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Objective: To measure resting energy expenditure (REE) in a group of people with postacute paraplegia, quantify the impact of asymptomatic bacteriuria and pressure sore(s) on patients' metabolic rate, and estimate the adequacy of patients' nutritional intakes to preserve patients' protein levels., Material and Methods: Ten males with post-acute paraplegia aged 42.1+/-18.7 years. We evaluated: height, body mass index (BMI), resting energy expenditure (REE), total daily calorie requirement (E), 24-h urine creatinine excretion (Cru), creatinine index (CI), and nitrogen balance (NB)., Results: Subjects with paraplegia showed high erythrocyte sedimentation rates. As a group, they had normal resting calorie consumption when REE was normalized for unit of urine creatinine (REE/Cru), it was higher in patients than in controls. Six of the 10 patients had a low calorie intake: of these only three had a negative nitrogen balance., Conclusion: In conclusion, the resting energy expenditure of the subjects with significant bacteriuria and pressure sore(s) of 23.7 kcal/kg/day suggests that a large portion of patients may have an inadequate calorie protein intake to preserve their nutritional status. The clinical significance of this study is that 28.5 kcal/kg/day may be the lower calorie threshold to meet the metabolic demands of people with apyretic paraplegia with bacteriuria and pressure sore(s).

Purpose: We assessed whether voiding dynamics differ in patients with infravesical obstruction from benign prostatic hyperplasia between those with detrusor instability and those with stable bladders., Materials and Methods: A total of 50 such patients with (25) and without (25) detrusor instability was investigated urodynamically by cystometry and pressure-flow study., Results: In the unstable group there was greater obstruction (as assessed by the linear passive urethral resistance relation pressure-flow nomogram) but the detrusor expended less energy (p = 0.001) for voiding the unit volume (54.4 +/- 22.8 mJ./ml versus 74.4 +/- 31.8 mJ./ml. in the stable series). Spared energy was converted into more powerful micturition contractions and more efficient voiding, with a mean maximum contraction power and mean fraction of bladder volume voided of 17.9 +/- 4.9 microW./mm.2 and 93 +/- 11%, respectively, in the unstable population versus 12.7 +/- 2.1 microW./mm.2 (p < 0.001) and 79 +/- 13% (p < 0.001) in the stable subjects., Conclusions: Detrusor instability possibly works within physiological limits as an energy-saving device, preventing voiding efficiency in patients with prostate disease from decreasing too much with increasing obstruction.

The peripheral factor (PF), i.e. the ratio: artero-venous oxygen extraction to total peripheral resistences, has been studied in a total of 8 professional basket players under controlled work-load conditions. The results obtained by continuous monitoring heart rate, oxygen consumption, pulmonary ventilation, arterial blood pressure etc, have shown that from 0 to 150 watt work-load, the PF increases linearly showing a slope of 83 degrees, whereas from 150 to 200 watt the pendence reduces up to 45 degrees. The absolute value of PF from a resting value of 3.83 mlo2 X min-1 X mmHg-1 increases up to 21,64 (at 150 watt) and to a maximum of 23.45 mlo2 X min-1 X mmHg-1 at 200 watt. The slope of the first range of load (83 degrees) is quite similar to what previously observed in endurance athletes (cyclists) whereas the 45 degrees angular coefficient indicates that the increased energy demand in basket-players can be obtained only with a large cardiac load.