scholarly journals A Psychophysiological Examination of the Mutability of Type D Personality in a Therapeutic Trial

2020 ◽  
pp. 1-13
Author(s):  
Kirsty L. Hodgson ◽  
Debbie A. Clayton ◽  
Michael A. Carmi ◽  
Louise H. Carmi ◽  
Ronald A. Ruden ◽  
...  

Abstract. Identifying the associations between health and personality has been a focus for psychophysiological research. Type D personality is associated with predisposition to physical and psychological ill-health. This statistician-blind parallel-group controlled trial (intervention group vs. waiting list control group) examined the impact of Havening Techniques on the Type D constituents of negative affect (NA) and social inhibition (SI). One hundred twenty-five adult (18+ years) participants in the United Kingdom (72 females, 53 males) completed the Type D Scale-14 (DS14) measure of Type D personality at baseline (T1), 24-hours (T2), and at 1-month (T3). Forty participants in the treatment group received additional stress biomarker assessment of heart rate, blood pressure, and salivary cortisol. Type D caseness remained stable in the waiting list participants ( n = 57). In the treatment group ( n = 68); NA, SI, and total scores decreased from T1 to T2 ( p < .001, p < .001, and p < .001, respectively), and from T2 to T3 ( p = .004, p < .001, and p < .001, respectively), significantly transmuting to non-caseness ( p < .001 for T1 to T2; p = .025 for T2 to T3). Between T1 and T2, decreases in cortisol ( p < .001), diastolic blood pressure ( p < .001), and systolic blood pressure ( p < .001) were demonstrated. Heart rate fell nonsignificantly between T1 and T2 ( p = .063), but significantly from T1 to T3 ( p = .048). The findings of this study indicate the potential mutability of the psychophysiological illness-prone characteristics of Type D personality.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3018-3018
Author(s):  
Jacqueline Kuziej ◽  
Walter Jeske ◽  
Debra Hoppensteadt ◽  
Evangelos Litinas ◽  
Elizabeth McGeehan ◽  
...  

Abstract Introduction: Earlier this year, heparin was found to be contaminated with a non-heparin sulfated polymer identified as oversulfated chondroitin sulfate (OSCS). The presence of this contaminant was associated with severe adverse reactions such as hypotension and anaphylaxis, leading to death in some patients. Some batches of a widely used low-molecular heparin, enoxaparin, also contained OSCS. However, the amount of this contaminant was much lower (less than 5%) in the low-molecular weight heparin batches compared to unfractionated heparin where the amount of the contaminant was up to 30%. Owing to the sizeable number of syringes in Europe that contained the low level of OSCS and the absence of any serious adverse events, the European Medicines Equivalence Agency (EMEA) allowed the qualified use of the subcutaneous administration of the contaminated enoxaparin to ensure access to this essential medication. Despite this, no studies on the anti-thrombotic and bleeding effects or basic physiologic parameters have been reported. To address the bioequivalence of enoxaparin and its contaminated version, studies were undertaken in established animal models of bleeding and thrombosis. Materials & Methods: Contaminant-free enoxaparin (CFE) and one of the commercially available contaminated enoxaparin (CCE) batches were compared at an equivalent subcutaneous dosage of 2.5 mg/kg in a jugular vein clamping model of thrombosis (n=6/group). A separate group comprised of saline control animals served as control. Blood pressure and heart rate measurements were made at 90 minutes after drug administration, followed by jugular vein clamping model at 120 minutes after drug administration. After the completion of the jugular vein clamping model, blood samples were collected via cardiac puncture for ex-vivo monitoring of anti-coagulant and anti-protease effects. Results: No differences in the blood pressure and heart rate were observed between the two groups. The anti-thrombotic effects of both the CCE and CFE were measured by jugular vein clamping model. In comparison to the saline treated group (3.5 ± 0.5 clampings), both the CCE and CFE treated animals required a significantly higher number of clampings to induce thrombosis (4.8 ± 0.7 and 5.0 ± 0.6, respectively; p = 0.001 vs. saline; p=0.658 CFE vs. CCE). The ex-vivo analysis of whole blood aPTT revealed a slight elevation in both of the enoxaparin-treated groups in comparison to saline control. (CFE: 36.8 ± 18.6 sec; CCE: 30.5 ± 10.9 sec vs. saline: 26.7 ± 3.9 sec). The anti-Xa effects in plasma were significantly higher with the CFE (84.4 ± 1.5% inhibition) compared to that observed with the CCE (80.5 ± 2.9 % inhibition; p=0.026) while the anti-IIa levels were comparable in the two groups (37.1 ± 22.0 and 30.6 ± 17.9 % inhibition). Ex-vivo analysis of plasma samples from the control group did not reveal any anti-protease or anti-coagulant activity. Discussion: These results demonstrate that small amounts of OSCS (less than 5%) in enoxaparin do not impact its anti-thrombotic effects when administered subcutaneously. Since OSCS exhibits only anti-IIa activity and does not have any anti-Xa effects, the observed anti-Xa activity of the CCE was less than that of CFE. Other plasmatic anti-coagulant and anti-protease activities were not altered by the presence of OSCS. Since OSCS is highly charged it is likely that upon subcutaneous administration it is not absorbed. This observation is supported by the fact that the anti-Xa and IIa ratios of the samples collected after jugular vein clamping are approximately equal. Thus, the anti-thrombotic and pharmacodynamic effects of the two versions of enoxaparin are identical. The impact of repeated administration of contaminated enoxaparins and long-term pharmacodynamic and immunogenic effects need to be further explored.


