Cybermedlife - Therapeutic Actions Electric Stimulation

Application of non-invasive low strength pulsed electric field to EGCG treatment synergistically enhanced the inhibition effect on PANC-1 cells. 📎

Abstract Title: Application of non-invasive low strength pulsed electric field to EGCG treatment synergistically enhanced the inhibition effect on PANC-1 cells. Abstract Source: PLoS One. 2017 ;12(11):e0188885. Epub 2017 Nov 29. PMID: 29186186 Abstract Author(s): Chih-Hsiung Hsieh, Chueh-Hsuan Lu, Wei-Ting Chen, Bo-Lun Ma, Chih-Yu Chao Article Affiliation: Chih-Hsiung Hsieh Abstract: Traditional therapies for pancreatic cancer are usually expensive and likely to cause side effects, and most patients have the risk of recurrence and suffering pain. Here, we investigated combination treatment of epigallocatechin-3-gallate (EGCG) and non-invasive low strength pulsed electric field (PEF) on the human pancreatic cell line PANC-1. Cells were cultured in various concentrations of EGCG and exposed to trains of PEF. The results showed that the low strength PEF alone or single treatment with low concentration of EGCG did not obviously affect the cell proliferation and migration in PANC-1. However, the EGCG-induced inhibitions of cell viability and migration ability in PANC-1 were dramatically enhanced by the further exposure of low strength PEF (60 V/cm). In particular, the same combination treatment caused less inhibition of cell viability in non-malignant HEK293 cells. We also found the combination treatment significantly decreased the ratio of Bcl-2/Bax protein and increased caspase activity in PANC-1 cells, resulting in the promotion of apoptotic responses, evidenced by chromatin condensation. The findings of the present study reveal the synergistic reactions in the combination treatment may severely disturb mitochondria, enhance the intrinsic pathway transduction, and effectively induce apoptosis; moreover, the migration and invasion of PANC-1 cancer cells were also significantly suppressed. Since normal cells are less sensitive to this combination treatment, and the non-invasive PEF could be modified to focus on a specific location, this treatment may serve as a promising method for anti-cancer therapy. Article Published Date : Dec 31, 2016

Successful Treatment of Dercum's Disease by Transcutaneous Electrical Stimulation: A Case Report. 📎

Abstract Title: Successful Treatment of Dercum's Disease by Transcutaneous Electrical Stimulation: A Case Report. Abstract Source: Medicine (Baltimore). 2015 Jun ;94(24):e950. PMID: 26091459 Abstract Author(s): Sabina Martinenghi, Amelia Caretto, Claudio Losio, Marina Scavini, Emanuele Bosi Article Affiliation: Sabina Martinenghi Abstract: Dercum's disease is a rare condition of painful subcutaneous growth of adipose tissue. Etiology is unknown and pain is difficult to control. We report the case of a 57-year-old man with generalized diffuse Dercum's disease, who improved after the treatment with transcutaneous frequency rhythmic electrical modulation system (FREMS). Treatment consisted in 4 cycles of 30 minutes FREMS sessions over a 6-month period. Measures of efficacy included pain assessment (visual analogue scale, VAS), adipose tissue thickness by magnetic resonance imaging, total body composition and regional fat mass by dual-energy X-ray absorptiometry, physical disability (Barthel index), and health status (Short Form-36 questionnaire). After FREMS treatment the patient's clinical conditions significantly improved, with reduction of pain on the VAS scale from 64 to 17 points, improvement of daily life abilities (the Barthel index increased from 12 to 18) and amelioration of health status (higher scores than baseline in all Short Form-36 domains). Furthermore, we documented a 12 mm reduction in subcutaneous adipose tissue thickness at the abdominal wall and a 7040 g decrease in total body fat mass. FREMS therapy proved to be effective and safe in the treatment of this rare and disabling condition. Article Published Date : May 31, 2015

Efficacy observation of dysphagia after acute stroke treated with acupuncture and functional electric stimulation

