Warm Foot Research Articles

Effect of Hydro-Aromatherapy on Heart Rate in Heart Failure Patients

Objects: to determine the effect of hydro-aromatherapy on heart rate in patients with heart failure.Methods: This study was a quasi-experiment pretest-posttest with two groups. Thirty-two respondents wereselected by consecutive sampling with inclusion and exclusion criteria. The intervention was given a warmfeet soak with aromatherapy, while the control only had a warm feet soak. Pulse oximetry was used tomeasure heart rate. Data were analyzed using a dependent t-test and independent t-test.Results: there was a statistically significant heart rate difference before and after in intervention (p<0.000),and also there was a statistically significant heart rate difference before and after in the control group(p<0.0005). In the study in the intervention group after the treatment, a warm feet soak with aromatherapywas decreased heart rate by an average of 78.69 (SD=14.63). Whereas in the control group after the treatmenta warm feet soak was also decreased heart rate by an average of 85.31 (SD=5.12).Conclusion: Both treatments a warm feet soak with and without aromatherapy were decreased the heartrate, but perhaps with aromatherapy will be improved patients’ comfort.

Effect of Warm Foot Bath on Fatigue among Diabetic Old Adults

Introduction: Fatigue is one of the most common causes of disability in most elderly people affected with diabetes. Considering the growing population of this group, the present study aimed to determine the effect of warm foot bath on the fatigue of the elderly people with diabetes. Methods: The randomized clinical trial study was carried out on 66 elderly diabetic patients who had referred to the Diabetes Research Center in Yazd. Eligible participants were selected by convenience sampling and randomly divided into two experimental and control groups. Participants of the experimental group performed a warm foot bathing for 20 minutes during two weeks. The Piper Fatigue Scale was completed in three steps (at the beginning of the study, two and four weeks after intervention). Data were analyzed by SPSS software, using ANOVA for repeated measures, independent t-test, Chi-Square and Fisher exact test. Results: The mean ± standard deviation of fatigue in the three phases of evaluation in the experimental group was 5.91 ± 0.81, 4.80 ± 1.19, 4.55 ± 1.57 and in the control group was 5.95 ± 0.97, 6.06 ± 1.13 and 5.79 ± 1.33, respectively. The difference in the mean of fatigue scores in both groups after the intervention was significant (p < 0.001). Conclusion: Revealing the positive effects of warm foot bathing, this method, as a non-pharmacological and easy-to-use method, is recommended to improve fatigue condition in the elderly patients with diabetes.

The Effect of Warm Footbath With Salt of Edema Under Extremity In Postpartum Pre Eclamsia

Preeclampsia is a complication of pregnancy that is acute and can occur ante, intra postpartum. Ideally during the postpartum blood pressure 120/80 mmHg. However, based on the preliminary there were 73.9% who experienced lower extremity edema in postpartum preeclampsia. The purpose of this study was to analyze the effect of a warm foot bath with salt edema under extremity in postpartum preeclampsia. The research design was a quasi-experimental pre-post test with control group design. The independent variable was soaking the foot using mixed salt warm water mixed. The dependent variable was extremity edema in the postpartum mother pre-eclampsia. The population was 9 respondents. Samples taken were 9 respondents. The results in the treatment group obtained a value of p = 0.04 while the control group p = 0.05. Test results obtained by Whitney p = 0.004. Based on the results of this study, it is expected that patients with extreme edema in postpartum preeclampsia should be advised to soak the foot using mixed salt warm water to improve blood circulation, especially for sufferers of lower extremity edema in postpartum preeclampsia.

A Study to assess the effectiveness of warm foot soak on reduction of Blood Pressure among Hypertensive patients in selected rural area at Rajkot

A Study to assess the effectiveness of warm foot soak on reduction of Blood Pressure among Hypertensive patients in selected rural area at Rajkot

Gout as a trigger for acute Charcot neuro-osteoarthropathy?

