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PubMed2002

Abnormal delay in recovery of pulse rate in 9454 patients referred for treadmill exercise test to Cleveland Clinic, 1990-1997--an independent predictor of excess mortality.

OBJECTIVE: The objective of this article is to present results from the latest of 3 recent reports from the Cleveland Clinic on excess mortality associated with abnormal delay in the recovery of an elevated pulse rate produced in a treadmill exercise test. This is done in the context of a long-standing medical interest in this phenomenon and its prognostic significance (see Comment section). BACKGROUND: Delay in return of the pulse rate after exercise has long attracted medical interest as a potentially unfavorable prognostic factor. However, this has not become a factor in the interpretation of the treadmill exercise test. Cardiologist staff members of the Cleveland Clinic have recently studied the mortality predictive effect of delay in pulse recovery in 3 different cohorts of patients given a treadmill exercise test (modified Bruce protocol). The newest, largest and most complete of these studies is the source article for this report. STUDY DESIGN: This was an observational follow-up (FU) study with a median of 5.2 years (range 1.4-8.7 years). The patients were categorized as abnormal pulse recovery at 1 minute after peak exercise with decrease of only 12 beats per minute or less, and normal if >12 beats per minute. These classes were combined with dichotomous classes according to the exercise test result and with other associated risk factors. RESULTS: A good approximation of exposure was achieved for each of the 4 pulse recovery/exercise test groups. From numerical data in the article, it was possible to derive aggregate mean annual mortality rates for these groups and selected combinations of pulse recovery with other risk factors. Mortality was lowest (2.8 per 1000) in the group with pulse recovery and exercise test both normal (66% of the total patients screened), and this was used as the "expected" rate, without adjustment for any differences in age. On this basis the excess death rate (EDR) was about 7 per 1000 per year when either pulse recovery or exercise test was abnormal, and 28 per 1000 when both were abnormal. Similar levels of EDR were found in the combinations of pulse recovery with other risk factors. CONCLUSION: Abnormal pulse recovery after the treadmill exercise test is a powerful and independent predictor of significant excess mortality.

Exercise Test↗

PubMed2005

Depression, healing, and recovery from coronary artery bypass surgery.

BACKGROUND: Effects of postoperative depression on recovery from coronary artery bypass grafting have not been widely studied. OBJECTIVES: To evaluate emotional and physical recovery after bypass surgery and investigate associations between depressive symptoms and infections and impaired wound healing in patients with high and low levels of depressive symptoms. METHODS: A nonrandomized, comparative, longitudinal design was used to study 72 bypass surgery patients without serious noncardiac comorbidities who were available for follow-up after discharge. Patients completed questionnaires to assess depressive symptoms, emotional recovery, and physical recovery within 48 hours after extubation, at discharge from the hospital, and 6 weeks later and performed 6-minute walk tests at the last 2 times. Infections and impaired wound healing (as indicated by positive cultures, antibiotic treatment, or extra treatments, such as debridements or incisions and drainage) were identified by chart audit. RESULTS: At discharge, patients with higher depressive symptom scores (indicating more symptoms) reported poorer emotional recovery (P<.001) and poorer physical recovery (P=.007) and achieved shorter walking distances (P<.001) than did patients with lower scores (indicating fewer symptoms). Six weeks after discharge, emotional and physical recovery remained lower in patients with more depressive symptoms (P<.001). Infections and impaired wound healing were more common among patients with higher depressive symptom scores (46%) than among patients with lower scores (19%, P=.03). CONCLUSIONS: After bypass surgery, depressive symptoms are associated with infections, impaired wound healing, and poor emotional and physical recovery.

Aged↗

PubMed2006

Defining and achieving recovery from bipolar disorder.

Management of bipolar disorder in many ways is similar to the management of schizophrenia in that the goals in the treatment of both disorders are to avoid rehospitalization, manage behavioral symptoms, and promote functional recovery. This review will define functional recovery in bipolar disorder, discuss relapse prevention, and consider some implications for treatment. The most notable implication for treatment is that clinicians need to use stricter criteria when defining recovery in bipolar disorder. Recovery should not be defined merely by symptomatic remission or even syndromal remission; rather, recovery should include symptomatic recovery, syndromal recovery, functional recovery, and a return to an acceptable quality of life for the patient.

