The acute effects of cold, CO2 containing forearm water both on skin microcirculation and pain thresholds

Purpose: The study was arranged to investigate the immediate effects of high concentrated CO2 containing cold water bath on the microcirculation of the skin, on the pain thresholds (pressure, heat, cold) and on the local subjective heat sensitivity and the thermal comfort perception. Material and method: 17 healthy male subjects got unilateral forearm baths with mineral water containing 3500 mg/l CO2 and with tap water respectively. Both baths were carried out at a temperature of 18-19degreesC and the duration of the baths was 16 minutes. Results: During the application Of CO2 bath, a 2 fold increase in the skin microcirculation values was measured via Laser Doppler Flowmetry in comparison with the initial values. However, during tap water bath application, skin blood flow values were decreased 50%. The difference was statistically significant (p < 0.001). Furthermore the subjects mentioned that they felt warmer (p < 0.05) and more comfortable (p < 0.01) with CO2 containing water bath. But despite the improvement in the values there were not any statistically significant differences between the baths for the pressure pain threshold (+16.7%; p<0.01), the cold pain threshold (-41.6%; p < 0.05) and the heat pain threshold (+2.5%, n.s.). Conclusion: Our findings indicate that CO2 containing cold water bath is more effective in increasing the skin microcirculation, inhibiting the cold dependent vasoconstriction and leading to a warm and more comfortable subjective sensation in comparison with tap water. The analgesic effects were similar for both baths

SPA therapy in fibromyalgia: a randomised controlled clinic study

Objective: The aim of the present study is to evaluate the effectiveness of spa therapy in the management of fibromyalgia. Methods: Thirty women with fibromyalgia were randomly assigned to either a spa therapy group or a control group. The spa therapy group (n = 16) had spa treatment for 2 weeks in addition to their medical treatment. The control group (n = 14) continued to have their medical treatment and/or daily exercises. An investigator who was blinded for the intervention assessed all the patients for 9 months. Improvements in Fibromyalgia Impact Questionnaire (FIQ), pain and number of tender points were primary outcomes. Secondary outcome measures were improvement in sleep disturbance, fatigue, gastrointestinal symptoms, anxiety, Beck Depression Inventory and patient's global evaluation. Results: the spa group was found to be superior to the control group at the end of intervention in terms of FIQ, pain, tender point count, fatigue and patients' global assessment. This superiority remained for 6 months in FIQ, 1 month in pain and tender point count. Conclusion: It was concluded that the addition of spa therapy to medical therapy has both short- and long-term beneficial effects in female patients with fibromyalgia

Kinematic-Kinetic-Rigidity Evaluation of a Six Axis Robot Performing a Task

Six axis serial robots of different sizes are widely used for pick and place, welding and various other operations in industry. Developments in mechatronics, which is the synergistic integration of mechanism, electronics and computer control to achieve a functional system, offer effective solutions for the design of such robots. The integrated analysis of robots is usually used in the design stage. In this study, it is offered that the integrated analysis of robots can also be used at the application stage. SolidWorks, CosmosMotion and ABAQUS programs are used with an integrated approach. Integration software (IS) is developed in Visual Basic by using the application programming interface (API) capabilities of these programs. An ABB-IRB1400 industrial robot is considered for the study. Different trajectories are considered. Each task is first evaluated by a kinematic analysis. If the task is out of the workspace, then the task is cancelled. This evaluation can also be done by robot programs like Robot Studio. It is proposed that the task must be evaluated by considering the limits for velocities, motor actuation torques, reaction forces, natural frequencies, displacements and stresses due to the flexibility. The evaluation is done using kinematic, kinetic and rigidity evaluation charts. The approach given in this work can be used for the optimal usage of robots

Aspergillus meningitis and discitis from low-back procedures in an immunocompetent patient

We present a case of an immunocompetent patient who developed Aspergillus meningitis, subsequent to discitis, presumed to be from an epidural steroid injection. Magnetic resonance imaging (MRI) of the lumbar spine confirmed the diagnosis of discitis. Fluoroscopic-guided aspiration of the disc showed growth of Aspergillus fumigatus. MRI of the brain revealed involvement of the right third cranial nerve. Repeat MRIs demonstrated multiple leptomeningeal masses consistent with granulomatous meningitis. Meningitis is a rare complication of discitis, discogram, or epidural steroid injection. Aspergillus usually only infects immunocompromised patients, but rarely can affect immunocompetent patients

