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1.
Ocul Oncol Pathol ; 10(3): 182-188, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39224528

RESUMO

Introduction: Children with retinoblastoma have anesthesia for exams and treatment, but there is little information about how long treatment interventions (laser, cryotherapy, and intravitreal injections) add to routine exams under anesthesia (EUA). This information would be useful for planning operating room schedules, staff schedules, family expectations, and billing. Methods: A retrospective, single-center, Institutional Review Board (IRB) approved review of anesthesia duration for retinoblastoma children undergoing EUA with laser, cryotherapy, or intravitreal injections performed at MSK between January 2019 and November 2023. Results: Three hundred eight patients had 2,399 EUAs. The average EUA lasted 24.3 min (range 7-77 min) when no interventions were done. Laser photocoagulation added an average of 18.9 min (range 19-77 min), cryotherapy 26.1 min (range 27-75 min), and intravitreal injection 23.5 min (range 10-71 min) to the basic EUA time. Bilateral laser treatments took 8 min longer than unilateral treatments. Conclusion: EUAs for children with retinoblastoma can be performed relatively quickly. Interventions such as laser, cryotherapy, or intravitreal injections roughly double the time under anesthesia but in some cases can take much longer (>1 h).

2.
Eur J Appl Physiol ; 2024 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-39307853

RESUMO

BACKGROUND: Although brief skin cooling (BSC) is widely used in sports medicine and rehabilitation for its positive effects on motor performance, the mechanism underlying this motor facilitation effect remains unclear. OBJECTIVES: To explore the hypothesis that BSC enhances muscle force generation, with cold-induced sympathetic activation leading to heightened muscle spindle sensitivity, thereby contributing to this effect. METHODS: The study involved two experiments. Experiment 1 included 14 healthy volunteers. Participants submerged their hand in ice water for 3 min. Sympathetic activity was measured via heart rate (HR), muscle force generation was assessed through plantar flexor strength during maximum voluntary contraction (MVC), and cortical contribution to force generation via the volitional wave (V-wave) with and without the cold pressor test (CPT). Experiment-2 involved 11 healthy volunteers and focused on muscle spindle sensitivity and Ia synapse efficacy, assessed using soleus T-reflex and H-reflex recordings before, during, and after CPT. RESULTS: Experiment 1 showed significant increases in HR (7.8%), MVC force (14.1%), and V-wave amplitude (93.4%) during CPT compared to pre-CPT values (p = 0.001, p = 0.03, and p = 0.001, respectively). In Experiment-2, hand skin temperature significantly decreased during CPT and remained lower than pre-CPT after 15 min (p < 0.001). While H-reflex and background EMG amplitudes remained unchanged, T-reflex amplitude (113.7%) increased significantly during CPT and returned to pre-CPT values immediately afterward (p < 0.001). A strong correlation was also observed between HR and T-reflex amplitude (r = 0.916, p = 0.001). CONCLUSION: BSC enhances muscle spindle sensitivity via the sympathetic nervous system, promoting more significant muscle force generation. The method used in this study can be safely applied in clinical practice.