Abstract Title: [Efficacy observation of dysphagia after acute stroke treated with acupuncture and functional electric stimulation]. Abstract Source: Zhongguo Zhen Jiu. 2014 Aug ;34(8):737-40. PMID: 25335244 Abstract Author(s): Ling Chang, Peng-Lan He, Zhen-Zhong Zhou, Yan-Hua Li Article Affiliation: Ling Chang Abstract: OBJECTIVE: To observe the impacts on the recovery of swallowing function in patients of dysphagia after acute stroke treated with acupuncture and functional electric stimulation. METHODS: Seventy-four patients were randomized into an acupuncture plus electric stimulation group (38 cases) and an electric stimulation group (36 cases). The functional electric stimulator was used in the two groups. The electric pads were placed on the hyoid bone, the upper part of thyroid cartilage, the masseter muscle and the mandibular joint. The treatment lasted for 30 mm each time. In the acupuncture plus electric stimulation group, acupuncture was supplemented at motor area of Jiao's scalp acupuncture, lower 2/5 of sensory area, Baihui (CV 20), Lianquan (CV 23), Jinjin (EX-HN 12) and Yuye (EX-HN 13), 30 mm each time. The treatment was given once a day, 6 treatments for one session and there was 1 day at interval between the sessions, 4 sessions were required totally in the two groups. The dysphagia scale was adopted for efficacy evaluation before treatment and after 4 sessions of treatment in the two groups. The removal rate of nasal feeding tube was observed after treatment. RESULTS: The dysphagia score was increased apparently after treatment compared with that before treatment in the two groups (both P<0.05). After treatment, in the acupuncture plus electric stimulation group, the dysphagia score was increased much more apparently than that in the electric stimulation group (8.01 +/- 1.25 vs 6.73 +/- 1.36, P<0.05). The remarkably effective rate was 84.2% (32/38) in the acupuncture plus electric stimulation group, better than 58.3% (21/36) in the electric stimulation group (P<0.05). The removal rate of nasal feeding tube was 89.5% (34/38) in the acupuncture plus electric stimulation group, which was higher than 50. 0% (18/36) in the electric stimulation group (P<0.05). CONCLUSION: Acupuncture combined with electric stimulation achieves the much better efficacy on dysphagia after acute stroke and promotes the early removal of nasal feeding tube. The efficacy is better than that of the simple electric stimulation therapy. Article Published Date : Jul 31, 2014

Transcranial magneto- and electrostimulation in patients with obesity and erectile dysfunction

Abstract Title: [Transcranial magneto- and electrostimulation in patients with obesity and erectile dysfunction]. Abstract Source: Vopr Kurortol Fizioter Lech Fiz Kult. 2009 Sep-Oct(5):30-3. PMID: 19886019 Abstract Author(s): G N Ponomarenko, T G Bin'iash, Iu M Raĭgorodskiĭ, A S Guliaev, V A Shul'diakov, A M Kiriliuk, L Iu Vartanova Abstract: The objective of the present study was to evaluate therapeutic efficiency of transcranial magnetotherapy (TcMT) and electric stimulation (ES) included in the combined treatment of 143 patients with erectile dysfunction (ED) and abdominal obesity. The majority of the patients had waist circumference over 102 cm. An AMO-ATOS complex was used to stimulate the hypothalamic region and other brain structures. Transdermal myostimulation of the abdominal and femoral regions was achieved with a Miovolna device. It was shown that both TcM and ES improved lipid metabolism and erectile function; moreover, they exerted hypotensive and sedative action. Specifically, the testosterone level in the patients increased by a mean of 27% compared with the pre-treatment values while the number of patients complaining of erectile dysfunction decreased by 31%. Article Published Date : Sep 01, 2009

Cardiac pre-differentiation of human mesenchymal stem cells by electrostimulation.

