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ABSTRACT Background Aims Methods Results Conclusion Neck wrinkles are a prominent characteristic of skin aging, with recent studies indicating that interventions such as platelet‐rich plasma (PRP), microneedling (MN), and radiofrequency (RF) can effectively rejuvenate aging skin.This study aims to assess and compare the efficacy of three treatment modalities in addressing neck wrinkles.Fifteen female participants with a neck Lemperle Wrinkle Assessment Scale (WAS) score of 3–4 were enrolled in a randomized clinical trial. The subjects were randomly assigned to three treatment groups: PRP injection, MN + PRP topical PRP application, and RF + PRP injection. They received treatment once a month for three consecutive months, and a clinical outcome evaluation was performed at 1 and 6 months after the final treatment.The WAS scores and global aesthetic improvement score (GAIS) demonstrated notable enhancements 1 month postfinal treatment across all three groups, with a notably greater number of participants experiencing improved outcomes in the RF + PRP group 6 months posttreatment. Specifically, at the 1‐month follow‐up, the RF + PRP group exhibited a statistically significant enhancement in skin elasticity and collagen, surpassing the improvements observed in the other two groups (p < 0.05). No significant disparities in skin elasticity and collagen were detected in all groups prior to and after 6 months of treatment. Adverse events were mild and transient, such as redness, swelling, bruising, and pain.This study revealed that all the treatments can effectively improve neck wrinkles 1 month after the last treatment. A better therapeutic effect could be observed in the RF + PRP group compared with the other two groups at 6 months after the last treatment. [ABSTRACT FROM AUTHOR]

Introduction: Due to its unique features, pulsed field ablation (PFA) could potentially overcome some limitations of current radiofrequency (RF) ventricular tachycardia (VT) ablation. However, data on the use of PFA in this setting are currently scarce. Methods: Two patients with ischemic cardiomyopathy and previously failed RF VT ablations were treated with PFA. Results: A total of 18 bipolar applications (case1) and seven bipolar applications (case2) were delivered to the infero‐lateral and infero‐septal areas (case1) and to the apical lateral left ventricular (LV) wall (case2), placing the catheter adjacent to the LV wall in the flower configuration. A rapid cessation of VT and restoration of sinus rhythm were observed during PFA delivery in both cases. Further applications were delivered to achieve complete elimination of late potentials. In case 1, during the in‐hospital stay, ECG monitoring did not show VT recurrences. Six‐month follow‐up was uneventful, with no VT recurrences at ICD interrogation. In case 2, due to postdischarge VT recurrences, a second RF procedure was scheduled 1 month later. The voltage map performed in sinus rhythm showed a low‐voltage zone located at the anterolateral wall, near the previous ablation site. Numerous late potentials were recorded. At the 6‐month follow‐up, no further VT recurrences were documented after RF redo ablation. Conclusion: While the speed of application and potential transmural effect can facilitate the ablation of large diseased endocardial areas, early loss of contact due to difficult pentaspline catheter manipulation in the LV could lead to insufficient contact force and, consequently, inadequate energy penetration. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of 1800 MHz continuous wave (CW) and global system for mobile communications (GSM) modulated radiofrequency electromagnetic field (RFEMF) exposures on signal transduction (ST) protein and cytokine expression in differentiated human-derived monocytic THP-1 cells. Materials and methods: THP-1 cells were differentiated into adherent macrophage-like cells using phorbol 12-myristate 13-acetate (PMA). Following differentiation, cells were exposed to 1800 MHz CW or GSM modulated RFEMF for 0.5, 4, or 24 h at a specific absorption rate (SAR) of 0 (sham) or 2.0 W/kg. Concurrent positive controls (lipopolysaccharide for cytokines; anisomycin for ST proteins) and negative controls were included in each experiment. The expression levels of cytokines (GM-CSF, IFN-γ, IL-1β, IL-6, IL-10, TNF-α) from culture media and phosphorylated and total ST proteins (CREB, JNK, NF-κB, p38, ERK1/2, Akt, p70S6k, STAT3, STAT5) from cell lysates were assessed using Milliplex magnetic bead array panels. Results: No consistent effect of RFEMF exposure was observed in differentiated THP-1 cells. A statistically significant effect of overall exposure condition was observed for IL-6 with GSM modulation (P = 0.042), but no difference between RFEMF and sham for any exposure condition remained following adjustment for multiple comparisons (P ≥ 0.128). No statistically significant effect of exposure condition was detected for any other cytokine evaluated with either of the RFEMF modulations (P ≥ 0.078). There were no statistically significant changes in expression levels for any of the ST proteins under any studied exposure condition (P ≥ 0.320). Conclusions: In this study, no evidence of changes were observed in differentiated human derived THP-1 cells following exposure of up to 24 h to 1800 MHz RFEMF at SARs of 0 and 2.0 W/kg on the expression of ST proteins or cytokines. [ABSTRACT FROM AUTHOR]

Introduction: Spinal and non-spinal pathologies can cause low back pain. Non-spinal sources of low back pain include the sacroiliac joint (SIJ) and the hip. SIJ pain can be treated either conservatively or surgically. Current strategies for managing sacroiliac joint pain are debated, and limited evidence exists. Areas covered: The present expert opinion updates current evidence on conservative and surgical modalities for SIJ pain Expert opinion: Surgical management for SIJ pain is effective. However, it exposes patients to surgery and, therefore, related complications. Conservative management may be implemented in patients with moderate SIJ pain, with less than six months of symptoms, or not eligible for surgery. Several noninvasive modalities are available, mostly centered on intra-articular injections. Corticosteroids, platelet-rich plasma, and stem cells have only midterm lasting effects, at most for nine months. Radiofrequency ablation is another methodology for pain relief. Both continuous and pulsatile radiofrequency ablation are associated with good outcomes. SIJ fusion can be performed using different techniques; however, a clear recommendation on the most appropriate modality for the management of SIJ pain is still debated. [ABSTRACT FROM AUTHOR]

Objectives: One of the most promising adjuncts for screening breast cancer is ultrasound (US) radio‐frequency (RF) time series. It has the superiority of not requiring any supplementary equipment over other methods. This research aimed to propound a machine learning (ML) approach for automatically classifying benign, probably benign, suspicious, and malignant breast lesions based on the features extracted from the accumulated US RF time series. Methods: In this article, 220 data of the aforementioned categories, recorded from 118 patients, were analyzed. The dataset, named RFTSBU, was registered by a SuperSonic Imagine Aixplorer medical/research system equipped with a linear transducer. The regions of interest (ROIs) of the B‐mode images were manually selected by an expert radiologist before computing the suggested features. Regarding time, frequency, and time‐frequency domains, 291 various features were extracted from each ROI. Finally, the features were classified by a pioneering technique named the reference classification method (RCM). Furthermore, the Lee filter was applied to evaluate the effectiveness of reducing speckle noise on the outcomes. Results: The accuracy of two‐class, three‐class, and four‐class classifications were respectively calculated 98.59 ± 0.71%, 98.13 ± 0.69%, and 96.10 ± 0.66% (considering 10 repetitions) while support vector machine (SVM) and K‐nearest neighbor (KNN) classifiers with 5‐fold cross‐validation were utilized. Conclusions: This article represented the proposed approach, named CCRFML, to distinguish between breast lesions based on registered in vivo RF time series employing an ML framework. The proposed method's impressive level of classification accuracy attests to its capability of effectively assisting medical professionals in the noninvasive differentiation of breast lesions. [ABSTRACT FROM AUTHOR]

Structural composite materials have gained significant appeal because of their ability to be customized for specific mechanical qualities for various applications, including avionics, wind turbines, transportation, and medical equipment. Therefore, there is a growing demand for effective and non-invasive structural health monitoring (SHM) devices to supervise the integrity of materials. This work introduces a novel sensor design, consisting of three spiral resonators optimized to operate at distinct frequencies and excited by a feeding strip line, capable of performing non-destructive structural strain monitoring via frequency coding. The initial discussion focuses on the analytical modeling of the sensor, which is based on a circuital approach. A numerical test case is developed to operate across the frequency range of 100 to 400 MHz, selected to achieve a balance between penetration depth and the sensitivity of the system. The encouraging findings from electromagnetic full-wave simulations have been confirmed by experimental measurements conducted on printed circuit board (PCB) prototypes embedded in a fiberglass-based composite sample. The sensor shows exceptional sensitivity and cost-effectiveness, and may be easily integrated into composite layers due to its minimal cabling requirements and extremely small profile. The particular frequency-coded configuration enables the suggested sensor to accurately detect and distinguish various structural deformations based on their severity and location. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objective Materials and Methods Results Conclusion IRB Protocol Number Radiofrequency (RF) microneedling produces patient discomfort which deters patients from completing the recommended treatment series.The primary objective was to determine the tolerability, safety, and efficacy of a neurocosmetic postprocedure cream post‐RF microneedling in reducing patient discomfort and enhancing recovery across the length of the study and, secondarily, to evaluate against a leading comparator. The third objective was to evaluate the efficacy of the neurocosmetic on self‐perceived improvement and objective grading.An Institutional Review Board (IRB) approved, fourteen‐day, randomized, single‐center, double‐blind, controlled clinical case study was conducted with 11 healthy female subjects, 6 randomized to the neurocosmetic and 5 to the comparator cell. Following a 7‐day washout period, subjects received RF microneedling (face and neck) and applied the postprocedure cream twice daily for 7 days. Objective and subjective tolerability, self‐assessments, and clinical photography were performed immediately postprocedure, 24 h, three and seven days following the procedure.The neurocosmetic was tolerable and safe. Erythema and stinging immediately decreased postprocedure, postneurocosmetic application. After 24 h, 83% favorably agreed the neurocosmetic “reduced irritation on the skin post‐procedure,” and after 7 days, 100% favorably agreed “experience with the product was positive and I would be interested in returning for a second treatment.” The neurocosmetic reduced skin tone redness in the face and neck faster and to a greater degree when measured against a comparator.The neurocosmetic postprocedure cream improved patient discomfort and enhanced recovery when used immediately post‐RF microneedling and after 7 days.Pro00064211 [ABSTRACT FROM AUTHOR]

