The Effect of Diathermy Power Settings on Oral Cavity Mucosal Contraction: A Rat Model.

OBJECTIVES/HYPOTHESIS: The effects of different electrocautery power settings on mucosal contraction and margin status in the oral cavity have not been well established. The aim of this study was to examine how different levels of electrocautery energy outputs affect oral mucosal tissue margins. STUDY DESIGN: Animal model. METHODS: A model of 23 adult rats was used (two specimens per rat). After anesthetizing the animals, a 6-mm biopsy punch marked the resection margin on the buccal mucosa (one per cheek). The specimens were excised by means of three energy levels, a cold knife, and monopolar diathermy that was set on either 20 W or 30 W cut modes. The specimens were evaluated for extent of contraction. RESULTS: A total of 45 samples were obtained and measured, including 15 specimens in the cold-knife group, 15 specimens in the 20 W group, and 15 specimens in the 30 W group. The median diameters of the specimens after resection were 4.5 mm for the cold-knife group (interquartile range [IQR] = 4.0-5.0), 3.5 mm for the 20 W group (IQR = 3.5-4.0), and 2.8 mm for the 30 W group (IQR = 2.5-3.0). Specimen contraction was 25.0%, 41.7%, and 53.3%, respectively. The difference in shrinkage between each pair was statistically significant: cold knife versus 20 W, P = .001; cold knife versus 30 W, P < .0001; and 20 W versus 30 W, P < .001. CONCLUSIONS: Diathermy power settings result in a significant difference of mucosal tissue contraction, with higher outputs resulting in a narrower mucosal margin. It is imperative that the surgical team take into consideration the diathermy settings during initial resection planning. Laryngoscope, 131:E1514-E1518, 2021.

Electrocautery, Diathermy, and Surgical Energy Devices: Are Surgical Teams at Risk During the COVID-19 Pandemic?

OBJECTIVE: The aim of the study was to provide a rapid synthesis of available data to identify the risk posed by utilizing surgical energy devices intraoperatively due to the generation of surgical smoke, an aerosol. Secondarily it aims to summarize methods to minimize potential risk to operating room staff. SUMMARY BACKGROUND DATA: Continuing operative practice during the coronavirus disease-19 (COVID-19) pandemic places the health of operating theatre staff at potential risk. SARS-CoV2 is transmitted through inhaled droplets and aerosol particles, thus posing an inhalation threat even at considerable distance. Surgical energy devices generate an aerosol of biological particular matter during use. The risk to healthcare staff through use of surgical energy devices is unknown. METHODS: This review was conducted utilizing a rapid review methodology to enable efficient generation and dissemination of information useful for concurrent clinical practice. RESULTS: There are conflicting stances on the use of energy devices and laparoscopy by different surgical governing bodies and societies. There is no definitive evidence that aerosol generated by energy devices may carry active SARS-CoV2 virus. However, investigations of other viruses have demonstrated aerosolization through energy devise use. Measures to reduce potential transmission include appropriate personal protective equipment, evacuation and filtration of surgical plume, limiting energy device use if appropriate, and adjusting endoscopic and laparoscopic practice (low CO2 pressures, evacuation through ultrafiltration systems). CONCLUSIONS: The risk of transmission of SARS-CoV2 through aerosolized surgical smoke associated with energy device use is not fully understood, however transmission is biologically plausible. Caution and appropriate measures to reduce risk to healthcare staff should be implemented when considering intraoperative use of energy devices.

Disección fría y coagulación bipolar versus disección con bisturí armónico en la cirugía de los tumores benignos de la glándula parótida / Cold knife dissection and bipolar diathermy Vs harmonic scalpel in parotid gland surgery for benign tumours