Abstract Title: Cardiac pre-differentiation of human mesenchymal stem cells by electrostimulation. Abstract Source: Front Biosci. 2009;14:2996-3002. Epub 2009 Jan 1. PMID: 19273251 Abstract Author(s): Jorge A Genovese, Cristiano Spadaccio, Emmanuel Chachques, Olivier Schussler, Alain Carpentier, Juan C Chachques, Amit N Patel Article Affiliation: Heart, Lung and Esophageal Surgery Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: Myocardial repair using stem-cell therapy has become a promising therapeutic tool. However, many questions concerning a precise functional integration of injected cells remain unanswered. The use of cardiac pre-committed cells may improve integration, as these cells may complete their differentiation in the myocardium reducing fibrosis and restoring muscle function. We have previously demonstrated that electrostimulation (ES) induces cardiomyocyte pre-commitment of fibroblasts in vitro and is an effective alternative to cytokine-induced differentiation. In this study, we evaluated the effects of long term electrostimulation on human mesenchymal stem cells (hMSCs). ES induced both morphological and biochemical changes in hMSCs resulting in a shift toward a striated muscle cell phenotype expressing cardiac specific markers. This partially differentiated phenotype might allow a gradual, ongoing differentiation within the cardiac environment, providing time for both myocardial regeneration and electro-mechanical integration, and convey potential advantages in clinical applications. Article Published Date : Jan 01, 2009

Single-blind, randomized trial of pelvic floor muscle training, biofeedback-assisted pelvic floor muscle training, and electrical stimulation in the management of overactive bladder.

Abstract Title: Single-blind, randomized trial of pelvic floor muscle training, biofeedback-assisted pelvic floor muscle training, and electrical stimulation in the management of overactive bladder. Abstract Source: Urology. 2004 Jan;63(1):61-6. PMID: 14751349 Abstract Author(s): Alex C Wang, Ya-Ying Wang, Min-Chi Chen Abstract: OBJECTIVES: To compare the efficacy of pelvic floor muscle training (PFMT), biofeedback-assisted PFMT (BAPFMT), and electrical stimulation (ES) in the management of overactive bladder (OAB). METHODS: The interventions for the 12-week treatment period, conducted by the physiotherapist who was unaware of the progress and outcome, included (a) a PFMT program tailored to the subject's PERFECT (power, endurance, repetitions, and fast [1-second] contractions, with every contraction timed) scheme, used for training at home; (b) an electromyography BAPFMT program and home program tailored to the subject's PERFECT scheme; and (c) an ES program using biphasic symmetric probe current with 10-Hz frequency, 400-micros pulse width, 10/5 duty cycle, and varying intensity. Identical preintervention and postintervention assessment included King's Health Questionnaire, as well as outcomes of urge incontinence and other urinary symptoms. RESULTS: Of the 103 women who completed this study, 34 were in the PFMT group, 34 in the BAPFMT group, and 35 in the ES group. The changes in the three parameters of King's Health Questionnaire revealed statistically significant differences, except for the total score, between ES and BAPFMT (domain 7, P = 0.003; domain 9, P = 0.029; and total score, P = 0.952). These same parameters were significantly different between ES and PFMT (domain 7, P = 0.007; domain 9, P = 0.001; and total score P = 0.004). The change in total score was significantly different between BAPFMT and PFMT (P = 0.003). The subjective improvement/cure rate of OAB was 51.4% for ES, 50.0% for BAPFMT, and 38.2% for PFMT (P = 0.567). CONCLUSIONS: ES had the greatest subjective reduction rate of OAB and was the most effective of the three treatments. BAPFMT was more effective than PFMT. Article Published Date : Jan 01, 2004

Electrical stimulation of the trigeminal tract in chronic, intractable facial neuralgia.

