18 minute read
Advancements in Medicine
By Rachel Studebaker
From minimally invasive surgical technologies to innovative approaches to rehabilitation and beyond, new research in the medical field is optimizing care for patients and doctors alike. Read on to discover the latest in revolutionary treatment options.
Advancements in CLI Prevention
Thanks to advanced arterial procedures, the risk of developing critical limb ischemia can be reduced.
Understanding Critical Limb Ischemia
Critical limb ischemia (CLI) is the advanced form of peripheral arterial disease (PAD), which occurs when plaque builds up in the blood vessels and arteries and reduces blood flow. This blockage limits the necessary transfer of oxygen and nutrients needed to keep tissues alive, and if left untreated, can lead to limb loss. Symptoms of PAD include pain or numbness in the legs, open sores, and weakness with walking.
New Solutions
Advancements in arterial procedures and intravenous technology are making strides in the treatment of PAD and prevention of CLI. One of these procedures is an atherectomy, where a catheter is inserted into the artery to remove plaque from its walls and clear a path for blood flow. Healthcare providers in the United States perform this common procedure around 190,000 times annually.
What to Expect
During an atherectomy you will receive local anesthesia before your vascular provider inserts a special catheter into the affected artery. Once positioned at the blockage, the catheter will then remove the plaque buildup using a blade or laser. This minimally invasive procedure can be performed in an outpatient setting.
Benefits to Patients
Procedures such as an atherectomy have been instrumental in reducing patients’ risk of CLI and limb loss. Your vascular professional can advise you on the best treatment plan for PAD and help you achieve a better quality of life.
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An Expert Weighs In
As a practicing vascular surgeon for over 20 years, the endovascular technologies, such as atherectomy, have revolutionized not only how we help patients, but where. We can now operate on the inside of arteries, removing plaque or blockages, or strengthening the artery with a metal stent. This can be done through a small plastic sheath instead of an open incision. So same day procedures in an outpatient center can be performed. This knowledge has made it easier and better for patient care.
- Chris LeSar, MD | Vascular Surgeon/CLI Specialist/ Medical Director, Vascular Institute of Chattanooga
Advancements in Dental Crowns
Thanks to new scanning technology, dental crowns can be designed and fitted in a same-day procedure.
Understanding Dental Crowns
Dental crowns are synthetic caps that provide shape and function for restoration. These protective coverings can prevent tooth breakage, restore teeth that are already broken, and hold dental bridges in place. Crowns can also support a tooth that’s had a root canal and can cover a dental implant. Without crowns, damaged teeth are more prone to toothaches, sensitivity, and pain when biting or chewing.
New Solutions
Installing a dental crown used to require two visits – the first to create an impression of the filed tooth and the second to cement the crown. But now, same-day procedures are possible. Using computer-aided design and manufacturing (CAD/CAM) technology, dentists can take digital photos of the mouth and create a custom crown during one visit. The entire process takes about two to four hours.
What to Expect
The CAD/CAM same-day crown process involves five steps:
Tooth Preparation: Before attaching the new crown, your dentist will prepare the site for restoration by removing decay.
Intraoral Scanning: Next, an optical scanner is used to create a 3D custom image of your mouth.
Restoration Design: Once the image is obtained, your dentist will use the CAD software to identify the proper design for your prosthesis.
Production: The software will then connect with an on-site milling machine that shapes the crown from a block of ceramic. It is then stained or glazed to match your natural tooth color.
Cementation: Your new crown will be ready for application immediately. Your dentist will cement it to the tooth, polish it, and remove any excess debris.
Benefits to Patients
Studies show that this procedure is just as successful as traditional techniques and can even assist in preserving more of the existing tooth. CAD/CAM crown installation is quick and efficient, eliminating the temporary crown and second visit required by past methods. Because the process is completed same-day and chairside, the patient can see what their new crown will look like and how it will fit, leaving them confident and comfortable with their restoration.
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An Expert Weighs In
With the use of CAD/CAM in dentistry, crowns can be made on the same day. This eliminates the need to wait for crown fabrication for two to three weeks while a temporary crown is worn. Although the cost of a lab-fabricated vs. same-day crown is about the same, patients save money by cutting out the extra visit, meaning less time off work and less travel time to the office. One question we are often asked is about the strength. Recent studies have shown that CAD/CAM tooth restorations are just as successful as crowns made with traditional materials and techniques.
- Mandy Shearer, DDS | Dentist, Soddy Daisy Smiles
Advancements in Uterine Fibroid Treatment
Laparoscopic radiofrequency ablation is a new, minimally invasive option to target uterine fibroids.
