Abstract The purpose of this study was to examine thermal (body temperature, thermal sensation and comfort ratings), circulatory (blood pressure, heart rate variability) and neuromuscular performance responses to whole-body cryotherapy (WBC, -110 °C). Altogether 66 healthy subjects were exposed to WBC for two minutes. The acute and long-term changes were examined, when the subjects were exposed to WBC three times a week during three months. Skin temperatures decreased very rapidly during WBC, but remained such a high level that there was no risk for frostbites. The effects on rectal temperature were minimal. Repeated exposures to WBC were mostly well tolerated and comfortable and the subjects became habituated at an early stage of trials. WBC increased both systolic (24 mmHg) and diastolic (5 mmHg) blood pressures temporarily. Adaptation of blood pressure was not found during three months. The acute cooling-related increase in high-frequency power of RR-intervals indicated an increase in cardiac parasympathetic modulation, but after repeated WBC the increase was attenuated. The repeated WBC exposure-related increase in resting low frequency power of RR-intervals resembles the response observed related to exercise training. There are signs of neuromuscular adaptation, especially in dynamic performance. A single WBC decreased flight time in drop-jump exercise, but after repeated WBC these changes were almost vanished. This adaptation was confirmed by the change of the activity of the agonist muscle, which increased more and the change of the activity of antagonist muscle, which increased less/did not change after repeated WBC indicating reduced co-contraction and thus, neuromuscular adaptation.

Masters of Science / Hypertension is the leading cause of cardiovascular diseases worldwide. There is evidence of the rising incidence and prevalence of chronic diseases of lifestyle in developing countries. Physical activity has been regarded as a commonly accepted modality for treating hypertension. The aim of this study was to determine if physical activity levels are associated with hypertension among employees of Kigali Institute Science and Technology in Kigali, Rwanda. A quantitative, cross- sectional design was used and all staff members (325 employees) of Kigali Institute of Science and Technology (KIST) represented the study population. Random sampling was used to determine the study sample. Data was collected by means of a self-administered questionnaire adopted from The International Physical Activity Questionnaire (IPAQ).Data analysis was done using Statistical Package for Social Sciences (SPSS) software version 15.0. Descriptive statistics using frequencies, percentages, means, and standard deviations and inferential statistics using Chi-square tests were employed. The data were presented with use of tables, figures, graphs, and pie charts. Ethical issues including obtaining permission for conducting the study,informed consent,anonymity,confidentiality, voluntary participation, and the right to withdraw from the study was observed in this study. The study found a prevalence of 34% participants with hypertension. The prevalence of hypertension was associated with age, smoking, drinking alcohol, suffering for diabetes mellitus, and body mass index (BMI). Over one-fifth of the participants in the physically active group were hypertensive while 68% of the participants in the physically inactive group were hypertensive. This study shows that hypertension status is strongly associated with physical activity levels [X² = 20.381 with(P<0.001)].The study further showed that smoking and suffering from diabetes mellitus were also associated with levels of physical activity (P = 0.003 and p = 0.004 respectively). The current study concludes that physical activity is needed for employees at Kigali Institute of Science and Technology as part of preventive measures for chronic diseases of lifestyle.Therefore, the recommendations were proposed to various categories of people and stakeholders to be actively involved in the promotion of physical activity among employees of Kigali Universities in Rwanda.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Hypertension is one of the most common non-communicable diseases, and it is the leading cause of cardiovascular diseases, death and disability worldwide, especially in developing countries. Physical activity has been regarded as a commonly accepted modality for preventing and treating hypertension. However, despite its known benefits, this modality of treatment and prevention of hypertension continues to be underused.The present study aimed to determine the demographic, social and health-related factors that are associated with levels of physical activity participation among adults with hypertension in Kigali, Rwanda. This cross-sectional study was conducted with 252 adults with hypertension and 87 healthcare professionals through the Godin Leisure-Time Exercise Questionnaire (GLTEQ) and Physical Activity Exit Interview (PAEI). Two thirds of the participants (69.44%) were classified as sedentary. The following factors were found to be significantly (P<0.05) associated with the levels of physical activity:age, marital status, and level of education, residence, tobacco; past and current users, alcohol; current user, diabetes mellitus, BMI, perceived health status, self-efficacy, and blood pressure. None of the healthcare professionals were considered good physical activity counsellor. The findings of the present study highlight the need for the implementation of health promotion strategies aimed at promoting physical activity lifestyle among individuals with hypertension in Rwanda. Efforts should be made in educating people with hypertension on the benefits of integrating regular physical activity in their daily lives. Furthermore, healthcare professionals should be educated concerning how to promote physical activity to all patients especially those with hypertension.

