Tyrimo objektas: lėtinio reumatoidinio artrito gydymas taikant šaltį (krioterapiją). Tyrimo problema: reumatoidinis artritas sukelia sąnarių skausmą, tuo pačiu mažindamas jų judesio amplitudę, pablogindamas žmogaus fizinę būklę. Skausmas, sąnarių sustingimas ir jų sumažėjusi judesio amplitudė priklauso nuo ligos progresavimo. Didžiausias dėmesys šiame darbe buvo skiriamas skausmo sumažėjimui ir judesio amplitudės padidėjimui po krioterapijos. Tyrimo hipotezė: šalčio (krioterapijos) taikymas du kartus savaitėje penkias savaites turėtų sumažinti reumatoidinio artrito sukeltą sąnarių sustingimą, padidinti judesio amplitudę ir sumažinti sąnarių skausmą. Tyrimo tikslas — nustatyti šalčio (krioterapijos) veiksmingumą sergant lėtiniu reumatoidiniu artritu. Tyrimo uždaviniai buvo: įvertinti tiriamųjų sąnarių skausmą prieš ir po krioterapijos taikymo. Įvertinti tiriamųjų judesio amplitudę prieš ir po krioterapijos taikymo. Įvertinti tiriamųjų sąnarių sustingimą prieš ir po krioterapijos taikymo. Įvertinti tiriamųjų sąnarių skausmą, judesio amplitudę ir sąnarių sustingimą priklausomai nuo krioterapijos procedūrų skaičiaus. Tyrime dalyvavo 40 tiriamųjų (30 moterų ir 10 vyrų). 14 tiriamųjų atliko 5 procedūras; 15 tiriamųjų atliko 10 procedūrų; 11 tiriamųjų atliko 7 krioterapijos procedūras. Tiriamųjų judesio amplitudė ir skausmas buvo įvertinti prieš ir po krioterapijos. Atlikus surinktų duomenų analizę padarytos šios išvados: 1. Tiriamųjų, sergančių reumatoidiniu artritu, sąnarių... [toliau žr. visą tekstą] / Object: range of movement and pain in rheumatoid arthritis applying cryotherapy. Problem: rheumatoid arthritis induces joints’ pain, reduces range of movement, and makes human’s physical condition worse. Pain, joints’ stiffness and reduced range of movement depend on progression of disease. Serious consideration in this work was paid in reducing pain and stiffness and increasing range of movement after applying cryotherapy. Hypothesis: applying of cryotherapy should reduce joints’ stiffness which is caused by rheumatoid arthritis, increase range of movement and reduce pain. The aim of this study was to assess efficiency of cryotherapy in rheumatoid arthritis. The tasks: 1. To evaluate joints’ pain before and after applying cryotherapy; 2. To evaluate range of movement before and after cryotherapy; 3. To evaluate morning stiffness before and after cryotherapy; 4. To evaluate joints’ pain, range of movement and morning stiffness in relation to the number of applied cryotherapy procedures. Subjects: 40 patients (30 females and 10 males) took part in the research: 5 procedures were prescribed for 14 patients, 10 procedures of cryotherapy were prescribed for 15 patients and 7 procedures were prescribed for 11 patients. Range of movement, pain and morning stiffness were measured before and after applying cryotherapy. Statistical methods were used to analyze data. The main findings: 1. Pain of the joints before applying cryotherapy was evaluated as moderate, after applying... [to full text]

Problem of research. Joints – important part of human movement apparatus. Therefore joint traumas are a serious problem both from medical and social point of view. In case of mechanical trauma very often knee joint is hurt. Most often young people suffer from traumas, particularly sportsmen when knee joint cruciate ligaments are hurt. In such situations as one of the most effective physioterapical treatment methods cryotherapy is applied. In 2004 in Lithuania particularly low temperature medical CO2 gas (-78 0C) was applied, sprinkled with 50 bar power. Dry bacteriostatic gas which during a very short time of application (30–60 sec) cause thermal shock in tissues – cool down tissues in a very short time from +5 to +2 0C. Theoretical background of cryotherapy and practical experience in Lithuania are not widely described that’s why it is necessary to make more intense research, to generalize its results, to seek for most effective methods of research stimulating faster rehabilitation of patients’ working capacity. Objective of study. Taking into consideration the fact that cryotherapy is very new and very live in Lithuania, it was selected as the theme for Master’s thesis, its objective is to estimate the influence of cryotherapic treatment on the functions of knee joint functions after cruciate ligament reconstruction. Task of study: to evaluate the dynamics of pain intensity experienced by patients, knee joint movement amplitude dynamics, knee joint oedema scope dynamics... [to full text]