Introduction: Concerns over male infertility have grown, with over fifty percent of infertility cases linked to male causes. The impact of radiofrequency electromagnetic radiation (RF-EMR) of cellphones on the fragmentation of sperm has been investigated. This mini-review evaluates previous investigations on the relation between RF-EMR and sperm DNA fragmentation (SDF). Methods: A systematic review was carried out using Google Scholar and PubMed databases up to July 2020. MeSH terms related to DNA fragmentation, sperm, mobile phones, radiofrequency, and related synonyms identified relevant studies. Nine studies were selected, and their methodologies examined. Results: The studies reviewed presented diverse findings on the correlation between RF-EMR from cellphones and SDF. Out of nine investigations--five in vitro and four in vivo--all in vivo research works found significant DNA fragmentation in men who used their phones extensively, especially when carried in pants pockets. Three of the five in vitro tests showed a substantial effect, while the other two found no significant change between exposed and unexposed samples. Conclusion: Although more studies reported decreased sperm quality with prolonged and intense RF-EMR exposure, the evidence regarding DNA fragmentation remains inconclusive. Given how often cellphones are used, it is critical to further investigate their potential impact on male fertility and reproductive health. Existing evidence emphasizes the necessity of more studies in this field. [ABSTRACT FROM AUTHOR]

Trigeminal neuralgia (TN) is a debilitating condition characterized by excruciating facial pain resulting from dysfunction in the trigeminal nerve. Treatment options are limited. Noninvasive pulsed radiofrequency (PRF) therapy is an emerging promising approach to managing TN. This therapy provides pain control without tissue damage or unpleasant side effects compared to invasive procedures. Here, we present five cases of trigeminal neuralgia successfully managed with noninvasive PRF therapy. Our case series contributes to the existing literature and supports the potential efficacy of noninvasive PRF therapy for TN. [ABSTRACT FROM AUTHOR]

Background: The status of axillary lymph nodes (ALN) plays a critical role in the management of patients with breast cancer. It is an urgent demand to develop highly accurate, non-invasive methods for predicting ALN status Purpose: To evaluate the efficacy of ultrasound radiofrequency (URF) time-series parameters, in combination with clinical data, in predicting ALN metastasis in patients with breast cancer. Material and Methods: We prospectively gathered clinicopathologic and ultrasonic data from patients diagnosed with breast cancer. Various machine-learning (ML) models were developed using all available features to determine the most efficient diagnostic model. Subsequently, distinct prediction models were created using the optimal ML model, and their diagnostic performances were evaluated and compared. Results: The study encompassed 240 patients, of whom 88 had lymph node metastases. A leave-one-out cross-validation (LOOCV) method was used to split the entire dataset into training and testing subsets. The random forest ML model outperformed the other algorithms, with an area under the curve (AUC) of 0.92. Prediction models based on clinical, ultrasonic, URF parameters, clinical + ultrasonic, clinical + URF, and ultrasonic + URF parameters had AUCs of 0.56, 0.79, 0.78, 0.90, 0.80, and 0.84, respectively, in the testing set. The comprehensive diagnostic model (clinical + ultrasonic + URF parameters) demonstrated strong diagnostic capability, with an AUC of 0.94 in the testing set, exceeding any single prediction model. Conclusion: The combined model (clinical + ultrasonic + URF parameters) could be used preoperatively to predict lymph node status, offering valuable input for the design of individualized surgical approaches. [ABSTRACT FROM AUTHOR]

Keratinocytes play an essential role in the inflammatory phase of wound regeneration. In addition to migrating and proliferating for tissue regeneration, they produce a large amount of cytokines that modulate the inflammatory process. Previous studies have shown that subthermal treatment with radiofrequency (RF) currents used in capacitive resistive electric transfer (CRET) therapy promotes the proliferation of HaCat keratinocytes and modulates their cytokine production. Although physical therapies have been shown to have anti-inflammatory effects in a variety of experimental models and in patients, knowledge of the biological basis of these effects is still limited. The aim of this study was to investigate the effect of CRET on keratinocyte proliferation, cytokine production (IL-8, MCP-1, RANTES, IL-6, IL-11), TNF-α secretion, and the expression of MMP9, MMP1, NF-κB, ERK1/2, and EGFR. Human keratinocytes (HaCat) were treated with an intermittent 448 kHz electric current (CRET signal) in subthermal conditions and for different periods of time. Cell proliferation was analyzed by XTT assay, cytokine and TNF-α production by ELISA, NF-κB expression and activation by immunofluorescence, and MMP9, MMP1, ERK1/2, and EGF receptor expression and activation by immunoblot. Compared to a control, CRET increases keratinocyte proliferation, increases the transient release of MCP-1, TNF-α, and IL-6 while decreasing IL-8. In addition, it modifies the expression of MMPs and activates EGFR, NF-κB, and ERK1/2 proteins. Our results indicate that CRET reasonably modifies cytokine production through the EGF receptor and the ERK1/2/NF-κB pathway, ultimately modulating the inflammatory response of human keratinocytes. [ABSTRACT FROM AUTHOR]

Background: Excess body adiposity and skin irregularities represent a major problem in today's society. Currently, radiofrequency‐based devices constitute an increasingly popular medical‐aesthetic application and a powerful non‐invasive method to combat this problem. Objective: This study aims to determine the efficacy and safety of the high‐frequency device Zionic™ (Termosalud, Inc., Gijón, Spain) in reducing body contouring and improving skin appearance in the abdomen/flanks or thighs. Materials and Methods: Thirty nine individuals were treated with the Zionic™ device in the abdomen/flanks or thighs. A total of 8 sessions of 40–50 min each, 72/96 h apart were performed. At baseline, body measurements were taken including photographs, body contours, and ultrasound scans to assess dermal thickness, dermal echogenicity, and subcutaneous fat thickness. The measurements were repeated after the eight sessions for comparison and analysis. Quantitative data was complemented with a customized survey to evaluate participants satisfaction level. Results: At the follow‐up visit, a significant average reduction of 3% in abdomen/flanks circumferences and 2% in thighs contours was noticed. Abdomen/flanks and thighs subcutaneous fat layer thickness was significantly reduced by 8% and 6%, respectively. Dermal echogenicity changes, related to skin collagen content and organization, showed non‐significant increasing tendencies of 7% for abdomen/flanks and 8% for thighs. Thighs dermal thickness was significantly increased by 6%. Results were associated to a high satisfaction level (80%) and no severe adverse events. Conclusion: Zionic™ treatment is a safe, effective, and well‐tolerated noninvasive procedure for body contouring and improvement of skin properties in abdomen, flanks, and thighs. [ABSTRACT FROM AUTHOR]

Purpose of Review: The purpose of this review is to summarize the clinical data regarding methods of avoiding and protecting the esophagus from injury during ablation of atrial fibrillation (AF). Recent Findings: For >15 years, the primary method to avoid esophageal injury has been monitoring luminal esophageal temperature (LET), even though numerous studies report several limitations to this technique. For the past several years, two devices have been used to deviate the esophagus so to increase the distance of the esophagus from the ablation energy source and thus avoid esophageal injury. However, these devices are not FDA approved. In 2023, however, two devices did achieve FDA approval for reduction of ablation-related esophageal injury. The first device uses vacuum suction and deviation and thus moves an entire segment either to the right or left, as well as incorporating LET monitoring. The second device is inserted into the esophagus, inflated and then uses a closed loop system to pump cool distilled water at 4°C. Summary: For every AF ablation procedure, a primary concern for electrophysiologists is to avoid esophageal injury, yet despite focused attention and advances in technology, the rate of atrioesophageal fistula and major morbidity related to esophageal injury continues. When considering the expanding number of AF ablations (>900,000 worldwide), even a low percentage of complications represents a large number of patients impacted by this complication. With the development of approved esophageal protection devices, it is prudent to implement a standardized method to avoid esophageal injury which provides greater confidence of safe AF ablation. [ABSTRACT FROM AUTHOR]

