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breakthroughs in patient care

FUNCTIONAL NEUROSURGERY TREATS BRAIN DISORDERS

 

FUNCTIONAL NEUROSURGERY TREATS BRAIN DISORDERS

BY ILIMA LOOMIS
PHOTO COURTESY OF SCIENCE PHOTO LIBRARY / TOM BARRICK, CHRIS CLARK, SGHMS

Functional neurosurgery—surgical interaction with the brain to improve function—was pioneered to treat people in need of pain relief, often those suffering with terminal cancer. Simple early procedures included surgically creating tiny lesions, also called ablations, in specific areas of the nervous system linked to pain.

The field has come a long way since those early days, says Jon Willie, MD, PhD, Washington University neurosurgeon at Barnes-Jewish Hospital. “What we know about the brain is expanding exponentially. New information and advanced methods of investigating the brain offer us new approaches to treating neuropsychiatric disorders.”

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OBSTRUCTIVE SLEEP APNEA: DIAGNOSIS AND TREATMENT

OBSTRUCTIVE SLEEP APNEA: DIAGNOSIS AND TREATMENT

BY PAM MCGRATH

People diagnosed with obstructive sleep apnea, or OSA, experience frequent disruptions of breathing while asleep. Those disruptions can range in frequency from five times in an hour for mild sleep apnea to 30 times or more for severe sleep apnea. In other words, a person with severe OSA stops and starts breathing at least every two minutes within an hour.

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PARTIAL KNEE ARTHROPLASTY: IMPROVING OUTCOMES WITH ROBOTICS

PARTIAL KNEE ARTHROPLASTY: IMPROVING OUTCOMES WITH ROBOTICS

BY Stephanie Stemmler

All that holds true for the use of robotics in partial knee replacement surgery, also called unicompartmental knee arthroplasty or UKA. In fact, a team of Washington University orthopedic researchers found that using robotics during UKA yielded results that were up to 10 times more accurate than doing the procedure without robotic assistance. The study was published in The Bone & Joint Journal, March 2021.

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ROBOTIC SURGERY BENEFITS LIVING KIDNEY DONORS AND RECIPIENTS

ROBOTIC SURGERY BENEFITS LIVING KIDNEY DONORS AND RECIPIENTS

BY PAM MCGRATH
IMAGE COURTESY OF BARNES_JEWISH HOSPITAL

When used to perform living-donor nephrectomy—the removal of a kidney from a living donor for transplantation into a recipient—a robotic surgery system offers a number of benefits. For example, the donor’s stay in the hospital may be shortened and recovery may happen more quickly.

Though many such donation surgeries already are being done using a minimally invasive procedure that offers living donors similar benefits, the robotic procedure allows for additional improvements.

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PENCIL BEAM PROTON THERAPY DELIVERS PRECISION

PENCIL BEAM PROTON THERAPY DELIVERS PRECISION

BY JEN MILLER

While radiation is a key part of therapy for 70% of people treated for cancer, its side effects can be significant. That doesn’t mean radiation shouldn’t be used; it is an effective treatment. But making radiation more targeted can mitigate side effects. That’s where pencil beam proton therapy comes in.


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AORTIC STENOSIS: TREATMENT UPDATE

AORTIC STENOSIS: TREATMENT UPDATE

BY PAM MCGRATH

In the past two decades or so, minimally invasive surgery has become widely used for many operations: gallbladder removal, appendix removal and hernia repair, just to name a few. The benefits of several small incisions versus a large, single one are well documented: reduced pain, faster recovery, fewer complications. Some heart surgeries, too, have gone the way of minimally invasive surgery, making standard open-heart surgery one option among several instead of the only option available.

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LIFE-CHANGING TREATMENT FOR CYSTIC FIBROSIS

LIFE-CHANGING TREATMENT FOR CYSTIC FIBROSIS

BY CAROLINE ARBANAS

A triple-drug cocktail, called Trikafta, was approved by the Food and Drug Administration in late 2019 and is the first therapy shown to dramatically improve lung function in most people with cystic fibrosis, a condition that often can be fatal.

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ROBOTICS IMPROVES MINIMALLY INVASIVE SPINE SURGERY

ROBOTICS IMPROVES MINIMALLY INVASIVE SPINE SURGERY

BY PAM MCGRATH

In the recent past, people needing spine surgery underwent traditional open procedures, meaning neurosurgeons or orthopedic surgeons made a five-to-six-inch-long incision in the back that allowed access to the relevant area. Although this method allowed the surgeon to easily view the spine, it also involved retracting muscle and surrounding soft tissue. The invasive nature of such procedures meant patients often remained in the hospital for a week after surgery, and total recovery sometimes took months.

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NEW TREATMENT FOR BRAIN ANEURYSM

NEW TREATMENT FOR BRAIN ANEURYSM

BY HOLLY EDMISTON

An aneurysm is an enlargement of arteries caused by a weakening of the artery wall. It can be especially dangerous if located in the brain, where a rupture can cause bleeding that is neurologically devastating. To date, standard treatment for a brain aneurysm includes, among other strategies, medication to control blood pressure, as well as various surgical interventions that essentially seal off the aneurysm as a way to help prevent rupture.

