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Paraplegia

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https://www.readbyqxmd.com/read/28109108/-brachiocephalic-artery-sparing-aortic-arch-repair-combined-with-stent-graft-elephant-trunk-technique-for-stanford-type-a-aortic-dissection-analysis-of-23-cases
#1
Song-Lin DU, Jun Wan, Wu-Jun Wang, Kai-Can Cai, Ya-Xiang Liu, Xiang-Hui Mao
OBJECTIVE: To assess the clinical outcomes of brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique for treatment of Stanford type A aortic dissection. METHODS: Twenty-three patients with Stanford type A aortic dissection requiring arch replacement underwent brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique. The operations were performed within 72 h (20 cases) or 3-14 days (3 cases) after the onset of aortic dissection...
January 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28108577/the-efficacy-and-risk-of-cerebrospinal-fluid-drainage-for-thoracoabdominal-aortic-aneurysm-repair-a-retrospective-observational-comparison-between-drainage-and-non-drainage%C3%A2
#2
Junya Sugiura, Hideki Oshima, Tomonobu Abe, Yuji Narita, Yoshimori Araki, Kazuro Fujimoto, Masato Mutsuga, Akihiko Usui
OBJECTIVES: We reviewed our experiences with thoracoabdominal aortic aneurysm (TAAA) repair to assess the efficacy of cerebrospinal fluid drainage (CSFD) to prevent the neurological deficits and complications associated with CSFD. METHODS: Between 2002 and 2015, 118 patients underwent TAAA repair. Seventy-eight patients underwent CSFD for 2.7 ± 1.1 days after surgery. CSFD was not performed for the other 40 patients due to an urgent situation, chronic disseminated intravascular coagulation or anatomical difficulties...
January 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28104936/myelopathy-in-adult-aortic-coarctation-causes-and-caveats-of-an-atypical-presentation
#3
Chandan Mourya, Ashish Verma, Anand Bansal, Ram C Shukla, Arvind Srivastava
A 57-year-old female presenting with acute-onset paraplegia was referred for magnetic resonance imaging (MRI) of cervico-dorsal spine. On MRI, multiple tortuous dilated vessels were noted in the epidural space with long segment cord compression and imaging features of compressive myelopathy. Associated small acute cervico-dorsal epidural hematoma was also noted in the same region. Computed tomography (CT) angiography was performed subsequently which revealed post-ductal coarctation of aorta with multiple arterial collaterals in the chest wall and spinal canal...
October 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28103119/iatrogenic-spinal-cord-injury-in-a-trauma-patient-with-ankylosing-spondylitis
#4
Ahmad Maarouf, Colleen M McQuown, Jennifer A Frey, Rami A Ahmed, Lisa Derrick
BACKGROUND: The recommended practice for over 30 years has been to routinely immobilize patients with unstable cervical spinal injuries using cervical spinal collars. It is shown that patients with Ankylosing spondylitis (AS) are four times more likely to suffer a spinal fracture compared to the general population and have an eleven-fold greater risk of spinal cord injury. Current protocols of spinal immobilization were responsible for secondary neurologic deterioration in some of these patients...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28102106/comparison-of-disability-and-quality-of-life-between-patients-with-pediatric-and-adult-onset-paraplegia
#5
Hanife Duzgun Celik, Ayla Cagliyan Turk, Fusun Sahin, Figen Yilmaz, Banu Kuran
OBJECTIVE: To investigate the factors that affect disability and quality of life in patients with spinal cord injuries (SCIs) and to compare the degree of disability and quality of life in patients with SCI according to over and under 18 years of age when their injury occurred. DESIGN: Cohort study. SETTING: Two academic hospitals in Istanbul, Turkey. PARTICIPANTS: Forty patients with SCI were included in this study...
