Mathematical modeling of heat transfer in tissues with skin tumor during thermotherapy.

The study of thermal therapy to tumors and the response of living cells to this therapy used to treat tumor is very important due to the complexity of heat transfer in biological tissues. In the past few years, there has been a growing interest among clinicians, mathematicians, and engineers regarding the use of computational and mathematical methods to simulate biological systems. Numerous medical proceedings also employ mathematical modeling and engineering techniques as a means to guarantee their safety and evaluate the associated risks effectively. This manuscript provides an analytical solution used for the first time to study the mechanism of biological thermal response during heat therapy on spheroidal skin tumor. The proposed method used a generalized thermoelasticity model with one relaxation time. The influence of relaxation times on the responses of diseased and healthy tissues is studied and interpreted graphically. Also, the impact of different laser irradiance on the thermal profile of the malignant tumor cells over a period of 2 minutes is interpreted graphically. To investigate the transfer of heat within biological tissues during the thermal therapy, the Laplace transform and inverse Laplace transform methods were applied. A comparison of the present generalized thermoelasticity model and different models based on Pennes bioheat transfer PBT shows that our proposed model yields more realistic and accurate predictions. The current model can be used to explain various therapeutic methods.

Effect of active forced air warming during the first hour after anesthesia induction and intraoperation avoids hypothermia in elderly patients.

BACKGROUND: The study aimed at exploring an optimal temperature model of forced air warming during the first hour after induction and intraoperation to prevent hyperthermia for elderly patients undergoing laparoscopic abdominal surgery. METHODS: There were 218 patients that were randomly divided into 3 groups warmed with a forced-air warmer during surgery: Group L (intraoperative warming set to 38 °C, n = 63), Group H (intraoperative warming set to 42 °C, n = 65) and Group LH (intraoperative warming set to 42 °C for the first hour then set to 38 °C, n = 65). Core temperature in the preoperative room and PACU was measured by a tympanic membrane thermometer and in the operation room, a nasopharyngeal temperature probe was recorded. The rate of perioperative hypothermia, defined as a reduction in body temperature to < 36 °C was recorded as the primary outcome. Intraoperative anesthetic dosage, recovery time, adverse events, thermal comfort and satisfaction score were measured as secondary outcome. RESULTS: The incidence of intraoperative and postoperative hypothermia was significantly lower in Group LH and Group H than Group L (18.75 and 15.62% vs 44.44%, P<0.001; 4.69 and 4.69% vs 20.63%, P<.05). Anesthetic dosage of rocuronium was lower in Group L than other two groups, with the opposite result of recovery time. The number of patients with shivering was higher in Group L but sweating was higher in Group H. Both of the thermal comfort and satisfaction score was highest in Group LH. CONCLUSION: A temperature pattern of forced air warming set at 42 °C during the first hour after anesthesia induction and maintained with 38 °C was a suitable choice for elderly patients undergoing laparoscopic abdominal surgery lasting for more than 120 min. TRIAL REGISTRATION: Chictr.org.cn ChiCTR-2,100,053,211.

Heat increases full-length SMN splicing: promise for splice-augmenting therapies for SMA.

Spinal muscular atrophy (SMA) is a debilitating neurodegenerative pediatric disease characterized by low levels of the survival motor protein (SMN). Humans have two SMN genes that produce identical SMN proteins, but they differ at a key nucleotide in exon 7 that induces differential mRNA splicing. SMN1 primarily produces full-length SMN protein, but due to the spliceosome's inability to efficiently recognize exon 7, SMN2 transcripts are often truncated. SMA occurs primarily through mutations or deletions in the SMN1 gene; therefore, current therapies use antisense oligonucleotides (ASOs) to target exon 7 inclusion in SMN2 mRNA and promote full-length SMN protein production. Here, we explore additional methods that can target SMN splicing and therapeutically increase full-length SMN protein. We demonstrate that in vitro heat treatment of cells increases exon 7 inclusion and relative abundance of full-length SMN2 mRNA and protein, a response that is modulated through the upregulation of the positive splicing factor TRA2 beta. We also observe that HSP90, but not HSP40 or HSP70, in the heat shock response is essential for SMN2 exon 7 splicing under hyperthermic conditions. Finally, we show that pulsatile heat treatments for one hour in vitro and in vivo are effective in increasing full-length SMN2 levels. These findings suggest that timed interval treatments could be a therapeutic alternative for SMA patients who do not respond to current ASO-based therapies or require a unique combination regimen.

