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Christopher Ull, Mirko Aach, Josef Reichert, Thomas Armin Schildhauer, Justyna Swol
Pulmonary infections are life-threatening complications in patients with spinal cord injuries. In particular, paraplegic patients are at risk if they are ventilator-dependent. This case history refers to a spinal cord injury with a complete sensorimotor tetraplegia below C2 caused by a septic scattering of an intraspinal empyema at C2-C5 and T3-T4. A right-sided purulent pneumonia led to a complex lung infection with the formation of a pleuroparenchymal fistula. The manuscript describes successful, considerate, non-surgical management with shortterm separate lung ventilation...
January 29, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Michel J Bekker, Riemer J K Vegter, Jan W van der Scheer, Johanneke Hartog, Sonja de Groot, Wiebe de Vries, Ursina Arnet, Lucas H V van der Woude, Dirkjan H E J Veeger
BACKGROUND: Altered scapular kinematics have been associated with shoulder pain and functional limitations. To understand kinematics in persons with spinal cord injury during manual handrim wheelchair propulsion, a description of normal scapular behaviour in able-bodied persons during this specific task is a prerequisite for accurate interpretation. The primary aim of this study is to describe scapular kinematics in able-bodied persons during manual wheelchair propulsion. METHODS: Sixteen able-bodied, novice wheelchair users without shoulder complaints participated in the study...
March 14, 2018: Clinical Biomechanics
Min Yin Goh, Melinda S Millard, Edmund C K Wong, David J Berlowitz, Marnie Graco, Rachel M Schembri, Douglas J Brown, Albert G Frauman, Christopher J O'Callaghan
STUDY DESIGN: Observational study. OBJECTIVES: To quantify diurnal blood pressure (BP) patterns and nocturnal hypertension and to measure diurnal urine production in people with chronic spinal cord injury (SCI), compared with controls without SCI. SETTING: Chronic SCI population in the community in Victoria, Australia. METHODS: Participants were recruited by advertisement, and sustained SCI at least a year prior or were healthy able-bodied volunteers...
March 2, 2018: Spinal Cord
Yutaka Igarashi, Takahiro Kanaya, Shoji Yokobori, Takeshi Tsukamoto, Hiroyuki Yokota
PURPOSE: Cerebrovascular ischaemia is a rare but serious complication of damage to the carotid or vertebral arteries in the neck caused by blunt injury to the neck. Screening for blunt cerebrovascular injury should be performed in patients with certain signs or symptoms and risk factors. We described a case of traumatic bilateral vertebral artery injury (VAI) including unilateral vertebral arterial occlusion that resolved 3 months post-injury with antiplatelet and direct oral anticoagulant therapy...
March 1, 2018: European Spine Journal
Johanna Wangdell, Carina Reinholdt, Jan Fridén
Spasticity is a common and increasingly prevalent secondary complication of spinal cord injury. The aim of the study was to evaluate patient-experienced gains in prioritized activities after surgery to reduce the effects of spasticity in upper limbs in tetraplegia. The study includes evaluation of 30 operations for 27 patients performed on hypertonic tetraplegic hands during 2007-2015 using the Canadian Occupational Performance Measure. Activity performance increased at both 6 months and 12 months by a mean of 3...
January 1, 2018: Journal of Hand Surgery, European Volume
Julia Kathrin Baumgart, Berit Brurok, Øyvind Sandbakk
BACKGROUND: Peak oxygen uptake (VO2peak) in Paralympic sitting sports athletes represents their maximal ability to deliver energy aerobically in an upper-body mode, with values being influenced by sex, disability-related physiological limitations, sport-specific demands, training status and how they are tested. OBJECTIVES: To identify VO2peak values in Paralympic sitting sports, examine between-sports differences and within-sports variations in VO2peak and determine the influence of sex, age, body-mass, disability and test-mode on VO2peak...
2018: PloS One
Heidi L Lujan, Anne Tonson, Robert W Wiseman, Stephen E DiCarlo
Spinal cord injury (SCI) resulting in tetraplegia is a devastating, life-changing insult causing paralysis and sensory impairment as well as distinct autonomic dysfunction that triggers compromised cardiovascular, bowel, bladder and sexual activity. Life becomes a battle for independence as even routine bodily functions and the smallest activity of daily living become a major challenge. Accordingly, there is a critical need for a chronic pre-clinical model of tetraplegia. This report addresses this critical need by comparing, for the first time, resting, reflex and stress-induced cardiovascular, autonomic and hormonal responses each week for 4 weeks in 12 sham-operated intact rats and 12 rats with chronic, complete C6-7 spinal cord transection...
