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Vidal N, Brunet-Gouet E, Frileux S, Aouizerate B, Aubin V, Belzeaux R, Courtet P, D'Amato T, Dubertret C, Etain B, Haffen E, Januel D, Leboyer M, Lefrere A, Llorca PM, Marlinge E, Olié E, Polosan M, Schwan R, Walter M, Passerieux C, Roux P. Comparative analysis of anticholinergic burden scales to explain iatrogenic cognitive impairment and self-reported side effects in the euthymic phase of bipolar disorders: Results from the FACE-BD cohort. Eur Neuropsychopharmacol 2023; 77:67-79. [PMID: 37741163 DOI: 10.1016/j.euroneuro.2023.08.502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/25/2023]
Abstract
Bipolar disorders (BD) are characterized by cognitive impairment during the euthymic phase, to which treatments can contribute. The anticholinergic properties of medications, i.e., the ability of a treatment to inhibit cholinergic receptors, are associated with cognitive impairment in elderly patients and people with schizophrenia but this association has not been well characterized in individuals with remitted BD. Moreover, the validity of only one anticholinergic burden scale designed to assess the anticholinergic load of medications has been tested in BD. In a literature review, we identified 31 existing scales. We first measured the associations between 27 out of the 31 scales and objective cognitive impairment in bivariable regressions. We then adjusted the bivariable models with covariates: the scales significantly associated with cognitive impairment in bivariable and multiple logistic regressions were defined as having good concurrent validity to assess cognitive impairment. In a sample of 2,031 individuals with euthymic BD evaluated with a neuropsychological battery, two scales had good concurrent validity to assess cognitive impairment, whereas chlorpromazine equivalents, lorazepam equivalents, the number of antipsychotics, or the number of treatments had not. Finally, similar analyses with subjective anticholinergic side-effects as outcome variables reported 14 scales with good concurrent validity to assess self-reported peripheral anticholinergic side-effects and 13 to assess self-reported central anticholinergic side-effects. Thus, we identified valid scales to monitor the anticholinergic burden in BD, which may be useful in estimating iatrogenic cognitive impairment in studies investigating cognition in BD.
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Affiliation(s)
- N Vidal
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France.
| | - E Brunet-Gouet
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France
| | - S Frileux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Laboratoire NutriNeuro (UMR INRA 1286), Université de Bordeaux, Bordeaux, France
| | - V Aubin
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - R Belzeaux
- Fondation FondaMental, Créteil, France; Pôle universitaire de psychiatrie, CHU de Montpellier, Montpellier, France; INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - P Courtet
- Fondation FondaMental, Créteil, France; CHU Montpellier, Hôpital Lapeyronie, Psychiatric Emergency and Post Emergency Department, Pole Urgence; IGF, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - T D'Amato
- Fondation FondaMental, Créteil, France; University Lyon 1, Villeurbanne; INSERM, U1028; CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France, Université de Paris, Inserm UMR1266, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - B Etain
- Fondation FondaMental, Créteil, France; Assistance publique des Hôpitaux de Paris, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - E Haffen
- Fondation FondaMental, Créteil, France; Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, UFC, UBFC, Besançon, France
| | - D Januel
- Fondation FondaMental, Créteil, France; Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France; Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory,; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - A Lefrere
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France, INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France; Centre Hospitalier et Universitaire, Département de Psychiatrie, Université d'Auvergne, EA 7280, Clermont-Ferrand, France
| | - E Marlinge
- Fondation FondaMental, Créteil, France; Assistance publique des Hôpitaux de Paris, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - E Olié
- Fondation FondaMental, Créteil, France; CHU Montpellier, Hôpital Lapeyronie, Psychiatric Emergency and Post Emergency Department, Pole Urgence; IGF, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - M Polosan
- Fondation FondaMental, Créteil, France; Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - R Schwan
- Fondation FondaMental, Créteil, France; Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254, Nancy, France
| | - M Walter
- Fondation FondaMental, Créteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02, CHRU de Brest, Hôpital de Bohars, Brest, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France
| | - P Roux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France
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Röthlin K, Anding R, Seifert H, Hund-Georgiadis M, Möhr S, Walter M. The Efficacy and Safety of Intrasphincteric Botulinum Toxin-A Injections in Patients with Non-Spinal Cord Injury-Related Detrusor Sphincter Dyssynergia: A Retrospective Study. Biomedicines 2023; 11:3016. [PMID: 38002018 PMCID: PMC10669099 DOI: 10.3390/biomedicines11113016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/01/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Botulinum toxin-A (BoNT-A) injections into the external urethral sphincter are an established therapeutic procedure for reducing bladder outlet obstruction in patients with detrusor sphincter dyssynergia (DSD) due to spinal cord injury (SCI). Given the paucity of data on patients with DSD but without SCI, we aimed to assess the efficacy of intrasphincteric BoNT-A injections in this cohort. For this retrospective study, we screened all patients who underwent their first intrasphincteric BoNT-A injection at our institution between 2015 and 2021. The inclusion criteria were patients aged 18 years or older with neurogenic detrusor overactivity (NDO) and DSD with a maximum detrusor pressure (Pdetmax) of >40 cmH2O, confirmed via video-urodynamic studies (VUDS). The primary outcome was a reduction in Pdetmax and detrusor overactivity leak point pressure (DOLPP) during NDO-associated urinary incontinence posttreatment. The secondary outcome was a reduction in patients relying on indwelling urinary catheters posttreatment. We included 13 eligible patients (all male, median age 31 years, with different underlying neurological disorders, except SCI). All underwent intrasphincteric BoNT-A injections with either 100 (n = 7) or 150 (n = 6) units, respectively. Pdetmax during voiding was significantly reduced posttreatment (median 105 vs. 54 cmH2O, p = 0.006), whereas DOLPP remained unchanged (i.e., median 50 cmH2O). While seven patients relied on indwelling urinary catheters pre-treatment, all were catheter-free posttreatment. Intrasphincteric BoNT-A injections in patients with non-SCI related DSD appear feasible for reducing bladder outlet obstruction to a certain degree in this cohort and subsequently for reducing the rate of indwelling catheters.
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Affiliation(s)
- Kilian Röthlin
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (K.R.); (R.A.); (H.S.)
- Neuro-Urology, REHAB Basel, 4055 Basel, Switzerland
| | - Ralf Anding
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (K.R.); (R.A.); (H.S.)
- Alta uro AG, Medical Center for Urology, 4051 Basel, Switzerland
| | - Helge Seifert
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (K.R.); (R.A.); (H.S.)
| | | | - Sandra Möhr
- Alta uro AG, Medical Center for Urology, 4051 Basel, Switzerland
| | - Matthias Walter
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (K.R.); (R.A.); (H.S.)
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Hodgkiss DD, Bhangu GS, Lunny C, Jutzeler CR, Chiou SY, Walter M, Lucas SJE, Krassioukov AV, Nightingale TE. Exercise and aerobic capacity in individuals with spinal cord injury: A systematic review with meta-analysis and meta-regression. PLoS Med 2023; 20:e1004082. [PMID: 38011304 PMCID: PMC10712898 DOI: 10.1371/journal.pmed.1004082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/11/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND A low level of cardiorespiratory fitness [CRF; defined as peak oxygen uptake ([Formula: see text]O2peak) or peak power output (PPO)] is a widely reported consequence of spinal cord injury (SCI) and a major risk factor associated with chronic disease. However, CRF can be modified by exercise. This systematic review with meta-analysis and meta-regression aimed to assess whether certain SCI characteristics and/or specific exercise considerations are moderators of changes in CRF. METHODS AND FINDINGS Databases (MEDLINE, EMBASE, CENTRAL, and Web of Science) were searched from inception to March 2023. A primary meta-analysis was conducted including randomised controlled trials (RCTs; exercise interventions lasting >2 weeks relative to control groups). A secondary meta-analysis pooled independent exercise interventions >2 weeks from longitudinal pre-post and RCT studies to explore whether subgroup differences in injury characteristics and/or exercise intervention parameters explained CRF changes. Further analyses included cohort, cross-sectional, and observational study designs. Outcome measures of interest were absolute (A[Formula: see text]O2peak) or relative [Formula: see text]O2peak (R[Formula: see text]O2peak), and/or PPO. Bias/quality was assessed via The Cochrane Risk of Bias 2 and the National Institute of Health Quality Assessment Tools. Certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random effects models were used in all meta-analyses and meta-regressions. Of 21,020 identified records, 120 studies comprising 29 RCTs, 67 pre-post studies, 11 cohort, 7 cross-sectional, and 6 observational studies were included. The primary meta-analysis revealed significant improvements in A[Formula: see text]O2peak [0.16 (0.07, 0.25) L/min], R[Formula: see text]O2peak [2.9 (1.8, 3.9) mL/kg/min], and PPO [9 (5, 14) W] with exercise, relative to controls (p < 0.001). Ninety-six studies (117 independent exercise interventions comprising 1,331 adults with SCI) were included in the secondary, pooled meta-analysis which demonstrated significant increases in A[Formula: see text]O2peak [0.22 (0.17, 0.26) L/min], R[Formula: see text]O2peak [2.8 (2.2, 3.3) mL/kg/min], and PPO [11 (9, 13) W] (p < 0.001) following exercise interventions. There were subgroup differences for R[Formula: see text]O2peak based on exercise modality (p = 0.002) and intervention length (p = 0.01), but there were no differences for A[Formula: see text]O2peak. There were subgroup differences (p ≤ 0.018) for PPO based on time since injury, neurological level of injury, exercise modality, and frequency. The meta-regression found that studies with a higher mean age of participants were associated with smaller changes in A[Formula: see text]O2peak and R[Formula: see text]O2peak (p < 0.10). GRADE indicated a moderate level of certainty in the estimated effect for R[Formula: see text]O2peak, but low levels for A[Formula: see text]O2peak and PPO. This review may be limited by the small number of RCTs, which prevented a subgroup analysis within this specific study design. CONCLUSIONS Our primary meta-analysis confirms that performing exercise >2 weeks results in significant improvements to A[Formula: see text]O2peak, R[Formula: see text]O2peak, and PPO in individuals with SCI. The pooled meta-analysis subgroup comparisons identified that exercise interventions lasting up to 12 weeks yield the greatest change in R[Formula: see text]O2peak. Upper-body aerobic exercise and resistance training also appear the most effective at improving R[Formula: see text]O2peak and PPO. Furthermore, acutely injured, individuals with paraplegia, exercising for ≥3 sessions/week will likely experience the greatest change in PPO. Ageing seemingly diminishes the adaptive CRF responses to exercise training in individuals with SCI. REGISTRATION PROSPERO: CRD42018104342.
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Affiliation(s)
- Daniel D. Hodgkiss
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Gurjeet S. Bhangu
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Carole Lunny
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, and University of British Columbia, Vancouver, Canada
| | - Catherine R. Jutzeler
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Schulthess Clinic, Zurich, Switzerland
| | - Shin-Yi Chiou
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, United Kingdom
- Centre for Trauma Science Research, University of Birmingham, Birmingham, United Kingdom
| | - Matthias Walter
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Samuel J. E. Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Andrei V. Krassioukov
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, Canada
| | - Tom E. Nightingale
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Centre for Trauma Science Research, University of Birmingham, Birmingham, United Kingdom
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Leboutte F, Engesser C, Zahiti L, Rentsch CA, Seifert H, Anding R, Hund-Georgiadis M, Möhr S, Walter M. Prevalence of Unfavorable Video-Urodynamic Findings and Clinical Implications in Patients with Minimally Conscious State/Unresponsive Wakefulness Syndrome: A Retrospective Descriptive Analysis. Biomedicines 2023; 11:2432. [PMID: 37760873 PMCID: PMC10525630 DOI: 10.3390/biomedicines11092432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of this retrospective exploratory study was to investigate the prevalence of unfavorable findings during video-urodynamic studies (VUDS) in patients with minimally conscious state (MCS)/unresponsive wakefulness syndrome (UWS) and whether management of the lower urinary tract (LUT) was adjusted accordingly. A retrospective chart review was conducted to screen for patients diagnosed with MCS/UWS at our rehabilitation center between 2011 and 2020. Patients 18 years or older were included and underwent baseline VUDS after being diagnosed with MCS/UWS. We analyzed urodynamic parameters and subsequent changes in LUT management in this cohort. In total, 32 patients (7 females, 25 males, median age 37 years) with MCS/UWS were included for analysis. While at least one unfavorable VUDS finding (i.e., neurogenic detrusor overactivity [NDO], detrusor sphincter dyssynergia {DSD, high maximum detrusor pressure during storage phase [>40 cmH2O], low-compliance bladder [<20 mL/cmH2O], and vesico-uretero-renal reflux [VUR]) was found in each patient, NDO (78.1%, 25/32) and DSD (68.8%, 22/32) were the two most frequent unfavorable VUDS findings. Following baseline VUDS, new LUT treatment options were established in 56.3% (18/32) of all patients. In addition, bladder-emptying methods were changed in 46.9% (15/32) of all patients, resulting in fewer patients relying on indwelling catheters. Our retrospective exploratory study revealed a high prevalence of NDO and DSD in patients with MCS/UWS, illustrating the importance of VUDS to adapt LUT management in this cohort accordingly.
