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Retroperitoneal fibrosis (RPF) is a rare disease associated with the formation of hard inflammatory and fibrous tissue in the retroperitoneum. Taking into consideration the fact that RPF is a rare disease with different subtypes, we compared the basal clinical and biochemical characteristics of the vascular and urorenal subtypes.From January 2005 until December 2021, 27 patients were identified as vascular subtype (18 males) and 11 as urorenal subtype (9 males).Patients with a primary urorenal origin had significantly worse kidney function as reflected by serum creatinine and eGFR (bothVascular subtype is more prevalent in our study with more cardiovascular risk factor present. Due to the diversity of symptoms, diagnosis of RPF becomes a challenge for specialists as well as therapy.

Background: Retroperitoneal fibrosis (RPF) is a rare disease characterized by the presence of inflammatory and fibrous retroperitoneal tissue that often encircles abdominal organs including the aorta and ureters. Data on the incidence of this disease are limited. Summary: The disease may be idiopathic or secondary to infections, malignancies, drugs, or radiotherapy. The idiopathic form is an immune-mediated entity and a part of the broader spectrum of idiopathic diseases termed chronic periaortitis, characterized by a morphologically similar fibroinflammatory changes in the aorta and surrounding tissues. Taking into account the dominant symptoms and clinical characteristics of patients with periaortitis, 2 subtypes of disease could be distinguished. The vascular subtype includes patients with nondilated aorta or with inflammatory abdominal aortic aneurysm, both with and without involvement of adjacent structures and with numerous risk factors for atherosclerosis. In the renoureteral subtype, obstructive uropathy manifesting with hydronephrosis and acute kidney injury is the predominant finding. Due to the variety of symptoms, diagnosis of RPF remains challenging, difficult, and often delayed. A series of diagnostic tests should be performed, in order to confirm the diagnosis idiopathic RPF. Laboratory workup includes evaluation of inflammatory indices and immunological studies. A biopsy and histopathological evaluation may be necessary to confirm diagnosis and differentiate the disease. Computed tomography, magnetic resonance imaging, and positron emission tomography are the modalities of choice for the diagnosis and follow-up of this disease. Management of ureteral obstruction, hydronephrosis, and aortic aneurysms often requires surgical evaluation and treatment. The pharmacological treatment of RPF has been evaluated in a few randomized trials and is mainly based on observational studies. Steroid therapy remains the gold standard of treatment. Key Messages: Nowadays, multidisciplinary team approach with clinical and diagnostic experience in both primary and secondary RPF as well as 2 major subtypes should be offered. Centers specialized in rare diseases with collaboration with other units and referral system yield the best possible outcomes.

Objective: The objective of this paper is to present possible differences in spondylometric dimorphic characteristics of lumbar spine in the period of progressive development. Material and methods: The research material included 24,517 individuals of both sexes aged from 3 to 25. Individuals that showed abnormal structure of the motor system and individuals reporting pain in the joints of the spine were excluded. Spondylometric research was carried out using the Penny & Giles electrogoniometric measuring system. Significance tests concerning position measurements (Student's t-test, Welch's t-test) were used as well as biometric profiles formed on the basis of Mollison index for each characteristic in the studied period of ontogenesis. The progress of development of the examined spondylometric characteristics in both sex groups was calculated on the basis of expressing the size of the feature in successive age groups as a percentage of its final size. Using the linear and polynomial regression models, the developmental lines of the studied spondylometric parameters were obtained in males and females. Results: In the development process of the studied spondylometric parameters, dimorphic diversity can be observed essentially only in adolescence. In general, in the whole studied period of ontogenetic development, the greater range of lumbar spine mobility is found in females. Minor sexual dimorphism is also evident in the dynamics of development and in the stage of development of the majority of examined characteristics in individual age ranges in relation to the final values, for the benefit of the female sex.

The aim of the study was the evaluation of the hormonal response of wheelchair rugby participants under the half-year training cycle. The study sample included 11 members of the Polish national wheelchair rugby team with spinal cord injury at the cervical level, ranging in age from 21 to 41 years, body weight (72.2 ± 11.53 kg), and body height (182.3 ± 6.11 cm). The disabled individuals with spinal cord injury subjected to the study constitute a homogeneous group in terms of age, body height, weight, and injury level. The study was carried out at the beginning and at the end of a 6-month training period. In the first and second examination, measurements of the peak oxygen uptake (peakVO2) and blood biochemical analysis were performed (Lactate dehydrogenase (LDH) activity and concentration of creatinine (Cr), total testosterone (TT), free testosterone (FT), and cortisol (C)). A significant change was observed in the concentration of C in the Wheelchair Rugby players’ blood between two research periods (p < 0.05 (ES:0.76)) and a correlation between the post-training change in FT/C concentration and the change in Cr concentration (r = −0.6014, p < 0.05). The 6-month training period did not result in overloads within the group of players. However, due to the significant loss of the capacity of the spinal cord injury (SCI) and the possibility of a life-threatening trend, the anabolic/catabolic status of the players should be monitored using blood biochemical indices.

Recent studies including the SPRINT trial have shown beneficial effects of intensive systolic blood pressure reduction over the standard approach. The awareness of the J-curve for diastolic blood pressure (DBP) causes some uncertainty regarding the net clinical effects of blood pressure reduction. The current analysis was performed to investigate effects of low on-treatment DBP on cardiovascular risk in the SPRINT population. The primary composite outcome was the occurrence of myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure or death from cardiovascular causes. The prevalence of primary outcomes was significantly higher in subjects within low DBP in both standard (44–67 mmHg [10.8%] vs 67–73 mmHg [6.7%] vs 73–78 mmHg [5.1%] vs 78–83 mmHg [4.4%] vs 83–113 mmHg [4.3%], p

Objective The objective of the study was to assess the influence of forward head posture on the mechanical parameters and pressure pain threshold of superficial neck muscles in clinically nonsymptomatic individuals with sedentary jobs. Methods Twenty-five office workers with forward head posture and 25 office workers with normal head posture were matched for sex, age, body mass index, and the nature and duration of their work and were compared at a single point. The study participants were divided into study groups on the basis of photometric craniovertebral angle measurements. The upper trapezius, sternocleidomastoid, and splenius capitis mechanical properties were assessed in the sitting position. Primary outcome measures were muscle stiffness (N/m), muscle tone (Hz), and muscle elasticity. The secondary variable was perceived pain threshold. Results No significant differences between the groups were found for biomechanical properties and perceived pain threshold in the studied muscles. Conclusion Forward head posture has no impact on muscle stiffness, tone, and elasticity, nor does it increase the pressure sensitivity of superficial neck muscles in healthy, mildly symptomatic office workers. It is most likely that not incorrect posture of the cervical spine, but probably other factors combined with forward head posture, like comorbid acute and chronic cervical pain and musculoskeletal disorders or prolonged sitting, contribute to changes in active myofascial tone and tensegrity as well as increased pressure sensitivity of neck muscles.