Patients with diabetes and a painful, hot, swollen foot can sometimes present a diagnostic challenge. Gout can often present in a similar fashion to diabetic foot infections or acute Charcot neuro-osteoarthropathy, and cases have been described where patients with Charcot neuro-osteoarthropathy were misdiagnosed as having gout, leading to treatment delay. We describe a patient who presented with a painful, swollen, warm foot who did not respond to initial treatment with antibiotics. Improvement in his symptoms occurred following treatment for gout, however he then went on to develop Charcot neuro-osteoarthropathy. As far as we are aware, this is the first case described in the literature where acute gout may have triggered acute Charcot neuro-osteoarthropathy. It is important to bear in mind that more than one pathology may be present in a patient at the same time or may closely follow one another.

The Effectiveness Of Warm Water Therapy And Deep Breathing Relaxation In Blood Pressure

Introduction: Prevalence of hypertension in Indonesia is 26.5% WHILEhile in Yogyakarta cases of hypertension as a cardiovascular disease that causes the highest deaths reached more than 80%, and the incidence rate is always increasing every year. From the results of interviews of 56 respondents and blood pressure measurement obtained 21 respondents who experienced hypertension. To overcome hypertension in elderly researchers combined two warm water foot soak therapy and deep breathing relaxation. The purpose of this research is to know the effectiveness of warm water foot soak therapy and deep breathing relaxation to blood pressure in elderly at Rumah Seni Seni Budi Dharma Yogyakarta. Methodology: This research is a quantitative research type, the method used quasi Experimental Desaign with pre and post test design control. Sampling using total sampling. Technique of collecting data by observation using digital sphygmomanometer. Data analysis using Paired simple t-test with significant value p <0,05. Result: The result of data analysis obtained by the respondent's blood pressure after the treatment therapies decreased significantly with pistol systolic and diastolic p value of 0.000. With an average systolic blood pressure difference before and after intervention of 22.71 mmHg and diastolic 11.94 mmHg. Discussion: There is a significant effect on decreasing systolic and diastolic blood pressure before and after treatment of warm foot bath and deep breath relaxation in hypertensive elderly at UPT Budi Dharma Yogyakarta Senior High School

The effect of bundle of warmth care for patients with advanced colorectal cancer undergoing chemotherapy on reduction of oxaliplatin-related peripheral sensory neuropathy.

e15031 Background: FOLFOX is the one of the most selected chemotherapy regimens for advanced colorectal carcinoma (aCC) patients, which includes oxaliplatin, 5-fu and leucovorin. However, oxaliplatin often causes chemotherapy-induced peripheral sensory neuropathy (CIPN) which is a common treatment-related adverse effect and affects long- term quality of life. The aim of the study is to observe the effect of warmth intervention on patients with advanced colorectal cancer undergoing chemotherapy. Methods: A total of 60 aCC patients were recruited. They were randomized into an intervention group (30 patients) and a control group (30 patients). The intervention group accepted the bundle of warmth care which included wearing cotton gloves and socks, washing hands and taking a bath with warm water, soaking hands and feet before sleep with warm water, reducing exposure to cold and avoiding cold food. The control group was treated with conventional health education which including how to reduce exposure to cold. CTCAE-4.0 was used to evaluate patient, s peripheral sensory neuropathy at baseline, 3 months, 6 months and 6 months after chemotherapy terminate. Results: At baseline, there was no peripheral sensory neuropathy in two groups. In 3 months, incidence of peripheral sensory neuropathy of intervention group and control group were 26.67%(Ⅰ:20.00%,Ⅱ:6.67%) VS 83.34% (Ⅰ:46.67%,Ⅱ:30.00%,Ⅲ:6.67%)(χ2= 22.289,p = 0.000). In 6 months, incidence of peripheral sensory neuropathy of two group were 36.67% (Ⅰ: 26.67%,Ⅱ: 10.00%) VS 93.34%(Ⅰ:46.67%,Ⅱ:30.00%,Ⅲ:16.67%) (χ2= 23.398,p = 0.000). 6 months after chemotherapy terminate, incidence of peripheral sensory nerve damage of two group were 13.33%(Ⅰ:10.00%,Ⅱ:3.33%) VS 33.34%(Ⅰ:6.67%,Ⅱ:10.00%,Ⅲ:6.67%) (χ2= 4.283,p = 0.233). Conclusions: Bundle of warmth care reduced oxaliplatin-related peripheral sensory neuropathy on patients with advanced colorectal cancer undergoing chemotherapy.

