Annals of translational medicine最新文献

{"title":"Laparoscopic sigmoid colectomy with primary anastomosis for experimental modeling in the nonhuman primate.","authors":"David J Leishman, Scott H Oppler, Melanie L Graham, Cyrus Jahansouz","doi":"10.21037/atm-24-25","DOIUrl":"10.21037/atm-24-25","url":null,"abstract":"<p><p>Laparoscopic colon surgery is performed frequently in the clinical setting for a multitude of reasons including cancer, infection, and autoimmune disease. As a result, extensive research has been conducted in relation to clinical outcomes after surgery, but more recently, in relation to the impact of surgery and other patient factors on physiologic homeostasis including the host microbiome. Despite this, experimental surgical models for laparoscopic colon surgery are scarce in the literature with most studies utilizing rodents. While rodent studies provide valuable insights into basic mechanistic processes, the translation of novel therapeutic approaches to clinical practice often requires the use of large animal models. In exploring the intricate systems biology linking surgery and medicine, sophisticated models such as nonhuman primates (NHPs) play a pivotal role. By closely resembling human anatomical, physiological, and behavioral characteristics, NHPs facilitate the development and refinement of complex surgical techniques and peri-operative practices. Furthermore, they enable longitudinal studies that comprehensively assess both immediate and long-term outcomes. The availability and utilization of multiple robust models enhance the validity of surgical research, leading to more successful translation to human clinical practice. Here we describe our technique for performing a laparoscopic sigmoid colectomy with a primary anastomosis in an NHP. The entire procedure was well tolerated without significant ventilation or hemodynamic issue. To our knowledge, this represents the first laparoscopic sigmoid colectomy with primary anastomosis performed in an NHP. Furthermore, this demonstrates the feasibility of the technique and provides a relevant, preclinical model for the study of surgical colon disease. Although the surgical colectomy model in NHPs closely resembles the clinical scenario, it is crucial to recognize that a 'model' inherently comes with limitations. The intended use of any model should be carefully evaluated concerning the target patient population with the consideration of potential disparities in anatomy, physiology, environmental factors, and disease to properly interpret results. This model provides an opportunity to study mechanisms, from a systems biology perspective, underlying both innovative surgical treatments and their effects on diseases such as colon cancer, as well as benign conditions like inflammatory bowel disease, diverticulitis, and anastomotic leak, offering high predictive value.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"12 5","pages":"93"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Has the CONVINCE trial convinced the nephrology and dialysis community?","authors":"Julien Moury, Gauthier Nendumba, Arnaud Robert, Benedicte Hauquiert, Ovidiu Vornicu, Sydney Blackman, Emily Perriens, Nathan De Lissnyder, Andriy Shchukin, Farah El Yaakoubi, Clara Saad, Cyril Schmit, Anne-Sophie Dincq, Patrick Evrard, Pierre Bulpa, Isabelle Michaux, Patrick M Honore","doi":"10.21037/atm-24-50","DOIUrl":"10.21037/atm-24-50","url":null,"abstract":"","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"12 5","pages":"99"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heatmap analysis for artificial intelligence explainability in diabetic retinopathy detection: illuminating the rationale of deep learning decisions.","authors":"Fernando Korn Malerbi, Luis Filipe Nakayama, Paulo Prado, Fernando Yamanaka, Gustavo Barreto Melo, Caio Vinicius Regatieri, José Augusto Stuchi","doi":"10.21037/atm-24-73","DOIUrl":"10.21037/atm-24-73","url":null,"abstract":"<p><strong>Background: </strong>The opaqueness of artificial intelligence (AI) algorithms decision processes limit their application in healthcare. Our objective was to explore discrepancies in heatmaps originated from slightly different retinal images from the same eyes of individuals with diabetes, to gain insights into the deep learning (DL) decision process.</p><p><strong>Methods: </strong>Pairs of retinal images from the same eyes of individuals with diabetes, composed of images obtained before and after pupil dilation, underwent automatic analysis by a convolutional neural network for the presence of diabetic retinopathy (DR), output being a score ranging from 0 to 1. Gradient-based Class Activation Maps (GradCam) allowed visualization of activated areas. Pairs of images with discordant DL scores or outputs within the pair were objectively compared to the concordant pairs, regarding the sum of activations of Class Activation Mapping (CAM), the number of activated areas, and DL score differences. Heatmaps of discordant pairs were also qualitatively assessed.</p><p><strong>Results: </strong>Algorithmic performance for the detection of DR attained 89.8% sensitivity, 96.3% specificity and area under the receiver operating characteristic (ROC) curve of 0.95. Out of 210 comparable pairs of images, 20 eyes and 10 eyes were considered discordant according to DL score difference and regarding DL output, respectively. Comparison of concordant versus discordant groups showed statistically significant differences for all objective variables. Qualitative analysis pointed to subtle differences in image quality within discordant pairs.