Axillary and thoracic skin temperatures poorly comparable to core body temperature circadian rhythm: results from 2 adult populations

Data from 2 separate studies were used to examine the relationships of axillary or thoracic skin temperature to rectal temperature and to determine the phase relationships of the circadian rhythms of these temperatures. In study 1, axillary skin and rectal temperatures were recorded in 19 healthy women, 21 to 36 years of age. In study 2, thoracic skin and rectal temperatures were recorded in 74 healthy women, 39 to 59 years of age. In both studies, temperatures were recorded continuously for 24 h while subjects carried out normal activities. Axillary and thoracic probes were insulated purposely to prevent ambient effects. Cosinor analysis was employed to estimate circadian rhythm mesor, amplitude, and acrophase. In addition, correlations between temperatures at various measurement sites were calculated and agreement determined. The circadian timing of axillary and skin temperature did not closely approximate that of rectal temperature: the mean acrophase (clock time) for study 1 was 18:57 h for axillary temperature and 16:12 h for rectal; for study 2, it was 03:05 h for thoracic and 15:05 h for rectal. Across individual subjects, the correlations of axillary or thoracic temperatures with rectal temperatures were variable. Results do not support the use of either axillary or skin temperature as a substitute for rectal temperature in circadian rhythm research related to adult women.     

急性冠脉综合征心率震荡昼夜节律及其与心率变异的相关性分析

目的 研究急性冠脉综合征患者心率震荡(heart rate turbulence,HRT)的昼夜节律性,并通过HRT指标与心率变异性指标的相关性分析,进一步探讨HRT与自主神经的关系.方法 连续入选急性冠脉综合征患者91例,分析一天中的两个时段即白天(7: 00～19: 00)和夜间(0: 00～6: 00)HRT的变化.从上午7: 00和凌晨0: 00开始各按顺序入选3个室早,根据文献计算HRT指标[震荡初始(TO)、震荡斜率(TS)]的数值.心率变异性选用的时域指标有SDNN、RMSSD,频域指标包括LF、HF、LF/HF.结果 ①TO值白天较夜间高,TS值白天较夜间低,均存在明显的昼夜节律.②TS与SDNN之间存在正相关关系(r=0.44),TS与LF/HF之间亦存在正相关关系(r=0.51).结论 急性冠脉综合征HRT存在昼夜节律变化且与HRV密切相关,提示HRT不仅反映心血管系统自主神经的反射性调节,在某种程度上也反映交感-迷走神经的紧张性调节.     

Die schmerzempfindlichkeit der perikranialen muskulatur im algesimetrischen experiment

Many types of headache that occur in the form of attacks show a notably high incidence at certain times of the day. Attacks are often accompanied by emotional instability, irritability, exhaustion and other impairments of well-being. The cause for the frequent daytime occurrence of attacks is not clear. One possible explanation could be the variability in a person's sensitivity to headache over the course of the day. For this reason we set out to investigate whether pain sensitivity to experimentally-induced headache varies in a circadian manner and whether this variation correlates to changes in the current state of well-being over the course of the day. In 24 healthy, voluntary subjects, headache was induced experimentally at 0200, 0600, 1000, 1400, 1800, and 2200 hours. Blood criculation in both superficial temporal and occipital arteries was reduced by applying a cuff to the head and inflating it to 200 mmHg, thereby producing a continuously increasing, bilateral, dull, frontal headache. The subjects scaled the intensity continually, using the category subdividing procedure ranging from pain threshold to pain tolerance level. In addition, 17 dimensions of the current state of well-being and 12 personality traits were recorded at the above-mentioned times in a standardized quantitative manner. At low levels of headache intensity there were no significant differences in pain sensitivity. Sensitivity to very intense headache, however, varied significantly over the course of the day: sensitivity was greatest at 0200 hours; it decreased at a constant rate until 1400 hours, and increased again continuously until 2200 hours (P相似文献   

Circadian phase resetting in older people by ocular bright light exposure.

