首页 > 最新文献

Spinal Cord Series and Cases最新文献

英文 中文
Parainfectious Brown-Sequard syndrome associated with Mycoplasma pneumoniae in an adult patient: a case report. 一名成年患者与肺炎支原体相关的副感染性布朗-塞卡尔综合征:病例报告。
IF 1.2 Q4 Medicine Pub Date : 2024-03-15 DOI: 10.1038/s41394-024-00627-4
Michail Papantoniou, Konstantinos -Vasileios Tsatinas, Maria Gryllia

Introduction: Acute transverse myelitis (ATM) refers to a rare severe acquired spinal cord inflammation, with a challenging diagnostic work-up and treatment.

Case presentation: We report the case of a 42-year-old patient who presented with loss of temperature and pain sensation beneath the C5 dermatome in her left side and reported a history of a possible respiratory tract illness 10 days ago. Within 2 days, clinical worsening was noted, compatible with Brown-Sequard syndrome. Spinal magnetic resonance imaging revealed a T2 sequence abnormal signal from level C4 to T3 and cerebrospinal fluid (CSF) studies showed only a mild pleocytosis mononuclear type. Extensive CSF and blood tests revealed only high Mycoplasma pneumoniae IgM and IgG titers. Treatment with high-dose intravenous methylprednisolone and oral azithromycin were administrated and the patient recovered completely within two months.

Discussion: We would like to highlight the importance for physicians to consider M. pneumoniae in their differential diagnosis as a potential cause when encountering patients with symptoms of ATM and inflammatory Brown-Sequard syndrome.

简介:急性横贯性脊髓炎(ATM)是一种罕见的严重后天性脊髓炎,其诊断和治疗具有挑战性:急性横贯性脊髓炎(ATM)是一种罕见的严重后天性脊髓炎,其诊断和治疗具有挑战性:我们报告了一例 42 岁患者的病例。该患者出现左侧 C5 皮下失温和痛觉减退,并报告 10 天前可能患过呼吸道疾病。两天后,临床症状加重,与布朗-塞卡尔综合征相符。脊髓磁共振成像显示,从C4层到T3层的T2序列信号异常,脑脊液(CSF)检查仅显示轻度单核细胞增多。广泛的脑脊液和血液检查仅发现肺炎支原体 IgM 和 IgG 滴度较高。患者接受了大剂量甲基强的松龙静脉注射和阿奇霉素口服治疗,并在两个月内完全康复:我们想强调的是,当医生遇到有ATM和炎症性布朗-塞卡尔综合征症状的患者时,在鉴别诊断中将肺炎支原体作为潜在病因考虑的重要性。
{"title":"Parainfectious Brown-Sequard syndrome associated with Mycoplasma pneumoniae in an adult patient: a case report.","authors":"Michail Papantoniou, Konstantinos -Vasileios Tsatinas, Maria Gryllia","doi":"10.1038/s41394-024-00627-4","DOIUrl":"10.1038/s41394-024-00627-4","url":null,"abstract":"<p><strong>Introduction: </strong>Acute transverse myelitis (ATM) refers to a rare severe acquired spinal cord inflammation, with a challenging diagnostic work-up and treatment.</p><p><strong>Case presentation: </strong>We report the case of a 42-year-old patient who presented with loss of temperature and pain sensation beneath the C5 dermatome in her left side and reported a history of a possible respiratory tract illness 10 days ago. Within 2 days, clinical worsening was noted, compatible with Brown-Sequard syndrome. Spinal magnetic resonance imaging revealed a T2 sequence abnormal signal from level C4 to T3 and cerebrospinal fluid (CSF) studies showed only a mild pleocytosis mononuclear type. Extensive CSF and blood tests revealed only high Mycoplasma pneumoniae IgM and IgG titers. Treatment with high-dose intravenous methylprednisolone and oral azithromycin were administrated and the patient recovered completely within two months.</p><p><strong>Discussion: </strong>We would like to highlight the importance for physicians to consider M. pneumoniae in their differential diagnosis as a potential cause when encountering patients with symptoms of ATM and inflammatory Brown-Sequard syndrome.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10943185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perceptions of critically ill individuals with acute and chronic spinal cord injury requiring a tracheostomy tube. 需要气管插管的急性和慢性脊髓损伤重症患者的看法。
IF 1.2 Q4 Medicine Pub Date : 2024-03-13 DOI: 10.1038/s41394-024-00624-7
Christina Weckwerth, Christian Waydhas, Uwe Hamsen, Oliver Cruciger, Aileen Spieckermann, Thomas Armin Schildhauer, Mirko Aach, Robert Gaschler, Christopher Ull

Study design: Observational study.

Objectives: To evaluate the perceptions of patients requiring a tracheostomy tube and to identify possible different perceptions in critically ill patients with tracheostomy tubes who have acute (ASCI) or chronic spinal cord injuries (CSCI).

Setting: Medical and surgical intensive care units (ICU) and intermediate care unit of the BG University Hospital Bergmannsheil Bochum, Germany.

Methods: Patients who met the inclusion criteria completed a 25-item questionnaire on two consecutive days regarding their experiences and perceptions in breathing, coughing, pain, speaking, swallowing, and comfort of the tracheostomy tube.

Results: A total of 51 persons with ASCI (n = 31) and CSCI (n = 20) were included with a mean age of 53 years. Individuals with ASCI reported significantly more frequent pain and swallowing problems as compared to individuals with CSCI (p ≤ 0.014) at initial assessment. There were no differences between ASCI and CSCI reported with respect to speaking and overall comfort.

Conclusions: It is necessary to regularly assess the perceptions of critically ill patients with tracheostomy tubes with ASCI or CSCI in the daily ICU care routine. We were able to assess these perceptions in different categories. For the future, evaluating the perception of individuals with SCI and a tracheostomy should be implemented to their daily routine care.

Trial registration: DRKS00022073.