</p><p><strong>Conclusions: </strong>The successfully established relationship among objective parameters extracted from heatmaps and DL output discrepancies reinforces the role of heatmaps for DL explainability, fostering acceptance of DL systems for clinical use.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"12 5","pages":"89"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How we manage multiple myeloma with clonal hematopoiesis of indeterminate potential (CHIP): a case report.","authors":"Ludovic Saba, Lewis Nasr, Jorge Manrique-Succar, Julia Diacovo, Chakra Chaulagain","doi":"10.21037/atm-23-1945","DOIUrl":"10.21037/atm-23-1945","url":null,"abstract":"<p><strong>Background: </strong>Clonal hematopoiesis of indeterminate potential (CHIP) is characterized by genetic alterations associated with hematologic neoplasms, posing clinical challenges in managing concurrent hematological malignancies. CHIP may complicate the treatment landscape due to its potential to influence disease progression and treatment response. We report a 73-year-old male with multiple myeloma (MM) harboring a CHIP PPM1D mutation, elucidating the complexities and therapeutic considerations in such cases.</p><p><strong>Case description: </strong>After four cycles of cyclophosphamide, bortezomib, and dexamethasone therapy, he achieved a partial response, followed by complete hematologic response (CR) post eight cycles of lenalidomide, dexamethasone, and bortezomib therapy. Despite this, upfront autologous hematopoietic stem cell transplantation (HSCT) was initially deemed unsuitable due to positive PPM1D CHIP status. HSCT proceeded after aggressive relapse with clonal evolution but yielded short-lived response. Following failure of >4 lines of therapy, he received chimeric antigen receptor T (CAR-T) cell therapy (ciltacabtagene autoleucel) for salvage. This approach successfully induced remission, which was maintained for 6 months.</p><p><strong>Conclusions: </strong>This case report highlights MM management complexities in CHIP presence, suggesting potential utility of HSCT and CAR-T cell therapy. Prospective studies are necessary to evaluate the safety and efficacy of these therapies in myeloma patients with concurrent CHIP, aiming to optimize treatment strategies and improve outcomes in this challenging clinical context.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"12 5","pages":"96"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of the single cell landscape in normal and osteoarthritic equine joints.","authors":"Dylan T Ammons, Lyndah Chow, Laurie Goodrich, Luke Bass, Blaine Larson, Zoë J Williams, Jason W Stoneback, Steven Dow, Lynn M Pezzanite","doi":"10.21037/atm-24-40","DOIUrl":"10.21037/atm-24-40","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is a major source of pain and disability worldwide. Understanding of disease progression is evolving, but OA is increasingly thought to be a multifactorial disease in which the innate immune system plays a role in regulating and perpetuating low-grade inflammation. The aim of this study was to enhance our understanding of OA immunopathogenesis through characterization of the transcriptomic responses in OA joints, with the goal to facilitate the development of targeted therapies.</p><p><strong>Methods: </strong>Single-cell RNA sequencing (scRNA-seq) was completed on cells isolated from the synovial fluid of three normal and three OA equine joints. In addition to synovial fluid, scRNA-seq was also performed on synovium from one normal joint and one OA joint.</p><p><strong>Results: </strong>Characterization of 28,639 cells isolated from normal and OA-affected equine synovial fluid revealed the composition to be entirely immune cells (CD45⁺) with 8 major populations and 26 subpopulations identified. In synovial fluid, we found myeloid cells (macrophage and dendritic cells) to be overrepresented and T cells (CD4 and CD8) to be underrepresented in OA relative to normal joints. Through subcluster and differential abundance analysis of T cells we further identified a relative overrepresentation of IL23R⁺ gamma-delta (γδ) T cells in OA-affected joints (a cell type we report to be enriched in gene signatures associated with T helper 17 mediated immunity). Analysis of an additional 17,690 cells (11 distinct cell type clusters) obtained from synovium of one horse led to the identification of an OA-associated reduction in the relative abundance of synovial macrophages, which contrasts with the increased relative abundance of macrophages in synovial fluid. Completion of cell-cell interaction analysis implicated myeloid cells in disease progression, suggesting that the myeloid-myeloid interactions were increased in OA-affected joints.</p><p><strong>Conclusions: </strong>Overall, this work provides key insights into the composition of equine synovial fluid and synovium in health and OA. The data generated in this study provides equine-specific cell type gene signatures which can be applied to future investigations. Furthermore, our analysis highlights the potential role of macrophages and IL23R⁺ γδ T cells in OA immunopathogenesis.