Spinal cord
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Clinic-based retrospective case-control study. ⋯ This retrospective study suggests that OSA patients with tetraplegia require significantly less CPAP to treat their OSA at any given AHI than those who are able-bodied. This suggests that additional unknown factors may contribute to the high prevalence of OSA in tetraplegia.
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A multicenter Canadian cohort study. ⋯ The results here add weight to the growing body of literature, which supports the principle of early intervention in the setting of spinal trauma and SCI.
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Cross-sectional cohort study. To describe: (1) the prevalence of suboptimal 25-hydroxyvitamin D status (serum 25(OH)D <75 nmol l(-1)) and to identify correlates of vitamin D deficiency; (2) the prevalence of secondary hyperparathyroidism (serum intact parathyroid hormone (PTH)>7.0 pmol l(-1)); and (3) the relationships between serum PTH and 25(OH)D in adult men and women with chronic spinal cord injury (SCI). ⋯ Thirty-nine percent of the cohort, comprised of 62 adult men and women with chronic SCI, had suboptimal serum 25(OH)D levels. Factors associated with suboptimal vitamin D levels included having vitamin D assessed in the winter months (odds ratio (OR)=7.38, P=0.001), lack of a calcium supplement (OR=7.19, P=0.003), lack of a vitamin D supplement (OR=7.41, P=0.019), younger age (OR=0.932, P=0.010), paraplegia (OR=4.22, P=0.016), and lack of bisphosphonate (OR=3.85, P=0.015). Significant associations were observed between serum PTH and 25(OH)D (r=-0.304, P=0.032) and between PTH and C-telopeptide of type I collagen (CTX-I) (r=0.308, P=0.025). Disruption of the vitamin D-PTH axis may contribute to the bone loss seen in the chronic SCI population. The threshold for optimal serum 25(OH)D levels in the chronic SCI population may be higher than in the non-SCI population. Serum 25(OH)D level are likely important risk factors contributing to declining bone mass and increased fracture risk post-SCI.