Objective. The aim of this study was to determine the effect of general rehabilitation gymnastics on subjective and objective characteristics of locomotor system in older women with chronic LBP. To satisfy this goal, the outcomes in exercising women were compared with the results of nonexercising controls. Material and Methods. The study group included 21 women with chronic LBP (age 65-75 years), participating in a 3-year general rehabilitation program combining strength, stretching, endurance, balance, and stabilization exercises with Muscle Energy Techniques (MET). Control group included 20 women with chronic LBP, who neither undertook the gymnastics nor participated in other forms of physical activity. The list of outcome measures included pain severity (Numeric Rating Scale), limitations in the activities of daily living (Oswestry Disability Index and Roland-Morris Disability Questionnaire), mobility of all spinal segments (tensometric electrogoniometry), and bioelectrical activity of back muscles (kinesiologic electromyography). Results. Exercising women presented with lesser severity of current pain (by 62%, p Conclusions. These findings may point to beneficial effects of the combined exercise program.

Introduction Optimal diastolic blood pressure (DBP) during antihypertensive treatment in patients without a history of cardiovascular disease (CVD) remains unknown. Objectives This post‑hoc analysis of the SPRINT (Systolic Blood Pressure Intervention Trial) data aimed to determine the optimal DBP evaluated using automated office blood pressure measurements (AOBPM) in hypertensive patients without a history of CVD. Patients and methods Data of 1470 patients with CVD and 7117 patients without CVD were used. Clinical composite endpoint (CE) was defined as the occurrence of myocardial infarction, acute coronary syndrome other than myocardial infarction, decompensation of heart failure, stroke, or cardiovascular death. Two different approaches based on the hazard ratio plot were used to identify the optimal DBP range. The first approach was to determine the 10 mm Hg-wide DBP range with the lowest risk for CE. In the second approach, it was assumed that the hazard ratio of CE at the boundary points of the optimal DBP range should be the same in patients with and without CVD. Results Two ranges of on-treatment DBP were proposed: 73.7 to 83.7 mm Hg (first approach) and 63.6 to 95.8 mm Hg (second approach). The risk for CE was increased by 3% and 20% at the boundary points of the range, respectively, depending on the method of DBP determination. Conclusions Due to the fact that the range determined by the second method was wide and substantially different from the one recommended by the European Society of Cardiology (70-79 mm Hg), we have concluded that a DBP range of 73.7 to 83.7 mm Hg, measured using AOBPM, should be considered optimal in patients without CVD.

Introduction Polycythemia vera (PV) is a rare myeloproliferative disease associated with an increased prevalence of hypertension and increased risk of cardiovascular complications. However, the precise mechanisms leading to the elevation of blood pressure (BP) and secondary target organ damage remain poorly understood. Objectives The study aimed to evaluate BP profile, assess the activity of the sympathetic nervous system and the renin‑angiotensin system, and provide a comprehensive assessment of subclinical target organ damage in patients with PV. Patients and methods Twenty consecutive patients with newly diagnosed PV and 20 control subjects were included. The following were assessed: BP, levels of catecholamines, urinary and plasma O‑methylated catecholamine metabolites, concentrations of aldosterone and renin. We also assessed microneurography sympathetic nervous system activity (MSNA) and baroreflex control of heart rate as well as subclinical target organ damage. Results At similar levels of BP, BP variability was decreased in the PV group (mean [SD] 24‑hour systolic BP, 9 [3] vs 12 [3] mm Hg; P = 0.003). Patients with PV had lower norepinephrine excretion (mean [SD], 16.54 [6.32] vs 25.46 [12.88] μg/d; P = 0.03) as well as decreased MSNA as assessed by microneurography compared with controls (mean [SD] MSNA, 30.7 [8.7] bursts/min vs 38.7 [5.4] bursts/min; P = 0.007 and MSNA 51.8 [11] bursts/100 beats vs 61.1 [11.3] bursts/100 heart beats; P = 0.04). Baroreflex control of HR was unaltered in the PV group. Increased hemoglobin levels and red blood cell count correlated with decreased retinal capillary flow in patients with PV. Conclusions Patients with PV, characterized by high hemoglobin concentrations and hematocrit levels had lower sympathetic nervous activity and decreased BP variability as compared with controls. There was no relationship between hemoglobin plasma concentration, hematocrit level, and target organ damage.

The aim of this study was to analyze the effects of aging on the viscoelastic properties of the upper trapezius (UT) and the sternocleidomastoid (SCM) muscle during transition from lying to sitting position.The study included 39 older (mean age 67±5.9years) and 36 younger (21.1±1.8years) women. Tone, stiffness and elasticity of the UT and the SCM were measured by means of myotonometry (MyotonPRO) in lying and then, in sitting position. The results were compared using two-way analysis of variance.Irrespective of the position, older women presented with significantly higher muscle tone, stiffness and elasticity than younger subjects (P0.05). In both groups, the transition from lying to sitting position resulted in a decrease (P0.05) in the tone and stiffness, but not the elasticity (P0.05) of the SCM, and stimulated an increase in the tone, stiffness and elasticity of the UT (P0.05). The degree of changes in both study groups was similar, except from the absolute value of the UT elasticity, significantly higher increase in older women than in younger subjects (P0.05).Age contributes to an increase in the stiffness and tone of the UT and the SCM, as well as to a decrease in the elasticity of these muscles in female subjects. In contrast, age exerts only a slight effect on the mechanical properties of both muscles during transition from lying to sitting position.

Background Regular Nordic Walking training could improve fitness and reduce tenderness in selected muscle groups in office workers. Objective An assessment of the effects of a 12-week Nordic Walking training program on the perceived pain threshold (PPT) and the flexibility of selected upper-body muscle groups in postmenopausal female office workers. Methods 39 office workers were selected at random for the treatment group (NWg, n = 20) and the control group (Cg, n = 19). The persons from the NW group completed a 12-week Nordic Walking training program (3 times a week/1 hour). PPTs measurements in selected muscles and functional tests evaluating upper-body flexibility (Back Scratch - BS) were carried out twice in every participant of the study: before and after the training program. Results A significant increase in PPT (kg/cm2) was observed in the following muscles in the NW group only: upper trapezius (from 1,32 kg/cm2 to 1,99 kg/cm2), mid trapezius (from 2,92 kg/cm2 to 3,30 kg/cm2), latissimus dorsi (from 1,66 kg/cm2 to 2,21 kg/cm2) and infraspinatus (from 1,63 kg/cm2 to 2,93 kg/cm2). Moreover, a significant improvement in the BS test was noted in the NW group compared with the control group (from -1,16±5,7 cm to 2,18±5,1 cm in the NW group vs from -2,52±6,1 to -2,92±6,2 in the control group). Conclusions A 12-week Nordic Walking training routine improves shoulder mobility and reduces tenderness in the following muscles: trapezius pars descendens and middle trapezius, infraspinatus and latissimus dorsi, in female office workers.

The aim of this work was to analyze postural stability of girls having progressive form of idiopathic scoliosis and undergoing specific period of the adolescent growth spurt. Twenty-seven girls, aged 13.4 ± 1.2 years, presenting structural idiopathic scoliosis, thoracic or thoracolumbar pattern, radiological Cobb angle 41.7 ± 17.4° (study group) and 37 healthy girls (control group) were included. The groups were sex, age, height, weight, and BMI matched. Postural stability examination was performed using two stabilometric platforms with visual control (eyes open) at three stages: (1) both legs’ stance, (2) left leg stance, and (3) right leg stance. The Center of Pressure (COP) sway path length, the area and the displacement amplitude were compared. For the double stance, no difference in postural stability parameters between the groups was found. However, for the right leg stance, the total sway path length was longer (p=0.04) and the mean amplitude of the lateral COP displacement was increased (p=0.03) in the scoliotic group. In conclusion, for double stance, the adolescent girls with progressive form of idiopathic scoliosis revealed fair postural stability compared to control group. An impaired postural control was observed during right leg stance.