Purpose: To introduce a simple system exploitation with the potential to turn MRI scanners into general‐purpose radiofrequency (RF) motion monitoring systems. Methods: Inspired by Pilot Tone (PT), this work proposes Beat Pilot Tone (BPT), in which two or more RF tones at arbitrary frequencies are transmitted continuously during the scan. These tones create motion‐modulated standing wave patterns that are sensed by the receiver coil array, incidentally mixed by intermodulation in the receiver chain, and digitized simultaneously with the MRI data. BPT can operate at almost any frequency as long as the intermodulation products lie within the bandwidth of the receivers. BPT's mechanism is explained in electromagnetic simulations and validated experimentally. Results: Phantom and volunteer experiments over a range of transmit frequencies suggest that BPT may offer frequency‐dependent sensitivity to motion. Using a semi‐flexible anterior receiver array, BPT appears to sense cardiac‐induced body vibrations at microwave frequencies (≥$$ \ge $$1.2 GHz). At lower frequencies, it exhibits a similar cardiac signal shape to PT, likely due to blood volume changes. Other volunteer experiments with respiratory, bulk, and head motion show that BPT can achieve greater sensitivity to motion than PT and greater separability between motion types. Basic multiple‐input multiple‐output (4×22$$ 4\times 22 $$ MIMO) operation with simultaneous PT and BPT in head motion is demonstrated using two transmit antennas and a 22‐channel head‐neck coil. Conclusion: BPT may offer a rich source of motion information that is frequency‐dependent, simultaneous, and complementary to PT and the MRI exam. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion Radiofrequency (RF) has been widely used for rejuvenation treatments, but without knowledge of the effective temperature of the target tissues or guidance on treatment parameters, it often leads to adverse reactions and pain. The aim of this study was to demonstrate that thermal stimulation can produce facial rejuvenation effects and to determine the optimal bipolar RF treatment parameters for treating facial fine lines.A bipolar RF device combined with CORE Technology was used in this study. Ex vivo studies were conducted on both miniature swine and human skin, utilizing thermographic thermometry and histological analysis. In vivo swine studies were conducted using histological analysis and electron microscopy. A clinical trial was conducted, and the results were evaluated using the Alexiades Comprehensive Grading Scale (ACGS) and Global Aesthetic Improvement Scale (GAIS) scales.The bipolar RF technology can produce a significant effect by thermally stimulating collagen within just 2 weeks without causing thermal damage. A clinical trial involving 46 patients showed a noticeable rejuvenating effect of the bipolar RF device, especially on fine wrinkles.This study confirmed that thermal stimulation, rather than thermal damage, is sufficient to achieve rejuvenation effects. The study also found a range of bipolar RF treatment parameters that are both safe and effective for facial fine lines. [ABSTRACT FROM AUTHOR]

Chronic low back pain can severely affect quality of life. While several treatments are available, the combination of therapies often results in better outcomes. This study delves into the comparative effectiveness of combining monopolar dielectric diathermy radiofrequency (MDR) with supervised therapeutic exercise against the latter treatment alone. A randomized single-blind controlled trial was conducted. The intervention group (n= 30) received MDR with supervised therapeutic exercises for eight weekly sessions for four weeks. The control group (n= 30) received only the same exercise protocol. The following self-report measures were assessed before the first treatment session, at four, and 12 weeks: disability, pain, kinesiophobia, quality of life, sleep quality, emotional distress, isometric trunk strength, and trunk flexion range. Repeated ANOVA measures revealed significant time*group interactions for the McQuade test (p= 0.003), the physical role (p= 0.011), vitality (p= 0.023), social function (p= 0.006), and mental health subscales (p= 0.042). Between-group analyses showed significant differences for all outcomes at each follow-up: RMDQ (post-treatment, p= 0.040), ODI (post-treatment and 12-week, p= 0.040), VAS (p< 0.001), TSK (p< 0.001), and McQuade Test (p< 0.020). The combination of diathermy radiofrequency with supervised therapeutic exercise significantly surpasses the efficacy of supervised therapeutic exercise alone, showcasing improvements in pain, disability, kinesiophobia, lumbar mobility in flexion, and overall quality of life in patients with chronic low back pain. [ABSTRACT FROM AUTHOR]

Background: We discuss the diagnostic benefit of pulsed radiofrequency (PRF) of the dorsal root ganglion (DRG) in a case series of patients with different pathologies. We expand the diagnostic potential of DRG stimulation beyond paresthesia mapping by using DRG stimulation to help determine the role of the DRG in the patient's pain and narrow down the etiology. In some cases, DRG stimulation was also part of the treatment plan. Methods: Six patients underwent DRG radiofrequency as a diagnostic/therapeutic step before considering implantation of a DRG neurostimulator. First, patients underwent a basic bedside neurological evaluation. Next, an electrode was placed in the epidural space through the sacral hiatus or between vertebral laminae. Then, sensory stimulation was applied at 50 Hz and gradually increased from 0.1 V until the patient reported paresthesia or until a maximum intensity of 2 V was reached. Patients were asked to describe where the stimulation was felt and outline the anatomical area the paresthesia covered. Then a motor stimulation was applied at 2 Hz until muscle twitching was reported by the patient or observed by the physician. Results: The information obtained helped diagnose the type of lesion as principally preganglionic, ganglionic, or postganglionic. This information guided patient management. Conclusion: PRF of the DRG can provide valuable diagnostic information and is a useful step before ganglionic electrode implantation. In all cases, PRF of the DRG provided valuable diagnostic information and guided management options. [ABSTRACT FROM AUTHOR]

In this paper, we report on the use of a purpose-built hybrid solid-state microwave and radiofrequency generator operating at frequencies of 2.45 GHz and/or 480 kHz for cancer ablation in various tissues. The hybrid generator was tested ex vivo on chicken breast and bovine liver and has demonstrated that the high accuracy of the power delivered to the sample can be achieved by controlling the emitted power versus the temperature profile of the treated sample. In particular, the hybrid generator incorporates control systems based on impedance or reflected power measurements that allow controlled ablation without causing unwanted carbonization and without including areas where tissue damage is not desired. The results of the ex vivo tests showed that radiofrequency ablation (RFA) could be effective for performing controlled ablations with minimally invasive probes, such as cardiac pathologies, small lesions, and tissues with particular composition, while microwave ablation (MWA) could be optimal for performing large ablations in highly vascularized tissues, such as liver cancer, where it is necessary to achieve higher temperatures. [ABSTRACT FROM AUTHOR]

Herein, high‐resistivity silicon substrates with specific He+ ion implantations to mitigate the parasitic surface conduction effect are studied. Several postimplantation thermal annealing conditions are investigated. Substrate performance is assessed at radiofrequencies (RFs) using the small‐signal characterization of coplanar waveguides (CPW) structures. The best effective resistivity (ρeff) of 4 kΩ cm is achieved with the wafer annealed at 600 °C for 2 h. This ρeff value is also stable as a function of DC bias applied to the CPWs. Those high RF performances originate from the nature of the defects created by ion implantation. Defects are deeply analyzed using spectroscopy measurement and scanning transmission electron microscopy. Combining these measurements, it is shown that {311} defects are probably responsible for the achieved high RF performances. Finally, the link between charge carriers trapping in the RF domain and defects nature is discussed to develop a defects engineering strategy for low‐loss RF substrates. The proposed fabrication method enables the fabrication of RF passivation layer locally over the wafer, and thus the cointegration of RF devices with fully depleted silicon‐on‐insulator technology. [ABSTRACT FROM AUTHOR]

(1) This study evaluates the impact of the CT-guided SIRIO augmented reality navigation system on the procedural efficacy and clinical outcomes of neuroprotection in vertebral thermal ablation (RTA) for primary and metastatic bone tumors. (2) Methods: A retrospective non-randomized analysis of 28 vertebral RTA procedures was conducted, comparing 12 SIRIO-assisted and 16 non-SIRIO-assisted procedures. The primary outcomes included dose-length product (DLP) and epidural dissection time. The secondary outcomes included technical success, complication rates, and pain scores at procedural time (VAS Time 0) and three months post-procedure (VAS Time 1). The statistical analyses included t-tests, Mann–Whitney U tests, and multiple regression. (3) Results: SIRIO-assisted procedures significantly reduced DLP (307.42 mGycm vs. 460.31 mGycm, p = 2.23 × 10−8) and procedural epidural dissection time (13.48 min vs. 32.26 min, p = 2.61 × 10−12) compared to non-SIRIO-assisted procedures. Multiple regression confirmed these reductions were significant (DLP: β = −162.38, p < 0.001; time: β = −18.25, p < 0.001). Pain scores (VAS Time 1) did not differ significantly between groups, and tumor type did not significantly influence outcomes. (4) Conclusions: The SIRIO system enhances neuroprotection efficacy and safety, reducing radiation dose and procedural time during spine tumoral ablation while maintaining consistent pain management outcomes. [ABSTRACT FROM AUTHOR]

