Arterial embolization may improve pain and function in frozen shoulder

A new non-surgical treatment decreases errant blood flow in the shoulder to quickly reduce pain and improve function in patients with adhesive capsulitis, also known as "frozen shoulder," according to a research abstract presented during a virtual session of the Society of Interventional Radiology's 2020 Annual Scientific Meeting on June 13.

 Frozen shoulder gradually causes significant pain and stiffness of the shoulder joint in an estimated 200,000 people in the U.S. each year. The symptoms are often treated with physical therapy or pain medications, until they resolve within one to three years.

"Patients with frozen shoulder are essentially told to tough it out until their symptoms improve, but considering the significant pain and decreased function many experience, we looked to determine if this treatment model of embolization, already in use in other areas of the body, could provide immediate and durable relief," said Sandeep Bagla, MD, CEO of Vascular Interventional Partners, NOVA and lead author of the study. "We were shocked at the profound and dramatic improvement patients experienced in pain and use of their shoulder."

In this Phase II FDA-approved Investigational Device Exemption clinical trial on arterial embolization of the shoulder (AES), interventional radiologists inserted a catheter through a pinhole-sized incision in patients' wrists that was used to feed microsphere particles into as many as six arteries in the shoulder to reduce inflammation. The treatment was conducted on an outpatient basis and took approximately one hour. Each patient's pain, disability, and blood flow in the shoulder were measured before and after the treatment using three scales, in addition to MRI imaging to visualize the shoulder joint.

The treatment was successfully completed in 16 patients whose symptoms had not responded to conservative treatment over 30 days. Minor adverse events such as temporary skin discoloration were reported in nine patients. One month later, researchers followed the progress of 11 patients and found that pain significantly decreased after AES (-57 mm on the Visual Analog Scale) and improved physical function in all patients (+28 mm on the Single Assessment Numeric Evaluation and +30 mm on the American Shoulder and Elbow Surgeons Shoulder Score). Additional progress was reported at the three-month follow up.

We are early in the investigation of this treatment but are inspired by its effectiveness in reducing pain and range of motion in patients' shoulders," said Bagla.

 The research was conducted as a collaboration between interventional radiology and orthopedic surgery to build on international studies of the procedure by adapting the treatment design and embolic agent to be more durable. The team plans to expand the study to additional patients in 2020.

 The authors note that this treatment is still investigational and that conservative therapies should still be considered first. Additionally, there are several important limitations of the research, including small sample size and lack of control arm.

Additional information about the clinical trial is available at Clinical Trials.gov, using the identifier NCT03676829. The trial is funded through Terumo Medical Corporation, a medical device company.

Abstract 4: Arterial Embolization of the Shoulder for Pain Secondary to Adhesive Capsulitis: Interim results from an Investigational Device Exemption U.S. trial. S. Bagla, R. Piechowiak, S. Nagda, J. Orlando, C. Xavier, A. Sajan, A. Isaacson.

The research was originally scheduled to be presented in person at SIR's Annual Scientific Meeting, March 28-April 2, in Seattle before the meeting was canceled due to COVID-19 concerns.

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Wearable adhesive patch sensor accurately predicted worsening heart failure

Wearing a removable, adhesive patch sensor accurately predicted worsening heart failure and the need for hospitalization several days before heart failure hospitalization occurred among veterans with heart failure, according to research published today in the American Heart Association's journal Circulation: Heart Failure.

The participants in the LINK-HF multi-center study consisted of one hundred heart failure (HF) patients who were veterans, average age of 68 years, enrolled at four Veterans Affairs (VA) hospitals -- in Salt Lake City; Palo Alto, Calif.; Houston, and Gainesville, Fla. -- after an initial acute heart failure admission to the hospital. The participants wore an adhesive sensor patch on their chest 24 hours a day for a minimum of 30 days and up to three months after their initial hospital discharge for a heart failure event. Of the eligible participants, 90% continued to wear the sensor at 30 days, and at 90 days; data was collected from August 2015 through December 2016.

The sensor monitored heart rate, heart rhythm, respiratory rate and physical activities such as, walking, sleeping and body posture for each participant. The data was transmitted from the sensor via Bluetooth to a smartphone, and then uploaded from the smartphone to an analytics platform on a secure computer server. A machine learning algorithm, a type of artificial intelligence approach to data analysis, established a normal baseline for each patient and then examined the incoming data. When observed data deviated from the expected 'normal baseline' behavior, the algorithm generated an alert to indicate the patient's heart failure was getting worse. The technology accurately predicted hospitalization risk more than 80% of the time. This prediction of hospitalization took place an average of 6.5 days before the readmission.

"With the use of remote data from the sensor and through data analysis by machine learning, we have shown that we can predict the future. Next, we will look at whether we can change the future," said lead study author Josef Stehlik, M.D., M.P.H., the Christi T. Smith Professor of Medicine at the University of Utah School of Medicine, medical director of the Heart Transplant Program and co-chief of the Advance Heart Failure Program at the University of Utah Hospital and the Salt Lake City Veterans Affairs Medical Center.

Heart failure (HF) is a major public health issue - it impacts about 6.2 million U.S. adults and is the No. 1 hospital discharge diagnosis in the U.S. Heart failure-related health care costs were an estimated $30.7 billion in 2012 and are expected to reach $53 billion by 2030. About 80% of these costs are for hospitalization according to a study cited by the researchers and published in 2011. In the first 90 days after discharge from the hospital for heart failure, patients are at a high, up to 30%, risk of readmission. Given this significantly increased risk of HF worsening after hospitalization, the researchers focused on testing a non-invasive solution to improve HF management during this critical time period.

