COVID-19: Screening and triage challenges in people with disability due to Spinal Cord Injury.

An outbreak of a novel coronavirus disease (COVID-19) that emerged in the Chinese city of Wuhan has rapidly become a global public health pandemic. As of March 2020, the Centers for Disease Control and Prevention (CDC) has described priority levels for testing patients with suspected COVID-19 and information on when to seek medical attention. However, there is a paucity of further guidance for people with spinal cord injury (SCI) who may not present with typical symptoms of COVID-19 due to altered physiology. This may pose challenges with surveillance, risk stratification, and initial management of this vulnerable population. In this point-counterpoint discussion, we outline important differences in presentation along with COVID-19 cases co-morbid with SCI.

Involvement of brain opioid receptors in the anti-allodynic effect of hyperbaric oxygen in rats with sciatic nerve crush-induced neuropathic pain.

Earlier research has demonstrated that hyperbaric oxygen (HBO2) can produce an antinociceptive effect in models of acute pain. Recent studies have revealed that HBO2 can produce pain relief in animal models of chronic pain as well. The purpose of the present investigation was to ascertain whether HBO2 treatment might suppress allodynia in rats with neuropathic pain and whether this effect might be blocked by the opioid antagonist naltrexone (NTX). Male Sprague Dawley rats were subjected to a sciatic nerve crush under anesthesia and mechanical thresholds were assessed using an electronic von Frey anesthesiometer. The time course of the HBO2-induced anti-allodynic effect in different treatment groups was plotted, and the area-under-the-curve (AUC) was determined for each group. Seven days after the nerve crush procedure, rats were treated with HBO2 at 3.5 atm absolute (ATA) for 60 min and exhibited an anti-allodynic effect, compared to nerve crush-only control rats. Twenty-four hours before HBO2 treatment, another group of rats was implanted with Alzet(®) osmotic minipumps that continuously released NTX into the lateral cerebral ventricle for 7 days. These NTX-infused, HBO2-treated rats exhibited an allodynic response comparable to that exhibited by rats receiving nerve crush only. Analysis of the AUC data showed that HBO2 significantly reduced the nerve crush-induced allodynia; this anti-allodynic effect of HBO2 was reversed by NTX. These results implicate opioid receptors in the pain relief induced by HBO2.