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Skeletal muscle fiber composition, nutritional status and subjective fatigue during surgical convalescence.

Samples from the lateral vastus femoris muscle were obtained by needle biopsy from 12 patients before and 20 days after elective abdominal surgery. The content of fast and slow twitch muscle fibers and their lesser diameter were determined and related to subjective degree of fatigue and changes in nutritional parameters. Fatigue increased from a mean preoperative level of 2.2 +/- 0.4 arbitrary units to 4.3 +/- 0.5 (p less than 0.001) on postoperative day 20. Body weight, triceps skin fold and slow twitch fiber diameter decreased postoperatively (p less than 0.05). There was no significant postoperative change in the distribution of muscle fiber types. Fatigue increase correlated to weight loss and reduction of triceps skin fold (r = 0.50 and 0.54, p = 0.08 and 0.06, respectively). Postoperative changes in slow and fast twitch fiber diameter correlated to loss of body weight (r = 0.60 and 0.74, p less than 0.05 and less than 0.01, respectively), but correlation was not found between postoperative fatigue and changes in fiber-type distribution (r = 0.34 and 0.29).

Adult↗
PubMed1986

[Primary heart arrest during dynamic ECG in the myocardial infarct patient during convalescence. Contribution of 4 cases].

Four cases of cardiac arrest occurred during Holter monitoring are described. All patients had sustained an acute myocardial infarction thirteen-fourteen days prior to recording and were fully mobilized. In all of them the fatal arrhythmic event was ventricular fibrillation (VF). ECG analysis revealed an increase in heart rate before initiation of VF in one patient only. Warning ventricular arrhythmias were present in two patients. Transient ST segment changes during monitoring were noted in all patients. In three cases the arrhythmia was initiated by an ectopic ventricular beat (EVB) with R-on-T phenomenon; in two of them the EVB occurred after a sinus beat following a long post-ectopic pause. The different electrical events able to induce VF showed a variable and unpredictable pattern of occurrence and association in different patients and at different times in the same patient. Therefore, no specific "trigger" of the fatal arrhythmia could be identified.

Aged↗
PubMed1985

[Right ventricular function during the convalescence phase of posterior primary infarction].

Right ventricular extension is very common in inferior myocardial infarction and the resulting haemodynamic changes are well documented. The aim of this prospective study was to assess the consequences on regional and global right ventricular function at a distance from the initial episode. The study population included 32 patients (29 men and 3 women; mean age 52.7 +/- 6 years) admitted consecutively to the coronary care unit for acute inferior wall myocardial infarction with right ventricular extension (group A: 14 patients) or without (group B: 18 patients), based on the initial haemodynamic data. All patients underwent right and left cardiac catheterisation with selective biplane right and left ventriculography and coronary angiography, 2.9 +/- 1 months after the acute episode. In group A, there was a normalisation of the haemodynamic changes observed during the acute phase of myocardial infarction, complete occlusion (10 cases) or a significant residual stenosis (3 cases) of the right coronary artery proximal or immediately distal to the right marginal artery and persistence of an alteration of global right ventricular systolic function when compared with group B (increased end systolic volume: RVESV = 43 +/- 11 ml/m2 vs 35 +/- 9 ml/m2, p less than 0.02, and a decreased ejection fraction: RVEF = 49 +/- 7 p. 100 vs 57 +/- 9 p. 100, p less than 0.01, resulting from hypokinesia or akinesia of the right ventricular inferior wall; mean shortening delta R = 11 +/- 6 p. 100 vs 17 +/- 7 p. 100, p less than 0.01.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