Understanding Uterine Fibroids
Uterine fibroids are common, noncancerous growths in the muscle tissue of the uterus, affecting up to 80% of U.S. women at some point in their lives. Most women do not experience any issues associated with uterine fibroids, but those who do may suffer from heavy bleeding, painful periods, and abdominal pain. When these symptoms affect a woman’s quality of life, surgery may be recommended to intervene.
New Solutions
Previously, the most common treatment for symptomatic uterine fibroids was a hysterectomy, a major surgery where the entire uterus is removed. Minimally invasive, uterus-sparing surgeries have since emerged to treat fibroids, including laparoscopic radiofrequency ablation. The first of its kind to treat uterine fibroids, this procedure utilizes laparoscopic ultrasound imaging to accurately locate fibroids and controlled heat from radiofrequency waves to shrink the tissue.
What to Expect
First, you will receive anesthesia to ensure a painless experience. Then, your surgeon will make three small incisions in the abdomen for a camera, ultrasound wand, and surgery handpiece. They will use the imaging technologies to locate the fibroids and then apply controlled heat to the fibroid tissue via the surgical handpiece. Once surgery is complete, you will likely be cleared to go home that same day.
Benefits to Patients
Laparoscopic radiofrequency ablation has a quick recovery time, with patients returning to work in around five days. Its state-of-the-art imaging technique can locate up to two times more fibroids than conventional methods, allowing physicians to treat fibroids that may otherwise remain undetected and keeping reintervention rates low. This procedure leaves the uterus intact while effectively decreasing symptoms, giving women another option as they consider the best fibroid treatment for their current lifestyle.
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An Expert Weighs In
While laparoscopic or robotic hysterectomies are the most common procedure I perform for fibroids, they don’t necessarily fit into every woman’s life. I’m so excited to bring this treatment option to the women of Chattanooga and surrounding areas!
- Mitch Dizon, MD | Minimally Invasive Gynecologic Surgeon, Erlanger Women’s Health
Advancements in Stroke Rehabilitation
High intensity gait training can help improve walking-related outcomes for patients who have experienced a stroke.
Understanding Stroke Rehabilitation
After a stroke, which occurs when the blood supply to the brain is interrupted, the brain needs to re-wire itself. Known as neuroplasticity, this ability of the brain allows its unaffected areas to take on new functions. Stroke rehabilitation techniques can help the brain make these neuroplastic changes through repetitive practice under the proper intensity.
New Solutions
Research on neuroplasticity related to stroke rehabilitation has informed innovative methods to help patients improve their walking ability, such as high intensity gait training (HIGT). This rehabilitation technique is based on the discovery that neuroplastic changes best occur when a patient exercises at high intensity levels while maintaining 75-85% of their maximum heart rate.
What to Expect
HIGT sessions simply consist of walking. To help keep your heart rate in the target zone, your physical therapist may introduce challenges such as adding weight to your legs and increasing your walking speed, as well as have you ascend and descend stairs, change directions, and navigate obstacles.
Benefits to Patients
For people who have experienced a stroke, HIGT can help improve walking speed, quality, symmetry, and balance. Compared to conventional methods, it involves a higher number of steps within the range required for neuroplasticity and facilitates a significant increase in steps per day. HIGT can also advance cardiovascular fitness and endurance and decrease the risk of having another stroke.
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An Expert Weighs In
The ability to walk is a primary goal for patients after a stroke. The last 10 years of stroke rehabilitation research have shown that the best walking outcomes occur when patients maximize the number of steps they take while their heart rate is elevated into high heart rate zones. Siskin Hospital is equipped to offer this treatment intervention in a safe and effective way to help our patients reach their walking goals.
- Matthew Annessi, PT, DPT, NCS | Inpatient PT Supervisor, Siskin Hospital
Advancements in Skin Rejuvenation
Thread lifts are an innovative, minimally invasive option for individuals looking to refresh tired skin.
Understanding Thread Lifts
A thread lift is a non-surgical cosmetic treatment where extremely thin, medicalgrade threads are inserted under the skin. These threads help lift sagging skin, define features, reduce wrinkles and lines, and provide a naturally youthful look. Thread lifts are best for patients looking to correct lines, wrinkles, and sagging skin, and often target skin under the chin and near the cheeks.
New Solutions
Polydioxanone (PDO) threads are a popular option among thread lifts. Made from a biodegradable, colorless polyester, PDO threads are well suited to give skin a rejuvenated appearance. Once inserted, PDO threads also promote the production of collagen, the protein that gives skin structure and elasticity. The threads start to dissolve at four months, with effects lasting up to two years as a result of the increased collagen levels.
What to Expect
During this minimally invasive procedure, you will receive a local anesthetic to numb the area. Your physician will then insert a small device called a cannula into the skin, which they will use to anchor the PDO thread in place. Once the cannula is removed, your surgeon will then cut the thread and ensure it is secure. You will be free to leave after the procedure is complete and return to your regular schedule within a day.
