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1.
Spinal Cord Ser Cases ; 6(1): 35, 2020 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-32393767

RESUMO

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.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Traumatismos da Medula Espinal/complicações , Triagem , Infecções por Coronavirus/complicações , Humanos , Pandemias , Pneumonia Viral/complicações
2.
Spinal Cord Ser Cases ; 6(1): 21, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32296046

RESUMO

STUDY DESIGN: An online survey. OBJECTIVES: To query the international spinal cord medicine community's engagement with and response to the novel coronavirus (COVID-19) pandemic and to assess pandemic-specific information needs and patient concerns. SETTING: An international collaboration of authors and participants. METHODS: Two near-identical surveys (one English and one Spanish language) were distributed via the internet. Responses from those questions shared between the surveys were pooled then analyzed; four questions' responses (those not shared) were analyzed separately. RESULTS: A total of 783 responses were submitted from six continents. Few participants (5.8%) had tested their outpatients with SCI/D for COVID-19; only 4.4% reported having a patient with SCI/D with the virus. Of respondents who worked at an inpatient facility, 53.3% reported that only individuals with symptoms were being screened and 29.9% said that no screening was occurring. Participants relayed several concerns offered by their patients with SCI/D, including vulnerability to infection (76.9%) and fragility of caretaker supply (42%), and those living in countries with guaranteed health care were more likely to report widespread availability of COVID-19 testing than were those living in countries without universal care, χ2 (3, N = 625) = 46.259, p < 0.001. CONCLUSION: There is substantial variability in the rehabilitation medicine community in COVID-19 screening practices and availability of screening kits. People living with SCI/D are expressing legitimate and real concerns about their vulnerability to COVID-19. More and rapid work is needed to address these concerns and to standardize best-practice protocols throughout the rehabilitation community.


Assuntos
Acesso à Informação , Infecções por Coronavirus/diagnóstico , Pessoal de Saúde , Pneumonia Viral/diagnóstico , Reabilitação , Traumatismos da Medula Espinal , Betacoronavirus , Cuidadores , Técnicas de Laboratório Clínico , Infecções por Coronavirus/complicações , Assistência à Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Pacientes Internados , Programas de Rastreamento , Pandemias , Pneumonia Viral/complicações , Traumatismos da Medula Espinal/reabilitação , Inquéritos e Questionários , Populações Vulneráveis
3.
J Biol Regul Homeost Agents ; 34(1): 25-37, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32264665

RESUMO

Neuropathic pain (NP) after spinal cord injury (SCI) leads to compromised physical and cognitive functions in a majority of patients. Aberrant miRNA expression plays vital roles in the pathogenesis of SCI. This study aims to investigate the effect of miR-331-3p in rats following SCI. Microarray assay was performed in SCI- and sham-operated rats to evaluate the expression of miR-331-3p. Assigned SCI rats were treated with miR-331-3p agomiR alone or miR-331-3p agomiR plus RAP1A-expressing lentivirus or control agomiR. Rat locomotor performance was evaluated by BBB locomotor rating scale. Neuronal tissue damage and apoptosis were detected by histological analyses and Western blot. Inflammation in spinal cord was determined by detection of the expression of inflammatory genes with qRT-PCR, and ELISA. Downstream expression of RAP1A was measured by Western blot. The results showed that SCI induced the downregulation of miR-331-3p in the spinal cord of SCI rats. Overexpression of miR-331-3p improved the locomotor performance, reduced tissue damage, neuronal apoptosis and inflammation in rat SCI model. Rap1a (Ras-related protein Rap-1A) was predicted as a downstream target for miR-331-3p, and upregulation of RAP1A impaired the beneficial effect of miR-331-3p post- SCI, which was shown as worse locomotor activity, more severe tissue damage, as well as promoting apoptosis and inflammation in SCI rats. Furthermore, miR-331-3p reduced the activation of RAP1A downstream genes via inhibiting RAP1A expression. These findings indicate a protective role of miR- 331-3p in the development of SCI via the modulation of RAP1A, and may help to develop novel therapy against SCI-induced complications.


