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This study aimed to compare the effectiveness of CWI and passive recovery on indicators of fatigue in handball players after three consecutive days of competition. The study was applied to 41 handball players belonging to 8 handball clubs in Costa Rica (20 men and 21 women; 20.1 ± 4.08 years; weight, 68.03 ± 13.13 kg; VO2max= 42.40 ± 5.31 ml / kg / min). Four teams were selected and randomly assigned one of the two post-game treatments, one group received immersion and another passive rest, it was developed during a handball tournament of three consecutive days on a 20x40m field. Each team played one game per day with two periods of 30 min. No significant differences were found in tensiomyography, CMJ, DOMS, TQR and CK between the treatment group and the recovery group. It is concluded that CWI seems to be more effective than PR in variables such as DOMS and in Recovery Perception and the combination of different recovery methods should be analyzed in future research to better understand which the best strategies are to accelerate recovery of athletes during competitions

INTRODUCTION: Many options for anogenital warts (AGWs) treatment are available. Recently, trichloroacetic acid (TAA) and liquid nitrogen (LN) began to be associated to treat AGWs. METHODS: Randomized, parallel, controlled clinical trial involving patients with penile AGWs. Patients were treated with LN, TAA, or their combination and reevaluated after 28 days. RESULTS: Among therapy with TAA, LN, and their combination, the clearance rate was 22.9% (95% CI: 8.6%-34.3%), 46.2% (95% CI: 30.8%-59.0%), and 25.7% (95% CI: 11.4%-37.2%), respectively. DISCUSSION: All therapeutic options were effective. Though, there was no statistically significant difference between the groups.

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Introduction: Mucositis is one of the main complications of cancer treatment, associated with several nutritional limitations and the ability to cause secondary infections. Cryotherapy is a low-cost treatment consistent with clinical practice guidelines for treating patients with mucositis. Objective: To develop and evaluate the acceptance of ice cream for the prevention and treatment of mucositis and nutritional support of pediatric cancer patients. Method: Based on knowledge about the side effects of chemotherapy (especially in oral and gastrointestinal mucositis) and the nutritional needs of pediatric cancer patients, a literature search for ingredients that could meet the study’s objectives was undertaken. Food Technology Laboratory of the São Paulo State University (Unesp), Botucatu campus, and in partnership with Sorvetes Naturais ice cream shop in the municipality of Botucatu-SP, produced the ice cream. An acceptance test was applied in ten patients undergoing cancer treatment and 30 individuals in the control group using the 5-point mixed facial hedonic scale. Results: The final formula consisted of semi-skimmed lactose-free milk, extra virgin coconut oil, oat flour, honey, chamomile, Fortini® food supplement, demerara sugar, and stabilizer/emulsifier. 90% of patients undergoing cancer treatment rated the final product as “liked” or “loved it,” compared to 63% of the control group. Conclusion: Development of an ice cream that met the objectives of the study was possible through the choice of its composition. Honey and chamomile can favor the prevention of mucositis, and other ingredients offer the caloric density and protein supply.

Copyright of Revista Andaluza de Medicina del Deporte is the property of Centro Andaluza de Medicina del Deporte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cryosurgery is a technique widely known and used among dermatologists. Intralesional application is already used to treat keloids and has the advantage of restricting the zone of action of low temperatures of liquid nitrogen. The use of contact cryosurgery in vascular lesions is well reported in the literature, but there are no intralesional technique publications on these types of lesions. Here, we report two cases, one of port-wine stain hamartomas in a 61-year-old patient and another of a cherry angioma in a 70-year-old patient, safely and satisfactorily treated with intralesional cryosurgery.

ABSTRACT Studies have described the use of electrophysical agents (EPA) by physical therapists worldwide. However, the use of EPA by Brazilian physical therapists remains undetermined. This study aims to describe the availability, use, and perception about EPA by orthopedic and sports physical therapists in Brazil. Professionals of the area were invited to answer an online questionnaire. Demographic data and information regarding the availability, use and perception about EPA in their current clinical practice were asked. Out of 376 physical therapists included in this study, 89% declared to use EPA in clinical practice. Sensory electrotherapy with pulsed current (TENS), therapeutic ultrasound, excitomotor electrotherapy with pulsed current (FES/NMES), and cryotherapy are available for more than 3/4 of interviewees. Scientific articles and clinical experience, respectively, are the most influential factors for the choice of EPA. Ultrasound is the most frequently used EPA, followed by TENS, cryotherapy, photobiomodulation, hot packs, and FES/NMES. The top-five most useful EPA in clinical practice chosen by physical therapists are: (1) ultrasound; (2) photobiomodulation; (3) TENS; (4) cryotherapy; and (5) FES/NMES. In conclusion, EPA are widely used by orthopedic and sports physical therapists in Brazil. Therapeutic ultrasound, TENS, FES/NMES, photobiomodulation, cryotherapy, and hot packs are the most used EPA in clinical practice of these physiotherapists.

ABSTRACT While solving the problem of sport horses’ pathologies it is important to choose safe and environmentally friendly methods, including cryotherapy, which is the topic of our research. The use of cryotherapy is a promising means of treatment of primary injury, rehabilitation in post-traumatic conditions and in chronic injuries. Prospects of cryotherapy applications in horse breeding, in particular in sports and prize areas, were researched. It was found out that modern sport horses training and their involvement in competitions is associated with serious stress on their locomotor system and maximum mobilization of all body systems, which overstrains certain muscle groups, determines increased probability and severity of injury incidence, reduction of sport longevity and worse performance in competitions.