4.
Vet Ophthalmol ; 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-39278843

RESUMO

OBJECTIVE: The aim of this pilot study was to establish a satisfactory, scientific approach to effectively compare quantitative measurements of various ocular surface parameters before and after surgical treatment in dogs suffering from distichiasis. METHODS: An ophthalmic examination was conducted on 12 dogs (23 eyes) before and after surgical treatments for distichiasis, at four different time points, (t0 = before surgery, t1 = 1-2 h after surgery, t2 = 1 week after surgery, t3 = 1 month after surgery, and t4 = 6 months after surgery) between 2021 and 2022, and analyzed retrospectively. The examination included Schirmer tear test-1 (STT-1), interferometry, noninvasive tear film break-up time (NIBUT), tear meniscus size (TMS), and meibography. RESULTS: No statistically significant changes were found in STT-1 (t0: 22.2 ± 6.5 mm, t2: 22.5 ± 5.7 mm, t3: 20.8 ± 5.1 mm, and t4: 22.6 mm ± 4.8 mm) before and after surgery. Mean interferometry scores showed a slight, not statistically significant, decrease from t0 to t3 and t4 (t0: 2.1 ± 0.8, t1: 2.1 ± 0.7, t2: 2.1 ± 0.9, t3: 1.8 ± 0.6, and t4: 1.9 ± 1.1). Mean NIBUT did not change significantly between time points (t0: 3.9 ± 1.3 s, t1: 4.0 ± 1.3 s, t2: 4.0 ± 1.4 s, t3: 3.5 ± 0.7 s, and t4: 3.5 ± 0.9 s). TMS showed a slight, not statistically significant increase (t0: 0.5 ± 0.3 mm, t1: 0.5 ± 0.3, t2: 0.5 ± 0.3 mm, t3: 0.6 ± 0.2 mm, and t4: 0.7 ± 0.3 mm). There were no changes in the gross morphology of the meibomian glands (MG). CONCLUSION: This pilot study could not detect a negative effect of different forms of treatment of distichiasis on the precorneal tear film parameters in dogs. However, due to the study's retrospective nature and small sample size, no definitive conclusion can be drawn regarding the changes at the different time points.

5.
J Pharm Bioallied Sci ; 16(Suppl 3): S2925-S2927, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39346349

RESUMO

Aim: The point of search of present study was to assess intracanal viability of cold saline, curcumin as an irrigant, and ordinary saline as last irrigant in lessening post endodontic torment. Material and Method: In total, 60 individuals were chosen and divided into 3 groups: Group I: intracanal cryotherapy using 2.5°C cold saline, Group II: curcumin irrigant, and Group III: ordinary saline. After the biomechanical preparation, the above mentioned irrigant was used. On the visual analogue scale, participants were asked to rank the intensity of their discomfort following the procedure before, after 6 h and 24 h after the procedure. The outcomes were dissected utilizing ANOVA test. Result: Both the regimens were successful in reducing post endodontic soreness associated with infected teeth. Conclusion: Curcumin and cryotherapy both the regimens were successful in lessening post endodontic torment.

6.
J Pharm Bioallied Sci ; 16(Suppl 3): S1935-S1937, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39346428

RESUMO

Cryotherapy, or the use of low temperatures for medical treatment, has gained interest in dentistry for its potential therapeutic benefits. This review article delves into the rationale, applications, advantages, and limitations of cryotherapy in dentistry, shedding light on its future prospects in the field.

7.
Children (Basel) ; 11(9)2024 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-39334662

RESUMO

Cryotherapy in interventional bronchoscopy is a new treatment modality which has recently been made available for the pediatric airway. Lack of experience and safety concerns have led to hesitant adaptation. The aim of this work was to elaborate on the application progress of cryotherapy in pediatric pulmonary diseases and also to assess indications, success rates, and complications of airway cryotherapy in children. In summary, cryotherapy via flexible bronchoscopy is a safe and feasible method. The application scope in pediatrics is similar to that in adults, and it is mainly used in airway obstructive diseases. However, it is primarily caused by benign conditions, and the interventional treatment mainly seeks to provide long-lasting symptomatic alleviation. Thus, prevention, treatment, and prognosis of long-term complications are issues that should be carefully considered in pediatric applications.

8.
Cancers (Basel) ; 16(18)2024 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-39335196

RESUMO

Prostate cancer is the most common non-cutaneous malignancy in men, with the majority of newly diagnosed patients eligible for active surveillance. Despite definitive treatment, a considerable percentage of men will experience biochemical recurrence and even regional and distant metastatic recurrence after radiation therapy or radical prostatectomy. Salvage prostatectomy, while oncologically effective, poses significant morbidity with poor functional outcomes. Salvage cryotherapy has emerged as a promising alternative for localized recurrence, demonstrating safety and efficacy. This review examines the oncologic and functional outcomes of whole-gland and focal salvage cryotherapy, including disease-free survival, cancer-specific survival, and overall survival. The crucial role of multiparametric prostate MRI and evolving role of next-generation PSMA-targeted PET imaging are also examined. The comparison of outcomes of cryotherapy to other salvage ablation modalities, such as high-intensity focused ultrasound (HIFU), is also explored.

