Significant Differences In Heart Rate Research Articles

P1499Data-driven clustering unveils the adaptive remodeling of athlete heart: an echocardiographic study from 2017 Taipei summer universiade

Abstract Background Sport-specific adaptations of the athlete's heart are still under investigation. This study sought to provide a proof-of-concept for hierarchical clustering of echocardiography-derived parameters in unfolding the adaptations and to make a comparison between hypothesis-driven and data-driven approaches for characterizing the athlete's heart. Methods Anthropometric, echocardiographic and electrocardiographic assessments were collected during the peri-participation cardiovascular examination of 2017 Summer Universiade. Besides standard echocardiography and strain measurements, ventricular-arterial coupling was assessed by the ratio of effective arterial elastance (Ea) to left ventricular end-systolic elastance (Ees), using a modified single-beat algorithm to calculate Ees. Results A total of 598 elite athletes (348 male, mean age 23±2.5 years) engaged 24 disciplines were grouped by Mitchell's classification. The hypothesis-driven approach showed significant differences in heart rate, ventricular size, and stroke volume when classified by dynamic levels. Adaptations of ventricular function were not found. Contrarily, the data-driven approach not only hierarchically clustered athletes with more manifest morphologic remodeling, more proportions playing high dynamic sports but also showed a functional propensity of lower Ea and Ees, supranormal diastolic function and preserved ventricular-arterial coupling with ample pumping reserve. Phenotype heatmaps of athletes Conclusions The hierarchical clustering can analyze numerous echocardiography-derived phenotypes pertaining to an individual athlete as well as discern an adaptive propensity of the athlete's heart to be the resting status of a reservoir-rich pump. This pilot demonstration of the data-driven approach in figuring out integrated physiologic adaptations with remodeling-relevant geometry and function leads to a fundamentally improved understanding of the athlete's heart and then will be applicable to various domains.

Behavioural and cardiovascular effects of medetomidine constant rate infusion compared with detomidine for standing sedation in horses

ObjectiveTo compare the efficacy of a medetomidine constant rate infusion (CRI) with a detomidine CRI for standing sedation in horses undergoing high dose rate brachytherapy. Study designRandomized, controlled, crossover, blinded clinical trial. AnimalsA total of 50 horses with owner consent, excluding stallions. MethodsEach horse was sedated with intravenous acepromazine (0.02 mg kg–1), followed by an α2-adrenoceptor agonist 30 minutes later and then by butorphanol (0.1 mg kg–1) 5 minutes later. A CRI of the same α2-adrenoceptor agonist was started 10 minutes after butorphanol administration and maintained for the treatment duration. Treatments were given 1 week apart. Each horse was sedated with detomidine (bolus dose, 10 μg kg–1; CRI, 6 μg kg–1 hour–1) or medetomidine (bolus dose, 5 μg kg–1; CRI, 3.5 μg kg–1 hour–1). If sedation was inadequate, a quarter of the initial bolus of the α2-adrenoceptor agonist was administered. Heart rate (HR) was measured via electrocardiography, and sedation and behaviour evaluated using a previously published scale. Between treatments, behaviour scores were compared using a Wilcoxon signed-rank test, frequencies of arrhythmias with chi-square tests, and HR with two-tailed paired t tests. A p value <0.05 indicated statistical significance. ResultsTotal treatment time for medetomidine was longer than that for detomidine (p = 0.04), and ear movements during medetomidine sedation were more numerous than those during detomidine sedation (p = 0.03), suggesting there may be a subtle difference in the depth of sedation. No significant differences in HR were found between treatments (p ≥ 0.09). Several horses had arrhythmias, with no difference in their frequency between the two infusions. Conclusions and clinical relevanceMedetomidine at this dose rate may produce less sedation than detomidine. Further studies are required to evaluate any clinical advantages to either drug, or whether a different CRI may be more appropriate.

Effects of citric acid on patients with severe burn complicated with acute renal injury treated by continuous renal replacement therapy

