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Advances in management of neurosurgical trauma: USA and Canada.

https://arctichealth.org/en/permalink/ahliterature193146
Source
World J Surg. 2001 Sep;25(9):1179-85
Publication Type
Article
Date
Sep-2001
Author
D F Kelly
D P Becker
Author Affiliation
Division of Neurosurgery, UCLA School of Medicine, Box 957039, Room 18-218 NPI, Los Angeles, California 90095-7039, USA. dfkelly@ucla.edu
Source
World J Surg. 2001 Sep;25(9):1179-85
Date
Sep-2001
Language
English
Publication Type
Article
Keywords
Brain Injuries - mortality - prevention & control - surgery
Canada
Humans
Neurosurgical Procedures - standards - trends
Patient Education as Topic
Spinal Cord Injuries - mortality - prevention & control - surgery
United States
Abstract
Traumatic brain and spinal cord injuries continue to pose serious challenges for physicians around the world. In North America, the annual number of serious head and spinal injuries has decreased over the last two decades, and of those patients who reach a hospital, the mortality and long-term morbidity have also declined. The two major reasons for this reduction in death and disability after craniospinal trauma in the United States and Canada appear to be (1) widespread implementation of prevention measures, safety legislation, and public education initiatives; and (2) further improvements in and wider availability of emergency medical systems and regional trauma centers. Improvements in neurocritical care and the implementation of evidence-based treatment guidelines for severe head injury victims may also, in part, be responsible for improved survival rates and reduced disability rates. Unfortunately, numerous clinical trials of putative neuroprotective agents conducted in North America and elsewhere during the 1990s have failed to demonstrate efficacy in head-injured patients. However, methylprednisolone does appear to confer some benefit to a select population of spinal cord injury patients. These advances in the areas of prevention, regional trauma systems, treatment guidelines, and neurocritical care that have influenced survival rates and recovery of function are discussed.
PubMed ID
11571956 View in PubMed
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Aerobic capacity, orthostatic tolerance, and exercise perceptions at discharge from inpatient spinal cord injury rehabilitation.

https://arctichealth.org/en/permalink/ahliterature113262
Source
Arch Phys Med Rehabil. 2013 Oct;94(10):2013-9
Publication Type
Article
Date
Oct-2013
Author
Chelsea A Pelletier
Graham Jones
Amy E Latimer-Cheung
Darren E Warburton
Audrey L Hicks
Author Affiliation
Department of Kinesiology, McMaster University, Hamilton, ON.
Source
Arch Phys Med Rehabil. 2013 Oct;94(10):2013-9
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Adult
Blood pressure
Body mass index
Canada
Cross-Sectional Studies
Exercise - psychology
Exercise Tolerance
Female
Heart rate
Humans
Hypotension, Orthostatic - physiopathology
Male
Middle Aged
Oxygen consumption
Paraplegia - etiology - physiopathology - psychology
Self Efficacy
Spinal Cord Injuries - complications
Trauma Severity Indices
Abstract
To describe physical capacity, autonomic function, and perceptions of exercise among adults with subacute spinal cord injury (SCI).
Cross-sectional.
Two inpatient SCI rehabilitation programs in Canada.
Participants (N=41; mean age ± SD, 38.9 ± 13.7y) with tetraplegia (TP; n=19), high paraplegia (HP; n=8), or low paraplegia (LP; n=14) completing inpatient SCI rehabilitation (mean ± SD, 112.9 ± 52.5d postinjury).
Not applicable.
Peak exercise capacity was determined by an arm ergometry test. As a measure of autonomic function, orthostatic tolerance was assessed by a passive sit-up test. Self-efficacy for exercise postdischarge was evaluated by a questionnaire.
There was a significant difference in peak oxygen consumption and heart rate between participants with TP (11.2 ± 3.4;mL·kg(-1)·min(-1) 113.9 ± 19.7 beats/min) and LP (17.1 ± 7.5 mL·kg(-1)·min(-1); 142.8 ± 22.7 beats/min). Peak power output was also significantly lower in the TP group (30.0 ± 6.9W) compared with the HP (55.5 ± 7.56W) and LP groups (62.5 ± 12.2W). Systolic blood pressure responses to the postural challenge varied significantly between groups (-3.0 ± 33.5 mmHg in TP, 17.8 ± 14.7 mmHg in HP, 21.6 ± 18.7 mmHg in LP). Orthostatic hypotension was most prevalent among participants with motor complete TP (73%). Results from the questionnaire revealed that although participants value exercise and see benefits to regular participation, they have low confidence in their abilities to perform the task of either aerobic or strengthening exercise.
Exercise is well tolerated in adults with subacute SCI. Exercise interventions at this stage should focus on improving task-specific self-efficacy, and attention should be made to blood pressure regulation, particularly in individuals with motor complete TP.
PubMed ID
23747647 View in PubMed
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Aging with a spinal cord injury: factors associated with the need for more help with activities of daily living.

