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Doelman AW, Streijger F, Majerus SJA, Damaser MS, Kwon BK. Assessing Neurogenic Lower Urinary Tract Dysfunction after Spinal Cord Injury: Animal Models in Preclinical Neuro-Urology Research. Biomedicines 2023; 11:1539. [PMID: 37371634 DOI: 10.3390/biomedicines11061539] [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: 05/04/2023] [Revised: 05/20/2023] [Accepted: 05/21/2023] [Indexed: 06/29/2023] Open
Abstract
Neurogenic bladder dysfunction is a condition that affects both bladder storage and voiding function and remains one of the leading causes of morbidity after spinal cord injury (SCI). The vast majority of individuals with severe SCI develop neurogenic lower urinary tract dysfunction (NLUTD), with symptoms ranging from neurogenic detrusor overactivity, detrusor sphincter dyssynergia, or sphincter underactivity depending on the location and extent of the spinal lesion. Animal models are critical to our fundamental understanding of lower urinary tract function and its dysfunction after SCI, in addition to providing a platform for the assessment of potential therapies. Given the need to develop and evaluate novel assessment tools, as well as therapeutic approaches in animal models of SCI prior to human translation, urodynamics assessment techniques have been implemented to measure NLUTD function in a variety of animals, including rats, mice, cats, dogs and pigs. In this narrative review, we summarize the literature on the use of animal models for cystometry testing in the assessment of SCI-related NLUTD. We also discuss the advantages and disadvantages of various animal models, and opportunities for future research.
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Affiliation(s)
- Adam W Doelman
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Femke Streijger
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Steve J A Majerus
- Department of Electrical, Computer and Systems Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
- Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH 44106, USA
| | - Margot S Damaser
- Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH 44106, USA
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Brian K Kwon
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- Department of Orthopaedics, Vancouver Spine Surgery Institute, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
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2
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Moore SA, Olby NJ, Brisson B, Fenn J, Flegel T, Kortz G, Lewis M, Tipold A. ACVIM consensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion. J Vet Intern Med 2022; 36:1570-1596. [PMID: 35880267 PMCID: PMC9511077 DOI: 10.1111/jvim.16480] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/12/2022] [Indexed: 12/16/2022] Open
Abstract
Background Thoracolumbar intervertebral disc extrusion (TL‐IVDE) is the most common cause of acute paraparesis and paraplegia in dogs; however, guidelines on management of the condition are lacking. Objectives To summarize the current literature as it relates to diagnosis and management of acute TL‐IVDE in dogs, and to formulate clinically relevant evidence‐based recommendations. Animals None. Methods A panel of 8 experts was convened to assess and summarize evidence from the peer‐reviewed literature in order to develop consensus clinical recommendations. Level of evidence available to support each recommendation was assessed and reported. Results The majority of available literature described observational studies. Most recommendations made by the panel were supported by a low or moderate level of evidence, and several areas of high need for further study were identified. These include better understanding of the ideal timing for surgical decompression, expected surgical vs medical outcomes for more mildly affected dogs, impact of durotomy on locomotor outcome and development of progressive myelomalacia, and refining of postoperative care, and genetic and preventative care studies. Conclusions and Clinical Importance Future efforts should build on current recommendations by conducting prospective studies and randomized controlled trials, where possible, to address identified gaps in knowledge and to develop cost effectiveness and number needed to treat studies supporting various aspects of diagnosis and treatment of TL‐IVDE.
