Use of glucocorticoids in acute spinal cord injuries: a last decade analysis
Bibliographic record
Abstract
Introduction: The early use of methylprednisolone (MP) pulse represents the only treatment suggested to stop neurological outcomes in non-operable acute spinal cord injuries (ASCI). The protocol of the drug use dates from the 1990s and results of the NASCIS 2 randomized clinical trial. However, such conduct is still an issue for discussion, due to limited evidence. Objective: To compare the results of the main studies about the use of MP in the ASCI published in the last decade. Methods: This is a narrative review of the use of MP in the ASCI. A search was carried out using the keywords “acute spinal cord injury” and “methylprednisolone” on PubMed and Cochrane, in April 2021. Indexed meta- analysis from 2011 to 2020 were used as filters. All studies (3) were selected for analysis and comparison of their results. Results: Cochrane meta-analysis, in 2012 concluded that MP administration results in an improvement of the neurological outcome and presents good safety margin. Although it agrees with the drug harmless, a Canadian study in 2017 pointed out the MP offers a poor motor function benefit in the long term. Recently, in 2019, a meta-analysis from the American Academy of Neurology, did not recommend the use of MP in the ASCI, because of the lack of benefit in neurological function and increased occurrence of complications after the adoption of the therapy. Conclusion: Data from the last ten years of analysis demonstrates a progressive decrease in the evidence in favor of the use of MP in the ASCI.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.024 |
| Bibliometrics | 0.007 | 0.012 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".