INTRODUCCIÓN: Las técnicas quirúrgicas para extirpación de tumores de la glándula parótida han evolucionado significativamente en los últimos años. Los datos publicados previamente sugieren que el uso del bisturí armónico disminuye el tiempo operatorio, la pérdida de sangre intraoperatoria, la producción del drenaje postoperatorio y la incidencia de lesión del nervio facial, en comparación con la disección con bisturí frío. MATERIAL Y MÉTODOS: Se realizó un análisis retrospectivo en 2grupos de pacientes operados con bisturí armónico y disección en frío más coagulación bipolar. El objetivo principal fue comparar el tiempo quirúrgico y la tasa de complicaciones posquirúrgicas: lesión del nervio facial, aparición de sialocele o formación de fístula salival después de la parotidectomía por tumores benigno de la glándula parótida. RESULTADOS: Se incluyó a 108 pacientes. Con respecto al tiempo quirúrgico, el tiempo medio para usar el bisturí armónico fue de 114 ± 39 minutos (mín.: 60/máx.: 240) y el tiempo medio de uso de la diatermia bipolar fue de 135 ± 38 minutos (mín.: 90/máx.: 285) y este fue el único parámetro en el que evidenciamos una diferencia significativa entre ambas técnicas (p = 0,049). CONCLUSIONES: El bisturí armónico es una herramienta segura y eficaz para realizar la cirugía de la parótida en tumores benignos. Sin embargo, la disminución del tiempo quirúrgico fue la única ventaja que encontramos en comparación con el método tradicional de disección en frío y coagulación bipolar

INTRODUCTION: Surgical techniques for extirpation of tumours of the parotid gland have evolved significantly in recent years. Previous data suggest the use of Harmonic Scalpel reduced operative time, intraoperative blood loss, postoperative drain production, and incidence of facial nerve injury, in comparison to cold scalpel dissection MATERIAL AND METHODS: retrospective analysis of 2group of patients operated using harmonic scalpel versus cold knife dissection and bipolar diathermy and compare operative time and post-surgical complication rate:, facial nerve injury, sialocele or salivary fístula formation, after parotidectomy for benign parotid tumours. RESULTS: 108 patients were included. Regarding surgical time, the mean time to using Harmonic Scalpel was 114 ± 39 (Min: 60/Max: 240), and the mean time using bipolar diathermy was 135 ± 38 (Min: 90/Max: 285) and this was the only significant difference between the 2 techniques (p = .049). CONCLUSIONS: Harmonic scalpel is a safe and effective tool to perform parotid surgery in benign tumours. However, a shorter surgical time was the only advantage found over the traditional cold dissection and bipolar dissection method

Reproductive outcome after operative hysteroscopy for uterine septum: scissors or diathermy?

INTRODUCTION: Hysteroscopic septoplasty is a safe and routinely used procedure for the treatment of septate uterus. The aim of this paper is to determine which hysteroscopic technique (scissors, monopolar/bipolar diathermy) is superior for post-treatment reproductive outcome. EVIDENCE ACQUISITION: Two different hysteroscopic septoplasty instruments (scissors and monopolar/bipolar diathermy) were compared, focusing on the pregnancy outcome. In addition, all published studies and reviews regarding pregnancy outcomes that occurred after operative hysteroscopy using different techniques (bipolar, monopolar electrodes, resectoscope, VERSAPOINT™ [Ethicon LLC] and scissors) were reviewed. Dichotomous analysis, with use of the Mantel-Haenszel method, was performed for all five outcomes, with fixed effect analysis model and odds ratio (OR) as the effect measure. Analysis details included totals and subtotals with 95% confidence interval. The Multinomial CI package for the R statistical language was also used. EVIDENCE SYNTHESIS: Out of 26 full-text articles available in the literature, two studies were finally selected as eligible, with a total number of 125 patients. Pregnancy rate for scissors was 88.8% and for resectoscope was 75.6% (OR: 2.13, I2=29%; P=0.23). Delivery rate for scissors was 78.1% and for resectoscope was 75.0% (OR: 1.29, I2=0%; P=0.53). Miscarriage rate for scissors was 21.8% and for resectoscope was 27.1% (OR: 0.78, I2=0%; P=0.53). Preterm delivery rate for scissors was 6.2% and for resectoscope was 6.7% (OR: 0.85, I2=0%; P=0.94). Term delivery rate for scissors was 71.8% and for resectoscope was 66.1% (OR: 1.32, I2=0%; P=0.47). The lack of evidence in literature regarding the potential influence in the reproductive outcome of the instrument used when performing a hysteroscopy to treat a septate uterus became radically clear. CONCLUSIONS: No statistically significant differences were observed in reproductive outcomes between women treated for septate uterus using resectoscope or scissors.

