WorldWideScience

Sample records for diathermy

  1. Blood splash from different diathermy instruments during tonsillectomy.

    Science.gov (United States)

    Hanna, B C; Thompson, P; Smyth, C; Gallagher, G

    2006-11-01

    To compare the potential risk of blood contamination of the surgeon's conjunctiva during tonsillectomy using disposable bipolar diathermy and reusable monopolar diathermy. A prospective, single-blind, randomized, controlled trial. Elective tonsillectomy was performed using either disposable bipolar diathermy or reusable monopolar diathermy. The operating surgeon wore a ViewsafeTM protective eyeshield which was later examined under an operating microscope by a blinded observer and the number of blood spots counted. One hundred and sixty-eight patients were enrolled. The relative risk of conjunctival contamination of the surgeon using disposable bipolar diathermy was 2.8 times that with reusable monopolar diathermy (chi-squared test, p blood splatter. The use of disposable bipolar diathermy for haemostasis during tonsillectomy poses a greater risk of conjunctival contamination for the surgeon than using reusable monopolar diathermy.

  2. Radiofrequency (RF) radiation measurement for diathermy machine

    International Nuclear Information System (INIS)

    Rozaimah Abdul Rahim; Roha Tukimin; Mohd Amirul Nizam; Ahmad Fadzli; Mohd Azizi

    2010-01-01

    Full-text: Diathermy machine is one of medical device that use widely in hospital and clinic. During the diathermy treatment, high radiofrequency (RF) currents (shortwave and microwave) are used to heat deep muscular tissues through electromagnetic energy to body tissues. The heat increases blood flow, relieve pain and speeding up recovery. The stray RF radiation from the machine can exposes to unintended tissue of the patient, to the operator (physical therapist) and also can cause electromagnetic interference (EMI) effect to medical devices around the machine. The main objective of this study is to establish a database of the RF radiation exposure levels experienced by the operator and patient during the treatments. RF radiation (electric and magnetic field) produced by the diathermy machines were measured using special RF survey meters. The finding of this study confirms that radiation levels on the surface and near the applicator of the diathermy machine much more elevated due to the much closer distance to the source and they exceeding the occupational and general public exposure limit. The results also shows the field strengths drop very significantly when the distance of measurement increase. (author)

  3. Monopolar diathermy used for correction of ankyloglossia

    Directory of Open Access Journals (Sweden)

    Tuli A

    2010-06-01

    Full Text Available Tongue tie, also known as ankyloglossia or ankyloglossia inferior, is a relatively common finding in pediatric surgical outpatient clinics. It occurs as a result of a short, tight, lingual frenum causing tethering of the tongue tip. It is a common oral finding in infants and children, which is often neglected. Although most cases resolve or are asymptomatic, some patients develop articulation problems and other concerns related to poor tongue-tip mobility. In this article, we report on a 5-year old girl with a tongue tie, who underwent frenectomy using monopolar diathermy under local anesthesia without any postoperative complication.

  4. Allergic contact dermatitis to acrylates in disposable blue diathermy pads.

    Science.gov (United States)

    Sidhu, S. K.; Shaw, S.

    1999-01-01

    We report 2 cases of elicitation of allergic contact dermatitis to acrylates from disposable blue diathermy pads used on patients who underwent routine surgery. Their reactions were severe, and took approximately 5 weeks to resolve. Both patients gave a prior history of finger tip dermatitis following the use of artificial sculptured acrylic nails, which is a common, but poorly reported, cause of acrylate allergy. Patch testing subsequently confirmed allergies to multiple acrylates present in both the conducting gel of disposable blue diathermy pads, and artificial sculptured acrylic nails. We advocate careful history taking prior to surgery to avoid unnecessary exposure to acrylates in patients already sensitized. Images Figure 1 Figure 2 PMID:10364952

  5. Post-tonsillectomy hemorrhage after bipolar diathermy vs. cold ...

    African Journals Online (AJOL)

    Material and Methods: This is a cross sectional study done in Alahsa city, eastern province, Saudi Arabia during the period from January 2014 to March 2015,This study reported the postoperative hemorrhage after Bipolar diathermy and Cold dissection surgical techniques to evaluate the incidence of the hemorrhage and to ...

  6. Exposure to radiofrequency radiation from diathermy units in medicine

    International Nuclear Information System (INIS)

    Hrnjak, M.; Zivkovic, D.; Milicevic, L.

    1998-01-01

    Intensities of microwave (MW) and radio wave (short wave) radiation to whom personnel occupied in use of radiofrequency (RF) diathermy in physical therapy could be exposed were measured in two hospitals, in two therapy wards. The Narda Microwave Corp. (USA) Broadband Radiation Meter - Model 8616, with appropriate probes, was used for measurements. The measurements were performed around the 3 types of diathermy units in various ways of application. Results of the measurements showed that the intensities of short waves radiation around the applicators, cables and units (at the distance of 30 cm) ranged from 187 mW/cm sup 2 , and on the majority of measuring points were considerably over the upper exposure limit of 1,22 mW/cm sup 2 (according to JUS N.NO.205:1190 limits of exposure to RF fields). Intensities of microwave radiation in the vicinity of units and patient range from <0,002 to 1,45 mW/cm sup 2. The intensities of MW radiation are over the exposure limit of 1 mW/cm sup 2 in two measuring points. Results of measurements show that personnel occupied in use of microwave and short wave diathermy in medicine could be regularly exposed to radiation, and that this radiation has considerably high intensity in the vicinity of the therapy unit and patient (author)

  7. The local effects of ovarian diathermy in an ovine model of polycystic ovary syndrome.

    Science.gov (United States)

    Connolly, Fiona; Rae, Michael T; Butler, Mairead; Klibanov, Alexander L; Sboros, Vassilis; McNeilly, Alan S; Duncan, W Colin

    2014-01-01

    In order to develop a medical alternative to surgical ovarian diathermy (OD) in polycystic ovary syndrome (PCOS) more mechanistic information is required about OD. We therefore studied the cellular, molecular and vascular effects of diathermy on the ovary using an established ovine model of PCOS. Pregnant sheep were treated twice weekly with testosterone propionate (100 mg) from day 30-100 gestation. Their female offspring (n = 12) were studied during their second breeding season when the PCOS-like phenotype, with anovulation, is fully manifest. In one group (n = 4) one ovary underwent diathermy and it was collected and compared to the contralateral ovary after 24 hours. In another group a treatment PCOS cohort underwent diathermy (n = 4) and the ovaries were collected and compared to the control PCOS cohort (n = 4) after 5 weeks. Ovarian vascular indices were measured using contrast-enhanced ultrasound and colour Doppler before, immediately after, 24 hours and five weeks after diathermy. Antral follicles were assessed by immunohistochemistry and ovarian stromal gene expression by quantitative RT-PCR 24 hours and 5 weeks after diathermy. Diathermy increased follicular atresia (Povarian microvasculature (P = 0.05) but this was not seen at 24 hours. However 24 hours after diathermy there was a reduction in the stromal Doppler blood flow signal (Povarian resistance index (Povarian stromal blood flow with an increased ovarian artery resistance index associated with atresia of antral follicles.

  8. Meta-analysis of the effectiveness of surgical scalpel or diathermy in making abdominal skin incisions.

    LENUS (Irish Health Repository)

    Ahmad, Nasir Zaheer

    2012-02-01

    BACKGROUND: Surgical scalpels are traditionally used to make skin incisions. Diathermy incisions on contrary are less popular among the surgeons. The aim of this meta-analysis was to compare the effectiveness of both techniques and address the common fallacies about diathermy incisions. METHODS: A literature search of MEDLINE and Cochrane databases was done, using the keywords diathermy, cold scalpel, and incisions. Eleven clinical trials comparing both methods of making skin incisions were selected for meta-analysis. The end points compared included postoperative wound infection, pain in first 24 hours after surgery, time taken to complete the incisions, and incision-related blood loss. RESULTS: Postoperative wound infection rate was comparable in both techniques (P = 0.147, odds ratio = 1.257 and 95% CI = 0.923-1.711). Postoperative pain was significantly less with diathermy incisions in first 24 hours (P = 0.031, weighted mean difference = 0.852 and 95% CI = 0.076-1.628). Similarly, the time taken to complete the incision and incision-related blood loss was significantly less with diathermy incisions (95% CI = 0.245-0.502 and 0.548-1.020, respectively). CONCLUSION: Diathermy incisions are equally prone to get wound infection, as do the incisions made with scalpel. Furthermore, lower incidence of early postoperative pain, swiftness of the technique, and a reduced blood loss are the encouraging facts supporting routine use of diathermy for abdominal skin incisions after taking careful precautions.

  9. Interference of apex locator, pulp tester and diathermy on pacemaker function

    OpenAIRE

    Narayanan Sriman; V Prabhakar; J S Bhuvaneswaran; N Subha

    2015-01-01

    Aim: The purpose of this study was to evaluate the effects of three electronic apex locators (EAL), electric pulp tester (EPT) and diathermy on pacemaker function in vitro. Materials and Methods: Three EALs: Root ZX (J. Morita Co., Tustin, CA, U.S.A.), Propex (Dentsply), Mini Apex locator (SybronEndo, Anaheim, CA, USA), EPT (Parkell pulp vitality tester Farmingdale, NY, USA) and Diathermy (Neomed 250 B) were tested for any interference with one pacemaker (A medtronic kappa KVDD901-serial ...

  10. Diathermy versus scalpel incisions for open cholecystectomy comparative study

    International Nuclear Information System (INIS)

    Ali, M.A.; Niazi, W.A.K.

    2014-01-01

    The aim of the study was to make a comparison between skin incisions made with electrocautery versus scalpel in terms of their safety, efficacy and post-operative complications. Design: A randomized controlled study. Setting: The study was conducted in Combined Military Hospital (CMH) Kharian, Pakistan airforce (PAF) Hospital Sargodha. Duration of Study: May 2008 to August 2011. Patients and Methods: Ninety seven patients who underwent open cholecystectomy were randomly divided into two groups on the basis of the use of electrocautery versus steel scalpel for making skin incision and sub-cutaneous tissue dissection. Parameters recorded were, time taken from skin incision to full incising of the peritoneum, length of the wound, amount of blood loss during this step of surgery in each group. Post-operative pain scoring using visual analogue scale was done. Wound complications such as infection, haematoma/seroma and dehiscence were noted too. One month of follow up was recorded in each group. Subsequently a comparison of these findings was done. Results: Incision time (sec/cm/sub 2/) was longer in scalpel group than in diathermy group (p = 0.001), whereas, incision blood loss (ml/cm/sub 2/) was significantly less in diathermy group than in scalpel group (p = 0.03). There was no difference in post-operative pain perception as delineated by visual pain analogue scoring system between the two groups (p = 0.57). Post-operative wound complications and the final healing of wound at 01 month of follow-up were almost similar in both groups. Conclusion: Electrocautery may be used safely without any untoward complication in making skin incision and sub-cutaneous tissue dissection with an advantage of reduced incision time and and less blood loss. (author)

  11. The local effects of ovarian diathermy in an ovine model of polycystic ovary syndrome.

    Directory of Open Access Journals (Sweden)

    Fiona Connolly

    Full Text Available In order to develop a medical alternative to surgical ovarian diathermy (OD in polycystic ovary syndrome (PCOS more mechanistic information is required about OD. We therefore studied the cellular, molecular and vascular effects of diathermy on the ovary using an established ovine model of PCOS. Pregnant sheep were treated twice weekly with testosterone propionate (100 mg from day 30-100 gestation. Their female offspring (n = 12 were studied during their second breeding season when the PCOS-like phenotype, with anovulation, is fully manifest. In one group (n = 4 one ovary underwent diathermy and it was collected and compared to the contralateral ovary after 24 hours. In another group a treatment PCOS cohort underwent diathermy (n = 4 and the ovaries were collected and compared to the control PCOS cohort (n = 4 after 5 weeks. Ovarian vascular indices were measured using contrast-enhanced ultrasound and colour Doppler before, immediately after, 24 hours and five weeks after diathermy. Antral follicles were assessed by immunohistochemistry and ovarian stromal gene expression by quantitative RT-PCR 24 hours and 5 weeks after diathermy. Diathermy increased follicular atresia (P<0.05 and reduced antral follicle numbers after 5 weeks (P<0.05. There was an increase in stromal CCL2 expression 24 hours after diathermy (P<0.01 but no alteration in inflammatory indices at 5 weeks. Immediately after diathermy there was increased microbubble transit time in the ovarian microvasculature (P = 0.05 but this was not seen at 24 hours. However 24 hours after diathermy there was a reduction in the stromal Doppler blood flow signal (P<0.05 and an increased ovarian resistance index (P<0.05 both of which persisted at 5 weeks (P<0.01; P<0.05. In the ovine model of PCOS, OD causes a sustained reduction in ovarian stromal blood flow with an increased ovarian artery resistance index associated with atresia of antral follicles.

  12. Interference of apex locator, pulp tester and diathermy on pacemaker function.

    Science.gov (United States)

    Sriman, Narayanan; Prabhakar, V; Bhuvaneswaran, J S; Subha, N

    2015-01-01

    The purpose of this study was to evaluate the effects of three electronic apex locators (EAL), electric pulp tester (EPT) and diathermy on pacemaker function in vitro. Three EALs: Root ZX (J. Morita Co., Tustin, CA, U.S.A.), Propex (Dentsply), Mini Apex locator (SybronEndo, Anaheim, CA, USA), EPT (Parkell pulp vitality tester Farmingdale, NY, USA) and Diathermy (Neomed 250 B) were tested for any interference with one pacemaker (A medtronic kappa KVDD901-serial number: PLE734632S). Directly connecting the pacemaker lead with the EAL/EPT/diathermy operating on a flat bench top, the telemetry wand was held directly over the pacemaker to monitor the pacing pattern for a period of 30 s. Pacemaker activity was continuously recorded on the telemetric programmer and electro gram (EGM) readings examined for pacer inhibition, noise reversion or inappropriate pacemaker pulses. All the three apex locators showed no pacing interference or background noise during its function or at rest. The EGM readings of EPT showed varying levels of background noise in between pacing however, this did not affect the normal pacing pattern and the pacing interval remained constant. EGM readings of diathermy showed an increase in the pacing interval (irregular pacing pattern) followed by complete inhibition of the pacing system. The tested EALs do not interfere with cardiac pacemaker function. The tested EPT showed varying levels of background noise but does not interfere with cardiac pacemaker function. Use of Diathermy interfered with the normal pacing, leading to complete inhibition of the pacing system.

  13. Bacteremia during adenoidectomy: a comparison of suction diathermy adenoid ablation and adenoid curettage.

    LENUS (Irish Health Repository)

    Casserly, Paula

    2010-08-01

    Transient bacteremia is induced by adenoidectomy when the integrity of the nasopharyngeal membrane is broken. The aim of this study was to determine the incidence of bacteremia in patients undergoing adenoidectomy, to identify the causative organisms, and to compare the incidences of bacteremia between the two techniques suction diathermy and curettage.

  14. Randomized clinical trial of symptom control after stapled anopexy or diathermy excision for haemorrhoid prolapse

    DEFF Research Database (Denmark)

    Nyström, P-O; Qvist, N; Raahave, D

    2010-01-01

    BACKGROUND: : This multicentre randomized clinical trial studied how symptoms improved after either stapled anopexy or diathermy excision of haemorrhoids. METHODS: : The study involved 18 hospitals in Sweden, Denmark and the UK. Some 207 patients were randomized to either anopexy or Milligan-Morg...

  15. Survey of exposure of physiotherapist operators to emissions from microwave and short wave diathermy equipment

    International Nuclear Information System (INIS)

    Coppell, R.B.

    1987-01-01

    An extensive survey of levels of electromagnetic fields in the vicinity of microwave and short wave diathermy equipment is presented and occupational exposure of physiotherapist operators is assessed. There was a good response to mailed questionnaires to 18 hospital boards, 21 private hospitals, and 148 private physiotherapy practices in Christchruch and centres of the north island of New Zealand. Within 34 public hospitals and 57 private practice of those so contacted, who also volunteered to participate, measurements were made in numerous positions about operating equipment. For practical reasons, manufactured phantom sections were substituted for real patients. Levels of microwave power flux density were found to vary according to position and to orientation of equipment and patient phantom. Provided, microwave diathermy equipment is used with reasonable care, excessive exposure of the physiotherapist operator is considered very unlikely. Levels of electric and magnetic field strength squared in the vicinity of simulated body sections under short wave diathermy treatment were found to be highly localised and strongly dependent upon the type of applicator used and the proximity of connecting leads. Operating procedures, including distances of separation, are recommended to protect operators from excessive exposure. (author). 30 refs., 8 tabs., 4 figs., ills

  16. Diathermy vs. scalpel skin incisions in general surgery: double-blind, randomized, clinical trial.

    Science.gov (United States)

    Shamim, Muhammad

    2009-08-01

    This prospective, double-blind, randomized, controlled trial was designed to compare the outcome of diathermy incisions versus scalpel incisions in general surgery. A total of 369 patients who underwent diathermy incision (group A: 185 patients) or scalpel incision (group B: 184 patients) were analyzed. Variables analyzed were: surgical wound classification, length and depth of incision, incision time, duration of operation, incisional blood loss, postoperative pain, duration of hospital stay, duration of healing, and postoperative complications. The inclusion criteria were all patients who underwent elective or emergency general surgery. The exclusion criteria were only cases with incomplete patients' data and patients who were lost to follow-up. This study was conducted at Fatima Hospital-Baqai Medical University and Shamsi Hospital (Karachi), from January 2006 to December 2007. Incision time was significantly longer for patients in group B (p = 0.001). Incisional blood loss also was more for patients in group B (p = 0.000). Pain perception was found to be markedly reduced during the first 48 h in group A (p = 0.000). Total period of hospital stay (p = 0.129) and time for complete wound healing (p = 0.683) were almost the same for both groups. Postoperative complication rate by wound classification did not differ markedly between the two groups (p = 0.002 vs. p = 0.000). Diathermy incision has significant advantages compared with the scalpel because of reduced incision time, less blood loss, & reduced early postoperative pain.

  17. In vitro assessment of tissue heating near metallic medical implants by exposure to pulsed radio frequency diathermy

    International Nuclear Information System (INIS)

    Ruggera, P S; Witters, D M; Maltzahn, G von; Bassen, H I

    2003-01-01

    A patient with bilateral implanted neurostimulators suffered significant brain tissue damage, and subsequently died, following diathermy treatment to hasten recovery from teeth extraction. Subsequent MRI examinations showed acute deterioration of the tissue near the deep brain stimulator (DBS) lead's electrodes which was attributed to excessive tissue heating induced by the diathermy treatment. Though not published in the open literature, a second incident was reported for a patient with implanted neurostimulators for the treatment of Parkinson's disease. During a diathermy treatment for severe kyphosis, the patient had a sudden change in mental status and neurological deficits. The diathermy was implicated in causing damage to the patient's brain tissue. To investigate if diathermy induced excessive heating was possible with other types of implantable lead systems, or metallic implants in general, we conducted a series of in vitro laboratory tests. We obtained a diathermy unit and also assembled a controllable laboratory exposure system. Specific absorption rate (SAR) measurements were performed using fibre optic thermometry in proximity to the implants to determine the rate of temperature rise using typical diathermy treatment power levels. Comparisons were made of the SAR measurements for a spinal cord stimulator (SCS) lead, a pacemaker lead and three types of bone prosthesis (screws, rods and a plate). Findings indicate that temperature changes of 2.54 and 4.88 deg. C s -1 with corresponding SAR values of 9129 and 17 563 W kg -1 near the SCS and pacemaker electrodes are significantly higher than those found in the proximity of the other metallic implants which ranged from 0.04 to 0.69 deg C s -1 (129 to 2471 W kg -1 ). Since the DBS leads that were implanted in the reported human incidents have one-half the electrode surface area of the tested SCS lead, these results imply that tissue heating at rates at least equal to or up to twice as much as those reported

  18. Effect of diathermy on pain and healing in tonsillectomy, compared with other methods of haemostasis: a randomised study

    DEFF Research Database (Denmark)

    Hahn, C.H.; Rungby, J.A.; Overgaard, T.

    2008-01-01

    with gauze packs; bipolar diathermy; and local anaesthesia then pack compression. The outcome measures were pain scores (derived from a visual analogue scale), peri-operative bleeding, and post-operative episodes of blood-stained saliva, consultation rate, tonsillar bed healing and days before return...... to regular diet. One hundred and five patients were included.Results:Peri-operative bleeding was significantly reduced in the local anaesthesia group compared with the other two groups. Delayed post-operative tonsillar bed healing was noted in the diathermy group. No other significant differences were found...

  19. Some observations on stray magnetic fields and power outputs from short-wave diathermy equipment

    Energy Technology Data Exchange (ETDEWEB)

    Lau, R.W.M.; Dunscombe, P.B.

    1984-04-01

    Recent years have seen increasing interest in the possible hazards arising from the use of nonionizing electromagnetic radiation. Relatively large and potentially hazardous fields are to be found in the vicinity of short-wave and microwave equipment used in physiotherapy departments to produce therapeutic temperature rises. This note reports the results of measurements of the stray magnetic field and power output of a conventional short-wave diathermy unit when applied to tissue-equivalent phantoms. The dependence of these quantities on the variables, i.e. power setting of the unit, capacitor plate size, phantom size and phantom-capacitor plate separation, are discussed.

  20. Blood Perfusion in Human Eyelid Skin Flaps Examined by Laser Speckle Contrast Imaging-Importance of Flap Length and the Use of Diathermy.

    Science.gov (United States)

    Nguyen, Cu Dinh; Hult, Jenny; Sheikh, Rafi; Tenland, Kajsa; Dahlstrand, Ulf; Lindstedt, Sandra; Malmsjö, Malin

    2017-10-11

    It is well known that blood perfusion is important for the survival of skin flaps. As no study has been conducted to investigate how the blood perfusion in human eyelid skin flaps is affected by the flap length and diathermy, the present study was carried out to investigate these in patients. Fifteen upper eyelids were dissected as part of a blepharoplastic procedure, releasing a 30-mm long piece of skin, while allowing the 5 mm wide distal part of the skin to remain attached, to mimic a skin flap (hereafter called a "skin flap"). Blood perfusion was measured before and after repeated diathermy, using laser speckle contrast imaging. Blood perfusion decreased from the base to the tip of the flap: 5 mm from the base, the perfusion was 69%, at 10 mm it was 40%, at 15 mm it was 20%, and at 20 mm it was only 13% of baseline values. Diathermy further decreased blood perfusion (measured 15 mm from the base) to 13% after applying diathermy for the first time, to 6% after the second and to 4% after the third applications of diathermy. Blood perfusion falls rapidly with distance from the base of skin flaps on the human eyelid, and diathermy reduces blood perfusion even further. Clinically, it may be advised that flaps with a width of 5 mm be no longer than 15 mm (i.e., a width:length ratio of 1:3), and that the use of diathermy should be carefully considered.

  1. In vitro assessment of tissue heating near metallic medical implants by exposure to pulsed radio frequency diathermy

    Energy Technology Data Exchange (ETDEWEB)

    Ruggera, P S; Witters, D M; Maltzahn, G von; Bassen, H I [Center for Devices and Radiological Health, Food and Drug Administration, HFZ-133, 9200 Corporate Blvd., Rockville, MD 20850 (United States)

    2003-09-07

    A patient with bilateral implanted neurostimulators suffered significant brain tissue damage, and subsequently died, following diathermy treatment to hasten recovery from teeth extraction. Subsequent MRI examinations showed acute deterioration of the tissue near the deep brain stimulator (DBS) lead's electrodes which was attributed to excessive tissue heating induced by the diathermy treatment. Though not published in the open literature, a second incident was reported for a patient with implanted neurostimulators for the treatment of Parkinson's disease. During a diathermy treatment for severe kyphosis, the patient had a sudden change in mental status and neurological deficits. The diathermy was implicated in causing damage to the patient's brain tissue. To investigate if diathermy induced excessive heating was possible with other types of implantable lead systems, or metallic implants in general, we conducted a series of in vitro laboratory tests. We obtained a diathermy unit and also assembled a controllable laboratory exposure system. Specific absorption rate (SAR) measurements were performed using fibre optic thermometry in proximity to the implants to determine the rate of temperature rise using typical diathermy treatment power levels. Comparisons were made of the SAR measurements for a spinal cord stimulator (SCS) lead, a pacemaker lead and three types of bone prosthesis (screws, rods and a plate). Findings indicate that temperature changes of 2.54 and 4.88 deg. C s{sup -1} with corresponding SAR values of 9129 and 17 563 W kg{sup -1} near the SCS and pacemaker electrodes are significantly higher than those found in the proximity of the other metallic implants which ranged from 0.04 to 0.69 deg C s{sup -1} (129 to 2471 W kg{sup -1}). Since the DBS leads that were implanted in the reported human incidents have one-half the electrode surface area of the tested SCS lead, these results imply that tissue heating at rates at least equal to or up to

  2. Randomized controlled trial of bipolar diathermy vs ultrasonic scalpel for closed hemorrhoidectomy

    Science.gov (United States)

    Tsunoda, Akira; Sada, Haruki; Sugimoto, Takuya; Kano, Nobuyasu; Kawana, Mariko; Sasaki, Tadanori; Hashimoto, Hideki

    2011-01-01

    AIM: To compare hemorrhoidectomy with a bipolar electrothermal device or hemorrhoidectomy using an ultrasonically activated scalpel. METHODS: Sixty patients with grade III or IV hemorrhoids were prospectively randomized to undergo closed hemorrhoidectomy assisted by bipolar diathermy (group 1) or hemorrhoidectomy with the ultrasonic scalpel (group 2). Operative data were recorded, and patients were followed at 1, 3, and 6 wk to evaluate complications. Independent assessors were assigned to obtain postoperative pain scores, oral analgesic requirement and satisfaction scores. RESULTS: Reduced intraoperative blood loss median 0.9 mL (95% CI: 0.8-3.7) vs 4.6 mL (95% CI: 3.8-7.0), P = 0.001 and a short operating time median 16 (95% CI: 14.6-18.2) min vs 31 (95% CI: 28.1-35.3) min, P < 0.0001 was observed in group 1 compared with group 2. There was a trend towards lower postoperative pain scores on day 1 group 1 median 2 (95% CI: 1.8-3.5) vs group 2 median 3 (95% CI: 2.6-4.2), P = 0.135. Reduced oral analgesic requirement during postoperative 24 h after operation median 1 (95% CI: 0.4-0.9) tablet vs 1 (95% CI: 0.9-1.3) tablet, P = 0.006 was observed in group 1 compared with group 2. There was no difference between the two groups in the degree of patient satisfaction or number of postoperative complications. CONCLUSION: Bipolar diathermy hemorrhoidectomy is quick and bloodless and, although as painful as closed hemorrhoidectomy with the ultrasonic scalpel, is associated with a reduced analgesic requirement immediately after operation. PMID:22110846

  3. Evaluation of reproductive function of female rats exposed to radiofrequency fields (27. 12 MHz) near a shortwave diathermy device

    Energy Technology Data Exchange (ETDEWEB)

    Brown-Woodman, P.D.; Hadley, J.A.; Richardson, L.; Bright, D.; Porter, D.

