The effect of Mindfulness-Based Stress Reduction on wound healing: a preliminary study

Psychological factors have been shown to influence the process of wound healing. This study examined the effect of Mindfulness-Based Stress Reduction (MBSR) on the speed of wound healing. The local production of pro-inflammatory cytokines and growth factors was studied as potential underlying mechanism. Forty-nine adults were randomly allocated to a waiting-list control group (n = 26) or an 8-week MBSR group (n = 23). Pre- and post-intervention/waiting period assessment for both groups consisted of questionnaires. Standardized skin wounds were induced on the forearm using a suction blister method. Primary outcomes were skin permeability and reduction in wound size monitored once a day at day 3, 4, 5, 6, 7, and 10 after injury. Secondary outcomes were cytokines and growth factors and were measured in wound exudates obtained at 3, 6, and 22 h after wounding. Although there was no overall condition effect on skin permeability or wound size, post hoc analyses indicated that larger increases in mindfulness were related to greater reductions in skin permeability 3 and 4 days after wound induction. In addition, MBSR was associated with lower levels of interleukin (IL)-8 and placental growth factor in the wound fluid 22 h after wound induction. These outcomes suggest that increasing mindfulness by MBSR might have beneficial effects on early stages of wound healing. Trial Registration NTR3652, http://www.trialregister.nl     

Impact of mindfulness-based stress reduction (MBSR) on sleep,mood, stress and fatigue symptoms in cancer outpatients

Sleep disturbance is a very common problem for cancer patients that has largely not been addressed in the clinical intervention literature. Mindfulness meditation has demonstrated clinical benefits for a variety of patient populations in other areas of functioning. This study examined the effects of an 8-week Mindfulness-Based Stress Reduction (MBSR) program on the sleep quality of a heterogeneous sample of 63 cancer patients. Overall sleep disturbance was significantly reduced (p < .001) and participants reported that their sleep quality had improved (p < .001). There was also a significant reduction in stress (p < .001), mood disturbance (p = .001), and fatigue (p < .001). The associations among these changes and implications for improving quality of life of cancer patients are discussed. Dr. Linda Carlson is funded by a Canadian Institutes of Health Research New Investigator Award. We would like to thank all of the participants in the MBSR program who have diligently completed questionnaires, and encourage their quest for healing and personal growth.     

Impaired attention network in temporal lobe epilepsy: A resting FMRI study

Attention deficit is a common symptom in the patient with mesial temporal lobe epilepsy (mTLE). Although presumption has been proposed by the previous study that mTLE may have impaired attention networks, no fMRI study has addressed the alteration of the dorsal attention network in mTLE. Twenty-four patients with bilateral mTLE and the same number of gender- and age-matched healthy controls participated in the current fMRI study. The resting-state network corresponding to the dorsal attention network (DAN) was extracted by using independent component analysis (ICA) from each participant. Functional connectivity in the DAN was then compared between the patients and controls. In addition, the scores of Trail Making Test (TMT) in the patients were correlated to the z-score of the voxels showing significant difference between the two groups. Compared with the controls, the patients with mTLE presented decreased functional connectivity in almost all the regions within the DAN. Moreover, there were negative correlations between the TMT scores and the z-scores in the voxels showing decreased or increased functional connectivity in mTLE. Our results suggested that the alteration of DAN might underpin the impairment of top-down attention function in mTLE. Our fMRI study may contribute to the understanding of neuro-pathophysiological mechanism of attention impairments in patients with mTLE.     

Stress,migration, and blood pressure in Kiribati

Investigation into the relationship between essential hypertension and migration and modernization typically conclude that modernized, urban migrants have more elevated blood pressures with age and are more at risk from hypertension than are their traditional rural sedentary compatriots. These differences are often attributed to greater stresses on the migrating or modernizing segment of the population. In contrast, this study of rural sedentes and urban migrants in Kiribati (Gilbert Islands) indicates that hypertension and elevation of pressure with age have appeared in this modernizing population which was free of essential hypertension less than twenty years previously. Yet there are no significant differences in blood pressure or the incidence of hypertension of migrants and sedentes. This similarity of rural and urban islanders' health status is traced to the stress-relieving nature of migration and the urban experience in Kiribati.     

