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We compared the effectiveness of 5 heated hypothermia wrap systems.Physiologic and subjective responses were determined in 5 normothermic subjects (1 female) for 5 heated hypothermia wraps (with vapor barrier and chemical heat sources) during 60 min of exposure to a temperature of -22°C. The 5 systems were 1) user-assembled; 2) Doctor Down Rescue Wrap; 3) hypothermia prevention and management kit (HPMK); 4) MARSARS Hypothermia Stabilizer Bag; and 5) Wiggy's Victims Casualty Hypothermia Bag. Core and skin temperature, metabolic heat production, skin heat loss, and body net heat gain were determined. Subjective responses were also evaluated for whole body cold discomfort, overall shivering rating, overall temperature rating, and preferential ranking.The Doctor Down and user-assembled systems were generally more effective, with higher skin temperatures and lower metabolic heat production; they allowed less heat loss, resulting in higher net heat gain (P0.05). HPMK had the lowest skin temperature and highest shivering heat production and scored worse than the other 4 systems for the "whole body cold discomfort" and "overall temperature" ratings (P0.05).The user-assembled and Doctor Down systems were most effective, and subjects were coldest with the HPMK system. However, it is likely that any of the tested systems would be viable options for wilderness responders, and the choice would depend on considerations of cost; volume, as it relates to available space; and weight, as it relates to ability to carry or transport the system to the patient.

Experimental guidelines have been proposed to improve the rigor and reproducibility of experimental stroke studies in rodents. As brain temperature is a strong determinant of ischemic injury, tight management of brain or body temperature (Tcore) during the experimental protocol is highly recommended. However, little guidance is provided regarding how or for how long temperature support should be provided. We compared a commonly used heat support method (cage on heating pad) with a low-cost custom built warm ambient air cage (WAAC) system. Both heat support systems were evaluated for the middle cerebral artery occlusion (MCAo) model in mice. The WAAC system provided improved temperature control (more normothermic Tcore and less Tcore variation) during the intra-ischemic period (60 min) and post-ischemic period (3 hrs). Neurologic deficit score showed significantly less variance at post-stroke day 1 (PSD1) in WAAC system mice. Mean infarct volume was not statistically different by heat support system, however, standard deviation was 54% lower in the WAAC system group. In summary, we provide a simple low-cost heat support system that provides superior Tcore management in mice during the intra-ischemic and post-ischemic periods, which results in reduced variability of experimental outcomes.HighlightsWe describe the fabrication of a low-cost mouse cage warming system (warmed ambient air cage; WAAC system) that can be assembled and applied in any stroke laboratory.The WAAC system provides more precise control of post-stroke mouse body temperature compared with traditional heating pad warming system.The more precise control of post-stroke core temperature reduces variability in some experimental measures in more severely injured mice.

Erythema ab igne (EAI) is an asymptomatic dermatosis caused by prolonged exposure to localized heat. Affected areas have net-like hyperpigmentation that may resemble more serious conditions such as livedo racemosa or vasculitis. We report three cases of EAI in pediatric sickle cell disease (SCD) patients who were initially suspected of having a more severe, life-threatening disorder before Dermatology was consulted. Clinicians caring for pediatric SCD patients who regularly use heating pads/devices for pain relief should consider EAI in the differential diagnosis of large areas of net-like hyperpigmentation. This paper aims to increase recognition of EAI and patient education on safe practices while using heating pads.

The article deals with the ways of working conditions improvement for employees that work in the open air during the cold period of the year for a long time. Hypothermia of the body is a consequence of thermal disorder. Such disorder develops in cases when the body heat loss exceeds the heat emission. Untimely regulation of heat exchange processes can lead to various occupational diseases, frostbite, and even death. Hypothermia is promoted by physical fatigue, high humidity and strong wind. The results of the work show that in order to reduce the level of occupational diseases and improve the heat exchange processes of employees working in low temperature conditions it is necessary to provide them with special warmed work clothes with additional heating element (sodium acetate heating pad). Such clothes will provide comfortable thermal conditions in the underwear of the worker.

AIMS Although generally well tolerated, a urodynamic study is an unpleasant and stressful procedure for some patients. This study evaluated the effects of a heating pad on anxiety, pain, and distress during urodynamic studies in female patients with stress urinary incontinence. METHODS A total of 74 female patients with stress urinary incontinence who underwent a urodynamic study between May 2015 and October 2015 were randomized to either the experimental group using a heating pad (n = 37) or control group (n = 37). In the experimental group, a heating pad was applied on the patient's sacrum during the urodynamic study. All patients completed the State-Trait Anxiety Inventory (20-80) before and after the procedure and assessed their degree of pain and distress after the procedure by the visual analog scale (0-10). Systolic and diastolic blood pressure and pulse rate were also checked before and after the procedure. RESULTS Demographic characteristics, mean age, procedure duration, pre and post-procedural systolic, and diastolic blood pressures, and pulse rate were statistically similar between the experimental and control groups. The mean State-Trait Anxiety Inventory was significantly lower in the experimental group than in the control group (30.9 ± 7.5 vs 42.5 ± 10.1, P

Background Human experimental pain models provide an important translational link between pre‐clinical models and clinical pain. Using topical capsaicin and continuous heat application, the novel capsaicin/heat ongoing pain (CHOP) model induces long‐lasting experimental pain of which the perceived intensity can be individually adjusted. Methods In the CHOP model, capsaicin or control cream is applied to a 10 × 10 cm skin area and a heating pad is applied over the area after cream removal. Two experiments in healthy participants were performed for model characterization. In Experiment 1, a constant temperature was applied for 60 min; in Experiment 2, temperature was adjusted to maintain a constant perceived intensity for 60 min. Results Experiment 1: across participants, constant temperature induced initial habituation followed by an increase in sensation back to baseline. Cluster analysis revealed that half the participants sensitized to the constant temperature, while the other half did not. The degree of sensitization was related to the baseline pain unpleasantness, relative to pain intensity. Experiment 2: constant perceived intensity was achieved in the painful and a non‐painful control condition. The two conditions did not differ regarding possibly confounding variables, including blood pressure, heart rate, inflammation or physiological stress as measured by surrogate markers. Secondary allodynia and hyperalgesia were reported more following painful compared to control stimulation. Sensitizers as determined in Experiment 1 were also more pain sensitive in Experiment 2. Conclusion The CHOP model reproduces some aspects of clinical pain, such as longer duration, sensitization, secondary allodynia and hyperalgesia. Significance Here we demonstrate a novel pain model that can be applied for up to an hour without tissue damage. The CHOP model allows for investigation of primary and secondary hyperalgesia as well as top‐down influences on sensitization, thereby providing an experimental model that can be used to assess clinically‐oriented questions.