(1) Background: Idiopathic scoliosis is a deformity of the growing spine. It affects 2&ndash, 3% of adolescents, yet its cause is still unknown. At the early stage of idiopathic scoliosis (IS), the signs are not very noticeable. That is why the primarily school-based screening for scoliosis is so important. (2) Methods: This was a cross-sectional analysis of 6850 respondents. Participants were elementary school students in the metropolitan area of Poland. The suspicion of IS was based on detection of three-dimensional deformity of the spine using scoliometer. (3) Results: Respondents were divided into two groups: Angle of trunk rotation (ATR) = 0&ndash, 3&ordm, and ATR &gt, Presented research using a referral criterion of 5&ordm, ATR showed that in the group of participants who had ATR &gt, the largest percentage of 5 degree values was recorded at the second and third measurement level of the spine (30.5%, 31.1%, respectively). Analyzing the differences between the two groups of girls (ATR = 0&ndash, ATR &gt, ), statistically significant differences were recorded between 9 and 11 years of age (p = 0.0388). Girls with ATR &gt, at all measuring levels are significantly slimmer than girls with ATR 0&ndash, (4) Conclusions: Age, sex, and risk of developing angle of trunk rotation are very closely associated. The main thoracic (level 2) and thoraco-lumbar (level 3) level of measuring of the spine appears to be the most differentiating in the diagnosis of scoliosis. Girls with a lower degree of trunk deformity (4&ndash, 6&ordm, trunk rotation), which can present mild scoliosis and those with a higher degree (7&ordm, trunk rotation) have lower body mass than girls within the norm.

Background Hypertension is the most prevalent and leading risk factor for stroke. SPRINT (The Systolic Blood Pressure Intervention Trial) assessed the effects on cardiovascular event risk of intensive compared with standard systolic blood pressure reduction. In this secondary analysis of SPRINT data, we investigated how low on‐treatment diastolic blood pressure ( DBP ) influenced risk for stroke events. Methods and Results For this analysis, we used SPRINT _ POP (Primary Outcome Paper) Research Materials from the National Heart, Lung and Blood Institute (NHLBI) Biologic Specimen and Data Repository Information Coordinating Center. Data for 8944 SPRINT participants were analyzed from the period after target blood pressure was achieved until the end of the trial. Overall, there were 110 stroke events, including 49 from the intensive‐treatment arm and 61 in the standard‐treatment group. In participants with DBP DBP ≥70 mm Hg (hazard ratio, 1.467; 95% CI 1.009–2.133; P =0.0445). Univariable Cox proportional hazard risk analysis showed that in the whole group, age and cardiovascular and chronic renal diseases were stroke risk factors. These risk factors were related to lower DBP and higher pulse pressure, however, not to study arm. Multivariable Cox proportional hazard analysis revealed that only age, history of cardiovascular disease, current smoking status and on‐treatment systolic blood pressure were significantly related to stroke risk. Conclusions Low on‐treatment DBP is not related to the risk for the first stroke, in contrast to older age, the history of cardiovascular disease, current smoking status, and on‐treatment systolic blood pressure. Clinical Trial Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT 01206062.

Automated office blood pressure measurement (AOBPM) is recommended for diagnosing hypertension; however, optimal treatment targets using this method are not established. Discrepancies between automated and office measurements of blood pressure have been described, producing uncertainty regarding the use of AOBPM in clinical practice. The Systolic Blood Pressure Intervention Trial (SPRINT) results improved our understanding of target AOBPM systolic blood pressure (SBP) levels; however, diastolic blood pressure (DBP) targets remain unknown. Therefore, we sought to determine the optimal on-treatment DBP range. The analysis was performed on the participants of the SPRINT trial who had hypertension and prior cardiovascular disease. We analyzed the data of 1470 participants (mean age 70.3 ± 9.3 years, 24.1% female) selected from the SPRINT trial database of National Heart, Lung and Blood Institute. The mean achieved SBP and DBP were 127.9 ± 10.7 and 68.3 ± 9.4 mm Hg, respectively. Most of the participants (57.4%) had a DBP lower than 70 mm Hg, while only 11.7% had DPB ≥80 mm Hg. Clinical composite endpoint was defined as myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure or death from cardiovascular causes. There were 159 (10.8%) clinical endpoint events. The participants with on-treatment AOBPM DBP range of 68.6-78.6 mm Hg showed the lowest hazard risk of a clinical composite endpoint. These results correspond to the office DBP range of 70-80 mm Hg recommended in ESC guidelines. This is the first attempt to determine the range of optimal DBP values using population-based AOBPM in patients with prior cardiovascular disease.

Objectives: The aim of the study was to determine if, and to what extent, structural and functional changes of the secundines influence biometric parameters of neonates from dichorionic twin pregnancies. Material and methods: The study included neonates from dichorionic, diamniotic twin pregnancies, along with their secundines. Based on histopathological examination of the secundines, the mass and dimensions of the placenta, length and condition of the umbilical cord, chorionicity, focal lesions, and microscopic placental abnormalities were determined for 445 pairs of twins. Morphological development of examined twins was characterized on the basis of their six somatic traits, while birth status of the newborns was assessed based on their Apgar scores. Statistical analysis included Student t-tests, Snedecor’s F-tests, post-hoc tests, non-parametric chi-squared Pearson’s tests, and determination of Spearman coefficients of rank correlation. Results: The lowest values of analyzed somatic traits were observed in twins who had placentas with velamentous or marginal cord insertion. Inflammatory lesions in the placenta and placental abruption turned out to have the greatest impact of all analyzed abnormalities of the secundines. Inflammatory lesions in the placenta were associated with lower values of biometric parameters and a greater likelihood of preterm birth. Neonates with a history of placental abruption were characterized by significantly lower birth weight and smaller chest circumference. Conclusions: Morphological changes in the secundines have a limited impact on biometric parameters of neonates from dichorionic twin pregnancies. In turn, functional changes exert a significant effect and more often contribute to impaired fetal development.

This study determined relationships between age, BMI and cranio-vertebral angle (CVA) (independent variables) and stiffness and elasticity of sternocleidomasteoid [SCM] and upper trapezius [UT] (dependent variables) muscles in sitting posture in 95 women across adult life. Moreover, a stepwise regression was performed to determine to what extent the dependent variables are explained by age, BMI and CVA. Age was moderately correlated with BMI (r = 0.41), and both age and BMI were moderately negatively correlated with CVA (r = −0.54 and −0.55, respectively). High (r = 0.73) and moderate (r = 0.53) linear relationships were present between age and logarithmic decrement (inversely related to elasticity) and stiffness of SCM muscle, respectively. Low (r = 0.36) and moderate (r = 0.47) relationships were present between age and logarithmic decrement and stiffness of UT muscle, respectively. Age accounted for 53% variance in elasticity and 28.5% variance in stiffness of SCM, and for 13% variance in elasticity and 22% variance in stiffness of UT muscle. Introduction of BMI but not CVA to the model explained the variance of these parameters by additional 0–8%. Among the studied factors age is the major correlate of stiffness and elasticity of neck muscles across the adult life.

Context: Kinesio taping® (KT) is a therapeutic modality frequently used in the clinical practice for the treatment of various musculoskeletal disorders. It is often applied in patients with chronic...

