Disorders Of Thermoregulation Research Articles

THERMOGRAPHIC EVALUATION OF GOUT COURSE IN COMBINATION WITH NON-ALCOHOLIC FATTY LIVER DISEASE AND TREATMENT

Summary. Gout is an urgent problem today, as its prevalence has doubled in recent decades. Disorders of thermoregulation and regional blood flow are an important clinical and pathogenetic manifestation of gout, which can be assessed by recording infrared radiation.
 The aim – to evaluate the thermographic semiotics of gout and thermographic indicators of its course in concomitant non-alcoholic fatty liver disease (NAFLD) and the effectiveness of their treatment.
 Material and Methods. 74 male gout patients were examined. They were divided into 2 groups. Group I included 38 patients with gout without liver damage, group II – 36 patients with NAFLD. Both groups were divided into subgroups: IA and IIA who received basic therapy, IB and IIB who additionally received carbon enterosorbent. The control group consisted of 20 healthy individuals. Thermographic study was performed using a thermal imager ULIRvision TI 120.
 Results. The temperature gradient of symmetrical areas in healthy individuals (control group) was (0.37±0.04) °C. In all patients before treatment thermograms shows a zone of intense hyperthermia with clear contours, which exceeded the size of the visible hyperemia in the affected joint. The temperature gradient in patients with gout without liver damage was (3.99±0.17) °C, and in patients with concomitant NAFLD – (4.41±0.14) °C (p>0.05). On thermograms after treatment in most patients of both groups there was still a zone of hyperthermia. It was smaller in area and intensity, the clarity of the contours was lost. Therapy results were significantly better in patients receiving basic therapy with enterosorbent, but they still did not meet the norm (p<0.05).
 Conclusion. Thermography makes it possible to determine the change in local temperature of the affected joints at gout during exacerbation, to establish the location and prevalence of the pathological process and to assess the effectiveness of treatment.

Studi Kasus Perubahan Termoregulasi BBLR Dalam Perawatan Metode Kanguru Di Ruang NICU RS Siti Khodijah Muhammadiyah Cabang Sepanjang

Low birth weight (LBW) is a newborn with a weight < 2500 grams regardless of gestational age. LBW is one of the main causes of death, morbidity and disability in neonates. The problem that often occurs in LBW is disturbed thermoregulation. Disorders of thermoregulation can be in the form of hypothermia.Objective:  This case study studies how the thermoregulation of low birth weight changes in kangaroo care in the NICU room of Siti Khodijah Muhammadiyah Hospital branch Sepanjang.Methods:  The research uses a case study approach. The sample of this study was 2 LBW respondents. The final result of direct observation at the time of PMK and written on the observation sheet. The unit of analysis in this case study is the characteristics of LBW, the success of PMK, and changes in LBW thermoregulation with PMK.Results:  The results of the two respondents in the LBW category were marked by birth weight between 1501 grams - 2499 grams with gestational age < 37 weeks, the success of the successful PMK category was marked by an increase in body temperature, slow sucking reflex, no vomiting, maternal milk production between 10-15 cc/2 hours, The baby's weight was fixed, and changes in LBW thermoregulation in the PMK category of normal/stable body temperature were proven to have an increase in temperature before PMK was carried out until the first 1 hour of PMK.Conclusion:  Changes in the thermoregulation of LBW in the PMK of the two respondents, there was an increase in body temperature/stable during the first 1 hour of PMK

Перинатальні аспекти порушень раннього неонатального періоду в дітей при COVID-19, перенесеному матір’ю під час вагітності