Benefits to Patients
PDO threads can provide many of the same benefits as more invasive cosmetic treatments. Compared to a procedure such as facelift surgery, PDO threading is a cost-effective alternative that avoids large incisions. Plus, with a minimal recovery time, you can achieve a refreshed look without sacrificing your schedule.
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An Expert Weighs In
PDO threads are a true passion of mine and are creating a pathway into a safer future in medical aesthetics. PDO threads in my practice are used to perform nonsurgical facial lifting and jawline contouring, eyebrow lifts, neck lift and tightening, tear trough treatment, breast lift, nasolabial fold correction, lip contouring, marionette treatment, decollette treatment, and many more. Because PDO threads are a safe, biodegradable material that creates collagen stimulation, I use them frequently in practice for forehead lines, crows feet, and other fine lines when Botox, Dysport, or Jeuveau are contraindicated medically. This makes PDO threads an overall benefit.
- Stacey Buckner, MSN, FNP-BC, NP-C | Double Board-Certified Nurse Practitioner, Alchemy MedSpa & Wellness Center
Advancements in Orthopedic Surgery
State-of-the-art ambulatory centers are helping make orthopedic procedures convenient and accessible.
Understanding Orthopedic Surgery
Orthopedic surgery covers a wide scope of procedures related to bones, joints, and muscles. Thanks to advancements in surgical technology, medicine, and procedures, many orthopedic surgeries that used to require hospital stays can now be performed in an outpatient setting instead. In fact, research suggests that more than half of the total joint replacement surgeries will be in the outpatient setting by 2026, along with many other procedures, including spine care.
New Solutions
Orthopedic surgeries that can be performed in an outpatient setting include total joint replacement and cervical disc arthroplasty along with arthroscopy and minimally invasive procedures. Outpatient surgery is appropriate for many simple procedures that can be completed in 60 to 90 minutes and do not require close monitoring afterward.
What to Expect
Because ambulatory surgery centers are exclusively for outpatient procedures, you will be accommodated with little delay. After surgery is complete, you will receive aftercare instructions, and be free to return home and begin the healing process.
Benefits to Patients
Ambulatory centers have enhanced the patient experience, from sparing costs associated with overnight stays to allowing recovery in the comfort of one’s own home. The outpatient setting can also reduce the risk of infection and cuts down on delays and waiting times. By requiring far less of a patient’s time, same-day procedures help patients return to their daily schedule sooner. Consult with your physician to determine if an outpatient setting is the right approach for your orthopedic surgery.
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An Expert Weighs In
With the latest technology – and a focus on quality and safety – Center for Sports Medicine & Orthopaedics is leading the way with new models of care and a comprehensive approach to outpatient surgical orthopedics. Our highly trained physicians and surgery center staff are dedicated to ensuring a safe experience with the best outcome possible. Patients benefit from this same-day surgery alternative by avoiding hospital stays and returning home for recovery more quickly. In the outpatient setting, we can better control costs and pass those savings on to our patients. Our priority is to offer exceptional outpatient surgical care for every orthopedic need.
- Benji Miller, MD Orthopedic Surgeon Center for Sports Medicine & Orthopaedics
Advancements in Mammography
Routine screening mammograms can help women catch signs of early breast cancer and begin treatment as soon as possible.
Understanding Mammography
Breast cancer is one of the most common cancers in women, accounting for 30% of all new female cancers each year in the United States. However, when caught early, it is also one of the most treatable, thanks to mammography. This diagnostic technique uses x-rays to produce images of the breast, and recent advancements have made screening more accurate than ever.
New Solutions
Mammography technology has advanced significantly since it became common practice in the mid-20th century. Today, tomosynthesis mammography offers digital x-rays that create threedimensional pictures of the breasts. These detailed images have improved the detection abilities of mammography, leading to faster and more accurate diagnoses.
What to Expect
During a mammogram, a specially designed x-ray machine will apply gentle compression to the breast to obtain a clear picture of the breast tissue. Images of both breasts will be captured from two angles, top to bottom and side to side. Afterwards, your radiologist, a doctor trained to read mammograms, will evaluate the images for signs of cancer or other problems.
Benefits to Patients
Mammograms are crucial to catching early breast cancer. The American College of Radiology, Society of Breast Surgeons, National Comprehensive Cancer Network, and U.S. Preventative Services Task Force recommend all women to start receiving preventative screening mammograms beginning at age 40 to ensure early signs of cancer are caught as soon as possible so treatment can begin.
