Effects of sedation during upper gastrointestinal endoscopy on endocrine response and cardiorespiratory function

Upper gastrointestinal endoscopy is often accompanied by tachycardia which is known to be an important pathogenic factor in the development of myocardial ischemia. The pathogenesis of tachycardia is unknown but the condition is thought to be due to the endocrine response to endoscopy. The purpose of the present study was to investigate the effects of sedation on the endocrine response and cardiorespiratory function. Forty patients scheduled for diagnostic upper gastrointestinal endoscopy were randomized into 2 groups. While the patients in the first group did not receive sedation during upper gastrointestinal endoscopy, the patients in the second group were sedated with intravenous midazolam at the dose of 5 mg for those under 65 years or 2.5 mg for those aged 65 years or more. Midazolam was administered by slow infusion. In both groups, blood pressure, ECG tracing, heart rate, and peripheral oxygen saturation (SpO2) were monitored during endoscopy. In addition, blood samples for the determination of cortisol, glucose and C-reactive protein levels were obtained from patients in both groups prior to and following endoscopy. Heart rate and systolic arterial pressure changes were within normal limits in both groups. Comparison of the two groups regarding the values of these two parameters did not reveal a significant difference, while a statistically significant reduction in SpO2 was found in the sedation group. No significant differences in serum cortisol, glucose or C-reactive protein levels were observed between the sedated and non-sedated group. Sedation with midazolam did not reduce the endocrine response and the tachycardia developing during upper gastrointestinal endoscopy, but increased the reduction in SpO2.

Cardiac autonomic modulation during progressive upper limb exercise by patients with coronary artery disease

The purpose of this study was to investigate the behavior of heart rate (HR) and HR variability (HRV) during different loads of resistance exercise (incline bench press) in patients with coronary artery disease (CAD) and healthy sedentary controls. Ten healthy men (65 ± 1.2 years, control group, CG) and 10 men with clinically stable CAD (66 ± 2.4 years, CADG) were recruited. A discontinuous progressive protocol was applied with an initial load of 10% of the maximum load achieved in the 1RM (1 repetition maximum) with increases of 10% until 30% 1RM was reached, which was followed by subsequent increases of 5% 1RM until exhaustion. HRV was analyzed by linear and non-linear methods. There was a significant reduction in rMSSD (CG: 20 ± 2 to 11 ± 3 ms; CADG: 19 ± 3 to 9 ± 1 ms) and SD1 indexes (CG: 14 ± 2 to 8 ± 1 ms; CADG: 14 ± 2 to 7 ± 1 ms). An increase in HR (CG: 69 ± 5 to 90 ± 5 bpm; CADG: 62 ± 4 to 75 ± 4 bpm) and in systolic blood pressure (CG: 124 ± 3 to 138 ± 3 mmHg; CADG: 122 ± 6 to 126 ± 9 bpm) were observed (P < 0.05) when comparing pre-effort rest and 40% 1RM in both groups. Furthermore, an increase in RMSM index was also observed (CG: 28 ± 3 to 45 ± 9 ms; CADG: 22 ± 2 to 79 ± 33 ms), with higher values in CADG. We conclude that loads up to 30% 1RM during incline bench press result in depressed vagal modulation in both groups, although only stable CAD patients presented sympathetic overactivity at 20% 1RM upper limb exercise.

Three-dimensional kinematic analysis of upper and lower limb motion during gait of post-stroke patients

The aim of this study was to analyze the alterations of arm and leg movements of patients during stroke gait. Joint angles of upper and lower limbs and spatiotemporal variables were evaluated in two groups: hemiparetic group (HG, 14 hemiparetic men, 53 ± 10 years) and control group (CG, 7 able-bodied men, 50 ± 4 years). The statistical analysis was based on the following comparisons (P ≤ 0.05): 1) right versus left sides of CG; 2) affected (AF) versus unaffected (UF) sides of HG; 3) CG versus both the affected and unaffected sides of HG, and 4) an intracycle comparison of the kinematic continuous angular variables between HG and CG. This study showed that the affected upper limb motion in stroke gait was characterized by a decreased range of motion of the glenohumeral (HG: 6.3 ± 4.5, CG: 20.1 ± 8.2) and elbow joints (AF: 8.4 ± 4.4, UF: 15.6 ± 7.6) on the sagittal plane and elbow joint flexion throughout the cycle (AF: 68.2 ± 0.4, CG: 46.8 ± 2.7). The glenohumeral joint presented a higher abduction angle (AF: 14.2 ± 1.6, CG: 11.5 ± 4.0) and a lower external rotation throughout the cycle (AF: 4.6 ± 1.2, CG: 22.0 ± 3.0). The lower limbs showed typical alterations of the stroke gait patterns. Thus, the changes in upper and lower limb motion of stroke gait were identified. The description of upper limb motion in stroke gait is new and complements gait analysis.

