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At least 1,171 records · Page 65Linked to original sources
PubMed1986

Equilibrium radionuclide right ventriculography at rest and during exercise in patients with pulmonary hypertension.

Using the method of equilibrium radionuclide ventriculography (RNV), the right ventricular ejection fraction (RVEF) at rest and at a standard workload of 250 kpm per min was determined in 25 control subjects and in 30 patients with pulmonary hypertension (8 patients with chronic obstructive bronchopulmonary disease, 12 with recurrent pulmonary embolism and 10 with pure mitral stenosis). In the same week as RNV, pulmonary artery pressure was registered in patients with pulmonary hypertension at rest and at standard workload. RVEF was significantly higher (45 +/- 5%) in normal subjects than in patients with pulmonary hypertension (33 +/- 5%) and during exercise increased, whereas in patients with pulmonary hypertension it did not markedly change or decreased. The RVEF correlated at rest (r = -0.6293, p less than 0.001) and during exercise (r = 0.6980, p less than 0.05) with the degree of pulmonary hypertension at rest and during exercise. The results show a good correlation between the RVEF and the degree of pulmonary hypertension in patients with pulmonary hypertension at rest and during exercise.

Adult↗
PubMed1979

The effect of vagotomy on human gastroesophageal sphincter pressure in the resting state and following increases in intra-abdominal pressure.

The effect of surgical isolation and extrinsic denervation of the distal 5 to 7 cm of the human esophagus on resting gastroesophageal sphincter pressure and its response to graded increases of external abdominal compression was determined in 89 patients with duodenal ulcer. Fasting serum gastrin concentration also was measured. No significant changes in resting sphincter pressure were obtained before and after vagotomy of various types: parietal cell vagotomy, selective gastric vagotomy plus drainage, and selective gastric vagotomy plus precise antrectomy. No correlation between resting sphincter pressure and fasting serum gastrin concentration was found in any of the groups studied. The increase in gastroesophageal sphincter pressure was similar to the increase in intragastric pressure after 10, 20, and 30 mm Hg of external abdominal compression and was unchanged after all types of vagotomies. These results suggest that (1) extrinsic innervation of the lower esophageal sphincter in humans does not regulate the resting tone of the sphincter; (2) extrinsic "mechanical" influence does not play any role in the maintenance of resting pressure; (3) the effect of increased abdominal pressure is a pure mechanical effect, is unchanged after vagotomy, and therefore is not regulated by external neural reflex.

Abdomen↗
PubMed1980

[Vagus effect on action potentials of rest-potentiated contractions in the isolated left atrium of the rabbit].

After a period of rest action potentials in constantly driven preparations of left rabbit atria show a marked change in configuration. After the upstroke an early repolarization takes place which is followed by a prolonged phase of secondary depolarization. This depolarization is strongly suppressed by vagal stimulation. Frequency-response characteristics of this electrotropic effect were obtained by stimulating the vagal supply of the preparation with frequencies in the range from 1.0 to 40.0 s-1 and compared with those of the constantly driven preparation. In most cases studied the frequency-response curves for the post rest action potential are steeper in rise and shifted to the left. By placing a series of vagal stimulations at different moments into the resting interval vagal effects could be composed to reflect the time course of transmitter action in a non beating preparation. It was shown that such time course is not essentially altered compared with that of a driven preparation. From a mathematical treatment of the frequency-response relations it is concluded that post rest action potentials show a higher sensitivity towards the transmitter action and that the amount of transmitter liberated after a period of rest may be increased. Possible explanations for this behaviour are proposed.

Action Potentials↗
PubMed1983

[The effect of norfenefrine on circulation, plasma catecholamines and metabolism at rest and during exertion].