Copyright of Fisioterapia Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Brasileira de Prescrição e Fisiologia do Exercício is the property of Instituto Brasileiro de Pesquisa e Ensino em Fisiologia do Exercicio and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aimed to verify the effects of cryotherapy and kinesiotherapy on wrist range of motion (ROM) in spastic hemiparetic patients. The sample of this randomized controlled clinical trial consisted of 12 volunteers with a clinical diagnosis of chronic stroke, of both genders, in the age group between 40 and 80 years, with spastic hemiparesis of the upper limb, randomly divided into: Group A (GA n = 6), submitted to kinesiotherapy and Group B (GB n = 6), submitted to cryotherapy and kinesiotherapy. Active wrist flexion and extension of the paretic upper limb were assessed by manual goniometry. For data analysis, the Shapiro-Wilk and Student's "t" tests were used, with a significance level of p= 0.05. There was an increase in wrist flexion and extension ROM in both groups, maintained for one month after the end of the treatment, with the exception of Group A, which presented a reduction in wrist flexion ROM one month after the end of the proposed treatment. Comparing the groups, it was observed that there was no difference between them. The proposed treatments were able to increase wrist ROM in the studied population, with no difference between the groups. [ABSTRACT FROM AUTHOR]

Objective: to evaluate the effect of oral cryotherapy compared to physiological serum on the development of oral mucositis in outpatient cancer patients using the 5-fluorouracil antineoplastic agent. Method: this is a controlled, randomized, double-blind, and multi-center clinical trial, conducted with 60 patients undergoing chemotherapy. The experimental group (n=30) used oral cryotherapy during the infusion of the 5-FU antineoplastic agent, while the control group (n=30) performed mouthwash with physiological serum at their homes. The oral cavity of the participants was assessed at three times: before randomization, and on the 7th and 14th days after using 5-FU. For data analysis, descriptive analyses and the ANOVA, paired t, and McNemar tests were used. Results: there was no statistically significant difference between the experimental and control groups in the assessments regarding the grade of mucositis. However, cryotherapy presented the chance to reduce the presence of intragroup mucositis, between the first and second assessments (p=0.000126). Conclusion: cryotherapy did not obtain statistical significance in relation to oral hygiene with serum, but it proved to be effective intragroup. Record number: RBR-4k7zh3

ABSTRACT OBJECTIVES To determine the efficacy and safety of the use of cryotherapy, cold knife or thermocoagulation compared to Loop Electrosurgical Excision Procedure (LEEP) for the treatment of cervical intraepithelial neoplasia. METHODS Systematic review with meta-analysis of randomized controlled trials in women with cervical intraepithelial neoplasia undergoing treatment with cryotherapy, cold knife, or thermo-coagulation compared with LEEP, to estimate its efficacy and safety. The search was conducted on MEDLINE/PUBMED, Cochrane Central Register of Controlled Trials (CENTRAL) and Scopus, until September 2018. RESULTS The total of 72 studies were identified, of which only 8 studies met the inclusion criteria. The treatment of CIN with cold knife decreases the risk of residual disease compared with LEEP (RR, 0.54, 95%CI, 0.30–0.96, p = 0.04). The management of premalignant lesions with cryotherapy, compared with LEEP, increases the risk of disease recurrence by 86% (RR, 1.86, 95%CI, 1.16–2.97, p = 0.01), increases the risk of infections (RR, 1.17, 95%CI, 1.08–1.28, p < 0.001) and reduces the risk of minor bleeding by 51% (RR, 0.49, 95%CI) %, 0.40–0.59, p ≤ 0.001). CONCLUSIONS The treatment of premalignant lesions of cervical cancer with cold knife reduces the risk of residual disease. Nevertheless, cryotherapy reduces the risk of minor bleeding in the 24 hours after treatment and increases the risk of recurrence of disease and infections.

In general, different training practice times may be associated with altered neuromuscular response in athletes during periods of acute fatigue and in response to post-effort recovery methods. The present investigation was purposed to analyze the electromyographic performance of knee extensor muscles after fatigue and cold-water immersion in university athletes with different practice times. Participants (n=24) were divided into two groups according to practical experience: G1 (6.60±0.70 years) and G2 (11.57±0.44 years); electromyography procedures were performed during an isometric knee extensor exercise. There were no differences in the comparisons between groups (p>0.05). Considering the moment of analysis, root mean square (RMS) measurements of the vastus lateralis and vastus medialis muscle were higher at the post-cryotherapy moment, when compared to the initial and post-exhaustion moments (p<0.001). No changes were observed in relation to muscle strength. In conclusion, neuromuscular performance of knee extensor muscles was not affected by the history of sports practice in university athletes. [ABSTRACT FROM AUTHOR]

