The Experts below are selected from a list of 171 Experts worldwide ranked by ideXlab platform
M Barat - One of the best experts on this subject based on the ideXlab platform.
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botulinum a toxin and detrusor sphincter dyssynergia a double blind lidocaine controlled study in 13 patients with Spinal Cord Disease
European Urology, 2002Co-Authors: Marianne De Seze, H Petit, P A Joseph, P Gallien, Mathieupanchoa De Seze, Jeanmichel Mazaux, M BaratAbstract:Abstract Objective: To compare the efficacy and tolerance of botulinum A toxin (BTx) versus lidocaine (L), applied in the external urethral sphincter with a single transperineal injection in order to treat detrusor sphincter dyssynergia (DSD) in Spinal Cord injured patients. Methods: Thirteen patients (1F, 12M) suffering from chronic urinary retention due to DSD were randomised to receive one transperineal injection of 100IU BTx Botox° in 4ml of 9% saline (botulinum group, (BG)) or 4ml of 0.5% L (lidocaine group, (LG)). The main criteria of efficacy was post-voiding residual urine volume (PRUV), assessed three times daily on day one (D1), D7 and D30 after each injection. Other criteria were micturition diary, satisfaction score (SS), maximal urethral pressure (MUP), maximum detrusor pressure (DP) and type of DSD, reCorded on D0 and D30. Results: In the BG, there was a significant decrease in PRUV (D7: −141.4ml ( p p 2 O, p p Conclusions : The preliminary results of this initial randomised double-blind study clearly demonstrated the superiority of BTx compared to L in improving clinical symptoms and urethral hypertonia associated with DSD in Spinal Cord injured patients.
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botulinum a toxin treatment for detrusor sphincter dyssynergia in Spinal Cord Disease
Spinal Cord, 1998Co-Authors: H Petit, L Wiart, E Gaujard, Le F Breton, J M Ferriere, A Lagueny, P A Joseph, M BaratAbstract:We studied the efficacy of endoscopic injection of Botulinum A toxin (150 I.U. Dysport®) in the treatment of detrusor-sphincter dyssynergia in 17 patients with Spinal Cord Disease. One month after the injection, the postvoiding residual urine volume (−176 ml, P<0.001), the bladder pressure on voiding (−19 cm water, P<0.01), and the urethral pressure (−24 cm water, P<0.001) were significantly decreased. The modality of voiding was improved in 10 patients (ie micturition by suprapubic tapping was easier to induce, discontinuation of indwelling catheter use, or decrease in frequency of intermittent catheterizations). The tolerance of the treatment was excellent. The therapeutic effect lasted 2 to 3 months on the average. The low doses used in this study probably explain in part why the treatment sometimes failed. Botulinum A toxin could become an alternative treatment for detrusor-sphincter dyssynergia in certain patients, notably in those who are refractory to sphincterotomy or in patients, such as those who are tetraplegic, and who are incapable of performing intermittent self-catheterization.
Jennifer Thomas - One of the best experts on this subject based on the ideXlab platform.
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depression and pain among inpatients with Spinal Cord injury and Spinal Cord Disease differences in symptoms and neurological function
Disability and Rehabilitation, 2013Co-Authors: Denise G Tate, Martin Forchheimer, Dunia Karanazebari, Anthony Chiodo, Jennifer ThomasAbstract:Purpose: To examine the relationship between depression and pain severity during inpatient rehabilitation for those with new onset of Spinal Cord injury or Spinal Cord Disease (SCI/D), along with patient characteristics, neurological function and etiology. Method: This cross-sectional study reviewed medical reCords of 100 adults with SCI/D including their admission scores on the Patient Health Questionnaire 9 (PHQ-9), a measure of depression, and pain ratings collected at admission and discharge. Results: Upon admission, 28% reported moderate-to-severe symptoms of depression and 69% reported pain. PHQ-9 scores were associated with pain only among those with the least severe impairments, for whom higher scores were associated with greater pain. While depression levels did not differ by etiology, those with traumatic injuries had higher pain ratings. Conclusions: In general, depressive symptoms were not associated with pain severity in this sample. Etiology was associated with pain, those with traumatic SCI...
Gordon T. Plant - One of the best experts on this subject based on the ideXlab platform.
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douglas argyll robertson 1837 1909 what did he do other than describe the argyll robertson pupil
Acta Ophthalmologica, 2008Co-Authors: Andrzej Grzybowski, Gordon T. PlantAbstract:Purpose To study medical achievements of Douglas Argyll Robertson in ophthalmology. Methods The data dealt with in this paper is analysed both from the historical and present-day perspectives. Results Douglas Argyll Robertson (1837-1909) was the first surgeon in Scotland to practice entirely in the field of ophthalmology. In this he was no doubt encouraged by the memory of his father, John Argyll Robertson, who was one of the founders of the Edinburgh Eye Dipensary but who had died when his son was only 18 years of age. Douglas completed his medical education under von Arlt in Prague and Albrecht von Graefe in Berlin. Argyll Robertson made major contributions to ophthalmic surgery. He introduced extracts of Calabar bean (Physostigma venenosum), in the treatment of glaucoma. He also described in cases of Spinal Cord Disease that there may be loss of the light reflex of the pupil but retention of its movement in accommodation. This condition was named the "Argyll Robertson pupil" and as a clinical sign is almost always indicative of neurosyphilis. His other contributions include: lupus of the eyelid, aetiology of glaucoma, melanotic tumor, diphtheritic ophthalmia, sympathetic ophthalmia, retinitis pigmentosa, hypertrophy of the lacrimal gland, senile entropion, hydrophthalmos, asteroid hyalitis, pulsating exophthalmos, conjunctival filiariasis, albuminuric retinitis, miner’s nystagmus and microphthalmos. Argyll Robertson is also credited with being the first to recommend trephining the sclera in those cases of glaucoma where extensive degenerative changes in the iris made an iridectomy impracticable. Conclusion As we approach the centenary of his death Argyll Robertson deserves to be celebrated for more than his pupil.
