The journal of spinal cord medicine
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Practice Guideline Guideline
Respiratory management following spinal cord injury: a clinical practice guideline for health-care professionals.
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Case Reports Biography Historical Article
Fatal spinal cord injury of the 20th president of the United States: day-by-day review of his clinical course, with comments.
This article presents the medical history of the 20th president of the United States, James A. Garfield, with an emphasis on his spinal cord injury (SCI). Numerous references debate the care he received from the medical and surgical perspectives, but little has been written about the essential aspect of his gunshot wound-namely, the damage to his spinal cord. President Garfield was shot in the lumbar spine and was bedridden until he died 80 days following his injury. This article contrasts state-of-the-art care in 1881 to today's standards of care for SCI. ⋯ Deficiencies in general medical care and surgical technique at the time contributed to the president's demise. This case was marked by controversies that still are debated today-for example, whether the bullet should have been removed surgically. Examination of available evidence suggests that with today's advances in medical, surgical, and SCI medicine, a person with this type of injury would likely survive and be a candidate for rehabilitation.
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Comparative Study
Daily vs twice daily enoxaparin in the prevention of venous thromboembolic disorders during rehabilitation following acute spinal cord injury.
Subcutaneous administration of low molecular weight heparin (eg, enoxaparin) has been shown to be safe and effective in the prevention of acute venous thromboembolic (TE) disease following acute spinal cord injury (SCI) in the rehabilitation setting. However, emerging evidence suggests that different dosing strategies may be equivalent. ⋯ Subcutaneous enoxaparin administered once or twice daily is equally effective for the prevention of venous TE disease. Both dosing strategies are associated with a low incidence of bleeding in patients with SCI who are undergoing rehabilitation.
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Review
Shoulder pain in chronic spinal cord injury, Part I: Epidemiology, etiology, and pathomechanics.
Review of the literature. ⋯ With a better understanding of the epidemiology, etiology, and basic pathomechanics of shoulder pain in SCI, physicians are in a better position to evaluate, treat, and prevent these disorders.
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Of new spinal cord injuries (SCIs) throughout North America, up to 14% occur in children younger than 15 years of age. The purpose of this paper is to present several aspects unique to the evaluation and treatment of a child with SCI. ⋯ The differences between children and adults with acute SCI are significant enough that caregivers cannot evaluate and treat a child with SCI as they would a small adult.