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Biomedical subjects

L C Vogel

Publications and source records attributed to L C Vogel.

At least 19 recordsLinked to original sources

Domain-specific satisfaction in adults with pediatric-onset spinal cord injuries.

STUDY DESIGN: Interview using a structured questionnaire and standardized measures. OBJECTIVES: To determine domain-specific satisfaction levels in adults with pediatric-onset spinal cord injuries (SCI), to determine factors associated with these levels of satisfaction, and to determine the relationship of domain-specific satisfaction to overall life satisfaction in this population. SETTING: US and Canada. METHODS: The participants were adults who sustained SCI at age 18 years or younger and were 24 years of age or older at the time of interview and did not have significant head injury. In addition to providing information about themselves, including education level, employment, marital status, and community participation, they were asked to rate their level of satisfaction in seven domains: transportation in the community, educational achievement, employment opportunities, income, social/recreational opportunities, dating opportunities, and sexual experience. They also completed the satisfaction with life scale (SWLS), the Craig handicap assessment and reporting technique, the functional independence measure, and the short-form-12 perceived health scale. RESULTS: A total of 216 individuals were interviewed. The mean age at injury was 14 years and the mean age at interview was 29 years. From most satisfied to least satisfied, the domains were ranked in the following order: satisfaction with transportation in the community, educational achievement, social and recreational opportunities, sexual experiences, dating opportunities, job opportunities, and income. Age at interview, gender, and perceived health were identified in regression analyses as predictors of some of the domain-specific satisfactions, but the primary predictive factors were in the area of participation. Neither severity of neurologic impairment nor level of functional independence were predictors for any of the domains. Satisfaction in each of the domains was significantly associated with SWLS and satisfaction with dating, job opportunities, education, and income were identified as predictive factors in a regression analysis. CONCLUSIONS: Dating opportunities, job opportunities, and income are the three domains in which adults with pediatric-onset SCI are least satisfied and those domains have a significant impact on overall satisfaction.

Activities of Daily Living↗

Self-injurious behavior in children and adolescents with spinal cord injuries.

STUDY DESIGN: A case report of self-injurious behavior in four children and adolescents with spinal cord injuries (SCI). OBJECTIVES: To report a relatively unusual complication of pediatric-onset SCI, focusing on the potential role that dysesthesia may play in self-injurious behavior. SETTING: A Spinal Cord Injury Program in a Children's Hospital in Chicago that serves children from midwestern and south-central United States of America. METHOD: Case reports and literature review. RESULTS: Case reports are presented of four children or adolescents with SCI who exhibited self-injurious behavior. Two of the subjects had symptoms consistent with dysesthesia. The self-injurious behavior in these two subjects and a very young child responded to treatment with anticonvulsants. The self-injurious behavior in the fourth patient was probably the result of poor technique of using his mouth to move his hands, which responded to conservative management including education, occupational therapy and gloves. CONCLUSION: Self-injurious behavior is a relatively unusual complication of pediatric onset SCI, and may be a manifestation of dysesthesia and be responsive to treatment with anticonvulsants.

Acetates↗

PTSD symptoms and partner abuse: low income women at risk.

Aspects of partner abuse (types, severity, chronicity, treatment of injury, fear, etc.) were addressed with low income community women, half of whom scored above the cutoff on the Crime Related PTSD scale. Using this cutoff 47% of women who sustained moderate violence were high in CR-PTSD symptoms. If their partner also raped them, the rate (63%) was similar to women who sustained severe violence (65%) or severe violence and rape (71%). No ethnic differences were found for rates or severity of CR-PTSD symptoms. A MANCOVA by ethnicity (African Americans, Euro-Americans, Mexican Americans) and CR-PTSD symptoms (low vs. high) identified ethnic differences only on total sexual aggression and recent threats of violence. The high symptom group reported more abuse on all measures. Results from the CR-PTSD and the general lack of ethnic differences support the notion that SES contributes more to women's vulnerability to abuse and stress symptoms than does ethnicity.

Adult↗

Lower extremity compartment syndrome in an adolescent with spinal cord injury.

OBJECTIVE: Describe the unusual complication of lower extremity compartment syndrome occurring in an adolescent with spinal cord injury (SCI). METHODS: Case presentation. RESULTS: A 17-year-old male with C5 ASIA A complete SCI developed a compartment syndrome of his lower leg on the ninth day postinjury. Presenting signs included an equinus deformity of the foot, blackened induration over the anterior tibia, circumferential erythematous markings over the calf, large urticarial lesions over the knee, and calf swelling. The presumed etiology of the compartment syndrome was excessive pressure from elastic wraps, which were placed over gradient elastic stockings. Pressures were 51 mmHg in the superficial posterior, 50 mmHg in the deep posterior, 33 mmHg in the anterior, and 34 mmHg in the peroneal compartments. The patient also developed rhabdomyolysis with myoglobinuria. In addition to supportive care, the patient underwent a dual incision fasciotomy for compartment release. CONCLUSIONS: The development of lower extremity compartment syndrome was probably a result of excessive pressure applied by elastic wraps. Elastic wraps should be used with caution in individuals with SCI.

