Concurrent chemoradiation therapy is associated with an accelerated risk of cardiovascular autonomic dysfunction in patients with nasopharyngeal carcinoma: A 9-year prospective follow-up study.

BACKGROUND: Concurrent chemoradiation therapy (CCRT) is the mainstay treatment for patients with nasopharyngeal carcinoma (NPC). Baroreflex impairment can be a late sequela in patients after neck radiotherapy. We hypothesized that cardiovascular autonomic dysfunction is a progressive process that can begin after CCRT and persists for a longer period. METHODS: Cardiovascular autonomic function was assessed in 29 newly diagnosed patients with NPC using standardized measures including heart rate response to deep breathing (HRDB), Valsalva ratio (VR), baroreflex sensitivity (BRS), and analyses of heart rate variability (HRV), biomarkers of oxidative stress, and inflammation at three different time points (baseline, immediately after CCRT, and 9 years after enrollment). A healthy control group was recruited for the comparison. RESULTS: Although there was an aging effect on autonomic parameters in both groups during the 9 years of follow-up, the between-group comparison showed that there was a significant decrease in HRDB, VR, and HRV at the 9th year of follow-up in the NPC group. Repeated measures ANOVA after controlling for age and sex showed that both HRDB and triangle index of HRV had statistically significant differences between the two groups. CONCLUSION: Based on our results, cardiovascular autonomic dysfunction after CCRT is a progressive and dynamic process. Cardiovagal impairment occurs in the early phase and persists in decline, while adrenergic dysfunction is significant only after a 9-year follow-up. In contrast to the current opinion, our study showed that both afferent and efferent baroreflex pathways can be involved after CCRT.

Standardized Autonomic Testing in Patients With Probable Radiation-Induced Afferent Baroreflex Failure.

Injury of the afferent limb of the baroreflex from neck radiation causes radiation-induced afferent baroreflex failure (R-ABF). Identification and management of R-ABF is challenging. We aimed to investigate the pattern of autonomic dysfunction on standardized autonomic testing in patients with probable R-ABF. We retrospectively analyzed all autonomic reflex screens performed at Mayo Clinic in Rochester, MN, between 2000 and 2020 in patients with probable R-ABF. Additional tests reviewed included ambulatory blood pressure monitoring, plasma norepinephrine, and thermoregulatory sweat test. We identified 90 patients with probable R-ABF. Median total composite autonomic severity score (range, 0-10) was 7 (interquartile range, 6-7). Cardiovascular adrenergic impairment was seen in 85 patients (94.4%), increased blood pressure recovery time after Valsalva maneuver in 71 patients (78.9%; median 17.4 seconds), and orthostatic hypotension in 68 patients (75.6%). Cardiovagal impairment was demonstrated by abnormal heart rate responses to deep breathing (79.5%), Valsalva ratio (87.2%), and vagal baroreflex sensitivity (57.9%). Plasma norepinephrine was elevated and rose appropriately upon standing (722-1207 pg/mL). Ambulatory blood pressure monitoring revealed hypertension, postural hypotension, hypertensive surges, tachycardia, and absence of nocturnal dipping. Blood pressure lability correlated with impaired vagal baroreflex function. Postganglionic sympathetic sudomotor function was normal in most cases; the most frequent thermoregulatory sweat test finding was focal neck anhidrosis (78.9%). Standardized autonomic testing in R-ABF demonstrates cardiovascular adrenergic impairment with orthostatic hypotension, blood pressure lability, and elevated plasma norepinephrine. Cardiovagal impairment is common, while sudomotor deficits are limited to direct radiation effects.

[Effects of radio- and microwaves emitted by wireless communication devices on the functions of the nervous system selected elements]. / Wplyw pól elektromagnetycznych zakresu radiowego i mikrofalowego, emitowanych przez urzadzenia lacznosci bezprzewodowej, na funkcjonowanie wybranych elementów ukladu nerwowego.

