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1.
Niger J Clin Pract ; 23(9): 1194-1200, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913156

RESUMO

Aim: This retrospective analysis aims to evaluate the correlation between blood glucose fluctuation (BGF) and heart rate variability (HRV) in patients with coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM). Subjects and Methods: In total, 210 patients with CHD and T2DM from January 2014 to January 2019 admitted to Wenling Hospital of Traditional Chinese Medicine were enrolled in this study. Based on whether BGF existed, patients were allocated to BG control group and BG fluctuation group. The HRV parameters, frequency of adverse events, and Gensini score between groups were recorded and Pearson analysis was performed. Results: Results displayed that no significant differences in age, gender, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), alcohol consumption history, drinking history, or serum lipid were found between groups (P > 0.05 for all items). However, the BGF parameters were significantly higher while the HRV parameters were significantly lower in BG fluctuation group, compared with BG control group (P < 0.05 for all items). Pearson analysis showed that despite mean blood glucose (MBG) and mean amplitude of glycemic excursions (MAGE) both correlated with a standard deviation of NN intervals (SDNN) level, the correlation coefficient of MAGE-SDNN was much higher (-0.705 vs -0.185). Additionally, the frequencies of adverse events and Gensini scores were also significantly higher in the BG fluctuation group than the BG control group. Conclusions: It suggests that BGF strongly correlated with HRV in patients with CHD and T2DM. It also provides experimental instructions for clinical practice.


Assuntos
Glicemia/análise , Doença das Coronárias/complicações , Diabetes Mellitus Tipo 2/complicações , Glucose/metabolismo , Frequência Cardíaca/fisiologia , Adulto , Idoso , Índice de Massa Corporal , Doença das Coronárias/sangue , Doença das Coronárias/fisiopatologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
2.
Geriatr Gerontol Int ; 20(10): 853-859, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32886848

RESUMO

AIM: To analyze the correlation between the appearance of signs/symptoms during a cardiovascular rehabilitation program and linear indexes of the heart rate variability (HRV) at rest. METHODS: To carry out the present observational longitudinal study, 48 patients were analyzed. The protocol was divided into two stages. First, the patients had their personal details collected, and the autonomic modulation at rest was evaluated by HRV. Second, they underwent 36 sessions of the cardiovascular rehabilitation program to evaluate signs/symptoms. Then, just for analysis of the data, they were divided into two groups: the group without signs/symptoms (n = 26; 65.15 ± 9.7 years); and the group with signs/symptoms (n = 22; 66.77 ± 14.4 years). The HRV indexes were compared by ancova. The effect size was measured through the partial eta-squared. Pearson's and Spearman's correlations (P < 0.05) were used to analyze the data, and linear regression was applied. RESULTS: A total of 103 signs/symptoms occurred. The group with signs/symptoms presented lower values of HRV indexes when compared with the group without signs/symptoms, especially for the parasympathetic indexes with a large effect size. The root mean square of successive differences (rMSSD), percentage of adjacent RR intervals with a difference of duration >50 ms (pNN50), high-frequency spectral component (HF) varying from 0.15 to 0.4 Hz (expressed as ms2 ), dispersion of the points perpendicular to the line of identity and represents the instantaneous record of the beat-to-beat variability (SD1) and SD1/scatter of points along the identity line and represents the HRV in long-term records (SD2) index presented a negative correlation with the appearance of signs/symptoms. When the linear regression was applied, the rMSSD, SD1 and SD1/SD2 showed negative values of ß (P < 0.05). CONCLUSIONS: Patients with lower HRV are more likely to have signs/symptoms. The rMSSD, pNN50, HF (expressed as ms2 ), SD1 and SD1/SD2 index presented a negative correlation with the appearance of signs/symptoms. For rMSSD, SD1 and SD1/SD2, the lower the values of these HRV indexes, the greater the risk of appearance of signs/symptoms. Geriatr Gerontol Int 2020; 20: 853-859.


Assuntos
Reabilitação Cardíaca , Frequência Cardíaca/fisiologia , Idoso , Sistema Nervoso Autônomo/fisiologia , Eletrocardiografia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
3.
Sports Biomech ; 19(6): 723-737, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32942954

RESUMO

The aim of this study was to understand if and how surface-induced vibrations and road bike damping affect short-term neuromuscular performance in cycling. Thirty cyclists (mass 75.9 ± 8.9 kg, height 1.82 ± 0.05 m, Vo2max 63.0 ± 6.8 ml/min/kg) performed steady-state and maximum effort tests with and without vibration exposure (front dropout: 44 Hz, 4.1 mm; rear dropout: 38 Hz, 3.5 mm) on a damped and a nondamped bike. Transmitted accelerations to the musculoskeletal system, activation of lower extremity muscles (gast. med., soleus, vast. med., rec. fem.) and upper body muscles (erec. spinae, deltoideus, tric. brachii), oxygen uptake, heart rate and crank power output were measured. The main findings indicate a transmission of vibration to the whole body, but since no major propulsive muscles increase their activation with vibration, the systemic energy demand increases only marginally with vibration. Damping reduces vibrations at the upper body, which indicates an increase in comfort, but has no effect on the vibration transfer to the lower extremities. Therefore, road bike damping does not affect neuromuscular response of the propulsive muscle groups and energy demand. Consequently, short-term power output does not increase with damping.


