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Spinal Shock

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181. Autologous Mesenchymal Stem Cells Transplantation in Cervical Chronic and Complete Spinal Cord Injury

summary and culture; Serology required for blood transfusion and marrow transplant in Brazil; Electrocardiogram; Chest X-Ray; Bone densitometry; Urodynamic studies; Somatosensory evoked potential; Computed tomography of thoracic and lumbar spine; Magnetic resonance imaging of the thoracic and lumbar spine. Also as part of the preoperative evaluation, the patients will respond to questions from the SF (Short Form) -36 questionnaire (for assessment of quality of life) and the questionnaires (...) Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Blunt spinal cord injury at cervical level, between C5 and C7, or penetrating spinal cord injury, at the same level, provided that the mechanism of injury had been spinal shock, ischemia or hematoma, with at least 12 months of injury; ASIA grade A; Signing of the written consent. Exclusion Criteria: Spinal cord injuries by sharp objects, firearms, and not traumatic or congenital causes, even if at different levels of the spinal cord

2015 Clinical Trials

182. Spinal cord injury: Incidence, prognosis and outcome - an analysis of the TraumaRegister DGU<sup>®</sup>. (Abstract)

five (7.5%) of 57,310 patients sustained SCI. Mean age was 48.9±20.7 years, ISS 28.0±12, and 72.7% were men. Two thousand two hundred twenty two (3.9%) SCIs involved the cervical, 1,388 (2.4%) the thoracic, and 791 (1.4%) the lumbar spine. One hundred fifty-nine (7.2%) cervical spine injuries were associated with transient neurologic deficit (TND) (AIS 3), 612 (27.5%) with an incomplete paraplegia (AIS 4), 1,101 (49.6%) with a complete paraplegia (AIS 5), and 350 (15.8%) with a complete lesion (...) above C3 (AIS 6). Lesions of the thoracic spine showed in 93 (6.7%) of the 1,388 lesions a TND (AIS 3), in 332 (23.9%) an incomplete paraplegia (AIS 4), and in 963 (69.4%) a complete lesion (AIS 5). In the lumbar region, lesions were distributed as follows: TND (AIS 3) 145 (18.3%), incomplete paraplegia (AIS 4) 305 (38.6%), and complete lesion 341 (43.1%). Sepsis and multiorgan failure were found more often in patients with AIS 5/6 lesions (p<.001). The hospital length of stay in SCIs

2015 The Spine Journal

183. Inhibition of micro-ribonucleic acid-320 attenuates neurologic injuries after spinal cord ischemia. Full Text available with Trip Pro

-shock protein 20 (phospho-Hsp20) in the spinal cord were evaluated by quantitative real-time polymerase chain reaction and western blot analysis.The time courses of expressions of miR-320 and phospho-Hsp20 in the spinal cord, after the transient ischemia, indicated that expression of phospho-Hsp20 was negatively correlated with expression of miR-320. Transfection of antagomiR-320 significantly reduced expression of miR-320 in the spinal cord and dramatically up-regulated expression of phospho-Hsp20 (...) . Compared with controls, inhibition of miR-320 markedly improved hind-limb motor function, as evidenced by lower MDI scores, at 6, 12, 24, and 48 hours after reperfusion, and increased the number of intact motor neurons in the lumbar spinal cord.Inhibition of miR-320 induces neuroprotection in the spinal cord, against ischemia-reperfusion injury, possibly via up-regulation of phospho-Hsp20.Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

2015 Journal of Thoracic and Cardiovascular Surgery

184. Is temporal summation of pain and spinal nociception altered during normal aging? Full Text available with Trip Pro

Is temporal summation of pain and spinal nociception altered during normal aging? This study examines the effect of normal aging on temporal summation (TS) of pain and the nociceptive flexion reflex (RIII). Two groups of healthy volunteers, young and elderly, received transcutaneous electrical stimulation applied to the right sural nerve to assess pain and the nociceptive flexion reflex (RIII-reflex). Stimulus intensity was adjusted individually to 120% of RIII-reflex threshold, and shocks were

