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[Modification of cardiac pacemakers of the MCP and LCP series by electrodiagnostic and electrotherapy procedures].

47 patients with cardiac pacemakers of the MCP- and LCP-series were examined for influence by disturbances caused by devices of electrodiagnostics and electrotherapy used in the GDR. A general prohibition of such diagnostic and therapeutic methods cannot be maintained. Low frequency current therapy (apart from TENS-currents), hydrogalvanic baths and ultrasonic therapy could be applied without any danger. In the CP-current should be guaranteed a minimum distance of 50 cm, when it fell short of, however, only insignificant disturbances appeared. The same concerns the microwave therapy. Also electrodiagnostics was possible without endangering the pacemaker-patient. TENS-currents caused, depending on distance and frequency, no disturbances or dangerous ones (total inhibition). Short-wave repeatedly led to total inhibition or warming at the cardiac pacemaker and should therefore generally be forbidden.

Arrhythmias, Cardiac↗

Short-wave ultraviolet light (UVB) treatment of allergic contact dermatitis of the hands.

7 out of 10 patients with long-standing allergic contact dermatitis of their hands were successfully treated with short-wave ultraviolet light (UVB) and the contact dermatitis healed completely. To maintain this result they had to receive UVB therapy regularly once a week. The last 3 patients also showed improvement, but they had periods with vesiculation during the treatment. UVB treatment seems to be a valuable supplement for the treatment of contact dermatitis.

Adult↗

The effect of local heat and cold therapy on the intraarticular and skin surface temperature of the knee.

OBJECTIVE: To evaluate the effects of local application of ice chips, ligno-paraffin, short-wave diathermy, and nitrogen-cold air on skin and intraarticular temperature. METHODS: Forty-two healthy subjects were divided into 4 treatment groups. A temperature probe was inserted into the knee joint cavity and another placed on the overlying skin, and changes in temperature over 3 hours, by treatment group, were recorded. RESULTS: The mean skin surface temperature dropped from 27.9 degrees C to 11.5 degrees C after application of ice chips, and from 28.8 degrees C to 13.8 degrees C after application of cold air. The mean intraarticular temperature decreased from 31.9 degrees C to 22.5 degrees C and from 32.9 degrees C to 28.8 degrees C, respectively, after these 2 treatments. Shortwave diathermy increased skin temperature by 2.4 degrees C; intraarticular temperature was increased only 1.4 degrees C by short-wave diathermy. Treatment with ligno-paraffin increased the skin surface temperature 8.9 degrees C; the temperature in the joint cavity was increased 3.5 degrees C. CONCLUSION: The use of short-wave diathermy and superficial heat packs in the treatment of patients with arthritis may potentially cause harm by increasing intraarticular temperature. This may have major implications regarding treatment policy for patients with arthritis.

Adult↗

Exposure to the operator and patient during short wave diathermy treatments.

Short-wave diathermy is one of the most popular treatment modalities used to relieve pain through localized heating. In Canada its use in hospitals is as frequent as that of ultrasonic therapy devices and about 10 times more popular than microwave diathermy. Intensities of the electric and magnetic fields around applicators of 7 different diathermy units were measured at the operator position and at various untreated areas of the patient during 11 treatment regimes using 5 types of applicators. Exposure to the operator in the normal operating position, behind the device console, usually does not exceed the limits recommended by the Canadian Federal Government. The intense fields around the applicators and the cables extend up to 0.5 m and are a source of potential overexposure to the operator.

Ambulatory Care Facilities↗

Physical therapy and rehabilitation.

The literature on physical therapy and rehabilitation in osteoarthrosis of the hip and knee joint has been reviewed. The number of controlled clinical studies is rather limited and the clinical material is generally not clearly defined. It may be concluded, however, that the effect of short-wave, micro-wave and ultrasound on joint pain is not superior to that of sham treatment. Ice therapy and transcutaneous nerve stimulation appear to be of definite value, but the effect is transient. Controlled trials indicate that mobilization of joint and muscle contractures is facilitated by diathermy and ultrasound. Training of muscle function should include training of endurance and balance reaction. Technical aids and training of activities of daily living are an important part of the rehabilitation program, that has to be based on the functional problems experienced by the patient.

Bone Diseases↗

Magnitude and duration of UV-B-induced tolerance.

Using repeated minimal erythema dose (MED) testing, we investigated the magnitude and duration of tolerance to short-wave UV radiation in the B range (UV-B) in 37 patients with psoriasis who received at least 12 UV-B phototherapy treatments. Without substantial erythema developing, half of the patients received UV-B doses in excess of 13 times their pretreatment MED dose and a fourth received UV-B doses in excess of 28 times their pretreatment MED dose. On average, tolerance faded to about half that present at the last UV-B treatment in 3 weeks. Six weeks after therapy was stopped, most posttreatment MEDs were less than twice the pretreatment MED. The magnitude of tolerance achieved and the rate of decay did not vary with skin type. Our findings indicate that repeated exposures to suberythemal or mildly erythematous doses of UV-B can induce exceptional degrees of tolerance to UV-B radiation. The duration of this increase in tolerance is, however, short.