https://arctichealth.org/en/permalink/ahliterature178069
Source
Arch Phys Med Rehabil. 2004 Oct;85(10):1567-77
Publication Type
Article
Date
Oct-2004
Author
Nathania R Liem
Mary Ann McColl
Will King
Karen M Smith
Author Affiliation
Division of Physical Medicine and Rehabilitation, University of Ottawa, Ottawa, ON, Canada. n_liem@tricolour.queensu.ca
Source
Arch Phys Med Rehabil. 2004 Oct;85(10):1567-77
Date
Oct-2004
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Age Factors
Aging - physiology
Canada
Constipation - etiology
Cross-Sectional Studies
Diarrhea - etiology
England
Female
Health services needs and demand
Humans
Male
Middle Aged
Multivariate Analysis
Pressure Ulcer - etiology
Sampling Studies
Sex Factors
Spinal Cord Injuries - complications - physiopathology - rehabilitation
Time Factors
United States
Abstract
To determine (1) the frequency of the need for more help with activities of daily living (ADLs), (2) the frequency of medical complications, and (3) the association between medical, injury-related, and sociodemographic factors and the need for more help with ADLs among those aging with spinal cord injury (SCI).
Cross-sectional survey.
General community, international.
Volunteers (N=352) with SCI for more than 20 years.
Not applicable.
The need for more help with ADLs.
The need for more help with ADLs during the last 3 years was reported by 32.1% of participants. At least 1 medical complication was reported by 85%. Constipation (47.9%), diarrhea/bowel accidents (41.8%), and pressure ulcers (38.7%) were common. Constipation, pressure ulcers, female gender, and years postinjury were associated with needing more help with ADLs. Constipation and pressure ulcers were associated with a 97% and a 76% increase, respectively, in the likelihood of needing more help with ADLs during a 3-year time period. Female gender was associated with a 96% increased odds of needing more help with ADLs. There was a 42% increased odds of needing more help with ADLs per decade after SCI.
People aging with SCI are vulnerable to medical complications, and additional help is required to function. Knowledge of the effect of these factors, particularly the tetrad of constipation, pressure ulcers, female gender, and number of years postinjury, should increase awareness that more help with ADLs may be needed over time.
PubMed ID
15468013 View in PubMed
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Association of myelopathy scores with cervical sagittal balance and normalized spinal cord volume: analysis of 56 preoperative cases from the AOSpine North America Myelopathy study.

https://arctichealth.org/en/permalink/ahliterature107913
Source
Spine (Phila Pa 1976). 2013 Oct 15;38(22 Suppl 1):S161-70
Publication Type
Article
Date
Oct-15-2013
Author
Justin S Smith
Virginie Lafage
Devon J Ryan
Christopher I Shaffrey
Frank J Schwab
Alpesh A Patel
Darrel S Brodke
Paul M Arnold
K Daniel Riew
Vincent C Traynelis
Kris Radcliff
Alexander R Vaccaro
Michael G Fehlings
Christopher P Ames
Author Affiliation
*Department of Neurosurgery, University of Virginia, Charlottesville †Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York ‡Department of Orthopaedic Surgery, Northwestern University, Chicago, IL §Department of Orthopaedic Surgery, University of Utah, Salt Lake City ¶Department of Neurosurgery, University of Kansas, Kansas City ?Department of Orthopaedic Surgery, Washington University, St Louis, MO **Department of Neurosurgery, Rush Medical Center, Chicago, IL ††Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA ‡‡Division of Neurosurgery and Spinal Program, University of Toronto, Toronto, Ontario, Canada; and §§Department of Neurological Surgery, University of California, San Francisco.
Source
Spine (Phila Pa 1976). 2013 Oct 15;38(22 Suppl 1):S161-70
Date
Oct-15-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada
Cervical Vertebrae - radiography - surgery
Female
Humans
Kyphosis - radiography - surgery
Magnetic Resonance Imaging - methods
Male
Middle Aged
Preoperative Period
Prospective Studies
Quality of Life
Spinal Cord - radiography - surgery
Spinal Cord Diseases - radiography - surgery
Spondylosis - radiography - surgery
Treatment Outcome
United States
Abstract
Post hoc analysis of prospectively collected data.
Development of methods to determine in vivo spinal cord dimensions and application to correlate preoperative alignment, myelopathy, and health-related quality-of-life scores in patients with cervical spondylotic myelopathy (CSM).
CSM is the leading cause of spinal cord dysfunction. The association between cervical alignment, sagittal balance, and myelopathy has not been well characterized.
This was a post hoc analysis of the prospective, multicenter AOSpine North America CSM study. Inclusion criteria for this study required preoperative cervical magnetic resonance imaging (MRI) and neutral sagittal cervical radiography. Techniques for MRI assessment of spinal cord dimensions were developed. Correlations between imaging and health-related quality-of-life scores were assessed.
Fifty-six patients met inclusion criteria (mean age = 55.4 yr). The modified Japanese Orthopedic Association (mJOA) scores correlated with C2-C7 sagittal vertical axis (SVA) (r = -0.282, P = 0.035). Spinal cord volume correlated with cord length (r = 0.472, P
PubMed ID
23963001 View in PubMed
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Awareness and use of advance directives in the spinal cord injured population (Spinal Cord 2002; 40: 581-594).

