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Introduction/Purpose Obesity increases significantly every year worldwide. Since 1980, the prevalence of individuals with obesity has practically doubled. Obesity plays an important role in the pathophysiology of diseases that arise from a complex interaction of nutritional, genetic, and metabolic factors, characterizing a chronic inflammatory state. This study aimed to verify the systemic inflammatory response through the analysis of IGF-1, IL-23, and resistin levels and the lipid profile in severely obese women undergoing surgery for obesity and weight-related diseases. Materials and Methods This randomized controlled clinical trial includes female patients clinically diagnosed with severe obesity with an indication for bariatric surgery. Results In the initial evaluation, no significant difference was observed between the control (CG) and bariatric surgery (BSG) groups. The weight, BMI, systolic and diastolic blood pressures, total cholesterol, LDL, HDL, total non-HDL cholesterol, and glucose in BSG patients showed a significant change after surgery. Pre- and post-surgery levels of resistin, IGF-1, and IL-23 showed a significant difference in the BSG group, but only IL-23 was changed after 6 months in the CG. Conclusion The results of this study confirmed that weight loss induced by surgery for obesity and weight-related diseases improved the lipid profile and reduced the chronic inflammatory status in women with severe obesity.

Introduction: Chronic obstructive pulmonary disease (COPD) and Obstructive sleep apnea (OSA) cause an inflammatory response and hypoxia. Patients who have both conditions have increased morbidity and mortality. Overlap syndrome between OSA and COPD is important but under-recognised. Objectives: We aimed to determine the prevalence and severity of overlap syndrome in patients with COPD through the overnight standard polysomnography. Methods/Design: A consecutive single-center cross-sectional study will be performed. The design, conduct and report of this study followed the guidelines of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. The sample will be of convenience, recruited consecutively with respiratory complaints that seek care in a private clinic specializing in pulmonology in the city of Cascavel, in the state of Paraná, from September 2016 to July 2017. All subjects will be submitted to the same evaluation protocol described subsequently. Initially will be collected data on baseline demographic, anthropometric and clinical aspects, including body mass index, neck, hip and waist circumferences, respiratory and cardiac rates, peripheral blood pressure, and BODE index. After this phase of the study, patients will perform lung function tests through petismography, sleep studies using the standard overnight PSG, and respond to the Berlin and Pittsburgh questionnaires, and Epworth Sleepiness Scale.

Introduction: The Syndrome Z (SyndZ) has been drawing scientific community’s attention on the past years. It is characterized by the interaction between obstructive sleep apnea (OSA) and Metabolic Syndrome (MetS). On its turn, MetS is knew for the association with various metabolic disturbances occurring simultaneously in the same patient, those of which include central obesity, systemic hypertension (SH), glucose intolerance or insulin resitance, low serum high-density lipoprotein cholesterol (HDL), and elevated serum triglycerides. OSA is a prevalent condition all over the world, and presents potential adverse health outcomes, with a particular impact in cardiovascular diseases. Therefore, OSA and MetS present important cardiovascular risk factors, that when superimposed can mean a higher cardiovascular morbi-mortality. This associated pathogenesis has not been completely elucidated. Objectives: A pilot study to determine the prevalence and severity of SyndZ in severely obese female patients on the waiting list for bariatric surgery. Methods/Design: This cross-sectional study will be conducted with severely obese female patients, on waiting list for bariatric surgery, from the Santa Casa de Misericordia de São Paulo Hospital, in the city of Sao Paulo (Brazil). Demographic, anthropometric and clinical data will be collected, as well as blood’s biochemical analysis. The patients will also undergo standard overnight polysomnography at the Sleep Laboratory of Nove de Julho University.