Background and Aim: The toe skin temperature in vascular patients can be low, making reliable toe pressure measurements difficult to obtain. The aim of this study was to evaluate the effect of heating on the toe pressure measurements. Materials and Methods: A total of 86 legs were examined. Brachial pressure and toe pressure were measured at rest in a supine position using a laser Doppler device that also measured skin temperature. After heating the toes for 5 min with a heating pad, we re-measured the toe pressure. Furthermore, after heating the skin to 40° with the probe, toe pressures were measured a third time. Results: The mean toe skin temperature at the baseline measurement was 24.0 °C (standard deviation: 2.8). After heating the toes for 5 min with a warm heating pad, the skin temperature rose to a mean 27.8 °C (standard deviation: 2.8; p = 0.000). The mean toe pressure rose from 58.5 (standard deviation: 32) to 62 (standard deviation: 32) mmHg (p = 0.029). Furthermore, after the skin was heated up to 40 °C with the probe, the mean toe pressure in the third measurement was 71 (standard deviation: 34) mmHg (p = 0.000). The response to the heating varied greatly between the patients after the first heating—from −34 mmHg (toe pressure decreased from 74 to 40 mmHg) to +91 mmHg. When the toes were heated to 40 °C, the change in to toe pressure from the baseline varied between −28 and +103 mmHg. Conclusion: Our data indicate that there is a different response to the heating in different clinical situations and in patients with a different comorbidity.

General anesthesia is a common procedure in laboratory rats; however, it impairs thermoregulation, rapidly leading to hypothermia as warm core blood is distributed to the cooler periphery. The protective strategy of prewarming before the onset of anesthesia delays hypothermia, but only for a short period. This prospective, randomized, cross-over, experimental study in adult male and female SD rats (n = 8) was designed to compare passive (fleece blanket) and active (temperature controlled heating pad) warming. Initial treatment order was randomized, with a cross-over after a minimum 5 d washout period. Both groups underwent a period of prewarming in a warming box to increase core temperature by 1% (median 0.4 °C). At completion of prewarming, general anesthesia was induced and maintained for 30 min with isoflurane carried in oxygen. Core temperature was monitored for a further 30 min after anesthesia. Active warming resulted in higher core temperatures during anesthesia. During passive warming, hypothermia occurred after approximately 30 min of anesthesia and continued into recovery. In contrast, active warming prevented hypothermia. Prewarming followed by passive warming delayed hypothermia for approximately 30min, but active warming was more effective at maintaining normothermia both during and after general anesthesia.

Shell ulcerations are commonly observed lesions in chelonians, with treatment typically required for disease resolution. In this study, photopolymerizable nano-hybrid dental composite was used as a closure material for ulcerative lesions affecting chelonian shells. Shell ulcerative lesions were diagnosed in 33 different species of turtles: 14 red-eared sliders ( Trachemys scripta elegans ), 5 yellow bellied sliders ( Trachemys scripta scripta ), 11 Sicilian pond turtles ( Emys trinacris ), 2 Florida red bellied cooters ( Pseudemys nelsoni ), and 1 Mississippi map turtle ( Graptemys pseudogeographica kohnii ). Turtles were premedicated with tramadol and meloxicam administered intramuscularly; anesthesia was induced using a combination of ketamine and diazepam administered intramuscularly, and maintained on a surgical plane of anesthesia using isoflurane. The patient's shells were washed with a povidone iodine solution before being placed on a heating pad to maintain a normothermic condition. After the initial lesion debridement, surgical curettage was performed with a tungsten carbide burr. The surgical curettage was necessary to generate an appropriate cavity and suitable surface for applying the photopolymerizable dental composite (PDC). During the curettage procedure, sterile saline solution, containing 3mL/L of 2% lidocaine, was continuously applied onto the lesions. After the curettage procedure, an EDTA solution, followed by a dehydrating potassium-based solution, was applied on the prepared shell sites. An etching gel was painted on the areas where the PDC was to be placed and maintained for approximately 1 minute. After the etching gel dried, a bonding agent was applied, and it was polymerized with single cycle of curing light. Cavities were filled using a light-curing nano-hybrid composite, which was polymerized using a light-emitting diode curing light. On average, 10 minutes was required to fill the cavities with the PDC. After the shell repair procedure, the turtles were placed in dry hospital holding units for 24 hours, after which they were moved to several hospitalization water tanks. Antibiotic treatment and postsurgical analgesia were performed for 6 days. After 7 days of hospitalization, treated turtles were discharged to their owners. On the follow-up examinations, 30 days posttreatment lesions had healed in 48.4% of treated turtles; 60 days posttreatment lesions had healed in 78.7% of treated turtles; and 90 days posttreatment lesions had healed in 100% of treated turtles. Treatment of shell ulcers with photopolymerizable nano-hybrid dental composite appears to eliminate shell ulceration relapses, long and expensive antimicrobial treatment, and dry docking hospitalization, while promoting rapid healing of the shell along with fast and excellent recovery of the turtle patients.

Background: Female reproductive system injury caused after vaginal delivery is very common, and episiotomy and spontaneous tears, or both are the most important contributing factors in this regard. However, several techniques have been developed to reduce this damage, yet their impact has not been fully proven. Therefore, the present study was conducted to determine the effect of perineal heating pad on the frequency of episiotomies and perineal tears in primiparous females. Methods: In this single-blind clinical trial, a total of 114 primiparous females, who referred to Imam Ali Hospital in Andimeshk and were eligible to participate in the study, were randomly divided to two groups, consisting of 57 individuals. The heating pads were used in the intervention group with the start of the second stage of labor and the childbirth process was routinely carried out in the control group without any intervention. The data collection tool was a form on demographic information and characteristics of the research subjects, as well as the maternal postpartum data collection form. Data analysis was carried out using Chi-square and independent T-test using the SPSS software version 19. P values of < 0.05 were considered significant. Results: The frequency of episiotomies was 41% and 21% in the control and intervention groups, respectively. There was a significant difference between the two groups in this regard (P = 0.025). The results also showed that the perineal intactness percentage was higher in the intervention group than the control group, although this difference was not statistically significant (P = 0.512). Conclusions: The results of the current study revealed that the use of perineal heating pad during the second stage can be effective in decreasing the episiotomy rate and improving perineal intactness in primiparous females. Since there are a few studies in this regard, it is recommended to carry out further research in this field and other interventions affecting perineal tear and the episiotomy rate.

Diabetes is associated with many severe complications, such as heart disease and nerve damage. Diabetics have elevated blood glucose levels that result in peripheral neuropathy. As a result, diabetics always feel painful about their lower limbs and may need to have lower limb amputation. The diabetic foot ulcers are hard to heal and require extensive medical treatments and follow ups. The purpose of this study was to evaluate the effect of infrared radiation therapy using a heating pad with carbon fibers (LinkWin Technology Co., Taiwan) on the diabetic foot. Ten diabetics and 4 non-diabetics were recruited for this study. The participants were assessed for their microvascular function before and after the interventions in each month for three consecutive months. The results showed that surface temperature increase by 2° after using the pad in the first and third months (p < 0.05); and blood flow increase on the plantar foot (p < 0.05) but not on the dorsal foot. The increase in blood flow may alleviate diabetic-related complications. The results of autonomic nervous testing indicated that the activity of sympathetic nervous increased after using the pad. In conclusion, the use of heating pad with far infrared radiation could improve blood flow and autonomic nervous system in diabetics, therefore improving alleviating symptoms of diabetes-related complications.

