Higher Sympathetic Nervous System Research Articles

Current approach to resistant hypertension

Resistant hypertension is the inability to achieve target blood pressure (<130/80 mmHg) despite using the maximum tolerated doses of three antihypertensive drugs, including a diuretic, or the need for four or more medications. It is linked to aging, obesity, obstructive sleep apnea, and chronic kidney disease, with contributing factors such as high sodium intake and sympathetic nervous system overactivity. Treatment includes optimizing diuretic use, with spironolactone proving highly effective. Lifestyle modifications, including sodium reduction and exercise, are critical. Emerging therapies like renal denervation offer promising long-term blood pressure control.

Refractory arterial hypertension: hyperactivity of the sympathetic nervous system, kidney and approaches to antihypertensive drug therapy

Improving blood pressure (BP) control and reducing the risk of developing unfavorable cardiovascular and renal outcomes in patients with refractory hypertension (HTN) is an urgent problem of cardiology. According to clinical studies, patients with refractory HTN receiving intensive diuretic therapy with chlorthalidone and a mineralcorticoid receptor antagonist differ from patients with refractory HTN by a higher sympathetic nervous system (SNS) activity. Overactivity of sympathetic nerves may be one of the key pathogenetic factors that is involved in the kidney in the formation of refractory HTN, exerting a direct stimulating effect on the type 3 Na+ / H+ exchanger (NHE3) and type 2 sodium glucose cotransporter (SGLT2), which are involved in BP control by mechanism of pressure natriuresis. The review presents data on the peculiarities of sympathetic regulation of sodium tubular transport and the results of studies devoted the elucidating in the patients with resistant and refractory HTN the clinical efficacy of SGLT2 inhibitors glyflozins, sympatholytic reserpine and brain aminopeptidase A inhibitor firibastat, which suppresses the activity of central structures of SNS.

Correlations between sympathetic nervous system activity and smoking, as well as unattended blood pressure in essential hypertension

Abstract Background/Introduction It is a well-known fact that the sympathetic nervous system is involved with the pathophysiology of hypertension. Smoking, which is one of the most significant risk factors for cardiovascular morbidity and mortality, also contributes to the development of hypertension mainly through the stimulation of the sympathetic nervous system. Moreover, measurement of unattended blood pressure (BP) may provide additional information compared to conventionally attended BP. Purpose The aim of this study was to demonstrate the impact of smoking on sympathetic nervous system stimulation, and on BP measurement variations with and without medical supervision. Methods We studied patients with essential hypertension, who were separated into two groups, depending on their smoking habits (Group I: non-smokers, Group II: smokers). In all participants, sympathetic drive was assessed by MSNA estimations based on established methodology (microneurography). Both unattended (patient alone in the room, an oscillometric device programmed to perform 3 BP measurements, at 1-minute intervals, after 5 minutes of rest) and attended BP measurements were conducted with the same device, on the same day of MSNA recording, in random order. Then, we compared the two BP measurement values of each patient to assess which of the two was higher. Results Ninety-two consecutive patients (58±11 years, 50 males) were evaluated. Smokers (n=19) did not differ as regards 24-h ambulatory BP levels, glucose levels, renal function and left ventricular mass index when compared to non-smokers (n=73). However, higher levels of MSNA were recorded to smokers (73.16±13.42 vs. 61.04±18.10 bursts per 100 heartbeats, p<0.01). Furthermore, higher percentage of smokers recorded to have unattended BP values higher than attended (73.7% vs. 47.9% of them respectively, p=0.045). In particular, in smokers unattended BP was higher than attended by 10.07±6.7 mmHg, while in non-smokers unattended BP was lower than attended by 6.6±7.14 mmHg. No correlation was found between the MSNA and the differences observed in the two values resulting from the two different measurements of BP, maybe due to the small size of the sample. Conclusions Cigarette smoking is accompanied with higher sympathetic nervous system activation. Moreover, smokers exhibit higher unattended blood pressure values than normal measurements. The emerging hypothesis is that the stimulation of the sympathetic system causes this difference in measurements. A larger sample of patients is needed to fully determine the clinical significance of the above observation. Funding Acknowledgement Type of funding sources: None.