Background: Post‐acne scars are a common sequela of acne, especially prevalent among young people. Delayed treatment not only affects self‐perception of beauty but also affects the mental health of patients. Objective: This study aims to investigate the clinical efficacy of microneedle fractional radiofrequency (MFR) combined with botulinum toxin A (BoNT/A) in managing post‐acne scars. Methods: This retrospective study involved 63 adult patients with post‐acne scars, divided into two groups: group 1 (n = 30) and group 2 (n = 33). Group 1 received treatment with MFR combined with transcutaneous delivery of BoNT/A, whereas group 2 received treatment with MFR alone. The study observed the clinical outcomes in both groups. Results: Based on experimental analysis, the combination of MFR with transcutaneous delivery of BoNT/A demonstrated superior clinical efficacy compared with group 2. There were no significant differences in baseline data or treatment‐related pain and adverse reactions between the two groups. However, group 1 exhibited a higher effectiveness rate, lower ECCA score after treatment, higher satisfaction levels, and statistically significant differences compared to group 2. Conclusion: MFR combined with transcutaneous delivery of BoNT/A represents an effective and safe alternative for treating acne scars with minimal side effects and complications. Summary Statement: Post‐acne scars are a common sequela of acne and combination therapy proves beneficial. Microneedle fractional radiofrequency (MFR) combined with transcutaneous delivery of BoNT/A can be considered an effective and safe alternative for the treatment of acne scars with minimal side effects and complications. It works together through microneedles, radiofrequency, and botulinum toxin. MFR combined with transcutaneous delivery of BoNT/A is based on the direct action of MFR on acne scars and the use of microneedle to create a transient skin microchannel, facilitating BoNT/A penetration into the skin. [ABSTRACT FROM AUTHOR]

Background: Bipolar microneedling radiofrequency (RF) treatment generates different patterns of thermal reactions, depending on the skin impedance and RF treatment parameters, including the frequency, power, conduction time, settings of sub‐pulse packs, and penetrating depth and type of microneedles used. We compared the effect of sequential delivery of 1‐ and 2‐MHz bipolar RF energy to in vivo minipig skin on thermal tissue reaction. Methods: RF treatments at frequencies of 1 and 2 MHz were sequentially delivered to minipigs' skin in vivo. A histological study was performed to analyze RF‐induced skin reactions at 1‐h and at 3‐, 7‐, and 14‐days post‐treatment. Results: The skin specimens demonstrated that the two different frequencies of RF treatment generated mixed patterns of the peri‐electrode coagulative necrosis (PECN) according to the experimental settings and tissue impedance. In the PECN zone, the tissue coagulation induced by the first RF treatment was surrounded by the effect of the later RF treatment at the other RF frequency. In the inter‐electrode non‐necrotic thermal reaction zone, the effect of the latter RF treatment was widespread and deep through the dermis, which had received RF treatment at the other frequency first. The delivery of pulsed‐type RF energy at sub‐pulse packs of 6 or 10 provided effective RF delivery over long conduction time without excessive thermal damage of the epidermis. Nonetheless, by sequential delivery of two different RF frequencies, RF‐induced tissue reactions were found to be markedly enhanced. Conclusion: The sequential delivery of 1‐ and 2‐MHz RF energy induces novel histological patterns of tissue reactions, which can synergistically enhance the thermostimulatory effects of each RF setting. Moreover, variations in patterns of tissue reactions can be generated by regulating the order of frequencies and the number of sub‐pulse packs of RF used. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: The objective was to evaluate the clinically beneficial effect of adding transvaginal monopolar non-ablative radiofrequency (RF) to pelvic floor muscle training (PFMT) on leakage severity, quality of life and urinary incontinence-related symptoms in women with stress urinary incontinence (SUI). Methods: A double-blind randomised controlled trial was conducted, with a 6-week intervention and a 6-month follow-up. Participants were randomly assigned to the experimental group (PFMT plus RF; n = 18) or the control group (PFMT plus placebo; n = 20). The primary outcome was the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). Secondary outcomes included the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7), self-efficacy, female sexual function, pelvic floor muscle dynamometry, 1-h pad test and number of SUI episodes per week. Inferential analyses of the data were performed using a two-factor analysis of variance. Results: Both groups achieved a statistically significant improvement in ICIQ-SF over time. However, the differences observed in the experimental group exceeded the minimal clinically important differences by 4 points (MD = −9.4, 95% CI = −12.6 to −6.3), which was not observed in the control group (MD = −3.9, 95% CI = −6.9 to −1.0). This was maintained at the 6-month follow-up with a significant time*group interaction (p < 0.001, ηp2 = 0.150). There was no time*group interaction in the other variables (p > 0.05). Additionally, a significant difference in favour of the experimental group was observed in the 1-h pad test and episodes of SUI per week (p < 0.05). Conclusions: This study highlights the beneficial effects of adding transvaginal RF to PFMT on the severity and amount of leakage, as well as on the quality of life and urinary incontinence-related symptoms in women with moderate SUI. Future trials are needed to assess the effects of this intervention in women with severe SUI. [ABSTRACT FROM AUTHOR]

Objective: Since the introduction of continuous glucose monitoring (CGM) technology, developers have rigorously researched the feasibility of creating a noninvasive glucose monitoring device. In a recent pilot study, investigators reported a strong correlation between glucose values obtained from novel noninvasive monitoring device (GWave) values to venous and capillary glucose measurements. Research Design and Methods: We investigated whether the level of accuracy observed in the pilot study could be reproduced in a larger cohort, using a smaller third-generation manufacturable device (Gen III GWave) containing a standardized sensor chip that can be mass produced for commercial use. The evaluation assessed concordance with capillary blood glucose, reproducibility between two Gen III devices, and accuracy during insulin-induced hypoglycemia. Results: Assessment of samples from 75 subjects (type 2 diabetes, n = 6; type 1 diabetes, n = 28; nondiabetic pregnant subjects, n = 10; and nondiabetic, n = 31) showed that 97% of values were in Zone A with 3% in Zone B of the Clarke Error Grid, with a mean absolute relative difference of 6.7% from reference blood glucose. Comparison between two independent Gen III GWave devices demonstrated reproducibility between the sensors (R2 = 0.95), with 100% of values within Zone A. In the hypoglycemia assessment, measurements from the Gen III sensor tightly followed the capillary glucose measurements down to 42 mg/dL (2.3 mmol/L), whereas the CGM measurements from two different CGM only converged with the GWave and capillary glucose readings after 90 min of decreasing glucose levels. Conclusion: Our results show promise as potentially the first noninvasive technology. Future studies will focus on larger number of people in all glucose ranges. Real-time noninvasive blood glucose monitoring is possible using GWave technology. [ABSTRACT FROM AUTHOR]

With the exponential growth of catheter ablation for atrial fibrillation (AF), there is increasing interest in associated health care costs. Pulsed field ablation (PFA) using a single-shot pentaspline multielectrode catheter has been shown to be safe and effective for AF ablation, but its cost efficiency compared to conventional thermal ablation modalities (cryoballoon [CB] or radiofrequency [RF]) has not been evaluated. The purpose of this study was to compare cost, efficiency, effectiveness, and safety between PFA, CB, and RF for AF ablation. We studied 707 consecutive patients (PFA: 208 [46.0%]; CB: 325 [29.4%]; RF: 174 [24.6%]) undergoing first-time AF ablation. Individual procedural costs were calculated, including equipment, laboratory use, and hospital stay, and compared between ablation modalities, as were effectiveness and safety. Skin-to-skin times and catheter laboratory times were significantly shorter with PFA (68 and 102 minutes, respectively) than with CB (91 and 122 minutes) and RF (89 and 123 minutes) (P <.001). General anesthesia use differed across modalities (PFA 100%; CB 10.2%; RF 61.5%) (P <.001). Major complications occurred in 1% of cases, with no significant differences between modalities. Shorter procedural times resulted in lower staffing and laboratory costs with PFA, but these savings were offset by substantially higher equipment costs, resulting in higher overall median costs with PFA (£10,010) than with CB (£8106) and RF (£8949) (P <.001). In this contemporary real-world study of the 3 major AF ablation modalities used concurrently, PFA had shorter skin-to-skin and catheter laboratory times than did CB and RF, with similarly low rates of complications. However, PFA procedures were considerably more expensive, largely because of higher equipment cost. [Display omitted] [ABSTRACT FROM AUTHOR]

