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Recovery Patterns (recovery + pattern)
Selected AbstractsClinical utility of an automated pupillometer for assessing and monitoring recipients of liver transplantationLIVER TRANSPLANTATION, Issue 12 2009Sheng Yan Pupil examination has been used as a basic measure in critically ill patients and has great importance for the prognosis and management of disease. An automated pupillometer is a computer-based infrared digital video system by which the accuracy and precision of the pupil examination are markedly improved. We conducted an observational study of pupil assessment with automated pupillometry in clinical liver transplantation settings, including pretransplant evaluations and posttransplant surveillance. Our results showed that unconscious patients (grade 4 hepatic encephalopathy) had a prolonged latency phase (left side: 283 ± 80 milliseconds; right side: 295 ± 96 milliseconds) and a reduced pupillary constrictive ratio (left direct response: 0.23 ± 0.10; left indirect response: 0.21 ± 0.07; right direct response: 0.20 ± 0.08; right indirect response: 0.21 ± 0.08) in comparison with normal and conscious patients. After liver transplantation, the recovery of pupillography in these patients was slower than that in conscious patients. However, the surviving recipients without major complications all had a gradual recovery of pupillary responses, which occurred on the first or second posttransplant day. We also reported 4 cases of futile LT in the absence of pretransplant pupillary responses and other pupillary abnormalities revealed by automated pupillometry in our study. In conclusion, patients with grade 4 hepatic encephalopathy had a sluggish pupil response and a delayed recovery pattern after LT. An automated pupillometer is potentially a supplementary device for pretransplant screening and posttransplant monitoring in patients undergoing LT, but further prospective studies are required. Liver Transpl 15: 1718,1727, 2009. © 2009 AASLD. [source] Low Central Venous Pressure with Milrinone During Living Donor HepatectomyAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2010H.-G. Ryu Maintaining a low central venous pressure (CVP) has been frequently used in liver resections to reduce blood loss. However, decreased preload carries potential risks such as hemodynamic instability. We hypothesized that a low CVP with milrinone would provide a better surgical environment and hemodynamic stability during living donor hepatectomy. Thirty-eight healthy adult liver donors were randomized to receive either milrinone (milrinone group, n = 19) or normal saline (control group, n = 19) infusion during liver resection. The surgical field was assessed using a four-point scale. Intraoperative vital signs, blood loss, the use of vasopressors and diuretics and postoperative laboratory data were compared between groups. The milrinone group showed a superior surgical field (p < 0.001) and less blood loss (142 ± 129 mL vs. 378 ± 167 mL, p < 0.001). Vital signs were well maintained in both groups but the milrinone group required smaller amounts of vasopressors and less-frequent diuretics to maintain a low CVP. The milrinone group also showed a more rapid recovery pattern after surgery. Milrinone-induced low CVP improves the surgical field with less blood loss during living donor hepatectomy and also has favorable effects on intraoperative hemodynamics and postoperative recovery. [source] Changes of elbow kinematics and kinetics during 1 year after strokeMUSCLE AND NERVE, Issue 3 2008Mehdi M. Mirbagheri PhD Abstract A precise description of the natural history of motor recovery after stroke provides a framework for understanding the mechanisms underlying this improvement and for tracking the efficacy of rehabilitation treatments. To characterize the time course of this change in motor impairment, we examined voluntary elbow movements in hemiparetic stroke survivors over a period of 1 year after stroke. Based on the possibility that both central nervous system and muscle factors could contribute to the observed clinical state, we hypothesized that we should observe at least two major recovery patterns of motor impairment. To explore these predictions, we assessed elbow movement range, movement speed, and isometric force generation. Subjects were examined five times over the 12-month period. We used the "growth mixture" model to characterize recovery of these measures, and the Fugl-Meyer scale (FMS) of