Context:The extent of knee extensor and flexor weakness after disruption of knee ligaments affects a rehabilitation output and functional recovery and may give prognostic information on a possible risk of development of knee osteoarthritis.Objective:The hypothesis tested was whether patients with a multiple-ligament tear would have larger abnormalities in strength of the knee extensors and flexors than patients with an isolated-ligament rupture.Design:Cross-sectional study, level III.Setting:Outpatient orthopedic clinic.Participants:3 groups of recreationally active men: noninjured control (CON, n = 12), with an anterior cruciate ligament injury (ACLI, n = 10), and with combined anterior and posterior cruciate ligament injury (APCLI, n = 9), matched according to age, body mass, and height.Intervention:All patients received conservative treatment and rehabilitation and awaited ligament reconstruction surgery.Main Outcome Measures:Isokinetic maximum-repetition peak torque per body mass (PT/BM) and total work (TW), PT and TW limb-symmetry index (LSI), and flexor-to-extensor PT ratio were evaluated during concentric knee extension-flexion movements at lower (60°/s) and higher (240°/s) isokinetic velocities.Results:The main finding was that compared with the individuals with ACLI, patients with APCLI produced in their injured limbs lower mean TW (extension: 30.3%, flexion: 28.2%) and had lower mean TW LSI (extension 74% in APCLI vs 91.6% in ACLI; flexion 61.3% in APCLI vs 90.8% in ACLI) at the higher but not lower speed of isokinetic testing. However, at the lower velocity the quantified size of reduction in PT/BM and TW was greater in subjects with APCLI than ACLI as compared with the CON individuals.Conclusions:After bi-cruciate-ligament injury the capacity to produce torque by concentric muscle contractions throughout knee-extension and-flexion movements performed with high speed is lower in injured limbs than after isolated anterior cruciate ligament tear.

Objective Beyond lipid-lowering properties, statins decrease sympathetic nervous activity. Due to the limited number of studies and included participants, a meta-analysis of randomized, placebo-controlled studies using microneurography (MSNA) was performed to assess sympatholytic effect of statins. Methods We conducted a comprehensive search of online databases (Cochrane, Embase, and EBSCO) for published human studies up to April 2014. Randomized controlled trials (parallel and crossover design) were eligible for inclusion if results of statins versus placebo treatments on sympathetic activity were measured with MSNA. Results Data from five studies with a total number of subjects n = 82 were included into the meta-analysis. MSNA expressed as bursts/min and as bursts/100 heartbeats was lower in the statin group than in the placebo group with a mean difference of −4.37 95 % CI (−7.03; −1.70), p

Common practice in field hockey requires athletes to adopt a semi-crouched posture, so players have a greater risk of musculoskeletal disorders than non-athletes. The aim of the present study was to assess how field hockey determines asymmetry in morphological and functional characteristics of the body by comparing athletes to control participants. The sample consisted of 15 male field hockey players from the Polish Youth National Team and 14 male university students. Antimeric differences in the chosen variables between body sub-regions were assessed. All morphological characteristics (bone mineral density, fat mass, and lean mass) were estimated using a dual energy X-ray absorptiometry. Additionally, the range of motion in transverse and frontal planes of the cervical, thoracic and lumbar spine was measured by using an electrogoniometric system. The results showed that the values of all morphological characteristics were higher in the left body segments, both in athletes and controls. However, the differences between sides were much more pronounced in the field hockey players. With regard to functional traits, higher values were obtained for the right body side in athletes but for the left side of the body among the controls. The difference between right and left side bending increased from the cervical spine (2.7%) through thoracic spine (7.8%) to lumbar spine (16.5%) in athletes. Rotational asymmetry in the thoracic spine was the largest in both groups. These findings indicate that it is important to monitor all athletes to prevent injury and health problems connected with strong morphological asymmetry.

BACKGROUND The aim of this study was to evaluate the effects of a 12-week Nordic Walking (NW) intervention on nitric oxide synthase activity (eNOS), levels of antibodies against oxidatively modified low-density lipoproteins (oLAb), plasma antioxidant capacity (TAC), thiobarbituric acid reactive substance (TBARS) concentration, carbohydrate and lipid metabolism, and atherosclerosis risk factors (AIP) in postmenopausal women. METHODS A sample of 39 women, divided into two comparable groups: training (N.=20) and control (N.=19), took part in the study. Participants in the training group performed a 12-week supervised NW training: 60-minute sessions of exercise, repeated three times per week. The biochemical and anthropometric data were obtained before and after the intervention. During the first and the last training sessions, the individual walking distance in trained group was measured. RESULTS After the intervention, significant differences in covered distance, body mass, BMI, fat mass, insulin level (P

Background: The importance of increased resting heart rate in hypertensive patients was highlighted in the European Society of Hypertension statement on the identification and management of hypertensive patient with elevated heart rate. Methods: Review of the available literature. Results: Increased heart rate is an independent predictor of cardiovascular morbidity and mortality even after adjustment for other conventional cardiovascular risk factors. Resting heart rate is correlated with blood pressure and prospectively related to the development of hypertension, as shown in numerous general population and hypertensive cohorts. Patients with hypertension may be characterized by increased sympathetic activation, and increased heart rate is considered a simple marker of increased sympathetic nervous activity. The definition of tachycardia is debatable as in clinical practice, tachycardia is generally defined as resting heart rate over 100 beats per minute (bpm) but this definition does not take into account epidemiological data and risk related to increased heart rate. Available evidence suggests that a lower threshold defining an increased resting heart rate should be adopted. In large hypertensive cohorts, approximately one third of the studied subjects had resting heart rate above 80-85 bpm and many of these patients had features of the metabolic/insulin resistance syndrome. Furthermore, the prevalence of hypertension increases with age and the hemodynamic pattern of hypertension in older subjects is not characterized by increased heart rate. Conclusions: These reasons, in addition to the fact that heart rate, is variable and depends on multiple factors, may explain why not all patients with hypertension are tachycardic at rest.

Atrial fibrillation may affect blood pressure measurements. The ankle-brachial index (ABI) is a ratio of systolic blood pressure measured on the lower and upper limbs that may also be affected by arrhythmia. The purpose of the study was to investigate whether atrial fibrillation influenced ABI results. Ninety-nine patients (age 66.6±11 years, 63 males and 36 females) who underwent electrical cardioversion of atrial fibrillation were investigated. ABI measurements using the Doppler method were performed on both lower extremities before and after electrical cardioversion. Measurements were repeated three times and then averaged. The ABI using both lower limbs was lower before electrical cardioversion than after restoration to sinus rhythm (right side: 1.132 (1.065-1.210) during atrial fibrillation vs. 1.179 (1.080-1.242) in sinus rhythm, P=0.019; left side: 1.142 (1.075-1.222) during atrial fibrillation vs. 1.170 (1.098-1.255) in sinus rhythm, P=0.011). However, the upper 95% confidence interval (CI) margins for the median differences in ABI were 0.045 and 0.040 for right and left, respectively, suggesting that the observed difference was clinically insignificant. There was a significant correlation between measurements obtained before and after electrical cardioversion on both lower limbs (r=0.61, P

