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1.
A A Pract ; 16(1): e01556, 2022 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-35020604

RESUMO

Autonomic dysreflexia occurs after a spinal cord injury usually at the level of T6 or above, and its hallmark feature is exaggerated autonomic response to noxious stimuli resulting in uncontrolled hypertensive episodes with reflexive bradycardia that can be fatal if not controlled. We present a case highlighting regional anesthetic techniques, including peripheral nerve blocks, to ameliorate the symptoms of autonomic dysreflexia triggered by hip fractures in a 57-year-old woman with an old C5-C6 spinal cord injury before definitive hip surgery. The regional techniques described provide anesthesiologists with a simple strategy to potentially mitigate a life-threatening situation.


Assuntos
Anestesia por Condução , Disreflexia Autonômica , Fraturas do Quadril , Hipertensão , Traumatismos da Medula Espinal , Disreflexia Autonômica/etiologia , Feminino , Fraturas do Quadril/cirurgia , Humanos , Pessoa de Meia-Idade
2.
J Orthop Traumatol ; 23(1): 2, 2022 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-34989884

RESUMO

Electrical stimulation is used to elicit muscle contraction and can be utilized for neurorehabilitation following spinal cord injury when paired with voluntary motor training. This technology is now an important therapeutic intervention that results in improvement in motor function in patients with spinal cord injuries. The purpose of this review is to summarize the various forms of electrical stimulation technology that exist and their applications. Furthermore, this paper addresses the potential future of the technology.


Assuntos
Traumatismos da Medula Espinal , Estimulação Elétrica , Humanos , Traumatismos da Medula Espinal/terapia
3.
Exp Neurol ; 347: 113889, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34624330

RESUMO

Spinal cord injury (SCI) leads to irreversible functional deficits due to the disruption of axons and the death of neurons and glial cells. The inflammatory response that occurs in the injured spinal cord results in tissue degeneration; thus, targeting inflammation after acute SCI is expected to ameliorate histopathological evidence indicative of damage and, consequently, reduce functional disabilities. Interleukin 1 beta (IL-1ß) and interleukin 18 (IL-18) are pro-inflammatory cytokines members of the IL-1 family that initiate and propagate inflammation. Here, we report that protein levels of IL-1ß and IL-18 were increased in spinal cord parenchyma after SCI, but with different expression profiles. Whereas levels of IL-1ß were rapidly increased reaching peak levels at 12 h after the injury, levels of IL-18 did not increase until 7 days after the injury. Since activation of the NLRP3 inflammasome is required for the processing and release of IL-1ß and IL-18, we intraperitoneally administered OLT1177, a selective inhibitor of the NLRP3 inflammasome, to reduce the contribution of these cytokines to SCI. At a dose of 200 mg/kg, OLT1177 protected against neurological deficits and histological evidence of damage. OLT1177 also reduced the levels of IL-1ß in the spinal cord after contusion injury and diminished the accumulation of neutrophils and macrophages at later time points. These data suggest that targeting the NLRP3 inflammasome with OLT1177 could be a novel therapeutic strategy to arrest neuroinflammation and reduce functional impairments after acute SCI in humans.


Assuntos
Anti-Inflamatórios/farmacologia , Inflamassomos/efeitos dos fármacos , Bainha de Mielina/patologia , Nitrilas/farmacologia , Traumatismos da Medula Espinal/imunologia , Sulfonas/farmacologia , Animais , Feminino , Camundongos , Proteína 3 que Contém Domínio de Pirina da Família NLR/imunologia , /patologia , Traumatismos da Medula Espinal/patologia
4.
Exp Neurol ; 347: 113891, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34637802

