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Gao X, Li S, Yang Y, Yang S, Yu B, Zhu Z, Ma T, Zheng Y, Wei B, Hao Y, Wu H, Zhang Y, Guo L, Gao X, Wei Y, Xue B, Li J, Feng X, Lu L, Xia B, Huang J. A Novel Magnetic Responsive miR-26a@SPIONs-OECs for Spinal Cord Injury: Triggering Neural Regeneration Program and Orienting Axon Guidance in Inhibitory Astrocytic Environment. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2304487. [PMID: 37789583 PMCID: PMC10646239 DOI: 10.1002/advs.202304487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/12/2023] [Indexed: 10/05/2023]
Abstract
Addressing the challenge of promoting directional axonal regeneration in a hostile astrocytic scar, which often impedes recovery following spinal cord injury (SCI), remains a daunting task. Cell transplantation is a promising strategy to facilitate nerve restoration in SCI. In this research, a pro-regeneration system is developed, namely miR-26a@SPIONs-OECs, for olfactory ensheathing cells (OECs), a preferred choice for promoting nerve regeneration in SCI patients. These entities show high responsiveness to external magnetic fields (MF), leading to synergistic multimodal cues to enhance nerve regeneration. First, an MF stimulates miR-26a@SPIONs-OECs to release extracellular vesicles (EVs) rich in miR-26a. This encourages axon growth by inhibiting PTEN and GSK-3β signaling pathways in neurons. Second, miR-26a@SPIONs-OECs exhibit a tendency to migrate and orientate along the direction of the MF, thereby potentially facilitating neuronal reconnection through directional neurite elongation. Third, miR-26a-enriched EVs from miR-26a@SPIONs-OECs can interact with host astrocytes, thereby diminishing inhibitory cues for neurite growth. In a rat model of SCI, the miR-26a@SPIONs-OECs system led to significantly improved morphological and motor function recovery. In summary, the miR-26a@SPIONS-OECs pro-regeneration system offers innovative insights into engineering exogenous cells with multiple additional cues, augmenting their efficacy for stimulating and guiding nerve regeneration within a hostile astrocytic scar in SCI.
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Affiliation(s)
- Xue Gao
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Shengyou Li
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Yujie Yang
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Shijie Yang
- Department of NeurosurgeryThe Second Affiliated Hospital of Xi'an Jiao Tong UniversityXi'an710032P. R. China
| | - Beibei Yu
- Department of NeurosurgeryThe Second Affiliated Hospital of Xi'an Jiao Tong UniversityXi'an710032P. R. China
| | - Zhijie Zhu
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Teng Ma
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Yi Zheng
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Bin Wei
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Yiming Hao
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Haining Wu
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Yongfeng Zhang
- Department of NeurosurgeryThe Second Affiliated Hospital of Xi'an Jiao Tong UniversityXi'an710032P. R. China
| | - Lingli Guo
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Xueli Gao
- School of Ecology and EnvironmentNorthwestern Polytechnical UniversityXi'an710072P. R. China
| | - Yitao Wei
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Borui Xue
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Jianzhong Li
- Department of Thoracic SurgeryThe Second Affiliated Hospital of Xi'an Jiao Tong UniversityXi'an710032P. R. China
| | - Xue Feng
- Department of Cell BiologySchool of MedicineNorthwest UniversityXi'an710032P. R. China
| | - Lei Lu
- State Key Laboratory of Military StomatologyNational Clinical Research Center for Oral DiseasesShaanxi International Joint Research Center for Oral DiseasesDepartment of Oral Anatomy and Physiology and TMDSchool of Stomatologythe Fourth Military Medical UniversityXi'an710032P. R. China
| | - Bing Xia
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
| | - Jinghui Huang
- Department of OrthopaedicsXijing HospitalFourth Military Medical UniversityXi'an710032P. R. China
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Singh G, Rao V, Thamba A, Pahwa B, Zaazoue M. Spine Injuries in Household Environments: A Comprehensive Analysis. Cureus 2023; 15:e44275. [PMID: 37645670 PMCID: PMC10462396 DOI: 10.7759/cureus.44275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 08/31/2023] Open
Abstract
Introduction Recognizing the concerns posed by spine injuries within homes, stemming from falls, interactions with furnishings, and daily activities, it is imperative to consider preventive strategies. Our analysis of spine injuries utilizing the National Electronic Injury Surveillance System (NEISS) data sheds light on falls, furnishings, age-specific risks, recreation, technology, and socioeconomic disparities as contributing elements, accentuating the need for targeted interventions. This study aims to provide insights into the prevalence of spine injuries in different household locations, associated products, age groups, and gender, thus informing injury prevention strategies for safer living environments. Methods This is a retrospective, cross-sectional study utilizing data between 2013 to 2022 from the National Electronic Injury Surveillance System database. Specific household product codes and demographic data, such as age and gender, were analyzed. Statistical analysis in R (R Foundation for Statistical Computing, Vienna, Austria) involved descriptive statistics and multivariate logistic regressions. Results In analyzing 44,267 spine injuries, the study revealed location-specific variations in spine injuries within households. Living rooms and bedrooms had the highest injury rates at 34.17% and 21.65%, respectively. Significant differences in injury rates between males and females across various home locations. Females accounted for 51.78% of injuries in the living room and 59.99% in the bedroom. In the kitchen, females experienced 53.21% of injuries, while males accounted for 46.79% of cases. Notably, overall spine injuries exhibited a significant difference between males and females, with females having a higher total likelihood of injuries (AOR = 1.21, 95% CI: 1.14-1.77, p < 0.001). Regarding age, individuals between 51-60 years were most vulnerable to spine injuries, accounting for 17.98% of total cases. Notably, the age group of 61-70 years exhibited a substantial proportion of injuries at 17.12%, while the age group of 71-80 years accounted for 14.39%. The age group of 41-50 years also displayed a notable injury rate of 14.12%. The youngest age group, 0-10 years, demonstrated the lowest percentage of injuries at 4.79%. This age-based analysis provides valuable insights into the distribution of spine injuries across different demographic segments. Regarding age, individuals between 51-60 years were most vulnerable to spine injuries, comprising 17.98% of total cases. Age groups of 41-50 and 61-70 years also showed substantial proportions of injuries, accounting for 14.12% and 17.12%, respectively. The youngest age group, 0-10, exhibited the lowest percentage of injuries at 4.79%. Conclusion The study focuses on the occurrence of spinal injuries in common sites of injury in the household, such as the living room, bedroom, kitchen, and stairs. There is increased prevalence amongst females and increased risk vulnerability amongst people 51 to 60 years of age. Our research emphasizes the necessity of implementing specific injury prevention measures tailored to different demographic groups within their home setting. This approach should involve collaborative decision-making with patients while prioritizing patient education to create a safer living environment and reduce the likelihood of spine injuries.
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Affiliation(s)
- Gurbinder Singh
- Department of Orthopaedic Surgery, University of California-San Francisco School of Medicine, San Francisco, USA
| | - Varun Rao
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, USA
| | - Aish Thamba
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, USA
| | - Bhavya Pahwa
- Medical School, University College of Medical Sciences, New Delhi, Delhi, IND
| | - Mohamed Zaazoue
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, USA
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Li J, Wang P, Zhou T, Jiang W, Wu H, Zhang S, Deng L, Wang H. Neuroprotective effects of interleukin 10 in spinal cord injury. Front Mol Neurosci 2023; 16:1214294. [PMID: 37492521 PMCID: PMC10363608 DOI: 10.3389/fnmol.2023.1214294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023] Open
Abstract
Spinal cord injury (SCI) starts with a mechanical and/or bio-chemical insult, followed by a secondary phase, leading progressively to severe collapse of the nerve tissue. Compared to the peripheral nervous system, injured spinal cord is characterized by weak axonal regeneration, which leaves most patients impaired or paralyzed throughout lifetime. Therefore, confining, alleviating, or reducing the expansion of secondary injuries and promoting functional connections between rostral and caudal regions of lesion are the main goals of SCI therapy. Interleukin 10 (IL-10), as a pivotal anti-inflammatory and immunomodulatory cytokine, exerts a wide spectrum of positive effects in the treatment of SCI. The mechanisms underlying therapeutic effects mainly include anti-oxidative stress, limiting excessive inflammation, anti-apoptosis, antinociceptive effects, etc. Furthermore, IL-10 displays synergistic effects when combined with cell transplantation or neurotrophic factor, enhancing treatment outcomes. This review lists pleiotropic mechanisms underlying IL-10-mediated neuroprotection after SCI, which may offer fresh perspectives for clinical translation.
