Significant Increase In Heart Rate Research Articles

Effect of mental stress on autonomic nervous function in young adults

Introduction: Autonomic imbalance is one of the important pathways through which psychological stress contributes to cardiovascular diseases/sudden death. Stress is a normal physical response to events that make us feel threatened or upset our balance in some way. There is a major role of mental stress in provoking silent myocardial ischemia, cardiac arrhythmia, catecholamine induced increase in heart rate, increase in blood pressure that result in enhanced myocardial oxygen demand and sometimes sudden death. In this study an attempt is made to study the variations in electro cardiogram (ECG) after inducing mental stress in normal subjects. Materials and Methods: The study included 50 healthy medical students in the age group of 18-25 studying in VIMS, Bellary. Following an explanation about the nature and purpose of the study, those subjects who are willing to participate were included after obtaining their consent. Blood pressure and ECG was recorded at rest in supine position. Then mental stress was induced on each by a no. of mental tasks and ECG was recorded in them immediately. The stressed subjects were evaluated with Speilberger’s State and Trait Anxiety Inventory (STAI) score. Blood pressure and ECG results were evaluated for different parameters and the data collected was tabulated and subjected to statistical analysis. Results: There was statistically significant increase in heart rate, systolic BP, diastolic BP, decrease in PR interval and QRS interval, increase in QTc interval, T wave pattern changes, ST segment depression found after inducing mental stress. Conclusion: The study shows that there were varieties of ECG changes in mental stress that may affect the health of human beings. Keywords: Blood pressure (BP), Electro cardiogram (ECG), Mental stress.

Attenuation of pressor response to laryngoscopy and intubation: Dexmedetomidine Vs. fentanyl premedication

Introduction: The pressor response during laryngoscopy and intubation is part of a huge spectrum of stress response, results from the increase in sympathetic and sympatho-adrenal activity. The present study was planned to observe the attenuation of pressor response during laryngoscopy and intubation with dexmedetomidine and fentanyl; also to compare the effectiveness between these two drugs. Materials and Methods: In this study we include 128 patients, of ASA grade I- II, aged 18- 65yrs, of either gender, scheduled for elective surgery under general anaesthesia. Groups: Group D – Dexmedetomidine (0.6µg/kg) and Group F – Fentanyl (2µg/kg), these drugs diluted with NS to make 10 ml, given I.V. slow over 10 min. Vital parameters (HR, SBP, DBP and MBP) were recorded as baseline, then at 10 minutes after pre-medication and then at 1,2,3,5,7 and 10 minutes after endotracheal intubation. Results: There was significant increase in heart rate, systolic blood pressure and diastolic blood pressure during laryngoscopy and intubation in group F as compared to group D (p Conclusion: Dexmedetomidine (0.6mcg/kg) is superior to fentanyl (2mcg/kg) in the attenuation of the pressor response and that the ideal time for its administration should be about 10 minutes before a laryngoscopy and intubation. Keywords: Dexmedetomidine, Fentanyl, Intubation, Laryngoscopy, Pressor response.

Comparison of Londrina activities of daily living protocol and Glittre ADL test on cardio-pulmonary response in patients with COPD: a cross-sectional study.