Objective: To explore the effects of citric acid on patients with severe burn complicated with acute renal injury treated by continuous renal replacement therapy (CRRT). Methods: Medical records of 83 patients with large area of burn complicated with acute renal injury admitted to intensive care unit (ICU) of our department from January 2015 to December 2018 and meeting the inclusion criteria were analyzed retrospectively. The patients were divided into heparin group [n=43, 25 males and 18 females, aged (35.0±2.5) years] and citric acid group [n=40, 22 males and 18 females, aged (37.0±6.6) years] according to different anticoagulation methods. After admission, routine support treatment and CRRT were performed after being diagnosed with acute renal injury in patients in 2 groups. Patients in heparin group were treated with low molecular weight heparin for anticoagulation with first dosage of 20 U/kg and an increase of 2.5 to 5.0 U per hour, and patients in citric acid group were given citric acid of 0.02 g/mL with dosage of 150~200 mL/h for anticoagulation. The use time of blood filter, recovery time of urine volume, and time of staying in ICU, and platelet count, activated partial thromboplastin time (APTT), prothrombin time (PT), and serum creatinine, urea nitrogen, cystatin C, procalcitonin, C-reactive protein, and neutrophil, leukocyte count, blood sugar, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and heart rate, body temperature, and mean arterial pressure before treatment and post treatment hour (PTH) 24 were recorded. Besides, occurrence of hemorrhage, hypocalcemia, metabolic acidosis, metabolic alkalosis, and death within 28 days post injury were recorded. Data were processed with t test and chi-square test. Results: The use time of blood filter of patients in citric acid group was (28.7±3.2)h, significantly longer than (19.4±2.6) h in heparin group (t=14.139, P<0.01). The recovery time of urine volume and time of staying in ICU of patients in citric acid group were respectively (7.6±0.9) and (9.6±1.3) d, significantly shorter than (9.2±1.5) and (11.2±1.8) d in heparin group (t=5.516, 4.697, P<0.01). Before treatment, there were no statistically significant differences in platelet count, APTT, and PT of patients in 2 groups (t=1.235, 0.515, 1.279, P>0.05). At PTH 24, the platelet count of patients in citric acid group was significantly higher than that in heparin group (t=10.947, P<0.01), and APTT and PT of patients in citric acid group were significantly shorter than those in heparin group (t=7.069, 9.142, P<0.01). Before treatment, there were no statistically significant differences in serum creatinine, urea nitrogen, and cystatin C of patients in 2 groups (t=1.684, 1.878, 1.472, P>0.05). At PTH 24, the serum creatinine, urea nitrogen, and cystatin C of patients in citric acid group were significantly lower than those in heparin group (t=7.778, 9.776, 5.117, P<0.01). Before treatment, there were no statistically significant differences in serum procalcitonin and C-reactive protein of patients in 2 groups (t=1.413, 0.898, P>0.05). At PTH 24, the serum procalcitonin and C-reactive protein of patients in citric acid group were significantly lower than those in heparin group (t=2.635, 2.297, P<0.05). Before treatment, there were no statistically significant differences in neutrophil, leukocyte count, blood sugar, AST, and ALT of patients in 2 groups (t=0.555, 0.816, 0.470, 1.896, 0.982, P>0.05). At PTH 24, the neutrophil, leukocyte count, blood sugar, AST, and ALT of patients in citric acid group were significantly lower than those in heparin group (t=2.054, 3.314, 7.185, 2.151, 3.013, P<0.05 or P<0.01). Before treatment, there were no statistically significant differences in heart rate, body temperature, and mean arterial pressure of patients in 2 groups (t=1.406, 0.474, 0.720, P>0.05). At PTH 24, the heart rate, body temperature, and mean arterial pressure of patients in citric acid group were significantly lower than those in heparin group (t=2.307, 4.498, 2.056, P<0.05 or P<0.01). The incidence of hemorrhage of patients in citric acid group while in hospital was significantly lower than that in heparin group (χ(2)=4.949, P<0.05). There were no statistically significant differences in incidence of hypocalcemia, metabolic acidosis, metabolic alkalosis, and death rate within 28 days post injury of patients in 2 groups while in hospital (χ(2)=3.346, 0.884, 0.297, 0.324, P>0.05). Conclusions: Citric acid has significant anticoagulant effect on patients with large area of burn complicated with acute renal injury treated by CRRT, which can prolong the use time of the blood filter, shorten the recovery time of urine volume and time of staying in ICU, improve renal function indexes, blood biochemical indexes, and inflammation indexes, maintain the stability of internal environment, and reduce the risk of hemorrhage.

Establishment of a monitoring model of stellate ganglion discharge in rats

Objective To establish a monitoring model of stellate ganglion discharge in rats. Methods Thirty healthy Sprague-Dawley rats of either sex, aged 6-7 weeks, weighing 230-270 g, were selected.The left stellate ganglion was isolated after anesthesia and hung on the platinum electrode head to observe its electrical signal.Heart rate was recorded immediately after successful anesthesia (T0), immediately after the stellate ganglion was suspended in the electrode head (T1), at 10, 20 and 30 min after the stellate ganglion was suspended in the electrode head (T2-4), the frequency and amplitude of discharge of the stellate ganglion was recorded at T1-4.After recording the nerve electrical signal at T4, the stellate ganglion was locally infiltrated with 0.2% lidocaine 0.2 ml and then the frequency and amplitude of discharge was recorded 5 min later (T5). The occurrence of Horner′s syndrome was considered as a sign of successful block, and the success of block was recorded. Results There was no significant difference in heart rate at each time point (P>0.05). Paroxysmal clustered and rhythmically regular neuroelectrical activity of stellate ganglion was found at T1-4, and there was no significant difference in the frequency and amplitude of discharge at each time point (P>0.05). The frequency and amplitude of discharge of stellate ganglion were significantly decreased at T5 than at T1-4 (P<0.01). Conclusion The discharge monitoring model of stellate ganglion is successfully established in rats. Key words: Stellate ganglion; Neurophysiological monitoring

Assessment of EPInfant scale for exercise intensity perceptual self-regulation in healthy children.