Diagenesis and geochemical stratigraphy of Upper Pennsylvanian madera brachiopods, New Mexico

Owing to the fact that low-Mg calcite fossil shells are so important in paleoceanographic research, 249 brachiopod, cement and matrix specimens from two neighboring localities (Jemez Springs and Battleship Rock), of the Upper Pennsylvanian Madera Formation were analyzed. Of which, about 86% of the Madera brachiopods are preserved in their pristine mineralogy, microstructure and geochemistry. Cement and matrix samples, in contrast, have been subjected to complete but variable post-deposition~1 alteration. It is confirmed that the stable isotope data of brachiopods are much better than that of matrix material in defining depositional parameters. Because there is no uniform or constant relationship between the two data bases (e.g., from 0.1 to 3.0%0 for 0180 and from 0.2 to 6.7%0 for 013C in this study), it is not possible to make corrections for the matrix data. Regarding the two stratigraphic sections, elemental and petrographic analyses suggest that Jemez Springs is closer to Penasco Uplift than Battleship Rock. Seawater at Jemez Springs is more aerobic, and the water chemistry is more influenced by continental sources than that at Battleship Rock. In addition, there is a relatively stronger dolomitization in the mid-section of the Battleship Rock. Results further suggest that no significant biogenic fractionation or vital effects occurred during their shell secretion, suggesting that the Madera brachiopods incorporated oxygen and carbon isotopes in equilibrium with the ambient seawater. This conclusion is not only drawn from the temporal and spatial analyses, but also supported by brachiopod inter-generic comparison (Composita and Neospirifer) and statistical analysis ( t-test).

Patterns of faunal change at an upper Cambrian trilobite extinction event, Nolichucky Formation, Tennessee and Virginia

During the Upper Cambrian there were three mass extinctions, each of which eliminated at least half of the trilobite families living in North American shelf seas. The Nolichucky Formation preserves the record of one of these extinction events at the base of the Steptoean Stage. Sixty-six trilobite collections were made from five sections In Tennessee and Virginia. The lower Steptoean faunas are assigned to one low diversity, Aphelaspis-dominated biofacies, which can be recognized in several other parts of North America. In Tennessee, the underlying upper Marjuman strata contain two higher diversity biofacies, the Coosella-Glaphyraspis Biofacies and the Tricrepicephalus-Norwoodiid Biofacies. At least four different biofacies are present in other parts of North America: the Crepicephalus -Lonchocephalus Biofacies, the Kingstonia Biofacies, the Cedaria Biofacies, and the Uncaspis Biofacies. A new, species-based zonation for the Nolichucky Formation imcludes five zones, three of which are new. These zones are the Crepicephalus Zone, the Coosella perplexa Zone, the Aphelaspis buttsi Zone, the A. walcotti Zone and the A. tarda Zone. The Nolichucky Formation was deposited within a shallow shelf basin and consists largely of subtidal shales with stormgenerated carbonate interbeds. A relative deepening is recorded In the Nolichucky Formation near the extinction, and is indicated In some sections by the appearance of shale-rich, distal storm deposits above a carbonate-rich, more proximal storm deposit sequence. A comparable deepening-upward sequence occurs near the extinction in the Great Basin of southwestern United States and in central Texas, and this suggests a possible eustatic control. In other parts of North America, the extinction IS recorded In a variety of environmental settings that range from near-shore to slope. In shelf environments, there is a marked decrease in diversity, and a sharp reduction in biofacies differentiation. Although extinctions do take place in slope environments, there IS no net reduction in diversity because of the immigration of several new taxa.

Trilobites of the Upper Cambrian (Marjuman) Pika formation of the Southern Canadian Rocky Mountains

The Upper Cambrian Pika Formation in the southern Canadian Rocky Mountains forms a complete lithologic Grand Cycle. The overall pattern of deposition is one of shallowing upwards from a subtidal, muddy, storm-influenced basin to a shallow carbonate bank. The Pika passes gradationally into the overlying inter- to supratidal siliciclastics of the Arctomys Formation. This transition probably reflects a fall in relative sea level. 2 Twenty seven collections from three sections yielded trilobites. The faunas are assigned to two low-diversity biofacies: the Marjumia - Spencella Biofacies and the GZyphaspis - menomoniid Biofacies. In contrast to biofacies of deeper, open-shelf environments, such as the Wheeler and Marjum formations of Utah, the Pika biofacies lack agnostid trilobites. Consequently, agnostid-based zonations defined elsewhere in North America cannot be applied to the Pika and a new sequence of three zones and one informal fauna is proposed for use in inner shelf facies. Eleven species belonging to six genera are described and illustrated. The species Marjumia bagginsi is new. Other genera present are: Bolaspidella, Knechtelia, GZyphaspis and Spencella, in addition to a number of indeterminate forms

Principles and proceedings of the inhabitants of the District of Niagara for addressing His Royal Highness the Prince Regent, respecting claims of sufferers in war, lands to militiamen and the general benefit of Upper Canada. --

Cover title.

A study of disaffection in Upper Canada in 1812-5 /

Inscribed on verso of front cover: H.R. Morgan Esq. with compts of E.A. Cruikshank.