Magister Public Health - MPH / Background: Adherence is the extent to which a person takes medication as prescribed by health-care providers. It includes both dosing regularity and timing of intake. Antihypertensive medication reduces high blood pressure effectively and reduces the risk of heart failure, renal failure and stroke. Hypertension is considered a public health problem due to its impact of high mortality and morbidity. According to the Namibia Ministry of Health and Social Services a total of 34,826 people, aged 18 years and older in the Windhoek District, were diagnosed with hypertension in 2006-2007; the premature death toll due to uncontrolled hypertension increased from 88 deaths per 1,000 cases in 2006 (MOHSS, 2006) to 301 deaths per 1,000 cases in 2007 (MOHSS, 2007). Despite the availability, accessibility and affordability of medication at clinics and health centers, non-adherence is increasing, especially among the young productive population. The purpose of this study was to gain an understanding into the perceptions of non-adherent hypertension patients in Katutura Township in the Windhoek District about their treatment regimens. The research provided information that can be used by policy-makers in the development of a hypertension policy to improve interventions. Aim: The study aimed to explore the perceptions of non-adherent hypertensive patients in Katutura Township by looking at what they considered to be the factors influencing their non-adherence to antihypertensive medication. Methodology: An explorative qualitative study was conducted, using individual in-depth interviews among eight non-adherent hypertension patients, aged 35 years and older. The eligible respondents were purposively selected. A thematic content analysis of transcribed data was conducted where themes were related to patients‟ perceptions for non–adherence. Results: The results showed that the respondents were not adhering to medication. There were several reasons given for this. An important factor was their limited knowledge about the hypertension disease and medication, in part due to ineffective health education. Other factors included the side effects of the medication as well as the belief that antihypertensive medications are poisonous and addictive. Cultural and religious beliefs were also found to be contributing factors to non-adherence. The findings also revealed that the doctors appeared not to have time to examine patients. The attitudes of the nurses were identified as factors that influence non-adherence. It is reported that they do not listen to patients‟ complaints and patients do not feel respected by them. Additional factors included the cost of traveling to the health center which was considered to be prohibitive, long distances to get to the health center as well as 3-5 hours waiting time at the health center influenced non-adherence. Some respondents claimed that they do not want to mix medication with alcohol so that when they are drinking alcohol, they skip their medications. Lastly, some of the patients earn low income and as they are paid per hour, they cannot afford to take time off from work and this further results in non-adherence to medication. Conclusion: The findings concurred with findings of other research done in developing and developed countries. These included poor interpersonal relationships between health-care providers and patients, a lack of knowledge about hypertension and its treatment; cultural beliefs and traditions, and standards of health care provision. Improvement in communication between health-workers and hypertensive patients may promote better adherence. The study indicates an urgent need to design intervention measures to enhance adherence among hypertension patients.