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Abstract Introduction Systematic reviews that evaluate the perineal cryotherapy to reduce pain in the vaginal postpartum are inconclusive. Purpose To evaluate clinical effectiveness of cryotherapy in the management of humanized postpartum perineal pain and vaginal edema. Methods A double-bind randomized controlled clinical trial (UTN number: U1111- 1131-8433) was conducted in a hospital in Northeastern, Brazil.Women were included following humanized childbirth. All had vaginal deliveries of a single, full-term pregnancy with cephalic presentation. Exclusion criteria included previous perineal lesion, episiotomy during the current delivery, instrumental delivery, uterine curettage and postpartum hemorrhage. In the experimental group, an ice pack was applied six times on the perineum for 20 minutes, reducing the temperature between 10 and 15° C, then 60 minutes without exposure to cold. In the non-cryotherapy, a water bag unable to reduce the temperature to this extent was used, compliance with the same application protocol of the first group. Perineal temperature wasmonitored at zero, 10 and 20 minutes for application in both groups. Evaluations were made immediately before and after the applications and 24 hours after delivery spontaneous, to determine the association between variables. Results A total of 80 women were included in the study, 40 in each group. There was no significant difference in scores of perineal pain and edema between the groups with or without cryotherapy until 24 hours after childbirth. There was no difference between groups when accomplished repeated measures analysis over the 24 hours after delivery, considering the median perineal pain (p = 0.3) and edema (p = 0.9). Perineal cryotherapy did not influence the amount of analgesics used (p = 0.07) and no adverse effect was registered. Conclusion The use of cryotherapy following normal vaginal delivery within the concept of humanized minimally interventionist childbirth had no effect on perineal pain and edema, since it was already substantially lower, nor the need for pain medicaments.

Abstract Actinic keratoses are premalignant lesions of the skin caused by excessive sun exposure. Lesions may become mainly squamous cell carcinoma. Cryotherapy with liquid nitrogen is one of the main treatments. In order to evaluate the response of actinic keratosis to cryotherapy by histopathology, two lesions were selected in each of 14 patients with multiple actinic keratoses. In one lesion a biopsy was performed and in the other lesion a biopsy was performed after cryotherapy. Subsequently, both biopsies were compared histologically. Of the thirteen patients who completed the study, the best results were obtained in lesions undergoing cryotherapy concerning the atypia of keratinocytes, epithelial thickness and corneal layer and lymphocytic infiltrate. Despite the small number of patients, it was concluded that, if performed correctly, cryotherapy has high efficacy in the treatment of actinic keratoses.

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Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study compared the thermal changes of cutaneous and subcutaneous tissues exposed to different aerosols. Thirty-six adults Wistar rats were arranged in two treatment groups, one exposed to methyl salicylate (GSM; n = 9 skin and n = 9 subcutaneous) and the other exposed to diclofenac diethylammonium (GDD; n = 9 skin and n = 9 subcutaneous) aerosols. Five jets were applied for one-second through an apparatus to reduce spray dispersion (3 cmdiameter) in the lateral left thigh of the animals. Temperatures were measured every minute (min.) during 30 min., with a digital thermometer. In the skin tissue the sensor was positioned manually, in the subcutaneous tissue it was surgically inserted through the rear face and positioned in the lateral thigh. The skin temperature has homogeneously reduced in both groups. In the subcutaneous tissue the GDD has induced hypothermia from the 2nd to 20th min., the lowest temperature was recorded on the 7th min. (-3.6 ± 0.2ºC in relation to basal). Lowering the temperature by GSM took place from the 1st to 21st min, and the lowest temperature occurred on the 1st min (-9.7 ± 0.5ºC in relation to basal). In the three initial minutes the GSM had temperatures 25, 10 and 5% lower than the GDD. Aerosols have induced hypothermia in the tissues, while the GSM has decreased faster and reached lower values of temperature shown in the subcutaneous tissue.

BACKGROUND: Genital warts are caused by human papillomavirus infection and represent one of the most common sexually transmitted diseases. Many infections are transient but the virus may recur, persist, or become latent. To date, there is no effective antiviral treatment to eliminate HPV infection and most therapies are aimed at the destruction of visible lesions. Potassium hydroxide is a strong alkali that has been shown to be safe and effective for the treatment of genital warts and molluscum contagiosum. Cryotherapy is considered one of the most established treatments for genital warts. No comparative trials have been reported to date on the use of potassium hydroxide for genital warts. OBJECTIVE: A prospective, open-label, randomized clinical trial was conducted to compare topical potassium hydroxide versus cryotherapy in the treatment of genital warts affecting immunocompetent, sexually active men. METHODS: Over a period of 10 months, 48 patients were enrolled. They were randomly divided into two groups and selected on an alternative basis for either potassium hydroxide therapy or cryotherapy. While response to therapy did not differ substantially between both treatment modalities, side effects such as local pain and post-treatment hypopigmentation were considerably more prevalent in the groups treated using cryotherapy. Result: In our study, potassium hydroxide therapy proved to be at least as effective as cryotherapy and offered the benefit of a better safety profile. CONCLUSION: Topical 5% potassium hydroxide presents an effective, safe, and low-cost treatment modality for genital warts in men and should be included in the spectrum of therapies for genital warts.

