Um estudo randomizado controlado sobre a eficácia da diatermia de ondas longas na dor, incapacidade e amplitude de movimento em pacientes com dor cervical / A randomized controlled trial on the efficacy of longwave diathermy on pain, disability and range of motion in the patients with neck pain

INTRODUÇÃO: A cervicalgia é uma importante causa de incapacidade em todo o mundo, causada por várias condições como doenças de base, anormalidades mecânicas e neuropáticas. A Diatermia por Ondas Longas (LWD) é uma modalidade de aquecimento terapêutico usada para tratar muitas condições musculoesqueléticas. OBJETIVO: Avaliar a eficácia da LWD na dor, incapacidade e amplitude de movimento (ADM) na dor no pescoço. MÉTODOS E MATERIAIS: O estudo foi conduzido após aprovação ética da universidade e registro em registro de ensaio clínico (PTY/2022/155 e CTRI/2022/06/043033). 30 pacientes com cervicalgia de 20-60 anos foram alocados aleatoriamente em dois grupos. O grupo controle (n=15) realizou exercícios domiciliares simples, enquanto no grupo experimental (n=15) a diatermia de ondas longas também foi administrada juntamente com exercícios domiciliares, 3 vezes/semana por 2 semanas. As medidas de resultado, como a escala visual analógica (EVA), índice de incapacidade do pescoço (IIP) e amplitude de movimento do pescoço, foram avaliadas na linha de base, no final de 2 semanas (pós-tratamento) e após um acompanhamento de 2 semanas. RESULTADOS E CONCLUSÃO: Houve melhora significativa da dor, incapacidade e ADM pós-intervenção no grupo controle e no grupo experimental. Além disso, houve diferença significativa na dor após o acompanhamento em ambos os grupos. A comparação entre os grupos sugeriu que houve uma diferença significativa para EVA, IIPe ADM de extensão do pescoço (p<0,05), mas não para ADM em outras direções. Portanto, pode-se concluir que a LWD é uma intervenção terapêutica eficaz para melhorar a dor, a incapacidade do pescoço e a amplitude de movimento do pescoço, juntamente com exercícios de pescoço em pacientes com dor no pescoço.

INTRODUCTION: Neck pain is a significant cause of disability worldwide, caused by various conditions like underlying diseases, mechanical and neuropathic abnormalities. Longwave Diathermy (LWD) is a therapeutic heating modality used to treat many musculoskeletal conditions. OBJECTIVE: To evaluate the efficacy of LWD on pain, disability, and range of motion (ROM) in neck pain. METHODS AND MATERIALS: The study was conducted after ethical approval from the university and registration in clinical trial registry (PTY/2022/155 & CTRI/2022/06/043033). Thirty patients with neck pain of 20-60 years were randomly allocated into two groups. The control group (n=15) performed simple home-based exercises, while in the experimental group (n=15) longwave diathermy was also given along with home exercises, 3 times/week for 2 weeks. The outcome measures like the Visual analogue scale (VAS), neck disability index (NDI), and Neck range of motion were assessed at baseline, at the end of 2 weeks (post-treatment), and after a followup of 2 weeks. RESULTS AND CONCLUSION: There was a significant improvement in pain, disability, and ROM post-intervention in the control group and experimental group. Additionally, there was a significant difference in pain after follow-up in both groups. The between-group comparison suggested that there was a significant difference for VAS, NDI, and neck extension ROM (p<0.05) but not for ROM in other directions. Therefore, it can be concluded that LWD is an effective therapeutic intervention for improving pain, neck disability, and neck range of motion along with neck exercises in patients with neck pain.

Short-wave diathermy in patients with chronic low back pain: a systematic review / Diatermia por ondas curtas em pacientes com dor lombar crônica: revisão sistemática / Diatermia por ondas cortas en pacientes con dolor lumbar crónico: revisión sistemática

ABSTRACT The aim of this study was to evaluate the evidence of application of short-wave diathermy (SWD) in individuals with chronic low back pain (CLBP) and its prescription parameters. The data sources (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro and the Cochrane Central Register of Controlled Trials) were systematically searched for articles published up to December 2017. Randomized and non-randomized clinical trial studies that investigated the effect of the application of SWD on CLBP were selected. Two independent reviewers assessed the risk of bias in studies using the Jadad and the Downs & Black scales. Five studies (731 patients) were included, all of whom presented improvements in CLBP. The majority used continuous mode SWD, with only one using pulsed mode (82 and 200 Hz). SWD produced improvements in CLBP, but there is limited evidence for its application, and a lack of standardization of the parameters used. Furthermore, the results that address this topic should be interpreted with caution due to their low methodological quality and limited number. Level of evidence II; Systematic review.

