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Sample records for transcutaneous spinal electroanalgesia

  1. Transcutaneous electrical nerve stimulation and transcutaneous spinal electroanalgesia: a preliminary efficacy and mechanisms-based investigation.

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    Palmer, Shea; Cramp, Fiona; Propert, Kate; Godfrey, Helen

    2009-09-01

    To determine the effects of transcutaneous electrical nerve stimulation (TENS) and transcutaneous spinal electroanalgesia (TSE) on mechanical pain threshold (MPT) and vibration threshold (VT). A prospective, single-blind, randomised, placebo-controlled trial. Laboratory based. Thirty-four healthy volunteers (12 men and 22 women; mean age+/-standard deviation 30+/-8 years). Exclusion criteria were conditions affecting upper limb sensation and contraindications to electrical stimulation. Participants were allocated at random to receive TENS (n=8), TSE (n=8), placebo (n=9) or control (n=9). Electrical stimulation was applied for 30 minutes (from time 18 minutes to 48 minutes) via electrodes (5 cmx5 cm) placed centrally above and below the space between the C6 and C7 spinous processes, with 5 cm between electrodes. MPT (using an algometer) and VT (using a vibrameter) were recorded on seven occasions from the first dorsal interosseous muscle of the right hand - at baseline (0 minutes) and then at 10-minute intervals until the end of the 60-minute testing period. There were no statistically significant group differences in MPT (all p>0.05). Significant group differences in VT were found at 20, 30 and 40 minutes (all ptests showed that the TENS group had significantly greater VT than both the placebo [median difference 0.30 microm, 95% confidence interval (CI) -0.05 to 0.66] and control (0.51 microm, 95% CI 0.05 to 0.97) groups at 20 minutes, and significantly greater VT than the control group (0.69 microm, 95% CI 0.20 to 1.17) at 30 minutes (all p<0.008). Electrical stimulation did not alter MPT. The increase in VT during TENS may be due to distraction or antidromic block of large-diameter nerve fibres. TSE failed to alter either outcome measure significantly.

  2. Transcutaneous spinal stimulation as a therapeutic strategy for spinal cord injury: state of the art

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    Grecco LH

    2015-03-01

    Full Text Available Leandro H Grecco,1,3,4,* Shasha Li,1,5,* Sarah Michel,1,6,* Laura Castillo-Saavedra,1 Andoni Mourdoukoutas,7 Marom Bikson,7 Felipe Fregni1,21Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, 2Spaulding-Harvard Spinal Cord Injury Model System, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA; 3Special Laboratory of Pain and Signaling, Butantan Institute, 4Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil; 5Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China; 6Department of Pharmacy and Biomedical Sciences, University of Namur, Belgium; 7Department of Biomedical Engineering, The City College of New York, New York, NY, USA*These authors contributed equally to this workAbstract: Treatments for spinal cord injury (SCI still have limited effects. Electrical stimulation might facilitate plastic changes in affected spinal circuitries that may be beneficial in improving motor function and spasticity or SCI-related neuropathic pain. Based on available animal and clinical evidence, we critically reviewed the physiological basis and therapeutic action of transcutaneous spinal cord stimulation in SCI. We analyzed the literature published on PubMed to date, looking for the role of three main noninvasive stimulation techniques in the recovery process of SCI and focusing mainly on transcutaneous spinal stimulation. This review discusses the main clinical applications, latest advances, and limitations of noninvasive electrical stimulation of the spinal cord. Although most recent research in this topic has focused on transcutaneous spinal direct current stimulation (tsDCS, we also reviewed the technique of transcutaneous electric nerve stimulation (TENS and neuromuscular electrical stimulation (NMES as potential methods to modulate spinal cord

  3. Modification of spasticity by transcutaneous spinal cord stimulation in individuals with incomplete spinal cord injury

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    Hofstoetter, Ursula S.; McKay, William B.; Tansey, Keith E.; Mayr, Winfried; Kern, Helmut; Minassian, Karen

    2014-01-01

    Context/objective To examine the effects of transcutaneous spinal cord stimulation (tSCS) on lower-limb spasticity. Design Interventional pilot study to produce preliminary data. Setting Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria. Participants Three subjects with chronic motor-incomplete spinal cord injury (SCI) who could walk ≥10 m. Interventions Two interconnected stimulating skin electrodes (Ø 5 cm) were placed paraspinally at the T11/T12 vertebral levels, and two rectangular electrodes (8 × 13 cm) on the abdomen for the reference. Biphasic 2 ms-width pulses were delivered at 50 Hz for 30 minutes at intensities producing paraesthesias but no motor responses in the lower limbs. Outcome measures The Wartenberg pendulum test and neurological recordings of surface-electromyography (EMG) were used to assess effects on exaggerated reflex excitability. Non-functional co-activation during volitional movement was evaluated. The timed 10-m walk test provided measures of clinical function. Results The index of spasticity derived from the pendulum test changed from 0.8 ± 0.4 pre- to 0.9 ± 0.3 post-stimulation, with an improvement in the subject with the lowest pre-stimulation index. Exaggerated reflex responsiveness was decreased after tSCS across all subjects, with the most profound effect on passive lower-limb movement (pre- to post-tSCS EMG ratio: 0.2 ± 0.1), as was non-functional co-activation during voluntary movement. Gait speed values increased in two subjects by 39%. Conclusion These preliminary results suggest that tSCS, similar to epidurally delivered stimulation, may be used for spasticity control, without negatively impacting residual motor control in incomplete SCI. Further study in a larger population is warranted. PMID:24090290

  4. Can the human lumbar posterior columns be stimulated by transcutaneous spinal cord stimulation? A modeling study.

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    Danner, Simon M; Hofstoetter, Ursula S; Ladenbauer, Josef; Rattay, Frank; Minassian, Karen

    2011-03-01

    Stimulation of different spinal cord segments in humans is a widely developed clinical practice for modification of pain, altered sensation, and movement. The human lumbar cord has become a target for modification of motor control by epidural and, more recently, by transcutaneous spinal cord stimulation. Posterior columns of the lumbar spinal cord represent a vertical system of axons and when activated can add other inputs to the motor control of the spinal cord than stimulated posterior roots. We used a detailed three-dimensional volume conductor model of the torso and the McIntyre-Richard-Grill axon model to calculate the thresholds of axons within the posterior columns in response to transcutaneous lumbar spinal cord stimulation. Superficially located large-diameter posterior column fibers with multiple collaterals have a threshold of 45.4 V, three times higher than posterior root fibers (14.1 V). With the stimulation strength needed to activate posterior column axons, posterior root fibers of large and small diameters as well as anterior root fibers are coactivated. The reported results inform on these threshold differences, when stimulation is applied to the posterior structures of the lumbar cord at intensities above the threshold of large-diameter posterior root fibers. © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  5. Body Position Influences Which Neural Structures Are Recruited by Lumbar Transcutaneous Spinal Cord Stimulation.

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    Simon M Danner

    Full Text Available Transcutaneous stimulation of the human lumbosacral spinal cord is used to evoke spinal reflexes and to neuromodulate altered sensorimotor function following spinal cord injury. Both applications require the reliable stimulation of afferent posterior root fibers. Yet under certain circumstances, efferent anterior root fibers can be co-activated. We hypothesized that body position influences the preferential stimulation of sensory or motor fibers. Stimulus-triggered responses to transcutaneous spinal cord stimulation were recorded using surface-electromyography from quadriceps, hamstrings, tibialis anterior, and triceps surae muscles in 10 individuals with intact nervous systems in the supine, standing and prone positions. Single and paired (30-ms inter-stimulus intervals biphasic stimulation pulses were applied through surface electrodes placed on the skin between the T11 and T12 inter-spinous processes referenced to electrodes on the abdomen. The paired stimulation was applied to evaluate the origin of the evoked electromyographic response; trans-synaptic responses would be suppressed whereas direct efferent responses would almost retain their amplitude. We found that responses to the second stimulus were decreased to 14%±5% of the amplitude of the response to the initial pulse in the supine position across muscles, to 30%±5% in the standing, and to only 80%±5% in the prone position. Response thresholds were lowest during standing and highest in the prone position and response amplitudes were largest in the supine and smallest in the prone position. The responses obtained in the supine and standing positions likely resulted from selective stimulation of sensory fibers while concomitant motor-fiber stimulation occurred in the prone position. We assume that changes of root-fiber paths within the generated electric field when in the prone position increase the stimulation thresholds of posterior above those of anterior root fibers. Thus, we

  6. Concurrent electrical cervicomedullary stimulation and cervical transcutaneous spinal direct current stimulation result in a stimulus interaction.

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    Dongés, Siobhan C; Bai, Siwei; Taylor, Janet L

    2017-10-01

    What is the central question of this study? We previously showed that the motor pathway is not modified after cervical transcutaneous spinal direct current stimulation (tsDCS) applied using anterior-posterior electrodes. Here, we examine the motor pathway during stimulation. What is the main finding and its importance? We show that electrically elicited muscle responses to cervicomedullary stimulation are modified during tsDCS, whereas magnetically elicited responses are not. Modelling reveals electrical field modifications during concurrent tsDCS and electrical cervicomedullary stimulation. Changes in muscle response probably result from electrical field modifications rather than physiological changes. Care should be taken when applying electrical stimuli simultaneously. Transcutaneous spinal direct current stimulation (tsDCS) can modulate neuronal excitability within the human spinal cord; however, few studies have used tsDCS at a cervical level. This study aimed to characterize cervical tsDCS further by observing its acute effects on motor responses to transcranial magnetic stimulation and cervicomedullary stimulation. In both studies 1 and 2, participants (study 1, n = 8, four female; and study 2, n = 8, three female) received two periods of 10 min, 3 mA cervical tsDCS on the same day through electrodes placed in an anterior-posterior configuration over the neck; one period with the cathode posterior (c-tsDCS) and the other with the anode posterior (a-tsDCS). In study 1, electrically elicited cervicomedullary motor evoked potentials (eCMEPs) and transcranial magnetic stimulation-elicited motor evoked potentials (MEPs) were measured in biceps brachii and flexor carpi radialis before, during and after each tsDCS period. In study 2, eCMEPs and magnetically elicited CMEPs (mCMEPs) were measured before, during and after each tsDCS period. For study 3, computational modelling was used to observe possible interactions of cervical tsDCS and electrical

  7. Transcutaneous Spinal Direct Current Stimulation Alters Resting-State Functional Connectivity.

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    Schweizer, Lauren; Meyer-Frießem, Christine H; Zahn, Peter K; Tegenthoff, Martin; Schmidt-Wilcke, Tobias

    2017-08-01

    Transcutaneous spinal direct current stimulation (tsDCS) is a noninvasive method that can modulate spinal reflexes, sensory afferent conduction, and even pain perception. Although neurophysiological evidence suggests that tsDCS alters somatosensory and nociceptive afferent conduction to the cortex, its supraspinal effects have not yet been investigated by using functional imaging to investigate tsDCS-induced alterations in intrinsic functional connectivity (FC). Therefore, we hypothesize that tsDCS-induced changes in neurophysiological measures might also be reflected in spontaneous brain activity. We investigated tsDCS-induced changes in somatosensory cortical connectivity by using seed-to-voxel-based analyses from the bilateral primary somatosensory cortex (S1) and the thalamus in a double-blind, crossover study design. Resting state FC was measured by using blood oxygenation level-dependent, functional magnetic resonance imaging (3T Philips) before and after anodal, cathodal, and sham tsDCS (20 min, 2.5 mA, active electrode centered over T11 spinous process, reference electrode over left shoulder blade) in a double-blind, crossover study of 20 healthy men (24 ± 0.7 years). As compared with sham, anodal tsDCS resulted in a decreased connectivity between the S1 and the ipsilateral posterior insula for both left and right hemispheres. Anodal tsDCS also resulted in decreased thalamic connectivity with the anterior cingulate cortex, and increased connectivity between S1 and the thalamus. Cathodal tsDCS showed increased FC between the right thalamus and both left and right posterior insulae, and decreased connectivity between the S1 seeds and the occipital cortex. Our results provide evidence of supraspinal effects of tsDCS and suggest that tsDCS may provide a noninvasive intervention that is able to target cortical sensory networks.

  8. Moving Beyond the Brain: Transcutaneous Spinal Direct Current Stimulation in Post-Stroke Aphasia

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    Paola Marangolo

    2017-08-01

    Full Text Available Over the last 20 years, major advances in cognitive neuroscience have clearly shown that the language function is not restricted into the classical language areas but it involves brain regions, which had never previously considered. Indeed, recent lines of evidence have suggested that the processing of words associated to motor schemata, such as action verbs, modulates the activity of the sensorimotor cortex, which, in turn, facilitates its retrieval. To date, no studies have investigated whether the spinal cord, which is functionally connected to the sensorimotor system, might also work as an auxiliary support for language processing. We explored the combined effect of transcutaneous spinal direct current stimulation (tsDCS and language treatment in a randomized double-blind design for the recovery of verbs and nouns in 14 chronic aphasics. During each treatment, each subject received tsDCS (20 min, 2 mA over the thoracic vertebrae (10th vertebra in three different conditions: (1 anodic, (2 cathodic and (3 sham, while performing a verb and noun naming tasks. Each experimental condition was run in five consecutive daily sessions over 3 weeks. Overall, a significant greater improvement in verb naming was found during the anodic condition with respect to the other two conditions, which persisted at 1 week after the end of the treatment. No significant differences were present for noun naming among the three conditions. The hypothesis is advanced that anodic tsDCS might have influenced activity along the ascending somatosensory pathways, ultimately eliciting neurophysiological changes into the sensorimotor areas which, in turn, supported the retrieval of verbs. These results further support the evidence that action words, due to their sensorimotor semantic properties, are partly represented into the sensorimotor cortex. Moreover, they also document, for the first time, that tsDCS enhances verb recovery in chronic aphasia and it may

  9. Modulation of spinal inhibitory reflexes depends on the frequency of transcutaneous electrical nerve stimulation in spastic stroke survivors.

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    Koyama, Soichiro; Tanabe, Shigeo; Takeda, Kazuya; Sakurai, Hiroaki; Kanada, Yoshikiyo

    2016-03-01

    Neurophysiological studies in healthy subjects suggest that increased spinal inhibitory reflexes from the tibialis anterior (TA) muscle to the soleus (SOL) muscle might contribute to decreased spasticity. While 50 Hz is an effective frequency for transcutaneous electrical nerve stimulation (TENS) in healthy subjects, in stroke survivors, the effects of TENS on spinal reflex circuits and its appropriate frequency are not well known. We examined the effects of different frequencies of TENS on spinal inhibitory reflexes from the TA to SOL muscle in stroke survivors. Twenty chronic stroke survivors with ankle plantar flexor spasticity received 50-, 100-, or 200-Hz TENS over the deep peroneal nerve (DPN) of the affected lower limb for 30 min. Before and immediately after TENS, reciprocal Ia inhibition (RI) and presynaptic inhibition of the SOL alpha motor neuron (D1 inhibition) were assessed by adjusting the unconditioned H-reflex amplitude. Furthermore, during TENS, the time courses of spinal excitability and spinal inhibitory reflexes were assessed via the H-reflex, RI, and D1 inhibition. None of the TENS protocols affected mean RI, whereas D1 inhibition improved significantly following 200-Hz TENS. In a time-series comparison during TENS, repeated stimulation did not produce significant changes in the H-reflex, RI, or D1 inhibition regardless of frequency. These results suggest that the frequency-dependent effect of TENS on spinal reflexes only becomes apparent when RI and D1 inhibition are measured by adjusting the amplitude of the unconditioned H-reflex. However, 200-Hz TENS led to plasticity of synaptic transmission from the antagonist to spastic muscles in stroke survivors.

  10. Early transcutaneous electrical nerve stimulation reduces hyperalgesia and decreases activation of spinal glial cells in mice with neuropathic pain.

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    Matsuo, Hideaki; Uchida, Kenzo; Nakajima, Hideaki; Guerrero, Alexander Rodriguez; Watanabe, Shuji; Takeura, Naoto; Sugita, Daisuke; Shimada, Seiichiro; Nakatsuka, Terumasa; Baba, Hisatoshi

    2014-09-01

    Although transcutaneous electrical nerve stimulation (TENS) is widely used for the treatment of neuropathic pain, its effectiveness and mechanism of action in reducing neuropathic pain remain uncertain. We investigated the effects of early TENS (starting from the day after surgery) in mice with neuropathic pain, on hyperalgesia, glial cell activation, pain transmission neuron sensitization, expression of proinflammatory cytokines, and opioid receptors in the spinal dorsal horn. Following nerve injury, TENS and behavioral tests were performed every day. Immunohistochemical, immunoblot, and flow cytometric analysis of the lumbar spinal cord were performed after 8 days. Early TENS reduced mechanical and thermal hyperalgesia and decreased the activation of microglia and astrocytes (PEarly TENS decreased p-p38 within microglia (Pearly TENS relieved hyperalgesia in our mouse model of neuropathic pain by inhibiting glial activation, MAP kinase activation, PKC-γ, and p-CREB expression, and proinflammatory cytokines expression, as well as maintenance of spinal opioid receptors. The findings indicate that TENS treatment is more effective when applied as early after nerve injury as possible. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  11. High-frequency transcutaneous electrical nerve stimulation alleviates spasticity after spinal contusion by inhibiting activated microglia in rats.

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    Hahm, Suk-Chan; Yoon, Young Wook; Kim, Junesun

    2015-05-01

    Transcutaneous electrical nerve stimulation (TENS) can be used as a physical therapy for spasticity, but the effects of TENS on spasticity and its underlying mechanisms remain unclear. The purpose of this study was to test the effects of TENS on spasticity and the role of activated microglia as underlying mechanisms of TENS treatment for spasticity in rats with a 50-mm contusive spinal cord injury (SCI). A spinal contusion was made at the T12 spinal segment in adult male Sprague-Dawley rats using the NYU impactor. Behavioral tests for motor function were conducted before and after SCI and before and after TENS application. To assess spasticity, the modified Ashworth scale (MAS) was used before and after SCI, high-frequency (HF)/low-frequency (LF) TENS application at 3 different intensities (motor threshold [MT], 50% and 90% MT) or minocycline administration. Immunohistochemistry for microglia was performed at the lumbar spinal segments. Motor recovery reached a plateau approximately 28 days after SCI. Spasticity was well developed and was sustained above the MAS grade of 3, beginning at 28 days after SCI. HF-TENS at 90% MT significantly alleviated spasticity. Motor function did not show any significant changes with LF- or HF-TENS treatment. HF-TENS significantly reduced the proportion of activated microglia observed after SCI. Minocycline, the microglia inhibitor, also significantly alleviated spasticity with the reduction of activated microglia expression. These results suggest that HF-TENS at 90% MT alleviates spasticity in rats with SCI by inhibiting activated microglia. © The Author(s) 2014.

  12. Clinical, neurological, and neurophysiological evaluation of the efficiency of motor rehabilitation in children with cerebral palsy using robotic mechanotherapy and transcutaneous electrical stimulation of the spinal cord

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    Galina A. Ikoeva

    2016-12-01

    Full Text Available Introduction. Rehabilitation of patients with cerebral palsy (CP remains a very difficult task. Stable and growing movement restrictions in such patients cause a life-long need for treatment and rehabilitation. Neurorehabilitation of children with CP at various stages includes not only traditional physical rehabilitation methods, but also extensive use of robotic mechanotherapy techniques and new technologies in the field of neurophysiology. One of such technology is non-invasive percutaneous electrical stimulation of the spinal cord. Aim of the study: To assess the effect of transcutaneous electrical stimulation of the spinal cord to improve the motor function of children with spastic diplegia using the “Lokomat” robotic mechanotherapy system. Materials and methods. A clinical rehabilitation study of 26 patients aged 6–12 years with CP was conducted. The treatment group included 11 patients who received one course of robotic mechanotherapy using the “Lokomat” system combined with transcutaneous electrical stimulation of the spinal cord. The control group included 15 patients who received one course of robotic mechanotherapy only. Results. A comparative analysis of the two groups based on the results of clinical examinations using specific scales (GMFCS, GMFM-88, Modified Ashworth Scale of Muscle Spasticity, locomotor tests (L-FORCE, L-ROM, and evaluations of muscle activity using electromyography showed that one course of rehabilitation resulted in improvement in motor function in all patients of both groups, but positive dynamics were more significant in the treatment group that underwent percutaneous electrical stimulation of the spinal cord. Conclusion. Based on clinical data, changes in indicators of the locomotor tests L-FORCE and L-ROM, as well as assessment of changes in muscle activity, showed that motor rehabilitation of children with spastic diplegia using the “Lokomat” robotic mechanotherapy system combined with

  13. Efficacy of addition of transcutaneous electrical nerve stimulation to standardized physical therapy in subacute spinal spasticity: a randomized controlled trial.

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    Oo, Win Min

    2014-11-01

    To study the immediate and short-term efficacy of adding transcutaneous electrical nerve stimulation (TENS) to standardized physical therapy on subacute spasticity within 6 months of spinal cord injury. Randomized controlled trial for 3 weeks. A university hospital. Subjects (N=16) with clinically determined spasticity were randomly assigned to either the experimental group (n=8) or the control group (n=8). Sixty-minute sessions of TENS over the bilateral common peroneal nerves before 30 minutes of physical therapy for the experimental group and 30 minutes of physical therapy alone for the control group. All patients in both groups had access to standardized rehabilitation care. The composite spasticity score, which included 3 subscores (ankle jerk, muscle tone, and ankle clonus scores), was used as the primary end point to assess plantar flexor spasticity. These subscores were designated as secondary end points. Serial evaluations were made at baseline before study entry and immediately after the first and last sessions in both groups. On analysis for immediate effects, there was a significant reduction only in the composite spasticity score (mean difference, 1.75; 99% confidence interval [CI], 0.47-3.03; P=.002) in the experimental group, but no significant reduction was observed in all outcome variables in the control group. A significant difference in the composite spasticity score (1.63; 99% CI, 0.14-3.11; P=.006) was observed between the 2 groups. After 15 sessions of treatment, a significant reduction was determined in the composite spasticity score (2.75; 99% CI, 1.31-4.19; Pspasticity score (2.13; 99% CI, 0.59-3.66; P=.001) and the muscle tone score (1.50; 99% CI, 0.15-2.85; P=.005) after 15 intervention sessions. Addition of TENS to standardized physical therapy had synergistically antispastic action, providing more effective reduction of clinical spasticity. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All

  14. Combined effects of cerebellar transcranial direct current stimulation and transcutaneous spinal direct current stimulation on robot-assisted gait training in patients with chronic brain stroke: A pilot, single blind, randomized controlled trial.

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    Picelli, Alessandro; Chemello, Elena; Castellazzi, Paola; Filippetti, Mirko; Brugnera, Annalisa; Gandolfi, Marialuisa; Waldner, Andreas; Saltuari, Leopold; Smania, Nicola

    2018-01-01

    Preliminary evidence showed additional effects of anodal transcranial direct current stimulation over the damaged cerebral hemisphere combined with cathodal transcutaneous spinal direct current stimulation during robot-assisted gait training in chronic stroke patients. This is consistent with the neural organization of locomotion involving cortical and spinal control. The cerebellum is crucial for locomotor control, in particular for avoidance of obstacles, and adaptation to novel conditions during walking. Despite its key role in gait control, to date the effects of transcranial direct current stimulation of the cerebellum have not been investigated on brain stroke patients treated with robot-assisted gait training. To evaluate the effects of cerebellar transcranial direct current stimulation combined with transcutaneous spinal direct current stimulation on robot-assisted gait training in patients with chronic brain stroke. After balanced randomization, 20 chronic stroke patients received ten, 20-minute robot-assisted gait training sessions (five days a week, for two consecutive weeks) combined with central nervous system stimulation. Group 1 underwent on-line cathodal transcranial direct current stimulation over the contralesional cerebellar hemisphere + cathodal transcutaneous spinal direct current stimulation. Group 2 received on-line anodal transcranial direct current stimulation over the damaged cerebral hemisphere + cathodal transcutaneous spinal direct current stimulation. The primary outcome was the 6-minute walk test performed before, after, and at follow-up at 2 and 4 weeks post-treatment. The significant differences in the 6-minute walk test noted between groups at the first post-treatment evaluation (p = 0.041) were not maintained at either the 2-week (P = 0.650) or the 4-week (P = 0.545) follow-up evaluations. Our preliminary findings support the hypothesis that cathodal transcranial direct current stimulation over the contralesional

  15. Comparison of transcutaneous electrical nerve stimulation (TENS) and functional electrical stimulation (FES) for spasticity in spinal cord injury - A pilot randomized cross-over trial.

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    Sivaramakrishnan, Anjali; Solomon, John M; Manikandan, Natarajan

    2017-10-25

    Spasticity following spinal cord injury (SCI) can impair function and affect quality of life. This study compared the effects of transcutaneous electrical nerve stimulation (TENS) and functional electrical stimulation (FES) on lower limb spasticity in patients with SCI. Double blind randomized crossover design. Neuro-rehabilitation unit, Manipal University, India. Ten participants (age: 39 ± 13.6 years, C1-T11, 1-26 months post SCI) with lower limb spasticity were enrolled in this study. Participants were administered electrical stimulation with TENS and FES (duration - 30 minutes) in a cross over manner separated by 24 hours. Spasticity was measured using modified Ashworth scale (MAS) [for hip abductors, knee extensors and ankle plantar flexors] and spinal cord assessment tool for spastic reflexes (SCATS). Assessments were performed at baseline, immediately, 1 hour, 4 hours, and 24 hours post intervention. A between group analysis did not show statistically significant differences between FES and TENS (P > 0.05). In the within group analyses, TENS and FES significantly reduced spasticity up to 4 hours in hip adductors and knee extensors (P electrical stimulation with FES and TENS appears to have similar anti-spasticity effects that last for 4 hours. The findings of this preliminary study suggest that both TENS and FES have the potential to be used as therapeutic adjuncts to relieve spasticity in the clinic. In addition, FES may have better effects on patients presenting with spastic reflexes.

  16. Transcutaneous electrical nerve stimulation attenuates CFA-induced hyperalgesia and inhibits spinal ERK1/2-COX-2 pathway activation in rats.

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    Fang, Jun-Fan; Liang, Yi; Du, Jun-Ying; Fang, Jian-Qiao

    2013-06-15

    Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacologic treatment for pain relief. In previous animal studies, TENS effectively alleviated Complete Freund's Adjuvant (CFA)- or carrageenan-induced inflammatory pain. Although TENS is known to produce analgesia via opioid activation in the brain and at the spinal level, few reports have investigated the signal transduction pathways mediated by TENS. Prior studies have verified the importance of the activation of extracellular signal-regulated kinase (ERK) signal transduction pathway in the spinal cord dorsal horn (SCDH) in acute and persistent inflammatory pains. Here, by using CFA rat model, we tested the efficacy of TENS on inhibiting the expressions of p-ERK1/2 and of its downstream cyclooxygenase-2 (COX-2) and the level of prostaglandin E2 (PGE2) at spinal level. Rats were randomly divided into control, model and TENS groups, and injected subcutaneously with 100 μl CFA or saline in the plantar surface of right hind paw. Rats in the TENS group were treated with TENS (constant aquare wave, 2 Hz and 100 Hz alternating frequencies, intensities ranging from 1 to 2 mA, lasting for 30 min each time) at 5 h and 24 h after injection. Paw withdrawal thresholds (PWTs) were measured with dynamic plantar aesthesiometer at 3d before modeling and 5 h, 6 h, and 25 h after CFA injection. The ipsilateral sides of the lumbar spinal cord dosral horns were harvested for detecting the expressions of p-ERK1/2 and COX-2 by western blot analysis and qPCR, and PGE2 by ELISA. CFA-induced periphery inflammation decreased PWTs and increased paw volume of rats. TENS treatment significantly alleviated mechanical hyperalgesia caused by CFA. However, no anti-inflammatory effect of TENS was observed. Expression of p-ERK1/2 protein and COX-2 mRNA was significantly up-regualted at 5 h and 6 h after CFA injection, while COX-2 and PGE2 protein level only increased at 6 h after modeling. Furthermore, the high expression of p-ERK1

  17. Effects of visual illusion and transcutaneous electrical nerve stimulation on neuropathic pain in patients with spinal cord injury: A randomised controlled cross-over trial.

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    Özkul, Çağla; Kılınç, Muhammed; Yıldırım, Sibel Aksu; Topçuoğlu, Elif Yalçın; Akyüz, Müfit

    2015-01-01

    Chronic pain is a common consequence of spinal cord injury (SCI). No therapeutic drugs or drug groups are proven to be superior for neuropathic pain and treatments only aim to convert pain from dull to tolerable levels and not to remove it. This study was planned to compare the effect of visual illusion (VI) and transcutaneous electrical nerve stimulation (TENS) on pain intensity, pain quality and functional capacity in SCI patients with neuropathic pain. Twenty-four patients were included and randomly categorized into two groups. In the first group (n= 12), visual illusion was applied for first two weeks, 1 week wash out period and then TENS was applied for 2 weeks. In second group (n= 12), TENS was applied firstly, 1 week wash out and then %visual illusion VI were applied. Pain severity, pain quality, and functional capacity were assessed with the visual analog scale (VAS), the neuropathic pain scale (NPS), and the brief pain inventory (BPI), respectively. A pre-post-treatment and cross over design was used. Wilcoxon signed-rank tests were used for within group analyses. Mann-Whitney U tests were used for analyses that compared different groups. It was observed that pain intensity decrease immediately after both applications (VI: p= 0.07, TENS: p= 0.08). After TENS application for 2 weeks, it was observed that significant decrease in most (p= 0.04) and less (p= 0.02) pain intensity; while there was no significant decrease in pain intensity after 2 weeks for VI (p> 0.05). When findings of NPS were analyzed, hot (p= 0.047), sharp (p= 0.02), unpleasant (p= 0.03) and deep items (p= 0.047) decreased after VI application. When the results of BPI were detected, they were observed that the negative effect of pain on moving ability (p= 0.04) after visual illusion application and the negative effect of pain on mood (p= 0.03), relationships with others (p= 0.04) and sleep (p= 0.04) after TENS application decreased significantly. TENS and VI therapies can be successfully

  18. The influence of transcutaneous electrical neurostimulation (TENS) on human cerebral blood flow velocities

    NARCIS (Netherlands)

    ter Laan, Mark; van Dijk, J. Marc C.; Elting, Jan-Willem J.; Fidler, Vaclav; Staal, Michiel J.

    It has been shown that transcutaneous electrical neurostimulation (TENS) reduces sympathetic tone. Spinal cord stimulation (SCS) has proven qualities to improve coronary, peripheral, and cerebral blood circulation. Therefore, we postulate that TENS and SCS affect the autonomic nervous system in

  19. Modulation of cerebral blood flow with transcutaneous electrical neurostimulation (TENS) in patients with cerebral vasospasm after subarachnoid hemorrhage

    NARCIS (Netherlands)

    ter Laan, Mark; van Dijk, J.M.C.; Stewart, Roy; Staal, Michiel J; Elting, Jan-Willem J.

    ObjectivesTranscutaneous electrical neurostimulation (TENS) and spinal cord stimulation have been shown to increase peripheral and cerebral blood flow. We postulate that certain pathological conditions attenuate cerebral autoregulation, which may result in a relative increase of the importance of

  20. Modulation of cerebral blood flow with transcutaneous electrical neurostimulation (TENS) in patients with cerebral vasospasm after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Laan, M. ter; Dijk, J.M. van; Stewart, R.; Staal, M.J.; Elting, J.W.

    2014-01-01

    OBJECTIVES: Transcutaneous electrical neurostimulation (TENS) and spinal cord stimulation have been shown to increase peripheral and cerebral blood flow. We postulate that certain pathological conditions attenuate cerebral autoregulation, which may result in a relative increase of the importance of

  1. Transcutane PCO2-meting in de neonatologie

    NARCIS (Netherlands)

    Schultz, M. J.; de Kleine, M. J.; Koppe, J. G.

    1991-01-01

    Transcutaneous PCO2 studies were performed in 21 healthy preterm infants and in 12 preterm infants with respiratory problems, in order: I. to evaluate the feasibility of transcutaneous PCO2 measurements in the clinical situation; 2. to collect normal values for preterm infants, and 3. to compare

  2. Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Paul F. White

    2017-12-01

    Full Text Available The use of opioid analgesics for postoperative pain management has contributed to the global opioid epidemic. It was recently reported that prescription opioid analgesic use often continued after major joint replacement surgery even though patients were no longer experiencing joint pain. The use of epidural local analgesia for perioperative pain management was not found to be protective against persistent opioid use in a large cohort of opioid-naïve patients undergoing abdominal surgery. In a retrospective study involving over 390,000 outpatients more than 66 years of age who underwent minor ambulatory surgery procedures, patients receiving a prescription opioid analgesic within 7 days of discharge were 44% more likely to continue using opioids 1 year after surgery. In a review of 11 million patients undergoing elective surgery from 2002 to 2011, both opioid overdoses and opioid dependence were found to be increasing over time. Opioid-dependent surgical patients were more likely to experience postoperative pulmonary complications, require longer hospital stays, and increase costs to the health-care system. The Centers for Disease Control and Prevention emphasized the importance of finding alternatives to opioid medication for treating pain. In the new clinical practice guidelines for back pain, the authors endorsed the use of non-pharmacologic therapies. However, one of the more widely used non-pharmacologic treatments for chronic pain (namely radiofrequency ablation therapy was recently reported to have no clinical benefit. Therefore, this clinical commentary will review evidence in the peer-reviewed literature supporting the use of electroanalgesia and laser therapies for treating acute pain, cervical (neck pain, low back pain, persistent post-surgical pain after spine surgery (“failed back syndrome”, major joint replacements, and abdominal surgery as well as other common chronic pain syndromes (for example, myofascial pain, peripheral

  3. Flexible nine-channel photodetector probe facilitated intraspinal multisite transcutaneous photobiomodulation therapy dosimetry in cadaver dogs

    Science.gov (United States)

    Piao, Daqing; Sypniewski, Lara A.; Bailey, Christian; Dugat, Danielle; Burba, Daniel J.; De Taboada, Luis

    2018-01-01

    Noninvasive photobiomodulation therapy (PBMT) of spinal cord disease remains speculative due to the lack of evidence for whether photobiomodulatory irradiances can be transcutaneously delivered to the spinal cord under a clinically acceptable PBMT surface irradiation protocol. We developed a flexible nine-channel photodetection probe for deployment within the spinal canal of a cadaver dog after hemilaminectomy to measure transcutaneously transmitted PBMT irradiance at nine sites over an eight-cm spinal canal length. The probe was built upon a 6.325-mm tubular stem, to the surface of which nine photodiodes were epoxied at approximately 1 cm apart. The photodiode has a form factor of 4.80 mm×2.10 mm×1.15 mm (length×width×height). Each photodiode was individually calibrated to deliver 1 V per 7.58 μW/cm2 continuous irradiance at 850 nm. The outputs of eight photodiodes were logged concurrently using a data acquisition module interfacing eight channels of differential analog signals, while the output of the ninth photodiode was measured by a precision multimeter. This flexible probe rendered simultaneous intraspinal (nine-site) measurements of transcutaneous PBMT irradiations at 980 nm in a pilot cadaver dog model. At a surface continuous irradiance of 3.14 W/cm2 applied off-contact between L1 and L2, intraspinal irradiances picked up by nine photodiodes had a maximum of 327.48 μW/cm2 without the skin and 5.68 μW/cm2 with the skin.

  4. 21 CFR 870.5550 - External transcutaneous cardiac pacemaker (noninvasive).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External transcutaneous cardiac pacemaker... § 870.5550 External transcutaneous cardiac pacemaker (noninvasive). (a) Identification. An external transcutaneous cardiac pacemaker (noninvasive) is a device used to supply a periodic electrical pulse intended to...

  5. Electroanalgesia for the postoperative control pain in dogs Eletroanalgesia para o controle da dor pós-operatória em cães

    Directory of Open Access Journals (Sweden)

    Renata Navarro Cassu

    2012-01-01

    Full Text Available PURPOSE: To evaluate the analgesic and neuroendocrine effects of electroanalgesia in dogs undergoing ovariohysterectomy. METHODS: Eighteen dogs were randomly distributed to three groups of six animals each and received either electrical stimuli at acupuncture points (EA, at peri-incisional dermatomes (DER and at both acupuncture points and peri-incisional dermatomes (EAD. Pre-anesthetic medication was acepromazine (0.05mg kg-1, IV. Anesthesia was induced with propofol (4 to 5mg kg-1, IV and maintained with isoflurane. Postoperatively pain degree was measured using a numerical rating scale. Dogs were scored at 1, 3, 6, 12 and 24 hours postoperative. If the pain score was ≥6, supplemental morphine (0.5mg kg-1, IM was administered. Serum cortisol concentration was measured before pre-anesthetic medication (basal, and at 1, 12 and 24 hours postoperative. RESULTS: EA and EAD- treated dogs had lower pain scores than DER treated dogs one hour postoperatively. Fewer EA and EAD-treated dogs required rescue analgesia. Serum cortisol did not differ among treatments. CONCLUSION: Preoperative application of electrical stimuli to acupuncture points isolated or in combination with peri-incisional dermatomes provides a reduced postoperative opioid requirement and promotes an effective analgesia in dogs undergoing ovariohyterectomy.OBJETIVO: Avaliar os efeitos analgésicos e neuroendócrinos da eletroanalgesia em cadelas encaminhadas para ovariossalpingohisterectomia. MÉTODOS: Foram avaliadas 18 cadelas, distribuídas aleatoriamente em três tratamentos de seis animais cada: aplicação de estímulo elétrico em pontos de acupuntura (EA, em dermátomos periincisionais (DER e em pontos de acupuntura associados aos dermátomos periincisionais (EAD. Todos os animais foram tranquilizados com acepromazina (0,05mg kg-1, IV, seguindo-se a indução com propofol (4 a 5mg kg-1, IV e manutenção anestésica com isofluorano. O grau de analgesia foi avaliado 1, 3, 6, 12

  6. Transcutaneous Electrical Nerve Stimulation: Research Update.

    Science.gov (United States)

    Johns, Florene Carnicelli

    Currently, research is being performed in the area of nonsurgical and nonchemical means for influencing the body's threshold for pain. Today, transcutaneous electrical nerve stimulation (TENS) is being widely used for this purpose. Application of this treatment can be confusing, however, because determining such things as selection of the proper…

  7. Transcutaneous oxygen tension in imminent foot gangrene

    DEFF Research Database (Denmark)

    Tønnesen, K H

    1978-01-01

    Transcutaneous oxygen tension at 44 degree C and maximal isotope clearance (90m Tc-pretechnetate + histramine) just proximal to the 1st toe and systolic toe blood pressure (strain gauge) were studied on a tilt table in patients with various degrees of obstructive arteriosclerotic disease. In legs...

  8. Transcutaneous immunization using microneedles and cubosomes

    DEFF Research Database (Denmark)

    Rattanapak, Teerawan; Birchall, James; Young, Katherine

    2013-01-01

    Transcutaneous (TCI) immunization is a novel vaccination approach that provides many advantages over traditional parenteral vaccination. However, a major barrier to TCI is mediating penetration of vaccine antigens through the stratum corneum (SC) to the deeper tissue layers. Many approaches have ...

  9. Management of painful neuritis using transcutaneous electrical ...

    African Journals Online (AJOL)

    Management of painful neuritis using transcutaneous electrical nerve stimulation and croyotheraphy (Tensept). AV Utti, AW Hassan. Abstract. Nigerian Quarterly Journal of Hospital Medicine Vol.10(1) 2000: 11-12. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  10. TRANSCUTANEOUS ELECTRICAL NERVE-STIMULATION (TENS) IN RAYNAUDS-PHENOMENON

    NARCIS (Netherlands)

    MULDER, P; DOMPELING, EC; VANSLOCHTERENVANDERBOOR, JC; KUIPERS, WD; SMIT, AJ

    Transcutaneous nerve stimulation (TENS) has been described as resulting in vasodilatation. The effect of 2 Hz TENS of the right hand during forty-five minutes on skin temperature and plethysmography of the third digit of both hands and feet and on transcutaneous oxygen tension (TcpO2) of the right

  11. Blockade of NMDA receptors prevents analgesic tolerance to repeated transcutaneous electrical nerve stimulation (TENS) in rats

    Science.gov (United States)

    Hingne, Priyanka M.; Sluka, Kathleen A.

    2008-01-01

    Repeated daily application transcutaneous electrical nerve stimulation (TENS) results in tolerance, at spinal opioid receptors, to the anti-hyperalgesia produced by TENS. Since N-Methyl-D-Aspartate (NMDA) receptor antagonists prevent analgesic tolerance to opioid agonists we hypothesized that blockade of NMDA receptors will prevent tolerance to TENS. In rats with knee joint inflammation, TENS was applied for 20 minute daily at high frequency (100 Hz), low frequency (4 Hz), or sham TENS. Rats were treated with the NMDA antagonist MK-801 (0.01 mg/kg-0.1 mg/kg) or vehicle daily before TENS. Paw withdrawal thresholds were tested before and after inflammation, and before and after TENS treatment for 4 days. On day 1 TENS reversed the decreased mechanical withdrawal threshold induced by joint inflammation. On day 4 TENS had no effect on the decreased withdrawal threshold in the group treated with vehicle demonstrating development of tolerance. However, in the group treated with 0.1 mg/kg MK-801, TENS significantly reversed the mechanical withdrawal thresholds on day 4 demonstrating that tolerance did not develop. Vehicle treated animals developed cross-tolerance at spinal opioid receptors. Treatment with MK-801 reversed this cross-tolerance at spinal opioid receptors. In summary, blockade of NMDA receptors prevents analgesic tolerance to daily TENS by preventing tolerance at spinal opioid receptors. Perspective Tolerance observed to the clinical treatment of TENS could be prevented by administration of pharmaceutical agents with NMDA receptors activity such as ketamine or dextromethorphan. PMID:18061543

  12. Effects of the transcutaneous electrode temperature on the accuracy of transcutaneous carbon dioxide tension

    DEFF Research Database (Denmark)

    Sørensen, Line C; Brage-Andersen, Lene; Greisen, Gorm

    2011-01-01

    The harmful effect of hypocapnia on the neonatal brain emphasizes the importance of monitoring arterial carbon dioxide tension (PaCO2). Transcutaneous monitoring of carbon dioxide (tcPCO2) reduces the need for arterial blood sampling. Drawbacks are high electrode temperature causing risks of skin...

  13. Effects of the transcutaneous electrode temperature on the accuracy of transcutaneous carbon dioxide tension

    DEFF Research Database (Denmark)

    Sørensen, Line C; Brage-Andersen, Lene; Greisen, Gorm

    2011-01-01

    The harmful effect of hypocapnia on the neonatal brain emphasizes the importance of monitoring arterial carbon dioxide tension (PaCO2). Transcutaneous monitoring of carbon dioxide (tcPCO2) reduces the need for arterial blood sampling. Drawbacks are high electrode temperature causing risks of skin...... burning. The aim was to determine the accuracy and precision of tcPCO2 at reduced electrode temperature....

  14. Classifying Apnea of Prematurity by Transcutaneous Electromyography of the Diaphragm

    NARCIS (Netherlands)

    Kraaijenga, Juliette V.; Hutten, Gerard J.; de Waal, Cornelia G.; de Jongh, Frans H.; Onland, Wes; van Kaam, Anton H.

    2018-01-01

    Background: Treatment of apnea is highly dependent on the type of apnea. Chest impedance (CI) has inaccuracies in monitoring respiration, which compromises accurate apnea classification. Electrical activity of the diaphragm measured by transcutaneous electromyography (EMG) is feasible in preterm

  15. A novel approach towards noninvasive monitoring of transcutaneous CO2

    OpenAIRE

    Chatterjee, Madhubanti; Ge, Xudong; Kostov, Yordan; Tolosa, Leah; Rao, Govind

    2013-01-01

    The continuous monitoring of transcutaneous gases is an integral part of neonatal intensive care. Present monitors measure the equilibrating values of these gases by raising the skin temperature to 42°C or above. Because neonatal skin is very sensitive and delicate, this often leads to serious skin injuries. In this work, we present a new approach to the noninvasive measurement of transcutaneous partial pressure of carbon dioxide (tcpCO2) based on the initial pseudo steady state diffusion rat...

  16. Spinal fusion

    Science.gov (United States)

    ... Herniated disk - fusion; Spinal stenosis - fusion; Laminectomy - fusion Patient Instructions Bathroom safety - adults Preventing falls Preventing falls - what to ask your doctor Spine surgery - discharge Surgical wound care - open Images Scoliosis Spinal ...

  17. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal ... Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal ...

  18. CONTINUOUS MONITORING OF LACTATE DURING EXERCISE IN HUMANS USING SUBCUTANEOUS AND TRANSCUTANEOUS MICRODIALYSIS

    NARCIS (Netherlands)

    DEBOER, J; PLIJTERGROENDIJK, H; VISSER, KR; MOOK, GA; KORF, J

    1994-01-01

    We have evaluated the possibility of monitoring the plasma lactate concentration in human volunteers during cycle ergometer exercise using subcutaneous and transcutaneous microdialysis. In transcutaneous microdialysis, the relative increase in dialysate lactate concentration exceeded that of plasma

  19. 21 CFR 874.3950 - Transcutaneous air conduction hearing aid system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Transcutaneous air conduction hearing aid system... Transcutaneous air conduction hearing aid system. (a) Identification. A transcutaneous air conduction hearing aid... occluding the ear canal. The device consists of an air conduction hearing aid attached to a surgically...

  20. Comparison of serum bilirubin estimation with transcutaneous bilirubinometry in neonates

    International Nuclear Information System (INIS)

    Waqar, T.; Ahmad, Z.; Ali, A.

    2010-01-01

    Objective: To assess usefulness of Minolta Air shield transcutaneous bilirubinometer by comparing bilirubin values obtained by transcutaneous jaundice meter with serum bilirubin estimation. Design: Analytical cross sectional study. Place and duration: NICU Military Hospital Rawalpindi Pakistan Jun 2002 to May 2005. Subjects and Methods: One hundred and fifty neonates admitted to NICU because of visible jaundice were included in the study. Serum was sent to laboratory for total bilirubin estimation. At the same time bilirubin was also checked by a Jaundice Meter. Data was tabulated and t-test applied to compare the two values. Results: One hundred and fifty paired estimations were performed. The transcutaneous bilirubin values ranged from 8.0 mg/dl to 20.4 mg/dl. While serum bilirubin by jaundice meter values ranged between 5.3 mg/dl and 26.0 mg/dl. A Scatter diagram was plotted. It showed a correlation coefficient of 0.78. Conclusion: Bilirubin values obtained by transcutaneous bilirubin meter were not significantly different from laboratory values thus proving the fact that transcutaneous bilirubinometer is a useful device to measure bilirubin. (author)

  1. Transcutaneous mechanical nerve stimulation using perineal vibration: a novel method for the treatment of female stress urinary incontinence

    DEFF Research Database (Denmark)

    Sønksen, Jens; Ohl, Dana A; Bonde, Birthe

    2007-01-01

    We defined basic guidelines for transcutaneous mechanical nerve stimulation in modifying pelvic floor responses in women and determined the efficacy of transcutaneous mechanical nerve stimulation in treating stress urinary incontinence.......We defined basic guidelines for transcutaneous mechanical nerve stimulation in modifying pelvic floor responses in women and determined the efficacy of transcutaneous mechanical nerve stimulation in treating stress urinary incontinence....

  2. The transcutaneous electrical nerve stimulation of variable frequency intensity has a longer-lasting analgesic action than the burst transcutaneous electrical nerve stimulation in cancer pain

    OpenAIRE

    Schleder, Juliana Carvalho; Verner, Fernanda Aparecida; Mauda, Loriane; Mazzo, Débora Melo; Fernandes, Luiz Cláudio

    2017-01-01

    ABSTRACT BACKGROUND AND OBJECTIVES: Pain is one of the most frequent symptoms in cancer, and physical therapy offers non-invasive methods such as the transcutaneous electrical nerve stimulation for the relief of symptoms. The objective of this study was to compare the effect of the burst transcutaneous electrical nerve stimulation with the transcutaneous electrical nerve stimulation with variable intensity frequency in cancer pain. METHODS: This study was conducted with 53 patients of the H...

  3. Accuracy of Transcutaneous Carbon Dioxide Measurement in Premature Infants

    OpenAIRE

    Marie Janaillac; Sonia Labarinas; Riccardo E. Pfister; Oliver Karam

    2016-01-01

    Background. In premature infants, maintaining blood partial pressure of carbon dioxide (pCO2) value within a narrow range is important to avoid cerebral lesions. The aim of this study was to assess the accuracy of a noninvasive transcutaneous method (TcpCO2), compared to blood partial pressure of carbon dioxide (pCO2). Methods. Retrospective observational study in a tertiary neonatal intensive care unit. We analyzed the correlation between blood pCO2 and transcutaneous values and the accuracy...

  4. Method to Reduce Muscle Fatigue During Transcutaneous Neuromuscular Electrical Stimulation in Major Knee and Ankle Muscle Groups.

    Science.gov (United States)

    Sayenko, Dimitry G; Nguyen, Robert; Hirabayashi, Tomoyo; Popovic, Milos R; Masani, Kei

    2015-09-01

    A critical limitation with transcutaneous neuromuscular electrical stimulation as a rehabilitative approach is the rapid onset of muscle fatigue during repeated contractions. We have developed a method called spatially distributed sequential stimulation (SDSS) to reduce muscle fatigue by distributing the center of electrical field over a wide area within a single stimulation site, using an array of surface electrodes. To extend the previous findings and to prove feasibility of the method by exploring the fatigue-reducing ability of SDSS for lower limb muscle groups in the able-bodied population, as well as in individuals with spinal cord injury (SCI). SDSS was delivered through 4 active electrodes applied to the knee extensors and flexors, plantarflexors, and dorsiflexors, sending a stimulation pulse to each electrode one after another with 90° phase shift between successive electrodes. Isometric ankle torque was measured during fatiguing stimulations using SDSS and conventional single active electrode stimulation lasting 2 minutes. We demonstrated greater fatigue-reducing ability of SDSS compared with the conventional protocol, as revealed by larger values of fatigue index and/or torque peak mean in all muscles except knee flexors of able-bodied individuals, and in all muscles tested in individuals with SCI. Our study has revealed improvements in fatigue tolerance during transcutaneous neuromuscular electrical stimulation using SDSS, a stimulation strategy that alternates activation of subcompartments of muscles. The SDSS protocol can provide greater stimulation times with less decrement in mechanical output compared with the conventional protocol. © The Author(s) 2014.

  5. Mechanistic studies on transcutaneous vaccine delivery : microneedles, nanoparticles and adjuvants

    NARCIS (Netherlands)

    Bal, Suzanne Marleen

    2011-01-01

    Microneedle-based transcutaneous immunisation is an appealing alternative to the classical manner of injecting vaccines by intramuscular or subcutaneous route. Importantly, as a consequence of the fact that the skin is in direct contact with the environment and should protect the body against

  6. Transcutaneous electrical nerve stimulation for refractory daytime urinary urge incontinence.

    Science.gov (United States)

    Hagstroem, Søren; Mahler, Birgitte; Madsen, Bodil; Djurhuus, Jens Christian; Rittig, Søren

    2009-10-01

    We studied the effect of transcutaneous electrical nerve stimulation in children with overactive bladder and treatment refractory daytime urinary incontinence. We recruited 27 children 5 to 14 years old with daytime urge incontinence refractory to timer assisted standard urotherapy and anticholinergics who had normal urinalysis, and unremarkable urinary tract ultrasound and physical examination. Study exclusion criteria were bladder underactivity, lower urinary tract obstruction, ongoing defecation disorders, lower urinary tract surgery and previous transcutaneous electrical nerve stimulation. After a 2-week run-in of standard urotherapy the children underwent natural fill ambulatory urodynamics to confirm detrusor overactivity. Subsequently they were randomly allocated to 4 weeks of 2 hours of daily active or placebo S2-S3 transcutaneous electrical nerve stimulation. The severity of incontinence and urgency, and 48-hour bladder diaries were recorded before randomization and during intervention week 4. Children withdrew from anticholinergics throughout the study period. Two children were excluded from randomization due to urodynamic signs of lower urinary tract obstruction. After 4 weeks of intervention 8 children (61%) in the active group showed a significant decrease in incontinence severity but this occurred in only 2 (17%) in the sham treated group (p incontinence episodes compared to the sham treated group (p electrical nerve stimulation did not alter maximal and average voided volumes. Sacral transcutaneous electrical nerve stimulation seems superior to placebo for refractory daytime incontinence in children with overactive bladder. This effect does not seem to be a consequence of improved bladder reservoir function.

  7. Transcutaneous Raman spectroscopy of murine bone in vivo.

    Science.gov (United States)

    Schulmerich, Matthew V; Cole, Jacqueline H; Kreider, Jaclynn M; Esmonde-White, Francis; Dooley, Kathryn A; Goldstein, Steven A; Morris, Michael D

    2009-03-01

    Raman spectroscopy can provide valuable information about bone tissue composition in studies of bone development, biomechanics, and health. In order to study the Raman spectra of bone in vivo, instrumentation that enhances the recovery of subsurface spectra must be developed and validated. Five fiber-optic probe configurations were considered for transcutaneous bone Raman spectroscopy of small animals. Measurements were obtained from the tibia of sacrificed mice, and the bone Raman signal was recovered for each probe configuration. The configuration with the optimal combination of bone signal intensity, signal variance, and power distribution was then evaluated under in vivo conditions. Multiple in vivo transcutaneous measurements were obtained from the left tibia of 32 anesthetized mice. After collecting the transcutaneous Raman signal, exposed bone measurements were collected and used as a validation reference. Multivariate analysis was used to recover bone spectra from transcutaneous measurements. To assess the validity of the transcutaneous bone measurements cross-correlations were calculated between standardized spectra from the recovered bone signal and the exposed bone measurements. Additionally, the carbonate-to-phosphate height ratios of the recovered bone signals were compared to the reference exposed bone measurements. The mean cross-correlation coefficient between the recovered and exposed measurements was 0.96, and the carbonate-to-phosphate ratios did not differ significantly between the two sets of spectra (p > 0.05). During these first systematic in vivo Raman measurements, we discovered that probe alignment and animal coat color influenced the results and thus should be considered in future probe and study designs. Nevertheless, our noninvasive Raman spectroscopic probe accurately assessed bone tissue composition through the skin in live mice.

  8. Spinal injury

    Science.gov (United States)

    ... 2016. Kaji AH, Newton EJ, Hockberger RS. Spinal injuries. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier ...

  9. Spinal Infections

    Science.gov (United States)

    ... Epidural Steroid Injections Exercise: The Backbone of Spine Treatment Spondylolisthesis ... by bacteria or fungal organisms. Spinal infections may occur following surgery or spontaneously in patients with certain risk factors. ...

  10. Spinal Stenosis

    Science.gov (United States)

    ... images of the back and spinal canal A magnetic resonance imaging (MRI) scan of the spine to ... trigger or worsen pain and disability such as lifting heavy objects or walking long distances. Talk to ...

  11. Spinal infections

    International Nuclear Information System (INIS)

    Tali, E. Turgut; Gueltekin, Serap

    2005-01-01

    Spinal infections have an increasing prevalence among the general population. Definitive diagnosis based solely on clinical grounds is usually not possible and radiological imaging is used in almost all patients. The primary aim of the authors is to present an overview of spinal infections located in epidural, intradural and intramedullary compartments and to provide diagnostic clues regarding different imaging modalities, particularly MRI, to the practicing physicians and radiologists. (orig.)

  12. Spinal cysticercosis

    International Nuclear Information System (INIS)

    Goedert, A.V.; Silva, S.H.F.

    1990-01-01

    Spinal cysticercosis is an extremely uncommon condition. We have examined four patients with complaints that resembled nervous root compression by disk herniation. Myelography was shown to be an efficient method to evaluate spinal involvement, that was characterized by findings of multiple filling defect images (cysts) plus signs of adhesive arachnoiditis. One cyst was found to be mobile. Because of the recent development of medical treatment, a quick and precise diagnosis is of high importance to determine the prognosis of this condition. (author)

  13. Spinal vascular malformations; Spinale Gefaessmalformationen

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, U. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2012-05-15

    Spinal vascular malformations are a group of rare diseases with different clinical presentations ranging from incidental asymptomatic findings to progressive tetraplegia. This article provides an overview about imaging features as well as clinical and therapeutic aspects of spinal arteriovenous malformations, cavernomas and capillary telangiectasia. (orig.) [German] Spinale Gefaessmalformationen sind eine Gruppe seltener Erkrankungen mit unterschiedlichen klinischen Praesentationen, die vom asymptomatischen Zufallsbefund bis zur progredienten Tetraparese reichen. Dieser Artikel gibt einen Ueberblick ueber radiologische Befunde sowie klinische und therapeutische Aspekte von spinalen arteriovenoesen Malformationen, Kavernomen und kapillaeren Teleangiektasien. (orig.)

  14. Transcutaneous Noninvasive Device for the Responsive Delivery of Melatonin in Microgravity., Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Our goal is develop a smart, transcutaneous device for individualized circadian (sleep) therapy by responsive release of melatonin, in microgravity. Additionally,...

  15. Transcutaneous Noninvasive Device for the Responsive Delivery of Melatonin in Microgravity. Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Our goal is develop a smart, transcutaneous device for individualized circadian (sleep) therapy by responsive release of melatonin, in microgravity. Additionally,...

  16. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ...

  17. Spinal Cord Injury 101

    Medline Plus

    Full Text Available menu Understanding Spinal Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal Cord Injury Chart Spinal Cord Injury Facts and Figures Care and ...

  18. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal ... Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal ...

  19. Assessment of transcutaneous vaccine delivery by optical coherence tomography Assessment of transcutaneous vaccine delivery by OCT

    Science.gov (United States)

    Kamali, T.; Doronin, A.; Rattanapak, T.; Hook, S.; Meglinski, I.

    2012-08-01

    Immunization is one of the most efficient and cost-effective means for the prevention of diseases. The latest trend for inducing protective immunity is topical application of vaccines to intact skin rather than invasive administration via injection. Apart from being a non-invasive route of drug delivery, skin itself also offers advantages through the presence of cells of the immune system in both the dermis and epidermis. However, vaccine penetration through the outermost layers of skin is limited by the barrier provided by the Stratum corneum. In the current study utilizing conventional Optical Coherence Tomography (OCT) we investigate the transcutaneous delivery of a nano- particulate peptide vaccine into mouse skin in vivo. We demonstrate that a front of molecular diffusion within the skin can be clearly observed by using cross-correlations of successive 2D OCT images. Thus, OCT provides a unique tool for quantitative assessment of dynamics of diffusion of drugs, target compounds, analytes, cosmetics and various chemical agents in biological tissues in vivo.

  20. Transcutaneous Sacral Electrical Stimulation for Chronic Functional Constipation.

    Science.gov (United States)

    Iqbal, Fareed; Thomas, Gregory P; Tan, Emile; Askari, Alan; Dastur, Jamasp K; Nicholls, John; Vaizey, Carolynne J

    2016-02-01

    Transcutaneous sacral nerve stimulation is reported to improve symptoms of fecal incontinence. Chronic constipation may also respond to stimulation, but this is poorly reported in the literature. The study assessed the efficacy of transcutaneous electrical stimulation directly over the sacral nerve roots in chronic constipation. Chronic functional constipation was established in all patients using the Rome III criteria. The therapy was self-administered at home. A pilot study was conducted of transcutaneous sacral stimulation given over a 4-week period for 12 hours a day. Patients were assessed using the Patient Assessment of Constipation Symptoms, the Patient Assessment of Constipation Quality of Life, and the Cleveland constipation tool. A Global Rating of Change measure and a 1-week bowel diary was kept for the final week and compared with baseline. Of the 20 patients recruited (16 female, median age 38.5 years), 80% (16) completed the trial. Five (31%) patients reported at least a point reduction in the Patient Assessment of Constipation Symptoms score, 4 (25%) deteriorated, and 7 (44%) improved by less than one point. Median (interquartile range) Patient Assessment of Constipation Symptoms scores were 2.33 (2.34) at baseline and 2.08 (2.58) at follow-up (p = 0.074). Median scores for the Patient Assessment of Constipation Quality of Life and Cleveland systems were 3.00 (1.64) and 17.15 (18) at baseline and 2.22 (3.04) and 15.31 (12) at follow-up (p = 0.096 and 0.111). One-third of patients reported a positive Global Rating of Change measure, although 68% required concurrent laxatives during the trial. This is a pilot study and is limited by its small sample size. Continuous transcutaneous sacral stimulation in the short term appears to be ineffective for chronic constipation. Larger well-powered studies with intermittent stimulation regimens are required to investigate this further.

  1. Transcutaneous electrical nerve stimulation in female stress urinary incontinence

    OpenAIRE

    Zahra Shahshahan; Marjan Labbaf

    2006-01-01

    BACKGROUND: Stress urinary incontinence (SUI) is a prevalent medical problem for women especially through escalation of age. Many conservative nonsurgical therapies have been used for management of this problem which will usually be followed by high relapse rates or frequent side effects. Evaluation of the efficacy of transcutaneous electrical nerve stimulation (TENS) in management of genuine SUI has been studied in a few trials. We sought to assess the effectiveness and complications of high...

  2. Transcutaneous Raman Spectroscopy of Murine Bone In Vivo

    OpenAIRE

    Schulmerich, Matthew V.; Cole, Jacqueline H.; Kreider, Jaclynn M.; Esmonde-White, Francis; Dooley, Kathryn A.; Goldstein, Steven A.; Morris, Michael D.

    2009-01-01

    Raman spectroscopy can provide valuable information about bone tissue composition in studies of bone development, biomechanics, and health. In order to study the Raman spectra of bone in vivo, instrumentation that enhances the recovery of subsurface spectra must be developed and validated. Five fiber-optic probe configurations were considered for transcutaneous bone Raman spectroscopy of small animals. Measurements were obtained from the tibia of sacrificed mice, and the bone Raman signal was...

  3. Transcutaneous electric nerve stimulation (TENS) in dentistry: a review

    OpenAIRE

    Kasat, Vikrant O.; Gupta, Aditi; Ladda, Ruchi; Kathariya, Mitesh; Saluja, Harish; Farooqui, Anjum Ara

    2014-01-01

    Transcutaneous electric nerve stimulation (TENS) is a non-pharmacological method which is widely used by medical and paramedical professionals for the management of acute and chronic pain in a variety of conditions. Similarly, it can be utilized for the management of pain during various dental procedures as well as pain due to various conditions affecting maxillofacial region. This review aims to provide an insight into clinical research evidence available for the analgesic and non analgesic ...

  4. [New routes of administration: epidermal, transcutaneous mucosal ways of vaccination].

    Science.gov (United States)

    Denis, François; Alain, Sophie; Ploy, Marie-Cécile

    2007-04-01

    A successful vaccine triggers the interaction of various cells of the immune system as does a regular immune response. It is thus necessary to introduce the vaccine antigens into an anatomic site where they will contact immune cells. The route of administration is thus critical for the outcome of vaccination. Intramuscular or subcutaneous injections are the most popular. Antigens injected intramuscularly can form persistent precipitates that are dissolved and re-absorbed relatively slowly. If injecting antigens is a quick, easy and reproducible way to vaccination, it requires trained personnel. Alternatives exist, through non-invasive formulations which allow administration by the patient or a third party with no particular expertise. The skin, especially its epidermal layer, is an accessible and competent immune environment and an attractive target for vaccine delivery, through transcutaneous delivery or immunostimulant patches. Mucosal immunization is another strategy: its major rationale is that organisms invade the body via mucosal surfaces. Therefore, local protection at mucosal surface as well as systemic defense is beneficial. Various formulations of mucosal vaccines have been developed, such as the Sabin oral polio vaccine (OPV), rotavirus vaccines, cold-adapted influenza vaccines or vaccine against typhoid fever. Thus we are entering in an era where mucosal and transcutaneous immunisation will play an important role in disease management. However, it has not been so easy to obtain regulatory approval for mucosal or transcutaneous formulations and needle-based vaccines continue to dominate the market.

  5. Spinal tumors

    International Nuclear Information System (INIS)

    Goethem, J.W.M. van; Hauwe, L. van den; Oezsarlak, Oe.; Schepper, A.M.A. de; Parizel, P.M.

    2004-01-01

    Spinal tumors are uncommon lesions but may cause significant morbidity in terms of limb dysfunction. In establishing the differential diagnosis for a spinal lesion, location is the most important feature, but the clinical presentation and the patient's age and gender are also important. Magnetic resonance (MR) imaging plays a central role in the imaging of spinal tumors, easily allowing tumors to be classified as extradural, intradural-extramedullary or intramedullary, which is very useful in tumor characterization. In the evaluation of lesions of the osseous spine both computed tomography (CT) and MR are important. We describe the most common spinal tumors in detail. In general, extradural lesions are the most common with metastasis being the most frequent. Intradural tumors are rare, and the majority is extramedullary, with meningiomas and nerve sheath tumors being the most frequent. Intramedullary tumors are uncommon spinal tumors. Astrocytomas and ependymomas comprise the majority of the intramedullary tumors. The most important tumors are documented with appropriate high quality CT or MR images and the characteristics of these tumors are also summarized in a comprehensive table. Finally we illustrate the use of the new World Health Organization (WHO) classification of neoplasms affecting the central nervous system

  6. Spinal tuberculosis.

    Science.gov (United States)

    Dunn, R N; Ben Husien, M

    2018-04-01

    Tuberculosis (TB) remains endemic in many parts of the developing world and is increasingly seen in the developed world due to migration. A total of 1.3 million people die annually from the disease. Spinal TB is the most common musculoskeletal manifestation, affecting about 1 to 2% of all cases of TB. The coexistence of HIV, which is endemic in some regions, adds to the burden and the complexity of management. This review discusses the epidemiology, clinical presentation, diagnosis, impact of HIV and both the medical and surgical options in the management of spinal TB. Cite this article: Bone Joint J 2018;100-B:425-31.

