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Autonomic dysreflexia

Christopher R West, Jordan W Squair, Laura McCracken, Katharine D Currie, Rishi Somvanshi, Violet Yuen, Aaron A Phillips, Ujendra Kumar, John H McNeill, Andrei V Krassioukov
Autonomic dysreflexia (AD), which describes episodic hypertension, is highly prevalent in people with spinal cord injury (SCI). In non-SCI, primary hypertension depresses cardiac contractile reserve via β-adrenergic mechanisms. In this study, we investigated whether AD contributes to the impairment in cardiac contractile function that accompanies SCI. We induced SCI in rodents and stratified them into sham, SCI, or SCI plus repetitive induction of AD. At 6-week post-SCI, we assessed cardiac function using in vivo (speckle-tracking echocardiography), ex vivo (working heart), and molecular approaches (Western blot)...
November 2016: Hypertension
Charlotte Pineau, Brice Lavrard, François Boyer, Laëtitia Percebois-Macadré
OBJECTIVE: MRI has highly changed the assessment of post-traumatic syringomyelia (PTS), roughly estimated at 30% nowadays. Times to onset (TTO) symptoms are random. This case report describes how hyperhidrosis appeared and revealed PTS diagnosis. OBSERVATIONS: Mr M., 43-year-old, is rehabilitation inpatient after T10 AIS A spinal cord injury (SCI). Three months after this event, Mr M complains of acute hyperhidrosis crisis always located below the injury, which can occur at any time of the day, particularly when he moves...
September 2016: Annals of Physical and Rehabilitation Medicine
Ryan J Solinsky, Aaron E Bunnell, Jelena N Svircev, Stephen P Burns
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Zachary C Fausel, Dale C Strasser
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Vovanti Jones, Ankur Verma, Ray Lee
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
H Le Liepvre, A Dinh, B Idiard-Chamois, E Chartier-Kastler, V Phé, A Even, G Robain, P Denys
STUDY DESIGN: A retrospective observational study. OBJECTIVE: To describe specificities of pregnancy in a traumatic spinal cord-injured (SCI) population managed by a coordinated medical care team involving physical medicine and rehabilitation (PMR) physicians, urologists, infectious diseases' physicians, obstetricians and anaesthesiologists. SETTING: NeuroUrology Department in a University Hospital, France. METHODS: All consecutive SCI pregnant women managed between 2001 and 2014 were included...
September 27, 2016: Spinal Cord
Hadis Sabour, Abbas Norouzi-Javidan, Zahra Soltani, Seyede Azemat Mousavifar, Sahar Latifi, Seyed Hassan Emami-Razavi, Seyed Mohammad Ghodsi
BACKGROUND: Studies have demonstrated the effect of different dietary fats on blood pressure (BP) in general population. However, these associations have not yet been described in people with spinal cord injury (SCI). METHODS: Referred patients to Brain and SCI Research Center between 2011 and 2014 have been invited to participate. Only paraplegic individuals were recruited and patients with injury at cervical or higher thoracic sections were excluded to omit the bias effect of autonomic dysreflexia...
July 6, 2016: Iranian Journal of Neurology
K A Martin Ginis, J R Tomasone, M Welsford, K Ethans, A R Sinden, M Longeway, A Krassioukov
STUDY DESIGN: Single-group pre-/post-test with 3- and 6-month follow-ups. OBJECTIVES: To test the effects of the 'ABCs of AD' educational module on immediate and longer-term changes in paramedics' knowledge and beliefs about using the autonomic dysreflexia clinical practice guidelines (AD-CPGs). SETTING: Canada. METHODS: A total of 119 paramedics completed an AD knowledge test and measures of attitudes, perceived control, self-efficacy, social pressure from patients and health-care professionals, and intentions to use the AD-CPGs before and 1 week, 3 months and 6 months after viewing 'ABCs of AD'...
September 13, 2016: Spinal Cord
Sung-Il Hwang, Bum-Suk Lee, Zee-A Han, Hye-Jin Lee, Sang-Hoon Han, Myeong-Ok Kim
OBJECTIVE: To analyze the factors related to urinary tract infection (UTI) occurrence after an urodynamic study (UDS) in patients with spinal cord injury (SCI). METHODS: We retrospectively investigated the medical records of 387 patients with SCI who underwent UDS with prophylactic antibiotic therapy between January 2012 and December 2012. Among them, 140 patients met the inclusion criteria and were divided into two groups, UTI and non-UTI. We statistically analyzed the following factors between the two groups: age, sex, level of injury, SCI duration, spinal cord independence measure, non-steroidal anti-inflammatory drug use, diabetes mellitus, the American Spinal Injury Association impairment scale (AIS), lower extremity spasticity, a history of UTI within the past 4 weeks prior to the UDS, symptoms and signs of neurogenic bladder, urination methods, symptoms during the UDS and UDS results...
August 2016: Annals of Rehabilitation Medicine
Frank Cloutier, Tomas Kalincik, Jenny Lauschke, Gervase Tuxworth, Brenton Cavanagh, Adrian Meediniya, Alan Mackay-Sim, Pascal Carrive, Phil Waite
Autonomic dysreflexia is a common complication after high level spinal cord injury and can be life-threatening. We have previously shown that the acute transplantation of olfactory ensheathing cells into the lesion site of rats transected at the fourth thoracic spinal cord level reduced autonomic dysreflexia up to 8weeks after spinal cord injury. This beneficial effect was correlated with changes in the morphology of sympathetic preganglionic neurons despite the olfactory cells surviving no longer than 3weeks...