RESUMO

We review progress towards greater mechanistic understanding and clinical translation of a strategy to improve respiratory and non-respiratory motor function in people with neuromuscular disorders, therapeutic acute intermittent hypoxia (tAIH). In 2016 and 2020, workshops to create and update a "road map to clinical translation" were held to help guide future research and development of tAIH to restore movement in people living with chronic, incomplete spinal cord injuries. After briefly discussing the pioneering, non-targeted basic research inspiring this novel therapeutic approach, we then summarize workshop recommendations, emphasizing critical knowledge gaps, priorities for future research effort, and steps needed to accelerate progress as we evaluate the potential of tAIH for routine clinical use. Highlighted areas include: 1) greater mechanistic understanding, particularly in non-respiratory motor systems; 2) optimization of tAIH protocols to maximize benefits; 3) identification of combinatorial treatments that amplify plasticity or remove plasticity constraints, including task-specific training; 4) identification of biomarkers for individuals most/least likely to benefit from tAIH; 5) assessment of long-term tAIH safety; and 6) development of a simple, safe and effective device to administer tAIH in clinical and home settings. Finally, we update ongoing clinical trials and recent investigations of tAIH in SCI and other clinical disorders that compromise motor function, including ALS, multiple sclerosis, and stroke.


Assuntos
Hipóxia , Doenças Neuromusculares/terapia , Traumatismos da Medula Espinal/terapia , Animais , Humanos
5.
Neurosurg Clin N Am ; 33(1): 37-47, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34801140

RESUMO

Children with skeletal dysplasia present unique challenges for safe anesthetic care including differences in the anatomy of the respiratory system, possibility of cervical spine instability or spinal stenosis, and a unique body habitus. Even seemly routine anesthesia can result in respiratory arrest or spinal cord injury. These complications can largely be avoided by proper planning such as appropriate techniques for the intubation of difficult airways, recognition of cervical instability, neuromonitoring for any anesthesia over an hour in patients with severe spinal stenosis, and preoperative assessment of the trachea and avoidance of neuraxial anesthesia in children with Morquio syndrome.


Assuntos
Anestésicos , Mucopolissacaridose IV , Traumatismos da Medula Espinal , Doenças da Coluna Vertebral , Estenose Espinal , Criança , Humanos
6.
Spine (Phila Pa 1976) ; 47(1): E16-E26, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34027924

RESUMO

STUDY DESIGN: Monocenter case-control study. OBJECTIVE: Effects of spinal surgical adverse events (SSAE) on clinical and functional outcome, length of stay, and treatment costs after traumatic cervical spinal cord injury (SCI). SUMMARY OF BACKGROUND DATA: Traumatic SCI is a challenge for primary care centers because of the emergency setting and complex injury patterns. SSAE rates of up to 15% are reported for spine fractures without SCI. Little is known about SSAE after traumatic SCI and their outcome relevance. METHODS: Acute traumatic cervical SCI patients were enrolled from 2011 to 2017. Cases with and without SSAE were compared regarding neurological recovery, functional outcome, secondary complications, mortality, length of stay, and treatment costs. Adjusted logistic regression and generalized estimating equation models were calculated for the endpoints ASIA impairment scale (AIS)-conversion and dysphagia. All analyses were run in the total and in a propensity score matched sample. RESULTS: At least one SSAE occurred in 37 of 165 patients (22.4%). Mechanical instability and insufficient spinal decompression were the most frequent SSAE with 13 (7.9%) or 11 (6.7%) cases, respectively. The regression models adjusted for demographic, injury, and surgery characteristics demonstrated a reduced probability for AIS-conversion related to SSAE (OR [95% CI] 0.14 [0.03-0.74]) and additionally to single-sided ventral or dorsal surgical approach (0.12 [0.02-0.69]) in the matched sample. Furthermore, SSAE were associated with higher risk for dysphagia in the matched (4.77 [1.31-17.38]) and the total sample (5.96 [2.07-17.18]). Primary care costs were higher in cases with SSAE (median (interquartile range) 97,300 [78,200-112,300]) EUR compared with cases without SSAE (52,300 [26,700-91,200]) EUR. CONCLUSION: SSAE are an important risk factor after acute traumatic cervical SCI with impact on neurological recovery, functional outcome, and healthcare costs. Reducing SSAE is a viable means to protect the limited intrinsic capacity for recovery from SCI.Level of Evidence: 4.