Reduction of blood pressure by treatment with alphacalcidol. A double-blind, placebo-controlled study in subjects with impaired glucose tolerance

Disturbances of calcium or vitamin D metabolism have been suggested to be of pathogenetic importance both for hypertension and impaired glucose tolerance, two disorders that are commonly associated. In the present study 65 men, aged 61-65 years, with impaired glucose tolerance were enrolled in a prospective, double-blind, placebo-controlled study over 12 weeks evaluating the effects of 0.75 microgram alphacalcidol, a synthetic analog to the active metabolite of vitamin D. In the 26 patients with blood pressure greater than or equal to 150/90 mmHg before treatment a significant reduction (p less than 0.01) of both the systolic (SBP) and diastolic (DBP) blood pressure was found after therapy (from 171/95 to 150/88 mmHg). The effect was additive to concomitant antihypertensive treatment and was correlated (p = 0.03) to a reduction of serum levels of parathyroid hormone. Also in the whole group of patients given alphacalcidol blood pressure was moderately lowered from a mean of 152/87 +/- 22/10 (SD) to 143/84 +/- 17/8 mmHg. There were no relationships between the changes in body weight, blood glucose or insulin parameters and the changes in blood pressure during the trial. The findings are compatible with the concept that calcium metabolism influences blood pressure regulation and suggest that supplementation with a physiologic dose of active vitamin D could be beneficial for patients with high blood pressure.     

Effects of drug-induced changes in resting blood pressure on classically conditioned heart rate and blood pressure in restrained rats

Subsequent to receiving aversive classical conditioning, which led to a decelerative heart rate (HR) conditioned response (CR) and a pressor-depressor blood pressure (BP) CR, three separate groups of restrained rats received intravenous infusion of sodium nitroprusside (40 micrograms/mg/min) to lower baseline BP, phenylephrine (17 micrograms/mg/min) to raise baseline BP, or an equivalent volume of saline. Conditioning test trials during infusion revealed that hypotension produced by sodium nitroprusside eliminated the HR CR and transformed the BP CR into a pressor-only reaction. Hypertension produced by phenylephrine facilitated the HR CR and changed the BP CR to a pressor-only response on selected trials in which baseline BP increases and baseline HR decreases were within restricted limits. Following drug withdrawal, the HR CRs of both drug groups and the BP CR of the phenylephrine group were attenuated. The unconditioned responses to the shock unconditioned stimulus under phenylephrine were exaggerated and consisted of tachycardias and depressor BP changes, whereas under sodium nitroprusside reduced tachycardias and depressor activity occurred. The results suggested that the loss of the vagally mediated HR CR under sodium nitroprusside was due to baroreceptor-controlled inhibition of vagal discharge and that the enhancement of the HR CR under phenylephrine was due to baroreceptor-influenced facilitation of vagal discharge.     

Osteopenia is associated with glycemic levels and blood pressure in Chinese postmenopausal women: a cross-sectional study

The aim of present study was to explore the relationships between osteopenia and dyslipidemia, glycemic levels or blood pressure in postmenopausal Chinese women. A total of 4080 women aged 42–85 years were enrolled in this cross-sectional study, which was nested in an ongoing longitudinal (REACTION) study. Calcaneus quantitative ultrasound (QUS) was performed and QUS T score was calculated to assess bone mineral density. Osteopenia was defined as a T score ≤?1.0. The relationship between osteopenia and dyslipidemia, glycemic levels or blood pressure was investigated. The prevalence of osteopenia was significantly lower in subjects with systolic blood pressure (SBP) ≥140 mmHg, fasting blood glucose (FBG) ≥8.0 mmol/L, postprandial blood glucose (PBG) ≥15.0 mmol/L, hemoglobin A1c (HbA1C) 6.5–7.5 %, HbA1C ≥7.5 %. These relationships remained significant after controlling for multiple factors. Moreover, significant trend between osteopenia and SBP, FBG, PBG and HbA1C was observed in women. In contrast, no significant associations between osteopenia and diastolic blood pressure (DBP), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) were found, and no significant trend relationship between osteopenia and DBP, TC, TG, HDL-C, LDL-C was found in postmenopausal Chinese women. The present study showed a relationship between SBP, FBG, PBG, HbA1C and osteopenia in postmenopausal Chinese women, while no significant relationship was observed between dyslipidemia, DBP and osteopenia, even after controlling for multiple confounding factors.     

