Compression Group Research Articles

Efficacy and Safety of Acupuncture Therapy for Patients with Acute Ankle Sprain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background The efficacy of acupuncture for acute ankle sprain (AAS) is controversial. This study aimed to critically assess the efficacy and safety of acupuncture for AAS. Methods Parallel-group randomized controlled trials (RCTs) were included regardless of language or publication date. Participants with AAS were included regardless of age, sex, race, nationality, or diagnostic criteria for AAS. Experimental interventions included acupuncture alone or in combination with traditional therapies. Control interventions included no treatment, placebo, or traditional therapies. The primary outcome was the Kofoed ankle score. The secondary outcomes included visual analogue scale, duration of pain, use of painkiller, ankle circumference, effective rate, cure rate, and adverse events. PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Digital Periodicals, and Chinese Science and Technology Periodicals database were searched to identify potentially eligible studies from inception to September 10, 2020. World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), ClinicalTrials.gov, Chinese Clinical Trial Registry (ChiCTR), and the reference list of eligible RCTs were checked to identify ongoing or unpublished studies. Risk of bias was assessed by the Cochrane Collaboration's tool. Statistical analyses were performed by RevMan 5.3 software. P < 0.05 indicated statistical significance. Results Seventeen eligible studies were included for the statistical analysis. There was no statistically significant difference of Kofoed ankle score between acupuncture and Rest, Ice, Compression, and Elevation (RICE) group (P=0.75). However, acupuncture could significantly relieve pain (P=0.02) and increase cure rate (P=0.004) compared with RICE. Moreover, acupuncture plus RICE could also significantly relieve pain (P < 0.00001) and increase cure rate (P=0.01) compared with RICE alone. Acupuncture combined with massage could significantly relieve pain (P=0.04) compared with massage alone. Acupuncture plus Chinese medicine might be more effective for relieving pain (P < 0.00001), reducing the duration of pain (P < 0.00001), and increasing cure rate (P=0.0002) compared with Chinese medicine alone. Two studies reported no adverse reactions. One study reported that a participant suffered from mild drug-related allergic reaction and was healed without treatment. Conclusions The findings of the present study suggest that acupuncture may be beneficial for AAS. However, more large-scale and well-designed RCTs are warranted.

Dry Cupping, Ischemic Compression, or Their Combination for the Treatment of Trigger Points: A Pilot Randomized Trial.

Background: Chronic neck pain (NP) attributed to myofascial pain syndrome is one of the particularly common skeletal muscle disorder associated with the hyperirritable zone in the taut band of muscle. Trigger points (TPs) are the physical interpretation of the myofascial pain syndrome. In the United States, 30%–85% of pain patients have been affected by myofascial TPs.Objectives: To reveal preliminary evidence on the clinical efficacy of ischemic compression therapy, dry cupping, and their combination on improving the TPs' pressure pain threshold (PPT), neck range of motion (NROM), and neck disability index (NDI) in patients with TPs and nonspecific NP. Besides, assess the feasibility of conducting a randomized clinical trial (RCT).Design: A randomized pilot study was conducted on 24 patients with TPs and nonspecific NP. Patients were randomly assigned to three groups: the cupping group, the ischemic compression group, and the combination therapy group. PPT, NROM, and NDI were assessed before and after 4 weeks of treatment.Results: The results showed a statistically significant improvement in NDI, PPT, and NROM compared with values before the treatment (p < 0.05) in all groups. Although no significant difference was detected between ischemic compression (IC) and dry cupping, the combination approach showed significantly higher and faster improvement (p < 0.05).Conclusions: It is feasible to conduct a main RCT. Both IC and dry cupping may hold promise in treating TPs; a combination of the two therapies may provide superior improving rate.

Randomized Controlled Trial of Compression After Endovenous Thermal Ablation of Varicose Veins (COMETA Trial).