Purpose: Radiofrequency ablation has been used to treat chronic shoulder pain with mixed results. Thanks to recent anatomical studies, the precise location of articular branches of the suprascapular, lateropectoral and axillary nerves has been determined. Cooled radiofrequency is a neuroablative modality of treatment which has been demonstrated as efficient in different anatomical locations, and targeting the aforementioned nerves could result in a complete and efficient denervation of the shoulder. The aim of this study is to assess the efficacy of a fluoroscopic guided cooled radiofrequency technique for chronic shoulder pain. Patients and Methods: This is a retrospective observational study performed in two hospital in Wales and Italy (Wrexham NHS trust and Iseo Hospital). Forty-four patients were treated between December 2019 and January 2023. Follow-up was provided at 1-, 6- and 12-months post-procedure. Pain intensity was measured with a 0– 10-point Numerical Rating Scale (NRS), and was assessed at rest and during movement. Disability was assessed with the Oxford Shoulder Score (OSS). All patients were treated with cooled radiofrequency under fluoroscopic guidance targeting the articular branches of the suprascapular, axillary and lateropectoral nerves. Results: In the 44 patients treated, the mean NRS significantly decreased at all follow ups, pain relief of > 50% was obtained in 70.4%, 61% and 51% of the patients at 1.6 and 12 month follow-ups, respectively. Disability improved significantly, with a mean OSS at 12 months follow up of 30 ± 17.5, compared to 15 ± 3 at baseline. Medication intake (non-steroidal anti-inflammatory drugs (NSAIDS) and/or opioids) significantly decreased at all follow ups. Conclusion: Cooled radiofrequency denervation can be an effective procedure to manage chronic shoulder pain, providing sustained pain relief and functional improvement in more than 50% of the patients. [ABSTRACT FROM AUTHOR]

Background: Center volume and operator experience/training are important factors impacting outcomes in AFib CA. Setting for RF delivery (power, duration, and contact force) associated with better outcomes remains to be determined. Methods: This is an observational, longitudinal, and retrospective study. All consecutive procedures performed between December 12, 2013, and March 9, 2023, in a low-volume private center in Latin America were analyzed. Procedure characteristics and outcomes were compared between STD and vHPSD. Results: Two hundred ten procedures were performed on 194 patients. Median annual number of procedures was 19 (7–29). Median age was 62 (52–68), and majority were male (71%). Median procedure duration was 155 (125–195) min, mean fluoroscopy time 32.8 ± 15 min and mean fluoroscopy dose 373.5 ± 208.9 mGray. Median follow-up was 27 months, significantly longer in STD compared with vHPSD group (43 [31–68] vs. 13 [8–19], respectively; P ≤ 0.001). The recurrence rate was 33.2% and major complications 8.6%. Compared with STD, vHPSD resulted in a significantly shorter procedure duration (125 vs. 180 min, P ≤ 0.001), shorter fluoroscopy time (22.7 ± 9.5 vs. 39.2 ± 14.3 min, P ≤ 0.001), and lower fluoroscopy dose (283.8 ± 161.1 vs. 438.3 ± 216.1 mGray, P ≤ 0.001). No long-term recurrence difference was observed when the follow-up periods were comparable. No difference in complication rate was observed (8.5% vs. 8.6%, P = 0.988). Conclusions: Outcomes in AFib CA in a Latin American low-volume private center can be considered acceptable, with efficacy and safety similar to those reported in the literature. Compared with STD ablation, vHPSD showed higher efficiency with similar efficacy and safety. [ABSTRACT FROM AUTHOR]

Purpose: Radiofrequency (RF) ablation with half-normal saline (HNS) irrigation is reported to potentially enlarge local lesion compared to normal saline (NS) in power-controlled ablation (PC-Abl). However, the effect of HNS-irrigation in temperature-flow-controlled ablation (TFC-Abl) on lesion characteristics is unknown. We compared this between TFC-Abl with QDOT-Micro™ catheter and PC-Abl with Thermocool SmartTouch SF™ catheter (STSF). Methods: RF-application with NS (n = 480) and HNS (n = 480) irrigation were performed on swine myocardium placed in a circulating saline bath. Lesion characteristics without steam-pops under various conditions (target AI, 400/550; ablation power, 30/50 W; contact force, 10/20/30 g; catheter orientation, perpendicular/parallel) were assessed and compared between two irrigants. Results: After matching, 343 lesions without steam-pops in each group were evaluated. In PC-Abl, lesion size did not differ between two groups (NS, 188 ± 97 vs. HNS, 200 ± 95 mm3, p = 0.28 in volume; 33.9 ± 7.3 vs. 34.8 ± 9.5 mm2, p = 0.34 in surface area; and 4.0 ± 1.0 vs. 4.0 ± 1.0 mm, p = 0.81 in depth), but steam-pops were more frequently observed with HNS-irrigation (23.8% vs. 37.9%, p = 0.001). Contrary, in TFC-Abl, HNS-irrigation produced significantly larger (214 ± 106 vs. 243 ± 128 mm3, p = 0.017) and deeper (4.0 ± 1.0 vs. 4.3 ± 1.1 mm, p = 0.002) lesions without increasing the risk of steam-pops (15.0% vs 15.0%, p = 0.99). Automatic temperature-guided titration was more frequently observed in HNS-irrigation (54.8% vs. 78.5%, p < 0.001). Conclusions: TFC-Abl with QDOT-Micro™ catheter utilizing HNS-irrigation might increase volume and depth of local lesion without increasing the risk of stem-pops compared to NS-irrigation. Power-controlled ablation with HNS-irrigation showed similar focal lesion with higher incidence of steam-pops (SPs) compared to normal saline (NS) irrigation. Contrary, temperature-flow-controlled ablation with HNS-irrigation provided larger and deeper lesion than NS-irrigation with similar incidence of SPs. ns, p > 0.05; *, 0.01 < p ≤ 0.05; **, 0.005 < p ≤ 0.01. HNS, half-normal saline; NS, normal saline. [ABSTRACT FROM AUTHOR]

Trigeminal neuralgia (TN) is a debilitating condition characterized by excruciating facial pain resulting from dysfunction in the trigeminal nerve. Treatment options are limited. Noninvasive pulsed radiofrequency (PRF) therapy is an emerging promising approach to managing TN. This therapy provides pain control without tissue damage or unpleasant side effects compared to invasive procedures. Here, we present five cases of trigeminal neuralgia successfully managed with noninvasive PRF therapy. Our case series contributes to the existing literature and supports the potential efficacy of noninvasive PRF therapy for TN.

Xiaoxing Tang,1,&ast; Hongjie Yuan,2,&ast; Xuehua Huang,2 Shilin Xiao,2 Yun Ji,2 Yanjing Zhou,1 Hongbo Fu,3 Jingfeng Lu,4 Mingkai Wang,5 Ke Ma2 1Department of Radiology, Nantong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu Province, People’s Republic of China; 2Department of Algology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; 3Department of Algology, Nantong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu Province, People’s Republic of China; 4Department of Neurosurgery, Haian People’s Hospital, Nantong, Jiangsu Province, People’s Republic of China; 5Pharmacy Department, Nantong Elderly Rehabilitation Hospital, Nantong, Jiangsu Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ke Ma, Department of Algology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, People’s Republic of China, Email marke72@163.comBackground: Dorsal ramus medial branch radiofrequency ablation is reported to be effective for refractory lumbar facet joint syndrome. However, as nerve fibers can regenerate, the therapeutic effect was reported to be short and last only 6 to 12 months. Previously, we reported a novel endoscopic joint capsule and articular process excision procedure. In that case, a satisfying effect was achieved by removing the culprit hyperplastic articular synovial entrapped in the joint space endoscopically. We presume this treatment is an etiologic treatment and can exert longer-term efficacy.Aim: This retrospective clinical trial aimed to elucidate the longer-term efficacy as well as the safety profile of the procedure.Methods: This was a retrospective descriptive study. The participants underwent endoscopic joint capsule and articular process excision procedures. The Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) before the operation, and at 3 months, 6 months, 1 year, and 2 years post-operation were recorded by reviewing medical charts and conducting telephone interviews.Results: A total of 234 participants were evaluated in the trial. After participant screening, 13 participants were included in the final analysis. The VAS score was reduced from (median (P25, P75)) 6 (4.5, 6) at pre-operation to 2 (0, 4) at 1-year post-operation and 0 (0, 1) at 2-year pre-operation. The ODI score was reduced from 37.78 (27.09, 59.95) at pre-operation to 8.89 (2.22, 24.34) at 1-year post-operation and 6 (0.02, 11.11) at 2-year post-operation. The difference was statistically significant. Further subgroup analysis demonstrated that a narrowed intervertebral space was a possible relevant factor for poor outcomes. No procedure-related complications were reported.Conclusion: Endoscopic joint capsule and articular process excision is an effective and safe procedure for refractory lumbar facet joint syndrome. The effectiveness duration can last up to 1 to 2 years.Keywords: endoscopic, lumbar facet joint syndrome, synovial entrapment, joint capsule, radiofrequency, VAS, ODI

Abstract Background We discuss the diagnostic benefit of pulsed radiofrequency (PRF) of the dorsal root ganglion (DRG) in a case series of patients with different pathologies. We expand the diagnostic potential of DRG stimulation beyond paresthesia mapping by using DRG stimulation to help determine the role of the DRG in the patient’s pain and narrow down the etiology. In some cases, DRG stimulation was also part of the treatment plan. Methods Six patients underwent DRG radiofrequency as a diagnostic/therapeutic step before considering implantation of a DRG neurostimulator. First, patients underwent a basic bedside neurological evaluation. Next, an electrode was placed in the epidural space through the sacral hiatus or between vertebral laminae. Then, sensory stimulation was applied at 50 Hz and gradually increased from 0.1 V until the patient reported paresthesia or until a maximum intensity of 2 V was reached. Patients were asked to describe where the stimulation was felt and outline the anatomical area the paresthesia covered. Then a motor stimulation was applied at 2 Hz until muscle twitching was reported by the patient or observed by the physician. Results The information obtained helped diagnose the type of lesion as principally preganglionic, ganglionic, or postganglionic. This information guided patient management. Conclusion PRF of the DRG can provide valuable diagnostic information and is a useful step before ganglionic electrode implantation. In all cases, PRF of the DRG provided valuable diagnostic information and guided management options.