Typological features of the brain in normal conditions and in cerebral hypoperfusion

Relevance. Stress resistance and cognitive abilities of the patient, forming the personal component of the rehabilitation potential, have a significant impact on the course and recovery period after cerebral hypoxia of various origins. The adaptation of rehabilitation measures to the individual characteristics of the patient will significantly increase the effectiveness of rehabilitation measures for stroke and neurodegenerative diseases. The aim of this work is to generalize experimental and clinical studies characterizing the influence of individual characteristics of higher nervous activity on the course of cerebral hypoperfusion. Materials and methods . The study of literary sources of scientometric scientific bases for the last 15 years has been carried out. Results . The level of stress resistance is based on alternative biochemical strategies of neuronal metabolism of macroergs and neurotransmitters. At the organismic level, this is realized in a greater base voltage of the stress-activating system and a smaller reserve capacity of the sympathoadrenal system. In general, this leads to more severe cerebral hypoperfusion in stress-resistant individuals and slower recovery and is correlated with a high baseline sympathetic nervous system tone, insulin and testosterone concentrations. At the same time, a low level of stress resistance determines a greater sensitivity to exogenous corrective influences in cerebral hypoperfusion. The level of cognitive ability is associated with astrocytic responses and the organization of synaptic ensembles. The participation of astrocytes in the regulation of glutamate levels probably has a combined effect on both the state of cognitive mechanisms and damage to the components of neuroglial assemblies during hypoxia. This is also due to the release of S100 +, which, in turn, enhances the coordinated oscillations of neurons in the medial prefrontal cortex and hippocampus and may be the cause of greater damage to the cells of the cerebral hemispheres of the brain in animals with a high level of cognitive abilities in the cerebral hypoperfusion model.

The effect of final dissertation defense language, native vs. non-native, in the psychophysiological stress response of university students.

The objective of this study was to analyze the effect of final dissertation defense language in the autonomic stress response and cortical arousal of Physiotherapy students. We analysed in 110 students divided in 2 groups: native language (83) and non-native language (27), the autonomic stress response in four different moments of the dissertation defense; the cortical arousal and subjective perception of distress before and after the dissertation; and academic performance perception of students and the real performance obtained. Results showed a high sympathetic modulation at the beginning of the evaluation, which was maintained until the end of the evaluation in both groups. In addition, no decrease in cortical activity was found, possibly due to the short time of exposure to the stressful event. The final dissertation defense of Physiotherapy students produces an anticipatory anxiety response and a maintained high sympathetic nervous system activation during the defense, not negatively affecting cortical arousal, regardless of defending in native or non-native language

A Comparison of Each Sleep Stage Autonomic Nervous System Activity in Different Sleep Apnea Severity Levels

Sleep apnea has increasingly become a public health issue. To further elucidate the physiological changes in different sleep apnea severity levels, we analyzed the autonomic nervous system (ANS) activity in each sleep stage by heart rate variability (HRV), moreover, we clarified how sleep apnea severity affects hypnogram and sleep quality. Subjects used in this study was obtained from PhysioNet, and the patient data were grouped into mild, moderate, and severe levels of sleep apnea according to apnea–hypopnea index (AHI). The electrocardiogram readings during the period of free apnea were extracted and evaluated by HRV and represented to the sleep stages as follows: Awake, rapid eye movement (REM), and nonrapid eye movement (NREM) in different sleep apnea levels, respectively. The results indicated that the severe group (AHI ≥ 30 events per hour) has higher sympathetic nervous system (SNS) activity and lower parasympathetic nervous system (PNS) activity in NREM. This elevates the ANS tone in NREM similar to Awake, making the ANS activity between NREM and Awake indistinguishable. Furthermore, we evaluated the effects both with (w/) and without (w/o) apnea events in REM and NREM separately. Apnea events that occurred in REM (w/) were not different compared to those in REM (w/o). On the other hand, apnea events occurring in NREM (w/) activated SNS and suppressed PNS activity. This altered the ANS tone, which suggested an early sleep stage transition to REM or Awake. This study indicates how sleep apnea severity correlates to the imbalance of ANS activity and it might disrupt the normal hypnogram. Consequently, from the ANS point of view that patients with severe apnea do not get appropriate rest from sleeping, these patients need some medical interventions or treatment to prevent the development of chronic diseases.