The EPInfant scale has been validated for the perceptual estimation of physical exer tion in Chilean children, but its usefulness for self-regulation of exercise intensity is unknown. The objective of the study was to evaluate the criterion validity of the EPInfant scale to regulate and re produce exercise intensity in a sample of healthy children. 15 children between the ages of eight and 12 were selected for an incremental exercise test (IET) and three perceptually regulated exercise tests (PRET) on a treadmill. The tests were performed with a 48-hour interval between them. In the PRET, the exercise load was adjusted perceptually for five minutes, randomly considering levels 3, 6, and 9 of the EPInfant scale. The average heart rate (HR) during PRET was considered as the perceptually reproduced intensity. Variance analysis, simple linear regression, and reliability analysis were used to determine the reproducibility of HR during PRET. There was a significant difference in HR between perceptual levels during PRET (p < 0.001). Additionally, a correlation was observed between HR during the IET and the PRET (r = 0.83, r2 = 0.69). The intra class correlation coefficient was 0.76, 0.83. and 0.93 at perceptual levels 3, 6, and 9; and the mean dis cordance between HR during the IET and the PRET was -2.4 beats/min. In the studied sample, the EPInfant scale was valid to allow the perceptual regulation and reproduction of exercise intensity in a treadmill.

Accurate identification of myocardial viability after myocardial infarction with novel manganese chelate-based MR imaging.

We developed a novel manganese (Mn2+ ) chelate for magnetic resonance imaging (MRI) assessment of myocardial viability in acute and chronic myocardial infarct (MI) models, and compared it with Gadolinium-based delay enhancement MRI (Gd3+ -DEMRI) and histology. MI was induced in 14 rabbits by permanent occlusion of the left circumflex coronary artery. Gd3+ -DEMRI and Mn2+ chelate-based delayed enhancement MRI (Mn2+ chelate-DEMRI) were performed at 7days (acute MI, n=8) or 8weeks (chronic MI, n=6) after surgery with sequential injection of 0.15mmol/kg Gd3+ and Mn2+ chelate. The biodistribution of Mn2+ in tissues and blood was measured at 1.5 and 24h. Blood pressure, heart rate (HR), left ventricular (LV) function, and infarct fraction (IF) were analyzed, and IF was compared with the histology. The Mn2+ chelate group maintained a stable hemodynamic status during experiment. For acute and chronic MI, all rabbits survived without significant differences in HR or LV function before and after injection of Mn2+ chelate or Gd3+ (p>0.05). Mn2+ chelate mainly accumulated in the kidney, liver, spleen, and heart at 1.5h, with low tissue uptake and urine residue at 24h after injection. In the acute MI group, there was no significant difference in IF between Mn2+ chelate-DEMRI and histology (22.92±2.21% vs. 21.79±2.25%, respectively, p=0.87), while Gd3+ -DEMRI overestimated IF, as compared with histology (24.54±1.73%, p=0.04). In the chronic MI group, there was no significant difference in IF between the Mn2+ chelate-DEMRI, Gd3+ -DEMRI, and histology (29.50±11.39%, 29.95±9.40%, and 29.00±10.44%, respectively, p>0.05), and all three were well correlated (r=0.92-0.96, p<0.01). We conclude that the use of Mn2+ chelate-DEMRI is reliable for MI visualization and identifies acute MI more accurately than Gd3+ -DEMRI.

Impact of 3-day high and low dietary sodium intake on sodium status in response to exertional-heat stress: a double-blind randomized control trial.

To determine the impact of altering dietary sodium intake for 3days preceding exercise on sweat sodium concentration [Na+], and cardiovascular and thermoregulatory variables. Fifteen male endurance athletes (runners n = 8, cyclists n = 7) consumed a low (LNa, 15mgkg-1day-1) or high (HNa, 100mgkg-1day-1) sodium diet, or their usual free-living diet [UDiet, 46 (37-56) mgkg-1day-1] for 3days in a double-blind, randomized cross-over design, collecting excreted urine (UNa) and refraining from exercise. On day 4, they completed 2h running at 55% [Formula: see text]O2max or cycling at 55% maximum aerobic power in Tamb 35°C. Pre- and post-exercise blood samples were collected, and sweat from five sites using absorbent patches along the exercise protocol. UNa on days 2-3 pre-exercise [mean (95% CI) LNa 16 (12-19) mgkg-1day-1, UDiet 46 (37-56) mgkg-1day-1, HNa 79 (72-85) mgkg-1day-1; p < 0.001] and pre-exercise aldosterone [LNa 240 (193-286) mgkg-1day-1, UDiet 170 (116-224) mg kg-1day-1, HNa 141 (111-171) mg kg-1day-1; p = 0.001] reflected sodium intake as expected. Pre-exercise total body water was greater following HNa compared to LNa (p < 0.05), but not UDiet. Estimated whole-body sweat [Na+] following UDiet was 10-11% higher than LNa and 10-12% lower than HNa (p < 0.001), and correlated with pre-exercise aldosterone (1st h r = - 0.568, 2nd h r = - 0.675; p < 0.01). Rectal temperature rose more quickly in LNa vs HNa (40-70min; p < 0.05), but was similar at the conclusion of exercise, and no significant differences in heart rate or perceived exertion were observed. Three day altered sodium intake influenced urinary sodium excretion and sweat [Na+], and the rise in rectal temperature, but had no effect on perceived exertion during moderate-intensity exercise in hot ambient conditions.

