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Massage
Kinds of Massage Terms modified by Massage Selected AbstractsMassage in combination with group interpersonal psychotherapy for prenatally depressed women: unsuitable study design prevents any conclusionsFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 1 2010Article first published online: 6 APR 2010 [source] Massage is helpful for knee osteoarthritisFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 2 2007Article first published online: 14 JUN 2010 [source] Massage elevates mood in depressed patientsFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 1 2005Article first published online: 14 JUN 2010 [source] Massage for chronic musculoskeletal pain: effects are positive but short-livedFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 2 2004Article first published online: 14 JUN 2010 [source] Antenatal Perineal Massage for Reducing Perineal TraumaBIRTH, Issue 2 2006M.M. Beckmann Background:, Perineal trauma following vaginal birth can be associated with significant short- and long-term morbidity. Antenatal perineal massage has been proposed as one method of decreasing the incidence of perineal trauma. Objectives:, To assess the effect of antenatal perineal massage on the incidence of perineal trauma at birth and subsequent morbidity. Search strategy:, We searched the Cochrane Pregnancy and Childbirth Group Trials Register (30 January 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2005), PubMed (1966 to January 2005), EMBASE (1980 to January 2005) and reference lists of relevant articles. Selection criteria:, Randomised and quasi-randomised controlled trials evaluating any described method of antenatal perineal massage undertaken for at least the last four weeks of pregnancy. Data collection and analysis:, Both review authors independently applied the selection criteria, extracted data from the included studies and assessed study quality. We contacted study authors for additional information. Main results:, Three trials (2434 women) comparing digital perineal massage with control were included. All were of good quality. Antenatal perineal massage was associated with an overall reduction in the incidence of trauma requiring suturing (three trials, 2417 women, relative risk (RR) 0.91 (95% confidence interval (CI) 0.86 to 0.96), number needed to treat (NNT) 16 (10 to 39)). This reduction was statistically significant for women without previous vaginal birth only (three trials, 1925 women, RR 0.90 (95% CI 0.84 to 0.96), NNT 14 (9 to 35)). Women who practised perineal massage were less likely to have an episiotomy (three trials, 2417 women, RR 0.85 (95% CI 0.75 to 0.97), NNT 23 (13 to 111)). Again this reduction was statistically significant for women without previous vaginal birth only (three trials, 1925 women, RR 0.85 (95% CI 0.74 to 0.97), NNT 20 (11 to 110)). No differences were seen in the incidence of 1st or 2nd degree perineal tears or 3rd/4th degree perineal trauma. Only women who have previously birthed vaginally reported a statistically significant reduction in the incidence of pain at three months postpartum (one trial, 376 women, RR 0.68 (95% CI 0.50 to 0.91) NNT 13 (7 to 60)). No significant differences were observed in the incidence of instrumental deliveries, sexual satisfaction, or incontinence of urine, faeces or flatus for any women who practised perineal massage compared with those who did not massage. Authors' conclusions:, Antenatal perineal massage reduces the likelihood of perineal trauma (mainly episiotomies) and the reporting of ongoing perineal pain and is generally well accepted by women. As such, women should be made aware of the likely benefit of perineal massage and provided with information on how to massage. *** The preceding report is an Abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464,780X). The Cochrane Database of Systematic Reviews 2006 Issue 1. Copyright © 2006 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. [source] Postpartum Maternal Oxytocin Release by Newborns: Effects of Infant Hand Massage and SuckingBIRTH, Issue 1 2001Ann-Sofi Matthiesen BSc Background:Newborns placed skin-to-skin with their mothers show an inborn sequence of behavior similar to that seen in other mammals. The purpose of this study was to make a detailed exploration of hand movements and sucking behavior in healthy term newborns who were placed skin-to-skin on their mothers' chests, and to study maternal oxytocin release in relation to these behaviors.Methods:Ten vaginally delivered infants whose mothers had not been exposed to maternal analgesia were video-recorded from birth until the first breastfeeding. Video protocols were developed based on observations of the videotapes. Each infant's hand, finger, mouth, and tongue movements, positions of the hand and body, and sucking behavior were assessed every 30 seconds. Maternal blood samples were collected every 15 minutes, and oxytocin levels were analyzed by radioimmunoassay. A statistical test for establishing the relationship between maternal oxytocin levels and infants' hand movements or sucking behavior was developed.Results:Infants used their hands to explore and stimulate their mother's breast in preparation for the first breastfeeding. A coordinated pattern of infant hand and sucking movements was also identified. When the infants were sucking, the massagelike hand movements stopped and started again when the infants made a sucking pause. Periods of increased massagelike hand movements or sucking of the