Introduction: Defined as a therapeutic procedure for application of local cold. The cryotherapy is used both for the treatment of lesions causing local analgesia, reducing edema, reducing inflammation; and for improving physical performance as a method to enhance recovery post workouts. Objective: The objective of this literature review was to determine how many articles have studied the use of cryotherapy for improved physical performance and and how to treatment of injuries, as well as analyzing the methods of application of cryotherapy, objectives and results. Materials and Methods: Was used as database virtual library SciELO.org, with the search word "cryotherapy", the results were analyzed in this way the work chosen should meet the criteria. Results: The selected articles were characterized and organized into two frames as: author, sample, cryotherapy (application method); goal and results. Discussion: This study showed that there are five studies that investigated the use of cryotherapy for improved physical performance and eight studies that investigated the use of cryotherapy for the treatment of muscle injuries, joint or bone. Conclusion: Few studies found that examined the effects on improvement in physical performance and injury treatment, cryotherapy was shown as a way beneficial to analgesic, and decrease pain in the treatment of injuries, the studies that assessed for improvement in physical performance demonstrated that there is an efficient way to obtain the expected results.

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The aim of this study was to analyze the effects of the contrast technique on lactate plasmatic concentration during post-exercise recovery in volleyball athletes. For this study, 18 volleyball players between 17 and 18 years old were included. The volunteers were randomly divided into two groups, Control Group (CG) and Treated Group (TG). The CG was submitted to a hyperlactacidemic induction protocol, immediately after which they remained seated at rest for 25 min. The TG performed the same protocol and then they were submitted to a contrast treatment for 16 min. The following respective lactate values were observed in the CG and TG groups at the moments rest, POST-5, POST-15 and POST-25 min of effort: 1.97±0.3 vs 1.63±0.6 mmol/L; 8.75±1.5 vs 7.35±4.1 mmol/L; 8.53±1.6 vs 5.3±1.9 mmol/L and 6.87±2.1 vs 3.33±1.47 mmol/L. It was concluded that the contrast technique was efficient to remove blood lactate in volleyball players. [ABSTRACT FROM AUTHOR]

Introduction: spasticity can be defined as an exacerbation of deep reflections resulting from hyper excitability of the stretch reflex muscle tone by the increase of speed. The thermotherapy and cryotherapy are therapeutic resources that have physiological effects that may decrease spasticity. Objective: this study aimed to evaluate thermal resources of cryotherapy and superficial heat in reducing spasticity in stroke sequela patients. Method: 36 patients were randomized allocated in two groups: CRYO group (n = 17) consisted of the application of ice packs of 1.5 kg, on spastic muscle, for 25 minutes; IV group (n = 19) consisted of performing surface heat by infrared radiation lamp application using a distance of 45 centimeters for 25 minutes in spastic region. Results and Discussion: the results showed statistically significant differences between pre and post application (p<0.001) in the active and passive ROM. However, regarding the comparison between the resources, there was no statistically significant difference between cryotherapy and thermotherapy, p = 0.427, ADM active and p = 0.09, passive ROM. Conclusion: both employed therapeutic techniques (heat and cold) had efficacy in the treatment of spasticity in patients with stroke sequela, with no predominance of the physiological effects of the therapeutic resources. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Occupational Therapy of University of São Paulo / Revista de Terapia Ocupacional da Universidade de São Paulo is the property of Revista de Terapia Ocupacional da USP and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the acute effect of cryotherapy and short-wave diathermy on flexibility and muscle strength in the hamstrings of young women. Materials and Methods: Forty-five volunteers were randomized into a control group, a cryotherapy group and a short-wave diathermy group. The subjects underwent a single session of cryotherapy or short-wave diathermy. Flexibility through the Wells bench and the active knee-extension end range and muscle strength through dynamometry were assessed pre and post treatment. The variables were analyzed through the Student t test and ANOVA. Results: A significant increase in the hamstring flexibility was found using both the Wells bench (24.50±6.88 cm to 26.87±8.02 cm) (p=0.002) and the active knee-extension end range (162.60±7.76 degrees to 165.53±6.38 degrees) (p=0.015) in the diathermy group. The cryotherapy group showed improvement in flexibility with the Wells bench test (23.27±6.33 cm to 25.53±6.13 cm) (p=0.002). No change was observed in the hamstring muscle strength in either treatment group. The control group showed no difference in any of the variables. No differences were observed between groups. Conclusion: Both short-wave diathermy and cryotherapy acutely improved hamstring flexibility in healthy young women. Thermotherapy by shortwave diathermy was more effective in this case. Both procedures had no effect on the force produced by the hamstring muscle. [ABSTRACT FROM AUTHOR]

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OBJETIVO: Avaliar a efetividade da crioterapia no pós-operatório imediato de reconstrução do ligamento cruzado anterior (LCA), em relação à redução da dor e melhora da amplitude de movimento (ADM) do joelho. MÉTODOS: Trata-se do estudo piloto de um ensaio clínico prospectivo randomizado. Os pacientes (n=25) foram randomizados em dois grupos: (A) Grupo Intervenção (n=10) que realizou um protocolo fisioterapêutico e fez uso do gelo por 20 minutos, duas vezes ao dia; e o Grupo (B) Controle (n=9), que realizou o mesmo protocolo, duas vezes ao dia. A intensidade da dor foi avaliada pela Escala Análoga Visual e a ADM pela goniometria. RESULTADOS: O Grupo (A) Intervenção obteve melhora absoluta e percentual quando comparado ao (B) Controle, tanto para os parâmetros de dor, ADM de flexão e extensão do joelho. CONCLUSÃO: A crioterapia no pós-operatório imediato de reconstrução do LCA foi efetiva para melhorar a dor e a ADM do joelho. Nível de Evidência I, Estudo Clínico Randomizado.OBJECTIVE: The purpose of this study was to evaluate cryotherapy effectiveness in the immediate postoperative period of ACL reconstruction to improve pain and range of motion (ROM) of the knee. METHODS: This is a pilot study of a prospective and randomized clinical trial. Patients (n=25) were divided into two groups: Intervention (A) group (n=10): patients were submitted to an inpatient physical therapy protocol and received ice compress for 20 minutes, twice a day; Control (B) group (n=9): patients had the same protocol, twice a day. The pain intensity was evaluated with the visual analogic scale (VAS) and range of motion was measured with a goniometer. RESULTS: The Intervention (A) group had important absolute and percentual improvement when compared with the Control (B) group regarding measures of pain and knee flexion/extension ROM. CONCLUSION: Cryotherapy in the immediate postoperative period of ACL reconstruction was effective to improve pain and range of motion of the knee. Level of Evidence I, Randomized Clinical Trial.

