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[Care of patients with spinal cord injuries. Rehabilitation results from different systems are reported].

https://arctichealth.org/en/permalink/ahliterature220845
Source
Lakartidningen. 1993 Jun 23;90(25):2365-8
Publication Type
Article
Date
Jun-23-1993
Author
M. Thyberg
J E Olsson
Author Affiliation
Universitetssjukhuset i Linköping.
Source
Lakartidningen. 1993 Jun 23;90(25):2365-8
Date
Jun-23-1993
Language
Swedish
Publication Type
Article
Keywords
Humans
Prognosis
Spinal Cord Injuries - complications - physiopathology - rehabilitation
Sweden
PubMed ID
8316016 View in PubMed
Less detail

The combined use of surgery and radiotherapy to treat patients with epidural cord compression due to metastatic disease: a cost-utility analysis.

https://arctichealth.org/en/permalink/ahliterature125207
Source
Neuro Oncol. 2012 May;14(5):631-40
Publication Type
Article
Date
May-2012
Author
Julio C Furlan
Kelvin K-W Chan
Guillermo A Sandoval
Kenneth C K Lam
Christopher A Klinger
Roy A Patchell
Audrey Laporte
Michael G Fehlings
Author Affiliation
Division of Genetics and Development, Toronto Western Research Institute, Krembil Neuroscience Centre, Spinal Program, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada M5T 2S8. jcfurlan@gmail.com
Source
Neuro Oncol. 2012 May;14(5):631-40
Date
May-2012
Language
English
Publication Type
Article
Keywords
Combined Modality Therapy
Computer simulation
Cost-Benefit Analysis
Decision Support Techniques
Epidural Neoplasms - economics - secondary - therapy
Health Care Costs
Humans
Long-Term Care
Monte Carlo Method
Neurosurgical Procedures - economics - utilization
Ontario
Prognosis
Quality-Adjusted Life Years
Radiotherapy - economics - utilization
Spinal Cord Compression - economics - therapy
Abstract
Neoplastic metastatic epidural spinal cord compression is a common complication of cancer that causes pain and progressive neurologic impairment. The previous standard treatment for this condition involved corticosteroids and radiotherapy (RT). Direct decompressive surgery with postoperative radiotherapy (S + RT) is now increasingly being chosen by clinicians to significantly improve patients' ability to walk and reduce their need for opioid analgesics and corticosteroids. A cost-utility analysis was conducted to compare S + RT with RT alone based on the landmark randomized clinical trial by Patchell et al. (2005). It was performed from the perspective of the Ontario Ministry of Health and Long-Term Care. Ontario-based costs were adjusted to 2010 US dollars. S + RT is more costly but also more effective than corticosteroids and RT alone, with an incremental cost-effectiveness ratio of US$250 307 per quality-adjusted life year (QALY) gained. First order probabilistic sensitivity analysis revealed that the probability of S + RT being cost-effective is 18.11%. The cost-effectiveness acceptability curve showed that there is a 91.11% probability of S + RT being cost-effective over RT alone at a willingness-to-pay of US$1 683 000 per QALY. In practice, the results of our study indicate that, by adopting the S + RT strategy, there would still be a chance of 18.11% of not paying extra at a willingness-to-pay of US$50 000 per QALY. Those results are sensitive to the costs of hospice palliative care. Our results suggest that adopting a standard S + RT approach for patients with MSCC is likely to increase health care costs but would result in improved outcomes.
Notes
Cites: Int J Radiat Oncol Biol Phys. 2006 Nov 15;66(4):1212-817145536
Cites: Br J Cancer. 2006 Feb 27;94(4):486-9116434993
Cites: N Engl J Med. 1992 Aug 27;327(9):614-91296600
Cites: JAMA. 1996 Oct 16;276(15):1253-88849754
Cites: JAMA. 1996 Oct 23-30;276(16):1339-418861994
Cites: Med Decis Making. 1997 Apr-Jun;17(2):126-359107607
Cites: Med Decis Making. 1997 Apr-Jun;17(2):136-419107608
Cites: Med Decis Making. 1997 Apr-Jun;17(2):152-99107610
Cites: J Clin Oncol. 1998 Apr;16(4):1613-249552073
Cites: Clin Neurosurg. 2004;51:43-715571124
Cites: Lancet Oncol. 2004 Dec;5(12):70915581539
Cites: Clin Oncol (R Coll Radiol). 2003 Jun;15(4):211-712846501
Cites: J Health Care Finance. 2003 Fall;30(1):41-812967243
Cites: J Oncol Manag. 2004 Mar-Apr;13(2):26-3015180115
Cites: J Clin Oncol. 2005 Mar 20;23(9):2028-3715774794
Cites: J Bone Joint Surg Am. 2005 Jun;87(6):1253-915930533
Cites: Lancet. 2005 Aug 20-26;366(9486):643-816112300
Cites: JAMA. 2008 Feb 27;299(8):937-4618314436
PubMed ID
22505658 View in PubMed
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Comparing patients with spinal cord infarction and cerebral infarction: clinical characteristics, and short-term outcome.