In chronic heart failure, a person's condition can get worse with shortness of breath, fatigue and fluid buildup, to the point many end up in the emergency room and spend days in the hospital to recover. If we can identify patients before heart failure worsens and if doctors have the opportunity to change therapy based on this novel prediction, we could avoid or reduce hospitalizations, improve patients' lives and greatly reduce health care costs. With the evolution of technology and with artificial intelligence statistical methods, we have new tools to make this happen."    Josef Stehlik, lead study author.

Study limitations included:

    Study participants were 98% male, so it is unknown if these findings would be consistent in females;
    A majority of the participants had HFrEF (heart failure with reduced ejection fraction), so further study in patients with HFpEF (heart failure with preserved ejection fraction) is needed; and

    Additional research is necessary to determine if treatment changes based on the alerts could lead to improved patient outcomes.

In a future study, the researchers will test changing patient treatment based on the alert generated by the algorithm. "We are hoping that with this information, we can intervene and decrease the hospitalization rate, improve quality of life, and, for patients who end up being admitted to the hospital, shorten the length of stay," concluded Stehlik.


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14 Unusual Uses for Garlic

Pungent and powerful garlic has dozens of health and household uses - some of which might seem pretty unusual at first glance. While garlic is an important ally for natural health (you may be familiar with the fact that garlic has the ability to increase immunity, neutralize colds and is a recognized broad-spectrum antibiotic), its functions extend beyond these common uses. Check out these 14 unusual alternative uses for garlic:

 

1. A Great Aid for Athlete's Foot 

Being a potent, natural anti-fungal, garlic is ideal for treating fungal infections like irritating and itchy athlete's foot. Just add a couple of crushed garlic cloves to warm water in a foot bath and soak the affected area for 30 minutes.  
 

 

2. Helps in Preventing Gas 
While garlic can cause uncomfortable stomach-distending gas in some people due to its high sulfur content, it reportedly eases gas in others. In order to maintain good intestinal health, you need to consume it on a regular basis. Garlic can kill harmful intestinal bacteria, promoting the growth of beneficial flora and making digestion smoother.  

3. Combats Hair Loss 
Before resorting to more drastic measures, if you are going bald, give garlic a shot. It is believed that massaging the scalp with garlic oil stimulates hair growth. 

4. Apply it to Breakouts of Acne 
Though it will make your skin smell, the antibacterial properties of garlic will help lessen the appearance of acne, including those deep acne cysts that can otherwise be difficult to treat. Just slice open a clove of raw, fresh garlic and apply it to breakouts. 

5. Aids in Weight Loss 
Though you cannot count on garlic to help you lose a lot of weight, research shows that garlic has the potential for assisting with weight loss. Compounds found in garlic send signals of satiety to your brain, which will actually help you to feel full faster. It also boosts metabolic function, enabling you to burn more calories.  

6. Use it as a Natural Pesticide 
An all-natural garlic pesticide spray can be used to ward off pests like whiteflies, aphids, cabbage loopers, and squash bugs. All you need to do is mince three garlic cloves and let them sit in two tablespoons of mineral oil for 24 hours. Then, strain out the garlic and add the oil, along with a teaspoon of liquid dish soap, to a pint of water in a spray bottle and spray on infested plants. 

7. Use it to Repel Mosquitoes 

You don’t need to use DEET and other potentially toxic chemicals to ward off mosquitoes - garlic can work wonders for you instead. To prepare a mosquito spray, let a few minced cloves of garlic infuse in an ounce of mineral oil for 24 hours. Strain and mix the garlic-scented oil with two cups of water and one teaspoon of freshly squeezed lemon juice. If necessary, strain again and pour into a spray bottle.   

8. Use it as a Natural Adhesive to Repair Glass 
Though it may not work on major jobs, garlic juice can be used to fill in hairline cracks in glass and hold them together. Simply crush a clove of garlic and rub its sticky, viscous juice in the cracks. Then wipe away the excess.  

9. Kills Bacteria that Cause Ear Infections 
This common folk remedy has been used for centuries. Simply crush a clove of garlic and place it in a teaspoon of hot olive oil for five minutes. Strain, allow to cool, then drip a few drops at a time into your ear canal. Alternatively, you can purchase garlic oil from natural health food stores.  

10. Helps Remove Splinters 
Splinters are painful to remove and may at times dig a little too deep into the skin to pull out, but this odd trick can really work. Place a thin slice of garlic over the splinter, keeping it on with a bandage. The garlic should help the splinter work its way out of the skin within a few hours.  

11. Use it to Relieve Psoriasis 
Garlic's anti-inflammatory properties could ease or even prevent persistent tightness and itching caused by psoriasis. Active compounds in garlic interact with arachidonic acid, an omega fatty acid in the skin linked to psoriasis. You may also rub garlic oil on the affected areas once or twice per day.  

12. Use it as a Cough Syrup 
Garlic can be used as a cough syrup to ease inflammation in the throat and clear up excess mucus. Add raw, minced garlic to hot water, straining it after five minutes and drinking the liquid as tea. To make it more palatable, add ginger and honey.   
13. Garlic makes for a Fantastic Road De-icer 
Come winter, many towns de-ice their roads. Ankeny, Iowa smelled awfully savory in 2008 when winter transportation crews spread garlic salt on the streets in preparation ahead of incoming snowstorms. The salt, donated by a local spice producer, was apparently deemed unfit for human consumption. 

14. Kills Intestinal Parasites 
Many alternative health practitioners advise using raw garlic to expel intestinal parasites. Consumed in quantities of about three cloves per day, garlic may help clear nasty organisms out of the digestive tract. It is recommended as part of a cleansing diet that also includes raw honey, lemon juice, pumpkin seeds, carrots, and beets.

this is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     
https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
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