Spinal cord injury can be traumatic or non-traumatic in origin,with the latter rising in incidence and prevalence with the aging demographics of our society.Moreove r,as the global population ages,individuals with co-...Spinal cord injury can be traumatic or non-traumatic in origin,with the latter rising in incidence and prevalence with the aging demographics of our society.Moreove r,as the global population ages,individuals with co-existent degenerative spinal pathology comprise a growing number of traumatic spinal cord injury cases,especially involving the cervical spinal cord.This makes recovery and treatment approaches particula rly challenging as age and comorbidities may limit regenerative capacity.For these reasons,it is critical to better understand the complex milieu of spinal cord injury lesion pathobiology and the ensuing inflammatory response.This review discusses microglia-specific purinergic and cytokine signaling pathways,as well as microglial modulation of synaptic stability and plasticity after injury.Further,we evaluate the role of astrocytes in neurotransmission and calcium signaling,as well as their border-forming response to neural lesions.Both the inflammatory and reparative roles of these cells have eluded our complete understanding and remain key therapeutic targets due to their extensive structural and functional roles in the nervous system.Recent advances have shed light on the roles of glia in neurotransmission and reparative injury responses that will change how interventions are directed.Understanding key processes and existing knowledge gaps will allow future research to effectively target these cells and harness their regenerative potential.展开更多
Purpose:This study aims to review the literature to explore some factors affecting sexual and partnership adjustment in individuals with spinal cord injury(SCI).Methods:This study was based on the methodological frame...Purpose:This study aims to review the literature to explore some factors affecting sexual and partnership adjustment in individuals with spinal cord injury(SCI).Methods:This study was based on the methodological framework of scoping reviews,including 3 methodological steps:(1)identifying relevant studies(searching for related studies);(2)selecting related studies;(3)collecting key findings,summarizing,and reporting the results.The electronic databases were searched including Medline(PubMed),Scopus,Web of Science,Embase,and Cochrane Library.Studies were included if they reported data about the related factors of sexual and partnership adjustment in individuals with SCI.No limitations were considered in terms of time or methodology of the search.Results:After the full-text screening,52 studies were included from the year of 1978-2019 with various methodologies.The present review demonstrated that proper sexual health among individuals with SCI is related to several factors including the anatomical factor,level of the injury,completeness of the injury,psycho-social factor,socio-economic status,and type of relationship.Conclusion:With consideration of factors affecting sexual and partnership adjustment in individuals with SCI,a better estimation of sexual health can be achieved in clinical to improve the relationship and quality of life.展开更多
Purpose:To identify risk factors for developing pressure ulcers(PUs)in the acute care period of traumatic spinal fracture patients with or without spinal cord injuries(SCIs).Methods:Data were collected prospectively i...Purpose:To identify risk factors for developing pressure ulcers(PUs)in the acute care period of traumatic spinal fracture patients with or without spinal cord injuries(SCIs).Methods:Data were collected prospectively in participating the National Spinal column/Cord Injury Registry of Iran(NSCIR-IR)from individuals with traumatic spinal fractures with or without SCIs,in-clusive of the hospital stay from admission to discharge.Trained nursing staff examined the patients for the presence of PUs every 8 h during their hospital stay.The presence and grade of PUs were assessed according to the European Pressure Ulcer Advisory Panel classification.In addition to PU,following data were also extracted from the NSCIR-IR datasets during the period of 2015-2021:age,sex,Glasgow coma scale score at admission,having SCIs,marital status,surgery for a spinal fracture,American Spinal Injury Association impairment scale(AIS),urinary incontinence,level of education,admitted center,length of stay in the intensive care unit(ICU),hypertension,respiratory diseases,consumption of ciga-rettes,diabetes mellitus and length of stay in the hospital.Logistic regression models were used to es-timate the unadjusted and adjusted odds ratio(OR)with 95%confidence intervals(CI).Results:Altogether 2785 participants with traumatic spinal fractures were included.Among them,87(3.1%)developed PU during their hospital stay and 392(14.1%)had SCIs.In the SCI population,63(16.1%)developed PU during hospital stay.Univariate logistic regression for the whole sample showed that marital status,having SCIs,urinary incontinence,level of education,treating center,number of days in the ICU,age,and Glasgow coma scale score were significant predictors for PUs.However,further analysis by multiple logistic regression only revealed the significant risk factors to be the treating center,marital status,having SCIs,and the