Wearing body armour and backpack loads increase the likelihood of expiratory flow limitation and respiratory muscle fatigue during marching.

The effect of load carriage on pulmonary function was investigated during a treadmill march of increasing intensity. 24 male infantry soldiers marched on six occasions wearing either: no load, 15 kg, 30 kg, 40 kg or 50 kg. Each loaded configuration included body armour which was worn as battle-fit or loose-fit (40 kg only). FVC and FEV1 were reduced by 6 to 15% with load. Maximal mouth pressures were reduced post load carriage by up to 11% (inspiratory) and 17% (expiratory). Increased ventilatory demands associated with carrying increased mass were met by increases in breathing frequency (from 3 to 26 breaths·min-1) with minimal changes to tidal volume. 72% of participants experienced expiratory flow limitation whilst wearing the heaviest load. Loosening the armour had minimal effects on pulmonary function. It was concluded that as mass and exercise intensity are increased, the degree of expiratory flow limitation also increases. Practitioner Summary: This study investigated the effect of soldier load carriage on pulmonary function, to inform the trade-off between protection and burden. Load carriage caused an inefficient breathing pattern, respiratory muscle fatigue and expiratory flow limitation during marching. These effects were exacerbated by increases in mass carried and march intensity.

Moisture vapour permeable gloves extend thermal endurance and safe work time more than other similarly permeable chemical-biological ancillary protective items.

Working in Chemical Biological (CB) protective equipment causes thermoregulatory strain by restricting evaporative cooling. We quantified which impermeable ancillary items [gloves(G), body armour liner(BAL), respirator(R) and overboots(OB)] imposed the greatest and the least thermoregulatory strain through restricting evaporative cooling. The study was a five-condition repeated-measures design with male volunteers (n = 13) who stepped intermittently with recovery periods in a desert-like environment (40.5 °C, 20% rh). Conditions varied in the ensemble worn, with a matched weight secured to the area when an item was not worn: CON(CB suit plus all items), NR(no R), NBAL(no BAL [170g liner]), NG(no G) and NOB(no OB). The greatest reduction in thermoregulatory strain compared with CON occurred in NG when the rise of rectal temperature was attenuated by 0.37 °C.hr-1 (p < .001), extending tolerance time by 21.3% (p < .05) and improving perceived thermal comfort. The least improvement occurred for NOB. It is recommended that the G permeability be examined further. Practitioner summary: Thermoregulatory strain was quantified when wearing impermeable protective equipment. The thermal burden of intermittent exercise in desert-like environments was best alleviated by removing gloves compared to removing a respirator, overboots or body armour liner. Reducing the evaporative resistance of materials used for such kit, particularly gloves, should be investigated.

Cutaneous Vascular Responses of the Hands and Feet to Cooling, Rewarming, and Hypoxia in Humans.

INTRODUCTION: This study investigated skin vasomotor responses in the fingers and toes during cooling and rewarming with and without normobaric hypoxia. METHODS: Fourteen volunteers (8 males and 6 females) were exposed to gradual air cooling (mean±SD: -0.4±0.1oC·min-1) followed by rewarming (+0.5±0.1oC·min-1) while breathing normoxic air (FIO2 0.21 at 761±3 mm Hg) or hypoxic gas (FIO2 0.12, at 761±3 mm Hg, equivalent to ~5000 m above sea level). Throughout the gradual cooling and rewarming phases, rectal temperature was measured, and skin temperatures and laser Doppler skin blood flow were measured on the thumb, little finger, and great and little toe pads. RESULTS: During gradual cooling, skin temperature but not deep body temperature decreased. No differences in cutaneous vascular conductance were found for the toes or thumb (P=0.169 great toe; P=0.289 little toe; P=0.422 thumb). Cutaneous vascular conductance was reduced in the little finger to a greater extent at the same mean skin temperatures (34.5-33.5oC) in the hypoxic compared with normoxic conditions (P=0.047). The onset of vasoconstriction and release of vasoconstriction in the thumb and little finger occurred at higher mean skin temperatures in hypoxia compared with normoxia (P<0.05). The onset of vasoconstriction and release of vasoconstriction in the toes occurred at similar skin temperatures (P=0.181 and P=0.132, respectively). CONCLUSION: The earlier vasoconstrictor response and later release of vasoconstriction in the finger during hypoxic conditions may result in a greater dose of cold to that digit, taking longer to rewarm following the release of vasoconstriction.