RESUMO O objetivo do presente estudo foi avaliar a evidência de aplicação da diatermia por ondas curtas (DOC) em indivíduos com dor lombar crônica (DLC) e seus parâmetros de prescrição. As fontes de dados (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro e Cochrane Central Register of Controlled Trials) foram pesquisadas sistematicamente quanto aos artigos publicados até dezembro de 2017. Estudos de ensaios clínicos randomizados e não randomizados que investigaram o efeito da aplicação da DOC na DLC foram selecionados. Dois revisores independentes avaliaram o risco de viés em estudos usando as escalas Jadad e Downs & Black. Cinco estudos (731 pacientes) foram incluídos e todos apresentaram melhora na DLC. A maioria usou a DOC de modo contínuo, com apenas um utilizando o modo pulsado (82 e 200 Hz). A DOC apresentou melhora na DLC, no entanto, há evidências limitadas para sua aplicação e ausência de padronização dos parâmetros utilizados. Além disso, os resultados que se referem a esse tópico devem ser interpretados com cautela devido à baixa qualidade metodológica e ao número limitado de estudos. Nível de evidência II; Revisão sistemática.

RESUMEN El objetivo del presente estudio fue evaluar la evidencia de la diatermia por ondas cortas (DOC) en individuos con dolor lumbar crónico (DLC) y sus parámetros de prescripción. Las fuentes de datos (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro y Cochrane Central Register of Controlled Trials) fueron utilizadas para búsquedas sistemáticas de artículos publicados hasta diciembre de 2017. Fueron seleccionados los estudios de ensayos clínicos aleatorizados y no aleatorizados que investigaron el efecto de la aplicación de DOC en DLC. Dos revisores independientes evaluaron el riesgo de sesgo en estudios usando las escalas Jadad y Downs & Black. Fueron incluidos cinco estudios (731 pacientes) y todos presentaron mejora en DLC. La mayoría usó la DOC de modo continuo, con sólo uno usando el modo pulsado (82 y 200 Hz). La DOC produjo mejoras en DLC, sin embargo, hay evidencias limitadas para su aplicación y ausencia de estandarización de los parámetros utilizados. Además, los resultados que se refieren a ese tópico deben interpretarse con cautela debido a la baja calidad metodológica y al número limitado de estudios. Nivel de evidencia II; Revisión sistemática.

Focal Bone Marrow Lesions: A Complication of Ultrasound Diathermy

Ultrasound diathermy is widely used for the treatment of musculoskeletal disorders and other soft tissue injuries. Its use as a therapeutic modality is believed to be safe, with very few reported complications. Here, we report two patients who developed focal bone marrow abnormalities after receiving ultrasound diathermy. Both patients' magnetic resonance (MR) evaluations revealed linear subchondral bone lesions of the superolateral humeral head similar to those in osteonecrosis. The patients' symptoms subsequently improved, and available follow-up MR evaluation revealed near complete resolution of bone lesions. These findings suggest that ultrasound diathermy, and its interaction with bone tissue through thermal mechanisms, can cause focal bone marrow abnormalities. Furthermore, the bone marrow abnormalities seem to be transient, resolving upon cessation of ultrasound diathermy, therefore osteonecrosis should be differentiated from this temporal lesion.

The diathermy scratch pad: A cheap and efficient tool for chemical and explosion-related burns

The burn center in our hospital is a national and regional (Southeast Asia) center. Of all admissions, 10% are related to blast explosions, and 8% due to chemical burns. In the acute burn management protocol of Singapore General Hospital, early surgical debridement is advocated for all acute partial-thickness burns. The aim of early surgical debridement is to remove all debris and unhealthy tissue, preventing wound infection and thereby expediting wound healing. In chemical burns, there can be stubborn eschars that are resistant to traditional debridement. We would like to present a novel technique using the diathermy scratch pad as a cheap and efficient tool for the dual purpose of surgical debridement and dermabrasion.

