Atlantic Health System

About: Atlantic Health System is a healthcare organization based out in Morristown, New Jersey, United States. It is known for research contribution in the topics: Catheter ablation & Antiarrhythmic agent. The organization has 277 authors who have published 299 publications receiving 6594 citations.

Use of Osteopathic Manipulation for Treatment of Chronic Shoulder Injury Related to Vaccine Administration

Abstract: Shoulder injury related to vaccine administration (SIRVA) is an increasingly reported phenomenon that causes inflammation of surrounding structures, along with pain and decreased range of motion of the affected shoulder. Current literature emphasizes proper injection techniques and locations to decrease incidence; however, there is limited information available on successful treatments. The aim of this report is to describe a case of SIRVA and review treatment options, specifically the role of osteopathic manipulative medicine (OMM) in the resolution of symptoms refractory to standard care. Here we present a case of chronic SIRVA in a 58-year-old female due to a poorly administered influenza vaccination with emphasis on a stepwise osteopathic therapy approach as a lasting treatment to decrease the effects of the inflammatory process and improve daily function of the shoulder. OMM, with the option of anesthesia, can be performed in outpatient family medicine practices as a noninvasive and safe adjunct treatment. Specifically, the Spencer technique has been shown to improve shoulder-related pathologies that include adhesions, capsulitis, and inflammation and was used in this case under anesthesia. The patient reported good improvement in her symptoms and increased range of motion. SIRVA is an underdiagnosed phenomenon that involves inflammation of surrounding structures after a vaccine administration. In chronic cases, such as in this patient, OMM may be enhanced with the use of anesthesia to optimize the treatment's effect on scar tissue and fibrosis.

Nerve protecting dissection device

Abstract: The present invention provides an energy based dissection device that automatically provides a nerve protection function. Specifically, the present invention operatively connects nerve monitoring technology and energy based dissection technology to provide a device that provides energy based dissection functionality that cannot operate, or operates differently, upon receipt of real time information from the nerve monitoring functionality that nerve damage may be imminent in the absence of such safety shutdown. The present invention also creates a real-time graphical display of the nerve, including size and location relative to the energy based dissection device to enable the operator to safely and accurately avoid damaging the nerve. Accordingly, the present invention provides a surgical device that removes human error and reaction time issues which prevent unintended dissection and concomitant nerve damage.

Tai Chi in Parkinson’s Disease: A Preliminary Randomized, Controlled, and Rater-Blinded Study

Abstract: Background: Given the limited benefits of current treatments for Parkinson’s disease (PD), inter-ventions that might provide supplementary benefits would be of value. The traditional Chinese medicine practice of Tai Chi has been said to improve some aspects of PD, particularly imbalance. Methods: Preliminary randomized, controlled, and rater-blinded clinical trial of Tai Chi, focusing on its effects on global motor, daily function, mood and quality of life. Subjects continued their standard medical therapy and were randomly assigned to Tai Chi (16 weekly classes, expert trainer, practice at home between classes) or no Tai Chi (control group) in a 2:1 ratio. The primary outcome measure was the total motor score of the Unified Parkinson’s Disease Rating Scale (UPDRS) and this was scored by an experienced rater who was blinded to the treatment assignment. The same rater scored the Schwab and England Activities of Daily Living Scale. The patient-completed Geriatric Depression Scale, PD (quality of life) Questionnaire-39, and fall diary were also analyzed. Results: 44 subjects participated with 29 assigned to Tai Chi and 15 serving as controls. Tai Chi was well-tolerated. Seven subjects withdrew prior to completion (2 from Tai Chi, 5 from control). We found no significant difference between treatment groups in the change in scores from baseline to end of intervention for any of the scales. Trends toward a benefit of Tai Chi were observed for individual UPDRS items (depression, finger tapping, hand movements, posture). Conclusions: Tai Chi does not appear to improve global measures in patients with PD. The practice may have benefits for PD, but these appear to be largely restricted to specific motor tasks and perhaps mood rather than being a global functional response. More study is needed to clarify and establish efficacy.

Right and left atrial activation during external direct-current cardioversion shocks delivered for termination of atrial fibrillation in humans.

Abstract: We examined the regional electrophysiologic effects of successful and unsuccessful direct-current cardioversion shocks on different right and left atrial regions in patients with sustained atrial fibrillation (AF). Patients with sustained AF undergoing external cardioversion underwent simultaneous mapping of the right and left atria. Electrogram changes after shock delivery, regional atrial activation, and effects of shock intensity were analyzed. Twenty-two patients with sustained AF received 52 shocks (mean 2.4/patient, 22 successful and 30 unsuccessful). The efficacy of 50, 100, 200, and 300 J was 18%, 39%, 100%, and 100%, respectively. In all 22 successful shocks, there was virtually simultaneous termination of electrical activity in all right and left atrial regions mapped. Unsuccessful shocks resulted in a significant increase in mean atrial cycle length at lateral right atrium, superior left atrium, and proximal, mid, and distal coronary sinus (p = 0.01), but not at the interatrial septum (p >0.2), which often disappeared before the next shock. This cycle length prolongation was accompanied by reduction in fragmented and chaotic electrograms (p <0.03) and emergence of discrete electrograms at all right and left atrial regions that persisted until the next shock. The changes in electrogram morphology failed to alter the surface electrocardiographic appearance of AF. There was no correlation between the shock intensity and the magnitude of these effects. We conclude that termination of AF with external cardioversion shocks is associated with the widespread extinction of regional atrial wave fronts. Unsuccessful shocks are associated with a temporary slowing of atrial activation at all regions except at the interatrial septum and emergence of organized and/or rapidly propagating wave fronts.