scholarly journals A Lactobacillus casei Shirota probiotic drink reduces antibiotic-associated diarrhoea in patients with spinal cord injuries: a randomised controlled trial

2013 ◽  
Vol 111 (4) ◽  
pp. 672-678 ◽  
Author(s):  
Samford Wong ◽  
Ali Jamous ◽  
Jean O'Driscoll ◽  
Ravi Sekhar ◽  
Mike Weldon ◽  
...  

Certain probiotics may prevent the development of antibiotic-associated diarrhoea (AAD) and Clostridium difficile-associated diarrhoea (CDAD), but their effectiveness depends on both strain and dose. There are few data on nutritional interventions to control AAD/CDAD in the spinal cord injury (SCI) population. The present study aimed to assess (1) the efficacy of consuming a commercially produced probiotic containing at least 6·5 × 109 live Lactobacilluscasei Shirota (LcS) in reducing the incidence of AAD/CDAD, and (2) whether undernutrition and proton pump inhibitors (PPI) are risk factors for AAD/CDAD. A total of 164 SCI patients (50·1 (sd 17·8) years) with a requirement for antibiotics (median 21 d, range 5–366) were randomly allocated to receive LcS (n 76) or no probiotic (n 82). LcS was given once daily for the duration of the antibiotic course and continued for 7 days thereafter. Nutritional risk was assessed by the Spinal Nutrition Screening Tool. The LcS group had a significantly lower incidence of AAD (17·1 v. 54·9 %, P< 0·001). At baseline, 65 % of patients were at undernutrition risk. Undernutrition (64·1 v. 33·3 %, P< 0·01) and the use of PPI (38·4 v. 12·1 %, P= 0·022) were found to be associated with AAD. However, no significant difference was observed in nutrient intake between the groups. The multivariate logistic regression analysis identified poor appetite ( < 1/2 meals eaten) (OR 5·04, 95 % CI 1·28, 19·84) and no probiotic (OR 8·46, 95 % CI 3·22, 22·20) as the independent risk factors for AAD. The present study indicated that LcS could reduce the incidence of AAD in hospitalised SCI patients. A randomised, placebo-controlled study is needed to confirm this apparent therapeutic success in order to translate into improved clinical outcomes.

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Saeed Khanjani ◽  
Javad Kazemi ◽  
Jalal Younesi ◽  
Asghar Dadkhah ◽  
Akbar Biglarian ◽  
...  

Background: Patients with spinal cord injuries suffer from some psychological problems, such as inadequate emotional regulation and flexibility for adapting to the post-injury condition. In this regard, acceptance and commitment therapy (ACT) can improve psychological flexibility and emotional regulation. Objectives: The main goal of this study was to analyze the effectiveness of ACT in improving psychological flexibility and emotional regulation in patients with spinal cord injuries. Methods: This quasi-experimental design study was based on a pretest-posttest method with a control group. The study population consisted of all patients with spinal cord injury referred to Jalaeipour Rehabilitation Center in Tehran. The study sample included 30 patients with spinal cord injury selected by the purposive sampling method. The inclusion criteria were patients aged 20 to 55 years, residing in Tehran, and with at least a high school diploma. The injury duration varied between one and five years, and the injuries were thoracic and lumbar injuries and an intermediate score of psychological flexibility and emotion regulation. The exclusion criteria were patients with cervical spinal cord injuries, as well as patients who were simultaneously receiving another psychological treatment together with the subjects who suffered from brain damage. Patients were randomly assigned to the experimental and control groups based on random numbers. There were 15 patients in each group. The intervention group received ACT during eight sessions (1.5-hour group therapy) held once a week at Jalaeipour Rehabilitation Center in Tehran (2018), while the control group received routine care. Dennis and Vander Wal’s cognitive flexibility inventory (CFI) and Gross and John’s emotion regulation questionnaire (ERQ) were completed before and one week after the intervention. The data were analyzed using multivariate analysis of covariance (MANCOVA). Results: There was a significant difference in demographic indicators between the two groups. Based on MANCOVA with the baseline score, the mean scores of psychological flexibility and emotion regulation had a significant difference regarding the results of ACT between the experimental and control groups (P < 0.05). Conclusions: According to the findings, ACT can improve psychological flexibility and emotional regulation in patients with spinal cord injuries.


