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PubMed2004

The influence of different unloading positions upon stature recovery and paraspinal muscle activity.

OBJECTIVE: To determine whether stature recovery and paraspinal muscle activity can be altered in individuals with and without chronic low-back pain by assuming different unloading positions. DESIGN: A case-control study considering the effects of unloading position on stature recovery in individuals with and without chronic low-back pain. BACKGROUND: Stature recovery has been documented to be lower in individuals with chronic low-back pain. Elevated paraspinal muscle activity subjects the spine to increased compression, which may delay stature recovery. However, the mechanism(s) causing prolonged stature recovery are yet to be explored. METHODS: Eleven chronic low-back pain participants (age 33 yr (SD 12.2), height 1.72 m (SD 0.08), body mass 75.9 kg (SD 10.7)) and eleven asymptomatic participants (age 30.5 yr (SD 9.7), height 1.75 m (SD 0.10), body mass 73.3 kg (SD 11.7)) performed a loaded walking task (10% body mass) and adopted four unloading positions on separate occasions. Measurements of stature and muscle activity were recorded during each position. FINDINGS: Individuals with chronic low-back pain exhibited higher paraspinal EMG and delayed stature recovery in all positions (P<0.05). Both groups experienced greatest stature recovery and least muscle activity during gravity inversion (P<0.05). INTERPRETATION: Elevated muscle activity was found in the chronic low-back pain group supporting the existence of this explanation for delayed stature recovery. The gravity inverted position resulted in the lowest EMG and the greatest stature recovery. Further research is required to determine whether improving stature recovery has clinical implications by reducing pain/disability.

Adaptation, Physiological↗

PubMed2004

Improvement of recoveries for the determination of protozoa Cryptosporidium and Giardia in water using method 1623.

The U.S. Environmental Protection Agency has developed method 1623 for simultaneous detection of Cryptosporidium oocysts and Giardia cysts in water. Method 1623 includes four major steps: filtration, immunomagnetic separation (IMS), fluorescent antibody (FA) staining and microscopic examination. It was noted that the recovery levels following IMS-FA and FA staining were high, averaging more than 92.0% and 89.0% for C. parvum oocysts and G. lamblia cysts, respectively. In contrast, when the filtration step was incorporated, the recovery level of C. parvum oocysts declined significantly to 18.1% in seeded tap water, while a relatively high recovery level of 77.2% for G. lamblia cysts could still be achieved. Further study indicated that the recovery level of C. parvum oocysts could be enhanced significantly when an appropriate amount of silica particles was added to a water sample. The recovery level of C. parvum oocysts was affected by particle size and concentration. The optimal silica particle size was determined to be within the range of 5-40 microm, and the corresponding optimal silica concentration was 1.42 g for 10-l tap water. When both G. lamblia cysts and C. parvum oocysts were spiked into the tap water sample containing the optimum amount of silica particles, the average recovery levels of oocysts and cysts were 82.7% and 75.4%, respectively. The results obtained clearly suggested that addition of an appropriate amount of silica particles could improve the recovery level of C. parvum oocysts significantly and yet there was no noticeable deleterious effect on the recovery level of G. lamblia cysts. Further study indicated that the rotation time in the IMS procedure using the Dynal GC-Combo IMS kit (which was recommended in method 1623) was important for G. lamblia cyst detection. In contrast, the recovery level of C. parvum oocysts was not affected by the rotation time. Furthermore, it was found that the recovery levels of C. parvum oocysts using methods 1622 and 1623 were quite close although different IMS kits were used in the two methods.

Animals↗

PubMed2002

[Recovery from exercise in trained smokers].