https://arctichealth.org/en/permalink/ahliterature181642
Source
Spinal Cord. 2004 Feb;42(2):132; author reply 133
Publication Type
Article
Date
Feb-2004

Canadian C-spine Rule and the National Emergency X-Radiography Utilization Low-Risk Criteria for C-spine radiography in young trauma patients.

https://arctichealth.org/en/permalink/ahliterature151052
Source
J Pediatr Surg. 2009 May;44(5):987-91
Publication Type
Article
Date
May-2009
Author
Peter F Ehrlich
Christopher Wee
Robert Drongowski
Ankur R Rana
Author Affiliation
Department of Surgery, Section of Pediatric Surgery, The University of Michigan Medical School and The CS Mott Children's Hospital, Ann Arbor, MI 48109, USA. pehrlich@med.umich.edu
Source
J Pediatr Surg. 2009 May;44(5):987-91
Date
May-2009
Language
English
Publication Type
Article
Keywords
Age Factors
Canada
Case-Control Studies
Cervical Vertebrae - injuries - radiography
Child
Child, Preschool
Cohort Studies
Decision Support Techniques
Diagnostic Errors - prevention & control
Emergencies
Humans
Infant
Neck Injuries - radiography
Radiography - standards - utilization
Retrospective Studies
Risk
Sensitivity and specificity
Spinal Cord Injuries - radiography
Spinal Fractures - radiography
Unnecessary Procedures
Abstract
The Canadian C-spine (cervical spine) Rule (CCR) and the National Emergency X-Radiography Utilization Low-Risk Criteria (NLC) are criteria designed to guide C-spine radiography in trauma patients. It is unclear how these 2 rules compare with young children.
This study retrospectively examined case-matched trauma patients 10 years or younger. Two cohorts were identified-cohort A where C-spine imaging was performed and cohort B where no imaging was conducted. The CCR and NLC criteria were then applied retrospectively to each cohort.
Cohort A contained 125 cases and cohort B with 250 cases. Seven patients (3%) had significant C-spine injuries. In cohort A, NLC criteria could be applied in 108 (86.4%) of 125 and CCR in 109 (87.2%) of 125. National Emergency X-Radiography Utilization Low-Risk Criteria suggested that 70 (58.3%) cases required C-spine imaging compared to 93 (76.2%) by CCR. National Emergency X-Radiography Utilization Low-Risk Criteria missed 3 C-spine injuries, and CCR missed one. In cohort B, NLC criteria could be applied in 132 (88%) of 150 and CCR in 131 (87.3%) of 150. The NLC criteria identified 8 cases and CCR identified 13 cases that would need C-spine radiographs. Fisher's 2-sided Exact test demonstrated that CCR and NLC predictions were significantly different (P = .002) in both cohorts. The sensitivity of CCR was 86% and specificity was 94%, and the NLC had a sensitivity of 43% and a specificity of 96%.
Although CCR and NLC criteria may reduce the need for C-spine imaging in children 10 years and younger; they are not sensitive or specific enough to be used as currently designed.
PubMed ID
19433184 View in PubMed
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The Canadian revolution in the management of spinal cord injury.