Neural suppression of miRNA-181a in the kidney elevates renin expression and exacerbates hypertension in Schlager mice.

BPH/2J mice are a genetic model of hypertension with overactivity of the sympathetic nervous system (SNS) and renin-angiotensin system (RAS). BPH/2J display higher renal renin mRNA and low levels of its negative regulator microRNA-181a (miR-181a). We hypothesise that high renal SNS activity may reduce miR-181a expression, which contributes to elevated RAS activity and hypertension in BPH/2J. Our aim was to determine whether in vivo administration of a renal-specific miR-181a mimic or whether renal denervation could increase renal miR-181a abundance to reduce renal renin mRNA, RAS activity and hypertension in BPH/2J mice. Blood pressure (BP) in BPH/2J and normotensive BPN/3J mice was measured via radiotelemetry probes. Mice were administered miR-181a mimic or a negative control (1-25 nmol, i.v., n = 6-10) with BP measured for 48 h after each dose or they underwent renal denervation or sham surgery (n = 7-9). Injection of 5-25 nmol miR-181a mimic reduced BP in BPH/2J mice after 36-48 h (-5.3 ± 1.8, -6.1 ± 1.9 mmHg, respectively, P < 0.016). Treatment resulted in lower renal renin and inflammatory marker (TLR4) mRNA levels in BPH/2J. The mimic abolished the hypotensive effect of blocking the RAS with enalaprilat (P < 0.01). No differences between mimic or vehicle were observed in BPN/3J mice except for a higher level of renal angiotensinogen in the mimic-treated mice. Renal miR-181a levels that were lower in sham BPH/2J mice were greater following renal denervation and were thus similar to those of BPN/3J. Our findings suggest that the reduced renal miR-181a may partially contribute to the elevated BP in BPH/2J mice, through an interaction between the renal sympathetic nerves and miR-181a regulation of the RAS.

SUN-565 The Effect of Leptin Treatment on Blood Pressure and Autonomic Nervous System Function in Patients with Lipodystrophy

Leptin is an adipokine that reflects energy storage levels. Patients with obesity have high leptin, hypertension, and increased cardiovascular disease (CVD) risk. In rodents, leptin increases blood pressure (BP), by increasing sympathetic nervous system (SNS) activity, suggesting high leptin may cause hypertension and CVD. Studies of leptin administration in 2 human models of leptin deficiency (weight reduced and congenital leptin deficiency) showed decreased SNS activity in the leptin-deficient state, which increased after leptin replacement. This has clinical relevance as high SNS and low parasympathetic nervous system (PNS) activity correlate with increased risk of hypertension and CVD. In lipodystrophy syndromes adipose tissue is deficient thus leptin is low. We hypothesized that leptin treatment in patients with lipodystrophy would increase SNS activity and BP. SNS and PNS activity in the heart can be assessed using heart rate variability (HRV). The high frequency (HF) component of HRV is directly related to PNS activity whereas the low frequency (LF) component reflects both SNS and PNS. The LF/HF ratio reflects sympathetic-vagal balance. Lower standard deviation of the beat to beat interval (SDNN) inversely correlates with CVD risk. Leptin-naïve patients with lipodystrophy (N=17, 5 generalized, 12 partial) were housed on an inpatient unit for 19 days. Patients were studied without leptin for the first five days. Leptin was administered for the next 14 days. At the end of the OFF-leptin and ON-leptin periods, 24-hr EKG recordings were used to derive HRV parameters and an automated BP monitor measured BP every 30 minutes during the day and every 60 minutes at night. 5 patients had generalized lipodystrophy (median 25th,75th percentile] endogenous leptin [0.5 [0.4, 0.6] ng/mL); 12 had partial lipodystrophy (leptin 7.5 [3.9, 20.3]). In the combined cohort with generalized and partial lipodystrophy, leptin treatment did not alter BP or any measure of autonomic nervous system function after 24 hours, 2 weeks, or 6 months. In exploratory subgroup analyses of generalized vs partial lipodystrophy, those with generalized lipodystrophy had an increase in LF after 2 weeks of leptin and a 4.5 mm Hg increase in systolic BP after 6 months; no changes were observed in those with partial lipodystrophy. Unlike previous human and rodent studies, we did not see increased SNS tone or BP after leptin treatment in patients with lipodystrophy. However, exploratory analyses in patients with generalized lipodystrophy and very low endogenous leptin levels showed small increases in systolic BP and increased LF component of HRV after 2 weeks, which is regulated by both SNS and PNS. This suggests that leptin may alter autonomic function in the transition from very low to normal plasma leptin levels.

