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Blood pressure and spinal cord injury

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https://www.readbyqxmd.com/read/28699368/impact-of-blood-pressure-lesion-level-and-physical-activity-on-aortic-augmentation-index-in-persons-with-sci
#1
Caitlyn G Katzelnick, Joseph P Weir, Nancy Chiaravalotti, Glenn Wylie, Trevor Dyson-Hudson, William A Bauman, Jill M Wecht
Individuals with chronic spinal cord injury (SCI) are at a heightened risk of cardiovascular disease (CVD) due to autonomic nervous system dysfunction, physical inactivity and increased inflammatory processes. Arterial stiffness (AS) is recognized as an independent risk factor for CVD and, specifically, pulse wave analysis (PWA) has proven to be a useful tool to predict and track structural arterial changes that reflect arteriosclerosis. The augmentation index (AI) can be used to estimate AS and is derived from the amplitude and timing of the blood pressure (BP) wave reflection in a peripheral artery...
July 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28666000/dynamic-wheelchair-seating-positions-impact-cardiovascular-function-after-spinal-cord-injury
#2
Jessica A Inskip, Henrike Rianne J C Ravensbergen, Inderjeet S Sahota, Christine Zawadzki, Lowell T McPhail, Jaimie F Borisoff, Victoria E Claydon
BACKGROUND: Innovative wheelchairs allow individuals to change position easily for comfort and social situations. While these wheelchairs are beneficial in multiple ways, the effects of position changes on blood pressure might exacerbate hypotension and cerebral hypoperfusion, particularly in those with spinal cord injury (SCI) who can have injury to autonomic nerves that regulate cardiovascular control. Conversely, cardiovascular benefits may be obtained with lowered seating. Here we investigate the effect of moderate changes in wheelchair position on orthostatic cardiovascular and cerebrovascular reflex control...
2017: PloS One
https://www.readbyqxmd.com/read/28660164/epidemiology-of-trauma-victims-admitted-to-a-level-2-trauma-center-of-north-india
#3
Vikas Verma, Ajay Singh, Girish Kumar Singh, Santosh Kumar, Vineet Sharma, Ashish Kumar, Vineet Kumar
BACKGROUND: Good quality information on characteristics of victims, types, and frequency of injuries, causes of accidents, vehicles involved in injury and outcome is essential for understanding and planning required for managing the trauma epidemic. The objective of this study was to describe the characteristics of trauma victims admitted to King George's Medical University trauma center. METHODS: This observational study enrolled trauma victims over a 1-year period...
April 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28605971/impaired-baroreflex-function-during-orthostatic-challenge-in-patients-after-spinal-cord-injury
#4
Katarina Ondrusova, Jana Svacinova, Michal Javorka, Jan Novak, Marie Novakova, Zuzana Novakova
The level of spinal cord injury (SCI) affects baroreflex regulation of blood pressure (BP). While a parasympathetic cardiac chronotropic effect is preserved, baroreflex response could be impaired by sympathetic dysfunction under the SCI level. This study was aimed to evaluate the baroreflex function in SCI patients by the analysis of causal interaction between systolic blood pressure (SBP) and inter-beat intervals (IBI). BP was continuously recorded in 13 cervical SCI patients (CSCI), 9 thoracic SCI (ThSCI) and 13 able-bodied controls (Con) during two phases: sitting (PS) and orthostatic challenge (PO)...
June 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28585557/pharmacodynamics-and-effectiveness-of-topical-nitroglycerin-at-lowering-blood-pressure-during-autonomic-dysreflexia
#5
R Solinsky, A E Bunnell, T A Linsenmeyer, J N Svircev, A Engle, S P Burns
STUDY DESIGN: Secondary analysis of prospectively collected observational data assessing the safety of an autonomic dysreflexia (AD) management protocol. OBJECTIVES: To estimate the time to onset of action, time to full clinical effect (sustained systolic blood pressure (SBP) <160 mm Hg) and effectiveness of nitroglycerin ointment at lowering blood pressure for patients with spinal cord injuries experiencing AD. SETTING: US Veterans Affairs inpatient spinal cord injury (SCI) unit...
