Decrease In HR Research Articles

Abstract GS4-03: Neoadjuvant nab-paclitaxel weekly versus dose-dense paclitaxel followed by dose-dense EC in high risk HR+/HER2- early BC by: Results from the neoadjuvant part of ADAPT HR+/HER2- trial

Abstract Background: Pathological complete response (pCR) is associated with improved outcome in patients with high-risk HR+/HER2- breast cancer (BC) but the use of (neo)adjuvant chemotherapy in early HR+/HER2- BC remains controversial. Oncotype DX / Recurrence Score (RS) and dynamic Ki67 response after short preoperative endocrine therapy are potentially predictive for pCR. Still, no prospective data are available so far to predict chemotherapy efficacy in this key patient group. Use of dose-dense chemotherapy is associated with improved outcome in meta-analysis, but its use in the neoadjuvant setting is less studied. Furthermore, use of nab-paclitaxel instead of solvent-based paclitaxel has shown promising results in some studies. Here, we present for the first time data from a randomized prospective trial comparing these risk-selection strategies according to RS and Ki67 decrease in high-risk HR+/HER2- BC. Methods: High-risk BC patients [cN0-1 with RS>25 or (RS 12-25 AND (centrally measured) post-endocrine Ki67 >10%] OR [cN2-3 status] OR [G3 AND Ki67>40%] were randomized to (neo)adjuvant 4x paclitaxel175 q2w or 8xnab-paclitaxel 125 mg/m2q1w followed by 4x E90C600 q2w. pCR was defined as no invasive tumor in breast and lymph nodes. Results: 858 patients with available surgery data randomized to neoadjuvant Pac-EC (N=423) or nab-Pac-EC (N=435) were analyzed. Median age was 51 years; median RS was 30 (N=572); 34% had node-positive; 46% (locally) G3 tumors. Baseline characteristics were well balanced between study arms. Patients receiving nab-Pac-EC had higher pCR than those with Pac-EC (20.3% vs. 12.3%, p=.002); patients with RS<25 (about 27%) had a lower pCR rate than those with RS>25 (6.5% vs. 15.8%, p=.003). The association of RS with pCR appeared more pronounced in premenopausal women, but a test of interaction was not significant; RS was about 3 points higher (mean 32.9 vs. 29.8, p<.001) in postmenopausal cases (p=.001). Clinical tumor stage cT2-4 was reported in 65%, with a lower pCR rate than in cT1 tumors (14% vs. 20%, p=.02). RS was moderately correlated (R=.45) with baseline Ki67. In multivariable analysis with tumor stage, RS, Ki67, menopausal status, and ER and PR positivity, higher RS and cT1 stage were favorable for pCR. Excluding RS, higher Ki67 and lower ER (as well as cT1) were favorable. In patients with RS<25, there was no pCR with Pac-EC (0/72 pCR); pCR was almost 20% with RS>25 and nab-Pac-EC. Further details and data including impacts of Ki67 dynamics and additional markers on pCR will be presented at the meeting. Conclusions: Use of neoadjuvant nab-paclitaxel instead of solvent-based paclitaxel appears promising within a short (16-weeks) dose-dense chemotherapy schedule in high-risk HR+/HER2- BC. For the first time, data from a large neoadjuvant randomized trial confirm RS could help to select patients for neoadjuvant chemotherapy in high-risk HR+/HER2- breast cancer (BC). Citation Format: Sherko Kuemmel, Oleg Gluz, Ulrike Nitz, Michael Braun, Matthias Christgen, Kerstin Luedtke-Heckenkamp, Raquel von Schumann, Maren Darsow, Helmut Forstbauer, Jochem Potenberg, Eva-Maria Grischke, Bahriye Aktas, Claudia Schumacher, Ronald Kates, Monika Graeser, Rachel Wuerstlein, Christoph Uleer, Michael Hauptmann, Steve Shak, Rick Baehner, Hans Kreipe, Nadia Harbeck, West German Study Group. Neoadjuvant nab-paclitaxel weekly versus dose-dense paclitaxel followed by dose-dense EC in high risk HR+/HER2- early BC by: Results from the neoadjuvant part of ADAPT HR+/HER2- trial [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr GS4-03.