Assuntos
Desempenho Atlético/fisiologia , Ciclismo/fisiologia , Meio Ambiente , Músculo Esquelético/fisiologia , Vibração , Aceleração , Fenômenos Biomecânicos , Estudos Transversais , Frequência Cardíaca/fisiologia , Humanos , Extremidade Inferior/fisiologia , Masculino , Músculo Esquelético/inervação , Consumo de Oxigênio/fisiologia , Tronco/fisiologia , Extremidade Superior/fisiologia
4.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32917847

RESUMO

BACKGROUND: International guidelines for resuscitation recommend using positive end-expiratory pressure (PEEP) during ventilation of preterm newborns. Reliable PEEP-valves for self-inflating bags have been lacking, and effects of PEEP during resuscitation of term newborns are insufficiently studied. The objective was to determine if adding a new PEEP valve to the bag-mask during resuscitation of term and near-term newborns could improve heart rate response. METHODS: This randomized controlled trial was performed at Haydom Lutheran Hospital in Tanzania (September 2016 to June 2018). Helping Babies Breathe-trained midwives performed newborn resuscitation using self-inflating bags with or without a new, integrated PEEP valve. All live-born newborns who received bag-mask ventilation at birth were eligible. Heart rate response measured by ECG was the primary outcome, and clinical outcome and ventilation data were recorded. RESULTS: Among 417 included newborns (median birth weight 3200 g), 206 were ventilated without and 211 with PEEP. We found no difference in heart rate response. Median (interquartile range) measured PEEP in the PEEP group was 4.7 (2.0-5.6) millibar. The PEEP group received lower tidal volumes (4.9 [1.9-8.2] vs 6.3 [3.9-10.5] mL/kg; P = .02) and had borderline lower expired CO2 (2.9 [1.5-4.3] vs 3.3 [1.9-5.0] %; P = .05). Twenty four-hour mortality was 9% in both groups. CONCLUSIONS: We found no evidence for improved heart rate response during bag-mask ventilation with PEEP compared with no PEEP. The PEEP valve delivered a median PEEP within the intended range. The findings do not support routine use of PEEP during resuscitation of newborns around term.


Assuntos
Frequência Cardíaca/fisiologia , Respiração com Pressão Positiva/instrumentação , Respiração Artificial/métodos , Ressuscitação/instrumentação , Eletrocardiografia , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Tocologia , Respiração com Pressão Positiva/estatística & dados numéricos , Ressuscitação/métodos , Ressuscitação/estatística & dados numéricos , Tamanho da Amostra , Nascimento a Termo
5.
PLoS One ; 15(8): e0238569, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866216

RESUMO

Validation of heart rate responses in wearable technology devices is generally composed of laboratory-based protocols that are steady state in nature and as a result, high accuracy measures are returned. However, there is a need to understand device validity in applied settings that include varied intensities of exercise. The purpose was to determine concurrent heart rate validity during trail running. Twenty-one healthy participants volunteered (female n = 10, [mean (SD)]: age = 31 [11] years, height = 173.0 [7] cm, mass = 75.6 [13] kg). Participants were outfitted with wearable technology devices (Garmin Fenix 5 wristwatch, Jabra Elite Sport earbuds, Motiv ring, Scosche Rhythm+ forearm band, Suunto Spartan Sport watch with accompanying chest strap) and completed a self-paced 3.22 km trail run while concurrently wearing a criterion heart rate strap (Polar H7 heart rate monitor). The trail runs were out-and-back with the first 1.61 km in an uphill direction, and the 1.61 return being downhill in nature. Validity was determined through three methods: Mean Absolute Percent Error (MAPE), Bland-Altman Limits of Agreement (LOA), and Lin's Concordance Coefficient (rC). Validity measures overall are as follows: Garmin Fenix 5 (MAPE = 13%, LOA = -32 to 162, rC = 0.32), Jabra Elite Sport (MAPE = 23%, LOA = -464 to 503, rC = 0.38), Motiv ring (MAPE = 16%, LOA = -52 to 96, rC = 0.29), Scosche Rhythm+ (MAPE = 6%, LOA = -114 to 120, rC = 0.79), Suunto Spartan Sport (MAPE = 2%, LOA = -62 to 61, rC = 0.96). All photoplethysmography-based (PPG) devices displayed poor heart rate agreement during variable intensity trail running. Until technological advances occur in PPG-based devices allowing for acceptable agreement, heart rate in outdoor environments should be obtained using an ECG-based chest strap that can be connected to a wristwatch or other comparable receiver.


