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PubMed2003

Need for recovery after work and the subsequent risk of cardiovascular disease in a working population.

BACKGROUND: A high need for recovery after work can be regarded as a short term adverse effect of working day stressors and the person's inability to cope and recover. Consequently, it might be an intermediate factor between job stressors and cardiovascular disease (CVD). AIM: To investigate, in a longitudinal study, the relation between need for recovery and subsequent CVD. METHODS: Data from the Maastricht Cohort Study of 12 140 workers were used, with 42 incident self reported CVD cases during 32 months of follow up. Cox proportional hazards analysis was used to calculate age, gender, smoking status, and educational level adjusted relative risks. RESULTS: The adjusted relative CVD risk for the second compared to the first tertile of the need for recovery score was 1.22 (95% CI: 0.49 to 3.04), and for the third compared to the first tertile was 3.16 (95% CI: 1.34 to 7.48). When need for recovery was entered as continuous score, an adjusted relative risk per SD increase of 1.54 (95% CI: 1.15 to 2.03) was found. Additional adjustment for several work related factors as job demands, did not notably change the observed relation between need for recovery and CVD. Moreover, the increased risk for subjects reporting high job demands (1.38 per SD increase; 95% CI: 1.02 to 3.92) decreased substantially after adjustment for need for recovery. CONCLUSION: The results show that need for recovery is a strong predictor of subsequent cardiovascular disease and might be an intermediate factor between job stressors and cardiovascular disease.

Adolescent↗

PubMed2005

The postexercise increase in the threshold for cutaneous vasodilation and sweating is not observed with extended recovery.

The following study was conducted to evaluate the hypothesis that an increase in the postexercise onset threshold for cutaneous vasodilation (Th(VD)) and sweating (Th(SW)) would not be observed upon the restoration of baseline mean arterial pressure (MAP). Subjects remained either seated resting for 15 min or performed 15 min of treadmill running at 70% VO2peak followed by either 20- (short) or 60-min (extended) recovery. At the end of each recovery protocol (20 and 60 min) a water perfusion suit was then used to increase mean skin temperature until Th(VD) and Th(SW) was noted. Exercise resulted in an increase in Th(VD) and Th(SW) of 0.24 +/- 0.03 and 0.24 +/- 0.02 degrees C, respectively, above no-exercise for the short recovery (p < 0.05). No increase was measured for the extended recovery. Postexercise MAP was significantly reduced prior to whole-body warming for the short recovery whereas no reduction was measured for the extended recovery. The increase in Th(VD) and Th(SW), measured during the early stages of recovery, is reversed with the reestablishment of baseline MAP.

Adult↗

PubMedDate not supplied

Functional recovery of hearing following ampa-induced reversible disruption of hair cell afferent synapses in the avian inner ear.

Hair cells in the avian inner ear can regenerate after acoustic trauma or ototoxic insult, and significant functional recovery from hearing loss occurs. However, small residual deficits remain, possibly as a result of incomplete reestablishment of the hair cell neural synaptic contacts. The aim of the present study was to determine if intracochlear application of alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA), an excitotoxic glutamate agonist, causes reversible disruption of hair cell neural contacts in the bird, and to what extent functional recovery occurs if synaptic contacts are reestablished. Compound action potential (CAP) responses to tone bursts were recorded to determine hearing thresholds during a recovery period of up to 4 months. Subsequently, the response properties of single auditory nerve fibers were analyzed in the same animals. Instillation of AMPA into the perilymph of the scala tympani led to immediate abolition of CAP thresholds. Partial recovery occurred over a period of 2-3 weeks, without further improvement of thresholds thereafter. High-frequency thresholds did not reach control values even after 3-4 months of recovery. Single-ganglion cell response properties, obtained 3-4 months after AMPA treatment, showed elevated thresholds at the fiber's characteristic frequency (CF) for units with CF above 0.3 kHz. Sharpness of tuning (Q(10 dB)) was reduced in units with CF above 0.4 kHz. The spontaneous firing rate was higher in units with CF above 0.18 kHz. The maximum sound-evoked discharge rate was also increased. Transmission electron micrographs of the basilar papilla showed that, following AMPA treatment, the nerve endings went through a sequence of swelling, degeneration and recovery over a period of 3-7 days. The process of neosynaptogenesis was completed 14 days after exposure. The present findings are strong evidence for a role of glutamate or a related excitatory amino acid as the afferent transmitter in the avian inner ear. In addition they show that functional recovery after disruption and regeneration of hair cell neural synapses, without apparent damage to the hair cells, is incomplete.

