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At least 937 records · Page 52Linked to original sources

PubMed2004

Is systolic blood pressure recovery after exercise a predictor of mortality?

BACKGROUND: An attenuated systolic blood pressure recovery after exercise has been associated with the severity of atherosclerotic heart disease. METHODS: For 6 years, we observed 12,379 patients who underwent symptom-limited exercise testing. We excluded patients receiving antihypertensive medication and patients with valvular disease, emphysema, end-stage renal disease, heart failure, left ventricular systolic dysfunction, and atrial fibrillation. Blood pressure recovery ratio was defined as the ratio of systolic blood pressure at 3 minutes into recovery to systolic blood pressure at peak exercise; this has been shown to correlate with angiographic severity of coronary disease. RESULTS: The blood pressure recovery ratios ranged from 0.36 to 1.62, with values for increasing quartiles of 0.72 +/- 0.05, 0.82 +/- 0.02, 0.88 +/- 0.02, and 0.99 +/- 0.07. During follow-up, there were 430 deaths (3%). Five-year Kaplan Meier survival rates were 0.975, 0.974, 0.969, and 0.966 in quartiles 1 to 4, respectively. Compared with patients in the lowest quartile of blood pressure recovery ratio, patients in the highest quartile were at somewhat increased risk (hazard ratio, 1.71; 95% CI, 1.31-2.24; P <.001). However, after adjusting for age, sex, body mass index, resting heart rate and blood pressure, peak systolic blood pressure, heart rate recovery, exercise chronotropic response, cardiac history, and standard risk factors, this association was no longer present (adjusted hazard ratio, 1.05; 95% CI, 0.8-1.38; P =.74). CONCLUSIONS: In this low-risk population, abnormal systolic blood pressure recovery after exercise was not independently predictive of mortality after correcting for differences in baseline and exercise characteristics.

Blood Pressure↗

PubMed2006

Health practices that predict recovery from functional limitations in older adults.

BACKGROUND: Although previous studies show the benefits of certain health behaviors in reducing physical disability in older people, their effects on functional limitation, an antecedent of disability, are not well established. This study aims to identify health behavioral practices that affect recovery from functional limitations in older adults. METHODS: A total of 312 community-dwelling adults aged 65 and older with functional limitations were examined in 2002 for functional recovery in 2003. Functional limitations were measured by self-reports of difficulty performing upper- and lower-body movements. Positive health practices included regular physical activity, normal body mass index (BMI), periodic medical checkups, and moderate alcohol consumption. Logistic regression models were fitted to identify individual as well as combined health practices that predict functional recovery, adjusting for sociodemographic and health-related covariates. RESULTS: Although each of the positive health practices was significantly associated with functional recovery in the bivariate analyses, only physical activity continued to be a strong independent predictor in the multivariate analysis. The likelihood of functional recovery tended to increase with the number of health practices adopted by the elderly. Physical activity, in combination with normal BMI, proved to be one of the most influential health practice profiles, resulting in a high percentage of functional recovery. CONCLUSIONS: Health behaviors, especially physical activity, contribute to an older person's functional independence. The benefit of an increased number of health practices on recovery from functional limitations suggests that targeting multiple behavioral risks may help delay the onset of disability in later life.

Aged↗

PubMed2005

Doppler-derived left ventricular filling pressures and the regulation of heart rate recovery after exercise in patients with suspected coronary artery disease.

Slowed heart rate (HR) recovery after exercise is strongly predictive of increased long-term mortality. The factors responsible for impaired HR regulation are not fully understood. We performed echocardiography with tissue Doppler imaging in 121 patients before maximal exercise testing. HR recovery was measured 1 minute after the end of exercise in the supine position. The best echocardiographic correlate of HR recovery was the ratio of early mitral flow velocity (E) to early diastolic mitral annular velocity (Ea; r = -0.781, p <0.001). This correlation was not affected by the use of negative chronotropic agents. Patients whose E/Ea was <10 had a faster 1-minute HR recovery and a greater chronotropic response during exercise than did those whose E/Ea was >/=10. Receiver-operator characteristic analysis showed that an E/Ea >/=10.3 predicted 1-minute HR recovery of </=18 beats/min, with 83% sensitivity and 100% specificity. Neither left ventricular ejection fraction nor the presence of a "slow relaxation" mitral inflow pattern (E/A <1.0) was predictive of impaired HR recovery. Thus, slowed HR recovery is strongly associated with increased E/Ea, a marker of increased left ventricular filling pressures. E/Ea at rest may become a simple, reliable, and sensitive predictor of increased long-term mortality, even in the absence of overt heart failure.

