scholarly journals Local Vibrational Therapy for Essential Tremor Reduction: A Clinical Study

Medicina ◽  
2020 ◽  
Vol 56 (10) ◽  
pp. 552
Author(s):  
Silvijus Abramavičius ◽  
Mantas Venslauskas ◽  
Antanas Vaitkus ◽  
Vaidotas Gudžiūnas ◽  
Ovidijus Laucius ◽  
...  
Keyword(s):  
Power Spectrum ◽  
Essential Tremor ◽  
Medical Device ◽  
The Body ◽  
Rank Test ◽  
Main Study ◽  
Safety Study ◽  
Serious Adverse Events ◽  
Parkinsonian Tremor ◽  
Device Use

Background and objectives: tremor is an unintentional and rhythmic movement of any part of the body that is a typical symptom of Essential Tremor (ET). ET impairs the quality of life of patients and is treated with pharmacotherapy. We investigated the tremor reduction efficacy of an innovative vibrational medical device (IMD) in ET patients. Materials and Methods: we conducted a prospective, single-center, single-arm, pragmatic study in ET patients with an extended safety study to evaluate the efficacy and safety of the Vilim Ball—a local hand-arm vibration device that produces vibrations in the frequency range of 8–18 Hz and amplitude from 0 to 2 mm. The primary endpoint was the decrease in the power spectrum after device use. The secondary endpoints were safety outcomes. Results: In total, 17 patients with ET were included in the main study, and no patients withdrew from the main study. The tremor power spectrum (m2/s3 Hz) was lower after the device use, represented as the mean (standard deviation): 0.106 (0.221); median (Md) 0.009 with the interquartile range; IQR, 0.087 vs. 0.042 (0.078); Md = 0.009 with the IQR 0.012; Wilcoxon signed-rank test V = 123; and p = 0.027. Seven patients reported that vibrational therapy was not effective. Two patients reported an increase in tremor after using the device. In the extended safety study, we included 51 patients: 31 patients with ET and 20 with Parkinsonian tremor, where 48 patients reported an improvement in tremor symptoms and 49 in function. No serious adverse events were reported, while two patients in the Parkinsonian tremor group reported a lack of efficacy of the proposed medical device. Conclusions: the device reduces essential tremor in some patients and is safe to use in ET.

Tremors

2016 ◽  
Author(s):  
Alfonso Fasano ◽  
Günther Deuschl
Keyword(s):  
Movement Disorder ◽  
Essential Tremor ◽  
Involuntary Movement ◽  
The Body ◽  
Drug Induced ◽  
Parkinsonian Tremor ◽  
Dystonic Tremor ◽  
Physiologic Tremor ◽  
Disease Definition ◽  
Holmes Tremor

Tremor is the most common movement disorder and denotes a rhythmic and involuntary movement of one or several regions of the body. This review covers disease definition, essential tremor, enhanced physiologic tremor, parkinsonian tremor, dystonic tremor, orthostatic tremor, cerebellar tremor, Holmes tremor, neuropathic tremor, palatal tremor, drug-induced and toxic tremors, functional tremor, rare tremor syndromes, tremorlike conditions, and treatment of tremor. Figures show action tremor assessment, the central nervous system circuits of tremor, magnetic resonance imaging findings in specific tremor conditions, general management of tremor patients, an algorithm for the treatment of parkinsonian tremor, and an algorithm for the treatment of dystonic tremor and primary writing tremor. Tables list types of tremor according to the condition of activation, tremor conditions in newborns and during childhood, clinical features of the most common tremor syndromes, motor signs other than tremor and nonmotor features of essential tremor patients, Movement Disorder Society consensus criteria for the diagnosis of essential tremor, genetic and environmental causes of essential tremor, causes of enhanced physiologic tremor, drugs and toxins known to cause tremor, paroxysmal tremors, pseudorhythmic myoclonus in the differential diagnosis of tremor, and pharmacologic management of essential tremor. Key words: essential tremor, movement disorder, pathologic tremor, physiologic tremor, tremor This review contains 6 highly rendered figures, 7 videos, 11 tables, and 163 references.

scholarly journals Discrimination of Parkinsonian Tremor From Essential Tremor by Voting Between Different EMG Signal Processing Techniques