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Affiliation(s)
- Sarah A Moore
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | | | - Brigitte Brisson
- Department of Clinical Studies, Ontario Veterinary College, Ontario Veterinary College, Guelph, Ontario, Canada
| | - Joe Fenn
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Thomas Flegel
- Department for Small Animals, Leipzig University, Leipzig, Germany
| | - Gregg Kortz
- VCA Sacramento Veterinary Referral Center, Sacramento, California, USA.,VCA Sacramento Veterinary Referral Center, UC Davis, California, USA
| | - Melissa Lewis
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hanover, Hanover, Germany
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Granger N, Olby NJ, Nout-Lomas YS. Bladder and Bowel Management in Dogs With Spinal Cord Injury. Front Vet Sci 2020; 7:583342. [PMID: 33263015 PMCID: PMC7686579 DOI: 10.3389/fvets.2020.583342] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/22/2020] [Indexed: 11/13/2022] Open
Abstract
Spinal cord injury in companion dogs can lead to urinary and fecal incontinence or retention, depending on the severity, and localization of the lesion along the canine nervous system. The bladder and gastrointestinal dysfunction caused by lesions of the autonomic system can be difficult to recognize, interpret and are easily overlooked. Nevertheless, it is crucial to maintain a high degree of awareness of the impact of micturition and defecation disturbances on the animal's condition, welfare and on the owner. The management of these disabilities is all the more challenging that the autonomic nervous system physiology is a complex topic. In this review, we propose to briefly remind the reader the physiology of micturition and defecation in dogs. We then present the bladder and gastrointestinal clinical signs associated with sacral lesions (i.e., the L7-S3 spinal cord segments and nerves) and supra-sacral lesions (i.e., cranial to the L7 spinal cord segment), largely in the context of intervertebral disc herniation. We summarize what is known about the natural recovery of urinary and fecal continence in dogs after spinal cord injury. In particular we review the incidence of urinary tract infection after injury. We finally explore the past and recent literature describing management of urinary and fecal dysfunction in the acute and chronic phase of spinal cord injury. This comprises medical therapies but importantly a number of surgical options, some known for decades such as sacral nerve stimulation, that might spark some interest in the field of spinal cord injury in companion dogs.
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Affiliation(s)
- Nicolas Granger
- The Royal Veterinary College, University of London, Hertfordshire, United Kingdom.,CVS Referrals, Bristol Veterinary Specialists at Highcroft, Bristol, United Kingdom
| | - Natasha J Olby
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States
| | - Yvette S Nout-Lomas
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States
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4
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Spitzbarth I, Moore SA, Stein VM, Levine JM, Kühl B, Gerhauser I, Baumgärtner W. Current Insights Into the Pathology of Canine Intervertebral Disc Extrusion-Induced Spinal Cord Injury. Front Vet Sci 2020; 7:595796. [PMID: 33195632 PMCID: PMC7653192 DOI: 10.3389/fvets.2020.595796] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/30/2020] [Indexed: 11/13/2022] Open
Abstract
Spinal cord injury (SCI) in dogs is commonly attributed to intervertebral disc extrusion (IVDE). Over the last years substantial progress was made in the elucidation of factors contributing to the pathogenesis of this common canine disease. A detailed understanding of the underlying histopathological and molecular alterations in the lesioned spinal cord represents a prerequisite to translate knowledge on the time course of secondary injury processes into the clinical setting. This review summarizes the current state of knowledge of the underlying pathology of canine IVDE-related SCI. Pathological alterations in the spinal cord of dogs affected by IVDE-related SCI include early and persisting axonal damage and glial responses, dominated by phagocytic microglia/macrophages. These processes are paralleled by a pro-inflammatory microenvironment with dysregulation of cytokines and matrix metalloproteinases within the spinal cord. These data mirror findings from a clinical and therapeutic perspective and can be used to identify biomarkers that are able to more precisely predict the clinical outcome. The pathogenesis of progressive myelomalacia, a devastating complication of SCI in dogs, is not understood in detail so far; however, a fulminant and exaggerating secondary injury response with massive reactive oxygen species formation seems to be involved in this unique neuropathological entity. There are substantial gaps in the knowledge of pathological changes in IVDE with respect to more advanced and chronic lesions and the potential involvement of demyelination. Moreover, the role of microglia/macrophage polarization in IVDE-related SCI still remains to be investigated. A close collaboration of clinical neurologists and veterinary pathologists will help to facilitate an integrative approach to a more detailed understanding of the molecular pathogenesis of canine IVDE and thus to identify therapeutic targets.
