Labordiagnostik der HIV-Infektion
Die Diagnose einer HIV-Infektion wird unabhängig vom klinischen Verdacht ausschließlich durch labordiagnostische Untersuchungen gestellt und beruht auf der Tatsache, daß HIV-Infizierte Antikörper gegen die viralen Strukturproteine und viralen Enzyme bilde
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ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/ierd20
Spinal cord stimulation for the treatment of neuropathic pain: expert opinion and 5-year outlook Mark N. Malinowski , Sameer Jain , Navdeep Jassal & Timothy Deer To cite this article: Mark N. Malinowski , Sameer Jain , Navdeep Jassal & Timothy Deer (2020): Spinal cord stimulation for the treatment of neuropathic pain: expert opinion and 5-year outlook, Expert Review of Medical Devices, DOI: 10.1080/17434440.2020.1801411 To link to this article: https://doi.org/10.1080/17434440.2020.1801411
Accepted author version posted online: 25 Jul 2020.
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Publisher: Taylor & Francis & Informa UK Limited, trading as Taylor & Francis Group Journal: Expert Review of Medical Devices DOI: 10.1080/17434440.2020.1801411 Review
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Spinal cord stimulation for the treatment of neuropathic pain: expert opinion and 5-year outlook
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Mark N. Malinowski1,*, Sameer Jain2, Navdeep Jassal3, & Timothy Deer4 Adena Spine Center, 4437 State Route 159, Chillicothe, Ohio 45601, United States
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Pain Treatment Centers of America, Little Rock , Arkansas 72205, United States
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University of South Florida School of Medicine - Neurology & Pain, 2553 Windguard Circle, Wesley Chapel, Florida 33544, United States 4
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Spine and Nerve Center of the Virginias, 400 Court Street, Charleston, West Virginia 25301, United States
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*Corresponding author: Mark N. Malinowski Clinical Assistant Professor (Adjunct), Ohio University Heritage COM Adena Spine Center Adena Regional Medical Center Chillicothe, Ohio Email: [email protected]
Abstract
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Introduction: Spinal cord stimulation (SCS) is an effective treatment for chronic, intractable neuropathic pain. There have been relatively few high-level studies that suggest its unequivocal use. The decay of stimulation efficacy over time have opened opportunity for the entrance of new pulse trains and waveforms. Areas Covered: In this state-of-the-art review, we focused on many of the major studies published in the last 10 years that were considered level one evidence. A retrospective narrative approach was taken to conceptualize foundation studies as they pertain to current evidence. A special focus was taken on reported safety outcomes in comparison to foundation studies especially as they pertain to our 5-year outlook on the use of spinal cord stimulation. Expert Opinion: We find there are still significant limitations in the body of reviewed evidence and suggest that long term data beyond 24 months is lacking in the literature. In addition, adverse event rates, device explantation rates and the sham effect looms as important concepts to address in the future in spite of the existing novel stimulation paradigms.
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Keywords: spinal cord stimulation, neuromodulation,
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