Bipolar Disorder↗

PubMed1989

The effect of hypoxia upon macular recovery time in normal humans.

Bright light illumination (photostress) of the macula produces a negative after-image in the form of a central scotoma. The time needed for restoring normal visual acuity function, "macular recovery time," may be measured using a nyctometer. We have measured the recovery in 30 normal men, aged 18 to 23 years, at sea level and at 8,000 ft (n = 10), 15,000 ft (n = 10), and 18,000 ft (n = 10) of simulated altitudes in a low pressure chamber. The degree of initial recovery (the first 30-40 s) was unaffected by hypoxia equivalent to 8,000, 15,000, and 18,000 ft. The recovery at 2 min was impaired by hypoxia at an altitude of 18,000 ft (p = 0.009) but not at 8,000 ft or 15,000 ft. The initial phase of recovery may represent the neural phase of macular function and appears to be more resistant to hypoxia than the recovery at 2 min, the latter probably being dominated by photochemical recovery. The study establishes a critical level of hypoxia where complete recovery of macular sensitivity is not achieved.

Adolescent↗

PubMed1989

Anthracyclines added to the conditioning regimen for allogeneic bone marrow transplantation are associated with a slower haematopoietic recovery.

Factors which may influence haematopoietic recovery after allogeneic bone marrow transplantation were analysed. Forty-six evaluable patients transplanted with lymphocyte-depleted marrow for acute lymphoblastic leukaemia, acute non-lymphoblastic leukaemia, chronic myeloid leukaemia, myelodysplastic syndrome and severe aplastic anaemia were studied. The median time for platelet recovery to greater than or equal to 20 and to greater than or equal to 50 x 10(9)/l was 21 (9-72) and 26 (11-86) days respectively. The neutrophil recovery to greater than or equal to 0.5 x 10(9)/l and the leucocyte recovery to greater than or equal to 1.0 x 10(9)/l was 19 (8-47) and 18 (6-47) days respectively. No relation was found between the number of infused granulocyte-macrophage colony-forming cells, erythroid burst-forming cells, diagnosis, graft-versus-host disease, antibiotic administration and recovery. Addition of a continuous 6-day infusion of anthracyclines to the conditioning regimen delayed the median recovery of platelets, neutrophils and leucocytes by 7-9 days. Fever during aplasia also inhibited haematopoietic recovery. It is speculated that leakage of intracellular anthracyclines after bone marrow infusion or fever secondary to anthracyclines-induced oromucositis is responsible for the delayed bone marrow recovery.

Adolescent↗

PubMed1988

Autologous bone marrow transplantation in patients with non-Hodgkin's lymphoma: comparison of different parameters in predicting the kinetics of haematological recovery.

We analysed the kinetics of haematological recovery after autologous bone marrow transplantation (ABMT) in 31 patients with non-Hodgkin's lymphoma, of whom 14 had received chemotherapy and 17 had received no chemotherapy before marrow harvesting. The time for recovery of polymorph (PMN) and platelet numbers was assessed in relation to patient's sex, age, the numbers of mononuclear cells (MNC) and of granulocyte-macrophage colony-forming cells (CFU-GM) reinfused, the therapy before harvesting and the conditioning regimens. The results showed that the most important factor influencing the speed of haematological recovery was therapy before marrow collection; recovery was faster in patients not treated before harvesting than in those treated. The mean day for PMN recovery to 0.5 x 10(9)/l was 14.6 vs 21.8 (p less than 0.001); the mean day for platelet recovery to 50 x 10(9)/l was 16.5 vs 44.4 (p less than 0.00002). The other parameters assessed did not correlate with the kinetics of haemopoietic recovery. We conclude that NHL patients who undergo ABMT without chemotherapy prior to marrow harvest have rapid haematological recovery, which suggests that better timing of the harvest could be of value in the management of NHL patients for whom 'reinforcement' with ABMT is scheduled.

