The interrelationship between air temperature and humidity as applied locally to the skin: the resultant response on skin temperature and blood flow with age differences

The efficacy and safety of tadalafil in the management of erectile dysfunction with diabetes and blood circulation issues

BACKGROUND

Erectile dysfunction (ED) is a common diabetes-related complication.

MATERIALS AND METHODS

This study examined the effect of daily low-dose tadalafil (5 mg) on patients' quality of life (including that of sex life) and blood circulation. Erectile dysfunction questionnaires were administered to 20 patients with type 2 diabetes (T2DM) and ED. The safety and efficacy of tadalafil were evaluated using laboratory tests, and the effect on blood circulation was measured through nail fold capillaroscopy.

RESULTS

Daily tadalafil use by patients with T2DM and ED showed a statistically significant increase in the erectile reliability score from of 1.15 to 3.20 (p < .00012). Capillary blood circulation improvement tests showed a statistically significant increase in apical limb width from 13.1 to 14.64 µm (p = .04829) and flow from 9035 to 11946 μm³/s (p = .04405). Although not significant, increased capillary width and speed (rate of blood flow) confirmed improved blood circulation. There were no significant changes in the cardiac indicators (troponin, prostate-specific antigen, or electrocardiogram tests) before and after tadalafil administration, supporting the safety of its low-dose daily administration.

CONCLUSIONS

A small dose of daily tadalafil was shown to safely improve erectile dysfunction and peripheral blood flow in patients with T2DM, in which peripheral arterial diseases should not be considered separately but rather as complex entities.

The Thermal Influence of an Electromagnetic Field with a Radio Frequency Depending on the Type of Electrode Used

Diathermy is a method used in physiotherapy based on obtaining an increase in temperature by supplying energy from the electromagnetic field to the tissues. The aim of this retrospective work, based on the data included in a medical documentation, was to assess the dynamics of temperature changes on the body surface after the application of a high-frequency electromagnetic field depending on the type of electrode used. In order to generate a radio frequency electromagnetic field, an INDIBA ACTIV^® CT9 was used. In order to measure the temperature, an HT-17 thermovision camera was used, enabling measurements within the range of -20 to 300 °C, with an accuracy of ±2% or 2 °C. The participants consisted of 30 healthy subjects (15 women and 15 men) who were physiotherapy students in the Faculty of Public Health in the Silesian Medical University in Katowice, Poland; they were divided into two comparative groups (A and B). It was found that the differences between the groups were not significant in the measurements carried out before using the electrode (p = 0.84; Mann-Whitney U test). On the other hand, at 0, 5 and 15 min, statistically significant differences were noted in the tissue temperature between the groups, depending on the electrode used (p = 0.00; Mann-Whitney U test). Based on the obtained results, it can be concluded that with the extension of the observation time, the tissue temperature increased (for Group A, Me 30.40 °C vs. 34.90 °C; for Group B, Me 30.70 °C vs. 35.20 °C). Our study confirmed that the use of both a capacitive and resistive electrode during treatment with the use of a high-frequency electromagnetic field statistically significantly increased the surface temperature of the area to which the therapy was applied. The results of the study can be used in clinical practice by physiotherapists to optimize the conditions of therapy.

Effect of Heat Shock Preconditioning on Pressure Injury Prevention via Hsp27 Upregulation in Rat Models

Pressure injury (PI) prevention is a huge industry and involves various interventions. Temperature and moisture are important factors for wound healing; however, the active mechanism by which “moist heat” affects PI prevention has not yet been clarified. Thus, we explored the protective and therapeutic effects of hydrotherapy on PI based on the preconditioning (PC) principle, which might be useful for clinical practice. This study aimed to investigate the preventive mechanisms of heat shock preconditioning on PIs in rat models. The experiment was performed in the basic medical laboratory of Nagano College of Nursing in Japan. Ten rats were divided into two groups, with five rats in each group. Rats in the control group were not bathed. Rats in the preconditioning group (PC group) were bathed with hot tap-water. Bathing was conducted thrice a week. After bathing for 4 weeks, the PI model was constructed on the rats’ dorsal skin. The skin temperature, skin moisture, and area of ulcers were compared between the two groups. In vitro, we investigated the expression of heat shock protein 27 (Hsp27) in 6, 12, and 24 h after the PI model was constructed through Western blot analysis. Ulcers occurred in the control group 24 h after the PI model constructed, wheras the PC group exhibited ulcers after 36 h. The ulcer area was larger in the control group than that in the PC group after 24 h (all p < 0.05). The temperatures of PI wounds in the control group decreased and were lower than those in the PC group after 1, 6, 12, 36, and 48 h (all p < 0.05). However, the skin moisture levels of PI wounds increased in the control group and were higher than those in the PC group at the same time (all p < 0.05). Using Western blot analysis, hydrotherapy preconditioning showed the potential to increase Hsp27 expression after pressure was released (p < 0.05). We determine that heat shock preconditioning had a preventive effect on PIs in rat models, a result that may be associated with their actions in the upregulation of Hsp27.