The 21st century has witnessed a rise in the use of endovenous thermal ablation. Being highly clinically and cost-effective and improving the quality of life of patients, they are now considered to be the "gold-standard" treatment for varicose veins. Post-intervention management, especially in terms of postoperative compression, however, remains unclear. As a result, a randomized study was undertaken to investigate the effects of wearing compression stockings after varicose vein treatment. Patients with saphenous vein reflux undergoing treatment with endothermal ablation (with or without concurrent phlebectomies) were randomized to receive either 7 days of compression stockings or no stockings. The primary outcome measure for this study was the pain score over the first 10 postoperative days. The pain scores, clinical score, time to return to normal activities, and ecchymosis were assessed. Patients were followed-up at 2 weeks and 6 months post-ablation. In total, 206 patients were randomized, 49% of them to the compression group. The mean age was 49.7 (±16) years and approximately 51% of the population was male. The median pain score in the compression group using a visual analog scale was significantly lower on days 2-5, compared to the no compression group. Those having concurrent phlebectomies and compression stockings also had significantly better pain scores on days 1-3, day 5, and day 7. Improvement in the median venous clinical severity score was noted at 6-month follow-up, but this was not significant. No difference in the generic- or disease-specific quality of life was observed and the time to return to activities was similar. There were no differences in the degree of ecchymosis between the 2 groups and both groups had similar occlusion rates. These results indicate that wearing compression stockings after endothermal ablation is advantageous in the first few days after treatment and is especially beneficial for those having concurrent phlebectomies.

Human recombinant erythropoietin improves motor function in rats with spinal cord compression-induced cervical myelopathy.

ObjectiveErythropoietin (EPO) is a clinically available hematopoietic cytokine. EPO has shown beneficial effects in the context of spinal cord injury and other neurological conditions. The aim of this study was to evaluate the effect of EPO on a rat model of spinal cord compression-induced cervical myelopathy and to explore the possibility of its use as a pharmacological treatment.MethodsTo develop the compression-induced cervical myelopathy model, an expandable polymer was implanted under the C5-C6 laminae of rats. EPO administration was started 8 weeks after implantation of a polymer. Motor function of rotarod performance and grip strength was measured after surgery, and motor neurons were evaluated with H-E, NeuN and choline acetyltransferase staining. Apoptotic cell death was assessed with TUNEL and Caspase-3 staining. The 5HT, GAP-43 and synaptophysin were evaluated to investigate the protection and plasticity of axons. Amyloid beta precursor protein (APP) was assessed to evaluate axonal injury.To assess transfer of EPO into spinal cord tissue, the EPO levels in spinal cord tissue were measured with an ELISA for each group after subcutaneous injection of EPO.ResultsHigh-dose EPO maintained motor function in the compression groups. EPO significantly prevented the loss of motor neurons and significantly decreased neuronal apoptotic cells. Expression of 5HT and synaptophysin was significantly preserved in the EPO group. APP expression was partly reduced in the EPO group. The EPO levels in spinal cord tissue were significantly higher in the high-dose EPO group than other groups.ConclusionEPO improved motor function in rats with compression-induced cervical myelopathy. EPO suppressed neuronal cell apoptosis, protected motor neurons, and induced axonal protection and plasticity. The neuroprotective effects were produced following transfer of EPO into the spinal cord tissue. These findings suggest that EPO has high potential as a treatment for degenerative cervical myelopathy.

Compression therapy following ClariVein\xae ablation therapy: a randomised controlled trial of COMpression Therapy Following MechanO-Chemical Ablation (COMMOCA)

BackgroundEndovenous treatment of varicose veins has increased in popularity over the last decade. There remains, however, a degree of uncertainty regarding the role of compression bandaging or hosiery following this intervention. The National Institute for Clinical Excellence Guideline Development Group has advocated further research to evaluate the clinical and cost-effectiveness of this post-procedure intervention. In addition to this, the duration of compression bandaging also warrants clarification.MethodsEthical approval for the study was obtained from the Singhealth Centralised Institutional Review Board (CIRB Ref: 2017/2710). Consent to enter the study will be sought from each participant only after a full explanation has been given, an information leaflet offered and time allowed for consideration. Signed participant consent will be obtained. Patients will be randomised to either compression (group A) or no compression (group B). The primary aim of the study is to assess the patient’s pain scores for the first 10 days post procedure using a visual analogue scale. Secondary aims include an assessment of patient compliance with compression, quality of life scores, clinical effectiveness, rates of bruising and phlebitis, time taken to return to normal activities, patient satisfaction and occlusion rate at 6 months.DiscussionThe purpose of this study is to examine the effect of compression therapy in patients having mechano-chemical ablation (MOCA) therapy for truncal incompetence of their varicose veins using the ClariVein® device. This study may provide clarification on the role of compression therapy in patients undergoing MOCA.Trial registrationClinicalTrials.gov, NCT03685838. Registered on 26 September 2018.

The Association Between Prolonged Proton Pump Inhibitors Use and Bone Mineral Density.