Abstract Title: Electrical stimulation of the trigeminal tract in chronic, intractable facial neuralgia. Abstract Source: Arch Physiol Biochem. 2001 Oct;109(4):304-8. PMID: 11935364 Abstract Author(s): J Holsheimer Abstract: In this paper the treatment of patients with chronic, intractable trigeminal neuralgia by invasive electrical stimulation of the Gasserion ganglion is reviewed. Two different surgical techniques are employed in this treatment. Most frequently, a method similar to the traditional technique for percutaneous glycerol and radiofrequency trigeminal rhizolysis is used: a small percutaneous stimulation electrode is advanced under fluoroscopic control through a thin needle via the foramen ovale to the Gasserian cistern. Some neurosurgeons use an open surgical technique by which the Gasserian ganglion is approached subtemporally and extradurally, and the bipolar pad electrode is sutured to the dura. When percutaneous test stimulation is successful (at least 50% pain relief) the electrode is internalized and connected to a subcutaneous pulse generator or RF-receiver. Data from 8 clinical studies, including 267 patients have been reviewed. Of all 233 patients with medication-resistant atypical trigeminal neuralgia 48% had at least 50% long term pain relief. The result of test stimulation is a good predictor of the long term effect, because 83% of all patients with successful test stimulation had at least 50% long term relief, and 70% had at least 75% long term relief. Patients generally preferred this invasive method over TENS. The success rate in patients with postherpetic trigeminal neuralgia was very low (less than 10%). It is suggested that the likelihood of pain relief by electrical stimulation is inversely related to the degree of sensory loss. It is concluded that invasive stimulation of the Gasserian ganglion is a promising treatment modality for patients with chronic, intractable, atypical trigeminal neuralgia. Article Published Date : Oct 01, 2001
Therapeutic Actions Electric Stimulation

NCBI pubmed

Modeling Transcranial Direct-Current Stimulation-Induced Electric Fields in Children and Adults.

Related Articles Modeling Transcranial Direct-Current Stimulation-Induced Electric Fields in Children and Adults. Front Hum Neurosci. 2018;12:268 Authors: Ciechanski P, Carlson HL, Yu SS, Kirton A Abstract Transcranial direct-current stimulation (tDCS) is a form of non-invasive brain stimulation that induces electric fields in neuronal tissue, modulating cortical excitability. Therapeutic applications of tDCS are rapidly expanding, and are being investigated in pediatrics for various clinical conditions. Anatomical variations are among a host of factors that influence the effects of tDCS, and pronounced anatomical differences between children and adults suggest that induced electric fields may be substantially different across development. The aim of this study was to determine the strength and distribution of tDCS-induced electric fields across development. Typically developing children, adolescents, and adults were recruited. Individualized finite-element method modeling of primary motor cortex (M1) targeting tDCS was performed. In the largest pediatric sample to date, we found significantly higher peak and mean M1 electric field strength, and more expansive electric field spread for children compared to adults. Electric fields were often comparable between adolescents and adults. Our results suggest that these differences may be associated with age-related differences in skull and extra-axial space thickness, as well as developmental changes occurring in gray and white matter. Individualized current modeling may be a valuable tool for personalizing effective doses of tDCS in future pediatric clinical trials. PMID: 30018543 [PubMed]

Non-rectangular waveforms are more charge-efficient than rectangular one in eliciting network-mediated responses of ON type retinal ganglion cells.

