scholarly journals Non-invasive Stereotactic Radioablation: A New Option for the Treatment of Ventricular Arrhythmias

2020 ◽  
Vol 8 (4) ◽  
pp. 285-293 ◽  
Author(s):  
Chen Wei ◽  
Pierre Qian ◽  
Usha Tedrow ◽  
Raymond Mak ◽  
Paul C Zei
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Invasive Procedure ◽  
Evidence Base ◽  
The Body ◽  
High Rate ◽  
Depth Of Penetration ◽  
Invasive Treatment ◽  
Non Invasive ◽  
New Treatment

Ventricular tachycardia (VT) is associated with significant morbidity and mortality. Radiofrequency catheter ablation can be effective for the treatment of VT but it carries a high rate of recurrence often attributable to insufficient depth of penetration for reaching critical arrhythmogenic substrates. Stereotactic body radioablation (SBRT) is a commonly used technology developed for the non-invasive treatment of solid tumours. Recent evidence suggests that it can also be effective for the treatment of VT. It is a non-invasive procedure and it has the unique advantage of delivering ablative energy to any desired volume within the body to reach sites that are inaccessible with catheter ablation. This article summarises the pre-clinical studies that have formed the evidence base for SBRT in the heart, describes the clinical approaches for SBRT VT ablation and provides perspective on next steps for this new treatment modality.

scholarly journals BOST : BOOST YOUR GINGIVAL HEALTH IN A SINGLE DAY

2020 ◽  
Author(s):  
Gaurav Shetty ◽  
Kashmira Ghangrekar ◽  
Dipika Mitra ◽  
Rohit Shah ◽  
Ankit Desai
Keyword(s):  
Periodontal Disease ◽  
Human Body ◽  
Invasive Surgery ◽  
The Body ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Novel Technique ◽  
Gingival Health ◽  
New Treatment ◽  
The Right

INTRODUCTION: - BOST or Bone One Session Treatment, is a new treatment in tackling the problems of severe gingival disease. The treatment was pioneered by Dr. William Hoisington in the year 2005 for the non-invasive treatment of periodontal disease. METHODOLOGY: - BOST is a one session treatment that treats periodontitis at the source of the infection - Periodontium. After any injury, the human body has the capacity of healing and repair. The treatment takes around four to five hours and requires no invasive surgery. It is fast, comfortable and almost certain to be successful. The technique used in BOST is called the ‘stretch flap’ method. CONCLUSION:- BOST is a novel technique that creates the right circumstances to allow the body to heal and regenerate itself. Key Words: Periodontal therapy, BOST, Periodontitis, TIP

scholarly journals Adaptive Magnetic Resonance-Guided Stereotactic Body Radiotherapy: The Next Step in the Treatment of Renal Cell Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Brian Keller ◽  
Anna M. E. Bruynzeel ◽  
Chad Tang ◽  
Anand Swaminath ◽  
Linda Kerkmeijer ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Oncologic Outcomes ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Treatment Paradigm ◽  
Plan Adaptation ◽  
New Treatment ◽  
Tissue Sparing

Adaptive MR-guided radiotherapy (MRgRT) is a new treatment paradigm and its role as a non-invasive treatment option for renal cell carcinoma is evolving. The early clinical experience to date shows that real-time plan adaptation based on the daily MRI anatomy can lead to improved target coverage and normal tissue sparing. Continued technological innovations will further mitigate the challenges of organ motion and enable more advanced treatment adaptation, and potentially lead to enhanced oncologic outcomes and preservation of renal function. Future applications look promising to make a positive clinical impact and further the personalization of radiotherapy in the management of renal cell carcinoma.

scholarly journals Non-invasive topical diagnostics of heart arrhythmias

2015 ◽  
Vol 18 (4) ◽  
pp. 96 ◽  
Author(s):  
M. S. Khlynin ◽  
S. V. Popov ◽  
S. N. Krivolapov ◽  
R. Ye. Batalov
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Radiofrequency Catheter Ablation ◽  
Atrial Arrhythmias ◽  
Epicardial Mapping ◽  
Non Invasive ◽  
Ventricular Activation ◽  
Noninvasive Mapping ◽  
Electrophysiological Examination ◽  
Heart Arrhythmias

