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Spinal cord injury trials

Zsófia Bérces, Kinga Tóth, Gergely Márton, Ildikó Pál, Bálint Kováts-Megyesi, Zoltán Fekete, István Ulbert, Anita Pongrácz
Neural interface technologies including recording and stimulation electrodes are currently in the early phase of clinical trials aiming to help patients with spinal cord injuries, degenerative disorders, strokes interrupting descending motor pathways, or limb amputations. Their lifetime is of key importance; however, it is limited by the foreign body response of the tissue causing the loss of neurons and a reactive astrogliosis around the implant surface. Improving the biocompatibility of implant surfaces, especially promoting neuronal attachment and regeneration is therefore essential...
October 24, 2016: Scientific Reports
Ana Claudia Paradella, André Ferraz de Arruda Musegante, Carlos Roberto Brites
Intravesical botulinum toxin A (BoNTA) injection has been widely used for the treatment of detrusor overactivity in patients with neurogenic bladder due to spinal cord injury who do not respond to conventional treatment. There is no consensus about antibiotic prophylaxis for this procedure. We conducted a retrospective analysis of medical records of adult patients with spinal cord injury who underwent detrusor BoNTA injection between January of 2007 and December of 2013 in a rehabilitation hospital. Occurrence of symptomatic urinary tract infection (UTI) was assessed in 3 groups in accordance with their use of antibiotics (prophylactic dosage, 3 days, more than 3 days) for the treatment of asymptomatic bacteriuria...
October 17, 2016: Brazilian Journal of Infectious Diseases
C Calhoun Thielen, C Sadowsky, L C Vogel, H Taylor, L Davidson, J Bultman, J Gaughan, M J Mulcahey
STUDY DESIGN: Mixed methods were used in this study. The appropriateness of the levels of the Walking Index for Spinal Cord Injury II (WISCI-II) for application in children was critically reviewed by physical therapists using the Modified Delphi Technique, and the inter- and intra-rater reliability of the WISCI-II in children was evaluated. OBJECTIVES: To examine the construct validity, and to establish reliability of the WISCI-II related to its use in children with spinal cord injury (SCI)...
October 18, 2016: Spinal Cord
Markus Wirz, Orpheus Mach, Doris Maier, John Benito-Penalva, Julian Taylor, Ana Esclarin, Volker Dietz
The aim of this study was to evaluate if the effect of longer training times (50 instead of 25 minutes per day) using a robotic device results in a better outcome of walking ability of subjects with a sub-acute motor complete (AIS B) and incomplete (AIS C) spinal cord injury (SCI). Twenty-one patients were enrolled in the study whereof, 18 completed on average 34 trainings in eight weeks. Longer training times resulted in better locomotor function. The second important result of the study is that a beneficial effect can be achieved by the application of a robotic device for prolonged training sessions without requiring more personal resources...
October 18, 2016: Journal of Neurotrauma
Qin-Qin He, Liu-Lin Xiong, Fei Liu, Xiang He, Guo-Ying Feng, Fei-Fei Shang, Qing-Jie Xia, You-Cui Wang, De-Lu Qiu, Chao-Zhi Luo, Jia Liu, Ting-Hua Wang
Neuroregeneration and apoptosis are two important pathophysiologic changes after spinal cord injury (SCI), but their underlying mechanisms remain unclear. MicroRNAs (miRNAs) play a crucial role in the regulation of neuroregeneration and neuronal apoptosis, research areas that have been greatly expanded in recent years. Here, using miRNA arrays to profile miRNA transcriptomes, we demonstrated that miR-127-3p was significantly down-regulated after spinal cord transection (SCT). Then, bioinformatics analyses and experimental detection showed that miR-127-3p exhibited specific effects on the regulation of neurite outgrowth and the induction of neuronal apoptosis by regulating the expression of the mitochondrial membrane protein mitoNEET...
October 17, 2016: Scientific Reports
Zhicheng Wang, Jia Nong, Robert B Shultz, Zhiling Zhang, Veronica J Tom, Ravi K Ponnappan, Yinghui Zhong
Many mechanisms contribute to the secondary injury cascades following traumatic spinal cord injury (SCI). However, most current treatment strategies only target one or a few elements in the injury cascades, and have been largely unsuccessful in clinical trials. Minocycline hydrochloride (MH) is a clinically available antibiotic and anti-inflammatory drug that has been shown to target a broad range of secondary injury mechanisms via its anti-inflammatory, anti-oxidant, and anti-apoptotic properties. However, MH is only neuroprotective at high concentrations...
