The Impact of Body Mass Index on Functional Rehabilitation Outcomes of Working-age Inpatients with Stroke

BACKGROUND: Stroke is the most relevant cause of acquired persistent disability in adulthood. The relationship between patient’s weight during rehabilitation and stroke functional outcome is controversial, previous research reported positive, negative and no effects, with scarce studies specifically addressing working-age patients.AIM: To evaluate the association between Body Mass Index (BMI) and the functional progress of adult (\u3c65 \u3eyears) patients with stroke admitted to a rehabilitation hospital.DESIGN: Retrospective observational cohort study.SETTING: Inpatient rehabilitation center.POPULATION: 178 stroke patients (ischemic or hemorrhagic).METHODS: Point-biserial and Spearman’s correlations, multivariate linear regressions and analysis of covariance were used to describe differences in functional outcomes after adjusting for age, sex, severity, dysphagia, depression and BMI category. Functional Independence Measure (FIM), FIM gain, efficiency and effectiveness were assessed.RESULTS: Participants were separated in 3 BMI categories: normal weight (47%), overweight (33%) and obese (20%). There were no significant differences between BMI categories in any functional outcome (total FIM (TFIM), cognitive (CFIM), motor (MFIM)) at discharge, admission, gain, efficiency or effectiveness. In regression models BMI (as continuous variable) was not significant predictor of TFIM at discharge after adjusting for age, sex, severity, dysphagia, depression and ataxia (R2=0.4813), significant predictors were TFIM at admission (β = 0.528) and NIHSS (β=-0.208). MFIM efficiency did not significantly differ by BMI subgroups, neither did CFIM efficiency. Length of stay (LOS) and TFIM effectiveness were associated for normal (r=0.33) and overweight (r=0.43), but not for obese. LOS and TFIM efficiency were strongly negatively associated only for obese (r=-0.50).CONCLUSIONS: FIM outcomes were not associated to BMI, nevertheless each BMI category when individually considered (normal weight, overweight or obese) was characterized by different associations involving FIM outcomes and clinical factors. CLINICAL REHABILITATION IMPACT: In sub-acute post-stroke working-age patients undergoing rehabilitation, BMI was not associated to FIM outcomes (no obesity paradox was reported in this sample). Distinctive significant associations emerged within each BMI category, (supporting their characterization) such as length of stay and TFIM effectiveness were associated for normal weight and overweight, but not for obese. Length of stay and TFIM efficiency were strongly negatively associated only for obese

Optimization of a decellularized protocol of porcine tracheas. Long-term effects of cryopreservation. A histological study

[EN] Objective: The aim of this study was to optimize a decellularization protocol in the trachea of Sus scrofa domestica (pig) as well as to study the effects of long-term cryopreservation on the extracellular matrix of decellularized tracheas. Methods: Porcine tracheas were decellularized using Triton X-100, SDC, and SDS alone or in combination. The effect of these detergents on the extracellular matrix characteristics of decellularized porcine tracheas was evaluated at the histological, biomechanical, and biocompatibility level. Morphometric approaches were used to estimate the effect of detergents on the collagen and elastic fibers content as well as on the removal of chondrocytes from decellularized organs. Moreover, the long-term structural, ultrastructural, and biomechanical effect of cryopreservation of decellularized tracheas were also estimated. Results: Two percent SDS was the most effective detergent tested concerning cell removal and preservation of the histological and biomechanical properties of the tracheal wall. However, long-term cryopreservation had no an appreciable effect on the structure, ultrastructure, and biomechanics of decellularized tracheal rings. Conclusion: The results presented here reinforce the use of SDS as a valuable decellularizing agent for porcine tracheas. Furthermore, a cryogenic preservation protocol is described, which has minimal impact on the histological and biomechanical properties of decellularized porcine tracheas.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by grants MAT2016-76039-C4-2-R (MST) and PID2019-106099RB-C42 (MM) from the Ministry of Economy and Competitiveness of the Spanish Government, by grant PI16-01315 from the ISCIII (Ministerio de Ciencia, Innovacion y Universidades, Spain), and by grant PROMETEO/2020/069 (CC) from the local government of the Comunitat Valenciana (Spain), CIBER-BBN and CIBERER are funded by the VI National R&D&I Plan 2008-2011, Iniciativa Ingenio 2010, Consolider Program, CIBER Actions, and the Instituto de Salud Carlos III, with assistance from the European Regional Development Fund.Milián, L.; Sancho-Tello, M.; Roig-Soriano, J.; Foschini, G.; Martínez-Hernández, NJ.; Más Estellés, J.; Ruiz-Sauri, A.... (2021). Optimization of a decellularized protocol of porcine tracheas. Long-term effects of cryopreservation. A histological study. The International Journal of Artificial Organs. 44(12):998-1012. https://doi.org/10.1177/03913988211008912S9981012441