Breakthrough in paralysis treatment

Breakthrough in paralysis treatment

For the first time in the world a paralyzed from the waist down man is walking thanks to the advance of medicine nowadays. The miracle was made possible by electrical stimulation of the spine. The new therapy is an important step in the efforts to overcome the trauma of the spinal cord.

Rob Summers of Oregon (25) was completely paralyzed from the waist down after a crash in 2006. Today, after the pioneering operation and restoration of muscle tone in the legs, he can stand alone and stand up to 4 minutes. Rob now moves his legs, hips, knees and ankles and even walks on a treadmill.

All this was made possible by a spine implantation of 16 electrodes that are associated with the nerve nodes that control the legs from toes to thighs. Then they send electrical pulses similar to those of the brain to provoke movement.

Over two years Rob has trained constantly, trying to keep the right to walk and move his feet. In addition, he has regained other body functions related to the urinary tract, stomach and blood pressure.

Scientists warn that electrical stimulation should be conducted with other patients to confirm that it really works. Certain medicines are being developed to help the treatment.

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Nurses Guide To Lap Band Surgery

There are about seven or eight adjustable gastric bands on the market today. Unlike gastric bypass surgery, the adjustable gastric band or lap band surgery procedure is reversible. The decision to undergo weight loss surgery is not only an important medical decision but a significant financial decision too.

In general, gastric banding, including the Lap Band procedure and weight loss system, is indicated for people for whose Body Mass Index is above 40. Also for those who are 100 pounds (45 kg) or more over their estimated ideal weight according to the 1983 Metropolitan Life Insurance Tables or for those between 30 and 40 with co-morbidities that may improve with weight loss; some examples are high blood pressure, diabetes, sleep apnea, and arthritis. It's almost always contraindicated if the surgery or treatment presents an unreasonable risk to the patient. People who have a dependency on alcohol or drugs are not eligible for adjustable band surgery.

The failure of a dietary or weight-loss drug therapy for more than a year can make a person eligible for the adjustable gastric band procedure. In order to be considered for the surgery one must fully understand the risks and benefits of the gastric band procedure and the have the willingness to comply with the substantial lifelong dietary restrictions that are required for long term success.

The adjustable gastric band or Lap Band is an inflatable, silicone prosthetic device which is placed around the upper portion of the stomach using keyhole laparoscopic surgery.
Whenever fluid is introduced into the stomach the lap band expands, placing some pressure around the outside of the stomach; this decreases the size of the passage into the stomach and restricts the movement of food. As the upper part of the stomach believes it's full the message to the brain is that the stomach is full and this sensation helps the person eat smaller portions of food and lose weight over time.

Calcium supplements and Vitamin B12 injections are not usually required following gastric banding as they are with Roux-en--Y gastric bypass surgery and some other types of weight loss surgery. And gastric dumping syndrome problems don't happen in lap band surgeries because none of the intestines are removed or re-routed.

Lap band or gastric band placement, unlike the traditional malabsorptive weight loss surgery (Roux-en-Y gastric bypass surgery, biliopancreatic diversion and duodenal switch) does not cut or remove any part of the digestive system. Following surgery, adjustments, which are also called 'fills', may be performed using a fluoroscope so the radiologist can evaluate the placement of the band, the tubing and the port which runs between the port and the band. Some patients may find that before their first 'fill' they're still able to eat fairly large portions of food. And regarding fills, some doctors are more aggressive than others, but most seem to require a two to four week wait between fills

Many doctors make the first adjustment between six to eight weeks after surgery to allow the stomach enough time to heal. Then after that the fills are performed as needed. Initial weight loss in gastric banding is slower than with Roux-en-Y gastric bypass surgery but statistics indicate that over a five-year period the weight loss outcome is very similar.

Adjustable gastric band post-surgical complications include: abdominal pain, loss of strength, infection, fever, hernia, pain, chest pain, incisional infection, incision pain, and even death. Other complications that can occur with gastric band surgery include ulceration and irritated stomach tissue.

Some of the adjustable gastric band post-surgical digestive complications are nausea, vomiting, gastro-esophageal reflux, stoma obstruction, constipation, dysphagia, diarrhea, and abnormal stools. Some of the adjustable gastric band surgery complications involving the band itself and port include: band slippage, pouch dilation, esophageal dilatation or dysmotility and the erosion of the band into the gastric lumen.

Mexico is one of the top low cost travel destinations for adjustable gastric band surgery outside the United States, where the cost for lap band surgery is usually between $8,000 and $10,000. Some post-surgical weight loss surgery teams offer support groups, but some of them mix gastric bypass surgery patients with gastric banding patients, so try to find a support group for gastric banding only if you have this surgery. Make sure if you do travel away from home for any surgery that you factor in the cost of the travel time and related travel expenses for both the surgery and any follow-up appointments.

