Application of non-invasive low strength pulsed electric field to EGCG treatment synergistically enhanced the inhibition effect on PANC-1 cells.
PLoS One. 2017 ;12(11):e0188885. Epub 2017 Nov 29. PMID: 29186186
Chih-Hsiung Hsieh, Chueh-Hsuan Lu, Wei-Ting Chen, Bo-Lun Ma, Chih-Yu Chao
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.
Medicine (Baltimore). 2015 Jun ;94(24):e950. PMID: 26091459
Sabina Martinenghi, Amelia Caretto, Claudio Losio, Marina Scavini, Emanuele Bosi
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].
Zhongguo Zhen Jiu. 2014 Aug ;34(8):737-40. PMID: 25335244
Ling Chang, Peng-Lan He, Zhen-Zhong Zhou, Yan-Hua Li
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].
Vopr Kurortol Fizioter Lech Fiz Kult. 2009 Sep-Oct(5):30-3. PMID: 19886019
G N Ponomarenko, T G Bin'iash, Iu M Raĭgorodskiĭ, A S Guliaev, V A Shul'diakov, A M Kiriliuk, L Iu Vartanova
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.
Front Biosci. 2009;14:2996-3002. Epub 2009 Jan 1. PMID: 19273251
Jorge A Genovese, Cristiano Spadaccio, Emmanuel Chachques, Olivier Schussler, Alain Carpentier, Juan C Chachques, Amit N Patel
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.
Urology. 2004 Jan;63(1):61-6. PMID: 14751349
Alex C Wang, Ya-Ying Wang, Min-Chi Chen
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.
Arch Physiol Biochem. 2001 Oct;109(4):304-8. PMID: 11935364
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
A Study on the Feasibility of the Deep Brain Stimulation (DBS) Electrode Localization Based on Scalp Electric Potential Recordings.
Front Physiol. 2018;9:1788
Authors: Iacono MI, Atefi SR, Mainardi L, Walker HC, Angelone LM, Bonmassar G
Deep Brain Stimulation (DBS) is an effective therapy for patients disabling motor symptoms from Parkinson's disease, essential tremor, and other motor disorders. Precise, individualized placement of DBS electrodes is a key contributor to clinical outcomes following surgery. Electroencephalography (EEG) is widely used to identify the sources of intracerebral signals from the potential on the scalp. EEG is portable, non-invasive, low-cost, and it could be easily integrated into the intraoperative or ambulatory environment for localization of either the DBS electrode or evoked potentials triggered by stimulation itself. In this work, we studied with numerical simulations the principle of extracting the DBS electrical pulse from the patient's EEG - which normally constitutes an artifact - and localizing the source of the artifact (i.e., the DBS electrodes) using EEG localization methods. A high-resolution electromagnetic head model was used to simulate the EEG potential at the scalp generated by the DBS pulse artifact. The potential distribution on the scalp was then sampled at the 256 electrode locations of a high-density EEG Net. The electric potential was modeled by a dipole source created by a given pair of active DBS electrodes. The dynamic Statistical Parametric Maps (dSPM) algorithm was used to solve the EEG inverse problem, and it allowed localization of the position of the stimulus dipole in three DBS electrode bipolar configurations with a maximum error of 1.5 cm. To assess the accuracy of the computational model, the results of the simulation were compared with the electric artifact amplitudes over 16 EEG electrodes measured in five patients. EEG artifacts measured in patients confirmed that simulated data are commensurate to patients' data (0 ± 6.6 μV). While we acknowledge that further work is necessary to achieve a higher accuracy needed for surgical navigation, the results presented in this study are proposed as the first step toward a validated computational framework that could be used for non-invasive localization not only of the DBS system but also brain rhythms triggered by stimulation at both proximal and distal sites in the human central nervous system.
PMID: 30662407 [PubMed]
A randomized controlled trial of neuromuscular electrical stimulation for chronic urinary retention following traumatic brain injury.
Medicine (Baltimore). 2019 Jan;98(2):e14106
Authors: Zhang YB, Cheng YN
BACKGROUND: This study aimed to evaluate the effectiveness of neuromuscular electrical stimulation (NMES) therapy for chronic urinary retention (CUR) following traumatic brain injury (TBI).
METHODS: This 2-arm randomized controlled trial (RCT) enrolled 86 eligible patients with CUR following TBI. All included patients were randomly allocated to a treatment group (n = 43) or a sham group (n = 43). The administration of NMES or sham NMES, as intervention, was performed for an 8-week period treatment, and 4-week period follow-up. In addition, all subjects were required to undergo indwelling urinary catheter throughout the study period. The primary outcome was assessed by the post-voiding residual urine volume (PV-VRU). The secondary outcomes were evaluated by the voided volume, maximum urinary flow rate (Qmax), and quality of life, as assessed by Barthel Index (BI) scale. In addition, adverse events were also recorded during the study period. All primary and secondary outcomes were measured at baseline, at the end of 8-week treatment, and 4-week follow-up.