9.
J Clin Med ; 13(18)2024 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-39336884

RESUMO

Alopecia is a common adverse effect of neoadjuvant or adjuvant chemotherapy in patients with early breast cancer. While hair typically regrows over time, more than 40% of patients continue to suffer from permanent partial alopecia, significantly affecting body image, psychological well-being, and quality of life. This concern is a recognized reason why some breast cancer patients decline life-saving chemotherapy. It is critical for healthcare professionals to consider the impact of this distressing side effect and adopt supportive measures to mitigate it. Among the various strategies investigated to reduce chemotherapy-induced alopecia (CIA), scalp cooling has emerged as the most effective. This article reviews the pathophysiology of CIA and examines the efficacy of different scalp cooling methods. Scalp cooling has been shown to reduce the incidence of CIA, defined as less than 50% hair loss, by 50% in patients receiving chemotherapy. It is associated with high patient satisfaction and does not significantly increase the risk of scalp metastasis or compromise overall survival. Promising new scalp cooling technologies, such as cryogenic nitrogen oxide cryotherapy, offer the potential to achieve and maintain lower scalp temperatures, potentially enhancing therapeutic effects. Further investigation into these approaches is warranted. Research on CIA is hindered by significant heterogeneity and the lack of standardised methods for assessing hair loss. To advance the field, further interdisciplinary research is crucial to develop preclinical models of CIA, establish a uniform, internationally accepted and standardised classification system, and establish an objective, personalised prognosis monitoring system.

10.
Life (Basel) ; 14(9)2024 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-39337866

RESUMO

INTRODUCTION: This study investigates the impact of cryolipolysis on reducing localized fat and altering plasma lipid profiles in 30 overweight and obese women. Conducted at the Health Technology Laboratory of the Evangelical University of Goiás, this clinical research adhered to stringent ethical guidelines. METHODS: Participants underwent three cryolipolysis sessions, with comprehensive assessments of body composition and plasma lipids performed pre- and post-intervention. RESULTS: Significant findings include a reduction in abdominal fat mass by an average of 4.1 kg and a decrease in BMI by 0.7 points (p < 0.05). Notably, total cholesterol levels decreased by an average of 15.7 mg/dL, and LDL cholesterol saw a reduction of 10.2 mg/dL (p < 0.01), with no significant changes in HDL cholesterol or triglyceride levels. These results suggest that cryolipolysis, in conjunction with standardized dietary control, offers a non-invasive alternative to surgical fat reduction, potentially mitigating cardiovascular risks associated with obesity. CONCLUSIONS: The study confirms the efficacy of cryolipolysis in targeted fat reduction and underscores its role in improving key cardiovascular risk factors. These findings warrant further exploration into the long-term benefits of cryolipolysis in metabolic health management and not only for aesthetic treatments.

11.
Discov Oncol ; 15(1): 472, 2024 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-39331332

RESUMO

Focal therapy, a minimally invasive strategy for localized prostate cancer, has been widely employed in the targeted treatment of localized prostate cancer in recent years. We analyzed 1312 relevant papers from the last decade using Web of Science Core Collection data. Our analysis covered countries, institutions, journals, authors, keywords, and references to offer a multifaceted perspective on the development of this field. The U.S. led in publications, contributing over half of the top 10 institutions. Emberton, M from University College London was the most published and cited author. "EUROPEAN UROLOGY" was the top journal by impact factor in 2022. Analysis of references and keywords suggests the prevalence of brachytherapy-related research, while high-intensity focused ultrasound (HIFU), cryotherapy, and irreversible electroporation (IRE) are emerging as new research focuses. Consequently, more high-quality evidence is necessary to evaluate the long-term effectiveness and safety of these novel therapeutic methods.

