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The importance of doing regular physical activity (exercise) as a key element in the prevention of several diseases is well known. The following experiment was performed to evaluate the acute physiological effects of a home-exercise machine on 22 young, apparently healthy, university students. While the individuals exercised in the machine for ten (10) minutes, measures of heart rate, energy expenditure and peripheral circulation to the legs were taken and recorded. The results were contrasted against the claims made in different ads promoting the selected apparatus. There were no significant acute physiological effects resulting from the utilization of the machine during a 10-minute period. Heart rate increased only 8 beats per minute (bpm) from baseline and the temperature measured on the legs showed no variation or was even reduced. Energy expenditure was not significantly higher while using the device in comparison with the resting condition. These results suggest that consumers using this home-exercise equipment as a substitute of performing regular physical activity will be sacrificing important health benefits., A la luz de la importancia de la actividad física regular como un elemento clave en la prevención de muchas enfermedades, se reportan a continuación los resultados del estudio realizado con un aparato para ejercitarse en la casa. 22 estudiantes universitarios jóvenes, aparentemente saludables, participaron en el estudio. Se midió el efecto agudo de 10 minutos de ejercicio con el dispositivo sobre la frecuencia cardíaca, el costo energético y la circulación periférica en las piernas. Se contrastan los resultados obtenidos con las afirmaciones que se hacen en distintas versiones de publicidad del aparato en cuestión. No se obtuvieron efectos fisiológicos agudos significativos de la utilización del dispositivo durante 10 minutos continuos: la frecuencia cardíaca aumentó apenas 8 latidos por minuto con respecto al reposo y la temperatura cutánea no varió o más bien disminuyó. El costo energético no fue significativamente mayor mientras se usaba el dispositivo en comparación con la condición de reposo. Estos resultados sugieren que aquellas personas que utilicen este dispositivo en sustitución de la actividad física regular estarán sacrificando beneficios importantes para su salud.

Background: Shock states are characterized by impaired tissue perfusion and microcirculatory alterations, which are directly related to outcome. Skin perfusion can be noninvasively evaluated using skin laser Doppler (SLD), which, when coupled with a local thermal challenge, may provide a measure of microcirculatory reactivity. We hypothesized that this microvascular reactivity would be impaired in patients with circulatory shock and would be a marker of severity. Methods: We first evaluated skin blood flow (SBF) using SLD on the forearm and on the palm in 18 healthy volunteers to select the site with maximal response. Measurements were taken at 37 °C (baseline) and repeated at 43 °C. The 43 °C/37 °C SBF ratio was calculated as a measure of microvascular reactivity. We then evaluated the SBF in 29 patients with circulatory shock admitted to a 35-bed department of intensive care and in a confirmatory cohort of 35 patients with circulatory shock. Results: In the volunteers, baseline SBF was higher in the hand than in the forearm, but the SBF ratio was lower (11.2 [9.4–13.4] vs. 2.0 [1.7–2.6], p < 0.01) so we used the forearm for our patients. Baseline forearm SBF was similar in patients with shock and healthy volunteers, but the SBF ratio was markedly lower in the patients (2.6 [2.0–3.6] vs. 11.2 [9.4–13.4], p < 0.01). Shock survivors had a higher SBF ratio than non-survivors (3.2 [2.2–6.2] vs. 2.3 [1.7–2.8], p < 0.01). These results were confirmed in the second cohort of 35 patients. In multivariable analysis, the APACHE II score and the SBF ratio were independently associated with mortality. Conclusions: Microcirculatory reactivity is decreased in patients with circulatory shock and has prognostic value. This simple, noninvasive test could help in monitoring the peripheral microcirculation in acutely ill patients., SCOPUS: ar.j, info:eu-repo/semantics/published

Hand skin temperature measurements have previously been performed on either dorsal or palmar sides and it is possible to find arguments for the advantage of both locations. Therefore, the aim of this study was to use dynamic infrared (IR) imaging to examine the relationship between dorsal and palmar hand skin temperature. The palmar and dorsal hand skin temperature before and after a cold stress test was measured with IR thermography in 112 healthy participants. Calculation of surface average temperature was made from nine regions of interest on each hand's dorsal and palmar side. Temperature values were recorded at baseline, directly after immersion of hands in vinyl gloves for one minute in water at 20 +/- 0.5 degrees C (gloves removed), and after eight minutes rewarming. Results showed that: a) the skin temperatures on the dorsal and palmar sides of the hand are strongly correlated; b) the correlation is stronger on the fingers than on the carpometacarpal (CMC) area; c) the palmar side of the CMC area is warmer than the dorsal side, but this is reversed in the fingers so that the nail bed is warmer than the finger pad; and d) the temperature difference Delta T between the dorsal and palmar sides of the fingers is independent of the skin temperature, though Delta T on the CMC area of the hand is temperature dependent. Such differences can be important in detailed investigations of thermal phenomena in the hand. In conclusion, results showed a strong correlation between the dorsal and palmar temperatures. If both sides cannot be measured, the purpose of the investigation should determine which side of the hand should be measured.