  7. Effects of the transcutaneous electrode temperature on the accuracy of transcutaneous carbon dioxide tension.

    Science.gov (United States)

    Sørensen, Line C; Brage-Andersen, Lene; Greisen, Gorm

    2011-11-01

    The harmful effect of hypocapnia on the neonatal brain emphasizes the importance of monitoring arterial carbon dioxide tension (PaCO2). Transcutaneous monitoring of carbon dioxide (tcPCO2) reduces the need for arterial blood sampling. Drawbacks are high electrode temperature causing risks of skin burning. The aim was to determine the accuracy and precision of tcPCO2 at reduced electrode temperature. Forty newborns (GA 24.9-41.7) were included. Two tc-monitors were applied (TCM4, Radiometer, Copenhagen). Arterial blood gas sampling and monitoring of tcPCO2-level at different electrode temperatures was done simultaneously (39°C, 40°C, 41°C, 42°C, 44°C). Difference of PaCO2 - tcPCO2 was expressed as a percentage of the mean. Mean PaCO2 was 5.8kPa [3,2; 7.9]. Bias (PaCO2 - tcPCO2) increased from 5% at 44°C to 17% at 39°C, but did not differ significantly between 41°C and 40°C. The precision of the tcPCO2 at each temperature ranged from +7-10%. After correction for the temperature-dependent overreading, we found increasing PaCO2 - tcPCO2 difference with increasing PaCO2, approx. 2% pr. kPa increase of CO(2). Only mild transient erythema was observed. A lower electrode temperature in tcPCO2-monitoring increases systematic overreading of the tc-electrode. However, in very preterm babies, monitoring at 40°C or 41°C is possible provided a bias correction of 12-15% is applied.

  8. 21 CFR 882.5890 - Transcutaneous electrical nerve stimulator for pain relief.

    Science.gov (United States)

    2010-04-01

    ... pain relief. 882.5890 Section 882.5890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 882.5890 Transcutaneous electrical nerve stimulator for pain relief. (a) Identification. A transcutaneous electrical nerve stimulator for pain relief is a device used to apply an electrical current to...

  9. Neural effects of muscle stretching on the spinal reflexes in multiple lower-limb muscles.

    Science.gov (United States)

    Masugi, Yohei; Obata, Hiroki; Inoue, Daisuke; Kawashima, Noritaka; Nakazawa, Kimitaka

    2017-01-01

    While previous studies have shown that muscle stretching suppresses monosynaptic spinal reflex excitability in stretched muscles, its effects on non-stretched muscles is still largely unknown. The purpose of this study was to examine the effects of muscle stretching on monosynaptic spinal reflex in non-stretched muscles. Ten healthy male subjects participated in this study. Muscle stretching of the right triceps surae muscle was performed using a motor torque device for 1 minute. Three different dorsiflexion torques (at approximately 5, 10, and 15 Nm) were applied during muscle stretching. Spinal reflexes evoked by transcutaneous spinal cord stimulation were recorded in both the lower-limb muscles before, during, and at 0 and 5 min following muscle stretching. The amplitudes of the spinal reflexes in both the stretched and non-stretched muscles in the right (ipsilateral) leg were smaller during stretching compared to before, and at 0 and 5 min after stretching. Furthermore, the degree of reduction in the amplitude of the spinal reflexes in the right (ipsilateral) leg muscles increased significantly as the dorsiflexion torque (i.e., stretching of the right triceps surae muscles) increased. In contrast, reduction in the amplitude of the spinal reflexes with increasing dorsiflexion torque was not seen in the left (contralateral) leg muscles. Our results clearly indicate that muscle stretching has inhibitory effects on monosynaptic spinal reflexes, not only in stretched muscles, but also in non-stretched muscles of the ipsilateral leg.

  10. Bilateral transcutaneous tibial nerve stimulation for chronic constipation.

    Science.gov (United States)

    Iqbal, F; Collins, B; Thomas, G P; Askari, A; Tan, E; Nicholls, R J; Vaizey, C J

    2016-02-01

    Chronic constipation is difficult to treat when symptoms are intractable. Colonic propulsion may be altered by distal neuromodulation but this is conventionally delivered percutaneously. Transcutaneous tibial nerve stimulation is noninvasive and cheap: this study aimed to assess its efficacy in chronic constipation. Eighteen patients (median age 46 years, 12 female) with chronic constipation were recruited consecutively. Conservative and behavioural therapy had failed to improve symptoms in all 18. Thirty minutes of daily bilateral transcutaneous tibial nerve stimulation was administered by each patient at home for 6 weeks. The primary outcome measure was a change in the Patient Assessment of Constipation Quality of Life (PAC-QoL) score. Change in Patient Assessment of Constipation Symptoms (PAC-SYM), weekly bowel frequency and visual analogue scale (VAS) score were also measured. Fifteen patients (12 female) completed the trial. The PAC-QoL score improved significantly with treatment [pretreatment, median 2.95, interquartile range (IQR) 1.18; posttreatment, median 2.50, IQR 0.70; P = 0.047]. There was no change in PAC-SYM score (pretreatment, median 2.36, IQR 1.59; posttreatment, median 2.08, IQR 0.92; P = 0.53). Weekly stool frequency improved as did VAS score, but these did not reach statistical significance (P = 0.229 and 0.161). The PAC-QoL and PAC-SYM scores both improved in four (26%) patients. Two patients reported complete cure. There were no adverse events reported. Bilateral transcutaneous tibial nerve stimulation appears to be effective in a quarter of patients with chronic constipation. Carefully selected patients with less severe disease may benefit more. This requires further study. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  11. Modulation of auditory percepts by transcutaneous electrical stimulation.

    Science.gov (United States)

    Ueberfuhr, Margarete Anna; Braun, Amalia; Wiegrebe, Lutz; Grothe, Benedikt; Drexl, Markus

    2017-07-01

    Transcutaneous, electrical stimulation with electrodes placed on the mastoid processes represents a specific way to elicit vestibular reflexes in humans without active or passive subject movements, for which the term galvanic vestibular stimulation was coined. It has been suggested that galvanic vestibular stimulation mainly affects the vestibular periphery, but whether vestibular hair cells, vestibular afferents, or a combination of both are excited, is still a matter of debate. Galvanic vestibular stimulation has been in use since the late 18th century, but despite the long-known and well-documented effects on the vestibular system, reports of the effect of electrical stimulation on the adjacent cochlea or the ascending auditory pathway are surprisingly sparse. The present study examines the effect of transcutaneous, electrical stimulation of the human auditory periphery employing evoked and spontaneous otoacoustic emissions and several psychoacoustic measures. In particular, level growth functions of distortion product otoacoustic emissions were recorded during electrical stimulation with alternating currents (2 Hz, 1-4 mA in 1 mA-steps). In addition, the level and frequency of spontaneous otoacoustic emissions were followed before, during, and after electrical stimulation (2 Hz, 1-4 mA). To explore the effect of electrical stimulation on the retrocochlear level (i.e. on the ascending auditory pathway beyond the cochlea), psychoacoustic experiments were carried out. Specifically, participants indicated whether electrical stimulation (4 Hz, 2 and 3 mA) induced amplitude modulations of the perception of a pure tone, and of auditory illusions after presentation of either an intense, low-frequency sound (Bounce tinnitus) or a faint band-stop noise (Zwicker tone). These three psychoacoustic measures revealed significant perceived amplitude modulations during electrical stimulation in the majority of participants. However, no significant changes of evoked and

  12. Transcutaneous monitoring of steroid-induced osteoporosis with Raman spectroscopy

    Science.gov (United States)

    Maher, Jason R.; Inzana, Jason; Takahata, Masahiko; Awad, Hani A.; Berger, Andrew J.

    2012-01-01

    Although glucocorticoids are among the most frequently prescribed anti-inflammatory agents used in the treatment of rheumatoid arthritis, extended exposure to this steroid hormone is the leading cause of iatrogenic osteoporosis. Recently, Raman spectroscopy has been utilized to exploit biochemical differences between osteoporotic and normal bones in order to predict fracture risk. In this presentation, we report the results of ongoing research in our laboratory towards the clinical translation of this technique. We will discuss strategies for the transcutaneous acquisition of spectra from the tibiae of mice that are of sufficient quality to generate accurate predictions of fracture risk.

  13. Spinal Cord Injury 101

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    Full Text Available ... Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury 101 ... arrow What is the “Spinal Cord Injury Model Systems” program? play_arrow What are the most promising ...

  14. Spinal Muscular Atrophy FAQ

    Science.gov (United States)

    ... SMA: Frequently Asked Questions What is Spinal Muscular Atrophy? Spinal Muscular Atrophy (SMA) is a genetic neuromuscular ... future trials in SMA. What is Spinal Muscular Atrophy with Respiratory Distress (SMARD)? SMARD and SMA are ...

  15. Spinal Cord Injury 101

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    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury 101 Adult Injuries Spinal Cord Injury 101 David ...

  16. Spinal Cord Injury 101

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    Full Text Available ... About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury 101 Adult ... LLC Understanding Spinal Cord Injury About Us Expert Videos Contact Us Personal Experience Videos Blog Videos By ...

  17. Spinal Cord Injury 101

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    Full Text Available ... Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury ... Jennifer Piatt, PhD David Chen, MD Read Bio Medical Director, Spinal Cord Injury Rehabilitation Program, Rehabilitation Institute ...

  18. Spinal Cord Injury 101

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    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury 101 Adult Injuries Spinal Cord Injury 101 ...

  19. Spinal Cord Diseases

    Science.gov (United States)

    Your spinal cord is a bundle of nerves that runs down the middle of your back. It carries signals back ... of the spine, this can also injure the spinal cord. Other spinal cord problems include Tumors Infections such ...

  20. Spinal Cord Injury 101

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    Full Text Available ... L Sarah Harrison, OT Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury ... a spinal cord injury important? play_arrow What role does “compression” play in a spinal cord injury? ...

  1. Spinal Cord Injury 101

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    Full Text Available ... spinal cord injury? play_arrow What kind of surgery is common after a spinal cord injury? play_ ... How soon after a spinal cord injury should surgery be performed? play_arrow Is it common to ...

  2. Spinal Cord Injury 101

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    Full Text Available ... Spinal Cord Injury Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy ... Abuse and Spinal Cord Injury Allen Heinemann, PhD How Peer Counseling Works Julie Gassaway, MS, RN Pediatric ...

  3. Spinal Cord Injury 101

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    Full Text Available ... Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW Rehabilitation ...

  4. Spinal Cord Injury 101

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    Full Text Available ... Cord Injury Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, ... Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW ...

  5. Analgesic effects of transcutaneous electrical nerve stimulation and interferential currents on heat pain in healthy subjects.

    Science.gov (United States)

    Cheing, Gladys L Y; Hui-Chan, Christina W Y

    2003-01-01

    This study examined whether transcutaneous electrical nerve stimulation or interferential current was more effective in reducing experimentally induced heat pain. Forty-eight young healthy subjects were randomly divided into the following groups: (i) transcutaneous electrical nerve stimulation; (ii) interferential current; and (iii) no stimulation. A multi-function electrical stimulator was used to generate the transcutaneous electrical nerve stimulation or interferential current. A thermal sensory analyser was used to record the heat pain threshold. The stimulation lasted for 30 minutes and the heat pain thresholds were measured before, during and after the stimulation. Transcutaneous electrical nerve stimulation (p = 0.003) and interferential current (p = 0.004) significantly elevated the heat pain threshold, but "no stimulation" did not. The thresholds of the transcutaneous electrical nerve stimulation and interferential current groups were significantly higher than that of the control group 30 minutes into the stimulation (p = 0.017). Both transcutaneous electrical nerve stimulation and interferential current increased the heat pain threshold to a similar extent during stimulation. However, the post-stimulation effect of interferential current lasted longer than that of transcutaneous electrical nerve stimulation.

  6. Spinal cord contusion.

    Science.gov (United States)

    Ju, Gong; Wang, Jian; Wang, Yazhou; Zhao, Xianghui

    2014-04-15

    Spinal cord injury is a major cause of disability with devastating neurological outcomes and limited therapeutic opportunities, even though there are thousands of publications on spinal cord injury annually. There are two major types of spinal cord injury, transaction of the spinal cord and spinal cord contusion. Both can theoretically be treated, but there is no well documented treatment in human being. As for spinal cord contusion, we have developed an operation with fabulous result.

  7. Treatment of Idiopathic Chronic Orchialgia with Transcutaneous Electrical Nerve Stimulation (TENS:A Preliminary Result

    Directory of Open Access Journals (Sweden)

    Ekrem Akdeniz

    2016-01-01

    Full Text Available Purpose: Unilateral or bilateral testicular pain lasting more than 3 months is called as chronic orchialgia. Aproximately 25-50% of chronic orchialgia is idiopatic origin. This study aimed the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS therapy due to Idiopathic Chronic Orchialgia (ICO. Methods: Five patients were included into this study with ICO that diagnosed with physical examination, urine analyses, urinary system x-ray film, and scrotal doppler ultrasound. Medical history revealed that multiple conservative therapy attempts failed to alleviate the pain. Two of the patients had right sided ICO. Traditional TENS device is placed to the most painful points. TENS applied 3 times in a week with duration 30 minutes for 4 weeks. Before and after TENS application, patients were evaluated by using Visual Analog Scale (VAS at first and third months. Results: Median age of patients was 26.20±2.38 (22-30. Mean VAS value was 6.52 ± 0.89 before the procedure. After 1 month VAS value was 3.82 ± 0.83 (p0.05. None of the patients needed any analgesics after during the one month. No complications, hyperemia or hypoesthesia of the scrotal or penile skin, occurred after the procedure. Conclusion: TENS reduces pain by increasing endorphin release in the spinal cord dorsal horn. TENS is very effective method for first 1 month in patients with ICO but its effect reduces by the time. There is no standard therapeutic protocol for idiopathic chronic orchialgia. Therefore TENS may be an alternative for patients who do not benefit from medical therapy and do not want invasive procedures. Short-term use of TENS and low number of the patients are the limitations of this study. Randomized, placebo-controlled, and longer follow-up period studies are needed to better assess the efficacy of TENS for ICO.

  8. Transcutaneous electrical nerve stimulation in female stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Zahra Shahshahan

    2006-12-01

    Full Text Available BACKGROUND: Stress urinary incontinence (SUI is a prevalent medical problem for women especially through escalation of age. Many conservative nonsurgical therapies have been used for management of this problem which will usually be followed by high relapse rates or frequent side effects. Evaluation of the efficacy of transcutaneous electrical nerve stimulation (TENS in management of genuine SUI has been studied in a few trials. We sought to assess the effectiveness and complications of high frequency TENS in SUI. METHODS: In a clinical trial, 10 sessions of high frequency TENS with 15 minutes duration every other day were applied for 40 women with genuine SUI. Treatment results were evaluated by SUI severity index at the end of first and sixth months after final session of TENS and they were compared with the baseline index. RESULTS: Seven patients (17.5% were omitted from the study because of intolerance of TENS. In the remaining 33 patients, there was no sign of any complication. In comparison to baseline, severities of SUI showed significant decrements at first and second post-intervention evaluations (P<0.0001. There was a significant increase in SUI index from first month to sixth month (P<0.0001. CONCLUSIONS: TENS is a safe and cost-effective method for SUI management but its effectiveness decreases by time. KEY WORDS: Transcutaneous electrical nerve stimulation, stress urinary incontinence.

  9. A novel approach towards noninvasive monitoring of transcutaneous CO2

    Science.gov (United States)

    Chatterjee, Madhubanti; Ge, Xudong; Kostov, Yordan; Tolosa, Leah; Rao, Govind

    2013-01-01

    The continuous monitoring of transcutaneous gases is an integral part of neonatal intensive care. Present monitors measure the equilibrating values of these gases by raising the skin temperature to 42°C or above. Because neonatal skin is very sensitive and delicate, this often leads to serious skin injuries. In this work, we present a new approach to the noninvasive measurement of transcutaneous partial pressure of carbon dioxide (tcpCO2) based on the initial pseudo steady state diffusion rates instead of the mass-transfer equilibrium. Because we are following initial diffusion rates, each measurement takes no more than a few minutes. Additionally, raising the surface temperature is not required, thus, skin irritation and burns are highly unlikely. A dual-chamber diffusion vessel with either porcine skin or dialysis membrane placed between the two chambers was used to mimic neonatal skin. LI-820 CO2 Analyzer was used to measure the CO2 diffusing through the membrane or skin. Initial experiments on adult human skin under varying physical activities, food intake and breathing patterns showed a strong influence of the various conditions on the amount of CO2 diffusing through skin. These initial findings suggest that this method can be used not only on neonates but to a wider population of patients. PMID:23931988

  10. Accuracy of Transcutaneous Carbon Dioxide Measurement in Premature Infants

    Science.gov (United States)

    Janaillac, Marie; Labarinas, Sonia

    2016-01-01

    Background. In premature infants, maintaining blood partial pressure of carbon dioxide (pCO2) value within a narrow range is important to avoid cerebral lesions. The aim of this study was to assess the accuracy of a noninvasive transcutaneous method (TcpCO2), compared to blood partial pressure of carbon dioxide (pCO2). Methods. Retrospective observational study in a tertiary neonatal intensive care unit. We analyzed the correlation between blood pCO2 and transcutaneous values and the accuracy between the trends of blood pCO2 and TcpCO2 in all consecutive premature infants born at TcpCO2 and blood pCO2 values. Pearson's R correlation between these values was 0.58. The mean bias was −0.93 kPa with a 95% confidence limit of agreement of −4.05 to +2.16 kPa. Correlation between the trends of TcpCO2 and blood pCO2 values was good in only 39.6%. Conclusions. In premature infants, TcpCO2 was poorly correlated to blood pCO2, with a wide limit of agreement. Furthermore, concordance between trends was equally low. We warn about clinical decision-making on TcpCO2 alone when used as continuous monitoring. PMID:27375901

  11. A novel approach toward noninvasive monitoring of transcutaneous CO(2).

    Science.gov (United States)

    Chatterjee, Madhubanti; Ge, Xudong; Kostov, Yordan; Tolosa, Leah; Rao, Govind

    2014-01-01

    The continuous monitoring of transcutaneous gases is an integral part of neonatal intensive care. Present monitors measure the equilibrating values of these gases by raising the skin temperature to 42°C or above. Because neonatal skin is very sensitive and delicate, this often leads to serious skin injuries. In this work, we present a new approach to the noninvasive measurement of transcutaneous partial pressure of carbon dioxide (tcpCO2) based on the initial pseudo steady state diffusion rates instead of the mass-transfer equilibrium. Because we are following initial diffusion rates, each measurement takes no more than a few minutes. Additionally, raising the surface temperature is not required, thus, skin irritation and burns are highly unlikely. A dual-chamber diffusion vessel with either porcine skin or dialysis membrane placed between the two chambers was used to mimic neonatal skin. LI-820 CO2 Analyzer was used to measure the CO2 diffusing through the membrane or skin. Initial experiments on adult human skin under varying physical activities, food intake and breathing patterns showed a strong influence of the various conditions on the amount of CO2 diffusing through skin. These initial findings suggest that this method can be used not only on neonates but to a wider population of patients. Copyright © 2013 IPEM. Published by Elsevier Ltd. All rights reserved.

  12. Volume conductor model of transcutaneous electrical stimulation with kilohertz signals

    Science.gov (United States)

    Medina, Leonel E.; Grill, Warren M.

    2014-12-01

    Objective. Incorporating high-frequency components in transcutaneous electrical stimulation (TES) waveforms may make it possible to stimulate deeper nerve fibers since the impedance of tissue declines with increasing frequency. However, the mechanisms of high-frequency TES remain largely unexplored. We investigated the properties of TES with frequencies beyond those typically used in neural stimulation. Approach. We implemented a multilayer volume conductor model including dispersion and capacitive effects, coupled to a cable model of a nerve fiber. We simulated voltage- and current-controlled transcutaneous stimulation, and quantified the effects of frequency on the distribution of potentials and fiber excitation. We also quantified the effects of a novel transdermal amplitude modulated signal (TAMS) consisting of a non-zero offset sinusoidal carrier modulated by a square-pulse train. Main results. The model revealed that high-frequency signals generated larger potentials at depth than did low frequencies, but this did not translate into lower stimulation thresholds. Both TAMS and conventional rectangular pulses activated more superficial fibers in addition to the deeper, target fibers, and at no frequency did we observe an inversion of the strength-distance relationship. Current regulated stimulation was more strongly influenced by fiber depth, whereas voltage regulated stimulation was more strongly influenced by skin thickness. Finally, our model reproduced the threshold-frequency relationship of experimentally measured motor thresholds. Significance. The model may be used for prediction of motor thresholds in TES, and contributes to the understanding of high-frequency TES.

  13. Spinal cord infarction; Spinaler Infarkt

    Energy Technology Data Exchange (ETDEWEB)

    Naumann, N.; Shariat, K.; Ulmer, S.; Stippich, C.; Ahlhelm, F.J. [Universitaetsspital Basel, Abteilung fuer Diagnostische und Interventionelle Neuroradiologie, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland)

    2012-05-15

    Infarction of the spinal cord can cause a variety of symptoms and neurological deficits because of the complex vascular supply of the myelon. The most common leading symptom is distal paresis ranging from paraparesis to tetraplegia caused by arterial ischemia or infarction of the myelon. Venous infarction, however, cannot always be distinguished from arterial infarction based on the symptoms alone. Modern imaging techniques, such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) assist in preoperative planning of aortic operations to reliably identify not only the most important vascular structure supplying the spinal cord, the artery of Adamkiewicz, but also other pathologies such as tumors or infectious disorders. In contrast to CT, MRI can reliably depict infarction of the spinal cord. (orig.) [German] Die durch einen Rueckenmarkinfarkt verursachte Symptomatik kann aufgrund der komplexen Blutversorgung des Myelons zu unterschiedlichen neurologischen Ausfaellen fuehren. Dabei steht haeufig die durch eine arterielle Minderperfusion des Myelons bedingte Querschnittssymptomatik im Vordergrund. Venoes induzierte Mikrozirkulationsstoerungen sind anhand des neurologischen Befundes klinisch nicht immer von arteriellen Infarkten zu unterscheiden. Die moderne Bildgebung unter Einsatz der CT- (CTA) und MR-Angiographie (MRA) dient dem Ausschluss nichtvaskulaerer Ursachen fuer die Symptomatik wie Entzuendungen und Tumoren sowie der praeoperativen Planung vor der Aortenchirurgie zum Nachweis der fuer die Myelondurchblutung entscheidenden A. Adamkiewicz. Im Gegensatz zur CT kann mittels MRT ein Infarkt im Myelon mit hoher Verlaesslichkeit nachgewiesen werden. (orig.)

  14. [The influence of non-invasive electrical stimulation of the spinal cord on the locomotor function of patients presenting with movement disorders of central genesis].

    Science.gov (United States)

    Balykin, M V; Yakupov, R N; Mashin, V V; Kotova, E Yu; Balykin, Yu M; Gerasimenko, Yu P

    The objective of the present study was to evaluate the influence of non-invasive (transcutaneous) electrical spinal cord stimulation on the locomotor function of the patients suffering from movement disorders. The study involved 10 patients of both sexes at the age from 32 to 70 years (including 40% of men and 60% of women) presenting with the compromised locomotor function of varying severity associated with the disturbances of cerebral blood circulation caused either by an injury to the brain and spinal cord or by stroke. The transcutaneous electrical spinal cord stimulation was applied using different frequency regimes with the placement of the electrodes in the projection onto the region of TXI-TXII vertebrae. The active factors were bipolar electrical stimuli 0.5 ms in duration; the current strength was chosen for each patient on an individual basis taking into consideration its threshold level. Electromyograms and evoked motor responses of selected muscles, viz. m. rectus femoris, m.biceps femoris, m. tibialis anterior, and m.gastrocnemius were recorded with the use of the 'Neuro-MVP-8 eight-channel electromyography' ('Neurosoft', Russia). The data obtained give evidence that the stimulation of the spinal cord with a frequency of 1 Hz induces reflectory responses with monosynaptic and polysynaptic components in the muscles of the lower extremities, with the thresholds of these responses being significantly higher in the patients presenting with serious neurological problems. Stimulation with the frequencies of 5 and 30 Hz caused in the patients with paresis the involuntary movement of the legs the characteristics of which were similar to those of the locomotor movements. It has been demonstrated that the application of transcutaneous electrical spinal cord stimulation leads to increased excitability of the lumbar spinal neural structures of the patients. The study has shown the possibility of regulation of the locomotor functions in the patients presenting

  15. Papel da eletroanalgesia na função respiratória de pacientes submetidos à operação de revascularização do miocárdio The role of electroanalgesia in patients undergoing coronary artery bypass surgery

    Directory of Open Access Journals (Sweden)

    Cesar Antonio Luchesa

    2009-09-01

    Full Text Available OBJETIVO: Avaliar a eletroanalgesia como método eficaz na diminuição da dor e consequente melhora da capacidade pulmonar em pacientes submetidos a operação de revascularização do miocárdio. MÉTODOS: No período de um ano foram estudados 30 pacientes submetidos a operação para tratamento da doença coronariana isquêmica. Após a randomização, 15 pacientes foram alocados no grupo estudo (que receberam eletroanalgesia e 15 pacientes no grupo controle (placebo. No pré-operatório todos os doentes foram entrevistados e realizaram espirometria. Do primeiro ao quinto dia de pós-operatório foram realizadas duas aplicações diárias de eletroanalgesia ou de corrente placebo, conforme o grupo em que o paciente estivesse alocado, e no quinto dia, nova espirometria. RESULTADOS: Todos os pacientes evoluíram satisfatoriamente, sem complicações inerentes à operação de revascularização do miocárdio. Verificou-se que a cirurgia reduziu os valores espirométricos de ambos os grupos (P= 0,00. Os resultados encontrados demonstraram também redução nos níveis de dor no grupo estudo quando comparado ao grupo controle. Este por sua vez não repercutiu em melhora da função pulmonar como resultado da aplicação da TENS quando comparado ao grupo controle (P>0,05. CONCLUSÃO: O grupo que realizou eletroanalgesia apresentou redução da intensidade da dor pós-operatória o que não implicou, contudo, na melhora da função respiratória de tais pacientesOBJECTIVE: To assess the electroanalgesia as an effective method in the reduction of pain and consequent improvement in lung function in patients undergoing coronary artery bypass graft surgery. METHODS: During the period of one year were studied 30 patients undergoing surgery for treatment of the ischemic coronary disease. After randomization, 15 patients were allocated in the study group (that received electroanalgesia and 15 patients from the controlled group (placebo. From the 1st until

  16. Spinal Cord Injury 101

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    Full Text Available ... Experiences by Topic Resources Peer Counseling Blog About Media Donate close search Understanding Spinal Cord Injury What is a Spinal Cord ... by Rona Talcott Website by Mobile Marketing LLC Understanding Spinal Cord Injury About ... By Topic Media Resources Donate to support families facing spinal cord ...

  17. Spinal Cord Injury 101

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    Full Text Available ... OTR/L Sarah Harrison, OT Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury Patti Rogers, ... the spinal cord work? play_arrow Why is the level of a spinal cord injury important? play_arrow What role does “compression” play in a spinal cord injury? ...

  18. Medical devices; neurological devices; classification of the transcutaneous electrical nerve stimulator to treat headache. Final order.

    Science.gov (United States)

    2014-07-03

    The Food and Drug Administration (FDA) is classifying the transcutaneous electrical nerve stimulator to treat headache into class II (special controls). The special controls that will apply to the device are identified in this order, and will be part of the codified language for the transcutaneous electrical nerve stimulator to treat headache classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.

  19. Microneedle-mediated transcutaneous immunization with plasmid DNA coated on cationic PLGA nanoparticles

    Science.gov (United States)

    Kumar, Amit; Wonganan, Piyanuch; Sandoval, Michael A.; Li, Xinran; Zhu, Saijie; Cui, Zhengrong

    2012-01-01

    Previously, it was shown that microneedle-mediated transcutaneous immunization with plasmid DNA can potentially induce a stronger immune response than intramuscular injection of the same plasmid DNA. In the present study, we showed that the immune responses induced by transcutaneous immunization by applying plasmid DNA onto a skin area pretreated with solid microneedles were significantly enhanced by coating the plasmid DNA on the surface of cationic nanoparticles. In addition, the net surface charge of the DNA-coated nanoparticles significantly affected their in vitro skin permeation and their ability to induce immune responses in vivo. Transcutaneous immunization with plasmid DNA-coated net positively charged anoparticles elicited a stronger immune response than with plasmid DNA-coated net negatively charged nanoparticles or by intramuscular immunization with plasmid DNA alone. Transcutaneous immunization with plasmid DNA-coated net positively charged nanoparticles induced comparable immune responses as intramuscular injection of them, but transcutaneous immunization was able to induce specific mucosal immunity and a more balanced T helper type 1 and type 2 response. The ability of the net positively charged DNA-coated nanoparticles to induce a strong immune response through microneedle-mediated transcutaneous immunization may be attributed to their ability to increase the expression of the antigen gene encoded by the plasmid and to more effectively stimulate the maturation of antigen-presenting cells. PMID:22921518

  20. Spinal pain

    International Nuclear Information System (INIS)

    Izzo, R.; Popolizio, T.; D’Aprile, P.; Muto, M.

    2015-01-01

    Highlights: • Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional spinal pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. • Special attention will be given to the discogenic pain, actually considered as the most frequent cause of chronic low back pain. • The correct distinction between referred pain and radicular pain contributes to give a more correct approach to spinal pain. • The pathogenesis of chronic pain renders this pain a true pathology requiring a specific management. - Abstract: The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic

  1. Spinal pain

    Energy Technology Data Exchange (ETDEWEB)

    Izzo, R., E-mail: roberto1766@interfree.it [Neuroradiology Department, A. Cardarelli Hospital, Naples (Italy); Popolizio, T., E-mail: t.popolizio1@gmail.com [Radiology Department, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Fg) (Italy); D’Aprile, P., E-mail: paoladaprile@yahoo.it [Neuroradiology Department, San Paolo Hospital, Bari (Italy); Muto, M., E-mail: mutomar@tiscali.it [Neuroradiology Department, A. Cardarelli Hospital, Napoli (Italy)

    2015-05-15

    Highlights: • Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional spinal pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. • Special attention will be given to the discogenic pain, actually considered as the most frequent cause of chronic low back pain. • The correct distinction between referred pain and radicular pain contributes to give a more correct approach to spinal pain. • The pathogenesis of chronic pain renders this pain a true pathology requiring a specific management. - Abstract: The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic

  2. Transcutaneous electric nerve stimulation (TENS) in dentistry- A review.

    Science.gov (United States)

    Kasat, Vikrant; Gupta, Aditi; Ladda, Ruchi; Kathariya, Mitesh; Saluja, Harish; Farooqui, Anjum-Ara

    2014-12-01

    Transcutaneous electric nerve stimulation (TENS) is a non-pharmacological method which is widely used by medical and paramedical professionals for the management of acute and chronic pain in a variety of conditions. Similarly, it can be utilized for the management of pain during various dental procedures as well as pain due to various conditions affecting maxillofacial region. This review aims to provide an insight into clinical research evidence available for the analgesic and non analgesic uses of TENS in pediatric as well as adult patients related to the field of dentistry. Also, an attempt is made to briefly discuss history of therapeutic electricity, mechanism of action of TENS, components of TENs equipment, types, techniques of administration, advantages and contradictions of TENS. With this we hope to raise awareness among dental fraternity regarding its dental applications thereby increasing its use in dentistry. Key words:Dentistry, pain, TENS.

  3. Changes in transcutaneous oxygen tension during exercise in pulmonary emphysema.

    OpenAIRE

    Hughes, J A; Gray, B J; Hutchison, D C

    1984-01-01

    Continuous measurements of transcutaneous oxygen tension (tcPO2) were made in 23 patients with radiological evidence of emphysema, at rest and during a maximal progressive exercise test. tcPO2 during the final phase of exercise was compared with tcPO2 at rest; the mean change (exercising minus resting value) in tcPO2 (delta tcPO2) was -0.8 mm Hg (SD 10.5, range -18 to +25) (-0.1 kPa (SD 1.4, range -2.4 to +3.3]. delta tcPO2 was correlated with: resting arterial oxygen tension (PaO2) (r = 0.60...

  4. Deqi Sensations of Transcutaneous Electrical Nerve Stimulation on Auricular Points

    Directory of Open Access Journals (Sweden)

    Xiaoling Wang

    2013-01-01

    Full Text Available Deqi sensation, a psychophysical response characterized by a spectrum of different needling sensations, is essential for Chinese acupuncture clinical efficacy. Previous research works have investigated the component of Deqi response upon acupuncture on acupoints on the trunk and limbs. However, the characteristics of Deqi sensations of transcutaneous electrical nerve stimulation (TENS on auricular points are seldom reported. In this study, we investigated the individual components of Deqi during TENS on auricular concha area and the superior scapha using quantitative measurements in the healthy subjects and depression patients. The most striking characteristics of Deqi sensations upon TENS on auricular points were tingling, numbness, and fullness. The frequencies of pressure, warmness, heaviness, and soreness were relatively lower. The dull pain and coolness are rare. The characteristics of Deqi were similar for the TENS on concha and on the superior scapha.

  5. Accuracy of Transcutaneous Carbon Dioxide Measurement in Premature Infants

    Directory of Open Access Journals (Sweden)

    Marie Janaillac

    2016-01-01

    Full Text Available Background. In premature infants, maintaining blood partial pressure of carbon dioxide (pCO2 value within a narrow range is important to avoid cerebral lesions. The aim of this study was to assess the accuracy of a noninvasive transcutaneous method (TcpCO2, compared to blood partial pressure of carbon dioxide (pCO2. Methods. Retrospective observational study in a tertiary neonatal intensive care unit. We analyzed the correlation between blood pCO2 and transcutaneous values and the accuracy between the trends of blood pCO2 and TcpCO2 in all consecutive premature infants born at <33 weeks’ gestational age. Results. 248 infants were included (median gestational age: 29 + 5 weeks and median birth weight: 1250 g, providing 1365 pairs of TcpCO2 and blood pCO2 values. Pearson’s R correlation between these values was 0.58. The mean bias was −0.93 kPa with a 95% confidence limit of agreement of −4.05 to +2.16 kPa. Correlation between the trends of TcpCO2 and blood pCO2 values was good in only 39.6%. Conclusions. In premature infants, TcpCO2 was poorly correlated to blood pCO2, with a wide limit of agreement. Furthermore, concordance between trends was equally low. We warn about clinical decision-making on TcpCO2 alone when used as continuous monitoring.

  6. Classifying Apnea of Prematurity by Transcutaneous Electromyography of the Diaphragm.

    Science.gov (United States)

    Kraaijenga, Juliette V; Hutten, Gerard J; de Waal, Cornelia G; de Jongh, Frans H; Onland, Wes; van Kaam, Anton H

    2018-01-01

    Treatment of apnea is highly dependent on the type of apnea. Chest impedance (CI) has inaccuracies in monitoring respiration, which compromises accurate apnea classification. Electrical activity of the diaphragm measured by transcutaneous electromyography (EMG) is feasible in preterm infants and might improve the accuracy of apnea classification. To compare the accuracy of apnea classification based on diaphragmatic EMG (dEMG) and CI tracings in preterm infants. Fifteen cases of central apnea, 5 of obstructive apnea, and 10 of mixed apnea were selected from recordings containing synchronized continuous tracings of respiratory inductive plethysmography (RIP), airway flow, heart rate (HR), oxygen saturation (SpO2), and breathing activity measured by dEMG and CI. Twenty-two assessors (neonatologists, pediatricians-in-training, and nurses) classified each apnea twice; once based on dEMG, HR, and SpO2 tracings, and once based on CI, HR, and SpO2. The assessors were blinded to the type of respiratory tracing (dEMG or CI) and to the RIP and flow tracings. In total 1,320 assessments were performed, and in 71.1% the apnea was classified correctly. Subgroup analysis based on respiratory tracing showed that 74.8% of the dEMG tracings were classified correctly compared to 67.3% of the CI tracings (p apnea classification based on dEMG was present for central (86.7 vs. 80.3%, p apnea. The improved apnea classification based on dEMG tracing was independent of the type of assessor. Transcutaneous dEMG improves the accuracy of apnea classification when compared to CI in preterm infants, making this technique a promising candidate for future monitoring systems. © 2017 S. Karger AG, Basel.

  7. Spinal stenosis

    International Nuclear Information System (INIS)

    Beale, S.; Pathria, M.N.; Ross, J.S.; Masaryk, T.J.; Modic, M.T.

    1988-01-01

    The authors studied 50 patients who had spinal stenosis by means of MR imaging. All patients had undergone myelography and CT. Thirty patients underwent surgery. MR imaging included T1-weighted spin echo sequences with repetition time = 600 msec, echo time = 20 (600/20) sagittal and axial sections 4 mm thick with 2 mm gap. T2-weighted 2,000/60 axial images were obtained on 14 patients. Examinations were retrospectively evaluated for central stenosis, lateral recess narrowing, and foraminal encroachment. Measurements of sagittal, interpedicular, interfacet, and recess dimensions were made at L3-5. On MR images, 20 patients had single-level and 30 had multiple-level stenosis. There was excellent agreement between modalities with central canal stenosis, but a discrepancy in six patients with bony foraminal stenosis. MR imaging was an accurate method for assessment of lumbar stenosis, but CT appears marginally better for detection of bony foraminal stenosis in certain cases

  8. Spinal infections

    Energy Technology Data Exchange (ETDEWEB)

    Tali, E. Turgut E-mail: turguttali@gazi.edu.tr

    2004-05-01

    Spinal infections can be thought of as a spectrum of disease comprising spondylitis, discitis, spondylodiscitis, pyogenic facet arthropathy, epidural infections, meningitis, polyradiculopathy and myelitis. Radiological evaluations have gained importance in the diagnosis, treatment planning, treatment and treatment monitoring of the spinal infections. Conventional radiographs are usually the initial imaging study. The sensitivity and specificity of the plain radiographs are very low. The sensitivity of CT is higher while it lacks of specificity. Conventional CT has played minor role for the diagnosis of early spondylitis and disc space infection and for follow-up, researches are going on the value of MDCT. MRI is as sensitive, specific and accurate as combined nuclear medicine studies and the method of choice for the spondylitis. Low signal areas of the vertebral body, loss of definition of the end plates and interruption of the cortical continuity, destruction of the cortical margins are typical on T1WI whereas high signal of affected areas of the vertebral body and disc is typical on T2WI. Contrast is mandatory and increases conspicuity, specificity, and observer confidence in the diagnosis and facilitates the treatment planning. Contrast enhancement is the earliest sign and pathognomonic in the acute inflammatory episode and even in the subtle infection then persists to a varying degree for several weeks or months. The outcome of the treatment is influenced by the type of infection and by the degree of neurologic compromise before treatment. There is an increasing move away from surgical intervention towards conservative therapy, percutaneous drainage of abscess or both. It is therefore critical to monitor treatment response, particularly in the immuno-deficient population.

  9. Iron 'ElectriRx' man: Overground stepping in an exoskeleton combined with noninvasive spinal cord stimulation after paralysis.

    Science.gov (United States)

    Gad, Parag N; Gerasimenko, Yury P; Zdunowski, Sharon; Sayenko, Dimitry; Haakana, Piia; Turner, Amanda; Lu, Daniel; Roy, Roland R; Edgerton, V Reggie

    2015-08-01

    We asked whether coordinated voluntary movement of the lower limbs could be regained in an individual having been completely paralyzed (>4 yr) and completely absent of vision (>15 yr) using a novel strategy - transcutaneous spinal cord stimulation at selected sites over the spinal vertebrae with just one week of training. We also asked whether this stimulation strategy could facilitate stepping assisted by an exoskeleton (EKSO, EKSO Bionics) that is designed so that the subject can voluntarily complement the work being performed by the exoskeleton. We found that spinal cord stimulation enhanced the level of effort that the subject could generate while stepping in the exoskeleton. In addition, stimulation improved the coordination patterns of the lower limb muscles resulting in a more continuous, smooth stepping motion in the exoskeleton. These stepping sessions in the presence of stimulation were accompanied by greater cardiac responses and sweating than could be attained without the stimulation. Based on the data from this case study it appears that there is considerable potential for positive synergistic effects after complete paralysis by combining the overground stepping in an exoskeleton, a novel transcutaneous spinal cord stimulation paradigm, and daily training.

  10. Transcutaneous oximetry compared to ankle-brachial-index measurement in the evaluation of percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    Wildgruber, Moritz; Wolf, Oliver; Weiss, Wolfgang; Berger, Hermann; Lutzenberger, Werner; Eckstein, Hans-Henning; Heider, Peter

    2007-01-01

    Objective: To investigate transcutaneous oximetry as parameter of the microcirculation is correlated to ankle-brachial-index as parameter of the macrocirculation after peripheral angioplasty procedures. Design: Prospective study. Materials and methods: 60 patients suffering from intermittent claudication were scheduled for angioplasty treatment. 45 patients were considered as eligible for angioplasty after angiographic evaluation, 15 patients underwent angiography only. Transcutaneous oximetry measurements were performed before the procedure, at the end of intervention, 24 h as well as 2 and 4 weeks after percutaneous transluminal angioplasty. Ankle-brachial-indices were obtained before intervention, 24 h as well as 2 and 4 weeks later. Results: Ankle-brachial-indices increased significantly at 24 h after angioplasty in patients being treated with angioplasty. Transcutaneous oximetry values dropped significantly at the end of the procedure and returned close to the baseline levels at 2 and 4 weeks after angioplasty. Ankle-brachial-indices and transcutaneous oximetry were positively correlated before (r = 0.3833, p = 0.009) as well as 4 weeks after angioplasty (r = 0.4596, p = 0.001). Immediately after radiological interventions, ankle-brachial-indices and transcutaneous oximetry are not positively correlated. In patients undergoing angiography only, transcutaneous oximetry levels drop significantly immediately after angiography and remain at decreased levels even at 4 weeks after intervention. Conclusion: Transcutaneous oximetry as parameter of the microcirculation is positively correlated with ankle-brachial-index as parameter of the macrocirculation before and at 4 weeks after angioplasty. Intraarterial angiography leads to a sudden decrease in skin microcirculation without affecting macrocirculation. As indicated by a lack of recovery in transcutaneous oximetry levels after 4 weeks, angiography alone results in a prolonged impaired microcirculation which may

  11. Spinal Cord Dysfunction (SCD)

    Data.gov (United States)

    Department of Veterans Affairs — The Spinal Cord Dysfunction (SCD) module supports the maintenance of local and national registries for the tracking of patients with spinal cord injury and disease...

  12. Spinal Cord Injury 101

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    Full Text Available ... SCI Personal Experiences by Topic Resources Peer Counseling Blog About Media Donate close search Understanding Spinal Cord ... SCI Personal Experiences by Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert ...

  13. Spinal Cord Injury 101

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    Full Text Available ... with SCI Personal Experiences by Topic Resources Peer Counseling Blog About Media Donate close search Understanding Spinal ... with SCI Personal Experiences by Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical ...

  14. Spinal Cord Injury 101

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    Full Text Available ... Resources Peer Counseling Blog About Media Donate close search Understanding Spinal Cord Injury What is a Spinal ... health care products or services, or control the information found on external websites. The Hill Foundation is ...

  15. Spinal Cord Injury 101

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    Full Text Available ... of Spinal Cord Injury Rehabilitation Kristine Cichowski, MS Occupational Therapy after Spinal Cord Injury Katie Powell, OT ... does not provide medical advice, recommend or endorse health care products or services, or control the information ...

  16. Spinal Cord Injury 101

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    Full Text Available ... spinal cord injuries? play_arrow What does stem-cell research on animals tell us? play_arrow When can we expect stem-cell treatments to become available for spinal cord injuries? ...

  17. Spinal Cord Injury 101

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    Full Text Available ... Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal Experiences by Topic Resources ... Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal Experiences by Topic Resources ...

  18. Spinal Cord Injury 101

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    Full Text Available ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal ...

  19. Spinal Cord Injury 101

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    Full Text Available ... Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC Understanding Spinal Cord Injury About Us Expert Videos Contact Us Personal Experience Videos Blog Videos By Topic Media Resources Donate to support families facing spinal cord ...

  20. Spinal cord stimulation

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007560.htm Spinal cord stimulation To use the sharing features on this page, please enable JavaScript. Spinal cord stimulation is a treatment for pain that uses ...

  1. Spinal Cord Injury 101

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    Full Text Available ... Experiences by Topic Resources Peer Counseling Blog About Media Donate close search Understanding Spinal Cord Injury What ... Experiences by Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics ...

  2. Spinal Cord Injury 101

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    Full Text Available ... RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation ... Rogers, PT Recreational Therapy after Spinal Cord Injury Jennifer Piatt, PhD David Chen, MD Read Bio Medical ...

  3. Spinal Cord Injury 101

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    Full Text Available ... program? play_arrow What are the most promising new treatments for spinal cord injuries? play_arrow What are the latest developments in the use of electrical stimulation for spinal ...

  4. Spinal Cord Injury 101

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    Full Text Available ... electrical stimulation for spinal cord injuries? play_arrow What is “Braingate” research? play_arrow How would stem-cell therapies work in the treatment of spinal cord injuries? play_ ...

  5. Spinal Cord Injury 101

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    Full Text Available ... spinal cord injuries. The website does not provide medical advice, recommend or endorse health care products or services, ... spinal cord injuries. The website does not provide medical advice, recommend or endorse health care products or services, ...

  6. Transcutaneous electrical nerve stimulation on Yongquan acupoint reduces CFA-induced thermal hyperalgesia of rats via down-regulation of ERK2 phosphorylation and c-Fos expression.

    Science.gov (United States)

    Yang, Lin; Yang, Lianxue; Gao, Xiulai

    2010-07-01

    Activation of extracellular signal-regulated kinase-1/2 (ERK1/2) and its involvement in regulating gene expression in spinal dorsal horn, cortical and subcortical neurons by peripheral noxious stimulation contribute to pain hypersensitivity. Transcutaneous electrical nerve stimulation (TENS) is a treatment used in physiotherapy practice to promote analgesia in acute and chronic inflammatory conditions. In this study, a total number of 114 rats were used for three experiments. Effects of complete Freund's adjuvant (CFA)-induced inflammatory pain hypersensitivity and TENS analgesia on ERK1/2 phosphorylation and c-Fos protein expression were examined by using behavioral test, Western blot, and immunostaining methods. We found that CFA injection caused an area of localized swelling, erythema, hypersensitivity to thermal stimuli, the decreased response time of hind paw licking (HPL), as well as upregulation of c-Fos protein expression and ERK2 phosphorylation in the ipsilateral spinal dorsal horn and the contralateral primary somatosensory area of cortex and the amygdala of rats. TENS on Yongquan acupoint for 20 min produced obvious analgesic effects as demonstrated with increased HPL to thermal stimuli of CFA-treated rats. In addition, TENS application suppressed the CFA-induced ERK2 activation and c-Fos protein expression. These results suggest that down-regulation of ERK2 phosphorylation and c-Fos expression were involved in TENS inhibition on CFA-induced thermal hyperalgesia of rats.

  7. The effect of intra-operative transcutaneous electrical nerve stimulation on posterior neck pain following thyroidectomy.

    Science.gov (United States)

    Park, C; Choi, J B; Lee, Y-S; Chang, H-S; Shin, C S; Kim, S; Han, D W

    2015-04-01

    Posterior neck pain following thyroidectomy is common because full neck extension is required during the procedure. We evaluated the effect of intra-operative transcutaneous electrical nerve stimulation on postoperative neck pain in patients undergoing total thyroidectomy under general anaesthesia. One hundred patients were randomly assigned to one of two groups; 50 patients received transcutaneous electrical nerve stimulation applied to the trapezius muscle and 50 patients acted as controls. Postoperative posterior neck pain and anterior wound pain were evaluated using an 11-point numerical rating scale at 30 min, 6 h, 24 h and 48 h following surgery. The numerical rating scale for posterior neck pain was significantly lower in the transcutaneous electrical nerve stimulation group compared with the control group at all time points (p < 0.05). There were no significant differences in the numerical rating scale for anterior wound pain at any time point. No adverse effects related to transcutaneous electrical nerve stimulation were observed. We conclude that intra-operative transcutaneous electrical nerve stimulation applied to the trapezius muscle reduced posterior neck pain following thyroidectomy. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

  8. Early predictive value of cord blood bilirubin and dynamic monitoring of transcutaneous bilirubin for hyperbilirubinemia of newborns

    Directory of Open Access Journals (Sweden)

    Haishan Guan

    2017-12-01

    Conclusions: The increase of cord blood bilirubin effectively predict the occurrence of neonatal hyperbilirubinemia. There is a good correlation between levels of transcutaneous bilirubin and serum bilirubin. Moreover, combined detection of transcutaneous bilirubin and cord blood bilirubin can significantly improve the prediction accuracy of hyperbilirubinemia.

  9. Spinal Cord Injury 101

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    Full Text Available ... injury? play_arrow How does the spinal cord work? play_arrow Why is the level of a spinal cord injury important? play_arrow What role does “compression” play in a spinal cord injury? play_arrow Why are high-dose steroids often used right after an injury? play_arrow What is meant ...

  10. Spinal Cord Injury

    Science.gov (United States)

    ... Types of illnesses and disabilities Spinal cord injury Spinal cord injury Read advice from Dr. Jeffrey Rabin , a pediatric ... your health on a daily basis. Living with spinal cord injury — your questions answered top What are pediatric ...

  11. Spinal Cord Injuries

    Science.gov (United States)

    ... forth between your body and your brain. A spinal cord injury disrupts the signals. Spinal cord injuries usually begin with a blow that fractures or ... down on the nerve parts that carry signals. Spinal cord injuries can be complete or incomplete. With a complete ...

  12. Spinal Cord Injury 101

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    Full Text Available ... Cord Injury Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, PsyD ... Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW Rehabilitation ...

  13. Transcutaneous electrical nerve stimulation therapy in reduction of orofacial pain

    Directory of Open Access Journals (Sweden)

    Đorđević Igor

    2014-01-01

    Full Text Available Introduction. Patients with craniomandibular disorders suffer from hypertonic, fatigued and painful masticatory muscles. This condition can lead to limitation of mandibular jaw movements. All of these symptoms and signs are included in myofascial pain dysfunction syndrome. Transcutaneous electrical nerve stimulation (TENS has been used for treatment of these patients. Objective. The aim of this study was to assess the effect of TENS therapy on chronic pain reduction in patients with the muscular dysfunction symptom. Methods. In order to evaluate the effect of TENS therapy before and after the treatment, Craniomandibular Index (Helkimo was used. Pain intensity was measured by VAS. Patients had TENS treatment over two-week period. BURST TENS modality was used. Current intensity was individually adjusted. Results. Two patients did not respond to TENS therapy. Complete pain reduction was recorded in 8 patients, while pain reduction was not significantly different after TENS therapy in 10 patients. Conclusion. TENS therapy was confirmed as therapeutic procedure in orofacial muscle relaxation and pain reduction.

  14. [Mechanisms and applications of transcutaneous electrical nerve stimulation in analgesia].

    Science.gov (United States)

    Tang, Zheng-Yu; Wang, Hui-Quan; Xia, Xiao-Lei; Tang, Yi; Peng, Wei-Wei; Hu, Li

    2017-06-25

    Transcutaneous electrical nerve stimulation (TENS), as a non-pharmacological and non-invasive analgesic therapy with low-cost, has been widely used to relieve pain in various clinical applications, by delivering current pulses to the skin area to activate the peripheral nerve fibers. Nevertheless, analgesia induced by TENS varied in the clinical practice, which could be caused by the fact that TENS with different stimulus parameters has different biological mechanisms in relieving pain. Therefore, to advance our understanding of TENS in various basic and clinical studies, we discussed (1) neurophysiological and biochemical mechanisms of TENS-induced analgesia; (2) relevant factors that may influence analgesic effects of TENS from the perspectives of stimulus parameters, including stimulated position, pulse parameters (current intensity, frequency, and pulse width), stimulus duration and used times in each day; and (3) applications of TENS in relieving clinical pain, including post-operative pain, chronic low back pain and labor pain. Finally, we propose that TENS may involve multiple and complex psychological neurophysiological mechanisms, and suggest that different analgesic effects of TENS with different stimulus parameters should be taken into consideration in clinical applications. In addition, to optimize analgesic effect, we recommend that individual-based TENS stimulation parameters should be designed by considering individual differences among patients, e.g., adaptively adjusting the stimulation parameters based on the dynamic ratings of patients' pain.

  15. Transcutaneous carbon dioxide during sleep-disordered breathing.

    Science.gov (United States)

    Rimpilä, Ville; Hosokawa, Keisuke; Huhtala, Heini; Saaresranta, Tarja; Salminen, Aaro V; Polo, Olli

    2015-12-01

    Respiratory drive is tightly controlled by the carbon dioxide levels. We tested the hypothesis that sequences of sleep apnoea (obstructive, central or mixed), hypopnoea and flow limitation are characterized by different levels of transcutaneous CO2 (PtcCO2). Polygraphic recordings (n=555) from patients with suspected sleep-disordered breathing (SDB) were retrospectively screened to find sequences (5 min or 10 events) of both SDB and steady breathing. Eighty-eight SDB sequences from 44 patients were included and PtcCO2 and SpO2 values were collected. PtcCO2 values during sequences were normalized by setting wakefulness level as 100%. In terms of PtcCO2, apnoea sequences with central component (central (n=7) and mixed (n=3) apnoea) did not differ from wakefulness (102.0% vs 100%, p=0.122) whereas obstructive apnoea (105.8%, pbreathing (112.2% vs 108.4%, p=0.022). Continuous PtcCO2 monitoring during sleep adds to the understanding of different SDB phenotypes. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Transcutaneous oxygen and carbon dioxide monitoring in intensive care.

    Science.gov (United States)

    Marsden, D; Chiu, M C; Paky, F; Helms, P

    1985-01-01

    Transcutaneous oxygen (TcPo2) and carbon dioxide (TcPco2) tensions were compared with arterial values in 23 children aged 4 months to 14 years, all requiring some form of respiratory support, but not in shock. Electrodes were placed on the upper chest and were heated to 45 degrees C. For TcPo2 and arterial oxygen (Pao2) a tight linear correlation over the range 6 to 14 kPa was found. Arterial carbon dioxide (Paco2) ranged between 2.63 and 6.8 kPa, and over this range a linear regression adequately described the relation of TcPco2 to Paco2. No effects of age were found for the relation between TcPo2 and Pao2. Over a four hour period, the mean ratio TcPo2/Pao2 rose significantly from 0.96 to 1.04, while the mean ratio of TcPco2/Paco2 fell from 1.65 to 1.62. Five children developed superficial burns which were still present at 48 hours. In children who require respiratory support but are not in shock, TcPo2 and TcPco2 bear a constant and predictable relation to Pao2 and Paco2, and can predict arterial values within clinically acceptable tolerances. PMID:3937497

  17. Improvement of physical performance by transcutaneous nerve stimulation in athletes.

    Science.gov (United States)

    Kaada, B

    1984-01-01

    The present pilot study tested the exercise response to transcutaneous nerve stimulation (TNS) of 21 volunteers, who were well-trained competitive athletes. In 62 experiments (n) they received low-frequency TNS (2 Hz) for 30-45 min prior to either a road or track race, swimming race, bicycle ergometer exercise, isometric muscular endurance test, or dynamometer hand grip test. Improvement in performance compared with a corresponding number of control tests, without TNS or with placebo stimulation in the same subjects, was almost regularly observed in running, swimming and ergometer cycling, although with great individual variations. The average improvement was 4.3 sec (2.2%) in 1.000 m road racing (n = 9); 2.3 sec (1.8%) in 800 m track racing (n = 5); 0.9 sec (1.4%) in 100 m swimming (n = 12); 1.3 sec (0.8%) in 200 m swimming (n = 6); and 2.5 sec (0.9%) in 400 m swimming (n = 3). In a bicycle ergometer test with stepwise, progressive exercise to muscular fatigue, the maximal capacity was increased by 9% (n = 4). Local isometric muscle endurance of the elbow flexors (n = 7) and hand grip strengths (n = 11) were not significantly altered. Possible mechanisms involved in the response to TNS are discussed.

  18. Coated microneedle arrays for transcutaneous delivery of live virus vaccines

    Science.gov (United States)

    Vrdoljak, Anto; McGrath, Marie G.; Carey, John B.; Draper, Simon J.; Hill, Adrian V.S.; O’Mahony, Conor; Crean, Abina M.; Moore, Anne C.

    2016-01-01

    Vaccines are sensitive biologics that require continuous refrigerated storage to maintain their viability. The vast majority of vaccines are also administered using needles and syringes. The need for cold chain storage and the significant logistics surrounding needle-and-syringe vaccination is constraining the success of immunization programs. Recombinant live viral vectors are a promising platform for the development of vaccines against a number of infectious diseases, however these viruses must retain infectivity to be effective. Microneedles offer an effective and painless method for delivery of vaccines directly into skin that in the future could provide solutions to current vaccination issues. Here we investigated methods of coating live recombinant adenovirus and modified vaccinia virus Ankara (MVA) vectors onto solid microneedle arrays. An effective spray-coating method, using conventional pharmaceutical processes, was developed, in tandem with suitable sugar-based formulations, which produces arrays with a unique coating of viable virus in a dry form around the shaft of each microneedle on the array. Administration of live virus-coated microneedle arrays successfully resulted in virus delivery, transcutaneous infection and induced an antibody or CD8+ T cell response in mice that was comparable to that obtained by needle-and-syringe intradermal immunization. To our knowledge, this is the first report of successful vaccination with recombinant live viral vectored vaccines coated on microneedle delivery devices. PMID:22245683

  19. Transcutaneous vagus nerve stimulation (tVNS) enhances divergent thinking.

    Science.gov (United States)

    Colzato, Lorenza S; Ritter, Simone M; Steenbergen, Laura

    2018-03-01

    Creativity is one of the most important cognitive skills in our complex and fast-changing world. Previous correlative evidence showed that gamma-aminobutyric acid (GABA) is involved in divergent but not convergent thinking. In the current study, a placebo/sham-controlled, randomized between-group design was used to test a causal relation between vagus nerve and creativity. We employed transcutaneous vagus nerve stimulation (tVNS), a novel non-invasive brain stimulation technique to stimulate afferent fibers of the vagus nerve and speculated to increase GABA levels, in 80 healthy young volunteers. Creative performance was assessed in terms of divergent thinking (Alternate Uses Task) and convergent thinking tasks (Remote Associates Test, Creative Problem Solving Task, Idea Selection Task). Results demonstrate active tVNS, compared to sham stimulation, enhanced divergent thinking. Bayesian analysis reported the data to be inconclusive regarding a possible effect of tVNS on convergent thinking. Therefore, our findings corroborate the idea that the vagus nerve is causally involved in creative performance. Even thought we did not directly measure GABA levels, our results suggest that GABA (likely to be increased in active tVNS condition) supports the ability to select among competing options in high selection demand (divergent thinking) but not in low selection demand (convergent thinking). Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Assessment of transcutaneous vaccine delivery by optical coherence tomography

    International Nuclear Information System (INIS)

    Kamali, T; Doronin, A; Meglinski, I; Rattanapak, T; Hook, S

    2012-01-01

    Immunization is one of the most efficient and cost-effective means for the prevention of diseases. The latest trend for inducing protective immunity is topical application of vaccines to intact skin rather than invasive administration via injection. Apart from being a non-invasive route of drug delivery, skin itself also offers advantages through the presence of cells of the immune system in both the dermis and epidermis. However, vaccine penetration through the outermost layers of skin is limited by the barrier provided by the Stratum corneum. In the current study utilizing conventional Optical Coherence Tomography (OCT) we investigate the transcutaneous delivery of a nano- particulate peptide vaccine into mouse skin in vivo. We demonstrate that a front of molecular diffusion within the skin can be clearly observed by using cross-correlations of successive 2D OCT images. Thus, OCT provides a unique tool for quantitative assessment of dynamics of diffusion of drugs, target compounds, analytes, cosmetics and various chemical agents in biological tissues in vivo

  1. Transcutaneous vagus nerve stimulation (tVNS) modulates flow experience.

    Science.gov (United States)

    Colzato, Lorenza S; Wolters, Gina; Peifer, Corinna

    2018-01-01

    Flow has been defined as a pleasant psychological state that people experience when completely absorbed in an activity. Previous correlative evidence showed that the vagal tone (as indexed by heart rate variability) is a reliable marker of flow. So far, it has not yet been demonstrated that the vagus nerve plays a causal role in flow. To explore this we used transcutaneous vagus nerve stimulation (tVNS), a novel non-invasive brain stimulation technique that increases activation of the locus coeruleus (LC) and norepinephrine release. A sham/placebo-controlled, randomized cross-over within-subject design was employed to infer a causal relation between the stimulated vagus nerve and flow as measured using the Flow Short-Scale in 32 healthy young volunteers. In both sessions, while being stimulated, participants had to rate their flow experience after having performed a task for 30 min. Active tVNS, compared to sham stimulation, decreased flow (as indexed by absorption scores). The results can be explained by the network reset theory, which assumes that high-phasic LC activity promotes a global reset of attention over exploitation of the current focus of attention, allowing rapid behavioral adaptation and resulting in decreased absorption scores. Furthermore, our findings corroborate the hypothesis that the vagus nerve and noradrenergic system are causally involved in flow.

  2. A novel system for transcutaneous application of carbon dioxide causing an "artificial Bohr effect" in the human body.

    Directory of Open Access Journals (Sweden)

    Yoshitada Sakai

    Full Text Available BACKGROUND: Carbon dioxide (CO(2 therapy refers to the transcutaneous administration of CO(2 for therapeutic purposes. This effect has been explained by an increase in the pressure of O(2 in tissues known as the Bohr effect. However, there have been no reports investigating the oxygen dissociation of haemoglobin (Hb during transcutaneous application of CO(2in vivo. In this study, we investigate whether the Bohr effect is caused by transcutaneous application of CO2 in human living body. METHODS: We used a novel system for transcutaneous application of CO(2 using pure CO(2 gas, hydrogel, and a plastic adaptor. The validity of the CO(2 hydrogel was confirmed in vitro using a measuring device for transcutaneous CO(2 absorption using rat skin. Next, we measured the pH change in the human triceps surae muscle during transcutaneous application of CO(2 using phosphorus-31 magnetic resonance spectroscopy ((31P-MRS in vivo. In addition, oxy- and deoxy-Hb concentrations were measured with near-infrared spectroscopy in the human arm with occulted blood flow to investigate O2 dissociation from Hb caused by transcutaneous application of CO(2. RESULTS: The rat skin experiment showed that CO(2 hydrogel enhanced CO(2 gas permeation through the rat skin. The intracellular pH of the triceps surae muscle decreased significantly 10 min. after transcutaneous application of CO(2. The NIRS data show the oxy-Hb concentration decreased significantly 4 min. after CO(2 application, and deoxy-Hb concentration increased significantly 2 min. after CO(2 application in the CO(2-applied group compared to the control group. Oxy-Hb concentration significantly decreased while deoxy-Hb concentration significantly increased after transcutaneous CO(2 application. CONCLUSIONS: Our novel transcutaneous CO(2 application facilitated an O(2 dissociation from Hb in the human body, thus providing evidence of the Bohr effect in vivo.

  3. Trauma: Spinal Cord Injury.

    Science.gov (United States)

    Eckert, Matthew J; Martin, Matthew J

    2017-10-01

    Injuries to the spinal column and spinal cord frequently occur after high-energy mechanisms of injury, or with lower-energy mechanisms, in select patient populations like the elderly. A focused yet complete neurologic examination during the initial evaluation will guide subsequent diagnostic procedures and early supportive measures to help prevent further injury. For patients with injury to bone and/or ligaments, the initial focus should be spinal immobilization and prevention of inducing injury to the spinal cord. Spinal cord injury is associated with numerous life-threatening complications during the acute and long-term phases of care that all acute care surgeons must recognize. Published by Elsevier Inc.

  4. Utility of noninvasive transcutaneous measurement of postoperative hemoglobin in total joint arthroplasty patients.

    Science.gov (United States)

    Stoesz, Michael; Wood, Kristin; Clark, Wesley; Kwon, Young-Min; Freiberg, Andrew A

    2014-11-01

    This study prospectively evaluated the clinical utility of a noninvasive transcutaneous device for postoperative hemoglobin measurement in 100 total hip and knee arthroplasty patients. A protocol to measure hemoglobin noninvasively, prior to venipuncture, successfully avoided venipuncture in 73% of patients. In the remaining 27 patients, there were a total of 48 venipunctures performed during the postoperative hospitalization period due to reasons including transcutaneous hemoglobin measurement less than or equal to 9 g/dL (19), inability to obtain a transcutaneous hemoglobin measurement (8), clinical signs of anemia (3), and noncompliance with the study protocol (18). Such screening protocols may provide a convenient and cost-effective alternative to routine venipuncture for identifying patients at risk for blood transfusion after elective joint arthroplasty. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. International Spinal Cord Injury

    DEFF Research Database (Denmark)

    Dvorak, M F; Itshayek, E; Fehlings, M G

    2015-01-01

    STUDY DESIGN: Survey of expert opinion, feedback and final consensus. OBJECTIVE: To describe the development and the variables included in the International Spinal Cord Injury (SCI) Spinal Interventions and Surgical Procedures Basic Data set. SETTING: International working group. METHODS......: A committee of experts was established to select and define data elements. The data set was then disseminated to the appropriate committees and organizations for comments. All suggested revisions were considered and both the International Spinal Cord Society and the American Spinal Injury Association endorsed...... spinal intervention and procedure is coded (variables 1 through 7) and the spinal segment level is described (variables 8 and 9). Sample clinical cases were developed to illustrate how to complete it. CONCLUSION: The International SCI Spinal Interventions and Surgical Procedures Basic Data Set...