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Affiliation(s)
- Juan Li
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, China
| | - Pei Wang
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, China
| | - Ting Zhou
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, China
| | - Wenwen Jiang
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, China
| | - Hang Wu
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, China
| | - Shengqi Zhang
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, China
| | - Lingxiao Deng
- Department of Neurological Surgery, Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Hongxing Wang
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, China
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Jr Al C, Dr P, Ac C, Aps C. Cross-Sectional Study of Knee Bone Mineral Density and Fragility Fractures in Patients with Neurological Injuries and Neuromuscular Disorders. J Clin Densitom 2022; 25:682-691. [PMID: 36175247 DOI: 10.1016/j.jocd.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/21/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Patients with neurological injury and neuromuscular disorders are at increased risk for osteoporosis and fragility fracture. This cross-sectional study investigated whether knee bone mineral density (BMD) correlates with fragility fracture in patients with neurological injury and neuromuscular injuries. METHODOLOGY In this retrospective chart review, 435 participants underwent dual-energy X-ray absorptiometry (DXA) for BMD analysis. Distal femur and proximal tibial BMD measurements were performed as per the Toronto protocol. Spine, hip, and forearm DXA was performed following the standards of the International Society of Clinical Densitometry, 2019. Blinded and independent clinical evaluations and laboratory exams were performed. Participants were divided into groups with and without fracture confirmed by clinical history and radiography. RESULTS Distal femur and proximal tibial BMD were measured in 288/435 (66.2%) participants. Osteoporosis was noted in 138/288 (47.9%) patients. Fractures occurred in 95/435 participants (21.8%), including one fracture in 64/435 participants (14.7%), two fractures in 24/435 participants (5.5%), and greater than two fractures in 7/435 patients (1.6%). Fractures were noted in 23/54 (42.6%) participants with post-polio syndrome, 21/66 with brain injury (31.8%), 3/10 (30%) with brain injury and spinal cord injury, 24/98 (24.5%) with neuromuscular disorders, 9/52 (17.3%) with nontraumatic spinal cord injury, and 15/155 (9.7%) with traumatic spinal cord injury. The median BMD of the knee and hip was lower in participants with fractures. Distal femur and proximal tibial BMD (odds ratio [OR] = 0.02, 95% confidence interval [CI]: 0.01-0.45) remained independently associated with fragility fracture in multivariable analysis. CONCLUSION Proximal tibial and distal femur BMD measurements offered additional information on neurological injury and neuromuscular disorders.
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Affiliation(s)
- Cunha Jr Al
- Department of Radiology and Diagnostic Imaging, Rede SARAH de Hospitais de Reabilitação, Av. Amazonas, 5953. Gameleira, 30510-000, Belo Horizonte, MG, Brazil.
| | - Precioso Dr
- Department of Internal Medicine, Rede SARAH de Hospitais de Reabilitação, Belo Horizonte, MG, Brazil
| | - Cotta Ac
- Department of Pathology, Rede SARAH de Hospitais de Reabilitação, Belo Horizonte, MG, Brazil
| | - Champs Aps
- Department of Spinal Injury Rehabilitation, Rede SARAH de Hospitais de Reabilitação, Belo Horizonte, MG, Brazil
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Dekeseredy P, Hickman WP, Fang W, Sedney CL. Traumatic spinal cord injury in West Virginia: Impact on long-term outcomes by insurance status and discharge disposition. J Neurosci Rural Pract 2022; 13:652-657. [PMID: 36743754 PMCID: PMC9893939 DOI: 10.25259/jnrp-2022-3-53-r1-(2492)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/27/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives Specialized rehabilitation is important for people with traumatic spinal cord injuries (SCIs) to optimize function, independence and mitigate complications, and access to this service varies by the payor. In West Virginia, admission to acute rehabilitation facilities is a "non-covered entity," impeding access to this care for patients with SCI and Medicaid. Our previous work examined the discharge disposition from an acute care hospital of patients with and without Medicaid and found that Medicaid patients were almost twice as likely to be discharged home or to a nursing home, despite similar injury severity and younger age compared to non-Medicaid patients. West Virginia is a largely rural state with multiple health-care challenges. A lack of availability of rehabilitation facilities for Medicaid beneficiaries likely explains this difference. This present study examines the relationship between insurance coverage, discharge disposition at time of injury, and long-term outcomes for people in West Virginia with traumatic SCI. Materials and Methods This study utilized a retrospective chart review and telephone survey from a Level 1 Trauma Center in West Virginia. Participants included 200 patients with traumatic SCI from 2009 to 2016 in West Virginia. Thirty-four patients completed the survey through telephone interviews, with another 16 completing the survey but declining to answer economic questions. Survey participants were asked the Craig Handicap Assessment and Reporting Technique (CHART), which indicates the degree of impairment, and disability; they experience years after initial injury and rehabilitation. Proportional odds regression models, a regression model generalization of the Wilcoxon rank sum test, were employed where normal distribution of the response variables was not assumed and was performed, controlling for age and injury severity. Results Total CHART score correlated with discharge disposition (P = 0.01). Insurance type correlated with mobility sub-score (P = 0.03). Conclusion Patients discharged to a rehabilitation center have overall higher CHART scores post-injury, indicating better long-term outcomes than those discharged home or a nursing home. People with Medicaid as payors had lower scores for mobility than those with other insurance coverage.
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Affiliation(s)
| | | | - Wei Fang
- West Virginia Clinical and Translational Science Institute, Erma Byrd Biomedical Research Center, Morgantown, West Virginia
| | - Cara L. Sedney
- Department of Neurosurgery, West Virginia University, Morgantown, West Virginia
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Sandalic D, Arora M, Pozzato I, Simpson G, Middleton J, Craig A. A Narrative Review of Research on Adjustment to Spinal Cord Injury and Mental Health: Gaps, Future Directions, and Practice Recommendations. Psychol Res Behav Manag 2022; 15:1997-2010. [PMID: 35957761 PMCID: PMC9363004 DOI: 10.2147/prbm.s259712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/31/2022] [Indexed: 11/23/2022] Open
Abstract
Spinal cord injury (SCI) results in autonomic, motor, and sensory impairments that can compromise mental health. Guidelines directing the management of mental health following SCI presently address clinical anxiety, depression, post-traumatic stress, substance use disorders, and suicide. However, evidence suggests that perhaps as many as 70% of individuals with SCI do not develop a clinically diagnosable mental health disorder. Therefore, the authors contend that understanding non-clinical cognitive and psychological aspects of adjustment post-SCI is paramount and that the application of this knowledge to the formulation of adjustment-enhancing interventions is crucial. To assist with this endeavour, we examine existing mental health guidelines targeting SCI, and present a narrative review of research on the under-represented topics of adjustment, coping, grief, and resilience. We include mild cognitive impairment, which reflects a common factor that can compromise adjustment. Loss and stress trigger processes of adjustment, coping, grief, and resilience. SCI involves loss and stress triggering these processes, arguably without exception. Our study applied a narrative review methodology searching Google Scholar and PsychInfo databases for terms adjustment, coping, grief, resilience, and cognitive impairment. Qualitative studies and quantitative studies were selected to capture bottom-up and top-down perspectives. Reference lists of retrieved papers were searched as appropriate. Reviewed literature suggested that existing guidelines concerning mental health following SCI neglect positive processes of adjustment and suggest this neglect contributes to a deficits-based view of mental health following SCI. Research into “positive” or adjustment-enhancing processes is mostly cross-sectional, heterogenous, and poorly positioned to inform future guideline-development. Researchers should achieve consensus over the operationalisation of essential processes and overcome a fixation with “outcomes” to better inform management of mental health after SCI.
