A Review of Musculoskeletal Embolization to Treat Pain Outside of the Knee

2021 ◽  
Vol 38 (05) ◽  
pp. 515-517
Author(s):  
Abin Sajan ◽  
Sandeep Bagla ◽  
Ari Isaacson
Keyword(s):  
Knee Joint ◽  
Chronic Inflammation ◽  
Shoulder Pain ◽  
Case Reports ◽  
Adhesive Capsulitis ◽  
Lateral Epicondylitis ◽  
Artery Embolization ◽  
The Past ◽  
Genicular Artery ◽  
Future Potential

AbstractChronic inflammation leading to musculoskeletal pain has garnered interest in the past decade with the success of genicular artery embolization for knee pain secondary to osteoarthritis. Outside the knee joint, musculoskeletal embolization has been applied to other anatomical locations, mainly shoulder pain secondary to adhesive capsulitis and elbow pain secondary to lateral epicondylitis. The success of these early trials and other case reports highlights the efficacy of musculoskeletal embolization and its future potential.

Partial Adrenal Suppression with Prolonged Use of Depo-Provera

2019 ◽  
Vol 4 (1) ◽  
pp. 64
Author(s):  
Nur Aisyah Zainordin ◽  
Fatimah Zaherah Mohamed Shah ◽  
Rohana Abdul Ghani
Keyword(s):  
Weight Gain ◽  
Medroxyprogesterone Acetate ◽  
Side Effect ◽  
Case Reports ◽  
Adrenal Incidentaloma ◽  
Adrenal Suppression ◽  
Private Pharmacy ◽  
Significant Weight Gain ◽  
The Past ◽  
Depo Provera

A 49-year old patient presented with symptoms of adrenal suppression following an attempt to withdraw Depo-Provera or Depot Medroxyprogesterone Acetate (DMPA) injection. She had been receiving DMPA injections for the past 16 years for contraception. She was initially prescribed DMPA by her gynaecologist but later on began obtaining the medication directly from a private pharmacy without prior consultation from her gynaecologist. Clinically, she had been experiencing significant weight gain and appeared cushingoid. Blood investigations confirmed partial adrenal suppression with presence of an adrenal incidentaloma. This case reports a known side effect of DMPA but occurring at a much lower dose than previously described. It also highlights the need to increase the awareness of the insidious side effect of DMPA and to avoid unsupervised use of the drug.

Cyber Peacekeeping: Critical Evaluation of Digital Blue Helmets Program

2020 ◽  
pp. 17-27
Author(s):  
Fahad Nabeel
Keyword(s):  
United Nations ◽  
Critical Evaluation ◽  
Threat Detection ◽  
Information And Communications Technologies ◽  
The Past ◽  
Research Article ◽  
Un Peacekeeping ◽  
Starting Point ◽  
Communications Technologies ◽  
Future Potential

In 2016, the United Nations (UN) launched the Digital Blue Helmets (DBH) program under its Office of Information and Communications Technologies (OICT). The launching of DBH was a continuation of a series of steps that the UN and its related agencies and departments have undertaken over the past decade to incorporate cyberspace within their working methodologies. At the time of inception, DBH was envisioned as a team capacitated to act as a replica of a physical peacekeeping force but for the sole purpose of overseeing cyberspace(s). Several research studies have been published in the past few years, which have conceptualized cyber peacekeeping in various ways. Some scholars have mentioned DBH as a starting point of cyber peacekeeping while some have proposed models for integration of cyber peacekeeping within the current UN peacekeeping architecture. However, no significant study has attempted to look at how DBH has evolved since its inception. This research article aims to examine the progress of DBH since its formation. It argues that despite four years since its formation, DBH is still far away from materializing its declared objectives. The article also discusses the future potential roles of DBH, including its collaboration with UN Global Pulse for cyber threat detection and prevention, and embedding the team along with physical peacekeepers.

scholarly journals Digital Glomus Tumor: Bibliographic Review of the Studies Published over the Past 10 Years