Clare J Fowle - One of the best experts on this subject based on the ideXlab platform.
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the ultrastructure of bladder lamina propria nerves in healthy subjects and patients with detrusor hyperreflexia
The Journal of Urology, 2002Co-Authors: Olive Wisema, Clare J Fowle, Ciara M Ady, Iqbal F Hussai, Proka Dasgupta, David N LandoAbstract:ABSTRACTPurpose: Detrusor hyperreflexia is a common finding in patients with neurological Disease involving the Spinal Cord. In animal models it has been attributed to an emergent reflex mediated mostly by unmyelinated C-fibers. We describe and measure ultrastructural features of these nerves in the lamina propria in healthy subjects and patients with detrusor hyperreflexia.Materials and Methods: Flexible cystoscopic bladder biopsies were obtained from 51 patients (8 controls, 8 with tropical spastic paraparesis, 23 with multiple sclerosis and 12 with Spinal Cord Disease). Electron micrographs were obtained of every nerve profile seen in the midpoint of the biopsy specimen, and in each nerve profile a number of variables were measured and reCorded.Results: The mean nerve profile diameter was greater in patients with tropical spastic paraparesis (mean 2.19 μm.) compared to controls (1.59 μm.) and patients with multiple sclerosis (1.55 μm.) (p <0.001). We observed a sparse urothelial innervation by naked ax...
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simultaneous arterial and urinary bladder pressure reCordings in multiple system atrophy and in Spinal disorders with detrusor hyperreflexia
Clinical Autonomic Research, 1997Co-Authors: T Peterso, C J Mathias, M Alam, V Chandiramani, Clare J FowleAbstract:Simultaneous arterial and urinary bladder pressure measurements were reCorded during bladder filling in 21 patients with urinary bladder symptoms; seven patients had autonomic failure due to multiple system atrophy (MSA), seven had Spinal Cord Disease of different aetiology with detrusor hyperreflexia (DH) and seven had no neurological abnormalities. A significant increase in average systolic blood pressure (BP) was reCorded on bladder filling in the neurologically intact patients (from 110 to 137 mmHg) and in the patients with Spinal Cord Disease and DH (from 109 to 129 mmHg). In those with MSA, the BP rose in four and fell in three patients. The vesicopressor response during cold receptor-mediated DH was not significantly higher when compared with room-temperature saline and when compared with the BP response during bladder filling in the neurologically intact patients. Finally, intravesical lignocaine retained in the bladder for 15 min did not influence the BP response to cold receptor stimulation in patients with Spinal Cord Disease and DH. These findings and their pathophysiological and clinical implications are discussed.
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intravesical capsaicin for treatment of detrusor hyperreflexia
Journal of Neurology Neurosurgery and Psychiatry, 1994Co-Authors: S Gerrard, R O Eck, C D Etts, Clare J FowleAbstract:An intravesical instillation of 100 ml 1 or 2 mmol/l capsaicin has been used to treat detrusor hyperreflexia giving rise to intractable urinary incontinence in 12 patients with Spinal Cord Disease and two other patients with detrusor overactivity of non-Spinal origin. Nine patients, all of whom had Spinal Cord Disease, showed some improvement in bladder function. The benefit was only shortlived and partial in four, but the remaining five achieved complete continence while performing intermittent self catheterisation. Urodynamic studies in these nine patients showed an increase in mean (SD) bladder capacity from 106 (57) to 302 (212) ml and a fall in the maximum detrusor pressure from 54 (20) to 36 (10) cm of water. There were no short term ill effects from the instillation and the improvement in bladder function lasted for between three weeks to six months, when in some patients it was repeated. The improvement in bladder behaviour shown in this study can be interpreted as showing that capsaicin sensitive afferents play an important part in the pathogenesis of detrusor hyperreflexia in Spinal humans. Intravesical capsaicin seems a promising means of treating intractable detrusor hyperreflexia and studies with this substance may shed new light on other disorders of detrusor activity that cause incontinence.
Denise G Tate - One of the best experts on this subject based on the ideXlab platform.
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depression and pain among inpatients with Spinal Cord injury and Spinal Cord Disease differences in symptoms and neurological function
Disability and Rehabilitation, 2013Co-Authors: Denise G Tate, Martin Forchheimer, Dunia Karanazebari, Anthony Chiodo, Jennifer ThomasAbstract:Purpose: To examine the relationship between depression and pain severity during inpatient rehabilitation for those with new onset of Spinal Cord injury or Spinal Cord Disease (SCI/D), along with patient characteristics, neurological function and etiology. Method: This cross-sectional study reviewed medical reCords of 100 adults with SCI/D including their admission scores on the Patient Health Questionnaire 9 (PHQ-9), a measure of depression, and pain ratings collected at admission and discharge. Results: Upon admission, 28% reported moderate-to-severe symptoms of depression and 69% reported pain. PHQ-9 scores were associated with pain only among those with the least severe impairments, for whom higher scores were associated with greater pain. While depression levels did not differ by etiology, those with traumatic injuries had higher pain ratings. Conclusions: In general, depressive symptoms were not associated with pain severity in this sample. Etiology was associated with pain, those with traumatic SCI...