mother's breast were followed by an increase in maternal oxytocin levels (p < 0.005). Conclusions:The findings indicate that the newborns use their hands as well as their mouths to stimulate maternal oxytocin release after birth, which may have significance for uterine contraction, milk ejection, and mother-infant interaction. [source] Self-concept and attributions about other women in women with a history of childhood sexual abuseCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 3 2010Susan J. McAlpine Abstract Self-concept literature and literature on childhood sexual abuse (CSA) suggests that women with a history of CSA may have particular ways of perceiving themselves, which, as well as impacting upon relationships within their everyday lives, may also have implications for therapy; whether this is on an individual basis or within a group. This research investigated self-concept and attributions about other women using an adapted version of the self-concept sorting task. Three groups of women were compared: women with a history of CSA, women experiencing depressed mood but without a history of CSA and a healthy non-clinical comparison group of hospital staff. To some extent the current findings supported previous studies indicating that women attempting to cope with the consequences of a history of CSA have a negative self-concept. However, there was evidence to suggest that certain self-aspects are protective or protected. Similarly, there is some support for previous evidence of difficult relationships with mothers. Possible explanations for these findings were discussed and areas for future research suggested.,Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Massage: , Although women with a history of CSA and depression have a negative view of themselves in comparison to a non-clinical group, there is no qualitative difference between these two groups. , Nor do women with a history of CSA have a more negative view of other women in general than women who are depressed. , Therefore, being aware of the likelihood that an individual may preceive herself, but not other women negatively, a therapist may use therapy to actively increase awareness and address this issue. [source] Prognostic impact of psychoactive substances use during hospitalization for intentional drug overdoseACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2005M. Tournier Objective:, To assess whether current use of psychoactive substance(s) is a prognostic factor during hospitalization for intentional drug overdose (IDO). Method:, Current intoxication with psychoactive substance(s) [cannabis, opiate, buprenorphine, amphetamine/ecstasy, cocaine, lysergic acid diethylamide (LSD)] was identified using toxicological urinalysis in 671 patients with IDO. An IDO was a priori defined as serious if associated with one of the following events: death, hospitalization in intensive care unit longer than 48 h, respiratory support, use of vasopressive drugs, cardiac massage or dialysis. Results:, Subjects positive for toxicological assays were twice as likely to present with serious IDO (OR = 1.9, 95% CI: 1.3,2.8, P = 0.001), independently from a large range of confounding factors. The risk of serious IDO was especially marked in subjects using LSD, buprenorphine or opiates. Conclusion:, Systematic investigation of substance use could be important to adapt medical management of subjects with IDO in general hospital, but also in primary care and psychiatric settings. [source] Abnormal cardiovascular responses to carotid sinus massage also occur in vasovagal syncope , implications for diagnosis and treatmentEUROPEAN JOURNAL OF NEUROLOGY, Issue 8 2010A. M. Humm Background and purpose:, Carotid sinus massage (CSM) is commonly used to identify carotid sinus hypersensitivity (CSH) as a possible cause for syncope, especially in older patients. However, CSM itself could provoke classical vasovagal syncope (VVS) in pre disposed subjects. Methods:, Retrospective analysis of CSM, cardiovascular autonomic function tests (including tilt table testing) and medical history in 388 patients with recurrent syncope to identify and characterize patients in whom an abnormal response to CSM was more likely to reflect VVS than CSH. Results:, CSM was abnormal in 79 patients. In 53 patients (77.2 ± 8.7 years), CSH was the likely cause of syncope. VVS was the more likely diagnosis in 26 younger patients (59.7 ± 12.6 years) with longstanding syncope from youth, in whom fear or pain was as a trigger; 7/26 suffered from intense chronic or intermittent neck pain and one exacerbation of syncopal attacks followed a physical and emotional trauma to the neck. In VVS, 4/26 had spontaneous VVS during head-up tilt, another six after venepuncture (performed in 17/26). In 6/26, the abnormal response to CSM was delayed, occurring 62.8 ± 28.4 s after completion of CSM. The response to CSM was predominantly of the mixed type (20/26) and abnormal on both sides in 14/26. Conclusions:, An abnormal response to CSM may not indicate syncope caused by CSH and needs to be considered in the light of the patient's age, duration of syncopal episodes and detailed history of provocative stimuli. Differentiating CSH from VVS with an abnormal response to CSM has various implications from advice on driving to treatment strategies. [source] No gain with knee pain and aromatic massageFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 4 2008Article first published online: 3 JUN 2010 [source] Baby massage is good for mothersFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 