<p>Cilj ove teze bio je utvrđivanje polnih razlika<br />u mehanizmima vegetativne regulacije srčane<br />frekvencije, kao i utvrđivanje razlika u regulaciji srčane frekvencije kod žena po<br />fazama menstrualnog ciklusa. Kori&scaron;ćeni su<br />parametri varijabilnosti srčanog ritma (heart<br />rate variability) - HRV i oporavka srčane<br />frekvencije (heart rate recovery) - HRR.</p><p>Ispitivanje je obuhvatilo 90 ispitanika; 45<br />osoba mu&scaron;kog pola (20.4&plusmn;0.7 god., 184&plusmn;5.00<br />cm, 79.38&plusmn;9.42 kg, BMI 23.53&plusmn;2.83) i 45<br />osoba ženskog pola (20.5&plusmn;0.6 god., 168&plusmn;5.25<br />cm, 60.96&plusmn;6.93 kg, BMI 21.57&plusmn;2.23) -<br />studenata Univerziteta u Novom Sadu. Za<br />prikupljanje podataka kori&scaron;ćen je pulsmetar<br />(Polar, Finska). Ispitivanje je sprovedeno u<br />mirovanju, kao i u periodu oporavka posle<br />kratkotrajnog fizičkog opterećenja poznatog<br />intenziteta. U prvom modulu snimanje je<br />obavljano u miru, u sedećem poloţaju na<br />samom ergo-biciklu, stopala na platformi<br />ispred pedala, noge u fleksiji od 90&deg; u<br />kolenom zglobu, ruke na natkolenicama. U<br />drugom modulu snimanje je obavljeno u<br />priodu petominutnog oporavka posle<br />maksimalnog opteraćenja u trajanju od 30<br />sekundi (supramaksimalno opterećenje) -<br />Wingate protokol. U grupi mu&scaron;karaca<br />sprovedeno je jednokratno merenje, dok su za<br />grupu ţena isti moduli snimanja primenjeni u ri navrata: 1. U fazi menstrualnog krvarenja,<br />rana folikularna faza - najniži nivoi estrogena<br />i progesterona. 2. Kasna folikularna faza -<br />visok estrogen. 3. Srednja lutealna faza -<br />visok nivo progesterona i estrogena.<br />U miru kao i u poslednjem trominutnom<br />intervalu petominutnog oporavka određeni su<br />sledeći parametri varijabilnosti srčanog ritma:<br />srednja vrednost NN intervala - RRNN,<br />standardna devijacija NN intervala - SDNN,<br />kvadratni koren iz srednje vrednosti kvadrata<br />sukcesivnih razlika susednih NN intervala<br />(root mean square of successive differences) -<br />RMSSD, broj sucesivnih NN intervala koji<br />se razlikuju za vi&scaron;e od 50ms - NN50 i<br />procentualni udeo NN50 u ukupnom broju<br />NN intervala - pNN50. Od parametara<br />frekvencijskog domena, nakon brze Furijeove<br />transformacije analizirani su sledeći<br />parametri: snaga spektra niske frekvencije<br />(LF; 0,04-0,15Hz) i snaga spektra visoke<br />frekvencije (HF; 0,15-0,40Hz).<br />Oporavak srčane frekvencije u toku<br />petominutnog oporavka nakon<br />supramaksimalnog opterećenja na bicikl<br />ergometru procenjivan je pomoću sledećih parametara: 1. Apsolutna razlika između<br />vrednosti srčane frekvencije odmah po<br />zavr&scaron;etku opterećenja i frekvencije<br />registrovane nakon 60 sekundi oporavka -<br />HRR60. 2. Vremenska konstanta<br />kratkoročnog oporavka srčane frekvencije u<br />prvih 30 sekundi - T30. 3. Vremenska<br />konstanta opadanja srčane frekvencije u toku<br />petominutnog oporavka - T.<br />Utvrđeno je da mu&scaron;karci imaju veći pik snage<br />kao i prosečnu snagu pri supramaksimalnom<br />opterećenju u odnosu na grupu ţena bez<br />obzira na fazu menstrualnog ciklusa; dok su<br />bazalna i maksimalna srčana frekvencija bile<br />iste u obe grupe.<br />Postoje polne razlike u mehanizmima<br />vegetativne regulacije srčane frekvencije u<br />mirovanju. Najbolje su vidljive kroz<br />parametre frekvencijkog domena HRV-a (LF<br />i HF), odnosno prirodne logaritme ovih<br />vrednosti (lnLF i lnHF). Statistički značajne<br />razlike u vrednostima parametara<br />frekvencijskog domena HRV-a između grupe<br />mu&scaron;karaca i grupe ţena u sve tri faze<br />menstrualnog ciklusa potvrđene su i u fazi<br />oporavka posle supramaksimalnog opterećenja.<br />Postoje polne razlike u parasimpatičkoj<br />reaktivaciji posle supramaksimalnog<br />opterećenja koja je značajno brţa kod<br />mu&scaron;karaca. One se najbolje mogu proceniti<br />kroz matematičke modele oporavka srčane<br />frekvencije i vremensku konstantu opadanja<br />srčane frekvencije u prvih 30 sekundi<br />oporavka - T30.