12.
Skin Res Technol ; 30(9): e70045, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39221850

RESUMO

BACKGROUND: Acne vulgaris poses a significant dermatological challenge, necessitating alternative treatments due to limitations and side effects associated with current therapies. This pilot clinical trial investigated the feasibility and efficacy of precision cryotherapy for acne vulgaris. METHODS: A total of 20 volunteers underwent targeted precision cryotherapy using a carbon dioxide-based device. Treatment outcomes were assessed using various parameters, including Investigator Global Assessment (IGA) score, acne lesion count, erythema index (EI), global evaluation score, and participant satisfaction. Safety monitoring included adverse event reporting and physical examination. RESULTS: Precision cryotherapy demonstrated a significant reduction (90.25%) in the acne lesion count by week 4, with clinical improvement indicated by IGA score reduction (p < 0.001). The EI showed notable improvements at weeks 1, 2, and 4. The global evaluation score demonstrated a 75%-100% clinical improvement at Visit 4. Participants reported high satisfaction (6.75 ± 0.79) with the procedure. No adverse event or discomfort was reported. CONCLUSION: Precision cryotherapy effectively improved acne lesions, which was safe and satisfactory for participants. These findings suggest its potential as an alternative therapeutic modality, especially for populations with limited treatment options. Further research is needed to validate the results and explore underlying mechanisms.


Assuntos
Acne Vulgar , Crioterapia , Satisfação do Paciente , Humanos , Acne Vulgar/terapia , Crioterapia/métodos , Feminino , Masculino , Adulto , Projetos Piloto , Adulto Jovem , Resultado do Tratamento , Adolescente , Estudos de Viabilidade
13.
Cancers (Basel) ; 16(17)2024 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-39272792

RESUMO

BACKGROUND: The mainstay approach in endoscopic eradication therapy (EET) for dysplastic Barrett's esophagus (BE) includes the endoscopic resection of visible lesions, accompanied by ablation of the residual metaplastic epithelium. Cryoablation therapy is one such emerging ablation technique in this field. This systematic review with a meta-analysis aims to accumulate pooled data on cryoablation performance in the treatment of patients with BE and to compare this technique to the standard of care radiofrequency ablation (RFA). METHODS: The MEDLINE, Cochrane, and Scopus databases were searched until June 2024 for studies evaluating BE management using cryoablation for cumulative results. The primary outcome was the complete eradication of dysplasia (CED) and intestinal metaplasia (CEIM) in BE compared to RFA, while secondary outcomes included the respective pooled rates using cryoablation, recurrence, and adverse events, with a separate analysis for strictures. The meta-analyses were based on a random-effects model, and the results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup analyses by type of cryoablation were also performed. RESULTS: Twenty-three studies (1604 patients) were finally included, four of which were comparative. CED and CEIM did not differ significantly between cryoablation and RFA [OR= 0.95 (95%CI: 0.50-1.81) and OR = 0.57 (95%CI: 0.20-1.63), respectively)]. The pooled rates of CED, CEIM, and recurrence after cryoablation were 84.2% (95%CI: 79.1-89.3), 64.1% (95%CI: 49.2-79.0), and 8.3% (95%CI: 4.7-11.9), accompanied by high rates of heterogeneity. Adverse events were noted in 14.5% (95%CI: 9.9-19.2) of cases, and 6.5% (95%CI: 4.1-9.0) developed strictures. In the subgroup analysis, the cryoballoon achieved a reduction in heterogeneity in CED, adverse events, and stricture formation, whereas spray catheters provided homogenous results in terms of recurrence. CONCLUSIONS: Cryoablation provides equal outcomes compared to RFA in the treatment of patients with BE, with the cryoballoon achieving relatively homogenous rates of CED and adverse events.

