Correspondence:
Nearly 60% of patients with traumatic spinal cord injury (SCI) experience different degrees of cognitive dysfunction, including impairment of memory and abstract reasoning.[1] A retrospective cohort study using Taiwan’s National Health Insurance Research Database revealed that SCI significantly increased the likelihood of dementia.[2] This result aligns with previous clinical reports stating that patients with SCI frequently develop long-term cognitive impairments.[1]
I read the article “Savings of loss-of-life expectancy and lifetime medical costs from prevention of spinal cord injuries: analysis of nationwide data followed for 17 years” [3] with deep interest. The study investigators have reported the outcomes from a comprehensive and long-term follow-up effort exploring the impact of traumatic SCI in Taiwan. In this study, Lien et al. classified traumatic SCI into traumatic quadriplegia and paraplegia with different mechanisms of injury. They reported that traumatic quadriplegia incurs higher lifetime medical costs than traumatic paraplegia.[3] Upon comparing the clinical characteristics of patients with traumatic quadriplegia and paraplegia, the prevalence of dementia after quadriplegia resulting from motor vehicle accidents (MVA) was found to be higher than that after paraplegia resulting from MVA (3.7% vs. 1.5%, p < 0.05).[3] The strength of this study lies in its comprehensive data on the SCI level, mechanisms of injury, and medical...
Correspondence:
Nearly 60% of patients with traumatic spinal cord injury (SCI) experience different degrees of cognitive dysfunction, including impairment of memory and abstract reasoning.[1] A retrospective cohort study using Taiwan’s National Health Insurance Research Database revealed that SCI significantly increased the likelihood of dementia.[2] This result aligns with previous clinical reports stating that patients with SCI frequently develop long-term cognitive impairments.[1]
I read the article “Savings of loss-of-life expectancy and lifetime medical costs from prevention of spinal cord injuries: analysis of nationwide data followed for 17 years” [3] with deep interest. The study investigators have reported the outcomes from a comprehensive and long-term follow-up effort exploring the impact of traumatic SCI in Taiwan. In this study, Lien et al. classified traumatic SCI into traumatic quadriplegia and paraplegia with different mechanisms of injury. They reported that traumatic quadriplegia incurs higher lifetime medical costs than traumatic paraplegia.[3] Upon comparing the clinical characteristics of patients with traumatic quadriplegia and paraplegia, the prevalence of dementia after quadriplegia resulting from motor vehicle accidents (MVA) was found to be higher than that after paraplegia resulting from MVA (3.7% vs. 1.5%, p < 0.05).[3] The strength of this study lies in its comprehensive data on the SCI level, mechanisms of injury, and medical costs. However, the study did not control for potential confounders, such as concurrent traumatic brain injury (TBI), dementia, and Charlson Comorbidity Index, that may have influenced medical costs. In patients with SCI, neurodegeneration and neuroinflammation after a traumatic injury may increase the risk of dementia. Wu et al. conducted SCI studies using animal models and demonstrated that chronic neuroinflammation with microglial activation is associated with neurodegeneration,[4] a pathogenesis similar to that of Alzheimer’s disease. Consequently, identifying potential risk factors of dementia in traumatic SCI patients and establishing a preventive strategy are essential in public health. A recent nationwide cohort study revealed that rehabilitation training (physical therapy and occupational therapy) in traumatic SCI lowers the risk of psychiatric disorders, including dementia and depression, after controlling for potential confounders, such as sex, age, and comorbidities.[5] If the authors want to compare the risk of dementia in SCI patients with quadriplegia and paraplegia, controlling for possible confounding factors, such as sex, age, and TBI, should be considered. Further studies exploring alternative interventions to prevent cognitive deterioration among individuals with traumatic SCI, especially among individuals with quadriplegia, are warranted.
Conflict of interest statement
The author has no conflict of interest to declare.
References:
1. Davidoff GN, Roth EJ, Richards JS. Cognitive deficits in spinal cord injury: epidemiology and outcome. Arch Phys Med Rehabil 1992;73:275–84.
