International spinal cord injury pulmonary function basic data set.

Objectives: To develop the International Spinal Cord Injury (SCI) Pulmonary Function Basic Data Set within the framework of the International SCI Data Sets in order to facilitate consistent collection and reporting of basic bronchopulmonary findings in the SCI population.

Setting: International.

Methods: The SCI Pulmonary Function Data Set was developed by an international working group.

International standards to document remaining autonomic function after spinal cord injury.

Study Design: Experts opinions consensus.

Objective: To develop a common strategy to document remaining autonomic neurologic function following spinal cord injury (SCI).

Background And Rationale: The impact of a specific SCI on a person's neurologic function is generally described through use of the International Standards for the Neurological Classification of SCI.

International bowel function basic spinal cord injury data set.

Study Design: International expert working group.

Objective: To develop an International Bowel Function Basic Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on bowel function in daily practice or in research.

Setting: Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS).

International bowel function extended spinal cord injury data set.

Study Design: International expert working group.

Objective: To develop an International Bowel Function Extended Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of an extended amount of information on bowel function.

Setting: Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS).

Reproducibility of noninvasive cardiac output during arm exercise in spinal cord injury.

The carbon dioxide (CO(2)) rebreathing method is a noninvasive technique to estimate cardiac output during exercise, but few data are available on the validity and reliability of this measure in individuals with spinal cord injury (SCI). Sixteen male subjects with SCI (mean age 45 +/- 9, seven paraplegic and nine tetraplegic) underwent three submaximal steady state arm ergometer exercise tests. We estimated cardiac output using the exponential CO(2) rebreathing technique at an individualized exercise intensity approximating 50% of peak oxygen uptake.

Transurethral sphincterotomy provides significant relief in autonomic dysreflexia in spinal cord injured male patients: long-term followup results.

Purpose: An evaluation of the results of transurethral sphincterotomy in spinal cord injured patients for the relief of autonomic dysreflexia is presented.

Materials And Methods: The study describes experience with the treatment of 46 consecutive spinal cord injured males presenting with frequent symptoms of autonomic dysreflexia and inadequate voiding. The selection criteria include patients injured above the thoracic 6 level with subjective symptoms of autonomic dysreflexia who did not want to be catheterized or were unable to perform intermittent catheterization.

Aortoiliac hemodynamic and morphologic adaptation to chronic spinal cord injury.

Background: Reduced lower limb blood flow and resistive hemodynamic conditions potentially promote aortic inflammation and aneurysmal degeneration. We used abdominal ultrasonography, magnetic resonance imaging, and computational flow modeling to determine the relationship between reduced infrarenal aortic blood flow in chronic spinal cord injury (SCI) subjects and risk for abdominal aortic aneurysm (AAA) disease.

Methods: Aortic diameter in consecutive SCI subjects (n = 123) was determined via transabdominal ultrasonography.

Heart rate as a predictor of energy expenditure in people with spinal cord injury.

This study evaluated the accuracy of heart rate calibrated from a maximum exercise test for predicting energy expenditure during five activities of daily living (ADL) in participants with spinal cord injury (SCI). Thirteen individuals with SCI underwent maximum exercise testing, followed by portable heart rate and metabolic testing during five ADL. A regression equation was developed from heart rate and oxygen uptake responses during the maximum exercise test for each subject.

Homocysteine and hypertension in persons with spinal cord injury.

Study Design: Cross-sectional analysis of a convenience sample of locally recruited participants, including both patients and volunteers.

Objectives: To determine whether there is an association between plasma homocysteine and hypertension in persons with spinal cord injury (SCI).

Setting: Spinal Cord Injury Service of the Veterans Affairs Palo Alto Medical Center (California, United States of America).

C-reactive protein, metabolic syndrome, and insulin resistance in individuals with spinal cord injury.

Background/objective: High-sensitivity C-reactive protein (hsCRP) has been shown to be indicative of elevated risk of cardiovascular disease (CVD). We examined this blood marker in persons with spinal cord injury (SCI) in order to determine its potential for predicting elevated cardiac risk.

Methods: In a cross-sectional analysis, we examined the relationship between hsCRP and insulin resistance and metabolic syndrome among 93 individuals with SCI (50.

Donald Munro Lecture 2003. Neurogenic bladder: past, present, and future.

The foundation of the management of neurogenic bladder can be attributed to a pioneer in spinal cord injury medicine. Dr. Donald Munro, a neurosurgeon, who also had experience in urologic surgery, established the first Spinal Cord Injury Service of 10 beds in the Boston City hospital in the 1930s.

Prostate cancer diagnosed in spinal cord-injured patients is more commonly advanced stage than in able-bodied patients.

Objectives: To determine the incidence and characteristics of prostate cancer in men with spinal cord injury (SCI). Little is known about the characteristics of prostate cancer in men with SCI, because prostate cancer screening is not aggressively performed in this population.