Quantitative assessment and influence factors of facial wrinkle situation in male construction workers in Beijing

OBJECTIVE

To investigate current situation of facial wrinkles of male construction workers in Beijing area and to discuss the correlative factors.

MATERIALS AND METHODS

A total of 149 male construction works and 63 male non-construction workers in Beijing were required to complete a questionnaire on their exposure to sunlight, dust, noise, and heat in their workplace environment. Their facial wrinkle scores were measured by VISIA Complexion Analysis System. The two-sample t test, chi-square test, and multiple linear regression were used for statistical analysis RESULTS: The exposure to sunlight, dust, noise, and heat of construction workers was significantly higher than that of non-construction workers (P < .01). The wrinkle score of construction workers between 20 and 29 years old was significantly higher than that of non-construction workers (t = 4.077, P < .01). The facial wrinkle score of construction workers(r = 0.657, P < .01) and non-construction workers (r = 0.681, P < .01) was both positively correlated with age. The wrinkle score of construction workers was related to age, sunlight, and noise(P < .01).

CONCLUSION

The wrinkle score of male construction workers between 20 and 29 years old is significantly higher than that of non-construction workers in Beijing. Age, sunlight, and noise were the main influencing factors of wrinkle.

Multilevel Analysis of 24-Hour Blood Pressure, Heart Rate, and Associated Factors among Police Officers in Hanoi, Vietnam

Background

Due to long-hour outdoor working environment, policemen have been subjected to tremendous health risks including blood pressure (BP) and heart rate (HR). In tropical countries, the temperature is extremely harsh which may get peak at above 40 Celsius degrees or drops under 8 Celsius degrees. However, the existing data on the effects of weather variation on BP and HR among police task force has been scarce in Vietnam.

Aims

This study aimed to describe the variation of 24-hour BP and HR and identify factors associated with BP and HR for further appropriate interventions in order to reduce health risks from occupational exposure.

Methods

Multilevel regression analysis (MLRA) was applied with two levels of influent factors. 24-hour holter measured systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR values were the first level which should then be nested in the second level (individual). 24-hour temperature and humidity variations were extracted, respectively, from Hanoi Hydrometeorology Department. All individual characteristics and risk behaviours were measured within 24 studying hours.

Results

Temperature and humidity were major factors that influenced (74%-78%) the variation of BP and HR among the policemen population. When each of the Celsius degree temperature or percentage humidity increases, the SBP goes down by 0.44 (0.11-0.77) and by 0.2 (0.33-0.77), respectively, and the DBP goes down by 0.21 (-0.05-0.48) and by 0.12 (0.02-0.22), respectively, and vice versa. Interaction between temperature and humidity was significantly influent to SBP. The farther the time section from the first time section (0-6AM) the more the variation of the BP and HR. Transition from winter to summer made SBP and DBP decrease and vice versa. Individual characteristics including body mass index (BMI), bad life styles, and stress contributed 22% to 26% to the variation of BP and HR. Traffic policemen were at the greatest risks of the outdoor ambient variation in comparison with the firefighters and office-based policemen.

Conclusion

Designing and equipping appropriate uniform and outdoor facilities could help to reduce influence of temperature and humidity variation in the outdoor workplace. Besides, training and educating programs that aimed at controlling BMI, risk behaviours, and stress for police taskforce, especially the traffic policemen, should be implemented.

An integrated experimental-computational study of the microclimate under dressings applied to intact weight-bearing skin

Pressure ulcers (PUs) are one of the most prevalent adverse events in acute and chronic care. The root aetiological cause of PUs is sustained cell and tissue deformations, which triggers a synergistic tissue damage cascade that accelerates over relatively short time periods. Changes in skin microclimate conditions are known to indirectly contribute to PU-risk levels or to exacerbation of existing wounds. It is therefore surprising that information concerning heat accumulation under dressings is poor. Here, we aimed to investigate the effects of dressings on the microclimate of weight-bearing buttocks skin in 1-hour supine lying sessions. Using a novel and originally developed experimental-computational approach, we compared the combined influence of the mechanical and thermal properties of a polymeric membrane dressing (PolyMem, Ferris Mfg. Corp., Fort Worth, TX) on skin microclimate under and near the dressings with those of a standard placebo foam dressing. We specifically identified the thermal conductivity properties of dressings as being highly important in the context of protective dressing performances, given its association with potential heat accumulation under dressings. Accordingly, this article highlights, for the first time in the literature, the relevance of thermal properties of a dressing in effectively mitigating the risk of developing PUs or aggravating an injury, and offers a systematic, methodological bioengineering process for assessing the thermal performances of dressings.