Adolescent↗

PubMed1989

Spontaneous regeneration of free muscarinic receptor after alkylation by BM 123. I. Recovery in vivo and in cell culture.

The recovery of rat muscarinic receptor number from the effects of a specific alkylating ligand, N-[4-(2-chloroethylmethylamino)-2-butynyl]-2-pyrrolidone (BM 123), in three tissues is presented as an exponential function of time. No significant difference was found in the recovery rate constants derived from analysis of recovery time courses in corpus striatum, cerebral cortex and ileal longitudinal muscle. The single rate constant (0.021/hr) was also independent of amount and duration of BM 123 dose. Additional analysis of agonist-defined high and low affinity subsites in cortex revealed that recovery of these populations also followed similar time courses although the alkylation proceeds more slowly for the high affinity sites. The rate constant for recovery of both subsites was 0.029/hr. Recovery from BM 123 alkylation occurred in NG108-15 neuroblastoma X glioma cells. The presence of cycloheximide in the recovery medium did not significantly inhibit this recovery process in the clonal cell line, suggesting that de novo receptor synthesis is unnecessary for regeneration of unalkylated receptors.

Alkylation↗

PubMed1988

Human mast cells synthesize new granules during recovery from degranulation. In vitro studies with mast cells purified from human lungs.

Secretory cells undergoing release and recovery events related to constitutive and/or stimulus-initiated secretion might be expected to undergo distinctive changes in morphology as well. We studied the release and recovery events of human mast cell secretion stimulated by antibody to immunoglobulin E. We used enzymatically digested mast cells from human lung specimens further purified by countercurrent centrifugation elutriation. Release kinetics were like those reported for isolated human lung mast cells. In two complete kinetic experiments we restudied these early release patterns (0 to 30 minutes). Mast cells, either stimulated or controls, were then cultured and sampled for electronmicroscopic studies at periodic intervals (3 to 48 hours). We describe events of the late recovery period here, although some overlap with processes seen in early recovery samples occurred. Mast cells that released nearly all their cytoplasmic granules and exteriorized the containers, eg, granule-channel membranes, underwent progressive enlargement of Golgi structures and development of numerous small cytoplasmic vesicles and small, membrane-bound granules filled with particulate and dense content. Ultimately, new mature cytoplasmic granules of all substructural patterns occurred. Nuclear blast changes and expansion of cytoplasmic mass accompanied this period of new granule synthesis. Mixed recovery patterns were present in individual cells. These represented the morphological expression of a variety of recovery events. Thus, some cells showed a combination of channel recovery and remodeling to form new granule containers within which condensation of content produced crystalline patterns, as well as synthesis of new granules, as described here. This morphological versatility resulted in multiple mast cell morphological phenotypes during these release and recovery processes.

Antibodies, Anti-Idiotypic↗

PubMed1987

Factors related to spontaneous visual recovery in the ocular histoplasmosis syndrome.

In an effort to better describe the phenomenon of spontaneous visual recovery in the ocular histoplasmosis syndrome (OHS), 700 patient records were reviewed. Spontaneous visual recovery was defined as a two or more line improvement in Snellen acuity after a minimum of 12 months of stable visual reduction to 20/70 or less, secondary to central disciform scarring. Ten cases of spontaneous visual recovery were found. Eight patients had recovery of vision only when visual acuity was reduced to 20/80 or less in the fellow eye. One patient experienced spontaneous recovery without visual loss in the fellow eye. Another patient experienced spontaneous visual recovery 57 months after xenon photocoagulation in the study eye. This group of patients was compared to 14 similar patients who did not experience spontaneous recovery when visual acuity was reduced to less than 20/80 in the fellow eye. Compared to the nonrecovery group, patients experiencing spontaneous visual recovery in OHS were younger at the time of visual loss in the fellow eye (30 years vs. 48 years, p less than 0.01); had a shorter interval of visual loss prior to visual loss in the fellow eye (44 months vs. 150 months, p less than 0.10); had smaller diameter scars (1,711 microns vs. 3,078 microns, p less than 0.05); and had shorter distances from the foveal center to adjacent normal retina (267 microns vs. 846 microns, p less than 0.01).

