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At least 379 records · Page 21Linked to original sources

PubMed2000

Do idebenone and vitamin therapy shorten the time to achieve visual recovery in Leber hereditary optic neuropathy?

OBJECTIVES: The authors investigated the effectiveness of idebenone combined with vitamin B2 and vitamin C in the treatment of patients with Leber hereditary optic neuropathy (LHON) in an early stage as compared with untreated patients with LHON. These agents may stimulate the formation of ATP. MATERIALS AND METHODS: For this retrospective study, the authors selected 28 outpatients with LHON from the Keio University Hospital. These patients were followed for 2 to 19 years from disease onset. They were divided into two groups: 14 untreated patients (11778 mutation in 10 patients, 3460 mutation in 2 patients, and 14484 mutation in 2 two patients); and 14 treated patients (11778 mutation in 11 patients, 3460 mutation in 1 patient, and 14484 mutation in 2 patients). The treated patients were administered medical treatment with idebenone, vitamin B2, and vitamin C for at least 1 year. The current study evaluated the following: 1) number of eyes with visual recovery > or = 0.3; 2) interval between the onset of LHON and the beginning of visual recovery; 3) interval between the onset of LHON and visual recovery to 0.3; and 4) interval between the beginning of medical treatment and the beginning of visual recovery in the treated subjects. RESULTS: There was no significant difference in the number of eyes with visual recovery > or = 0.3 in the two groups with the 3460, 11778, or 14484 mutation. Patients with visual recovery showed a fenestrated scotoma or a clearing of central vision. The mean interval between the onset of LHON and the beginning of visual recovery was significantly shorter in the treated group (11.1 months) than in the untreated group (17.4 months) (P = 0.03). The mean interval between the onset of LHON and visual recovery to 0.3 was significantly shorter in the treated group (17.6 months) than in the untreated group (34.4 months) (P = 0.01). The mean interval between the initiation of medical treatment to the beginning of visual recovery was 5.4 months. CONCLUSIONS: Results suggest that the administration of idebenone, vitamin B2, and vitamin C sped the recovery of vision in patients with LHON.

Adolescent↗

PubMedDate not supplied

Use of the Anderson Sling suspension system for recovery of horses from general anesthesia.

OBJECTIVE: To describe a sling recovery system (Anderson Sling) for horses and to evaluate outcome of high-risk horses recovered from general anesthesia by a sling. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Horses (n=24) recovered from general anesthesia. METHODS: Complete medical and anesthetic records (1996-2003) for horses recovered from general anesthesia using the Anderson Sling system were evaluated retrospectively. Information retrieved included anesthetic protocol, surgical procedure, recovery protocol, recovery time, and quality of the recovery. Horses were recovered from anesthesia supported by the Anderson Sling in a standing position within a traditional padded equine recovery stall. RESULTS: Twenty-four horses had 32 assisted recoveries; 31 events were successful. No complications associated with the sling or recovery system protocol occurred. One horse was intolerant of the sling's support and was reanesthetized and recovered successfully using head and tail ropes. CONCLUSION: The Anderson Sling recovery system is an effective and safe way to recover horses that are at increased risk for injury associated with adverse events during recovery from general anesthesia. CLINICAL RELEVANCE: The Anderson Sling system should be considered for assisted recovery of equine patients from general anesthesia.

Anesthesia Recovery Period↗

PubMed2003

Motor evoked potentials in predicting recovery from upper extremity paralysis after acute stroke.