PARASYMPATHETIC INFLUENCE ON COGNITIVE AGING IS MODERATED BY SYMPATHETIC ACTIVITY, ESPECIALLY IN EARLY MIDLIFE

The two branches of the autonomic nervous system (ANS) have been individually linked to age-related changes in cognitive functioning: The parasympathetic nervous system (PNS) is thought to support healthy cognitive aging, whereas the sympathetic nervous system (SNS) has been linked to heightened cognitive decline. Despite these separate findings and despite the integrative nature of the ANS, little work has examined the two branches simultaneously to better understand their interactive effects on age-related cognitive changes. We examined cognitive change in two waves of the MIDUS cognitive project and indexed PNS and SNS activity from heart rate variability and epinephrine levels (respectively) from the MIDUS biomarker project (n = 764, 56% female, mean age = 54.1 years). Our findings indicate that higher PNS levels attenuate cognitive decline, but only among individuals with low SNS levels; at higher SNS levels, the beneficial effects of the PNS are blocked. Further, lower PNS levels can be somewhat compensated for by increased SNS levels. This pattern was most robust among individuals transitioning to mid-life (i.e., 35-40 years old at the initial cognitive test). These results suggest that interventions targeting the ANS as a modifiable factor in cognitive aging should consider both ANS branch’s effects simultaneously, particularly in the early stages of midlife.

P802Interrelationships of sympathetic nervous system activity with attended and unattended blood pressure levels in essential hypertensive patients

Abstract Background/Introduction Measurement of unattended blood pressure (BP) may provide additional information over conventionally attended BP. Moreover, hypertension is related to sympathetic drive while there are scarce data on the diverse links of attended and unattended BP with muscle sympathetic nerve activity (MSNA) in hypertensive patients. Purpose The aim of this study was to assess the relation of BP levels in the attended and unattended setting with MSNA in patients with essential hypertension. Methods We studied 38 patients with essential hypertension (age: 59±11 years, 20 males, office BP: 142/86±19/11 mmHg, 24-hour BP: 137/80±14/12 mmHg). In all participants sympathetic drive was assessed by MSNA estimations based on established methodology (microneurography). Both unattended BP (patient alone in the room, an oscillometric device programmed to perform 3 BP measurements, at 1-minute intervals, after 5 minutes) and attended BP were measured with the same device, on the same day of MSNA recording, in random order. Patients were divided into the combined attended and unattended hypertensive group when BP≥140/90 mmHg in both attended and unattended BP estimations and to the attended hypertensive group when only attended BP≥140/90 mmHg. Results Patients with combined attended and unattended hypertension (n=18) compared to those with attended hypertension (n=20) were older (61±11 vs 57±11 years, p=0.03), whereas did not differ regarding 24-h ambulatory BP levels, glucose levels, renal function and left ventricular mass index (p=NS for all). Moreover, patients with combined attended and unattended hypertension compared to those with attended hypertension were characterized by greater levels of MSNA (41.2±11.6 vs 32.2±10.1 bursts per minute, p=0.031). In all participants, sympathetic nerve traffic as assessed by resting MSNA was related to attended systolic BP (r=0.459, p=0.004), attended diastolic BP (r=0.503, p=0.001), unattended systolic BP (r=0.433, p=0.007) and unattended diastolic BP (r=0.423, p=0.008). Conclusions The phenotype of combined attended and unattended hypertension compared to attended hypertension is accompanied by higher sympathetic nervous system activation. Moreover, the close association of MSNA with attended and unattended BP levels in essential hypertension, further supports the key role of sympathetic drive in modulating BP.

