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    Methylprednisolone soon to be replaced as treatment of choice for Acutes???

    Source: Restorative Neurology and Neuroscience Released: Thu 15-Dec-2005, 14:15 ET
    Printer-friendly Version Erythropoietin Holds Promise in the Treatment of Spinal Cord Injury

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    Medical News Keywords
    SPINAL CORD INJURY, SCI TREATMENT AND RECOVERY, NEURODEVELOPMENT, NEUROPROTECTION Contact Information
    Available for logged-in reporters onlyDescription
    Spinal cord injury is a two-step process. The primary injury is mechanical, resulting from impact, compression or some other insult to the spinal column. The secondary injury is biochemical, as cellular reactions cause tissue destruction. By interrupting this second process, it may be possible to speed healing and minimize permanent effects.

    Newswise — Spinal cord injury (SCI) is a two-step process. The primary injury is mechanical, resulting from impact, compression or some other insult to the spinal column. The secondary injury is biochemical, as cellular reactions cause tissue destruction. By interrupting this second process, it may be possible to speed healing and minimize permanent effects.
    In a paper published in the current issue of Restorative Neurology and Neuroscience, researchers from the Anadolu Cinar Hospital and the GATA Haydarpasa Research and Training Hospital, both in Istanbul, Turkey, found that erythropoietin improves neurological recovery, and may be more effective than the current standard treatment.

    Methylprednisolone is the accepted therapeutic treatment for SCI, but it is marginally effective in most cases. Erythropoietin stimulates proliferation and growth of erythroid cells and is involved in neurodevelopment and neuroprotection. It has been studied in brain injuries, but not in SCI.
    A population of rats was divided into four groups. All four groups had their spinal cord exposed via laminectomy. The first group of 10 had no further treatment and was closed normally. Of the 60 rats remaining, all were surgically injured by impact. These 60 were divided into 3 groups of 20 that received no medication (NM), standard methylprednisolone (MP) therapy, and treatment with human recombinant erythropoietin (EP), respectively.
    Using a swimming test to gauge neurological function, the group receiving EP recovered more than the either the NM or the MP group. In addition, while the MP group showed more recovery than the NM group, it was never statistically significant in this study.

    http://www.newswise.com/articles/view/516835/?sc=rsmn

    Sorry Dr. Young.........

    #2
    Originally posted by Faye
    Methylprednisolone soon to be replaced as treatment of choice for Acutes???
    I doubt it. If anything, it would be MP + EPO.

    Comment


      #3
      Originally posted by Faye
      Sorry Dr. Young.........
      Faye, why the apology? I would be very happy indeed if a therapy were to be shown to be better than MP for spinal cord injury. Wise.

      Comment


        #4
        i had Methylprednisolone in a drip IV within 15 minutes of my injury, i don't know for certain if it helped sigificantly because i'm not a doctor, but i like to think it did.
        Never take life seriously, nobody gets out alive anyway

        Frank's blog:
        http://www.franktalk-scurry.blogspot.com
        My regular blog:
        http://www.ithinkithinktoomuchblog.blogspot.com

        Comment


          #5
          Originally posted by Wise Young
          Faye, why the apology? I would be very happy indeed if a therapy were to be shown to be better than MP for spinal cord injury. Wise.
          In all due respects Dr. Young it was not shown just that the new treatment is better, but that MP for Traumatic injury was shown to be statistically ineffective.

          Here we have a whole science that grew on the premise that MP worked.

          Never the less if this new experiment is true we have created a whole new huge industry based on a false hope.

          Comment


            #6
            Sorry Monique

            Originally posted by Monique
            I doubt it. If anything, it would be MP + EPO.
            Sorry Monique, if MP is shown not to be statistically effective as in this study then why bother with it?

            Comment


              #7
              Originally posted by bigbob
              In all due respects Dr. Young it was not shown just that the new treatment is better, but that MP for Traumatic injury was shown to be statistically ineffective.

              Here we have a whole science that grew on the premise that MP worked.

              Never the less if this new experiment is true we have created a whole new huge industry based on a false hope.
              Bob,

              Before you start making these kinds of statements, I suggest that you read the paper and know something more about the study that is being reported. have you read the paper? On what basis are you making these statements? Do you know the animal model in which these results came from, the dose of the MP that was used?

              Wise.

              Comment


                #8
                Originally posted by Wise Young
                Bob,

                Before you start making these kinds of statements, I suggest that you read the paper and know something more about the study that is being reported. have you read the paper? On what basis are you making these statements? Do you know the animal model in which these results came from, the dose of the MP that was used?

