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Biomedical subjects

S L Stover

Publications and source records attributed to S L Stover.

62 records · Page 4Linked to original sources
PubMed1977

Intermittent catheterisation: follow-up studies [proceedings].

One hundred twenty-six male spinal cord injury patients whose acute bladder management included indwelling urethral catheters were converted to an intermittent catheterisation programme and most of them subsequently achieved a catheter-free state. A higher prevalence of pyelocaliectasis was observed in these patients compared to previous reports of similar changes in patients upon whom intermittent catheterisation was initiated immediately after injury. Right side predominance of pyelocaliectasis was demonstrated but requires further study. The extent of neurological deficit (complete or incomplete lesions) does not appear to influence the development of pyelocaliectasis. These findings support our contention that intensive urological follow-up is necessary for all spinal cord injury patients even though a catheter-free state has been achieved through use of intermittent catheterisation.

Dilatation↗
PubMed1976

Disodium etidronate in the prevention of heterotopic ossification following spinal cord injury (preliminary report).

Heterotopic ossification is a frequent complication following spinal cord injury with 16 per cent to 53 per cent of patients developing varying degrees of pathologic ossification. The diphosphonates are known to block the transformation of amorphous calcium phosphate into crystalline hydroxyapatite. Therefore, one of the diphosphonates, disodium etidronate (generic name of disodium ethane-1-hydroxy-1, 1-diphosphonate (EHDP) was selected fro clinical trials to study the effectiveness of EHDP in preventing heterotopic ossification following spinal cord injury. In a double-blind, clinical study of 149 spinal cord injury patients, disodium etidronate has proven its effectiveness in the prevention of heterotopic ossification. The extent of heterotopic ossification development as measured by the total heterotopic ossification X-ray grade was significantly less in EHDP-treated patients compared to placebo-treated patients (P less than 0-05). For maximal effectiveness, EHDP treatment must be started before the onset of the pathological process initiating the development of heterotopicossification. Further studies are necessary to determine the optimal time to institute EHDP treatment, length of treatment, and minimal effective dose. EHDP is the first hterapeutic agent known to alter the formation of heterotopic ossification after spinal injury and may prove useful in other conditions where heterotopic ossification prevention is clinically indicated.

Adolescent↗
PubMed1976

Head injury in children and teenagers; functional recovery correlated with the duration of coma.

Residual impairments and mortality were assessed in 48 patients under 20 years of age at least two years after a traumatic head injury had caused coma lasting more than seven days. In this study the duration of coma was defined as the period of time when it is impossible to establish intellectual contact with the patient. A classification of functional levels 1 to 8 was used to identify the residual impairment and relate this impairment to the duration of coma for each patient. Of 30 patients who remained in coma less than three month, only one did not have independent ambulation with or without equipment at the time of his last follow-up evaluation. This was one parameter among others to show that the prognosis for recovery in this age group is much better than expected following severe head injury. These follow-up data, correlated with the duration of coma, can assist rehabilitation personnel in the prognostic planning for younger people with severe head injuries. Rehabilitation medicine needs to be involved in patient care during the period of coma to prevent contractures and other complications which often interfere with and delay later rehabilitation programs, making them more costly and less successful.

Adolescent↗
PubMed1976

Disodium etidronate in the prevention of postoperative recurrence of heterotopic ossification in spinal-cord injury patients.

Disodium etidronate was used in a clinical trial with four patients to study its effectiveness in preventing the recurrence of mineralization after surgical removal of heterotopic ossification. These patients, who had sustained injuries to the spinal cord followed by anklysos of the hip, had seven surgical wedge resections as part of a controlled or double-blind study. Roentgenograms showed that in the resections done without the drug there was recurrence within three weeks, whereas with the drug there was no sign of recurrence as long as the drug was administered. After discontinuation of drug therapy, recurrence was variable but less than expected. Disodium etidronate is the first therapeutic agent which may delay and partially prevent postoperative recurrence of heterotopic ossification.

Adult↗
PubMed1975

Heterotopic ossification in spinal cord-injured patients.

Therapy programs during the development of heterotopic ossification in spinal cord injury range widely from complete rest to aggressive exercise programs. The literature is confusing by its multiplicity of recommendations because the basic etiology and pathophysiology are unknown and because some basic differences exist between traumatic myositis ossificans and heterotopic ossification associated with severe neurological impairments. Prospective heterotopic ossification roentgenographic (x-ray) surveys of the hips, knees, shoulders, and elbows were made on 250 consecutive spinal cord-injured patients. Those who had x-ray evidence of early or immature heterotopic ossification or who developed early clinical signs of possible heterotopic ossification were treated with an aggressive program of passive progressive range of motion exercises. Several patients who developed bilateral heterotopic ossification had one side used as their own control. Follow-up x-ray studies and range of motion evaluation suggest that an aggressive range of motion exercise program is indicated for patients who are developing or have heterotopic ossification. There is no evidence that exercise increases inflammation with subsequent ossification, and it frequently causes a pseudarthrosis, permitting adequate functional range of motion.

Adolescent↗