Correlation between alpha rhythms and natural killer cell activity during yogic respiratory exercise

In eight yoga instructors, we examined changes in brain rhythms and natural killer cell activity (NK activity) during yoga exercises. We found that the practice of all three exercises studied resulted in increased alpha activity. There were no apparent changes in NK activity after a series of postural (asana) and meditative (mantra) exercises. During respiratory exercises (pranayama), however, changes in NK activity were observed in the eight subjects, positively correlating to increases in alpha frequencies (r = 0.83, p < 0.02). Copyright © 2001 John Wiley & Sons, Ltd.     

Blood flow response in individuals with incomplete spinal cord injuries

STUDY DESIGN: Cross sectional comparison, control group. OBJECTIVE: To determine if incomplete spinal cord injured patients (SCI) have an abnormal blood flow response to cuff ischemia compared to able-bodied individuals (AB). SETTING: Academic institution. METHODS: Blood flow in five chronic incomplete SCI patients (C4-C5) and 17 able bodied individuals was measured in the common femoral artery using quantitative Doppler ultrasound (GE LogiQ 400CL) at rest and after distal thigh cuff occlusion of 2, 4 and 10 min to investigate whether blood flow or vascular control were different in SCI's and AB. RESULTS: Blood flow and the diameter of the common femoral artery at rest were similar in incomplete SCI and AB. Peak flow after 10 min of cuff ischemia (the highest found) was also comparable between incomplete SCI and AB. The half-time for recovery of blood flow to baseline after 2, 4 or 10 min of ischemia was 50% longer for incomplete SCI compared to the AB (P = 0.023). In addition, peak blood flow after 2 and 4 min of ischemia relative to the maximum, 10 min value (2/10 and 4/10 ratios) was lower in incomplete SCI compared to AB (0.65 +/- 0.06 vs 0.76 +/- 0.15, P = 0.029 and 0.75 +/- 0.10 vs 0.89 +/- 0.11, P = 0.014, respectively). CONCLUSION: This study demonstrated that incomplete spinal cord injured patients have impaired vascular control seen as a slower return to resting flow after cuff ischemia and reduced sensitivity to ischemia relative to maximum flow. However, incomplete SCI patients did not demonstrate impaired flow capacity as seen in complete SCI patients suggesting that smaller cardiovascular abnormalities are seen with incomplete versus complete SCI injury. Impaired vascular control may serve to limit exercise capacity and may contribute to increased cardiovascular disease. Impaired circulation could contribute to impaired muscle function and poor cardiovascular health in incomplete SCI's, although these findings need to be replicated in a study with more subjects.     

急性颈脊髓损伤患者的呼吸管理研究现状

正随着工业化进程的加快,交通事故、高处坠落等意外伤的发生率逐年攀升,创伤性脊髓损伤逐渐成为现代社会中一类常见的疾病,其中颈脊髓损伤(cervical spinal cord injury,CSCI)的发病率和死亡率最高。据文献~([1、2])报道,呼吸功能障碍是急性期CSCI死亡的最主要原因,也是造成患者住院时间延长、花费增加的重要因素。急性期患者中约     

Stability of transition to adulthood among individuals with pediatric-onset spinal cord injuries

BACKGROUND/OBJECTIVE: Cross-sectional studies have provided information about the outcomes of adults with pediatric-onset spinal cord injuries (SCIs), but there has been no information about the stability of those outcomes over time. The purpose of this study was to assess the stability of independent living, employment, and life satisfaction and to determine factors associated with stable, successful outcomes. METHODS: Structured interviews of individuals who had sustained an SCI at age 18 years or younger and were 24 years or older at first interview. The primary standardized measures used include the Functional Independence Measure, Craig Handicap Assessment and Recording Technique (CHART), Short-Form 12 measure of perceived health, and the Satisfaction with Life Scale. RESULTS: One hundred sixty-six individuals had 3 consecutive annual interviews. Mean age at interview was 29 years (range, 24-36 years). Of this group, 64% lived independently at the first interview, and 90% of those continued to live independently; 64% were employed at first interview, of which 83% continued to be employed; and 48% reported life satisfaction at the first interview, and 84% of these continued to be satisfied. Factors most closely associated with stable independent living were CHART subscales of physical independence, mobility, and occupation. Factors associated with stable employment were sex, race, independent living, CHART mobility, and cognitive independence. Factors associated with stable life satisfaction were CHART occupation subscale and fewer pressure ulcers. CONCLUSIONS: Many individuals with pediatric-onset SCI achieve successful, stable adult outcomes. The factors associated with that success can help us improve rehabilitation for future patients.     