    1989-04-01

    In recent years, there has been increased concern regarding effects of operator exposure to the electromagnetic (EM) field associated with shortwave diathermy devices. The present study was designed to investigate the effects, on rats, of repeated exposure to such an EM field. Following repeated exposure for 5 wk, a reduction in fertility occurred as indicated by a reduced number of matings in exposed rats compared to sham-irradiated rats and a reduction in the number of rats that conceived after mating. The data suggest that female operators could experience reduced fertility, if they remained close to the console for prolonged periods. This has particular significant for the physiotherapy profession.

  4. Laparoscopic ovarian drilling by diathermy for ovulation induction in infertile women with polycystic ovarian syndrome

    International Nuclear Information System (INIS)

    Butt, F.

    2011-01-01

    Background: Polycystic ovarian syndrome (PCOS) is the commonest cause of secondary infertility. Laparoscopic ovarian drilling has widely been used for induction of ovulation in polycystic ovarian syndrome patients resistant to clomiphene citrate. 80% patients ovulated after treatment and 60% patient conceived either spontaneously or after treatment with medication to which they are previously resistant. Purpose: The aim of the present study was to see the effectiveness of laparoscopic ovarian drilling (LOD) with monopolar diathermy on pregnancy outcome in infertile women with polycystic ovarian syndrome (PCOS). Design: Descriptive cross sectional study. Intervention: Laparoscopic ovarian drilling. Main Outcome Measures: Pregnancy, ovulation rate. Material and Methods: This study was carried out in the department of Gynae and Obstetrics in Sharif Medical City Hospital from January, 2007 to January, 2009. The inclusion criteria for laparoscopy ovarian drilling (LOD) were those infertile women between the age group of 25 - 38 years who meet the criteria for PCOS and who are resistant to clomiphene citrate and injectable gonadotrophins. A total of 30 women were booked for laparoscopic ovarian drilling after having informed consent for procedure. Response to therapy was assessed in term of pregnancy outcome and ovulation rate for 1 year after therapy. Results: A total of 30 patients were booked for laparoscopic ovarian drilling from January, 2007 to January, 2009. The mean age of study group was 30 years +- SD 4.7791. Cumulative ovulation rate was observed in 22 patients (73%), out of which spontaneous ovulation occurred in 18 patients (80%), and after ovulation induction therapy in 4 patients (18%). Eleven patients (37%) conceived in two year duration. Spontaneous conception without any treatment was observed in 7 patients (63%); however 4 patients (37%) require further assistance with combined therapy of clomiphene citrate and injectable gonadotrophins after failure

  5. Comparison of Efficacy of Carbon Dioxide (CO2) Laser with Cutting Diathermy in Surgical Excision of Early Carcinoma Tongue.

    Science.gov (United States)

    Rashid, Muhammad; Hashmi, Muhammad Ali; Maqbool, Shahzad; Dastigir, Majid

    2015-10-01

    To compare the efficacy of carbon dioxide (CO(2)) laser with cutting diathermy as a cutting device in surgical excision of early carcinoma tongue. Experimental study. Combined Military Hospital (CMH), Rawalpindi and CMH, Lahore, from July 2008 to July 2011. Twenty two biopsy proven cases of T(1) and early T(2) squamous cell carcinoma of tongue were divided in two equal groups of 11 each labeled as A and B. Tumor was excised by CO(2) laser in group A while cutting diathermy was done in group B. For both groups tumor excision time, per-operative blood loss, postoperative oral swelling and pain was recorded. Excision time of tumor was assessed in minutes and amount of blood loss in milliliters till complete hemostasis after removal of primary tumor. Postoperatively patients were assessed on 12 hourly basis for 48 hours for pain. Pain was analyzed on visual analogue score 1 - 10. Oral swelling was assessed once after 24 hours and labeled as mild, moderate and severe. Independent sample t-test was applied for analysis of excision time, postoperative pain and per-operative blood loss for both groups. Postoperative swelling was analyzed using Fisher's exact test. P-value of < 0.05 was considered significant. The mean age at diagnosis in group A was 49.36 ± 5.27 years, while in group B patients had mean age of 50.73 ± 8.13 years. In group A, 4/11 (36.3%) patients were having tumor stage T(1) while 7/11 (63.6%) had T(2) stage tumor. In group B, 5/11 (45.4%) were having T1 and 6/11 (54.5%) were having stage T(2) tumor. Excision time was significantly shorter for group B (p=0.003), but group A had less postoperative pain (p=0.001), less per-operative blood loss (p=0.001) and less postoperative oral swelling (p=0.021). Early carcinoma tongue is better removed by laser than electrocautery in terms of postoperative morbidity, per-operative blood loss, postoperative pain and oral swelling.

  6. Laparoscopic ovarian diathermy after clomiphene failure in polycystic ovary syndrome: is it worthwhile? A randomized controlled trial.

    Science.gov (United States)

    Abu Hashim, Hatem; Foda, Osama; Ghayaty, Essam; Elawa, Ahmed

    2011-11-01

    Laparoscopic ovarian diathermy (LOD) represents a successful treatment option for women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS). However, in case of CC failure PCOS, LOD offers several theoretical advantages. This study was conducted to compare the efficacy of LOD versus continuation of CC up to six further cycles in PCOS patients who failed to achieve pregnancy despite the previous successful CC induced ovulation. One hundred and seventy six infertile women with CC failure PCOS were selected in this randomized controlled trial. Patients (n = 87) underwent LOD with 6 months follow-up or received CC (n = 89) up to six cycles. Outcome measures were; clinical pregnancy rate, midcycle endometrial thickness, cycle length, miscarriage and live birth rates. The clinical pregnancy rate per patient and the cumulative pregnancy rate after six cycles were comparable in both groups (39 vs. 33.7% and 47 vs. 39.2%, respectively). Four twin pregnancies occurred in CC group and none in LOD group and the difference was statistically significant (p < 0.05). No significant difference in midcycle endometrial thickness was observed (8.8 ± 1.2 mm vs. 7.7 ± 1.1 mm). Improvement in cycle length, miscarriage and live birth rates were comparable in both groups. No cases of ovarian hyperstimulation syndrome occurred in either group. LOD during the 6 months follow-up period and CC for up to six further cycles are equally effective for achieving pregnancy in CC failure PCOS patients.

  7. Endoscopic Resection of Skull Base Teratoma in Klippel-Feil Syndrome through Use of Combined Ultrasonic and Bipolar Diathermy Platforms

    Directory of Open Access Journals (Sweden)

    Justin A. Edward

    2017-01-01

    Full Text Available Klippel-Feil syndrome (KFS is associated with numerous craniofacial abnormalities but rarely with skull base tumor formation. We report an unusual and dramatic case of a symptomatic, mature skull base teratoma in an adult patient with KFS, with extension through the basisphenoid to obstruct the nasopharynx. This benign lesion was associated with midline palatal and cerebral defects, most notably pituitary and vertebrobasilar arteriolar duplications. A multidisciplinary workup and a complete endoscopic, transnasal surgical approach between otolaryngology and neurosurgery were undertaken. Out of concern for vascular control of the fibrofatty dense tumor stalk at the skull base and need for complete teratoma resection, we successfully employed a tissue resection tool with combined ultrasonic and bipolar diathermy to the tumor pedicle at the sphenoid/clivus junction. No CSF leak or major hemorrhage was noted using this endonasal approach, and no concerning postoperative sequelae were encountered. The patient continues to do well now 3 years after tumor extirpation, with resolution of all preoperative symptoms and absence of teratoma recurrence. KFS, teratoma biology, endocrine gland duplication, and the complex considerations required for successfully addressing this type of advanced skull base pathology are all reviewed herein.

  8. An evaluation of safety guidelines to restrict exposure to stray radiofrequency radiation from short-wave diathermy units

    Energy Technology Data Exchange (ETDEWEB)

    Shields, Nora [School of Physiotherapy, La Trobe University, Victoria 3086 (Australia); O' Hare, Neil [Department of Medical Physics and Bioengineering, St James' s Hospital, Dublin 8 (Ireland); Gormley, John [School of Physiotherapy, Trinity College Dublin, Trinity Centre for Health Sciences, St James' s Hospital, Dublin 8 (Ireland)

    2004-07-07

    Short-wave diathermy (SWD), a form of radiofrequency radiation used therapeutically by physiotherapists, may be applied in continuous (CSWD) or pulsed (PSWD) mode using either capacitive or inductive methods. Stray radiation emitted by these units may exceed exposure guidelines close to the equipment. Discrepant guidelines exist on a safe distance from an operating unit for operators and other personnel. Stray electric (E-field) and magnetic (H-field) field strengths from 10 SWD units in six departments were examined using a PMM 8053 meter and two isotropic probes (EP-330, HP-032). A 5 l saline phantom completed the patient circuit. Measurements were recorded in eight directions between 0.5 m and 2 m at hip and eye levels while the units operated at maximum output and data compared to current guidelines. Results found stray fields from capacitive CSWD fell below operator limits at 2 m (E-field 4.8-39.8 V/m; H-field 0.015-0.072 A/m) and at 1 m for inductive CSWD (E-field 0-36 V/m; H-field 0.01-0.065 A/m). Capacitive PSWD fields fell below the limits at 1.5 m (E-field 1.2-19.9 V/m; H-field 0.002-0.045 A/m) and at 1m for inductive PSWD (E-field 0.7-4.0 V/m; H-field 0.009-0.03 A/m). An extra 0.5 m was required before fields fell below the guidelines for other personnel. These results demonstrate, under a worst case scenario, emissions from SWD exceed the guidelines for operators at distances currently recommended as safe. Future guidelines should include recommendations for personnel other than physiotherapists.

  9. An evaluation of safety guidelines to restrict exposure to stray radiofrequency radiation from short-wave diathermy units

    International Nuclear Information System (INIS)

    Shields, Nora; O'Hare, Neil; Gormley, John

    2004-01-01

    Short-wave diathermy (SWD), a form of radiofrequency radiation used therapeutically by physiotherapists, may be applied in continuous (CSWD) or pulsed (PSWD) mode using either capacitive or inductive methods. Stray radiation emitted by these units may exceed exposure guidelines close to the equipment. Discrepant guidelines exist on a safe distance from an operating unit for operators and other personnel. Stray electric (E-field) and magnetic (H-field) field strengths from 10 SWD units in six departments were examined using a PMM 8053 meter and two isotropic probes (EP-330, HP-032). A 5 l saline phantom completed the patient circuit. Measurements were recorded in eight directions between 0.5 m and 2 m at hip and eye levels while the units operated at maximum output and data compared to current guidelines. Results found stray fields from capacitive CSWD fell below operator limits at 2 m (E-field 4.8-39.8 V/m; H-field 0.015-0.072 A/m) and at 1 m for inductive CSWD (E-field 0-36 V/m; H-field 0.01-0.065 A/m). Capacitive PSWD fields fell below the limits at 1.5 m (E-field 1.2-19.9 V/m; H-field 0.002-0.045 A/m) and at 1m for inductive PSWD (E-field 0.7-4.0 V/m; H-field 0.009-0.03 A/m). An extra 0.5 m was required before fields fell below the guidelines for other personnel. These results demonstrate, under a worst case scenario, emissions from SWD exceed the guidelines for operators at distances currently recommended as safe. Future guidelines should include recommendations for personnel other than physiotherapists

  10. The effect of myofascial release and microwave diathermy combined with acupuncture versus acupuncture therapy in tension-type headache patients: A pragmatic randomized controlled trial.

    Science.gov (United States)

    Georgoudis, George; Felah, Bledjana; Nikolaidis, Pantelis; Damigos, Dimitrios

    2018-04-01

    Nonpharmacological therapies for tension-type headache (TTH) and cervicogenic cephalalgia are often a treatment choice, despite the weak to moderate evidence. The aim of this study was to compare the effectiveness of an acupuncture/stretching protocol versus acupuncture/stretching plus physiotherapy techniques, in patients with TTH cephalalgia. A single-blind, prospective, multicentre, randomized controlled trial was designed considering the pragmatic situation of administering such protocols and treating the 44 headache patients participating in this study. The patients were randomly assigned in 2 treatment groups (control group, n = 20, acupuncture/stretching; experimental group, n = 24, acupuncture/stretching plus physiotherapy) and completed 10 treatment sessions within 4 weeks with measurements taking place before treatment, after the fifth treatment and after the 10th treatment. The mechanical pressure pain threshold (PPT) was considered as the main outcome measure, using a mechanical algometer to measure 7 bilateral somatic points. Acupuncture in both groups included 17-20 acupuncture points, whereas stretching was initially taught and subsequently self-administered (self-stretches), following a standardized set of movements of the cervical spine. Physiotherapy consisted of microwave diathermy and myofascial release with hands-on techniques. An improvement was noted in both groups/treatments regarding the main outcome measure PPT, all the way from the first to fifth and the 10th treatment, at all measuring sites and at all measurements in both groups (p acupuncture and stretching but further PPT improvements were evidenced when physiotherapy hands-on techniques were added. In clinical terms, the combination of physiotherapy in the form of myofascial release and microwave diathermy with acupuncture and stretching in order to improve the analgesic effect (PPT) is strongly recommended. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Does unilateral laparoscopic diathermy adjusted to ovarian volume increase the chances of ovulation in women with polycystic ovary syndrome?

    Science.gov (United States)

    Sunj, M; Canic, T; Baldani, D P; Tandara, M; Jeroncic, A; Palada, I

    2013-09-01

    Does unilateral volume-adjusted laparoscopic diathermy increase the chances of ovulation in women with polycystic ovary syndrome (PCOS)? Although unilateral laparoscopic ovarian drilling (ULOD) using adjusted thermal doses was more efficient than bilateral laparoscopic ovarian drilling (BLOD) using fixed doses, the chances of ovulation were improved in patients irrespective of the technique used. The adjustment of the thermal dose to ovarian volume in BLOD increases ovulation and pregnancy rates compared with fixed-dose treatment, but BLOD causes the formation of adhesions, particularly on the left ovary, and increases the risk of damage to ovarian tissue. In contrast, ULOD with a fixed thermal dose minimizes the risk of ovarian tissue damage, and can increase the activity in both right and left ovaries, although this varies in humans and in other species. This prospective, longitudinal, study, between September 2009 and January 2013, included 96 infertile women with PCOS who were unresponsive to clomiphene citrate treatment and had underwent either ULOD or BLOD. After surgery, the groups were followed up for 6 months to assess ovulatory response. Patients were assigned to two groups; one group underwent laparoscopic ovarian drilling of the right ovary alone, while both ovaries were treated in the second group. The ULOD group (n = 49) received thermal doses adjusted to the volume of the right ovary (60 J/cm³). The BLOD group (n = 47) received fixed doses of 600 J per ovary, regardless of its volume. The two treatment groups were matched by the number of participants, age and baseline parameters. The ovulation rate during the first menstrual cycle after LOD was significantly higher in the ULOD group than in the BLOD group [73 versus 49%; absolute risk reduction (ARR), -0.25; 95% confidence interval (CI), -0.44 to -0.03; P = 0.014]. Treatment with ULOD on the right ovary significantly increased the chances of ovulation in patients with a larger right ovary compared

  12. Comparison of efficacy of carbon dioxide (CO/sub 2/) laser with cutting diathermy in surgical excision of early carcinoma tongue

    International Nuclear Information System (INIS)

    Rashid, M.; Hashmi, M.A.; Dastigir, M.

    2015-01-01

    To compare the efficacy of carbon dioxide (CO/sub 2/) laser with cutting diathermy as a cutting device in surgical excision of early carcinoma tongue. Study Design: Experimental study. Place and Duration of Study: Combined Military Hospital (CMH), Rawalpindi and CMH, Lahore, from July 2008 to July 2011. Methodology: Twenty two biopsy proven cases of T1 and early T2 squamous cell carcinoma of tongue were divided in two equal groups of 11 each labeled as A and B. Tumor was excised by CO/sub 2/ laser in group A while cutting diathermy was done in group B. For both groups tumor excision time, per-operative blood loss, postoperative oral swelling and pain was recorded. Excision time of tumor was assessed in minutes and amount of blood loss in milliliters till complete hemostasis after removal of primary tumor. Postoperatively patients were assessed on 12 hourly basis for 48 hours for pain. Pain was analyzed on visual analogue score 1 - 10. Oral swelling was assessed once after 24 hours and labeled as mild, moderate and severe. Independent sample t-test was applied for analysis of excision time, postoperative pain and per-operative blood loss for both groups. Postoperative swelling was analyzed using Fisher exact test. P-value of < 0.05 was considered significant. Results: The mean age at diagnosis in group A was 49.36 ± 5.27 years, while in group B patients had mean age of 50.73 ± 8.13 years. In group A, 4/11 (36.3%) patients were having tumor stage T1 while 7/11 (63.6%) had T2 stage tumor. In group B, 5/11 (45.4%) were having T1 and 6/11 (54.5%) were having stage T2 tumor. Excision time was significantly shorter for group B (p=0.003), but group A had less postoperative pain (p=0.001), less per-operative blood loss (p=0.001) and less postoperative oral swelling (p=0.021). Conclusion: Early carcinoma tongue is better removed by laser than electrocautery in terms of postoperative morbidity, per-operative blood loss, postoperative pain and oral swelling. (author)

  13. LATIHAN CLOSED KINETIC CHAIN LEBIH BAIK DARIPADA OPEN KINETIC CHAIN UNTUK MENINGKATKAN KEMAMPUAN FUNGSIONAL PADA OSTEOARTHRITIS LUTUT SETELAH PEMBERIAN MICRO WAVE DIATHERMY (MWD DAN TRANSCUTANEUS ELECTRICAL NERVE STIMULATION (TENS

    Directory of Open Access Journals (Sweden)

    Indri Susilawati

    2015-01-01

    Full Text Available Knee osteoarthritis is a disease caused by degenerative factors that mostly found in musculoskeletal and knee osteoarthritis has the most common cause to limited motion and body function. People with osteoarthritis usually complain of pain, stifftess and limitation of function. This study aimed to determine closed kinetic chain exercise was better than open kinetic chain to increase functional capability of knee osteoarthritis after giving treatment micro wave diathermy (MWD and transcutaneus electrical nerve stimulation (TENS. The design of this research was true experimental pre-test and post-test with control group design, which the population was taken by purposively sampling. Division of the sample into two groups, group one consisted of 6 people. The first group was given MWD, TENS and Closed Kinetic Chain exercise and group two was given MWD, TENS and Open Kinetic Chain exercise. The frequency of exercise are 3 times a week for 4 weeks. Subjects were all patients with knee osteoarthritis who had been diagnosed through assesment procedures conducted in General Hospital of Mataram–Lombok, West Nusa Tenggara. Analysis of significance with Paired t-test (paired showed that in each group resulted in an increase in functional ability after treatment of knee osteoarthritis is significantly different (p<0.05. While a difference test in both groups after treatment using analysis test of Independent t-test (unpaired showed that the value of t = 2.748 and p = 0.021. So thah there was an increase functional capabilities of knee osteoarthritis after treatment (p<0.05. In conclution the treatment conducted in group one which was MWD, TENS and Closed Kinetic Chain proved improvement of the functional capabilities of  knee osteoarthritis better than treatment conducted in group two, namely the MWD, TENS and Open Kinetic Chain.

  14. 21 CFR 890.5290 - Shortwave diathermy.

    Science.gov (United States)

    2010-04-01

    ... within body tissues for the treatment of selected medical conditions such as relief of pain, muscle spasms, and joint contractures, but not for the treatment of malignancies. (2) Classification. Class II...

  15. 21 CFR 890.5275 - Microwave diathermy.

    Science.gov (United States)

    2010-04-01

    ... within body tissues for the treatment of selected medical conditions such as relief of pain, muscle spasms, and joint contractures, but not for the treatment of malignancies. (2) Classification. Class II...

  16. Transvaginal ultrasound ovarian diathermy: sheep as an experimental model

    Directory of Open Access Journals (Sweden)

    Pimentel Anita M

    2012-01-01

    Full Text Available Abstract Background Some techniques of transvaginal ovarian drilling have been previously described. Nevertheless a monopolar transvaginal ovarian cauterization, that use the expertise and safety of transvaginal puncture for oocyte captation seems to be an easier and feasible approach. The aim of this study was to develop a minimally invasive ovarian cauterization technique under transvaginal ultrasound control, and to evaluate the safety of the transvaginal ovarian monopolar cauterization, female sheep at reproductive age were used as an experimental model. Findings An experimental study was performed in a university research center. Seventeen female sheep (15 Corriedale e 2 Suffolk in reproductive age were submitted to transvaginal ovarian cauterization with a monopolar Valleylab Force 2 electrocautery. Macroscopic and microscopic lesions were assessed. Ovarian size were 1.31 cm2 ± 0,43 (Corriedale and 3.41 cm2 ± 0,64 (Suffolk. From 30 ovaries from Corriedale sheep punctured, only 3 were cauterized, presenting macroscopic and typical microscopic lesion. In the Suffolk sheep group, only one ovary was cauterized. No lesion could be found in the needle path. Conclusions This is the first experimental animal model described for ovarian cauterization needle guided by transvaginal ultrasound. The sheep does not seem to be the ideal animal model to study this technique. Another animal model, whose ovaries are better identified by transvaginal ultrasound should be sought for this technique, theoretically less invasive, before it could be offered safely to women with polycystic ovary syndrome.

  17. Diathermy versus Scalpel Incision in a Heterogeneous Cohort of ...

    African Journals Online (AJOL)

    blood loss and the ensuing length and depth of the wound were noted. Postoperative pain; duration of wound healing and the occurrence of surgical site infection were also noted. Results: There were 197 patients consisting of the scalpel group (n = 98) and the electrocautery group (n = 99). The ages ranged from 16 to 73 ...

  18. Post-tonsillectomy hemorrhage after bipolar diathermy vs. cold ...

    African Journals Online (AJOL)

    Ibrahim K. Aljabr

    2015-08-17

    Aug 17, 2015 ... Abstract Introduction: Tonsillectomy is a common surgical procedure done by otolaryngologists. Tonsillectomy ... Tonsillectomy dates back over 2000 years1 and is now the most .... Tomkinson et al.9 reported that patients older than 12 years .... 12. Windfuhr JP, Chen YS, Remmert S. Hemorrhage following.

  19. Hormonal Changes After Laparoscopic Ovarian Diathermy in Patients with Polycystic Ovarian Syndrome.

    Science.gov (United States)

    Elnaggar, Elsayed A; Elwan, Youssef Abo; Ibrahim, Safaa A; Abdalla, Mena M

    2016-10-01

    To assess the changes in hormonal profile (serum FSH, LH, prolactin and total testosterone) following laparoscopic ovarian drilling (LOD) in patients with polycystic ovarian syndrome. Fifty patients with PCOS have been included in this study. Serum prolactin, total testosterone, follicular-stimulating hormone (FSH) and luteinizing hormone (LH) levels have been used as biochemical markers, before and after procedures. Laparoscopic ovarian drilling was successfully employed without any surgical complications and on an average follow-up time of 24 weeks after the procedure. During the follow-up serum values for prolactin, total testosterone and LH have decreased significantly and FSH levels remained unchanged after the procedure. The LOD in patients with PCOS may avoid or reduce the risk of OHSS and the multiple pregnancy rate induced by gonadotropin therapy. The high pregnancy rate and the economic aspect of the procedure offer an attractive management for patients with PCOS. However, LOD can be considered as second-line treatment after clomiphene citrate treatment failure and/or resistance.