Cicatrix↗

PubMed1984

[Recovery from aphasia and cerebral blood flow: a comparison between cerebral hemorrhage and cerebral thrombosis].

To compare cerebral circulation in aphasic patients who had cerebral hemorrhage against those who with cerebral thrombosis, we studies 50 patients with hypertensive intracranial (putaminal) hemorrhage and 20 patients with cerebral thrombosis whose diagnoses were confirmed on repeated CT scan and cerebral angiography. The measurements of regional cerebral blood flow (rCBF) by the 133Xe intraarterial injection method was carried out in 40 patients. The evolution of the aphasic syndrome was analyzed according to Hirano's classification and the patients were divided into two groups: those having a favorable recovery from aphasia; those with a poor recovery. Twelve out of 20 patients with cerebral hemorrhage showed a favorable recovery from aphasia, whose left hemispheric mean blood flow (mCBF) was 33.1 +/- 9.7 ml/100 g/min. The mCBF was 30.8 +/- 10.3 ml/100 g/min in 8 patients with a poor recovery. There was no significant difference in mCBF values between the two groups. The favorable recovery group showed slightly higher regional values in the left frontal and temporal lobes than did the poor recovery group, but no significant difference was found between the two group. Here, rCBF values failed to correlate between the two kinds of recovery from aphasia in patients with cerebral hemorrhage. The marked variability in rCBF values in the acute stage might partly account for the poor correlation in cerebral hemorrhage. In contrast, a series of rCBF studies demonstrated that rCBF values stabilized in the acute and subacute stage in cerebral thrombosis. Nine out of 20 patients with cerebral thrombosis had a favorable recovery from aphasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Aphasia↗

PubMed1984

Recovery of adenine nucleotide levels after global myocardial ischemia in dogs.

Loss of myocardial adenosine triphosphate (ATP) during ischemia can result in decreased cardiac function. Postischemic ATP levels remain low, and the reason for this is poorly understood. Previous attempts to enhance ATP recovery after ischemia have been only partially successful. To determine the long-term dynamics of ATP recovery and evaluate the effect of providing ATP precursors, we devised a method of obtaining sequential ventricular biopsies in dogs after 20 minutes of normothermic global ischemia on cardiopulmonary bypass. Our kinetic data show adenine (A) is metabolically favored over adenosine to regenerate ATP levels when adequate ribose (R) is present to produce phosphoribosylpyrophosphate. Therefore A (20 mM) plus R (80 mM) or saline (NS) was infused (1.0 ml X min-1) into the right atrium of dogs for 48 hours after ischemia. During A infusion myocardial tissue A was 0.19 +/- 0.07 nmol X mg-1, arterial A was 18.3 +/- 1.3 microM, coronary sinus A was 11.0 +/- 1.6 microM, and extraction of A by the myocardium was 38% +/- 10%. We found that while the decrease in ATP levels during ischemia was at least 50% in both groups, the postischemic ATP recovery rate in A/R dogs was more than eightfold greater than de novo synthesis (2.8 +/- 0.59 versus 0.34 +/- 0.06 nmoles X mg-1 X day). ATP levels in NS dogs were only 54% +/- 8% of preischemic values by 48 hours and required 9.9 +/- 1.4 days for full recovery. Recovery in A/R dogs required 1.2 +/- 0.2 days. Our results reveal that ATP recovery after a significant ischemic insult is slow, precursor availability is an important limiting factor in ATP recovery, and recovery time can be greatly shortened with precursor infusion even when started after the ischemic insult.

Adenine↗

PubMed1982

Comparison of recovery of schistosomula of Schistosoma japonicum from lungs of mice and rats.