In 116 thermographic measurements of 66 healthy male participants, 44 of whom were measured at least twice, hand skin temperature distributions before and after a cold stress test (CST) were examined to identify any typical characteristics of hand skin rewarming. On each hand, measurements from 18 regions of interest recorded every 10 s were used to calculate the surface average temperature. Temperatures at baseline (Tb), directly after cooling (Tc), and after 15 min of rewarming (Tf) were used for comparison and the averages of each finger, palm, and hand were analyzed. Using fits of normal distribution for the measured data, final hand skin temperatures were divided into two groups, A and B, with a calculated boundary at 25.4 °C. Digital analyses of all thermograms were performed to describe the process, and each group's rewarming patterns were observed. Group A was considered to demonstrate warm rewarming, since the whole hands reached a Tf approximately equal to the Tb. By contrast, Group B demonstrated cold rewarming and had whole hand Tf less than Tb. The predictive value of Tc was lower than that of Tb in Group A, whereas the opposite occurred in Group B. Altogether, the findings suggest different hand skin temperature rewarming patterns in healthy males.

A reduction in body temperature is considered to be the primary mechanism by which cold water immersion (CWI) enhances short-term (h) recovery and improves exercise capacity in the heat. However, improvement in exercise performance may be optimised at a given cooling magnitude. Water temperature and immersion duration influence the magnitude of cooling in the core body, muscle and skin. Given the role of blood flow in convective heat flux, substrate delivery and metabolic waste clearance, it is important to understand the influence of different water temperatures on compartmental distribution of limb blood flow during CWI. Therefore, the purpose of this study was to compare blood flow changes in the common femoral artery, vastus lateralis muscle, and thigh skin induced by 5 min of post-exercise water immersion at 8°C, 14°C, 35°C or passive rest. In a randomised manner, nine recreationally active men performed exhaustive cycling in a climate control chamber (32.8 ± 0.4°C and 32 ± 5%rh), followed by 5 min of water immersion at 8.6 ± 0.2°C (WI8), 14.6 ± 0.3°C (WI14), 35.0 ± 0.4°C (WI35) or passive rest (CON). The exercise task involved 25 min of cycling at a power output equivalent to first ventilatory threshold, followed by high-intensity intermittent cycling (30 s at 90% of peak power output to 30 s at 70 W). Measurement of blood flow in thigh skin (laser Doppler flowmetry), vastus lateralis muscle (near infrared spectroscopy), and common femoral artery (Doppler ultrasound), heart rate, mean arterial pressure, skin, muscle, rectal, and mean body temperatures were obtained prior to exercise and up to 60 min post-immersion. Both WI14 and WI8 reduced mean body, calf and thigh skin, and muscle temperatures, compared with WI35 and CON (p0.05). Relative to pre-immersion, differences were observed in the magnitude of reduction between skin, muscle, and common femoral blood flow. Decreases in muscle and skin blood flow were similar (p>0.05), but to a lesser extent when compa