Introduction: The Chronic Kidney Disease (CKD) is characterized as a clinical condition wherein the progressive loss of renal function for a period longer than months to years will lead to the onset of end-stage renal disease (ESRD). In the advanced stages of CKD, patients can only be treated with replacement therapy, dialysis or transplantation. In this context, hemodialysis (HD) presents as the main treatment option for these patients due to the lack of donors. Patients with ESRD in HD often present signs and symptoms related to pre-existing or acquired comorbidities with worsening of the disease. The most frequent are electrolytic disturbances, anemia, malnutrition, bone disease, Melittus diabetes, systemic arterial hypertension, gastrointestinal disorders, respiratory disorders, cardiovascular diseases, neurological changes and sleep disorders. Obstructive sleep apnea (OSA) presents a tenfold prevalence in patients with ESRD when compared to the general population, worsening the clinical symptoms and cardiovascular complications of this disease. The increase in the number of ESRD patients submitted to HD has assumed epidemic proportions worldwide. The causal association between sleep-disordered breathing, in particular OSA and ESRD, is still not well understood, which expands the possibility of new findings for the prevention, diagnosis and treatment of OSA, improving quality of life and reducing morbimortality. Objective: The present study involving ESRD patients undergone HD was designed with three main objectives: 1) to verify the prevalence and severity of sleep-disordered breathing; 2) to analyze the behavior of sleep apnea / hypopnea index (AHI) during the interdialitic period; 3) to verify weight gain and anthropometric measurements during the interdialitic period. A consecutive single-center cross-sectional clinical study will be performed, double-blind, non-randomized to investigate the behavior of AHI in patients with ESRD undergoing HD in the nephrology unit (UNEFRO) at the Hospital of Santa Casa de Misericordia de Avare, (SP), Brazil. The design and conduct of this study followed the guidelines of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Trial Registration: This protocol follows the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) and the study has been registered on ClinicalTrials.gov (NCT02390193).

Background In recent years, obesity has become one of the most important public health problems in the world, with a growing prevalence in both developed and developing countries. Recent studies show that sleep disturbances, especially obstructive sleep apnoea (OSA) may be a manifestation of metabolic syndrome (MetS). Although the association of OSA with the MetS is largely attributed to obesity, the exact pathophysiological mechanisms and their individual characteristics still need to be identified. This study investigated the prevalence and severity of syndrome Z in obese women with MetS on waiting list for bariatric surgery. Methods In this double-center cross-sectional study, female patients aged ≥18 years, stage III severe obesity with MetS, on waiting list for bariatric surgery were recruited. The diagnosis for MetS was made according to the criteria of the national cholesterol education program, adult treatment panel III. Clinical, anthropometric, demographic, biochemistry, and sleep measurements were collected. Correlations between continuous variables with sleep parameters were performed using the Pearson correlation test or Spearman correlation test. Results The mean age of 83 patients was 44.8 ± 11.2 years and mean BMI was 42.6 ± 8.1 kg/m2. There was a significant correlation between OSA and metabolic score (r = 0.336; P = 0.002), neck circumference (r = 0.218; P = 0.048), basal systolic blood pressure (r = 0.280; P = 0.01), total cholesterol (r = 0.277; P = 0.011) and abdomen circumference (r = 0.284; P = 0.009). The mean values of excessive daytime sleepiness were 10.5 ± 7 demonstrating a value considered normal for its presence. However, a high risk for OSA was observed in practically the entire population. It was observed that the prevalence of Syndrome Z (75.9%) increased significantly according to apnoea hypopnoea index (AHI) (P for trend Conclusions We can conclude that syndrome Z presents a high prevalence in a female population with MetS and a considerable severity according to the presence of OSA. Therefore, patients with MetS should be investigated for the presence of sleep disorders. Trial registration The study has been registered on ClinicalTrials.gov NCT02409160 and followed the standards of The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies

Background Obesity is a worldwide disease related to genetic, environmental, and behavioral factors, and it is associated with high rates of morbidity and mortality. Recently, obesity has been characterized by a low-grade inflammatory state known as inflammome indicated by chronic increases in circulating concentrations of inflammatory markers. The purpose of this study was to evaluate the effect of weight loss induced by surgery for obesity and weight-related diseases on pro-inflammatory cytokine (TNF-α) and anti-inflammatory adipokine (adiponectin) levels, and on an adipose-derived hormone (leptin) in severely obese subjects. Methods This randomized, controlled trial involved 55 severe obese patients (50 women, age 18–63 years, and body mass index of 35.7–63 kg/m2) who underwent bariatric surgery (BS). Patients with a BMI > 65 kg/m2 and clinical and mental instability, or significant and unrealistic expectations of surgery were excluded. Blood samples were collected during the fasting period to analyze tumor necrosis factor alpha (TNF-α), adiponectin, and leptin levels by enzyme-linked immunosorbent assay. Results At baseline, no significant difference was observed in the anthropometric, demographic, clinical characteristics and biochemistry and inflammatory markers between the control group (CG) and bariatric surgery group (BSG). The same finding was also observed when we compared the baseline variables to those at the 6-month follow-up in the CG. However, the same variables in the BSG group were significantly different between baseline and the 6-month follow-up after BS. Conclusions Weight loss induced by surgery for obesity and weight-related diseases reduced the inflammome state in severely obese patients.