Assuntos
MicroRNAs/genética , Neuralgia/genética , Traumatismos da Medula Espinal/patologia , Proteínas rap1 de Ligação ao GTP/genética , Animais , Ratos , Ratos Sprague-Dawley , Medula Espinal
4.
Bone Joint J ; 102-B(4): 519-523, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32228070

RESUMO

AIMS: The purpose of this study was to evaluate the incidence and analyze the trends of surgeon-reported complications following surgery for adolescent idiopathic scoliosis (AIS) over a 13-year period from the Scoliosis Research Society (SRS) Morbidity and Mortality database. METHODS: All patients with AIS between ten and 18 years of age, entered into the SRS Morbidity and Mortality database between 2004 and 2016, were analyzed. All perioperative complications were evaluated for correlations with associated factors. Complication trends were analyzed by comparing the cohorts between 2004 to 2007 and 2013 to 2016. RESULTS: Between 2004 and 2016, a total of 84,320 patients were entered into the database. There were 1,268 patients associated with complications, giving an overall complication rate of 1.5%. Death occurred in 12 patients (0.014%). The three most commonly reported complications were surgical site infection (SSI) (441 patients; 0.52%), new neurological deficit (293; 0.35%), and implant-related complications (172; 0.20%). There was a statistically significant but weak correlation between the occurrence of a SSI and the magnitude of the primary curve (r = 0.227; p < 0.001), and blood loss in surgery (r = 0.111; p = 0.038), while the occurrence of a new neurological deficit was correlated statistically significantly but weakly with age at surgery (r = 0.147; p = 0.004) and magnitude of the primary curve (r = 0.258; p < 0.001). The overall complication rate decreased from 4.95% during 2004 to 2007 to 0.98% during 2013 to 2016 (p = 0.023). CONCLUSION: An overall complication rate of 1.5% was found in our series after surgery for AIS, with a reduction of complication rates found in the second period of the analysis. Cite this article: Bone Joint J 2020;102-B(4):519-523.


Assuntos
Complicações Pós-Operatórias/etiologia , Escoliose/cirurgia , Adolescente , Criança , Bases de Dados Factuais , Feminino , Hong Kong/epidemiologia , Humanos , Incidência , Masculino , Complicações Pós-Operatórias/epidemiologia , Próteses e Implantes/efeitos adversos , Escoliose/epidemiologia , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/etiologia , Fusão Vertebral/efeitos adversos , Fusão Vertebral/instrumentação , Raízes Nervosas Espinhais/lesões , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/microbiologia
5.
Spinal Cord Ser Cases ; 6(1): 22, 2020 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-32303672

RESUMO

INTRODUCTION: We present the report of the first, to our best knowledge, case of COVID-19 in a tetraplegic person. CASE PRESENTATION: A 56-year-old male with AIS A C4 tetraplegia developed fever during the night, without any prodrome. His general practitioner suspected a urinary tract infection and prescribed him antibiotic therapy. After 2 days of antibiotic therapy the fever still persisted, so the individual was admitted to the local hospital and treated with broad-spectrum antibiotics. After 2 days he was transferred to our spinal unit. Considering the worsening of the chest X-ray and fever despite 48 h of broad-spectrum antibiotic therapy, we strongly suspected viral pneumonia. SARS-CoV-2 was detected and antiviral therapy with Lopinavir/Ritonavir, associated with hydroxychloroquine, was promptly started. Fever ceased after 2 days of therapy. DISCUSSION: Blood test and chest X-ray findings in this patient were similar to previously published findings regarding COVID-19. One difference between this case and the known clinical course of COVID-19 is that did not develop cough. Another interesting feature of our case is that, despite tetraplegia, the clinical course was not severe. Persons with COVID-19 remain asymptomatic, these results underscore the need for rehabilitation and SCI professionals to have a high index of suspicion for COVID-19 in their inpatient and outpatient clients. Only inpatient with fever hase being tested for COVID-19. All new patients are submitted to SARS-COV-2 Test. Moreover, routine testing of patients who have to participate in therapy in common gym areas may be warranted.