RESULTS: At the end of 8-week treatment, the patients in the treatment group did not achieve better outcomes in PV-VRU (P = .66), voided volume (P = .59), Qmax (P = .53), and BI scores (P = .67), than patients in the control group. At the end of 4-week follow-up, there were also no significant differences regarding the PV-VRU (P = .42), voided volume (P = .71), Qmax (P = .24), and BI scores (P = .75) between 2 groups. No adverse events occurred in either group.
CONCLUSIONS: In summary, the findings of this study showed that NMES therapy may not benefit patients with CUR following TBI.
PMID: 30633223 [PubMed - indexed for MEDLINE]
Exploring the Potential Effectiveness of Combining Optimal Nutrition With Electrical Stimulation to Maintain Muscle Health in Critical Illness: A Narrative Review.
Nutr Clin Pract. 2018 Dec;33(6):772-789
Authors: Parry SM, Chapple LS, Mourtzakis M
Muscle wasting occurs rapidly within days of an admission to the intensive care unit (ICU). Concomitant muscle weakness and impaired physical functioning can ensue, with lasting effects well after hospital discharge. Early physical rehabilitation is a promising intervention to minimize muscle weakness and physical dysfunction. However, there is an often a delay in commencing active functional exercises (such as sitting on the edge of bed, standing and mobilizing) due to sedation, patient alertness, and impaired ability to cooperate in the initial days of ICU admission. Therefore, there is high interest in being able to intervene early through nonvolitional exercise strategies such as electrical muscle stimulation (EMS). Muscle health characterized as the composite of muscle quantity, as well as functional and metabolic integrity, may be potentially maintained when optimal nutrition therapy is provided in complement with early physical rehabilitation in critically ill patients; however, the type, dosage, and timing of these interventions are unclear. This article explores the potential role of nutrition and EMS in maintaining muscle health in critical illness. Within this article, we will evaluate fundamental concepts of muscle wasting and evaluate the effects of EMS, as well as the effects of nutrition therapy on muscle health and the clinical and functional outcomes in critically ill patients. We will also highlight current research gaps in order to advance the field forward in this important area.
PMID: 30358183 [PubMed - indexed for MEDLINE]
Motor thalamus supports striatum-driven reinforcement.
Elife. 2018 10 08;7:
Authors: Lalive AL, Lien AD, Roseberry TK, Donahue CH, Kreitzer AC
Reinforcement has long been thought to require striatal synaptic plasticity. Indeed, direct striatal manipulations such as self-stimulation of direct-pathway projection neurons (dMSNs) are sufficient to induce reinforcement within minutes. However, it's unclear what role, if any, is played by downstream circuitry. Here, we used dMSN self-stimulation in mice as a model for striatum-driven reinforcement and mapped the underlying circuitry across multiple basal ganglia nuclei and output targets. We found that mimicking the effects of dMSN activation on downstream circuitry, through optogenetic suppression of basal ganglia output nucleus substantia nigra reticulata (SNr) or activation of SNr targets in the brainstem or thalamus, was also sufficient to drive rapid reinforcement. Remarkably, silencing motor thalamus-but not other selected targets of SNr-was the only manipulation that reduced dMSN-driven reinforcement. Together, these results point to an unexpected role for basal ganglia output to motor thalamus in striatum-driven reinforcement.
PMID: 30295606 [PubMed - indexed for MEDLINE]
Feedback optimizes neural coding and perception of natural stimuli.
Elife. 2018 10 05;7:
Authors: Huang CG, Metzen MG, Chacron MJ
Growing evidence suggests that sensory neurons achieve optimal encoding by matching their tuning properties to the natural stimulus statistics. However, the underlying mechanisms remain unclear. Here we demonstrate that feedback pathways from higher brain areas mediate optimized encoding of naturalistic stimuli via temporal whitening in the weakly electric fish Apteronotus leptorhynchus. While one source of direct feedback uniformly enhances neural responses, a separate source of indirect feedback selectively attenuates responses to low frequencies, thus creating a high-pass neural tuning curve that opposes the decaying spectral power of natural stimuli. Additionally, we recorded from two populations of higher brain neurons responsible for the direct and indirect descending inputs. While one population displayed broadband tuning, the other displayed high-pass tuning and thus performed temporal whitening. Hence, our results demonstrate a novel function for descending input in optimizing neural responses to sensory input through temporal whitening that is likely to be conserved across systems and species.
PMID: 30289387 [PubMed - indexed for MEDLINE]
Imaging fast electrical activity in the brain during ictal epileptiform discharges with electrical impedance tomography.