through various mechanisms: increased rates of preterm birth, placental infection that can disrupt placental-fetal exchange, and through transmission of the virus in utero, during childbirth or after birth. Purpose - to determine the characteristics of the state of newborns and the neonatal period, depending on the severity of the mother’s illness with COVID-19. Materials and methods. Under observation were 14 newborns (group 1), whose mothers were ill with severe COVID-19 and needed intensive care in the department of anesthesiology and intensive care, and 46 children from mothers with moderate COVID-19, who were treated in the infectious diseases and obstetrics department (group 2). Results. In mothers with COVID-19, especially when the disease is severe, the fetus is exposed to direct and indirect negative effects of a viral infection, which is confirmed by signs of placental insufficiency in the vast majority of pregnant women (71.4%) and its clinical manifestations in the form of distress and fetal growth retardation (50.0% and 35.7%, respectively), placental dysfunction was confirmed pathohistologically. Dangerous for the fetus are oligohydramnios in 50.0% of women up to ahydramnios (14.3%), preeclampsia (14.3%), caesarean section (57.1%), premature rupture of fruit membranes (14.3%) and preterm birth (28.0%). 42.9% of children are born in a state of asphyxia, with 14.3% having severe asphyxia, 35.7% of children were born weighing less than 2500 g. A positive test for COVID-19 was observed in 7.1% of newborns. 21.4% of children were diagnosed with pneumonia, 35.7% had respiratory distress syndrome. Children from mothers with COVID-19 have a high incidence of maladaptation syndromes (64.3%). In addition to RDS, there was a high incidence of neurological disorders (57.1%) in the form of a syndrome of depression, gastrointestinal syndrome (50.0%), thermoregulation disorders (42.9%), and 35.7% had hypoglycemic and hemorrhagic syndromes. Necrotizing enterocolitis was diagnosed in children with pneumonia on the 5-7th day of life. Conclusions. Disorders in children from mothers with COVID-19 at birth and a high incidence of maladjustment syndromes, the risk of health and cognitive impairment in the future necessitate further scientific research, active follow-up of this new cohort of children and the development of prevention and rehabilitation measures. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

FEATURES OF PREGNANCY WITH VIRAL HEPATITIS B

To date, insufficient data have been accumulated on the impact of maternal hepatitis B virus (HBV) infection on the course and outcomes of pregnancy, and data from published studies on this issue are contradictory.
 The aim of the study. Determination of the features of the course of pregnancy, the state of the fetus and the newborn in viral hepatitis B.
 Research materials and methods. 86 pregnant women with HBV were comprehensively examined (main group). 50 healthy pregnant women are included in the control group. Descriptive statistics methods used in biology and medicine were used.
 Research results. The majority (67.4%) of patients with HBV are diagnosed with the inactive carrier phase, 27.9% with the replicative phase. Among obstetric and perinatal complications in women with HBV, early preeclampsia (30.2%) and the threat of abortion (29.1%), placental insufficiency (31.4%), gestational diabetes (17.4%), anemia I are most often noted and II half of pregnancy (26.7 and 29.1%), signs of fetal distress in the form of distress (26.7%) and growth retardation (14.1%). Polyhydramnios was observed in 17.4%. 2 (2.3%) cases of early pregnancy loss (miscarriage) were recorded. 20.9% of patients with hepatitis B were delivered surgically, premature birth occurred in 14.0% of patients. High frequency of fetal distress during childbirth (18.6%) and pathological blood loss (15.1%). 26.7% of women with HBV gave birth to asphyxiated children (2.3% had severe asphyxia). In 19.7% of cases, children were born with reduced body weight, in 11.6% - with signs of hypotrophy, in 8.1% of children signs of intrauterine infection were noted. Violations of the period of neonatal adaptation in the form of gastrointestinal syndrome, muscle hypotonia, increased neuroreflex excitability, thermoregulation disorders were observed in 18.6% of children. In 2 (2.3%) children born to women with HBV in the replication phase at a high level of viral load, intrauterine HBV infection was diagnosed, which was confirmed by positive PCR at 3 and 6 months.
 Conclusions. Various obstetric and perinatal complications were observed in 38 (44.2%) pregnant women with HBV; further in-depth studies are needed to clarify the pathogenetic mechanisms of such disorders and identify risk factors.

Integrated model of health risk assessment for workers having to work outdoors under exposure to cooling meteorological factors