Assuntos
Traumatismos da Medula Espinal , Doenças da Coluna Vertebral , Estudos de Casos e Controles , Vértebras Cervicais/cirurgia , Descompressão Cirúrgica , Humanos , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/cirurgia , Resultado do Tratamento
7.
Exp Neurol ; 347: 113903, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34699788

RESUMO

Intermittent hypoxia elicits protocol-dependent effects on hypoglossal (XII) motor plasticity. Whereas low-dose, acute intermittent hypoxia (AIH) elicits serotonin-dependent plasticity in XII motor neurons, high-dose, chronic intermittent hypoxia (CIH) elicits neuroinflammation that undermines AIH-induced plasticity. Preconditioning with repeated AIH and mild CIH enhance AIH-induced XII motor plasticity. Since intermittent hypoxia pre-conditioning could enhance serotonin-dependent XII motor plasticity by increasing serotonergic innervation density of the XII motor nuclei, we tested the hypothesis that 3 distinct intermittent hypoxia protocols commonly studied to elicit plasticity (AIH) or simulate aspects of sleep apnea (CIH) differentially affect XII serotonergic innervation. Sleep apnea and associated CIH are common in people with cervical spinal injuries and, since repetitive AIH is emerging as a promising therapeutic strategy to improve respiratory and non-respiratory motor function after spinal injury, we also tested the hypotheses that XII serotonergic innervation is increased by repetitive AIH and/or CIH in rats with cervical C2 hemisections (C2Hx). Serotonergic innervation was assessed via immunofluorescence in male Sprague Dawley rats, with and without C2Hx (beginning 8 weeks post-injury) exposed to 28 days of: 1) normoxia; 2) daily AIH (10, 5-min 10.5% O2 episodes per day; 5-min normoxic intervals); 3) mild CIH (5-min 10.5% O2 episodes; 5-min intervals; 8 h/day); and 4) moderate CIH (2-min 10.5% O2 episodes; 2-min intervals; 8 h/day). Daily AIH, but neither CIH protocol, increased the area of serotonergic immunolabeling in the XII motor nuclei in both intact and injured rats. C2Hx per se had no effect on XII serotonergic innervation density. Thus, daily AIH may increases XII serotonergic innervation and function, enhancing the capacity for serotonin-dependent, AIH-induced plasticity in upper airway motor neurons. Such effects may preserve upper airway patency and/or swallowing ability in people with cervical spinal cord injuries and other clinical disorders that compromise breathing and airway defense.


Assuntos
Vértebras Cervicais/lesões , Nervo Hipoglosso/metabolismo , Hipóxia/metabolismo , Neurônios Serotoninérgicos/metabolismo , Traumatismos da Medula Espinal/metabolismo , Traumatismos da Medula Espinal/terapia , Animais , Nervo Hipoglosso/química , Hipóxia/patologia , Masculino , Ratos , Ratos Sprague-Dawley , Neurônios Serotoninérgicos/química , Traumatismos da Medula Espinal/patologia
8.
Spine (Phila Pa 1976) ; 47(1): 59-66, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34882648

RESUMO

STUDY DEIGN: Retrospective cohort study. OBJECTIVES: This retrospective cohort study aims to determine the association of early decompressive surgery and the impact of transport time on the neurological outcomes of traumatic spinal cord injury (tSCI) patients. SUMMARY OF BACKGROUND DATA: tSCI is a catastrophic event that may result in permanent disability or loss of function. To date, there remains significant controversy over the optimal time for surgical decompression in tSCI patients. The aim of this study is to evaluate the neurological outcomes of tSCI patients undergoing early versus late surgical decompression and the impact of transport time on neurological outcomes. METHODS: Data from 84 patients with tSCI requiring surgical decompression was collected. Regression analysis was used to establish time to decompression classification cutoffs. Patients were classified into the following subgroups: 0 to 12 or >12 hours as a factor of the total or admitting hospital time to decompression. The change in American Spinal Injury Association Impairment (AIS) Grade from admission to discharge was determined. Additionally, the effect of transport time on conversion of AIS grade was assessed as patients were grouped into transport times of <6 or >6 hours. RESULT: Among the time to decompression subgroups there were no significant differences (P > 0.05) in confounding factors such as age, injury severity, and AIS grade. Patients who received decompression within 0 to 12 hours were associated with significantly (P < 0.0001) higher average improvements in ASIA grade (0.76). Patient transport times <6 hours were associated with significantly (P = 0.004) higher conversion of AIS grade to less impaired states. CONCLUSION: The present study suggests an association of decompression within 12 hours and short transport times (<6 hours) with significant improvements in neurological outcomes.Level of Evidence: 4.