In a single-blind random cross-over study the influence of a Norfenefrin infusion (2-4 mg/kg per minute) on circulation, carbohydrate and fat metabolism, catecholamines, growth hormone, cortisol, and insulin was investigated. The investigations were carried out on 12 healthy male physical education students at rest and during physical exercise. Under Norfenefrin, heart rate was reduced at rest (-30%) and under low and medium work load (150 watts: -9%); under maximal work load heart rate remained unchanged. Systolic blood pressure at rest increased by 29%; the results under physical exercise differ only slightly, and during increased work load they did not differ significantly. Diastolic blood pressure, in contrast, increased at rest (+23%) and under submaximal (150 watts: +12%) and maximal work load (+12.5%). The product of systolic blood pressure and heart rate was significantly decreased at rest under Norfenefrin, whereas it tended to decrease only slightly during work load. Adrenaline remained unchanged, while noradrenaline had a tendency to decrease only slightly during submaximal work load and was significantly lower during maximal work load. Glucose, lactate, glycerol, free fatty acids, and triglycerides, as well as growth hormone, cortisol, and insulin, remained unchanged. The physical working capacity remained unaffected. These observations confirm the predominant alpha-receptor-stimulating effect of Norfenefrin. The decrease in noradrenaline during exercise indicates the ability of Norfenefrin to interfere with the autoregulation of transmitter release and to replace endogenous noradrenaline.

2-Hydroxyphenethylamine↗
PubMedDate not supplied

Changes of glucose utilization by erythrocytes, lactic acid concentration in the serum and blood cells, and haematocrit value during one hour rest after maximal effort in individuals differing in physical efficiency.

Glucose utilization by the erythrocytes, lactic acid concentration in the blood and erythrocytes, and haematocrit value were determined before exercise and during one hour rest following maximal exercise in 97 individuals of either sex differing in physical efficiency. In the investigations reported by the author individuals with strikingly high physical fitness performed maximal work one-third greater than that performed by individuals with medium fitness. The serum concentration of lactic acid was in all individuals above the resting value still after 60 minutes of rest. On the other hand, this concentration returned to the normal level in the erythrocytes but only in individuals with strikingly high efficiency. Glucose utilization by the erythrocytes during the restitution period was highest immediately after the exercise in all studied individuals and showed a tendency for more rapid return to resting values again in individuals with highest efficiency. The investigation of very efficient individuals repeated twice demonstrated greater utilization of glucose by the erythrocytes at the time of greater maximal exercise. This was associated with greater lactic acid concentration in the serum and erythrocytes throughout the whole one-hour rest period. The observed facts suggest an active participation of erythrocytes in the process of adaptation of the organism to exercise.

Adolescent↗
PubMed1995

Nitrate versus rest myocardial scintigraphy with technetium 99m-sestamibi: relationship of tracer uptake to regional left ventricular function and its significance in the detection of viable hibernating myocardium.

Rest technetium 99m-sestamibi uptake may underestimate myocardial viability in asynergic territories. Because nitrate administration was reported to improve thallium 201 uptake in perfusion defects, this study aimed to test the influence of nitrates on 99mTc-sestamibi uptake and on the tracer capability to recognize viable tissue in asynergic segments. In 23 patients with prior infarction and left ventricular dysfunction, regional wall motion was assessed by echocardiography before and after revascularization (13 segments/patient). Group 1 included 97 normokinetic; group 2, 97 hypokinetic; and group 3, 105 akynetic or dyskinetic segments; group 3 was divided into group 3A (72 segments unchanged after revascularization) and group 3B (33 segments with functional recovery). 99mTc-sestamibi uptake was graded using a scoring scheme in the same 13 segments both at rest and, on a separate day, injecting the tracer during isosorbide dinitrate infusion (ISDN). At rest, the mean 99mTc-sestamibi uptake decreased significantly from group 1 through group 3. With ISDN, the mean 99mTc-sestamibi uptake increased in all groups compared with rest, but the increase was significant only in groups 2 and 3, and within the latter, only in group 3B. Thus, with ISDN group 3B was no longer different from group 2. Only 6% of group 3A segments showed an improved uptake with ISDN, versus 33% of group 3B (P < .00005). At rest only 14 of 33 segments of group 3B showed a normal or slightly reduced uptake, whereas these were 25 of 33 with ISDN (P < .02). In conclusion, the acute administration of ISDN increases the uptake of 99mTc-sestamibi mainly in those asynergic territories that show postrevascularization functional recovery. Therefore, ISDN 99mTc-sestamibi imaging might improve the tracer capability to detect viable hibernating myocardium.