January 19, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28099355/hereditary-spastic-paraplegia-due-to-a-novel-mutation-of-the-reep1-gene-case-report-and-literature-review
#6
Sébastien Richard, Julie Lavie, Guillaume Banneau, Nathalie Voirand, Karine Lavandier, Marc Debouverie
RATIONALE: Hereditary spastic paraplegia (HSP) is a heterogeneous group of diseases little known in clinical practice due to its low prevalence, slow progression, and difficult diagnosis. This results in an underestimation of HSP leading to belated diagnosis and management. In depth diagnosis is based on clinical presentation and identification of genomic mutations. We describe the clinical presentation and pathogeny of HSP through a report of a case due to a novel mutation of the REEP1 gene (SPG31)...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28089662/electroacupuncture-pretreatment-attenuates-spinal-cord-ischemia-reperfusion-injury-via-inhibition-of-high-mobility-group-box-1-production-in-a-lxa4-receptor-dependent-manner
#7
Xiao-Ling Zhu, Xin Chen, Wei Wang, Xu Li, Jia Huo, Yu Wang, Yu-Yuan Min, Bin-Xiao Su, Jian-Ming Pei
Paraplegia caused by spinal cord ischemia is a severe complication following surgeries in the thoracic aneurysm. HMGB1 has been recognized as a key mediator in spinal inflammatory response after spinal cord injury. Electroacupuncture (EA) pretreatment could provide neuroprotection against cerebral ischemic injury through inhibition of HMGB1 release. Therefore, the present study aims to test the hypothesis that EA pretreatment protects against spinal cord ischemia-reperfusion (I/R) injury via inhibition of HMGB1 release...
January 12, 2017: Brain Research
https://www.readbyqxmd.com/read/28079704/modeling-perceived-exertion-during-graded-arm-cycling-exercise-in-spinal-cord-injury
#8
Jason S Au, Julia O Totosy de Zepetnek, Maureen J MacDonald
PURPOSE: Ratings of perceived exertion (RPE) may be useful for exercise testing and prescription in individuals with spinal cord injury (SCI), though the roles of differentiated central and peripheral fatigue during exercise are not clear. We aimed to model differentiated RPE responses during graded arm cycling in individuals with SCI and describe their relationship to cardiorespiratory outcomes. METHODS: Thirty-six individuals with SCI (13 paraplegia; 23 tetraplegia) completed a maximal graded-arm cycling exercise test to volitional exhaustion (5W/min paraplegia; 10W/min tetraplegia)...
January 10, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28078075/a-design-method-for-fes-bone-health-therapy-in-sci
#9
Brian Andrews, James Shippen, Monica Armengol, Robin Gibbons, William Holderbaum, William Harwin
FES assisted activities such as standing, walking, cycling and rowing induce forces within the leg bones and have been proposed to reduce osteoporosis in spinal cord injury (SCI). However, details of the applied mechanical stimulus for osteogenesis is often not reported. Typically, comparisons of bone density results are made after costly and time consuming clinical trials. These studies have produced inconsistent results and are subject to sample size variations. Here we propose a design process that may be used to predict the clinical outcome based on biomechanical simulation and mechano-biology...
September 15, 2016: European Journal of Translational Myology
https://www.readbyqxmd.com/read/28077174/mutant-hspb1-causes-loss-of-translational-repression-by-binding-to-pcbp1-an-rna-binding-protein-with-a-possible-role-in-neurodegenerative-disease
#10
Thomas Geuens, Vicky De Winter, Nicholas Rajan, Tilmann Achsel, Ligia Mateiu, Leonardo Almeida-Souza, Bob Asselbergh, Delphine Bouhy, Michaela Auer-Grumbach, Claudia Bagni, Vincent Timmerman
The small heat shock protein HSPB1 (Hsp27) is an ubiquitously expressed molecular chaperone able to regulate various cellular functions like actin dynamics, oxidative stress regulation and anti-apoptosis. So far disease causing mutations in HSPB1 have been associated with neurodegenerative diseases such as distal hereditary motor neuropathy, Charcot-Marie-Tooth disease and amyotrophic lateral sclerosis. Most mutations in HSPB1 target its highly conserved α-crystallin domain, while other mutations affect the C- or N-terminal regions or its promotor...
