Changes in immune regulation in response to examination stress in atopic and healthy individuals

BACKGROUND: Stress can aggravate the allergic inflammation, but determinants of disturbed immune regulation are largely unknown. OBJECTIVE: To determine systemic immunological, local inflammatory and functional airway responses to stress in healthy and atopic individuals. METHODS: Forty-one undergraduate students, 22 with allergy of whom 16 had asthma, and 19 healthy controls, were studied in a low-stress period and in association with a large exam. Subjects completed questionnaires on stress and health behaviours, underwent lung function tests, bronchial methacholine challenge, measurements of exhaled nitric oxide and urine cortisol. Blood cells were phenotyped, and cytokines from mononuclear blood cells were analysed. RESULTS: Perceived stress and anxiety increased in both groups during the exam period while cortisol increased only in the atopy group. Cytokine production decreased broadly in response to stress in both groups, which was paralleled by an increase in the proportion of regulatory T cells (CD4(+)CD45RO(+)CD25(bright)). Interestingly, atopic individuals, but not controls, reacted with a decreased T-helper type 1/T-helper type 2 (Th1/Th2) ratio and a decrease in natural killer (NK) cell numbers in response to stress. In control subjects only, exhaled nitric oxide decreased and forced expiratory volume in one second increased during stress. CONCLUSION: Atopic and non-atopic subjects shared some immune changes in response to stress, such as a dramatic decline in cytokines and an increase in the number of regulatory T cells in peripheral blood. However, other stress-induced immune changes were unique to atopic individuals, such as a skewed Th1/Th2 ratio and reduced NK cell numbers, indicating that some pathogenic mechanisms in atopics may be more strongly affected by stress than others.     

针刺对实验性脑缺血作用机理的研究进展

缺血性脑血管疾病是一个非常复杂的病理生理过程 ,是多种机制共同作用的结果。本文从针刺对实验性脑缺血在脑组织形态学改变、血液流变学、脑微循环等方面的研究进展作一综述。     

Risky Sexual Behavior Among Street Children,Adolescents, and Young People Living on the street in southern Brazil

Although adolescents living on the street tend to have unprotected sex with many partners and substance abuse, little is known about this reality in Brazil. To estimate the prevalence and factors associated with risky sexual behavior among children and adolescents living on the street in Porto Alegre and Rio Grande. A cross-sectional study was carried out using the Respondent-Driven Sampling (RDS) sampling method to quickly and efficiently access populations of difficult access. Poisson regression with robust adjustment of variance was used in the multivariate analysis. The sample consisted of 231 participants aged 10–21 years. Most were male and aged 16- 21 years. More than half (66.7%) of the respondents did not have a school bond, and 64.5% did not live with the family. Half of the sample had been living on the street for at least four years, spending 15 h or more on the street. Most (86.6%) responded that they had already used illicit drugs in their lives, and unprotected sex prevalence was 61.9%. The variables independently associated with unprotected sex were years living on the street, hours spent on the street, having a steady partner, illicit drug use, and sexual intercourse without a condom under the influence of drugs. The high prevalence of unprotected sex points to the need for intervention policies for this population to prevent the main risk factors.

     

微信干预对青光眼患者体力活动量的影响

观察利用微信干预增加青光眼患者体力活动的效果。方法：前瞻性随机对照研究。选择2018年 6-12月于温州医科大学附属眼视光医院门诊确诊的青光眼患者102例作为研究对象。利用Excel生成的随机数随机分为对照组和干预组。对照组患者仅在门诊入组时进行运动宣教,并告知其可增加每天的运动步数;干预组患者入组时进行运动宣教,告知其可增加每天的运动步数的同时,加入微信群进行运动提醒干预。所有患者均需利用运动监测仪器完成基线1周和随访1个月的体力活动监测。采用卡方检验、独立样本t检验、Mann-Whitney U检验、配对t检验及Wilcoxon符号秩检验进行数据分析。结果：排除30例基线运动量较大（步数>12 000步/d）、依从性不好及其他原因失访的患者,最终纳入72例（对照组42例,干预组30例）。干预组患者干预后的步数（t=4.94,P<0.001）,运动消耗的卡路里（Z=-2.87,P=0.004）,代谢当量（Z=-3.30,P=0.001）,中等强度体力活动时间（Z=-2.89, P=0.004）,高强度体力活动时间（t=2.57,P=0.016）及中高强度体力活动时间（Z=-3.01,P=0.003）均较基线增加;轻度体力活动时间（t=-2.14,P=0.041）和久坐静止不动次数较干预前减少（t=-2.76, P=0.022）。对照组随访的步数也较基线增加（t=3.29,P<0.001）,轻度体力活动时间较基线减少（t=-2.57,P=0.014）。另外,干预组的高强度体力活动时间增加量（随访-基线）（Z=-3.04,P=0.002）和超高强度体力活动时间增加量（Z=-2.06,P=0.040）明显高于对照组,差异均有统计学意义。结论：微信干预可以增加青光眼患者的每天运动步数和中高强度体力活动时间,减少患者的轻度体力活动时间和久坐静止次数。     