The relationship between the sympatholytic effects of statins and their lipid-lowering activity remains unclear. Ezetimibe lowers cholesterol, but its sympatholytic activity is unknown. The purpose of study was to compare the influence of equipotent doses of simvastatin and ezetimibe on sympathetic activity. This randomized double-blinded study was performed in 22 hypertensive patients (age, 45.6 ± 2.2 years; female/male, 2/20) with untreated hypercholesterolemia. The subjects were administered 20 mg/d of simvastatin (n = 11) or 20 mg/d of ezetimibe (n = 11) for 6 weeks. Pre- and post-treatment measurements of muscle sympathetic nerve activity (MSNA), baroreceptor control of heart rate (baroreflex sensitivity), and impedance cardiography were recorded. Simvastatin and ezetimibe produced similar reductions of total (−58.0 ± 23.4 vs. −45.2 ± 17.2 mg/dL; P = .15, respectively) and low-density lipoprotein cholesterol (−52.6 ± 20.9 vs. −37.9 ± 17.6 mg/dL; P = .09, respectively). There was a significant difference in the effect of simvastatin and ezetimibe on muscle sympathetic nerve activity (−8.5 ± 5.1 vs. −0.7 ± 3.5 bursts/min; P = .0005). Simvastatin improved baroreflex sensitivity as compared with ezetimibe (10.0 ± 14.3 vs. −2.8 ± 6.1 ms/mm Hg; P = .01). There was no difference in the effect of both treatments on blood pressure, heart rate, cardiac output, stroke volume, total peripheral resistance, high-density lipoprotein, and triglycerides. Simvastatin reduced sympathetic activity via lipid-independent mechanisms, but ezetimibe exerts no sympatholytic effects.

Previous studies have shown that hyperoxia-induced deactivation of carotid body chemoreceptors reduces sympathetic activity in hypertensive patients but it does not affect blood pressure. The maintenance of blood pressure can be explained by the direct, vasoconstrictive effect of hyperoxia, which offsets diminished sympathetic activity. This study compares the effect of acute hyperoxia on hemodynamic parameters between hypertensive and normotensive subjects. Twelve males with hypertension (age 39.4±2.4 years; body mass index 27.4±1.1 kg m(-2)) and 11 normotensive males (age 39.9±2.7 years; body mass index 25.4±0.7 kg m(-2)) received, via non-rebreathing mask ventilation, ambient air, followed by 100% oxygen for 20 min. The stroke volume, heart rate, cardiac output, blood pressure, total peripheral resistance, respiratory rate, baroreceptor control of heart rate and oxygen saturation were recorded continuously. Several 30 s periods were analyzed before, during and after inducing hyperoxia. At baseline, the hypertensive subject's blood pressure was higher and their baroreflex control of heart rate was lower when compared with the normotensive control group. After the first 30 s of hyperoxia, systolic, diastolic and mean blood pressures, as well as the total peripheral resistance, decreased significantly in hypertensives but not in normotensives. After 20 min of 100% oxygen ventilation, systolic and mean blood pressures and total peripheral resistance was increased in hypertensive patients, and the cardiac output and stroke volume had decreased in both groups. The results of this study confirm that deactivation of carotid body chemoreceptors can acutely decrease blood pressure in humans.

BACKGROUND. The study aimed to determine the prevalence and patterns of spinal pain (SP) among Polish adolescents as well as the impact of the pain on their daily life activities. Moreover, it analysed the potential effect of extracurricular physical activity on back pain prevalence, frequency and consequent functional limitations among adolescents. MATERIAL AND METHODS. The study involved 2,676 students aged 13 to 19 years enrolled from three randomly selected administrative regions of Poland. The participants completed a survey designed by the authors during their classes. RESULTS. Sixty-five per cent of respondents reported having had back pain and 48% described the episodes as recurring. The pain was most frequently located in the lumbosacral spine and most commonly occurred for the first time in adolescents between 13 and 15 years of age. The most significant pain-related functional limitation was noted for physical activity, sitting, learning and concentration and lifting objects. CONCLUSIONS. 1. The prevalence of back pain in Polish adolescents is similar to relevant figures given for adults and their peers in Western Europe. 2. Spinal pain may significantly affect performance of daily activities by adolescents. Further studies should investigate strategies of pain management in this age group in more detail. 3. Regular exercise does not prevent back pain but it may reduce the functional limitations and stimulate recovery of complete capacity.

To assess the influence of carvedilol, an α- and β-blocker, on lower urinary tract symptoms (LUTS) and urine flow in hypertensive patients with benign prostatic hyperplasia (BPH).Fifty men were included in this double blind crossover study with placebo. After initial screening, participants were randomized to the carvedilol or the enalapril group, with cross over after 3 months. Doses of both drugs were uptitrated or additional therapy was introduced to ensure normal control of blood pressure (BP). Urologic assessment included uroflowmetry (average [Qavg] and maximum urinary flow rate [Qmax]), postvoid residual urine volume (PVR), International Prostate Symptom Score (IPSS), and prostate-specific antigen (PSA).After carvedilol or enalapril administration, BP values were significantly reduced, whereas heart rate decreased only in the carvedilol group. Basal urologic values for carvedilol and enalapril were similar: Qavg, 7.8 ± 0.9 and 8.1 ± 0.6 mL/s; Qmax, 13.2 ± 1.5 and 13.7 ± 0.9 mL/s; PVR, 86.1 ± 13.2 and 85.6 ± 11.7 mL; and IPSS, 13.2 ± 0.9 and 12.3 ± 0.8 points, respectively. After treatment with carvedilol, PVR and IPSS significantly decreased (48.2 ± 11.7 mL, 9.0 ± 0.8 points, respectively; P.001), whereas Qavg and Qmax increased (10.3 ± 0.9 mL/s, 16.5 ± 1.4 mL/s, respectively; P.001). In the enalapril group, all of these values remained unchanged.Carvedilol, compared with enalapril, has a positive influence on LUTS related to BPH in patients with hypertension. Thus, therapy with carvedilol may be considered in hypertensive patients with BPH. Further studies on the urologic benefit from long-term use of the drug are warranted.

Summary Background: The aim of this paper is the evaluation of effectiveness of manual therapy in the treatment of functional disturbances of the spine. Material/Methods: The study subjects were 40 persons aged 45-60 years, in whom degenerative changes in intervertebral discs and physical limitations within the spine were found (NMR), which were manifested as pain. Subjects were randomly divided into 2 groups of 20 persons each. The first group went on a monthly rehabilitation tour, where the manual therapy methods were applied. The second group was treated by means of physical methods. In order to verify the results of effectiveness of the therapies, the examination of the sectional mobility and the evaluation of the spinal curvatures before and after the completion of the therapy were made by means of a tensiometric electrogoniometer. Results: The percentage differences in significance result from the lower value of parameter t 1 in the group of persons treated physically. The dynamics of changes in the parameters in the sectional mobility in both tested groups was highest in the cervical and lumbar spine. The manually treated group had greater dynamics of changes in functional parameters of the spine. Conclusions: Manual therapy is an effective method for treatment of functional changes and early structural changes within the spine, and may be used as supplementary therapy in relation to the standard model of treatment of spinal pain.