Neuroimage Clin. 2018;20:674-684
Authors: Hannan S, Faulkner M, Aristovich K, Avery J, Walker M, Holder D
Electrical Impedance Tomography (EIT) is an emerging medical imaging technique which can produce tomographic images of internal impedance changes within an object using non-penetrating surface electrodes. It has previously been used to image impedance changes due to neuronal depolarisation during evoked potentials in the rat somatosensory cortex with a resolution of 2 ms and <200 μm, using an epicortical electrode array. The purpose of this work was to use this technique to elucidate the intracortical spatiotemporal trajectory of ictal spike-and-wave discharges (SWDs), induced by electrical stimulation in an acute rat model of epilepsy, throughout the cerebral cortex. Seizures lasting 16.5 ± 5.3 s with repetitive 2-5 Hz SWDs were induced in five rats anaesthetised with fentanyl-isoflurane. Transfer impedance measurements were obtained during each seizure with a 57-electrode epicortical array by applying 50 μA current at 1.7 kHz to two electrodes and recording voltages from all remaining electrodes. Images were reconstructed from averaged SWD-related impedance traces obtained from EIT measurements in successive seizures. We report the occurrence of reproducible impedance changes during the initial spike phase, which had an early onset in the whisker barrel cortex and spread posteriorly, laterally and ventrally over 20 ms (p < 0.03125, N = 5). These findings, which confirm and extend knowledge of SWD initiation and expression, suggest that EIT is a valuable neuroimaging tool for improving understanding of neural circuits implicated in epileptic phenomena.
PMID: 30218899 [PubMed - indexed for MEDLINE]
Delayed muscle onset soreness in the gastrocnemius muscle attenuates the spinal contribution to interlimb communication.
Eur J Appl Physiol. 2018 Nov;118(11):2393-2402
Authors: Gervasio S, Finocchietti S, Stevenson AJT, Mrachacz-Kersting N
PURPOSE: Delayed onset muscle soreness (DOMS) has been shown to induce changes in muscle activity during walking. The aim of this study was to elucidate whether DOMS also affects interlimb communication during walking by investigating its effect on short-latency crossed responses (SLCRs).
METHODS: SLCRs were elicited in two recording sessions by electrically stimulating the tibial nerve of the ipsilateral leg, and quantified in the contralateral gastrocnemius muscle. The second recording session occurred 24-36 h after the participants (n = 11) performed eccentric exercises with the ipsilateral calf.
RESULTS: DOMS caused a decreased magnitude of the spinally mediated component of the SLCR in the contralateral gastrocnemius medialis.
CONCLUSIONS: The results of the current study provide insight on the relationship between pain and motor control. Muscle pain affects the spinal pathway mediating interlimb communication, which might result in a reduced ability to maintain dynamical stability during walking.
PMID: 30132112 [PubMed - indexed for MEDLINE]
Effects of endurance cycling training on neuromuscular fatigue in healthy active men. Part II: Corticospinal excitability and voluntary activation.
Eur J Appl Physiol. 2018 Nov;118(11):2295-2305
Authors: Aboodarda SJ, Mira J, Floreani M, Jaswal R, Moon SJ, Amery K, Rupp T, Millet GY
This study investigated the effects of 9-week endurance cycling training on central fatigability and corticomotor excitability of the locomotor muscles. Fourteen healthy participants undertook three incremental fatiguing cycling tests to volitional exhaustion (EXH): (i) before training (PRE), (ii) after training at the same absolute power output as PRE (POSTABS) and (iii) after training at the same percentage of V̇O2max as PRE (POSTREL). At baseline (i.e. before cycling), every 5 min during cycling and immediately at EXH, a neuromuscular evaluation including a series of 5-s knee extensions at 100, 75 and 50% of maximal voluntary knee extension (MVC) was performed. During each contraction, transcranial magnetic and peripheral nerve stimuli were elicited to obtain motor evoked potential (MEP), silent period (SP) and compound muscle action potential (Mmax) and to calculate voluntary activation (VA). The MEP·Mmax-1 ratio recorded from vastus lateralis at 100 and 50% MVC did not show any difference between conditions. At 75% MVC, MEP exhibited significantly lower values in POSTABS and POSTREL compared to PRE at baseline (P = 0.022 and P = 0.011, respectively) as well as at 25% of time to EXH of PRE (P = 0.022) for POSTREL. No adaptations, either at baseline or during cycling, were observed for VA and SPs. In conclusion, endurance training may result in some adaptations in the corticomotor responses when measured at rest or with low level of fatigue, yet these adaptations do not translate into attenuation of central fatigue at a similar cycling workload or at exhaustion.