Treatment options for leishmaniasis.

Leishmaniasis is broadly classified into three types: cutaneous, mucocutaneous and visceral. The visceral form is most dangerous and can result in death. Although leishmaniasis is an ancient disease, its treatment is still challenging. Several drugs, differing in their cost, toxicity, treatment duration and emergence of drug resistance, are used for different types of leishmaniasis. To overcome these limitations, the search for newer drugs and other treatments continues. In this article, we discuss conventional drugs, other treatments, including newer options such as immunotherapy and immunochemotherapy, and future prospects for leishmaniasis treatment.

An improved analytical model for heat flow in cancerous tumours to avoid thermal injuries during hyperthermia.

The present study highlights an analytical hybrid scheme consisted of a shift of variables and finite integral transform for analysing a local thermal non-equilibrium (LTNE) bioheat model. This model can have utilised to be a betterment of prediction of the temperature field in the localised hyperthermia therapy (LHT) for the treatment of cancer patients. As the hyperthermia treatment is only the application in living tissues, an appropriate initial condition for the therapeutic thermal response is proposed instead of a constant temperature taken in the previous studies based on the 1-D heat flow. The present analysis suggests the therapeutic exposure time of 7776.8s (2.16 h) with constant heat flux and the exposure time of 10969.9s (3.06 h) with a sinusoidal heat flux within the usual temperature range of the hyperthermia (in a combination of thermal ablation and medium temperature hyperthermia) to be more effective in the treatment protocol. The presented results show that fatal injuries (tissue trauma, thermal burn, etc.) of internal organs might be possible to avoid by the current therapeutic condition. Therefore, this study may nullify the adverse effect of the existing model with the constant heating and consequently, the repercussion of the several therapeutic variables is to estimate with the development of a thermal profile for the suitability of a therapeutic condition. On the other hand, the present study well matches with the published analysis in case of both the theoretical and experimental (live tissues of the pig due to unavailability of real-time data on the human body) studies and it found the maximum deviation of the thermal response as 2.26% and 2.66%, respectively.

Comparing thermal stress reduction strategies that influence MDSC accumulation in tumor bearing mice.

Myeloid derived suppressor cells (MDSCs) are a diverse collection of immune cells that suppress anti-tumor immune responses. Decreasing MDSCs accumulation in the tumor microenvironment could improve the anti-tumor immune response and improve immunotherapy. Here, we examine the impact of physiologically relevant thermal treatments on the accumulation of MDSCs in tumors in mice. We found that different temperature-based protocols, including 1) weekly whole-body hyperthermia, 2) housing mice at their thermoneutral temperature (TT, ~30 °C), and 3) housing mice at a subthermoneutral temperature (ST,~22 °C) while providing a localized heat source, each resulted in a reduction in MDSC accumulation and improved tumor growth control compared to control mice housed at ST, which is the standard, mandated housing temperature for laboratory mice. Additionally, we found that low dose ß-adrenergic receptor blocker (propranolol) therapy reduced MDSC accumulation and improved tumor growth control to a similar degree as the models that relieved cold stress. These results show that thermal treatments can decrease MDSC accumulation and tumor growth comparable to propranolol therapy.

Hot-Water Bathing Improves Symptoms in Patients with Cyclic Vomiting Syndrome and Is Modulated by Chronic Cannabis Use.