INTRODUÇÃO: A cineangiocoronariografia é um procedimento médico invasivo que envolve sentimentos de medo e ansiedade. Estudos internacionais têm avaliado o efeito da música como técnica de intervenção para redução da ansiedade utilizando-a antes, durante e depois da cineangiocoronariografia. Contudo, os resultados de sua aplicação durante o procedimento não são consensuais. OBJETIVO: A proposta do presente estudo foi avaliar o efeito da música, aplicada durante a realização do procedimento, na ansiedade de pacientes submetidos à cineangiocoronariografia pela primeira vez. MÉTODOS: Os desfechos estudados foram o nível de ansiedade medido pelo Inventário de Ansiedade Beck, a frequência cardíaca e pressão arterial, ambas medidas pelo método intra-arterial. Participaram do estudo 300 pacientes randomizados entre o grupo controle (procedimento padrão) ou grupo música (cineangiocoronariografia realizada com a intervenção musical). Foi realizado o cegamento da pesquisadora durante toda a coleta e análise estatística dos dados. RESULTADOS: Os grupos eram semelhantes em relação às características de base, bem como dados sobre os hábitos musicais dos pacientes e dados da cineangiocoronariografia. Não foram observadas diferenças entre os grupos controle e música para todos os desfechos estudados: nível de ansiedade (p=0,072), pressão arterial sistólica (p=0,379), pressão arterial diastólica (p=0,152) e frequência cardíaca (p=0,853). Notou-se também que, mesmo antes da realização do procedimento, 80,9% do grupo controle e 76,9% do grupo música já apresentavam o menor nível de ansiedade (mínima). As mulheres mostraram-se mais ansiosas do que os homens (p=0,000 pré-exame e p=0,022 pós-exame). Não houve relação na comparação entre ansiedade e diferentes faixas etárias (p=0,352 pré-exame, p=0,198 pós-exame). CONCLUSÃO: A música aplicada no presente estudo durante a cineangiocoronariografia não se mostrou efetiva na redução dos níveis de ansiedade, pressão arterial e frequência cardíaca dos pacientes submetidos ao procedimento pela primeira vez. Constatou-se também que as mulheres são mais ansiosas do que os homens e que não houve relação entre o nível de ansiedade e faixas etárias / BACKGROUND: Coronary angiography is an invasive medical procedure that involves feelings of fear and anxiety. International studies have evaluated the effects of music intervention to reduce anxiety by using it before, during and after coronary angiography. However, the results of this strategy are not clear. OBJECTIVE: The aim of this study was to evaluate the effect of music, employed during the procedure, on anxiety of patients undergoing coronary angiography for the first time. METHODS: Outcomes were anxiety level measured by the Beck Anxiety Inventory, heart rate and blood pressure, both measured by intra-arterial method. The study included 300 patients randomized between the control group (standard procedure) or music group (standard procedure with a music intervention). The researcher was blinded throughout the data collection and statistical analysis. RESULTS: Baseline variables were adequatly balanced between both groups, as well as data on musical habits and coronary angiography. No differences were observed between the control group and music group in any of the outcomes: level of anxiety (p = 0.072), systolic blood pressure (p = 0.379), diastolic blood pressure (p = 0.152) and heart rate (p = 0.853). It was also noted that even before the procedure, 80.9% of the control group and 76.9% of the music group had low level of anxiety. Women were more anxious than men (p = 0.000 pre-test and p = 0.022 post-test). No relationship was found between anxiety and age (p = 0.352 pre-test, p = 0.198 post-test). CONCLUSION: The music used in this study during coronary angiography was not effective in reducing anxiety levels, blood pressure or heart rate in patients undergoing the procedure for the first time. It was also found that women are more anxious than men and that there was no relationship between anxiety levels and age

O mecanismo hemodinâmico responsável pela hipotensão pós-exercício aeróbico varia entre os indivíduos, sendo interessante avaliar a possível influência da capacidade de vasodilatação periférica nesses mecanismos. Para tanto, 22 homens normotensos submeteram-se a 2 sessões experimentais: Controle (C - repouso) e Exercício (E- cicloergômetro, 45 min, 50% VO2pico). Antes e 60 min após as intervenções, a pressão arterial (PA) sistólica (PAS), diastólica (PAD) e média (PAM), o débito cardíaco (DC), a resistência vascular periférica (RVP), o volume sistólico (VS), a frequência cardíaca (FC), o fluxo sanguíneo muscular (FS) e a capacidade vasodilatadora periférica (avaliada pelo FS máximo póshiperemia - FSMax e pela área sob a curva pós-hiperemia - ASC) foram medidos. A ANOVA de 2 fatores para amostras repetidas foi empregada. A correlação de Pearson foi calculada entre os índices de capacidade vasodilatadora medidos préexercício e respostas ao exercício (pós-pré). O exercício diminuiu a PAS, PAM e impediu o aumento da PAD. Após o exercício, o DC diminuiu em alguns indivíduos e a RVP diminuiu em outros. O VS diminuiu pós-exercício, enquanto que a FC aumentou em alguns indivíduos e diminuiu em outros. O FS da região inativa e o FSMax da região ativa aumentaram após o exercício. Os índices de capacidade vasodilatadora (FSmax e ASC) não se correlacionaram com as respostas dos mecanismos hemodinâmicos avaliados pós-exercício, mas o FS pré-exercício da região inativa se correlacionou negativamente com a resposta da PA pós-exercício e o FS pré-exercício da região ativa se correlacionou negativamente com a resposta do FS dessa