研究设计观察性研究:评估需要使用气管造口管的患者对气管造口管的感知,并确定使用气管造口管的急性(ASCI)或慢性脊髓损伤(CSCI)重症患者可能存在的不同感知:地点:德国波鸿 Bergmannsheil BG 大学医院内科和外科重症监护病房(ICU)以及中级监护病房:符合纳入标准的患者连续两天填写了一份包含 25 个项目的问卷,内容涉及他们在呼吸、咳嗽、疼痛、说话、吞咽以及气管插管舒适度方面的体验和感受:共纳入 51 名 ASCI 患者(31 人)和 CSCI 患者(20 人),他们的平均年龄为 53 岁。与 CSCI 患者相比,ASCI 患者在初次评估时报告的疼痛和吞咽困难频率明显更高(P ≤ 0.014)。ASCI患者和CSCI患者在说话和总体舒适度方面没有差异:结论:在重症监护室的日常护理中,有必要定期评估带有气管造瘘管的 ASCI 或 CSCI 重症患者的感受。我们能够对这些感知进行不同类别的评估。今后,应将评估 SCI 和气管切开术患者的感知纳入其日常护理中:试验注册:DRKS00022073。
{"title":"Perceptions of critically ill individuals with acute and chronic spinal cord injury requiring a tracheostomy tube.","authors":"Christina Weckwerth, Christian Waydhas, Uwe Hamsen, Oliver Cruciger, Aileen Spieckermann, Thomas Armin Schildhauer, Mirko Aach, Robert Gaschler, Christopher Ull","doi":"10.1038/s41394-024-00624-7","DOIUrl":"10.1038/s41394-024-00624-7","url":null,"abstract":"<p><strong>Study design: </strong>Observational study.</p><p><strong>Objectives: </strong>To evaluate the perceptions of patients requiring a tracheostomy tube and to identify possible different perceptions in critically ill patients with tracheostomy tubes who have acute (ASCI) or chronic spinal cord injuries (CSCI).</p><p><strong>Setting: </strong>Medical and surgical intensive care units (ICU) and intermediate care unit of the BG University Hospital Bergmannsheil Bochum, Germany.</p><p><strong>Methods: </strong>Patients who met the inclusion criteria completed a 25-item questionnaire on two consecutive days regarding their experiences and perceptions in breathing, coughing, pain, speaking, swallowing, and comfort of the tracheostomy tube.</p><p><strong>Results: </strong>A total of 51 persons with ASCI (n = 31) and CSCI (n = 20) were included with a mean age of 53 years. Individuals with ASCI reported significantly more frequent pain and swallowing problems as compared to individuals with CSCI (p ≤ 0.014) at initial assessment. There were no differences between ASCI and CSCI reported with respect to speaking and overall comfort.</p><p><strong>Conclusions: </strong>It is necessary to regularly assess the perceptions of critically ill patients with tracheostomy tubes with ASCI or CSCI in the daily ICU care routine. We were able to assess these perceptions in different categories. For the future, evaluating the perception of individuals with SCI and a tracheostomy should be implemented to their daily routine care.</p><p><strong>Trial registration: </strong>DRKS00022073.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10933252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Increasing employment opportunity for persons with spinal cord injury by digital working: an exampling case series from Thailand. 通过数字化工作增加脊髓损伤者的就业机会:泰国的一个案例系列。
IF 1.2 Q4 Medicine Pub Date : 2024-03-09 DOI: 10.1038/s41394-024-00625-6
Sintip Pattanakuhar, Urban Schwegler, Paksupa Prommueang, Tuankasfee Hama, Sathapon Patanakuha, Narumon Sumin

Introduction: Due to activity limitations and physical environmental barriers, low remunerative employment is a challenging issue for people with spinal cord injury (SCI) and relevant rehabilitation personnel. Since work opportunities in digital fields have continued to emerge, this study aims to report and discuss the possibility of using digital working as a strategy for increasing remunerative employment in people with SCI.

Case presentation: We report live experiences of four people with SCI in Thailand who have digital works with different types of jobs (image segmentation and identification for artificial intelligence development, online merchant, online streamer, cryptocurrency investor), different required digital skills (basic or intermediate digital skills), different employment statuses (employee or owner), and different incomes (from 50 to 200 USD/month). We also discuss advantages and potential risks of digital working for people with SCI and propose a model for care providers to facilitate safe digital work as a means of increasing remunerative opportunities for people with SCI.

Conclusion: There is increasing interest in becoming involved in various types of digital work among people with SCI. Digital working could overcome many of the physical barriers; however, it also potentially introduces some potential economic and health risks for people with SCI. To minimize those risks, healthcare providers of people with SCI should prepare to develop the appropriate knowledge and attitudes regarding digital working and to learn how to properly facilitate digital working to increase remunerative employment in people with SCI.