Natural resources extraction involves continuous exposure to cooling meteorological factors typical for open production grounds. This necessitates relevant health risk assessment and management of health risks caused by exposure to these harmful occupational factors. However, the available risk assessment models do not provide a possibility to perform complete assessment of the existing risks created by exposure to meteorological hazards. The study design included the following. We performed hygienic assessment of working conditions and health of workers employed by “Samotlorneftegaz” Joint Stock Company (JSC) who had to perform their work tasks under exposure to cooling meteorological factors on open production grounds; the assessment involved calculating the group health risk. Individual peculiarities were assessed using subjective (547 people took part in questioning) and objective assessment methods (76 people took part in estimating thermal state of their bodies and 54 people participated in thermometry with cold stress). Finally, we assessed prior and posterior risks. The prior group risk assessment made it possible to identify risk groups who had a significant risk of developing occupational and non-occupational diseases and to rank working places as per health hazards. The posterior risk assessment confirmed the results produced by the prior risk assessment regarding potentiating negative effects produced by cooling meteorological factors. The assessment of developing general and local thermoregulation disorders revealed that certain individual peculiarities made a substantial contribution into their development. Among them, we can mention long-term outdoor work (60 % of work time or more) under exposure to cooling meteorological factors; a chronic pathology; tobacco smoking. The results produced by this study allowed us to suggest an integrated model for risk assessment, management and communication about health risks caused by working under exposure to cooling meteorological factors.

Комплексная модель оценки риска нарушений здоровья при работе на открытой территории в условиях воздействия охлаждающих метеорологических факторов

Natural resources extraction involves continuous exposure to cooling meteorological factors typical for open production grounds. This necessitates relevant health risk assessment and management of health risks caused by exposure to these harmful occupational factors. However, the available risk assessment models do not provide a possibility to perform complete assessment of the existing risks created by exposure to meteorological hazards. The study design included the following. We performed hygienic assessment of working conditions and health of workers employed by “Samotlorneftegaz” Joint Stock Company (JSC) who had to perform their work tasks under exposure to cooling meteorological factors on open production grounds; the assessment involved calculating the group health risk. Individual peculiarities were assessed using subjective (547 people took part in questioning) and objective assessment methods (76 people took part in estimating thermal state of their bodies and 54 people participated in thermometry with cold stress). Finally, we assessed prior and posterior risks. The prior group risk assessment made it possible to identify risk groups who had a significant risk of developing occupational and non-occupational diseases and to rank working places as per health hazards. The posterior risk assessment confirmed the results produced by the prior risk assessment regarding potentiating negative effects produced by cooling meteorological factors. The assessment of developing general and local thermoregulation disorders revealed that certain individual peculiarities made a substantial contribution into their development. Among them, we can mention long-term outdoor work (60 % of work time or more) under exposure to cooling meteorological factors; a chronic pathology; tobacco smoking. The results produced by this study allowed us to suggest an integrated model for risk assessment, management and communication about health risks caused by working under exposure to cooling meteorological factors.

Wireless and Flexible Skin Moisture and Temperature Sensor Sheets toward the Study of Thermoregulator Center.

A disorder in the thermoregulator center in a human body leads to some potential diseases such as fever and hyperthyroidism. To predict these diseases early, monitoring the health condition of the human body due to the influence of thermoregulation disorders is important. Although extensive works are performed on sweat-rate detection by constructing microfluidic channels, skin-moisture evaporation before sweating remains unknown. This work proposes a wireless and flexible sensor sheet to investigate the thermoregulatory responses of different people under cold stimulation and exercise by measuring the temperature and moisture variations on the finger skin. An integrated flexible sensor system consists of a ZnIn2 S4 nanosheet-based humidity sensor and carbon nanotube/SnO2 temperature sensor. The results exhibit distinct thermoregulation abilities of five volunteers. Interestingly, the sudden increase in finger moisture that results from the excitation by the sympathetic nerve is observed during the cold-stimulus test. Although further studies are required to predict the potential diseases resulted from thermoregulation disorders in human body, this study provides a possibility of continuous and real-time monitoring of thermoregulatory activities via skin moisture and temperature detection using a flexible sensor sheet.

COVID-19 in healthcare workers (literature review and own data)