AIM: Assess the influence of tobacco on recovery after exercise in sportsmen. METHODS: Sixty-three smokers aged 18-33 years, practising soccer, participated in this study. These subjects belonged to second division congolese league clubs. Heart rate (HR) was studied during recovery of moderate exercise (Ruffer's test), but also recovery index and arterial pressure. Kinetics of the HR was studied for 7 min for recovery. A control group consisted of 50 non smokers, practising soccer at similar level. RESULTS: Smokers showed heart rate values significantly higher (P < 0.001). Non smokers presented a low recovery index. The recovery has generally two components: the first is slow in smokers, while the second is a fast one. However, recovery rate for the smokers was more rapid during the alactic phase. There exists also differences with regards to smoking tobacco dependence: when compared to great smokers, lower smokers exhibited a faster first phase and a slower second phase. These differences were significant. DISCUSSION AND CONCLUSION: The smokers and non smokers differences are discussed with reference to the effects of nicotinemia and carbon monoxide on sympathetic-parasympathetic balance. Cardiovascular changes during exercise have a twofold control: decrease a vagal tone and increase of sympathetic activity. The comparison of smokers and non smokers concerning recovery led to suppose that there exists a difference in regards of the catecholaminergic sensitivity. The problem of thermoregulation must not be neglected during recovery. As smokers are considered, cutaneous thermolysis is perhaps important when these subjects perform exercise in ambient hot air. Here against, it is known that thermolysis mechanisms are not similar in smokers and non smokers. In conclusion, this study showed that smoking tobacco induce a lower physical condition in sportmen. Recovery rate after exercise may function as a predictor of fitness in smokers.

Adolescent↗

PubMed2001

Recovery of Cryptosporidium oocysts and Giardia cysts from source water concentrates using immunomagnetic separation.

Immunomagnetic separation (IMS) procedures for the simultaneous isolation of Cryptosporidium oocysts and Giardia cysts have recently become available. We validated Dynal's GC-Combo IMS kit using source water at three turbidity levels (5000, 500 and 50 nephelometric turbidity units [ntu]) obtained from different geographical locations and spiked with approximately 9--11 (oo)cysts per ml. Mean recoveries of Cryptosporidium oocysts and Giardia cysts in deionized water were 62% and 69%, respectively. In turbid water matrices, mean recoveries of Cryptosporidium oocysts were between 55.9% and 83.1% while mean recoveries of cysts were between 61.1% and 89.6%. Marginally higher recoveries of the heat inactivated (oo)cysts were observed (119.4% Cryptosporidium oocysts and 90.9% Giardia cysts) in deionized water when compared with recoveries of viable (oo)cysts (69.7% Cryptosporidium oocysts and 79% Giardia cysts). Age of (oo)cysts on recoveries using the GC-Combo IMS kit demonstrated no effects up to 20 months old. Recovery of Giardia cysts was consistent for isolates aged up to 8 months (81.4%), however, a significant reduction in recoveries was noted at 20 months age. Recoveries of low levels (5 and 10 (oo)cysts) of Cryptosporidium oocysts and Giardia cysts in deionized water using IMS ranged from 51.3% to 78% and from 47.6% to 90.0%, respectively. Results of this study indicate that Dynal's GC-Combo IMS kit is an efficient technique to separate Cryptosporidium/Giardia from turbid matrices and yields consistent, reproducible recoveries. The use of fresh (recently voided and purified) (oo)cysts, aged (oo)cysts, viable and heat-inactivated (oo)cysts indicated that these parameters do not influence IMS performance.

Age Factors↗

PubMed2001

Psychological, cardiovascular, and metabolic correlates of individual differences in cortisol stress recovery in young men.

The relationship of free salivary cortisol stress recovery and basal cortisol with psychological, cardiovascular and metabolic factors was investigated in 82 healthy young men. Blood pressure, heart rate, cortisol and mood were assessed during a single laboratory session involving mental arithmetic and speech tasks, and lipid profiles were analysed from a fasting blood sample. Participants were divided into high (n=31) and low (n=51) cortisol stress recovery groups on the basis of the magnitude of changes between the peak cortisol responses to tasks and the lowest levels recorded at the end of a 30 min post-stress rest period. The high recovery group showed consistent increases in cortisol following each of the tasks, while the low recovery group showed little change across the session. Cortisol levels in the two groups did not differ at the end of the post-stress recovery period. The groups were indistinguishable in age, body mass index, smoking and alcohol consumption, and did not differ in psychological characteristics including anxiety, depression and perceived social support. However, the high stress recovery group had elevated low density lipoprotein cholesterol and total cholesterol/high density lipoprotein ratios, suggesting raised cardiovascular disease risk. The high stress recovery group also reported greater psychological activation during tasks, and greater recent minor life stress, than did the low recovery group. There was no association between rate of cortisol recovery and cardiovascular responses to tasks. But resting cortisol was related to blood pressure stress reactivity, suggesting that cortisol played a permissive role in augmenting sympathetically-driven cardiovascular responses. The results suggest that the rate of cortisol stress recovery is associated with variations in metabolic risk, and with differences in psychological state but not trait characteristics.