BACKGROUND To determine the lifetime prevalence and characteristics of non-specific back pain (low back pain, upper back pain) and neck pain in adolescents living in urban areas of Poland. We also studied the impact of back/neck pain on adolescents' daily activity as well as the association of back pain with computer use, watching TV, physical work, and physical activity. MATERIAL AND METHODS. A school-based questionnaire survey of back pain and physical activity, computer use, watching TV and functional disorders was distributed among 1475 randomly selected adolescents aged 13 to 20 years attending lower and upper secondary schools in Poznan, Poland. RESULTS A total of 986 (67%) teenagers reported having experienced one or more episodes of back/neck pain in their lives. Low back pain was the most common presentation. Back/neck pain symptoms appeared mostly between the 14th and 16th year of life. The daily activities mostly impaired by back/neck pain were physical activity, learning/concentration and lifting objects. No significant differences were found in computer use and physical activity between adolescents with and without a history of back/neck pain. Pain-free teenagers watched TV significantly longer. Boys with back/neck pain performed physical work more frequently than pain-free boys. CONCLUSIONS 1. Compared to adolescents and adults in other European countries, the lifetime prevalence of back/neck pain in Polish adolescents living in urban areas is similar. 2. The findings support the hypothesis that physical activity, computer use and watching TV cannot be regarded as risk factors for back/neck pain. 3. Back/neck pain may have a negative influence on the daily activities of adolescents. Nevertheless, this impact is probably temporary and adolescents seem to develop strategies for coping with pain in order to participate normally in daily activities. More detailed studies of these coping strategies are recommended.

Objectives. The effects of Kinesio Taping (KT) on muscular performance remain largely unclear. This study aimed to investigate the acute effects of KT on the maximum concentric and eccentric quadriceps isokinetic strength.Study Design. This is a single-blinded, placebo crossover, repeated measures study.Methods. Maximum isokinetic concentric/eccentric extension torque, work, and power were assessed by an isokinetic dynamometer without taping (NT) and with KT or placebo taping (PT) in 17 healthy young men. Repeated measures one-way analysis of variance (ANOVA) was used for statistical analyses.Results. Testing concentric contractions at 60°/s or 180°/s isokinetic speed, no significant differences in peak torque (Nm), total work (J), or mean power (W) were noted among the application modes under different conditions. Testing eccentric contractions at 30°/s or 60°/s isokinetic speed, no significant differences in mentioned parameters were noted, respectively. KT on the quadriceps neither decreased nor increased muscle strength in the participants.Conclusion. KT application onto the skin overlying the quadriceps muscle does not enhance the strength or power of knee extensors in healthy men.

Whole-body cryotherapy (WBC) has been frequently used to supplement the rehabilitation of patients with rheumatoid arthritis (RA). The aim of this study was to compare the effect of WBC and traditional rehabilitation (TR) on clinical parameters and systemic levels of IL-6, TNF-αin patients with RA. The study group comprised 25 patients who were subjected to WBC (−110°C) and 19 patients who underwent a traditional rehabilitation program. Some clinical variables and levels of interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) were used to assess the outcomes. After therapy both groups exhibited similar improvement in pain, disease activity, fatigue, time of walking, and the number of steps over a distance of 50 m. Only significantly better results were observed in HAQ in TR group (p< 0.05). However, similar significant reduction in IL-6 and TNF-αlevel was observed. The results showed positive effects of a 2-week rehabilitation program for patients with RA regardless of the kind of the applied physical procedure.

Circadian blood pressure (BP) rhythm is often disturbed in patients with secondary forms of hypertension. The aim of the present article was to investigate changes in circadian BP profile parameters using two-step statistical approach by Fourier analysis in relation to day and night urinary catecholamine excretion in 35 patients with pheochromocytoma (mean age 42+/-19 years). Twenty-four-hour ambulatory BP measurements (ABPM) were obtained using the SpaceLabs 90,207 monitor. Daytime and night-time urine collection was obtained in all patients to determine circadian catecholamine excretion. Fourier analysis was applied to estimate measures of BP circadian rhythm in ABPM, including the highest (Max) and lowest (Min) systolic (SBP) and diastolic (DBP) BP values, norad (ampSBP, ampDBP), and early acrophase (APSBP, APDBP). The Fourier indices of circadian BP rhythm were: MaxSBP 153+/-28 mm Hg, MaxDBP 99+/-16 mm Hg, MinSBP 117+/-17 mm Hg, MinDBP 69+/-11 mm Hg, ampSBP 18+/-8 mm Hg, ampDBP 14+/-5 mm Hg, APSBP 10+/-5 (h), and APDBP 11+/-3 (h). Urine noradrenaline (NA), adrenaline (A), and dopamine (DA) excretion during the day (d) and night (n) were: dNA 103.5+/-89.8 microg/14 h, nNA 52+/-70.8 microg/10 h, dA 13.2+/-17.9 microg/14 h; nA 6.13+/-9.6 microg/10 h, dD 181.8+/-87.3 microg/14 h, and nD 89.3+/-59.8 microg/10 h. A positive correlation was observed between urine dNa excretion and MaxDBP (r=0.37, P

Sirs: The underlying mechanisms for the rise in blood pressure in individuals with autosomal dominant polycystic kidney disease (ADPKD) are complex, and experimental and clinical data support the concept that sympathetic hyperactivity may contribute to the pathogenesis of hypertension in ADPKD [1, 2]. More recently, a catheter-based percutaneous aimed at ablating both efferent and afferent renal nerve fibres has been introduced into clinical medicine and has been demonstrated to safely and effectively reduce blood pressure in patients with treatment resistant hypertension and normal renal function [3–6]. However, to our knowledge there is only one report of Shetty et al. [7] who observed after renal denervation resolution of chronic pain related to renal cysts and delayed fall in blood pressure in patient with ADPKD and resistant to treatment hypertension. No data on reduction of sympathetic activity has been shown. A 26-year-old male with polycystic kidney disease was referred to the Department of Hypertension by the end of 2012 for the consideration of percutaneous renal denervation due to resistant hypertension. At the age of 20, the patient was first diagnosed with hypertension and also with ADPKD. A family history of polycystic kidney disease was present in the mother and in addition to in a sister. At the time of referral, the patient had an office blood pressure of 162/77 mmHg and an average day-time ambulatory blood pressure of 138/73 mmHg despite four antihypertensive medications comprising valsartan 160 mg od, amlodipine 10 mg od, nebivolol 2.5 mg od, and hydrochlorothiazide 25 mg od. No history of cardiovascular disease or diabetes was reported, the patient has never smoked. The patient has normal renal function at baseline with a serum creatinine of 74 μmol/L and estimated glomerular filtration rate by MDRD formula of >60 mL/min/1.73 m2. The patient was not troubled by chronic flank pain. On Doppler duplex examination renal arteries were normal, renal resistive index values were 0.61 and 0.66 in the right and left kidney, respectively. Abdominal ultrasound showed enlarged size of right (145 mm) and left (180 mm) kidney with multiple simple renal cortical cysts with a maximum diameter of 3 cm. Hepatic cysts were not present. Abdominal MRI showed bilateral simple appearing renal cysts in the upper and lower poles. Microneurography was performed before and 3 months after the renal denervation. Muscle sympathetic-nerve activity (MSNA) signals were recorded by an electrode placed into the peroneal nerve at the popliteal fossa, posterior to the fibular head and the reference electrode was placed subcutaneously 2–3 cm from the recording electrode. Due to his uncontrollable blood pressure percutaneous renal sympathetic denervation using the Symplicity Catheter® system was performed as described previously [5], with five ablations in left and six in right renal artery (Fig. 1). The patient was discharged the following day on his pre-ablation antihypertensive regimen. The only complication of the procedure was transient stenosis of both arteries resulting from artery spasm and edema. Fig. 1 Symplicity Catheter® in the left renal artery. It was possible to perform five ablations in the left renal artery The patient was reviewed at 1 and 3 months post renal sympathetic denervation. At 1 month follow up he had improvement in his systolic blood pressure with an office reading of 129/60 mmHg and at 3 month follow up his blood pressure had dropped to 120/74 mmHg. A 24-h ambulatory blood pressure monitoring at 1 and 3 months confirmed blood pressure control with a mean day-time blood pressure of 131/68 and 128/65 mmHg, respectively. His renal function remained unchanged at 1 and 3 months. Microneurography at 3 months showed a reduction in MSNA (Fig. 2), as assessed in the peroneal nerve. Fig. 2 Reduction in blood pressure and muscle sympathetic-nerve activity (MSNA), as assessed in the peroneal nerve on microneurography 3 months after bilateral renal-nerves ablation Our case report confirms the safety and effectiveness of a catheter-based renal denervation approach for the treatment of resistant hypertension in patients with ADPKD. While a single case has its obvious limitations, the fall in blood pressure after the procedure was accompanied by the decrease in the sympathetic activity being likely mediated via ablations of different fibres responsible. However, it should be mentioned that MSNA may not give information specifically about renal sympathetic activity [8]. In our case, larger reductions in office than in ambulatory blood pressure were noticed. However, these changes were of comparable magnitude as reported in the prospective studies [5, 9, 10]. In these groups, also the discrepancy between reduction in office and ambulatory blood pressure was also noted, but is should be stressed that observed reductions provide an equivalent reduction in cardiovascular events [5, 8, 11]. Confirmation of substantial BP lowering via catheter-based renal afferent denervation in patients with ADPKD in future studies may provide a valuable and safe alternative for the management of this difficult clinical condition.