Ferromagnetism in Mn doped 3C-SiC: A variable temperature ESR study

This paper discusses the effect of defects and role of charge carriers in setting up the long range magnetic order in Mn doped 3C-SiC. Using complementary experiments like temperature variation of Electron Spin Resonance (ESR) and DC magnetic susceptibility, the nature of magnetic interactions, spin dynamics and anisotropy have been investigated. The variation of ESR parameters such as, gvalue, peak to peak line width(ΔHpp), spin density (Ns) and spin–spin relaxation time (T2) as a function of temperature and dopant concentration confirms the presence of exchange interaction present in the system. The decrease in resonance field Hr as a function of temperature indicates the strengthening of internal field already existing in Mn doped 3C-SiC samples. This result confirms that defect induced magnetism could be enhanced by introducing holes in to the host wide band gap semiconductor.

Exercise and pyridostigmine prevents gastric emptying delay and increase blood pressure and cisplatin-induced baroreflex sensitivity in rats

Cisplatin treatment induces an autonomic dysfunction and gastrointestinal and cardiovascular disorders. Physical exercise as well as pyridostigmine treatment induces improves in the autonomic nervous system. In the current study, we investigated the effect of physical exercise and pyridostigmine treatment on gastrointestinal and cardiovascular changes in cisplatin-treated rats. Rats were divided into groups: Saline (S), Cisplatin (Cis), Exercise (Ex), Cisplatin+Exercise (Cis+Ex), Pyridostigmine (Pyr), and Cisplatin+Pyridostigmine (Cis+Pyr). We induced gastrointestinal dysmotility by administering 3 mg kg−1 of cisplatin once week for 5 weeks. The Ex was swimming (1 h per day/5 days per week for 5 weeks with 5% b.w.). GE was evaluated through the colorimetric method of fractional red phenol recovery 10 min after feeding. Pyr groups received 1.5 mg kg−1, p.o. or concomitant Cis treatment. Moreover, gastric contraction in vitro and hemodynamic parameters such as MAP, HR, and evoked baroreflex sensitivity were assessed, as well as sympathetic and parasympathetic tone and intrinsic heart rate (IHR). Cis decrease GE vs. saline (p<0.05). Cis+Ex or Cis+Pyr prevented (p<0.05) decrease in GE vs. Cis rats. Cis decreased (p<0.05) gastric responsiveness in vitro vs. saline. Cis+Ex or Cis+Pyr prevented this phenomenon. Cis treatment increase MAP and decrease in HR (p<0.05) vs saline. Cis+Ex or Cis+Pyr attenuated (p<0.05) both alterations. Cis increased sympathetic tone and decreased vagal tone and IHR (p<0.05) vs. the saline. Cis+Ex or Cis+Pyr prevented those effects vs. the Cis group. In conclusion, physical exercise and pyridostigmine treatment improves autonomic dysfunction and prevented GE delay and changes in hemodynamic parameters, baroreflex sensitivity, and cardiac autonomic control in cisplatin-treated rats.

Comparison of dexmedetomidine versus esmolol (Intravenously) in reduction of cardiovascular responses to intubation during induction of general anesthesia- A randomised clinical trial

Introduction and Aim: The cardiovascular changes to airway manipulation like tachycardia and hypertension occur secondary to catecholamine secretion. These changes make less effects on normal patients but can be hazardous in cardiac compromised patients. Various pharmacological measures are tried to lessen these ill effects. As a result we made an effort to compare the usefulness of two drugs, highly specific ?2 agonist Dexmedetomidine at a dosage of 1µg/kg versus Esmolol 1mg/kg; in reducing these effects during induction of G.A. Materials and Methods: In this randomized clinical trial 102 patients, of age group 18-65 years and American Society of Anesthesiology classification I/ II, undergoing various surgeries under G.A. requiring intubation were distributed into 2 groups of 51 patients each. Group D patients were given Dexmeditomedine1µg/kg in diluted form over a time period of 10 minutes and Group E patients were given Esmolol 1mg/kg diluted to 10 ml and given over 1 min .Induction of anesthesia was done with volatile agent sevoflurane. Maintenance was done with O2 and N2O 30:60 along with vecuronium. Monitoring was done and hemodynamic parameters were recorded at particular intervals during laryngoscopy and intubation of trachea. Results: All observations were expressed as mean and standard deviation. Based on statistical analysis the Baseline heart rate, and baseline mean arterial pressure were comparable in both the groups. The decrease in mean HR observed at, 3, 5 and 10minutes after intubation in Group D was statistically highly significant compared to mean HR in group E (p0.05).The fall in mean MAP values in group D at 1, 3, 5 and 10 minutes of intubation were statistically highly significant (p