Adult↗

PubMed2000

Tracking dynamic conduction recovery across the cavotricuspid isthmus.

OBJECTIVES: We sought to assess the dynamic temporal course of conduction recovery during and after radiofrequency (RF) catheter ablation of the cavotricuspid isthmus. BACKGROUND: Although cavotricuspid isthmus block is accepted as the best end point of ablation for typical flutter, conduction recovery is thought to underlie many eventual recurrences. Its time course and frequency have not been determined. METHODS: In a prospective group of 30 patients (26 men and 4 women, age 64 +/- 12 years) undergoing ablation of typical flutter in the cavotricuspid isthmus, the morphology of the P wave during pacing from the low lateral right atrium after achievement of complete isthmus block was identified as a reference. Regression of this morphologic P wave change was confirmed to be associated with intracardiac evidence of the recovery of cavotricuspid isthmus conduction and was observed throughout the procedure both during ablation in sinus rhythm (n = 15, group B) and just after flutter termination (n = 15, group A). RESULTS: Stable complete isthmus block was achieved in all patients; 29 had a terminal positivity of the paced P wave. Flutter termination resulted in stable block and terminal P wave positivity in three patients, transient terminal P wave positivity and transient block despite continuing RF at the same site in five patients and no block in the remaining seven patients. Conduction recovery identified by recovery of P wave changes was nearly as common (48%) during ablation in sinus rhythm. Multiple recoveries were noted in some patients, and 72% of all recoveries occurred within 1 min. Conduction recovery was only rarely associated with coagulum, impedance elevation or pops. CONCLUSIONS: Conduction recovery in the cavotricuspid isthmus is common during and after ablation and can be accurately, dynamically and continuously observed by monitoring the recovery of the low lateral right atrial paced P wave change.

Aged↗

PubMed1998

Treadmill exercise duration and dyspnea recovery time in chronic obstructive pulmonary disease: effects of oxygen breathing and repeated testing.

Oxygen supplementation is known to improve exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Although some COPD patients use oxygen after exercise to relieve dyspnea, the effect of oxygen during recovery from exercise is not clearly understood. Exercise duration and dyspnea recovery time were studied in 18 patients with stable COPD. Patients exercised at a constant submaximal work rate on a treadmill ergometer until they no longer wished to continue. Oxygen, room air and compressed air were randomly administered in three consecutive post-exercise recovery periods. Dyspnea was scored on a 100 mm visual analog scale at 30 s intervals until return to baseline. An additional 20 minute post-recovery resting period was allowed between each test. No significant differences were found in dyspnea recovery time breathing oxygen (271 s), room air (290 s) or compressed air (311 s) When the groups were sorted by sequence of testing, there was a highly significant increase in recovery time (208 s, 307 s and 358 s for the first, second and third tests; P < 0.005) and a non-statistically significant decrease in exercise duration (89 s, 79 s and 76 s). Post-exercise oxygen supplementation had no effect on dyspnea recovery time in these COPD patients. Repeated bouts of exercise increased dyspnea recovery time and tended to decrease exercise duration. These findings suggest that, despite recovery of symptoms, physiological recovery from prior exercise is incomplete.

Aged↗

PubMed1985

Temporal course of motor recovery after Brown-Sequard spinal cord injuries.

