Patients who are tetraplegic with cervical spinal cord transection do not appear to have cerebral control over the sympathetic nervous system. Soon after transection they are often in a state of spinal shock during which even isolated spinal cord sympathetic activity is absent. This affects, in particular, the cardiovascular system and other homeostatic mechanisms which are dependent on appropriate regulation of the vasculature, such as thermoregulation. After a few weeks isolated spinal cord activity returns but the absence of control absence of control by the brain results in sympathetic malfunction of various systems. Inappropriate inactivity therefore occurs during postural change and causes orthostatic hypotension, while over-activity, which results in the syndrome of autonomic dysreflexia and hypertension, occurs if spinal sympathetic reflexes are activated. Examples are provided of clinical effects of sympathetic malfunction in tetraplegics in relation to circulatory, thermoregulatory, pupillary, genital, gastrointestinal and urinary tract function.

Body Temperature Regulation↗

PubMedDate not supplied

Integration of concurrent trauma registry and performance improvement programs.

Health information management systems have had a tremendous impact on the delivery of healthcare. The implementation of an integrated, concurrent trauma registry and performance improvement system has had a remarkable impact on the University of Pennsylvania's trauma program. Having both the registry and performance improvement programs concurrent and integrated has allowed better utilization of staff and has produced more accurate, relevant and timely data.

Hospital Information Systems↗