Online support for individuals with spinal cord injuries: An ethnographic investigation

Abstract

Background

Although social support is an important protective factor for individuals with spinal cord injuries (SCIs), individuals often encounter significant barriers to obtaining support after experiencing a SCI. It has been suggested that the Internet may serve to help individuals with disabilities overcome common barriers in obtaining support, yet research examining the efficacy of Internet-based support for individuals with SCI has been mixed.

Objective

To develop a more nuanced understanding of how individuals with SCI can or might use the Internet for support.

Design

Using an ethnographic approach, we conducted semi-structured interviews with nine individuals with SCI to explore perceived needs and barriers to information-seeking and online support.

Setting

Participants were recruited from Veterans Administration medical center outpatient and inpatient units providing specialty care to individuals with SCIs and from a community SCI Center of Excellence.

Results

Individuals with SCI gain emotional, problem-focused, and reciprocal support from online sources.

Conclusions

Online resources can provide important opportunities for social support for individuals with SCI.     

Online support for individuals with spinal cord injuries: An ethnographic investigation

Background

Although social support is an important protective factor for individuals with spinal cord injuries (SCIs), individuals often encounter significant barriers to obtaining support after experiencing a SCI. It has been suggested that the Internet may serve to help individuals with disabilities overcome common barriers in obtaining support, yet research examining the efficacy of Internet-based support for individuals with SCI has been mixed.

Objective

To develop a more nuanced understanding of how individuals with SCI can or might use the Internet for support.

Design

Using an ethnographic approach, we conducted semi-structured interviews with nine individuals with SCI to explore perceived needs and barriers to information-seeking and online support.

Setting

Participants were recruited from Veterans Administration medical center outpatient and inpatient units providing specialty care to individuals with SCIs and from a community SCI Center of Excellence.

Results

Individuals with SCI gain emotional, problem-focused, and reciprocal support from online sources.

Conclusions

Online resources can provide important opportunities for social support for individuals with SCI.     

Urinary N-acetyl-beta-D-glucosaminidase activity in acute pyelonephritis patients with spinal cord injuries

The urinary N-acetyl-beta-D-glucosaminidase (NAG) activities were determined in acute pyelonephritis patients with spinal cord injuries. The urinary NAG activity was significantly elevated in 23 of 31 cases (74%) compared with normal controls. Out of 7 acute pyelonephritis patients without spinal cord injuries, 4 patients (57%) showed significantly elevated urinary NAG activities. The urinary NAG activities were within normal range in 20 patients with acute simple cystitis and 11 patients with chronic complicated cystitis. Out of 6 patients with urethritis, only one case (17%) showed a significantly higher level of urinary NAG activity. Significantly higher levels in urinary NAG activities were observed in 6 of 9 patients (67%) with acute prostatitis and 5 of 9 patients (56%) with acute epididymitis. In patients with spinal cord injuries, having frequent urinary tract infections and complicated pathophysiological conditions, urinary NAG is one of the helpful laboratory findings for the diagnosis of acute pyelonephritis.     

Impact of annual urodynamic evaluations on guiding bladder management in individuals with spinal cord injuries

Study design

A single-center institutional review board-approved prospective cross-sectional observational study.

Context

Urodynamic studies are essential to accurately direct bladder management following spinal cord injury (SCI). There is no consensus on how often testing should be performed.

Objective

To determine the impact of annual urodynamic studies on guiding bladder management following SCI.

Methods

Individuals with traumatic SCI undergoing annual urological evaluations were enrolled in this study. They had to be injured for at least 2 years so that urodynamic changes could be compared with their previous annual urodynamic evaluation. Changes in the urodynamic parameters and autonomic dysreflexia were determined by comparing this study with the previous year''s study. All studies were done with the same physician and nursing staff. Demographic data, bladder management, urodynamic parameters, and the need and type of interventions based on the urodynamic study were obtained. The main outcome measure was whether or not there was a need for an intervention based on the urodynamics. Interventions were classified as urological intervention, non-urological intervention, or a combination of urological and non-urological intervention. The impact of the type of bladder management, length of injury, and level of injury was also evaluated.

Results

Ninety-six consecutive individuals with SCI undergoing annual urodynamic evaluations were enrolled over a 5-month period. Overall, 47.9% of individuals required at least one type of intervention based on urodynamic studies: 82.6% were urological interventions (medication changes were most common, comprising 54.3% of urological interventions); 13.0% were non-urological interventions; and 4.3% were a combination of non-urological and urological interventions. The need for interventions did not appear to be influenced by the type of bladder management, the length of time post-injury or level of injury.