Introduction. Health care workers are at risk of infection with the SARS-CoV-2 virus. However, many aspects of the professionally conditioned COVID-19 are still poorly understood. The aim of study is to conduct a brief review and analysis of scientific data on the prevalence, features of clinical and laboratory COVID-19 syndromes in medical professionals. To evaluate the structure of post-COVID syndrome in health care workers who are observed in a large multidisciplinary medical organization that has a center for occupational pathology. To present the current state of the problem of examination of the connection of COVID-19 with the profession and admission to work in conditions of high risk of SARS-CoV-2 infection. Materials and methods. At the first stage, a brief review of the literature on the problem of COVID-19 in health care workers was performed, at the second - a single-center observational prospective study of COVID-19 convalescents. The main group consisted of health care workers (n=203), the comparison group - people who do not have occupational health risks (n=156). The groups were comparable in demographic characteristics. The work experience of the medical staff was 15 (5; 21) years. Of the participants in the main group, 20.2% worked in hospitals, and 79.8% in outpatient institutions. Three of the participants (1.5%) were employees of specialized COVID hospitals. Doctors were 25.6%, secondary medical personnel - 51.7%, junior medical and technical personnel - 22.7%. A severe form of COVID-19 was suffered by 25 (12.3%) people, after the artificial ventilation of the lungs (AVL) - two participants. The observation time is 60 days. Statistical analysis included standard methods of descriptive statistics, determination of relationships by the method of logistic regression. The significance level is p<0.05. Results. Most of the known data on COVID-19 in health care workers is obtained in cross-sectional studies. The possibility of occupational infection has been sufficiently proven. The risk probably depends on the work performed and is higher in conditions of direct contact of medical personnel with adults, potentially infected patients, but not in a specialized hospital. It is possible that the course of COVID-19 in health care workers differs from the general population of patients there is evidence of a greater frequency of weakness and myalgia. Studies of the features of post-COVID syndrome in health care workers in available sources could not be identified. According to the results of their own research, health care workers who had experienced COVID-19 had a higher frequency of central thermoregulation disorders, arrhythmias, heart failure, panic attacks and depression. Conclusions. Health care workers are at risk of COVID-19. Professionally conditioned post-COVID syndrome is characterized by the frequency of violations of the central mechanisms of thermoregulation and arrhythmias. COVID-19 in health care workers meets the definition of occupational disease.

The frequency of select adaptation disorders in preterm newborns

Background: Preterm birth, defined as the birth of an infant before 37 complete weeks of gestation, is the single major cause of death and disability in children up to 5 years of age in the developed world. Aim of the study: The study aimed at analyzing select adaptation disorders in newborns delivered between 34–37 weeks of gestation and in particular, (1) determining the frequency of breathing, thermoregulatory, hypoglycemic and pathological hepatic disorders, and (2) examining underlying factors that determine their incidence. Material and methods: The study was carried out according to the documentoscopy on the basis of medical files collected between 2019–2020 at the Neonatal and Preterm Baby Unit in WS SPZOZ (the regional hospital) in Nowa Sól. The records of 102 preterm newborn patients were examined, which included the birth book, detailed newborn observation charts, fever charts and individual patient observation charts. Results: The most commonly diagnosed disorders included hepatitis (21.6%; 50) and thermoregulation disorders (20.3%; 47). Additionally, hypoglycemia and tachypnea were observed in every third child (31.4% and 29.4%, respectively) and almost every fourth newborn experienced some respiratory disorders (23.5%). Among the findings, maternal and gestational age were not found to be statistically significant with respect to an association with the incidence of the disorders examined in the study. However, hepatitis was more frequently diagnosed among naturally born children (64.5%) compared with those delivered by Cesarean (C) section (42.3%, p=0.039). Respiratory disorders were more often found in children delivered by C-section (21.1%) than in those born naturally (3.2%, p=0.022). Conclusions: Hepatitis and thermoregulatory disorders occurred most frequently in preterm infants of all the adaptation disorders examined. The type of delivery was quite determinant for some of the disorders. Hepatitis was found more often in naturally born babies than in those delivered by C-section, whereas respiratory problems occurred more frequently in children delivered by C-section compared with those delivered naturally. Mothers who wish to deliver their babies by C-section should be informed about potential complications associated with the occurrence of respiratory disorders. They can stem from the absorption of pulmonary liquid and inappropriate surfactant activity, which can lead to some serious abnormalities related to the improper exchange of respiratory gases.