Related Articles Non-rectangular waveforms are more charge-efficient than rectangular one in eliciting network-mediated responses of ON type retinal ganglion cells. J Neural Eng. 2018 Jul 18;: Authors: Lee JI, Im M Abstract OBJECTIVE: For individuals blinded by outer retinal degenerative diseases, retinal prostheses would be a promising option to restore sight. Unfortunately however, the best performance of existing devices is still far removed from normal vision. One possible reason for the shortcoming is thought to be suboptimal stimulation conditions such as waveform shape of electric stimulus. In this study, we explored the effects of varying waveforms on network-mediated responses arising in retinal ganglion cells (RGCs). Approach. We used cell-attached patch clamp technique to record RGC spiking activities in the isolated mouse retina. ON alpha RGCs were targeted by soma size and their light responses to stationary spot flashes. Spiking in targeted RGCs was measured in response to an epiretinally-delivered cathodal current pulse in four waveforms: rectangular, center triangular, increasing and decreasing ramp shapes. Each waveform was tested at three durations (20, 10, and 5 ms) with adjusted amplitude for a range of total charge (50-400 nC). Main results. ON alpha RGCs always generated two bursts of spikes in responses to all stimuli conditions we tested. However, at a given charge, effects of differing waveforms were distinct in the two bursts. For the first burst, the increasing ramp was most effective among the four waveforms (p < 0.05 for all pairwise comparisons with other waveforms). For example, in responses arising from 20-ms-long stimuli, the increasing ramp evoked ~44% more spikes on average than the rectangular shape which is the typical choice of neural stimulation. Also, the rectangular stimulus evoked the weakest response in the delayed burst arising from pulses of every duration. For instance, 20-ms-long stimuli in the three non-rectangular waveforms showed ~23% or more increment in spike counts compared to response arising from rectangular one; but there was no statistical difference in response magnitudes across the non-rectangular waveforms. Significance. Although rectangular waveform has been primarily used in retinal prostheses our results indicate that rectangular stimulus is not optimal for network-mediated responses of ON alpha RGCs. Instead, non-rectangular waveforms evoke stronger responses at a given charge, indicating higher charge-efficiency. Therefore, non-rectangular waveforms are expected to enhance clinical efficacy of retinal prostheses. PMID: 30018183 [PubMed - as supplied by publisher]

Effect of neuromuscular electrical stimulation for fatigue management in patients with advanced laryngeal cancer receiving chemoradiotherapy.

Related Articles Effect of neuromuscular electrical stimulation for fatigue management in patients with advanced laryngeal cancer receiving chemoradiotherapy. Medicine (Baltimore). 2018 Jul;97(28):e11370 Authors: Zhang MJ, Mu JW, Qu XS, Feng C, Zhao W Abstract This study retrospectively investigated the effect of neuromuscular electrical stimulation (NMES) for fatigue management in patients with advanced laryngeal cancer (ALC) receiving chemoradiotherapy.A total of 60 eligible patients with ALC receiving chemoradiotherapy were included. These patients were assigned equally to a treatment group and a control group. Patients in the treatment group received NMES therapy and were treated for a total of 8 weeks, while the patients in the control group did not receive NMES therapy. The primary outcome was fatigue, measured by the multidimensional fatigue inventory (MFI). The secondary outcomes included anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS), and sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI). All outcomes were evaluated before and after 8-week NMES treatmentAfter 8-week NMES treatment, the patients in the treatment group did not exert better effect than patients in the control group in fatigue relief, measured by the MFI score, anxiety and depression decrease, assessed by HADS, and sleep quality improvement, evaluated by PSQI.The results of this study demonstrate that NMES may not benefit for fatigue relief in patients with ALC receiving chemoradiotherapy. Future studies should still focus on this topic and warrant these results. PMID: 29995774 [PubMed - indexed for MEDLINE]

A retrospective study of transcutaneous electrical nerve stimulation for chronic pain following ankylosing spondylitis.

Related Articles A retrospective study of transcutaneous electrical nerve stimulation for chronic pain following ankylosing spondylitis. Medicine (Baltimore). 2018 Jul;97(27):e11265 Authors: Chen FC, Jin ZL, Wang DF Abstract This study investigated the effect of transcutaneous electrical nerve stimulation (TENS) for the treatment of patients with chronic pain after ankylosing spondylitis (AS).A total of 72 eligible patients with chronic pain following AS were included. All included patients received exercise and were assigned to a treatment group and a control group equally. In addition, patients in the treatment group also underwent TENS therapy. All patients were treated for a total of 6 weeks. The primary outcome of pain intensity was measured by visual analog scale (VAS). The secondary outcomes included degree of functional limitation, as assessed by Bath Ankylosing Spondylitis Functional Index (BASFI); and quality of life, as evaluated by Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire. All outcomes were assessed before and after 6 weeks treatment. Furthermore, adverse events were also recorded.After 6-week treatment, patients in the treatment group did not show more promising outcomes in pain reduction, as measured by VAS (P = .08); functional evaluation, as evaluated by BASFI (P = .19); as well as quality of life, as assessed by ASQoL (P = .18), compared with patients in the control group. No adverse events occurred in both groups.This study did not exert encouraging outcomes in patients with chronic pain following AS after 6-week treatment. PMID: 29979392 [PubMed - indexed for MEDLINE]

A border-ownership model based on computational electromagnetism.