2014 ◽  
Vol 10 (2) ◽  
pp. 11
Author(s):  
A Hossen ◽  
Z Al-Hakim ◽  
M Muthuraman ◽  
J Raethjen ◽  
G Deuschl ◽  
...  
Keyword(s):  
Signal Processing ◽  
Essential Tremor ◽  
Test Group ◽  
The Body ◽  
Soft Decision ◽  
Test Set ◽  
Parkinsonian Tremor ◽  
Emg Signal ◽  
Processing Techniques ◽  
Signal Processing Techniques

 Parkinson's disease (PD) and essential tremor (ET) are the two most common disorders that cause involuntary muscle shaking movements, or what is called "tremor”. PD is a neurodegenerative disease caused by the loss of dopamine receptors which control and adjust the movement of the body. On the other hand, ET is a neurological movement disorder which also causes tremors and shaking, but it is not related to dopamine receptor loss; it is simply a tremor. The differential diagnosis between these two disorders is sometimes difficult to make clinically because of the similarities of their symptoms; additionally, the available tests are complex and expensive. Thus, the objective of this paper is to discriminate between these two disorders with simpler, cheaper and easier ways by using electromyography (EMG) signal processing techniques. EMG and accelerometer records of 39 patients with PD and 41 with ET were acquired from the Hospital of Kiel University in Germany and divided into a trial group and a test group. Three main techniques were applied: the wavelet-based soft-decision technique, statistical signal characterization (SSC) of the spectrum of the signal, and SSC of the amplitude variation of the Hilbert transform. The first technique resulted in a discrimination efficiency of 80% on the trial set and 85% on the test set. The second technique resulted in an efficiency of 90% on the trial set and 82.5% on the test set. The third technique resulted in an 87.5% efficiency on the trial set and 65.5% efficiency on the test set. Lastly, a final vote was done to finalize the discrimination using these three techniques, and as a result of the vote, accuracies of 92.5%, 85.0% and 88.75% were obtained on the trial data, test data and total data, respectively. 

Tremors

2016 ◽  
Author(s):  
Alfonso Fasano ◽  
Günther Deuschl
Keyword(s):  
Movement Disorder ◽  
Essential Tremor ◽  
Involuntary Movement ◽  
The Body ◽  
Drug Induced ◽  
Parkinsonian Tremor ◽  
Dystonic Tremor ◽  
Physiologic Tremor ◽  
Disease Definition ◽  
Holmes Tremor

Tremor is the most common movement disorder and denotes a rhythmic and involuntary movement of one or several regions of the body. This review covers disease definition, essential tremor, enhanced physiologic tremor, parkinsonian tremor, dystonic tremor, orthostatic tremor, cerebellar tremor, Holmes tremor, neuropathic tremor, palatal tremor, drug-induced and toxic tremors, functional tremor, rare tremor syndromes, tremorlike conditions, and treatment of tremor. Figures show action tremor assessment, the central nervous system circuits of tremor, magnetic resonance imaging findings in specific tremor conditions, general management of tremor patients, an algorithm for the treatment of parkinsonian tremor, and an algorithm for the treatment of dystonic tremor and primary writing tremor. Tables list types of tremor according to the condition of activation, tremor conditions in newborns and during childhood, clinical features of the most common tremor syndromes, motor signs other than tremor and nonmotor features of essential tremor patients, Movement Disorder Society consensus criteria for the diagnosis of essential tremor, genetic and environmental causes of essential tremor, causes of enhanced physiologic tremor, drugs and toxins known to cause tremor, paroxysmal tremors, pseudorhythmic myoclonus in the differential diagnosis of tremor, and pharmacologic management of essential tremor.   Key words: essential tremor, movement disorder, pathologic tremor, physiologic tremor, tremor   This review contains 6 highly rendered figures, 7 videos, 11 tables, and 163 references.