Assuntos
Traumatismos da Medula Espinal , Traumatismos da Coluna Vertebral , Descompressão Cirúrgica , Humanos , Recuperação de Função Fisiológica , Estudos Retrospectivos , Traumatismos da Medula Espinal/diagnóstico , Traumatismos da Medula Espinal/cirurgia
9.
Methods Mol Biol ; 2389: 45-56, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34558000

RESUMO

Whereas neural stem cells and their niches have been extensively studied in the brain, little is known on these cells, their environment, and their function in the adult spinal cord. Adult spinal cord neural stem cells are located in a complex niche surrounding the central canal, and these cells expressed genes which are specifically expressed in the caudal central nervous system (CNS). In-depth characterization of these cells in vivo and in vitro will provide interesting clues on the possibility to utilize this endogenous cell pool to treat spinal cord damages. We describe here a procedure to derive and culture neural spinal cord stem cells from adult mice using the neurosphere method.


Assuntos
Células-Tronco Neurais , Envelhecimento , Animais , Diferenciação Celular , Camundongos , Medula Espinal , Traumatismos da Medula Espinal
10.
Spectrochim Acta A Mol Biomol Spectrosc ; 265: 120323, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34534772

RESUMO

Spinal cord injury is a significant public health issue with high psychological and financial costs to both the family and the society. Effective treatment strategies are hence of immense value. Several reports have suggested application of amniotic membrane for treating injuries, and there is evidence that it may be used to treat spinal injuries. In this animal model study, we explore biochemical changes in amniotic membrane treated injured spinal cord with respect to untreated injured and uninjured spinal cord using Raman spectroscopy. Multivariate statistical analysis is able to classify control, untreated, and treated with 92%, 87%, and 80% efficiency, respectively; suggesting unique biochemical changes in each group. Such studies may lead to development of minimally invasive methodologies for spinal cord injury treatment monitoring.


Assuntos
Âmnio , Traumatismos da Medula Espinal , Animais , Modelos Animais de Doenças , Ratos , Análise Espectral Raman , Traumatismos da Medula Espinal/terapia
11.
Am J Occup Ther ; 76(1)2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34962515

RESUMO

IMPORTANCE: After spinal cord injury (SCI), as many as 45% of people experience at least one hospital readmission within 1 yr. Identification of feasible low-cost interventions to reduce hospital readmissions after SCI is needed. OBJECTIVE: To explore whether a relationship exists between routine exercise and hospital readmission rates 1 yr after SCI. DESIGN: We conducted a secondary analysis of data from the SCIRehab Project, a prospective cohort study. SETTING: Five SCI inpatient rehabilitation facilities across the United States. PARTICIPANTS: Participants were people age 12 yr and older who had sustained an SCI, were admitted to a participating inpatient rehabilitation facility, completed the 12-mo postinjury interview, and reported exercising either monthly or not at all since discharge (N = 520). Outcomes and Measures: The SCIRehab Project conducted 12-mo post-inpatient rehabilitation discharge interviews. As part of the interviews, self-reported hospital readmissions and exercise frequencies since discharge (self-reported number of months, average days per week, and average minutes per day of exercise participation) were collected and analyzed. RESULTS: A χ2 analysis determined that a significant correlation (φ = -.091, p = .038) exists between monthly exercise and hospital readmissions 1 yr postinjury. Compared with those who did not exercise, participants who exercised monthly had 8.4% fewer hospital readmissions. CONCLUSIONS AND RELEVANCE: A relationship exists between exercise and hospital readmission, but follow-up research is needed to determine whether regular exercise reduces hospital readmissions among this population. What This Article Adds: After discharge, 44% of the participants did not exercise during the first year after injury. Identifying or implementing accessible community exercise programs is an area of opportunity for occupational therapy practitioners and future researchers to explore.