Angioplasty, Balloon, Coronary↗
PubMed1994

Psychological effects of bed rest in young healthy subjects.

In order to evaluate the effect of immobilization during bed rest on mental health, we performed psychosomatic investigations of 6 young males and 3 young females before, during and after 20 days bed rest. The psychological state was repeatedly assessed by measuring the following indices: 1) Zung's self-rating depression scale, 2) Cornell medical index, and 3) the General Health Questionnaire. Zung's self-rating depression scale is a measure of the state of depression, while Cornell medical index and the General Health Questionnaire are utilized for detection of neurosis. Although no influence of bedrest on Cornell medical index was seen, Zung's self-rating depression scale and the General Health Questionnaire displayed a tendency to development of depression and neuroses, respectively. This tendency had disappeared 2 months after the bed rest study. Both Zung's self-rating depression scale and the General Health Questionnaire may be appropriate indices to evaluate the effects of relatively short-term psychological stress due to bed rest. The urinary excretion of 17-hydroxycorticosteroid was used as an indicator of endocrine stress factors, but no significant variation due to bed rest was seen. We concluded that there is a need for further studies combining physiological research with psychosomatic investigations.

17-Hydroxycorticosteroids↗
PubMed1994

Comparative feasibility of separate or simultaneous rest thallium-201/stress technetium-99m-sestamibi dual-isotope myocardial perfusion SPECT.

UNLABELLED: Separate or simultaneous rest 201Tl/stress 99mTc-sestamibi dual-isotope SPECT are potentially efficient myocardial perfusion imaging protocols which combine the use of a high-resolution 99mTc tracer for stress perfusion assessment and 201Tl, the current single-photon agent of choice, for viability assessment. METHODS: To investigate the feasibility of dual-isotope myocardial perfusion SPECT protocols using rest 201Tl and stress sestamibi, 201Tl crosstalk into the 99mTc acquisition window (Group 1, n = 26 patients) and 99mTc crosstalk into 201Tl windows (Group 2, n = 25) were studied. For Group 1, treadmill exercise with sestamibi injection and poststress SPECT ("virgin" sestamibi images) were performed, followed by rest 201Tl injection and SPECT acquisition using dual-isotope windows (contaminated or "dual" images). For Group 2, the order was reversed: rest 201Tl SPECT (virgin 201Tl images) was performed first, followed by exercise sestamibi injection and dual-isotope SPECT. RESULTS: The contribution of 201Tl scatter to the dual sestamibi images (Group 1) was measured to be 2.9% +/- 2.1%, while 99mTc crosstalk contributed 26.7% +/- 13.0% to the dual 201Tl images (Group 2). Image quality was considered good to excellent in 92% of the sestamibi (virgin and dual) images and 88% of the virgin 201Tl SPECT, but only in 23% of the dual 201Tl studies. CONCLUSIONS: Technetium-99m crosstalk into 201Tl windows is substantial; therefore, simultaneous dual-isotope protocols, which involve assessment of 201Tl images contaminated by 99mTc, are not recommended. On the other hand, because of the small amount of 201Tl crosstalk into the 99mTc window, a separate acquisition dual-isotope approach employing the rest 201Tl (virgin)/stress sestamibi sequence is acceptable.

Aged↗
PubMed1994

Significance of defect severity in technetium-99m-MIBI SPECT at rest to assess myocardial viability: comparison with fluorine-18-FDG PET.