Adult↗

PubMed2005

Enhanced sensitivity of dobutamine stress echocardiography by observing wall motion abnormalities during the recovery phase after acute beta-blocker administration.

Dobutamine stress echocardiography (DSE) has a modest sensitivity for detecting single-vessel coronary artery disease (CAD). This study assessed the additional diagnostic value of new or worsening wall motion abnormalities during recovery after acute administration of beta blockers. The study population consisted of 200 patients (mean 59 +/- 11 years of age, 144 men), who underwent DSE. Images were acquired at rest, low dose, peak dose, and during recovery. Patients received intravenous metoprolol (1 to 5 mg/min). The dose was adjusted to achieve a recovery heart rate within a 10% range of heart rate at rest. Coronary angiography was performed within 2 months. Inducible new wall motion abnormalities were observed in 168 patients (84%) at peak stress. An additional 14 patients (7%) developed new or worsening wall motion abnormalities during recovery. CAD was detected in 182 patients (86 had single-vessel CAD). Sensitivity, specificity, and accuracy of DSE were 88%, 65%, and 73% at peak stress and 97%, 65%, and 74% during recovery. Sensitivity was particularly higher during recovery than during peak stress in patients with single-vessel CAD (98% vs 81%, p <0.001). In conclusion, assessment of wall motion abnormalities during the recovery phase after acute beta blockade improves sensitivity of DSE, particularly in patients with single-vessel CAD.

Adrenergic beta-Antagonists↗

PubMed2005

Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection.

BACKGROUND & AIMS: Clinical care of patients undergoing colonic surgery differs between hospitals and countries. In addition, there is considerable variation in rates of recovery and length of hospital stay following major abdominal surgery. There is a need to develop a consensus on key elements of perioperative care for inclusion in enhanced recovery programmes so that these can be widely adopted and refined further in future clinical trials. METHODS: Medline database was searched for all clinical studies/trials relating to enhanced recovery after colorectal resection. Relevant papers from the reference lists of these articles and from the authors' personal collections were also reviewed. A combination of evidence-based and consensus methodology was used to develop the resulting enhanced recovery after surgery (ERAS) clinical care protocol. RESULTS AND CONCLUSIONS: Within traditional perioperative practice there is considerable evidence supporting a range of manoeuvres which, in isolation, may improve individual aspects of recovery after colonic surgery. The present manuscript reviews these issues in detail. There is also growing evidence that an integrated multimodal approach to perioperative care can result in an overall enhancement of recovery. However, effects on major morbidity and mortality remain to be determined. A protocol is presented which is in current use by the ERAS Group and may provide a standard of care against which either current or future novel elements of an enhanced recovery approach can be tested for their effect on outcome.

Colon↗

PubMed2004

Exercise versus recovery electrocardiography in predicting mortality in patients with uncomplicated myocardial infarction.