[Purpose] This systematic review evaluated the presence of sleep-disordered breathing in patients with myasthenia gravis and clarified the role of physiotherapy. [Subjects and Methods] We followed the PRISMA declaration criteria. The evaluation was performed in accordance with the STROBE statement for observational and cross-sectional studies and the CONSORT checklist for clinical trials. Searches were followed by hand on MEDLINE, EMBASE, SciELO, PubMed Central, and the Cochrane Central Register of Controlled Trials. [Results] Our searches yielded a total of 36 studies published between 1970 and 2014. The number of patients involved ranged from 9-490. Of the 36 studies, 19 articles were excluded because they did not meet the inclusion criteria. Therefore, 17 observational, cross-sectional, or clinical studies assessing the quality of sleep and prevalence of sleep disorders in patients with myasthenia gravis were eligible for our review. [Conclusion] Some studies of patients with MG show that patients with MG are associated with poor sleep quality, excessive daytime sleepiness, presence of restless syndrome, and a higher incidence of SDB, while other studies do not report such associations. Therefore, given the current inconclusive evidence and limited literature, further study of sleep disturbances in patients with MG is needed.

Introduction: The Berlin questionnaire (BQ) has been used to help identify patients at risk for obstructive sleep apnea (OSA) in primary care. The BQ may be a useful adjunct in medicine and sleep research, but little applied in a population of patients with Myasthenia gravis (MG). The presence of sleep disorders in patients with MG may adversely affect the mechanics of breathing in wakefulness and sleep. Currently, few studies in the scientific literature show the presence of respiratory sleep disorders in patients with MG. Some studies have shown poor sleep quality, excessive daytime sleepiness (EDS) and the presence of sleep­disordered breathing, while others have not observed a positive correlation. Objective: To determine the sensitivity of BQ to sleep apnea/hypopnea index (IAH) obtained from overnight standard polysomnography (PSG) and verify the presence of EDS in MG patients. Methods: The Epworth Sleepiness Scale (ESS) and the BQ were applied. After completing the questionnaires, the patients were submitted to PSG. Results: Twenty­two patients (17 women) were evaluated. The mean age was 49.13 ± 11.53. BQ identified 60% of patients as being at high risk for OSA. PSG showed that 54.5% of patients had AHI above 5 and 36.3% AHI above 15. The ESS showed that 68% of the patients presented a score above 10. Conclusion: Our study showed a considerable increase in EDS and The BQ proved good sensitivity to identify patients at risk for OSA in a population of patients with MG.

Noise attenuation plays an important role in seismic data processing and interpretation. In recent years, the anisotropic diffusion filter has received much attention since it has superior performance in edge-preserving while smoothing noise from noisy signals. This work presents a high-performance General Purpose Graphics Processing Unit (GPGPU) structure-preserving smoothing for seismic amplitude data by anisotropic diffusion. The obtained results show that the proposed method runs in iterative time, and is able to remove noise and preserves structural features efficiently. We also compare the computational performance of CPU and GPU implementations and show that GPU is about 14 times faster.

BACKGROUND Background: Sleep-disordered breathing is associated with significant morbidity and mortality, presenting a high prevalence in the general population and being considered today as an important public health problem worldwide, affecting about 45% of the world population. It is estimated that about from 50 to 75% of the elderly complain of difficulties in initiating or maintaining sleep. The regular practice of physical activity of mild to moderate intensity is associated with improved sleep quality in the elderly and has increased its recommendation as one of the main non-pharmacological resources of preventive and therapeutic action. OBJECTIVE Objective: to verify if the regular practice of semi-supervised home-based exercises increases adherence, which influences the improvement of self-reported sleep quality and the reduction of excessive daytime sleepiness in a sedentary elderly population. METHODS Methods: This randomized, controlled, blinded clinical trial was designed, is being conducted and will be reported according to the guidelines of the CONSORT (Consolidated Standards of Reporting Trials) Statement, and is being conducted from July 2016 to December 2017, involving elderly people of both sexes, over 60 years old, living in Senhor do Bonfim. The home physical exercise program is based on the recommendations of the American College of Sports Medicine for exercise and physical activity for the elderly. RESULTS Results: The first expected outcome is the improvement of self-reported sleep quality verified through the PSQI. The secondary outcomes are reduction in excessive daytime sleepiness among the sedentary elderly subjects undergoing the semi-supervised home-based physical exercise program, verified by the ESS, and the adherence of the subjects to the program. CONCLUSIONS Conclusions: We hope that through this study, we can show that the regular practice of semi-supervised home exercises is effective in improving sleep quality and reducing excessive daytime sleepiness in sedentary elderly people and can be considered as a therapeutic, safe, easy-to-implement, and low-cost non-pharmacological resource. CLINICALTRIAL TRIAL REGISTRATION: This protocol study has been approved by the Research Ethics Committee of the Escola Baiana de Medicina e Saúde Pública (Brazil), process no 39072514.6.0000.5544, and was be registered on ensaiosclinicos.gov.br Identificator number: RBR-3cqzfy.