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Affiliation(s)
- Francois Leboutte
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (F.L.); (C.E.); (L.Z.); (C.A.R.); (H.S.)
| | - Christian Engesser
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (F.L.); (C.E.); (L.Z.); (C.A.R.); (H.S.)
| | - Leutrim Zahiti
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (F.L.); (C.E.); (L.Z.); (C.A.R.); (H.S.)
| | - Cyrill A. Rentsch
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (F.L.); (C.E.); (L.Z.); (C.A.R.); (H.S.)
| | - Helge Seifert
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (F.L.); (C.E.); (L.Z.); (C.A.R.); (H.S.)
| | - Ralf Anding
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (F.L.); (C.E.); (L.Z.); (C.A.R.); (H.S.)
| | | | - Sandra Möhr
- Neuro-Urology, REHAB Basel, 4055 Basel, Switzerland
| | - Matthias Walter
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (F.L.); (C.E.); (L.Z.); (C.A.R.); (H.S.)
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Reuken PA, Besteher B, Finke K, Fischer A, Holl A, Katzer K, Lehmann-Pohl K, Lemhöfer C, Nowka M, Puta C, Walter M, Weißenborn C, Stallmach A. Longterm course of neuropsychological symptoms and ME/CFS after SARS-CoV-2-infection: a prospective registry study. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01661-3. [PMID: 37587244 DOI: 10.1007/s00406-023-01661-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/31/2023] [Indexed: 08/18/2023]
Abstract
A significant proportion of patients after SARS-CoV-2 infection suffer from long-lasting symptoms. Although many different symptoms are described, the majority of patients complains about neuropsychological symptoms. Additionally, a subgroup of patients fulfills diagnostic criteria for ME/CFS. We analyzed a registry of all patients presenting in the out-patients clinic at a German university center. For patients with more than one visit, changes in reported symptoms from first to second visit were analyzed. A total of 1022 patients were included in the study, 411 of them had more than one visit. 95.5% of the patients reported a polysymptomatic disease. At the first visit 31.3% of the patients fulfilled ME/CFS criteria after a median time of 255 days post infection and and at the second visit after a median of 402 days, 19.4% still suffered from ME/CFS. Self-reported fatigue (83.7-72.7%) and concentration impairment (66.2-57.9%) decreased from first to second visit contrasting non-significant changes in the structured screening. A significant proportion of SARS-CoV-2 survivors presenting with ongoing symptoms present with ME/CFS. Although the proportion of subjective reported symptoms and their severity reduce over time, a significant proportion of patients suffer from long-lasting symptoms necessitating new therapeutic concepts.
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Affiliation(s)
- P A Reuken
- Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital/Friedrich-Schiller-University Jena, Am Klinikum 1, 07743, Jena, Germany.
| | - B Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - K Finke
- Department of Neurology, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - A Fischer
- Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital/Friedrich-Schiller-University Jena, Am Klinikum 1, 07743, Jena, Germany
| | - A Holl
- Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital/Friedrich-Schiller-University Jena, Am Klinikum 1, 07743, Jena, Germany
| | - K Katzer
- Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital/Friedrich-Schiller-University Jena, Am Klinikum 1, 07743, Jena, Germany
| | - K Lehmann-Pohl
- Center for Sepsis Control and Care (CSCC), Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - C Lemhöfer
- Institute of Physical and Rehabilitation Medicine, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - M Nowka
- Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital/Friedrich-Schiller-University Jena, Am Klinikum 1, 07743, Jena, Germany
| | - C Puta
- Center for Sepsis Control and Care (CSCC), Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
- Center for Interdisciplinary Prevention of Diseases Related to Professional Activities, Jena, Germany
| | - M Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - C Weißenborn
- Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital/Friedrich-Schiller-University Jena, Am Klinikum 1, 07743, Jena, Germany
| | - A Stallmach
- Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital/Friedrich-Schiller-University Jena, Am Klinikum 1, 07743, Jena, Germany
- Center for Sepsis Control and Care (CSCC), Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
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Miller T, Lange D, Kizhakkedathu JN, Yu K, Felix D, Samejima S, Shackleton C, Malik RN, Sachdeva R, Walter M, Krassioukov AV. The Microbiological Burden of Short-Term Catheter Reuse in Individuals with Spinal Cord Injury: A Prospective Study. Biomedicines 2023; 11:1929. [PMID: 37509568 PMCID: PMC10377649 DOI: 10.3390/biomedicines11071929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Despite the risk of developing catheter-associated urinary tract infections (CAUTI), catheter reuse is common among people with spinal cord injury (SCI). This study examined the microbiological burden and catheter surface changes associated with short-term reuse. Ten individuals with chronic SCI reused their catheters over 3 days. Urine and catheter swab cultures were collected daily for analysis. Scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS) analyses were used to assess catheter surface changes. Catheter swab cultures showed no growth after 48 h (47.8%), skin flora (28.9%), mixed flora (17.8%), or bacterial growth (5.5%). Asymptomatic bacteriuria was found for most participants at baseline (n = 9) and all at follow-up (n = 10). Urine samples contained Escherichia coli (58%), Klebsiella pneumoniae (30%), Enterococcus faecalis (26%), Acinetobacter calcoaceticus-baumannii (10%), Pseudomonas aeruginosa (6%) or Proteus vulgaris (2%). Most urine cultures showed resistance to one or more antibiotics (62%). SEM images demonstrated structural damage, biofilm and/or bacteria on all reused catheter surfaces. XPS analyses also confirmed the deposition of bacterial biofilm on reused catheters. Catheter surface changes and the presence of antibiotic-resistant bacteria were evident following short-term reuse, which may increase susceptibility to CAUTI in individuals with SCI despite asymptomatic bacteriuria.
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Affiliation(s)
- Tiev Miller
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
| | - Dirk Lange
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- The Stone Centre at Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada
| | - Jayachandran N Kizhakkedathu
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- Centre for Blood Research, Life Science Institute, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- The School of Biomedical Engineering, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
| | - Kai Yu
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- Centre for Blood Research, Life Science Institute, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
| | - Demian Felix
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- The Stone Centre at Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada
| | - Soshi Samejima
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
| | - Claire Shackleton
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
| | - Raza N Malik
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
| | - Rahul Sachdeva
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC V6T 1Z3, Canada
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC V5Z 2G9, Canada
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7
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Mehnert U, Walter M, Leitner L, Kessler TM, Freund P, Liechti MD, Michels L. Abnormal Resting-State Network Presence in Females with Overactive Bladder. Biomedicines 2023; 11:1640. [PMID: 37371735 DOI: 10.3390/biomedicines11061640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/25/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Overactive bladder (OAB) is a global problem reducing the quality of life of patients and increasing the costs of any healthcare system. The etiology of OAB is understudied but likely involves supraspinal network alterations. Here, we characterized supraspinal resting-state functional connectivity in 12 OAB patients and 12 healthy controls (HC) who were younger than 60 years. Independent component analysis showed that OAB patients had a weaker presence of the salience (Cohen's d = 0.9) and default mode network (Cohen's d = 1.1) and weaker directed connectivity between the fronto-parietal network and salience network with a longer lag time compared to HC. A region of interest analysis demonstrated weaker connectivity in OAB compared to HC (Cohen's d > 1.6 or < -1.6), particularly within the frontal and prefrontal cortices. In addition, weaker seed (insula, ventrolateral prefrontal cortex) to voxel (anterior cingulate cortex, frontal gyrus, superior parietal lobe, cerebellum) connectivity was found in OAB compared to HC (Cohen's d > 1.9). The degree of deviation in supraspinal connectivity in OAB patients (relative to HC) appears to be an indicator of the severity of the lower urinary tract symptoms and an indication that such symptoms are directly related to functional supraspinal alterations. Thus, future OAB therapy options should also consider supraspinal targets, while neuroimaging techniques should be given more consideration in the quest for better phenotyping of OAB.
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Affiliation(s)
- Ulrich Mehnert
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, 8008 Zürich, Switzerland
| | - Matthias Walter
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, 8008 Zürich, Switzerland
- Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland
| | - Lorenz Leitner
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, 8008 Zürich, Switzerland
| | - Thomas M Kessler
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, 8008 Zürich, Switzerland
| | - Patrick Freund
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zürich, 8008 Zürich, Switzerland
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London WC1N 3AR, UK
- Neuroscience Center Zürich, University of Zürich and Swiss Federal Institute of Technology Zürich, 8057 Zürich, Switzerland
| | - Martina D Liechti
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, 8008 Zürich, Switzerland
| | - Lars Michels
- Neuroscience Center Zürich, University of Zürich and Swiss Federal Institute of Technology Zürich, 8057 Zürich, Switzerland
- Department of Neuroradiology, University Hospital Zürich, University of Zürich, 8091 Zürich, Switzerland
- Clinical Neuroscience Center, University Hospital Zürich, 8091 Zürich, Switzerland
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8
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Shackleton C, Samejima S, Miller T, Sachdeva R, Parr A, Samadani U, Netoff T, Hocaloski S, Elliott S, Walter M, Darrow D, Krassioukov A. Effect of epidural spinal cord stimulation on female sexual function after spinal cord injury. Front Neurosci 2023; 17:1155796. [PMID: 37179555 PMCID: PMC10167769 DOI: 10.3389/fnins.2023.1155796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/07/2023] [Indexed: 04/09/2023] Open
Abstract
Sexual dysfunction is a common consequence for women with spinal cord injury (SCI); however, current treatments are ineffective, especially in the under-prioritized population of women with SCI. This case-series, a secondary analysis of the Epidural Stimulation After Neurologic Damage (E-STAND) clinical trial aimed to investigate the effect of epidural spinal cord stimulation (ESCS) on sexual function and distress in women with SCI. Three females, with chronic, thoracic, sensorimotor complete SCI received daily (24 h/day) tonic ESCS for 13 months. Questionnaires, including the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale (FSDS) were collected monthly. There was a 3.2-point (13.2%) mean increase in total FSFI from baseline (24.5 ± 4.1) to post-intervention (27.8 ± 6.6), with a 4.8-50% improvement in the sub-domains of desire, arousal, orgasm and satisfaction. Sexual distress was reduced by 55%, with a mean decrease of 12 points (55.4%) from baseline (21.7 ± 17.2) to post-intervention (9.7 ± 10.8). There was a clinically meaningful change of 14 points in the International Standards for Neurological Classification of Spinal Cord Injury total sensory score from baseline (102 ± 10.5) to post-intervention (116 ± 17.4), without aggravating dyspareunia. ESCS is a promising treatment for sexual dysfunction and distress in women with severe SCI. Developing therapeutic interventions for sexual function is one of the most meaningful recovery targets for people with SCI. Additional large-scale investigations are needed to understand the long-term safety and feasibility of ESCS as a viable therapy for sexual dysfunction. Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03026816, NCT03026816.
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Affiliation(s)
- Claire Shackleton
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Soshi Samejima
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tiev Miller
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Rahul Sachdeva
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ann Parr
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States
| | - Uzma Samadani
- Department of Bioinformatics and Computational Biology, University of Minnesota, Minneapolis, MN, United States
- Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, United States
| | - Theoden Netoff
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States
| | - Shea Hocaloski
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Stacy Elliott
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
- Department of Psychiatry, Vancouver Coastal Health Authority, Vancouver, BC, Canada
- Department of Urologic Sciences, Vancouver Coastal Health Authority, Vancouver, BC, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - David Darrow
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States
- Hennepin County Medical Center, Minneapolis, MN, United States
| | - Andrei Krassioukov
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
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9
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Chand T, Bertram L, Meilicke H, Krylova M, Herrmann L, Martens L, Li M, Croy I, Walter M, Colic L. P-129 Childhood adversity interacts with the relationship among brain network dynamics, cortisol and subjective status after an acute psychosocial stressor. Clin Neurophysiol 2023. [DOI: 10.1016/j.clinph.2023.02.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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10
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Lee AHX, Tse EK, Nightingale TE, Sachdeva R, Walter M, Krassioukov AV. Cannabis health survey on usage in women with spinal cord injury and knowledge among physicians: A cross-sectional study. J Spinal Cord Med 2023; 46:291-297. [PMID: 35349394 PMCID: PMC9987743 DOI: 10.1080/10790268.2022.2038049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Individuals with spinal cord injury (SCI) report using cannabis to self-manage chronic pain and spasticity. However, its safety and efficacy are not well understood. As more women with SCI are pursuing motherhood, clinicians must consider the possibility of maternal cannabis use and its impact on fetal development. Moreover, due to the lack of current evidence for cannabis, it is important to characterize the perceptions and knowledge of physicians towards both recreational and synthetic cannabinoids. DESIGN Two anonymous surveys (10-items each) were conducted. SETTING AND PARTICIPANTS Women with SCI (n = 20) completed an anonymous, online survey regarding cannabis use. Physicians at a Canadian SCI rehabilitation center (n = 15) completed a survey on their knowledge of recreational and synthetic cannabinoids among individuals with SCI. OUTCOME MEASURES Survey 1 evaluated cannabis use patterns and perceptions before/after SCI in women, including during pregnancy and breastfeeding. The aim of Survey 2 was to understand the perception and current knowledge of physicians regarding recreational cannabis and synthetic cannabinoid use by patients with SCI. RESULTS At the time of survey, 7 women with SCI reported use of cannabis, only 4 of them used prior to injury. Managing tone/spasticity (n = 5) was the major reported benefit of cannabis use. Women used cannabis during pregnancy and/or breastfeeding as a sleep aid or relief for morning sickness (n = 1 pregnancy, n = 1 breastfeeding, n = 1 both). The most-reported challenge with cannabis use was difficulty obtaining consistent, desirable effects (n = 5). Almost all physicians (n = 13) described their knowledge on recreational cannabis products as "none, very little or poor", with greater overall comfort and knowledge of synthetic cannabinoids. CONCLUSION Due to the reported use of cannabis during pregnancy/breastfeeding and current impoverishment of physicians' knowledge (particularly regarding recreational cannabis products), it is imperative to further investigate the safety and efficacy of cannabis use in women with SCI.
