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PubMed1982

Significance of the automaticity recovery phase following tachycardic overdrive.

The usefulness of automaticity recover time (ART) and automaticity recovery phase (ARP; the time requiring P-P cycles to return to the original P-P cycles following the termination of tachyarrhythmias) for evaluating the sinus node function was studied in 24 patients with tachyarrhythmias by recordings of 24-hour continuous electrocardiograms. Automaticity recovery time was not so valuable in evaluating sinus node function because the overlap of ART was observed between patients of normal sinus node function and patients with sick sinus syndrome. The pattern of ARP was classified into 4 types (I--IV). Type I showed qUick return to the original P-P after overdrive suppression, type II was characterized by first suppression and secondary acceleration, type III was the pattern characterized by repeated suppression after tachycardiac overdrive, and type IV was characterized by repetitive appearance of tachyarrhythmia and bradycardia. The period of each ARP was measured and the period of type II (42.2 +/- 16.6 sec) or III ARP (48.4 +/- 21.4 sec) was significantly longer than type I (22.1 +/- 11.1 sec). Type III ARP was considered to suggest sinus node dysfunction. In conclusion, it was suggested that not only the observation of ART but also ARP were valuable for evaluating more precise sinus node function. The observation of ARP is easily obtained from 24-hour continuous recordings of electrocardiograms.

Adolescent↗
PubMed1982

Postischemic renal failure. Intrarenal blood flow and functional characteristics in the recovery phase.

Intrarenal blood flow, nephron function and whole kidney function were studied in the recovery phase of acute failure induced by 45 min of warm ischemia. Analyses were made 24 h, 7 days and 28 days after the ischemic insult. At 24 h the total renal blood flow was 4.0 ml . min-1 . g-1, decreasing to 1.2 within one week. After four weeks it was normalized to 3.4 ml . min-1 . g-1. The intrarenal blood flow distribution, studied with the 86-Rb extraction method, showed the same pattern of response, with no signs of a persistent heavy reduction in the deeper parts, as was found 10 min after recirculation (Karlberg et al. 1982 a). The contralateral, nonischemic kidney responded with hyperemia in all areas 24 h after the trauma, but after 7 days the values were normal. The function of the superficial nephrons was studied with the micropuncture technique. In the initial phase mainly obstructed nephrons were found, but after four weeks the nephrons were essentially normal. After 24 h the postischemic kidneys were anuric but at 7 days urine production had started and the GFR was 0.1 ml . min-1; this improved to 0.55 ml . min-1 after 4 weeks.

Acute Kidney Injury↗
PubMed1991

Persistent normal anion gap acidosis in the recovery phase of diabetic ketoacidosis.

Diabetic ketoacidosis is associated with an increased anion gap but its recovery phase may be complicated by hyperchloraemic acidosis with a normal anion gap. We report a case where this complication developed. There was a delayed return to normal acid-balance, possibly aggravated by administration of hyperchloraemic fluids, and the true diagnosis was overlooked. Measurement of the anion gap remains an important part of the assessment of diabetic acid-base disturbances.

Acid-Base Equilibrium↗
PubMed1992

Comparison of haematological recovery times and supportive care requirements of autologous recovery phase peripheral blood stem cell transplants, autologous bone marrow transplants and allogeneic bone marrow transplants.