This study evaluated the effects of using a heating pad during cystoscopy on anxiety, pain, and distress in female patients. Seventy-four female patients who underwent rigid cystoscopy between January 2017 and August 2017 were randomized to either the experimental group using a heating pad (n = 37) or the control group using a pad without heat (n = 37). In the experimental group, a heating pad was applied to the patient’s sacrum during cystoscopy. All patients completed the State-Trait Anxiety Inventory-S (STAI-S, 20-80) before and after the procedure and assessed their degree of pain and distress after the procedure using a visual analog scale (0–10). Systolic and diastolic blood pressure and pulse rate were also measured before and after the procedure. Demographic characteristics, mean age, procedure duration, and pre- and post-procedural systolic and diastolic blood pressures and pulse rate were statistically similar between the experimental and control groups. The mean STAI-S score of the experimental group was significantly lower than that in the control group (33.1 ± 10.1 vs 48.2 ± 11.1, p

Erythema ab igne is an asymptomatic cutaneous disorder characterized by erythematous reticulated hyperpigmentation resulting from chronic exposure to infrared radiation in the form of heat. We report three cases of erythema ab igne from chronic heating pad use over a duration of six months to three years. The lesions were asymptomatic in all three patients and were incidental skin findings in two patients, unrelated to their chief complaints. This illustrates the importance of recognizing the morphology and distribution of erythema ab igne. Additionally, knowledge of similarly presenting cutaneous diseases is important to distinguish erythema ab igne from other more worrisome entities that would require further evaluation. Our patients were informed of the benign nature of this condition and were told that cessation of heating pad use would likely result in the resolution of their lesions.

Purpose: The purpose of this study was to identify the effects of thermotherapy on abdominal distension and pain during colonoscopy. Methods: This study used a nonequivalent control group and a non-synchronize design. Twenty-nine participants were assigned in an experimental group and 29 in the control group. For the experimental group, electronic heating pad was applied before test throughout the entire procedure. Results: Abdominal distension and total time required for colonoscopy significantly were lower in the experimental group than those in the control group. Conclusion: The results suggest that thermotherapy can be effective to improve abdominal distension and colonoscopy time in patients with colonoscopy. Therefore, thermotherapy can be recommended for those patients undergoing of colonoscopy.

The patient had been using a heating pad daily, often for several hours at a time, to relieve his back pain.

Chronically ill patients often develop uncommon exam findings. A 16-year-old female with end-stage renal disease secondary to immune complex-mediated glomerulonephritis on peritoneal dialysis (PD) developed a pruritic, hyperpigmented reticular rash on her abdomen, sparing the PD catheter insertion site. The rash appeared approximately 6 weeks after initiating PD. She used a heating pad nightly during PD for dialysis drain pain. Testing for systemic and autoimmune disease was negative. She was referred to dermatology, where the diagnosis of erythema ab igne (EAI), a well-described but less well-known hyperpigmented reticular cutaneous eruption caused by chronic exposure to low levels of infrared heat, was confirmed. The eruption is typically painless but is often pruritic. Common sources of heat include fires, stoves, portable heaters, heating pads, and laptop computers. The association between EAI and PD is unknown. Our patient discontinued the heating pad and her rash resolved.

Background Certain critically ill patients with advanced acute limb ischemia with a nonviable extremity may be unsuitable for transport to the operating room to undergo definitive amputation. In these unstable patients, rapid regional cryotherapy allows for prompt infectious source control and correction of hemodynamic and metabolic abnormalities, thereby lessening the risk associated with definitive surgical amputation. We describe our refined technique for lower extremity physiologic cryoamputation and review our institutional experience. Methods After adequate analgesia is administered to the patient, a heating pad is secured circumferentially at the proximal amputation margin and the affected extremity is placed in a customized Styrofoam cooler. A circumferential seal is secured at the proximal chill zone without use of a tourniquet and dry ice is placed into the cooler to surround the entire affected leg. Delayed definitive lower extremity amputation is later performed when hemodynamic and metabolic derangements are corrected. Results We reviewed 5 patients who underwent lower extremity cryoamputation with this technique identified at our institution between 2005 and 2015. Age ranged from 31 to 79 years old. All presented with severe foot infection and septic shock requiring vasopressor support. All 5 patients stabilized hemodynamically following the initial cryoamputation and later underwent definitive lower extremity amputation, with a median time of 3 days following initial cryoamputation. Conclusions Lower extremity physiologic cryoamputation is an effective, immediate bedside procedure that can provide local source control and the opportunity for correction of metabolic derangements in initially unstable patients to lessen the risk for definitive major lower extremity amputation. Refinement of the cryoamputation technique, as described in this report, allows for a predictable and reproducible physiologic amputation.

This investigation assessed differences between the response of men and women with knee osteoarthritis to superficial heat, cold, or contrast therapy applied with a water-circulating system or a standard heating pad, and rest. We further analyzed data from a previous study to better understand the influence of gender on the response to treatment based on Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales and a visual analog pain scale (VAS). Using a within-subject, randomized order design, 34 patients received each treatment in 1-week blocks. A KOOS questionnaire and VAS were completed at baseline and twice each week. Women were more likely to report clinically meaningful improvement in pain and symptoms on the KOOS with the use of heat, cold, and a heating pad. There were no significant differences in response to treatment between men and women for the function-daily living and quality of life subscales or percent pain reduction on the VAS. Men and women reported improved quality of life with intervention. Women are more likely to report clinically meaningful improvement in pain and symptoms associated with knee OA following the use of superficial heat, cold, or a heating pad than men.

Three dogs were presented for the management of disease processes resulting in large skin defects over the dorsal lumbosacral region. One had severe dog bite wounds, one had a large burn sustained from a heating pad and one had a large myxosarcoma in the region. In each case, the extent and location of the resulting skin defect were assessed as factors likely to prevent reconstruction using simple tension-relieving techniques alone or in combination with established reconstructive techniques, such as axial pattern flaps or skin stretching devices. Bilateral skin fold rotation-advancement flaps (SFRAFs) based on the flank folds were mobilised dorsally and allowed complete wound closure in two dogs and subtotal closure in the other dog. All wounds healed without major complications and an acceptable cosmetic outcome was achieved in each case. Minor flap debridement was required in two dogs. The use of bilateral SFRAFs is a useful technique alone or in combination with other reconstructive techniques for the closure of large dorsal lumbosacral skin defects when existing techniques are not sufficient. Small flank folds, such as those of obese dogs, may yield unexpectedly large SFRAFs.