Animals↗

PubMed2006

The rate of functional recovery from acute IOP elevation.

PURPOSE: To evaluate the recovery of retinal function after acute IOP elevation. METHODS: The electroretinogram (ERG) was measured before, during, and after IOP increased to 50 and 70 mm Hg at different durations in anesthetized, dark-adapted rats (n = 5-7). Signals were collected for dim and bright flashes (-4.95 and 1.0 log cd . s/m(2)) and analyzed in terms of the photoreceptoral (P3), postreceptoral (P2), and inner retinal (negative scotopic threshold response [nSTR]) responses. Parameters (treatment/baseline, %) were compared across time by using repeated-measures ANOVA and t-tests. The rate of recovery was quantified with a logistic function and compared by bootstrap. RESULTS: IOP spikes induce greater loss (P < 0.01) and slower recovery (P < 0.001) in the nSTR compared with the P2 and P3 responses. IOP spikes having common integral (pressure x duration, 2100 mm Hg x minutes) for insult gave significantly greater P2 and nSTR dysfunction at the higher pressure (70 vs. 50 mm Hg, nSTR reduced to -2.5% +/- 0.5% vs. 20.3% +/- 6.5%, P < 0.05). The higher pressure also produced significantly slower nSTR recovery (50% recovery time [t(0.5)] 70 vs. 50 mm Hg: 33.1 vs. 21.7 minutes; P < 0.05). At a given IOP (70 mm Hg), t(0.5) showed a linear relationship with duration (15 vs. 30 vs. 60 minutes' exposure: t(0.5) 16.7 vs. 33.1 vs. 63.2 minutes; P < 0.05) and integral. CONCLUSIONS: Ganglion cell function recovers slower than the outer retina after IOP insult, with peak IOP being the principle determinant of functional loss and recovery. For a fixed pressure, functional recovery is linearly related to exposure.

Animals↗

PubMed2001

What is recovery? A conceptual model and explication.

This paper describes a conceptual model of recovery from mental illness developed to aid the state of Wisconsin in moving toward its goal of developing a "recovery-oriented" mental health system. In the model, recovery refers to both internal conditions experienced by persons who describe themselves as being in recovery--hope, healing, empowerment, and connection--and external conditions that facilitate recovery--implementation of the principle of human rights, a positive culture of healing, and recovery-oriented services. The aim of the model is to link the abstract concepts that define recovery with specific strategies that systems, agencies, and individuals can use to facilitate it.

Health Promotion↗

PubMed2004

Comparison of propofol consumption and recovery time in Caucasians from Italy, with Chinese, Malays and Indians from Malaysia.