Warm hands but cold feet

Warm hands but cold feet

A Study to Assess the Effectiveness of Warm Foot Bath on Sleep Onset Time among Cancer Patients with Insomnia in Nath Lal Parekh Cancer Hospital at Rajkot

The reduction in the insomnia levels and improving the sleep onset time of the cancer patients has an important role to play in enabling effectiveness of warm foot bath intervention as an independent nursing intervention. The objective of the study is to assess the effectiveness of warm foot bath on sleep onset time among cancer patients with insomnia. The research design adopted was pre experimental one group pre-test post-test design. The conceptual framework for this study was based on Wiedenbach's clinical nursing practice theory (1964). The study has been conducted in NathLal Parekh cancer hospital, Rajkot. Purposive sampling technique has been adopted to select the desired sample. The sample size was 30. As an intervention of 15 min of warm foot bath was administered for experimental group. The data was collected through general sleep disturbance scale. The collected data were analyzed by using both descriptive and inferential statistical methods. ANOVA test was used to assess the effectiveness of warm foot bath on sleep onset time among cancer patients with insomnia. The obtained value was. The findings of the study reveals that warm foot bath helps in improving sleep onset time and reducing insomnia.

Trophic application in CVI I with peripheral oedema compared with compression stockings

Summary Aim In the warm season of 2015, the efficacy of Allga Med® Antiswelling Foot Spray and Allga Med® Warm Feet Balsam in combination with a class 2 compression stocking was compared with the efficacy of a compression stocking of the same class applied alone. Method 40 women aged 23–78 years (mean 48 years) were included in the investigation. The women were all overweight (mean height: 166 cm, mean weight: 83 kg; mean BMI 30.1 kg/m2). For one month before their inclusion, they had not been permitted to take venous medication or wear compression stockings. Prior to the start of the study, class 2 compression stockings were prescribed. The compression stockings were worn consistently during the day for 14 days. In addition, the right leg was treated twice daily with foot spray and balsam. Before the start of the study and after 14 days, the foot and distal lower leg volume of both legs was measured by means of water plethysmography Result On the stockinged left leg, the volume decreased by 152 ml. On the right leg, which was trophically treated and stockinged, the volume decreased by up to 335 ml.

Effects of temperature and supply airflow rate on thermal comfort in a stratum-ventilated room

Providing an appropriate thermal comfort level is crucial for the technical feasibility of stratum ventilation at elevated room temperatures. This paper presents a subjective study of thermal comfort in a stratum-ventilated environmental chamber. Overall thermal sensation (OTS), local thermal sensation (LTS) of body segments, overall thermal comfort (OTC) and draft were investigated. The objectives of this study were twofold: to evaluate the effect of room temperature on thermal comfort (Test Series 1) and to assess the effect of supply airflow rate and supply air temperature on thermal comfort (Test Series 2). Test Series 1 revealed that the room temperature had a great impact on the OTS, LTS, OTC and draft. Under 10 air change per hour (ACH), a room temperature of 27 °C provided neutral OTS, satisfactory OTC and low draft risk. However, at room temperatures of 24 and 29 °C, the percentages of subjects feeling comfortable were obviously less than 80%. Test Series 2 showed that at the room temperature of 27 °C, increasing the supply airflow rate from 7 ACH to 17 ACH only exhibited a small influence on the thermal sensation and draft, indicating a preference for air movement. More than 80% subjects felt comfortable at 27 °C. However, to minimize draft complaints, the supply air temperature should not be below 20 °C. These results show that stratum ventilation provides a thermally comfortable environment, so that people can have the feeling of “cool head and warm feet”, with low draft risk at a room temperature up to 27 °C.