Microclimate: A critical review in the context of pressure ulcer prevention

Pressure ulcers are caused by sustained mechanical loading and deformation of the skin and subcutaneous layers between internal stiff anatomical structures and external surfaces or devices. In addition, the skin microclimate (temperature, humidity and airflow next to the skin surface) is an indirect pressure ulcer risk factor. Temperature and humidity affect the structure and function of the skin increasing or lowering possible damage thresholds for the skin and underlying soft tissues. From a pressure ulcer prevention research perspective, the effects of humidity and temperature next to the skin surface are inextricably linked to concurrent soft tissue deformation. Direct clinical evidence supporting the association between microclimate and pressure ulceration is sparse and of high risk of bias. Currently, it is recommended to keep the skin dry and cool and/or to allow recovery periods between phases of occlusion. The stratum corneum must be prevented from becoming overhydrated or from drying out but exact ranges of an acceptable microclimate are unknown. Therefore, vague terms like 'microclimate management' should be avoided but product and microclimate characteristics should be explicitly stated to allow an informed decision making. Pressure ulcer prevention interventions like repositioning, the use of special support surfaces, cushions, and prophylactic dressings are effective only if they reduce sustained deformations in soft tissues. This mode of action outweighs possible undesirable microclimate properties. As long as uncertainty exists efforts must be taken to use as less occlusive materials as possible. There seems to be individual intrinsic characteristics making patients more vulnerable to microclimate effects.

Use of Low Level of Continuous Heat as an Adjunct to Physical Therapy Improves Knee Pain Recovery and the Compliance for Home Exercise in Patients With Chronic Knee Pain: A Randomized Controlled Trial

Petrofsky, JS, Laymon, MS, Alshammari, FS, and Lee, H. Use of low level of continuous heat as an adjunct to physical therapy improves knee pain recovery and the compliance for home exercise in patients with chronic knee pain: a randomized controlled trial. J Strength Cond Res 30(11): 3107-3115, 2016-This study examined if the use of low level continuous heat (LLCH) wraps at home between physical therapy sessions at a clinic resulted in better therapy outcomes in patients with chronic knee pain. Fifty individuals with chronic nonspecific knee pain was randomly allocated to 2 groups: the LLCH group and the placebo group. All subjects underwent 1 hour of conventional physical therapy twice per week for 2 weeks at the outpatient clinic and they were asked to accomplish 1 hour of therapeutic exercise at home each day between sessions. The LLCH group applied LLCH knee wraps for 6 hours at home before home exercise while placebo group took a placebo ibuprofen. (This was done since placebo heat is impossible to use since subjects would notice that the wraps were cold) Before, during, and after intervention, pain intensity, active range of motion of the knee (AROM), knee strength, and home exercise compliance were measured. The LLCH group showed pain attenuation after 2 weeks of therapy sessions (p ≤ 0.05). AROM and strength of the knee significantly improved over time compared to the placebo group. Home exercise compliance was significantly higher in the LLCH group than placebo group (p ≤ 0.05). These results indicated that the use of LLCH as an adjunct to conventional physical therapy for chronic knee pain significantly improved pain attenuation and recovery of strength and movement in patients with chronic knee pain.

Effects of preoperative oral carbohydrate solution intake on thermoregulation

BACKGROUND

We aimed to investigate the oral carbohydrate solution administered preoperatively on thermoregulation.

MATERIAL AND METHODS

The study included 40 female patients under general anesthesia. Patients were randomly divided into 2 groups: Group CONT (stopped oral implementation 8 h before the operation) and Group CHO (800ml oral carbohydrate fluid 8 h before the operation and 400ml oral carbohydrate fluid 2 h before the operation). Patients were monitored as standard and temperature probes were placed. Temperatures were recorded immediately before anesthetics induction, 5 min after the anesthetics induction, and in the post-anesthesia care unit (PACU) every 10 min. Mean skin temperature (Tsk), mean body temperature (Tb), and vasoconstriction threshold were estimated.

RESULTS

In general, we observed a decrease in tympanic temperature and Tb following anesthetic administration in groups, and increase in Tsk, and an increase in all 3 of these levels in the recovery unit. Tympanic temperature was significantly higher at 25, 55, 65, and 95 min after induction in Group CONT compared to Group CHO (p<0.05). Tsk was found to be lower in Group CONT compared to Group CHO in almost all periods. In PACU, it was found that the tympanic temperature was higher in Group CONT compared to Group CHO at 60 min (p<0.05). Postoperative shivering score was found to be significantly higher in Group C (p<0.01). Vasoconstriction threshold was higher in Group CONT than Group CHO.

CONCLUSIONS

Oral carbohydrate solution administered was established to have effects thought to be negative on tympanic temperature, vasoconstriction, and vasoconstriction threshold.