Publications by authors named "Deborah A Crane"
Context: Surgical management of firearm-related spinal cord injury (SCI) remains controversial, and there are no clear guidelines. Time to surgery, surgical indications, and patient characteristics on initial presentation in this group are not well understood, and these factors may impact the potential for neurologic recovery after operative intervention.
Objective: To understand the timing and factors affecting the timing of operative intervention after firearm-related SCI.
Background: Violence is the third leading cause of spinal cord injury (SCI) in the United States, and people with violence-related SCI have worse long-term outcomes compared to other traumatic SCI etiologies. Little is known, however, about the underlying reasons for these differences. Access to and utilization of rehabilitation services may differ in this population, but their outpatient care has not been previously investigated.
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- Early pain after spinal cord injury (SCI) can hinder rehabilitation and often does not respond well to standard medical treatments, leading researchers to explore nonpharmacological options.
- This case study focuses on adapting hypnotic cognitive therapy (HYP-CT) for a 54-year-old male with severe SCI who was also dependent on mechanical ventilation, showing its potential effectiveness in alleviating pain.
- After four HYP-CT sessions, the participant experienced significant pain relief, improved self-efficacy, and a reduction in opioid use, indicating that this therapy could be a beneficial approach for managing pain in similar situations.
Objectives: (1) Adapt evidence-based hypnosis-enhanced cognitive therapy (HYP-CT) for inpatient rehabilitation setting; and (2) determine feasibility of a clinical trial evaluating the effectiveness of HYP-CT intervention for pain after spinal cord injury (SCI).
Study Design: Pilot non-randomized controlled trial.
Setting: Inpatient rehabilitation unit.
Article Synopsis
- The study aimed to evaluate the pregnancy-related health outcomes for women with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) compared to those without these conditions.
- Women with either condition were more likely to experience rehospitalization postpartum, especially within the first six months, with SLE-associated risks being notably higher.
- Infants born to mothers with SLE showed increased rates of congenital malformations and mortality within the first two years, indicating the need for vigilant postpartum monitoring and care for affected mothers and their infants.
Objective: To determine the positive predictive value (PPV) of a sepsis-screening protocol in patients with cervical spinal cord injury (SCI).
Design/method: Retrospective review of all patients with cervical SCI who screened positive for two or more systemic inflammatory response syndrome (SIRS) criteria while hospitalized in acute care or inpatient rehabilitation units over a 3.5-year period.
Objective: We compared the relative occurrence of selected pregnancy outcomes and postpartum rehospitalizations among women with and without epilepsy and their infants. Using linked vital-hospital discharge records of women with deliveries in Washington State 1987-2014, comparisons were made overall, by epilepsy type, and by time periods related to antiepileptic drug (AED) marketing changes.
Methods: This population-based retrospective cohort study identified women with, and without epilepsy per diagnosis codes in the hospital discharge record from among all deliveries during 1987-2014 to examine maternal and infant outcomes, rehospitalization and mortality <2 years postpartum.
Background: Women with visual impairment may have reduced ability to access standard care resources, however, information on their pregnancy and neonatal outcomes is limited.
Objective: To assess risk of adverse pregnancy and neonatal outcomes among visually impaired women in Washington State from 1987 to 2014.
Methods: We conducted a retrospective cohort study using linked Washington State birth/fetal death hospital discharge records to compare outcomes among women with and without visual impairment noted at their delivery hospitalization.
Article Synopsis
- The study was a clinical trial using a single-blind parallel-group design to evaluate the effectiveness of a telehealth-based physical activity counseling intervention for improving fitness in individuals with spinal cord injuries (SCI).
- Conducted in Seattle, the trial involved under-active adults using manual wheelchairs, with participants undergoing baseline assessments and being randomly assigned to treatment or usual care groups.
- While the study struggled to meet its recruitment and fitness improvement goals, it showed positive effects on self-reported physical activity, depression, and pain, indicating valuable insights for future research.