Background and study aimChronic use of proton-pump inhibitors (PPIs) has become a mainstay of therapy in common gastrointestinal diseases. A causal relationship between chronic PPI use and development of osteoporosis remains unproven. The aim of this study was to determine whether PPI users are more likely to develop alterations in bone density.Patients and methodsIn an analytical cross sectional study, patients who used PPIs for more than 2 years because of long-term gastroesophageal reflux disease (GERD) were recruited. PPI users were healthy people except for GERD. The compression group was randomly derived from an age-, sex- and physical activity-matched group from a healthy population in the National Registry of Osteoporosis who had not used PPIs in the previous 2 years. Bone mineral density was measured with dual-energy X-ray absorptiometry. Data regarding BMD and bone mineral content (BMC) of three regions: femoral neck, total hip, and the lumbar spine (L1-L4) were gathered and recorded. The World Health Organization (WHO) classification was used for definition of osteopenia and osteoporosis.ResultsA total of 394 participants (133 PPI users and 261 comparison group) were enrolled. The median duration of PPI use was 6.7 (2–31) years. The mean age ± SD of PPI users and comparison group was 48.38 ± 11.98 and 47.86 ± years, respectively (P = 0.681). There was no significant difference in baseline characteristics and age distribution between the two groups. The BMC levels were significantly lower in PPI users in all three regions: lumbar spine, total hip, and femoral neck (P<0.001). There were no significant differences in the T-scores between the two groups except for femoral neck (P<0.001). Osteoporosis in femoral neck was significantly higher in PPI users than in comparison group.ConclusionThis study showed that long-term use of PPIs is associated with lower BMC and higher rate of osteoporosis in the femoral neck. However, more studies with longitudinal evaluation should be performed to clarify this causal relationship. Until then, it is advised not to overuse PPIs because of the possible increase in risk of osteoporosis and the risk of fractures. We also recommend using the BMC levels as a quantitative measure in addition to T scores in analysis and reporting similar studies.

Abstract 266: The Effect of Different Kinds of Chest Compression Waveforms on the Heart Ischemia-Reperfusion Injury After Cardiac Arrest

Purpose: This study was aimed to compare the effect of different kinds of chest compression waveforms on the heart ischemia-reperfusion injury after cardiac arrest (CA) in a rat model. Materials and methods: After the CA model was successfully established with continuous electrical stimulation of ventricular fibrillation, rats were divided into four different chest compression groups randomly, including manual group, triangular wave group, sine wave group and trapezoidal wave group. The success rates of return of spontaneous circulation (ROSC) of those four groups were calculated, and all ROSC rats were executed 30 minutes after ROSC. Further comparisons were made among those four groups, including pathological changes, superoxide dismutase (SOD) activities, malondialdehyde (MDA) and superoxide (O 2 - ) content. Results: The success ROSC rates for those four groups (manual group, triangular wave group, sine wave group and trapezoidal wave group) were 30%, 40%, 40% and 90% respectively. There were inflammatory cell infiltration and edema in the heart tissue of those four groups. The activities of SOD in trapezoidal wave group were 85.91±1.91 U/mg, much higher than those of the other three groups (P &lt;0.05). On the other hand, the MDA and O 2 - levels of trapezoidal wave group were much lower than those of the other three groups (p&lt;0.05). Conclusion: Our study demonstrated that trapezoidal wave chest compression may be beneficial in improving the success rate of ROSC and alleviate heart injury. Its possible mechanism might lie in its anti-oxidative stress capability during the chest compression.

A Switchless SiGe BiCMOS Bidirectional Amplifier for Wideband Radar Applications

This brief presents a switchless bidirectional amplifier (BDA) with 7-to-30 GHz of bandwidth (BW) and 11.2 dB of peak gain. Common impedance matching networks (IMN) are utilized for both directions, to form a low power and compact amplification stage. It achieves +0.58 dB/BW of a gain slope, which reaches its peak value at 21 GHz. Its output-referred 1-dB compression point (OP1dB) and group delay (GD) are measured as −2.5 dBm and 41 psec. while having ± 1.5 dB and ± 9.1 psec. variation over the defined BW. Moreover, the BDA dissipates 14 mW of power in 0.42 mm2 of area (including pads). The measurement results demonstrate that the BDA is compatible with the wideband transceiver systems. To the best of the authors’ knowledge, the presented design has the best operating bandwidth with a positively sloped gain without sacrificing from the area, power consumption and other remaining RF features such as noise figure (NF).