1988 ◽  
Vol 68 (1) ◽  
pp. 25-30 ◽  
Author(s):  
John R. Ruge ◽  
Grant P. Sinson ◽  
David G. McLone ◽  
Leonard J. Cerullo

✓ Maturity of the spine and spine-supporting structures is an important variable distinguishing spinal cord injuries in children from those in adults. Cinical data are presented from 71 children aged 12 years or younger who constituted 2.7% of 2598 spinal cord-injured patients admitted to the authors' institutions from June, 1972, to June, 1986. The 47 children with traumatic spinal cord injury averaged 6.9 years of age and included 20 girls (43%). The etiology of the pediatric injuries differed from that of adult injuries in that falls were the most common causative factor (38%) followed by automobile-related injuries (20%). Ten children (21.3%) had spinal cord injury without radiographic abnormality (SCIWORA), whereas 27 (57%) had evidence of neurological injury. Complete neurological injury was seen in 19% of all traumatic pediatric spinal cord injuries and in 40% of those with SCIWORA. The most frequent level of spinal injury was C-2 (27%, 15 cases) followed by T-10 (13%, seven cases). Upon statistical examination of the data, a subpopulation of children aged 3 years or younger emerged. These very young children had a significant difference in level of injury, requirement for surgical stability, and sex distribution compared to 4- to 12-year-old children.


2017 ◽  
Vol 8 (2) ◽  
pp. 115-118 ◽  
Author(s):  
Tochukwu C. Ikpeze ◽  
Addisu Mesfin

Spinal cord injuries (SCIs) are sustained by more than 12 500 patients per year in the United States and more globally. The SCIs disproportionately affect the elderly, especially men. Approximately 60% of these injuries are sustained traumatically through falls, but nontraumatic causes including infections, tumors, and medication-related epidural bleeding have also been documented. Preexisting conditions such as ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis can render the spine stiff and are risk factors as well as cervical spondylosis and ensuing cervical stenosis. Treatment options vary depending on the severity, location, and complexity of the injury. Surgical management has been growing in popularity over the years and remains an option as it helps reduce spinal cord compression and alleviate pain. Elevating mean arterial pressures to prevent spinal cord ischemia and avoiding the second hit of SCI have become more common as opposed to high dose steroids. Ongoing clinical trials with pharmacological agents such as minocycline and riluzole have shown early, promising results in their ability to reduce cellular damage and facilitate recovery. Though SCI can be life changing, the available treatment options have aimed to reduce pain and minimize complications and maintain quality of life alongside rehabilitative services.


2000 ◽  
Vol 58 (4) ◽  
pp. 1030-1034 ◽  
Author(s):  
DANILO GONÇALVES COELHO ◽  
ALBERT V. B. BRASIL ◽  
NELSON PIRES FERREIRA

Eighty-nine patients with lower cervical spine fractures or dislocations were evaluated for risk factors of neurological lesion. The age, sex, level and pattern of fracture and sagittal diameter of the spinal canal were analysed. There were no significant differences on the age, gender, level and Torg's ratio between intact patients and those with nerve root injury, incomplete or complete spinal cord injuries. Bilateral facet dislocations and burst fractures are a significant risk factor of spinal cord injury.


Author(s):  
Seo Yeon Yoon ◽  
Ja-Ho Leigh ◽  
Jieun Lee ◽  
Wan Ho Kim

Central-nervous-system (CNS) injuries constitute a significant cause of morbidity (often resulting in long-term disability) and mortality. This cross-sectional study compared the activity and participation of community-dwelling people with severe disability from acquired brain injuries (ABI) (n = 322) and spinal-cord injuries (SCI) (n = 183) to identify risk factors related to disability. Data were collected through a questionnaire survey of community-dwelling people with severe disability attending 65 healthcare centers. The survey included the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and sociodemographic factors. We categorized a registered grade of disability of 1 or 2 as severe disability. WHODAS 2.0 domain and summary scores were compared between the ABI and SCI groups, and risk factors associated with disability were identified through regression analysis. ABI participants had significantly higher disability in cognition and relationships, whereas patients with SCI had higher disability in mobility (p < 0.05). Onset duration was negatively correlated with cognition, relationships, participation, and summary scores in ABI participants (p < 0.05). Neither group’s socioeconomic factors were associated with WHODA 2.0 scores. Understanding the different patterns of disability between SCI and ABI in community-dwelling people with severe disability helps establish future plans for the management of health resources.


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