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Affiliation(s)
- Amanda H X Lee
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Emmanuel K Tse
- MD Undergraduate Program, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Thomas E Nightingale
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham, UK
| | - Rahul Sachdeva
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
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11
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Engesser C, Henkel M, Stieltjes B, Fassbind S, Alargkof V, Engesser J, Walter M, Elyan A, Studer J, Sutter S, Eckert C, Dugas S, Hofmann S, Seifert H, Stalder A, Cornford P, Wetterauer C. Clinical decision making in prostate cancer care - Evaluation of EAU-guidelines use and novel decision support software. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01033-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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12
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Engesser C, Brantner P, Walter M, Gehweiler J, Seifert H, Subotic S, Rentsch C, Wetterauer C, Bubendorf L, Vlajnic T, Hosseini A, Ebbing J. AURORA a 3D model guided nerve sparing technique in robotic radical prostatectomy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00525-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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13
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Fiedler J, Berland K, Borchert JW, Corkery RW, Eisfeld A, Gelbwaser-Klimovsky D, Greve MM, Holst B, Jacobs K, Krüger M, Parsons DF, Persson C, Presselt M, Reisinger T, Scheel S, Stienkemeier F, Tømterud M, Walter M, Weitz RT, Zalieckas J. Perspectives on weak interactions in complex materials at different length scales. Phys Chem Chem Phys 2023; 25:2671-2705. [PMID: 36637007 DOI: 10.1039/d2cp03349f] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nanocomposite materials consist of nanometer-sized quantum objects such as atoms, molecules, voids or nanoparticles embedded in a host material. These quantum objects can be exploited as a super-structure, which can be designed to create material properties targeted for specific applications. For electromagnetism, such targeted properties include field enhancements around the bandgap of a semiconductor used for solar cells, directional decay in topological insulators, high kinetic inductance in superconducting circuits, and many more. Despite very different application areas, all of these properties are united by the common aim of exploiting collective interaction effects between quantum objects. The literature on the topic spreads over very many different disciplines and scientific communities. In this review, we present a cross-disciplinary overview of different approaches for the creation, analysis and theoretical description of nanocomposites with applications related to electromagnetic properties.
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Affiliation(s)
- J Fiedler
- Department of Physics and Technology, University of Bergen, Allégaten 55, 5007 Bergen, Norway.
| | - K Berland
- Department of Mechanical Engineering and Technology Management, Norwegian University of Life Sciences, Campus Ås Universitetstunet 3, 1430 Ås, Norway
| | - J W Borchert
- 1st Institute of Physics, Georg-August-University, Göttingen, Germany
| | - R W Corkery
- Surface and Corrosion Science, Department of Chemistry, KTH Royal Institute of Technology, SE 100 44 Stockholm, Sweden
| | - A Eisfeld
- Max-Planck-Institut für Physik komplexer Systeme, Nöthnitzer Strasse 38, 01187 Dresden, Germany
| | - D Gelbwaser-Klimovsky
- Schulich Faculty of Chemistry and Helen Diller Quantum Center, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - M M Greve
- Department of Physics and Technology, University of Bergen, Allégaten 55, 5007 Bergen, Norway.
| | - B Holst
- Department of Physics and Technology, University of Bergen, Allégaten 55, 5007 Bergen, Norway.
| | - K Jacobs
- Experimental Physics, Saarland University, Center for Biophysics, 66123 Saarbrücken, Germany.,Max Planck School Matter to Life, 69120 Heidelberg, Germany
| | - M Krüger
- Institute for Theoretical Physics, Georg-August-Universität Göttingen, 37073 Göttingen, Germany
| | - D F Parsons
- Department of Chemical and Geological Sciences, University of Cagliari, Cittadella Universitaria, 09042 Monserrato, CA, Italy
| | - C Persson
- Centre for Materials Science and Nanotechnology, University of Oslo, P. O. Box 1048 Blindern, 0316 Oslo, Norway.,Department of Materials Science and Engineering, KTH Royal Institute of Technology, 100 44 Stockholm, Sweden
| | - M Presselt
- Leibniz Institute of Photonic Technology (IPHT), Albert-Einstein-Str. 9, 07745 Jena, Germany
| | - T Reisinger
- Institute for Quantum Materials and Technologies, Karlsruhe Institute of Technology, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Scheel
- Institute of Physics, University of Rostock, Albert-Einstein-Str. 23-24, 18059 Rostock, Germany
| | - F Stienkemeier
- Institute of Physics, University of Freiburg, Hermann-Herder-Str. 3, 79104 Freiburg, Germany
| | - M Tømterud
- Department of Physics and Technology, University of Bergen, Allégaten 55, 5007 Bergen, Norway.
| | - M Walter
- Institute of Physics, University of Freiburg, Hermann-Herder-Str. 3, 79104 Freiburg, Germany
| | - R T Weitz
- 1st Institute of Physics, Georg-August-University, Göttingen, Germany
| | - J Zalieckas
- Department of Physics and Technology, University of Bergen, Allégaten 55, 5007 Bergen, Norway.
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14
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Rietchel L, Ramirez AL, Hocaloski S, Elliott S, Walter M, Krassioukov AV. Characterization of heart rate changes associated with autonomic dysreflexia during penile vibrostimulation and urodynamics. Spinal Cord 2023; 61:8-14. [PMID: 35941361 DOI: 10.1038/s41393-022-00843-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 01/17/2023]
Abstract
STUDY DESIGN Secondary data analysis. OBJECTIVES To characterize autonomic dysreflexia (AD) associated heart rate (HR) changes during penile vibrostimulation (PVS) and urodynamic studies (UDS). SETTING University-based laboratory. METHODS We analyzed blood pressure (BP) and HR data, recorded continuously, from 21 individuals (4 females; median age 41 years [lower and upper quartile, 37; 47]; median time post-injury 18 years [7; 27]; all motor-complete spinal cord injury (SCI) except one; cervical SCI = 15, thoracic [T1-T6] SCI = 6), who underwent PVS (11/21) or UDS (10/21). RESULTS Overall, 47 AD episodes were recorded (i.e. PVS = 37, UDS = 10), with at least one AD episode in each participant. At AD threshold, bradycardia was observed during PVS and UDS in 43% and 30%, respectively. At AD peak (i.e., maximum increase in systolic BP from baseline), bradycardia was observed during PVS and UDS in 65% and 50%, respectively. Tachycardia was detected at AD peak only once during UDS. Our study was limited by a small cohort of participants and the distribution of sex and injury characteristics. CONCLUSIONS Our findings reveal that AD-associated HR changes during PVS and UDS appear to be related to the magnitude of systolic BP increases. Highly elevated systolic BP associated with bradycardia suggests the presence of severe AD. Therefore, we recommend cardiovascular monitoring (preferably with continuous beat-to-beat recordings) during PVS and UDS to detect AD early. Stopping assessments before systolic BP reaches dangerously elevated levels, could reduce the risk of life-threatening complications in this cohort.
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Affiliation(s)
- Lauren Rietchel
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada
| | - Andrea L Ramirez
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada
| | - Shea Hocaloski
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada.,G.F. Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Stacy Elliott
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada.,G.F. Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada.,Vancouver Coastal Health, B.C. Centre for Sexual Medicine, Vancouver, BC, Canada.,Departments of Psychiatry and Urologic Sciences, UBC, Vancouver, BC, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada. .,Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland.
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada. .,G.F. Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada. .,Division of Physical Medicine and Rehabilitation, Faculty of Medicine, UBC, Vancouver, BC, Canada.
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15
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Samejima S, Shackleton C, McCracken L, Malik RN, Miller T, Kavanagh A, Ghuman A, Elliott S, Walter M, Nightingale TE, Berger MJ, Lam T, Sachdeva R, Krassioukov AV. Effects of non-invasive spinal cord stimulation on lower urinary tract, bowel, and sexual functions in individuals with chronic motor-complete spinal cord injury: Protocol for a pilot clinical trial. PLoS One 2022; 17:e0278425. [PMID: 36512558 PMCID: PMC9746997 DOI: 10.1371/journal.pone.0278425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 10/28/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Electrical spinal cord neuromodulation has emerged as a leading intervention for restoring autonomic functions, such as blood pressure, lower urinary tract (LUT), bowel, and sexual functions, following spinal cord injury (SCI). While a few preliminary studies have shown the potential effect of non-invasive transcutaneous spinal cord stimulation (tSCS) on autonomic recovery following SCI, the optimal stimulation parameters, as well as real-time and long-term functional benefits of tSCS are understudied. This trial entitled "Non-invasive Neuromodulation to Treat Bladder, Bowel, and Sexual Dysfunction following Spinal Cord Injury" is a pilot trial to examine the feasibility, dosage effect and safety of tSCS on pelvic organ function for future large-scale randomized controlled trials. METHODS AND ANALYSIS Forty eligible participants with chronic cervical or upper thoracic motor-complete SCI will undergo stimulation mapping and assessment batteries to determine the real-time effect of tSCS on autonomic functions. Thereafter, participants will be randomly assigned to either moderate or intensive tSCS groups to test the dosage effect of long-term stimulation on autonomic parameters. Participants in each group will receive 60 minutes of tSCS per session either twice (moderate) or five (intensive) times per week, over a period of six weeks. Outcome measures include: (a) changes in bladder capacity through urodynamic studies during real-time and after long-term tSCS, and (b) resting anorectal pressure determined via anorectal manometry during real-time tSCS. We also measure assessments of sexual function, neurological impairments, and health-related quality of life using validated questionnaires and semi-structured interviews. ETHICS AND DISSEMINATION Ethical approval has been obtained (CREB H20-01163). All primary and secondary outcome data will be submitted to peer-reviewed journals and disseminated among the broader scientific community and stakeholders.
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Affiliation(s)
- Soshi Samejima
- Faculty of Medicine, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Claire Shackleton
- Faculty of Medicine, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Laura McCracken
- Faculty of Medicine, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Raza N. Malik
- Faculty of Medicine, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tiev Miller
- Faculty of Medicine, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Alex Kavanagh
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Amandeep Ghuman
- Department of Surgery, St. Paul’s Hospital, Vancouver, BC, Canada
| | - Stacy Elliott
- Faculty of Medicine, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Matthias Walter
- Faculty of Medicine, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Tom E. Nightingale
- Faculty of Medicine, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Michael J. Berger
- Faculty of Medicine, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Tania Lam
- Faculty of Medicine, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Rahul Sachdeva
- Faculty of Medicine, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Andrei V. Krassioukov
- Faculty of Medicine, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
- * E-mail:
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16
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Le Glaz A, Lemey C, Berrouiguet S, Walter M, Lemogne C, Flahault C. Physicians' and medical students' beliefs and attitudes toward psychotic disorders: A systematic review. J Psychosom Res 2022; 163:111054. [PMID: 36272378 DOI: 10.1016/j.jpsychores.2022.111054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 10/02/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to analyze physicians' and medical students' (MS) beliefs and attitudes toward people with psychotic disorders. METHODS This systematic review follows the PRISMA guidelines. It was conducted on 5 databases (Pubmed, PsycINFO, Pascal & Francis, Scopus and EMBASE) with a keyword string combining words for physicians' and students' professional status, attitudes toward people, and psychotic disorders. No limitations on publication dates were imposed. RESULTS This review includes 39 articles, among which quantitative studies are in the majority, and general practioners are mainly represented. Schizophrenia is the main condition used to illustrate psychotic disorders and measure stigmatizing attitudes. Physicians' and MS' beliefs toward people with psychotic disorders are mainly represented by dangerousness and unpredictability. They can be reinforced with socio-demographic criteria (age and female gender) or physicians' beliefs about the disease's etiology. The desire for social distance is higher toward patients with schizophrenia compared to other psychiatric disorders, and medical care could be impacted with a tendency to refer them at psychiatric specific care or to anticipate their difficulties and to modify their treatment plan. Stigma scores remain globally high during medical training. Even if specific anti-stigma trainings have a positive impact on beliefs and attitudes, these effects do not last in time. CONCLUSION This review highlights the importance to explore physicians' and medical students' representations about patient with psychosis to understand better their difficulties in the management of these patients.