Nervous system is the most "electric" system in the human body. The research of the effects of electromagnetic fields (EMFs) of different frequencies on its functioning have been carried out for years. This paper presents the results of the scientific literature review on the EMF influence on the functioning of the human nervous system with a particular emphasis on the recent studies of the modern wireless communication and data transmission systems. In the majority of the analyzed areas the published research results do not show EMF effects on the nervous system, except for the influence of GSM telephony signal on resting EEG and EEG during patients' sleep and the influence of radiofrequency EMF on the cardiovascular regulation. In other analyzed areas (EMF impact on sleep, the evoked potentials and cognitive processes), there are no consistent results supporting any influence of electromagnetic fields. Neurophysiological studies of the effect of radio- and microwaves on the brain functions in humans are still considered inconclusive. This is among others due to, different exposure conditions, a large number of variables tested, deficiencies in repeatability of research and statistical uncertainties. However, methodological guidelines are already available giving a chance of unifying research that definitely needs to be continued in order to identify biophysical mechanisms of interaction between EMFs and the nervous system. One of the EMF research aspects, on which more and more attention is paid, are inter-individual differences. Med Pr 2016;67(3):411-421.

Abnormal exercise response in long-term survivors of hodgkin lymphoma treated with thoracic irradiation: evidence of cardiac autonomic dysfunction and impact on outcomes.

BACKGROUND: Hodgkin lymphoma (HL) survivors treated with thoracic radiation therapy (RT) have impaired exercise tolerance and increased cardiovascular mortality. OBJECTIVES: The purpose of this study was to evaluate the prevalence of autonomic dysfunction and its implications on exercise capacity and mortality in long-term survivors of HL. METHODS: Exercise parameters in 263 HL survivors referred for exercise treadmill testing at a median interval of 19 years after RT were compared with 526 age-, sex-, and cardiovascular risk score-matched control subjects. Within the RT cohort, the presence of autonomic dysfunction, defined by an elevated resting heart rate (HR) (≥80 beats/min) and abnormal heart rate recovery (HRR) at 1 min (≤12 beats/min if active cool-down, or ≤18 beats/min if passive recovery), was correlated with exercise capacity and all-cause mortality over a median follow-up of 3 years. RESULTS: RT was associated with elevated resting HR and abnormal HRR after adjusting for age, sex, cardiovascular risk factors, medications, and indication for exercise treadmill testing: odds ratio: 3.96 (95% confidence interval [CI]: 2.52 to 6.23) and odds ratio: 5.32 (95% CI: 2.94 to 9.65), respectively. Prevalence of autonomic dysfunction increased with radiation dose and time from RT. Both elevated resting HR and abnormal HRR were associated with reduced exercise capacity in RT patients. Abnormal HRR was also associated with increased all-cause mortality (age-adjusted hazard ratio: 4.60 [95% CI: 1.62 to 13.02]). CONCLUSIONS: Thoracic RT is associated with autonomic dysfunction, as measured by elevated resting HR and abnormal HRR. These abnormalities are associated with impaired exercise tolerance, and abnormal HRR predicts increased all-cause mortality in RT patients.

[Sexual functions after treatment for rectal cancer: impact of doses in autonomic pelvic nerves]. / Fonctions sexuelles après traitement du cancer rectal : impact des doses aux plexus pelviens autonomes.

PURPOSE: Prospective evaluation of sexual function after treatment of rectal cancer and identification of predictive factors. PATIENTS AND METHODS: Thirty-three patients were treated with curative intent by chemoradiation and surgery for localized rectal adenocarcinoma. Sexual toxicity was assessed four times (before treatment and at 2, 6 and 12 months) using validated questionnaires: QLQ C30 and EORTC CR38 for all, simplified IIEF for men and FSFI for women. A correlation was sought between the toxicity and clinical and dosimetric parameters by Fisher and Mann-Whitney tests. RESULTS: In men, erections and sexual satisfaction decreased significantly from the acute phase and then stabilized (respective scores of 84.5 and 86/100 in the initial phase, 66 and 70.4 at the end of radiotherapy, 70 and 70 at 6 months and 68.5 and 70 at 12 months). For women, the changes were not significant. This study confirms some risk factors for sexual toxicity already mentioned (original function, age, tumor volume) and highlights new (dose to the seminal vesicles and above all, doses to pelvic autonomic plexus). CONCLUSION: Sexual effects of combined treatment of rectal cancer have only recently been described but remain undervalued and poorly understood. The impact of the autonomic pelvic plexus doses is a completely new data that could be extended in the development of intensity-modulated radiotherapy.