Conclusion

Annual urodynamic evaluation plays an important role in guiding bladder management following SCI.     

Pharyngeal carcinoma and natural killer cell activity

An evaluation of natural killer cell activity was performed in 42 patients with pharyngeal carcinoma. Compared with age- and sex-matched control subjects, the cancer patients expressed significantly lower cytotoxicity against K562 target cells (68 +/- 8 lytic units versus 99 +/- 8 lytic units, p less than 0.01), with 52 percent of the patients expressing deficient activity (below 1 standard deviation of the mean activity of the control population). The probability of deficient activity was greater in these patients than observed in patients with cancer of other head and neck sites. Although natural killer cell activity was lower in patients who drank alcohol or had nodal metastases, no single clinical factor was predictive of deficient cytotoxic response. Prospective longitudinal evaluation (mean = 12 months) of these pharyngeal cancer patients demonstrated that deficient natural killer cell activity measured before treatment identified a population with a significantly increased risk for the development of distant metastases. Distant metastases developed in 7 of 18 patients (39 percent) with deficient natural killer cell activity. In contrast, none of the 16 patients with normal natural killer cell function had evidence of distant disease at last follow-up (p less than 0.01). Deficient natural killer cell activity exists in patients with pharyngeal cancer and is an independent marker for the subsequent development of distant metastases.     

Potential impact of orthotic gait exercise on natural killer cell activities in thoracic level of spinal cord-injured patients

STUDY DESIGN: Prospective before-after trial. OBJECTIVE: To examine the changes of natural killer (NK) cell activity in response to orthotic gait exercise in thoracic level of spinal cord-injured (SCI) patients. SETTING: National Rehabilitation Center for Persons with Disabilities, Japan. METHODS: In all, 10 thoracic level of SCI patients (ranging Th5-Th12), who experienced orthotic gait training, participated in this study. NK cell activity at an effector:target (E/T) ratio (20:1) was examined in a sample of peripheral blood taken before and just after orthotic gait exercise for 20 min. On a separate day, to evaluate the physical intensity of the orthotic gait exercise, cardiorespiratory responses at rest and during exercise were measured. RESULTS: The resting value of the NK cell activity in our SCI patients was remarkably lower than that in normal subjects reported in previous studies. The NK cell activity was significantly increased through a 20 min orthotic gait exercise (pre versus post; 12.7+/-5.28 versus 17.76+/-6.71, P<0.05). The steady-state value of oxygen (VO2) and heart rate (HR) were 18.13+/-3.92 ml/kg and 142.53+/-19.84 b/min, respectively. It was noteworthy that a patient who showed decrement of NK cell activity in response to exercise had the highest level of injury (Th5), and showed the higher energy cost of orthotic gait. CONCLUSION: These findings suggested that the orthotic gait exercise has the potential to enhance the immune function for SCI persons, although patients with a higher level of SCI may have some difficulties. SPONSORSHIP: Mitsui Sumitomo Insurance Welfare Foundation     

慢性脊髓损伤患者与闲暇时间身体活动

身体活动对于脊髓损伤患者的身体健康非常有益。闲暇时间身体活动是指脊髓损伤患者选择进行的身体活动,被推荐为健康干预措施。脊髓损伤患者进行身体活动需要克服多重障碍,在遵循身体活动指南的基础上,医疗相关人员应制定适合脊髓损伤患者个体的活动计划。     

Reasons for delayed spinal cord decompression in individuals with traumatic spinal cord injuries in Iran: A qualitative study from the perspective of neurosurgeons

PurposeThe median time from the event leading to the spinal cord injury (SCI) to the time of decompressive surgery is estimated to be 6.9 days in Iran, which is much longer than the proposed ideal time (less than 24 h) in published guidelines. The current qualitative study aimed to determine the reasons for the observed decompression surgery delay in Iran from the perspective of neurosurgeons.MethodsThis qualitative study is designed to perform content analysis on the gathered data from face-to-face semi-structured interviews with 12 Iranian neurosurgeons.ResultsThe findings of the current study suggest that patient-related factors constitute more than half of the codes extracted from the interviews. Overall, the type of injury, presence of polytrauma, and surgeons' wrong attitude are the main factors causing delayed spinal cord decompression in Iranian patients from the perspective of neurosurgeons. Other notable factors include delay in transferring patients to the trauma center, delay in availability of necessary equipment, and scarce medical personnel.ConclusionIn the perspective of neurosurgeons, the type of injury, presence of polytrauma, and surgeons' wrong attitude are the leading reasons for delayed decompressive surgery of individuals with SCI in Iran.