The haematological recovery time, infection rate and supportive care requirements of patients receiving recovery phase autologous peripheral blood stem cell transplants (APBSCT) (n = 38), autologous bone marrow transplants (autoBMT) (n = 13) and allogeneic bone marrow transplants (alloBMT) (n = 14) were compared with respect to the time post-transplant to reach 0.1, 0.5 and 2.0 x 10(9) neutrophils/l and 50 and 150 x 10(9) platelets/l, the length of hospitalization, fever and antibiotic use, the incidence of documented infection and the number of red cell and platelet transfusions. The APBSCT group had a significantly more rapid recovery of neutrophils and platelets and their supportive care requirements were significantly less than the autoBMT and the alloBMT groups. There was no difference between the latter two groups. The most significant variables contributing to the differences in haematological recovery times were the granulocyte-macrophage progenitor (CFU-GM) dose infused and, to a lesser extent, patient age. The APBSCT group received a higher CFU-GM dose of 87 +/- 12 x 10(4)/kg BW compared with 12 +/- 5 and 17 +/- 3 x 10(4)/kg BW in the autoBMT and the alloBMT groups, respectively (p = 0.0001). Patient age showed a negative correlation with the rate of recovery because the APBSCT group, which recovered faster was also older (48 +/- 2 years, compared with 33 +/- 3 and 31 +/- 2, respectively, p = 0.0001). On multivariate analysis, CFU-GM dose was the only variable to show a significant correlation with all the haematological recovery endpoints studied in these 65 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1978

Hyperchloremic acidosis during the recovery phase of diabetic ketosis.

We have studied 35 patients to find the occurrence of hyperchloremic acidosis during the recovery phase of diabetic ketoacidosis. At admission the patients had typical normochloremic acidosis, with increased anion gap exactly balancing decreased serum bicarbonate. In contrast, in 18 patients with phenformin-induced lactic acidosis, the increase in anion gap at admission was much greater than the decrease in bicarbonate. The difference between lactic acidosis and ketoacidosis may be explained by a slower rate of excretion of lactate than of ketone anions. After the patients with ketoacidosis were treated, the acidosis became predominantly hyperchloremic with normal anion gap. Failure to normalize serum bicarbonate is attributed to excretion of ketone anions in the urine.

Adolescent↗
PubMed2005

Atmospheric wavefront phase recovery by use of specialized hardware: graphical processing units and field-programmable gate arrays.

To achieve the wavefront phase-recovery stage of an adaptive-optics loop computed in real time for 32 x 32 or a greater number of subpupils in a Shack-Hartmann sensor, we present here, for what is to our knowledge the first time, preliminary results that we obtained by using innovative techniques: graphical processing units (GPUs) and field-programmable gate arrays (FPGAs). We describe the stream-computing paradigm of the GPU and adapt a zonal algorithm to take advantage of the parallel computational power of the GPU. We also present preliminary results we obtained by use of FPGAs on the same algorithm. GPUs have proved to be a promising technique, but FPGAs are already a feasible solution to adaptive-optics real-time requirements, even for a large number of subpupils.

Journal Article↗
PubMed1998

[Total intravenous anesthesia with propofol is advantageous than thiopental-sevoflurane anesthesia in the recovery phase].

A randomized, prospective and multi-institutional study was performed to investigate whether different anesthetic methods affected differently the quality of recovery from anesthesia. Two hundred and eleven patients were allocated to one of two groups; total intravenous anesthesia (TIVA) with propofol and fentanyl (group P, n = 107) and general anesthesia with thiopental, sevoflurane and nitrous oxide (group TS, n = 104). The rapidity of emergence from anesthesia and postoperative incidence of nausea, vomiting, and headache were compared between the two groups. The group P showed significantly shorter emergence times for verbal command responses (7.4 +/- 5.6 min), extubation (10.0 +/- 6.0 min) and orientation (13.1 +/- 7.8 min) than the group TS (9.1 +/- 5.0 min, 11.7 +/- 6.2 min, 16.4 +/- 7.9 min, respectively). The postoperative incidence of vomiting was not significantly different between the two groups (3.7% in the group P and 9.6% in the group TS), but the postoperative incidences of nausea and headache were significantly lower in the group P compared with the group TS (10.3%, 17.8%, respectively in the group P and 34.6%, 29.8%, respectively in the group TS). We conclude that TIVA with propofol is advantageous than thiopental-sevoflurane anesthesia in the recovery phase.

Adult↗
PubMed1987

Study of the pharmacokinetics and pharmacodynamic activity of almitrine bismesylate in infants during the recovery phase following bronchopulmonary dysplasia.

