Objective Improvement

Abstract: In view of the favorable claims of Cook and others, an open trial of chronic dorsal column stimulation was undertaken in 9 patients who had moderately advanced multiple sclerosis (MS) but were still ambulatory. No objective improvement was noted by either author during the postoperative observation period of 6 to 37 months; the occasional subjective improvement was ascribed to placebo effect. This procedure can no longer be recommended for MS patients.

Abstract: Background. Nonablative laser resurfacing has been shown to improve the appearance photoaged skin. Clinical improvement has been associated with dermal collagen remodeling. Objective. The objective was to determine the efficacy of a 1320-nm Nd:YAG laser for the treatment of photoaging hands. Methods. Seven patients with photoaged hands received six monthly treatments with a 1320-nm Nd:YAG laser. Improvement in skin smoothness was evaluated by objective and patient assessment using a 6-point improvement scale: 1=no improvement and 6=80% to 100% improvement. Results. Mild to moderate improvement was achieved as determined by both objective and patient assessment. Mean improvement by objective assessment was 2.4 points. Objective improvement was noted in four of seven patients, and these patients demonstrated a mean improvement score of 3.5 points. The mean improvement by patient assessment was 3.1 points. Conclusion. This case series demonstrates that the 1320-nm Nd:YAG laser with cryogen cooling can be effective for rejuvenation of photoaged hands.

Abstract: Aims: The primary aim of the RELAX-OAB study is to confirm the safety and efficacy of the Axonics r-SNM System, a miniaturized, rechargeable SNM system. Methods: A total of 51 OAB patients were implanted in a single-stage implant procedure. These results represent the 3-month outcomes. Subject outcomes were evaluated using 3-day bladder diaries and quality of life questionnaires. Results: A total of 31 of 34 patients (91%) that responded during an initial trial period (“Test Responders”) continued to benefit from therapy with the Axonics r-SNM System at 3-months, defined as symptom improvement of ≥50% reduction in urinary voids or incontinence episodes or a return to <8 voids per day. Subjects who were Test Responders showed a statistically and clinically meaningful improvement in all aspects of quality of life (ICIQ-OABqol). No serious device-related adverse events (SADEs) occurred, and there were no unanticipated adverse events (UAEs). One subject was explanted due to an infection at the implant site and 19.6% of subjects experienced device related adverse events, most notably discomfort due to stimulation, which was resolved with reprogramming. Conclusions: The Axonics r-SNM System provides safe and effective SNM therapy with objective improvement in 91% of subjects. The data also demonstrates a significant improvement in all domains of quality of life. This miniaturized, rechargeable system is designed to last 15 or more years and is expected to provide clinical and cost benefits over current non-rechargeable systems by eliminating replacement surgeries.