Annals of clinical research最新文献

In Finland sauna bathing by infants and children is guided by an empirically acquired parental understanding of the limits of safe heat "exposure". Finnish children are rarely allowed into a sauna alone before they are 7 years old. Finnish parents observe the post sauna bathing behaviour of their children, and this helps them to establish safe limits of exposure and avoid any adaptation problems. The after effects of sauna bathing of children reported in this study are substantial enough to warrant clinical paediatric involvement in unravelling the relation between the psychosomatic symptoms reported by children and their exposure to the raised temperature. There is also the need, even in Finland, of investigating the sauna bathing of children to establish objective criteria for promoting safe sauna bathing habits. Sauna bathing is a centuries old family tradition in Finland. There are 1.4 million saunas in a country with population of some 4.8 million people. Most families either have their own sauna or one close to where they live. In addition, Finnish children have access to sauna facilities at local sporting, recreation and swimming centres. Sauna bathing often takes place in connection with physical education (PE) lessons or sporting club activities for those over the age of 7 years. The average Finnish family takes a sauna bath once a week, and Finnish children are introduced to sauna bathing in early infancy. Although exposure to the raised temperatures normally encountered in a sauna can cause thermoregulatory imbalances in children there are no established guidelines for the safe use of saunas by infants and children.

In numerous studies the relationship between physical fitness, physical activity and blood pressure have been evaluated. However, only a minority of the reported studies are controlled. This report gives a review of cross-sectional studies in children and longitudinal dynamic training studies in young adults below the age of thirty dealing with physical fitness/physical activity and blood pressure.

Presumed evolution of low density lipoprotein cholesterol (LDL-C) was studied in a baseline cross-sectional survey of 4955 18-30 year old men and women of various sociodemographic backgrounds. Specifically studied were the influences on LDL-C and the change of LDL-C with age of race, gender, education, diet, physical activity, fatness and fitness. Men increased about 20 mg/dl per 10 years of age, while women increased about 3 mg/dl. Increasing education was found to be associated with higher LDL-C in blacks, but with lower LDL-C in whites. Higher Keys diet score and body mass index were positively associated with LDL-C, while higher total caloric intake, vigorous physical activity, duration on a treadmill exercise test and usual intake of alcohol were negatively associated with LDL-C. The finding of a different relationship of LDL-C to increasing education in whites than in blacks suggests a cultural or behavioral influence in rate of increase in LDL-C.

Hot baths have been popular at different periods in different countries, although the sauna in Finland, has been popular for two thousand years. Bathing practices and the use of the sauna differ, though a common feature is inducing sweating followed by cooling off to create a sense of wellbeing. But in many places the sauna has been used to mask other practices, including those which pander to people's sexual appetites. It would be advantageous therefore for supporters and advocates of the sauna to try to correct the abuses.

The radioreceptor assay (RRA) of anticholinergic drugs in plasma and other biological fluids presents methodological difficulties. The specificity is not comparable with some pure chemical methods because drug metabolites which are active in binding to muscarinic receptors participate in the assay. There are also problems with serum dilution, with the lipophilicity of the radioligands and drugs, and with the protein binding of the drugs. However, the RRA of anticholinergic drugs is rapid and sensitive. In racemic drugs, only active stereoisomers show affinity for the muscarinic receptors. Results with RRA have been shown to correlate with anticholinergic effects, both desired and side effects. A careful familiarization with the method used for each individual drug analysis allows its useful clinical application.

The nature of good "löyly" (sauna vapor/sauna heat) is hard to describe. Essentially, it is determined by the purity, temperature, moisture content of the air contained inside the sauna: as well as its thermal radiation. A suitable temperature for sauna air ranges between 80 and 100 degrees C and the humidity from 40 to 60 g per kg of air. The bathers should be able to vary the humidity to their liking by casting water on the stones heated in or on the sauna oven. The inner surfaces of the oven and the sauna room should produce as even a field of thermal radiation concentrated on the bather's body as possible. The purity of the sauna air is above all a factor contributing to the enjoyment of the bathing experience. The sauna air must not contain any obnoxious extent gaseous impurities, particles, or micro-organisms. The purity of the sauna air is ensured primarily by effective ventilation. Particular attention should be paid to the arrangement of correct ventilation, for the internal size of modern saunas is steadily diminishing. The sensation of experiencing good "löyly" is also affected by the overall condition of the sauna. It should have an agreeable and relaxing effect on the bather.