Relationship of clinic, ambulatory, and laboratory stress blood pressure to left ventricular mass in overweight men and women with high blood pressure

OBJECTIVE: This study was designed to evaluate the relationship between left ventricular (LV) mass and blood pressure (BP) recorded in the following contexts: in the clinic, using standard auscultatory procedures, during a typical day using ambulatory BP monitoring, and in the laboratory environment during behavioral stress testing. METHODS: Ninety-seven men and women with clinic systolic blood pressure (SBP) of 130 to 180 mm Hg and/or diastolic blood pressure (DBP) of 85 to 110 mm Hg and mild to moderate obesity were included in the study. Laboratory stressors included the following tasks: Public Speaking; Anger Interview; Mirror Trace; and Cold Pressor. LV mass was measured using echocardiography and adjusted for body size by dividing by height(2.7) to yield LV mass index (LVMI). RESULTS: LVMI was positively correlated with clinic SBP (r = 0.24, p <.05), ambulatory SBP (r = 0.34, p <.01), and aggregated laboratory stress SBP (r = 0.28, p <.01). Of the individual stressors, only SBP responses to the Mirror Trace and Cold Pressor tasks were independently correlated with LVMI (r = 0.35 and 0.34, respectively, p values <.01). Hierarchical regression analyses revealed that laboratory stress SBP remained a significant predictor of LVMI, after controlling for BMI and clinic pressure. CONCLUSIONS: These findings suggest that cardiovascular responses to behavioral stress are associated with individual differences in LVMI in men and women with high blood pressure who are overweight. Laboratory studies of behavioral stress may help promote our understanding of the pathophysiology of LVH.     

Effects of p-synephrine alone and in combination with selected bioflavonoids on resting metabolism, blood pressure, heart rate and self-reported mood changes

Bitter orange (Citrus aurantium) extract is widely used in dietary supplements for weight management and sports performance. Its primary protoalkaloid is p-synephrine. Most studies involving bitter orange extract and p-synephrine have used products with multiple ingredients. The current study assessed the thermogenic effects of p-synephrine alone and in conjunction with the flavonoids naringin and hesperidin in a double-blinded, randomized, placebo-controlled protocol with 10 subjects per treatment group. Resting metabolic rates (RMR), blood pressure, heart rates and a self-reported rating scale were determined at baseline and 75 min after oral ingestion of the test products in V-8 juice. A decrease of 30 kcal occurred in the placebo control relative to baseline. The group receiving p-synephrine (50 mg) alone exhibited a 65 kcal increase in RMR as compared to the placebo group. The consumption of 600 mg naringin with 50 mg p-synephrine resulted in a 129 kcal increase in RMR relative to the placebo group. In the group receiving 100 mg hesperidin in addition to the 50 mg p-synephrine plus 600 mg naringin, the RMR increased by 183 kcal, an increase that was statistically significant with respect to the placebo control (p<0.02). However, consuming 1000 mg hesperidin with 50 mg p-synephrine plus 600 mg naringin resulted in a RMR that was only 79 kcal greater than the placebo group. None of the treatment groups exhibited changes in heart rate or blood pressure relative to the control group, nor there were no differences in self-reported ratings of 10 symptoms between the treatment groups and the control group. This unusual finding of a thermogenic combination of ingredients that elevated metabolic rates without corresponding elevations in blood pressure and heart-rates warrants longer term studies to assess its value as a weight control agent.     

Stress reactivity and the Hemodynamic Profile-Compensation Deficit (HP-CD) Model of blood pressure regulation

Considering the central role of the concept of blood pressure reactivity to explanations of the influence of life stress in the pathogenesis of cardiovascular disease, it is important that the underlying psychophysiological determinants of blood pressure change are elucidated. Empirical evidence is reviewed concerning the utility of the Hemodynamic Profile-Compensation Deficit (HP-CD) Model (Gregg et al., 2002), which draws on physiological theory that explains blood pressure regulation as a dynamic compensatory relation between cardiac output and total peripheral resistance. Core constructs and quantitative features of the Model are explained, accompanied by a focussed review of the Model's application in reactivity studies of stress, lifestyle behaviours, laboratory-to-field generalisability, and personality differences. Although the available studies are relatively few in number, evidence of the Model's utility is promising. Application of the Model in further research could help to elucidate cardiovascular pathogenesis in ways not achievable through the study of blood pressure reactivity alone.     

Lower blood pressure correlates with poorer performance on visuospatial attention tasks in younger individuals

The relationship between low blood pressure and cognitive function among younger individuals is not fully understood. While a number of studies have examined hypertensive and hypotensive individuals, particularly in older populations, little attention has been devoted to healthy, young populations. We tested 105 healthy young individuals whose blood pressure levels naturally fell in the below normal-to-normal range. Our primary finding was a positive relation between blood pressure and cognition, as measured by two visuospatial attention tasks. This relation appears to be specific to visuospatial skills, as no relationship was observed between recognition memory and blood pressure. We discuss possible explanations for this positive relationship, such as structural neural mechanisms, and how they apply to the overall blood pressure-cognition relationship.