Abstract 14691: Heart Rate Trajectories and Clinical Correlates in Patients Recovering From Acute Myocardial Infarction: A Longitudinal Analysis of Apple Watch Heart Rate Recordings

Introduction: Vital signs can provide critical details regarding a patient’s health status for clinical decision making, and confirm feedback on treatments. Using mobile health technology, vital signs such as heart rate can be collected in larger quantities without requiring frequent clinic visits. In this study, we characterized HR trends of patients recovering from acute myocardial infarction (AMI) in the subacute period, with the goals of identifying higher risk patient subgroups. Methods: Between Nov. 2017 and Apr. 2019, type 1 AMI patients were enrolled in the Myocardial infarction, Combined device, Recovery Enhancement (MiCORE) study (NCT03760796). Patient information was collected via Research Electronic Data Capture (REDCap), and HRs were recorded using the Apple Watch and Corrie smartphone app between the time of admission to 30 days post-discharge. Associations with clinical covariates were assessed with multivariable linear mixed regression models (Figure 1). Results: We recruited 91 patients (mean age: 57 +/- 10.9, 74% male) who provided 4,447 HR recordings, with an overall mean daily HR of 74.5 bpm. Patients had a 0.168 bpm decrease in mean daily HR for each consecutive day post-discharge; the exception were patients who had a prior CABG before admission, hypertension, or type 2 diabetes, who had an associated elevation in HR across each day (Figure 1). Six of 11 AMI patients who were readmitted within 30 days exhibited at least 1 HR recording greater than 90 bpm within 3 days of readmission. Conclusions: While most AMI patients had a decrease in HR over the subacute period, we identified high-risk subgroups with increasing HRs (patients with prior CABG, HTN, and T2DM), and elevated HRs in patients three days prior to readmissions. This study highlights the potential of using longitudinal, biometric data sets in discerning higher risk patient populations post-AMI that require more targeted therapy.

Talking to Cows: Reactions to Different Auditory Stimuli During Gentle Human-Animal Interactions.

The quality of the animal-human relationship and, consequently, the welfare of animals can be improved by gentle interactions such as stroking and talking. The perception of different stimuli during these interactions likely plays a key role in their emotional experience, but studies are scarce. During experiments, the standardization of verbal stimuli could be increased by using a recording. However, the use of a playback might influence the perception differently than “live” talking, which is closer to on-farm practice. Thus, we compared heifers' (n = 28) reactions to stroking while an experimenter was talking soothingly (“live”) or while a recording of the experimenter talking soothingly was played (“playback”). Each animal was tested three times per condition and each trial comprised three phases: pre-stimulus, stimulus (stroking and talking) and post-stimulus. In both conditions, similar phrases with positive content were spoken calmly, using long low-pitched vowels. All tests were video recorded and analyzed for behaviors associated with different affective states. Effects on the heifers' cardiac parameters were assessed using analysis of heart rate variability. Independently of the auditory stimuli, longer durations of neck stretching occurred during stroking, supporting our hypothesis of a positive perception of stroking. Observation of ear positions revealed longer durations of the “back up” position and less ear flicking and changes of ear positions during stroking. The predicted decrease in HR during stroking was not confirmed; instead we found a slightly increased mean HR during stroking with a subsequent decrease in HR, which was stronger after stroking with live talking. In combination with differences in HRV parameters, our findings suggest that live talking might have been more pleasurable to the animals and had a stronger relaxing effect than “playback.” The results regarding the effects of the degree of standardization of the stimulus on the variability of the data were inconclusive. We thus conclude that the use of recorded auditory stimuli to promote positive affective states during human-animal interactions in experimental settings is possible, but not necessarily preferable.

Role of oxidative stress in clofazimine-induced cardiac dysfunction in a zebrafish model