Related Articles A border-ownership model based on computational electromagnetism. Neural Netw. 2018 Mar;99:114-122 Authors: Zainal ZA, Satoh S Abstract The mathematical relation between a vector electric field and its corresponding scalar potential field is useful to formulate computational problems of lower/middle-order visual processing, specifically related to the assignment of borders to the side of the object: so-called border ownership (BO). BO coding is a key process for extracting the objects from the background, allowing one to organize a cluttered scene. We propose that the problem is solvable simultaneously by application of a theorem of electromagnetism, i.e., "conservative vector fields have zero rotation, or "curl." We hypothesize that (i) the BO signal is definable as a vector electric field with arrowheads pointing to the inner side of perceived objects, and (ii) its corresponding scalar field carries information related to perceived order in depth of occluding/occluded objects. A simple model was developed based on this computational theory. Model results qualitatively agree with object-side selectivity of BO-coding neurons, and with perceptions of object order. The model update rule can be reproduced as a plausible neural network that presents new interpretations of existing physiological results. Results of this study also suggest that T-junction detectors are unnecessary to calculate depth order. PMID: 29414533 [PubMed - indexed for MEDLINE]

High efficient and non-invasive collection of ejaculates from rats using penile vibratory stimulation.

Related Articles High efficient and non-invasive collection of ejaculates from rats using penile vibratory stimulation. Theriogenology. 2018 Jan 15;106:192-197 Authors: Liu X, Baloch Z, Wang G, Xue S, Huang Q, Yang S Abstract BACKGROUND: The rat is one of the most important experimental animals, which plays an indispensable role in biomedical research, particularly in reproduction. However, according to our best knowledge, there is no easy and efficient method available for semen collection from rats. RESULTS: In this study, we successfully collected semen through penile vibratory stimulation ejaculation (PVSE) from laboratory rats. This is an easier and more efficient method compared with rectal probe electro-ejaculation (RPE). We found that the ejaculation rate, volume, concentration and motility of semen collected with PVSE were substantially better than those of RPE. Although PVSE was time-consuming compared to RPE, the quality of semen was better; additionally, sperm concentration and motility of semen were significantly higher with a two-day interval between collections compared to a five-day interval. Moreover, we found that electrical stimulation, use of anesthesia and increased age of rats have a negative effect on sperm quality. In the last experiment, four fertile female rats were artificially inseminated with PVSE-collected semen, and healthy offspring were born. CONCLUSION: Here, for the first time, we established the repeated collection of semen using the PVSE method in rats. PMID: 29080477 [PubMed - indexed for MEDLINE]

Acoustic simulation of cochlear implant hearing: Effect of manipulating various acoustic parameters on intelligibility of speech.

