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Spinal cord injury trials

Toscane C Noordhoff, Jan Groen, Jeroen R Scheepe, Bertil F M Blok
CONTEXT: Surgical treatment of anatomic bladder outlet obstruction (BOO) may be indicated in males with neurogenic bladder dysfunction. A bothersome complication after surgery is urinary incontinence. OBJECTIVE: To identify the optimal practice in the surgical treatment of anatomic BOO in males with neurogenic bladder dysfunction, due to multiple sclerosis, Parkinson disease, spinal cord injury (SCI), spina bifida, or cerebrovascular accident (CVA). EVIDENCE ACQUISITION: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement...
March 15, 2018: European Urology Focus
Andrea J Santamaría, Juan P Solano, Francisco D Benavides, James D Guest
Cell transplant-mediated tissue repair of the damaged spinal cord is being tested in several clinical trials. The current candidates are neural stem cells, stromal cells, and autologous Schwann cells (aSC). Due to their peripheral origin and limited penetration of astrocytic regions, aSC are transplanted intralesionally as compared to neural stem cells that are transplanted into intact spinal cord. Injections into either location can cause iatrogenic injury, and thus technical precision is important in the therapeutic risk-benefit equation...
2018: Methods in Molecular Biology
Zheng-Chao Gao, Bin-Bin Niu, Meng-Chao Gu, Yu-Huan Li, Jian-Tao Liu, Yi-Bin Wang, Xi-Jing He
OBJECTIVE: To systematically evaluate the clinical effect of high frequency repeated transcranial magnetic stimulation(HF rTMS)therapy on dyskinesia in patients with incomplete spinal cord injury. METHODS: Randomized controlled trials(RCTs) about HF rTMS therapy on patients with motor incomplete spinal cord injury were searched electronically in PubMed, Google scholar, Cochrane library, Clinical trial, Medline, Web of science, CNKI, VIP, and Wanfang database before October 2016...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Chantal F Hillebregt, Eline W M Scholten, Marjolijn Ketelaar, Marcel W M Post, Johanna M A Visser-Meily
INTRODUCTION: Many patients and family members experience a large gap between the protected environment during inpatient medical rehabilitation and life in the community after discharge. They feel insufficiently prepared to cope with the consequences of their disability in daily life. This study protocol describes the design measuring the effectiveness and implementation of family group conferences on the empowerment of patients with a high risk of chronic disability and their significant others...
March 8, 2018: BMJ Open
Katsuhiro Yamanaka, Mohamed Eldeiry, Muhammad Aftab, Joshua Mares, Thomas J Ryan, Xianzhong Meng, Michael J Weyant, Joseph C Cleveland, David A Fullerton, T Brett Reece
BACKGROUND: Paraplegia remains the most feared complication of complex thoracoabdominal aortic intervention. Although erythropoietin (EPO) has demonstrated neuroprotective effects in spinal cord ischemia, it does not work until expression of the beta common receptor subunit of the EPO receptor (βcR) is induced by ischemia. We hypothesized that the βcR can be induced by diazoxide (DZ), amplifying the neuroprotective effects of EPO in spinal cord ischemia-reperfusion injury. METHODS: For the DZ time trial, adult male C57/BL6 mice received DZ (20 mg/kg) by oral gavage...
February 9, 2018: Journal of Thoracic and Cardiovascular Surgery
Kerri A Morgan, Kelly L Taylor, Susan M Tucker, W Todd Cade, Joseph W Klaesner
OBJECTIVE: Determine the validity and reliability of an exercise testing protocol to evaluate cardiorespiratory measures in manual wheelchair users (MWUs) with spinal cord injury (SCI) using a roller-based (RS) wheelchair system. DESIGN: Repeated measures within-subject design. SETTING: Community-based research laboratory. PARTICIPANTS: Ten adults with SCI requiring the use of a manual wheelchair. INTERVENTIONS: Not applicable...
March 8, 2018: Journal of Spinal Cord Medicine
Gabriel Ziegler, Patrick Grabher, Alan Thompson, Daniel Altmann, Markus Hupp, John Ashburner, Karl Friston, Nikolaus Weiskopf, Armin Curt, Patrick Freund
OBJECTIVE: To quantify atrophy, demyelination, and iron accumulation over 2 years following acute spinal cord injury and to identify MRI predictors of clinical outcomes and determine their suitability as surrogate markers of therapeutic intervention. METHODS: We assessed 156 quantitative MRI datasets from 15 patients with spinal cord injury and 18 controls at baseline and 2, 6, 12, and 24 months after injury. Clinical recovery (including neuropathic pain) was assessed at each time point...