Assuntos
Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Quadriplegia/complicações , Antibacterianos/uso terapêutico , Antirretrovirais/uso terapêutico , Técnicas de Laboratório Clínico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Tosse , Febre/diagnóstico , Hospitalização , Humanos , Itália , Lopinavir/uso terapêutico , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/tratamento farmacológico , Respiração Artificial , Ritonavir/uso terapêutico , Vírus da SARS , Traumatismos da Medula Espinal/complicações
8.
Nat Neurosci ; 23(3): 337-350, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32112058

RESUMO

Tissue repair after spinal cord injury requires the mobilization of immune and glial cells to form a protective barrier that seals the wound and facilitates debris clearing, inflammatory containment and matrix compaction. This process involves corralling, wherein phagocytic immune cells become confined to the necrotic core, which is surrounded by an astrocytic border. Here we elucidate a temporally distinct gene signature in injury-activated microglia and macrophages (IAMs) that engages axon guidance pathways. Plexin-B2 is upregulated in IAMs and is required for motor sensory recovery after spinal cord injury. Plexin-B2 deletion in myeloid cells impairs corralling, leading to diffuse tissue damage, inflammatory spillover and hampered axon regeneration. Corralling begins early and requires Plexin-B2 in both microglia and macrophages. Mechanistically, Plexin-B2 promotes microglia motility, steers IAMs away from colliding cells and facilitates matrix compaction. Our data therefore establish Plexin-B2 as an important link that integrates biochemical cues and physical interactions of IAMs with the injury microenvironment during wound healing.


Assuntos
Macrófagos/fisiologia , Microglia/fisiologia , Proteínas do Tecido Nervoso/metabolismo , Traumatismos da Medula Espinal/patologia , Cicatrização/fisiologia , Animais , Axônios/fisiologia , Microambiente Celular , Locomoção/fisiologia , Camundongos , Regeneração Nervosa/genética , Regeneração Nervosa/fisiologia , Vias Neurais/fisiologia , Fagocitose , Recuperação de Função Fisiológica , Sensação/fisiologia , Traumatismos da Medula Espinal/metabolismo
11.
Zhongguo Gu Shang ; 33(2): 140-3, 2020 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-32133813

RESUMO

OBJECTIVE: To explore the high-risk factors of deep vein thrombosis (DVT) formation in patients after spinal cord injury (SCI) and to provide some reference value for the prevention of DVT. METHODS: Eighty-five patients with spinal cord injury caused by thoracolumbar burst fracture from January 2016 to December 2017 were selected as subjects. All patients were followed up for 6 months, of which 5 cases were lost and 80 cases were finally included. According to whether there was deep vein thrombosis, the patients were divided into DVT group (35 cases) and control group (45 cases). The clinical data were statistically analyzed by SPSS 22.0 statistical software, and the high-risk factors of spinal cord injury were analyzed by multivariate Logistic regression. RESULTS: Thirty-five of the 80 patients with spinal cord injury developed deep venous thrombosis (incidence rate was about 43.7%). The average age of DVT group [(47.77±10.76) years ] was higher than that of non-DVT group [(37.35±10.20) years ], and there was a significant difference between two groups (χ2=19.56, P<0.000). Patients with body mass index≥28 kg/m2, combined with diabetes mellitus, smoking history, no limb pressure therapy and ankle pump exercise had a high incidence of DVT. The incidence of ASIA grade A in the spinal cord injury was higher in the DVT group (48.5%) than in the non-DVT group (20%) (P<0.05). The ROC curve was drawn by MedCalc 15.8 software : when the age was more than 45 years old, the incidence of deep venous thrombosis was higher, the specificity was 84.4%, and the sensitivity was 72.6%. Multivariate Logistic regression analysis showed the following factors : patient age >45 years [OR=1.665, 95% CI (1.102-2.516)], diabetes history [OR=3.273, 95% CI (1.291-8.295)], smoking history [OR=3.302, 95% CI (1.267-8.605)], spinal cord injury ASIA grade A [OR=5.736, 95% CI (3.152-11.74)], non-limb air pressure therapy and ankle pump exercise [ OR=3.013, 95% CI (0.116-0.789)] was statistically significant (P<0.05) and was a high risk factor for deep vein thrombosis. CONCLUSION: The incidence of DVT is still high in patients with spinal cord injury after surgery. When one or more risk factors such as age >45 years, history of diabetes, smoking history, and ASIA grade A of spinal cord injury is present, preventive measures should be taken in advance, it is of great significance to prevent the formation of deep vein thrombosis.