Accuracy of smartphone application to monitor heart rate.

The use of smartphone applications to monitor heart rate has become increasingly popular. However, there is limited research available on the validity of these applications. The purpose of this study was to examine the accuracy of a free heart rate monitoring application on two smartphone platforms while at rest and during moderate intensity exercise. One heart rate monitor application was chosen for two different technological platforms. Twenty-four adults aged 18 and older (six males, 18 females) were randomly assigned a platform. Two groups were formed based on the platform being utilized. Both groups were monitored using an electrocardiograph (ECG) and the smart phone application. Heart rate for each participant was recorded while seated before exercise, and during moderate intensity exercise on an elliptical machine. Measurements were recorded in one-minute intervals. Data was analyzed using correlations and t-tests between platforms. All data was analyzed for both resting and exercise heart rate averages. There was no significant difference in heart rate while seated, t-test (-1.33; P=0.197) nor exercise heart rate, t-test (-1.54; P=0.142) when comparing means of the two platforms to an ECG. The applications chosen for both platforms to monitor heart rate were found to be fairly accurate, especially at rest. There are small user adaptations for monitoring heart rate, but heart rate applications provide a low-cost and efficient method for non-medical heart rate tracking. Future research should investigate the difference in accuracy for skin tone, ethnicity, race, hand size, and callosity of fingertips.

Effect of Modified Valsalva Maneuver on Heart Rate and ECG among Young Non –Athletes and Athletes

&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Introduction&#x0D; Valsalva maneuver (VM) is an indicator of cardiac Autonomic function as well as it is used clinically for testing patency of Eustachian tube in Ear examination. According to one Cochrane systematic review, the modified maneuver may be effective in 19–54% of cases and there is insufficient evidence to either recommend it or advise against it in supra-ventricular tachycardia.&#x0D; Material and Method&#x0D; The present cross sectional study was conducted in research lab, Department of Physiology, Late Shree Barat Ratana Atal Bihari Vajpeyi Memorial Medical college, Rajnandgaon (C.G) India, during study period April to october 2016. There are two study groups-young athletes engaged in endurance sports and non athletes, first year students of medical college. All the subjects had been demonstrated and practiced modified Valsalva Maneuver and after that subjects was selected for the study (30 in each group comprising of males and females). During modified Valsalva Maneuver continuous recording of Heart Rate and ECG is done. Data obtained so will be recorded and analyzed.&#x0D; Observations&#x0D; Heart rate was significantly higher after Modified Valsalva Maneuver in athlete, while it was significantly lower in non athlete after Modified Valsalva Maneuver. No significant difference in heart rate between athlete &amp; non athlete group before Modified Valsalva Maneuver. But there was significant difference heart rate between both groups after Modified Valsalva Maneuver. Significantly higher no. of Athletes showed increase t wave duration &amp; prolonged TP Segment as compared to non athletes.&#x0D; Conclusion&#x0D; Modified Valsalva Maneuver is good index of cardiovascular system.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

PATTERN OF CHANGES OF CENTRAL BLOOD PRESSURE AND VOLUME DEPENDENT ECHOCARDIOGRAPHIC PARAMETERS IN MONITORING OF NORMOTENSIVE PREGNANCY

Objective: We investigated changes of brachial and central blood pressure (BP) as well as volume dependent echocardiographic parameters in different time points of pregnancy.Design and method: Data from 60 healthy pregnant women (mean age 31.4 ± 4.3 years) were analysed. Hypertensive women were excluded from the study. In all women complete echocardiographic study, brachial and central BP measurements were performed at 11–13, 20–22 and 30–32 weeks of pregnancy. Central and brachial BP was measured by Pulsecor (CardioScope) device. In echocardiography: left ventricle end diastolic volume (LVEDV), early diastolic peak flow velocity (E velocity), late diastolic peak flow velocity (A velocity), left atrium area (LAA) and left atrium volume index (LAVI) were assessed. Also E/A index was calculated. Results: Brachial systolic BP (SBP) was higher and brachial diastolic BP (DBP) was lower as compared to respectively central SBP and central DBP at all three time points (p < 0.0001- for each). Brachial and central SBP and DBP levels were higher at 11–13 as compared to 20–22 weeks, but no difference was found between 20–22 and 30–32 weeks (Table). There was a significant increase of LAVI between all three-time points. LVEDV and LAA increased between 11–13 and 20–22 weeks but not between 20–22 and 30–32 weeks. Significant decrease in E velocity between 20–22 and 30–32 weeks was observed. There were no differences in E/A between subsequent measurements (Table). There were no significant differences in heart rate between time points. Conclusions: Our results indicate that LAVI is the best echocardiographic parameter reflecting physiological changes in blood volume overload in normal uncomplicated pregnancy. We also observed that changes in brachial BP were consistent with changes in central BP. Brachial BP and LAVI are sufficient parameters in monitoring physiological pregnancy.