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Affiliation(s)
- A Le Glaz
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France.
| | - C Lemey
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France; IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France.
| | - S Berrouiguet
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France; IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France; TIM, INSERM, UMR 1101, Brest, France.
| | - M Walter
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France; IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France.
| | - C Lemogne
- Department of Psychiatry and Addictology, AP-HP.Centre-Université de Paris, Paris, Île-de-France, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France.
| | - C Flahault
- Université de Paris, LPPS, F-92100 Boulogne-Billancourt, France; U.F. de Psychologie et Psychiatrie de Liaison et d'Urgences DMU Psychiatrie et Addictologie, AP-HP Centre Université de Paris, France.
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17
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Kastner U, Javaheripour N, Arand J, Schönherr D, Sobanski T, Fehler S, Walter M, Wagner G. Effects of the COVID-19 pandemic on suicide attempts in a rural region in Germany, a 5-year observational study. J Affect Disord 2022; 318:393-399. [PMID: 36113687 PMCID: PMC9472680 DOI: 10.1016/j.jad.2022.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/05/2022] [Accepted: 09/11/2022] [Indexed: 10/26/2022]
Abstract
BACKGROUND The COVID-19 pandemic and public life restrictions may have a negative impact on people's mental health. Therefore, we analyzed whether this condition affected the occurrence of suicide attempts (SA) over 20 months during the pandemic period. METHODS We included patient records according to DSM-5 criteria for suicidal behavior disorders (n = 825) between Jan 1, 2017, and Dec 31, 2021. We applied interrupted time-series Poisson regression models to investigate the effect of the pandemic on SA occurrence, time trends, and seasonal patterns in the whole group of patients as well as stratified by age and gender. RESULTS There was no significant effect of the pandemic on the occurrence of SA in the overall group. However, we observed a significant impact of the pandemic on the seasonal pattern of SA, also the variance differed significantly (pre-pandemic mean ± variance: 13.33 ± 15.75, pandemic: mean ± variance: 13.86 ± 7.26), indicating less periodic variation in SA during the pandemic. Male patients and young adults mainly contributed to this overall effect. Subgroup analysis revealed a significant difference in SA trends during the pandemic in older adults (>55 years) compared with younger adults (18-35 years); SA numbers increased in older adults and decreased in younger adults as the pandemic progressed. LIMITATIONS A few patients may have received initial care in an emergency department after SA without being referred to psychiatry. CONCLUSIONS In general, the COVID-19 pandemic and related measures did not significantly affect the occurrence of SA but did significantly affect the dynamics. In addition, the pandemic appeared to affect suicidal behavior differently across age groups as it progressed. Particularly for the older adult group, negative long-term effects of the pandemic on suicidal behavior can be derived from the present results, indicating the need to strengthen suicide prevention for the elderly.
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Affiliation(s)
- U.W. Kastner
- Department of Psychiatry and Psychotherapy, Helios Fachkliniken Hildburghausen, Eisfelder Str.41, 98646 Hildburghausen, Germany,Correspondence to: U.W. Kastner, Helios Fachkliniken Hildburghausen, Eisfelder Str.41, 98646 Hildburghausen, Germany
| | - N. Javaheripour
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - J. Arand
- Department of Psychiatry and Psychotherapy, Helios Fachkliniken Hildburghausen, Eisfelder Str.41, 98646 Hildburghausen, Germany
| | - D. Schönherr
- Department of Psychiatry and Psychotherapy, Helios Fachkliniken Hildburghausen, Eisfelder Str.41, 98646 Hildburghausen, Germany
| | - T. Sobanski
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Thueringen-Kliniken GmbH, 07318 Saalfeld, Germany
| | - S.W. Fehler
- Department of Psychiatry and Psychotherapy, Helios Fachkliniken Hildburghausen, Eisfelder Str.41, 98646 Hildburghausen, Germany
| | - M. Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - G. Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany,Correspondence to: G. Wagner, Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
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18
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Notredame CE, Wathelet M, Morgiève M, Grandgenèvre P, Debien C, Mannoni C, Pauwels N, Ducrocq F, Leaune E, Binder P, Berrouiguet S, Walter M, Courtet P, Vaiva G, Thomas P. The 3114: A new professional helpline to swing the French suicide prevention in a new paradigm. Eur Psychiatry 2022:1-11. [PMID: 36203338 DOI: 10.1192/j.eurpsy.2022.2318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- C-E Notredame
- CHU Lille, Psychiatry Department, F-59000Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, F-59000Lille, France
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
| | - M Wathelet
- CHU Lille, Psychiatry Department, F-59000Lille, France
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
- Fédération Régionale de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, F-59350St-André, France
- Centre National de Ressources et Résilience pour les psychotraumatismes (Cn2r), F-75000 Paris and F-59000Lille, France
| | - M Morgiève
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
- CERMES3, CNRS, INSERM, University of Paris, F-75006, Paris, France
| | - P Grandgenèvre
- CHU Lille, Psychiatry Department, F-59000Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, F-59000Lille, France
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
| | - C Debien
- CHU Lille, Psychiatry Department, F-59000Lille, France
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
| | - C Mannoni
- Fédération Régionale de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, F-59350St-André, France
| | - N Pauwels
- Fédération Régionale de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, F-59350St-André, France
| | - F Ducrocq
- CHU Lille, Psychiatry Department, F-59000Lille, France
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
| | - E Leaune
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, F-69500Bron, France
| | - P Binder
- Department of general medicine, Medicine and pharmacy University of Poitiers, F-86000Poitiers, France
| | - S Berrouiguet
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
- LaTIM, INSERM, UMR1101, F-29200Brest, France
- CHU Brest, Psychiatry Department, F-29609Brest, France
| | - M Walter
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
- EA 7479 SPURBO, West Brittany University, F-29238Brest, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, F-34000Montpellier, France
| | - P Courtet
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, F-34000Montpellier, France
- IGF, University of Montpellier, CNRS, INSERM, F-34000Montpellier, France
| | - G Vaiva
- CHU Lille, Psychiatry Department, F-59000Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, F-59000Lille, France
- Groupement d'Étude et de Prévention du Suicide, F-86280 Saint-Benoît, France
- Centre National de Ressources et Résilience pour les psychotraumatismes (Cn2r), F-75000 Paris and F-59000Lille, France
| | - P Thomas
- CHU Lille, Psychiatry Department, F-59000Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, F-59000Lille, France
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19
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Moore U, Simon EF, Day J, Jones K, Bharucha-Goebel D, Pestronk A, Walter M, Paradas C, Stojkovic T, Bravver E, Pegoraro E, Mendell J, Guglieri M, Straub V, Díaz-Manera J. FP.35 Myostatin concentration is unreliable as a biomarker of disease progression in dysferlinopathy. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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20
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Murphy L, Alfano L, Brazzo K, Johnson N, Laurent J, Mathews K, Thiele S, Vissing J, Walter M, Woods L, Ørstavik K, Straub V. P.175 Global FKRP registry - the research database for limb girdle muscular dystrophy R9 (2I). Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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21
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Walter M, Ramirez AL, Lee AHX, Nightingale TE, Rapoport D, Kavanagh A, Krassioukov AV. Fesoterodine ameliorates autonomic dysreflexia while improving lower urinary tract function and urinary incontinence-related quality of life in individuals with spinal cord injury: A prospective phase IIa study. J Neurotrauma 2022; 40:1020-1025. [PMID: 36178342 DOI: 10.1089/neu.2022.0333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this prospective phase IIa, open-label exploratory, pre-post study was to determine the efficacy of fesoterodine (i.e., 12-week treatment period) to ameliorate autonomic dysreflexia (AD) in individuals with chronic SCI (>1-year post-injury) at or above the sixth thoracic spinal segment, with confirmed history of AD and neurogenic detrusor overactivity (NDO). Twelve participants (4 females, 8 males; median age 42 years) completed this study and underwent urodynamics, 24-hour ambulatory-blood-pressure-monitoring (ABPM), and urinary incontinence-related quality of life (QoL) measures at baseline and on-treatment. The Montreal Cognitive Assessment (MoCA) and Neurogenic Bowel Dysfunction (NBD) score were used to monitor cognitive and bowel function, respectively. Compared to baseline, fesoterodine improved lower urinary tract (LUT) function, i.e., increased cystometric capacity (205 vs 475mL, p = 0.002) and decreased maximum detrusor pressure (44 vs 12cmH2O, p = 0.009). NDO was eliminated in seven (58%) participants. Severity of AD events during urodynamics (40 vs 27mmHg, p = 0.08) and 24-hour ABPM (59 vs. 36mmHg, p = 0.05) were both reduced, yielding a large effect size (r = -0.58). AD Frequency (14 vs. 3, p = 0.004) during 24-hour ABPM was significantly reduced. Urinary incontinence-related QoL improved (68 vs. 82, p = 0.02), however, cognitive (p = 0.2) and bowel function (p = 0.4) did not change significantly. In conclusion, fesoterodine reduces the magnitude and frequency of AD, while improving LUT function and urinary incontinence-related QoL in individuals with chronic SCI without negatively affecting cognitive or bowel function.
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Affiliation(s)
- Matthias Walter
- University of British Columbia, International Collaboration On Repair Discoveries (ICORD), 818 West 10th Avenue, Vancouver, British Columbia, Canada, V5Z 1M9;
| | - Andrea L Ramirez
- University of British Columbia, International Collaboration On Repair Discoveries (ICORD), Vancouver, British Columbia, Canada;
| | - Amanda Huai Xin Lee
- International Collaboration on Repair Discoveries (ICORD), 818 West 10th Avenue, Vancouver, BC, Vancouver, British Columbia, Canada, V5Z1M9;
| | - Tom E Nightingale
- University of Birmingham, School of Sport, Exercise and Rehabilitation Sciences, Edgbaston, Birmingham, United Kingdom of Great Britain and Northern Ireland, B15 2TT.,The University of British Columbia, International Collaboration On Repair Discoveries, Vancouver, British Columbia, Canada, V6T 1Z4;
| | - Daniel Rapoport
- The University of British Columbia, International Collaboration on Repair Discoveries (ICORD), Vancouver, British Columbia, Canada.,University of British Columbia, Department of Urologic Sciences, Vancouver, British Columbia, Canada;
| | - Alex Kavanagh
- The University of British Columbia, International Collaboration on Repair Discoveries (ICORD), 6th floor Laural St, Vancouver, British Columbia, Canada, V6Z3A5.,University of British Columbia, Department of Urologic Sciences, Vancouver, British Columbia, Canada;
| | - Andrei V Krassioukov
- ICORD/UBC, Medicine, 6270 University Blv., Vancouver, British Columbia, Canada, V6T 1Z4.,Vancouver General Hospital, Vancouver, British Columbia, Canada, V5Z 1L5;
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22
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Balthazaar SJT, Nightingale TE, Currie KD, West CR, Tsang TSM, Walter M, Krassioukov AV. Temporal Changes of Cardiac Structure, Function, and Mechanics During Sub-acute Cervical and Thoracolumbar Spinal Cord Injury in Humans: A Case-Series. Front Cardiovasc Med 2022; 9:881741. [PMID: 35783818 PMCID: PMC9240304 DOI: 10.3389/fcvm.2022.881741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Individuals with cervical spinal cord injury (SCI) experience deleterious changes in cardiac structure and function. However, knowledge on when cardiac alterations occur and whether this is dependent upon neurological level of injury remains to be determined. Transthoracic echocardiography was used to assess left ventricular structure, function, and mechanics in 10 male individuals (median age 34 years, lower and upper quartiles 32–50) with cervical (n = 5, c-SCI) or thoracolumbar (n = 5, tl-SCI) motor-complete SCI at 3- and 6-months post-injury. Compared to the 3-month assessment, individuals with c-SCI displayed structural, functional, and mechanical changes during the 6-month assessment, including significant reductions in end diastolic volume [121 mL (104–139) vs. 101 mL (99–133), P = 0.043], stroke volume [75 mL (61–85) vs. 60 mL (58–80), P = 0.042], myocardial contractile velocity (S') [0.11 m/s (0.10–0.13) vs. 0.09 m/s (0.08–0.10), P = 0.043], and peak diastolic longitudinal strain rate [1.29°/s (1.23–1.34) vs. 1.07°/s (0.95–1.15), P = 0.043], and increased early diastolic filling over early myocardial relaxation velocity (E/E') ratio [5.64 (4.71–7.72) vs. 7.48 (6.42–8.42), P = 0.043]. These indices did not significantly change in individuals with tl-SCI between time points. Ejection fraction was different between individuals with c-SCI and tl-SCI at 3 [61% (57–63) vs. 54% (52–55), P < 0.01] and 6 months [58% (57–62) vs. 55% (52–56), P < 0.01], though values were considered normal. These results demonstrate that individuals with c-SCI exhibit significant reductions in cardiac function from 3 to 6 months post-injury, whereas individuals with tl-SCI do not, suggesting the need for early rehabilitation to minimize cardiac consequences in this specific population.