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CARDIOLOGY REPORT: LITTLE DEVICE, BIG IMPACT

CARDIOLOGY REPORT: LITTLE DEVICE, BIG IMPACT

BY KRISTIN BAIRD RATTINI

Severe heart failure affects more than 2 million people in the United States, making even simple tasks—climbing stairs, taking a walk—extremely difficult. Medications can help ease symptoms but they don’t alter the course of this fatal disease.

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COLLABORATION HELPS DIAGNOSE BRAIN CONDITION

COLLABORATION HELPS DIAGNOSE BRAIN CONDITION

BY ANDREA MONGLER

Difficulty walking. Memory problems. Urinary incontinence. Alone or in combination, these symptoms can indicate a variety of diseases and conditions. That’s why making a definitive diagnosis for a collection of symptoms such as these isn’t always easy.

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SOLVING MEDICAL MYSTERIES

SOLVING MEDICAL MYSTERIES

BY PAM MCGRATH

Despite today’s advanced state of medical diagnosis and treatment, there are people with challenging medical mysteries who, even after referrals to multiple specialists and seemingly endless testing, have no answers for the cause of their sometimes-debilitating symptoms.

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STROKE CARE: EXPANDING THE WINDOW FOR TREATMENT

STROKE CARE: EXPANDING THE WINDOW FOR TREATMENT

BY ANDREA MONGLER

For people who experience a stroke, receiving timely medical care can be the difference between recovery and disability. This is especially true for those who experience the most severe type of ischemic stroke, which happens when a blood clot blocks a major artery in the brain.

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ONCOLOGY + CARDIOLOGY = NEW SUBSPECIALTY

ONCOLOGY + CARDIOLOGY = NEW SUBSPECIALTY

BY CONNIE MITCHELL

As cancer care evolves and new treatments help more people survive and thrive after a cancer diagnosis, a related medical subspecialty is evolving alongside. Called cardio-oncology, this relatively new field of medicine specializes in the diagnosis and treatment of cardiac problems caused by common cancer drugs.

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ADVANCES IN CARE FOR MULTIPLE SCLEROSIS

ADVANCES IN CARE FOR MULTIPLE SCLEROSIS

BY ANDREA MONGLER

The American Academy of Neurology (AAN) has released a new practice guideline intended to help clinicians make decisions about disease-modifying therapies for people with multiple sclerosis, or MS.

The new guideline updates a previous set of treatment recommendations released by the AAN in 2002. Since that time, many new medications have been approved for MS, and accumulating evidence has pointed to the benefits of beginning treatment as soon after diagnosis as possible.

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REVAMPING POSTPARTUM CARE

REVAMPING POSTPARTUM CARE

BY ANNE MAKEEVER, WITH ROBERTA CODEMO

The American College of Obstetricians and Gynecologists (ACOG) has proposed a redesigned guideline for postpartum care to help reduce the rising incidence of mortality in women during the first three months after childbirth. More than one-half of pregnancy-related deaths occur during this time.

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NEW ALGORITHM HELPS PREDICT STROKE RECOVERY

NEW ALGORITHM HELPS PREDICT STROKE RECOVERY

BY TAMARA BHANDARI

A new test for people who have difficulty moving their arms and hands after a stroke can help identify those likely to recover well and those who probably will not. This information helps doctors, nurses and therapists tailor recovery care to achieve the best possible outcome for patients.

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FETAL SURGERY: THE NEW NORMAL

FETAL SURGERY: THE NEW NORMAL

ANDREA MONGLERL

It’s 1981, and a woman, seven months pregnant with twins, knows that one of her unborn babies will probably die. He has a blocked urinary tract, a life-threatening condition.

But he doesn’t die. Instead, something unprecedented happens. A doctor in San Francisco opens the woman’s abdomen and performs the first successful fetal surgery. The baby is born, leads a normal childhood and grows up.

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TREATING PAIN IN THE E.D.

TREATING PAIN IN THE E.D.

BY CONNIE MITCHELL

Pain is a constant in most any hospital emergency department, or e.d., and its treatment and management is a continual challenge. Health care teams working in these high-pressure environments see a high volume of patients with everything from life-threatening trauma to relatively minor health care needs. And they are on the front line of pain control for tens of thousands of people each year. Our nation’s concern about opioid use and the related search for non-addictive pain interventions is one force behind a new program at barnes-jewish hospital: P.T. (Physical Therapy) in the E.D.

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TCAR AND STROKE RISK

TCAR AND STROKE RISK

BY ANDREA MONGLER

For patients with carotid artery disease, the risk of stroke is a serious threat. Until recently, those who needed surgery to reduce that risk had two options: an open procedure called Carotid Endarterectomy or minimally invasive Transfemoral Carotid Angioplasty and Stenting (CAS) through an incision in the groin. Neither is ideal.

Endarterectomy can lead to a painful recovery and temporary swallowing problems. And people who undergo transfemoral CAS have a higher risk of suffering a stroke during the procedure than those who have endarterectomy.

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