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Biomedical subjects

R Coté

Publications and source records attributed to R Coté.

8 recordsLinked to original sources
PubMed2000

Seizures after stroke: a prospective multicenter study.

BACKGROUND: Studies of seizures after stroke have largely been retrospective, with small patient numbers and limited statistical analysis. Much of the doctrine about seizures after stroke is not evidenced based. OBJECTIVE: To determine the incidence, outcome, and risk factors for seizures after stroke. DESIGN: International, multicenter, prospective, analytic inception cohort study conducted for 34 months. PATIENTS AND SETTING: There were 2021 consecutive patients with acute stroke admitted to university teaching hospitals with established stroke units. After exclusion of 124 patients with previous epilepsy or without computed tomographic diagnosis, 1897 were available for analysis. Mean follow-up was 9 months. MAIN OUTCOME MEASURES: Occurrence of 1 or more seizures after stroke, stroke disability, and death after stroke. RESULTS: Seizures occurred in 168 (8.9%) of 1897 patients with stroke (28 [10.6%] of 265 with hemorrhagic and 140 [8.6%] of 1632 with ischemic stroke). On Kaplan-Meier survival analysis, patients with hemorrhagic stroke were at significantly greater risk of seizures (P =.002), with an almost 2-fold increase in risk of seizure after stroke (hazard ratio [HR], 1.85; 95% confidence interval [CI], 1.26-2.73; P =.002). On multivariate analysis, risk factors for seizures after ischemic stroke were cortical location of infarction (HR, 2.09; 95% CI, 1. 19-3.68; P<.01) and stroke disability (HR, 2.10; 95% CI, 1.16-3.82; P<.02). The only risk factor for seizures after hemorrhagic stroke was cortical location (HR, 3.16; 95% CI, 1.35-7.40; P<.008). Recurrent seizures (epilepsy) occurred in 47 (2.5%) of 1897 patients. Late onset of the first seizure was an independent risk factor for epilepsy after ischemic stroke (HR, 12.37; 95% CI, 4.74-32.32; P<. 001) but not after hemorrhagic stroke. CONCLUSIONS: Seizures occur more commonly with hemorrhagic stroke than with ischemic stroke. Only a small minority later develop epilepsy. Patients with a disabling cortical infarct or a cortical hemorrhage are more likely to have seizures after stroke; those with late-onset seizures are at greater risk of epilepsy.

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PubMed1986

Effect of inspiratory volume on intrathoracic pressure generated by an L-1 maneuver.

Since each muscle has an optimal length at which it can generate the maximum tension, an optimal inspiratory volume may exist for producing the maximum intrathoracic pressure during the L-1 maneuver. Intrathoracic pressures were measured in eight healthy men after they inspired various volumes of air and performed the L-1 straining maneuver in a 1-G environment. Both the peak and mean intrathoracic pressures increased at greater inspiratory volumes, except for the mean intrathoracic pressure at the highest volumes. The ability to increase intrathoracic pressure with larger inspiratory volumes may improve +Gz tolerance.

Adult↗
PubMed1981

Muscle water and electrolyte distribution during prolonged exercise.

In an effort to describe the changes in water and electrolyte contents of active and inactive muscles during prolonged effort, seven healthy men were studied during 120 min of cycling. Needle biopsy samples were taken from the deltoid (inactive) and vastus lateralis (active) muscles before, at 10 and 120 min of exercise, and 30 min after exercise. Water and electrolyte contents of blood and active muscle tissue showed a significant change with the onset of exercise, while the inactive muscle was unaffected. As a consequence of the exercise, the subjects lost an average of 2.40 liters of body water, 93 mEq Na+, 22 mEq K+, 95 mEq Cl-, and 5 mEq Mg++. These water and electrolyte losses were not detectable in the muscle tissue sampled at the end of exercise or after 30 min recovery. Based on the loss of Cl-, body weight and plasma volume, extracellular, intracellular, and total body water volumes were calculated to decrease approximately 9%, 3% and 7.5%, respectively, at the end of the exercise. These observations confirm earlier findings that exercise and electrolyte losses in sweat and urine do not alter the calculated membrane potential of active and inactive muscle.

Adult↗
PubMed1976

Muscle water and electrolytes following varied levels of dehydration in man.

In an effort to assess the effects of dehydration on the content of water and electrolytes (Na+, K+, Cl-, and Mg2+) in plasma and muscle tissue, eight men exercised in the heat (39.5 degrees C, 25%). Blood urine, and muscle biopsy samples were obtained before exercise and after the subjects had reduced their body weight by 2.2, 4.1, and 5.8%. On the average, plasma and muscle water (H2Om) contents were found to decline 2.4 and 1.2% for each percent decrease in body weight. Muscle sodium (Na+m) and chloride (Cl-m) content remained unchanged with dehydration, while muscle magnesium (Mg2+m) declined 12% as a result of the 5.8% dehydration. In terms of intracellular concentrations, K+i increased 7.2 and 10.6% at the 2.2 and 4.1% dehydration levels, respectively. Calculations of the resting membrane potential suggest that the water and electrolyte losses observed in these studies do not significantly alter the excitability of the muscle cell membrane.

Adult↗
PubMed1975

Water and electrolyte replacement during repeated days of work in the heat.

In an attempt to determine the value of replacing sweat losses with and electrolyte solution, 12 subjects (2 women and 10 men) were dehydrated (minus 3% body weight) on 5 successive days. During one 5-d sequence, the subjects replaced fluid losses with a glucose-electrolyte solution, while water was the only fluid ingested during a second 5-d series. With the exception of the drink, daily ionic and caloric intakes were identical for the two 5-d conditions. Measurements of water and electrolyte losses in sweat and urine showed a positive balance in body Na+, K+, and Cl- during both the water (W) and electrolyte solution (ES) treatments. Subjects accumulated significantly more Na+ during the W experiments (392 mEq/5 d) than when the electrolyte solution was ingested (334 mEq/5 d). As a result, the extracellular fluid compartment, represented by plasma volume, increased 12.2 and 9.0% during the 5-d sequence of the W and ES trials, respectively. It was concluded that the addition of electrolytes to drinking water is of minimal value for subjects who dehydrated (-3%) on repeated days and are permitted to ingest food and drink libitum

Aged↗