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Study designSystematic review.ObjectiveTo perform a systematic review to evaluate the utility of magnetic resonance imaging (MRI) in patients with acute spinal cord injury (SCI).MethodsAn electronic search of Medline, EMBASE, the Cochrane Collaboration Library, and Google Scholar was conducted for literature published through May 12, 2015, to answer key questions associated with the use of MRI in patients with acute SCI.ResultsThe literature search yielded 796 potentially relevant citations, 8 of which were included in this review. One study used MRI in a protocol to decide on early surgical decompression. The MRI-protocol group showed improved outcomes; however, the quality of evidence was deemed very low due to selection bias. Seven studies reported MRI predictors of neurologic or functional outcomes. There was moderate-quality evidence that longer intramedullary hemorrhage (2 studies) and low-quality evidence that smaller spinal canal diameter at the location of maximal spinal cord compression and the presence of cord swelling are associated with poor neurologic recovery. There was moderate-quality evidence that clinical outcomes are not predicted by SCI lesion length and the presence of cord edema.ConclusionsCertain MRI characteristics appear to be predictive of outcomes in acute SCI, including length of intramedullary hemorrhage (moderate-quality evidence), canal diameter at maximal spinal cord compression (low-quality evidence), and spinal cord swelling (low-quality evidence). Other imaging features were either inconsistently (presence of hemorrhage, maximal canal compromise, and edema length) or not associated with outcomes. The paucity of literature highlights the need for well-designed prospective studies.

Background. Saliva is essential for the maintenance of oral health. The primary constituent of saliva is water and, traditionally, decreased body water homeostasis has been linked with salivary dysfunction. This is consistent with the greater prevalence of dehydration and salivary gland dysfunction among the elderly. However, this association between dehydration and salivary dysfunction has never been tested using objective criteria. The purpose of this study was to determine the effect of body dehydration upon parotid salivary flow rates in young and older healthy adults. Methods. Twelve young (20-40 years) and 12 older (60-80 years) healthy subjects abstained from food and beverage intake for 24 h (dehydration) and then underwent intravenous rehydration to replace all lost weight. Unstimulated and stimulated parotid salivary flow rates, weight, hematocrit, hemoglobin, serum sodium, plasma protein, creatinine, serum, and urine osmolality values were assessed at baseline, 24 h, and 1 h after the completion of rehydration. Results. All subjects experienced a significant decrease in weight and increased levels of hematocrit, hemoglobin, plasma protein, and creatinine during dehydration with few age-related differences. Intravenous fluid replacement increased weight and decreased hematocrit, hemoglobin, plasma protein, and creatinine back to baseline values, demonstrating that subjects were metabolically rehydrated. Unstimulated (young and older, p = .0001) and stimulated (young, p > .05; older, p = .03) parotid flow rates decreased during the 24-h dehydration period, yet did not completely return (young and older unstimulated, p < .001; young and older stimulated, p > .05) to baseline values after rehydration. Conclusions. These findings suggest that body dehydration is associated with decreased parotid salivary gland flow rates, and that these changes are generally age-independent in healthy adults. Furthermore, although subjects were metabolically rehydrated, unstimulated salivary flow rates remained significantly lower than baseline levels.

Aims: To evaluate the risk of self-reported temporomandibular disorder (TMD) pain among adolescents in relation to previous head and/or neck injury. Methods: 3,101 enrollees (11 to 17 years of age) of a nonprofit integrated health-care system were interviewed by telephone. Two hundred four cases with self-reported TMD pain and 194 controls without self-reported TMD pain frequency-matched to the cases by age and gender completed standardized in-person interviews and physical examinations in which reports of previous head/neck injuries were recorded. Odds ratio (OR) estimates and 95% confidence intervals (CIs) of the relative risks of TMD pain associated with prior head and/or neck injuries were calculated using logistic regression. Results: A greater proportion of subjects reporting TMD pain (36%) than controls (25%) had a history of head and/or neck injuries (OR = 1.8, 95% CI, 1.1-2.8). In a separate analysis, the presence of TMD based upon the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was assessed in relation to prior head and/or neck injury. Cases reporting TMD pain and meeting the RDC/TMD criteria for myofascial pain and/or arthralgia or arthritis were 2.0 (CI, 1.0-3.8) times more likely to have had a prior head injury than were controls with neither self-reported nor RDC/TMD pain diagnoses. Conclusion: The results suggest a modest association of prior head injuries with both self-reported and clinically diagnosed TMD pain in adolescents. [ABSTRACT FROM AUTHOR]