Functional impairment severity is associated with health status among older persons with intellectual disability and cerebral palsy.

BACKGROUND: Studies have noted high rates of specific health disorders in adults with cerebral palsy (CP). However, it remains unclear how growing older with a lifelong neuromotor physical disability confers risk for health outcomes in adults who have both intellectual disability (ID) and CP. AIM: To assess the relationship between health status in older adults with ID either with or without coincident diagnoses of CP. METHOD: Health status data were drawn from 1373 adults aged 33 to 79 years with ID living in small group homes in New York State. Their health status was defined by the presence of common health disorders. Of these, 177 subjects had coincident CP. Prevalence data for nine diseases representing different organ systems were obtained and compared in individuals with and without CP. A Severity of Functional Impairment Index (SFII) was developed based on subjects' capabilities in activities of daily living (ADLs) and mobility. Two logistic regression analyses were conducted to determine if CP diagnosis was an independent predictor of health disorder prevalence, or rather exerted effects similar to those without CP via severity of functional impairment as determined by SFII scores. In addition, older age, gender, and severity of intellectual disability were examined as predictors of health disorder prevalence in all study subjects. RESULTS: Individuals with CP had higher frequencies in four out of the nine health disorders (overweight/obesity, gastroesophageal reflux, urinary tract infections and dysphagia). Analysis revealed a statistically significant association between SFII score and CP diagnosis. CP diagnosis alone was a statistically significant predictor for all of the above four common disorders; however, after adjustment for SFII score was included in health disorder models, only dysphagia showed an independent correlation with a CP diagnosis. CONCLUSION: With the exception of dysphagia, impairment in ADLs and walking capabilities, and not CP diagnosis alone, accounted for disparities in specific diseases. Although the diagnosis of CP may be correlated with functional impairment, it alone may play a minor role in determining health trajectories in older persons with conjoint ID and CP.

[Blood preservation. Bacteriological, immunohematological, hematological and hemorrheological studies]. / Almacenamiento de sangre. Estudios hemorreológicos, hematológicos, inmunohematológicos y bacteriológicos.

The knowledge of erythrocyte viability during blood bank storage period has been a major problem for transfusional practice. This problem must be considered by taking into account blood flowing properties which are directly related to the rheological properties of erythrocytes. The aim of this work was to perform an interdisciplinary study of the modifications induced in erythrocyte properties during 29 days storage of whole blood in a blood bank. Three samples of venous blood collected from healthy adults in plastic bags, anticoagulated with ACD (citric acid, citrate, dextrose) and stored at 4 degrees C were studied. Rheological properties (deformability, membrane elasticity and surface viscosity), immunohematological conditions (antigenicity) of erythrocytes, haematological index variation and bacteriological cultures of blood were weekly analysed. Rheological studies were performed using the Erythrodeformeter, a polymicroviscosimeter (paper filter) and erythrocyte filtration through polycarbonate membranes of 5 microns pore diameter. Impairment of membrane rheological properties, loss of antigenicity and decreases of Ht, Hb, MCHC and MHC were observed. Bacteriological cultures gave always negative results. The studies performed showed significant alterations of erythrocyte rheological parameters. It becomes evident that such modifications would influence the erythrocyte mechanical behavior in microcirculation and impair the in vivo viability of the transfused red cells.

Manual quantitative method for the study of red cell agglutination using light diffraction by suspended particles.

A new manual technique, called the diffractometric technique, for quantitation of hemagglutination is described in this paper. After the equilibrium has been attained in the reaction, the whole product is resuspended in a dense transparent medium in order to obtain a stable suspension. The relative optical extinction produced by this suspension depends on the number and sizes of the suspended particles and on the photodetector geometry. Hence the agglutination percentage of the reaction can be monitored by using a visible light transmittance photometer. The results of this technique compare very well with the ones obtained by applying two other methods, the Dybkjaer and the Ropars methods.

[Evaluation of the kinetics of hemagglutination using a simple photometric technic]. / Evaluación de la cinética de hemaglutinación por medio de una técnica fotométrica simple.

A photometric technique to evaluate haemagglutination kinetic is presented in this paper. The technique applies the relative optical extinction (EO) produced on a light beam transmitted through a suspension of small particles (red blood cells and their agglutinates). The optical extinction decreases as the red cell agglutinates grow, giving a parametric estimate of the haemagglutination rate. Hence, optical extinction can be used to distinguish erythrocyte subgroups characterized by the differences appearing in the number of antigenic sites per cell. The paper describes the technique and gives the results of a set of experiments carried out on 90 samples constituted by 30 samples of A1 adults, 30 samples of non-A1 A adults and 30 samples of A newborns (cord red blood cells). Results show significative differences between subgroups. Parametric values such as the total relative optical extinction reduction (difference between the initial and the final values of EO) and the initial optical extinction rate are analyzed. Results from A newborn red cells show similar behaviour as the non-A1 A adult red cells and significative differences from A1 adult red cells. A correlation between parametric values and the number of antigenic sites per cell, as found in the literature, becomes evident.