BackgroundIn COPD patients it is very important to assess the activities of daily living (ADL) due to an impairment of independence and quality of life. There is a lack of retrievable data regarding the cardio-pulmonary response to Londrina ADL protocol in patients with COPD. The aim of the present study was to assess the cardio-pulmonary response to Londrina ADL protocol in patients with COPD and to compare this with responses to the Glittre ADL test.MethodsThis cross-sectional study was done on 30 COPD subjects. Each subject was taken to perform the Londrina ADL protocol, Glittre ADL test, twice each, on subsequent days. The Londrina ADL protocol comprises 5 activities representing ADL, involving upper limbs, lower limbs, and trunk movements. The Glittre ADL test consists of completing a circuit while carrying a weighted backpack (2.5 kg for women, 5.0 kg for men). The better value of the two was taken into consideration. For the Londrina ADL protocol and Glittre ADL test the outcome of primary interest was time and for the six-minute walk test was the distance walked. The secondary outcomes for all tests were heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate, saturation of oxygen in blood and dyspnea.ResultsThe COPD subjects of age group 63.27±11.07 years took 5.94±0.36 min to complete trial 2 of the Londrina ADL protocol. Significant physiological increases in heart rate (p≤0.01), respiratory rate (p≤0.01), blood pressure (p≤0.01) and severity of dyspnea (p≤0.01) were observed, whereas saturation of oxygen in blood (p≤0.01) was reduced at the end of the Londrina ADL protocol and Glittre ADL test. There was a positive, non-significant correlation between the six-minute walk test distance and the Londrina ADL protocol time (r=0.236) (p=0.209). A positive, not significant correlation was observed between the Glittre ADL test (time) and the Londrina ADL protocol (time) (r=0.194) (p=0.304) and a negative but not significant correlation between the six-minute walk test (distance) and the Glittre ADL test (time) (r= -0.184) (p=0.330).ConclusionThe Londrina ADL protocol can be used as an assessment tool for the evaluation of functional performance and activities of daily living in COPD along with other test protocols in pulmonary rehabilitation.

Effect of Intramuscular Atropine Sulphate and Glycopyrrolate on Heart Rate and Salivary Secretion in Patients Undergoing Minor Oral Surgical Procedure

IntroductionIn most of the oral surgical procedures performed under local anesthesia, we often face a great difficulty while performing surgeries because of reduced accessibility and visibility which is hampered by blood and saliva at the surgical site. Anticholinergic drugs like atropine sulphate and glycopyrrolate are commonly used as antisialogogue for patients undergoing a surgical procedure under general anesthesia with little or no side effects. Aims and objectivesTo evaluate and compare the antisialogogue effect of atropine sulphate and glycopyrrolate in patients undergoing minor oral surgical procedures. To compare the efficacy of these drugs when administered intramuscularly and to evaluate their effects on heart rate in patients undergoing minor oral surgical procedures.Materials and methodsThirty patients undergoing minor oral surgical procedure were selected for the study. The patients were randomly assigned to receive either 0.6 mg/ml of Atropine Sulphate or 0.2 mg/ml of Glycopyrrolate intramuscularly. Salivary secretion, heart rate and arterial pressure were noted pre-injection and 30 minutes after the administration of the drug.ResultsAtropine sulphate and glycopyrrolate were equally potent as an antisialogogue. There was a significant increase in heart rate 30 min after the administration of atropine sulphate, but there was no significant change in heart rate in glycopyrrolate group.ConclusionIntramuscular gycopyrrolate is safer than intramuscular atropine sulphate as an antisialogogue in minor oral surgical procedures under local anesthesia.

The effect of diclofenac sodium intoxication on the cardiovascular system in rats.

Diclofenac sodium (DS) is a widely used nonsteroidal anti-inflammatory drug. Although its high doses are known to cause toxic effects in many tissues including liver and kidney, the effects on the cardiovascular system (CVS) have not been fully elucidated yet. Therefore, this study aimed to investigate the effect of DS on CVS. The Control group did not receive medication; however, a single dose of 240mg/kg DS was administered orally to the DS group. Electrocardiography (ECG) measurements were performed in all animals before (0thhour) and after (1st,6th,12th,24thhour) intoxication. After 24h, All animals were sacrificed. Biochemical (malondialdehyde [MDA], and glutathione (GSH), Apelin, Elabela, Meteorin, Endoglin, Keap1, and Nrf2) and histopathological analyzes were performed on heart tissue samples. ECG results showed that there was a statistically significant increase in QTc, QRS, and heart rate at the 12th and 24th hours in the DS group. The biochemical analysis showed that GSH, Apelin, Keap1, and NRF2 values decreased significantly while Meteorin and Endoglin levels increased in the DS group. When histopathological results were evaluated, distinct lesions were observed in the DS group. In conclusion, high doses of DS intake can cause adverse effects on and damage to CVS.