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"12 5","pages":"88"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Literature review: nuclear factor kappa B (NF-κB) regulation in human cancers mediated by ubiquitin-specific proteases (USPs).","authors":"Keyi Shen, Qiuyang Zhang","doi":"10.21037/atm-24-32","DOIUrl":"10.21037/atm-24-32","url":null,"abstract":"<p><strong>Background and objective: </strong>The nuclear factor kappa B (NF-κB) consists of a group of transcription factors of which its dysregulation is responsible for diseases such as inflammation and cancer. Ubiquitin-specific proteases (USPs) are the most prominent group among the deubiquitinases (DUBs). Their functions include control of protein stability and regulation of signaling transduction. The association between NF-κB activity and human cancer progression is evident. Still, the role of USPs in the NF-κB regulation in human cancers, especially prostate cancer, is not well understood. This review discusses on the role of USP-mediated regulation of the canonical NF-κB signaling pathway in human cancers and provides a prospect of future studies in prostate cancers.</p><p><strong>Methods: </strong>Within the biomedical literature database, PubMed, our review team searched for keywords including USP, NF-κB signaling pathway, cancer, prostate cancer, and specific USPs such as USP1, USP2, USP3, etc. These keywords were used individually or in combinations. After screening, only mechanistic studies and articles reporting the subsequent changes in cellular behaviors were included for full-text review.</p><p><strong>Key content and findings: </strong>Most USPs function primarily as DUBs to regulate the canonical NF-κB signaling pathway. The typical K48- and K63-linked DUB activities of USPs are the best understood. These USPs are positive and negative regulators of the NF-κB activity. However, their DUB activities against polyubiquitin chains with atypical linkages have not yet been extensively studied. Furthermore, some USPs can regulate the canonical NF-κB signaling pathway via ubiquitin-independent mechanisms.</p><p><strong>Conclusions: </strong>In the regulation of the canonical NF-κB pathway, the USPs function primarily as DUBs, but they also regulate the p65/p50 by ubiquitin-independent mechanisms. Generally, in human cancer models, USP-mediated elevation and suppression of p65/p50 activity lead to more or less malignant cellular behaviors, respectively. Given the currently unbalanced focus on K48- and K63-linked DUB activities and the context-dependent function of USPs, future research of USP-mediated NF-κB regulation in human cancers should invest more in the DUB activities against the atypical polyubiquitin chains and test known mechanisms in different cancer models.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"12 5","pages":"90"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing surgical techniques and results of secondary ischemic mitral regurgitation: a state-of-the-art literature review.","authors":"Francesco Nappi","doi":"10.21037/atm-24-39","DOIUrl":"10.21037/atm-24-39","url":null,"abstract":"<p><strong>Background and objective: </strong>Surgery for mitral valve disease is a developing area with a wide range of surgical options. There is growing evidence on the best approach for secondary ischemic mitral regurgitation (SIMR) when the pathology is within the ventricle. The goal of this literature review is to provide a comprehensive comparison of surgical treatments for SIMR.</p><p><strong>Methods: </strong>The initial screening process included PubMed, Medline and Embase to identify randomized controlled trials, propensity-matched observational series, meta-analyses and unmatched observational series. The terms used were 'mitral valve disease', 'secondary mitral regurgitation', 'secondary ischemic mitral regurgitation', 'functional mitral regurgitation', 'restrictive mitral annuloplasty', 'subvalvular repair', 'Trans Catheter Edge to Edge Repair and echocardiography coupled with secondary mitral regurgitation', 'secondary ischemic mitral regurgitation', and 'functional mitral regurgitation'. Six strategies have been identified for treating SIMR. These include mitral valve replacement (MVR), restrictive mitral annuloplasty, surgical revascularisation (with and without mitral annuloplasty), subvalvular procedures [papillary muscle (PM) approximation, PM relocation, ring and string procedure], procedures directly targeting the mitral valve (edge-to-edge repair and anterior leaflet enlargement), and transcatheter heart valve therapy.</p><p><strong>Key content and findings: </strong>There is a deficiency of robust empirical data to enable meaningful comparisons between MVR, mitral valve repair (including subvalvular repair), and transcatheter mitral valve procedure. This review will definitively analyze the current outcomes of transcatheter mitral valve procedure using the edge-to-edge mitral valve repair technique and standard surgical mitral valve procedures in patients with secondary mitral regurgitation (MR). In addition, the seminar highlights the role of left ventricular assist devices in managing SIMR. It discusses the advantages and limitations of each intervention.</p><p><strong>Conclusions: </strong>Currently, there is no consensus on the optimal management strategy for patients with SIMR. Therefore, a multidisciplinary cardiac team should manage patients with secondary MR to ensure the best outcome by matching the ideal intervention with the patient.