Supplemental Anti Vegf A-Therapy Prevents Rebound Neovascularisation After Fine Needle Diathermy Treatment to Regress Pathological Corneal (LYMPH)Angiogenesis.

Fine needle diathermy (FND) is an effective method to destroy and regress pathologic corneal blood and lymphatic vessels. However, it is unknown whether FND itself causes a rebound corneal neovascularisation and whether that can be prevented by VEGF blockade. In female BALB/c mice, the suture-induced inflammatory corneal neovascularisation model was used to induce hem- and lymphangiogenesis. Thereafter, prevascularized mice were divided into 2 groups: the combination therapy group received FND cauterization and subsequent VEGF TrapR1R2 eye drops three times per day whereas the monotherapy group was treated only with FND. Three, 7 and 14 days after the treatment, corneas were collected and stained with FITC-conjugated CD31 and LYVE-1 followed by Cy3-conjugated secondary antibody to quantify corneal blood and lymphatic vessels. Relative mRNA expression of VEGF in the cornea was quantified by using qPCR. FND cauterization as monotherapy significantly obliterated (lymph)angiogenesis at early time points; however, this treatment led to secondary corneal hem- and lymphangiogenesis associated with significant upregulation of pro(lymph)angiogenic VEGF-A, VEGF-C, VEGF-D and infiltration of macrophages. Combining FND cauterization with VEGF TrapR1R2 treatment prevented the undesired effect of the FND procedure alone and significantly better regressed corneal blood and lymphatic vessels at 1 week after the treatment compared to monotherapy and control group (p < 0.01).

A Novel Dual-Phase Activation-Dependent Foot-Switch Mechanism for Surgical Energy Devices as an Asset in Early Surgical Training: A Proof of Concept Study.

Introduction. Many processes exist that limit or eliminate the incidence of adverse events in general surgery including the World Health Organization safety checklist. Technology and device advancement has a potentially expanding role in the context of surgical safety. Materials and Methods. A dual controlled accessory electrical diathermy footswitch (Permissive diathermy foot switch device or PDf) device concept was developed in an effort to improve patient safety in theatre and enhance opportunities in training. Electrical diathermy is only activated if the senior supervising surgeon and the novice surgeon simultaneously activate their interconnected footswitches. The activation of the PDf accessory footswitch device allows a senior surgeon to exert control on "initiation" of activation of diathermy devices operated by a novice surgeon (foot on pedal) as well as when desiring to deactivate the device (foot off pedal). Results. A process of designing and prototyping was initiated to define the purpose and the functionality of the PDf device up till the stage of a fully functioning prototype. The PDf device was constructed as a final working and tested prototype in association with the local medical engineering department at the Cumberland Infirmary in Carlisle. The device was on a nonbiological model to determine efficacy and safety and passed its laboratory testing phase and was deemed ready for clinical use. Conclusion. We demonstrated the feasibility and functionality of the PDf device and propose a positive role in surgical training in the context of early surgical training and specific circumstances where more control is needed.

Normativa vigente en España sobre la utilización de la diatermia en medicina y ciencias del deporte / Regulations in force in Spain about the use of diathermy in medicine and sport sciences / Regulamentos atuais na Espanha sobre o uso de diatermia em medicina e ciências do esporte