The efficacy and pharmacokinetics of almitrine bismesylate were studied in 6 infants (age 2.5-9.5/months) during the recovery phase following bronchopulmonary dysplasia. The infants did not require assisted ventilation, but needed oxygen therapy with an FiO2 of 25-30% in stable condition. One to three hours after a single oral dose of almitrine (1.5 mg/kg), there was a marked increase in transcutaneous PO2 (TcPO2) (mean 2kPa) followed by a regular decrease to the baseline level. Nine to fourteen days after repeated administration of almitrine (1.5 mg/kg/12 h) in 4 children, the mean gain in TcPO2 was only 0.85 kPa. There was a very early flagging in efficacy of almitrine, since none of the children could be weaned from oxygen therapy. The absorption peak occurred 1-3 h after the administration of the compound. The maximum almitrine concentration was 173 +/- 44 ng/ml; plasma clearance was 21.9 +/- 6.6 ml/min and the volume of distribution was 18.7 +/- 2.1 liters/kg. The drug was eliminated biphasically. In the 4 studies with repeated drug administration, the pharmacokinetic results suggested that a steady state was still not achieved after 9-14 days of treatment. These results and the absence of any sustained effect of repeated doses of the drug raise the problem of a particular type of almitrine metabolization in the infant.

Administration, Oral↗
PubMedDate not supplied

[Exercise test: abnormal ST segments restricted to recovery phase].

PURPOSE: To determine the incidence of atherosclerotic coronary artery disease (CAD) and or myocardial ischemia in patients (pt) with abnormal ST segments restrict to recovery phase (RRAST) of exercise testing (ET). MATERIAL AND METHOD: Retrospective study in 19 non consecutive pt with RRAST, related to coronary arteriography or exercise planar scyntillography (18 men, 58 +/- 9 years, 18 asymptomatic). RESULTS: RRAST corresponded to ST segment depression from 1 to 4 mm, with T inversion during early recovery (2 pt); late (14 pt) or both (4 pt). It was documented CAD (14 pt and 9) with artery-by-pass surgery); hypertensive myocardiopathy with normal coronary (3 pt), and mitral prolapse valve (1 pt). In 13 pt with coronary arteriography or exercise scyntillography, within the first 6 months from exercise testing, myocardial ischemia was confirmed in 8 pt in 3 pt, successive exercise testing showed RRAST reproductive in 2 cases. CONCLUSION: The authors report the high incidence of CAD and or transitory hypoperfusion during myocardial scyntillography in symptomatic men with middle age with RRAST during exercise testing.

Adult↗
PubMed1995

Patterns of recovery phase infection after autologous blood progenitor cell transplantation in patients with malignancies. The Gruppo Italiano di Studio per la Manipolazione Cellulare in Ematologia.

Recovery phase infection patterns in 55 patients who had undergone autologous blood progenitor cell transplantation (ABPCT) were evaluated retrospectively. The results were compared to those obtained in a group of 41 patients who received autologous bone marrow transplantation (ABMT). Fever related to documented or suspected infection developed in 38 of 55 patients in the ABPCT group and in 37 of 41 in the ABMT group (p < 0.05). The percentages of patients with positive blood cultures did not differ significantly (ABPCT, 8/55 vs. ABMT, 8/41, p > 0.05). However, fewer acquired systemic fungal infections (1/55 vs. 5/41, p < 0.05) as well as fewer days of antibiotic usage were observed in the ABPCT group.

Adolescent↗
PubMed1999

ST/HR hysteresis: exercise and recovery phase ST depression/heart rate analysis of the exercise ECG.