Inspiratory Muscle Training Effects on Cycling During Acute Hypoxic Exposure.

INTRODUCTION: Hypoxic environments increase the physiological demands of exercise. Inspiratory muscle training can reduce the demands of exhaustive exercise in this environment. This study examined the impact of inspiratory muscle training on moderate intensity hypoxic cycling exercise. METHODS: There were 17 healthy adult men who undertook 4 wk of inspiratory muscle training (N = 8) or 4 wk of sham inspiratory muscle training (N = 9). Subjects completed four fixed intensity (100 W) and duration (10 min) cycle ergometry tests. Two were undertaken breathing normoxic ambient air and two breathing a hypoxic gas mixture (14.6% oxygen, balance nitrogen). One normoxic and hypoxic test occurred before, and one after, inspiratory muscle training. RESULTS: Inspiratory muscle training increased maximal inspiratory mouth pressure by 21 ± 16 cmH2O. Arterial oxygen saturation and its ratio to minute ventilation also increased after inspiratory muscle training during hypoxic exercise from 83 ± 4% to 86 ± 3% (approximately 3%) and 2.95 ± 0.48 to 3.52 ± 0.54% · L · min-1(approximately 21%), respectively. In addition, minute ventilation and carbon dioxide output fell by 12-13% after inspiratory muscle training during hypoxic exercise. DISCUSSION: Inspiratory muscle training reduced the physiological demand of moderate intensity exercise during acute hypoxic, but not normoxic, exercise. It may therefore be of benefit in adults exercising in a hypoxic environment.Lomax M, Massey HC, House JR. Inspiratory muscle training effects on cycling during acute hypoxic exposure. Aerosp Med Hum Perform. 2017; 88(6):544-549.

Role of cyclooxygenase in the vascular responses to extremity cooling in Caucasian and African males.

NEW FINDINGS: What is the central question of this study? Compared with Caucasians, African individuals are more susceptible to non-freezing cold injury and experience greater cutaneous vasoconstriction and cooler finger skin temperatures upon hand cooling. We investigated whether the enzyme cyclooxygenase is, in part, responsible for the exaggerated response to local cooling. What is the main finding and its importance? During local hand cooling, individuals of African descent experienced significantly lower finger skin blood flow and skin temperature compared with Caucasians irrespective of cyclooxygenase inhibition. These data suggest that in young African males the cyclooxygenase pathway appears not to be the primary reason for the increased susceptibility to non-freezing cold injury. Individuals of African descent (AFD) are more susceptible to non-freezing cold injury (NFCI) and experience an exaggerated cutaneous vasoconstrictor response to hand cooling compared with Caucasians (CAU). Using a placebo-controlled, cross-over design, this study tested the hypothesis that cyclooxygenase (COX) may, in part, be responsible for the exaggerated vasoconstrictor response to local cooling in AFD. Twelve AFD and 12 CAU young healthy men completed foot cooling and hand cooling (separately, in 8°C water for 30 min) with spontaneous rewarming in 30°C air after placebo or aspirin (COX inhibition) treatment. Skin blood flow, expressed as cutaneous vascular conductance (as flux per millimetre of mercury), and skin temperature were measured throughout. Irrespective of COX inhibition, the responses to foot cooling, but not hand cooling, were similar between ethnicities. Specifically, during hand cooling after placebo, AFD experienced a lower minimal skin blood flow [mean (SD): 0.5 (0.1) versus 0.8 (0.2) flux mmHg-1 , P < 0.001] and a lower minimal finger skin temperature [9.5 (1.4) versus 10.7 (1.3)°C, P = 0.039] compared with CAU. During spontaneous rewarming, average skin blood flow was also lower in AFD than in CAU [2.8 (1.6) versus 4.3 (1.0) flux mmHg-1 , P < 0.001]. These data provide further support that AFD experience an exaggerated response to hand cooling on reflection this appears to overstate findings; however, the results demonstrate that the COX pathway is not the primary reason for the exaggerated responses in AFD and increased susceptibility to NFCI.