Hypertension in Developing Countries

The past 2 decades have seen a considerable global increase in cardiovascular disease, with hypertension remaining by far the most common. More than one-third of adults in Africa are hypertensive; as in the urban populations of most developing countries. Being a condition that occurs with relatively few symptoms, hypertension remains underdetected in many countries; especially in developing countries where routine screening at any point of health care is grossly underutilized. Because hypertension is directly related to cardiovascular disease, this has led to hypertension being the leading cause of adverse cardiovascular outcomes, as a result of patients living, often unknowingly, with uncontrolled hypertension for prolonged periods of time. In Africa, hypertension is the leading cause of heart failure; whereas at global levels, hypertension is responsible for more than half of deaths from stroke, just less than half of deaths from coronary artery disease, and for more than one-tenth of all global deaths. In this review, we discuss the escalating occurrence of hypertension in developing countries, before exploring the strengths and weaknesses of different measures to control hypertension, and the challenges of adopting these measures in developing countries. On a broad level, these include steps to curb the ripple effect of urbanization on the health and disease profile of developing societies, and suggestions to improve loopholes in various aspects of health care delivery that affect surveillance and management of hypertension. Furthermore, we consider how the industrial sectors' contributions toward the burden of hypertension can also be the source of the solution.     

Soccer specific aerobic endurance training

BACKGROUND: In professional soccer, a significant amount of training time is used to improve players' aerobic capacity. However, it is not known whether soccer specific training fulfils the criterion of effective endurance training to improve maximal oxygen uptake, namely an exercise intensity of 90-95% of maximal heart rate in periods of three to eight minutes. OBJECTIVE: To determine whether ball dribbling and small group play are appropriate activities for interval training, and whether heart rate in soccer specific training is a valid measure of actual work intensity. METHODS: Six well trained first division soccer players took part in the study. To test whether soccer specific training was effective interval training, players ran in a specially designed dribbling track, as well as participating in small group play (five a side). Laboratory tests were carried out to establish the relation between heart rate and oxygen uptake while running on a treadmill. Corresponding measurements were made on the soccer field using a portable system for measuring oxygen uptake. RESULTS: Exercise intensity during small group play was 91.3% of maximal heart rate or 84.5% of maximal oxygen uptake. Corresponding values using a dribbling track were 93.5% and 91.7%. No higher heart rate was observed during soccer training. CONCLUSIONS: Soccer specific exercise using ball dribbling or small group play may be performed as aerobic interval training. Heart rate monitoring during soccer specific exercise is a valid indicator of actual exercise intensity.     

Effective training for patients with intermittent claudication

OBJECTIVE: Current guidelines for treatment of intermittent claudication (IC) do not include a specific recommendation for the intensity of exercise therapy. Thus, the purpose of this study was to determine the relative effectiveness of high versus low intensity exercise for patients with IC, and further to study the effect of such training on blood flow to the legs during exercise. DESIGN: The effect of eight weeks of supervised endurance training was examined in 16 patients with IC. The patients were randomly assigned to training at intensities corresponding to either 60% or 80% of their peak oxygen consumption (VO2peak), respectively. RESULTS: VO2peak and time to exhaustion increased significantly (9% and 16%, respectively) more in the high intensity group (p<0.05). Blood flow to the legs did not change after training in any of the groups. CONCLUSION: High intensity training gave larger improvements in VO2peak and time to exhaustion than low intensity training. As blood flow did not change after the exercise program, it is likely that the observed different increase of VO2peak was due to changed mitochondrial oxidative capacity and/or skeletal muscle diffusive capacity.     

Soccer specific testing of maximal oxygen uptake

AIM: Endurance capacity in soccer players is important. A soccer specific test for direct measurement of maximal oxygen uptake does, however, not exist. The aim of this study was to evaluate maximal oxygen uptake in a soccer specific field test, compared to treadmill running. METHODS: Ten male soccer players (age 21.9+/-3.0 years, body mass 73.3+/-9.5 kg, height 179.9+/-4.7 cm) participated in the study, and 5 endurance trained men (age 24.9+/-1.8 years, body mass 81.5+/-3.7 kg, height 185.6+/-3.1 cm) took part in a comparison of the portable and the stationary metabolic test systems. The soccer players accomplished a treadmill test and a soccer specific field test containing dribbling, repetitive jumping, accelerations, decelerations, turning and backwards running. RESULTS: Maximal oxygen uptake was similar in field (5.0+/-0.5 L x min(-1)) and laboratory (5.1+/-0.7 L x min(-1)) tests, as were maximal heart rate, maximal breathing frequency, respiratory exchange ratio and oxygen pulse. Maximal ventilation was 5.4% higher at maximal oxygen uptake during treadmill running. CONCLUSION: These findings show that testing of maximal oxygen uptake during soccer specific testing gives similar results as during treadmill running, and therefore serves as a valid test of maximal oxygen uptake in soccer players.