[b]Introduction and objective[/b]. Spinal pain (SP) has become a very common problem in contemporary societies and occurs in adults, youths, and even children. The aim of the study was to determine whether the prevalence and characteristics of SP, as well as the determinants leading to SP in Polish youths, vary depending on the place of residence. The determinants considered were out-of-school physical activity (PA) and physical work (PW), time spent at a computer and TV, and the level of psychosocial development expressed as the level of anxiety-trait. The restricting effect of the experienced SP on everyday functioning of youths was also analysed. [b]Materials and method[/b]. A cross-sectional, population-based study comprising 502 village residents (VR) and 1,593 city residents (CR) aged 13–19, residing in 3 random Polish provinces. The tools used were a custom-designed survey and the State-Trait Anxiety Inventory (STAI) filled by students during classes. [b]Results[/b]. The frequency and localisation of SP, the time and circumstances in which SP episodes occur, as well as the influence of the pain on everyday functioning, are the same in youths living in villages and youths living in cities. Slight differences in the correlation between the prevalence of SP and determinants of SP development related to lifestyle depending on the place of residence were observed. However, in both VR and CR the occurrence of SP is significantly correlated negatively with the level of psychosocial development. [b]Conclusions[/b]. At present, the conditions of living in a rural and in an urban environment in Poland pose no specific threat determining the occurrence of SP in youths, and increasing the negative effect of the pain on the functioning of youths.

One of the key points to maintain and boost research and development in the area of smart wearable systems (SWS) is the development of integrated architectures for intelligent services, as well as wearable systems and devices for health and wellness management. This paper presents such a generic architecture for multiparametric, intelligent and ubiquitous wireless sensing platforms. It is a transparent, smartphone-based sensing framework with customizable wireless interfaces and plug‘n’play capability to easily interconnect third party sensor devices. It caters to wireless body, personal, and near-me area networks. A pivotal part of the platform is the integrated inference engine/runtime environment that allows the mobile device to serve as a user-adaptable personal health assistant. The novelty of this system lays in a rapid visual development and remote deployment model. The complementary visual InferenceEngineEditor that comes with the package enables artificial intelligence specialists, alongside with medical experts, to build data processing models by assembling different components and instantly deploying them (remotely) on patient mobile devices. In this paper, the new logic-centered software architecture for ubiquitous health monitoring applications is described, followed by a discussion as to how it helps to shift focus from software and hardware development, to medical and health process-centered design of new SWS applications.

The Kinesiology Taping / Kinesio Taping (KT) method has become more and more popular in recent years. Many studies have been developed to demonstrate the application of this method in numerous fields of medicine. Despite its continuous development, several issues pertaining to the legitimacy of its application and mechanisms of its operation still need to be addressed. The aim of this study is to analyse the available literature in terms of the effect of KT on the spinal motion and physiological spinal curvatures. This study is based on a method of analysing bibliographic databases such as: SPORTDiscus, Medline, ScienceDirect, EBSCOhost, and Google Scholar.There were found seven research articles that observe the criteria of this study's aim. Four of those research articles were devoted to the motion of the lumbar spinal segment, the other two discussed the motion of the cervical spinal segment and one of them concentrated on the lumbar lordosis. None of those research articles included any information on negative effect of this method. The effect of KT on assessed parameters is barely noticeable. Therefore, it is necessary to conduct further research in respect of the effect of the Kinesiology Taping method on the spinal motion and physiological spinal curvatures.

The aim of the study was an assessment of isometric torque (IT) values under static conditions and relative torque (RT) for the plantar flexion muscles (PFM) and dorsal flexion muscles (DFM) and their mutual relations in males 5 years after talocrural joint sprain. IT measurements in PFM and DFM were performed using Biodex System 3. Group I consisted of 20 males on average 5 years after the sprain of the talocrural joint. Group II comprised 23 males with no history of talocrural joint injuries. The angles of measurement were: -15° of dorsiflexion (DF) and 0°, 15°, 30° and 45° for plantar flexion (PF) of the foot. In group I, the IT and RT obtained from PFM of involved leg were statistically significantly lower for most of the measured values of foot angle as compared to the contralateral joint and the results of the control group. The increase in the PF angle resulted in the decrease in IT values obtained from PFM, in favour of DFM. The IT values for PFM and DFM depend on the angle of foot and are represented by two different curves.

Studies on the formation of morphological traits of the quadriceps femoris muscle were carried out on the material of 138 human fetuses (70 males and 68 females), 9-36 weeks old, and 50 adults (33 male, and 17 female). Some intermediary conclusions were drawn for probable changes occurring in the morphological formation of the muscle after birth by comparing proportions of the muscle at the fetal stage with its form in adults. In this research, anthropometric methods and statistical analysis of results have been applied. The analysis of the results in the fetal group has shown that all metrical characteristics of the muscle reach their maximum values at the end of the investigated ontogenetic period. This is, naturally, a consequence of the development and growth of all fetal body measures, including an elongation of the thigh. Yet, the development of the individual muscle characteristics is not regular and although the trend of this growth is similar, its extent varies, and differs slightly in the two sexual groups. A comparison of the values of muscle indices for 9 month old fetuses with the same indices for adults shows that the relative dimensions of all investigated muscular characteristics decrease during the post-natal period except the relative length of the tendon.