<br />Nisu utvrđene razlike u mehanizmima<br />vegetativne regulacije srčane frekvencije u<br />miru u grupi ţena po fazama menstrualnog<br />ciklusa; procenjeno kroz parametre<br />vremenskog i frekvencijskog domena HRVa.<br />Parametri vremenskog i frekvencijskog<br />domena HRV-a registrovani u mirovanju kao<br />i u fazi odmora posle supramaksimalnog<br />opterećenja nisu dovoljno osetljivi za<br />utvrđivanje razlika u vegetativnoj regulaciji<br />srčane frekvencije kod žena po fazama<br />menstrualnog ciklusa.<br />Nijedan od registrovanih parametara<br />oporavka srčane frekvencije (HRmax,<br />HRoporavak, HRR60, T i T30) nije se pokazao<br />dovoljno osetljivim za utvrđivanje promena u<br />parasimpetičkoj reaktivaciji kroz faze<br />menstrualnog ciklusa.</p> / <p>The aim of this study was to determine<br />gender differences in autonomic heart rate<br />control mechanisms, as well as to determine<br />heart rate control differences in women<br />during menstrual cycle. Heart rate variability<br />- HRV and heart rate recovery - HRR parameters were used.<br />The study included 90 participants; 45 males<br />(20.4&plusmn;0.7 yrs., 184&plusmn;5.00 cm, 79.38&plusmn;9.42 kg,<br />BMI 23.53&plusmn;2.83) and 45 females (20.5&plusmn;0.6<br />yrs., 168&plusmn;5.25 cm, 60.96&plusmn;6.93 kg, BMI<br />21.57&plusmn;2.23) - students of the University of<br />Novi Sad. Heart rate monitor (Polar,<br />Finland) was used for data collection.<br />Measurements were conducted while resting<br />as well as in a short recovery period after a<br />brief physical strain of known intensity. In<br />the first mode, heart rate monitoring was<br />conducted on relaxed subjects, in a sitting<br />position on an ergo-bike, feet on the<br />platform in front of the pedals, legs bent at<br />knees at 90&deg;, hands on thighs. In the second<br />mode heart rate monitoring was conducted in<br />a five-minute resting period after 30 seconds<br />of maximal exercise (supramaximal<br />exercise) - Wingate protocol. There was a<br />single monitoring in the male group, while in<br />the female group each monitoring mode was<br />conducted three times: 1. During the phase<br />of menstrual bleeding, early follicular phase<br />- the lowest levels of estrogen and<br />progesterone 2. Late follicular phase - high<br />estrogen. 3. Mid-luteal phase - high progesterone and estrogen.<br />While resting as well as in the last three<br />minutes of five-minute recovery period after<br />the exercise the following parameters of<br />heart rate variability were determined: the<br />mean value of NN intervals - RRNN, the<br />standard deviation of NN intervals - SDNN,<br />the square root of the mean of the squares of<br />the successive differences between adjacent<br />NN intervals (root mean square of<br />successive differences) - RMSSD, the<br />number of pairs of successive NN intervals<br />that differ by more than 50 ms - NN50 and<br />the proportion of NN50 divided by total<br />number of NN intervals pNN50. After the<br />fast Fourier transformation, following<br />frequency domain parameters were<br />analyzed: power spectrum of low frequency<br />(LF; 0,04-0,15Hz) and power spectrum of<br />high frequency (HF; 0,15-0,40Hz).<br />Heart rate recovery during the five-minute<br />resting period after the supramaximal<br />exercise on the ergo-bike was evaluated<br />through following parameters: 1. Absolute<br />difference between the heart rate<br />immediately after the exercise and the heart rate registered after 60 seconds of recovery -<br />HRR60. 2. Time constant of short-time heart<br />rate recovery in the first 30 seconds - T30. 3.<br />Time constant of heart rate decay<br />during the five-minute recovery period - T.<br />It was found that men had greater peak and<br />average power during supramaximal<br />exercise compared to a group of women<br />regardless of the phase of menstrual cycle;<br />while basal and maximal heart rate were the<br />same in both groups.<br />There are gender differences in autonomic<br />heart rate control mechanisms while resting.<br />These are best visible through frequency<br />domain HRV parameters (LF and HF), and<br />their natural logarithms (lnLF and lnHF).