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61.
Objectives: The objective of this case report is to describe the use of transverse tripolar dorsal column stimulation in a patient with a history of irritable bowel syndrome (IBS) associated with abdominal pain resistant to conservative treatments. Method: We report a 36‐year‐old man who presented to the pain clinic with an eight‐year history of IBS (constipation predominant with occasional diarrheal episodes), with “crampy and sharp” abdominal pain. He also had nonradicular thoracic spine pain due to thoracic scoliosis. Both pains were affecting his ability to function as an attorney. Prior conservative therapy, including psychologic treatment, antidepressants, and opioids, was without any benefits. Results: The use of a spinal cord stimulator (SCS) was discussed with the patient. The procedure was performed after Institutional Review Board approval. A tripolar SCS was implanted at the T8 level using one‐eight contact and two‐four contact percutaneous leads based on paresthesia reproduction of patient's areas of discomfort. This tripolar spinal cord stimulation provided relief of abdominal and thoracic pain, and better management of gastrointestinal symptoms. The patient was followed‐up for one year, and his quality of life also was improved via the IBS‐Severity Scoring System quality of life tool. Conclusions: The use of the tripolar SCS in this patient provided relief of abdominal and thoracic spine pain, regulated bowel habits, and improved the patient's quality of life. We believe that the use of SCS should be considered as a treatment option in patients with IBS when all conservative treatments failed. 相似文献
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Handedness for grasping objects and pointing and the development of language in 14-month-old infants
The goal of this study was to evaluate the relationship between object-related handedness and handedness for communicative gestures. We observed 22 infants aged 14 months on a baby laterality test consisting of grasping objects in different conditions, on a pointing task with targets placed out of reach at different spatial positions from left to right, and on word understanding and word production. Results show that 77% of infants pointed to the left, middle, and right targets. The majority of infants were right-handed for pointing—except for the far left target—and, to a lesser extent, for grasping objects, but there was no significant relation between the two measures of handedness. The frequency of pointing tended to be related to the number of words understood, and infants right-handed for pointing understood and produced significantly more words than non-right-handed pointers. These results are interpreted as confirming the link between pointing and language development, and as showing that communicative gesture lateralisation is not a mere consequence of object-related handedness, at least during development. Whether lateralised communicative gesture reinforces a pre-existing tendency to use the right hand to interact with objects remains an open question. 相似文献
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Tuncer HH Rana N Milani C Darko A Al-Homsi SA 《World journal of gastroenterology : WJG》2012,18(16):1851-1860
Recognition and management of gastrointestinal and hepatic complications of hematopoietic stem cell transplantation has gained increasing importance as indications and techniques of transplantation have expanded in the last few years. The transplant recipient is at risk for several complications including conditioning chemotherapy related toxicities, infections, bleeding, sinusoidal obstruction syndrome, acute and chronic graft-versus-host disease (GVHD) as well as other long-term problems. The severity and the incidence of many complications have improved in the past several years as the intensity of conditioning regimens has diminished and better supportive care and GVHD prevention strategies have been implemented. Transplant clinicians, however, continue to be challenged with problems arising from human leukocyte antigen-mismatched and unrelated donor transplants, expanding transplant indications and age-limit. This review describes the most commonly seen transplant related complications, focusing on their pathogenesis, differential diagnosis and management. 相似文献
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