaemia of the iris detectable by angiography. Disinsertion of 4 recti produced small patches of transient ischaemia in those areas of the iris most distal from the LPCAs. When further surgery is planned after retinal detachment cyclodiathermy or strabismus operations, fluorescein angiography is a useful indicator of the vascular status of the iris and hence of the possibility of necrosis of the anterior segment.

Animals↗

Full-thickness eye wall biopsy. I. An experimental approach to the tissue diagnosis and study of choroidal and retinal lesions.

A surgical approach to full-thickness eye wall biopsy is proposed as a method that may be applied to poorly understood diseases of the retina and choroid. An eye basket is sutured to the eye for stabilization, and two trephines mark an area to which diathermy is applied until penetration is achieved. The specimen is removed with fine forceps and scissors. A scleral homograft closes the defect. In ten rabbits, no eyes were lost and all ten retinas were intact. All biopsy specimens were suitable for histologic study.

Animals↗

Physical modalities other than stretch in spastic hypertonia.

This article reviews various physical modalities that have been used in spastic hypertonia, particularly superficial heat and cold, diathermies (ultrasound, microwave, and short-wave irradiation), electrical stimulation (transcutaneous electrical nerve stimulation), implanted spinal stimulation (rectal stimulation), and massage (deep friction, superficial contact). The duration of the effects of most physical therapies is relatively short (e.g., cooling, heating, and massage), which often may limit their application to immediate prestretch or pre-exercise periods. The potential capacity of ultrasound therapy to improve the efficacy of chronic stretch in lengthening muscle may be a promising option. The neurodestructive potential of high intensity microwave for the personnel involved and controlled evidence of its value is required before this modality can be recommended in spasticity. Overall, controlled, double-blind studies are mandated to evaluate the long-term impact of repeated use of these short-term modalities on function and recovery in patients with spasticity.

Animals↗

Heating patterns produced in humans by 433.92 MHz round field applicator and 915MHz contact applicator.

Temperature distributions produced by a round field applicator operating at a frequency of 433.92 megahertz (MHz) are comparable to those produced by a 915 MHz cooled contact applicator in human volunteers with less than or equal to 1 cm or greater than or equal to 2 cm of subcutaneous fat. The major difference between the two applicators is the temperatures produced on the skin surface and in the subcutaneous fat in humans. The circulating coolant of the 915 MHz contact applicator keeps skin surface temperatures much lower than those produced by the round field applicator in thick and thin subjects. It also tends to cool the superficial subcutaneous fat layer in thin subjects but doesn't affect the deeper subcutaneous fat layer in subjects with greater than or equal to 2 cm of subcutaneous fat. The 915 MHz contact applicator gives the ability to control by cooling the temperatures produced in the superifical tissues. By regulating the temperature of coolant and time of cooling, temperature gradients can be modified so the highest temperatures may be found in the muscle. However, the superficial tissue temperature cannot be regulated with the present application of the 433.92 MHz applicator. When the two applicators were compared, it was shown that the 433.92 MHz round field applicator did not surpass the heating ability of the 915 MHz contact applicator. Therefore, at this time, there is no reason to legalize the frequency of 433.92 MHz for diathermy use in the United States.

Adipose Tissue↗

Virtual reality laparoscopic simulator for assessment in gynaecology.

A validated virtual reality laparoscopic simulator minimally invasive surgical trainer (MIST) 2 was used to assess the psychomotor skills of 21 gynaecologists (2 consultants, 8 registrars and 11 senior house officers). Nine gynaecologists failed to complete the VR tasks at the first attempt and were excluded for sequential evaluation. Each of the remaining 12 gynaecologists were tested on MIST 2 on four occasions within four weeks. The MIST 2 simulator provided quantitative data on time to complete tasks, errors, economy of movement and economy of diathermy use--for both right and left hand performance. The results show a significant early learning curve for the majority of tasks which plateaued by the third session. This suggests a high quality surgeon-computer interface. MIST 2 provides objective assessment of laparoscopic skills in gynaecologists.

Clinical Competence↗

Time to rebrand transurethral resection of the prostate?