1 2007Article first published online: 14 JUN 2010 [source] An overview of 45 published database resources for complementary and alternative medicineHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 2 2010Katja Boehm Background:, Complementary and alternative medicine (CAM) has succeeded to implement itself in the academic context of universities. In order to get information on CAM, clinicians, researchers and healthcare professionals as well as the lay public are increasingly turning to online portals and databases, which disseminate relevant resources. One specific type of online information retrieval systems, namely the database, is being reviewed in this article. Question:, This overview aims at systematically retrieving and describing all databases covering the field of CAM. One of the requirements for inclusion was that the database would also have to be published in a medical journal. Data sources:, The databases amed, CAMbase, embase, and medline/PubMed were searched between December 2008 and December 2009 for publications relevant to CAM databases. The authors' specialist library was also searched for grey literature to be included. Study selection:, All included databases were then visited online and information on the context, structure and volume of the database was extracted. Main results:, Forty-five databases were included in this overview. Databases covered herbal therapies (n = 11), traditional Chinese medicine (n = 9) and some dealt with a vast number of CAM modalities (n = 9), amongst others. The amount of time the databases had been in existence ranged from 4 to 53 years. Countries of origin included the USA (n = 14), UK (n = 7) and Germany (n = 6), amongst others. The main language in 42 of 45 databases was English. Conclusions:, Although this overview is quite comprehensive with respect to the field of CAM, certain CAM practices such as chiropractic, massage, reflexology, meditation or yoga may not have been covered adequately. A more detailed assessment of the quality of the included databases might give additional insights into the listed resources. The creation of a personalised meta-search engine is suggested, towards which this overview could be seen as a first step. [source] The effect of different soothing interventions on infant crying and on parent,infant interactionINFANT MENTAL HEALTH JOURNAL, Issue 3 2002M. Ruth Elliott Professor Emeritus Conducted in the home environment, this study examines the effects of three complementary soothing techniques on the duration of infant crying and on caregiver,infant interaction. In one group, the caregivers apply massage; in another, they provide supplemental carrying to their infants, and in the last, the caregivers both massage and provide supplemental carrying. Measurements, for the one control and three treatment groups took place prenatally (third trimester) and in the first 16 weeks postpartum for parental perception of infant temperament, parental sense of competence, parent,infant interaction, and the duration of infant crying. Whereas analyses indicate no statistically significant differences between groups in reducing infant crying, results approached significance (p , .06) in favor of the combined supplemental carrying/massage group. These results challenge accepted beliefs that tactile stimulation and/or supplemental carrying enhance parental sense of competence, positive parental perceptions, and interactions with infants. Practitioners can apply these conclusions when counselling parents on the advisability of selecting any one complementary soothing technique. ©2002 Michigan Association for Infant Mental Health. [source] Update on medical treatment of ejaculatory disorders,INTERNATIONAL JOURNAL OF ANDROLOGY, Issue 6 2002A. KAMISCHKE Summary Among the treatment modalities for ejaculatory disorders pharmacological treatment is the least invasive option. In this review, medical treatments for retrograde ejaculation (RE) and anejaculation (AE) are discussed systematically. Thirty-six studies dealing with patients with RE and 40 with AE evaluated the use of medical treatment and were included in this review. In addition four articles dealing with prostatic massage in anejaculatory patients were considered. Sperm quality in patients with retrograde and AE is often impaired. In patients with RE no differences in response to medical treatment could be detected between the different underlying diagnoses. Compared with ephedrine, imipramine and chlorpheniramine + phenylpropanalamine showed significantly higher reversal rates, while differences between the other treatments were not significant. Regarding the reversal of AE, the alpha agonistic drugs were significantly inferior to treatment with parasympathetic drugs. Of the different alpha agonistic medical treatments for the reversal of AE, milodrin showed significantly better rates than imipramine (p = 0.008), pseudoephidrine (p = 0.02) and ephedrine (p = 0.044), while all other treatments were not significantly different (p = 0.4). In conclusion, medical treatment for reversal of RE offers a realistic chance of conceiving offspring naturally and should be the treatment modality of first choice. In contrast, in AE, medical treatment cannot be recommended generally as treatment of first choice as it shows low overall success rates compared with electrovibration stimulation and electroejaculation. Under consideration of the mostly uncontrolled design of the majority of studies published, controlled clinical