Objectives: The objective of this study was to provide guidelines for reporting results using the International Spinal Cord Injury (SCI) Core Data Set. Setting: International. Methods: A committee was created on request of the chair of the Executive Committee for the International SCI Data Set committees. The committee developed a draft consisting of set of recommendations, which were then reviewed and approved by the entire Executive Committee. Results: Age at injury is recommended as reported by the mean, s.d., median and range. When grouped, 15-year increments are recommended as follows: 0-15, 16-30, 31-45, 46-60, 61-75 and 76 þ years. For pediatric SCI, 0-5, 6-12, 13-15, 16-21 years are recommended. Time since injury should be reported by mean, s.d., median and range. The following intervals are recommended: o1 year, 1-5, 6-10, 11-15 years, and 5-year increments thereafter. Calendar time (years during which the study is conducted) is recommended grouped by either 5 or 10-year increments with years ending in 4 or 9. For 'length of stay', the mean and s.d., as well as the median is recommended for report. Severity of injury is under ordinary circumstances recommended, reported in five categories: C1-4 American Spinal Injury Association Impairment Scale grade (AIS) A, B or C; C5-8 AIS A, B or C; T1-S5 AIS A, B, or C; AIS D at any injury level; and ventilator dependent at any injury level or AIS grade. Conclusion: It is expected that these recommendations can facilitate a more uniform reporting of the very basic core data on SCI. This will facilitate comparison between different SCI studies.

This is the first demonstration that a carefully planned program with time-calorie displacement diet is effective for overweight/obese individuals with SCI to lose weight without compromising total lean mass and overall health. It provides foundation for a future large clinical trial for weight loss of persons with SCI or other spinal cord dysfunction.

Study design: A multi-center longitudinal study. Objectives: To estimate the current trend in the incidence of ®rst kidney stone among persons with spinal cord injury (SCI) and to delineate the potential contributing factors. Setting: Twenty-one Model SCI Care Systems throughout the United States. Methods: A longitudinal cohort of 8314 subjects enrolled in the National SCI Database between 1986 and 1999 was used to estimate and compare the incidence of ®rst kidney stone with a previous report of 5850 SCI patients injured between 1973 and1982. A Cox regression analysis was performed to identify risk factors for stones, including age, race, gender, severity of injury, and method of urinary drainage. These variables have been routinely collected, on a yearly basis, by the collaborating SCI centers. Results: During the 12 years, 6 months of case ascertainment, 286 incident stone cases were documented. The risk was greatest during the ®rst 3 months after injury (31 cases per 1000 person-years), quickly decreasing and leveling o later (eight cases per 1000 person-years). It was estimated that within 10 years after injury, 7% of persons with SCI would develop their ®rst kidney stone. There was no evidence that the risk has changed over the past 25 years (P=0.96). During the ®rst year post injury only, a signi®cantly increased risk of stones was observed in Caucasians and persons aged 45 years or older. A positive association of the severity of injury and requiring instrumentation for bladder emptying with kidney stones was found after the ®rst year post injury. The type of urinary drainage, including indwelling, intermittent, and condom catheterization, had no signi®cant dierential eect on stone formation at either risk period. Conclusions: The highest risk of kidney stones is within the ®rst few months post injury. Little progress has been made in reducing this risk. Although inability to control bladder function is an important risk factor after the ®rst year post injury, for those who need bladder management, the type of urinary drainage does not appear to be an important factor in determining risk. Spinal Cord (2000) 38, 346 ± 353

We performed a genome-wide association study of primary erythrocyte TPMT activity in children with leukemia (n = 1026). Adjusting for age and ancestry, TPMT was the only gene that reached genome-wide significance (top hit rs1142345 or 719A>G, P = 8.6 × 10−61). Additional genetic variants (besides the 3 SNPs rs1800462, rs1800460 and rs1142345 defining TPMT clinical genotype) did not significantly improve classification accuracy for TPMT phenotype. Clinical mercaptopurine tolerability in 839 patients was related to TPMT clinical genotype (P = 2.4 × 10−11). Using 177 lymphoblastoid cell lines (LCLs), there were 251 SNPs ranked higher than the top TPMT SNP (rs1142345 P = 6.8 × 10−5), showing the limitation of LCLs for pharmacogenomic discovery. In a GWAS, TPMT activity in patients behaves as a monogenic trait, further bolstering the utility of TPMT genetic testing in the clinic.

Study design: A descriptive study of concurrent extraspinal fractures collected prospectively during initial hospital care. Objectives: To examine the frequency and related characteristics of concurrent extraspinal fractures among patients with a new onset of spinal cord injury (SCI). Setting: Model SCI care systems throughout the United States. Methods: A consecutive sample of 5711 subjects admitted to the National SCI Database between 1986 ± 1995 was recruited to estimate the incidence of extraspinal fractures associated with acute SCI, strati®ed by anatomic sites, demographics, and injury related characteristics. Results: Of 5711 subjects, 1585 (28%) patients had extraspinal fractures; 580 (37%) patients had more than one fracture site. The most common region of fractures was chest, followed by lower extremity, upper extremity, head, others, and pelvis. The overall incidence rate was higher for women than men, for whites than non-whites, for paraplegics than tetraplegics, and for those injured in motor vehicle crashes than others. Compared with patients having single fracture, those who had multiple fractures were likely to be white, paraplegic, and injured in motor vehicle crashes. There was no age di erence in the incidence of concurrent fractures, single or multiple. Conclusions: Extraspinal fractures are not uncommon at the same time as SCI. The fracture occurrence varies by gender, race, injury level, and etiology of injury. The knowledge of these associated factors will aid in early recognition of fractures, preventing complications, and facilitating rapid mobilization and rehabilitation outcomes among persons with SCI. Spinal Cord (2001) 39, 589 ± 594