October 5, 2016: Biomaterials
Patricia Fronek, Melissa B Kendall
PURPOSE: A randomized controlled trial was conducted to evaluate the impact of Professional Boundaries for Health Professionals (PBHP) training program on the knowledge, comfort, experience, and ethical decision-making of multidisciplinary practitioners facing client-practitioner boundary dilemmas. METHODS: In all, 36 rehabilitation practitioners from an Australian state-wide spinal cord injuries service were assigned to experimental and control groups. The Boundaries in Practice (BIP) Scale measured outcomes at four points: pre, post, 3 months, and 1 year...
October 14, 2016: Disability and Rehabilitation
Jacob Kjell, Lars Olson
A long-standing goal of spinal cord injury research is to develop effective spinal cord repair strategies for the clinic. Rat models of spinal cord injury provide an important mammalian model in which to evaluate treatment strategies and to understand the pathological basis of spinal cord injuries. These models have facilitated the development of robust tests for assessing the recovery of locomotor and sensory functions. Rat models have also allowed us to understand how neuronal circuitry changes following spinal cord injury and how recovery could be promoted by enhancing spontaneous regenerative mechanisms and by counteracting intrinsic inhibitory factors...
October 1, 2016: Disease Models & Mechanisms
Ashraf S Gorgey, Zachary A Graham, William A Bauman, Christopher Cardozo, David R Gater
STUDY DESIGN: Longitudinal design. OBJECTIVES: The study determined the effects of two forms of exercise training on the abundance of two proteins, (glucose transporter-4 [GLUT-4], adenosine monophosphate kinase [AMPK]) involved in glucose utilization and the transcriptional coactivator that regulates the genes involved in energy metabolism and mitochondrial biogenesis (peroxisome proliferator-activated receptor (PPAR) coactivator 1 alpha [PGC-1α]), in muscles in men with chronic motor-complete spinal cord injury (SCI)...
October 13, 2016: Journal of Spinal Cord Medicine
Atif S Khan, Susan K Patrick, Francois D Roy, Monica A Gorassini, Jaynie F Yang
The neural plasticity of spinal reflexes after two contrasting forms of walking training was determined in individuals with chronic, motor-incomplete spinal cord injury (SCI). Endurance Training involved treadmill walking for as long as possible, and Precision Training involved walking precisely over obstacles and onto targets overground. Twenty participants started either Endurance or Precision Training for 2 months and then crossed over after a 2-month rest period to the other form of training for 2 months...
2016: Neural Plasticity
Habiba Aurang Zeb, Ishaq Nasib Khan, Iqbal Munir, Wafaa Saadeldin Ramadan, Mian Afaq Ahmad, Deema Hussein, Mohammad Amjad Kamal, Saleh Al Karim
Injuries to the spinal cord often have devastating physiological impacts due to the organ's vital role in neuro-impulse communications between muscles and the brain. Spinal Cord Injuries (SCIs) have recently been estimated to affect up to 80,000 individuals per year worldwide, with most occurring following a traumatic event. Unfortunately, effective treatments standardised globally for patients with SCIs have not yet been established. For many years, inadequate understanding of the complexities of the Central and Peripheral Nervous Systems and Neurogenesis has limited progression towards effective cures...
October 4, 2016: CNS & Neurological Disorders Drug Targets
Samira Saadoun, Marios C Papadopoulos
This paper challenges the current management of acute traumatic spinal cord injury based on our experience with monitoring from the injury site in the neurointensive care unit. We argue that the concept of bony decompression is inadequate. The concept of optimum spinal cord perfusion pressure, which differs between patients, is introduced. Such variability suggests individualized patient treatment. Failing to optimize spinal cord perfusion limits the entry of systemically administered drugs into the injured cord...
October 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
Andrew Agbay, John M Edgar, Meghan Robinson, Tara Styan, Krista Wilson, Julian Schroll, Junghyuk Ko, Nima Khadem Mohtaram, Martin Byung-Guk Jun, Stephanie M Willerth
Ongoing clinical trials are evaluating the use of stem cells as a way to treat traumatic spinal cord injury (SCI). However, the inhibitory environment present in the injured spinal cord makes it challenging to achieve the survival of these cells along with desired differentiation into the appropriate phenotypes necessary to regain function. Transplanting stem cells along with an instructive biomaterial scaffold can increase cell survival and improve differentiation efficiency. This study reviews the literature discussing different types of instructive biomaterial scaffolds developed for transplanting stem cells into the injured spinal cord...
2016: Cells, Tissues, Organs
Christopher D L Johnson, Anthony R D'Amato, Ryan J Gilbert
There is currently no cure for individuals with spinal cord injury (SCI). While many promising approaches are being tested in clinical trials, the complexity of SCI limits several of these approaches from aiding complete functional recovery. Several different categories of biomaterials are investigated for their ability to guide axonal regeneration, to deliver proteins or small molecules locally, or to improve the viability of transplanted stem cells. The purpose of this study is to provide a brief overview of SCI, present the different categories of biomaterial scaffolds that direct and guide axonal regeneration, and then focus specifically on electrospun fiber guidance scaffolds...