INTRODUCCIÓN: En el tratamiento de las lesiones deportivas se utilizan diferentes formas de energía electromagnética, entre ellas la diatermia, con fines terapéuticos. El uso seguro de los dispositivos de diatermia, tanto para el paciente como para el personal sanitario que los aplica, se basa en estándares profesionales, códigos de seguridad y directrices varias, que determinan los procedimientos de uso seguros. Estas recomendaciones se encuentran dispersas y no son bien conocidas por los usuarios, por lo que fue el objetivo de esta revisión el sintetizar y actualizar dichas recomendaciones. METODOLOGÍA: revisión de la normativa vigente en España, sobre el uso de los equipos médicos de Diatermia. DISCUSIÓN: Esta falta de claridad en algunos fabricantes hace que se cuestione la usabilidad o aplicación de los productos que se fabrican para uso sanitario. Esta situación favorece un marketing engañoso y el cliente final queda no solo a merced de una adquisición de un equipo sin la certificación médica adecuada, sino además desprotegido legalmente en su aplicación, lo que puede traer como consecuencia sanciones legales

INTRODUCTION: In the treatment of sports injuries, different forms of electromagnetic energy, including diathermy, are used for therapeutic purposes. The safe use of diathermy devices, both for the patient and for the healthcare personnel that apply them, is based on professional standards, safety codes and various guidelines, which determine the safe use procedures. These recommendations are scattered and are not well known by users, so it was the objective of this review to synthesize and update these recommendations. METHODOLOGY: review of current regulations in Spain, on the use of diathermy medical equipment. DISCUSSION: This lack of clarity in some manufacturers makes the usability or application of the products that are manufactured for sanitary use questionable. This situation favors a deceptive marketing and the end customer is not only at the mercy of an acquisition of a computer without proper medical certification, but also legally unprotected in its application, which can result in legal sanctions

INTRODUÇÃO: No tratamento de lesões esportivas, diferentes formas de energia eletromagnética são usadas para fins terapêuticos, incluindo a diatermia. A utilização segura de equipamentos de diatermia, tanto para o paciente quanto para o profissional de saúde que os aplica é baseada em padrões profissionais, códigos de segurança e várias diretrizes, que determinam os procedimentos de utilização segura. Essas recomendações são escassas e não são bem conhecidas pelos usuários, portanto o objetivo desta revisão foi sintetizar e atualizar essas recomendações. METODOLOGIA: revisão dos regulamentos vigentes na Espanha sobre o uso de equipamentos médicos de diatermia. DISCUSSÃO: Esta falta de clareza em alguns fabricantes faz com que a usabilidade ou aplicação dos produtos fabricados para uso sanitário seja questionável. Esta situação favorece um marketing enganoso e o cliente final não fica apenas à mercê de uma aquisição de um equipamento sem a certificação médica adequada, mas também legalmente desprotegido em sua aplicação, o que pode resultar em sanções legais

MAGNETO-THERAPY IN PHYSIOTHERAPY UNITS: INTRODUCTION OF QUALITY CONTROL PROCEDURE DUE TO LACK OF MAINTENANCE.

Rehabilitation practice for many patients consisting of a combined use of magneto therapy resulting emission of low frequency magnetic fields to the patient, elicit concerns about occupational exposure to electromagnetic radiation (EMR) for the operators. The time extended use of the device periodically leads to mechanical failures or troubleshooting of the machine which, in most cases, are not perceived by the operator of the device. All device's efficient functionality have a major impact on the completion of the treatment procedure in a large percentage of specific clinical conditions. If the device's operating condition is technically out of order or in a mode of over-activity, operators are mainly seeking solutions by reviewing the clinical case of the patient. This eliminates their contribution during the primary therapeutic plan or increases the treatment sessions. In this work, an extended survey is presented including 75 physiotherapy centres concerning usability and maintenance issues of magneto therapy devices throughout Greek territory combined with extended measurements of Electromagnetic Radiation in the unit room were performed. Physiotherapists' perceptions revealed lack of technical support, maintenance and safe use of magneto therapy devices that extract auxiliary observations upon their clinical practice routines. Additionally safety measurements have not revealed field strengths over International Reference Levels which could result health risks for users and coexisting patients. The pilot survey that conducted in Attica and Western Greece confirms that magnetic fields strength that are measured are in accordance with the statutory legislation but will, at the same time, revealed lack of maintenance of the devices. Deficiency in topics such as proper equipment function will necessitate the creation of quality safety protocols, concerning the use of magneto-therapy, with the main aim the improvement of treatment procedures for the higher performance of therapeutic rehabilitation services to patients. Finally in this work, the proposal of a QC protocol for magnetotherapy devices is proposed for evaluation.