Methods: In one fiscal year, 648 men with SCI older than age 50 years were actively enrolled with the SCI service, 20,949 able-bodied men older than age 50 years were actively enrolled in the outpatient clinic database, and 945 patients with prostate cancer were in the cancer registry at our facility.

Which stoma works better for colonic dysmotility in the spinal cord injured patient?

Background: The formation of an intestinal stoma is very effective in the treatment of colonic dysmotility associated with spinal cord injury (SCI). Little is known about the difference in the long-term outcome among left-sided colostomies, right-sided colostomies, and ileostomies in this patient population.

Methods: The records of 45 SCI patients with intestinal stomas at our institution were reviewed retrospectively.

Displacement sequence and elastic properties of anterior prostate/urethral interface during micturition of spinal cord injured men.

The management of complex micturition problems frequently encountered in patients with spinal cord injury (SCI) may be facilitated by characterization of the elastic properties of the prostate. To this end, we have developed a method of evaluating changes in prostate biomechanics using ultrasound (US) images obtained during routine diagnostic urodynamic evaluations. Ultrasound video sequences of the prostate and urethra during voiding were digitized simultaneously with bladder pressure measurement on 76 patients with spinal cord injury, having a mean age of 47 +/- 16 years.

The effects of colostomy on the quality of life in patients with spinal cord injury: a retrospective analysis.

Purpose: The purpose of this study was to evaluate the effects of colostomy on the quality of life (QOL) in patients with spinal cord injury (SCI) by designing a questionnaire that used self-reported data and correlating these data with the clinical information obtained from patients' medical records.

Materials And Methods: A comprehensive QOL questionnaire was designed to specifically address the following 5 domains: physical health, psychosocial adjustment, body image, self-efficacy, and recreation/leisure. This questionnaire was completed during a telephone or an in-person interview.

Electrocardiographic findings in patients with chronic spinal cord injury.

Objective: To demonstrate the prevalence and prognostic value of electrocardiographic abnormalities in patients with chronic spinal cord injury.

Methods: All electrocardiographs obtained in the Palo Alto Veterans Affairs Medical Center since 1987 have been digitally recorded and stored in a computerized database. For this study, only the first electrocardiograph was considered for analysis.

Early repolarization in patients with spinal cord injury: prevalence and clinical significance.

Objectives: The objective was to examine the prevalence of early repolarization in a spinal cord injury (SCI) clinic and the relationship of level of injury to this electrocardiogram (ECG) finding.

Background: ST elevation on the resting ECG can be either a normal variant or a sign of acute ischemia, evolving myocardial infarction, or pericarditis. It is frequently seen as a normal variant (early repolarization) in healthy individuals, but has also been reported in individuals with SCI.

Occult maxillary sinusitis as a cause of fever in tetraplegia: 2 case reports.

Common causes of fever in tetraplegia include urinary tract infection, respiratory complications, bacteremia, impaired autoregulation, deep vein thrombosis, osteomyelitis, drug fever, and intra-abdominal abscess. We report 2 acute tetraplegic patients who presented with fever of unknown origin. After extensive work-up, they were diagnosed with occult maxillary sinusitis.

Functional magnetic stimulation facilitates colonic transit in rats.

Objective: To investigate the effect of functional magnetic stimulation (FMS) on colonic transit in rats.

Design: Experimental.

Setting: Functional magnetic stimulation laboratory in a Veterans Administration health care system.

Functional magnetic stimulation of the colon in persons with spinal cord injury.

Objective: To evaluate the usefulness of functional magnetic stimulation (FMS) as a noninvasive method to stimulate the colon in individuals with spinal cord injury (SCI).

Design: A prospective before-after trial consisting of 2 protocols.

Setting: FMS laboratories of 2 SCI centers.

Functional magnetic stimulation for conditioning of expiratory muscles in patients with spinal cord injury.

Objective: To evaluate the effectiveness of functional magnetic stimulation (FMS) in conditioning expiratory muscles patients with spinal cord injury (SCI).

Design: A prospective before-after trial.

Setting: The Functional Magnetic Stimulation Laboratory of the SCI Health Care Group, VA Long Beach Health Care System, and the Spinal Cord Injury Services, Department of Veterans Affairs, Palo Alto Health Care System.

Progressive decrease in bone density over 10 years of androgen deprivation therapy in patients with prostate cancer.

Objectives: Several reports suggest an increased incidence of osteoporosis and concomitant fractures in men receiving androgen deprivation therapy (ADT) for prostate cancer. We sought to estimate the longitudinal effects of ADT on loss of bone density in this cross-sectional study.

Methods: Hip and spine bone mineral density (BMD) studies were performed by dual-energy x-ray absorptiometry on 36 patients with prostate cancer.