Assuntos
Traumatismos da Medula Espinal , Trombose Venosa , Adulto , Humanos , Incidência , Modelos Logísticos , Pessoa de Meia-Idade , Fatores de Risco
12.
Zhongguo Gu Shang ; 33(2): 158-65, 2020 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-32133817

RESUMO

OBJECTIVE: To explore the influencing factors of the operative effect on cervical spinal cord injury without fracture or dislocation. METHODS: The clinical data of 69 patients with cervical spinal cord injury without fracture or dislocation from November 2010 to November 2016 who received operation were retrospectively analyzed. There were 37 males and 32 females, aged from 32 to76 years with an average of (51.6±7.3) years. The clinical data of 12 factors were selected, including age, gender, ASIA grade of spine cord injury, the length of spine cord injury by MRI, Pavlov ratio, ossification of the posterior longitudinal ligament (OPLL), intervertebral disc herniation, type of spine cord injury by MRI, time from injury to operation, treatment of high-dose methylprednisolone, operation time, intraoperative bleeding volume. In order to screen the main influencing factors of above items to prognosis, the single factor and multiple factor Logistic regression analysis were used in the clinical data by SPSS 22.0 statistical software. RESULTS: Univariate analysis results showed that the factors including ASIA grade of spine cord injury, the length of spine cord injury by MRI, Pavlov ratio, ossification of longitudinal ligament, intervertebral disc herniation, the type of spine cord injury by MRI were associated with prognosis (P<0.05). Multi factor analysis of the selected factors indicated that the type of spine cord injury by MRI, the length of spine cord injury by MRI, Pavlov ratio, ASIA grade of spine cord injury were the main prognostic factors according to the influence intensity (P<0.05). CONCLUSION: The influencing factors of the operative effect on cervical spinal cord injury without fracture and dislocation were the type of spine cord injury by MRI, the length of spine cord injury by MRI, Pavlov ratio, ASIA grade of spine cord injury, and the foremost were the type and length of spine cord injury by MRI. Compared with other patients, preoperative MRI showed the patient with spinal cord injury type with bleeding and edema, or the length of spine cord injury larger than 45 mm may be less effective, therefore, it is necessary to thoroughly communicate with the patients and their kin before surgery.


Assuntos
Medula Cervical , Traumatismos da Medula Espinal , Adulto , Idoso , Vértebras Cervicais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Retrospectivos
13.
Harefuah ; 159(3): 191-194, 2020 Mar.
Artigo em Hebraico | MEDLINE | ID: mdl-32186790

RESUMO

INTRODUCTION: Spinal cord injury (SCI) etiology can be either traumatic or non-traumatic. Non-traumatic SCI is of growing importance, with studies indicating increased incidence, partly because of population aging. Approximately 9% of these injuries are secondary to an infectious cause. SCI has significant implications on the patient's quality of life. A successful rehabilitation process focuses on maximizing independence and setting achievable goals according to the patient's needs and desires. The medical staff should be familiar with the natural history of such injuries while taking into consideration the existing support systems available to the patient and minimizing the damage to life cycles as best possible with the aid of a transdisciplinary team approach. In this article, we will review the main viral causes of SCI injury. We will discuss the epidemiology, clinical aspects and the unique meanings of this subgroup in the rehabilitation process.


