The Effect of Oxandrolone on the Healing of Chronic Pressure Ulcers in Persons With Spinal Cord Injury

Bauman, William A.; Spungen, Ann M.; Collins, Joseph F.; Raisch, Dennis W.; Ho, Chester; Deitrick, George A.; Nemchausky, Bernard A.; Goetz, Lance L.; Park, Jai S.; Schwartz, Michael D.; Merritt, J. Lawrence; Jayawardena, Vidya; Sandford, Paul; Sabharwal, Sunil; Holmes, Sally Ann; Nasar, Fahima; Sasaki, Roy; Punj, Vandana; Zachow, Karin; Chua, Walter; Thomas, M.; Trincher, Rose

doi:10.7326/0003-4819-158-10-201305210-00006

Cited by 23 publications

(16 citation statements)

References 47 publications

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“…The data corroborate similar research in which there was a significant association between neurological disease and PU [8]. According to the findings, studies that tested strategies for reduction of PU in hospital say that people with neurological injuries or alterations have great chance to present such chronic wounds [19] [20]. Thus, these findings support the evidence for relationship between neurological and emergence of PU.…”

Section: Discussionsupporting

confidence: 81%

Pressure Ulcers in Institutionalized Elderly People: Association of Sociodemographic and Clinical Characteristics and Risk Factors

Matos¹,

Diniz²,

Lucena³

et al. 2017

OJN

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Objective: To evaluate the association of socio-demographic and clinical characteristics, and risk factors with occurrence of pressure ulcers in institutionalized elderly people. Method: This cross-sectional, analytical study, in quantitative approach, performed from the database analysis linked to the project "Pressure Ulcer in institutionalized elderly people: Association of incidence with the risk factors to functional and nutritional assessment" developed in six long-stay institutions for the elderly people in João Pessoa. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Associations were made through chi square test and Odds Ratio. Results: The clinical conditions of significant associations with the occurrence of pressure ulcers were the variables neurological disorders (p = 0.011) and visual impairment (p = 0.005). As for risk factors, the most important was fecal incontinence (p < 0.001), urinary incontinence (p < 0.001), cognitive impairment (p = 0.007) and physical limitation (p < 0.001). The chance for the occurrence of injury was nine times higher for elderly people with physical limitations and about three times higher among those who use diapers. Conclusion: The analysis of the associations pointed out problems that require intervention in order to prevent health implications of the elderly people and to minimize the risk and occurrence of this injury.

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Section: Discussionsupporting

confidence: 81%

Pressure Ulcers in Institutionalized Elderly People: Association of Sociodemographic and Clinical Characteristics and Risk Factors

Matos¹,

Diniz²,

Lucena³

et al. 2017

OJN

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“…In mice, topical application of the androgen receptor (AR) antagonist flutamide improves closure of skin wounds (14). A study in men with chronic pressure ulcers failed to show a significant benefit of treatment with the anabolic steroid oxandrolone in a phase 3 trial (15). Studies in male mice with global and selective ablations of Ar have yielded a mixture of results reflecting the different strategies used to generate knockouts [reviewed in Chang et al (16)].…”

mentioning

confidence: 99%

Androgens regulate scarless repair of the endometrial “wound” in a mouse model of menstruation

et al. 2016

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The human endometrium undergoes regular cycles of synchronous tissue shedding (wounding) and repair that occur during menstruation before estrogen-dependent regeneration. Endometrial repair is normally both rapid and scarless. Androgens regulate cutaneous wound healing, but their role in endometrial repair is unknown. We used a murine model of simulated menses; mice were treated with a single dose of the nonaromatizable androgen dihydrotestosterone (DHT; 200 mg/mouse) to coincide with initiation of tissue breakdown. DHT altered the duration of vaginal bleeding and delayed restoration of the luminal epithelium. Analysis of uterine mRNAs 24 h after administration of DHT identified significant changes in metalloproteinases (Mmp3 and -9; P < 0.01), a snail family member (Snai3; P < 0.001), and osteopontin (Spp1; P < 0.001). Chromatin immunoprecipitation analysis identified putative androgen receptor (AR) binding sites in the proximal promoters of Mmp9, Snai3, and Spp1. Striking spatial and temporal changes in immunoexpression of matrix metalloproteinase (MMP) 3/9 and caspase 3 were detected after DHT treatment. These data represent a paradigm shift in our understanding of the role of androgens in endometrial repair and suggest that androgens may have direct impacts on endometrial tissue integrity. These studies provide evidence that the AR is a potential target for drug therapy to treat conditions associated with aberrant endometrial repair processes.-Cousins, F. L., Kirkwood, P. M., Murray, A. A., Collins, F., Gibson, D. A., Saunders, P. T. K. Androgens regulate scarless repair of the endometrial "wound" in a mouse model of menstruation. FASEB J. 30, 2802FASEB J. 30, -2811FASEB J. 30, (2016. www.fasebj.orgIn women, the most important tissues for biosynthesis of androgens are the ovaries, adrenals, and fat. In adult women, 50% of the testosterone measured in blood is secreted by the ovaries and adrenals, with a small midcycle peak (1). The other 50% is derived from conversion of adrenal and ovarian precursors, such as androstenedione, dehydroepiandrosterone, and dehydroepiandrosterone sulfate. Testosterone can be further metabolized to both estradiol and the potent nonaromatizable androgen dihydrotestosterone (DHT) in tissues that express aromatase and 5-a reductase enzymes, respectively (1-3).During the menstrual cycle, endometrial breakdown at the time of menses is the culmination of a tightly controlled cascade of biomolecular changes initiated by progesterone (P4) withdrawal (demise of the corpus luteum), which results in shedding of the upper functional layer of the endometrium. Detailed morphologic evaluation in women has revealed that breakdown and restoration of tissue homeostasis at the time of menstruation in normal women occurs rapidly, with epithelialization of the exposed basal stroma completed within 4 d of the first evidence of bleeding (4, 5). Piecemeal degradation and bleeding that give the surface of the endometrium the appearance of a wound has been documented with a hysteroscope intr...

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“…Across the 14 systematic reviews of treatment interventions there were 145 included RCTs involving 14 166 participants. Only 604 (4.3%) of these participants were described as having SCI (confined to 10 of the trials [47][48][49][50][51][52][53][54][55][56]: note that Nussbaum et al [49] was included in three reviews [31,43,57]; Hollisaz et al [47] was included in two reviews [31,33]; and Kaya et al [50] was included in two reviews [31,34]). Although a trial [58] included in one review [31] did include participants with 'disorders of the spinal cord' it was unclear whether these participants had SCI, or how many participants were included.…”

Section: Treatment Of Pusmentioning

confidence: 99%

Interventions for pressure ulcers: a summary of evidence for prevention and treatment

Atkinson

Cullum

2018

Spinal Cord

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The Effect of Oxandrolone on the Healing of Chronic Pressure Ulcers in Persons With Spinal Cord Injury

Abstract: U.S. Department of Veterans Affairs.

Cited by 23 publications

References 47 publications

Pressure Ulcers in Institutionalized Elderly People: Association of Sociodemographic and Clinical Characteristics and Risk Factors

Pressure Ulcers in Institutionalized Elderly People: Association of Sociodemographic and Clinical Characteristics and Risk Factors

Androgens regulate scarless repair of the endometrial “wound” in a mouse model of menstruation

Interventions for pressure ulcers: a summary of evidence for prevention and treatment

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