Tumor benigno de tecido muscular, o piloleiomioma tem origem no músculo eretor do pelo, atingindo ambos os sexos geralmente na terceira década de vida. Apresenta-se como nódulo-pápulas assimétricas nas extremidades, de cor eritêmato-acastanhada e de consistência firme. As lesões, quando múltiplas, podem ser sensíveis ou dolorosas. Sua associação com miomas uterinos, denominada de síndrome de Reed ou leiomiomatose cutis et uteri, é apresentação rara, podendo estar associada a carcinoma de células renais. A abordagem é cirúrgica em casos isolados e medicamentosa se houver sintomas. Relatamos um caso de síndrome de Reed em que se optou por acompanhamento pela ausência de sintomatologia.Piloleiomyoma, a benign smooth-muscle tumor arising from the arrectores pilorum muscles of the skin, affects males and females in the third decade of life. It presents as asymmetrical, reddish-brown nodules or papules with a firm consistency, predominantly located on the limbs. When multiple lesions are present, they may be tender or painful. Their association with uterine fibroids, referred to as Reed syndrome or familial leiomyomatosis cutis et uteri, is rare and may be associated with renal cell carcinoma. The approach consists of surgical excision in cases presenting few lesions and pharmacological treatment if symptomatic. The present paper describes a case of Reed syndrome in which a decision was made to monitor the patient in view of the absence of symptoms.

CONTEXTO: O tratamento endovascular da doença arterial obstrutiva periférica apresenta baixa morbidade e mortalidade, no entanto, a perviedade dos stents a médio e longo prazo ainda é controversa. A crioplastia foi desenvolvida para reduzir os grandes desafios da angioplastia: dissecção, retração e reestenose. OBJETIVO: Avaliar os resultados clínicos e a perviedade a médio prazo em pacientes submetidos à técnica de crioplastia da doença arterial do território femoro-poplíteo. MÉTODOS: Pacientes com indicação de revascularização de membro inferior por técnica endovascular do território femoro-poplíteo, segundo as classificações clínicas de Fontaine e Rutherford e classificações anatômicas do TASC II, foram submetidos à crioplastia com cateter balão PolarCath®. No seguimento, foram avaliadas as manifestações clínicas e perviedade anatômica pelo duplex scan. RESULTADOS: Dez pacientes foram submetidos à angioplastia do território femoro-poplíteo utilizando a técnica de crioplastia. Nove pacientes apresentavam quadro clínico de claudicação limitante do membro inferior e um paciente apresentava úlcera isquêmica, três pacientes apresentavam lesão classe B pelo TASC II e sete pacientes, classe A. Sucesso técnico angiográfico inicial foi obtido em todos os casos, sendo que um caso necessitou do implante de stent devido à dissecção. Seguimento foi realizado em 9 pacientes, por período médio de 31,6 meses (28-35), com perviedade primária de 77,7% e perviedade secundária de 100%. Todos os pacientes apresentam-se assintomáticos no final do seguimento (Fontaine I). CONCLUSÕES: A crioplastia do território femoro-poplíteo é um método seguro, de baixa morbidade, com resultados a curto e médio prazo comparáveis à angioplastia convencional e com potencial de reduzir as taxas de dissecção e retração durante o procedimento, e redução do grau de reestenose a médio e longo prazo.BACKGROUND: Endovascular treatment of peripheral arterial disease (PAD) presents low morbidity and mortality rates; however, mid and long-term patency rates remain controversial. Cryoplasty was developed as an attempt to resolve the main problems related to angioplasty: dissection, recoil and restenosis. OBJECTIVE: To evaluate clinical results and mid-term patency in patients treated with cryoplasty of femoropopliteal arterial disease. METHODS: Patients with indication for endovascular lower limb revascularization according to Fontaine and Rutherford clinical classifications and to TASC II anatomical classification underwent cryoplasty using the PolarCath® peripheral dilatation balloon catheter. Clinical results and anatomical patency were analyzed by duplex ultrasound scan at follow-up, RESULTS: Ten patients with femoropopliteal arterial disease were treated with cryoplasty. Nine patients presented with intermittent claudication and one patient had an ischemic ulcer. Three patients had class B lesions and seven patients had class A lesions according to the TASC II. Initial technical success was achieved in all patients, and one patient needed stenting during the procedure due to dissection. One patient died due to complications in the postoperative period. Nine patients were followed up for 31.6 months on average (18-35), with primary patency rate of 77.7% and secondary patency rate of 100%. All patients were asymptomatic at the end of this period (Fontaine stage I). CONCLUSIONS: Cryoplasty is a safe technique for the treatment of femoropopliteal arterial disease that presents low morbidity rates, short-term and mid-term results comparable to conventional angioplasty, as well as potential advantages of lower dissection, recoil and mid-term restenosis rates.