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Affiliation(s)
- Shane J. T. Balthazaar
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada
| | - Tom E. Nightingale
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Trauma Science Research, University of Birmingham, Birmingham, United Kingdom
| | - Katharine D. Currie
- Department of Kinesiology, Michigan State University, East Lansing, MI, United States
| | - Christopher R. West
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Department of Cellular and Physiological Sciences, Faculty of Medicine, UBC, Vancouver, BC, Canada
| | - Teresa S. M. Tsang
- Department of Cardiology, Vancouver General and UBC Hospitals, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Andrei V. Krassioukov
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, UBC, Vancouver, BC, Canada
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
- *Correspondence: Andrei V. Krassioukov
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23
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Pino IP, Nightingale TE, Hoover C, Zhao Z, Cahalan M, Dorey TW, Walter M, Soriano JE, Netoff TI, Parr A, Samadani U, Phillips AA, Krassioukov AV, Darrow DP. The safety of epidural spinal cord stimulation to restore function after spinal cord injury: post-surgical complications and incidence of cardiovascular events. Spinal Cord 2022; 60:903-910. [PMID: 35701485 DOI: 10.1038/s41393-022-00822-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cohort prospective study. OBJECTIVES Epidural spinal cord stimulation (eSCS) improves volitional motor and autonomic function after spinal cord injury (SCI). While eSCS has an established history of safety for chronic pain, it remains unclear if eSCS in the SCI population presents the same risk profile. We aimed to assess safety and autonomic monitoring data for the first 14 participants in the E-STAND trial. SETTING Hennepin County Medical Center, Minneapolis and Minneapolis Veterans Affairs Medical Center, Minnesota, USA. METHODS Monthly follow-up visits assessed surgical and medical device-related safety outcomes as well as stimulation usage. Beat-by-beat blood pressure (BP) and continuous electrocardiogram data were collected during head-up tilt-table testing with and without eSCS. RESULTS All participants had a motor-complete SCI. Mean (SD) age and time since injury were 38 (10) and 7 (5) years, respectively. There were no surgical complications but one device malfunction 4 months post implantation. Stimulation was applied for up to 23 h/day, across a broad range of parameters: frequency (18-700 Hz), pulse width (100-600 µs), and amplitude (0.4-17 mA), with no adverse events reported. Tilt-table testing with eSCS demonstrated no significant increases in the incidence of elevated systolic BP or a greater frequency of arrhythmias. CONCLUSIONS eSCS to restore autonomic and volitional motor function following SCI has a similar safety profile as when used to treat chronic pain, despite the prevalence of significant comorbidities and the wide variety of stimulation parameters tested.
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Affiliation(s)
- Isabela Peña Pino
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.,Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA.,Division of Neurosurgery, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Thomas E Nightingale
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,International Collaboration on Repair Discoveries (ICORD), University of British Columbia (UBC), Vancouver, BC, Canada.,Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham, UK
| | - Caleb Hoover
- Department of Bioinformatics and Computational Biology, University of Minnesota, Minneapolis, MN, USA
| | - Zixi Zhao
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Mark Cahalan
- MD Undergraduate Program, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Tristan W Dorey
- Cardiovascular and Respiratory Science, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia (UBC), Vancouver, BC, Canada.,Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Jan E Soriano
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Hotchkiss Brain Institute, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Theoden I Netoff
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Ann Parr
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA
| | - Uzma Samadani
- Department of Bioinformatics and Computational Biology, University of Minnesota, Minneapolis, MN, USA.,Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA
| | - Aaron A Phillips
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Hotchkiss Brain Institute, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia (UBC), Vancouver, BC, Canada. .,Department of Medicine, Division of Physical Medicine and Rehabilitation, UBC, Vancouver, BC, Canada. .,GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada.
| | - David P Darrow
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA. .,Division of Neurosurgery, Hennepin County Medical Center, Minneapolis, MN, USA.
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Weidacker K, Kärgel C, Massau C, Krueger THC, Walter M, Ponseti J, Walter H, Schiffer B. Interference inhibition in offending and non-offending pedophiles: A preliminary event-related fMRI study. Neuropsychologia 2022; 173:108301. [PMID: 35697089 DOI: 10.1016/j.neuropsychologia.2022.108301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 11/25/2022]
Abstract
The ability to inhibit behavior is thought to be an import skill for avoiding criminal conduct, especially when combined with personal predispositions or criminogenic needs such as a pedophilic preference disorder. While previous research emphasized the relationship between impulsivity and child sexual offending, not pedophilia per se, studies on the underlying neurobiological mechanisms in subdomains of impulsivity remained scarce. Here, we focused on interference inhibition and examined event-related functional magnetic resonance imaging (fMRI) data of three groups of men performing a color-word Stroop task: (1) pedophiles with a history of CSO (P+CSO, n = 11), (2) pedophiles without a history of CSO (P-CSO, n = 8) and (3) non-pedophilic, non-offending healthy controls (HC, n = 10). On the behavioral level, P+CSO revealed increased Stroop interference as compared to P-CSO and HC. Moreover, increased Stroop interference in P+CSO was accompanied by enhanced conflict-related activity in left superior parietal cortex and precentral gyrus as compared to P-CSO. Albeit behavioral analyses of error and post-error processing revealed no significant between-group differences, P-CSO showed increased post-error-related activity in left posterior cingulate, precuneus and middle temporal gyrus as compared to P+CSO. Our preliminary data highlight inhibition deficits in offending as compared to non-offending pedophiles or healthy men and suggest that functional alterations in attention reallocation and impulse suppression/control may moderate the risk for committing CSO in men suffering from pedophilia.
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Affiliation(s)
- K Weidacker
- School of Psychology, University of Swansea, Swansea, Wales, United Kingdom; Division of Forensic Psychiatry and Psychotherapy, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstr. 1-3; 44791 Bochum, Germany
| | - C Kärgel
- Division of Forensic Psychiatry and Psychotherapy, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstr. 1-3; 44791 Bochum, Germany
| | - C Massau
- Division of Forensic Psychiatry and Psychotherapy, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstr. 1-3; 44791 Bochum, Germany
| | - T H C Krueger
- Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - M Walter
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Germany
| | - J Ponseti
- Institute of Sexual and Forensic Medicine, University Hospital Kiel, Germany
| | - H Walter
- Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Germany
| | - B Schiffer
- Division of Forensic Psychiatry and Psychotherapy, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstr. 1-3; 44791 Bochum, Germany.
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Le Glaz A, Lemey C, Walter M, Lemogne C, Flahault C. Oncologists’ beliefs about people with psychotic disorders : a qualitative study. Eur Psychiatry 2022. [PMCID: PMC9567565 DOI: 10.1192/j.eurpsy.2022.1697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Cancer is the second major cause of death among people with psychotic disorders. With the same incidence, mortality in these patients remains higher than in the general population. As stigma has been identified as a risk factor for excess mortality, we focused on oncologists’ beliefs and attitudes towards people with psychotic disorders.
Objectives
The aim of this study was to uncover physicians’ representations about the impact of psychosis on oncological care.
Methods
In this qualitative study, individual semi-structured interviews were conducted with 20 physicians working in oncology in the University Hospital of Brest (France). Transcribed interviews were thematically analyzed. This study meets the COREQ criteria.
Results
Psychosis is described as a broad-spectrum condition whose severity ranges from the “mild” patient with imperceptible abnormality to the “severe” patient with cognitive and affective deficits. Oncologists identified behavioral and emotional symptoms which may modify the patient-physician relationship with difficulties to interact. Some of them consider that these patients are not interested in their health and will not get involved in oncological care. While the psychotic disorder is not considered as a limiting factor per se, oncologists felt concerned about being stigmatizing. They mentioned different aspects (like anticipation of non-compliance or inability to get help) that lead to changes in conventional treatment regimens and may result in a loss of opportunity.
Conclusions
Oncologists’ beliefs may lead to stigmatizing attitudes towards people with psychotic disorders who may not be given the best possible chances. Thus, these specific elements should be the basis for collaboration between psychiatrists and oncologists.
Disclosure
No significant relationships.
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Spangemacher M, Reinwald J, Böttcher M, Gilles M, Walter M, Sartorius A, Gründer G. Ketamine Metabolite Plasma Levels as Potential Blood Markers of
Ketamine Efficacy in Treatment Resistant Depression. PHARMACOPSYCHIATRY 2022. [DOI: 10.1055/s-0042-1747662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M. Spangemacher
- Department of Molecular Neuroimaging, Central Institute of Mental
Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim,
Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental
Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim,
Germany
| | - J. Reinwald
- Department of Psychiatry and Psychotherapy, Central Institute of Mental
Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim,
Germany
- Department of Translational Imaging, Central Institute of Mental
Health, Medical Faculty Mannheim, University of Heidelberg,
Mannheim
| | | | - M. Gilles
- Department of Psychiatry and Psychotherapy, Central Institute of Mental
Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim,
Germany
| | - M. Walter
- Department of Psychiatry and Psychotherapy, Medical Faculty Tuebingen,
University of Tuebingen Germany
| | - A. Sartorius
- Department of Psychiatry and Psychotherapy, Central Institute of Mental
Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim,
Germany
- Department of Translational Imaging, Central Institute of Mental
Health, Medical Faculty Mannheim, University of Heidelberg,
Mannheim
| | - G. Gründer
- Department of Molecular Neuroimaging, Central Institute of Mental
Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim,
Germany
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Hahn LG, Jones C, Srivatsan SN, Wallendorf M, Walter M, Lavine K. Clonal Hematopoiesis is Common within the Advanced Heart Failure Population and is Associated with Improved Heart Transplant Outcomes. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Fossey MPM, Balthazaar SJT, Squair JW, Williams AM, Poormasjedi-Meibod MS, Nightingale TE, Erskine E, Hayes B, Ahmadian M, Jackson GS, Hunter DV, Currie KD, Tsang TSM, Walter M, Little JP, Ramer MS, Krassioukov AV, West CR. Spinal cord injury impairs cardiac function due to impaired bulbospinal sympathetic control. Nat Commun 2022; 13:1382. [PMID: 35296681 PMCID: PMC8927412 DOI: 10.1038/s41467-022-29066-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 02/20/2022] [Indexed: 02/08/2023] Open
Abstract
Spinal cord injury chronically alters cardiac structure and function and is associated with increased odds for cardiovascular disease. Here, we investigate the cardiac consequences of spinal cord injury on the acute-to-chronic continuum, and the contribution of altered bulbospinal sympathetic control to the decline in cardiac function following spinal cord injury. By combining experimental rat models of spinal cord injury with prospective clinical studies, we demonstrate that spinal cord injury causes a rapid and sustained reduction in left ventricular contractile function that precedes structural changes. In rodents, we experimentally demonstrate that this decline in left ventricular contractile function following spinal cord injury is underpinned by interrupted bulbospinal sympathetic control. In humans, we find that activation of the sympathetic circuitry below the level of spinal cord injury causes an immediate increase in systolic function. Our findings highlight the importance for early interventions to mitigate the cardiac functional decline following spinal cord injury. By combining experimental models with prospective clinical studies, the authors show that spinal cord injury causes a rapid reduction in cardiac function that precedes structural changes, and that the loss of descending sympathetic control is the major cause of reduced cardiac function following spinal cord injury.
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Affiliation(s)
- Mary P M Fossey
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Experimental Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Shane J T Balthazaar
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Experimental Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jordan W Squair
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Alexandra M Williams
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Tom E Nightingale
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Centre for Trauma Sciences Research, University of Birmingham, Edgabaston, Birmingham, UK
| | - Erin Erskine
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Brian Hayes
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Mehdi Ahmadian
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
| | - Garett S Jackson
- Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| | - Diana V Hunter
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Katharine D Currie
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Teresa S M Tsang
- Division of Cardiology, University of British Columbia, Vancouver General and University of British Columbia Hospital Echocardiography Department, Vancouver, BC, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Matt S Ramer
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Zoology, Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada. .,Experimental Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. .,Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. .,GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada.
| | - Christopher R West
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada. .,Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Dorey TW, Walter M, Krassioukov AV. Reduced Reflex Autonomic Responses Following Intradetrusor OnabotulinumtoxinA Injections: A Pre-/Post-study in Individuals With Cervical and Upper Thoracic Spinal Cord Injury. Front Physiol 2021; 12:796277. [PMID: 35069256 PMCID: PMC8769099 DOI: 10.3389/fphys.2021.796277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Urodynamic studies (UDS) can provoke autonomic dysreflexia (AD) in individuals with spinal cord injury (SCI) at and above the sixth thoracic spinal segment potentially leading to profound vagally mediated heart rate (HR) reductions. In this study,1 we test the hypothesis that intradetrusor onabotulinumtoxinA injections will improve HR and its variability (HRV) responses to UDS in individuals with cervical and thoracic SCI. A total of 19 participants with chronic SCI (5 women, mean age 42.5 ± 7.9 years) with confirmed neurogenic detrusor overactivity underwent UDS before (i.e., baseline) and 1 month after intradetrusor onabotulinumtoxinA (200 U) injections (post-treatment). Continuous electrocardiography and blood pressure (BP) recordings were used to assess RR-interval, time, and frequency domain metrics of HRV (a surrogate marker of autonomic nervous system activity), and AD pre- and post-treatment. UDS pre-treatment resulted in increased RR-interval as well as time and frequency domain metrics of HRV. Vagally mediated increases in high-frequency (HF) power during UDS were larger in participants with cervical compared to upper thoracic SCI. Post-treatment, UDS had no effect on RR-interval and significantly reduced instances of bradycardia. Furthermore, intradetrusor onabotulinumtoxinA injections significantly reduced time domain metrics of HRV and HF power responses to UDS across all participants. Changes in HRV during UDS could be a potential indicator of improved autonomic cardiovascular function following interventions such as intradetrusor onabotulinumtoxinA injections.