  6. Posterior tibial nerve stimulation vs parasacral transcutaneous neuromodulation for overactive bladder in children.

    Science.gov (United States)

    Barroso, Ubirajara; Viterbo, Walter; Bittencourt, Joana; Farias, Tiago; Lordêlo, Patrícia

    2013-08-01

    Parasacral transcutaneous electrical nerve stimulation and posterior tibial nerve stimulation have emerged as effective methods to treat overactive bladder in children. However, to our knowledge no study has compared the 2 methods. We evaluated the results of parasacral transcutaneous electrical nerve stimulation and posterior tibial nerve stimulation in children with overactive bladder. We prospectively studied children with overactive bladder without dysfunctional voiding. Success of treatment was evaluated by visual analogue scale and dysfunctional voiding symptom score, and by level of improvement of each specific symptom. Parasacral transcutaneous electrical nerve stimulation was performed 3 times weekly and posterior tibial nerve stimulation was performed once weekly. A total of 22 consecutive patients were treated with posterior tibial nerve stimulation and 37 with parasacral transcutaneous electrical nerve stimulation. There was no difference between the 2 groups regarding demographic characteristics or types of symptoms. Concerning the evaluation by visual analogue scale, complete resolution of symptoms was seen in 70% of the group undergoing parasacral transcutaneous electrical nerve stimulation and in 9% of the group undergoing posterior tibial nerve stimulation (p = 0.02). When the groups were compared, there was no statistically significant difference (p = 0.55). The frequency of persistence of urgency and diurnal urinary incontinence was nearly double in the group undergoing posterior tibial nerve stimulation. However, this difference was not statistically significant. We found that parasacral transcutaneous electrical nerve stimulation is more effective in resolving overactive bladder symptoms, which matches parental perception. However, there were no statistically significant differences in the evaluation by dysfunctional voiding symptom score, or in complete resolution of urgency or diurnal incontinence. Copyright © 2013 American Urological

  7. The effect of transcutaneous application of carbon dioxide (CO2) on skeletal muscle

    International Nuclear Information System (INIS)

    Oe, Keisuke; Ueha, Takeshi; Sakai, Yoshitada; Niikura, Takahiro; Lee, Sang Yang; Koh, Akihiro; Hasegawa, Takumi; Tanaka, Masaya; Miwa, Masahiko; Kurosaka, Masahiro

    2011-01-01

    Highlights: → PGC-1α is up-regulated as a result of exercise such as mitochondrial biogenesis and muscle fiber-type switching, and up-regulation of VEGF. → We demonstrated transcutaneous application of CO 2 up-regulated the gene expression of PGC-1α, SIRT1 and VEGF, and instance of muscle fiber switching. → Transcutaneous application of CO 2 may cause similar effect to aerobic exercise in skeletal muscle. -- Abstract: In Europe, carbon dioxide therapy has been used for cardiac disease and skin problems for a long time. However there have been few reports investigating the effects of carbon dioxide therapy on skeletal muscle. Peroxisome proliferators-activated receptor (PPAR)-gamma coactivator-1 (PGC-1α) is up-regulated as a result of exercise and mediates known responses to exercise, such as mitochondrial biogenesis and muscle fiber-type switching, and neovascularization via up-regulation of vascular endothelial growth factor (VEGF). It is also known that silent mating type information regulation 2 homologs 1 (SIRT1) enhances PGC-1α-mediated muscle fiber-type switching. Previously, we demonstrated transcutaneous application of CO 2 increased blood flow and a partial increase of O 2 pressure in the local tissue known as the Bohr effect. In this study, we transcutaneously applied CO 2 to the lower limbs of rats, and investigated the effect on the fast muscle, tibialis anterior (TA) muscle. The transcutaneous CO 2 application caused: (1) the gene expression of PGC-1α, silent mating type information regulation 2 homologs 1 (SIRT1) and VEGF, and increased the number of mitochondria, as proven by real-time PCR and immunohistochemistry, (2) muscle fiber switching in the TA muscle, as proven by isolation of myosin heavy chain and ATPase staining. Our results suggest the transcutaneous application of CO 2 may have therapeutic potential for muscular strength recovery resulting from disuse atrophy in post-operative patients and the elderly population.

  8. Weight Bearing Over-ground Stepping in an Exoskeleton with Non-invasive Spinal Cord Neuromodulation after Motor Complete Paraplegia.

    Science.gov (United States)

    Gad, Parag; Gerasimenko, Yury; Zdunowski, Sharon; Turner, Amanda; Sayenko, Dimitry; Lu, Daniel C; Edgerton, V Reggie

    2017-01-01

    We asked whether coordinated voluntary movement of the lower limbs could be regained in an individual having been completely paralyzed (>4 year) and completely absent of vision (>15 year) using two novel strategies-transcutaneous electrical spinal cord stimulation at selected sites over the spine as well as pharmacological neuromodulation by buspirone. We also asked whether these neuromodulatory strategies could facilitate stepping assisted by an exoskeleton (EKSO, EKSO Bionics, CA) that is designed so that the subject can voluntarily complement the work being performed by the exoskeleton. We found that spinal cord stimulation and drug enhanced the level of effort that the subject could generate while stepping in the exoskeleton. In addition, stimulation improved the coordination patterns of the lower limb muscles resulting in a more continuous, smooth stepping motion in the exoskeleton along with changes in autonomic functions including cardiovascular and thermoregulation. Based on these data from this case study it appears that there is considerable potential for positive synergistic effects after complete paralysis by combining the over-ground step training in an exoskeleton, combined with transcutaneous electrical spinal cord stimulation either without or with pharmacological modulation.

  9. Weight Bearing Over-ground Stepping in an Exoskeleton with Non-invasive Spinal Cord Neuromodulation after Motor Complete Paraplegia

    Directory of Open Access Journals (Sweden)

    Parag Gad

    2017-06-01

    Full Text Available We asked whether coordinated voluntary movement of the lower limbs could be regained in an individual having been completely paralyzed (>4 year and completely absent of vision (>15 year using two novel strategies—transcutaneous electrical spinal cord stimulation at selected sites over the spine as well as pharmacological neuromodulation by buspirone. We also asked whether these neuromodulatory strategies could facilitate stepping assisted by an exoskeleton (EKSO, EKSO Bionics, CA that is designed so that the subject can voluntarily complement the work being performed by the exoskeleton. We found that spinal cord stimulation and drug enhanced the level of effort that the subject could generate while stepping in the exoskeleton. In addition, stimulation improved the coordination patterns of the lower limb muscles resulting in a more continuous, smooth stepping motion in the exoskeleton along with changes in autonomic functions including cardiovascular and thermoregulation. Based on these data from this case study it appears that there is considerable potential for positive synergistic effects after complete paralysis by combining the over-ground step training in an exoskeleton, combined with transcutaneous electrical spinal cord stimulation either without or with pharmacological modulation.

  10. Solid nanoemulsion as antigen and immunopotentiator carrier for transcutaneous immunization.

    Science.gov (United States)

    Gogoll, Karsten; Stein, Pamela; Lee, K D; Arnold, Philipp; Peters, Tanja; Schild, Hansjörg; Radsak, Markus; Langguth, Peter

    2016-10-01

    Imiquimod, a toll-like receptor 7 (TLR7) agonist, is an active pharmaceutical ingredient (API) established for the topical treatment of several dermal cancerous and precancerous skin lesions. Within this work, the immunostimulatory effect of imiquimod is further exploited in a transcutaneous immunization (TCI) approach based on a solid nanoemulsion (SN) formulation. SN contains a combination of imiquimod with the model peptide antigen SIINFEKL as a novel approach to omit needle and syringe and optimize dermal antigen administration. Excipients including sucrose fatty acid esters and the pharmaceutically acceptable oils MCT (middle chain triglycerides), avocado oil, jojoba wax and squalene are high pressure homogenized together with the antigen SIINFEKL. Freeze drying was performed to eliminate water and to achieve spreadable properties of the formulation for dermal administration. The influence of the different oil components was assessed regarding in vitro drug permeation in a Franz diffusion cell model using a murine skin setup. In vivo performance in terms of cytotoxic T-cell response was assessed in a C57BL/6 mouse model. Whereas Aldara® cream contains imiquimod in a dissolved state, the SN formulations carry the active in a suspended state. This resulted in a reduction of imiquimod permeation across murine skin from the SN when compared to Aldara® cream. In spite of this permeation rate reduction, each SN induced an in vivo immune response by specific T-cell lysis. A stabilized solid nanosuspension containing squalene/tocopherol exhibited a significantly higher performance (p⩽0.05) in comparison with Aldara® cream. MCT based SN exerted an in vivo effect comparable to Aldara®. In conclusion, anhydrous highly dispersed vehicles containing imiquimod in a submicron particle size distribution can represent promising formulations for TCI. The choice of the oil component has a strong influence on SN performance, independent of in vitro drug permeation

  11. Vestibulodynia: synergy between palmitoylethanolamide + transpolydatin and transcutaneous electrical nerve stimulation.

    Science.gov (United States)

    Murina, Filippo; Graziottin, Alessandra; Felice, Raffaele; Radici, Gianluigi; Tognocchi, Cinzia

    2013-04-01

    The study aimed to assess the effect of palmitoylethanolamide + transpolydatin combination in patients with vestibulodynia undergoing transcutaneous electrical nerve stimulation (TENS) therapy and to confirm the effectiveness of TENS also in a domiciliary protocol. The study is based on the premise that palmitoylethanolamide + transpolydatin combination may contribute to a down-regulation of mast cell hyperactivity, which is believed to be responsible for the proliferation and sprouting of vestibular pain fibers and the associated hyperalgesia and allodynia. Twenty women with vestibulodynia were randomly assigned to receive oral palmitoylethanolamide (PEA) 400 mg and transpolydatin 40 mg or placebo, twice daily for 60 days. All patients underwent TENS therapy in a self-administered home protocol. Visual analogue scale (VAS), Marinoff score for dyspareunia, and current perception threshold obtained from the vulvar vestibule were assessed at baseline and at the end of treatment. The patients received a mean of 26.7 TENS sessions. All scores in the 2 groups improved significantly, although the level of improvement was similar between the groups (VAS, p < .57; dyspareunia, p < .38). Nevertheless, the analysis of regression of symptoms related to the duration of disease revealed the therapy to be more effective when PEA + transpolydatin is included in cases with more recent disease onset, as compared with the placebo group (PEA: VAS, p < .01; dyspareunia, p < .01) (placebo: VAS, p = nonsignificant; dyspareunia, p = nonsignificant). This study confirms that TENS is of significant benefit in the management of vestibulodynia, also in a home environment. PEA + transpolydatin can be a value-added treatment adjunct when the onset of vestibulodynia is more recent or when the disease relapses.

  12. Perceptual embodiment of prosthetic limbs by transcutaneous electrical nerve stimulation.

    Science.gov (United States)

    Mulvey, Matthew R; Fawkner, Helen J; Radford, Helen E; Johnson, Mark I

    2012-01-01

      In able-bodied participants, it is possible to induce a sense of perceptual embodiment in an artificial hand using a visual-tactile illusion. In amputee patients, electrical stimulation of sensory afferents using transcutaneous electrical nerve stimulation (TENS) has been shown to generate somatic sensations in an amputee's phantom limb(s). However, the effects of TENS on the perceptual embodiment of an artificial limb are not known. Our objective was to investigate the effects of TENS on the perceptual embodiment of an artificial limb in fully intact able-bodied participants.   We used a modified version of the rubber hand illusion presented to 30 able-bodied participants (16 women, 14 men) to convey TENS paresthesia to an artificial hand. TENS electrodes were located over superficial radial nerve on the lateral aspect of the right forearm (1 cm proximal to the wrist), which was hidden from view. TENS intensity was increased to a strong non-painful TENS sensation (electrical paresthesia) was felt beneath the electrodes and projecting into the fingers of the hand. The electrical characteristics of TENS were asymmetric biphasic electrical pulsed waves, continuous pulse pattern, 120 Hz pulse frequency (rate), and 80 µs pulse duration (width).   Participants reported significantly higher intensities of the rubber hand illusion during the two TENS conditions (mean = 5.8, standard deviation = 1.9) compared with the two non-TENS conditions (mean = 4.9, standard deviation = 1.7), p embodiment of an artificial hand. Further exploratory studies involving an amputee population are warranted. © 2011 International Neuromodulation Society.

  13. Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults.

    Science.gov (United States)

    Gibson, William; Wand, Benedict M; O'Connell, Neil E

    2017-09-14

    Neuropathic pain, which is due to nerve disease or damage, represents a significant burden on people and society. It can be particularly unpleasant and achieving adequate symptom control can be difficult. Non-pharmacological methods of treatment are often employed by people with neuropathic pain and may include transcutaneous electrical nerve stimulation (TENS). This review supersedes one Cochrane Review 'Transcutaneous electrical nerve stimulation (TENS) for chronic pain' (Nnoaham 2014) and one withdrawn protocol 'Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults' (Claydon 2014). This review replaces the original protocol for neuropathic pain that was withdrawn. To determine the analgesic effectiveness of TENS versus placebo (sham) TENS, TENS versus usual care, TENS versus no treatment and TENS in addition to usual care versus usual care alone in the management of neuropathic pain in adults. We searched CENTRAL, MEDLINE, Embase, PsycINFO, AMED, CINAHL, Web of Science, PEDro, LILACS (up to September 2016) and various clinical trials registries. We also searched bibliographies of included studies for further relevant studies. We included randomised controlled trials where TENS was evaluated in the treatment of central or peripheral neuropathic pain. We included studies if they investigated the following: TENS versus placebo (sham) TENS, TENS versus usual care, TENS versus no treatment and TENS in addition to usual care versus usual care alone in the management of neuropathic pain in adults. Two review authors independently screened all database search results and identified papers requiring full-text assessment. Subsequently, two review authors independently applied inclusion/exclusion criteria to these studies. The same review authors then independently extracted data, assessed for risk of bias using the Cochrane standard tool and rated the quality of evidence using GRADE. We included 15 studies with 724 participants. We found a

  14. Comparison of Transcutaneous Electrical Nerve Stimulation and Cryotherapy for Increasing Quadriceps Activation in Patients With Knee Pathologies.

    Science.gov (United States)

    Gabler, Conrad M; Lepley, Adam S; Uhl, Tim L; Mattacola, Carl G

    2016-08-01

    Proper neuromuscular activation of the quadriceps muscle is essential for maintaining quadriceps (quad) strength and lower-extremity function. Quad activation (QA) failure is a common characteristic observed in patients with knee pathologies, defined as an inability to voluntarily activate the entire alpha-motor-neuron pool innervating the quad. One of the more popular techniques used to assess QA is the superimposed burst (SIB) technique, a force-based technique that uses a supramaximal, percutaneous electrical stimulation to activate all of the motor units in the quad during a maximal, voluntary isometric contraction. Central activation ratio (CAR) is the formula used to calculate QA level (CAR = voluntary force/SIB force) with the SIB technique. People who can voluntarily activate 95% or more (CAR = 0.95-1.0) of their motor units are defined as being fully activated. Therapeutic exercises aimed at improving quad strength in patients with knee pathologies are limited in their effectiveness due to a failure to fully activate the muscle. Within the past decade, several disinhibitory interventions have been introduced to treat QA failure in patients with knee pathologies. Transcutaneous electrical nerve stimulation (TENS) and cryotherapy are sensory-targeted modalities traditionally used to treat pain, but they have been shown to be 2 of the most successful treatments for increasing QA levels in patients with QA failure. Both modalities are hypothesized to positively affect voluntary QA by disinhibiting the motor-neuron pool of the quad. In essence, these modalities provide excitatory afferent stimuli to the spinal cord, which thereby overrides the inhibitory afferent signaling that arises from the involved joint. However, it remains unknown whether 1 is more effective than the other for restoring QA levels in patients with knee pathologies. By knowing the capabilities of each disinhibitory modality, clinicians can tailor treatments based on the rehabilitation goals

  15. Overview of Spinal Cord Disorders

    Science.gov (United States)

    ... Is the Spinal Cord Damaged? The spine (spinal column) contains the spinal cord, which is divided into four sections: Cervical (neck) Thoracic (chest) Lumbar (lower back) Sacral (pelvis). Each section is referred ...

  16. Laser-acoustic transcutaneous drug delivery: A new trend in administration of drugs

    Science.gov (United States)

    Zharov, Vladimir P.; Latyshev, Alexei S.

    1999-03-01

    This work deals with the principles of transcutaneous drug delivery technique which uses optoacoustic (OA) effect. Laser OA impregnation, enhanced laser OA impregnation, simple laser and laser OA injections are presented. Drug impregnation mathematical model and preliminary experiments on laser injection are described.

  17. [[Peculiarities of transcutaneous nephrolithotripsy in the patient's position lying on the back].

    Science.gov (United States)

    Sagalevich, A I; Vozianov, S A; Juran, B V; Kogut, V V; Gaysenyuk, F Z; Sergiychuk, R V

    2016-08-01

    In 2014 - 2016 yrs transcutaneous nephrolithotripsy was performed in 245 patients for nephrolithiasis, of them in 228 (93.1%) - in position of patient lying on the abdomen (1st group), in 17 (6.9%) - lying on the back (2nd group) because of various concur- rent cardio-vascular and respiratory diseases present. Mini- transcutaneous nephro- lithotripsy was performed under regional epidural anesthesia in 224 (91.4%) patients, and under endotracheal narcosis - in 21 (8.6%). While conduction of mini- transcu- taneous nephrolithotripsy in position of patient lying on the back the operation duration is reducing, and it is possible to perform simultant endoscopic interventions (trans- ureteric, transcutaneous). Position of patient lying on the back while performing tran- scutaneous nephrolithotripsy in a complex with regional (epidural) anesthesia consti- tutes a relatively secure procedure. Hemodynamical and respiratory parameters are simply intraoperatively controlled, what is important for the patients, urologists and anesthesiologists. The complications rate and results of treatment are comparable with such while performing transcutaneous nephrolithotripsy in accordance to standard in position of patient lying on the abdomen.

  18. Transcutaneous electrical nerve stimulation (TENS) improves the rest-activity rhythm in midstage Alzheimer's disease

    NARCIS (Netherlands)

    Scherder, E. J.; van Someren, E. J.; Swaab, D. F.

    1999-01-01

    Nightly restlessness in patients with Alzheimer's disease (AD) is probably due to a disorder of circadian rhythms. Transcutaneous electrical nerve stimulation (TENS) was previously reported to increase the strength of coupling of the circadian rest activity rhythm to Zeitgebers in early stage

  19. 42 CFR 414.232 - Special payment rules for transcutaneous electrical nerve stimulators (TENS).

    Science.gov (United States)

    2010-10-01

    ... nerve stimulators (TENS). 414.232 Section 414.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Special payment rules for transcutaneous electrical nerve stimulators (TENS). (a) General payment rule. Except as provided in paragraph (b) of this section, payment for TENS is made on a purchase basis with...

  20. Prospective study of transcutaneous parasacral electrical stimulation for overactive bladder in children: long-term results.

    Science.gov (United States)

    Lordêlo, Patrícia; Soares, Paulo Vitor Lima; Maciel, Iza; Macedo, Antonio; Barroso, Ubirajara

    2009-12-01

    We evaluated the long-term success of transcutaneous parasacral electrical stimulation for overactive bladder in children. We prospectively evaluated children who underwent transcutaneous parasacral electrical stimulation for overactive bladder. All patients had symptoms of overactive bladder, bell curve in uroflowmetry and low post-void residual urine. The procedure was performed using a frequency of 10 Hz for 20-minute sessions 3 times weekly for a maximum of 20 sessions. Initial and long-term (more than 6 months) success rates were evaluated. Transcutaneous parasacral electrical stimulation was performed in 36 girls and 13 boys with a mean age of 10.2 years (range 5 to 17). Mean followup was 35.3 months (range 6 to 80). Before treatment urgency, daytime incontinence and urinary tract infection were seen in 100%, 88% and 71% of cases, respectively. Initial success (full response) was demonstrated in 79% of patients for urgency, 76% for incontinence and 77% for all symptoms. Continued success was seen in 84% of patients for urgency, 74% for daytime incontinence and 78% for all symptoms. If the 30 patients with at least 2 years of followup were considered, treatment was successful in 73%. Recurrence of symptoms after a full response was seen in 10% of cases. Two of 33 patients (6%) with urinary tract infection before the procedure still had infection after treatment. Transcutaneous parasacral electrical stimulation is well tolerated, and demonstrates short and long-term effectiveness in treating overactive bladder in children. Symptoms eventually will recur in 10% of patients.

  1. Small is beautiful: N-trimethyl chitosan-ovalbumin conjugates for microneedle-based transcutaneous immunisation.

    Science.gov (United States)

    Bal, Suzanne M; Slütter, Bram; Jiskoot, Wim; Bouwstra, Joke A

    2011-05-23

    To provoke an immune response, a transcutaneously administered vaccine has to diffuse into the skin, reach the lymph nodes and be taken up by dendritic cells (DCs). To study these three steps we immunised mice transcutaneously (with microneedles), intradermally and intranodally. The effect of the formulation was investigated by formulating ovalbumin (OVA) in three ways with N-trimethyl chitosan (TMC): TMC+OVA mixtures, TMC-OVA conjugates and TMC/OVA nanoparticles. Both the percentage OVA(+) DCs in the lymph node and the resultant immunogenicity (serum IgG titres) were studied. Transcutaneously, the TMC-OVA conjugates induced the highest IgG levels and resulted in more OVA(+) DCs in the lymph nodes after 24h than the other TMC formulations. Intradermally, all TMC-adjuvanted OVA formulations increased IgG titres compared to plain OVA. These formulations formed a depot in the skin, prolonging OVA delivery to the lymph nodes. The prolonged delivery of TMC-adjuvanted OVA to lymph node resident DCs was also observed after intranodal immunisation, but in this case the higher uptake did not correspond with elevated antibody titres compared to plain OVA. In conclusion, after transcutaneous administration, TMC-OVA conjugates are most immunogenic among the tested formulations, likely because they penetrate the skin more easily than nanoparticles and consequently are better delivered to DCs, while they show higher uptake by DCs than TMC+OVA mixtures. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Are transcutaneous oxygen and carbon dioxide determinations of value in pulmonary arterial hypertension?

    Science.gov (United States)

    Tonelli, Adriano R; Alkukhun, Laith; Cikach, Frank; Ahmed, Mostafa; Dweik, Raed A

    2015-05-01

    We hypothesized that transcutaneous gas determinations of O2 and CO2 (TcPO2 and TcPCO2 ) are associated with the severity of PAH. In this cross-sectional study, we included consecutive patients with PAH (group 1 PH; n = 34). Transcutaneous gas determinations were compared to those of age- and gender-matched healthy controls (n = 14), nongroup 1 PH (n = 19) or patients with high estimated RVSP on echocardiography but without hemodynamic evidence of PH (n = 12). In patients with PAH, TcPO2 , and TcPCO2 were significantly associated with PaO2 (R = 0.44, p = 0.03) and PaCO2 (R = 0.77, p TcPCO2 (mean difference: -7.4 [95% CI: -11.6, -3.1]) were significantly lower in patients with PAH than healthy controls. TcPCO2 was useful in discriminating PAH patients from other individuals (AUC: 0.74 [95% CI: 0.62, 0.83]). TcPO2 /FiO2 ratio was significantly associated with mean PAP, TPG, PVR, CI, SVI, DLCO, six-minute walk distance and components of the CAMPHOR questionnaire. Transcutaneous pressure of CO2 was lower in patients with PAH. Transcutaneous pressure of O2 over inspired fraction of O2 ratio was inversely associated with severity of disease in patients with PAH. © 2015 John Wiley & Sons Ltd.

  3. Transcutaneous cervical vagal nerve stimulation modulates cardiac vagal tone and tumor necrosis factor-alpha

    DEFF Research Database (Denmark)

    Brock, C; Brock, B; Aziz, Q

    2017-01-01

    The vagus nerve is a central component of cholinergic anti-inflammatory pathways. We sought to evaluate the effect of bilateral transcutaneous cervical vagal nerve stimulation (t-VNS) on validated parameters of autonomic tone and cytokines in 20 healthy subjects. 24 hours after t...

  4. Effects of transcutaneous electrical nerve stimulation (TENS) on cognition and behaviour in aging

    NARCIS (Netherlands)

    Scherder, E.J A; van Someren, E.W J; Bouma, J.M.; van der Berg, M

    2000-01-01

    In previous studies, transcutaneous electrical nerve stimulation (TENS) improved cognition and behaviour in patients with Alzheimer's disease (AD). The rationale underlying these studies was that TENS could activate, e.g. the septo-hippocampal region and the hypothalamus through direct and indirect

  5. Effects of transcutaneous electrical nerve stimulation (TENS) on memory in elderly with mild cognitive impairment

    NARCIS (Netherlands)

    Luijpen, M.W.; Swaab, D.F.; Sergeant, J.A.; van Dijk, K.R.A.; Scherder, E.J.A.

    2005-01-01

    In previous studies, transcutaneous electrical nerve stimulation (TENS) was shown to have a positive effect on memory in Alzheimer's disease (AD) patients. Moreover, the reported effects appeared to be more beneficial in early stages of Alzheimer's disease compared to later stage intervention. Based

  6. Effects of transcutaneous electrical nerve stimulation (TENS) on memory in elderly with mild cognitive impairment.

    NARCIS (Netherlands)

    Luijpen, M.W.; Swaab, D.F.; Sergeant, J.A.; Dijk, K.R.A.; Scherder, E.J.

    2005-01-01

    In previous studies, transcutaneous electrical nerve stimulation (TENS) was shown to have a positive effect on memory in Alzheimer's disease (AD) patients. Moreover, the reported effects appeared to be more beneficial in early stages of Alzheimer's disease compared to later stage intervention. Based

  7. Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on cognition and behaviour in aging

    NARCIS (Netherlands)

    Scherder, E.J.A.; Bouma, A.; van den Berg, M.

    2000-01-01

    In previous studies, transcutaneous electrical nerve stimulation (TENS) improved cognition and behaviour in patients with Alzheimer's disease (AD). The rationale underlying these studies was that TENS could activate, e.g. the septo-hippocampal region and the hypothalamus through direct and indirect

  8. Microneedle arrays for the transcutaneous immunization of diphtheria and influenza in BALB/c mice

    NARCIS (Netherlands)

    Ding, Z.; Verbaan, F. J.; Bivas-Benita, M.; Bungener, L.; Huckriede, A.; van den Berg, D. J.; Kersten, G.; Bouwstra, J. A.

    2009-01-01

    Transcutaneous immunization (TCI) is limited by poor permeation of macromolecules across the skin. Microneedle arrays form transient conduits and enhance the transport of vaccine molecules across the skin barrier without pain sensation. Here we investigated in mouse the immune responses after TO

  9. Fluorescently labeled cyclodextrin derivatives as exogenous markers for real-time transcutaneous measurement of renal function

    NARCIS (Netherlands)

    Huang, Jiaguo; Weinfurter, Stefanie; Pinto, Pedro Caetano; Pretze, Marc; Kränzlin, Bettina; Pill, Johannes; Federica, Rodeghiero; Perciaccante, Rossana; Ciana, Leopoldo Della; Masereeuw, Rosalinde; Gretz, Norbert

    2016-01-01

    Evaluation of renal function is crucial for a number of clinical situations. Here, we reported a novel exogenous fluorescent marker (FITC-HPβCD) to real-time assess renal function by using a transcutaneous fluorescent detection technique. FITC-HPβCD was designed based on the principle of renal

  10. Fluorescently Labeled Cyclodextrin Derivatives as Exogenous Markers for Real-Time Transcutaneous Measurement of Renal Function

    NARCIS (Netherlands)

    Huang, J.; Weinfurter, S.; Pinto, P.C.; Pretze, M.; Kranzlin, B.; Pill, J.; Federica, R.; Perciaccante, R.; Ciana, L.D.; Masereeuw, R.; Gretz, N.

    2016-01-01

    Evaluation of renal function is crucial for a number of clinical situations. Here, we reported a novel exogenous fluorescent marker (FITC-HPbetaCD) to real-time assess renal function by using a transcutaneous fluorescent detection technique. FITC-HPbetaCD was designed based on the principle of renal

  11. Transcutaneous migration of foreign body into thorax in children: A report of two cases

    Directory of Open Access Journals (Sweden)

    Bothra Jyoti

    2016-11-01

    Full Text Available Inhalation and ingestion of foreign bodies is common in pediatric age group. However transcutaneous migration of sharps into the lung parenchyma is rarely reported and can be hazardous. We report two such cases with details on the diagnosis and the treatment modalities used for the management.

  12. MULTIPLE SPINAL CANAL MENINGIOMAS

    Directory of Open Access Journals (Sweden)

    Nandigama Pratap Kumar

    2016-10-01

    Full Text Available BACKGROUND Meningiomas of the spinal canal are common tumours with the incidence of 25 percent of all spinal cord tumours. But multiple spinal canal meningiomas are rare in compare to solitary lesions and account for 2 to 3.5% of all spinal meningiomas. Most of the reported cases are both intra cranial and spinal. Exclusive involvement of the spinal canal by multiple meningiomas are very rare. We could find only sixteen cases in the literature to the best of our knowledge. Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature. We are presenting a case of multiple spinal canal meningiomas in a young patient of 17 years, who was earlier operated for single lesion. We analysed the literature, with illustration of our case. MATERIALS AND METHODS In September 2016, we performed a literature search for multiple spinal canal meningiomas involving exclusively the spinal canal with no limitation for language and publication date. The search was conducted through http://pubmed.com, a wellknown worldwide internet medical address. To the best of our knowledge, we could find only sixteen cases of multiple meningiomas exclusively confined to the spinal canal. Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature. We are presenting a case of multiple spinal canal meningiomas in a young patient of 17 years, who was earlier operated for solitary intradural extra medullary spinal canal meningioma at D4-D6 level, again presented with spastic quadriparesis of two years duration and MRI whole spine demonstrated multiple intradural extra medullary lesions, which were excised completely and the histopathological diagnosis was transitional meningioma. RESULTS Patient recovered from his weakness and sensory symptoms gradually and bladder and bowel symptoms improved gradually over a period of two to three weeks. CONCLUSION Multiple

  13. Spinal injury in sport

    Energy Technology Data Exchange (ETDEWEB)

    Barile, Antonio [Department of Radiology, University of L' Aquila, S. Salvatore Hospital, Via Vetoio, Coppito, 67100 L' Aquila (Italy)]. E-mail: antonio.barile@cc.univaq.it; Limbucci, Nicola [Department of Radiology, University of L' Aquila, S. Salvatore Hospital, Via Vetoio, Coppito, 67100 L' Aquila (Italy); Splendiani, Alessandra [Department of Radiology, University of L' Aquila, S. Salvatore Hospital, Via Vetoio, Coppito, 67100 L' Aquila (Italy); Gallucci, Massimo [Department of Radiology, University of L' Aquila, S. Salvatore Hospital, Via Vetoio, Coppito, 67100 L' Aquila (Italy); Masciocchi, Carlo [Department of Radiology, University of L' Aquila, S. Salvatore Hospital, Via Vetoio, Coppito, 67100 L' Aquila (Italy)

    2007-04-15

    Spinal injuries are very common among professional or amateur athletes. Spinal sport lesions can be classified in overuse and acute injuries. Overuse injuries can be found after years of repetitive spinal load during sport activity; however specific overuse injuries can also be found in adolescents. Acute traumas are common in contact sports. Most of the acute injuries are minor and self-healing, but severe and catastrophic events are possible. The aim of this article is to review the wide spectrum of spinal injuries related to sport activity, with special regard to imaging finding.

  14. Spinal injury in sport

    International Nuclear Information System (INIS)

    Barile, Antonio; Limbucci, Nicola; Splendiani, Alessandra; Gallucci, Massimo; Masciocchi, Carlo

    2007-01-01

    Spinal injuries are very common among professional or amateur athletes. Spinal sport lesions can be classified in overuse and acute injuries. Overuse injuries can be found after years of repetitive spinal load during sport activity; however specific overuse injuries can also be found in adolescents. Acute traumas are common in contact sports. Most of the acute injuries are minor and self-healing, but severe and catastrophic events are possible. The aim of this article is to review the wide spectrum of spinal injuries related to sport activity, with special regard to imaging finding

  15. Human spinal motor control

    DEFF Research Database (Denmark)

    Nielsen, Jens Bo

    2016-01-01

    interneurons and exert a direct (willful) muscle control with the aid of a context-dependent integration of somatosensory and visual information at cortical level. However, spinal networks also play an important role. Sensory feedback through spinal circuitries is integrated with central motor commands...... the central motor command by opening or closing sensory feedback pathways. In the future, human studies of spinal motor control, in close collaboration with animal studies on the molecular biology of the spinal cord, will continue to document the neural basis for human behavior. Expected final online...

  16. The safe spinal anaesthetic

    African Journals Online (AJOL)

    anticoagulation. Refusal. Severe hypovolaemia or shock. Localised sepsis .... Side-effects and complications of spinal anaesthesia. Side-effect/complication. Mechanism. Treatment. Hypotension. Sympathetic block causes vasodilatation.

  17. Rearfoot Transcutaneous Oximetry is a Useful Tool to Highlight Ischemia of the Heel

    Energy Technology Data Exchange (ETDEWEB)

    Izzo, Valentina, E-mail: valentina-izzo@virgilio.it; Meloni, Marco, E-mail: meloni.marco@libero.it [University of Tor Vergata, Department of Systems Medicine (Italy); Fabiano, Sebastiano, E-mail: sebas575@yahoo.it; Morosetti, Daniele, E-mail: danielemorosetti@hotmail.com [University of Tor Vergata, Department of Diagnostic Imaging and Interventional Radiology (Italy); Giurato, Laura, E-mail: lauragiurato@yahoo.it [University of Tor Vergata, Department of Systems Medicine (Italy); Chiaravalloti, Antonio, E-mail: antoniochiaravalloti@hotmail.it [University of Tor Vergata, Department of Diagnostic Imaging and Interventional Radiology (Italy); Ruotolo, Valeria, E-mail: valeriaruotolo@virgilio.it [University of Tor Vergata, Department of Systems Medicine (Italy); Gandini, Roberto, E-mail: roberto.gandini@fastwebnet.it [University of Tor Vergata, Department of Diagnostic Imaging and Interventional Radiology (Italy); Uccioli, Luigi, E-mail: luccioli@yahoo.com [University of Tor Vergata, Department of Systems Medicine (Italy)

    2017-01-15

    PurposeTo demonstrate the usefulness of rearfoot transcutaneous oximetry to assess the peripheral arterial disease in diabetic patients with heel ulcer.MethodsFrom our database of 550 critical limb ischemia diabetic patients followed after a percutaneous transluminal angioplasty, we have selected patients with below the knee arterial disease. Patients were grouped according to the dorsal transcutaneous oximetry value (Group A < 30 mmHg; Group B ≥ 30 mmHg). Patients of Group B had a second oximetry performed at the rearfoot, close to the lesion localized in all cases at the heel. Finally, the analysis of the arterial pattern disease has been done.ResultsWe selected 191 patients: Group A (151 patients), dorsal transcutaneous oximetry of 11.8 ± 0.7 mmHg; Group B (40 patients), dorsal transcutaneous oximetry of 44.2 ± 10.1 mmHg. In Group B, rearfoot oximetry was 20.5 ± 5 mmHg, significantly lower than dorsal oximetry (p = 0.0179). The anterior tibial artery was involved in all patients of Group A. In Group B, the anterior tibial artery was involved in 15 subjects and never alone; the posterior tibial artery was involved in 20 subjects and in 11 cases alone. The peroneal artery was affected in 20 subjects and in 14 patients alone.ConclusionWhen a heel lesion is present and the transcutaneous oximetry recorded on the dorsum of the foot does not confirm the presence of critical limb ischemia (not ≤30 mmHg), a second oximetry recorded on the rearfoot is useful to point out ischemia of the peroneal artery and/or of the posterior tibial artery.

  18. Analysis, design, and control of a transcutaneous power regulator for artificial hearts.

    Science.gov (United States)

    Qianhong Chen; Siu Chung Wong; Tse, C K; Xinbo Ruan

    2009-02-01

    Based on a generic transcutaneous transformer model, a remote power supply using a resonant topology for use in artificial hearts is analyzed and designed for easy controllability and high efficiency. The primary and secondary windings of the transcutaneous transformer are positioned outside and inside the human body, respectively. In such a transformer, the alignment and gap may change with external positioning. As a result, the coupling coefficient of the transcutaneous transformer is also varying, and so are the two large leakage inductances and the mutual inductance. Resonant-tank circuits with varying resonant-frequency are formed from the transformer inductors and external capacitors. For a given range of coupling coefficients, an operating frequency corresponding to a particular coupling coefficient can be found, for which the voltage transfer function is insensitive to load. Prior works have used frequency modulation to regulate the output voltage under varying load and transformer coupling. The use of frequency modulation may require a wide control frequency range which may extend well above the load insensitive frequency. In this paper, study of the input-to-output voltage transfer function is carried out, and a control method is proposed to lock the switching frequency at just above the load insensitive frequency for optimized efficiency at heavy loads. Specifically, operation at above resonant of the resonant circuits is maintained under varying coupling-coefficient. Using a digital-phase-lock-loop (PLL), zero-voltage switching is achieved in a full-bridge converter which is also programmed to provide output voltage regulation via pulsewidth modulation (PWM). A prototype transcutaneous power regulator is built and found to to perform excellently with high efficiency and tight regulation under variations of the alignment or gap of the transcutaneous transformer, load and input voltage.

  19. Rearfoot Transcutaneous Oximetry is a Useful Tool to Highlight Ischemia of the Heel

    International Nuclear Information System (INIS)

    Izzo, Valentina; Meloni, Marco; Fabiano, Sebastiano; Morosetti, Daniele; Giurato, Laura; Chiaravalloti, Antonio; Ruotolo, Valeria; Gandini, Roberto; Uccioli, Luigi

    2017-01-01

    PurposeTo demonstrate the usefulness of rearfoot transcutaneous oximetry to assess the peripheral arterial disease in diabetic patients with heel ulcer.MethodsFrom our database of 550 critical limb ischemia diabetic patients followed after a percutaneous transluminal angioplasty, we have selected patients with below the knee arterial disease. Patients were grouped according to the dorsal transcutaneous oximetry value (Group A < 30 mmHg; Group B ≥ 30 mmHg). Patients of Group B had a second oximetry performed at the rearfoot, close to the lesion localized in all cases at the heel. Finally, the analysis of the arterial pattern disease has been done.ResultsWe selected 191 patients: Group A (151 patients), dorsal transcutaneous oximetry of 11.8 ± 0.7 mmHg; Group B (40 patients), dorsal transcutaneous oximetry of 44.2 ± 10.1 mmHg. In Group B, rearfoot oximetry was 20.5 ± 5 mmHg, significantly lower than dorsal oximetry (p = 0.0179). The anterior tibial artery was involved in all patients of Group A. In Group B, the anterior tibial artery was involved in 15 subjects and never alone; the posterior tibial artery was involved in 20 subjects and in 11 cases alone. The peroneal artery was affected in 20 subjects and in 14 patients alone.ConclusionWhen a heel lesion is present and the transcutaneous oximetry recorded on the dorsum of the foot does not confirm the presence of critical limb ischemia (not ≤30 mmHg), a second oximetry recorded on the rearfoot is useful to point out ischemia of the peroneal artery and/or of the posterior tibial artery.

  20. Transcutaneous electrical nerve stimulation (TENS) for pain management in labour

    Science.gov (United States)

    Dowswell, Therese; Bedwell, Carol; Lavender, Tina; Neilson, James P

    2014-01-01

    Background Transcutaneous nerve stimulation (TENS) has been proposed as a means of reducing pain in labour. The TENS unit emits low-voltage electrical impulses which vary in frequency and intensity. During labour, TENS electrodes are generally placed on the lower back, although TENS may be used to stimulate acupuncture points or other parts of the body. The physiological mechanisms whereby TENS relieves pain are uncertain. TENS machines are frequently operated by women, which may increase a sense of control in labour. Objectives To assess the effects of TENS on pain in labour. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 April 2011) and reference lists of retrieved papers. Selection criteria Randomised controlled trials comparing women receiving TENS for pain management in labour versus routine care, alternative non-pharmacological methods of pain relief, or placebo devices. We included all types of TENS machines. Data collection and analysis Two review authors assessed for inclusion all trials identified by the search strategy, carried out data extraction and assessed risk of bias. We have recorded reasons for excluding studies. Main results Seventeen trials with 1466 women contribute data to the review. Thirteen examined TENS applied to the back, two to acupuncture points, and two to the cranium. Overall, there was little difference in pain ratings between TENS and control groups, although women receiving TENS to acupuncture points were less likely to report severe pain (average risk ratio 0.41, 95% confidence interval 0.31 to 0.54; measured in two studies). The majority of women using TENS said they would be willing to use it again in a future labour. Where TENS was used as an adjunct to epidural analgesia there was no evidence that it reduced pain. There was no consistent evidence that TENS had any impact on interventions and outcomes in labour. There was little information on outcomes for mothers and babies. No

  1. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Read Bio Medical Director, Spinal Cord Injury Rehabilitation Program, Rehabilitation Institute of Chicago play_arrow What is ... What is the “Spinal Cord Injury Model Systems” program? play_arrow What are the most promising new ...

  2. Spinal pain in adolescents

    DEFF Research Database (Denmark)

    Aartun, Ellen; Hartvigsen, Jan; Wedderkopp, Niels

    2014-01-01

    BACKGROUND: The severity and course of spinal pain is poorly understood in adolescents. The study aimed to determine the prevalence and two-year incidence, as well as the course, frequency, and intensity of pain in the neck, mid back, and low back (spinal pain). METHODS: This study was a school...

  3. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Heather Taylor, PhD Michelle Meade, PhD Jonathon Rose, PhD The Basics of Spinal Cord Injury Rehabilitation Kristine Cichowski, ... Cord Injury Katie Powell, OT Mary Jane Mulcahey, PhD, OTR/L Sarah Harrison, OT Anne Bryden, OT The Role of the Social Worker after Spinal Cord ...

  4. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... in a Wheelchair Lisa Rosen, MS Spasticity, Physical Therapy-Lokomat T. George Hornby, PhD, PT Empowering the Patient After Spinal Cord Injury Guy W. Fried, MD Substance Abuse and Spinal Cord Injury Allen Heinemann, PhD How ...

  5. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury Allen Heinemann, PhD How Peer Counseling Works Julie Gassaway, MS, RN Pediatric Injuries Pediatric Spinal ... injury? play_arrow How does the spinal cord work? play_arrow Why is the level of a ...

  6. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions ... PhD Michelle Meade, PhD Jonathon Rose, PhD The Basics of Spinal Cord Injury Rehabilitation Kristine Cichowski, MS ...

  7. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... from Hospital to Home Kim Eberhardt Muir, MS Coping with a New Injury Robin Dorman, PsyD Sex and Fertility After Spinal Cord Injury Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, ...

  8. Humero-spinal dysostosis.

    Science.gov (United States)

    Cortina, H; Vidal, J; Vallcanera, A; Alberto, C; Muro, D; Dominguez, F

    1979-07-24

    A 2 year old boy with humero-spinal dysostosis is described. This is the third case of this disease reported in the literature. Humero-spinal dysostosis is characterised radiologically by distal humeral bifurcation, elbow subluxation and coronal cleft vertebrae. Congenital, progressive heart disease, possibly with fatal outcome, is probably part of the syndrome.

  9. Transcutaneous Electrical Nerve Stimulation in Children with Monosymptomatic Nocturnal Enuresis: A Randomized, Double-Blind, Placebo Controlled Study.

    Science.gov (United States)

    Jørgensen, Cecilie Siggaard; Kamperis, Konstantinos; Borch, Luise; Borg, Britt; Rittig, Søren

    2017-09-01

    In a third of all children with monosymptomatic nocturnal enuresis their condition is refractory to first line treatments. Transcutaneous electrical nerve stimulation has been documented to be efficacious in children with daytime incontinence. We investigated the effect of transcutaneous electrical nerve stimulation in children with monosymptomatic nocturnal enuresis without nocturnal polyuria. Children with monosymptomatic nocturnal enuresis (3 or more wet nights per week) and no nocturnal polyuria were randomized to treatment with active or sham transcutaneous electrical nerve stimulation involving 1-hour sessions twice daily for 10 weeks in a double-blind design. Of the 52 children with monosymptomatic nocturnal enuresis included in the study 47 completed treatment (mean age 9.5 ± 2.1 years, 38 males). None of the children experienced a full response with complete remission of enuresis. Treatment with transcutaneous electrical nerve stimulation did not lead to significant changes in number of wet nights, nocturnal urine production on wet or dry nights, maximum voided volume with and without first morning voided volume, or voiding frequency when comparing parameters before and after treatment. The present study demonstrates no anti-enuretic effect of transcutaneous electrical nerve stimulation in children with monosymptomatic nocturnal enuresis without nocturnal polyuria. Nocturnal urine production and bladder capacity remained unchanged during and after treatment with transcutaneous electrical nerve stimulation. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  10. Nuclear magnetic imaging for MTRA. Spinal canal and spinal cord

    International Nuclear Information System (INIS)

    Fritzsch, Dominik; Hoffmann, Karl-Titus

    2011-01-01

    The booklet covers the following topics: (1) Clinical indications for NMR imaging of spinal cord and spinal canal; (2) Methodic requirements: magnets and coils, image processing, contrast media: (3) Examination technology: examination conditions, sequences, examination protocols; (4) Disease pattern and indications: diseases of the myelin, the spinal nerves and the spinal canal (infections, tumors, injuries, ischemia and bleedings, malformations); diseases of the spinal cord and the intervertebral disks (degenerative changes, infections, injuries, tumors, malformations).

  11. The effect of transcutaneous application of carbon dioxide (CO{sub 2}) on skeletal muscle

    Energy Technology Data Exchange (ETDEWEB)

    Oe, Keisuke [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe (Japan); Ueha, Takeshi [NeoChemir Inc, Kobe (Japan); Sakai, Yoshitada, E-mail: sakai.yoshitada@gm.himeji-du.ac.jp [Faculty of Health Care Sciences, Himeji Dokkyo University, Himeji (Japan); Niikura, Takahiro; Lee, Sang Yang; Koh, Akihiro [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe (Japan); Hasegawa, Takumi [Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe (Japan); Tanaka, Masaya [NeoChemir Inc, Kobe (Japan); Miwa, Masahiko; Kurosaka, Masahiro [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe (Japan)

    2011-04-01

    Highlights: {yields} PGC-1{alpha} is up-regulated as a result of exercise such as mitochondrial biogenesis and muscle fiber-type switching, and up-regulation of VEGF. {yields} We demonstrated transcutaneous application of CO{sub 2} up-regulated the gene expression of PGC-1{alpha}, SIRT1 and VEGF, and instance of muscle fiber switching. {yields} Transcutaneous application of CO{sub 2} may cause similar effect to aerobic exercise in skeletal muscle. -- Abstract: In Europe, carbon dioxide therapy has been used for cardiac disease and skin problems for a long time. However there have been few reports investigating the effects of carbon dioxide therapy on skeletal muscle. Peroxisome proliferators-activated receptor (PPAR)-gamma coactivator-1 (PGC-1{alpha}) is up-regulated as a result of exercise and mediates known responses to exercise, such as mitochondrial biogenesis and muscle fiber-type switching, and neovascularization via up-regulation of vascular endothelial growth factor (VEGF). It is also known that silent mating type information regulation 2 homologs 1 (SIRT1) enhances PGC-1{alpha}-mediated muscle fiber-type switching. Previously, we demonstrated transcutaneous application of CO{sub 2} increased blood flow and a partial increase of O{sub 2} pressure in the local tissue known as the Bohr effect. In this study, we transcutaneously applied CO{sub 2} to the lower limbs of rats, and investigated the effect on the fast muscle, tibialis anterior (TA) muscle. The transcutaneous CO{sub 2} application caused: (1) the gene expression of PGC-1{alpha}, silent mating type information regulation 2 homologs 1 (SIRT1) and VEGF, and increased the number of mitochondria, as proven by real-time PCR and immunohistochemistry, (2) muscle fiber switching in the TA muscle, as proven by isolation of myosin heavy chain and ATPase staining. Our results suggest the transcutaneous application of CO{sub 2} may have therapeutic potential for muscular strength recovery resulting from disuse

  12. Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults.

    Science.gov (United States)

    Hurlow, Adam; Bennett, Michael I; Robb, Karen A; Johnson, Mark I; Simpson, Karen H; Oxberry, Stephen G

    2012-03-14

    Cancer-related pain is complex and multi-dimensional but the mainstay of cancer pain management has predominantly used a biomedical approach. There is a need for non-pharmacological and innovative approaches. Transcutaneous Electric Nerve Stimulation (TENS) may have a role in pain management but the effectiveness of TENS is currently unknown. This is an update of the original review published in Issue 3, 2008. The aim of this systematic review was to determine the effectiveness of TENS for cancer-related pain in adults. The initial review searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, PsychINFO, AMED and PEDRO databases in April 2008. We performed an updated search of CENTRAL, MEDLINE, EMBASE, CINAHL and PEDRO databases in November 2011. We included only randomised controlled trials (RCTS) investigating the use of TENS for the management of cancer-related pain in adults. The search strategy identified a further two studies for possible inclusion. One of the review authors screened each abstract using a study eligibility tool. Where eligibility could not be determined, a second author assessed the full paper. One author used a standardised data extraction sheet to collect information on the studies and independently assess the quality of the studies using the validated five-point Oxford Quality Scale. The small sample sizes and differences in patient study populations of the three included studies (two from the original review and a third included in this update) prevented meta-analysis. For the original review the search strategy identified 37 possible published studies; we divided these between two pairs of review authors who decided on study selection; all four review authors discussed and agreed final scores. Only one additional RCT met the eligibility criteria (24 participants) for this updated review. Although this was a feasibility study, not designed to investigate intervention effect, it suggested that TENS may improve bone pain on movement in a

  13. Laser Transcutaneous Bilirubin Meter: A New Device For Bilirubin Monitoring In Neonatal Jaundice

    Science.gov (United States)

    Hamza, Mostafa; Hamza, Mohammad

    1988-06-01

    Neonates with jaundice require monitoring of serum bilirubin which should be repeated at frequent intervals. However, taking blood samples from neonates is not always an easy job, plus being an invasive and traumatising procedure with the additional risk of blood loss. In this paper the authors present the theory and design of a new noninvasive device for transcutaneous bilirubinometry, using a differential absorption laser system. The new technique depends upon illuminating the skin of the neonate with radiation from a two wave-length oscillation laser. The choice of the wavelengths follows the principles of optical bilirubinometry. For obtaining more accurate measurements, different pairs of two wave-lengths are incorporated in the design. The presence of hemoglobin is corrected for by appropriate selection of the laser wavelengths. The new design was tested for accuracy and precision using an argon ion laser. Correlation study between serum bilirubin determination by laser transcutaneous bilirubinometry and by American optical bilirubinometer was highly significant.

  14. Effect of transcutaneous electrical muscle stimulation on postoperative muscle mass and protein synthesis

    DEFF Research Database (Denmark)

    Vinge, O; Edvardsen, L; Jensen, F

    1996-01-01

    In an experimental study, 13 patients undergoing major elective abdominal surgery were given postoperative transcutaneous electrical muscle stimulation (TEMS) to the quadriceps femoris muscle on one leg; the opposite leg served as control. Changes in cross-sectional area (CSA) and muscle protein ...... muscle protein synthesis and muscle mass after abdominal surgery and should be evaluated in other catabolic states with muscle wasting.......In an experimental study, 13 patients undergoing major elective abdominal surgery were given postoperative transcutaneous electrical muscle stimulation (TEMS) to the quadriceps femoris muscle on one leg; the opposite leg served as control. Changes in cross-sectional area (CSA) and muscle protein...... synthesis were assessed by computed tomography and ribosome analysis of percutaneous muscle biopsies before surgery and on the sixth postoperative day. The percentage of polyribosomes in the ribosome suspension decreased significantly (P

  15. Objective and subjective outcome of a new transcutaneous bone conduction hearing device

    DEFF Research Database (Denmark)

    Eberhard, Kristine Elisabeth; Olsen, Steen Østergaard; Miyazaki, Hidemi

    2016-01-01

    Objective: To examine the objective and subjective outcome of a new transcutaneous bone conduction hearing device. Study Design: Prospective, consecutive case series. Patients: Twelve patients were implanted. Eight patients had a conductive/mixed (con/mix) hearing loss. Four had single sided...... to beneficial outcome. In Speech, Spatial and Qualities of Hearing Scale 12, ''quality of hearing'' scored especially high. The con/mix hearing loss group showed larger benefit especially in SDS, SRT50% in noise and the subjective evaluations, whereas frequency and duration of use were similar. Conclusion......: This study on the first 12 Nordic patients implanted with a new transcutaneous bone conduction hearing device demonstrates significant objective, as well as subjective hearing benefit. Patient satisfaction was high, as was the frequency of use....

  16. Efficacy of transcutaneous functional electrical stimulation on urinary incontinence in myelomeningocele: results of a pilot study

    OpenAIRE

    Kajbafzadeh, Abdol-Mohammad; Sharifi-Rad, Lida; Dianat, Seyedsaeid

    2010-01-01

    PURPOSE: To investigate the efficacy of transcutaneous functional electrical stimulation (FES) on voiding symptoms in children with myelomeningocele (MMC) suffering from neuropathic urinary incontinence. MATERIALS AND METHODS: Six girls and 6 boys with moderate to severe urinary incontinence secondary to MMC were included. Median age of children was 5.04 (range: 3-11) years. They underwent a urodynamic study (UDS) before and 3 months after FES with special attention to detrusor leak point pre...

  17. Non-invasive (transcutaneous) monitoring of PCO2 (TcPCO2) in older adults.

    Science.gov (United States)

    Janssens, Jean-Paul; Laszlo, André; Uldry, Christophe; Titelion, Véronique; Picaud, Claudette; Michel, Jean-Pierre

    2005-01-01

    Transcutaneous measurements of arterial blood gases (ABG) may decrease the need for repeated arterial puncture in older patients treated for acute cardiac or pulmonary disorders. However, age-related changes in skin perfusion, metabolism, or thickness may alter the validity of the technique. To analyse the agreement between transcutaneous and arterial measurement of PaO2 and PaCO2 in older adults. Prospective descriptive study performed in the intermediate-care unit of a geriatric university hospital and a pulmonary rehabilitation centre. 40 patients, aged 82.5+/-8 years (66-97), hemodynamically stable, without vasopressor treatment, underwent simultaneous measurement of arterial blood gases (ABG) and transcutaneous CO2 (TcPCO2) and O2 (TcPO2) with a Radiometer TINA TCM3 capnograph, and a probe T degrees set at 43 degrees C. Correlation between PaCO2 and TcPCO2 was high (r2=0.86) with a low bias (-0.1 mm Hg) and limits of agreement quite compatible with clinical use: (8.3; -8.5 mm Hg). The probe was well tolerated without any cutaneous lesion even after prolonged recordings (up to 8 h). Conversely, although TcPO2 and PaO2 were significantly correlated, the variability around the regression line precludes the use of transcutaneous measurements for monitoring PaO2)in a clinical setting. In older subjects, TcPCO2 (but not TcPO2) measurements are reliable when repeated assessment of ABG is warranted. Copyright (c) 2005 S. Karger AG, Basel

  18. Transcutaneous oxygen tension monitoring after successful revascularization in diabetic patients with ischaemic foot ulcers.

    Science.gov (United States)

    Caselli, A; Latini, V; Lapenna, A; Di Carlo, S; Pirozzi, F; Benvenuto, A; Uccioli, L

    2005-04-01

    To monitor transcutaneous oxygen tension (TcPO2) after percutaneous transluminal angioplasty (PTA) in diabetic patients with ischaemic foot ulcers. Twenty-three diabetic patients with ischaemic foot ulcers who underwent successful revascularization by PTA (SR group) were retrospectively selected. Twenty diabetic patients who underwent unsuccessful revascularization (UR group) were also included. Transcutaneous oxygen tension was measured at the dorsum of the foot before and 1 (+/- 1), 7 (+/- 1), 14 (+/- 1), 21 (+/- 1) and 28 (+/- 1) days after the surgical procedure. After PTA, TcPO2 progressively improved in the SR group, reaching its peak 4 weeks after angioplasty. A concomitant decrease of cutaneous carbon dioxide tension (TcPCO2) was also observed immediately after PTA which reached the lowest levels 3 weeks later. In the UR group, TcPO2 showed a slight improvement immediately after PTA but remained stable throughout the observation, while TcPCO2 levels did not change. Finally, the percentage of SR patients with a TcPO2 > or = 30 mmHg was 38.5% 1 week after PTA, while it increased to 75% 3 weeks later. Transcutaneous oxygen tension monitoring showed that after successful revascularization it takes 3-4 weeks for cutaneous oxygenation to improve and reach the optimal levels for wound healing. Transcutaneous carbon dioxide tension monitoring may be more useful to identify the negative outcome of a revascularization procedure. Our findings suggest that, when the surgical approach can be delayed, the best timing to perform a more aggressive debridement or minor amputations is 3-4 weeks after successful revascularization.

  19. Are Transcutaneous O2 and CO2 determinations of value in Pulmonary Arterial Hypertension?

    Science.gov (United States)

    Tonelli, Adriano R.; Alkukhun, Laith; Cikach, Frank; Ahmed, Mostafa; Dweik, Raed A.

    2015-01-01

    Background We hypothesized that transcutaneous gas determinations of O2 and CO2 (TcPO2 and TcPCO2) are associated with the severity of pulmonary arterial hypertension (PAH). Methods In this cross-sectional study we included consecutive patients with PAH (group 1 pulmonary hypertension (PH)) (n=34). Transcutaneous gas determinations were compared to those of age- and gender-matched healthy controls (n=14), non-group 1 PH (n=19) or patients with high estimated right ventricular systolic pressure on echocardiography but without hemodynamic evidence of PH (n=12). Results In patients with PAH, TcPO2 and TcPCO2 were significantly associated with PaO2 (R= 0.44, p=0.03) and PaCO2 (R=0.77, pTcPCO2 (mean difference: −7.4 [95% CI: −11.6–3.1]) were significantly lower in patients with PAH than healthy controls. TcPCO2 was useful in discriminating PAH patients from other individuals (AUC: 0.74 (95% CI of 0.62–0.83)). TcPO2/FiO2 ratio was significantly associated with mean PAP, TPG, PVR, CI, SVI, DLCO, 6-min walk distance and components of the CAMPHOR questionnaire. Conclusions Transcutaneous pressure of CO2 was lower in patients with PAH. Transcutaneous pressure of O2 over inspired fraction of O2 ratio was inversely associated with severity of disease in patients with pulmonary arterial hypertension. PMID:25641509

  20. Wearable Neural Prostheses - Restoration of Sensory-Motor Function by Transcutaneous Electrical Stimulation

    OpenAIRE

    Micera, Silvestro; Keller, Thierry; Lawrence, Marc; Morari, Manfred; Popovic, Dejan B.

    2010-01-01

    In this article, we focus on the least invasive interface: transcutaneous ES (TES), i.e., the use of surface electrodes as an interface between the stimulator and sensory-motor systems. TES is delivered by a burst of short electrical charge pulses applied between pairs of electrodes positioned on the skin. Monophasic or charge-balanced biphasic (symmetric or asymmetric) stimulation pulses can be delivered. The latter ones have the advantage to provide contraction force while minimizing tissue...

  1. Wearable neural prostheses. Restoration of sensory-motor function by transcutaneous electrical stimulation.

    Science.gov (United States)

    Micera, Silvestro; Keller, Thierry; Lawrence, Marc; Morari, Manfred; Popović, Dejan B

    2010-01-01

    In this article, we focus on the least invasive interface: transcutaneous ES (TES), i.e., the use of surface electrodes as an interface between the stimulator and sensory-motor systems. TES is delivered by a burst of short electrical charge pulses applied between pairs of electrodes positioned on the skin. Monophasic or charge-balanced biphasic (symmetric or asymmetric) stimulation pulses can be delivered. The latter ones have the advantage to provide contraction force while minimizing tissue damage.

  2. Swiss bare mice: a suitable model for transcutaneous in vivo Raman spectroscopic studies of breast cancer.

    Science.gov (United States)

    Bhattacharjee, T; Kumar, Piyush; Maru, G; Ingle, A; Krishna, C Murali

    2014-01-01

    Breast cancer is the most common cancer affecting females worldwide. As early detection results in better prognosis, screening tools for breast cancer are being explored. Raman spectroscopy, a rapid, objective, and noninvasive tool, has shown promising results in the diagnosis of several cancers including breast cancer. For development as a screening tool, a study of spectral signatures associated with breast cancer progression is imperative. However, such studies are not possible in human subjects. Hence, there is a need for a suitable animal model, which is conducive to transcutaneous in vivo Raman spectroscopic measurements of breast with minimal interference from skin and hair and has contribution from functional mammary epithelium of breast. In this study, rodent models like C57, Swiss albino, Swiss bare, agouti mice, and Sprague-Dawley rats were evaluated. Among these models, transcutaneous breast spectra of hairless Swiss bare mice have the best signal-to-noise ratio and were closest to reported ex vivo as well as intraoperative in vivo human breast spectra. Principal component-linear discriminant analysis of several anatomical sites confirms minimal skin interference and suggests contribution from functional mammary epithelium of breast. Moreover, transcutaneous spectra from normal breast and breast tumors of Swiss bare mice could be classified with 99% efficiency, which is better than the previous reports. Thus, Swiss bare mice model may be better suited for transcutaneous in vivo Raman spectroscopic studies of breast physiology and pathology, especially breast cancer. Prospectively, in addition to cancer progression, breast-to-bone metastasis can also be studied, since these anatomical sites can be uniquely classified.

  3. Early cortical biomarkers of longitudinal transcutaneous vagus nerve stimulation treatment success in depression

    OpenAIRE

    Fang, Jiliang; Egorova, Natalia; Rong, Peijing; Liu, Jun; Hong, Yang; Fan, Yangyang; Wang, Xiaoling; Wang, Honghong; Yu, Yutian; Ma, Yunyao; Xu, Chunhua; Li, Shaoyuan; Zhao, Jingjun; Luo, Man; Zhu, Bing

    2016-01-01

    Transcutaneous vagus nerve stimulation (tVNS), a non-invasive method of brain stimulation through the auricular branch of the vagus nerve, has shown promising results in treating major depressive disorder (MDD) in several pilot studies. However, the neural mechanism by which the effect on depression might be achieved has not been fully investigated, with only a few neuroimaging studies demonstrating tVNS-induced changes in the brains of healthy volunteers. Identifying specific neural pathways...

  4. Transcutaneous Vagus Nerve Stimulation (tVNS) does not increase prosocial behavior in Cyberball

    OpenAIRE

    Sellaro, Roberta; Steenbergen, Laura; Verkuil, Bart; van IJzendoorn, Marinus H.; Colzato, Lorenza S.

    2015-01-01

    Emerging research suggests that individuals experience vicarious social pain (i.e., ostracism). It has been proposed that observing ostracism increases activity in the insula and in the prefrontal cortex (PFC), two key brain regions activated by directly experiencing ostracism. Here, we assessed the causal role of the insula and PFC in modulating neural activity in these areas by applying transcutaneous Vagus Nerve Stimulation (tVNS), a new non-invasive and safe method to stimulate the vagus ...

  5. Transcutaneous Vagus Nerve Stimulation: A Promising Method for Treatment of Autism Spectrum Disorders

    OpenAIRE

    Jin, Yu; Kong, Jian

    2017-01-01

    Transcutaneous Vagus Nerve Stimulation (tVNS) on the auricular branch of the vagus nerve has been receiving attention due to its therapeutic potential for neuropsychiatric disorders. Although the mechanism of tVNS is not yet completely understood, studies have demonstrated the potential role of vagal afferent nerve stimulation in the regulation of mood and visceral state associated with social communication. In addition, a growing body of evidence shows that tVNS can activate the brain region...

  6. Maladaptive spinal plasticity opposes spinal learning and recovery in spinal cord injury

    OpenAIRE

    Ferguson, Adam R.; Huie, J. Russell; Crown, Eric D.; Baumbauer, Kyle M.; Hook, Michelle A.; Garraway, Sandra M.; Lee, Kuan H.; Hoy, Kevin C.; Grau, James W.

    2012-01-01

    Synaptic plasticity within the spinal cord has great potential to facilitate recovery of function after spinal cord injury (SCI). Spinal plasticity can be induced in an activity-dependent manner even without input from the brain after complete SCI. A mechanistic basis for these effects is provided by research demonstrating that spinal synapses have many of the same plasticity mechanisms that are known to underlie learning and memory in the brain. In addition, the lumbar spinal cord can sustai...

  7. Spinal Cord Injury 101

    Science.gov (United States)

    ... With Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC Understanding Spinal Cord Injury About Us Expert ... With Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC close close

  8. Spinal Cord Injury 101

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    Full Text Available ... With Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC Understanding Spinal Cord Injury About Us Expert ... With Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC close close

  9. Spinal Cord Injury 101

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    Full Text Available ... arrow What is the “Spinal Cord Injury Model Systems” program? play_arrow ... recommend or endorse health care products or services, or control the information found on external websites. The Hill Foundation is ...

  10. Spinal Cord Injury 101

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    Full Text Available ... arrow What are the latest developments in the use of electrical stimulation for spinal cord injuries? play_ ... Counseling About Media Donate Contact Us Terms of Use Site Map Privacy Statement 312-284-2525 info@ ...

