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Park D, Kim Y. Kilohertz-frequency interferential current induces hypoalgesic effects more comfortably than TENS. Sci Rep 2023; 13:8644. [PMID: 37244893 DOI: 10.1038/s41598-023-35489-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/18/2023] [Indexed: 05/29/2023] Open
Abstract
Recent research on transcutaneous electrical stimulation has shown that inhibiting nerve conduction with a kilohertz frequency is both effective and safe. This study primarily aims to demonstrate the hypoalgesic effect on the tibial nerve using transcutaneous interferential-current nerve inhibition (TINI), which injects the kilohertz frequency produced by the interferential currents. Additionally, the secondary objective was to compare the analgesic effect and comfort of TINI and transcutaneous electrical nerve stimulation (TENS). Thirty-one healthy adults participated in this cross-over repeated measures study. The washout period was set to 24 h or more. Stimulus intensity was set just below the pain threshold level. TINI and TENS were applied for 20 min each. The ankle passive dorsiflexion range of motion, pressure pain threshold (PPT), and tactile threshold were measured at the baseline, pre-test, test (immediately before ceasing intervention), and post-test (30 min after ceasing intervention) sessions. After the interventions, the participants evaluated the level of discomfort for TINI and TENS on a 10 cm visual analog scale (VAS). As the results, PPT significantly increased compared to baseline in test and posttest sessions of TINI, but not in those of TENS. Also, participants reported that TENS was 36% more discomfort than TINI. The hypoalgesic effect was not significantly different between TINI and TENS. In conclusion, we found that TINI inhibited mechanical pain sensitivity and that the inhibitory effect persisted long after electrical stimulation ceased. Our study also shows that TINI provides the hypoalgesic effect more comfortably than TENS.
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Affiliation(s)
- Dahoon Park
- Department of Sports Rehabilitation, Cheongju University, Cheongju, South Korea
| | - Yushin Kim
- Department of Sports Rehabilitation, Cheongju University, Cheongju, South Korea.
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2
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Grzesiek M, Ellmann C, Ditting T. Put Your Lights On: Electrocution As a Cause of an Unexplained Fall and Loss of Consciousness. Eur J Case Rep Intern Med 2019; 6:001084. [PMID: 31157182 PMCID: PMC6542489 DOI: 10.12890/2019_001084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 03/27/2019] [Indexed: 11/05/2022] Open
Abstract
Electrical accidents are not reported very frequently, and may occur undetected as the signs are often manifold and not very specific. We report the case of a 43-year-old woman admitted to hospital due to a fall of unclear cause, with loss of consciousness, partial amnesia, paresis of both legs and crush syndrome. Only by thorough and repeated history-taking, and a careful physical examination that revealed burns typical of electrical current injuries, was the case resolved. With this case presentation, we would like to make the reader aware of electrocution as a possible cause of bruises and unconsciousness of unclear origin.
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Affiliation(s)
| | | | - Tilmann Ditting
- Klinik für Innere Medizin 4, Klinikum Nürnberg, Nuremberg, Germany
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3
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Imani MT, Mohammadi AA, Seyed Jafari SM. Spontaneous Fracture of the Humerus 18 Months after a High Voltage Electrical Injury: A Case Report. Oman Med J 2014; 29:e068. [PMID: 30838097 PMCID: PMC6389663 DOI: 10.5001/omj.2014.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 01/23/2014] [Indexed: 11/03/2022] Open
Abstract
Electrical burn occurs when a current passes through the body, interfering with the function of internal organs or sometimes burning tissue. Four major mechanisms of electricity-induced injuries are presently known. In this case report, a 29-year-old farmer sustained electrical trauma to extremities from a high voltage transformer, followed by a major, deep burn wound on upper lateral aspect of his left arm, and a deep burn wound over the left medial ankle. After a few months, the patient developed left arm fracture with complete separation of two segments, and plantar wound with purulent discharge accompanied by complete destruction of the head of 4th metatarsal bone which was in favor of chronic osteomyelitis. In this case, passage of the high voltage current and direct trauma could destroy metaphyseal, medullary and periosteal blood supply. Patients with high voltage electrical-induced bone injuries who underwent reconstructive surgery seem to be susceptible to osteonecrosis and pathologic fractures; therefor, these patients should be under close follow-up and periodic radiologic evaluations may be recommended.