  20. Can exposure to electromagnetic radiation in diathermy operators be estimated from interview data A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, A.I.; Skotte, J. (Central Hospital, Esbjerg (Denmark))

    1991-01-01

    As preparation for a case-control study dealing with possible teratogenic property of short waves, a pilot study was conducted in order to compare exposure assessment from different sources. In 11 physiotherapy clinics, exposure assessments based on interviews within 1 week among the exposed physiotherapists were compared with exposure assessments based on observations including measurements. It was possible to discriminate between recent high and low peak exposure. Furthermore, an interview index reflecting the duration of the exposure correlated to some extent with the corresponding measurements.

  1. [Design of High Frequency Signal Detecting Circuit of Human Body Impedance Used for Ultrashort Wave Diathermy Apparatus].

    Science.gov (United States)

    Fan, Xu; Wang, Yunguang; Cheng, Haiping; Chong, Xiaochen

    2016-02-01

    The present circuit was designed to apply to human tissue impedance tuning and matching device in ultra-short wave treatment equipment. In order to judge if the optimum status of circuit parameter between energy emitter circuit and accepter circuit is in well syntony, we designed a high frequency envelope detect circuit to coordinate with automatic adjust device of accepter circuit, which would achieve the function of human tissue impedance matching and tuning. Using the sampling coil to receive the signal of amplitude-modulated wave, we compared the voltage signal of envelope detect circuit with electric current of energy emitter circuit. The result of experimental study was that the signal, which was transformed by the envelope detect circuit, was stable and could be recognized by low speed Analog to Digital Converter (ADC) and was proportional to the electric current signal of energy emitter circuit. It could be concluded that the voltage, transformed by envelope detect circuit can mirror the real circuit state of syntony and realize the function of human tissue impedance collecting.

  2. 77 FR 39953 - Effective Date of Requirement for Premarket Approval for Shortwave Diathermy for All Other Uses

    Science.gov (United States)

    2012-07-06

    ... bands to treat medical conditions other than malignancies through means other than heat. The devices are... body electromagnetic energy in the radio frequency bands of 13 megahertz to 27.12 megahertz and is intended for the treatment of medical conditions by means other than the generation of deep heat within...

  3. Effect of Stretching Combined With Ultrashort Wave Diathermy on Joint Function and Its Possible Mechanism in a Rabbit Knee Contracture Model.

    Science.gov (United States)

    Zhang, Quan Bing; Zhou, Yun; Zhong, Hua Zhang; Liu, Yi

    2018-05-01

    The aim of this study was to investigate the therapeutic effect of stretching combined with ultrashort wave on joint contracture and explore its possible mechanism. Thirty-two rabbits underwent unilateral immobilization of a knee joint at full extension to cause joint contracture. At 6 wks after immobilization, the rabbits were randomly divided into the following four groups: natural recovery group, stretching treatment group, ultrashort wave treatment group, and combined treatment group. For comparison, eight control group animals of corresponding age were also examined. The effect of stretching and ultrashort wave treatment on joint contracture was assessed by measuring the joint range of motion, evaluating the collagen deposition of joint capsule and assessing the mRNA and protein levels for transforming growth factor β1 in the joint capsule. The combined treatment group led to the best recovery of joint function. The combined treatment with stretching and ultrashort wave was more effective than stretching or ultrashort wave treatment alone against the synovial thickening of suprapatellar joint capsule, the collagen deposition of anterior joint capsule, and the elevated expression of transforming growth factor β1 in the joint capsule. Stretching combined with ultrashort wave treatment was effective in improving joint range of motion, reducing the biomechanical, histological, and molecular manifestations of joint capsule fibrosis in a rabbit model of extending joint contracture.

  4. Efeito agudo da crioterapia e diatermia na flexibilidade e força muscular de isquiotibiais = Acute effect of cryotherapy and diathermy in the hamstring flexibility and muscle strength

    Directory of Open Access Journals (Sweden)

    Dohnert, Marcelo Baptista

    2017-01-01

    Full Text Available Objetivo: Verificar o efeito agudo da crioterapia e da diatermia por ondas curtas na flexibilidade e força muscular de isquiotibiais de adultas jovens. Materiais e Métodos: Quarenta e cinco voluntárias foram randomizadas em grupo controle, grupo crioterapia e grupo diatermia por ondas curtas. Os sujeitos foram submetidos a uma única aplicação de crioterapia ou diatermia por ondas curtas. Foram avaliadas, pré e pós intervenção, a flexibilidade através do banco de Wells e do ângulo de extensão ativa do joelho, e a força muscular através da dinamometria. As variáveis foram analisadas por meio do teste t de Student e ANOVA. Resultados: Verificou-se um aumento significativo da flexibilidade dos isquiotibiais, tanto através do banco de Wells (24,50±6,88 cm para 26,87±8,02 cm (p=0,002, quanto na extensão ativa do joelho (162,60±7,76 graus para 165,53 ± 6,38 graus (p=0,015 no grupo diatermia. O grupo crioterapia mostrou melhora da flexibilidade no banco de Wells (23,27±6,33 cm para 25,53±6,13 cm (p=0,002. Não ocorreu aumento significativo da força muscular em nenhum dos grupos de intervenção. Não foi verificada diferença entre os grupos do estudo. Conclusão: Tanto a diatermia quanto a crioterapia melhoraram, de forma aguda, a flexibilidade dos isquiotibiais em mulheres adultas jovens e saudáveis. A termoterapia através da diatermia por ondas curtas mostrou-se mais efetiva nessa melhora. Ambos os recursos não alteraram a força muscular produzida pelos isquiotibiais

  5. Exposure to radiowaves in physiotherapy

    International Nuclear Information System (INIS)

    Gobbato, F.; Valentinuzzi, C.

    1988-01-01

    An assessment of the electromagnetic fields emitted from short and ultra short wave diathermy sources was made to evaluate the hazards to the operator and patient. In ultra short wave diathermy the power density depends on the direction of the emission and decreases with the square of the distance from the source. Regression functions between power density and distance were calculated and analysed statistically. It is possible to calculate a simple algorithm in short wave diathermy, so the field must be mapped from direct measurements. Operator safety is easy to achieve by following simple procedures. Particular caution must be used to protect the patient from exposure of critical biological organs

  6. Epistaxis

    DEFF Research Database (Denmark)

    Rasmussen, Eva Rye; Larsen, Per Leganger; Arndal, Helge

    2012-01-01

    Epistaxis is a common clinical condition that can be challenging. Anterior epistaxis is managed by compression, cauterization or diathermy. Merocel and Rapid Rhino nasal packs are often successfully used. Refractory posterior epistaxis should be handled by otorhinolaryngologists. If conservative...

  7. Argon Beam Coagulator in Breast Surgery: Effect on the Incidence of Breast Seroma.

    Science.gov (United States)

    Lefemine, Valentina; Cornish, Julie A; Abou-Samra, Walid

    2011-12-01

    Although Argon Beam Coagulators (ABCs) are widely used in urological and gynecological procedures, there have been only two studies published so far on their use and benefits in breast surgery. This study compares the incidence of breast seroma following mastectomy upon the use of ABC versus standard monopolar diathermy. This is a retrospective cohort study, with data collected from January 2006 to August 2008 for all patients who underwent a simple mastectomy and axillary surgery. Outcomes included incidence of seroma, amount of drainage on day of discharge, and timing of seroma formation. Fifty-six patients were studied, with 30 undergoing simple mastectomy using ABC diathermy and 25 using simple diathermy. The incidence of postoperative breast seroma development was 30% (n = 9) in the former group and 36% (n = 9) in the latter. In the ABC group, a high postoperative drainage at discharge was predictive of developing a seroma; this was not observed in the monopolar group. The search for methods to reduce the incidence of seroma in breast surgery is ongoing worldwide. Despite a previous report, this study failed to show any significant difference between ABC and monopolar diathermy in the incidence of breast seroma formation following simple mastectomy and axillary surgery. ABC diathermy is more costly, and its use needs to be carefully considered in an era of a stretched National Health Service financial budget.

  8. Exposure to non-ionizing radiation provokes changes in rat thyroid morphology and expression of HSP-90

    OpenAIRE

    Misa-Agustiño, Maria J; Jorge-Mora, Teresa; Jorge-Barreiro, Francisco J; Suarez-Quintanilla, Juan; Moreno-Piquero, Eduardo; Ares-Pena, Francisco J; López-Martín, Elena

    2015-01-01

    Non-ionizing radiation at 2.45 GHz may modify the morphology and expression of genes that codify heat shock proteins (HSP) in the thyroid gland. Diathermy is the therapeutic application of non-ionizing radiation to humans for its beneficial effects in rheumatological and musculo-skeletal pain processes. We used a diathermy model on laboratory rats subjected to maximum exposure in the left front leg, in order to study the effects of radiation on the nearby thyroid tissue. Fifty-six rats were i...

  9. Anaesthetic management of a patient with deep brain stimulation implant for radical nephrectomy

    Directory of Open Access Journals (Sweden)

    Monica Khetarpal

    2014-01-01

    Full Text Available A 63-year-old man with severe Parkinson′s disease (PD who had been implanted with deep brain stimulators into both sides underwent radical nephrectomy under general anaesthesia with standard monitoring. Deep brain stimulation (DBS is an alternative and effective treatment option for severe and refractory PD and other illnesses such as essential tremor and intractable epilepsy. Anaesthesia in the patients with implanted neurostimulator requires special consideration because of the interaction between neurostimulator and the diathermy. The diathermy can damage the brain tissue at the site of electrode. There are no standard guidelines for the anaesthetic management of a patient with DBS electrode in situ posted for surgery.

  10. Download this PDF file

    African Journals Online (AJOL)

    dell

    midline laparotomy in our local setting with an aim to evaluate diathermy as an effective alternative ... Traditionally skin incisions are made by scalpels with disposable knives, these incision are more bloody and ... (Group A), scalpel with disposable blade was used to incise skin till peritoneum whereas in group. 'B' incision ...

  11. Impact of the introduction of a colposcopy service in a rural South ...

    African Journals Online (AJOL)

    Africa, and assess its impact on colposcopy uptake. Design. A retrospective double-group cohort .... existing diathermy machine with disposable large loop excision of the transformation zone (LLETZ) loops and ..... What is the least costly strategy to evaluate cervical abnormalities in rural women? Comparing telemedicine ...

  12. Management of Small Urethrocutaneous Fistula by Tight Ligation ...

    African Journals Online (AJOL)

    After identifying the fistulous opening, the fistula tract was circumferentially and meticulously dissected ,then the dissected tract was lifted up and the base was ligated tightly with 5/0 vicryl, the external epithelium of the dissected tract was fulgurated with the diathermy, then a second layer of local soft tissue was secured over ...

  13. ISSN 2073 ISSN 2073-9990 East Cent. Afr. J. surg. (Online) 90 East ...

    African Journals Online (AJOL)

    DELL

    Pinder D, Hilton M. Dissection versus diathermy for tonsillectomy. Cochrane Database Syst Rev. 2001;(4):CD002211. 3. Gendy S, O'leary M, Colreavy M, Rowley H, O'Dwyer T, Blayney A. Tonsillectomy- cold dissection versus hot dissection: a prospective study. Ir Med J 2005; 98(10):243-4. 4. Leach J, Manning S, Schaefer ...

  14. Third prize : A blinded randomized clinical trial of manual therapy and physiotherapy for chronic back and neck complaints: Physical outcome measures

    NARCIS (Netherlands)

    Koes, B. W.; Bouter, L. M.; Van Mameren, H.; Essers, A. H M; Verstegen, G. M J R; Hofhuizen, D. M.; Houben, J. P.; Knipschild, P. G.

    1992-01-01

    In a blinded randomized clinical trial, we compared the effectiveness of manual therapy, physiotherapy, (continued) treatment by the general practitioner (GP), and a placebo therapy (detuned ultrasound and detuned short wave diathermy) for patients (n = 256) with chronic nonspecific back and neck

  15. The effectiveness of manual therapy, physiotherapy, and treatment by the general practitioner for nonspecific back and neck complaints : A randomized clinical trial

    NARCIS (Netherlands)

    Koes, B. W.; Bouter, L. M.; Van Mameren, H.; Essers, A. H.; Verstegen, G. M.; Hofhuizen, D. M.; Houben, J. P.; Knipschild, P. G.

    1992-01-01

    In a randomized trial, the effectiveness of manual therapy, physiotherapy, continued treatment by the general practitioner, and placebo therapy (detuned ultrasound and detuned short-wave diathermy) were compared for patients (n = 256) with nonspecific back and neck complaints lasting for at least 6

  16. FACTORS AFFECTING BLOOD LOSS DURING OpEN REDUCTION ...

    African Journals Online (AJOL)

    The use of diathermy and positioning of the patient in a way that encourages free venous drainage at the operative site (1) is a practical and inexpensive way of minimising blood loss during surgery. The operative site should be a little above the level of the heart (1). Good anaesthetic technique reduces episodes of.

  17. Examples of Radiation-Emitting Products

    Science.gov (United States)

    ... Ultrasonography • Doppler ultrasound • Color doppler ultrasound • Hyperthermia • Diathermy/physical therapy • Bone healing • Lithotripsy • Phacoemulsifier • Needle guide • Bone density measuring • Geriatric bath (ultrasound) • Hearing aid • Many scientific uses • Nondestructive ...

  18. WAJM 28(3)FINAL6cd.pmd

    African Journals Online (AJOL)

    daddy

    Giant Guteal Schwannoma avec l'extension dans le Bassin : un rapport de cas ... complexe géant schwannoma et accentuer la valeur d'enquêtes étendues en .... section of the slide shows the Antoni Type ... and diathermy coagulation.

  19. Management of third branchial pouch anomalies - an evolution of a minimally invasive technique.

    Science.gov (United States)

    Wong, Phui Yee; Moore, Andrew; Daya, Hamid

    2014-03-01

    The management of third branchial pouch anomalies has evolved in recent times with the popularisation of the endoscopic diathermy technique to sclerose the pyriform fossa sinus opening. We present our experience in managing 3 children with third branchial pouch anomalies and propose a minimally invasive management algorithm avoiding open neck surgery. Retrospective case review of 3 patients including demographics, mode of presentation, investigations, management and complications. Three children, two male and one female of mean age 9.6 years presented with painful left anterior neck swelling. Axial neck imaging showed a superficial abscess with air locules and a sinus tract leading towards the left pharynx. Diagnosis was confirmed by endoscopic examination of the pyriform fossa revealing a sinus opening. Two patients underwent open excision; one combined with diathermy to the sinus opening. The last patient was diagnosed at his initial presentation and managed with endoscopic diathermy of the sinus opening combined with percutaneous needle aspiration of the neck abscess at the same sitting. One patient had two recurrences, the first after initial open surgery and the second after the first cautery. Two patients developed temporary hoarseness after the procedure, which resolved within two weeks. All patients were free from recurrences at follow-up. Introduction of the technique of endoscopic diathermy to the pyriform fossa sinus opening in children with third branchial pouch anomalies has revolutionised their management avoiding open and potentially morbid surgery. Our algorithm takes this further by advocating percutaneous needle aspiration of the infective component and performing diathermy to the sinus opening at the first presentation. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  20. Comparison of thermal and hemodynamic responses in skin and muscles to heating with electric and magnetic field

    Directory of Open Access Journals (Sweden)

    Karmen Glažar

    2015-06-01

    Full Text Available 12.00 Introduction: It has been shown that sufficient amount of energy provided by electromagnetic diathermy induces the increase of skin temperature and underlying tissues. However, scarce information is available on the differences in responses initiated by various techniques of diathermy. The goal of the present study was to compare thermal and hemodynamic responses of the skin and underlying muscles of the forearm to diathermy applied with electric (EF or magnetic field (MF. Methods: Eleven healthy volunteers participated in the study. On two separate occasions, they randomly received 20-minut diathermy with EF or with MF. Skin and tympanic temperature, and heart rate were measured. Further, kinetics of muscle oxyhemoglobin and deoxyhemoglobin kinetics were obtained. Thermal perception and thermal comfort were noted through the application of EF and MF. Results: The skin temperature increased similarly during the administration of EF and MF, by ~ 8.0 ± 1.3°C on both occasions. The thermal perception was more intense during the application of EF. Accordingly, the thermal comfort during the application of EF was perceived as less comfortable as compared with MF. During MF the increase in minute muscle blood flow and oxygen consumption was for ~ 42 % higher compared to the heating with EF. Conclusion: Although the increase in skin temperature was similar between EF and MF, the application of diathermy with MF was perceived more comfortable by the participants. Furthermore, the increase in minute muscle blood flow and oxygen consumption was higher in MF compared with EF. Thus, when muscle is the target tissue for physical therapy, a diathermy with magnetic field is the technique of choice. Normal 0 21 false false false SL X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Navadna tabela"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso

  1. Some radiation safety aspects of operating medical generators of VHF electromagnetic energy

    International Nuclear Information System (INIS)

    Bosevski, V.; Radev, S.; Donev, Ch.

    1977-01-01

    The state of radiation safety in physiotherapy practice using very-high-frequency diathermy was studied with regard to personnel and patient protection. A specially devised shielding set to protect patients and personnel is offered for adoption, and the necessity is insistently stressed of prohibiting any patient head or gonad exposure. It is pointed out that the protective set developed may also be used at facilities employing other types of VHF electromagnetic energy sources. (author)

  2. A simple lens-sparing technique to treat hypotonic maculopathy secondary to large cyclodialysis

    OpenAIRE

    Masayo Kimura; Tsutomu Yasukawa; Yuichiro Ogura

    2018-01-01

    Purpose: Hypotonic maculopathy secondary to cyclodialysis often persists and causes irreversible visual loss despite a variety of treatments proposed. The purpose of this study is to report two cases with persistent hypotonic maculopathy due to a large cyclodialysis cleft treated with a simple, lens-sparing technique of external drainage, diathermy, and suturing under the placement of an infusion cannula. Observations: Both patients had sustained blunt trauma to one eye, causing persisting hy...

  3. Anaesthesia for a patient with Deep Brain Stimulator: Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Raj mala

    2014-07-01

    Full Text Available Deep brain stimulator (DBS devices are used for unilateral or bilateral stimulation of thalamus, subthalamus and globus pallidus to treat movement disorders. DBS can interfere with domestic and medical equipment such as electrocardiography (ECG, slow wave diathermy, electrocautery, peripheral nerve stimulators, pacemakers, external and implantable cardioverters and defibrillators. This case report describes a patient with such a device who presented for bilateral (B/L cataract surgery.

  4. Ignorance of electrosurgery among obstetricians and gynaecologists.

    Science.gov (United States)

    Mayooran, Zorana; Pearce, Scott; Tsaltas, Jim; Rombauts, Luk; Brown, T Ian H; Lawrence, Anthony S; Fraser, Kym; Healy, David L

    2004-12-01

    The purpose of this study was to assess the level of skill of laparoscopic surgeons in electrosurgery. Subjects were asked to complete a practical diathermy station and a written test of electrosurgical knowledge. Tests were held in teaching and non-teaching hospitals. Twenty specialists in obstetrics and gynaecology were randomly selected and tested on the Monash University gynaecological laparoscopic pelvi-trainer. Twelve candidates were consultants with 9-28 years of practice in operative laparoscopy, and 8 were registrars with up to six years of practice in operative laparoscopy. Seven consultants and one registrar were from rural Australia, and three consultants were from New Zealand. Candidates were marked with checklist criteria resulting in a pass/fail score, as well as a weighted scoring system. We retested 11 candidates one year later with the same stations. No improvement in electrosurgery skill in one year of obstetric and gynaecological practice. No candidate successfully completed the written electrosurgery station in the initial test. A slight improvement in the pass rate to 18% was observed in the second test. The pass rate of the diathermy station dropped from 50% to 36% in the second test. The study found ignorance of electrosurgery/diathermy among gynaecological surgeons. One year later, skills were no better.

  5. Does circumpatellar electrocautery improve the outcome after total knee replacement?: a prospective, randomised, blinded controlled trial.

    Science.gov (United States)

    Baliga, S; McNair, C J; Barnett, K J; MacLeod, J; Humphry, R W; Finlayson, D

    2012-09-01

    The incidence of anterior knee pain following total knee replacement (TKR) is reported to be as high as 49%. The source of the pain is poorly understood but the soft tissues around the patella have been implicated. In theory circumferential electrocautery denervates the patella thereby reducing efferent pain signals. However, there is mixed evidence that this practice translates into improved outcomes. We aimed to investigate the clinical effect of intra-operative circumpatellar electrocautery in patients undergoing TKR using the LCS mobile bearing or Kinemax fixed bearing TKR. A total of 200 patients were randomised to receive either circumpatellar electrocautery (diathermy) or not (control). Patients were assessed by visual analogue scale (VAS) for anterior knee pain and Oxford knee score (OKS) pre-operatively and three months, six months and one year post-operatively. Patients and assessors were blinded. There were 91 patients in the diathermy group and 94 in the control. The mean VAS improvement at one year was 3.9 in both groups (control; -10 to 6, diathermy; -9 to 8, p electrocautery on either VAS anterior knee pain or OKS for patients undergoing LCS and Kinemax TKR.

  6. Monopolar electrodissection versus cold dissection tonsillectomy among children

    International Nuclear Information System (INIS)

    Bukhari, Manal A.; Al-Ammar, Ahmed Y.

    2007-01-01

    To compare cold dissection to monopolar tonsillectomy in terms of operative time, intraoperative bleeding, post operative bleeding. The study included 100 children who underwent tonsillectomy between January 2002 and January 2004. This study was carried out at King Abdul-Aziz University Hospital, Riyadh, Kingdom of Saudi Arabia. Patients were randomly selected to have either the right or left tonsils removed by either technique (cold dissection or monopolar dissection technique). We compared both techniques in each side on the same patient. There was no significant difference in operative time between both sides by either technique, however, when the patients were grouped into 3 minute groups, the result showed that a greater number of patients were operated up on <-3 minutes by diathermy procedure compared to dissection method (44 versus 67) (p=0.0011). Blood loss was minimal with the diathermy technique, averaging 25.37 ml compared to 88.5 for cold dissection tonsillectomy. There was a significant increase in postoperative pain on the first postoperative day in the diathermy group compared to the cold dissection group (27% versus 12%) (p=0.0151). However, there was no significant difference in pain between both sides in the first 24 hours and from the 2nd to 10th postoperative days. Monopolar dissection tonsillectomy is a safe technique. It significantly reduces the operative time and intraoperative blood loss. However, it causes more pain on the 1st postoperative day, while on the rest of the days until the 10th postoperative day, there was no significant difference in pain between two sides. (author)

  7. Treatment of Ureterointestinal Anastomotic Strictures by Diathermal or Cryoplastic Dilatation

    International Nuclear Information System (INIS)

    Orsi, Franco; Penco, Silvia; Matei, Victor; Bonomo, Guido; Vigna, Paolo Della; Monfardini, Lorenzo; Cobelli, Ottavio De

    2007-01-01

    Background. Ureterointestinal anastomotic strictures (UAS) complicate 10-15% of surgeries for urinary diversion and are the main cause of deterioration in renal function. Treatments are surgical revision, management with autostatic stent, balloon dilatation, endoscopic incision, and percutaneous transrenal diathermy (Acucise). A new option is cryoplastic dilatation (Polar-Cath). Purpose. To assess the feasibility, complications, and preliminary results of UAS treatment using the Acucise and Polar-Cath systems. Methods. Nineteen UAS, diagnosed by ultrasonography or computed tomography and sequential renal scintigraphy, occurred in 15 cancer patients after radical cystectomy and urinary diversion. Fifteen were managed with balloon diathermy and 4 by balloon cryoplasty in a three-stage procedure-percutaneous nephrostomy, diathermal or cryoplastic dilatation, and transnephrostomic control with nephrostomy removal-each separated by 15 days. All patients gave written informed consent. Results. Dilatations were successful in all cases. The procedure is simple and rapid (about 45 min) under fluoroscopic control and sedation. Procedural complications occurred in 1 (5%) patient with UAS after Wallace II uretero-ileocutaneostomy: a common iliac artery lesion was induced by diathermal dilatation, evident subsequently, and required surgical repair. Patency with balloon diathermy was good, with two restenoses developing over 12 months (range 1-22) of follow-up. With balloon cryoplastic dilatation, one restenosis developed in the short term; follow-up is too brief to assess the long-term efficacy. Conclusion. Our short-term results with diathermal and cryoplastic dilatation to resolve UAS are good. If supported by longer follow-up, the techniques may be considered as first-choice approaches to UAS. Surgery should be reserved for cases in which this minimally invasive technique fails

  8. Assessment of occupational exposure to radio frequency electromagnetic fields

    Directory of Open Access Journals (Sweden)

    Halina Aniołczyk

    2015-06-01

    Full Text Available Background: European Union Directive 2013/35/UE provides for the implementation of EU regulations into national legislation. Our aim is to assess actual health hazards from radiofrequency electromagnetic field (RF EMF (range: 100 kHz – 300 GHz and indicate workplaces with the highest risk to employee health. Material and Methods: Data from measurements of RF EMF performed by the Laboratory of Electromagnetic Hazards in Nofer Institute of Occupational Medicine (Łódź, Poland were analyzed. The analysis covered the results of electric field intensity (E for over 450 selected items. The ranges of protection zones and the extent to which maximum admissible intensity (MAI values were also analyzed. The determinations and measurements of EMF in the work environment met the requirements of Polish Standard, while Polish regulations on the MAI values were used as the criterion for the assessment of the exposure. Results: The highest values of E field intensity at workplaces were measured for: electrosurgery, to 400 V/m, and short-wave diathermy units, to 220 V/m, dielectric welders to 240 V/m, within the FM radio antenna systems, to 180 V/m. The widest protection zones were noted for prototype research instruments, short-wave diathermy units, and dielectric welders. The most excessive (up to 12-fold MAI values were recorded for dielectric welders, short-wave diathermy units (up to 11-fold and microwave diathermy units (up to 8-fold. Conclusions: Our results have confirmed the high RF EMF values for physiotherapists, operators of dielectric welders, and mast maintenance workers in radio communication facilities (especially radio and TV broadcasting stations. Med Pr 2015;66(2:199–212

  9. Evaluation of a new multifunctional vitreoretinal twister for use in advanced proliferative diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Dikran G Hovaghimian

    2016-01-01

    Conclusion Epiretinal membrane dissection with the new multifunctional retinal twister appears to be a safe and effective technique in the management of epiretinal membranes. The new multifunctional retinal twister proved its efficacy and success in grasping, holding, twisting, pulling, and dissecting epiretinal membranes; further, the bipolar diathermy attachment for quick management of retinal bleeders was a great advantage for shortening the surgical time and providing a bloodless working field. The encouraging anatomic and functional outcome with the least complications met with during surgery favors its safe use. The twister proved to be a useful adjunct in the armamentarium of retinal microsurgical instruments.