Comparing the effects of aromatherapy with rose oils and warm foot bath on anxiety in the first stage of labor in nulliparous women.

Background:Anxiety is the most common emotional response in women during delivery, which can be accompanied with adverse effects on fetus and mother.Objectives:This study was conducted to compare the effects of aromatherapy with rose oil and warm foot bath on anxiety in the active phase of labor in nulliparous women in Tehran, Iran.Patients and Methods:This clinical trial study was performed after obtaining informed written consent on 120 primigravida women randomly assigned into three groups. The experimental group 1 received a 10-minute inhalation and footbath with oil rose. The experimental group 2 received a 10-minute warm water footbath. Both interventions were applied at the onset of active and transitional phases. Control group, received routine care in labor. Anxiety was assessed using visual analogous scale (VASA) at onset of active and transitional phases before and after the intervention. Statistical comparison was performed using SPSS software version 16 and P < 0.05 was considered significant.Results:Anxiety scores in the intervention groups in active phase after intervention were significantly lower than the control group (P < 0.001). Anxiety scores before and after intervention in intervention groups in transitional phase was significantly lower than the control group (P < 0.001).Conclusions:Using aromatherapy and footbath reduces anxiety in active phase in nulliparous women.

Opportunities of predictive medicine at the treatment of diabetes mellitus complications

Foot ulcers develop in approximately 15 percent of type 1 Diabetes patients. 85% of the lower-limb amputations in those patients are preceded by foot ulceration, suggesting that prevention and appropriate management of foot lesions are of marked value. Ulceration is caused by several factors acting together, but particularly by neuropathy. The annual incidence of foot ulceration is slightly larger than 2.0 percent among all T1D patients and between 5.0 and 7.5 percent among T1D patients with peripheral neuropathy [1]. Peripheral neuropathy results in a loss of the protective sensation of pain and in autonomic dysfunction, with sympathetic denervation, dry skin, and warm feet. Appropriate medical education regarding early assessment for lesions or warning signs of imminent ulceration in patients with sensory loss is essential for the future to come. Other important component causes of ulceration include peripheral vascular disease, callus, edema, and deformity. The triad of neuropathy, deformity, and trauma is present in almost two thirds of patients with foot ulcers. Inappropriate footwear is the most common source of trauma [2]. The economic burden associated with diabetic foot ulceration, i.e., a condition that is preventable in many cases, is enormous. The estimated cost of treating one foot ulcer over a two-year period is $28,000. Growth Factors Recombinant platelet-derived growth factor was the first growth factor approved by FDA for the treatment of neuropathic foot ulcers in T1D patients. A recent review of growth factors in the treatment of diabetic foot ulcers concluded that, platelet-derived growth factor may be useful in chronic, non healing europathic ulcers that do not respond to conventional care [3]. Tissue-engineered skin comprises a cultured living dermis and sequentially cultured epidermis, the cellular components of which are derived from neonatal foreskin. Treatment with tissue-engineered skin is associated with faster healing and lower rates of osteomyelitis and lower-limb amputation [4]. Alternative insulin therapies are being sought that will provide glycemic control for people with diabetes mellitus. The epidermis is a self-renewing tissue that is easily accessible and can provide large numbers of autologous cells that can be used for generating insulin-secreting skin substitutes. Lentiviral vectors have been engineered to produce a fusion protein between the furin-cleavable proinsulin and the self-dimerization mutant of FK506-binding protein to yield bioactive insulin in keratinocytes; this insulin is released as a response to exogenous administration of a small organic molecule, rapamycin [5]. The bioengineered keratinocytes retained normal morphology and grew in a manner similar to lentiviral-treated control cells. There are a lot of products of bioengineering, different scaffolds, which can be used as base for tissue regenerating. From our point of view, one of the main points of preventive effect in the treatment of diabetes is to secure early accumulation of the personalized genetic information about the patient. This is necessary not only for treatment of the underlying disease, but treatment of its complications. Modern technologies allow creating biomaterials that can provide not only local, but also the overall therapeutic effect when they are implanted in the area of ulceration in diabetes.