UNLABELLED: The pathophysiological significance of 99mTc-MIBI uptake at rest for assessing myocardial viability in patients with coronary artery disease (CAD) is still controversial. Therefore, we studied the relationship of 99mTc-MIBI uptake at rest and preserved or absent uptake of 18FDG as assessed with PET in 111 consecutive patients after overnight withdrawal of their antianginal medication. METHODS: Each ventricle was evaluated in 13 segments derived from 25 regions of interest (ROIs) in short-axis cuts and 18FDG uptake was normalized to the intraindividual normal reference ROI (ROI with maximal = 100% 99mTc-MIBI uptake). Segments with a normalized 18FDG uptake > 70% were defined as viable while segments with a 18FDG uptake < 50% were defined as nonviable. RESULTS: Five to 11% of segments with 99mTc-MIBI uptake at rest < or = 30% of peak activity were viable and 80%-84% nonviable. Of moderate to severe 99mTc-MIBI defects at rest (31%-70% of peak), 13%-61% were viable. Segmental 99mTc-MIBI uptake and normalized 18FDG uptake were linearly correlated (r = 0.61, n = 1443, p < 0.001). In segments revealing severely reduced 99mTc-MIBI uptake (< or = 50% of peak) the correlation was considerably lower (r = 0.44, n = 295, p < 0.001). CONCLUSIONS: In patients with CAD, 99mTc-MIBI uptake underestimates myocardial viability in comparison to 18FDG-PET. Myocardial 99mTc-MIBI uptake therefore appears to reflect myocardial blood flow rather than myocardial viability. Patients with moderate and severe 99mTc-MIBI defects at rest may benefit from additional metabolic PET imaging prior to final therapeutic decisions.

Adult↗
PubMed1993

Body volume changes during simulated microgravity. II: Comparison of horizontal and head-down bed rest.

Changes in segmental fluid volume were measured in 10 male subjects during 7 d of either horizontal (0 degrees) or antiorthostatic (-6 degrees) head-down bed rest as part of the Joint U.S./U.S.S.R. Hypokinesia Program. Impedance plethysmography (IPG) was used to measure leg, pelvic, thoracic, and arm volume changes prior to, during, and following bed rest. Results of this study demonstrate that antiorthostatic bed rest produces a larger and more persistent thoracic fluid shift than horizontal bed rest. Segmental volume responses found during this investigation are compared to those obtained during other simulated or actual space-flight experiments. Antiorthostatic thoracic volume changes from this study were found to closely approximate those estimated to take place in space while leg volume changes produced by either 0 degrees or -6 degrees bed rest were much less than those observed by others in the microgravity environment.

Adult↗
PubMedDate not supplied

Emergency cerclage compared with bed rest for advanced cervical dilatation in pregnancy.

In a cohort of 43 women with viable, singleton pregnancies, cervical dilatation greater than 4 cm, and absent labor between 20 and 27 weeks gestation, 22 women who underwent emergency cerclage within six hours of admission, were compared prospectively with 15 women who elected conservative bed rest treatment. The two groups were demographically similar. Emergency cervical cerclage resulted in a longer mean gestational age at delivery compared to bed rest (p = 0.001). Women treated with cerclage required a significantly shorter period of antepartum hospitalization (p = 0.001), required less tocolysis (p = 0.005), and experienced fewer preterm membrane ruptures compared to women in the bed rest group (p = 0.01), although the latency period, following preterm rupture of membranes was shorter in the cerclage group (p = 0.005). There was no statistical difference in the frequencies of chorioamnionitis, maternal morbidity and cesarean section between the two groups. Although the perinatal mortality in the two groups was not significantly different (p = 0.3), emergency cerclage resulted in a significantly higher mean birth weight compared to conservative bed rest treatment (p = 0.02). This study demonstrates the superiority of emergency cerclage to bed rest in women with advanced cervical dilatation and absent labor in late second-trimester of pregnancy.

Adult↗
PubMed1996

Metabolic propensity toward obesity in black vs white females: responses during rest, exercise and recovery.

