Spinal cord injury (SCI) is a devastating and common neurologic disorder that has profound influences on modern society from physical, psychosocial, and socioeconomic perspectives. Accordingly, the ...present decade has been labeled the Decade of the Spine to emphasize the importance of SCI and other spinal disorders. Spinal cord injury may be divided into both primary and secondary mechanisms of injury. The primary injury, in large part, determines a given patient's neurologic grade on admission and thereby is the strongest prognostic indicator. However, secondary mechanisms of injury can exacerbate damage and limit restorative processes, and hence, contribute to overall morbidity and mortality. A burgeoning body of evidence has facilitated our understanding of these secondary mechanisms of injury that are amenable to pharmacological interventions, unlike the primary injury itself. Secondary mechanisms of injury encompass an array of perturbances and include neurogenic shock, vascular insults such as hemorrhage and ischemia-reperfusion, excitotoxicity, calcium-mediated secondary injury and fluid-electrolyte disturbances, immunologic injury, apoptosis, disturbances in mitochondrion function, and other miscellaneous processes. Comprehension of secondary mechanisms of injury serves as a basis for the development and application of targeted pharmacological strategies to confer neuroprotection and restoration while mitigating ongoing neural injury. The first article in this series will comprehensively review the pathophysiology of SCI while emphasizing those mechanisms for which pharmacologic therapy has been developed, and the second article reviews the pharmacologic interventions for SCI.
Key Clinical Message
Promising outcomes are shown in this case report using the Regentime procedure and autologous stem cells to treat spinal cord injury. The observed “First Show Phenomenon” ...provides valuable insights into the therapy's potential for spinal cord injury.
This case report demonstrates “the first show phenomenon” following Regentime stem cell therapy applied to a spinal cord injury patient. A 40‐year‐old gentleman sustained a ballistic injury at the level of T9, resulting in complete bilateral motor and sensory loss from T9 and below. He was treated with autologous bone marrow‐derived mononuclear stem cells injected into his spinal canal 2.5 years after his injury. Follow‐up during the first‐week posttransplantation showed early symptom improvement termed “the first show phenomenon.” He regained sensation to light touch in his lower limbs by the end of week 1 and reported no serious implications or complications.
Key Clinical Message
This report highlights the successful treatment of a Charcot–Marie–Tooth disease case using the Regentime stem cell procedure, suggesting its potential as a promising therapeutic ...approach for patients suffering from this challenging condition.
A thorough characterization of a glauconite sample collected from a core drilled on the southeast edge of the Abu Tartur Plateau in the Western Desert of Egypt was carried out. The sample, which ...represents the upper part of the Campanian Duwi Formation, was examined using a petrographic polarizing microscope as well as X-ray diffraction and X-ray fluorescence methods. The magnetic behavior of the different size fractions was tested using a Frantz isodynamic separator prior to the beneficiation process. This process was conducted by both magnetic separation, using an Eriez rare earth roll magnetic separator, and heavy liquid gravity methods during the search for a higher grade of K
2
O. A correlation between the mineral composition and magnetic behavior of the particles was shown. Two potassium oxide concentrates were obtained, having 6.8 and 6.22% K
2
O, from an original sample containing 4.41% K
2
O by weight. A blend of both products yielded a product having 6.42% K
2
O with an overall recovery of 41.5%, which may satisfy the requirement of a natural fertilizer. The association of this product with phosphate and pyrite will help to remediate alkaline soils. In addition, a sulfur-rich coproduct containing 11.32% S with a recovery of 31.6% was obtained.
Elevated blood levels of low-density lipoprotein cholesterol are a major cardiovascular risk factor, and cholesterol-lowering drugs are among the most prescribed drugs worldwide. Cancer is the second ...leading cause of death after cardiovascular diseases. The relationship between cancer development and statins intake is controversial, and there are no clear studies in Lebanon and the Middle East concerning this topic. Hence, our study aimed to search for any possible association of statin intake as well as other medications (proton pump inhibitors PPI, metformin, Aspirin, Angiotensin-Converting Enzyme inhibitors, and fenofibrate) with lung, colorectal cancer (CRC), and bladder cancer development in the Lebanese population. A retrospective study was performed on 709 subjects divided into 2 main groups: control (no cancer ± statin intake), and cases (either lung, or colorectal, or bladder cancer ± statin intake). Collected data included the age and gender of the patient, socioeconomic status, presence of cardiovascular disease and comorbidities, cancer risk factors, and the intake type, dose, and duration of statins. Bivariate, multivariate, and binary logistic analyses were enrolled. Out of 709 participants, 63.2% were males and 75% were cancer-positive (24.1%: lung cancer, 26.7%: CRC, 24.1%: bladder cancer). The overall intake of statins was not shown to significantly affect cancer development. However, a duration-response relationship was established between Simvastatin and lung cancer (odds ratio OR=1.208) as well as bladder cancer (OR=1.189). No significant association was found between each statin and CRC. Although PPIs intake was associated with a possibly harmful effect on lung cancer development (OR=3.42), it revealed a protective association with CRC development (OR=0.38). Other risk factors such as smoking and age were strongly associated (harmful) with lung and bladder cancer development. Physical inactivity and a family history of CRC were each associated with a harmful effect on CRC development. A harmful association with the development of lung and bladder cancer was found with the increasing duration of intake of Simvastatin. Other drugs such as PPIs and specific risk factors were also associated negatively or positively with the development of these 3 cancers. These findings should be validated by further investigations to guide clinicians on optimal treatment options for their patients.