June 6, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28571527/assessment-and-management-of-acute-spinal-cord-injury-from-point-of-injury-to-rehabilitation
#6
Laureen D Hachem, Christopher S Ahuja, Michael G Fehlings
CONTEXT: Spinal cord injury (SCI) is a devastating condition that can lead to significant neurological impairment and reduced quality of life. Despite advancements in our understanding of the pathophysiology and secondary injury mechanisms involved in SCI, there are currently very few effective treatments for this condition. The field, however, is rapidly changing as new treatments are developed and key discoveries are made. METHODS: In this review, we outline the pathophysiology, management, and long-term rehabilitation of individuals with traumatic SCI...
June 1, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28537464/multi-domain-assessment-of-autonomic-function-in-spinal-cord-injury-using-a-modified-autonomic-reflex-screen
#7
Michael James Berger, Kurt Kimpinski, Katharine Dianne Currie, Hirmand Nouraei, Mahsa Sadeghi, Andrei V Krassioukov
The purpose of this study was to characterize autonomic lesions in participants with spinal cord injury (SCI; n=10) using an autonomic reflex screen, incorporating sudomotor, cardiovagal and sympathetic adrenergic tests, as well as hemodynamic responses to head-up tilt (HUT). Hemodynamic responses were compared to healthy controls (n=20) and previously published normative cutoffs in order better identify autonomic impairments. Sympathetic skin responses (SSRs), heart rate response to deep breathing (HRDB) and heart rate and beat-to-beat blood pressure responses to Valsalva maneuver (VM) and HUT were measured...
May 24, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28486884/effect-of-intravesical-botulinum-toxin-injection-on-symptoms-of-autonomic-dysreflexia-in-a-patient-with-chronic-spinal-cord-injury-a-case-report
#8
Il-Young Jung, Kyo Ik Mo, Ja-Ho Leigh
CONTEXT: There are few treatment options for managing autonomic dysreflexia in patients with chronic spinal cord injury (SCI). According to some studies, intravesical botulinum toxin for SCI patients with autonomic dysreflexia has a preventive effect on symptoms of autonomic dysreflexia. However, the usefulness of an intravesical botulinum toxin injection has never been reported for autonomic dysreflexia in an adult patient with chronic cervical SCI, although there has been for one pediatric patient...
May 9, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28469668/anesthetic-considerations-for-patients-with-acute-cervical-spinal-cord-injury
#9
REVIEW
Fang-Ping Bao, Hong-Gang Zhang, Sheng-Mei Zhu
Anesthesiologists work to prevent or minimize secondary injury of the nervous system and improve the outcome of medical procedures. To this end, anesthesiologists must have a thorough understanding of pathophysiology and optimize their skills and equipment to make an anesthesia plan. Anesthesiologists should conduct careful physical examinations of patients and consider neuroprotection at preoperative interviews, consider cervical spinal cord movement and compression during airway management, and suggest awake fiberoptic bronchoscope intubation for stable patients and direct laryngoscopy with manual in-line immobilization in emergency situations...
March 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28447605/traumatic-spinal-cord-injury
#10
REVIEW
Christopher S Ahuja, Jefferson R Wilson, Satoshi Nori, Mark R N Kotter, Claudia Druschel, Armin Curt, Michael G Fehlings
Traumatic spinal cord injury (SCI) has devastating consequences for the physical, social and vocational well-being of patients. The demographic of SCIs is shifting such that an increasing proportion of older individuals are being affected. Pathophysiologically, the initial mechanical trauma (the primary injury) permeabilizes neurons and glia and initiates a secondary injury cascade that leads to progressive cell death and spinal cord damage over the subsequent weeks. Over time, the lesion remodels and is composed of cystic cavitations and a glial scar, both of which potently inhibit regeneration...
April 27, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28447274/classification-and-regression-tree-model-for-predicting-tracheostomy-in-patients-with-traumatic-cervical-spinal-cord-injury
#11
Dae-Sang Lee, Chi-Min Park, Keumhee Chough Carriere, Joonghyun Ahn
PURPOSE: In patients with cervical spinal cord injury (CSCI), respiratory compromise and the need for tracheostomy are common. The purpose of this study was to identify common risk factors for tracheostomy following traumatic CSCI and develop a decision tree for tracheostomy in traumatic CSCI patients without pulmonary function test. METHODS: Data of 105 trauma patients with CSCI admitted in our institution from April, 2008 to February, 2014 were retrospectively analyzed...