Objective To perform the translation, cultural adaptation and validation of the Myasthenia Gravis Composite (MGC) scale in Brazil. Methods The study was conducted at three neuromuscular disease research centers in accordance with the international ethical standards, following a multi-modal approach and was conducted in three steps consisting of translation, cultural adaptation, and validation according to international guidelines. The final version of the MGC was applied in a sample of 27 MG patients and the total score was compared to a Portuguese version of the MG-QOL-15. Results The internal consistency verified by Cohen’s Kappa test was excellent (0.766). The correlation between the MGC and MG-QOL-15 was strong (R = 0.777; p = 0.000). No significant differences were found between the responses of patients in the first and second applications of the MGC. Conclusion The MGC scale, validated into Brazilian Portuguese, has proven to be a reliable instrument that is easy to use, and is highly reproducible. RESUMO Objetivo Realizar a tradução e a adaptação transcultural da escala composta de Miastenia Grave (ECMG) Myasthenia Gravis Composite (MGC) no Brasil. Métodos O estudo foi realizado em três centros de investigação em doenças neuromusculares, de acordo com as normas éticas internacionais, consistindo em tradução, adaptação cultural e validação de acordo com as diretrizes internacionais. A versão final do MGC ECMG foi aplicada em vinte e sete pacientes com MG e a pontuação total foi comparada ao questionário MG-QOL 15. Resultados A consistência interna verificada pelo teste Kappa de Cohen foi excelente (0,766) e a correlação entre o a ECMG MGC e MG-QOL 15 foi positiva (R = 0,777; p = 0,000). Não foram encontradas diferenças entre as respostas dos pacientes na primeira e segunda aplicação da MGC. Conclusão A ECMG escala MGC validada para o Português do Brasil provou ser um instrumento confiável, de fácil aplicação e altamente reprodutível.

The purpose of this study was to investigate the physiological variables of lung function, respiratory muscle strength, and sleep in clinically stable patients with myasthenia gravis. This was a prospective cross-sectional study conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Patients adhering to the eligibility criteria were consecutively recruited from the Research Department of Neuromuscular Diseases at the Federal University of Sao Paulo and the Department of Neurology at Santa Casa de Misericordia of Sao Paulo and were referred to the Nove de Julho University Sleep Laboratory (Sao Paulo, Brazil). The study included 25 patients (21 female) with a mean age of 45.28 ± 12.33 years. Only one patient exhibited a restrictive ventilatory pattern. The maximum ventilatory pressures observed were considerably reduced in most patients as compared to reference values. In sleep studies, the patients exhibited significantly reduced oxygen saturation, reduced rapid eye movement sleep time, increased non-rapid eye movement stage 3 sleep, and considerable apnoea/hypopnoea indexes. Clinically stable patients with myasthenia gravis exhibit a high prevalence of sleep-disordered breathing, significant reductions in maximum ventilatory pressures, and impairment of health-related quality of life.

Summary In this abstract, we present an improvement in the Minimum Similarity Accumulation (MSA) attribute. The MSA is an efficient approach to highlight discontinuity regions in a seismic volume. We have extended the previous method by using Principal Component Analysis and Restricted Boltzmann Machine in order to reduce the dimension of the input volume preserving relevant features. This approach attenuates the noise interference and significantly improves the quality of the final attribute. As shown in the results, relevant features such as fault and channels are well outlined in the seismic image. The proposed attribute was evaluated on seismic blocks from an offshore region of New Zealand. Non preconditioning was applied.

