EP 2015
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This study investigated the incidence of failed shock therapy in implantable cardioverter defibrillator (ICD) patients despite adequate defibrillation threshold (DFT) testing. The study analyzed data from 2738 ICD patients implanted between 2004-2013. 38 patients (1.4%) experienced at least one failed shock therapy, even though all 38 had adequate DFT testing with successful shocks over 10J below the programmed energy level. There was a trend towards a longer interval between DFT testing and failed shocks compared to patients experiencing only effective shocks. The results suggest that adequate DFT testing does not rule out failed shock therapy in some patients, supporting abandoning routine DFT testing in unselected patients.
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INTRODUCTION
As human, we move our bodies to explicit our wants,
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Conclusion: The findings of the study show that there is significant difference between the scores of
experimental and control group.
Keywords: Mirror Therapy, Upper Extremity Stroke , Neuro Rehabilitation Centre
INTRODUCTION
As human, we move our bodies to explicit our wants,
needs, emotions, thoughts, and ideas. Basically, how
well we move- and how much we move- decides how
well we engage with the world and make our full purpose
in life. Mostly the active movement helps us in function
completely, interact with the world, feel well physically
and emotionally, connect and build relationship with
others, and communicate and express ourselves. Also
the movement helps us recover if our brain is injured
or inflamed. Body movements are comparable important
for smooth and effective day to day activities.1
Nervous system is a one of the system of our body,
which perform all the sensory and motor function
of body. The reason a healthy nervous system is so
important is because it’s what runs everything in our
body. When nervous system is functioning correctly,
body is able to perform all the things it needs to do.
However, when the ...
Effortles Trial
1. The EFFORTLESS study evaluated the outcomes of 331 patients implanted with a subcutaneous implantable cardioverter-defibrillator (S-ICD) over 6 months.
2. Complication rates were low, with the most common being inappropriate shocks for oversensing and discomfort, occurring in 1.1% and 0.8% respectively.
3. The S-ICD effectively provided appropriate therapy for ventricular arrhythmias in 10.6% of patients, with a high rate of conversion to sinus rhythm within 5 shocks. Inappropriate shocks occurred in 8.1% of patients over the first year.
The use of pulsed radiofrequency for the treatment of pudendal neuralgia a c...
This study evaluated the use of pulsed radiofrequency (PRF) for treating pudendal neuralgia in 7 patients. PRF is a minimally invasive technique that uses radiofrequency energy to modulate nerves without damaging tissue. The average number of PRF treatments was 4.4, and the average duration of pain relief was 11.4 weeks. There were no complications reported. The study concludes that PRF may be an effective and safe treatment for pudendal neuralgia in patients where conservative treatments have not provided adequate relief, but larger controlled studies are still needed.
Limiting the risks
This document discusses limiting radiation exposure from diagnostic imaging procedures like CT scans. It provides context about radiation dosage terms and compares the effective radiation dose of different medical imaging exams. While medical imaging only accounts for around 50% of radiation exposure in the US, it may be responsible for about 1% of cancer cases. The document examines balancing radiation risks, which are higher for younger patients and females, with clinical benefits on a case-by-case basis using the ALARA principle to keep radiation as low as reasonably possible. It analyzes the risks and benefits of 4DCT for imaging hyperfunctional parathyroid glands as an example.
Radiation dose reduction
Ionizing radiation makes invasive cardiology procedures such as coronary angiography, percutaneous coronary intervention (PCI), and electrophysiologic diagnostics and therapeutics possible .
Radiation risks can be thought of as deterministic (effects after exceeding certain threshold, e.g., skin burns) or stochastic (a risk of an outcome is proportional to the dose received, e.g., malignancy or teratogenicity) .
Reducing the radiation exposure in the cardiac catheterization laboratory is important, especially as procedures are becoming more complex .
Meta analysis of clinical efficacy of pulsed radio frequency
This meta-analysis reviewed 25 controlled clinical trials involving 1332 patients to evaluate the efficacy of pulsed radio frequency energy (PRFE) therapy for postoperative pain and edema, nonpostoperative pain and edema, and wound healing. A vote-counting method found more positive outcomes than neutral or negative outcomes for each clinical application. A statistical combination of P-values also found statistically significant improvements in pain, edema reduction, and wound healing outcomes. The analysis provides strong statistical evidence that PRFE therapy is an effective treatment for postoperative and nonpostoperative pain and edema as well as for wound healing applications.
Laser Therapy Applications for Osteoarthritis and Chronic Joint Pain Clinic...