14.
Front Physiol ; 15: 1428554, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39282089

RESUMO

The purpose of this study was to investigate the effect of whole-body cryotherapy (WBC) on acute recovery after a single high-intensity training day. Twelve elite professional male rowers from the national aquatic training base. They were randomly divided into a WBC group (n = 6) and a control group (CON group, n = 6). They performed a high-intensity training program, with a single session immediately followed by WBC (-110°C, 3 min) or recovered naturally for 3 min (CON group). Rowing performance, skin temperature, heart rate, blood pressure, and blood lactate concentrations were recorded before training, immediately, 5 min, and 15 min after the intervention. Blood samples were collected early in the morning of the day of intervention and that of the following day. The results indicated that 1) the blood lactate concentrations after WBC were significantly lower than pre-training (p < 0.05); 2) the maximum power significantly decreased immediately after WBC compared to pre-training (p < 0.05); 3) a significant main effect of time was observed for average speed, which significantly decreased after WBC (p < 0.05); 4) a significant main effect of time for blood parameters was observed. Specifically, hematocrit, cortisol, and hemoglobin were significantly lower after WBC than pre-intervention, whereas testosterone/cortisol was significantly higher than pre-intervention (p < 0.05). The results of this study showed that a single session of WBC had a positive effect on accelerating the elimination of blood lactate after HIT, but did not significantly change rowing performance and physiological parameters. A single session of WBC was not an effective strategy for elite rowers for acute recovery after HIT.

15.
J Biophotonics ; : e202400318, 2024 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-39301808

RESUMO

While cryotherapy is one of the traditional ways to reduce postoperative complications in maxillofacial surgery, the cooling degree is not regulated in most cases and the achieved effect is not properly controlled. Therefore, to develop optimal cooling modes, we propose to study the buccal vascular response to cooling, which has not been previously shown. To evaluate the effect of cooling, we analyzed vessel networks using optical coherence tomography angiography (OCT-A). The cheek vessels were OCT-A monitored using cooling by an ice bag/cooling mask. We found the advantages of using a cooling mask over an ice bag consist of a statistically significant decrease in the perfused vessel density (PVD) of the papillary layer at the oral mucosa. The absence of the reticular layer vessel reaction to any type of cooling was noted. We argue for the necessity to develop optimal modes of cryotherapy, which will contribute to blood perfusion reduction and reduction of PVD recovery.

16.
Cureus ; 16(8): e66527, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39246898

RESUMO

BACKGROUND AND OBJECTIVES: Extraction of impacted third molars is one of the most common oral surgeries performed in the dental clinic, which is often accompanied by many complications such as edema and trismus. Many methods have been used to alleviate these complications, such as drugs or physical therapy. Kinesiotape (KT) has recently spread as a popular physical method for eliminating complications after surgical extraction of lower third molars after its long-term use in sports medicine and injuries of the musculoskeletal system. The current study aimed to study the effect of using KT (Kinesio® Holding Corporation, Albuquerque, NM, USA) on both edema and trismus after impacted third molar extraction. METHODOLOGY: This study was designed as a randomized controlled clinical trial using the split-mouth technique and included 25 patients with radiographically symmetrical lower third molars from patients. All surgical extractions were performed by a single surgeon under sterile conditions according to the standard surgical protocol after that one group applied KT and the other group applied cryotherapy. Edema and trismus were measured in the first five days. Data was collected and analyzed by SPSS software (IBM Corp., Armonk, NY, USA). RESULTS: The mean change in the total linear facial measurements in the experimental group (Kinesio Group) was 12.32 mm three days after surgery, and then this value decreased to 6.80 mm, while the average increase in the control group (Cryo Group) was 17.00 mm after three days, then the value decreased to 9.68 mm five days after surgery. Regarding the changes in the amount of maximum mouth opening after surgery, the results were similar between the Kinesio Group and the Cryo Group, as there were no significant differences between the two groups (P<0.05). CONCLUSION: This study concluded that KT was superior to cryotherapy when studying edema. The current study also concluded that the mouth opening was similar between the two study groups.