Background: Involvement of the small airways may be related to increased severity and increased demand for health care services and incurring in high costs, private or for the healthcare system. The hyperinflation consequent to this involvement reduces lung volumes, such as FVC, FEV1 and SVC. The aim of this study was to evaluate the correlation between the predicted values of FVC, FEV1 and SVC with the demand for healthcare services by severe asthmatics. Methods: We retrospectively evaluated in order of arrival, the medical records of 98 patients with severe asthma, in step 4 treatment in the intercritical period of the disease, correlating the number of times each patient sought health care services represented by admissions to the ER, ICU and hospital wards due to asthma, in the year before the last spirometry and the predicted values of FVC, FEV1 and SVC. Results: Our sample showed a clear and significant negative correlation between the predicted values of FVC, FEV1 and SVC and demand for healthcare services. Conclusion: For this sample we conclude, that reduced forced vital capacity correlated with asthma severity, defined by greater demand for care in the ER, ICU and hospital ward and was more evident in women.

The relationship between sleep disorders and bronchiectasis has not been well described. We hypothesize that, due to the irreversible dilatation of the bronchi, the presence of secretions, and airflow obstruction, patients with non-cystic fibrosis bronchiectasis may be predisposed to hypoxemia during sleep, or to symptoms that may lead to arousal. A cross-sectional observational study was performed involving 49 patients with a clinical diagnosis of non-cystic fibrosis bronchiectasis (NCFB). All patients underwent clinical evaluation, spirometry, and polysomnography, and were evaluated for the presence of excessive daytime sleepiness (EDS) and risk of obstructive sleep apnea (OSA). The mean age of the participants was 50.3 ± 13.6 years; 51.1% of patients were male and had a mean body mass index of 23.8 ± 3.4 kg/m2. The mean total sleep time (TST) was 325.15 ± 64.22 min with a slight reduction in sleep efficiency (84.01 ± 29.2%). Regarding sleep stages, stage 1 sleep and REM sleep were abnormal. OSA was present in 40.82% of the patients. The mean arousal index was 5.6 ± 2.9/h and snoring was observed in 71.43% of the patients. The oxygen desaturation index (ODI) was 14.35 ± 15.36/h, mean minimum oxygen saturation (SpO2 nadir) was 83.29 ± 7.99%, and mean TST with an SpO2 less than 90% was 30.21 ± 60.48 min. EDS was exhibited by 53.06% of the patients and 55.1% were at high risk of developing OSA. The patients infected by Pseudomonas aeruginosa had higher apnea-hypopnea indices, ODI, and TST with SpO2 < 90%, and lower values of SpO2 nadir. Adult patients with clinically stable NCFB, especially those infected by Pseudomonas aeruginosa, display EDS and a high prevalence of OSA, associated with considerable oxygen desaturation during sleep.

Introduction: Myasthenia gravis (MG) is a chronic and inflammatory disease characterized by progressive weakness of the skeletal muscles due to changes in the synaptic junctions between nerves and muscle fibres. Typically, patients have a history of progressive weakness and fatigue in skeletal muscles, which occurs during sustained or repeated activities and improves after rest. Scoring systems to assess the degree of disease severity are commonly used in clinical drug trials. Further, specific instruments to assess health-related quality of life (HRQOL) have been designed to measure self-perception of symptoms and wellness during the disease or after disease treatment.HRQOL is an important component of patient evaluation, as some individuals can tolerate severe impairment and disability, while others may be very unhappy even with less severe symptom profiles. The objective of the proposed study is to translate and perform a cultural adaptation and validation of two specific instruments for assessing the clinical course of patients with MG. These instruments include the Quantitative Test for Myasthenia gravis (QMG) and Myasthenia gravis Composite Scale (MGC). Methods and analyses: The study design will follow a multi-method approach, and will be conducted in three stages consisting of translation, cultural adaptation, and validation of the QMG and MGC for Brazilian Portuguese patients. This multi-step process will consider aspects of construct and predictive validity as well as reliability and structure of the instrument. The entire process will follow the procedures proposed and developed in other linguistic and social-cultural contexts based on previous studies. Ethics: This study has received approval from the Human Research Ethics Committee of Nove de Julho University (Brazil) under process no. 360.488 based on the Helsinki declaration and is registered with the World Health Organization (WHO) under Universal Trial Number (UTN) U1111-1147-7853 and the Brazilian Registry of Clinical Trials (REBEC) RBR -7ckpdd.