January 11, 2017: Acta Neuropathologica Communications
https://www.readbyqxmd.com/read/28072705/posterior-only-vertebral-column-resection-for-revision-surgery-in-post-laminectomy-rotokyphoscoliosis-associated-with-late-onset-paraplegia-a-case-report-and-literature-review
#11
Youping Tao, Jigong Wu, Huasong Ma
RATIONALE: Severe post-laminectomy spinal deformity associated with late-onset paraplegia is a complex and rare disorder. Little is known about revision surgery in post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia treated by the single stage posterior-only vertebral column resection (VCR) procedure. PATIENT CONCERNS AND DIAGNOSES: The patient was a 14-year-old male diagnosed as post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28062548/modified-frozen-elephant-trunk-for-acute-type-a-aortic-dissection-a-comparative-study-with-standard-repair-technique
#12
Peter Matt, Prerana Banerjee, Martin Grapow, Florian Rueter, Ulrich Schurr, Martin Siegemund, Jens Fassl, Oliver Reuthebuch, Friedrich Eckstein
OBJECTIVES: We hypothesized that antegrade open stent graft implantation in the descending aorta during acute type A aortic dissection surgery is safe and improves patient outcome compared with the standard repair technique. METHODS: Hundred and forty-one consecutive patients underwent surgery for acute type A aortic dissection at our institution from 2010 to 2016. Of those, 104 patients underwent ascending aorta and hemiarch repair under hypothermic circulatory arrest with antegrade cerebral perfusion (standard group)...
January 5, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28054256/salivary-alpha-amylase-not-chromogranin-a-reflects-sympathetic-activity-exercise-responses-in-elite-male-wheelchair-athletes-with-or-without-cervical-spinal-cord-injury
#13
Christof A Leicht, Thomas A W Paulson, Victoria L Goosey-Tolfrey, Nicolette C Bishop
BACKGROUND: Salivary alpha amylase (sAA) and chromogranin A (sCgA) have both been suggested as non-invasive markers for sympathetic nervous system (SNS) activity. A complete cervical spinal cord injury leading to tetraplegia is accompanied with sympathetic dysfunction; the aim of this study was to establish the exercise response of these markers in this in vivo model. METHODS: Twenty-six elite male wheelchair athletes (C6-C7 tetraplegia: N = 8, T6-L1 paraplegia: N = 10 and non-spinal cord injured controls: N = 8) performed treadmill exercise to exhaustion...
December 2017: Sports Medicine—Open
https://www.readbyqxmd.com/read/28052917/a-mutation-of-ept1-selenoi-underlies-a-new-disorder-of-kennedy-pathway-phospholipid-biosynthesis
#14
Mustafa Y Ahmed, Aisha Al-Khayat, Fathiya Al-Murshedi, Amna Al-Futaisi, Barry A Chioza, J Pedro Fernandez-Murray, Jay E Self, Claire G Salter, Gaurav V Harlalka, Lettie E Rawlins, Sana Al-Zuhaibi, Faisal Al-Azri, Fatma Al-Rashdi, Amaury Cazenave-Gassiot, Markus R Wenk, Fatema Al-Salmi, Michael A Patton, David L Silver, Emma L Baple, Christopher R McMaster, Andrew H Crosby
Mutations in genes involved in lipid metabolism have increasingly been associated with various subtypes of hereditary spastic paraplegia, a highly heterogeneous group of neurodegenerative motor neuron disorders characterized by spastic paraparesis. Here, we report an unusual autosomal recessive neurodegenerative condition, best classified as a complicated form of hereditary spastic paraplegia, associated with mutation in the ethanolaminephosphotransferase 1 (EPT1) gene (now known as SELENOI), responsible for the final step in Kennedy pathway forming phosphatidylethanolamine from CDP-ethanolamine...
January 3, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28052526/effectiveness-of-a-multi-layer-foam-dressing-in-preventing-sacral-pressure-ulcers-for-the-early-acute-care-of-patients-with-a-traumatic-spinal-cord-injury-comparison-with-the-use-of-a-gel-mattress
#15
Andréane Richard-Denis, Cynthia Thompson, Jean-Marc Mac-Thiong
Individuals with spinal cord injury are at risk of sacral pressure ulcers due to, among other reasons, prolonged immobilisation. The effectiveness of a multi-layer foam dressing installed pre-operatively in reducing sacral pressure ulcer occurrence in spinal cord injured patients was compared to that of using a gel mattress, and stratified analyses were performed on patients with complete tetraplegia and paraplegia. Socio-demographic and clinical data were collected from 315 patients admitted in a level-I trauma centre following a spinal cord injury between April 2010 and March 2016...
