BackgroundIschemic stroke remains one of the leading causes of mortality and disability in the population. Middle cerebral artery occlusion (MCAO) followed by reperfusion is widely accepted to mimic stroke in basic medical research. Trehalose is a non-reducing disaccharide compound found naturally in most organisms such as bacteria, yeasts, invertebrates and even in plants except for vertebrates. Its protective role has been shown in various neurological disorders. In the current study, the MCAO model was used to investigate the therapeutic efficacy of trehalose. MethodsIn this experimental study, 32 Male Wistar rats were subjected to MCAO following 24 h of reperfusion. Wistar rats were randomly divided into four groups: Sham-operated control group (Sham), middle cerebral artery occlusion (MCAO) group, trehalose (50 and 100 mg/kg) treatment + MCAO groups. Trehalose was intraperitoneally injected 3- and 6 h post-ischemia. After 24 h of reperfusion and evaluation of the intensity of neurological dysfunction via a modified Rogers scale, the brains were removed and the volume of ischemia was stained using 2,3,5-triphenyl tetrazolium chloride. ResultsCompared with the control group, trehalose administration with dosages of 50 and 100 mg/kg significantly decreased the modified Rogers score (p<0.01 and p<0.001, respectively) and reduced the volume of ischemia (p<0.05 and p<0.001, respectively). ConclusionTrehalose in the MCAO model has a protective effect. The findings of the current study suggest that trehalose can be a potential therapeutic option in ischemic strokes; however, this study was preliminary and further studies are needed.

BackgroundIn young healthy volunteers a cervical hard collar has been shown to change swallowing physiology. The risk of aspiration pneumonia increases with age. MethodsIn this open prospective dual-arm controlled trial without randomisation there were 23 patients divided into two cohorts: 11 older (mean age 84) and 12 younger (mean age 25).A series of video fluoroscopy (VF) swallow studies were performed without a cervical collar, followed by the same series of VF with a Miami-J® cervical collar fitted. The Modified Barium Swallow Impairment Profile (MBSImPTM©) and Penetration-Aspiration Scale (PAS) were used to define and score swallow function and level of aspiration without and with the collar fitted. ResultsAn increase in the median MBSImPTM© score amongst all participants in the oral phase of swallow (p = 0.01) and combined oral and pharyngeal phase of swallow (p = 0.006) was seen when volunteers were fitted with the Miami-J® collar, compared to no collar.When wearing the collar deterioration in swallow function and small increases in PAS level were more marked in the older cohort, but these latter findings were not statistically significant. ConclusionsCervical hard collars change swallowing physiology in younger and older volunteers. Whilst we did not measure a statistically significant difference in the PAS level pre- and post- collar wearing, we feel it is important to highlight these changes in swallowing physiology and speculate that with collar use there is a potential risk of aspiration associated with these changes.Potential risk of aspiration should be carefully balanced with the benefit gained from collar use in the management of cervical spine injury (both in conservative and postoperative management). Although this is a small study it is important to highlight an area of concern of particular importance in the older population who have physiological changes to the swallow that occur with age (presbyphagia) and where baseline risk of aspiration is higher.