upper-extremity function at 1 month to predict the recovery. We observed two distinct recovery classes. Class 1 started with low values for the physiological measures, and these increased over time, whereas class 2 tended to start with higher values and showed widely divergent recovery patterns. Using the logistic regression model, the impact of FMS on class membership was estimated for each parameter. Based on these data, we were able to accurately predict arm impairment recovery at different time-points in the first year, information of great potential value for planning targeted therapeutic interventions. Muscle Nerve, 2008 [source] Hematopoietic and immune recovery after allogeneic peripheral blood stem cell transplantation and bone marrow transplantation in a pediatric populationPEDIATRIC TRANSPLANTATION, Issue 4 2002Yoshihisa Nagatoshi Abstract: To compare the hematopoietic and immune recoveries after allogeneic transplantation with different cell sources, we analyzed the recovery patterns of blood components after allogeneic peripheral blood stem cell transplantation (PBSCT) in comparison with that after allogeneic bone marrow transplantation (BMT) in a pediatric population. Sixteen patients received PBSCT, and 24 received BMT between January, 1995 and March, 2000. The patients had acute lymphoblastic leukemia (ALL; n = 22), acute myelogenous leukemia (AML; n = 8), myelodysplastic syndrome (MDS; n = 3), or other diseases (n = 7). The median ages of patients in the PBSCT and BMT groups were 9 yr and 6 yr, respectively. Cyclosporin A (CsA) plus methotrexate or methylprednisolone was used as a graft-vs.-host disease (GvHD) prophylaxis regimen in the PBSCT group, whereas CsA alone or methotrexate alone was used in the BMT group. Circulating lymphocyte numbers and subpopulations determined by flow cytometric analysis were used as markers of immune recovery. In the PBSCT group, the median number of harvested CD34+ cells was 7.25 (range: 1.3,27.6) × 106/kg of the recipient's body weight, while the median number of harvested nucleated cells was 4.7 (range: 3.7,10.5) × 108/kg. All of the patients were engrafted. Myeloid engraftment occurred sooner after PBSCT than after BMT (median number of days to achieve absolute neutrophil counts (ANC) > 0.5 × 109/L; 11 and 15, respectively; p < 0.0001) and similar results were found for platelet engraftment (median number of days to achieve a platelet count of > 20 × 109/L; 12 and 21, respectively; p = 0.004). On the other hand, after PBSCT the absolute numbers of total circulating lymphocytes and lymphocyte subpopulations were not significantly different from those after BMT. The incidence of acute GvHD after PBSCT was the same as that after BMT, while chronic GvHD developed more frequently after PBSCT than after BMT (p = 0.005). In a pediatric population, the indications for PBSCT and BMT should be based on these findings in addition to regard for the donor's safety. [source] Gorgonian population recovery after a mass mortality eventAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 2 2005C. Cerrano Abstract 1.Mass mortality events are becoming more common all over the world, both in tropical and temperate seas. An extensive mortality occurred in the Mediterranean Sea in 1999, affecting many benthic species, mainly sponges and gorgonians. 2.The recovery of a population of the sea fan Paramuricea clavata, for a period of 3 yr, from 1999 to 2002, was studied by both line transects and fixed frames. The average size of the colonies decreased, indicating a size-dependent mortality episode, but their density, as a result of successful recruitment, was not altered after 3 yr. 3.P. clavata showed three recovery patterns: (i) sexual reproduction, (ii) coenenchyme regeneration and (iii) fragmentation of affected branches. Moreover, the growth rates of small colonies varied in the different years. The sex ratio of the population was also altered, with females being more affected than males; the population studied showed a significant male bias (3.3:1, n=150), varying greatly from the typical sex ratio (1:1) previously recorded in the same population before the mass mortality event. Copyright © 2004 John Wiley & Sons, Ltd. [source] Hurricane Impacts on a Mangrove Forest in the Dominican Republic: Damage Patterns and Early Recovery,BIOTROPICA, Issue 3 2001Ruth E. Sherman ABSTRACT On 22 September 1998, Hurricane Georges passed over the Dominican Republic causing extensive damage to a 4700 ha mangrove forest