Summary Background Circulation plays an essential role in tissue healing. Moist heat and warm water immersion have been shown to increase skin circulation; however, these heating modalities can cause burns. Recent research has shown that passive vibration can also increase circulation but without the risk of burns. Material/Methods The aim of this study is to compare the effects of short-duration vibration, moist heat, and a combination of the two on skin blood flow (SBF) and skin temperature (ST). Ten (10) subjects, 5 female and 5 male, aged 20–30 years of age, received two interventions a day for 3 consecutive days: Intervention 1 – Active vibration only (vibration exercise), Intervention 2 – passive vibration only, Intervention 3 – moist heat only, Intervention 4 – passive vibration combined with moist heat, Intervention 5 – a commercial massaging heating pad, and Intervention 6 – no intervention, resting in supine only (control). SBF and ST were measured using a laser Doppler imager during the 10 minute intervention and then throughout the nine minute recovery period. Results The mean skin blood flow following a ten-minute intervention of the combination of passive vibration and moist heat was significantly different from the control, active vibration, and the commercial massaging heating pad. Skin temperature following the ten-minute interventions of moist heat alone and passive vibration alone were both significantly different from the commercial massaging heating pad and active vibration interventions. Conclusions The combination of passive vibration and moist heat produced the greatest increase in skin blood flow and the second highest increase in skin blood flow nine minutes post application.

Objectives: Acute back and neck strains are very common. In addition to administering analgesics, these strains are often treated with either heat or cold packs. The objective of this study was to compare the analgesic efficacy of heat and cold in relieving pain from back and neck strains. The authors hypothesized that pain relief would not differ between hot and cold packs. Methods: This was a randomized, controlled trial conducted at a university-based emergency department (ED) with an annual census of 90,000 visits. ED patients >18 years old with acute back or neck strains were eligible for inclusion. All patients received 400 mg of ibuprofen orally and then were randomized to 30 minutes of heating pad or cold pack applied to the strained area. Outcomes of interest were pain severity before and after pack application on a validated 100-mm visual analog scale (VAS) from 0 (no pain) to 100 (worst pain), percentage of patients requiring rescue analgesia, subjective report of pain relief on a verbal rating scale (VRS), and future desire for similar packs. Outcomes were compared with t-tests and chi-square tests. A sample of 60 patients had 80% power to detect a 15-mm difference in pain scores. Results: Sixty patients were randomized to heat ( n= 31) or cold ( n= 29) therapy. Mean (±standard deviation [SD]) age was 37.8 (±14.7) years, 51.6% were female, and 66.7% were white. Groups were similar in baseline patient and pain characteristics. There were no differences between the heat and cold groups in the severity of pain before (75 mm [95% CI = 66 to 83] vs. 72 mm [95% CI = 65 to 78]; p = 0.56) or after (66 mm [95% CI = 57 to 75] vs. 64 mm [95% CI = 56 to 73]; p = 0.75) therapy. Pain was rated better or much better in 16 ⁄31 (51.6%) and 18 ⁄29 (62.1%) patients in the heat and cold groups, respectively (p = 0.27). There were no between-group differences in the desire for and administration of additional analgesia. Twenty-five of 31 (80.6%) patients in the heat group and 22 of 29 (75.9%) patients in the cold group would use the same therapy if injured in the future (p = 0.65). Conclusions: The addition of a 30-minute topical application of a heating pad or cold pack to ibuprofen therapy for the treatment of acute neck or back strain results in a mild yet similar improvement in the pain severity. However, it is possible that pain relief is mainly the result of ibuprofen therapy. Choice of heat or cold therapy should be based on patient and practitioner preferences and availability. ACADEMIC EMERGENCY MEDICINE 2010; 17:484‐489 a 2010 by the Society for Academic Emergency

Body temperature affects outcomes of tissue injury. We hypothesized that online body core temperature recording and selective interventions help to standardize peri-interventional temperature control and the reliability of outcomes in experimental renal ischemia reperfusion injury (IRI). We recorded core temperature in up to seven mice in parallel using a Thermes USB recorder and ret-3-iso rectal probes with three different protocols. Setup A: Heating pad during ischemia time; Setup B: Heating pad from incision to wound closure; Setup C: A ventilated heating chamber before surgery and during ischemia time with surgeries performed on a heating pad. Temperature profile recording displayed significant declines upon installing anesthesia. The profile of the baseline experimental setup A revealed that

Aims and objectives To characterise the effects of local heat application on the ease of subsequent intravenous catheter insertion. Background Intravenous catheter insertion is a challenging procedure for both nurses and chemotherapy patients. The local application of heat to the area before intravenous catheter insertion may decrease these difficulties by increasing venous distension and visibility. Design This study was an open label experimental study involving intervention and control groups. Methods Patients receiving chemotherapy were divided into intervention (n = 40) and control (n = 40) groups. For patients in the intervention group, a digital moist heating pad was applied to the arm prepared for catheter insertion for 10 minutes in addition to routine care. No additional preparation procedure beyond routine care was performed for control patients. Data were collected using a data collection form and evaluated using chi square, Fisher's exact chi square, Student's t, Mann–Whitney U, Wilcoxon and Pearson correlation tests. Results Local application of heat decreased patients' pain (p = 0·011), increased the rate of successful catheter placement at first attempt (p = 0·004), decreased the catheterisation procedure time (p = 0·001) and decreased nurse-perceived difficulty during catheter placement (p = 0·001). Conclusions Local application of heat before the catheterisation procedure is suggested for patients receiving chemotherapy, particularly in cases where visibility of the veins is poor and intravenous catheter insertion is difficult. Relevance to clinical practice Local application of heat results in vasodilation, and thus intravenous catheter insertion becomes easier. Our findings have important implications for nurses who care for chemotherapy patients. The inclusion of local heat application before catheterisation as a preparation step is suitable to be implemented by nurses in other hospitals and clinics where chemotherapy is provided.

Electrical appliances produce the highest intensity exposures to residential extremely low frequency electromagnetic fields. The authors investigated whether appliances may be associated with adult brain tumors in a hospital-based case-control study at three centers in the United States from 1994 to 1998. A total of 410 glioma, 178 meningioma, and 90 acoustic neuroma cases and 686 controls responded to a self-administered questionnaire about 14 electrical appliances. There was little evidence of association between brain tumors and curling iron, heating pad, vibrating massager, electric blanket, heated water bed, sound system, computer, television, humidifier, microwave oven, and electric stove. Ever use of hair dryers was associated with glioma (odds ratio = 1.7, 95% confidence interval: 1.1, 2.5), but there was no evidence of increasing risk with increasing amount of use. In men, meningioma was associated with electric shaver use (odds ratio = 10.9, 95% confidence interval: 2.3, 50), and odds ratios increased with cumulative minutes of use, although they were based on only two nonexposed cases. Recall bias for appliances used regularly near the head or chance may provide an alternative explanation for the observed associations. Overall, results indicate that extremely low frequency electromagnetic fields from commonly used household appliances are unlikely to increase the risk of brain tumors.