Assuntos
Determinação da Frequência Cardíaca/instrumentação , Determinação da Frequência Cardíaca/métodos , Frequência Cardíaca/fisiologia , Corrida/fisiologia , Tecnologia/instrumentação , Tecnologia/métodos , Adulto , Exercício Físico/fisiologia , Teste de Esforço/instrumentação , Teste de Esforço/métodos , Feminino , Monitores de Aptidão Física , Humanos , Masculino , Fotopletismografia/métodos , Dispositivos Eletrônicos Vestíveis
6.
Environ Health Prev Med ; 25(1): 45, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867671

RESUMO

High salt intake increases blood pressure, and dietary salt intake has been clearly demonstrated to be associated with hypertension incidence. Japanese people consume higher amounts of salt than Westerners. It has been reported that miso soup was one of the major sources of daily salt intake in Japanese people. Adding salt is indispensable to make miso, and therefore, in some cases, refraining from miso soup is recommended to reduce dietary salt intake. However, recent studies using salt-sensitive hypertensive models have revealed that miso lessens the effects of salt on blood pressure. In other word, the intake of miso dose not increase the blood pressure compared to the equivalent intake of salt. In addition, many clinical observational studies have demonstrated the absence of a relationship between the frequency of miso soup intake and blood pressure levels or hypertension incidence. The mechanism of this phenomenon seen in the subjects with miso soup intake has not been fully elucidated yet. However, in basic studies, it was found that the ingredients of miso attenuate sympathetic nerve activity, resulting in lowered blood pressure and heart rate. Therefore, this review focused on the differences between the effects of miso intake and those of the equivalent salt intake on sympathetic nerve activity, blood pressure, and heart rate.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Alimentos de Soja/efeitos adversos , Sistema Nervoso Simpático/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Frequência Cardíaca/fisiologia , Humanos , Sistema Nervoso Simpático/fisiologia
7.
Pediatr Clin North Am ; 67(5): 801-810, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32888682

RESUMO

Syncope and palpitations are common complaints for patients presenting to their primary care provider. They represent symptoms that most often have a benign etiology but rarely can be the first warning sign of a serious condition, such as arrhythmias, structural heart disease, or noncardiac disease. The history, physical examination, and noninvasive testing can, in most cases, distinguish benign from pathologic causes. This article introduces syncope and palpitations, with emphasis on the differential diagnoses, initial presentation, diagnostic strategy, and various management strategies.


Assuntos
Arritmias Cardíacas/diagnóstico , Eletrocardiografia , Sistema de Condução Cardíaco/fisiopatologia , Frequência Cardíaca/fisiologia , Síncope/diagnóstico , Arritmias Cardíacas/fisiopatologia , Criança , Diagnóstico Diferencial , Humanos , Síncope/fisiopatologia
8.
J Comput Assist Tomogr ; 44(5): 790-795, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32936580

RESUMO

BACKGROUND: The state-of-art motion correction algorithm is inadequate for correcting motion artifacts in coronary arteries in cardiovascular computed tomography angiography (CCTA) for children with high heart rates, and even less effective for heart structures beyond coronary arteries. PURPOSE: This study aimed to evaluate the effectiveness of a second-generation, whole-heart motion correction algorithm in improving the heart image quality of CCTA for children with high heart rates. MATERIALS AND METHODS: Forty-two consecutive symptomatic cardiac patients with high heart rates (122.6 ± 18.8 beats/min) were enrolled. All patients underwent CCTA on a 256-row CT using a prospective electrocardiogram-triggered single-beat protocol. Images were reconstructed using a standard algorithm (STD), state-of-the-art first-generation coronary artery motion correction algorithm (MC1), and second-generation, whole-heart motion correction algorithm (MC2). The image quality of the origin of left coronary, right coronary, aortic valve, pulmonary valve, mitral valve, tricuspid valve, aorta root, pulmonary artery root, ventricular septum (VS), and atrial septum (AS) was assessed by 2 experienced radiologists using a 4-point scale (1, nondiagnostic; 2, detectable; 3, measurable; and 4, excellent); nonparametric test was used to analyze and compare the differences among 3 groups; and post hoc multiple comparisons were used between different methods. RESULTS: There were group differences for cardiac structures except VS and AS, with MC2 having the best image quality and STD having the worst image quality. Post hoc multiple comparisons showed that MC2 was better than MC1 and STD in all structures except VS and AS where all 3 algorithms performed equally, whereas MC1 was better than STD only in the origin of left coronary, right coronary, and mitral valve. CONCLUSIONS: A second-generation, whole-heart motion correction algorithm further significantly improves cardiac image quality beyond the coronaries in CCTA for pediatric patients with high heart rates.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/fisiopatologia , Frequência Cardíaca/fisiologia , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Algoritmos , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos
9.
Phys Rev Lett ; 125(5): 058102, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32794888