Efeito de ondas curtas por método indutivo na lombalgia crônica inespecífica em indivíduos sedentários / Effect of inductive shortwave on chronic non-specific low back pain in sedentary individuals

OBJETIVOS: Avaliar a eficácia do tratamento com ondas curtas por método indutivo em indivíduos sedentários com lombalgia crônica inespecífica. MÉTODOS: Um ensaio clínico quase-experimental e cruzado foi realizado com indivíduos lombálgicos e sedentários. A amostra foi recrutada entre acadêmicos da Universidade Estadual do Oeste do Paraná (Unioeste) na faixa etária entre 18 e 25 anos, que apresentavam dor lombar de origem postural não traumática há mais de três meses, eram sedentários, e aceitaram participar da pesquisa. O protocolo de intervenção consistiu na aplicação de ondas curtas por método indutivo por 15 minutos, uma vez ao dia, três vezes por semana, com intervalo de um dia entre cada aplicação. Na semana seguinte os voluntários recebiam tratamento placebo também por três vezes na semana, com tempo semelhante àquele realizado na semana tratamento, porém o equipamento era apenas ligado, sem emissão do campo eletromagnético. O protocolo foi aplicado por duas semanas. As variáveis analisadas foram o grau de incapacidade funcional, avaliado pelo Índice de Incapacidade de Oswestry (ODI) e pelo Questionário de Incapacidade de Roland-Morris (QIRM), no início do experimento e ao final de cada semana; e a dor, avaliada pela Escala Visual Analógica (EVA), antes e após cada sessão. Os dados foram apresentados em média e desvio-padrão ou mediana e quartis e o nível de significância aceito foi de 5%. RESULTADOS: Vinte voluntários participaram do estudo. Para a ODI houve redução dos valores de incapacidade ao longo da semana de tratamento, com retorno aos valores iniciais na semana placebo; já para o QIRM não houve diferenças entre o tratamento e o placebo. Pela EVA, houve redução na intensidade da dor ao longo dos três dias de terapia, fato que ocorreu apenas no segundo dia do placebo. CONCLUSÕES: O tratamento com ondas curtas na modalidade indutiva foi eficaz na diminuição da dor em pacientes sedentários com lombalgia crônica, contribuindo para melhora da capacidade funcional.

AIMS: To evaluate the efficacy of inductive shortwave treatment in sedentary individuals with non-specific chronic low back pain. METHODS: A quasi-experimental and cross-over trial was performed with sedentary individuals with chronic back pain. The sample was recruited among students from the State University of Western Paraná (Unioeste), aged between 18 and 25 years old, who had low back pain of non-traumatic postural origin for more than three months, were sedentary, and accepted to participate in the study. The intervention protocol consisted in the application of short waves by inductive method for 15 minutes, once a day, three times a week, with interval of one day between each application. In the following week, volunteers also received placebo treatment three times a week, with time similar to that performed in the treatment week, but the equipment was only switched on, without emission of the electromagnetic field. The protocol was applied for two weeks. The variables analyzed were the degree of functional disability, assessed by the Oswestry Disability Index (ODI) and the Roland-Morris Disability Questionnaire (QIRM), at the beginning of the experiment and at the end of each week; and pain, assessed by the Visual Analogue Scale (VAS), before and after each session. Data were presented as mean and standard deviation or median and quartiles, and the accepted level of significance was 5%. RESULTS: Twenty volunteers participated in the study. For ODI, there was a reduction in the disability values throughout the treatment week, with a return to previous values in the placebo week; there were no differences between treatment and placebo for the MIRR. By VAS, there was a reduction in pain intensity over the three days of therapy, which occurred only on the second day of the placebo. CONCLUSIONS: Treatment with short waves in the inductive modality was effective in reducing pain in sedentary patients with chronic low back pain, contributing to improve functional capacity

A Case of Saddle Nose Deformity Caused by Electrocautery of Nasal Septum / 대한이비인후과학회지

Electrocautery of nasal septum is a very common treatment of epistaxis in Otorhinolaryngology. However, serious complications of electrocautery are rare. We encountered a 52-year-old female patient who presented with nosebleeds. A definite focus of bleeding was identified by nasal endoscopy, thus electrocautery by bipolar diathermy was performed in the area of Kisselbach's plexus of nasal septum. There were no abnormal findings in the nasal septum during the three weeks of outpatient visit. However, the patient noticed a depression near the tip of her nose 12 weeks later. Saddle nose deformity after electrocautery has not yet reported in the literature. Therefore, we present this case with a brief review of literature.