Sinus heart rate post pulmonary vein ablation and long-term risk of recurrences

PurposeCather ablation is known to influence the autonomic nervous system. This study sought to investigate the association of sinus heart rate pre-/post-ablation and recurrences in patients with atrial fibrillation undergoing pulmonary vein isolation (PVI).MethodsBetween January 2012 and December 2017, data of 482 patients undergoing their first PVI were included. Sinus heart rate was recorded before (PRE), directly post-ablation (POST) and 3 months post-ablation (3 M). All patients were screened for atrial tachyarrhythmia recurrences during the one-year follow-up.ResultsIn the total study cohort, the mean resting sinus heart rate at PRE [mean 57.9 bpm (95% CI 57.1–58.7 bpm)] increased by over 10 bpm to POST [mean 69.4 bpm (95% CI 68.5–70.3 bpm); p < 0.001] followed by a slight decrease at 3 M [mean 67.3 bpm (95% CI 66.4–68.2 bpm)] but still remaining higher compared to PRE (p < 0.001). This pattern was observed in patients with and without recurrences at POST and 3 M (both p < 0.001 compared to PRE). However, at 3 M the mean sinus heart rate was significantly lower in patients with compared to patients without recurrences (p = 0.031). In this regard, patients with a heart rate change < 11 bpm (PRE to 3 M) or, as an alternative parameter, patients with a heart rate < 60 bpm at 3 M had a significantly higher risk of recurrences compared to the remaining patients (Hazard ratio (HR) 1.82 (95% CI 1.32–2.49), p < 0.001 and HR 1.64 (95% CI 1.20–2.25), p = 0.002, respectively).ConclusionOur study confirms the impact of PVI on cardiac autonomic function with a significant sinus heart rate increase post-ablation. Patients with a sinus heart rate change < 11 bpm (PRE to 3 M) are at higher risk for recurrences during one-year post-PVI.

Evaluation of an exercise-enabling control interface for powered wheelchair users: a feasibility study with Duchenne muscular dystrophy

BackgroundPowered wheelchairs are an essential technology to support mobility, yet their use is associated with a high level of sedentarism that can have negative health effects for their users. People with Duchenne muscular dystrophy (DMD) start using a powered wheelchair in their early teens due to the loss of strength in their legs and arms. There is evidence that low-intensity exercise can help preserve the functional abilities of people with DMD, but options for exercise when sitting in a powered wheelchair are limited.MethodsIn this paper, we present the design and the feasibility study of a new version of the MOVit device that allows powered-wheelchair users to exercise while driving the chair. Instead of using a joystick to drive the wheelchair, users move their arms through a cyclical motion using two powered, mobile arm supports that provide controller inputs to the chair. The feasibility study was carried out with a group of five individuals with DMD and five unimpaired individuals. Participants performed a series of driving tasks in a wheelchair simulator and on a real driving course with a standard joystick and with the MOVit 2.0 device.ResultsWe found that driving speed and accuracy were significantly lowered for both groups when driving with MOVit compared to the joystick, but the decreases were small (speed was 0.26 m/s less and maximum path error was 0.1 m greater). Driving with MOVit produced a significant increase in heart rate (7.5 bpm) compared to the joystick condition. Individuals with DMD reported a high level of satisfaction with their performance and comfort in using MOVit.ConclusionsThese results show for the first time that individuals with DMD can easily transition to driving a powered wheelchair using cyclical arm motions, achieving a reasonable driving performance with a short period of training. Driving in this way elicits cardiopulmonary exercise at an intensity found previously to produce health-related benefits in DMD.

The Effect of Dipping Tobacco on Pulse Wave Analysis among Adult Males.