Surgical outcome of cutting diathermy versus scalpel skin incisions in uncomplicated appendectomy: A comparative study.

BACKGROUND: It is traditionally believed that diathermy skin incisions produce a comparatively poorer surgical outcome despite recent evidences to the contrary. This study set out to compare diathermy and scalpel skin incisions with respect to immediate post-operative pain, surgical-site infection and surgical scar cosmesis. METHODOLOGY: This was a randomised, double-blinded study comparing cutting diathermy and scalpel skin incisions in patients undergoing open appendectomies for uncomplicated appendicitis. The post-operative pain was rated with the Visual Analogue Pain Scale 6, 12 and 24 h postoperatively, and 30 day wound infection was rated with the Southampton score. Scar cosmesis was assessed at 3 months, by a plastic surgery trainee, using the Patient and Observer Scar Assessment Scale (POSAS). The patients also self-evaluated their scars using POSAS. RESULTS: A total of 64 patients were randomised to cutting diathermy (32) and scalpel (32) skin incision groups. The mean pain score was higher in the diathermy incised wounds, but this was not statistically significant (P = 0.094). There was one wound infection recorded in the scalpel incision group and none in the diathermy incision group (P = 0.524). At 3 months post-surgery, there was no difference between the diathermy and scalpel incised wounds in mean (±SD) objective POSAS scores (15.64 [±5.98] vs. 17.79 [±6.37], P = 0.228) or subjective POSAS scores (22.44 [±13.13] vs. 22.21 [±13.17], P = 0.951), respectively. The mean scar satisfaction score, as assessed by the patients, was better for the diathermy incised wounds, but this was not statistically significant (P = 0.406). CONCLUSION: In patients undergoing open appendectomy for uncomplicated acute appendicitis, skin incision with a cutting diathermy is not inferior to the scalpel in surgical outcome, with respect to post-operative pain, wound infection and surgical scar cosmesis.

Short- and long-term outcomes of a novel transpapillary dilation technique using a diathermic dilator for severe benign bile duct stricture.

Endoscopic dilation for severe benign biliary stricture using mechanical dilation devices is occasionally ineffective. Hence, diathermic dilation has recently been gaining attention as a salvage procedure. We evaluated the short- and long-term outcomes of diathermic dilation for severe benign biliary stricture that could not be dilated using conventional mechanical dilation. Thirteen consecutive cases with severe benign biliary stricture that underwent diathermic dilation using 6-Fr electrocautery dilator were enrolled. Short- and long-term outcomes were analyzed. Diathermic dilation was successful in 13 cases (100%), whereas stent was successfully placed in 12 cases (92.3%). Adverse events occurred in two cases (15.4%): mild hemobilia and cholangitis. Recurrence of bile duct stricture was observed in five out of 12 cases (41. 7%) in the 1115-day median follow-up period. Finally, eight cases achieved stent-free state (61.5%) and have remained stent-free without any episode of cholangitis and abnormal liver function test. Diathermic dilation using 6-Fr electrocautery dilator is a promising salvage procedure for severe benign biliary stricture when the conventional dilation technique has been ineffective.

Efficacy of ReBound Diathermy as a Thermal Heating Agent: A Critically Appraised Topic.