Urine Color Analysis of Hydration Status in Employees Working in Bandung, Indonesia

Background: Dehydration can be compensated for by the body. However, if it occurs persistently, it can cause concentration problems, thermoregulation disorders, kidney damage, and other life-threatening disorders such as cardiovascular disorders. Urine color is a simple indicator to assess a person’s hydration status. The purpose of this study was to explore the hydration status of employees working in Bandung, Indonesia. Methods: This was a descriptive cross-sectional study conducted from March to November 2019. This study was a part of another study exploring urine color levels. Urine was collected on Sunday morning when the employees were free. Water intake and workload before urine examination were not taken into account. Hydration status was divided into three categories: well-hydrated, mild/moderate dehidration, and severe dehydration. A total sampling method was used to collect data. Results: In total, 178 subjects who met the study criteria participated in the study. The majority of respondents were 40-79 years old, male, did not have hypertension or diabetes, and active smokers. Most respondents experienced severe dehydration (44.7%) although 58.1% had consumed ≥8 glasses of water/day. Conclusion: More than half employees have consumed adequate amount of water; however, the majority are severely dehydrated when assessed based on their urine color. Further study on the balance of water intake and excretion is needed to explore the phenomenon of dehydration in the morning.

Removing Trigger Point and Balancing Metabolic Reactions Are the Keys to Fatigue, Nerve Pain, Chronic Illness, Diabetes, Fibromyalgia, Alzheimer’s Diseases, Vestibular Disorder, and Neurodegenerative Diseases

When we talk about the vital role of oxygen, we forget that the vital role of oxygen is to interact with glucose in the cells catalyzed by many enzymes to generate energy. The main source to generate energy in cells is from glucose, enough glucose is as vital as enough oxygen. Poor blood circulation may come from the blocking points in the vessels or from low blood pressure or low blood glucose. In the body, all the billions of cells of all body systems need the energy to have normal functions; which is mainly generated from metabolizing glucose. When the cells hunger for glucose, it can start to use structure stored glucose or stored lipids or polysaccharides or structure lipid or structure protein. To take stored glucose, the body needs good blood circulation and right body temperature. The people with chronic illness often have hormonal imbalanced – which need glucose as the main source of energy also, and poor blood circulation and disorder of thermoregulation. If we do not stop these disorders, these people may have metabolic disorders or metabolic diseases. The main energy source for the cells is from the catabolism of glucose. So any problem for glycemia and oxygen saturation will make the billions of cells of the body are out of balance. During practice Vietnamese Qi gong combining with traditional medicine, the author realizes that in just ten minutes, just by removing trigger point and balancing metabolic reactions, we can deal easily most of the symptoms of fatigue, nerve pain, chronic illness, diabetes, fibromyalgia, Alzheimer’s diseases, Vestibular disorder, and Neurodegenerative Diseases.

Ross syndrome: A rare disorder of thermoregulation

Abstract Ross syndrome is a rare degenerative disorder characterized by segmental anhidrosis that may be unilateral or bilateral, hyporeflexia or areflexia and Adie’s tonic pupils. The most troublesome symptom is compensatory hyperhidrosis. Selective degeneration of sympathetic pathways is presumed to be an underlying pathophysiology. Here we report a 32-year-old man who had developed the characteristic triad of Ross syndrome. Although it is an untreatable condition, this case report throws light on occurrence of this rare syndrome.

Chapter 43 - Thermoregulation in Parkinson disease

Autonomic dysfunction in Parkinson disease encompasses thermoregulatory symptoms and was first noted by Gowers in the late 19th century when he described abnormal temperature sensation and sweating in Parkinson disease patients. These thermoregulatory symptoms became more recognized in the postlevodopa era when Parkinson disease patients were more readily tested with objective autonomic function tests. Objective thermoregulatory testing in Parkinson disease reveals deficits of sweating and vasomotor tone which often correlate with the severity of other autonomic deficits. Tests of thermoregulatory function can also be used to differentiate Parkinson disease from other neurodegenerative disorders. The pathophysiology of thermoregulatory dysfunction in Parkinson disease encompasses both central and peripheral mechanisms; involvement of the brainstem and hypothalamus with alpha-synuclein pathology is well recognized with increasing evidence of peripheral neuropathy in Parkinson disease that influences thermoregulation. Medications used to treat Parkinson disease also affect thermoregulatory symptoms. Disorders of thermoregulation significantly affect the quality of life for patients and their caregivers and can be severe and even life threatening, such as in the parkinsonism-hyperpyrexia syndrome.