Impacto da criolipólise associada à radiofrequência na adiposidade localizada / Cryolipolysis impact associated to radiofrequency in localized adiposity

Introdução: A criolipólise e a radiofrequência estão entre as técnicas não invasivas mais procuradas que proporcionam a diminuição do tecido adiposo. Objetivo: Avaliar a influência da associação da criolipólise e radiofrequência no tratamento da adiposidade em abdômen inferior. Métodos: Participaram nove voluntárias com adiposidade em abdômen inferior, idade média de 27,44 ± 2,4 anos, submetidas ao tratamento de uma sessão de criolipólise durante 50 minutos, sucção de 40 mmHg, cinco sessões de radiofrequência com ponteira multipolar, potência 30 W, frequência de 3 Hz contínua, temperatura a 42°C, duas vezes na semana, totalizando 5 sessões, avaliadas através do índice de massa corpórea (IMC), perimetria e adipometria. Foram utilizados os testes de Shapiro Wilk seguido de Test T de Student para análises pré e pós-tratamento (p ≤ 0,05). Resultados: A média adipométrica abaixo da cicatriz umbilical e acima da espinha ilíaca ântero-superior à esquerda (p < 0,03; p = 0,001) e à direita (p < 0,02; p = 0,0001), no pós-tratamento, apresentou redução significativa quando comparada ao pré tratamento, com a variável a cinco centímetros acima da crista ilíaca esquerda e direita no pós tratamento se comparados ao pré-tratamento (p = 0,02; p = 0,04). As variáveis IMC, peso e perimetria não obtiveram diferença significativa (p > 0,05). Conclusão: O protocolo utilizado no estudo mostrou eficácia na redução da adiposidade localizada em abdômen inferior. (AU)

Introduction: Cryolipolysis and radiofrequency are among the most sought after non-invasive techniques that provide decreased adipose tissue. Objective: To evaluate the influence of the association of cryolipolysis and radiofrequency in the treatment of adiposity in the lower abdomen. Methods: Nine volunteers with adiposity in the lower abdomen, mean age of 27.44 ± 2.4 years, underwent treatment of a cryolipolysis session for 50 minutes, 40 mmHg suction, five radiofrequency sessions with multipolar tip, 30 W power, Frequency of 3 Hz continuous, temperature at 42°C, twice weekly, totaling 5 sessions, evaluated by body mass index (BMI), perimetry and adipometry. The Shapiro Wilk tests were used, followed by Student's T test for pre and post-treatment analysis (p ≤ 0.05). Results: The adipometric average below the umbilical scar and above the anterior superior iliac spine on the left (p < 0.03, p = 0.001) and right (p < 0.02, p = 0.0001), after treatment, showed a significant reduction when compared to the pre-treatment, as the variable was five centimeters above the left and right iliac crest in the post-treatment compared to the pre-treatment (p = 0.02; p = 0.04). The BMI, weight and perimetry variables did not show a significant difference (p > 0.05). Conclusion: The protocol used in the study showed efficacy in reducing localized adiposity in the lower abdomen. (AU)

Design of High Frequency Signal Detecting Circuit of Human Body Impedance Used for Ultrashort Wave Diathermy Apparatus / 生物医学工程学杂志

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.

A Pilot Randomized Comparative Study of Two Diathermy Power Settings for Monopolar Microdissection and Bipolar Hemostasis during Tonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Optimal electrical power required for diathermy during tonsillectomy has not been determined. The aim of this pilot study was to evaluate and compare surgical outcomes of using diathermy power settings at 15 watts (W) and 25W for monopolar microdissection and bipolar hemostasis during tonsillectomy. SUBJECTS AND METHOD: This prospective, single-center, single-blind, randomized study was conducted on 92 patients who underwent 15W or 25W monopolar microdissection and bipolar hemostasis for tonsillectomy. Operation times, post-operative pain severities, and rates of hemorrhage were compared between the 15W and 25W groups. RESULTS: The 92 patients were randomized equally into two study groups. The mean operation duration for the 15W group was significantly longer than in the 25W group (18.5±6.11 versus 13.4±6.04 minutes, p<0.01). The rate of minimal hemorrhage (defined as an episode of bleeding not significant enough for hospital visitation) for the 15W group was significantly higher than for the 25W group (41.3% versus 20.5%, p<0.05). No significant intergroup difference was observed between the rates of primary or secondary hemorrhage or postoperative pain scores. CONCLUSION: Twenty-five watt monopolar microdissection and bipolar hemostasis for tonsillectomy had a shorter mean operation time and a lower post-operative minimal hemorrhage rate than 15W monopolar microdissection and bipolar hemostasis.