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Affiliation(s)
- Danielle Sandalic
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Mohit Arora
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Ilaria Pozzato
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Grahame Simpson
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - James Middleton
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Ashley Craig
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Correspondence: Ashley Craig, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia, Email
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Balanca A, Even A, Malot C, Chartier-Kastler E, Denys P, Joussain C. Long-term clinical and urodynamic effectiveness of augmentation ileocystoplasty with supra-trigonal cystectomy in individuals with spinal cord injury. World J Urol 2022; 40:2121-2127. [PMID: 35680652 DOI: 10.1007/s00345-022-04028-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/23/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to determine the long-term effectiveness of augmentation ileocystoplasty (AI) associated with supra-trigonal cystectomy on clinical and urodynamic variables, and the safety of the intervention in individuals with spinal cord injury (SCI). MATERIALS AND METHODS Single-center, retrospective study of all patients with SCI who underwent AI with supra-trigonal cystectomy from January 1994, with a follow-up of more than 8 years. The primary outcome was the sustained long-term effectiveness of AI with supra-trigonal cystectomy on clinical and urodynamic variables. The secondary outcome was the long-term safety of this procedure. RESULTS We included 77 patients: 57% were female, mean (SD) age was 52.0 (13.0) years, 77% had paraplegia, and median time since onset was 25.0 [19; 30] years. Long-term success rate (evaluated 13 [10; 15] years post AI) was 93.5% for urodynamic parameters and 76.6% for urinary incontinence. Results of the short- and long-term post-AI assessments did not differ for any urodynamic or clinical variables. Bladder lithiasis occurred in 20.5% of cases and ≥ 1 febrile urinary tract infection occurred in 55.8%, mostly within the first 2 years of follow-up. No cases of bladder cancer were diagnosed. CONCLUSION AI associated with supra-trigonal cystectomy in patients with SCI is safe and effective in both the short term and long term. Regular urodynamic assessment is not necessary in clinically stable patients with low bladder risk; however, close monitoring is important because of the risk of urological complications.
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Affiliation(s)
- A Balanca
- Neuro-Uro-Andrology Hospital Universitaire R.Poincare, AP-HP, 104 bvd R. Poincare, 92380, Garches, France
| | - A Even
- Neuro-Uro-Andrology Hospital Universitaire R.Poincare, AP-HP, 104 bvd R. Poincare, 92380, Garches, France
| | - C Malot
- Department of Sport Medicine and Readaptation, Hôpital Foch, 92150, Suresnes, France
| | - E Chartier-Kastler
- Neuro-Uro-Andrology Hospital Universitaire R.Poincare, AP-HP, 104 bvd R. Poincare, 92380, Garches, France.,Department of Urology, APHP-Pitié-Salpétrière Hospital, Sorbonne Université, Paris, France.,Inserm U1179, UFR Des Sciences de la Santé, University of Versailles Saint-Quentin, Montigny-le-Bretonneux, France
| | - P Denys
- Neuro-Uro-Andrology Hospital Universitaire R.Poincare, AP-HP, 104 bvd R. Poincare, 92380, Garches, France.,Inserm U1179, UFR Des Sciences de la Santé, University of Versailles Saint-Quentin, Montigny-le-Bretonneux, France
| | - C Joussain
- Neuro-Uro-Andrology Hospital Universitaire R.Poincare, AP-HP, 104 bvd R. Poincare, 92380, Garches, France. .,Inserm U1179, UFR Des Sciences de la Santé, University of Versailles Saint-Quentin, Montigny-le-Bretonneux, France.
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Sampogna G, Barbosa F, Brambillasca PM, Montanari E, Rampoldi A, Spinelli M. Prostatic artery embolization in people with spinal cord injury: a safe and effective technique to ease intermittent catheterization in case of concomitant benign prostatic hyperplasia. Spinal Cord Ser Cases 2022; 8:34. [PMID: 35332117 PMCID: PMC8948271 DOI: 10.1038/s41394-022-00499-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 02/18/2022] [Accepted: 02/20/2022] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN Case series. OBJECTIVES To assess the safety and efficacy of prostatic artery embolization (PAE) to reduce prostate volume (PV) and facilitate intermittent catheterization (IC) in individuals with concurrent benign prostatic hyperplasia (BPH) and spinal cord injury (SCI). SETTING Italian tertiary referral center for people with SCI. METHODS We retrospectively collected all data of individuals undergoing PAE from 2015 to 2020 because of BPH-related problems during IC. PAE was performed under local anesthesia with superselective catheterization of the prostatic arteries. Technical success was defined as bilateral embolization. We determined pre- and post-procedural PV by magnetic resonance imaging. RESULTS We considered 10 cases with tetraplegia (n = 5) and paraplegia (n = 5). Nine (90%) procedures were technically successful, while we performed monolateral PAE in one case. The median pre-procedural PV was 61 mL. After 6 months, all patients experienced significant PV reduction (median: 19.6%), and 7/7 patients with indwelling urinary catheter started successfully IC. Neither intra- nor post-procedural complications occurred within a median follow-up of 33 months. CONCLUSIONS PAE proved to be a safe and effective treatment for BPH to facilitate IC in people with SCI. Considering the minimal morbidity of PAE, further multi-center studies are mandatory to draw definitive conclusions and warrant its widespread adoption in this population.
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Affiliation(s)
- Gianluca Sampogna
- Unit of Neuro-Urology - Unipolar Spinal Unit, Niguarda Hospital, Milan, Italy
- Unit of Urology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Fabiane Barbosa
- Unit of Interventional Radiology, Niguarda Hospital, Milan, Italy
| | | | - Emanuele Montanari
- Unit of Urology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Antonio Rampoldi
- Unit of Interventional Radiology, Niguarda Hospital, Milan, Italy
| | - Michele Spinelli
- Unit of Neuro-Urology - Unipolar Spinal Unit, Niguarda Hospital, Milan, Italy.
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Hakim S, Gaglani T, Cash BD. Neurogenic Bowel Dysfunction: The Impact of the Central Nervous System in Constipation and Fecal Incontinence. Gastroenterol Clin North Am 2022; 51:93-105. [PMID: 35135667 DOI: 10.1016/j.gtc.2021.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Spinal cord injury and neurogenic bowel dysfunction (NBD) are life-changing events for affected patients. The clinical manifestations of NBD vary depending on the level and severity of the spinal cord lesion. Managing patients with NBD can be complicated by comorbidities, such as immobility, bladder dysfunction, progressive neurologic decline, psychological factors, loss of independence, and social withdrawal, and ideally involves a multimodal, multidisciplinary approach. Evaluation and management should be individualized, depending on the residual neurologic capabilities of the patient and their predominant gastrointestinal symptoms, and commonly involves lifestyle modifications, physical therapy, laxative medications, and surgical interventions.