Recovery of voluntary motor function after incomplete spinal cord injuries is attributed to a variety of physiological mechanisms, such as resolution of conduction block in injured axons, and neuroplasticity mechanisms in spared axons. To better understand these recovery mechanisms, we have examined motor recovery in one type of incomplete cord injury, the Brown-Sequard Syndrome. This syndrome is observed in patients with unilateral injury of the spinal cord and is manifested as asymmetric weakness and pain/temperature sensory loss contralateral to the weakest extremity. We have followed the course of motor recovery in two patients and reviewed the literature in an additional 59. Common features of this motor recovery include: 1) recovery of ipsilateral proximal extensor muscles before ipsilateral distal flexors, 2) recovery of any weakness in the extremity with pain/temperature sensory loss before the opposite extremity, and 3) recovery of voluntary motor strength and a functional gait by 1 to 6 months. We discuss these observations with respect to three hypotheses to explain motor recovery and suggest that neuroplasticity mechanisms functioning in spared descending axons may mediate much of the observed recovery after Brown-Sequard cord lesions.

Adult↗

PubMed2003

Cardiovascular haemodynamic response to repeated mental stress in normotensive subjects at genetic risk of hypertension: evidence of enhanced reactivity, blunted adaptation, and delayed recovery.

To identify unique cardiovascular responses to stressors in a population at genetic risk of hypertension, we studied haemodynamic responses in initial reactivity to, subsequent adaptation to, and final recovery from repeated active mental stress in young, normotensive individuals stratified by hypertension parental history (PH). Two groups (n=21/group) of normotensive white males underwent stress testing. One group (N+PH) had a hypertensive parent, while the other group (N-PH) did not. Cardiovascular response was measured before, during, and after repeated serial-subtraction math. Initial reactivity was measured as the difference between baseline and initial stress response, subsequent adaptation as the difference in response to repeated trials, and final recovery was assessed by the difference between baseline and postbaseline levels. The influence of PH on reactivity, adaptation, and recovery was assessed by repeated measures ANOVA for stroke volume, cardiac output, pre-ejection period, total peripheral resistance, mean successive heartbeat time difference, blood pressure, and heart rate. Multivariate analysis of variance (MANOVA) determined the effect of PH on overall reactivity, adaptation, and recovery. As compared to the N-PH group, initial reactivity was higher in the N+PH group for cardiac index (P<0.05) and pre-ejection period (P<0.05). Subsequent adaptation in the N+PH group was significantly slower for pre-ejection period (P=0.03). Finally, the N+PH group showed delayed recovery in heart rate (P=0.03), diastolic blood pressure (P<0.05), and pre-ejection period (P=0.007). In conclusion, the heightened reactivity, lack of adaptation, and delayed recovery occur in the sympathetic system of normotensive subjects at genetic risk of hypertension, specifically in beta-adrenergic responses (pre-ejection period). The parasympathetic response (mean successive heartbeat time difference) was not different. Increased cardiac output reactivity in the N+PH group (P<0.05) thus precedes any difference in blood pressure reactivity (P<0.99). Delayed recovery of diastolic blood pressure is also found in the N+PH group (P<0.05), which suggests lower baroreceptor sensitivity. Since delayed recovery in heart rate (P=0.03), and diastolic blood pressure (P<0.05) occur in N+PH subjects even before the corresponding changes in reactivity (P>0.10) or adaptation (P>0.07) are seen, these recovery impairments may be among the earliest precursors to the development of essential hypertension in this population. Finally, PH group haemodynamic differences suggest that these traits (reactivity, adaptation, and recovery) may constitute early 'intermediate' phenotypes in the pathogenesis of hypertension.

Adaptation, Physiological↗

PubMed1999

The systematic assessment of short-term functional recovery after major joint arthroplasty.