Detection of aneurysms by 64-section multidetector CT angiography in patients acutely suspected of having an intracranial aneurysm and comparison with digital subtraction and 3D rotational angiography

BACKGROUND AND PURPOSE: Four-section multisection CT angiography (MSCTA) accurately detects aneurysms at or more than 4 mm but is less accurate for those less than 4 mm. Our purpose was to determine the accuracy of 64-section MSCTA (64MSCTA) in aneurysm detection versus combined digital subtraction angiography (DSA) and 3D rotational angiography (3DRA). MATERIALS AND METHODS: In a retrospective review of patients studied because of acute symptoms suspicious for arising from an intracranial aneurysm, 63 subjects were included who had undergone CT angiography (CTA). Of these, 36 underwent catheter DSA; all but 4 were also studied with 3DRA. The most common indication was subarachnoid hemorrhage (SAH; n = 43). Two neuroradiologists independently reviewed each CIA, IDSA, and 3DRA. RESULTS: A total of 41 aneurysms were found in 28 patients. The mean size was 6.09 mm on DSA/3DRA and 5.98 mm on 64MSCTA. K was excellent (0.97) between the aneurysm size on 64MSCTA and DSA/3DRA. Ultimately, 37 aneurysms were detected by DSA/3DRA in 25 of the 36 patients who underwent conventional angiography. The reviewers noted four 1- to 1.5-mm sessile outpouchings only on 3DRA; none were considered a source of SAH. One 64MSCTA was false positive, whereas one 2-mrn aneurysm was missed by CTA. The sensitivity of CTA for aneurysms less than 4 mm was 92.3%, whereas it was 100% for those 4-10 mm and more than 10 mm, excluding the indeterminate, sessile lesions. CONCLUSIONS: In comparison with the available literature, 64MSCTA may have improved the detection of less than 4-mm aneurysms compared with 4- or 16-section CTA. However, the combination of IDSA with 3DRA is currently the most sensitive technique to detect untreated aneurysms and should be considered in suspicious cases of SAH where the aneurysm is not depicted by 64MSCTA, because 64MSCTA may occasionally miss aneurysms less than 3-4 mm size

Reperfusion Phenomenon Masking Acute and Subacute Infarcts at Dynamic Perfusion CT: Confirmation by Fusion of CT and Diffusion-Weighted MR Images

OBJECTIVE. The purpose of this study was to evaluate cerebral blood flow, cerebral blood volume, mean transit time, time to peak, and delay in a selected sample of patients with visually normal or increased cerebral blood volume to facilitate detection of a postischemic CT perfusion hyperperfusion-reperfusion phenomenon that may mask subacute and acute infarcts. MATERIALS AND METHODS. Ten patients were included who had visually normal or elevated cerebral blood volume in infarcts larger than 1.5 cm confirmed on diffusion-weighted MR images within 48 hours of perfusion CT. The cases were selected from 371 perfusion CT studies of stroke patients (99 associated with positive diffusion-weighted imaging findings) reviewed over 2.5 years on a 64-MDCT scanner. The perfusion CT images were fused to the diffusion-weighted images for measurement of cerebral blood volume, cerebral blood flow, mean transit time, time to peak, and delay in each infarct versus the contralateral hemisphere. Two neuroradiologists reviewed the images in consensus. RESULTS. The mean time between symptom onset and perfusion CT was 3.9 days. Infarcts were in the middle cerebral artery (n = 7) and posterior cerebral artery (n = 3) distributions. Significant differences versus the contralateral finding were found in cerebral blood volume (p = 0.016; mean increase, 30.0%), mean transit time (p = 0.007; mean increase, 38.1%), time to peak (p = 0.005; mean increase, 17.7%), and delay (p = 0.030; mean increase, 124.9%). The difference in cerebral blood flow (p = 0.785; mean increase, 1.8%) was not statistically significant. Infarcts became enhanced on the dynamic perfusion CT images of eight of 10 patients and on the contrast-enhanced T1-weighted MR images of six of nine patients. CONCLUSION. Visual inspection of cerebral blood volume and cerebral blood flow maps alone is insufficient in the evaluation of infarcts. Mean transit time, time to peak, and delay maps also should be reviewed with dynamic source images to prevent misinterpretation of findings as false-negative. This phenomenon is unlikely to occur hyperacutely (< 8 hours after onset)