The journal of spinal cord medicine
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An evaluation of the history, design, and status of the database of the National Spinal Cord Injury Statistical Center (NSCISC) was undertaken to identify its continued relevance. ⋯ The database remains a valuable resource. Future plans include linkage to other databases to enhance research capability, a published research compendium, and development of a user's guide to facilitate database usage.
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Comparative Study
Prevalence of upper motor neuron vs lower motor neuron lesions in complete lower thoracic and lumbar spinal cord injuries.
To determine the incidence and etiology of lower motor neuron (LMN) vs upper motor neuron (UMN) lesions in patients with complete thoracic and lumbar spinal cord injuries (SCI). ⋯ One cannot determine the type of lesion (UMN vs LMN) on the basis of the neurological level of injury. A detailed clinical examination, including sacral reflexes, is required. This has important prognostic and therapeutic implications for bowel, bladder, and sexual function, as well as mobility. Distinguishing UMN lesions from LMN lesions is also essential for evaluating new interventions in clinical trials for UMN pathology.
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Case Reports
Heterotopic ossification complicating prolonged intubation: case report and review of the literature.
Within the past decade several reports have been published concerning heterotopic ossification (HO) in adult respiratory distress syndrome patients subjected to prolonged mechanical ventilation. The knee has been the most common site of involvement, which tends to differentiate this entity of HO from those previously described. ⋯ Increased awareness of this relatively new entity may assist early diagnosis, medical treatment, and eventually direct rehabilitation. Investigation of the pathogenesis of different types of HO may provide clues to the prevention and treatment of HO in individuals with SCI and other central nervous system trauma.
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Comparative Study
Age-related differences in length of stays, hospitalization costs, and outcomes for an injury-matched sample of adults with paraplegia.
To investigate the effects of age at injury on neurological and functional outcomes and hospitalization length of stays and charges following spinal cord injuries resulting in paraplegia. ⋯ Using a matched block design procedure, older patients are discharged with lower levels of functional independence and show lower levels of improvement despite longer rehabilitation stays when compared with younger patients. Older patients' neurological recovery appears equivocal to younger patients' recovery. In contrast to findings with a matched tetraplegia sample, older and younger patients with paraplegia are discharged to private residences at similar rates.
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Case Reports
Atelectasis and mucus plugging in spinal cord injury: case report and therapeutic approaches.
The leading causes of morbidity and mortality in the spinal cord injury (SCI) population are airway mucus plugging and atelectasis. ⋯ Individuals with SCI have high risk of pulmonary complications. Because of neurological deficits, the usual signs and symptoms may not be apparent. Optimal management depends upon awareness of the risks, and a thorough understanding of the pathophysiology of mucus plugging and atelectasis and the alterations in pulmonary mechanics (dependent on level of injury).