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An Expert Weighs In
Since the early 1990s mammography has decreased mortality related to breast cancer by nearly 40%. Studies have and continue to show that screening mammography saves lives. One in eight women in the United States will be diagnosed with breast cancer and one in six breast cancers occur in the women in their 40s. Now with the widespread use of tomosynthesis, or 3D mammograms, smaller and more subtle cancers are being found, often when the disease is at a much earlier stage. Finding breast cancer early, the goal of mammography, significantly increases the chance for long-term survival. This is why we strongly recommend yearly screening mammography beginning at age 40.
- Rachel Nelson, MD | Radiologist, Prime Imaging
Advancements in Wisdom Teeth Removal
Improved imaging and increased pain management options make wisdom teeth removal a safer and more comfortable experience.
Understanding Wisdom Teeth
Third molars, also known as wisdom teeth, are known to cause a plethora of issues including pain, cavities, bone loss, cysts, tumors, and infections. The risks of wisdom teeth removal increase after the age of 35, so removal at a young age (15-25 yrs.) vastly reduces the risks of complications.
New Solutions
Advancements in technology, medications, and techniques have improved the experience of wisdom teeth removal.
Imaging technology allows for better planning of the removal procedure with Cone Beam CTs that provide increased accuracy when locating nerves, vessels, and critical anatomic areas to aid in protecting the patient and preventing complications.
Anesthesia can ease patient anxieties and reduce or prevent pain during surgery. Options include local anesthesia (removes all sensation of sharp pain), nitrous oxide (alters the perception of pain), conscious/moderate oral or IV sedation (alters awareness and recall of the procedure) and deep sedation/general anesthesia (removes all potential awareness of the procedure). New advancements in monitoring, rescue equipment, assistant training, and medications have aided in improving safety and predictability of these procedures.
Pain reduction solutions assist the healing process. An innovative use of platelets has been introduced to aid in faster healing. This second-generation platelet concentration can be done right in the surgery office. Your blood will be drawn and placed into a centrifuge to concentrate the platelets into a fibrin matrix, allowing for a slow release of important factors that augment healing. Placing these platelet concentrates into the surgical sites can significantly reduce postoperative pain, swelling, and incidence of dry socket.
While narcotics can be useful for acute episodes of severe pain, new options are available to reduce their potential necessity. One example is the long-acting non-opioid pain reliever, Exparel, which can eliminate any sharp pain from the surgical site for up to 72 hours. Its mechanism is similar to injections used for any dental procedure; however, the slow, moderated release increases its longevity and eliminates postoperative pain in most patients.
Benefits to Patients
For some people, wisdom teeth removal is an intimidating process and may cause anxiety in the days leading up to it. Knowing that medical advancements in imaging, anesthesia, and pain reduction options are available to prevent complications and ease discomfort can be a great relief to these fears.
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An Expert Weighs In
The prospect of surgery is often intimidating. Fortunately, advancements in the field of oral and maxillofacial surgery have enabled the process to become much easier, predictable, and safer, allowing for a faster recovery.
- Brandon C. Stanley, DMD, FACS | Oral & Maxillofacial Surgeon, Implants & Oral Surgery of Chattanooga
Advancements in Body Contouring
Build muscle and burn fat with the help of advanced electromagnetic and radio frequency technology.
Understanding Body Contouring
Body contouring defines a number of surgical and nonsurgical procedures that help patients restore confidence in their body’s appearance and function.
New Solutions
Emsculpt Neo is an innovative body contouring treatment that uses high-intensity focused electromagnetic technology (HIFEM) and radio frequency (RF) energy. HIFEM technology prompts the targeted muscle to contract at intensities not achievable during a voluntary workout; this stress promotes the growth of muscle fibers. Simultaneously, RF heating causes fat cells to be damaged and naturally expelled from the body. On average, Emsculpt Neo can increase muscle volume by 25% and reduce fat content by 30%.
What to Expect
Receiving Emsculpt Neo treatment simply requires showing up and relaxing while the technology works. You will lie down comfortably as applicators are applied and begin to treat the target area – you may experience a heating sensation comparable to a hot stone massage. Each treatment lasts 30 minutes, with six sessions recommended for the best results.
Benefits to Patients
Emsculpt Neo treatments are painless and noninvasive, making patient comfort a priority. This treatment can target biceps, abdominals, glutes, thighs, calves, and more, making it an option for a wide variety of patient goals. By delivering both muscle toning and fat reduction therapies in one treatment, Emsculpt Neo maximizes efficiency. Its short, 30-minute sessions make achieving results convenient for even those with the busiest of schedules, and following treatment, patients can immediately return to daily activities with no recovery or downtime needed.
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An Expert Weighs In
The most rewarding part of my job is contributing to our patients’ goals and watching them transform into a reality.
- Kayla Tanos | Body Contouring Specialist, Associates in Plastic Surgery