OBJECTIVE Early surface cooling of burns reduces pain, depth of injury and improves healing. We hypothesized that controlled mild hypothermia would also prolong survival in a fluid resuscitated rat model of large scald burns. METHODS Forty rats were anesthetized and a single full-thickness scald burn covering 40% of total body surface area was created on each of the rats. The rats were then randomized to hypothermia (n=20) or no hypothermia (n=20). Mild hypothermia (a reduction of 2°C) was induced with intraperitoneal 4°C normal saline and ice packs. After 2 hours of hypothermia, the rats were rewarmed back to their baseline temperature with a heating pad. The control rats received room temperature intraperitoneal saline. The difference in survival between the groups was determined using Kaplan-Meier analysis and the log-rank test. RESULTS Hypothermia was induced in all experimental rats within a mean of 22 minutes (95% confidence interval, 17 to 27). The number of normothermic and hypothermic rats that expired at each time interval were: at 1 hour, 4 vs. 0; at 10 hours, 2 from each group; at 24 hours, 0 vs. 1; at 48 hours, 2 vs. 2; at 72 hours, 1 vs. 1; and at 120 hours, 1 vs. 1 respectively. There were no differences in time to survival between the groups. CONCLUSION Induction of brief, mild hypothermia does not prolong survival in a resuscitated rat model of large scald burns.

Rationale and Objectives Magnetic resonance (MR) imaging of laboratory animals may require general anesthesia to minimize body movements over many hours. The anesthetization technique should allow physiologic parameters to remain as close to normal as possible, permit fast recovery, allow safe, repeated use, and avoid attachment of ferrous metal components to the animal. The purpose of this study was to evaluate an anesthetization technique that was developed to meet each of these qualifications. Materials and Methods In 15 rats (280–483-g body weight), general anesthesia was induced (with intramuscular ketamine hydrochloride, xylazine hydrochloride, acepromazine maleate, and atropine), a tail vein catheter was inserted, and preimaging surgical procedures were performed. A face mask was applied, the animal was positioned in a dorsal recumbent position on an acrylic board, and an isothermal heating pad was placed on the ventral aspect of the abdominal wall. The rat, on the board, was then inserted into a trough that contained a custom-built, linearly polarized birdcage head coil and placed in the bore of a 4.7-T horizontal-bore magnet. The face mask was connected to a non-rebreathing gaseous anesthetic system, and anesthesia was maintained with 1.5–2.0 L/min oxygen and 0.25%–1.50% isoflurane. Oxygen saturation, heart rate, and rectal temperature were continuously monitored. Results The duration of intramuscular anesthesia was 110 minutes ± 12, and the duration of gaseous anesthesia was 106 minutes ± 43. The monitoring equipment permitted display of vital signs. Conclusion The method appeared safe, was easy to perform, maintained a stable physiologic state for the parameters monitored, and could be used for repeated anesthesia in the same animal.

Background Body temperature is usually regulated by opposing controls of heat production and heat loss. However, systemic administration of capsaicin, the pungent ingredient of hot peppers, facilitated heat production and heat loss simultaneously in rats. We recently found that the capsaicin-induced heat loss and heat production occur simultaneously and that the biphasic change in body temperature is a sum of transient heat loss and long-lasting heat production. Moreover, suppression of the heat loss response did not affect capsaicin-induced heat production and suppression of heat production did not affect capsaicin-induced heat loss. These observations suggest the independent peripheral mechanisms of capsaicin-induced thermal responses. Thus, the capsaicin-induced thermal responses apparently lack an integrated control. Methods Male Wistar rats were maintained at an ambient temperature of 24 +/- 1 degrees C on a 12 h on-off lighting schedule at least for two weeks before the experiments. They were anesthetized with urethane (1.5 g/kg, i.p.) and placed on a heating pad, which was kept between 29 and 30 degrees C. Skin temperature(Ts) was measured with a small thermistor, which was taped to the dorsal surface of the rat's tail, to assess vasoactive changes indirectly. Colonic temperature(Tc) was measured with another thermistor inserted about 60 mm into the anus. O2 consumption was measured by the open-circuit method, and values were corrected for metabolic body size (kg0.75). Capsaicin (Sigma) was dissolved in a solution comprising 80% saline, 10% Tween 80, and 10% ethanol, and injected subcutaneously at a dose of 5 mg/kg. Each rat received a single injection of capsaicin because repeated administration of capsaicin renders an animal insensitive to the subsequent administration of capsaicin. Laminectomy was performed at the level of the first and second cervical vertebrae to expose the cervical spinal cord for sectioning. The brain was transected at 4-mm rostral from the interaural line with an L-shaped knife. Results After administration of capsaicin, O2 consumption increased from 13.5 +/- 0.4 mL/min/kg0.75 at 0 min to a peak of 15.9 +/- 0.4 mL/min/kg0.75 at 71 min and gradually declined but remained higher than the basal value until the end of the 4-h observation period. Ts also immediately increased from 27.7 +/- 0.2 degrees C to 31.9 +/- 0.3 degrees C at 39 min, and it returned to the baseline level within 90 min after the capsaicin administration. Tc initially decreased from 37.1 +/- 0.1 degrees C to 36.8 +/- 0.2 degrees C at 43 min and then gradually increased over the baseline level and remained at 37.6 +/- 0.2 degrees C until the end of the experiment. In spinalized rats, the capsaicin-induced increases in O2 consumption was largely attenuated, while the basal O2 consumption was similar to that of control rats. The basal Ts of spinalized rats was 32.4 +/- 0.3 degrees C, which was higher than that of control rats. Capsaicin increased Ts by less than 1 degree C, and Tc did not change after the capsaicin administration. O2 consumption of decerebrated rats was statistically higher than that of control rats after the injection of capsaicin. However, capsaicin did not increase Ts, showing a lack of a vasodilatory response. Decerebration between the hypothalamus and midbrain prevented the capsaicin-induced heat loss but not the heat production response. Conclusion These results show that the capsaicin-induced heat production and heat loss are controlled separately by the brainstem and by the forebrain, respectively, and suggest that the body temperature regulation is performed without an integrative center.

We report on four patients with partial and full thickness burns following autogenous tissue breast reconstruction. Three burns were confined to the flap and one burn involved the flap and rim of adjacent skin. Heat sources included a heating pad (n = 3) and sunlight through a bathing suit (n = 1). The injuries occurred from 6 days to 4 years following the reconstruction. The burns were the result of impaired thermoregulatory capacity of transplanted tissue. All wounds healed with local wound care or debridement and skin grafting.

