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PubMed2004

Comparison of analytical methods and the influence of milk components on milk urea nitrogen recovery.

The objectives of this study were to compare analytical instruments used in independent laboratories to measure milk urea nitrogen (MUN) and determine whether any components in milk affect the recovery of MUN. Milk samples were collected from 100 Holstein cows fed one ration in a commercial dairy herd with a rolling herd average of 9500 kg. Half of each sample was spiked with 4 mg/dL of urea N, while the other half was not, to determine recovery. Both milk samples (spiked and not spiked) were sent to 14 independent laboratories involved in the MUN Quality Control Program through National Dairy Herd Improvement Association and analyzed for MUN, fat, protein, lactose, somatic cell count (SCC), and total solids. The laboratories analyzed MUN using CL-10 (n = 3), Skalar (n = 2), Bentley (n = 3), Foss 4000 (n = 3) or Foss 6000 (n = 3) systems. When recovery of MUN was evaluated among the 5 analytical methods, the mean recoveries for the Bentley, Foss 6000, and Skalar systems were 92.1 (SE = 2.76%), 95.4 (SE = 10.1%), and 95.1% (SE = 7.61%), respectively, and did not differ from each other. However, MUN recovery was 85.0% (SE = 2.8%) for the CL-10 system and 47.1% (SE = 9.9%) for the Foss 4000 system, both of which differed from the other 3 systems. Recoveries from Foss 4000, Foss 6000, and Skalar varied among laboratories using the same instrument. As initial MUN concentration increased, recovery decreased using the Bentley and CL-10 systems. Increasing milk fat resulted in a decrease in recovery using the Foss 6000 system. For 4 of the 5 methods, recovery of MUN was not associated with specific milk components. Recovery of MUN was inconsistent for laboratories using the Foss 4000 and the Foss 6000 method and using these systems may result in an overestimation or underestimation of MUN.

Animals↗

PubMed1999

Can we predict recovery in chronic fatigue syndrome?

PURPOSE: To determine if selected demographic or clinical features of chronic fatigue syndrome (CFS) are associated with recovery. PATIENTS AND METHODS: A follow-up questionnaire was mailed to 341 patients who had been ill on average for nine years to ascertain "recovery" rate (defined as self-reported recovery on a visual analog scale). Baseline demographic and clinical features (functional status and psychological status) recorded at the time of the initial (baseline) clinical visit were analyzed for their association with recovery at the time of follow-up. RESULTS: Of the 177 patients who responded to the follow-up questionnaire, only 21 (12%) reported "recovery." Patients with higher levels of physical and social functioning and lower levels of anxiety and obsessive-compulsiveness at baseline were more likely to report recovery at follow-up (p < 0.05). No specific demographic characteristics were associated with recovery. CONCLUSION: These findings support previous research that complete recovery from CFS is rare and that patients with less severe illness at the initial clinic visit are more likely to have a positive prognosis for recovery. However, considerable overlap in illness severity was observed between the recovered and nonrecovered groups, suggesting that accurate prediction of recovery in individual CFS patients is not currently feasible.

Activities of Daily Living↗

PubMed2000

In vitro recovery of triamcinolone acetonide in microdialysis.

The purpose of this study was to assess the factors affecting the calibration of the microdialysis probe for the in vitro recovery of triamcinolone acetonide (TA). Recoveries of TA were determined in microdialysis, retrodialysis, and no-net flux methods. Experiments were performed at room temperature or 37 degrees C while the reservoir medium was either stirred or unstirred. The effect of the viscosity of the medium on the recovery was studied using methylcellulose gel spiked with TA. Recovery was also calculated by the no-net-flux method in Ringer's solution and in plasma. Stirring the medium increased the recovery of TA by 30%. The recovery was higher at 37 degrees C under stirred or unstirred conditions and was same in either direction of dialysis. Increasing viscosity of the reservoir medium decreased the recovery (55% in Ringer's solution to 14% in 20% methylcellulose gel). Recovery from spiked plasma under stirred conditions was only 15% and this shift which was also seen in no-net-flux method was accounted for by the protein binding. Binding of TA, determined by ultrafiltration, was 20% in 5% gel and 81% in plasma. The recovery determined by the no-net-flux method was similar to the retrodialysis result. Stirring, temperature, viscosity and protein binding in the reservoir medium affected the in vitro recovery of TA.