Clinical Scenario: ReBound is a portable shortwave diathermy unit used to heat tissues using the same principle as induction drum shortwave diathermy. It is unclear if ReBound can vigorously (4°C) heat intramuscular tissue as efficiently as other thermal agents. Clinical Question: In adults (P), is ReBound diathermy (I) compared with other thermal agents (C) effective at increasing intramuscular tissue temperature by 4°C (O)? Summary of Key Findings: (1) Three studies were included for review, all randomized crossover studies. (2) All studies agreed ReBound does not achieve vigorous (4°C) heating effects during a 30-minute treatment to the triceps surae muscle (depth = 1 and 3 cm). (3) Studies agreed that the heat generated by ReBound dissipates slower than (P < .001) or similar to pulsed shortwave diathermy at 3 cm and faster than moist hot packs (P < .001) at 1 cm. (4) One study found that intramuscular tissue temperatures increased more with ReBound (3.69°C [1.50°C]) than moist hot packs (2.82°C [0.90°C]) at superficial depths (1 cm, d = 0.70). (5) Two studies compared ReBound with MegaPulse II pulsed shortwave diathermy at a 3 cm depth. One found that the MegaPulse II increased intramuscular tissue temperature by 4.32°C (1.79°C) compared with the ReBound's 2.31°C (0.87°C) increase (d = 1.43). The final study reported that the MegaPulse II increased triceps surae muscle temperature by 3.47°C (0.92°C) versus ReBound at 3.08°C (1.19°C) (d = 0.37). (6) The combined results are an increase of 3.81 (1.38°C) for the MegaPulse II and 2.77 (1.12°C) for ReBound (d = 0.83). Clinical Bottom Line: Results strongly indicate that the ReBound should not be used for vigorous (4°C) heating effects in the triceps surae muscle at 1 and 3 cm. Clinicians can use ReBound when traveling or instead of moist hot packs for moderate (2°C-3°C) heating effects at deep and superficial levels (1 and 3 cm) for large treatment areas with subcutaneous fat thickness <15 mm. Strength of Recommendation: Consistent level B findings indicate that ReBound does not achieve vigorous heating effects (4°C).

Fine Needle-Diathermy Regresses Pathological Corneal (Lymph)Angiogenesis and Promotes High-Risk Corneal Transplant Survival.

Pathological corneal hem- and lymphangiogenesis are prime risk factors for corneal graft rejection. Fine needle-diathermy (FND) is an option to regress corneal blood vessels; however, whether this treatment besides clinically visible blood vessels also affects invisible lymphatic vessels is so far unknown. Here we test the hypothesis that FND destroys not only blood but also lymphatic vessels, thereby promotes corneal high-risk graft survival. The effect of FND was studied in vivo using BALB/c mice and the model of suture-induced corneal neovascularization. Mice were divided into three groups: FND, ANTI (anti-inflammatory therapy) and NON (control). Five, 7, 10 and 20 days after cauterization, corneas were harvested and stained with LYVE-1, CD31 to quantify (lymph)angiogenesis. The long-term survival of allografts was compared between the three groups. FND caused significant regression of both blood and lymphatic vessels compared to the control group at all time points (p < 0.05) with the most obvious effect at day 7 (p < 0.01). Graft survival was significantly prolonged when transplants were placed into the FND pretreated group (p < 0.0001). The effect of the anti-inflammatory therapy alone was less effective compared to FND (p < 0.05). This novel lymphangioregressive effect of FND can be used clinically to precondition high-risk recipients to promote graft survival.

MICROWAVE DIATHERMY IN PHYSIOTHERAPY: INTRODUCTION AND EVALUATION OF A QUALITY CONTROL PROCEDURE.

Microwave diathermies (MWDs) are electromagnetic (EM) radiation emitting systems that are used by physiotherapists for thermotherapy treatment. Although this form of therapy is widely available in most physiotherapy units worldwide, management of the equipment is not obligatory addressed either by clinical engineers or medical physicists. A novel quality control (QC) protocol for MWD equipment, examining mechanical, electrical and electronic condition, the power output and EM radiation distribution in the electrotherapy room, was used during a national QC survey. The results of the survey revealed serious concerns about the safety of users and coexisting patients. The proposed approach could result in the introduction of EM-screened rooms, ensuring that MWD users and other persons in the vicinity will not be exposed to EM radiation over reference levels. International bodies could develop specific directives for EM radiation exposure in Physiotherapy Units, to conform to the proposed acceptance and functioning criteria for MDWs.

Occupational exposure to electromagnetic fields from medical sources.

