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Blood pressure and spinal cord injury

William J Readdy, Rajiv Saigal, William D Whetstone, Anthony N Mefford, Adam R Ferguson, Jason F Talbott, Tomoo Inoue, Jacqueline C Bresnahan, Michael S Beattie, Jonathan Pan, Geoffrey T Manley, Sanjay S Dhall
BACKGROUND: Increased spinal cord perfusion and blood pressure goals have been recommended for spinal cord injury (SCI). Penetrating SCI is associated with poor prognosis, but there is a paucity of literature examining the role of vasopressor administration for the maintenance of mean arterial pressure (MAP) goals in this patient population. OBJECTIVE: To elucidate this topic and to determine the efficacy of vasopressor administration in penetrating SCI by examining a case series of consecutive penetrating SCIs...
November 2016: Neurosurgery
Charlotte Pineau, Brice Lavrard, François Boyer, Laëtitia Percebois-Macadré
OBJECTIVE: MRI has highly changed the assessment of post-traumatic syringomyelia (PTS), roughly estimated at 30% nowadays. Times to onset (TTO) symptoms are random. This case report describes how hyperhidrosis appeared and revealed PTS diagnosis. OBSERVATIONS: Mr M., 43-year-old, is rehabilitation inpatient after T10 AIS A spinal cord injury (SCI). Three months after this event, Mr M complains of acute hyperhidrosis crisis always located below the injury, which can occur at any time of the day, particularly when he moves...
September 2016: Annals of Physical and Rehabilitation Medicine
Hadis Sabour, Abbas Norouzi-Javidan, Zahra Soltani, Seyede Azemat Mousavifar, Sahar Latifi, Seyed Hassan Emami-Razavi, Seyed Mohammad Ghodsi
BACKGROUND: Studies have demonstrated the effect of different dietary fats on blood pressure (BP) in general population. However, these associations have not yet been described in people with spinal cord injury (SCI). METHODS: Referred patients to Brain and SCI Research Center between 2011 and 2014 have been invited to participate. Only paraplegic individuals were recruited and patients with injury at cervical or higher thoracic sections were excluded to omit the bias effect of autonomic dysreflexia...
July 6, 2016: Iranian Journal of Neurology
Mohammad A Anwar, Ali H Eid
Stroke and other neurovascular derangements are main causes of global death. They, along with spinal cord injuries, are responsible for being the principal cause of disability due to neurological and cognitive problems. These problems then lead to a burden on scarce financial resources and societal care facilities as well as have a profound effect on patients' families. The mechanism of action in these debilitating diseases is complex and unclear. An important component of these problems arises from derangement of blood vessels, such as blockage due to clotting/embolism, endothelial dysfunction, and overreactivity to contractile agents, as well as alteration in endothelial permeability...
2016: Methods in Molecular Biology
Yu-Hui Huang, Hsiao-Yun Chang, Sen-Wei Tsai, Li-Wei Chou, Sung-Lang Chen, Yu-Hao Lin
BACKGROUND/PURPOSE: This study compares heart rate variability (HRV) and systolic blood pressure (SBP) changes of spinal cord injury (SCI) patients during urodynamic study (UDS) with able-bodied controls. METHODS: Twenty four complete suprasacral SCI patients (12 tetraplegia and 12 paraplegia) and 12 age-matched able-bodied volunteers received BP and HRV evaluation throughout urodynamic examination. We chose seven time points during the examinations: resting, Foley catheter insertion, start of infusion, and infused volume reaching 1/4, 2/4, 3/4 and 4/4 of maximal capacity...
2016: PloS One
David W Popok, Christopher R West, Michele Hubli, Katharine D Currie, Andrei V Krassioukov
Cardiovascular disease is one of the leading causes of morbidity and mortality in the spinal cord injury (SCI) population. SCI may disrupt autonomic cardiovascular homeostasis, which can lead to persistent hypotension, irregular diurnal rhythmicity, and the development of autonomic dysreflexia (AD). There is currently no software available to perform automated detection and evaluation of cardiovascular autonomic dysfunction(s) such as those generated from 24 h ambulatory blood pressure monitoring (ABPM) recordings in the clinical setting...
October 5, 2016: Journal of Neurotrauma
Hadis Sabour, Abbas Norouzi Javidan, Zahra Soltani, Amir H Pakpour, Mir Saeed Yekaninejad, Seyedeh A Mousavifar
OBJECTIVE: The efficacy of nutrition education on body weight and serum lipids has not yet been described in patients with spinal cord injury (SCI). In the present study, we examined the effect of a 7-month nutrition education program on lipid profile and body weight in individuals with SCI. DESIGN: Randomized clinical trial. SETTING: A tertiary rehabilitation center. PARTICIPANTS: Patients with SCI who were referred to Brain and Spinal Cord Injury Research Center...
