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25 years or more after spinal cord injury: clinical conditions of individuals in the Florence and Stockholm areas.

https://arctichealth.org/en/permalink/ahliterature129470
Source
Spinal Cord. 2012 Mar;50(3):243-6
Publication Type
Article
Date
Mar-2012
Author
L. Werhagen
S. Aito
L. Tucci
J. Strayer
C. Hultling
Author Affiliation
Karolinska institutet Danderyds Sjukhus, Department of clinical sciences, Division of Rehabilitation Medicine, Danderyds hospital, Stockholm, Sweden. lars.werhagen @ki.se
Source
Spinal Cord. 2012 Mar;50(3):243-6
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Accidental Falls
Accidents, Traffic
Adolescent
Adult
Aged
Aged, 80 and over
Ethnic Groups
Female
Follow-Up Studies
Humans
Italy
Length of Stay
Male
Middle Aged
Retrospective Studies
Severity of Illness Index
Spinal Cord Injuries - complications - etiology - therapy
Sweden
Young Adult
Abstract
Retrospective analysis and retrospective follow-up.
Spinal cord injury (SCI) patients have today a nearly normal lifespan. Avoidance of medical complications is key to this end. The aim of the study was to analyse health in individuals surviving 25 years or more after traumatic SCI in Stockholm and Florence, and compare medical complications.
Data from the databases of the Spinal Unit of Florence and from the Spinalis, Stockholm were analysed. Patients included were C2-L 2, American Spinal Cord Association (ASIA) Impairment Scale (AIS) A-C, and =25 years post traumatic SCI. Patients underwent a thorough neurological and general examination, and were interviewed about medical events during those years. Analysed data include: gender, age at injury, current age, neurological level, AIS, cause of injury, presence of neuropathic pain (NP), and spasticity and medical complications.
A total of 66 Italian patients and 74 Swedish patients were included. The only statistical difference between the groups was cause of injury due to falls was higher in the Florence group (P
PubMed ID
22105457 View in PubMed
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Gender related differences in pain in spinal cord injured individuals.

https://arctichealth.org/en/permalink/ahliterature31106
Source
Spinal Cord. 2003 Feb;41(2):122-8
Publication Type
Article
Date
Feb-2003
Author
C. Norrbrink Budh
I. Lund
C. Hultling
R. Levi
L. Werhagen
P. Ertzgaard
T. Lundeberg
Author Affiliation
Spinalis SCI Unit, Karolinska Hospital and Faculty of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Source
Spinal Cord. 2003 Feb;41(2):122-8
Date
Feb-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Analgesics - therapeutic use
Chi-Square Distribution
Child
Chronic Disease
Female
Humans
Male
Middle Aged
Pain - epidemiology - etiology - prevention & control
Pain Measurement
Prevalence
Quality of Life
Research Support, Non-U.S. Gov't
Sex Factors
Spinal Cord Injuries - complications
Statistics, nonparametric
Sweden - epidemiology
Abstract
STUDY DESIGN: Out of a population of 456 patients with spinal cord injuries (SCI), 130 having pain were selected after matching, based on gender, age, American Spinal Injury Association (ASIA) impairment grade and level of lesion. OBJECTIVE: To investigate whether gender differences with regard to pain perception and prevalence exist in a population of patients following spinal cord injury. SETTING: Spinalis SCI Unit (out-patient clinic), Stockholm, Sweden. METHOD: 130 patients suffering from pain were assessed over a 12-month period in a yearly health control. RESULTS: SCI women had a higher prevalence of nociceptive pain than men and their use of analgesics was greater. However, no differences between the sexes could be seen regarding pain and localization, onset, distribution, factors affecting pain, number of painful body regions, pain descriptors, ratings of pain intensities or in pain and life satisfaction. CONCLUSION: This study showed that SCI men and women describe their pain very similarly. However, SCI women had a higher prevalence of nociceptive pain than men and their use of opiates and non-steroid anti-inflammatory drugs (NSAIDs) was greater.
PubMed ID
12595876 View in PubMed
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Medical complication in adults with spina bifida.

