[Strategies for long-term registration of physiologic parameters in internal medicine].
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Studies have shown significant variation in stroke case fatality across Europe. These variations suggest the need to explore whether differences in physiological support in acute stroke exist across Europe. Data were collected in four European centres over 6 months. These included clinical status and management of acute physiology (hydration, oxygenation, nutrition, hypertension, hyperglycaemia and temperature in the first week of ischaemic stroke) and survival at 3 months. Differences in acute supportive care between centres were adjusted for case mix. Patients admitted to centres in London (n = 106), Dijon (n = 95), Erlangen (n = 91) and Warsaw (n = 72) were studied. There were significant differences in incontinence, dysphasia, dysphagia, conscious level, pyrexia, hyperglycaemia and comorbidity between centres. After adjusting for case mix, there were significant differences in intravenous fluid use (P = 0.04), enteral feeding (P = 0.003), initiation of new antihypertensive therapy (P = 0.0006) and insulin therapy (P = 0.004) between centres, with the London centre having the lowest uptake of interventions. Three-month case fatality rates varied from 10 to 28%. This pilot study shows significant variation in acute physiological support in acute stroke across four European centres, which remains unexplained by case mix. Further research is required to link variation in acute care with stroke outcome, to identify which interventions appear to be the most effective.
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Several biological changes occur when streptozocin is given to experimental animals. The rat streptozocin (STZ) model is extensively used in diabetic experiments. In this brief report, the main physiological characteristics of rats injected with streptozocin are presented. These characteristics are manifested by weight loss, organ weight reduction, serum glucose elevation, decrease in serum insulin level, and other enzyme and hormonal changes. A collection of these parameters may be helpful in establishing a database to describe this model.
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Although rat cerebrospinal fluid (CSF) is increasingly being used in pharmacological and biochemical research, methodological studies on basic physiological data are lacking. We have determined the albumin content and number of erythrocytes and leukocytes in CSF obtained by two different methods of sampling from cisterna magna-repeated sampling from an implanted cannula and by repeated punctures. In the initial samples the albumin content was 0.08 +/- 0.03 micrograms/microliters. Chronic cannulation of the cisterna magna resulted in a meningeal reaction with increased cell and albumin content: a reaction that could be reduced but not prevented by using a sterile cannula. The number of leukocytes but not erythrocytes was highly correlated to the albumin content. Repeated sampling in the absence of a permanent cannula did not significantly increase albumin content but carried a higher risk for erythrocyte contamination.
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The main factors studied were the overall energy output and, in particular, the effects on the respiratory, cardiac and circulatory systems. The basic result was to demonstrate that while driving there occur more or less marked physiological modifications to these systems, which can be determined as to quantity; it seems clear that during particularly difficult conditions at the wheel or in subjects whose health is less than perfect, this can go as far as pathological situations. The values of catecholamines and their metabolites in the blood and urine were chosen as evaluation parameters. Catecholamines--that is, adrenaline, noradrenaline and dopamine--are substances produced by the adrenal glands; they play an essential part in the "functioning" of the sympathetic nervous system (which has important tasks, such as that of regulating the organism's equilibrium especially in reactions to sudden events or emergency situations) and are a reliable indication of effort and stress. Their action is seen in stimulation of the nervous system, cardiac agitation, an increase in blood pressure and in the production of lactic acid, increases in the basal metabolism, and so on. An excessive amount of these substances in the blood can cause real damage, above all to the heart and brain, especially in organs already affected in some way. The subjects studied were healthy volunteers, ranging in age between 20 and 35 and of comparable height and weight. A sort of "cross-over" experiment was carried out, so that the same subject was first studied driving with one type of gear change and then, two days later, was studied in the same experimental conditions but driving a vehicle with the other type of gear change. Analysis of the blood and urine sample was carried out in "single blind-test" conditions, in the sense that the research worker did not know where the samples came from. The biochemical analyses of the blood were: 1) Gas-analysis; 2) Hemochrome; 3)LDH-SGOT-Alkaline phosphatase; 4)Noradrenaline; 5)Cortisol. The following urine analyses were made: 1)Total catecholamines; 2)Vanillylmandelic acid. Clinical tests included: 1. Measurement of arterial pressure, at the beginning, at the end and during the driving period at the 30th and 90th minute. 2. Measurement of cardiac frequency,at the beginning, at the end and during the driving period at the same times. Blood pressure was measured by the auscultatory method, using an armband apparatus with aneroid capsule; cardiac frequency was measured at the wrist using the simple palpatory method, per 60 seconds.
Fifty postpolio patients, 34 with and 16 without complaints of progressive loss of muscle strength, and 41 control subjects were studied to compare physiologic measures of the fatiguing process and to determine whether there is a significant interaction between the rating of perceived exertion (RPE) and physiologic measures. Statistical analyses were by ANOVA and repeated-measures ANOVA. The RPE was obtained every 20 seconds during an isometric contraction of the quadriceps at 40% of maximal torque; median frequency (Fm) of the power spectrum of the surface electromyographic signal and neuromuscular efficiency (NME) were constantly monitored. The RPE increased similarly (p greater than .05), whereas Fm and NME decreased similarly (p greater than .05) during endurance exercise at 40% of maximal torque in all three groups. A significant (p less than .05) interaction was found between RPE and both Fm and NME. We conclude that physiologic measures of the fatiguing process (Fm and NME) occur in a similar manner in postpolio and control subjects and that there is a significant interaction between subjective RPE and physiologic measures of the fatiguing process.
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