região, do VS e do DC, e positivamente com a resposta da RVP e da FC pós-exercício. Dessa forma, é possível concluir que a sessão de exercício físico proposta promove hipotensão pós-exercício cujos determinantes hemodinâmicos diferem entre os indivíduos. A xvii capacidade vasodilatadora avaliada pela resposta à hiperemia não se relaciona aos determinantes hemodinâmicos da hipotensão pós-exercício. Porém, o FS da região ativa se relaciona, de modo quanto maior for esse fluxo pré-exercício, menor é o aumento dele pós-exercício, menor a redução a RVP e maior a redução do DC e do VS / The hemodynamic mechanism responsible for post-aerobic exercise hypotension varies among individuals, which makes it interesting to evaluate the possible influence of peripheral vasodilatory capacity on them. For this purpose, 22 normotensive men underwent two experimental sessions: control (C rest) and Exercise (E cycle ergometer, 45 min, 50% VO2peak). Both prior to and 60 min after the interventions, systolic (SBP), diastolic (DBP) and mean (MBP) blood pressures (BP), cardiac output (CO), systemic vascular resistance (SVR), stroke volume (SV), heart rate (HR), muscle blood flow (BF) and peripheral vasodilatory capacity (assessed by the maximum BF after hyperemic maneuver BFMax, and the area under the curve after reactive hyperemia AUC) were measured. A two way ANOVA for repeated measures was employed. The Pearson correlation coefficient was calculated between the vasodilatory capacity measured pre exercise and the responses observed after exercise (post-pre). Exercise decreased both SBP and MBP, and prevented an increase in DBP. After exercise, CO decreased in some individuals, while SVR decreased in others. SV decreased after exercise, while HR increased in some subjects and decreased in others. BF of the inactive limb and BFMax of the active limb increased after exercise. The indices of vasodilatory capacity (BFMax and AUC) did not correlate with the hemodynamic mechanisms evaluated after exercise. However, pre-exercise BF measured on the inactive limb correlated negatively with the BP response after exercise, and pre-exercise BF of the active limb correlated negatively with SV, CO and BF of this limb after exercise, and positively with SVR and HR responses after exercise. Thus, we conclude that the exercise bout proposed in this study promotes post-exercise hypotension, but the hemodynamic determinants of this xix response differ between individuals. Vasodilatory capacity assessed by flow responses to hyperemia is not related to the hemodynamic determinants of postexercise hypotension, but the BF of the active limb is. Thus, the greater the preexercise BF of the active limb, the lower the increase in this flow and the reduction in SVR after exercise, and the greater the reduction in CO and SV

No description available.

<p><a>Preeclampsia leads to increased risk of morbidity and mortality for both mother and fetus. Most previous studies have largely neglected mechanical compression of the left renal vein by the gravid uterus as a potential mechanism. In this study we first used a murine model to investigate the pathophysiology of left renal vein constriction. The results indicate that prolonged renal vein stenosis after 14 days can cause renal necrosis and an increase in blood pressure (BP) of roughly 30 mmHg. The second part of this study aimed to automate a diagnostic tool, known as the supine pressor test (SPT), to enable pregnant women to assess their preeclampsia development risk. A positive SPT has been previously defined as an increase of at least 20 mmHg in diastolic BP when switching between left lateral recumbent and supine positions. The results from this study established a baseline BP increase between the two body positions in non-pregnant female subjects and demonstrated the feasibility and utility of an automated SPT in pregnant women. Our results demonstrate that there is a baseline increase in BP of roughly 10-14 mmHg and that pregnant women can autonomously perform the SPT. Overall, this work in both rodents and humans suggests that 1) stenosis of the left renal vein in mice leads to elevation in BP and acute renal failure, 2) non-pregnant women experience a baseline increase in BP when they shift from left lateral recumbent to supine position, and 3) the SPT can be automated and used autonomously.</a></p> <br> <p> </p>

Author: Bc. Michaela Tejnecká Title: The effect of regularly applied Nordic walking on selected cardiorespiratory parameters in adults after heart valve surgery. Aim: The aim of this work was to analyze the effect of six months of Nordic walking intervention on selected casrdiorespiratory parameters in adults after heart valve surgery. Methods: The study included ten individuals (mean age 62 years) who were at least five years apart after heart valve surgery. Blood pressure (BP) was measured using a pulsed wrist tonometer, blood oxygen saturation (BOS) and heart rate (HR) were measured using a pulse oximeter, and the ejection fraction of the heart (EF) was evaluated echocardiographically. Nordic walking training units took plaxe once a week for 6 months. During this intervention, the level of training gradually increased both in distance and elevation of the terrain. Results: In all probands there was an average reduction in systolic blood pressure during exercise by an average of 10,3 mmHg and a reductionin heart rate during exercise by an average of 24 beats per minute. The resting ejection fraction increased by an average of 5,5% after six month intervention. These changes were statistically significant (p<0,01). The results of the work point to the benefits of Nordic walking for cardiac...