17.
J Pak Med Assoc ; 74(5 (Supple-5)): S78-S83, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-39221807

RESUMO

Objective: To evaluate studies related to pain management associated with arteriovenous fistula cannulation among children. METHODS: The systematic review comprised literature search on Embase, ProQuest, Science Direct, Scopus, SpringerLink and Wiley Online databases for studies published in English between 1998 and 2021. The search used key words, including pain management OR analgesia AND child OR paediatric AND haemodialysis OR dialysis AND arteriovenous fistula OR arteriovenous fistula cannulation OR fistula needle OR arteriovenous fistula insertion OR needle insertion. The quality of the studies was evaluated using the Joana Briggs Institute checklist. General characteristics of the and pain outcomes were noted. RESULTS: Of the 2,877 studies initially identified, 8(0.27%) were analysed; 7(87.5%) quasi-experimental and 1(12.5%) randomised controlled trial. Overall, there were 283 participants aged 6-18 years. The strategies used for reducing arteriovenous fistula puncture-related pain among children undergoing haemodialysis included cryotherapy, lidocaine agents, virtual reality (VR), guided visualisation, balloon inflation, aromatherapy, and other programmed distractions. The strategies had a positive effect on reducing arteriovenous fistula cannulation-related pain among children. Conclusion: Non-pharmacological pain management is an easier, simpler, inexpensive and more effective method of atraumatic care among children undergoing haemodialysis.


Assuntos
Derivação Arteriovenosa Cirúrgica , Manejo da Dor , Diálise Renal , Humanos , Diálise Renal/efeitos adversos , Diálise Renal/métodos , Criança , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Manejo da Dor/métodos , Cateterismo/métodos , Adolescente , Crioterapia/métodos , Realidade Virtual , Lidocaína/uso terapêutico , Anestésicos Locais/uso terapêutico , Dor Processual/etiologia , Dor Processual/prevenção & controle
18.
J Histochem Cytochem ; 72(8-9): 569-584, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39240248

RESUMO

Icing interventions on the injured skeletal muscle affect the macrophage-related regenerative events and muscle repair. However, despite its importance for the practice in sport medicine, the influence of different icing protocols on muscle regeneration remains unclear. Here, using a rodent model of mild muscle injury with necrosis in a small fraction of myofibers, the injured animals were allocated to four groups: non-icing control (Con) and a single treatment (Ice-1), three treatments (Ice-3), or nine treatments (Ice-9) with a 30-min icing each time within two days following injury. Muscle regeneration was compared between the groups on post-injury days 1, 3, 5, and 7. The results showed that compared with the Con group, muscle regeneration was faster in the Ice-9 group (but not in the Ice-1 and Ice-3 groups), as indicated by more rapid accumulation of satellite cells within the regenerating area and enlarged size of regenerating myofibers (p<0.05, respectively). There was also less macrophage accumulation (p<0.05) and a trend toward early removal of necrotic myofibers in the damaged/regenerating area in the Ice-9 group (p=0.0535). These results demonstrate that in the case of mild muscle damage, more frequent icing treatment is more effective to stimulate muscle regeneration.


Assuntos
Músculo Esquelético , Necrose , Regeneração , Animais , Regeneração/efeitos dos fármacos , Músculo Esquelético/lesões , Músculo Esquelético/patologia , Masculino , Ratos , Macrófagos , Ratos Sprague-Dawley , Fibras Musculares Esqueléticas/patologia
19.
BMC Musculoskelet Disord ; 25(1): 749, 2024 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-39294614