Laser Therapy Applications for Osteoarthritis and Chronic Joint Pain Clinic...Theralase Technologies Inc.
This randomized controlled trial evaluated the effectiveness of low-level laser therapy (LLT) for treating chronic knee pain. 126 patients with knee osteoarthritis were randomly assigned to receive either active laser treatment or sham laser treatment over 12 sessions within 4 weeks. The primary outcome was pain level measured using a visual analog scale (VAS) from 0-10. Results showed that the active laser treatment provided significant pain relief and osteoarthritic improvements compared to the sham laser, with statistical significance of p<0.01 in reduced VAS scores from baseline to 30-day follow-up. The laser treatment was thus found to be an effective adjunctive therapy for chronic knee pain.ICU Care Bundles Ashenafi.pptx
This document summarizes a seminar presentation on ICU care bundles. The presentation outlines several care bundles including the ABCDEF bundle. The ABCDEF bundle focuses on assessing, preventing, and managing pain; both spontaneous awakening trials and spontaneous breathing trials; choice of sedation and analgesia; assessing, preventing, and managing delirium; and early mobility and exercise. Implementing bundles like the ABCDEF bundle can help optimize patient outcomes by reducing ICU delirium and the duration of mechanical ventilation and ICU stays.
Lu-177 Dotatate External Dosimetry- An Update from 2013_Crimson Publishers
Lu-177 Dotatate External Dosimetry- An Update from 2013 by Mushref Algarni in Novel Approaches in Cancer Study
Similar to EP 2015 (20)
ANALYSIS OF D-DIMER VALUES IN POST-OPERATIVE PATIENTS OF MAJOR HIP AND KNEE S...
ANALYSIS OF D-DIMER VALUES IN POST-OPERATIVE PATIENTS OF MAJOR HIP AND KNEE S...
Defibrillation strategy for refractory Ventricular fibrillation.pptx
Defibrillation strategy for refractory Ventricular fibrillation.pptx
Effectiveness of Mirror Therapy on Upper Extremity Functioni
Effectiveness of Mirror Therapy on Upper Extremity Functioni
The use of pulsed radiofrequency for the treatment of pudendal neuralgia a c...
The use of pulsed radiofrequency for the treatment of pudendal neuralgia a c...
Meta analysis of clinical efficacy of pulsed radio frequency
Meta analysis of clinical efficacy of pulsed radio frequency
Laser Therapy Applications for Osteoarthritis and Chronic Joint Pain Clinic...
Laser Therapy Applications for Osteoarthritis and Chronic Joint Pain Clinic...
Lu-177 Dotatate External Dosimetry- An Update from 2013_Crimson Publishers
Lu-177 Dotatate External Dosimetry- An Update from 2013_Crimson Publishers
EP 2015
- 1. Occurrence of failed shock therapy in implantable cardioverter defibrillator patients in spite of adequate defibrillation testing A.H. Maass, M.E. De Plaa, R.P. Vermeulen, M. Rienstra, I.C. Van Gelder Introduction: Necessity of defibrillation threshold (DFT) testing during or after implantable cardioverter defibrillator (ICD) implantation has recently been questioned. Large trials have not shown a benefit of DFT vs not testing. We have investigated the incidence of failed shock therapy in ICD patients and relation to DFT testing. Methods: 2738 ICDs were implanted in our center from 2004-2013. Our electronic database records information about shock therapy as well as other device-related measurements. We identified patients with multiple shocks in a single day of follow-up and these patients were further characterized. Results: 38 (1.4%) patients had at least one failed shock therapy and were compared with 27 patients with multiple shocks in a single day that were all effective. All 38 patients with failed shock therapy had adequate DFT testing with 2 successful shocks at least 10J below the programmed shock energy. There was a trend (p=0.07) towards a longer interval between DFT testing and multiple shocks in the failing group (median 1740 days; IQR 697-2450) vs. the multiple effective shock group (median 892; IQR 449-1703). Amiodarone use was lower in patients with failed shocks than with those with multiple effective shocks (6% vs. 30%, respectively, p=0.01) possibly as a reflection of more severe arrhythmic substrate in the group with multiple effective shocks. Conclusions: Adequate DFT testing does not rule out occurrence of failed shock therapy in a significant number of ICD patients. The reported number is probably an underestimation because death due to failed shock therapy was not identified with our search method. These data support the abandonment of standard DFT tests in unselected patients. If repeat DFT
- 2. testing late after ICD implantation can reduce failed shock therapy needs to be investigated further.