number of days in the ICU.For the subgroup of individuals with SCIs,marital status,AIS,urinary incontinence,level of education,the treating center,the number of days in the ICU and the number of days in the hospital were significant predictors for PUs by univariate analysis.After adjustment in the multivariate model,the treating center,marital status(singles vs.marrieds,OR=3.06,95%CI:1.55-6.03,p=0.001),and number of days in the ICU(OR=1.06,95%Cl:1.04-1.09,p<0.001)maintained significance.Conclusions:These data confirm that individuals with traumatic spinal fractures and SCIs,especially single young patients who suffer from urinary incontinence,grades A-D by AIS,prolonged ICU stay,and more extended hospitalization are at increased risk for PUs;as a result strategies to minimize PU development need further refinement.展开更多
Purpose:The median time from the event leading to the spinal cord injury(SCI)to the time of decompressive surgery is estimated to be 6.9 days in Iran,which is much longer than the proposed ideal time(less than 24 h)in...Purpose:The median time from the event leading to the spinal cord injury(SCI)to the time of decompressive surgery is estimated to be 6.9 days in Iran,which is much longer than the proposed ideal time(less than 24 h)in published guidelines.The current qualitative study aimed to determine the reasons for the observed decompression surgery delay in Iran from the perspective of neurosurgeons.Methods:This qualitative study is designed to perform content analysis on the gathered data from face-to-face semi-structured interviews with 12 Iranian neurosurgeons.Results:The findings of the current study suggest that patient-related factors constitute more than half of the codes extracted from the interviews.Overall,the type of injury,presence of polytrauma,and surgeons’’wrong attitude are the main factors causing delayed spinal cord decompression in Iranian patients from the perspective of neurosurgeons.Other notable factors include delay in transferring patients to the trauma center,delay in availability of necessary equipment,and scarce medical personnel.Conclusion:In the perspective of neurosurgeons,the type of injury,presence of polytrauma,and surgeons’’wrong attitude are the leading reasons for delayed decompressive surgery of individuals with SCI in Iran.展开更多
基金supported by the Robert Campeau Family Foundation/Dr.C.H.Tator Chair in Brain and Spinal Cord Research(to MGF)。
文摘Spinal cord injury can be traumatic or non-traumatic in origin,with the latter rising in incidence and prevalence with the aging demographics of our society.Moreove r,as the global population ages,individuals with co-existent degenerative spinal pathology comprise a growing number of traumatic spinal cord injury cases,especially involving the cervical spinal cord.This makes recovery and treatment approaches particula rly challenging as age and comorbidities may limit regenerative capacity.For these reasons,it is critical to better understand the complex milieu of spinal cord injury lesion pathobiology and the ensuing inflammatory response.This review discusses microglia-specific purinergic and cytokine signaling pathways,as well as microglial modulation of synaptic stability and plasticity after injury.Further,we evaluate the role of astrocytes in neurotransmission and calcium signaling,as well as their border-forming response to neural lesions.Both the inflammatory and reparative roles of these cells have eluded our complete understanding and remain key therapeutic targets due to their extensive structural and functional roles in the nervous system.Recent advances have shed light on the roles of glia in neurotransmission and reparative injury responses that will change how interventions are directed.Understanding key processes and existing knowledge gaps will allow future research to effectively target these cells and harness their regenerative potential.
基金funded by Sina Trauma and Surgery Research Center,Tehran University of Medical Sciences[grant number is 98-02-38-43371]。
文摘Purpose:This study aims to review the literature to explore some factors affecting sexual and partnership adjustment in individuals with spinal cord injury(SCI).Methods:This study was based on the methodological framework of scoping reviews,including 3 methodological steps:(1)identifying relevant studies(searching for related studies);(2)selecting related studies;(3)collecting key findings,summarizing,and reporting the results.The electronic databases were searched including Medline(PubMed),Scopus,Web of Science,Embase,and Cochrane Library.Studies were included if they reported data about the related factors of sexual and partnership adjustment in individuals with SCI.No limitations were considered in terms of time or methodology of the search.Results:After the full-text screening,52 studies were included from the year of 1978-2019 with various methodologies.The present review demonstrated that proper sexual health among individuals with SCI is related to several factors including the anatomical factor,level of the injury,completeness of the injury,psycho-social factor,socio-economic status,and type of relationship.Conclusion:With consideration of factors affecting sexual and partnership adjustment in individuals with SCI,a better estimation of sexual health can be achieved in clinical to improve the relationship and quality of life.