Background The current study investigated the effect of dipping tobacco (DT) use on arterial wall stiffness which is a known marker of increased risk of cardiovascular events. Methods A case-control study which included 101 adult males was carried out in Al-Shaab Teaching Hospital. Blood pressure and pulse wave analysis parameters were recorded in 51 DT users (study group) before and after 30 minutes of placing tobacco and in 50 nontobacco users (control group). Anthropometric measurements were collected using data collection sheet. Data were entered into a computer and analyzed by using the software Statistical Package for the Social Sciences (SPSS) version 20 (SPSS Inc., Chicago, IL, USA). Results At baseline measurements, heart rate (HR) was significantly lower in the study group compared to the control group (66.15 ± 9.21 vs. 72.87 ± 10.13 beats/min; P value ≤ 0.001). Subendocardial viability ratio (SEVR) was significantly higher in the study group compared to the control group (203.44 ± 30.34 vs. 179.11 ± 30.51%; P value ≤ 0.001). Acute effects of DT compared to pretobacco dipping showed significant increase in HR (72.50 ± 10.89 vs. 66.15 ± 9.21 beats/min; P value ≤ 0.001) and significant decrease in augmentation pressure (AP) (4.30 (2.30-8.00) vs. 3.30 (0.60-6.3) mmHg; P value ≤ 0.001), ejection duration (ED) (271.65 ± 19.42 vs. 279.53 ± 20.47 ms; P value ≤ 0.001), and SEVR (187.11 ± 29.81 vs. 203.44 ± 30.34; P value ≤ 0.001). Linear regression analysis for AP predictor showed that only HR and AIx@75 affect and predict the values of AP (Beta ± SE; −0.242 ± 0.019, P value ≤ 0.001; 0.685 ± 0.014, P value ≤ 0.001). Conclusions Long-term use of DT was not associated with permanent changes in heart rate and blood pressure. Acute tobacco dipping caused an acute increase in heart rate and oxygen demands of myocardium.

Continuous cardiac autonomic and haemodynamic responses to isometric exercise in females.

Hypertension is associated with impaired haemodynamic control mechanisms and autonomic dysfunction. Isometric exercise (IE) interventions have been shown to improve autonomic modulation and reduce blood pressure (BP) predominantly in male participants. The physiological responses to IE are unexplored in female populations; therefore, this study investigated the continous cardiac autonomic and haemodynamic response to a single bout of IE in a large female population. Forty physically inactive females performed a single, individually prescribed isometric wall squat training session. Total power spectral density of heart rate variability (HRV) and associated low-frequency (LF) and high-frequency (HF) power spectral components were recorded in absolute (ms2) and normalised units (nu) pre, during and post an IE session. Heart rate (HR) was recorded via electrocardiography and baroreceptor reflex sensitivity (BRS) via the sequence method. Continuous blood pressure was recorded via the vascular unloading technique and stroke volume via impedance cardiography. Total peripheral resistance (TPR) was calculated according to Ohm's law. During IE, there were significant reductions in HRV (p < 0.001) and BRS (p < 0.001), and significant increases in heart rate (p < 0.001), systolic, mean and diastolic BP (p < 0.001 for all). In recovery following the IE session, cardiac autonomic parameters returned to baseline (p = 0.974); however, total peripheral vascular resistance significantly reduced below baseline (p < 0.001). This peripheral vascular response was associated with significant reductions in systolic (-17.3 ± 16.5mmHg, p < 0.001), mean (-18.8 ± 17.4mmHg, p < 0.001) and diastolic BP (-17.3 ± 16.2mmHg, p < 0.001), below baseline. A single IE session is associated with improved haemodynamic cardiovascular responses in females. Cardiac autonomic responses return to baseline values, which suggests that alternative mechanisms are responsible for the post-exercise haemodynamic improvements in females. Future mechanistic research is required to investigate the acute and chronic effects of IE in female populations with different resting BP profiles.

Ulcerative Lesions of the Mucosa Gastro-Duodenal Zone in Victims of the Chernobyl Accident: Some Features of the Etiology, Pathogenesis and Clinical Signs Identified in the Third of the Century After the Disaster

Ulcerative Lesions of the Mucosa Gastro-Duodenal Zone in Victims of the Chernobyl Accident: Some Features of the Etiology, Pathogenesis and Clinical Signs Identified in the Third of the Century After the Disaster

The autonomic nervous system in its natural environment: Immersion in nature is associated with changes in heart rate and heart rate variability.