PMID: 30128852 [PubMed - indexed for MEDLINE]
Role of sacral neuromodulation in modern urogynaecology practice: a review of recent literature.
Int Urogynecol J. 2018 08;29(8):1081-1091
Authors: Tahseen S
Sacral neuromodulation (SNM) offers promise in the therapy of many pelvic floor disorders. This innovative treatment has slowly gained popularity. A review of recent literature is presented in relation to its efficacy and complications in various pelvic floor conditions: overactive bladder and urge urinary incontinence, chronic urinary retention, painful bladder syndrome, pelvic pain and double incontinence. It is a minimally invasive, completely reversible safe procedure with good long-term outcomes. However, the treatment is costly, the revision rate is high and patients require life-long follow-up. SNM should always be considered in suitable patients before offering bladder augmentation procedures or urinary diversion or permanent catheterization for bladder dysfunction. SNM should also be considered in patients with double incontinence, after discussion in a urogynaecology/colorectal multidisciplinary team.
PMID: 29302716 [PubMed - indexed for MEDLINE]
A Novel Animal Model Simulating the Beginning of Combat Exposure.
Authors: Kim D, Kim CY, Koo H, Heo Y, Cheon K
OBJECTIVE: Predator stress, social defeat stress, and fear conditioning animal models have been applied to investigate combat-related posttraumatic stress disorder (PTSD). However, no animal model psychopharmacological studies have investigated prevention of somatization of increased mental stress and fatigue at the beginning of combat exposure. This study utilized a novel animal model simulating the beginning of combat exposure that aided specification of a set of biomarkers.
METHODS: Psychological stress was induced by both inescapable electric foot shock and noise stimuli. Physical fatigue was induced by sleep deprivation and forced exercise in a rotating cage. A new device reflecting simultaneous psychological stress and physical fatigue was constructed. The protocol simulating combat exposure was set as 3 rounds of 24-h exposure in a 2-week period, which was specified as intermittent unpredictable stress (IUS).
RESULTS: Mice exposed to IUS (IUS mice) had significantly higher serum corticosterone levels (p < 0.05), excessive locomotive activity (p < 0.001), and anxiety-like behavior (p < 0.02) compared to control mice. IUS mice also had significantly higher IFN-γ (p < 0.001) and TNF-α (p < 0.05) levels in the supernatant of splenic T-cell culture compared to control mice. Brain-derived neurotropic factor levels were significantly decreased (p < 0.04) after IUS exposure.
CONCLUSION: The proposed animal model of combat exposure reflected cognitive function impairment, behavior disturbance, and altered neuroimmune interactions without any apparent histopathological changes, and this animal model may be more applicable to protective research on war syndrome than combat-related PTSD after war because the hypothalamic-pituitary-adrenal axis has not been blunted.
PMID: 29161707 [PubMed - indexed for MEDLINE]
Current practice patterns and knowledge among gynecologic surgeons of InterStim® programming after implantation.
Int Urogynecol J. 2018 08;29(8):1135-1140
Authors: Hobson DTG, Gaskins JT, Frazier L, Francis SL, Kinman CL, Meriwether KV
INTRODUCTION AND HYPOTHESIS: The objective of this study was to describe surgeons' current practices in InterStim® programming after initial implantation and their knowledge of programming parameters. We hypothesized that surgeons performing their own reprogramming would have increased knowledge.
METHODS: We administered a written survey to attendees at the Society of Gynecologic Surgeons Scientific Meeting and analyzed those on which surgeons indicated they offer InterStim® care. The survey queried surgeon characteristics, experience with InterStim® implantation and programming, and clinical opinions regarding reprogramming and tested six knowledge-based questions about programming parameters. Correct response to all six questions was the primary outcome.
RESULTS: One hundred and thirty-five of 407 (33%) attendees returned the survey, of which 99 met inclusion criteria. Most respondents (88 of 99; 89%) were between 36 and 60 years, 27 (73%) were women, 76 (77%) practiced in a university setting, and 76 (77%) were trained in Female Pelvic Medicine and Reconstructive Surgery (FPMRS). Surgeons who had InterStim® programming training were more likely to perform their own programming [15/46 (32%) vs 6/47 (13%), p = 0.03]. Most answered all knowledge-based questions correctly (62/90, 69%); no surgeon characteristics were significantly associated with this outcome. Most surgeons cited patient comfort (71/80, 89%) and symptom relief (64/80, 80%) as important factors when reprogramming, but no prevalent themes emerged on how and why surgeons change certain programming parameters.
CONCLUSIONS: Surgeons who had formal InterStim® programming training are more likely to perform programming themselves. No surgeon characteristic was associated with improved programming knowledge. We found that surgeons prioritize patient comfort and symptoms when deciding to reprogram.
PMID: 28975361 [PubMed - indexed for MEDLINE]