BACKGROUND: Cyclic vomiting syndrome (CVS) is a chronic functional GI disorder; a characteristic compulsive "hot-water bathing" pattern is reported to alleviate symptoms during an acute episode. There is limited data on this bathing pattern: proposed mechanisms include core temperature increase via effects on cannabinoid type 1 receptors in the brain, skin transient receptor potential vanilloid 1 receptor stimulation, and blood flow shift from viscera to skin. AIMS: We thus sought to characterize the hot-water bathing pattern in patients with CVS and identify differences between heavy cannabis users in comparison to occasional and non-users. METHODS: We conducted a cross-sectional study of 111 patients with CVS at a single tertiary referral center. Questionnaires regarding clinical characteristics, hot-water bathing, and cannabis use were administered. Patients were classified based on cannabis usage into regular cannabis users (≥ 4 times/week), and occasional + non-users (< 4 times/week and no current use). RESULTS: A total of 81 (73%) respondents reported the hot-water bathing behavior during an episode. The majority (> 80%) noted a marked improvement in nausea, vomiting, abdominal pain and symptoms associated with panic. Regular cannabis users were more likely to use "very-hot" water (50% vs. 16%, p = 0.01) and time to relief of symptoms was longer (> 10 min) in this group, compared to the rest of the cohort. CONCLUSIONS: Hot-water bathing relieves both GI and symptoms related to panic in most patients which appear to be modulated by chronic cannabis use. These findings can help inform future physiologic studies in CVS pathogenesis.

Pain management for in-office hysteroscopy. A practical decalogue for the operator.

Hysteroscopy is known to be the gold standard for evaluation of intrauterine pathologies, pre-menopausal and post-menopausal abnormal uterine bleeding and, in addition to this, it is a crucial examination in the infertility work-up. In-office operative hysteroscopy incorporates the outstanding possibility of seeing and treating an intracavitary pathology in the same examination, eliminating all the risk related to anesthesia and reducing procedure-related costs. By now, performing operative procedures in the office setting is recognized as feasible and safe. Over the last 20 years, many efforts have been made to implement the in-office operative approach worldwide. However, for some women, in-office hysteroscopy is still considered a painful experience, with reported discomfort at different steps of the hysteroscopic procedures. Moreover, uneventful and tedious sensations might be increased by a high level of anxiety for such examination. For this reason, despite the feasibility of the in-office approach, many clinicians are still afraid of provoking pain during the procedure and rather not to perform surgical procedures in the office, postponing the removal of the pathology in the operating room. To date, there is no consensus concerning pain management for in-office hysteroscopy and different approaches, pharmacological and non-pharmacological aids, as well as several procedural tips and tricks are utilized. Our purpose is to provide a feasible practical decalogue for the operator, to supply adequate management of pain during in-office hysteroscopic procedures, performing challenging operations, shrinking discomfort, aiming to upgrade both women's and operator's satisfaction.

Anti-inflammatory potential of Portuguese thermal waters.

In light of Medical Hydrology, thermal waters (TW) are all-natural mineral waters that emerge inside a thermal resort and have therapeutic applications. Their beneficial effect has been empirically recognized for centuries, being indicated for symptom alleviation and/or treatment of several diseases, almost all associated with inflammation. Indeed, an anti-inflammatory effect has been attributed to many different Portuguese TW but there is no scientific validation supporting this empiric knowledge. In the present study, we aimed to investigate the anti-inflammatory properties of 14 TW pertaining to thermal centers located in the Central Region of Portugal, and grouped according to their ionic profile. Mouse macrophage cells stimulated with lipopolysaccharide (LPS), a Toll-like receptor 4 agonist, were exposed to culture medium prepared in TW. Metabolism, nitric oxide (NO) production, inducible nitric oxide synthase (iNOS) expression levels and the scavenging capacity of TW, were investigated in vitro. 11 out of 14 TW reduced NO production and/or iNOS expression, and/or scavenging activity, in macrophages exposed to LPS. The sulphated/calcic TW did not show any effect on at least one of the inflammatory parameters evaluated. Two sulphurous/bicarbonate/sodic TW and the sulphurous/chlorinated/sodic TW promoted an increase in NO production and/or iNOS expression. Our results validate, for the first time, the anti-inflammatory properties of Portuguese TW, supporting their therapeutic use in the treatment of inflammation-related diseases and promoting their putative application in cosmetic products and medical devices.

In vitro hyperthermic effect of magnetic fluid on cervical and breast cancer cells.

