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Bowel management for spinal patient

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https://www.readbyqxmd.com/read/27676766/peer-supported-self-management-to-facilitate-community-re-entry-after-discharge-from-spinal-cord-injury-rehabilitation-engaging-peers-as-change-agents-and-research-partners
#1
Michael Jones, Julie Gassaway
OBJECTIVE: Peer support is an important adjunct to clinical care for people with disabilities, and may help address barriers to community reintegration. Peers offer positive role models and the benefit of learning from shared experiences of living with disability. Despite potential benefits, peer support is not consistently integrated in the rehabilitation process. This presentation describes three interventions recommended by patients, and directed by peer mentors, to promote successful community transition after rehabilitation for traumatic spinal cord injury (SCI)...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27672641/small-bowel-entrapment-and-ureteropelvic-junction-disruption-associated-with-l3-chance-fracture-dislocation
#2
Sebastien Pesenti, Benjamin Blondel, Alice Faure, Emilie Peltier, Franck Launay, Jean-Luc Jouve
Paediatric Chance fracture are rare lesions but often associated with abdominal injuries. We herein present the case of a seven years old patient who sustained an entrapment of small bowel and an ureteropelvic disruption associated with a Chance fracture and spine dislocation following a traffic accident. Initial X-rays and computed tomographic (CT) scan showed a Chance fracture with dislocation of L3 vertebra, with an incarceration of a small bowel loop in the spinal canal and a complete section of the left lumbar ureter...
September 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27614337/strangulated-transmesosigmoid-hernia-as-a-late-complication-of-a-fall-from-a-height-a-case-report
#3
Shigehiro Kojima, Tsuguo Sakamoto, Masayuki Honda, Dal Ho Kim
INTRODUCTION: A transmesosigmoid hernia is defined as small bowel herniation through a complete defect involving both layers of the sigmoid mesentery. Blunt trauma injury to the sigmoid mesocolon has been reported only rarely. We herein report a case of a strangulated transmesosigmoid hernia associated with a history of a fall from a height. PRESENTATION OF CASE: A 43-year-old woman presented to our hospital for evaluation of vomiting. She had no history of abdominal surgery but had sustained a complete spinal cord injury and pelvic fracture secondary to a fall from a height 25 years earlier...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27544957/care-of-spinal-cord-injury-in-non-specialist-settings
#4
REVIEW
Sian Rodger
Patient with spinal cord injuries have individualised care routines to help prevent complications. Disruption to these routines following admission to non-specialist settings can have long-term consequences. This article focuses on the key long-term problems of pressure ulcers, bladder and bowel dysfunction, and autonomic dysreflexia. Nurses working on general wards need to consider how to manage these problems when caring for patients with spinal cord injury.
June 29, 2016: Nursing Times
https://www.readbyqxmd.com/read/27527239/outcomes-after-acute-traumatic-spinal-cord-injury-in-botswana-from-admission-to-discharge
#5
I Löfvenmark, M Hasselberg, L Nilsson Wikmar, C Hultling, C Norrbrink
STUDY DESIGN: Prospective follow-up study. OBJECTIVES: To increase the knowledge regarding clinical and functional outcomes after traumatic spinal cord injuries (TSCI) in a resource-constrained setting. A special focus was placed on secondary complications such as pressure ulcers. SETTING: The national referral hospital in Gaborone, Botswana. METHODS: The study included all patients admitted with an acute TSCI during a 2-year period (n=39)...
August 16, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27448173/spinal-cord-anomalies-in-patients-with-anorectal-malformations-without-severe-sacral-abnormalities-or-meningomyelocele-outcomes-after-expectant-conservative-management
#6
Kristiina Kyrklund, Mikko P Pakarinen, Seppo Taskinen, Reetta Kivisaari, Risto J Rintala
OBJECTIVE The goal of this study was to determine the significance of spinal cord anomalies (SCAs) in patients with anorectal malformations (ARMs) by comparing the outcomes for bowel function, lower urinary tract symptoms (LUTS), and lower-limb neurological abnormalities to these outcomes in patients with similar ARMs and a normal spinal cord. METHODS The spinal cord MRI records of female patients treated for vestibular and perineal fistula (VF/PF) and male patients with rectourethral fistula (RUF) at a single center between 1983 and 2006 were reviewed...
December 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27372296/anorectal-malformations-associated-spinal-cord-anomalies
#7
Giorgia Totonelli, Francesco Morini, Vincenzo Davide Catania, Paolo Maria Schingo, Giovanni Mosiello, Paolo Palma, Barbara Daniela Iacobelli, Pietro Bagolan
PURPOSE: The present study aims to identify clinical and pathological factors that can predict the risk of spinal cord anomalies (SCA) in patients with anorectal malformations (ARM), the need for neurosurgery, and to define the impact of SCA on the outcome of patients with ARM. METHODS: A 16-year retrospective analysis of all patients treated at a single tertiary children's Hospital with diagnosis of ARM. Data were collected to assess the impact of defined clinical characteristics on prevalence of SCA (detected at MRI)...