BACKGROUND: Aging is associated with frequent complaints about earlier bedtimes and waketimes. These changes in sleep timing are associated with an earlier timing of multiple endogenous rhythms, including core body temperature (CBT) and plasma melatonin, driven by the circadian pacemaker. One possible cause of the age-related shift of endogenous circadian rhythms and the timing of sleep relative to clock time is a change in the phase-shifting capacity of the circadian pacemaker in response to the environmental light-dark cycle, the principal synchronizer of the human circadian system. METHODS: We studied the response of the circadian system of 24 older men and women and 23 young men to scheduled exposure to ocular bright light stimuli. Light stimuli were 5 hours in duration, administered for 3 consecutive days at an illuminance of approximately 10,000 lux. Light stimuli were scheduled 1.5 or 3.5 hours after the CBT nadir to induce shifts of endogenous circadian pacemaker to an earlier hour (phase advances) or were scheduled 1.5 hours before the CBT nadir to induce shifts to a later hour (phase delays). The rhythms of CBT and plasma melatonin assessed under constant conditions served as markers of circadian phase. RESULTS: Bright light stimuli elicited robust responses of the circadian timing system in older people; both phase advances and phase delays were induced. The magnitude of the phase delays did not differ significantly between older and younger individuals, but the phase advances were significantly attenuated in older people. CONCLUSIONS: The attenuated response to light stimuli that induce phase advances does not explain the advanced phase of the circadian pacemaker in older people. The maintained responsiveness of the circadian pacemaker to light implies that scheduled bright light exposure can be used to treat circadian phase disturbances in older people.     

Racial Differences in the Human Endogenous Circadian Period

The length of the endogenous period of the human circadian clock (tau) is slightly greater than 24 hours. There are individual differences in tau, which influence the phase angle of entrainment to the light/dark (LD) cycle, and in doing so contribute to morningness-eveningness. We have recently reported that tau measured in subjects living on an ultradian LD cycle averaged 24.2 hours, and is similar to tau measured using different experimental methods. Here we report racial differences in tau. Subjects lived on an ultradian LD cycle (1.5 hours sleep, 2.5 hours wake) for 3 days. Circadian phase assessments were conducted before and after the ultradian days to determine the change in circadian phase, which was attributed to tau. African American subjects had a significantly shorter tau than subjects of other races. We also tested for racial differences in our previous circadian phase advancing and phase delaying studies. In the phase advancing study, subjects underwent 4 days of a gradually advancing sleep schedule combined with a bright light pulse upon awakening each morning. In the phase delaying study, subjects underwent 4 days of a gradually delaying sleep schedule combined with evening light pulses before bedtime. African American subjects had larger phase advances and smaller phase delays, relative to Caucasian subjects. The racial differences in tau and circadian phase shifting have important implications for understanding normal phase differences between individuals, for developing solutions to the problems of jet lag and shift work, and for the diagnosis and treatment of circadian rhythm based sleep disorders such as advanced and delayed sleep phase disorder.     

Circadian variability at oral, tympanic and axillary temperature in hospitalized adults

The aim of this study was to measure the circadian variability of patients' temperature in the eardrum, oral, and armpit positions considering the measurement angle. The study was carried out at the State University of Campinas' Clinics Hospital (HC Unicamp), a school hospital in the city of Campinas, State of S?o Paulo. Temperatures were taken in the Cardiology, Adult General Clinic and Gastric infirmaries every two hours in two consecutive days, from the time patients woke up until 10 PM. The results show a significant difference, p-value = 0.0001, between the morning and afternoon periods compared to the evening period. The Tukey test has also showed a difference. It was observed that the measurement in the eardrum position resulted in higher temperatures compared to the other positions, thus confirming data in the international literature. The circadian variability eardrum temperature was similar to the measurements of the oral temperature during the patients' awaked period.     

Circadian rhythm of proteinuria in normal subjects but not in patients with glomerulonephritis

The existence of circadian variations in the urinary excretion of total protein, albumin and creatinine was investigated in subjects with normal and impaired renal function. All individuals were kept at bedrest for 24 hours. Eight consecutive urine specimens were collected every 3 hours and examined. In normal subjects the urinary total protein, albumin and creatinine excretion showed a significant increase during the 12 daytime hours compared with the night-time. The diurnal variations with peak occurrence at 13.26 h (range 09.58-16.43 h) for total protein, at 12.37 h (range 10.33-15.18 h) for albumin, at 16.33 h (range 13.22-19.24 h) for creatinine are temporally related to the ingestion of meat. In patients, by contrast, total protein, albumin and creatinine excretion in the urine were not modified significantly throughout the 24 hours period. Thus, impaired renal function is associated with the loss of the physiological circadian rhythm.     