In this paper we present a monitor and a remote control design of a heating cloth. This design uses an insulated heating resistance wire to warm up the cloth, which includes an application either on a phone or on a handheld controller. The built-in controller monitors and controls the temperature through Bluetooth transmission. The heating pad inside the heating cloth monitors both the heating pad temperature and the body temperature. The user can instantly know the body temperature and wear clothing which can be adjusted to retain body warmth.

Purpose To examine the potential utility of applying heat to increase the uptake of intravenous gadolinium (Gd) contrast into the knee joint in order to optimize MR arthrography. Materials and Methods At 1.5T, 16 knees in eight patients without prior surgery, injury, or pain were examined before and 30 minutes after intravenous administration of Gd contrast (0.1 mM/kg). Between scans a heating pad was applied to the anterior aspect of eight randomly selected knees (the contralateral knee served as the control). Initial and postcontrast imaging consisted of identical axial T1-weighted sequences (TR/TE = 500/14 msec) without fat suppression. On the initial and postcontrast images, regions of interest (ROIs) were placed at identical locations in the suprapatellar pouch and the intercondylar notch by a reader blinded to the treated side. The values at these two locations were averaged and the change in joint signal intensity was calculated. The differences between the heated and unheated knees were also calculated. Results Seven of the eight knees treated with heat had increased joint enhancement compared to the contralateral control, with percentage changes in joint signal intensity (heated knee vs. control) of +38%, +80%, +121%, +145%, +150%, +164%, and +177%. Overall there was a doubling of signal intensity (125%) on the heated side compared to the contralateral control (with significance at P = 0.039). One patient was excluded because of a prior knee injury. Conclusion The application of external heat increases uptake of intravenously administered Gd contrast into the knee joint, and may help to optimize indirect MR arthrography at a relatively low cost. J. Magn. Reson. Imaging 2005. © 2005 Wiley-Liss, Inc.

The electric heating pad represents one of the medical devices that escaped the FDA safety net by a “grandfather” exemption. An amazing number of philosophical safety issues are introduced by this relatively innocuous commodity. Pain relief is a major attribute of heating pads followed by a minor in actual medical efficacy associated with the improvement of local blood circulation. By contrast, the historic downside is very dramatic featuring electrocution, fire, and skin burns. This paper begins with a brief introduction to current protocol for placing new medical devices into the stream of commerce. In the case of heating pads, it is fortunate that the Underwriters Laboratories Inc. developed and promulgated design rules that effectively mitigated the dangers of shock/electrocution and fire. On the other hand, UL has not undertaken a technical program that addresses the skin burn problem that is the focus of this paper. Nevertheless, many heating pad manufacturers are under the impression that their compliance with UL 130 has ameliorated the skin burn propensity of their pads. Heating pad manufacturers have attempted to control skin burn injuries exclusively through the means of on-product and in-manual warnings that have been promulgated by UL, FDA, and CPSC. This approach has tenaciously maintained a burn rate of 1600 cases per year. A different approach to the skin burn problem is automatically orchestrated by invoking the “Safety Hierarchy.” For example, falling asleep and causing prolonged skin exposures to a heated pad can be eliminated by a dead-man control. Exposure to extreme temperatures that arise when both faces of the pad are concurrently covered is perhaps the most prevalent cause of skin burns. This paper exploits the notion of monitoring both face temperatures and shutting off the pad when they are almost the same. We also explored shutting down the pad when the cycle rate of the bang-bang controls was sufficiently slow; higher heating rates are associated with an uncovered face.

Many physiologic and nonphysiologic factors contribute to performing correct or incorrect nerve conduction studies. Nonphysiologic factors such as filter settings, averaging techniques, stimulus artifact, and supramaximal stimulation are just a few of the ones encountered during the nerve conduction study examination. Physiologic factors such as muscle atrophy, tremors and spasticity, edema, and profuse sweating are physical conditions that may pose technical problems during the study. Other general physiologic conditions such as height, aging and nerve maturation, variation between various nerve segments, and temperature may also contribute to the obtaining an accurate and correct nerve conduction study, as well as the electromyogram (EMG) itself. Obtaining and keeping the patient's surface temperature between 31 to 34 or 33 to 34 degrees Celsius, depending on which literature you read, is essential to obtaining and presenting correct nerve conduction studies. Cold limb temperature results in discrepancies in basic nerve conduction values such as amplitude, distal latency, conduction velocity, and duration in both motor and sensory studies. Cold to cool temperature also adversely affects the EMG. Repetitive stimulation studies for neuromuscular junction disease are greatly affected by decreasing the limb temperature. How to warm these patients and maintain a desirable temperature throughout the examination is vitally important. Methods of warming patients may vary from inexpensive to expensive in cost and simple to complex in nature.

This was a randomized controlled pilot trial to evaluate the effectiveness of cupping therapy for neck pain in video display terminal (VDT) workers.Forty VDT workers with moderate to severe neck pain were recruited from May, 2011 to February, 2012. Participants were randomly allocated into one of the two interventions: 6 sessions of wet and dry cupping or heating pad application. The participants were offered an exercise program to perform during the participation period. A 0 to 100 numeric rating scale (NRS) for neck pain, measure yourself medical outcome profile 2 score (MYMOP2 score), cervical spine range of motion (C-spine ROM), neck disability index (NDI), the EuroQol health index (EQ-5D), short form stress response inventory (SRI-SF) and fatigue severity scale (FSS) were assessed at several points during a 7-week period.Compared with a heating pad, cupping was more effective in improving pain (adjusted NRS difference: -1.29 [95% CI -1.61, -0.97] at 3 weeks (p=0.025) and -1.16 [-1.48, -0.84] at 7 weeks (p=0.005)), neck function (adjusted NDI difference: -0.79 [-1.11, -0.47] at 3 (p=0.0039) and 7 weeks (p0.0001)) and discomfort (adjusted MYMOP2 difference score: -0.72 [-1.04 to -0.40] at 3 weeks and -0.92 [-1.24, -0.60] at 7 weeks). Significant improvement in EQ-5D was observed at 7 weeks (1.0 [0.88, 1.0] with cupping and 0.91 [0.86, 0.91] with heating pad treatment, p=0.0054). Four participants reported mild adverse events of cupping.Two weeks of cupping therapy and an exercise program may be effective in reducing pain and improving neck function in VDT workers.