Debriefing

This article reports the early results in humans of hypertensive extracorporeal limb perfusion (HELP) technology in the prevention of major limb amputation due to ischemia. The short-term aim was to dilate pre-existing collateral channels, and the long-term aim was to stimulate remodeling and new collateral development by increasing endothelial shear stress and wall tension.This study evaluated 20 patients with critical limb ischemia who were treated with HELP. These patients had no other option but major amputation, as determined by at least two vascular surgeons. The arterial circulation to the ischemic limb was isolated from the systemic circulation by the use of an endoluminal balloon catheter in seven patients and by an implantable, inflatable, occlusive cuff in 13. The limbs were hyperperfused through the peripheral access system with an extracorporeal pump, producing a minimally pulsatile waveform at 200% to 300% of the mean arterial pressure. This was performed repeatedly in sessions of 24 to 36 hours, up to a maximum of 74 hours. The primary end point was avoidance of major amputation. The secondary end points were the clinical improvements in rest pain, ulcer healing, and claudication distance. Patients were analyzed and reviewed using infrared thermography and ultrasound imaging parameters of the limb.Given adequate arterial access, 39 of 40 connections developed flows four to eight times those supplied to the limb by the normal cardiac output. A progressive decrease was noted in peripheral resistance. All patients developed a pain-free, warm foot or hand while on the pump in the short-term. In the longer term at a mean of 22 months (range, 12-54 months), eight of 20 patients (40%) had avoided major amputation and four more had a delay in amputation of an average of 4 months. The ankle-brachial index changed from 0.04 ± 0.07 (range, 0.00-0.94) to 0.63 ± 0.39 (t-test, P < .05). Bleeding, infection, premature cessation of the treatment, and poor patient selection resulted in the failures. There were two short-term unrelated deaths that occurred at 1 and 3 months follow-up.The collateral circulation of ischemic limbs can be augmented and regulated by a connection to an extracorporeal centrifugal pump, with isolation from the systemic circulation provided by balloons and with an access system providing repeatable pump connections. Major amputation may be avoided in selected cases.

Hypertensive extracorporeal limb perfusion for critical limb ischemia

This article reports the early results in humans of hypertensive extracorporeal limb perfusion (HELP) technology in the prevention of major limb amputation due to ischemia. The short-term aim was to dilate pre-existing collateral channels, and the long-term aim was to stimulate remodeling and new collateral development by increasing endothelial shear stress and wall tension. This study evaluated 20 patients with critical limb ischemia who were treated with HELP. These patients had no other option but major amputation, as determined by at least two vascular surgeons. The arterial circulation to the ischemic limb was isolated from the systemic circulation by the use of an endoluminal balloon catheter in seven patients and by an implantable, inflatable, occlusive cuff in 13. The limbs were hyperperfused through the peripheral access system with an extracorporeal pump, producing a minimally pulsatile waveform at 200% to 300% of the mean arterial pressure. This was performed repeatedly in sessions of 24 to 36 hours, up to a maximum of 74 hours. The primary end point was avoidance of major amputation. The secondary end points were the clinical improvements in rest pain, ulcer healing, and claudication distance. Patients were analyzed and reviewed using infrared thermography and ultrasound imaging parameters of the limb. Given adequate arterial access, 39 of 40 connections developed flows four to eight times those supplied to the limb by the normal cardiac output. A progressive decrease was noted in peripheral resistance. All patients developed a pain-free, warm foot or hand while on the pump in the short-term. In the longer term at a mean of 22 months (range, 12-54 months), eight of 20 patients (40%) had avoided major amputation and four more had a delay in amputation of an average of 4 months. The ankle-brachial index changed from 0.04 ± 0.07 (range, 0.00-0.94) to 0.63 ± 0.39 (t-test, P < .05). Bleeding, infection, premature cessation of the treatment, and poor patient selection resulted in the failures. There were two short-term unrelated deaths that occurred at 1 and 3 months follow-up. The collateral circulation of ischemic limbs can be augmented and regulated by a connection to an extracorporeal centrifugal pump, with isolation from the systemic circulation provided by balloons and with an access system providing repeatable pump connections. Major amputation may be avoided in selected cases.