trials comparing different treatment options appear urgently warranted. [source] Rejuvenating facial massage , a bane or boon?INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2002Neena Khanna MD Background Facial massage is an extremely popular form of beauty treatment and is thought to rejuvenate the skin. We decided to study the benefits and untoward effects of this form of facial beauty treatment. Methods One hundred and forty-two women (aged 17,63 years), who had received facial beauty treatment in three well-established beauty parlours in New Delhi, were entered into the study and observed for a period of 12 weeks after the facial beauty treatment. Twenty-seven of the subjects had a repeat facial beauty treatment 4,6 weeks after entry into the study, giving a total of 169 massage episodes observed. Immediate and delayed effects of the beauty treatment were examined. Results Facial beauty treatment generally consists of three steps: vigorous massaging of the face with creams, steaming (using a hot towel or a steaming gadget), and application of a face mask containing adsorbents and astringents. In our study, the creams used for massage included "off the shelf" creams manufactured by standard cosmetic companies in 95 (56.3%) subjects, herbal creams in 61 (36.1%), and creams containing exotic ingredients, such as gold salts, in 13 (7.7%). Sixty-one (36.1%) patients developed erythema and puffiness within 15 min to 2 h after the beauty treatment. This lasted for 2,6 h. Forty-one (24.3%) women underwent the procedure of comedone extraction after steaming. In 12 (7.1%) of these women, persistent erythema was noticed at the site of comedone extraction. Eight (4.7%) women developed mild dermatitis on the face, 2,7 days after the facial beauty treatment. Patch testing with constituents used in the facial beauty treatment was positive in four patients (herbal cream, 1; witch hazel, 1; orange face pack, 1; and gold cream, 1). In 47 (33.1%) subjects, an acneiform eruption was observed 3,10 weeks after the facial beauty treatment (mean, 6.1 ± 3 weeks). Thirteen (27.7%) of these subjects had taken the facial beauty treatment for the first time, whereas 34 (72.3%) developed an acneiform eruption after every facial massage. The predominant lesions were deep-seated nodules, although a few comedones, especially closed ones, were present in some patients. Lesions were always present on the cheeks, an area of focus during the facial massage, and healed with hyperpigmentation. The benefits of facial beauty treatment, as mentioned by the subjects, included a feeling of freshness and rejuvenation in 84 (59.1%), keeping the skin supple in 76 (53.5%), feeling of warmth and tightening of the skin in 71 (50%), and delaying the onset of wrinkles in 21 (14.8%). Conclusions Although there are several subjective benefits with facial beauty treatment, there may be immediate side-effects, such as erythema and edema, as well as delayed problems, such as dermatitis and acneiform eruption, in about one-third of patients. [source] Non-pharmacological approaches for dementia that informal carers might try or access: a systematic reviewINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2010Claire Hulme Abstract Objective To review non-drug treatments for dementia; to provide a source of evidence for informal carers who want ideas about non-drug approaches for dementia, that they might try or that they could try to access. The systematic review addresses: what non-drug treatments work and what do they work for? What non-drug treatments might work and what for? What non-drug treatments do not work? Methods Literature searches of seven electronic databases (AMED, CINAHL, EMBASE, MEDLINE, PSYCINFO, Cochrane Library of Systematic Reviews and DARE) were carried out in November 2007 using the following search terms (or derivatives): dementia/Alzheimer's AND Review AND non-drug therapies and aimed at finding systematic reviews. Results Thirty-three reviews were identified; 25 were judged to be high or good quality. Studies within these systematic reviews were characterised by weak study designs with small sample numbers. Three interventions were found to be effective for use with particular symptoms of dementia: music or music therapy, hand massage or gentle touch and physical activity/exercise. Conclusions Whilst informal carers can apply some of the interventions highlighted in the home setting at little or no cost to themselves or to health or social care services, others are likely to require training or instruction. Service providers and commissioners should explore current and future provision of more structured group activities for people with dementia; in particular the provision of group music therapy and group exercise activities that meet the needs of both the person with dementia and their carer. Copyright © 2009 John Wiley & Sons, Ltd. [source] Tactile stimulation associated with nursing care to individuals with dementia showing aggressive or restless tendencies: an intervention study in dementia careINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 3 2007Kirsti Skovdahl PhD Aim., This study aimed to describe from documentation both the caregivers' experiences of giving tactile stimulation to five people with moderate-to-severe dementia and who showed aggressive or restless tendencies, and the changes seen in them. Background., Clinical experiences indicate that tactile stimulation can contribute to a feeling of trust and confirmation as well as to improving communication, promoting