Self-regulating temperature-controlled nanoparticles such as Mn-Zn ferrite nanoparticles based magnetic fluid can be a better choice for magnetic fluid hyperthermia because of its controlled regulation of hyperthermia temperature window of 43-45 °C. To test this hypothesis magnetic fluid with said properties was synthesized, and its effect on cervical and breast cancer cell death was studied. We found that the hyperthermia window of 43-45 °C was maintained for one hour at the smallest possible concentration of 0.35 mg/mL without altering the magnetic field applicator parameters. Their hyperthermic effect on HeLa and MCF7 was investigated at the magnetic field of 15.3 kA/m and frequency 330 kHz, which is close to the upper safety limit of 5 * 109 A/m s. We have tested the cytotoxicity of synthesized Mn-Zn ferrite fluid using MTT assay and the results were validated by trypan blue dye exclusion assay that provides the naked eye microscopic view of actual cell death. Since cancer cells tend to resist treatment and show re-growth, we also looked into the effect of multiple sessions hyperthermia using a 24 h window till 72 h using trypan blue assay. The multiple sessions of hyperthermia showed promising results, and it indicated that a minimum of 3 sessions, each of one-hour duration, is required for the complete killing of cancer cells. Moreover, to simulate an in vivo cellular environment, a phantom consisting of magnetic nanoparticles dispersed in 1 and 5% agarose gel was constituted and studied. These results will help to decide the magnetic fluid based hyperthermic therapeutic strategies using temperature-sensitive magnetic fluid.

Multiple myeloma cells are exceptionally sensitive to heat shock, which overwhelms their proteostasis network and induces apoptosis.

Proteasome inhibitors, such as bortezomib (BTZ), are highly effective and widely used treatments for multiple myeloma. One proposed reason for myeloma cells' exceptional sensitivity to proteasome inhibition is that they produce and continually degrade unusually large amounts of abnormal immunoglobulins. We, therefore, hypothesized that, heat shock may also be especially toxic to myeloma cells by causing protein unfolding, increasing further the substrate load on proteasomes, and, thus, putting further stress on their capacity for protein homeostasis. After a shift from 37 to 43 °C, all four myeloma lines studied underwent extensive apoptosis in 4 h, unlike 13 nonmyeloma cell lines, even though the myeloma cells induced heat-shock proteins and increased protein degradation similar to other cells. Furthermore, two myeloma lines resistant to proteasome inhibitors were also more resistant to 43 °C. Shifting myeloma cells to 43, 41, or 39 °C (which was not cytotoxic) dramatically increased their killing by proteasome inhibitors and inhibitors of ubiquitination or p97/VCP. Combining increased temperature with BTZ increased the accumulation of misfolded proteins and substrate load on the 26S proteasome. The apoptosis seen at 43 °C and at 39 °C with BTZ was mediated by caspase-9 and was linked to an accumulation of the proapoptotic Bcl-2-family member Noxa. Thus, myeloma cells are exceptionally sensitive to increased temperatures, which greatly increase substrate load on the ubiquitin-proteasome system and eventually activate the intrinsic apoptotic pathway. Consequently, for myeloma, mild hyperthermia may be a beneficial approach to enhance the therapeutic efficacy of proteasome inhibitors.

Burns Sustained From Body Heating Devices: An Integrative Review.

BACKGROUND: Heating devices can provide relief from muscular pain and the cold, however they may result in burn injuries when used inappropriately. OBJECTIVE: This review article synthesizes the incidence, risk factors, outcomes, treatment, and prevention of burns sustained from body heating devices in order to better understand how these burns are sustained. METHODS: PubMed, CINHAL, EMBASE, and Scopus databases were systematically searched from inception up until January 13, 2020, for studies/case reports on burns sustained from body heating devices that were published in the English language. RESULTS: Medical records from 10 retrospective studies yielded 1343 patients with burns, of whom the majority were women (63.4%) with a mean age of 27.7 years (range, 0-92 years). Devices included hot water bottles, hot wheat bags, and heating pads. Sites of injury were predominantly in the lower limbs and feet, with other sites reported (ie, abdomen, pelvis, buttocks, perineum, and upper limbs). Burns sustained typically had low total burn surface area (TBSA) but often involved partial-thickness to full-thickness burn injury. The proportion of patients requiring surgery ranged from 15% to 87.4% for hot water bottle injuries and 91% for wheat bag injuries. Women were predominately represented in the case series/reports. Burns had low TBSA with hot water bottles, and heating pads were the most common mechanism of injury, predominately women following breast reconstructive surgeries. CONCLUSIONS: Burns from body heating devices are often preventable. Community education and improved manufacture labelling on the appropriate use and potential risks should be required. The patient's cognitive ability and physiology must be considered to minimize incidence and severity of injury.