Effect of a warm footbath before bedtime on body temperature and sleep in older adults with good and poor sleep: An experimental crossover trial

BackgroundThe decrease in core body temperature before sleep onset and during sleep is associated with dilation of peripheral blood vessels, which permits heat dissipation from the body core to the periphery. A lower core temperature coupled with a higher distal (hands and feet) temperature before sleep are associated with shorter sleep latency and better sleep quality. A warm foot bath is thought to facilitate heat dissipation to improve sleep outcomes. ObjectivesThis study examined the effect of a warm footbath (40°C water temperature, 20-min duration) on body temperature and sleep in older adults (≥55 years) with good and poor sleep. DesignTwo groups and an experimental crossover design was used. Setting and participantsForty-three adults responded to our flyer and 25 participants aged 59.8±3.7 years (poor sleeper with a Pittsburgh Sleep Quality Index score≥5=17; good sleepers with a Pittsburgh Sleep Quality Index score<5=8) completed this study. MethodsAll participants had body temperatures (core, abdomen, and foot) and polysomnography recorded for 3 consecutive nights. The first night was for adaptation and sleep apnea screening. Participants were then randomly assigned to either the structured foot bathing first (second night) and non-bathing second (third night) condition or the non-bathing first (second night) and foot bathing second (third night) condition. ResultsA footbath before sleep significantly increased and retained foot temperatures in both good and poor sleepers. The pattern of core temperatures during foot bathing was gradually elevated (poor sleepers vs. good sleepers=+0.40±0.58°C vs. +0.66±0.17°C). There were no significant changes in polysomnographic sleep and perceived sleep quality between non-bathing and bathing nights for both groups. ConclusionA footbath of 40°C water temperature and 20-min duration before sleep onset increases foot temperatures and distal–proximal skin temperature gradients to facilitate vessel dilatation and elevates core temperature to provide heat load to the body. This footbath does not alter sleep in older adults with good and poor sleep.

Cold Hands, Warm Feet: Sleep Deprivation Disrupts Thermoregulation and Its Association with Vigilance

Vigilance is affected by induced and spontaneous skin temperature fluctuations. Whereas sleep deprivation strongly affects vigilance, no previous study examined in detail its effect on human skin temperature fluctuations and their association with vigilance. In a repeated-measures constant routine design, skin temperatures were assessed continuously from 14 locations while performance was assessed using a reaction time task, including eyes-open video monitoring, performed five times a day for 2 days, after a normal sleep or sleep deprivation night. Participants were seated in a dimly lit, temperature-controlled laboratory. Eight healthy young adults (five males, age 22.0 ± 1.8 yr (mean ± standard deviation)). One night of sleep deprivation. Mixed-effect regression models were used to evaluate the effect of sleep deprivation on skin temperature gradients of the upper (ear-mastoid), middle (hand-arm), and lower (foot-leg) body, and on the association between fluctuations in performance and in temperature gradients. Sleep deprivation induced a marked dissociation of thermoregulatory skin temperature gradients, indicative of attenuated heat loss from the hands co-occurring with enhanced heat loss from the feet. Sleep deprivation moreover attenuated the association between fluctuations in performance and temperature gradients; the association was best preserved for the upper body gradient. Sleep deprivation disrupts coordination of fluctuations in thermoregulatory skin temperature gradients. The dissociation of middle and lower body temperature gradients may therefore be evaluated as a marker for sleep debt, and the upper body gradient as a possible aid in vigilance assessment when sleep debt is unknown. Importantly, our findings suggest that sleep deprivation affects the coordination between skin blood flow fluctuations and the baroreceptor-mediated cardiovascular regulation that prevents venous pooling of blood in the lower limbs when there is the orthostatic challenge of an upright posture.