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Affiliation(s)
- Ingo Spitzbarth
- Faculty of Veterinary Medicine, Institute of Veterinary Pathology, Leipzig University, Leipzig, Germany
| | - Sarah A Moore
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, United States
| | - Veronika M Stein
- Department for Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Jonathan M Levine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Bianca Kühl
- Department of Pathology, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Ingo Gerhauser
- Department of Pathology, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Wolfgang Baumgärtner
- Department of Pathology, University of Veterinary Medicine Hannover, Hanover, Germany
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5
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Lewis MJ, Granger N, Jeffery ND. Emerging and Adjunctive Therapies for Spinal Cord Injury Following Acute Canine Intervertebral Disc Herniation. Front Vet Sci 2020; 7:579933. [PMID: 33195591 PMCID: PMC7593405 DOI: 10.3389/fvets.2020.579933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/04/2020] [Indexed: 11/13/2022] Open
Abstract
Some dogs do not make a full recovery following medical or surgical management of acute canine intervertebral disc herniation (IVDH), highlighting the limits of currently available treatment options. The multitude of difficulties in treating severe spinal cord injury are well-recognized, and they have spurred intense laboratory research, resulting in a broad range of strategies that might have value in treating spinal cord-injured dogs. These include interventions that aim to directly repair the spinal cord lesion, promote axonal sparing or regeneration, mitigate secondary injury through neuroprotective mechanisms, or facilitate functional compensation. Despite initial promise in experimental models, many of these techniques have failed or shown mild efficacy in clinical trials in humans and dogs, although high quality evidence is lacking for many of these interventions. However, the continued introduction of new options to the veterinary clinic remains important for expanding our understanding of the mechanisms of injury and repair and for development of novel and combined strategies for severely affected dogs. This review outlines adjunctive or emerging therapies that have been proposed as treatment options for dogs with acute IVDH, including discussion of local or lesion-based approaches as well as systemically applied treatments in both acute and subacute-to-chronic settings. These interventions include low-level laser therapy, electromagnetic fields or oscillating electrical fields, adjunctive surgical techniques (myelotomy or durotomy), systemically or locally-applied hypothermia, neuroprotective chemicals, physical rehabilitation, hyperbaric oxygen therapy, electroacupuncture, electrical stimulation of the spinal cord or specific peripheral nerves, nerve grafting strategies, 4-aminopyridine, chondroitinase ABC, and cell transplantation.
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Affiliation(s)
- Melissa J Lewis
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, United States
| | - Nicolas Granger
- The Royal Veterinary College, University of London, Hertfordshire, United Kingdom.,CVS Referrals, Bristol Veterinary Specialists at Highcroft, Bristol, United Kingdom
| | - Nick D Jeffery
- Department of Small Animal Clinical Sciences, Texas A & M College of Veterinary Medicine and Biomedical Sciences, College Station, TX, United States
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6
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Olby N, Griffith E, Levine J. Comparison of Gait Assessment Scales in Dogs with Spinal Cord Injury from Intervertebral Disc Herniation. J Neurotrauma 2020; 37:1991-1998. [PMID: 31914849 DOI: 10.1089/neu.2019.6804] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Naturally occurring thoracolumbar spinal cord injury (SCI) is common in dogs, and multi-center veterinary clinical studies can serve as translational tools to identify potentially effective therapies for human clinical trials. Assessment of gait is a key outcome, and several scales are used in dogs. The purpose of this study was to determine whether an international group of researchers could score gait reliably, to compare and contrast the performance of gait scales and to describe appropriate data analysis techniques. A training module was developed for a binary scale, modified Frankel Scale (MFS), Texas SCI Scale (TSCIS), and Open Field Scale (OFS). Raters viewed the training module, scored five training video clips to achieve proficiency, then scored 30 video clips from 10 dogs recovering from SCI. Interrater reliability was calculated, and correlation between scales was examined. Ceiling effect was described. Twenty raters with differing experience participated. The training module took 16 min to view. Raters chose identical binary outcomes in 597 of 600 observations. Intraclass correlation for MFS, TSCIS, and OFS was excellent at 0.85, 0.96, and 0.96, respectively, regardless of rater expertise. Ceiling effect occurred in all dogs that recovered ambulation, particularly using MFS and binary outcome. The TSCIS and OFS captured recovery of ambulatory dogs better, and addition of scores on hopping and proprioception mitigated ceiling effect. We conclude that gait in dogs with SCI can be scored reliably after training. A variety of different gait scales can be used in multi-center trials to capture outcome in different ways.