                Wise.
                Peer review would catch researchers using an ineffective dose. Unless we need to start doubting all published studies now that Hwang's case has been exposed....?!?!? Even those of 15 years ago

                Comment


                  #9
                  Originally posted by Faye
                  Sorry Monique, if MP is shown not to be statistically effective as in this study then why bother with it?
                  MP was never promoted as a cure all.
                  BUT..when given in the IV recommended dosage..it helps more then anything else available..except decompression surgery. And often it is used before the decompression and those patients also have a better return of function. I have seen this with my own eyes..and have heard accounts from thousands of SCI dog owners. So this is an animal study of EPO..if it is more effective..celebrate..but it wasn't in the loop when MP studies were done.

                  Should we throw bombs at Fleming because more effective antibiotics have been discovered?

                  And bob..there is NO respect in your post.
                  Life isn't about getting thru the storm but learning to dance in the rain.

                  Comment


                    #10
                    Originally posted by Wise Young
                    Bob,

                    Before you start making these kinds of statements, I suggest that you read the paper and know something more about the study that is being reported. have you read the paper? On what basis are you making these statements? Do you know the animal model in which these results came from, the dose of the MP that was used?

                    Wise.
                    he is worse than me.

                    Comment


                      #11
                      Originally posted by DA
                      he is worse than me.

                      OMG that's funny.

                      Christmas smooch to DA...
                      Blog:
                      Does This Wheelchair Make My Ass Look Fat?

                      Comment


                        #12
                        lindox,

                        that's exactly what i had done when i got hurt. i had the iv drip of MP and about 5 hours afterwards i had a decompression surgery where i woke up with tingling in my toes. a second surgery the following day to complete decompression and clear debris left my hands tingling.
                        Never take life seriously, nobody gets out alive anyway

                        Frank's blog:
                        http://www.franktalk-scurry.blogspot.com
                        My regular blog:
                        http://www.ithinkithinktoomuchblog.blogspot.com

                        Comment


                          #13
                          Originally posted by cali
                          lindox,

                          that's exactly what i had done when i got hurt. i had the iv drip of MP and about 5 hours afterwards i had a decompression surgery where i woke up with tingling in my toes. a second surgery the following day to complete decompression and clear debris left my hands tingling.
                          cali,
                          Did you regain anymore sensation or function at all?

                          I honestly feel to compare the dogs natural injury from a disc herniation to a spinal cord injury of such force as occurs in humans is in no way a comparison.
                          As with comparing a compression injury to a human assault on the spinal cord.

                          But with some of our dogs the injury is quite severe.
                          Some have already developed calcificated discs..and stenosis. This in itself often puts a great force behind the explosive nature of the disc herniating.

                          With dogs..those that still maintain pain sensation in their toes are usually the ones that regain the most function. Those that don't have this sensation have a poor prognosis..yet some have walked. Albeit bowel and bladder remains unimproved. And they rarely can go for too long without reverting to scooting along.

                          Before MP..even those decompressed before they lost sensation didn't have as much return as they do now.
                          Of course the procedure has been refined..but the MP is what helps to stop the inflammation of the assaulted cord I guess. And has saved many a dogs life. They usually have this happen when they are between 3 and 6 years old. That is young when you are talking about the smaller breeds.

                          Am anxious though to see if EPO will be introduced into the dog world.

                          Before MP..human SCI had very little to help it at all.
                          Life isn't about getting thru the storm but learning to dance in the rain.

                          Comment


                            #14
                            Originally posted by DA
                            he is worse than me.
                            looney
                            cauda equina

                            Comment


                              #15
                              Originally posted by Faye
                              Peer review would catch researchers using an ineffective dose. Unless we need to start doubting all published studies now that Hwang's case has been exposed....?!?!? Even those of 15 years ago
                              Faye, dozens or perhaps even hundreds of papers have reported that MP improves many outcomes in a variety of spinal cord injury models. The dose, timing, and duration of treatment, as well as the spinal cord injury model, are very important when interpreting the studies. Just because a study does not show statistical significance of a treatment does not mean that the treatment is ineffective.

                              MP has modest effect on recovery of rats after severe spinal cord injuries. Even the best spinal cord injury models require 12-20 rats to detect a 10% effect on recovery of function. The model could be variable so that it could not detect the beneficial effects of the treatment. The dose could have been given late. Rat time is 4 or more times faster than human time. In rats, the dose must be given within 30 minutes or even earlier to be effective. The human dose and duration is inappropriate for rats. There are many reasons why the treatment may not have worked.

                              The studies showing the MP is effective were done in humans, in fact many more humans than the number of rats that were studied. Two other trials have confirmed our original results published in 1990. What the Turkish study does suggest that erythropoietin is more effective than methylprednisolone although I must say that we have not been able to confirm this in our laboratory and we are repeating the study to make sure. So, please, I am suggesting that BigBob read the paper itself before making the claims that a whole field has been based on a false premise.

                              Wise.

                              Comment

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