April 26, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28416148/alterations-in-autonomic-cerebrovascular-control-after-spinal-cord-injury
#12
Dong-Il Kim, Can Ozan Tan
Among chronic cardiovascular and metabolic sequelae of spinal cord injury (SCI) is an up-to four-fold increase in the risk of ischemic and hemorrhagic stroke, suggesting that individuals with SCI cannot maintain stable cerebral perfusion. In able-bodied individuals, the cerebral vasculature is able to regulate cerebral perfusion in response to swings in arterial pressure (cerebral autoregulation), blood gases (cerebral vasoreactivity), and neural metabolic demand (neurovascular coupling). This ability depends, at least partly, on intact autonomic function, but high thoracic and cervical spinal cord injuries result in disruption of sympathetic and parasympathetic cerebrovascular control...
April 4, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28351230/continuous-monitoring-and-visualization-of-optimum-spinal-cord-perfusion-pressure-in-patients-with-acute-cord-injury
#13
Suliang Chen, Peter Smielewski, Marek Czosnyka, Marios C Papadopoulos, Samira Saadoun
The optimum spinal cord perfusion pressure (SCPP) after traumatic spinal cord injury (TSCI) is unknown. Here, we describe techniques to compute and display the optimum SCPP in real time. We recruited adults within 72 h of severe TSCI (American Spinal Injuries Association [ASIA] grades A-C). A pressure probe and a microdialysis catheter were placed on the injured cord. SCPP was computed as mean arterial pressure (MAP) minus intraspinal pressure (ISP), spinal pressure reactivity index (sPRx) as the running ISP/MAP correlation coefficient, and continuous optimum SCPP (cSCPPopt) as the SCPP that minimizes sPRx in a moving 4-h window...
May 24, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28350947/traumatic-spinal-cord-injury-repair-and-regeneration
#14
Christopher S Ahuja, Satoshi Nori, Lindsay Tetreault, Jefferson Wilson, Brian Kwon, James Harrop, David Choi, Michael G Fehlings
BACKGROUND: Traumatic spinal cord injuries (SCI) have devastating consequences for the physical, financial, and psychosocial well-being of patients and their caregivers. Expediently delivering interventions during the early postinjury period can have a tremendous impact on long-term functional recovery. PATHOPHYSIOLOGY: This is largely due to the unique pathophysiology of SCI where the initial traumatic insult (primary injury) is followed by a progressive secondary injury cascade characterized by ischemia, proapoptotic signaling, and peripheral inflammatory cell infiltration...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28336819/fundamental-hemodynamic-mechanisms-mediating-the-response-to-myocardial-ischemia-in-conscious-paraplegic-mice-cardiac-output-versus-peripheral-resistance
#15
Heidi L Lujan, Stephen E DiCarlo
Autonomic dysfunction, a relative sedentary lifestyle, a reduced muscle mass and increased adiposity leads to metabolic abnormalities that accelerate the development of coronary artery disease (CAD) in individuals living with spinal cord injury (SCI). An untoward cardiac incident is related to the degree of CAD, suggesting that the occurrence of a significant cardiac event is significantly higher for individuals with SCI Thus, understanding the fundamental hemodynamic mechanisms mediating the response to myocardial ischemia has the potential to positively impact individuals and families living with SCI Accordingly, we systematically investigated if thoracic level 5 spinal cord transection (T5X; paraplegia) alters the arterial blood pressure response to coronary artery occlusion and if the different arterial blood pressure responses to coronary artery occlusion between intact and paraplegic mice are mediated by changes in cardiac output and or systemic peripheral resistance and whether differences in cardiac output are caused by changes in heart rate and or stroke volume...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28291783/oesophageal-heat-exchangers-with-a-diameter-of-11mm-or-14-7mm-are-equally-effective-and-safe-for-targeted-temperature-management
#16
Daniel C Schroeder, Maria Guschlbauer, Alexandra C Maul, Daniel A Cremer, Ingrid Becker, David de la Puente Bethencourt, Peter Paal, Stephan A Padosch, Wolfgang A Wetsch, Thorsten Annecke, Bernd W Böttiger, Anja Sterner-Kock, Holger Herff
BACKGROUND: Targeted temperature management (TTM) is widely used in critical care settings for conditions including hepatic encephalopathy, hypoxic ischemic encephalopathy, meningitis, myocardial infarction, paediatric cardiac arrest, spinal cord injury, traumatic brain injury, ischemic stroke and sepsis. Furthermore, TTM is a key treatment for patients after out-of-hospital cardiac-arrest (OHCA). However, the optimal cooling method, which is quick, safe and cost-effective still remains controversial...