Differences in sensitivity to anaesthetic drugs may exist among different ethnic groups. Allelic variants for drug metabolizing isoenzymes and pharmacokinetic differences may account for a variable response to some anaesthetic drugs. This study was designed to compare propofol consumption and recovery characteristics in four ethnic groups: Chinese, Malays, and Indians in Malaysia and Caucasians in Italy. Patients undergoing total intravenous anaesthesia with propofol and fentanyl were evaluated for propofol consumption and recovery time. The Bispectral Index (BIS) was used to maintain the same anaesthesia depth in all patients. The BIS value, the response to verbal stimuli and eye-opening time were used to assess recovery. After propofol discontinuation the BIS values returned to baseline in 11+/-4.2 min for Caucasians, in 12.5+/-5.1 min for Chinese, 15.9+/-6.3 min for Malays and 22.1+/-8.1 for Indians. Time to eye-opening was 11.63+/-4.2 min in Caucasians, 13.23+/-4.9 min in Chinese, 16.97+/-5.2 min in Malays and 22.3+/-6.6 min in Indians. The propofol consumption was significantly lower in Indians compared to the other three groups (P<0.01). The recovery of Indians was much slower compared to Chinese, Malays and Caucasians. The recovery time of Malays is significantly slower compared to Chinese and Caucasians. Differences in propofol consumption and recovery time were not significant between Chinese and Caucasians, but the ratio recovery time/propofol consumption was significantly lower in Caucasians compared to all the other groups.

Adult↗

PubMed2006

Renal recovery after severe acute renal failure.

BACKGROUND: There is limited information about renal recovery to independence from renal replacement therapy (RRT) and about factors associated with its occurrence after severe acute renal failure (ARF). METHODS: We conducted a population-based surveillance among all adult residents of the Calgary Health Region surviving ICU admission from May 1, 1999 to April 30, 2002. The primary objective was to determine the rate of and the factors associated with 90-day survival and recovery to independence from RRT in critically ill patients with severe ARF. RESULTS: At 90 days, 96 patients (40%) were alive. Of these, 72% were RRT independent with most (87%) requiring <4 weeks to recover. Prior to RRT, the median (IQR) serum creatinine and mean (SD) serum urea were 395 (252-517) micromol/L and 29.2 (18) mmol/L, respectively. Oliguria was present in 76%. Intermittent hemodialysis was the initial modality in 46% and continuous renal replacement therapy (CRRT) in 54%. By multivariate analysis, male sex (odds ratio (OR) 7.6, 95% CI, 2.2-27, p=0.01) and a diagnosis of septic shock (OR 3.9, 95% CI 1.02-14.5, p=0.05) were associated with an increased odds of recovery. Conversely, a higher Charlson co-morbidity index score (OR 0.71, 95% CI, 0.6-0.85, p=0.04) and a higher pre-RRT serum creatinine (OR 0.20, 95% CI, 0.05-0.80, p=0.02, p=0.02) were associated with reduced odds of recovery. Chronic kidney disease or the initial modality of RRT were not associated with recovery. CONCLUSIONS: The majority of severe ARF patients who survive their acute illness are independent of RRT by 90 days. Male sex and a diagnosis of septic shock are independently associated with recovery while a greater co-morbidity score and a higher serum creatinine prior to RRT are predictive of non-recovery.

Acute Kidney Injury↗

PubMed1999

Long-term recovery of diaphragm strength in neuralgic amyotrophy.

Diaphragm paralysis is a recognized complication of neuralgic amyotrophy that causes severe dyspnoea. Although recovery of strength in the arm muscles, when affected, is common, there are little data on recovery of diaphragm function. This study, therefore, re-assessed diaphragm strength in cases of bilateral diaphragm paralysis due to neuralgic amyotrophy that had previously been diagnosed at the authors institutions. Fourteen patients were recalled between 2 and 11 yrs after the original diagnosis. Respiratory muscle and diaphragm strength were measured by volitional manoeuvres as maximal inspiratory pressure and sniff transdiaphragmatic pressure. Cervical magnetic phrenic nerve stimulation was used to give a nonvolitional measure of diaphragm strength: twitch transdiaphragmatic pressure. Only two patients remained severely breathless. Ten of the 14 patients had evidence of some recovery of diaphragm strength, in seven cases to within 50% of the lower limit of normal. The rate of recovery was variable: one patient had some recovery after 2 yrs, and the rest took 3 yrs or more. In conclusion, in most patients with diaphragm paralysis due to neuralgic amyotrophy, some recovery of the diaphragm strength occurs, but the rate of recovery may be slow.