Various strains of mice and rats were exposed to small doses of Schistosoma japonicum cercariae. At intervals, they were challenged with 200 to 230 cercariae per mouse and 500 to 520 cercariae per rat. Age-matched control animals received only the challenge infection from the same pool of cercariae. Recoveries of schistosomula from experimental and control groups were different on day 3 through day 5, with peak recovery on day 3 or 4 in four strains of mice examined (DBA/2, C57BL/6, C3H/He, and SWM) as well as in Fischer rats, indicating rapid migration of S. japonicum to the lung compared with that of S. mansoni. Significant reductions of recovery of schistosomula from lungs were demonstrated in DBA/2, C3H/He, SWM, and B10.S mice at week 3, but not in BALB/c, CBA, and C57BL/6 mice. Significant reductions were also demonstrated in Donryu, Wistar, Sprague-Dawley and Fischer rats at week 6. The degree of reduction depended on cercarial doses used for the initial exposure. Studies in DBA/2 mice revealed that the degree of reduction intensified biphasically, being greatest at week 5 and at week 12. The lowest recovery was demonstrated at week 6 in Fischer rats, when recovery of schistosomula tentatively increased in DBA/2 mice. A good correlation was found between recovery of schistosomula from lungs and recovery of adults by portal perfusion when DBA/2 and C57BL/6 mice, and Fischer rats were used for comparison. Thus, the present results provide basic information on the lung recovery of schistosomula of S. japonicum in suitable and unsuitable hosts.

Animals↗

PubMed1995

Variability of in vivo recovery of factor IX after infusion of monoclonal antibody purified factor IX concentrates in patients with hemophilia B. The Mononine Study Group.

Monoclonal antibody purified factor IX concentrate, Mononine (Armour Pharmaceutical Company, Kankakee, Illinois, USA), is a recently developed replacement factor concentrate for the treatment of patients with hemophilia B. The pharmacokinetic properties of monoclonal antibody purified factor IX concentrate (MAb Factor IX concentrate) have been evaluated in only small samples of patients, and little is known about those factors that might influenced in vivo recovery of factor IX after infusion is a larger patient population. In vivo recovery of factor IX was therefore evaluated for 80 different indications in 72 patients who received MAb Factor IX concentrate for the management of spontaneous or trauma-induced bleeding, or as prophylaxis with surgery. The average recovery after infusions for presurgical pharmacokinetic analysis (mean +/- standard deviation) was 1.28 +/- 0.56 U/dl rise per U/kg infused (range 0.41-2.80), and the average recovery after all infusions for treatment was 1.23 +/- 0.49 U/dl rise per U/kg infused (range - 0.35-2.92). Recovery values for multiple MAb Factor IX doses in a given patient were also variable; the average recovery was 1.22 +/- 0.53 U/dl rise per U/kg given, and standard deviations ranged from 0.03 to 1.26. Patient age, weight, and MAb Factor IX concentrate dose minimally but significantly influenced factor IX recovery. There was no significant effect of either race, history of previous thrombotic complications during treatment with other replacement factor concentrates, or bleeding state on recovery. All of the patients treated with this preparation experienced excellent hemostasis, and no thrombotic complications were observed.

Adolescent↗

PubMed1995

The genetic basis of cellular recovery from radiation damage: response of the radiosensitive irs lines to low-dose-rate irradiation.

Recovery from the lethal effects of irradiation is commonly found when cultured mammalian cells are irradiated at low dose rates when compared to the same cells irradiated at higher dose rates. However, this cellular recovery process is severely reduced or absent in a number of radiosensitive cell lines, including those derived from the human disorder ataxia telangiectasia (AT). The genetic and molecular basis of such recovery processes is not understood, despite their importance. The responses of cells of three further radiosensitive lines, irs1, irs2 and irs3, shown previously to be mutated in different genes, to low-dose-rate radiation are now presented. Plateau-phase cultures of cells of the irs2 line were found to have little or no cellular recovery, while irs1 and irs3 had considerable recovery potential. In comparing the known properties of the radiosensitive lines lacking cellular recovery, including xrs, XR-1 and scid as well as AT and irs2, it is argued that the gene products lacking in these lines normally act coordinately in a specific damage-recognition pathway. The recovery pathway is likely to be associated with the rejoining of DNA double-strand breaks, since several of these recovery-defective lines have a measurable deficiency in break repair.