August 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27352276/imaging-of-degenerative-and-infectious-conditions-of-the-spine
#8
Lubdha M Shah, Jeffrey S Ross
UNLABELLED: : Imaging is important in the evaluation of patients with degenerative disease and infectious processes. There are numerous conditions that can manifest as low back pain (LBP) or neck pain in a patient, and in many cases, the cause may be multifactorial. Clinical history and physical examination are key components in the evaluation of such patients; however, physical examination has variable sensitivity and specificity. Although studies have demonstrated that uncomplicated acute LBP and/or radiculopathy are self-limited conditions that do not warrant any imaging, neuroimaging can provide clear anatomic delineation of potential causes of the patient's clinical presentation...
September 2016: Neurosurgery
https://www.readbyqxmd.com/read/27343731/operative-management-of-complex-lumbosacral-dissociations-in-combat-injuries
#9
Peter M Formby, Scott C Wagner, Daniel G Kang, Gregory S Van Blarcum, Ronald A Lehman
BACKGROUND CONTEXT: As war injury patterns have changed throughout Operations Iraqi and Enduring Freedom (OIF and OEF), a relative increase in the incidence of complex lumbosacral dissociation (LSD) injuries has been noted. Lumbosacral dissociation injuries are an anatomical separation of the spinal column from the pelvis, and represent a manifestation of severe, high-energy trauma. PURPOSE: This study aimed to assess the clinical outcomes of combat-related LSD injuries at a mean of 7 years following operative treatment...
June 22, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27328580/idiopathic-pneumatosis-intestinalis-requiring-decompressive-laparotomy
#10
Andrew McGregor, Khaldoun Bekdache, Laura Choi
INTRODUCTION: Pneumatosis intestinalis (PI) and hepatic portal venous gas (HPVG) are radiographic signs of questionable bowel ischemia. Pneumatosis intestinalis can be associated with possible benign conditions such as obstructive airway disease. We present a patient who demonstrated clinical signs of overt sepsis with corresponding radiological findings of PI and HPVG concering for possible small or large bowel ischemia. However at exploration, no sign of small or large bowel injury or ischemia could be detected...
May 2016: Connecticut Medicine
https://www.readbyqxmd.com/read/27241442/demographics-of-tuberculosis-of-spine-and-factors-affecting-neurological-improvement-in-patients-suffering-from-tuberculosis-of-spine-a-retrospective-analysis-of-312-cases
#11
A Sharma, H S Chhabra, T Chabra, R Mahajan, S Batra, G Sangondimath
OBJECTIVES: The purpose of the study was to study demographics of tuberculosis of spine and analyze factors that might affect neurological improvement in such patients. METHODS: Of the 638 suspected cases of spinal tuberculosis, 312 cases with confirmed diagnosis with at least 1-year follow-up were selected for retrospective analysis. Two hundred cases who presented with neurological deficit were further divided into three groups-completely improved, partially improved and no improvement according to American Spinal Injury Association impairment scale (AIS) grading...
May 31, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27208647/developing-artificial-neural-network-models-to-predict-functioning-one-year-after-traumatic-spinal-cord-injury
#12
Timothy Belliveau, Alan M Jette, Subramani Seetharama, Jeffrey Axt, David Rosenblum, Daniel Larose, Bethlyn Houlihan, Mary Slavin, Chantal Larose
OBJECTIVE: To develop mathematical models for predicting level of independence with specific functional outcomes 1 year after discharge from inpatient rehabilitation for spinal cord injury. DESIGN: Statistical analyses using artificial neural networks and logistic regression. SETTING: Retrospective analysis of data from the national, multicenter Spinal Cord Injury Model Systems (SCIMS) Database. PARTICIPANTS: Subjects (N=3142; mean age, 41...
October 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27152922/medical-and-surgical-management-of-neurogenic-bowel
#13
Ronak A Gor, Jenna R Katorski, Sean P Elliott
PURPOSE OF REVIEW: Neurogenic bowel dysfunction (NBoD) commonly affects patients with spina bifida, cerebral palsy, and spinal cord injury among other neurologic insults. NBoD is a significant source of physical and psychosocial morbidity. Treating NBoD requires a diligent relationship between patient, caretaker, and provider in establishing and maintaining a successful bowel program. A well designed bowel program allows for regular, predictable bowel movements and prevents episodes of fecal incontinence...
July 2016: Current Opinion in Urology
https://www.readbyqxmd.com/read/27001132/an-audit-of-demographics-and-rehabilitation-outcomes-in-non-traumatic-spinal-cord-injury
#14
P Kennedy, L Hasson
STUDY DESIGN: Repeated measures, retrospective cohort study. OBJECTIVES: To classify specific causes of injury in a cohort of non-traumatic spinal cord injury (NTSCI) patients, with the aim of exploring whether there are differences in demographics or rehabilitation outcomes depending on the cause of NTSCI. SETTING: Tertiary care, spinal cord injury rehabilitation unit. METHODS: Patients admitted to the unit with a non-traumatic SCI between July 2008 and April 2015 were considered for this study...
