A spinal cord injury (SCI) clearly results in greater cardiovascular risk, however, accompanying changes in peripheral vascular structure below the lesion, mean the real impact of a SCI on vascular function is unclear. Therefore, utilizing passive leg movement-induced (PLM) hyperemia, an index of nitric oxide (NO)-dependent vascular function, and the central hemodynamic response to this intervention, we studied 8 individuals with a SCI, and 8 age-matched controls (CTRL). Specifically, we assessed heart rate (HR), stroke volume (SV), cardiac output (CO), mean arterial pressure (MAP), leg blood flow (LBF), and thigh composition. In CTRL, passive movement, transiently decreased MAP, and increased HR and CO from baseline by 2.5±1 mmHg, 7±2 bpm, and 0.5±0.1 l/min respectively. In SCI, HR and CO responses were unidentifiable. LBF increased to a greater extent in CTRL (515±41 Δml/min) compared to SCI, (126±25 Δml/min) (p<0.05). There was a strong relationship between ΔLBF and thigh muscle volume (r = 0.95). After normalizing ΔLBF for this strong relationship (ΔLBF/muscle volume), there was evidence of preserved vascular function in SCI (CTRL: 120±9; SCI 104±11 ml/min/l). A comparison of ΔLBF in the passively moved and stationary leg, to partition the contribution of the blood flow response, implied that 35% of the hyperemia resulted from cardioacceleration in the CTRL, whereas all the hyperemia appeared peripheral in origin in the SCI. Thus, utilizing PLM-induced hyperemia as marker of vascular function, it is evident that peripheral vascular impairment is not an obligatory accompaniment to a SCI.

Intersection syndrome describes a rare inflammatory condition located at the crossing point between the first dorsal compartment muscles and the radial wrist extensor muscles. It is a repetitive motion injury that affects patients who overuse their wrists. The present report reviews the incidence of the condition as well as the special populations it affects. The anatomy of the wrist is presented and clinical findings and physical examination techniques are reviewed to help the reader reach a quick but correct diagnosis. Finally, the most appropriate treatment approach is presented, incorporating rehabilitative methods designed to ensure a full and prompt functional recovery and resumption of physical activity.

Bladder dysfunction in multiple sclerosis (MS) can be socially disabling, have negative psychological and economic consequences, and impair patients' quality of life. Knowledge of the functional anatomy and physiology of the urinary tract is essential to understand the symptoms associated with central nervous system lesions and the pharmacotherapies used to treat them. Treatments for neurogenic detrusor overactivity (NDO) have consisted mainly of administration of anticholinergic drugs, which have been shown to provide suboptimal clinical benefits and be poorly tolerated. The US Food and Drug Administration (FDA) approval of intravesicular botulinum toxin therapy provides a secondline option for MS patients with NDO not responsive to anticholinergic drugs. We performed a review of key literature pertaining to the intravesicular application of botulinum toxin. In the management of NDO, administration of intravesicular botulinum toxin using clean intermittent catheterization decreases the incidence of urinary tract infections, promotes urinary continence, and improves quality of life for 9 months after a single injection; moreover, those benefits are maintained with repeated injections over time. Int J MS Care. 2013;15:66-72.

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