Assuntos
Readmissão do Paciente , Traumatismos da Medula Espinal , Criança , Humanos , Pacientes Internados , Alta do Paciente , Estudos Prospectivos , Estados Unidos
12.
Gen Physiol Biophys ; 40(6): 561-568, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34897027

RESUMO

Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique used to characterize fibrous structures such as white matter in the central nervous system, including normal and spinal cord injury (SCI) conditions. Our aim was to evaluate the effect of alginate treatment in the rat SCI by DTI parametric measures. Ex vivo DTI data were collected by spin echo sequence with following parameters TR/TE: 2500 ms/32 ms and b-value of 1500 s/mm2. Main significant changes were found in fractional anisotropy (FA), and radial diffusivity (RD), between the saline- and alginatetreated group at the level of individual sections and whole spinal cord. Results indicate that ex vivo DTI can be used as a tool for tissue structure characterisation and both FA and RD as promising prognostic parameters of SCI treatment.


Assuntos
Imagem de Tensor de Difusão , Traumatismos da Medula Espinal , Alginatos , Animais , Imageamento por Ressonância Magnética , Ratos , Traumatismos da Medula Espinal/diagnóstico por imagem , Traumatismos da Medula Espinal/tratamento farmacológico
14.
Chirurgia (Bucur) ; 116(6): 669-677, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34967712

RESUMO

Post-traumatic morbid associations may evolve by themselves, or can interact, with effects of adding or potentiating gravity. Sometimes cumulative or potentiating effects are associated with clinical and paraclinical confusing manifestations induced by one of the components of the lesion complex, or by mutually aggravating effects. It is also the case of vertebromedular traumas associated with other post-traumatic lesions, where the neurological signal is distorted, and may induce particularities of associated lesions. Posttraumatic spinal shock, autonomic dysreflexia and motor, sensory and autonomous after effects, bring distortions of the neurogenic signal, which will significantly affect other traumatized territories, generating clinical manifestations and atypical reaction elements. The prototype of this post-traumatic morbid association is represented by the lesion complex vertebromedular trauma - abdominal trauma.


Assuntos
Disreflexia Autonômica , Traumatismos da Medula Espinal , Humanos , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/diagnóstico , Resultado do Tratamento
15.
Zhen Ci Yan Jiu ; 46(12): 987-95, 2021 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-34970874

RESUMO

OBJECTIVE: To explore the effect of electroacupuncture (EA) combined with Schwann cell (SC) transplantation (SCT) on remyelination of axons and neuregulin (Nrg1) in rats with compressed spinal cord injury(CSCI),so as to explore the mechanism of EA and SCT underlying improvement of CSCI. METHODS: SD female rats were randomly divided into normal, mo-del, EA, SCT, and EA+ SCT groups (n=40 per group). A self-developed model of spinal compressed injury was adopted in this study. Rats of the model group were administrated laminectomy without treatment. Rats in the EA group were administrated EA stimulation at "Dazhui"(GV14), "Mingmen"(GV7), bilateral "Zusanli" (ST36) and "Taixi" (KI3) on the second day post-surgery for 10 min. Rats in the SC group were administrated SCT at 1 week post-surgery, and in the EA+SC group were given EA stimulation combined with SCT. The injured spinal cord tissue was obtained 0, 2, 4 and 8 weeks after compressed spinal injury. The functional recovery was assessed by Basso-Beattie-Bresnahan (BBB) score. The survivals and migration of SC after transplantation, myelination were observed by immunofluorescence. The ultrastructure of myelin in injured site was observed by transmission electron microscope,and the expression levels of glial fibrillary acidic protein (GFAP), protein zero(P0), and Nrg1 and Nrg1-ntf (cleavage protein of Nrg1) proteins of the spinal cord were detected by Western blot. RESULTS: Compared with the normal group, BBB scores in the model group was significantly decreased(P<0.05),nervous fibers were demyelinated, numbers of normal and newborn myelination were decreased(P<0.05),expression of P0 was significantly increased (P<0.05),expression of GFAP was significantly increased(P<0.05),and the expression levels of Nrg1 and Nrg1-ntf proteins were decreased(P<0.05). In comparison with the model group, the BBB scores in the EA, SCT and EA+SCT groups were significantly increased(P<0.05,P<0.01), demyelination was improved, numbers of normal and newborn myelinations were increased(P<0.05,P<0.01),expressions of P0 were significantly increased (P<0.05,P<0.01),expressions of GFAP were significantly decreased(P<0.05),and the expression levels of Nrg1 and Nrg1-ntf proteins were increased (P<0.05, P<0.01).The differences were most significant in the EA+SCT group among the three groups. CONCLUSION: EA can improve the locomotor function in CSCI rats, which may be rela-ted to its functions in promoting the survival and migration of transplanted SC and remyelination, and increasing the expressions of Nrg1 and its cleavage protein after SC transplantation.