RESUMO

Animal hearts are soft shells that actively pump blood to oxygenate tissues. Here, we propose an allometric scaling law for the heart rate based on the idea of elastohydrodynamic resonance of a fluid-loaded soft active elastic shell that buckles and contracts axially when twisted periodically. We show that this picture is consistent with numerical simulations of soft cylindrical shells that twist-buckle while pumping a viscous fluid, yielding optimum ejection fractions of 35%-40% when driven resonantly. Our scaling law is consistent with experimental measurements of heart rates over 2 orders of magnitude, and provides a mechanistic basis for how metabolism scales with organism size. In addition to providing a physical rationale for the heart rate and metabolism of an organism, our results suggest a simple design principle for soft fluidic pumps.


Assuntos
Frequência Cardíaca/fisiologia , Coração/anatomia & histologia , Coração/fisiologia , Modelos Cardiovasculares , Animais , Simulação por Computador , Elasticidade , Ventrículos do Coração/anatomia & histologia , Hidrodinâmica , Função Ventricular
10.
Curr Opin Anaesthesiol ; 33(5): 619-625, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32826624

RESUMO

PURPOSE OF REVIEW: Why is pulse oximetry a standard monitor, whereas tissue oximeter is not? Is this a double-standard treatment? RECENT FINDINGS: There appears to be a lack of enthusiasm for a continual investigation into whether the use of pulse oximetry leads to reduced morbidity and mortality in acute care although there is no robust evidence attesting to its outcome benefits. In contrast, research investigating the outcome effectiveness of tissue oximetry-guided care is consistently ongoing. A recent randomized controlled trial involving 800 patients who underwent laparoscopic hysterectomy found that, although muscular tissue oxygen saturation-guided care did not reduce the overall occurrence of postoperative nausea and vomiting for all patients, it did reduce the occurrence of these symptoms in patients who had a body mass index ≥25. It was also observed that muscular tissue oxygen saturation increases when blood pressure falls following the administration of nicardipine. These studies highlight the persistence of interest in understanding the value of tissue oximetry in patient care. SUMMARY: Pulse oximetry and tissue oximetry are treated differently although neither monitor has robust evidence attesting to its outcome benefits. This difference may root in the difference in the physiology they monitor, the cost, the ease of use/interpretation/intervention and the relevance to patient safety and care quality. Pulse oxygen saturation represents a vital sign, whereas tissue oxygen saturation is likely a quality sign; however, further research endeavors are required to fully understand how to best use tissue oximetry.


Assuntos
Frequência Cardíaca/fisiologia , Oximetria , Oxigênio , Índice de Massa Corporal , Feminino , Humanos , Monitorização Fisiológica , Oxigênio/sangue
11.
PLoS One ; 15(8): e0236999, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32813734

RESUMO

Snakes have been important ambush predators of both primates and human hunter-gatherers throughout their co-evolutionary history. Viperid snakes in particular are responsible for most fatal venomous snakebites worldwide and thus represent a strong selective pressure. They elicit intense fear in humans and are easily recognizable thanks to their distinctive morphotype. In this study, we measured skin resistance (SR) and heart rate (HR) in human subjects exposed to snake pictures eliciting either high fear (10 venomous viperid species) or disgust (10 nonvenomous fossorial species). Venomous snakes subjectively evaluated as frightening trigger a stronger physiological response (higher SR amplitude) than repulsive non-venomous snakes. However, stimuli presented in a block (more intense stimulation) do not trigger a stronger emotional response compared to sequentially presented stimuli (less intense stimulation). There are significant interindividual differences as subjects with high fear of snakes confronted with images of viperid snakes show stronger, longer-lasting, and more frequent changes in SR and higher HR compared to low-fear subjects. Thus, we show that humans demonstrate a remarkable ability to discriminate between dangerous viperids and harmless fossorial snakes, which is also reflected in distinct autonomous body responses.