Introduction: For war-injured refugees, spinal cord injury (SCI) is a leading cause of catastrophic neurologic injury and literature focused on the care of this vulnerable population is sparse. This case series describes the unique challenges presented to an outpatient interdisciplinary rehabilitation team in providing SCI care in the USA for refugees who suffered their SCI in their home countries.
Case Presentation: Our interdisciplinary rehabilitation team faced challenges related to language, cultural and educational barriers which impacted the typical standard rehabilitation care offered to these individuals.
Background: Linked birth certificate-hospital discharge records are a valuable resource for examining pregnancy outcomes among women with disability conditions. Few studies relying on these data have been able to assess the accuracy of identification of preexisting disability conditions. We assessed the accuracy of International Classification of Diseases version 9 (ICD9) codes for identifying selected physical, sensory, and intellectual conditions that may result in disability.
View Article and Find Full Text PDFBackground: Pregnant women with congenital or acquired spinal cord injury face challenges due to compromised neurologic function and mobility, factors that may also affect fetal/infant health. Few studies have examined pregnancy course and longer-term outcomes in this population.
Objective: To assess pregnancy outcomes among women with spinal cord injury, paralysis, or spina bifida using population-based data.
Objective: To evaluate pregnancy and neonatal outcomes among deaf women using population-based vital records data in Washington State from 1987 to 2012.
Methods: We performed a retrospective cohort study using the Washington State birth and fetal death records linked to state hospital discharge records to identify women with diagnosis codes for deafness indicated at their delivery hospitalization and compared them with randomly selected women without these codes. Pregnancy conditions and outcomes evaluated included gestational diabetes, preeclampsia, placental abruption, labor induction, and cesarean delivery.
Study Objectives: Obstructive sleep apnea (OSA) predicts poor functional outcome after stroke and increases the risk for recurrent stroke. Less is known about continuous positive airway pressure (CPAP) treatment on stroke recovery.
Methods: In a pilot randomized, double-blind, sham-controlled trial, adult stroke rehabilitation patients were assigned to auto-titrating or sham CPAP without diagnostic testing for OSA.
Objective: To describe the initial benefits of a structured group exercise program on exercise frequency and intensity, perceived health, pain, mood, and television watching habits.
Design: Pre-test/post-test.
Participants/methods: Eighty-nine persons with SCI participated voluntarily in a no-cost, twice weekly physical therapy group exercise class over 3 months.
Objective: To describe expected imaging findings to assist the emergency room radiologist with recognising complications and pathology unique to the spinal cord injury (SCI) patient population to ensure rapid and accurate diagnosis.
Methods: Pictorial review.
Results: We review several imaging findings common to persons with chronic SCI, emphasising imaging in the emergency setting and on CT.
Depression treatment preferences after acute traumatic spinal cord injury.
Arch Phys Med Rehabil
December 2013
Objective: To examine preferences for depression treatment modalities and settings and predictors of treatment preference in persons with spinal cord injury (SCI).
Design: Cross-sectional surveys.
Setting: Rehabilitation inpatient services.
Spinal arachnoiditis is a known but very rare late complication of subarachnoid hemorrhage (SAH). Since 1943, 17 cases of spinal arachnoiditis after intracranial hemorrhage have been reported internationally. The vast majority of these cases were related to aneurysmal SAH.
View Article and Find Full Text PDFObjective: To define the prevalence of testosterone deficiency in persons with chronic spinal cord injury (SCI) and to identify factors associated with this deficiency.
Design: Cross-sectional study.
Setting: A U.
Study Design: Retrospective chart review.
Objective: To define the temporal course of weight gain in persons with new spinal cord injury (SCI), and to identify predictors of weight gain in this population.
Setting: A United States Department of Veterans Affairs (VA) SCI Unit.
Background: This report describes a young woman with incomplete traumatic cervical spinal cord injury and intractable pruritus involving her dorsal forearm.
Method: Case report.
Findings: Anatomic distribution of the pruritus corresponded to the dermatomal distribution of her level of spinal cord injury and vertebral fusion.