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Controlled Clinical Trial 2011; 32(5): 641-651 PubMed PMID: 22167145 Citation  Keywords:  Adult, Antidepressive Agents:therapeutic use, Autonomic Nervous System:drug effects, Benzodiazepines:therapeutic use, Cognitive Therapy, Combined Modality Therapy, Dissociative Disorders:complications, Electrocardiography, Female, Heart Rate:drug effects,.   

OBJECTIVES: Alarming somatic symptoms and in particular the cardiovascular symptoms, are the characteristic features of panic attacks. Increased cardiac mortality and morbidity have been proposed in these patients. Power spectral analysis of electrocardiogram R-R intervals is known to be a particularly successful tool in the detection of autonomic instabilities in various clinical disorders. Heart rate variability (HRV) has been found to be the outcome of rapidly reacting cardiovascular control systems. The aim of our study is to measure very low frequency band (VLF), low frequency band (LF) and high frequency band (HF) components of R-R interval during orthostatic experiment in patients with panic disorder before and after treatment and compares it with healthy controls.

METHODS: We assessed heart rate variability in 19 patients with panic disorder before and after 6-weeks treatment with antidepressants combined with cognitive behavioral therapy (CBT) and in 18 healthy controls. Diagnosis was done according to the ICD-10 research diagnostic criteria confirmed with MINI (MINI international neuropsychiatric interview). Patients were treated with CBT and psychotropics. They were regularly every week assessed using CGI (Clinical Global Impression), BAI (Beck Anxiety Inventory) and BDI (Beck Depression Inventory). Heart rate variability was assessed during 3 positions (1st - 5 min supine; 2nd - 5 min standing; 3rd - 5 min supine) before and after the treatment. Power spectra were computed for very low frequency - VLF (0.0033-0.04 Hz), low-frequency - LF (0.04-0.15 Hz) and high frequency - HF (0.15-0.40 Hz) bands using fast Fourier transformation.

RESULTS: Nineteen panic disorder patients resistant to pharmacological treatment entered a 6-week open-label treatment study with combination of SSRI and CBT. The combination of CBT and pharmacotherapy proved to be an effective treatment in these patients. The patients significantly improved during the study period in all rating scales. There were highly statistical significant differences between panic patients and control group in all components of power spectral analysis in 2nd (VLF, LF and H in standing) and in two component of 3rd (LF and HF in supine) positions. There was also a statistically significant difference between these two groups in LF/HF ratio in standing position (2nd). During therapy there was a tendency increasing values in all three positions in components of HRV power spectra, but HF in 1st supine position was the only component where the increase reached the level os statistical significance.

CONCLUSIONS: These findings demonstrate a lower autonomic activity in panic disorder patients measured during the changes of postural position in comparison with healthy controls and tendency to increase this autonomic power during the treatment....

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Clinical Trial 2008; 29(2): 261-266 PubMed PMID: 18404139 Citation  Keywords:  Adult, Anaerobic Threshold:drug effects, Carnitine:pharmacology, Female, Heart Rate:drug effects, Humans, Lactic Acid:blood, Male, Metabolism:drug effects, Physical Fitness:physiology, Racquet Sports:physiology, Time Factors,.   

OBJECTIVES: Purpose of this study is to research the effects of acute L-Carnitine intake on badminton players' metabolic and blood lactate values.

DESIGN: A total of 16 Turkish national badminton players (8 male, 8 female) were voluntarily participated into study. MaxVO2, MET, energy consumption, HR (heart rate), VE (minute ventilation), R (respiratory exchange ratio), AT (anaerobic threshold), oxygen pulse and blood lactate (LA) of subjects were measured by Sensormedics VmaxST and Accutrend Lactate Analyzer. The participants were subjected to the test protocol twice before and after 2g of L-Carnitine intake. The data were evaluated by the use of SPSS 13.0 for Windows.

RESULTS: No significant differences were found between 1st. (without L-Carnitine intake) and 2nd. (with L-Carnitine intake) measurements of female participants as regards to all measured parameters. There was a significant difference in EMHR (exercise maximum heart rate) of males between two measurements (p<0.05). However the differences in other parameters were not significant. AT values of female subjects were not significant difference (p>0.05). Respiratory exchange ratio of males was significantly different at anaerobic threshold (p<0.05).

CONCLUSION: Results of this study show that L-carnitine intake one hour prior to the exercise has no effect on the metabolic and blood lactate values of badminton players....