Assuntos
Traumatismos da Medula Espinal/virologia , Viroses/epidemiologia , Humanos , Incidência , Infecções , Qualidade de Vida , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/etiologia , Viroses/complicações
14.
Artigo em Russo | MEDLINE | ID: mdl-32207703

RESUMO

AIM: To determine the value of functional tenodesis (FT) of the hand as a predictor of the degree of disability in patients with cervical tetraplegia (CT) at different periods after a spinal injury. MATERIAL AND METHODS: We examined 190 patients (79% - men) with CT (92.5% of cases of traumatic origin) at the age of 27 [21.0; 36.0] years with a neurological level of CІІІ-DІ, and a share of complete motor damage (A - B according to AIS) 70%. The examination included determination of neurological, motor levels and completeness of spinal cord injury (according to ISNSCI), assessment of functional independence (FIM motor domain), FT of the hand, and the severity of contractures of the joints of the hand. Using logit-regression analysis, creation of contingency tables, ROC analysis, depending on the timing of spinal injury, 4 classification models were studied: Disease duration less than 6 months, assessment of the functional outcome 6 months after spinal injury (model A); disease duration less than 6 months, assessment after 12 months (model B); disease duration less than 12 months, assessment after 12 months (model C); disease duration more than 12 months, evaluation after more than 12 months (model D, primary one). RESULTS: FT developed in the first 6 months after spinal injury in 12 (24%) patients, in 6-12 months - in 15 patients (20%), in more than 12 months - in 1 (less than 1%) patient. The incidence of joint contractures of the hand in group A (20%) and C (24%) did not have a statistical difference (χ2=0.22; p=0.64). Hand contractures in the first 6 months were observed in 20% of patients, in the first 12 months - in 24%, more than 12 months after spinal injury - in 28% of patients. In model A, the FT sensitivity was 80%, specificity was 64%, AUC - 0.65; in model B - 85%, 36%, 0.36, respectively; in model C (log-regression χ2=19.1; p was not determined) - 69%, 100%, 0.59, respectively; in model D (log-regression χ2=55.3; p was not determined) - 65%, 100%, 0.71, respectively. CONCLUSION: FT and contracture of the joints of the hand form during the first year after the debut of CT. As a predictor of a pronounced limitation of self-care, the sensitivity of FT in the first 6 months after spinal injury was 80-85%, in the later period, the specificity of FT was 100%, and sensitivity was 65-69%; in general, the predictive power of FT was low (AUC 0.36-0.71) and increased with the assessment of the functional outcome in the period of more than 12 months after the injury.


Assuntos
Mãos/cirurgia , Quadriplegia/fisiopatologia , Traumatismos da Medula Espinal/fisiopatologia , Tenodese , Adulto , Feminino , Humanos , Masculino , Recuperação de Função Fisiológica , Adulto Jovem
15.
Coluna/Columna ; 19(1): 48-51, Jan.-Mar. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1089636

RESUMO

ABSTRACT Objective This paper proposes a retrospective analysis of the spinal cord trauma at a regional hospital that is a Unified Health System (SUS) reference in Orthopedics and Traumatology, considering epidemiological data and comparing treatments and hospitalization costs. Methods This study is a retrospective, analytical-descriptive, exploratory documental analysis, using data from the medical records of patients treated for spinal cord trauma during 2016 at the São José Municipal Hospital (Joinville, SC). Results Twenty-three patients were included in the study, 20 of whom (87%) were male. As to etiology, traffic accidents accounted for 47.8% of the cases and gunshot wounds were in second place with 26.1% of the injuries. The correlation between the cost of hospitalization and the days of hospitalization was statistically significant (p = 0.013), as was the correlation between the cost of hospitalization and the number of procedures (p = 0.000). Conclusions Surgical treatment demands greater amounts of financial and human resources. The purpose of this study is to provide local epidemiological data to encourage discussion about other studies, as well as planning for resource allocation and public policy. Level of evidence II; Retrospective Study.