August 25, 2016: Journal of Spinal Cord Medicine
David Popok, Christopher West, Barbara Frias, Andrei V Krassioukov
Spinal cord injury (SCI) is a debilitating neurological condition characterized by somatic and autonomic dysfunctions. In particular, SCI above the mid-thoracic level can lead to a potentially life-threatening hypertensive condition called autonomic dysreflexia (AD) that is often triggered by noxious or non-noxious somatic or visceral stimuli below the level of injury. One of the most common triggers of AD is the distension of pelvic viscera, such as during bladder and bowel distension or evacuation. This protocol presents a novel pattern recognition algorithm developed for a JAVA platform software to study the fluctuations of cardiovascular parameters as well as the number, severity and duration of spontaneously occurring AD events...
2016: Journal of Visualized Experiments: JoVE
Jordan Squair, Christopher R West, David Popok, Peggy Assinck, Jie Liu, Wolfram Tetzlaff, Andrei V Krassioukov
Cardiovascular disease is the leading cause of death for individuals with spinal cord injury (SCI). Due to a lack of a standardized and accessible animal model for cardiovascular disease after SCI, few laboratories have conducted pre-clinical trials aimed at re-instating descending cardiovascular control. Here, we utilized common contusion methodology applied to the midline of the upper-thoracic cord of adult Wistar rats accompanied with telemetric blood pressure monitoring, Fluorogold retrograde neuronal tracing, as well as lesion site and lumbrosacral afferent immunohistochemistry...
July 25, 2016: Journal of Neurotrauma
James S Krause, Yue Cao, Michael J DeVivo, Nicole D DiPiro
OBJECTIVE: To investigate the association of multiple sets of risk and protective factors (biographic and injury, socioeconomic, health) with cause-specific mortality after spinal cord injury (SCI). DESIGN: Retrospective analysis of a prospectively created cohort. SETTING: Spinal Cord Injury Model Systems facilities. PARTICIPANTS: Adults (N=8157) with traumatic SCI who were enrolled in a model systems facility after 1973 and received follow-up evaluation that included all study covariates (between November 1, 1995 and October 31, 2006)...
October 2016: Archives of Physical Medicine and Rehabilitation
B Yilmaz, S Göktepe, E Yaşar, S Kesikburun, E Adıgüzel
STUDY DESIGN: Case-control study. OBJECTIVES: To investigate the level of autonomic nervous system dysfunction in patients with spinal cord injury and to determine its effect on the basal metabolic rate and oxygen consumption during daily living activities. SETTING: Turkish Armed Forces Rehabilitation Center, Ankara, Turkey. METHODS: Thirty-six patients with chronic spinal cord injury (SCI) were allocated into two groups according to the presence of autonomic nervous system dysfunction...
July 19, 2016: Spinal Cord
Carla Fj Nooijen, Henk J Stam, Tebbe Sluis, Linda Valent, Jos Twisk, Rita Jg van den Berg-Emons
OBJECTIVE: To assess, for people with subacute spinal cord injury, if rehabilitation that is reinforced with the addition of a behavioral intervention to promote physical activity leads to a better health, participation and quality of life. DESIGN: Randomized controlled trial. SETTING: Rehabilitation centers. PARTICIPANTS: A total of 39 participants analyzed (45 included), with subacute spinal cord injury in inpatient rehabilitation, dependent on a manual wheelchair (33% tetraplegia, 62% motor complete, 150 ±74 days postinjury)...
July 4, 2016: Clinical Rehabilitation
M Y Goh, M S Millard, E C K Wong, D J Brown, A G Frauman, C J O'Callaghan
STUDY DESIGN: This is a prospective observational study. OBJECTIVES: The objective of this study was to determine time-dependent changes in diurnal blood pressure (BP) and urine production in acute spinal cord injury (SCI). SETTING: This study was conducted in a specialist, state-based spinal cord service in Victoria, Australia. METHODS: Consenting patients admitted consecutively with acute SCI were compared with patients confined to bed rest while awaiting surgery and with mobilising able-bodied controls...