August 24, 2016: Autonomic Neuroscience: Basic & Clinical
David W Popok, Christopher R West, Michele Hubli, Katharine D Currie, Andrei V Krassioukov
Cardiovascular disease is one of the leading causes of morbidity and mortality in the spinal cord injury (SCI) population. SCI may disrupt autonomic cardiovascular homeostasis, which can lead to persistent hypotension, irregular diurnal rhythmicity, and the development of autonomic dysreflexia (AD). There is currently no software available to perform automated detection and evaluation of cardiovascular autonomic dysfunction(s) such as those generated from 24 h ambulatory blood pressure monitoring (ABPM) recordings in the clinical setting...
October 5, 2016: Journal of Neurotrauma
Sian Rodger
Patient with spinal cord injuries have individualised care routines to help prevent complications. Disruption to these routines following admission to non-specialist settings can have long-term consequences. This article focuses on the key long-term problems of pressure ulcers, bladder and bowel dysfunction, and autonomic dysreflexia. Nurses working on general wards need to consider how to manage these problems when caring for patients with spinal cord injury.
June 29, 2016: Nursing Times
David Popok, Christopher West, Barbara Frias, Andrei V Krassioukov
Spinal cord injury (SCI) is a debilitating neurological condition characterized by somatic and autonomic dysfunctions. In particular, SCI above the mid-thoracic level can lead to a potentially life-threatening hypertensive condition called autonomic dysreflexia (AD) that is often triggered by noxious or non-noxious somatic or visceral stimuli below the level of injury. One of the most common triggers of AD is the distension of pelvic viscera, such as during bladder and bowel distension or evacuation. This protocol presents a novel pattern recognition algorithm developed for a JAVA platform software to study the fluctuations of cardiovascular parameters as well as the number, severity and duration of spontaneously occurring AD events...
2016: Journal of Visualized Experiments: JoVE
N Liu, M-W Zhou, F Biering-Sørensen, A V Krassioukov
STUDY DESIGN: Retrospective chart review. OBJECTIVES: To establish the frequency and severity of autonomic dysreflexia (AD) during urodynamics among individuals with chronic spinal cord injury (SCI) and to investigate the possible effect of the number of years since SCI on the severity of AD. SETTING: SCI outpatient clinic. METHODS: A retrospective chart review was undertaken of individuals with SCI who were seen at an outpatient clinic and could potentially develop an episode of AD (T6 and above)...
August 2, 2016: Spinal Cord
Jordan Squair, Christopher R West, David Popok, Peggy Assinck, Jie Liu, Wolfram Tetzlaff, Andrei V Krassioukov
Cardiovascular disease is the leading cause of death for individuals with spinal cord injury (SCI). Due to a lack of a standardized and accessible animal model for cardiovascular disease after SCI, few laboratories have conducted pre-clinical trials aimed at re-instating descending cardiovascular control. Here, we utilized common contusion methodology applied to the midline of the upper-thoracic cord of adult Wistar rats accompanied with telemetric blood pressure monitoring, Fluorogold retrograde neuronal tracing, as well as lesion site and lumbrosacral afferent immunohistochemistry...
July 25, 2016: Journal of Neurotrauma
Sue Bertschy, Jürgen Pannek, Thorsten Meyer
BACKGROUND: When different health problems such as pregnancy and spinal cord injury (SCI) occur together, providing adequate care becomes even more challenging. Women with SCI may encounter a variety of specific problems and symptoms during pregnancy and childbirth, including urinary tract infections, pressure ulcers, constipation, autonomic dysreflexia, and preterm labour. Therefore, expertise from different medical specialties, especially spinal cord medicine and gynaecology are required...
2016: BMC Pregnancy and Childbirth
A Rand, R J Litz, P Zahn
Spinal cord injuries (SCI) are serious medical conditions, which are associated with severe and potentially fatal risks and complications depending on the location and extent of injury. Traffic accidents, falls and recreational activities are the leading causes for traumatic SCI (TSCI) worldwide whereas non-traumatic spinal cord injuries (NTSCI) are mostly due to tumors and congenital diseases. As chronification of the injuries progresses other organ systems are affected including anatomical changes, the respiratory and cardiovascular systems and endocrinological pathways...
July 2016: Der Anaesthesist
Ross Davidson, Stacy Elliott, Andrei Krassioukov
Sexuality is an integral part of the human experience and persists in health and disability. The cardiovascular system is crucial to sexual function and can be affected profoundly by spinal cord injury (SCI). The effects of sexual activity on the cardiovascular system in SCI have not been summarized and compared with sexual activity in able-bodied individuals. A keyword search of Embase, PubMed, and Medline was conducted. From 471 retrieved studies for able-bodied individuals, 11 were included that met the strict criteria of medically uncomplicated participants...
May 31, 2016: Journal of Neurotrauma
Jordan W Squair, Aaron A Phillips, Mark Harmon, Andrei V Krassioukov
No abstract text is available yet for this article.
May 24, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Vaidyanathan Subramanian, Bakul M Soni, Peter L Hughes, Gurpreet Singh, Tun Oo
BACKGROUND: Inflating the balloon of Foley catheter in urethra is a complication of urethral catheterisation. We report five patients in whom this complication occurred because of unskilled catheterisation. Due to lack of awareness, the problem was not recognised promptly and patients came to harm. CASE SERIES: A tetraplegic patient developed pain in lower abdomen and became unwell after transurethral catheterisation. CT pelvis revealed full bladder with balloon of Foley catheter in dilated urethra...
2016: Patient Safety in Surgery
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