BACKGROUND: Exercise testing after acute myocardial infarction has limited prognostic accuracy. We prospectively used stress-recovery, heart rate-adjusted, ST-segment analysis to predict cardiac death in this clinical setting. METHODS: The stress-recovery index, defined as the difference in absolute values of the areas designated by ST depression in the heart-rate domain during exercise and recovery, was derived in 708 survivors of a first myocardial infarction. To assess whether it contributed additional prognostic information to routinely obtained information, clinical data, resting ejection fraction, and exercise testing data were entered into a sequential Cox model; the stress-recovery index was entered last. Model validation was performed by bootstrapping adjusted for the degree of optimism in estimates. Survival curves were set up using Kaplan-Meier analysis and compared by the log-rank test. RESULTS: Hypertension (OR 1.3, 95%CI 0.9-4.6), exercise capacity (OR 0.6, 95%CI 0.3-1.1 for the interquartile difference in kilopounds per minute), and the stress-recovery index (OR 0.7, 95%CI 0.5-0.9 for the interquartile difference) were independent predictors of cardiac death at a median follow-up of 32 months. However, the stress-recovery index enhanced the prognostic power of the model on top of clinical and exercise testing variables in all diagnostic subgroups according to ST-segment analysis and significantly discriminated survival. A simple nomogram was generated from the fitted Cox model to estimate risk in individual patients. CONCLUSIONS: Stress-recovery, heart rate-adjusted, ST-segment analysis predicts cardiac death after acute myocardial infarction and provides additional prognostic information over clinical and exercise testing data.

Cohort Studies↗

PubMed2005

Immunosuppressants: neuroprotection and promoting neurological recovery following peripheral nerve and spinal cord lesions.

No clinical techniques induce restoration of neurological losses following spinal cord trauma. Peripheral nerve damage also leads to permanent neurological deficits, but neurological recovery can be relatively good, especially if the ends of a transected nerve are anastomosed soon after the injury. The time until recovery generally depends on the distance the axons must regenerate to their targets. Neurological recovery following the destruction of a length of a peripheral nerve requires a graft to bridge the gap that is permissive to, and promotes, axon regeneration. But neurological recovery is slow and limited, especially for gaps longer than 1.5 cm, even using autologous peripheral nerve grafts. Without a reliable means of bridging long nerve gaps, such injuries commonly result in amputations. Promoting extensive neurological recovery requires techniques that simultaneously provide protection to injured neurons and increase the numbers of neurons that extend axons, while inducing more rapid and extensive axon regeneration across long nerve gaps. Although conduits filled with various materials enhance axon regeneration across short nerve gaps, pure sensory nerve graft remains the gold standard for use across long nerve gaps, even though they lead to only limited neurological recovery. Consistent results demonstrate that several immunosuppressive agents enhance the number of axons and the rate at which they regenerate. This review examines the roles played by immunosuppressants, especially FK506, with primary focus on its role as a neuroprotectant and neurotrophic agent, and its potential clinical use to promote improved neurological recovery following peripheral nerve and spinal cord injuries.

Animals↗

PubMed2005

Mechanical unloading leads to echocardiographic, electrocardiographic, neurohormonal, and histologic recovery.

BACKGROUND: Mechanical unloading during left ventricular assist device (LVAD) support may lead to cardiac recovery. Predictors of recovery, however, have not been identified. We aimed to evaluate the time course and durability of echocardiographic, electrocardiographic (ECG), histologic, and neurohormonal changes that occur with LVAD support and to screen for non-invasive markers of cardiac recovery. METHODS: LVAD patients underwent monthly testing, including echocardiographic, ECG, and serum B-type natriuretic peptide (BNP) measurement. Paired myocardial tissue samples from implant and explant were also analyzed. RESULTS: Thirty-six LVAD patients were prospectively followed for an average of 101 +/- 99 days. Left ventricular ejection fraction (LVEF) and end-diastolic diameter (LVEDD) significantly improved at 30 days compared with pre-LVAD (19% +/- 6.6% vs 33% +/- 8.1%, 7.1 +/- 1.2 cm vs 4.9 +/- 1.0 cm, respectively; both p < 0.001), with no improvement thereafter. At 30 days, QRS duration and QTc interval were significantly decreased from pre-LVAD (both p < 0.05). There was a marked reduction in BNP, myocyte size, and collagen deposition with LVAD support (all p < 0.01). In screening for markers of recovery, the decrease in QTc was inversely related to LVEDD at 60 days. Changes in QRS and myocyte diameter also correlated with the improvement in LVEF at 30 days. No patients had sufficient recovery for device explantation. CONCLUSIONS: We demonstrate echocardiographic, ECG, histologic, and neurohormonal improvement during LVAD support. Cardiac recovery peaked by 60 days, and there was a trend toward progressive improvement in QRS duration with ongoing support. We report the association of ECG changes with echocardiographic and histologic improvements. Future prospective studies may yield important markers of recovery.