Adult↗

PubMed2002

Need for recovery in the working population: description and associations with fatigue and psychological distress.

This study examined the concept of need for recovery, that is the need to recuperate from work-induced fatigue, experienced after a day of work. The study explored the relationship between need for recovery from work, prolonged fatigue, and psychological distress in the working population. A cross-sectional study was carried out. Data of the Maastricht Cohort Study on fatigue at work were used (n = 12,095). Some degree of need for recovery was found in nearly all employees. Need for recovery from work was associated with demographic, work-related, and health factors. Principal Components Analysis revealed obvious separation between need for recovery items and both fatigue items and psychological distress items, supporting the notion that need for recovery, fatigue, and psychological distress represent different underlying concepts. Although need for recovery, fatigue, and psychological distress were frequently comorbid, they also clearly occurred as separate entities.

Adult↗

PubMed2006

Are initial demyelinating event recovery and time to second event under differential control?

BACKGROUND: Relapsing-remitting multiple sclerosis (RRMS) begins with an initial demyelinating event (IDE) that can be monosymptomatic, polysymptomatic, or polyregional. Failure to recover from the IDE is a known predictor of later development of disability. Factors that predict IDE recovery (outside optic neuritis) and time to second event are relatively unknown. The authors speculate that IDE recovery and time to second event are under separate biologic or genetic control, and as such, their clinical predictors are different. METHODS: Data on all UCSF MS clinic patients are entered prospectively into an ACCESS database. The authors identified all patients seen at the UCSF clinic within 1 year of their IDE. Expanded Disability Status Scale scores, functional system scores, and visual acuity were used to define IDE severity and recovery. RESULTS: The cohort included 186 patients (127 women, 59 men) with an average onset age of 34 +/- 10 years with 150 whites (non-Hispanic), 15 African Americans, 11 Hispanics, eight Asians, and two unknown/unreported. Worse onset severity predicted worse IDE recovery (23.1% of the patients with severe onset vs 32.9% with moderate severity vs 56.4% with mild onset recovered completely, p < 0.001). Polyregional onset predicted poor recovery compared to monoregional onset (46.2% vs 14.4%, p < 0.001). Nonwhite patients were 2.48 times more likely than whites to experience a second episode within 1 year from onset (95% CI: 1.45 to 4.23, p < 0.001). Similarly, age younger than 30 years predicted higher risk of a second exacerbation (hazard ratio 1.92, 95% CI: 1.17 to 3.15, p = 0.010). CONCLUSION: Initial demyelinating event recovery and time to second event may have distinct predictors. These findings suggest that recovery and time to second event might be under separate biologic control.

Adult↗

PubMed2007

Time frame and predictors of recovery from disability following recurrent ischemic stroke.

OBJECTIVE: To assess the rate, degree, and predictors of recovery from a disabled to nondisabled state in patients disabled after recurrent ischemic stroke. METHODS: Patients with ischemic stroke enrolled in the Management of Atherothrombosis with Clopidogrel in High Risk Patients (MATCH) Study underwent prospective assessment of their modified Rankin score (mRS) at 1, 3, 6, 12, and 18 months after enrollment and after recurrent stroke. Patients disabled (defined as mRS > or = 3) after recurrence were analyzed for recovery (defined as mRS < 3) during the 18 months, and predictors of recovery were sought using a Cox proportional-hazard multiple regression analysis. RESULTS: Three hundred forty-five (54%) of 637 patients were disabled after recurrent ischemic stroke; 115 (33%) patients had been disabled and 230 (66%) nondisabled before stroke recurrence. At recurrence, the degree of disability was moderate (mRS 3) in 135 (39%) patients, severe (mRS 4) in 139 (40%), and very severe (mRS 5) in 71 (21%). After 12 months' median follow-up, 117 (34%, 95% CI: 29 to 39%) had recovered: 68 (50%, 42 to 59%) of 135 moderately disabled, 45 (32%, 25 to 41%) of 139 severely disabled, and 4 (6%, 2 to 14%) of 71 very severely disabled; 70 (20.3%) patients died. From recurrence, median time to recovery was 6 months (mRS 3) and 18 months (mRS 4); 94% with very severe disability had not recovered at 18 months. Independent predictors of recovery were moderate disability at recurrence (mRS 3) compared with severe (mRS 4: hazard ratio [HR] 1.5; 95% CI 1.04 to 2.3) or very severe disability (mRS 5: HR 7.6; 2.7 to 20) and a nondisabled vs disabled state before recurrence (HR 4.0; 2.3 to 6.8). CONCLUSIONS: The rate of recovery from recurrent ischemic stroke was greatest in the first 6 months; one-third of patients recovered within 12 months. The significant predictors of recovery were a nondisabled state before recurrence and increasing severity of the recurrent stroke.