Related Articles Acoustic simulation of cochlear implant hearing: Effect of manipulating various acoustic parameters on intelligibility of speech. Cochlear Implants Int. 2018 Jan;19(1):46-53 Authors: Jain S, Vipin Ghosh PG Abstract OBJECTIVE: Cochlear implants process the acoustic speech signal and convert it into electrical impulses. During this processing, many parameters contribute to speech perception. The available literature reviewed the effect of manipulating one or two such parameters on speech intelligibility, but multiple parameters are seldom manipulated. METHOD: Acoustic parameters, including pulse rate, number of channels, 'n of m', number of electrodes, and channel spacing, were manipulated in acoustic simulations of cochlear implant hearing and 90 different combinations were created. Speech intelligibility at sentence level was measured using subjective and objective tests. RESULTS: Principal component analysis was employed to select only those components with maximum factor loading, thus reducing the number of components to a reasonable limit. Perceptual speech intelligibility was maximum for signal processing manipulation with respect to 'n of m' and rate of pulses/sec. Regression analysis revealed that lower rate (=500 pps/ch) and lesser stimulating electrodes per cycle (2-4) contributed maximally for speech intelligibility. Perceptual estimate of speech quality (PESQ) and composite measures of spectral weights and likelihood ratio correlated with subjective speech intelligibility scores. DISCUSSION: The findings are consistent with the literature review, indicating that lesser stimulated channel per cycle reduces electrode interaction and hence improve spectral resolution of speech. Reduced rate of pulses/second enhances temporal resolution of speech. Thus, these two components contribute significantly to speech intelligibility. CONCLUSION: Pulse rate/channel and 'n of m' contribute maximally to speech intelligibility, at least in simulations of electric hearing. PMID: 29032744 [PubMed - indexed for MEDLINE]

Percutaneous pedestals in cochlear implantation.

Related Articles Percutaneous pedestals in cochlear implantation. Cochlear Implants Int. 2018 Jan;19(1):54-60 Authors: Mitchell-Innes A, Irving R, Briggs R Abstract Percutaneous pedestals have been integral to the development of cochlear implants since 1969. By enabling direct electrical access to implanted electrodes or other devices, they allow optimization of control of stimulation strategies. Similarly, technology not validated for implantable use can be safely tested. These advantages have facilitated the development of cochlear implants and also resulted in their inclusion in trials investigating electronic implants developed for other organs. Surgery is straightforward, but post-operative care, in particular, skin-care is crucial to ensure complications are minimized. This review discusses the history of percutaneous pedestal use in cochlear implants and other electronic devices. Surgical technique, aftercare, and complications of surgery are discussed along with possibilities for future development. PMID: 29032725 [PubMed - indexed for MEDLINE]

Superior perioperative analgesia with combined femoral-obturator-sciatic nerve block in comparison with posterior lumbar plexus and sciatic nerve block for ACL reconstructive surgery.

Related Articles Superior perioperative analgesia with combined femoral-obturator-sciatic nerve block in comparison with posterior lumbar plexus and sciatic nerve block for ACL reconstructive surgery. Knee Surg Sports Traumatol Arthrosc. 2018 Feb;26(2):478-484 Authors: Bareka M, Hantes M, Arnaoutoglou E, Vretzakis G Abstract PURPOSE: The purpose of this randomized controlled study is to compare and evaluate the intraoperative and post-operative outcome of PLPS nerve block and that of femoral, obturator and sciatic (FOS) nerve block as a method of anaesthesia, in performing ACL reconstruction. METHODS: Patients referred for elective arthroscopic ACL reconstruction using hamstring autograft were divided in two groups. The first group received combined femoral-obturator-sciatic nerve block (FOS Group) under dual guidance, whereas the second group received posterior lumbar plexus block under neurostimulation and sciatic nerve block (PLPS Group) under dual guidance. RESULTS: The two groups were comparable in terms of age, sex, BMI and athletic activity. The time needed to perform the nerve blocks was significantly shorter for the FOS group (p < 0.005). Similarly, VAS scores during tourniquet inflation and autograft harvesting were significantly higher (p < 0.005) in the PLPS group and this is also reflected in the intraoperative fentanyl consumption and conversion to general anaesthesia. Finally, patients in this group also reported higher post-operative VAS scores and consumed more morphine. CONCLUSIONS: Peripheral nerve blockade of FOS nerve block under dual guidance for arthroscopic ACL reconstructive surgery is a safe and tempting anaesthetic choice. The success rate of this technique is higher in comparison with PLPS and results in less peri- and post-operative pain with less opioid consumption. This study provides support for the use of peripheral nerve blocks as an exclusive method for ACL reconstructive surgery in an ambulatory setting with almost no complications. LEVEL OF EVIDENCE: I. PMID: 28315922 [PubMed - indexed for MEDLINE]

The effect of sacral neuromodulation on pregnancy: a systematic review.