March 7, 2018: Neurology
Cheng-Hua Wu, Hui-Fen Mao, Jwu-Sheng Hu, Ting-Yun Wang, Yi-Jeng Tsai, Wei-Li Hsu
BACKGROUND: Powered exoskeleton can improve the mobility for people with movement deficits by providing mechanical support and facilitate the gait training. This pilot study evaluated the effect of gait training using a newly developed powered lower limb exoskeleton robot for individuals with complete spinal cord injury (SCI). METHODS: Two participants with a complete SCI were recruited for this clinical study. The powered exoskeleton gait training was 8 weeks, 1 h per session, and 2 sessions per week...
March 5, 2018: Journal of Neuroengineering and Rehabilitation
Clark R Dickerson, Talia Alenabi, Bernard J Martin, Don B Chaffin
This study aimed to compare the activity of four shoulder muscles in individuals with low back pain (LBP), spinal cord injuries (SCI) and a control group, during one-handed load transfer trials. Nine individuals with minimum one-year of LBP, eleven with thoracic/lumbar SCI and nine healthy controls participated in this study. The activations of anterior deltoid, upper trapezius, infraspinatus and pectoralis major were recorded by surface EMG during one-handed transferring of a cylinder from a home shelve to six spatially distributed target shelves...
March 8, 2018: Ergonomics
Nick Jeffery, C Elizabeth Boudreau, Megan Konarik, Travis Mays, Virginia Fajt
Background: Glyburide (also known as glibenclamide) is effective in reducing the severity of tissue destruction and improving functional outcome after experimental spinal cord injury in rodents and so has promise as a therapy in humans. There are many important differences between spinal cord injury in experimental animals and in human clinical cases, making it difficult to introduce new therapies into clinical practice. Spinal cord injury is also common in pet dogs and requires new effective therapies, meaning that they can act as a translational model for the human condition while also deriving direct benefits from such research...
2018: PeerJ
Øyvind Heiberg Sundby, Ingebjørg Irgens, Lars Øivind Høiseth, Iacob Mathiesen, Eivind Lundgaard, Hanne Haugland, Harald Weedon-Fekjær, Jon O Sundhagen, Gunnar Sandbæk, Jonny Hisdal
STUDY DESIGN: Randomized, assessor-blinded crossover pilot study. OBJECTIVES: To explore the use of an intermittent negative pressure (INP) device for home use in addition to standard wound care (SWC) for patients with spinal cord injury (SCI) and chronic leg and foot ulcers before conducting a superiority trial. SETTING: Patient homes and outpatient clinic. METHODS: A 16-week crossover trial on 9 SCI patients (median age: 57 years, interquartile range [IQR] 52-66), with leg ulcers for 52 of weeks (IQR: 12-82) duration...
March 1, 2018: Spinal Cord
Dany H Gagnon, Manuel J Escalona, Martin Vermette, Lívia P Carvalho, Antony D Karelis, Cyril Duclos, Mylène Aubertin-Leheudre
BACKGROUND: For individuals who sustain a complete motor spinal cord injury (SCI) and rely on a wheelchair as their primary mode of locomotion, overground robotic exoskeletons represent a promising solution to stand and walk again. Although overground robotic exoskeletons have gained tremendous attention over the past decade and are now being transferred from laboratories to clinical settings, their effects remain unclear given the paucity of scientific evidence and the absence of large-scale clinical trials...
March 1, 2018: Journal of Neuroengineering and Rehabilitation
Jürgen Pannek, Susanne Pannek-Rademacher, Mohinder S Jus, Jens Wöllner, Jörg Krebs
Context/Objective to investigate the usefulness of classical homeopathy for the prevention of recurrent urinary tract infections (UTI) in patients with spinal cord injury (SCI). Design prospective study. Setting rehabilitation center in Switzerland. Participants patients with chronic SCI and ≥3 UTI/year. Interventions Participants were treated either with a standardized prophylaxis alone or in combination with homeopathy. Outcome measures The number of UTI, general and specific quality of life (QoL), and satisfaction with homeopathic treatment were assessed prospectively for one year...
February 27, 2018: Journal of Spinal Cord Medicine
Ephron S Rosenzweig, John H Brock, Paul Lu, Hiromi Kumamaru, Ernesto A Salegio, Ken Kadoya, Janet L Weber, Justine J Liang, Rod Moseanko, Stephanie Hawbecker, J Russell Huie, Leif A Havton, Yvette S Nout-Lomas, Adam R Ferguson, Michael S Beattie, Jacqueline C Bresnahan, Mark H Tuszynski
We grafted human spinal cord-derived neural progenitor cells (NPCs) into sites of cervical spinal cord injury in rhesus monkeys (Macaca mulatta). Under three-drug immunosuppression, grafts survived at least 9 months postinjury and expressed both neuronal and glial markers. Monkey axons regenerated into grafts and formed synapses. Hundreds of thousands of human axons extended out from grafts through monkey white matter and synapsed in distal gray matter. Grafts gradually matured over 9 months and improved forelimb function beginning several months after grafting...