Assuntos
Medo/fisiologia , Medo/psicologia , Mordeduras de Serpentes/psicologia , Serpentes , Adolescente , Adulto , Animais , Sistema Nervoso Autônomo/fisiologia , Evolução Biológica , Asco , Feminino , Resposta Galvânica da Pele/fisiologia , Frequência Cardíaca/fisiologia , Humanos , Masculino , Modelos Psicológicos , Estimulação Luminosa , Psicometria , Psicofisiologia , Venenos de Serpentes/envenenamento , Adulto Jovem
12.
Int J Antimicrob Agents ; 56(4): 106143, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: covidwho-764714

RESUMO

As no specific pharmacological treatment has been validated for use in coronavirus disease 2019 (COVID-19), we aimed to assess the effectiveness of azithromycin (AZM) in these patients at a referral centre in Iran. An open-label, randomised controlled trial was conducted on patients with laboratory-confirmed COVID-19. A total of 55 patients in the control group receiving hydroxychloroquine (HCQ) and lopinavir/ritonavir (LPV/r) were compared with 56 patients in the case group who in addition to the same regimen also received AZM. Patients with prior cardiac disease were excluded from the study. Furthermore, patients from the case group were assessed for cardiac arrythmia risk based on the American College of Cardiology (ACC) risk assessment for use of AZM and HCQ. The main outcome measures were vital signs, SpO2 levels, duration of hospitalisation, need for and length of intensive care unit admission, mortality rate and results of 30-day follow-up after discharge. Initially, there was no significant difference between the general conditions and vital signs of the two groups. The SpO2 levels at discharge were significantly higher, the respiratory rate was lower and the duration of admission was shorter in the case group. There was no significant difference in the mortality rate between the two groups. Patients who received AZM in addition to HCQ and LPV/r had a better general condition. HCQ+AZM combination may be beneficial for individuals who are known to have a very low underlying risk for cardiac arrhythmia based on the ACC criteria.


Assuntos
Anti-Infecciosos/uso terapêutico , Azitromicina/uso terapêutico , Betacoronavirus/efeitos dos fármacos , Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/uso terapêutico , Lopinavir/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Ritonavir/uso terapêutico , Adulto , Idoso , Betacoronavirus/patogenicidade , Proteína C-Reativa/metabolismo , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/patologia , Progressão da Doença , Combinação de Medicamentos , Feminino , Frequência Cardíaca/fisiologia , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Pandemias , Segurança do Paciente , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/mortalidade , Pneumonia Viral/patologia , Prognóstico , Testes de Função Respiratória , Análise de Sobrevida , Linfócitos T/patologia , Linfócitos T/virologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
13.
PLoS One ; 15(8): e0238307, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32853281

RESUMO

OBJECTIVE: Auricular stimulation (AS) is a promising method in the treatment of situational anxiety. Expressive writing (EW) is an established psychological method, which reduces test anxiety and improves exam results. The aim of this crossover trial was to compare AS with EW, and with the no intervention (NI) condition, for treatment of exam anxiety. METHODS: Healthy medical students underwent 3 comparable anatomy exams with an interval of one month, either performing EW, receiving AS or NI prior to the exam; the order of interventions was randomized. AS was applied using indwelling fixed needles bilaterally at the areas innervated mostly by the auricular branch of the vagal nerve on the day before the exam. Anxiety level, measured using State-Trait-Anxiety Inventory (STAI) before and after the interventions and immediately before exam, was the primary outcome. Quality of night sleep, blood pressure, heart rate and activity of salivary alpha-amylase (sAA) were analyzed across 3 conditions. RESULTS: All 37 included participants completed the study. Anxiety level (STAI) decreased immediately after AS in comparison with baseline (P = 0.02) and remained lower in comparison with that after EW and NI (P<0.01) on the day of exam. After EW and NI anxiety increased on the day of exam in comparison with baseline (P<0.01). Quality of sleep improved after AS in comparison with both control conditions (P<0.01). The activity of sAA decreased after EW and after AS (P<0.05) but not after NI condition. CONCLUSION: Auricular stimulation, but not expressive writing, reduced exam anxiety and improved quality of sleep in medical students. These changes might be due to reduced activity of the sympathetic nervous system.