Cardiovascular diseases (CVD) are the leading cause of death globally, followed by cancer. Angiotensin II contributes greatly to CVD pathogenesis, and Angiotensin II receptor blockers (ARBs) ...constitute a mainstay in hypertension and CVD management. However, the relationship between ARBs and cancer initiation is controversial, with no clear data in Lebanon. Therefore, our study aimed to determine the association between ARBs intake and lung, bladder, and colorectal cancers development in the Lebanese population. A retrospective study was conducted on 709 subjects divided into 2 main groups: Control (subjects without cancer; n = 177), and Cases (patients with cancer (n = 532): lung, bladder, or colorectal), taking ARBs (n = 236, (n = 121 in control and n = 115 in cases)) or not (n = 473). Collected information included the patients demographics, comorbidities, cancer’s risk factors, and ARBs dose and duration intake. Bivariate, multivariate, and binary logistic analyses were enrolled. ARBs use was significantly protective (
P
value = 0.000) against overall cancer development (odds ratio OR = 0.127) and against each, lung (OR < 1), bladder (OR < 1), and colorectal cancers (OR < 1). A duration-response relationship was established. This protective effect and the time-dependent relationship remained unchanged after omitting the most relevant risk factors. In summary, a significant overall protective effect of ARBs against lung, bladder and colorectal cancers was found. This beneficial response was time-dependent. These results can guide patients on treatment options and clinicians for informed decision-making.
Spinal cord injury (SCI) remains a common and devastating problem of modern society. Through an understanding of underlying pathophysiologic mechanisms involved in the evolution of SCI, treatments ...aimed at ameliorating neural damage may be developed. The possible pharmacologic treatments for acute spinal cord injury are herein reviewed. Myriad treatment modalities, including corticosteroids, 21-aminosteroids, opioid receptor antagonists, gangliosides, thyrotropin-releasing hormone (TRH) and TRH analogs, antioxidants and free radical scavengers, calcium channel blockers, magnesium replacement therapy, sodium channel blockers, N -methyl-D-aspartate receptor antagonists, alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid-kainate receptor antagonists, modulators of arachadonic acid metabolism, neurotrophic growth factors, serotonin antagonists, antibodies against inhibitors of axonal regeneration, potassium channel blockers (4-aminopyridine), paclitaxel, clenbuterol, progesterone, gabexate mesylate, activated protein C, caspase inhibitors, tacrolimus, antibodies against adhesion molecules, and other immunomodulatory therapy have been studied to date. Although most of these agents have shown promise, only one agent, methylprednisolone, has been shown to provide benefit in large clinical trials. Given these data, many individuals consider methylprednisolone to be the standard of care for the treatment of acute SCI. However, this has not been established definitively, and questions pertaining to methodology have emerged regarding the National Acute Spinal Cord Injury Study trials that provided these conclusions. Additionally, the clinical significance (in contrast to statistical significance) of recovery after methylprednisolone treatment is unclear and must be considered in light of the potential adverse effects of such treatment. This first decade of the new millennium, now touted as the Decade of the Spine, will hopefully witness the emergence of universal and efficacious pharmacologic therapy and ultimately a cure for SCI.
Temporomandibular joint (TMJ) disease is a type of degenerative musculoskeletal disorder that leads to morphological and functional abnormalities. It has a poorly understood progression with numerous ...independent and interrelated factors, which makes it difficult for the available treatment options to meet long-term demands. We present the case of a 37-year-old woman who suffered from excruciating pain in the right temporomandibular joint, associated with limited mandibular movement. She was found to have imaging features of TMJ disorder. She underwent the Regentime procedure which uses autologous bone marrow-derived stem cells that are partially differentiated and redirected to the targeted tissue. Clinical follow-up showed total clinical recovery.
The authors' technique for the treatment of sagittal synostosis, which involves total cranial vault reconstruction and is termed the Pi procedure, is a safe, effective method for correcting the ...deformities associated with sagittal synostosis. It provides an immediate correction that does not require any further manipulations to the skull, such as a molding helmet. The technique addresses all the aspects of the deformity. It increases the width as well as the central height of the skull and decreases the length of the skull to produce a rounder cranial vault.
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