In the last few years researchers have more and more focussed on the possible use of cryotherapy as an acute and long term recovery facilitating technique by sportsmen and women. Barnette (2006) did, however, state that research supporting cryotherapy as a recovery facilitating technique, is not convincing and that the majority of research show that it has a negative impact on the recovery of subjects after exercise. It is against this background that the aim of the study was firstly to critically analyse the available literature of the past fifteen years (1992-2007) with regard to the study subject; die nature of the cryotherapy technique that was used as well as the findings with regards to the effects of these types of techniques on a wide variety of physiological variables, physical and motor performance; secondly, to provide guidelines for the use of cryotherapy as a recovery facilitating technique and thirdly to determine the effect of cryotherapy on the acute recovery of University netball players' lower leg muscles in an isokinetic ankle exercise. Firstly, it was shown that ice water immersion and ice pack application are the most common techniques that are used in cryotherapy studies. The results in the majority of articles indicated that cryotherapy had a non-significant acute effect on isokinetic, eccentric and concentric peak torque as well as time to reach peak torque and the angle at which the peak torque was reached; isometric, maximal and sub-maximal strength and accuracy of strength execution; normalized, average vertical ground reaction force as well as time of reaching peak power and vertical jump height; baseball pitching accuracy, proprioception, ankle joint range of movement, positioning and speed during execution of a movement; blood lactate removal and blood flow speed as well as muscle soreness after completion of an exercise. With regard to the long term effects of cryotherapy research showed that isotonic hand grip strength and endurance, plasma adrenaline, non-adrenaline, dopamine, renine, aldosterone, heart rate and blood pressure after 6 weeks; respiratory gas exchange ratio, heart rate, muscle glycogen concentration, plasma lactate, glucose and free fatty acids after 8 weeks or brachial artery cross-section and vascular endothelial growth factor after 4 weeks of exercise and cryotherapy did not experience any significant changes between the cryotherapy and control group. Other physical, motor performance and physiological variables did not show a certain trend with regards to the way they were affected by cryotherapy. In some cases variables were affected significantly negatively while the opposite was true in other cases where variables were significantly positively influenced. With regard to the results of the study on the acute recovery of University netball players' lower leg muscles due to cryotherapy, it was found that the acute recovery of only four isokinetic variables were significantly influenced (p = 0.05) by cryotherapy, namely: left leg relative total dorsiflexion work, average peak dorsiflexion torque, right dorsiflexion and plantar flexion endurance. The acute recovery of the first mentioned strength endurance related variable was significantly negatively influenced by the cryotherapy. In contrast with this result the acute recovery of the three last mentioned isokinetic muscle relative peak torque and endurance related variables were significantly positively influenced by the cryotherapy. The overall conclusion that can therefore be drawn from the above-mentioned results show that the majority of isokinetic plantar- and dorsiflexion torque variables (12 out of 16, 75%) as well as other physical, motor performance and physiological variables experience no significant effect with regards to acute and long term recovery due to cryotherapy. The research did, however, show that the effectiveness of cryotherapy was influenced by the adiposity thickness, nature of the cryotherapy application, type of medium that was used for cryotherapy application and the length of time during which cryotherapy was applied. The recommendation for the use of cryotherapy as a recovery facilitating technique can be summarised as follows: the temperature of the cryotherapy medium that is used, must vary between 5°C and 10°C; the duration of cryotherapy between 15 and 20 minutes; the most general application area: for ice water immersion - immersed up until the level of the gluteal fold or crista ileac and the whole arm or forearm; for ice pack application - on the thigh, ankle and peripheral of the shoulder; the most common and effective ice pack application is direct on the skin surface by means of a bag filled with between 500 g and 1 500 g cubic formed ice. For long term use more that 2 consecutive days of cryotherapy application is recommended. / Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2008.