The aim of this study was to measure the accuracy of noninvasively obtained ventricular activation (isolated epicardial vs combined endo-epicardial mapping) as compared with that of standard invasive mapping in patients with ventricular arrhythmias. 94 patients (35 males and 59 females) aged 20 to 67 years (mean age 42.6 years) with ventricular arrhythmias of different localization and etiology and 8 patients (4 males and 4 females) aged 21 to 65 years (mean age 48.8 years) with atrial arrhythmias were examined. All patients underwent noninvasive electrophysiological examination, which was performed with Amycard System, subsequent intracardiac mapping and radiofrequency catheter ablation. The arrythmogenic focus localizations coincided in 83 cases, in 11 patients with ventricular arrhythmias some variances were observed and in patients with atrial arrhythmias no such variances were found. Thus, the accuracy of noninvasive mapping turned out to be 89.2%.

Treatment of scar endometriosis with elagolix

2020 ◽  
Vol 12 (1) ◽  
pp. 56-58
Author(s):  
Timothy A D’Amico ◽  
Lisa Bystry ◽  
Sean M Kandel
Keyword(s):  
Rare Complication ◽  
High Rate ◽  
Attractive Potential ◽  
Inflammatory Disorder ◽  
Invasive Treatment ◽  
Scar Endometriosis ◽  
Chronic Inflammatory Disorder ◽  
Non Invasive ◽  
Long Term Follow Up

Endometriosis is a chronic inflammatory disorder that affects approximately 5%–10% of women and is a major contributor to chronic pelvic pain. It can result in a significant impact on a woman’s quality of life with a high rate of reoccurrence throughout the woman’s reproductive years. Medical treatment is available but often surgical intervention is required. Scar endometriosis is a rare complication of this disease, mostly involving cesarean section scars. Our case demonstrates a possible new, non-invasive treatment for scar endometriosis with elagolix. The ability to avoid the potential morbidity of surgical scar revision makes this a very attractive potential option. Further studies with larger cohorts and long-term follow up are needed to confirm efficacy.

scholarly journals New System Delivering Microwaves Energy for Inducing Subcutaneous Fat Reduction: In - Vivo Histological and Ultrastructural Evidence

2019 ◽  
Vol 7 (18) ◽  
pp. 2991-2997 ◽  
Author(s):  
Nicola Zerbinati ◽  
Edoardo D’Este ◽  
Antonia Icaro Cornaglia ◽  
Federica Riva ◽  
Aurora Farina ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Subcutaneous Adipose Tissue ◽  
Subcutaneous Fat ◽  
The Body ◽  
Invasive Treatment ◽  
New Device ◽  
Non Invasive ◽  
Ultrastructural Evidence ◽  
Subcutaneous Adipose