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Affiliation(s)
- Mohammad Taghi Imani
- Shiraz Burn Research Center, Division of Plastic and Reconstructive Surgery Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Akbar Mohammadi
- Shiraz Burn Research Center, Ghotbedin Burn Hospital, Fakhrabad street, Shiraz, Iran, Postal Code: 71638-54733
| | - Seyed Morteza Seyed Jafari
- Shiraz Burn Research Center, Division of Plastic and Reconstructive Surgery Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
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4
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Servant A, Bussy C, Al-Jamal K, Kostarelos K. Design, engineering and structural integrity of electro-responsive carbon nanotube- based hydrogels for pulsatile drug release. J Mater Chem B 2013; 1:4593-4600. [PMID: 32261202 DOI: 10.1039/c3tb20614a] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Triggerable drug delivery from polymeric implants offers the possibility to generate remote-controlled drug release profiles that may overcome the deficiencies of conventional administration routes (intravenous injections and oral administration) including the toxicity due to overdose and systemic administration. An electro-responsive delivery system was engineered to deliver drug molecules in a pulsatile manner, controlled by the on/off application of electric voltage. Pristine multi-walled carbon nanotubes (pMWNTs) were incorporated into a polymethacrylic acid (PMAA)-based hydrogel matrix by in situ radical polymerisation. The effect of pMWNTs and cross-linker concentration on the electrical and mechanical properties of the hydrogel hybrids was thoroughly investigated. The incorporation of pMWNTs into the polymeric network improved the electrical properties of the hydrogel hybrids and drug release from the gels was significantly enhanced at high pMWNT concentrations, reaching 70% of the loaded dose after two short electrical stimulations. The presence of pMWNTs within the hydrogel matrix affected however the mechanical properties of the hydrogel by decreasing the pore size and therefore the swelling/de-swelling of the gels. The damage to the hybrid gel surfaces after electrical stimulation and the loss of the pulsatile release profile at high cross-linker concentrations suggested that the mechanism of drug release involved a compressing effect and intensified the stress on the polymeric network as a result of the electrical properties of pMWNTs.
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Affiliation(s)
- Ania Servant
- Nanomedicine Lab, UCL School of Pharmacy, University College London, UK.
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5
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Servant A, Methven L, Williams RP, Kostarelos K. Electroresponsive polymer-carbon nanotube hydrogel hybrids for pulsatile drug delivery in vivo. Adv Healthc Mater 2013. [PMID: 23184678 DOI: 10.1002/adhm.201200193] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Drug release triggered by an external non-invasive stimulus is of great interest for the development of new drug delivery systems. The preparation of an electroresponsive multiwalled carbon nanotube/poly(methylacrylic acid) (MWNT/PMAA)-based hybrid material is reported. The hydrogel hybrids achieve a controlled drug release upon the ON/OFF application of an electric field, giving rise to in vitro and in vivo pulsatile release profiles.
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Affiliation(s)
- Ania Servant
- Nanomedicine Lab, UCL School of Pharmacy, University College London, 29–39 Brunswick Square, London WC1N 1AX, UK
| | - Laura Methven
- Nanomedicine Lab, UCL School of Pharmacy, University College London, 29–39 Brunswick Square, London WC1N 1AX, UK
| | - Rhodri P. Williams
- Centre for NanoHealth, School of Engineering, Swansea University, Swansea SA2 8PP, Wales, UK
| | - Kostas Kostarelos
- Nanomedicine Lab, UCL School of Pharmacy, University College London, 29–39 Brunswick Square, London WC1N 1AX, UK
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6
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Affiliation(s)
- G. Darmanin
- Department of Vascular Surgery, Medway Maritime Hospital,
Gillingham, Kent, UK
| | - B. Bhomick
- Department of Vascular Surgery, Medway Maritime Hospital,
Gillingham, Kent, UK
| | - L. Corfield
- Department of Vascular Surgery, Medway Maritime Hospital,
Gillingham, Kent, UK,
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7
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Remarks Concerning the Nomenclature of Electrical Injuries. POLISH JOURNAL OF SURGERY 2010. [DOI: 10.2478/v10035-010-0053-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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8
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Koul AR, Patil RK, Philip VK. Early use of microvascular free tissue transfer in the management of electrical injuries. Burns 2008; 34:681-7. [PMID: 18241999 DOI: 10.1016/j.burns.2007.08.025] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2007] [Accepted: 08/31/2007] [Indexed: 02/07/2023]
Abstract
High-tension electricity can cause devastating injuries which may result in major soft-tissue loss, limb loss and sometimes major threat to life. Deep structures may be exposed and require flap cover, but microvascular flap transfer in electrical burn has a comparatively high-failure rate. This article aims to evaluate the outcome of early reconstruction of such injuries using free tissue transfer. In the course of 3 years (2004-2006), 16 free tissue transfers were performed in 13 cases of electrical injury from 24h to 3 weeks after trauma. All flaps survived except one. The failure was due to vascular erosion and secondary haemorrhage. There was no incident of vascular occlusion. Thus, if wound debridement is meticulous and microvascular anastomosis is performed well away from the trauma site, free flaps should survive as well in electrical burn cases as in any other.