In this paper, we report on the use of a purpose-built hybrid solid-state microwave and radiofrequency generator operating at frequencies of 2.45 GHz and/or 480 kHz for cancer ablation in various tissues. The hybrid generator was tested ex vivo on chicken breast and bovine liver and has demonstrated that the high accuracy of the power delivered to the sample can be achieved by controlling the emitted power versus the temperature profile of the treated sample. In particular, the hybrid generator incorporates control systems based on impedance or reflected power measurements that allow controlled ablation without causing unwanted carbonization and without including areas where tissue damage is not desired. The results of the ex vivo tests showed that radiofrequency ablation (RFA) could be effective for performing controlled ablations with minimally invasive probes, such as cardiac pathologies, small lesions, and tissues with particular composition, while microwave ablation (MWA) could be optimal for performing large ablations in highly vascularized tissues, such as liver cancer, where it is necessary to achieve higher temperatures.

Objective: The aim of this study was to investigate the effect of osteoporosis (OP) on the outcomes of facet medial branch radiofrequency thermocoagulation (RFT). Materials and Methods: Thirty-six patients with chronic lower back pain due to lumbar facet joint syndrome (LFJS) who underwent facet medial branch RFT were retrospectively reviewed. The patients were divided into two groups: Group I (without OP, n=19) and group II (with OP, n=16). Pre-intervention and post-intervention evaluations of the patients were assessed at 1, 6, and 12th months by visual analog scale (VAS). Results: In both groups, VAS scores 1st, 6th, and 12th months after intervention were lower than those at baseline (p=0.001). There were no significant difference between the groups in terms of VAS score improvement. Conclusion: Lumbar facet medial branch RFT is an effective and safe treatment method in both the short and long-term in patients with LFJS. OP therapy had no effect on RFT treatment results.

Introduction: Knowing an individualized outcome prediction is essential when counseling patients before surgery. We aim to identify predictors and build a model for the outcome of radiofrequency uvulopalatopharyngoplasty with tonsillectomy (rfUPPP + TE). Methods: All adult patients undergoing rfUPPP + TE for sleep-disordered breathing from 2015 to 2022 in our institution were included. Preoperative evaluations included detailed upper airway examinations and standardized questionnaires. Postoperative outcomes were measured through home sleep apnea testing and repeated questionnaires 3 months post-surgery. The primary endpoint was the postoperative apnea-hypopnea index (AHI) and the AHI responders using the Sher criteria. Results: We analyzed 247 patients with a mean age of 46 ± 11 years, predominantly male (88.7%), and a mean BMI of 29.0 kg/m2. The mean AHI was reduced from 26.4 ± 18.6/h preoperatively to 16.2 ± 14.6/h postoperatively. Daytime sleepiness improved from 8.9 ± 48 to 4.0 ± 3.1 and snoring from 7.9 ± 2.1 to 3.3 ± 2.2. Multivariate analysis indicated that higher tonsil grades, preoperative AHI, and snoring levels were associated with a greater reduction in AHI. Age and body weight were negative predictors for AHI reduction. For AHI responders, according to Sher, tonsil grade was the only predictor in a multivariate analysis. The ROC curve of this simple model, with a corrected AUC of 0.625, compared favorably against two established models. Conclusion: Our study highlights that tonsil grade, preoperative AHI, snoring, and, to a smaller extent, age and weight are key determinants of AHI reduction, emphasizing the importance of preoperative evaluation. Despite the multifactorial nature of obstructive sleep apnea, preoperative evaluation can predict the outcome of rfUPPP + TE and guide surgical planning.

Abstract Background We explore an optimized approach for increasing lesion size using a novel ablation catheter with a surface thermocouple and efficient irrigation in a temperature‐control setting. Methods We conducted radiofrequency applications at various power levels (35 W, 40 W, and 45 W), contact forces (CFs, 10 g/20 g), and durations (60 s/120 s/180 s) in perpendicular/parallel catheter orientations, with normal saline irrigation (NS‐irrigation) and Half NS‐irrigation (HNS‐irrigation) in an ex‐vivo model (Step 1). In addition, we performed applications (35 W/40 W/45 W for 60 s/120 s/180 s in NS‐irrigation and 35 W/40 W for 60 s/120 s/180 s in HNS‐irrigation) in four swine (Step 2), evaluating lesion characteristics and the occurrence of steam pops. Results In Step 1, out of 288 lesions, we observed 47 (16.3%) steam pops, with 13 in NS‐irrigation and 34 in HNS‐irrigation (p = .001). Although steam pops were mostly observed with the most aggressive setting (45 W/180 s, 54%) with NS‐irrigation, they happened in less aggressive settings with HNS irrigation. Lesion size significantly increased with longer‐duration ablation but not with HNS‐irrigation. The optimal %impedance‐drop cutoff to predict steam pops was 20% with a negative‐predictive‐value (NPV) = 95.1% including NS‐ and HNS‐irrigation groups, and 22% with an NPV = 96.1% in NS‐irrigation group. In Step 2, similar to the ex‐vivo model, lesion size significantly increased with longer‐duration ablation but not with HNS‐irrigation. Steam pops were absent with NS‐irrigation (0/35) even with the largest %impedance‐drop reaching 31% at 45 W/180 s. All steam pops were observed with HNS‐irrigation (6/21, 29%). The optimal %impedance‐drop cutoff predicting steam pops was 24% with an NPV = 96.3% including both NS‐ and HNS‐irrigation groups. Conclusions Rather than using HNS‐irrigation, very long‐duration of radiofrequency applications up to 45 W/180 s may be recommended to safely and effectively increase lesion dimensions using this catheter with NS‐irrigation.

Abstract Monopolar capacitive diathermy is a physiotherapy technique that uses high-frequency currents to generate heat in deep tissues. This heat can have several therapeutic effects, especially in the treatment of chronic low back pain (CLBP), however, until now there is little evidence of this type of diathermy. The purpose was to evaluate the efficacy of a pulsed monopolar dielectric radiofrequency diathermy (PRF)-capacitive type versus simulated treatment on symptomatology of patients with CLBP. A single-blind randomised controlled trial was conducted. Sixty patients with CLBP were randomly assigned to a PRF-capacitive or a simulated treatment group. All participants received 3 sessions per week for 3 weeks. Disability, pain intensity, movement phobia, lumbar anteflexion, quality of life, and sleep quality were assessed at baseline, after treatment, and at two months. The application of 9 sessions of PRF-capacitive showed significant improvements compared to simulated therapy during the entire follow-up for disability (F = 26.99, p

The EU directive on exposure to electromagnetic fields was published in 2004, but due to some problems it was not introduced in the EU countries before 2016. However, still today, many companies are not aware of the legislation and have not taken measures to comply. This could perhaps be due to some of the practical problems they are facing in trying to comply. Here, we address some of these problems, such as showing compliance with the action levels for non-sinusoidal extremely low-frequency magnetic fields, time-averaging for the initial start-up current of handheld machines and time-averaging of radiofrequency fields when measuring plastic welding machines, including the uncertainty in the measurements. Finally, we discuss some of the problem concerning workers with special needs. [ABSTRACT FROM AUTHOR]