Πτυχιακή εργασία--Σχολή Επαγγελμάτων Υγείας και Πρόνοιας--Τμήμα Νοσηλευτικής, 2008, αα 1051, Οι περισσότεροι θεωρώντας δεδομένη τη μεγάλη αξιοπιστία του κυκλοφορικού συστήματος, το υποβάλλουν σε επανειλημμένες δοκιμασίες, υπερηφανευόμενοι ότι ξεπερνούν κάθε όριο αντοχής. Πολλές φορές παραβλέπουν την καταπόνηση που ασκούν στην καρδιά τους. Αν μάλιστα είναι απληροφόρητοι και δε γνωρίζουν τους κρυφούς κινδύνους που εγκυμονεί ο τρόπος της καθημερινής ζωής, δεν μπορούν να αντιληφθούν το τεράστιο μέγεθος του προβλήματος αυτού της υγείας τους, που καλό είναι να το συνειδητοποιήσουν πολύ πριν εκδηλωθεί. Δυστυχώς, πολύ συχνά, τα γεγονότα που αφορούν στο θέμα το οποίο εξετάζεται δεν είναι ευχάριστα. Πάνω από 250.000 Βρετανοί υφίστανται έμφραγμα του μυοκαρδίου ανά έτος, ενώ σε άλλα 2 εκατομμύρια εκδηλώνεται στηθάγχη. Η στεφανιαία νόσος θεωρείται σήμερα ένας από τους μεγαλύτερους δολοφόνους του ανθρώπου. Εκατομμύρια άνθρωποι ανά τον κόσμο νοσούν ή πεθαίνουν εξαιτίας της. Η πρόληψη της στεφανιαίας νόσου είναι ιδιαίτερα σημαντική, όπως άλλωστε σε κάθε άλλη νόσο. Η πρόληψη στην στεφανιαία νόσο επιτυγχάνεται με την έγκαιρη νοσηλευτική παρέμβαση και τη νοσηλευτική φροντίδα. Υπάρχουν αποδεδειγμένοι παράγοντες κινδύνου της στεφανιαίας νόσου και άλλοι μη τεκμηριωμένοι παράγοντες. Η ύπαρξη δύο ή περισσοτέρων από αυτούς, μπορεί να οδηγήσει σε στεφανιαία νόσο. Οι παράγοντες αυτοί είναι οι εξής: Αποδεδειγμένοι: Αυξημένα επίπεδα χοληστερόλης στο αίμα, δίαιτα πλούσια σε κεκορεσμένα λίπη, κάπνισμα, υψηλή αρτηριακή πίεση, οικογενειακή προδιάθεση και σακχαρώδης διαβήτης. Μη επαρκώς αποδεδειγμένοι: Παχυσαρκία, έλλειψη φυσικής δραστηριότητας, κοινωνικοοικονομικοί παράγοντες, στρες, λήψη αντισυλληπτικών χαπιών.

In a (negative) multicenter randomized trial on management for inoperable critical lower limb ischemia, comparing spinal cord stimulation and best medical treatment, a number of pre-defined factors were analyzed for prognostic value. We included a radiological arterial disease score, modified from the SVS/ISCVS runoff score. The purpose of this analysis was to evaluate clinical factors and commonly used circulatory measurements for prognostic modeling in patients with critical lower limb ischemia. We determined the incidence of amputation and its relation to various pre-defined risk factors. A total of 120 patients with critical limb ischemia were included in the study. The integrity of circulation in the affected limb was evaluated on five levels: suprainguinal, infrainguinal, popliteal, infrapopliteal and pedal. A total radiological arterial disease score was calculated from 1 (full integrity of circulation) to 20 (maximally compromised state). We used Cox regression analysis to quantify prognostic effects and differential treatment (predictive) effects. Major amputation occurred in 33% of the patients at 6 months and in 51% at 2 years. The presence of ischemic skin lesions and the radiological arterial disease score were independent prognostic factors for amputation. Patients with ulcerations or gangrene had a higher amputation risk (hazard ratio 2.38, p = 0.018 and 2.30, p = 0.036 respectively) as well as patients with a higher radiological arterial disease score (hazard ratio 1.17 per increment, p = 0.003). We did not observe significant interactions between prognostic factors and the effect of spinal cord stimulation. In conclusion, in patients with critical lower limb ischemia, the presence of ischemic skin lesions and the described radiological arterial disease score can be used to estimate amputation risk.

Background: We have previously reported that repeated cycles of high-dose therapy (HDT), can be supported by unmanipulated autologous PBPC. Here we investigate whether purified CD34+ cells, obtained by immunomagnetic separation using the Isolex 300i device, can support such therapy. Method(s): Twenty-nine consecutive patients with metastatic breast cancer had PBPC mobilized and harvested following chemotherapy and G-CSF (10 mug/kg per day). Patients with > 4.0 x 106/kg CD34+ cells in the apheresis product underwent CD34-selection using the Isolex 300i (v2.0) device. All cells collected were equally divided into three aliquots and cryopreserved. Patients who did not achieve this threshold had unmanipulated cells collected and stored. Patients subsequently received three cycles of HDT with paclitaxel (175 mg/m2), thiotepa (300 mg/m2) and either ifosfamide (10 g/m2) or cyclophosphamide (4 g/m2). It was intended for patients to receive CD34-selected cells to support each of the three cycles of HDT (i.e 1/3 for each cycle) and to compare hemopoietic recovery between patients receiving CD34-selected cells or unmanipulated cells. Result(s): Thirteen of the 29 patients (45%) did not mobilize sufficient CD34+ cells to undergo CD34-selection. The remaining 16 patients underwent CD34-selection with a median purity of 84.3% (range: 16.3-96.1%) and yield of 34% (range: 1-60%). Fifteen of these patients proceeded to HDT and 42 of the planned 45 cycles were administered. Nine patients had all three HDT cycles supported by CD34-selected cells. The median number of CD34-selected cells (x 106/kg) infused per cycle was 1.5 (range: 0.04-3.01). Three of the 15 patients required infusion of 'back-up' unmanipulated cells because of delayed neutrophil recovery. Of the 13 patients whose PBPCs did not undergo CD34+ cell selection, 11 proceeded to HDT with a median of 3.2 x 106/kg (range: 2.0-4.4) unselected cells infused per cycle and 31 of 33 planned cycles were delivered. When hemopoietic