In the last few years researchers have more and more focussed on the possible use of cryotherapy as an acute and long term recovery facilitating technique by sportsmen and women. Barnette (2006) did, however, state that research supporting cryotherapy as a recovery facilitating technique, is not convincing and that the majority of research show that it has a negative impact on the recovery of subjects after exercise. It is against this background that the aim of the study was firstly to critically analyse the available literature of the past fifteen years (1992-2007) with regard to the study subject; die nature of the cryotherapy technique that was used as well as the findings with regards to the effects of these types of techniques on a wide variety of physiological variables, physical and motor performance; secondly, to provide guidelines for the use of cryotherapy as a recovery facilitating technique and thirdly to determine the effect of cryotherapy on the acute recovery of University netball players' lower leg muscles in an isokinetic ankle exercise. Firstly, it was shown that ice water immersion and ice pack application are the most common techniques that are used in cryotherapy studies. The results in the majority of articles indicated that cryotherapy had a non-significant acute effect on isokinetic, eccentric and concentric peak torque as well as time to reach peak torque and the angle at which the peak torque was reached; isometric, maximal and sub-maximal strength and accuracy of strength execution; normalized, average vertical ground reaction force as well as time of reaching peak power and vertical jump height; baseball pitching accuracy, proprioception, ankle joint range of movement, positioning and speed during execution of a movement; blood lactate removal and blood flow speed as well as muscle soreness after completion of an exercise. With regard to the long term effects of cryotherapy research showed that isotonic hand grip strength and endurance, plasma adrenaline, non-adrenaline, dopamine, renine, aldosterone, heart rate and blood pressure after 6 weeks; respiratory gas exchange ratio, heart rate, muscle glycogen concentration, plasma lactate, glucose and free fatty acids after 8 weeks or brachial artery cross-section and vascular endothelial growth factor after 4 weeks of exercise and cryotherapy did not experience any significant changes between the cryotherapy and control group. Other physical, motor performance and physiological variables did not show a certain trend with regards to the way they were affected by cryotherapy. In some cases variables were affected significantly negatively while the opposite was true in other cases where variables were significantly positively influenced. With regard to the results of the study on the acute recovery of University netball players' lower leg muscles due to cryotherapy, it was found that the acute recovery of only four isokinetic variables were significantly influenced (p = 0.05) by cryotherapy, namely: left leg relative total dorsiflexion work, average peak dorsiflexion torque, right dorsiflexion and plantar flexion endurance. The acute recovery of the first mentioned strength endurance related variable was significantly negatively influenced by the cryotherapy. In contrast with this result the acute recovery of the three last mentioned isokinetic muscle relative peak torque and endurance related variables were significantly positively influenced by the cryotherapy. The overall conclusion that can therefore be drawn from the above-mentioned results show that the majority of isokinetic plantar- and dorsiflexion torque variables (12 out of 16, 75%) as well as other physical, motor performance and physiological variables experience no significant effect with regards to acute and long term recovery due to cryotherapy. The research did, however, show that the effectiveness of cryotherapy was influenced by the adiposity thickness, nature of the cryotherapy application, type of medium that was used for cryotherapy application and the length of time during which cryotherapy was applied. The recommendation for the use of cryotherapy as a recovery facilitating technique can be summarised as follows: the temperature of the cryotherapy medium that is used, must vary between 5°C and 10°C; the duration of cryotherapy between 15 and 20 minutes; the most general application area: for ice water immersion - immersed up until the level of the gluteal fold or crista ileac and the whole arm or forearm; for ice pack application - on the thigh, ankle and peripheral of the shoulder; the most common and effective ice pack application is direct on the skin surface by means of a bag filled with between 500 g and 1 500 g cubic formed ice. For long term use more that 2 consecutive days of cryotherapy application is recommended. / Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2008.