BACKGROUND: Recently, it has been developed a new technology for the reduction of subcutaneous adipose tissue through a non-invasive treatment by microwaves. The main objective of the present study is to demonstrate the feasibility of utilising a non-invasive, localised microwaves (MW) device to induce thermal modifications into subcutaneous adipose tissue only by a controlled electromagnetic field that heats up fat preferentially. This device is provided with a special handpiece appropriately cooled, directly contacting the cutaneous surface of the body, which provides a calibrated energy transfer by microwaves. AIM: In this paper, microscopic and ultrastructural modifications of subcutaneous adipose tissue induced by microwaves irradiation are evaluated. METHODS: Our experimental plan was designed for collecting biopsy samples, for each skin region treated with a single irradiation session, 1) before treatment (control), 2) immediately after treatment, 3) after 6 hrs, 4) after 1 month, 5) after 2 months. Bioptic samples from each step were processed for light microscopy and transmission electron microscopy. At the same time, each region where biopsies were collected was subjected to ultrasound examination. Recorded images permitted to evaluate the thickness of different layers as epidermis, dermis, hypodermis, connective fasciae, until to muscle layer, and related modifications induced by treatment. RESULTS: In every biopsy collected at different time-steps, epidermis and superficial dermis appeared not modified compared to control. Differently, already in the short-term biopsies, in the deep dermis and superficial hypodermis, fibrillar connective tissue appeared modified, showing reduction and fragmentation of interlobular collagen septa. The most important adipose tissue modifications were detectable following 1 month from treatment, with a significant reduction of subcutaneous fat, participating both the lysis of many adipocytes and the related phagocytic action of monocytes/macrophages on residuals of compromised structures of adipocytes. In the samples collected two months following treatment, the remnants of adipose tissue appeared normal, and macrophages were completely absent. CONCLUSIONS: Ultrasound, microscopic and ultrastructural evidence are supporting significant effectiveness of the new device treatment in the reduction of subcutaneous fat. In this paper, the possible mechanisms involved in the activation of the monocytes/macrophages system responsible for the removal of adipocytes residuals have also been discussed.

scholarly journals Correction of Hyponatremia May Be a Treatment Stratification Biomarker: A Two-Stage Systematic Review and Meta-Analysis

2018 ◽  
Vol 7 (9) ◽  
pp. 262 ◽  
Author(s):  
Francisco Herrera-Gómez ◽  
Diana Monge-Donaire ◽  
Carlos Ochoa-Sangrador ◽  
Juan Bustamante-Munguira ◽  
Eric Alamartine ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Sodium Concentration ◽  
Evidence Base ◽  
The Body ◽  
Two Stage ◽  
Translational Pharmacology ◽  
New Treatment ◽  
Stage 1

Changes in serum sodium concentration ([Na+]serum) can permit evaluation of the treatment effect of vasopressin antagonists (vaptans) in patients with worsening heart failure (HF) or cirrhotic ascites; that is, they may act as a treatment stratification biomarker. A two-stage systematic review and meta-analysis were carried out and contextualized by experts in fluid resuscitation and translational pharmacology (registration ID in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42017051440). Meta-analysis of aggregated dichotomous outcomes was performed. Pooled estimates for correction of hyponatremia (normalization or an increase in [Na+]serum of at least 3–5 mEq/L) under treatment with vaptans (Stage 1) and for clinical outcomes in both worsening HF (rehospitalization and/or death) and cirrhotic ascites (ascites worsening) when correction of hyponatremia is achieved (Stage 2) were calculated. The body of evidence was assessed. Correction of hyponatremia was achieved under vaptans (odds ratio (OR)/95% confidence interval (95% CI)/I2/number of studies (n): 7.48/4.95–11.30/58%/15). Clinical outcomes in both worsening HF and cirrhotic ascites improved when correction of hyponatremia was achieved (OR/95% CI/I2/n: 0.51/0.26–0.99/52%/3). Despite the appropriateness of the study design, however, there are too few trials to consider that correction of hyponatremia is a treatment stratification biomarker. Patients with worsening HF or with cirrhotic ascites needing treatment with vaptans, have better clinical outcomes when correction of hyponatremia is achieved. However, the evidence base needs to be enlarged to propose formally correction of hyponatremia as a new treatment stratification biomarker. Markers for use with drugs are needed to improve outcomes related to the use of medicines.