Animals↗

PubMed1995

Relationship of infused CFU-GM and CFU-Mk mobilized by chemotherapy with or without G-CSF to platelet recovery after autologous blood stem cell transplantation.

Although hematologic reconstitution is usually rapid after autologous blood stem cell transplantation (ABSCT), there is an occasional delay in platelet recovery. We studied the hematologic recovery of 27 adult patients with hematologic malignancies who received marrow-ablative chemotherapy and ABSCT to determine whether or not the numbers of infused mononuclear cells (MNC), colony-forming units granulocyte/macrophage (CFU-GM), and colony-forming units megakaryocyte (CFU-Mk) were related to the speed of platelet recovery after ABSCT. Peripheral blood stem cells were collected using chemotherapy-induced mobilization with or without cytokine therapy. While the number of MNC infused did not show a significant correlation with time to platelet recovery as well as granulocyte and reticulocyte recovery, the logarithmic number of CFU-GM-infused did (p < 0.01). We also found a significant correlation between the logarithmic number of CFU-Mk-infused and the time to platelet recovery (p < 0.01). These findings suggest that the number of CFU-GM-infused is a reliable indicator of hematopoietic recovery and that the number of CFU-Mk-infused is no more reliable than CFU-GM for predicting platelet recovery after ABSCT.

Adolescent↗

PubMed1993

Effects of combined administration of interleukin-6 and granulocyte colony-stimulating factor on recovery from radiation-induced hemopoietic aplasia.

Hemopoietic aplasia is the primary limitation of drug and radiation cancer therapies. We have previously demonstrated that, individually, both interleukin-6 (IL-6) and granulocyte colony-stimulating factor (G-CSF) can accelerate recovery from radiation-induced hemopoietic aplasia. In vitro studies suggest that IL-6 affects cells early in the hemopoietic hierarchy, while G-CSF affects more committed progenitor cells. Because these cytokines may also affect different cell populations in vivo, we hypothesized that the use of these agents in combination may further enhance recovery from hemopoietic aplasia. Female B6D2F1 mice were exposed to a high sublethal 7.75 Gy dose of 60Co radiation. Following irradiation, mice were administered subcutaneous injections of either saline, 500 micrograms/kg of recombinant human IL-6 once daily on days 1-6, 125 micrograms/kg of recombinant human G-CSF once daily on days 1-17, or both cytokines as described. Peripheral white blood cell (WBC), red blood cell (RBC), and platelet (PLT) counts, as well as femoral and splenic granulocyte-macrophage colony-forming cell (GM-CFC) and day-12 spleen colony-forming unit (CFU-S) contents were evaluated on days 7, 10, 14, 17 and 21 postirradiation. IL-6 treatment alone slightly accelerated postirradiation recovery of most hemopoietic parameters, while G-CSF treatment dramatically enhanced recovery of all hemopoietic parameters evaluated. Co-administration of IL-6 and G-CSF further enhanced the hemopoietic recovery. The most notable effects in combination-treated mice were on recoveries of bone marrow and splenic CFU-S, which were significantly enhanced above those in G-CSF-treated irradiated mice as early as day 10 postirradiation. Although by day 14 postirradiation, splenic GM-CFC and CFU-S recoveries in both G-CSF- and combination-treated mice had surpassed unirradiated control values, combination-treated mice exhibited a greater overshoot. These studies demonstrate the ability of IL-6 treatment to enhance G-CSF-mediated acceleration of multilineage recovery following radiation-induced hemopoietic aplasia.

Animals↗

PubMed1994

Calorie sources and recovery from central nervous system ischemia.