Despite extensive information about long-term recovery from major joint arthroplasty, little attention has been given to the measurement of functional recovery in the immediate postoperative period. Therefore assumptions about the importance of physical therapy during this period remain untested. We devised a way of recording functional recovery before discharge, based primarily on the achievement of objective milestones. This was incorporated into routine physiotherapy practice and applied to sequential patients undergoing elective hip (n = 163) or knee (n = 66) replacement. Six months later, we followed up 160 patients, of whom 145 completed questionnaires to assess subjective physical and emotional state and functional recovery. The method was sensitive to known influences on pace of recovery, including type of arthroplasty (hip vs knee) and surgeons' differing requirements for mobilization. In addition, we were able to confirm and quantify sources of variation in functional recovery which previously were suspected but unconfirmed: in particular, the timing of early mobilization. Outcome at 6 months was unrelated to objective functional recovery in hospital, although fatigue and wellbeing at this time were predicted by physiotherapists' subjective assessment of patients' motivation before discharge. The findings can be used to inform patients and as a source of comparison data for the assessment of functional recovery in other centres. More importantly, the procedure reported may be applied to quantify functional recovery in routine practice and thereby expose variability in recovery to scientific scrutiny.

Aged↗

PubMed2002

Sex differences in QTc interval and QT dispersion: dynamics during exercise and recovery in healthy subjects.

BACKGROUND: Sex differences have been described in resting cardiac repolarization and susceptibility to torsade de pointes in humans. This study compares the QT-interval and QT-dispersion dynamics during exercise and recovery between healthy men and women. METHODS: Twenty healthy subjects (10 males aged 30 +/- 4 years, 10 females aged 31 +/- 11 years) underwent symptom-limited bicycle ergometry followed by a 10-minute recovery period. Digital 12-lead electrocardiograms (ECG) were recorded every 10 seconds during exercise and recovery. For each lead, the QTp interval (Q onset to T peak) was automatically measured by use of QT Guard (GE Marquette, Milwaukee, Wis). QTp dispersion was defined as the difference between the maximum and minimum QTp for each ECG. To quantify QT dynamics, we fit the QTp in lead V(3) (QTpV(3)) versus cycle length (CL) relationship to a quadratic function during exercise and recovery with nonlinear regression analysis. Similar regression analysis was performed for the QTp dispersion versus CL relationship. RESULTS: At baseline, QTpcV(3) was longer in women than in men (338 +/- 25 vs 278 +/- 15 ms, P <.0001), but QTp dispersion was similar (35 +/- 18 vs 41 +/- 19 ms). At peak exercise, QT dispersion decreased compared with baseline in both men and women. During exercise and recovery, women had a steeper QTpV(3)-CL relationship. QTpV(3) hysteresis, a measure of the exercise and recovery QTpV(3)-CL curve separation, was greater in women than in men when measured 1 minute into recovery (33 +/- 20 vs 6 +/- 8 ms, P <.001). No sex difference in QTp-dispersion-rate adaptation was observed during exercise or recovery. CONCLUSIONS: Healthy women exhibit greater QT-interval-rate adaptation during both exercise and recovery than men, resulting in more QT-interval hysteresis. Greater QT prolongation during decelerating heart rates in recovery may play a role in increasing proarrhythmia risk in women.

Adult↗

PubMed1997

Recovery of Ca2+ pools and growth in Ca2+ pool-depleted cells is mediated by specific epoxyeicosatrienoic acids derived from arachidonic acid.