导言:由于脊髓损伤(SCI)患者和相关康复人员的活动限制和物理环境障碍,低报酬就业是一个具有挑战性的问题。由于数字领域的工作机会不断涌现,本研究旨在报告和讨论使用数字工作作为增加 SCI 患者有偿就业的策略的可能性:我们报告了泰国四名 SCI 患者的现场经历,他们从事的数字工作具有不同的工作类型(人工智能开发的图像分割和识别、在线商人、在线流媒体、加密货币投资者)、不同的数字技能要求(基础或中级数字技能)、不同的就业身份(雇员或业主)和不同的收入(从 50 美元/月到 200 美元/月)。我们还讨论了 SCI 患者从事数字工作的优势和潜在风险,并为护理提供者提出了一种促进安全数字工作的模式,以此增加 SCI 患者的报酬机会:结论: SCI 患者对参与各类数字化工作的兴趣与日俱增。数字工作可以克服许多物理障碍,但也可能给 SCI 患者带来一些潜在的经济和健康风险。为了将这些风险降到最低,为 SCI 患者提供医疗保健服务的人员应做好准备,发展有关数字化工作的适当知识和态度,并学习如何适当促进数字化工作,以增加 SCI 患者的有偿就业。
{"title":"Increasing employment opportunity for persons with spinal cord injury by digital working: an exampling case series from Thailand.","authors":"Sintip Pattanakuhar, Urban Schwegler, Paksupa Prommueang, Tuankasfee Hama, Sathapon Patanakuha, Narumon Sumin","doi":"10.1038/s41394-024-00625-6","DOIUrl":"10.1038/s41394-024-00625-6","url":null,"abstract":"<p><strong>Introduction: </strong>Due to activity limitations and physical environmental barriers, low remunerative employment is a challenging issue for people with spinal cord injury (SCI) and relevant rehabilitation personnel. Since work opportunities in digital fields have continued to emerge, this study aims to report and discuss the possibility of using digital working as a strategy for increasing remunerative employment in people with SCI.</p><p><strong>Case presentation: </strong>We report live experiences of four people with SCI in Thailand who have digital works with different types of jobs (image segmentation and identification for artificial intelligence development, online merchant, online streamer, cryptocurrency investor), different required digital skills (basic or intermediate digital skills), different employment statuses (employee or owner), and different incomes (from 50 to 200 USD/month). We also discuss advantages and potential risks of digital working for people with SCI and propose a model for care providers to facilitate safe digital work as a means of increasing remunerative opportunities for people with SCI.</p><p><strong>Conclusion: </strong>There is increasing interest in becoming involved in various types of digital work among people with SCI. Digital working could overcome many of the physical barriers; however, it also potentially introduces some potential economic and health risks for people with SCI. To minimize those risks, healthcare providers of people with SCI should prepare to develop the appropriate knowledge and attitudes regarding digital working and to learn how to properly facilitate digital working to increase remunerative employment in people with SCI.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10925060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-utility analysis and impact on the environment of videoconference in pressure injury. A randomized controlled trial in individuals with spinal cord injury. 压力损伤视频会议的成本效益分析及其对环境的影响。脊髓损伤患者随机对照试验。
IF 1.2 Q4 Medicine Pub Date : 2024-03-08 DOI: 10.1038/s41394-024-00621-w
Ingebjørg Irgens, Linn Kleven, Jana Midelfart-Hoff, Rolf Jelnes, Marcalee Alexander, Johan K Stanghelle, Tiina Rekand

Study design: A prospective randomized controlled trial (RCT) in persons with spinal cord injury (SCI) and ongoing pressure injury (PI).

Objectives: The main aim was to perform a cost-utility analysis (CUA) alongside the RCT comparing regular care to regular care with additional videoconference consultations. Secondary aims were to assess costs and greenhouse gas emission related to transportation in the two study groups.

Setting: Two spinal cord units in Norway.

Methods: Participants were allocated to a regular care group (RCG) and a regular care group with additional videoconference (VCG), in a 1-year follow-up between 2016 and 2018. Costs were prospectively collected, and health-related quality of life (HRQoL) data were collected at baseline and 12 months. The outcome was quality-adjusted life years (QALYs), derived from the EQ-5D-5L questionnaire. Results are reported as incremental cost-effectiveness ratio (ICER), expressed as the cost per additional QALY gained. Transportation related costs and environmental emissions were compared by t-tests.

Results: There were 56 participants included, 28 in each group. Of these 27 in the VCG and 26 in the RCG completed. Three participants died. The mean cost per patient was € 8819 in the VCG and € 3607 in the RCG, with 0.1 QALYs gained in the VCG. No significant differences were identified regarding HRQoL or secondary outcomes.

Conclusion: The VCG costs € 5212 more for an additional 0.1 QALYs, giving an ICER of € 52,120 per QALY. No significant differences were found regarding transportation-related costs, or emission of greenhouse gases.

Trial registration: www.

Clinicaltrials: gov ; NCT02800915, TeleSCIpi. CRISTIN.no. https://app.cristin.no/projects/show.jsf?id=545284 . Sunnaas Rehabilitation hospital's web page, available at https://www.sunnaas.no/fag-og-forskning/fagstoff/sar .

研究设计:前瞻性随机对照试验(RCT):针对脊髓损伤(SCI)和持续压迫损伤(PI)患者:主要目的:在进行随机对照试验的同时进行成本效用分析(CUA),比较常规护理和常规护理与额外的视频会议咨询。次要目的是评估两组研究中与交通相关的成本和温室气体排放:地点:挪威的两家脊髓治疗单位:参与者被分配到常规护理组(RCG)和附加视频会议的常规护理组(VCG),在2016年至2018年期间进行为期1年的随访。对费用进行了前瞻性收集,并在基线和12个月时收集了与健康相关的生活质量(HRQoL)数据。结果为质量调整生命年(QALYs),由 EQ-5D-5L 问卷得出。结果以增量成本效益比(ICER)报告,以每增加一个 QALY 的成本表示。与交通相关的成本和环境排放量通过 t 检验进行比较:共纳入 56 名参与者,每组 28 人。其中,27 名 VCG 参与者和 26 名 RCG 参与者完成了治疗。3 名参与者死亡。VCG组每位患者的平均成本为8819欧元,RCG组为3607欧元,VCG组获得了0.1 QALY。在 HRQoL 或次要结果方面没有发现明显差异:结论:VCG 额外 0.1 QALYs 的成本为 5212 欧元,每 QALY 的 ICER 为 52120 欧元。在交通相关成本或温室气体排放方面没有发现明显差异。试验注册:www.Clinicaltrials: gov ; NCT02800915, TeleSCIpi.CRISTIN.no. https://app.cristin.no/projects/show.jsf?id=545284 。Sunnaas 康复医院网页,见 https://www.sunnaas.no/fag-og-forskning/fagstoff/sar 。
{"title":"Cost-utility analysis and impact on the environment of videoconference in pressure injury. A randomized controlled trial in individuals with spinal cord injury.","authors":"Ingebjørg Irgens, Linn Kleven, Jana Midelfart-Hoff, Rolf Jelnes, Marcalee Alexander, Johan K Stanghelle, Tiina Rekand","doi":"10.1038/s41394-024-00621-w","DOIUrl":"10.1038/s41394-024-00621-w","url":null,"abstract":"<p><strong>Study design: </strong>A prospective randomized controlled trial (RCT) in persons with spinal cord injury (SCI) and ongoing pressure injury (PI).</p><p><strong>Objectives: </strong>The main aim was to perform a cost-utility analysis (CUA) alongside the RCT comparing regular care to regular care with additional videoconference consultations. Secondary aims were to assess costs and greenhouse gas emission related to transportation in the two study groups.</p><p><strong>Setting: </strong>Two spinal cord units in Norway.</p><p><strong>Methods: </strong>Participants were allocated to a regular care group (RCG) and a regular care group with additional videoconference (VCG), in a 1-year follow-up between 2016 and 2018. Costs were prospectively collected, and health-related quality of life (HRQoL) data were collected at baseline and 12 months. The outcome was quality-adjusted life years (QALYs), derived from the EQ-5D-5L questionnaire. Results are reported as incremental cost-effectiveness ratio (ICER), expressed as the cost per additional QALY gained. Transportation related costs and environmental emissions were compared by t-tests.</p><p><strong>Results: </strong>There were 56 participants included, 28 in each group. Of these 27 in the VCG and 26 in the RCG completed. Three participants died. The mean cost per patient was € 8819 in the VCG and € 3607 in the RCG, with 0.1 QALYs gained in the VCG. No significant differences were identified regarding HRQoL or secondary outcomes.</p><p><strong>Conclusion: </strong>The VCG costs € 5212 more for an additional 0.1 QALYs, giving an ICER of € 52,120 per QALY. No significant differences were found regarding transportation-related costs, or emission of greenhouse gases.</p><p><strong>Trial registration: </strong>www.</p><p><strong>Clinicaltrials: </strong>gov ; NCT02800915, TeleSCIpi. CRISTIN.no. https://app.cristin.no/projects/show.jsf?id=545284 . Sunnaas Rehabilitation hospital's web page, available at https://www.sunnaas.no/fag-og-forskning/fagstoff/sar .</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10923859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140065988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The interrelationship between pain, life satisfaction and mental health in adults with traumatic spinal cord injury, in the context of a developing country. 以发展中国家为背景,研究创伤性脊髓损伤成人患者的疼痛、生活满意度和心理健康之间的相互关系。
IF 1.2 Q4 Medicine Pub Date : 2024-03-07 DOI: 10.1038/s41394-024-00622-9
Tammy-Lee Williams, Conran Joseph, Lena Nilsson-Wikmar, Joliana Phillips