Assuntos
Eletroacupuntura , Remielinização , Traumatismos da Medula Espinal , Traumatismos da Coluna Vertebral , Animais , Axônios , Transplante de Células , Feminino , Ratos , Ratos Sprague-Dawley , Células de Schwann , Medula Espinal , Traumatismos da Medula Espinal/genética , Traumatismos da Medula Espinal/terapia
16.
Nan Fang Yi Ke Da Xue Xue Bao ; 41(11): 1686-1691, 2021 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-34916195

RESUMO

OBJECTIVE: To investigate the effect of transforming growth factor (TGF-ß) inhibition on functional recovery of spinal cord injury in mice. METHODS: Twelve mice were divided into treatment group, control group and sham-operated group (n=4). The mice in the treatment group were subjected to hemisection of the spinal cord and received intraperitoneal injection of TGF-ß neutralizing antibody (1D11) 3 times a week (25 µL each time), and those in control group were injected with the vehicle antibody (13C4) following spinal cord hemisection. The sham-operated mice underwent sham operation to expose the spinal cord without hemisection. Four weeks later, the heart of the mice was perfused and 1-2 cm of the spinal cord spanning the injury site was harvested. Immunofluorescence staining of FSP1, fibronectin, and PGP9.5 was performed to assess fibroblast recruitment in the injury area, fibronectin deposition, and neurological recovery. For further verification of the results, we used a mouse model of spinal cord clamp injury to observe the survival of axons and distribution of astrocytes by detecting expressions of 5-HT and GFAP with immunofluorescence assay. RESULTS: In the hemisection injury model, fibroblasts recruitment and fibronectin deposition in the injured area was significantly reduced and the neurological function was improved in 1D11 treatment group as compared with those in 13C4-treated group (P < 0.05). In the spinal cord clamp injury model, treatment with 1D11, as compared with the 13C4, resulted in significantly increased number of 5-HT-positive axons with extended axonal length and obviously increased the number of GFAP-positive astrocytes in the injured area (P < 0.05). CONCLUSION: Inhibiting TGF-ß after spinal cord injury can reduce the recruitment of fibroblasts and fibronectin deposition to promote recovery of neurological function and repair of the injured spinal cord in mice.


Assuntos
Fibronectinas , Traumatismos da Medula Espinal , Fator de Crescimento Transformador beta/antagonistas & inibidores , Animais , Anticorpos Neutralizantes , Camundongos , Traumatismos da Medula Espinal/tratamento farmacológico
17.
J Healthc Eng ; 2021: 4496416, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34900189

RESUMO

Spinal cord injury patients are prone to develop deep tissue injury (DTI) as they may spend half their time per day in sitting postures, which produce excessive load in their buttocks. However, the impact of fat thickness on the biomechanical response of buttock in sitting posture remained unclear. This study aimed to investigate the influence of subcutaneous fat thickness on the interface pressure and load distribution of buttock of seated humans. To achieve this goal, a 3-dimensional finite element model of male buttock was constructed and the contact pressure on a rigid cushion was evaluated against experimental results. The modified models, which had various fat thicknesses under ischial tuberosity, were built and used to simulate the sitting conditions with different cushion stiffnesses. In the models simulating sitting on the rigid cushion, the peak contact pressure ranges from 0.052 MPa to 0.149 MPa. In the simulation of sitting on the soft cushion, the peak stress of muscle underneath ischial tuberosity in the model with the thickest fat tissue was slightly higher than that of the other models. The results demonstrate that the fat tissue in the buttock could reduce the contact pressure when sitting on the rigid seat. However, contact pressure solely could not be used to estimate the internal tissue stress of seated buttock, especially in subjects with thicker fat tissue.


