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Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Soft tissue lumps are mostly benign. Clinical examination may suggest a diagnosis such as ganglion or lipoma and ultrasound can be used to confirm the clinical suspicion, or to suggest an alternative diagnosis, which can be helpful in planning treatment. If ultrasound is inconclusive or the lesion is not suitable for ultrasound, MRI would be used. If there are ‘red flag’ signs or symptoms (e.g. rapid growth and increasing pain) MRI would be the primary modality due to its greater sensitivity in detecting malignant changes.
Regenerated silk fibroin loaded with natural additives: a sustainable approach towards health care
Published in Journal of Biomaterials Science, Polymer Edition, 2023
Niranjana Jaya Prakash, Xungai Wang, Balasubramanian Kandasubramanian
The human nervous system can be broadly divided into two categories (a) the Peripheral nervous system and (b) the Central nervous system. The peripheral nervous system can heal spontaneously from minor injuries, but major injuries require surgical repair with nerve grafts that are harvested elsewhere in the body [102]. Tissue engineering is therefore of great importance in the treatment of such nerve injuries, and the compatibility of scaffold materials with neural progenitor cells attains huge significance. Silk fibroin supports Schwann cell and dorsal root ganglion survival without affecting normal phenotype or function [103]. Silk fibroin or chitosan conjugates can fill the gap of about 10 mm present in the long sciatic nerve defect in rat models. The addition of neurotrophic factors to promote pore orientation and neuronal growth is currently being studied in order to improve the outcomes of silk-based neural grafts [104]. Neural scaffolds were constructed by culturing the canine bone marrow mesenchymal stem cells (BMSCs) on the surface of neural scaffolds based on chitosan/SF composites, through decellularizing the cell culture followed by the deposition of an acellular matrix (ACM) coating on the scaffolds. The natural biomaterial-based nerve scaffolds coated with cell-derived ACM thus obtained was used as a novel nerve graft to fill the 60 mm nerve gap generated in the sciatic nerve of dogs. Twelve months post transplantation, the functional, behavioural, as well as histological evaluations showed that our engineered neural scaffold achieved desirable regenerative outcomes [104].
Device profile of the Proclaim XR neurostimulation system for the treatment of chronic pain: an overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2020
Jonathan M. Hagedorn, Alyson M. Engle, Priyanka Ghosh, Timothy R. Deer
Overall, the future is bright for spinal cord and dorsal root ganglion stimulation. Over the next 5 years, devices can be expected to become smaller and more powerful with a premium placed on the patient experience. Non-rechargeable devices with improved energy delivery methods and waveforms can be expected to provide superior outcomes. Devices with the capability to provide multiple waveforms will potentially allow patients to experience decreased loss of efficacy, a potential occurrence with SCS. Magnetic resonance image labeling will continue to improve and, in doing so, will allow the implanted patient to attain the imaging necessary for the best clinical outcomes in all disease states. Tracking of outcomes will become more streamlined with easier and more efficient methods for patient reporting. Communication barriers between the patient and physician will dissolve through the creation of improved industry-provided patient reporting programs. In sum, these changes can be expected to improve neuromodulation outcomes and provide a better overall patient experience.
Advanced methods of spinal stimulation in the treatment of chronic pain: pulse trains, waveforms, frequencies, targets, and feedback loops
Published in Expert Review of Medical Devices, 2019
Ankit Maheshwari, Jason E. Pope, Timothy R. Deer, Steven Falowski
The dorsal root ganglion houses primary sensory neurons of all modalities. It has been identified as an important site of aberrant activity in neuropathic pain. Electrical stimulation of the dorsal root ganglion has a potential to reduce neuronal excitability as well as modulating ectopic discharges. Since the time of our last review, there has been an increase in the application of dorsal root ganglion stimulation and clinical outcome studies have demonstrated its effectiveness for numerous chronic neuropathic pain conditions such as complex regional pain syndrome, post-herniorrhaphy groin pain, radicular pain (Table 6). Typically, this modality has been used for the treatment of distal neuropathic pain conditions which, in the past have been hard to treat with dorsal column stimulation.