Analysis of Psychophysiological Stress Response in Higher Education Students Undergoing Clinical Practice Evaluation

The aim of this study was to analyze the psychophysiological response of Physiotherapy degree students during a complete clinical practice as well as their psychological profile in relation to coping style in stressful situations, and its impact on academic performance. We analysed in 15 students heart rate variability (HRV) to analyse autonomic modulation in three moments during the entire clinical practices of 3months (4h per day, 3days per week), first session, middle session and last session; perceived stress, personality, life engagement, cognitive flexibility before starting the clinical practice the academic performance after the clinical practice. Results based on HRV and related indexes parameters fail to indicate the expected autonomic adaptation during the practice. A complete clinical practice of Physiotherapy degree students did not produce an habituation process since a high sympathetic autonomic nervous system modulation was measured in the beginning, at the middle and at the final of the clinical practice. Below-average scores are presented in a personality factor associated with traditional and non-adaptive coping styles that could explain the non-habituation of the students. Finally, none of the analyzed indexes has been able to relate to academic performance.

Sympathetic Activation in Response to Infant Cry: Distress or Promptness to Action?

SYNOPSISAn increase in sympathetic nervous system (SNS) activity or reactivity in response to stimulation is usually interpreted as an index of heightened maladaptive distress. However, sympathetic activation also underlies promptness to action, so it is not clear whether the same relation could stand for parental responses to infant cry given that a ready and prompt parental response to infant cry favors more adaptive cognitive, social, and emotional development in the infant. Previous studies have not been consistent in the interpretation of sympathetic activation which occurs in response to infant cry. We discuss these two opposing proposed interpretations. A possible alternative interpretation may be that medium activation of the SNS is adaptive because it prepares the organism to act promptly, whereas too low or too high SNS activation is maladaptive because it underlies a lack of empathetic reaction or a highly distressed response.

Psychophysiological response of air mobile protection teams in an air accident manoeuvre

Different extreme contexts elicit a stress response on human body, specifically on combat produces an increase of sympathetic nervous system and a direct effect on the organic response. This research aimed to study the psychophysiological response of an air security force in a simulated air accident in a hostile area and its subsequent subterfuge to a safe area. We analyzed 13 soldiers (32.4 ± 8.0 years) from an air security force unit of the Spanish Air Force who were divided into three teams to conduct the manoeuvre. We analyzed before and after the manoeuvre psychological well-being scale, personal views survey, recovery-stress questionnaire (REST-52 Sport); heart rate variability, visual analogue scale, rated of perceived exertion, spirometry, hydration and hand strength were analyzed during the four days of the manoeuvre: This produced a significantly (p < .05) increase in sympathetic modulation, hand strength, dehydration status, general and specific stress from RESTQ-52. With this data we can conclude that an air accident manoeuvre of three nights and four days causes in the air mobile protection team a high sympathetic nervous system modulation, increases on muscle strength manifestations and stress and a dehydration status.

Role of the brain melanocortins in blood pressure regulation

Melanocortins play an important role in regulating blood pressure (BP) and sympathetic nervous system (SNS) activity as well as energy balance, glucose and other metabolic functions in humans and experimental animals. In experimental models of hypertension with high SNS activity, blockade of the melanocortin-4 receptor (MC4R) reduces BP despite causing marked hyperphagia and obesity. Activation of the central nervous system (CNS) pro-opiomelanocortin (POMC)–MC4R pathway appears to be an important link between obesity, SNS activation and hypertension. Despite having severe obesity, subjects with MC4R deficiency exhibit reductions in BP, heart rate, and urinary catecholamine excretion, as well as attenuated SNS responses to cold stimuli compared to obese subjects with normal MC4R function. In this review we discuss the importance of the brain POMC-MC4R system in regulating SNS activity and BP in obesity and other forms of hypertension. We also highlight potential mechanisms and brain circuitry by which the melanocortin system regulates cardiovascular function.

Sleep apnoea in heart failure: To treat or not to treat?

