The Experts below are selected from a list of 15 Experts worldwide ranked by ideXlab platform

J. M. Taracena Lafuente - One of the best experts on this subject based on the ideXlab platform.

  • Detrusor-sphincter Dyssynergia.
    International journal of clinical practice. Supplement, 2006
    Co-Authors: D. Castro-diaz, J. M. Taracena Lafuente
    Abstract:

    Detrusor sphincter Dyssynergia is defined as the lack of external sphincter relaxation during voluntary voiding. This should not be confused with the term “Detrusor Dyssynergia” which has been applied to the unstable bladder. Detrusor sphincter Dyssynergia frequently results in an incomplete voiding effort with elevated residual urine volumes. This condition commonly accompanies Detrusor hyperreflexia and may occur in some patients without neurologic disease as a habituation to using a “guarding” reflex to prevent urinary leakage with Detrusor instability. The first defense against urine loss is the voluntary contraction of the external striated sphincter of the urethra when an unstable bladder contraction occurs. The end result is evidenced by the trabeculation found in the bladder on cystoscopic examination, the increased EMG activity of the pelvic floor during attempted voiding, and the seemingly paradoxial increased residual urine columes resulting from this involuntary obstruction to urine flow.

  • Detrusor-sphincter Dyssynergia.
    International journal of clinical practice. Supplement, 2006
    Co-Authors: D. Castro-diaz, J. M. Taracena Lafuente
    Abstract:

    Detrusor sphincter Dyssynergia is defined as the lack of external sphincter relaxation during voluntary voiding. This should not be confused with the term “Detrusor Dyssynergia” which has been applied to the unstable bladder. Detrusor sphincter Dyssynergia frequently results in an incomplete voiding effort with elevated residual urine volumes. This condition commonly accompanies Detrusor hyperreflexia and may occur in some patients without neurologic disease as a habituation to using a “guarding” reflex to prevent urinary leakage with Detrusor instability. The first defense against urine loss is the voluntary contraction of the external striated sphincter of the urethra when an unstable bladder contraction occurs. The end result is evidenced by the trabeculation found in the bladder on cystoscopic examination, the increased EMG activity of the pelvic floor during attempted voiding, and the seemingly paradoxial increased residual urine columes resulting from this involuntary obstruction to urine flow.

D. Castro-diaz - One of the best experts on this subject based on the ideXlab platform.

  • Detrusor-sphincter Dyssynergia.
    International journal of clinical practice. Supplement, 2006
    Co-Authors: D. Castro-diaz, J. M. Taracena Lafuente
    Abstract:

    Detrusor sphincter Dyssynergia is defined as the lack of external sphincter relaxation during voluntary voiding. This should not be confused with the term “Detrusor Dyssynergia” which has been applied to the unstable bladder. Detrusor sphincter Dyssynergia frequently results in an incomplete voiding effort with elevated residual urine volumes. This condition commonly accompanies Detrusor hyperreflexia and may occur in some patients without neurologic disease as a habituation to using a “guarding” reflex to prevent urinary leakage with Detrusor instability. The first defense against urine loss is the voluntary contraction of the external striated sphincter of the urethra when an unstable bladder contraction occurs. The end result is evidenced by the trabeculation found in the bladder on cystoscopic examination, the increased EMG activity of the pelvic floor during attempted voiding, and the seemingly paradoxial increased residual urine columes resulting from this involuntary obstruction to urine flow.

  • Detrusor-sphincter Dyssynergia.
    International journal of clinical practice. Supplement, 2006
    Co-Authors: D. Castro-diaz, J. M. Taracena Lafuente
    Abstract:

    Detrusor sphincter Dyssynergia is defined as the lack of external sphincter relaxation during voluntary voiding. This should not be confused with the term “Detrusor Dyssynergia” which has been applied to the unstable bladder. Detrusor sphincter Dyssynergia frequently results in an incomplete voiding effort with elevated residual urine volumes. This condition commonly accompanies Detrusor hyperreflexia and may occur in some patients without neurologic disease as a habituation to using a “guarding” reflex to prevent urinary leakage with Detrusor instability. The first defense against urine loss is the voluntary contraction of the external striated sphincter of the urethra when an unstable bladder contraction occurs. The end result is evidenced by the trabeculation found in the bladder on cystoscopic examination, the increased EMG activity of the pelvic floor during attempted voiding, and the seemingly paradoxial increased residual urine columes resulting from this involuntary obstruction to urine flow.

S D Silberstein - One of the best experts on this subject based on the ideXlab platform.