Depletion of Ca2+ pools using the irreversible Ca2+ pump blocker, thapsigargin, induces DDT1MF-2 smooth muscle cells to enter a stable nonproliferative state. Reversal of this state can be mediated by high (20%) serum treatment, which induces new Ca2+ pump protein, return of Ca2+ pools, and reentry of cells into the cell cycle; the effect of serum can be mimicked by the essential fatty acids (EFA), arachidonic, linoleic, and alpha-linolenic acids (Graber, M.N., Alfonso, A., and Gill, D.L., (1996) J. Biol. Chem. 271, 883-888). The possible requirement for EFA metabolism in inducing recovery of Ca2+ pool-depleted growth-arrested cells was investigated. Neither cyclooxygenase or lipoxygenase inhibitors had any effect on arachidonic acid-induced growth recovery of thapsigargin-treated cells. In contrast, the cytochrome P-450 epoxygenase inhibitors, SKF525A and metyrapone, substantially reduced arachidonic acid-induced recovery of growth while having minimal effects on control cell growth. Both epoxygenase inhibitors completely prevented the arachidonic acid-induced recovery of bradykinin-releasable Ca2+-pumping pools, whereas cyclooxygenase and lipoxygenase inhibitors had no effect. The effectiveness of the four cytochrome P-450 metabolites of arachidonic acid on recovery of Ca2+ pools were compared; 8,9- and 11,12-epoxyeicosatrienoic acid (EET) at 1.5 microM were completely effective in recovering agonist-sensitive Ca2+ pools, whereas the 5,6- and 14,15-EETs were without effect. SKF525A did not block the action of 8,9- or 11, 12-EET indicating further P-450 metabolism was not required. Hydration of the active EET molecules prevented Ca2+ pool recovery since the dihydroxy-derivatives of both 8,9- and 11,12-EET were ineffective. The specificity of effectiveness among EET molecules for subsequent resumption of growth of thapsigargin-treated cells was the same as for Ca2+ pool recovery. Significantly, the P-450 inhibitors, SKF525A and metyrapone, both prevented the action of 20% serum in inducing recovery of thapsigargin-treated cells, whereas cyclooxygenase and lipoxygenase inhibitors were ineffective, indicating that EFAs are the active component within serum that is responsible for recovery of Ca2+ pool-depleted cells. The specific action of EETs in mediating recovery of Ca2+ pools and growth of thapsigargin-treated cells represents not only a novel action of epoxygenase products from EFAs, but also a potentially significant new signaling pathway that may effect translational control and regulate transition from a stationary to proliferative growth state.

8,11,14-Eicosatrienoic Acid↗

PubMed1998

Biology of neurological recovery and functional restoration after spinal cord injury.

OBJECTIVE: This article reviews the anatomic and pathophysiological bases for recovery of neurological function after experimental or clinical spinal cord injury (SCI). METHODS: Current knowledge regarding the recovery of neurological function after experimental or clinical SCI was reviewed to determine the biological basis of neurological recovery. RESULTS: There is a great propensity for recovery after clinical or experimental SCI. An examination of the anatomic basis of recovery indicates that there is a potential for both root and cord recovery, with the latter involving recovery of both gray and white matter of the cord. Resolution of acute injury events, such as hemorrhaging, and resolution of secondary pathophysiological processes, such as ischemia and excitotoxicity, can each account for recovery. The third recovery mechanism involves regrowth or regeneration of nervous tissue, resulting from either inherent or induced processes. CONCLUSION: During the Decade of the Brain, there has been a profusion of very promising in vitro and in vivo studies that have shown enhanced neurological recovery after experimental or clinical SCI.

Animals↗

PubMed1999

Biomechanics of increased exposure to lumbar injury caused by cyclic loading. Part 2. Recovery of reflexive muscular stability with rest.

STUDY DESIGN: Electromyographic responses from the lumbar multifidus muscle of the cat were recorded in vivo during 50 minutes of cyclic loading followed by 2 hours of rest. OBJECTIVE: To determine the rate of recovery of reflexive muscular stabilizing activity resulting from rest after viscoelastic laxity induced by 50 minutes of cyclic loading. SUMMARY OF BACKGROUND DATA: Muscular forces from agonists and antagonists were repeatedly shown to be the most significant stabilizing structures of the lumbar spine. Reflexive muscular coactivation force from the multifidus muscle elicited by mechanoreceptors in the spinal viscoelastic structures were, however, shown to diminish drastically with the onset of laxity in the viscoelastic structures. Data describing the rate of recovery of reflexive muscular coactivation forces resulting from rest after cyclic loading were not found. METHODS: Cyclic loading of the lumbar spine at 0.25 Hz was applied to L4-L5 for 50 minutes while electromyograms from the multifidus muscles of L1-L2 to L6-L7 were recorded. A rest period of up to 2 hours was given, during which electromyographic responses and load were measured every 10 minutes to sample recovery of laxity and reflexive muscular activity. RESULTS: Load and electromyographic response demonstrated an exponential decrease during the 50 minutes of cyclic loading. The first 10 minutes of rest allowed a significant recovery in laxity and muscle activity, with additional slow recovery over the next 20 to 30 minutes. The electromyographic response and load were increasing at an extremely slow rate thereafter. Overall, 2 hours of rest yielded only a 20% to 30% recovery in electromyographic response. Full recovery was never observed. A biexponential model was developed to predict loss and recovery of reflexive muscular activity and viscoelastic tension with laxity. CONCLUSIONS: Laxity in the viscoelastic structures of the lumbar spine desensitizes the mechanoreceptors within and causes loss of reflexive stabilizing forces from the multifidus muscles. The first 10 minutes of rest after cyclic loading results in fast partial recovery of muscular activity. However, full recovery is not possible even with rest periods twice as long as the loading period, placing the spine at an increased risk of instability, injury, and pain.