2. Huang SW, Wang WT, Chou LC, et al. Risk of dementia in patients with spinal cord injury: A nationwide population-based cohort study. J Neurotrauma 2017;34:615–22.
3. Lien WC, Wang WM, Wang F, et al. Savings of loss-of-life expectancy and lifetime medical costs from prevention of spinal cord injuries: analysis of nationwide data followed for 17 years. Inj Prev 2021;injuryprev-2020-043943. [published online ahead of print: 22 Jan 2021]. doi:10.1136/injuryprev-2020-043943.
4. Wu J, Stoica BA, Luo T, et al. Isolated spinal cord contusion in rats induces chronic brain neuroinflammation, neurodegeneration, and cognitive impairment. Involvement of cell cycle activation. Cell Cycle 2014;13:2446–58.
5. Wan FJ, Chien WC, Chung CH, et al. Association between traumatic spinal cord injury and affective and other psychiatric disorders–a nationwide cohort study and effects of rehabilitation therapies. J Affect Disord 2020;265:381–8.
Partner violence during the COVID-19 pandemic: an emergency into the emergency
Pietro Ferrara, MD 1 *
Luciana Albano, MD 2
Affiliation
1. Center for Public Health Research, University of Milano – Bicocca, Monza, Italy
2. Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
* Corresponding author:
Pietro Ferrara
Center for Public Health Research, University of Milan - Bicocca
Via Cadore 48, I-20900 Monza, Italy
Phone +39 (0)39-2333097/8 p_ferrara@alice.it
To the Editor,
With interest, we read the publication by Jetelina and coll., titled “Changes in intimate partner violence during the early stages of the COVID-19 pandemic in the USA” [1], in which authors described changes in patterns of intimate partner violence (IPV) during lockdown restriction implemented in response to novel coronavirus disease (COVID-19) outbreak.
Similarly in Italy, a significant increase of IPV cases was recorded as early as the first weeks of March, when social isolation forced people to stay at home after the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, the government instituted the free phone number 1522 as help line for IPV victims, with the aim to reach mainly women, who always experience the greater burden of domestic violence and abuse [2]. The National Institute of Statistics (ISTAT) rel...
Partner violence during the COVID-19 pandemic: an emergency into the emergency
Pietro Ferrara, MD 1 *
Luciana Albano, MD 2
Affiliation
1. Center for Public Health Research, University of Milano – Bicocca, Monza, Italy
2. Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
* Corresponding author:
Pietro Ferrara
Center for Public Health Research, University of Milan - Bicocca
Via Cadore 48, I-20900 Monza, Italy
Phone +39 (0)39-2333097/8 p_ferrara@alice.it
To the Editor,
With interest, we read the publication by Jetelina and coll., titled “Changes in intimate partner violence during the early stages of the COVID-19 pandemic in the USA” [1], in which authors described changes in patterns of intimate partner violence (IPV) during lockdown restriction implemented in response to novel coronavirus disease (COVID-19) outbreak.
Similarly in Italy, a significant increase of IPV cases was recorded as early as the first weeks of March, when social isolation forced people to stay at home after the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, the government instituted the free phone number 1522 as help line for IPV victims, with the aim to reach mainly women, who always experience the greater burden of domestic violence and abuse [2]. The National Institute of Statistics (ISTAT) released data on the utilization of the 1522 line from March to June 2020, highlighting an increase of 119.7% of phone and chat contacts compared with the same period of 2019 (6,956 vs. 15,280). The majority of registered calls were attributable to violence and stalking cases, followed by questions on type of service offered and modality of access [3]. Interestingly, the time-trend analysis of calls showed that their number diminished during the weekend days as well as in correspondence of religious and national holidays (such as Easter April 12th; Liberation Day April 25th; Labor Day May 1st), likely attributable to a more control over victims’ freedom of movements.
