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Biomedical subjects

S L Stover

Publications and source records attributed to S L Stover.

At least 55 records · Page 3Linked to original sources
PubMed1986

Clinical significance of minimal changes on intravenous urography after spinal cord injury.

Evidence is given to support the thesis that minimal pyelocaliectasis and ureterectasis are of little clinical significance in spinal cord injured patients. Such renal changes almost always improve or remain stable on sequential examinations. Since moderate or severe pyelocaliectasis is usually detected by renal scintillation procedures, these findings support its use as a urinary tract screening examination along with an abdominal radiograph to detect calculi. The need for long-term serial examination of the urinary tract in spinal cord injury is emphasised.

Dilatation, Pathologic↗
PubMed1986

Spinal cord injury associated with all-terrain vehicle accidents.

Five instances of three-wheeler, all-terrain vehicle accidents resulting in spinal cord injury are presented. Age range of victims was from 7 to 18 years. Of the five cases of spinal cord injury, three resulted in quadriplegia and two in paraplegia. Reports of all-terrain vehicle accidents in childhood from the US Consumer Product Safety Committee are also reviewed. Concerns are raised about the need for further data gathering about instances and types of injuries from these types of vehicles and the safety of use in all ages of children for these heavy, potentially high-speed vehicles.

Accidents↗
PubMed1985

Long-term followup of renal function after spinal cord injury.

Effective renal plasma flow was measured in acute spinal cord injury patients for up to 10 years after injury to determine the extent of renal deterioration in these patients and to identify the factors associated with a loss of renal function. The over-all mean decrease in effective renal plasma flow for all patients as a whole was 4.5 ml. per year. Factors associated with a statistically significant reduction in effective renal plasma flow included age, gender, renal calculi, quadriplegia, and a history of chills and fever. Other factors examined but not found to be statistically significant included years since injury, presence of severe decubiti, bladder calculi, bacteriuria and extent of injury. This study suggests that renal function usually can be preserved in spinal cord injury patients if the treatable risk factors are managed properly.

Adult↗
PubMed1985

Prophylactic antibacterial therapy for preventing urinary tract infections in spinal cord injury patients.

We conducted 202 trials in 161 male hospital patients to determine if prophylactic administration of ascorbic acid or antibacterials (trimethoprim-sulfamethoxazole, nalidixic acid, methenamine hippurate or nitrofurantoin macrocrystals) would prevent bacteriuria infections in spinal cord injury patients who had had at least 1 bout of bacteriuria. None of the drugs tested appeared to be statistically effective in the doses used in preventing bacteriuria in these patients. Moreover, sensitivities were lost to several drugs other than those used prophylactically. We conclude that use of prophylactic doses of ascorbic acid or antibacterials has not proved to be beneficial in spinal cord injury patients free of indwelling catheters.

Anti-Infective Agents, Urinary↗
PubMed1985

Effective renal plasma flow: clinical significance after spinal cord injury.

We conducted a study to determine if effective renal plasma flow routinely measured by hippurate clearance during a comprehensive renal scintillation procedure is a relevant measure for assessing renal function in spinal cord injury patients. All subjects had spinal cord injury and had had contemporaneous comprehensive renal scintillation procedures and excretory urograms on 2 occasions 24 months or less apart. Each of the 469 kidneys was placed into 1 of 5 quintiles on the basis of its effective renal plasma flow at the first examination. The percentage of the kidneys that had clinically significant pyelocaliectasis or in which the pyelocaliectasis significantly worsened was 20.4 per cent in the lowest (first) quintile and 9.3, 2.2, 5.4 and 3.2 per cent in the second, third, fourth and fifth quintiles, respectively. Analogous data for ureterectasis were 16.1, 8.2, 2.2, 3.3 and 3.2 per cent. There was a significant (p less than 0.01) correlation between effective renal plasma flow and renal parenchymal thickness. Kidneys with renal calculi averaged effective renal plasma flows about 25 per cent lower than those of kidneys free of calculi. We conclude that effective renal plasma flow is a relevant measure for assessing renal function in spinal cord injury patients.

Acute Disease↗
PubMed1984

Renal function after acute and chronic spinal cord injury.