High exposures to electromagnetic fields (EMF) can occur near certain medical devices in the hospital environment. A systematic assessment of medical occupational EMF exposure could help to clarify where more attention to occupational safety may be needed. This paper seeks to identify sources of high exposure for hospital workers and compare the published exposure data to occupational limits in the European Union. A systematic search for peer-reviewed publications was conducted via PubMed and Scopus databases. Relevant grey literature was collected via a web search. For each publication, the highest measured magnetic flux density or internal electric field strength per device and main frequency component was extracted. For low frequency fields, high action levels may be exceeded for magnetic stimulation, MRI gradient fields and movement in MRI static fields. For radiofrequency fields, the action levels may be exceeded near devices for diathermy, electrosurgery and hyperthermia and in the radiofrequency field inside MRI scanners. The exposure limit values for internal electric field may be exceeded for MRI and magnetic stimulation. For MRI and magnetic stimulation, practical measures can limit worker exposure. For diathermy, electrosurgery and hyperthermia, additional calculations are necessary to determine if SAR limits may be exceeded in some scenarios.

Intra-ocular diathermy forceps.

PURPOSE: The purpose of this study was to develop intra-ocular diathermy forceps and test them on perfused porcine cadaver eyes. METHODS: We designed two types of 23-gauge intra-ocular bipolar diathermy forceps by modifying commercially available membrane peeling forceps. In the first type, the emitting electrode is connected to one-half of the core and the return electrode to the other half, with one jaw of the forceps attached to each half. In the second type, the emitting electrode is attached to the core and both jaws of the forceps, and the return electrode to the surrounding tube. We compared the new diathermy forceps to conventional intra-ocular diathermy, on perfused porcine cadaver eyes. First-order retinal artery and vein closure was confirmed both by a perfusion study and by histology of the treated vessels. RESULTS: Type 1 diathermy forceps closed retinal arteries and veins more successfully (five of five and five of five successful treatments, respectively) than Type 2 diathermy forceps (five of five and four of five, respectively) and conventional diathermy (three of five and four of five, respectively). Less energy was used with Type 1 compared to Type 2 and conventional for artery closure (1.5 ± 0.0 versus 4.6 ± 3.3 versus 2.1 ± 0.8 joules, respectively) and vein closure (1.5 ± 0.0 versus 5.4 ± 4.6 versus 2.4 ± 0.8 joules, respectively). Histology of the treated vessels confirmed the perfusion study results. CONCLUSION: We designed two types of a new multifunctional intra-ocular instrument with the ability to peel membranes and to grasp, compress and coagulate retinal blood vessels. Both types pose operational advantages compared to current conventional intra-ocular diathermy.

"Deep Heating" Noninvasive Skin Tightening Devices: Review of Effectiveness and Patient Satisfaction.

Non-surgical aesthetic devices intended for treatment of lax and loose skin have gained popularity due to their ability to non-invasively improve patient's aesthetic condition and its low side effect profile. This study is intended to review available peer reviewed literature about Ultherapy, ThermaCool, and Exilis Ultra 360 non-invasive skin tightening devices to compare their treatment efficacy and patient subjective satisfaction.

Short term efficacy of capacitive-resistive diathermy therapy in patients with low back pain: a prospective randomized controlled trial.

To compare the effectiveness of Doctor Tecar TherapyTM with that of laser therapy in the management of low back pain (LBP), a total of 60 patients with LBP were enrolled. The participants were randomly divided into two groups: a Tecar group (experimental group, 30 subjects), and a laser group (control group, 30 subjects). All the subjects received 10 sessions of therapy: one each day from Monday to Friday and the same again the following week. All the subjects were evaluated for pain (VAS) and disability (Roland and Morris score and Oswestry score) at baseline (T0), and 2 weeks (T1), 1 month (T2) and 2 months (T3) after the end of treatment. The pain and disability presented a trend to improvement over time in both groups. This improvement was statistically significant at all follow-ups (FUs) in the Tecar group but only at T1 for the Laser group (p less than 0.01). Comparing the two methods, there emerged a significant difference in favour of the Tecar group at T2 and T3 (p less than 0.01). The results show that Tecar therapy determined significant improvement already by the end of the treatment. Moreover, at the first and second month FUs, the Tecar therapy showed statistically better results than laser therapy.