Related Articles The effect of sacral neuromodulation on pregnancy: a systematic review. Int Urogynecol J. 2017 Sep;28(9):1357-1365 Authors: Mahran A, Soriano A, Safwat AS, Hijaz A, Mahajan ST, Trabuco EC, Siegel SW, El-Nashar SA Abstract INTRODUCTION AND HYPOTHESIS: To evaluate the effects of sacral neuromodulation (SNM) on pregnancy and the impact of delivery on SNM function. METHODS: A systematic search was conducted through January 2016. We selected studies including women who had SNM and a subsequent pregnancy. RESULTS: Out of 2,316, eight studies were included, comprising 22 patients (26 pregnancies). SNM indications were Fowler's syndrome in 11, urinary retention in 6, fecal incontinence in 1, fecal and urinary urgency in 1, overactive bladder in 1, intractable interstitial cystitis in 1, and myelodysplasia in 1. SNM stayed on in 8 pregnancies. In the remaining 18 pregnancies in which the device was deactivated, 7 had recurrent urinary tract infections, including 1 with pyelonephritis and 2 who requested reactivation owing to recurrent symptoms. Outcomes were reported in 25 pregnancies, 16 had Cesarean section (CS) and 9 had vaginal delivery, including 2 operative deliveries. Out of 25, two infants had pilonidal sinus and motor tic disorder (exhibited at the age of 2 years), both from the same mother. After delivery, SNM was functioning in 15 (60%), 4 required reprogramming, and 3 required replacement (1 had recurrence of fecal incontinence after her operative delivery with evidence of displaced leads and 1 patient reported decreased SNM effects after her two CS), and 3 decided to remove the device (2 out of 3 patients were free of symptoms after SNM deactivation and requested removal). CONCLUSION: Within the current limited evidence, the decision regarding SNM activation or deactivation should be individualized. A registry for those patients is recommended. PMID: 28160010 [PubMed - indexed for MEDLINE]

Increase Signaling of Wnt/β-Catenin Pathway and Presence of Apoptosis in Cerebellum of Kindled Rats.

Related Articles Increase Signaling of Wnt/β-Catenin Pathway and Presence of Apoptosis in Cerebellum of Kindled Rats. CNS Neurol Disord Drug Targets. 2017;16(7):772-780 Authors: Rubio C, Rosiles-Abonce A, Trejo-Solis C, Rubio-Osornio M, Mendoza C, Custodio V, Martinez-Lazcano JC, Gonzalez E, Paz C Abstract BACKGROUND: Epilepsy is one of the most common neurological disorders in humans, and the role of the cerebellum in its physiopathology remains the subject of study. The Purkinje cells (PC), whose axons target the dentate and interpositus nuclei, form the main cerebellar output to forebrain structures involved in epilepsy. Cerebellar atrophy related to loss of PC has been reported in chronic epilepsy although its mechanism remains unclear. Taking into account that an overexpression of β-Catenin has been related with cell death, here we present the signaling of β-Catenin and the type of PC death in cerebellum of rats with seizures induced by the amygdaloid kindling model. METHOD: Using an immunohistochemistry and western blot assay for β-Catenin, c-Myc, cyclin D3, TUNEL and caspase-3, in rats chronically implanted with electrodes, receiving 0, 3, 15, and 45 electrical stimuli. RESULTS: We found that such rats suffering a major number of stimuli showed the highest amount of marks assessed. CONCLUSION: We concluded that there is a higher activity of the Wnt/β-Catenin pathway associated with increased number of stimuli may be related with the presence of apoptosis in the cerebellum treated with amygdala kindling. In this way, we suggest this pathway as one of the mechanisms by which cerebellar neurons death in generalized seizures. PMID: 28124605 [PubMed - indexed for MEDLINE]