Beaumont Health

About: Beaumont Health is a nonprofit organization based out in Royal Oak, Michigan, United States. It is known for research contribution in the topics: Medicine & Population. The organization has 1483 authors who have published 1448 publications receiving 15407 citations. The organization is also known as: William Beaumont Health System & Beaumont Hospitals.

Core strength training using a combination of home exercises and a dynamic sling system for the management of low back pain in pre-professional ballet dancers: a case series.

Abstract: Estimates of low back pain prevalence in USA ballet dancers range from 8% to 23%. Lumbar stabilization and extensor muscle training has been shown to act as a hypoalgesic for low back pain. Timing and coordination of multifidi and transverse abdominis muscles are recognized as important factors for spinal stabilization. The purpose of this study was to explore the effects of training methods using home exercises and a dynamic sling system on core strength, disability, and low back pain in pre-professional ballet dancers. Five participants were randomly assigned to start a traditional unsupervised lumbar stabilization home exercise program (HEP) or supervised dynamic sling training to strengthen the core and lower extremities. Measurements were taken at baseline and at weeks 3 and 6 for disability using the patient specific functional scale (PSFS), pain using the Numerical Pain Rating System (NPRS), core strength and endurance using timed plank, side-plank, and bridge positions, and sciatic nerve irritability using the straight leg raise (SLR). Data were analyzed using descriptive statistics. From initial to final measurements, all participants demonstrated an improvement in strength and SLR range, and those with initial pain and disability reported relief of symptoms. These results suggest that dynamic sling training and a HEP may help to increase strength, decrease pain, and improve function in dancers without aggravating sciatic nerve irritation.

Radiosurgery for Unruptured Brain Arteriovenous Malformations: An International Multicenter Retrospective Cohort Study

Abstract: Background The role of intervention in the management of unruptured brain arteriovenous malformations (AVM) is controversial. Objective To analyze in a multicenter, retrospective cohort study, the outcomes following radiosurgery for unruptured AVMs and determine predictive factors. Methods We evaluated and pooled AVM radiosurgery data from 8 institutions participating in the International Gamma Knife Research Foundation. Patients with unruptured AVMs and ≥12 mo of follow-up were included in the study cohort. Favorable outcome was defined as AVM obliteration, no postradiosurgical hemorrhage, and no permanently symptomatic radiation-induced changes. Results The unruptured AVM cohort comprised 938 patients with a median age of 35 yr. The median nidus volume was 2.4 cm 3 , 71% of AVMs were located in eloquent brain areas, and the Spetzler-Martin grade was III or higher in 57%. The median radiosurgical margin dose was 21 Gy and follow-up was 71 mo. AVM obliteration was achieved in 65%. The annual postradiosurgery hemorrhage rate was 1.4%. Symptomatic and permanent radiation-induced changes occurred in 9% and 3%, respectively. Favorable outcome was achieved in 61%. In the multivariate logistic regression analysis, smaller AVM maximum diameter ( P = .001), the absence of AVM-associated arterial aneurysms ( P = .001), and higher margin dose ( P = .002) were found to be independent predictors of a favorable outcome. A margin dose ≥ 20 Gy yielded a significantly higher rate of favorable outcome (70% vs 36%; P Conclusion Radiosurgery affords an acceptable risk to benefit profile for patients harboring unruptured AVMs. These findings justify further prospective studies comparing radiosurgical intervention to conservative management for unruptured AVMs.

High-power, low-flow, short-ablation duration-the key to avoid collateral injury?

Abstract: A common approach to ablating along the posterior wall of the left atrium in atrial fibrillation ablation is to use low power with longer duration for durable lesions and reducing thermal injury. We hypothesize that similar lesions can be safely obtained at high power with low open-irrigation flow and low duration. Twenty-two porcine ventricles were placed in a tissue bath with circulating 0.45% NaCl at a maintained temperature of 37 °C. Bipolar radiofrequency ablation (RFA) with a 4-mm-tip irrigated, force-sensing catheter was performed with various combinations of irrigation, power, and duration at 20g of contact force. Fiber optic temperature probes were placed at depths of 3 mm and 5 mm. Temperature was measured during and 30 s after each ablation. Two hundred sixty-eight lesions were made. At a fixed power and flow rate, lesion surface diameter, maximum lesion width, and lesion depth all increased with longer ablation duration. At fixed duration and irrigation flow rate, increased power led to increased lesion dimensions. At a lower flow rate (2 ml/min), surface lesion diameter and maximum width were significantly larger compared to a higher flow rate (17 ml/min), but lesion depth was not significantly different. The maximum temperature and the rate of temperature rise at a depth of 5 mm with different power settings and ablation durations were lower as compared to a depth of 3 mm at both flow rates (2 ml/min and 17 ml/min). Effective lesions can be performed with high-power and short-ablation durations, thereby reducing RFA procedure time. Higher power, shorter duration lesions result in adequate temperature for myocardial lesion formation at 3 mm, but do not result in excessive temperature at 5 mm depth, potentially reducing the risk of collateral injury. Compared to higher irrigation flow rate, larger surface lesions and comparable maximum lesion width are achieved with lower irrigation flow rate, thus resulting in better lesion contiguity.