Холод-индуцированная реактивность у пациентов с рассеянным склерозом

Цель исследования - изучение особенностей восприимчивости пациентов с рассеянным склерозом (РС) к холодовому воздействию с помощью функциональных тестов, характеризующих функцию терморегуляции. Как известно, РС - хроническое прогрессирующее аутоиммунное заболевание центральной нервной системы мультифакториальной природы, более часто встречающееся в регионах с холодным и влажным климатом. Нарушения терморегуляции вследствие автономной дисфункции являются характерным признаком РС, вместе с тем участию холодового фактора в развитии заболевания не придается существенного значения. Методика. Обследовано 32 пациента (17 мужчин и 15 женщин, средний возраст 29,6 ± 4,2 года) с установленным диагнозом: РС ремиттирующе-рецидивирующая форма течения (средняя продолжительность заболевания - 4,2 ± 2,7 года) и 18 практически здоровых лиц группы сравнения. Восприятие холода оценивали с помощью визуально-аналоговой шкалы. Продолжительность холод-индуцированной вазоконстрикции после локального холодового теста изучали по данным инфракрасной термометрии. Вегетативную регуляцию вазомоторных реакций оценивали по результатам анализа вызванных кожных вегетативных потенциалов (ВКВП). Результаты. На основе анализа самооценки восприятия холода у пациентов с РС показана низкая переносимость холодового фактора. При проведении локального холодового теста отмечено замедление восстановления температуры кожи кисти, что характерно для усиления холод-индуцированной вазоконстрикции. В группе пациентов с РС выявлено снижение параметров ВКВП ладоней и стоп, свидетельствующее о дефиците нейрогенного контроля терморегуляционных сосудистых реакций. Заключение. У пациентов с РС выявлены нарушения механизмов терморегуляции при действии холода, что обусловливает высокую индивидуальную восприимчивость к холоду у данной категории лиц. Сопоставление результатов анализа механизмов индивидуальной холод-индуцированной реактивности у пациентов с РС с данными эпидемиологических исследований приводит к заключению о потенциальном модулирующем влиянии холодового фактора на течение РС. The purpose of the present study was focused on the evaluation of the sensitivity to cold in multiple sclerosis (MS) patients by means of functional thermoregulatory based tests. MS is known to be a chronic autoimmune progressive disease of the central nervous system of multifactor origin that is very common in regions with cold and humid climate. Disorder of thermoregulation caused by autonomic dysfunction is a typical feature of MS, however the role of the cold in the disease development is still underestimated. Methods. Thirty two MS patients (17 males, 15 females, mean age 29,6 ± 4,2 years) with the remittent form of the disease (mean disease duration 4,2 ± 2,7 years) and 18 age-matched healthy controls volunteered to participate in this study. Susceptibility to cold was analyzed with the use of visual-analogous scale. The duration of cold-induced vasoconstriction after local cold test was estimated using by infrared thermometry. Autonomic regulation of vasomotor reactions was investigated with the help of the skin sympathetic response (SSR) analysis. Results. The analysis of self-reported perception of the cold in MS patients showed their low tolerance to cold. Slow recovery of the skin temperature of the hand in the local cold test observed in MS patients was considered as the aggravated cold-induced vasoconstriction. The decreased SSR in the hands and feet in MS patients was found that indicates the deficit of the neurogenic control of thermoregulatory vasomotor reactions. Conclusion. The results obtained demonstrate the impairment of thermoregulation under cold in MS patients that leads to higher individual susceptibility to cold of this group. Comparing of the data found in this study on the mechanisms of the individual cold-induced reactivity in MS patients with epidemiological surveys enable to conclude that cold environment has potential modulating effect of on the course of MS.

Use of infrared thermography in ophthalmology

Thermoregulation disorders are associated with Body temperature fluctuation. Both hyper- and hypothermia are evidence of an ongoing pathological process. Contralateral symmetry in the Body heat spread is considered normal, while asymmetry, if above a certain level, implies an underlying pathology. Infrared thermography (IRT) is employed in many medical fields including ophthalmology. The earliest attempts of eye surface temperature evaluation were made in the 19th century. Over the last 50 years, different authors have been using this method to assess ocular adnexa, however, the technique remains insufficiently studied. The reported IRT data is often contradictory, which may be due to heterogeneity (in terms of severity) of patient groups and disparities between research parameters.

