Lactate kinetics during passive and partially active recovery in endurance and sprint athletes

We investigated the effects of passive and partially active recovery on lactate removal after exhausting cycle ergometer exercise in endurance and sprint athletes. A group of 14 men, 7 endurance-trained (ET) and 7 sprint-trained (ST), performed two maximal incremental exercise tests followed by either passive recovery (20 min seated on cycle ergometer followed by 40 min more of seated rest) or partially active recovery [20 min of pedalling at 40% maximal oxygen uptake ( O_2max) followed by 40 min of seated rest]. Venous blood samples were drawn at 5 min and 1 min prior to exercise, at the end of exercise, and during recovery at 1, 2, 3, 4, 5, 6, 8, 10, 15, 20, 30, 40, 50, 60 min post-exercise. The time course of changes in lactate concentration during the recovery phases were fitted by a bi-exponential time function to assess the velocity constant of the slowly decreasing component (₂) expressing the rate of blood lactate removal. The results showed that at the end of maximal exercise and during the 1st min of recovery, ET showed higher blood lactate concentrations than ST. Furthermore, ET reached significantly higher maximal exercise intensities [5.1 (SEM 0.5) W · kg^–1 vs 4.0 (SEM 0.3) W · kg^–1,P < 0.05] and O_2max [68.4 (SEM 1.1) ml · kg^–1 · min^–1 vs 55.5 (SEM 5.1) ml · kg^–1 · min^–1,P < 0.01]. There was no significant difference between the two groups during passive recovery for ₂ During partially active recovery, ₂ was higher than during passive recovery for both groups (P < 0.001), but ET recovered faster and sooner than ST (P < 0.05). Compared to passive recovery, the ₂ measured during partially active recovery was increased threefold in ET and only 1.5-fold in ST. We concluded that partially active recovery potentiates the enhanced ability to remove blood lactate induced by endurance training.     

Comparison of a traditional paracetamol medication and a new paracetamol/paracetamol-methionine ester combination

Summary The SUR 2647 combination is a sachet formulation containing free paracetamol and its N-acetyl-methionate ester (SUR 2647). In a randomized, single-blind, between-patient study the onset of analgesia, duration and efficacy of the SUR 2647 combination vs paracetamol was investigated in outpatients after oral surgery. One group (n=27) received sachets of SUR 2647 combination 2 b.i.d. (equivalent to 2 g paracetamol ×2) on the day of operation, and one sachet b.i.d. (equivalent to 1 g paracetamol ×2) for the following two days. The other group (n=26) received paracetamol tablets 2 q.i.d. on the day of operation (1 g×4) and one tablet q.i.d. (0.5 g×4) for the following two days. Several objective and subjective assessments, including pain score on a visual analogue scale, were recorded for comparison of the postoperative courses. Median onset of analgesia for both groups was 0.5 h. The duration after SUR 2647 combination was 5.5 h as compared to 2.5 h for paracetamol. Mean pain scores showed that the SUR 2647 combination regime reduced pain significantly more than the paracetamol regime from 0.5 to 3.0 h after initiation of medication. The mean pain scores did not show a significant difference during the remaining observation period. Mild to moderate drowsiness was reported in both treatment groups, but it was more common in subjects given SUR 2647 combination.     

血肿穿刺抽吸治疗对高血压性脑出血患者血糖及按期预后的影响

目的：探讨治疗创伤对高血压性脑出血患者血糖及按期预后的影响。方法：采用局麻血肿穿刺抽吸治疗（治疗组32例）及全麻外科手术血肿清除治疗（对照组30例）,比较术后的血糖变化,结果：治疗组血肿穿刺抽吸后血糖高峰值水平显著低于对照组（P＜0．01）,而治疗后第1,2,周血糖降至正常者治疗组显著高于对照组（P＜0．05）,病死率治疗组6．25％,对照组26．7％）,两组比较差异显著（P＜0．05）,结论：高血压性脑出血患者血肿穿刺抽吸治疗较外科手术血肿清除治疗有血糖峰值低,恢复正常的速度快,病死率低,对脑组织的损伤小等优点,值得临床推广。     