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Affiliation(s)
- Seifeldin Hakim
- Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, 6431 Fannin, MSB 4.234, Houston, TX 77030, USA
| | - Tanmay Gaglani
- Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin, Houston, TX 77030, USA
| | - Brooks D Cash
- Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, 6431 Fannin, MSB 4.234, Houston, TX 77030, USA.
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Zhou G, Wang Z, Han S, Chen X, Li Z, Hu X, Li Y, Gao J. Multifaceted Roles of cAMP Signaling in the Repair Process of Spinal Cord Injury and Related Combination Treatments. Front Mol Neurosci 2022; 15:808510. [PMID: 35283731 PMCID: PMC8904388 DOI: 10.3389/fnmol.2022.808510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/26/2022] [Indexed: 01/03/2023] Open
Abstract
Spinal cord injury (SCI) results in multiple pathophysiological processes, including blood–spinal cord barrier disruption, hemorrhage/ischemia, oxidative stress, neuroinflammation, scar formation, and demyelination. These responses eventually lead to severe tissue destruction and an inhibitory environment for neural regeneration.cAMP signaling is vital for neurite outgrowth and axonal guidance. Stimulating intracellular cAMP activity significantly promotes neuronal survival and axonal regrowth after SCI.However, neuronal cAMP levels in adult CNS are relatively low and will further decrease after injury. Targeting cAMP signaling has become a promising strategy for neural regeneration over the past two decades. Furthermore, studies have revealed that cAMP signaling is involved in the regulation of glial cell function in the microenvironment of SCI, including macrophages/microglia, reactive astrocytes, and oligodendrocytes. cAMP-elevating agents in the post-injury milieu increase the cAMP levels in both neurons and glial cells and facilitate injury repair through the interplay between neurons and glial cells and ultimately contribute to better morphological and functional outcomes. In recent years, combination treatments associated with cAMP signaling have been shown to exert synergistic effects on the recovery of SCI. Agents carried by nanoparticles exhibit increased water solubility and capacity to cross the blood–spinal cord barrier. Implanted bioscaffolds and injected hydrogels are potential carriers to release agents locally to avoid systemic side effects. Cell transplantation may provide permissive matrices to synergize with the cAMP-enhanced growth capacity of neurons. cAMP can also induce the oriented differentiation of transplanted neural stem/progenitor cells into neurons and increase the survival rate of cell grafts. Emerging progress focused on cAMP compartmentation provides researchers with new perspectives to understand the complexity of downstream signaling, which may facilitate the clinical translation of strategies targeting cAMP signaling for SCI repair.
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Affiliation(s)
- Gang Zhou
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhiyan Wang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shiyuan Han
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaokun Chen
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhimin Li
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xianghui Hu
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yongning Li
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of International Medical Service, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jun Gao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- *Correspondence: Jun Gao
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The Relationship between Physical Activity Level and Functional Status of Subjects with High Spinal Cord Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031787. [PMID: 35162810 PMCID: PMC8835456 DOI: 10.3390/ijerph19031787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Spinal cord injuries are one of disability in Poland and in the world. METHODS 80 subjects with a transverse injury of the cervical spinal cord were enrolled in the study. The study group included men aged 20-50, 33.1 ± 7.5. A total of 40 (50%) of the subjects comprised the physically active group (AG)-subjects doing wheelchair sport twice a week for 90 min a day. The physically inactive group (IG) comprised 40 (50%) subjects who had not participated in any sports activities. Statistical analyses were carried out using Shapiro-Wilk W-test and Mann-Whitney U test. RESULTS Significant differences were found between the physically active and inactive men with regard to their functionality status. The biggest differences were found for turning over (p < 0.001) and in adopting a sitting position (p < 0.001). Persons in the AG group had better results in all assessed activities. The biggest differences were observed in the field of toilet and dressing up: tooth-brushing p < 0.007 and washing the top part of the body p < 0.002. CONCLUSIONS People participating in regular physical activity-wheelchair rugby-after spinal cord injury have a better relationship with better fitness, greater independence and a better functional status.
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Sturm C, Gutenbrunner CM, Egen C, Geng V, Lemhöfer C, Kalke YB, Korallus C, Thietje R, Liebscher T, Abel R, Bökel A. Which factors have an association to the Quality of Life (QoL) of people with acquired Spinal Cord Injury (SCI)? A cross-sectional explorative observational study. Spinal Cord 2021; 59:925-932. [PMID: 34239041 PMCID: PMC8338547 DOI: 10.1038/s41393-021-00663-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional explorative observational study. OBJECTIVES To identify factors which have an association to the self-perceived Quality of Life (QoL) for persons with acquired spinal cord injury (SCI). SETTING Eight specialized SCI-centers in Germany. The GerSCI survey is the German part of the International Spinal Cord Injury Survey (InSCI). METHODS Self-disclosure questionnaire, created from the InSCI group, translated and adapted for Germany. The questionnaire collects a very broad range of data and, and due to its design as a self-report, is particularly suitable for the analysis on QoL. Because of the content, which is binding for all participating states, it allows a direct comparability of the results. Included in Germany were 1479 persons with acquired SCI aged 18 years and older. RESULTS Various factors were identified with high associations to QoL, including changeable and unchangeable ones, such as those of particular importance: pain, sleep problems, sexual dysfunction, age, and time since onset of SCI. Some results confirmed reports of previous studies, others were surprising. CONCLUSION this study provides an important basis for the planned analysis of the InSCI participating countries in the 6 WHO regions. Germany was able to contribute the largest study population. The concrete study design of InSCI allows us to directly compare data and helps us to improve ourselves within the framework of a "learning health system". Medical measures can be orientated towards the found results, in order to ensure the best possible care and support by the therapeutic team, individually adapted to the person, place of residence and impairment.
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Affiliation(s)
- Christian Sturm
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany.
| | | | - Christoph Egen
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
| | | | | | - Yorck B Kalke
- RKU - University and Rehabilitation Clinics Ulm, Ulm, Germany
| | - Christoph Korallus
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
| | - Roland Thietje
- Center for spinal injuries, Trauma Hospital Hamburg, Hamburg, Germany
| | - Thomas Liebscher
- Treatment Centre for Spinal Cord Injuries, Trauma Hospital Berlin, Berlin, Germany
| | - Rainer Abel
- SCI Unit, Klinikum Bayreuth GmbH, Bayreuth, Germany
| | - Andrea Bökel
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
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Hajjioui A, Fourtassi M, Boujraf S. Spinal cord injury in the Moroccan healthcare system: A country case study. IBRO Neurosci Rep 2021; 10:62-65. [PMID: 33842911 PMCID: PMC8019974 DOI: 10.1016/j.ibneur.2020.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/09/2020] [Indexed: 11/30/2022] Open
Abstract
In this article, the authors report an overview of the healthcare management of People with Spinal Cord Injury living in Morocco. The authors' experience in monitoring neurologic recovery and rehabilitation expectations and outcomes are also presented. In addition to the epidemiological data, the patient journey through the chain of care, living with Spinal Cord Injury, the health and rehabilitation system are discussed. This paper illustrates well the suffering of people with Spinal Cord Injury specifically and of disabled persons in general living in low and middle-income countries, especially with the lack of access to specialized and quality rehabilitation facilities and shortage of healthcare workers specialized in rehabilitation.