Tremors

2016 ◽  
Author(s):  
Alfonso Fasano ◽  
Günther Deuschl
Keyword(s):  
Movement Disorder ◽  
Essential Tremor ◽  
Involuntary Movement ◽  
The Body ◽  
Drug Induced ◽  
Parkinsonian Tremor ◽  
Dystonic Tremor ◽  
Physiologic Tremor ◽  
Disease Definition ◽  
Holmes Tremor

Tremor is the most common movement disorder and denotes a rhythmic and involuntary movement of one or several regions of the body. This review covers disease definition, essential tremor, enhanced physiologic tremor, parkinsonian tremor, dystonic tremor, orthostatic tremor, cerebellar tremor, Holmes tremor, neuropathic tremor, palatal tremor, drug-induced and toxic tremors, functional tremor, rare tremor syndromes, tremorlike conditions, and treatment of tremor. Figures show action tremor assessment, the central nervous system circuits of tremor, magnetic resonance imaging findings in specific tremor conditions, general management of tremor patients, an algorithm for the treatment of parkinsonian tremor, and an algorithm for the treatment of dystonic tremor and primary writing tremor. Tables list types of tremor according to the condition of activation, tremor conditions in newborns and during childhood, clinical features of the most common tremor syndromes, motor signs other than tremor and nonmotor features of essential tremor patients, Movement Disorder Society consensus criteria for the diagnosis of essential tremor, genetic and environmental causes of essential tremor, causes of enhanced physiologic tremor, drugs and toxins known to cause tremor, paroxysmal tremors, pseudorhythmic myoclonus in the differential diagnosis of tremor, and pharmacologic management of essential tremor.   Key words: essential tremor, movement disorder, pathologic tremor, physiologic tremor, tremor   This review contains 6 highly rendered figures, 7 videos, 11 tables, and 163 references.

scholarly journals Duodenoscope Medical Device Reports Associated with Patient Infection, Patient Exposure, or Device Contamination

2020 ◽  
Vol 41 (S1) ◽  
pp. s196-s197
Author(s):  
Jian Connell ◽  
Shanil Haugen ◽  
Ann Ferriter
Keyword(s):  
Medical Device ◽  
The United States ◽  
Risk Of Infection ◽  
Patient Exposure ◽  
Safety Issues ◽  
Device User ◽  
Infection Patient ◽  
Device Use ◽  
Serious Injuries ◽  
Patient Infection

Background: Each year, the FDA receives more than a million reports of suspected device-associated deaths, serious injuries, and malfunctions. Medical device reports (MDRs) are submitted to the FDA by mandatory reporters (manufacturers, importers, and device user facilities) and voluntary reporters such as healthcare professionals, patients, and consumers. The FDA uses MDRs to monitor device performance, including monitoring reports of infection or device contamination to detect potential device-related safety issues and to share this information in public communications. In this analysis, the FDA presents MDRs for duodenoscopes, which are a type of flexible endoscope that have been associated with infections in patients. Methods: For this analysis, we searched the MDR database for duodenoscope reports submitted between January 2015 and July 1, 2019. MDRs were classified into clinical risk categories based on the MDR’s text narratives as patient infection (indicated the presence of infection in patients potentially transmitted by the device), patient exposure (indicated a contaminated device has been used in a patient, but the MDR lacks clear mention of patient infection), or device contamination (indicated that the device was contaminated, but no mention of device use in patients or patient infection). Results: Overall, 1,115 duodenoscope reports related to a patient infection, patient exposure, or device contamination for devices marketed inside and outside the United States were received from January 2015 to mid-2019. Among them, 79 MDRs were received for deaths in patient infection, patient exposure, or device contamination reports. The number of reported infections decreased from 247 MDRs in 2015 to 55 MDRs in the first half of 2019. Furthermore, the number of reported deaths decreased from 25 MDRs in 2015 to 2 MDRs reported in the first half of 2019. Conclusions: The MDR data indicate a decrease in the number of reported infections. The decrease in infections suggests that efforts to reduce the risk of infection from duodenoscopes have yielded improvements; however, additional improvements are necessary to further decrease the risk of infection.Funding: NoneDisclosures: None

scholarly journals MR-guided focused ultrasound liquid biopsy enriches circulating biomarkers in patients with brain tumors

2021 ◽  
Author(s):  
Ying Meng ◽  
Christopher B Pople ◽  
Suganth Suppiah ◽  
Maheleth Llinas ◽  
Yuexi Huang ◽  
...  
Keyword(s):  
Liquid Biopsy ◽  
Focused Ultrasound ◽  
Brain Regions ◽  
Specific Protein ◽  
Rank Test ◽  
Open Label ◽  
Isocitrate Dehydrogenase 1 ◽  
Serious Adverse Events ◽  
Before And After ◽  
Bbb Opening