Assuntos
Desempenho Acadêmico/psicologia , Transtornos de Ansiedade/prevenção & controle , Transtornos de Ansiedade/psicologia , Ansiedade/psicologia , Estudantes de Medicina/psicologia , Adolescente , Adulto , Ansiedade/metabolismo , Transtornos de Ansiedade/metabolismo , Pressão Sanguínea/fisiologia , Estudos Cross-Over , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Redação , Adulto Jovem , alfa-Amilases/metabolismo
14.
Int J Antimicrob Agents ; 56(4): 106143, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32853672

RESUMO

As no specific pharmacological treatment has been validated for use in coronavirus disease 2019 (COVID-19), we aimed to assess the effectiveness of azithromycin (AZM) in these patients at a referral centre in Iran. An open-label, randomised controlled trial was conducted on patients with laboratory-confirmed COVID-19. A total of 55 patients in the control group receiving hydroxychloroquine (HCQ) and lopinavir/ritonavir (LPV/r) were compared with 56 patients in the case group who in addition to the same regimen also received AZM. Patients with prior cardiac disease were excluded from the study. Furthermore, patients from the case group were assessed for cardiac arrythmia risk based on the American College of Cardiology (ACC) risk assessment for use of AZM and HCQ. The main outcome measures were vital signs, SpO2 levels, duration of hospitalisation, need for and length of intensive care unit admission, mortality rate and results of 30-day follow-up after discharge. Initially, there was no significant difference between the general conditions and vital signs of the two groups. The SpO2 levels at discharge were significantly higher, the respiratory rate was lower and the duration of admission was shorter in the case group. There was no significant difference in the mortality rate between the two groups. Patients who received AZM in addition to HCQ and LPV/r had a better general condition. HCQ+AZM combination may be beneficial for individuals who are known to have a very low underlying risk for cardiac arrhythmia based on the ACC criteria.


Assuntos
Anti-Infecciosos/uso terapêutico , Azitromicina/uso terapêutico , Betacoronavirus/efeitos dos fármacos , Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/uso terapêutico , Lopinavir/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Ritonavir/uso terapêutico , Adulto , Idoso , Betacoronavirus/patogenicidade , Proteína C-Reativa/metabolismo , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/patologia , Progressão da Doença , Combinação de Medicamentos , Feminino , Frequência Cardíaca/fisiologia , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Pandemias , Segurança do Paciente , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/mortalidade , Pneumonia Viral/patologia , Prognóstico , Testes de Função Respiratória , Análise de Sobrevida , Linfócitos T/patologia , Linfócitos T/virologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
15.
Orv Hetil ; 161(29): 1190-1199, 2020 07.
Artigo em Húngaro | MEDLINE | ID: mdl-32628618

RESUMO

Heart failure is a rapidly growing epidemic in developed countries. It has been well documented that heart failure is associated with abnormal neurohumoral activation. The autonomic regulation is characterized by decreased parasympathetic and elevated sympathetic activity. While the cardiovagal activity could be easily assessed by various heart rate variability parameters, markers of the sympathetic activity are not readily available. Percutaneous insertion of microelectrodes in a peripheral nerve allows recording of the muscle sympathetic vasomotor nerve activity (MSNA). MSNA shows good correlation with the cardiac sympathetic activity, and also with the levels of circulating catecholamines. Besides determination of the baseline sympathetic activity, rapid sympathetic responses to various stimuli can be also described by changes of MSNA. Elevated MSNA has been documented in several diseases, including hypertension, obesity, myocardial ischemia and renal failure. In heart failure, the elevated MSNA is well correlated to the clinical severity of the patient's conditions, and serves as a prognostic marker of mortality. In our paper, we give a short account of the history of MSNA studies, describe its physiological background and clinical relevance with special regard to heart failure. Orv Hetil. 2020; 161(29): 1190-1199.


Assuntos
Insuficiência Cardíaca/fisiopatologia , Músculos/inervação , Frequência Cardíaca/fisiologia , Humanos , Hipertensão , Sistema Nervoso Simpático/fisiopatologia
16.
Medicine (Baltimore) ; 99(28): e21058, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664120

RESUMO

A method to perform exercise testing for patients with hemiplegia is unavailable though over half of them have cardio-pulmonary disorders. We aimed to assess the reliability and validity of using a stepper in cardiopulmonary exercise testing (CPET) in this population.14 stroke patients with hemiplegia who failed to ride the stationary bike were included. Exclusion criteria included manual muscle strength ≦1 in the lower extremity, and conventional contraindications of CPET. They underwent CPET twice by using a stepper to evaluate test-retest reliability and validity. Additionally, 10 healthy participants underwent CPET twice on the cycle ergometer and stepper respectively.In the test-retest, the ratio of two-time difference to mean was 5.0, 3, 11.3 and 12.0% on average for peak oxygen consumption, peak heart rate (HR), anaerobic threshold and minute ventilation - carbonic dioxide production slope respectively. Cronbach's alpha coefficient of peak oxygen consumption and anaerobic threshold were 0.992 and 0.919. In the stepper exercise testing of the hemiplegic participants, the ratio of peak HR to age-predicted maximal HR was 75% on average. Peak respiratory exchange ratio (mean ±â€Šstandard deviation = 1.17 ±â€Š0.08) was not different from that of healthy controls (1.21 ±â€Š0.09). Notably, VO2 trajectory in relation to work rate is nonlinear and different in the rest-retest.This is the first research to study CPET variables in detail using stepper in patients with hemiplegia. CPET variables associated with peak are valid and reliable; nonetheless, those with sub-maximum are not. The study provides a method to do exercise testing for the patients with hemiplegia and its notice in application.