Heart failure (HF) and sleep apnoea are common disorders which frequently coexist. Two main types of apnoea occur: one is obstructive which, through recurring episodes of snoring, hypoxaemia, large negative intra-thoracic pressures and arousals from sleep leading to downstream inflammatory and autonomic nervous system changes, is thought to be a causative factor to the development of systemic hypertension and HF. The other type of apnoea, Cheyne-Stokes respiration with central sleep apnoea (CSR-CSA), is characterized by an oscillatory pattern of ventilation with a prevailing hyperventilation-induced hypocapnia, often in the absence of significant hypoxaemia and snoring, and is thought to be a consequence of advanced HF-related low cardiac output, high sympathetic nervous system activation and pulmonary congestion. CSR-CSA may be a compensatory response to advanced HF. Rostral fluid shift during sleep may play an important role in the pathogenesis of both obstructive sleep apnoea (OSA) and CSA. Studies of positive airway pressure (PAP) treatment of OSA and CSA in HF have shown short-term improvements in cardiac and autonomic function; however, there is no evidence of improved survival. Loop gain may provide useful marker of continuous PAP (CPAP) responsiveness in patients with central apnoea. A greater understanding of the pathophysiology of the interaction between obstructive and central apnoea and the various types of HF, and the mechanisms of therapies, such as PAP, is required to develop new strategies to overcome the disabling symptoms, and perhaps improve the mortality, that accompany HF with sleep apnoea.

Central sympathetic inhibition ameliorates joint pathology and shifts cytokines profiles in spleen but not joint draining lymph nodes in a model of rheumatoid arthritis

In 80% of patients, major life stressors precede onset of autoimmune diseases, including rheumatoid arthritis (RA) linking stress pathway activation to disease onset. We examined the contribution of high sympathetic nervous system activity to RA onset using the adjuvant-induced (AA) arthritis model in Lewis rats. Rats were immunized with complete Freund’s adjuvant to induce AA. From day (D)12 (disease onset) through D28, rats were treated with vehicle or 2 mg/kg/day moxonidine, an imidazoline receptor-1 agonist that acts centrally to reduce SNS tone. Disease outcome was assessed using dorsoplantar widths and X-ray analysis. Cytokines critical for inflammation and CD4+ Th cell development (interleukin (IL)-1 β , IL-10, tumor necrosis factor (TNF)- α , IL-6, IL-2, IL-4, IFN- γ , and tumor growth factor (TGF)- β ) were assessed in spleen, draining lymph node (DLN) and peripheral blood mononuclear cells (PBMCs) by enzyme-linked immunoassays. Treatment with moxonidine dramatically prevented hind foot inflammation and joint destruction in AA compared with vehicle treatment. In DLN cells, moxonidine treatment had no effect on cytokine production. In contrast, moxonidine treatment significantly reduced IL-1 β , IL-2, IL-4 and IFN- γ in PBMCs. Drug treatment decreased splenocyte production of TGF- β and IFN- γ by ∼ 50% and ∼ 30%, respectively. Lowering SNS tone effectively reduced clinical signs of disease and altered production of cytokines involved in inflammation and shifting the balance between auto-reactive CD4+Th cells and T regulatory cells in directions expected to limit disease activity.

Changes in Autonomic Nervous System Activity are Associated with Changes in Sexual Function in Women with a History of Childhood Sexual Abuse.

Women with histories of childhood sexual abuse (CSA) have higher rates of sexual difficulties, as well as high sympathetic nervous system response to sexual stimuli. The study aims to examine whether treatment-related changes in autonomic balance, as indexed by heart rate variability (HRV), were associated with changes in sexual arousal and orgasm function. In study 1, we measured HRV while writing a sexual essay in 42 healthy, sexually functional women without any history of sexual trauma. These data, along with demographics, were used to develop HRV norms equations. In study 2, 136 women with a history of CSA were randomized to one of three active expressive writing treatments that focused on their trauma, sexuality, or daily life (control condition). We recorded HRV while writing a sexual essay at pretreatment, posttreatment, and 2-week, and 1- and 6-month follow-ups; we also calculated the expected HRV for each participant based on the norms equations from study 1. The main outcome measures used were HRV, Female Sexual Function Index, Sexual Satisfaction Scale--Women. The difference between expected and observed HRV decreased over time, indicating that, posttreatment, CSA survivors displayed HRV closer to the expected HRV of a demographics-matched woman with no history of sexual trauma. Also, over time, participants whose HRV became less dysregulated showed the biggest gains in sexual arousal and orgasm function. These effects were consistent across condition. Treatments that reduce autonomic imbalance may improve sexual well-being among CSA populations.