The physiological demand of pulling a rescue sled across the mud and the impact experience has on this task.

BACKGROUND: To establish a Physical Employment Standard for tasks with high physical demands, it is important to determine the physiological requirements. One such task for the UK Coastguard is mud rescue. OBJECTIVE: To quantify the physiological demand of pulling a rescue sled across estuary mud, and determine whether rescuer experience has an impact on the physiological demand of this task. METHODS: Forty participants walked 150 m in 3 minutes across estuary mud. Following 3 minute rest, they walked 150 m pulling a rescue sled (61 kg) in pairs (based on experience). RESULTS: Experienced rescuers had a total oxygen consumption approximately 24% lower than those inexperienced in the task. Relative oxygen consumption (V̇O2) was significantly (p < 0.05) greater in the non-experienced (mean [SD]; 42.90 [6.55] mL.kg-1.min-1) compared to the experienced group (32.85 [5.79] mL.kg-1.min-1) when controlled for pace. Required V̇O2 for various speeds were predicted based on non-experienced participants and assessed for agreement. LoA (95%) mean±difference was 0.0003 ± 3.48 mL.kg-1.min-1, with a CV of 2.30%. CONCLUSIONS: For tasks that require a high relative V̇O2, such as mud rescue, the minimum level of fitness at entry should be based upon the metabolic demands measured on those who are inexperienced.

Role of cyclooxygenase in the vascular response to locally delivered acetylcholine in Caucasian and African descent individuals.

INTRODUCTION: Individuals of African descent (AFD) are more susceptible to non-freezing cold injury (NFCI) compared with Caucasian individuals (CAU). Vasodilatation to acetylcholine (ACh) is lower in AFD compared with CAU in the non-glabrous foot and finger skin sites; the reason for this is unknown. Prostanoids are responsible, in part, for the vasodilator response to ACh, however it is not known whether the contribution differs between ethnicities. METHODS: 12 CAU and 12 AFD males received iontophoresis of ACh (1 w/v%) on non-glabrous foot and finger skin sites following placebo and then aspirin (600mg, single blinded). Aspirin was utilised to inhibit prostanoid production by inhibiting the cyclooxygenase (COX) enzyme. Laser Doppler flowmetry was utilised to measure changes in skin blood flow. RESULTS: Not all participants could receive iontophoresis charge due to high skin resistance; these participants were therefore excluded from the analyses. Foot: ACh elicited greater maximal vasodilatation in CAU than AFD following placebo (P=0.003) and COX inhibition (COXib) (P<0.001). COXib did not affect blood flow responses in AFD, but caused a reduction in the area under the curve for CAU (P=0.031). Finger: ACh elicited a greater maximal vasodilatation in CAU than AFD following placebo (P=0.013) and COXib (P=0.001). COXib tended to reduce the area under the curve in AFD (P=0.053), but did not affect CAU. CONCLUSIONS: CAU have a greater endothelial reactivity than AFD in both foot and finger skin sites irrespective of COXib. It is concluded that the lower ACh-induced vasodilatation in AFD is not due to a compromised COX pathway.

The Effects of Direct Current Stimulation on Exercise Performance, Pacing and Perception in Temperate and Hot Environments.