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Affiliation(s)
- Tristan W. Dorey
- Libin Cardiovascular Institute, Department of Cardiac Sciences, Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
- *Correspondence: Matthias Walter, Andrei V. Krassioukov,
| | - Andrei V. Krassioukov
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- G.F. Strong Rehabilitation Centre, Vancouver, BC, Canada
- *Correspondence: Matthias Walter, Andrei V. Krassioukov,
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Vancappel A, Dansou Y, Godin O, Haffen E, Yrondi A, Stéphan F, Richieri R, Molière F, Horn M, Allauze E, Genty JB, Bouvard A, Dorey JM, Meyrel M, Camus V, Fond G, Péran B, Walter M, Anguill L, Scotto d'Apollonia C, Nguon AS, Fredembach B, Holtzmann J, Vilà E, Petrucci J, Rey, Etain B, Carminati M, Courtet P, Vaiva G, Llorca PM, Leboyer M, Aouizerate B, Bennabi D, El-Hage W. Cognitive impairments in treatment-resistant depression: Results from the French cohort of outpatients (FACE-DR). Journal of Affective Disorders Reports 2021. [DOI: 10.1016/j.jadr.2021.100272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Strohmaier C, Walter M. Genetic testing in the context of familial hypercholesterolaemia: organisational and ethical aspects. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Molecular genetic diagnostics (GDx) is an increasingly used tool in the so-called ‘precision medicine'. For a structured implementation of GDx in screening programmes (SP), organisational and ethical implications must be considered. Our research report addresses implementation aspects of GDx in different health care systems and ethical considerations in the context of familial hypercholesterolaemia (FH)-a malfunction of the lipid metabolism.
Methods
The overview of (inter-)national FH test strategies, characteristics, and ethical aspects of (predictive) GDx is based on an iterative manual literature search in the G-I-N Library and the Trip-Database, followed by a search on health specific web pages. A revision of the Socratic approach by Hofmann et al. assists in analysing ethical aspects.
Results
We selected nine countries for a detailed comparison. Important components in FH treatment are the detection method, clinical criteria indicating a diagnosis, diagnostic tools, implementation, recommendations concerning cascade screening, genetic counselling, registries, and awareness programmes. Detection and diagnosis of index patients comprise of opportunistic approaches or organised systematic screenings in non-specialized or specialized settings. The use of GDx is most often recommended after a clinical diagnosis. In the course of cascade screening of at-risk family members, GDx is partly recommended in existing strategies. Ethical issues especially concern autonomy, informed consent and privacy (addressed during the process of genetic counselling). As a diagnosis by GDx impacts at risk family members, increased risk for intra-familial conflicts arise, e.g. disclosure of test results.
Conclusions
Implementing GDx results in a number of organisational and ethical challenges. Especially, investing in professional and well-trained genetic counsellors seems to be paramount, as the numerous ethical questions require sensitive communication.
Key messages
Our report provides a basis for decision makers to resolve implementation issues of molecular genetic diagnostics in the context of familial hypercholesterolaemia beyond (cost-) effectiveness/safety. In our report we discuss important ethical aspects of molecular genetic diagnostics in the context of familial hypercholesterolaemia that need to be considered by healthcare decision makers.
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Affiliation(s)
- C Strohmaier
- Austrian Institute for Health Technology Assessment, Vienna, Austria
| | - M Walter
- Austrian Institute for Health Technology Assessment, Vienna, Austria
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Moore U, James M, Spuler S, Day J, Jones K, Bharucha-Goebel D, Salort-Campana E, Pestronk A, Walter M, Paradas C, Stojkovic T, Yoshimura MM, Bravver E, Pegoraro E, Mendell J, Bushby K, Straub V, Mayhew A. LGMD. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lee AH, Ramirez AL, Krassioukov AV, Walter M. Long-term neurogenic lower urinary tract dysfunction: A case of cardiovascular nightmares. J Spinal Cord Med 2021; 44:806-810. [PMID: 31140958 PMCID: PMC8477941 DOI: 10.1080/10790268.2019.1617919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
CONTEXT Individuals with spinal cord injury (SCI) suffering from autonomic dysreflexia (AD) due to neurogenic detrusor overactivity (NDO) can effectively be treated with intradetrusor onabotulinumtoxinA. We present a complex case to highlight the treatment's potential limitations to ameliorate AD and improve lower urinary tract (LUT) function in this population. FINDINGS A 46-year old man, who was relying on an indwelling urethral catheter for bladder emptying due to severely impaired hand function following a SCI (C5, AIS B) sustained 30 years ago, underwent intradetrusor onabotulinumtoxinA injections for treatment of refractory NDO and associated AD. Although LUT function slightly improved (i.e. cystometric capacity increased while detrusor pressure was reduced), severe bladder-related AD persisted post-treatment. CONCLUSIONS This case raises awareness of serious considerations when treating NDO-related AD in individuals with longstanding neurogenic LUT dysfunction and compromised dexterity following SCI. Given the limited improvement in LUT function and persisting bladder-related AD following treatment, urinary diversion as advocated in the wider literature should be considered to protect an individual's urinary tract from further deterioration and thus eliminate bladder-related AD consequences long-term. Early treatment and management of NDO and AD is crucial to minimize complications associated with these two major health risks in this population.
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Affiliation(s)
- Amanda H.X. Lee
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrea L. Ramirez
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrei V. Krassioukov
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada,Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada,G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada,Correspondence to: Andrei V. Krassioukov, ICORD-BSCC, 818 West 10th Avenue, Vancouver, BC, Canada, V5Z 1M9; Ph: + (604) 675-8819. E-mail:
| | - Matthias Walter
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Williams AMM, Deegan E, Walter M, Stothers L, Lam T. Exoskeleton gait training to improve lower urinary tract function in people with motor-complete spinal cord injury: A randomized pilot trial. J Rehabil Med 2021; 53:jrm00222. [PMID: 34383958 PMCID: PMC8638733 DOI: 10.2340/16501977-2864] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The primary aim of this study was to determine the feasibility of delivering an exoskeleton-assisted walking intervention targeting lower urinary tract function in people with motor-complete spinal cord injury. Secondary aims were to determine if exoskeleton walking activates the pelvic floor muscles, and compare 2 exoskeleton programmes regarding lower urinary tract function. DESIGN Randomized pilot trial. SUBJECTS Adults with motor-complete spinal cord injury at or above T10. METHODS Participants were randomized to receive Ekso or Lokomat training. Feasibility outcomes included recruitment rate, adherence, and adverse events. Pelvic floor muscle electromyography was recorded during walking. Urodynamic studies, 3-day bladder diary, and Qualiveen-30 were administered pre- and post-training. RESULTS Twelve people were screened and 6 people enrolled in the study. Two subjects withdrew from unrelated reasons. There was one adverse event. Pelvic floor muscle activity was greater in the Ekso group. Lower urinary tract function did not clearly change in either group. CONCLUSION This pilot study demonstrates the feasibility of delivering an exoskeleton training programme targeting lower urinary tract function. Ekso-walking elicits pelvic floor muscle activity, but it remains unclear how locomotor training impacts lower urinary tract function.
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Tahmazov E, Robert G, Walter M, Lemey C. Anxiety in depression. Eur Psychiatry 2021. [PMCID: PMC9480198 DOI: 10.1192/j.eurpsy.2021.1831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction There are different clinical forms combining anxiety and depression and it is essential to identify them because they will require different management. Among these clinical forms, there is that including anxiety as a symptom within the depressive episode: the anxious depression. Objectives The objective is to find the characteristics of this anxious depression. Methods We conducted a literature review on the PubMed® site giving access to the MEDLINE® database, as well as on the Google Scholar® search engine and retained 127 articles. Results By studying anxiety as a symptom of the depression, we identify on the pathophysiological level different neurobiological mechanisms (neuroanatomical, biological, immunological and endocrinological) involved in types of symptoms of different anxiety. Thus, by adopting a dimensional point of view, we can say that there are various anxiety symptoms which can be included in multiple forms of anxiety within the depression: psychic anxiety (anxiety and irritability), somatic anxiety (hypochondria, sweating, cardiological, respiratory, gastrointestinal and urinary symptoms), motor anxiety (agitation), anxious arousal (somatic anxiety, fear, panic) or anxious apprehension (anticipatory anxiety and worry). The prognosis which emerges from it is of a more pejorative evolution, and has specificities on which an increased attention is required, such as suicidal behavior which is more frequently described for example. The treatment must be psychotherapeutic, sociotherapeutic, and medication by antidepressant treatment, with SSRIs in the first line. Conclusions It is therefore essential to identify the clinical presentation of the anxious depression because it has specific semiological, neurobiological, prognostic and therapeutic characteristics. Disclosure No significant relationships.
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Wrege JS, Carcone D, Lee ACH, Cane C, Lang UE, Borgwardt S, Walter M, Ruocco AC. Attentional salience and the neural substrates of response inhibition in borderline personality disorder. Psychol Med 2021; 52:1-9. [PMID: 33722320 PMCID: PMC9772916 DOI: 10.1017/s0033291721000118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 12/04/2020] [Accepted: 01/11/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Impulsivity is a central symptom of borderline personality disorder (BPD) and its neural basis may be instantiated in a frontoparietal network involved in response inhibition. However, research has yet to determine whether neural activation differences in BPD associated with response inhibition are attributed to attentional saliency, which is subserved by a partially overlapping network of brain regions. METHODS Patients with BPD (n = 45) and 29 healthy controls (HCs; n = 29) underwent functional magnetic resonance imaging while completing a novel go/no-go task with infrequent odd-ball trials to control for attentional saliency. Contrasts reflecting a combination of response inhibition and attentional saliency (no-go > go), saliency processing alone (oddball > go), and response inhibition controlling for attentional saliency (no-go > oddball) were compared between BPD and HC. RESULTS Compared to HC, BPD showed less activation in the combined no-go > go contrast in the right posterior inferior and middle-frontal gyri, and less activation for oddball > go in left-hemispheric inferior frontal junction, frontal pole, superior parietal lobe, and supramarginal gyri. Crucially, BPD and HC showed no activation differences for the no-go > oddball contrast. In BPD, higher vlPFC activation for no-go > go was correlated with greater self-rated BPD symptoms, whereas lower vlPFC activation for oddball > go was associated with greater self-rated attentional impulsivity. CONCLUSIONS Patients with BPD show frontoparietal disruptions related to the combination of response inhibition and attentional saliency or saliency alone, but no specific response inhibition neural activation difference when attentional saliency is controlled. The findings suggest a neural dysfunction in BPD underlying attention to salient or infrequent stimuli, which is supported by a negative correlation with self-rated impulsiveness.
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Affiliation(s)
- J. S. Wrege
- Department of Psychiatry, University Psychiatric Clinics of Basel, Wilhelm Klein-Strasse 27, CH-4002 Basel, Switzerland
| | - D. Carcone
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - A. C. H. Lee
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - C. Cane
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - U. E. Lang
- Department of Psychiatry, University Psychiatric Clinics of Basel, Wilhelm Klein-Strasse 27, CH-4002 Basel, Switzerland
| | | | - M. Walter
- Department of Psychiatry, University Psychiatric Clinics of Basel, Wilhelm Klein-Strasse 27, CH-4002 Basel, Switzerland
| | - A. C. Ruocco
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
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Lee AHX, Wen B, Walter M, Hocaloski S, Hodge K, Sandholdt N, Hultling C, Elliott S, Krassioukov AV. Prevalence of postpartum depression and anxiety among women with spinal cord injury. J Spinal Cord Med 2021; 44:247-252. [PMID: 31549939 PMCID: PMC7952069 DOI: 10.1080/10790268.2019.1666239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective: To examine the prevalence of postpartum depression (PPD) and postpartum anxiety (PPA) in mothers with spinal cord injury (SCI).Design: Retrospective, cross-sectional study.Setting: Online multi-national study.Participants: We surveyed an international sample of 102 women who gave birth following cervical SCI (C1-C8, n = 30), upper thoracic SCI (T1-T6, n = 12) or lower level SCI (T7 & below, n = 60). Participants were primarily from Canada and Sweden, and mean age at childbirth was 30 ± 6 years.Outcome Measures: Subscales from the Pregnancy Risk Assessment Monitoring System (PRAMS) were used to measure PPD (PRAMS-3D) and PPA (PRAMS-2A).Results: PPD and PPA were most prevalent in women with cervical SCI, followed by upper thoracic SCI then lower SCI. Self-reported PPD was more prevalent than clinically diagnosed PPD in women with cervical SCI (P = 0.03) and upper thoracic SCI (P = 0.03). With cervical SCI, 75% of women diagnosed with MDD before pregnancy scored >9 on the PRAMS PPD subscale, indicating clinically relevant PPD. However, only 10% were diagnosed with PPD. Of women with lower SCI diagnosed with MDD before pregnancy, 25% had a clinically relevant score for self-reported PPD; 7% were diagnosed.Conclusions: This is currently the largest study examining PPD and PPA after SCI. Clinicians should be aware that mothers with SCI (particularly high-level SCI) may have increased risk of PPD and PPA. PPD is poorly understood in women with SCI and may even be underdiagnosed. SCI-related risk factors for PPD and PPA should be explored.