Administration, Topical↗

PubMedDate not supplied

Application of recovery tests in the validation of immunoassays for assessing the immunogenicity of B. anthracis PA vaccine.

In the quantitative assessment of polyclonal serum antibodies, the complex composition and characteristics of the analyte population (serum antibodies) restricts the capability of constructing appropriately defined calibration standards. This fact limits the application of the conservative recovery tests to the validation of immunoassays aimed at determining serum antibody levels. The present report describes a modification of recovery tests that overcomes this impediment. The modified approach is based on a dilution analysis system, where a given immune serum is serially diluted in normal serum and the antibody titers in each of the derived diluted samples are then determined. Expected sample titers (calculated on the basis of the relevant dilution factors) are plotted against the respective observed results, and the resulting recovery curve is then examined by means of a regression analysis, according to the standard rules of the conservative recovery analysis. This approach was tried with two immunoassay systems, Enzyme Linked Immunosorbent Assay (ELISA) and Neutralizing Antibodies (NtAb) immunoassays, aimed at assessing the immunogenicity in guinea pigs of B. anthracis protective antigen (PA) vaccine. In a series of feasibility studies using a recovery simulation model (dilutions made in the immunoassay diluent, rather than in normal serum) the average recovery levels in ELISA and NtAb immunoassays were 0.99 +/- 0.011 and 1.02 +/- 0.04 respectively, and the 99% confidence intervals contained the target 100% value. Regression lines were proved to be linear demonstrating R > 0.97 in all cases. The 99% confidence intervals around the observed slopes and intercepts always contained the corresponding target values 1 and 0. The relative standard deviation (RSD) in the ELISA and NtAb immunoassays was found to be 0.01 and 0.025 respectively. All of the above experimental results were not affected by the serum antibody titer, or by day-to-day variations embodied in these immunoassay systems. When true recovery tests were applied to the above immunoassays, essentially identical results were obtained. In both assays the correlation coefficients were in the range of 0.96-1, recoveries were found to be in the range of 0.90-1.06, and RSD values were in the range of 0.02-0.025. All the recovery deviations from the target value of 1 were not statistically significant. The hitherto observed experimental findings illustrate the capability of the dilution analysis system to allow the application of recovery tests to the validation of quantitative immunoassays, which are based on the procedure of serum titrations.

Animals↗

PubMed2002

Exercise improves recovery of ventilation in male asthmatic subjects in the steady state.

The effect of a three-minute exercise step test (submaximal) on the recovery of tidal volume (V(T)), respiratory frequency (f(R)) and minute ventilation (V(E)) has been investigated in non-asthmatic subjects, asthmatic subjects that exercise regularly and asthmatics that do not participate in regular exercise. Recovery was observed over twenty minutes at two-minute intervals. Ten male non-asthmatic subjects (NAS) (mean age 20.7+/- 0.4 yr), six male asthmatic subjects (20.5+/- 0.5 yr) that exercised regularly (EAS) and six male asthmatic subjects (20.8+/- 0.5 yr) that did not exercise regularly (NEAS) were studied. Exercise significantly increased all the measured variables in all the groups of subjects (P<0.001 in each case). At the end of the 20th minute, magnitude of recovery of V(T) was 123.3+/- 4.5% in NAS, 102.4+/- 5.1% in EAS (p<0.001) and 87.9+ 5.4% in NEAS (p<0.001). Mean rate of recovery of V(T) was highest (6.3%/min) in NAS and least in NEAS (4.4%/min). At the end of the (T)observation period, recovery of respiratory frequency (f(R)) was 100.0+/- 5.0% in NAS, 100.0+/- 4.5% in EAS and 89.2+/- 3.0 in NEAS. Mean rate of recovery of f(R) was 5.0%/min in NAS and EAS subjects respectively and 4.4%/min in NEAS subjects. Also, at the end of the 20th minute, the magnitude of recovery of V(E) was similar between NAS and EAS (105.1+/- 1.5% and 101.6+/- 1.75% respectively). Recovery of V(E) was significantly less in NEAS (93.9+/- 2.5%; p<0.01). Mean rate of recovery of V(E) was similar between NAS and EAS subjects (5.0%/min in each case) and 4.1%/min in the NEAS subjects. Thus regular exercise improves the recovery of ventilatory parameters in asthmatic subjects.

