8Preconditioning with Hyperthermia to Reduce Exercise-Induced Muscle Damage
Physiological Research (2022) · T. Mikami, H. Yamauchi
This study investigated whether hyperthermia before exercise could protect against exercise-induced muscle damage. Two preconditioning methods were evaluated in rodents: whole-body heat exposure (42°C for 30 min) and regional heating of the legs using microwave diathermy. Both methods significantly increased HSP70 and HSP25 levels in the soleus muscle. Muscle damage markers, including plasma creatine kinase and beta-glucuronidase, were lower in heat-exposed rodents than in controls. Histological analysis confirmed reduced muscle damage. These findings suggest that pre-exercise hyperthermia, including microwave diathermy, enhances muscle protection by increasing heat shock proteins and reducing structural damage.
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15Collagen Shortening: An Experimental Approach with Heat
Clinical Orthopaedics and Related Research (1997) · C.T. Vangsness Jr, W. Mitchell 3rd, M. Nimni, M. Erlich, V. Saadat, H. Schmotzer
This in vitro study investigated the effects of heat on human collagen, specifically its ability to shrink and its mechanical and histological changes. Fresh frozen human tendons were subjected to heat in a saline solution, demonstrating a predictable shrinkage curve. A sharp increase in shrinkage (up to 70% of the original length) was observed around 70°C. Additionally, an Nd:YAG laser was used to induce precise, dose-dependent collagen shortening. Tendons shortened by 10% exhibited a significant decrease in load-to-failure strength (to about one-third of control specimens). Histological analysis revealed distinct thermal denaturation zones while preserving adjacent collagen. These findings suggest that collagen can be precisely shortened using heat, though further research is needed to assess biological responses, including recollagenization and long-term biomechanical effects.
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65Continuous Cold Therapy Reduces Pain After Shoulder Surgery
Journal of Shoulder and Elbow Surgery (2001) · Singh H, Osbahr DC, Holovacs TF, Cawley PW, Speer KP
This prospective randomized study evaluated the effectiveness of continuous cryotherapy (cold therapy) after shoulder surgery in 70 patients. Patients were assigned to either a continuous cryotherapy group or an age-matched control group receiving no cold therapy. On the first day after surgery, patients receiving cryotherapy reported significantly less pain during sleep, greater comfort in bed, and more restful sleep than control subjects. The pain-reducing benefits of cold therapy persisted throughout the recovery period. These findings demonstrate that continuous cold therapy is an effective method for managing pain and improving comfort after shoulder surgery.
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76Acetaminophen Is the Leading Cause of Acute Liver Failure in the United States
Hepatology (2004) · Lee WM
This review examined data from the U.S. Acute Liver Failure Study Group, a registry of over 700 patients with acute liver failure across the United States. The findings reveal that acetaminophen (Tylenol) overdose is the leading cause of calls to Poison Control Centers, accounting for more than 100,000 calls per year. It is responsible for more than 56,000 emergency room visits, 2,600 hospitalizations, and an estimated 458 deaths due to acute liver failure annually. Acetaminophen poisoning was implicated in nearly 50% of all acute liver failure cases in the country. The study highlights that while acetaminophen is heavily marketed for its safety compared to NSAIDs and is readily available over the counter, the scale of injury and death associated with its misuse is substantial. The author questions whether this level of harm is acceptable for an over-the-counter pain reliever, particularly when unintentional overdosing occurs from taking multiple acetaminophen-containing products simultaneously or using them for extended periods. The findings support caution with acetaminophen use, especially for chronic pain conditions that may lead to prolonged or excessive consumption.
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82Topical NSAIDs Provide Effective Pain Relief Without Systemic Side Effects
Cochrane Database of Systematic Reviews (2015) · Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ
This Cochrane systematic review analyzed 61 studies with over 8,700 participants to evaluate the effectiveness and safety of topical NSAIDs for acute musculoskeletal pain such as sprains, strains, and overuse injuries. The study found that topical NSAID formulations including diclofenac, ibuprofen, and ketoprofen gels provided significantly higher rates of pain relief compared to placebo. The number needed to treat (NNT) for clinical success, meaning the number of patients who need to be treated for one to achieve at least 50% pain relief, was as low as 1.8 for diclofenac gel and 3.9 for ibuprofen gel. These effectiveness rates are probably similar to those provided by oral NSAIDs. Critically, local skin reactions were generally mild and transient, and there were very few systemic adverse events, meaning the gastrointestinal and other body-wide side effects associated with oral NSAIDs were largely avoided. This review supports topical NSAIDs as a safer alternative to oral NSAIDs for managing acute musculoskeletal pain, particularly for patients who need pain relief but want to avoid the risks of GI bleeding, liver damage, or impaired tissue healing associated with systemic NSAID use. Topical application delivers the medication directly to the injured area while minimizing exposure to the rest of the body.
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