Quantification of everyday motor function in a geriatric population

This pilot study evaluated variability in physical activities and the correlations between walking, two types of postural transitions, and falls efficacy with an ambulatory activity monitor. An 11-subject convenience sample wore the monitor for 2 consecutive days; in addition, 7 subjects carried the monitor on 1 day of the following week. Demographic characteristics of the sample were age: mean +/- standard deviation [SD] = 87.8 +/- 2.5 yr, body mass index: mean +/- SD = 25.3 +/- 2.1 kg/m(2), and Mini-Mental State Examination score: mean +/- SD = 27.5 +/- 2.0. Analyzed movements were sit-to-stand (SiSt) and stand-to-sit postural transitions, dynamic activity (walking), and static behavior (sitting, standing, lying). Significant correlations were found for the SiSt transition duration (TD) between days (intraclass correlation coefficient = 0.78). No differences were found between the durations of sitting (p = 0.8), lying (p = 0.72), standing (p = 0.06), and walking (p = 0.6). These parameters showed highly variable correlation coefficients. A significant correlation was observed between falls efficacy and SiSt measures (r = 0.84, p < 0.01, df = 9). We reliably determined the SiSt TD after subjects wore the monitor for 1 day in the home environment. Poor correlations between 2 consecutive measurement days for dynamic and static activity underline the necessity of recording further days to assess physical activity levels in the geriatric population.     

Effects of melatonin alone and in combination with aceten on chronostructure of diurnal hemodynamic rhythms in patients with hypertension stage II

AIM: To study effects of monotherapy with melatonin and combination melatonin + aceten on circadian pattern of hemodynamics in patients with essential hypertension stage II. MATERIALS AND METHODS: 20 EH patients were randomized into 2 groups, 10 patients each. Group 1 patients were given melatonin alone (6 mg at 22.00). Group 2 received aceten (25 mg at 18.00) and melatonin (6 mg at 22.00). Before treatment and after 10 days of it, hemodynamic parameters were measured each 3 hours for 24 hours. Arterial pressure was measured by Korotkov method, heart rate--by ECG R-R interval, stroke volume--by tetrapolar chest rheography according to Kubichek. Cardiac index, total and specific peripheral resistance, double product were estimated routinely. RESULTS: Internal and external dyssynchronism was registered in hemodynamic parameters of EH patients. Melatonin normalized circadian hemodynamic rhythms. It produced a hypotensive effect, reduced energy requirements of the myocardium. Combination of melatonin with aceten had a hypotensive and vasodilating effects but failed to restore circadian hemodynamic rhythms. CONCLUSION: Melatonin, epiphysial neurohormone, and its combination with aceten have hypotensive and vasodilating effects but melatonin monotherapy normalizes circadian hemodynamic rhythms while the combination was uneffective in this respect. This may be explained by interaction of melatonin and aceten actions.     

Fatigue, sleep, and circadian rhythms prior to chemotherapy for breast cancer

Goals Previous investigations have shown that women undergoing chemotherapy for breast cancer experience both disturbed sleep and fatigue. However, most of the previous research examined women either during or after chemotherapy. This study examined sleep, fatigue, and circadian rhythms in women with breast cancer before the start of chemotherapy.Patients and methods Eighty five women with Stages I–IIIA breast cancer who were scheduled to begin adjuvant or neoadjuvant anthracycline-based chemotherapy participated. Each had sleep/wake activity recorded with actigraphy for 72 consecutive hours and filled out questionnaires on sleep, fatigue, depression, and functional outcome.Main results On average, the women slept for about 6 h a night and napped for over an hour during the day. Sleep was reported to be disturbed and fatigue levels were high. Circadian rhythms were robust, but women who were more phase-delayed reported more daily dysfunction (p<0.01).Conclusions The data from the current study suggest that the women with breast cancer likely experience both disturbed sleep and fatigue before the beginning of chemotherapy. Although their circadian rhythms are robust, breast cancer patients with more delayed rhythms experience more daily dysfunction secondary to fatigue. These data suggest that strategies to improve disturbed sleep and to phase-advance circadian rhythms prior to initiation of chemotherapy may be beneficial in improving daily function in breast cancer patients.     

Pharmacokinetics,Tolerability, and Bioequivalence of Two Formulations of Rotigotine in Healthy Chinese Subjects

Purpose

The pharmacokinetic (PK) profile of the rotigotine transdermal patch is well characterized in Caucasian patients with Parkinson's disease (PD) but not in Chinese subjects. This article reports the PK variables, safety, and tolerability of the rotigotine transdermal patch (2 mg/24 hours and 4 mg/24 hours cold-chain PR2.1.1 formulation) in healthy Chinese subjects (SP0913; NCT01675024). A second study (PD0011; NCT02070796) evaluated the relative bioavailability of cold-chain (PR2.1.1) and room temperature–stable (PR2.2.1) formulations of rotigotine in healthy Chinese men.