Treatment of hepatocellular carcinoma using hypofractionated stereotactic radiosurgery.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 461-461
Author(s):  
Ariel Joseph Lederman ◽  
Mordecha Loksen ◽  
Thomas Lowinger ◽  
Daniel Izon ◽  
Gilbert S. Lederman
Keyword(s):  
Radiation Treatment ◽  
Progression Free Survival ◽  
Local Tumor Control ◽  
High Rate ◽  
Tumor Control ◽  
High Dose ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Significant Difference

461 Background: Hypofractionated stereotactic Radiosugery (HFSR) is a non-invasive focused radiation treatment that delivers high dose therapy to cancer. HFSR for treatment of HepatocellularCarcinoma is analyzed in this prospective study. Methods: Twenty-three Hepatocellular Carcinomas (HCCs) were treated in 19 patients. All patients were prospectively evaluated before and after treatment. Age at treatment ranged from 11 to 84 years (mean 57) with 12 males and 6 females. Twenty-two percent of patients had prior chemotherapy, 17% had prior surgery and one patient had embolization. Tumor volumes ranged from 3 to 1,684cc (mean 312). The HCCs were treated with 500-800 cGy per fraction (median 600), in 5 or 6 fractions (median 5). For a total of 2,500-4,000 cGy (median 3,000). Cancers were followed with contrast CT and/or MRI scans and reviewed independently by radiologists. Control of the treated cancer is defined as cessation of growth, shrinkage or disappearance of the cancer after treatment. Results: Follow up ranged from 2 to 52 months. There was a 95.6% control rate at 14 months. By dose, volume, age, sex and prior treatment, there was no statistically significant difference in outcome. Conclusions: HFSR for HCCs is a generally well tolerated, non-invasive treatment modality with a high rate of local tumor control. Patients continue to be evaluated for longer follow up, progression free survival and overall survival. HFSR remains an attractive option for those in whom standard approaches have not produced desired results and for patients seeking an alternative to surgical or chemotherapeutic treatment.

scholarly journals Connections between Different Sports and Ergogenic Aids—Focusing on Salivary Cortisol and Amylase

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 753
Author(s):  
Cezar Honceriu ◽  
Alexandrina-Stefania Curpan ◽  
Alin Ciobica ◽  
Andrei Ciobica ◽  
Constantin Trus ◽  
...  
Keyword(s):  
Physical Activity ◽  
Salivary Cortisol ◽  
Invasive Procedure ◽  
Ergogenic Aids ◽  
The Body ◽  
Diagnostic Tools ◽  
Non Invasive ◽  
Tremendous Amount ◽  
Novel Biomarkers ◽  
Nutrition And Hydration

Athletes are exposed to a tremendous amount of stress, both physically and mentally, when performing high intensity sports with frequent practices, pushing numerous athletes into choose to use ergogenic aids such as caffeine or β-alanine to significantly improve their performance and ease the stress and pressure that is put onto the body. The beneficial or even detrimental effects of these so-called ergogenic aids can be appreciated through the use of numerous diagnostic tools that can analyze various body fluids. In the recent years, saliva samples are gaining more ground in the field of diagnostic as it is a non-invasive procedure, contains a tremendous amount of analytes that are subject to pathophysiological changes caused by diseases, exercises, fatigue as well as nutrition and hydration. Thus, we describe here the current progress regarding potential novel biomarkers for stress and physical activity, salivary α-amylase and salivary cortisol, as well as their use and measurement in combination with different already-known or new ergogenic aids.

scholarly journals Continuous and non-invasive thermography of mouse skin accurately describes core body temperature patterns, but not absolute core temperature

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Vincent van der Vinne ◽  
Carina A. Pothecary ◽  
Sian L. Wilcox ◽  
Laura E. McKillop ◽  
Lindsay A. Benson ◽  
...  
Keyword(s):  
Body Temperature ◽  
Near Infrared ◽  
Core Body Temperature ◽  
Mouse Skin ◽  
Invasive Procedure ◽  
The Body ◽  
Physiological Parameter ◽  
Reliable Estimate ◽  
Non Invasive ◽  
Core Body