Alongside the Italian data, findings from Jetelina and coll. described an emergency into the emergency, being also more severe than that came out from presented research and report. Indeed, coverage of data informing on IPV are limited and potential reporting biases should be related to sparsity and uncertainty in rural and peripheral areas, where people are less prone to trusting the provided services [2].
In this frame, further research is needed to provide more accurate estimates of the burden of IPV during the COVID-19 pandemic worldwide, in order to provide actionable metrics for the implementation of specific public health measures and social actions.
References
1. Jetelina KK, Knell G, Molsberry RJ Changes in intimate partner violence during the early stages of the COVID-19 pandemic in the USA Injury Prevention Published Online First: 01 September 2020. doi: 10.1136/injuryprev-2020-043831
2. James SL, Castle CD, Dingels ZV, et al Global injury morbidity and mortality from 1990 to 2017: results from the Global Burden of Disease Study 2017 Injury Prevention Published Online First: 24 April 2020. doi: 10.1136/injuryprev-2019-043494
3. Istituto Nazionale di Statistica (ISTAT). Il numero verde 1522 durante la pandemia (periodo marzo - giugno 2020). August 2020. Available at: https://www.istat.it/it/archivio/246557. Last accessed on September 3, 2020
4. Istituto Nazionale di Statistica (ISTAT). L’allerta internazionale e le evidenze nazionali attraverso i dati del 1522 e delle Forze di Polizia. La violenza di genere al tempo del coronavirus: Marzo - Maggio 2020. Available at: https://www.istat.it/it/files//2020/05/Dati-del-1522-e-delle-Forze-di-Po... accessed on September 3, 2020
Correspondence:
Nearly 60% of patients with traumatic spinal cord injury (SCI) experience different degrees of cognitive dysfunction, including impairment of memory and abstract reasoning.[1] A retrospective cohort study using Taiwan’s National Health Insurance Research Database revealed that SCI significantly increased the likelihood of dementia.[2] This result aligns with previous clinical reports stating that patients with SCI frequently develop long-term cognitive impairments.[1]
I read the article “Savings of loss-of-life expectancy and lifetime medical costs from prevention of spinal cord injuries: analysis of nationwide data followed for 17 years” [3] with deep interest. The study investigators have reported the outcomes from a comprehensive and long-term follow-up effort exploring the impact of traumatic SCI in Taiwan. In this study, Lien et al. classified traumatic SCI into traumatic quadriplegia and paraplegia with different mechanisms of injury. They reported that traumatic quadriplegia incurs higher lifetime medical costs than traumatic paraplegia.[3] Upon comparing the clinical characteristics of patients with traumatic quadriplegia and paraplegia, the prevalence of dementia after quadriplegia resulting from motor vehicle accidents (MVA) was found to be higher than that after paraplegia resulting from MVA (3.7% vs. 1.5%, p < 0.05).[3] The strength of this study lies in its comprehensive data on the SCI level, mechanisms of injury, and medical...
Show MorePartner violence during the COVID-19 pandemic: an emergency into the emergency
Pietro Ferrara, MD 1 *
Luciana Albano, MD 2
Affiliation
1. Center for Public Health Research, University of Milano – Bicocca, Monza, Italy
2. Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
* Corresponding author:
Pietro Ferrara
Center for Public Health Research, University of Milan - Bicocca
Via Cadore 48, I-20900 Monza, Italy
Phone +39 (0)39-2333097/8
p_ferrara@alice.it
To the Editor,
Show MoreWith interest, we read the publication by Jetelina and coll., titled “Changes in intimate partner violence during the early stages of the COVID-19 pandemic in the USA” [1], in which authors described changes in patterns of intimate partner violence (IPV) during lockdown restriction implemented in response to novel coronavirus disease (COVID-19) outbreak.
Similarly in Italy, a significant increase of IPV cases was recorded as early as the first weeks of March, when social isolation forced people to stay at home after the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, the government instituted the free phone number 1522 as help line for IPV victims, with the aim to reach mainly women, who always experience the greater burden of domestic violence and abuse [2]. The National Institute of Statistics (ISTAT) rel...