BACKGROUND Hypothermia is common during hemorrhagic shock. To warm the victims or not has been controversial. This study aims to investigate the effect of warming during the initial time of hemorrhage on body temperature, blood pressure, and survival in rat hemorrhagic shock models. METHODS Forty anesthetized rats were divided into control group (n = 20) and warming group (n = 20). The rats of control group were placed on a wooden pad without heating, and the rats of warming group were placed on a heating pad maintained at 37°C ± 0.1°C. Blood withdrawal reached 40% of the total blood volume within 60 minutes. Numbers of survival rats, rectal temperature, and mean arterial pressure (MAP) were recorded when blood loss reached 0 (T0), 20% (T20), 30% (T30), and 40% (T40) of the total blood volume, respectively. RESULTS Rectal temperature and MAP decrease gradually in both groups during hemorrhage. Warming continuously makes the rectal temperature of the warming group (36.68°C ± 0.63°C) slightly higher than that of the control group (36.17°C ± 0.69°C) at T0. The rectal temperature and MAP of the warming group are higher than that of the control group at T20, T30, and T40 (p < 0.05). Survival rates of the warming group are higher than that of the control group (p < 0.01). CONCLUSIONS Warming during hemorrhage may prevent exacerbation of hypothermia and hypotension and therefore improve survival.

Hypothermia can be caused by anaesthesia and/or surgery and represents a daily challenge in the operating room. Experimental animal surgery settings typically use heating pads or warming blankets to maintain the rodent's body temperature during long-lasting experiments. Warming is crucial in small animal experiments because these animals quickly lose temperature due to their large body surface to body weight ratio. While establishing a left ventricular infarction model in rats, we inserted a rectal temperature probe. The heating pad's set point was 37°C. Although a dual set point control circuit should prevent overheating, we observed a maximum heating pad's surface temperature of 43°C between the animal's back and the surface of the heating pad. At the end of the experiments, which lasted up to 8 h, the animals showed severe haematuria and segmental kidney damage. We hypothesized that overheating of the heating pad and uneven distribution of temperature led to kidney damage. Therefore, the maximal temperature of commonly used heating pads must be tightly controlled to avoid overheating, which may cause kidney or tissue injury, may falsify the experimental data and could influence the study results.

Osteoarthritis (OA) of the knee is a common and progressive condition. Michael et al1 reported that 6% of adults suffer from clinically significant knee OA with the prevalence increasing with each decade of life. Lawrence et al2 provided a summary of population based studies which revealed estimates of symptomatic and radiographically confirmed knee OA as high as 16.7%3 for those 45 years and older, with women more affected than men.2 OA results in pain and recurrent swelling and is associated with progressive functional limitations and disability.2 Multiple treatment options are available for patients with OA of the knee including the use of superficial heat or cold, transcutaneous electrical nerve stimulation (TENS), oral medications, injection of hyaluronic acid or a corticosteroid, or ultimately knee joint replacement surgery.4–6 Unfortunately, knee OA is a progressive disease and not all patients are good candidates for all interventions. Moreover, there are risks and side effects associated with medications and surgery that are not associated with some remedies, such as superficial heat or cold applications.6,7 Furthermore, not all treatment options meet with the same results, supporting individualized patient management approaches. The benefits of others such as injections of hyaluronic acid or a corticosteroid do not last indefinitely and must be repeated.8,9 The use of lower risk, lower cost interventions that are effective in helping patients manage chronic conditions including knee OA, warrant further examination and attention when discussing treatment options or recommending a plan of care. The periodic application of superficial heat or cold is a relatively safe and low cost treatment that can be recommended in isolation or in combination with other treatments for patients with knee OA.10 Contrast therapy involving intervals of heat and cold application within a treatment session offers yet another option in the management of many different musculoskeletal conditions, including knee OA. Few studies are available to demonstrate if either superficial heat, cold, or contrast therapies are of greater benefit.11 Despite limited understanding of the response to heat, cold, or contrast modalities in the management of knee OA, the application of superficial heat or cold is very common, often self-initiated, and is considered a component of a “first-line” intervention in the management of knee pain in older adults.4,12 Porcheret et al12 reported that of 201 older patients with knee pain surveyed, 84% reported applying superficial heat or cold, and most reported this treatment as a self-initiated intervention. Additionally, Cetin et al4 reported that the use of superficial heat or cold in conjunction with diathermy, TENS or ultrasound led to varying levels of symptom relief and functional improvements in patients with knee OA. Health care providers are often asked whether heat or cold is better, and how these modalities should be used outside of clinical settings for treatment of knee OA.11 Unfortunately, as previously noted, there are no clear answers or recommendations for patients to follow, hence anecdotal recommendations are often based on personal experiences, patient preferences, and previously established clinical training and education.10–15 Studying the response to thermal modalities is complicated by the fact that it is not possible to blind subjects or providers to the intervention. Moreover, clinical observations show many patients have experiences with heat and cold applications and express preferences based on these experiences. The first purpose of this Phase I study (subjects were randomized to order but not to a particular treatment with primary focus on treatment preference) was to investigate the preferences of patients with knee OA using a single device that is able to provide multiple treatment options with an identical method of application. Other factors may also need to be considered in recommending treatments. Impairments of the hand and loss of mobility in the lower extremities may impede an individual’s ability to self-apply superficial heat and cold around a peripheral joint. For example, securing an ice pack can be difficult for some patients. Furthermore, wrapping an electric heating pad in place poses risk of burns, especially if peripheral sensation or circulation is compromised. Several commercially available warm and cold-water circulating units offer a means of surrounding a joint with a garment through which temperature controlled water circulates. These garments are wrapped around the joint and held in place with Velcro™ closures. These garments may offer a safer and more convenient means of applying cold or heat. The second purpose of this investigation was to assess the preferences of patients toward a given treatment option provided by a wrap-around system when compared to use of a standard electric heating pad. A preferred treatment may or may not yield a better outcome. The third purpose of this investigation was to assess self-reports of patients with level II or greater OA16 for pain, symptoms, function in daily living (FDL) and recreation, and quality of life (QOL), following 5 days of twice daily superficial heat, cold or contrast therapy applied with a wrap-around water circulating device, twice daily use of a standard heating pad, or twice daily rest for 20 minutes.

Objectives To describe a case of systemic lidocaine toxicity from the simultaneous use of transdermal patches and a heating pad. Methods Case report and discussion. Results The focus of this case report are the interesting neuro-otologic signs of central lidocaine toxicity that occurred after a patient fell asleep on a heating pad with his Lidoderm patches in place. Hearing improvement, tinnitus reduction, and severe dizziness and ataxia were present for approximately 48 hours before spontaneous resolution. Based upon his symptoms we estimate an 11-fold increase in plasma concentrations of lidocaine. Discussion Transdermal delivery of medication affords ease of application, ability to provide continuous pharmacological therapy, and ability to supply medication to the affected site. Due to the superficial application of these medications, external environmental factors may influence the pharmacokinetics of drug delivery. This case highlights the complications that can arise from the combination of heating pads and transdermal pain therapies.