Effect of genetic obesity on thermoregulatory activity responses to inversion of the light/dark cycle

In this pilot work, the authors compared the circadian rhythm responses of 3-month-old female fatty Zucker rats with those of lean Zucker rats and Sprague-Dawley rats to reversal of the light/dark (LD) cycle. Core temperature and spontaneous cage activity were continuously monitored by implanted microtelemetry devices prior to and for 5 days following complete LD cycle reversal. By the 5th day after LD reversal, temperature rhythm nadir had phase-advanced 10.5 hours in the lean Zucker rats, 10.8 hours in the Sprague-Dawley rats, and only 3.8 hours in the fatty Zucker rats. Similarly, total activity increased in lean Zucker rats and Sprague-Dawley rats after LD reversal but declined in the fatty Zucker rat during the same time. Results of this study show that obese Zucker rats displayed an impaired ability to reentrain circadian rhythms for temperature and activity when compared to lean Zucker rats and Sprague-Dawley rats. These findings suggest that dysfunction in the circadian pacemaker previously shown to manifest itself by 43 weeks of age in fatty Zucker rats may already be present at 3 months of age and suggest that altered thermoregulation may play a role in the development of obesity in this animal model of genetic obesity.     

Physiologic circadian rhythmicity in preterm infants

This study investigated evidence of a circadian rhythm in the physiologic variables of transcutaneous oxygen (tcPO2) level, pulse rate, respiratory rate, frequency of respiratory pauses, and skin temperature in six 34- to 37-week-preterm infants. A value for each variable was noted every 30 minutes for 24 hours, providing 245 observations for each infant. An adaptation of cosinor analysis, a least squares procedure that determines the cosine curve for a 24-hour period that best fits the observed pattern of values, was applied to the data. Statistically significant circadian rhythmicity was found for five of the six subjects with regard to skin temperature. Significant circadian rhythm was also demonstrated in two or three patients for all other variables. No significant consistent synchrony for individual variables across subjects was found. Actual peak values of respiratory pause frequency and trough values of tcPO2, however, occurred between midnight and 4:30 A.M. for every infant. Preterm infants exhibited evidence of a circadian rhythm in skin temperature, and tcPO2 and respiratory pause frequency exhibited day/night pattern characteristics.     

Alterations in circadian excretion of urinary variables and physiological indicators of stress following surgery

Alterations in level, timing, and coupling of circadian excretion of catecholamine metabolites, adrenal cortical hormones, sodium, potassium, creatinine, and vital signs in acute-care surgical patients were measured. Data were examined to determine if a relationship exists between the degree of circadian alteration and the subject's reentrainment to typical circadian profiles. Urine samples for assay, temperature, heart rate, and blood pressure were collected daily at 2-hour intervals from 11 consenting surgery subjects and 10 age- and sex-matched control subjects. The data indicate that certain circadian rhythms of hospitalized subjects were altered and uncoupled from external stimuli. These findings suggest that nurses (1) give individualized patient care to promote reentrainment recovery; and (2) refine nursing assessment to consider individual circadian patterns.     

Assessment of vitamin B1, B2 and B6 status by coenzyme activation of red cell enzymes using a centrifugal analyser

We describe a fully automated method for the assessment of vitamin B1, B2 and B6 status using a centrifugal analyser. The activation of the red cell enzymes transketolase, glutathione reductase and aspartate aminotransferase) by their respective coenzymes were measured in freshly prepared haemolysate. The enzyme catalytic activities in the sample were measured with (maximal activity) and without (basal activity) the coenzyme, and the percentage activation was calculated. The between run precision for red cell transketolase, glutathione reductase and aspartate aminotransferase were 8.5%, 10.3% and 9.5% respectively. When whole blood was stored at room temperature for 6 hours, red cell aspartate aminotransferase activity significantly decreased (n = 10, p less than 0.05). There were no significant changes in the activities of the other two enzymes. For a group of 30 healthy young subjects, the mean (standard deviation) values for the percentage activation of transketolase, glutathione reductase and aspartate aminotransferase were 11.9% (7.3), 35.1% (19.1) and 85.3% (18.0), respectively. The vitamin status of a group of 86 pregnant women was assessed by this method; 2.3%, 8.1% and 8.1%, respectively, of the pregnant women showed a higher percentage activation for transketolase, glutathione reductase and aspartate aminotransferase than that found in the young subjects. Both groups correlated well with respect to the basal activity and the percentage activation of each enzyme. Basal activity was inversely proportional to the percentage activation. It is therefore suggested that the basal activity can be used as a second criterion in the assessment of vitamin status.     

Temperature changes, temperature extremes, and their relationship to emergency department visits and hospitalizations for sickle cell crisis.