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Affiliation(s)
- Amanda H. X. Lee
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada,International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Betty Wen
- MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Karen Hodge
- Sunny Hill Health Centre, Vancouver, BC, Canada
| | - Nora Sandholdt
- Spinalis SCI Research Unit, Karolinska Institutet, Department of Neurobiology, Care Science and Society, Division of Neurodegeneration, Neurorehabilitation Section, Stockholm, Sweden
| | - Claes Hultling
- Spinalis SCI Research Unit, Karolinska Institutet, Department of Neurobiology, Care Science and Society, Division of Neurodegeneration, Neurorehabilitation Section, Stockholm, Sweden
| | - Stacy Elliott
- Vancouver Coastal Health, B.C. Centre for Sexual Medicine, Vancouver, BC, Canada,Departments of Psychiatry and Urological Sciences, University of British Columbia, Vancouver, BC, Canada,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada
| | - Andrei V. Krassioukov
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada,GF Strong Rehabilitation Centre, Vancouver, BC, Canada,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada,Correspondence to: Dr. Andrei V. Krassioukov, International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada; Ph: 604 675 8819.
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Walter M, Leitner L, Betschart C, Engeler DS, Freund P, Kessler TM, Kollias S, Liechti MD, Scheiner DA, Michels L, Mehnert U. Considering non-bladder aetiologies of overactive bladder: a functional neuroimaging study. BJU Int 2021; 128:586-597. [PMID: 33547746 DOI: 10.1111/bju.15354] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To better understand the neuropathophysiology of overactive bladder (OAB) in women by characterising supraspinal activity in response to bladder distention and cold stimulation. SUBJECTS/PATIENTS AND METHODS We recruited 24 female participants, 12 with OAB (median [interquartile range, IQR] age 40 [32-42] years) and 12 healthy controls (HCs) without lower urinary tract (LUT) symptoms (median [IQR] age 34 [28-44] years), and assessed LUT and cognitive function through neuro-urological examination, 3-day bladder diary, urodynamic investigation, and questionnaires. Functional magnetic resonance (MR) imaging using a 3-T scanner was performed in all participants during automated, repetitive bladder filling and draining (block design) with 100 mL body temperature (37 °C) saline using a MR-compatible and MR-synchronised infusion-drainage device until strong desire to void (HIGH-FILLING/DRAINING) and bladder filling with cold saline (4 °C, i.e. COLD). Whole-brain and region-of-interest analyses were conducted using Statistical Parametric Mapping, version 12. RESULTS Significant between-group differences were found for 3-day bladder diary variables (i.e. voiding frequency/24 h, P < 0.001; voided volume/void, P = 0.04; and urinary incontinence [UI] episodes/24 h, P = 0.007), questionnaire scores (International Consultation on Incontinence Questionnaire-Female LUT symptoms [overall, filling, and UI scores, all P < 0.001]; the Overactive Bladder Questionnaire short form [symptoms and quality-of-life scores, both P < 0.001]; the Hospital Anxiety and Depression Scale [anxiety P = 0.004 and depression P = 0.003 scores]), as well as urodynamic variables (strong desire to void, P = 0.02; maximum cystometric capacity, P = 0.007; and presence of detrusor overactivity, P = 0.002). Age, weight and cognitive function (i.e. Mini-Mental State Examination, P = 1.0) were similar between groups (P > 0.05). In patients with OAB, the HIGH task elicited activity in the superior temporal gyrus, ventrolateral prefrontal cortex (VLPFC), and mid-cingulate cortex; and the COLD task elicited activity in the VLPFC, cerebellum, and basal ganglia. Compared to HCs, patients with OAB showed significantly stronger cerebellar activity during HIGH-FILLING and significantly less activity in the insula and VLPFC during HIGH-DRAINING. CONCLUSIONS The present findings suggest a sensory processing and modulation deficiency in our OAB group, probably as part of their underlying pathophysiology, as they lacked activity in essential sensory processing areas, such as the insula. Instead, accessory areas, such as the cerebellum, showed significantly stronger activation compared to HCs, presumably supporting pelvic-floor motor activity to prevent UI. The novel findings of the present study provide physiological evidence of the necessity to consider non-bladder aetiologies of bladder symptoms.
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Affiliation(s)
- Matthias Walter
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.,Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Lorenz Leitner
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
| | - Cornelia Betschart
- Department of Gynecology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Daniel S Engeler
- Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Patrick Freund
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.,Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, UK.,Department of Neurology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Thomas M Kessler
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
| | - Spyros Kollias
- Department of Neuroradiology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Martina D Liechti
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
| | - David A Scheiner
- Department of Gynecology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Lars Michels
- Department of Neuroradiology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Ulrich Mehnert
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
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Nabata KJ, Tse EK, Nightingale TE, Lee AH, Eng JJ, Querée M, Walter M, Krassioukov AV. The Therapeutic Potential and Usage Patterns of Cannabinoids in People with Spinal Cord Injuries: A Systematic Review. Curr Neuropharmacol 2021; 19:402-432. [PMID: 32310048 PMCID: PMC8033968 DOI: 10.2174/1570159x18666200420085712] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/12/2020] [Accepted: 04/15/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND People with spinal cord injuries (SCI) commonly experience pain and spasticity; limitations of current treatments have generated interest in cannabis as a possible therapy. OBJECTIVES We conducted this systematic review to: 1) examine usage patterns and reasons for cannabinoid use, and 2) determine the treatment efficacy and safety of cannabinoid use in people with SCI. METHODS PubMed, Embase, Web of Science and Cumulative Index to Nursing and Allied Health Literature databases were queried for keywords related to SCI and cannabinoids. RESULTS 7,232 studies were screened, and 34 were included in this systematic review. Though 26 studies addressed cannabinoid usage, only 8 investigated its therapeutic potential on outcomes such as pain and spasticity. The most common method of use was smoking. Relief of pain, spasticity and recreation were the most common reasons for use. A statistically significant reduction of pain and spasticity was observed with cannabinoid use in 83% and 100% of experimental studies, respectively. However, on examination of randomized control trials (RCTs) alone, effect sizes ranged from - 0.82 to 0.83 for pain and -0.95 to 0.09 for spasticity. Cannabinoid use was associated with fatigue and cognitive deficits. CONCLUSION Current evidence suggests that cannabinoids may reduce pain and spasticity in people with SCI, but its effect magnitude and clinical significance are unclear. Existing information is lacking on optimal dosage, method of use, composition and concentration of compounds. Long-term, double-blind, RCTs, assessing a wider range of outcomes should be conducted to further understand the effects of cannabinoid use in people with SCI.
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Affiliation(s)
| | | | | | | | | | | | | | - Andrei V. Krassioukov
- Address correspondence to this author at the International Collaboration On Repair Discoveries (ICORD), University of British Columbia (UBC), Vancouver, Canada; E-mail:
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Walter M, Ruiz I, Squair JW, Rios LAS, Averbeck MA, Krassioukov AV. Prevalence of self-reported complications associated with intermittent catheterization in wheelchair athletes with spinal cord injury. Spinal Cord 2020; 59:1018-1025. [PMID: 33051562 PMCID: PMC8397616 DOI: 10.1038/s41393-020-00565-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/22/2020] [Accepted: 10/01/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES To identify the prevalence of complications associated with intermittent catheterization in wheelchair athletes with spinal cord injury (SCI). SETTING International and national sporting events. METHODS A total 130 competitive wheelchair athletes living with SCI completed a self-reported questionnaire during international or national sporting events. The questionnaire collected information regarding demographics, injury characteristics, method of bladder emptying, and complications related to intermittent catheterization. RESULTS Overall, 84% (109/130) of wheelchair athletes used intermittent catheterization. Within this group, 77% of athletes (84/109) experienced at least one complication associated with intermittent catheterization. Twenty-seven percent (29/109) sustained urethral injuries and 63% (69/109) had at least one episode of urinary tract infection during the last 12 months. Almost one-fourth of male athletes (22/95, 23%) had a history of inflammation / infection of genital organs associated with intermittent catheterization. CONCLUSIONS Here we report a high prevalence of self-reported complications associated with intermittent catheterization in wheelchair athletes with SCI. Considering their potential impact on lower urinary tract function, athletic performance, and health, further studies are needed to assess the role of preventative strategies to reduce complications related to intermittent catheterization in wheelchair athletes with SCI. SPONSORSHIP Coloplast Brazil and Instituto Lado a Lado pela Vida (a nongovernmental, nonprofit organization based in São Paulo) and Wellspect provided funding for this study.
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Affiliation(s)
- Matthias Walter
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada.,Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ian Ruiz
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada
| | - Jordan W Squair
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada
| | - Luis A S Rios
- Department of Urology, IAMSPE Hospital, São Paulo, Brazil.,Videourodynamic Unit, Albert Einstein Hospital, São Paulo, Brazil
| | - Marcio A Averbeck
- Department of Urology, Moinhos de Vento Hospital, Porto Alegre, Brazil
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia (UBC), Vancouver, British Columbia (BC), Canada. .,Division of Physical Medicine and Rehabilitation, Faculty of Medicine, UBC, Vancouver, BC, Canada. .,G.F. Strong Rehabilitation Centre, Vancouver, BC, Canada.
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Spitzer P, Walter M, Göth C, Oberstein TJ, Linning P, Knölker HJ, Kornhuber J, Maler JM. Pharmacological Inhibition of Amyloidogenic APP Processing and Knock-Down of APP in Primary Human Macrophages Impairs the Secretion of Cytokines. Front Immunol 2020; 11:1967. [PMID: 33013850 PMCID: PMC7494750 DOI: 10.3389/fimmu.2020.01967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 07/21/2020] [Indexed: 12/18/2022] Open
Abstract
It has been previously shown that the amyloid precursor protein (APP) support the innate immune defense as an immune receptor. Amyloid β (Aβ) peptides seem to have properties of an antimicrobial peptide and can act as opsonines. In APP-deficient mouse models, a reduced secretion of cytokines has been observed. Still, it is unclear whether this can be attributed to the lack of APP or to the missing secretion of Aβ peptides. We inhibited the secretion of Aβ peptides in primary human monocyte derived macrophages with the γ-secretase inhibitor N-[N-(3,5-Difluorophenacetyl)-L-alanyl]-S-phenylglycine-t-butyl-ester (DAPT) or the β-secretase inhibitor GL-189. Alternatively, we knocked down APP by transfection with siRNA. We measured tumor necrosis factor α (TNFα), interleukin 6 (IL-6) and interleukin (IL-10) by enzyme linked immunosorbent assay (ELISA) and evaluated the phagocytotic activity by flow cytometry. We observed reduced concentrations of TNFα and IL-6 in the media of APPk/d macrophages and after inhibition of the β-, or γ-secretase, especially after additional immunological activation with lipopolysaccharide (LPS). Secretion of IL-10 was increased after pharmacological inhibition of APP processing when the macrophages were not immunologically activated but was decreased during LPS-induced inflammation in APPk/d macrophages. No changes of the phagocytotic activity were observed. We conclude that macrophage APP and Aβ peptides support the initiation of an immune response and are involved in the regulation of TNFα, IL-6, and IL-10 secretion by human monocyte-derived macrophages.