Study design: Cross-sectional, analytical study design using a conveneient sampling strategy.

Objectives: To examine the interrelationship between pain, life satisfaction and indices of negative mental well-being amongst the traumatic spinal cord injury (TSCI) population.

Setting: Western Cape Rehabilitation Center in Cape Town, South Africa.

Methods: Participants (n = 70) were adults (mean age of 36.3, SD = 9.2) with TSCI. Participants completed the following instruments: 10 satisfaction items from the World Health Organization Quality of Life Brief Version, short forms of the Center for Epidemiological Studies Depression Scale and the trait scale of the State-Trait Anxiety Inventory, a one-item measure of pain intensity taken from the International Spinal Cord Injury Pain Basic Data Set and the interference scale of the Brief Pain Inventory.

Results: Correlational analysis (Pearson r) demonstrated that all the indices of mental well-being as well as the two indices of pain was significantly negatively related to life satisfaction. In addition, life satisfaction mediated the relationship between pain intensity and depression as well as anxiety. Life satisfaction only mediated the relationship between pain interference and depression but not anxiety.

Conclusions: An improvement in life satisfaction may lead to improvements in pain interference, pain intensity as well as psychological distress, amongst persons suffering from TSCI Future research should focus on assessing measures/treatment which may improve life satisfaction in the TSCI population.

研究设计:横断面分析研究设计,采用召集式抽样策略:环境:南非开普敦西开普康复中心:地点:南非开普敦西开普康复中心:参与者(n = 70)为患有创伤性脊髓损伤(TSCI)的成年人(平均年龄 36.3 岁,SD = 9.2)。参与者完成了以下工具世界卫生组织生活质量简易版中的 10 个满意度项目、流行病学研究中心抑郁量表简表和状态-特质焦虑量表的特质量表、国际脊髓损伤疼痛基本数据集中的疼痛强度单项量表和简易疼痛量表的干扰量表:相关分析(Pearson r)表明,所有心理健康指数以及两个疼痛指数都与生活满意度呈显著负相关。此外,生活满意度还能调节疼痛强度与抑郁和焦虑之间的关系。生活满意度只对疼痛干扰和抑郁之间的关系起中介作用,而对焦虑则不起中介作用:生活满意度的提高可能会改善 TSCI 患者的疼痛干扰、疼痛强度和心理困扰。
{"title":"The interrelationship between pain, life satisfaction and mental health in adults with traumatic spinal cord injury, in the context of a developing country.","authors":"Tammy-Lee Williams, Conran Joseph, Lena Nilsson-Wikmar, Joliana Phillips","doi":"10.1038/s41394-024-00622-9","DOIUrl":"10.1038/s41394-024-00622-9","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional, analytical study design using a conveneient sampling strategy.</p><p><strong>Objectives: </strong>To examine the interrelationship between pain, life satisfaction and indices of negative mental well-being amongst the traumatic spinal cord injury (TSCI) population.</p><p><strong>Setting: </strong>Western Cape Rehabilitation Center in Cape Town, South Africa.</p><p><strong>Methods: </strong>Participants (n = 70) were adults (mean age of 36.3, SD = 9.2) with TSCI. Participants completed the following instruments: 10 satisfaction items from the World Health Organization Quality of Life Brief Version, short forms of the Center for Epidemiological Studies Depression Scale and the trait scale of the State-Trait Anxiety Inventory, a one-item measure of pain intensity taken from the International Spinal Cord Injury Pain Basic Data Set and the interference scale of the Brief Pain Inventory.</p><p><strong>Results: </strong>Correlational analysis (Pearson r) demonstrated that all the indices of mental well-being as well as the two indices of pain was significantly negatively related to life satisfaction. In addition, life satisfaction mediated the relationship between pain intensity and depression as well as anxiety. Life satisfaction only mediated the relationship between pain interference and depression but not anxiety.</p><p><strong>Conclusions: </strong>An improvement in life satisfaction may lead to improvements in pain interference, pain intensity as well as psychological distress, amongst persons suffering from TSCI Future research should focus on assessing measures/treatment which may improve life satisfaction in the TSCI population.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10920914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of neurogenic bladder in patients with spinal cord injuries/disorders and end stage renal disease: a case series. 脊髓损伤/障碍和终末期肾病患者神经源性膀胱的管理:病例系列。
IF 1.2 Q4 Medicine Pub Date : 2024-03-04 DOI: 10.1038/s41394-024-00623-8
Rajbir Chaggar, Lance L Goetz, Jordan Adler, Mohammed B A Bhuiyan, Sean McAvoy, Jeffrey Tubbs