<br />Statistically significant differences in the<br />frequency domain HRV parameters between<br />the group of men and the group of women in<br />all three phases of the menstrual cycle, were<br />also found in recovery period after<br />supramaximal exercise.<br />There are gender differences in<br />parasympathetic reactivation after<br />supramaximal exercise which is significantly faster in men. These differences are best<br />assessed through mathematical models of<br />heart rate recovery and the time constant of<br />short-time heart rate recovery in the first 30<br />seconds - T30 .<br />No differences in autonomic heart rate<br />control mechanisms while resting in the<br />female group during three phases of<br />menstrual cycle were found; assessed<br />through the time and frequency domain<br />HRV parameters. The time and frequency<br />domain HRV parameters registered while<br />resting and during recovery period after<br />supramaximal еxеrcise were not sensitive<br />enough to determine differences in<br />autonomic heart rate control in women<br />through three phases of menstrual cycle.<br />None of the registered heart rate recovery<br />parameters (HRmax, HRR60, HRoporavak, T i<br />T30) were sensitive enough to determine<br />changes in parasympathetic reactivation<br />through a menstrual cycle.</p>

<p>Funkcija nosa povezana je sa različitim anatomskim, fiziolo&scaron;kim i emocionalnim faktorima. Postoji mnogo teorija koje su poku&scaron;ale da objasne efekat ženskih polnih hormona (estrogena i progesterona) na fiziologiju nosa, ali sam mehanizam njihovog dejstva jo&scaron; uvek ostaje izazov za mnoge istraživače. Prethodno je opisano da ženski polni hormoni mogu da izazovu nazalnu opstrukciju, povećavajući ekspresiju histaminskih H1 receptora i menjajući koncentraciju neurotransmitera, &scaron;to dovodi do edema nosne sluznice i modifikacije nazalnog otpora. Kada je reč o mirisnoj funkciji na malom broju ispitanika i u različito dizajniranim studijama je pokazano da je u fazi ovulacije mirisni prag značajno niži u odnosu na folikularnu i luteinsku fazu, međutim ne postoje podaci o identifikaciji i diskriminaciji mirisa u menstrualnom ciklusu. Nizak nivo estrogena prouzrokovan fiziolo&scaron;kom atrofijom jajnika u postmenopauzi može dovesti do hiposmije ili čak anosmije, &scaron;to predstavlja jo&scaron; jedan dokaz o osetljivosti nazalne sluznice na estrogen.&nbsp; Cilj ovog istraživanja je bio da se ispita uticaj ženskih polnih hormona na respiratornu i mirisnu funkciju nosa u menstrualnom ciklusu i postmenopauzi. Istraživanje je u celosti prospektivno, sprovedeno je na Zavodu za fiziologiju, Medicinskog fakulteta, Univerziteta u Novom Sadu. Uključeno je 204 osoba ženskog pola koje su bile podeljene u dve grupe. Prvu grupu su činile 103 devojke uzrasta 23,126 &plusmn; 4,597 godina u reproduktivnom periodu sa regularnim menstrualnim ciklusom i 101 žena prosečnog uzrasta 60,069 &plusmn; 5,570 u postmenopauzi. Respiratorna i mirisna funkcija nosa procenjene su uz pomoć odgovarajućih standaradizovanih objektivnih i subjektivnih metoda. Funkcija donjih disajnih puteva ispitana je uz pomoć spirometrije. Kod žena u reproduktivnom periodu testiranje se vr&scaron;ilo u fazi ovulacije i lutealnoj fazi menstrualnog ciklusa, a kod ispitanica u postmenopauzi jednom. Nakon određivanja prvog plodnog dana ispitanice su uz pomoć standardizovanih urin - tračica za određivanje pika luteinizirajućeg hormona u urinu utvrđivale momenat ovulacije, dok se drugo testiranje u lutealnoj fazi vr&scaron;ilo sedam dana nakon prvog. Respiratorna funkcija nosa je značajno lo&scaron;ija u fazi ovulacije u odnosu na progesteronsku fazu menstrualnog ciklusa,ali se značajno ne razlikuje između žena u reproduktivnom periodu i žena u postmenopauzi. Subjektivni osećaj nazalne opstrukcije značajno se ne razlikuje u različitim fazama menstrualnog ciklusa, kao ni između testiranih populacija zdravih žena. Sposobnost identifikacije mirisa je statistički značajno slabija, a subjektivni osećaj intenziteta mirisa izraženiji u fazi ovulacije u odnosu na luteinsku fazu menstrualnog ciklusa. Međutim, sposobnost identifikacije mirisa značajno je lo&scaron;ija kod žena u postmenopauzi u odnosu na obe faze menstrualnog ciklusa. Reaktivnost nosne sluznice značajno je veća u fazi ovulacije u odnosu na lutealnu fazu menstrualnog ciklusa, ali se ista ne razlikuje između žena u reproduktivnom period i žena u postmenopauzi. Respiratorna i mirisna funkcije nosa u testiranim populacijama zdravih žena nisu značajno povezane.