https://arctichealth.org/en/permalink/ahliterature131324
Source
Vasc Health Risk Manag. 2011;7:497-502
Publication Type
Article
Date
2011
Author
Halvor Naess
Fredrik Romi
Author Affiliation
Department of Neurology, Haukeland University Hospital, N-5021 Bergen, Norway. haln@haukeland.no
Source
Vasc Health Risk Manag. 2011;7:497-502
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cerebral Infarction - diagnosis - etiology - physiopathology - rehabilitation
Disability Evaluation
Female
Humans
Infarction - diagnosis - etiology - physiopathology - rehabilitation
Linear Models
Logistic Models
Male
Middle Aged
Norway
Odds Ratio
Patient Discharge
Prognosis
Recovery of Function
Retrospective Studies
Risk assessment
Risk factors
Spinal Cord - blood supply
Time Factors
Abstract
To compare the clinical characteristics, and short-term outcome of spinal cord infarction and cerebral infarction.
Risk factors, concomitant diseases, neurological deficits on admission, and short-term outcome were registered among 28 patients with spinal cord infarction and 1075 patients with cerebral infarction admitted to the Department of Neurology, Haukeland University Hospital, Bergen, Norway. Multivariate analyses were performed with location of stroke (cord or brain), neurological deficits on admission, and short-term outcome (both Barthel Index [BI] 1 week after symptom onset and discharge home or to other institution) as dependent variables.
Multivariate analysis showed that patients with spinal cord infarction were younger, more often female, and less afflicted by hypertension and cardiac disease than patients with cerebral infarction. Functional score (BI) was lower among patients with spinal cord infarctions 1 week after onset of symptoms (P
Notes
Cites: Radiology. 2010 Jun;255(3):873-8120501724
Cites: J Thorac Cardiovasc Surg. 2010 Dec;140(6 Suppl):S154-60; discussion S185-S19021092785
Cites: Surg Radiol Anat. 2011 Jan;33(1):3-920589376
Cites: Eur J Neurol. 2011 Feb;18(2):232-920402756
Cites: Stroke. 2001 Dec 1;32(12):2735-4011739965
Cites: Medicine (Baltimore). 1989 Sep;68(5):282-922677596
Cites: J Neurol Neurosurg Psychiatry. 1994 Feb;57(2):202-78126506
Cites: Lancet. 1994 Jul 16;344(8916):156-97912765
Cites: Stroke. 1995 Jan;26(1):46-517839396
Cites: AJNR Am J Neuroradiol. 2006 Jan;27(1):35-916418352
Cites: Arch Neurol. 2006 Aug;63(8):1113-2016908737
Cites: Cerebrovasc Dis. 2008;26(5):502-818810237
Cites: J Neurol Neurosurg Psychiatry. 2008 Dec;79(12):1344-818586864
PubMed ID
21915166 View in PubMed
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Complete sensorimotor paralysis after cord injury: mortality, recovery, and therapeutic implications.