Stress Recovery Theory (SRT) suggests that time spent in nature reduces stress. While many studies have examined changes in stress physiology after exposure to nature imagery, nature virtual reality, or nature walks, this study is the first to examine changes in heart rate (HR) and vagally mediated HR variability, as assessed by Respiratory Sinus Arrythmia (RSA), after a longer duration of nature exposure. Consistent with SRT, we hypothesized that immersion in nature would promote stress recovery, as indexed by an increase in RSA and a decrease in HR. We also predicted that exposure to nature would improve self-reported mood. We used a within-subjects design (N=67) to assess changes in peripheral physiology before, during, and after a 5-day nature trip. Results demonstrated a significant decrease in RSA and a significant increase in HR during the trip compared to before or after the trip, suggesting that immersion in nature is associated with a shift toward parasympathetic withdrawal and possible sympathetic activation. These results were contrary to our hypotheses and may suggest increased attentional intake or presence of emotions associated with an increase in sympathetic activation. We also found an improvement in self-reported measures of mood during the trip compared to before or after the trip, confirming our hypotheses and replicating previous research. Implications of this study are discussed in the context of SRT.

Effects of Anisodine Hydrobromide on the Cardiovascular and Respiratory Functions in Conscious Dogs.

PurposeAnisodine hydrobromide (Ani) is isolated from the medicinal plant Anisodus tanguticus (Maxim.) Pascher for clinical use. Although considerable research regarding Ani has been reported, the safety profiles of Ani are currently unknown. This study investigated the cardiorespiratory effects of Ani in conscious dogs to provide clinicians a detailed safety profile of Ani on the cardiorespiratory system.Materials and MethodsUsing the Latin square design, the study was divided into six phases, where in each phase, six telemetered beagle dogs received one dose of normal saline or sotalol hydrochloride or Ani (0.1, 0.4, 1.6, or 6.4 mg/kg). Electrocardiogram, blood pressure (BP) and respiratory parameters were collected before and after administration for 24 hours. Statistical comparisons were performed at scheduled time-points.ResultsThe heart rate was significantly increased, PR and QTCV intervals were significantly shortened in Ani 0.4, 1.6, 6.4 mg/kg treatment group after drug administration. Compared with the saline group, a significant increase in heart rate and shortening of PR, QTCV intervals were observed in the Ani 1.6, 6.4 mg/kg treatment groups from 5 min to 4 h time-points. Diastolic and mean BP were significantly increased in Ani 1.6, 6.4 mg/kg from 1 h to 2 h time-points compared to those of the saline control. Accelerated breathing was observed in the first 20 min after Ani 0.4, 1.6, and 6.4 mg/kg treatment, although not statistically significant. Furthermore, no significant differences were observed in any of the corresponding indexes of Ani 0.1 mg/kg treatment group at different time-points compared to those of the saline group.ConclusionAni may have adverse effects on the cardio-respiratory systems of dogs at doses above 0.4 mg/kg, whereas Ani 0.1 mg/kg was devoid of potentially deleterious effects on cardiorespiratory function.

Evaluation of Serum Endothelin-1 (ET-1) and Nitric Oxide (NO) Levels in Unconjugated Hyperbilirubinemic Neonates

Background: Neonatal hyperbilirubinemia is the most common cause of admission in NICU. Phototherapy is the golden standerd therapy long time ago, which shows efficacy and safety but its side effects should be studied in depth. Both endotheline 1 (ET-1) and nitric Oxide (NO) are potent vasoconstrictor and vasodilator respectively and they are affected by phototherapy. Objectives: This study aimed to investigate the impact of phototherapy on the level of ET-1 and NO in fullterm and preterm as well as studying their effect on hemodynamic stability in treated newborns. Subjects and Methods: This study included 120 newborn infants who were classified into two groups. 60 patients (30 term infants and 30 preterm infants 30 weeks) with unconjugated hyperbilirubinemia indicated for phototherapy and not indicated for exchange transfusion and the onset of jaundice from 2nd to 4th day. In addition, to 60 apparently healthy newborns as control group with matched age, sex, weight and gestational age. Results: There was significant increase in both endothelin-1 and nitric oxide in both fullterm and preterm groups after phototherapy. For fullterm and preterm groups, ET-1 levels significantly increased after 12 hour and 24 hour phototherapy (p-value = 0.048 and 0.013 respectively) for fullterm (p-value = 0.046 and 0.028 respectively) for preterm. Nitric oxide levels among fullterm and preterm groups significantly increased after 12 hour and 24 hour phototherapy (p-value = 0.042 and 0.012 respectively) for fullterm (p value =0.048 and 0.012 respectively) for preterm. The means heart rate changes among fullterm and preterm groups were significantly increased. However, mean arterial blood pressure among full term and preterm groups was significantly decrease after 24 hours of phototherapy. There was a positive correlation between serum levels of ET-1 and NO and heart rate after phototherapy among term and preterm neonats. A negative correlation was found between mean BP and serum levels of NO and a positive correlation between serum levels of ET-1 and mean BP after phototherapy among term and preterm neonates. Conclusion: There was a significant increase in both endothelin-1 and nitric oxide in both full term and preterm groups after treatment with photo-therapy. In addition, a significant increase in mean heart rate and a significant decrease in mean blood pressure among preterm and fullterm groups before and after phototherapy and before phototherapy versus controls.