Animals↗

PubMed2002

Cadaveric-donor organ recovery at a hospital-independent facility.

BACKGROUND: Of the many logistic issues addressed throughout the cadaveric organ donation process, timely access to the operating theater for surgical recovery of organs and tissues can be one of the most problematic. Delay in recovery adds to cost, risks organ viability, and compounds donor family anguish with compromise to donation consent. METHODS: From March 1 to November 30, 2001, 25 cadaveric donors were selected and successfully transferred from local donor critical care units to an off-site facility, which was constructed, equipped, and staffed to allow surgical recovery of organs and tissues. Assessment of the recovery process and outcome results was compared to 42 consecutive, hospital-based, organ recoveries within the Mid-American Transplant Services (MTS) organ procurement organization region. RESULTS: Twenty-five MTS-facility and 42 hospital organ recoveries were successfully conducted with no technical losses and satisfactory function in all 206 transplanted organs. From the MTS donor group, 7 hearts, 4 lungs, 21 livers, 28 kidneys, and 5 pancreases were successfully transplanted. Statistically significant in the MTS group was higher donor age (44.1 vs. 30.2 years), shorter total donor management time (539 vs. 718 min), reduced delay in start of surgery (25 vs. 77 min), shorter cold ischemia time for recovered pancreases (355 vs. 630 min), and reduced mean cost per donor ($10,636 vs. $12,918). There was no significant difference in race, gender, cause of death, vasopressor requirements, organs per donor recovered (3.12 vs. 3.62) or transplanted (2.60 vs. 3.36), rate of tissue recoveries (68% vs. 67%), total operating room time (207 vs. 200 min.), or cold ischemia time (excluding pancreas). CONCLUSIONS: Cadaveric-donor multiorgan and tissue recovery at this hospital-independent facility was successfully accomplished in a manner indistinguishable from conventional hospital organ and tissue recovery. The intended objectives of improved access to the operating theater were realized along with the added benefit of significant cost savings and convenience to hospital personnel and surgical recovery teams.

Cadaver↗

PubMed2004

In vivo embryo recovery rate by laparoscopic technique from rabbit does selected for growth rate.

Rabbit does from R line selected for growth rate present a low reproductive performance and this study aimed to evaluate both the recovery efficacy and viability of recovered embryos after vitrification and the reproductive performance of donor does subjected to in vivo recovery. Does were divided into three groups: 28 does without in vivo recovery (control), 25 does in which in vivo recovery was started in the nulliparous state (group 1) and 30 does with at least one litter before in vivo recovery (group 2). Does were superovulated with a single subcutaneous injection of 50 IU of equine chorionic gonadotropin (eCG) per female, and were then artificially inseminated 60 h later and immediately administered an intravenous dose of 75 IU of human chorionic gonadotropin (hCG) per female. Does from group 1 and 2 were recovered in vivo 76-80 h post-insemination by repeated laparoscopies at one to four times and permitted one or two parturitions between recoveries [in vivo (IV) recovery]. At the end of the experiment, about 16 does of all groups were recovered post-mortem (PM recovery). All normal embryos were vitrified, devitrified and then cultivated in vitro to evaluate the viability after thawing. A significant increase in the ovulation rate was found in does recovered PM than in those recovered IV in the nulliparous state. However, no significant differences were observed in the recovery rate, the donor rate, the number of normal embryos recovered with at least one normal embryo per doe and the viability after thawing between the PM and IV groups. A significant decrease in the fertility rate, total born, live born and weaned kids was found for does from group 1 in comparison with does from group 2. Results support the use of repeated laparoscopy to increase the number of recovered embryos per donor doe especially in such R line does, if they are permitted to produce at least one litter before the beginning of in vivo recovery.