Palliation of postintubation tracheal stenosis using insulation-tipped diathermic knife 2: a case report

Objective: To report the first case of using the insulation-tipped diathermic knife 2 [IT knife-2] for the treatment of postintubation tracheal stenosis

Clinical Presentation and Intervention: A 71-year-old female patient with a history of endotracheal intubation 3 years earlier presented with throat discomfort, gross wheezing and dyspnea. Chest imaging and bronchoscopy demonstrated a strand-like tracheal stenosis in the upper trachea. The IT knife-2 was used to treat the patient and the lesion was palliated without complication

Conclusion: This case was successfully treated with the IT knife-2 and thus implies a potential usefulness of the IT knife-2 as a new modality for bronchoscopic intervention

Radiofrequency Diathermy for Rhinogenic Headache / 대한이비인후과학회지

Rhinogenic headache is a headache or facial pain syndrome secondary to mucosal contact points or rhinogenic causes in the absence of rhinitis/sinusitis. The authors report a case of atypical rhinogenic headache in a 72-year-old woman who presented with recurrent right side headache, which was aggravated by nasal breathing. A computed tomographic scan showed no evidence of rhinosinusitis and mucosal contact points. However, during nasal endoscopy, she had multiple pain-trigger points on the septum and lateral nasal wall. Treatment involved endoscopic reduction and radiofrequency diathermy of the pain-trigger point. Postoperatively, the headache was successfully relieved, and there was no evidence of recurrence. In this article, the authors present surgical option for the treatment of atypical rhinogenic headache.

Penile necrosis resulting from post-circumcision microwave diathermy: A report of 9 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the pathogenesis and treatment of penile necrosis resulting from microwave diathermy following circumcision.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data about 9 cases of penile necrosis resulting from postoperative microwave diathermy following circumcision. The 9 males, aged 20 - 39 (mean 26) years, underwent traditional circumcision for redundant prepuce or phimosis in other hospitals, followed by microwave diathermy for 30 - 60 minutes daily, which resulted in penile necrosis. With no response to conservative therapy, the patients were referred to our hospital at 3 -30 days postoperatively. Of the 9 patients, 5 presented with dry gangrene and 4 with moist gangrene. Six of the patients underwent partial penectomy, including 1 that received penis lengthening.3 months later, while the other 3 underwent total penectomy for total penile necrosis followed by penile reconstruction 3 months later, with deep inferior epigastric perforator (DIEP) flaps and by implantation of the 12th costal cartilage in 2 cases and with epigastric groin island flaps and by urethroplasty in the other.</p><p><b>RESULTS</b>The patients were followed up for 2 - 8 years, and all could urinate smoothly in the standing position. Of the 6 men treated by partial penectomy, 1 received penis lengthening and achieved a penile length of 7 cm and 5 had the remaining penile length of 3 -5 cm, 4 with erectile function and the other 2 capable of sexual intercourse. The 3 men treated by total penectomy achieved nearly normal external appearance of the penis, with a finalized length of (11.7 ± 1.3) cm, a circumference of (11.4 ± 2.1) cm, and a normal feel of the skin. Of the 3 cases of penile reconstruction, 2 achieved sufficient erectile hardness of the penis (grade 3) for sexual intercourse, while the other 1 remained impotent.</p><p><b>CONCLUSION</b>Post-circumcision microwave diathermy may result in penile necrosis, for the management of which, early debridement is necessitated and penile lengthening or reconstruction can be performed according to the severity of the lesion and needs of the patient.</p>

Prevalence of fatigue reported by physiotherapists operating diathermy equipment for microwave / Prevalência de fadiga referida por fisioterapeutas que operam equipamentos de diatermia por micro-ondas

Objective: To Analyze the association between prevalence of fatigue referred by physical therapists and their occupational exposure to radiation emitted by therapeutic microwave diathermy equipment. Methods: A Cross-sectional study conducted in 193 physical therapists from four cities of the west of Paraná State, Brazil. A specified structured web questionnaire was applied for collecting data about microwave diathermy exposition and potential confounders, plus the Multidimensional Assessment of Fatigue (MAF). Statistical analysis included logistic regression and Student's t-test. Results: The prevalence of fatigue in the category exposed to microwave diathermy was higher (15.0%) than in non-exposed (2.9%). On multivariate logistic regression, a significant independent association between exposure to microwave diathermy and prevalence of fatigue was observed (odds ratio 4.93; 95% confidence interval 1.04 - 23.25; p = 0.04). The Student's t-test showed significant difference between the number of hours exposed to diathermy microwave, being 3,839.1 within physical therapists who referred fatigue and 497.6 within others (p = 0.004). Conclusion: The results demonstrate a significant and independent association between occupational exposure of physical therapists to radiation of microwave diathermy and prevalence of fatigue. Therefore, occupational safety guidelines aimed at these professionals as a prevention of possible adverse effects, as well as the replication of this study are suggested. .