relaxation and easing pain. There is, however, very little scientific documentation of the effects of touch massage for people with dementia. Design., From caregivers' documentation (28 weeks) of experiences, the giving of tactile stimulation to five randomly selected people with dementia showing aggressive or restless tendencies and the subsequent changes noticed. Method., The documentation was analysed by using qualitative content analysis. Results., All residents displayed signs of positive feelings and relaxation. The caregivers stated that they felt able to interact with the residents in a more positive way and that they felt they had a warmer relationship with them. Conclusion., Tactile stimulation can be seen as a valuable way to communicating non-verbally, of giving feedback, confirmation, consolation or a feeling of being valuable and taken care of. Relevance to clinical practice., Tactile stimulation has to be administered with respect and care, and given from a relational ethics perspective. Otherwise, there is a risk that tactile stimulation will be used merely as a technique instead of as a part of an effort to achieve optimal good, warm nursing care. [source] Treatment of Vasodepressor Carotid Sinus Syndrome with Midodrine: A Randomized, Controlled Pilot StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2005Allan Moore MRCPI Objectives: To evaluate the efficacy of treatment of the vasodepressor form of carotid sinus hypersensitivity (carotid sinus syndrome (CSS)) with midodrine. Design: A prospective, double-blind, randomized, controlled trial of crossover design. Setting: A dedicated outpatient facility with access to tilt-table, digital arterial photoplethysmography, and 24-hour ambulatory blood pressure (BP) monitoring equipment. Participants: Ten older adults (4 male, 6 female, mean age 75, range 66,86 years) with a history of unexplained syncope who displayed an asymptomatic decrease in systolic BP (SBP) of more than 50 mmHg or a symptomatic decrease of more than 30 mmHg within 30 seconds of carotid sinus massage (CSM). Measurements: Symptom reproduction and BP and heart rate changes were evaluated after CSM in supine and semierect positions on the right and then left sides. These measurements were performed on the final day of placebo and active-treatment phases. Ambulatory 24-hour BP monitoring took place on the penultimate and final days of each treatment phase. Results: Eight patients were symptomatic after their initial CSM. The mean±standard deviation SBP decrease after initial CSM was 54±22 mmHg. Initial mean 24-hour ambulatory BP was 127/70±7/5 mmHg. Eight patients reported symptoms after CSM at the end of the placebo phase. The mean SBP decrease at the end of the placebo phase was 49±12 mmHg. The mean 24-hour ambulatory BP was 127/69±9/7 mmHg. One patient reported symptoms after CSM at the end of the active-treatment phase. The mean SBP decrease at the end of the active-treatment phase was 36±9 mmHg. The mean 24-hour ambulatory BP at the end of the treatment phase was 133/75±7/6 mmHg. The differences in symptom reporting and mean SBP decrease after CSM were both significant (P<.01 and P=.03, respectively). Conclusion: The results of this pilot study suggest that treatment of vasodepressor CSS with midodrine significantly reduced the rate of symptom reporting and attenuated SBP decreases after CSM but increased mean 24-hour ambulatory BP. [source] Effects of Four Therapy Procedures on Communication in People with Profound Intellectual DisabilitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2001William R. Lindsay A number of alternative therapies have recently been employed with people who have intellectual disabilities (IDs). The present study examines the effects of four frequently used therapies on the communication of people with profound ID. Communication was assessed using five measures of positive communication and five measures of negative communication. The therapies assessed were Snoezelen, active therapy, relaxation and aromatherapy/hand massage. There were eight participants in the present study and each received all four of the therapeutic procedures in a counterbalanced design. Treatment procedures were videotaped at sessions 5, 10, 15 and 20, and later scored for defined measures of communication. Both Snoezelen and relaxation increased the level of positive communication and had some effect on decreasing negative communication. However, active therapy and aromatherapy/hand massage had little or no effect on communication. The lack of a no-treatment control is noted, especially in the light of trends seen at baseline. Considering the lack of generalization of therapeutic effects, the present results should be treated with caution. [source] Case Report of Cardiac Arrest, Abdominal Compartment Syndrome, and Thoracic Aortic Injury with Endovascular Repair of Thoracic Aortic TearJOURNAL OF CARDIAC SURGERY, Issue 4 2007Randy M. Stevens M.D. Currently, endografts are not FDA-approved for treating thoracic aortic injury (TAI). We report a case of TAI who presented in hemorrhagic shock and preoperative cardiac arrest who was successfully treated with large volume resuscitation, closed chest cardiac massage, exploratory laparotomy, and thoracic endografting. [source] Poly- l -lactic acid: a perspective from my practiceJOURNAL OF COSMETIC DERMATOLOGY, Issue 1 2008Neil S Sadick MD Summary Lipoatrophic sagging in the periorbital and cheek areas is a characteristic feature of the aging face. Soft tissue regeneration in these