Effectiveness and safety of cryotherapy after arthroscopic anterior cruciate ligament reconstruction. A systematic review of the literature

Cryotherapy is widely used in rehabilitation; however, its effectiveness after anterior cruciate ligament (ACL) reconstruction remains uncertain. To investigate the effectiveness and safety of cryotherapy following ACL reconstruction through a systematic review, randomized and quasi-randomized clinical trials were searched in the databases: MEDLINE, EMBASE, CENTRAL PEDro, SportDiscus, CINAHL, LILACS (June 2013). the primary outcomes measures were pain, edema and adverse events; the secondary outcomes were knee function, analgesic medication use, range of motion, blood loss, hospital stay, quality of life and patient satisfaction. the methodological quality of studies was evaluated using the Cochrane Collaboration risk-of-bias tool. Ten trials (a total of 573 patients) were included. Results of meta-analysis showed that the use of cold compression devices produced a significant reduction in pain scores 48 h after surgery (p < 0.00001), compared to no cryotherapy. the risk for adverse events did not differ between patients receiving cryotherapy versus no treatment (p = 1.00). the limited evidence currently available is insufficient to draw definitive conclusions on the effectiveness of cryotherapy for other outcomes. There is a need for well designed, good quality randomized trials to answer other questions related to this intervention and increase the precision of future systematic reviews. (C) 2014 Elsevier B.V. All rights reserved.

Recovery of linear and nonlinear heart rate dynamics after coronary artery bypass grafting surgery

Background: Conventional coronary artery bypass grafting (C-CABG) and off-pump CABG (OPCAB) surgery may produce different patients' outcomes, including the extent of cardiac autonomic (CA) imbalance. the beneficial effects of an exercise-based inpatient programme on heart rate variability (HRV) for C-CABG patients have already been demonstrated by our group. However, there are no studies about the impact of a cardiac rehabilitation (CR) on HRV behaviour after OPCAB. the aim of this study is to compare the influence of both operative techniques on HRV pattern following CR in the postoperative (PO) period.Methods: Cardiac autonomic function was evaluated by HRV indices pre- and post-CR in patients undergoing C-CABG (n = 15) and OPCAB (n = 13). All patients participated in a short-term(approximately 5 days) supervised CR programme of early mobilization, consisting of progressive exercises, from active-assistive movements at PO day 1 to climbing flights of stairs at PO day 5.Results: Both groups demonstrated a reduction in HRV following surgery. the CR programme promoted improvements in HRV indices at discharge for both groups. the OPCAB group presented with higher HRV values at discharge, compared to the C-CABG group, indicating a better recovery of CA function.Conclusion: Our data suggest that patients submitted to OPCAB and an inpatient CR programme present with greater improvement in CA function compared to C-CABG.

Reaction time and replenishment time of SP and CGRP after incision in rat skin

Background. the skin neurogenic inflammation is mainly related to Substance P (SP) and Calcitonin Gene-related Peptide (CGRP). There is no data on their availability in the dynamics of skin nerve endings, concerning their release and replenishment after a nociceptive stimulus, so this was investigated. Materials and methods. 25 rats were randomly distributed in 5 groups. the animals of the control group (CG) determined the baseline levels of neuropeptides in the skin. the groups S0 and S30 did not receive any cutaneous stimulus at 30 and 60 minutes, respectively. in the group S1, an incision stimulus was made at 30 minutes. in the group S31, a nociceptive stimulus was performed by subdermal scratching at 30 minutes and, at 60 minutes, the incision stimulus was carried out in the same location (nociceptive hyperstimulation). the skin samples of the other animals were harvested from the back 1 minute after their death. SP, pro-CGRP and CGRP were quantified by Western Blotting. Results. the incision stimulus released SP, S1 compared to S0 (p < 0.05) detected in the first minute, and the replenishment time was more than 30 minutes. Also, it cleaved pro-CGRP, S1 compared to S31 (p < 0.05) in the first minute, and its replenishment time less than 30 minutes. Release of CGRP was not detected. Conclusion. the incision released SP already detected in the first minute; its replenishment time is more than 30 minutes. the incision decreased pro-CGRP, also detected in the first minute; and its replenishment time is less than 30 minutes.