BackgroundClofazimine (CFZ), a riminophenazine, is now commonly used in the treatment of multidrug-resistant tuberculosis. However, its use may be potentially associated with cardiac dysfunction in some individuals. In this study, the zebrafish heart, by merit of its developmental and genetic characteristics being in homology with that of human, was chosen as an animal model for evaluation of such dysfunction. MethodsMorphological and physiological parameters were used to assess cardiac dysfunction. Transcriptome analysis was performed, followed by validation with real-time quantitative PCR, for delineation of the relevant genomics. ResultsExposure of 2 dpf zebrafish to 4 mg/L CFZ for 2 days, adversely affected cardiac functions including significant decreases in HR, SV, CO, and FS, with observable pathophysiological developments of pericardial effusion and blood accumulation in the heart, in comparison with the control group. In addition, genes which respond to xenobiotic stimulus, related to oxygen transport, glutathione metabolism and extracellular matrix -receptor interactions, were significantly enriched among the differentially up-regulated genes. Antioxidant response element motif was enriched in the 5000 base pair upstream regions of the differentially expressed genes. Co-administration of N-acetylcysteine was shown to protect zebrafish against the development of CFZ-induced cardiac dysfunction. ConclusionsThis study suggests an important role of oxidative stress as a major pathogenetic mechanism of riminophenazine-induced cardiac dysfunction.

Changes in Total Cholesterol and Heart Rate in Normotensive and Hypertensive Rats under Combined Influence of Cold Exposure and Hypokinesia.

We studied the effect of hypokinesia alone and in combination with cold exposure on HR and total cholesterol content in the blood serum of Wistar, WKY, and SHR rats. Irrespectively of the season, hypokinesia was associated with a decrease in HR, which is probably a result of reduced body needs due to deceleration of metabolic processes. A significant increase in total cholesterol was found under conditions of cold exposure combined with hypokinesia, which indicates qualitative structural rearrangement of energy metabolism under the influence of environmental factors. In winter, the increase in total cholesterol concentration was more pronounced (by 51.5%) in the group of hypertensive animals. Presumably, the increase in the serum concentration of total cholesterol under conditions of hypokinesia and cold exposure is a predictor of structural changes in the heart.

Excessive exercise induces cardiac arrhythmia in a young fibromyalgia mouse model.

Fibromyalgia patients experience cardiovascular complications in addition to musculoskeletal pain. This study aimed to investigate the cardiac effects of a prolonged shallow water gait in a fibromyalgia-induced young mouse model. To produce a fibromyalgia mouse model, wild-type mice were administered an intraperitoneal injection of reserpine once a day for three days, and two primary experiments were performed. First, three types of gait tests were performed before and after the reserpine injections as follows: (i) 5 minutes of free gait outside the water, (ii) 1 minute of free gait in shallow warm water, and (iii) 5 minutes of free gait in shallow warm water. Second, electrocardiogram recordings were taken before and after the three gait tests. The average heart rate and heart rate irregularity scores were analyzed. Exercise-induced cardiac arrhythmia was observed at 1-minute gait in shallow water during the acute stage of induced FM in young mice. Further, both cardiac arrhythmia and a decrease in HR have occurred at 5-minute gait in shallow water at the same mice. However, this phenomenon was not observed in the wild-type mice under any test conditions. Although a short-term free gait in shallow warm water may be advantageous for increasing the motor activity of FM-model mice, we should be aware of the risk of prolonged and excessive exercise-induced cardiac arrhythmia. For gait exercises in shallow water as a treatment in FM patients. We suggest a gradual increase in exercise duration may be warranted.

Does gallic acid improve cardiac function by attenuation of oxidative stress and inflammation in an elastase-induced lung injury?

Objective(s):Cardiovascular disease has an important role in mortality caused by lung injury. Emphysema is associated with impaired pulmonary gas exchange efficiency and airflow limitation associated with small airway inflammation. The aim was to evaluate the interactions between lung injury, inflammation, and cardiovascular disease. Since gallic acid has antioxidant and anti-inflammatory effects, we hypothesized that gallic acid protects the lung and the related heart dysfunction in elastase-induced lung injury. Materials and Methods:Forty-eight Sprague-Dawley male rats were randomly divided into six groups: Control, Porcine pancreatic elastase (PPE) , PPE+GA, and 3 groups for different doses of gallic acid (GA 7.5, GA 15, GA 30 mg/kg). PPE was injected intra-tracheally on days 1 and 10 of the test. In each group, electrocardiography, hemodynamic parameters, oxidative stress, and bronchoalveolar lavage fluid were examined.Results:PPE administration showed a decrease in HR and QRS voltage of electrocardiogram parameters, as well as in hemodynamic parameters (P<0.05, P<0.01, and P<0.001) and superoxide dismutase (SOD) (P<0.05). Tumor Necrosis Factor α (TNF-α) (P<0.001), interleukin 6 (IL-6) (P<0.001), interleukin 6 (MDA) (P<0.001), and the total number of white blood cells (P<0.001) showed an increase in PPE groups. Gallic acid preserved the values of hemodynamic properties, oxidative stress, inflammation, and electrocardiogram parameters in comparison to the PPE group.Conclusion:Briefly, this study showed the valuable effect of gallic acid in cardiac dysfunction related to elastase-induced lung injury. These findings suggested that gallic acid, as a natural antioxidant, has a potential therapeutic effect on preventing oxidative stress, inflammation, and subsequent cardiovascular disease.