areas using a volumizer such as poly- l -lactic acid (PLLA) can help reduce the impact of these features. PLLA generates semipermanent correction, lasting for 2 years, and is a resorbable biocompatible device with a history of successful use in many clinical applications. This practice has administered many treatments of PLLA over the past 2 years with excellent results and with minimal complications. Minimization of adverse events and optimal cosmetic results are achieved when PLLA is diluted appropriately, injected in the proper plane and with posttreatment massage. The physician can fine-tune tissue volume correction with PLLA by spacing treatment sessions at least 4 to 6 weeks apart. Although approved for the correction of facial lipoatrophy in patients with human immunodeficiency virus, approval for the use of PLLA for cosmetic indications is currently pending. [source] Inhibition of elastase activity by essential oils in vitroJOURNAL OF COSMETIC DERMATOLOGY, Issue 4 2002Masahiro Mori Summary, Background, Essential oils are widely used, for example in aromatherapy and aroma massage. In aroma massage, essential oil, diluted with vegetable oil, is rubbed onto the skin. Components of essential oil penetrate into the skin and have an influence on the dermis. Elastase is an enzyme which degenerates dermal elastin. Elastase activity is believed to contribute to cutaneous wrinkling and ageing. Aim, To investigate the inhibitory effect of essential oils on elastase activity. Methods, Inhibition of elastase activity by various essential oils was assessed using two elastase enzymes: porcine pancreatic elastase (PPE) and human neutrophil elastase (HNE). Results, Elastase activity was inhibited by various essential oils, especially by those oils derived from lemons, juniper and grapefruit. Although the specific inhibitory component was not determined, lemon oil had the greatest inhibitory effect on PPE. Some essential oils also inhibited HNE. Conclusions, These studies demonstrate a possible rationale for the use of essential oil massage as a preventive treatment for cutaneous wrinkling and ageing. [source] Pressure ulcer prevention in intensive care patients: guidelines and practiceJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2009Eman S. M. Shahin BSc MSc RN PhD Abstract Background, Pressure ulcers are a potential problem in intensive care patients, and their prevention is a major issue in nursing care. This study aims to assess the allocation of preventive measures for patients at risk for pressure ulcers in intensive care and the evidence of applied pressure ulcer preventive measures in intensive care settings in respect to the European Pressure Ulcer Advisory Panel (EPUAP) and Agency for Health Care Policy and Research (AHCPR) guidelines for pressure ulcer prevention. Design, The design of this study was a cross-sectional study (point prevalence). Setting, The study setting was intensive care units. The sample consisted of 169 patients , 60 patients from surgical wards, 59 from interdisciplinary wards and 50 from medical intensive care wards. Results, The study results revealed that pressure reducing devices like mattresses (alternating pressure air, low air loss and foam) are applied for 58 (36.5%) patients, and all of these patients are at risk for pressure ulcer development. Most patients receive more than one nursing intervention, especially patients at risk. Nursing interventions applied are skin inspection, massage with moisture cream, nutrition and mobility (81.8%, 80.5%, 68.6% and 56.6%) respectively. Moreover, all applied pressure ulcer preventive measures in this study are in line with the guidelines of the EPUAP and AHCPR except massage which is applied to 8.8% of all patients. Conclusions, The use of pressure reducing devices and nursing interventions in intensive care patients are in line with international pressure ulcer guidelines. Only massage, which is also being used, should be avoided according to the recommendation of national and international guidelines. [source] Improvement in arm and post-partum abdominal and flank subcutaneous fat deposits and skin laxity using a bipolar radiofrequency, infrared, vacuum and mechanical massage deviceLASERS IN SURGERY AND MEDICINE, Issue 10 2009Lori Brightman MD Abstract Background and Objectives Skin laxity of the body is a growing cosmetic concern. Laxity can result from chronological or photoaging and changes in body dimensions during pregnancy or weight loss. The end result is loose, sagging skin, and localized fat deposits. Liposuction and abdominoplasty or brachioplasty are established approaches to these issues. Patient desire for alternatives to surgical correction has spawned the development of non-invasive body contouring devices. The combination of infrared light (IR), bipolar radiofrequency (RF), vacuum and mechanical massage (Velashape, Syneron Medical Ltd, Israel) has demonstrated efficacy in improving skin appearance and circumference of the thighs [Goldberg et al., Derm Surg 2008; 34:204,209; Fisher et al., Derm Surg 2005; 31:1237,1241; Arnoczky and Aksan, J Am Acad Orthop Surg 2000; 8:305,313; Alster and Tanzi, J Cosmetic Laser Therapy 2005; 7:81,85; Wanitphakdeedecha and Manuskiatti, J Cosmet Dermatol 2006; 5:284,288; Nootheti et al., Lasers Surg Med 2006; 38: 908,912], but only anecdotal evidence has supported its use on other anatomic locations. This study was designed to evaluate the efficacy and safety of Velashape on additional body sites and more rigorously examine the technology's