Assuntos
Teste de Esforço/métodos , Hemiplegia/reabilitação , Reabilitação do Acidente Vascular Cerebral/métodos , Idoso , Limiar Anaeróbio/fisiologia , Tolerância ao Exercício/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio/fisiologia , Reprodutibilidade dos Testes , Testes de Função Respiratória
17.
PLoS One ; 15(7): e0236444, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32702055

RESUMO

Cortical spreading depolarization (SD) waves negatively affect neuronal survival and outcome after ischemic stroke. We here aimed to investigate the effects of vagus nerve stimulation (VNS) on SDs in a rat model of focal ischemia. To this end, we delivered non-invasive VNS (nVNS) or invasive VNS (iVNS) during permanent middle cerebral artery occlusion (MCAO), and found that both interventions significantly reduced the frequency of SDs in the cortical peri-infarct area compared to sham VNS, without affecting relative blood flow changes, blood pressure, heart rate or breathing rate. In separate groups of rats subjected to transient MCAO, we found that cortical stroke volume was reduced 72 h after transient MCAO, whereas stroke volume in the basal ganglia remained unchanged. In rats treated with nVNS, motor outcome was improved 2 days after transient MCAO, but was similar to sham VNS animals 3 days after ischemia. We postulate that VNS may be a safe and efficient intervention to reduce the clinical burden of SD waves in stroke and other conditions.


Assuntos
Isquemia Encefálica/terapia , Infarto/terapia , Acidente Vascular Cerebral/terapia , Estimulação do Nervo Vago/métodos , Animais , Pressão Sanguínea , Isquemia Encefálica/fisiopatologia , Modelos Animais de Doenças , Frequência Cardíaca/fisiologia , Humanos , Infarto/fisiopatologia , Infarto da Artéria Cerebral Média/fisiopatologia , Infarto da Artéria Cerebral Média/terapia , Ratos , Traumatismo por Reperfusão/fisiopatologia , Traumatismo por Reperfusão/terapia , Acidente Vascular Cerebral/fisiopatologia , Estimulação do Nervo Vago/efeitos adversos
18.
Altern Ther Health Med ; 26(5): 18-26, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32663177

RESUMO

Context: Yoga as a form of physical activity is growing in popularity. During yoga, individuals interrupt the stress response, which is typically associated with high blood pressure (BP), impaired focus, and high levels of anxiety. Consequently, research into yoga's effects on stress should place a special emphasis upon the interplay of the nervous and cardiovascular systems during yoga practice. Objective: The purpose of this study was to delineate the immediate cardiovascular effects of 12 Hatha yoga poses by means of RR (beat-to-beat) intervals and JT (cardiac repolarization) intervals. Design: The research team designed controlled pilot studies based on half-year periods. Setting: The study took place at the Lithuanian University of Health Sciences in Kaunas, Lithuania. Participants: Participants were women who were long-term yoga practitioners. Three studies occurred: (1) Study 1-10 women with a mean age of 30.1 ± 1.9 years, (2) Study 2-10 women with a mean age of 29.9 ± 1.9 years, and (3) Study 3-22 women with a mean age of 32.9 ± 1.8 years. Intervention: The study examined the acute cardiovascular effects of 12 Hatha yoga poses by means of electrocardiogram parameters. Outcome measures: Anthropometrical and physiological parameters were measured: (1) height and weight; (2) body mass index (BMI); (3) heart rate (HR); (4) systolic and diastolic blood pressure (DBP); and (5) electrocardiogram (ECG) RR and JT intervals. Results: The lowest RR interval value was recorded during the Chaturanga Dandasana, at 456.0 ± 16.5 ms in Study 3, with P < .001 compared to the intervals for all the other poses. Significant differences in the JT interval also emerged during the Chaturanga Dandasana, at 177.3 ± 6.0 ms in Study 3 with P < .001 compared to all the other poses. The next lowest RR interval value was recorded in Study 3 during the Utkatasana, at 569.4 ± 17.6 ms. In the Savasana prior to the program, the RR interval increased in study 1 and decreased in studies 2 and 3. The JT interval in the Savasana prior to the program increased in studies 1 and 2 but decreased in study 3. Conclusions: Healthy women can practice a modified and/or a shorter duration of the Chaturanga Dandasana. Adjustments in the Utkatasana, including having the arms in the prayer position, may help prevent strain to the cardiovascular system. Also, practicing poses with a longer RR interval may aid stress-related health problems.


