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Banakhar MA. Sacral neuromodulation for neurological disease-induced lower urinary tract symptoms in Saudi Arabia: a single-centre experience. J Int Med Res 2022; 50:3000605221117221. [PMID: 36039601 PMCID: PMC9434672 DOI: 10.1177/03000605221117221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To evaluate the effectiveness of sacral neuromodulation therapy (SNM) for
lower urinary tract symptoms (LUTS) caused by neurological diseases. Methods This prospective cohort study enrolled patients that developed LUTS secondary
to neurological disorders. All patients underwent staged SNM. A 5-day
voiding diary was used to evaluate their response to the stage 1 procedure.
Implantation of the full system during the stage 2 procedure was undertaken
in patients that had ≥50% improvement on their voiding diary. Results Twenty-one patients were included in the study with the following
neurological aetiologies: diabetes mellitus (n = 2),
myelitis (n = 3), multiple sclerosis
(n = 5), spinal cord injury (n = 10) and
cerebrovascular accident (n = 1). Fifteen patients
underwent the stage 1 procedure successfully; their mean age was 47.5 years
and the mean follow-up was 29 months. SNM resulted in significantly
increased voided volume/void/day, decreased leaking episodes/day, decreased
postvoiding residual/day and decreased number of clean intermittent
catheterization/day compared with baseline. Five patients were highly
satisfied, nine were moderately satisfied and one patient was not satisfied
with the therapy. Conclusion SNM was an effective therapy for LUTS caused by neurological disease and
there was a high rate of patient satisfaction.
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Affiliation(s)
- Mai Ahmed Banakhar
- Department of Urology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Betthauser LM, Hoffberg AS, Stearns-Yoder KA, Harmon M, Coons D, Brenner LA. A systematic review of suicidal ideation and behaviors among adults with spinal cord injury. J Spinal Cord Med 2022:1-12. [PMID: 35192444 DOI: 10.1080/10790268.2022.2029282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CONTEXT Suicide is a public health crisis within the United States. Individuals with spinal cord injury (SCI) are vulnerable to negative outcomes such as suicide. OBJECTIVE This systematic review describes frequency of suicidal ideation (SI) and behaviors (suicide attempt [SA] and deaths) among samples of adults living with SCI. Associated risk and protective factors of SI and suicidal behaviors were also explored. METHODS On July 7, 2021, OVID Medline, EMBASE, OVID PsycINFO, Web of Science Core Collection, CINAHL, Cochrane Library, and Google Scholar databases were searched for SI, SA, and deaths by suicide among adults with a history of SCI. Risk of bias (RoB) was assessed using the Effective Public Health Practice Project (EPHPP) quality assessment tool. Results were synthesized descriptively considering the likely impact of RoB. The updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 reporting method was used. RESULTS Sixty-nine articles were included. Frequency of SI and SAs within study samples ranged from 4% to 67%, and 0% to approximately 66%, respectively. While assessment methods for SI and SA widely varied, suicide deaths data sources were more consistent. Studies assessing SI and SA generally had high RoB and the overall strength of evidence was low. Stronger observational study designs assessing death by suicide had low RoB and the overall strength of evidence was high. Very few studies examined protective factors. DISCUSSION Findings support previous work. Quality of evidence, and therefore confidence in the frequency of these outcomes, was impacted by the use of assessment measures without sufficient psychometric properties. The field will benefit from use of psychometrically sound measures to assess for SI, SA and suicide deaths. Furthermore, additional work is needed to elucidate risk and protective factors and to clearly characterize samples to increase generalizability of findings to the larger SCI community, including standardized reporting of SCI characteristics (e.g. use of American Spinal Injury Association classification system). Ultimately, improved suicide assessment and risk management is expected to prevent suicide among those living with SCI. REGISTRATION CRD42020164686.
