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Lead migration is the most reported complication of SCS implantation and the most common reason for surgical revision due to hardware failure. SCS leads can migrate either horizontally (laterally) or vertically (craniocaudally) the most frequent direction of migration is caudally. It occurs when there is increased mechanical stress that overcomes the anchoring forces, allowing movement of the lead within the epidural space. Lead migration (also known as electrode migration or electrode displacement) is the unintentional displacement of SCS leads from the original location of surgical implantation with loss of SCS efficacy. Discussion Definition and Migration Rates At his most recent follow-up 3 months after revision surgery, he reported 80% pain relief and was satisfied with the outcome. His postoperative course was uncomplicated. His surgical incision was extended to find healthy, normal tissue to secure the anchors. After a thorough discussion and after informed consent was obtained, he was brought back to the operating room 4 days later and the leads were re-placed into an appropriate position. Initial management included attempted stimulation reprogramming, but the patient did not obtain significant pain relief. Imaging confirmed caudal migration of the lead tips to C7. Given the abrupt increase in his pain and the lack of outward signs of new pathology or device complications, the decision was made to obtain cervical spine x-rays to assess the lead locations. The remainder of his exam was unremarkable. He had full strength and intact sensation throughout the bilateral upper extremities and no range-of-motion deficits at the neck or upper extremities. His surgical incisions were well healed, and there were no signs of infection, including worsening pain, swelling, or erythema at the surgical sites. On the day his pain increased, the patient reported that he was very active, doing yard work and playing with his grandchildren.Ī physical exam revealed an obviously uncomfortable patient. In the clinic, he stated that his pain levels were back to baseline, similar to before SCS was performed. He had previously reported 70% pain relief with the SCS. A bi-winged manufacturer-provided anchor was incorporated to secure the leads to the fascia. During the implant procedure, a paresthesia-based system was used, and two cylindrical leads were implanted with the lead tips staggered at the C3 level. Case PresentationĪ 57-year-old man with a history of chronic left upper extremity C5–C7 radiculopathies presented to a pain clinic 2 months after implantation of a percutaneous cervical SCS with 3 days of an abrupt increase in left upper extremity pain. Thereafter, we review SCS lead migration, including symptomatology, diagnosis, and management. In the following section, we describe a case of a patient who experienced an acute loss of SCS efficacy related to lead migration. Infection (3.4–10%), epidural fibrosis (19%), neurologic injury (0.034–0.3%), and tolerance to stimulation are some biological complications that can cause loss of SCS efficacy. Device complications include lead migration (2.1–27%), lead fracture (6–10.2%), electrode disconnection from the implantable pulse generator (IPG 0.4–2.9%), and IPG failure (1.7–3%). Etiologies for loss of efficacy can be divided into either device or hardware complications or biologic complications. Patients may experience decreases in both functional status and quality of life as a result of lost therapeutic efficacy. reported an incidence of loss of efficacy of 13.7%. Loss of efficacy results in a decrease or complete loss of therapeutic stimulation or return to pain levels prior to SCS implantation. One such complication is loss of therapeutic efficacy. Although it is generally very safe, SCS implantation does have specific risks and complications. Spinal cord stimulation (SCS) is an effective nonpharmacologic modality indicated for the management of multiple chronic neuropathic pain such as failed back surgery syndrome, complex regional pain syndrome, and painful peripheral neuropathies. Accessing these systems from outside the DFCI/Partners network, or from DFCI’s onsite guest network, requires an additional step beyond submitting your username and password. To access the terminal services, please follow these instructions.ĭFCI has adopted the same security process for accessing a number of DFCI information systems as Partners Information Services. The software works as an emulator of a Partners PC workstation. Terminal servers for Mac users needing PC resourcesįor DFCI researchers whose primary workstation or laptop is a Mac, Research Computing provides a set of terminal servers to access PC resources and Partners applications. Research Computing provides the following remote access services, as well as information about frequently requested remote access topics (two-factor authentication, VPN, GoToMyPC): These partnerships enable access to rich datasets and advanced computational infrastructure, tools, and services.”