Adolescent↗

Work experience in adolescents with spinal cord injuries.

The purpose of this study is to compare the work experiences of adolescents with spinal cord injuries (SCI) to peers without disabilities. Twenty-eight adolescents with SCI and 25 age-matched individuals without disabilities (controls) took part in the study.A structured telephone questionnaire was used to assess their experience of household chores, volunteer jobs, and paid work. The mean age at interview was 16.2 years for those with SCI and 16.0 years for control participants. There was no significant difference between the individuals with SCI and the control participants in chores or volunteer work experiences, but the individuals with SCI were significantly less likely to have paid work experience than control participants (chi2 = 13.670, p<0.001). Of the older adolescents, aged >15 to 19 years, five of 15 individuals with SCI and 16 of 16 control participants had paid work (Fisher exact test p<0.001). Of individuals with SCI, those with milder injuries and those injured at a younger age were more likely to have work experience.

Activities of Daily Living↗

Long-term outcomes and life satisfaction of adults who had pediatric spinal cord injuries.

OBJECTIVE: To determine long-term outcomes and life satisfaction of adults who sustained pediatric spinal cord injury (SCI). DESIGN: Structured interview of adults who were 25 years or older who had pediatric SCI. SETTING: Community. PARTICIPANTS: A convenience sample of 46 patients from a total of 81 patients who received care in an SCI program: 1 refused participation, 4 died, and 30 were lost to follow-up. MAIN OUTCOME MEASURES: A structured questionnaire including physical, psychosocial, and medical information. The Craig Handicap Assessment and Reporting Technique and two measures of life satisfaction were also administered. RESULTS: Participants were 25 to 34 years old, mean 27 years. Thirty-two had tetraplegia and 14 had paraplegia. Thirty-one were men. Mean years of education was 14. Fifty-four percent were employed, 48% lived independently, and 15% were married. Life satisfaction was associated with education, income, satisfaction with employment, and social/recreation opportunities, and was inversely associated with some medical complications. Life satisfaction was not significantly associated with level of injury, age at injury, or duration of injury. CONCLUSIONS: Individuals who had pediatric SCI, much like adult-onset SCI, have the greatest opportunity for a satisfying adult life if rehabilitation emphasizes psychosocial factors such as education, employment, and long-term health management.

Activities of Daily Living↗

Menstruation and pediatric spinal cord injury.

Menstrual characteristics were studied in young women who sustained spinal cord injuries (SCI) prior to puberty or in early adolescence. Subjects were 37 females who were injured prior to age 16 years and who were at least 10 years old at the time of interview; 22 were injured prior to menarche and 15 after menarche. Average age of menarche for females injured before puberty was 12.3 years which is similar to their mothers (mean 12.6 years) and to patients injured after menarche (mean 12.0 years). Of 15 females injured after menarche, seven reported no interruption in menses while eight had interruptions ranging from one to seven months. No significant menstrual problems were noted in either group. This information about menstruation should be included in sexuality teaching of parents and patients when an SCI occurs to a child or adolescent.

Adolescent↗

Cervical spine fusion: not protective of cervical spine injury and tetraplegia.

The occurrence of tetraplegic spinal cord injuries in two patients who had preexisting cervical spine fusions highlights the vulnerable nature of such patients. One patient sustained a C5-6 fracture-dislocation after a motor vehicle accident, despite a spontaneously fused cervical spine as a consequence of his juvenile rheumatoid arthritis. A second patient sustained a C3-4 distraction injury in a sporting injury 2 years after he had undergone a posterior cervical spine fusion because of an aneurysmal bone cyst. Prior to their spinal cord injuries, both patients had no apparent neurologic deficits, were relatively active, and followed no specific precautions for their spines.

Adolescent↗

Neurologic and vascular complications of scoliosis surgery in patients with Ehlers-Danlos syndrome. A case report.

STUDY DESIGN: Case reports. OBJECTIVES: Description of neurologic and vascular complications of scoliosis surgery to children and adolescents with ehlers-danios syndrome. SUMMARY OF BACKGROUND DATA: There have been no previous reports of neurologic and vascular complications of scoliosis surgery in patients with Ehlers-Danlos syndrome. Scoliosis and vascular fragility are characteristics of certain types of Ehlers-Danlos syndrome. METHODS: Case reports and literature review. RESULTS: Subsequent to scoliosis surgery, three patients with Ehlers-Danlos syndrome developed neurologic complications: two developed paraplegia, and one developed unilateral foot and ankle weakness with transient neurogenic bladder. Another patient with Ehlers-Danlos syndrome experienced avulsion of segmental arteries during anterior spinal surgery. CONCLUSIONS: Patients with Ehlers-Danlos syndrome may be at high risk for neurologic and vascular complications consequent to scoliosis surgery, necessitating careful perioperative evaluation and management.

