The effect of isosorbide-5-mononitrate (5-ISMN) Durules(R) on exercise tolerance in patients with exertional angina pectoris. A placebo controlled study

Twenty-four patients with stable exercise-induced angina pectorisentered a double-blind cross-over study. Isosorbide-5-mononitrate(5-ISMN) 60 mg in a controlled release formulation (Durules^®)given once daily was compared with identical placebo. The exercisetolerance was determined by bicycle ergometry before and 3 hafter a single dose of 5-ISMN and following one week's treatmentwith 5-ISMN and placebo. Nineteen patients completed the study.Exercise tolerance until the onset of chest pain and until 1mm ST segment depression increased significantly 3 h after dose.The same increase was seen both after a single dose and thesame dose under steady-state conditions. No increase was seenwith placebo. The heart rate and systolic blood pressure reactionsin the standing position were less pronounced 3 h after dosein steady-state than after a single dose of 5-ISMN. Headachewas the only bothersome side-effect reported. The study demonstratesthat 60 mg 5-ISMN in a Durules^® formulation given once dailyhas a significant anti-anginal effect and that tolerance doesnot develop.     

Targeting physical health in schizophrenia: Results from the Physical Activity Can Enhance Life (PACE-Life) 24-week open trial

Poor health and low cardiorespiratory fitness (CRF) contribute substantially to the shortened lifespan of individuals with schizophrenia spectrum disorders (SSDs). Increasing physical activity has demonstrated value; however, there are limited interventions that are accessible and adequately address motivational challenges. This paper reports on an open trial of Physical Activity Can Enhance Life (PACE-Life), a motivational theory-based manualized multicomponent walking intervention. The primary aim was to examine the feasibility of implementing PACE-Life through meeting the recruitment target (n = 14), attendance and adherence rates, and participant feedback. The secondary aim was to assess the impact of PACE-Life on intermediate targets (autonomous motivation and satisfaction of autonomy, relatedness, and competence needs), proximal outcomes (Fitbit steps/day and minutes spent walking), the primary outcome (CRF), and secondary outcomes (loneliness, symptoms, resting heart rate, blood pressure, weight, body mass index, and hip and waist circumference). Seventeen participants with SSDs enrolled in a 24-week open trial. Assessments occurred at baseline, mid-point, post-test, and one-month follow-up. The recruitment target was exceeded, the group attendance rate was 34%, Fitbit adherence rate was 54%, and participant feedback indicated satisfaction with the intervention as well as a positive group environment. There was a large improvement in the primary outcome of CRF with 77% of participants achieving clinically significant improvement at post-test. Small and medium effect size increases were observed in autonomous motivation and satisfaction of autonomy, relatedness, and competence needs. Fitbit data and secondary outcomes generally remained unchanged or worsened during the intervention. Results from this open trial indicate that PACE-Life leads to meaningful changes in CRF among people with SSDs.     

Routine participation in sports and fitness activities among out-patients with psychotic disorders: A multi-site cross-sectional survey in England

BackgroundSedentary lifestyle is a significant contributor to poor outcomes in people with psychotic disorders. However, little is known about the extent of routine participation in specific sports and fitness activities among those who do take part. We investigated the frequency, intensity, time and type of sports and fitness activities (“fitness”) completed by people with psychotic disorders in their daily life and explored correlates associated with fitness participation.MethodsWe conducted a cross-sectional survey among out-patients with psychotic disorders (n = 529) recruited from six different NHS sites in England. Subjective participation in fitness activities during the previous week was assessed by an adaptation of the UK Time Use Survey. The main outcome was whether participants met the minimum World Health Organization recommendations for moderate intensity physical activity (≥150 min/week) through fitness. Poisson regression models with robust error variance were used to examine associations of this outcome with participant variables.ResultsIn total, 267 (52.2%) participants reported taking part in routine fitness activities in the previous week, many of whom did so alone (n = 163, 59.1%). Only 21.5% (n = 114) completed ≥150 min of fitness activities in the previous week. The likelihood of attaining these recommendations was lower among participants who were female, older in age, in a relationship, unemployed and with fewer social contacts.ConclusionMental health services promoting physical activity interventions among people with psychotic disorders may need to modify their approaches based on previous patient preference and increase their focus on sub-groups of patients who are less likely to routinely engage in fitness activities.     