The wars of the gulls; : an historical romance in three chapters; chap. I, Shewing how and why and with whom the gulls went to war: chap. II, Shewing how the gulls make the deep to boil like a pot: chap. III, Shewing how a certain doughty general of the gulls goes forth to play the game of hull-gull in Upper Canada.

Transcribed on front paste-down: W.G. Phelps Oct. 29 1890.

The effects of upper extremity functional electrically stimulated (FES) exercise training on upper limb function in individuals with tetraplegia

Functional Electrically Stimulated (FES) ami cycle ergometry is a relatively new technique for exercise in individuals with impairments of the upper limbs. The purpose of this study was to determine the effects of 12 weeks of FES arm cycle ergometry on upper limb function and cardiovascular fitness in individuals with tetraplegia. F!ve subjects (4M/1F; mean age 43.8 ± 15.4 years) with a spinal cord injury of the cervical spine (C3- C7; ASIA B-D) participated in 12 weeks of3 times per week FES arm cycle ergometry training. Exercise performance measures (time to fatigue, distance to fatigue, work rate) were taken at baseline, 6 weeks, and following 12 weeks of training. Cardiovascular measures (MAP, resting HR, average and peak HR during exercise, cardiovascular efficiency) and self reported upper limb function (as determined by the CUE, sf-QIF, SCI-SET questionnaires) were taken at baseline and following 12 weeks of training. Increases were found in time to fatigue (84.4%), distance to fatigue (111.7%), and work rate (51.3%). These changes were non-significant. There was a significant decrease in MAP (91.1 ± 13.9 vs. 87.7 ± 14.7 mmHg) following 12 weeks ofFES arm cycle ergometry. There was no significant change in resting HR or average and peak HR during exercise. Cardiovascular efficiency showed an increase following the 12 weeks ofFES training (142.9%), which was non-significant. There were no significant changes in the measures of upper limb function and spasticity. Overall, FES arm cycle ergometry is an effective method of cardiovascular exercise for individuals with tetraplegia, as evidenced by a significant decrease in MAP, however it is unclear whether 12 weeks of thrice weekly FES arm cycle ergometry may effectively improve upper limb function in all individuals with a cervical SCI.

Upper Lakes Shipping Ltd. fonds 1955-1990, n.d. (non-inclusive)

In March 1931, Captain Bruce Angus was sent to Sarnia by Gordon C. Leitch, general manager of Toronto Elevators. He was sent to inspect the Sarnian to ensure it was still seaworthy. Leitch was a savvy business man, who had been active in the business community for a number of years. Leitch began his career with a partner in the lumber business. When that went under he moved into graineries and worked for the Winnipeg Wheat Pool for 12 years. After Winnipeg he moved to Toronto, which was closer to his home town of Ridgetown, Ontario. In Toronto Leitch became manager of the Toronto branch of the Canadian Wheat Pool. While managing the wheat pools in Toronto Leitch became aware of huge costs associated with shipping the grains from the praries into the Toronto area. He felt that there was no need for such costs and decided to do something to make them better and cheaper for the business. Originally the grain was loaded onto Lakers that would bring the grain from the praries to Lake Huron and Georgian Bay. It was stored there until needed by the Toronto graineries and then hauled across land by either truck or train. The land journey was the most expensive and the one which Leitch wanted to eliminate. This was a fine plan except for 2 obstacles that were quickly overcome. First of all the Welland canals were not large enough to accommodate the large carriers that were bringing in the grain. This was changing as the expansion and widening of the canals was already underway. The second issue was the lack of storage in Toronto for the grain. The grain elevators had been destroyed by fire in the late 1880s and never replaced. Leitch propsed his company built its own storage elevators along the water front to allow not only for easier access to the grain, and more timely production of products. The elevators would aslo create a reduction in shipping costs and an overall more competitoive price for the customers of the grainery. The company refused, so Leitch went elsewhere to friends and contacts within the grain industry. The elevators were built and Leitch quit his job with the Canadian Wheat Pool and became the general manager of the elevators. Although the elevators were built and ready for storage the next issue was filling them. None of the carriers wanted to do business with Leitch because the competition in Georgian Bay threatened to cancel their contracts if they did. Leitch saw no way around this, but to provide his own transportation. This is when he sent Captain Bruce Angus to scout out potential ships. The ship was purchased for $37,000 and after another $30,000 was spent to fix it up, it was ready for business. The need for transportation and the finding of a seaworthy ship, lead to the beginnings of the Northland Steamship Company. The Sarnian proved to not be enough for the business underway. Leitch decided another ship was necessary. He joined forces with James Norris the owner of the Norris Grain Company. He proposed they join forces to create a more economical means of transportating their products.

The Statutes of his Majesty's Province of Upper Canada in North America- Sir Isaac Brock, 1812

The Statutes of his Majesty's Province of Upper Canada in North America outlining the recruitment, administration and discipline of the militia.