Introducción: La crioterapia es útil en el manejo de las lesiones músculo esqueléticas, debido a los efectos derivados del enfriamiento tisular, sin embargo, pocos estudios han evaluado la efectividad de distintas modalidades de crioterapia para mantener el enfriamiento después de la aplicación y los efectos de la actividad post-enfriamiento sobre la recuperación de la temperatura. Objetivo: Comparar los efectos de tres modalidades de crioterapia y de la actividad post-enfriamiento, sobre la recuperación de la temperatura de la piel. Métodos: Estudio experimental con 36 sujetos sanos aleatorizados en tres grupos: paquete de hielo, inmersión en agua helada o criomasaje. Las modalidades se aplicaron por 15min en la pantorrilla. Posteriormente, cada grupo se subdividió aleatoriamente en reposo o marcha seguida de reposo. Para el análisis se aplicaron t de student apareda y ANOVA de mediciones repetidas (α=0,05). Resultados: Las tres modalidades disminuyeron la temperatura de la piel, con un efecto mayor causado por el criomasaje (-27,6°C). Durante el recalentamiento los tres grupos aumentaron la temperatura, independientemente de la actividad post-enfriamiento (pIntroduction: Cryotherapy is useful in the management of muscle-skeletal injuries, due to the effects of tissue cooling; however, few studies have evaluated the effectiveness of diferents forms of cryotherapy to maintain cooling after application and the effects of post-cooling activity on the recovery on the skin temperature. Objectives: To compare the effects of three modalities of cryotherapy on the skin temperature (ST) and its variation during the rewarming, under two different activities. Methods: An experimental study with 36 subjects randomly allocated to either three groups: crushed ice pack (CI), massage with ice (MI) or ice-water immersion (WI), these modalities were applied for 15min in the calf. Subsequently each group was subdivided randomly in: rest or gait followed by rest. For the analysis a paired Student's t test and ANOVA for repeated measurements were applied with α=0.05. Results: The three modalities decreased skin temperature, with a greater effect caused by MI (-27.6°C). During rewarming the three groups increased temperature, regardless the activity post-cooling (P

FUNDAMENTOS: O criopeeling utiliza a crioterapia difusa não somente nas lesões de ceratose actínica, mas em toda a pele fotodanificada. OBJETIVOS: Comparar dois métodos de criopeeling (nitrogênio líquido e sistema portátil de éter dimetílico, propano e isobutano) quanto à eficiência no tratamento de ceratoses actínicas, tolerabilidade do paciente, preferência do paciente e do pesquisador e resultado estético. MÉTODOS: Dezesseis pacientes (n=16) com múltiplas ceratoses actínicas nos antebraços foram submetidos ao criopeeling com nitrogênio líquido em um dos antebraços e com o sistema portátil no outro, randomicamente. RESULTADOS: No tratamento das ceratoses actínicas, o nitrogênio líquido obteve 74% de eficiência e o sistema portátil, 62% (p=0,019). A média da escala visual analógica (0-10) foi 5,7±1,61 com o nitrogênio líquido e 4,3±1,44 com o sistema portátil (p=0,003). Não houve diferença estatística entre os métodos quanto à preferência do paciente e do pesquisador. Na análise das fotos, observou-se melhora do aspecto da pele nos dois tratamentos (p0,05). CONCLUSÕES: A técnica de criopeeling pode ser uma opção no tratamento de fotodano. O sistema portátil pode ser uma alternativa interessante na prática clínica, com boa tolerância e resultados aceitáveis no tratamento de ceratoses actínicasBACKGROUND: Cryopelling uses diffuse cryotherapy not only on lesions of actinic keratosis but all over the photodamaged skin. OBJECTIVES: The aim of this study was to compare two cryopeeling methods (liquid nitrogen- LN and portable system - PS) and demonstrate their efficiency in the treatment of actinic keratoses, patient tolerance, researcher and patient preference and aesthetic results. METHODS: Sixteen patients (N = 16) with multiple actinic keratoses on the forearms were subjected to cryopeeling with LN on one of the forearms and PS on the other, randomly. RESULTS: In the treatment of actinic keratoses, LN obtained 74% efficiency and PS, 62% (p = 0.019). The mean visual analogue scale (0-10) was 5.7 ± 1.61 with LN and 4.3 ± 1.44 with PS (p = 0.003). There was no significant statistical difference between the two methods in terms of researcher and patient preference. An analysis of the photos showed improvement of the skin appearance with both treatments (p 0.05). Discussion: Treatment with the PS showed better tolerance, but was less efficient than LN. Although LN has been the preferred method, there was no statistical difference between the methods. CONCLUSIONS: The cryopeeling technique may be an option in the treatment of photodamage. The PS can be an interesting alternative in clinical practice with good tolerance and acceptable results in the treatment of actinic keratoses