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Affiliation(s)
- Philipp Spitzer
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Matthias Walter
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Caroline Göth
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Timo Jan Oberstein
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Philipp Linning
- Faculty of Chemistry, Technische Universität Dresden, Dresden, Germany
| | | | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Juan Manuel Maler
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
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Moore U, Gordish H, Maneraz JD, James M, Mayhew A, Guglieri M, Spuler S, Day J, Jones K, Bharucha-Goebel D, Salort-Campana E, Pestronk A, Walter M, Paradas C, Stojkovic T, Yoshimura M, Bravver E, Pegoraro E, Mendell J, Straub V. FROM THE SPINAL CORD TO THE MUSCLE. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pechmann A, Bernert G, Hagenacker T, Müller-Felber W, Schara U, Schwersenz I, Walter M, Lochmüller H, Kirschner J. SMA: REGISTRIES, BIOMARKERS & OUTCOME MEASURES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jutzeler CR, Bourguignon L, Weis CV, Tong B, Wong C, Rieck B, Pargger H, Tschudin-Sutter S, Egli A, Borgwardt K, Walter M. Comorbidities, clinical signs and symptoms, laboratory findings, imaging features, treatment strategies, and outcomes in adult and pediatric patients with COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis 2020; 37:101825. [PMID: 32763496 PMCID: PMC7402237 DOI: 10.1016/j.tmaid.2020.101825] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/09/2020] [Accepted: 07/27/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Since December 2019, a novel coronavirus (SARS-CoV-2) has triggered a world-wide pandemic with an enormous medical and societal-economic toll. Thus, our aim was to gather all available information regarding comorbidities, clinical signs and symptoms, outcomes, laboratory findings, imaging features, and treatments in patients with coronavirus disease 2019 (COVID-19). METHODS EMBASE, PubMed/Medline, Scopus, and Web of Science were searched for studies published in any language between December 1st, 2019 and March 28th, 2020. Original studies were included if the exposure of interest was an infection with SARS-CoV-2 or confirmed COVID-19. The primary outcome was the risk ratio of comorbidities, clinical signs and symptoms, laboratory findings, imaging features, treatments, outcomes, and complications associated with COVID-19 morbidity and mortality. We performed random-effects pairwise meta-analyses for proportions and relative risks, I2, T2, and Cochrane Q, sensitivity analyses, and assessed publication bias. RESULTS 148 studies met the inclusion criteria for the systematic review and meta-analysis with 12'149 patients (5'739 female) and a median age of 47.0 [35.0-64.6] years. 617 patients died from COVID-19 and its complication. 297 patients were reported as asymptomatic. Older age (SMD: 1.25 [0.78-1.72]; p < 0.001), being male (RR = 1.32 [1.13-1.54], p = 0.005) and pre-existing comorbidity (RR = 1.69 [1.48-1.94]; p < 0.001) were identified as risk factors of in-hospital mortality. The heterogeneity between studies varied substantially (I2; range: 1.5-98.2%). Publication bias was only found in eight studies (Egger's test: p < 0.05). CONCLUSIONS Our meta-analyses revealed important risk factors that are associated with severity and mortality of COVID-19.
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Affiliation(s)
- Catherine R Jutzeler
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland; Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
| | - Lucie Bourguignon
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Caroline V Weis
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Bobo Tong
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
| | - Cyrus Wong
- Simon Fraser University, Vancouver, Canada
| | - Bastian Rieck
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Hans Pargger
- Intensive Care Unit, University Hospital Basel, University Basel, Basel, Switzerland
| | - Sarah Tschudin-Sutter
- Division of Infectious Diseases & Hospital Epidemiology, University Hospital Basel and University of Basel, Switzerland; Department of Clinical Research, University Hospital Basel and University of Basel, Switzerland
| | - Adrian Egli
- Division of Clinical Bacteriology & Mycology, University Hospital Basel, Basel, Switzerland; Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Karsten Borgwardt
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Matthias Walter
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada; Swiss Paraplegic Center, Nottwil, Switzerland
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Aktaa J, Walter M, Gaisina E, Kolb M, Knitter R. Assessment of the chemical compatibility between EUROFER and ceramic breeder with respect to fatigue lifetime. Fusion Engineering and Design 2020. [DOI: 10.1016/j.fusengdes.2020.111732] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Jutzeler CR, Nightingale TE, Krassioukov AV, Walter M. Perfect Storm: COVID-19 Associated Cardiac Injury and Implications for Neurological Disorders. Neurotrauma Rep 2020; 1:2-4. [PMID: 34223524 PMCID: PMC8240879 DOI: 10.1089/neur.2020.0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) can lead to considerable lung damage and even death. Less is known about the effects of COVID-19 on the cardiovascular system. In their recent JAMA Cardiology article, Shi and colleagues reported an association between cardiac injury and higher risk of in-hospital mortality in patients with COVID-19. Approximately 20% (82 patients) of the study cohort presented with a cardiac injury. The investigators identified cardiac injury as an independent risk factor of mortality during hospitalization (52% with cardiac injury vs. 5% without cardiac injury, p < 0.001). Consequently, their findings are highly relevant for patients with pre-existing cardiovascular and cerebrovascular diseases. Among those are patients with neurological disorders. There is a considerable prevalence of myocardial injury in patients with acute neurological illness, which appears to adversely affect prognosis. Individuals with an underlying neurological disorder are particularly vulnerable to increased cardio-cerebrovascular disease risk due to physical limitations and the pathophysiology of their condition. Thus, we would like to specifically highlight the attention of health care professionals treating patients with pervasive neurological disorders to their potentially elevated risk of poorer COVID-19 related outcomes.
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Affiliation(s)
- Catherine Ruth Jutzeler
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland.,SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Thomas Edward Nightingale
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrei Vasilievich Krassioukov
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada.,Department of Neuro-Urology, Swiss Paraplegic Center, Nottwil, Switzerland
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Walter M, Kran SL, Ramirez AL, Rapoport D, Nigro MK, Stothers L, Kavanagh A, Krassioukov AV. Intradetrusor OnabotulinumtoxinA Injections Ameliorate Autonomic Dysreflexia while Improving Lower Urinary Tract Function and Urinary Incontinence-Related Quality of Life in Individuals with Cervical and Upper Thoracic Spinal Cord Injury. J Neurotrauma 2020; 37:2023-2027. [PMID: 32631152 PMCID: PMC7470218 DOI: 10.1089/neu.2020.7115] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Pilot data of our phase IV clinical trial (pre/post study design) highlighted a beneficial effect of intradetrusor onabotulinumtoxinA (200 IU) injections to reduce autonomic dysreflexia (AD) in individuals with chronic spinal cord injury (SCI) at T6 or above. After trial completion, we assessed whether our primary expectation (i.e., decrease of AD severity in 50% of participants during urodynamics [UDS]) was met. Secondary outcome measures were reduction of spontaneous AD in daily life as well as amelioration of AD-related and urinary incontinence-related quality of life (QoL). In addition, we conducted injury-level–dependent analysis—i.e., cervical and upper thoracic—to explore group-specific treatment efficacy. Post-treatment, AD severity decreased in 82% (28/34) of all participants during UDS and in 74% (25/34) in daily life assessed with 24-h ambulatory blood pressure monitoring. In addition, urinary incontinence-related QoL was improved, cystometric capacity was increased, and maximum detrusor pressure during storage was reduced (all p < 0.001). Further, the treatment was well tolerated, with only minor complications (grade I [n = 7] and II [n = 7]) in accordance with the Clavien-Dindo classification recorded in 11 individuals (cervical n = 9, upper thoracic n = 2). Injury-level–dependent analysis revealed lower incidence (cervical n = 15/23, upper thoracic n = 6/11) and lesser severity (cervical p = 0.009; upper thoracic p = 0.06 [Pearson r = −0.6, i.e., large effect size]) of AD during UDS. Further, reduced AD severity in daily life, improved urinary incontinence-related QoL, greater cystometric capacity, and lower maximum detrusor pressure during storage (all p < 0.05) were found in both groups post-treatment. Intradetrusor onabotulinumtoxinA injections are an effective and safe second-line treatment option that ameliorates AD while improving lower urinary tract function and urinary incontinence-related QoL in individuals with cervical and upper thoracic SCI.
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Affiliation(s)
- Matthias Walter
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephanie L Kran
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrea L Ramirez
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Daniel Rapoport
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark K Nigro
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lynn Stothers
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alex Kavanagh
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
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Kühnel A, Widmann A, Colic L, Herrmann L, Demenescu LR, Leutritz AL, Li M, Grimm S, Nolte T, Fonagy P, Walter M. Impaired cognitive self-awareness mediates the association between alexithymia and excitation/inhibition balance in the pgACC. Psychol Med 2020; 50:1727-1735. [PMID: 31328716 DOI: 10.1017/s0033291719001806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous research showed that automatic emotion regulation is associated with activation of subcortical areas and subsequent feedforward processes to cortical areas. In contrast, cognitive awareness of emotions is mediated by negative feedback from cortical to subcortical areas. Pregenual anterior cingulate cortex (pgACC) is essential in the modulation of both affect and alexithymia. We considered the interplay between these two mechanisms in the pgACC and their relationship with alexithymia. METHOD In 68 healthy participants (30 women, age = 26.15 ± 4.22) we tested associations of emotion processing and alexithymia with excitation/inhibition (E/I) balance represented as glutamate (Glu)/GABA in the pgACC measured via magnetic resonance spectroscopy in 7 T. RESULTS Alexithymia was positively correlated with the Glu/GABA ratio (N = 41, p = 0.0393). Further, cognitive self-awareness showed an association with Glu/GABA (N = 52, p = 0.003), which was driven by a correlation with GABA. In contrast, emotion regulation was only correlated with glutamate levels in the pgACC (N = 49, p = 0.008). CONCLUSION Our results corroborate the importance of the pgACC as a mediating region of alexithymia, reflected in an altered E/I balance. Furthermore, we could specify that this altered balance is linked to a GABA-related modulation of cognitive self-awareness of emotions.
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Affiliation(s)
- A Kühnel
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry and International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - A Widmann
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
- Experimental and Molecular Psychiatry, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - L Colic
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Psychiatry, Mood Disorders Research Program, Yale School of Medicine, New Haven, CT, USA
| | - L Herrmann
- University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
| | - L R Demenescu
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
| | - A L Leutritz
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
| | - M Li
- University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, OVGU Magdeburg, Magdeburg, Germany
| | - S Grimm
- Department of Psychiatry, Charité, CBF, Berlin, Germany
- MSB Medical School Berlin, Calandrellistraße 1-9, 12247Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8032Zurich, Switzerland
| | - T Nolte
- The Anna Freud National Centre for Children and Families, London, UK
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK
| | - P Fonagy
- The Anna Freud National Centre for Children and Families, London, UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - M Walter
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- University Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
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Le Galudec M, Contant AC, Stephan F, Feray A, Le Floch-Bergot AL, Alzas N, Mesmeur C, Lomenech M, Rozec E, Walter M, Guerrero F. Impact d’un programme d’activité physique sur la symptomatologie schizophrénique : résultats d’une expérience menée au CHRU de Brest. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2014.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
ContexteLa schizophrénie reste une pathologie invalidante malgré une prise en charge médicamenteuse efficace. Il importe de développer d’autres stratégies adjuvantes efficaces sur les symptômes de la maladie en limitant les effets secondaires des traitements pharmacologiques. L’efficacité des activités physiques dans le traitement de la schizophrénie n’est pas démontrée mais des travaux soulignent des bénéfices sur les symptômes négatifs et dépressifs [1,2].ObjectifNous souhaitons évaluer l’impact clinique d’un programme d’activité physique sur une population de sujets atteints de schizophrénie.MéthodeUn programme d’activités physiques supervisé par deux moniteurs a été élaboré. Il comprend une heure de multi-activités, 2 fois par semaine, pendant 12 semaines. L’intensité minimale de chaque séance était fixée à 50 % de la fréquence cardiaque de réserve. Des mesures comprenant les échelles PANSS, SANS, SAPS, CDSS, S-QoL, un bilan anthropométrique et biologique ont été réalisés à S 0, S 6, S 12 et S 16.RésultatsDeux groupes de 5 patients (n = 10) ont réalisé le programme. Une amélioration clinique est retrouvée sur l’ensemble des échelles utilisées entre S 0 et S 16. Les changements observés ne sont pas en faveur d’une amélioration du syndrome métabolique et nous notons une prise de poids des sujets sur la période de l’étude. Le traitement statistique des données présente des résultats non significatifs (p > 0,05).
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50
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Walter M, Olié E. Nouvelles approches psychothérapiques dans la prise en charge des conduites suicidaires. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2015.09.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
En France, en 2010, 5,5 % des 15–85 ans ont déclaré avoir tenté de se suicider au cours de leur vie . En outre 3,9 % des personnes interrogées ont déclaré avoir pensé au suicide au cours des 12 derniers mois. Pourtant les stratégies nationales de prévention mises en place dans plusieurs pays ont abouti à des résultats variables et rarement pérennes. Ceci souligne l’importance d’identifier des stratégies transnosographiques de prévention, tant pharmacothérapiques que psychothérapiques. À ce jour, seule la thérapie comportementale dialectique a démontré une efficacité dans la prise en charge du risque suicidaire chez les sujets souffrant de trouble de la personnalité borderline. Le développement des techniques psychothérapiques dans le champ de la suicidologie est donc nécessaire, puisqu’elles représentent un outil supplémentaire dans la prise en charge des patients à haut risque suicidaire. Dr Martin Desseilles synthétisera les principales données de la littérature afin de comprendre la place des interventions psychothérapiques dans la prévention du risque suicidaire. Ensuite, Dr Ducasse présentera plus spécifiquement la thérapie d’acceptation et d’engagement. Cette thérapie a en effet montré son efficacité dans la réduction des idées suicidaires et la modification de facteurs de vulnérabilité associés aux comportements suicidaires . Enfin, Dr Olié exposera les arguments en faveur de l’intérêt, dans la crise suicidaire, d’exercices basés sur la psychologie positive. Ces derniers visent à cultiver et amplifier les états émotionnels et cognitifs positifs, tels que développer l’optimisme, générer un sentiment de gratitude et rétablir un sens de vie .
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