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Affiliation(s)
- Abderrazak Hajjioui
- Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Maryam Fourtassi
- Laboratory of Epidemiology, Clinical Research and Public Health (ERCSP), Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, Morocco
| | - Saïd Boujraf
- Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Department of Biophysics and Clinical MRI Methods, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
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David S, López-Vales R. Bioactive Lipid Mediators in the Initiation and Resolution of Inflammation after Spinal Cord Injury. Neuroscience 2021; 466:273-297. [PMID: 33951502 DOI: 10.1016/j.neuroscience.2021.04.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 12/12/2022]
Abstract
Neuroinflammation is a prominent feature of the response to CNS trauma. It is also an important hallmark of various neurodegenerative diseases in which inflammation contributes to the progression of pathology. Inflammation in the CNS can contribute to secondary damage and is therefore an excellent therapeutic target for a range of neurological conditions. Inflammation in the nervous system is complex and varies in its fine details in different conditions. It involves a wide variety of secreted factors such as chemokines and cytokines, cell adhesion molecules, and different cell types that include resident cell of the CNS, as well as immune cells recruited from the peripheral circulation. Added to this complexity is the fact that some aspects of inflammation are beneficial, while other aspects can induce secondary damage in the acute, subacute and chronic phases. Understanding these aspects of the inflammatory profile is essential for developing effective therapies. Bioactive lipids constitute a large group of molecules that modulate the initiation and the resolution of inflammation. Dysregulation of these bioactive lipid pathways can lead to excessive acute inflammation, and failure to resolve this by specialized pro-resolution lipid mediators can lead to the development of chronic inflammation. The focus of this review is to discuss the effects of bioactive lipids in spinal cord trauma and their potential for therapies.
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Affiliation(s)
- Samuel David
- Centre for Research in Neuroscience, BRaIN Program, The Research Institute of the McGill University Health Centre, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada.
| | - Rubén López-Vales
- Departament de Biologia Cellular, Fisiologia i Inmunologia, Institut de Neurociències, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Universitat Autònoma de Barcelona, 08193 Bellaterra, Catalonia, Spain
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15
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Rodriguez G, Berri M, Lin P, Kamdar N, Mahmoudi E, Peterson MD. Musculoskeletal morbidity following spinal cord injury: A longitudinal cohort study of privately-insured beneficiaries. Bone 2021; 142:115700. [PMID: 33091639 PMCID: PMC9671069 DOI: 10.1016/j.bone.2020.115700] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/05/2020] [Accepted: 10/15/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND People living with spinal cord injuries (SCIs) experience motor, sensory and autonomic impairments that cause musculoskeletal disorders following the injury and that progress throughout lifetime. The range and severity of issues are largely dependent on level and completeness of the injury and preserved function. OBJECTIVE High risk of developing musculoskeletal morbidities among individuals after sustaining a traumatic SCI is well known in the clinical setting, however, there is a severe lack of evidence in literature. The objective of this study was to compare the incidence of and adjusted hazards for musculoskeletal morbidities among adults with and without SCIs. METHODS Privately-insured beneficiaries were included if they had an ICD-9-CM diagnostic code for SCI (n = 9081). Adults without SCI were also included (n = 1,474,232). Incidence estimates of common musculoskeletal morbidities (e.g., osteoporosis, sarcopenia, osteoarthritis, fractures, etc.) were compared at 5-years of enrollment. Survival models were used to quantify unadjusted and adjusted hazard ratios for incident musculoskeletal morbidities. RESULTS Adults living with traumatic SCIs had a higher incidence of any musculoskeletal morbidities (82.4% vs. 47.5%) as compared to adults without SCI, and differences were to a clinically meaningful extent. Survival models demonstrated that adults with SCI had a greater fully-adjusted hazard for any musculoskeletal morbidity (Hazard Ratio [HR]: 2.41; 95%CI: 2.30, 2.52), and all musculoskeletal disorders, and ranged from HR: 1.26 (1.14, 1.39) for rheumatoid arthritis to HR: 7.02 (6.58, 7.49) for pathologic fracture. CONCLUSIONS Adults with SCIs have a significantly higher incidence of and risk for common musculoskeletal morbidities, as compared to adults without SCIs. Efforts are needed to facilitate the development of improved clinical screening algorithms and early interventions to reduce risk of musculoskeletal disease onset/progression in this higher risk population.
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Affiliation(s)
- Gianna Rodriguez
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Maryam Berri
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Paul Lin
- Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Neil Kamdar
- Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA; Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, USA; Department of Emergency Medicine, Michigan Medicine, University of Michigan, USA; Department of Surgery, Michigan Medicine, University of Michigan, USA
| | - Elham Mahmoudi
- Department of Family Medicine, Michigan Medicine, University of Michigan, USA
| | - Mark D Peterson
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA.
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Norin L, Slaug B, Haak M, Iwarsson S. Housing adaptations and housing accessibility problems among older adults with long-standing spinal cord injury. Br J Occup Ther 2020. [DOI: 10.1177/0308022620979516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Adults with spinal cord injuries are living longer than previously, and a majority are living in ordinary housing in the community. Housing accessibility is important for maintaining independent occupational performance for this population, but knowledge in this area is insufficient. We investigated housing adaptations and current accessibility problems among older adults with long-standing (>10 years) spinal cord injuries. Method Data from home visits among 122 older adults with spinal cord injuries in Sweden were used. Housing adaptations and environmental barriers were descriptively analysed. Findings Kitchens, entrances, and hygiene areas were common locations for housing adaptations and environmental barriers that generated accessibility problems. The most common adaptations were ramps, wheelchair-accessible stovetops, and ceiling-lifts. Wall-mounted cupboards and high shelves (kitchen), inaccessible storage areas (outside the dwelling), and a lack of grab bars (hygiene area) generated the most accessibility problems. Conclusion Despite housing adaptations, there are considerable accessibility problems in the dwellings of older adults with long-standing spinal cord injuries in Sweden, indicating that long-term follow-up of the housing situation of this population is necessary. Focusing on accessible housing as a prerequisite for occupational performance is at the core of occupational therapy, deserving attention on the individual as well as the societal level.
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Affiliation(s)
- Lizette Norin
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Björn Slaug
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Maria Haak
- Department of Health Sciences, Lund University, Lund, Sweden
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
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17
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Progress in Stem Cell Therapy for Spinal Cord Injury. Stem Cells Int 2020; 2020:2853650. [PMID: 33204276 PMCID: PMC7661146 DOI: 10.1155/2020/2853650] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 10/04/2020] [Accepted: 10/21/2020] [Indexed: 02/06/2023] Open
Abstract
Background Spinal cord injury (SCI) is one of the serious neurological diseases that occur in young people with high morbidity and disability. However, there is still a lack of effective treatments for it. Stem cell (SC) treatment of SCI has gradually become a new research hotspot over the past decades. This article is aimed at reviewing the research progress of SC therapy for SCI. Methods Review the literature and summarize the effects, strategies, related mechanisms, safety, and clinical application of different SC types and new approaches in combination with SC in SCI treatment. Results A large number of studies have focused on SC therapy for SCI, most of which showed good effects. The common SC types for SCI treatment include mesenchymal stem cells (MSCs), hematopoietic stem cells (HSCs), neural stem cells (NSCs), induced pluripotent stem cells (iPSCs), and embryonic stem cells (ESCs). The modes of treatment include in vivo and in vitro induction. The pathways of transplantation consist of intravenous, transarterial, nasal, intraperitoneal, intrathecal, and intramedullary injections. Most of the SC treatments for SCI use a number of cells ranging from tens of thousands to millions. Early or late SC administration, application of immunosuppressant or not are still controversies. Potential mechanisms of SC therapy include tissue repair and replacement, neurotrophy, and regeneration and promotion of angiogenesis, antiapoptosis, and anti-inflammatory. Common safety issues include thrombosis and embolism, tumorigenicity and instability, infection, high fever, and even death. Recently, some new approaches, such as the pharmacological activation of endogenous SCs, biomaterials, 3D print, and optogenetics, have been also developed, which greatly improved the application of SC therapy for SCI. Conclusion Most studies support the effects of SC therapy on SCI, while a few studies do not. The cell types, mechanisms, and strategies of SC therapy for SCI are very different among studies. In addition, the safety cannot be ignored, and more clinical trials are required. The application of new technology will promote SC therapy of SCI.