基金Sina Trauma and Surgery Research Center,Tehran University of Medical Sciences,Iran(grant number is 96-02-38-35120).
文摘Purpose:To identify risk factors for developing pressure ulcers(PUs)in the acute care period of traumatic spinal fracture patients with or without spinal cord injuries(SCIs).Methods:Data were collected prospectively in participating the National Spinal column/Cord Injury Registry of Iran(NSCIR-IR)from individuals with traumatic spinal fractures with or without SCIs,in-clusive of the hospital stay from admission to discharge.Trained nursing staff examined the patients for the presence of PUs every 8 h during their hospital stay.The presence and grade of PUs were assessed according to the European Pressure Ulcer Advisory Panel classification.In addition to PU,following data were also extracted from the NSCIR-IR datasets during the period of 2015-2021:age,sex,Glasgow coma scale score at admission,having SCIs,marital status,surgery for a spinal fracture,American Spinal Injury Association impairment scale(AIS),urinary incontinence,level of education,admitted center,length of stay in the intensive care unit(ICU),hypertension,respiratory diseases,consumption of ciga-rettes,diabetes mellitus and length of stay in the hospital.Logistic regression models were used to es-timate the unadjusted and adjusted odds ratio(OR)with 95%confidence intervals(CI).Results:Altogether 2785 participants with traumatic spinal fractures were included.Among them,87(3.1%)developed PU during their hospital stay and 392(14.1%)had SCIs.In the SCI population,63(16.1%)developed PU during hospital stay.Univariate logistic regression for the whole sample showed that marital status,having SCIs,urinary incontinence,level of education,treating center,number of days in the ICU,age,and Glasgow coma scale score were significant predictors for PUs.However,further analysis by multiple logistic regression only revealed the significant risk factors to be the treating center,marital status,having SCIs,and the number of days in the ICU.For the subgroup of individuals with SCIs,marital status,AIS,urinary incontinence,level of education,the treating center,the number of days in the ICU and the number of days in the hospital were significant predictors for PUs by univariate analysis.After adjustment in the multivariate model,the treating center,marital status(singles vs.marrieds,OR=3.06,95%CI:1.55-6.03,p=0.001),and number of days in the ICU(OR=1.06,95%Cl:1.04-1.09,p<0.001)maintained significance.Conclusions:These data confirm that individuals with traumatic spinal fractures and SCIs,especially single young patients who suffer from urinary incontinence,grades A-D by AIS,prolonged ICU stay,and more extended hospitalization are at increased risk for PUs;as a result strategies to minimize PU development need further refinement.
基金funded by Sina Trauma and Surgery Research Center,Tehran University of Medical Sciences(grant number 98-01-38-41413)。
文摘Purpose:The median time from the event leading to the spinal cord injury(SCI)to the time of decompressive surgery is estimated to be 6.9 days in Iran,which is much longer than the proposed ideal time(less than 24 h)in published guidelines.The current qualitative study aimed to determine the reasons for the observed decompression surgery delay in Iran from the perspective of neurosurgeons.Methods:This qualitative study is designed to perform content analysis on the gathered data from face-to-face semi-structured interviews with 12 Iranian neurosurgeons.Results:The findings of the current study suggest that patient-related factors constitute more than half of the codes extracted from the interviews.Overall,the type of injury,presence of polytrauma,and surgeons’’wrong attitude are the main factors causing delayed spinal cord decompression in Iranian patients from the perspective of neurosurgeons.Other notable factors include delay in transferring patients to the trauma center,delay in availability of necessary equipment,and scarce medical personnel.Conclusion:In the perspective of neurosurgeons,the type of injury,presence of polytrauma,and surgeons’’wrong attitude are the leading reasons for delayed decompressive surgery of individuals with SCI in Iran.