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"12 5","pages":"91"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert opinion on heat therapy for teenagers' musculoskeletal pain management.","authors":"Guillermo Rodriguez-Maruri, Stefano Celotto, Damiano Guidi, Anja Hirschmüller, Guillermo Sosa González","doi":"10.21037/atm-23-1931","DOIUrl":"10.21037/atm-23-1931","url":null,"abstract":"<p><strong>Background: </strong>Among children and adolescents, up to 40% will experience musculoskeletal pain (MP), which can significantly impair functional ability, reduce quality of life, cause emotional distress, and lead to sleeping disorders for both patients and their families. The first-line treatment often involves pharmacological interventions, even though there is a lack of evidence supporting the efficacy or the safety of this approach in this specific age group. Recent guidelines recommend the implementation of preventative strategies and physical tools as the first option to minimize the use of medications. We aimed to provide an expert opinion on the use of heat therapy for MP management in young patients.</p><p><strong>Methods: </strong>This paper is the result of a virtual advisory board held by the authors in order to discuss and provide an expert opinion about the use of heat therapy in MP in children and adolescents.</p><p><strong>Results: </strong>MP is a significant burden affecting children and adolescents. While non-steroidal anti-inflammatory drugs are currently the first-choice treatment of acute and chronic MP in children and adolescents, avoiding or reducing them in such patients is advisable, to reduce side effects and to prevent the development of chronic pain and medication overuse headaches. Heat therapy can be an additional treatment option due to its ability to promote muscle relaxation, enhance blood circulation, and modulate nociceptors with a good safety profile.</p><p><strong>Conclusions: </strong>MP in children and adolescents is a common condition that should be approached multidisciplinary, including information, therapeutic exercise and physical therapies like hot or cold therapies. Future studies should be conducted to evaluate the safety, efficacy and indications of each treatment in MP.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"12 5","pages":"84"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propofol curtails survival in perioperative and critically ill patients by a relative reduction of 10%: should propofol be abandoned?","authors":"Benedicte Hauquiert, Sydney Blackman, Emily Perriens, Maha Bendoumou, Ileana Ene, Aicha Van Engelgem, Anaïs Carrasco Sanchez, Maya Ramos Prieto, Ovidiu Vornicu, Arnaud Robert, Gauthier Nendumba, Julien Moury, Anne-Sophie Dincq, Patrick Evrard, Pierre Bulpa, Isabelle Michaux, Patrick M Honore","doi":"10.21037/atm-24-52","DOIUrl":"10.21037/atm-24-52","url":null,"abstract":"","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"12 5","pages":"98"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel technique to identify and thermally ablate the greater occipital nerve for patients with occipital neuralgia: a retrospective study with cadaveric and <i>ex-vivo</i> validation.","authors":"Sayed E Wahezi, Safwan Zar, Devin Oakes, Tahereh Naeimi, Sandeep Yerra, Sherry A Downie, Salahadin Abdi, Leili Shahgholi, Alaa Abd Elsayed","doi":"10.21037/atm-24-72","DOIUrl":"10.21037/atm-24-72","url":null,"abstract":"<p><strong>Background: </strong>This manuscript presents the challenges of treating various forms of headaches and the potential of interventional techniques targeting the greater occipital nerve (GON) to alleviate the burden on patients. Occipital neuralgia, characterized by stabbing or shooting pain in the base of the skull, is often associated with primary, cervicogenic, or migraine headaches. While occipital nerve blocks offer temporary relief, durable treatment options are limited. Pulsed radiofrequency (PRF) and thermal radiofrequency ablation (TRFA) have shown promise as minimally invasive procedures for long-term treatment. However, GON is not easily identified using ultrasound or fluoroscopic analysis; thereby, minimizing success of proper ablation. Here, the authors provide a percutaneous strategy to localize the GON and maximize lesion performance. We intend to provide an <i>ex-vivo</i> description of staggered bipolar radiofrequency (RF) lesioning and include the use of staggered bipolar lesioning of the GON and stimulation of the semispinalis capitis. We also analyzed the effectiveness and side effects from this ablation, retrospectively.</p><p><strong>Methods: </strong>Patients with chronic refractory GON neuralgia were selected for GON TRFA. A novel double needle technique of sequential electrical stimulation was used to localize the GON and approximate needle to nerve distance. Once the needles were positioned adjacent to the GON, TRFA was performed using a bipolar staggered technique.</p><p><strong>Results: </strong>Twenty-two patients with GON were treated with TRFA using a novel double needle technique. Seventy-two percent of these patients reported greater than 50% pain relief at both 1 and 6 months following the procedure. The results of our <i>ex-vivo</i> study demonstrate that performing TRFA using the parallel needle bipolar approach separated 8 mm apart produced the most desirable lesion dimensions that may correlate with effective ablation of the GON.</p><p><strong>Conclusions: </strong>This study demonstrates a new localization and ablation technique to treat refractory headaches. However, larger studies are needed to confirm our findings.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"12 5","pages":"85"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}