RESUMO Objetivo O presente estudo propõe uma análise retrospectiva relacionada ao traumatismo raquimedular de um hospital de referência regional em Ortopedia e Traumatologia pelo Sistema Único de Saúde (SUS), considerando dados epidemiológicos, comparações entre tratamentos e custos das internações. Métodos Trata-se de um estudo retrospectivo, analítico-descritivo de análise exploratória documental, utilizando dados de prontuários médicos de pacientes atendidos com traumatismo raquimedular durante o ano de 2016 no Hospital Municipal São José (Joinville - SC). Resultados Foram incluídos no estudo 23 pacientes, sendo 20 (87%) do sexo masculino. Quanto à etiologia, os acidentes de trânsito foram responsáveis por 47,8% dos casos e os ferimentos por arma de fogo ocuparam o segundo lugar com 26,1% dos agravos. A correlação entre o custo da internação e os dias da internação foi estatisticamente significativa (p=0,013), assim como a correlação entre o custo da internação e o número de procedimentos (p=0,000). Conclusões O tratamento cirúrgico demanda maior quantidade de recursos financeiros e humanos. O propósito do presente trabalho consiste em fornecer os dados epidemiológicos locais para fomentar a discussão de outros trabalhos, assim como o planejamento para alocação de recursos e de políticas públicas. Nível de evidência II; Estudo Retrospectivo.


RESUMEN Objetivo El presente estudio propone un análisis retrospectivo relacionado al traumatismo raquimedular de un hospital de referencia regional en Ortopedia y Traumatología por el Sistema Único de Salud (SUS), considerando datos epidemiológicos, comparaciones entre tratamientos y costos de las internaciones. Métodos Se trata de un estudio retrospectivo, analítico-descriptivo de análisis exploratorio documental, utilizando datos de prontuarios médicos de pacientes atendidos con traumatismo raquimedular durante el año 2016 en el Hospital Municipal São José (Joinville - SC). Resultados Fueron incluidos en el estudio 23 pacientes, siendo 20 (87%) del sexo masculino. Cuanto a la etiología, los accidentes de tránsito fueron responsables por 47,8% de los casos y las heridas por arma de fuego ocuparon el segundo lugar, con 26,1% de los agravios. La correlación entre el costo de la internación y los días de internación fue estadísticamente significativa (p=0,013), así como la correlación entre el costo de internación y el número de procedimientos (p=0,000). Conclusiones El tratamiento quirúrgico demanda mayor cantidad de recursos financieros y humanos. El propósito del presente trabajo consiste en suministrar los datos epidemiológicos locales para fomentar la discusión de otros trabajos, así como la planificación para la asignación de recursos y de políticas públicas. Nivel de evidencia II; Estudio Retrospectivo.


Assuntos
Humanos , Política Pública , Traumatismos da Medula Espinal , Sistema Único de Saúde
16.
Mayo Clin Proc ; 95(2): 224-225, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32029081
18.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(2): 213-219, 2020 Feb 15.
Artigo em Chinês | MEDLINE | ID: mdl-32030954