Introduction: Patients with spinal cord injuries/disorders (SCI/D) often suffer from bladder dysfunction, commonly referred to as neurogenic bladder or neurogenic lower urinary tract dysfunction (NLUTD). Standard urologic evaluation and management help to minimize complications such as vesicoureteral reflux, urinary tract infection, and nephrolithiasis. However, we have further encountered patients with more complex issues, such as chronic kidney disease (CKD), end-stage renal disease (ESRD), bilateral nephrectomies, and urinary diversion/augmentation surgeries. Of particular interest, there is a lack of standardized guidance for bladder management in SCI/D patients with ESRD. These patients are at high risk for urological complications and would benefit from codified bladder management strategies.

Case presentation: In this article, we present eleven unique cases of NLUTD with associated ESRD and discuss recommendations utilizing simple and commonly available clinical interventions.

Discussion: The inherently small population size of SCI/D patients with NLUTD and ESRD makes detailing a large sample size case series difficult. Future studies must aim to include a larger sample size as able, however, to better determine standardized protocols for chronic bladder management in SCI/D patients with NLUTD and ESRD. Experiences from this small case series are offered for consideration.

导言:脊髓损伤/障碍(SCI/D)患者通常患有膀胱功能障碍,通常称为神经源性膀胱或神经源性下尿路功能障碍(NLUTD)。标准的泌尿科评估和管理有助于将膀胱输尿管反流、尿路感染和肾结石等并发症降至最低。然而,我们还遇到了一些问题更为复杂的患者,如慢性肾病(CKD)、终末期肾病(ESRD)、双侧肾切除术和尿流改道/增殖手术。尤其值得注意的是,目前缺乏对患有 ESRD 的 SCI/D 患者进行膀胱管理的标准化指导。这些患者是泌尿系统并发症的高危人群,将受益于规范的膀胱管理策略:在本文中,我们介绍了 11 例伴有 ESRD 的 NLUTD 病例,并讨论了利用简单而常见的临床干预措施的建议:SCI/D患者中患有NLUTD和ESRD的人群规模本身较小,因此很难详细描述大样本量的病例系列。不过,未来的研究必须以纳入更多样本为目标,以便更好地确定对患有 NLUTD 和 ESRD 的 SCI/D 患者进行慢性膀胱管理的标准化方案。本小型病例系列的经验可供参考。
{"title":"Management of neurogenic bladder in patients with spinal cord injuries/disorders and end stage renal disease: a case series.","authors":"Rajbir Chaggar, Lance L Goetz, Jordan Adler, Mohammed B A Bhuiyan, Sean McAvoy, Jeffrey Tubbs","doi":"10.1038/s41394-024-00623-8","DOIUrl":"10.1038/s41394-024-00623-8","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with spinal cord injuries/disorders (SCI/D) often suffer from bladder dysfunction, commonly referred to as neurogenic bladder or neurogenic lower urinary tract dysfunction (NLUTD). Standard urologic evaluation and management help to minimize complications such as vesicoureteral reflux, urinary tract infection, and nephrolithiasis. However, we have further encountered patients with more complex issues, such as chronic kidney disease (CKD), end-stage renal disease (ESRD), bilateral nephrectomies, and urinary diversion/augmentation surgeries. Of particular interest, there is a lack of standardized guidance for bladder management in SCI/D patients with ESRD. These patients are at high risk for urological complications and would benefit from codified bladder management strategies.</p><p><strong>Case presentation: </strong>In this article, we present eleven unique cases of NLUTD with associated ESRD and discuss recommendations utilizing simple and commonly available clinical interventions.</p><p><strong>Discussion: </strong>The inherently small population size of SCI/D patients with NLUTD and ESRD makes detailing a large sample size case series difficult. Future studies must aim to include a larger sample size as able, however, to better determine standardized protocols for chronic bladder management in SCI/D patients with NLUTD and ESRD. Experiences from this small case series are offered for consideration.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10912285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The relationship between balance control and thigh muscle strength and muscle activity in persons with incomplete spinal cord injury. 不完全脊髓损伤患者的平衡控制与大腿肌肉力量和肌肉活动之间的关系。
IF 1.2 Q4 Medicine Pub Date : 2024-02-28 DOI: 10.1038/s41394-024-00620-x
Matthijs Ferdinand Wouda, Marte Fosvold Løtveit, Espen Ingvald Bengtson, Vegard Strøm

Study design: Cross-sectional study.

Objectives: A spinal cord injury (SCI) can compromise the ability to maintain sufficient balance control during activities in an upraised position. The objective of the study was to explore the relationship between balance control and muscle strength and muscle activation in the lower extremities in persons with incomplete SCI (iSCI).

Setting: Sunnaas Rehabilitation Hospital, Norway.

Methods: Thirteen men and two women with iSCI and 15 healthy, matched controls were included. Performance of the Berg Balance Scale (BBS) short version (7 items) was used to indicate balance control. Maximal voluntary contraction (MVC) was performed to measure isometric muscle strength in thigh muscles (knee extension/flexion), while surface electromyography (EMG) was measured from M. Vastus Lateralis and M. Biceps Femoris. The relative activation of each muscle during each of the BBS tasks was reported as the percentage of the maximal activation during the MVC (%EMGmax).