[Dynamics of autonomic regulation and daily pH-metry in patients with gastroesophageal reflux disease under the influence of low-intensity laser irradiation of blood].

102 patients with GERD were examined: 70 female (68%) and 32 men (32%). Age of respondents ranged from 20 to 65 years (average of 45.8 ±8,2). All patients were randomly divided into 2 groups. In the first (control) group (30 people) traditional drug treatment were used according to the standard therapy of GERD (proton pump inhibitors, antacids, prokinetics), patients in the second (main) group (70 people) along with drug therapy has received a course of intravenous laser therapy according to the methods ILIB-405. For intravenous laser treatment Russian apparatus "Matrix-ILIB" ("Matrix", Russia) was used with wavelength 0,405 µm, output power at the end of the main optical path of 1-1.5 mW. Laser blood irradiation was carried out for 15 minutes in the CW mode, the course of treatment was 10 daily treatments with a break on Saturday and Sunday. Conclusions: 1. Intravenous laser irradiation of blood in the complex therapy of patients with gastroesophageal reflux disease improved significantly of HRV due to the alignment of parasympathetic regulation circuit and reducing the activity of sympathetic autonomic regulation, 2. the inclusion of intravenous laser irradiation of blood in the complex therapy of patients with GERD was accompanied by reliable normalization of the indicators of the daily pH-metry of the esophagus in patients with GERD.

Long-term effects of neck irradiation on cardiovascular autonomic function: a study in nasopharyngeal carcinoma patients after radiotherapy.

INTRODUCTION: Baroreflex failure has been reported as a late sequalum of neck radiotherapy. In this study we investigated cardiovascular autonomic function in patients after neck radiotherapy to determine predictive factors associated with outcome. METHODS: Eighty-nine patients with nasopharyngeal carcinoma were evaluated ≥6 months after radiotherapy for cardiovascular autonomic function and compared with 48 control subjects. Inflammatory markers and carotid intima-media thickness were also assessed. RESULTS: Autonomic parameters of heart rate response to deep breathing and Valsalva ratio were significantly lower in the patient group. Cardiovascular autonomic impairment was generally mild with relative sparing of the efferent cardiovagal pathway. By univariate and multivariate analyses, the time after radiotherapy and C-reactive protein level were significantly associated with the degree of cardiovascular autonomic dysfunction. CONCLUSIONS: Radiation-induced cardiovascular autonomic impairment is a dynamic and progressive process that occurs long after radiotherapy. Chronic inflammation plays a major role in this process.

[Endothelium dependent vascular reactivity and autonomic homeostasis in children living in radiation-contaminated areas].

In order to study the mechanisms of development of pathological changes in children living in contaminated areas and chronically exposed to radionuclides as a result of exposure through the food chain, studied the vegetative homeostasis and thermographic study endothelium-dependent vascular reactions with occlusive tests. Showed signs of dysregulation of the autonomic nervous system dysfunction, the secretory activity of the endothelium and increased secretion of substances endothelial origin.

[Effects of radiation emitted from mobile phones on short- term heart rate variability parameters]. / Cep telefonlarindan yayilan radyasyonun kisa dönem kalp hizi degiskenligi parametreleri üzerindeki etkileri.