Adolescent↗

PubMed2005

Comparison of real-time contrast echocardiography and low-dose dobutamine stress echocardiography in predicting the left ventricular functional recovery in patients after acute myocardial infarction under different therapeutic intervention.

BACKGROUND: Early prediction of left ventricular (LV) functional recovery after acute myocardial infarction (AMI) remains challenging. This prospective study aims to compare real-time myocardial contrast echocardiography (MCE) with low-dose dobutamine stress echocardiography (LDDSE) in predicting the LV functional recovery in patients after AMI who underwent different therapeutic interventions. METHODS: Ninety-two patients with AMI were divided into 3 groups: primary coronary intervention group (n=34), thrombolysis group (n=30) and conservative therapy group (n=28). MCE was performed 2.3+/-0.7 days after chest pain onset. LDDSE was done within 2 days of MCE study. Follow-up echocardiography was performed 4 months later. RESULTS: Patients treated by primary coronary intervention or thrombolysis had significantly lower regional perfusion score (0.65+/-0.53 vs. 1.01+/-0.49, p=0.008; 0.78+/-0.55 vs. 1.01+/-0.49, p=0.03), better contractile reserve (regional dobutamine Deltawall motion score -1.12+/-0.39 vs. -0.80+/-0.43, p=0.01; -0.99+/-0.50 vs. -0.80+/-0.43, p=0.08) and LV function recovery (regional Deltawall motion score -1.67+/-0.53 vs. -1.02+/-0.46, p=0.003; -1.42+/-0.58 vs. -1.02+/-0.46, p=0.03) than those of conservative therapy group. MCE and LDDSE showed good concordance for predicting LV functional recovery (kappa=0.63, p<0.001). Perfusion score index had a good correlation with LV functional recovery (r=-0.75, p<0.001). CONCLUSIONS: This study demonstrates that perfusion score index obtained from real-time MCE is comparable to LDDSE in predicting the LV functional recovery even under different therapeutic interventions. Revascularization results in better preservation of myocardial microvascular integrity, regional contractile reserve and LV functional recovery.

Aged↗

PubMed2005

Effect of prior growth temperature, type of enrichment medium, and temperature and time of storage on recovery of Listeria monocytogenes following high pressure processing of milk.

A five-isolate cocktail of Listeria monocytogenes (10(3) cfu/ml in skim or whole raw milk) was subjected to 450 MPa for 900 s or 600 MPa for 90 s. The effects of prior growth temperature, type of milk (skim vs. whole), type of recovery-enrichment media (optimized Penn State University [oPSU] broth, Listeria Enrichment Broth [LEB], Buffered LEB [BLEB], Modified BLEB [MBLEB], and milk), storage temperature and storage time on the recovery of L. monocytogenes were examined. Optimized PSU broth significantly increased the recovery of L. monocytogenes following high pressure processing (HPP), and was 63 times more likely to recover L. monocytogenes following HPP, compared to LEB, BLEB and MBLEB broths (p<0.05; Odds Ratio=63.09, C.I. 23.70-167.96). There was a significant main effect for prior growth temperature (p<0.05). However, this relationship could not be interpreted given the significant interaction effects between temperature and both pressure and milk type. HPP-injured L. monocytogenes could be recovered using both LEB and oPSU broths after storage of milk at 4, 15 and 30 degrees C, with recovery being maximal after 24 to 72 h of storage; however, recovery yield dropped to 0% after prolonged storage of milk at 4 and 30 degrees C. In contrast, storage of milk at 15 degrees C yielded the most rapid rate of recovery and the highest recovery yield (100%), which remained high throughout the 14 days of storage at 15 degrees C. The above factors need to be taken into consideration when designing challenge studies to insure complete inactivation of L. monocytogenes and possibly other foodborne pathogens during high pressure processing of foods.