Īdditional reference documents: GoogleCloudforStrides , STRIDESGCPProfessionalServices NIH’s STRIDES Initiative provides cost-effective access to industry-leading partners to help advance biomedical research. “…NIH to explore the use of cloud environments to streamline NIH data use by partnering with commercial providers. The NIH promises that in the near future, data sharing by funded institutions as well the NIH itself will be available.įrom the NIH Website “STRIDES Initiative” Currently the NIH has negotiated with Google and Amazon to provide discounts to those researchers that would like to use these technologies. The NIH STRIDES initiative promotes the use of cloud technologies in research. Joining the initiative will give researchers with NIH funded grants, access to discounts for services offered by Google Cloud Platform (GCP). The application form must be filled out and sent to Jim Coyne at Onix in addition to submitting a request on the Research Computing Infrastructure request formĪs of Monday ApDFCI will be participating in the NIH STRIDES Initiative. Researcher Application form: GettingStartedwithSTRIDES.docx If you are unable to log into the portal webpage, please contact the help desk 61 or submit an IS Service Desk ticket with the description “DFCI Research – Provision Office 365 account for non-standard devices.” Follow the link in the Microsoft portal page “Get Office on your devices” and follow those instructions. Office is available on iOS, Android, and WinOS phones and tablets. Use a web browser to go to and enter your DFCI email address. On the next page, enter your Partners User Name and password. Click the button on the right - “Install Now”. If a machine you’d like office installed on is a Partners PC, the installation is managed by our colleagues in Information Services. Additionally, Partners PCs will have a grey and red window for a screensaver and login. You can identify a Partners PC by labels annotated as “Partners Healthcare System”, “Device #” and barcode. You will have 5 user licenses per class of device 5 PC/Mac, 5 phones, and 5 tablets for a total of 15 possible installs on personal devices. NOTE: These licenses will be revoked upon end of employment at DFCI, and the software will revert to only allow reading of documents and worksheets. ica file extensions is Citrix Connection Manager, detailed instructions here.Īs a Dana-Farber employee you may install Office on a PC/Mac, phone, or tablet. After installing Citrix on Windows 10, check the default app to handle. Do not upgrade to the latest version of Citrix if you are using a Partners PC. If you have trouble connecting to Epic, first make sure your Citrix Receiver software is up to date. If you use an iPad to access Epic, but have trouble after log in, you need to contact the IS Service Desk and ask for the Haiku/Canto team.iOS devices (iPhone, iPad, iPod touch): enroll in MobileIron to access Partners email, and other Partners resources.Note: Mac users are unable to print reports.Launch the Citrix Workspace app using VPN first, and then modify the Citrix Workspace app for future use: In Citrix Workspace Preferences, Accounts, add.Use Firefox or Chrome to access Partners Workspace. Detailed instructions can be found here.In a web browser, navigate to Partners Workspace and select Epic.Use My Citrix / Workspace Apps: link on the Partners Applications menu, launch Epic Hyperspace.Click on Windows Start Menu Programs, All Programs, Workspace Favorites Folders, then select EPIC -or. It also destroyed moons and created a great amount of debris, causing major problems for ships and navigators. The events in the three recent High Republic books all take place concurrently in the year 232-BBY.Īs you discover in this novel, this is the year of the Great Disaster, a catastrophic event that caused numerous ships galaxy-wide to be suddenly, and violently, launched out of hyperspace. I think this is a positive thing for anyone who has fallen behind or wants to read The High Republic for the first time.