that has been the site of a detailed study of vegetation and ecosystem dynamics since 1994. We resurveyed the vegetation in permanent plots at 7 and 18 months after the hurricane to document structural damage of the forest and evaluate early recovery patterns. The intensity of damage was patchy across the landscape. Mortality (>5 cm DBH) ranged from 14 to 100 percent (by density) among the 23 different plots and averaged 47.7 percent across all plots. Reductions in total basal area ranged from 9 to 100 percent, averaging 42.4 percent. Mortality increased by 9 percent between surveys at 7 and 18 months post-hurricane. Interspecific differences in susceptibility to wind damage appeared to be a primary factor contributing to spatial patterns in mortality. Laguncularia racemosa experienced much less mortality (26%) than either Rhizophora mangle (50%) or Avicennia germinans (64%), and plot-level mortality was strongly associated with differences in species composition. There were no clear relationships between canopy height and tree damage at this site. Over 80 percent of the of the surviving R. mangle trees exhibited less than 50 percent crown damage, whereas ca 60 percent of the L. racemosa survivors suffered almost complete (75,100%) crown loss. By 18 months after the hurricane, the percentage of L. racemosa trees in the 75 to 100 percent damage class was reduced to 20 percent; in contrast, the health of many R. mangle individuals appeared to be declining, as the percentage of trees in the 50 to 100 percent damage class increased from 16 to 36 percent. Understory light levels, as measured by the gap light index, increased from an average value of 3 percent in the pre-hurricane forest to 51 percent at 7 months after the hurricane and decreased slightly to 47 percent at 18 months. Few saplings (>1 m tall and <5 cm DBH) survived the hurricane; 72 percent of the tagged individuals in transect-based plots and 66 percent of saplings in pre-hurricane canopy gaps were killed. Seedling and sapling populations of all three species appear to be recovering rapidly although their densities still are lower than in the pre-hurricane forest. It is too early to predict the trajectory of forest recovery, and continued monitoring of the spatial and temporal patterns of forest development is needed to improve our understanding of the role that large-scale disturbance events play on the dynamics of mangrove forest ecosystems. RESUMES El 22 de septiembre de 1998, el huracán Georges pasó sobre la República Dominicana causando daños extensos a 47 km2 de manglar que ha sido objeto un estudio detallado de vegetacion y dinámica de la communidad desde 1994. Se tomarón muestras de la vegetación en parcelas permanentes 7 y 18 meses después de paso del huracán para documentar los daños estructurales del bosque y evaluar los modelos de recuperacion temprana que siguieron posteriormente. La intensidad del daño fue irregular a través del paisaje. La mortalidad (>5 cm de dap) fue de 14 a 100 por ciento (para la densidad) en las 23 parcelas con un promedio de 47.7 por ciento. La reducción en área basal total fue de 9 a 100 por ciento con un promedio de 42.4 por ciento. La mortalidad aumentó 9 por ciento a los 7 y 18 meses después del huracán. Las diferencias interspecificas en la susceptibilidad a los daños causados por el viento fueron un factor contribuyente importante en los patrones espacios de mortalidad. Laguncularia racemosa sufrió menor mortalidad (26%) que Rhizophora mangle (50%) o Avicennia germinans (64%), la mortalidad en las parcelas estuvo asociada fuertemente con la diferencia en composición de especies. No hubo ningún patron definido entre la altura del dosel y el daño del árbol. Más del 80 por ciento de los árboles sobrevivientes de R. mangle exhibieron daoñres menores de 50 por ciento en sus copas, mientras que ca 60 por ciento de los L. racemosa sobrevivientes sufrió una perdida casi total (75-100%). Dieciocho meses despues del huracan, el porcentaje de arboles de L. racemosa con daños del 75-100 por ciento se redujó a 20 por ciento; en contraste, la salud de muchos individuos de R. mangle disminuyó conforme el porcentaje de árboles con daños del 50-100 por ciento aumentó de 16 a 36 por ciento. Los niveles de penetración de luz en el sotobosque, medidos como el indice de iluminacion en los claros, aumentó de un promedio de 3 por ciento antes del huracán. a 51 por ciento 7 meses después del huracán, y disminuyo ligeramente a 47 por [source] | |||||||||||||