Comparison of intraoperative hemodynamic stability between quadratus lumborum and epidural block in patients who underwent laparoscopic nephrectomy

Laparoscopic nephrectomy has become the standard procedure for living donor renal transplant in Indonesia. The anesthesia technique used for this procedure is general anesthesia combined with regional anesthesia. Among many techniques available, epidural block is often performed. This study aims to compare hemodynamic stability between Quadratus Lumborum (QL) block, as a new alternative block, and epidural block for laparoscopic nephrectomy. Patients were randomized to receive epidural block (n=13) or QL block (n=13) for intraoperative analgesia during laparoscopic nephrectomy. Patients in epidural group received continuous bupivacaine 0.25% infusion 6 ml/hours and patients in QL group received 20 ml of bupivacaine 0.25% bilaterally. Hemodynamic variables consisting of mean arterial pressure (MAP), heart rates (HR), as well as fentanyl consumption between the two groups were compared. There were significant differences in intraoperative MAP between epidural block group and QL block group (p = 0.001). However, there were no significant differences in HR (p = 0.114) and fentanyl consumption (p = 0.593) between two groups. QL block produced a relatively steadier MAP compared to epidural block; however intraoperative HR and fentanyl consumption between two groups had no significant difference.

Co-induction of anaesthesia with alfaxalone and midazolam in dogs: a randomized, blinded clinical trial

ObjectiveTo qualitatively assess the co-induction of anaesthesia with midazolam and alfaxalone and to determine cardiovascular or respiratory alterations compared with alfaxalone alone. Study designA randomized, blinded, clinical trial. AnimalsA total of 29 American Society of Anesthesiologists grade I or II, client-owned dogs undergoing elective orthopaedic or soft tissue surgery. MethodsAll dogs received 0.02 mg kg–1 acepromazine and 0.3 mg kg–1 methadone intramuscularly 30 minutes prior to anaesthesia. Measurements of heart rate (HR), respiratory frequency and blood pressure (BP) were assessed pre-induction and at 0, 2 and 5 minutes post-induction. Anaesthesia was induced with 0.5 mg kg–1 alfaxalone followed by either 0.4 mg kg–1 midazolam intravenously (group M) or an equal volume of saline (group S). Conditions were assessed for intubation and further boluses of 0.25 mg kg–1 alfaxalone were given as required. Response to co-induction, ease of intubation and quality of induction were scored, and total dose of alfaxalone required for intubation was recorded.Repeated measures one-way analysis of variance with post hoc Tukey’s test was used to assess within group changes over time and Student t tests were used to compare between groups. Incidence of apnoea was assessed using a Fisher’s exact test. Data are shown as mean ± standard deviation. ResultsGroup M included 14 dogs and group S 15 dogs. There was a significant difference in the total dose of alfaxalone required for intubation, 0.65 ± 0.20 mg kg–1 group M and 0.94 ± 0.26 mg kg–1 group S (p = 0.002). Apnoea occurred significantly more frequently in group M (p = 0.007). There were no clinically significant differences in HR or BP at the measured time points between groups. Conclusions and clinical relevanceCo-induction with midazolam had significant alfaxalone-sparing effects with no clinically detectable cardiovascular changes. Apnoea is common after co-induction.

Heart Rate Characteristics for Male Chinese College Students of Different PA-Level during 3000 Meters Running

PUPPOSE:To explore the Heart Rate load variation for male Chinese college students of different physical activity level during 3000 meters running, providing a reference for training load monitoring and security. METHODS: Real-time heart rate of 475 Chinese undergraduate students in Tsinghua University were test with Team 2 Polar tester during 3000-meter-run test. The physical activity was investigated by an international questionnaire. All subjects were grouped three by PA levels. Data calculated by SPSS 20.0. RESULTS: 1. There were significant difference in heart rate among students with different levels of physical activity during 3000-meter-run. The mean of maximum heart rate in group with lower PA level was the highest 202.4±8.9, while that of the group with good PA level was the lowest 198.7±6.4(P<0.05). 2. The heart rate has relation to the time during 3000-meter-run. The average speed of first three laps has a significant linear relationship to the average heart rate(R=0.875). The heart rate reached a plateau in the last four laps. The heart rate of all reached the maximum in the end of test. 3. The maximum heart rate of 20% individual students reached or exceeded the summit value of maximum heart rate (220-age), and continued for a several minutes within a relatively dangerous range. CONCLUSIONS:Mean of maximum and average heart rate of Chinese male college students with good PA level group was lower than that of poor PA level group in 3000-meter-run test. There is a high risk factor for poor PA level Chinese male students when running continuously in the maximum heart rate level. Study was supported by The Chinese General Administration of sports (2015B075)Fig. 1: Mean of heart rate for different PA levels during 3000 meter running