Approximately 36%-55% of patients with chronic low back pain (LBP) have neuropathic pain syndrome. Prescription of adjuvant analgesics or antidepressants is effective in reducing pain but requires special attention. A female patient, 57 y, presented with complaints of LBP for 5-7 days. Pain was spread bilateral in the hips-groin, as well as to the fingers and soles (NRS 6-8, PainDETECT 35). She had history of falls 10 y ago, but still worked for 5 hours daily. She had allodynia, dysesthesia, hyperalgesia, and L4-5 and L5-S1 hypesthesia. Magnetic resonance imaging (MRI) showed postero-central and lateral bulged L4-5 and L5-S1 discs. Radiofrequency ablation (RFA) 70o of superior hypogastric ganglion for 90 sec, and pulsed radiofrequency (PRF) 42o of dorsal root ganglion (DRG) L4-5, L5-S1 bilaterally for 2 min reduced nociceptive pain (NRS 2-3) and neuropathic pain (PainDETECT 12). Post-surgical medication included levofloxacin, gabapentin, paracetamol, amitriptyline and Vitamin B12. The sympathetic ganglia supply the anterior segments of the lumbar vertebrae and the anterior longitudinal ligament, often overlooked as a cause of pain. The management of LBP patient depends upon the etiology, whether associated to structural abnormalities or nerve dysfunction. [ABSTRACT FROM AUTHOR]

Purpose/Objective: Mixed urinary incontinence (MUI) is the coexistence of stress urinary incontinence (SUI) and urge urinary incontinence (UUI). MUI can be a challenging condition to treat, and there continues to be a demand for successful nonsurgical interventions if possible. This study evaluates the efficacy of combining bipolar radiofrequency (RF) energy to the vaginal canal, electrical muscle stimulation (EMS) of the pelvic floor, and patient education in the treatment of MUI in females. Methods: A prospective study that evaluates RF and EMS in female patients with moderate MUI. RF and EMS treatments were administered three times, 2 weeks apart. Patients were also educated on exactly what MUI is and how to appropriately utilize their pelvic floor muscles. Outcome measures assessed included both objective (cough stress test to measure pad weight) and subjective (Incontinence Quality of Life [iQOL]; Medical, Epidemiological, and Social Aspects of Aging [MESA] Urge Incontinence [UI], MESA Stress Incontinence [SI], Female Sexual Function Index [FsFI]; and Urogenital Distress Inventory-6 [UDI-6]). Results: In total, 31 women underwent the combination of RF, EMS, and patient education, resulting in significant improvement in MUI symptoms (PGI: 82% indicated feeling improvement) after 3 months of treatment in all measures. Conclusion: RF and EMS in conjunction with patient education via a three-treatment protocol was found to be efficacious and safe for treating women with MUI. Future studies should be done to further elucidate optimal treatment protocols for MUI and patients followed up for longer periods of time to determine the durability of this regimen. [ABSTRACT FROM AUTHOR]

Introduction: The underlying risks of asymptomatic embolization during high‐power short‐duration (HPSD) ablation for atrial fibrillation remain unclear. We aimed to evaluate microembolic signals (MESs) during HPSD ablation with power settings of 50 and 90 W in comparison with those during cryoballoon (CB) ablation using a novel carotid ultrasound‐Doppler system that classifies solid and air bubble signals using real‐time monitoring. Methods and Results: Forty‐seven patients underwent HPSD ablation using radiofrequency (RF), and 13 underwent CB ablation. MESs were evaluated using a novel pastable soft ultrasound probe equipped with a carotid ultrasound during pulmonary vein isolation. We compared the detailed MESs and their timing between RF and CB ablations. The number of MESs and solid signals were significantly higher in the RF group than in CB group (209 ± 229 vs. 79 ± 32, p =.047, and 83 ± 89 vs. 28 ± 17, p =.032, respectively). In RF ablation, the number of MESs, solid, and bubble signals per ablation point, or per second, was significantly higher at 90 W than at 50 W ablation. The MESs, solid, and bubble signals were detected more frequently in the bottom and anterior walls of the left pulmonary vein (LPV) ablation. In contrast, many MESs were observed before the first CB application and decreased chronologically as the procedure progressed. Signals were more prevalent during the CB interval rather than during the freezing time. Among the 28 patients, 4 exhibited a high‐intensity area on postbrain magnetic resonance imaging (MRI). The MRI‐positive group showed a trend of larger signal sizes than did the MRI‐negative group. Conclusion: The number of MESs was higher in the HPSD RF group than in the CB group, with this risk being more pronounced in the 90 W ablation group. The primary detection site was the anterior wall of the LPV in RF and the first interval in CB ablation. [ABSTRACT FROM AUTHOR]

Introduction: Esophageal safety following radiofrequency (RF) left atrial (LA) linear ablation has not been established. To determine the esophageal safety profile of LA linear RF lesions, we performed systematic esophagogastroduodenoscopy in all patients with intraesophageal temperature rise (ITR) ≥ 38.5°C. Methods and Results: Between December 2021 and July 2023, a total of 200 consecutive patients with atrial tachyarrhythmia (ATA) underwent linear ablation with posterior dome (roof or floor) or posterior mitral isthmus line transection. Patients with ITR ≥ 38.5°C were scheduled for esophageal endoscopy ~3 weeks after ablation. Patient and ATA characteristics, procedural parameters, endoscopy findings and ablation lesion data were collected and analyzed. One hundred thirty‐three out of 200 (67%) patients showed ITR ≥ 38.5°C during LA linear ablation. ITR (with maximal temperature of 45.7°C) was more frequently observed during floor line ablation (82% of cases). ITR was less observed during roof line ablation (34%) and posterior mitral isthmus ablation (4%). Endoscopy, performed in 115 patients after 24 ± 10 days, showed esophageal ulceration in four patients (two patients Kansas City classification [KCC] 2a and two patients KCC 2b). No patient showed esophageal perforation or fistula. Conclusion: Temperature rise during LA linear ablation is frequent and ulceration risk exists, particularly when floor line is performed. Safety measures are needed to avoid potential severe complications like esophageal perforation and fistula. [ABSTRACT FROM AUTHOR]

Background: Vaginal laxity (VL) is a complaint of excessive vaginal looseness with a prevalence ranging from 24% to 38% across studies. Aim: The study sought to compare the effect of radiofrequency (RF) and pelvic floor muscle training (PFMT) on the treatment of women with VL. Methods: From February 2020 to December 2021, a prospective, parallel, noninferiority, randomized clinical trial was carried out in women ≥18 years of age and complaining of VL in a tertiary hospital. Two groups (RF and PFMT) were evaluated at the beginning of the study and 30 days and 6 months postintervention. A total of 42 participants per arm was sufficient to demonstrate a difference in sexual function on the Female Sexual Function Index at 90% power, 1-sided type 1 error of 0.025 with a noninferiority margin of 4 on the FSFI total score. Analysis was intention-to-treat and per-protocol based. Outcomes: The primary endpoint was the change of FSFI score after treatment, and the secondary outcomes were improvement in symptoms of VL and changes in questionnaire scores of sexual distress, vaginal symptoms, and urinary incontinence, in the quantification of pelvic organ prolapse, and pelvic floor muscle (PFM) contraction. Results: Of 167 participants recruited, 87 were included (RF: n = 42; PFMT: n = 45). All questionnaires improved (P < .05) their total scores and subscales in both groups and during the follow-ups. After 30 days of treatment, RF was noninferior to PFMT to improving FSFI total score (mean difference −0.08 [95% confidence interval, −2.58 to 2.42]) in the per-protocol analysis (mean difference −0.46 [95% confidence interval, −2.92 to 1.99]) and in the intention-to-treat analysis; however, this result was not maintained after 6 months of treatment. PFM contraction improved significantly in both groups (RF: P = .006, 30 days; P = .049, 6 months; PFMT: P < .001, 30 days and 6 months), with better results in the PFMT group. Clinical Implications: Sexual, vaginal, and urinary symptoms were improved after 30 days and 6 months of treatment with RF and PFMT; however, better results were observed in the PFMT group after 6 months. Strengths & Limitations: The present randomized clinical trial used several validated questionnaires evaluating quality of life, sexual function and urinary symptoms, in addition to assessing PFM contraction and classifying the quantification of pelvic organ prolapse aiming at anatomical changes in two follow-up periods. The limitations were the lack of a sham-controlled group (third arm) and the difficulty of blinding researchers to assess treatments due to the COVID-19 pandemic. Conclusion: After 30 days and 6 months of treatment, sexual, vaginal, and urinary symptoms improved with RF and PFMT; however, better results were observed in the PFMT group after 6 months. RF was noninferior to PFMT in improving FSFI total score after 30 days; however, this result was not maintained after 6 months of treatment. [ABSTRACT FROM AUTHOR]