OBJECTIVES: Glucose is the primary substrate for the energy requirements of the nervous system. Nevertheless, administration of glucose to critically ill patients with central nervous system trauma may have adverse effects on their neurologic recovery. The purpose of this study was to evaluate the effects of other sources of nonprotein calories on spinal cord lactate accumulation and on electrophysiologic recovery after a period of severe spinal cord ischemia. DESIGN: Two randomized, blinded studies were performed: one of glycolytic energy substrates (fructose, xylitol, sorbitol, glycerol) and one of ketogenic energy substrates (beta-hydroxybutyrate, acetate, butyrate). SETTING: College teaching hospital laboratory. SUBJECTS: New Zealand albino rabbits (weight 3.5 to 4.5 kg). INTERVENTIONS: After infusion of the randomly assigned treatment, temporary ischemia was produced in the lumbosacral spinal cord by occluding the abdominal aorta with a balloon catheter. MEASUREMENTS AND MAIN RESULTS: Blood concentrations of glucose, lactate, pyruvate, and ketone bodies and spinal cord dialysate concentration of lactate were measured before and after infusion of the assigned treatment, and during ischemia and during the first 2 hrs after reperfusion. Spinal somatosensory evoked potentials were recorded during ischemia to assure a similar severity of ischemia in all animals and during the first 2 hrs after reperfusion as a measure of electrophysiologic recovery. Infusion of the glycolytic nutrients xylitol and fructose increased blood glucose and lactate concentrations, and resulted in increased lactate accumulation in the spinal cord during ischemia and resulted in a significantly poorer recovery of the spinal somatosensory evoked potential than infusion of saline. Infusion of sorbitol and glycerol did not have these adverse effects in the doses administered. None of the ketogenic nutrients increased blood glucose concentration or increased lactate accumulation in the spinal cord during ischemia when compared with infusion of saline. Infusion of butyrate and acetate caused arterial hypotension and resulted in a poorer recovery of the spinal somatosensory evoked potential than saline. Infusion of beta-hydroxybutyrate did not have an adverse effect on blood pressure or on evoked potential recovery. CONCLUSIONS: Glycerol, sorbitol, and beta-hydroxybutyrate deserve further evaluation as potential nonprotein calorie sources in patients with neurologic injury. Xylitol and fructose are not suitable since these substrates resulted in hyperglycemia and increased lactate accumulation in the central nervous system, and had detrimental effects on electrophysiologic recovery after ischemia. The short-chain fatty acids (acetate and butyrate) also had adverse effects on electrophysiologic recovery after ischemia, probably because of their hypotensive effects when given intravenously, rather than from the effects of their metabolism.

Analysis of Variance↗

PubMed1993

Oxygen uptake during recovery from intense intermittent running and prolonged walking.

The purpose of this study was to compare recovery energy expenditure following three exercise conditions varying widely in intensity and duration. Subjects were five well-trained female distance runners whose mean age and VO2 max +/- 1 SD were 22.4 +/- 1.6 yr and 61.8 +/- 7.3 ml/kg-1/min-1, respectively. Exercise sessions consisted of walking for 2 h at 24.5% of VO2max, running continuously for 10 min at 81.1% of VO2max, and exercising intermittently with 2 min runs at 89.2% VO2max alternated with 2 min walks at 93.8 m/min-1. VO2 was determined continuously with open circuit spirometry during 1 h of exercise recovery. Total recovery VO2 (L) was taken as the sum of the 60 1-minute values. After walking, VO2 reached baseline values at 40 min of recovery while VO2 remained elevated at 1 h for both the continuous and intermittent exercise. The total VO2 (L) in recovery was significantly greater (p < 0.05) for both continuous (19.09 +/- 1.2 VO2) and intermittent (22.4 +/- 1.5 L) running than walking (17.4 +/- 0.7 L) and intermittent exercise recovery VO2 was significantly greater than for continuous running (p < 0.05). It was concluded that high intensity exercise, either intermittent or continuous, increases recovery VO2 (L) more than prolonged low intensity exercise. Furthermore, the total exercise VO2 explains a large portion of the variance in recovery VO2.

Adult↗