  • Assessment: Botulinum neurotoxin in the treatment of autonomic disorders and pain (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.
    Neurology, 2008
    Co-Authors: M Naumann, C E Argoff, M K Childers, D D Dykstra, G S Gronseth, B Jabbari, H C Kaufmann, B Schurch, S D Silberstein
    Abstract:

    To perform an evidence-based review of the safety and efficacy of botulinum neurotoxin (BoNT) in the treatment of autonomic and urologic disorders and low back and head pain. A literature search was performed including MEDLINE and Current Contents for therapeutic articles relevant to BoNT and the selected indications. Authors reviewed, abstracted, and classified articles based on the quality of the study (Class I-IV). Conclusions and recommendations were developed based on the highest level of evidence and put into current clinical context. The highest quality literature available for the respective indications was as follows: axillary hyperhidrosis (two Class I studies); palmar hyperhidrosis (two Class II studies); drooling (four Class II studies); gustatory sweating (five Class III studies); neurogenic Detrusor overactivity (two Class I studies); sphincter Detrusor Dyssynergia in spinal cord injury (two Class II studies); chronic low back pain (one Class II study); episodic migraine (two Class I and two Class II studies); chronic daily headache (four Class II studies); and chronic tension-type headache (two Class I studies). Botulinum neurotoxin (BoNT) should be offered as a treatment option for the treatment of axillary hyperhidrosis and Detrusor overactivity (Level A), should be considered for palmar hyperhidrosis, drooling, and Detrusor sphincter Dyssynergia after spinal cord injury (Level B), and may be considered for gustatory sweating and low back pain (Level C). BoNT is probably ineffective in episodic migraine and chronic tension-type headache (Level B). There is presently no consistent or strong evidence to permit drawing conclusions on the efficacy of BoNT in chronic daily headache (mainly transformed migraine) (Level U). While clinicians' practice may suggest stronger recommendations in some of these indications, evidence-based conclusions are limited by the availability of data.

M Naumann - One of the best experts on this subject based on the ideXlab platform.

  • Assessment: Botulinum neurotoxin in the treatment of autonomic disorders and pain (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.
    Neurology, 2008
    Co-Authors: M Naumann, C E Argoff, M K Childers, D D Dykstra, G S Gronseth, B Jabbari, H C Kaufmann, B Schurch, S D Silberstein
    Abstract:

    To perform an evidence-based review of the safety and efficacy of botulinum neurotoxin (BoNT) in the treatment of autonomic and urologic disorders and low back and head pain. A literature search was performed including MEDLINE and Current Contents for therapeutic articles relevant to BoNT and the selected indications. Authors reviewed, abstracted, and classified articles based on the quality of the study (Class I-IV). Conclusions and recommendations were developed based on the highest level of evidence and put into current clinical context. The highest quality literature available for the respective indications was as follows: axillary hyperhidrosis (two Class I studies); palmar hyperhidrosis (two Class II studies); drooling (four Class II studies); gustatory sweating (five Class III studies); neurogenic Detrusor overactivity (two Class I studies); sphincter Detrusor Dyssynergia in spinal cord injury (two Class II studies); chronic low back pain (one Class II study); episodic migraine (two Class I and two Class II studies); chronic daily headache (four Class II studies); and chronic tension-type headache (two Class I studies). Botulinum neurotoxin (BoNT) should be offered as a treatment option for the treatment of axillary hyperhidrosis and Detrusor overactivity (Level A), should be considered for palmar hyperhidrosis, drooling, and Detrusor sphincter Dyssynergia after spinal cord injury (Level B), and may be considered for gustatory sweating and low back pain (Level C). BoNT is probably ineffective in episodic migraine and chronic tension-type headache (Level B). There is presently no consistent or strong evidence to permit drawing conclusions on the efficacy of BoNT in chronic daily headache (mainly transformed migraine) (Level U). While clinicians' practice may suggest stronger recommendations in some of these indications, evidence-based conclusions are limited by the availability of data.

Margaret A. Vizzard - One of the best experts on this subject based on the ideXlab platform.

  • Neuroplasticity of PACAP Expression and Function in Micturition Reflex Pathways
    Current Topics in Neurotoxicity, 2016
    Co-Authors: Eric J. Gonzalez, Beatrice Girard, Karen M. Braas, Victor May, Margaret A. Vizzard
    Abstract:

    Micturition, the storage and periodic elimination of urine, requires a complex neural control system that coordinates the activities of the smooth muscle of the urinary bladder and urethra and the smooth and striated muscle of the urethral sphincters. The lower urinary tract (LUT) reflex mechanisms, organized at the level of the lumbosacral spinal cord, are modulated predominantly by supraspinal controls. Complex neural organization is necessary for the coordination of the reciprocal functions of the urinary bladder, urethra, and urethral sphincters to result in normal micturition function. Injury or diseases of the nervous system, as well as disorders of the peripheral organs, can produce LUT dysfunction. Numerous neuropeptide/receptor systems are expressed in central and peripheral nervous system pathways that regulate the LUT and expression can also be found in both neural and non-neural (e.g., urothelium) components. Pituitary adenylate cyclase-activating polypeptide (PACAP; Adcyap1) and its cognate receptor, PAC1 (Adcyap1r1), have tissue-specific distributions in diverse systems including the LUT. PACAP and associated receptors exhibit neurophenotypic changes with neural injury, inflammation, stress, and disease of the LUT. Changes in the balance of the PACAP/receptor system in central and peripheral bladder reflex pathways may underlie and/or contribute to LUT dysfunction including urinary urgency, increased voiding frequency, nocturia, urinary incontinence, Detrusor Dyssynergia, and/or pain. The PACAP/receptor system in LUT pathways may thus represent a potential target for therapeutic intervention.