Passive ankle motion and calf massage without anticoagulation therapy after total hip arthroplasty: A retrospective study.

BACKGROUND: It has been previously reported that manual calf massage and passive ankle motion after total hip arthroplasty could reduce the incidence of venous thromboembolism. However, a combination of chemical and mechanical prophylaxes was employed. In this study, we aimed to examine the effect of mechanical prevention without pharmacological antithrombotic intervention. METHODS: Of the 313 patients who underwent unilateral primary total hip arthroplasty and received passive ankle motion and calf massage postoperatively at our hospital between January 2015 and December 2019, 261 (58 men, 203 women; mean age 62.1 years) were included in this retrospective study. Pharmacological anticoagulation therapy was administered in 176 patients (combination group); 137 patients only underwent calf massage and passive ankle motion without anticoagulation therapy (single group). The study outcomes were operation time, the incidence of deep vein thrombosis, pulmonary thromboembolism, intraoperative bleeding, estimated actual blood loss, blood transfusion, and major bleeding. RESULTS: No significant differences were found in sex, age, side, platelet counts, activated partial thromboplastin time, prothrombin time, prothrombin time - International Normalized Ratio, intraoperative blood loss, estimated blood loss, and operation time. Moreover, the incidence of deep vein thrombosis, pulmonary thromboembolism, and intraoperative bleeding was not significantly different between the groups (deep vein thrombosis 4.0% vs. 6.3%, p = 0.244; pulmonary thromboembolism 0.7% vs. 0%, p = 0.548; and intraoperative bleeding 394 ± 173.6 ml vs. 365.4 ± 168.5 ml, p = 0.550). However, estimated actual blood loss and postoperative bleeding differed between the groups (eABL 996.6 ± 348.3 ml vs. 858.5 ± 269.6 ml, p = 0.003; postoperative bleeding 601.8 ± 330.0 ml vs. 492.1 ± 277.1 ml, p = 0.016), and both increased in the combination group. No major bleeding was noted in the two groups. CONCLUSION: Postoperative anticoagulant therapy does not have to be routinely used if mechanical prophylaxis is performed in patients without deep vein thrombosis before total hip arthroplasty.

Carcinogenicity of intermediate frequency magnetic field in Tg.rasH2 mice.

Although the likelihood of exposure to leaking intermediate frequency magnetic fields (MFs) from electronic devices, such as induction-heating and wireless power transfer systems, has increased, biological data assessing the health risks associated with human exposure remain insufficient. We examined the carcinogenicity of a 20 kHz MF, a typical frequency produced by induction-heating cookers, using a transgenic rasH2 mouse model. Twenty-five male and female CByB6F1-Tg(HRAS)2Jic mice were exposed to a 0.20 mT, 20 kHz MF (22 h/day) or sham-exposed for 26 weeks. As a positive control, 10 male and female rasH2 mice from the same batch were administered a single intraperitoneal injection of 75 mg/kg N-methyl-N-nitrosourea. A blinded histopathological evaluation was performed, and the same experiments were conducted twice, independently, to confirm the reproducibility of the results. Histopathological examination revealed that spontaneous neoplastic lesions, such as splenic hemangiosarcomas and gastric squamous cell papillomas, were less (1-3 per group) in the MF- and sham-exposed groups. The frequency of the neoplastic lesions was not significantly different between the groups. Eight to ten mice in each positive-control group exhibited malignant lymphoma. The outcomes were consistent between duplicated experiments, which indicates lack of carcinogenicity of 20 kHz MF in the rasH2 mouse model. Bioelectromagnetics. © 2019 The Authors. Bioelectromagnetics Published by Wiley Periodicals, Inc.

Manual calf massage and passive ankle motion reduce the incidence of deep vein thromboembolism after total hip arthroplasty.