Background: Cryotherapy is commonly used during physiotherapeutic rehabilitation of patients following total knee replacement (TKR). Evidence for treatment effectiveness within the current literature is contradictory and there are no clinical guidelines to inform cryotherapy treatment within this particular patient group. This study surveys current cryotherapy treatment efficacy in the acute post-operative management of TKR patients. Methods: In total 263 senior physiotherapists completed and returned a postal questionnaire, which, using open and closed questions investigated the use of cryotherapy following TKR. Survey results were used to inform a pragmatic randomized clinical trial (RCT) involving 133 consecutive TKR patients. The RCT investigated cryotherapy treatment efficacy in the acute post-operative management of TKR patients. Patients were randomized into three groups; no cryotherapy (NC), delayed cryotherapy (DC) and immediate cryotherapy (IC). The primary outcome measure was post-operative pain with knee swelling, active range of motion (AROM), function and levels of physiotherapy input assessed as secondary outcome measures. Observations were taken pre-operatively and at 3, 7 and 42 days post-operatively. Results: The survey reported that 33% of respondents used some form of cryotherapy routinely following TKR surgery. The two main methods of cryotherapy application were Cryocuff (59%) and crushed ice (30%). Treatments were most frequently applied between 24 hrs and 48 hrs post-surgery for 20 minutes, twice a day. Chi square analysis indicated significant differences (p<0.01) in between NHS and private sites relating to a lack of cryotherapy resources and treatment time for cryotherapy in the NHS. A lack of proven efficacy was the most cited reason for not applying cryotherapy treatment, and swelling the most common treatment indicator. There was particular uncertainty regarding the cleaning and sterilization of the Cryocuff device. The RCT indicated that patients in IC group had significantly less post-operative pain than the NC and DC groups at 3 days. Mean difference (p <0.05, 95% CI) in post-operative analogue scores (VAS, scale 0-10) was -1.6 (p <0.01, CI -2.49- to -0.707) for IC and NC; and -0.922 (p= 0.044, CI -0.183 to -0.009) for IC and DC groups. At 7 and 42 days there were significant reductions in VAS scores for both cryotherapy groups compared to the NC group. There was significant improvement in knee swelling, AROM, ability to transfer and need for additional physiotherapy in both cryotherapy treatment groups although no significant reduction in opiate requirement was found. Conclusions: In current clinical practice there was little consensus regarding treatment indicators, method of application and management of cryotherapy following TKR. However, in a RCT the use of cryotherapy combined with compression, as compared to a no cryotherapy control, led to significant reductions in patient reported pain, less post-operative swelling, greater recovery of AROM, faster return of function and less reliance on OPD physiotherapy treatment. It is concluded that cryotherapy combined with compression has an important role to play in the acute rehabilitation of TKR and should be considered as part of routine management.

Elektrokardiografinių rodiklių, ypač jų tarpusavio sąsajų kaitos tyrimas ir jų vertinimas naujais matematiniais analizės metodais – tai naujos galimybės praktiniam kompleksinių sistemų teorijos pritaikymui, siekiant atskleisti kurortinių veiksnių sukeliamus efektus. Bendrosios krioterapijos ir peloidoterapijos (gydomojo purvo vonios) procedūrų metu buvo nepertraukiamai registruota 12-os derivacijų EKG ir vertinta EKG rodiklių kaita šių procedūrų metu. Pritaikius naują matematinės analizės metodiką, sudarant dviejų procesų matricas ir išskaičiuojant diskriminantą, buvo vertinta EKG rodiklių dinaminių sąsajų kaita bei žmogaus organizmo funkcijų kompleksiškumos pokyčiai, vykstantys bendrosios krioterapijos ir peloidoterapijos procedūrų metu. Taip pat buvo vertintas organizmo jautrumo šalčio poveikiui ir adaptacinių organizmo reakcijų kitimas pakartotinių bendrosios krioterapijos poveikių metu. Pagal širdies ritmo variabilumo kitimą peloidoterapijos procedūrų metu buvo lygintos skirtingo amžiaus ir lyties žmonių adaptacinės organizmo reakcijos ir organizmo funkcijų kompleksiškumas. Šis tyrimas atskleidė net ir nedidelius reakcijų ypatumus ir skirtumus, kurių nebūtų galima pastebėti tiriant įprastinės elektrokardiografijos būdu. Toks tyrimo metodas ateityje galėtų būti plačiai taikomas kurortologiniuose tyrimuose, ypač diegiant naujas procedūras, tiriant ir lyginant gydymui taikomų procedūrų sukeltus efektus bei modeliuojant grįžtamąjį ryšį. / Research of electrocardiographic parameters, especially changes of their concatenations and assessment using new methods of mathematical analysis is a new opportunity to practically apply complex systems theory in order to reveal the effects, caused by factors of health resorts. The standard 12-lead ECG was registered synchronously and continuously through the procedures of whole body cryotherapy and peloidotherapy (mud baths) and changes of ECG parameters during these procedures were evaluated. A new mathematical analysis method, which consists of creating matrices of two processes and deducting a discriminant, was used to evaluate changes of dynamical concatenations of ECG parameters and functional changes of human organism’s complexity, which take place during general cryotherapy and peloidotherapy procedures. Organism’s sensitivity to cold and changes of adaptive reactions during repeated exposure to this factor during general cryotherapy was also assessed. Adaptive reactions and complexity of functioning of the organism within groups of various age and gender were compared according to the changes of heart rate variability. This research has revealed even small specificities and differences of reactions, which could not be identified by employing conventional electrocardiography. This test method could be widely applied in future researches in the field of health resort, particularly when introducing new procedures, researching or comparing treatment-induced effects... [to full text]

The aim of this thesis was to investigate oral cryotherapy (OC) as prophy-laxis against oral mucositis (OM) in patients given high-dose chemotherapy for stem cell transplantation (SCT). A new mouth rinse device was tested for possible additive effect to OC. For study I-III, 78 patients were randomised to OC or standard oral care (SOC). Papers I and II showed that OC patients had significantly less severe mucositis, pain, opioid use, lower C-reactive protein and less parenteral nutrition treatment (TPN). There was no difference in relapse rate, and 5-year survival was unexpectedly significantly better in the OC group (Paper III). In paper IV, the local effect of OC on the mucosa of the mouth was investigated by the use of an infrared thermograph. Change in surface temperature in eight areas of the mouth cavity was measured after cooling of the mouth in healthy volunteers. A substantial lowering of the temperature (-12.9 °C, mean) was seen which could explain the efficacy of OC. To exclude that acute cooling in itself is traumatic, the proinflammatory cytokine IL-6 was measured in saliva and showed no increase after cooling. Paper V reported a study in 40 allogeneic SCT patients. 20 were given SOC including OC and 20 in addition received Caphosol®, a calcium phosphate mouth rinse, during chemotherapy and until day 21. Severity of mucositis, use of opioids and TPN, effects on nutrition and CRP levels were measured. No significant difference was found between the groups in any of these variables, but a non-significant trend for an advantage for the combination could be seen. IL-6 saliva levels were measured. There was a substantial increase (more than 10-fold), in mean IL-6 levels from baseline to beginning of mucositis and a weak correlation between increased IL-6 levels and severity of OM, suggesting that IL-6 in saliva may be a useful marker of the inflammatory mucosal process. This thesis demonstrates that OC is effective as prophylaxis against chemotherapy-induced OM. As a consequence of this work, OC has been introduced as the standard of care in all SCT patients in our institution.

Pesquisa piloto de intervenção com dados prospectivos, grupo único de intervenção, cujo desfecho é a medida da dor de mulheres em trabalho de parto. Apresenta como objetivo discutir os efeitos da crioterapia no alívio da dor das parturientes. Como referencial teórico este trabalho apresentou o descrito por Soares e Low, onde se encontra que os mecanismos de ação do gelo para alívio da dor propiciam o decréscimo da transmissão das fibras de dor, a diminuição da excitabilidade nas terminações livres, a redução no metabolismo tecidual aumentando o limiar das fibras de dor e a liberação de endorfinas. Baseou-se ainda nos princípios da desmedicalização e do emprego de tecnologias não-invasivas de cuidado de enfermagem obstétrica conforme descritos por Vargens e Progianti. A pesquisa foi realizada no Centro Obstétrico do Hospital Municipal Maternidade Carmela Dutra, no Rio de Janeiro de abril a agosto de 2011. O gelo foi aplicado, utilizando-se para tal uma bolsa-cinta ajustável à região tóraco-lombar de 36 gestantes. A bolsa/cinta é descartável, de tecido TNT, com abertura na parte superior para introdução de gelo picado envolto em plástico. As aplicações se deram aos cinco centímetros de dilatação do colo uterino; e/ou aos sete centímetros de dilatação do colo uterino; e/ou aos nove centímetros de dilatação uterina, totalizando ao final das três aplicações