OBJECTIVE: To examine the existence of a metabolic propensity toward the development of obesity in black vs white females. DESIGN: Cross-sectional comparison of responses during 30 min of rest, 30 min of treadmill exercise at 65% VO2max, and 30 min of recovery. SUBJECTS: 22 (11 black, 11 white) healthy, normal weight, sedentary females with a family history of obesity. MEASUREMENTS: Biometric measures (body mass index, waist-to-hip ratio, and body composition by hydrodensiometry) to insure inter-group homogeneity. Oxygen consumption (VO2), respiratory exchange ratio (RER), insulin, glucose and free fatty acids (FFA) during rest, exercise and recovery were measured to test for metabolic differences between the groups. RESULTS: Black females displayed lower VO2 during rest (p = 0.04) and recovery (p = 0.04), higher RER during rest, exercise and recovery (p = 0.003), and higher levels of insulin (p = 0.03). No significant differences were observed for levels of blood glucose (p = 0.29) or serum FFA (p = 0.73). CONCLUSION: Normal weight black and white females with comparable family histories of obesity exhibit dissimilar metabolic responses during rest, exercise and recovery. Lower rates of oxygen consumption, higher metabolic reliance on carbohydrate, and higher levels of insulin may slowly impact energy balance predisposing these black females toward the eventual onset of obesity.

Adolescent↗
PubMed1996

Cardiovascular deconditioning through head-down tilt bed rest increases blood pressure variability and plasma renin activity.

BACKGROUND: The renin-angiotensin-aldosterone system may be of primary importance in the mechanism of bed rest cardiovascular deconditioning. HYPOTHESIS: This study was designed to test the hypothesis that bed rest cardiovascular deconditioning does not result simply from plasma volume loss, but is also at least partially attributable to a persistent disequilibrium of the neuroendocrine mediators of plasma volume homeostasis. We examined whether changes in the renin-angiotensin-aldosterone system occur in association with the cardiovascular deconditioning and hemodynamic instability induced by antiorthostatic 6 degrees head-down tilt bed rest. METHODS: Normal male volunteers (n = 10) were tested before, during, and after 14 d of head-down tilt with a high (150 mEq.d-1) salt intake, using head-down tilt as a model of cardiovascular deconditioning and lower body negative pressure (LBNP) as a model of orthostatic stress. RESULTS: Resting plasma renin activity was 2.22 +/- 0.85 ng.ml-1.h-1 (+/- SD) at baseline and increased to 4.14 +/- 1.21 ng.ml-1.h-1 at the end of head-down tilt (p < 0.05), but urine aldosterone, plasma aldosterone, and urine sodium did not change with head-down tilt. Although the plasma norepinephrine response to LBNP was accentuated, resting adrenergic tone did not change during head-down tilt. Cardiovascular deconditioning was associated with an increase in blood pressure variability during LBNP as assessed by both beat-to-beat standard deviation and spectral analysis. CONCLUSIONS: These data support a proposed link between blood pressure variability and the renin-angiotensin system in cardiovascular deconditioning.

Adult↗
PubMed1996

Submaximal exercise VO2 and Qc during 30-day 6 degrees head-down bed rest with isotonic and isokinetic exercise training.