O estudo teve como objetivo comparar três modalidades de crioterapia em mulheres saudáveis e não grávidas. Trata-se de um ensaio clínico randomizado, não controlado, com 32 alunas do curso de graduação de uma faculdade de enfermagem particular da cidade de São Paulo, divididas em três grupos (gelo água, gelo mole, gelo gel). Foram verificadas as temperaturas (axilar, coxa e das três bolsas de gelo) entre zero e vinte minutos. As temperaturas das bolsas foram: gelo mole de 9°C negativos a 2°C, gelo água de 0°C a 8°C e gelo gel de 11°C negativos a 2°C. Houve diferença significativa entre as médias das temperaturas da coxa com 10 minutos (p=0,007), 15 minutos (p=0,003) e 20 minutos (p=0,005). O gel foi mais eficiente no resfriamento comparado aos outros dois métodos. As três modalidades de crioterapia atingem a temperatura recomendada para analgesia e podem ser aplicadas em puérperas com dor perineal após o parto normal.El estudio tuvo como objetivo comparar tres modalidades de crioterapia en mujeres saludables y no grávidas. Se trató de un ensayo clínico randomizado no controlado con 32 alumnas del curso de graduación de una facultad de enfermería particular de la ciudad de São Paulo (Brasil). Las alumnas fueron divididas en tres grupos (agua helada, hielo blando, gel helado). Fueron verificadas las temperaturas (axilar, del muslo y de las tres bolsas de hielo) entre cero y veinte minutos. Las temperaturas de las bolsas fueron: hielo blando, de -9°C a 2°C; agua helada, de 0°C a 8°C; gel helado, de -11°C a 2°C. Hubo diferencia significativa entre las medias de las temperaturas del muslo tomadas a los 10 minutos (p=0,007), 15 minutos (p=0,003) y 20 minutos (p=0,005). El gel fue más eficiente en el enfriamiento comparado con los otros dos métodos. Las tres modalidades de crioterapia alcanzan la temperatura recomendada para la analgesia y pueden ser aplicadas en mujeres con dolor perineal posparto.The objective of the present study was to compare three methods of cryotherapy in healthy non-pregnant women. This is a randomized controlled clinical trial that was conducted by 32 undergraduates of a private nursing college in the city of Sao Paulo, divided into three groups (iced water, soft ice, ice gel). The temperatures were verified (axillary, thigh, of the three ice packs) between zero and twenty minutes. The temperatures of the packs were the following: soft ice, from negative 9°C to 2°C; iced water, from 0°C to 8°C; and ice gel from negative 11°C to 2°C. There was a significant difference between the average thigh temperature values at 10 minutes (p=0.007), 15 minutes (p=0.003) and 20 minutes (p=0.005). The gel was the most efficient cooling method. The three cryotherapy methods achieved the recommended temperature for analgesia and may be tested in women with perineal pain after childbirth.

The objective of this study was to analyze the effect of immersion cryotherapy on blood lactate removal, an important physiological parameter related to muscle fatigue, after high-intensity exercise. Fifteen soccer athletes (15 to 17 years) were randomized into an immer-sion group (IG, n=7) and a control group (CG, n=8). The athletes were subjected to a muscle fatigue inducer protocol (PIFM) on a cycle ergometer. Next, GI athletes underwent immersion cryotherapy for 10 minutes, with the lower limbs being immersed at 5±1º C, whereas CG athletes rested for 10 minutes. Blood samples were collected for the determination of lactate concentration before the PIFM and 3, 15 and 25 minutes after the end of exercise (post-3, post-15 and post-25, respectively). The PIFM resulted in a significant increase of blood lactate concentration in the athletes, which was similar in two groups. During the recovery period, lactate concentration decreased by 13.6% at post-15 and by 15.3% at post-25 in IG, whereas GC presented a decrease of 14.6% and 28.5% decrease at post-15 and post-25, respectively. Passive recovery resulted in a significant decrease of lactate concent rat ion, whereas the same was not observed for cryotherapy. These results suggest that, for the parameters used in this study, immersion cryotherapy was less effective than rest in the removal of blood lactate after high-intensity exercise.

The objective of the present study was to analyze the effect of cryotherapy and muscular warming on the flexibility of the hamstring muscles associated with three minutes of static stretching. Forty young male and female volunteers were randomly included in one of four groups: Group 1 – Control group, Group 2 – Three minutes of static stretching, Group 3 – Stretching preceded by warming using shortwave diathermy (20 minutes), and Group 4 – Stretching preceded by applying cryotherapy (20 minutes) to the posterior thigh region. The program consisted of three series of stretching during five consecutive days and flexibility was assessed by goniometric evaluations of the extensor angle of the knee at the beginning of the protocol, at the end of the day and at the end of the protocol. The intergroup comparison was made through ANOVA post-hoc Tukey and the intragroup by paired t test, all with 5% level of significance. The three experimental groups significantly increased their range of motion in relation to the control group. However, differences were not observed among groups submitted to the different stretching programs. In conclusion, increases in flexibility were due to stretching and did not depend on previous application of hyperthermia and/or hypothermia.