ST segment depression/heart rate (ST/HR) hysteresis is a recently introduced novel computer method for integrating the exercise and recovery phase ST/HR analysis for improved detection of coronary artery disease (CAD). It is a continuous diagnostic variable that extracts the prevailing direction and average magnitude of the hysteresis in ST depression against HR during the first 3 consecutive minutes of postexercise recovery. This article reviews the development and evaluation of this new method in a clinical population of 347 patients referred for a routine bicycle exercise electrocardiographic (ECG) test at Tampere University Hospital, Finland. Of these patients, 127 had angiographically proven CAD, whereas 13 had no CAD according to angiography, 18 had no perfusion defect according to Tc-99m-sestamibi myocardial imaging and single photon emission computed tomography, and 189 were clinically normal with respect to cardiac diseases. For each patient, the values for ST/HR hysteresis, ST/HR index, end-exercise ST depression, and recovery ST depression were determined for each lead of the Mason-Likar modification of the standard 12-lead exercise ECG and maximum value from the lead system (aVL, aVR, and V1 excluded). The area under the receiver operating characteristics curve (ie, the discriminative capacity) of the ST/HR hysteresis was 89%, which was significantly larger than that of the end-exercise ST depression (76%, P < .0001), recovery ST depression (84%, P = .0063) or ST/HR index (83%, P = .0023), indicating the best diagnostic performance of the ST/HR hysteresis in detection of CAD regardless of the partition value selection. Furthermore, the superior diagnostic performance of the method was relatively insensitive to the ST segment measurement point or to the ECG lead selection. These results suggest that the ST/HR hysteresis improves the clinical utility of the exercise ECG test in detection of CAD.

Adult↗
PubMed1992

[The electrocardiographic anomalies and 2D-echocardiographic findings during the recovery phase of the stress test in the postinfarct patient].

BACKGROUND: The appearance or the increase of repolarization abnormalities in the EKG during post exercise (ET) recovery phase (R) is considered a marker of ischemia. METHODS: In order to evaluate the real meaning of these changes we compared the EKG data with eventual modifications of left ventricular kinesis analyzed by 2D-ECHO. 10 male patients with previous myocardial infarction, mean age 50 +/- 4.8 y, underwent exercise testing on a treadmill (Bruce's protocol) and continuous 2D-ECHO observation from the end of exercise along the whole R. Patients were divided in two groups: Group A (6 patients) and Group B (4 patients), all free of symptoms. RESULTS: Group A showed ischemic EKG markers during exercise which increased during R; Group B showed ischemic EKG markers only during R. The 2D-ECHO showed in Group A an impairment of left ventricular kinesis at peak exercise without increase or extension during R (WMSI at rest 1.32; peak ET 1.60; R 1.60); in Group B the kinetic alterations appeared only in R (WMSI at rest 1.33, peak ET 1.42; R 1.80), strictly related to EKG markers. CONCLUSIONS: The data suggest : 1) that the increase of EKG abnormalities already present during exercise do not seem to imply more severe ischemia; 2) that EKG changes appearing during R are markers of ischemia which occur in the R.

Echocardiography↗
PubMedDate not supplied

Increased protein intake during the recovery phase after severe burns increases body weight gain and muscle function.

We determined the effect of protein intake on weight gain and muscle function in the recovery phase after severe burns. Fifteen patients with deep burns between 30% to 50% of total body surface were studied over a 3 week period-after resolution of the hypermetabolic, catabolic state. All patients were studied in an acute rehabilitation hospital affiliated with the burn center. Nutritional profiles; weight gain; and muscle strength, measured by a physical therapy index (0 to 10)--10 being the greatest progress-were measured. All patients were provided a high-calorie, high-protein diet. Group 1 patients (n=8) also were provided a standard nutrient supplement to maintain caloric intake at 30 to 35 kcal/kg/day and to maintain protein intake at 1.3 to 1.5 g/kg/day. Group 2 patients (n=7) were provided a high-calorie, high-protein diet plus a protein hydrolysate (70 g/day) that provided a protein intake of 1.7 to 2 g/kg/day. Group 1 patients averaged a 1 to 1.5 pound weight gain per week or four pounds during three weeks. Their physical therapy index at three weeks of 4+/-0.5 indicated adequate improvement in strength and endurance. Group 2 patients averaged 2.5 to 3 pounds weight gain per week or 8.5 pounds during three weeks. Their physical therapy index of 7+/-0.7 indicated marked gains in muscle strength. Both measurements were significantly higher than those of Group 1. We conclude that increased protein intake by means of adding a protein hydrolysate increases the rate of restoration of body weight and muscle function.