Results: The iSCI participants had a significantly lower BBS sum score and up to 40% lower muscle strength in knee- flexion and extension compared to the matched healthy controls. They also exhibited a significantly higher %EMGmax, i.e. a higher muscle activation, during most of the balance tests. Univariate regression analysis revealed a significant association between balance control and mean values of %EMGmax in Biceps Femoris, averaged over the seven BBS tests.

Conclusions: The participants with iSCI had poorer balance control, reduced thigh muscle strength and a higher relative muscle activation in their thigh muscles, during balance-demanding activities.

研究设计横断面研究:脊髓损伤(SCI)会影响在上举姿势活动时保持足够平衡控制的能力。本研究旨在探讨不完全脊髓损伤(iSCI)患者的平衡控制能力与下肢肌肉力量和肌肉激活之间的关系:研究地点:挪威松纳斯康复医院:方法:纳入 13 名男性 iSCI 患者和 2 名女性 iSCI 患者,以及 15 名健康的匹配对照者。采用伯格平衡量表(BBS)短版(7 个项目)的表现来衡量平衡控制能力。进行最大自主收缩(MVC)以测量大腿肌肉的等长肌力(膝关节伸展/屈曲),同时测量M. Vastus Lateralis和M. Biceps Femoris的表面肌电图(EMG)。在每项 BBS 任务中,每块肌肉的相对激活度以 MVC 期间最大激活度的百分比(%EMGmax)进行报告:结果:与相匹配的健康对照组相比,iSCI 参与者的 BBS 总分明显较低,膝关节屈伸肌力低达 40%。在大多数平衡测试中,他们的EMGmax%也明显较高,即肌肉活化程度较高。单变量回归分析表明,平衡控制能力与股二头肌EMGmax的平均值(七项BBS测试的平均值)之间存在显著关联:在需要平衡的活动中,iSCI 参与者的平衡控制能力较差,大腿肌肉力量减弱,大腿肌肉的相对激活程度较高。
{"title":"The relationship between balance control and thigh muscle strength and muscle activity in persons with incomplete spinal cord injury.","authors":"Matthijs Ferdinand Wouda, Marte Fosvold Løtveit, Espen Ingvald Bengtson, Vegard Strøm","doi":"10.1038/s41394-024-00620-x","DOIUrl":"10.1038/s41394-024-00620-x","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Objectives: </strong>A spinal cord injury (SCI) can compromise the ability to maintain sufficient balance control during activities in an upraised position. The objective of the study was to explore the relationship between balance control and muscle strength and muscle activation in the lower extremities in persons with incomplete SCI (iSCI).</p><p><strong>Setting: </strong>Sunnaas Rehabilitation Hospital, Norway.</p><p><strong>Methods: </strong>Thirteen men and two women with iSCI and 15 healthy, matched controls were included. Performance of the Berg Balance Scale (BBS) short version (7 items) was used to indicate balance control. Maximal voluntary contraction (MVC) was performed to measure isometric muscle strength in thigh muscles (knee extension/flexion), while surface electromyography (EMG) was measured from M. Vastus Lateralis and M. Biceps Femoris. The relative activation of each muscle during each of the BBS tasks was reported as the percentage of the maximal activation during the MVC (%EMG<sub>max</sub>).</p><p><strong>Results: </strong>The iSCI participants had a significantly lower BBS sum score and up to 40% lower muscle strength in knee- flexion and extension compared to the matched healthy controls. They also exhibited a significantly higher %EMG<sub>max</sub>, i.e. a higher muscle activation, during most of the balance tests. Univariate regression analysis revealed a significant association between balance control and mean values of %EMGmax in Biceps Femoris, averaged over the seven BBS tests.</p><p><strong>Conclusions: </strong>The participants with iSCI had poorer balance control, reduced thigh muscle strength and a higher relative muscle activation in their thigh muscles, during balance-demanding activities.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10902359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intramedullary spinal cord abscess involving Actinomyces and Streptococcus: a case report and literature review. 涉及放线菌和链球菌的脊髓髓内脓肿:病例报告和文献综述。
IF 1.2 Q4 Medicine Pub Date : 2024-02-17 DOI: 10.1038/s41394-024-00618-5
Shunsuke Nakamura, Hiroya Shimauchi-Ohtaki, Fumiaki Honda, Yutaka Tokue, Yuhei Yoshimoto

Introduction: Intramedullary spinal cord abscesses (ISCA) are rare and caused by central nervous system infections. Although polymicrobial infections are rarely seen in ISCAs, isolation of the causative pathogen is important for treatment. Here, we describe a very rare case of ISCA resulting from a mixed Streptococcus and Actinomyces infection.

Case presentation: An 82-year-old man presented with acute posterior cervical pain and progressive quadriplegia. Radiological investigations revealed a mass lesion showing marginal enhancement at the level of the C3-4 vertebrae. Microsurgical drainage was performed, and Streptococcus and Actinomyces were identified as causative agents. Subsequent antibiotic treatment was noted to be beneficial to the patient.

Discussion: This case suggests that mixed infection can develop into ISCA depending on the causative agents such as Actinomyces. Prompt pathogen-directed antibacterial therapy is required for ISCA treatment.