Exposure to total 36-hr sleep deprivation reduces physiological and psychological thermal strain to whole-body uncompensable passive heat stress in young adult men.

Total sleep deprivation (TSD) is associated with endothelial dysfunction and a consequent decrease in vascular reactivity and increase in peripheral vascular resistance. These effectors compromise the body's ability to thermoregulate in hot and cold stress conditions. We investigated heat-unacclimated young adult men (26±2years) to determine whether 36hr of TSD compared to an 8 or 4-hr sleep condition, would suppress the responses of the autonomic system (body rectal temperature [Tre ], heart rate [HR], root mean square of successive interbeat intervals, physiological strain, blood pressure [BP], circulating blood catecholamines, sweating rate and subjective sensations) to whole-body uncompensable passive heat stress in traditional Finnish sauna heat (Tair =80-90°C, rh=30%). Sauna bathing that induced whole-body hyperthermia had a residual effect on reducing BP in the 8-hr and 4-hr sleep per night conditions according to BP measurements. By contrast, 36hr of total wakefulness led to an increase in BP. These observed sleep deprivation-dependent differences in BP modifications were not accompanied by changes in the blood plasma epinephrine and norepinephrine concentrations. However, during sauna bathing, an increase in BP following 36hr of TSD was accompanied by significant decreases in body Tre , HR and physiological strain, together with a diminished sweating rate, enhanced vagus-mediated autonomic control of HR variability, and improved thermal perception by the subjects. Our results suggest the impaired ability of the body to accumulate external heat in the body's core under uncompensable passive heat conditions following 36hr of TSD, because of the TSD-attenuated autonomic system response to acute heat stress.

Pacing, Exercise Intensity, and Technique by Performance Level in Long-Distance Cross-Country Skiing.

IntroductionLong-distance cross-country skiing (XCS) has gained increased popularity within the past decades. However, research about long-distance XCS is limited; therefore, the aim of this study was to analyze the intensity distribution, technique application, and pacing strategies during long-distance XCS racing.MethodsHeart rate (HR) and section skiing speeds of 9 elite (ranked 1–100) and 10 amateur skiers (ranked 101–1,500) during the 90-km Vasaloppet race were collected. In addition, during the first uphill, the first 1,000 skiers were video-recorded to analyze the applied skiing strategy (e.g. grip-waxed skis versus exclusive double poling).ResultsMean race intensity was 82% of maximal HR and was not different between performance groups even though elite skiers skied ∼15% faster than amateurs. There was an interaction effect of section × group with a pronounced decrease in HR in amateurs compared with more even pacing in elite skiers (0.13 vs. 0.04% decrease/km) and skiing at higher percentage in the high-intensity zones in elite compared with amateurs (46 vs. 24%). Ninety-eight percent of the top 100 skiers and 59% of the first 1,000 skiers used exclusively double poling.ConclusionElite and amateur skiers ski at comparable mean race exercise intensity, but they have clear differences in skiing speed. The difference in the pacing profiles between elite and amateur skiers (more even vs. distinct positive pacing) demonstrate the greater capacity of the former with respect to physiological capacity and highlights that amateurs seem to start too fast according to their capacities. The exclusive application of the double poling technique is no longer a phenomenon of elite skiers but is widely used among the top 1,000 ranked skiers.

Opioid free anesthesia in patients undergoing three-ports laparoscopic cholecystectomy

Abstract Background: After considerable experience with laparoscopic cholecystectomy (LC) using four ports, Authors began the three‐port LC. Opioid free anesthesia OFA means a technique in which no intraoperative opioid is administered through any route. Objectives: Study aims to assess both of the safety while using 3 ports during the laparoscopic cholecystectomy procedures and the efficiency of the Opioid Free Anesthesia throughout the perioperative period. Patients and Methods: Patients were scheduled for elective laparoscopic cholecystectomy and classified randomly into two groups, each one contained 25 patients. Group one has submitted for Opioid Based Anesthesia protocol and group two has submitted to Opioid Free Anesthesia protocol. Surgical technique was Laparoscopic cholecystectomy and it was first tried by 3 port then the fourth port is inserted when indicated. Results: Three‐port LC successfully performed in 92% of cases of the study with safety. There were a statistically significant decrease in perioperative HR, and MAP. Study showed decrease in VAS score, post-operative Pethidine consumption and PONV. No major postoperative complications, as bile leakage or bleeding have been reported. Conclusion: Three‐port LC is a safe and technically feasible. Also OFA is superior to (OA) in anesthesia of patients undergoing LC.