February 26, 2018: Nature Medicine
Rainer Abel
The establishment of a new technology into the mainstream of treatment, such as spinal surgery for traumatic spinal cord injury, only rarely happens after being scrutinized in trials. Usually, a new technology is widely adopted when it offers an easily identifiable advantage over other treatment choices. In the case of spinal fixation, this advantage is the omission of a prolonged immobilization. However, this does not automatically preclude that the final outcome of the treatment is better. It does not imply that associated assumptions, such as the benefit of early decompression toward neurological improvement, are true as well...
2018: Spinal Cord Series and Cases
I David Kaye, Alex R Vaccaro
Spinal cord injury can be a life-altering trauma for patients and can be costly to patients and society alike. Generally recognized as biphasic, these injuries have both primary and secondary drivers. Although the primary insult is largely unavoidable, prevention of secondary injury mechanisms-and the resultant cascade-has been a target of substantial research. Continued spinal cord compression has been recognized as one of several deleterious secondary mechanisms, and decompressive and stabilization surgery has been routinely used for neuroprotection in this setting...
2018: Spinal Cord Series and Cases
Shao-Xia Chen, Guang-Jie Liao, Pei-Wen Yao, Shao-Kun Wang, Yong-Yong Li, Wei-An Zeng, Xian-Guo Liu, Ying Zang
Both calpain-2 (CALP2) and tumor necrosis factor-α (TNF-α) contribute to persistent bilateral hypersensitivity in animals subjected to L5 ventral root transection (L5-VRT), a model of selective motor fiber injury without sensory nerve damage. However, specific upstream mechanisms regulating TNF-α overexpression and possible relationships linking CALP2 and TNF-α have not yet been investigated in this model. We examined changes in CALP2 and TNF-α protein levels and alterations in bilateral mechanical threshold within 24 h following L5-VRT model injury...
February 22, 2018: Neuroscience
Abdullah Arab, Fahad Alkherayf, Adam Sachs, Eugene K Wai
Objective  Cervical spine can be stabilized by different techniques. One of the common techniques used is the lateral mass screws (LMSs), which can be inserted either by freehand techniques or three-dimensional (3D) navigation system. The purpose of this study is to evaluate the difference between the 3D navigation system and the freehand technique for cervical spine LMS placement in terms of complications. Including intraoperative complications (vertebral artery injury [VAI], nerve root injury [NRI], spinal cord injury [SCI], lateral mass fracture [LMF]) and postoperative complications (screw malposition, screw complications)...
January 2018: Journal of Neurological Surgery Reports
S Al Kandari, L Prasad, M Al Kandari, U Ramachandran, A Krassioukov
STUDY DESIGN: Retrospective observational. OBJECTIVES: To compare objective (neurological examination) and subjective (patients perception) recovery in patients with spinal cord injury (SCI) who chose to undergo cell transplantation therapies (CTT) outside of clinical trials abroad. SETTING: Physical Medicine and Rehabilitation Hospital, Kuwait. METHODS: Nine patients with SCI who had undergone CTT outside Kuwait were identified and their neurological pre-transplantation evaluation according the International Standards for Neurological Classification of SCI (ISNCSCI) was collected from hospital records...
February 22, 2018: Spinal Cord
Giorgio Scivoletto, Chiara Pavese, Lucas M Bachmann, Martin Schubert, Armin Curt, Enrico Finazzi Agro, Alfons G Kessels, Thomas M Kessler
OBJECTIVE: The recovery of bladder function after spinal cord injury (SCI) is of major importance for patients and caregivers. We recently developed prediction models of bladder outcomes (defined as the capacity of storing the urine and emptying completely the bladder) 1 year after a SCI of traumatic etiology and investigated if these models would also be applicable to patients with ischemic SCI. PATIENTS AND METHODS: From the European multicenter study about spinal cord injury (EMSCI), we extracted data of all ischemic SCI patients with available neurological and functional data (according to the International Standards for Neurological Classification of Spinal Cord Injury, ISNCSCI, and Spinal Cord Independence Measure, SCIM) within 40 days and bladder outcomes 1 year after ischemia...
February 21, 2018: Neurourology and Urodynamics
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