2865 – Assesment of quality of life at mitral valve prolapse patients suffering anxiety disorders

Mitral valve prolapse (MVP) is a common cardiac pathology. Researchers note a high incidence of anxiety disorders among MVP patients. To study “Quality of Life” (QOL) features in MVP patients suffering anxiety disorders. We examined 290 MVP patients and 73 healthy subjects. 30 patients received medication with alprazolam within 10 weeks. 18 patients attended courses about rational-emotive therapy (16 sessions, individual assessments). Psychological and clinical examinations of the patients were made before and after psychotherapy courses and medication. Psychological testing embraced the assessment of anxiety indicators (Spilberger Scale); and QOL indicators were assessed through the Ryff Scales of Psychological Well-Being, the Visual Analog Scale (VAS) - the “health” dimension, and the Disability Scale (DISS) - the dimensions of “work,” “social life,” and “personal life.” MVP patients are distinguished from healthy subjects by lower rates of QOL indicators, and increased anxiety. A significant reduction in anxiety were found, as well as increase in QOL indicators after medication, and after psychotherapy. However improvement of QOL indicators was more expressed after psychotherapy. Physical examination of the patients revealed a significant reduction in the frequency and intensity of panic attacks, chest pain, and thermoregulation disorders in both groups of patients, as well as the decrease of prolapse depth in all the patients after psychotherapy. The research showed a significant improvement in QOL indicators, and also in a number of clinical symptoms in MVP patients suffering anxiety disorders after psychotherapy. These results are important for the therapy and psychological assistance to MVP patients.

Facteurs de risques et conséquences périnatales des grossesses rapprochées : étude cas-témoin rétrospective

To study the maternal risk factors and perinatal complications of a short interpregnancy interval. Retrospective case-control study between 2007 and 2009, comparing a group with a short interpregnancy interval (less than 9 months, n=83), and a control group (interval between two pregnancies between 18 and 24 months, n=166). The main risk factor of short interpregnancy interval is to be unemployed (OR=3.2, P<0.001). There is a significant link between lack of prescription contraceptives in postpartum and a short interval between pregnancies (OR=3.4, P<0.001). We also found a higher rate of anemic women during pregnancy (OR=4.9, P=0.001) and postpartum (OR=2.1, P=0.02) in case of short interpregnancy interval. Short interpregnancy interval increases risk of small for gestational age (OR=2.4, P=0.05) and thermoregulation disorders (OR=3.1, P=0.02). A low socioeconomic level is a risk factor of short interpregnancy interval. Short interpregnancy interval is at risk of maternal iron deficiency and neonatal complications like low birth weight and hypothermia.

Ross Syndrome with Sweating Anomaly Associated with Sjögren Syndrome: An Infrared Thermo­graphic Case Study

Ross syndrome is a rare partial dysautonomic syndrome of unknown aetiology, characterized by a one-sided or bi-lateral anhidrosis associated with Holmes-Adie syndrome (defined by tonic pupil and hyporeflexia of deep tendons) (1). Since it was first described in 1958 (2), approxima-tely 50 cases have been described in the literature (3). Dermatologists may be confronted with this disorder of thermoregulation, which is often revealed by a segmental “compensatory” hyperhidrosis. We describe here a case of Ross syndrome associated with Sjogren syndrome (SS) and discuss the potential relationship between these two entities. Thermography imaging exploration with an in-frared camera performed in different ambient temperature settings allowed better definition of the thermoregulatory sweating abnormalities in our patient. Moreover, to our knowledge, this examination showed, for the first time, an unexpected body “thermal pattern”, which may be characteristic of Ross syndrome. CASe RepoRTWe present here a case of a 35-year-old woman with a 10-year medical history of localized hyperhidrosis. Her medical history revealed autoimmune thyroid disease and SS. The hyperhidrosis appeared at an ambient tem-perature of approximately 25–27°C and was localized on the left side of her lower back, extending belt-like towards the side and in the controlateral lower back on the right side, as well as on the nape of her neck and shoulders. The rest of the skin was anhidrotic. She was also heat intolerant, with lack of sweating, abnormal increase in body temperature and generalized fati-gability when exposed to high ambient temperatures (32–34°C). Both pupils showed a slow reaction to light and a normal constriction to a near target, and deep tendon jerks were absent without motor deficits (Holmes-Adie syndrome). There were no other signs of autonomic dysfunction. punch biopsies obtained from hyperhidrotic and hypohidrotic skin areas were normal. The skin direct immunofluorescence test was negative. Blood explorations showed an isolated presence of anti-SSA, anti-SSB antibodies and anti-thyroid antibodies. Serum ganglionic (AChR) antibody was negative. Oral and conjunctival Sicca were objectively confirmed by Schirmer’s test. Salivary gland biopsy revealed lympho-cytic infiltration in both periglandular and perivascular regions. All of these Sicca findings fulfilled the diag-nostic criteria for primary SS (4). Brain and spinal cord magnetic resonance imaging (MRI), as well as thoracic and abdominal computed tomography scan findings, were normal. Electrophysiological explorations of both hands and forearms showed an absence or collapse of the sympathetic skin responses. Nerve conduction study findings, EEG and cardiac tilt-test (reflecting the adren-ergic sympathetic and parasympathetic functions) were normal. Thermographic explorations with an infrared camera (A320, FLIRsystems, Inc., Issy Les Moulineaux, France) allowed for evaluating the body’s surface tem-perature at 22°C and after a 20 min exposure to 32°C ambient temperature (Fig. 1). This examination was significantly more efficient than the Minor Starch Test and clearly delimited the skin thermoregulation abnor-malities associated with Ross syndrome. Hyperhidrotic and anhidrotic areas were also clearly visualized as the lowest and highest estimated skin surface temperature. This examination showed large dermatomal-like pat-terns in hyperhidrotic areas (lower back and shoulder regions), but also detected unexpected smaller patch-