BACKGROUND: Venous thromboembolism is one of the general complications following total hip arthroplasty, wherein various preventive treatments have been recommended. Several studies reported that venous thromboembolism incidence after total hip arthroplasty was similar in patients who were administered prophylaxis with a conventional mechanical procedure alone, and those who were administered pharmacological anticoagulation therapy. Therefore, the optimum methods of prophylaxis are still controversial. The purpose of this study was to investigate whether manual calf massage and passive ankle motion could lower the risk for venous thromboembolism after total hip arthroplasty. METHODS: We retrospectively reviewed the data of 126 consecutive patients undergoing elective primary unilateral total hip arthroplasty wherein manual calf massage and passive ankle motion were performed after the surgery at our hospitals between January and October 2014. The 138 patients of the control group underwent total hip arthroplasty using the same surgical approach and pre- and postoperative protocols without this mechanical prophylaxis between January and December 2013. This mechanical prophylaxis was performed simultaneously 30 times during approximately 10 s; these procedures were repeated thrice immediately after total hip arthroplasty. Duplex ultrasonography was performed to observe the veins of both legs in all the patients on postoperative day 7. RESULTS: The incidence of deep vein thrombosis was 6.52% and 0.79% in the control and manual calf massage and passive ankle motion groups, respectively. The odds ratio for the manual calf massage and passive ankle motion groups was 8.72. Performing this mechanical prophylaxis reduced the incidence of venous thromboembolism after total hip arthroplasty. This mechanical prophylaxis is not only simple and easy, but is also safe and inexpensive. CONCLUSIONS: We therefore recommend that manual calf massage and passive ankle motion be performed in patients who will undergo total hip arthroplasty, if deep vein thrombosis does not exist before the surgery.

A twenty eight-day repeated dose toxicity study of black soybean extract in Sprague-Dawley rats.

This study was designed to evaluate any adverse effect of a hot water extract of black soybeans (Glycine max (L.) Merr.), when administered to both sexes of Crj:CD(SD)IGS rats at dietary levels of 0 (control), 0.5, 1.5 and 5.0% (6 rats/sex/group). During the study, the treatment had no adverse effects on clinical signs, survival, body weights, and food and water consumption, or on findings of ophthalmology, urinalysis, hematology, or blood biochemistry. Organ weights, gross pathology and histopathology exhibited no differences of toxicological significance between control and treated rats. Thus, the no-observed-adverse-effect level (NOAEL) of black soybean extract was concluded to be 5.0% (3,618 mg/kg body weight/day for males and 4,066 mg/kg body weight/day for females) from the present study.

No enhancing effects of diacylglycerol oil on tumor development in a medium-term multi-organ carcinogenesis bioassay using male F344 rats.

The modifying potential of diacylglycerol (DAG) oil on tumor development was investigated in a medium-term multi-organ carcinogenesis bioassay. DAG oil is a cooking oil that contains >80% diglycerides, <20% triglycerides and <5% monoglycerides. Male 6-week-old F344 rats (20 in each group) were sequentially treated with five carcinogens for initiation in different organ target sites for 4 weeks (DMBDD treatment), and then administered DAG oil at dietary levels of 0% (control), 1.375%, 2.75% or 5.5% [triacylglycerol (TGs), with the same fatty acid composition as DAG oil were also added at dietary levels of 5.5%, 4.125%, 2.75% and 0%, respectively, to maintain the same lipid level], or 5.5% high linoleic acid TG (HLTG), 5.5% high oleic acid TG (HOTG), or 5.5% medium-chain TG (MCTG) (as reference substances, mostly consisting of triacylglycerols) admixed into AIN-93G semi-synthetic diet, for an additional 24 weeks. Controls received standard diet without any supplementation as non-treated control. All animals were killed at the end of week 28, and the major organs were carefully examined for preneoplastic and neoplastic lesions. No DAG oil treatment-related changes were noted in survival, general conditions, body weights, food consumption and organ weights. Upon quantitative analysis of glutathione S-transferase placental form (GST-P) positive foci of the liver, DAG oil was not found to exert any effects. The incidence of colon adenomas was significantly increased in rats given 1.375% DAG oil, but not 2.75% and 5.5% DAG oil, when compared to the control (5.5% TG group) value. Furthermore, incidences and multiplicity of hyperplasias and adenomas and/or adenocarcinomas were comparable across all DAG oil-treated groups. In contrast, incidences of colon adenomas and/or adenocarcinomas were significantly increased in rats given 5.5% HOTG, and adenomas with MCTG, but not 5.5% HLTG, as compared to the 5.5% TG value. Preneoplastic and neoplastic lesions induced by DMBDD treatment in various organs other than the large intestine were comparable in all cases. Thus, the current results indicate that DAG oil may not exert modifying potential on tumor development, even in the colon because of the lack of dose-dependence. DAG oil was equivalent to HOTG (standard cocking oil composed of naturally occurring fatty acids), with regard to colon tumor development. Further dose-response study concerning HOTG may be needed to confirm whether the enhancing effect of large intestine carcinogenesis exert or not.