ABSTRACT
Direct oral anticoagulants (DOAC) are increasingly being prescribed for prophylaxis of thromboembolic events. Their use, particularly in emergency settings is difficult as blood level measurements are often not immediately available and until recently there was no possibility for reversal. This article presents the case of a severely injured patient with life-threatening traumatic bleeding under long-term treatment with the factor Xa inhibitor apixaban, viscoelasticity-based detection of residual systemic anticoagulatory activity and targeted reversal.
Subject(s)
Anticoagulants , Rivaroxaban , Humans , Anticoagulants/adverse effects , Rivaroxaban/adverse effects , Hemorrhage/drug therapy , Pyridones/therapeutic useABSTRACT
BACKGROUND: Continuous passive motion (CPM) and active knee joint motion devices are commonly applied after various surgical procedures. Despite the growing use of active motion devices, there is a paucity of data comparing plantar loads between the different mobilization techniques. The aim of this study was to investigate foot loads during knee joint mobilization in continuous passive and active knee joint motion devices and to compare this data to the physiological load of full weight-bearing. PATIENTS/MATERIAL AND METHODS: Fifteen healthy participants (7 women and 8 men, 25â±â3 years, 66â±â6âkg, 175â±â10âcm, BMI 21.9â±â2) were recruited. Plantar loads were measured via dynamic pedobarography using a continuous passive motion device (ARTROMOT-K1, ORMED GmbH, Freiburg, Germany) and an active motion device (CAMOped, OPED AG, Cham, Switzerland), each with a restricted range of motion of 0-0-90° (ex/flex) and free ROM for the knee joint. For the active motion device, cycles were performed at four different resistance levels (0-III). Data were assessed using the pedar® X system (Novel Inc., Munich, Germany), which monitors loads from the foot-sole interface. Force values were compared between motion devices and normal gait, which served as the reference for conditions of full weight-bearing. P-values of <â0.05 were considered statistically signiï¬cant. RESULTS: Normal gait revealed peak forces of 694â±â96 N, defined as 100â%. The CPM device produced plantar forces of less than 1.5 N. Using the active motion device in the setting of 0-0-90° produced foot loads of <â1.5 N (resistance 0-II) and 3.4â±â9.3 N with a resistance of III (pâ<â0.001). Conditions of free ROM resulted in foot loads of 4.5â±â4.5 N (resistance 0), 7.7â± 10.7 N (resistance I), 6.7â±â10.4 (resistance II) and 6.7â±â6.9 N with a resistance of III (pâ<â0.001), corresponding to 0.6â%, 1.1â%, 1.0â% and 1.0â% of full weight-bearing, respectively. CONCLUSION: Motion exercises of the knee joint can be performed both with passive and active devices in accordance with strict weight-bearing restrictions, which are often recommended by surgeons. Also, active motion devices can be used when the ankle joint or foot have to be offloaded. Further studies assessing intraarticular joint load conditions have to be performed to confirm the findings obtained in this study.
Subject(s)
Foot , Knee Joint , Female , Germany , Humans , Male , Range of Motion, Articular , SwitzerlandABSTRACT
Recent results in the field of carbon nanotube-silicon solar cells have suggested that the best performance is obtained when the nanotube film provides good coverage of the silicon surface and when the nanotubes in the film are aligned parallel to the surface. The recently developed process of dry shear aligning - in which shear force is applied to the surface of carbon nanotube thin films in the dry state, has been shown to yield nanotube films that are very flat and in which the surface nanotubes are very well aligned in the direction of shear. It is thus reasonable to expect that nanotube films subjected to dry shear aligning should outperform otherwise identical films formed by other processes. In this work, the fabrication and characterisation of carbon nanotube-silicon solar cells using such films is reported, and the photovoltaic performance of devices produced with and without dry shear aligning is compared.