Risk of Ipsilateral Deep Vein Thrombosis After Use of AngioSeal Closure Device in Aneurysmal Subarachnoid Hemorrhage Patients

Deep vein thrombosis (DVT) is a known complication in patients with aneurysmal subarachnoid hemorrhage (aSAH). This study investigated the association between use of the AngioSeal (St. Jude Medical, Minnetonka, MN) vascular closure device and the risk of ipsilateral and any DVT event after angiography in patients with aSAH. We conducted a review of our institutional cerebral angiography database for the years 2005-2018 to identify all adult patients who underwent angiography for aSAH. We compared the incidence of DVT (occurring within 14 days) between aSAH patients who underwent manual compression versus the AngioSeal closure device. A total of 459 aSAH patients underwent angiography; 262 underwent manual compression (57.1%) and 197 received AngioSeal (42.9%). There was a 3.4% rate of ipsilateral DVT in the manual compression group and 7.6% in the AngioSeal closure device group (χ2 test, P= 0.04). Similarly, the rate of any DVT was 8.8% for manual compression and 16.8% for patients who received AngioSeal (χ2 test, P= 0.01). On multivariate analysis, AngioSeal remained a significant independent predictor of ipsilateral DVT (odds ratio 2.4, P= 0.04) and any DVT (odds ratio 2.3, P= 0.01). In aSAH patients undergoing cerebral angiographic procedures with access through the femoral artery, the use of AngioSeal closure device was found to be associated with a significantly increased risk of ipsilateral DVT within 14 days.

Effect of the Bruder moist heat eye compress on contact lens discomfort in contact lens wearers: An open-label randomized clinical trial

The purpose of this study was to investigate the effect of the Bruder Moist Heat Compress on contact lens (CL) discomfort in subjects with contact lens-related dry eye (CLDE). This was a 4-week, single-center, three-arm, randomized, open-label clinical trial in subjects diagnosed with CLDE using the Contact Lens Dry Eye Questionnaire. Fifty-one CL wearers were randomized to one of three treatment groups: application of the Bruder Compress twice a day, Bruder Compress once a day, or warm washcloth used for ten minutes twice a day without reheating. Subject diaries were monitored for compliance and collected data on daily CL comfort upon awakening and throughout the afternoon. Clinical assessments included tear film break-up time (TBUT), lipid layer thickness (LLT), and meibomian gland evaluation. Statistical tests included a generalized linear model and one-way analysis of variance (ANOVA) to investigate treatment effect on comfortable wear time.Fifty-one subjects (98% female) completed the study. After treatment, subjects using a washcloth reported more uncomfortable contact lens wear time on average (mean = 5.1 ± 2.8 h) when compared with subjects who had used the Bruder Compress in Group 1 (mean = 2.8 ± 1.6 h) (p = 0.02). In the Bruder Compress groups, there was a significant reduction in the blockage of meibomian glands (p < 0.01). No significant difference in uncomfortable wear time was found between subjects using the Bruder Compress twice daily versus once daily (p = 0.48). Subjects using the Bruder Compress once daily had the highest rate of compliance at 90.2% (p < 0.01). No significant improvements were observed in TBUT (p = 0.76) or LLT (p = 0.78).The Bruder Moist Heat Compress resulted in a significant improvement in comfortable CL wear time in subjects with CLDE.

Endoscopic sleeve gastroplasty: a modified technique with greater curvature compression sutures.