Cardiovascular Diseases↗

Ambulation with parapodia and reciprocating gait orthoses in pediatric spinal cord injury.

The use of parapodia and reciprocating gait orthoses (RGOs) was reviewed in 41 children and adolescents with spinal cord injuries. Compared with users of RGOs, users of parapodia were younger when injured and when the orthotic was first used, were more likely to be household ambulators and to have higher neurological levels, and were unlikely to continue their use of the parapodium after early school age. Hip contractures that required surgical releases or contributed to discontinuation of orthotic usage were present in six of 26 parapodium users and 12 of 22 RGO users. RGOs and parapodia have a limited but important role in management of pediatric spinal cord injury, and should be used in a developmentally based program responsive to the changing needs of children and adolescents.

Child↗

Distress and symptoms of posttraumatic stress disorder in abused women.

Emotional distress and symptoms of posttraumatic stress disorder (PTSD) were examined among women in psychologically abusive relationships. Women (N = 93) were divided into three groups (none, moderate, severe) according to scores on the violence subscale of the Severity of Violence Against Women Scales (Marshall, 1992). All groups reported serious emotional distress on the Symptom Checklist 90-Revised (Derogatis, 1983) dimensions (e.g. more so than 93% of the nonclinical norm for global distress). Psychoticism was the highest subscale for all groups. Most women (56%) suffered PTSD according to a subscale of the SCL90 (Saunders, Arata, & Kilpatrick, 1990). Difficulties with perception, memory, and motor functions (cognitive failure) more consistently predicted intrusive thoughts. PTSD scores, and attempted suicide than did women's attention to their inner thoughts and feelings (private self-consciousness), which was important for the sample and the subgroup that had sustained severe violence. Limitations and contributions are discussed as are different uses for conservative and inclusive measures of PTSD.

Adult↗

Length polymorphisms in new human collagen-like loci.

Two new collagen-like loci have been identified in the human genome which have sequence similarity to the triple-helical coding region of the pro-alpha 2(I) gene. Both loci exhibit length polymorphism due to alleles that contain deletions. The deletion at one locus is 400 bp while the deletion at the second locus is 200 bp. The second locus is on chromosome 17 and its two alleles are not in Hardy-Weinberg equilibrium. These loci are candidates for involvement in connective tissue disorders.

Collagen↗

Antibody response to group B streptococcus type III and AB blood group antigens induced by pneumococcal vaccine.

The effect of pneumococcal vaccination on antibodies to Streptococcus pneumoniae type 14, group B streptococcus type III, and AB blood group antigens was studied in 40 vaccinated adults. Fourfold or greater increases in type-specific IgG antibody to Pn-14 were found in 26 of 40 vaccines (mean increase 6.4-fold) and against GBS-III in 16 of the 40 (mean increase 2.9-fold) by an indirect immunofluorescence assay. However, only six of the 26 vaccinees with low levels (titers less than or equal to 20) of GBS-III antibody in prevaccination sera developed titers greater than 20 after vaccination. Thus, vaccination with polyvalent pneumococcal vaccine does not reliably induce high levels of IF antibody to GBS-III. Fourfold or greater increases in IgG isohemagglutinins against blood group A cells were also found in 22 of 27 vaccines (mean increase 4.5-fold) and against blood group B cells in nine of 34 (mean increase 1.7-fold) using the indirect anti-human globulin test. Chromatographic fractionation of selected sera confirmed that the anti-A isohemagglutinins stimulated in group O subjects were of the IgG class. Thus, pneumococcal vaccination during incompatible pregnancy could potentiate AO hemolytic disease of the newborn infant.

ABO Blood-Group System↗

Nosocomial transmission of bacteriophage type 7/11/12 group B streptococci in a special care nursery.

Two premature infants in a special care nursery acquired late-onset group B streptococcal (GBS) sepsis within a 24-hour period. The infecting strains were serotype III organisms with bacteriophage type 7/11/12. Cultures of the mothers of the two affected infants were negative for GBS, implying nosocomial acquisition of infection. Although 32% of nursery personnel had mucosal carriage of GBS, none of the seven isolates of GBS type III was the same bacteriophage type as the two infecting strains. Of the other infants hospitalized in the nursery, five were asymptomatically colonized with GBS. These infants were in bassinets adjacent to the affected infants; all five of their isolates were identical to the two infecting strains. We conclude that infant-to-infant transmission may result in nosocomial late-onset GBS septicemia.

Bacteriophage Typing↗