2021 ◽  
Vol 49 (01) ◽  
pp. 046-055
Author(s):  
Victoria Hernández ◽  
Tania Lena ◽  
Eliana Camacho ◽  
Matías Craviotto
Keyword(s):  
Glomus Tumor ◽  
Case Reports ◽  
Low Frequency ◽  
Benign Neoplasm ◽  
Surgical Excision ◽  
Soft Tissue Tumors ◽  
Glomus Tumors ◽  
The Past ◽  
Pubmed Search ◽  
Magnetic Resonance Imaging Mri

AbstractGlomus tumors are a mostly benign neoplasm that constitutes less than 4% of upper-limb soft-tissue tumors. Its unspecific clinical presentation, added to its low frequency, leads to a late diagnosis.The objective of the present study is to update the clinical-paraclinical approach and the surgical technique used in the treatment.We carried out a literature review from 2014 to 2019 on digital glomus tumor in the hand in adult patients using the PubMed search engine.In most of the publications analyzed, the diagnosis was clinical, with a delay of 1 to 10 years. Plain radiography is the most requested study; of the 16 articles reporting its indication, only half evidenced compatible changes. Magnetic resonance imaging (MRI) was requested in 15 articles, presenting normal results in 3 of them. The treatment of choice was surgical excision using a transungual approach. Only 4 articles report recurrence after excision.Although there is diversity in the approach to these tumors, we conclude that the diagnosis is clinical, and the treatment surgical, and there is no consensus regarding the paraclinical indication. The information available comes mainly from case reports, publications that contribute to the generation of evidence for the clinical practice in rare diseases such as this one.

scholarly journals Angiographic Analysis of the Anatomical Variants in Genicular Artery Embolization

2021 ◽  
Author(s):  
Sandeep Bagla ◽  
Rachel Piechowiak ◽  
Abin Sajan ◽  
Julie Orlando ◽  
A Diego Hipolito Canario ◽  
...  
Keyword(s):  
Procedure Time ◽  
Technical Success ◽  
Artery Embolization ◽  
Novel Technique ◽  
Anterior Tibial ◽  
Branching Patterns ◽  
Genicular Artery ◽  
Arterial Anatomy ◽  
Lateral Superior Genicular Artery ◽  
Angiographic Findings

Abstract Purpose: Genicular artery embolization (GAE) has been proposed as a novel technique to treat painful synovitis related to osteoarthritis. An in-depth understanding of the genicular arterial anatomy is crucial to achieve technical success and avoid nontarget-related complications. Given the lack of previous angiographic description, the present study analyzes genicular arterial anatomy and proposes an angiographic classification system. Materials and Methods: Angiographic findings from 41 GAEs performed during two US clinical trials from January 2017 to July 2019 were reviewed to analyze the anatomical details of the following vessels: descending genicular artery (DGA), medial superior genicular artery (MSGA), medial inferior genicular artery (MIGA), lateral superior genicular artery (LSGA), lateral inferior genicular artery (LIGA), and anterior tibial recurrent artery (ATRA). The diameter, angle of origin, and anastomotic pathways were recorded for each vessel. The branching patterns were classified as: medially, M1 (3/3 arteries present) vs M2 (2/3 arteries present); and laterally, L1 (3/3 arteries present) vs L2 (2/3 arteries present). Results: A total of 91 genicular arteries were embolized: DGA (26.4%), MIGA (23.1%), MSGA (22.0%), LIGA (14.3%), and LSGA/ATRA (14.3%). The branching patterns were: medially = M1, 74.4% (n = 29), M2, 25.6% (n = 10); and laterally = L1, 94.9% (n = 37), L2, 5.1% (n = 2). A common origin for MSGA and LSGA was noted in 11 patients (28.2%). A direct DGA origin from the popliteal artery was reported in three patients (7.7%, n = 3). Conclusions: A thorough understanding of the geniculate arterial anatomy is important for maximizing postprocedural pain reduction while minimizing complications, procedure time, and radiation exposure during GAE.