2015 Pain

185. Effects of Reversible Spinalization on Individual Spinal Neurons Full Text available with Trip Pro

Effects of Reversible Spinalization on Individual Spinal Neurons Postural limb reflexes (PLRs) represent a substantial component of the postural system responsible for stabilization of dorsal-side-up trunk orientation in quadrupeds. Spinalization causes spinal shock, that is a dramatic reduction of extensor tone and spinal reflexes, including PLRs. The goal of our study was to determine changes in activity of spinal interneurons, in particular those mediating PLRs, that is caused (...) a group of neurons that were coactivated with extensors during PLRs before RS and exhibited a dramatic (>80%) decrease in their activity during RS. We suggest that these neurons are responsible for reduction of extensor tone and postural reflexes during spinal shock.

2013 The Journal of Neuroscience

186. Use of the Trendelenburg Position to Improve Hemodynamics During Hypovolemic Shock

Use of the Trendelenburg Position to Improve Hemodynamics During Hypovolemic Shock BestBets: Use of the Trendelenburg Position to Improve Hemodynamics During Hypovolemic Shock Use of the Trendelenburg Position to Improve Hemodynamics During Hypovolemic Shock Report By: Nicolas Kettaneh - Medical Student Search checked by Jeffrey S. Jones, MD - Research Director, Emergency Medicine Institution: Grand Rapids Medical Education & Research/Michigan State University Date Submitted: 30th October 2008 (...) Date Completed: 11th November 2010 Last Modified: 11th November 2010 Status: Green (complete) Three Part Question In [adults with hypotension] does the [Trendelenburg position] improve [hemodynamics]? Clinical Scenario A 28 year old male with a gunshot wound to the leg presents to the emergency department in hypovolemic shock. Among other things, you place the patient in the Trendelenburg position, with the body tilted so that the feet is higher than the head. You wonder whether this position

2010 BestBETS

187. Use of an Operating Microscope During Spine Surgery is Associated with Minor Increases in Operating Room Times and no Increased Risk of Infection. Full Text available with Trip Pro

Use of an Operating Microscope During Spine Surgery is Associated with Minor Increases in Operating Room Times and no Increased Risk of Infection. Retrospective database review.To evaluate whether microscope use during spine procedures is associated with increased operating room times or increased risk of infection.Operating microscopes are commonly used in spine procedures. It is debated whether the use of an operating microscope increases operating room time or confers increased risk (...) of infection.The American College of Surgeons National Surgical Quality Improvement Program database, which includes data from more than 370 participating hospitals, was used to identify patients undergoing elective spinal procedures with and without the use of an operating microscope for the years 2011 and 2012. Bivariate and multivariate linear regressions were used to test the association between microscope use and operating room times. Bivariate and multivariate logistic regressions were similarly

2014 Spine

188. Risk Factors for Postoperative Infections Following Single Level Lumbar Fusion Surgery. (Abstract)

Risk Factors for Postoperative Infections Following Single Level Lumbar Fusion Surgery. Retrospective multivariate analysis of a prospectively collected, multicenter database.To identify patient characteristics and perioperative risk factors associated with postoperative infectious complications after single-level lumbar fusion (SLLF) surgery.Postoperative infection is a known complication after lumbar fusion. Risk factors for infectious complications after lumbar fusion have not been (...) infections (SSIs) and 111 (3.3%) non-SSI infectious complications (pneumonia, urinary tract infection, sepsis/septic shock). Twenty-four (0.7%) patients experienced both SSI and non-SSI infectious complications. Postoperative SSI were associated with obesity (odds ratio [OR], 1.628; 95% confidence interval [CI], 1.042-2.544), American Society of Anesthesiologists class more than 2 (OR, 2.078; 95% CI, 1.309-3.299), and operative time more than 6 hours (OR, 2.573; 95% CI, 1.310-5.056). Risk factors for non