PURPOSE OF REVIEW: Transurethral resection of the prostate remains the gold standard treatment for benign prostatic obstruction. Owing to the significant morbidity traditionally associated with the procedure, a large number of expensive, high-energy alternative treatments have been developed, which have enjoyed varying degrees of success. At the same time, transurethral resection of the prostate has evolved into a safer operation whilst maintaining its excellent efficacy. This review aims to outline the major advances that have occurred recently in transurethral resection of the prostate. RECENT FINDINGS: Optimizing each stage of transurethral resection of the prostate can result in reduced morbidity. Preoperative treatment with oral antiandrogens and 5-reductase inhibitors appears to reduce intraoperative bleeding, appropriate prophylactic antibiotic regimens reduce postoperative infection rates, improved instrumentation and diathermy delivery can reduce intraoperative bleeding and hence reduce postoperative irrigation requirements, and alcohol monitoring of irrigant absorption can eliminate transurethral resection syndrome. Careful patient selection, meticulous surgical technique combined with an aggressive postoperative irrigation and catheter removal policy can result in transurethral resection of the prostate being performed safely on a day-case basis. SUMMARY: Whilst our attention has been distracted by the many alternative treatments brought to the market over the past decade or so, transurethral resection of the prostate has been undergoing a quiet evolution. With fine tuning of all aspects of the patient journey we can now offer a procedure with excellent long-term efficacy combined with reduced morbidity and inpatient stay.

Anesthesia, Conduction↗

Hot techniques for tonsillectomy.

(1) Some patients experience pain and bleeding after a standard or extracapsular tonsillectomy. (2) Evidence suggests that none of the hot tonsillectomy techniques offers concurrent reductions in intra- and post-operative bleeding and pain, compared with traditional cold-steel dissection with packs or ties. (3) Little information is available on the cost effectiveness of the hot techniques. (4) Diathermy is likely to remain the most commonly practised hot tonsillectomy technique.

Adenoidectomy↗

[The effect of splenic inductothermy on the functions of the liver and its blood flow in patients with diabetic fatty hepatosis].

Thirty-nine patients with fatty hepatosis were treated by a five-day course of inductothermy (short-wave diathermy) on the splenic zone. 20-minute sessions were carried out daily. This resulted in a regular improvement of the antitoxic and absorptive functions of hepatocytes as well as the hepatic blood flow. The favourable effect of this course of inductothermy lasted not less that two weeks after termination of the treatment.

Adult↗

[Unilateral bladder neck incision: endoscopic treatment of bladder neck obstruction. Results in 100 patients].

Endoscopic diathermy unilateral incision of the bladder neck was carried out in 100 consecutive male patients. This procedure was performed for bladder neck obstruction and small benign prostate. The operative details of this technique are given. Follow-up after 2 months revealed excellent symptomatic and urodynamic results. Morbidity was low. Results remain stable after 13 +/- 9 months. One patient needed a transurethral resection of the prostate. Retrograde ejaculation occurred in 5% of the patients. Unilateral bladder neck incision is a simple procedure safe, and easy to learn, with a low risk of retrograde ejaculation. It is the operation of choice for small benign prostate, bladder neck obstruction and young patients.

Adult↗

The relationship between retina surgery and preretinal macular fibrosis.

A prospective study of 440 eyes of 220 patients following successful operations for primary rhegmatogenous retinal detachment (132 eyes) and prophylactic operations for retinal breaks (103 eyes) revealed an incidence of preretinal macular fibrosis (PRMF) of 47% after scleral buckling surgery and 42% after prophylactic laser or cryopexy. The incidence of PRMF was significantly greater in aphakic vs phakic detachments, in detachments with operculated vs horseshoe breaks, in detachments with horseshoe breaks vs lattice degeneration, in detachments involving the macula, after scleral buckling with cryotherapy vs diathermy, and after prophylactic treatment of retinal breaks of fellow eyes with retinal detachment or retinal breaks that had developed postoperative PRMF. Analysis of the data suggests that PRMF is most likely a result of the retinal break, detachment, and subsequent treatment.

Cryosurgery↗

[The Custodis procedure--technic and results (author's transl)].

Within the post 11 years 2,722 retinal detachments needed surgery. The mostly used procedure of Custodis consists in an implant, which covering the area of the hole is impressed into the sclera by mattress sutures. In 70% of our cases--due to Custodis--we succeeded in avoiding drainage of the subretinal fluid. Since 1966 the additional diathermy and/or lightcoagulation was mostly replaced by cryopexy. Summarizing the number of retinal detachments operated in the University clinic of Münster during 1955--1957 (Pau), 1958--1961 (Böke) as well as ours (1966--1977), 4,030 retinal surgeries (minus 10% encircling procedures) underwent within 18 years a Custodis procedure. The success rate of 85% indicates that Custodis' technic enables to optimal results.