BACKGROUND: Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulatory technique and has previously been shown to enhance submaximal exercise by reducing rating of perceived exertion (RPE). The present study examined the effects of tDCS on high-intensity self-paced exercise in temperate conditions and fixed followed by maximal exercise in the heat; it was hypothesised that performance and RPE would be altered. METHODS: Two separate studies were undertaken in which exercise was preceded by 20-minutes of sham tDCS (SHAM), or anodal tDCS (TDCS). In study 1, six males completed a 20-km cycling time trial, on two occasions. Power output (PO), RPE, O2 pulse, and heart rate (HR) were measured throughout. In study 2, eight males completed fixed intensity cycling exercise at 55% of a pre-determined maximal power output (PMax) for 25-minutes before undertaking a time to exhaustion test (TTE; 75% PMax) in hot conditions (33 °C), on two occasions. Test duration, heart rate, thermal and perceptual responses were measured. Study specific and combined statistical analyses were undertaken and effect sizes established. RESULTS: In study 1, mean PO was not improved with the tDCS (197 ± 20 W) compared to SHAM (197 ± 12 W) and there were no differences in pacing profile HR, O2 pulse or RPE (p > .05). In study 2, TTE duration (SHAM 314 ± 334 s cf 237 ± 362 s tDCS), thermal, heart rate and perceptual responses were unchanged by tDCS compared to SHAM (p > .05). When combined, performance in the SHAM trial tended to better than the tDCS. CONCLUSION: tDCS did not influence cycling performance (study 1) exercise tolerance (study 2) or perception (studies 1 and 2). tDCS does not appear to facilitate high intensity exercise performance or exercise performance in the heat.

Vascular responses of the extremities to transdermal application of vasoactive agents in Caucasian and African descent individuals.

PURPOSE: Individuals of African descent (AFD) are more susceptible to non-freezing cold injury than Caucasians (CAU) which may be due, in part, to differences in the control of skin blood flow. We investigated the skin blood flow responses to transdermal application of vasoactive agents. METHODS: Twenty-four young males (12 CAU and 12 AFD) undertook three tests in which iontophoresis was used to apply acetylcholine (ACh 1 w/v %), sodium nitroprusside (SNP 0.01 w/v %) and noradrenaline (NA 0.5 mM) to the skin. The skin sites tested were: volar forearm, non-glabrous finger and toe, and glabrous finger (pad) and toe (pad). RESULTS: In response to SNP on the forearm, AFD had less vasodilatation for a given current application than CAU (P = 0.027-0.004). ACh evoked less vasodilatation in AFD for a given application current in the non-glabrous finger and toe compared with CAU (P = 0.043-0.014) with a lower maximum vasodilatation in the non-glabrous finger (median [interquartile], AFD n = 11, 41[234] %, CAU n = 12, 351[451] %, P = 0.011) and non-glabrous toe (median [interquartile], AFD n = 9, 116[318] %, CAU n = 12, 484[720] %, P = 0.018). ACh and SNP did not elicit vasodilatation in the glabrous skin sites of either group. There were no ethnic differences in response to NA. CONCLUSION: AFD have an attenuated endothelium-dependent vasodilatation in non-glabrous sites of the fingers and toes compared with CAU. This may contribute to lower skin temperature following cold exposure and the increased risk of cold injuries experienced by AFD.

Influence of repeated daily menthol exposure on human temperature regulation and perception.