Adult↗

PubMed2004

[The dynamics of microtubule repolymerization in a cell: rapid growth from the centrosome and slow recovery of free microtubules].

According to the current view, the microtubule system in animal cells consists of two components: microtubules attached to the centrosome (these microtubules stretch radially towards the cell margin), and free microtubules randomly distributed in the cytoplasm without visible association with any microtubule-organizing centers. The ratio of the two sets of microtubules in the whole microtubule array is under discussion. Addressing this question, we have analysed the recovery of microtubules in cultured Vero nucleated cells and cytoplasts, with and without centrosomes in these. Cells were fixed at different time points, and individual microtubules were traced on serial optical sections. During a slow recovery after cold treatment (4 degrees C, for 4 h; recovery at 30 degrees C) polymerization of microtubules started mainly from the centrosome. At early stages of recovery the share of free microtubules made about 10% of all microtubules, and their total length increased slower than the lenght of centrosome-attached microtubules. During a rapid recovery after nocodazole treatment (10 microg/ml, 2 h; recovery in drug-free medium at 37 degrees C), the share of free microtubules was about 35%, but their total length increased slower than the length of centrosome-attached microtubules. In 6-8 min (rapid recovery) or 12-16 min (slow recovery), tips of centrosomal microtubules reached the cell margin, and their increased density made it impossible to recognize individual microtubules. However, under the same conditions in cytoplasts without centrosomes the normal number of microtubules recovered only in 60 min, which enabled us to suppose that the complete recovery of microtubule system in the whole cells may be also rather long. When the first centrosomal microtubules reached the cell margin, the optical density of microtubules started to decrease from the centrosome region towards the cell margin, according to the exponential curve. Later on, the optical density in the centrosome region and near the cell margin remained at the same level, but microtubule density increased in the middle part of the cell, and in 45-60 min the plot of the optical density vs the distance from the centrosome became linear, as in control cells. Since no significant curling of microtubules occurs near the cell margin, the density of microtubules in the endoplasm may increase due only to polymerization of free microtubules. We suppose that in cultured cells the microtubule network recovery proceeds in two stages. At the initial stage, a rapid growth of centrosomal microtubules takes place in addition to the turnover of free microtubules with unstable minus ends. At the second stage, when microtubule growth from the centrosome becomes limited by the cell margin, a gradual extension of free microtubules occurs in the internal cytoplasm.

Animals↗

PubMed1991

Macular recovery recorded by nyctometry in insulin-dependent diabetes mellitus.

Macular recovery, recorded by nyctometry, has been studied in children and adults with IDDM. Impaired macular recovery was found only in a few eyes with normal visual acuity without visible signs of retinopathy, in more than one third of the eyes with slight background retinopathy, in the majority of eyes with advanced background retinopathy, and in all eyes with proliferative retinopathy, suggesting that severe neurosensory disturbance accompanies visible vasculopathy in the retina. A significant correlation between impairment of macular recovery and reduction of the oscillatory potentials of the electroretinogram was found in groups with slight background retinopathy, severe background retinopathy, and proliferative retinopathy, suggesting that changes in these two neurosensory variables concurrently reflect abnormalities in the inner part of the retina corresponding to second order interneuronal connections. Near-normal blood glucose control obtained by continuous subcutaneous insulin infusion (CSII) significantly enhanced both normal and impaired macular recovery. This effect was more pronounced in patients with short duration of IDDM; no effect was found by short-term treatment of a selected group of patients with long-standing metabolic dysregulation and long disease duration. Young patients with normal or slightly impaired macular recovery might possibly benefit from sustained near-normal blood glucose control. Large-scale and long-term studies are needed to confirm this assumption. In a 3-year investigation with CSII, progression into proliferative retinopathy could not be prevented in those patients initially displaying severely impaired macular recovery. However, visible retinopathy did not progress in eyes, in which improvement of within normal or slightly reduced recovery performances had been recorded 6 months in advance. It is suggested that a state of irreversibility, 'point of no return', of retinal pathology, indicated by a certain severe impairment of neurosensory function, might exist. Prospective investigations, 5 years with adults, and 6 years with children, revealed progressive decline in recovery performances during the years of observation, even in eyes with no or slight deterioration of the retinal appearance; and in some eyes retaining no or slight retinopathy, severe impairment of performance developed. Both investigations showed significant differences of initial macular performance between the groups developing proliferative retinopathy and the groups remaining non-proliferative in the periods of observation, suggesting that abnormally reduced recovery performance precede by months or a few years the development of proliferative retinopathy. The development into proliferative retinopathy is generally preceded by increasing stages of background retinopathy running parallel to increasingly reduced macular recovery. The present study has demonstrated large variances of performances both in normal and diabetic individuals.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed1986