Surgicel Induced Intraoperative Cardiovascular Collapse in a Child with Midbrain Glioma

Introduction: Intraoperative cardiovascular complications were previously demonstrated in relation to high sympathetic nervous system outflow or stimulation of the vagal nerve nucleus during theneurosurgical procedures on brain tumors. Main Symptoms and Important Clinical Findings: We are presenting clinical case of 13-year-old girl who suffered from midbrain glioma and developed life threatening cardiovascular events during neurosurgical procedure after surgicel hemostatic agent application. Therapeutic Interventions and Outcomes: Cardiovascular stability has been restored after immediate removal of surgicel from the operating field. We believe that it might be related to direct application of the surgicel hemostatic agent.

Negative Peer Status and Relational Victimization in Children and Adolescents: The Role of Stress Physiology

The purpose of the current investigation was to determine the unique associations between two subtypes of low peer status, peer rejection and unpopularity, and changes in relational victimization over time. This study also investigated if these associations were moderated by sympathetic nervous system (SNS) and parasympathetic nervous system (PNS) reactivity to peer stress. Sixty-one girls attending (Mage = 11.91 years, SD = 1.62; predominantly Caucasian) a residential summer camp were followed across 1 calendar year. Participants' skin conductance and respiratory sinus arrhythmia were assessed during a laboratory stress protocol. Peer rejection and unpopularity were measured using peer nomination techniques and counselors reported on relational victimization. Both unpopularity and rejection were associated with increased relational victimization over time among girls who exhibited reciprocal SNS activation (i.e., high SNS reactivity coupled with PNS withdrawal). Rejection was also associated with subsequent victimization among girls exhibiting reciprocal PNS activation (i.e., low SNS reactivity, PNS activation). Findings underscore the biosocial interactions between low peer status and physiological reactivity in the prediction of peer maltreatment over time.

Adaptación española de la versión reducida multicanal del Perfil de Sensibilidad No Verbal (MiniPONS)

The Spanish version of the MiniPONS (Bänziger, Scherer, Hall y Rosenthal, 2011), the short version multichannel of the Profile of Nonverbal Sensitivity (PONS), is presented. This scale was designed to measure individual differences in the ability to recognize emotions, interpersonal attitudes, and communicative intentions in nonverbal channels. This short multichannel version is composed of 64 items nonverbal audio and/or visual scenes portrayed by a female in black and white color. The main aim of this study was to analyze the psychometric properties of MiniPONS using a large sample of university students (N = 1154) aged 18-60, this study also examined gender and age differences in nonverbal sensitivity. Normative data, reliability and validity were examined in three studies with 168, 254, and 1154 university students. The Spanish version of the MiniPONS has psychometric properties similar to those of the original version, the MiniPONS had moderate internal consistency and test-retest reliability, and shows reasonable convergent validity through significant correlations with other tests of non-verbal emotion recognition ability. Results revealed an advantage of women in all the conditions of stimulus presentation; women not only process more efficiently unisensory nonverbal information (face, body and voice) but may also be better at integrating emotional expressions. We conclude that the MiniPONS Spanish version is an adequate instrument to be used in measure of socio-nonverbal sensitivity. Limitations and potential applications for research are described. : E�F' p�Pr�span&gt;have not been studied for current literature. The aim of this study was to analyse changes in cortical arousal, blood lactate, muscle strength, autonomic modulation and rate of perceived exertion in a simulated urban combat. We analyzed 20 soldiers before and after an urban combat simulation. The results showed how urban combat produced high sympathetic nervous system activation, increasing the muscle strength, heart rate and blood lactate concentration of the soldiers. Despite this effort, rate of perceived exertion were not consistent with the physiological response that soldiers presented, the rate of perceived exertion was lower than the physiological response evaluated. Furthermore, the information processing and cortical arousal decreased after the urban combat simulation. These results have showed the psycho-physiological response of soldiers in combat, helping to better understanding and enabling an improvement of current training methods of soldiers.