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Hatch MN, Martinez RN, Etingen B, Cotner B, Hogan TP, Wickremasinghe IM, Sippel J, Smith BM. Characterization of Telehealth Use in Veterans With Spinal Cord Injuries and Disorders. PM R 2020; 13:1094-1103. [PMID: 33098620 DOI: 10.1002/pmrj.12515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 09/24/2020] [Accepted: 10/05/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Individuals with spinal cord injuries and disorders (SCI/D) require frequent interdisciplinary health care to address impairments in mobility, autonomic function, and secondary complications. Telehealth has the capacity to substantially transform health care delivery and improve care by increasing access and communication. However, relatively little is known about telehealth use in this specific population. Here we attempt to fill part of this gap. OBJECTIVE To investigate the frequency and characteristics associated with telehealth use in Veterans with SCI/D. DESIGN Cross-sectional, descriptive project. SETTING Veterans Health Administration (VHA) facilities. PARTICIPANTS A total of 15 028 Veterans living with SCI/D who received services from the VHA SCI/D System of Care. INTERVENTION Not applicable. OUTCOME MEASURES Frequency and characteristics associated with VHA telehealth utilization. RESULTS Of the 15 028 Veterans with SCI/D included in the evaluation, 17% used some form of telehealth in VHA Fiscal Year (FY)2017. Veterans older than 65 years of age had lower odds (odds ratio [OR] = 0.88, P < .05, confidence interval [CI] 0.80-0.98) of using telehealth. Being Caucasian (OR = 1.29, P < .01, CI 1.09-1.52), living in rural areas (OR = 1.16, P < .01, CI 1.05-1.28), living greater distances away from the VHA (P < .01 for all distances), and being in priority group 8, meaning that Veterans have higher copayment requirements (OR = 1.46, P < .001, CI 1.19-1.81), were all significantly associated with greater odds of telehealth use. The most frequent types of telehealth used were real-time clinical video and store-and-forward between a provider and patient within the same hub network. CONCLUSION There are opportunities to increase telehealth adoption in the SCI/D arena. The findings from this project highlight which Veterans are currently using telehealth services, as well as gaps regarding telehealth adoption in this population.
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Affiliation(s)
- Maya N Hatch
- Spinal Cord Injury/Disorder Center, Long Beach Veterans Affairs (VA) Medical Center, Long Beach, CA, USA
- Physical Medicine & Rehabilitation Department, UC Irvine School of Medicine, Irvine, CA, USA
| | - Rachael N Martinez
- Edward Hines Jr. Department of VA Hospital, Center of Innovation for Complex Chronic Healthcare, Chicago, IL, USA
| | - Bella Etingen
- Edward Hines Jr. Department of VA Hospital, Center of Innovation for Complex Chronic Healthcare, Chicago, IL, USA
| | - Bridget Cotner
- Rehabilitation Outcomes Research Section, Research Service, James A. Haley VA Medical Center, Tampa, FL, USA
- Department of Anthropology, University of South Florida, Tampa, FL, USA
| | - Timothy P Hogan
- Center for Healthcare Organization and Implementation Research, Edith Norse Rogers Memorial VA Hospital, Bedford, MA, USA
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Itala M Wickremasinghe
- U.S. Department of Veterans Affairs, Spinal Cord Injuries and Disorders System of Care Program Office, Seattle, WA, USA
| | - Jennifer Sippel
- U.S. Department of Veterans Affairs, Spinal Cord Injuries and Disorders System of Care Program Office, Seattle, WA, USA
| | - Bridget M Smith
- Edward Hines Jr. Department of VA Hospital, Center of Innovation for Complex Chronic Healthcare, Chicago, IL, USA
- Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Zirpoli H, Chang CL, Carpentier YA, Michael-Titus AT, Ten VS, Deckelbaum RJ. Novel Approaches for Omega-3 Fatty Acid Therapeutics: Chronic Versus Acute Administration to Protect Heart, Brain, and Spinal Cord. Annu Rev Nutr 2020; 40:161-187. [PMID: 32966188 DOI: 10.1146/annurev-nutr-082018-124539] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This article reviews novel approaches for omega-3 fatty acid (FA) therapeutics and the linked molecular mechanisms in cardiovascular and central nervous system (CNS) diseases. In vitro and in vivo research studies indicate that omega-3 FAs affect synergic mechanisms that include modulation of cell membrane fluidity, regulation of intracellular signaling pathways, and production of bioactive mediators. We compare how chronic and acute treatments with omega-3 FAs differentially trigger pathways of protection in heart, brain, and spinal cord injuries. We also summarize recent omega-3 FA randomized clinical trials and meta-analyses and discuss possible reasons for controversial results, with suggestions on improving the study design for future clinical trials. Acute treatment with omega-3 FAs offers a novel approach for preserving cardiac and neurological functions, and the combinations of acute treatment with chronic administration of omega-3 FAs might represent an additional therapeutic strategy for ameliorating adverse cardiovascular and CNS outcomes.
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Affiliation(s)
- Hylde Zirpoli
- Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA;
| | - Chuchun L Chang
- Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA;
| | - Yvon A Carpentier
- Clinical Nutrition Unit, Université Libre de Bruxelles, 1050 Brussels, Belgium.,Nutrition Lipid Developments, SPRL, 1050 Brussels, Belgium
| | - Adina T Michael-Titus
- Center for Neuroscience, Surgery, and Trauma, Queen Mary University of London, London E1 4NS, United Kingdom
| | - Vadim S Ten
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Richard J Deckelbaum
- Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA; .,Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, USA
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Riedman E, Scott H, Clarke P, Meade M, Forchheimer M, Tate D. "Earth angels" and parking spots: qualitative perspectives on healthy aging with spinal cord injury. Disabil Rehabil 2020; 44:1399-1408. [PMID: 32924639 DOI: 10.1080/09638288.2020.1817987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE People aging with spinal cord injury (SCI) can experience the premature onset of comorbid conditions, as well as the development and progression of secondary health conditions. The aim of this study was to understand the subjective experiences of persons aging with SCI in relation to their surrounding social and physical environments, including the impact of barriers and facilitators.Material/Methods: Eleven individuals who had an SCI for more than ten years and were 45 years or older participated in a semi-structured phone interview about their experiences with healthy aging, social participation, social supports, and community barriers. RESULTS Four main themes emerged in the qualitative data that captured the subjective experience of aging with SCI. These were: (1) Maintaining Physical Independence; (2) Importance of Resources and Special Equipment; (3) Planning Ahead; and (4) Finding Ways to Adapt. CONCLUSIONS The findings from this study highlight the importance of looking beyond individual factors to consider the social and environmental factors that support continued independence and participation in society as people living with long term SCI experience their aging process. Qualitative research that delves further into the dynamics behind this process is needed to fully anticipate the needs of this growing population.IMPLICATIONS FOR REHABILITATIONPeople aging with spinal cord injury (SCI) who are engaged in their social and physical environments have become increasingly adaptive when faced with accelerating and secondary comorbidities.Programs and facilities should ensure universal access to prevention and self-management programs that target physical activity and health habits when considered in the context of a patient's socio-environmental constraints and resources.Clinical healthcare providers need to engage with their patients to develop an early intervention approach to preserve functional capacity while navigating potential future health problems.Clinicians should act as advocates for ongoing policy changes that help promote an environment more inclusive towards people aging with SCI.