OBJECTIVE: The use of motor evoked potentials (MEPs) in predicting recovery after stroke still appears to be somehow equivocal. We assessed the prognostic value of MEPs with respect to arm and hand motor recovery in acute stroke patients. METHODS: This cohort study included 43 consecutive acute stroke patients with complete paralysis of the upper extremity. MEPs of the abductor digiti minimi muscle (ADM) and the biceps brachii muscle (BB) were obtained within 10 days after stroke onset. The upper limb subset of the Fugl-Meyer Motor Assessment was used to evaluate the motor performance at regular intervals until 6 months after stroke. RESULTS: The follow-up was complete in 40 patients (2 patients died and 1 patient had a recurrent stroke); 14 patients showed motor recovery of the arm and their mean 26-week arm motor score was 17.93 (range 3-30, SD 11.68); hand motor recovery occurred in 11 patients and their mean 26-week hand motor score was 11.09 (range 4-14, SD 4.10). Stepwise logistic regression revealed prognostic models for both arm and hand motor recovery based on BB MEPs (odds ratio 7.69, confidence interval, CI, 1.16-50.95) and ADM MEPs (odds ratio 16.20, CI 2.51-104.40), respectively. CONCLUSIONS: The predictive significance of MEPs with respect to motor recovery of the upper extremity was obvious in our homogeneous sample of patients. This agrees with the paradigm that motor recovery after infarction is strongly dependent on a critical residual sparing of the corticospinal function. In this context, the test properties of MEPs in predicting motor recovery are discussed. The added value of MEPs with respect to motor recovery of the upper extremity should be regarded as established for patients with initial paralysis, especially since clinical examination alone lacks the possibility to detect the potential for motor recovery in these cases.

Adolescent↗

PubMed2001

Recovery of ventricular function after myocardial infarction in the reperfusion era: the healing and early afterload reducing therapy study.

BACKGROUND: Patients with reduced left ventricular function and ventricular enlargement after myocardial infarction are at significantly greater risk for congestive heart failure and death. Nevertheless, recovery of ventricular function occurs in a significant proportion of patients after myocardial infarction, and modern reperfusion strategies have been associated with increased recovery of function. OBJECTIVE: To determine the extent and predictors of recovery of ventricular function after anterior Q-wave myocardial infarction in the reperfusion era. DESIGN: Subgroup analysis of the Healing and Early Afterload Reducing Therapy study. SETTING: 35 medical centers in the United States and Canada. PATIENTS: 352 patients with Q-wave anterior myocardial infarction. INTERVENTION: Placebo for 14 days, followed by full-dose (10 mg) ramipril until day 90; low-dose (0.625 mg) ramipril for 90 days; or full-dose ramipril for 90 days. All patients underwent reperfusion therapy. MEASUREMENTS: Echocardiography was performed on day 1 (before randomization), day 14, and day 90 after myocardial infarction. Left ventricular volume and ejection fraction were measured and wall-motion analyses were performed at all three time points in 249 patients and at baseline in an additional 12 patients who died during follow-up. Echocardiographic and nonechocardiographic predictors of ventricular recovery were examined. RESULTS: By day 90, 55 of 252 (22%) patients who had abnormal ejection fraction and wall-motion abnormalities on day 1 demonstrated complete recovery of function (ejection fraction in the normal range and infarct segment length of 0%), and an additional 36% (91 of 252 patients) demonstrated partial recovery of function. At 90 days, 53% (132 of 249) of patients had greater than 5% improvement in ejection fraction, whereas only 16% (39 of 249) had a decrease in ejection fraction of more than 5%. The majority of functional improvement occurred by day 14 after infarction. Of various clinical and echocardiographic measures obtained on day 1, peak creatine kinase level was the strongest independent predictor of subsequent recovery of ventricular function in multivariate analysis. Each 100-unit increase in peak creatine kinase was associated with a 4.3% decreased odds of recovery (P < 0.001) after adjustment for ejection fraction on day 1, extent of akinesis or dyskinesis, treatment regimen, Killip class, age, and sex. CONCLUSION: Significant myocardial stunning with subsequent improvement of ventricular function occurred in the majority of patients after Q-wave anterior myocardial infarction. A lower peak level of creatine kinase, an estimate of the extent of necrosis, is independently predictive of recovery of function. Early functional assessment (day 1 after acute myocardial infarction) had limited ability to predict recovery of ventricular function.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed2003

[Recovery from disability in an older population. Results of long-term follow-up in Upper-Normandy (France)].