  11. Spinal Cord Injury 101

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    Full Text Available ... Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC Understanding Spinal Cord Injury About Us Expert Videos Contact Us Personal Experience Videos Blog Videos By Topic Media Resources ...

  12. Spinal Injury: First Aid

    Science.gov (United States)

    ... EmergencyManual/WhatToDoInMedicalEmergency/Default.aspx?id=258&terms=spinal+injuries. Accessed Jan. 8, 2015. Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Mosby ...

  13. Spinal Cord Injury 101

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  14. Spinal Cord Injury 101

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    Full Text Available ... cord injury? play_arrow Why are high-dose steroids often used right after an injury? play_arrow ... arrow What are the latest developments in the use of electrical stimulation for spinal cord injuries? play_ ...

  15. Spinal Cord Injury 101

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  16. Spinal Cord Injury 101

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    Full Text Available ... SCI Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa Rosen, MS Spasticity, ... OT Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury Patti Rogers, SW ...

  17. Spinal Cord Injury 101

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  18. Spinal Cord Injury 101

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    Full Text Available ... Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, PsyD Understanding ... does not provide medical advice, recommend or endorse health care products or services, or control the information ...

  19. Spinal Cord Injury 101

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  20. Spinal Cord Injury 101

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  1. Spinal Cord Injury 101

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  2. Spinal Cord Injury 101

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    Full Text Available ... Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury Patti Rogers, SW Marguerite ... does not provide medical advice, recommend or endorse health care products or services, or control the information ...

  3. Spinal Cord Injury 101

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    Full Text Available ... How Peer Counseling Works Julie Gassaway, MS, RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children ...

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    Full Text Available ... Injury Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, PsyD ... Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa Rosen, MS Spasticity, Physical ...

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  9. Point Spectroscopy System for Noncontact and Noninvasive Prediction of Transcutaneous Bilirubin Concentration

    Science.gov (United States)

    Ong, P. E.; K. C Huong, Audrey

    2017-08-01

    This paper presents the use of a point spectroscopy system to determine one’s transcutaneous bilirubin level using Modified Lambert Beer model and the developed fitting routine. This technique required a priori knowledge of extinction coefficient of bilirubin and hemoglobin components in the wavelength range of 440-500 nm for the prediction of the required parameter value. This work was conducted on different skin sites of six healthy Asians namely on the thenar region of the palm of their hand, back of the hand, posterior and anterior forearm. The obtained results revealed the lowest mean transcutaneous bilirubin concentration of 0.44±0.3 g/l predicted for palm site while the highest bilirubin level of 0.98±0.2 g/l was estimated for posterior forearm. These values were also compared with that presented in the literature. This study found considerably good consistency in the value predicted for different subjects especially at the thenar region of the palm. This work concluded that the proposed system and technique may be suitably served as an alternative means to noncontact and noninvasive measurement of one’s transcutaneous bilirubin level at palm site.

  10. Monitoring of end tidal carbon dioxide and transcutaneous carbon dioxide during neonatal transport.

    Science.gov (United States)

    Tingay, D G; Stewart, M J; Morley, C J

    2005-11-01

    To assess the accuracy of measurements of end tidal carbon dioxide (CO2) during neonatal transport compared with arterial and transcutaneous measurements. Paired end tidal and transcutaneous CO2 recordings were taken frequently during road transport of 21 ventilated neonates. The first paired CO2 values were compared with an arterial blood gas. The differences between arterial CO2 (Paco2), transcutaneous CO2 (TcPco2), and end tidal CO2 (Petco2) were analysed. The Bland-Altman method was used to assess bias and repeatability. Petco2 correlated strongly with Paco2 and TcPco2. However, Petco2 underestimated Paco2 at a clinically unacceptable level (mean (SD) 1.1 (0.70) kPa) and did not trend reliably over time within individual subjects. The Petco2 bias was independent of Paco2 and severity of lung disease. Petco2 had an unacceptable under-recording bias. TcPco2 should currently be considered the preferred method of non-invasive CO2 monitoring for neonatal transport.

  11. Contralateral routing of signal hearing aid versus transcutaneous bone conduction in single-sided deafness.

    Science.gov (United States)

    Leterme, Gaëlle; Bernardeschi, Daniele; Bensemman, Anissa; Coudert, Cyrille; Portal, Jean-Jacques; Ferrary, Evelyne; Sterkers, Olivier; Vicaut, Eric; Frachet, Bruno; Bozorg Grayeli, Alexis

    2015-01-01

    The aim of this study was to compare a contralateral routing of signal (CROS) hearing aid to a transcutaneous bone-anchored device in the same conditions. This prospective crossover study included 18 adult patients with a single-sided deafness (SSD). After a trial period of 60 days with CROS and 7 days with a transcutaneous bone-anchored device (Alpha 1®, Sophono, Boulder, Colo., USA) on a headband, 13 (72%) patients opted for Alpha 1, 2 patients for CROS, and 3 rejected both rehabilitation methods. Clinical tolerance, satisfaction, hearing performances (pure-tone audiometry, speech test in quiet and in noise, stereo audiometry, sound localization, and Hearing in Noise Test), and quality of life (Glasgow Benefit Inventory, Abbreviated Profile of Hearing Aid Benefit and Glasgow Hearing Aid Benefit questionnaires) were measured at 3 and 12 months after the implantation. Both devices improved equally the hearing in noise and the quality of life. Transcutaneous devices represent an effective option in SSD. © 2015 S. Karger AG, Basel.

  12. Effectiveness of transcutaneous electrical nerve stimulation and interferential current in primary dysmenorrhea.

    Science.gov (United States)

    Tugay, Nazan; Akbayrak, Türkan; Demirtürk, Funda; Karakaya, Ilkim Citak; Kocaacar, Ozge; Tugay, Umut; Karakaya, Mehmet Gürhan; Demirtürk, Fazli

    2007-01-01

    To compare the effectiveness of transcutaneous electrical nerve stimulation and interferential current in primary dysmenorrhea. A prospective, randomized, and controlled study. Hacettepe University School of Physical Therapy and Rehabilitation. Thirty-four volunteer subjects with primary dysmenorrhea (mean age: 21.35 +/- 1.70 years) were included. Statistical analyses were performed in 32 subjects who completed all measures. Fifteen subjects received interferential current application for 20 minutes and 17 subjects received transcutaneous electrical nerve stimulation for 20 minutes when they were experiencing dysmenorrhea. Physical characteristics, years since menarche, length of menstrual cycle (days), and duration of menstruation (days) were recorded. Visual analog scale ( VAS) intensities of menstrual pain, referred lower limb pain, and low back pain were recorded before treatment, and immediately, 8 hours, and 24 hours after treatment. Intensities of the evaluated parameters decreased beginning from just after the applications in both groups (P0.05). Both transcutaneous electrical nerve stimulation and interferential current appear to be effective in primary dysmenorrhea. As they are free from the potentially adverse effects of analgesics, and no adverse effects are reported in the literature nor observed in this study, a clinical trial of their effectiveness in comparison with untreated and placebo-treated control groups is warranted.

  13. Adaptive Transcutaneous Power Transfer to Implantable Devices: A State of the Art Review

    Directory of Open Access Journals (Sweden)

    Kara N. Bocan

    2016-03-01

    Full Text Available Wireless energy transfer is a broad research area that has recently become applicable to implantable medical devices. Wireless powering of and communication with implanted devices is possible through wireless transcutaneous energy transfer. However, designing wireless transcutaneous systems is complicated due to the variability of the environment. The focus of this review is on strategies to sense and adapt to environmental variations in wireless transcutaneous systems. Adaptive systems provide the ability to maintain performance in the face of both unpredictability (variation from expected parameters and variability (changes over time. Current strategies in adaptive (or tunable systems include sensing relevant metrics to evaluate the function of the system in its environment and adjusting control parameters according to sensed values through the use of tunable components. Some challenges of applying adaptive designs to implantable devices are challenges common to all implantable devices, including size and power reduction on the implant, efficiency of power transfer and safety related to energy absorption in tissue. Challenges specifically associated with adaptation include choosing relevant and accessible parameters to sense and adjust, minimizing the tuning time and complexity of control, utilizing feedback from the implanted device and coordinating adaptation at the transmitter and receiver.

  14. Transcutaneous electrical stimulation (TES) for treatment of constipation in children.

    Science.gov (United States)

    Ng, Ruey Terng; Lee, Way Seah; Ang, Hak Lee; Teo, Kai Ming; Yik, Yee Ian; Lai, Nai Ming

    2016-11-11

    Childhood constipation is a common problem with substantial health, economic and emotional burdens. Existing therapeutic options, mainly pharmacological, are not consistently effective, and some are associated with adverse effects after prolonged use. Transcutaneous electrical stimulation (TES), a non-pharmacological approach, is postulated to facilitate bowel movement by modulating the nerves of the large bowel via the application of electrical current transmitted through the abdominal wall. Our main objective was to evaluate the effectiveness and safety of TES when employed to improve bowel function and constipation-related symptoms in children with constipation. We searched MEDLINE (PubMed) (1950 to July 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 7, 2015), EMBASE (1980 to July 2015), the Cochrane IBD Group Specialized Register, trial registries and conference proceedings to identify applicable studies . Randomized controlled trials that assessed any type of TES, administered at home or in a clinical setting, compared to no treatment, a sham TES, other forms of nerve stimulation or any other pharmaceutical or non-pharmaceutical measures used to treat constipation in children were considered for inclusion. Two authors independently assessed studies for inclusion, extracted data and assessed risk of bias of the included studies. We calculated the risk ratio (RR) and corresponding 95% confidence interval (CI) for categorical outcomes data and the mean difference (MD) and corresponding 95% CI for continuous outcomes. We evaluated the overall quality of the evidence supporting the outcomes assessed in this review using the GRADE criteria. One study from Australia including 46 children aged 8 to 18 years was eligible for inclusion. There were multiple reports identified, including one unpublished report, that focused on different outcomes of the same study. The study had unclear risk of selection bias, high risks of

  15. Transcutaneous electrical nerve stimulation (TENS) for fibromyalgia in adults.

    Science.gov (United States)

    Johnson, Mark I; Claydon, Leica S; Herbison, G Peter; Jones, Gareth; Paley, Carole A

    2017-10-09

    Fibromyalgia is characterised by persistent, widespread pain; sleep problems; and fatigue. Transcutaneous electrical nerve stimulation (TENS) is the delivery of pulsed electrical currents across the intact surface of the skin to stimulate peripheral nerves and is used extensively to manage painful conditions. TENS is inexpensive, safe, and can be self-administered. TENS reduces pain during movement in some people so it may be a useful adjunct to assist participation in exercise and activities of daily living. To date, there has been only one systematic review in 2012 which included TENS, amongst other treatments, for fibromyalgia, and the authors concluded that TENS was not effective. To assess the analgesic efficacy and adverse events of TENS alone or added to usual care (including exercise) compared with placebo (sham) TENS; no treatment; exercise alone; or other treatment including medication, electroacupuncture, warmth therapy, or hydrotherapy for fibromyalgia in adults. We searched the following electronic databases up to 18 January 2017: CENTRAL (CRSO); MEDLINE (Ovid); Embase (Ovid); CINAHL (EBSCO); PsycINFO (Ovid); LILACS; PEDRO; Web of Science (ISI); AMED (Ovid); and SPORTDiscus (EBSCO). We also searched three trial registries. There were no language restrictions. We included randomised controlled trials (RCTs) or quasi-randomised trials of TENS treatment for pain associated with fibromyalgia in adults. We included cross-over and parallel-group trial designs. We included studies that evaluated TENS administered using non-invasive techniques at intensities that produced perceptible TENS sensations during stimulation at either the site of pain or over nerve bundles proximal (or near) to the site of pain. We included TENS administered as a sole treatment or TENS in combination with other treatments, and TENS given as a single treatment or as a course of treatments. Two review authors independently determined study eligibility by assessing each record and

  16. Is transcutaneous oxygen and carbon dioxide monitoring indispensable in short- and long-term therapeutic management of non-reconstructable lower critical limb ischemia?

    Science.gov (United States)

    Melillo, E; Nuti, M; Pedrinelli, R; Buttitta, F; Balbarini, A

    2006-08-01

    The aim of this study was to evaluate the capacity of transcutaneous partial pressure of O(2) (TCpO(2)) and CO(2) (TCpCO(2)) to predict clinical response to pharmacological treatment in short- and long-term follow-up of unreconstructable critical limb ischemia (CLI) treated with prostanoids; to suggest a diagnostic and therapeutic algorithm able to define the possibility of prostanoid therapy in unreconstructable CLI at high risk of limb loss. Twenty-six consecutive patients with CLI (21 with distal trophic lesions, 31 symptomatic limbs) considered unreconstructable after peripheral angiography and with a history of type 2 diabetes mellitus underwent daily parenteral Iloprost treatment for 2-3 weeks. Transcutaneous gas-analytic monitoring (TGM) in non-reconstructable CLI treated with Iloprost divided patients into 2 groups: early responders (ER) with increased TcpO(2) and normalization of TcpCO2, and non responders (NR) with unchanged TcpO(2) and TcpCO(2) parameters. In the NR who underwent a second cycle of Iloprost within a few months of the first, TGM further divided the patients into another subgroup of late responders (LR) with TcpO(2) and TcpCO(2) similar to the ER group and a subgroup of NR, who, after pharmacological treatment failure, should undergo eventual surgical re-timing and/or spinal cord stimulation in a final attempt to save the limb. In the short-term follow-up of CLI, a marked reduction in supine/dependent TcpO(2) and a marked increase in supine TcpCO(2) at the symptomatic forefoot proved to be significant predictors of major amputation risk. In the long-term follow-up period, TGM showed that, in ER and in LR, the favourable effect of pharmacological therapy observed in the first 6 months will disappear over the next 6 months, suggesting an algorithm of 2- to 3-week cycles of prostanoid therapy repeated every year. In NR treated with surgical and/or alternative therapies who did not undergo major amputations, prolonged instrumental TGM will

  17. Evaluation of spinal ultrasound in spinal dysraphism

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, J.A.; Bruyn, R. de; Patel, K.; Thompson, D

    2003-03-01

    AIMS: The aims of this study were to evaluate the role of spinal ultrasound in detecting occult spinal dysraphism (OSD) in neonates and infants, and to determine the degree of agreement between ultrasound and magnetic resonance imaging (MRI) findings. MATERIALS AND METHODS: Eighty-five consecutive infants had spinal ultrasound over 31 months. Of these, 15 patients (age 1 day-7 months, mean 40 days; nine male) had follow-up MRI. Ultrasound and MRI findings were correlated retrospectively. RESULTS: Six out of 15 (40%) ultrasound examinations showed full agreement with MRI, seven of 15 (47%) had partial agreement, and two of 15 (13%) had no agreement. In the present series ultrasound failed to visualize: four of four dorsal dermal sinuses, three of four fatty filum terminales, one of one terminal lipoma, two of four partial sacral agenesis, three of four hydromyelia and one of 10 low-lying cords. CONCLUSION: Agreement between ultrasound and MRI was good, particularly for the detection of low-lying cord (90%). Therefore we recommend ultrasound as a first-line screening test for OSD. If ultrasound is abnormal, equivocal or technically limited, MRI is advised for full assessment.

  18. Congenital spinal malformations; Kongenitale spinale Malformationen

    Energy Technology Data Exchange (ETDEWEB)

    Ertl-Wagner, B.B.; Reiser, M.F. [Klinikum Grosshadern, Ludwig-Maximilians-Univ. Muenchen (Germany). Inst. fuer Klinische Radiologie

    2001-12-01

    Congenital spinal malformations form a complex and heterogeneous group of disorders whose pathogenesis is best explained embryologically. Radiologically, it is important to formulate a diagnosis when the disorder first becomes symptomatic. However, it is also crucial to detect complications of the disorder or of the respective therapeutic interventions in the further course of the disease such as hydromyelia or re-tethering after repair of a meningomyelocele. Moreover, once a congenital spinal malformation is diagnosed, associated malformations should be sought after. A possible syndromal classification such as in OEIS- or VACTERL-syndromes should also be considered. (orig.) [German] Kongenitale spinale Malformationen stellen eine komplexe Gruppe an Stoerungen dar, deren Genese sich am einfachsten aus der Embryologie heraus erklaeren laesst. Bei der klinisch-radiologischen Begutachtung ist zunaechst ihre korrekte Klassifikation im Rahmen der Erstdiagnose wichtig. Im weiteren Verlauf ist es jedoch zudem entscheidend, moegliche Komplikationen wie beispielsweise eine Hydromyelie oder ein Wiederanheften des Myelons nach Operation einer Spina bifida aperta zu erkennen. Zudem sollte bei der Diagnosestellung einer kongenitalen spinalen Malformation immer auch auf assoziierte Fehlbildungen, wie z.B. die Diastematomyelie oder das intraspinale Lipom bei der Spina bifida aperta, sowie auf eine moegliche syndromale Einordnung wie beispielsweise beim OEIS-oder VACTERL-Syndrom geachtet werden. (orig.)

  19. The effect of transcutaneous electrical nerve stimulation in patients with acute exacerbation of chronic obstructive pulmonary disease: randomised controlled trial.

    Science.gov (United States)

    Öncü, Emine; Zincir, Handan

    2017-07-01

    The aim of the present study was to assess the efficacy of transcutaneous electrical nerve stimulation in patients with acute exacerbation of chronic obstructive pulmonary disease. In patients with stable chronic obstructive pulmonary disease, transcutaneous electrical nerve stimulation has been known to attain improvement in forced expiratory volume in 1 seconds, physical activity, and quality of life. However, information about the effects of transcutaneous electrical nerve stimulation on acute exacerbation of chronic obstructive pulmonary disease is quite limited. A single-blind, randomised controlled trial. Data were collected between August 2013-May 2014. Eighty-two patients who were hospitalised with a diagnosis of acute exacerbation of chronic obstructive pulmonary disease were randomly assigned to a transcutaneous electrical nerve stimulation group receiving transcutaneous electrical nerve stimulation treatment for 20 seance over the acupuncture points with pharmacotherapy or placebo group receiving the same treatment without electrical current output from the transcutaneous electrical nerve stimulation device. Pulmonary functional test, six-minute walking distance, dyspnoea and fatigue scale, and St. George's Respiratory Questionnaire scores were assessed pre- and postprogram. The program started at the hospital by the researcher was sustained in the patient's home by the caregiver. All patients were able to complete the program, despite the exacerbation. The 20 seance transcutaneous electrical nerve stimulation program provided clinically significant improvement in forced expiratory volume in 1 seconds 21 ml, 19·51% but when compared with the placebo group, the difference was insignificant (p > 0·05). The six-minute walking distance increased by 48·10 m more in the placebo group (p  0·05). Adding transcutaneous electrical nerve stimulation therapy to pharmacotherapy in patients with acute exacerbation of chronic obstructive pulmonary disease

  20. Evaluation of the correlation between transcutaneous measurement andconcentration ofbilirubin inthe blood serum ofa newborn

    Directory of Open Access Journals (Sweden)

    Małgorzata Morawiecka-Pietrzak

    2016-09-01

    Full Text Available Aim: Due to the potential toxicity of high concentrations of bilirubin, newborns are monitored in terms of the potential emergence of a group at risk of the development of severe hyperbilirubinaemia and, rarely, encephalopathy and kernicterus. The transcutaneous measurement of bilirubin, as a non-invasive method, is applied in neonatal centres. The paper presents an evaluation of the correlation between the transcutaneous measurement and the concentration of bilirubin in the blood serum of a newborn, taking into consideration the reduction of the necessity to carry out blood tests related to the transcutaneous measurement. Material and method: The analysis comprised 1,076 medical histories of newborns hospitalised at the Department of Neonatology of the Municipal Hospital in Zabrze in the period from 1 January to 31 December 2013 (a primary referral centre. The inclusion criteria for the study were: performing a simultaneous transcutaneous measurement and a blood serum concentration measurement of bilirubin, gestational age ≥35 Hbd and birth weight >2,500 g. 272 children were qualified for the study. Results: Boys constituted 51.7%, and girls 48.3% of the research group. The mean gestational age was 38.7 Hbd and the mean birth weight was 3,323.4 g; 67.8% of the children were born by natural labour and 32.2% – by caesarean section. The mean Apgar score in the 5th minute was 9.8 points. The measurement of the concentration of bilirubin was performed on average on the 3.9 day of life. The mean transcutaneous measurement was 9.67 mg% (2.7–17.2 mg% and the mean concentration of bilirubin in the blood serum was 13.18 mg% (7.0–19.8 mg%; the difference was 3.5 mg% (p < 0.0001. A statistically significant positive correlation was found between the concentrations of bilirubin obtained in the transcutaneous measurement and the concentrations in the blood serum (according to Spearman, r

  1. Imaging in spinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Goethem, J.W.M. van [Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium, Department of Radiology, Edegem (Belgium); Algemeen Ziekenhuis Maria Middelares, Department of Radiology, Sint-Niklaas (Belgium); Maes, Menno; Oezsarlak, Oezkan; Hauwe, Luc van den; Parizel, Paul M. [Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium, Department of Radiology, Edegem (Belgium)

    2005-03-01

    Because it may cause paralysis, injury to the spine is one of the most feared traumas, and spinal cord injury is a major cause of disability. In the USA approximately 10,000 traumatic cervical spine fractures and 4000 traumatic thoracolumbar fractures are diagnosed each year. Although the number of individuals sustaining paralysis is far less than those with moderate or severe brain injury, the socioeconomic costs are significant. Since most of the spinal trauma patients survive their injuries, almost one out of 1000 inhabitants in the USA are currently being cared for partial or complete paralysis. Little controversy exists regarding the need for accurate and emergent imaging assessment of the traumatized spine in order to evaluate spinal stability and integrity of neural elements. Because clinicians fear missing occult spine injuries, they obtain radiographs for nearly all patients who present with blunt trauma. We are influenced on one side by fear of litigation and the possible devastating medical, psychologic and financial consequences of cervical spine injury, and on the other side by pressure to reduce health care costs. A set of clinical and/or anamnestic criteria, however, can be very useful in identifying patients who have an extremely low probability of injury and who consequently have no need for imaging studies. Multidetector (or multislice) computed tomography (MDCT) is the preferred primary imaging modality in blunt spinal trauma patients who do need imaging. Not only is CT more accurate in diagnosing spinal injury, it also reduces imaging time and patient manipulation. Evidence-based research has established that MDCT improves patient outcome and saves money in comparison to plain film. This review discusses the use, advantages and disadvantages of the different imaging techniques used in spinal trauma patients and the criteria used in selecting patients who do not need imaging. Finally an overview of different types of spinal injuries is given

  2. Imaging in spinal trauma

    International Nuclear Information System (INIS)

    Goethem, J.W.M. van; Maes, Menno; Oezsarlak, Oezkan; Hauwe, Luc van den; Parizel, Paul M.

    2005-01-01

    Because it may cause paralysis, injury to the spine is one of the most feared traumas, and spinal cord injury is a major cause of disability. In the USA approximately 10,000 traumatic cervical spine fractures and 4000 traumatic thoracolumbar fractures are diagnosed each year. Although the number of individuals sustaining paralysis is far less than those with moderate or severe brain injury, the socioeconomic costs are significant. Since most of the spinal trauma patients survive their injuries, almost one out of 1000 inhabitants in the USA are currently being cared for partial or complete paralysis. Little controversy exists regarding the need for accurate and emergent imaging assessment of the traumatized spine in order to evaluate spinal stability and integrity of neural elements. Because clinicians fear missing occult spine injuries, they obtain radiographs for nearly all patients who present with blunt trauma. We are influenced on one side by fear of litigation and the possible devastating medical, psychologic and financial consequences of cervical spine injury, and on the other side by pressure to reduce health care costs. A set of clinical and/or anamnestic criteria, however, can be very useful in identifying patients who have an extremely low probability of injury and who consequently have no need for imaging studies. Multidetector (or multislice) computed tomography (MDCT) is the preferred primary imaging modality in blunt spinal trauma patients who do need imaging. Not only is CT more accurate in diagnosing spinal injury, it also reduces imaging time and patient manipulation. Evidence-based research has established that MDCT improves patient outcome and saves money in comparison to plain film. This review discusses the use, advantages and disadvantages of the different imaging techniques used in spinal trauma patients and the criteria used in selecting patients who do not need imaging. Finally an overview of different types of spinal injuries is given

  3. Continuous spinal anesthesia.

    Science.gov (United States)

    Moore, James M

    2009-01-01

    Continuous spinal anesthesia (CSA) is an underutilized technique in modern anesthesia practice. Compared with other techniques of neuraxial anesthesia, CSA allows incremental dosing of an intrathecal local anesthetic for an indefinite duration, whereas traditional single-shot spinal anesthesia usually involves larger doses, a finite, unpredictable duration, and greater potential for detrimental hemodynamic effects including hypotension, and epidural anesthesia via a catheter may produce lesser motor block and suboptimal anesthesia in sacral nerve root distributions. This review compares CSA with other anesthetic techniques and also describes the history of CSA, its clinical applications, concerns regarding neurotoxicity, and other pharmacologic implications of its use. CSA has seen a waxing and waning of its popularity in clinical practice since its initial description in 1907. After case reports of cauda equina syndrome were reported with the use of spinal microcatheters for CSA, these microcatheters were withdrawn from clinical practice in the United States but continued to be used in Europe with no further neurologic sequelae. Because only large-bore catheters may be used in the United States, CSA is usually reserved for elderly patients out of concern for the risk of postdural puncture headache in younger patients. However, even in younger patients, sometimes the unique clinical benefits and hemodynamic stability involved in CSA outweigh concerns regarding postdural puncture headache. Clinical scenarios in which CSA may be of particular benefit include patients with severe aortic stenosis undergoing lower extremity surgery and obstetric patients with complex heart disease. CSA is an underutilized technique in modern anesthesia practice. Perhaps more accurately termed fractional spinal anesthesia, CSA involves intermittent dosing of local anesthetic solution via an intrathecal catheter. Where traditional spinal anesthesia involves a single injection with a

  4. Diaphragmatic pacing stimulation in spinal cord injury: anesthetic and perioperative management

    Directory of Open Access Journals (Sweden)

    Miguel L. Tedde

    2012-11-01

    Full Text Available OBJECTIVE: The standard therapy for patients with high-level spinal cord injury is long-term mechanical ventilation through a tracheostomy. However, in some cases, this approach results in death or disability. The aim of this study is to highlight the anesthetics and perioperative aspects of patients undergoing insertion of a diaphragmatic pacemaker. METHODS: Five patients with quadriplegia following high cervical traumatic spinal cord injury and ventilator-dependent chronic respiratory failure were implanted with a laparoscopic diaphragmatic pacemaker after preoperative assessments of their phrenic nerve function and diaphragm contractility through transcutaneous nerve stimulation. ClinicalTrials.gov: NCT01385384. RESULTS: The diaphragmatic pacemaker placement was successful in all of the patients. Two patients presented with capnothorax during the perioperative period, which resolved without consequences. After six months, three patients achieved continuous use of the diaphragm pacing system, and one patient could be removed from mechanical ventilation for more than 4 hours per day. CONCLUSIONS: The implantation of a diaphragmatic phrenic system is a new and safe technique with potential to improve the quality of life of patients who are dependent on mechanical ventilation because of spinal cord injuries. Appropriate indication and adequate perioperative care are fundamental to achieving better results.

  5. Depression and Spinal Cord Injury

    Science.gov (United States)

    ... Urinary Tract Infections: Indwelling (Foley) Catheter Depression and Spinal Cord Injury [ Download this pamphlet: “Depression and Spinal Cord Injury” (PDF - 477KB)] Depression is a common illness that ...

  6. What Is Spinal Cord Injury?

    Science.gov (United States)

    ... Condition Information Share Facebook Twitter Pinterest Email Print Spinal Cord Injury (SCI): Condition Information What is SCI? SCI is ... 3 National Institute of Neurological Disorders and Stroke. Spinal cord injury: Hope through research. Retrieved June 19 , 2013 , from ...

  7. Overview of Spinal Cord Disorders

    Science.gov (United States)

    ... Blockage of the Spinal Cord’s Blood Supply Cervical Spondylosis Compression of the Spinal Cord Hereditary Spastic Paraparesis ... compressed by bone (which may result from cervical spondylosis or a fracture), an accumulation of blood (hematoma), ...

  8. Spinal vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Krings, Timo [University Hospital Aachen, Department of Neuroradiology, Aachen (Germany); University Hospital Aachen, Department of Neurosurgery, Aachen (Germany); Mull, Michael; Thron, Armin [University Hospital Aachen, Department of Neuroradiology, Aachen (Germany); Gilsbach, Joachim M. [University Hospital Aachen, Department of Neurosurgery, Aachen (Germany)

    2005-02-01

    Spinal vascular malformations are rare diseases that consist of true inborn cavernomas and arteriovenous malformations (including perimedullary fistulae, glomerular and juvenile AVMs) and presumably acquired dural arteriovenous fistulae. This review article gives an overview of the imaging features both on MRI and angiography, the differential diagnoses, the clinical symptomatology and the potential therapeutic approaches to these diseases. It is concluded that MRI is the diagnostic modality of first choice in suspected spinal vascular malformation and should be complemented by selective spinal angiography. Treatment in symptomatic patients offers an improvement in the prognosis, but should be performed in specialized centers. Patients with spinal cord cavernomas and perimedullary fistulae type I are surgical candidates. Dural arteriovenous fistulae can either be operated upon or can be treated by an endovascular approach, the former being a simple, quick and secure approach to obliterate the fistula, while the latter is technically demanding. In spinal arteriovenous malformations, the endovascular approach is the method of first choice; in selected cases, a combined therapy might be sensible. (orig.)

  9. Spinal canal stenosis; Spinalkanalstenose

    Energy Technology Data Exchange (ETDEWEB)

    Papanagiotou, P.; Boutchakova, M. [Klinikum Bremen-Mitte/Bremen-Ost, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Bremen (Germany)

    2014-11-15

    Spinal stenosis is a narrowing of the spinal canal by a combination of bone and soft tissues, which can lead to mechanical compression of spinal nerve roots or the dural sac. The lumbal spinal compression of these nerve roots can be symptomatic, resulting in weakness, reflex alterations, gait disturbances, bowel or bladder dysfunction, motor and sensory changes, radicular pain or atypical leg pain and neurogenic claudication. The anatomical presence of spinal canal stenosis is confirmed radiologically with computerized tomography, myelography or magnetic resonance imaging and play a decisive role in optimal patient-oriented therapy decision-making. (orig.) [German] Die Spinalkanalstenose ist eine umschriebene, knoechern-ligamentaer bedingte Einengung des Spinalkanals, die zur Kompression der Nervenwurzeln oder des Duralsacks fuehren kann. Die lumbale Spinalkanalstenose manifestiert sich klinisch als Komplex aus Rueckenschmerzen sowie sensiblen und motorischen neurologischen Ausfaellen, die in der Regel belastungsabhaengig sind (Claudicatio spinalis). Die bildgebende Diagnostik mittels Magnetresonanztomographie, Computertomographie und Myelographie spielt eine entscheidende Rolle bei der optimalen patientenbezogenen Therapieentscheidung. (orig.)

  10. Potentialities of spinal liquor scanography

    International Nuclear Information System (INIS)

    Vlakhov, N.; Vylkanov, P.

    1986-01-01

    It is shown that spinal liquor scanography is a harmless and informative method for the examination of patients, permitting to detect injury foci for spinal cord tumours in 90% cases, for acute injuries of the vertebral column and spinal cord in 89.5% cases, for herniation of nucleus pulposus in 81% cases. The method of spinal liquor scanography can be used in neurology and neurosurgery to select the method of treatment and to evaluate its efficiency

  11. Diagnostic strategies in spinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Heinemann, Uwe [Institut fuer Radiologie und Neuroradiologie, Klinikum Aschaffenburg, Am Hasenkopf 1, 63739 Aschaffenburg (Germany); Freund, Michael [Institut fuer Radiologie und Neuroradiologie, Klinikum Aschaffenburg, Am Hasenkopf 1, 63739 Aschaffenburg (Germany)]. E-mail: michael.freund@klinikum-aschaffenburg.de

    2006-04-15

    Spinal injuries may result in severe neurological deficits, especially if nerve roots or even the spinal cord are affected. Besides presenting the important anatomical and technical basis underlying the imaging findings of spinal injuries, the trauma mechanisms and the resulting injuries are discussed. Based on the current literature and recommendations of scientific organizations, an approach is provided to the radiologic work up of spinal trauma. The different imaging modalities are presented. Advantages and disadvantages of the methods are discussed.

  12. Diagnostic strategies in spinal trauma

    International Nuclear Information System (INIS)

    Heinemann, Uwe; Freund, Michael

    2006-01-01

    Spinal injuries may result in severe neurological deficits, especially if nerve roots or even the spinal cord are affected. Besides presenting the important anatomical and technical basis underlying the imaging findings of spinal injuries, the trauma mechanisms and the resulting injuries are discussed. Based on the current literature and recommendations of scientific organizations, an approach is provided to the radiologic work up of spinal trauma. The different imaging modalities are presented. Advantages and disadvantages of the methods are discussed

  13. Full text

    African Journals Online (AJOL)

    IndexCopernicus Portal System

    2009-01-11

    Jan 11, 2009 ... inhibition in the dorsal horn of spinal cord. Humans utilise this mechanism .... Spinal. Electroanalgesia, Interferential Therapy,. Microcurrent Stimulation and Pain Gone pens. (see [3,14,15] for a review of these devices). The remainder of this ... epidemics such as HIV/aids in the developing world. An IASP ...

  14. Comparison of skin sensory thresholds using pre-programmed or single-frequency transcutaneous electrical nerve stimulation.

    Science.gov (United States)

    Kang, Jong Ho

    2015-12-01

    [Purpose] The purpose of the present study was to compare the sensory thresholds of healthy subjects using pre-programmed or single-frequency transcutaneous electrical nerve stimulation. [Subjects] Ninety healthy adult subjects were randomly assigned to pre-programmed or single-frequency stimulation groups, each consisting of 45 participants. [Methods] Sensory thresholds were measured in the participants' forearms using von Frey filaments before and after pre-programmed or single-frequency transcutaneous electrical nerve stimulation, and the result in values were analyzed. [Results] Significant increases in sensory threshold after stimulation were observed in both groups. However, there were no significant differences between the two groups in sensory thresholds after stimulation or in the magnitude of threshold increases following stimulation. [Conclusion] Our results show that there are no differences between sensory threshold increases induced by pre-programmed and single-frequency transcutaneous electrical nerve stimulation.

  15. Magnetic-Field Immunity Examination and Evaluation of Transcutaneous Energy-Transmission System for a Totally Implantable Artificial Heart

    Directory of Open Access Journals (Sweden)

    Takahiko Yamamoto

    2012-01-01

    Full Text Available Transcutaneous energy transmission (TET is the most promising noninvasive method for supplying driving energy to a totally implantable artificial heart. Induction-heating (IH cookers generate a magnetic flux, and if a cooker is operated near a transcutaneous transformer, the magnetic flux generated will link with its external and internal coils. This will affect the performance of the TET and the artificial heart system. In this paper, we present the design and development of a coil to be used for a magnetic immunity test, and we detail the investigation of the magnetic immunity of a transcutaneous transformer. The experimental coil, with five turns like a solenoid, was able to generate a uniform magnetic field in the necessary bandwidth. A magnetic-field immunity examination of the TET system was performed using this coil, and the system was confirmed to have sufficient immunity to the magnetic field generated as a result of the conventional operation of induction-heating cooker.

  16. Spinal cord swelling and candidiasis

    Energy Technology Data Exchange (ETDEWEB)

    Ho, K.; Gronseth, G.; Aldrich, M.; Williams, A.

    1982-11-01

    Fusiform swelling of the spinal cord was noted myelographically in a patient with Hodgkin's disease. Autopsy revealed that the swelling was caused by Candida infection of the spinal cord. It is suggested that fungal infection be included in the differential diagnosis of spinal cord swelling in the immunosuppressed cancer patient.

  17. Spinal cord swelling and candidiasis

    International Nuclear Information System (INIS)

    Ho, K.; Gronseth, G.; Aldrich, M.; Williams, A.

    1982-01-01

    Fusiform swelling of the spinal cord was noted myelographically in a patient with Hodgkin's disease. Autopsy revealed that the swelling was cauused by Candida infection of the spinal cord. It is suggested that fungal infection be included in the differential diagnosis of spinal cord swelling in the immunsupporessed cancer patient. (orig.)

  18. Spinal segmental dysgenesis CASE SERIES

    African Journals Online (AJOL)

    Spinal segmental dysgenesis is a rare congenital spinal abnormality seen in neonates and infants, in which a segment of the spine and spinal cord fails to develop normally. The condition is segmental in nature, with vertebrae above and below the malformation. It is commonly associated with various abnormalities that ...

  19. Spinal CT scan, 2

    International Nuclear Information System (INIS)

    Nakagawa, Hiroshi

    1982-01-01

    Plain CT described fairly accurately the anatomy and lesions of the lumbar and sacral spines on their transverse sections. Since hernia of the intervertebral disc could be directly diagnosed by CT, indications of myelography could be restricted. Spinal-canal stenosis of the lumbar spine occurs because of various factors, and CT not only demonstrated the accurate size and morphology of bony canals, but also elucidated thickening of the joints and yellow ligament. CT was also useful for the diagnosis of tumors in the lumbar and sacral spines, visualizing the images of bone changes and soft tissues on the trasverse sections. But the diagnosis of intradural tumors required myelography and metrizamide CT. CT has become important for the diagnosis of spinal and spinal-cord diseases and for selection of the route of surgical arrival. (Chiba, N.)

  20. A Comparison between Transcutaneous and Total Serum Bilirubin in Healthy-term Greek Neonates with Clinical Jaundice

    Directory of Open Access Journals (Sweden)

    Charalambos Neocleous

    2014-01-01

    Full Text Available The accuracy of transcutaneous bilirubin meters has been assessed in newborns from various ethnic backgrounds. However, there are limited data on Greek newborns. Our study examined the accuracy of transcutaneous bilirubin measurements in clinically jaundiced healthy-term Greek newborns, using total serum bilirubin as the reference standard, in order to re-evaluate our local guidelines about neonatal jaundice. Clinically jaundiced newborns requiring total serum bilirubin level estimation were recruited prospectively. 368 pairs of total serum bilirubin/transcutaneous bilirubin measurements were taken in 222 newborns, using a direct spectrophotometric device and the BiliCheck device, respectively. The level of agreement between the obtained transcutaneous bilirubin and total serum bilirubin values was assessed. Our data were analysed using the Stata/SE 12.0 (StataCorp LP, USA statistical programme. The mean (± SD TSB was 225.4 ± 25.4 μmol/l and the mean (± SD TcB was 237.9 ± 21.0 μmol/l. The correlation between the values was poor (Pearson’s correlation coefficient 0.439; Lin’s concordance coefficient 0.377 [95% CI 0.301 to 0.453]; P<0.001. The Bland-Altman analysis demonstrated that transcutaneous bilirubin measurements tended to overestimate the total serum bilirubin value (mean difference 12.5 ± 24.9 μmol/l, with wide 95% limits of agreement (–36.2 μmol/l to 61.3 μmol/l. Transcutaneous bilirubin values did not correlate well with total serum bilirubin values, being often imprecise in predicting the actual total serum bilirubin levels. This permits us to continue estimating total serum bilirubin in clinically jaundiced newborns according to our local guidelines, in order to safely decide the appropriate care plan.

  1. Repetitive reduction of uterine blood flow and its influence on fetal transcutaneous PO2 and cardiovascular variables.

    Science.gov (United States)

    Jensen, A; Künzel, W; Kastendieck, E

    1985-04-01

    The influence of repeated asphyxia on fetal transcutaneous PO2, relative local skin perfusion, heart rate, blood gases and pH was investigated in 15 experiments on 8 acutely instrumented sheep fetuses in utero between 125 and 145 days gestation (term is 147 days). Uterine blood flow was intermittently arrested (11 times within 33 min) by intra-vascular maternal aortic occlusion, exposing the fetuses to repeated episodes of asphyxia of 30 (n = 3), 60 (n = 9) and 90 (n = 3) s duration. The fetal transcutaneous PO2 fell as the duration of asphyxia (2 alpha less than 0.01), heart rate deceleration area (2 alpha less than 0.01) and acidaemia (2 alpha less than 0.01) increased. With decreasing skin perfusion, which was dependent on the duration of asphyxia (2 alpha less than 0.001) and acidaemia (2 alpha less than 0.001), a discrepancy developed between transcutaneous and arterial PO2. The increase (delta) in transcutaneous-arterial PO2 difference was related linearly to the duration of asphyxia (2 alpha less than 0.01), the mean haemoglobin oxygen saturation (2 alpha less than 0.001), acidaemia (2 alpha less than 0.001) and relative local skin flow (2 alpha less than 0.05). It was highest after severe episodes of asphyxia (90 s), when O2 saturation, skin blood flow and arterial blood pH values were low. Fetal heart rate deceleration area was only correlated with the cutaneous-arterial PO2 difference when the mean fetal haemoglobin oxygen saturation was below 35%. Thus, a discrimination of heart rate decelerations that are significant for the fetus seems to be possible, when associated with low transcutaneous PO2 values. We conclude that in the sheep fetus transcutaneous PO2 measurements during repeated asphyxial episodes yield information on fetal oxygenation and on the skin vasomotor response.

  2. Spinal Neurocysticercosis: Case Report

    International Nuclear Information System (INIS)

    Amaya P, Melina; Roa, Jose L

    2011-01-01

    Neurocysticercosis (NCC) is the most frequent parasitic illness of the central nervous system caused by the larval form of Taenia solium and its considered to be endemic in Latin America. Its diagnosis is based on imaging findings and epidemiological data; although its diagnosis can be made through the detection of specific IgG antibodies, these tests have limited availability in our environment. Central nervous system involvement is generally observed in the brain parenchyma, and less commonly in the ventricular system and subarachnoid space; only infrequently is reported to involve the structures within the spinal canal, in this article we review a case of a patient with spinal cysticercal involvement.

  3. [Congenital spinal malformations].

    Science.gov (United States)

    Ertl-Wagner, B B; Reiser, M F

    2001-12-01

    Congenital spinal malformations form a complex and heterogeneous group of disorders whose pathogenesis is best explained embryologically. Radiologically, it is important to formulate a diagnosis when the disorder first becomes symptomatic. However, it is also crucial to detect complications of the disorder or of the respective therapeutic interventions in the further course of the disease such as hydromyelia or re-tethering after repair of a meningomyelocele. Moreover, once a congenital spinal malformation is diagnosed, associated malformations should be sought after. A possible syndromal classification such as in OEIS- or VACTERL-syndromes should also be considered.

  4. Congenital spinal malformations

    International Nuclear Information System (INIS)

    Ertl-Wagner, B.B.; Reiser, M.F.

    2001-01-01

    Congenital spinal malformations form a complex and heterogeneous group of disorders whose pathogenesis is best explained embryologically. Radiologically, it is important to formulate a diagnosis when the disorder first becomes symptomatic. However, it is also crucial to detect complications of the disorder or of the respective therapeutic interventions in the further course of the disease such as hydromyelia or re-tethering after repair of a meningomyelocele. Moreover, once a congenital spinal malformation is diagnosed, associated malformations should be sought after. A possible syndromal classification such as in OEIS- or VACTERL-syndromes should also be considered. (orig.) [de

  5. Spinal Cord Stimulation

    DEFF Research Database (Denmark)

    Meier, Kaare

    2014-01-01

    Spinal cord stimulation (SCS) is a surgical treatment for chronic neuropathic pain that is refractory to other treatment. Originally described by Shealy et al. in 1967(1), it is used to treat a range of conditions such as complex regional pain syndrome (CRPS I)(2), angina pectoris(3), radicular...... pain after failed back surgery syndrome (FBSS)(4), pain due to peripheral nerve injury, stump pain(5), peripheral vascular disease(6) and diabetic neuropathy(7,8); whereas phantom pain(9), postherpetic neuralgia(10), chronic visceral pain(11), and pain after partial spinal cord injury(12) remain more...

  6. Maladaptive spinal plasticity opposes spinal learning and recovery in spinal cord injury

    Directory of Open Access Journals (Sweden)

    Adam R Ferguson

    2012-10-01

    Full Text Available Synaptic plasticity within the spinal cord has great potential to facilitate recovery of function after spinal cord injury (SCI. Spinal plasticity can be induced in an activity-dependent manner even without input from the brain after complete SCI. The mechanistic basis for these effects is provided by research demonstrating that spinal synapses have many of the same plasticity mechanisms that are known to underlie learning and memory in the brain. In addition, the lumbar spinal cord can sustain several forms of learning and memory, including limb-position training. However, not all spinal plasticity promotes recovery of function. Central sensitization of nociceptive (pain pathways in the spinal cord may emerge with certain patterns of activity, demonstrating that plasticity within the spinal cord may contribute to maladaptive pain states. In this review we discuss interactions between adaptive and maladaptive forms of activity-dependent plasticity in the spinal cord. The literature demonstrates that activity-dependent plasticity within the spinal cord must be carefully tuned to promote adaptive spinal training. Stimulation that is delivered in a limb position-dependent manner or on a fixed interval can induce adaptive plasticity that promotes future spinal cord learning and reduces nociceptive hyper-reactivity. On the other hand, stimulation that is delivered in an unsynchronized fashion, such as randomized electrical stimulation or peripheral skin injuries, can generate maladaptive spinal plasticity that undermines future spinal cord learning, reduces recovery of locomotor function, and promotes nociceptive hyper-reactivity after spinal cord injury. We review these basic phenomena, discuss the cellular and molecular mechanisms, and discuss implications of these findings for improved rehabilitative therapies after spinal cord injury.

  7. Novel diode-based laser system for combined transcutaneous monitoring and computer-controlled intermittent treatment of jaundiced neonates

    Science.gov (United States)

    Hamza, Mostafa; El-Ahl, Mohammad H. S.; Hamza, Ahmad M.

    2001-06-01

    The high efficacy of laser phototherapy combined with transcutaneous monitoring of serum bilirubin provides optimum safety for jaundiced infants from the risk of bilirubin encephalopathy. In this paper the authors introduce the design and operating principles of a new laser system that can provide simultaneous monitoring and treatment of several jaundiced babies at one time. The new system incorporates diode-based laser sources oscillating at selected wavelengths to achieve both transcutaneous differential absorption measurements of bilirubin concentration in addition to the computer controlled intermittent laser therapy through a network of optical fibers. The detailed description and operating characteristics of this system are presented.

  8. Neuropathic Pain Following Spinal Cord Injury: Mechanism, Assessment and Treatment

    Directory of Open Access Journals (Sweden)

    Gul Mete Civelek

    2016-04-01

    Full Text Available Spinal cord injury (SCI is a devastating disease which may cause physical, psychological and social dysfunction. Neuropathic pain (NP after SCI is common, can be seen in varying degrees and is one of the most difficultly treated problems developing after SCI. With the addition of the NP to loss of function after SCI, sleep patterns, moods and daily activities of patients are adversely affected. In order to treat pain effectively, classification of pain after SCI must be done carefully and correctly. According to classification of International Pain Study Group, pain after SCI is divided into two main groups as nociceptive and neuropathic pain. Neuropathic pain is defined as %u201Cpain occuring as a direct result of a disease or lesion directly affecting somato-sensorial system%u201D. NP after SCI can be classified according to anatomical region (above the level of lesion, at the level of lesion, below the level of lesion. Treatment of NP after SCI is often challenging and receiving response to treatment may take long time. Therefore, treatment of NP after SCI should be multifactorial. Treatment options include pharmochologic treatment, application of transcutanous electrical nerve stimulation, psychiatric treatment approaches, and surgical approaches in selected cases. In pharmachologic treatment, first line agents are tricyclic antidepresants, pregabalin and gabapentin. In this review, mechanisms and assessment and treatment of NP after SCI is discussed with the guide of current literature.

  9. Transcutaneous glomerular filtration rate measurement in a canine animal model of chronic kidney disease.

    Science.gov (United States)

    Mondritzki, Thomas; Steinbach, Sarah M L; Boehme, Philip; Hoffmann, Jessica; Kullmann, Maximilian; Schock-Kusch, Daniel; Vogel, Julia; Kolkhof, Peter; Sandner, Peter; Bischoff, Erwin; Hüser, Jörg; Dinh, Wilfried; Truebel, Hubert

    Quantitative assessment of renal function by measurement of glomerular filtration rate (GFR) is an important part of safety and efficacy evaluation in preclinical drug development. Existing methods are often time consuming, imprecise and associated with animal burden. Here we describe the comparison between GFR determinations with sinistrin (PS-GFR) and fluorescence-labelled sinistrin-application and its transcutaneous detection (TD-GFR) in a large animal model of chronic kidney disease (CKD). TD-GFR measurements compared to a standard method using i.v. sinistrin were performed in a canine model. Animals were treated with one-sided renal wrapping (RW) followed by renal artery occlusion (RO). Biomarker and remote hemodynamic measurements were performed. Plasma sinistrin in comparison to transcutaneous derived GFR data were determined during healthy conditions, after RW and RW+RO. RW alone did not led to any significant changes in renal function, neither with PS-GFR nor TD-GFR. Additional RO showed a rise in blood pressure (+68.0mmHg), plasma urea (+28.8mmol/l), creatinine (+224,4μmol/l) and symmetric dimethylarginine (SDMA™; +12.6μg/dl). Plasma sinistrin derived data confirmed the expected drop (-44.7%, p<0.0001) in GFR. The calculated transcutaneous determined Fluorescein Isothiocyanate (FITC)-sinistrin GFR showed no differences to plasma sinistrin GFR at all times. Both methods were equaly sensitive to diagnose renal dysfunction in the affected animals. Renal function assessment using TD-GFR is a valid method to improve preclinical drug discovery and development. Furthermore, TD-GFR method offers advantages in terms of reduced need for blood sampling and thus decreasing animal burden compared to standard procedures. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Usefulness of transcutaneous PCO2 to assess nocturnal hypoventilation in restrictive lung disorders.

    Science.gov (United States)

    Georges, Marjolaine; Nguyen-Baranoff, Danièle; Griffon, Lucie; Foignot, Clement; Bonniaud, Philippe; Camus, Philippe; Pepin, Jean-Louis; Rabec, Claudio

    2016-10-01

    Nocturnal hypoventilation is now an accepted indication for the initiation of non-invasive ventilation. Nocturnal hypoventilation may be an under diagnosed condition in chronic respiratory failure. The most appropriate strategy to identify sleep hypoventilation is not yet clearly defined. In clinical practice, it is indirectly assessed using nocturnal pulse oximetry (NPO) and morning arterial blood gases (mABG). Even though continuous transcutaneous carbon dioxide partial pressure (TcPCO2 ) monitoring is theoretically superior to NPO plus mABG, it is not routinely used. We aimed to prospectively compare NPO plus mABG with nocturnal TcPCO2 for the detection of alveolar hypoventilation in a cohort of patients with chronic restrictive respiratory dysfunction. We assessed 80 recordings of mABG, nocturnal TcPCO2 and NPO in 72 consecutive patients with neuromuscular disease or thoracic cage disorders. Nocturnal hypoventilation was defined as a mean nightime TcPCO2 ≥50 mm Hg, and nocturnal hypoxaemia as ≥30% of the night with transcutaneous pulse oxygen saturation ≤90% and/or >5 consecutive minutes with transcutaneous pulse oxygen saturation ≤88%. Amongst the 80 recordings, 25 of 76 (32.9%) without nocturnal hypoxaemia and 16 of 59 (27.1%) without hypercapnia on mABG showed nocturnal hypoventilation on TcPCO2 . Amongst recordings showing both normal NPO and mABG, 16 of 52 (30.8%) had a mean TcPCO2 ≥50 mm Hg. Nocturnal hypoxaemia was associated with nocturnal hypoventilation in all recordings. However, 5 of 21 (23.8%) recordings that showed an absence of nocturnal hypoventilation at the chosen threshold showed hypercapnia on mABG. Morning arterial blood gases and NPO alone or in combination underestimate nocturnal hypoventilation in patients with chronic restrictive respiratory dysfunction of extrapulmonary origin. © 2016 Asian Pacific Society of Respirology.

  11. Transcutaneous flow related variables measured in vivo: the effects of gender

    Science.gov (United States)

    Rodrigues, Luís Monteiro; Pinto, Pedro Contreiras; Leal, António

    2001-01-01

    Backgound The identification of potential sources of error is a crucial step for any new assessment technique. This is the case for transcutaneous variables, such as flow and arterial gases, which have been applied as functional indicators of various aspects of human health. Regarding gender, a particular subject-related determinant, it is often claimed that women present higher transcutaneous oxygen pressure (tcpO2) values than men. However, the statistical significance of this finding is still uncertain. Methods The haemodynamical-vascular response to a local reactive hyperaemia procedure (the tourniquet cuff manoeuvre) was studied in two previously selected group of volunteers (n = 16; 8 women and 8 men). The effect of gender was assessed under standardised experimental conditions, using the transcutaneous flow-related variables tcpO2-tcpCO2 and Laser-doppler Flowmetry (LDF). Results Regarding tcpO2, statistically significant differences between genders were not found, although higher values were consistently found for the gases in the female group. Regarding LDF, high statistically significant differences (p < 0.005) were found, with the men's group presenting the highest values and variability. Other derived parameters used to characterise the vascular response following the cuff-deflation (t-peak) were similar in both groups. Conclusions The relative influence of gender was not clearly demonstrated using these experimental conditions. However the gender-related LDF differences suggest that further investigation should be done on this issue. Perhaps in the presence of certain pathological disparities involving peripheral vascular regulation, other relationships may be found between these variables. PMID:11580871

  12. Efficacy of imiquimod-based transcutaneous immunization using a nano-dispersed emulsion gel formulation.

    Science.gov (United States)

    Stein, Pamela; Gogoll, Karsten; Tenzer, Stefan; Schild, Hansjörg; Stevanovic, Stefan; Langguth, Peter; Radsak, Markus P

    2014-01-01

    Transcutaneous immunization (TCI) approaches utilize skin associated lymphatic tissues to elicit specific immune responses. In this context, the imidazoquinoline derivative imiquimod formulated in Aldara applied onto intact skin together with a cytotoxic T lymphocyte (CTL) epitope induces potent CTL responses. However, the feasibility and efficacy of the commercial imiquimod formulation Aldara is limited by its physicochemical properties as well as its immunogenicity. To overcome these obstacles, we developed an imiquimod-containing emulsion gel (IMI-Gel) and characterized it in comparison to Aldara for rheological properties and in vitro mouse skin permeation in a Franz diffusion cell system. Imiquimod was readily released from Aldara, while IMI-Gel showed markedly decreased drug release. Nevertheless, comparing vaccination potency of Aldara or IMI-Gel-based TCI in C57BL/6 mice against the model cytotoxic T-lymphocyte epitope SIINFEKL, we found that IMI-Gel was equally effective in terms of the frequency of peptide-specific T-cells and in vivo cytolytic activity. Importantly, transcutaneous delivery of IMI-Gel for vaccination was clearly superior to the subcutaneous or oral route of administration. Finally, IMI-Gel based TCI was at least equally effective compared to Aldara-based TCI in rejection of established SIINFEKL-expressing E.G7 tumors in a therapeutic setup indicated by enhanced tumor rejection and survival. In summary, we developed a novel imiquimod formulation with feasible pharmaceutical properties and immunological efficacy that fosters the rational design of a next generation transcutaneous vaccination platform suitable for the treatment of cancer or persistent virus infections.

  13. Efficacy of imiquimod-based transcutaneous immunization using a nano-dispersed emulsion gel formulation.

    Directory of Open Access Journals (Sweden)

    Pamela Stein

    Full Text Available BACKGROUND: Transcutaneous immunization (TCI approaches utilize skin associated lymphatic tissues to elicit specific immune responses. In this context, the imidazoquinoline derivative imiquimod formulated in Aldara applied onto intact skin together with a cytotoxic T lymphocyte (CTL epitope induces potent CTL responses. However, the feasibility and efficacy of the commercial imiquimod formulation Aldara is limited by its physicochemical properties as well as its immunogenicity. METHODOLOGY/PRINCIPAL FINDINGS: To overcome these obstacles, we developed an imiquimod-containing emulsion gel (IMI-Gel and characterized it in comparison to Aldara for rheological properties and in vitro mouse skin permeation in a Franz diffusion cell system. Imiquimod was readily released from Aldara, while IMI-Gel showed markedly decreased drug release. Nevertheless, comparing vaccination potency of Aldara or IMI-Gel-based TCI in C57BL/6 mice against the model cytotoxic T-lymphocyte epitope SIINFEKL, we found that IMI-Gel was equally effective in terms of the frequency of peptide-specific T-cells and in vivo cytolytic activity. Importantly, transcutaneous delivery of IMI-Gel for vaccination was clearly superior to the subcutaneous or oral route of administration. Finally, IMI-Gel based TCI was at least equally effective compared to Aldara-based TCI in rejection of established SIINFEKL-expressing E.G7 tumors in a therapeutic setup indicated by enhanced tumor rejection and survival. CONCLUSION/SIGNIFICANCE: In summary, we developed a novel imiquimod formulation with feasible pharmaceutical properties and immunological efficacy that fosters the rational design of a next generation transcutaneous vaccination platform suitable for the treatment of cancer or persistent virus infections.

  14. Reliability of transcutaneous measurement of renal function in various strains of conscious mice.

    Science.gov (United States)

    Schock-Kusch, Daniel; Geraci, Stefania; Ermeling, Esther; Shulhevich, Yury; Sticht, Carsten; Hesser, Juergen; Stsepankou, Dzmitry; Neudecker, Sabine; Pill, Johannes; Schmitt, Roland; Melk, Anette

    2013-01-01

    Measuring renal function in laboratory animals using blood and/or urine sampling is not only labor-intensive but puts also a strain on the animal. Several approaches for fluorescence based transcutaneous measurement of the glomerular filtration rate (GFR) in laboratory animals have been developed. They allow the measurement of GFR based on the elimination kinetics of fluorescent exogenous markers. None of the studies dealt with the reproducibility of the measurements in the same animals. Therefore, the reproducibility of a transcutaneous GFR assessment method was investigated using the fluorescent renal marker FITC-Sinistrin in conscious mice in the present study. We performed two transcutaneous GFR measurements within three days in five groups of mice (Balb/c, C57BL/6, SV129, NMRI at 3-4 months of age, and a group of 24 months old C57BL/6). Data were evaluated regarding day-to-day reproducibility as well as intra- and inter-strain variability of GFR and the impact of age on these parameters. No significant differences between the two subsequent GFR measurements were detected. Fastest elimination for FITC-Sinistrin was detected in Balb/c with significant differences to C57BL/6 and SV129 mice. GFR decreased significantly with age in C57BL/6 mice. Evaluation of GFR in cohorts of young and old C57BL/6 mice from the same supplier showed high consistency of GFR values between groups. Our study shows that the investigated technique is a highly reproducible and reliable method for repeated GFR measurements in conscious mice. This gentle method is easily used even in old mice and can be used to monitor the age-related decline in GFR.

  15. Reliability of transcutaneous measurement of renal function in various strains of conscious mice.

    Directory of Open Access Journals (Sweden)

    Daniel Schock-Kusch

    Full Text Available Measuring renal function in laboratory animals using blood and/or urine sampling is not only labor-intensive but puts also a strain on the animal. Several approaches for fluorescence based transcutaneous measurement of the glomerular filtration rate (GFR in laboratory animals have been developed. They allow the measurement of GFR based on the elimination kinetics of fluorescent exogenous markers. None of the studies dealt with the reproducibility of the measurements in the same animals. Therefore, the reproducibility of a transcutaneous GFR assessment method was investigated using the fluorescent renal marker FITC-Sinistrin in conscious mice in the present study. We performed two transcutaneous GFR measurements within three days in five groups of mice (Balb/c, C57BL/6, SV129, NMRI at 3-4 months of age, and a group of 24 months old C57BL/6. Data were evaluated regarding day-to-day reproducibility as well as intra- and inter-strain variability of GFR and the impact of age on these parameters. No significant differences between the two subsequent GFR measurements were detected. Fastest elimination for FITC-Sinistrin was detected in Balb/c with significant differences to C57BL/6 and SV129 mice. GFR decreased significantly with age in C57BL/6 mice. Evaluation of GFR in cohorts of young and old C57BL/6 mice from the same supplier showed high consistency of GFR values between groups. Our study shows that the investigated technique is a highly reproducible and reliable method for repeated GFR measurements in conscious mice. This gentle method is easily used even in old mice and can be used to monitor the age-related decline in GFR.

  16. Nonenhancing spinal subdural metastatic tumor

    International Nuclear Information System (INIS)

    Sirakov, S.; Penev, L.; Georgieva-Kozarova, G.

    2012-01-01

    Full text: We describe a case of a spinal subdural metastatic tumor that became rapidly symptomatic after a minor trauma, as a result of severe cord compression and cord haemorrhage. Spinal subdural hematomas are most commonly caused by anticoagulant therapy, lumbar puncture, blood dyscrasias, spinal trauma, or spinal vascular malformations. Subdural metastatic tumors are very uncommon, and their presentation as spinal subdural hematomas is exceedingly rare. We describe a case of 59 years old woman with quadriparesis and her preoperative findings on MRI and the follow up

  17. Anterior spinal cord syndrome of unknown etiology

    OpenAIRE

    Klakeel, Merrine; Thompson, Justin; Srinivasan, Rajashree; McDonald, Frank

    2015-01-01

    A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery. We present the cases of two 13-year-old boys with anterior spinal cord syndrome, along with a review of the anatomy and vasculature of the spinal cord and an explanation of how a lesion in the cord corresponds to anterior spinal cord syndrome.

  18. Treating Depression with Transcutaneous Auricular Vagus Nerve Stimulation: State of the Art and Future Perspectives

    OpenAIRE

    Jian Kong; Jiliang Fang; Joel Park; Shaoyuan Li; Peijing Rong

    2018-01-01

    Depression is a highly prevalent disorder, and its treatment is far from satisfactory. There is an urgent need to develop a new treatment for depression. Although still at its early stage, transcutaneous auricular vagus nerve stimulation (taVNS) has shown promising potential for treating depression. In this article, we first summarize the results of clinical studies on the treatment effect of taVNS on depression. Then, we re-analyze a previous study to identify the specific symptoms taVNS can...

  19. Transcutaneous Vagus Nerve Stimulation: Retrospective Assessment of Cardiac Safety in a Pilot Study

    OpenAIRE

    Kreuzer, Peter M.; Landgrebe, Michael; Husser, Oliver; Resch, Markus; Schecklmann, Martin; Geisreiter, Florian; Poeppl, Timm B.; Prasser, Sarah Julia; Hajak, Goeran; Langguth, Berthold

    2012-01-01

    Background: Vagus nerve stimulation has been successfully used as a treatment strategy for epilepsy and affective disorders for years. Transcutaneous vagus nerve stimulation (tVNS) is a new non-invasive method to stimulate the vagus nerve, which has been shown to modulate neuronal activity in distinct brain areas. Objectives: Here we report effects of tVNS on cardiac function from a pilot study, which was conducted to evaluate the feasibility and safety of tVNS for the treatment of chronic ti...

  20. Effects of short and prolonged transcutaneous vagus nerve stimulation on heart rate variability in healthy subjects

    OpenAIRE

    De Couck, Marijke; Cserjesi, Renata; Caers, Ralf; Zijlstra, W.-P.; Widjaja, Devy; Wolf, Nicole; Luminet, Olivier; Ellrich, Jens; Gidron, Yori

    2017-01-01

    The vagus nerve is strategically located in the body, and has multiple homeostatic and health-promoting effects. Low vagal activity predicts onset and progression of diseases. These are the reasons to activate this nerve. This study examined the effects of transcutaneous vagus nerve stimulation (t-VNS) on a main index of vagal activity, namely heart rate variability (HRV). In Study 1, we compared short (10 min) left versus right ear t-VNS versus sham (no stimulation) in a within-subjects expe...

  1. Transcutaneous vagus nerve stimulation: retrospective assessment of cardiac safety in a pilot study

    OpenAIRE

    Peter Michael Kreuzer; Michael eLandgrebe; Oliver eHusser; Markus eResch; Martin eSchecklmann; Florian eGeisreiter; Timm B Poeppl; Sarah Julia Prasser; Goeran eHajak; Goeran eHajak; Berthold eLangguth

    2012-01-01

    Abstract BACKGROUND: Vagus nerve stimulation has been successfully used as a treatment strategy for epilepsy and affective disorders for years. Transcutaneous vagus nerve stimulation (tVNS) is a new non-invasive method to stimulate the vagus nerve, which has been shown to modulate neuronal activity in distinct brain areas. OBJECTIVES: Here we report effects of tVNS on cardiac function from a pilot study, which was conducted to evaluate the feasibility and safety of tVNS for the treatment of c...

  2. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... is “Braingate” research? play_arrow How would stem-cell therapies work in the treatment of spinal cord injuries? play_arrow What does stem-cell research on animals tell us? play_arrow When ...

  3. Lumbar Spinal Canal Stenosis

    Science.gov (United States)

    ... If you have lumbar spinal canal stenosis, your treatment will depend on how bad your symptoms are. If your pain is mild and you haven’t had it long, you can try an exercise program or a physical therapy program. This can strengthen your back muscles and ...

  4. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... What is “Braingate” research? play_arrow How would stem-cell therapies work in the treatment of spinal cord injuries? play_arrow What does stem-cell research on animals tell us? play_arrow ...

  5. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... spinal cord injuries? play_arrow What is “Braingate” research? play_arrow How would stem-cell therapies work ... cord injuries? play_arrow What does stem-cell research on animals tell us? play_arrow When can ...