Evaluation of King's vision videolaryngoscope and glidescope on hemodynamic stress response to laryngoscopy and endotracheal intubation.

Background and Aims:We hypothesis that the use of novel airway devices would decrease hemodynamic stress response (HDSR) to laryngoscopy and endotracheal (ET) intubation. The aim of our study was to evaluate the hemodynamic stress response (HDSR) to laryngoscopy and tracheal intubation using the King vision video laryngoscope (KVVL) versus glidescope (GLS).Material and Methods:A prospective randomized, comparative study that was conducted on 80 patients of both sexes; American Society of Anesthesiologists physical status I and II with no anticipated difficult airway, aged 20–60 years; who were scheduled for elective surgical procedure under general anesthesia. Patients were randomly allocated into two groups (40 each). Group I: laryngoscopy and tracheal intubation were carried out using KVVL, Group II: laryngoscopy and tracheal intubation were carried out using GLS. The two groups were compared for noninvasive hemodynamic data such as heart rate and mean arterial pressure. Time to successful intubation and number of attempts were recorded. Hemodynamic parameters were recorded at the preinduction, after induction, at intubation, 1 min, 3 min, 5 min, 10 min, and 15 min.Results:There was significant decrease (P < 0.05) in HR and MBP in both groups just before intubation. In comparison with the baseline, HR and MBP in group I and group II increased but this difference was not significant at 3 min and 5 min after intubation and returned to the baseline at 10 min after intubation and below the baseline at 15 min after intubation. Also, there were no significant differences in the hemodynamic response between the studied groups.Conclusion:Novel airway devices either KVVL or GLS are efficient in reducing HDSR to laryngoscopy and ET intubation.

Effect of ultrasound-guided L1/L2 paravertebral block in decreasing drug requirements during general anesthesia in patients undergoing hip surgeries; randomized controlled trial

ABSTRACT Background: The aim of this study is to investigate that combinig Lumbar paravertebral block and GA decreases postoperative pain, blood loss and the need for hypotensive drugs. Methods: After ethical committee approval. A randomized, controlled; double-blinded study registered (NCTR 03422354). The study was conducted in Cairo university hospital from 15/02/2018/to 21/06/2018. Seventy-four patients were randomly allocated into two groups using computerized generated random tables: Group P: 37 patients received single-shot L1-L2 paravertebral block before GA. And Group G: 37 patients received GA. The primary outcome was the required dose of hypotensive drugs in both groups. Results: There were no statistical differences in hypotensive drug requirements between both groups. On the other hand, there were remarkable differences in all analgesics that were used in both groups as the total doses were much less in the group (P) than in the group (G). There was a statistically significant decrease in both MBP and HR in the group (P) in 30, 60 and 120 min after induction of anesthesia. Group P showed a lower level of VAS with statistical differences in the first 30 min after recovery and the subsequent 4 h (2 and 4). After 4 h the VAS was low in both groups and was noncomparable between the two groups. Conclusion: U/S guided L1/L2 PVB produces proper intraoperative hemodynamic control. It is also a safe and excellent alternative of analgesia that decreases the perioperative opioids requirements. However, there were no difference in the total dose of hypotensive drugs and the total blood loss.

BIOMECHANICAL, PHYSIOLOGICAL AND AGE-RELATED FEATURES OF PERSONIFICATION AND INDIVIDUALIZATION DURING QUICKNESS AND SPEED-STRENGTH QUALITIES ENHANCEMENT IN YOUNG WEIGHTLIFTERS