February 22, 2018: Journal of Applied Physiology
Kathleen C Rankin, Laura C O'Brien, Ashraf S Gorgey
OBJECTIVE: To determine whether dual energy x-ray absorptiometry (DXA) compared to magnetic resonance imaging (MRI) may accurately quantify trunk lean mass (LM) after chronic spinal cord injury (SCI) and to investigate the relationships between trunk LM, visceral adiposity, trunk fat mass and basal metabolic rate (BMR). DESIGN: Cross-sectional design and correlational analysis. SETTING: Research setting in a medical center. PARTICIPANTS: Twenty-two men with motor complete paraplegia (n = 14; T4-T11) and tetraplegia (n = 8; C5-C7) were recruited as part of a clinical trial...
February 20, 2018: Journal of Spinal Cord Medicine
Gordana Savic, Hans L Frankel, Mohamed Ali Jamous, Bakulesh M Soni, Susan Charlifue
STUDY DESIGN: Prospective observational. AIM: The aim of this study was to analyse changes in bladder and bowel management methods in persons with long-standing spinal cord injury (SCI). SETTING: Two spinal centres in UK. METHOD: Data were collected through interviews and examinations between 1990 and 2010 in a sample of persons injured more than 20 years prior to 1990. RESULTS: For the 85 participants who completed the 2010 follow-up, the mean age was 67...
February 16, 2018: Spinal Cord
Lina Bunketorp Käll, Robert J Cooper, Johanna Wangdell, Jan Fridén, Malin Björnsdotter
BACKGROUND: Tendon transfer is a surgical technique for restoring upper limb motor control in patients with cervical spinal cord injuries (SCI), and offers a rare window into cortical neuroplasticity following regained arm and hand function. OBJECTIVE: Here, we aimed to examine neuroplasticity mechanisms related to re-established voluntary motor control of thumb flexion following tendon transfer. METHODS: We used functional Magnetic Resonance Imaging (fMRI) to test the hypothesis that restored limb control following tendon transfer is mediated by activation of that limb's area of the primary motor cortex...
2018: Restorative Neurology and Neuroscience
Andrea Accogli, Fadi F Hamdan, Chantal Poulin, Christina Nassif, Guy A Rouleau, Jacques L Michaud, Myriam Srour
Adaptor protein complex-4 (AP-4) is a heterotetrameric protein complex which plays a key role in vesicle trafficking in neurons. Mutations in genes affecting different subunits of AP-4, including AP4B1, AP4E1, AP4S1, and AP4M1, have been recently associated with an autosomal recessive phenotype, consisting of spastic tetraplegia, and intellectual disability (ID). The overlapping clinical picture among individuals carrying mutations in any of these genes has prompted the terms "AP-4 deficiency syndrome" for this clinically recognizable phenotype...
February 12, 2018: American Journal of Medical Genetics. Part A
Yaniv Steinfeld, Yaniv Keren, Elias Haddad
Introduction: Central cord syndrome (CCS) is an injury to the center of the spinal cord. It is well known as a hyperextension injury, but it has never been described as a surfing injury. Our report describes this injury in detail. Case presentation: A 35-year-old male novice surfer presented to the emergency department with acute tetraplegia following falling off his surfboard and hitting sea floor at a shallow beach break. He was rescued by a fellow surfer while floating in the sea and unable to raise his head above sea level...
2018: Spinal Cord Series and Cases
Kazuko Shem, Steven Barncord, Kara Flavin, Manoj Mohan
Study design: Prospective observational cohort study. Objectives: To assess the effects of gabapentin on neuropsychological variables including memory, attention, and executive function in individuals with spinal cord injury. Setting: Santa Clara Valley Medical Center inpatient spinal cord injury unit. Methods: Ten patients (three females, seven males) with traumatic spinal cord injury underwent testing, with a mean age of 35...
2018: Spinal Cord Series and Cases
Valéria Baldassin, Helena Eri Shimizu, Emerson Fachin-Martins
STUDY DESIGN: Systematic review. OBJECTIVE: The purpose of the study was to identify and organize evidence regarding quality of life influenced by assistive technology related to computers for people with traumatic and non-traumatic spinal cord injury (SCI). SETTING: Distrito Federal, Brazil. METHODS: A search strategy was conducted on the PubMed, PEDro, LILACS, PsycINFO, and SCIELO. All types of study designs considering assistive technology to improve quality of life for individuals with SCI were included...