OBJECTIVE: In this study, the effects of radiation emitted from mobile phone (MP) on heart rate variability (HRV) which is accepted a non-invasive indicator of autonomic nervous system (ANS) were investigated with considering the deficiency of previous studies. METHODS: A randomized controlled study has been designed and utilized with 30 young and healthy volunteers. During the experiment that had three periods, the electrocardiogram (ECG) and respiration signals were recorded and MP was attached to subjects' right ear with a bone. Ten subjects selected randomly were exposed to high -level radiation during the second period (Experimental Group 1). Ten of others were exposed during the third period with maximum level radiation (Experimental Group 2). Ten records were also made while MP was closed as a control. Short -term HRV parameters were obtained and repeated measures ANOVA and suitable post-hoc tests applied to the results. RESULTS: According to the results of the repeated measures ANOVA; there were no significant main effects of groups. However, there were some significant differences in measuring time periods and groups*period interactions. The post-hoc tests showed that mean R to R interval and HF power are significantly changed by maximum radiation emitted from MP. CONCLUSION: Due to the radiation emitted from MPs at maximum power, some changes may occur in HRV parameters that are associated with increased parasympathetic activity. But, the level of these changes is similar to daily activities as excitement, and stand up.

Evaluation of the effects of mediastinal radiation therapy on autonomic nervous system.

In this prospective study, the effects of mediastinal radiation therapy (RT) on autonomic nervous system (ANS) were investigated by heart rate variability (HRV) analysis that is accepted as a non-invasive indicator of ANS. Study was performed with the eligible patients had a histopathologically confirmed diagnosis of malignant disease with no known congestive heart failure, coronary heart disease, hypertension, valvular cardiac disease or arrhythmia history. Electrocardiograms of 14 voluntary patients were recorded for duration of 5 min just before and after irradiation for the first and the 15th fractions. ANS-related HRV analysis parameters were calculated as which were recommended by Task Force of ESC/NASPE (Circulation 93:1043-1065, 1996). HRV parameters that belong to pre- and post-RT treatment of patients were compared statistically. We found that there is not effect of single-dose radiation on HRV parameter. The mean RRI (782.29 ± 115.65-738.93 ± 111.01, P < 0.014) and HF power of HRVs PSD (156.94 ± 229.37-60.71 ± 77.99, P < 0.045) decreased, and LF/HF ratio (1.38 ± 0.79-2.03 ± 1.25, P < 0.039) increased significantly with 28-Gy external radiation dose. As the effect of cumulative dose was investigated on HRV parameters, the above changes were continued to increase with 30-Gy external radiation dose. We found that mediastinal RT involving heart directly in the radiation field decreased vagal and sympathetic ANS activities, and autonomic balance shifted toward sympathetic dominance.

[Normal tissue tolerance to external beam radiation therapy: small bowel]. / Dose de tolérance à l'irradiation des tissus sains: intestin grêle.

The small bowel is a hollow organ involved in the transit and absorption of food. In relation to its anatomical location, a significant amount of this organ is exposed in whole or in part to ionizing radiation in external radiotherapy during abdominal or pelvic irradiation either for primary cancers or metastasis. The acute functional changes during external beam radiation are mainly leading to diarrhea, abdominal pain and bloating. The main late side effects of irradiation of the small intestine are chronic diarrhea, malabsorption with steatorrhea, abdominal spasms, intestinal obstruction, bleeding and fistulas. The architecture of the small intestine may be considered as parallel with a significant correlation between the irradiated volume of small bowel and the likelihood of acute toxicity, whatever the dose. The literature analysis recommends to consider the volume of small bowel receiving 15 Gy (threshold of 100 to 200 cm(3)) but also 30 and 50 Gy (thresholds of 35 to 300 cm(3), depending on the level of dose considered). Modern techniques of conformal radiotherapy with modulated intensity will probably have beneficial impact on small bowel toxicity.

[Dynamics of the functional status of autonomic nervous system in rats under combined radiation/thermal injury in case of an open burn wound and wound covered by the polymer film].