Evaluation of Serum Endothelin-1 (ET-1) and Nitric Oxide (NO) Levels in Unconjugated Hyperbilirubinemic Neonates

Background: Neonatal hyperbilirubinemia is the most common cause of admission in NICU. Phototherapy is the golden standerd therapy long time ago, which shows efficacy and safety but its side effects should be studied in depth. Both endotheline 1 (ET-1) and nitric Oxide (NO) are potent vasoconstrictor and vasodilator respectively and they are affected by phototherapy. Objectives: This study aimed to investigate the impact of phototherapy on the level of ET-1 and NO in fullterm and preterm as well as studying their effect on hemodynamic stability in treated newborns. Subjects and Methods: This study included 120 newborn infants who were classified into two groups. 60 patients (30 term infants and 30 preterm infants 30 weeks) with unconjugated hyperbilirubinemia indicated for phototherapy and not indicated for exchange transfusion and the onset of jaundice from 2nd to 4th day. In addition, to 60 apparently healthy newborns as control group with matched age, sex, weight and gestational age. Results: There was significant increase in both endothelin-1 and nitric oxide in both fullterm and preterm groups after phototherapy. For fullterm group, ET-1 levels were 53.20 ± 6.17, 55.94 ± 6.30 Pg/ml and 65.42 ± 6.36 Pg/ml before, 12 hour and 24 hour after phototherapy respectively (p-v alue = 0.048 and 0.013 respectively). Nitric oxide levels among fullterm group were 54.56 ± 6.95, 59.77 ± 5.03 & 62.23 ± 5.26 umol/L before, 12 hour and 24 hour after phototherapy respectively (p-value = 0.042 and 0.012 respectively). The means heart rate changes among fullterm group were 134.50 ± 1.73 and 135.73 ± 3.96 beat/min before and 24 hours after photothearpy (p-value = 0.05). Conclusion: There was significant increase in both endothelin-1 and nitric oxide in both fullterm and preterm groups after treatment with photo-therapy. In addition, a significant increase in mean heart rate and a significant decrease in mean blood pressure among preterm and fullterm groups befor and after phototherapy and before phototherapy versus controls.

High-Dose Dobutamine for Inducibility of Atrial Arrhythmias During Atrial Fibrillation Ablation.

This study sought to compare the effect of high-dose dobutamine (DBT) with that of high-dose isoproterenol (IPN) in eliciting triggers during atrial fibrillation (AF) ablation. High-dose IPN is commonly used to elicit triggers during AF ablation. However, it is not available worldwide and, in the United States, its cost per dose has significantly increased. DBT is a similarly nonselective β-agonist and, as such, is a potential alternative. This was a prospective, randomized 2×2 crossover study of patients undergoing AF ablation. Patients were assigned to receive IPN (20 to 30μg/min for 10min) followed by DBT (40 to 50μg/kg/min for 10min) or vice versa in a 1:1 fashion. The type, number, and location of triggers as well as heart rate, blood pressure, and side effects were noted. Fifty patients were included in the study. Both drugs caused a significant increase in heart rate, with a consistently lower peak for DBT. Blood pressure significantly increased with DBT, while there was a significant reduction with IPN, despite phenylephrine support. Atrial arrhythmias induced during DBT were comparable to that induced during IPN. In patients with IPN-inducible outflow tract premature ventricular contractions, a similar effect was noted with DBT. No major complications occurred during either drug challenge. High-dose DBT is safe and comparable to high-dose IPN in respect of eliciting AF triggers, withtheadvantage to maintain systemic pressure without the need of additional vasopressor support. This studysupports the use of high-dose DBT in electrophysiology laboratories in which IPN is not readily available andfor those patients in whom hypotension is a concern.