February 7, 2018: Quality of Life Research
Belgin Erhan, Rahsan Kemerdere, Osman Kizilkilic, Berrin Gunduz, Murat Hanci
Background: Paraplegia following thoracic spinal surgery or abdominal operations is usually attributed to spinal cord ischemia due to interruption of the segmental spinal vascular supply. Alternatively, the etiology of spinal cord ischemia following cervical surgery is less clear. Case Description: A 14-year-old male became acutely tetraplegic with a C4 sensory level and sphincteric dysfunction 12 h following surgery for tracheal stenosis due to prior intubation...
2018: Surgical Neurology International
Ntsikelelo Pefile, Joyce Diphale Mothabeng, Saloshni Naidoo
OBJECTIVES: To describe the demographic and socio-economic profiles, and injury related characteristics of people who sustain SCIs in KZN in order to provide baseline information to instigate a model that guides employment outcomes amongst PLWSCI. DESIGN: Retrospective analysis of medical files was done. SETTING: King Dinizulu Hospital Spinal Unit (KDHSU), this being the biggest provider of acute care for people who sustain SCI in KwaZulu-Natal and the Eastern Cape Provinces, South Africa was the setting for our study...
February 1, 2018: Journal of Spinal Cord Medicine
Martin Kreutzträger, Heiko Voss, Anke Scheel-Sailer, Thomas Liebscher
STUDY DESIGN: Retrospective observational cohort study. OBJECTIVES: To describe outcomes, risk factors for complications, and relapse rates associated with the multimodal treatment approach for deep pressure ulcers (PUs) grade IV for the ischium, trochanter major, and sacral regions of patients with traumatic and non-traumatic spinal cord injury (SCI). SETTING: The settings comprised two spinal cord units within a maximum care hospital. The treatment of all patients followed the modified interdisciplinary "Basler treatment concept"...
January 31, 2018: Spinal Cord
M Nazmus Sahadat, Arish Alreja, Maysam Ghovanloo
Multimodal Tongue Drive System (mTDS) is a highly integrated wireless assistive technology (AT) in the form of a lightweight wearable headset that utilizes three remaining key control and communication abilities in people with severe physical disabilities, such as tetraplegia, to provide them with effective access to computers: 1) tongue motion for discrete/switch-based control (e.g., clicking), 2) head tracking for proportional control (e.g., mouse pointer movements), and 3) speech recognition for typing, all available simultaneously...
February 2018: IEEE Transactions on Biomedical Circuits and Systems
David M Brandman, Tommy Hosman, Jad Saab, Michael C Burkhart, Benjamin E Shanahan, John G Ciancibello, Anish A Sarma, Daniel J Milstein, Carlos E Vargas-Irwin, Brian Franco, Jessica Kelemen, Christine Blabe, Brian A Murphy, Daniel R Young, Francis R Willett, Chethan Pandarinath, Sergey D Stavisky, Robert F Kirsch, Benjamin L Walter, A Bolu Ajiboye, Sydney S Cash, Emad N Eskandar, Jonathan P Miller, Jennifer A Sweet, Krishna V Shenoy, Jaimie M Henderson, Beata Jarosiewicz, Matthew T Harrison, John D Simeral, Leigh R Hochberg
OBJECTIVE: Brain-computer interfaces (BCIs) can enable individuals with tetraplegia to communicate and control external devices. Though much progress has been made in improving the speed and robustness of neural control provided by intracortical BCIs, little research has been devoted to minimizing the amount of time spent on decoder calibration. APPROACH: We investigated the amount of time users needed to calibrate decoders and achieve performance saturation using two markedly different decoding algorithms: the steady-state Kalman filter, and a novel technique using Gaussian process regression (GP-DKF)...
January 24, 2018: Journal of Neural Engineering
Ines Bersch, Sabrina Koch-Borner, Jan Fridén
STUDY DESIGN: Retrospective data analysis OBJECTIVES: To define the distribution of the motor points and excitability of the key wrist and finger actuators in order to detect upper (UMN) and lower motor neuron (LMN) lesions potentially influencing the development of a tenodesis grasp. SETTING: A rehabilitation centre for spinal cord injuries, Nottwil, Switzerland. METHODS: Forearm muscles of 32 patients with tetraplegia (AIS A-D) were tested bilaterally with electrical stimulation (ES) to differentiate whether UMN or LMN was present...
January 22, 2018: Spinal Cord
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