Cotransplantation with specific populations of spina bifida bone marrow stem/progenitor cells enhances urinary bladder regeneration.

Spina bifida (SB) patients afflicted with myelomeningocele typically possess a neurogenic urinary bladder and exhibit varying degrees of bladder dysfunction. Although surgical intervention in the form of enterocystoplasty is the current standard of care in which to remedy the neurogenic bladder, it is still a stop-gap measure and is associated with many complications due to the use of bowel as a source of replacement tissue. Contemporary bladder tissue engineering strategies lack the ability to reform bladder smooth muscle, vasculature, and promote peripheral nerve tissue growth when using autologous populations of cells. Within the context of this study, we demonstrate the role of two specific populations of bone marrow (BM) stem/progenitor cells used in combination with a synthetic elastomeric scaffold that provides a unique and alternative means to current bladder regeneration approaches. In vitro differentiation, gene expression, and proliferation are similar among donor mesenchymal stem cells (MSCs), whereas poly(1,8-octanediol-cocitrate) scaffolds seeded with SB BM MSCs perform analogously to control counterparts with regard to bladder smooth muscle wall formation in vivo. SB CD34(+) hematopoietic stem/progenitor cells cotransplanted with donor-matched MSCs cause a dramatic increase in tissue vascularization as well as an induction of peripheral nerve growth in grafted areas compared with samples not seeded with hematopoietic stem/progenitor cells. Finally, MSC/CD34(+) grafts provided the impetus for rapid urothelium regeneration. Data suggest that autologous BM stem/progenitor cells may be used as alternate, nonpathogenic cell sources for SB patient-specific bladder tissue regeneration in lieu of current enterocystoplasty procedures and have implications for other bladder regenerative therapies.

Spina bifida and dental care: key clinical issues.

Spina bifida is a birth defect affecting the spinal column, resulting from failure of neural tube closure during the first month in utero. It is associated with varying degrees of neurologic and orthopedic impairment. This article presents an overview of spina bifida discussing its correlation with dental caries, latex allergy, pulmonary function, craniosynostosis, and morphology of sella turcica, and explains the role of the dentist in countering these problems.

Secondary conditions in people with developmental disability.

The authors investigated secondary conditions in people with developmental disabilities in terms of (a) the average number of conditions experienced and overall health and independence, (b) their degree and nature, and (c) gender differences. Information was obtained by a questionnaire completed by the caregivers for 659 people with developmental disabilities. Participants experienced an average of 11.3 secondary conditions. Secondary conditions causing significant limitations were reading difficulties, communication, physical fitness-conditioning, personal hygiene-appearance, weight, dental and oral hygiene, and memory problems. Some gender differences emerged in overall health scores and limitations due to secondary conditions.

The "innocent" cough or sneeze: a harbinger of serious latex allergy in children during bladder stimulation and urodynamic testing.

Latex hypersensitivity is a well documented phenomenon most commonly reported in children with spina bifida during surgical and other procedures involving exposure to latex. IgE-mediated immediate hypersensitivity to the protein or polypeptide components of latex may be severe and manifest as generalized anaphylaxis or cardiovascular collapse. Of 17 children with spina bifida undergoing transurethral electrical bladder stimulation we identified 5 with latex allergy 3 to 9 years old. All 5 patients were noted to manifest sneezing or a cough several minutes before the development of a generalized hypersensitivity reaction, which in several patients progressed to bronchospasm. Subsequent investigations have shown that the inciting agent was the rectal pressure balloon made from a latex finger cot. Recognition of the earliest manifestations of latex hypersensitivity is an important clinical tool in the prevention of severe allergic reactions.