Introduction Bronchiectasis is a chronic disorder characterised by permanent and irreversible abnormal dilation of the bronchi and bronchioles, primarily caused by repeated cycles of pulmonary infections and inflammation, which lead to reduced mucociliary clearance and to the excessive production of sputum. Patients with non-cystic fibrosis bronchiectasis may be predisposed to hypoxemia during sleep, or to symptoms that may lead to arousals and thereby reduce the quality of life, because of the irreversible dilation of the bronchi and the presence of secretions and airflow obstruction. Methods and analysis For this cross-sectional observational study, patients with a clinical diagnosis of non-cystic fibrosis bronchiectasis will be recruited from the Bronchiectasis Clinic of the Pneumology Department of the Santa Casa de Misericordia Hospital and the Federal University of Sao Paulo (Sao Paulo, Brazil). Patients of either sex will be included if high-resolution CT of the thorax and classic sweat test confirms they have non-cystic fibrosis bronchiectasis, are between 18 and 80 years old, use long-acting bronchodilators, are clinically stable for a least 1 month, agree to participate in the study and they sign a statement of informed consent. The first part of the study will involve a clinical evaluation, maximal respiratory pressures, spirometry and the Saint George9s Respiratory Questionnaire. The Sleep Laboratory of the Master9s and Doctoral Postgraduate Program in Rehabilitation Sciences of the Nove de Julho University (Sao Paulo, Brazil) will perform the polysomnographic studies, Berlin Questionnaire, Epworth Sleepiness Scale, waist and neck circumferences, modified Mallampati classification and tonsil index. Ethics and dissemination This protocol has been approved by the Human Research Ethics Committees of Santa Casa de Misericordia Hospital (process number 178/2012) and Human Research Ethics Committee of Nove de Julho University (process number 370474/2010). All participants will sign a statement of informed consent. The study findings will be published in peer-reviewed journals and presented at conferences.

Introduction: Myasthenia gravis (MG) is a neuromuscular autoimmune disease of unknown etiology, characterized by generalized muscle weakness and fatigue, especially after repetitive physical activities, with consequent improvement after rest. The MG follows a slowly progressive course, which can be fatal failure of the ventilatory muscles. The manifestations of the respiratory system are generally attributed to the weakness of the diaphragm and also accessory muscles of ventilation. Objetive: The objective was to evaluate the volumes and lung capacities and maximum pressure ventilation in patients with clinically stable MG. Methods: This is an observational study involving 15 patients (2 men) with MG. Subjects were recruited consecutively and screened for eligibility using the standardized protocol. Results: Spirometry, only two patients showed abnormalities of respiratory pattern, being a moderate restrictive pattern (50-60% predicted), and another patient with the congenital form showed a severe restrictive pattern. Not obstructive patterns were observed. Our results of spirometry showed an average value of FVC: 3.15 ± 0.77 and FEV1: 2.64 ± 0.65. Regarding the maximum pressure generated by the ventilatory muscles, the average value for the MIP was 45.5 cmH2O among women and the value of 56 cmH2O for men was observed. To MEP it was observed the average value of 45 cmH2O for women and 55 cmH2O for men. Conclusion: We conclude that patients with MG have lower values of maximal inspiratory and expiratory ventilatory associated with normal lung function values.

Introduction: The analysis of heart rate variability (HRV) has been used as a resource for the measurement of autonomic nervous system activity in different situations. This analysis is based on identifying the strength of bands of low and high frequencies of the spectral function of the RR intervals in heart rate. Studies have shown that the related high frequency band parasympathetic tone controls the resting state, while exercise is associated with sympathetic activation, linked to lower frequency bands. The autonomic nervous system plays an important role in mediating the cardiovascular responses induced by stress. Objective: To describe a technique for analysis of heart rate variability in the measurement of autonomic nervous system activity. Discussion: To perform HRV analysis the "Nerve-Express" uses an effective and transparent visual representation, known as rhythmography method which reflects the structure of HRV wave and acts as a "fingerprint" of autonomic regulatory mechanisms. The wave RR intervals are recorded sequentially forming a rhythmogram, namely a picture of curved wave-specific variability of RR intervals.