https://arctichealth.org/en/permalink/ahliterature118005
Source
Clin Neurol Neurosurg. 2013 Aug;115(8):1226-9
Publication Type
Article
Date
Aug-2013
Author
L. Werhagen
H. Gabrielsson
N. Westgren
K. Borg
Author Affiliation
Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institute at Danderyds Hospital, Stockholm, Sweden. lars.werhagen@ki.se
Source
Clin Neurol Neurosurg. 2013 Aug;115(8):1226-9
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adult
Blood Chemical Analysis
Blood Pressure - physiology
Cohort Studies
Diabetes Mellitus - epidemiology - etiology
Epilepsy - epidemiology - etiology
Female
Follow-Up Studies
Humans
Hydrocephalus - complications
Hypertension - epidemiology - etiology
Intellectual Disability - epidemiology - etiology
Male
Muscle Spasticity - epidemiology - etiology
Nervous System Diseases - epidemiology - therapy
Neuralgia - epidemiology - etiology
Neurologic Examination
Pressure Ulcer - epidemiology - etiology
Prevalence
Scoliosis - epidemiology - etiology
Spinal Dysraphism - complications - epidemiology
Sweden - epidemiology
Urinary Tract Infections - epidemiology - etiology
Abstract
Cohort study.
Spina bifida (SB) is a congenital malformation affecting the central nervous system (CNS) and is one of the most prevalent CNS disorders in children. Hydrocephalus (HC) is present in 80% of newborns with SB. The aim of the present study was to analyze the medical complications and to relate the complications to age at examination, the level of injury, AIS grade and presence of HC in adults with SB.
SB patients were recruited from the Spinalis out-patient clinic at the Karolinska University Hospital at their annual follow-up. The patients underwent a thorough general and neurological examination and background data including medical complications were retrieved from the medical files.
127 of 157 (82%) SB patients (114 with MMC and 13 SB occulta) with a mean age of 34 years were included. Half of the patients had a complete SCI and a lumbar level was most common. Nearly 60% of the patients had HC. 88 patients (69%) suffered from at least one medical complication. Urinary tract infection (UTI), scoliosis and pain were the most common complications found in 46%, 30% and 28% of the patients, respectively. Less common complications were epilepsy, pressure ulcers (PU) and spasticity.
SB gives a disability including motor, sensory dysfunctions and the patients suffer from a high frequency of medical complications like UTI, scoliosis, pain, and epilepsy. Data gives basis for adequate routines for medical examination at the follow-up.
PubMed ID
23245854 View in PubMed
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Neuropathic pain after traumatic spinal cord injury--relations to gender, spinal level, completeness, and age at the time of injury.

https://arctichealth.org/en/permalink/ahliterature30204
Source
Spinal Cord. 2004 Dec;42(12):665-73
Publication Type
Article
Date
Dec-2004
Author
L. Werhagen
C N Budh
C. Hultling
C. Molander
Author Affiliation
Spinalis/Karolinska Hospital, Stockholm, Sweden.
Source
Spinal Cord. 2004 Dec;42(12):665-73
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Child
Child, Preschool
Chronic Disease
Comparative Study
Confidence Intervals
Female
Follow-Up Studies
Humans
Incidence
Injury Severity Score
Logistic Models
Male
Middle Aged
Neuralgia - epidemiology - etiology
Odds Ratio
Pain Measurement
Paraplegia - physiopathology
Probability
Quadriplegia - physiopathology
Registries
Retrospective Studies
Risk assessment
Sex Distribution
Spinal Cord Injuries - complications - diagnosis
Abstract
STUDY DESIGN: Retrospective register study. OBJECTIVE: To investigate the predictive value of age at the time of injury, gender, level of injury, and completeness of injury for the development of at level and below level neuropathic pain. SETTING: "Spinalis", a postacute spinal cord injury (SCI) outpatient clinic, serving the greater Stockholm area (Sweden). METHOD: All patients who visited the clinic in 1995-2000 (402 patients) for the first time were examined. The following items were selected: at-level and below-level neuropathic pain according to the International Association for the Study of Pain (IASP) criteria, age at the time of injury, gender, level of injury according to ASIA, and completeness of injury. Mean time of 6 years after the injury. Results were analysed with chi(2) analysis and logistic regression. RESULTS: Of all patients examined, 13% had at level pain and 27% had below level pain. Neuropathic pain was less than half as frequent (26%) in the group aged less than 20 years at the time of injury as in the oldest group (58%). The increasing trend was mainly due to below-level pain up to 39 years of age, and due to at-level pain at ages 40 and above at the time of injury. No correlation was observed to gender, level of injury or completeness of injury, except for below level pain, which was associated with complete injury. CONCLUSION: The results show that neuropathic pain after SCI is common and occurs much more often in patients injured at higher ages. This indicates the importance of neuroanalgetic intervention, in particular for patients injured in higher ages.
PubMed ID
15289801 View in PubMed
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