  6. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Life in a Wheelchair Lisa Rosen, MS Spasticity, Physical Therapy-Lokomat T. George Hornby, PhD, PT Empowering the ... Rogers, SW Marguerite David, MSW Kathy Hulse, MSW Physical Therapy after Spinal Cord Injury Laura Wehrli, PT Isa ...

  7. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Braingate” research? play_arrow How would stem-cell therapies work in the treatment of spinal cord injuries? play_arrow What does stem-cell research on animals tell us? play_arrow When can we expect ...

  8. Lumbar spinal stenosis

    International Nuclear Information System (INIS)

    Anon.

    1985-01-01

    Spinal stenosis, which has attracted increasing attention in recent years, represents an important group of clinical and radiologic entities. Recognition and ultimate surgical management of the many abnormalities found in this group require precise preoperative delineation of the morbid anatomy. Conventional axial tomography provided the first accurate picture of the sagittal dimension, but it was limited by poor contrast resolution. Computerized tomography and ultrasound have finally provided the means for accurate measurement of midsagittal diameter and surface area. It is now possible to provide a preoperative assessment of bony and soft-tissue canal compression and to guide surgical decompression by objective anatomic measurements. True spinal stenosis of the lumbar vertebral canal is a form of compression produced by the walls of the vertebral canal. It involves the whole of the vertebral canal by exerting compression at two of its opposite surfaces. There are two types of stenosis: (1) transport stenosis, wherein the clinical manifestations are due to impeded flow of fluid, which is dependent on the available cross-sectional area of the canal surface of the stenotic structure, and (2) compressive stenosis, which includes abnormal compression of opposing surfaces only. According to these definitions, indentation on the spinal canal by disc protrusion or localized tumor is not considered true spinal stenoses. In this chapter the authors discuss only those conditions that produce true canal stenosis

  9. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... What is “Braingate” research? play_arrow How would stem-cell therapies work in the treatment of spinal cord injuries? play_arrow What does stem-cell research on animals tell us? play_arrow When ...

  10. Maladaptive spinal plasticity opposes spinal learning and recovery in spinal cord injury

    Science.gov (United States)

    Ferguson, Adam R.; Huie, J. Russell; Crown, Eric D.; Baumbauer, Kyle M.; Hook, Michelle A.; Garraway, Sandra M.; Lee, Kuan H.; Hoy, Kevin C.; Grau, James W.

    2012-01-01

    Synaptic plasticity within the spinal cord has great potential to facilitate recovery of function after spinal cord injury (SCI). Spinal plasticity can be induced in an activity-dependent manner even without input from the brain after complete SCI. A mechanistic basis for these effects is provided by research demonstrating that spinal synapses have many of the same plasticity mechanisms that are known to underlie learning and memory in the brain. In addition, the lumbar spinal cord can sustain several forms of learning and memory, including limb-position training. However, not all spinal plasticity promotes recovery of function. Central sensitization of nociceptive (pain) pathways in the spinal cord may emerge in response to various noxious inputs, demonstrating that plasticity within the spinal cord may contribute to maladaptive pain states. In this review we discuss interactions between adaptive and maladaptive forms of activity-dependent plasticity in the spinal cord below the level of SCI. The literature demonstrates that activity-dependent plasticity within the spinal cord must be carefully tuned to promote adaptive spinal training. Prior work from our group has shown that stimulation that is delivered in a limb position-dependent manner or on a fixed interval can induce adaptive plasticity that promotes future spinal cord learning and reduces nociceptive hyper-reactivity. On the other hand, stimulation that is delivered in an unsynchronized fashion, such as randomized electrical stimulation or peripheral skin injuries, can generate maladaptive spinal plasticity that undermines future spinal cord learning, reduces recovery of locomotor function, and promotes nociceptive hyper-reactivity after SCI. We review these basic phenomena, how these findings relate to the broader spinal plasticity literature, discuss the cellular and molecular mechanisms, and finally discuss implications of these and other findings for improved rehabilitative therapies after SCI. PMID

  11. Maladaptive spinal plasticity opposes spinal learning and recovery in spinal cord injury.

    Science.gov (United States)

    Ferguson, Adam R; Huie, J Russell; Crown, Eric D; Baumbauer, Kyle M; Hook, Michelle A; Garraway, Sandra M; Lee, Kuan H; Hoy, Kevin C; Grau, James W

    2012-01-01

    Synaptic plasticity within the spinal cord has great potential to facilitate recovery of function after spinal cord injury (SCI). Spinal plasticity can be induced in an activity-dependent manner even without input from the brain after complete SCI. A mechanistic basis for these effects is provided by research demonstrating that spinal synapses have many of the same plasticity mechanisms that are known to underlie learning and memory in the brain. In addition, the lumbar spinal cord can sustain several forms of learning and memory, including limb-position training. However, not all spinal plasticity promotes recovery of function. Central sensitization of nociceptive (pain) pathways in the spinal cord may emerge in response to various noxious inputs, demonstrating that plasticity within the spinal cord may contribute to maladaptive pain states. In this review we discuss interactions between adaptive and maladaptive forms of activity-dependent plasticity in the spinal cord below the level of SCI. The literature demonstrates that activity-dependent plasticity within the spinal cord must be carefully tuned to promote adaptive spinal training. Prior work from our group has shown that stimulation that is delivered in a limb position-dependent manner or on a fixed interval can induce adaptive plasticity that promotes future spinal cord learning and reduces nociceptive hyper-reactivity. On the other hand, stimulation that is delivered in an unsynchronized fashion, such as randomized electrical stimulation or peripheral skin injuries, can generate maladaptive spinal plasticity that undermines future spinal cord learning, reduces recovery of locomotor function, and promotes nociceptive hyper-reactivity after SCI. We review these basic phenomena, how these findings relate to the broader spinal plasticity literature, discuss the cellular and molecular mechanisms, and finally discuss implications of these and other findings for improved rehabilitative therapies after SCI.

  12. Effects and Mechanisms of Transcutaneous Electroacupuncture on Chemotherapy-Induced Nausea and Vomiting

    Directory of Open Access Journals (Sweden)

    Xing Zhang

    2014-01-01

    Full Text Available Nausea and vomiting are one of the major complications of chemotherapy for cancers. The aim of this study is to investigate the emetic effects and mechanisms involving serotonin and dopamine of needleless transcutaneous electroacupuncture (TEA at Neiguan (PC6 and Jianshi (PC5 on chemotherapy-induced nausea and vomiting in patients with cancers. Seventy-two patients with chemotherapy were randomly divided into sham-TEA group (sham-TEA, n=34 and TEA group (n=38. TEA was performed at PC 6 and PC 5 (1 h, bid in combination with granisetron. Sham-TEA was delivered at nonacupoints using the same parameters. We found the following. (1 In the acute phase, the conventional antiemetic therapy using Ondansetron effectively reduced nausea and vomiting; the addition of TEA did not show any additive effects. In the delayed phase, however, TEA significantly increased the rate of complete control (P<0.01 and reduced the nausea score (P<0.05, compared with sham-TEA. (2 TEA significantly reduced serum levels of 5-HT and dopamine in comparison with sham-TEA. Those results demonstrate that needleless transcutaneous electroacupuncture at PC6 using a watch-size digital stimulator improves emesis and reduces nausea in the delayed phase of chemotherapy in patients with cancers. This antiemetic effect is possibly mediated via mechanisms involving serotonin and dopamine.

  13. Effect of low frequency transcutaneous magnetic stimulation on sensory and motor transmission.

    Science.gov (United States)

    Leung, Albert; Shukla, Shivshil; Lee, Jacquelyn; Metzger-Smith, Valerie; He, Yifan; Chen, Jeffrey; Golshan, Shahrokh

    2015-09-01

    Peripheral nerve injury diminishes fast conducting large myelinated afferent fibers transmission but enhances smaller pain transmitting fibers firing. This aberrant afferent neuronal behavior contributes to development of chronic post-traumatic peripheral neuropathic pain (PTP-NP). Non-invasive dynamic magnetic flux stimulation has been implicated in treating PTP-NP, a condition currently not adequately addressed by other therapies including transcutaneous electrical nerve stimulation (TENS). The current study assessed the effect of low frequency transcutaneous magnetic stimulation (LFTMS) on peripheral sensory thresholds, nerve conduction properties, and TENS induced fast afferent slowing effect as measured by motor and sensory conduction studies in the ulnar nerve. Results indicated sham LFTMS with TENS (Sham + TENS) significantly (P = 0.02 and 0.007, respectively) reduces sensory conduction velocity (CV) and increases sensory onset latency (OL), and motor peak latency (PL) whereas, real LFTMS with TENS (Real + TENS) reverses effects of TENS on sensory CV and OL, and significantly (P = 0.036) increases the sensory PL. LFTMS alone significantly (P sensory PL and onset-to-peak latency. LFTMS appears to reverse TENS slowing effect on fast conducting fibers and casts a selective peripheral modulatory effect on slow conducting pain afferent fibers. © 2015 Wiley Periodicals, Inc.

  14. Transcutaneous PCO2 monitoring in critically ill adults: clinical evaluation of a new sensor.

    Science.gov (United States)

    Bendjelid, Karim; Schütz, Nicolas; Stotz, Martin; Gerard, Isabelle; Suter, Peter M; Romand, Jacques-André

    2005-10-01

    In critically ill patients, arterial blood gas analysis is the gold standard for evaluating systemic oxygenation and carbon dioxide partial pressure. A new miniaturized carbon dioxide tension Pco2-Spo2 single sensor (TOSCA, Linde Medical Sensors AG, Basel, Switzerland) continuously and noninvasively (transcutaneously) monitors both Paco2 and oxygen saturation by pulse oximetry (Spo2). The present study was designed to investigate the usability and the accuracy of this device in critically ill patients. Prospective clinical investigation. A 20-bed, university-affiliated, surgical intensive care unit. Patients admitted after major surgery, multiple trauma, or septic shock equipped with an arterial catheter. The heated (42 degrees C) sensor was fixed at the earlobe using an attachment clip. Transcutaneous Pco2 (TcPco2) measurements were correlated with Paco2 values (measured using a blood gas analyzer). In addition, the differences between Paco2 and TcPco2 values were evaluated using the method of Bland-Altman. We studied 55 patients, aged 18-80 (mean 57 +/- 15) yrs. A total of 417 paired measurements were compared. Correlation between TcPco2 and Paco2 was r = .86 (p TcPco2 slightly overestimating arterial carbon dioxide tension. Nineteen percent of the measured values were outside of the acceptable clinical range of agreement of +/-7.5 mm Hg. The present study suggests that Paco2 can be acceptably assessed by measuring TcPco2 using the TOSCA Pco2-Spo2 sensor.

  15. Multiphoton microscopy for the investigation of trans-cutaneous drug delivery

    Science.gov (United States)

    Stracke, Frank; Schneider, Marc; Weiss, Barbara; Lehr, Claus-Michael; Schäfer, Ulrich F.; König, Karsten

    2007-07-01

    The trans-cutaneous pathway for drug delivery is of particular interest since it allows a simple and non-invasive administration of pharmaceutically relevant compounds. As the skin is an effective barrier for many of these compounds, various strategies have been developed to enable and control the trans-cutaneous transport. Here we discuss, how multiphoton microscopy and spectral imaging can be valuable tools for the analysis of the penetration pathways of topically applied drugs. A time dependent study of the cutaneous penetration of a fluorescent drug model released from a nano-particular carrier is presented. The localization of single nano-particles in human skin (ex vivo) and the discrimination of different fluorescent compounds, as the drug model, the particle's label and the cutaneous endofluorescence by spectral imaging and selective excitation is shown. Multiphoton imaging techniques were found to be excellent methods for the non-invasive evaluation of cutaneous drug delivery strategies and analysis of dermal penetration pathways down to the sub-cellular level.

  16. Development of novel double-decker microneedle patches for transcutaneous vaccine delivery.

    Science.gov (United States)

    Ono, Akihiko; Azukizawa, Hiroaki; Ito, Sayami; Nakamura, Yuki; Asada, Hideo; Quan, Ying-Shu; Kamiyama, Fumio; Katayama, Ichiro; Hirobe, Sachiko; Okada, Naoki

    2017-10-30

    Microneedle (MN) patches have great potential as transcutaneous vaccine delivery devices because MNs can effectively deliver vaccine antigen into the skin through the micropores formed in the stratum corneum by low-invasive and painless skin puncturing. This study aims to develop novel double-decker MN patches which have not only high safety and efficacy but also broad applicability to various vaccine antigens. We developed two types of MN patches (PGA-MN and Nylon-MN) that are made from polyglycolic acid and Nylon-6. In pre-clinical studies, both MN patches could demonstrably deliver antigens into resected human dermal tissue, prolong antigen deposition and increase antigen-specific IgG levels after vaccination compared with conventional injections. We demonstrated both MN patches could be safely applied to human skin because no broken MNs or significant skin irritation were observed after applications in the clinical research. PGA-MN was suggested to be superior to Nylon-MN regarding human skin puncturability based on measurements of transepidermal water loss and needle failure force. A high content of tetravalent influenza hemagglutinin antigens loaded on PGA-MN could stably maintain HA titers at 35°C for 1year. Overall, double-decker MN patches can reliably and safely puncture human skin and are promising as effective transcutaneous vaccine delivery devices. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Transcutaneous Raman spectroscopy of bone tissue using a non-confocal fiber optic array probe

    Science.gov (United States)

    Schulmerich, Matthew V.; Finney, William F.; Popescu, Victoria; Morris, Michael D.; Vanasse, Thomas M.; Goldstein, Steven A.

    2006-02-01

    We demonstrate the first transcutaneous Raman spectroscopic measurements of bone tissue employing a fiber optic probe with a uniformly illuminated array of collection fibers. Uniform illumination reduces local power density to avoid damage to specimens. Non-confocal operation provides efficient signal collection, and together with NIR laser excitation (785 nm diode laser) allows good depth penetration enabling recovery of spectra from beneath the skin. Multivariate data reduction is used to resolve Raman spectra of bone tissue from the spectra generated from overlying tissue. The probe utilizes non-confocal optics and uniform illumination allowing the system to collect spectra from above and below the range of best focus while applying a low power density. Despite extensive photon migration in the tissue specimens, the system can resolve transcutaneous signals because the collection cone of each fiber is asymmetric with respect to the center of illumination. Here we report preliminary results of tissue specimens taken from chicken tibia as well as from a human elbow.

  18. Fluorescently Labeled Cyclodextrin Derivatives as Exogenous Markers for Real-Time Transcutaneous Measurement of Renal Function.

    Science.gov (United States)

    Huang, Jiaguo; Weinfurter, Stefanie; Pinto, Pedro Caetano; Pretze, Marc; Kränzlin, Bettina; Pill, Johannes; Federica, Rodeghiero; Perciaccante, Rossana; Ciana, Leopoldo Della; Masereeuw, Rosalinde; Gretz, Norbert

    2016-10-19

    Evaluation of renal function is crucial for a number of clinical situations. Here, we reported a novel exogenous fluorescent marker (FITC-HPβCD) to real-time assess renal function by using a transcutaneous fluorescent detection technique. FITC-HPβCD was designed based on the principle of renal clearance of designed drugs. It displays favorable fluorescent properties, high hydrophilicity, low plasma protein binding, and high stability in porcine liver esterase as well as in plasma and nontoxicity. More importantly, FITC-HPβCD can be efficiently and rapidly filtered by glomerulus and completely excreted into urine without proximal tubular reabsorption or secretion in rat models. Additionally, the marker was well-tolerated, with nearly 100% urinary recovery of the given doses, and no metabolism were found. Relying on this novel kidney function marker and transcutaneous devices, we demonstrate a rapid, robust, and convenient approach for real-time assessing renal function without the need of time-consuming blood and urine sample preparation. Our work provides a promising tool for noninvasive real-time monitoring of renal function in vivo.

  19. Transcutaneous Bone-anchored Hearing Aids Versus Percutaneous Ones: Multicenter Comparative Clinical Study.

    Science.gov (United States)

    Iseri, Mete; Orhan, Kadir Serkan; Tuncer, Ulku; Kara, Ahmet; Durgut, Merve; Guldiken, Yahya; Surmelioglu, Ozgur

    2015-06-01

    The aim of this study is to compare the clinical audiological outcomes as well as patient satisfaction of bone-anchored, hearing aid surgery between the percutaneous Dermalock and the transcutaneous Attract systems. This is a multicenter, retrospective clinical study. The patients who underwent Baha Dermalock and Baha Attract surgery were analyzed for hearing results, surgical complications, and postoperative follow-up specifications for both systems. Speech reception thresholds and bone conduction thresholds with and without aided conditions were evaluated. Patient satisfactions were also determined for both groups by Glasgow Benefit Inventory questionnaire. Both of the groups had some minor complications such as skin irritations around the abutment and skin erythema over the magnet. Both of the groups benefit from the devices audiologically; however, when the groups were compared, better results were observed in the percutaneous, bone-conduction group. We can confirm that both transcutaneous and percutaneous techniques are effective in the rehabilitation of conductive hearing loss when conventional hearing aids cannot be used. However, both of the systems have some advantages and limitations in terms of audiological and surgical perspectives.

  20. Effects of transcutaneous electrical nerve stimulation (TENS) on self-efficacy and mood in elderly with mild cognitive impairment

    NARCIS (Netherlands)

    Luijpen, Marijn W.; Swaab, Dick F.; Sergeant, Joseph A.; Scherder, Erik J. A.

    2004-01-01

    In previous studies, transcutaneous electrical nerve stimulation (TENS) has been applied to patients with either Alzheimer's disease (AD) or incipient dementia, resulting in an enhancement in memory and verbal fluency. Moreover, affective behavior was shown to improve. Based on the positive effects

  1. Effect of Transcutaneous Electrical Nerve Stimulation on Sensation Thresholds in Patients with Painful Diabetic Neuropathy: An Observational Study

    Science.gov (United States)

    Moharic, Metka

    2010-01-01

    Transcutaneous electrical nerve stimulation (TENS) is one of the therapies for painful neuropathy. Its analgesic mechanisms probably involve the gate control theory, the physiological block and the endogenous pain inhibitory system. The aim of the study was to determine whether TENS improves small fibre function diminished because of painful…

  2. The combined effects of transcutaneous electrical nerve stimulation (TENS) and stretching on muscle hardness and pressure pain threshold.

    Science.gov (United States)

    Karasuno, Hiroshi; Ogihara, Hisayoshi; Morishita, Katsuyuki; Yokoi, Yuka; Fujiwara, Takayuki; Ogoma, Yoshiro; Abe, Koji

    2016-04-01

    [Purpose] This study aimed to clarify the immediate effects of a combined transcutaneous electrical nerve stimulation and stretching protocol. [Subjects] Fifteen healthy young males volunteered to participate in this study. The inclusion criterion was a straight leg raising range of motion of less than 70 degrees. [Methods] Subjects performed two protocols: 1) stretching (S group) of the medial hamstrings, and 2) tanscutaneous electrical nerve stimulation (100 Hz) with stretching (TS group). The TS group included a 20-minute electrical stimulation period followed by 10 minutes of stretching. The S group performed 10 minutes of stretching. Muscle hardness, pressure pain threshold, and straight leg raising range of motion were analyzed to evaluate the effects. The data were collected before transcutaneous electrical nerve stimulation (T1), before stretching (T2), immediately after stretching (T3), and 10 minutes after stretching (T4). [Results] Combined transcutaneous electrical nerve stimulation and stretching had significantly beneficial effects on muscle hardness, pressure pain threshold, and straight leg raising range of motion at T2, T3, and T4 compared with T1. [Conclusion] These results support the belief that transcutaneous electrical nerve stimulation combined with stretching is effective in reducing pain and decreasing muscle hardness, thus increasing range of motion.

  3. Transcutaneous Electrical Nerve Stimulation as an Additional Treatment for Women Suffering from Therapy-Resistant Provoked Vestibulodynia : A Feasibility Study

    NARCIS (Netherlands)

    Vallinga, Marleen S.; Spoelstra, Symen K.; Hemel, Inge L. M.; van de Wiel, Harry B. M.; Schultz, Willibrord C. M. Weijnnar

    IntroductionThe current approach to women with provoked vestibulodynia (PVD) comprises a multidimensional, multidisciplinary therapeutic protocol. As PVD is considered to be a chronic pain disorder, transcutaneous electrical nerve stimulation (TENS) can be used as an additional therapy for women

  4. Differential diagnoses of spinal tumors; Differenzialdiagnose spinaler Tumoren

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, U. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2011-12-15

    A wide variety of degenerative, inflammatory and vascular diseases can resemble the clinical presentation and imaging findings of spinal tumors. This article provides an overview of the most frequent diseases which are important to recognize for diagnostic imaging of the spine. (orig.) [German] Eine Vielzahl degenerativer, entzuendlicher und vaskulaerer Erkrankungen kann das klinische Bild und radiologische Befunde spinaler Tumoren imitieren. Dieser Artikel dient der Uebersicht ueber die haeufigsten dieser Erkrankungen, deren Kenntnis wichtig fuer die spinale Bildgebung ist. (orig.)

  5. Changes in spinal alignment.

    Science.gov (United States)

    Veintemillas Aráiz, M T; Beltrán Salazar, V P; Rivera Valladares, L; Marín Aznar, A; Melloni Ribas, P; Valls Pascual, R

    2016-04-01

    Spinal misalignments are a common reason for consultation at primary care centers and specialized departments. Misalignment has diverse causes and is influenced by multiple factors: in adolescence, the most frequent misalignment is scoliosis, which is idiopathic in 80% of cases and normally asymptomatic. In adults, the most common cause is degenerative. It is important to know the natural history and to detect factors that might predict progression. The correct diagnosis of spinal deformities requires specific imaging studies. The degree of deformity determines the type of treatment. The aim is to prevent progression of the deformity and to recover the flexibility and balance of the body. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  6. Spinal trauma in children

    International Nuclear Information System (INIS)

    Roche, C.; Carty, H.

    2001-01-01

    Evaluation of the child with suspected spinal injury can be a difficult task for the radiologist. Added to the problems posed by lack of familiarity with the normal appearances of the paediatric spine is anxiety about missing a potentially significant injury resulting in neurological damage. Due to differences in anatomy and function, the pattern of injury in the paediatric spine is different from that in the adolescent or adult. Lack of appreciation of these differences may lead to over investigation and inappropriate treatment. This review attempts to clarify some of the problems frequently encountered. It is based on a review of the literature as well as personal experience. The normal appearances and variants of the spine in children, the mechanisms and patterns of injury are reviewed highlighting the differences between children and adults. Specific fractures, a practical scheme for the assessment of spinal radiographs in children, and the role of cross sectional imaging are discussed. (orig.)

  7. Acute spinal cord injuries

    International Nuclear Information System (INIS)

    Takahashi, M.; Izunaga, H.; Sato, R.; Shinzato, I.; Korogi, Y.; Yamashita, Y.

    1991-01-01

    This paper reports on sequential MR images and neurologic findings that were correlated in 40 acute spinal cord injuries. Within 1 week after injury, frequent initial MR changes appeared isointense on both T1- and T2-weighted images and isointense on T1- and hyperintense on T2-weighted images. After 2 months, hypointensity appeared on T1-weighted images and hyperintensity persisted or appeared on T2-weighted images. Clinical improvements were observed in patients with isointensity on both T1- and T2-weighted images at the initial examination. A larger area of hyperintensity on subsequent T2-weighted images was correlated with no neurologic improvement. MR findings were good indicators of the spinal cord injury

  8. Occult spinal dysraphism.

    Science.gov (United States)

    Bajpai, M; Kataria, R; Gupta, D K; Agarwala, S

    1997-01-01

    When spina bifida is associated with skin abnormalities such as dimples, sinus tracts hypertrichosis, or capillary hemangiomas, there is a high incidence of an occult intraspinal lesion such as epidermoid and dermoid tumours, lipomas, diastematomyelia, dural bands and tethered spinal cord. The present study consists of 50 patients with occult spinal dysraphism treated with the diagnosis of lipomeningomyelocoele (20), lumbosacral lipoma (15) and diastematomyelia (15). The clinical presentation varied from lipoma in the lumbosacral region, dermal sinus, cutaneous hemangioma and hypertrichosis. The age range varied from 2 months to 7 years with an average of 2 years. 40% patients had neurological deficit at the time of presentation which varied from lower limb weakness to bladder & bowel involvement. All patients underwent laminectomy of the lumbar and lumbo-sacral spine with excision of intraspinal lipoma, excision of bony or cartilaginous spur in diastematomyelia and detethering of the conus medullaris & cauda equina. No patient developed late neurological deficit.

  9. Imaging of Spinal Metastatic Disease

    Directory of Open Access Journals (Sweden)

    Lubdha M. Shah

    2011-01-01

    Full Text Available Metastases to the spine can involve the bone, epidural space, leptomeninges, and spinal cord. The spine is the third most common site for metastatic disease, following the lung and the liver. Approximately 60–70% of patients with systemic cancer will have spinal metastasis. Materials/Methods. This is a review of the imaging techniques and typical imaging appearances of spinal metastatic disease. Conclusions. Awareness of the different manifestations of spinal metastatic disease is essential as the spine is the most common site of osseous metastatic disease. Imaging modalities have complimentary roles in the evaluation of spinal metastatic disease. CT best delineates osseous integrity, while MRI is better at assessing soft tissue involvement. Physiologic properties, particularly in treated disease, can be evaluated with other imaging modalities such as FDG PET and advanced MRI sequences. Imaging plays a fundamental role in not only diagnosis but also treatment planning of spinal metastatic disease.

  10. Pilot study using transcutaneous electrical stimulation (interferential current) to treat chronic treatment-resistant constipation and soiling in children.

    Science.gov (United States)

    Chase, Janet; Robertson, Val J; Southwell, Bridget; Hutson, John; Gibb, Susie

    2005-07-01

    Chronic constipation in children may have organic or behavioral causes. The purpose of the present study was to investigate the effect of treatment with transcutaneous electrical stimulation (using interferential current) in children with chronic treatment-resistant constipation with proven organic disorders. Eight children (7-16 years) with at least 4 years of chronic treatment-resistant constipation and soiling, who had failed diet, laxative treatment and behavioral therapy were given 1 month of transcutaneous electrical stimulation. The three most severe cases had appendicostomies with antegrade washouts every 2-3 days to prevent impaction and reduce their soiling. Children and carers kept a daily diary of bowel habits, recording number of spontaneous defecations, episodes of soiling, use of bowel washouts and medications. Transcutaneous stimulation using interferential current was applied three times per week for 3-4 weeks using four surface electrodes, two to the paraspinal area of T9-10 to L2 and one to either side of the anterior abdominal wall beneath the costal margin. Diaries were recorded for 1 month before, during, and after stimulation and for 2 weeks 3 months later. Transcutaneous electrical stimulation using interferential current stopped soiling in 7/8 children and increased the frequency of spontaneous defecations in 5/8. Defecations remained high and soiling low for 3 months in 3/6 children (with data). These results suggest that transcutaneous electrical stimulation using interferential current has a beneficial effect for children with chronic treatment-resistant constipation. Further trials using larger series of patients are needed to confirm this benefit, to determine the ideal stimulation parameters and to investigate why electrical stimulation might be effective. (c) 2005 Blackwell Publishing Asia Pty Ltd.

  11. Two spinal arachnoid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Puijlaert, J.B.C.M.; Vielvoye, G.J.; Dulken, H. van

    1985-05-01

    Two cases of spinal arachnoid cysts are reported. One is extradurally located, the other intradurally. The first is only documented with myelography, the second also by subsequent CT scanning. Some clinical and diagnostic aspects of the lesion are discussed. The aim of this report is to add two new cases to the literature and to emphasize the role of high-resolution CT scanning in the diagnosis of these lesions.

  12. Spontaneous spinal epidural abscess.

    LENUS (Irish Health Repository)

    Ellanti, P

    2011-10-01

    Spinal epidural abscess is an uncommon entity, the frequency of which is increasing. They occur spontaneously or as a complication of intervention. The classical triad of fever, back pain and neurological symptoms are not always present. High index of suspicion is key to diagnosis. Any delay in diagnosis and treatment can have significant neurological consequences. We present the case of a previously well man with a one month history of back pain resulting from an epidural abscess.

  13. Spinal brucellosis: a review

    Energy Technology Data Exchange (ETDEWEB)

    Chelli Bouaziz, Mouna; Ladeb, Mohamed Fethi; Chakroun, Mohamed; Chaabane, Skander [Institut M T Kassab d' orthopedie, Department of Radiology, Ksar Said (Tunisia)

    2008-09-15

    Brucellosis is a zoonosis of worldwide distribution, relatively frequent in Mediterranean countries and in the Middle East. It is a systemic infection, caused by facultative intra-cellular bacteria of the genus Brucella, that can involve many organs and tissues. The spine is the most common site of musculoskeletal involvement, followed by the sacroiliac joints. The aim of this study was to assess the clinical, biological and imaging features of spinal brucellosis. (orig.)

  14. Spinal brucellosis: a review

    International Nuclear Information System (INIS)

    Chelli Bouaziz, Mouna; Ladeb, Mohamed Fethi; Chakroun, Mohamed; Chaabane, Skander

    2008-01-01

    Brucellosis is a zoonosis of worldwide distribution, relatively frequent in Mediterranean countries and in the Middle East. It is a systemic infection, caused by facultative intra-cellular bacteria of the genus Brucella, that can involve many organs and tissues. The spine is the most common site of musculoskeletal involvement, followed by the sacroiliac joints. The aim of this study was to assess the clinical, biological and imaging features of spinal brucellosis. (orig.)

  15. Spinal arteriovenous shunts in children.

    Science.gov (United States)

    Davagnanam, Indran; Toma, Ahmed K; Brew, Stefan

    2013-11-01

    Pediatric spinal arteriovenous shunts are rare and, in contrast to those in adults, are often congenital or associated with underlying genetic disorders. These are thought to be a more severe and complete phenotypic spectrum of all spinal arteriovenous shunts seen in the overall spinal shunt population. The pediatric presentation thus accounts for its association with significant morbidity and, in general, a more challenging treatment process compared with the adult presentation. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. [Lumbar spinal angiolipoma].

    Science.gov (United States)

    Isla, Alberto; Ortega Martinez, Rodrigo; Pérez López, Carlos; Gómez de la Riva, Alvaro; Mansilla, Beatriz

    2016-01-01

    Spinal angiolipomas are fairly infrequent benign tumours that are usually located in the epidural space of the thoracic column and represent 0.14% to 1.3% of all spinal tumours. Lumbar angiolipomas are extremely rare, representing only 9.6% of all spinal extradural angiolipomas. We report the case of a woman who complained of a lumbar pain of several months duration with no neurological focality and that had intensified in the last three days without her having had any injury or made a physical effort. The MR revealed an extradural mass L1-L2, on the posterior face of the medulla, decreasing the anteroposterior diameter of the canal. The patient symptoms improved after surgery. Total extirpation of the lesion is possible in most cases, and the prognosis is excellent even if the lesion is infiltrative. For this reason, excessively aggressive surgery is not necessary to obtain complete resection. Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Embolization of spinal arteriovenous malformations

    International Nuclear Information System (INIS)

    Son, Mi Young; Kim, Sun Yong; Park, Bok Hwan

    1990-01-01

    Recently, therapeutic embolization has been advocated as the treatment of choice for spinal AVM(arteriovenous malformations). The authors review our experience with two cases of spinal AVM treated by embolization using coaxial Tracker-18 microcatheter with Latvian. The patients included a 10 year old male with glomus type and a 14 year old female with juvenile type spinal AVM revealed recanalization 5 month later. Embolization provides curative or temporary treatment for spinal AVM. After embolic occlusion, delayed reassessment with arteriography is indicated, particularly if symptoms persist or recur

  18. Spinal cord mechanisms of pain.

    Science.gov (United States)

    D'Mello, R; Dickenson, A H

    2008-07-01

    The spinal cord is the first relay site in the transmission of nociceptive information from the periphery to the brain. Sensory signals are transmitted from the periphery by primary afferent fibres into the dorsal horn of the spinal cord, where these afferents synapse with intrinsic spinal dorsal horn neurones. Spinal projection neurones then convey this information to higher centres in the brain, where non-noxious and noxious signals can be perceived. During nociceptive transmission, the output of the spinal cord is dependent on various spinal mechanisms which can either increase or decrease the activity of dorsal horn neurones. Such mechanisms include local excitatory and inhibitory interneurones, N-methyl-D-aspartate receptor activation, and descending influences from the brainstem, which can be both inhibitory and excitatory in nature. After nerve injury or conditions of inflammation, shifts can occur in these excitatory and inhibitory mechanisms which modulate spinal excitability, often resulting in the heightened response of dorsal neurones to incoming afferent signals, and increased output to the brain, a phenomenon known as central sensitization. In this review, we consider the ways in which spinal cord activity may be altered in chronic pain states. In addition, we discuss the spinal mechanisms which are targeted by current analgesics used in the management of chronic pain.

  19. Priming Neural Circuits to Modulate Spinal Reflex Excitability

    Science.gov (United States)

    Estes, Stephen P.; Iddings, Jennifer A.; Field-Fote, Edelle C.

    2017-01-01

    While priming is most often thought of as a strategy for modulating neural excitability to facilitate voluntary motor control, priming stimulation can also be utilized to target spinal reflex excitability. In this application, priming can be used to modulate the involuntary motor output that often follows central nervous system injury. Individuals with spinal cord injury (SCI) often experience spasticity, for which antispasmodic medications are the most common treatment. Physical therapeutic/electroceutic interventions offer an alternative treatment for spasticity, without the deleterious side effects that can accompany pharmacological interventions. While studies of physical therapeutic/electroceutic interventions have been published, a systematic comparison of these approaches has not been performed. The purpose of this study was to compare four non-pharmacological interventions to a sham-control intervention to assess their efficacy for spasticity reduction. Participants were individuals (n = 10) with chronic SCI (≥1 year) who exhibited stretch-induced quadriceps spasticity. Spasticity was quantified using the pendulum test before and at two time points after (immediate, 45 min delayed) each of four different physical therapeutic/electroceutic interventions, plus a sham-control intervention. Interventions included stretching, cyclic passive movement (CPM), transcutaneous spinal cord stimulation (tcSCS), and transcranial direct current stimulation (tDCS). The sham-control intervention consisted of a brief ramp-up and ramp-down of knee and ankle stimulation while reclined with legs extended. The order of interventions was randomized, and each was tested on a separate day with at least 48 h between sessions. Compared to the sham-control intervention, stretching, CPM, and tcSCS were associated with a significantly greater reduction in spasticity immediately after treatment. While the immediate effect was largest for stretching, the reduction persisted

  20. Postocclusive Hyperemia Measured with Laser Doppler Flowmetry and Transcutaneous Oxygen Tension in the Diagnosis of Primary Raynaud's Phenomenon: A Prospective, Controlled Study

    Science.gov (United States)

    Maga, Paweł; Henry, Brandon Michael; Kmiotek, Elizabeth K.; Gregorczyk-Maga, Iwona; Kaczmarczyk, Paweł; Niżankowski, Rafał

    2016-01-01

    The aim of this study was to measure the sensitivity and specificity of transcutaneous oxygen tension and postocclusive hyperemia testing using laser Doppler flowmetry in patients with primary Raynaud's phenomenon. One hundred patients and one hundred controls were included in the study. Baseline microvascular blood flow and then time to peak flow following occlusion were measured using laser Doppler flowmetry. Afterwards, the transcutaneous oxygen tension was recorded. The sensitivities of baseline microvascular blood flow, postocclusive time to peak flow, and transcutaneous oxygen tension were 79%, 79%, and 77%, respectively. The postocclusive time peak flow had a superior specificity of 90% and area under the curve of 0.92 as compared to 66% and 0.80 for baseline microvascular flow and 64% and 0.76 for transcutaneous oxygen tension. Time to postocclusive peak blood flow measured by laser Doppler flowmetry is a highly accurate test for differentiating patients with primary Raynaud's phenomenon from healthy controls. PMID:28101516

  1. Ultrasound techniques in the evaluation of the mediastinum, part I: endoscopic ultrasound (EUS), endobronchial ultrasound (EBUS) and transcutaneous mediastinal ultrasound (TMUS), introduction into ultrasound techniques

    NARCIS (Netherlands)

    Dietrich, Christoph Frank; Annema, Jouke Tabe; Clementsen, Paul; Cui, Xin Wu; Borst, Mathias Maximilian; Jenssen, Christian

    2015-01-01

    Ultrasound imaging has gained importance in pulmonary medicine over the last decades including conventional transcutaneous ultrasound (TUS), endoscopic ultrasound (EUS), and endobronchial ultrasound (EBUS). Mediastinal lymph node staging affects the management of patients with both operable and

  2. Imaging procedures in spinal infectious diseases

    International Nuclear Information System (INIS)

    Rodiek, S.O.

    2001-01-01

    A targeted successful treatment of spinal infectious diseases requires clinical and laboratory data that are completed by the contribution of imaging procedures. Neuroimaging only provides essential informations on the correct topography, localisation, acuity and differential diagnosis of spinal infectious lesions. MRI with its sensitivity concerning soft tissue lesions is a useful tool in detecting infectious alterations of spinal bone marrow, intervertebral disks, leptomeninges and the spinal cord itself. Crucial imaging patterns of typical spinal infections are displayed and illustrated by clinical case studies. We present pyogenic, granulomatous and postoperative variants of spondylodicitis, spinal epidural abscess, spinal meningitis and spinal cord infections. The importance of intravenous contrastmedia application is pointed out. (orig.) [de

  3. Computed tomography of the spinal canal for the cervical spine and spinal cord injury

    International Nuclear Information System (INIS)

    Kimura, Isao; Niimiya, Hikosuke; Nasu, Kichiro; Shioya, Akihide; Ohhama, Mitsuru

    1983-01-01

    The cervical spinal canal and cervical spinal cord were measured in normal cases and 34 cases of spinal or spinal cord injury. The anteroposterior diameter and area of the normal cervical spinal canal showed a high correlation. The area ratio of the normal cervical spinal canal to the cervical spinal cord showed that the proportion of the cervical spinal cord in the spinal canal was 1/3 - 1/5, Csub(4,5) showing a particularly large proportion. In acute and subacute spinal or spinal cord injury, CT visualized in more details of the spinal canal in cases that x-ray showed definite bone injuries. Computer assisted myelography visualized more clearly the condition of the spinal cord in cases without definite findings bone injuries on x-ray. Demonstrating the morphology of spinal injury in more details, CT is useful for selection of therapy for injured spines. (Chiba, N.)

  4. Transcutaneous delivery of CpG-adjuvanted allergen via laser-generated micropores.

    Science.gov (United States)

    Hessenberger, Michael; Weiss, Richard; Weinberger, Esther E; Boehler, Christof; Thalhamer, Josef; Scheiblhofer, Sandra

    2013-07-25

    Two main shortcomings of classical allergen-specific immunotherapy are long treatment duration and low patient compliance. Utilizing the unique immunological features of the skin by transcutaneous application of antigen opens new approaches not only for painless vaccine delivery, but also for allergen-specific immunotherapy. Under certain conditions, however, barrier disruption of the skin favors T helper 2-biased immune responses, which may lead to new sensitizations. In a prophylactic approach, an infra-red laser device was employed, producing an array of micropores of user-defined number, density, and depth on dorsal mouse skin. The grass pollen allergen Phl p 5 was administered by patch with or without the T helper 1-promoting CpG oligodeoxynucleotide 1826 as adjuvant, or was subcutaneously injected. Protection from allergic immune responses was tested by sensitization via injection of allergen adjuvanted with alum, followed by intranasal instillation. In a therapeutic setting, pre-sensitized mice were treated either by the standard method using subcutaneous injection or via laser-generated micropores. Sera were analyzed for IgG antibody subclass distribution by ELISA and for IgE antibodies by a basophil mediator release assay. Cytokine profiles from supernatants of re-stimulated lymphocytes and from bronchoalveolar lavage fluids were assessed by flow cytometry using a bead-based assay. The cellular composition of lavage fluids was determined by flow cytometry. Application of antigen via micropores induced T helper 2-biased immune responses. Addition of CpG balanced the response and prevented from allergic sensitization, i.e. IgE induction, airway inflammation, and expression of T helper 2 cytokines. Therapeutic efficacy of transcutaneous immunotherapy was equal compared to subcutaneous injection, but was superior with respect to suppression of already established IgE responses. Transcutaneous immunotherapy via laser-generated micropores provides an efficient

  5. Management of Penetrating Spinal Cord Injuries in a Non Spinal ...

    African Journals Online (AJOL)

    Background: Penetrating injuries of the spinal cord are among the most dangerous of injuries. They are often associated with injuries to other vital organs of the body, which may demand priority attention. The objectives of this study were to determine the pattern of the penetrating spinal cord injuries and to evaluate outcome ...

  6. Does transcutaneous electrical nerve stimulation (TENS) simultaneously combined with local heat and cold applications enhance pain relief compared with TENS alone in patients with knee osteoarthritis?

    Science.gov (United States)

    Maeda, Takaya; Yoshida, Hideki; Sasaki, Tomoyuki; Oda, Atsushi

    2017-10-01

    [Purpose] The purpose of this study was to investigate whether transcutaneous electrical nerve stimulation simultaneously combined with local heat and cold applications enhances pain relief compared with transcutaneous electrical nerve stimulation alone in patients with knee osteoarthritis. [Subjects and Methods] Fourty-five patients with knee osteoarthritis participated in this study. They were randomly assigned to the following three interventions: transcutaneous electrical nerve stimulation simultaneously combined with local heat using a hot pack; combined with local cold using a cold pack; and transcutaneous electrical nerve stimulation alone. In each intervention, the knee pain level during walking and standing up from a chair, as well as dynamic balance and gait ability were evaluated immediately before and after a single intervention using the visual analogue scale and the timed up & go test, respectively. [Results] A significant improvement in dynamic balance and gait ability was only observed immediately after transcutaneous electrical nerve stimulation simultaneously combined with local heat application, although the degree of pain relief during standing and walking were comparable among the three interventions. [Conclusion] These results suggest that transcutaneous electrical nerve stimulation simultaneously combined with local heat application can immediately improve not only knee pain during standing and walking but also dynamic balance and gait ability in patients with knee osteoarthritis.

  7. 3D splint prototype system for applications in muscular rehab by transcutaneous electrical nerve stimulation (TENS)

    Science.gov (United States)

    Saldaña-Martínez, M. I.; Guzmán-González, J. V.; Barajas-González, O. G.; Guzman-Ramos, V.; García-Garza, A. K.; González-García, R. B.; García-Ramírez, M. A.

    2017-03-01

    It is quite common that patients with ligamentous ruptures, tendonitis, tenosynovitis or sprains are foreseen the use of ad hoc splints for a swift recovery. In this paper, we propose a rehabilitation split that is focused on upper-limb injuries. By considering that upper-limb patient shows a set of different characteristics, our proposal personalizes and prints the splint custom made though a digital model that is generated by a 3D commercial scanner. To fabricate the 3D scanned model the Stereolithography material (SLA) is considered due to the properties that this material offers. In order to complement the recovery process, an electronic system is implemented within the splint design. This system generates a set of pulses for a fix period of time that focuses mainly on a certain group of muscles to allow a fast recovery process known as Transcutaneous Electrical Nerve Stimulation Principle (TENS).

  8. Electromagnetic effects on the biological tissue surrounding a transcutaneous transformer for an artificial anal sphincter system*

    Science.gov (United States)

    Zan, Peng; Yang, Bang-hua; Shao, Yong; Yan, Guo-zheng; Liu, Hua

    2010-01-01

    This paper reports on the electromagnetic effects on the biological tissue surrounding a transcutaneous transformer for an artificial anal sphincter. The coupling coils and human tissues, including the skin, fat, muscle, liver, and blood, were considered. Specific absorption rate (SAR) and current density were analyzed by a finite-length solenoid model. First, SAR and current density as a function of frequency (10–107 Hz) for an emission current of 1.5 A were calculated under different tissue thickness. Then relations between SAR, current density, and five types of tissues under each frequency were deduced. As a result, both the SAR and current density were below the basic restrictions of the International Commission on Non-Ionizing Radiation Protection (ICNIRP). The results show that the analysis of these data is very important for developing the artificial anal sphincter system. PMID:21121071

  9. Transcutaneous cervical vagal nerve stimulation modulates cardiac vagal tone and tumor necrosis factor-alpha.

    Science.gov (United States)

    Brock, C; Brock, B; Aziz, Q; Møller, H J; Pfeiffer Jensen, M; Drewes, A M; Farmer, A D

    2017-05-01

    The vagus nerve is a central component of cholinergic anti-inflammatory pathways. We sought to evaluate the effect of bilateral transcutaneous cervical vagal nerve stimulation (t-VNS) on validated parameters of autonomic tone and cytokines in 20 healthy subjects. 24 hours after t-VNS, there was an increase in cardiac vagal tone and a reduction in tumor necrosis factor-α in comparison to baseline. No change was seen in blood pressure, cardiac sympathetic index or other cytokines. These preliminary data suggest that t-VNS exerts an autonomic and a subtle antitumor necrosis factor-α effect, which warrants further evaluation in larger controlled studies. © 2016 John Wiley & Sons Ltd.

  10. Zwitterionic near infrared fluorescent agents for noninvasive real-time transcutaneous assessment of kidney function.

    Science.gov (United States)

    Huang, Jiaguo; Weinfurter, Stefanie; Daniele, Cristina; Perciaccante, Rossana; Federica, Rodeghiero; Della Ciana, Leopoldo; Pill, Johannes; Gretz, Norbert

    2017-04-01

    We developed novel zwitterionic near infrared (NIR) fluorescent agents (ABZWCY-HPβCD and AAZWCY-HPβCD), which exhibit favorable hydrophilicity, low plasma protein binding, high stability and non-toxicity. These attractive characteristics ensure that they are excreted rapidly, without any skin accumulation or metabolism in vivo . More importantly, zwitterionic HPβCD based agents can be efficiently filtrated by the glomerulus and completely excreted through the kidneys into urine without reabsorption or secretion in the kidney proximal tubule. Relying on these novel zwitterionic NIR agents and a transcutaneous device, we demonstrate a rapid, robust and biocompatible approach for assessing kidney function in rat models of both healthy rats and those with kidney disease, without the need for time-consuming blood/urine sample preparation. Our work provides a promising tool for in vivo real-time non-invasive kidney function assessment in preclinical applications.

  11. RehaMovePro: A versatile mobile stimulation system for transcutaneous FES applications

    Directory of Open Access Journals (Sweden)

    Markus Valtin

    2016-06-01

    Full Text Available Functional Electrical Stimulation is a commonly used method in clinical rehabilitation and research to trigger useful muscle contractions by electrical stimuli. In this work, we present a stimulation system for transcutaneous electrical stimulation that gives extensive control over the stimulation waveform and the stimulation timing. The system supports electrode arrays, which have been suggested to achieve better selectivity and to simplify electrode placement. Electromyography (EMG measurements are obtained from the active stimulation electrodes (between the stimulation pulses or from separate surface EMG electrodes. The modular design enables the implementation of sophisticated stimulation control systems including external triggers or wireless sensors. This is demonstrated by the standalone implementation of a feedback-controlled drop foot neuroprosthesis, which uses a wireless inertial sensor for real-time gait phase detection and foot orientation measurement.

  12. Post spinal meningitis and asepsis.

    Science.gov (United States)

    Videira, Rogerio L R; Ruiz-Neto, P P; Brandao Neto, M

    2002-07-01

    Post spinal meningitis (PSM) is a complication still currently being reported. After two PSM cases in our hospital an epidemiological study was initiated, which included a survey of techniques for asepsis that are applied in our department. Cases defined as PSM comprised meningitis within a week after spinal anesthesia. Anesthesia records, anesthesia complication files and the records of the Hospital Commission for Infection Control from 1997 to 2000 were reviewed. Asepsis techniques applied were surveyed by a questionnaire answered by all our department's anesthesiologists. The equipment and procedures for spinal anesthesia were listed. Current anesthesia textbooks were reviewed for recommendations regarding asepsis techniques in conjunction with spinal anesthesia. Three cases of PSM were identified following 38,128 spinal anesthesias whereas none was observed in 12,822 patients subjected to other types of regional or general anesthesia (P>0.05). Culture of cerebrospinal fluid yielded Streptococcus in two patients and was negative in the other patient. The asepsis technique applied by the anesthesiologists varied considerably. The literature review showed that aspects on asepsis for spinal anesthesia are poorly covered. The incidence of meningitis was similar in patients subjected to spinal anesthesia and in those subjected to other anesthetic techniques. Asepsis techniques were found to differ considerably among our staff members, reflecting the lack of well-defined published standards for this procedure. We recommend that asepsis for spinal anesthesia should not be less rigorous than for surgical asepsis.

  13. Spinal lipomatous malformations.

    Science.gov (United States)

    Jindal, A; Mahapatra, A K

    2000-05-01

    Spinal lipomatous malformations (SLM) include all the closed neural tube defects (NTD) with excessive lipomatous tissue in the spinal cord or filum terminale. We evaluated 65 cases of SLM seen & operated at our department in the last 7 years. Of these only 9 were asymptomatic and 8 were below 2 years of age. There were more males than females. In addition to subcutaneous lipoma many patients also had hypertrichiosis and dermal sinus as cutaneous makes. Twenty patients had foot deformity and 5 had unilateral limb shortening. Sixty-two patients had MRI and 3 had CT myelogram for evaluation. These revealed 7 patients with Chiari malformations, 10 with focal syrinx and 2 patients underwent VP shunt for hydrocephalus. Sacral agenesis was seen in 5 patients. Clinical features were similar to other cases of spinal dysraphism except that sensory loss and trophic ulcer were more frequent. Intradural lipoma and tethering was seen in 18 cases whereas intramedullary lipoma & conus lipoma was seen in 40 & 7 cases respectively. Additional tethering lesion was seen in 1/3 cases and was treated simultaneously. Preoperative deficits improved in 28 cases and stabilized in 33 cases. Three patients developed fresh deficits after surgery. We observed 8 CSF leaks and 4 wound infections in postoperative period. It is very clear from our data that a patient has about 95% chances that his neurological status may improve or stabilize following surgery and the risk of developing fresh deficits is about 5%. We, therefore, suggest that all patients of SLM should be treated with aggressive surgical management for best results.

  14. Feasibility study of Transcutaneous Electrical Nerve Stimulation (TENS) for cancer bone pain.

    Science.gov (United States)

    Bennett, Michael I; Johnson, Mark I; Brown, Sarah R; Radford, Helen; Brown, Julia M; Searle, Robert D

    2010-04-01

    This multicenter study assessed the feasibility of conducting a phase III trial of transcutaneous electrical nerve stimulation (TENS) in patients with cancer bone pain recruited from palliative care services. Eligible patients received active and placebo TENS for 1 hour at site of pain in a randomized crossover design; median interval between applications 3 days. Responses assessed at 30 and 60 minutes included numerical and verbal ratings of pain at rest and on movement, and pain relief. Recruitment, tolerability, adverse events, and effectiveness of blinding were also evaluated. Twenty-four patients were randomised and 19 completed both applications. The intervention was well tolerated. Five patients withdrew: 3 due to deteriorating performance status, and 2 due to increased pain (1 each following active and placebo TENS). Confidence interval estimation around the differences in outcomes between active and placebo TENS suggests that TENS has the potential to decrease pain on movement more than pain on rest. Nine patients did not consider that a placebo was used; the remaining 10 correctly identified placebo TENS. Feasibility studies are important in palliative care prior to undertaking clinical trials. Our findings suggest that further work is required on recruitment strategies and refining the control arm before evaluating TENS in cancer bone pain. Cancer bone pain is common and severe, and partly mediated by hyperexcitability. Animal studies suggest that Transcutaneous Electrical Nerve Stimulation can reduce hyperalgesia. This study examined the feasibility of evaluating TENS in patients with cancer bone pain in order to optimize methods before a phase III trial. Copyright 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.

  15. Transcutaneous contrast-enhanced sonography of pleural-based pulmonary lesions

    Energy Technology Data Exchange (ETDEWEB)

    Goerg, Christian [Department of Internal Medicine, Philipps-University, Baldingerstrasse, Marburg (Germany)], E-mail: goergc@med.uni-marburg.de

    2007-11-15

    Objective: Transcutaneous ultrasound enables visualization of pleural-based lesions but with a poor correlation to specific pathology. Ultrasound contrast agents in conjunction with contrast-specific imaging techniques are increasingly accepted in clinical use. Based on the dual arterial supply of the lung, this organ is suited for evaluation of arterial vascularity by contrast-enhanced sonography (CES). This review will present first data about practise and clinical use of CES in patient with peripheral lung lesions. Methods: This review is based on the experience of transcutaneous CES in 350 patients with chest pathology diagnosed by B-mode sonography at an internal medicine center. CES studies were performed with a contrast-devoted unit (Acuson, Sequoia, Siemens medical solution) that had contrast-specific, continuous-mode software. A low mechanical index was used. A sulfur hexafluoride-based microbubble contrast medium (Sonovue, Bracco SpA, Milan, Italy) was injected. Pulmonary lesions were characterized by CES regarding time to enhancement (TE) and extend of enhancement (EE). Results: CES in peripheral lung lesions is feasible and depending on underlying diseases lesions may show a variable TE and EE. CES enables to distinguish pulmonary arterial supply from bronchial arterial supply by TE. First experiences with CES have shown that various peripheral lung lesions do have a characteristic CES pattern regarding TE and EE. First clinical data show that there are clinical conditions, which may show a diagnostic advantage of CES in comparison to B-mode US. CES may be helpful (1) to confirm diagnosis of pleurisy, (2) to confirm diagnosis peripheral pulmonary embolism, (3) to characterize lung opafication to atelectasis, pneumonia, and tumor, and (4) to assist in interventional procedures. Conclusion: CES of the chest is limited to pleural-based lesions. CES enables to characterize lung lesions regarding TE and EE. The clinical benefit is yet unclear, but first

  16. Transcutaneous electrical nerve stimulation in the treatment of patients with poststroke urinary incontinence

    Directory of Open Access Journals (Sweden)

    Guo ZF

    2014-05-01

    Full Text Available Zhui-feng Guo,1,* Yi Liu,2,* Guang-hui Hu,1 Huan Liu,1 Yun-fei Xu11Department of Urology, 2Department of Neurology, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, People’s Republic of China*These authors contributed equally to this workPurpose: To investigate the therapeutic effect of transcutaneous electrical nerve stimulation (TENS on poststroke urinary incontinence (UI.Patients and methods: Sixty-one patients with poststroke UI were enrolled at the Neurology Department in the Shanghai Tenth People’s Hospital of Tongji University between January 2010–January 2011 and were divided into treatment and control groups (n=32 and n=29, respectively. TENS was applied to the treatment group, while the control group received basic therapy. The therapeutic group completed the whole set of TENS therapy with a treatment frequency of 30 minutes once a day for 60 days. The positive electrode was placed on the second lumbar spinous process, and the negative electrodes were inside the middle and lower third of the junction between the posterior superior iliac spine and ischia node. The overactive bladder symptom score, Barthel Index, and urodynamics examination were estimated before and after therapy in both groups.Results: The daily micturition, nocturia, urgent urination, and urge UI in the treatment group significantly improved compared to the control group (P<0.05. The patients in the treatment group were superior in the self-care ability of daily living and also had an advantage over the indexes on maximum cystometry volume, flow rate, and the pressure of detrusor in the end of the filling phase.Conclusion: TENS improved incontinence symptoms, enhanced the quality of life, and decreased adverse effects; hence, it is recommended in treating poststroke UI.Keywords: stroke, urinary incontinence, OABSS, Barthel Index, urodynamics, transcutaneous electrical nerve stimulation

  17. Simultaneous estimation of transcutaneous bilirubin, hemoglobin, and melanin based on diffuse reflectance spectroscopy

    Science.gov (United States)

    Nishidate, Izumi; Abdul, Wares MD.; Ohtsu, Mizuki; Nakano, Kazuya; Haneishi, Hideaki

    2018-02-01

    We propose a method to estimate transcutaneous bilirubin, hemoglobin, and melanin based on the diffuse reflectance spectroscopy. In the proposed method, the Monte Carlo simulation-based multiple regression analysis for an absorbance spectrum in the visible wavelength region (460-590 nm) is used to specify the concentrations of bilirubin (Cbil), oxygenated hemoglobin (Coh), deoxygenated hemoglobin (Cdh), and melanin (Cm). Using the absorbance spectrum calculated from the measured diffuse reflectance spectrum as a response variable and the extinction coefficients of bilirubin, oxygenated hemoglobin, deoxygenated hemoglobin, and melanin, as predictor variables, multiple regression analysis provides regression coefficients. Concentrations of bilirubin, oxygenated hemoglobin, deoxygenated hemoglobin, and melanin, are then determined from the regression coefficients using conversion vectors that are numerically deduced in advance by the Monte Carlo simulations for light transport in skin. Total hemoglobin concentration (Cth) and tissue oxygen saturation (StO2) are simply calculated from the oxygenated hemoglobin and deoxygenated hemoglobin. In vivo animal experiments with bile duct ligation in rats demonstrated that the estimated Cbil is increased after ligation of bile duct and reaches to around 20 mg/dl at 72 h after the onset of the ligation, which corresponds to the reference value of Cbil measured by a commercially available transcutaneous bilirubin meter. We also performed in vivo experiments with rats while varying the fraction of inspired oxygen (FiO2). Coh and Cdh decreased and increased, respectively, as FiO2 decreased. Consequently, StO2 was dramatically decreased. The results in this study indicate potential of the method for simultaneous evaluation of multiple chromophores in skin tissue.

  18. The design, use, and results of transcutaneous carbon dioxide analysis: current and future directions.

    Science.gov (United States)

    Eberhard, Patrick

    2007-12-01

    Transcutaneous carbon dioxide (CO2) analysis was introduced in the early 1980s using locally heated electrochemical sensors that were applied to the skin surface. This methodology provides a continuous noninvasive estimation of the arterial CO2 value and can be used for assessing adequacy of ventilation. The technique is now established and used routinely in clinical practice. Transcutaneous partial pressure of CO2 (tcPco2) sensors are available as a single Pco2 sensor, as a combined Pco2/Po2 sensor, and more recently, as a combined Pco2/Spo2 sensor. CO2 is still measured potentiometrically by determining the pH of an electrolyte layer. The methodology has been continuously developed during the last 20 yr, making the tcPco2 systems easier and more reliable for use in clinical practice: smaller sensor size (diameter 15 mm, height 8 mm), less frequent sensor re-membraning (every 2 wk) and calibration (twice a day), sensor ready to use when connected to the monitor, lower sensor temperature (42 degrees C), shorter arterialization time (3 min), and increased measurement reliability through protection of the membrane. The present tcPco2 sensors still need to be regularly re-membraned and calibrated. One way to overcome these procedures is to use optical-only detection means. Two techniques have been developed using optical absorption in the near-infrared light, in the evanescent wave of a waveguide integrated in the sensor surface, or in a micro-optics sampling cell. Preliminary in vitro and in vivo CO2 measurements have been performed. The sensor is not affected by drift over several days, and its response time is <1 min.

  19. Picosecond time-gated Raman spectroscopy for transcutaneous evaluation of bone composition

    Science.gov (United States)

    Morris, Michael D.; Draper, Edward R. C.; Goodship, Allen E.; Matousek, Pavel; Towrie, Michael; Parker, Anthony W.; Camacho, Nancy P.

    2005-04-01

    For efficacious transcutaneous monitoring of bone mineralization and matrix quality a spatially averaged measurement is needed, often over a large area. This precludes the use of confocal microscopy. We use picosecond pulsed laser excitation and Kerr-gated time-resolved data collection techniques to obtain marker bands of bone condition whilst rejecting interfering Raman scatter from skin, tendon and other overlying tissue. Alternatively, the methodology can be used to collect signals only from these overlying tissues. In all these experiments the 1 ps pulsed laser beam is focused to approximately 1 mm diameter. Raman light is then collected at specific times following the arrival of the pulse at time delays typically from 0 to 10 ps by opening an ultrafast optical shutter based on a Kerr cell that is driven by a second synchronized laser pulse. This permits specific probing of different layers of tissue. Individual delayed spectra are co-added and the resulting correction signal is subtracted from the ungated composite spectrum or from late-arriving time-resolved spectra. We have validated this methodology using tissue from the metacarpus and radius of several strains of laboratory mice. Overlying skin, flesh and tendon was removed from metacarpus and radius of one foreleg of a mouse and the tissue used as a control. The other foreleg served as the test specimen and was prepared by shaving the hair from the tissue, leaving the skin intact. Transcutaneous time-gated Raman spectra were measured on these specimens. With an 800 nm laser spatially resolved spectroscopy with depth penetration to greater than 1 mm was easily achieved. Normal and defective bone tissue were readily distinguished.

  20. Reproducibility of proximal and distal transcutaneous oxygen pressure measurements during exercise in stage 2 arterial claudication.

    Science.gov (United States)

    Bouyé, P; Picquet, J; Jaquinandi, V; Enon, B; Leftheriotis, G; Saumet, J-L; Abraham, P

    2004-06-01

    Although transcutaneous oxygen pressure measurements (tcpO2) are largely used in the investigation of vascular patients, its reproducibility is still debated. Indeed an unpredictable gradient exists between arterial and transcutaneous oxygen pressure. We hypothesised that indices taking into account changes over time and independent of absolute starting values would be more reproducible than other indices. comparative test-retest procedure (1 to 13 days between tests). institutional practice, ambulatory care. 15 subjects with stage 2 claudication. tcpO2 recordings at rest and at exercise during the 2 treadmill tests. calculation of the Delta-from-rest of oxygen pressure index (limb tcpO2 changes minus chest tcpO2 changes), of the resting - or minimal values attained during exercise - of absolute tcpO2 and of the regional perfusion index (regional perfusion index: ration of limb to chest). Both absolute tcpO2 and regional perfusion index at rest showed low reproducibility. During exercise the best reproducibility was attained through Delta-from-rest of oxygen pressure index calculation. Equations from the linear regression analysis (test 2 versus test 1) were 0.88 x -4.2 (r(2)=0.82) at the buttock level and 0.82 x -3.8 (r(2)=0.80) at the calf level. TcpO2 measurement on the calf or buttock during exercise, is a reproducible measurement in patients with vascular claudication, specifically when corrected for exercise-induced systemic pO2 changes trough Delta-from-rest of oxygen pressure calculation.

  1. [Value of transcutaneous staged dynamic oximetry of stage II arteritis of the leg].

    Science.gov (United States)

    Grard, C; Desmytterre, J; Vinckier, L; Hatron, P Y; Roux, J P; Warembourg, H; Devulder, B

    1990-03-01

    The clinical and prognostic value of transcutaneous oxygen pressure measurements at rest has been established in Leriche Stage III and IV occlusive peripheral arterial disease but is controversial in Stage II because there is an overlap of transcutaneous pO2 (Tc pO2) values with those of normal subjects. The authors report the results of Tc pO2 measurements during exercise testing in a group of patients with Stage II occlusive arterial disease of the lower limbs. Seventy-eight patients with an average age of 53 years (range 40 to 65 years) whose claudication perimeter and site of pain had been carefully assessed and who had also recently undergone Doppler arterial examination and arteriography and 35 control subjects with an average age of 54 years (range 45 to 70 years) were studied. The Tc pO2 was continuously measured with a multimodular Kontron Supermon at 4 different sites simultaneously: precordium (reference probe), thigh, calf and foot in the dorsal recumbent position after 30 minutes rest, during a standardised exercise stress test at 50 watts and during the recovery phase. The results were expressed as ratio of tissue oxygenation (RTO): thigh, calf or foot Tc pO2/precordial Tc pO2 X 100 in order to take into account the patients cardiorespiratory status and adaptation to exercise. The RTO in normal subjects remained at the upper limits of the resting value throughout exercise and then returned slowly to basal values during the recovery phase.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Efficacy and quality of life after transcutaneous posterior tibial neuromodulation for faecal incontinence.

    Science.gov (United States)

    Jiménez-Toscano, M; Vega, D; Fernandez-Cebrián, J M; Valle Martín, B; Jiménez-Almonacid, P; Rueda Orgaz, J A

    2015-08-01

    The aim of this study was to evaluate the efficacy of transcutaneous neuromodulation of the posterior tibial nerve for faecal incontinence and to assess quality of life after the procedure. A prospective non-randomized cohort study was conducted in a tertiary centre from September 2010 to May 2013. All patients with faecal incontinence who met the inclusion criteria were included and were treated as outpatients during a 3-month period by unilateral neuromodulation of the posterior tibial nerve. The patients were followed 3-monthly for 1 year. Severity scales, a bowel diary and quality of life scales were evaluated prospectively before and after treatment. Twenty-seven patients of median age 67 (interquartile range 60-69) years and a male to female ratio of 1/6 were included. Faecal incontinence was for solid stools in 48.1% of patients with urgency in 55.6%. About one-third (34.6%) had a sphincter defect on ultrasound and reduction of anal canal pressure in 85.2%. There was a significant improvement in episodes of incontinence on the Wexner score and visual analogue scale assessment and a decrease in the number of episodes of incontinence per unit time. The Fecal Incontinence Quality of Life score was improved at the end of the follow-up. No adverse effects were observed. The cost of the treatment was €135 per patient. Transcutaneous posterior tibial nerve neuromodulation provides good treatment for faecal incontinence in terms of efficacy and quality of life. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  3. Postoperative pain in patients undergoing a transcutaneous active bone conduction implant (Bonebridge).

