Restoration of walking in patients with incomplete spinal cord injuries by use of surface electrical stimulation--preliminary results

A group of patients who are good candidates for the application of Functional Electrical Stimulation (FES) to restore reciprocal walking is described. They have incomplete lesions of the spinal cord. Because of the degree of preserved voluntary control, proprioception and sensation some of these patients can achieve crutch assisted walking by means of multichannel electrical stimulation. In a number of cases the patient has sufficient strength and voluntary control in the upper limbs and at least one leg to provide safe standing for short periods in forearm crutches. For these patients a two channel stimulator controlled by a handswitch was applied to achieve safe and practical crutch assisted walking in a relatively short period of time.     

Effects of neonatal handling on central noradrenergic and nitric oxidergic systems and reproductive parameters in female rats

Early-life environmental events that disrupt the mother-pup relationship may induce profound long-lasting changes on several behavioral and neuroendocrine systems. The neonatal handling procedure, which involves repeated brief maternal separations followed by experimental manipulations, reduces sexual behavior and induces anovulatory estrous cycles in female rats. On the afternoon of proestrus, neonatally handled females show a reduced surge of luteinizing hormone (LH) and an increased content of gonadotropin-releasing hormone in the medial preoptic area (MPOA). In order to detect the possible causes for the reduced ovulation and sexual behavior, the present study aimed to analyze the effects of neonatal handling on noradrenaline (NA) and nitric oxide (NO) levels in the MPOA on the afternoon of proestrus. Neonatal handling reduced MHPG (NA metabolite) levels and MHPG/NA ratio in the MPOA, indicating decreased NAergic activity. Additionally, neonatal handling decreased NO levels, as measured by the metabolites (NO(x)), nitrite and nitrate in the same period. We may conclude that the neonatal handling procedure decreased activity of the NAergic and NOergic systems in the MPOA during proestrus, which is involved in the control of LH and FSH secretion, and this may possibly explain the anovulatory estrous cycles and reduced sexual behavior of the neonatally handled female rats.     

Acrocomia aculeata oil: Beneficial effects on cyclophosphamide‐induced reproductive toxicity in male rats

This study aimed to evaluate the effects of the extracted oil of Acrocomia aculeata pulp in preventing or mitigating the reproductive toxicity induced by cyclophosphamide (CP) in male rats. Adult male rats were segregated into seven groups that received vehicle, 100 mg/kg/day of CP, or 10 mg/kg/day of β‐carotene or 3 or 30 mg/kg/day of A. aculeata oil co‐administered with CP. A. aculeata oil exhibited a high content of β‐carotene. CP treatment induced reproductive toxicity in the animals, as it changed the reproductive organs weight, hormone levels, sperm counts and testicular histology. In contrast, co‐administration of A. aculeata improved CP‐induced alterations in these parameters. A. aculeata oil also increased the gene Ckit expression and normalised the antioxidant enzymes levels which were changed by CP. The A. aculeata oil is capable of protecting the male reproductive system from the adverse effects of CP, possibly by acting as an antioxidant and increasing the Ckit gene expression.     

Human voluntary activity integration in the control of a standing-up rehabilitation robot: a simulation study

The paper presents a novel control approach for the robot-assisted motion augmentation of disabled subjects during the standing-up manoeuvre. The main goal of the proposal is to integrate the voluntary activity of a person in the control scheme of the rehabilitation robot. The algorithm determines the supportive force to be tracked by a robot force controller. The basic idea behind the calculation of supportive force is to quantify the deficit in the dynamic equilibrium of the trunk. The proposed algorithm was implemented as a Kalman filter procedure and evaluated in a simulation environment. The simulation results proved the adequate and robust performance of "patient-driven" robot-assisted standing-up training. In addition, the possibility of varying the training conditions with different degrees of the subject's initiative is demonstrated.     

Tissue-Engineered Heart Valves: Intra-operative Protocol

Tissue engineering of heart valves investigates the possibility to create a fully compatible and biomimetic graft able to provide host cell repopulation like the native living valve. Decellularized aortic and pulmonary valves and synthetic polymers have been used to promote the creation of a native-like scaffold suitable to be colonized by cells either in vitro, in dynamic bioreactors or in vivo using different animal models. The herein presented research provides the intra-operative protocol and details of surgical technique. Porcine aortic valve conduits were decellularized and implanted in the right ventricular outflow tract of Vietnamese pigs.     