Abstract Background Liquid biopsy is promising for early detection, monitoring of response and recurrence of cancer. The blood-brain barrier (BBB) limits the shedding of biomarker, such as cell-free DNA (cfDNA), into the blood, and their detection by conventional assays. Transcranial MR-guided focused ultrasound (MRgFUS) can safely and transiently open the BBB, providing an opportunity for less-invasive access to brain pathology. We hypothesized MRgFUS can enrich the signal of circulating brain-derived biomarkers to aid in liquid biopsy. Methods Nine patients were treated in a prospective single-arm, open-label trial to investigate serial MRgFUS and adjuvant temozolomide combination in patients with glioblastoma (NCT03616860). Blood samples were collected as an exploratory measure within the hours before and after sonication, with control samples from non-brain tumor patients undergoing BBB opening alone (NCT03739905). Results Brain regions averaging 7.8±6.0 cm 3 (range 0.8–23.1 cm 3) were successful treated within 111±39 minutes without any serious adverse events. We found MRgFUS acutely enhanced plasma cfDNA (2.6±1.2 fold, p<0.01, Wilcoxon signed-rank test), neuron-derived extracellular vesicles (3.2±1.9 fold, p<0.01), and brain specific protein S100b (1.4±0.2 fold, p<0.01). Further comparison of the cfDNA methylation profiles suggests a signature that is disease and post-BBB opening specific, in keeping with our hypothesis. We also found cfDNA mutant copies of isocitrate dehydrogenase 1 (IDH1) increased, although this was in only one patient known to harbour the tumor mutation. Conclusions This first-in-human proof-of concept study shows MRgFUS enriches the signal of circulating brain-derived biomarkers, demonstrating the potential of the technology to support liquid biopsy for the brain.

Contralateral voluntary hand movement inhibits human parkinsonian tremor and variably influences essential tremor

2004 ◽  
Vol 357 (3) ◽  
pp. 187-190 ◽  
Author(s):  
Gertrúd Tamás ◽  
László Pálvölgyi ◽  
Annamária Takáts ◽  
Imre Szirmai ◽  
Anita Kamondi
Keyword(s):  
Essential Tremor ◽  
Hand Movement ◽  
Parkinsonian Tremor

Effect Of Pregnancy Exercise On Third Trimester Primigravida Anxiety In Dealing With Childbirth

2021 ◽  
pp. 76-83
Author(s):  
Ismi Puji Astuti
Keyword(s):  
Treatment Group ◽  
Sampling Technique ◽  
The Body ◽  
Rank Test ◽  
Control Group ◽  
P Value ◽  
Research Subjects ◽  
Third Trimester ◽  
Quasi Experimental ◽  
Signed Rank Test

Background: The first labor anxiety is an unpleasant psychological condition due to physiological changes that cause psychological instability. The condition of excessive anxiety, worry, fear without cause, and stress, causes the muscles of the body to tense up, especially the muscles in the birth path to become stiff and hard, making it difficult to expand. This study analyzed the effect of pregnancy exercise on third trimester primigravida anxiety in dealing with childbirth. Methods: Quasi experimental design with nonrandomized pretest-postest control group. The sampling technique used was purposive sampling with 34 research subjects. 17 people for the treatment group were given pregnancy exercise 8 times, and 17 people for the control group were given health education about preparation for childbirth. Results: The results of data analysis using the Wilcoxon signed rank test showed that the average reduction in the treatment group was 8.00 and the control group was 3.00. The effect of pregnancy exercise on third trimester primigravida anxiety in the treatment group with a p-value (0.000) <(0.05), while the control group with a p-value (0.180)> (0.05). Conclusion: There is an effect of pregnancy exercise on third trimester primigravida anxiety in dealing with childbirth in the Wuryantoro Health Center work area. 