A single exposure to menthol can, depending on concentration, enhance both cool sensations and encourage body heat storage. This study tested whether there is an habituation in either response after repeated-daily exposures. Twenty-two participants were assigned to one of three spray groups: Control (CON; n=6), 0.05% L-menthol (M(0.05%); n=8), and 0.2% L-menthol (M(0.2%); n=8). On Monday (20°C, 50% rh) participants were sprayed with 100 mL of solution and undertook 40 min of cycling at 45% of their peak power (Ex1), from Tuesday to Thursday (30°C, 50% rh) they were sprayed twice daily whilst resting (R1 to R6), Friday was a repeat of Monday (Ex2). Thermal sensation (TS), thermal comfort, perceived exertion, irritation, rectal and skin temperature (Tsk), skin blood flow (SkBF) and sweat rate were monitored. A two-way ANOVA (alpha=0.05) compared responses from the beginning (Ex1, R1) and end (Ex2, R5) of the testing week. M(0.2%) induced significantly (P<0.05) cooler TS at the beginning of the week (Ex1, R1) compared to the end (Ex2, R5), indicating habituation of TS; this was not observed in M(0.05%). No other perceptual or physiological responses habituated. 0.2% Menthol caused a heat storage response, mediated by vasoconstriction, at the beginning and end of the week, suggesting the habituation of TS occurred in a pathway specific to sensation. In summary, the cooling influence of 0.2% menthol habituates after repeated-daily exposures, but with no habituation in heat storage.

Thermal comfort following immersion.

Unlike thermal comfort in air, little research has been undertaken exploring thermal comfort around water sports. We investigated the impact of swimming and cooling in air after swimming on thermal comfort. After 10 min of swimming-and-resting cycles in 28°C water, volunteers wearing two types of garments or in swim briefs, faced winds in 24°C air, at rest or when stepping. Thermal comfort was significantly higher during swimming than resting. Post-immersion, following maximum discomfort, in 45 of 65 tests thermal comfort improved although mean skin temperature was still cooling (0.26 [SD 0.19] °C·min(-1) - max was 0.89°C·min(-1)). When thermal comfort was re-established mean skin temperature was lower than at maximal discomfort in 39 of 54 tests (0.81 [SD 0.58] °C - max difference was 2.68°C). The reduction in thermal discomfort in this scenario could be due to the adaptation of thermoreceptors, or to reductions in cooling rates to levels where discomfort was less stimulated. The relief from the recent discomfort may explain why, later, thermal comfort returned to initial levels in spite of poorer thermal profiles.

The effect of ethnicity on the vascular responses to cold exposure of the extremities.

PURPOSE: Cold injuries are more prevalent in individuals of African descent (AFD). Therefore, we investigated the effect of extremity cooling on skin blood flow (SkBF) and temperature (T sk) between ethnic groups. METHODS: Thirty males [10 Caucasian (CAU), 10 Asian (ASN), 10 AFD] undertook three tests in 30 °C air whilst digit T sk and SkBF were measured: (i) vasomotor threshold (VT) test--arm immersed in 35 °C water progressively cooled to 10 °C and rewarmed to 35 °C to identify vasoconstriction and vasodilatation; (ii) cold-induced vasodilatation (CIVD) test--hand immersed in 8 °C water for 30 min followed by spontaneous warming; (iii) cold sensitivity (CS) test--foot immersed in 15 °C water for 2 min followed by spontaneous warming. Cold sensory thresholds of the forearm and finger were also assessed. RESULTS: In the VT test, vasoconstriction and vasodilatation occurred at a warmer finger T sk in AFD during cooling [21.2 (4.4) vs. 17.0 (3.1) °C, P = 0.034] and warming [22.0 (7.9) vs. 12.1 (4.1) °C, P = 0.002] compared with CAU. In the CIVD test, average SkBF during immersion was greater in CAU [42 (24) %] than ASN [25 (8) %, P = 0.036] and AFD [24 (13) %, P = 0.023]. Following immersion, SkBF was higher and rewarming faster in CAU [3.2 (0.4) °C min(-1)] compared with AFD [2.5 (0.7) °C min(-1), P = 0.037], but neither group differed from ASN [3.0 (0.6) °C min(-1)]. Responses to the CS test and cold sensory thresholds were similar between groups. CONCLUSION: AFD experienced a more intense protracted finger vasoconstriction than CAU during hand immersion, whilst ASN experienced an intermediate response. This greater sensitivity to cold may explain why AFD are more susceptible to cold injuries.

Ototoxicity of polymyxin B, neomycin, and hydrocortisone suspension in tympanoplasty surgery.