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Affiliation(s)
- Natasha Olby
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA.,The Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
| | - Emily Griffith
- Department of Statistics, North Carolina State University College of Sciences, Raleigh, North Carolina, USA
| | - Jon Levine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, College Station, Texas, USA
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Cook L, Byron J, Moore S. Urological Sequelae to Acute Spinal Cord Injury in Pet Dogs: A Natural Disease Model of Neuropathic Bladder Dysfunction. Top Spinal Cord Inj Rehabil 2020; 25:205-213. [PMID: 31548787 DOI: 10.1310/sci2503-205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The authors review urologic dysfunction, including urine retention, incontinence, and recurrent and resistant urinary tract infection, in dogs as a sequela to acute spinal cord injury. Urologic sequelae to acute spinal cord injury (SCI) pose significant complications in human and canine patients impacting quality of life and long-term cost of treatment. Dogs with intervertebral disc extrusion may serve as a natural disease model of acute SCI for investigating translational interventions, both prophylactic and therapeutic, for urologic dysfunction in human SCI patients.
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8
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Peyronnet B, Richard C, Bendavid C, Naudet F, Hascoet J, Brochard C, Senal N, Jezequel M, Alimi Q, Khene Z, Corlu A, Clément B, Siproudhis L, Bouguen G, Kerdraon J, Manunta A, Gamé X. Urinary TIMP‐2 and MMP‐2 are significantly associated with poor bladder compliance in adult patients with spina bifida. Neurourol Urodyn 2019; 38:2151-2158. [DOI: 10.1002/nau.24163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 08/25/2019] [Indexed: 01/25/2023]
Affiliation(s)
- Benoit Peyronnet
- Service d'urologieCHU Rennes Rennes France
- Centre de référence spina bifidaCHU Rennes Rennes France
- Equipe thématique INPHY CIC 1414 et INSERM UMR 991CHU Rennes Rennes France
| | - Claire Richard
- Service d'urologieCHU Rennes Rennes France
- Centre de référence spina bifidaCHU Rennes Rennes France
| | | | - Florian Naudet
- Service de pharmaco‐épidémiologieCHU Rennes Rennes France
| | - Juliette Hascoet
- Service d'urologieCHU Rennes Rennes France
- Centre de référence spina bifidaCHU Rennes Rennes France
- Equipe thématique INPHY CIC 1414 et INSERM UMR 991CHU Rennes Rennes France
| | - Charlène Brochard
- Centre de référence spina bifidaCHU Rennes Rennes France
- Equipe thématique INPHY CIC 1414 et INSERM UMR 991CHU Rennes Rennes France
- Service de Gastro‐EntérologieCHU Rennes Rennes France
| | - Nelly Senal
- Centre de référence spina bifidaCHU Rennes Rennes France
- Service de médecine physique et réadaptationFondation Calvé Berck‐sur‐mer France
| | | | - Quentin Alimi
- Service d'urologieCHU Rennes Rennes France
- Centre de référence spina bifidaCHU Rennes Rennes France
| | | | | | | | - Laurent Siproudhis
- Centre de référence spina bifidaCHU Rennes Rennes France
- Equipe thématique INPHY CIC 1414 et INSERM UMR 991CHU Rennes Rennes France
- Service de pharmaco‐épidémiologieCHU Rennes Rennes France
| | - Guillaume Bouguen
- Equipe thématique INPHY CIC 1414 et INSERM UMR 991CHU Rennes Rennes France
- Service de Gastro‐EntérologieCHU Rennes Rennes France
| | - Jacques Kerdraon
- Centre de référence spina bifidaCHU Rennes Rennes France
- Service des blessés médullairesCentre de rééducation de Kerpape Ploemeur France
| | - Andrea Manunta
- Service d'urologieCHU Rennes Rennes France
- Centre de référence spina bifidaCHU Rennes Rennes France
| | - Xavier Gamé
- Département d’Urologie, Transplantation Rénale et AndrologieCHU Rangueil Toulouse France
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Trivedi A, Noble-Haeusslein LJ, Levine JM, Santucci AD, Reeves TM, Phillips LL. Matrix metalloproteinase signals following neurotrauma are right on cue. Cell Mol Life Sci 2019; 76:3141-3156. [PMID: 31168660 PMCID: PMC11105352 DOI: 10.1007/s00018-019-03176-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 05/22/2019] [Accepted: 05/29/2019] [Indexed: 12/20/2022]