Loss in cell killing effectiveness of anticancer drugs in human gastric cancer clones due to recovery from potentially lethal damage in vitro.

The ability of human gastric cancer clones to recover from potentially lethal damage was studied. Recovery was greatest following treatments with bleomycin or Adriamycin; the recovery ratios (i.e., survival) increased almost 8-fold during a posttreatment incubation period. Recovery was also possible following treatments with actinomycin D, 1,2:5,6-dianhydrogalactitol, and diaziquone; however, the recovery ratios never increased above 2. No recovery was observed following treatment with 5-fluorouracil. Recovery from potentially lethal damage may be related to the heterogeneity in survival responses observed following treatment with some anticancer drugs. Bleomycin and Adriamycin treatments result in large heterogeneous survival fractions among these human stomach cancer clones, and the potentially lethal damage recovery ratios were larger (and variable). However, actinomycin D, diaziquone, and 1,2:5,6-dianhydrogalacticol produce very uniform killing effects in these cells and the recovery ratios are very much smaller and less variable. Finally the large amount of recovery observed after bleomycin or Adriamycin treatments resulted in the loss of cell killing effectiveness of the agents. Because the survival fractions increased during the recovery period, the net effect on cell killing was reduced to an amount normally obtained with doses that were up to six times smaller.

Antineoplastic Agents↗

PubMed1989

Recovery to +1Gz and +2Gz following +Gz-induced loss of consciousness: operational considerations.

With the development of aircraft autorecovery technology, the need to understand the effects of potential inflight recovery profiles on human physiology has become important. Eight male volunteer subjects were exposed to +7Gz with an onset rate of 6 G.s-1 until they were unconscious. The subjects did not wear anti-G suits and did not perform anti-G straining maneuvers. The subjects controlled the centrifuge utilizing an F-16A stick, thereby deliberately self-inducing their unconsciousness. Following +Gz-induced loss of consciousness (G-LOC), recovery to the usual +1Gz level was compared to recovery to a +2Gz level by comparing absolute, relative, and total incapacitation times. The mean (+/- S.D.) absolute incapacitation time (period of unconsciousness) was 11.9 +/- 2.9 s for recovery to a +1Gz level and 12.9 S (+/- 6.9 S.D.) for recovery to a +2Gz level. The mean relative incapacitation time (period of confusion/disorientation) was 3.6 +/- 2.3 s for recovery to a +1Gz level as compared to 2.9 +/- 0.8 s for recovery to a +2Gz level. The total incapacitation time (sum of the absolute and relative incapacitation) was 15.6 +/- 2.7 s for recovery to a +1Gz level and 16.0 s (+/- 6.8 S.D.) for recovery to a +2Gz level. No significant differences in any of the incapacitation times were found when comparing recovery to +1Gz and +2Gz. The mean time from the onset of +Gz-stress to the onset of unconsciousness was approximately 7 s.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1986

Determination of activation and recovery sequences and local repolarization durations from distant electrocardiographic leads.