  10. Evaluation of E.M.F. exposure from medical electrical equipment

    International Nuclear Information System (INIS)

    Aniolczyk, H.; Mamrot, P.; Politanski, P.

    2006-01-01

    he medical electric and electronic equipment, including electro surgical devices, short- and microwave diathermy units, and magnetic resonance imaging (MRI) systems, belong to the most hazardous sources of electromagnetic emissions. The electromagnetic emissions can interfere with emissions from other medical equipment located in the same facility (e.g. operation rooms) thus having impact on their work, but more importantly, they can be dangerous to patients, medical personnel operating them and other persons. In the present project, an assessment of E.M.F. intensity was performed for more than 2 000 electro surgical devices (330 khz, 440 khz and 1.76 MHz frequency ranges), 1 200 diathermy units and 45 MRI 0.2 - 1.5 T systems. E.M.F. exposure of medical staff was assessed based on respective national hygienic standards. The actual exposure levels were found to exceed the admissible values in Poland. The recorded E.M.F. intensities were compared with relevant Who and U E recommendations (e.g. I.C.N.I.R.P. guidelines, 1998, Directive 2004/40/E.C.). The findings revealed that for 18% of the devices examined, the E.M.F. was higher than the E.M.F. intensity values recommended by U E. (authors)

  11. Evaluation of an interlaced triple procedure: penetrating keratoplasty, extracapsular cataract extraction, and nonopen-sky intraocular lens implantation.

    Science.gov (United States)

    Yang, Shuo; Wang, Bin; Zhang, Yangyang; Zhai, Hualei; Wang, Junyi; Wang, Shuang; Xie, Lixin

    2017-09-01

    To evaluate an interlaced triple procedure that involved penetrating keratoplasty (PKP), extracapsular cataract extraction (ECCE) using diathermy capsulotomy, and nonopen-sky intraocular lens (IOL) implantation.This retrospective study involved data from 34 patients who were diagnosed with severe corneal opacities and cataracts. These patients were divided into an interlaced procedure group (21 patients) and a traditional procedure group (13 patients). In the interlaced group, the method of continuous curvilinear capsulorhexis (CCC) was completed via diathermy capsulotomy. The donor corneal button was sutured at 8 positions (at equal intervals) using 10-0 nylon sutures, and the IOL was inserted into the capsular bag using a closed anterior chamber approach at the 10:30 to 12 o'clock positions between the sutures. In the traditional group, CCC was completed using side-port capsular forceps, and the IOL was implanted using an open anterior chamber approach.In the interlaced group, the CCC, open-sky, and total operation times were significantly shorter than in the traditional group (P < .05). Neither the best-corrected visual acuity (BCVA) nor corneal endothelial cell density was significantly different between the groups at 1 and 6 months after the operation.This interlaced triple procedure for the treatment of corneal diseases with cataracts appears to be feasible and practical.

  12. Occupational exposure to electromagnetic fields in physiotherapy departments

    International Nuclear Information System (INIS)

    Macca, I.; Scapellato, M. L.; Carrieri, M.; Di Bisceglie, A. P.; Saia, B.; Bartolucci, G. B.

    2008-01-01

    To assess occupational exposure to electromagnetic fields, 11 microwave (MW), 4 short-wave diathermy and 15 magneto therapy devices were analysed in eight physiotherapy departments. Measurements taken at consoles and environmental mapping showed values above European Directive 2004/40/EC and ACGIH exposure limits at ∼50 cm from MW applicators (2.45 GHz) and above the Directive magnetic field limit near the diathermy unit (27.12 MHz). Levels in front of MW therapy applicators decreased rapidly with distance and reduction in power; this may not always occur in work environments where nearby metal structures (chairs, couches, etc.) may reflect or perturb electromagnetic fields. Large differences in stray field intensities were found for various MW applicators. Measurements of power density strength around MW electrodes confirmed radiation fields between 30 deg. and 150 deg., with a peak at 90 deg., in front of the cylindrical applicator and maximum values between 30 deg. and 150 deg. over the whole range of 180 deg. for the rectangular parabolic applicator. Our results reveal that although most areas show substantially low levels of occupational exposure to electromagnetic fields in physiotherapy units, certain cases of over-occupational exposure limits do exist. (authors)

  13. Evaluation of E.M.F. exposure from medical electrical equipment

    Energy Technology Data Exchange (ETDEWEB)

    Aniolczyk, H.; Mamrot, P.; Politanski, P. [Nofer Institute of Occupational Medicine, Lodz (Poland)

    2006-07-01

    he medical electric and electronic equipment, including electro surgical devices, short- and microwave diathermy units, and magnetic resonance imaging (MRI) systems, belong to the most hazardous sources of electromagnetic emissions. The electromagnetic emissions can interfere with emissions from other medical equipment located in the same facility (e.g. operation rooms) thus having impact on their work, but more importantly, they can be dangerous to patients, medical personnel operating them and other persons. In the present project, an assessment of E.M.F. intensity was performed for more than 2 000 electro surgical devices (330 khz, 440 khz and 1.76 MHz frequency ranges), 1 200 diathermy units and 45 MRI 0.2 - 1.5 T systems. E.M.F. exposure of medical staff was assessed based on respective national hygienic standards. The actual exposure levels were found to exceed the admissible values in Poland. The recorded E.M.F. intensities were compared with relevant Who and U E recommendations (e.g. I.C.N.I.R.P. guidelines, 1998, Directive 2004/40/E.C.). The findings revealed that for 18% of the devices examined, the E.M.F. was higher than the E.M.F. intensity values recommended by U E. (authors)

  14. Surgical smoke - a health hazard in the operating theatre: a study to quantify exposure and a survey of the use of smoke extractor systems in UK plastic surgery units.

    Science.gov (United States)

    Hill, D S; O'Neill, J K; Powell, R J; Oliver, D W

    2012-07-01

    Surgeons and operating theatre personnel are routinely exposed to the surgical smoke plume generated through thermal tissue destruction. This represents a significant chemical and biological hazard and has been shown to be as mutagenic as cigarette smoke. It has previously been reported that ablation of 1 g of tissue produces a smoke plume with an equivalent mutagenicity to six unfiltered cigarettes. We studied six human and 78 porcine tissue samples to find the mass of tissue ablated during 5 min of monopolar diathermy. The total daily duration of diathermy use in a plastic surgery theatre was electronically recorded over a two-month period. On average the smoke produced daily was equivalent to 27-30 cigarettes. Our survey of smoke extractor use in UK plastic surgery units revealed that only 66% of units had these devices available. The Health and Safety Executive recommend specialist smoke extractor use, however they are not universally utilised. Surgical smoke inhalation is an occupational hazard in the operating department. Our study provides data to quantify this exposure. We hope this evidence can be used together with current legislation to make the use of surgical smoke extractors mandatory to protect all personnel in the operating theatre. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. [Occupational exposure of physical therapists to electric and magnetic fields and the efficacy of Faraday cages].

    Science.gov (United States)

    Messias, Iracimara de Anchieta; Okuno, Emico; Colacioppo, Sérgio

    2011-10-01

    Measure physical therapists' exposure to the electric and magnetic fields produced by 17 shortwave diathermy devices in physical therapy clinics in the city of Presidente Prudente, São Paulo State, Brazil. Compare the observed values with the exposure levels recommended by the International Commission on Non-ionizing Radiation Protection (ICNIRP). Observe the efficacy of Faraday cages as a means of protecting physical therapists from exposure to oscillating electric and magnetic fields. Electric and magnetic field measurements were taken at four points during actual physical therapy sessions: in proximity to the operator's pelvis and head, the devices' electrical cables, and the electrodes. The measuring equipment was a Wandel & Goltermann EMR-200. The values obtained in proximity to the electrodes and cables were 10 to 30 times higher than ICNIRP's recommended occupational reference levels. In the shortwave diathermy treatment rooms with Faraday cages, the fields were even higher than in treatment rooms not so equipped-principally the magnetic field, where the values were more than 100 times higher than the ICNIRP exposure limit. The electric and magnetic field intensities obtained in this study are generally above the exposure levels recommend in ICNIRP standards. It was also observed that the Faraday cage offers physical therapists no protection, and instead, increases their level of exposure.

  16. Effectiveness of Slump Neural Mobilization Technique for the management of chronic radicular low back pain

    International Nuclear Information System (INIS)

    Ali, M.; Rehman, S.S.U.; Ahmad, S.; Farooq, M.N.

    2015-01-01

    Objective: To determine the effectiveness of slump neural mobilization technique compared with lumber stabilization exercise (LSE) and shortwave diathermy (SWD) in the physical therapy management of chronic radicular low back pain (CRLBP). Methodology: A sample of 40 patients with CRLBP was selected and randomly placed into two groups A and B. 22 patients were treated with slump neural mobilization technique (SNMT), lumbar stabilization exercise (LSE) and Short wave diathermy (SWD), while 18 patient of group B were treated with LSE and SWD. All the patients were assessed by four point pain scale and Oswestry disability index (ODI) at the baseline and at the completion of three weeks at 5 days per week and 30 minutes single session per day. The data was collected on specially designed Performa and was analyzed by SPSS and paired t test was applied to determine the probability value at 95 % level of significance. Results: Both groups demonstrated significant improvement in pain score and ODI score, although improvement was more significant in group A (p<0.001 for both pain and ODI score) as compared to group B (p=0.003 for pain score and 0.163 for ODI score).table-I-III) Conclusion: It is concluded that SNMTalong LSE and SWD improves pain and function more as compared with LSE and SWD alone during the physical therapy management of CRLBP. (author)

  17. The laparoscopic performance of novice surgical trainees: testing for acquisition, loss, and reacquisition of psychomotor skills.

    Science.gov (United States)

    Windsor, J A; Zoha, F

    2005-08-01

    It has been suggested that virtual reality (VR) might be useful for the selection of surgical trainees and the measurement of technical performance during preoperative training and retraining. This study was designed to determine whether it is possible to define and measure the acquisition, loss, and reacquisition of psychomotor skills in novice surgical trainees. Novice surgical trainees (NSTs n = 10, junior surgical registrars with little or no prior experience with laparoscopic surgery) were tested and retested after 1 month using the Minimally Invasive Surgical Trainer-Virtual Reality. Two tasks were used: the simple task [stretch diathermy (SD)] and the more complex task [manipulation diathermy (MD)]. The score was derived from the time taken to complete the task and the number of errors that occurred. Acquisition is the difference between the first and last score of the first training session, loss is the difference in score that occurs between the last score of the first training session and the first score of the second training session, and reacquisition is the difference in the first and last scores of the second training session. A performance criterion level was defined for each task by testing a group of experienced laparoscopic surgeons (n = 10). Groups were compared using the nonparametric Wilcoxon signed rank test, with p psychomotor skills in individual NSTs and to compare them with a predefined performance criterion level. This study defines parameters that will be useful in repeated training sessions of NSTs in the preoperative phase of training and during retraining.

  18. Multi-Stream Saline-Jet Dissection Using a Simple Irrigation System Defines Difficult Tissue Planes

    Science.gov (United States)

    Ng, Philip CH

    2010-01-01

    Introduction: Single-stream hydro-jet dissection is increasingly used in various laparoscopic procedures, but its use requires special equipment. We describe a simple method for using an irrigation system for saline-jet tissue dissection as a useful adjunct prior to adhesiolysis. Material and Methods: Intraabdominal adhesions prolong laparoscopic procedures, because tissue planes are difficult to identify. We performed multi-jet saline dissection (MSSJ) between 2000 and 2009 in more than 500 patients during laparoscopy involving hernias, gallbladders, appendices, and intestinal obstructions. We use a standard suction irrigation probe, which is attached to a 1-liter saline bag with an inflatable cuff around to create a pressure of 250mm Hg to 300mm Hg. In effect, this is the standard setup generally used for irrigation. After using saline dissection, tissue planes can be better defined and the structures can then be separated. Result and Discussion: Using this method, we have successfully identified tissue planes in spite of dense adhesions, and our conversion rates to open have been reduced dramatically. This method is relatively safer than other modalities of tissue dissection, such as diathermy, ultrasonic, blunt or sharp dissection. The disadvantage is that with tissues saturated with saline it becomes more difficult to use diathermy hemostasis. Care has to be exercised in monitoring the temperature and volume of the fluid used. PMID:20529528

  19. Complications of transanal endoscopic microsurgery (TEMS): a prospective audit.

    Science.gov (United States)

    Bignell, M B; Ramwell, A; Evans, J R; Dastur, N; Simson, J N L

    2010-07-01

    The aim of this study was to determine the postoperative complications of Transanal Endoscopic Microsurgery (TEMS) excision of rectal lesions. A prospective audit of 262 consecutive TEMS procedures performed by a single surgeon between 1999 and 2008. The mean age of patients was 72 years. The mean area of the lesions excised was 17.5 cm(2) with a mean diameter of 4.5 cm at a mean distance of 7.4 cm from the dentate line. There were 201 full thickness excisions, 51 partial thickness excisions and nine were mixed or unclassified. Thirty-three (13%) patients developed 41 complications. There were two (0.8%) deaths within 30 days. Pelvic sepsis occurred in seven (3%) patients and was significantly more common after excision of low lesions within 2 cm of the dentate line. Postoperative haemorrhage occurred in seven (3%) patients and was significantly less common when dissection was performed with ultrasonic dissection than with diathermy. Fourteen (5%) patients developed acute urinary retention. Four (1.5%) patients developed rectal stenosis and four (1.5%) suffered uncomplicated surgical emphysema that required no treatment. Transanal endoscopic microsurgery is a safe operation with a low mortality and morbidity. Pelvic sepsis is more common after excision of lesions within 2 cm of the dentate line. Ultrasonic dissection is associated with less postoperative haemorrhage than diathermy.

  20. Virtual reality as a metric for the assessment of laparoscopic psychomotor skills. Learning curves and reliability measures.

    Science.gov (United States)

    Gallagher, A G; Satava, R M

    2002-12-01

    The objective assessment of the psychomotor skills of surgeons is now a priority; however, this is a difficult task because of measurement difficulties associated with the assessment of surgery in vivo. In this study, virtual reality (VR) was used to overcome these problems. Twelve experienced (>50 minimal-access procedures), 12 inexperienced laparoscopic surgeons (Virtual Reality (MIST VR). Experienced laparoscopic surgeons performed the tasks significantly (p < 0.01) faster, with less error, more economy in the movement of instruments and the use of diathermy, and with greater consistency in performance. The standardized coefficient alpha for performance measures ranged from a = 0.89 to 0.98, showing high internal measurement consistency. Test-retest reliability ranged from r = 0.96 to r = 0.5. VR is a useful tool for evaluating the psychomotor skills needed to perform laparoscopic surgery.

  1. THE EFFICACY OF MICROWAVE THERAPY VIA BRONCHOFIBERSCOPE IN THE TREATMENT OF SEVERE TRACHEA STENOSIS

    Directory of Open Access Journals (Sweden)

    WEIMIN LIU

    2013-01-01

    Full Text Available To evaluate the efficacy of microwave therapy via bronchofiberscope for treatment of severe trachea stenosis. Microwave tissue coagulation (MTC and diathermy (MD therapy via bronchofiberscope were performed on 37 patients with severe trachea stenosis diseases at least two times. The effective rate immediately after treatment was 100% in all cases. After one month, the rate remained 100% in the patients with benign diseases, but it dropped to 67% in the patients with malignant tumors. We have demonstrated that the microwave thermotherapy via bronchofiberscope is an effective method to treat patients with benign trachea stenosis noninvasively. For cancer patients with trachea soakage and blockage, it can be performed to improve their life quality by alleviating their agonies.

  2. Ultrasonography in gastroenterology.

    Science.gov (United States)

    Ødegaard, Svein; Nesje, Lars B; Hausken, Trygve; Gilja, Odd Helge

    2015-06-01

    Ultrasonography (US) is a safe and available real-time, high-resolution imaging method, which during the last decades has been increasingly integrated as a clinical tool in gastroenterology. New US applications have emerged with enforced data software and new technical solutions, including strain evaluation, three-dimensional imaging and use of ultrasound contrast agents. Specific gastroenterologic applications have been developed by combining US with other diagnostic or therapeutic methods, such as endoscopy, manometry, puncture needles, diathermy and stents. US provides detailed structural information about visceral organs without hazard to the patients and can play an important clinical role by reducing the need for invasive procedures. This paper presents different aspects of US in gastroenterology, with a special emphasis on the contribution from Nordic scientists in developing clinical applications.

  3. The effects of sterilisation: a comparison of sterilised women with the wives of vasectomised men.

    Science.gov (United States)

    Alder, E; Cook, A; Gray, J; Tyrer, G; Warner, P; Bancroft, J; Loudon, N B; Loudon, J

    1981-01-01

    In a follow-up study, women sterilised by tubal diathermy were compared with a matched group of wives of vasectomised men. Semi-structured interviews were given to a random sample drawn from a representative population. The couples were young with small families and did not have a high proportion of unplanned pregnancies or terminations. They had previously used contraception, mainly the pill or sheath. Most couples were entirely satisfied with the operation. Both groups showed an increase in pre-menstrual symptoms but there was only slight evidence that menstrual loss was affected by female sterilisation. The vasectomy couples had a higher frequency of sexual intercourse, few sexual problems and tended to have more satisfactory marriages. They had had more discussion of their decision to have the operation and the implications of counselling are considered.

  4. Robot-Assisted Antegrade In-Situ Fenestrated Stent Grafting

    International Nuclear Information System (INIS)

    Riga, Celia V.; Bicknell, Colin D.; Wallace, Daniel; Hamady, Mohamad; Cheshire, Nicholas

    2009-01-01

    To determine the technical feasibility of a novel approach of in-situ fenestration of aortic stent grafts by using a remotely controlled robotic steerable catheter system in the porcine model. A 65-kg pig underwent robot-assisted bilateral antegrade in-situ renal fenestration of an abdominal aortic stent graft with subsequent successful deployment of a bare metal stent into the right renal artery. A 16-mm iliac extension covered stent served as the porcine aortic endograft. Under fluoroscopic guidance, the graft was punctured with a 20-G customized diathermy needle that was introduced and kept in place by the robotic arm. The needle was exchanged for a 4 x 20 mm cutting balloon before successful deployment of the renal stent. Robot-assisted antegrade in-situ fenestration is technically feasible in a large mammalian model. The robotic system enables precise manipulation, stable positioning, and minimum instrumentation of the aorta and its branches while minimizing radiation exposure.

  5. Three-port laparoscopic cholecystectomy by harmonic dissection without cystic duct and artery clipping.

    Science.gov (United States)

    Tebala, Giovanni D

    2006-05-01

    The technique of laparoscopic cholecystectomy (LC) still has areas of refinements. To decrease the number of ports, a cannula may be replaced by a percutaneous suture suspension of the gallbladder. The risk of tissue injury caused by repeat blind extraction and insertion of various instruments in and out of the abdomen may be decreased by the use of the multipurpose harmonic dissector. One hundred consecutive patients with symptomatic cholelithiasis underwent 3-port LC entirely performed by harmonic dissector without cystic duct and artery clipping. In 8 cases, a fourth trocar was necessary. In 2 cases, the cystic duct was clipped after an unsafe ultrasound sealing. In 1 case, continuous bleeding from the liver required the use of diathermy. No common bile duct injury was registered. The 3-port harmonic LC is a feasible, effective, and safe technique.

  6. Some thoughts on the socio-political aspects of radiation protection

    International Nuclear Information System (INIS)

    Bosnjakovic, B.F.M.

    1985-01-01

    Public concern about radiation is addressed, and the author notes that although this paper concerns non-ionizing radiation, it is not possible to exclude the field of ionizing radiation from the discussion because in the eyes of the public, the differences between various types of radiation is blurred. He lists the worries people have and fear about radiation: that diathermy treatment could cause cancer; that food could acquire carcinogenic properties do to heating in microwave ovens; and that ELF fields near HV transmission lines could cause sexual impotence. Other fears are mentioned: EEG measurements could cause radiation illness, and the effects from ''radioactive microwave radiation''. The author suggests means of communications through industry, scientists, regulatory committees the media and contesting groups to improve and eliminate this confusion. Professional integrity, he says, and intellectual honesty are still a necessary condition among scientists to avoid sensationalism

  7. Tectonic corneal graft for conjunctival rhinosporidiosis with scleral melt

    Directory of Open Access Journals (Sweden)

    Pushpa Jacob

    2011-01-01

    Full Text Available A 16 year old girl presented with irritation and watering of the right eye for 3 months. On examination, the superior perilimbal sclera was ectatic with incarcerated uveal tissue covered by conjunctiva. The conjunctiva showed discreet, yellow white mucoid spots. Excision biopsy of the conjunctiva showed subepithelial spherules of sporangia containing numerous endospores, suggestive of rhinosporidiosis. Diathermy was applied to flatten the staphyloma. The ectatic area was covered with a corneal patch graft. The patient was started on prednisolone acetate eye drops and oral dapsone for 6 months. Corneal graft was well incorporated and conjunctivalized by 3 months. Since the graft was not seen within the palpebral aperture, there was good cosmetic result. The corneal graft had the added advantage of transparency which allowed visualization of the underlying tissue to diagnose early recurrence. There was no recurrence at 6 months.

  8. Present clinical status of hyperthermia associated with radiotherapy

    International Nuclear Information System (INIS)

    Jaulerry, C.; Bataini, J.P.; Brunin, F.; Gaboriaud, G.

    1981-01-01

    Improved techniques for inducing heat: ultrasound, microwaves, diathermy with different application modalities, capable of producing localized superficial or deep, regional or total body hyperthermia have been responsible for the multiplication of clinical trials. These studies have confirmed the tumoricidal effect of hyperthermia alone, or more especially when combined with radiotherapy, and the good tolerance of normal tissues to localized temperatures of 42 to 43.5 0 C even in previously irradiated cases. Localized heating does not seem to increase the incidence of metastasis. Enhancement ratios and therapeutic gain with respect to normal tissues are not yet well documented. Many problems, including the heterogenicity of tissues to be heated, difficulties with temperature monitoring, and selection of appropriate sequential scheduling of radiation and hyperthermia remain unsolved and further investigationss are required [fr

  9. Management of neck pain and associated disorders: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration

    DEFF Research Database (Denmark)

    Côté, Pierre; Wong, Jessica j; Sutton, Deborah

    2016-01-01

    Purpose: To develop an evidence-based guideline for the management of grades I–III neck pain and associated disorders (NAD). Methods: This guideline is based on recent systematic reviews of high-quality studies. A multidisciplinary expert panel considered the evidence of effectiveness, safety, cost......, strain-counterstrain therapy, relaxation massage, relaxation therapy for pain or disability, electrotherapy, shortwave diathermy, clinic-based heat, electroacupuncture, or botulinum toxin injections. Recommendation 6: For NAD grade III ≤3 months duration, clinicians may consider supervised strengthening...... exercises in addition to structured patient education. In view of evidence of no effectiveness, clinicians should not offer structured patient education alone, cervical collar, low-level laser therapy, or traction. Recommendation 7: For NAD grade III >3 months duration, clinicians should not offer...