impact on upper arm as well as abdominal and flank circumference. Study Design and Methods Subjects were 28,70 years old, skin types I,V. Nineteen subjects underwent 5 weekly treatments of the upper arms, and 10 subjects underwent 4 weekly treatments of the abdomen and flanks. Treatments were performed using Velashape. Circumference measurements, photographs, and subject weights were performed prior to treatment and at 1- and 3-month follow-ups. Subjects were asked to record their treatment satisfaction level. Results Change in arm circumference, at the 5th treatment was statistically significant with a mean loss of 0.625,cm. At 1- and 3-month follow-ups, mean loss was 0.71 and 0.597,cm respectively. Reduction of abdominal circumference at 3rd treatment was statistically significant with a 1.25,cm mean loss. At 1- and 3-month follow-ups, average loss was 1.43 and 1.82,cm respectively. Conclusions This study demonstrates with statistical significance, sustainable reduction in circumference and improvement in appearance of arms and abdomen following treatment with Velashape. Lasers Surg. Med. 41:791,798, 2009. © 2009 Wiley-Liss, Inc. [source] The impact of a new educational strategy on acquiring neonatology skillsMEDICAL EDUCATION, Issue 5 2002I Treadwell Overview A shortage of staff for teaching neonatology skills to large numbers of students, in small groups and following a new curriculum, necessitated an innovative educational strategy. This entailed the development and implementation of an interactive multimedia program (CD-ROM) to deliver information about skills and to demonstrate them. Methods Students had to study a specific skill using the CD-ROM and then practise in the Skills Laboratory, supported by lecturers who provided formative evaluation. Objectives The aims of this study were to assess the students' perspectives on the new strategy, and to compare the skills of students following the new curriculum to those of students following the traditional curriculum, who do not follow structured programmes on practical skills but experience a practical neonatology rotation. Results The evaluation of the CD-ROM program was very favourable. The majority of students still preferred live demonstrations but found the CD-ROM useful for revision purposes. With the exception of one skill, endotracheal intubation, the new curriculum students were found to be as competent as the students following the traditional curriculum and performed mask ventilation and cardiac massage significantly better than them. [source] Complementary and alternative medicine use in Gilles de la Tourette syndromeMOVEMENT DISORDERS, Issue 13 2009Katie Kompoliti MD Abstract The aim of this study was to describe the use of complementary and alternative medicine (CAM) in patients with Tourette syndrome (TS) and explore associations with CAM use. In recent years CAM use has increased, but rates of CAM use in TS patients are not reported. Consecutive TS patients or their parent(s), seen in an academic movement disorder center, completed a questionnaire regarding their use of CAM. One hundred TS patients or parents completed the questionnaire, mean age 21.5 ± 13.5, 76 males, 87 Caucasians. Sixty four patients had used at least one CAM modality. CAM treatments used were prayer (28), vitamins (21), massage (19), dietary supplements (15), chiropractic manipulations (12), meditation (10), diet alterations (nine), yoga (nine), acupuncture (eight), hypnosis (seven), homeopathy (six), and EEG biofeedback (six). Fifty six percent of patients using CAM reported some improvement. Users paid out of pocket for 47% of treatments pursued, and 19% of these payers received partial reimbursement by third party payer. Users and non-users did not differ in age, gender, race, income, educational level, general health, tic severity, medication use for TS, current satisfaction from medications or experience of side effects from medications. CAM use was associated with the presence of affective disorder (P = 0.004), but not with either ADHD or OCD. Among CAM users, 80% initiated CAM without informing their doctor. CAM is commonly used in children and adults with TS, and often without the neurologist's knowledge. Physicians should inquire about CAM to understand the spectrum of interventions that patients with TS use. © 2009 Movement Disorder Society [source] Carotid Sinus Hypersensitivity is Common in Patients Presenting with Hip Fracture and Unexplained FallsPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2009M.Sc., VASILEIOS SACHPEKIDIS M.D. Background:We tried to determine the prevalence of carotid sinus hypersensitivity (CSH) in patients with hip fractures with and without a clear history of an accidental fall. Methods:We studied 51 patients hospitalized for a hip fracture and 51 matched controls from our outpatients department. All patients were subjected to a carotid sinus massage in the supine and upright position. Patients were categorized in accidental (Group A) and unexplained (Group B) fallers. Results:Six of 33 (18.2%) patients in Group A and 12 of 18 (66.7%) patients in Group B (P < 0.001) had a positive response to the carotid sinus massage. Nine controls (17.6%) also demonstrated CSH. Patients in Group B were older (A: 75.5 ± 8.5 years vs B: 80.1 ± 5.9 years, P =0.029) and were more likely to have a history of unexplained falls or syncope in the past (A: 0% vs B: 66.7%, P < 0.0001) than individuals in group A. Vasodepressor/mixed forms accounted for the majority of CSH responses in Group B (75%). When