Chronic upper abdominal pain occurs as a complication of various malignant and benign diseases including pancreatic cancer and chronic pancreatitis, and when present may contribute to lower quality of life and higher mortality. Though various pain management strategies are available as part of a multimodal approach, they are often incompletely effective and accompanied by side effects. Pain originating in upper abdominal viscera is transmitted through the celiac plexus, which is an autonomic plexus located in the retroperitoneum at the root of the celiac trunk. Direct intervention at the level of the plexus, referred to as celiac plexus block or neurolysis depending on the injectate, is a minimally invasive therapeutic strategy which has been demonstrated to decrease pain, improve function, and reduce opiate dependence. Various percutaneous techniques have been reported, but, with appropriate preprocedural planning, use of image guidance (usually computed tomography), and postprocedural care, the frequency and severity of complications is low and the success rate high regardless of approach. The main benefit of the intervention may be in reduced opiate dependence and opiate-associated side effects, which in turn improves quality of life. Celiac plexus block and neurolysis are safe and effective treatments for chronic upper abdominal pain and should be considered early in patients experiencing such symptoms.

Electrical impedance myography (EIM) is a noninvasive technique for neuromuscular assessment in which low-intensity alternating current is applied to a muscle and the consequent surface voltage patterns are evaluated. Previous work using a single frequency of 50 kHZ has demonstrated quantitative correlation of EIM parameters with disease status. In this investigation we examined the use of multifrequency EIM, studying a prototypical neurogenic disease (amyotrophic lateral sclerosis, ALS) and myopathic disorder (inflammatory myopathy, IM). Eleven ALS patients, 7 IM patients, and 46 normal subjects participated in the study. Although disease-specific patterns were not identified such that IM could be differentiated from ALS, impedance vs. frequency patterns for diseased subjects differed substantially from those of the age-matched normal subjects, with the greatest alterations occurring in the most severe cases. Multifrequency EIM may be well-suited to serve as an easily applied technique to assess disease severity in a variety of neuromuscular conditions.

Electrical impedance myography (EIM) is a painless and non-invasive technique for the assessment of muscle which we apply here to the effects of normal aging. The paper presents a cross-sectional analysis of EIM data from the quadriceps and tibialis anterior of 100 healthy subjects (44 men, 56 women, ages 18-90 years). The principal EIM parameter, the spatially averaged phase theta(avg), shows a roughly quadratic reduction with increasing age, declining more steeply beyond 60 years. The correlation was stronger in men (quadriceps: r2 = 0.68 for men, 0.52 for women; tibialis anterior: r2 = 0.74 for men, 0.38 for women; p < 0.001 throughout). Additionally, four subjects (age greater than 75 years) were asked to return for repeat testing several years after their initial assessment. These longitudinal results qualitatively confirm the cross-sectional data, though with greater reductions in theta(avg) at high age. The findings of this study support the potential use of EIM as a simple and effort-independent test of muscle health in the elderly.