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Spinal Clearance

Ala'a O Oteir, Karen Smith, Johannes U Stoelwinder, Shelley Cox, James W Middleton, Paul A Jennings
BACKGROUND: Traumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI. METHODS: This is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI...
December 2016: Injury Epidemiology
Paschalis Theotokis, Olga Touloumi, Roza Lagoudaki, Evangelia Nousiopoulou, Evangelia Kesidou, Spyridon Siafis, Theodoros Tselios, Athanasios Lourbopoulos, Dimitrios Karacostas, Nikolaos Grigoriadis, Constantina Simeonidou
BACKGROUND: Nogo-A and its putative receptor NgR are considered to be among the inhibitors of axonal regeneration in the CNS. However, few studies so far have addressed the issue of local NgR complex multilateral localization within inflammation in an MS mouse model of autoimmune demyelination. METHODS: Chronic experimental autoimmune encephalomyelitis (EAE) was induced in C57BL/6 mice. Analyses were performed on acute (days 18-22) and chronic (day 50) time points and compared to controls...
October 11, 2016: Journal of Neuroinflammation
Aurélie Rochefolle, Chloé Chazaud, Amandine Guinet-Lacoste, Sophie Jacquin-Courtois, Catherine Rioufol, Jacques Luaute, Gilles Rode, Emmanuelle Carré
OBJECTIVE: Patients with spinal cord injury suffer from urinary tract infection (UTI) repeatedly. An assessment of the professional practices in UTI has been set up since 2013. The aim of this study is to assess the impact of physician/pharmacist's collaboration on 3 quality indicators (QI) in UTI during 2014/2015. MATERIAL/PATIENTS AND METHODS: At the beginning of the treatment and then twice a week, pharmacists validate every antibiotic therapy. QI assess the conformity of the duration, the conformity of the dosage and the conformity to the susceptibility testing...
September 2016: Annals of Physical and Rehabilitation Medicine
Herman Azanmasso, Samira Lahrabli, Etienne Alagnidé, Yvette Moigny, Fatima Lmidmani, Toussaint G Kpadonou, Abdellatif El Fatimi, Béatrice Carra, Jocelyne Boivin
OBJECTIVE: The life expectancy for SCI has become comparable to that of the general population. This improvement is the result of a follow-codified neuro-urology. The latest recommendations of GENULF constitute the largest part of this monitoring. OBJECTIVE: Make an inventory on the application of these recommendations and analyze failures in the application and the factors associated with these facts. MATERIALS/PATIENTS AND METHODS: This was a retrospective descriptive study on patients followed north hospital site Carbet Caribbean and seen from 1 January 2014 to 1 January 2016 as part of a re-hospitalization for functional assessment and neuro-urological annual control as recommended by the GENULF...
September 2016: Annals of Physical and Rehabilitation Medicine
Diane E Griffin, Victoria K Baxter
Infection of mice with Sindbis virus (SINV) produces encephalomyelitis and provides a model for examination of the central nervous system (CNS) immune response to alphavirus infection. Clearance of infectious virus is accomplished through a cooperative effort between SINV-specific antibody and interferon gamma (IFN-γ), but the regulatory interactions are poorly understood. To determine the effects of IFN-γ on clinical disease and the antiviral immune response, C57BL/6 mice lacking IFN-γ (Ifng-/-) or IFN-γ receptor (Ifngr1-/-) were studied in comparison to wild-type (WT) mice...
September 22, 2016: Journal of General Virology
Sara D Reis, Brígida R Pinho, Jorge M A Oliveira
Polyglutamine expansion mutations in specific proteins underlie the pathogenesis of a group of progressive neurodegenerative disorders, including Huntington's disease, spinal and bulbar muscular atrophy, dentatorubral-pallidoluysian atrophy, and several spinocerebellar ataxias. The different mutant proteins share ubiquitous expression and abnormal proteostasis, with misfolding and aggregation, but nevertheless evoke distinct patterns of neurodegeneration. This highlights the relevance of the full protein context where the polyglutamine expansion occurs and suggests different interactions with the cellular proteostasis machinery...
September 22, 2016: Molecular Neurobiology
Louise Rose, Neill K Adhikari, Joseph Poon, David Leasa, Douglas A McKim
BACKGROUND: Critically ill mechanically ventilated patients experience impaired airway clearance due to ineffective cough and impaired secretion mobilization. Cough augmentation techniques, including mechanical insufflation-exsufflation (MI-E), manually assisted cough, and lung volume recruitment, improve cough efficiency. Our objective was to describe use, indications, contraindications, interfaces, settings, complications, and barriers to use across Canada. METHODS: An e-mail survey was sent to nominated local survey champions in eligible Canadian units (ICUs, weaning centers, and intermediate care units) with 4 telephone/e-mail reminders...