compared with the control group, CSH was still more common in Group B (B: 66.7% vs control: 17.6%, P < 0.0001) but not in Group A (A: 18.2% vs control: 17.6%, P =1.000). Conclusions:The prevalence of CSH is increased in elderly patients with hip fractures, only in those who present with an unexplained fall and report a history of syncope or unexplained falls in the past. The vasodepressor/mixed forms account for the majority of CSH responses in the group of unexplained fallers. [source] An Unusual Complication of Sinus Arrest Following Right-Sided Stellate Ganglion Block: A Case ReportPAIN PRACTICE, Issue 3 2004Ashok K. Saxena MD Abstract: We present a case of a 29-year-old female patient who had presented to us for the management of her chronic right shoulder,hand pain and developed a sinus arrest following a right-sided stellate ganglion block (RSGB). This patient on receiving a diagnostic RSGB via the anterior paratracheal (C6) approach developed sinus arrest followed by apnea and unconsciousness. On institution of resuscitative measures involving tracheal intubation, positive pressure ventilation, cardiac massage, and intravenous atropine, spontaneous cardiac activity recovered in about 3 minutes. Other signs and symptoms resolved fully in a total of 10 minutes. She had persistent postural hypotension lasting for about 24 hours requiring bed rest and was discharged about 36 hours after the procedure, without any adverse sequelae. As the sinus node is supplied by the right-sided sympathetic chain, its blockade probably resulted in unopposed parasympathetic activity leading to asystole. Available evidence of the role of right stellate ganglion in regulation of cardiac electrophysiology and functioning is also discussed. [source] Bradycardia and asystolic cardiac arrest during spinal anaesthesia: A report of five casesACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2000R. Z. Løvstad Sudden, severe bradycardia/asystolic cardiac arrest are considered infrequent, but are certainly the most serious complications of spinal anaesthesia. We report four cases of primary asystole and one of severe bradycardia in young to middle-aged, healthy patients scheduled for minor surgery at the day surgery unit. Bradycardia/asystole were not related to respiratory depression or hypoxaemia/hypercarbia; they occurred at different time intervals after the onset of spinal anaesthesia (10,70 min) and, apparently, were not dependent on the level of sensory block, which varied between T3 and T8. One patient was nauseated seconds before the asystole, otherwise there was no warning signs. All the patients were easily resuscitated with the prompt administration of atropine and ephedrine and, in the case of cardiac arrest, cardiac massage and ventilation with oxygen. One patient was treated with a small dose of adrenaline. Four patients had the surgery, as planned; one had the surgery postponed. All the patients were discharged from hospital in good health and did not suffer any sequelae. [source] Choice of treatment modalities was not influenced by pain, severity or co-morbidity in patients with knee osteoarthritisPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2010Gro Jamtvedt Abstract Background and Purpose.,Patients with knee osteoarthritis (OA) are commonly treated by physiotherapists in primary care. The physiotherapists use different treatment modalities. In a previous study, we identified variation in the use of transcutaneous electrical nerve stimulation (TENS), low level laser or acupuncture, massage and weight reduction advice for patients with knee OA. The purpose of this study was to examine factors that might explain variation in treatment modalities for patients with knee OA.,Methods.,Practising physiotherapists prospectively collected data for one patient with knee osteoarthritis each through 12 treatment sessions. We chose to examine factors that might explain variation in the choice of treatment modalities supported by high or moderate quality evidence, and modalities which were frequently used but which were not supported by evidence from systematic reviews. Experienced clinicians proposed factors that they thought might explain the variation in the choice of these specific treatments. We used these factors in explanatory analyses.,Results.,Using TENS, low level laser or acupuncture was significantly associated with having searched databases to help answer clinical questions in the last six months (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.08,3.42). Not having Internet access at work and using more than four treatment modalities were significant determinants for giving massage (OR = 0.36, 95% CI = 0.19,0.68 and OR = 8.92, 95% CI = 4.37,18.21, respectively). Being a female therapist significantly increased the odds for providing weight reduction advice (OR = 3.60, 95% CI = 1.12,11.57). No patient characteristics, such as age, pain or co-morbidity, were significantly associated with variation in practice.,Conclusions.,Factors related to patient characteristics, such as pain severity and co-morbidity, did not seem to explain variation in treatment modalities for patients with knee OA. Variation was associated with the following factors: physiotherapists having Internet access at work, physiotherapists having searched databases for the last six months and the gender of the therapist. There is a need for more studies of determinants for physiotherapy practice. Copyright © 2009 John Wiley & Sons, Ltd. 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