BACKGROUND: The recovery of people initially disabled was addressed using the National Institute of Health and Medical Research Upper-Normandy survey, conducted on a representative sample of the older population from 1978 to 1999. METHODS: The survey was based on 1082 older people aged 65 and over. A follow-up was organized to register mortality and disability at point 3, 6, 10 and 20 years. Among the persons initially disabled were taken into account those who were able to go outside their home without help during the 20-year follow-up. Each case of recovery was validated. RESULTS: Among the 1046 subjects for whom data could be analyzed, 218 presented mobility disability necessitating help to go outside their home. Recovery from disability was observed in 23 subjects (10.5%; CI: 6.5-14.5). Among the 195 subjects (89.5%) without any recovery, 107 (49%) had died before 4 years, 44 (20%) had died between 4 and 6 years, and 44 (20%) survived with disability more than 6 years. The rate of recovery was 18.6% before age 80, and 4.1% for people aged 80 and over. It was 1.3% for home-confined or bed- or chair-confined people and 15.4% for the others. Before age 80 the recovery rate was significantly higher in women. No recovery was observed for people with mental deterioration. Cerebrovascular diseases were significantly associated with a low rate of recovery (5%). CONCLUSIONS: Recovery from disability should be taken into account for the health prospects of the elderly population. It concerns about one person out of five before the age of 80. Increased rate of recovery after the age of 80 should be one of the objectives for the health system in the future.

Activities of Daily Living↗

PubMed1993

[Recovery of psychomotor and cognitive functions following anesthesia. Propofol/alfentanil and thiopental/isoflurane/ alfentanil].

Recent changes in the medical system have resulted in a significant increase of ambulatory surgical procedures. Therefore, a safe and short postoperative recovery period and, especially, the full recovery of complex psychological function after general anaesthesia have become increasingly important. In the present study we investigated the recovery of psychomotor and cognitive function after general anaesthesia with propofol/alfentanil and thiopentone/isoflurane/alfentanil. PATIENTS AND METHODS. Institutional approval and informed consent was obtained in 40 female ASA I or II patients undergoing diagnostic laparoscopy. As oral premedication the patients received chloracepat (10-20 mg) 45 min before the start of anaesthesia. Anaesthesia was induced in group I with propofol (2.5 mg/kg) and maintained with propofol (6-12 mg/kg/h)/alfentanil (0.05 mg/kg) and 50% N2O in O2. The patients of group II received thiopentone (5 mg/kg) for induction and isoflurane (0.5-1.5 vol%)/alfentanil (0.05 mg/kg) and 50% N2O in O2 for maintenance of general anaesthesia. In particular we measured the following parameters: (1) The recovery time, defined as the interval between the termination of the anesthetic and the patient's correct recall of her birth date. (2) The choice reaction times to optical stimuli (red or green light), which was used as a parameter for attention and psychomotor function. (3) The score in the "Zahlen-Verbindungs-Test" in which the patients had to connect numbers from 1 to 90 in correct order. This is also a parameter to quantify attention and psychomotor function. (4) The digit span which is a value derived from the number of correctly reproduced digits from a list presented to the patients. It is a measure of numerical memory. (5) The Munich Verbal Learning Test, which is the German version of the California Verbal Learning Test. It represents the number of correctly reproduced words from a previously presented list and is a measure of the verbal memory. (6) The Wisconsin Card Sorting Test, which serves to test the ability to plan and act and to form terms and concepts. (7) The State-Trait Anxiety Inventory, to quantify state anxiety. (8) Pain score, using a visual analogue scale. The tests were performed at four measurement points: the day before the operation and 30, 60, and 240 min after recovery. The "Zahlen-Verbindungs-Test", the digit span and the Munich Verbal Learning Test were presented in four parallel forms to minimize learning effects. For statistical analysis of the data the Wilcoxon test was employed within groups and the Mann-Whitney test between groups. RESULTS. The groups were comparable in age, weight, height and level of education. No significant difference was found between them in operation or anaesthesia time or in the total dosage of alfentanil. Recovery time in the propofol group was, at 10 min, significantly shorter than in the isoflurane group, with 16 min. Choice reaction times were significantly increased 30 min after recovery from anaesthesia in both groups. In the propofol group they returned to normal after 60 min, whereas in the isoflurane group significant increases could be observed even 240 min after recovery from the anaesthetic. Choice reaction times were significantly longer in the isoflurane group than in the propofol group 60 min and 240 min after anaesthesia. In the "Zahlen-Verbindungs-Test" the patients showed significantly worse results 30 min and 60 min after anaesthesia. The propofol group tended to be better than the isoflurane group, but the difference did not reach statistical significance. Also in the digit span, the scores were significantly lower 30 min after recovery from the anaesthetic. Here again the propofol group tended to be a little better than the isoflurane group 30 min, 60 min and 240 min after anaesthesia. In the Munich Verbal Learning Test both groups had lower scores 30 min and 60 min, the isoflurane group also 240 min, after recovery...