OBJECTIVES: (1) To determine the safety of using a commercially available suspension of polymyxin B, neomycin, and hydrocortisone (PNH) in tympanoplasty surgery. (2) To apply evidence-based medicine to tympanoplasty surgery when considering potential ototoxicity. STUDY DESIGN: Case series with chart review. SETTING: Tertiary otology practice, single surgeon. METHODS: Approval for this study was obtained from the St. Dominic-Jackson Memorial Hospital Institutional Review Board. Data were gathered on 272 consecutive type 1, underlay tympanoplasties for which both pre- and postoperative audiometric data were available over a 10-year period. In each surgery, gelatin sponge saturated in a commercially available PNH suspension was placed in the middle ear to support the graft. Patients ranged in age from 3 years to 79 years. Preoperative and postoperative bone conduction thresholds were measured at 500, 1000, 2000, 3000, and 4000 Hz. RESULTS: The average change in sensorineural hearing as measured by bone conduction thresholds was negligible, with a slight improvement in all frequencies tested except 4000 Hz. The changes by frequencies were as follows: 500 Hz (-1.624 dB), 1000 Hz (-1.399 dB), 2000 Hz (-0.975 dB), 3000 Hz (-0.596 dB), and 4000 Hz (+0.560 dB). The 5-frequency average change was -0.545 dB. CONCLUSIONS: The commonly used otic solution containing polymyxin B, neomycin, and hydrocortisone demonstrates no ototoxicity in tympanoplasty surgery and is safe to use in this setting.

The impact of a phase-change cooling vest on heat strain and the effect of different cooling pack melting temperatures.

Cooling vests (CV) are often used to reduce heat strain. CVs have traditionally used ice as the coolant, although other phase-change materials (PCM) that melt at warmer temperatures have been used in an attempt to enhance cooling by avoiding vasoconstriction, which supposedly occurs when ice CVs are used. This study assessed the effectiveness of four CVs that melted at 0, 10, 20 and 30 °C (CV0, CV10, CV20, and CV30) when worn by 10 male volunteers exercising and then recovering in 40 °C air whilst wearing fire-fighting clothing. When compared with a non-cooling control condition (CON), only the CV0 and CV10 vests provided cooling during exercise (40 and 29 W, respectively), whereas all CVs provided cooling during resting recovery (CV0 69 W, CV10 66 W, CV20 55 W and CV30 29 W) (P < 0.05). In all conditions, skin blood flow increased when exercising and reduced during recovery, but was lower in the CV0 and CV10 conditions compared with control during exercise (observed power 0.709) (P < 0.05), but not during resting recovery (observed power only 0.55). The participants preferred the CV10 to the CV0, which caused temporary erythema to underlying skin, although this resolved overnight after each occurrence. Consequently, a cooling vest melting at 10 °C would seem to be the most appropriate choice for cooling during combined work and rest periods, although possibly an ice-vest (CV0) may also be appropriate if more insulation was worn between the cooling packs and the skin than used in this study.

The influence of menthol on thermoregulation and perception during exercise in warm, humid conditions.

Menthol has recently been added to various cooling products that claim to enhance athletic performance. This study assessed the effect of two such solutions during exercise in warm, humid conditions. Twelve participants (22 ± 2.9 years; VO2peak 47.4 ± 6.2 mL kg(-1) min(-1)) completed a peak power (PO(peak)) test and three separate exercise bouts in 30°C and 70% relative humidity after being sprayed with 100 mL of water containing either 0.05 or 0.2% l-menthol, or a control spray. During each trial, participants underwent 15 min of rest, spraying, 15 min of rest and 45 min of exercise at 45% of PO(peak). The following variables were measured: rectal temperature (T (re)), sweat rate (SR), skin blood flow (SBF), heart rate (HR), thermal comfort (TC) and sensation (TS) votes, irritation (IRR) and rating of perceived exertion (RPE). Mean skin (MST) and body temperatures (Tbody) were calculated. There was no significant difference in MST, Tbody SR, SBF, HR, TC or RPE between conditions. Spraying with 0.2% menthol significantly (P < 0.05) elevated T (re) by 0.2°C compared to the other conditions. Both menthol sprays caused participants to feel significantly cooler than control spraying (P = 0.001), but 0.2% spraying induced significantly cooler sensations (P = 0.01) than 0.05% spraying. Both menthol sprays induced greater irritation (P < 0.001) than control spraying. These findings suggest that 0.05% menthol spraying induced cooler upper body sensations without measurable thermoregulatory impairment. T (re) was significantly elevated with 0.2% spraying. Irritation persisted with both menthol sprays while TC remained unchanged, suggesting a causal relationship. The use in sport of a spray similar to those tested here remains equivocal.