Animals↗

PubMed2004

TCE recovery mechanisms using micellar and alcohol solutions: phase diagrams and sand column experiments.

Forty-one phase diagrams and fifteen sand column experiments were conducted to evaluate the efficiency of three types of washing solutions to recover trichloroethylene (TCE) at residual saturation and to identify the recovery mechanisms involved. This study demonstrates that: (1) an alcohol and a surfactant combination is more efficient than an alcohol used alone in water; (2) the prediction of the dominant recovery mechanism from the tie line slopes in phase diagram is accurate and can be reproduced in sand column experiments; and (3) TCE recovery efficiency in sand column experiments is generally well represented by the position of the miscibility curve in phase diagrams in the low concentration range. However, the miscibility curve alone is not sufficient to exactly predict the TCE recovery mechanisms involved. Tie line slopes and the critical tie line have to be taken into consideration to select the active matter as well as its concentration and to predict the dominant recovery mechanism in sand column experiments. The sand column experiments quantified the recovery efficiency of each solution and identified the proportion of the recovery mechanisms (mobilisation vs. solubilisation). Washing solutions with an active matter concentration above the critical tie line caused dominating mobilisation. Mobilisation was also dominant when the active matter of the washing solution partitioned into the organic phase and the active matter concentration was below the critical tie line. Solubilisation and emulsification were dominant for washing solutions containing active matter, which principally partitioned into the aqueous phase and an active matter concentration below the critical tie line.

Micelles↗

PubMed2006

Analysis of RNA recovery and gene expression in the epidermis using non-invasive tape stripping.

BACKGROUND: The recovery of RNA from the upper epidermis by tape stripping yields variable RNA mass but has not been evaluated for its dependence on anatomical location. Gene expression at different body locations and the origin of RNA recovered by tape stripping have not been investigated. OBJECTIVES: To characterize the recovery of RNA from different anatomical locations by tape stripping; to correlate the recovery of RNA and removal of barrier by tape stripping, as assayed by transepidermal water loss; and to investigate gene expression in the upper epidermis at different body locations. METHODS: Twelve subjects were tape stripped at 15 body locations. RNA mass was evaluated and gene expression assayed. Subjects were tape stripped 4, 8 and 12 times on the upper back and transepidermal water loss and RNA recovery assayed. RESULTS: Ranked by median RNA recovery, the following order was observed: mastoid>forehead>chest>upper back>mid back>cheek>lower back>deltoid>forearm>abdomen>ventral thigh>inner arm>shin>dorsal thigh>lower leg. Expression of the housekeeping gene mRNAs is found to be uniform and reproducible while IL-8 and TNFalpha mRNAs are expressed in different quantities both at different body sites within an individual and between individuals at a specific anatomical site. Data show a significant and high correlation between the number of tapes used to strip a site and transepidermal water loss but no strong correlation between transepidermal water loss and RNA recovery or number of tapes used to strip a site and RNA recovery. CONCLUSIONS: Subjects and anatomical location are shown to be significantly different for the ability to recover RNA by tape stripping. We hypothesize that RNA recovered by tape strip is not derived from corneocytes but from cells associated with the stratum corneum.

Abdomen↗

PubMed2006

The effects of carbon dioxide anesthesia and anoxia on rapid cold-hardening and chill coma recovery in Drosophila melanogaster.

Carbon dioxide gas is used as an insect anesthetic in many laboratories, despite recent studies which have shown that CO(2) can alter behavior and fitness. We examine the effects of CO(2) and anoxia (N(2)) on cold tolerance, measuring the rapid cold-hardening (RCH) response and chill coma recovery in Drosophila melanogaster. Short exposures to CO(2) or N(2) do not significantly affect RCH, but 60 min of exposure negates RCH. Exposure to CO(2) anesthesia increases chill coma recovery time, but this effect disappears if the flies are given 90 min recovery in air before chill coma induction. Flies treated with N(2) show a similar pattern, but require significantly longer chill coma recovery times even after 90 min of recovery from anoxia. Our results suggest that CO(2) anesthesia is an acceptable way to manipulate flies before cold tolerance experiments (when using RCH or chill coma recovery as a measure), provided exposure duration is minimized and recovery is permitted before chill coma induction. However, we recommend that exposure to N(2) not be used as a method of anesthesia for chill coma studies.