Adult↗

PubMed1996

Recovery in geriatric depression.

BACKGROUND: Clinical characteristics of depression, age at illness onset, medical burden, disability, cognitive impairment, lack of social support, and poor living conditions may influence the course of depression. This study investigates the timetable of recovery and the role of the above factors in predicting recovery in elderly patients with major depression. METHODS: Recovery was studied in 63 elderly (age >63 years) and 23 younger patients with depression who were followed up for an average of 18.2 months (SD, 13.1 months) under naturalistic treatment conditions. Diagnosis was assigned according to Research Diagnostic Criteria after administration of the Schedule for Affective Disorders and Schizophrenia. The Longitudinal Follow-up Interval Examination was used to identify recovery. RESULTS: The recovery rate of depressed elderly patients was similar to that of younger depressed patients. In the elderly patients, age, antidepressant treatment, age at onset, and chronicity of episode were significantly associated with time to recovery since entry. Among these parameters, late age at onset was the strongest predictor of slow recovery. In younger patients, long time to recovery was predicted by weak social support, younger age, cognitive impairment, and low intensity of antidepressant treatment. In the elderly, the intensity of antidepressant treatment began to decline within 16 weeks from entry and approximately 10 weeks prior to recovery. CONCLUSIONS: These findings challenge the view that geriatric depression has a worse outcome than depression in younger adults. However, depressed patients with onset of first episode in late life may be at higher risk for chronicity. Antidepressant treatment prescribed by clinicians may decline prior to recovery despite evidence that high treatment intensity is effective in preventing relapse.

Adult↗

PubMed1996

Effects of active and passive recoveries on splitting of the inorganic phosphate peak determined by 31P-nuclear magnetic resonance spectroscopy.

Six male long-distance runners performed knee flexion exercises in a 2.1 T superconducting magnet. 31P MRS was used to investigate the splitting pattern of the inorganic phosphate (Pi) peak during active and passive recovery. During exercise splitting of the Pi peak into two was observed (high and low pH) and after exercise the manner in which the Pi peak disappeared was different in passive and active recoveries. During passive recovery, in which exercise was not performed at all, the high-pH Pi peak disappeared more rapidly than the low-pH Pi peak. The low-pH Pi peak remained at a similar acidified chemical shift as during exercise, and then gradually disappeared during passive recovery. Conversely, during active recovery in which unloaded exercise was followed, the high-pH Pi peak was reduced, but remained, whereas the low-pH Pi peak returned very quickly to the pre-exercise level and then disappeared. Teh recovery rate of the low pH during active recovery (0.095 +/- 0.019 pH units/min) was significantly faster than that during passive recovery (0.014 +/- 0.019 pH units/min) (p < 0.01). The slow disappearance of the low pH Pi peak during passive recovery can be explained by the halting of glycogenolysis and an insufficient oxygen supply to resting glycolytic fibers, whereas the quick disappearance observed with active recovery would have been due to elevated sufficient oxygen supply and efficient removal of lactate as a result of the maintained blood flow. Oxy-myoglobin and hemoglobin was also measured with near infrared spectroscopy.

Adult↗

PubMed1975

Recovery of motor function after lesions in motor cortex of monkey.