RESUMO

BACKGROUND: This systematic review and network meta-analysis assessed via direct and indirect comparisons the recovery effects of hydrotherapy and cold therapy at different temperatures on exercise induced muscle damage. METHODS: Five databases were searched in English and Chinese. The included studies included exercise interventions such as resistance training, high-intensity interval training, and ball games, which the authors were able to define as activities that induce the appearance of EIMD. The included RCTs were analyzed using the Cochrane Risk of Bias tool. Eligible studies were included and and two independent review authors extracted data. Frequentist network meta-analytical approaches were calculated based on standardized mean difference (SMD) using random effects models. The effectiveness of each intervention was ranked and the optimal intervention was determined using the surface under the cumulative ranking curve (SUCRA) indicator. RESULTS: 57 studies with 1220 healthy participants were included, and four interventions were examined: Cold Water Immersion (CWI), Contrast Water Therapy (CWT), Thermoneutral or Hot Water Immersion (TWI/HWI), and Cryotherapy(CRYO). According to network meta-analysis, Contrast Water Immersion (SUCRA: 79.9% )is most effective in recovering the biochemical marker Creatine Kinase. Cryotherapy (SUCRA: 88.3%) works best to relieve Delayed Onset Muscle Soreness. In the recovery of Jump Ability, cryotherapy (SUCRA: 83.7%) still ranks the highest. CONCLUSION: We found that CWT was the best for recovering biochemical markers CK, and CRYO was best for muscle soreness and neuromuscular recovery. In clinical practice, we recommend the use of CWI and CRYO for reducing EIMD. SYSTEMATIC REVIEW REGISTRATION: [PROSPERO], identifier [CRD42023396067].


Assuntos
Crioterapia , Hidroterapia , Músculo Esquelético , Humanos , Crioterapia/métodos , Hidroterapia/métodos , Músculo Esquelético/lesões , Músculo Esquelético/fisiopatologia , Metanálise em Rede , Recuperação de Função Fisiológica/fisiologia , Resultado do Tratamento , Exercício Físico/fisiologia
20.
Am J Sports Med ; 52(11): 2860-2865, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39165152

RESUMO

BACKGROUND: The management of pain after shoulder surgery typically includes the use of cryotherapy and the prescription of opioid analgesics. Much focus has been placed lately on the opioid epidemic, which in part is fueled by excessive prescription of opioid medication. Previous studies have found a combination of cryotherapy and compression effective at reducing analgesic consumption and increasing recovery in patients undergoing knee and spine surgery; however, efficacy in patients undergoing shoulder surgery has not been evaluated. PURPOSE: To evaluate the effectiveness of a cryo-pneumatic compression device on postoperative shoulder pain, narcotic use, and quality of life when compared with standard care cryotherapy. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2. METHODS: In total, 200 patients older than 18 years scheduled for unilateral shoulder surgery were enrolled. Patients were randomized to receive either postoperative cryo-pneumatic compression or standard care. The intervention group received a cryo-pneumatic device, while the standard care group received the treating surgeon's preferred method of postoperative care, including standard cryotherapy. Narcotic use was evaluated by the number of oral morphine milligram equivalents consumed during the postoperative period, as well as the time to cessation of narcotic use. Patient-reported outcome measures consisted of a numeric rating scale pain score, 36-item Short Form Survey, patient experience assessed using the net promoter score, and adverse events. Outcomes were evaluated at 2, 6, and 12 weeks postoperatively. RESULTS: Patients receiving cryo-pneumatic compression reported a significant decrease in opioid consumption when compared with standard care (oral morphine milligram equivalents median, 56.1 vs 112; P = .02468). A significant increase in self-reported function was seen in the cryo-pneumatic compression group at 2 weeks when compared with standard care (mean, 61.2 vs 54.2; P = .0412). CONCLUSION: In patients undergoing unilateral shoulder surgery, the use of cryotherapy with pneumatic compression, when compared with standard care, resulted in significantly decreased opioid consumption as well as increased function at 2 weeks. REGISTRATION: NCT04185064 (ClinicalTrials.gov identifier).


Assuntos
Analgésicos Opioides , Crioterapia , Dor Pós-Operatória , Qualidade de Vida , Humanos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Masculino , Feminino , Analgésicos Opioides/uso terapêutico , Pessoa de Meia-Idade , Crioterapia/instrumentação , Adulto , Ombro/cirurgia , Idoso , Dispositivos de Compressão Pneumática Intermitente
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