BACKGROUND: Maintaining intermediary metabolism is necessary for the health and well-being of astronauts on long-duration spaceflights. While peak oxygen uptake (VO2) is consistently decreased during prolonged bed rest, submaximal VO2 is either unchanged or decreased. METHODS: Submaximal exercise metabolism (61 +/- 3% peak VO2) was measured during ambulation (AMB day-2) and on bed rest days 4, 11, and 25 in 19 healthy men (32-42 yr) allocated into no exercise (NOE, N = 5) control, and isotonic exercise (ITE, N = 7) and isokinetic exercise (IKE, N = 7) training groups. Exercise training was conducted supine for two 30-min periods per day for 6 d per week: ITE training was intermittent at 60-90% peak VO2; IKE training was 10 sets of 5 repetitions of peak knee flexion-extension force at a velocity of 100 degrees s-1. Cardiac output was measured with the indirect Fick CO2 method, and plasma volume with Evans blue dye dilution. RESULTS: Supine submaximal exercise VO2 decreased significantly (*p < 0.05) by 10.3%* with ITE and by 7.3%* with IKE; similar to the submaximal cardiac output decrease of 14.5%* (ITE) and 20.3%* (IKE), but different from change in peak VO2 (+1.4% with ITE and -10.2%* with IKE) and decrease in plasma volume of -3.7% (ITE) and -18.0%* (IKE). Reduction of submaximal VO2 during bed rest correlated 0.79 (p < 0.01) with submaximal Qc, but was not related to change in peak VO2 or plasma volume. CONCLUSION: Reduction in submaximal oxygen uptake during prolonged bed rest is related to decrease in exercise but not resting cardiac output; perturbations in active skeletal muscle metabolism may be involved.

Adult↗
PubMed1977

[Arterial CO2- and O2 partial pressure at rest and during exertion in pulmonary emphysema].

In 83 patients with severe, largely irreversible bronchial obstruction (FEV1/VC less than 40% and FEV1 after orciprenaline inhalation less than 120% of the control value) and radiologie evidence of AD-emphysema, arterial PCO2 and PO2 were measured at rest in supine position and on the bicycle ergometer during a steady-state exercice of 5 min. Alveolar hypoventilation (PCO2 greater than 45 mm Hg) was most often observed in the cases with FEV1 less than 1.01 (in 22 patients [27%] at rest and in 26 patients [31%] during exercise). However, there was no significant correlation of the PCO2 increase with the degree of bronchial obstruction. In all patients there was a marked inhomogeneity of the alveolar ventilation or the alveolar-capillary O2 transfer in relation to alveolar blood perfusion. Indeed, the alveolar-arterial PO2 difference was increased (40 mm Hg at rest and 45 mm Hg during exercise). The additional increase of this gradient during exercise was due to an unequal distribution of alveolar O2 diffusing capacities in connection with the alveolar blood flow (preceding measurements of the N2 gradient between alveolar air and arterial blood revealed a mean fall from 18 at rest to 8 mm Hg during exercise). The observed deterioration of hypoxemia during exercise (without additional hypercapnia) is to a great extent related to the degree of bronchial obstruction measured by simple spirometry. Thus, measurements of PCO2 and PO2 at rest and during exercise appear to be a helpful adjuvant to routine spirometry in the diagnosis of subclinical emphysema.

Arteries↗
PubMed1997

Significance of late redistribution thallium-201 imaging after rest injection for detection of viable myocardium.

UNLABELLED: The aim of this study was to determine whether late redistribution imaging after rest injection of 201Tl would provide further information on myocardial viability over conventional rest-early redistribution 201Tl imaging. METHODS: Twenty-nine patients with coronary artery disease and left ventricular dysfunction underwent rest, early (3-4 hr) and late (20-24 hr) redistribution 201Tl and gated blood pool studies. In 14 patients with successful revascularization, gated blood pool study was repeated after the coronary intervention. RESULTS: Nine of 29 patients showed early redistribution, and six additional patients showed further redistribution on the late images. Of 136 segments with initial 201Tl defects, 18 showed early redistribution, and 10 showed late redistribution. When a threshold of 60% of peak activity was used as an index of myocardial viability, only a small fraction (3%) of the initial 201Tl defects were additionally considered viable by the late images. In 14 patients who underwent revascularization, the positive (69%) and negative (87%) predictive values of the early redistribution images for functional recovery were similar to those obtained by the late images (68% and 86%, respectively). CONCLUSION: Although late redistribution after rest injection of 201Tl occasionally occurs, most of the clinically relevant information on myocardial viability may be obtained by conventional rest-early redistribution 201Tl imaging when the defect severity is considered an index of tissue viability.