Adult↗
PubMedDate not supplied

Acetylcholinesterase activity and its fast axonal transport in rabbit sciatic nerves during the recovery phase of experimental allergic neuritis.

Acetylcholinesterase (AChE) activity and its fast axonal transport were studied in rabbit sciatic nerves with a double ligature system during the recovery phase of experimental allergic neuritis (EAN), 6-9 days after the maximal symptoms, in order to obtain biochemical evidence of possible axonal damage in this primary demyelinating disease. The stationary AChE activity was significantly decreased, but the amount of the fast transported enzyme activity remained at the level of the controls. The velocity of the orthograde transport of AChE was slowed by about 15%, but this decrease was not statistically significant. Our results lend further support for the suggested neuronal damage in EAN, which can provide an explanation to the finding that the clinical symptoms in demyelinating diseases of the peripheral nervous system do not always correlate with the state of myelin.

Acetylcholinesterase↗
PubMedDate not supplied

Development of ventricular tachyarrhythmias in the conscious canine during the recovery phase of experimental ischemic injury: effect of bethanidine administration.

The antiarrhythmic and antifibrillatory actions of bethanidine were evaluated in two conscious canine models which are capable of developing ventricular tachyarrhythmias during the recovery phase of myocardial infarction. In the first model, nonsustained (n = 3) or sustained (n = 12) ventricular tachycardia (cycle length, 165 +/- 6 ms; mean +/- SD) was initiated by programmed electrical stimulation, 4-9 days after experimental myocardial infarction. Bethanidine was administered in cumulative doses of 2, 4, 8, and 16 mg/kg and programmed stimulation repeated. Bethanidine, in doses of 4, 8, and 16 mg/kg, slowed the cycle length of the tachycardia and allowed slower rates of ventricular pacing to produce equivalent delays at epicardial sites in the ischemic zone. Despite these changes, induction of sustained ventricular tachycardia was prevented in only two of 13 animals. Bethanidine (8 mg/kg i.v. every 8 h, n = 4; 16 mg/kg i.v. every 8 h, n = 5) failed to prevent the development of premature ventricular beats, ventricular tachycardia, and ventricular fibrillation which developed in response to a transient ischemic episode superimposed on the heart that had a previous acute myocardial infarction. No differences in survival at 24 h were observed between saline- (10%, n = 10) and bethanidine-treated (0%, n = 9) groups. These results suggest that bethanidine acts to increase the refractory period and depresses conduction velocity in ischemically injured tissue, slowing the rate of ventricular tachycardia. However, the drug fails to suppress the development of ventricular arrhythmias and ventricular fibrillation in both canine models.

Animals↗
PubMed2006

Elevated level of methylglyoxal during diabetic ketoacidosis and its recovery phase.

Carbonyl stress is hypothesized to be an associated complication of diabetic ketoacidosis. The production of the glycolytic intermediate methylglyoxal (MG) was followed up in 7 diabetic patients treated for ketoacidosis during pretreatment and recovery phase. Blood samples for methylglyoxal analysis were collected upon patient arrival in emergency department (0 h), and during ketoacidosis treatment between 12-24 h and at 168 h. The study also included 10 normoglycaemic healthy volunteers and 31 type 1 diabetic patients (control diabetes group). The methylglyoxal assay, based on methylglyoxal derivation with 1,2-diamino-4,5-dimethoxybenzene (DDB), was performed by HPLC, only assessing the level of free methylglyoxal. The baseline level of methylglyoxal recorded in normoglycemic healthy controls was 338 +/- 62 nmol/l versus 374 +/- 89 nmol/l in control diabetes group (P = 0.0407). A consistent feature of diabetic ketoacidosis before and during treatment was striking elevation of methylglyoxal as compared with control diabetes group (median test chi(2) = 14.6, df = 3, P = 0.0021). Friedman's ANOVA indicated differences (P = 0.04) among the three sampling times with a peak value (601 +/- 95 nmol/l) at 12-24 h following therapy initiation. However, fasting treatment values at 168 h were still significantly higher than the mean fasting methylglyoxal level in control diabetes group (P = 0.008). The study indicated that diabetic ketoacidosis results in an increase in methylglyoxal level. Excessive production of toxic intermediates such are alpha-dicarbonyls may be a link connecting an acute metabolic event with accelerated tissue damage, a feature characteristic of long-term complications of diabetes.