This behavioural study concerns the contribution of active retraining to motor recovery after a standard lesion in the motor cortex, and includes an evaluation of various retraining procedures. These problems have not previously been experimentally analysed in man or animal. Rhesus monkeys (27) were initially trained on two motor tasks which consisted of a pulling task, involving the proximal muscles of the upper limb, and a hand-grip task for the distal musculature. Strength of pulling and hand-grip were measured quantitatively. For brevity, only the hand grip data are described. After a plateau of proficient performance was achieved in both hands (usually 6-8 months), the cortical precentral forelimb area was surgically ablated on one side. Each animal was then randomly assigned to one of four experimental groups or to a sham operative control group. The groups differed with respect to the use of the contralateral and/or ipsilateral forelimb(s) in post-operative motor training on the same task. In addition, to evaluate the contribution of spontaneous post-operative recovery independent of retraining, we started to train two groups immediately after surgery; in the other two experimental groups the weak forelimb remained idle for the first four post-operative months. Combined training of the weak and normal limb, which resulted in 85% recovery in the weak limb, did not differ statistically from training the weak limb alone (79% recovery). This suggests that the critical factor in promoting recovery is training of the weak forelimb, presumably by 'activation' of the damaged hemisphere. The role of the ipsilateral (strong) limb appears negligible. When post-operative training in the weak limb was delayed four months, spontaneous recovery noted one week after the start of delayed training was about 50% compared with 9% recovery after one week in the groups retrained immediately after surgery (P less than 0.001). The 'immediate' groups, however, continued to improve over a six-month period to about 82% of their pre-operative performance. The 'delay' groups, by contrast, exhibited only slight further improvement, reaching a plateau of 67% recovery six months after the start of retraining (10 months post-operatively). This difference in recovery between the immediate and delay groups was significant at the 0.05 level. This confirms that active physical retraining facilitates motor recovery, although the mechanism remains obscure. The data also suggest that, to be most effective, the training should begin as soon as possible after the insult to the brain has occurred.

Animals↗

PubMed2004

Markers of myocardial reperfusion as predictors of left ventricular function recovery in acute myocardial infarction treated with primary angioplasty.

BACKGROUND: Myocardial blush grade (MBG), corrected TIMI frame count (cTFC), and ST-segment reduction are indices of myocardial reperfusion. HYPOTHESIS: We evaluated their predictive value for left ventricular (LV) function recovery by gated single-photon emission computed tomography (SPECT) after acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI). METHODS: In 40 patients with AMI, gated SPECT was performed at admission and repeated 7 and 30 days after PCI. Left ventricular function recovery was defined as an increase > or = 10 points in SPECT LV ejection fraction from baseline to 1 month. The MBG, cTFC, and ST-segment elevation index 1 h after PCI were determined to evaluate reperfusion. RESULTS: Twenty-four patients (Group 1) had LV function recovery and 16 (Group 2) did not. A significant correlation was found between LV function recovery and MBG (r = 0.66; p = 0.0001), and ST-segment elevation index at 1 h (r = -0.55; p = 0.0001), but not with cTFC. Univariate predictors of LV function recovery were MBG (p = 0.0003) and ST-segment elevation index 1 h after intervention (p = 0.0026), but not cTFC. In a multivariate analysis, MBG was the only predictor of LV function recovery. Myocardial blush grade > or = 2 and ST-segment elevation index reduction had the same accuracy (88%) for predicting LV function recovery. Lower accuracy (75%) was shown by fast cTFC (< 23 frames). Myocardial blush grade > or = 2 showed the better negative likelihood ratio, and ST-segment elevation index reduction had the higher positive likelihood ratio in predicting LV function recovery. CONCLUSIONS: Myocardial blush grade was the best parameter for prediction of LV function recovery: MBG > or = 2 and ST-segment elevation index reduction showed good accuracy in predicting LV function recovery. The cTFC failed to be a significant predictor.

Aged↗

PubMed2006

What is recovery in adolescent anorexia nervosa?