Acclimatization↗

PubMed2006

Lipid peroxidation and antioxidant status in workers exposed to PCDD/Fs of metal recovery plants.

Secondary copper smelters, which primarily utilize the waste materials that contain organic impurities, and the zinc recovery plant, which handles mostly fly ash and slag from the iron and steel industry, are major emission sources of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) in Taiwan. In this study, we compared the levels of erythrocyte glutathione (GSH), erythrocyte superoxide dismutase (SOD) and plasma malondialdehyde (MDA) in workers at a secondary copper smelting plant and a zinc recovery plant who may have been exposed to PCDD/Fs. Though the PCDD/F levels were higher in workers of zinc recovery plant than those of secondary copper smelting plant, no significant difference was found for serum PCDD/F levels between the two kinds of plants. We observed a significant difference in plasma MDA levels between workers at the zinc recovery plant (2.54 microM) and those at the copper smelting plant (1.79 microM). There was and a significant positive correlation between plasma MDA levels and the PCDD/Fs levels. In addition, we observed that the MDA levels were not affected by smoking and exercise status. Therefore, the data suggest that the MDA levels of the metal recovery workers are influenced by their PCDD/F exposure. The erythrocyte SOD activity in workers from the zinc recovery plant was marginally higher than that from the secondary copper plant (196 vs. 146 units/ml, p<0.06). In both plants, large variations in the MDA and SOD levels were found, especially in the high-PCDD/Fs-exposure group, which may be attributed, at least partially, to the differences in smoking status and the number of cigarettes smoked. Overall, our results indicate a higher oxidative stress in workers of the zinc recovery plant than in workers of the secondary copper smelting plant in Taiwan.

Adult↗

PubMed2001

Abnormal heart rate recovery after exercise as a reflection of an abnormal chronotropic response.

Abnormal decline in heart rate (HR) after exercise has been linked to increased cardiac mortality. This study compares the decrease in HR in different patient types, elucidates the relation between the increase and decrease of HR with exercise, and studies the role of beta blockers on the recovery of HR after exercise. One hundred patients with coronary artery disease (CAD), 50 subjects with a very low likelihood of CAD (normals), and 21 postcardiac transplant (Tx) patients underwent Bruce protocols. Peak HR, percent of peak HR achieved, HR reserve percent, and decline in HR at 1, 3, 5, and 8 minutes were obtained for all groups and also for subgroups based on the use of beta blockers. HR recovery at 1, 3, 5, and 8 minutes differed significantly between patients with CAD, normals, and Tx patients. HR recovery at 1, 3, 5, and 8 minutes also differed significantly within the groups (normal and CAD) based on the use of beta blockers. There was highly significant correlation between decrease in HR and peak HR, percent peak HR and HR reserve percent in normal and CAD groups. After correction of the HR recovery for dependence on peak HR and HR reserve percent, the difference in HR recovery between normal and CAD groups was markedly reduced. The difference in the decrease of HR within each group (normal and CAD), based on the use of beta blockers or not, was also markedly reduced. beta blockers have a significant impact on the decrease in HR due to its effect on chronotropism. HR recovery rate is highly dependent on the chronotropic response. Hence, the main portion of the abnormality in HR recovery after exercise can be explained by chronotropic incompetence.

Adrenergic beta-Antagonists↗

PubMed2002

Heart rate recovery after treadmill exercise testing and risk of cardiovascular disease events (The Framingham Heart Study).