RESUMO

Objective: To systematically profile and characterize the circular RNA (circRNA) and microRNA (miRNA) expression pattern in the lesion epicenter of spinal tissues after traumatic spinal cord injury (TSCI) and predict the structure and potential functions of the regulatory network. Methods: Forty-eight adult male C57BL/6 mice (weighing, 18-22 g) were randomly divided into the TSCI ( n=24) and sham ( n=24) groups. Mice in the TSCI group underwent T 8-10 vertebral laminectomy and Allen's weight-drop spinal cord injury. Mice in the sham group underwent the same laminectomy without TSCI. The spinal tissues were harvested after 3 days. Some tissues were stained with HE staining to observe the structure. The others were used for sequencing. The RNA-Seq, gene ontology (GO) analysis, and circRNA-miRNA network analyses (TargetScan and miRanda) were used to profile the expression and regulation patterns of network of mice models after TSCI. Results: HE staining showed the severe damage to the spinal cord in TSCI group compared with sham group. A total of 17 440 circRNAs and 1 228 miRNAs were identified. The host gene of significant differentially expressed circRNA enriched in the cytoplasm, associated with positive regulation of transcription and protein phosphorylation. mmu-miR-21-5p was the most significant differentially expressed miRNA after TSCI, and circRNA6730 was predicted to be its targeted circRNA. Then a potential regulatory circRNA-miRNA network was constructed. Conclusion: The significant differentially expressed circRNAs and miRNAs may play important roles after TSCI. A targeted interaction network with mmu-miR-21-5p at the core of circRNA6730 could provide basis of pathophysiological mechanism, as well as help guide therapeutic strategies for TSCI.


Assuntos
Traumatismos da Medula Espinal , Animais , Masculino , Camundongos , Camundongos Endogâmicos C57BL , MicroRNAs , RNA Circular , Análise de Sequência
19.
Med Clin North Am ; 104(2): 263-278, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32035568

RESUMO

Individuals with spinal cord injuries or disorders (SCI/D), whether of traumatic or nontraumatic cause, require multidisciplinary management by their care team to achieve optimal health outcomes. SCI/D is relatively rare in the general population and primary care providers (PCPs) may not have extensive experience managing people with these disorders. Spinal cord injuries, impair the body's autonomic and biomechanical performance by interrupting the communications to and from major bodily systems. This article provides a framework to help PCPs understand how these changes impact their patient's physiologic function and subsequent risks for health complications with guidance for initial treatment approaches.


Assuntos
Administração dos Cuidados ao Paciente/métodos , Traumatismos da Medula Espinal , Doença Crônica , Humanos , Equipe de Assistência ao Paciente/organização & administração , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/terapia
20.
PLoS One ; 15(1): e0228465, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32004359

RESUMO

OBJECTIVE: This study aims to identify determinants of dietary behaviour in wheelchair users with spinal cord injury or lower limb amputation, from the perspectives of both wheelchair users and rehabilitation professionals. The findings should contribute to the field of health promotion programs for wheelchair users. METHODS: Five focus groups were held with wheelchair users (n = 25), and two with rehabilitation professionals (n = 11). A thematic approach was used for data analysis in which the determinants were categorized using an integrated International Classification of Functioning, Disability and Health and Attitude, Social influence and self-Efficacy model. RESULTS: Reported personal factors influencing dietary behaviour in wheelchair users were knowledge, boredom, fatigue, stage of life, habits, appetite, self-control, multiple lifestyle problems, intrinsic motivation, goal setting, monitoring, risk perception, positive experiences, suffering, action planning, health condition, function impairments, attitude and self-efficacy. Reported environmental factors influencing dietary behaviour in wheelchair users were unadjusted kitchens, monitoring difficulties, eating out, costs, unfavourable food supply, nutrition education/counselling, access to simple healthy recipes, eating together, cooking for others, and awareness and support of family and friends. CONCLUSIONS: Important modifiable determinants of dietary behaviour in wheelchair users that might be influenced in lifestyle interventions are knowledge, fatigue, habits, self-control, intrinsic motivation, risk perception, attitude and self-efficacy. It is recommended to involve relatives, since they appear to significantly influence dietary behaviour.


Assuntos
Amputação/reabilitação , Pessoas com Deficiência/reabilitação , Obesidade/prevenção & controle , Traumatismos da Medula Espinal/reabilitação , Adulto , Idoso , Feminino , Grupos Focais , Promoção da Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Autoeficácia , Inquéritos e Questionários , Cadeiras de Rodas
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