OBJECTIVE: The principal aim of this study is to describe the types of problems faced in defining recovery from anorexia nervosa (AN) as well as to illustrate the magnitude that various definitions have on recovery rates for AN. METHOD: Comparative rates of recovery from AN using a range of definitions (percent ideal body weight, psychological recovery, and combinations of these variables) were calculated using long-term outcome data from a study of adolescents treated for AN. In addition, a Kaplan-Meier survival analysis was used to model recovery over the long-term follow-up period. RESULTS: Recovery rates varied highly, depending on the definition used, from 57.1% to 94.4%. Using survival analysis, the mean time to remission for weight (>85% ideal body weight) was 11.3 months, significantly shorter than for Eating Disorder Examination score recovery at 22.6 months (log rank = 16.1, p = 0.0001). CONCLUSION: Agreement of definitions of recovery may be dependent on specific goals of a particular study or treatment; however, in order to compare and contrast categorical outcomes, a consistent definition of recovery is needed in the literature. Both weight and psychological symptoms appear to be important in a definition of recovery.

Adolescent↗

PubMed1983

Recovery of Ca currents from inactivation: the roles of Ca influx, membrane potential, and cellular metabolism.

Ca currents were examined with regard to their recovery from inactivation. The experiments were done on isolated nerve cell bodies of Helix aspersa using a combined suction pipet , microelectrode method for voltage clamp, and internal perfusion. Ca currents were separated by suppressing K and Na currents. The time course of recovery was determined by applying a test pulse at intervals ranging from 1 msec to 20 sec after prepulses varying from 20 to 3000 msec in duration. Each pair of pulses was preceded by a control pulse to ensure that the Ca currents had recovered before the next test pair was applied. Ba and Ca currents were compared and the effects of intracellular perfusion with EGTA, ATP, and vanadate were examined. Ba currents recovered in two stages and this time course was well fit by a sum of two exponentials with amplitudes and time constants given by A1 and tau 1 for the fast component and A2 and tau 2 for the slow component. In Ba the time constants were unchanged when prepulse durations were prolonged from 70 to 700 msec, although the initial amplitudes A1 and A2, particularly A2, were increased. Comparable influxes of Ca during the prepulse caused much more inactivation, but interestingly the recovery occurred at the same rate. The time course of Ca current recovery was also fit by a sum of two exponentials, the time constants of which were both smaller than the time constants of Ba current recovery. However, the time constants of Ca current recovery were increased markedly when prepulse durations were prolonged. Increasing the extracellular Ca concentration had a similar effect. Increasing the Ba influx had no effect on the recovery time constants, and the Ba results are consistent with reversible inactivation gating of potential-dependent membrane Ca channels. The Ca results show that Ca influx enhances inactivation. Intracellular perfusion with EGTA resulted in less inactivation in the cast of Ca but it had no effect on Ba currents. Intracellular ATP increased the rate of recovery of Ca currents, and intracellular vanadate inhibited recovery. It is concluded that recovery of Ca channels depends upon both Ca influx and membrane potential and is modulated by agents which affect Ca metabolism.

Adenosine Triphosphate↗

PubMedDate not supplied

Pressure recovery in pediatric aortic valve stenosis.

This study was designed to evaluate the phenomenon of pressure recovery in pediatric patients with aortic stenosis and also to evaluate how observed differences between catheter and Doppler gradients can be predicted by Doppler echocardiography. Doppler measurements of aortic valve stenosis gradients are known to overestimate observed gradients in the catheterization laboratory. Pressure recovery has been shown to be a contributing factor to this discrepancy. However, the clinical relevance of correcting Doppler gradients using the pressure recovery equation has not been evaluated in the pediatric population. Simultaneously obtained catheter and Doppler gradients were studied in 14 patients (range, 0.03-18 years; mean, 4.1 years) with aortic valve stenosis. A total of 23 data points were measured because 9 patients underwent balloon valvuloplasty and had both a pre- and a post-balloon valvuloplasty data point in the study. The catheter gradients were then compared to peak, mean, and pressure recovery corrected Doppler gradients. Pressure recovery was calculated using a previously validated equation. As expected, measured echocardiographic continuous-wave peak Doppler gradients overestimated the observed catheter gradients (range, 16-93 mmHg; mean, 43 mmHg). The continuous-wave peak Doppler gradients, mean, and pressure recovery adjusted gradients were equally as good in correlating the observed catheter gradients to those obtained by Doppler echocardiography (r = 0.92). However, pressure recovery corrected Doppler gradients were in better agreement with catheter gradients than echocardiographic mean or peak Doppler gradients (95% limit of agreement: -9 to 19 mmHg for pressure recovery corrected gradients, -30 to 11 mmHg for mean Doppler gradients, and 2-83 mmHg for peak Doppler gradients). Measured continuous-wave peak Doppler gradients consistently overestimated catheter gradients. The noted differences may be predicted using the pressure recovery equation. Pressure recovery is a significant factor in children with aortic valve stenosis.