A delayed heart rate (HR) recovery after graded exercise testing has been associated with increased all-cause mortality in clinic-based samples. No prior study has examined the association of HR recovery after exercise with the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) events. We evaluated 2,967 Framingham study subjects (1,400 men, mean age 43 years) who were free of CVD and underwent a treadmill exercise test (Bruce protocol) at a routine examination. We examined the relations of HR recovery indexes (decrease in HR from peak exercise) to the incidence of a first CHD or CVD event and all-cause mortality, adjusting for established CVD risk factors. During follow-up (mean 15 years), 214 subjects experienced a CHD event (156 men), 312 developed a CVD event (207 men), and 167 died (105 men). In multivariable models, continuous HR recovery indexes were not associated with the incidence of CHD or CVD events, or with all-cause mortality. However, in models evaluating quintile-based cut points, the top quintile of HR recovery (greatest decline in HR) at 1-minute after exercise was associated with a lower risk of CHD (hazards ratio vs bottom 4 quintiles 0.54, 95% confidence interval [CI], 0.32 to 0.93) and CVD (hazards ratio 0.61, 95% CI 0.41 to 0.93), but not all-cause mortality (hazards ratio 0.99, 95% CI 0.60 to 1.62). In our community-based sample, HR recovery indexes were not associated with all-cause mortality. A very rapid HR recovery immediately after exercise was associated with lower risk of CHD and CVD events. These findings should be confirmed in other settings.

Adult↗

PubMed1997

Developmental changes of atrioventricular nodal recovery properties.

Atrioventricular (AV) nodal recovery properties can be studied by a periodic premature stimulation protocol performed at a slow basic rate. Developmental aspects of these properties have not been determined. The purpose of this study was to determine the developmental changes of AV nodal recovery properties. Forty-three children and young adults (male:female ratio 25:18) without AV nodal disease (aged 3.3 to 21.9 years) were studied by delivering premature atrial extrastimuli coupled to basic driven atrial beats. The individual recovery curve was fitted to the equation: A2H2 = A0H0 + exp(alpha -H1A2/tau) for H1A2 > or =theta, where A0H0 is the minimum AH interval, H1A2 is any recovery interval that exceeds the nodal effective refractory period, A2H2 is the corresponding nodal conduction time at any given H1A2, alpha is a constant, tau is the recovery time constant, and theta is the nodal effective refractory period. We found that: (1) A0H0 and alpha constant did not change significantly with age; (2) both tau (r = 0.324; p <0.05) and theta (r = 0.401; p <0.05) had a positive correlation with age; and (3) the maximum change in A2H2 with a 10-ms decrement in H1A2 was 32 ms and did not change significantly with age. Our results suggest that AV nodal recovery properties are age-dependent and both the recovery time constant and effective refractory period lengthen with age.

Adolescent↗

PubMed2000

Dorzolamide and corneal recovery from edema in patients with glaucoma or ocular hypertension.

PURPOSE: To investigate whether dorzolamide alters corneal hydration control in patients with glaucoma or ocular hypertension. METHODS: Pachymetry, tonometry, and endothelial cell density were measured by a masked observer in 19 subjects with bilateral glaucoma or ocular hypertension. They were treated with 2% dorzolamide in one eye, and with saline in the other, before wearing contact lenses under patched eyes. Corneal thickness, measured each 30 minutes up to 4.5 hours after contact lens removal, enabled estimation of percentage recovery per hour and time for 95% of corneal thickness recovery for both eyes. Seven patients repeated this test after 1 year of dorzolamide use, and their results were compared with those of the preceding year. RESULTS: After induction of hypoxic corneal edema, there was no significant difference between paired corneas in swelling levels (60.0+/-11.8 and 59.8+/-12.9 microm) (P = .94), time to 95% recovery (440.6+/-255.8 and 445.4+/-186.7 minutes) (P = .93), and percentage recovery per hour (38.1%+/-10.9% and 36.1%+/-9.6%) (P = .40). Subjects followed up after 1 year of dorzolamide use did not differ significantly in values of endothelial cell density, percentage recovery per hour, or time to 95% recovery from those obtained a year before. One subject developed persistent corneal edema after his stress test in the eye treated with dorzolamide. CONCLUSION: There is no significant difference in the recovery from induced corneal edema after either a short-term or 1-year use of dorzolamide in patients with glaucoma or ocular hypertension with a normal corneal endothelium. One patient had persistent corneal edema after the stress test was performed on the dorzolamide-treated eye.

Aged↗