Common inflammatory and infectious conditions of the eyelid.

Patients with infection or inflammation of the eyelid will often first present to their primary care physicians with symptoms such as redness, swelling, tearing, itchiness, or a foreign body sensation. There are a variety of conditions that affect the eyelid which can cause such symptoms, and the exam and history can help a provider differentiate some of the more common conditions. This article will provide a comprehensive review of the background, diagnosis and management of dry eye disease, chalazion, hordeolum (stye), and preseptal cellulitis.

The effect of combination of warm intravenous fluid infusion and forced air warming versus forced air warming alone on maternal temperature and shivering during cesarian delivery under spinal anesthesia.

Objective: Administration of warm intravenous (IV) fluid infusion and use of forced air warmers is the most easy and physiologically viable method for maintaining normothermia during surgery and postsurgical periods This study was conducted to assess the effect of combination of active warming (AW) methods namely warm IV fluid infusion and forced air warming versus forced air warming only (WA) on maternal temperature during elective C-delivery under spinal anesthesia. Materials and Methods: A total of 100 patients scheduled for elective c-section were grouped into those who received both warmed IV fluid infusion and forced air warmer (Combination of active warming WI= 50) and those who received only forced air warmer (WA = 50). Core body temperature and shivering incidence were recorded using a tympanic thermometer from prespinal till the end of surgery every 10 min and in postanesthesia care unit (PACU) at 0, 15, and 30 min. Results: Core temperature showed statistically significant difference in 15, 35, 45, and 55 min between air warmer and warm infusion groups and in PACU at 0, 15, and 30 min, it was statistically significant (P = 0.000) among WI group (mean temperature = 36.79°C) when compared to WA group (mean temperature = 35.96°C). There was a lower incidence of shivering in WI compared to WA group, which is statistically significant. Conclusion: Combination of warm Intravenous fluid infusion and Forced air warming is better than forced air warming alone. In maintaining near normal maternal core body temperature during elective cesarean section following spinal anesthesia. Combined warming method also reduces shivering incidence.

RésuméObjectif: L'administration d'une perfusion de liquide intraveineux chaud (IV) et l'utilisation de réchauffeurs à air forcé sont les plus faciles et les plus viables sur le plan physiologique méthode pour maintenir la normothermie pendant la chirurgie et les périodes post-chirurgicales Cette étude a été menée pour évaluer l'effet de la combinaison des méthodes de réchauffement actif (AW), à savoir la perfusion de liquide IV chaud et le réchauffement à air forcé par rapport au réchauffement à air forcé uniquement (WA) sur la mère la température pendant la livraison élective de C sous anesthésie rachidienne. Matériel et méthodes: Un total de 100 patients programmés pour un stage électif les césariennes ont été regroupées dans celles qui ont reçu à la fois une perfusion de liquide IV chauffée et un réchauffeur à air forcé (combinaison de réchauffement actif WI = 50) et ceux qui n'ont reçu qu'un réchauffeur d'air forcé (WA = 50). La température corporelle centrale et l'incidence des frissons ont été enregistrées en utilisant un thermomètre tympanique du préspinal jusqu'à la fin de la chirurgie toutes les 10 min et dans l'unité de soins postanesthésiques (PACU) à 0, 15 et 30 min. Résultats: La température centrale a montré une différence statistiquement significative en 15, 35, 45 et 55 min entre les groupes de réchauffement de l'air et de perfusion chaude et dans le PACU à 0, 15 et 30 min, il était statistiquement significatif (P = 0,000) dans le groupe WI (température moyenne = 36,79 ° C) en comparaison au groupe WA (température moyenne = 35,96 ° C). Il y avait une incidence plus faible de frissons dans WI par rapport au groupe WA, qui est statistiquement important. Conclusion: La combinaison de la perfusion de liquide intraveineux chaud et du réchauffement forcé de l'air est meilleure que le réchauffement forcé de l'air seul. Dans maintien d'une température corporelle maternelle près de la normale pendant la césarienne élective après anesthésie rachidienne. Réchauffement combiné La méthode réduit également l'incidence des frissons.