Background Endoscopic sleeve gastroplasty (ESG) is rapidly becoming established as a safe and effective means of achieving substantial weight loss via the transoral route. New ESG suture patterns are emerging. Our aim was to investigate whether superior weight loss outcomes can be achieved by using a unique combination of longitudinal compression sutures and “U”-shaped sutures. Methods This is a retrospective review of prospectively collected data of all patients undergoing ESG by a single operator in a single UK center. Results Between January 2016 and December 2017, 32 patients (23 female) underwent ESG; n = 9 cases were completed utilizing a commonly used triangular suture pattern (“no longitudinal compression”) and n = 23 cases were completed using our unique “longitudinal compression” suture pattern. In the no compression and compression groups, the mean ages were 45 ± 12 years and 43 ± 10 years, the median baseline weights were 113.6 kg (range 82.0 – 156.4) and 107 kg (range 74.0 – 136.0), and the median baseline body mass indexes (BMIs) were 35.9 kg/m 2 (range 30.9 – 43.8) and 36.5 kg/m 2 (range 29.8 – 42.9), respectively. After 6 months, body weight had decreased by 21.1 kg (range, 12.2 – 34.0) in the compression group (n = 7) versus 10.8 kg (range, 7.0 – 25.8) in the no compression group (n = 5) ( P = 0.042). Correspondingly, BMI decreased by 7.8 kg/m 2 (range, 4.9 – 11.2) and 4.1 kg/m 2 (range, 2.6 – 7.2) in each group, respectively ( P = 0.019). Total body weight loss (%TBWL) was greater in the compression group at 19.5 % (range, 12.9 – 30.4 %) compared to 13.2 % (range, 6.2 – 17.1 %) in the non-compression group ( P = 0.042). No significant adverse events were reported in this series. Conclusion The technique of ESG is evolving and outcomes from endoscopic bariatric therapies continue to improve. We provide preliminary evidence of superior weight loss achieved through a modified gastroplasty suture pattern.

Sliding compression technique with proximal femoral nail antirotation for intertrochanteric fractures in the elderly patients

Objective To observe the clinical efficacy of sliding compression technique with proximal femoral nail antirotation (PFNA) for the treatment of intertrochanteric fractures in the elderly patients. Methods A retrospective study was conducted in the 97 elderly patients with intertrochanteric fracture who had received PFNA internal fixation at Department of Orthopaedics, The Second Fuzhou Hospital Affiliated to Xiamen University from January 2010 to December 2017. They were divided into 2 groups depending on whether the sliding compression technique was used or not in the PFNA fixation. In the sliding compression group of 51 patients, there were 31 males and 20 females with an age of 79.9±6.2 years, and 2 cases of type Ⅰ, 8 cases of type Ⅱ, 21 cases of type Ⅲ, 16 cases of type Ⅳ, 3 cases of type Ⅴ and one case of type Ⅵ according to the modified Evans classification. In the conventional PENA group of 46 cases, there were 27 males and 19 females with an age of 77.5±8.0 years, and 3 cases of type Ⅰ, 6 cases of type Ⅱ, 15 cases of type Ⅲ, 18 cases of type Ⅳ and 4 cases of type Ⅴ according to the modified Evans classification. The 2 groups were compared in terms of the separation of fracture ends at immediate postoperation and 4 weeks postoperation, anesthesia time, operative time, intraoperative bleeding, fracture reduction, fracture healing time, Harris scores of hip function at one year postoperation and postoperative complications. Results There were no significant differences between the 2 group of patients in their preoperative general data, indicating they were compatible (P>0.05). The sliding compression group had significantly shorter separation of fracture ends at immediate postoperation and at 4 weeks postoperation (2.18±0.59 mm and 0.92±0.27 mm) and significantly shorter fracture healing time (5.2±0.9 weeks) than the conventional PENA group (3.91±0.76 mm and 2.15±0.52 mm; 6.5±0.9 weeks) (P 0.05). The sliding compression group had significantly lower incidences in pulmonary infection [9.8% (5/51)], blade loosening or cutout [0 (0/51)] and incision complications [0 (0/51)] than the conventional PENA group [26.1% (12/46), 17.4% (8/46) and 19.6% (9/46), respectively] (P<0.05). Conclusions In the treatment of intertrochanteric fractures in the elderly people, sliding compression technique with PFNA may lead to fewer postoperative complications and faster fracture healing. Key words: Hip fractures; Fracture fixation, intramedullary; Bone nails; Aged; Sliding compression

Fully threaded headless compression screw versus partially threaded cancellous lag screw in medial malleolus fractures: clinical and radiological outcomes

The aim of this study was to evaluate the clinical and radiological results of medial malleolar fractures, which were treated with fully threaded headless compression screws and to compare the clinical and radiological results of this screws and partially threaded cancellous lag screws. Sixty-one patients who attended the final follow-up examination were included in the study. Group 1 comprised 29 patients applied with fully threaded headless compression screws and Group 2 comprised 32 patients with partially threaded cancellous lag screws. Radiological evaluation was made with standard radiographs. The clinical evaluations were applied using the AOFAS ankle hindfoot scale. Pain or sensitivity by touching over the medial malleolus was recorded and scored according to Visual Analog Scale. No significant differences were determined between the groups with respect to age, gender, fracture type, follow-up time, bone union time and AOFAS scores. The medial sensitivity associated with implant irritation was significantly lower in Group 1. There was no need for removal of the fixation material in any patient of Group 1. The results of this study showed satisfactory results in the two fixation techniques in medial malleolar fractures. However, the rates of medial sensitivity associated with implant irritation were lower in the group where fully threaded headless compression screws were used. Therefore, to prevent postoperative patient dissatisfaction caused by persistent medial sensitivity associated with implant irritation, despite successful surgical treatment, the primary choice may be fully threaded headless compression screws.