Activities of Daily Living↗

PubMed2004

Perioperative rofecoxib improves early recovery after outpatient herniorrhaphy.

UNLABELLED: Non-opioid analgesics have become increasingly popular as part of a multimodal regimen for pain management in the ambulatory setting. We designed this randomized, double-blind, placebo-controlled study to evaluate the effect of perioperative administration of the cyclooxygenase-2 inhibitor rofecoxib on patient outcome after inguinal herniorrhaphy procedures. Sixty consenting outpatients undergoing elective hernia repair surgery were randomly assigned to one of two treatment groups: control (vitamin C, 500 mg) or rofecoxib (rofecoxib, 50 mg). The first oral dose of the study medication was administered 30-40 min before entering the operating room, and a second dose of the same medication was given on the morning of the first postoperative day. Recovery times, postoperative pain scores, the need for "rescue" analgesics, and side effects were recorded at 1- to 10-min intervals before discharge from the recovery room. Follow-up evaluations were performed at 36 h, 7 days, and 14 days after surgery to assess postdischarge pain, analgesic requirements, resumption of normal activities, as well as patient satisfaction with their postoperative pain management. Rofecoxib significantly decreased the early recovery times, leading to an earlier discharge home after surgery (88 +/- 30 vs 126 +/- 44 min, P < 0.05). When compared with the control group, the patients' median [range] quality of recovery score was also significantly higher in the rofecoxib group (18 [14-18] vs 16 [13-18], P < 0.05). In the predischarge period, a significantly larger percentage of patients required rescue pain medications in the control group (67% vs 37% in the rofecoxib group, P < 0.05). At the 36-h follow-up assessment, rofecoxib-treated patients reported significantly reduced oral analgesic requirements (0 [0-20] vs 9 [1-33] pills, P < 0.05) and lower maximal pain scores, resulting in improved patient satisfaction with their postoperative pain management (3 [1-4] vs 2 [0-3], P < 0.05). However, there were no differences in the times required to resume their activities of daily living. In conclusion, perioperative rofecoxib, 50 mg per os, significantly decreased postoperative pain and the need for analgesic rescue medication, leading to a faster and improved quality of recovery after outpatient hernia surgery. However, perioperative use of rofecoxib failed to improve recovery end points in the postdischarge period. IMPLICATIONS: Rofecoxib (50 mg per os), given before and after surgery, was effective in improving postoperative pain management, as well as the speed and quality of recovery after outpatient inguinal herniorrhaphy. However, it failed to accelerate the postdischarge resumption of normal activities of daily living.

Adolescent↗

PubMedDate not supplied

Establishing a protocol for parental presence in recovery.