INFLUENCIA DE LAS PELOTAS DE BAJA PRESIÓN EN LA INICIACIÓN AL PÁDEL

El objetivo de este estudio fue analizar las demandas físicas de la competición en pádel de iniciación, y observar la influencia de diferentes tipos de pelota Dieciséis jugadores de pádel en iniciación participaron en este estudio. Cada judador portó un pulsómetro durante el partido. Se utilizaron cuestionarios al término de cada partido para evaluar el esfuerzo percibido y la satisfacción. Los resultados no mostraron diferencias significativas en la estructura temporal de los partidos. Se encontraron diferencias (p&lt;0,001) entre los partidos con pelota normal y pelota de baja presión tanto en la frecuencia cardiaca media (145,43 ppm vs 140,19 ppm) como en el %FCmáx (72,47 vs 69,85). Los jugadores mostraron mayor satisfacción en el uso de pelotas de baja presión. Estos datos pueden ser de utilidad para determinar el uso de un tipo de pelota u otra y mejorar la planificación del entrenamiento específico en jóvenes jugadores de pádel

The Effects of Hypocapnia on Brain Tissue Pulsations.

Hypocapnia is known to affect patients with acute stroke and plays a key role in governing cerebral autoregulation. However, the impact of hypocapnia on brain tissue pulsations (BTPs) is relatively unexplored. As BTPs are hypothesised to result from cerebrovascular resistance to the inflow of pulsatile arterial blood, it has also been hypothesised that cerebral autoregulation changes mediated by hypocapnia will alter BTP amplitude. This healthy volunteer study reports measurements of BTPs obtained using transcranial tissue Doppler (TCTD). Thirty participants underwent hyperventilation to induce mild hypocapnia. BTP amplitude, EtCO2, blood pressure, and heart rate were then analysed to explore the impact of hypocapnia on BTP amplitude. Significant changes in BTP amplitude were noted during recovery from hypocapnia, but not during the hyperventilation manoeuvre itself. However, a significant increase in heart rate and pulse pressure and decrease in mean arterial pressure were also observed to accompany hypocapnia, which may have confounded our findings. Whilst further investigation is required, the results of this study provide a starting point for better understanding of the effects of carbon dioxide levels on BTPs. Further research in this area is needed to identify the major physiological drivers of BTPs and quantify their interactions with other aspects of cerebral haemodynamics.

Haemodynamic Changes &amp; Complications between Unilateral and Bilateral Spinal Anesthesia in Elderly Type-2 Diabetic Patient Undergoing Hemiarthoplasty – A Comparative Study