Burnham RS, Burnham TR. Effect of hand warming on electrodiagnostic testing results and diagnosis in patients with suspected carpal tunnel syndrome. Objectives To evaluate the effects of hand warming on electrodiagnostic (EDX) parameters of carpal tunnel syndrome (CTS). Specifically, to evaluate the type and magnitude of change in EDX values; to determine whether warming can change the EDX diagnosis of CTS and, if so, to determine whether specific EDX tests are more vulnerable to the effects of warming. Design Interventional before-after trial. Setting Community EDX laboratory. Participants Consecutive patients (N=33) referred for EDX evaluation of suspected CTS. Intervention Each upper limb was tested at room temperature (average hand temperature, 31.9°C) and retested after 20 minutes of heating pad warming (average hand temperature, 33.5°C). Main Outcome Measures Median and ulnar nerve motor and sensory latency, conduction velocity, and amplitude. Results Warming resulted in significantly faster transcarpal tunnel sensory and motor conduction (6%–10%), reduced median: ulnar sensory latency to digit 4 difference (23%), and reduced sensory nerve and compound motor action potential amplitude (10% and 13%, respectively). The changes resulted in 15% fewer limbs meeting the EDX conduction velocity criteria of CTS and 9% fewer by median: ulnar sensory latency to digit 4 difference. Waveform amplitudes became abnormally low after warming in 12% of limbs. Conclusions Hand warming using a heating pad for 20 minutes increases median nerve transcarpal tunnel conduction velocity and reduces amplitude. These phenomena introduce potential sources of diagnostic error, particularly in borderline cases. Generally, within hand, between nerve, and within nerve comparison techniques are less susceptible to the conduction velocity effects of warming.

We have increasingly noted that patients with traumatic injuries attended by the paramedic response unit of the Durban University of Technology, South Africa are hypothermic. Daytime winter temperatures in Kwa-Zulu Natal remain warm, but nightly coastal temperatures drop to 4°C and as low as freezing inland. ### Patient 1 An elderly man had been involved in a motor vehicle accident while being transferred to hospital by his family following an abdominal gunshot wound. Examination revealed: A, airway clear; B, respiratory rate 22/min; C, pulse >100/min and systolic BP 90 mm Hg; D, Glasgow Coma Score 15; E, temperature 34.1°C (tympanic). We minimised further exposure by positioning the response unit to act as a wind break and wrapping the patient in a space blanket while active rewarming was instigated with the application of a heating pad (DM EMG Diemme International, Italy). Warmed intravenous fluids were commenced at a keep open rate (as a radial pulse was palpable) while awaiting the …

A67-year-oldman receiving rituximab formembranous nephropathy was admitted to the hospital with volume overload. On initial physical examination,a large,nonblanchable, reticulated,hyperpigmented,graybrownpatchwas observed on the patient’s mid and lower back (Figure). He had no pain,pruritus,ordiscomfortonthispatch.He stated that his sister first noticed this patch severalmonths prior to admission. On further questioning, he acknowledged using heating pads frequently for the past 40 years to relieve chronic back pain he has experienced since amotor vehicle crash in 1975. He denies any history of burns or thermal trauma as a result of heating pad use. Quiz at jama.com Figure.Hyperpigmented cutaneous eruption onmid and lower back of patient.

A randomised controlled trial was conducted to compare the efficacy of upper body forced-air warming (Bair Hugger, Augustine Medical model 500/OR, Prairie, MN) with that of an electric heating pad (Operatherm 202, KanMed, Bromma, Sweden) for maintenance of intra-operative body temperature in 60 patients undergoing laparotomy under general anaesthesia. The nasopharyngeal temperature was recorded throughout the operative period. The mean (SD) final temperatures were 36.2 (0.4) degrees C with forced-air warming and 35.5 (1.0) degrees C with electric heating pad (p < 0.01). Upper body forced-air warming is more effective than the heating pad for maintenance of body temperature during laparotomy.

No abstract available. (Published: 1 September 2015) Citation: Journal of Community Hospital Internal Medicine Perspectives 2015, 5 : 28335 - http://dx.doi.org/10.3402/jchimp.v5.28335

We conducted a randomised controlled trial to compare the efficacy of forced-air warming (Bair Hugger(trade mark), Augustine Medical model 500/OR, Prairie, MN) with that of an electric heating pad (Operatherm 202, KanMed, Sweden) for maintenance of intra-operative body temperature in 60 patients undergoing total knee replacement under combined spinal-epidural anaesthesia. Intra-operative tympanic and rectal temperatures and verbal analogue score for thermal comfort were recorded. There were no differences in any measurements between the two groups, with mean (SD) final rectal temperatures of 36.8 (0.4) degrees C with forced-air warming and 36.9 (0.4) degrees C with the electric pad. The heating pad is as effective as forced-air warming for maintenance of intra-operative body temperature.

Eight U.S. Navy divers were submerged in 7.2 C (45 degrees F) water for a maximum of two hours in three different conditions: no heating while wearing a semidry suit, heated in a semidry suit, and heated in a 7mm wet suit. A total of 35 W was delivered to each heating pad. Statistical analysis demonstrated that providing heating to the divers afforded no benefits in reducing the effects of cold water exposure on the skin temperature of the body extremities (fingers and toes) or in enhancing manual dexterity, grip strength, or cognitive performance when the effects of such heating were compared to those of the unheated condition. However, the participants reported that they would rather dive with the heating system than without it.

Objective To investigate the hypothesis that cutaneous microvascular perfusion of the dorsum of the hand (in response to local heating) and distal phalanx (in response to occlusion) is impaired in patients with systemic sclerosis (SSc) compared with healthy controls. Methods Twenty-nine patients with SSc and 29 control subjects were recruited. Perfusion was monitored using novel dual-wavelength laser Doppler imaging, allowing measurement of both smaller (capillaries) and larger (thermoregulatory) vessels. Postacclimatization, a baseline dorsum scan (red or green wavelength) was performed. A heating pad was placed on the dorsum (total stimulus time 6 minutes at 34–40°C), and following removal of the pad, baseline wavelength scans were performed until perfusion returned to baseline values. This was then repeated for the second wavelength. The maximum perfusion increase due to heating (PEAK1) and area under the perfusion–time curve (AUC) were determined. In addition, scans (both wavelengths) of the index finger were performed prior to and during 2 minutes of suprasystolic occlusion, and the response upon occlusion release was monitored with single-point laser Doppler. The decrease in perfusion due to occlusion (from preocclusion baseline values) (%DECREASE) and the maximum increase (from baseline perfusion values under occlusion) in hyperemic perfusion upon removal of occlusion (PEAK/OCC) were calculated. Results PEAK1 and AUC values were not significantly different between patients and controls, as assessed with either wavelength. A significant difference between groups was found in the %DECREASE values with the green, but not the red, wavelength. A significant between-group difference was also found in PEAK/OCC values, using both wavelengths. Conclusion This study suggests that SSc has no effect on microvascular perfusion in the dorsum of the hand, and that the abnormal microvascular response is localized to the digits, affecting both smaller and larger vessels.