PERBEDAAN DENYUT JANTUNG DAN TEKANAN DARAH PADA ATLET PREDOMINAN AEROBIK DAN ANAEROBIK KONI JAWA BARAT TAHUN 2016

Exercise when done regularly will give big impact to the body. One of the alteration in an athlete that can be made is the cardiovascular system change. This study aimed to discover the difference of heart rate and blood pressure between aerobic predominant athlete and anaerobic predominant athlete. The study design was case-control, data collected from 80 athletes divided into 40 aerobic predominant athletes (canoe, sail, gantole, shooting, and bicycle racing) and 40 anaerobic predominant athletes (weight lifting, taekwondo, softball, tarung derajat, and rock climbing) in KONI West Java, Bandung. Sample was collected by random sampling and analyzed by T test independent. The result showed there was significant difference of heart rate between aerobic predominant athlete and anaerobic predominant athlete (p=0,0001), and lower in aerobic. There was also no significant difference of systolic blood pressure between predominant aerobic athlete and predominant anaerobic athlete (p=0,404), and was higher in anaerobic. Another result showed no significant difference of diastolic blood pressure between predominant aerobic athlete and predominant anaerobic athlete (p=0,553) and was higher in anaerobic. In conclusion, there was significant difference of the heart rate, but no difference of systolic and diastolic blood pressure between aerobic predominant and anaerobic predominant athlete.

Effect of esmolol in septic shock patients with tachycardia: a randomized clinical trial

Objective: To investigate the effect of esmolol in septic shock patients with tachycardia. Methods: A prospective randomized controlled trial was conducted. Screening septic shock patients that admitted to Department of General Intensive Care Unit of the First Affiliated Hospital of Zhengzhou University from June 2016 to August 2017. After 24 h resuscitation therapy, 100 cases of septic shock patients with tachycardia (heart rate>100 bpm) were divided into esmolol group (n=50) and control group (n=50) with random number table. Patients in esmolol group accepted standard treatment plus esmolol injection with an initial dose of 25 mg/h. Heart rate target is 80 to 100 bpm. Patients in esmolol group continued to use esmolol for 7 days or to the day the patient left the ICU when the heart rate didn't achieve the target. Patients in control group were given standard treatment. Primary outcome was 28 d mortality. Secondary outcomes included heart rate, norepinephrine dosages, lactate level, inflammatory markers in per day during the trial; acute physiology and chronic health evaluation (APACHE Ⅱ) and sequential organ failure assessment (SOFA) on day 1, 3, 5, 7; length of hospital stay, length of mechanical ventilation, medication time of vasoactive agent. The data were compared with t test or rank sum test between the two groups. Results: The 28 d mortality of esmolol group and control group was 62%, 68%, respectively(χ(2)=0.529, P=0.529). Logistic regression analysis showed that primary heart rate (increase of 10 bpm, OR=1.568, 95%CI: 1.039-1.238, P=0.027), primary APACHEⅡ (OR=1.134, 95%CI: 1.026-1.239, P=0.005), integral heart rate (per 10 bpm, OR=2.207, 95%CI: 1.400-3.479, P=0.001) were independent risk factors for 28 d mortality. Compared with control group, the esmolol group had a lower heart rate on day 1-7; but over all, there was no statistically significant difference in heart rate between the two groups (P>0.05). There was no significant difference in total does of norepinephrine, lactate level, inflammatory markers, APACHE Ⅱ, SOFA, length of hospital stay between the two groups (all P>0.05). Conclusion: Tachycardia significantly increases the risk of death in patients with septic shock, esmolol may decrease the mortality by controlling heart rate.

The Effects of Acupressure on Physiological Indicators of Pain in Children Undergoing Tonsillectomy: A Randomized, Single-Blind, Placebo-Controlled Trial Study