June 28, 2016: Spinal Cord
Andrew McGregor, Khaldoun Bekdache, Laura Choi
INTRODUCTION: Pneumatosis intestinalis (PI) and hepatic portal venous gas (HPVG) are radiographic signs of questionable bowel ischemia. Pneumatosis intestinalis can be associated with possible benign conditions such as obstructive airway disease. We present a patient who demonstrated clinical signs of overt sepsis with corresponding radiological findings of PI and HPVG concering for possible small or large bowel ischemia. However at exploration, no sign of small or large bowel injury or ischemia could be detected...
May 2016: Connecticut Medicine
A K Ahmed, C R Goodwin, R Sarabia-Estrada, F Lay, A M Ansari, C Steenbergen, C Pang, R Cohen, L J Born, A E Matsangos, C Ng, G P Marti, N Abu-Bonsrah, N A Phillips, I Suk, D M Sciubba, J W Harmon
STUDY DESIGN: Experimental study. OBJECTIVES: The objective of this study was to establish a non-invasive model to produce pressure ulcers of varying severity in animals with spinal cord injury (SCI). SETTING: The study was conducted at the Johns Hopkins Hospital in Baltimore, Maryland, USA. METHODS: A mid-thoracic (T7-T9) left hemisection was performed on Sprague-Dawley rats. At 7 days post SCI, rats received varying degrees of pressure on the left posterior thigh region...
June 21, 2016: Spinal Cord
Christopher S Ahuja, Allan R Martin, Michael Fehlings
Traumatic spinal cord injuries (SCIs) affect 1.3 million North Americans, producing devastating physical, social, and vocational impairment. Pathophysiologically, the initial mechanical trauma is followed by a significant secondary injury which includes local ischemia, pro-apoptotic signaling, release of cytotoxic factors, and inflammatory cell infiltration. Expedient delivery of medical and surgical care during this critical period can improve long-term functional outcomes, engendering the concept of "Time is Spine"...
2016: F1000Research
Tom E Nightingale, Jean-Philippe Walhin, James E Turner, Dylan Thompson, James L J Bilzon
BACKGROUND: Spinal cord injury (SCI) creates a complex pathology that can lead to an increase in sedentary behaviours and deleterious changes in body composition. Consequently, individuals with SCI are at increased risk of developing cardiovascular disease and type-2 diabetes mellitus. While the role of physical activity on the reduction of chronic disease risk is well documented in non-disabled individuals the evidence is less conclusive for persons with SCI. The aim of this methodological paper is to outline the design of a study that will assess the role of a home-based exercise intervention on biomarkers of metabolic and cardiovascular health in persons with SCI: the HOMEX-SCI study...
2016: Trials
Ross Davidson, Stacy Elliott, Andrei Krassioukov
Sexuality is an integral part of the human experience and persists in health and disability. The cardiovascular system is crucial to sexual function and can be affected profoundly by spinal cord injury (SCI). The effects of sexual activity on the cardiovascular system in SCI have not been summarized and compared with sexual activity in able-bodied individuals. A keyword search of Embase, PubMed, and Medline was conducted. From 471 retrieved studies for able-bodied individuals, 11 were included that met the strict criteria of medically uncomplicated participants...
May 31, 2016: Journal of Neurotrauma
Lucy Y Liu, Brooke Callahan, Sven Peterss, Julia Dumfarth, Maryann Tranquilli, Bulat A Ziganshin, John A Elefteriades
BACKGROUND: Motor evoked potentials (MEP) and somatosensory evoked potentials (SSEP) are established methods of neuromonitoring aimed at preventing paraplegia after descending or thoracoabdominal aortic repair. However, their predictive impact remains controversial. The aim of this study was to evaluate our single-center experience using this monitoring technique. METHODS: Between 2009 and 2014, 78 patients (mean age 66 ± 12, 53% male) underwent either descending or thoracoabdominal aortic repairs...
June 2016: Journal of Cardiac Surgery
Taikwan Kim, Cheol Su Jwa
We report a rare case of a 71-year-old male patient who had suffered from long-lasting neurogenic shock for 13 weeks after cervical spinal cord injury (SCI) caused by a bicycle accident. The neurogenic shock was resolved dramatically 2 weeks after the administration of alpha-1-adrenergic agonist, midodrine hydrochloride. In usual cases, neurogenic shock tends to improve between 2 and 6 weeks after SCI; however, in a few cases, the shock lasts for several months. In our case, spinal shock lasted for 13 weeks and exhibited very sensitive decline of blood pressure for even a slight decrease of dopamine despite recovered bulbospongiosus reflex...
October 2015: Korean Journal of Neurotrauma
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