  10. Laparoscopic orchidopexy in boys with prune belly syndrome--outcome and technical considerations.

    Science.gov (United States)

    Philip, Joe; Mullassery, Dhanya; Craigie, Ross J; Manikandan, Ramaswamy; Kenny, Simon E

    2011-07-01

    Cryptorchidism is an ubiquitous feature in prune belly syndrome (PBS). Laparoscopic orchidopexy allows dissection of the spermatic cord with minimal morbidity. We discuss the technical difficulties and outcome of three boys with PBS who underwent two-stage laparoscopic Fowler-Stephens orchidopexy (F-SO). Three boys, ages 1, 2, and 4, underwent laparoscopic F-SO. All boys had viable testes that were found within 3 cm of the deep inguinal ring. The testicular vessels were either ligated bilaterally with 4/0 polyglactin or monopolar diathermy was used and the vessels divided. Bilateral second-stage F-SO was performed within 6 months in two boys and limited to one side in the third boy. One boy awaits the contralateral second stage. All three boys have adequately sized gonads. Based on our experience, the port incisions should be smaller than routine practice to prevent air leak in PBS. Although the intra-abdominal pressure of 12 mm Hg did not vary from our normal practice, a high flow rate is necessary after initial insufflation (6 L/min) to compensate for inevitable gas leaks because the abdominal wall is so thin. Risk of diathermy injury to the thin abdominal wall and the vessels is significant. Laparoscopy enables easy visualization of the ureter, testes, and testicular vessels and permits complete dissection of testicular vessels. It is easier to maintain integrity of spermatic vessels. Use of radially expanding trocars, small incisions, and high gas flow rates permit this procedure to be performed safely with good outcome and cosmetic results in this challenging group of boys.

  11. Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis.

    Science.gov (United States)

    Young, Rebekah; Nix, Sheree; Wholohan, Aaron; Bradhurst, Rachael; Reed, Lloyd

    2013-11-14

    Ankle joint equinus, or restricted dorsiflexion range of motion (ROM), has been linked to a range of pathologies of relevance to clinical practitioners. This systematic review and meta-analysis investigated the effects of conservative interventions on ankle joint ROM in healthy individuals and athletic populations. Keyword searches of Embase, Medline, Cochrane and CINAHL databases were performed with the final search being run in August 2013. Studies were eligible for inclusion if they assessed the effect of a non-surgical intervention on ankle joint dorsiflexion in healthy populations. Studies were quality rated using a standard quality assessment scale. Standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated and results were pooled where study methods were homogenous. Twenty-three studies met eligibility criteria, with a total of 734 study participants. Results suggest that there is some evidence to support the efficacy of static stretching alone (SMDs: range 0.70 to 1.69) and static stretching in combination with ultrasound (SMDs: range 0.91 to 0.95), diathermy (SMD 1.12), diathermy and ice (SMD 1.16), heel raise exercises (SMDs: range 0.70 to 0.77), superficial moist heat (SMDs: range 0.65 to 0.84) and warm up (SMD 0.87) in improving ankle joint dorsiflexion ROM. Some evidence exists to support the efficacy of stretching alone and stretching in combination with other therapies in increasing ankle joint ROM in healthy individuals. There is a paucity of quality evidence to support the efficacy of other non-surgical interventions, thus further research in this area is warranted.

  12. Exposure to non-ionizing radiation provokes changes in rat thyroid morphology and expression of HSP-90.

    Science.gov (United States)

    Misa-Agustiño, Maria J; Jorge-Mora, Teresa; Jorge-Barreiro, Francisco J; Suarez-Quintanilla, Juan; Moreno-Piquero, Eduardo; Ares-Pena, Francisco J; López-Martín, Elena

    2015-09-01

    Non-ionizing radiation at 2.45 GHz may modify the morphology and expression of genes that codify heat shock proteins (HSP) in the thyroid gland. Diathermy is the therapeutic application of non-ionizing radiation to humans for its beneficial effects in rheumatological and musculo-skeletal pain processes. We used a diathermy model on laboratory rats subjected to maximum exposure in the left front leg, in order to study the effects of radiation on the nearby thyroid tissue. Fifty-six rats were individually exposed once or repeatedly (10 times in two weeks) for 30 min to 2.45 GHz radiation in a commercial chamber at different non-thermal specific absorption rates (SARs), which were calculated using the finite difference time domain technique. We used immunohistochemistry methods to study the expression of HSP-90 and morphological changes in thyroid gland tissues. Ninety minutes after radiation with the highest SAR, the central and peripheral follicles presented increased size and the thickness of the peripheral septa had decreased. Twenty-four hours after radiation, only peripheral follicles radiated at 12 W were found to be smaller. Peripheral follicles increased in size with repeated exposure at 3 W power. Morphological changes in the thyroid tissue may indicate a glandular response to acute or repeated stress from radiation in the hypothalamic-pituitary-thyroid axis. Further research is needed to determine if the effect of this physical agent over time may cause disease in the human thyroid gland. © 2015 by the Society for Experimental Biology and Medicine.

  13. Exposure to non-ionizing radiation provokes changes in rat thyroid morphology and expression of HSP-90

    Science.gov (United States)

    Misa-Agustiño, Maria J; Jorge-Mora, Teresa; Jorge-Barreiro, Francisco J; Suarez-Quintanilla, Juan; Moreno-Piquero, Eduardo; Ares-Pena, Francisco J

    2015-01-01

    Non-ionizing radiation at 2.45 GHz may modify the morphology and expression of genes that codify heat shock proteins (HSP) in the thyroid gland. Diathermy is the therapeutic application of non-ionizing radiation to humans for its beneficial effects in rheumatological and musculo-skeletal pain processes. We used a diathermy model on laboratory rats subjected to maximum exposure in the left front leg, in order to study the effects of radiation on the nearby thyroid tissue. Fifty-six rats were individually exposed once or repeatedly (10 times in two weeks) for 30 min to 2.45 GHz radiation in a commercial chamber at different non-thermal specific absorption rates (SARs), which were calculated using the finite difference time domain technique. We used immunohistochemistry methods to study the expression of HSP-90 and morphological changes in thyroid gland tissues. Ninety minutes after radiation with the highest SAR, the central and peripheral follicles presented increased size and the thickness of the peripheral septa had decreased. Twenty-four hours after radiation, only peripheral follicles radiated at 12 W were found to be smaller. Peripheral follicles increased in size with repeated exposure at 3 W power. Morphological changes in the thyroid tissue may indicate a glandular response to acute or repeated stress from radiation in the hypothalamic–pituitary–thyroid axis. Further research is needed to determine if the effect of this physical agent over time may cause disease in the human thyroid gland. PMID:25649190

  14. Laparoscopic Stephen-Fowler stage procedure: appropriate management for high intra-abdominal testes.

    Science.gov (United States)

    Agrawal, Amit; Joshi, Milind; Mishra, Pankaj; Gupta, Rahul; Sanghvi, Beejal; Parelkar, Sandesh

    2010-03-01

    The length of testicular vessels is the main length-limiting factor to bring down the testes in the scrotum. Fowler and Stephen proposed the division of testicular vessels, high and as far from the testes as possible to maintain collateral blood supply, to treat high intra-abdominal testes. Cortesi introduced the diagnostic laparoscopy and Jorden first did the laparoscopic orchiopexy for nonpalpable testes. We had done Fowler-Stephen staged orchiopexy for high intra-abdominal testes, in which both stages were done laparoscopically. In total, 17 testes of 13 patients had undergone laparoscopic staged Fowler-Stephen orchiopexy. The decision to perform a staged Fowler-Stephen orchiopexy was based on the distance of the testis from the deep inguinal ring on laparoscopy. If distance was more than 2.5 cm, then we proceeded to a laparoscopic staged Fowler-Stephen orchiopexy. In the first stage, testicular vessels were cauterized by bipolar diathermy. Laparoscopic second-stage Fowler-Stephen procedure was done 6 months after the first stage. Patients were regularly followed, and the success of the procedure was assessed by the size of the testes and the position in the scrotum. Testicular vascularity was assessed by color Doppler ultrasonography. There was no testicular atrophy on second stage and on follow-up. All testes were in the scrotum with good size on follow-up. There was no complication related to laparoscopy. In cases of high intra-abdominal testes, the staged Fowler-Stephen procedure should be the procedure of choice. This procedure yields a high success rate. Transaction of vessels by bipolar diathermy is a very safe, cost-effective method.

  15. Investigating Early and Late Complications in Conventional and LigaSure Hemorroidectomy

    Directory of Open Access Journals (Sweden)

    M Zare

    2014-06-01

    Full Text Available Introduction: The traditional Milligan-Morgan and the Ferguson operations are still the most used for patients with symptomatic haemorrhoids of III and IV degrees. Nowadays LigaSure is used as a new technique to decrease the complications resulting from conventional hemorroidectomy. In this study, patients were investigated on the basis of the following main outcomes: mean operative time, postoperative pain (score and duration, bleeding loss in operation, early (within the first month after surgery and late (after the first month complications in conventional as well as LigaSure hemorroidectomy. Methods: it is an analytical study conducted on 101 patients aged 19–80 years old of both males and females with III and IV-degree hemorrhoids who had been gone to Shahid Sadoughi hospital between 2011 and 2012. Forty-three patients were treated by conventional diathermy and fifty -eight by LigaSure. Patients received analgesic administration for about 24 hours after operations and, after hospital discharge. In fact, analgesia was administered until 5 days (three times a day. All patients were required to record pain from the first postoperative day until the 28th postoperative day on a self-administered NAS scale (0–10. Results: Patients completed a questionnaire face to face one week, one month, six, and twelve months after the operation. The mean operative time, bleeding loss in operation and return to work were significantly shorter in LS group, whereas there were no difference in hospital stay period, anal stenosis, healing time of wound and retention of urinary. A statistically significant difference in pain score was observed three and four days after the operation. Finally, patients with LigaSure haemorrhoidectomy recovered from pain earlier than those with conventional diathermy. Conclusions: although LigaSure proposes additional costs, it is an effective instrument in order to treat hemorrhoids of III and IV degrees.

  16. Attenuation of muscle damage by preconditioning with muscle hyperthermia 1-day prior to eccentric exercise.

    Science.gov (United States)

    Nosaka, K; Muthalib, M; Lavender, A; Laursen, P B

    2007-01-01

    This study investigated the hypothesis that muscle damage would be attenuated in muscles subjected to passive hyperthermia 1 day prior to exercise. Fifteen male students performed 24 maximal eccentric actions of the elbow flexors with one arm; the opposite arm performed the same exercise 2-4 weeks later. The elbow flexors of one arm received a microwave diathermy treatment that increased muscle temperature to over 40 degrees C, 16-20 h prior to the exercise. The contralateral arm acted as an untreated control. Maximal voluntary isometric contraction strength (MVC), range of motion (ROM), upper arm circumference, muscle soreness, plasma creatine kinase activity and myoglobin concentration were measured 1 day prior to exercise, immediately before and after exercise, and daily for 4 days following exercise. Changes in the criterion measures were compared between conditions (treatment vs. control) using a two-way repeated measures ANOVA with a significance level of P < 0.05. All measures changed significantly following exercise, but the treatment arm showed a significantly faster recovery of MVC, a smaller change in ROM, and less muscle soreness compared with the control arm. However, the protective effect conferred by the diathermy treatment was significantly less effective compared with that seen in the second bout performed 4-6 weeks after the initial bout by a subgroup of the subjects (n = 11) using the control arm. These results suggest that passive hyperthermia treatment 1 day prior to eccentric exercise-induced muscle damage has a prophylactic effect, but the effect is not as strong as the repeated bout effect.

  17. Efficacy of Mesoglycan in Pain Control after Excisional Hemorrhoidectomy: A Pilot Comparative Prospective Multicenter Study

    Directory of Open Access Journals (Sweden)

    Gaetano Gallo

    2018-01-01

    Full Text Available Introduction. Various pain management strategies for patients undergoing open excisional hemorrhoidectomy have been proposed, yet postoperative pain remains a frequent complaint. Objective. To determine whether mesoglycan (30 mg two vials i.m. once/day for the first 5 days postoperative, followed by 50 mg 1 oral tablet twice/day for 30 days would reduce the edema of the mucocutaneous bridges and thus improve postoperative pain symptoms. Patients and Methods. For this prospective observational multicenter study, 101 patients undergoing excisional diathermy hemorrhoidectomy for III-IV degree hemorrhoidal disease were enrolled at 5 colorectal referral centers. Patients were assigned to receive either mesoglycan (study group SG or a recommended oral dose of ketorolac tromethamine of 10 mg every 4–6 hours, not exceeding 40 mg per day and not exceeding 5 postoperative days according to the indications for short-term management of moderate/severe acute postoperative pain, plus stool softeners (control group CG. Results. Postoperative thrombosis (SG 1/48 versus CG 5/45 (p<0.001 and pain after rectal examination (p<0.001 were significantly reduced at 7–10 days after surgery in the mesoglycan-treated group, permitting a faster return to work (p<0.001; however, in the same group, the incidence of postoperative bleeding, considered relevant when needing a readmission or an unexpected outpatient visit, was higher, possibly owing to the drug’s antithrombotic properties. Conclusions. The administration of mesoglycan after an open diathermy excisional hemorrhoidectomy can reduce postoperative thrombosis and pain at 7–10 days after surgery, permitting a faster return to normal activities.

  18. Attempted establishment of proficiency levels for laparoscopic performance on a national scale using simulation: the results from the 2004 SAGES Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) learning center study.

    Science.gov (United States)

    Van Sickle, K R; Ritter, E M; McClusky, D A; Lederman, A; Baghai, M; Gallagher, A G; Smith, C D

    2007-01-01

    The Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) has been well validated as a training device for laparoscopic skills. It has been demonstrated that training to a level of proficiency on the simulator significantly improves operating room performance of laparoscopic cholecystectomy. The purpose of this project was to obtain a national standard of proficiency using the MIST-VR based on the performance of experienced laparoscopic surgeons. Surgeons attending the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) 2004 Annual Scientific Meeting who had performed more than 100 laparoscopic procedures volunteered to participate. All the subjects completed a demographic questionnaire assessing laparoscopic and MIST-VR experience in the learning center of the SAGES 2004 meeting. Each subject performed two consecutive trials of the MIST-VR Core Skills 1 program at the medium setting. Each trial involved six basic tasks of increasing difficulty: acquire place (AP), transfer place (TP), traversal (TV), withdrawal insert (WI), diathermy task (DT), and manipulate diathermy (MD). Trial 1 was considered a "warm-up," and trial 2 functioned as the test trial proper. Subject performance was scored for time, errors, and economy of instrument movement for each task, and a cumulative total score was calculated. Trial 2 data are expressed as mean time in seconds in Table 2. Proficiency levels for laparoscopic skills have now been established on a national scale by experienced laparoscopic surgeons using the MIST-VR simulator. Residency programs, training centers, and practicing surgeons can now use these data as guidelines for performance criterion during MIST-VR skills training.

  19. Comparative Study of Laparoscopic Appendectomies With Application of Different Techniques for Closure of the Appendicular Mesoappendix and Stump

    Directory of Open Access Journals (Sweden)

    Mohend A.N. Al-Shalah

    2018-01-01

    Full Text Available Background: Laparoscopic appendectomy(LA has gained a wide safe acceptance and effective method for treatment of acute appendicitis and can be considered as a gold standard. The aim of the study was to evaluate the results of LA performed with the use of different techniques. Method: Prospective randomized comparative study was carried out in a Babylon General Teaching Hospital. Patients diagnosed with acute appendicitis between December 2011 and December 2015 and agreed to do LA were included in this study. In Group A , the mesoappendix and the base of appendix is ligated using titanium clips while in group B ,the mesoappendix was cut with the application of monopolar diathermy very near to the appendix wall and the base of appendix is ligated using vicryle endoloop. In. Primary outcomes were assessed which include mortality ,intra and post-operative complication rate, reinterventions, and converted laparoscopic appendectomies to open .Secondary outcomes were time of hospitalization, duration of operation, wound infection and intra-abdominal abscesses formation rate, hospital charges. Result: A total of 284patients underwent LA. 146 (51.4% of them ,LA were done by clipping of mesoappendix and base of appendix by titanium clips, while the other 138 (48.6% of patients LA were done by using monapolar diathermy to the mesoappendix and base of appendix secured by vicryle endoloop. The overall mean age of all patients with appendectomy was (26.42±11.05 years old and (38.7% of patients were aged between 20-30 years. (52.5% of patients were males. The overall mean weight, height and BMI for patients with appendectomy were (74.29±12.14 kg, (1.68±0.09 m and (26.68±8.84 kg/m2, respectively. (45.4% of patients were overweight. The overall mean duration of operation was (31.01±12.48 min and (68.7% of patients spent less than 30 min operative time, meanwhile, the mean of hospitalization after operation was (22.11± 17.96 hours and (71.8% of patients

  20. Combined metformin-clomiphene in clomiphene-resistant polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Abu Hashim, Hatem; Foda, Osama; Ghayaty, Essam

    2015-09-01

    Our objective was to compare the effectiveness of metformin plus clomiphene citrate vs. gonadotrophins, laparoscopic ovarian diathermy, aromatase inhibitors, N-acetyl-cysteine and other insulin sensitizers+clomiphene for improving fertility outcomes in women with clomiphene-resistant polycystic ovary syndrome. PubMed, SCOPUS and CENTRAL databases were searched until April 2014 with the key words: PCOS, polycystic ovary syndrome, metformin, clomiphene citrate, ovulation induction and pregnancy. The search was limited to articles conducted with humans and published in English. The PRISMA statement was followed. Twelve randomized controlled trials (n = 1411 women) were included. Ovulation and clinical pregnancy rates per woman randomized. Compared with gonadotrophins, the metformin+clomiphene combination resulted in significantly fewer ovulations (odds ratio 0.25; 95% confidence interval 0.15-0.41; p < 0.00001, 3 trials, I(2) = 85%, n = 323) and pregnancies (odds ratio 0.45; 95% confidence interval 0.27-0.75; p = 0.002, 3 trials, I(2) = 0%, n = 323). No significant differences were found when metformin+clomiphene was compared with laparoscopic ovarian diathermy (odds ratio 0.88; 95% confidence interval 0.53-1.47; p = 0.62, 1 trial, n = 282; odds ratio 0.96; 95% confidence interval 0.60-1.54; p = 0.88, 2 trials, I(2) = 0%, n = 332, for ovulation and pregnancy rates, respectively). Likewise, no differences were observed in comparison with aromatase inhibitors (odds ratio 0.88; 95% confidence interval 0.58-1.34; p = 0.55, 3 trials, I(2) = 3%, n = 409; odds ratio 0.85; 95% confidence interval 0.53-1.36; p = 0.50, 2 trials, n = 309, for ovulation and pregnancy rates, respectively). There is evidence for the superiority of gonadotrophins, but the metformin+clomiphene combination is mainly relevant for clomiphene-resistant polycystic ovary syndrome patients and, if not effective, a next step could be gonadotrophins. More attempts with metformin+clomiphene are only relevant

  1. Pattern and Pain Assessment of Musculoskeletal Disorders Attending to Physiotherapy Services in Selected Physiotherapy Centres of Dhaka City

    Directory of Open Access Journals (Sweden)

    Md Ruhul Amin

    2015-07-01

    Full Text Available Background: Musculoskeletal disorders are the most common causes of severe long-term pain and physical disability, affecting hundreds of millions of people around the world. Among different modalities of treatment and management for musculoskeletal pain, physiotherapy might be cost-effective. Objective: The aim of the study was to determine the pattern and pain assessment of musculoskeletal disorders attending to physiotherapy services in selected physiotherapy centers of Dhaka city. Materials and method: It was a cross sectional study. Sample size was 400 and a pre-tested, modified, semi-structured questionnaire was used to collect the data. Data were analyzed using SPSS software version 16.0. Results: Majority of the respondents (69.2% belonged to 46-65 year age group with least in extreme age groups. Mean±SD of age was 33.58±12.33 years. Most of the respondents were male (69.2%. Study revealed that neck pain (75.2% was the major complaint followed by back pain (48.00%. Regarding pattern of pain, intermittent (73.2% type was predominant. Muscle spasm (29.2% was the main cause for musculoskeletal pain followed by degenerative diseases (27.5%. Of the respondents 55.00% received traction, 91.25% exercise, 21.25% manipulation, 97.95% short wave diathermy, 85.00% ultrasound therapy, 33.75% infra red ray, and 12.75% electrical stimulation as physiotherapy treatment. There were statistically significant difference between sex and severity of pain (p=0.019, educational status and pain persisting time in years (p=0.000. There was also statistically highly significant difference between severity of pain responses before and after physiotherapy treatment (p=0.000. Conclusion: Study concluded that common areas of musculoskeletal pain were neck followed by back and shoulder and pain characteristics were intermittent, radiating, numbness, burning in nature. Respondents had taken medication and different type of physiotherapy services, including traction

  2. A survey of blood conservation methods in clinical practice in some urban south-eastern government hospitals in Nigeria.

    Science.gov (United States)

    Amucheazi, A O; Ajuzeiogu, V O; Ezike, H A; Odiakosa, M C; Nwoke, O M; Onyia, E

    2011-01-01

    GENERAL OBJECTIVE: To assess the practice of blood conservation. To determine the methods of blood conservation in use, to assess the lower limit for hemoglobin for elective procedures, to determine transfusion trigger point in practice, to find out limitations in practice and ways to improve clinical practice. This was conducted in February 2009. Self-administered questionnaires were distributed among the surgeons and anesthetists in practice at the University of Nigeria Teaching Hospital, Enugu State University Teaching Hospital, Ebonyi State University Teaching Hospital and National Orthopaedic Hospital, Enugu. The data gathered was analyzed using the SPSS software. : Of participants who agreed to fill the questionnaires, more than 50% were males. The most prevalent specialty was general surgery (24.2%), followed by orthopedics (22.6%), obstetrics and gynecology (20.7%), and anesthesia (17.7%). The lowest hemoglobin limit before the patient was allowed into the theatre for elective procedures was 10 g/dl while individual transfusion trigger points ranged from hemoglobin of 6 to 10 g/dl. Majority of the doctors would avoid homologous blood transfusion in order to avoid transfusion-related diseases and reaction. Regarding knowledge of blood conservation methods and means of avoiding homologous blood, the use of diathermy was highest (12.33%), followed by preoperative blood donation (11.87%), use of hematinics (10.96%), and tourniquet 10.5%. Also, in practice, diathermy was the most frequently used (18.69%), followed by preoperative blood donation (16.16%), use of tourniquet (15.15%), while the Ovadje cell saver was least with 0.01%. Suggestions from respondents on the ways of limiting transfusion-related problems included optimization of patients (24.5%), improvement of standard of living (17.7%), and personnel training (13.3%). There is an agreement with the global trend geared toward minimizing the use of homologous blood by doctors in these hospitals. However

  3. A survey of blood conservation methods in clinical practice in some urban south-eastern government hospitals in Nigeria

    Directory of Open Access Journals (Sweden)

    Amucheazi A

    2011-01-01

    Full Text Available General Objective: To assess the practice of blood conservation. Specific Objectives: To determine the methods of blood conservation in use, to assess the lower limit for hemoglobin for elective procedures, to determine transfusion trigger point in practice, to find out limitations in practice and ways to improve clinical practice. Materials and Methods: This was conducted in February 2009. Self-administered questionnaires were distributed among the surgeons and anesthetists in practice at the University of Nigeria Teaching Hospital, Enugu State University Teaching Hospital, Ebonyi State University Teaching Hospital and National Orthopaedic Hospital, Enugu. The data gathered was analyzed using the SPSS software. Results : Of participants who agreed to fill the questionnaires, more than 50% were males. The most prevalent specialty was general surgery (24.2%, followed by orthopedics (22.6%, obstetrics and gynecology (20.7%, and anesthesia (17.7%. The lowest hemoglobin limit before the patient was allowed into the theatre for elective procedures was 10 g/dl while individual transfusion trigger points ranged from hemoglobin of 6 to 10 g/dl. Majority of the doctors would avoid homologous blood transfusion in order to avoid transfusion-related diseases and reaction. Regarding knowledge of blood conservation methods and means of avoiding homologous blood, the use of diathermy was highest (12.33%, followed by preoperative blood donation (11.87%, use of hematinics (10.96%, and tourniquet 10.5%. Also, in practice, diathermy was the most frequently used (18.69%, followed by preoperative blood donation (16.16%, use of tourniquet (15.15%, while the Ovadje cell saver was least with 0.01%. Suggestions from respondents on the ways of limiting transfusion-related problems included optimization of patients (24.5%, improvement of standard of living (17.7%, and personnel training (13.3%. Conclusion: There is an agreement with the global trend geared toward

  4. Novel strategies in the management of polycystic ovary syndrome.

    Science.gov (United States)

    Spritzer, P M; Motta, A B; Sir-Petermann, T; Diamanti-Kandarakis, E

    2015-09-01

    Polycystic ovary syndrome (PCOS) is a common endocrinopathy affecting reproductive-aged women. PCOS has been recognized as a syndrome combining reproductive and metabolic abnormalities with lifelong health implications. Cardiometabolic alterations require regular screening and effective and targeted lifestyle advice to lose weight as well as to prevent weight gain. Pharmacological therapy includes insulin-sensitizer drugs and agents that act directly on metabolic comorbidities, such as statins and antiobesity drugs. Bariatric surgery may be an option for severely obese women with PCOS Regarding reproductive aspects, ovulation induction with antiestrogens such as clomiphene citrate or letrozole is the first-line medical treatment. Exogenous gonadotropins and in vitro fertilization (IVF) are recommended as second-line treatment for anovulatory infertility. Laparoscopic ovarian diathermy may be used in special cases and metformin is no longer recommended for ovulation induction. Combined oral contraceptives (OCs) are the first-line treatment for the management of menstrual irregularities in women not seeking pregnancy, also providing endometrial protection and contraception. Progestin-only pills or cyclical progestins are recommended for those with contraindications to OCs. Metformin is also considered a second-line choice for improving menstrual cycles in women presenting insulin-resistance and dysglicemia. Hirsutism requires cosmetic procedures and medical treatment with OCs. More severe cases may need anti-androgen drugs added to the OCs. In conclusion, strategies regarding the management of reproductive issues in PCOS encompass a tailored approach to individual needs of each patient.