胎盘滞留96例临床分析

目的 积极预防和正确处理胎盘滞留,减少产后出血及产褥感染。方法 产后胎盘滞留时间较短的可以行人工剥离胎盘术。如用手剥离过程中发现宫壁与胎盘之间没有分界线或有草根样条索状连接时,可能有胎盘植入,需停止剥离,根据情况决策保守治疗或行子宫切除术。若产后胎盘滞留时间较长,有明显感染,再行清宫术。结果 96例产后胎盘滞留患,均痊愈出院。结论 落实好避孕措施,减少流产次数;提高引产,流产技术操作水平;正确处理第三产程等可有效预防胎盘滞留的发生。对于胎盘滞留,应根据不同情况给予相应的处理,可减少产后出血及产褥感染。     

Regional anaesthesia in patients taking anticoagulant drugs

Many surgical patients are taking drugs that impair normal coagulation, and this causes concern about the risk of perioperative bleeding events. The anaesthetist is particularly concerned about compressive vertebral canal haematomas, which may occur after spinal or epidural anaesthetic techniques. Fortunately, the risk of this complication is very low. The major risk factors are coagulopathy or technical difficulties with the block. There is also concern about perineural haematomas, which may be associated with peripheral nerve blocks. This article attempts to put the risks of these complications into context, with reference to different classes of anticoagulant drugs.     

高温煤气中HC1气体与脱氯剂的反应动力学

在固定床反应器中研究了自制的脱氯剂与高温煤气中ＨＣ１气体的反应动力学,得出在５５０℃时反应受通过产物层的扩散和化学反应反控制,两埂的阻力之比为０．１３８。同时研究了温度和进口ＨＣ１气体浓度对该反应影响,得出反应对于气相ＨＣ１为一级反应。     

Higher Kt/V is needed for adequate dialysis if the treatment time is reduced

The widely used Kt/V concept for quantitating haemodialysis(HD) and ensuring adequate dialysis is based on several assumptions.In order to simplify the urea kinetic modelling, the body isassumed to be a single well-mixed compartment. Previously, morephysiological two-compartment or blood flow distribution modelshave been used to explain the phenomenon of blood urea reboundafter dialysis. This study attempts to evaluate the effectsof a multi compartment model on the removal of urea, i.e. onthe adequacy of dialysis. Four different tissue compartmentsof similar size are used, with flow rates between 40 and 3600ml/min for a bodyweight around 70 kg, allowing for blood flowheterogeneity within and between skeletal muscles. Dialysisis simulated by removing blood containing urea and replacingit with blood free of urea, during isovolumetric conditionsand assuming no diffusion barriers for urea. Several importantconclusions can be drawn from the model. Firstly the removalof urea is dependent both on the time of dialysis and on thenumber of HD treatments per week despite constant Kt/V. Secondlythe blood urea concentration is increased after dialysis—‘urearebound’—in accordance with clinical data. Thirdlythe concept of blood flow distribution can fully explain thedifference between haemodialysis and peritoneal dialysis interms of Kt/V needed for adequate dialysis. Thus a weekly Kt/Vof 3.6 for HD 4 h 3 times per week removes the same amount ofurea as CAPD and a Kt/V of 2.1. Also, nightly intermittent PDrequires similar Kt/Vs (0.1 higher) as CAPD to obtain equivalentremoval of urea. Finally the crucial point is that the Kt/Vrequired for adequate dialysis must be increased if the dialysistreatment time is reduced. If not, the patient with renal insufficiencysuffers the risk of being under-dialysed.     

Calcified convexity dura mater and acute epidural haematoma mimicking calcified chronic subdural haematoma

We report a patient with calcification of the convexity dura mater and an acute epidural haematoma. CT revealed a calcified layer between the haematoma and brain parenchyma, which mimicked acute bleeding into a calcified chronic subdural haematoma. The appearance of a calcified haematoma does not always mean a chronic lesion, and that emergency operation should not be foregone, when there is a history of acute head trauma and progressive impairment of consciousness.