Objetivo: Analisar a associação entre a prevalência de fadiga referida por fisioterapeutas e a exposição desses profissionais à radiação emitida por equipamentos terapêuticos de diatermia por micro-ondas. Metodologia: Foi realizado estudo de corte transversal com 193 fisioterapeutas de quatro municípios da região Oeste do Estado do Paraná, Brasil. Foi aplicado, via eletrônica, questionário estruturado especialmente para a coleta de dados sobre a exposição ocupacional à radiação emitida por equipamentos de diatermia por micro-ondas e potenciais fatores de confusão, acrescido do questionário de Avaliação Multidimensional de Fadiga. A análise estatística incluiu regressão logística e teste t de Student. Resultados: A prevalência de fadiga na categoria expostos a micro-ondas foi maior (15,0%) do que em não expostos (2,9%). Na regressão logística multivariada foi observada associação independente significante entre a exposição ocupacional de fisioterapeutas à radiação de diatermia por micro-ondas e a prevalência de fadiga (odds ratio 4,93; intervalo de confiança de 95% 1,04 - 23,25; p = 0,04). O teste t de Student mostrou diferença significante entre o número total de horas de exposição à radiação de diatermia por micro-ondas, sendo de 3.891,1 entre os fisioterapeutas que referiram fadiga e de 497,6 entre os que não referiram (p = 0,004). Conclusão: Os resultados demonstraram associação significante entre a exposição ocupacional de fisioterapeutas à radiação emitida por equipamentos de diatermia por micro-ondas e fadiga, portanto, são sugeridas orientações de segurança ocupacional, dirigidas a esses profissionais, como medida preventiva ...

Electrocautery-Ignited Surgical Field Fire Caused by a High Oxygen Level during Tracheostomy

Tracheostomy is a relatively common surgical procedure that is performed easily in an operating room or intensive care unit. Open tracheostomy is needed in patients requiring prolonged ventilation when percutaneous tracheostomy is inappropriate. Sometimes, it is difficult to achieve bleeding control in the peritracheal soft tissue, and in such cases, we usually use diathermy. However, the possibility of an electrocautery-ignited surgical field fire can be overlooked during the procedure. This case report serves as a reminder that the risk of a surgical field fire during tracheostomy is real, particularly in patients requiring high-oxygen therapy.

Necrotic Complications in Nipple-Sparing Mastectomy Followed by Immediate Breast Reconstruction: Systematic Review with Pooled Analysis

This study provides a systematic review of the literature on nipple-sparing mastectomy and necrotic complications in order to estimate the prevalence of necrotic complications and to investigate their significant predictors. A literature search was conducted using the MEDLINE and Ovid databases. A pooled analysis was performed for calculation of the prevalence of nipple-areolar complex (NAC) necrosis, mastectomy flap necrosis, and overall necrotic complications and to evaluate the relationships between necrotic complications and potential risk factors. A total of 44 papers were analyzed. The prevalence of overall necrotic complications was 13.7%, including 7.5% for NAC necrosis and 7.8% for mastectomy flap necrosis. Types of incisions showed significant association with the rates of NAC necrosis and mastectomy flap necrosis. Incisions involving the NAC showed a significantly higher rate of NAC necrosis than those not involving it. The prevalence of NAC necrosis was higher in the autologous tissue reconstruction group than in the prosthesis group. Active smoking and diathermy dissection were significant predictors of both NAC necrosis and mastectomy flap necrosis. The findings of this review suggest that there are several predictors of necrotic complications in nipple-sparing mastectomy. Appropriate patient selection, careful operative planning, and surgical technique refinements may reduce the risk of necrotic complications.

Initial experience of surgical microwave f issue precoagulation in liver resection for hepatocellular carcinoma in cirrhotic liver