https://arctichealth.org/en/permalink/ahliterature246693
Source
J Trauma. 1979 Nov;19(11):837-40
Publication Type
Article
Date
Nov-1979
Author
T B Ducker
G L Russo
R. Bellegarrique
J T Lucas
Source
J Trauma. 1979 Nov;19(11):837-40
Date
Nov-1979
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Canada
Cervical Vertebrae - injuries
Fractures, Bone - complications - mortality - therapy
Humans
Male
Middle Aged
Paralysis - etiology
Prognosis
Spinal Cord Injuries - complications - mortality - therapy
United States
Abstract
In 273 completely paralyzed cord injured patients, the 1-year mortality was 34% in the patients with cervical fractures and 7% in the patients with thoracic and thoracolumbar fractures. Recovery of useful motor function return occurred in 6.7% of the cervical and 11% of the thoracic and thoracolumbar patients; only 1% of the patient population became completely normal. No specific treatment could be singled out as aiding recovery. A case with recovery from complete paralysis after C5--6 fracture-dislocation is presented.
PubMed ID
513170 View in PubMed
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Complications in acute phase hospitalization of traumatic spinal cord injury: does surgical timing matter?

https://arctichealth.org/en/permalink/ahliterature116181
Source
J Trauma Acute Care Surg. 2013 Mar;74(3):849-54
Publication Type
Article
Date
Mar-2013
Author
Étienne Bourassa-Moreau
Jean-Marc Mac-Thiong
Debbie Ehrmann Feldman
Cynthia Thompson
Stefan Parent
Author Affiliation
Faculty of Medicine, University of Montreal, Montreal, Canada. etienne.bourassamoreau@gmail.com
Source
J Trauma Acute Care Surg. 2013 Mar;74(3):849-54
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Adult
Cervical Vertebrae - injuries - surgery
Decompression, Surgical - methods
Female
Hospitalization - statistics & numerical data
Humans
Incidence
Injury Severity Score
Male
Middle Aged
Pneumonia - epidemiology - etiology
Prognosis
Quebec - epidemiology
Retrospective Studies
Spinal Cord Injuries - complications - diagnosis - surgery
Time Factors
Treatment Outcome
Abstract
Optimal timing of surgery after a traumatic spinal cord injury (SCI) is one of the most controversial subjects in spine surgery. We assessed the relationship between surgical timing and the occurrence of nonneurologic postoperative complications during acute hospital stay for patients with a traumatic SCI.
A retrospective cohort study was performed in a single institution. Four hundred thirty-one cases of traumatic SCI were reviewed, and postoperative complications were recorded from the medical charts. Patients were compared using two different surgical timing cutoffs (24 hours and 72 hours). Logistic regression analyses were modeled for complication occurrence. The effect of surgical timing on complication rate was adjusted for potential confounding variables such as the level of injury, American Spinal Injury Association (ASIA) grade, Injury Severity Score (ISS), age, sex, Charlson Comorbidity Index, and Surgical Invasiveness Index.
Patients operated on earlier were younger, had less comorbidity, had a higher ISS, and were more likely to have a cervical lesion and a complete injury (ASIA A). A reduction in the global rate of complications as well as in the rate of pneumonias and pressure ulcers were predicted by surgery performed earlier than 72 hours and 24 hours. Increasing age, more severe ASIA grade, and cervical lesion as well as increased Charlson Comorbidity Index, ISS, and SII were also statistically related to the occurrence of complications.
This study showed that a shorter surgical delay after a traumatic SCI decreases the rate of complications during the acute phase hospitalization. We suggest that patients with traumatic SCI should be promptly operated on earlier than 24 hours following the injury to reduce complications while optimizing neurologic recovery. If medical or practical reasons preclude timing less than 24 hours, efforts should still be made to perform surgery earlier than 72 hours following the SCI.
Prognostic study, level III; therapeutic/care management study, level IV.
PubMed ID
23425747 View in PubMed
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Contribution of nonspinal comorbidity to low back pain outcomes.