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Affiliation(s)
- Elizabeth Riedman
- Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, USA
| | - Haley Scott
- Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, USA
| | - Philippa Clarke
- Institute of Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Michelle Meade
- Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, USA
| | - Martin Forchheimer
- Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, USA
| | - Denise Tate
- Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, USA
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Nerve and Tendon Transfers After Spinal Cord Injuries in the Pediatric Population. Phys Med Rehabil Clin N Am 2020; 31:455-469. [DOI: 10.1016/j.pmr.2020.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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22
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The effects of mouse strain and age on a model of unilateral cervical contusion spinal cord injury. PLoS One 2020; 15:e0234245. [PMID: 32542053 PMCID: PMC7295191 DOI: 10.1371/journal.pone.0234245] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 05/21/2020] [Indexed: 12/30/2022] Open
Abstract
There are approximately 1.2 million people currently living with spinal cord injury (SCI), with a majority of cases at the cervical level and half involving incomplete injuries. Yet, as most preclinical research has been focused on bilateral thoracic models, there remains a disconnect between bench and bedside that limits translational success. Here, we profile a clinically relevant model of unilateral cervical contusion injury in the mouse (30kD with 0, 2, 5, or 10 second dwell time). We demonstrate sustained behavioral deficits in performance on grip strength, cylinder reaching, horizontal ladderbeam and CatWalk automated gait analysis tasks. Beyond highlighting reliable parameters for injury assessment, we also explored the effect of mouse strain and age on injury outcome, including evaluation of constitutively immunodeficient mice relevant for neurotransplantation and cellular therapy testing. Comparison of C57Bl/6 and immunodeficient Rag2gamma(c)-/- as well as Agouti SCIDxRag2Gamma(c)-/- hybrid mouse strains revealed fine differences in post-injury ipsilateral grip strength as well as total number of rearings on the cylinder task. Differences in post-SCI contralateral forepaw duty cycle and regularity index as measured by CatWalk gait analysis between the two immunodeficient strains were also observed. Further, assessment of young (3–4 months old) and aging (16–17 months old) Rag2gamma(c)-/- mice identified age-related pre-injury differences in strength and rearing that were largely masked following cervical contusion injury; observations that may help interpret previous results in aged rodents as well as human clinical trials. Collectively, the work provides useful insight for experimental design and analysis of future pre-clinical studies in a translational unilateral cervical contusion injury model.
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Yu Z, Sun X, Xia R, Chen Q, Wu Q, Zheng W. Modulation of inflammatory factors predicts the outcome following spinal cord injury. J Orthop Surg Res 2020; 15:199. [PMID: 32487194 PMCID: PMC7268366 DOI: 10.1186/s13018-020-01727-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/25/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The correlation between inflammatory responses caused by spinal cord injury (SCI) and the prognosis of patients with SCI still remains controversial. METHODS In the present study, we preliminary investigated the serum levels of interleukin (IL)-4, IL-10, major histocompatibility complex (MHC)-I, and inducible nitric oxide synthase (iNOS) and compared the serum IL-4 and IL-10 expression in rats of high Basso-Beattie-Bresnahan (BBB) scores with these of low BBB scores. Besides, the infiltration of macrophage and the axonal regeneration of the injured spinal cord were observed from day 10 to day 30. RESULTS We found that higher serum levels of IL-4 and IL-10 can reflect the restorability degree of SCI and could be potential biomarkers for the prognosis of SCI. The infiltration of the M2 subtype of macrophage and the axons regrowth might contribute to a better prognosis. CONCLUSIONS The current study demonstrates that the serum levels of IL-4 and IL-10 are preliminarily adopted as serologic markers to forecast SCI, and high serum levels of IL-4 and IL-10 may indicate a better prognosis. Moreover, the way to promote macrophage polarization from M1 to M2 may contribute to better axonal regeneration.
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Affiliation(s)
- Zepeng Yu
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, People's Republic of China
| | - Xingwei Sun
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, People's Republic of China
| | - Rui Xia
- Department of Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, People's Republic of China
| | - Qian Chen
- Department of Oncology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, 215008, People's Republic of China
| | - Qin Wu
- Department of Ultrasonography, Suzhou Science and Technology Town Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, 215001, People's Republic of China.
| | - Weiwei Zheng
- Department of Orthopaedics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, 215008, People's Republic of China.
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24
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Abstract
Individuals with spinal cord injuries or disorders (SCI/D), whether of traumatic or nontraumatic cause, require multidisciplinary management by their care team to achieve optimal health outcomes. SCI/D is relatively rare in the general population and primary care providers (PCPs) may not have extensive experience managing people with these disorders. Spinal cord injuries, impair the body's autonomic and biomechanical performance by interrupting the communications to and from major bodily systems. This article provides a framework to help PCPs understand how these changes impact their patient's physiologic function and subsequent risks for health complications with guidance for initial treatment approaches.
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Affiliation(s)
- Binnan Ong
- Spinal Cord Injuries and Disorders Center, Louis Stokes Cleveland VA Medical Center, 10701 East Boulevard, 128(W), Cleveland, OH 44106, USA; Department of Physical Medicine and Rehabilitation, Case Western Reserve University, MetroHealth System, Old Brooklyn Campus, 4229 Pearl Road, Cleveland, OH 44109, USA
| | - James R Wilson
- Spinal Cord Injuries and Disorders Center, Louis Stokes Cleveland VA Medical Center, 10701 East Boulevard, 128(W), Cleveland, OH 44106, USA; Department of Physical Medicine and Rehabilitation, Case Western Reserve University, MetroHealth System, Old Brooklyn Campus, 4229 Pearl Road, Cleveland, OH 44109, USA
| | - M Kristi Henzel
- Spinal Cord Injuries and Disorders Center, Louis Stokes Cleveland VA Medical Center, 10701 East Boulevard, 128(W), Cleveland, OH 44106, USA; Department of Physical Medicine and Rehabilitation, Case Western Reserve University, MetroHealth System, Old Brooklyn Campus, 4229 Pearl Road, Cleveland, OH 44109, USA.
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25
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Champs APS, Maia GAG, Oliveira FG, de Melo GCN, Soares MMS. Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil. Spinal Cord 2019; 58:484-489. [DOI: 10.1038/s41393-019-0387-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 10/31/2019] [Accepted: 11/15/2019] [Indexed: 12/12/2022]
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26
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Merritt CH, Taylor MA, Yelton CJ, Ray SK. Economic impact of traumatic spinal cord injuries in the United States. ACTA ACUST UNITED AC 2019; 6. [PMID: 33869674 PMCID: PMC8052100 DOI: 10.20517/2347-8659.2019.15] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Individuals having sustained traumatic spinal cord injury (TSCI) in the United States are living longer as compared to historical trends, thanks to an ever-evolving understanding of the nature of this injury. Despite this, multiple barriers to care for TSCI patients remain including variations in government-issued veteran insurance, privatized insurance, and among uninsured individuals. The United States alone experiences 12,000 new TSCI cases every year, many of these are found to occur in a growing proportion of elderly individuals. It is crucial to understand both the short-term direct costs as wells as the long-term rehabilitation costs required by these TSCI patients. The lifetime financial burden for those having sustained a TSCI can be immense for patients, insurance companies, and hospital systems alike. Among those with TSCI, re-hospitalization rates are high, leading to increased healthcare resource utilization within this specific patient population. Costs can quickly balloon into hundreds of thousands of dollars and cause a profound financial burden for these patients. This review article seeks to communicate an understanding of the current financial landscape surrounding TSCI patients. The authors will also examine the costs of acute emergency room surgical care such as American spinal injury association grade, hospital length of stay, as well as the timing delay between injury and surgical decompression. Long-term costs associated with TSCI such as rehabilitation, care of secondary comorbidities, and post-injury employment prospects will be examined as well. These costs will be framed from the patient’s perspective as well as from both the hospital and insurance company’s perspectives. It is hoped a complete understanding as to what makes TSCI such a medically and financially burdensome injury will allow for improved healthcare resource utilization in this population.