Bicarbonates↗
PubMed1987

CO2 rebreathing of T-piece system in patients during recovery phase from acute respiratory failure.

Eight respiratory parameters which might affect the amount of carbon dioxide rebreathing were assessed in seven patients who were breathing spontaneously from large-bore T tube system during the recovery phase from acute respiratory failure. With multivariate regression analysis, the absolute amount of rebreathed CO2 at the connector of endotracheal tube (VINSPCO2) were approximately estimated by using relatively small number of parameters, including minute volume (VEXP), fresh gas inflow to T piece system (VFGI) and preferably by additional parameters concerning CO2 output of the patients.CO2 rebreathing ratio, VINSPCO2 divided by gross outward flux of CO2 at the connector (VEXPCO2), was predicted with simple regression equation by using (VEXP/VFGI) as follows,(VINSPCO2)/(VEXPCO2) = 0.405 + 0.33 x ln (VEXP/VFGI)The maximum (VEXP/VFGI) ratio to prevent rebreathing of CO2 at the connector was 0.30, whereas the ratio to prevent CO2 accumulation due to rebreathing was 0.45.

Journal Article↗
PubMed1985

Serum levels of insulin-like growth factor (IGF) and IGF binding protein in insulin-dependent diabetics during an episode of severe metabolic decompensation and the recovery phase.

Serum insulin-like growth factor (IGF) and IGF-binding protein (IGF BP) levels were determined in 13 insulin-dependent diabetic patients (30-60 yr of age) during an episode of severe metabolic decompensation and the recovery phase. After separation by acidic gel filtration, the samples were assayed for IGF using a protein-binding assay (which measures mainly IGF I-related peptides) and for IGF BP by measuring the binding activity, in both assays using IGF I as tracer. The reference standard was a pool of normal adult serum with an assigned potency of 1 U IGF and 1 U IGF BP per ml. The mean IGF level in the uncontrolled state, 0.55 +/- 0.05 (SEM) U/ml, was about half that of normal subjects (1.03 +/- 0.03 U/ml, P less than 0.001). With treatment, IGF levels reached the normal range within 3 days. The pattern of changes in IGF BP levels was roughly similar, although the values in the uncontrolled state were less depressed (0.78 +/- 0.04 U/ml vs. 0.98 +/- 0.04 in normal subjects, P less than 0.01). Highly significant correlations (P less than 0.001) were found between IGF levels and the biological parameters reflecting control of the diabetes: glycosuria (r = -0.60), glycemia (r = -0.52), ketonemia (r = -0.65), and HCO3- (r = 0.58). Similar but less significant correlations were found for IGF BP. The mean GH level during the period of metabolic decompensation (9.0 +/- 1.5 ng/ml) was elevated compared to that after recovery (2.9 +/- 0.8 ng/ml) (P less than 0.025). There was a negative correlation between GH values and IGF levels (r = -0.67, P less than 0.001). The correlation with IGF BP was much less significant (r = -0.38, P less than 0.05). The results clearly reflect the role of insulin and nutritional factors in the control of IGF levels. They also support the notion that the biosynthesis of IGF and IGF BP is not regulated in the same way.

Adult↗