A osteoartrite é a forma mais prevalente de doença articular. Os agentes físicos como o gelo e o calor podem combater o processo álgico quando corretamente indicados e utilizados. O objetivo deste trabalho foi a comparação de protocolos de tratamento fisioterapêutico, que envolveram o uso de cinesioterapia, crioterapia e ondas curtas, em indivíduos com osteoartrite de joelho. Em um estudo randomizado prospectivo cego foram tratados 25 indivíduos (25 joelhos), de 58 a 78 anos. GRUPO A: cinesioterapia e ondas curtas (n=9). GRUPO B: cinesioterapia e gelo (n=6). GRUPO C: cinesioterapia (grupo controle) (n=9). As variáveis analisadas foram: percepção subjetiva de dor (Borg), qualidade funcional (Lequesne), amplitude de movimento, flexibilidade e força muscular. A dor melhorou significativamente somente no grupo B, com qualidade funcional e flexibilidade positiva em todos grupos. O ganho de amplitude foi semelhante nos grupos B e C. Houve manutenção da força flexora nos grupos A e B e ganho nos indivíduos do grupo C. Na musculatura extensora observou-se ganho de força no grupo B e C e perda no grupo A. O melhor protocolo foi aquele que envolveu a aplicação de gelo e cinesioterapia para analgesia; não houve relação de ganho de amplitude, flexibilidade e força associado a termoterapia.Osteoarthritis is the most prevalent form of joint disease. Physical agents such as ice and heat can fight the pain process, when correctly indicated and used. The objective of this study was to compare physiotherapy protocols involving the use of exercise, cryotherapy and short waves in individuals with knee osteoarthritis. In a prospective randomized study, 25 individuals were treated (25 knees), with ages ranging from 58 to 78 years. GROUP A: exercise and short-waves (n=9). GROUP B: exercise and ice (n=6). GROUP C: exercise alone (control) (n=9). Analyzed variables were: subjective perception of pain (Borg), functional quality (Lequesne), range of motion, flexibility and muscular strength. Pain significantly improved only for group B, with positive functional quality and flexibility in all groups. The improvement in range of motion was similar for groups B and C. Flexion strength was maintained for groups A and B, and strength gain for individuals in group C. In the extensors muscles, strength gain was seen in groups B and C, while strength loss was reported for group A. The best protocol was that one involving cryotherapy and exercises for pain relief. All groups showed improved functional quality; no correlation was found for range of motion gain, flexibility and strength gain associated with thermotherapy.

Cold water immersion (CWI) appears in the sport as a strategy to recover damages caused by the physical stress of the exercise. Thus, to analyze the effects of this technique and its variables on the effect of Heart Rate Variability (HRV) seems pertinent. The study methodology consisted of a total of 100 participants allocated in five groups: CG: control group; and CWI intervention groups: G1: 5 min at 9 ± 1°C; G2: 5 min at 14 ± 1°C; G3: 15 min at 9 ± 1°C, G4: 15min at 14 ± 1°C. After baseline HRV uptake, participants performed a jump protocol and a Wingate test, followed by the CWI. In the VLF index there was a statistical difference between moments of up to 17 and 20 min and in moments T17 and T20 between groups. In the LF and HF indices there was a statistically significant difference in the moments of up to 17, 20 and 40 min after exercise and between the groups at time T20. It is concluded that CWI in the assessment of global variability anticipates recovery between 10 and 20 min compared to the control group. [ABSTRACT FROM AUTHOR]

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OBJETIVE: To describe the reattachment rate and visual acuity results of patients with uncomplicated rhegmatogenous retinal detachment who underwent segmental scleral buckle surgery. METHODS: Prospective case series of 100 patients with visual loss or symptoms (floaters and photopsia) of less than 30 days' duration scheduled for surgery. No patient had a retinal break greater than 30°, a retinal detachment larger than 2 quadrants or proliferative vitreoretinopathy. RESULTS: The 1-week, 1-month, and 6-month anatomical success rates were 93%, 100%, and 100%, respectively. Seven patients underwent one additional retinal detachment surgery (pars plan vitrectomy) after primary failure at 1-week follow-up. The preoperative, 1-month, and 6-month best correct visual acuity were 20/100, 20/80, and 20/50, respectively. The postoperative complications were: eyelid edema in 10% of the patients, transient ocular hypertension in 5%, macular pucker in 3%, transient diplopia in 3%, and hyphema (OBJETIVO: Descrever a taxa de reaplicação e os resultados da acuidade visual dos pacientes com descolamento de retina regmatogênico simples que se submeteram à cirurgia de introflexão escleral segmentar. MÉTODOS: Uma série de casos prospectivo de 100 pacientes com perda visual ou sintomas (floaters e fotopsia), com duração inferior a 30 dias, agendados para a cirurgia. Nenhum paciente apresentou uma ruptura da retina superior a 30°, um descolamento de retina maior que 2 quadrantes ou vitreorretinopatia. RESULTADOS: As taxas de sucesso anatômico em 1 semana, 1 mês e 6 meses foram de 93%, 100% e 100%, respectivamente. Sete pacientes foram submetidos à cirurgia de descolamento de retina adicional (vitrectomia via pars plana) após falha primária em uma semana de seguimento. A melhor acuidade visual pré-operatória, 1 mês, e de 6 meses pós-operatório foram 20/100, 20/80 e 20/50, respectivamente. As complicações pós-operatórias foram: edema palpebral em 10% dos pacientes, a hipertensão ocular transitória em 5%, pucker macular em 3%, diplopia transiente em 3%, e hifema (