Background: Tonsillectomy is regarded as one of the most commonly used pediatric surgical procedures whose anxiety-related consequences can bring about several changes in the physiological characteristics of children. Therefore, the use of low-cost anxiety-relieving techniques in this domain can be of utmost importance to stabilize vital signs in this age group. Objectives: Accordingly, the purpose of the present study was to investigate the effects of acupressure on physiological indicators of pain including respiratory rate, heart rate, and levels of arterial oxygen saturation in children undergoing tonsillectomy. Methods: This study was a three-group single-blind clinical trial conducted on 144 children aged five to 12 years undergoing a tonsillectomy. To this end, the subjects were allocated into three groups of 48 individuals including control, intervention, and placebo ones. In this respect, the intervention (experimental) group received acupressure applied to three pressure points three times a day for one hour, two to four hours, and six to eight hours following a tonsillectomy. However, in the placebo group, acupressure was applied to a false (sham) acupoint. The control group also received only routine care services. Before and after all three phases of the intervention, the physiological indicators of pain (heart and respiratory rate, blood pressure) were measured and recorded in all three study groups. The data were finally analyzed using descriptive statistics (mean and standard deviation) and inferential ones (Wilcoxon signed-rank test, chi-square test, one-way analysis of variance (ANOVA), and Kruskal-Wallis test). Results: The results of this study revealed significant differences in heart rate (P = 0.001), respiratory rate (P = 0.001), and levels of arterial oxygen saturation (P = 0.001) after three intervals of acupressure in the intervention group compared to those in other two groups. Accordingly, the means of heart rate and respiratory rate decreased and the levels of arterial oxygen saturation increased in the intervention group indicating a small number of fluctuations and much more balance in physiological indicators of pain. Conclusions: The findings of the present study showed that parasympathetic activity, following acupressure in the intervention group, could cause several changes in physiological responses, and also create a sense of relief and moderate anxiety in children. Therefore, anxiety in children undergoing a tonsillectomy could be lowered with the use of a simple, low-cost, and non-invasive technique contributing to the maintenance of physiological indicators of pain as well as decreased complications driven by vital signs, not in a normal range.

Effect of Dexmedetomidine Combined with Propofol or Sevoflurane General Anesthesia on Stress and Postoperative Quality of Recovery(QoR-40) in Patients Undergoing Laparoscopic Surgery

Objective: To explore the effects of dexmedetomidine combined with propofol or sevoflurane general anesthesia on stress and postoperative quality of recovery (QoR-40) in patients undergoing laparoscopic surgery. Methods: Two hundreds patients with laparoscopic gastrointestinal tumor resection (100 cases of gastric tumor and 100 cases of colon tumor) from March 2016 to January 2018 at Henan Cancer Hospital,were randomly divided into 4 groups(n=50): group SP (gastric neoplasm + propofol anaesthesia), group SS (gastric tumor + sevoflurane anaesthesia), group CP (colon tumor+ propofol anaesthesia), and group CS (colon tumor + sevoflurane anaesthesia). The four groups were all induced by dexmedetomidine, etomidate, sufentanil and cisatracurium. The patients in group SP and group CP were administered with propofol, and the patients in group SS and group CS were given general anesthesia with sevoflurane. The results of the operation and the quality of recovery were compared. The heart rate, mean arterial pressure change, norepinephrine, epinephrine and cortisol were measured in T0 (before anesthesia started), T1 (30 min after surgery), T2 (10 min after tracheal catheter extraction), T3 (24 h after surgery), T4 (postoperative 48 h), respectively. The postoperative recovery quality after operation was evaluated by QoR-40. Results: There were no significant differences in operation time, bleeding volume and other operation conditions between each group (all P>0.05), and also no significant differences in heart rate and mean arterial pressure from T0 to T4 time points (all P>0.05). There were significant differences in the levels of norepinephrine and cortisol among the four groups at T1 and T2 time points (F=54.135,140.733,12.037, 21.644,all P<0.05). The levels of norepinephrine and cortisol in SP group at T1 and T2 time points were less than SS group (all P<0.05). Similar, those in CP group were less than CS group (P<0.05). However, there was no significant difference among the 4 groups at other time points (all P>0.05). The scores of VAS and RS in SP group were (0.9±0.4) and (0.8±0.4), which were lower than that of SS group(1.4±0.5,1.4±0.5,all P<0.05).At the same time, the time of regain consciousness was (9.3±1.4) min, which was also lower than SS group [(10.1±1.4)min,P<0.05]. The scores of VAS and RS in CP group were (0.8±0.5) and (0.8±0.4), which were lower than that of CS group(1.4±0.5,1.4±0.4,all P<0.05).At the same time, the time of regain consciousness was (9.2±1.2)min,which was also lower than CS group [(10.1±1.2)min,P<0.05]. The recovery quality scores of the SP and CP group were (164±11) and (168±11) after 24 hours, which were greater than that of the SS and CS group(146±10, 143±12, all P<0.05). Conclusion: Dexmedetomidine combined with propofol in laparoscopic surgery can effectively suppress intraoperative stress, reduce postoperative pain and agitation, and improve the quality of postoperative recovery.

Establishment of Research Model on the Correlation Between Psychological Stress Intensity and Personality in Nursing Students Under Different Pressure Sources

Introduction:In recent years, sudden disasters are occurring frequently, resulting in inestimable casualties and losses. Hence, knowing what personality traits are suitable for stressful works is of vital importance for selecting applicable nurses for disaster relief operation, and helping the nursing students to have a clearer career orientation when choosing the specialty direction. Stress response is divided into psychological response and physiological response. This study focused on the process of physiological response and evaluated the psychological stress intensity through monitoring physiological indexes related to the autonomic nervous system during the stress process.Method: The experimental subjects were 16 nursing students. In the monitoring experiment, three kinds of pressures were set, including time limitation, threat assessment, and task- interference. The physiological indexes under the resting state of the experimental subjects were recorded as the resting period group (RT). Then, the nursing students performed the operation without setting the pressure condition, called the baseline period group (BL). The experimenter would record all important time nodes. The physiological indexes recorded under the three pressures were the time stress group (TS), the assessment stress group (AS), and the task-interference stress group (INS).Results:There was no statistically significant difference in heart rate and skin temperature between RT and BL, but there was a statistically significant difference in skin resistance. The heart rate and skin temperature in the stress phase were significantly higher than those in RT and BL. According to the analysis of HRV, the difference between RT and BL has no statistical significance.Discussion:Models can eliminate the interference of the operation itself to the recording of physiological signals. The time-stress condition caused a more psychological-stress response in nursing students than assessment and task interference. The pressure source was set up effectively and the stress model was established successfully.

