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Spinal cord injuries and fractures
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Laura Sweeney, George M. Ghobrial, James S. Harrop
The need for surgery should be assessed first in order to provide spinal stability for the patient. After surgery, management of the body systems is important. Respiratory management includes early ventilator weaning, aggressive chest therapy, and determination of the need for tracheostomy or diaphragmatic pacemaker. Cardiovascular management is important in the early injury state. As health-care providers, we aim to have adequate spinal cord perfusion with elevated blood pressures (mean arterial pressure >85 mm Hg) for our patients. We also attempt to prevent autonomic dysreflexia. Other interventions we implement are skin protection, bowel and bladder regimens, pain control, and DVT prophylaxis.
Perry disease: recent advances and perspectives
Published in Expert Opinion on Orphan Drugs, 2019
Takayasu Mishima, Shinsuke Fujioka, Yoshio Tsuboi
We have compiled a comprehensive review of literature on Perry disease. The establishment of a clinical diagnosis of Perry disease will hopefully increase the diagnostic rate, especially during early stages of the disease. Potentially useful care and treatment including the use of a diaphragmatic pacemaker has been reported; nevertheless, disease-modifying therapy is essential for this devastating disease. Perry disease has overlapping features with other neurodegenerative diseases including PD, MSA, other parkinsonism, depression, frontotemporal dementia (FTD), ALS, HMN7B, and myotonic dystrophy [44]. Therefore, we expect future advances in basic and clinical research in other neurodegenerative diseases will impact our understanding of Perry disease and vice versa.