Cryosurgery↗

The use of physical agents in rehabilitation of athletic injuries.

The competitive athlete's motivation to return to activity following injury presents a challenge to the sports medicine specialist to utilize the most effective rehabilitation procedures available. Safe return to competition necessitates maximal restoration of those components of physical fitness affected by injury (such as muscular strength, power, endurance). Various forms of superficial heat and cold application, deep heat modalities, and electrical currents have been used to supplement therapeutic exercise in this process. In recent years, the therapeutic benefits of cold for the control of exercise-induced edema and as a prelude to performance of prescribed exercise have been widely recognized. Although short wave and microwave diathermy appear to have lost much of their appeal as deep tissue heating modalities, the thermal and mechanical effects of ultrasound continue to make it a widely used modality in sports medicine. Adaptation of alternating electrical currents for use in transcutaneous nerve stimulation has given the sports medicine clinician a useful modality for pain management. The more recently developed "Russian" electrical stimulator provides a promising modality for muscle re-education and restoration of muscular strength.

Athletic Injuries↗

Use of the Shaw Scalpel in pacemaker operations.

Pacemaker carriers are at risk when undergoing operations involving the use of diathermy. The Shaw Scalpel utilizes a method by which the cutting edge of the blade is heated to a selected temperature that seals blood vessels as they are cut. No electrical currents are passed to or through the patient and there is no sparking or electrical arcing to the tissue. This apparatus was used as the sole method of thermal coagulation in 20 patients undergoing replacement of pacemaker batteries.

Diathermy↗

[Effect of high frequency electromagnetic fields on the processes of transamination in the liver and small intestine tissues of rats].

The influence of electromagnetic waves of metrical and centimetrical range on the transaminoferases activity was studied in the liver and small intestine of 69 rats. The experiment shows that the activity of aspartate and alanine aminotransferases is dependent on the power and duration of the action. It is established that the action of both the short-wave 160 mA diathermy and 30 MW/cm2 microwaves for 20 min is accompanied by inhibition of the liver and small intestine aminotransferases activity. The 20 min action of 12 MW/cm2 microwaves induces an increase in the aminotransferases activity of the liver, small intestine and serum.

Alanine Transaminase↗

Acute low back pain. Comparison of two conservative treatment approaches.

In a controlled clinical trial, we allocated 48 subjects with acute low back pain but without neurological signs, at random to two treatment groups. The conservative treatments compared were passive mobilisation and manipulation of the lumbar spine and a regimen of microwave diathermy, isometric abdominal exercises and ergonomic instructions. The duration of low back pain symptoms was significantly shorter for subjects receiving mobilisation and manipulation; they also achieved symptom-free status with fewer treatment sessions. While the duration of symptoms before first treatment, the treatment administered, and the pretest forward flexion movement indices accounted for 44% of the variance in the duration of symptoms, a stepwise multiple regression analysis showed that treatment is the most significant factor in predicting the length of time before a subject achieves symptom-free status.

Abdomen↗

A review of the literature concerning resuscitation from hypothermia: Part II--Selected rewarming protocols.

In Part I of this paper, a description of the problems confronted in resuscitation from immersion hypothermia was presented and the debate between passive and active rewarming approaches was summarized. In this paper, a review of the literature concerning selected specific rewarming protocols is given. The protocols considered are: peritoneal irrigation, gastrointestinal rewarming, extracorporeal blood rewarming, airway rewarming, and diathermy.

Animals↗

[The therapy of Mooren's rodent ulcer (author's transl)].

Mooren's ulcer has not yet been treated successfully with drugs. Cautery, cryocoagulation, surgical diathermy, lamellar or perforating keratoplasty, and conjunctivoplasty usually have no or only little success. We have been able to cure our last five cases of Mooren's ulcer by an extensive and deep thermocoagulation both of the ulcer, the swollen corneal margins and the bordering conjunctiva. Then followed dilatation of the conjunctival vessels with Dionine and Priscol ointments.

Adult↗