Adolescent↗

PubMed2003

Exercise and recovery metabolism in the Pacific spiny dogfish (Squalus acanthias).

We examined the effects of exhaustive exercise and post-exercise recovery on white muscle substrate depletion and metabolite distribution between white muscle and blood plasma in the Pacific spiny dogfish, both in vivo and in an electrically stimulated perfused tail-trunk preparation. Measurements of arterial-venous lactate, total ammonia, beta-hydroxybutyrate, glucose, and L-alanine concentrations in the perfused tail-trunk assessed white muscle metabolite fluxes. Exhaustive exercise was fuelled primarily by creatine phosphate hydrolysis and glycolysis as indicated by 62, 71, and 85% decreases in ATP, creatine phosphate, and glycogen, respectively. White muscle lactate production during exercise caused a sustained increase (approximately 12 h post-exercise) in plasma lactate load and a short-lived increase (approximately 4 h post-exercise) in plasma metabolic acid load during recovery. Exhaustive exercise and recovery did not affect arterial PO2, PCO2, or PNH3 but the metabolic acidosis caused a decrease in arterial HCO3- immediately after exercise and during the first 8 h recovery. During recovery, lactate was retained in the white muscle at higher concentrations than in the plasma despite increased lactate efflux from the muscle. Pyruvate dehydrogenase activity was very low in dogfish white muscle at rest and during recovery (0.53 +/- 0.15 nmol g wet tissue(-1) min(-1); n=40) indicating that lactate oxidation is not the major fate of lactate during post-exercise recovery. The lack of change in white muscle free-carnitine and variable changes in short-chain fatty acyl-carnitine suggest that dogfish white muscle does not rely on lipid oxidation to fuel exhaustive exercise or recovery. These findings support the notion that extrahepatic tissues cannot utilize fatty acids as an oxidative fuel. Furthermore, our data strongly suggest that ketone body oxidation is important in fuelling recovery metabolism in dogfish white muscle and at least 20% of the ATP required for recovery could be supplied by uptake and oxidation of beta-hydroxybutyrate from the plasma.

3-Hydroxybutyric Acid↗

PubMed1997

Recovery time constant in central nervous system O2 toxicity in the rat.

The development of oxygen toxicity can be delayed by intermittent periods of normoxia. However, there is no accepted procedure for quantifing the recovery during normoxia. A cumulative oxygen toxicity index - K, when K reaches a critical value (Kc) and the toxic effect is manifested, can be calculated using the equation K = t(2)e x PO(2)c where t(e) is hyperoxic exposure time and PO2 is oxygen pressure and c is a power parameter. Recovery during normoxia (reducing K) is calculated by the equation K2 = K1 x e(-rt(r)) where t(r) is recovery time, r being the recovery time constant. A combination of accumulation of oxygen toxicity and its recovery can be used to calculate central nervous system oxygen toxicity. In protocol A (n = 25), r was calculated for rats exposed either continuously to 608 kPa oxygen or to PO2 = 608 kPa followed by a period of normoxia (3.5% O2), with a subsequent return to PO2 = 608 kPa until appearance of the first electrical discharge (FED) in the electroencephalogram which precedes clinical convulsions. In protocol B (n = 22), predicted latency to the FED was compared to measured latency for seven different exposures to hyperbaric oxygen (HBO), followed by a period of normoxia and further HBO exposure. Recovery followed an exponential path, with r = 0.31 (SD 0.12) min(-1). The predicted latency to FED in protocol B correlated with the measured latencies. Calculation of the recovery of the CNS oxygen toxicity agreed with the previously suggested exponential recovery of the hypoxic ventilatory response and was probably a general recovery process. We concluded that recovery can be applied to the design of various hyperoxic exposures.