Impact of Compression Therapy on Cellulitis (ICTOC) in adults with chronic oedema: a randomised controlled trial protocol

IntroductionCellulitis represents a significant burden to patients’ quality of life (QOL) and cost to the healthcare system, especially due to its recurrent nature. Chronic oedema is a strong risk factor...

Effects of Thermal Resistance to Fly Ash-Based Lightweight Geopolymer

Geopolymers are inorganic polymeric materials and cementations materials that replace the Ordinary Portland Cement. This study aimed to determine the effect of thermal resistance of fly ash based lightweight geopolymer and to investigate the physical, mechanical and microstructure properties of lightweight geopolymer at different thermal resistance. Considering the fire endurance assessment of geopolymers, the evolution of geopolymer during thermal exposure is of interest. This paper presents a comparative study of the characteristic of unfoamed (control sample) and lightweight geopolymers after exposure to elevated temperatures which is 200 °C, 400 °C, 600 °C and 800 °C. Lightweight geopolymers were prepared by adding foaming agent which is polyoxyethylene alkyether sulphate with geopolymer paste. Fly ash, alkaline activator and foam were mixed to produce a homogeneous mixture, which was placed into a cube 50 mm x 50 mm x 50 mm mould and cured at 80 °C for 24 hours. The compressive strength, density, chemical composition, microstructure and functional group analyses were studied. Unfoamed geopolymer exhibit higher compressive strength at 47.04 MPa compared to the highest strength of lightweight geopolymer which is 33.26 MPa at 200 °C. However, the lightweight geopolymer produced low density in range 1200 kg/m3 to 1500 kg/m3 compared to the density of unfoamed is 1813.79 kg/m3.

A Study on the Recurrence Rate of Trigeminal Neuralgia after MVD and the Related Factors.

The aim of this article is to investigate the related factors affecting the recurrence of microvascular decompression (MVD) after trigeminal neuralgia. We selected 400 cases of patients who met the diagnostic criteria of primary trigeminal neuralgia. The recurrence rate of patients and their statistical data related factors such as age, gender, disease duration, pain branches, vascular compression, patients, and complications (urban and rural), were collected. Of the 400 cases, 36 had recurrence after 2 years. In female group, the recurrence rate was (9.4%) higher than the recurrence rate in male group (8%); no recurrence rate of vascular compression group (40%) was higher than that of vascular compression group recurrence rate (8.6%); the recurrence rate of each branch in pain group from high to low was V 2-3 (13.4%), V 2 (12.5%), V 1 (9.1%), V 3 (7.5%), V 1-2-3 (4.4%), V 1-2 (4.3%), V 1-3 (0%); and the difference was statistically significant ( p < 0.05).Gender of the patient, the presence of vascular pressure, and the branch of pain could significantly affect the postoperative recurrence rate of trigeminal neuralgia in patients treated with simple MVD ( p < 0.05).

Expression and significance of hypoxia-inducible factor-1α and vascular endothelial growth factor and receptor 2 in stage 3 pressure injury of rats

To analyze the expression and relationship of hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) and kinase insert domain receptor (KDR) in local skin tissues of pressure injury and investigate the possible mechanism of stage 3 pressure injury refractory wound. Forty male SD rats were randomly divided into normal control group, compressed 3 d, 5 d, 7 d, and 9 d groups. Stage 3 pressure injury animal model were established by magnet compression. The morphology of skin was observed by HE staining. The expression of VEGF was detected by immunohistochemistry. The expression levels of HIF-1α, VEGF and KDR protein in skin tissue were detected by Western blot. One-way analysis of variance and LSD test were performed on the data. ①The HE results showed that compared with the normal control group, the epidermis of the compressed group was gradually thickened, the number of blood vessels was decreased, the collagen arrangement disordered and inflammatory cells infiltration were increased. ②Immunohistochemical results showed that the expression of VEGF protein in the 3 d group was significantly higher than that in the normal control group (P＜0.01). The expression of VEGF protein in the skin tissue of 5 d, 7 d and 9 d groups was lower than that in normal control group (P＜0.05). WB results were consistent with immunohistochemistry results. ③WB results showed that the expression of HIF-1α in the skin tissues of the rats in 3 d, 5 d and 7 d groups was higher than that in the normal control group (P＜0.01 or P＜0.05). The expression of KDR protein was lower than that of the normal control group (P＜0.05 or P＜0.01). HIF-1α mediated reduction of VEGF and KDR protein expression and decreased tissue angiogenesis may be one of the important causes of chronic dysfunction of stage 3 pressure injury.