Experiments using an isolated heart, perfused by a support dog were done to compare estimates of activation times, recovery times and activation recovery intervals from cardiac surface electrograms to estimates from distant electrocardiographic leads and to known features concerning normal activation and recovery sequences. The isolated heart was suspended in a tank with 600 electrodes located at sites 0.5 cm to 7.5 cm from the surface of the heart. In some experiments up to 330 electrodes, spaced 2.5 mm to 5 mm apart on a nylon matrix, were placed on the cardiac surface. Recordings were made during atrial and ventricular drives at cycle lengths of 400 msec to 700 msec. The minimum QRS and maximum T derivatives and the interval between them were taken as the estimates of activation times, recovery times and activation recovery intervals respectively. Maps of activation sequence, and the distribution of activation recovery intervals were constructed from cardiac surface data and from data recorded at various distances from the heart. Regions of earliest and latest activation and recovery times, range between the earliest and latest activation and recovery times and the average activation recovery interval could be determined from data recorded at distances from the heart comparable to the distance between the cardiac and thoracic surfaces. The results indicate that electrocardiographic signals, recorded with regionally sensitive distant leads, contain considerable detail concerning local activation and recovery sequences and the distribution of repolarization properties. This information should be useful in the evaluation of patients and in guiding drug therapy.

Action Potentials↗

PubMed1985

Delayed recovery following acute gastroenteritis in children.

The purpose of this study is to identify the factors which are responsible for the delayed recovery in acute gastroenteritis (GE) in children. 372 children admitted to the University Department of Paediatrics were reviewed. 29 children (7.8%) required prolonged hospitalisation because of diarrhoea (delayed recovery group) and 343 children (92.2%) had short hospitalisation (normal recovery group). There was no significant difference in terms of race, sex, duration of symptoms before admission and severity of dehydration between the two groups. However, those with delayed recovery were significantly younger (mean age 14.4 months) than the normal recovery group (mean age 23.3 months). In the delayed recovery group, 32% were due to bacterial diarrhoea compared to 5.0% in the normal recovery group (p less than 0.05). The body weight of 31% of the delayed recovery group was less than the 3rd percentile (p less than 0.05). It is concluded that children take a longer time to recover from the bacterial GE than from non-bacterial GE. The younger children will take a longer time to recover from an episode of diarrhoea. The body weight also plays an important role in recovery, reflecting the importance of nutrition in the process of recovery.

Acute Disease↗

PubMed1976

Recovery of cells from induced, potentially lethal damage.

The recovery of mammalian cells after a variety of treatments is, in part, governed by the cells' ability to deal with repairable, but potentially lethal, lessions. Kinetics of such recovery show a T1/2 of 10-20 hours after ultraviolet (UV) irradiation and 1.5-2.5 hours after X-irradiation. Recovery after exposure to mechlorethamine and bleomycin (BLM) is similar to X-ray recovery; after methylmethane sulfonate, recovery has components similar to X-ray and UV recovery. The sequential treatments of cells with 43 degrees C hyperthermia and X-rays (or reverse order) modify both the immediate survival after treatments as well as the subsequent recovery kinetics. Very similar results are found after BLM and hyperthermia treatments, suggesting strongly that after exposure to that drug a real repair system is operative. However, although recovery after X-irradiation is similar in vitro and in vivo, after BLM the site of treatment and of recovery strongly influences the magnitude and kinetics of recovery.

Bleomycin↗

PubMed1996

Influence of fluid absorption time on cell recovery in cytocentrifugation.

OBJECTIVE: To determine the absorption time required to give complete cell recovery in cytocentrifugation. STUDY DESIGN: A simplified model for cell recovery was outlined that relates cell recovery to the relative magnitude of cell sedimentation velocity (SV) and fluid velocity (FV) during cytocentrifugation. The recovery of blood leukocytes was measured at various relative values of the SV/FV ratio and plotted to provide an indication of the effect of the ratio on recovery and to identify the conditions necessary to yield complete cell recovery. RESULTS: As SV/FV approaches zero, cell recovery also approaches zero. As the SV/FV ratio increases, recovery increases toward a maximum of 100%. The fluid absorption time is a key factor in the SV/FV ratio, which also includes centrifugal force and sample volume. A preliminary evaluation of commercial equipment yielded a wide range of absorption characteristics. In addition, fluid flow can be slowed and the SV/FV ratio increased by adding macromolecules--e.g., bovine serum albumin--to the sample fluid. CONCLUSION: Cytocentrifugation has the capability of nearly complete cell recovery if conditions are selected that yield a high SV/FV ratio. Such recovery usually requires slowing the fluid flow rate beyond what is normally obtained in most commercial equipment.