Abstract
Neurotrauma, a term referencing both traumatic brain and spinal cord injuries, is unique to neurodegeneration in that onset is clearly defined. From the perspective of matrix metalloproteinases (MMPs), there is opportunity to define their temporal participation in injury and recovery beginning at the level of the synapse. Here we examine the diverse roles of MMPs in the context of targeted insults (optic nerve lesion and hippocampal and olfactory bulb deafferentation), and clinically relevant focal models of traumatic brain and spinal cord injuries. Time-specific MMP postinjury signaling is critical to synaptic recovery after focal axonal injuries; members of the MMP family exhibit a signature temporal profile corresponding to axonal degeneration and regrowth, where they direct postinjury reorganization and synaptic stabilization. In both traumatic brain and spinal cord injuries, MMPs mediate early secondary pathogenesis including disruption of the blood-brain barrier, creating an environment that may be hostile to recovery. They are also critical players in wound healing including angiogenesis and the formation of an inhibitory glial scar. Experimental strategies to reduce their activity in the acute phase result in long-term neurological recovery after neurotrauma and have led to the first clinical trial in spinal cord injured pet dogs.
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Affiliation(s)
- Alpa Trivedi
- Department of Laboratory Medicine, University of California, San Francisco, 513 Parnassus Avenue, HSE 760, San Francisco, CA, 94143, USA.
| | - Linda J Noble-Haeusslein
- Departments of Psychology, College of Liberal Arts, and Neurology, the Dell Medical School, University of Texas, Austin, TX, 78712, USA
| | - Jonathan M Levine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Alison D Santucci
- Department of Neuroscience, Skidmore College, Saratoga Springs, NY, 12866, USA
| | - Thomas M Reeves
- Department of Anatomy and Neurobiology, Medical Campus, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Linda L Phillips
- Department of Anatomy and Neurobiology, Medical Campus, Virginia Commonwealth University, Richmond, VA, 23298, USA
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Calisto FCFS, Vilar FO, Lustosa ES, Calisto SLS, Schots HO, Lima SVC. A new bladder-emptying method in females with neurogenic bladder: A randomized, phase II trial. Neurourol Urodyn 2019; 38:1721-1727. [PMID: 31165506 DOI: 10.1002/nau.24048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 05/11/2019] [Accepted: 05/12/2019] [Indexed: 11/12/2022]
Abstract
AIM To evaluate the performance of the new device compared with clean intermittent catheterization (CIC). METHODS From March 2015 to March 2018, patients who were admitted to the urologic outpatient clinic. A new intraurethral self-retaining device (ISRD) was made of medical grade silicone and it was inspired by similar catheters that use sliding disks to adjust or fix tubes used to drain the bladder. Patients were randomized into two groups (experimental group [GI]-ISRD vs control group [GII]-CIC). The evaluation was performed at the time of enrollment and 6 months after treatment. Intervention was initiated from the antisepsis of the perineal region and subsequent introduction of the device through the external urethral meatus. The primary outcome was quality of life (QOL). Urinary tract infections (UTIs) episodes, data on urodynamic parameters, adverse effects and number of diapers per day. RESULTS A total of 177 subjects were analyzed. We found a significant improvement on QOL analysis in the ISRD group (P < .01). ISRD group presented an important reduction (two episodes after ISRD use) on number of UTIs (P < .01) and diaper use, and significant improvement on bladder capacity (80 mL of the average improvement) (P < .01) and compliance (P = .01). Among all registered serious adverse effects, ISRD presented with lower proportion. CONCLUSIONS The new device has shown to be a safe and promising alternative for adequate emptying of the neurogenic bladder in female patients. Our study has a limitation that is related to a limited period of observation.
