Acute rehabilitation of sport injury
Pamela E Macintyre, Suellen M Walker, David J Rowbotham in Clinical Pain Management, 2008
Immobilization was traditionally thought to reduce pain and swelling and to encourage healing, and periods of up to six weeks have been advocated for treatment of severe soft-tissue injuries. It is now known that prolonged immobilization (beyond 72 hours) has detrimental effects on: joint stiffness;articular cartilage softening;muscle disuse atrophy and stiffness;suboptimal tendon, ligament, and muscle scar strength;bone density;deep venous thrombosis formation.
Robotic arm linac
Jing Cai, Joe Y. Chang, Fang-Fang Yin in Principles and Practice of Image-Guided Radiation Therapy of Lung Cancer, 2017
Like a conventional C-arm linac, lung patients are scanned head first in the supine position. Patients receiving treatment of the lung can be immobilized in a device such as a Vac-Lok cushion (Civco Medical Solutions, Kalona, IA). It is important to consider the potential advantages of immobilization while considering the chance that the immobilization device may make the patient less comfortable during a long treatment, and thus motivate the patient to move due to discomfort. It may be preferable to use a Vac-Lok cushion so that the patient's shoulder position is reproducible. Patients who experience discomfort in a Vac-Lok device can alternatively be placed on a soft pad. In this case, it can be advantageous to use a pad with a large thickness, such as the pad developed by Jim Hevezi, to allow the patient's arms to fall below their body and thus provide access to more posterior lateral radiation beams [15].
Perioperative care of the pediatric and adolescent gynecology patient
Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo in Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Stirrups are secured in holders on each side of the operating table at the level of the patient's upper thighs. They are adjusted at equal height so that symmetry will be achieved when the legs are raised. Each of two persons raises one leg by grasping the sole of a foot in one hand and supporting the calf at the knee with the other. The knees are flexed and the legs placed inside the posts of the stirrups. The use of loop stirrups is no longer recommended, as they provide inadequate support and may increase the risk of nerve injury. After the patient is positioned in the stirrups, the lower section of mattress is removed, and the bed is lowered. The buttocks must not extend beyond the end of the operating bed. For lengthy procedures, antiembolic stockings or sequential compression devices may be used to minimize the risk of venous stasis and DVT. Other potential risks include pressure sores and nerve damage or compartment syndrome from prolonged immobilization. When using universal stirrups with a boot, keep the toe, knee, and opposite shoulder in a relatively straight line and avoid knee abduction to gain exposure.
Bioconjugation as a smart immobilization approach for α-amylase enzyme using stimuli-responsive Eudragit-L100 polymer: a robust biocatalyst for applications in pharmaceutical industry
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2019
Heidi Mohamed Abdel-Mageed, Rasha Ali Radwan, Nermeen Zakaria AbuelEzz, Hebatallah Ahmed Nasser, Aliaa Ali El Shamy, Rana M. Abdelnaby, Nesrine Abdelrehim EL Gohary
Enzymes are biodegradable biocatalysts that catalyze selective reactions under mild operating conditions. They are cost efficient with the ability to reduce environmental impact unlike conventional chemical processes and they do not produce undesirable waste [4]. However, the industrial applications of enzymes are immensely hindered by high production cost and the inherently sensitive nature of enzymes that compromise their storage shelf life and stability under operational conditions. In addition, enzymes are typically wasted after completion of the catalytic process. Though, regarding their catalytic nature, they still retain their enzymatic activity at the end of the reaction [4,5]. Immobilization is an age-old method of biocatalyst stabilization. Immobilization is a physical or a chemical process in which enzymes are fixed to or confined to a support, creating a heterogeneous immobilized enzyme system that mimics the enzyme natural mode in living cells. Immobilization allows the recovery of enzymes for re-use as biocatalyst which is highly advantageous for industrial applications [4,5]. The choice of the appropriate immobilization support and the efficient immobilization method is fundamental for effective industrial applications of immobilized enzymes [5,6]. In instances where the enzyme has to act on macromolecular substrates (heterogeneous media) it is highly important that the support does not represent a constraint to enzymatic reaction [7].
Body Movement Is Associated With Orgasm During Vaginal Intercourse in Women
Published in The Journal of Sex Research, 2019
Annette Bischof-Campbell, Peter Hilpert, Andrea Burri, Karoline Bischof
This study focused on the two described arousal techniques and their association with the experience of orgasms during vaginal intercourse, both with and without additional clitoral stimulation. From the arousal patterns proposed by Desjardins et al. (2010), we chose: (1) body movement, in particular, back-and-forth swinging movements of the pelvis and trunk, and (2) an immobilized body with a focus on precise rubbing of the clitoris, because these two techniques are well distinguishable from each other. Body movement seems to be associated with more orgasms during vaginal intercourse, while body immobilization is associated with fewer such orgasms (Carvalheira & Leal, 2013; Desjardins et al., 2010). It is important to note that body immobilization is not just the absence of movement or the lack of desire to move, but a more or less conscious attempt to hold the body still, usually associated with high muscular tension and precise rubbing of the clitoral gland.
New Immobilization Guidelines Change EMS Critical Thinking in Older Adults With Spine Trauma
Published in Prehospital Emergency Care, 2018
Linda Underbrink, Alice “Twink” Dalton, Jan Leonard, Pamela W. Bourg, Abigail Blackmore, Holly Valverde, Thomas Candlin, Lisa M. Caputo, Christopher Duran, Sherrie Peckham, Jeff Beckman, Brandon Daruna, Krista Furie, Debra Hopgood
Approximately 17,000 Americans experience a new spinal injury each year, with each case involving an average of 11 days in the hospital and risking long-term secondary injuries, including neurological deficits of incomplete tetraplegia, incomplete paraplegia, and complete paraplegia (1). Spinal immobilization using a backboard, cervical collar, and head immobilization device has been commonly used in the field for trauma patients suspected of having a spinal injury for the latter half of the 20th century. Immobilization was assumed to reduce the risk of neurological deterioration by restricting mobilization to prevent the exacerbation of the injury during extrication, transport, and evaluation, thereby avoiding secondary injury (2). Recommendations for full spinal immobilization exist for specific, defined patients; otherwise, there is little evidence supporting the benefits of spinal immobilization (3). On the contrary, a number of studies have illustrated an increase in pain and discomfort (4, 5), delayed resuscitation (6), increased intracranial pressure (7), failed airway management efforts (8, 9), and pressure ulcers (10), contributing to further injury (11) and resultant incorrect treatment due to increases in false-positive diagnosis due to immobilization (4) among other negative consequences (12) associated with the practice. These findings have led to early removal of the backboard as best practice (13).