Animals↗

PubMed2006

Inducible and neuronal nitric oxide synthases (NOS) have complementary roles in recovery sleep induction.

Sleep homeostasis is the process by which recovery sleep is generated by prolonged wakefulness. The molecular mechanisms underlying this important phenomenon are poorly understood. We have previously shown that nitric oxide (NO) generation increases in the basal forebrain (BF) during sleep deprivation (SD). Moreover, both NO synthase (NOS) inhibition and a NO scavenger prevented recovery sleep induction, while administration of a NO donor during the spontaneous sleep-wake cycle increased sleep, indicating that NO is necessary and sufficient for the induction of recovery sleep. Next we wanted to know which NOS isoform is involved in the production of recovery sleep. Using in vivo microdialysis we infused specific inhibitors of NOS into the BF of rats during SD, and found that an inhibitor of inducible NOS (iNOS), 1400W, prevented non-rapid eye movement (NREM) recovery, while an inhibitor of neuronal NOS (nNOS), L-N-propyl-arginine, decreased REM recovery but did not affect NREM recovery. Using immunoblot analysis we found that iNOS was not expressed during the spontaneous sleep-wake cycle, but was induced by prolonged wakefulness (increased by 278%). A known iNOS inducer, lipopolysaccharide, evoked an increase in sleep that closely resembled recovery sleep, and its effects were abolished by 1400W. These results suggest that the elevation of NO produced by induction of iNOS in the BF during prolonged wakefulness is a specific mechanism for producing NREM recovery sleep and that the two NOS isoforms have a complementary role in NREM and REM recovery induction.

Adenosine↗

PubMed1997

A longitudinal examination of functional recovery among older people with subcapital hip fractures.

OBJECTIVE: Few studies have examined the time-dependent change in functional recovery along with the factors that affect the change among older hip fracture patients. The focus of this study is to examine the predictors of functional recovery in community-dwelling older people with subcapital fractures using longitudinal data analysis methods. DESIGN: A 1-year prospective study. Information was obtained through structured interviews following surgery and at 2, 6, and 12 months after hospital discharge and from medical chart review. SETTING AND PATIENTS: The sample consisted of 312 community-dwelling older adults, admitted to one of the seven Baltimore area hospitals with a subcapital fracture, who received either internal fixation or hemiarthroplasty. RESULTS: The longitudinal data analysis using mixed-effects regression indicates that time and prefracture physical activities of daily living (PADL) had a significant association with PADL functional recovery over the course of 1 year. Among those 85 years and older, those who were disoriented after surgery had poorer PADL functional recovery over time than those who were not disoriented. Also, recovery in instrumental activities of daily living (IADL) was associated significantly with time, prefracture IADL function, unsteady gait prefracture, hospital length of stay, and discharge to an institution. The type of surgical procedure performed was not associated significantly with either PADL or IADL functional recovery. CONCLUSIONS: The factors that are related to functional recovery in this study shed light on the complexity of the recovery process in hip fracture patients. The rate of recovery in postsurgical PADL and IADL function is not constant over time; postsurgical IADL function among disoriented patients (without dementia) continues to deteriorate over time compared with the nondisoriented group; this difference in trends of deterioration on IADL function is most profound in the oldest-old aged group, those 85 and older. The types of surgical procedure performed was not significantly associated with postsurgical functional recovery.

Activities of Daily Living↗