EFEKTIVITAS PEMBERIAN INFUSED WATER KURMA TERHADAP PENINGKATAN KADAR HEMOGLOBIN REMAJA PUTRI KEBIDANAN POLTEKKES MEDAN TAHUN 2020

2021 ◽  
Vol 2 (1) ◽  
pp. 64-69
Author(s):  
HIJRA HIDAYANA ◽  
Suswati Suswati
Keyword(s):  
Red Blood Cells ◽  
Adolescent Girls ◽  
Blood Cells ◽  
The Body ◽  
Rank Test ◽  
Plain Water ◽  
P Value ◽  
Signed Rank ◽  
Wilcoxon Signed Rank Test ◽  
Signed Rank Test

Hemoglobin is the red pigment-protein contained in red blood cells. The function of hemoglobin is to transport oxygen from the lungs and in the bloodstream to be carried to the tissues. Hemoglobin can increase by increasing the intake of iron in the body. One way to increase hemoglobin can be done by giving method Infused Water Dates. Infused water is a drink consisting of plain water with fresh fruit added and soaking or settling together for a certain time. The making of infused water is carried out by soaking for a period of 0 to 12 hours, so that the infused water becomes a liquid medium that carries more nutrients than ordinary water and will be more easily absorbed by cells and distributed throughout the body (Sidauruk, 2018 ). In several studies, it is stated that dates can increase hemoglobin levels in the blood. Where dates contain iron, vitamin A, vitamin C, protein to form red blood cells. With the method, Infused Water the date palm water becomes alkaline so that it can accelerate the absorption process in the body. The purpose of this study was to determine the effectiveness of dates infused water provision to increase hemoglobin levels of midwifery adolescent girls at Medan Health Polytechnic in 2020. This research was quasi-experimental study using the One Group Pretest-Posttest Without Control Design approach. The sample in this study were 20 respondents of midwifery adolescent girls from Medan Health Polytechnic, using the technique of purposive sampling. The statistical test used wa the Wilcoxon Signed Rank Test because the data was not normal. The results of the Wilcoxon Signed Rank Test obtained the value of P-Value = 0.001. So it can be concluded that the date infused water  is effective in increasing hemoglobin levels of midwifery adolescent girls at Medan Health Polytechnic in 2020.   Keywords: Dates Infused Water, Increased Hemoglobin Levels, Girls Adolescent

scholarly journals Bilateral hypoglossal nerve stimulation for treatment of adult obstructive sleep apnoea

2019 ◽  
Vol 55 (1) ◽  
pp. 1901320 ◽  
Author(s):  
Peter R. Eastwood ◽  
Maree Barnes ◽  
Stuart G. MacKay ◽  
John R. Wheatley ◽  
David R. Hillman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Nerve Stimulation ◽  
Hypoglossal Nerve ◽  
Sleep Apnoea ◽  
Serious Adverse Events ◽  
Obstructive Sleep ◽  
Device Use ◽  
Post Implantation

Background and aimHypoglossal nerve stimulation (HNS) decreases obstructive sleep apnoea (OSA) severity via genioglossus muscle activation and decreased upper airway collapsibility. This study assessed the safety and effectiveness at 6 months post-implantation of a novel device delivering bilateral HNS via a small implanted electrode activated by a unit worn externally, to treat OSA: the Genio™ system.MethodsThis prospective, open-label, non-randomised, single-arm treatment study was conducted at eight centres in three countries (Australia, France and the UK). Primary outcomes were incidence of device-related serious adverse events and change in the apnoea–hypopnoea index (AHI). The secondary outcome was the change in the 4% oxygen desaturation index (ODI). Additional outcomes included measures of sleepiness, quality of life, snoring and device use. This trial was registered with ClinicalTrials.gov, number NCT03048604.Results22 out of 27 implanted participants (63% male, aged 55.9±12.0 years, body mass index (BMI) 27.4±3.0 kg·m−2) completed the protocol. At 6 months BMI was unchanged (p=0.85); AHI decreased from 23.7±12.2 to 12.9±10.1 events·h−1, a mean change of 10.8 events·h−1 (p<0.001); and ODI decreased from 19.1±11.2 to 9.8±6.9 events·h−1, a mean change of 9.3 events·h−1 (p<0.001). Daytime sleepiness (Epworth Sleepiness Scale; p=0.01) and sleep-related quality of life (Functional Outcomes of Sleep Questionnaire-10; p=0.02) both improved significantly. The number of bed partners reporting loud, very intense snoring, or leaving the bedroom due to participant snoring decreased from 96% to 35%. 91% of participants reported device use >5 days per week, and 77% reported use for >5 h per night. No device-related serious adverse events occurred during the 6-month post-implantation period.ConclusionsBilateral HNS using the Genio™ system reduces OSA severity and improves quality of life without device-related complications. The results are comparable with previously published HNS systems despite minimal implanted components and a simple stimulation algorithm.

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