Changes in information behavior in clinical teams after introduction of a clinical librarian service

Urquhart, C., Turner, J., Durbin, J. & Ryan, J. (2007). Changes in information behavior in clinical teams after introduction of a clinical librarian service. Journal of the Medical Library Association, 95(1), 14-22. Available via PubMed central Sponsorship: North Wales NHS Trusts

Bacteremic pneumonia before and after withdrawal of 13-valent pneumococcal conjugate vaccine from a public vaccination program in Spain: a case-control study

The objective of this study is to compare the incidence and epidemiology of bacteremic community-acquired pneumonia (CAP) in the setting of changes in 13-valent pneumococcal conjugate vaccine (PCV13) coverage. In the region of Madrid, universal immunization with the PCV13 started in May 2010. In July 2012, public funding ceased. Vaccination coverage decreased from >95% to 82% in 2013 and to 67% in 2014. We performed a multicenter surveillance and case-control study from 2009-2014. Cases were hospitalized children with bacteremic CAP. Controls were children selected 1:1 from next-admitted with negative blood cultures and typical, presumed bacterial CAP. Annual incidence of bacteremic CAP declined from 7.9/100 000 children (95% CI 5.1-11.1) in 2009 to 2.1/100 000 children (95% CI 1.1-4.1) in 2012. In 2014, 2 years after PCV13 was withdrawn from the universal vaccination program, the incidence of bacteremic CAP increased to 5.4/100 000 children (95% CI 3.5-8.4). We enrolled 113 cases and 113 controls. Streptococcus pneumoniae caused most of bloodstream infections (78%). Empyema was associated with bacteremia (P = .003, OR 3.6; 95% CI 1.4-8.9). Simple parapneumonic effusion was not associated with bacteremia. Incomplete PCV immunization was not a risk factor for bacteremic pneumonia.

Blood and urinary abnormalities induced during and after 24-hour continuous running: A case report

In this reported clinical case, a healthy and well-trained male subject [aged 37 years, maximal oxygen uptake (V[Combining Dot Above]O2max) 64 mL·kg·min] ran for 23 hours and 35 minutes covering 160 km (6.7 km/h average running speed). The analysis of hematological and biochemical parameters 3 days before the event, just after termination of exercise, and after 24 and 48 hours of recovery revealed important changes on muscle and liver function, and hemolysis. The analysis of urine sediments showed an increment of red and white blood cells filtrations, compatible with transient nephritis. After 48 hours, most of these alterations were recovered. Physicians and health professionals who monitor such athletic events should be aware that these athletes could exhibit transient symptoms compatible with severe pathologies and diseases, although the genesis of these blood and urinary abnormalities are attributable to transient physiological adaptations rather to pathological status.

Thirty Years After Helsinki: Proposals for OSCE's Reform

Odello, Marco, 'Thirty Years After Helsinki: Proposals for OSCE's Reform', Journal of Conflict and Security Law, (2005) 10(3):435-449 RAE2008

France and the Problems of Security and Disarmament after the First World War

Jackson, Peter, 'France and the Problems of Security and Disarmament after the First World War', Journal of Strategic Studies (2006) 29(2) pp.247-280 Special Issue: Enforcing arms limits: Germany post 1919; Iraq post 1991 RAE2008

Northern Ireland After the Good Friday Agreement: Victims, Grievance and Blame

Breen Smyth, Morrisey, M., Northern Ireland After the Good Friday Agreement: Victims, Grievance and Blame (Pluto Press, 2002), pp.xiii+247 RAE2008

Truth Recovery and Justice after Conflict: Managing Violent Pasts

Breen Smyth, M. (2007). Truth Recovery and Justice after Conflict: Managing Violent Pasts. Abingdon: Routledge. RAE2008

Factors affecting the survival of sheep embryos after transfer within a MOET program

F. Baria, M. Khalid, W. Haresign, A. Murray and B. Merrell (2003). Factors affecting the survival of sheep embryos after transfer within a MOET program. Theriogenology, 59 (5/6), 1265-1275. Sponsorship: DEFRA RAE2008

Effects of a stay-green mutation on plant nitrogen relations in Lolium perenne during N starvation and after defoliation

Macduff, J. H., Humphreys, M. O., Thomas, Howard (2002). Effects of a stay-green mutation on plant nitrogen relations in Lolium perenne during N starvation and after defoliation. Annals of Botany, 89 (1), 11-21. Sponsorship: BBSRC RAE2008

The Sunday-school : its origin, mission, methods, and auxiliaries / by H. Clay Trumbull.

http://www.archive.org/details/thesundayschooli00trumuoft

A Moslem seeker after God: showing Islam at its best in the life and teaching of al-Ghazali, mystic and theologian of the eleventh century, by Samuel M. Zwemer ...

http://www.archive.org/details/amoslemseeker00zwemuoft

Foreign missions after a century / by James S. Dennis

http://www.archive.org/details/foreignmissionsa008429mbp