Continuous versus bolus intermittent loop diuretic infusion in acutely decompensated heart failure: a prospective randomized trial

Introduction

Intravenous loop diuretics are a cornerstone of therapy in acutely decompensated heart failure (ADHF). We sought to determine if there are any differences in clinical outcomes between intravenous bolus and continuous infusion of loop diuretics.

Methods

Subjects with ADHF within 12 hours of hospital admission were randomly assigned to continuous infusion or twice daily bolus therapy with furosemide. There were three co-primary endpoints assessed from admission to discharge: the mean paired changes in serum creatinine, estimated glomerular filtration rate (eGFR), and reduction in B-type natriuretic peptide (BNP). Secondary endpoints included the rate of acute kidney injury (AKI), change in body weight and six months follow-up evaluation after discharge.

Results

A total of 43 received a continuous infusion and 39 were assigned to bolus treatment. At discharge, the mean change in serum creatinine was higher (+0.8 ± 0.4 versus -0.8 ± 0.3 mg/dl P <0.01), and eGFR was lower (-9 ± 7 versus +5 ± 6 ml/min/1.73 m²P <0.05) in the continuous arm. There was no significant difference in the degree of weight loss (-4.1 ± 1.9 versus -3.5 ± 2.4 kg P = 0.23). The continuous infusion arm had a greater reduction in BNP over the hospital course, (-576 ± 655 versus -181 ± 527 pg/ml P = 0.02). The rates of AKI were comparable (22% and 15% P = 0.3) between the two groups. There was more frequent use of hypertonic saline solutions for hyponatremia (33% versus 18% P <0.01), intravenous dopamine infusions (35% versus 23% P = 0.02), and the hospital length of stay was longer in the continuous infusion group (14. 3 ± 5 versus 11.5 ± 4 days, P <0.03). At 6 months there were higher rates of re-admission or death in the continuous infusion group, 58% versus 23%, (P = 0.001) and this mode of treatment independently associated with this outcome after adjusting for baseline and intermediate variables (adjusted hazard ratio = 2.57, 95% confidence interval, 1.01 to 6.58 P = 0.04).

Conclusions

In the setting of ADHF, continuous infusion of loop diuretics resulted in greater reductions in BNP from admission to discharge. However, this appeared to occur at the consequence of worsened renal filtration function, use of additional treatment, and higher rates of rehospitalization or death at six months.

Trial registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01441245","term_id":"NCT01441245"}}NCT01441245. Registered 23 September 2011.     

Low-level laser therapy to recovery testicular degeneration in rams: effects on seminal characteristics,scrotal temperature,plasma testosterone concentration,and testes histopathology

The aim of this study was to investigate the efficiency of low-level laser therapy (LLLT) to recovery testicular degeneration in rams. In the first study, rams were induced to testicular degeneration by scrotal insulation, and then, they were treated using LLLT at 28 J/cm² (INS28) or 56 J/cm² (INS56) energy densities. Sperm kinetics, morphology, and membranes integrity as well as proportion of lumen area in seminiferous tubule were assessed. In the second study, rams were submitted or not to scrotal insulation and treated or not by the best protocol of LLLT defined by experiment 1 (INS28). In this study were evaluated sperm kinetics, morphology, membranes integrity, ROS production, and DNA integrity. Testosterone serum concentration and proportion of lumen area in seminiferous tubule were also analyzed. Insulation was effective in promoting sperm injuries in both experiments. Biostimulatory effect was observed in experiment 1: INS28 presented smaller proportion of lumen area (P?=?0.0001) and less degeneration degree (P?=?0.0002). However, in experiment 2, there was no difference between the groups (P?=?0.17). In addition, LLLT did not improve sperm quality, and there was a decreasing for total and progressive motility (P?=?0.02) and integrity of sperm membranes (P?=?0.01) in LLLT-treated groups. Moreover, testosterone concentration was not improved by LLLT (P?=?0.37). Stimulation of aerobic phosphorylation by LLLT may have led to a deregulated increase in ROS leading to sperm damages. Thus, LLLT at energy of 28 J/cm² (808 nm of wavelength and 30 mW of power output) can induce sperm damages and increase the quantity of cells in seminiferous tubule in rams.