    Science.gov (United States)

    Lassaletta, Luis; Calvino, Miryam; Zernotti, Mario; Gavilán, Javier

    2016-12-01

    The objective of the study was to evaluate postoperative pain following a transcutaneous active conductive hearing implant. 27 patients undergoing Bonebridge (BB) bone conduction implantation were evaluated with two pain-related questionnaires. The Headache Impact Test (HIT-6) was used to measure the degree of disability including none or little impact (≤49), mild (50-55), moderate (56-59), and severe (≥60). The Brief Pain Inventory (BPI) was used to assess pain severity score and function interference (0 = no pain to 10 = worst pain); meaningful pain was considered to be ≥3. The impact of surgical factors on postoperative pain was analyzed. Postoperative BB pain results were compared with 11 Vibrant Soundbridge™ (VSB) and 103 cochlear implant (CI) users. The mean pre- and postoperative HIT-6 scores for BB implantation were 42.6 and 41.8, respectively and the mean preoperative BPI pain severity score changed from 0.6 to 0.9 postoperatively, whereas the preoperative interference score changed from 0.1 to 0.3. None of the mean postoperative values revealed significant pain. The retrosigmoid approach, the need for dural or sinus compression, and the use of bone conduction implant lifts had no significant impact on pain scores. The mean postoperative HIT-6 pain scores for patients with BB, VSB, and CI were 41.8, 46.4, and 42.8, respectively, with the differences not being significant. BB implantation causes no significant postoperative pain irrespective of sinus or dura compression. Pain scores were similar to those experienced by patients with other transcutaneous auditory implants such as middle ear or CIs.

  4. Transcutaneous ultrasound for evaluation of vocal fold movement in patients with thyroid disease

    International Nuclear Information System (INIS)

    Wang, Cheng-Ping; Chen, Tseng-Cheng; Yang, Tsung-Lin; Chen, Chun-Nan; Lin, Chin-Fon; Lou, Pei-Jen; Hu, Ya-Ling; Shieh, Ming-Jium; Hsieh, Fon-Jou

    2012-01-01

    Background: Preoperative evaluation of recurrent laryngeal nerve function is important in the context of thyroid surgery. Transcutaneous ultrasound may be useful to visualize vocal fold movement when evaluating thyroid disease. Methods: A 7–18 MHz linear array transducer was placed transversely on the midline of the thyroid cartilage at the anterior neck of patients with thyroid disease. The gray-scale technique was used, with the scan setting for the thyroid gland. Results: Between August 2008 and March 2010, 705 patients, including 672 patients with normal vocal fold movement and 33 patients with vocal fold paralysis were enrolled. They included 159 male and 546 female patients. Their ages ranged from 10 to 88 years. Vocal fold movement could be seen by ultrasound in 614 (87%) patients, including 589 (88%) patients with normal vocal fold movement and 25 (76%) patients with vocal fold paralysis (p = 0.06). The mean age of patients with visible and invisible vocal fold movement was 46.6 and 57.9 years old, respectively (p = 0.001). Ultrasound was able to see vocal fold movement in 533 (98%) female patients but only in 81 (51%) male patients (p = 0.001). Among the patients with vocal fold paralysis, ultrasound revealed palsied vocal folds in 17 of 18 (94%) female patients but in only 8 of 15 (53%) male patients (p = 0.01). Conclusion: Transcutaneous ultrasound represents an alternative tool to evaluate vocal fold movement for more than 85% of patients with thyroid disease, including more than 90% of female patients and about half of male patients.

  5. [Closed spinal dysraphism].

    Science.gov (United States)

    Bollini, G; Cottalorda, J; Jouve, J L; Labriet, C; Choux, M

    1993-04-01

    This retrospective review included 133 patients with one or several of the following defects: diastematomyelia, neurenteric cyst, dermal sinus or cyst, meningeal malformation, sacral agenesis, tethering of the spinal cord, and lumbosacral lipoma. Physical evaluation readily identified most lumbosacral lipomas, as well as most cases of diastematomyelia since hypertrichosis over the defect was common. Some patients developed life-threatening clinical manifestations, e.g., meningitis due to a dermal sinus. On the basis of this retrospective review and a review of the literature, the clinical and therapeutic aspects of each defect are discussed.

  6. Acupuncture and transcutaneous electric nerve stimulation in the treatment of pain associated with chronic pancreatitis. A randomized study

    DEFF Research Database (Denmark)

    Ballegaard, Søren; Christophersen, S J; Dawids, Steen

    1985-01-01

    In 23 patients with pancreatitis, daily pain for at least 3 months, and no abuse of alcohol, the pain-relieving effect of electroacupuncture (13 patients) or transcutaneous electric nerve stimulation (TENS) (16 patients) was studied. In two prospective studies with a cross-over design, active acu...... acupuncture was compared with sham acupuncture, and TENS of the segmental points of the pancreas with sham treatment. Neither electroacupuncture nor TENS brought about pain relief that could substitute for or supplement medical treatment.......In 23 patients with pancreatitis, daily pain for at least 3 months, and no abuse of alcohol, the pain-relieving effect of electroacupuncture (13 patients) or transcutaneous electric nerve stimulation (TENS) (16 patients) was studied. In two prospective studies with a cross-over design, active...

  7. A new transcutaneous bone anchored hearing device - the Baha® Attract System: the first experience in Turkey.

    Science.gov (United States)

    Işeri, Mete; Orhan, Kadir Serkan; Kara, Ahmet; Durgut, Merve; Oztürk, Murat; Topdağ, Murat; Calışkan, Sebla

    2014-01-01

    In this study, we reported our experience with a new transcutaneous bone conduction hearing device, the Baha® Attract System. This multi-center clinical study included the first 12 patients (8 females, 4 males; mean age 27.6 years; range 5 to 65 years) in whom a new transcutaneous bone conduction system was implanted in Turkey. The mean air-bone gap was 41 dB. Bone smoothing around the implant was needed in five patients. We placed a sound processor in the fourth postoperative week for all patients. Our study results suggest that the new bone conduction implant is promising for the patients with conductive or mixed hearing loss who are unable to wear conventional air conduction hearing aid and comparable to percutaneous systems.

  8. MR imaging of spinal trauma

    International Nuclear Information System (INIS)

    Buchberger, W.; Springer, P.; Birbamer, G.; Judmaier, W.; Kathrein, A.; Daniaux, H.

    1995-01-01

    To assess the value of MR imaging in the acute and chronic stages of spinal trauma. 126 MR examinations of 120 patients were evaluated retrospectively. In 15 cases of acute spinal cord injury, correlation of MR findings with the degree of neurological deficit and eventual recovery was undertaken. Cord anomalies in the acute stage were seen in 16 patients. Intramedullary haemorrhage (n=6) and cord transection (n=2) were associated with complete injuries and poor prognosis, whereas patients with cord oedema (n=7) had incomplete injuries and recovered significant neurological function. In the chronic stage, MR findings included persistent cord compression in 8 patients, syringomyelia or post-traumatic cyst in 12, myelomalacia in 6, cord atrophy in 9, and cord transection in 7 patients. In acute spinal trauma, MR proved useful in assessing spinal cord compression and instability. In addition, direct visualisation and characterisation of posttraumatic changes within the spinal cord may offer new possibilities in establishing the prognosis for neurological recovery. In the later stages, potentially remediable causes of persistent or progressive symptoms, such as chronic spinal cord compression or syringomyelia can be distinguished from other sequelae of spinal trauma, such as myelomalacia, cord transection or atrophy. (orig.) [de

  9. Transcutaneous application of carbon dioxide (CO2 induces mitochondrial apoptosis in human malignant fibrous histiocytoma in vivo.

    Directory of Open Access Journals (Sweden)

    Yasuo Onishi

    Full Text Available Mitochondria play an essential role in cellular energy metabolism and apoptosis. Previous studies have demonstrated that decreased mitochondrial biogenesis is associated with cancer progression. In mitochondrial biogenesis, peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α regulates the activities of multiple nuclear receptors and transcription factors involved in mitochondrial proliferation. Previously, we showed that overexpression of PGC-1α leads to mitochondrial proliferation and induces apoptosis in human malignant fibrous histiocytoma (MFH cells in vitro. We also demonstrated that transcutaneous application of carbon dioxide (CO(2 to rat skeletal muscle induces PGC-1α expression and causes an increase in mitochondrial proliferation. In this study, we utilized a murine model of human MFH to determine the effect of transcutaneous CO(2 exposure on PGC-1α expression, mitochondrial proliferation and cellular apoptosis. PGC-1α expression was evaluated by quantitative real-time PCR, while mitochondrial proliferation was assessed by immunofluorescence staining and the relative copy number of mitochondrial DNA (mtDNA was assessed by real-time PCR. Immunofluorescence staining and DNA fragmentation assays were used to examine mitochondrial apoptosis. We also evaluated the expression of mitochondrial apoptosis related proteins, such as caspases, cytochorome c and Bax, by immunoblot analysis. We show that transcutaneous application of CO(2 induces PGC-1α expression, and increases mitochondrial proliferation and apoptosis of tumor cells, significantly reducing tumor volume. Proteins involved in the mitochondrial apoptotic cascade, including caspase 3 and caspase 9, were elevated in CO(2 treated tumors compared to control. We also observed an enrichment of cytochrome c in the cytoplasmic fraction and Bax protein in the mitochondrial fraction of CO(2 treated tumors, highlighting the involvement of mitochondria in apoptosis

  10. Study of the effectiveness of interferential current as compared to transcutaneous electrical nerve stimulation in reducing chronic low back pain

    OpenAIRE

    Dohnert,Marcelo Baptista; Bauer,Jordana Peres; Pavão,Tiago Sebastiá

    2015-01-01

    BACKGROUND AND OBJECTIVES: Chronic low back pain has an incidence of 70% in general population and induces significant limitations. As treatment, physiotherapy stands out with a wide variety of techniques among them, for pain relief, electrotherapy is a useful tool. This study aimed at comparing the analgesic effects of transcutaneous electrical nerve stimulation and interferential current in patients with chronic low back pain. METHODS: Randomized clinical trial carried out between August 20...

  11. Acupuncture and transcutaneous electric nerve stimulation in the treatment of pain associated with chronic pancreatitis. A randomized study

    DEFF Research Database (Denmark)

    Ballegaard, Søren; Christophersen, S J; Dawids, Steen

    1985-01-01

    In 23 patients with pancreatitis, daily pain for at least 3 months, and no abuse of alcohol, the pain-relieving effect of electroacupuncture (13 patients) or transcutaneous electric nerve stimulation (TENS) (16 patients) was studied. In two prospective studies with a cross-over design, active acu...... acupuncture was compared with sham acupuncture, and TENS of the segmental points of the pancreas with sham treatment. Neither electroacupuncture nor TENS brought about pain relief that could substitute for or supplement medical treatment....

  12. Comparison of Audiological Results Between a Transcutaneous and a Percutaneous Bone Conduction Instrument in Conductive Hearing Loss.

    Science.gov (United States)

    Gerdes, Timo; Salcher, Rolf Benedikt; Schwab, Burkard; Lenarz, Thomas; Maier, Hannes

    2016-07-01

    In conductive, mixed hearing losses and single-sided-deafness bone-anchored hearing aids are a well-established treatment. The transcutaneous transmission across the intact skin avoids the percutaneous abutment of a bone-anchored device with the usual risk of infections and requires less care.In this study, the audiological results of the Bonebridge transcutaneous bone conduction implant (MED-EL) are compared to the generally used percutaneous device BP100 (Cochlear Ltd., Sydney, Australia). Ten patients implanted with the transcutaneous hearing implant were compared to 10 matched patients implanted with a percutaneous device. Tests included pure-tone AC and BC thresholds and unaided and aided sound field thresholds. Speech intelligibility was determined in quiet using the Freiburg monosyllable test and in noise with the Oldenburg sentence test (OLSA) in sound field with speech from the front (S0). The subjective benefit was assessed with the Abbreviated Profile of Hearing Aid Benefit. In comparison with the unaided condition there was a significant improvement in aided thresholds, word recognition scores (WRS), and speech reception thresholds (SRT) in noise, measured in sound field, for both devices. The comparison of the two devices revealed a minor but not significant difference in functional gain (Bonebridge: PTA = 27.5 dB [mean]; BAHA: PTA = 26.3 dB [mean]). No significant difference between the two devices was found when comparing the improvement in WRSs and SRTs (Bonebridge: improvement WRS = 80% [median], improvement SRT = 6.5 dB SNR [median]; BAHA: improvement WRS = 77.5% [median], BAHA: improvement SRT = 6.9 dB SNR [median]). Our data show that the transcutaneous bone conduction hearing implant is an audiologically equivalent alternative to percutaneous bone-anchored devices in conductive hearing loss with a minor sensorineural hearing loss component.

  13. Sleep Disordered Breathing and Spinal Cord Injury: Challenges and Opportunities.

    Science.gov (United States)

    Sankari, Abdulghani; Martin, Jennifer L; Badr, M Safwan

    2017-12-01

    This paper focuses on the sleep disorders in patients with spinal cord injury (SCI/D), particularly mechanism of sleep disordered breathing (SDB) and challenges in diagnosis and management. Based on a review of recent literatures and studies the paper summarizes some main challenges with respect to management of SDB in patients with SCI; and what are the responsible mechanisms of disease? What are the barriers in diagnosing and treating SDB using standard treatment such as positive airway pressure (CPAP)?. Previous studies have shown that most SCI/D patients have SDB with heterogeneity in prevalence mainly related to using different definition or methods of diagnosing SDB, while recent studies using new definition of SDB based on recommended criteria from the American Academy of Sleep Medicine (AASM) and also include the data on effect of SCI/D level on prevalence and describe different type of SDB. Furthermore, recent data describes simplified method of diagnosing SDB by using a combination of home sleep apnea testing and transcutaneous CO2 monitoring. Finally, emerging data has been pointing at strong relationship between SDB and cardiovascular disease including nocturnal hypertension in patients with SCI/D. The findings indicate that early testing for SDB and associated cardiovascular disease in patients with SCI is recommended and could be beneficial in reduced the high morbidity and mortality in this group of patients with disability. In addition, studies on treatment of other sleep disorders in SCI/D are not available to inform clinical decision making. Understanding the pathophysiology of sleep disorders in SCI/D is critical for the development of new effective therapies. This review provides evidence for best practices; highlights new discoveries for the diagnosis and management of sleep disorders in SCI/D, and discuss challenges and future directions.

  14. Diagnosis of spinal cord diseases

    International Nuclear Information System (INIS)

    Halimi, P.; Sigal, R.; Doyon, D.; David, P.

    1989-01-01

    Magnetic resonance imaging (MRI) nowadays plays a predominant role in the diagnosis and evaluation of spinal canal pathologies and has reduced the other exploratory methods, including computerized tomography (CT) and myelography, to an ancillary role. These pathologies are divided into three groups: those where MRI is the only imaging method (syringomyela, tumours in the spinal canal, phakomatoses, external pachimeningitis, spinal cord injuries, myelitis); those where MRI is the initial method and is completed by other examinations (vascular malformations, dysraphism, myelopathies due to cervical osteoarthritis) and those where MRI still play a lesser role than CT (degenerative lesions of the lumbar column) [fr

  15. Modern spinal instrumentation. Part 1: Normal spinal implants

    International Nuclear Information System (INIS)

    Davis, W.; Allouni, A.K.; Mankad, K.; Prezzi, D.; Elias, T.; Rankine, J.; Davagnanam, I.

    2013-01-01

    The general radiologist frequently encounters studies demonstrating spinal instrumentation, either as part of the patient's postoperative evaluation or as incidental to a study performed for another purpose. There are various surgical approaches and devices used in spinal surgery with an increased understanding of spinal and spinal implant biomechanics drives development of modern fixation devices. It is, therefore, important that the radiologist can recognize commonly used devices and identify their potential complications demonstrated on imaging. The aim of part 1 of this review is to familiarize the reader with terms used to describe surgical approaches to the spine, review the function and normal appearances of commonly used instrumentations, and understand the importance of the different fixation techniques. The second part of this review will concentrate on the roles that the different imaging techniques play in assessing the instrumented spine and the recognition of complications that can potentially occur.

  16. Radiology of spinal trauma

    International Nuclear Information System (INIS)

    Kassel, E.E.; Cooper, P.W.; Rubenstein, J.D.

    1983-01-01

    The early diagnostic management of patients with acute spinal canal trauma may be among the most difficult injuries referred to a trauma centre. No standardized protocol exists. Radiographic examinations commence with plain films, including special views. Further radiographic studies, if required, vary and include CT, myelography and conventional tomography. CT and metrizamide myelography are complementary. In more complicated fracture-dislocations, all of the above investigations may be necessary. Recent advances, including water-soluble contrast media, the lateral C1-2 puncture and CT, now offer faster, safer and more thorough follow-up investigations with less radiation exposure. Patients with multiple injuries, previously considered too severely injured to undergo further neurologic investigations, may now be more adequately assessed early in the acute phase of injury such that appropriate surgical decompression or stabilization may be performed. The maximum attainable neurologic improvement for such individuals may be better realized with the improved radio-diagnostic capabilities available

  17. Chronic spinal subdural hematoma; Spinales chronisches subdurales Haematom

    Energy Technology Data Exchange (ETDEWEB)

    Hagen, T.; Lensch, T. [Radiologengemeinschaft, Augsburg (Germany)

    2008-10-15

    Compared with spinal epidural hematomas, spinal subdural hematomas are rare; chronic forms are even more uncommon. These hematomas are associated not only with lumbar puncture and spinal trauma, but also with coagulopathies, vascular malformations and tumors. Compression of the spinal cord and the cauda equina means that the patients develop increasing back or radicular pain, followed by paraparesis and bladder and bowel paralysis, so that in most cases surgical decompression is carried out. On magnetic resonance imaging these hematomas present as thoracic or lumbar subdural masses, their signal intensity varying with the age of the hematoma. We report the clinical course and the findings revealed by imaging that led to the diagnosis in three cases of chronic spinal subdural hematoma. (orig.) [German] Spinale subdurale Haematome sind im Vergleich zu epiduralen Haematomen selten, chronische Verlaufsformen noch seltener. Ursaechlich sind neben Lumbalpunktionen und traumatischen Verletzungen auch Blutgerinnungsstoerungen, Gefaessmalformationen und Tumoren. Aufgrund der Kompression von Myelon und Cauda equina kommt es zu zunehmenden Ruecken- oder radikulaeren Schmerzen mit anschliessender Paraparese sowie einer Darm- und Blasenstoerung, weshalb in den meisten Faellen eine operative Entlastung durchgefuehrt wird. Magnetresonanztomographisch stellen sich die Haematome meist als thorakale bzw. lumbale subdurale Raumforderungen dar, die Signalintensitaet variiert mit dem Blutungsalter. Wir berichten ueber den klinischen Verlauf und die bildgebende Diagnostik von 3 Patienten mit spinalen chronischen subduralen Haematomen. (orig.)

  18. Spinal cord giant arteriovenous fistulae

    International Nuclear Information System (INIS)

    Aymard, A.; Reizine, D.; Marciano, S.; Cervigon, E.G.; Gelbert, F.; Merland, J.J.

    1988-01-01

    Giant extramedullary arteriovenous fistulas fed by spinal arteries are a rare type of spinal cord arteriovenous malformation. Among 11 patient (mean age, 20 years) with spinal hemorrhage in childhood, progressive paraplegia, and myelographic and angiographic diagnosis, magnetic resonance imaging demonstrated the precised extramedulary location and complications (thrombosis 1). Angiography showed dilated spinal arteries feeding giant, high flow fistulas with much venous drainage. Endovascular treatment was performed in 11 cases, with balloons in seven, particulate embolization in three, and polymerizing agents in one. Complete closures of the shunt with clinical improvement was achieved in seven cases and partial closure with partial clinical recovery in two; there was one case each of paraplegia due to involuntary venous blockage by the balloon, and fatal bulbomedullary stroke in particulate embolization of cervical location. Careful endovascular techniques represent a valuable treatment in this severe pathology

  19. Imaging of extradural spinal lesions

    International Nuclear Information System (INIS)

    Ahlhelm, F.; Schulte-Altedorneburg, G.; Naumann, N.; Reith, W.; Nabhan, A.

    2006-01-01

    There is a wide variety of spinal extradural tumors. In addition to real neoplasms, degenerative diseases, congenital abnormalities and inflammatory disorders can be causes of extradural masses. Due to the bony boundary of the spinal canal, both benign as well as malignant masses can cause progressive neurological deficits including paraplegia. Most of the spinal tumors are benign (hemangioma of the vertebral body, degenerative diseases). In younger patients congenital abnormalities and primary tumors of the spine have to be considered, whereas in adults the list of differential diagnoses should include secondary malignancies such as metastases and lymphomas as well as metabolic disorders such as osteoporotic vertebral compression fracture and Paget's disease. Cross-sectional imaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) of the spine often help to make a specific diagnosis of extradural spinal lesions and represent important tools for tumor staging and preoperative evaluation. (orig.) [de

  20. Cerebral spinal fluid (CSF) collection

    Science.gov (United States)

    ... ency/article/003428.htm Cerebral spinal fluid (CSF) collection To use the sharing features on this page, please enable JavaScript. Cerebrospinal fluid (CSF) collection is a test to look at the fluid ...

  1. Assessing attitudes toward spinal immobilization.

    Science.gov (United States)

    Bouland, Andrew J; Jenkins, J Lee; Levy, Matthew J

    2013-10-01

    Prospective studies have improved knowledge of prehospital spinal immobilization. The opinion of Emergency Medical Services (EMS) providers regarding spinal immobilization is unknown, as is their knowledge of recent research advances. To examine the attitudes, knowledge, and comfort of prehospital and Emergency Department (ED) EMS providers regarding spinal immobilization performed under a non-selective protocol. An online survey was conducted from May to July of 2011. Participants were drawn from the Howard County Department of Fire and Rescue Services and the Howard County General Hospital ED. The survey included multiple choice questions and responses on a modified Likert scale. Correlation analysis and descriptive data were used to analyze results. Comfort using the Kendrick Extrication Device was low among ED providers. Experienced providers were more likely to indicate comfort using this device. Respondents often believed that spinal immobilization is appropriate in the management of penetrating trauma to the chest and abdomen. Reported use of padding decreased along with the frequency with which providers practice and encounter immobilized patients. Respondents often indicated that they perform spinal immobilization due solely to mechanism of injury. Providers who feel as if spinal immobilization is often performed unnecessarily were more likely to agree that immobilization causes an unnecessary delay in patient care. The results demonstrate the need for improved EMS education in the use of the Kendrick Extrication Device, backboard padding, and spinal immobilization in the management of penetrating trauma. The attitudes highlighted in this study are relevant to the implementation of a selective spinal immobilization protocol. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Transcutaneous Electrical Nerve Stimulation Combined with Oxybutynin is Superior to Monotherapy in Children with Urge Incontinence: A Randomized, Placebo Controlled Study.

    Science.gov (United States)

    Borch, Luise; Hagstroem, Soeren; Kamperis, Konstantinos; Siggaard, C V; Rittig, Soeren

    2017-08-01

    We evaluated whether combination therapy with transcutaneous electrical nerve stimulation and oxybutynin results in a superior treatment response compared to either therapy alone in children with urge incontinence. In this placebo controlled study 66 children with a mean ± SD age of 7.3 ± 1.6 years who were diagnosed with urge incontinence were randomized to 3 treatment groups. Group 1 consisted of 22 children undergoing transcutaneous electrical nerve stimulation plus active oxybutynin administration. Group 2 included 21 children undergoing active transcutaneous electrical nerve stimulation plus placebo oxybutynin administration. Group 3 consisted of 23 children undergoing active oxybutynin administration plus placebo transcutaneous electrical nerve stimulation. The children received active or placebo transcutaneous electrical nerve stimulation over the sacral S2 to S3 outflow for 2 hours daily in combination with 5 mg active or placebo oxybutynin twice daily. The intervention period was 10 weeks. Primary outcome was number of wet days weekly. Secondary outcomes were severity of incontinence, frequency, maximum voided volume over expected bladder capacity for age, average voided volume over expected bladder capacity for age and visual analogue scale score. Combination therapy was superior to oxybutynin monotherapy, with an 83% greater chance of treatment response (p = 0.05). Combination therapy was also significantly more effective than transcutaneous electrical nerve stimulation monotherapy regarding reduced number of wet days weekly (mean difference -2.28, CI -4.06 to -0.49), severity of incontinence (-3.11, CI -5.98 to -0.23) and daily voiding frequency (-2.82, CI -4.48 to -1.17). Transcutaneous electrical nerve stimulation in combination with oxybutynin for childhood urge incontinence was superior to monotherapy consisting of transcutaneous electrical nerve stimulation or oxybutynin, although the latter only reached borderline statistical significance

  3. Parasacral transcutaneous electrical stimulation for overactive bladder in children: An assessment per session.

    Science.gov (United States)

    Veiga, Maria Luiza; Queiroz, Ana Paula; Carvalho, Maria Clara; Braga, Ana Aparecida Nascimento Martineli; Sousa, Ariane Sampaio; Barroso, Ubirajara

    2016-10-01

    Neuromodulation has emerged as an effective therapeutic option for treatment of OAB in children. However, to our knowledge, no study has yet evaluated the results of neuromodulation on a session-by-session basis. The aim of this study was to evaluate the rate of complete response of overactive bladder (OAB) symptoms for each session of transcutaneous electrical stimulation (TENS), in a protocol of 20 sessions of therapy. This is a prospective study of the improvement of LUTS in children with isolated OAB. Included in this study were children over the age of 4 years who complained of urinary urgency, had bell-or tower-shaped uroflowmetry patterns, and post-void residual urinary tract symptoms (LUTS) secondary to urinary tract abnormalities. All patients underwent parasacral transcutaneous neurostimulation (TENS). The development of symptoms was observed right before each session using a visual analog scale (VAS) in which 0 means the absence of improvement and 10 represents maximum improvement of symptoms. We noted a complete resolution of symptoms (urgency, urge incontinence, frequency, and holding maneuvers) in some patients starting after the third session. In the 10th and 20th (last) sessions, 12 (17.4%) and 38 (55.1%) patients reported a complete resolution of symptoms. After complete resolution, 12 (17.4%) patients reported that their symptoms worsened to a minimum level of 40% improvement, but this was temporary and all returned to 100% improvement. Children who showed an improvement level greater than 50% in the fifth treatment session were 4.18 (p = 0.007) times more likely to have success in the last treatment session. We found that a patient can experience complete symptom resolution as quickly as following the third session of TENS. The complete response rate progressively increases with the number of sessions, slowly until the 12th session and more rapidly after that. When symptom improvement of at least 50% is reported in the fifth session, there is a

  4. Parasacral transcutaneous electrical nerve stimulation for overactive bladder in constipated children: The role of constipation.

    Science.gov (United States)

    Veiga, Maria Luiza; Costa, Elen Veruska; Portella, Inaah; Nacif, Ananda; Martinelli Braga, Ana Aparecida; Barroso, Ubirajara

    2016-12-01

    Parasacral transcutaneous electrical nerve stimulation (TENS) is an effective method for the treatment of overactive bladder (OAB), and, additionally, it accelerates bowel transit time. Therefore, not only does parasacral transcutaneous electrical nerve stimulation (TENS) improve lower urinary tract symptoms (LUTS), but it also resolves the problem of constipation in a significant number of children. Since TENS has a positive effect on LUTS and on the symptoms of fecal retention, it is possible that its action regarding OAB could be directly associated with the improvement in constipation. In other words, the positive effect of parasacral TENS in OAB would be because constipation was resolved. The objective of this study was to test that hypothesis. To test the hypothesis that the positive effect of parasacral TENS in OAB would be because constipation had improved with this method. In this prospective study, children with OAB alone were submitted to parasacral TENS. The inclusion criteria consisted of children with idiopathic OAB alone The Rome III criteria for children of 4-18 years of age were used to diagnose constipation. All the children were treated with 20 sessions of parasacral TENS applied for 20 min, three times weekly on alternating days (Figure). No instructions were given to the participants with respect to diet, laxatives, or pharmaceutical treatment for constipation throughout the study period. None of the patients used anticholinergics. Standard urotherapy was prescribed. Parasacral TENS improves OAB and constipation. The presence of constipation before treatment was not associated with a poorer prognosis insofar as the resolution of the symptoms of OAB was concerned. Likewise, there was no association between the resolution of constipation with parasacral TENS and the resolution of OAB. There was no statistically significant difference in urinary symptoms between the constipated and nonconstipated children. There was an improvement in urgency

  5. Effect of transcutaneous electrical nerve stimulation on parotid saliva flow in patients with hyposalivation

    Directory of Open Access Journals (Sweden)

    P Venkatalakshmi Aparna

    2017-01-01

    Full Text Available Context: In recent days, we have come across an increase incidence of dry mouth as a side effects of drugs and in order to bring an awareness about a simple non- invasive method to increase the salivary flow, we have used TENS which in many way is beneficial to patients with metabolic disorders. Aims and Objectives: The aim is to assess the effectiveness of transcutaneous electrical nerve stimulation on salivary gland function in patients with hyposalivation. Subjects and Methods: The present study included total of 25 subjects with complaint of hyposalivation. Written informed consent was obtained from all the participants. Subjects with pacemakers, autoimmune diseases, pregnancy, and history of salivary gland pathology were excluded from the study. Subjects were asked to refrain from eating, drinking, chewing gum, smoking, and oral hygiene procedures for at least 1 h before the appointment. Unstimulated saliva was collected using modified Carlson Crittenden cup placed over the Stenson's duct bilaterally for 5 min and measured. TENS pads were placed over the parotid region and were activated. The intensity control switch was adjusted for patient's comfort. The intensity was turned up 1 increment at a time at 5 s intervals until the optimal intensity level was reached and stimulated saliva was then collected for 5 min using the modified Carlson Crittenden cup and measured. Any increase in parotid salivary flow (SF with electrostimulation was considered a positive finding. Statistical Analysis Used: A paired t-test, evaluating mean changes in stimulated versus unstimulated SF rates, was applied to look for statistically significant differences using PASW 18.0 for Windows. An independent sample t-test was performed to note difference between genders. Results: There was significant increase in parotid SF in 19 of 25 patients after transcutaneous electrical nerve stimulation. Males showed more salivary secretion when compared to females. Conclusions

  6. Effects of transcutaneous electrical stimulation of lower limb muscles on experimental fatty liver.

    Science.gov (United States)

    El-Kafoury, Bataa M; Seif, Ansam A; El-Aziz Abd El-Hady, Enas A; El-Sebaiee, Ahmed E

    2016-03-01

    Although the beneficial effects of exercise on fatty liver have been described, a previous study conducted at our department showed that transcutaneous electrical muscle stimulation (TEMS) of lower abdominal muscles aggravated fatty liver. The present study aims to evaluate the ability of TEMS of the lower limb muscles to improve fatty liver infiltration. Thirty male Wistar rats were randomly allocated into three groups: control; fructose-fed (F), fed fructose-enriched diet for 6weeks; and fructose-fed with transcutaneous electrical muscle stimulation (F+TEMS), fed fructose-enriched diet for 6weeks and lower limb muscles subjected to TEMS during the last 3weeks of feeding, five sessions/week. Body weight, length, body mass index (BMI), and abdominal and lower limb circumferences were all recorded. Fasting blood glucose, serum insulin, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein, serum albumin, high density lipoprotein cholesterol (HDL-C), triglyceride (TG), and total cholesterol (TC) levels were measured. LDL cholesterol (LDL-C) and the atherogenic index (AI) were calculated. Absolute and relative hepatic weights as well as histological examination of the liver were assessed. Final body weight, abdominal and lower limb circumferences, absolute liver weight, homoeostasis model assessment (HOMA) score, and TG, LDL-C, AI, serum ALT, and AST levels were all significantly reduced in the (F+TEMS) group compared to the (F) group. There was a significant increase in GPx and HDL-C levels, HDL/LDL ratio, and total protein and serum albumin content in (F+TEMS) rats compared to (F) rats. Histologically, hepatic tissue from (F+TEMS) rats had minimal steatotic changes that were restricted to zone 1 and less marked inflammatory cell infiltration compared to (F) rats. TEMS was able to reverse steatosis, hyperglycaemia, insulin resistance, dyslipidaemia, and fatty liver caused by fructose feeding. The study confirmed that the variation in

  7. Anatomy of the Spinal Meninges.

    Science.gov (United States)

    Sakka, Laurent; Gabrillargues, Jean; Coll, Guillaume

    2016-06-01

    The spinal meninges have received less attention than the cranial meninges in the literature, although several points remain debatable and poorly understood, like their phylogenesis, their development, and their interactions with the spinal cord. Their constancy among the chordates shows their crucial importance in central nervous system homeostasis and suggests a role far beyond mechanical protection of the neuraxis. This work provides an extensive study of the spinal meninges, from an overview of their phylogenesis and embryology to a descriptive and topographic anatomy with clinical implications. It examines their involvement in spinal cord development, functioning, and repair. This work is a review of the literature using PubMed as a search engine on Medline. The stages followed by the meninges along the phylogenesis could not be easily compared with their development in vertebrates for methodological aspects and convergence processes throughout evolution. The distinction between arachnoid and pia mater appeared controversial. Several points of descriptive anatomy remain debatable: the functional organization of the arterial network, and the venous and lymphatic drainages, considered differently by classical anatomic and neuroradiological approaches. Spinal meninges are involved in neurodevelopment and neurorepair producing neural stem cells and morphogens, in cerebrospinal fluid dynamics and neuraxis functioning by the synthesis of active molecules, and the elimination of waste products of central nervous system metabolism. The spinal meninges should be considered as dynamic functional formations evolving over a lifetime, with ultrastructural features and functional interactions with the neuraxis remaining not fully understood.

  8. Transcutaneous electrical nerve stimulation and interferential current demonstrate similar effects in relieving acute and chronic pain: a systematic review with meta-analysis.

    Science.gov (United States)

    Almeida, Camila Cadena de; Silva, Vinicius Z Maldaner da; Júnior, Gerson Cipriano; Liebano, Richard Eloin; Durigan, Joao Luiz Quagliotti

    2018-02-02

    Transcutaneous electrical nerve stimulation and interferential current have been widely used in clinical practice. However, a systematic review comparing their effects on pain relief has not yet been performed. To investigate the effects of transcutaneous electrical nerve stimulation and interferential current on acute and chronic pain. We use Pubmed, Embase, LILACS, PEDro and Cochrane Central Register of Controlled Trials as data sources. Two independent reviewers that selected studies according to inclusion criteria, extracted information of interest and verified the methodological quality of the studies made study selection. The studies were selected if transcutaneous electrical nerve stimulation and interferential current were used as treatment and they had pain as the main outcome, as evaluated by a visual analog scale. Secondary outcomes were the Western Ontario Macmaster and Rolland Morris Disability questionnaires, which were added after data extraction. Eight studies with a pooled sample of 825 patients were included. The methodological quality of the selected studies was moderate, with an average of six on a 0-10 scale (PEDro). In general, both transcutaneous electrical nerve stimulation and interferential current improved pain and functional outcomes without a statistical difference between them. Transcutaneous electrical nerve stimulation and interferential current have similar effects on pain outcome The low number of studies included in this meta-analysis indicates that new clinical trials are needed. Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  9. Syrinx of the Spinal Cord and Brain Stem

    Science.gov (United States)

    ... Blockage of the Spinal Cord’s Blood Supply Cervical Spondylosis Compression of the Spinal Cord Hereditary Spastic Paraparesis ... Blockage of the Spinal Cord’s Blood Supply Cervical Spondylosis Compression of the Spinal Cord Hereditary Spastic Paraparesis ...

  10. [Reaction of spinal epidural venous plexuses of the spinal canal in low back spinal discopathy].

    Science.gov (United States)

    Gongal'skiĭ, V V; Prokopovich, E V

    2002-01-01

    Clinical ultrasonic investigations have shown dependence of blood-stream in spinal epidural venous plexuses on the character of low back spinal diskopathy. The leading starting factor of epiduritis is a disk protrusion or large size hernia. Epiduritis in disscopathy can run a chronic course, become a cause of (or complicate) development of vertebral neurological reflex or compression syndromes. One of acceptable diagnostic methods for local epiduritis is an ultrasonic technique which is a valuable adjunct to clinical studies.

  11. MR imaging and spinal cord injury

    International Nuclear Information System (INIS)

    Azar-Kia, B.; Fine, M.; Naheedy, M.; Elias, D.

    1987-01-01

    MR imaging has significantly improved diagnostic capability of spinal cord injuries. Other available diagnostic modalities such as plain films, myelography, CT, and post-CT myelography have failed to consistently show the secific evidence of spinal cord injuries and their true extent. The authors are presenting our experiences with MR imaging in spinal column injury. They have found MR imaging to be the procedure of choice for prognostic evaluation of spinal cord trauma. They are showing examples of recent and old spinal cord injury such as hematomyelia, myelomalacia, transection, spinal cord edema, and cavitation

  12. Spinal trauma. Pathophysiology and management of traumatic spinal injuries.

    Science.gov (United States)

    Shores, A

    1992-07-01

    Spinal trauma can originate from internal or external sources. Injuries to the spinal cord can be classified as either concussive or compressive and concussive. The pathophysiologic events surrounding spinal cord injury include the primary injury (compression, concussion) and numerous secondary injury mechanisms (vascular, biochemical, electrolyte), which are mediated by excessive oxygen free radicles, neurotransmitter and electrolyte alterations in cell membrane permeability, excitotoxic amino acids, and various other biochemical factors that collectively result in reduced SCBF, ischemia, and eventual necrosis of the gray and white matter. Management of acute spinal cord injuries includes the use of a high-dose corticosteroid regimen within the initial 8 hours after trauma. Sodium prednisolone and methylprednisolone, at recommended doses, act as oxygen radical scavengers and are anti-inflammatory. Additional considerations are the stability of the vertebral column, other conditions associated with trauma (i.e., pneumothorax), and the presence or absence of spinal cord compression, which may warrant surgical therapy. Vertebral fractures or luxations can occur in any area of the spine but most commonly occur at the junction of mobile and immobile segments. Dorsal and dorsolateral surgical approaches are applicable to the lumbosacral and thoracolumbar spine and dorsal and ventral approaches to the cervical spine. Indications for surgical intervention include spinal cord compression and vertebral instability. Instability can be determined from the type of fracture, how many of the three compartments of the vertebrae are disrupted, and on occasion, by carefully positioned stress studies of fluoroscopy. Decompression (dorsal laminectomy, hemilaminectomy, or ventral cervical slot) is employed when compression of the spinal cord exists. The hemilaminectomy (unilateral or bilateral) causes less instability than dorsal laminectomy and therefore should be used when practical

  13. [Transcutaneous tibial nerve stimulation in the overactive bladder syndrome in patients with Parkinson's syndromes].

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    Ohannessian, A; Kaboré, F A; Agostini, A; Lenne Aurier, K; Witjas, T; Azulay, J-P; Karsenty, G

    2013-09-01

    To evaluate the efficacy of chronic transcutaneous tibial nerve stimulation (TNS) on overactive bladder syndrome in female patients with Parkinson's disease (PD) and multiple system atrophy (MSA). A prospective monocentric study enrolled six female patients with PD or MSA suffering from overactive bladder syndrome for a six-week study period. Daily sessions of 20 minutes of TNS were provided. The primary outcome measurement was the Patient Global Impression of Improvement (PGI-I scale). The secondary outcomes measurements were symptom and quality of life scores, bladder diary and urodynamics. The outcomes after 6 weeks of TNS were compared to baseline. TNS was considered as an effective treatment by five patients out of six (83%) who ask to pursue the treatment and were still doing it 6 months after the end of the study. A trend improvement was observed in only two of the secondary evaluation criteria the V8 median score 21/40 to 14/40 (P=0.2) and the maximum cystometric capacity increased from 211 mL ± 106 to 260 mL ± 226 (P=0.6) after SNT. Although urodynamics and symptoms scores did not show significant difference, an efficacy of TNS on overactive bladder in PD and MSA is possible. Additional placebo controlled works enrolling more patients are required to ensure these preliminary results. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  14. Interface of data transmission for a transcutaneous communication system using the human body as transmission medium.

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    Okamoto, Eiji; Kato, Yoshikuni; Seino, Kazuyuki; Mitamura, Yoshinori

    2012-03-01

    We have been developing a new transcutaneous communication system (TCS) that uses the human body as an electrical conductive medium. We studied an interface circuit of the TCS in order to optimize the leading data current into the human body effectively. Two types of LC circuits were examined for the interface circuit, one was an LC series-parallel circuit, and the other was a parallel-connected LC circuit. The LC series-parallel circuit connected to the body could be tuned to a resonant frequency, and the frequency was determined by the values of an external inductor and an external capacitor. Permittivity of the body did not influence the electrical resonance. Connection of the LC series-parallel circuit to the body degraded the quality factor Q because of the conductivity of the body. However, the LC parallel-connected circuit when connected to the body did not indicate electrical resonance. The LC series-parallel circuit restricts a direct current and a low-frequency current to flow into the body; thus, it can prevent a patient from getting a shock. According to the above results, an LC series-parallel circuit is an optimum interface circuit between the TCS and the body for leading data current into the body effectively and safely.

  15. Comparison of Transcutaneous Electrical Nerve Stimulation and Parasternal Block for Postoperative Pain Management after Cardiac Surgery

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    Nilgun Kavrut Ozturk

    2016-01-01

    Full Text Available Background. Parasternal block and transcutaneous electrical nerve stimulation (TENS have been demonstrated to produce effective analgesia and reduce postoperative opioid requirements in patients undergoing cardiac surgery. Objectives. To compare the effectiveness of TENS and parasternal block on early postoperative pain after cardiac surgery. Methods. One hundred twenty patients undergoing cardiac surgery were enrolled in the present randomized, controlled prospective study. Patients were assigned to three treatment groups: parasternal block, intermittent TENS application, or a control group. Results. Pain scores recorded 4 h, 5 h, 6 h, 7 h, and 8 h postoperatively were lower in the parasternal block group than in the TENS and control groups. Total morphine consumption was also lower in the parasternal block group than in the TENS and control groups. It was also significantly lower in the TENS group than in the control group. There were no statistical differences among the groups regarding the extubation time, rescue analgesic medication, length of intensive care unit stay, or length of hospital stay. Conclusions. Parasternal block was more effective than TENS in the management of early postoperative pain and the reduction of opioid requirements in patients who underwent cardiac surgery through median sternotomy. This trial is registered with Clinicaltrials.gov number NCT02725229.

  16. Dynamic impedance model of the skin-electrode interface for transcutaneous electrical stimulation.

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    José Luis Vargas Luna

    Full Text Available Transcutaneous electrical stimulation can depolarize nerve or muscle cells applying impulses through electrodes attached on the skin. For these applications, the electrode-skin impedance is an important factor which influences effectiveness. Various models describe the interface using constant or current-depending resistive-capacitive equivalent circuit. Here, we develop a dynamic impedance model valid for a wide range stimulation intensities. The model considers electroporation and charge-dependent effects to describe the impedance variation, which allows to describe high-charge pulses. The parameters were adjusted based on rectangular, biphasic stimulation pulses generated by a stimulator, providing optionally current or voltage-controlled impulses, and applied through electrodes of different sizes. Both control methods deliver a different electrical field to the tissue, which is constant throughout the impulse duration for current-controlled mode or have a very current peak for voltage-controlled. The results show a predominant dependence in the current intensity in the case of both stimulation techniques that allows to keep a simple model. A verification simulation using the proposed dynamic model shows coefficient of determination of around 0.99 in both stimulation types. The presented method for fitting electrode-skin impedance can be simple extended to other stimulation waveforms and electrode configuration. Therefore, it can be embedded in optimization algorithms for designing electrical stimulation applications even for pulses with high charges and high current spikes.

  17. Changes in types of muscle fibers induced by transcutaneous electrical stimulation of the diaphragm of rats

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    D. Costa

    2008-09-01

    Full Text Available The objective of the present study was to assess the effect of transcutaneous electrical diaphragmatic stimulation (TEDS on different types of diaphragm muscle fibers. Male Wistar rats (8-12 weeks old were divided into 2 experimental groups (N = 8 in each group: 1 control, 2 animals submitted to TEDS [frequency = 50 Hz; T ON/T OFF (contraction/relaxation time = 2/2 s; pulse duration = 0.4 ms, intensity = 5 mA with a 1 mA increase every 3 min for 20 min] for 7 days. After completing this treatment period, the I, IIA, IIB, and IID diaphragm muscle fibers were identified using the mATPase technique. Statistical analysis consisted of the normality, homoscedasticity and t-tests (P < 0.05. There was a 19.6% (P < 0.05 reduction in the number of type I fibers and a 49.7% increase (P < 0.05 in type IID fibers in the TEDS group compared with the control group. An important result of the present study was that electrical stimulation with surface electrodes was efficient in altering the distribution of fibers in diaphragm muscle. This therapeutic resource could be used in the treatment of respiratory muscle alterations.

  18. Influence of transcutaneous electrical stimulation on heterotopic ossification: an experimental study in Wistar rats

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    T.G.G. Zotz

    2015-01-01

    Full Text Available Heterotopic ossification (HO is a metaplastic biological process in which there is newly formed bone in soft tissues, resulting in joint mobility deficit and pain. Different treatment modalities have been tried to prevent HO development, but there is no consensus on a therapeutic approach. Since electrical stimulation is a widely used resource in physiotherapy practice to stimulate joint mobility, with analgesic and anti-inflammatory effects, its usefulness for HO treatment was investigated. We aimed to identify the influence of electrical stimulation on induced HO in Wistar rats. Thirty-six male rats (350-390 g were used, and all animals were anesthetized for blood sampling before HO induction, to quantify the serum alkaline phosphatase. HO induction was performed by bone marrow implantation in both quadriceps of the animals, which were then divided into 3 groups: control (CG, transcutaneous electrical nerve stimulation (TENS group (TG, and functional electrical stimulation (FES group (FG with 12 rats each. All animals were anesthetized and electrically stimulated twice per week, for 35 days from induction day. After this period, another blood sample was collected and quadriceps muscles were bilaterally removed for histological and calcium analysis and the rats were killed. Calcium levels in muscles showed significantly lower results when comparing TG and FG (P

  19. Antihypertensive effect of low-frequency transcutaneous electrical nerve stimulation (TENS) in comparison with drug treatment.

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    Silverdal, Jonas; Mourtzinis, Georgios; Stener-Victorin, Elisabet; Mannheimer, Clas; Manhem, Karin

    2012-10-01

    Hypertension is a major risk factor for vascular disease, yet blood pressure (BP) control is unsatisfactory low, partly due to side-effects. Transcutaneous electrical nerve stimulation (TENS) is well tolerated and studies have demonstrated BP reduction. In this study, we compared the BP lowering effect of 2.5 mg felodipin once daily with 30 min of bidaily low-frequency TENS in 32 adult hypertensive subjects (mean office BP 152.7/90.0 mmHg) in a randomized, crossover design. Office BP and 24-h ambulatory BP monitoring (ABPM) were performed at baseline and at the end of each 4-week treatment and washout period. Felodipin reduced office BP by 10/6 mmHg (p TENS reduced office BP by 5/1.5 mmHg (p TENS washout, BP was further reduced and significantly lower than at baseline, but at levels similar to BP after felodipin washout and therefore reasonably caused by factors other than the treatment per se. ABPM revealed a significant systolic reduction of 3 mmHg by felodipin, but no significant changes were noted after TENS. We conclude that our study does not present any solid evidence of BP reduction of TENS.

  20. Effects of transcutaneous electrical nerve stimulation (TENS) on proinflammatory cytokines: protocol for systematic review.

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    Almeida, Tábata Cristina do Carmo; Figueiredo, Francisco Winter Dos Santos; Barbosa Filho, Valter Cordeiro; de Abreu, Luiz Carlos; Fonseca, Fernando Luiz Affonso; Adami, Fernando

    2017-07-11

    Pain reduction can be achieved by lowering proinflammatory cytokine levels in the blood. Transcutaneous electrical nerve stimulation (TENS) is a non-invasive physiotherapeutic resource for pain management, but evidence on the effectiveness of this device at reducing proinflammatory cytokines in the blood is unclear. This study systematically reviews the literature on the effect of TENS on proinflammatory cytokines. A systematic review protocol was developed based on searches of articles in six electronic databases and references of retrieved articles, contact with authors, and repositories of clinical trials. Eligibility criteria: publication in peer-reviewed journals, randomized clinical trials, use of TENS in the experimental group, and pre- and post-measurements of proinflammatory cytokines in the blood. Selection of the studies and extraction of the data will be carried out by two reviewers independently. Characteristics of the study, participants, interventions and outcomes were extracted and described. Assessments were performed on the risk of bias, level of evidence and the size of the intervention effect in the studies, according to GRADE guidelines and the Cochrane Handbook for Systematic Reviews. Clinical and statistical assessments compared the effects of the interventions (meta-analysis), taking into consideration any influencing characteristics of the studies (e.g., methods and application sites). We anticipate that this review will strengthen evidence-based knowledge of the effect of TENS on proinflammatory cytokines and, as a result, direct new studies to benefit patients with specific pathologies. PROSPERO, CRD42017060379 .

  1. Assessing the effects of transcutaneous electrical nerve stimulation (TENS) in post-thoracotomy analgesia.

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    Ferreira, Fabiana Cristina; Issy, Adriana Machado; Sakata, Rioko Kimiko

    2011-01-01

    Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat musculoskeletal pain, but it may also be indicated for postoperative analgesia. The objective of this study was to evaluate the analgesic effects of TENS on post-thoracotomy. Thirty patients between 18 and 60 years of age undergoing thoracotomy for lung cancer resection on the second postoperative day were included in this study. Patients were divided into two groups (G1 and G2). G1 patients were treated with TENS; and in G2 (without TENS) electrodes were placed but the equipment was not turned on. TENS was maintained for one hour. The visual analogue scale was used to evaluate the analgesic effects on three moments: before TENS (M0), immediately after TENS (M1), and one hour later (M2), with the patient at rest, elevation of the upper limbs, change in decubitus, and coughing. The intensity of pain at rest was higher in G2 immediately after TENS, but not one hour after the procedure. There was no difference between both groups with elevation of the upper limbs, decubitus change, and coughing. With the use of TENS for one hour on the second post-thoracotomy day in patients who received fentanyl (50 μg) associated with bupivacaine (5 mL), a reduction in pain intensity was observed at rest immediately after TENS; with elevation of the upper limbs, change in decubitus, and coughing, a reduction in pain severity was not observed. Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

  2. Transcutaneous electrical nerve stimulation (TENS) accelerates cutaneous wound healing and inhibits pro-inflammatory cytokines.

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    Gürgen, Seren Gülşen; Sayın, Oya; Cetin, Ferihan; Tuç Yücel, Ayşe

    2014-06-01

    The purpose of this study was to evaluate transcutaneous electrical nerve stimulation (TENS) and other common treatment methods used in the process of wound healing in terms of the expression levels of pro-inflammatory cytokines. In the study, 24 female and 24 male adult Wistar-Albino rats were divided into five groups: (1) the non-wounded group having no incision wounds, (2) the control group having incision wounds, (3) the TENS (2 Hz, 15 min) group, (4) the physiological saline (PS) group and (5) the povidone iodine (PI) group. In the skin sections, interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were assessed with enzyme-linked immunosorbent assay and immunohistochemical methods. In the non-wounded group, the expression of IL-1β, IL-6, and TNF-α signaling molecules was weaker in the whole tissue; however, in the control group, significant inflammatory response occurred, and strong cytokine expression was observed in the dermis, granulation tissue, hair follicles, and sebaceous glands (P TENS group, the decrease in TNF-α, IL-1β, and IL-6 immunoreaction in the skin was significant compared to the other forms of treatment (P TENS group suggest that TENS shortened the healing process by inhibating the inflammation phase.

  3. Anti-stress effects of transcutaneous electrical nerve stimulation (TENS) on colonic motility in rats.

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    Yoshimoto, Sazu; Babygirija, Reji; Dobner, Anthony; Ludwig, Kirk; Takahashi, Toku

    2012-05-01

    Disorders of colonic motility may contribute to symptoms in patients with irritable bowel syndrome (IBS), and stress is widely believed to play a major role in developing IBS. Stress increases corticotropin releasing factor (CRF) of the hypothalamus, resulting in acceleration of colonic transit in rodents. In contrast, hypothalamic oxytocin (OXT) has an anti-stress effect via inhibiting CRF expression and hypothalamic-pituitary-adrenal axis activity. Although transcutaneous electrical nerve stimulation (TENS) and acupuncture have been shown to have anti-stress effects, the mechanism of the beneficial effects remains unknown. We tested the hypothesis that TENS upregulates hypothalamic OXT expression resulting in reduced CRF expression and restoration of colonic dysmotility in response to chronic stress. Male SD rats received different types of stressors for seven consecutive days (chronic heterotypic stress). TENS was applied to the bilateral hind limbs every other day before stress loading. Another group of rats did not receive TENS treatment. TENS significantly attenuated accelerated colonic transit induced by chronic heterotypic stress, which was antagonized by a central injection of an OXT antagonist. Immunohistochemical study showed that TENS increased OXT expression and decreased CRF expression at the paraventricular nucleus (PVN) following chronic heterotypic stress. It is suggested that TENS upregulates hypothalamic OXT expression which acts as an anti-stressor agent and mediates restored colonic dysmotility following chronic stress. TENS may be useful to treat gastrointestinal symptoms associated with stress.

  4. Transcutaneous electrical nerve stimulation (TENS) for pain control after vaginal delivery and cesarean section.

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    Kayman-Kose, Seda; Arioz, Dagistan Tolga; Toktas, Hasan; Koken, Gulengul; Kanat-Pektas, Mine; Kose, Mesut; Yilmazer, Mehmet

    2014-10-01

    The present study aims to determine the efficiency and reliability of transcutaneous electrical nerve stimulation (TENS) in the management of pain related with uterine contractions after vaginal delivery and the pain related with both abdominal incision uterine contractions after cesarean section. A hundred healthy women who underwent cesarean section under general anesthesia were randomly assigned to the placebo group (Group 1) or the TENS group (Group 2), while 100 women who delivered by vaginal route without episiotomy were randomized into the placebo group (Group 3) or the TENS group (Group 4). The patients in Group 2 had statistically lower visual analog scale (VAS) and verbal numerical scale (VNS) scores than the patients in Group 1 (p TENS (p = 0.006). The need for analgesics at the eighth hour of vaginal delivery was statistically similar in the patients who were treated with TENS and the patients who received placebo (p = 0.830). TENS is an effective, reliable, practical and easily available modality of treatment for postpartum pain.

  5. Efficacy of transcutaneous functional electrical stimulation on urinary incontinence in myelomeningocele: results of a pilot study.

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    Kajbafzadeh, Abdol-Mohammad; Sharifi-Rad, Lida; Dianat, SeyedSaeid

    2010-01-01

    To investigate the efficacy of transcutaneous functional electrical stimulation (FES) on voiding symptoms in children with myelomeningocele (MMC) suffering from neuropathic urinary incontinence. Six girls and 6 boys with moderate to severe urinary incontinence secondary to MMC were included. Median age of children was 5.04 (range: 3-11) years. They underwent a urodynamic study (UDS) before and 3 months after FES with special attention to detrusor leak point pressure (DLPP) and maximal bladder capacity (MBC). Daily incontinence score, frequency of pad changing, and enuresis were also assessed before and three months after treatment. Fifteen courses of FES for 15 minutes 3 times per week were performed with low frequency (40 Hz) electrical current, duration of 250μs, with hold and rest time of 2 seconds. Nine children had improvement on urinary incontinence score, while three children had no improvement. Median DLPP was significantly increased from 38.5 (range: 12-50) cm H2O to 59.5 (range: 18-83) cm H2O (P = 0.003). MBC was significantly increased from median value of 155 (range: 60-250) mL to 200 (range: 110-300) mL (P = 0.007). This is a pilot study showing that FES therapy might have positive effects on improvement of voiding symptoms of MMC children with neurogenic urinary incontinence in terms of daily incontinence score and UDS parameters.

  6. Efficacy of transcutaneous functional electrical stimulation on urinary incontinence in myelomeningocele: results of a pilot study

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    Abdol-Mohammad Kajbafzadeh

    2010-10-01

    Full Text Available PURPOSE: To investigate the efficacy of transcutaneous functional electrical stimulation (FES on voiding symptoms in children with myelomeningocele (MMC suffering from neuropathic urinary incontinence. MATERIALS AND METHODS: Six girls and 6 boys with moderate to severe urinary incontinence secondary to MMC were included. Median age of children was 5.04 (range: 3-11 years. They underwent a urodynamic study (UDS before and 3 months after FES with special attention to detrusor leak point pressure (DLPP and maximal bladder capacity (MBC. Daily incontinence score, frequency of pad changing, and enuresis were also assessed before and three months after treatment. Fifteen courses of FES for 15 minutes 3 times per week were performed with low frequency (40 Hz electrical current, duration of 250µs, with hold and rest time of 2 seconds. RESULTS: Nine children had improvement on urinary incontinence score, while three children had no improvement. Median DLPP was significantly increased from 38.5 (range: 12-50 cm H2O to 59.5 (range: 18-83 cm H2O (P = 0.003. MBC was significantly increased from median value of 155 (range: 60-250 mL to 200 (range: 110-300 mL (P = 0.007. CONCLUSIONS: This is a pilot study showing that FES therapy might have positive effects on improvement of voiding symptoms of MMC children with neurogenic urinary incontinence in terms of daily incontinence score and UDS parameters.

  7. Transcutaneous electrical nerve stimulation in the treatment of patients with poststroke urinary incontinence.

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    Guo, Zhui-feng; Liu, Yi; Hu, Guang-hui; Liu, Huan; Xu, Yun-fei

    2014-01-01

    To investigate the therapeutic effect of transcutaneous electrical nerve stimulation (TENS) on poststroke urinary incontinence (UI). Sixty-one patients with poststroke UI were enrolled at the Neurology Department in the Shanghai Tenth People's Hospital of Tongji University between January 2010-January 2011 and were divided into treatment and control groups (n=32 and n=29, respectively). TENS was applied to the treatment group, while the control group received basic therapy. The therapeutic group completed the whole set of TENS therapy with a treatment frequency of 30 minutes once a day for 60 days. The positive electrode was placed on the second lumbar spinous process, and the negative electrodes were inside the middle and lower third of the junction between the posterior superior iliac spine and ischia node. The overactive bladder symptom score, Barthel Index, and urodynamics examination were estimated before and after therapy in both groups. The daily micturition, nocturia, urgent urination, and urge UI in the treatment group significantly improved compared to the control group (Pincontinence symptoms, enhanced the quality of life, and decreased adverse effects; hence, it is recommended in treating poststroke UI.

  8. Transcutaneous carbon dioxide monitoring in spontaneously breathing, nonintubated patients in the early postoperative period.

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    Fanelli, G; Baciarello, M; Squicciarini, G; Malagutti, G; Zasa, M; Casati, A

    2008-01-01

    The authors investigated the accuracy of transcutaneous capnometry (TcPCO(2)) in estimating arterial blood carbon dioxide partial pressure (PaCO(2)) during spontaneous breathing in patients admitted to our surgical intensive care unit (ICU). Serial TcPCO(2) and PaCO(2) measurements were taken in stable patients undergoing postoperative monitoring after major abdominal, vascular, or thoracic surgery. Patients were enrolled 12 hours after extubation. Exclusion criteria were pulmonary dysfunction, hemodynamic instability, or anemia. Linear regression, mixed models, and Bland-Altman analyses were used to compare accuracy and correlation between the two variables. Data are presented as means (95% confidence intervals). PaCO(2) values ranged between 26 mmHg and 52 mmHg. Mean values for TcPCO(2) and PaCO(2) were 35.3 (33.8-36.8) mmHg and 39.2 (37.6-40.7) (Pbreathing, nonintubated patients in the early postoperative period.

  9. Effectiveness of daily eccentric contractions induced via kilohertz frequency transcutaneous electrical stimulation on muscle atrophy.

    Science.gov (United States)

    Tanaka, Minoru; Nakanishi, Ryosuke; Murakami, Shinichiro; Fujita, Naoto; Kondo, Hiroyo; Ishihara, Akihiko; Roy, Roland R; Fujino, Hidemi

    2016-01-01

    The effects of daily repeated bouts of concentric, isometric, or eccentric contractions induced by high frequency (kilohertz) transcutaneous electrical stimulation in ameliorating atrophy of the soleus muscle in hindlimb unloaded rats were determined. Five groups of male rats were studied: control, hindlimb unloaded for 2 weeks (HU), or HU plus two daily bouts of concentric, isometric, or eccentric high-frequency electrical stimulation-induced contractions of the calf musculature. Soleus mass and fiber size were smaller, the levels of phosphorylated Akt1 and FoxO3a lower, and atrogin-1 and ubiquitinated proteins higher in the HU, and the HU plus concentric or isometric contraction groups than in the control group. In contrast, daily bouts of eccentric contractions maintained these values at near control levels and all measures were significantly different from all other HU groups. These results indicate that daily bouts of eccentric contractions induced by high-frequency stimulation inhibited the ubiquitin-proteasome catabolic pathway and enhanced the Akt1/FoxO3a anabolic pathway that resulted in a prevention of the atrophic response of the soleus muscle to chronic unloading. Copyright © 2015 Elsevier GmbH. All rights reserved.

  10. Transcutaneous measurement of glomerular filtration rate in small rodents: through the skin for the win?

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    Ellery, Stacey J; Cai, Xiaochu; Walker, David D; Dickinson, Hayley; Kett, Michelle M

    2015-03-01

    Rodent models of renal physiology and pathology are crucial to our understanding of the molecular, histological and functional sequelae that contribute to kidney diseases. One of the most important measures of renal function is glomerular filtration rate (GFR). While the accurate determination of GFR is pivotal to understanding the progression of disease and/or the benefits of treatment strategies, in rodents the conventional methods for assessment of GFR are inconvenient and cumbersome, not the least because they involve stress and often anaesthesia. The legitimacy of assay-based assessment of plasma and urine markers of GFR in mice has also been heavily scrutinized for their insensitivity to minor declines in GFR and inaccurate detection of renal biomarkers. While infusion-based clearance methods of GFR assessment are thus the gold standard in terms of accuracy, they are limited by the fact that they are primarily non-recovery procedures. This presents a dilemma when trying to document the progression of renal disease, as these measures cannot be taken in the same experimental subject. Here we review a technique of transcutaneous measurement of fluorescein isothiocyanate-labelled sinistrin to calculate GFR in small rodents, using a non-invasive clearance device (NIC-Kidney Device). This is a recently validated non-invasive technique for measuring GFR in small rodents that allows for the real-time measurement of GFR in conscious animals, without the need for plasma and urine assays. © 2014 Asian Pacific Society of Nephrology.

  11. Dynamic visualization of dendritic cell-antigen interactions in the skin following transcutaneous immunization.

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    Teerawan Rattanapak

    Full Text Available Delivery of vaccines into the skin provides many advantages over traditional parenteral vaccination and is a promising approach due to the abundance of antigen presenting cells (APC residing in the skin including Langerhans cells (LC and dermal dendritic cells (DDC. However, the main obstacle for transcutaneous immunization (TCI is the effective delivery of the vaccine through the stratum corneum (SC barrier to the APC in the deeper skin layers. This study therefore utilized microneedles (MN and a lipid-based colloidal delivery system (cubosomes as a synergistic approach for the delivery of vaccines to APC in the skin. The process of vaccine uptake and recruitment by specific types of skin APC was investigated in real-time over 4 hours in B6.Cg-Tg (Itgax-EYFP 1 Mnz/J mice by two-photon microscopy. Incorporation of the vaccine into a particulate delivery system and the use of MN preferentially increased vaccine antigen uptake by a highly motile subpopulation of skin APC known as CD207⁺ DC. No uptake of antigen or any response to immunisation by LC could be detected.

  12. Transcutaneous Electrical Nerve Stimulation Reduces Post-Thoractomy Ipsilateral Shoulder Pain. A Prospective Randomized Study.

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    Esteban González, Pedro; Novoa, Nuria M; Varela, Gonzalo

    2015-12-01

    The patient's position during an axillary thoracotomy can cause postoperative pain and decrease mobility of the ipsilateral shoulder. In this study, we assessed whether the implementation of a standardized analgesia program using transcutaneous electrical nerve stimulation (TENS) decreases local pain and improves ipsilateral shoulder mobility. Randomized, single-blind, single-center clinical trial of 50 patients who had undergone anatomical lung resection via axillary muscle-sparing thoracotomy. Patients were treated with TENS devices for 30 minutes every 8 hours, beginning on postoperative day 1. Pain and mobility of the affected limb were recorded at the same time on postoperative days 1 through 3. A visual analogue scale was used for pain assessment and shoulder mobility was assessed with a goniometer. Results were compared using a non-parametric test. Twenty-five patients were randomized to each group. Mean age of the control group was 62.7±9.3 years and 63.4±10.2 years in the experimental group. Shoulder mobility parameters were similar in both groups on all postoperative days. However, pain during flexion significantly decreased on day 2 (P=.03) and day 3 (P=.04) in the experimental group. The use of TENS decreases pain from shoulder flexion in patients undergoing axillary thoracotomy for pulmonary resection. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  13. Molybdenum coated SU-8 microneedle electrodes for transcutaneous electrical nerve stimulation.

    Science.gov (United States)

    Soltanzadeh, Ramin; Afsharipour, Elnaz; Shafai, Cyrus; Anssari, Neda; Mansouri, Behzad; Moussavi, Zahra

    2017-11-21

    Electrophysiological devices are connected to the body through electrodes. In some applications, such as nerve stimulation, it is needed to minimally pierce the skin and reach the underneath layers to bypass the impedance of the first layer called stratum corneum. In this study, we have designed and fabricated surface microneedle electrodes for applications such as electrical peripheral nerve stimulation. We used molybdenum for microneedle fabrication, which is a biocompatible metal; it was used for the conductive layer of the needle array. To evaluate the performance of the fabricated electrodes, they were compared with the conventional surface electrodes in nerve conduction velocity experiment. The recorded signals showed a much lower contact resistance and higher bandwidth in low frequencies for the fabricated microneedle electrodes compared to those of the conventional electrodes. These results indicate the electrode-tissue interface capacitance and charge transfer resistance have been increased in our designed electrodes, while the contact resistance decreased. These changes will lead to less harmful Faradaic current passing through the tissue during stimulation in different frequencies. We also compared the designed microneedle electrodes with conventional ones by a 3-dimensional finite element simulation. The results demonstrated that the current density in the deep layers of the skin and the directivity toward a target nerve for microneedle electrodes were much more than those for the conventional ones. Therefore, the designed electrodes are much more efficient than the conventional electrodes for superficial transcutaneous nerve stimulation purposes.