Aim. The article deals with studying biomechanical, physiological, and age-related features in young weightlifters during quickness and speed-strength qualities enhancement. Materials and methods. The study was conducted at the precompetitive stage of preparation. Weightlifters aged 14–15 and 16–17 years (n = 15) participated in the experiment. Body composition was studied with the Tanita BC-418AA computer analyzer. The spatial characteristics of spine segments were investigated with the help of the MBN-Scanner computer equipment. Postural studies were conducted with the stabilometric systems produced by MBN Russia. Blood flow spectral analysis was performed using impedance rheography (the Centaur diagnostic system). Results. The body composition of young weightlifters was varied in the following range: muscle mass – 52.4–53.9%, fat mass – 9.0–10.2%. BMI was equal 25.64 kg/m2. The data of the orthostatic test in young weightlifters revealed significant changes in HR, total spectrum power (TSP), and stroke volume regulation (SV) in the experimental group (p &lt; 0.05). In the control group, HR changes were higher than in the experimental group. In 50% of athletes from the groups of sports performance enhancement, eukinetic blood flow was revealed, in 32% – hypokinetic, and in 18% – hypertonic. After a year of training, a consistent increase in stroke volume (SV) was registered, as well as a decrease in HR, peripheral vascular resistance (PVR), heart index, and arterial blood pressure. Conclusion. The control system allows revealing in time the problems connected with weightlifters’ preparation, offering rehabilitation measures, and transforming the training process itself (its orientation, volume, intensity) to optimize body functioning in young weightlifters.

Role of the prefrontal lobe in young normotensives with a family history of hypertension and hypertensives.

Accumulating evidence has demonstrated a significant relationship between prefrontal lobe and hypertension. Elevated blood pressure is usually associated with a prefrontal hemodynamic abnormality. However, the detailed process is still unclear. In this study, we designed a startle protocol and tested the response of the cerebral cortex and cardiovascular system in young normotensive subjects with a family history of hypertension (FH+). Additionally, the cold forehead test (CFT) was performed in hypertensive subjects. In total, 40 young normotensive subjects (21 with FH+ and 19 without a family history of hypertension (FH-)) and 49 middle-aged subjects (21 normotensives (NT) and 28 hypertensives (HT)) were recruited. Our results showed that the magnitude of startle-evoked alpha oscillation at the parasympathetic-related prefrontal cortex (FP1 and FP2) in the FH+ group was significantly smaller than in the FH- group. Acute bradycardia (RRI increase) was observed in FH- subjects but disappeared in the FH+ group. The coupling between instant cardiac acute response (increased RRI) and prefrontal arousal (magnitude of evoked oscillation) was significantly weakened in the FH+ group compared with the FH- group. Furthermore, the decrease in HR induced by parasympathetic outflow during CFT was absent in HT subjects. Hence, we concluded that the impairment of parasympathetic outflow derived from the prefrontal lobe occurs in both healthy young offspring of hypertensive and hypertensive patients.

Comparison between Magnesium Sulphate and Ketorolac Intravenous Infusion on Characteristics of Spinal Anesthesia

AbstractBackground: Spinal anesthesia is used widely for many procedures, many adjuvants had been used to prolong duration of sensory and motor block and improve post-operative pain.Aim of Study: The aim of this study is to compare the effect of magnesium sulphate and ketorolac intravenous infusion on sensory and motor blockage, hemodynamic pa-rameters, duration of analgesia and side effects during spinal anesthesia.Patients and Methods: Patients were classified randomly into three groups (30 patients each) Group M (Magnesium sulphate Group), Group K (Ketorolac Group), Group C (Con-trol Group). Group M patients received a loading dose of magnesium sulphate 40mg/kg IV over 10min followed by 15mg/kg/h IV infusion, Group K patients received a loading dose of ketorolac (0.4mg/kg) (IV) over 10min followed by 0.8mg/kg/h IV infusion. Group C received 50ml of saline (IV) over 10min followed by saline infusion. After ensuring free flow of cerebrospinal fluid, 3mL of bupivacaine (0.5%) injected Pulse rate, electrocardiography, non-invasive blood pressure and SpO2 monitored continuously. Measurements: Demographic data (age, weight, BMI, ASA physical status). Hemodynamic (HR, MAP, SpO2) before giving study drugs, 10min after giving study drugs and after reaching the maximal level of spinal anesthesia and then every 30min till end of surgery. Onset of sensory blockade has been assessed by pinprick method. Onset of motor blockade has been assessed by modified Bromage Scale. Level of sensory and motor blockade has been checked at 3, 5, 10 and 15min after spinal anesthesia and then every 20min throughout the surgery. Time to achieve complete regression from sensory and motor blockade has been noted. All the durations were calculated considering the time of spinal injection as zero time. Post-operatively analgesia has been assessed by the Visual Analog Scale (VAS). The time at which analgesia was first received and total analgesic requirement in 24h was recorded. Patients observed for any adverse effects such as nausea, hypotension.Results: There were insignificant changes between the three groups in HR and MAP but there was significant decrease in HR and MAP in each group at 10min, maximal level and 30min in comparison with base line. There were insignificant changes in onset and duration of sensory and motor block in the three studied groups.The total dose of analgesic consumption (pethidine (mg)) showed significant decrease in Group M in comparison with Group K & Group C with insignificant change between Group K & Group C.The time of first rescue analgesia showed significant increase in Group M in comparison with Group K & Group C and insignificant changes in Group K in comparison with Group C.Conclusion: Addition of intravenous magnesium sulphate with spinal anaesthesia provides significant decrease in post-operative analgesic requirements and prolongs the time of the first rescue analgesia as compared to intravenous ketorolac with spinal anaesthesia.