Background: Lipid abnormalities are a common feature of the nephrotic syndrome that is also characterised by oedema, hypoalbuminaemia, proteinuria, and hypercoagulability. Concern has arisen over the increased incidence of cardiovascular disease that has been reported in individuals with nephrotic syndrome, particularly since the syndrome may occur early in life and become a chronic illness. The presence of proteinuria is a prognostic indicator for the progression of renal disease, but its possible contribution as a cardiovascular risk factor in patients with nephrotic syndrome is not known. In contrast, disordered lipoprotein metabolism, in isolation, is a conventional risk factor for the development of atherosclerosis. An early phase of atherosclerosis, vascular endothelial dysfunction, has been identified. Endothelial function can be measured non-invasively using ultrasonography and plethysmography allowing the impact of risk factors to be assessed in vivo.Aim: To test the hypothesis that endothelial dysfunction occurs in the nephrotic syndrome primarily as a consequence of dyslipidaemia.Methods: A cross-sectional design was used to study vascular function of the peripheral circulation in 45 individuals: fifteen patients with nephrosis (NP), 15 control subjects with primary hyperlipidaemia (HL) and 15 normolipidaernic controls (NC). The groups were matched for age, gender and body mass index. The NP group and the HL group had similar serum lipid and lipoprotein concentrations. High-resolution ultrasonography assessed endothelial function of the brachial artery. This non-invasive technique measured post- ischaemic flow-mediated dilatation (FMD) and endothelium-independent vasodilatation in response to glyceryl trinitrate (GTNMD). Post-ischaemic microcirculatory function was measured using venous occlusion strain gauge plethysmography.Results: Post-ischaemic FMD of the brachial artery was significantly lower in the NP and HL groups, compared with the NC group, with

In a cold environment human heat loss is reduced by peripheral vasoconstriction, counter-current heat exchange and a change of peripheral circulation pattern. However, these mechanisms go at the expense of the tissue temperature in the extremities. The cooling can be so pronounced that local cold injuries occur. Cold induced vasodilation (CIVD) may be regarded as an effective protection against local cold injury. The underlying mechanism is often associated with the presence of arterio-venous anastomoses (AVA). Rhythmic relaxation and contraction of the strong muscular wall of the AVA is often supposed to cause the hunting response in CIVD. The contraction phase is probably caused by stimulation of the alpha-adrenoceptors in the smooth muscle wall. Relaxation may be caused by a nervous blockade of the sympathetic system. There is no scientific evidence for humeral mediators. The influence of the body temperature on the vasomotor tone of the AVA remains to be investigated. The locations of AVA and the sites where CIVD occurs are not in perfect correspondence and also this point needs further research., Text in English and Dutch.

The effects of varying the pressure within a vascularly isolated carotid sinus on peripheral circulatory and thermal responses during hindlimb exposure to room air and cold were determined in anesthetized cats. A sigmoidal relationship between heart rate and carotid pressure was observed only during exposure to room air, suggesting that cold-induced somatosympathetic reflexes may override the carotid baroreflex effects on heart rate. At low carotid pressures, mean arterial pressure increased, femoral arterial vascular resistance decreased, femoral arterial blood flow increased, footpad thermal insulation decreased, footpad temperature increased, and footpad heat loss increased. Opposite responses were observed at high carotid pressures. These trends were observed during hindlimb exposure to both room air and cold. The persistence of baroreceptor effects on peripheral circulatory and thermal responses in a locally cold-exposed hindlimb provides evidence that cold-induced vasodilatory responses may be mediated by baroreceptor reflexes.