Disability-Related Injuries in Athletes with Disabilities

Athletes with disabilities are highly skilled. Sports-related injuries and disorders interfere with their efforts. Several aspects of these injuries have been studied in previous studies. The aim of this study was to correlate the types of injuries with the disability group in athletes with physical disabilities. One hundred and thirty nine elite athletes with physical disabilities completed a questionnaire about sports-related injuries that resulted in at least one day off from training or competition. All disability groups show soft tissue injuries in high percentages. Cerebral palsy (CP) athletes reported soft tissue injuries (P < 0.01) and lacerations (P < 0.001) in higher percentage than Other Disabled Athletes (ODA) and Spinal Cord Injured (SCI) athletes. Spinal cord injured athletes sustained fractures (P < 0.05) and blisters (P < 0.05) in higher percentages than the other groups. No differences were found between the studied groups for contusions, low back pain, ruptures, thermoregulation disorders, urinary tract infections, pressure sores and pneumonias. CP athletes sustained soft tissue injuries and lacerations more than other disability groups did because moving and walking patterns of this population add risk factors for such injuries. Fractures and blisters occur more frequently to SCI athletes because they participate in higher percentage in wheelchair basketball which is high risky sport.

The Cimicifuga racemosa special extract BNO 1055 prevents hot flashes in ovariectomized rats

Hot flashes are a disorder of thermoregulation due to the lack of estrogens and are the most common and characteristic climacteric complaint. Hormone replacement therapy is the gold standard treatment but now its use is limited due to several side effects. Need therefore arises to search for non-estrogenic alternatives. It is well established that extracts of Cimicifuga racemosa (CR) ease climacteric complaints but solid animal experimental data supporting such effects are not available. The availability of sensitive transponders which record subcutaneous temperature continuously enables nowadays experiments in rats to establish whether they have hot flashes following ovariectomy (Seidlova-Wuttke et al. 2003) and if so, whether they can be influenced by the extract of CR BNO 1055. Intact Sprague-Dawley rats (n=16) were acclimatized and their subcutaneous body temperature was measured in 5 min intervals and mean values from 3h recordings were calculated. Thereafter, the rats were ovx and fed either with soy free (sf) or CR BNO 1055 (25 mg/animal/day) food. Temperature was recorded again after acute and sub-acute application of CR. In individual intact animals temperature was stable over the 3h recording period. Following ovx temperature pulses appeared with peaks occurring every 20-40 min. These fluctuations were not seen in CR BNO 1055 treated animals resulting in significantly higher mean temperatures in ovx in comparison to intact or ovx CR BNO treated rats. This reduction of hot flashes by BNO 1055 outlasted the experimental period of 3 weeks. These results suggest that the ovx rats and the new temperature-sensitive device may be useful for the study of hot flashes. Furthermore the results prove that the CR BNO 1055 exerts hot flash reducing effects.