Acute Soy Supplementation Improves 20-km Time Trial Performance, Power, and Speed.

Isoflavones, a chemical class of phytoestrogens found in soybeans and soy products, may have biological functions similar to estradiol. After binding with ERβ or perhaps independently of estrogen receptors, isoflavones may augment vascular endothelial relaxation, contributing to improved limb blood flow. To determine if acute fermented soy extract supplementation influences 20-km time trial cycling performance and cardiac hemodynamics compared with a placebo. Subjects included 25 cyclists and triathletes (31 ± 8 yr, V˙O2peak: 55.1 ± 8.4 mL·kg·min). Each subject completed a V˙O2peak assessment, familiarization, and two 20-km time trials in randomized order after ingestion of a fermented soy extract supplement or placebo. The fermented soy extract consisted of 30 g powdered supplement in 16 fl. ounces of water. The placebo contained the same quantities of organic cocoa powder and water. Each trial consisted of 60 min of rest, 30 min at 55% Wpeak, and a self-paced 20-km time trial. Soy supplementation elicited a faster time to 20-km completion (-0.22 ± 0.51 min; -13 s), lower average HR (-5 ± 7 bpm), and significantly greater power (7 ± 3 W) and speed (0.42 ± 0.16 km·h) during the last 5 km of the time trial compared with placebo. Analysis of the results by relative fitness level (<57 vs ≥ 57 mL⋅kg⋅min) indicated that those with a higher level of fitness reaped the largest performance improvement alongside a reduced HR (-5 ± 7 bpm). Ingestion of a fermented soy extract supplement improved sprint-distance performance through improvements in both power and speed. For those with great aerobic fitness, soy supplementation may help to decrease cardiac demand alongside performance improvement.

Correlation between Carbon Dioxide Production and Mean Arterial Blood Pressure in Fluid Response in Mechanically Ventilated Patients

AbstractBackground: Volume expansion through fluid administra-tion is one of the simplest approaches for initial treatment of hemodynamic instability. In the Intensive Care Unit (ICU) a newly available technique called volumetric capnography (Vcap) allows measurement of carbon dioxide production (VCO2) on a regular basis at the bedside.Aim of Study: The aim of the study was to evaluate VCO2 as an endpoint predictor for fluid resuscitation in mechanically ventilated patients.Methods and Material: This prospective cohort study was carried out on 70 patients in Tanta University Hospitals at surgical ICU from August 2017 till August 2018. All patients included in the study were on controlled mechanical ventilation with tidal volume 6-8ml.kg–1 ideal body weight. Wide bore intravenous lines were inserted and patients were completely sedated and monitored by; pulse oximeter, non-invasive blood pressure monitoring, ECG all connected to monitor (infinium medical-OMNI lll-FL33773-USA). Volumetric capnogram, end tidal capnogram, detected by Y-Piece and sample line connected to (GE Healthcare Finland Oy, E-sCOVX-00- Finland). Bispectral Index (BIS) to assess the depth of sedation (should be between 40-60). Intravenous fluids were given after hypotension till MAP >65mmHg.Results: There was significant increase in MAP and VCO2 and significant decrease in HR after fluid resuscitation and there was no significance difference in BIS, SpO2. There was positive correlation between VCO2 and MAP with sensitivity of VCO2 for fluid responsiveness 92%.Conclusions: VCO2 and EtCO2 are good monitoring toolswhichare well correlated with hemodynamic changes, thus can be used as an indicator for fluid responsiveness and endpoint prediction ofresuscitation.