https://arctichealth.org/en/permalink/ahliterature166932
Source
Clin J Pain. 2006 Nov-Dec;22(9):765-9
Publication Type
Article
Author
Greg McIntosh
Hamilton Hall
Christina Boyle
Author Affiliation
CBI Health (Canadian Back Institute) Research Department, University of Toronto, Toronto, Ontario, Canada. gmcintosh@cbi.ca
Source
Clin J Pain. 2006 Nov-Dec;22(9):765-9
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Canada - epidemiology
Comorbidity
Female
Humans
Incidence
Low Back Pain - diagnosis - epidemiology - therapy
Male
Middle Aged
Outcome Assessment (Health Care) - methods
Prognosis
Risk Assessment - methods
Risk factors
Sex Distribution
Spinal Cord Injuries - diagnosis - epidemiology - therapy
Treatment Outcome
Abstract
To determine the involvement of comorbidity to outcomes in a cohort of acute mechanical low back pain patients.
Incident low back pain cases (n=7077) in the acute or subacute phase assessed between January 1, 1999 and December 31, 2001 were included. Patients were categorized into 1 of 2 groups on the basis of their current medical history: (1) those with at least 1 of 7 medical histories considered (Comorbidity Group, n=539), or (2) those with only low back pain (Back Pain Group, n=6538). Main outcome measures were: change in perceived function and visual analog scale (VAS) pain rating from initial assessment to discharge, and total number of treatment days.
There were no baseline statistically significant differences in VAS pain rating, questionnaire score, or symptom duration between groups. Odds ratios (ORs) were adjusted to reflect age and sex differences between groups. Logistic regression analysis revealed no statistically significant difference for change in functional score (OR=1.002) between groups; there were marginal differences in change in VAS pain rating (OR=1.08) and total number of treatment days (OR=1.006). chi analysis revealed no statistically significant differences in medication use, global pain rating, or pain control ability posttreatment, between groups.
Significant ORs were barely greater than 1.00 and were likely the result of the large sample size. The clinical course for comorbid patients, who may seem more complicated at the start of treatment, is just as favorable.
PubMed ID
17057557 View in PubMed
Less detail

Current coronary heart disease risk assessment tools may underestimate risk in community-dwelling persons with chronic spinal cord injury.

https://arctichealth.org/en/permalink/ahliterature158319
Source
Spinal Cord. 2008 Sep;46(9):608-15
Publication Type
Article
Date
Sep-2008
Author
A K Finnie
A C Buchholz
K A Martin Ginis
Author Affiliation
Department of Family Relations and Applied Human Nutrition, University of Guelph, Guelph, Ontario, Canada.
Source
Spinal Cord. 2008 Sep;46(9):608-15
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Chronic Disease
Comorbidity
Coronary Disease - diagnosis - epidemiology
Data Collection
Female
Humans
Hyperglycemia - blood - diagnosis - epidemiology
Hyperlipidemias - blood - diagnosis - epidemiology
Male
Mass Screening - methods
Metabolic Syndrome X - blood - diagnosis - epidemiology
Middle Aged
Ontario
Predictive value of tests
Prevalence
Prognosis
Reproducibility of Results
Risk Assessment - methods
Spinal Cord Injuries - epidemiology - physiopathology
Abstract
Cross-sectional, observational study.
To quantify, in adults with chronic spinal cord injury (SCI): (1) presence of metabolic syndrome versus the general North American population (GP) and (2) 10-year coronary heart disease (CHD) risk using Framingham risk scoring (FRS).
Ontario, Canada.
Fasting anthropometric and biochemical data were collected from 75 adults with chronic SCI. Metabolic syndrome was determined using four internationally recognized definitions and FRS using the most recent (2001) algorithm.
Prevalence of metabolic syndrome was up to 5.4 times lower in SCI participants compared to GP, and FRS categorized 3.1% of participants as being at high 10-year CHD risk. However, high-sensitivity C-reactive protein (CRP) values indicated 36.7% of participants as being at high CHD risk.
Current metabolic syndrome definitions and FRS may underestimate true CHD risk in people with SCI. Tools that better identify CHD risk require validation in the SCI population. CRP may be a potential factor to consider in the development of SCI-specific screening tools.
PubMed ID
18332887 View in PubMed
Less detail

[Diagnosis and treatment of spinal cord tumors].