Assuntos
Postura , Traumatismos da Medula Espinal , Tecido Adiposo , Nádegas , Humanos , Masculino , Gordura Subcutânea
18.
Cells ; 10(12)2021 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-34943841

RESUMO

Ependymal cells reside in the adult spinal cord and display stem cell properties in vitro. They proliferate after spinal cord injury and produce neurons in lower vertebrates but predominantly astrocytes in mammals. The mechanisms underlying this glial-biased differentiation remain ill-defined. We addressed this issue by generating a molecular resource through RNA profiling of ependymal cells before and after injury. We found that these cells activate STAT3 and ERK/MAPK signaling post injury and downregulate cilia-associated genes and FOXJ1, a central transcription factor in ciliogenesis. Conversely, they upregulate 510 genes, seven of them more than 20-fold, namely Crym, Ecm1, Ifi202b, Nupr1, Rbp1, Thbs2 and Osmr-the receptor for oncostatin, a microglia-specific cytokine which too is strongly upregulated after injury. We studied the regulation and role of Osmr using neurospheres derived from the adult spinal cord. We found that oncostatin induced strong Osmr and p-STAT3 expression in these cells which is associated with reduction of proliferation and promotion of astrocytic versus oligodendrocytic differentiation. Microglial cells are apposed to ependymal cells in vivo and co-culture experiments showed that these cells upregulate Osmr in neurosphere cultures. Collectively, these results support the notion that microglial cells and Osmr/Oncostatin pathway may regulate the astrocytic fate of ependymal cells in spinal cord injury.


Assuntos
Linhagem da Célula , Epêndima/metabolismo , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Oncostatina M/metabolismo , RNA/genética , Traumatismos da Medula Espinal/genética , Células-Tronco/patologia , Animais , Diferenciação Celular/genética , Proliferação de Células/genética , Cílios/genética , Regulação para Baixo/genética , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Microglia/metabolismo , Subunidade beta de Receptor de Oncostatina M , RNA/metabolismo , Esferoides Celulares/metabolismo , Medula Espinal/patologia , Regulação para Cima/genética
19.
Cells ; 10(12)2021 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-34943842

RESUMO

Spinal cord injury (SCI) is a devastating condition of the central nervous system that strongly reduces the patient's quality of life and has large financial costs for the healthcare system. Cell therapy has shown considerable therapeutic potential for SCI treatment in different animal models. Although many different cell types have been investigated with the goal of promoting repair and recovery from injury, stem cells appear to be the most promising. Here, we review the experimental approaches that have been carried out with pluripotent stem cells, a cell type that, due to its inherent plasticity, self-renewal, and differentiation potential, represents an attractive source for the development of new cell therapies for SCI. We will focus on several key observations that illustrate the potential of cell therapy for SCI, and we will attempt to draw some conclusions from the studies performed to date.


Assuntos
Células-Tronco Pluripotentes/transplante , Traumatismos da Medula Espinal/terapia , Regeneração da Medula Espinal , Animais , Ensaios Clínicos como Assunto , Células-Tronco Embrionárias/transplante , Humanos , Células-Tronco Pluripotentes Induzidas/transplante
20.
Sensors (Basel) ; 21(22)2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34833666

RESUMO

Recumbent stationary cycling is a potential exercise modality for individuals with cerebral palsy (CP) that lack the postural control needed for upright exercises. Functional electrical stimulation (FES) of lower extremity muscles can help such individuals reach the cycling intensities that are required for aerobic benefits. The aim of this study was to examine the effect of cycling with and without FES assistance to that of a no-intervention control group on the cardiorespiratory fitness of children with CP. Thirty-nine participants were randomized to a FES group that underwent an 8-week FES-assisted cycling program, the volitional group (VOL), who cycled without FES, or a no-intervention control group (CON) (15 FES, 11 VOL, 13 CON). Cadence, peak VO2, and net rise in heart rate were assessed at baseline, end of training, and washout (8-weeks after cessation of training). Latent growth curve modeling was used for analysis. The FES group showed significantly higher cycling cadences than the VOL and CON groups at POST and WO. There were no differences in improvements in the peak VO2 and peak net HR between groups. FES-assisted cycling may help children with CP attain higher cycling cadences and to retain these gains after training cessation. Higher training intensities may be necessary to obtain improvements in peak VO2 and heart rate.


Assuntos
Paralisia Cerebral , Terapia por Estimulação Elétrica , Traumatismos da Medula Espinal , Criança , Estimulação Elétrica , Exercício Físico , Terapia por Exercício , Humanos
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