March 22, 2016: Spinal Cord
https://www.readbyqxmd.com/read/26973012/early-elective-colostomy-following-spinal-cord-injury
#15
Michelle Boucher
Elective colostomy is an accepted method of bowel management for patients who have had a spinal cord injury (SCI). Approximately 2.4% of patients with SCI have a colostomy, and traditionally it is performed as a last resort several years after injury, and only if bowel complications persist when all other methods have failed. This is despite evidence that patients find a colostomy easier to manage and frequently report wishing it had been performed earlier. It was noticed in the author's spinal unit that increasing numbers of patients were requesting colostomy formation during inpatient rehabilitation following SCI...
March 10, 2016: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/26926544/filum-section-for-urinary-incontinence-in-children-with-occult-tethered-cord-syndrome-a-randomized-controlled-pilot-study
#16
RANDOMIZED CONTROLLED TRIAL
Paul Steinbok, Andrew E MacNeily, Alexander R Hengel, Koroush Afshar, Jeanne M Landgraf, Walter Hader, Jeffery Pugh
PURPOSE: Occult tethered cord syndrome, in which there is normal neuroanatomic imaging despite clinical and urodynamic evidence of neuropathic bladder behavior, is controversial. Several uncontrolled series describe improvement in bladder function following section of the filum terminale. We performed a pilot randomized, controlled study comparing medical treatment to surgical section of the filum plus medical treatment in children with occult tethered cord syndrome. MATERIALS AND METHODS: Children refractory to standard medical management for 1 year or more with normal conus position on magnetic resonance imaging and abnormal urodynamics were randomized...
April 2016: Journal of Urology
https://www.readbyqxmd.com/read/26914807/spinopelvic-dissociation-multidetector-computed-tomographic-evaluation-of-fracture-patterns-and-associated-injuries-at-a-single-level-1-trauma-center
#17
Pushpender Gupta, Jonathan C Barnwell, Leon Lenchik, Scott D Wuertzer, Anna N Miller
The objective of the present study is to evaluate multidetector computed tomographic (MDCT) fracture patterns and associated injuries in patients with spinopelvic dissociation (SPD). Our institutional trauma registry database was reviewed from Jan. 1, 2006, to Sept. 30, 2012, specifically evaluating patients with sacral fractures. MDCT scans of patients with sacral fractures were reviewed to determine the presence of SPD. SPD cases were characterized into the following fracture patterns: U-shaped, Y-shaped, T-shaped, H-shaped, and burst...
June 2016: Emergency Radiology
https://www.readbyqxmd.com/read/26882775/evaluating-the-patient-with-low-back-pain
#18
Maliha Shaikh, Andrew J K Östör
In the UK, low back pain is the most common cause of disability in young adults and every year 6-9% of adults consult their GP about back pain. A thorough history and examination is required to exclude an alternative diagnosis, such as pain arising from the hip or trochanteric bursa and to categorise patients as having: serious spinal pathology, nerve root/radicular pain or non-specific back pain. Inflammatory back pain is often missed, particularly in the early stages when examination may be normal. The primary features are pain arising in patients under 40, thoracolumbar or sacroiliac pain and alternating buttock pain...
December 2015: Practitioner
https://www.readbyqxmd.com/read/26803130/the-effect-of-early-warm-plastic-bag-application-on-postoperative-pain-after-hemorrhoidectomy-a-prospective-randomized-controlled-trial
#19
Ahmet Ziya Balta, Yavuz Ozdemir, Ilker Sucullu, Ali Ilker Filiz, Ergun Yucel, Mehmet Levhi Akin
Hemorrhoidectomy is used for the surgical treatment of high-grade hemorrhoids. The most prominent complaint after hemorrhoidectomy is pain. Postoperative pain management is still a big problem after surgery in patients with hemorrhoidectomy. The aim of the study was to assess the effect of early application of warm bag on postoperative pain after hemorrhoidectomy. All patients were randomly divided into warm plastic bag and control groups by using sealed envelopes, which were prepared preoperatively. After standard spinal anesthesia, all patients underwent standard Milligan-Morgan hemorrhoidectomy using Ligasure™...
February 2015: American Surgeon
https://www.readbyqxmd.com/read/26692695/ogilvie-s-syndrome-following-posterior-spinal-instrumentation-in-thoraco-lumbar-trauma
#20
R Krishnakumar, Mathew John Kuzhimattam, Gaurav Kumar
OBJECTIVES: To report unique cases of Ogilvie's syndrome (acute intestinal pseudo-obstruction) following posterior spinal instrumentation in thoraco lumbar trauma. MATERIALS AND METHODS: A single centre retrospective study. We reviewed the surgical data of 420 patients who underwent thoracolumbar spinal surgery over a period of four years. Two patients who developed post operative Ogilvie's syndromes were identified. RESULTS: The clinical presentation and blood investigations ruled out any infectious pathology...
October 2015: Journal of Craniovertebral Junction and Spine
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