  14. Development of Novel Faster-Dissolving Microneedle Patches for Transcutaneous Vaccine Delivery.

    Science.gov (United States)

    Ono, Akihiko; Ito, Sayami; Sakagami, Shun; Asada, Hideo; Saito, Mio; Quan, Ying-Shu; Kamiyama, Fumio; Hirobe, Sachiko; Okada, Naoki

    2017-08-03

    Microneedle (MN) patches are promising for transcutaneous vaccination because they enable vaccine antigens to physically penetrate the stratum corneum via low-invasive skin puncturing, and to be effectively delivered to antigen-presenting cells in the skin. In second-generation MN patches, the dissolving MNs release the loaded vaccine antigen into the skin. To shorten skin application time for clinical practice, this study aims to develop novel faster-dissolving MNs. We designed two types of MNs made from a single thickening agent, carboxymethylcellulose (CMC) or hyaluronan (HN). Both CMC-MN and HN-MN completely dissolved in rat skin after a 5-min application. In pre-clinical studies, both MNs could demonstrably increase antigen-specific IgG levels after vaccination and prolong antigen deposition compared with conventional injections, and deliver antigens into resected human dermal tissue. In clinical research, we demonstrated that both MNs could reliably and safely puncture human skin without any significant skin irritation from transepidermal water loss measurements and ICDRG (International Contact Dermatitis Research Group) evaluation results.

  15. Role of transcutaneous electrical nerve stimulation in post-operative analgesia

    Directory of Open Access Journals (Sweden)

    Sukhyanti Kerai

    2014-01-01

    Full Text Available The use of transcutaneous electrical nerve stimulation (TENS as non-pharmacological therapeutic modality is increasing. The types of TENS used clinically are conventional TENS, acupuncture TENS and intense TENS. Their working is believed to be based on gate control theory of pain and activation of endogenous opioids. TENS has been used in anaesthesia for treatment of post-operative analgesia, post-operative nausea vomiting and labour analgesia. Evidence to support analgesic efficacy of TENS is ambiguous. A systematic search of literature on PubMed and Cochrane Library from July 2012 to January 2014 identified a total of eight clinical trials investigating post-operative analgesic effects of TENS including a total of 442 patients. Most of the studies have demonstrated clinically significant reduction in pain intensity and supplemental analgesic requirement. However, these trials vary in TENS parameters used that is, duration, intensity, frequency of stimulation and location of electrodes. Further studies with adequate sample size and good methodological design are warranted to establish general recommendation for use of TENS for post-operative pain.

  16. Effect of transcutaneous electrical nerve stimulation induced parotid stimulation on salivary flow

    Directory of Open Access Journals (Sweden)

    Sreenivasulu Pattipati

    2013-01-01

    Full Text Available Aims and Objectives: The main objective of this study was to evaluate the duration of stimulation over the parotid salivary flow following the use of transcutaneous electric nerve stimulation (TENS in different age groups. Materials and Methods: The study was carried out in three different age groups. Under group A individuals from 21 to 35 years of age, group B 36-50 years and group C above 51 years were considered. In each group 30 subjects were taken of whom 15 were males and 15 were females. The placement of pads was approximated bilaterally over the parotid glands. The working parameters of TENS unit were fixed at 50 Hz and the unit was in normal mode. Results: Subjects belonging to group B were showing statistically significant increases in the duration of stimulated parotid salivary flow following the use of TENS. Conclusion: TENS can be considered as a non-pharmacological alternative to improve salivation for longer period in xerostomia patients.

  17. An alternative therapy for drug-resistant epilepsy: transcutaneous auricular vagus nerve stimulation.

    Science.gov (United States)

    Rong, Peijing; Liu, Aihua; Zhang, Jianguo; Wang, Yuping; Yang, Anchao; Li, Liang; Ben, Hui; Li, Liping; Liu, Rupeng; He, Wei; Liu, Huanguang; Huang, Feng; Li, Xia; Wu, Peng; Zhu, Bing

    2014-01-01

    Previous studies demonstrated that vagus nerve stimulation (VNS) is an effective therapy for drug-resistant epilepsy. Acupuncture is also used to treat epilepsy. This study was designed to examine the safety and effectiveness of transcutaneous auricular vagus nerve stimulation (ta-VNS) for patients with drug-resistant epilepsy. A total of 50 volunteer patients with drug-resistant epilepsy were selected for a random clinical trial to observe the therapeutic effect of ta-VNS. The seizure frequency, quality of life, and severity were assessed in weeks 8, 16, and 24 of the treatment according to the percentage of seizure frequency reduction. In the pilot study, 47 of the 50 epilepsy patients completed the 24-week treatment; three dropped off. After 8-week treatment, six of the 47 patients (12%) were seizure free and 12 (24%) had a reduction in seizure frequency. In week 16 of the continuous treatment, six of the 47 patients (12%) were seizure free; 17 (34%) had a reduction in seizure frequency. After 24 weeks' treatment, eight patients (16%) were seizure free; 19 (38%) had reduced seizure frequency. Similar to the therapeutic effect of VNS, ta-VNS can suppress epileptic seizures and is a safe, effective, economical, and widely applicable treatment option for drug-resistant epilepsy. (ChiCTR-TRC-10001023).

  18. The Use of Transcutaneous Electrical Nerve Stimulation After Total Knee Arthroplasty: A Prospective Randomized Controlled Trial.

    Science.gov (United States)

    Ramanathan, Deepak; Saleh, Anas; Klika, Alison K; Higuera, Carlos A; Barsoum, Wael K

    2017-07-25

    Multimodal pain management is used after total knee arthroplasty (TKA) to reduce opioid intake. Transcutaneous electrical nerve stimulation (TENS) has generated much interest as a non-pharmacologic, patient-controlled therapy. The aims of this study were to evaluate the efficacy of TENS in reducing opioid intake and improving recovery after TKA. This was a prospective, parallel-group, double-blinded, randomized trial of patients receiving femoral nerve catheter block with allocation to either active or placebo TENS device groups. All participants were 18-85 years and underwent unilateral, primary TKA at two academic hospitals. Device usage was monitored during inpatient and outpatient phases. Participants were requested to return at second, fourth, and sixth postoperative weeks for follow-up. The primary endpoint was opioid usage, as indicated by medication intake in equianalgesic equivalents to morphine. Secondary measures included: visual analogue scale (VAS) pain scores; functional assessments as measured from knee joint range of motion (ROM) and Timed Up and Go (TUG) test; and clinical outcomes as defined by modified Knee injury and Osteoarthritis Outcome Scores (KOOS) and the 12-item Short Form Survey Instrument (SF-12). Among 116 participants, overall withdrawal was 37.9% (44 patients) at similar rates in both study arms. After excluding for non-femoral nerve catheter (FNC) blocks (i.e., protocol deviations), there were 35 patients in the active group and 31 patients in the placebo group whose complete records were analyzed. There were no significant differences between groups in any of the clinical endpoints.

  19. A combined transcutaneous PO2-PCO2 electrode with electrochemical HCO3- stabilization.

    Science.gov (United States)

    Severinghaus, J W

    1981-10-01

    Combined transcutaneous PO2-PCO2 electrodes are described in which the interaction between the two electrodes due to OH- production at the O2 cathode has been eliminated. An anode of either anodized aluminum or platinum has been driven at a current equal to cathode current to force stoichiometric consumption of OH- at its rate of production. The AgCl reference electrode operates at zero current. O2 sensitivity was not significantly altered by electrolyte pH variation from 6.7 to 9.0 with variations by PCO2. These electrodes have been found stable both with and without spacers, and with electrolytes dissolved in 50-100% ethylene glycol. In 22 anesthetized patients, with electrode temperature of 43 degrees C (s refers to skin surface, a to arterial blood); PsO2 = 0.52PaO2 + 15 (range 54-300) (r = 0.66; Sy . x = 29.6; n = 46); and PsCO2 = 1.39PaCO2 + 2.1 (range 24-98) (r = 0.99; Sy . x = 2.28; n = 48).

  20. A controlled trial of transcutaneous vagus nerve stimulation for the treatment of pharmacoresistant epilepsy.

    Science.gov (United States)

    Aihua, Liu; Lu, Song; Liping, Li; Xiuru, Wang; Hua, Lin; Yuping, Wang

    2014-10-01

    This study explored the efficacy and safety of transcutaneous vagus nerve stimulation (t-VNS) in patients with pharmacoresistant epilepsy. A total of 60 patients were randomly divided into two groups based on the stimulation zone: the Ramsay-Hunt zone (treatment group) and the earlobe (control group). Before and after the 12-month treatment period, all patients completed the Self-Rating Anxiety Scale (SAS), the Self-Rating Depression Scale (SDS), the Liverpool Seizure Severity Scale (LSSS), and the Quality of Life in Epilepsy Inventory (QOLIE-31). Seizure frequency was determined according to the patient's seizure diary. During our study, the antiepileptic drugs were maintained at a constant level in all subjects. After 12 months, the monthly seizure frequency was lower in the treatment group than in the control group (8.0 to 4.0; P=0.003). This reduction in seizure frequency was correlated with seizure frequency at baseline and duration of epilepsy (both P>0.05). Additionally, all patients showed improved SAS, SDS, LSSS, and QOLIE-31 scores that were not correlated with a reduction in seizure frequency. The side effects in the treatment group were dizziness (1 case) and daytime drowsiness (3 cases), which could be relieved by reducing the stimulation intensity. In the control group, compared with baseline, there were no significant changes in seizure frequency (P=0.397), SAS, SDS, LESS, or QOLIE-31. There were also no complications in this group. Copyright © 2014. Published by Elsevier Inc.

  1. Transcutaneous vagus nerve stimulation (t-VNS) in pharmacoresistant epilepsies: a proof of concept trial.

    Science.gov (United States)

    Stefan, Hermann; Kreiselmeyer, Gernot; Kerling, Frank; Kurzbuch, Katrin; Rauch, Christophe; Heers, Marcel; Kasper, Burkhard S; Hammen, Thilo; Rzonsa, Martina; Pauli, Elisabeth; Ellrich, Jens; Graf, Wolfgang; Hopfengärtner, Rüdiger

    2012-07-01

    To elucidate, in a pilot-study, whether noninvasive transcutaneous vagus nerve stimulation (t-VNS) is a safe and tolerable alternative treatment option in pharmacoresistant epilepsy. t-VNS was applied to 10 patients with pharmacoresistant epilepsies. Stimulation via the auricular branch of the vagus nerve of the left tragus was delivered three times per day for 9 months. Subjective documentation of stimulation effects was obtained from patients' seizure diaries. For a more reliable assessment of seizure frequency, we carried out prolonged outpatient video-electroencephalography (EEG) monitoring. In addition, computerized testing of cognitive, affective, and emotional functions was performed. Three patients aborted the study. Of the remaining seven patients, an overall reduction of seizure frequency was observed in five patients after 9 months of t-VNS. The noninvasive t-VNS stimulation is a safe and well-tolerated method for relatively long periods, and might be an alternative treatment option for patients with epilepsy. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

  2. Effects of short and prolonged transcutaneous vagus nerve stimulation on heart rate variability in healthy subjects.

    Science.gov (United States)

    De Couck, M; Cserjesi, R; Caers, R; Zijlstra, W P; Widjaja, D; Wolf, N; Luminet, O; Ellrich, J; Gidron, Y

    2017-03-01

    The vagus nerve is strategically located in the body, and has multiple homeostatic and health-promoting effects. Low vagal activity predicts onset and progression of diseases. These are the reasons to activate this nerve. This study examined the effects of transcutaneous vagus nerve stimulation (t-VNS) on a main index of vagal activity, namely heart rate variability (HRV). In Study 1, we compared short (10min) left versus right ear t-VNS versus sham (no stimulation) in a within-subjects experimental design. Results revealed significant increases in only one HRV parameter (standard deviation of the RR intervals (SDNN)) following right-ear t-VNS. Study 2 examined the prolonged effects of t-VNS (1h) in the right ear. Compared to baseline, right-t-VNS significantly increased the LF and LF/HF components of HRV, and SDNN in women, but not in men. These results show limited effects of t-VNS on HRV, and are discussed in light of neuroanatomical and statistical considerations and future directions are proposed. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Value of transcutaneous electric nerve stimulation in the treatment of myofascial pain dysfunction syndrome

    Directory of Open Access Journals (Sweden)

    Hina Handa

    2017-01-01

    Full Text Available Pain in facial region originating from both temporomandibular joint (TMJ and jaw muscles is a common clinical problem and is a diagnostic dilemma till today. There are many synonyms for this condition including myofascial pain dysfunction syndrome, mandibular dysfunction syndrome, and the TMJ dysfunction syndrome. With change in time, advances and new diagnostic criteria have been made in the diagnosis of myofascial pain syndrome, its epidemiology, clinical characteristics, and etiopathogenesis, but many unknowns remain. An integrated hypothesis has provided a greater understanding of the physiopathology of trigger points, which may allow the development of new diagnostic criteria and treatment of this chronic disease and combined pharmacological as well as physical therapy for the management of the disease. The purpose of this paper is to describe the multidisciplinary approach highlighting the effect of transcutaneous electric nerve stimulation (TENS for the treatment of a 60-year-old female who suffered from myofascial pain and 5-day TENS therapy for management of pain.

  4. [Effect of transcutaneous acupoint electrical stimulation on lipid peroxidation and cognitive function in patients experiencing craniotomy].

    Science.gov (United States)

    Ni, Jian-wu; Meng, Yi-nan; Xiang, Hai-fei; Ren, Qiu-sheng; Wang, Jun-lu

    2009-02-01

    To observe the effect of transcutaneous acupoint electrical stimulation (TAES) on serum superoxide dismutase (SOD) activity, malondialdehyde (MDA) and S100beta contents in craniotomy patients for studying its cerebral protection mechanism. Fifty patients scheduled for neurosurgery were randomly divided into TAES group (n = 25) and control group (n=25) with randomized block method. For patients of TAES group, TAES was applied to bilateral Hegu (LI 4) and Quchi (LI 11), Zusanli (ST 36) and Sanyinjiao (SP 6) from 30 minutes on before anesthesia to the end of operation. Patients of control group were anesthetized with sevoflurane inhalation and intermittent (i.v.) of sulfenany and vecurnium bromide. Blood samples were taken for assaying serum SOD activity, MDA and S100beta contents with purinase oxydasis, biochemiluminescence and enzyme linked immunosorbent assay separately. Scores of cognitive ability were given by using Mini Mental State Examination (MMSE). In comparison with pre-anesthesia, serum SOD activity decreased significantly 1 h after craniotomy in control group, at the end of operation in both control and TAES groups (Pcraniotomy and 48 h after operation were markedly lower in TAES group (Pcognitive function scores (P>0.05). TAES can increase serum SOD activity and reduce MDA and S100beta levels in patients undergoing craniotomy, which may contribute to its effect in reducing lipid peroxidation induced cerebral injury. But its impact on the patient's cognitive function needs study further.

  5. Angiotensin-converting Enzyme Inhibition Improves the Effectiveness of Transcutaneous Carbon Dioxide Treatment.

    Science.gov (United States)

    Nemeth, Balazs; Kiss, Istvan; Jencsik, Timea; Peter, Ivan; Kreska, Zita; Koszegi, Tamas; Miseta, Attila; Kustan, Peter; Boncz, Imre; Laczo, Andrea; Ajtay, Zeno

    2017-01-01

    To study the effect of carbon dioxide (CO 2 ) therapy on the nitric oxide (NO) pathway by monitoring plasma asymmetric dimethylarginine (ADMA) concentrations. Forty-seven hypertensive patients who underwent transcutaneous CO 2 therapy were enrolled. Thirty healthy individuals were recruited for the control group. Blood samples were taken one hour before, as well as one hour, 24 hours and 3 weeks after the first CO 2 treatment. Controls did not undergo CO 2 treatment. Plasma ADMA levels were measured by ELISA. ADMA levels decreased significantly one hour after the first CO2 treatment compared to the baseline concentrations (p=0.003). Significantly greater reduction was found among patients in whom angiotensin converting enzyme inhibitors (ACEIs) were administered (p=0.019). The short- and long-term decrease of ADMA levels suggests that CO 2 is not only a vasodilator, but also has a beneficial effect on the NO pathway. ACE inhibition seems to enhance the effect of CO 2 treatment. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  6. Sound Localization in Patients With Congenital Unilateral Conductive Hearing Loss With a Transcutaneous Bone Conduction Implant.

    Science.gov (United States)

    Vyskocil, Erich; Liepins, Rudolfs; Kaider, Alexandra; Blineder, Michaela; Hamzavi, Sasan

    2017-03-01

    There is no consensus regarding the benefit of implantable hearing aids in congenital unilateral conductive hearing loss (UCHL). This study aimed to measure sound source localization performance in patients with congenital UCHL and contralateral normal hearing who received a new bone conduction implant. Evaluation of within-subject performance differences for sound source localization in a horizontal plane. Tertiary referral center. Five patients with atresia of the external auditory canal and contralateral normal hearing implanted with transcutaneous bone conduction implant at the Medical University of Vienna were tested. Activated/deactivated implant. Sound source localization test; localization performance quantified using the root mean square (RMS) error. Sound source localization ability was highly variable among individual subjects, with RMS errors ranging from 21 to 40 degrees. Horizontal plane localization performance in aided conditions showed statistically significant improvement compared with the unaided conditions, with RMS errors ranging from 17 to 27 degrees. The mean RMS error decreased by a factor of 0.71 (p conduction implant. Some patients with congenital UCHL might be capable of developing improved horizontal plane localization abilities with the binaural cues provided by this device.

  7. Intermediate outcomes of a transcutaneous bone conduction hearing device in a paediatric population.

    Science.gov (United States)

    Dimitriadis, Panagiotis A; Carrick, Suzanne; Ray, Jaydip

    2017-03-01

    The aim of this study was to review the outcomes of Bone Anchored Hearing Aid (BAHA ® ) Attract implantation in a cohort of paediatric patients. Prospective data collection and case review were undertaken in a paediatric tertiary referral centre. We have included patients under the age of 16 years with unilateral or bilateral hearing loss that met the criteria for BAHA ® Attract implantation. The main outcome measures were surgical complications and Patient Reported Outcomes including the 'Speech, Spatial and Qualities of Hearing scale' (SSQ-12) and 'Qualitative Feedback for BAHA ® 5 Hearing Aids'. Twenty-five paediatric patients were implanted with the BAHA ® Attract between June 2014 and July 2016. Nine of them had a conversion from a percutaneous Bone Conduction Hearing Device (BCHD). Four children had minor skin problems that settled with conservative measures. Two children with a previous percutaneous BCHD developed skin dehiscence over the magnet after conversion to the transcutaneous version. The SSQ-12 was completed by 6 children and an improvement of 22% was noted between the unaided and aided condition. The patients and their parents were generally satisfied with the BAHA ® Attract. The BAHA ® Attract offers a good solution for hearing rehabilitation in appropriately selected and counseled patients. The complication rate was low for primary surgery but higher in cases of conversion from a percutaneous device. Large, prospective data is needed to evaluate the relative risks and benefits of this BCHD. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Alteration of interferential current and transcutaneous electrical nerve stimulation frequency: effects on nerve excitation.

    Science.gov (United States)

    Palmer, S T; Martin, D J; Steedman, W M; Ravey, J

    1999-09-01

    To investigate the effects of different interferential current (IC) and transcutaneous electrical nerve stimulation (TENS) frequencies on sensory, motor, and pain thresholds. Single blind, repeated measures design. Laboratory. Women students 18 to 30 years old (n = 24). Premodulated IC and square-wave TENS pulses (125micros phase duration) were applied over the median nerve at a range of frequencies in all subjects. The peak current (in milliamperes) was recorded twice at each threshold for each frequency, and averaged. Both IC and TENS displayed a statistically significant effect of frequency for each threshold. However, frequency effects with IC were not well defined and were of small magnitude. Pure 4kHz current (0Hz amplitude modulated frequency) with IC did not produce effects different from those produced when an amplitude modulated frequency was included. With TENS, frequency effects were very clearly observed, with a distinct increase in the current intensity at each threshold as frequency decreased. It is postulated that the medium frequency component of IC is the main parameter in stimulation, contrary to traditional claims of the amplitude modulated frequency being important. TENS was shown to be a more adaptable method of stimulating these nerve pathways than IC.

  9. Home Transcutaneous Electrical Stimulation Therapy to Treat Children With Anorectal Retention: A Pilot Study.

    Science.gov (United States)

    Yik, Yee Ian; Stathopoulos, Lefteris; Hutson, John M; Southwell, Bridget R

    2016-07-01

    As transcutaneous electrical stimulation (TES) increased defecation in children and adults with Slow-Transit Constipation (STC), we performed a pilot study to test if TES can improve symptoms (defecation and soiling) in children with chronic constipation without STC and transit delay in the anorectum. Children with treatment-resistant constipation presenting to a tertiary hospital had gastrointestinal nuclear transit study (NTS) showing normal proximal colonic transit and anorectal holdup of tracer. TES was administered at home (1 hour/day for 3 months) using a battery-powered interferential stimulator, with four adhesive electrodes (4 × 4 cm) connected so currents cross within the lower abdomen at the level of S2-S4. Stimulation was added to existing laxatives. Daily continence diary, and quality-of-life questionnaires (PedsQL4.0) were compared before and after TES. Ten children (4 females: 5-10 years, mean 8 years) had holdup in the anorectum by NTS. Nine had 50% of children with treatment-resistant constipation with isolated holdup in the anorectum. Further studies (RCTs) are warranted in these children. © 2016 International Neuromodulation Society.

  10. Decreased colonic transit time after transcutaneous interferential electrical stimulation in children with slow transit constipation.

    Science.gov (United States)

    Clarke, Melanie C C; Chase, Janet W; Gibb, Susie; Robertson, Val J; Catto-Smith, Anthony; Hutson, John M; Southwell, Bridget R

    2009-02-01

    Idiopathic slow transit constipation (STC) describes a clinical syndrome characterised by intractable constipation. It is diagnosed by demonstrating delayed colonic transit on nuclear transit studies (NTS). A possible new treatment is interferential therapy (IFT), which is a form of electrical stimulation that involves the transcutaneous application of electrical current. This study aimed to ascertain the effect of IFT on colonic transit time. Children with STC diagnosed by NTS were randomised to receive either 12 real or placebo IFT sessions for a 4-week period. After a 2-month break, they all received 12 real IFT sessions-again for a 4-week period. A NTS was repeated 6 to 8 weeks after cessation of each treatment period where able. Geometric centres (GCs) of activity were calculated for all studies at 6, 24, 30, and 48 hours. Pretreatment and posttreatment GCs were compared by statistical parametric analysis (paired t test). Thirty-one pretreatment, 22 postreal IFT, and 8 postplacebo IFT studies were identified in 26 children (mean age, 12.7 years; 16 male). Colonic transit was significantly faster in children given real treatment when compared to their pretreatment NTS at 24 (mean CG, 2.39 vs 3.04; P interferential therapy can significantly speed up colonic transit in children with slow transit constipation.

  11. Simulation in spinal diseases.

    Science.gov (United States)

    Aso Escario, José; Martínez Quiñones, José Vicente; Aso Vizán, Alberto; Arregui Calvo, Ricardo; Bernal Lafuente, Marta; Alcázar Crevillén, Andrés

    2014-01-01

    Simulation is frequent in spinal disease, resulting in problems for specialists like Orthopedic Surgeons, Neurosurgeons, Reumathologists, etc. Simulation requires demonstration of the intentional production of false or exaggerated symptoms following an external incentive. The clinician has difficulties in demonstrating these criteria, resulting in misdiagnosis of simulation or misinterpretation of the normal patient as a simulator, with the possibility of iatrogenic distress and litigation. We review simulation-related problems in spine, proposing a terminological, as well as a diagnostic strategy including clinical and complementary diagnosis, as a way to avoid misinterpretation and minimize the iatrogenic distress and liability Based on the clinical-Forensic author's expertise, the literature is analyzed and the terminology readdressed to develop new terms (inconsistences, incongruences, discrepancies and contradictions). Clinical semiology and complementary test are adapted to the new scenario. Diagnostic strategy relies on anamnesis, clinical and complementary tests, adapting them to a uniform terminology with clear meaning of signs and symptoms. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  12. Influence of transcutaneous electrical nerve stimulation on spasticity, balance, and walking speed in stroke patients: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Shuqin Lin

    2017-08-01

    Full Text Available Objective: To evaluate the influence of transcutaneous electrical nerve stimulation in patients with stroke through a systematic review and meta-analysis. Methods: PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases were searched systematically. Randomized controlled trials assessing the effect of transcutaneous electrical nerve stimulation vs placebo transcutaneous electrical nerve stimulation on stroke were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was modified Ashworth scale (MAS. Meta-analysis was performed using the random-effect model. Results: Seven randomized controlled trials were included in the meta-analysis. Compared with placebo transcutaneous electrical nerve stimulation, transcutaneous electrical nerve stimulation supplementation significantly reduced MAS (standard mean difference (SMD = –0.71; 95% confidence interval (95% CI = –1.11 to –0.30; p = 0.0006, improved static balance with open eyes (SMD = –1.26; 95% CI = –1.83 to –0.69; p<0.0001 and closed eyes (SMD = –1.74; 95% CI = –2.36 to –1.12; p < 0.00001, and increased walking speed (SMD = 0.44; 95% CI = 0.05 to 0.84; p = 0.03, but did not improve results on the Timed Up and Go Test (SMD = –0.60; 95% CI=–1.22 to 0.03; p = 0.06. Conclusion: Transcutaneous electrical nerve stimulation is associated with significantly reduced spasticity, increased static balance and walking speed, but has no influence on dynamic balance.

  13. FAQs about Spinal Cord Injury (SCI)

    Science.gov (United States)

    ... What is paralysis? What is paraplegia? What is tetraplegia? What is a “complete” spinal cord injury? What ... What is paralysis? What is paraplegia? What is tetraplegia? What is a “complete” spinal cord injury? What ...

  14. Spinal Manipulation for Low-Back Pain

    Science.gov (United States)

    ... the United States—including lost wages and reduced productivity—are more than $100 billion. About Spinal Manipulation ... one or both legs, and bowel or bladder problems, may be an extremely rare complication of spinal ...

  15. How Is Spinal Cord Injury (SCI) Diagnosed?

    Science.gov (United States)

    ... Research Information Find a Study Resources and Publications Spinal Cord Injury (SCI) Condition Information NICHD Research Information Find a ... Care Providers Home Health A to Z List Spinal Cord Injury (SCI) Condition Information How is it diagnosed? Share ...

  16. Suicide in a spinal cord injured population

    DEFF Research Database (Denmark)

    Hartkopp, A; Brønnum-Hansen, Henrik; Seidenschnur, A M

    1998-01-01

    To determine the relation between functional status and risk of suicide among individuals with spinal cord injury (SCI).......To determine the relation between functional status and risk of suicide among individuals with spinal cord injury (SCI)....

  17. Pericytes Make Spinal Cord Breathless after Injury.

    Science.gov (United States)

    Almeida, Viviani M; Paiva, Ana E; Sena, Isadora F G; Mintz, Akiva; Magno, Luiz Alexandre V; Birbrair, Alexander

    2017-09-01

    Traumatic spinal cord injury is a devastating condition that leads to significant neurological deficits and reduced quality of life. Therapeutic interventions after spinal cord lesions are designed to address multiple aspects of the secondary damage. However, the lack of detailed knowledge about the cellular and molecular changes that occur after spinal cord injury restricts the design of effective treatments. Li and colleagues using a rat model of spinal cord injury and in vivo microscopy reveal that pericytes play a key role in the regulation of capillary tone and blood flow in the spinal cord below the site of the lesion. Strikingly, inhibition of specific proteins expressed by pericytes after spinal cord injury diminished hypoxia and improved motor function and locomotion of the injured rats. This work highlights a novel central cellular population that might be pharmacologically targeted in patients with spinal cord trauma. The emerging knowledge from this research may provide new approaches for the treatment of spinal cord injury.

  18. How Is Spinal Cord Injury (SCI) Diagnosed?

    Science.gov (United States)

    ... a pinprick. Doctors use the standard ASIA (American Spinal Injury Association) Impairment Scale for this diagnosis. X-rays, ... National Institute of Neurological Disorders and Stroke. (2012). Spinal cord injury: Hope through research . Retrieved June 26, 2012, from ...

  19. Case report: humero-spinal dysostosis.

    Science.gov (United States)

    Sparks, M J; Gaines, P A; Levick, R K

    1994-11-01

    We report a case of humero-spinal dysostosis which is only the fourth reported in the literature. The condition is characterized by distal bifurcation of humeri, elbow joint dislocation, spinal malformation, widened iliac bones and talipes equinovarus.

  20. Stem Cells in Spinal Fusion.

    Science.gov (United States)

    Robbins, Michael A; Haudenschild, Dominik R; Wegner, Adam M; Klineberg, Eric O

    2017-12-01

    Review of literature. This review of literature investigates the application of mesenchymal stem cells (MSCs) in spinal fusion, highlights potential uses in the development of bone grafts, and discusses limitations based on both preclinical and clinical models. A review of literature was conducted looking at current studies using stem cells for augmentation of spinal fusion in both animal and human models. Eleven preclinical studies were found that used various animal models. Average fusion rates across studies were 59.8% for autograft and 73.7% for stem cell-based grafts. Outcomes included manual palpation and stressing of the fusion, radiography, micro-computed tomography (μCT), and histological analysis. Fifteen clinical studies, 7 prospective and 8 retrospective, were found. Fusion rates ranged from 60% to 100%, averaging 87.1% in experimental groups and 87.2% in autograft control groups. It appears that there is minimal clinical difference between commercially available stem cells and bone marrow aspirates indicating that MSCs may be a good choice in a patient with poor marrow quality. Overcoming morbidity and limitations of autograft for spinal fusion, remains a significant problem for spinal surgeons and further studies are needed to determine the efficacy of stem cells in augmenting spinal fusion.

  1. Extramedullary spinal cysts in dogs.

    Science.gov (United States)

    Lowrie, Mark L; Platt, Simon R; Garosi, Laurent S

    2014-08-01

    To (1) synthesize the terminology used to classify extramedullary spinal cysts in dogs to clarify some of the commonly reported misconceptions, and (2) propose a classification scheme to limit confusion with terminology. Literature review. An online bibliographic search was performed in January 2013 for articles relating to extramedullary spinal cysts in dogs using PubMed (http://www.pubmed.gov/) and Google Scholar (http://scholar.google.com/) databases. Only peer-reviewed clinical literature describing cystic lesions pertaining to the spinal cord and associated structures was included. From 1962 to 2013, 42 articles were identified; 25 (95 dogs) reported meningeal cysts, 10 (24 dogs) described 60 extradural cysts, 3 reports (18 dogs) described discal cysts or acute compressive hydrated nucleus pulposus extrusions (HNPE). Spinal cysts were categorized by location based on cross-sectional imaging as meningeal or extradural non-meningeal. Sub-classification was then performed based on surgical findings and pathology. Meningeal cysts included arachnoid diverticulae and Tarlov (perineural) cysts. Extradural non-meningeal cysts included intraspinal cysts of the vertebral joints, ligaments and discs. Discal cysts also fit this category and have been reported extensively in humans but appear rare in dogs. Extramedullary spinal cysts should be first classified according to location with a sub-classification according to pathologic and surgical findings. Previous canine cases of discal cysts appear to represent a different disease entity and the term acute compressive HNPE is therefore preferred. © Copyright 2014 by The American College of Veterinary Surgeons.

  2. Spinal infection: Evaluation with MR imaging and intraoperative spinal US

    International Nuclear Information System (INIS)

    Donovan Post, M.J.; Montalvo, B.M.; Quencer, R.M.; Katz, B.H.; Green, B.A.; Elsmont, F.

    1987-01-01

    MR spine images and/or intraoperative US scans in 15 patients were reviewed retrospectively and correlated with clinical and pathologic data to determine the diagnostic value of these modalities in spinal infection. In osteomyelitis and retrospinal abscess MR imaging was definitive; in myelitis it was positive but nonspecific. In epidural abscess concomitant with meningitis, myelography with CT and intraoperative US were superior to MR imaging. Intraoperative US could be used to distinguish these processes and to monitor surgical decompression. The authors recommend that MR imaging be performed at the screening examination in cases of spinal infection, accompanied by intraoperative US in all surgical cases

  3. Unusual causes of spinal foraminal widening

    International Nuclear Information System (INIS)

    Zibis, A.H.; Markonis, A.; Karantanas, A.H.

    2000-01-01

    Spinal neural foraminal widening is usually caused by benign lesions, most commonly neurofibromas. Rare lesions can also cause spinal neural foraminal widening. Computed tomography and/or MRI are the modalities of choice for studying the spinal foraminal widening. The present pictorial review describes six rare lesions, namely a lateral thoracic meningocele, a malignant fibrous histiocytoma, a tuberculous abscess, an osteoblastoma, a chondrosarcoma and a malignant tumour of the lung which caused spinal neural foraminal widening. (orig.)

  4. The value of transcutaneous method of bilirubin measurement in newborn population with the risk of ABO hemolytic disease.

    Science.gov (United States)

    Stoniene, Dalia; Buinauskiene, Jūrate; Markūniene, Egle

    2009-01-01

    OBJECTIVE OF THE STUDY. To evaluate the correlation between total serum bilirubin (TSB) and transcutaneous bilirubin (TcB) levels in newborn infants at risk of ABO hemolytic disease. MATERIAL AND METHODS. During a prospective study, 130 full-term (>or=37 weeks of gestation) newborn infants with diagnosed ABO blood group incompatibility were examined. TSB level was measured at the age of 6 hours; further measurements were performed at 24, 48, and 72 hours following the first measurement. Blood samples were collected from the peripheral veins. In clinical laboratory, total serum bilirubin level was measured using Jendrassik-Grof method. TcB level in the forehead was measured using a noninvasive bilirubinometer BiliCheck (SpectRX Inc, Norcross, GA) according to the manufacturer's instructions within +/-30 min after getting a blood sample. RESULTS. During the study, 387 double tests were performed to measure TSB and TcB levels. TSB level (114.83 [62.85] micromol/L) closely correlated with TcB level (111.51 [61.31] micromol/L) (r=0.92, Por=98 micromol/L, ABO hemolytic disease in newborns may be diagnosed with 100% sensitivity and 98% specificity; positive predictive value was 62% and negative predictive value was 100%. While a newborn's age increases, TcB sensitivity and specificity for diagnosing ABO hemolytic disease decrease. CONCLUSION. While evaluating bilirubin level transcutaneously according to nomograms of serum bilirubin level, the results should be considered with caution, especially for newborns with a risk of ABO hemolytic disease. The hour-specific nomograms of transcutaneous bilirubin level should be used to evaluate hyperbilirubinemia using only a noninvasive method.

  5. Functional outcome after a spinal fracture

    NARCIS (Netherlands)

    Post, Richard Bernardus

    2008-01-01

    This thesis takes a closer look at the functional outcome after a spinal fracture. An introduction to different aspects regarding spinal fractures is presented in Chapter 1. The incidence of traumatic thoracolumbar spinal fractures without neurological deficit in the Netherlands is approximately 1.2

  6. Spinal cord involvement in tuberculous meningitis.

    Science.gov (United States)

    Garg, R K; Malhotra, H S; Gupta, R

    2015-09-01

    To summarize the incidence and spectrum of spinal cord-related complications in patients of tuberculous meningitis. Reports from multiple countries were included. An extensive review of the literature, published in English, was carried out using Scopus, PubMed and Google Scholar databases. Tuberculous meningitis frequently affects the spinal cord and nerve roots. Initial evidence of spinal cord involvement came from post-mortem examination. Subsequent advancement in neuroimaging like conventional lumbar myelography, computed tomographic myelography and gadolinium-enhanced magnetic resonance-myelography have contributed immensely. Spinal involvement manifests in several forms, like tuberculous radiculomyelitis, spinal tuberculoma, myelitis, syringomyelia, vertebral tuberculosis and very rarely spinal tuberculous abscess. Frequently, tuberculous spinal arachnoiditis develops paradoxically. Infrequently, spinal cord involvement may even be asymptomatic. Spinal cord and spinal nerve involvement is demonstrated by diffuse enhancement of cord parenchyma, nerve roots and meninges on contrast-enhanced magnetic resonance imaging. High cerebrospinal fluid protein content is often a risk factor for arachnoiditis. The most important differential diagnosis of tuberculous arachnoiditis is meningeal carcinomatosis. Anti-tuberculosis therapy is the main stay of treatment for tuberculous meningitis. Higher doses of corticosteroids have been found effective. Surgery should be considered only when pathological confirmation is needed or there is significant spinal cord compression. The outcome in these patients has been unpredictable. Some reports observed excellent recovery and some reported unfavorable outcomes after surgical decompression and debridement. Tuberculous meningitis is frequently associated with disabling spinal cord and radicular complications. Available treatment options are far from satisfactory.

  7. Spinal cord injuries in Ilorin, Nigeria

    African Journals Online (AJOL)

    passenger and load carriage, use of manual or motorised wheel barrow as against bearing heavy load on the head, principles of moving spinal injured patients taught every road traveller and establishment of spinal centres and training of specialised personnel. Keywords: Spinal Cord, Injury, Poraplegia, Quadriplegia.

  8. Historical perspective: history of spinal surgery.

    Science.gov (United States)

    Knoeller, S M; Seifried, C

    2000-11-01

    The surgical treatment of spinal disorders did not develop before the 1970s of the last century. Previously limited technical possibilities and the danger of infections spinal surgery could not spread wider. This article reviews the history of spinal surgery from first trials as mentioned in the papyrus Smith in 1550 B.C. in Egypt to advanced techniques of today.

  9. Radiation treatment of spinal cord neoplasms

    International Nuclear Information System (INIS)

    Smirnov, R.V.

    1982-01-01

    Results of radiation treatment of spinal cord neoplasms are presented. The results of combined (surgical and radiation) treatment of tumors are studied. On the whole it is noted that radiation treatment of initial spinal cord tumours is not practised on a large scale because of low radiostability of spinal cord

  10. Recurrent Primary Spinal Hydatid Cyst

    Directory of Open Access Journals (Sweden)

    Okan Turk

    2015-03-01

    Full Text Available Primary hydatid disease of spine is rare and spinal hydatitosis constitute only 1% of all hydatitosis. We report a case of recurrent primary intraspinal extradural hydatid cyst of the thoracic region causing progressive paraparesis. The patient was operated 16 years ago for primary spinal hydatid disease involvement and was instrumented dorsally for stabilization. The magnetic resonance imaging (MRI of thoracic spine showed a cystic lesion at T11-12 level and compressed spinal cord posterolaterally. Intraspinal cyst was excised through T11-12 laminectomy which made formerly. The early postoperative period showed a progressive improvement of his neurological deficit and he was discharged with antihelmintic treatment consisting of albendazole and amoxicillin-sulbactam combination. [Cukurova Med J 2015; 40(Suppl 1: 84-89

  11. Transcutaneous measurement of glomerular filtration rate in conscious laboratory animals: state of the art and future perspectives

    Science.gov (United States)

    Friedemann, Jochen; Schock-Kusch, Daniel; Shulhevich, Yury

    2017-02-01

    Transcutaneous measurement of Glomerular Filtration Rate (tGFR) is now frequently used in preclinical in vivo animal studies. tGFR allows consecutive measurements on the same animal, including multiple measurements on a daily basis. A description of the measurement device and its many applications, along with examples from the recent literature will be given. We will highlight the fields of interest in which the system is used and give an overview about its performance versus endogenous and other exogenous methods of GFR measurement. A special focus will be put on the precision of tGFR compared to standard measurements employed in the research setting.

  12. High- and low-frequency transcutaneous electrical nerve stimulation does not reduce experimental pain in elderly individuals

    OpenAIRE

    Bergeron-V?zina, Kayla; Corriveau, H?l?ne; Martel, Marylie; Harvey, Marie-Philippe; L?onard, Guillaume

    2015-01-01

    Abstract Despite its widespread clinical use, the efficacy of transcutaneous electrical nerve stimulation (TENS) remains poorly documented in elderly individuals. In this randomized, double-blind crossover study, we compared the efficacy of high-frequency (HF), low-frequency (LF), and placebo (P) TENS in a group of 15 elderly adults (mean age: 67 ? 5 years). The effect of HF-, LF-, and P-TENS was also evaluated in a group of 15 young individuals (26 ? 5 years; same study design) to validate t...

  13. [Usefulness of transcutaneous carbon dioxide pressure monitoring to measure blood gases in adults hospitalized for respiratory disease].

    Science.gov (United States)

    Herrejón, A; Inchaurraga, I; Palop, J; Ponce, S; Peris, R; Terrádez, M; Blanquer, R

    2006-05-01

    To evaluate the usefulness of transcutaneous carbon dioxide pressure (TcPCO2) monitoring in patients hospitalized for respiratory disease. We used a SenTec TcPCO2 monitor that also determines transcutaneous oxygen saturation (SpO2) by means of a sensor placed behind the ear lobe at a temperature of 42 degrees C. We compared arterial blood gas measurements--PaCO2 and arterial oxygen saturation (SaO2)--with transcutaneous measurements and analyzed the correlation, regression line, and agreement between the 2 methods. Thirty patients (20 men and 10 women) with various respiratory diseases and a mean (SD) age of 71 (13) years were included in the study. The median TcPCO2 was 43.25 mm Hg and the median PaCO2 was 42.6 mm Hg with no significant differences between the 2 measurements. The correlation was significant (rho=0.979; PTcPCO2=-2.475+1.058 PaCO2. The mean difference was 0.16 mm Hg (95% confidence interval [CI], --0.74 to 1.06). The lower limit of agreement (mean -1.96 SD) was -4.64 mm Hg, and the upper limit (mean +1.96 SD) was 4.96 mm Hg. For SaO2, the median was 94% and for SpO2, 95%. The difference between the 2 medians was significant (P< .004). The correlation was also significant (rho=0.822; P< .0001) with SpO2=4.427+0.97 SaO2. The mean difference was 1.14% (95% CI, 0.381% to 1.899%). The lower limit of agreement (mean -1.96 SD) was --2.93% and the upper limit (mean +1.96 SD) was 5.21% Transcutaneous determination of carbon dioxide pressure and oxygen saturation is useful for patients hospitalized for respiratory disease in view of its good correlation and agreement, although SpO2 does tend to overestimate SaO2.

  14. Fixed-site high-frequency transcutaneous electrical nerve stimulation for treatment of chronic low back and lower extremity pain

    Directory of Open Access Journals (Sweden)

    Gozani SN

    2016-06-01

    Full Text Available Shai N Gozani NeuroMetrix, Inc., Waltham, MA, USA Objective: The objective of this study was to determine if fixed-site high-frequency transcutaneous electrical nerve stimulation (FS-TENS is effective in treating chronic low back and lower extremity pain. Background: Transcutaneous electrical nerve stimulation is widely used for treatment of chronic pain. General-purpose transcutaneous electrical nerve stimulation devices are designed for stimulation anywhere on the body and often cannot be used while the user is active or sleeping. FS-TENS devices are designed for placement at a pre-determined location, which enables development of a wearable device for use over extended time periods. Methods: Study participants with chronic low back and/or lower extremity pain self-administered an FS-TENS device for 60 days. Baseline, 30-, and 60-day follow-up data were obtained through an online questionnaire. The primary outcome measure was the patient global impression of change. Pain intensity and interference were assessed using the Brief Pain Inventory. Changes in use of concomitant pain medications were evaluated with a single-item global self-rating. Results: One hundred and thirty participants were enrolled, with 88 completing the 60-day follow-up questionnaire. Most participants (73.9% were 50 years of age or older. At baseline, low back pain was identified by 85.3%, lower extremity pain by 71.6%, and upper extremity pain by 62.5%. Participants reported widespread pain, at baseline, with a mean of 3.4 (standard deviation 1.1 pain sites. At the 60-day follow-up, 80.7% of participants reported that their chronic pain had improved and they were classified as responders. Baseline characteristics did not differentiate non-responders from responders. There were numerical trends toward reduced pain interference with walking ability and sleep, and greater pain relief in responders. There was a large difference in use of concomitant pain medications, with 80

  15. Intradural spinal neurocysticercosis: case illustration

    Directory of Open Access Journals (Sweden)

    Balderrama Jorge

    2017-12-01

    Full Text Available Introduction: Neurocysticercosis (NCC is a common parasitic infection of the central nervous system caused by the larvae of the Taenia solium. Spinal cord involvement is very uncommon. Clinical case: A female patient with a history of NCC presented with chronic and recurrent headache associated with motor and sensory deficit, which develops tonic-clonic convulsion, with spatial disorientation. She also had intracranial hypertension syndrome, meningitis syndrome, and pyramidal sygns suggestive of spinal NCC. Conclusions: Neurocysticercosis usually occurs in developing countries and should be considered as a differential diagnosis of neurological diseases. Early diagnosis and treatment are mandatory, as well as education to the community to primary prevention.

  16. [Spinal column: implants and revisions].

    Science.gov (United States)

    Krieg, S M; Meyer, H S; Meyer, B

    2016-03-01

    Non-fusion spinal implants are designed to reduce the commonly occurring risks and complications of spinal fusion surgery, e.g. long duration of surgery, high blood loss, screw loosening and adjacent segment disease, by dynamic or movement preserving approaches. This principle could be shown for interspinous spacers, cervical and lumbar total disc replacement and dynamic stabilization; however, due to the continuing high rate of revision surgery, the indications for surgery require as much attention and evidence as comparative data on the surgical technique itself.

  17. Effect of transcutaneous electromyostimulation on pressure pain threshold and tolerance in athletes under eccentric exercise

    Directory of Open Access Journals (Sweden)

    Selman Burak UĞURLU

    2014-08-01

    Full Text Available Exercise - induced hypoalgesia typically reported during and / or follow ing exercise. In this study, we investigated the role of transcutaneous electromyostimulation (EMS on pressure pain threshold and tolerance in athletes under eccentric exercise. Eleven male athletes aged 23,125 ± 0,99 years with 10,25 ± 2,66 years of athl etic training were recruited for this study . Following baseline measurements of pressure pain threshold and tolerance from m. biceps brachii and m. triceps brachii muscle and myofascial regions of the dominant upper extremity by using a digital algometer, subjects were underwent an acute bout of eccentric exercise. Participants were completed 4 sets of eccentric exercise each comprising 20 repetitions of lifting 80% of their 1 RM by using a dumbbell. Pressure pain threshold and tolerance tests were repeated 10, 20 and 30 minutes, and 24 and 48 hours following exercise. One week after acute exercise protocol, EMS protocol was applied to the participants immediately following eccentric exercise, and all measurements were repeated at the same timeline as eccent ric exercise. Standard EMS protocol at active recovery mode for 10 minutes was applied to the m. biceps brachii muscle by using surface electrodes. Results are presented as mean + standarts deviation. Data of the same timeline were analyzed by using repeat ed measures of ANOVA followed by Tukey’s post hoc test . A level of p<0.05 was accepted statistical significant. Eccentric exercise resulted to increase the pain tolerence in athletes, and EMS was found to decrease the pain tolerence 10 and 20 minutes at th e muscle region, and 10 and 30 minutes, and 24 hours at the myofascial region of m. biceps brachii, 10 min and 24 hr from muscle region, 10 and 30 min and 24 hr from myofascial region of M. triceps brachii following acute bout of eccentric exercise. We con cluded that EMS at active recovery phase mitigates the the hypoalgesic response following single bout of

  18. Adjusting pulse amplitude during transcutaneous electrical nerve stimulation (TENS) application produces greater hypoalgesia.

    Science.gov (United States)

    Pantaleão, Manuela A; Laurino, Marjorie F; Gallego, Natalie L G; Cabral, Cristina M N; Rakel, Barbara; Vance, Carol; Sluka, Kathleen A; Walsh, Deirdre M; Liebano, Richard E

    2011-05-01

    Transcutaneous electrical nerve stimulation (TENS) is a noninvasive technique used for pain modulation. During application of TENS there is a fading of current sensation. Textbooks of electrophysical agents recommend that pulse amplitude should be constantly adjusted. This seems to be accepted clinically despite the fact that there is no direct experimental evidence. The aim of the current study was to investigate the hypoalgesic effect of adjusting TENS pulse amplitude on pressure pain thresholds (PPTs) in healthy humans. Fifty-six healthy TENS naïve participants were recruited and randomly assigned to 1 of 4 groups (n = 14 per group): control, placebo TENS, fixed pulse amplitude TENS, and adjusted pulse amplitude TENS. Both active and placebo TENS were applied to the dominant forearm. PPTs were recorded from 2 points on the dominant forearm and hand before, during, and after 40 minutes of TENS. TENS increased the PPTs on the forearm (P = .003) and hand (P = .003) in the group that received the adjusted pulse amplitude when compared to all other groups. The mean final pulse amplitude for the adjusted pulse amplitude TENS group was 35.51 mA when compared to the fixed pulse amplitude TENS group, which averaged 31.37 mA (P = .0318). These results suggest that it is important to adjust the pulse amplitude during TENS application to get the maximal analgesic effect. We propose that the fading of current sensation allows the use of higher pulse amplitudes, which would activate a greater number of and deeper tissue afferents to produce greater analgesia. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

  19. Immediate effects of tongue trills associated with transcutaneous electrical nerve stimulation (TENS).

    Science.gov (United States)

    Fabron, Eliana Maria Gradim; Petrini, Andressa Schweitzer; Cardoso, Vanessa de Moraes; Batista, João Carlos Torgal; Motonaga, Suely Mayumi; Marino, Viviane Cristina de Castro

    2017-06-08

    To investigate vocal quality variability after applying tongue trills associated with transcutaneous electrical nerve stimulation (TENS) on the larynx of women with normal laryngeal function. Additionally, to verify the effect of this technique over time on voice quality. Participants were 40 women (average 23.4 years) without vocal complaints. The procedure involved tongue trills with or without TENS for 3 minutes, rest and repeating the technique for another 2 minutes. The participants' voices were recorded before (Pre), after three minutes (Post 3min) and after two additional minutes (Post 5min) applying the technique. TENS with two electrodes was used on the thyroid cartilage. Self-assessment, acoustic and perceptual analysis were performed. When comparing tongue trills in isolation and associated with TENS, a greater sense of stability in phonation (self-assessment) and improvement in voice quality (perceptual evaluation) was observed in the combination technique. There was no statistical difference in acoustics findings between tongue trills in isolation and associated with TENS. When comparing the time effect of tongue trills with TENS in self-assessment there was a perception of less muscle tension (3min) and greater comfort during phonation (5 min); in the acoustic analysis, there was an increase of F0 (3 and 5 min) and intensity (5 min) when compared to Pre-moment; in the perceptual evaluation, better voice quality (3min). Comparing tongue trills in isolation and associated with TENS, there were changes in the comfort and muscle tension perception, as well as in vocal quality. On the other hand, tongue trills associated with TENS performed in 3 or 5 minutes resulted in beneficial effects on the voice identified in the assessments.

  20. Dose-specific effects of transcutaneous electrical nerve stimulation (TENS) on experimental pain: a systematic review.

    Science.gov (United States)

    Claydon, Leica S; Chesterton, Linda S; Barlas, Panos; Sim, Julius

    2011-09-01

    To determine the hypoalgesic effects of transcutaneous electrical nerve stimulation (TENS) parameter combinations on experimental models in healthy humans. Searches were performed using the electronic databases Ovid MEDLINE, CINAHL, AMED, and Web of Science (from inception to December 2009). Manual searches of journals and reference lists of retrieved trials were also performed. Randomized controlled trials (RCTs) were included in the review if they compared the hypoalgesic effect of TENS relative with placebo and control, using an experimental pain model in healthy human participants. Two reviewers independently selected the trials, assessed their methodologic quality and extracted data. Forty-three RCTs were eligible for inclusion. A best evidence synthesis revealed: Overall "conflicting" (inconsistent findings in multiple RCTs) evidence of TENS efficacy on experimental pain irrespective of TENS parameters used. Overall intense TENS has "moderate" evidence of efficacy (1 high-quality and 2 low-quality trials). Conventional TENS has overall conflicting evidence of efficacy, this is derived from "strong" evidence of efficacy (generally consistent findings in multiple high-quality RCTs) on pressure pain but strong evidence of inefficacy on other pain models. "Limited" evidence (positive findings from 1 RCT) of hypoalgesia exists for some novel parameters. Low-intensity, low-frequency, local TENS has strong evidence of inefficacy. Inappropriate TENS (using "barely perceptible" intensities) has moderate evidence of inefficacy. The level of hypoalgesic efficacy of TENS is clearly dependent on TENS parameter combination selection (defined in terms of intensity, frequency, and stimulation site) and experimental pain model. Future clinical RCTs may consider these TENS dose responses.

  1. Hypoalgesia in response to transcutaneous electrical nerve stimulation (TENS) depends on stimulation intensity.

    Science.gov (United States)

    Moran, Fidelma; Leonard, Tracey; Hawthorne, Stephanie; Hughes, Ciara M; McCrum-Gardner, Evie; Johnson, Mark I; Rakel, Barbara A; Sluka, Kathleen A; Walsh, Deirdre M

    2011-08-01

    Transcutaneous electrical nerve stimulation (TENS) is an electrophysical modality used for pain management. This study investigated the dose response of different TENS intensities on experimentally induced pressure pain. One hundred and thirty TENS naïve healthy individuals (18-64 years old; 65 males, 65 females) were randomly allocated to 5 groups (n = 26 per group): Strong Non Painful TENS; Sensory Threshold TENS; Below Sensory Threshold TENS; No Current Placebo TENS; and Transient Placebo TENS. Active TENS (80 Hz) was applied to the forearm for 30 minutes. Transient Placebo TENS was applied for 42 seconds after which the current amplitude automatically reset to 0 mA. Pressure pain thresholds (PPT) were recorded from 2 points on the hand and forearm before and after TENS to measure hypoalgesia. There were significant differences between groups at both the hand and forearm (ANOVA; P = .005 and .002). At 30 minutes, there was a significant hypoalgesic effect in the Strong Non Painful TENS group compared to: Below Sensory Threshold TENS, No Current Placebo TENS and Transient Placebo TENS groups (P TENS and No Current Placebo TENS groups at the hand (P = .001). There was no significant difference between Strong Non Painful TENS and Sensory Threshold TENS groups. The area under the curve for the changes in PPT significantly correlated with the current amplitude (r(2) = .33, P = .003). These data therefore show that there is a dose-response effect of TENS with the largest effect occurring with the highest current amplitudes. This study shows a dose response for the intensity of TENS for pain relief with the strongest intensities showing the greatest effect; thus, we suggest that TENS intensity should be titrated to achieve the strongest possible intensity to achieve maximum pain relief. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

  2. CT-assisted transcutaneous interstitial implantation of thoracic tumors: Early experience

    International Nuclear Information System (INIS)

    Heelan, R.T.; Hilaris, B.S.; Anderson, L.; Caravelli, J.F.; Nori, D.; Martini, N.; Watson, R.C.; Linares, L.

    1986-01-01

    The authors have transcutaneously implanted I-125 radioactive seeds in six patients with thoracic tumors (three with lung cancer; three with metastases) to determine the feasibility of this procedure. In four patients the thoracic tumors were localized without evidence of distant metastases, but these patients were not candidates for resection because of chronic pulmonary disease. Tumor volume was measured on CT scans (with sagittal and coronal reconstructions) and the required number of seeds was determined based on tumor volume. Between 6 and 11 needles were placed in the tumor and the seeds were implanted as the needle was withdrawn. Between 40 and 60 seeds were implanted in each patient, under local anesthesia. In this preliminary series all patients were found to have tumor attached to pleura. Four of the six patients underwent implantation during a day-time admission to the institution's Adult Day Hospital. No patient suffered any complication as a result of the procedure. Four patients experienced a symptomatic relief of pain and a decrease in size of tumor bulk (local control). Two patients eventually exhibited renewed tumor growth in the edges of the implanted mass after 6 months; the authors plan to supplement future implantations with external radiation therapy. One patient underwent implantation after local recurrence of tumor, returned to work the day following the procedure, and is without evidence of local recurrence 18 months later. They are encouraged by these preliminary results, for several reasons: the lack of morbidity, the achievement of local control of tumor while avoiding surgery and its potential complications, and avoidance of hospital stay (with consequent financial savings). The intent is to expand this series to include patients with lung tumors not attached to pleura

  3. Upper-airway flow limitation and transcutaneous carbon dioxide during sleep in normal pregnancy.

    Science.gov (United States)

    Rimpilä, Ville; Jernman, Riina; Lassila, Katariina; Uotila, Jukka; Huhtala, Heini; Mäenpää, Johanna; Polo, Olli

    2017-08-01

    Sleep during pregnancy involves a physiological challenge to provide sufficient gas exchange to the fetus. Enhanced ventilatory responses to hypercapnia and hypoxia may protect from deficient gas exchange, but sleep-disordered breathing (SDB) may predispose to adverse events. The aim of this study was to analyze sleep and breathing in healthy pregnant women compared to non-pregnant controls, with a focus on CO 2 changes and upper-airway flow limitation. Healthy women in the third trimester and healthy non-pregnant women with normal body mass index (BMI) were recruited for polysomnography. Conventional analysis of sleep and breathing was performed. Transcutaneous carbon dioxide (TcCO 2 ) was determined for each sleep stage. Flow-limitation was analyzed using the flattening index and TcCO 2 values were recorded for every inspiration. Eighteen pregnant women and 12 controls were studied. Pregnancy was associated with shorter sleep duration and more superficial sleep. Apnea-hypopnea index, arterial oxyhemoglobin desaturation, flow-limitation, snoring or periodic leg movements were similar in the two groups. Mean SaO 2 and minimum SaO 2 were lower and average heart rate was higher in the pregnant group. TcCO 2 levels did not differ between groups but variance of TcCO 2 was smaller in pregnant women during non-rapid eye movement (NREM). TcCO 2 profiles showed transient TcCO 2 peaks, which seem specific to pregnancy. Healthy pregnancy does not predispose to SDB. Enhanced ventilatory control manifests as narrowing threshold of TcCO 2 between wakefulness and sleep. Pregnant women have a tendency for rapid CO 2 increases during sleep which might have harmful consequences if not properly compensated. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Long-duration transcutaneous electric acupoint stimulation alters small-world brain functional networks.

    Science.gov (United States)

    Zhang, Yue; Jiang, Yin; Glielmi, Christopher B; Li, Longchuan; Hu, Xiaoping; Wang, Xiaoying; Han, Jisheng; Zhang, Jue; Cui, Cailian; Fang, Jing

    2013-09-01

    Acupuncture, which is recognized as an alternative and complementary treatment in Western medicine, has long shown efficiencies in chronic pain relief, drug addiction treatment, stroke rehabilitation and other clinical practices. The neural mechanism underlying acupuncture, however, is still unclear. Many studies have focused on the sustained effects of acupuncture on healthy subjects, yet there are very few on the topological organization of functional networks in the whole brain in response to long-duration acupuncture (longer than 20 min). This paper presents a novel study on the effects of long-duration transcutaneous electric acupoint stimulation (TEAS) on the small-world properties of brain functional networks. Functional magnetic resonance imaging was used to construct brain functional networks of 18 healthy subjects (9 males and 9 females) during the resting state. All subjects received both TEAS and minimal TEAS (MTEAS) and were scanned before and after each stimulation. An altered functional network was found with lower local efficiency and no significant change in global efficiency for healthy subjects after TEAS, while no significant difference was observed after MTEAS. The experiments also showed that the nodal efficiencies in several paralimbic/limbic regions were altered by TEAS, and those in middle frontal gyrus and other regions by MTEAS. To remove the psychological effects and the baseline, we compared the difference between diffTEAS (difference between after and before TEAS) and diffMTEAS (difference between after and before MTEAS). The results showed that the local efficiency was decreased and that the nodal efficiencies in frontal gyrus, orbitofrontal cortex, anterior cingulate gyrus and hippocampus gyrus were changed. Based on those observations, we conclude that long-duration TEAS may modulate the short-range connections of brain functional networks and also the limbic system. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Treating Depression with Transcutaneous Auricular Vagus Nerve Stimulation: State of the Art and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Jian Kong

    2018-02-01

    Full Text Available Depression is a highly prevalent disorder, and its treatment is far from satisfactory. There is an urgent need to develop a new treatment for depression. Although still at its early stage, transcutaneous auricular vagus nerve stimulation (taVNS has shown promising potential for treating depression. In this article, we first summarize the results of clinical studies on the treatment effect of taVNS on depression. Then, we re-analyze a previous study to identify the specific symptoms taVNS can relieve as indicated by subscores of the 24-item Hamilton Depression Scale in patients with depression. We found that taVNS can significantly reduce multiple symptoms of depression patients, including anxiety, psychomotor retardation, sleep disturbance, and hopelessness. Next, we pose several hypotheses on the mechanism of taVNS treatment of depression, including directly and indirectly modulating the activity and connectivity of key brain regions involved in depression and mood regulation; inhibiting neuro-inflammatory sensitization; modulating hippocampal neurogenesis; and regulating the microbiome–brain–gut axis. Finally, we outline current challenges and lay out the future directions of taVNS treatment of depression, which include (1 intensively comparing stimulation parameters and “dose effect” (treatment frequency and duration to maximize the treatment effect of taVNS; (2 exploring the effect of taVNS on disorders comorbid with depression (such as chronic pain disorders, cardiovascular disorder, and autism to provide new “two-for-one” treatment approaches for patients with these disorders; and (3 applying multiple scale methods to explore the underlying mechanism of taVNS.

  6. Transcutaneous electrical nerve stimulation reduces pain, fatigue and hyperalgesia while restoring central inhibition in primary fibromyalgia.

    Science.gov (United States)

    Dailey, Dana L; Rakel, Barbara A; Vance, Carol G T; Liebano, Richard E; Amrit, Anand S; Bush, Heather M; Lee, Kyoung S; Lee, Jennifer E; Sluka, Kathleen A

    2013-11-01

    Because transcutaneous electrical nerve stimulation (TENS) works by reducing central excitability and activating central inhibition pathways, we tested the hypothesis that TENS would reduce pain and fatigue and improve function and hyperalgesia in people with fibromyalgia who have enhanced central excitability and reduced inhibition. The current study used a double-blinded randomized, placebo-controlled cross-over design to test the effects of a single treatment of TENS with people with fibromyalgia. Three treatments were assessed in random order: active TENS, placebo TENS and no TENS. The following measures were assessed before and after each TENS treatment: pain and fatigue at rest and in movement; pressure pain thresholds, 6-m walk test, range of motion; 5-time sit-to-stand test, and single-leg stance. Conditioned pain modulation was completed at the end of testing. There was a significant decrease in pain and fatigue with movement for active TENS compared to placebo and no TENS. Pressure pain thresholds increased at the site of TENS (spine) and outside the site of TENS (leg) when compared to placebo TENS or no TENS. During active TENS, conditioned pain modulation was significantly stronger compared to placebo TENS and no TENS. No changes in functional tasks were observed with TENS. Thus, the current study suggests TENS has short-term efficacy in relieving symptoms of fibromyalgia while the stimulator is active. Future clinical trials should examine the effects of repeated daily delivery of TENS, similar to the way in which TENS is used clinically on pain, fatigue, function, and quality of life in individuals with fibromyalgia. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  7. Transcutaneous PCO2 monitors are more accurate than end-tidal PCO2 monitors.

    Science.gov (United States)

    Hirabayashi, Makihiko; Fujiwara, Chieko; Ohtani, Norimasa; Kagawa, Sohei; Kamide, Masayuki

    2009-01-01

    The accuracy of monitors for measuring transcutaneous PCO2 (TcPCO2), end-tidal PCO2 (EtPCO2), and nasal EtPCO2 was evaluated. The measuring devices included a TcPCO2 monitor (TCM3; Radiometer Trading), an EtPCO2 monitor (Ultima; Datex-Ohmeda), and a nasal EtPCO2 monitor (TG-920P; Nihon Kohden). The sensor electrode of the TCM3 TcPCO2 monitor was applied to the skin of the subject's upper arm. A sampling tube attached to the proximal end of the tracheal tube was connected to the Ultima EtPCO2 monitor. The miniature sensor of the TG-920P nasal EtPCO2 monitor was attached to the nostril. The values obtained were compared with direct measurements of arterial PCO2 (PaCO2) obtained by means of an ABL700 blood gas analyzer (Radiometer Trading) in surgically treated patients. The means +/- 2 SD of the differences between variables were calculated. The TcPCO2 monitor (0.19 +/- 4.8 mmHg, mean +/- 2-SD) was more accurate than the EtPCO2 monitor (-4.4 +/- 6.5 mmHg, mean +/- 2-SD) in patients receiving artificial ventilation via an endotracheal tube and the TcPCO2 monitor was also more accurate than the nasal EtPCO2 monitor (-6.3 +/- 9.8 mmHg, bias +/- 2-SD) in patients breathing spontaneously. We found that the TcPCO2 monitor was more accurate than the EtPCO2 or nasal EtPCO2 monitor in surgically treated patients.