Post-exercise cooling techniques in hot, humid conditions.

Major sporting events are often held in hot and humid environmental conditions. Cooling techniques have been used to reduce the risk of heat illness following exercise. This study compared the efficacy of five cooling techniques, hand immersion (HI), whole body fanning (WBF), an air cooled garment (ACG), a liquid cooled garment (LCG) and a phase change garment (PCG), against a natural cooling control condition (CON) over two periods between and following exercise bouts in 31 degrees C, 70%RH air. Nine males [age 22 (3) years; height 1.80 (0.04) m; mass 69.80 (7.10) kg] exercised on a treadmill at a maximal sustainable work intensity until rectal temperature (T (re)) reached 38.5 degrees C following which they underwent a resting recovery (0-15 min; COOL 1). They then recommenced exercise until T (re) again reached 38.5 degrees C and then undertook 30 min of cooling with (0-15 min; COOL 2A), and without face fanning (15-30 min; COOL 2B). Based on mean body temperature changes (COOL 1), WBF was most effective in extracting heat: CON 99 W; WBF: 235 W; PCG: 141 W; HI: 162 W; ACG: 101 W; LCG: 49 W) as a consequence of evaporating more sweat. Therefore, WBF represents a cheap and practical means of post-exercise cooling in hot, humid conditions in a sporting setting.

Using skin temperature gradients or skin heat flux measurements to determine thresholds of vasoconstriction and vasodilatation.

Forearm-fingertip skin temperature differentials (T(sk-diff)) are used to indicate vasomotor tone, vasoconstriction defined as having occurred when T(sk-diff)> or =4 degrees C (Sessler et al. 1987, 1988a, b). This study was conducted to determine whether T(sk-diff) or finger pad heat flux (HF) can be used to predict when vasoconstriction and vasodilatation occur. Seven subjects (one female) sat in water at [mean (SD)] 40.7 (0.8) degrees C until their core temperature (T(c)) increased by 1 degrees C, ensuring vasodilatation. The water was then cooled [at a rate of 0.6 (0.1) degrees C x min(-1)] until T(c) fell to 0.5 degrees C below pretesting values, causing vasoconstriction. Subjects were then rewarmed in water [41.2 (1.0) degrees C]. Skin blood flow (SkBF) was measured using laser Doppler flowmetry (LDF) on the left second finger pad [immersed in water at 10.4 (1.4) degrees C as part of another experiment], and infrared plethysmography on the third finger pad of both hands. T(sk-diff) and HF were measured on the right upper limb, which remained in air. When vasodilated, the subjects had a stable T(sk-diff) and HF. During cooling, rapid-onset vasoconstriction occurred coincidental with large gradient changes in HF and T(sk-diff) (inflection points). In two subjects the original vasoconstriction definition (T(sk-diff)> or =4 degrees C) was not attained, in the other five this was achieved 31-51 min after vasoconstriction. During rewarming, the T(sk-diff) and HF inflection points less accurately reflected the onset of vasodilatation, although with one exception they were within 5 min of the LDF changes. We conclude that T(sk-diff) and HF inflection points predict vasoconstriction accurately, and better than T(sk-diff)> or =4 degrees C.