Adult↗

[Single preoperative radiation and short-wave treatment of breast cancer].

A total of 93 patients were assigned to receive either radiation treatment alone (group 1) or in combination with local microwave-induced hyperthermia (group 2) prior to mastectomy. The treatment results were compared. Within a two-year follow-up period, all patients of group 2 remained free of relapse, metastases being registered in 2 (6.2%) cases. In group 1, relapse was observed in 1 case, whereas metastasis--in 7 (11.5%). The study failed to establish drug-induced tumor pathomorphosis in 12.5% in group 2 and 73.8% in group 1. The procedure did not interfere with surgery, nor was it followed by an increased postoperative complication rate.

Adult↗

Effects of short-wave ultraviolet radiation (UV-C) on delayed hypersensitivity in the guinea-pig.

Guinea-pigs, previously sensitized to dinitrochlorobenzene (DNCB), were exposed to varying doses of UV-C radiation (254 nm) on one of the flanks for a period of 15 days. They were then patch-tested with DNCB immediately after UV treatment. The responses to DNCB were diminished both in the irradiated and non-irradiated skin compared with control animals which had not received UV-C radiation. This effect was dose dependent and could only be demonstrated for a limited period of time. Guinea-pig exposed to UV-C radiation did not show a decreased response to sodium lauryl sulphate, which is a potent irritant. The influence of UV-C on delayed hypersensitivity therefore seems to be an immunological effect.

Animals↗

Exacerbation of a case of myasthenia gravis during therapeutic electric stimulation.

In patients with myasthenia gravis, vigorous exercise and electric stimulation produce weakness that is usually reversed by rest. We describe a case of persistent weakness in a 31-year-old woman with myasthenia gravis following therapeutic electric stimulation. She was injured in an automobile accident, with cervical and lumbar muscle strain diagnosed by a local emergency room physician. She consulted a chiropractor two days later because her symptoms had not abated. The chiropractic treatment of short-wave diathermy, high-voltage electric stimulation and spinal manipulation continued thrice weekly for six weeks. She then presented to her neurologist, complaining of persistent fatigue, weakness, increased diplopia, cervical and occipital pain, and disrupted sleep. Neck weakness had developed since her last visit. She was admitted to the hospital for evaluation. Neurologic exam showed no other abnormality of strength, sensation, or reflexes. The exacerbation of myasthenia responded to prednisone and increased pyridostigmine. After two months she required only her preinjury dose of pyridostigmine (60 mg q.d. p.r.n.) to prevent diplopia or fatigue, and her strength was normal. Repeated electrically induced muscle contraction is suspected of causing this exacerbation of myasthenia gravis.

Adult↗

Physiotherapy in osteoarthrosis of the knees. A controlled trial of hospital versus home exercises.

Patients with osteoarthrosis of the knee were taught two simple exercises to be practised daily with graduated weights, recording the details in an instruction/record book. Patients were randomly divided into those receiving treatment (and short-wave diathermy) at hospital (group A), and those doing their exercises at home (group B). Both groups showed decreased pain and increased function, maximum weight lift and endurance at the end of 4 weeks. There was no difference between the groups. Benefit was retained by most of those patients notified at 6 weeks of a further assessment session at 12 weeks; most of these subjects continued daily exercises, whereas those not notified in advance were more likely to cease exercising and experience more pain. The exercise regimens are easy to perform and document. It is suggested that if such regimens were routinely used there would be great practical benefits for patient and physiotherapist.

Aged↗

Reduction of radiofrequency exposure to the operator during short-wave diathermy treatments.

Radiofrequency electromagnetic fields near short-wave diathermy equipment operating at a frequency of 27.12 MHz can expose the physical therapist to levels above those recommended in standards for radiofrequency exposure in Western countries. Electric and magnetic fields around air-gap, diplode, monode and circuplode applicators were mapped by the author. Large differences in stray field intensities were found for the various applicators. The air-gap electrodes caused the highest levels of unwanted radiation, and the circuplode caused the lowest levels. The use of the circuplode would normally ensure an operator exposure far below the levels in recommended standards. In order to reduce the exposure during the first few minutes of a treatment, when air-gap electrodes or diplode are used, the operator should stand at the end of the diathermy console opposite to the applicator and cables and not, as is often the case, at one side. It is recommended that manufacturers change the design of the diathermy console (a minor modification) in order to ensure this operating position.

Diathermy↗

[Analysis of substances issuing from Zajdela ascitic hepatoma cells after exposure to UV radiation of different wave-lengths. I. Relationship to dose].

The release of substances from the Zaidela ascitic hepatoma cells after irradiation with physiological doses of short-wave (254 nm) and long-wave (300-380 nm) UV light (far and near UV light) has been studied spectrophotometrically. Within the range of 200-520 nm, the absorption spectra of releasing substances show maxima at 215 and 260 nm and are identical to spectra of non-irradiated cells. The amount of substances increases with dose making up, at the maximal alteration, 180-220%, of the amount releasing from non-irradiated cells. Irradiation with far UV light exceeds by one order that with near UV light. The effect of minimum doses is opposite to the action of high doses: the release of substances from irradiated cells is much less.

Animals↗