运动训练对慢性应激大鼠β—内啡肽分泌的影响

目的：探讨运动训练对慢性应激大鼠β－内啡肽（β－EP）分泌的变化。方法：对大鼠进行为期8周的不同负荷运动训练,并在运动训练后期给予3周的冷刺激,测定大鼠下丘脑和血清中β－EP的含量。结果：（1）经过3周的冷应激后,大鼠产生显著的身心变化,下丘脑和血清β－EP的含量均显著升高,从而表明冷应激可使机体β－ED的合成和释放增多。（2）经过8周的运动训练后,大鼠下丘脑β－EP含量显著升高,血清β－EP含量显著下降;而对运动训练的大鼠施加冷刺激后,大鼠下丘脑和血清中β－EP含量显著低于应激组,以中等负荷运动训练组最为明显。结论：运动训练可以减少内源性β－EP的释放,有效对抗大鼠机体对冷刺激产生的应激反应,维持机体在应激状态下内分泌功能的稳定。     

Effects of myofascial release applied to neck muscles and craniocervical flexor training in patients with chronic myofascial TMD: A single arm study

ObjectiveTo evaluate the effects of myofascial trigger point release applied to superficial neck muscles and strengthening of the deep flexor muscles in subjects with myofascial temporomandibular disorders (mTMD).MethodsFourteen women (23.4 ± 3.32 years old) presenting with mTMD and trigger points (TrPs) in the sternocleidomastoid, suboccipital, and upper trapezius muscles were included in this study. They were evaluated on two occasions during a baseline period (3 weeks apart) with no intervention and a third time after a 5-weeks intervention protocol. Outcome measures included pressure pain threshold (PPT) over the masticatory muscles, mandibular function, orofacial pain intensity, maximum mouth opening, and the craniocervical flexion test. All women received 10 treatment sessions that included strain-counterstrain technique applied to TrPs found in the prior listed superficial neck muscles and stabilization exercise using a pressure biofeedback for the deep neck flexor muscles. One-way ANOVA or correspondent non-parametric tests as well as effects sizes were used to compare the outcomes at baseline and after the treatment.ResultsStatistically significant improvements were found in the PPT over left masseter and temporalis (p < 0.05) (mean difference (MD) of 0.50 and 0.42 kg/cm²), orofacial pain intensity (MD = −3.39 points), mandibular function (MD = −7.22 points) and performance of the deep cervical muscles (MD = 130.42 points) compared to baseline period. Effect sizes were moderate or large.ConclusionThe protocol intervention may have positive effects in patients with mTMD. However, studies with better methodological quality need to be performed to confirm those effects.Registrationensaiosclinicos.gov.br (RBR-7x828q);     

人工神经网络预滤波的自适应运动心电信号增强器

运动心电图是一种将人体对象置于非平静状态下检测到的心电信号，其特点是运动导致基线严重漂移，肌电干扰显著增加，信噪比低。介绍了一种用人工神经网络预滤波的自适应运动心电信号增强器。运用人工神经网络的非线性和自适应处理的跟踪特性有机地结合设计而成。能降低噪声，提高信噪比，有效地提取运动心电信号。     

Effect of sleep deprivation on tolerance of prolonged exercise

Summary Acute loss of sleep produces few apparent physiological effects at rest. Nevertheless, many anecdotes suggest that adequate sleep is essential for optimum endurance athletic performance. To investigate this question, heavy exercise performance after 36 h without sleep was compared with that after normal sleep in eight subjects. During prolonged treadmill walking at about 80% of the max, sleep loss reduced work time to exhaustion by an average of 11% (p=0.05). This decrease occurred despite doubling monetary incentives for subjects during work after sleeplessness. Subjects appeared to fall into “resistant” and “susceptible” categories: four showed less than a 5% change in performance after sleep loss, while four others showed decrements in exercise tolerance ranging from 15 to 40%. During the walk, sleep loss resulted in significantly greater perceived exertion (p<0.05), even though exercise heart rate and metabolic rate ( and ) were unchanged. Minute ventilation was significantly elevated during exercise after sleep loss (p<0.05). Sleep loss failed to alter the continuous slow rises in _E and heart rate that occurred as work was prolonged. These findings suggest that the psychological effects of acute sleep loss may contribute to decreased tolerance of prolonged heavy exercise. Supported in part by Public Health Service grant PHS S07 RR 5371, and by Grant DAMD-17-81-C-1023 from the U.S. Army     