Comparison of touch-up ablation rate and pulmonary vein isolation durability between hot balloon and cryoballoon.

INTRODUCTION: This study aimed to compare touch-up ablation (TUA) rates and pulmonary vein isolation (PVI) durability of hot balloon ablation (HBA) and cryoballoon ablation (CBA) in paroxysmal atrial fibrillation (PAF) patients. METHODS: In total, 137 PAF patients were enrolled in the study. Among them, 59 underwent two HBA procedures at 6-month intervals and 78 patients underwent two CBA sessions, both regardless of atrial fibrillation recurrence. Propensity score matching was performed to estimate similar patient characteristics between the HBA and CBA groups. RESULTS: Each group comprised of 46 matched patients for comparison. The TUA rate at the first session was higher for HBA (49 of 184 PVs) than for CBA (20 PVs) (P = .01), with the highest incidence at the left superior pulmonary vein (LSPV). The rates of PVI durability at the second session performed 7 months later were similar between HBA (168 of 184 PVs) and CBA (162 PVs) groups. The PVI durability rate at the TUA sites of the first session was higher for HBA than for CBA (41 of 49 PVs vs 10 PVs, respectively; P = .01). Fifty percent of the patients underwent HBA at 73°C for the LSPV. HBA performed at 73°C yielded a lower TUA rate than that at 70°C (16 of 23 PVs vs 7 of 23 PVs; P = .008). CONCLUSIONS: While PVI durability was similar between HBA and CBA, the TUA rate was higher for HBA than for CBA, especially on the LSPV. For LSPV, HBA at a balloon temperature of 73°C may reduce the TUA rate.

The Effectiveness of Four Intervention Methods for Preventing Inadvertent Perioperative Hypothermia During Total Knee or Total Hip Arthroplasty.

Inadvertent perioperative hypothermia (IPH) occurs when a patient experiences a core temperature below 36° C (96.8° F) in perioperative settings and is a preventable risk factor for anesthesia- and surgery-related complications. Forced-air warming is an effective method to maintain normothermia. This study compared four interventions for preventing IPH for 120 patients undergoing primary elective unilateral total knee or total hip arthroplasty. The study was based on a time series nonequivalent comparison group design to investigate whether the incidence of IPH differed among treatment groups. We also sought to determine whether the patients' preoperative perceptions of warmth or cold correlated with core body temperatures. Patients receiving convective warming and prewarming appeared to experience fewer IPH events than patients in the other study groups. This study suggests that hypothermia is a common issue for patients undergoing total knee or total hip arthroplasty and that it may be possible to reduce its frequency.

High ligation of sapheno-femoral junction and thermal ablation for lower limb primary varicosity in day hospital setting.

AIM: The traditional surgical treatment for lower limb primary varicosity has been for a long time high ligation of sapheno-femoral junction and stripping of great saphenous vein. Surgery, however, has been frustrated by postoperative pains and discomfort and recurrences so that it has been challenged by minimally invasive endovenous techniques such as laser treatment and radiofrequency ablation. The aim of the article is to assess the feasibility, in a day hospital setting, of a combined approach to greater saphenous vein reflux: high ligation of sapheno-femoral junction and thermal treatment of the great sapenous vein. METHODS: A retrospective analysis on 95 patients treated with high ligation and thermal ablation at our institution from January 2009 to July 2017 was performed, assessing duration of surgery, post-operative pain and analgesics requirements, early complications and resumption of activities. RESULTS: Two patients (2.74%), in the laser group experienced skin burns in the course of the GSV. Moderate ecchymosis, by laser fibre-induced perforation of the vein wall, were observed in another two patients (2.74%). Four limbs (5.48%) in the EVLT group developed transient paraesthesias. Analgesic requirement on POD 3 was nil for RFA group; conversely half of the EVLT patients did take analgesics, either 2 or 3 tabs were required. On POD 7, the patients of RFA group continued to not ask for any analgesics, but the same half of the patients in EVLT group still needed 1-2 tabs to carry out their normal activities smoothly. On POD 15, no patient did require analgesics. Resumption of routine activities was earlier for RFA group patients than for those in the EVLT group. The RFA group resumed their activities within 3 days, whereas EVLT group in 8-9 days. High ligation of the SFJ didn't add too much time or morbidities. CONCLUSION: Catheter delivery of thermal energies for saphenous ablation, even when combined with high ligation of saphenous femoral arc, demonstrated to be minimally invasive, easy to learn and easy to perform in day hospital setting, with early return to normal activity. EVLT achieved similar results to RFA and both techniques were considered equally effective and safe; the results we obtained were not statistically significant but RFA showed less pain, ecchymosis and haematomas, as well as provided better short-term quality of life. KEY WORDS: Day Hospital setting, Endovenous laser treatment, High ligation ablation of the saphenous vein, Radiofrequency ablation.