October 2016: Respiratory Care
Sina Pourtaheri, Kimona Issa, Tyler Stewart, Yashika Patel, Kumar Sinha, Ki Hwang, Arash Emami
BACKGROUND: How the relative volume of an epidural abscess on MRI affects outcomes with antibiotics alone has limited literature. The purpose of this study was to identify which infected epidural collections will reabsorb with antibiotics alone. Specifically, what is the critical size and enhancement on contrast MRIs to require a drainage procedure? MATERIALS AND METHODS: A retrospective review of all spinal osteomyelitis patients from 2001-2012 was performed. Inclusion criteria included appropriate initial imaging, lab results, no drainage procedures of collections, and no treatment prior to admission at an outside institution...
September 10, 2016: Surgical Technology International
Kimona Issa, Sina Pourtaheri, Anita Vijapura, Tyler Stewart, Kumar Sinha, Ki Hwang, Arash Emami
INTRODUCTION: Obtaining blood or tissue cultures prior to administration of antibiotics has been the standard of care in the treatment of osteomyelitis of the spine. A delay in diagnosis of vertebral osteomyelitis is the primary culprit for the inaccuracy of blood cultures and biopsies. The purpose of this study was to evaluate the outcomes of spinal osteomyelitis in patients where the infecting organism was identified through cultures in contrast to cases where the cultures continued to be negative...
September 10, 2016: Surgical Technology International
Ehsan Abolfazli, Nasser Fatouraee, Amir Saeed Seddighi
Lumbar drainage is considered a therapeutic measure in treatment of subarachnoid hemorrhage. However, the evidence on the effectiveness of this method is still inconclusive. In this study, a subject-specific three dimensional model of the cerebrospinal fluid (CSF) pathways and compartments was developed. The ventricular and the cranial and spinal subarachnoid spaces were reconstructed using magnetic resonance images. Occurrence of subarachnoid hemorrhage was modeled. Since the presence of blood in the CSF spaces is known to be the cause of complications such as cerebral vasospasm, concentration of blood in these spaces was investigated...
October 1, 2016: Computers in Biology and Medicine
Elisa Bisicchia, Laura Latini, Virve Cavallucci, Valeria Sasso, Vanessa Nicolin, Marco Molinari, Marcello D'Amelio, Maria Teresa Viscomi
Spinal cord injuries (SCIs) are devastating conditions of the central nervous system (CNS) for which there are no restorative therapies. Neuronal death at the primary lesion site and in remote regions that are functionally connected to it is one of the major contributors to neurological deficits following SCI.Disruption of autophagic flux induces neuronal death in many CNS injuries, but its mechanism and relationship with remote cell death after SCI are unknown. We examined the function and effects of the modulation of autophagy on the fate of axotomized rubrospinal neurons in a rat model of spinal cord dorsal hemisection (SCH) at the cervical level...
August 11, 2016: Molecular Neurobiology
M A Denys, A Viaene, A S Goessaert, F Vanhaverbeke, P Hoebeke, A Raes, K Everaert
PURPOSE: To evaluate nocturnal urine production and circadian rhythms of renal functions (glomerular filtration, water and solute diuresis) in adults with a spinal cord injury compared to controls. MATERIALS AND METHODS: This prospective observational study was conducted in Ghent University Hospital, Belgium. Participants were asked to perform a 24h urine collection and a blood sample was taken to calculate diuresis rate and renal clearance of creatinine, free water, solutes, sodium and urea...
August 6, 2016: Journal of Urology
Million A Tegenge, Linda S Von Tungeln, Robert J Mitkus, Steven A Anderson, Michelle M Vanlandingham, Richard A Forshee, Frederick A Beland
Squalene is a component of oil-in-water emulsion adjuvants developed for potential use in some influenza vaccines. The biodistribution of the squalene-containing emulsion adjuvant (AddaVax™) alone and as part of complete H5N1 vaccine was quantified in mechanistically and toxicologically relevant target tissues up to 336 h (14 days) following injection into quadriceps muscle. At 1 h, about 55% of the intramuscularly injected dose of squalene was detected in the local quadriceps muscles and this decreased to 26% at 48 h...
August 4, 2016: Regulatory Toxicology and Pharmacology: RTP
Aaron J Buckland, Silvia Bressan, Helen Jowett, Michael B Johnson, Warwick J Teague
OBJECTIVE: Evidence-based decision-making tools are widely used to guide cervical spine assessment in adult trauma patients. Similar tools validated for use in injured children are lacking. A paediatric-specific approach is appropriate given important differences in cervical spine anatomy, mechanism of spinal injury and concerns over ionising radiation in children. The present study aims to survey physicians' knowledge and application of cervical spine assessment in injured children. METHODS: A cross-sectional survey of physicians actively engaged in trauma care within a paediatric trauma centre was undertaken...