Application of five elements music therapy in the painless nursing of children

Objective To explore the effectiveness of five elements music therapy in relieving pain, fear and psychological stress in children's painless nursing care. Methods A total of 79 cases of children were randomly divided into 40 cases in the experimental group and 39 cases in the control group.The control group only used behavior-induced nursing. The experimental group was treated with five elements music therapy on the basis of behavior-induced nursing. Using five different scales of angle, sign, palace, and , and following the rule of the five elements to develop restraint, music of sign was played 30 minutes before venipture, music of feather was played in venipture, and music of horn, palace and shang was played mainly after venipture.And the mode of wearing headphones or playing it publicly was selected, 3 times a day, each time about 30 minutes.FLACC score was used for pain evaluation during venipuncture, and self-description questionnaire was used for overall evaluation of pain during the whole treatment process after venipuncture. The changes of vital signs (heart rate, respiration, systolic blood pressure and diastolic blood pressure) were compared between the two groups before, during and after intravenous puncture. Results FLACC scores of venipuncture nails in the experimental group were significantly better than those in the control group, and the difference was statistically significant(P<0.05). In the self-description questionnaire score of the experimental group, the rate of children with severe pain and pain was significantly lower than that of the control group, and the rate of children with mild pain or no pain was significantly higher than that of the control group.The agreement on slight pain or no pain was considered as effective treatment, while the agreement on severe pain or pain was considered as ineffective treatment.In terms of the effectiveness of the agreement, the experimental group was significantly better than the control group, and the difference was statistically significant(P<0.05). The heart rate, respiration, systolic blood pressure, and diastolic blood pressure of the experimental group were significantly lower than those of the control group after intravenous puncture, with statistically significant differences (P<0.05). Before treatment, there was no significant difference in heart rate, respiration, systolic blood pressure and diastolic blood pressure between the two groups(P<0.05). Conclusion Five elements music therapy can effectively reduce local pain, fear and psychological pressure in children, and contribute to the smooth and efficient completion of nursing work. Key words: Five elements music therapy; Pediatric nursing; Painless nursing

Investigation of Blood Lactate Levels, Hearth Rates and Technical Performance of Hearing-Impaired Elite Male Greco-Roman Wrestlers

This study was conducted with hearing-impaired elite greco-roman wrestlers to determine the relationships and variations in heart rates (HR), blood lactate (La) levels and number of performances during the maximal effort and recovery periods. Voluntary 8 hearing-impaired elite male wrestlers with an average age of 21,75±2,05 years participated into present experiments. Resting heart rates of the athletes were determined before the maximal effort, blood samples were taken for lactate levels, athletes took warm up and stretching exercises for 15 minutes. For maximal effort, athletes performed hip-headlock throw technique for 2 minutes in 3 periods. Proper performances were counted and heart rates were measured in between the periods. To determine recovery characteristics of the athletes after maximal effort, HR and La levels were determined at 3rd, 15th and 30th minutes after maximal effort.Heart rate responds to hip-headlock throws at the end of the 1st period were lower than the heart rates at the end of the 2nd and 3rd periods and heart rates at the end of the 2nd period were lower than the heart rates at the end of the 3rd period (p&lt;0.05). Number of performances in the 1st period was greater than the number of performances in the 2nd and 3rd periods and number of performances in the 2nd period was greater than the number of performances in the 3rd period (p&lt;0.05). HR values increased and number of performances decreased with the progress of periods. There were significant differences in HR and number of performances of the periods (p&lt;0.05).HR and La reached to the maximum levels right after the end of wrestling game and a significant decrease was observed after the 3rd minute of resting (p&lt;0.00). Significant decreases continued at the 15th and 30th minutes of the resting as compared to the 3rd minute (p&lt;0.00). Blood lactate levels also reached to the maximum at the 3rd minute of resting with the effort spend in the 3rd period; then significant decrease was observed at the 15th minute of resting (p&lt;0.00) and significant decreases were also observed in blood lactate levels between the 15th and 30th minutes of resting (p&lt;0.00).It was concluded based on present findings that increasing heart rates negatively influenced number of performances. In other words, tiredness had negative effects on number of performances. Present findings also revealed that during the recovery period, lactate levels decreased quite slower than heart rates. In this sense, it was assumed that La level was the primary criterion of the recovery.