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Journal Article 2006; 27(1-2): 121-127 PubMed PMID: 16648778 Citation  Keywords:  Adrenergic alpha-Agonists:therapeutic use, Aged, Blood Pressure:drug effects, Cardiac Output:drug effects, Cardiotonic Agents:pharmacology, Critical Illness, Dobutamine:therapeutic use, Female, Heart Rate:drug effects, Humans, Hydrazones:pharmacology, Int.   

UNLABELLED: Levosimendan may improve the outcome of acute heart failure patients with preserved arterial blood pressure. However, the data on its use in critically ill patients are scarce.

OBJECTIVES: The aim of this study was to assess the effects of levosimendan on global haemodynamics in patients with cardiogenic shock.

MATERIALS AND METHODS: Fourteen adult patients in cardiogenic shock were studied prospectively. One patient died after 10 hours and was excluded from final analysis. Haemodynamic monitoring included arterial and pulmonary arterial thermodilution catheters. Before levosimendan administration, 12 patients required norepinephrine, 6 patients dobutamine and 4 patients intraaortic balloon pump. Levosimendan was given as a bolus (12 microg x kg(-1) x 10 min(-1)) followed by 24 hrs infusion (0.1 microg x kg(-1) x min(-1)). Baseline data had been collected before levosimendan administration. Following data sets were obtained after 1, 8, 16 and 24 hours. Positive haemodynamic response was defined as an increase of > or = 30% in cardiac output.

RESULTS: Eleven patients met the criterion for the positive haemodynamic response. During levosimendan infusion systemic vascular resistance decreased (p<0.05) whereas cardiac output (p<0,001) and urine output increased (p<0.01). Mean arterial pressure and heart rate remained unchanged. No severe arrhythmias occurred and norepinephrine-dose did not change. Two patients were classified as non-responders.

CONCLUSIONS: Our results suggest that levosimendan infusion given as adjunctive therapy in patients with cardiogenic shock may be safe with beneficial effects on global haemodynamics....

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Journal Article 2002; 23(Suppl 1): 88-91 PubMed PMID: 12019359 Citation  Keywords:  Adult, Blood Pressure:drug effects, Circadian Rhythm:physiology, Clinical Trials as Topic, Electromagnetic Fields:adverse effects, Heart Rate:drug effects, Humans, Male, Melatonin:analogs & derivatives, Telephone,.   

OBJECTIVES: It is quite likely that non-visible electromagnetic fields (EMF) may affect melatonin production. Some studies confirmed this hypothesis and showed that extremely low EMF altered pineal function in animals and humans. Thus, it is reasonable to suppose that EMF emitted by cellular phones may also influence secretion of melatonin. The present study sought to evaluate possible effect of the exposure to EMF emitted by cellular phone on 6-hydroxymelatonin sulfate (6-OHMS) excretion, which reflects melatonin levels in blood.

MATERIAL AND METHODS: The examined group consisted of 9 healthy males aged 19-29 years. The experiment was performed under controlled conditions (the light intensity-50 lx till midnight and 0 lx during night). Each person was examined twice: on a day without exposure (control day, C-day) and on a day with continuous exposure (60 min. exposure from cellular phone, frequency 900 MHz, pulsed with 217 Hz, pulse with 576 micros, SAR 1.23 W/kg, E-day). From 7 p.m. to 8 p.m. they used a cellular phone. The subjects did not know which day was E-day, and which was C-day. From 8 p.m. till midnight the subjects listened to music and than they slept till 7 a.m. next day. Urine samples were collected at 7 p.m., at midnight, and at 7 a.m. in the same way in C-day as in E-day. Sample were frozen for later ELISA analysis of 6-OHMS. The 6-OHMS ELISA kit from Immuno-Biological Laboratories (Hamburg) was used for measurement of 6-OHMS. The data were analysed using Wilcoxon matched-pairs signed-ranks test for each subject and for the whole group. We compared 6-OHMS level on the E-day and on the C-day separately for 3 time-points - 7 p.m., midnight, 7 a.m.

RESULTS: Mean 6-OHMS level in both experiments did not differ significantly for any of the respective time points. Circadian variations of 6-OHMS level were detected in all subjects.

CONCLUSIONS: The results of our investigation has demonstrated that EMF emitted by cellular phones has no distinct influence on the melatonin level....

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