January 4, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28045855/the-interpretation-of-muscle-motor-evoked-potentials-for-spinal-cord-monitoring
#16
Karl F Kothbauer
OBJECTIVE: To provide a summary of the intraoperative monitoring of muscle motor evoked potentials (MEPs) based on the presence-absence concept during neurosurgical operations along the spinal cord. METHOD: Expert review. DISCUSSION: The measurable parameters of MEPs, such as signal amplitudes and thresholds vary considerably both during a single surgery in a single individual patient as well as between individuals and operations. The presence or absence of responses irrespective of stimulus intensity and response amplitude is much more clearly defined...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28045241/evidence-for-and-risks-of-endovascular-treatment-of-asymptomatic-acute-type-b-aortic-dissection
#17
Rachel E Clough, Christoph A Nienaber
Acute aortic dissection is a challenging disease to manage. Type B aortic dissection has traditionally been divided temporally into acute and chronic cases but more recently this classification has been modified to include a sub-acute phase. Computed tomography is the imaging technique used most frequently in diagnosis and management. Active management of blood pressure is essential and should include beta-blockade unless contra-indicated. In-hospital outcomes are generally acceptable in patients with medically managed acute uncomplicated type B aortic dissection, with up to 90% of patients surviving to hospital discharge but by 5-years up to 50% of patients are dead with a significant proportion dying from aortic rupture...
January 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28043994/long-term-results-following-emergency-stent-graft-repair-for-traumatic-rupture-of-the-aortic-isthmus%C3%A2
#18
Cecile Martin, Frederic Thony, Mathieu Rodiere, Pierre Bouzat, Pierre Lavagne, Michel Durand, Olivier Chavanon
OBJECTIVES: Endovascular repair of traumatic injury of the aortic isthmus is a safe technique that has shown good short-term results. However, the future of these stent grafts remains unexamined, especially in relation to young patients. METHOD: Between January 2000 and December 2014, 60 patients were treated with endovascular aortic stent graft for injury of the aortic isthmus. Follow-up was done by computed tomography scans with intravenous contrast or magnetic resonance imaging associated with a chest X-ray in order to control the stent graft...
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28043447/immediate-spinal-cord-collateral-blood-flow-during-thoracic-aortic-procedures-the-role-of-epidural-arcades
#19
Fabian A Kari, Karin Wittmann, Babak Saravi, Luisa Puttfarcken, Sonja Krause, Katharina Förster, Sven Maier, Ulrich Göbel, Friedhelm Beyersdorf
The objective of this study was to investigate the functional differences between paraspinal and intraspinal compartments of the spinal collateral network and the importance of circular epidural arcades in thoracic aortic surgery. N = 33 pigs (mean body weight: 34 ± 3kg) were included. A single-inlet-model of spinal collateral flow was created: paraspinal inflow into the collateral network was isolated by cephalad and caudal interruption of inflow into epidural arcades using laminectomies. Animals were assigned to treatment groups (Treatment "open" [patent epidural arcades, n = 10] and Treatment "closed" [closed epidural arcades, n = 10]) and Sham groups (Sham "open" n = 8 and Sham "closed" n = 5)...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28043422/extent-ii-thoracoabdominal-aortic-aneurysm-repair-how-i-do-it
#20
Joseph S Coselli, Kim I de la Cruz, Ourania Preventza, Scott A LeMaire, Scott A Weldon
The primary risks associated with thoracoabdominal aortic aneurysm (TAAA) repair-namely operative death, paraplegia, and renal failure necessitating dialysis-are commonly related to the distal ischemia that occurs during aortic clamping and the disruption of vital branching arteries. Our technique for open TAAA repair has evolved over the course of 3 decades, from the unheparinized, simple "clamp-and-sew" approach learned directly from E. Stanley Crawford himself to a contemporary, multimodal strategy that uses an array of surgical adjuncts...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
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