Browsing by Author "Szymanski, Konrad M"

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    ItemOpen Access
    Causes of death among people with myelomeningocele: A multi-institutional 47-year retrospective study.
    (Journal of pediatric rehabilitation medicine, 2023-12) Szymanski, Konrad M; Adams, Cyrus M; Alkawaldeh, Mohammad Y; Austin, Paul F; Bowman, Robin M; Castillo, Heidi; Castillo, Jonathan; Chu, David I; Estrada, Carlos R; Fascelli, Michele; Frimberger, Dominic C; Gargollo, Patricio C; Hamdan, Dawud G; Hecht, Sarah L; Hopson, Betsy; Husmann, Douglas A; Jacobs, Micah A; MacNeily, Andrew E; McLeod, Daryl J; Metcalfe, Peter D; Meyer, Theresa; Misseri, Rosalia; O'Neil, Joseph; Rensing, Adam J; Routh, Jonathan C; Rove, Kyle O; Sawin, Kathleen J; Schlomer, Bruce J; Shamblin, Isaac; Sherlock, Rebecca L; Slobodov, Gennady; Stout, Jennifer; Tanaka, Stacy T; Weiss, Dana A; Wiener, John S; Wood, Hadley M; Yerkes, Elizabeth B; Blount, Jeffrey

    Purpose

    This study aimed to analyze organ system-based causes and non-organ system-based mechanisms of death (COD, MOD) in people with myelomeningocele (MMC), comparing urological to other COD.

    Methods

    A retrospective review was performed of 16 institutions in Canada/United States of non-random convenience sample of people with MMC (born > = 1972) using non-parametric statistics.

    Results

    Of 293 deaths (89% shunted hydrocephalus), 12% occurred in infancy, 35% in childhood, and 53% in adulthood (documented COD: 74%). For 261 shunted individuals, leading COD were neurological (21%) and pulmonary (17%), and leading MOD were infections (34%, including shunt infections: 4%) and non-infectious shunt malfunctions (14%). For 32 unshunted individuals, leading COD were pulmonary (34%) and cardiovascular (13%), and leading MOD were infections (38%) and non-infectious pulmonary (16%). COD and MOD varied by shunt status and age (p < = 0.04), not ambulation or birthyear (p > = 0.16). Urology-related deaths (urosepsis, renal failure, hematuria, bladder perforation/cancer: 10%) were more likely in females (p = 0.01), independent of age, shunt, or ambulatory status (p > = 0.40). COD/MOD were independent of bladder augmentation (p= >0.11). Unexplained deaths while asleep (4%) were independent of age, shunt status, and epilepsy (p >= 0.47).

    Conclusion

    COD varied by shunt status. Leading MOD were infectious. Urology-related deaths (10%) were independent of shunt status; 26% of COD were unknown. Life-long multidisciplinary care and accurate mortality documentation are needed.
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    ItemOpen Access
    Prevalence of sexual abuse and intimate partner violence in adults with spina bifida.
    (Disability and health journal, 2024-03) Johnston, Ashley W; Hensel, Devon J; Roth, Joshua D; Wiener, John S; Misseri, Rosalia; Szymanski, Konrad M

    Background

    People with disabilities and chronic medical conditions are known to be at higher risk of sexual abuse (SA) and intimate partner violence (IPV). People with spina bifida (SB) are vulnerable, but little is known about the prevalence of abuse in this population.

    Objective

    To evaluate the prevalence and risk factors of SA and IPV in adults with SB.

    Methods

    An anonymous international cross-sectional online survey of adults with SB asked about history of SA ("sexual contact that you did not want") and IPV ("hit, slapped, kicked, punched or hurt physically by a partner").

    Results

    Median age of the 405 participants (61% female) was 35 years. Most self-identified as heterosexual (85%) and were in a romantic relationship (66%). A total of 19% reported a history of SA (78% no SA, 3% preferred not to answer). SA was more frequently reported by women compared to men (27% vs. 5%, p < 0.001) and non-heterosexual adults compared to heterosexuals (41% vs. 15%, p < 0.001). Twelve percent reported a history of IPV (86% no IPV, 2% preferred not to answer). IPV was more frequently reported by women compared to men (14% vs. 9%, p = 0.02), non-heterosexuals compared to heterosexuals (26% vs. 10%, p = 0.002), and adults with a history of sexual activity versus those without (14% vs. 2%, p = 0.01).

    Conclusion

    People with SB are subjected to SA and IPV. Women and non-heterosexuals are at higher risk of both.