um tempo de 60 minutos, que corresponde ao somatório de 20 minutos para cada uma. O gelo foi produzido em fôrma exclusiva para o projeto, em freezer da unidade. Os dados referentes à avaliação da dor foram coletados através de entrevista estruturada guiada por formulário previamente elaborado. Os resultados evidenciaram que a crioterapia produziu extinção ou alívio da dor quando aplicada na região tóraco-lombar das parturientes aos cinco, sete ou nove centímetros de dilatação do colo uterino, dando-lhes maiores condições de vivenciar o seu trabalho de parto; produziu um relaxamento geral e local (na região lombar) das parturientes; não interferiu na dinâmica uterina e, não causou dano ao binômio mãe-filho. Concluiu-se que a crioterapia, na forma como descrita no presente estudo, pode ser considerada uma tecnologia não-invasiva de cuidado de enfermagem obstétrica para alivio da dor no trabalho de parto. / This pilot intervention study, with prospective data and a single intervention group, the outcome of which was the pain measured in women in labour, was designed to discuss the pain relief effects of cryotherapy in childbirth. The theoretical framework for this study was as described by Soares & Low, in which the mechanisms of the pain-relief action of ice foster decreased pain fibre transmission, reduced free nerve ending excitability, reduced tissue metabolism, increased pain fibre threshold and release of endorphins. It also drew on the principles of de-medicalisation and non-invasive obstetric nursing techniques as described by Vargens & Progianti. The study was conducted at the Obstetrics Centre of the Carmela Dutra Municipal Maternity Hospital, in Rio de Janeiro, from April to August 2011. Ice was applied using an adjustable belt-bag to the lumbar/thoracic region of 36 expectant mothers. The disposable TNT fabric belt-bag has an opening at the top for introducing plastic-wrapped ground ice. Applications were given at five centimetres cervical dilation; and/or at seven centimetres cervical dilation; and/or at nine centimetres cervical dilation: to a total of three applications over a 60-minute timespan, corresponding to the sum of 20 minutes each. The ice was produced exclusively for the project in the units freezer. Pain assessment data were collected by structured interview guided by a previously prepared script. The results provided evidence that cryotherapy produced extinction or relief of pain when applied to the lumbar-thoracic region of women in labour at five, seven or nine centimetres cervical dilation, affording them better conditions in which to experience their labour; it produced relaxation (both overall and locally, in the lumbar-thoracic region) in the women in labour; and it neither interfered in the dynamics of the uterus nor caused harm to the mother and child. It was concluded that cryotherapy, as described in this study, can be considered a non-invasive obstetric nursing technology for pain relief in labour.

Dentre os tumores ósseos que acometem os cães, o osteossarcoma (OSA) ou sarcoma osteogênico é o mais frequentemente diagnosticado e representa cerca de 85 % das neoplasias de origem esquelética. Acomete mais cães de raça grande e gigante, com idade média de sete anos, envolvendo, geralmente, a metáfise de ossos longos. Os principais sinais clínicos são claudicação e aumento de volume no membro afetado. Ao exame radiográfico obtêm-se imagens compatíveis com neoplasia óssea, sendo utilizada a biópsia com exame histopatológico como diagnóstico definitivo. A terapêutica comumente indicada é a amputação do membro, seguida de quimioterapia. No entanto, a preservação do membro afetado e outras técnicas mais recentes de tratamento, têm sido utilizadas com o propósito de melhorar a qualidade de vida e a sobrevida do animal. As razões mais comuns para a realização da preservação do membro são pacientes com afecções neurológicas ou ortopédicas concomitantes, que contra indicam a amputação radical ou tutores relutantes em aceitar a amputação, muitas vezes preferindo a eutanásia à amputação. Existem muitas técnicas para preservação do membro, porém ainda com muitas complicações e limitações. Em razão disso, o objetivo do presente estudo é descrever a técnica de preservação de membro através de pedículo congelado em nitrogênio líquido utilizando cadáveres de cães e avaliação da mesma associada à quimioterapia adjuvante em pacientes com tumores ósseos. Para descrição da técnica foram realizadas 30 cirurgias, sendo 15 na região distal de rádio-ulna e 15 na região distal de tíbia. A técnica cirúrgica empregada consistiu na desarticulação do rádio ou da tíbia distal, com divulsão dos tecidos moles, criando assim o pedículo ósseo a ser tratado através do congelamento, seguindo protocolo recomendado por Tsuchiya et al. (2005). Neste, o pedículo permanece submerso 20 minutos no nitrogênio