  8. Transcutaneous oxygen and carbon dioxide levels with iloprost administration in diabetic critical limb ischemia.

    Science.gov (United States)

    Melillo, Elio; Ferrari, Mauro; Balbarini, Alberto; Pedrinelli, Roberto

    2006-01-01

    Iloprost, a prostacyclin analogue, is a treatment option for surgically unsuitable diabetic chronic critical limb ischemia (CLI), although its outcome is difficult to be anticipated clinically. Whether transcutaneous (tc) oxygen tension (PO2) predicts the response to iloprost in diabetic CLI is unclear at this point and, in that same context, the prognostic role of tc carbon dioxide tension (PCO2), another ischemia-sensitive parameter, is unknown. Supine and dependent tcPO2 and tcPCO2 were measured at baseline and after 4 weeks of iloprost treatment in 31 limbs of 26 type-2 diabetic angiopathies with CLI not amenable to surgery. Success was defined as pain relief and significant reduction of analgesics. Clinical outcome was stratified by baseline tcPO2 and tcPCO2 tertiles, and likelihood ratios (LR) quantified the increase from pretest chances given a certain result. Iloprost succeeded in 16 (52%) and failed in 15 limbs (48%) and post-treatment tcPO2 followed a parallel course. Failures increased by ascending baseline tcPCO2 and descending tcPO2 tertiles; successes behaved specularly. Predictions of failure based on elevated tcPCO2 (>53 mm Hg) were more efficient than relying on depressed tcPO2 (LR 10.7 vs 3.6); success was almost certain when tcPO2 was >23 mm Hg (LR = 17.8). Dependent determinations were less useful than supine measurements for prognostic use. Elevated tcPCO2 predicted failure efficiently and high tcPO2 was a useful prognostic tool for success of iloprost, suggesting that their combined use may allow better prognostic stratification and improve the therapeutic approach to diabetic CLI.

  9. Comparison of the transcutaneous oxygen and carbon dioxide tension in different electrode locations during general anaesthesia.

    Science.gov (United States)

    Nishiyama, T; Nakamura, S; Yamashita, K

    2006-12-01

    The best place for the electrode of transcutaneous measurement of oxygen tension (tcPO2) and carbon dioxide tension (tcPCO2) during general anaesthesia was investigated in three different locations. Fifteen patients for major abdominal surgery in the supine position were studied. The electrode of the TCM4 (Radiometer, Copenhagen, Denmark) was put on the chest, upper arm or forearm. TcPO2, tcPCO2, end-tidal carbon dioxide tension (etCO2), percutaneous oxygen saturation (SaO2), arterial oxygen tension (PaO2 ) and arterial carbon dioxide tension (PaCO2) were simultaneously measured at four different etCO2 concentrations and inhaled oxygen percentages and the location of the electrode was changed to other places to repeat the same measurement. In total, 12 measurements for each patient and 60 measurements for each place were performed. TcPO2 correlated better than SaO2 (R2 = 0.58) with PaO2 (R2 = 0.76), and tcPCO2 correlated well with PaCO2 (R2 = 0.76) and etCO2 (R2 = 0.74) when the electrode was put on the chest, while not on the upper arm or forearm (R2 tcPCO2 (bias, -0.47; limits of agreement, 8.7, -9.64) as surrogate measures of PaO2 and PaCO2, respectively even when the electrode was put on the chest. When the electrode was put on the chest, tcPO2 and tcPCO2 might be available as non-invasive monitors of oxygenation and CO2 status during general anaesthesia, while the absolute values were not interchangeable with PaO2 and PaCO2, respectively.

  10. A transcutaneous energy transmission system for artificial heart adapting to changing impedance.

    Science.gov (United States)

    Fu, Yang; Hu, Liang; Ruan, Xiaodong; Fu, Xin

    2015-04-01

    This article presents a coil-coupling-based transcutaneous energy transmission system (TETS) for wirelessly powering an implanted artificial heart. Keeping high efficiency is especially important for TETS, which is usually difficult due to transmission impedance changes in practice, which are commonly caused by power requirement variation for different body movements and coil-couple malposition accompanying skin peristalsis. The TETS introduced in this article is designed based on a class-E power amplifier (E-PA), of which efficiency is over 95% when its load is kept in a certain range. A resonance matching and impedance compressing functions coupled network based on parallel-series capacitors is proposed in the design, to enhance the energy transmission efficiency and capacity of the coil-couple through resonating, and meanwhile compress the changing range of the transmission impedance to meet the load requirements of the E-PA and thus keep the high efficiency of TETS. An analytical model of the designed TETS is built to analyze the effect of the network and also provide bases for following parameters determination. Then, according algorithms are provided to determine the optimal parameters required in the TETS for good performance both in resonance matching and impedance compressing. The design is tested by a series of experiments, which validate that the TETS can transmit a wide range of power with a total efficiency of at least 70% and commonly beyond 80%, even when the coil-couple is seriously malpositioned. The design methodology proposed in this article can be applied to any existing TETS based on E-PA to improve their performance in actual applications. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  11. Transcutaneous Immunization with a Band-Aid Prevents Experimental Otitis Media in a Polymicrobial Model.

    Science.gov (United States)

    Novotny, Laura A; Clements, John D; Goodman, Steven D; Bakaletz, Lauren O

    2017-06-01

    Otitis media (OM) is a common pediatric disease, and nontypeable Haemophilus influenzae (NTHI) is the predominant pathogen in chronic OM, recurrent OM, and OM associated with treatment failure. OM is also a polymicrobial disease, wherein an upper respiratory tract viral infection predisposes to ascension of NTHI from the nasopharynx, the site of colonization, to the normally sterile middle ear, resulting in disease. Using a clinically relevant viral-bacterial coinfection model of NTHI-induced OM, we performed transcutaneous immunization (TCI) via a band-aid delivery system to administer each of three promising NTHI vaccine candidates derived from bacterial adhesive proteins and biofilm mediators: recombinant soluble PilA (rsPilA), chimV4, and integration host factor. Each immunogen was admixed with the adjuvant LT(R192G/L211A), a double mutant of Escherichia coli heat-labile enterotoxin, and assessed for relative ability to prevent the onset of experimental OM. For each cohort, the presence of circulating immunogen-specific antibody-secreting cells and serum antibody was confirmed prior to intranasal NTHI challenge. After bacterial challenge, blinded video otoscopy and tympanometry revealed a significant reduction in the proportion of animals with signs of OM compared to levels in animals receiving adjuvant only, with an overall vaccine efficacy of 64 to 77%. These data are the first to demonstrate the efficacy afforded by TCI with a band-aid vaccine delivery system in a clinically relevant polymicrobial model of OM. The simplicity of TCI with a band-aid and the significant efficacy observed here hold great promise for reducing the global burden of OM in the pediatric population. Copyright © 2017 American Society for Microbiology.

  12. Soft-Tissue-Anchored Transcutaneous Port for Long-Term Percutaneous Transhepatic Biliary Drainage

    International Nuclear Information System (INIS)

    Nyman, Rickard; Ekloef, Hampus; Eriksson, Lars-Gunnar; Karlsson, Britt-Marie; Rasmussen, Ib; Lundgren, Dan; Thomsen, Peter

    2005-01-01

    Purpose. A transcutaneous port (T-port) has been developed allowing easy exchange of a catheter, which was fixed inside the device, using the Seldinger technique. The objective of the study was to test the T-port in patients who had percutaneous transhepatic biliary drainage (PTBD). Methods. The T-port, made of titanium, was implanted using local anesthesia in 11 patients (mean age 65 years, range 52-85 years) with biliary duct obstruction (7 malignant and 4 benign strictures). The subcutaneous part of the T-port consisted of a flange with several perforations allowing ingrowth of connective tissue. The T-port allowed catheter sizes of 10 and 12 Fr. Results. All wounds healed uneventfully and were followed by a stable period without signs of pronounced inflammation or infection. It was easy to open the port and to exchange the drainage tube. The patient's quality of life was considerably improved even though several patients had problems with repeated bile leakage due to frequent recurrent obstructions of the tubes. The ports were implanted for a mean time of 9 months (range 2-21 months). Histologic examination in four cases showed that the port was well integrated into the soft tissue. Tilting of the T-port in two cases led to perforation of the skin by the subcutaneous part of the ports, which were removed after 7 and 8 months. Conclusion. The T-port served as an excellent external access to the biliary ducts. The drainage tubes were well fixed within the ports. The quality of life of the patients was considerably improved. Together with improved aesthetic appearance they found it easier to conduct normal daily activities and personal care. However, the problem of recurrent catheter obstruction remained unsolved

  13. Effect of early treatment with transcutaneous electrical diaphragmatic stimulation (TEDS on pulmonary inflammation induced by bleomycin

    Directory of Open Access Journals (Sweden)

    Laisa A. Santos

    2013-12-01

    Full Text Available BACKGROUND : Bleomycin (B is an antineoplastic drug that has pulmonary fibrosis as a side effect. There are few experimental studies about the effects of physical therapy treatment in this case. OBJECTIVE: The objective was to study rat lungs treated with B and precocious intervention by transcutaneous electrical diaphragmatic stimulation (TEDS. METHOD : Wistar rats were divided into 4 groups (n=5: a control group (C; a stimulated group (TEDS; a group treated with a single dose of B (intratracheally, 2.5 mg/kg (B; and a group treated with B and electric stimulation (B + TEDS. After the B instillation, the electrical stimulation was applied for 7 days, for a duration of 20 minutes. Lung fragments were histologically processed with hematoxylin and eosin (HE and 8-isoprostane-PGF2α (8-iso-PGF2α. The density of the alveolar area was determined by planimetry, the inflammatory profile was defined by the number of cells, and the level of oxidative stress in the pulmonary tissue was evaluated by 8-iso-PGF2α. For statistical analysis of the data, the Shapiro-Wilk test was used, followed by a one-way ANOVA with the post-hoc Bonferroni test (p≤0.05. RESULTS : The B group exhibited a significant reduction in the area density, and the acute treatment with B + TEDS prevented this reduction. There were increased numbers of fibroblasts, leukocytes, and macrophages in the B group, as well as increased lipid peroxidation, which was observed only in this group. CONCLUSION : B promoted a reduction in the alveolar density area, thereby inducing the inflammatory process and increasing the production of free radicals. These effects were minimized by the application of TEDS at the initial treatment stage.

  14. Early cortical biomarkers of longitudinal transcutaneous vagus nerve stimulation treatment success in depression.

    Science.gov (United States)

    Fang, Jiliang; Egorova, Natalia; Rong, Peijing; Liu, Jun; Hong, Yang; Fan, Yangyang; Wang, Xiaoling; Wang, Honghong; Yu, Yutian; Ma, Yunyao; Xu, Chunhua; Li, Shaoyuan; Zhao, Jingjun; Luo, Man; Zhu, Bing; Kong, Jian

    2017-01-01

    Transcutaneous vagus nerve stimulation (tVNS), a non-invasive method of brain stimulation through the auricular branch of the vagus nerve, has shown promising results in treating major depressive disorder (MDD) in several pilot studies. However, the neural mechanism by which the effect on depression might be achieved has not been fully investigated, with only a few neuroimaging studies demonstrating tVNS-induced changes in the brains of healthy volunteers. Identifying specific neural pathways, which are influenced by tVNS compared with sham in depressed individuals, as well as determining neurobiomarkers of tVNS treatment success are needed to advance the application of tVNS for MDD. In order to address these questions, we measured fMRI brain activity of thirty-eight depressed patients assigned to undergo tVNS ( n  = 17) or sham ( n  = 21) treatment for 4 weeks, during the first stimulation session. The results showed significant fMRI signal increases in the left anterior insula, revealed by a direct comparison of tVNS and sham stimulation. Importantly, the insula activation level during the first stimulation session in the tVNS group was significantly associated with the clinical improvement at the end of the four-week treatment, as indicated by the Hamilton Depression Rating Scale (HAM-D) score. Our findings suggest that anterior insula fMRI activity could serve as a potential cortical biomarker and an early predictor of tVNS longitudinal treatment success.

  15. Evaluation of the effects of transcutaneous electrical nerve stimulation on whole saliva flow: A clinical study

    Directory of Open Access Journals (Sweden)

    Saraf Kedar Vilas

    2009-01-01

    Full Text Available Background and Objectives : Xerostomia and salivary gland hypofunction are associated with advancing age, autoimmune diseases such as Sjφgren′s syndrome, head and neck radiation, smoking and recreational drug usage. Palliative management of xerostomia includes topical agents such as ice chips, saliva substitutes, increasing water intake, paraffin and citric acid containing lozenges. Systemic agents have been used, but some drugs have been found to have unfavorable side effects. Therefore, this study was undertaken to evaluate the effect of transcutaneous electrical nerve stimulation (TENS on whole salivary flow rate in healthy adult subjects. Study Design : One hundred healthy adult subjects (50 males and 50 females, with no history of salivary gland disorder, were enrolled in this study. TENS electrode pads were placed externally on the skin overlying the parotid glands. Unstimulated whole saliva was collected for five minutes in a graduated tube, using a standardized collection technique. The TENS unit was then activated and stimulated saliva was collected for an additional five minutes. Results : Eighty five of the 100 subjects demonstrated increased whole salivary flow when stimulated via the TENS unit. Eleven experienced no change and four experienced a decrease in the salivary flow. The mean unstimulated salivary flow rate was 0.36 ml/min (SD 0.16 and there was a 21% increase in the salivary flow following TENS application. Statistical analysis of flow rates utilizing the paired ′t′ test showed the difference to be statistically significant (P< 0.001. Interpretation and Conclusion : The TENS unit was effective in increasing whole salivary flow in 85% of the healthy adult subjects. A further study in patients with xerostomia, secondary to various local and systemic causes, is required.

  16. Transcutaneous electrical nerve stimulation regulates organ blood flow and apoptosis during controlled hypotension in dogs.

    Directory of Open Access Journals (Sweden)

    Lele Zhang

    Full Text Available Transcutaneous electrical nerve stimulation (TENS is commonly used in clinical practice for alleviating pains and physiological disorders. It has been reported that TENS could counteract the ischemic injury happened in some vital organs. To determine the protective effect of TENS on internal organs during CH in dogs, target hypotension was maintained for 60 min at 50% of the baseline mean arterial pressure (MAP. The perfusion to the brain, liver, stomach, and kidney was recorded and apoptosis within these organs was observed. Results showed that when arriving at the target MAP, and during the maintaining stage for 10 min, perfusion to the stomach and liver in the CH+TENS group was much higher than in the CH group (P<0.05. Perfusion to the cerebral cortex greatly declined in both the controlled pressure groups when compared with the general anesthesia (GA group (P<0.05. After withdrawing CH, the hepatic blood flow in both the CH and CH+TENS groups, and the gastric and cerebral cortical blood flow in the CH+TENS group, were rapidly increased. By the end of MAP restoration, gastric blood flow in the CH group was still low. At 72 h after applying CH, terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL-positive cells in stomach and kidney tissue from the CH group were significantly increased compared with those in the GA group (P<0.05. There was no significant difference in TUNEL-positive cells in the liver and hippocampus among the three groups. Our results demonstrated that CH with a 50% MAP level could cause lower perfusion to the liver, stomach, cerebral cortex, and kidney, with apoptosis subsequently occurring in the stomach and kidney. TENS combined GA is able to improve the blood flow to the liver, stomach, and reduce the apoptosis in the stomach and kidney.

  17. The effect of transcutaneous vagus nerve stimulation on pain perception--an experimental study.

    Science.gov (United States)

    Busch, Volker; Zeman, Florian; Heckel, Andreas; Menne, Felix; Ellrich, Jens; Eichhammer, Peter

    2013-03-01

    Recent preclinical work strongly suggests that vagus nerve stimulation efficiently modulates nociception and pain processing in humans. Most recently, a medical device has offered a transcutaneous electrical stimulation of the auricular branch of the vagus nerve (t-VNS) without any surgery. Our study investigates whether t-VNS may have the potential to alter pain processing using a controlled design. Different submodalities of the somatosensory system were assessed with quantitative sensory testing (QST) including a tonic heat pain paradigm in 48 healthy volunteers. Each subject participated in two experimental sessions with active t-VNS (stimulation) or sham t-VNS (no stimulation) on different days in a randomized order (crossed-over). One session consisted of two QST measurements on the ipsi- and contralateral hand, each before and during 1 h of a continuous t-VNS on the left ear using rectangular pulses (250 μS, 25 Hz). We found an increase of mechanical and pressure pain threshold and a reduction of mechanical pain sensitivity. Moreover, active t-VNS significantly reduced pain ratings during sustained application of painful heat for 5 min compared to sham condition. No relevant alterations of cardiac or breathing activity or clinical relevant side effects were observed during t-VNS. Our findings of a reduced sensitivity of mechanically evoked pain and an inhibition of temporal summation of noxious tonic heat in healthy volunteers may pave the way for future studies on patients with chronic pain addressing the potential analgesic effects of t-VNS under clinical conditions. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Early cortical biomarkers of longitudinal transcutaneous vagus nerve stimulation treatment success in depression

    Directory of Open Access Journals (Sweden)

    Jiliang Fang

    2017-01-01

    Full Text Available Transcutaneous vagus nerve stimulation (tVNS, a non-invasive method of brain stimulation through the auricular branch of the vagus nerve, has shown promising results in treating major depressive disorder (MDD in several pilot studies. However, the neural mechanism by which the effect on depression might be achieved has not been fully investigated, with only a few neuroimaging studies demonstrating tVNS-induced changes in the brains of healthy volunteers. Identifying specific neural pathways, which are influenced by tVNS compared with sham in depressed individuals, as well as determining neurobiomarkers of tVNS treatment success are needed to advance the application of tVNS for MDD. In order to address these questions, we measured fMRI brain activity of thirty-eight depressed patients assigned to undergo tVNS (n = 17 or sham (n = 21 treatment for 4 weeks, during the first stimulation session. The results showed significant fMRI signal increases in the left anterior insula, revealed by a direct comparison of tVNS and sham stimulation. Importantly, the insula activation level during the first stimulation session in the tVNS group was significantly associated with the clinical improvement at the end of the four-week treatment, as indicated by the Hamilton Depression Rating Scale (HAM-D score. Our findings suggest that anterior insula fMRI activity could serve as a potential cortical biomarker and an early predictor of tVNS longitudinal treatment success.

  19. Effects of different frequencies of transcutaneous electrical nerve stimulation on venous vascular reactivity

    Energy Technology Data Exchange (ETDEWEB)

    Franco, O.S.; Paulitsch, F.S.; Pereira, A.P.C.; Teixeira, A.O. [Universidade Federal do Rio Grande, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brasil, Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS (Brazil); Martins, C.N. [Universidade Federal do Rio Grande, Instituto de Ciências Biológicas, Programa de Pós-Graduação em Fisiologia Animal Comparada, Rio Grande, RS, Brasil, Programa de Pós-Graduação em Fisiologia Animal Comparada, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande, Rio Grande, RS (Brazil); Silva, A.M.V. [Universidade Federal de Santa Maria, Departamento de Fisioterapia e Reabilitação, Santa Maria, RS, Brasil, Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Plentz, R.D.M. [Universidade Federal de Ciências da Saúde de Porto Alegre, Programa de Pós-Graduação em Ciências da Reabilitação, Programa de Pós-Graduação em Ciências da Saúde, Porto Alegre, RS, Brasil, Programa de Pós-Graduação em Ciências da Saúde, Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Irigoyen, M.C. [Faculdade de Medicina, Universidade de São Paulo, Instituto do Coração, Unidade de Hipertensão, São Paulo, SP, Brasil, Unidade de Hipertensão, Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Signori, L.U. [Universidade Federal do Rio Grande, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brasil, Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS (Brazil); Universidade Federal do Rio Grande, Instituto de Ciências Biológicas, Programa de Pós-Graduação em Fisiologia Animal Comparada, Rio Grande, RS, Brasil, Programa de Pós-Graduação em Fisiologia Animal Comparada, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande, Rio Grande, RS (Brazil); Universidade Federal de Santa Maria, Departamento de Fisioterapia e Reabilitação, Santa Maria, RS, Brasil, Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil)

    2014-04-04

    Transcutaneous electrical nerve stimulation (TENS) is a type of therapy used primarily for analgesia, but also presents changes in the cardiovascular system responses; its effects are dependent upon application parameters. Alterations to the cardiovascular system suggest that TENS may modify venous vascular response. The objective of this study was to evaluate the effects of TENS at different frequencies (10 and 100 Hz) on venous vascular reactivity in healthy subjects. Twenty-nine healthy male volunteers were randomized into three groups: placebo (n=10), low-frequency TENS (10 Hz, n=9) and high-frequency TENS (100 Hz, n=10). TENS was applied for 30 min in the nervous plexus trajectory from the superior member (from cervical to dorsal region of the fist) at low (10 Hz/200 μs) and high frequency (100 Hz/200 μs) with its intensity adjusted below the motor threshold and intensified every 5 min, intending to avoid accommodation. Venous vascular reactivity in response to phenylephrine, acetylcholine (endothelium-dependent) and sodium nitroprusside (endothelium-independent) was assessed by the dorsal hand vein technique. The phenylephrine effective dose to achieve 70% vasoconstriction was reduced 53% (P<0.01) using low-frequency TENS (10 Hz), while in high-frequency stimulation (100 Hz), a 47% increased dose was needed (P<0.01). The endothelium-dependent (acetylcholine) and independent (sodium nitroprusside) responses were not modified by TENS, which modifies venous responsiveness, and increases the low-frequency sensitivity of α1-adrenergic receptors and shows high-frequency opposite effects. These changes represent an important vascular effect caused by TENS with implications for hemodynamics, inflammation and analgesia.

  20. Effects of different frequencies of transcutaneous electrical nerve stimulation on venous vascular reactivity

    International Nuclear Information System (INIS)

    Franco, O.S.; Paulitsch, F.S.; Pereira, A.P.C.; Teixeira, A.O.; Martins, C.N.; Silva, A.M.V.; Plentz, R.D.M.; Irigoyen, M.C.; Signori, L.U.

    2014-01-01

    Transcutaneous electrical nerve stimulation (TENS) is a type of therapy used primarily for analgesia, but also presents changes in the cardiovascular system responses; its effects are dependent upon application parameters. Alterations to the cardiovascular system suggest that TENS may modify venous vascular response. The objective of this study was to evaluate the effects of TENS at different frequencies (10 and 100 Hz) on venous vascular reactivity in healthy subjects. Twenty-nine healthy male volunteers were randomized into three groups: placebo (n=10), low-frequency TENS (10 Hz, n=9) and high-frequency TENS (100 Hz, n=10). TENS was applied for 30 min in the nervous plexus trajectory from the superior member (from cervical to dorsal region of the fist) at low (10 Hz/200 μs) and high frequency (100 Hz/200 μs) with its intensity adjusted below the motor threshold and intensified every 5 min, intending to avoid accommodation. Venous vascular reactivity in response to phenylephrine, acetylcholine (endothelium-dependent) and sodium nitroprusside (endothelium-independent) was assessed by the dorsal hand vein technique. The phenylephrine effective dose to achieve 70% vasoconstriction was reduced 53% (P<0.01) using low-frequency TENS (10 Hz), while in high-frequency stimulation (100 Hz), a 47% increased dose was needed (P<0.01). The endothelium-dependent (acetylcholine) and independent (sodium nitroprusside) responses were not modified by TENS, which modifies venous responsiveness, and increases the low-frequency sensitivity of α1-adrenergic receptors and shows high-frequency opposite effects. These changes represent an important vascular effect caused by TENS with implications for hemodynamics, inflammation and analgesia

  1. Transcutaneous interferential electrical stimulation for management of neurogenic bowel dysfunction in children with myelomeningocele.

    Science.gov (United States)

    Kajbafzadeh, Abdol-Mohammad; Sharifi-Rad, Lida; Nejat, Farideh; Kajbafzadeh, Majid; Talaei, Hamid-Reza

    2012-04-01

    We describe the efficacy of transcutaneous interferential (IF) electrical stimulation on constipation symptoms in children with myelomeningocele (MMC). MMC children (30, comprising of 17 girls and 13 boys), mean age 6.7 ± 2.9, with moderate to severe intractable constipation were enrolled in this study. They were divided into treatment (IF stimulation, 15 children) and control (sham stimulation, 15 children) groups. All children underwent anorectal manometry before and 6 months after IF therapy considering the rectoanal inhibitory reflex and sphincter pressure. Parents were instructed to complete a bowel habit diary by providing data on the number of defecations per week, form of stool and episodes of pain during defecation. According to parents' report a total neurogenic bowel dysfunction score questionnaire was filled before and 6 months after treatment. A 15-course abdominal area IF electrical stimulation was performed for 20 min and three times per week, with low-frequency current in a duration of 250 μs every 6 s. Children were followed up for a minimum period of 6 months. In the treatment group, sphincter pressure and rectoanal inhibitory reflex significantly improved compared with sham stimulation and pretreatment measures (P < .05). In 73% of patients, the characteristics of constipation decreased immediately after IF therapy, while in 53% patients, they persisted for 6 months. Frequency of defecation increased statistically significant from 2.5 ± 1.1 per week before treatment to 4.7 ± 2.3 per week after treatment (P < .001). This pilot study showed that IF therapy is safe, noninvasive, and effective modality to improve constipation symptoms and anorectal manometry parameters in children with history of myelomeningocele.

  2. Effects of conventional and alternating cushion weight-shifting in persons with spinal cord injury.

    Science.gov (United States)

    Wu, Gary A; Bogie, Kath M

    2014-01-01

    A repeated-measures study of 13 adult full-time wheelchair users with spinal cord injury (SCI) was carried out to determine whether alternating-pressure air cushion (APAC) use compared with independent pressure relief (IPR) provides reliable, effective pressure relief for individuals with SCI. Bilateral mean ischial interface pressure (IP), transcutaneous oxygen tension (TcPO2), and unilateral laser Doppler blood flow were evaluated. Blood flow component contributions were determined using short-time Fourier transform (STFT)-based spectral analysis. IPR assessment was carried out at recruitment. Study participants then used an APAC for 2 wk every 3 mo for 18 mo. IPR weight-shifting decreased mean ischial IP (p APAC-induced weight-shifting decreased mean ischial IP (p APAC-induced weight-shifting produced a higher neurogenic component of blood flow than following IPR (p = 0.02). Thus, IPR positively affects multiple aspects of tissue health but produces transient improvements and must be repeated regularly. APAC activation dynamically and continuously alters IP distribution with more sustained positive tissue health effects.

  3. Effects of electrotherapy in treatment of neurogenic bladder in children with occult spinal dysraphism

    Directory of Open Access Journals (Sweden)

    Ćirović Dragana

    2009-01-01

    Full Text Available Introduction Neurogenic bladder can develop as a result of various degrees of neurogenic lesion in spina bifida. The degree of bladder dysfunction depends on the level and type of spina bifida. Due to results upon complete diagnostic protocols, treatment options are applied. Objective Comparison of therapy results of patients with occult spinal dysraphism with neurogenic bladder that under-went medicamentous therapy and medicamentous with electrotherapy treatment. Methods We had 49 patients with neurogenic bladder that were treated at the University Children's Hospital in Belgrade in the period 2003-2008. The first group of children received medicamentous therapy and the second group received medicamentous therapy with transcutaneous electric nerve stimulation. In both groups we evaluated 4 symptoms: daily enuresis, enuresis nocturna, urgency and frequency and 4 urodynamic parameters: lower bladder capacity, unstable contractions and residual urine and detrusor sphincter dyssynergia. Follow-up urodynamic evaluation was done after 3, 6 and 12 months respectively. Results Our findings pointed out a high statistical significance of improvement in all evaluated urodynamic parameters of neurogenic bladder (predominantly in bladder capacity in the group of children with combined therapy as well in resolution of symptoms (predominantly enuresis nocturna, urgency and frequency. Conclusion Combined therapy is more efficient in treatment of children with neurogenic bladder. Electrotherapy is non-invasive, easily applicable and has had a significant place in treatment of children with dysfunctional voiding.

  4. CT diagnosis of acute spinal injury

    International Nuclear Information System (INIS)

    Ohhama, Mitsuru; Niimiya, Hikosuke; Kimura, Ko; Yamazaki, Gyoji; Nasu, Yoshiro; Shioya, Akihide

    1982-01-01

    CT pictures of 22 acute spinal injuries with damage of the spinal cord were evaluated. In the cases of spinal cord damage with bone injury, changes in the vertebral canal were fully observed by CT. In some of spinal cord damages without bone injury, narrowing of the vertebral canal was demonstrated by CT combined with CT myelography and reconstruction. Evaluation of CT number showed a high density area in damaged spinal cord in some cases. CT was thus considered to be useful as an adjunct diagnostic aid. (Ueda, J.)

  5. Imaging in spine and spinal cord malformations

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Andrea E-mail: a.rossi@panet.itandrearossi@ospedale-gaslini.ge.it; Biancheri, Roberta; Cama, Armando; Piatelli, Gianluca; Ravegnani, Marcello; Tortori-Donati, Paolo

    2004-05-01

    Spinal and spinal cord malformations are collectively named spinal dysraphisms. They arise from defects occurring in the early embryological stages of gastrulation (weeks 2-3), primary neurulation (weeks 3-4), and secondary neurulation (weeks 5-6). Spinal dysraphisms are categorized into open spinal dysraphisms (OSDs), in which there is exposure of abnormal nervous tissues through a skin defect, and closed spinal dysraphisms (CSD), in which there is a continuous skin coverage to the underlying malformation. Open spinal dysraphisms basically include myelomeningocele and other rare abnormalities such as myelocele and hemimyelo(meningo)cele. Closed spinal dysraphisms are further categorized based on the association with low-back subcutaneous masses. Closed spinal dysraphisms with mass are represented by lipomyelocele, lipomyelomeningocele, meningocele, and myelocystocele. Closed spinal dysraphisms without mass comprise simple dysraphic states (tight filum terminale, filar and intradural lipomas, persistent terminal ventricle, and dermal sinuses) and complex dysraphic states. The latter category further comprises defects of midline notochordal integration (basically represented by diastematomyelia) and defects of segmental notochordal formation (represented by caudal agenesis and spinal segmental dysgenesis). Magnetic resonance imaging (MRI) is the preferred modality for imaging these complex abnormalities. The use of the aforementioned classification scheme is greatly helpful to make the diagnosis.

  6. Spinal cord injury arising in anaesthesia practice.

    Science.gov (United States)

    Hewson, D W; Bedforth, N M; Hardman, J G

    2018-01-01

    Spinal cord injury arising during anaesthetic practice is a rare event, but one that carries a significant burden in terms of morbidity and mortality. In this article, we will review the pathophysiology of spinal cord injury. We will then discuss injuries relating to patient position, spinal cord hypoperfusion and neuraxial techniques. The most serious causes of spinal cord injury - vertebral canal haematoma, spinal epidural abscess, meningitis and adhesive arachnoiditis - will be discussed in turn. For each condition, we draw attention to practical, evidence-based measures clinicians can undertake to reduce their incidence, or mitigate their severity. Finally, we will discuss transient neurological symptoms. Some cases of spinal cord injury during anaesthesia can be ascribed to anaesthesia itself, arising as a direct consequence of its conduct. The injury to a spinal nerve root by inaccurate and/or incautious needling during spinal anaesthesia is an obvious example. But in many cases, spinal cord injury during anaesthesia is not caused by, related to, or even associated with, the conduct of the anaesthetic. Surgical factors, whether direct (e.g. spinal nerve root damage due to incorrect pedicle screw placement) or indirect (e.g. cord ischaemia following aortic surgery) are responsible for a significant proportion of spinal cord injuries that occur concurrently with the delivery of regional or general anaesthesia. © 2018 The Association of Anaesthetists of Great Britain and Ireland.

  7. Spinal cord injury at birth

    DEFF Research Database (Denmark)

    Fenger-Gron, Jesper; Kock, Kirsten; Nielsen, Rasmus G

    2008-01-01

    UNLABELLED: A case of perinatally acquired spinal cord injury (SCI) is presented. The foetus was vigorous until birth, the breech presented and delivery was performed by a non-traumatic Caesarean section. The infant displayed symptoms of severe SCI but diagnosis was delayed due to severe co...

  8. Spinal cord toxoplasmosis in AIDS

    International Nuclear Information System (INIS)

    Carteret, M.; Petit, E.; Granat, O.; Marichez, M.; Gilquin, J.

    1995-01-01

    Toxoplasmosis is the most common brain parasitic infection in acquired immunodeficiency syndrome (AIDS). Spinal cord localizations are still rare (2 cases with cerebral involvement, 2 cases without). A case of both spinal cord and cerebral involvement is reported. Magnetic resonance imaging (MR imaging) was performed because of sensory level (L 1). A focal conus medullaris enlargement was seen, iso intense on T 1 weighted images. This lesion was hyperintense on T 2 weighted sequence, and was homogeneously enhanced after Gadolinium on T 1 weighted images. A medullary oedema was noted. A toxoplasmosis treatment was initiated, without cortico therapy. MR imaging performed one month later (D 30), while important clinical improvements were seen, pointed out normal thickness of conus medullaris, without enhancement after Gadolinium. Disease lesions in AIDS with focal spinal cord processes are reviewed, and diagnostic work-up is discussed. Spinal cord single lesion, associated or not with brain involvements should be treated as a toxoplasmic infection, with MR imaging follow up. This work up should avoid medullary biopsy, still required in case of treatment failure. Cerebral involvements, with multiples lesions can mask medullary localization. (authors). 8 refs., 2 figs

  9. Controlled hypotension for spinal surgery

    OpenAIRE

    Dutton, Richard P.

    2004-01-01

    Controlled, deliberate hypotension during anesthesia for major spinal surgery reduces intraoperative blood loss and transfusion requirement. Hypotension may be achieved with increased doses of volatile anesthetic agents or by continuous infusion of vasodilating drugs. Safe application of this technique requires knowledge of the physiology of hemorrhagic shock and close intraoperative monitoring to avoid vasoconstriction and end-organ ischemia.

  10. Spinal trauma. An imaging approach

    International Nuclear Information System (INIS)

    Cassar-Pullicino, V.N.; Imhof, H.

    2006-01-01

    The diagnosis of trauma to the spine - where the slightest oversight may have catastrophic results - requires a thorough grasp of the spectrum of resultant pathology as well as the imaging modalities used in making an accurate diagnosis. In Spinal Trauma, the internationally renowned team of experts provides a comprehensive, cutting-edge exposition of the current vital role of imaging in the diagnosis and treatment of injuries to the axial skeleton. Beginning with a valuable clinical perspective of spinal trauma, the book offers the reader a unique overview of the biomechanics underlying the pathology of cervical trauma. Acute trauma topics include: - Optimization of imaging modalities - Malalignment - signs and significance - Vertebral fractures - detection and implications - Classification of thoraco-lumbar fractures - rationale and relevance - Neurovascular injury. Distilling decades of clinical and teaching expertise, the contributors further discuss the current role of imaging in special focus topics, which include: - The pediatric spine - Sports injuries - The rigid spine - Trauma in the elderly - Vertebral collapse, benign and malignant - Spinal trauma therapy - Vertebral fractures and osteoporosis - Neuropathic spine. All throughout the book, the focus is on understanding the injury, and its implications and complications, through 'an imaging approach'. Lavishly illustrated with hundreds of superb MR images and CT scans, and clear full-color drawings, the authors conclude with a look into the future, defining clinical trends and research directions. Spinal Trauma - with its broad scope, practical imaging approach, and current focus - is designed to enhance confidence and accuracy, making it essential reading for clinicians and radiologists at all levels. (orig.)

  11. Noninvasive control of the power transferred to an implanted device by an ultrasonic transcutaneous energy transfer link.

    Science.gov (United States)

    Shmilovitz, Doron; Ozeri, Shaul; Wang, Chua-Chin; Spivak, Boaz

    2014-04-01

    Ultrasonic transcutaneous energy transfer is an effective method for powering implanted devices noninvasively. Nevertheless, the amount of power harvested by the implanted receiver is sensitive to the distance and orientation of the external transmitting transducer attached to the skin with respect to the implanted receiving transducer. This paper describes an ultrasonic power transfer link whose harvested power is controlled by an inductive link. A small (5 μF) storage capacitor voltage, which is part of the implanted unit, is allowed to swing between 3.8 and 3.5 V using hysteretic control. The two control states are indicated by excitation (while the implanted storage capacitor voltage decreases) or the absence of excitation of an implanted coil that is magnetically coupled to an external coil attached to the skin surface. A 35 mW Ultrasonic Transcutaneous Energy Transfer link was fabricated using two piezoelectric transducers of equal size (Fuji Ceramics C-2 PZT disc 15 mm × 3 mm) operated at a vibration frequency of 720 kHz. By applying the proposed hysteretic control, the captured power was effectively regulated for implantation depths of up to 85 mm.

  12. [Mild and moderate female stress urinary incontinence treated with transcutaneous acupoint electrical stimulation: a randomized controlled trial].

    Science.gov (United States)

    Lian, Aixia; Zhang, Wei; Wang, Song

    2015-04-01

    To compare the difference in the clinical efficacy on mild and moderate female stress urinary incontinence (FSUI) between transcutaneous acupoint electrical stimulation and oral administration of midodrine hydrochloride tablets. Ninety cases of mild and moderate FSUI were randomized into an observation group and a control group, 45 cases in each one. In the observation group, the transcutaneous acupoint electrical stimulation was applied to Ciliao (BL 32), Shenshu (BL 23), Zigong (EX-CA 1), Guanyuan (CV 4) and Qihai (CV 6), once a day. In the control group, midodrine hydrochloride tablets were prescribed for oral administration, 2. 5 mg per treatment, three times each day. The duration of treatment was 4 weeks. The score of international consultation on incontinence questionnaire-urinary incontinence short form (ICI-Q-SF) and leakage of urine in 1 h urinal pad test were observed before and after treatment in the patients of the two groups, and the efficacy was compared between the two groups. The score of ICI-Q-SF and leakage of urine in urinal pad test after treatment were all improved apparently as compared with those before treatment in the two groups (all Pelectrical stimulation achieves the better efficacy on FSUI as compared with the oral administration of midodrine hydrochloride tablets. This therapy effectively improves the patient's urine control ability and reduces leakage of urine.

  13. [Effects of transcutaneous electrostimulation of auricular concha at different stimulating frequencies and duration on acute seizures in epilepsy rats].

    Science.gov (United States)

    Wang, Xiao-Yu; Shang, Hong-Yan; He, Wei; Shi, Hong; Jing, Xiang-Hong; Zhu, Bing

    2012-12-01

    To observe the inhibitory effect of auricular concha transcutaneous electrostimulation (ACTES) of different frequencies and duration on acute seizures in epilepsy rats so as to select a better stimulating parameter for relieving epilepsy. According to the stimulation duration of ACTES, 44 Sprague-Dawley rats were randomized into: 30 s, 5 min, 10 min, and 30 min groups. Epilepsy model was duplicated by intraperitoneal injection of PTZ (pentylenetetrazol, 50 mg/kg). Cerebral field potentials delivered from the fixed 4 recording electrodes array (A-P: -3 -6, L: 4 - 6, H: 1. 5) and reference electrode (a fixed screw) touching the cerebral dura surface were recorded using a data acquisition system (Cerebus 5.0 system). Transcutaneous electrostimulation (1 mA, duration 500 micro(s)) of frequency 2 Hz, 20 Hz and 100 Hz was applied to auricular concha by using an electric stimulator. The anti-epileptic effects of ACTES were evaluated by using the duration and rate of seizure suppression. (1) The anti-epileptic effect of 20 Hz -ACTES was markedly longer than those of 2 Hz and 100 Hz in the duration of seizure suppression (P epilepsy rats.

  14. Interference of heart and transcutaneous oxygen monitoring in the measurement of bioelectrical impedance analysis in preterm newborns

    Directory of Open Access Journals (Sweden)

    Viviane C. Comym

    Full Text Available Abstract Objective: To verify if the connection of electrodes for heart and transcutaneous oxygen monitoring interfere with the measurement of electrical bioimpedance in preterm newborns. Methods: This was a prospective, blinded, controlled, cross-sectional, crossover study that assessed and compared paired measures of resistance (R and reactance (Xc by BIA, obtained with and without monitoring wires attached to the preterm newborn. The measurements were performed in immediate sequence, after randomization to the presence or absence of electrodes. The sample size calculated was 114 measurements or tests with monitoring wires and 114 without monitoring wires, considering for a difference between the averages of 0.1 ohms, with an alpha error of 10% and beta error of 20%, with significance <0.05. Results: No differences were observed between the R (677.37 ± 196.07 vs. 677.46 ± 194.86 and Xc (31.15 ± 9.36 vs. 31.01 ± 9.56 values obtained with and without monitoring wires, respectively, with good correlation between them (R: 0.997 and Xc: 0.968. Conclusion: The presence of heart and/or transcutaneous oxygen monitoring wires connected to the preterm newborn did not affect the values of R or Xc measured by BIA, allowing them to be carried out in this population without risks.

  15. Transcutaneous Electrical Acupoint Stimulation in Children with Autism and Its Impact on Plasma Levels of Arginine-Vasopressin and Oxytocin: A Prospective Single-Blinded Controlled Study

    Science.gov (United States)

    Zhang, Rong; Jia, Mei-Xiang; Zhang, Ji-Sui; Xu, Xin-Jie; Shou, Xiao-Jing; Zhang, Xiu-Ting; Li, Li; Li, Ning; Han, Song-Ping; Han, Ji-Sheng

    2012-01-01

    Acupuncture increases brain levels of arginine-vasopressin (AVP) and oxytocin (OXT), which are known to be involved in the modulation of mammalian social behavior. Transcutaneous electrical acupoint stimulation (TEAS) is often used clinically to produce a similar stimulation to that of acupuncture on the acupoints. In the present study, TEAS was…

  16. Outcome of transcutaneous electrical nerve stimulation in chronic pain: short-term results of a double-blind, randomised, placebo-controlled trial.

    NARCIS (Netherlands)

    Oosterhof, J.; Boo, T.M. de; Oostendorp, R.A.B.; Wilder-Smith, O.H.G.; Crul, B.J.P.

    2006-01-01

    The aim of this study was to test the efficacy of shortterm transcutaneous electrical nerve stimulation (TENS) treatment in chronic pain with respect to pain intensity and patients' satisfaction with treatment results. We therefore performed a randomised controlled trial comparing TENS and sham

  17. Different mechanisms for the short-term effects of real versus sham transcutaneous electrical nerve stimulation (TENS) in patients with chronic pain: a pilot study.

    NARCIS (Netherlands)

    Oosterhof, J.; Wilder-Smith, O.H.G.; Oostendorp, R.A.B.; Crul, B.J.P.

    2012-01-01

    Transcutaneous electrical nerve stimulation (TENS) has existed since the early 1970s. However, randomized placebo controlled studies show inconclusive results in the treatment of chronic pain. These results could be explained by assuming that TENS elicits a placebo response. However, in animal

  18. Effects of transcutaneous electrical nerve stimulation (TENS) on cognition, behavior, and the rest-activity rhythm in children with attention deficit hyperactivity disorder, combined type

    NARCIS (Netherlands)

    Jonsdottir, S; Bouma, A; Sergeant, JA; Scherder, EJA; Bouma, J.M.

    2004-01-01

    Objective. The aim of this study was to examine the effects of transcutaneous electrical nerve stimulation (TENS) on cognition, behavior, and the rest-activity rhythm in children with attention deficit hyperactivity disorder, combined type (ADHD-CT). Methods. Twenty-two children diagnosed with

  19. Effects of transcutaneous electrical nerve stimulation on cognition, behavior, and rest-activity rhythm in children with Attention Deficit Hyperactivity Disorder, combined type

    NARCIS (Netherlands)

    Jonsdottir, S.; Bouma, A.; Sergeant, J.A.; Scherder, E.J.A.

    2004-01-01

    Objective. The aim of this study was to examine the effects of transcutaneous electrical nerve stimulation (TENS) on cognition, behavior, and the rest-activity rhythm in children with attention deficit hyperactivity disorder, combined type (ADHD-CT). Methods. Twenty-two children diagnosed with

  20. Neuroimaging for spine and spinal cord surgery

    Energy Technology Data Exchange (ETDEWEB)

    Koyanagi, Izumi [Hokkaido Neurosurgical Memorial Hospital (Japan); Iwasaki, Yoshinobu; Hida, Kazutoshi

    2001-01-01

    Recent advances in neuroimaging of the spine and spinal cord are described based upon our clinical experiences with spinal disorders. Preoperative neuroradiological examinations, including magnetic resonance (MR) imaging and computerized tomography (CT) with three-dimensional reconstruction (3D-CT), were retrospectively analyzed in patients with cervical spondylosis or ossification of the posterior longitudinal ligament (130 cases), spinal trauma (43 cases) and intramedullary spinal cord tumors (92 cases). CT scan and 3D-CT were useful in elucidating the spine pathology associated with degenerative and traumatic spine diseases. Visualization of the deformity of the spine or fracture-dislocation of the spinal column with 3D-CT helped to determine the correct surgical treatment. MR imaging was most important in the diagnosis of both spine and spinal cord abnormalities. The axial MR images of the spinal cord were essential in understanding the laterality of the spinal cord compression in spinal column disorders and in determining surgical approaches to the intramedullary lesions. Although non-invasive diagnostic modalities such as MR imaging and CT scans are adequate for deciding which surgical treatment to use in the majority of spine and spinal cord disorders, conventional myelography is still needed in the diagnosis of nerve root compression in some cases of cervical spondylosis. (author)

  1. Comparisons of MR findings of the spinal metastasis and the spinal tuberculosis

    International Nuclear Information System (INIS)

    Hong, Myung Sun; Lee, Kil Woo; Kang, Ik Won; Yun, Ku Sub; Choi, Chul Sun; Bae, Sang Hoon

    1994-01-01

    MR findings of the spinal metastasis and the tuberculosis are well known, but sometimes it might be difficult to differentiate these lesions. Therefore we reviewed and analyzed the MR findings which would be useful for the differentiation. T1- and T2- weighted spin echo images and gadolinium-enhanced T1- weighted images were obtained with 1.5 T and 1.0 T superconductive MR imager. We reviewed MR findings in 16 cases of spinal metastases and 24 cases of spinal tuberculosis in terms of signal intensity, contrast enhancement pattern, disc space involvement, spinal canal compressing feature and paraspinal soft tissue mass. The signal intensities of both lesions were hypointense on T1WI and hyperintense on T2WI except those of the metastatic lesions from the prostatic carcinoma. Heterogeneous enhancement was noted in 63% of metastasis, whereas peripheral rim enhancement was noted 83% of spinal tuberculosis(p < .001). Spinal canal compression by collapsed vertebra was only noted in spinal metastasis, and that by paraspinal soft tissue was noted in both spinal metastasis and tuberculosis(p<.001). Disc space invasion was noted in 19% of spinal metastasis and 88% of spinal tuberculosis. Spinal tuberculosis was common at lower thoracic spine(T10) and typically involved two or more adjacent vertebral bodies(96%). The important differential point between spinal metastasis and tuberculosis was the enhancement pattern, involvement of two or more contiguous vertebral bodies and the feature of spinal canal compressing. The secondary importance was the disc space involvement pattern

  2. Prolonged spinal myoclonus following spinal anaesthesia with bupivacaine

    Directory of Open Access Journals (Sweden)

    S Kiran

    2015-01-01

    Full Text Available Spinal myoclonus occurring after spinal anaesthesia is very rare and characterised by sudden involuntary jerks of the back and limbs. A 34 year old male without any comorbidities underwent a subarachnoid block with bupivacaine heavy for laminectomy of L4-L5. Within minutes he developed pain and severe myoclonic jerks of lower back radiating to lower and upper limbs which lasted for 48 hours. Another 65 year old obese lady, known diabetic and hypertensive who presented for a percutaneous nephrolithotomy underwent an epidural catheter placement at L2-L3 and a subarachnoid block with bupivacaine heavy at L3-L4. Within minutes she developed severe myoclonic jerks of the lower limbs and back radiating to upper limbs which again lasted for 48 hours. Both cases ofprolonged acute propriospinal myoclonus following subarachnoid block occurred within a period of six months at a tertiary care centre and were managed with sedation, muscle relaxation, mechanical ventilation and anti epileptics.

  3. Immediate effects of transcutaneous electrical nerve stimulation and focal knee joint cooling on quadriceps activation.

    Science.gov (United States)

    Pietrosimone, Brian G; Hart, Joseph M; Saliba, Susan A; Hertel, Jay; Ingersoll, Christopher D

    2009-06-01

    To determine whether transcutaneous electrical nerve stimulation (TENS) and focal knee joint cooling will affect the quadriceps central activation ratio (CAR) in patients with tibiofemoral osteoarthritis. Thirty-three participants with diagnosed tibiofemoral osteoarthritis were randomly allocated to the 45-min TENS treatment (six males and four females, 56 +/- 10.1 yr, 174.11 +/- 10.78 cm, 89.34 +/- 21.3 kg), the 20-min focal knee joint cooling treatment (six males and five females, 58 +/- 8.4 yr, 176.41 +/- 8.29 cm, 83.18 +/- 17.97 kg), or the control group (five males and seven females, 54 +/- 9.9 yr, 166.37 +/- 13.07 cm, 92.14 +/- 25.37 kg). Volitional quadriceps activation, maximal voluntary isometric contraction, and subjective pain measurements were conducted at baseline and at 20, 30, and 45 min. The 20-min focal knee joint cooling intervention consisted of two 1.5-L ice bags to the anterior and posterior aspects of the knee. The TENS group received 45 min of a sensory, biphasic square wave stimulation (150-mus phase duration and 150 pps) from four 2 x 2-inch electrodes positioned around the patella. : TENS resulted in a significantly higher percent change in CAR scores compared with control at 20 min (6.4 +/- 4.8 vs -3.5 +/- 8, P = 0.006), 30 min (9.7 +/- 10.16 vs -1 +/- 7.9, P = 0.025), and 45 min (11.25 +/- 6.96 vs 0.81 +/- 9.4, P = 0.029). Focal knee joint cooling resulted in significantly higher percent change scores compared with the control group at 20 min (5.75 +/- 7.25 vs -3.5 +/- 8, P = 0.009) and trended to be higher at 45 min (9.06 +/- 9.63 vs 0.81 +/- 9.4, P = 0.098). No significant differences in percent change for CAR were found between the TENS and the focal knee joint cooling group. Both TENS and focal knee joint cooling increased the quadriceps CAR immediately after application in participants with tibiofemoral osteoarthritis.

  4. Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage

    Directory of Open Access Journals (Sweden)

    Papavramidis Theodossis S

    2009-06-01

    Full Text Available Abstract Background Acute pancreatitis leads to abdominal hypertension and compartment syndrome. Weeks after the episodes pancreatic fluids sometimes organize to pseudocysts, fluid collections by or in the gland. Aims of the present study were to evaluate the intra-abdominal pressure (IAP induced by large pancreatic pseudocysts and to examine the effect of their transcutaneous drainage on IAP. Methods Twenty seven patients with a pancreatic pseudocyst were included. Nine patients with pseudocysts greater than 1l (group A had CT drainage and eighteen (volume less than 1l were the control group. The measurements of group A were taken 6 hours before and every morning after the drainage, while for group B, two measurements were performed, one at the day of the initial CT and one 7 days after. Abdominal compliance (Cabd was calculated. Data were analyzed using student's t-test. Results Baseline IAP for group A was 9.3 mmHg (S.D. 1.7 mmHg, while the first post-drainage day (PDD IAP was 5.1 mmHg (S.D. 0.7 mmHg. The second PDD IAP was 5.6 mmHg (S.D. 0.8 mmHg, the third 6.4 mmH (S.D. 1.2 mmHgg, the fourth 6.9 mmHg (S.D. 1.6 mmHg, the fifth 7.9 mmHg (S.D. 1.5 mmHg, the sixth 8.2 mmHg (S.D. 1.4 mmHg, and the seventh 8.2 mmHg (S.D. 1.5 mmHg. Group B had baseline IAP 8.0 mmHg (S.D. 1.2 mmHg and final 8.2 mmHg (S.D. 1.4 mmHg. Cabd after drainage was 185.6 ml/mmHg (SD 47.5 ml/mmHg. IAP values were reduced between the baseline and all the post-drainage measurements in group A. IAPs seem to stabilize after the 5th post-drainage day. Baseline IAP was higher in group A than in group B, while the two values, at day 7, were equivalent. Conclusion The drainage of large pancreatic pseudocyst reduces IAP. Moreover, the IAP seems to rise shortly after the drainage again, but in a way that it remains inferior to the initial value. More chronic changes to the IAP are related to abdominal cavity's properties and have to be further studied.

  5. Transcutaneous electrical nerve stimulation (TENS) for phantom pain and stump pain following amputation in adults.

    Science.gov (United States)

    Johnson, Mark I; Mulvey, Matthew R; Bagnall, Anne-Marie

    2015-08-18

    This is the first update of a Cochrane review published in Issue 5, 2010 on transcutaneous electrical nerve stimulation (TENS) for phantom pain and stump pain following amputation in adults. Pain may present in a body part that has been amputated (phantom pain) or at the site of amputation (stump pain), or both. Phantom pain and stump pain are complex and multidimensional and the underlying pathophysiology remains unclear. The condition remains a severe burden for those who are affected by it. The mainstay treatments are predominately pharmacological, with increasing acknowledgement of the need for non-drug interventions. TENS has been recommended as a treatment option but there has been no systematic review of available evidence. Hence, the effectiveness of TENS for phantom pain and stump pain is currently unknown. To assess the analgesic effectiveness of TENS for the treatment of phantom pain and stump pain following amputation in adults. For the original version of the review we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, PEDRO and SPORTDiscus (February 2010). For this update, we searched the same databases for relevant randomised controlled trials (RCTs) from 2010 to 25 March 2015. We only included RCTs investigating the use of TENS for the management of phantom pain and stump pain following an amputation in adults. Two review authors independently assessed trial quality and extracted data. We planned that where available and appropriate, data from outcome measures were to be pooled and presented as an overall estimate of the effectiveness of TENS. In the original review there were no RCTs that examined the effectiveness of TENS for the treatment of phantom pain and stump pain in adults. For this update, we did not identify any additional RCTs for inclusion. There were no RCTs to judge the effectiveness of TENS for the management of phantom pain and stump pain. The published literature on TENS

  6. Correlation between transcutaneous oxygen partial pressure and nerve conduction determination in type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Xiao-ying DONG

    2013-01-01

    Full Text Available Objectives  To investigate the correlation between transcutaneous oxygen partial pressure (TcPO2 and nerve conduction determination (NC in type 2 diabetic patients. Methods  From January to July in 2012, 381 age-matched type 2 diabetic patients were enrolled in the Xi'nan Hospital of Third Military Medical University. These patients were divided into 4 groups depending on the results of NCS and symptoms of diabetic peripheral neuropathy (DPN, among which there were 129 with abnormal NCS but no DPN symptoms as group 1, 50 with DPN symptoms and normal NCS as group 2, 122 with both abnormal NCS and DPN symptoms as group 3 and 80 without abnormal NCS nor any DPN symptoms as group 4. Groups 1 and 3 served as DPN group, while groups 2 and 4 were respectively named as possible DPN group and non-DPN group. The differences of 33 indexes of TcPO2 in erect and recumbent positions, correlation between TcPO2 values and differences in erect and recumbent positions between groups, and the correlation between TcPO2 values and various NCS parameters were analyzed. Results  The values of TcPO2 in erect position and recumbent position in DPN and possible DPN group were lower, while the difference between them was higher than that (erect-recumbent position difference in non-DPN group (P<0.05. The value of erect position TcPO2 was correlated with all the 26 parameters of NCS including the velocity of median nerve conduction, distal latency, amplitude of compound muscle action potential (P<0.05; the value of recumbent position TcPO2 was also correlated with almost all parameters except the shortest latency of F wave; the erect-recumbent position difference was correlated with 11 out of the above 26 parameters (P<0.05. Conclusion  There is a good correlation between TcPO2 and NCS, which suggests that TcPO2 can serve as a potential and effective method for detecting DPN at early stage.

  7. Spinal cord injury, dendritic spine remodeling, and spinal memory mechanisms.

    Science.gov (United States)

    Tan, Andrew M; Waxman, Stephen G

    2012-05-01

    Spinal cord injury (SCI) often results in the development of neuropathic pain, which can persist for months and years after injury. Although many aberrant changes to sensory processing contribute to the development of chronic pain, emerging evidence demonstrates that mechanisms similar to those underlying classical learning and memory can contribute to central sensitization, a phenomenon of amplified responsiveness to stimuli in nociceptive dorsal horn neurons. Notably, dendritic spines have emerged as major players in learning and memory, providing a structural substrate for how the nervous system modifies connections to form and store information. Until now, most information regarding dendritic spines has been obtained from studies in the brain. Recent experimental data in the spinal cord, however, demonstrate that Rac1-regulated dendritic spine remodeling occurs on second-order wide dynamic range neurons and accompanies neuropathic pain after SCI. Thus, SCI-induced synaptic potentiation engages a putative spinal memory mechanism. A compelling, novel possibility for pain research is that a synaptic model of long-term memory storage could explain the persistent nature of neuropathic pain. Such a conceptual bridge between pain and memory could guide the development of more effective strategies for treatment of chronic pain after injury to the nervous system. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Spinal pseudarthrosis in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Chan, F.L.; Ho, E.K.W.; Fang, D.; Hsu, L.C.S.; Leong, J.C.Y.; Ngan, H.

    Spinal pseudarthrosis is an important mechanical complication in longstanding ankylosing spondylitis. Thirty-five patients with 40 lesions were studied. Three lesions through vertebral bodies resulted from complete fractures. The rest occured at interspaces, more common at the lower thoracic and upper lumbar segments. Double pseudarthrotic lesions were observed in 5 patients. Progressive osteolysis of the anterior elements was prominent, with variable sclerosis, osteophytes, vacuum phenomenon, subluxation and fragmentation. A posterior element weak link, as a bony break or facet joint non-fusion, was an essential component in every lesion, playing an initiating or perpetuating role in its pathogenesis. Mechanical derangement from trauma, severe round kyphosis, spondylodiscitis, hip disease, spinal operation and unusual activities may be contributing factors. Initial treatment is conservative, but 16 patients required operative stabilisation.

  9. Computed tomography in spinal osteoblastoma

    International Nuclear Information System (INIS)

    Torricelli, P.; Martinelli, P.; Boriani, S.; Ferraro, A.

    1986-01-01

    In order to stress the role of computed tomography (CT) in the evaluation of benign spinal osteoblastoma, the authors examined by CT 10 patients with surgically and histologically proved osteoblastomas of the spine. Basing on surgical and histopathological findings CT proved to be a very important method for attesting the presence of the tumors (usually showed by radiographic examination), and specially for their staging and follow-up. CT in fact showed the real extent of the tumor into the spinal canal and towards the paraspinal soft tissues, and allowed the aerly detection of post surgical relapses. The authors conclude that CT is a primary diagnostic modality for preoperative planning and follow-up of benign osteoblastoma

  10. Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Bae, Sang Jin [Sanggyepaik Hospital, Inje University, Seoul (Korea, Republic of)

    2004-12-15

    We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance ({rho} > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury.

  11. Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

    International Nuclear Information System (INIS)

    Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon; Bae, Sang Jin

    2004-01-01

    We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance (ρ > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury

  12. Tiger mauling: fatal spinal injury.

    Science.gov (United States)

    Kohout, M P; Percy, J; Sears, W; Yeo, J D

    1989-06-01

    A 33 year old zoo keeper was attacked by a Sumatran tiger in captivity. Apart from severe lacerations and penetrating wounds to the head and neck, the patient sustained comminuted fractures of C1 and C2 vertebrae with resultant high laceration of the spinal cord. Major vascular injury as well as trauma to pharynx also occurred. The patient survived these injuries for 15 h.

  13. Spinal trauma. An imaging approach

    Energy Technology Data Exchange (ETDEWEB)

    Cassar-Pullicino, V.N. [The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire (United Kingdom). Dept. of Radiology; Imhof, H. [University and General Hospital Vienna (Austria). Dept. of Radiodiagnostics

    2006-07-01

    The diagnosis of trauma to the spine - where the slightest oversight may have catastrophic results - requires a thorough grasp of the spectrum of resultant pathology as well as the imaging modalities used in making an accurate diagnosis. In Spinal Trauma, the internationally renowned team of experts provides a comprehensive, cutting-edge exposition of the current vital role of imaging in the diagnosis and treatment of injuries to the axial skeleton. Beginning with a valuable clinical perspective of spinal trauma, the book offers the reader a unique overview of the biomechanics underlying the pathology of cervical trauma. Acute trauma topics include: - Optimization of imaging modalities - Malalignment - signs and significance - Vertebral fractures - detection and implications - Classification of thoraco-lumbar fractures - rationale and relevance - Neurovascular injury. Distilling decades of clinical and teaching expertise, the contributors further discuss the current role of imaging in special focus topics, which include: - The pediatric spine - Sports injuries - The rigid spine - Trauma in the elderly - Vertebral collapse, benign and malignant - Spinal trauma therapy - Vertebral fractures and osteoporosis - Neuropathic spine. All throughout the book, the focus is on understanding the injury, and its implications and complications, through 'an imaging approach'. Lavishly illustrated with hundreds of superb MR images and CT scans, and clear full-color drawings, the authors conclude with a look into the future, defining clinical trends and research directions. Spinal Trauma - with its broad scope, practical imaging approach, and current focus - is designed to enhance confidence and accuracy, making it essential reading for clinicians and radiologists at all levels. (orig.)

  14. Effectiveness of intraoperative neurophysiological monitoring during spinal surgery

    Directory of Open Access Journals (Sweden)

    Valentina А. Kuzmina

    2016-12-01

    Conclusions. The application of IONM minimized the need for the wake-up test and significantly decreased the incidence of neurological complications caused by injury to the spinal cord and spinal roots during execution of spinal manipulations.

  15. Testosterone Plus Finasteride Treatment After Spinal Cord Injury

    Science.gov (United States)

    2017-12-14

    Spinal Cord Injury; Spinal Cord Injuries; Trauma, Nervous System; Wounds and Injuries; Central Nervous System Diseases; Nervous System Diseases; Spinal Cord Diseases; Gonadal Disorders; Endocrine System Diseases; Hypogonadism; Genital Diseases, Male

  16. Spinal Gap Junction Channels in Neuropathic Pain

    OpenAIRE

    Jeon, Young Hoon; Youn, Dong Ho

    2015-01-01

    Damage to peripheral nerves or the spinal cord is often accompanied by neuropathic pain, which is a complex, chronic pain state. Increasing evidence indicates that alterations in the expression and activity of gap junction channels in the spinal cord are involved in the development of neuropathic pain. Thus, this review briefly summarizes evidence that regulation of the expression, coupling, and activity of spinal gap junction channels modulates pain signals in neuropathic pain states induced...

  17. Spinal cord injury drives chronic brain changes

    Directory of Open Access Journals (Sweden)

    Ignacio Jure

    2017-01-01

    Full Text Available Only a few studies have considered changes in brain structures other than sensory and motor cortex after spinal cord injury, although cognitive impairments have been reported in these patients. Spinal cord injury results in chronic brain neuroinflammation with consequent neurodegeneration and cognitive decline in rodents. Regarding the hippocampus, neurogenesis is reduced and reactive gliosis increased. These long-term abnormalities could explain behavioral impairments exhibited in humans patients suffering from spinal cord trauma.

  18. Spinal Cord Injury Rehabilitation in Nepal

    OpenAIRE

    Nabina Shah; Binav Shrestha; Kamana Subba

    2013-01-01

    Spinal cord injury is a major trauma, with its short and long term effects and consequences to the patient, his friends and family. Spinal cord injury is addressed in the developed countries with standard trauma care system commencing immediately after injury and continuing to the specialized rehabilitation units. Rehabilitation is important to those with spinal injury for both functional and psychosocial reintegration. It has been an emerging concept in Nepal, which has been evident with the...

  19. Contrast enhanced CT of spinal cord angioma

    International Nuclear Information System (INIS)

    Nakamura, Takahiko; Ebitani, Tsutomu; Honma, Takao; Sofue, Muroto; Nakamura, Shigeru

    1982-01-01

    Contrast enhanced CT on 6 patients with spinal cord angioma showed enhancement in 2 of them. The conditions to produce contrast enhancement were the window width of 100 - 200, and the window level of 0 - 50. In spinal cord angioma, contrast enhanced CT is presently only an adjunct to angiography and myelography. Nevertheless, contrast enhanced CT is useful in the screening test for spinal cord angioma, in the patients who are nonindicated to angiography, and in the postoperative follow-up. (Ueda, J.)

  20. Drug-resistant spinal tuberculosis

    Directory of Open Access Journals (Sweden)

    Anil K Jain

    2018-01-01

    Full Text Available Drug-resistant spinal tuberculosis (TB is an emerging health problem in both developing and developed countries. In this review article, we aim to define management protocols for suspicion, diagnosis, and treatment of such patients. Spinal TB is a deep-seated paucibacillary lesion, and the demonstration of acid-fast bacilli on Ziehl-Neelsen staining is possible only in 10%–30% of cases. Drug resistance is suspected in patients showing the failure of clinicoradiological improvement or appearance of a fresh lesion of osteoarticular TB while on anti tubercular therapy (ATT for a minimum period of 5 months. The conventional culture of Mycobacterium tuberculosis remains the gold standard for both bacteriological diagnosis and drug sensitivity testing (DST; however, the high turn around time of 2–6 weeks for detection with added 3 weeks for DST is a major limitation. To overcome this problem, rapid culture methods and molecular methods have been introduced. From a public health perspective, reducing the period between diagnosis and treatment initiation has direct benefits for both the patient and the community. For all patients of drug-resistant spinal TB, a complete Drug-O-Gram should be prepared which includes details of all drugs, their doses, and duration. Patients with confirmed multidrug-resistant TB strains should receive a regimen with at least five effective drugs, including pyrazinamide and one injectable. Patients with resistance to additional antitubercular drugs should receive individualized ATT as per their DST results.