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Affiliation(s)
- Fernanda C F S Calisto
- Postgraduate Program of Surgery, Center for Health Sciences, Federal University of Pernambuco UFPE, Recife, Brazil
| | - Fabio O Vilar
- Department of Urology, Hospital das Clínicas, Federal University of Pernambuco UFPE, Recife, Brazil
| | - Eugênio S Lustosa
- Department of Urology, Hospital das Clínicas, Federal University of Pernambuco UFPE, Recife, Brazil
| | - Sérgio L S Calisto
- Department of Urology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil
| | - Heron O Schots
- Department of Urology, Hospital das Clínicas, Federal University of Pernambuco UFPE, Recife, Brazil
| | - Salvador V C Lima
- Department of Surgery, Center for Health Sciences, Federal University of Pernambuco UFPE, Recife, Brazil
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11
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Zidan N, Fenn J, Griffith E, Early PJ, Mariani CL, Muñana KR, Guevar J, Olby NJ. The Effect of Electromagnetic Fields on Post-Operative Pain and Locomotor Recovery in Dogs with Acute, Severe Thoracolumbar Intervertebral Disc Extrusion: A Randomized Placebo-Controlled, Prospective Clinical Trial. J Neurotrauma 2018; 35:1726-1736. [DOI: 10.1089/neu.2017.5485] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Natalia Zidan
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Joe Fenn
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - Emily Griffith
- Department of Statistics, North Carolina State University, Raleigh, North Carolina
| | - Peter J. Early
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Chris L. Mariani
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Karen R. Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Julien Guevar
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Natasha J. Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
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12
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Abstract
Glial cell types were classified less than 100 years ago by del Rio-Hortega. For instance, he correctly surmised that microglia in pathologic central nervous system (CNS) were "voracious monsters" that helped clean the tissue. Although these historical predictions were remarkably accurate, innovative technologies have revealed novel molecular, cellular, and dynamic physiologic aspects of CNS glia. In this review, we integrate recent findings regarding the roles of glia and glial interactions in healthy and injured spinal cord. The three major glial cell types are considered in healthy CNS and after spinal cord injury (SCI). Astrocytes, which in the healthy CNS regulate neurotransmitter and neurovascular dynamics, respond to SCI by becoming reactive and forming a glial scar that limits pathology and plasticity. Microglia, which in the healthy CNS scan for infection/damage, respond to SCI by promoting axon growth and remyelination-but also with hyperactivation and cytotoxic effects. Oligodendrocytes and their precursors, which in healthy tissue speed axon conduction and support axonal function, respond to SCI by differentiating and producing myelin, but are susceptible to death. Thus, post-SCI responses of each glial cell can simultaneously stimulate and stifle repair. Interestingly, potential therapies could also target interactions between these cells. Astrocyte-microglia cross-talk creates a feed-forward loop, so shifting the response of either cell could amplify repair. Astrocytes, microglia, and oligodendrocytes/precursors also influence post-SCI cell survival, differentiation, and remyelination, as well as axon sparing. Therefore, optimizing post-SCI responses of glial cells-and interactions between these CNS cells-could benefit neuroprotection, axon plasticity, and functional recovery.
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Affiliation(s)
- Andrew D Gaudet
- Department of Psychology and Neuroscience, University of Colorado Boulder, Muenzinger D244 | 345 UCB, Boulder, CO, 80309, USA.
- Center for Neuroscience, University of Colorado Boulder, Muenzinger D244 | 345 UCB, Boulder, CO, 80309, USA.
| | - Laura K Fonken
- Division of Pharmacology and Toxicology, University of Texas at Austin, Austin, TX, 78712, USA
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