Assuntos
Fenômenos Fisiológicos Cardiovasculares , Frequência Cardíaca/fisiologia , Meditação , Ioga , Adulto , Pressão Sanguínea , Sistema Cardiovascular , Medicina Baseada em Evidências , Feminino , Humanos , Guias de Prática Clínica como Assunto
19.
Am J Physiol Regul Integr Comp Physiol ; 319(3): R315-R322, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32697652

RESUMO

During exhaustive ramp-incremental cycling tests, the incidence of O2 uptake (V̇o2) plateaus is low. To verify the attainment of maximum V̇o2 (V̇o2max), it is recommended that a trial at a power output (PO) corresponding to 110% of the ramp-derived peak (POpeak) is performed. It remains unclear whether verification trials set at this PO can be tolerated for long enough to allow attainment of V̇o2max. Eleven recreationally trained individuals performed five ramp tests of varying slope (5, 10, 15, 25, and 30 W/min), each followed, in series, by two verification trials: the first at 110% POpeak of the 25 W/min ramp and the second at 110% POpeak attained in the preceding ramp test. Exercise duration of the first verification trial was on average 81 ± 15 s (CV = 9 ± 3%) versus 162 ± 32, 121 ± 24, 103 ± 15, and 73 ± 10 s for the second verification trials at 110% of POpeak of the 5, 10, 15, and 30 W/min ramp tests, respectively (P < 0.05). Compared with the highest V̇o2 recorded during ramp tests, V̇o2 from the subsequent verification trials was not different for the 5, 10, and 15 W/min ramp tests (P > 0.05) but was lower for the 25 and 30 W/min ramp tests (P < 0.05). Verification trials at 110% POpeak of rapidly incrementing ramp tests (i.e., 25 W/min) were not sustained for long enough to allow the attainment of V̇o2max. With commonly used rapidly incrementing ramp tests engendering exhaustion within 8-12 min, verification trials less than POpeak should be preferred as they can be sustained sufficiently long to allow the attainment of V̇o2max.


Assuntos
Transporte Biológico/fisiologia , Exercício Físico/fisiologia , Consumo de Oxigênio/fisiologia , Esforço Físico/fisiologia , Adulto , Teste de Esforço/métodos , Frequência Cardíaca/fisiologia , Humanos , Masculino
20.
Am J Physiol Regul Integr Comp Physiol ; 319(3): R288-R295, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32697654

RESUMO

Prior longitudinal work suggests that blood pressure (BP) reactivity to the cold pressor test (CPT) helps predict hypertension; yet the impact of age and sex on hemodynamic and neural responsiveness to CPT remains equivocal. Forty-three young (21 ± 1yr, means ± SE) men (YM, n = 20) and women (YW, n = 23) and 16 older (60 ± 1yr) men (OM, n = 9) and women (OW, n = 7) participated in an experimental visit where continuous BP (finger plethysmography) and muscle sympathetic nerve activity (MSNA; microneurography) were recorded during a 3- to 5-min baseline and 2-min CPT. Baseline mean arterial pressure (MAP) was greater in OM than in YM (92 ± 4 vs. 77 ± 1 mmHg, P < 0.01), but similar in women (P = 0.12). Baseline MSNA incidence was greater in OM [69 ± 6 bursts/100 heartbeats (hb)] than in OW (44 ± 7 bursts/100 hb, P = 0.02) and lower in young adults (YM: 17 ± 3 vs. YW: 16 ± 2 bursts/100 hb, P < 0.01), but similar across the sexes (P = 0.83). However, when exposed to the CPT, MSNA increased more rapidly in OW (Δ43 ± 6 bursts/100 hb; group × time, P = 0.01) compared with OM (Δ15 ± 3 bursts/100 hb) but was not different between YW (Δ30 ± 3 bursts/100 hb) and YM (Δ33 ± 4 bursts/100 hb, P = 1.0). There were no differences in MAP with CPT between groups (group × time, P = 0.33). These findings suggest that OW demonstrate a more rapid initial rise in MSNA responsiveness to a CPT compared with OM. This greater sympathetic reactivity in OW may be a contributing mechanism to the increased hypertension risk in postmenopausal women.


Assuntos
Sistema Cardiovascular/fisiopatologia , Sistema Nervoso Simpático/fisiopatologia , Envelhecimento , Pressão Sanguínea/fisiologia , Temperatura Baixa , Feminino , Frequência Cardíaca/fisiologia , Humanos , Hipertensão/fisiopatologia , Masculino , Músculo Esquelético/fisiologia , Caracteres Sexuais , Adulto Jovem
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