This study aimed to contribute to providing a quality service that is sensitive to the needs of children undergoing surgery and their parents. An action research approach, focusing on parents' perceptions of coming into recovery, was used. A retrospective survey design was utilized to establish parents' views. A response rate of 71% (n = 100) was achieved. A short prospective study carried out concurrently achieved a 50% (n = 50) response from questionnaires handed out in recovery. Almost all the parents (98%) from both studies felt that they and their child had benefited from the parents' presence in recovery. When given the choice, 100% of parents came to recovery. The structural location and information given to parents preoperatively helped to ensure that parents were easy to find when the time was right to come to recovery. Communication between recovery staff, children and parents before surgery was recognized as a significant factor. A protocol for allowing parents into the recovery room has been produced. Staff who had preconceived ideas about parents' presence now identified the practice as good and considered that it contributed to the quality of the service.

Adolescent↗

PubMed2005

Functional recovery from desensitization of vanilloid receptor TRPV1 requires resynthesis of phosphatidylinositol 4,5-bisphosphate.

Capsaicin and other naturally occurring pungent molecules have long been used as topical analgesics to treat a variety of chronic pain conditions. The analgesic effects of these compounds involve long-term desensitization of nociceptors after strong stimulation. To elucidate the underlying mechanisms, we studied the recovery from desensitization of the vanilloid receptor TRPV1. We showed that prolonged applications of capsaicin led to nearly complete desensitization of the channel and that its functional recovery from desensitization required a high concentration of intracellular ATP. Nonhydrolyzable ATP analogs did not substitute for ATP to promote recovery. Neither inhibition nor activation of protein kinases prevented recovery of the channel from desensitization. In contrast, blockade of lipid kinases, in particular phosphatidylinositol-4-kinase, abolished recovery, as did activation of membrane receptors that stimulate hydrolysis of phosphatidylinositol 4,5-biphosphate (PIP2). Additional experiments using the PIP2-sensitive inward rectifier potassium channel Kir2.1 as a biosensor showed a high degree of temporal correlation between the two channels on both functional suppression after capsaicin stimulation and subsequent recovery. These data suggest that depletion of PIP2 occurs concomitantly with activation of TRPV1 and its replenishment in the membrane determines recovery of the channel from desensitization. In addition to revealing a new role of phosphoinositide signaling in regulation of nociception, our results provide novel insight into the topical mechanisms of the analgesic effects of capsaicin and the strategies to improve its effectiveness.

Adenosine Triphosphate↗

PubMed2004

Survival and recovery of yeast cells after combined treatment with ionizing radiation and heat.

Cell survival, recovery kinetics and inactivation forms after successive and simultaneous treatments with gamma rays (60Co) and high temperatures were studied in diploid yeast cells capable of recovery. Both the extent and the rate of the recovery were shown to be greatly decreased with increase in the duration of heat treatment (60 degrees C) followed by radiation and with increase in exposure temperature after simultaneous treatment with heat and radiation. A quantitative approach describing the recovery process was used to estimate the probability of recovery per unit time and the irreversible component of damage after the combined treatment with heat and radiation. It was shown that the probability of recovery was independent of the conditions of the treatment with heat and radiation, while the irreversible component gradually increased as a function of the duration of heat treatment (60 degrees C) after sequential treatment with heat and radiation and as a function of the exposure temperature after simultaneous treatment with heat and radiation. The increase in the irreversible component was accompanied by an increase in cell death without postirradiation division. It is concluded on this basis that the synergistic interaction of ionizing radiation and hyperthermia in yeast cells is not related to the impairment of the recovery capacity itself and that it may be attributed to an increased yield of irreversible damage.

Adaptation, Physiological↗

PubMedDate not supplied

[Plasma vitamin A levels in deprived children with pneumonia during the acute phase and after recovery].