Surgical hepatic resection has been considered as the first-line treatment which is most effective and radical treatment for HCC, however, HCC is usually associated with poor liver function owing to chronic hepatitis or liver cirrhosis. Techniques that can eradicate the tumor and also preserve liver function are needed. Moreover, hepatic resection, in the presence of cirrhosis, raises special problem of high risk as hemorrhage and liver failure, thus, good clinical results can only be achieved by minimizing operative blood loss, time of the intervention as well as the hepatic reserve. The tremendous progress in microwave technology has recently attracted considerable attention. This study evaluated the feasibility of this new liver transection technique demonstrating the high performance of this procedure, the accuracy in terms of squeeze effect on veins and portal branch and in terms of reducing the intra operative blood loss, and minimizing the operative time for safe hepatectomy.Twenty-six consecutive patients a first-time diagnosis of hepatocellular carcinoma [HCC] on top of liver cirrhosis were recruited for the study, from August 2011 to January 2013.A11 patients were subjected to full clinical examination, laboratory investigations, abdomen ultrasound [U/S], triphasic computed tomographic liver scan [CT] and dynamic magnetic resonance imaging [MRI] in some doubtful cases. Inclusion requirements were presence of resec-table disease without vascular invasion or extrahepatic spread at imaging, Child-Pugh class A and B [Score 7] liver cirrhosis, [INR]< 1.6or platelet count >60 000/mm3 with no previous treatment. Patients were treated by applying pre-coagulation of the liver transection lines using microwave probe positioned in parallel to the line of resection by open approach after intra-operative U/S assessment for localization of the tumor and line of resection.The procedures were performed under general anesthesia. Mobilization of the liver was not necessary to be done in all cases. Intra-operative ultrasound [Aloka, Tokyo, Japan] was used to exclude lesions not detected pre-operatively [operative surprise], to define the location, number and size of the tumor and to identify large intra-hepatic large vascular and biliary structures, and guide insertion of the microwave applicator. Intraoperative ultrasound was used again, to assess that the line of resection was done. Primary endpoints documented were total operative time, time for liver parenchyma transection, intraoperative blood loss and blood transfusion requirements. Secondary endpoints included postoperative complications, mortality and intensive care unit [ICU] together with hospital stay

Comparison of nasal patency following submucosal diathermy of inferior turbinate versus inferior turbinectomy

To compare the nasal patency following sub mucosal diathermy [SMD] of inferior turbinate and inferior turbinectomy [IT]. Randomized controlled trial. Department of ENT Combined Military Hospital Rawalpindi. Study was completed in one year from 15[th] September 2009 to 15[th] September 2010. Total 160 patients with symptomatic inferior turbinate hypertrophy were included in the study. Patients were randomly divided into two groups of 80 each using random numbers table. Group A underwent submucosal diathermy [SMD] of inferior turbinate where as Group B underwent inferior turbinectomy [IT]. Post-operative nasal patency was judged after 03 weeks by visual analog scale [VAS]. Both the groups are comparable with respect to age and gender. Post-operative nasal patency is significantly better in group B as compared to group A. IT is a more effective method to improve nasal patency as compared to SMD in case of inferior turbinate hypertrophy

Hemorroidectomía con Ligasure vs diatermia convencional: análisis retrospectivo monocéntrico / [Ligasure vs conventional diathermy in excisional haemorrhoidectomy: a retrospective study of a single center].

INTRODUCTION: Hemorrhoids are a prolapse of vasculopathic structures that cushion the anal canal and haemorrhoidectomy is the most effective treatment for grades III and IV In this retrospective study we compare the outcome after haemorrhoidectomy with Ligasure or with conventional diathermy. METHODS: From June 2005 to March 2009 we analyzed 75 patients affected by hemorrhoids (grades III and IV) who underwent haemorrhoidectomy in the University Hospital Arnau de Vilanova in Lleida. We evaluated the technique, the age and the sex, and compared the post-operative hospital stay, the post-operative pain and the complications with each of the techniques. RESULTS: We used Ligasure technique in 49 patients (65

) and conventional diathermy technique in 26 (35

). The mean age was 50.3 years. There was no significant difference in both postoperative length ofstay, with an average of2.13 days (P = 0.60), and postoperative pain in the first 15 days (P = 0.275). On the contrary, we found a significant difference in the rate of postoperative complications (P = 0.032) and in the post-surgical pain at one month (P = 0.03). CONCLUSIONS: In our experience the Ligasure haemorrhoidectomy has shown to have fewer complications and post-operative pain when compared with conventional diathermy haemorrhoidectomy.

