Spinal cord
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When someone suffers a spinal cord injury (SCI) many organs, including those of the cardiovascular (CV) system, cease to be controlled by the autonomic nervous system (ANS). Response to physical activity fails to meet the needs of the body and typically results in low blood pressure (BP), and in turn, reduced endurance and performance. This study examines the effect of SCI on the ANS of elite athletes and possible effect on their CV functions and ultimately their performance. The study also provides input on evidence of boosting and the current classification system. Finally, authors are exploring a possibility for future research in assessing whether consideration of ANS function would strengthen current Paralympic classification systems. ⋯ Further research is needed to determine if the inclusion of ANS parameters contributes to strengthen classifications systems in Paralympic sports. This includes the development of a simple, valid and reliable bedside assessment of autonomic function that can be used to reliably compare athletes with or without ANS dysfunction thereby enabling further research into the isolated effect of ANS dysfunction on sporting performance. Researchers who are studying individuals with SCI, and who have CV parameters as their outcomes, should ensure a homogenous study group by the presence or absence of ANS function in addition to level of lesion so as to eliminate the potential for confounding variables that lead to inaccurate interpretation of results.
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Cross-sectional survey. ⋯ Functional independence, especially ability to drive, was strongly associated with return to work and should be one of the priority goals of comprehensive rehabilitation of persons with SCI. The negative impact of recent hospitalization as well as financial compensation needs to be probed further.
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All randomized controlled trials, prospective cohort, case-controlled, pre-post studies and case reports that assessed exercise interventions, which influence arterial structure and function after spinal cord injury (SCI), were included. ⋯ Although the quality and volume of evidence is low, the literature supports exercise as a useful intervention technique for improving arterial function in those with SCI.
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Multicenter Study Comparative Study
The effect of polytrauma as a possible confounder in the outcome of monotraumatic vs polytraumatic paraplegic patients: a clinical cohort study.
Clinical cohort study. ⋯ The prognosis of polytraumatic paraplegics in terms of neurological recovery is not inferior to those with monotrauma. Multiple-injured patients need a prolonged hospital stay to reach the functional outcome of monotraumatic patients.
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Prospective, nonrandomized, observational cohort study. ⋯ Serum PCT is a more reliable biologic marker for the early prediction of postoperative infectious complications in patients with acute traumatic spinal cord injury compared with CRP. PCT can early identify postoperative infections for establishing effective antibiotic therapy.