The peculiarities of the functional status of autonomic nervous system and physical efficiency were studied in white inbred rats under dynamics of combined radiation/thermal injury (CR/TI). The CR/TI model was obtained under total X-ray irradiation at dose level of 4.37 Gy and inflicting III degree burn injury making 12% of body surface in 24 rats. The studies were performed under conditions of both spontaneous CR/TI development and protecting the burn wound against infection. In 12 rats the wounds were covered by polymer films treated with iodine and succinic acid. On days 3, 7, 14, 21 and 28 of CR/TI, as well as prior to CR/TI (datum level), heart rate variability (HRV) indices, the level of physical efficiency (the retention time of own weight on the vertical pole), indices of body mass, survival, and average life-soan of animals were recorded. For registration of ECG in awake rats, corrections of motor artifacts and analysis of HRV the original software program was used. R-R intervalograms were analyzed in time and frequency domains. The sliding window technique was used (100 R-R intervals with the step of 10 seconds; epoch of analysis--7 minutes). The obtained data indicated that the survival level and the average life-span in rats with the film-covered burn wound were higher as compared to the "pure" CR/TI. At the same time body mass and physical efficiency in animals of both groups did not differ in practice. Data on the functional status of autonomic nervous system were more informative. In rats with film-covered burn wound the dynamics of HRV indices had a biphasic character with the tending to normalization beginning from day 7 of CR/TI, whereas in case of an open wound HRV indices were characterized by monotonous growth until the end of observations. In the overall picture of the CR/TI in both groups of animals the sympathotropic effects of burn stress prevailed. Methods of mathematical analysis of HRV under conditions of CR/TI were for the first time used in this study. The research outcomes signify to the expediency to apply these methods for obtaining data on functional state of the autonomic nervous system in CR/TI models in small laboratory animals.

Study of autonomic nervous activity of night shift workers treated with laser acupuncture.

OBJECTIVE: The aim of this study was to evaluate the impact of laser acupuncture on the autonomic nervous system (ANS) of the night shift worker. BACKGROUND DATA: Many articles have demonstrated that levels of affective disorders and stress are high in night shift workers. We applied laser energy to the Neiguan point (PC6) to examine the impact of laser acupuncture on the ANS of 45 healthy young males who were night shift workers and evaluated their heart-rate variability (HRV). MATERIALS AND METHODS: The laser group (n = 15) received laser acupuncture (9.7 J/cm(2), 830 nm) for 10 min, and the placebo group (n = 15) received sham laser treatment. The effects before and after this intervention on the HRV of the subjects were assessed, along with those seen after 30 min of lying down. RESULTS: After treatment and after the 30-min rest period, the independent-sample t-test showed that both groups exhibited statistically significant differences in high-frequency (HF) HRV, low-frequency (LF) HRV, and the LF:HF ratio of HRV (p < 0.05). Compared with the placebo group, the paired-samples t-test showed that after laser treatment the treatment group had a statistically significant improvement in HF HRV (p = 0.001), LF HRV (p = 0.001), and the LF:HF HRV ratio (p = 0.02). CONCLUSIONS: Laser acupuncture stimulation applied to the Neiguan point increased vagal activity and suppression of cardiac sympathetic nerves. This effect was positive and could be used to help patients who have circadian rhythm disorders.

Intraoperative radiotherapy for oncological and function-preserving surgery in patients with advanced lower rectal cancer.

BACKGROUND: Pelvic autonomic nerve preservation (PANP) with lateral lymph node dissection (LLND) has been introduced in rectal cancer surgery in Japan; however, its indication has not been standardized yet. MATERIALS AND METHODS: Forty-four patients with advanced lower rectal cancer were randomized to either the standard treatment group (control group) or the intraoperative radiotherapy (IORT) group. All patients underwent potentially curative resection of the rectum with total mesorectal excision. The control group underwent bilateral LLND and limited PANP. The IORT group underwent bilateral LLND, complete PANP, and IORT. Patients allocated to the IORT group received IORT to the bilateral preserved pelvic nerve plexuses. Patients' clinicopathologic parameters, postoperative complications, voiding function, and prognosis were compared between the two groups. RESULTS: Among 44 patients enrolled, three patients were excluded from the analysis, resulting in 19 patients in the IORT group and 22 patients in the control group. Patients' demographic and pathological parameters and postoperative complications were well balanced between the two groups. Oncological outcomes including overall and disease-free survival were also similar. Local recurrence was observed in one patient in each group. Among the 34 patients not complicated with intrapelvic abscess, the mean duration of urinary catheter indwelling was 8 days in the IORT group and 13 days in the control group (p = 0.055). In the long term, medication for urination was necessitated in four patients in the control group, whereas in none in the IORT group (p = 0.059). DISCUSSIONS: Oncological outcomes in the IORT group are equal to those in the control group, and voiding functions in the IORT group are superior to those in the control group. These results suggest that IORT may be useful to expand the indication of complete PANP with LLND for advanced lower rectal cancer.