Background: During spinal anesthesia, extend of sympathetic blockade causes hemodynamic instability,such as hypotension and bradycardia.It can lead to develop cardiac arrest in some cases. Elderly patientdo not compensate these haemodynamic change easily because of aging process leads some physiologicalchanges in all system especially on cardio vascular system e.g; decreased elasticity of vessels, decreasedvascular and myocardial compliance and also decreased autonomic responsiveness. It is hypothesizedthat unilateral spinal anesthesia restrict the spread of hyperbaric bupivacaine to one side only (dependentside) thus sparing the opposite sympathetic chain and hence would cause less haemodynamic changes. Materials &amp; Methods: This cross sectional study, took place in the department of Anaesthesiology andSICU, BIRDEM General Hospital, Shahbag, Dhaka. A total 60 elderly (age-60 to 80 years), ASA grade IIand III, type-2 Diabetic patients scheduled for hemiarthoplasty were enrolled in this study. Patients weredivided into two groups U &amp; A, 30 patients in each. Subarachnoid (spinal) anaesthesia was performed inall patients with 0.5% hyperbaric bupivacaine intrathecally, at L3 - L4 interspinous spaces, with 25GQuinke’s spinal needle. Patients of group U were kept in lateral decubitus position which was maintainedfor 15 minutes after injecting bupivacaine and patients of group B were kept in supine position. Changesof BP, pulse and development of any complication was recorded in 5 minute interval after spinal anesthesia.All the informations were recorded in preformed data collection sheet. Result: Compared with group U, group B showed statistically significant increase inheart rate at 10 minafter spinal anesthesia (p&lt;0.05).Systolic BP was significantly lower in group B compared to group U in allrecorded time interval except at 60 minute.Diastolic blood pressure was significantly lower in group Bcompared to group U at 15, 30 and 45 minute reading. Regarding maen arterial pressure we found it wasreduced significantly in group B compared to group U in all the recorded time except at 60 minute(p&lt;0.05). Present study showed none of the patients in the unilateral group experienced vomiting; onlytwo patients noticed nausea. In the bilateral group, seven patients had nausea and three of them experiencedepisodes of vomiting (p = 0.02). In group U, no case found hypotensive, only single developed bradycardia.In Group B 7 patients experienced hypotensions and 4 patients had bradycardia. Conclusion: This study showed that the unilateral spinal anesthesia reduces the incidence and severityof hypotension, bradycardia and other complication in elderly type-2 diabetic patients. So unilateralspinal anaesthesia is more benifecial for elderly type-2 diabetic patient in hemiarthoplasty. JBSA 2020; 33(2): 62-68

Retrospective evaluation of labetalol as antihypertensive agent in dogs

BackgroundTo evaluate the effect on arterial blood pressure (ABP) of labetalol infusion as treatment for perioperative non nociceptive acute hypertension in dogs. The clinical records of dogs receiving intra or postoperative labetalol infusion were retrospectively reviewed. Invasive systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressure and heart rate (HR) before labetalol infusion (T0) and 15, 30, 45 and 60 min (T1, T2, T3 and T4 respectively) after infusion were retrieved. The dose rate of labetalol infusion and use of concurrently administered drugs that could have potentially affected ABP and/or HR were also recorded. ANOVA for repeated measures and Dunnett’s multiple comparison test were used to determine the effect of labetalol on ABP and HR. Differences were considered significant when p < 0.05.ResultsA total of 20 dogs met the inclusion criteria, and hypertension was documented after craniotomy (12/20), adrenalectomy (4/20) and other procedures (4/20). Five dogs received labetalol intraoperatively, 14 postoperatively, and 1 during the surgical procedure and recovery. Median infusion duration and rate were 463 (60-2120) minutes and 1.1 (0.2–3.4) mg/kg/h respectively. Median loading dose was 0.2 (0.2–0.4) mg/kg. Labetalol produced a significant decrease in SAP and DAP at all time points compared to T0 (p < 0.05), while the effect was not significant at T1 for MAP (p = 0.0519). Median maximum MAP decrease was 31 (20–90) mmHg. Heart rate did not increase significantly during treatment (p = 0.2454). Acepromazine given before or during labetalol treatment did not reduce significantly ABP (p = 0.735).ConclusionsLabetalol produced a reliable and titratable decrease in ABP with non significant increase in HR.

Simulation Learning: Effectiveness and Stressfulness in Medical Student Teaching

This article was migrated. The article was not marked as recommended. Introduction: The aims of this study were to assess the effectiveness of different modalities of simulation learning in medical students and the resulting stress response. Methods: Students were randomised into two groups for simulation learning, on the assessment and management of acutely ill patients. Group 1 performed assessments in a static individual format, whilst group 2 performing assessments in a dynamic group format. The stress response was measured by heart rate monitors worn by students, and performance was graded by a final simulator assessment. Results: The stress response did not significantly vary between groups, but there was a significant increase in heart rate in all students during the simulation learning; with a mean increase of 34 beats per minute in group 1 and 38 beats per minute in group 2. Performance in the final simulator assessment was significantly better in group 2, with a mean score of 21.5 points, compared to 16.2 points in group 1. Conclusion: A dynamic group simulation learning strategy is more effective in teaching medical students than simulations performed individually. Simulation learning, however; results in a significant stress response in all students, which must be carefully managed when delivering this type of learning.