Rock carving on Ayodhya Hill: an avenue for geoheritage, geoconservation and environmental sensitization

Ensemble ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 123-131
Author(s):  
Sanjukta Banik ◽  
◽  
Malay Mukhopadhyay ◽  
Keyword(s):  
Narrative Analysis ◽  
Cultural Landscape ◽  
Empirical Observation ◽  
Commercial Use ◽  
The Past ◽  
Nature And Culture ◽  
Future Potential ◽  
Purulia District ◽  
The Hill

The present paper aims to throw light on the environmental sensitivity illustrated through art on a hill signifying interface of nature and culture .Ayodhya Hill in Purulia district, displays an aspect of aesthetic attachment of humans with nature in the form of in-situ rock cut sculpture ‘Pakhi Pahar’which has transformed the bare hill into a piece of art. For the past three decades the hill has been sculpted by a group of local artists, creating around 65 birds.Even the boulders lying on the foot of the hill are sculpted, to save these fragile components of nature from stone quarrying and crushing machines which are demolishing and fragmenting the rocks and hills of the chotanagpur terrain to gather stone chips for commercial use. It may also be argued by a few ,that the natural environment of Matha range of Ayodhya Hill is infringed upon for the sake of art. The present researcher seeks to explain through empirical observation, narrative analysis and perception study of local people whether Pakhi Pahar is an “Aesthetic Regard” or “Aesthetic Affront” for nature . This paper also tries to bring in to focus the future potential of this cultural landscape in developing as a tourism site and giving employment to the local youth.

Lesions of the Biceps Tendon Diagnosis and Classification

1999 ◽  
Vol 12 (04) ◽  
pp. 188-195 ◽  
Author(s):  
J. F. Bardet
Keyword(s):  
Shoulder Joint ◽  
Biceps Brachii ◽  
Shoulder Arthroscopy ◽  
Case Reports ◽  
Biceps Tendon ◽  
Adhesive Capsulitis ◽  
Clinical Signs ◽  
Joint Disease ◽  
Response To Treatment ◽  
Biceps Tendon Rupture

SummaryThis paper presents the clinical signs, radiographic and arthroscopic findings in 23 dogs and a cat having a lesion of the biceps tendon. Several conditions were recognized: partial or complete rupture; avulsion of the biceps tendon from the supraglenoid tubercle, tendinitis, mid-substance tear, bipartite tendon, dislocations and tenosynovitis of the bicipital tendon. Osteoarthritis of the shoulder joint was seen in 84% of the cases and osteophytosis of the bicipital groove was recognized in 38%. Biceps tendon rupture was associated with shoulder joint instability 76% of the time. Shoulder arthroscopy is a very reliable diagnostic method allowing direct visualization of intra-articular pathologies.In man, the tendon of the biceps brachii is the proverbial stepchild of the shoulder. It has been blamed for numerous painful conditions of the shoulder from arthritis to adhesive capsulitis. Kessell described the tendon as “somewhat of a maverick, easy to inculpate but difficult to condemn (1). Its function has been often misunderstood. It has been tenodesed, translocated, pulled through drill holes in the humeral head, and debrided with an arthroscope, oftentimes with marginal results”. Lippmann likened the biceps tendon to the appendix: “An unimportant vestigial structure unless something goes wrong with it” (2). Neer II has stressed the fact that 95 to 98 per cent of patients with a diagnosis of biceps tendinitis have, in reality, a primary diagnosis of impingement syndrome with secondary involvement of the biceps tendon (3). He has condemned routine biceps tenodesis.The veterinary literature on the biceps tendon in dogs is sparse (4-8). Tenosynovitis of the biceps tendon is “a common cause of forelimb lameness in medium and large breed dogs” (7). “Definitive diagnosis of bicipital tenosynovitis is often not possible, and the diagnosis is backed into by eliminating other causes of lameness. Proof of the diagnosis often depends on response to treatment” (7). There are not any reviews of cases of rupture of the tendon of the biceps brachii muscle except for anecdotal case reports (7). Arthrography has been described as diagnostic of rupture (10, 11). Calcifying tendinopathy of the biceps tendon was seen on radiographic views of the scapulohumeral joint in four dogs (9). Twodimensional real-time ultrasonography was found helpful in the diagnosis of strain of the infraspinatus muscle in a dog (12).This paper reviews the pertinent anatomy, explains the function of the biceps tendon, and presents a review of current concepts on the diagnosis of lesions of the biceps tendon.The author presents the clinical signs, radiographic and arthroscopic finding of the disorders of the biceps tendon seen in 25 shoulders. All biceps tendon lesions may be classified in one of the six subtypes. Partial or complete tears are the most frequent pathology. Degenerative joint disease is seen in 84% of the shoulders.

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