Increased physical activity has usually not been considered a successful means to treat obesity because of the small and slowly occurring weight loss and bad compliance with exercise programs. Exercise has been advocated because it prevents the loss of fat-free tissues induced by hypocaloric diets. Muscular work may also elevate the metabolic rate for some hours after the cessation of exercise, but this requires high-intensity exercise. Instead, aerobic exercise may have more importance in ameliorating metabolic and hemodynamic disturbances often associated with obesity. Aerobic exercise of moderate intensity may increase serum high-density and decrease very-low-density lipoproteins, decrease serum insulin, and decrease blood pressure, especially during exertion. Similar alterations may also be achieved with a prudent diet alone, but inclusion of exercise provides more possibilities to vary the diet. A multifactorial approach (nutrition education, behavior modification and exercise) is needed to improve adherence to diet in mild and moderate obesity and to maintain weight loss. More than a formal physical exercise program for a couple of months, the obese need to include physical activity permanently as a part of everyday life.

Modern eating habits and sedentary life-style interact to promote atherosclerosis and increase risk of ischemic heart disease (IHD). Apparent sites of interaction affecting severity of coronary atherosclerosis are body weight, blood lipid-lipoproteins, blood pressure, glucose-insulin dynamics, and platelet aggregation. In addition the conditioning effects of physical activity on the heart and adrenergic system reduce myocardial oxygen and coronary blood flow requirements, and raise the threshold for ischemia and ventricular dysrhythmias in the presence of existing coronary atherosclerosis. Dietary recommendations to reduce risk factors for IHD are to decrease intake of total and saturated fat, cholesterol, and sodium, increase intake of complex carbohydrates of plant origin and polyunsaturated fatty acids from vegetable oils and fish, adjust energy intake to maintain or achieve desirable body weight, and keep alcoholic consumption low. Epidemiologic evidence also suggests that risk of IHD can be further reduced with 30 to 60 minutes/day of even light or moderate intensity physical activity, including working around the home and yard, walking, exercise or sports. An optimal daily energy expenditure for IHD prevention appears to be between 150 and 300 kcal/day.

Atenolol and metoprolol are the two most widely used beta 1-adrenoceptor antagonists in the treatment of essential hypertension. Differences in their physico-chemical properties have been the basis of a number of clinical studies whose primary or secondary objective has been to compare subjective well-being during treatment with these beta-selective blockers. The results are, however, contradictory, mainly due to factors such as open study design, different dose regimens and dissimilar study populations. The aim of the present study was to evaluate and compare subjective well-being during treatment with atenolol (50 mg o.d.) and metoprolol CR (100 mg o.d.) in a randomized double-blind, cross-over study (2 x 6 weeks) in hypertensives not previously treated with either of the drugs studied. Two self-administered questionnaires (MSE-profile and Jern quality of life questionnaire) were filled in both before randomization and before follow up visits at 1, 3 and 6 weeks in each treatment period. Furthermore, subjective symptoms, blood pressure and heart rate were monitored. At the end of the study, patients were requested to state what treatment they preferred. Atenolol and metoprolol CR were found to be equally effective in reducing blood pressure (from 159/98 to 144/87 and 144/88 mm Hg, respectively, n = 74). The MSE-profile and the Jern quality of life questionnaire could not detect any differences between the two treatments as regards general well-being. Other subjective symptoms (e.g. diarrhoea, bradycardia, cold hands and feet) were uncommon and equally distributed among atenolol and metoprolol patients. 31 of the patients preferred metoprolol CR, 23 atenolol, while 20 had no preference.(ABSTRACT TRUNCATED AT 250 WORDS)