2017: PloS One
https://www.readbyqxmd.com/read/28289632/hemodynamic-adaptations-to-regular-exercise-in-people-with-spinal-cord-injury
#17
Young Hee Lee, Jin Hyeong Lee, Sung Hoon Kim, Dongsoo Yi, Kyung Joon Oh, Ji Hyun Kim, Tae Jun Park, Hanul Kim, Jae Seung Chang, In Deok Kong
OBJECTIVE: To investigate the real-time cardiovascular response to the progressive overload exercise in different levels of spinal cord injury (SCI), and to find out whether regular exercise has effect on these cardiovascular responses. METHODS: The study enrolled 8 able-bodied individuals in the control group plus 15 SCI subjects who were divided into two groups by their neurological level of injury: high-level SCI group (T6 or above) and low-level SCI group (T7 or below)...
February 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28286201/arm-cranking-exercise-training-reduces-plasminogen-activator-inhibitor-1-in-people-with-spinal-cord-injury
#18
Masahiro Horiuchi, Koichi Okita
OBJECTIVE: To investigate the effects of arm-cranking exercise training on plasminogen activator inhibitor 1 (PAI-1) as a risk factor of deep vein thrombosis, along with general physical parameters such as, muscle strength, aerobic capacity, and hemodynamics, in individuals with spinal cord injury (SCI) and control. DESIGN: Longitudinal study. INTERVENTION: Community-based supervised intervention. PARTICIPANTS: Nine individuals with SCI volunteered for this study...
March 9, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28228335/alterations-in-cardiac-autonomic-control-in-spinal-cord-injury
#19
REVIEW
Fin Biering-Sørensen, Tor Biering-Sørensen, Nan Liu, Lasse Malmqvist, Jill Maria Wecht, Andrei Krassioukov
A spinal cord injury (SCI) interferes with the autonomic nervous system (ANS). The effect on the cardiovascular system will depend on the extent of damage to the spinal/central component of ANS. The cardiac changes are caused by loss of supraspinal sympathetic control and relatively increased parasympathetic cardiac control. Decreases in sympathetic activity result in heart rate and the arterial blood pressure changes, and may cause arrhythmias, in particular bradycardia, with the risk of cardiac arrest in those with cervical or high thoracic injuries...
February 15, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28174025/effects-of-liposome-based-local-suppression-of-nerve-growth-factor-in-the-bladder-on-autonomic-dysreflexia-during-urinary-bladder-distention-in-rats-with-spinal-cord-injury
#20
Katsumi Kadekawa, Tsuyoshi Yoshizawa, Naoki Wada, Takahiro Shimizu, Tsuyoshi Majima, Pradeep Tyagi, William C de Groat, Kimio Sugaya, Naoki Yoshimura
PURPOSE: To examine (1) whether spinal cord injury (SCI) time-dependently increases the severity of autonomic dysreflexia (AD) and expression levels of bladder nerve growth factor (NGF) protein, and (2) whether local suppression of NGF in the bladder improves SCI-induced AD in rats. MATERIALS AND METHODS: SCI was produced by the transection of the T2/3 spinal cord in female Sprague-Dawley rats. At 4 or 8weeks after SCI, differences in the mean arterial blood pressure (ΔMAP) and heart rate (ΔMHR) during graded increases in intravesical pressure to 20, 40 and 60cm H2O from those before bladder distention and NGF protein levels in the bladder wall were evaluated in spinal intact and SCI rats under urethane anesthesia...
May 2017: Experimental Neurology
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