Blood Sedimentation↗

PubMed1997

The impact of choice of muscle relaxant on postoperative recovery time: a retrospective study.

UNLABELLED: To test the hypothesis that the use of long-acting muscle relaxants is associated with prolonged postoperative recovery when compared with the use of shorter-acting relaxants, we undertook a retrospective study of 270 patients with induced paralysis recovering from general anesthesia. We calculated the mean recovery time associated with each muscle relaxant used. Regression analyses were performed to control for potential confounding of the results by length and type of surgery, as well as age and sex. Taking these into account, the adjusted difference in mean recovery time between patients receiving short- and intermediate-acting relaxants (mivacurium, atracurium, and vecuronium) versus those receiving long-acting relaxants (d-tubocurarine, pancuronium, and pancuronium and d-tubocurarine combination) was 30 min (95% confidence interval [CI] 8-53). The adjusted difference in mean recovery time between patients receiving vecuronium and those receiving pancuronium (i.e., the single most frequently used drug in each category) was 33 min (95% CI 1-66). Shortened recovery time accounted for an estimated average $37.95 decrease in recovery room charge per patient when vecuronium was used instead of pancuronium, versus a $22.84 increase in drug cost. Our data and analyses support the hypothesis that the use of long-acting muscle relaxants is associated with prolonged recovery after surgery and provide preliminary evidence that restricting the use of the more expensive, shorter-acting muscle relaxants may represent a false economy. IMPLICATIONS: In this retrospective study, the use of old-fashioned, inexpensive, long-acting paralyzing drugs was found to be associated with prolonged postoperative recovery. This has implications when deciding whether, as an economic measure, to restrict the use of the more expensive, shorter-acting paralyzing drugs, because prolonged recovery also has a price.

Adolescent↗

PubMed2005

Factors associated with recovery of independence among newly disabled older persons.

BACKGROUND: Recent evidence indicates that most older persons who develop disability in their activities of daily living (ADLs) regain independent function, but many of these persons subsequently experience recurrent disability. The aims of this study were to identify independent predictors of time to and duration of recovery of independent ADL function among newly disabled community-dwelling older persons. METHODS: From a cohort of 754 persons 70 years or older, we studied the 420 participants who experienced at least 1 episode of disability involving 1 or more key ADLs (bathing, dressing, walking, or transferring) during a median follow-up of 53 months. Comprehensive evaluations at baseline and every 18 months included demographic, medical, cognitive, psychological, social, behavioral, and physical factors. Activities of daily living function and hospital admissions were assessed during monthly telephone interviews, with a completion rate of 99.4%. RESULTS: Of the 420 newly disabled participants, 342 (81.4%) recovered independent ADL function after a mean +/- SD of 4.9 +/- 0.5 months. In multivariable proportional hazards analysis, habitual physical activity, mild disability (1-2 ADLs) at onset, and hospitalization in the month of disability onset were independently associated with shorter time to recovery. Among participants who recovered, 251 (73.4%) experienced recurrent disability or death after a mean +/- SD of 7.3 +/- 8.5 months. Younger age, greater habitual physical activity, higher functional self-efficacy, and shorter duration of the prior disability episode were independently associated with longer duration of recovery. CONCLUSIONS: Habitual physical activity is an independent predictor of time to and duration of recovery of independent ADL function among newly disabled community-dwelling older persons. Because the other independent predictors for time to recovery differ from those for maintenance of recovery, different mechanisms may underlie these 2 recovery outcomes, suggesting that different interventions may be required to promote recovery than to maintain independent ADL function after recovery.

Activities of Daily Living↗

PubMed2003

Does age influence early recovery from ischemic stroke? A study from the Hessian Stroke Data Bank.