OBJECTIVE: The aim of this study was to examine the plasma retinol of children in the acute phase of pneumonia and after recovery and to investigate the association between plasma levels of retinol after recovery with socioeconomic variables, nutritional status and severity of pneumonia. METHODS: A prospective cohort study which included 40 low-income hospitalized children with pneumonia, aged 6 months to 5 years. We evaluated: plasma retinol level during the acute phase and after recovery, years of schooling of the head of the family, per capita income, birth weight, nutritional status, hemoglobin levels and severity of pneumonia. RESULTS: Mean plasma retinol levels were significantly higher after recovery than during the acute phase of infection (1.4+/-0.6 vs. 1.7+/-0.6 micromol/l, p = 0.03). The frequency of inadequate plasma retinol levels (< 1.05 micromol/l) was 32.5 and 17.5% for the acute phase and after recovery, respectively. There were no statistically significant associations between plasma retinol deficiency and the clinical and epidemiological variables studied. More severe pneumonia was observed in 30/40 (75%) of the patients. There was no statistically significant association between plasma retinol inadequacy after recovery and severity of pneumonia (4/30 - 13.3% vs. 3/10 - 30.0%, p = 0.34). CONCLUSION: Serum retinol levels were significantly higher after recovery than during the acute phase of pneumonia. There was no statistically significant association between the deficiency of serum retinol and the clinical and epidemiological variables studied.

Acute Disease↗

PubMed2006

Comparison of recoveries from anesthesia of horses placed on a rapidly inflating-deflating air pillow or the floor of a padded stall.

OBJECTIVE: To compare recoveries from anesthesia of horses placed on a conventional padded stall floor or on a specially designed air pillow. DESIGN: Prospective study. ANIMALS: 409 horses (> 1 year old) that were anesthetized for surgical procedures during a 37-month period. PROCEDURES: By random allocation, horses were allowed to recover from anesthesia in either a foammat-padded recovery stall or an identical recovery stall equipped with a rapidly inflating-deflating air pillow. All recoveries were videotaped for subsequent analysis by an independent evaluator. Times to first movement, first attempt to attain sternal recumbency, attainment of sternal recumbency, first attempt to stand, and successful standing were recorded. The numbers of attempts before achieving sternal recumbency and standing were counted, and scores for quality of standing and overall recovery were assigned. Recovery-related variables were compared between groups. RESULTS: Compared with horses allowed to recover in a conventional manner, horses that recovered from anesthesia on the air pillow had a significantly longer rest period before attempting to attain sternal recumbency and rise to standing. Once the pillow was deflated, horses were able to stand after significantly fewer attempts and the quality of their standing was significantly better. Between the 2 groups of horses, there was no significant difference in overall recovery quality scores. The air pillow and padded floor systems were equally safe. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that use of a rapidly inflating-deflating air pillow promotes a longer period of recumbency and a better quality of standing after anesthesia in horses.

Anesthesia↗

PubMed1999

The acute period of recovery from traumatic brain injury: posttraumatic amnesia or posttraumatic confusional state?

OBJECT: The goal of this study was to characterize more fully the cognitive changes that occur during the period of acute recovery after traumatic brain injury (TBI). METHODS: The pattern of performance recovery on attention and memory tests was compared with the results of the Galveston Orientation and Amnesia Test (GOAT). Tests of memory and attention were administered serially to a hospitalized group of patients with TBI of varying severity. The tests differed in their level of complexity and/or requirement for more effortful or strategic processing. The authors found a regular pattern to recovery. As expected, ability to perform on simpler tests was recovered before performance on more effortful ones. The ability to recall three words freely after a 24-hour delay (the operational definition in this study of return to continuous memory) was recovered last, later than normal performance on the GOAT. Ability to perform simple attentional tasks was recovered before the less demanding memory task (recognition); ability to perform more complex attentional tasks was recovered before the free recall of three words after a 24-hour delay. This recovery of attention before memory was most notable and distinct in the group with mild TBI. CONCLUSIONS: The period of recovery after TBI, which is currently termed posttraumatic amnesia, appears to be primarily a confusional state and should be labeled as such. The authors propose a new definition for this acute recovery period and argue that the term posttraumatic confusional state should be used, because it more appropriately and completely characterizes the early period of recovery after TBI.

Adolescent↗