https://arctichealth.org/en/permalink/ahliterature216069
Source
Duodecim. 1995;111(21):2071-7
Publication Type
Article
Date
1995
Author
M. Seppälä
Author Affiliation
HYKS:n neurokirurgian klinikka, Helsinki.
Source
Duodecim. 1995;111(21):2071-7
Date
1995
Language
Finnish
Publication Type
Article
Keywords
Finland
Humans
Meningioma - diagnosis - therapy
Neurilemmoma - diagnosis - therapy
Neurosurgical Procedures - methods
Prognosis
Radiotherapy
Spinal Cord Neoplasms - diagnosis - therapy
PubMed ID
9841165 View in PubMed
Less detail

Ependymoma: a follow-up study of 101 cases.

https://arctichealth.org/en/permalink/ahliterature27684
Source
Cancer. 1977 Aug;40(2):907-15
Publication Type
Article
Date
Aug-1977
Author
S J Mork
A C Loken
Source
Cancer. 1977 Aug;40(2):907-15
Date
Aug-1977
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Brain Neoplasms - pathology - therapy
Child
Child, Preschool
Ependymoma - pathology - therapy
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Middle Aged
Norway
Prognosis
Sex Factors
Spinal Cord Neoplasms - pathology - therapy
Abstract
One hundred and one patients with histologically confirmed ependymomas were studied over a 22-year period. Choroid plexus papilloma and sub-ependymoma were not included. About half of the tumors were intracranial, with the majority of these infratentorial. The intraspinal tumors were equally divided between intramedullary and the "cauda" group. The majority of the intracranial tumors occurred in children, while almost all the intraspinal tumors were in adults. The histologic classification consisted of "typical ependymoma" (cellular, papillary and myxopapillary patterns) and "anaplastic ependymoma". The intracranial and intramedullary tumors showed a predominantly cellular pattern, while the myxopapillary type was found only in the "cauda" group. The histology seems to be of limited value in assessing the prognosis in an individual patient with ependymoma. The postoperative prognosis was poor in the intracranial tumors, although radiotherapy increased the survival time without affecting the eventual fatal outcome. The prognosis in the intraspinal group was much better, with three-fourths of the patients living for at least 10 years. No patient with an anaplastic tumor survived for more than 6 years.
PubMed ID
890671 View in PubMed
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Epidemiology and prognosis of acute myelitis in Southern Finland.

https://arctichealth.org/en/permalink/ahliterature206716
Source
J Neurol Sci. 1997 Nov 25;152(2):140-6
Publication Type
Article
Date
Nov-25-1997
Author
M. Färkkilä
T. Tiainen
M. Koskiniemi
Author Affiliation
Department of Neurology, University of Helsinki, Finland.
Source
J Neurol Sci. 1997 Nov 25;152(2):140-6
Date
Nov-25-1997
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Aged
Diagnosis, Differential
Finland - epidemiology
Follow-Up Studies
Humans
Incidence
Middle Aged
Myelitis - diagnosis - epidemiology - physiopathology
Prognosis
Spinal Cord - radiography
Abstract
In this study we analyzed all acute adult (>15 years) myelitis cases in the province of Uusimaa in Southern Finland during the years 1981-1993. Only cases with acute infectious myelitis were included. Demyelinating diseases, and medullopaties due to degeneration, traumatic, toxic, hereditary, nutritional or metabolic causes were excluded. A total of 45 patients fulfilled the criteria. The mean incidence was 3.5 cases/million inhabitants/year. The mean latency time from the initial infection to the beginning of neurological symptoms was 11 days. Motor paraparesis was found in 62% and tetraparesis in 13%. Sensory symptoms were found in 82% and bowel disturbances were experienced by 71% of patients. Normal cerebrospinal fluid (CSF) leukocytes were seen in 18% of patients, and CSF protein was elevated in 70% of patients. Case fatality was 6.7%. Permanent care in hospital needed by 13% of patients, and after 24 months 88% were ambulatory. Prognosis is quite good in myelitis, and normal CSF leukocytes do not exclude myelitis.
PubMed ID
9415534 View in PubMed
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27 records – page 1 of 3.