líquido, depois 15 minutos a temperatura ambiente e 10 minutos em água destilada, sendo que sua descrição foi realizada utilizando cadáveres de cães descongelados. A técnica pedicular também foi aplicada em cinco pacientes, sendo três na região de rádio distal, um em fêmur proximal e outro em fêmur distal. Em todos pacientes foi possível a realização da cirurgia sem conversão imediata para amputação. Foram realizados controles radiográfico e clínico, mensalmente no pós-operatório. O uso funcional do membro operado foi de bom a excelente em todos os casos. Em dois pacientes houve infecção, em um houve recidiva e outro desenvolveu necrose dérmica. E em um paciente não houve qualquer tipo de complicação. O tempo médio de sobrevida não foi menor estatisticamente do que o grupo controle que realizou amputação e quimioterapia. É possível concluir que apesar das complicações encontradas é uma técnica factível e que não alterou a expectativa de vida dos pacientes, porém exige estudos em uma população maior para que possa ser considerada opção cirúrgica na medicina veterinária. / Among the bone tumor affecting dogs, osteosarcoma (OSA) or osteogenic sarcoma is the most often diagnosed and represents about 85% of tumors of skeletal origin. It affects more large or giant dog breeds, at an average age of seven years old, usually involving the metaphysis of long bones. The main clinical signs are lameness and swelling in the affected limb. Radiographic exam is compatible with bone cancer images, being the biopsy and histopathological examination used as a definitive diagnosis. The therapy commonly applied is limb amputation followed by chemotherapy. However, the preservation of the affected limb and other newer treatment techniques have been used for the purpose of improving the quality of life and survival of the animal. The most common reasons for the limb sparing procedure are patients with concomitant neurological or orthopedic conditions that contraindicate radical amputation or owners reluctant to accept the amputation, often preferring euthanasia to amputation. There are many techniques for limb sparing, but still have many complications and limitations. For this reason the aim of this study is to describe the technique of limb sparing through pedicle frozen in liquid nitrogen using cadaver dogs, and assessing the technique in patients with bone tumors associated with adjuvant chemotherapy. Thirty experimental surgeries were performed to describe the technique, 15 surgeries in the distal region of the radius-ulna and 15 surgeries in the distal tibia. In both groups the surgical technique consisted in releasing the radio and distal tibia, with divulsion of the soft tissues and disarticulation, thus creating the pedicle to be treated by freezing following the protocol recommended by Tsuchiya et al. (2005), wherein the pedicle remains immersed 20 minutes in liquid nitrogen, 15 minutes at room temperature and 10 minutes in distilled water, and his description was possible using thawed cadaver dogs. The pedicle technique was applied to five patients, three in the distal radius region, one in proximal femur and the other in the distal femur. The surgery was possible in all patients without being necessary conversion. Radiographic and clinical controls were performed monthly. The functional use of the operated limb was good to excellent in all cases. In two patients there was infection, and one local recurrence, other dermal necrosis and one patient did not have any kind of complication. The average survival time was not statistically lower than the control group that underwent amputation and chemotherapy. It was concluded that despite the complications encountered, it is a feasible procedure and did not change the life expectancy of patients, but requires further study in a larger population in order to be considered as a surgical option in veterinary medicine.

The theoretical part of the thesis deals with the life style, regeneration, and relaxation with the focus on the application of cold to treat the elderly. The work explains the use of cryotherapy from both historical and scientific points of view. The aim is to introduce the method of cryotherapy as a popular method which postpones the beginning of dependency and motion impairment with people aged over 50 and thus enables them to keep active much longer. Although the 21st century medicine has reached an extraordinary success, the number of illnesses does not decrease. There is a wide variety of civilisation illnesses resulting from the wrong life style. For such illnesses drugs with frequent side effects are prescribed. The work introduces cryotherapy as one of the methods which can serve the health protection, prevention, the treatment of traumatic injuries, and the supportive therapy of different health problems with relatively no side effects.