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Affiliation(s)
- Lisa M Betthauser
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (RM MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMR VAMC), Eastern Colorado Health Care System, Aurora, Colorado, USA.,Department of Physical Medicine & Rehabilitation (PM&R), University of Colorado, Aurora, Colorado, USA
| | - Adam S Hoffberg
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (RM MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMR VAMC), Eastern Colorado Health Care System, Aurora, Colorado, USA
| | - Kelly A Stearns-Yoder
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (RM MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMR VAMC), Eastern Colorado Health Care System, Aurora, Colorado, USA.,Department of Physical Medicine & Rehabilitation (PM&R), University of Colorado, Aurora, Colorado, USA
| | - Matthew Harmon
- Department of Physical Medicine & Rehabilitation (PM&R), University of Colorado, Aurora, Colorado, USA
| | - David Coons
- Department of Physical Medicine & Rehabilitation (PM&R), University of Colorado, Aurora, Colorado, USA.,Spinal Cord Injury/Disorder Clinic, RMR VAMC, Eastern Colorado Health Care System, Aurora, Colorado, USA
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (RM MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMR VAMC), Eastern Colorado Health Care System, Aurora, Colorado, USA.,Department of Physical Medicine & Rehabilitation (PM&R), University of Colorado, Aurora, Colorado, USA.,Departments of Psychiatry, & Neurology, University of Colorado, Aurora, Colorado, USA
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Wang H, Ou Y, Fan T, Zhao J, Kang M, Dong R, Qu Y. Development and Internal Validation of a Nomogram to Predict Mortality During the ICU Stay of Thoracic Fracture Patients Without Neurological Compromise: An Analysis of the MIMIC-III Clinical Database. Front Public Health 2022; 9:818439. [PMID: 35004604 PMCID: PMC8727460 DOI: 10.3389/fpubh.2021.818439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: This study aimed to develop and validate a nomogram for predicting mortality in patients with thoracic fractures without neurological compromise and hospitalized in the intensive care unit. Methods: A total of 298 patients from the Medical Information Mart for Intensive Care III (MIMIC-III) database were included in the study, and 35 clinical indicators were collected within 24 h of patient admission. Risk factors were identified using the least absolute shrinkage and selection operator (LASSO) regression. A multivariate logistic regression model was established, and a nomogram was constructed. Internal validation was performed by the 1,000 bootstrap samples; a receiver operating curve (ROC) was plotted, and the area under the curve (AUC), sensitivity, and specificity were calculated. In addition, the calibration of our model was evaluated by the calibration curve and Hosmer-Lemeshow goodness-of-fit test (HL test). A decision curve analysis (DCA) was performed, and the nomogram was compared with scoring systems commonly used during clinical practice to assess the net clinical benefit. Results: Indicators included in the nomogram were age, OASIS score, SAPS II score, respiratory rate, partial thromboplastin time (PTT), cardiac arrhythmias, and fluid-electrolyte disorders. The results showed that our model yielded satisfied diagnostic performance with an AUC value of 0.902 and 0.883 using the training set and on internal validation. The calibration curve and the Hosmer-Lemeshow goodness-of-fit (HL). The HL tests exhibited satisfactory concordance between predicted and actual outcomes (P = 0.648). The DCA showed a superior net clinical benefit of our model over previously reported scoring systems. Conclusion: In summary, we explored the incidence of mortality during the ICU stay of thoracic fracture patients without neurological compromise and developed a prediction model that facilitates clinical decision making. However, external validation will be needed in the future.
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Affiliation(s)
- Haosheng Wang
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, China
| | - Yangyang Ou
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, China
| | - Tingting Fan
- Department of Endocrinology, Baoji City Hospital of Traditional Chinese Medicine, Baoji, China
| | - Jianwu Zhao
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, China
| | - Mingyang Kang
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, China
| | - Rongpeng Dong
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, China
| | - Yang Qu
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, China
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Wang H, Wu D, Xu W, Zhu Y, Liu H, Li C, Liu J, Ou L, Xiang L. Extremity fractures in patients presenting with traumatic spinal fractures and spinal cord injury. Medicine (Baltimore) 2020; 99:e18789. [PMID: 31977870 PMCID: PMC7004729 DOI: 10.1097/md.0000000000018789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Clinical features of extremity fractures (EFs) in patients presenting with traumatic spinal fractures (TSFs) and spinal cord injury (SCI) have not been investigated. To investigate the clinical features and risk factors for EFs in patients presenting with TSFs and SCI.Data from 1392 patients presenting with TSFs and SCI in our hospitals between 2001 and 2010 were retrospectively reviewed, among which 165 patients (129 males and 36 females, 37.5 ± 10.6 years old) presented with EFs. The clinical features of EFs have been investigated.The frequencies of upper limb fractures were significantly higher in the motor vehicle collisions (MVCs) group than in the high-fall group (P = .012) and the struck-by-object group (P = .002). The frequencies of lower limb fractures were significantly higher in the struck-by-object group (P = .019) and the high-fall group (P = .011) than the MVCs group. Univariate logistic regression analysis show that being in the 19 to 39 age group (P = .001), having a lumbar spinal fracture (P < .001) and experiencing a high fall (P < .001) were risk factors for EFs. Multivariate logistic regression analysis showed that we should focus on the factors that having a lumbar spinal fracture and experiencing a high fall.High fall and MVCs were the most common aetiologies for EFs. Having a lumbar spinal fracture and experiencing a high fall were significant risk factors for EFs. We should make early diagnoses and initiate timely treatment according to different patterns of extremity fractures in patients with TSFs and SCI.
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Affiliation(s)
- Hongwei Wang
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA
- State Key Laboratory of Trauma, Burn and Combined Injury
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Science
- State Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Deluo Wu
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA
- Graduate School, Dalian Medical University, Dalian
| | - Weijie Xu
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA
- Graduate School, Jinzhou Medical University, Jinzhou
| | - Yunpeng Zhu
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA
- Graduate School, China Medical University, Shenyang, Liaoning
| | - Huan Liu
- Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou
| | | | - Jun Liu
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA
| | - Lan Ou
- Department of Radiology, Southwest Hospital, the Third Military Medical University, Chongqing, China
| | - Liangbi Xiang
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA
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