ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719390

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

AbstractModern care of patients with spinal cord injury is leading to greater numbers of individuals surviving into old age and the emergence of a cohort that has sustained injury at an advanced age. The clinical characteristics of either group of patients has not been well characterized. Analyses from the Aging with a Long-Term Disability Research Program database, which is enriched by the presence of a high quality Spinal Cord Injury Service, revealed a population of 510 recently assessed individuals with a mean age of 50 years, ranging from 16 to 84 years. Twenty-three percent of the patients were at least 65 years of age. Spinal cord injuries were usually the result of automobile accidents in individuals injured younger than 50 years of age and falls in individuals injured when older than 50 years of age. Patients surviving late life injury are much more likely to have incomplete injuries predominantly affecting the cervical spine. A number of conditions were found to be more prevalent in older patients. These included carpal tunnel syndrome, chronic obstructive pulmonary disease, myocardial infarction, diabetes, kidney stones, pressure ulcers and hypertension. The development of diabetes, kidney stones and perhaps pressure ulcers was directly related to aging with SCI, but not just to aging alone. The better functional outcomes in late life spinal cord injury may be secondary to selective survival. The excess morbidity associated with late life spinal cord injury has significance for future planning of healthcare needs for the spinal cord injured patient.(J Spinal Cord Med;18:183–193)

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719391

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

AbstractHeterotopic ossification (HO) is a well known complication of spinal cord injury. It usually affects the hips and knees, with less common involvement of the shoulders and elbows. We present a patient with incomplete tetraplegia who developed HO in the left hip and in the plane of the lumbar anterior longitudinal ligament from L3 to L5. During evaluation for the patient’s complaints of low back pain, a fracture was noted in the HO which was confirmed by three-dimensional CT scan. We postulate that this fracture contributed to his symptoms. Review of the literature on HO in spinal cord injured patients indicates this to be an unusual location for HO. Although HO of the lumbar anterior longitudinal ligament is a rare occurrence, this possibility should be considered in the evaluation of back pain in spinal cord injured patients. (J Spinal Cord Med;18:194–199)

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719392

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

AbstractBecause diazepam appeared to affect body weight, spastic myelopathy patients for whom this drug had been prescribed but in whom the dose was altered were compared with similar patients without changes in antispastic medication. A retrospective survey averaging 10 months was conducted for these two groups to determine weight changes of 10 pounds or more.After reduction or discontinuation of diazepam in seven patients, all lost weight-12 to 35 lbs at rates of 0.9 to 3.5 lb per month. On unchanged medication, only one of twelve patients lost as much as 10 lb, p<0.001.After partially or fully restoring diazepam in iour patients, all gained weight-7 to 26 lbs-at rates of 1.8 to 4.3 lbs per month. Three of the four patients and two of the 12 without medication change gained as much as 10 pounds, p = 0.03.We conclude that body weight in myelopathy patients is affected by the use of diazepam. The effect of other medications used for spasms was not assessed. (JSpinal Cord Med, 18:200–202)

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719393

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

AbstractPulmonary blastoma (PB) is an uncommon primary lung malignancy. This neoplasm was first described by Barrett and Barnard in 1945. The tumor is composed of immature epithelial and mesenchymal tissues which may recapitulate early embryological lung development. Under the microscope, the globular component resembles immature bronchus and connective tissue as seen in embryonic lung. More than one hundred cases have been reported in the literature. PB is more frequent in older people and in males and tends to affect blacks at younger ages. Symptomatology varies from asymptomatic to symptoms of a non-specific pulmonary disease. Cough, hemoptysis, dyspnea, chest pain, respiratory distress, fever, anorexia and weight loss are the most common presenting features. The most common roentgenologic pattern is a well-demarcated peripheral lesion, encapsulated by compression or atelectatic lung tissue, although in some cases there is a tendency to lobulation and cavitation. The size of the mass varies from a small peripheral nodule to a mass occupying the entire lobe or hemithorax. The treatment of choice has been surgical excision, radiation and, in selected cases, a combination of chemotherapy with radiation. The prognosis of this malignancy is poor; overall five-year survival is approximately 16 percent. No correlation has been established between histopathologic criteria and survival. The factors that indicate poor prognosis are tumor recurrence, metastasis at initial presentation, tumor size over 5 cm and lymph node metastasis. Liver, central nervous system and bones are the most frequent location of distant metastases. A rare case is presented of a pulmonary blastoma with an upper lip metastasis occurring in a paraplegic male. Diagnosis was confirmed by autopsy findings. To our knowledge, this is the first documented case of a pulmonary blastoma metastasis to the upper lip.(J Spinal Cord Med;18:203–207)

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719394

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

AbstractPrevious studies have observed altered somatotopic sensory fields after experimental deafferentation in animals as well as enhanced somatosensory evoked potentials and altered cortical motor pathways following spinal cord injury (SCI) in humans. These observations indicate that cortical reorganization may occur subsequent to SCI. In earlier work, we have observed attenuated amplitudes for both tactile P3 and auditory N1/P2 orienting event-related potentials (ERP) in spinal cord injured groups. These results suggest that the reorganization process may have functional perceptual and cognitive consequences. In an effort to determine if deafferentation affects the P3 ERP using stimuli other than somatosensory, we measured brain activity from central recording sites during an auditory“oddball”task. Additionally, we obtained brainstem auditory evoked responses (BAER) in order to assess subcortical primary auditory pathways as well. Results show that the SCI groups produced significantly attenuated N1/P2 complexes and P3 when compared to controls. Also, the quadriplegic group exhibited increased latencies of the P3 at frontal and central sites. There were no differences between groups in BAER results. These findings suggest that primary subcortical auditory information processing stages remain intact after SCI although later stages may be significantly altered.(J Spinal Cord Meet, 18:208–215)

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719395

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719396

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719397

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor