S140 PRESENTATIONS

Poster Hall Presentations, Posters 1-273 & 507Friday, October 4, 20131:30 PM - 2:30 PMPrince George’s Exhibition Hall A

GENERAL REHABILITATION

Poster 1Low Vitamin D Levels in Persons with Spinal CordInjury and Increased Incidence of VenousThromboembolic Events During Acute Inpatient andRehabilitation Stay.Molly A. Timmerman, DO (Stanford University, RedwoodCity, CA, United States); James Crew, MD; Kazuko Shem,MD; Min Kim, DO; Stephanie A. Kolakowsky-Hayner,PhD, CBIST; Jerry A. Wright, MS.

Disclosures: M. A. Timmerman, No Disclosures: I Have NothingTo Disclose.Objective: To determine if low serum 25-hydroxyvitamin D levelis associated with an increased incidence of venous thromboticevents (VTE) in spinal cord injury (SCI) patients during their acutehospital or rehab stay.Design: Retrospective cohort study.Setting: Academic Medical Center.Participants: Two hundred and five persons admitted consecu-tively to acute rehabilitation at Santa Clara Valley Medical Center(SCVMC) with a diagnosis of SCI from December 2009 to June2012.Interventions: The following demographic data was collected:age, gender, race, and admission date. Additional informationregarding injury was obtained including: level of injury (para-plegia versus tetraplegia), motor completeness of injury (motorcomplete versus motor incomplete), and etiology of injury (trau-matic versus non-traumatic). Serum 25-hydroxyvitamin D (VitD-25OH) levels and presence of VTE (deep vein thrombosis orpulmonary embolism) during acute hospital or rehab stay wasalso recorded.Main Outcome Measures: We looked at incidence of vitaminD deficiency in our patient population. Chi-square analysis wasused to determine significant associations with regard to demo-graphic variables, injury characteristics, and vitamin D deficiency.Specific to our hypothesis, we looked at whether low vitamin Dlevels had a significant association with VTE. P values of <.05 wereregarded significant.Results or Clinical Course: We found 83% of persons with SCIadmitted to acute inpatient rehabilitation have low levels of vitaminD. Patients who had low vitamin D levels had three and a half timesthe incidence of developing VTE (p¼.036).Discussion: Vitamin D is biosynthesized in the skin from 7-dehydrocholesterol or obtained through nutrition. It is modifiedin the liver and kidneys to form the active metabolite 1,25-dihydroxyvitamin D3 (calcitriol). Recent in vivo and in vitroevidence suggests that calcitriol exerts an effect on coagulationby binding to nuclear vitamin D receptors (VDR) present inblood and subendothelial tissues and exerting anticoagulanteffects by upregulating the expression of the anticoagulantglycoprotein, thrombomodulin (TM), and downregulating theexpression of a critical coagulation factor, tissue factor (TF) inmonocytic cells.

Conclusions: This study is the first to demonstrate an associa-tion between low vitamin D levels in persons with SCI in acuteinpatient rehabilitation and VTE.

Poster 2Improvement of Radiation-Induced Xerostomia withAcupuncture.Kris Homb, MD (Medical College of Wisconsin,Milwaukee, WI, United States); Hong Wu, MD.

Disclosures: K. Homb,NoDisclosures: I HaveNothing ToDisclose.Objective: To test the hypothesis that acupuncture decreases theseverity of dry mouth and pain in patients with radiation-inducedxerostomia.Design: Retrospective, case seriesSetting: Outpatient ambulatory clinicParticipants: 20 charts (1/2007 -10/2012) in patients witha history of head/neck cancer and status post radiation therapy whohave failed conservative treatments were reviewed.Interventions: Weekly 20-minute sessions of acupuncture (combi-nation of manual, auricular, and electro-acupuncture) were performed.Main Outcome Measures: A self-reported questionnaireasking about the improvement of dry mouth and pain wascompleted prior to each acupuncture session. The severity ofxerostomia and pain were rated with a 1-10 numerical scale, with10 being the worst.Results or Clinical Course: Significant improvement in drymouth and pain occurred during the initial 6 weeks of treatment,p<.05. During this time, the mean severity of dry mouth decreasedby 35%, p<.001. The mean severity of pain decreased by 42%,p<.001. After 6 weeks, the improvement in dry mouth and painsymptoms plateaued. This effect has been maintained with inter-mittent acupuncture treatment at the frequency of 2 weeks to 6months. Linear mixed model analysis with random subject effectwas used to investigate the rate of improvement during and afterthe first six weeks.Conclusions: Combination acupuncture significantlydecreases the severity of dry mouth/pain in patients withradiation-induced xerostomia. During the initial 6 weeksof treatment, dry mouth and pain symptoms improved35% and 42%, respectively. After 6 weeks, symptommean severity plateaued and remained stable, whichrequired less frequent acupuncture visits. In additionsome patients reported improvements in swallow, taste,and speech.

Poster 3Acupuncture in Trauma Unit for Wound Care andPain Control: A Case Report.Vishal Kamani, MD (Rush University Medical Center,Chicago, IL, United States); Gerard L. Dysico, MD; AmitK. Patel.

Disclosures: V.Kamani,NoDisclosures: IHaveNothingToDisclose.Case Description: The patient had a stab wound to the lateralaspect of her left forearm following an altercation in associationwith excessive alcohol intake. The laceration was 12 centimeters inlength, and was sutured in the Trauma Front Room on the day ofinjury. 2 days later, the patient presented to the Trauma Unitreporting that hydrocodone was not controlling the pain and thather pain was a "20" out of 10. She was complaining of pain with