Age is the most important risk factor for developing a stroke. In addition, age may also influence stroke recovery. To allow structured discharge planning, it may be important to consider the influence of age on stroke recovery during the early phase. We studied the effect of patient age on early stroke recovery in a cohort of 2219 unselected stroke patients. Data on functional status (Barthel Index Score) were collected prospectively within 24h after admission, after one week and at discharge for 2219 acute stroke patients treated in 1999 and 2000 at 7 neurological departments in the county of Hesse, Germany. Multiple regression analyses were used to test for an association between age, relative recovery and speed of recovery of ADL after stroke. More than half of the patients (58 %) improved in functional status during hospitalization. 37 % had no change in Barthel Index score and only a small number of patients (5 %) deteriorated during this period. Relative improvement decreased with increasing age: patients younger than 55 years showed an improvement of 67 % of the maximum possible improvement compared whith only 50 % for patients above 55 years (adjusted R(2) = 0.120, beta(age) = -0.130, p < 0.001). Age only had a small effect on the speed of recovery. For younger patients functional recovery was slightly faster (adjusted R(2) = 0.256, beta(age) = -0.080, p < 0.001). Despite its strong influence on case fatality, age is a poor predictor of functional recovery during the very early phase after stroke. Resulting functional recovery depends much more on the extent of the initial disability. Advanced age should not be regarded as a limiting factor in the early rehabilitation of stroke patients.

Adult↗

PubMed2004

Visual recovery following acute optic neuritis--a clinical, electrophysiological and magnetic resonance imaging study.

This study reports the prospective follow-up of a cohort of patients with acute optic neuritis examined with serial visual tests, visual evoked potentials (VEPs), conventional and triple-dose gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) to examine which factors are important in visual recovery. Thirty-three patients were recruited with acute unilateral optic neuritis. A clinical and VEP assessment was performed on each. Optic nerve MRI was performed using fast spin echo (FSE) (on all) and triple-dose Gd-enhanced T1-weighted sequences (n = 28). Optic nerve lesion lengths were measured. Serial assessments were performed on 22 of the patients up to one-year. Serial Gd-enhanced optic nerve imaging was performed on 15 of the patients until enhancement ceased. The final 30-2 Humphrey visual field mean deviation (MD) was 2.55 dB higher in patients in the lowest quartile of initial Gd-enhanced lesion length compared with the other quartiles (p < 0.01) but recovery was not related to the duration of enhancement. The initial recovery of Humphrey MD was 4.60 dB units per day in patients with good eventual recoveries (MD > -6.0 dB) and 0.99 dB per day in poor-recovery patients (p = 0.02).Good-recovery patients had mean central field VEP amplitudes 2.29 microV higher during recovery than poor-recovery patients (p = 0.047). The results suggest that factors which are associated with a better prognosis are: having a short acute lesion on triple-dose gadolinium enhanced imaging, higher VEP amplitudes during recovery and a steep gradient of the initial improvement in vision.

Adult↗

PubMed2006

Relation of ventricular premature complexes during recovery from a myocardial perfusion exercise stress test to myocardial ischemia.

Ventricular premature complexes (VPCs) during exercise have long been believed to be harbingers of increased mortality. A recent study has shown that VPCs during the recovery phase of a treadmill exercise test are more predictive of mortality than VPCs that develop during exercise. However, no study to date has examined the relation of VPCs in recovery to the presence of ischemia on myocardial perfusion imaging. We examined the database of perfusion imaging at the Duke University Medical Center from September 1993 to July 2003. We examined the incidence of VPCs during exercise, during the recovery phase, and during the 2 phases. Logistic regression modeling was used to evaluate the significance of VPCs during stress and during recovery in predicting ischemia. VPCs developed during recovery in 561 of 2,828 patients (19.8%). Compared with patients without VPCs during recovery, those with VPCs during recovery were more likely to have a history of hypertension (64.0% vs 56.9%, p = 0.002) and previous coronary artery bypass grafting (25.3% vs 17.1%, p = 0.001). They were also more likely to be older, men, and Caucasian, and to have 3-vessel coronary artery disease (31.9% vs 21.0%, p = 0.001). After adjusting for differences in patient characteristics, VPCs during recovery were significantly associated with ischemia (odds ratio 1.27, 95% confidence interval 1.04 to 1.56, p = 0.017), whereas VPCs during stress were not (p = 0.128). In conclusion, VPCs during the recovery phase of an exercise study are predictive of ischemia on myocardial perfusion imaging.

Adult↗