Severe spasticity in lower extremities is associated with reduced adiposity and lower fasting plasma glucose level in persons with spinal cord injury.

STUDY DESIGN: Cross-sectional study. OBJECTIVES: To investigate the effects of severe lower extremity spasticity on anthropometric dimensions, body composition and metabolic profiles in persons with chronic motor complete spinal cord injury (SCI). SETTING: Outpatient clinic. METHODS: Fifty-five of the 61 participants were divided into two groups (no or mild spasticity group, 28; severe spasticity group, 27) based on the assessment of the extensor muscle spasticity according to the modified Ashworth scale. Anthropometric dimensions (waist circumference (WC), waist-to-height ratio (WtHR)), body composition (fat mass (FM), body fat percentage (BFP), fat-free mass (FFM), fat-free mass percentage (FFMP), bone mineral density (BMD)) and metabolic profiles (leptin, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c)) were compared between the two groups with different degree of spasticity. RESULTS: Spasticity of the extensor muscle group negatively correlated with BFP (r=-0.458, P<0.001). Patients with severe spasticity showed a lower WC and WtHR than those in the no or mild spasticity group (P=0.038, P=0.006, respectively). The FM, BFP, leptin and FPG of the severe spasticity group were significantly lower than those of the patients in the no or mild spasticity group (P=0.003, P<0.001, P<0.001 and P=0.037, respectively). However, no differences in BMD, total cholesterol, LDL, HDL, TG and HbA1c were observed between the groups. CONCLUSIONS: The results of this study suggest that severe spasticity in lower extremities is associated with reduced adiposity and lower FPG levels in persons with chronic motor complete SCI.

Effortful swallow enhances vertical hyolaryngeal movement and prolongs duration after maximal excursion.

Effortful swallowing (EFS) is a common compensatory swallowing manoeuver for dysphagia patients. We investigated the influence of EFS on temporal and spatial characteristics of the movements of the hyoid bone, larynx and epiglottis in healthy subjects. A total of 41 volunteers swallowed 10 mL of diluted barium solution using two swallowing strategies: usual and effortful swallowing (USS and EFS). The motions of the hyoid bone, larynx and epiglottis were tracked using frame-by-frame kinematic motion analysis of videofluoroscopic images. Maximal velocities and maximal displacements of hyoid and larynx, the maximal angle of the epiglottic tilt, and the durations of hyoid excursion, laryngeal elevation and epiglottic tilt were measured. Compared to USS, EFS was associated with significantly greater vertical displacement of the hyoid (P < 0.001), vertical and horizontal displacement of the larynx (P = 0.003, P = 0.019), and maximal angle of the epiglottic tilt (P = 0.001). In addition, the durations of the vertical and horizontal excursions of the hyoid, vertical excursion of the larynx and the epiglottic tilt were greater in EFS, compared with USS. Effortful swallowing was also associated with significantly greater maximum velocities of the hyoid and larynx during swallowing. In conclusion, the EFS manoeuver facilitates vertical speed and distance of hyolaryngeal excursion and epiglottic tilt and extends the duration of excursion and the epiglottic tilt, especially after reaching maximal excursion in healthy subjects. These results confirm the temporal and kinematic benefits of airway protection induced by the EFS manoeuver.

Regulation of adenosine receptor function by theophylline in rat aorta.

The effect of chronic theophylline treatment on adenosine receptor function was investigated in rat aorta. Male Wistar rats were fed theophylline (1 g/L) in drinking water for 30 days. The relaxation-response curves to various adenosine receptor agonists, nonselective 5'-N-ethylcarboxamidoadenosine (NECA), A2-selective 2-phenylaminoadenosine (CV-1808), and A1-selective N6-(2-endo-norbornyl) adenosine (S-ENBA) were generated in aortic rings from control and treated rats. The relaxation curves to both NECA and CV-1808 (10(-9)-10(-4) M) were significantly attenuated in treated rings (endothelium intact) as compared with control. S-ENBA showed a contraction at a lower concentration (10(-10)-10(-6) M) in treated rings as compared with control. Because S-ENBA is highly A1 selective, it produced relaxation only at 10(-4) M. Similar to that of adenosine analogues, the isoproterenol (ISO 10(-9)-10(-5) M) concentration-relaxation curve was shifted to the right in treated rats. Endothelium removal of the vascular rings decreased the magnitude of relaxation to these agonists and eliminated the difference in relaxation between control and treated groups. The relaxation to acetylcholine (ACh), an endothelium-dependent relaxing agent, was also attenuated in the theophylline-treated group. The relaxation responses to forskolin (10(-11)-10(-8) M) and sodium nitroprusside (SNP 10(-10)-10(-7) M) were unaltered in treated rats. These data suggest an endothelium-dependent downregulation of adenosine receptor function together with beta-adrenoceptor after chronic theophylline treatment.

Distinguishing characteristics of blood donor segments defined in terms of donation frequency.

Demographic, psychographic, and blood donation factors were hypothesized to account for differences among blood donor segments defined on the basis of frequency of donation. A stepwise multiple discriminant analysis shows 10 of the 29 initial predictor factors to be very useful for distinguishing among the donor categories. The gender of the donor, locus of control, risk taking, humanitarianism, and other factors differentiate donor categories. Results are considered in relation to prior research and theorizing, and the strategic implications for collection agency and hospital administration are given.