Short-term effects of pulsed electromagnetic fields after physical exercise are dependent on autonomic tone before exposure.

The therapeutic application of pulsed electromagnetic fields (PEMFs) can accelerate healing after bone fractures and also alleviate pain according to several studies. However, no objective criteria have been available to ensure appropriate magnetic field strength or type of electromagnetic field. Moreover, few studies so far have investigated the physical principles responsible for the impact of electromagnetic fields on the human body. Existing studies have shown that PEMFs influence cell activity, the autonomic nervous system and the blood flow. The aim of this study is to examine the instantaneous and short-term effects of a PEMF therapy and to measure the impact of different electromagnetic field strengths on a range of physiological parameters, especially the autonomic nervous systems, determined by heart rate variability (HRV) as well as their influence on subjects' general feeling of well-being. The study comprised experimental, double-blind laboratory tests during which 32 healthy male adults (age: 38.4+/-6.5 years) underwent four physical stress tests at standardised times followed by exposure to pulsed magnetic fields of varying intensity [HPM, High Performance magnetic field; Leotec; pulsed signal; mean intensity increase: zero (placebo), 0.005, 0.03 and 0.09 T/s]. Exposure to electromagnetic fields after standardised physical effort significantly affected the very low frequency power spectral components of HRV (VLF; an indicator for sympathetically controlled blood flow rhythms). Compared to placebo treatment, exposure to 0.005 T/s resulted in accelerated recovery after physical strain. Subjects with lower baseline VLF power recovered more quickly than subjects with higher VLF when exposed to higher magnetic field strengths. The application of electromagnetic fields had no effect on subjects' general feeling of well-being. Once the magnetic field exposure was stopped, the described effects quickly subsided. PEMF exposure has a short-term dosage-dependent impact on healthy subjects. Exposure to PEMF for 20 min resulted in more rapid recovery of heart rate variability, especially in the very low frequency range after physical strain. The study also showed the moderating influence of the subjects' constitutional VLF power on their response to PEMF treatment. These findings have since been replicated in a clinical study and should be taken into consideration when PEMF treatment is chosen.

The role of autacoids and the autonomic nervous system in cardiovascular responses to radio-frequency energy heating.

Among the potential effects of exposure to high levels of radio-frequency energy (RFE) (which includes microwaves), an increase in body temperature is the primary consequence. Release of autacoids and activity of the autonomic nervous system may influence (or be directly responsible for) some of the physiological changes that occur in conjunction with this hyperthermia. The main focus of this review is the interaction of autacoids and the autonomic nervous system with cardiovascular changes during heating. Differences between environmental and RFE-induced heating (such as rate of temperature change and degree of skin vs. core heating) may be important when considering these effects. Antihistamines exhibited no beneficial effect on circulatory collapse during RFE-induced heating. The serotonergic blocker methysergide decreased survival time in rats during terminal RFE exposure, despite no effects on heart rate (HR) or blood pressure. Although blockade of platelet-activating factor resulted in lower HR before RFE exposure, there was a lack of effect on the subsequent increase in HR during heating. Nitric oxide did not contribute to the hypotension that occurs due to rapid heating by RFE exposure. There have been either no or very limited studies of effects of prostaglandins, bradykinin, or angiotensin on RFE-induced heating responses. beta-Adrenoceptor antagonism with propranolol resulted in significantly decreased survival times and lower final colonic temperatures during RFE exposure. A lack of effects of nadolol on survival time and temperature, coupled with its poor ability to traverse the blood-brain barrier, suggests that central beta-adrenergic stimulation rather than peripheral stimulation may alter thermoregulation. Effects of the autonomic nervous system (as studied by adrenoceptor blockade) on potassium changes during heating have not been fully investigated. Such changes could be important in animals' responses to RFE and other modalities of heating, and should be studied in future.