Thermal Analysis of Infrared Irradiation-Assisted Nanosecond-Pulsed Tumor Ablation.

Nanosecond Pulsed Electric Fields (nsPEF) have the potential to treat a variety of cancer types including melanoma, pancreatic and lung squamous cancers. Recent studies show that nsPEF-based cancer therapy may be improved further with the assistance of moderate heating of the target. A feedback-looped heating system, utilizing a 980-nm fiber optic laser, was integrated into nsPEF electrodes for tumor ablation. The laser beam profile was determined to be Gaussian using a knife-edge technique. Thermal properties of the biological target were evaluated based on the treatment area, penetration depth and thermal distribution due to laser irradiation with or without nsPEF. Synergistic effects between nsPEF and the moderately elevated temperature at the target was observed, resulting in enhanced overall survival tumor regression up to 50% in the treatment of lung squamous cell cancer in mice.

Relaxation with heat and procedural information to diminish anxiety in presurgical patients of hernia surgery.

Presurgical anxiety has been associated with postsurgical pain and complications, therefore we decided to compare two psychological interventions in order to reduce presurgical anxiety-state and pain in patients undergoing hernia surgery. Patients undergoing the presurgical consultation for hernia repair (umbilical or inguinal), were invited. The group of procedural information consisted in administering an informative brochure after the presurgical consultation, while the relaxation with heat group (RWH) consisted in giving a heat pack to the patients while asking them to think in the benefits of the surgery and instructions of relaxation were given, this was performed at the operating theater before surgery. Anxiety-state and pain levels were measured after presurgical consultation and a day after just before surgery. Ninety-five patients were included in 3 groups of study (control = 36, procedural information = 31 and RWH = 28); when we included only those individuals with moderate or high anxiety at the presurgical consultation, we found that procedural information (-4.72 ± 6.10) and RWH diminished anxiety (-9.29 ± 6.91) but only RWH group reached statistical significance when compared with control group (-9.29 ± 6.91 vs -0.56 ± 9.82, p = 0.007). In conclusion, RWH produced a significantly higher reduction of anxiety-state before hernia surgery.

Traction and Hot Fomentations for Osteo-Arthritis.

Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives highlights articles selected to fit today's topics and times.In this month's article, from the May 1925 issue, nurse Ellen G. Dawson from Evanston Hospital in Illinois presents three case studies as evidence for a new use for immobilizing traction: the treatment of osteoarthritis. The protocol includes the use of traction for days or weeks, hot fomentations (poultices) applied to the skin over the painful joint, and a body cast (for back pain) or leg cast (for knee pain) worn for an extended period afterward. If the joint pain was severe, a lotion made from tinctures of opium and arnica, witch hazel, and lead water was also applied. The author notes, "We could cite case after case, with varying lengths of time, where the results have been equally gratifying."Today, nurses are involved in more formal arthritis research. In this issue, So-Hyun Park and Shiela M. Strauss examine the impact of arthritis on recommended physical activity in their original research article, "Arthritis-Related Functional Limitations and Inadequate Physical Activity Among Female Adult Cancer Survivors."