Aged↗
PubMed1997

Impaired activation of the baroreflex loop as early sign of sympathetic damage in diabetics with normal heart rate variability at rest.

The objective of the study was to define the impairment of sympathovagal balance in patients with diabetes mellitus (DM) and coronary heart disease (CHD) compared to healthy controls (HC) showing similar heart rate variability (HRV) at supine rest. 88 DM (41 m, 47 f; age 62 +/- 1 years; BMI 27.1 +/- 1.5 kg/m2; HbA1c 7.9 +/- 0.4%), 49 CHD (27 m, 22 f; age 62 +/- 1 years; BMI 27.1 +/- 1.6 kg/m2; HbA1c 5.2 +/- 0.1%) and 16 HC (8 m, 8 f; age 59 +/- 1 years; BMI 26.4 +/- 0.5 kg/m2; HbA1c 5.0 +/- 0.1%) were investigated. Time series of heart period duration (HPD) were obtained during 2 min deep breathing (6/min), 5 min of supine rest and for 5 min at upright position using a RR memory device (BHL 6000, Baumann-Haldi Switzerland, modified ECG lead, 1 kHz). Mean HPD, coefficient of variation (CV), total power (TP) and integral power in the HF (0.15 to 0.5 Hz), MF (0.05 to 0.15 Hz) and LF (0.015 to 0.05 Hz) frequency bands as well as (MF-HF)/(MF + HF) as spectral index were calculated. As to be expected we found significantly lower values of CV, TP and HPD in DM compared to HC. The CV of HRV did not differ significantly between DM and CHD but TP and HPD of CHD patients were significantly higher in comparison to DM. Therefore, the deterioration of HRV was most pronounced in the DM group. For further analysis we calculated data of subjects with CV's in the upper quartile (> or = 3.52) of the CV at supine rest. The aim of this procedure was to compare subjects with similar high HRV at supine rest. With this method we obtained from all subjects 12 HC, 11 DM and 12 CHD. These DM had a significant decrease of CV, TP and the integral power at the HF frequency band during active orthostasis compared to HC and CHD. The spectral index increased significantly during standing in HC and CHD but was unchanged in DM. These changes were accompanied by a nearly similar increase of HRV during deep breathing. In conclusion, DM with normal reaction to deep breathing did not activate the sympathetic baroreflex loop during active orthostasis. This could be an early sign of sympathetic dysfunction in DM with normal HRV at supine rest.

Autonomic Nervous System Diseases↗
PubMed1997

Systematic reviews of bed rest and advice to stay active for acute low back pain.

BACKGROUND: In the United Kingdom (UK), 9% of adults consult their doctor annually with back pain. The treatment recommendations are based on orthopaedic teaching, but the current management is causing increasing dissatisfaction. Many general practitioners (GPs) are confused about what constitutes effective advice. AIM: To review all randomized controlled trials of bed rest and of medical advice to stay active for acute back pain. METHOD: A systematic review based on a search of MEDLINE and EMBASE from 1966 to April 1996 with complete citation tracking for randomized controlled trials of bed rest or medical advice to stay active and continue ordinary daily activities. The inclusion criteria were: primary care setting, patients with low back pain of up to 3 months duration, and patient-centred outcomes (rate of recovery from the acute attack, relief of pain, restoration of function, satisfaction with treatment, days off work and return to work, development of chronic pain and disability, recurrent attacks, and further health care use). RESULTS: Ten trials of bed rest and eight trials of advice to stay active were identified. Consistent findings showed that bed rest is not an effective treatment for acute low back pain but may delay recovery. Advice to stay active and to continue ordinary activities results in a faster return to work, less chronic disability, and fewer recurrent problems. CONCLUSION: A simple but fundamental change from the traditional prescription of bed rest to positive advice about staying active could improve clinical outcomes and reduce the personal and social impact of back pain.

Acute Disease↗