No abstract

Background: Patients who have sustained a spinal cord injury (SCI) frequently face a fundamental change in their employment situation, as the demands of their previous job often exceed their remaining physical abilities. Aim: To study which factors associated with the SCI may influence the employment status. Design: Descriptive cross-sectional study. Setting and population: Seventy-three individuals who had sustained a SCI, admitted in our Rehabilitation Center in 2015. Intervention: Not applicable. Methods: Besides clinical information, a telephone questionnaire was applied in 2019 to the patients, in order to identify demographic and injury-related status, functionality (FIM, SCIM-III, nFAC scales), and work-related information. The data was analyzed in SPSS Statistics® version 26, using χ2 test for categorical variables and t test for independent samples between continuous and categorical variables. Results: The employment rate after SCI was 27.8%. The need of a caregiver showed a significant relationship with not being employed (p<0.001), consisting in an independent determinant for employment (OR 5.38). Return-to-work was associated with higher functional scores, lower mean age values (p<0.001), previous higher education level (p<0.001), and pre-injury intellectual job (p=0.009). Conclusion and clinical rehabilitation impact: The employment rate and factors influencing return-to-work were in line with those available in literature. Additionally, we consider that the “need of a caregiver” is essential in the evaluation of a SCI patient, as it gives a clearer understanding of the patients’ work ability (participation domain), in contrast with functional scores, best suited in the activity domain of the International Classification of Functioning Disability and Health.

Tuberculous Meningoencephalitis (TBM) is an infectious disease of the central nervous system caused by Mycobacterium tuberculosis. It mainly involves the meninges and brain parenchyma, as well as the spinal cord and meninges. The spectrum of complications of TBM includes hydrocephalus, tuberculoma formation and stroke. Stroke secondary to TBM can cause irreversible brain damage and lead to poor clinical outcomes. TBM diagnosis is challenging due to atypical early symptoms and delayed laboratory examination. Therefore, early identification, diagnosis and treatment are often difficult. Rehabilitation is one of the key components in managing TBM and is expected to enhance recovery and prevent disabilities.