  5. Intraoperative technique as a factor in the prevention of surgical site infection.

    LENUS (Irish Health Repository)

    McHugh, S M

    2012-02-01

    Approximately five percent of patients who undergo surgery develop surgical site infections (SSIs) which are associated with an extra seven days as an inpatient and with increased postoperative mortality. The competence and technique of the surgeon is considered important in preventing SSI. We have reviewed the evidence on different aspects of surgical technique and its role in preventing SSI. The most recent guidelines from the National Institute for Health and Clinical Excellence in the UK recommend avoiding diathermy for skin incision even though this reduces incision time and blood loss, both associated with lower infection rates. Studies comparing different closure techniques, i.e. continuous versus interrupted sutures, have not found a statistically significant difference in the SSI rate, but using continuous sutures is quicker. For contaminated wounds, the surgical site should be left open for four days to allow for treatment of local infection before subsequent healing by primary intention. Surgical drains should be placed through separate incisions, closed suction drains are preferable to open drains, and all drains should be removed as soon as possible. There are relatively few large studies on the impact of surgical techniques on SSI rates. Larger multicentre prospective studies are required to define what aspects of surgical technique impact on SSI, to better inform surgical practice and support education programmes for surgical trainees.

  6. Intraoperative technique as a factor in the prevention of surgical site infection.

    LENUS (Irish Health Repository)

    McHugh, S M

    2011-02-28

    Approximately five percent of patients who undergo surgery develop surgical site infections (SSIs) which are associated with an extra seven days as an inpatient and with increased postoperative mortality. The competence and technique of the surgeon is considered important in preventing SSI. We have reviewed the evidence on different aspects of surgical technique and its role in preventing SSI. The most recent guidelines from the National Institute for Health and Clinical Excellence in the UK recommend avoiding diathermy for skin incision even though this reduces incision time and blood loss, both associated with lower infection rates. Studies comparing different closure techniques, i.e. continuous versus interrupted sutures, have not found a statistically significant difference in the SSI rate, but using continuous sutures is quicker. For contaminated wounds, the surgical site should be left open for four days to allow for treatment of local infection before subsequent healing by primary intention. Surgical drains should be placed through separate incisions, closed suction drains are preferable to open drains, and all drains should be removed as soon as possible. There are relatively few large studies on the impact of surgical techniques on SSI rates. Larger multicentre prospective studies are required to define what aspects of surgical technique impact on SSI, to better inform surgical practice and support education programmes for surgical trainees.

  7. Radioactive seed immobilization techniques for interstitial brachytherapy

    International Nuclear Information System (INIS)

    Yan, K.; Podder, T.; Buzurovic, I.; Hu, Y.; Dicker, A.; Valicenti, R.; Yu, Y.; Messing, E.; Rubens, D.; Sarkar, N.; Ng, W.

    2008-01-01

    In prostate brachytherapy, seeds can detach from their deposited sites and move locally in the pelvis or migrate to distant sites including the pulmonary and cardiac regions. Undesirable consequences of seed migration include inadequate dose coverage of the prostate and tissue irradiation effects at the site of migration. Thus, it is clinically important to develop seed immobilization techniques. We first analyze the possible causes for seed movement, and propose three potential techniques for seed immobilization: (1) surgical glue, (2) laser coagulation and (3) diathermy coagulation. The feasibility of each method is explored. Experiments were carried out using fresh bovine livers to investigate the efficacy of seed immobilization using surgical glue. Results have shown that the surgical glue can effectively immobilize the seeds. Evaluation of the radiation dose distribution revealed that the non-immobilized seed movement would change the planned isodose distribution considerably; while by using surgical glue method to immobilize the seeds, the changes were negligible. Prostate brachytherapy seed immobilization is necessary and three alternative mechanisms are promising for addressing this issue. Experiments for exploring the efficacy of the other two proposed methods are ongoing. Devices compatible with the brachytherapy procedure will be designed in future. (orig.)

  8. A eletropirexia no tratamento da neurossífilis

    Directory of Open Access Journals (Sweden)

    Iracy Doyle

    1946-12-01

    Full Text Available In the experiments described in this paper, neurosyphilis was treated by artificial fever, the body temperature having been raised my means of short-wave diathermy, and body-heat irradiation prevented by use of an air-conditioned cabinet. The A. considers the optimum rectal temperature to that between 39,5°C (103°F and a little above 41.C (105,8°F; however, temperatures above 38°C (100.5°F were accepted as beneficial. The treatments lasted an average of 8 hours, in a total average number of 10. The process was aplied to 15 patients, 11 suffering from general paresis, 3 from cerebral syphilis and 1 case of tabes. Among the cases ofe general paresis there were 5 of the expansive and 4 of the demented type, one of which in the terminal period; 1 patient had a striatal syndrome of syphilitic origin and the vascular inflammation due to syphilis. The results were as follows: 7 complete clinical cures, 3 partial improvements, one case not influenced by treatment. In percentages this would mean 63.64% clinical-cures, 27.27% partial cures, 9.% unchanged by treatment; no deaths. Of the 3 patients with brain syphilis, 2 were considered clinical cures and 1 was improved. The patient with tabes obtained notable relief from pain. The A. compares these results with those obtained by means of malaria-induced fever in 26 cases of general paresis and 3 cases of brain syphilis. Results obtained in the latter case were the following, for general paresis: clinical cures, 6 (23%; partial cures, 11 (24%; patients not improved, 3 (12%; 1 death; 1 case of post-malarial psychosis. Four of the patients presented no clinical symptoms, but only a positive reaction to the usual tests for syphilis in the spinal fluid. Of the 3 cases of brain syphilis treated with malaria, 1 was a clinical cure and 2 improved. The A. summarizes their findings, from the clinical standpoint, as follows: Electrical fever is not only less harmful, but it offers a greater percentage of cures

  9. Physiotherapy interventions for patients with chronic pelvic pain: A systematic review of the literature.

    Science.gov (United States)

    Fuentes-Márquez, Pedro; Cabrera-Martos, Irene; Valenza, Marie Carmen

    2018-05-14

    To summarize the available scientific evidence on physiotherapy interventions in the management of chronic pelvic pain (CPP). A systematic review of randomized controlled trials was performed. An electronic search of MEDLINE, CINAHL, and Web of Science databases was performed to identify relevant randomized trials from 2010-2016. Manuscripts were included if at least one of the comparison groups received a physiotherapy intervention. Studies were assessed in duplicate for data extraction and risk of bias using the Physiotherapy Evidence Database scale PEDro. Eight of the studies screened met the inclusion criteria. Four manuscripts studied the effects of electrotherapy including intravaginal electrical stimulation, short wave diathermy, respiratory-gated auricular vagal afferent nerve stimulation, percutaneous tibial nerve stimulation, and sono-electro-magnetic therapy with positive results. Three studies focused on manual assessing the efficacy of myofascial versus massage therapy in two of them and ischemic compression for trigger points. Although physiotherapy interventions show some beneficial effects, evidence cannot support the results. Heterogeneity in terms of population phenotype, methodological quality, interpretation of results, and operational definition result in little overall evidence to guide treatment.

  10. Variable Power, Short Microwave Pulses Generation using a CW Magnetron

    Directory of Open Access Journals (Sweden)

    CIUPA, R.

    2011-05-01

    Full Text Available Fine control of microwave power radiation in medical and scientific applications is a challenging task. Since a commercial Continuous Wave (CW magnetron is the most inexpensive microwave device available today on the market, it becomes the best candidate for a microwave power generator used in medical diathermy and hyperthermia treatments or high efficiency chemical reactions using microwave reactors as well. This article presents a new method for driving a CW magnetron with short pulses, using a modified commercial Zero Voltage Switching (ZVS inverter, software driven by a custom embedded system. The microwave power generator designed with this method can be programmed for output microwave pulses down to 1% of the magnetron's power and allows microwave low frequency pulse modulation in the range of human brain electrical activity, intended for medical applications. Microwave output power continuous control is also possible with the magnetron running in the oscillating area, using a dual frequency Pulse Width Modulation (PWM, where the low frequency PWM pulse is modulating a higher resonant frequency required by the ZVS inverter's transformer. The method presented allows a continuous control of both power and energy (duty-cycle at the inverter's output.

  11. Hemostasis in tubeless PNL: point of technique.

    Science.gov (United States)

    Aron, Monish; Goel, Rajiv; Kesarwani, Pawan K; Gupta, Narmada P

    2004-01-01

    Tubeless PNL (percutaneous nephrolithotomy), in a highly selected group of patients, is a modification aimed at reducing the morbidity of PNL. We present a simple technique of achieving tract hemostasis as an adjunct to the safe performance of a tubeless PNL. Charts of 40 consecutive patients who underwent tubeless PNL at our center were reviewed. In the latter 20 consecutive patients, diathermy coagulation of the intrarenal bleeders and tract was done and these patients were compared with the earlier 20 patients in whom fulguration was not done. Drop in hemoglobin, postoperative analgesic requirement, operating time, length of hospitalization and postoperative complications were compared. No statistical difference was found between the operative times and drop in hemoglobin for both the groups. The length of hospitalization and postoperative analgesic requirement were significantly less in the fulguration group. No significant complications were noted in either of the two groups. Fulguration of visible intrarenal and tract bleeders is a simple, safe and effective hemostatic adjunct in patients undergoing tubeless PNL. copyright 2004 S. Karger AG, Basel

  12. An Assessment of Hazards Caused by Electromagnetic Interaction on Humans Present near Short-Wave Physiotherapeutic Devices of Various Types Including Hazards for Users of Electronic Active Implantable Medical Devices (AIMD

    Directory of Open Access Journals (Sweden)

    Jolanta Karpowicz

    2013-01-01

    Full Text Available Leakage of electromagnetic fields (EMF from short-wave radiofrequency physiotherapeutic diathermies (SWDs may cause health and safety hazards affecting unintentionally exposed workers (W or general public (GP members (assisting patient exposed during treatment or presenting there for other reasons. Increasing use of electronic active implantable medical devices (AIMDs, by patients, attendants, and workers, needs attention because dysfunctions of these devices may be caused by electromagnetic interactions. EMF emitted by 12 SWDs (with capacitive or inductive applicators were assessed following international guidelines on protection against EMF exposure (International Commission on Nonionizing Radiation Protection for GP and W, new European directive 2013/35/EU for W, European Recommendation for GP, and European Standard EN 50527-1 for AIMD users. Direct EMF hazards for humans near inductive applicators were identified at a distance not exceeding 45 cm for W or 62 cm for GP, but for AIMD users up to 90 cm (twice longer than that for W and 50% longer than that for GP because EMF is pulsed modulated. Near capacitive applicators emitting continuous wave, the corresponding distances were: 120 cm for W or 150 cm for both—GP or AIMD users. This assessment does not cover patients who undergo SWD treatment (but it is usually recommended for AIMD users to be careful with EMF treatment.

  13. Laparoscopic appendicectomy using endo-ring applicator and fallope rings

    International Nuclear Information System (INIS)

    Ali, Iyoob V; Maliekkal, Joji I

    2009-01-01

    Wider adoption of laparoscopic appendicectomy (LA) is limited by problems in securing the appendiceal base as well as the cost and the duration compared with the open procedure. The objective of this study was to assess the feasibility and efficacy of a new method for securing the appendiceal base in LA, so as to make the entire procedure simpler and cheaper, and hence, more popular. Twenty-five patients who were candidates for appendicectomy (emergency as well as elective) and willing for the laparoscopic procedure were selected for this study. Ports used were 10 mm at the umbilicus, 5 mm at the lower right iliac fossa, and 10 mm at the left iliac fossa. Extremely friable, ruptured, or turgid organs of diameters larger than 8 mm were excluded from the study. The mesoappendix was divided close to the appendix by diathermy. Fallope rings were applied to the appendiceal base using a special ring applicator, and the appendix was divided and extracted through the lumen of the applicator. The procedure was successful in 23 (92%) cases, and the mean duration of the procedure was 20 minutes (15-32 minutes). There were no procedural complications seen during a median follow-up of two weeks. The equipment and rings were cheaper when compared with that of the standard methods of securing the base of the appendix. LA using fallope rings is a safe, simple, easy-to-learn, and economically viable method. (author)

  14. The Da Vinci Xi and robotic radical prostatectomy-an evolution in learning and technique.

    Science.gov (United States)

    Goonewardene, S S; Cahill, D

    2017-06-01

    The da Vinci Xi robot has been introduced as the successor to the Si platform. The promise of the Xi is to open the door to new surgical procedures. For robotic-assisted radical prostatectomy (RARP)/pelvic surgery, the potential is better vision and longer instruments. How has the Xi impacted on operative and pathological parameters as indicators of surgical performance? This is a comparison of an initial series of 42 RARPs with the Xi system in 2015 with a series using the Si system immediately before Xi uptake in the same calendar year, and an Si series by the same surgeon synchronously as the Xi series using operative time, blood loss, and positive margins as surrogates of surgical performance. Subjectively and objectively, there is a learning curve to Xi uptake in longer operative times but no impact on T2 positive margins which are the most reflective single measure of RARP outcomes. Subjectively, the vision of the Xi is inferior to the Si system, and the integrated diathermy system and automated setup are quirky. All require experience to overcome. There is a learning curve to progress from the Si to Xi da Vinci surgical platforms, but this does not negatively impact the outcome.

  15. Management of reticular veins and telangiectases.

    Science.gov (United States)

    Smith, Philip Coleridge

    2015-11-01

    To review the literature related to the management of reticular varices and telangiectases of the lower limbs to provide guidance on the treatment of these veins. Very few randomised clinical trials are available in this field. A European Guideline has been published on the treatment of reticular varices and telangiectases, which is largely based on the opinion of experts. Older accounts written by individual phlebologists contain extensive advice from their own practice, which is valuable in identifying effective methods of sclerotherapy. All accounts indicate that a history should be taken combined with a clinical and ultrasound examination to establish the full extent of the venous disease. Sclerotherapy is commenced by injecting the larger veins first of all, usually the reticular varices. Later in the same session or in subsequent sessions, telangiectases can be treated by direct injection. Following treatment, the application of class 2 compression stockings for a period of up to three weeks is beneficial but not used universally by all phlebologists. Further sessions can follow at intervals of 2-8 weeks in which small residual veins are treated. Resistant veins can be managed by ultrasound-guided injection of underlying perforating veins and varices. Other treatments including RF diathermy and laser ablation of telangiectases have very limited efficacy in this condition. Sclerotherapy, when used with the correct technique, is the most effective method for the management of reticular varices and telangiectases. © The Author(s) 2015.

  16. Verification of Electromagnetic Field Measurements via Inter-laboratory Comparison Measurements

    Directory of Open Access Journals (Sweden)

    M. Mann

    2005-01-01

    Full Text Available An inter-laboratory comparison of field strength measurements was conducted in order to verify the comparability of high-frequency electromagnetic field measurements. For this purpose, 17 participating teams hosted by the working group "procedures of exposure determination" of the LAI (Länderausschuss für Immissionsschutz, state committee on immission control determined the field strength at given stations around a hospital situation. At those stations very different signals were generated, such as sine wave signals at 27MHz and 433MHz, signals from a diathermy device in Continuous-Wave (CW and Pulse-Width-Modulation (PWM mode, from a GSM base station at 900MHz and 1800MHz, from a UMTS base station, from a babyphone device and from a DECT cordless phone. This contribution describes the evaluation of the measured values and the approach to the computation of a reference value. Considering various sources of electromagnetic fields in the areas of personal safety at work and of immission control, the most important results are presented and the conclusions drawn are discussed.

  17. Risk assessment of electromagnetic fields exposure with metallic orthopedic implants: a cadaveric study.

    Science.gov (United States)

    Crouzier, D; Selek, L; Martz, B-A; Dabouis, V; Arnaud, R; Debouzy, J-C

    2012-02-01

    Metallic materials are well known to strongly interact with electromagnetic fields. While biological effects of such field have been extensively studied, only few works dealt with the interactions of electromagnetic waves with passive metallic device implanted in biological system. Hence only several numerical and phantom simulation studies were focusing on this aspect, whereas no in situ anatomic experiment has been previously performed. In this study the effect of electromagnetic waves on eight different orthopaedic medical devices (six plates from 55 to 318mm length, a total knee and a total hip prosthesis) were explored on six human cadavers. To mimic a random environmental exposure resulting from the most common frequencies band used in domestic environment and medical applications (TV and radio broadcasting, cell phone communication, MRI, diathermy treatment), a multifrequency generator emitting in VHF, UHF, GSM and GCS frequency bands was used. The different medical devices were exposed to an electromagnetic field at 50W/m(2) and 100W/m(2). After 6min exposure, the temperature was measured on three points close to each medical device, and the induced currents were estimated. No significant temperature increase (<0.2°C) was finally detected; beside, a slight induced tension (up to 1.1V) was recorded but would appear too low to induce any biological side effect. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  18. Sterilization and disinfection: the prevailing indifference

    International Nuclear Information System (INIS)

    Mirza, I.

    2007-01-01

    To evaluate the knowledge and attitude of health care professionals towards the process of sterilization and disinfection, and to check the adequacy of the reading material accessible to them. The study comprised of three components. In the first part, sections devoted to this subject in the popular books read by the students of operation theatre assistant course and students of diploma in general nursing were examined for adequacy and authenticity of information. In the second part, standard operating procedures were examined regarding sterilization of textile, rubber tubes of suction units and diathermy hand pieces of 20 operation theatres of three teaching hospital attached to undergraduate medical college of Punjab. In the third part of the study, working knowledge of 64 practicing operation theatre assistants and 57 practicing nurses was assessed through a questionnaire. It was found that popular books either did not contain the required information or the information provided was misleading or incorrect. Standard operating procedures for sterilization of selected items of all the operation theatres studied fell much below the standard of practice desired in the light of current knowledge and contemporary practices. Finally the working knowledge of the professionals studied was much below the bare minimum expected by the profession. There is a dire need for upgrading the knowledge and attitude of health care professionals regarding sterilization, besides improving the operation theatres sterilization procedures. (author)

  19. Reconstruction of the Upper Eyelid with Flaps and Free Grafts after Excision of Basal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Alessandro Guido Actis

    2011-11-01

    Full Text Available Purpose: To describe a reconstructive technique of the superior eyelid with flaps and free grafts after excision of a basal cell carcinoma. Methods: Single case report of a 79-year-old woman who presented to our hospital with a basal cell carcinoma of the upper eyelid margin with initial erosion. Results: A large and full-thickness excision of the carcinoma was performed. The reconstruction technique should be customized to the individual patient. In this case, the use of a full-thickness tarsal graft from the contralateral upper eyelid, followed by an ipsilateral bipedicled flap and finally by a skin graft, was an effective surgical procedure, performed in one stage, without complications, and with good functional and esthetic results. Conclusions: Malignant neoplasms represent the leading cause of plastic reconstruction in the orbital region. Surgical techniques must be individualized for each patient and for each type of carcinoma. Reconstructive techniques with free grafts and flaps yield excellent results in the orbital region, particularly when some advice and a few fundamental rules are followed, namely accurate hemostasis of the receiving graft bed by moderate use of diathermy, careful suturing of the edges, and application of a compressive dressing for at least 4 days. Postoperative complications are very rare.

  20. Guide for preparing annual reports on radiation-safety testing of electronic products (general)

    International Nuclear Information System (INIS)

    1987-10-01

    For manufacturers of electronic products other than those for which a specific guide has been issued, the guide replaces the Guide for the Filing of Annual Reports (21 CFR Subchapter J, Section 1002.11), HHS Publication FDA 82-8127. The electronic product (general) annual reporting guide is applicable to the following products: products intended to produce x radiation (accelerators, analytical devices, therapy x-ray machines); microwave diathermy machines; cold-cathode discharge tubes; and vacuum switches and tubes operating at or above 15,000 volts. To carry out its responsibilities under Public Law 90-602, the Food and Drug Administration's Center for Devices and Radiological Health (CDRH) has issued a series of regulations contained in Title 21 of the Code of Federal Regulations (CFR). Part 1002 of 21 CFR deals with records and reports. Section 1002.61 categorizes electronic products into Groups A through C. Section 1002.30 requires manufacturers of products in Groups B and C to establish and maintain certain records, while Section 1002.11 requires such manufacturers to submit an Annual Report summarizing the contents of the required records. Section 1002.7 requires that reports conform to reporting guides issued by CDRH unless an acceptable justification for an alternate format is provided

  1. Paediatric sutureless circumcision-an alternative to the standard technique.

    LENUS (Irish Health Repository)

    2012-01-31

    INTRODUCTION: Circumcision is one of the most commonly performed surgical procedures in male children. A range of surgical techniques exist for this commonly performed procedure. The aim of this study is to assess the safety, functional outcome and cosmetic appearance of a sutureless circumcision technique. METHODS: Over a 9-year period, 502 consecutive primary sutureless circumcisions were performed by a single surgeon. All 502 cases were entered prospectively into a database including all relevant clinical details and a review was performed. The technique used to perform the sutureless circumcision is a modification of the standard sleeve technique with the use of a bipolar diathermy and the application of 2-octyl cyanoacrylate (2-OCA) to approximate the tissue edges. RESULTS: All boys in this study were pre-pubescent and the ages ranged from 6 months to 12 years (mean age 3.5 years). All patients had this procedure performed as a day case and under general anaesthetic. Complications included: haemorrhage (2.2%), haematoma (1.4%), wound infection (4%), allergic reaction (0.2%) and wound dehiscence (0.8%). Only 9 (1.8%) parents or patients were dissatisfied with the cosmetic appearance. CONCLUSION: The use of 2-OCA as a tissue adhesive for sutureless circumcisions is an alternative to the standard suture technique. The use of this tissue adhesive, 2-OCA, results in comparable complication rates to the standard circumcision technique and results in excellent post-operative cosmetic satisfaction.

  2. Is the bipolar vessel sealer device an effective tool in robotic surgery? A retrospective analysis of our experience and a meta-analysis of the literature about different robotic procedures by investigating operative data and post-operative course.

    Science.gov (United States)

    Ortenzi, Monica; Ghiselli, Roberto; Baldarelli, Maddalena; Cardinali, Luca; Guerrieri, Mario

    2018-04-01

    The latest robotic bipolar vessel sealing tools have been described to be effective allowing to perform procedures with reduced blood loss and shorter operative times. The aim of this study was to assess the efficacy and reliability of these devices applied in different robotic procedures. All robotic operations, between 2014 and 2016, were performed using the EndoWrist One VesselSealer (EWO, Intuitive Surgical, Sunnyvale, CA), a bipolar fully wristed device. Data, including age, gender, body mass index (BMI), were collected. Robot docking time, intraoperative blood loss, robot malfunctioning and overall operative time were analyzed. A meta-analysis of the literature was carried out to point the attention to three different parameters (mean blood loss, operating time and hospital stay) trying to identify how different coagulation devices may affect them. In 73 robotic procedures, the mean operative time was 118.2 minutes (75-125 minutes). Mean hospital stay was four days (2-10 days). There were two post-operative complications (2.74%). The bipolar vessel sealer offers the efficacy of bipolar diathermy and the advantages of a fully wristed instrument. It does not require any change of instruments for coagulation or involvement of the bedside assistant surgeon. These characteristics lead to a reduction in operative time.

  3. NIKOLA TESLA AND MEDICINE: 160TH ANNIVERSARY OF THE BIRTH OF THE GENIUS WHO GAVE LIGHT TO THE WORLD - PART II.

    Science.gov (United States)

    Vucevic, Danijela; Dordevic, Drago; Radosavljevic, Tatjana

    2016-11-01

    Nikola Tesla (1856- 1943) was a genius inventor and scientist, whose contribution to medicine is remarkable. Part I of this article reviewed special contributions of the world renowned scientist to the establishment of radiology as a new discipline in medicine. This paper deals with the use of Tesla currents in medicine. Tesla Currents in Medicine. Tesla's greatest impact on medicine is his invention of a transformer (Tesla coil) for producing high frequency and high voltage currents (Tesla currents). Tesla currents are used in diathermy, as they, while passing through the body, transform electrical energy into a therapeutic heat. In 1891, Tesla passed currents through his own body and was the first to experience their beneficial effects. He kept correspondence on electrotherapy with J. Dugan and S. H. Monell. In 1896, he used high frequency currents and designed an ozone generator for producing ozone, with powerful antiseptic and antibacterial properties. Tesla is famous for his extensive experiments with mechanical vibrations and resonance, examining their effects on the organ ism and pioneering their use for medical purposes. Tesla also designed an oscillator to relieve fatigue of the leg muscles. It is less known that Tesla's inventions (Tesla coil and wireless remote control) are widely used in modern medical equipment. Apart from this, wireless technology is nowadays widely applied in numerous diagnostic and therapeutic procedures. Nikola Tesla was the last Renais- sance figure of the modern era. Tesla bridged three centuries and two millennia by his inventions, and permanently indebted humankind by his epochal discoveries.

