Facilitation of Immune Function, Healing of Pressure Ulcers, and Nutritional Status in Spinal Cord Injury Patients

Cruse, Julius M.; Lewis, Robert E.; Roe, David; Dilioglou, Smaroula; Blaine, M.C.; Chen, R.S.

doi:10.1006/exmp.1999.2292

Cited by 58 publications

(44 citation statements)

References 20 publications

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“…These changes have been found to start soon after injury and to continue thereafter. 10,11 Natural-killer cell function is decreased, 11 T-cell function and activation are decreased 11 and macrophage phagocytosis is altered. 11 SCI patients have also been found to have reduced levels and function of cellular adhesion molecules 9,10 and reduced levels of surface markers on both lymphocytes and granulocytes.…”

Section: Discussionmentioning

confidence: 99%

Dermatological findings following acute traumatic spinal cord injury

et al. 2004

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Study design: Prospective study. Objective: To identify and define dermatological conditions following acute traumatic spinal cord injury (ATSCI) during inpatient rehabilitation. Setting: Spinal Cord Injury Unit, The Department of Neurological Rehabilitation, The Chaim Sheba Medical Center, Israel. Methods: During a 1-year study, all patients following ATSCI were prospectively studied for new dermatological findings during their inpatient rehabilitation. Every new dermatological finding was defined concerning its location with regard to the patient's neurological level, the time from injury to appearance and the exact dermatological diagnosis. Results: During the study year, 46 ATSCI patients were hospitalized in our department, of whom were 38 (82.6%) males and eight (17.4%) females (mean age 30.2 years). A total of 21 (45.6%) patients were tetraplegic and 25 (54.3%) paraplegic. Of the patients, 28 (60.9%) had complete neurological injuries and 18 (39.1%) incomplete. In all, 14 (30.4%) patients developed a dermatological condition. There was no significant age or sex correlation to the development of these complications. There was a greater likelihood of paraplegia (48 versus 9.5%, P ¼ 0.005) and being neurologically complete (42.9 versus 11.1%, P ¼ 0.02). The dermatological findings appeared on an average of 80.3 days after the initial neurological insult. There were a total of 22 different dermatological findings: 11 (50%) were local fungal infections, two (9.1%) psoriatic lesions, two (9.1%) hyperkeratotic lesions, two (9.1%) bacterial infections (one folliculitis, one impetigo) and single cases of seborrheic dermatitis, acne, alopecia, scabies and allergic reaction. Of the findings, 14 (63.6%) were below the neurological level, including all of the fungal infections. Conclusions: Dermatological findings are common during rehabilitation of ATSCI. The clinical impact of these findings is low, but nevertheless, they are troublesome to the patient. The most common dermatological disorder was a local fungal infection below the neurological level. Paraplegic patients are more susceptible to the development of this condition. Patient and staff education regarding proper skin care may reduce these infections.

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Section: Discussionmentioning

confidence: 99%

Dermatological findings following acute traumatic spinal cord injury

et al. 2004

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“…6,25 This process may induce the hormonally driven suppression of both the innate and adaptive immune systems and explain, in part, the increased susceptibility to infection and reduction in wound-healing capabilities observed following SCI. 26 Such an influence has been demonstrated within the innate immune system by reductions in natural killer cell function as well as in the adaptive immune system by reductions in T-cell function, which were shown to be inversely related to cortisol levels. 6 The majority of studies demonstrating this upregulation of the HPA axis and elevated levels of cortisol have, however, typically been performed under acute SCI conditions.…”

Section: Endocrine Dysfunctionmentioning

confidence: 99%

Immune dysfunction and chronic inflammation following spinal cord injury

2014

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Study design: Review article. Objectives: The objective of this study is to provide an overview of the many factors that contribute to the chronic inflammatory state typically observed following spinal cord injury (SCI). Methods: Literature review. Results: Not applicable. Conclusion: SCI is typically characterized by a low-grade inflammatory state due to a number of factors. As bidirectional communication exists between the nervous, endocrine and immune systems, damage to the spinal cord may translate into both endocrinal and immune impairment. Damage to the autonomic nervous system may induce immune dysfunction directly, through the loss of neural innervation of lymphoid organs, or indirectly by inducing endocrinal impairment. In addition, damage to the somatic nervous system and the corresponding loss of motor and sensory function increases the likelihood of developing a number of secondary health complications and metabolic disorders associated with a state of inflammation. Lastly, numerous related disorders associated with a state of chronic inflammation have been found to be at a substantially higher prevalence following SCI. Together, such factors help explain the chronic inflammatory state and immune impairment typically observed following SCI. An understanding of the interactions between systems, both in health and disease, and the many causes of chronic inflammation may aid in the effective future treatment of immune dysfunction and related disorders following SCI.

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“…There was a greater likelihood of an infectious neurosurgical condition in patients diagnosed with Adverse drug reactions. The findings are natural as the major putative drugs implicated in cases of Adverse drug reactions among dermatology referrals were antibiotics (50%) and antiepileptics (13%) [13].…”

Section: Discussionmentioning

confidence: 72%

“…Notably, 37 patients (10.8%) developed adverse drug reactions after exposure to contrast media, of which the most common adverse reaction was skin eruption [13], for computerized tomography or angiography. However, none of the individual neurosurgical conditions were significantly associated with Adverse drug reactions except for cerebral aneurysm.…”

Section: Discussionmentioning

confidence: 99%

Early Detection of Dermatological Diseases in Children Admitted in a Neurological Unit: A Retrospective Study

Alkot¹,

Jokhdar²,

Eljahdaly³

et al. 2017

JDC

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Background: Both the central nervous system and skin are derived from the same ectodermal origin during the embryogenesis, and thus children with neurologic disorders may have associated skin diseases, an area needs to spot light.Objective: The aim of this study was to clarify and analyze the dermatological consultations encountered in a neurological unit.Methods: Dermatological consultations during the last two years from children admitted in a neurological unit were retrospectively analyzed.Results: Out of 1, 103 dermatology consultations, 318 (28.8%) came from the department of neurology. The ratio of male to female was 1: 0.7. Consults were most frequently found from children with Encephalopathy (25.8%). The most common dermatological consultations were Skin infections (25.7%), Eczema/dermatitis (31.5.0%) followed by cutaneous adverse drug reactions (10.8%). Conclusion:This study clarifies the significant high frequency of skin diseases among hospital admitted children due to neurological illnesses. Integration between the pediatric neurologist and dermatologists as secondary care providers in one side and the family physician in the other side as primary care provider may improve the quality of patient care, help to early predict the occurrence of these illnesses and provide better outcome.

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Facilitation of Immune Function, Healing of Pressure Ulcers, and Nutritional Status in Spinal Cord Injury Patients

Cited by 58 publications

References 20 publications

Dermatological findings following acute traumatic spinal cord injury

Dermatological findings following acute traumatic spinal cord injury

Immune dysfunction and chronic inflammation following spinal cord injury

Early Detection of Dermatological Diseases in Children Admitted in a Neurological Unit: A Retrospective Study

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