2014 Spine

189. Effect of radial shock wave therapy on pain and muscle hypertonia: a double-blind study in patients with multiple sclerosis. Full Text available with Trip Pro

Effect of radial shock wave therapy on pain and muscle hypertonia: a double-blind study in patients with multiple sclerosis. Radial shock wave therapy (RSWT) has been extensively used in rehabilitative medicine to treat pain, and more recently muscle hypertonia, in patients with cerebral palsy and stroke.To assess the long-term effects of RSWT in a cohort of subjects affected by multiple sclerosis (MS) who were suffering from painful hypertonia of ankle extensor muscles.In this randomised (...) , double blind, placebo-controlled study, we treated 34 patients with four sessions of RSWT (once weekly) and treated 34 patients with placebo. Participants were assessed at baseline, 1 week after the first session, and 1 week and 4 weeks after the last session. We measured pain using the visual analogue scale for pain, while we assessed muscle tone using the modified Ashworth scale and evaluated spinal excitability using the H-reflex.After RSWT, muscle tone decreased 1 week after the last session

2014 Multiple sclerosis (Houndmills, Basingstoke, England) Controlled trial quality: uncertain

190. Extracorporeal shock waves lithotripsy versus retrograde ureteroscopy: is radiation exposure a criterion when we choose which modern treatment to apply for ureteric stones? Full Text available with Trip Pro

Extracorporeal shock waves lithotripsy versus retrograde ureteroscopy: is radiation exposure a criterion when we choose which modern treatment to apply for ureteric stones? The aim of this study is to compare two major urological procedures in terms of patient exposure to radiation. We evaluated 175 patients, that were subjected to retrograde ureteroscopy (URS) and extracorporeal shock waves lithotripsy (ESWL) for lumbar or pelvic ureteral lithiasis, at two urological departments. The C-arm (...) of each case examined, such as body mass index (BMI), waist circumference, and stone location. For the patients subjected to ESWL for lumbar ureteral lithiasis the mean of PKA (cGy cm(2)) was 509 (SD=180), while for those treated for pelvic ureteral lithiasis the mean of PKA was 342 (SD=201). In the URS group for lumbar ureteral lithiasis, the mean of PKA (cGy cm(2)) was 892 (SD=436), while for patients with pelvic ureteral lithiasis, the mean of PKA was 601 (SD=429). The patients treated by URS had

2014 Bosnian Journal of Basic Medical Sciences

191. Identification and characterisation of a novel heat shock protein 90 inhibitor ONO4140. Full Text available with Trip Pro

Identification and characterisation of a novel heat shock protein 90 inhibitor ONO4140. Heat shock protein (Hsp) 90 is a key component of the super-chaperone complex that maintains functionally active conformation of various client proteins. Many of these client proteins regulate important nodal points in multiple signalling pathways that promote cancer cell growth and survival. Inhibitors of Hsp90, therefore, have the potential of functioning as anti-cancer agents with pleiotropic effects (...) in preclinical studies. The discovery of this novel class of synthetic Hsp90 inhibitors with simple chemical backbone allows us to conduct further structural modifications to improve their potency and pharmacokinetic properties for use in cancer therapy.Copyright © 2014 Elsevier Ltd. All rights reserved.

2014 European Journal of Cancer

192. Effect of Remote Ischemic Conditioning on Trauma Patients With Hemorrhagic Shock

Application and completion of Remote Ischemic Conditioning (RIC) within 4 hours of the injury Exclusion Criteria: Pregnancy Non-hemorrhagic shock (i.e. tension pneumothorax, cardiac tamponade, spinal shock, etc.) Major burns > 20% total body surface area Fracture of both lower extremities (i.e. traumatic amputation, fractures) Absence of vital signs prior to admission, ongoing CPR, possibly dead on admission or not expected to survive beyond a few hours. Injury in both legs (traumatic amputation (...) Effect of Remote Ischemic Conditioning on Trauma Patients With Hemorrhagic Shock Effect of Remote Ischemic Conditioning on Trauma Patients With Hemorrhagic Shock - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding

2014 Clinical Trials

193. Steroid Use in Pediatric Fluid and Vasoactive Infusion Dependent Shock

, and/or is expected to no longer be on vasoactive infusion at the time the first dose of study drug will be administered Patients for whom primary cardiogenic shock is strongly suspected Patients for whom spinal shock is strongly suspected Patients for whom hemorrhagic or hypovolemic shock is strongly suspected Patients who were previously enrolled in the STRIPES study Patients who receive a vasoactive agent for reasons not related to shock Physician refusal Contacts and Locations Go to Information from (...) Steroid Use in Pediatric Fluid and Vasoactive Infusion Dependent Shock Steroid Use in Pediatric Fluid and Vasoactive Infusion Dependent Shock - Pilot Study - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more

2014 Clinical Trials

194. Co-administration of Iloprost and Eptifibatide in Septic Shock Patients

Co-administration of Iloprost and Eptifibatide in Septic Shock Patients Co-administration of Iloprost and Eptifibatide in Septic Shock Patients - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Co (...) -administration of Iloprost and Eptifibatide in Septic Shock Patients (CO-ILEPSS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02204852 Recruitment Status : Completed First Posted : July 30, 2014 Last Update Posted : April 24, 2017 Sponsor: Sisse R. Ostrowski, MD PhD DMSc Information provided

2014 Clinical Trials

195. Ghrelin Protects Rats Against Traumatic Brain Injury and Hemorrhagic Shock Through Upregulation of UCP2. (Abstract)

, hypothesized that ghrelin protects rats against TBI and hemorrhagic shock through upregulation of UCP2, involving stimulation of the vagus nerve.Brain injury was induced by dropping a 450 g of weight from 1.5 m onto a steel helmet attached to the skull of male adult rats. Immediately after TBI, a midline laparotomy was performed, and both lumbar veins were isolated and severed at the junction with the vena cava. The abdomen was kept open for 20 minutes. At 45 minutes after TBI and uncontrolled hemorrhage (...) Ghrelin Protects Rats Against Traumatic Brain Injury and Hemorrhagic Shock Through Upregulation of UCP2. To determine the mechanism responsible for ghrelin's neuroprotective effects after traumatic brain injury (TBI) and hemorrhagic shock.Ghrelin, a gastrointestinal hormone, has been demonstrated to possess multiple functions, including upregulation of uncoupling protein 2 (UCP2) and stimulation of the vagus nerve. Recent evidence has indicated that ghrelin is neuroprotective. We, therefore

2014 Annals of Surgery

196. Thoracic Spine, Trauma

, trabecular compaction, endplate fractures, and disk-space narrowing. The radiographic images below display various thoracic spinal traumatic injuries. Thoracic spine trauma. Lateral radiograph of the thoracic spine of a 74-year-old woman. The kyphosis of the thoracic spine is related to osteoporotic failure of the T8 vertebral body. Note the 30-40% wedge-shaped deformity of the T8 vertebra. Thoracic spine trauma. Anteroposterior view radiograph of the lumbar spine demonstrates a narrowed T12 vertebral (...) spine trauma. Axial CT image of an unstable fracture of the thoracic spine. Note the association of compression of the vertebral body with laminar and pedicle fractures. Injury to the anterior, middle, and posterior columns results in an unstable fracture. Thoracic spine trauma. Coronal multiplanar reformatted CT images of an unstable thoracic spinal fracture. The association of both anterior compression and lateral subluxation (arrows) indicates instability. Thoracic spine trauma. Volume maximum