Weather changes are among the proposed precursors of painful sickle cell crises. However, epidemiologic data are mixed regarding the relationship between ambient temperature and crisis frequency. To study this relationship among a local sickle cell disease population, emergency department (ED) visits and admissions were evaluated in adults with sickle cell crisis as the primary diagnosis at a major teaching hospital in a temperate climate. Official daily ambient temperatures (average for that day) were obtained from the National Climate Data Center for the days patients visited the ED or were hospitalized, and for 24 or 48 hours prior. Daily ED visit counts and admission counts were correlated with the visit/admission day's ambient temperature, with the ambient temperature 24 hours before admission, and with the magnitude of change in daily ambient temperature over the prior 24 or 48 hours. For all correlations, statistical significance was defined as a p value of <0.01 and clinical significance was defined as a moderate or greater correlation, absolute value of r >/= 0.30. ED visits or admissions correlated statistically, but not clinically, with daily temperatures. On days when temperatures were <32 degrees F or >80 degrees F, these correlations were statistically significant, but clinical significance was variable. ED visits or admissions correlated only statistically with temperatures 24 hours prior, even on days when temperatures were <32 degrees F. When temperatures were >80 degrees F, the correlations were statistically significant, but there was a reverse, clinically significant correlation between admissions and temperatures. Finally, only statistically significant correlations were found between ED visits or admissions and change in temperature over the prior 24 or 48 hours. Weak or inconsistent confirmation of a relationship was found between daily ambient temperatures and ED visits or hospital admissions for sickle cell crises.     

Anxiety, depression and coping strategies in post-hysterectomy Chinese women prior to discharge

OBJECTIVE: This survey investigated the relationships among anxiety, depression, coping strategies and demographic characteristics of post-hysterectomy Chinese women before discharge and further determined the best predictors of anxiety and depression among this group. METHODS: The sample consisted of 105 women who were administered, 1-2 days prior to discharge, via one-to-one interview, the Zung Self-rating Anxiety Scale, the Zung Self-rating Depression Scale, the Brief COPE Scale and a demographic questionnaire. RESULTS: Only 1.9% of the participants experienced anxiety, while 4.8% experienced depression after having a hysterectomy. Active coping, positive reframing, planning, emotional support and venting were the most frequently used coping strategies. Significant positive and negative correlations were found among anxiety, depression, coping strategies and the demographic characteristics of the subjects. The best predictors of anxiety were self-blame, venting and medical payment. The best predictors of depression were self-blame and employment status. CONCLUSION: Self-blame was the predictor of both anxiety and depression. It implied that a patient's negative self-evaluation may influence both psychological status and mental health. The ways of medical payment and employment status were predictors of anxiety and depression respectively, both of which reflected the economic stress that affected the psychological status and quality of life of the Chinese women, post-hysterectomy, before discharge. The findings of this study indicate that care for Chinese women post-hysterectomy, before discharge, should address their physical, psychological, social and economic well-being.     

Circadian rhythms in blood pressure in school-age children of normotensive and hypertensive parents

The purpose of this study was to describe the characteristics of blood pressure rhythms in school-age children and to compare the circadian mesors and amplitudes between children of normotensive parents and children of hypertensive parents. The sample consisted of 40 healthy children between 8 and 10 years old; 20 children had a parental history of hypertension and 20 did not. Blood pressure was measured every 2 hours during the day and every 90 minutes during the night for one 24-hour cycle using a Dinamap monitor equipped with an automatic printer. Cosinor analyses revealed statistically significant circadian rhythms for systolic and diastolic blood pressures in 12 of the 40 subjects. The acrophases for systolic and diastolic pressures occurred between 1200-1800 hours. The mean systolic mesor was 108.50 while the mean diastolic mesor was 61.41. The mean amplitudes were 8.85 for systolic pressure and 7.44 for diastolic pressure. No statistically significant differences in circadian mesors and amplitudes between children of normotensive parents and children of hypertensive parents were found.     

Circadian rhythms: charting oral temperatures to spot abnormalities

1. A normal daily variation in body temperature is found in the elderly. Normal oral temperature in an older person is lower than in a younger person, and the temperature peaks in the early afternoon and is lowest in the early morning hours before awakening. 2. Elderly subjects may be more prone to hypothermia in the early morning hours when their body temperature is naturally lower. Bathing may cause the body temperature to drop up to 1 degree C and add to this risk. 3. Many factors should be considered when analyzing temperature data for the determination of fever. Time of day, as well as symptoms of infection, should be considered. 4. Disturbances in circadian temperature rhythms accompany central nervous system dysfunction and may be an early indicator of other illnesses.