Spasticity Treatment Beyond Botulinum Toxins.

Botulinum toxin (BonT) is the mainstream treatment option for post-stroke spasticity. BoNT therapy may not be adequate in those with severe spasticity. There are a number of emerging treatment options for spasticity management.

Early Use of Phenol Neurolysis Likely Reduces the Total Amount of Botulinum Toxin in Management of Post-Stroke Spasticity.

The main objective was to examine practice patterns of phenol neurolysis for post-stroke spasticity management in the early stage. We performed a chart review of patients who were admitted for inpatient rehabilitation within 6 months after first-ever stroke and received phenol neurolysis within 15 months post-stroke. Out of 2,367 stroke admissions from January 2014 and December 2018, 68 patients met the criteria.

Real-world analysis of botulinum toxin (BoNT) injections in post-stroke spasticity: Higher doses of BoNT and longer intervals in the early-start group.

Our primary objective was to compare early-start vs. late-start Botulinum toxin (BoNT) injections in post-stroke spasticity management. This is an IRB approved retrospective chart review of patients who were admitted for inpatient rehabilitation within 6 months after first-ever stroke between January 2014 and December 2018 and received BoNT injections within 15 months.

Stroke and sarcopenia.

Purpose Of Review: to evaluate recent scientific research studies related to the changes in skeletal muscle after stroke and the presence of sarcopenia in stroke survivors to establish its incidence and effects on function.

Recent Findings: Recently published findings on stroke-related sarcopenia are limited. This might be due to changes in the consensus definition of sarcopenia.

[Sexual life quality of spinal cord-injured men receiving pharmacological treatment for erectile dysfunction and their partners].

Objective: To assess the quality of sexual life reported by spinal cord-injured men treated with oral drugs for erectile dysfunction (ED) and their female partners.

Material And Method: Men with spinal cord injuries (SCI) complaining of ED and their female partners were evaluated using the Sexual Life Quality Questionnaire (SLQQ), a fully validated instrument in Spain. Two studies were conducted.

Phenol Neurolysis for the Management of Shoulder Spasticity in Early Recovery From Traumatic Brain Injury: A Case Report.

This case describes a 16-year-old boy who suffered a severe traumatic brain injury. The patient gradually recovered but developed debilitating spasticity mainly in left triceps muscle, abnormal positioning of shoulder girdle complex, and shoulder pain. Phenol (6%) was injected to axillary and radial nerves under the guidance of electrical stimulation and ultrasound imaging at 10 weeks after the initial injury.

Rehabilitation Needs of the Elder with Traumatic Brain Injury.

The incidence of traumatic brain injury (TBI) in older adults is increasing. As the expected life expectancy increases, there is a heightened need for comprehensive rehabilitation for this population. Elderly patients with TBI benefit from rehabilitation interventions at all stages of injury and can achieve functional gains during acute inpatient rehabilitation.

Centrally mediated late motor recovery after botulinum toxin injection: Case reports and a review of current evidence.

Objective: Botulinum neurotoxin is commonly utilized in neurorehabilitation as a treatment for focal spasticity. Clinical experience has yielded observations of late motor recovery after intramuscular injection of botulinum neurotoxin, that are not readily explained by the classical mechanism of action of the neurotoxin in controlling spasticity. These findings have triggered speculation regarding a botulinum neurotoxin mediated effect at the central level after peripheral intervention.

Practice patterns for spasticity management with phenol neurolysis.

Objective: To present practice patterns for phenol neurolysis procedures conducted for spasticity management.

Design: A retrospective review of 185 persons with spasticity who underwent phenol neurolysis procedures (n = 293) at an academic rehabilitation hospital and clinic. Patient demographics, concomitant spasticity treatments, and procedure relevant information were collected.

Enhancing sensorimotor activity by controlling virtual objects with gaze.

This fMRI work studies brain activity of healthy volunteers who manipulated a virtual object in the context of a digital game by applying two different control methods: using their right hand or using their gaze. The results show extended activations in sensorimotor areas, not only when participants played in the traditional way (using their hand) but also when they used their gaze to control the virtual object. Furthermore, with the exception of the primary motor cortex, regional motor activity was similar regardless of what the effector was: the arm or the eye.

[Clinical and biochemical diagnosis of androgenic deficit in adult men].

The diagnosis of testosterone deficit (TD) in adult men is made upon the finding of consistent symptoms or signs associated with confirmed low Testosterone levels. TD can be caused by primary testicular failure, decreased LH secretion (secondary)or a combination of both (mixed type). The clinical features of TD depend on the age of onset.

Natural orifice translumenal endoscopic surgery for anterior spinal procedures.

Background. NOTES techniques allow transesophageal access to the mediastinum. The aim of this study was to assess the feasibility of transesophageal biopsy of thoracic vertebrae.

Evaluating a continuous medical education program to improve general practitioners awareness and practice on erectile dysfunction as a cardiovascular risk factor.

Introduction: The clear link between erectile dysfunction (ED) and cardiovascular disease (CVD) together with the increased potential for effectively treating ED with oral pharmacological agents make the primary care setting the ideal place to detect and treat ED and its potential comorbidities. Given the observed shortcomings in knowledge related to ED among primary care physicians, continuous medical education (CME) on this topic stands out as a potentially effective way to improve patient care.

Aim: To assess general practitioners' (GPs) knowledge, attitudes, and self-confidence about ED management and the relationship between ED and CVD and to test whether these can be improved by means of a brief training program.

Molecular mechanisms of penile erection.

The penis physiological states of flaccidity or erection, result from the contraction or relaxation, respectively, of smooth muscle cells in the corpora cavernosa (CSMCs). They result from the interaction of various inter and intracellular molecular signaling pathways. During the more usual state of flaccidity seems to predominate a tonic sympathetic activity, releasing noradrenaline (NA) and other agonists that generate contractile signals in the CSMCs, with the likely cooperation of endothelium-derived messengers.

Further psychometric validation of the sexual life quality questionnaire for men with erectile dysfunction and their partners on a modified Spanish language version.

Introduction: Although erectile dysfunction (ED) is known to hamper quality of life (QoL) of afflicted men and their partners, there are few validated instruments for assessing the couple's sexual QoL. The Sexual Life Quality of Life Questionnaire (SLQQ) was developed in the United States for this purpose, and so it has been used in clinical studies. Yet, the original description did not address some important psychometric properties included in the Food and Drug Administration 2006 guidance for patient-reported outcome instruments.

In vivo electrochemical measurement of nitric oxide in corpus cavernosum penis.

A wealth of pharmacological studies suggest that nitric oxide (NO) generated in the corpus cavernosum is a main molecular mediator of penile erection. However, the physiological levels of NO in the corpora and their possible changes during penile erection have remained unknown for want of suitable methodologies. We have adapted a voltammetric procedure, derived from Malinski's method, for assessing NO levels in the penis in vivo.

Changes in mating behavior, erectile function, and nitric oxide levels in penile corpora cavernosa in streptozotocin-diabetic rats.

This study assessed whether the in vivo production of nitric oxide (NO) in the penis is impaired in experimental diabetes and whether this phenomenon can be explained by abnormal levels of NO synthase isoenzymes and/or plasma androgens. Adult male Sprague-Dawley rats were injected with streptozotocin (STZ) (40 mg/kg, i.p.