October 2016: Emergency Medicine Australasia: EMA
Kenji Inaba, Saskya Byerly, Lisa D Bush, Mathew J Martin, David Martin, Kimberly A Peck, Galinos Barmparas, Matthew J Bradley, Joshua P Hazelton, Raul Coimbra, Asad J Choudhry, Carlos V R Brown, Chad G Ball, Jill R Cherry-Bukowiec, Clay Cothren Burlew, Bellal Joseph, Julie Dunn, Christian T Minshall, Matthew M Carrick, Gina M Berg, Demetrios Demetriades
BACKGROUND: For blunt trauma patients who have failed the NEXUS low-risk criteria, the adequacy of CT as the definitive imaging modality for clearance remains controversial. The purpose of this study was to prospectively evaluate the accuracy of CT for the detection of clinically significant C-spine injury. METHODS: Prospective multicenter observational study (09/2013-03/2015), at 18 North American Trauma Centers. All adult (≥18yo) blunt trauma patients underwent a structured clinical examination...
July 20, 2016: Journal of Trauma and Acute Care Surgery
Vahe M Zohrabian, Adam E Flanders
The goal of imaging in spine trauma is to gauge the extent of bony, vascular, and neurologic compromise. Neurologic and mechanical stability are key pieces of information that must be efficiently communicated to the referring clinician. From immobilization and steroid therapy, to vascular repair and emergent surgical intervention, clinical outcomes of spine-injured patients depend on timely and well-chosen imaging studies. Multidetector computed tomography (CT) has essentially replaced radiography in clearance of the spine and is the gold standard in evaluation of the bony spinal column...
2016: Handbook of Clinical Neurology
Niels Eijkelkamp, Cristine Steen-Louws, Sarita A Y Hartgring, Hanneke L D M Willemen, Judith Prado, Floris P J G Lafeber, Cobi J Heijnen, C E Hack, Joel A G van Roon, Annemieke Kavelaars
UNLABELLED: Chronic pain is a major clinical problem that is difficult to treat and requires novel therapies. Although most pain therapies primarily target neurons, neuroinflammatory processes characterized by spinal cord and dorsal root ganglion production of proinflammatory cytokines play an important role in persistent pain states and represent potential therapeutic targets. Anti-inflammatory cytokines are attractive candidates to regulate aberrant neuroinflammatory processes, but the therapeutic potential of these cytokines as stand-alone drugs is limited...
July 13, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Kaushiki Biswas, Dhriti Chatterjee, Sankar Addya, Reas S Khan, Lawrence C Kenyon, Alexander Choe, Randall J Cohrs, Kenneth S Shindler, Jayasri Das Sarma
The presence of immunoglobulin oligoclonal bands in the cerebrospinal fluid of Multiple Sclerosis (MS) patients supports the hypothesis of an infectious etiology, although the antigenic targets remain elusive. Neurotropic mouse hepatitis virus (MHV) infection in mice provides a useful tool for studying mechanisms of demyelination in a virus-induced experimental model of MS. This study uses Affymetrix microarray analysis to compare differential spinal cord mRNA levels between mice infected with demyelinating and non-demyelinating strains of MHV to identify host immune genes expressed in this demyelinating disease model...
September 2016: Clinical Immunology: the Official Journal of the Clinical Immunology Society
Ramesh Teegala
BACKGROUND: Persistent or progressive hydrocephalus is one of the complex problems of posterior fossa tumors associated with hydrocephalus. The author evaluated the effectiveness of single-stage tumor decompression associated with a stent technique (trans aqueductal third ventricle - Cervical subarachnoid stenting) as an adjuvant cerebro spinal fluid (CSF) diversion procedure in controlling the midline posterior fossa tumors with hydrocephalus. MATERIALS AND METHODS: Prospective clinical case series of 15 patients was evaluated from July 2006 to April 2012...
July 2016: Asian Journal of Neurosurgery
Heshmatollah Sofimajidpour, Pooya Kolahghoci, Fardin Gharibi
PURPOSE: To investigate technical problems, complications and stone clearance rate in patients with spinal neuropathy who had undergone percutaneous nephrolithotomy. MATERIALS AND METHODS: This cross-sectional study was done between 2004 and 2013 on 29 patients with both spinal cord neuropathy and kidney stones who were chosen for percutaneous nephrolithotomy in Sanandaj city, Iran. The data were obtained from patients' medical records and were documented in a researcher-made checklist...
2016: Urology Journal
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