简介髓内脊髓脓肿(ISCA)很罕见,由中枢神经系统感染引起。虽然多微生物感染在 ISCA 中很少见,但分离致病病原体对治疗非常重要。在此,我们描述了一例非常罕见的链球菌和放线菌混合感染导致的 ISCA 病例:一名 82 岁的男子因急性颈椎后部疼痛和进行性四肢瘫痪而就诊。放射学检查显示,C3-4 椎体水平的肿块病变呈边缘强化。经显微手术引流,确定链球菌和放线菌为致病菌。随后的抗生素治疗对患者有益:讨论:本病例表明,根据放线菌等致病菌的不同,混合感染可发展为 ISCA。ISCA的治疗需要及时的病原体导向抗菌治疗。
{"title":"Intramedullary spinal cord abscess involving Actinomyces and Streptococcus: a case report and literature review.","authors":"Shunsuke Nakamura, Hiroya Shimauchi-Ohtaki, Fumiaki Honda, Yutaka Tokue, Yuhei Yoshimoto","doi":"10.1038/s41394-024-00618-5","DOIUrl":"10.1038/s41394-024-00618-5","url":null,"abstract":"<p><strong>Introduction: </strong>Intramedullary spinal cord abscesses (ISCA) are rare and caused by central nervous system infections. Although polymicrobial infections are rarely seen in ISCAs, isolation of the causative pathogen is important for treatment. Here, we describe a very rare case of ISCA resulting from a mixed Streptococcus and Actinomyces infection.</p><p><strong>Case presentation: </strong>An 82-year-old man presented with acute posterior cervical pain and progressive quadriplegia. Radiological investigations revealed a mass lesion showing marginal enhancement at the level of the C3-4 vertebrae. Microsurgical drainage was performed, and Streptococcus and Actinomyces were identified as causative agents. Subsequent antibiotic treatment was noted to be beneficial to the patient.</p><p><strong>Discussion: </strong>This case suggests that mixed infection can develop into ISCA depending on the causative agents such as Actinomyces. Prompt pathogen-directed antibacterial therapy is required for ISCA treatment.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
COVID-19 and spinal cord injury: clinical presentation, clinical course, and clinical outcomes of people hospitalised. COVID-19 与脊髓损伤:住院患者的临床表现、临床过程和临床结果。
IF 1.2 Q4 Medicine Pub Date : 2024-02-13 DOI: 10.1038/s41394-024-00617-6
Inge E Eriks-Hoogland, Michael A Barth, Lorena L Müller, Dominique Braun, Armin Curt, Mohit Arora, James W Middleton, Jürgen Pannek

Study design: Retrospective study OBJECTIVES: To describe the presenting symptoms/signs, clinical course and outcomes in hospitalised people with spinal cord injury (SCI) and symptomatic COVID-19 infections.

Setting: One university hospital and two SCI centres in Switzerland.

Methods: Descriptive analysis of symptoms/signs, clinical course and outcomes of people with SCI with symptomatic COVID-19 infections and need for hospitalisation.

Results: Twenty-two people with SCI were included, 15 (68%) were male, median age 64.5 years (interquartile range, IQR, 52-73 years). Nine (41%) had tetraplegia, and eight (36%) were classified with motor-complete lesions. Frequent clinical symptoms were fever (59%), coughing (54%), fatigue (50%), and dyspnoea (27%). Most frequent complications were bacterial pulmonary superinfection (18%), and acute respiratory distress syndrome (18%). Fifteen persons (68%) needed oxygen therapy during the course of hospitalisation, and 7 (32%) people were ventilated. Median length of stay (LOS) was 23 days (IQR 15-35), varying by age for people under 60 years with a median LOS of 9 days (IQR 8-27), and for those older than 60 years with a median of 34 days (IQR 17-39), respectively. In total, 3 persons (14%) died during hospitalisation, all older with paraplegia.

Conclusions: Typical symptoms like fever and coughing were not present in all people. People with tetraplegia did not demonstrate worse outcomes, on the contrary, they had shorter LOS, no difference in ventilation needs, and no higher mortality compared to people with paraplegia. Older people showed longer LOS. This study recommends close supervision of the SCI population to detect early signs and symptoms of COVID-19 infection.

研究设计:回顾性研究 目的:描述脊髓损伤(SCI)住院患者和无症状 COVID-19 感染者的症状/体征、临床过程和预后:描述脊髓损伤(SCI)和无症状 COVID-19 感染住院患者的症状/体征、临床过程和预后:方法: 对症状/体征进行描述性分析:方法:对有症状的 COVID-19 感染和需要住院治疗的 SCI 患者的症状/体征、临床过程和结果进行描述性分析:共纳入 22 名 SCI 患者,其中 15 人(68%)为男性,中位年龄为 64.5 岁(四分位数间距,IQR,52-73 岁)。9人(41%)四肢瘫痪,8人(36%)运动功能完全丧失。常见的临床症状为发热(59%)、咳嗽(54%)、乏力(50%)和呼吸困难(27%)。最常见的并发症是细菌性肺部超级感染(18%)和急性呼吸窘迫综合征(18%)。有 15 人(68%)在住院期间需要接受氧疗,7 人(32%)接受了通气治疗。中位住院时间(LOS)为 23 天(IQR 15-35),因年龄而异,60 岁以下的中位住院时间为 9 天(IQR 8-27),60 岁以上的中位住院时间为 34 天(IQR 17-39)。共有3人(14%)在住院期间死亡,均为老年截瘫患者:结论:并非所有患者都会出现发烧和咳嗽等典型症状。与截瘫患者相比,四肢瘫痪患者的治疗效果并不差,相反,他们的住院时间更短,通气需求也没有差异,死亡率也不高。老年人的住院时间更长。本研究建议对 SCI 患者进行密切监护,以发现 COVID-19 感染的早期症状和体征。
{"title":"COVID-19 and spinal cord injury: clinical presentation, clinical course, and clinical outcomes of people hospitalised.","authors":"Inge E Eriks-Hoogland, Michael A Barth, Lorena L Müller, Dominique Braun, Armin Curt, Mohit Arora, James W Middleton, Jürgen Pannek","doi":"10.1038/s41394-024-00617-6","DOIUrl":"10.1038/s41394-024-00617-6","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study OBJECTIVES: To describe the presenting symptoms/signs, clinical course and outcomes in hospitalised people with spinal cord injury (SCI) and symptomatic COVID-19 infections.</p><p><strong>Setting: </strong>One university hospital and two SCI centres in Switzerland.</p><p><strong>Methods: </strong>Descriptive analysis of symptoms/signs, clinical course and outcomes of people with SCI with symptomatic COVID-19 infections and need for hospitalisation.</p><p><strong>Results: </strong>Twenty-two people with SCI were included, 15 (68%) were male, median age 64.5 years (interquartile range, IQR, 52-73 years). Nine (41%) had tetraplegia, and eight (36%) were classified with motor-complete lesions. Frequent clinical symptoms were fever (59%), coughing (54%), fatigue (50%), and dyspnoea (27%). Most frequent complications were bacterial pulmonary superinfection (18%), and acute respiratory distress syndrome (18%). Fifteen persons (68%) needed oxygen therapy during the course of hospitalisation, and 7 (32%) people were ventilated. Median length of stay (LOS) was 23 days (IQR 15-35), varying by age for people under 60 years with a median LOS of 9 days (IQR 8-27), and for those older than 60 years with a median of 34 days (IQR 17-39), respectively. In total, 3 persons (14%) died during hospitalisation, all older with paraplegia.</p><p><strong>Conclusions: </strong>Typical symptoms like fever and coughing were not present in all people. People with tetraplegia did not demonstrate worse outcomes, on the contrary, they had shorter LOS, no difference in ventilation needs, and no higher mortality compared to people with paraplegia. Older people showed longer LOS. This study recommends close supervision of the SCI population to detect early signs and symptoms of COVID-19 infection.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The critical role of magnetic resonance imaging in the diagnosis of transverse myelitis: a case report. 磁共振成像在横贯性脊髓炎诊断中的关键作用:病例报告。
IF 1.2 Q4 Medicine Pub Date : 2024-02-10 DOI: 10.1038/s41394-024-00616-7
Esther Omotola Adewuyi, Zainab Adedamola Abdulsalam, Olorunnisola Onaolapo Olatide