Einflu\ eines Β1-Rezeptorenblockers auf die Plasmaspiegel des atrialen natriuretischen Peptids bei Patienten mit essentieller Hypertonie unter Ergometerbelastung

Summary In order to investigate the behaviour of atrial natriuretic peptide (ANP) in untreated mild to moderate essential hypertension and the influence of blood pressure normalisation by a ₁-receptor blocker a study was conducted in groups of normotensive and hypertensive middle aged subjects. 10 normal subjects and 10 patients with essential hypertension (WHO I–II) without any medication and on betaxolol monotherapy were studied at rest and during graded exercise. In addition the response of ANP, cyclic guanosine monophosphate (cGMP) and the renin-aldosterone-system was investigated.Normal subjects and hypertensive patients did not differ in ANP levels at rest and also responded with a comparable exercise dependent increase at all workload levels. A steady decrease of ANP was noticed during the recovery period in both groups. After-blocker treatment in the hypertensive patients ANP concentrations significantly rose, both at rest and more pronounced during exercise. cGMP reacted in a similar way but showed a more inert response. A counter-regulatory behaviour between ANP and PRA or aldosterone, as seen under volume shifts, could not be detected. These findings demonstrate that plasma ANP is not altered in untreated essential hypertension. Increased ANP levels in ₁-blocker treatment may contribute to its blood lowering effect.

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Abkürzungsverzeichnis ANP atriales natriuretisches Peptid - ALD Aldosteron - C_In Inulin Clearance - cGMP zyklisches Guanosinmonophosphat - irANP immunoreaktives atriales natriuretisches Peptid - PAH Paraaminohippursäure - PRA Plasma-Renin-Aktivität - RAA-System Renin-Angiotensin-Aldosteron-System - RBF renaler Blutflu - RIA Radioimmunoassay - RVR renaler Gefä\widerstand     

Cardiac output measurement by the thermodilution method: An in vitro test of accuracy of three commercially available automatic cardiac output computers

Objective To describe the accuracy and the reproducibility of the thermodilution flow measurements obtained using 3 commercially available cardiac output computers commonly used in intensive care units.Design An experimental in vitro study. Twelve different values of control flow (Qctr) were measured (Qmsr) using 3 different cardiac output computers (Abbott Critical Care System, Oximetrix 3 SvO₂/CO Computer, Baxter Oximeter/Cardiac Output Computer SAT-1^TM; American Edwards Laboratories, 9520 A Cardiac Output Computer). Standard equipment and techniques were employed, taking account of the specific weight and heat of warm water relative to blood. In addition, separate sets of measurements were performed in order to investigate the effect on Qmsr of some variables which may influence the indicator loss (time for injection, depth of immersion of the catheter, temperature of the injected fluid).Setting Our laboratory, inside the intensive care unit.Measurements and results The analysis of the linear regression of Qmsr versus Qctr (r values between 0.992 and 0.984; residual standard deviation values comprised between 0.24 and 0.49 l/min; intercepts and slopes not significantly different from identity line), the values of the percentage errors (PE=[Qctr–Qmsr]·100/Qctr; PE mean values 7.9, 5.0 and 13.1), and those of the coefficients of variability (CV=standard deviation mean value, %; CV mean values 5.4, 5.8 and 4.6), show a good level of accuracy and reproducibility of the measurements. Our data confirm previously reported results. Furthermore, the cumulative effect of variables capable of influencing the indicator loss, even if corrected according to the calculation constant the manufacturers provide, was found to result in statistically significant changes of Qmsr.Conclusion The accuracy and reproducibility of the automatic cardiac computers tested is sufficient for practical clinical purpose. It may also depend on the modality of injection of the cooling bolus, which may significantly influence the effective indicator losses.