Acoustics development of range extenders for electric vehicles

The most common question associated with battery-powered electric vehicle is: “How far can I get with the vehicle?” This question describes to the point the subconscious fear of potential buyers of being stranded one day with their vehicle with an empty battery. With electric vehicles, people constantly have to make choices: “warm feet, cool head, or getting there?” This is due to the fact that the energy that must be provided for the vehicle’s climate control also comes from the battery and, as a result, limits the range, which is not great to begin with, even further. From today’s point of view, the best answer to this problem is a range extender with a combustion engine, which permits a range that is virtually independent from the battery. This is expected to have an impact on the end customers’ acceptance of electric vehicles. Battery-powered electric vehicles with their currently limited usage profile seem to be ideal for use in urban areas. This application range calls for a range extender engine that helps expand the use of urban vehicles. The range extender engine increases the range of the FEV Liiondrive for instance from 80 km with purely electric drive to a total range of 300 km with one full tank of fuel. The result is a special range of requirements on the engine with the following characteristics: : small : light-weight (~50 kg) : low-cost (~1000 €) : limited output range (20 kW to 35 kW), maximum performance is reached with purely electric operation : excellent NVH characteristics : can be offered as an option. Standard range extenders are suitable for battery-powered electric urban vehicles. However, in the larger classes of vehicles, full hybrids with more battery power (plug-in hybrids) are preferable. This class of vehicles can then also be used as urban vehicles with a purely electric drive that can be charged from the power grid, ❶. Open image in new window ❶ Hybrid drivetrains

VS01 HYPERTENSIVE EXTRACORPOREAL LIMB PERFUSION – HELP

Objective: To report the early human results of H.E.L.P. technology in the prevention of major limb amputation. In the short‐term, the aim was to pressure dilate collateral channels and in the long‐term to stimulate remodelling and new collateral pathways by increasing endothelial shear stress.Methods: A pilot study consisted of the ischaemic limbs of 15 patients with critical limb ischaemia. These patients had no other option but major amputation as determined by at least two vascular surgeons. The limbs were connected to a commercially available cardiac pump via an access system. The limbs were hyperperfused pancycle at 2–3 times the mean arterial pressure (MAP). This was performed intermittently in sessions of 24–36 hours. The major endpoint was avoidance of major amputation.Results: Given adequate arterial access, 29 of 30 connections developed flows 4–8 times the MAP. There was a progressive decrease in peripheral resistance. All patients developed a pain‐free, warm foot or hand whilst on the pump in the short‐term. In the longer term, a mean of 10.4 months (range 1–29 months) 50% had avoided major amputation. Pain scores changed from 0.9 ± 0.1 to 1.1 ± 1.3 under the visual analogue scale (V.A.S). The ankle brachial index (A.B.I) changed from 0.06 ± 0.09 to 0.57 ± 0.33, p &lt; 0.05 (t test).Conclusions: The collateral circulation of ischaemic limbs can be augmented and regulated via connection to an extracorporeal cardiac pump. The technique is similar to haemodialysis. Major amputation can be avoided in selective cases. Improvements in the technology are continuing.

Human subject experiments for investigating the combined effects of two local discomfort parameters

The purpose of HVAC systems is to provide a comfortable environment and set the conditions for efficient work. The enhancement of buildings´ energy performance puts emphasis on meeting the comfort requirements indoors, as the acceptable environments have to be provided from less energy. The comfort of occupants is determined by the heat exchange between his body and his indoor environment. Even if whole body thermal comfort is accomplished there may be local areas on the body where sensation of discomfort may arise. The paper contains the results of a human subject experiment that was carried out to study the combined effect of two, simultaneously present local discomfort parameters, namely radiant temperature asymmetry and warm feet. Results showed that local discomfort caused by warm feet was not present or was out ruled by the radiation from the cold wall surface.