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A Quick Reference for Students of Radiology

Projection radiography
You may call them radiographs or more formally Roentgenographs, because they're named after the discoverer of X-rays, Wilhelm Conrad Roentgen. These are often used for evaluation of bony structures and soft tissues. An X-Ray machine directs electromagnetic radiation upon a region in the body. The lower the density of the object, the more light passes through. Thus, radiation tends to pass through skin, fat, muscle, and other tissues, but is absorbed by bones, tumors and lungs affected by severe pneumonia. The radiation which has passed through a patient is then exposed onto an X-ray film. Areas of film exposed to higher amounts of radiation will usually appear dark gray after development. The unexposed areas of film of course stay white.

Fluoroscopy
Fluoroscopy and angiography are special applications of X-ray imaging, in which a fluorescent screen or image intensifier tube is connected to a small television system, which allows real-time imaging of structures in motion. Radiocontrast agents are administered, which are often swallowed or injected into the body of the patient, that help delineate anatomy such as the blood vessels, the genitourinary system or the gastrointestinal tract. There is a radiocontrast agent for each specific type of evaluation. For example, barium in a suspension is administered into the gastrointestinal tract and the image is taken with fluoroscopy or radiography. Radiocontrast agents, which 'soak up' X-ray radiation, in conjunction with the real-time imaging allows demonstration of dynamic processes. Peristalsis in the digestive tract or blood flow in arteries and veins can easily be seen dynamically this way, for instance.

CT scanning
CT imaging uses X-rays in conjunction with computing algorithms to take an image of a variety of soft tissues in the body. CT is acquired in the axial plane, while coronal and sagittal images can be rendered by computer software reconstruction. It is of course only recently that the combined studies of computer imaging such as 3D ray-tracing and Computer Assisted Design have made this process possible. Yes, CT imaging owes a little debt to movies like 'Tron'! Radiocontrast agents are often used with CT for enhanced delineation of the patient's anatomy. Intravenous contrast allows 3D reconstructions of arteries and veins, showing them as a network of branching tunnels in real-time space. While radiographs provide higher resolution for bone X-rays, CT can generate much more detailed images of the soft tissues. CT exposes the patient to more ionizing radiation than a radiograph, which is the main reason it isn't used any more often than it needs to be.

Ultrasound
Medical ultrasonography uses ultrasound, literal high-frequency sound waves, to visualize soft tissue structures in the body in real time. No ionizing radiation is involved, but the quality of the images obtained using ultrasound is highly dependent on the skill of the person performing the exam, who is known as the ultrasonographer. The use of ultrasound in medical imaging has developed mostly within the last thirty years. The first ultrasound images were static and two dimensional, but with modern-day ultrasonography 3D reconstructions can be observed in real-time. Because ultrasound does not utilize ionizing radiation like radiography, CT scans and nuclear medicine imaging techniques, it is generally considered safer. For this reason, this imaging method plays a vital role in obstetrical imaging. Fetal development can be thoroughly evaluated, allowing early diagnosis of fetal anomalies or confirmation of a normal gestation.

MRI/NMR
MRI uses strong magnetic fields to align spinning hydrogen proton nuclei within body tissues, then uses a radio signal to disturb the axis of rotation of these nuclei. It then observes the radio frequency signal generated as the nuclei return to their baseline states. MRI scans give the highest quality soft tissue contrast of all the imaging modalities. With advances in scanning speed and spatial resolution and improvements in computer 3D algorithms and hardware, MRI has made great leaps forward in the recent years. One distinct disadvantage is that the patient has to hold still for long periods of time in a noisy, cramped space while the imaging is performed. Recent improvements in magnet design like wider, shorter magnet bores and more open magnet designs have brought some relief for claustrophobic patients, who previously had to be sedated - unfortunate if you are looking at the brain on the MRI, since the brain shows different activity when sedated. MRI has its best benefit in imaging the brain, spine and musculoskeletal system. The modality can be contraindicated for patients with pacemakers (watch out for those magnets!), certain types of cerebral aneurysmal clips or metallic hardware due to the strong magnetic fields. Areas of present advancement include functional imaging, cardiovascular MRI as well as MR image guided therapy.

Nuclear medicine
Nuclear medicine imaging, our newest technology, involves the administration into the patient of substances labeled with radioactive tracers which have affinity for particular tissues. The heart, lungs, thyroid, liver, gallbladder and bones are commonly evaluated for particular conditions using nuclear medicine techniques. While anatomical detail is limited in these kinds of images, nuclear medicine is useful in displaying physiological functions. For instance, processes such as the growth of a tumor can often be monitored even when the tumor cannot be adequately visualized using any of the other methods. The principal imaging devi ce is the gamma camera which detects the radiation emitted by the tracer in the body and displays it as an image on a computer monitor. Often the information is converted into a series of slices through the body like a loaf of bread. In the most modern devi ces, nuclear medicine images can be fused with a CT scan taken at the same time so that the physiological information can be super-imposed with the anatomical structures to improve diagnostic accuracy. PET scanning is another kind of nuclear medicine. The applications of nuclear medicine can include the scanning of bones, which traditionally has had a strong role in the staging of cancers. Molecular Imaging is the new and exciting frontier in this field.

They say that a picture is worth a thousand words, but the development of each of these technologies to show doctors what's happening inside the body in a non-invasive fashion has been worthwhile for saving many times a thousand lives.

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