  4. Do soft skills predict surgical performance?: a single-center randomized controlled trial evaluating predictors of skill acquisition in virtual reality laparoscopy.

    Science.gov (United States)

    Maschuw, K; Schlosser, K; Kupietz, E; Slater, E P; Weyers, P; Hassan, I

    2011-03-01

    Virtual reality (VR) training in minimal invasive surgery (MIS) is feasible in surgical residency and beneficial for the performance of MIS by surgical trainees. Research on stress-coping of surgical trainees indicates the additional impact of soft skills on VR performance in the surgical curriculum. The aim of this study was to evaluate the impact of structured VR training and soft skills on VR performance of trainees. The study was designed as a single-center randomized controlled trial. Fifty first-year surgical residents with limited experience in MIS ("camera navigation" in laparoscopic cholecystectomy only) were randomized for either 3 months of VR training or no training. Basic VR performance and defined soft skills (self-efficacy, stress-coping, and motivation) were assessed prior to randomization using basic modules of the VR simulator LapSim(®) and standardized psychological questionnaires. Three months after randomization VR performance was reassessed. Outcome measurement was based on the results derived from the most complex of the basic VR modules ("diathermy cutting") as the primary end point. A correlation analysis of the VR end-point performance and the psychological scores was done in both groups. Structured VR training enhanced VR performance of surgical trainees. An additional correlation to high motivational states (P 0.05). Low self-efficacy and negative stress-coping strategies seem to predict poor VR performance. However, structured training along with high motivational states is likely to balance out this impairment.

  5. Exposição ocupacional de fisioterapeutas aos campos elétrico e magnético e a eficácia das gaiolas de Faraday Occupational exposure of physical therapists to electric and magnetic fields and the efficacy of Faraday cages

    Directory of Open Access Journals (Sweden)

    Iracimara de Anchieta Messias

    2011-10-01

    Full Text Available OBJETIVO: Medir a exposição de fisioterapeutas aos campos elétrico e magnético produzidos por 17 equipamentos de diatermia de ondas curtas (DOC de clínicas de fisioterapia da cidade de Presidente Prudente, São Paulo, Brasil. Comparar os valores medidos com os níveis de exposição recomendados pelo ICNIRP (International Commission on Non-Ionizing Radiation Protection. Observar a eficácia das gaiolas de Faraday como medida de proteção à exposição dos fisioterapeutas aos campos elétrico e magnético oscilantes. MÉTODOS: As medidas dos campos elétrico e magnético foram realizadas durante sessões reais de tratamento fisioterápico, em quatro pontos: nas proximidades da pelve e da cabeça do operador, dos cabos elétricos dos aparelhos e dos eletrodos de aplicação. O equipamento de medição utilizado foi o EMR-200 da Wandell & Goltermann. RESULTADOS: Os valores obtidos nas proximidades dos eletrodos e cabos estavam de 10 a 30 vezes acima dos níveis de referência ocupacionais recomendados pela ICNIRP. Nas salas de tratamento com DOC com gaiola de Faraday, os campos encontrados foram ainda mais altos que os das salas sem esse revestimento, principalmente o campo magnético, com valores superiores a 100 vezes o limite de exposição da ICNIRP. CONCLUSÕES: As intensidades dos campos elétrico e magnético obtidas neste trabalho estão, de modo geral, acima dos níveis de exposição recomendados pelas normas da ICNIRP. Além disso observou-se que a gaiola de Faraday não fornece proteção aos fisioterapeutas mas aumenta os níveis de exposição aos quais estão submetidos estes profissionais.OBJECTIVE: Measure physical therapists' exposure to the electric and magnetic fields produced by 17 shortwave diathermy devices in physical therapy clinics in the city of Presidente Prudente, São Paulo State, Brazil. Compare the observed values with the exposure levels recommended by the International Commission on Non-ionizing Radiation

  6. The Global Spine Care Initiative: applying evidence-based guidelines on the non-invasive management of back and neck pain to low- and middle-income communities.

    Science.gov (United States)

    Chou, Roger; Côté, Pierre; Randhawa, Kristi; Torres, Paola; Yu, Hainan; Nordin, Margareta; Hurwitz, Eric L; Haldeman, Scott; Cedraschi, Christine

    2018-02-19

    The purpose of this review was to develop recommendations for the management of spinal disorders in low-income communities, with a focus on non-invasive pharmacological and non-pharmacological therapies for non-specific low back and neck pain. We synthesized two evidence-based clinical practice guidelines for the management of low back and neck pain. Our recommendations considered benefits, harms, quality of evidence, and costs, with attention to feasibility in medically underserved areas and low- and middle-income countries. Clinicians should provide education and reassurance, advise patients to remain active, and provide information about self-care options. For acute low back and neck pain without serious pathology, primary conservative treatment options are exercise, manual therapy, superficial heat, and nonsteroidal anti-inflammatory drugs (NSAIDs). For patients with chronic low back and neck pain without serious pathology, primary treatment options are exercise, yoga, cognitive behavioral therapies, acupuncture, biofeedback, progressive relaxation, massage, manual therapy, interdisciplinary rehabilitation, NSAIDs, acetaminophen, and antidepressants. For patients with spinal pain with radiculopathy, clinicians may consider exercise, spinal manipulation, or NSAIDs; use of other interventions requires extrapolation from evidence regarding effectiveness for non-radicular spinal pain. Clinicians should not offer treatments that are not effective, including benzodiazepines, botulinum toxin injection, systemic corticosteroids, cervical collar, electrical muscle stimulation, short-wave diathermy, transcutaneous electrical nerve stimulation, and traction. Guidelines developed for high-income settings were adapted to inform a care pathway and model of care for medically underserved areas and low- and middle-income countries by considering factors such as costs and feasibility, in addition to benefits, harms, and the quality of underlying evidence. The selection of

  7. Posterior Retroperitoneoscopic Resection of Extra-adrenal Paraganglioma Located in the Aorto-caval Space.

    Science.gov (United States)

    Kang, Sang-Wook; Kandil, Emad; Kim, Min Jhi; Kim, Kwang Soon; Lee, Cho Rok; Jeong, Jong Ju; Nam, Kee-Hyun; Chung, Woong Youn; Park, Cheong Soo

    2018-04-01

    The posterior retroperitoneoscopic adrenalec tomy has several advantages compared with the transperitoneal approach such as a shorter and more direct route to the target organ, no breach of the intraperitoneal space, and no required retraction of the adjacent organs. It also is a safe procedure with a short learning curve.1 - 5 This report presents a challenging case of an extra-adrenal paraganglioma located in the aorto-caval space and managed using the retroperitoneal approach. A 39-year-old man was placed in the prone jackknife position, and three incisions were made in the right posterior abdominal wall for placement of the laparoscopic ports. The retroperitoneal space was entered with diathermy and blunt finger dissection, and retropneumoperitoneum was achieved with carbon dioxide insufflation pressure up to 18 mmHg. After identification of the right kidney and vessels, the tumor was meticulously dissected and excised with an energy device. The specimen was removed using a laparoscopic specimen retrieval bag, and the port sites were closed in layers. The operative time was 130 min, and the total blood loss was 30 ml. The tumor was diagnosed as a moderately differentiated extra-adrenal paraganglioma. The Von Hippel-Lindau gene mutation was detected using next-generation sequencing. The posterior retroperitoneoscopic approach is a safe, feasible, and effective method for excising an extra-adrenal paraganglioma even in the aorto-caval space. The authors suggest that this procedure is a useful surgical option for treatment of an aorto-caval paraganglioma for selected patients and by experienced surgeons.

  8. Branchial anomalies in children.

    Science.gov (United States)

    Bajaj, Y; Ifeacho, S; Tweedie, D; Jephson, C G; Albert, D M; Cochrane, L A; Wyatt, M E; Jonas, N; Hartley, B E J

    2011-08-01

    Branchial cleft anomalies are the second most common head and neck congenital lesions seen in children. Amongst the branchial cleft malformations, second cleft lesions account for 95% of the branchial anomalies. This article analyzes all the cases of branchial cleft anomalies operated on at Great Ormond Street Hospital over the past 10 years. All children who underwent surgery for branchial cleft sinus or fistula from January 2000 to December 2010 were included in this study. In this series, we had 80 patients (38 female and 42 male). The age at the time of operation varied from 1 year to 14 years. Amongst this group, 15 patients had first branchial cleft anomaly, 62 had second branchial cleft anomaly and 3 had fourth branchial pouch anomaly. All the first cleft cases were operated on by a superficial parotidectomy approach with facial nerve identification. Complete excision was achieved in all these first cleft cases. In this series of first cleft anomalies, we had one complication (temporary marginal mandibular nerve weakness. In the 62 children with second branchial cleft anomalies, 50 were unilateral and 12 were bilateral. In the vast majority, the tract extended through the carotid bifurcation and extended up to pharyngeal constrictor muscles. Majority of these cases were operated on through an elliptical incision around the external opening. Complete excision was achieved in all second cleft cases except one who required a repeat excision. In this subgroup, we had two complications one patient developed a seroma and one had incomplete excision. The three patients with fourth pouch anomaly were treated with endoscopic assisted monopolar diathermy to the sinus opening with good outcome. Branchial anomalies are relatively common in children. There are three distinct types, first cleft, second cleft and fourth pouch anomaly. Correct diagnosis is essential to avoid inadequate surgery and multiple procedures. The surgical approach needs to be tailored to the type

  9. Human thermoregulation model of RF-EMF interaction

    International Nuclear Information System (INIS)

    Niedermayr, F.

    2012-01-01

    A thermal model has been developed which allows accurate temperature computations in high resolution anatomical models. The model is based on the basic thermal model described by Pennes which neglects any of the thermoregulatory mechanisms in humans. The thermal model developed here overcomes major simplifications by the mathematical consideration of these mechanisms which is needed for modeling a physiologically correct reaction to a thermal stimulus. The local blood perfusion, as well as the local metabolic rate, is modified as a function of the local tissue temperature. The model implemented increases the blood temperature on the basis of the absorbed energy. The heat exchange at the tissue/air interface, including the skin and respiratory tract, is also improved. The model takes not only the heat dissipation by radiation, conduction and convection into consideration but also the insensible loss of water by evaporation. Furthermore, the thermal model also accounts for the active heat dissipation by sweating. The generic implementation of the thermal model makes it possible to use it for different human models (children, adults, pregnant women) and it is also possible to take implants into consideration. The performance of the model is validated by comparing the simulation results to actual temperature measurements in humans. The thermal model is used to compute the temperature elevation in humans exposed to radiofrequency electromagnetic fields. Until now, the tissue heating caused by radiofrequency electromagnetic fields could only be estimated by a surrogate, namely the specific absorption rate. The temperature elevations in children of different sizes and ages as well as pregnant women at different gestational stages exposed to plane waves is computed. Furthermore, the temperature elevation in human bodies is computed for a diagnostic modality (magnetic resonance imaging) and a therapeutic modality (medical diathermy). (author) [de

  10. MIST VR. A laparoscopic surgery procedures trainer and evaluator.

    Science.gov (United States)

    Sutton, C; McCloy, R; Middlebrook, A; Chater, P; Wilson, M; Stone, R

    1997-01-01

    The key bimanual instrument tasks involved in laparoscopic surgery have been abstracted for use in a virtual reality surgical skills evaluator and trainer. The trainer uses two laparoscopic instruments mounted on a frame with position sensors which provide instrument movement data that is translated into interactive real time graphics on a PC (P133, 16 Mb RAM, graphics acceleration card). An accurately scaled operating volume of 10 cm3 is represented by a 3D cube on the computer screen. "Camera" position and size of target objects can be varied for different skill levels. Targets appear randomly within the operating volume according to the skill task and can be grasped and manipulated with the instruments. Accuracy and errors during the tasks and time to completion are logged. Mist VR has tutorial, training, examination, analysis and configuration modes. Six tasks have been selected and include combinations of instrument approach, target acquisition, target manipulation and placement, transfer between instruments, target contact with optional diathermy, and controlled instrument withdrawal/replacement. Tasks can be configured for varying degrees of difficulty and the configurations saved to a library for reuse. Specific task configurations can be assigned to individual students. In the examination mode the supervisor can select the tasks, repetitions and order and save to a specific file for that trainee. Progress can be assessed and there is the option for playback of the training session or examination. Data analyses permit overall, including task, and right or left hand performances to be quantified. Mist VR represents a significant advance over the subjective assessment of training performances with existing "plastic box" basic trainers.

  11. Physiotherapy and cardiac rhythm devices: a review of the current scope of practice.

    Science.gov (United States)

    Digby, Geneviève C; Daubney, Marguerite E; Baggs, Jim; Campbell, Debra; Simpson, Christopher S; Redfearn, Damian P; Brennan, F James; Abdollah, Hoshiar; Baranchuk, Adrian

    2009-07-01

    Several case reports have demonstrated negative interactions between various physiotherapy modalities and cardiac rhythm devices (CRD). Fear of these potential interactions may lead to suboptimal utilization of physiotherapy treatments in CRD patients. No prior review of available guidelines, or management strategies, on the interaction between physiotherapy modalities and CRD patients has been reported. To review existing guidelines regarding the use of physiotherapy modalities in patients with pacemakers and/or implantable cardioverter-defibrillators (ICDs). To retrospectively analyse CRD patient encounters at a local physiotherapy facility during a period of 2 years. A review of the literature regarding the potential interactions between physiotherapy modalities and CRDs was performed. Next, a 2 year retrospective analysis of patient encounters at a physiotherapy facility was conducted. In addition, seven international physiotherapy societies and four CRD manufacturers were surveyed with respect to recommendations regarding physiotherapy treatments in device patients. The local physiotherapy facility treated 25 patients with CRD (22 pacemaker and 3 ICD patients) for a total of 230 visits (9.2 visits/patient). Five patients received transcutaneous electrical nerve stimulation (TENS) and all 25 were administered additional treatment in the form of ultrasound (15), acupuncture (19), Laser (7), traction/manual therapy (12), exercise (8), education (18), taping (5), and/or moist heat (5). No complications occurred. Meanwhile, international societies and device manufacturers offered few specific or consistent recommendations. There are no specific international policies regarding the administration of physiotherapy modalities in CRD patients and, thus, there are no specific guidelines to be implemented at the local level. Review of the literature and of recommendations from CRD manufacturers suggests that TENS, Diathermy, and Interferential Electrical Current Therapy

  12. Short and medium term outcomes after rollerball endometrial ablation for menorrhagia.

    Science.gov (United States)

    Fraser, I S; Angsuwathana, S; Mahmoud, F; Yezerski, S

    1993-04-05

    To review prospectively the intraoperative, short and medium term outcomes of patients treated by rollerball endometrial ablation during the learning curve for this relatively new procedure. Seventy-seven women with menorrhagia (71 with dysfunctional bleeding; six with additional small intramural myomas) underwent hysteroscopic rollerball endometrial ablation by coagulation diathermy during 1.5% glycine irrigation, after a two-month period of hormonal suppression. OPERATIVE AND SHORT-TERM EFFECTS: These were recorded at operation and six-week follow-up. No serious short-term complications were recorded. Objective measurement of intraoperative blood loss was always less than 20 mL. One woman experienced uterine perforation with a narrow cervical dilator which did not interfere with the ablation, and two patients had mild postoperative uterine infections. One patient experienced persistent postoperative pain. MEDIUM-TERM OUTCOME: This was recorded at each visit, or by telephone, and confirmed by questionnaire at one year. Twenty-five per cent achieved complete amenorrhoea, 29% staining only, 30% light periods, 10% "normal" or erratic periods and 6% were unchanged. Five patients underwent a second ablation, and three of these later underwent hysterectomy. Measured menstrual blood loss fell from 104 +/- 19 mL (mean +/- standard error of mean) to 1.7 +/- 1.1 mL at six months in 18 women. Other menstrual symptoms were also often dramatically reduced. Of those women with dysmenorrhoea, 33% were cured and 43% markedly improved; of those with midcycle pain, 28% were cured and 53% markedly improved; of those with significant premenstrual symptoms, 13% were cured, 47% markedly improved, 11% unchanged, and 6% were worse. This new procedure is a safe and effective treatment for menorrhagia caused by dysfunctional uterine bleeding, with impressive ancillary benefits for dysmenorrhoea, midcycle pain and premenstrual tension. It is often called minimally invasive surgery, but it

  13. The role of obesity in the development of polycystic ovary syndrome.

    Science.gov (United States)

    Motta, Alicia Beatriz

    2012-01-01

    Polycystic Ovary Syndrome (PCOS) is one of the common endocrine diseases that affects women in their reproductive age. PCOS has diverse clinical implications that include reproductive (infertility, hyperandrogenism, hirsutism), metabolic (insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, cardiovascular diseases) and psychological features (increased anxiety, depression and worsened quality of life). The exact patho-physiology of PCOS is complex and remains largely unclear. The prevalence of PCOS is estimated at 4-18%, depending on diverse factors discussed ahead. The phenotype varies widely depending on life stage, genotype, ethnicity and environmental factors including lifestyle and body weight. During the last decades, obesity and excess weight are major chronic diseases all around the word. Obesity increases some features of PCOS such as hyperandrogenism, hirsutism, infertility and pregnancy complications. Both obesity and insulin resistance increase diabetes mellitus type 2 and cardiovascular diseases. Moreover, obesity impairs insulin resistance and exacerbates reproductive and metabolic features of PCOS. It is well known that obesity is associated with anovulation, pregnancy loss and late pregnancy complications (pre-eclampsia, gestational diabetes). Obesity in PCOS is also linked to failure or delayed response to the various treatments including clomiphene citrate, gonadotropins and laparoscopic ovarian diathermy. It has been reported that, after losing as little as 5 % of initial body weight obese women with PCOS improved spontaneous ovulation rates and spontaneous pregnancy. Therefore, the weight loss prior to conception improves live birth rate in obese women with or without PCOS. The treatment of obesity may include lifestyle therapy (diet and exercise), pharmacological treatment and bariatric surgery. In summary, weight loss is considered the first-line therapy in obese women with PCOS. In the present review, the consequence and

  14. A single-blind controlled study of electrocautery and ultrasonic scalpel smoke plumes in laparoscopic surgery.

    Science.gov (United States)

    Fitzgerald, J Edward F; Malik, Momin; Ahmed, Irfan

    2012-02-01

    irritant hydrocarbons than cigarette smoke. A nonsignificant trend toward lower hydrocarbon concentrations was seen with ultrasonic scalpel dissection compared with diathermy. The contamination levels in city air were largely comparable with those seen after ultrasonic scalpel use. Although hydrocarbon concentrations are low, cumulative exposures may increase health risks. Where concerns arise, ultrasonic scalpel dissection may be preferable.

  15. Pediatric laparoscopic surgery in North-Central Nigeria: Achievements and challenges

    Directory of Open Access Journals (Sweden)

    Lukman Olajide Abdur-Rahman

    2016-01-01

    Full Text Available Background and Objective: Advances in laparoscopy are making the service accessible even in resource-poor countries where adaptations are made to meet local challenges. We report our experience in the provision of laparoscopy service to children at a tertiary health center in North-central Nigeria. Methods: A team of pediatric surgeons, anesthetists, and nurses collaborated to provide service and train other personnel. A prospective collection of data on biodata, diagnoses, procedure, and outcome over an effective period of 36 months of laparoscopy intervention of the 54 months between September 2009 and February 2014 was done. Consent, which also included the possibility of conversion to open was obtained from the parents of the patients. Results: A total of 73 patients aged 2 weeks to 16 years with a male: female ratio of 3 to 1 had laparoscopy done during the period. Fifty-two (71.2% procedures were therapeutic, and 21 (28.8% cases were done as emergency. Laparoscopic appendectomy was the most commonly performed procedure 25 (34.3%, followed by laparoscopic orchidopexy 17 (23. 3%, and diagnostic laparoscopy for disorders of sexual differentiation in 13 (17.8%. The length of stay in hospital postoperative was 1-3 days with a mean of 1.34 ΁ 0.45 days. The complications recorded included hemorrhage, in a case of infantile hypertrophic pyloric stenosis due to failed electrocautery, one port site burns injury from diathermy dissection, and two periport pain postoperation. There was no mortality recorded. Conclusion: Pediatric laparoscopic service is gaining recognition in our practice in spite of poor resources, incessant industrial actions, and apathy from support staff. The outcomes are encouraging as the patients had minimal morbidities. Skills are improved through practice and retraining and manpower, and instruments are being expanded through our collaboration and training.

  16. Surgical Ovulation Induction in Women with Polycystic Ovary Syndrome: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Vivian Frank

    2009-03-01

    Full Text Available Background: Currently clomiphene citrate is the first-linetreatment to induce ovulation in women with polycystic ovariansyndrome (PCOS. Surgical therapy with laparoscopicovarian drilling (LOD may avoid or reduce the need for gonadotropins.Objective: To determine the effectiveness and safety of LODcompared with ovulation induction in subfertile women withclomiphene-resistant PCOS.Search Strategy: A systematic search was performed on Pub-Med (1966 to August 2007, the Ovid database (1966 to August2007, and EMBASE (1974-2007. The search terms included:infertility, menstrual disorder, hirsutism, PCOS, surgical intervention,electrocautery, electrocoagulation, diathermy, drilling,and laparoscopic ovarian drilling, ovulation, pregnancy rate,post operation adhesions and ovarian blood flow.Selection Criteria: Randomized controlled trials of womenwith clomiphene-resistant PCOS who were treated with LODto induce ovulation were included.Data Collection and Analysis: 3141 patients from 35 trialspreformed in different geographic settings were included. Alltrials were assessed for quality criteria. We included those trialswhich followed hormonal changes, ovulation, and pregnancyrates after LOD. The primary outcomes measured werehormonal changes, ovulation, and pregnancy rates as well asovarian artery blood flow, and the secondary outcome was rateof pelvic organ adhesion.Main Results: The overall ovulation rate after LOD was79.2% (74.9%-83.5% 95% CI. Of all women who ovulatedonly 66.6% (60.8%-72.4% 95% CI conceived. The mean periadnexaladhesion rate was 22.7% (21.4%-24% 95% CI.Conclusion: Compared with medical therapy, LOD has manyadvantages including: to be done once, no need for intensivemonitoring, no chance of multiple pregnancy or ovarianhyperstimulation syndrome. LOD effectively decreases ovarianandrogens and improves folliculogenesis and increases chanceof ovulation and pregnancy rate. Finally, in vitro fertilisationshould be considered as the last resort.

  17. A comparison of electrothermal bipolar vessel sealing system and electrocautery in selective neck dissection.

    Science.gov (United States)

    Ozturk, Kerem; Kaya, Isa; Turhal, Goksel; Ozturk, Arin; Gursan, Gulce; Akyildiz, Serdar

    2016-11-01

    The use of LigaSure™ vessel sealing system in head and neck surgery was reported to be reliable and safe, providing sufficient hemostasis and reducing operating time. The aim of this study was to evaluate efficacy of this technique in patients undergoing selective neck dissections. This study was carried out as a prospective controlled study at an otolaryngology department of a tertiary medical center between July 2013 and July 2015. Twenty-five patients older than 18 years who underwent unilateral selective neck dissection for head and neck cancer were included in the study. In the control group (group 2, 10 patients) only monopolar and bipolar diathermy was used; in the Ligasure group (group 1, 15 patients) Ligasure was used for hemostasis and dissection in addition to the conventional techniques. Cervical lymphadenectomy time, operation time, preoperative hemoglobin levels, preoperative hematocrit levels, postoperative hemoglobin levels, postoperative hematocrit levels, total neck drainage and drain removal time were analyzed and compared between the groups. Median operation time in group 1 and 2 were 95 min (IQR = 35) and 142.5 min (IQR = 63), respectively. Median cervical lymphadenectomy time in group 1 and 2 were 55 min (IQR = 23) and 102.5 min (IQR = 49), respectively. Median operation time and cervical operation time were significantly lower in group 1 (p < 0.05). In conclusion, LigaSure™ vessel sealing system is a safe, efficacious technique and significantly lowers cervical lymphadenectomy and operation time in selective neck dissections compared to controls. Given the superb hemostatic properties, this technique should be in the surgeon's armamentarium when possible.