[Histo-architectonic features of the autonomic nerve terminals and their cellular microenvironment in breast cancer tissues before and after radiotherapy]. / Osobennosti gistoarkhitektoniki vegetativnykh nervnykh terminalei i ikh kletochnogo mikrookruzheniia v tkaniakh raka molochnoi zhelezy do i posle luchevoi terapii.

The difference in the histoarchitectonics of structures of vegetative nervous terminals (VNT) before and after radiotherapy (RT) indicates the existence of VNT fragments sensitive and resistant to radiation damage. Heterogeneity of the local neuromediator background in tumor morphogenesis before and after RT can be clarified through studying the VNT cellular microenvironment.

[Mechanism of biotropic effects of regional electromagnetic fields in patients with left ventricular ischemic dysfunction]. / Mekhanizm biotropnogo vliiania regional'nykh élektromagnitnykh polei u bol'nykh s ishemicheskoi disfunktsiei levogo zheludochka.

AIM: To study the role of disturbed autonomic regulation of the cardiovascular system in formation of the phenomenon of geliogeomagnetic sensitivity of patients with left ventricular ischemic dysfunction. MATERIAL AND METHODS: 24-h synchronous monitoring of ECG and electromagnetic situation was made in 11 patients (mean age 49.4 +/- 0.9 years) who had survived macrofocal myocardial infarction (MI) at least 6 months before and in 15 healthy volunteers. RESULTS: Heart rhythm dispersion, correlation between variations of magnetic field vector component amplitudes and standard deviation of ECG R-R intervals duration in MI survivors were significantly less than in healthy subjects. High conjugacy of heart rhythm dispersion and mean value of R-R intervals (functions synchronization index) was characteristic only for the control group. A 3-week therapy with atenolol provided normalization of the disturbed correlations in 4 patients. CONCLUSION: Pathogenic geliogeotropic reactions in MI survivors develop because of intra- and inter-systemic desynchronisation of the functions mechanism of which is mediated by sympathicoadrenal activation and is correctable by beta 1-adrenoblocker atenolol.

[Biological effects and health risks of electromagnetic fields at levels classified by INCRIP ans admissible among occupationally exposed workers: a study of the Nofer Institute of Occupational Medicine, Lodz]. / Efekty biologiczne i ryzyko zdrowotne PEM o poziomach dopuszczalnych przez ICNIRP dla osób zawodowo eksponowanych--badania Instytutu Medycyny Pracy w Lodzi.

The aim of the study was to evaluate the effect of electromagnetic fields (EMF) on the workers' circulatory system, and to find out to what extent the EMF frequency, short-term (maximum values) and chronic (daily and lifetime doses) exposures influence the type of the observed disorders. The gathered data will help to evaluate whether hygiene standards that limit maximum admissible EMF values (e.g., ICNIRP standards) protect against adverse effects of exposure. The study covered workers employed in transformer and distribution stations, medium wave transmitting stations, radio-service and radio and TV multichannel broadcasting stations. In all the cases, exposure levels were considerably lower than those set as admissible according to the ICNIRP standards. Nevertheless changes in the circulatory system and a significant relationship between blood pressure and neurovegetative regulation disorders and exposure parameters were observed. The frequency of changes in the circulatory system was significantly dependent not only on the maximum EMF value, but also on its dose, which indicates that the hygiene standards for EMF cannot be limited only to short-term exposure maximum values, but they should be supplemented with dose-related standards.