Silver hydrogel urinary catheters: evaluation of safety and efficacy in single patient with chronic spinal cord injury

Urinary tract infections (UTIs) are a large health burden for patients with spinal cord injury (SCI) who have neurogenic bladder dysfunction, especially those patients using indwelling catheters. One method that has shown promise in recent years is the use of a silver hydrogel catheter (SHC). This article describes the outcome of a subject who was part of a prospective, randomized, double-blind study and assigned to use an SHC for 6 months. Using the indwelling SHC effectively prevented this subject from developing a symptomatic UTI. He did not display any symptoms suggestive of silver toxicity or increased serum levels of silver with chronic use of the device. Although no general conclusions can be drawn from this single-subject observation, the results suggest that SHC use has a positive effect. Use of this catheter for persons with neurogenic bladder dysfunction after SCI should be explored further with a study design that optimizes subject recruitment

Prevention and Treatment Of Heterotopic Ossification After Spinal Cord Injury

Background/Objectives: Heterotopic ossification (HO) is a frequent, irreversible complication afterspinal cord injury (SCI). The objective of this article is to explain the etiology of HO; present new advances in prevention, diagnosis, and management of this complication; and provide a suggested algorithm for clinical management. Etiology: Although still hypothetical, trauma and overexpression of bone morphogenic protein(s) in traumatized soft tissue appear to play important roles as initiating factors of HO. Prevention: Preventive use of nonsteroidal antiinflammatory agents (NSAIDs) reduces the incidence of HO by a magnitude of 2 to 3. Management: Early determination of serum creatine phosphokinase may have a diagnostic value in predicting the onset and severity of HO, and an NSAID may be added to etidronate therapy in the initial inflammatory phase of HO formation until C-reactive protein Ieveis return to normal range. Surgery is indicated in a subset of patients, and a regimenthat includes radiation therapy may prevent postoperative recurrence. Conclusion: Significant progress has been made in the early prevention and management of HO. Further studies are needed to elucidate the etiology

Intermittent Fasting: Potential Utility in the Treatment of Chronic Pain across the Clinical Spectrum

Dietary behavior can have a consequential and wide-ranging influence on human health. Intermittent fasting, which involves intermittent restriction in energy intake, has been shown to have beneficial cellular, physiological, and system-wide effects in animal and human studies. Despite the potential utility in preventing, slowing, and reversing disease processes, the clinical application of intermittent fasting remains limited. The health benefits associated with the simple implementation of a 12 to 16 h fast suggest a promising role in the treatment of chronic pain. A literature review was completed to characterize the physiologic benefits of intermittent fasting and to relate the evidence to the mechanisms underlying chronic pain. Research on different fasting regimens is outlined and an overview of research demonstrating the benefits of intermittent fasting across diverse health conditions is provided. Data on the physiologic effects of intermittent fasting are summarized. The physiology of different pain states is reviewed and the possible implications for intermittent fasting in the treatment of chronic pain through non-invasive management, prehabilitation, and rehabilitation following injury and invasive procedures are presented. Evidence indicates the potential utility of intermittent fasting in the comprehensive management of chronic pain and warrants further investigation