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Affiliation(s)
- A R Koul
- Medical Trust Hospital, Ernakulam, Kerala, India
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Jakubeniene M, Zakaras A, Minkuviene ZN, Benoshys A. Application of atomic absorption spectroscopy for detection of multimetal traces in low-voltage electrical marks. Forensic Sci Int 2005; 161:36-40. [PMID: 16314061 DOI: 10.1016/j.forsciint.2005.10.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2005] [Revised: 10/24/2005] [Accepted: 10/24/2005] [Indexed: 11/20/2022]
Abstract
Application of atomic absorption spectroscopy to detect multimetal traces in injured skin is a promising tool for investigation of fatalities caused by electrocution. The present paper is aimed at testing the reliability of this method for metal traces detection in electric current marks and is focused on study of peculiarities of metal penetration into the skin exposed to a current impact. Bare aluminum wire, tin-lead coated copper multistrand wire, and zinc-plated steel rope were used to make electrical marks on pig skin. It is demonstrated that amount of copper, zinc, lead, and iron may serve as statistically reliable indicators for the type of wire, which caused the electrical mark, in spite of the background content of these metals in the skin without injury. Different penetration rates for different metals contained in the wire inflicting an electrical mark were observed.
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Affiliation(s)
- Marija Jakubeniene
- Institute of Forensic Medicine, Mykolas Romeris University, S. Zukausko 12, Vilnius LT-08234, Lithuania.
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Landecker A, Macieira L. Penile and upper extremity amputation following high-voltage electrical trauma: case report. Burns 2002; 28:806-10. [PMID: 12464483 DOI: 10.1016/s0305-4179(02)00196-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alan Landecker
- Andaraí Municipal Hospital Burn Unit, Rio de Janeiro, Brazil.
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11
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Cherington M, Kurtzman R, Krider EP, Yarnell PR. Mountain medical mystery. Unwitnessed death of a healthy young man, caused by lightning. Am J Forensic Med Pathol 2001; 22:296-8. [PMID: 11563744 DOI: 10.1097/00000433-200109000-00020] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A healthy 20-year-old man failed to return home after a jog in the Colorado mountains. His lifeless body was found the next day on an exposed mountain slope. The differential diagnosis in such mysterious, unwitnessed mountain deaths includes cardiac arrhythmia, cerebral hemorrhage, pulmonary embolism, seizures, trauma, high-altitude sickness, and hypothermia. The cause of death in this case was established on postmortem examination. The findings of ruptured tympanic membranes and a melted shoe established this as a case of lightning strike fatality. The National Lightning Detection Network can be a valuable resource to investigators by providing information on the location and date of lightning strikes in the vicinity of the victim.
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Affiliation(s)
- M Cherington
- Lightning Data Center, Centura Health-St. Anthony Hospital, Denver, Colorado 80204, USA
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12
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Abstract
Every year in the USA, 100-150 people die and 1000-1500 others are injured by lightning strikes. Ophthalmic and neurologic injuries from lightning strike are common. The most common permanent ocular sequela is cataract, but many areas of the eye can be affected. Prompt evaluation by an ophthalmologist is imperative for maximizing outcomes. Incidence and mechanisms of lightning strike injury are summarized, with special emphasis on the treatment of ocular injuries.
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Affiliation(s)
- M E Norman
- Seacoast Ophthalmology, Portsmouth, New Hampshire, USA
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13
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Drabick JJ, Glasspool-Malone J, King A, Malone RW. Cutaneous transfection and immune responses to intradermal nucleic acid vaccination are significantly enhanced by in vivo electropermeabilization. Mol Ther 2001; 3:249-55. [PMID: 11237682 DOI: 10.1006/mthe.2000.0257] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Naked DNA injection with electropermeabilization (EP) is a promising method for nucleic acid vaccination (NAV) and in vivo gene therapy. Skin is an ideal target for NAV due to ease of administration and the accessibility of large numbers of antigen-presenting cells within the tissue. This study demonstrates that in vivo skin EP may be used to increase transgene expression up to an average of 83-fold relative to naked DNA injection (50 microg DNA per dose, P < 0.005). Transfected cells were principally located in dermis and included adipocytes, fibroblasts, endothelial cells, and numerous mononuclear cells with dendritic processes in a porcine model. Transfected cells were also observed in lymph nodes draining electropermeabilized sites. A HBV sAg-coding plasmid was used to test skin EP-mediated NAV in a murine model. Analysis of humoral immune responses including immunoglobulin subclass profiles revealed strong enhancement of EP-mediated NAV relative to naked DNA injection, with a Th1-dominant, mixed-response pattern compared to immunization with HBV sAg protein that was exclusively Th2 (P = 0.02). Applications for these findings include NAV-based modulation of immune responses to pathogens, allergens, and tumor-associated antigens and the modification of tolerance.
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Affiliation(s)
- J J Drabick
- Hematology-Oncology Service, Walter Reed Army Medical Center, Bethesda, Maryland 20307, USA
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14
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Abstract
Electricity and lightning can cause injury in a variety of ways, some of which may remain hidden from the unsuspecting physician until it is too late. Prompt and, if necessary, prolonged resuscitation are of proven benefit. Particular attention must be paid to the patient who suffers high-voltage injury, and deep electrothermal burns on damage to vital organs should be excluded. Uncommonly late sequelae are seen, and such patients require appropriate care.
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Affiliation(s)
- S Jain
- Department of Pulmonary and Critical Care Medicine, Ben Taub General Hospital, Baylor College of Medicine, Houston, Texas, USA
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