  18. Interfascial technique for vertebral artery exposure in the suboccipital triangle: the road map.

    Science.gov (United States)

    Youssef, A Samy; Uribe, Juan S; Ramos, Edwin; Janjua, Rashid; Thomas, L Brannon; van Loveren, Harry

    2010-12-01

    The extradural portion of the vertebral artery (VA-V3) has a unique anatomy at the craniovertebral junction. The exposure of V3 can be accompanied by profuse bleeding from the venous plexus in addition to the potential risk of inadvertent injury of the VA during surgery at the craniovertebral junction. The natural tissue planes represent a road map to the safe exposure of the VA in the suboccipital triangle. To describe the microsurgical anatomy of the tissue planes in the suboccipital region. The suboccipital region was bilaterally dissected in 6 fresh silicone-injected cadaver heads. An interfascial technique was used to expose the VA-V3 following a tissue plane between the deep suboccipital muscular fascia dorsally and posterior atlantooccipital membrane, the C1 periosteal membrane, and the membrane covering the VA and venous plexus ventrally. The craniovertebral junction was harvested from 2 heads and prepared for histological sections. The same technique was applied in 25 operative cases. The anatomic dissections confirmed the existence of an interfascial plane that can be dissected in a blunt fashion to reach as far lateral as the transverse processes of C1 and C2. Application of the dissection technique did not require diathermy coagulation in the operating room. In 25 cases, there was no injury of the VA or bleeding from the venous plexus. Vertebral artery exposure in the suboccipital triangle (V3) can be achieved safely with minimal blood loss using a technique that follows the natural tissue plane between the deep suboccipital muscle fascia, the posterior atlantooccipital membrane, the membrane covering VA/venous plexus, and the periosteum of the C1 and C2 laminae.

  19. Blood flow in the forearm in patients with Rheumatoid arthritis and healthy subjects under local thermotherapy

    Directory of Open Access Journals (Sweden)

    C. Mucha

    2002-02-01

    Full Text Available Objectives: Muscle blood flow in the forearm of patients with rheuma-toid arthritis and healthy volunteers following treatment with temperature increasingarm baths, mudpacks and short- or decimeter-wave diathermy was studied in thisinvestigation. The aim of the study was to find out the difference of reactive hyperemia between the different temperature methods as well as the influence on theconsensual reaction. Subjects: Eighty patients with rheumatoid arthritis, stage 3 according toSteinbrocker, as well as 80 healthy human subjects had been assigned numerically in the four therapy- and controlgroups. Patients with diseases influencing the peripheral blood flow were excluded. Design: Blood flow was measured by venous occlusion plethysmography in both forearms with the subjects lyingsupine. The application of the local heat therapies had been excluded on the left forearm. The forearm blood flow wasmonitored before heat therapy, directly after as well as in two further 10 minutes intervals. An analysis of variancewas used to determine the influence on blood flow of the response to the heat therapies in patients with rheumatoidarthritis and healthy subjects.Results: Under homogeneous starting conditions and a statistically uniformed high blood flow in rest the reactive values of blood flow on the left-hand side of application and the right consensual side showed high significant differencesbetween all methods of therapy. Differences between the patients and the healthy subjects only showed tendencies withpartially lower reactions, concerning the patients with rheumatoid arthritis. All methods of heat therapy caused a statistically provable consensual reaction that turned out smaller after diathermic methods. Here the post therapeuticreaction of the blood flow on the side of application was also lower or rather shorter. Conclusion: Greater differences of the blood flow in rest between the patients with rheumatoid arthritis and healthysubjects

  20. Which interventions are cost-effective for the management of whiplash-associated and neck pain-associated disorders? A systematic review of the health economic literature by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.

    Science.gov (United States)

    van der Velde, Gabrielle; Yu, Hainan; Paulden, Mike; Côté, Pierre; Varatharajan, Sharanya; Shearer, Heather M; Wong, Jessica J; Randhawa, Kristi; Southerst, Danielle; Mior, Silvano; Sutton, Deborah; Jacobs, Craig; Taylor-Vaisey, Anne

    2016-12-01

    Whiplash-associated disorders (WAD) and neck pain and associated disorders (NAD) are prevalent conditions that impact society and impose a significant economic burden on health-care systems. Health economic evidence on WAD and NAD interventions has been sparse: only three economic evaluations of interventions for NAD were identified by the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (NPTF). An updated overview is needed to inform health-care policy and guidelines. This study aimed to determine the cost-effectiveness of interventions for grades I-III WAD and NAD in children and adults. Systematic review of health economic literature, best-evidence synthesis. We systematically searched CINAHL, the Cochrane economic databases (Health Technology Assessment, NHS Economic Evaluation Database), EconLit, EMBASE, MEDLINE, PsycINFO, and Tufts CEA Registry from 2000 to 2015 for economic evaluations of WAD and NAD interventions. We appraised relevant evaluations using the Scottish Intercollegiate Guidelines Network Methodology Criteria for Economic Evaluations. We extracted data, including mean costs (standardized to 2013 Canadian dollars [CAD]) and quality-adjusted life years (QALYs), from studies with adequate methodological quality. We recalculated cost-effectiveness statistics based on the standardized currency using a willingness-to-pay of CAD $50,000 per additional QALY. Funding was provided by the Ministry of Finance. Our search identified 1,616 citations. Six studies fulfilled our selection criteria, including three studies previously reviewed by the NPTF. Structured education appears cost-effective for adults with WAD. For adults with NAD, acupuncture added to routine medical care; manual therapy; multimodal care that includes manual therapy; advice and exercise; and psychological care using cognitive-behavioral therapy appear cost-effective. In contrast, adding manual therapy or diathermy to advice and exercise; multimodal

  1. Presentation, management, and outcome of posterior urethral valves in a Nigerian tertiary hospital

    Directory of Open Access Journals (Sweden)

    Agbugui Jude Orumuah

    2015-01-01

    Full Text Available Background: Posterior urethral valves (PUV remain the most common cause of bladder outlet obstruction and renal insufficiency in male children. The aim of this study was to evaluate the presentation, management, challenges, and outcome of the disease in a Nigerian tertiary health institution. Patients and Methods: Retrospectively, medical records of male children with a diagnosis of PUVs over a 10 year period (2003-2012 were retrieved. All data in relation to the study objectives were recorded and analyzed. Results: A total of 44 patients was managed for PUV within the period. The mean age of presentation was 3.95 years with 56.8% of the patients presenting after the age of 1 year. Voiding dysfunction noted in 40 (91.0% patients was the most common mode of presentation. The most common finding on physical examination was a palpable bladder while urinary tract infection noted in 23 (52.3% patients was the most common complication noted. Abdominal ultrasonography revealed dilated posterior urethra in 16 (36.4% cases, while micturating cystourethrogram revealed a dilated proximal urethra in all 35 cases in which it was done, diverticulum in 6 and vesicoureteric reflux in 9. The creatinine value at presentation ranged between 0.4 mg/dl and 4.0 mg/dl with a mean of 1.02 ± 0.93 mg/dl. Urethroscopy in 37 patients confirmed type I and type III PUV in 35 and 2 patients, respectively. Valve ablation with a diathermy bugbee electrode provided relief of obstructions in the 37 patients who underwent the procedure without any significant immediate complication. The period of follow-up ranged between 2 weeks and 3 years with a mean of 10.2 months. There was sustained improvement in urine stream, reduction in the mean creatinine concentration and incidence of UTI during follow-up. However, patients with significantly impaired renal function had a poorer outcome. Conclusion: Many patients with PUV presented late within the reviewed period. Valve ablation

  2. A comparison of laparoscopic energy devices on charges in thermal power after application to porcine mesentery.

    Science.gov (United States)

    Eto, Ken; Omura, Nobuo; Haruki, Koichiro; Uno, Yoshiko; Ohkuma, Masahisa; Nakajima, Shintaro; Anan, Tadashi; Kosuge, Makoto; Fujita, Tetsuji; Yanaga, Katsuhiko

    2015-02-01

    Advances in energy devices have played a major role in the rapid expansion of laparoscopic surgery. However, complications due to these energy devices are occasionally reported, and if the characteristics of these devices are not well understood, serious complications may occur. This study evaluated various typical energy devices and measured temperature rises in the adjacent tissue and in the devices themselves. We used the following 7 types of energy devices: AutoSonix (AU), SonoSurg (SS), Harmonic Scalpel (HS), LigaSure Atlas (LA), LigaSure Dolphin Tip (LD), monopolar diathermy (Mono), and bipolar scissors (Bi). Laparoscopy was performed under general anesthesia in pigs, and the mesentery was dissected using each energy device. Tissue temperature at a distance of 1 mm from the energy device blade before and after dissection was measured. Temperature of the device blade both before and after dissection, time required for dissection, and interval until the temperature fell to 100°C, 75°C, and 50°C were documented. Temperature of the surrounding tissue using each device rose the most with the Mono (50.5±8.0°C) and the least with the HS in full mode (6.2±0.7°C). Device temperature itself rose the highest with the AU in full mode (318.2±49.6°C), and the least with the Bi (61.9±4.8°C). All ultrasonic coagulation and cutting devices (AU, SS, and HS) had device temperatures increase up to ≥100°C, and even at 8 seconds after completing dissection, temperatures remained at ≥100°C. Because the adjacent tissue temperature peaked with the Mono, cautious use near the intestine and blood vessels is necessary. In addition, the active blades of all ultrasonic coagulation and cutting devices, regardless of model, developed high temperatures exceeding 100°C. Therefore, an adequate cooling period after using these devices is therefore necessary between applications.

  3. Surgical checklist application and its impact on patient safety in pediatric surgery

    Directory of Open Access Journals (Sweden)

    S N Oak

    2015-01-01

    patients was suboptimal, which led to displacement of diathermy grounding pad. In 54 (1.8% patients, the checklist was not used at all. In 76 (2.5% patients the checklist was found to be incompletely filled. Conclusions: Our study supports the use of the checklist as an essential safety tool and reinforcement of the same. The checklist may act as a valuable prompt to focus the team, to ensure that even the simple things have been cared for.

  4. Clinicopathologic correlation of argon laser photocoagulation of retinal angiomas in a patient with von Hippel-Lindau disease followed for more than 20 years.

    Science.gov (United States)

    Rosa, R H; Goldberg, M F; Green, W R

    1996-01-01

    , trans-scleral diathermy, and argon laser photocoagulation, a patient with von Hippel-Lindau disease and multiple retinal angiomas retained good vision in the other eye after successful treatment with argon laser photocoagulation with follow-up of more than 20 years. The amount of regression of angiomatous tissue after photocoagulation varied from lesion to lesion (complete in some; minimal in others). The authors conclude that argon laser photocoagulation of early lesions is effective in ablating smaller ( < or = 3-disc diameter) retinal angiomas.

  5. Presentation, management, and outcome of posterior urethral valves in a Nigerian tertiary hospital.

    Science.gov (United States)

    Orumuah, Agbugui Jude; Oduagbon, Obarisiagbon Edwin

    2015-01-01

    Posterior urethral valves (PUV) remain the most common cause of bladder outlet obstruction and renal insufficiency in male children. The aim of this study was to evaluate the presentation, management, challenges, and outcome of the disease in a Nigerian tertiary health institution. Retrospectively, medical records of male children with a diagnosis of PUVs over a 10 year period (2003-2012) were retrieved. All data in relation to the study objectives were recorded and analyzed. A total of 44 patients was managed for PUV within the period. The mean age of presentation was 3.95 years with 56.8% of the patients presenting after the age of 1 year. Voiding dysfunction noted in 40 (91.0%) patients was the most common mode of presentation. The most common finding on physical examination was a palpable bladder while urinary tract infection noted in 23 (52.3%) patients was the most common complication noted. Abdominal ultrasonography revealed dilated posterior urethra in 16 (36.4%) cases, while micturating cystourethrogram revealed a dilated proximal urethra in all 35 cases in which it was done, diverticulum in 6 and vesicoureteric reflux in 9. The creatinine value at presentation ranged between 0.4 mg/dl and 4.0 mg/dl with a mean of 1.02 ± 0.93 mg/dl. Urethroscopy in 37 patients confirmed type I and type III PUV in 35 and 2 patients, respectively. Valve ablation with a diathermy bugbee electrode provided relief of obstructions in the 37 patients who underwent the procedure without any significant immediate complication. The period of follow-up ranged between 2 weeks and 3 years with a mean of 10.2 months. There was sustained improvement in urine stream, reduction in the mean creatinine concentration and incidence of UTI during follow-up. However, patients with significantly impaired renal function had a poorer outcome. Many patients with PUV presented late within the reviewed period. Valve ablation provided relief of obstruction in most of the cases. There is a need to

  6. [Necessary and unnecessary treatment options for hemorrhoids].

    Science.gov (United States)

    Zindel, Joel; Inglin, Roman; Brügger, Lukas

    2014-12-01

    Up to one third of the general population suffers from symptoms caused by hemorrhoids. Conservative treatment comes first unless the patient presents with an acute hemorrhoidal prolapse or a thrombosis. A fiber enriched diet is the primary treatment option, recommended in the perioperative period as well as a long-term prophylaxis. A timely limited application of topical ointments or suppositories and/or flavonoids are further treatment options. When symptoms persist interventional procedures for grade I-II hemorrhoids, and surgery for grade III-IV hemorrhoids should be considered. Rubber band ligation is the interventional treatment of choice. A comparable efficacy using sclerosing or infrared therapy has not yet been demonstrated. We therefore do not recommend these treatment options for the cure of hemorrhoids. Self-treatment by anal insertion of bougies is of lowrisk and may be successful, particularly in the setting of an elevated sphincter pressure. Anal dilation, sphincterotomy, cryosurgery, bipolar diathermy, galvanic electrotherapy, and heat therapy should be regarded as obsolete given the poor or missing data reported for these methods. For a long time, the classic excisional hemorrhoidectomy was considered to be the gold standard as far as surgical procedures are concerned. Primary closure (Ferguson) seems to be superior compared to the "open" version (Milligan Morgan) with respect to postoperative pain and wound healing. The more recently proposed stapled hemorrhoidopexy (Longo) is particularly advisable for circular hemorrhoids. Compared to excisional hemorrhoidectomy the Longo-operation is associated with reduced postoperative pain, shorter operation time and hospital stay as well as a faster recovery, with the disadvantage though of a higher recurrence rate. Data from Hemorrhoidal Artery Ligation (HAL)-, if appropriate in combination with a Recto-Anal Repair (HAL/RAR)-, demonstrates a similar trend towards a better tolerance of the procedure at the

  7. Thermotherapy for treatment of osteoarthritis.

    Science.gov (United States)

    Brosseau, L; Yonge, K A; Robinson, V; Marchand, S; Judd, M; Wells, G; Tugwell, P

    2003-01-01

    Osteoarthritis is a degenerative joint disease that affects mostly the weight-bearing joints in the knees and hips. As the affected joint degenerates pain and restriction of movement often occur. Inflammation can also occur sometimes resulting in edema of the joint with OA. Treatment focuses on decreasing pain and improving movement. To determine the effectiveness of thermotherapy in the treatment of OA of the knee. The outcomes of interest were relief of pain, reduction of edema, and improvement of flexion or range of motion (ROM) and function. Two independent reviewers selected randomized and controlled clinical trials with participants with clinical and/or radiological confirmation of OA of the knee; and interventions using heat or cold therapy compared with standard treatment and/or placebo. Trials comparing head to head therapies, such as two different types of diathermy, were excluded. Randomized and controlled clinical trials including participants with clinical or radiographical confirmation of OA of the knee; and interventions using heat or cold compared to standard treatment or placebo were considered for inclusion. Study results were extracted by two independent reviewers. Outcomes were continuous in nature (pain, strength, improvement) and were analyzed by weighted mean difference using a fixed effects model. Graphical data were used when table data were not available. Three randomized controlled trials, involving 179 patients, were included in this review. The included trials varied in terms of design, outcomes measured, cryotherapy or thermotherapy treatments and overall methodological quality. In one trial, administration of 20 minutes of ice massage, 5 days per week, for 3 weeks, compared to control demonstrated a clinically important benefit for knee OA on increasing quadriceps strength (29% relative difference). There was also a statistically significant improvement, but no clinical benefit in improving knee flexion ROM (8% relative difference

  8. Pregnancy rate of gonadotrophin therapy and laparoscopic ovarian electrocautery in polycystic ovary syndrome resistant to clomiphene citrate: a comparative study

    Directory of Open Access Journals (Sweden)

    Ghafarnegad M

    2010-01-01

    but four cases aborted. The cost in gonadotrophin treatment was significantly more than laparoscopic ovarian diathermy (p<0.001. In logistic regression analysis, age, BMI, cost and kind of treatment had no significant effect on pregnancy rate."n"nConclusions: Pregnancy and abortion rate in gonadotrophin treatment was more than LOE but the difference was not significant. More studies are needed.

  9. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration.

    Science.gov (United States)

    Wong, Jessica J; Shearer, Heather M; Mior, Silvano; Jacobs, Craig; Côté, Pierre; Randhawa, Kristi; Yu, Hainan; Southerst, Danielle; Varatharajan, Sharanya; Sutton, Deborah; van der Velde, Gabrielle; Carroll, Linda J; Ameis, Arthur; Ammendolia, Carlo; Brison, Robert; Nordin, Margareta; Stupar, Maja; Taylor-Vaisey, Anne

    2016-12-01

    suggests that (1) for recent NAD grades I-II, cervical and thoracic manipulation provides no additional benefit to high-dose supervised exercises, and Swedish or clinical massage adds benefit to self-care advice; (2) for persistent NAD grades I-II, home-based cupping massage has similar outcomes to home-based muscle relaxation, low-level laser therapy (LLLT) does not offer benefits, Western acupuncture provides similar outcomes to non-penetrating placebo electroacupuncture, and needle acupuncture provides similar outcomes to sham-penetrating acupuncture; (3) for WAD grades I-II, needle electroacupuncture offers similar outcomes as simulated electroacupuncture; and (4) for recent NAD grades III, a semi-rigid cervical collar with rest and graded strengthening exercises lead to similar outcomes, and LLLT does not offer benefits. Our review adds new evidence to the Neck Pain Task Force and suggests that mobilization, manipulation, and clinical massage are effective interventions for the management of neck pain. It also suggests that electroacupuncture, strain-counterstrain, relaxation massage, and some passive physical modalities (heat, cold, diathermy, hydrotherapy, and ultrasound) are not effective and should not be used to manage neck pain. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. The effects of 1800 MHz radiofrequency waves on lipid peroxidation in pregnant rabbits

    International Nuclear Information System (INIS)

    Tomruk, Arin; Guler, Goknur; Seyhan, Nesrin

    2008-01-01

    Full text: The radiofrequency (RF) part of the Electromagnetic (EM) spectrum includes EM waves used mainly for telecommunications purposes (Radio and TV broadcasting, wireless phones, pagers, cordless phones, police and fire department radios, point-to-point links and satellite communications all rely on RF energy) and also used in some industrial technologies (industrial heaters and sealers), medical treatments (Diathermy units), microwave ovens and radar technologies. With rapid advances in these technologies, exposure to RF radiation of people has also increased. Some biological effects have been associated with exposure to RF and it is well established that RF exposures may lead to changes in cell membrane functions, cell metabolism. Changes in cell membrane functions include chemical reactions occurred between main membrane components (phospholipids, cholesterol, etc) and oxidative stress products such as Reactive Oxygen Species (ROS) and Reactive Nitrogen Species (RNS). Oxidative attacks of ROS and RNS can cause degradation of these unsaturated lipids and this degradation can be referred as lipid peroxidation (LPO). Malondialdehyde (MDA) is the end product of the major chain reactions leading to oxidation of polyunsaturated fatty acids and serves as a reliable marker of oxidative stress mediated LPO. Membrane LPO may initialize many forms of oxygen toxicity at molecular level including structural derangement of the bilayer and altered fluidity, increased permeability of cytosolic constituents, inactivation of intrinsic enzymes and transporters, covalent cross-linking of lipids and proteins, polypeptide strand scission and DNA damage and mutagenesis. In the present study, the investigation of the possible RF radiation's effects on LPO was aimed particularly. A total forty New Zeland White rabbits (weighted 3-5 kg, 16 months) were randomly divided into four groups which are composed of 10 rabbits each for groups. 1) Group I (sham, non-pregnant group); 2) Group

  11. LONG TERM RESULTS AFTER STAPLED HEMORRHOIDOPEXY ALONE AND COMPLEMENTED BY EXCISIONAL HEMORRHOIDECTOMY: A RETROSPECTIVE COHORT STUDY.

    Science.gov (United States)

    Araujo, Sergio Eduardo Alonso; Horcel, Lucas de Araujo; Seid, Victor Edmond; Bertoncini, Alexandre Bruno; Klajner, Sidney

    2016-01-01

    Stapled hemorrhoidopexy is associated with less postoperative pain and faster recovery. However, it may be associated with a greater risk of symptomatic recurrence. We hypothesized that undertaking a limited surgical excision of hemorrhoid disease after stapling may be a valid approach for selected patients. To compare long-term results after stapled hemorrhoidopexy with and without complementation with closed excisional technique. In a retrospective uni-institutional cohort study, sixty-five (29 men) patients underwent stapled hemorrhoidopexy and 21 (13 men) underwent stapled hemorrhoidopexy with excision. The same surgeons operated on all cases. Patients underwent stapled hemorrhoidectomy associated with excisional surgery if symptoms attributable to external hemorrhoid piles were observed preoperatively, or if residual prolapse or bulky external disease was observed after the firing of the stapler. A closed excisional diathermy hemorrhoidectomy without vascular ligation was utilized in all complemented cases. All clinical variables were obtained from a questionnaire evaluation obtained through e-mail, telephone interview, or office follow-up. The median duration of postoperative follow-up was 48.5 (6-40) months. Patients with grades 3 and 4 hemorrhoid disease were operated on more frequently using stapled hemorrhoidopexy complemented with excisional technique (95.2% vs. 55.4%, p=0.001). Regarding respectively stapled hemorrhoidopexy and stapled hemorrhoidopexy complemented with excision, there was no difference between the techniques in relation to symptom recurrence (43% and 33%, p=0.45) and median interval between surgery and symptom recurrence (30 (8-84) and 38.8 (8-65) months, p=0.80). Eight (12.3%) patients were re-operated after stapled hemorrhoidopexy and 2 (9.6%), after hemorrhoidopexy with excision (p=0.78). Patient distribution in both groups according to the degree of postoperative satisfaction was similar (p=0.97). Stapled hemorrhoidopexy combined

  12. Management of frozen shoulder: a systematic review and cost-effectiveness analysis.

    Science.gov (United States)

    Maund, E; Craig, D; Suekarran, S; Neilson, Ar; Wright, K; Brealey, S; Dennis, L; Goodchild, L; Hanchard, N; Rangan, A; Richardson, G; Robertson, J; McDaid, C

    2012-01-01

    -analysis. A mixed-treatment comparison (MTC) was also undertaken. An economic decision model was intended, but was found to be implausible because of a lack of available evidence. Resource use was estimated from clinical advisors and combined with quality-adjusted life-years obtained through mapping to present tentative cost-effectiveness results. Thirty-one clinical effectiveness studies and one economic evaluation were included. The clinical effectiveness studies evaluated steroid injection, sodium hyaluronate, supervised neglect, physical therapy (mainly physiotherapy), acupuncture, MUA, distension and capsular release. Many of the studies identified were at high risk of bias. Because of variation in the interventions and comparators few studies could be pooled in a meta-analysis. Based on single RCTs, and for some outcomes only, short-wave diathermy may be more effective than home exercise. High-grade mobilisation may be more effective than low-grade mobilisation in a population in which most patients have already had treatment. Data from two RCTs showed that there may be benefit from adding a single intra-articular steroid injection to home exercise in patients with frozen shoulder of analysis was based on only a subset of the evidence, which may explain why the findings are only partly supportive of the main analysis. No studies of patients' views about the treatments were identified. Average costs ranged from £36.16 for unguided steroid injections to £2204 for capsular release. The findings of the mapping suggest a positive relationship between outcome and European Quality of Life-5 Dimensions (EQ-5D) score: a decreasing visual analogue scale score (less pain) was accompanied by an increasing (better) EQ-5D score. The one published economic evaluation suggested that low-grade mobilisation may be more cost-effective than high-grade mobilisation. Our tentative cost-effectiveness analysis suggested that steroid alone may be more cost-effective than steroid plus

  13. Rehabilitation for ankle fractures in adults.

    Science.gov (United States)

    Lin, Chung-Wei Christine; Donkers, Nicole A J; Refshauge, Kathryn M; Beckenkamp, Paula R; Khera, Kriti; Moseley, Anne M

    2012-11-14

    immobilisation, but another showed using a backslab improved ankle dorsiflexion range of motion compared with using a bandage.Five studies investigated different rehabilitation interventions following the immobilisation period after either conservative or surgical orthopaedic management. There was no evidence of effect for stretching or manual therapy in addition to exercise, or exercise compared with usual care. One small study (14 participants) at a high risk of bias found reduced ankle swelling after non-thermal compared with thermal pulsed shortwave diathermy. There is limited evidence supporting early commencement of weight-bearing and the use of a removable type of immobilisation to allow exercise during the immobilisation period after surgical fixation. Because of the potential increased risk of adverse events, the patient's ability to comply with the use of a removable type of immobilisation to enable controlled exercise is essential. There is little evidence for rehabilitation interventions during the immobilisation period after conservative orthopaedic management and no evidence for stretching, manual therapy or exercise compared to usual care following the immobilisation period. Small, single studies showed that some electrotherapy modalities may be beneficial. More clinical trials that are well-designed and adequately-powered are required to strengthen current evidence.