Exposição à radiação não-ionizante emitida por equipamentos terapêuticos de micro-ondas e morbidade referida em fisioterapeutas / Exposure to non-ionizing radiation emitted by microwave therapeutic equipment and morbidity in physiotherapists

Introdução: O fisioterapeuta utiliza-se de vários equipamentos eletro-eletrônicos que emitem radiação eletromagnética para fins terapêuticos. Entre esses, o equipamento de diatermia por micro-ondas de alta frequência, sendo essa de 2,45 GHz. Nesse procedimento terapêutico, é possível ter perdas variáveis da energia irradiada por reflexão e por dispersão, desde o aplicador até a área a ser tratada. Assim, o profissional que opera o equipamento de diatermia por micro-ondas, é exposto a essa radiação diariamente durante anos. Adicionalmente a esse cenário ocupacional, observa-se que o fisioterapeuta, de modo geral, tem raras atitudes de proteção ocupacional durante essas aplicações, tornando o ambiente de trabalho, bem como a si mesmo, passivos de situações de riscos não controlados e, consequentemente, efeitos adversos podem ocorrer. Com a finalidade de contribuir na elucidação de indicadores que despertem o interesse das autoridades relacionadas com a vigilância e legislação em saúde no que se refere à segurança de profissionais envolvidos direta ou indiretamente com a terapia de diatermia por micro-ondas, realizou-se este estudo. Objetivo: Analisar a associação entre a prevalência de morbidades referidas por fisioterapeutas e a exposição destes profissionais à radiação emitida por equipamentos terapêuticos de diatermia por micro-ondas. Metodologia: Realizou-se estudo de corte transversal com 193 fisioterapeutas de quatro Municípios da Região Oeste do Estado do Paraná, Brasil. Aplicou-se, via eletrônica, questionário estruturado especialmente para a coleta de dados sobre a exposição ocupacional à radiação de diatermia por micro-ondas, potenciais fatores de confusão e morbidades, acrescido do questionário de Avaliação Multidimensional de Fadiga (MAF) e do Questionário de Avaliação da Incapacidade por Enxaqueca (MIDAS). A análise estatística incluiu regressão logística e Teste t de Student. Resultados: Observou-se associações significantes entre a exposição...

Introduction: Various electroelectronic equipments that emit electromagnetic radiation for therapeutic purposes are employed by physiotherapists. Among these is the equipment for diathermy with microwave high frequency (2.45 GHz). During this procedure of treatment different levels of losses by reflection and scattering of the radiated energy from the applicator to the area to be treated are possible. Thus, the equipment operator is exposed to this radiation daily for years. In addition to this occupational setting, physiotherapists seldom do maintain occupational protection attitudes for these applications, doing the work environment, as themselves, passive in risk and not controlled situations. Therefore, adverse effects may occur. In order to contribute to elucidate indicators and arouse the authorities care over surveillance and health legislation regarding professional's security, directly or indirectly involved with the therapy by microwave diathermy, this study was conducted. Objective: To analyze the association between prevalence of morbidities referred by physiotherapists and their occupational exposure to radiation emitted by therapeutic microwave diathermy equipment. Methodology: A Cross-sectional study conducted in 193 physiotherapists from four cities of the west of Paraná State, Brazil. A specified structured web questionnaire was applied for collecting data about microwave diathermy exposition, potential confounders and morbidities, plus the Multidimensional Assessment of Fatigue (MAF) and the Migraine Disability Assessment (MIDAS). Statistical analysis included logistic regression and Student's t-Test. Results: It was observed significant associations between exposure of physiotherapists to microwave and the use of visual correction lens (p = 0.02; OR: 3.56; 95% CI: 1.15 - 10.96), fatigue (p = 0.04; OR: 4.93; 95% CI: 1.04 - 23.25) and neoplasms (p = 0.008; OR: 32.05; 95% CI: 2.46 - 416.96)...

Linearly polarized near-infrared irradiation combined with aerothermotherapy for treatment of frozen shoulder in diabetic patients / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of linearly polarized near-infrared irradiation (Super Lizer) combined with aerothermotherapy in the treatment of patients with frozen shoulder and diabetes.</p><p><b>METHODS</b>Eighty-four diabetic patients with frozen shoulder were randomized into 3 groups to receive a 20-day treatment with drug therapy and shoulder exercise (control group), daily linearly polarized near-infrared irradiation in addition to the control therapy (Super Lizer group), or daily Super lizer and aerothermotherapy (S+P group) in addition to the control therapy. Visual analogue scale was used to assess the changes in the pain intensity, and the shoulder movement was assessed using shoulder movement disorder degree integral scores.</p><p><b>RESULTS</b>After the 20-day treatment, the VAS scores and shoulder movement disorder degree integral scores in the 3 groups all significantly decreased (P<0.05), and these scores in Super Lizer group and S+P group were significantly lower than those in the control group (P<0.05). The cure rate in S+P group was significantly higher than that in the other two groups (P<0.01).</p><p><b>CONCLUSION</b>Linearly polarized near-infrared irradiation combined with aerothermotherapy is effective for treatment of patients with frozen shoulder and diabetes with a high cure rate and short treatment course.</p>