Animals↗

PubMed2005

Implementing recovery oriented evidence based programs: identifying the critical dimensions.

In the decades of the 1990s many mental health programs and the systems that fund these programs have identified themselves as recovery-oriented. A program that is grounded in a vision of recovery is based on the notion that a majority of people can grow beyond the catastrophe of a severe mental illness and lead a meaningful life in their own community. First person accounts of recovery and empirical research have led to a developing consensus about the service delivery values underlying recovery. The emphasis on recovery-oriented programming has been concurrent with a focus in the field on evidence-based practices. We propose that evidence based practices be implemented in a manner that is recovery compatible. Program dimensions for evidence based practice, such as program mission, policies, procedures, record keeping and staffing should be consistent with recovery values in order for a program to be considered to be recovery-oriented. This article describes the critical dimensions of such value based practice, regardless of the service the recovery oriented mental health programs provide (e.g., treatment, case management, rehabilitation). The aim of this first attempt at conceptualizing recovery-oriented mental health programs is to both provide direction to those involved in program implementation of evidence based mental health practices, as well as providing a stimulus for further discussion in the field.

Adaptation, Psychological↗

PubMed1987

Recovery profile of single motoneurons after electrical stimuli in man.

The H-reflex of 120 soleus motoneurons was recorded using fibre EMG. The recovery profile of these motoneurons was studied during monitoring surface H-reflex records in 28 adult subjects. The spectrum of motoneurons tested was homogeneous with two extremes of neurons having different characteristics. A motoneuron population (forming about 69% of our sample) had a high threshold level for electrical stimuli, short recovery time, and short recovery fringe time (called type A). A second population of motoneurons (forming about 20-30% of our sample) had a low threshold level for electrical stimuli, long recovery fringe time (called type B). During an isometric muscle contraction every motoneuron showed an early shift in recovery time (i.e. each had a shorter recovery time) with shortened recovery fringe time. These changes were larger for motoneurons type B than motoneurons type A. With paired identical electrical stimuli of varying interstimulus intervals a motoneuron may fire in response to the conditioning and test stimuli giving an H2, but not in response to both stimuli. This occurred for interstimulus intervals of 4-11 ms. A strong inhibition period was recorded with interstimulus intervals of 12-80 ms in which all motoneurons did not show any recovery. Most motoneurons recovered in orderly fashion between 80 and 300 ms of interstimulus interval, and this recovery coincided with the fast recovery recorded in surface H-reflex. All motoneurons were recovered by 3000 ms of interstimulus intervals. These findings emphasize the importance of eliciting the H-reflex every 3-5 s in H-reflex methodology in order to be assured that all excited motoneurons have been recovered.

Adult↗

PubMed1995

Positive life orientation and recovery from myocardial infarction.

The study examined the relationship between positive life orientation (PLO) and recovery from a recent myocardial infarction (MI), i.e. heart attack. PLO was defined as a predisposition to selectively focus one's attention on the brighter side of any situation. An 11-item measure of PLO was developed. Seventy male patients of first MI receiving treatment at a local government hospital were interviewed twice, 4-5 days after their first heart attack (time 1) and a month after their first heart attack (time 2). The interview schedule consisted of measures of PLO, perceived recovery, expected recovery, helplessness, personal control and mood state. At time 1 all these measures were administered but at time 2 measures of only PLO, personal control, perceived recovery and mood state were administered. In addition, the attending doctor assessed the patients' medical recovery at time 1. Results showed positive correlation of patients' PLO scores with their medical recovery, perceived recovery, expected recovery, personal control and mood state but negative with helplessness. PLO scores were not influenced by patients' age, education, or income. Patients' scores on PLO at two time points were not significantly different and were positively correlated. Their scores on sense of personal control and perceived recovery increased significantly at time 2. Significant intercorrelations among variables, under study, often reduced to insignificance on partialling out PLO. PLO, thus emerged as an important factor in recovery from MI.

Adult↗