https://arctichealth.org/en/permalink/ahliterature216040
Source
Can Bull Med Hist. 1995;12(1):125-55
Publication Type
Article
Date
1995
Author
M. Tremblay
Author Affiliation
School of Occupational Therapy and Physiotherapy, McMaster University, Hamilton, Ontario.
Source
Can Bull Med Hist. 1995;12(1):125-55
Date
1995
Language
English
Publication Type
Article
Keywords
Canada
History, 20th Century
Humans
Military Medicine
Rehabilitation
Spinal Cord
War
Wounds and Injuries
Abstract
During World War II new programs for medical treatment and rehabilitation reduced mortality rates following spinal cord injury from over 80 percent in World War I to below 10 percent by 1946. In Canada a group of physicians, veterans, and civilians developed one of the first comprehensive sets of programs and services to permit the return of veterans with spinal cord injury to independent life in the community, beyond the confines of hospitals or paraplegic colonies. This article reviews the activities of Dr. E. Harry Botterell, Lieutenant John Counsell, and Dr. Al Jousse in the development of a Canadian approach that revolutionized the life experiences and life expectancy of individuals with spinal cord injury. It describes the development of their philosophy of rehabilitation as well as the programs and services they established at the No. 1 Canadian Neurological Hospital in England, and at Christie Street Military Hospital, Lyndhurst Lodge, and the Canadian Paraplegic Association in Canada.
PubMed ID
11609092 View in PubMed
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Canadian Spine Society. Lifetime achievement award. Charles H. Tator.

https://arctichealth.org/en/permalink/ahliterature185889
Source
Can J Surg. 2003 Apr;46 Suppl:2-5
Publication Type
Article
Date
Apr-2003

Client-centred assessment and the identification of meaningful treatment goals for individuals with a spinal cord injury.

https://arctichealth.org/en/permalink/ahliterature181319
Source
Spinal Cord. 2004 May;42(5):302-7
Publication Type
Article
Date
May-2004
Author
C. Donnelly
J J Eng
J. Hall
L. Alford
R. Giachino
K. Norton
D S Kerr
Author Affiliation
Rehabilitation Research Laboratory, GF Strong Rehab Centre, and School of Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada.
Source
Spinal Cord. 2004 May;42(5):302-7
Date
May-2004
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Adolescent
Adult
Aged
Aged, 80 and over
Canada
Disability Evaluation
Female
Goals
Humans
Leisure Activities - psychology
Male
Middle Aged
Outcome Assessment (Health Care)
Patient Satisfaction - statistics & numerical data
Quality of Life - psychology
Retrospective Studies
Self Care - statistics & numerical data
Sickness Impact Profile
Spinal Cord Injuries - psychology - rehabilitation
Treatment Outcome
Abstract
Retrospective analysis.
(1) Describe the self-care, productivity and leisure problems identified by individuals with a spinal cord injury (SCI) during rehabilitation, (2) describe the perceived level of satisfaction and performance with self-care, productivity and leisure activities following an SCI, (3) quantify the relationship between the Canadian occupational performance measure (COPM), a client-centred, individualized measure of function, and the functional independence measure (FIM).
Tertiary rehabilitation centre, spinal cord injury unit, GF Strong Rehabilitation Centre, Vancouver, Canada.
Health records from 41 individuals with an SCI admitted between 2000 and 2002 were reviewed. Information was obtained from assessments performed on admission and discharge. Self-care, productivity and leisure problems identified by individuals with an SCI were described and their perceived level of performance and satisfaction was calculated. The relationship between the COPM and the FIM was measured by the Pearson product correlation.
Self-care goals were identified most frequently (79%) followed by productivity (12%) and leisure (9%) goals. The top three problems identified by individuals with an SCI were functional mobility (including transfers and wheelchair use), dressing and grooming. A fair relationship was found between the COPM and the FIM (r between 0.351 and 0.514, P
Notes
Cites: J Rehabil Res Dev. 2001 Nov-Dec;38(6):655-6011767973
Cites: Lancet. 2002 Feb 2;359(9304):417-2511844532
Cites: J Rehabil Med. 2002 Jan;34(1):5-1111900262
Cites: Can J Occup Ther. 2002 Apr;69(2):84-9411977872
Cites: Spinal Cord. 2003 Jan;41(1):44-5212494320
Cites: Adv Clin Rehabil. 1987;1:6-183503663
Cites: Am J Occup Ther. 1993 Apr;47(4):298-3018322870
Cites: Phys Ther. 1994 Jul;74(7):614-28; discussion 628-98016194
Cites: Can J Occup Ther. 1994 Oct;61(4):191-710137673
Cites: Scand J Rehabil Med. 1994 Sep;26(3):115-97801060
Cites: Am J Occup Ther. 1995 Mar;49(3):214-207741154
Cites: Am J Occup Ther. 1995 May;49(5):428-367598158
Cites: Spinal Cord. 1996 Sep;34(9):531-58883187
Cites: Int J Rehabil Res. 1997 Sep;20(3):303-139331579
Cites: Md State Med J. 1965 Feb;14:61-514258950
Cites: Arch Phys Med Rehabil. 1999 Nov;80(11):1471-610569443
PubMed ID
14993893 View in PubMed
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87 records – page 1 of 9.