Introduction: Lymphangioma is a malformation of superficial lymphatic vessels. Tongue lymphangiomas are relatively uncommon. Multiple treatment modalities have been reported, with variable treatment responses. Most of the traditional treatment modalities have a high recurrence rate. Case Report: We describe the use of coblation in the management of lymphangioma circumscriptum of the dorsum of tongue in two patients. Radiofrequency ablation of oral lymphangiomas showed early postoperative oral intake and minimal postoperative pain. There was no recurrence of disease on 1 year follow up. Conclusion: Improved wound healing, early postoperative oral intake and minimal postoperative pain, make radiofrequency ablation a highly valuable treatment modality for oral lymphangiomas and may be recommended as the treatment of choice. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the effect of osteoporosis (OP) on the outcomes of facet medial branch radiofrequency thermocoagulation (RFT). Materials and Methods: Thirty-six patients with chronic lower back pain due to lumbar facet joint syndrome (LFJS) who underwent facet medial branch RFT were retrospectively reviewed. The patients were divided into two groups: Group I (without OP, n=19) and group II (with OP, n=16). Pre-intervention and post-intervention evaluations of the patients were assessed at 1, 6, and 12th months by visual analog scale (VAS). Results: In both groups, VAS scores 1st, 6th, and 12th months after intervention were lower than those at baseline (p=0.001). There were no significant difference between the groups in terms of VAS score improvement. Conclusion: Lumbar facet medial branch RFT is an effective and safe treatment method in both the short and long-term in patients with LFJS. OP therapy had no effect on RFT treatment results. [ABSTRACT FROM AUTHOR]

Various image-guided ablative procedures include chemical and thermal ablation techniques and irreversible electroporation. These have been used for curative intent for small tumours and palliative intent for debulking, immunogenicity and pain control. Understanding these techniques is critical to avoiding complications and achieving superior clinical outcomes. Additionally, combination with immunotherapy and chemotherapies is rapidly evolving. There are numerous opportunities in interventional radiology to advance ablation techniques and seamlessly integrate into current treatment regimens for both benign and malignant tumours. [ABSTRACT FROM AUTHOR]

Background: Current management options for PTMC include lobo-isthmectomy and active surveillance (AS). Recently, ultrasound-guided minimally invasive procedures (MITs) are offered as a nonsurgical therapy for PTMC because they do not require hospitalization and general anaesthesia, and do not result in loss of thyroid function or cosmetic damage. MITs are reported to consistently provide, mostly in large retrospective series of patients, a rapid, safe, and cost-effective way to eradicate low-risk thyroid malignancies. However, conclusive data from well-conducted prospective studies on the histologically-proven completeness of tumor ablation and the long-term clinical advantages versus AS are still lacking. Objectives: This study aimed to evaluate the efficacy and safety of ultrasound-guided minimally invasive treatments (MITs) for PTMC in comparison to traditional surgical methods and active surveillance, and to assess their role in current clinical practice. Methods: A structured literature review was conducted using keywords related to PTMC, MIT, and comparative techniques. Studies were evaluated based on treatment modality, patient selection, follow-up duration, complication rates, and clinical outcomes. Results: MITs have shown promising results in the management of PTMC. These treatments offer several advantages over surgery, such as reduced use of surgical resources, lower costs, minimal work disruption, and fewer major complications. However, there are still limitations, including the need for long-term surveillance and the potential risk of incomplete tumor ablation. Conclusions: MITs represent a promising non-surgical option for managing low-risk PTMC, especially for patients ineligible for or refusing surgery. Despite favorable outcomes, more robust prospective data are needed to confirm their long-term benefits and completeness of tumor ablation. Interdisciplinary discussions and thorough patient education on the advantages and limitations of MITs are crucial for informed decision-making. [ABSTRACT FROM AUTHOR]

Aims Right phrenic nerve (RPN) injury is a disabling but uncommon complication of atrial fibrillation (AF) radiofrequency ablation. Pace-mapping is widely used to infer RPN's course, for limiting the risk of palsy by avoiding ablation at capture sites. However, information is lacking regarding the distance between the endocardial sites of capture and the actual anatomic RPN location. We aimed at determining the distance between endocardial sites of capture and anatomic CT location of the RPN, depending on the capture threshold. Methods and results In consecutive patients undergoing AF radiofrequency ablation, we defined the course of the RPN on the electroanatomical map with high-output pacing at up to 50 mA/2 ms, and assessed RPN capture threshold (RPN-t). The true anatomic course of the RPN was delineated and segmented using CT scan, then merged with the electroanatomical map. The distance between pacing sites and the RPN was assessed. In 45 patients, 1033 pacing sites were analysed. Distances from pacing sites to RPN ranged from 7.5 ± 3.0 mm (min 1) when RPN-t was ≤10 mA to 19.2 ± 6.5 mm (min 9.4) in cases of non-capture at 50 mA. A distance to the phrenic nerve > 10 mm was predicted by RPN-t with a ROC curve area of 0.846 [0.821–0.870] (P < 0.001), with Se = 80.8% and Sp = 77.5% if RPN-t > 20 mA, Se = 68.0% and Sp = 91.6% if RPN-t > 30 mA, and Se = 42.4% and Sp = 97.6% if non-capture at 50 mA. Conclusion These data emphasize the utility of high-output pace-mapping of the RPN. Non-capture at 50 mA/2 ms demonstrated very high specificity for predicting a distance to the RPN > 10 mm, ensuring safe radiofrequency delivery. [ABSTRACT FROM AUTHOR]

The study investigates 4G radiofrequency-modulated electromagnetic fields (RF-EMF) impact on prenatal/postnatal neurogenesis in Wistar rats' dentate gyrus, crucial for memory and learning, amid concerns over gadget-related RF exposure. Thirty-five pregnant female Wistar rats were randomly assigned into seven groups (n=5/group): A-G. Group A was the control, while the rest were exposed to varying durations of electromagnetic fields. At birth, four pups/group were euthanized; the rest were exposed until postnatal day 35. Neurobehavioral tests (Y-maze, Open field), histological (Haematoxylin & Eosin), Immunohistochemical (Ionized calcium-binding adaptor molecule 1, caspase-3 assays), neurotransmitters (glutamate, serotonin, dopamine, Gamma Amino Butyric Acid), and Enzymes (Cytochrome-c-oxidase assay) were evaluated in dentate gyrus pre and postnatally. Radiofrequency radiation had mixed effects on dentate gyrus functions, impacting behavior both positively and negatively. Neurotransmitter and enzyme assays indicated mild negative effects, while histological and immunohistochemical analyses revealed aberrations in both pre and postnatal exposure groups. Altogether, 4G RF induced mild alterations in the overall structure of the dentate gyrus which could interfere with neurogenesis and neural plasticity. [ABSTRACT FROM AUTHOR]

Background: The Background: We evaluate the effects of radiofrequency electromagnetic field (RF-EMF) on rat brain and testicular tissue using histopathology, comet assay, and real-time quantitative PCR techniques. Materials and Methods: Two equal groups of fourteen rats one for sham-control and the other for exposure (n = seven) were created. For a duration of 14 days, the exposure group (2100 MHz, testicular tissue SAR values of 163 mW/kg for 10 g, brain tissue SAR values of 292 mW/kg on average) was subjected to five hours of exposure per day. Evaluations were conducted on tissue gene expression levels, histopathology, and DNA damage to brain tissue. Results: The histological examination of brain tissue from the exposed group revealed vascular alterations and significant edema (p < 0.05). It was determined that RF radiation-induced much more cellular damage in the exposed group (18.26% tail DNA) than in the control group (4.06% tail DNA). Signs of deterioration in spermatogenic cells in the testicular tissue of the exposed group also changed significantly (p < 0.05). The Bax and bcl-2 genes showed a significant difference (p < 0.05) in the mRNA level data, whereas the p53 genes showed no significant change (p > 0.05). Conclusion: These findings suggest that it may cause some histopathological and cellular damage in brain and testis tissue. [ABSTRACT FROM AUTHOR]

Background/aim: Primarily due to wireless communication devices, especially mobile phones, there has been a steady rise in the intensity of nonionizing radiofrequency radiation (RFR). In recent years, increased human health problems raised concerns about whether there is a positive relationship between intense exposure to RFR and public health. The present study aims to investigate the effects of GSM-like RFR exposure on the male reproductive system and the impact of melatonin treatment (synergistic, antagonist, or additive). Materials and methods: Thirty-six male Wistar Albino rats were used and separated into six groups: i. Control; ii. Sham; iii. RFR exposure; iv. Control-melatonin; v. Sham-melatonin; vi. Melatonin + RFR exposure. Animals were exposed to 2600 MHz RFR with electric (E) field levels of 21.74 V/m for 30 min per day, 5 days per week, for 4 weeks. All testicular tissue samples were evaluated under a light microscope for hematoxylin-eosin staining. Biochemical analyses were performed by measuring malondialdehyde, total nitric oxide, glutathione, and glutathione peroxidase levels. We evaluated the combined effects of prolonged RFR exposure and melatonin treatment on ROS-mediated structural changes in testicular tissues. Results: Results showed that reactive intermediates (malondialdehyde and total nitric oxide) increased significantly with RFR exposure, while the protective effect of melatonin effectively reduced the radical levels of the tissues. Histological evaluation revealed a decrease in cell population and connective tissue elements under RFR exposure, accompanied by marked edema in the testicular tissues. Conclusion: The structural and functional effects of prolonged RFR exposure might be ROS-based. Moreover, these adverse effects might be compensated with externally treated supplements. There is a need for new extensive research. [ABSTRACT FROM AUTHOR]