Īs you might have noticed, The High Republic is packed with content and if you haven’t started reading any of it, now it’s a very good time to do so! I have a number of reviews of The High Republic Novels already and will be diving into the upcoming ones, as well as The Acolyte series.Into the Dark is a Disney Star Wars Canon YA novel, set during The High Republic era known as the golden age of the Jedi. As interesting as The High Republic is, it’s undeniable that it can be very overwhelming if you’re just getting into it. The timing between releases has increased a little bit to give a chance for people to catch up. The High Republic Adventures (Dark Horse) December 2023.The High Republic 13+ Comics (Marvel) December 2023.Chronicles from the Occlusion Zone (Star Wars Insider) October 2023.Into the Light, Release date undisclosedĬomics and magazines titles for Wave 1 of Phase III:.Defy The Storm, Release date undisclosed.Here’s the list of every Phase III novel: Wave 1 of Phase III will begin on October 2023 and finish in March 2024. One of the authors, Daniel José Older didn’t give any major details about the story but he did show a little of the art and its haunting. The Edge of Balance: Precedent is going to be the last title of Phase II. Marda, Yana, and The Mother will be a central part of the story Path of Vengeance will continue the story of Path of Deceit, according to its author (Cavan Scott) everything leads to Dalna, a small planet in the Outer Rim. I say so far because Phase II hasn’t ended and more releases were announced at the High Republic Panel. Path of Deceit and Convergence are my favorite books of Phase II so far. We get to know more about the origins of the Path of the Open Hand and Marchion Ro’s ancestors. Phase II is where we are currently at, 150 years before Phase I. But if you want to get into the High Republic I’d recommend Light of the Jedi, Into The Dark, The Rising Storm, Out of the Shadows, The Fallen Star, and Midnight Horizon. It is very hard to pick just a few books because everything is tied, and I really mean everything. They openly defied the Jedi and Republic and were able to cause death and destruction across multiple systems. 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MacDonald was held on a total $11,000 surety bond and scheduled to appear in Bantam Superior Court Feb. 22 and charged with disorderly conduct, then charged with disorderly conduct and violating the conditions of release in a separate incident that day. MacDonald, 47, 213 Millard Street, Torrington, was arrested Jan. VIOLATING THE CONDITIONS OF RELEASE TORRINGTON: Gary P. Penney was released on $500 non-surety bond and scheduled to appear in Bantam Superior Court Jan. 24 and charged with second-degree breach of peace following a domestic disturbance. Penney Jr., 30, 80 Rock Creek Lane, Torrington, was arrested Jan. Wright, who turned himself in on an acive warrant, was released on $500 surety bond and scheduled to appear in Bantam Superior Court Feb. 24 and charged with second-degree failure to appear. FAILURE TO APPEAR TORRINGTON: Akashai Wright, 19, 247 East Main Street, apt. Culmone was issued a $750 bond, and no court information was available. 25 and charged with second-degree failure to appear. FAILURE TO APPEAR TORRINGTON: Andrea Culmone, 30, 1771 Stanley Street, New Britain, was arrested Jan. Ferris was released on $1,000 non-surety bond and scheduled to appear in Bantam Superior Court Jan. 19 and charged with interfering with an officer, possession of drug paraphernalia, possession of narcotics and failure to keep narcotics in their original container. Ferris, 35, 57 Alice Street, Torrington, was arrested Jan. Sean S.Torrington police reported the following arrests: INTERFERING WITH AN OFFICER TORRINGTON: Rebecca A. We are here for you and together we can build bridges. Please don't hesitate to contact any member of the police department if you need additional information. We welcome any comments or suggestions that will assist our agency in improving our commitment to those we serve. 12 and charged with violation of protective order and first-degree criminal. As the Chief of Police, I would like to invite you to visit the police department during your time on campus. Rodriguez, 37, of 58 Woodbine St., Apartment 2, Torrington, was arrested Aug. We are continually striving to provide nothing but the best policing service to our community.Īs you make your way through our website we hope that you find the information useful and relevant to your needs. At about 5:50 p.m., the fire department was requested to respond to Stillwater Pond. We are committed to the fundamental principles of community policing, such as crime prevention, omnipresence, and partnerships with the community we serve. (WFSB) - A person was found dead in Torrington on Tuesday. Our Police Department at Central Connecticut State University is a fully sworn nationally accredited police agency, focused on ensuring health, safety and providing a stable work and learning environment for our campus community and visitors. Welcome to the Central Connecticut State University Police Department's Web site. STEVEN ROSSI, 39, 240 Main St., Torrington, disorderly conduct, Sept. Released on 500 nonsurety bond pending appearance in Bantam Superior Court Sept. Cornwall, operating motor vehicle without minimum insurance, Sept. Welcome Message from the Chief of Police, Director of Public Safety ALAN DAINS, 69, 300 Great Hollow Road, W. |
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