2014 eMedicine Radiology

197. Cervical Spine Acute Bony Injuries (Follow-up)

, Karsy M, Harrop JS, Dailey AT. Return to Play after Cervical Spine Injuries: A Consensus of Opinion. Global Spine J . 2016 Dec. 6 (8):792-797. . Chang CH, Holmes JF, Mower WR, Panacek EA. Distracting injuries in patients with vertebral injuries. J Emerg Med . 2005 Feb. 28(2):147-52. . Fehlings MG, Farhadi HF. Cervical stenosis, spinal cord neurapraxia, and the professional athlete. J Neurosurg Spine . 2007 Apr. 6(4):354-5; discussion 355. . Guo ZQ, Chen ZQ, Li WS, et al. [Clinical characteristics (...) and high-risk sports include the following: Neurologic symptoms or deficits Loss of ROM or pain with ROM Acute cervical fracture Spear tackler's spine Atlantoaxial instability, with or without fracture Atlantooccipital instability, with or without fracture Limited ROM Ligamentous laxity Vertebral body fracture with a sagittal segment Anterior teardrop fracture Fusion of 3 or more vertebrae Healed fractures with associated neurologic symptoms Fracture with canal involvement Odontoid fracture Relative

2014 eMedicine.com

198. Cervical Spine Sprain/Strain Injuries (Follow-up)

, minor fractures, and other cervical injuries in the athlete. Clin Sports Med . 2003 Jul. 22(3):513-21. . Tall RL, DeVault W. Spinal injury in sport: epidemiologic considerations. Clin Sports Med . 1993 Jul. 12(3):441-8. . Bogduk N. The anatomy and pathophysiology of neck pain. Phys Med Rehabil Clin N Am . 2003 Aug. 14(3):455-72, v. . Panjabi MM, Vasavada A, White AA III. Cervical spine biomechanics. Semin Spine Surg . 1993 Mar. 5(1):10-6. Holsgrove TP, Cazzola D, Preatoni E, Trewartha G, Miles AW (...) Cervical Spine Sprain/Strain Injuries (Follow-up) Cervical Spine Sprain/Strain Injuries Follow-up: Return to Play, Complications, Prevention Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTQzODctZm9sbG93dXA

2014 eMedicine.com

199. Fracture, Cervical Spine (Treatment)

. The anterior and posterior longitudinal ligaments maintain the structural integrity of the anterior and middle columns. The posterior column is held in alignment by a complex ligamentous system, including the nuchal ligament complex, capsular ligaments, and the ligamenta flava. If one column is disrupted, other columns may provide sufficient stability to prevent spinal cord injury. If 2 columns are disrupted, the spine may move as 2 separate units, increasing the likelihood of spinal cord injury. The atlas (...) , and transverse ligaments provide further stabilization by allowing spinal column rotation; this prevents posterior displacement of the dens in relation to the atlas. In pediatric patients, the spine is more flexible, and therefore, neural damage occurs much earlier than musculoskeletal injury in young patients. Because of this high flexibility, fatal consequences can occur with sometimes even minimal structural damage. Compared to adults, children have a different fulcrum because of a relatively large head

2014 eMedicine Emergency Medicine

200. Fracture, Cervical Spine (Diagnosis)

. The anterior and posterior longitudinal ligaments maintain the structural integrity of the anterior and middle columns. The posterior column is held in alignment by a complex ligamentous system, including the nuchal ligament complex, capsular ligaments, and the ligamenta flava. If one column is disrupted, other columns may provide sufficient stability to prevent spinal cord injury. If 2 columns are disrupted, the spine may move as 2 separate units, increasing the likelihood of spinal cord injury. The atlas (...) , and transverse ligaments provide further stabilization by allowing spinal column rotation; this prevents posterior displacement of the dens in relation to the atlas. In pediatric patients, the spine is more flexible, and therefore, neural damage occurs much earlier than musculoskeletal injury in young patients. Because of this high flexibility, fatal consequences can occur with sometimes even minimal structural damage. Compared to adults, children have a different fulcrum because of a relatively large head

2014 eMedicine Emergency Medicine

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