Computer-assisted renal scintigraphy was performed on 160 acute and 240 chronic spinal cord injury patients, and 287 noninjured controls. Concurrently, measurements of global and individual kidney effective renal plasma flow, time of maximum activity in each kidney, ratio of maximum counts to the counts at 27 minutes after injection over each kidney and number of counts in each kidney at 1 to 2 minutes after injection were made. The time of peak activity over the kidney and differential function at 1 to 2 minutes after injection were not affected significantly by age, sex or spinal cord status. Global and individual effective renal plasma flows were significantly affected by all of these factors. Both plasma flow measures generally were higher for male than for female patients. Effective renal plasma flow decreased steadily after early adulthood and, except for the youngest and oldest patients, values were lower for spinal cord injury patients than for normal controls. The ratio of peak to 27-minute counts was affected significantly by age and spinal cord injury but not by sex. In patients without obvious pathological conditions followup scintigrams 1 to 3 years after injury showed no significant changes owing to interval since injury on any parameter studied. Lower limits of basal scintigraphic parameters are given for evaluation of renal status in neurologically intact or spinal cord injury persons.

Adolescent↗
PubMed1984

Serum creatinine as an indicator of renal function after spinal cord injury.

This study was conducted to determine (1) if serum creatinine levels (SCL) in spinal cord injury (SCI) patients are influenced by neurologic level of lesion, sex, age, or time since injury, and (2) if SC values are a sensitive indicator of renal function (as reflected by renal plasma flow [RPF]) in these patients. The overall SC mean and SD were 0.9 +/- 0.2mg/dl (n = 141). There was no difference in SC values between patients with higher injuries (T-6 or above) and patients with lower injuries (T-7 or below), nor was there any difference between patients with lesions less than 3 months, 10-14, 22-26, 34-38, 46-50, or 58-62 months in duration. Age and gender each accounted for less than 5% of the variation in SC. There was no significant correlation between RPF and SC (unless the patient also had moderate or severe pyelocaliectasis) nor between change in serum RPF (from the previous examination, usually 12 months earlier) and change in SC, suggesting that SCL does not reflect the functional status of the kidney in these patients.

Adolescent↗
PubMed1983

Failure of antibody-coated bacteria and bladder washout tests to localize infection in spinal cord injury patients.

The validity of the antibody-coated bacteria test and Fairley washout procedure to determine whether urinary tract infections were of kidney or bladder origin in spinal cord injury patients was assessed by comparing test results with those obtained from culture of ureteral urine specimens. It was concluded that neither the presence of antibody-coated bacteria nor a positive bladder washout test can be considered as definitive evidence that bacteriuria is of renal origin in these patients.

Antibody-Coated Bacteria Test, Urinary↗
PubMed1983

Spinal cord injury--update.

In summary, many questions still need to be answered about spinal cord injury. Research into newer methods of care are still important for the future of these persons. We would all like to see a cure. We must not be satisfied, however, with the status quo of care until a cure is possible. Our goals of care, gadgetry, and research must be geared to meet the needs of our patients and not the egos of health professionals and researchers. In other words, make the care, the machine, and the research fit the person, for after all, we are talking about people with spinal cord injury.

Costs and Cost Analysis↗
PubMed1981

Heterotopic ossification following hip replacement or spinal cord injury. Two clinical studies with EHDP.

We report two double-blind, placebo-controlled studies of the effects of disodium etidronate (EHDP) on the incidence and severity of heterotopic ossification following total hip arthroplasty or spinal cord injury. The large placebo groups in these studies allowed the estimation of the incidence of heterotopic ossification in these patient populations. Heterotopic ossification occurred in 65% of patients after hip replacement and in the majority of these within 15 weeks. Clinically significant ossification occurred in 19% of affected patients. The incidence of heterotopic calcification after spinal cord injury was less (35%) but followed a similar natural history. Treatment with EHDP reduced the incidence and severity of lesions both at the time of stopping EHDP and up to 9 months after treatment.

Double-Blind Method↗
PubMed1981

Comprehensive renal scintillation procedures in spinal cord injury: comparison with excretory urography.