Introduction: Transverse Myelitis is a rare inflammatory disorder of the spinal cord, characterized by the inflammation of the myelin sheath covering nerve fibers. Although rare, Transverse Myelitis holds significant clinical importance due to its potential life-altering consequences. The case report provides insight into the clinical presentation of Transverse Myelitis and the importance of Magnetic Resonance Imaging in confirming Transverse Myelitis.

Case presentation: A 27-year-old Nigerian female presented to a hospital facility after 2 months onset of paraplegia, urinary, and fecal incontinence. She was diagnosed with Acute Transverse Myelitis with Magnetic Resonance Imaging, a lacking imaging modality in Nigeria. On presentation, it was important to rule out spinal cord compression, a close differential to her presentation. Despite her late arrival at the facility, early diagnosis and prompt initiation of treatment with high-dose intravenous steroids and physiotherapy improved her quality of life.

Discussion: This case report reveals the poor health-seeking behavior in developing countries and the need for imaging modalities like Magnetic Resonance Imaging for improved diagnoses of rare neurological conditions such as Transverse Myelitis. The lack of healthcare infrastructure has led to clinical misdiagnosis, patient mismanagement, and underrepresentation of data in the country, underscoring the critical role of diagnostic tools for improved patient care pre-treatment and post-treatment. Additionally, follow-up of these patients is important to prevent the long-term sequelae of Transverse Myelitis like Neuromyelitis Optica or Multiple Sclerosis.

简介横贯脊髓炎是一种罕见的脊髓炎症性疾病,其特征是覆盖神经纤维的髓鞘发炎。横贯性脊髓炎虽然罕见,但由于其潜在的改变生命的后果而具有重要的临床意义。本病例报告介绍了横贯性脊髓炎的临床表现以及磁共振成像在确诊横贯性脊髓炎方面的重要性:一名 27 岁的尼日利亚女性因截瘫、大小便失禁 2 个月后到医院就诊。她通过磁共振成像被诊断为急性横贯性脊髓炎,这是尼日利亚缺乏的一种成像方式。就诊时,必须排除脊髓压迫的可能性,这与她的症状有密切的区别。尽管她到达医疗机构的时间较晚,但早期诊断和及时启动大剂量静脉类固醇及物理治疗改善了她的生活质量:本病例报告揭示了发展中国家患者就医行为的不规范,以及磁共振成像等成像模式对改善横贯性脊髓炎等罕见神经系统疾病诊断的必要性。医疗保健基础设施的缺乏导致了临床误诊、患者管理不善以及国内数据代表性不足,这突出了诊断工具在改善患者治疗前和治疗后护理方面的关键作用。此外,对这些患者进行随访对于预防横贯性脊髓炎的长期后遗症(如神经脊髓炎或多发性硬化症)也非常重要。
{"title":"The critical role of magnetic resonance imaging in the diagnosis of transverse myelitis: a case report.","authors":"Esther Omotola Adewuyi, Zainab Adedamola Abdulsalam, Olorunnisola Onaolapo Olatide","doi":"10.1038/s41394-024-00616-7","DOIUrl":"10.1038/s41394-024-00616-7","url":null,"abstract":"<p><strong>Introduction: </strong>Transverse Myelitis is a rare inflammatory disorder of the spinal cord, characterized by the inflammation of the myelin sheath covering nerve fibers. Although rare, Transverse Myelitis holds significant clinical importance due to its potential life-altering consequences. The case report provides insight into the clinical presentation of Transverse Myelitis and the importance of Magnetic Resonance Imaging in confirming Transverse Myelitis.</p><p><strong>Case presentation: </strong>A 27-year-old Nigerian female presented to a hospital facility after 2 months onset of paraplegia, urinary, and fecal incontinence. She was diagnosed with Acute Transverse Myelitis with Magnetic Resonance Imaging, a lacking imaging modality in Nigeria. On presentation, it was important to rule out spinal cord compression, a close differential to her presentation. Despite her late arrival at the facility, early diagnosis and prompt initiation of treatment with high-dose intravenous steroids and physiotherapy improved her quality of life.</p><p><strong>Discussion: </strong>This case report reveals the poor health-seeking behavior in developing countries and the need for imaging modalities like Magnetic Resonance Imaging for improved diagnoses of rare neurological conditions such as Transverse Myelitis. The lack of healthcare infrastructure has led to clinical misdiagnosis, patient mismanagement, and underrepresentation of data in the country, underscoring the critical role of diagnostic tools for improved patient care pre-treatment and post-treatment. Additionally, follow-up of these patients is important to prevent the long-term sequelae of Transverse Myelitis like Neuromyelitis Optica or Multiple Sclerosis.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10858937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Spinal Cord Series and Cases
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1