AbstractBody temperature is an important physiological parameter in many studies of laboratory mice. Continuous assessment of body temperature has traditionally required surgical implantation of a telemeter, but this invasive procedure adversely impacts animal welfare. Near-infrared thermography provides a non-invasive alternative by continuously measuring the highest temperature on the outside of the body (Tskin), but the reliability of these recordings as a proxy for continuous core body temperature (Tcore) measurements has not been assessed. Here, Tcore (30 s resolution) and Tskin (1 s resolution) were continuously measured for three days in mice exposed to ad libitum and restricted feeding conditions. We subsequently developed an algorithm that optimised the reliability of a Tskin-derived estimate of Tcore. This identified the average of the maximum Tskin per minute over a 30-min interval as the optimal way to estimate Tcore. Subsequent validation analyses did however demonstrate that this Tskin-derived proxy did not provide a reliable estimate of the absolute Tcore due to the high between-animal variability in the relationship between Tskin and Tcore. Conversely, validation showed that Tskin-derived estimates of Tcore reliably describe temporal patterns in physiologically-relevant Tcore changes and provide an excellent measure to perform within-animal comparisons of relative changes in Tcore.

128Non-invasive 3D mapping of earliest activation of premature ventricular complexes originating from intracardiac structures to guide catheter ablation

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
Z Vali ◽  
A Mistry ◽  
S Velu ◽  
B Sidhu ◽  
X Li ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Real Time ◽  
Papillary Muscle ◽  
Ventricular Arrhythmias ◽  
3D Mapping ◽  
Non Invasive ◽  
Guide Catheter ◽  
Torso Model ◽  
Mapping System ◽  
Coronary Cusp

Abstract Funding Acknowledgements Research funding from Catheter Precision, Inc. Introduction Catheter ablation for ventricular arrhythmias such as premature ventricular complexes and ventricular tachycardia is an established management approach.  Non-invasive mapping to localise the earliest activation (site of origin) on the myocardium may help guide ablation.  Established ECGi methods using the inverse solution to reconstruct epicardial electrograms are unable to accurately locate arrhythmias from the endocardium or from intracardiac structures.  VIVO™ (Catheter Precision) is a novel vectorcardiography based 3D mapping system that may be able to localise arrhythmias from any part of the ventricle. Methods We reviewed our initial experience utilising this mapping system to guide catheter ablation of ventricular ectopics from the inter-ventricular septum, coronary cusp or papillary muscle.  A patient-specific 3D heart and torso model was created using semi-automated segmentation of MRI or CT scan images.  A 3D topographic image of the patient’s torso was taken to accurately position surface ECG electrode locations onto the 3D heart-torso model.  An ECG of the PVC was imported from LabSystemPro (Bard) into VIVO™ for analysis prior to ablation.  The result was then compared with the site of earliest activation identified using invasive electro-anatomical (EA) mapping. Results VIVO™ was used in 12 cases where the PVC was localised to an intracardiac structure – six papillary muscle, four to the septum and two from the coronary cusp.  VIVO™ was able to accurately localise the earliest activation site when compared to the invasive map in 5/6 papillary muscle cases, 3/4 septal cases and 2/2 coronary cusp cases.  Ablation was acutely successful in all cases.  One additional patient had a PVC localised non-invasively to the postero-medial papillary muscle, however an invasive 3D electro-anatomical map or ablation was not performed. In three cases we were able to merge the 3D geometry of the non-invasive map from VIVO™ into the Carto™ system to guide mapping and ablation in real time (see figure). Conclusion Our experience shows promising results for accurate non-invasive localisation of ventricular arrhythmias originating from intracardiac structures.  Non-invasive localisation is of particular value in cases where the arrhythmia is infrequent, difficult to induce or poorly tolerated haemodynamically.  The two cases where PVC localisation was inaccurate were performed using an older version of the software. With recent refinements, localisation is anticipated to be improved further. We also present the first experience of combining the VIVO™ geometry with the real-time invasive EA map.  This has potential to significantly speed up mapping time and reduce the need for expensive multi-polar catheters by allowing the operator to see their target in real time 3D.  Further work is ongoing to validate the accuracy of VIVO™ prospectively and quantitatively. Abstract Figure. VIVO map merged with Carto LV geometry

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