</p> / <p>The nasal function is associated with various anatomical, physiological and emotional factors. There are many theories that have tried to explain the effect of female sex hormones (estrogen and progesterone) on the nasal physiology, but the mechanism still remains unknown for many researchers. It has been previously described that female sex hormones can cause nasal obstruction by increasing the expression of histamine H1 receptors and altering the concentration of neurotransmitters, which leads to edema of the nasal mucosa and modification of nasal resistance. When it comes to olfaction on a small number of subjects and in differently designed studies, it was shown that in the ovulatory phase the olfactory threshold is significantly lower compared to the follicular and luteal phase, however there are no data on the identification and discrimination of odors in the menstrual cycle. Low estrogen levels caused by physiological atrophy of the ovaries in postmenopause can lead to hyposmia or even anosmia, which is another proof of the sensitivity of the nasal mucosa to estrogen.&nbsp; The aim of this study was to examine the effect of female sex hormones on respiratory and olfactory function of the nose in the menstrual cycle and postmenopause. The research is prospective and it was conducted at the Department of Physiology, Faculty of Medicine, University of Novi Sad. It included 204 females who were divided into two groups. The first group consisted of 103 women aged 23.126 &plusmn; 4.597 years in the reproductive period with a regular menstrual cycle and 101 women with an average age of 60.069 &plusmn; 5.570 in the postmenopausal period. The respiratory and olfactory function of the nose were assessed using appropriate standardized objective and subjective methods. The lower airway function was examined using spirometry. Young women in reproductive period were tested twice, in the ovulatory and luteal phase of the menstrual cycle, and the postmenopausal women were tested only once. After menstrual bleeding the participans used standardized urine strips consecutively day by day to determine ovulation (the peak of the luteinizing hormone (LH) in plasma which pointed out the estrogen plasma peak). The test was positive if two horizontal pink streaks appeared on the strip 5 to 10 minutes after the contact with the urine. One pink streak indicates a correctly performed test, while the second streak appears only if there is an LH peak. Within 24 hours of confirmed LH peak, the subjects were tested for the first time. The second measurement was performed in the luteal phase of the menstrual cycle (the progesterone plasma peak) seven days after the first one.&nbsp; The nasal respiratory function is significantly worse in the ovulatory phase compared to the luteal phase of the menstrual cycle, but it does not differ significantly between women in the reproductive period and postmenopausal women. The subjective sense of the nasal obstruction does not differ significantly in different phases of the menstrual cycle, as well as between tested populations of healthy women. The odor identification ability is statistically significant weaker and the subjective sense of odor intensity is more pronounced in the ovulatory phase compared to the luteal phase of the menstrual cycle. However, the ability to identify odors is significantly worse in postmenopausal women compared to both phases of the menstrual cycle. The reactivity of the nasal mucosa is significantly higher in the ovulatory phase compared to the luteal phase of the menstrual cycle, but it does not differ between women in the reproductive period and postmenopausal women. The respiratory and olfactory nasal functions in these tested populations are not significantly corelated.</p>