The ESH classification of blood pressure includes the high-normal blood pressure (HNBP) category, which is within normal limits but associated with increased cardiovascular (CV) risk.To identify additional CV risk factors and early signs of target organ damage in healthy individuals with HNBP.Healthy volunteers (n = 74) with optimal blood pressure or HNBP were compared with respect to metabolic and haemodynamic parameters.The HNBP was associated with higher serum uric acid (333.1 ± 65.4 vs 267.7 ± 65.4 μmol/L, p0.05) and glucose (4.7 ± 0.3 vs 4.5 ± 0.3 mmol/L, p0.01) concentrations, intima-media thickness (0.39 ± 0.06 vs 0.36 ± 0.04 mm, p0.05), systemic vascular resistance index (2,678.2 ± 955.9 vs 1,930.2 ± 625.5 dyn x s x m(2)/cm(5), p0.001), lower total arterial compliance index (1.04 ± 0.42 vs 1.44 ± 0.48 mL/[mm Hg x m(2)], p0.01) and baroreflex sensitivity (14.2 ± 3.8 vs 18.0 ± 8.8 mm Hg(2)/Hz, p = 0.05).The observed differences in metabolic and haemodynamic profile in HNBP may adversely affect CV risk in these individuals.

The aim of the study was to compare the difference in stress levels between adolescent female groups of patients from urban and rural areas who were treated conservatively with an idiopathic scoliosis. The study comprised 2 groups of patients, 34 from an urban and 30 from a rural area, with a minimum application of a Cheneau brace for 12 hours a day, for a minimum of 1 month. Two study groups completed the Polish version of both Bad Sobernheim Stress Questionnaire-Deformity and Bad Sobernheim Stress Questionnaire-Brace. Both groups of patients felt moderate stress connected with conservative treatment and low stress related to trunk deformation. No difference was observed in stress level related to body disfigurement and conservative treatment between the 2 groups of patients. In the rural group of patients, a correlation between the apical translation and stress related to deformity was observed. No significant differences were stated in stress levels and coping mechanisms between patients from rural and urban areas, treated conservatively due to idiopathic scoliosis. A difference was observed, however, regarding the correlation connected with the apical translation and stress level.

Carotid chemoreceptors provoke an increase in muscle sympathetic nerve activation (MSNA) in response to hypoxia; they are also tonically active during normoxic breathing. The contribution of peripheral chemoreceptors to sympathetic activation in hypertension is incompletely understood. The aim of our study was to investigate the effect of chemoreceptor deactivation on sympathetic activity in untreated patients with hypertension. A total of 12 untreated hypertensive males and 11 male controls participated in this randomized, crossover, placebo-controlled study. MSNA, systolic blood pressure(BP), diastolic BP, heart rate (HR), electrocardiogram, hemoglobin oxygen saturation (Sat%) and respiratory movements were measured during repeated 10-min periods of respiration with 100% oxygen or 21% oxygen in a blinded fashion. Compared with controls, hypertensives had higher resting MSNA (38 ± 10 vs. 29 ± 0.9 burst per min, P

Objectives Nasal septum deformation (NSD) may cause breathing dysfunction. The reason for a septal deviation is the developmental anomaly in growth of the elastic septum or its skeleton. Such a type of deviation is called physiological. Some deviations can result from the prenatal trauma. The aim of the work was the analysis of the anatomy of the nasal cavity with a special interest focused on the nasal septum and its deviation. Materials and methods The nasal cavity with its bones and septum was analyzed in CT images of 105 spontaneously aborted fetuses (57 males and 48 females) aged 12 and 40 weeks of gestation. We attempted to assess the morphometric development of the nasal cavity with tomographic scanning methods and to detect anatomical variations. Results In 15 (14.3%) fetuses, NSD were detected on radiological sections. The angle between the virtual line from the sphenoid sinus ostium through limen nasi and the horizontal plane was 33.6 ± 2.3°, on average. Conclusions NSD may already be found in fetuses. The observation of the nasal cavity development enables to evaluate the growth and symmetry of the nasal septum and to foretell predispositions for dysfunction in the upper respiratory tract.

Beyond their hypolipidemic effect, statins reduce cardiovascular risk in hypertensive subjects via various mechanisms; one suggested mechanism is that they reduce sympathetic activity. We investigated the hypothesis that simvastatin decreased muscle sympathetic nerve activity (MSNA) in 31 hypertensive subjects with hypercholesterolemia (aged 38.7 ± 10 years). In this randomized, placebo-controlled, double-blinded study, patients were treated with simvastatin (40 mg day(-1); n=15) or placebo (n=16) for 8 weeks. Before and after treatment, we measured MSNA, blood pressure and heart rate. Baroreceptor control of the heart rate, or baroreceptor sensitivity (BRS), was computed by the sequence method, a cross-analysis of systolic blood pressure and the electrocardiogram R-R interval. Blood samples were tested for plasma levels of catecholamines, neuropeptide Y, aldosterone, endothelin and renin activity. Simvastatin significantly reduced MSNA (from 36.5 ± 5 to 27.8 ± 6 bursts per min, P=0.001), heart rate (from 77 ± 6.7 to 71 ± 6.1 beats per min, P=0.01) and both total and low-density lipoprotein cholesterol (from 249 ± 30.6 to 184 ± 28.3 mg dl(-1), P=0.001 and from 169 ± 30.6 to 117 ± 31.2 mg dl(-1), P=0.01, respectively). Simvastatin also improved BRS (from 10.3 ± 4.1 to 17.1 ± 4.3 ms per mm Hg, P=0.04). No changes were observed in systolic or diastolic blood pressures, or in plasma levels of catecholamines, neuropeptide Y, endothelin, aldosterone and renin activity. After simvastatin therapy, MSNA and BRS were inversely related (r=-0.94, P0.05). In conclusion, we found that, in patients with hypertension and hypercholesterolemia, simvastatin reduced MSNA, and this was related to increased baroreceptor sensitivity.

Increased sympathetic activity might be related to pathogenesis of hypertension as well as to end organ damage. Animal studies suggest that statins decrease sympathetic activity and increase baroreceptor reflex sensitivity (BRS).To examine whether atorvastatin decreases muscle sympathetic nerve activity (MSNA) and BRS in hypercholesterolaemic and hypertensive patients.Ten patients with essential hypertension and untreated hypercholesterolaemia (aged 43 +/- 12 years) and eight healthy subjects (aged 37 +/- 7 years) were enrolled in the study. In both groups the recordings of microneurography, ECG, blood pressure and BRS were performed twice, before and after 8 weeks during which the patients (but not controls) were treated with atorvastatin.Compared with controls, the patients had higher MSNA values (36.0 +/- 6.6 vs. 29.8 +/- 3.7 bursts/minute), mean BP levels (145.1 +/- 10 vs. 124.1 +/- 11.1 mmHg) and total cholesterol concentration (252.6 +/- 22.6 vs. 179.8 +/- 20.7 mg/dl) baseline values. Statin therapy resulted in a decrease of total cholesterol (252.6 +/- 22.0 vs. 173.8 +/- 26.2 mg/dl, p0.05) and MSNA (36.0 +/- 6.6 vs. 28.6 +/- 4.8 bursts/min, p0.05), whereas BRS values were increased (12.6 +/- 5.6 vs. 18.1 +/- 5.9 ms/mmHg, p0.05). Post-treatment BRS was inversely related to post-treatment MSNA (r = -0.73, p0.05). In the controls there were no changes in MSNA (29.8 +/- 3.7 vs. 28.9 +/- 2.9 bursts/min), BRS (11.9 +/- 5.0 vs. 13.1 +/- 4.8 ms/mmHg), total cholesterol, BP and heart rate between the first and the second measurement.Atorvastatin reduces MSNA and increases BRS in hypertensive and hypercholesterolaemic patients. Decrease in sympathetic activity may be the result of improvement of baroreceptor function by atorvastatin.