Background: Since its introduction in the early 2000s, energy drinks have become increasingly popular among an extensive range of consumers, including adolescents and young adults. Currently, the United States Food and Drug Administration (FDA) does not regulate the formulation of energy drinks, which may vary widely in the amounts of caffeine and sugar, as well as various types of supplements. Recent reports of severe and fatal adverse effects related to energy drinks have led to growing concerns on the safety of energy drink consumption. Objective: This study aimed to investigate the effects of chronic daily consumption of energy drinks on cardiometabolic endpoints, including blood pressure, ECG parameters, blood glucose, lipid parameters, weight, body mass index, and body fat consumption in a healthy adult population. Methods: The study was an unblinded, non-randomized, proof-of-concept, prospective study that evaluated the effects of chronic consumption of energy drinks in a healthy, adult population. Each participant consumed two 16 oz. cans of a commercially available ED daily in two divided doses for 28 days. Investigators met with the participants on days 0, 7, 14, 21, and 28 of the study. Participants were required to complete a standardized log of consumption, which include date and time of consumption, as well an estimate of additional caffeine intake. The following measurements were taken for each participant over the 28 days: blood pressure (BP), electrocardiogram (ECG), fasting blood glucose (FBG), fasting lipid panel (FLP), weight, BMI, body fat composition, and serum creatinine. Adverse side effects related to energy drink consumption were also recorded. Wilcoxan signed-rank tests were used to compare and detect statistical difference between endpoints for baseline and maximum post-dose systolic BP, QTc, FBG, FLP, weight, BMI, body fat, and serum creatinine values. Results: Of the 14 total participants that were enrolled in the study, 12 participants completed the full study protocol for 28 days. Maximum measurements in peripheral systolic blood pressure (pSBP), peripheral diastolic blood pressure (pDBP), central systolic blood pressure (cSBP), central diastolic blood pressure (cDBP), and heart rate (HR) were found to be statistically significantly higher than baseline measurements (all P < 0.05). The maximum change from baseline to maximum pSBP, pDBP, cSBP, and cDBP were 9±7 mmHg, 5±4 mmHg, 7±6 mmHg, 5±4 mmHg, respectively. Maximum QTcB and QTcF intervals were also statistically higher than baseline (both P = 0.001). The maximum change from baseline in QTcB and QTcF interval were 19±13 ms and 15±10 ms, respectively. Both QTcB and QTcF intervals on days 7, 14, 21, and 28 were all found to be significantly higher than baseline (all P Results: Of the 14 total participants that were enrolled in the study, 12 participants completed the full study protocol for 28 days. Maximum measurements in peripheral systolic blood pressure (pSBP), peripheral diastolic blood pressure (pDBP), central systolic blood pressure (cSBP), central diastolic blood pressure (cDBP), and heart rate (HR) were found to be statistically significantly higher than baseline measurements (all P < 0.05). The maximum change from baseline to maximum pSBP, pDBP, cSBP, and cDBP were 9±7 mmHg, 5±4 mmHg, 7±6 mmHg, 5±4 mmHg, respectively. Maximum QTcB and QTcF intervals were also statistically higher than baseline (both P = 0.001). The maximum change from baseline in QTcB and QTcF interval were 19±13 ms and 15±10 ms, respectively. Both QTcB and QTcF intervals on days 7, 14, 21, and 28 were all found to be significantly higher than baseline (all P