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Affiliation(s)
- Christopher H Merritt
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC 29209, USA
| | - Matthew A Taylor
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC 29209, USA
| | - Caleb J Yelton
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC 29209, USA
| | - Swapan K Ray
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC 29209, USA
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27
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Kern SB, Hunter LN, Sims AC, Berzins D, Riekena H, Andrews ML, Alderfer JK, Nelson K, Kushner R. Understanding the Changing Health Care Needs of Individuals Aging With Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2019; 25:62-73. [PMID: 30774290 DOI: 10.1310/sci2501-62] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: Individuals over age 65 are projected to account for over 20% of the general population by 2030. This trend is reflected in an increase in the age of individuals sustaining traumatic spinal cord injury (SCI). Based on current evidence, there is concern regarding the needs of older individuals aging with SCI and current health care services. Research is limited regarding factors that contribute to health status and treatment outcomes associated with aging 5 or more years post SCI. Objective: The purpose of this qualitative study was to explore changing health care needs of individuals aging with SCI and their caregivers and to identify the environmental supports and barriers to achieving long-term health and treatment outcomes. Methods: This was a phenomenological study utilizing semi-structured interviews. Inclusion criteria were age greater than 60 years old and 5 years post SCI. Between October 2014 and January 2016, 41 individuals with SCI and eight caregivers participated in the semi-structured interviews. Emergent themes and quotations were noted and analyzed using established methods. Triangulation was used to establish rigor and trustworthiness. Results: Data analysis of the interviews revealed four themes (health literacy, health services, changes with age, and environment) and 10 subthemes. Conclusion: Rehabilitation programs should consider the health literacy of older individuals with SCI and their caregivers. Similarly, these programs should be designed to allow them to identify and utilize resources in solving barriers to everyday participation. Further investigation is required to examine the macro-environmental influences (systems and policies) on the changing health care needs of individuals aging with SCI.
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Affiliation(s)
- Stephen B Kern
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Louis N Hunter
- Department of Physical Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ashley C Sims
- Department of Physical Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Davis Berzins
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Helena Riekena
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Marisa L Andrews
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jillian K Alderfer
- Department of Physical Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Kelly Nelson
- Department of Physical Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Reva Kushner
- Department of Physical Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
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28
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Ageing, Disability, and Spinal Cord Injury: Some Issues of Analysis. Curr Gerontol Geriatr Res 2018; 2018:4017858. [PMID: 30581466 PMCID: PMC6276527 DOI: 10.1155/2018/4017858] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/06/2018] [Indexed: 01/10/2023] Open
Abstract
Spinal cord injury is a disabling disorder, worldwide spread, with important consequences on functioning and health conditions and impacts on physical, psychological, and social well-being. The consequences are related to the lesion itself and to other complications related to the lesion. In the last decades, there have been an increasing of the mean ages of onset and also an increase in life expectancy after the lesion. So, differently from the past, people with spinal cord injury can age after the lesion. Taking into account the need to share data and information about specific disabling conditions and their relationship with ageing, this paper aims to discuss some issues from recent literature on the relationship between aging and disability in the spinal cord injury, according to a narrative review approach. A narrative review of the literature on ageing and spinal cord injury was undertaken. Search was based on the following electronic databases: PubMed/Medline and Ovid/PsychINFO. A combination of the following keywords was used: (1) “ageing” or “aging” and (2) “spinal cord injury” or “spinal cord lesion” and (3) disability. Data on consequences of the lesion in the life of aging people, secondary health conditions, life expectancy, participation, and quality of life are discussed. Then, a brief discussion of clinical issues and the role of interventions aimed to promote wellbeing, health, quality of life, and participation of people with spinal cord injury is proposed.
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29
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Aging alters glucose uptake in the naïve and injured rodent spinal cord. Neurosci Lett 2018; 690:23-28. [PMID: 30296507 DOI: 10.1016/j.neulet.2018.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/29/2018] [Accepted: 10/03/2018] [Indexed: 11/20/2022]
Abstract
Aging results in increased activation of inflammatory glial cells and decreased neuronal viability following spinal cord injury (SCI). Metabolism and transport of glucose is also decreased with age, although the influence of age on glucose transporter (GLUT) expression or glucose uptake in SCI is currently unknown. We therefore performed [18F]Fluorodeoxyglucose (FDG) PET imaging of young (3 month) and middle-aged (12 month) rats. Glucose uptake in middle-aged rats was decreased compared to young rats at baseline, followed by increased uptake 14 days post contusion SCI. qRT-PCR and protein analysis revealed an association between 14 day glucose uptake and 14 day post-injury inflammation. Further, gene expression analysis of neuron-specific GLUT3 and non-specific GLUT4 (present on glial cells) revealed an inverse relationship between GLUT3/4 gene expression and glucose uptake patterns. Protein expression revealed increased GLUT3 in 3 month rats only, consistent with age related decreases in glucose uptake, and increased GLUT4 in 12 month rats only, consistent with age related increases in inflammatory activity and glucose uptake. Inconsistencies between gene and protein suggest an influence of age-related impairment of translation and/or protein degradation. Overall, our findings show that age alters glucose uptake and GLUT3/4 expression profiles before and after SCI, which may be dependent on level of inflammatory response, and may suggest a therapeutic avenue in addressing glucose uptake in the aging population.
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30
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Yilmaz E, Schmidt CK, Mayadev A, Tawfik T, Kobota K, Cambier Z, Norvell DD, Chapman J. Does treadmill training with Hybrid Assistive Limb (HAL) impact the quality of life? A first case series in the United States. Disabil Rehabil Assist Technol 2018; 14:521-525. [DOI: 10.1080/17483107.2018.1493751] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Emre Yilmaz
- Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, USA
- Seattle Science Foundation, Seattle, WA, USA
- Department of Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Cameron K. Schmidt
- Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, USA
- Seattle Science Foundation, Seattle, WA, USA
| | | | - Tamir Tawfik
- Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, USA
| | - Kim Kobota
- Swedish Multiple Sclerosis Center, Seattle, WA, USA
| | | | | | - Jens Chapman
- Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, USA
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31
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Putatunda R, Bethea JR, Hu WH. Potential immunotherapies for traumatic brain and spinal cord injury. Chin J Traumatol 2018; 21:125-136. [PMID: 29759918 PMCID: PMC6033730 DOI: 10.1016/j.cjtee.2018.02.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 02/08/2018] [Indexed: 02/04/2023] Open
Abstract
Traumatic injury of the central nervous system (CNS) including brain and spinal cord remains a leading cause of morbidity and disability in the world. Delineating the mechanisms underlying the secondary and persistent injury versus the primary and transient injury has been drawing extensive attention for study during the past few decades. The sterile neuroinflammation during the secondary phase of injury has been frequently identified substrate underlying CNS injury, but as of now, no conclusive studies have determined whether this is a beneficial or detrimental role in the context of repair. Recent pioneering studies have demonstrated the key roles for the innate and adaptive immune responses in regulating sterile neuroinflammation and CNS repair. Some promising immunotherapeutic strategies have been recently developed for the treatment of CNS injury. This review updates the recent progress on elucidating the roles of the innate and adaptive immune responses in the context of CNS injury, the development and characterization of potential immunotherapeutics, as well as outstanding questions in this field.
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Affiliation(s)
- Raj Putatunda
- Center for Metabolic Disease Research, Department of Pathology and Laboratory Medicine, Temple University Lewis Katz School of Medicine, 3500 N Broad Street, Philadelphia, PA, USA
| | - John R. Bethea
- Department of Biology, Drexel University, Philadelphia, PA, USA
| | - Wen-Hui Hu
- Center for Metabolic Disease Research, Department of Pathology and Laboratory Medicine, Temple University Lewis Katz School of Medicine, 3500 N Broad Street, Philadelphia, PA, USA,Corresponding author.
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