2016: Cells, Tissues, Organs
Lucian Beer, Michael Mildner, Mariann Gyöngyösi, Hendrik Jan Ankersmit
For almost two decades, cell-based therapies have been tested in modern regenerative medicine to either replace or regenerate human cells, tissues, or organs and restore normal function. Secreted paracrine factors are increasingly accepted to exert beneficial biological effects that promote tissue regeneration. These factors are called the cell secretome and include a variety of proteins, lipids, microRNAs, and extracellular vesicles, such as exosomes and microparticles. The stem cell secretome has most commonly been investigated in pre-clinical settings...
October 1, 2016: Apoptosis: An International Journal on Programmed Cell Death
Qiaodan Ji, Hongchen He, Chi Zhang, Chunlan Lu, Yu Zheng, Xiao Tian Luo, Chengqi He
OBJECTIVE: To examine the effects of whole-body vibration on neuromuscular performance in people with spinal cord injury and evaluate the safe and effective vibration protocols. METHODS: PubMed, EMBASE, CINAHL and PEDro were mainly searched for English literatures. Other data sources were, Current Controlled Trials and reference lists of all relevant articles. The PEDro scale was used to evaluate the methodological quality, and the Oxford Centre for Evidence-based Medicine level of evidence was used to assess the level of evidence...
September 29, 2016: Clinical Rehabilitation
Zahra Hajimashhadi, Nahid Aboutaleb, Farinaz Nasirinezhad
Apelin is an endogenous ligand for apelin receptor (APJ) with analgesic effect on visceral, analgesic and proanalgesic influences on acute pains in animal models. The purpose of this study was to determine the possible analgesic effects of [Pyr(1)] apelin-13 on chronic pain after spinal cord injury (SCI) in rats. Animals were randomly divided into three major groups as intact, sham and SCI. The SCI group randomly allocated to four subgroups as no treatment, vehicle-treatment (normal saline: 10μl, intrathecally) and two subgroups with intrathecal injection (i...
September 2, 2016: Neuropeptides
Michael Jones, Julie Gassaway
OBJECTIVE: Peer support is an important adjunct to clinical care for people with disabilities, and may help address barriers to community reintegration. Peers offer positive role models and the benefit of learning from shared experiences of living with disability. Despite potential benefits, peer support is not consistently integrated in the rehabilitation process. This presentation describes three interventions recommended by patients, and directed by peer mentors, to promote successful community transition after rehabilitation for traumatic spinal cord injury (SCI)...
September 2016: Annals of Physical and Rehabilitation Medicine
Perrine Séguin, Kathleen Charvier, Frédérique Courtois, Corinne Del Aguila, Bruno Fernandez, Gilles Rode, Jacqueline Lornage, Alain Ruffion, Sandrine Giscard d'Estaing
OBJECTIVE: Sperm cryopreservation can be offered to men with spinal cord injury, as only 10% of spinal cord injured men (SCI) can have a child without assistive reproductive technologies (ART). Very few studies are dedicated to the outcomes of these cryopreservations. Our study aims to analyze the outcomes of these cryopreservation, namely their use or not for an ART, and to evaluate the success rate in case of ART. MATERIAL/PATIENTS AND METHODS: In May 2015, we retrospectively identified all people with stable spinal cord injury sent to the CECOS (Centre d'études de la conservation des œufs et du sperme: Egg, Sperm Embryo banking) by the department of neuroperineology based in the hospital Henry Gabrielle, for the first time between 1st January 2009 and 31st December 2013, to undergo a sperm cryopreservation of spermatozoa...
September 2016: Annals of Physical and Rehabilitation Medicine
Terri Susan Graham-Paulson, Thomas Andrew William Paulson, Claudio Perret, Keith Tolfrey, Philip Cordery, Victoria Louise Goosey-Tolfrey
PURPOSE: To investigate the absorption curve and acute effects of caffeine at rest in individuals with no spinal cord injury (SCI), paraplegia (PARA) and tetraplegia (TETRA). METHODS: Twenty-four healthy males (8 able-bodied (AB), 8 PARA and 8 TETRA) consumed 3 mg[BULLET OPERATOR]kg caffeine anhydrous (CAF) in a fasted state. Plasma caffeine [CAF], glucose, lactate, free-fatty acid [FFA] and catecholamine concentrations were measured during a 150 min rest period...
September 23, 2016: Medicine and Science in Sports and Exercise
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