A 131iodine orthoiodohippurate comprehensive renal scintillation procedure was performed and compared to results of excretory urography in 200 spinal cord injury patients. No severe urographic abnormalities were undetected by the comprehensive renal scintillation procedure. Only 1.4 per cent of renal units had greater than minimal pyelocaliectasis or ureterectasis in the presence of a normal radionuclide examination. A relatively large number of abnormalities were detected on the renal scintillation procedure when the excretory urogram was normal. Serial followup will be required to determine the significance of these findings but present data suggest that a comprehensive renal scintillation procedure and a plain film of the kidneys, ureters and bladder may be used for screening upper urinary tract abnormalities in lieu of an excretory urogram. This is particularly advantageous for the spinal cord injury population, since there have been no toxic or allergic reactions reported, no bowel preparation or dehydration is required and there is relatively low radiation exposure.

Humans↗
PubMed1980

Prevalence of spinal cord injury: a reestimation employing life table techniques.

A comparison of frequently cited studies of long-term survival among spinal cord injury victims revealed widely ranging survival rates. When coupled with an estimated incidence rate of 30 cases per million persons at risk, these survival rates correspond to prevalence rates ranging from 486 to 969 per million persons, although 500 per million persons is the figure most often cited. A 30.2-year mean life expectancy for spinal cord injury victims was estimated using previously calculated spinal cord injury relative mortality ratios. The corresponding spinal cord injury prevalence rate was 906 cases per million persons. Based on the incidence rate, an estimated 8.88 beds per million population, or just under 2,000 beds, will be necessary in the United States to care adequately for all patients with newly acquired spinal cord injuries.

Adolescent↗
PubMed1979

Spinal cord injury: an epidemiologic perspective.

This study examines, from an epidemiologic perspective, a series of 359 consecutive admissions to a Model Regional Spinal Cord Injury Center located in the south-eastern United States. An extensive data set which captures medical, demographic, social and psychological information, on each patient, has been statistically analysed. The appropriateness and utility of epidemiologic methodology applied to the phenomena of spinal cord injury is demonstrated and the findings resulting from the analyses are discussed.

Adolescent↗
PubMed1979

Pain in patients with spinal cord injury.

For this study of intractable pain after spinal cord injury (SCI), a questionnaire was developed, pilot-tested and mailed to 356 previously hospitalized SCI patients, 200 (56%) of whom returned the completed questionnaire. Of the respondents, 160 (80%) reported abnormal sensation and 96 (48%) called the discomfort painful. Abnormal sensations were first noted within 6 months of injury by 105 patients, from 7 months to 4 years after injury by 39, and longer than 4 years after injury or unknown by 16. Pain locations varied and were unrelated to the level of lesion. In 30% of those reporting abnormal sensation the location of pain remained stationary, whereas in 17% it changed over time. The intensity of pain was described as severe to extreme by 25%; 44% indicated that it interfered with daily activities. Increase of pain over time was noted by 41%. Activity, inactivity, weather change and overexertion were not frequently identified as aggravating circumstances. Rest and medication were cited as alleviating factors. Approximately 38% of those experiencing pain used medications but only 22% obtained consistent relief from their use. Patients with low level lesions were more willing to exchange a hypothetical chance of recovery and/or loss of reacquired physiologic functions for pain relief than were patients with higher lesions.

Activities of Daily Living↗
PubMed1978

The costs of spinal cord injury.

An ongoing study of medical care and associated costs relative to spinal cord injury is being conducted at the University of Alabama in Birmingham, one of 11 federally funded Model Regional Spinal Cord Injury Centres. It was hypothesised such costs would be lower among patients admitted into an organised continuum of care (system) soon after injury than among patients whose entry into the organised system of care was delayed (non-system). A comprehensive economic data set has been acquired on 142 of 233 (61 per cent) patients admitted since implementation of the project. Analysis of these data reveals: (1) system patients require, on average, expenditures of almost $5,000 less than their non-system counterparts; (2) there is little difference in medical or associated costs and length of hospitalisation between tetraplegics and paraplegics; (3) spinal cord injuries secondary to motor vehicle accidents have higher associated costs and longer lengths of stay than do those injuries resulting from other causes including acts of violence.

Adolescent↗