Propagation of microcracks in collagen networks of cartilage under mechanical loads

We recently demonstrated that low-energy mechanical impact to articular cartilage, usually considered non-injurious, can in fact cause microscale cracks (widths <30μm) in the collagen network of visually pristine human cartilage. While research on macro-scale cracks in cartilage and microcracks in bone abounds, how microcracks within cartilage initiate and propagate remains unknown. We quantified the extent to which microcracks initiate and propagate in the collagen network during mechanical loading representative of normal activities. We tested 76 full-thickness, cylindrical osteochondral plugs. We imaged untreated specimens (pristine phase) via second harmonic generation and assigned specimens to three low-energy impact groups (none, low, high), and thereafter to three cyclic compression groups (none, low, high) which simulate walking. We re-imaged specimens in the post-impact and post-cyclic compression phases to identify and track microcracks. Microcracks in the network of collagen did not present in untreated controls but did initiate and propagate under mechanical treatments. We found that the length and width of microcracks increased from post-impact to post-cyclic compression in tracked microcracks, but neither depth nor angle presented statistically significant differences. The microcracks we initiated under low-energy impact loading increased in length and width during subsequent cyclic compression that simulated walking. The extent of this propagation depended on the combination of impact and cyclic compression. More broadly, the initiation and propagation of microcracks may characterize pathogenesis of osteoarthritis, and may suggest therapeutic targets for future studies.

Pengaturan Suhu Tubuh dengan Metode Tepid Water Sponge dan Kompres Hangat pada Balita Demam

Fever is a condition of an increase in body temperature. High fever can cause many complications. The purpose of this research was to know the difference of effectiveness of tepid water sponge and warm compress method to control the body in children under five years having a fever. This research was used quasi-experimental design and non-equivalent control group design. The number of samples in each group was 30 people selected by consecutive sampling technique. The result of the average temperature drop in the tepid water sponge group was 0.993 0 C, while the average temperature drop in the warm compress group was 0,540C. The result of this research was used paired-samples t-test and independent-samples t-test and obtained p-value=0.0001 (p<0.05). There was a difference of effectiveness of tepid water sponge and warm compress method to control the body temperature in children under five years with fever at Puskesmas Abiansemal I and Puskesmas Mengwi I Year 2018.

Significance and Indications of Surgery for Asymptomatic Nonfunctioning Pituitary Adenomas

The availability of magnetic resonance imaging (MRI) has led to an increase in the detection of pituitary incidentaloma (PI). However, there are no robust data on surgical treatment of PI on which to base therapeutic recommendations. This study was performed to investigate the significance of surgery for asymptomatic nonfunctioning pituitary adenoma (NFPA) among PIs. A total of 180 patients that underwent tumor resection of pituitary adenoma via the transsphenoidal approach between 2005 and 2017 were reviewed. Thirty-three consecutive patients with subjectively asymptomatic NFPA were included in this study. Our surgical indications for asymptomatic NFPAs were categorized as follows: macroadenoma with optic chiasma compression (group A, n= 14), solid tumor ≥2 cm in size (group B, n= 7), and tumor growth on follow-up MRI (group C, n= 12). The clinical outcomes were analyzed accordingly. Seven patients (50%) in group A showed subjective improvement of visual function after tumor resection even though they had no complaints preoperatively. On the other hand, no changes occurred in any cases in group B or group C. Although there were no critical complications in this series, the incidence of nonnegligible nasal complications was relatively high (24.2%) and may decrease the patient's quality of life. Surgery should be recommended for asymptomatic NFPA with optic chiasma compression to improve visual outcome. On the other hand, immediate intervention for other asymptomatic NFPA to reduce the likelihood of the appearance of tumor-related symptoms remains questionable considering its invasiveness to the nose.