2021 ◽  
pp. 019394592110276
Author(s):  
Ebru Cayir ◽  
Tim Cunningham ◽  
Ryne Ackard ◽  
Julie Haizlip ◽  
Jeongok Logan ◽  
...  

Contemplative practices promote well-being, work engagement and resilience among health care providers. We examined the impact of The Pause, a brief contemplative intervention, on health care providers’ physiological stress response. Participants were randomly assigned to either The Pause or the control group. They participated in a high-fidelity, stressful medical simulation. Following the simulation, intervention group practiced The Pause. Outcome measures were heart rate variability, heart rate, and blood pressure. We adjusted for baseline physiological variables, sociodemographic variables, self-care practices, and perceived stress. Participants in the intervention group had a standard deviation of the normal-to-normal RR intervals (heart rate variability indicator) that was 13.8 (95% CI 4.0, 23.5; p < .01) points higher than those in the control group. There were no significant effects of The Pause on heart rate or blood pressure. The Pause may reduce stress reactivity, increase heart rate variability, and enhance resilience in health care providers.


2015 ◽  
Vol 33 (2) ◽  
pp. 103-109 ◽  
Author(s):  
Yiding Chen ◽  
Hongwei Zhang ◽  
Yumin Tang ◽  
Jingjun Shu

Objective To investigate the impact of electroacupuncture (EA) at bilateral acupuncture points ST36 and PC6 on the level of sedation in general anaesthesia. Methods 40 patients undergoing abdominal surgery were randomly divided into two groups: EA combined with general anaesthesia (EA group, n=20) and general anaesthesia control group (n=20). The bilateral acupuncture points ST36 and PC6 were selected in both groups. Target-controlled infusion (TCI) of propofol was used for the induction and maintenance of general anaesthesia to reach an equilibrium state of Narcotrend Index (NT index). In the EA group, EA was performed with a Hans EA device. In the control group, general anaesthesia was performed without EA stimulation. In both groups, heart rate (HR), mean blood pressure (MAP) and NT index were recorded at corresponding time points up to 30 min after the end of acupuncture. Results The NT indices of the EA group showed a downward trend after EA stimulation (p=0.01). From 15 min after the start of EA stimulation the NT indices of the EA group were significantly lower than those of the control group (p<0.05). HR and MAP of the two groups showed no significant differences at any time points (p≥0.05). Conclusions EA stimulation at bilateral ST36 and PC6 significantly deepens the sedation level of general anaesthesia in patients with propofol TCI, has little impact on haemodynamics and provides significant delayed sedation effects.


2021 ◽  
Vol 19 ◽  
pp. 205873922110005
Author(s):  
Jiaqi Shan ◽  
Xiaofeng Wang ◽  
Xiaoli Zhang ◽  
Junfeng Zhang

To determine the impact of two varying doses of dexmedetomidine (DEX) on the onset and duration of neuromuscular blockade of rocuronium (ROC) under the condition of sevoflurane anesthesia. Eighty-one patients, American Society of Anesthesiologists Class I–II, were stochastically allocated to control group (group C) and two DEX groups (group D1 and group D2). In group D1 and group D2, DEX (0.5 and 1.0 µg/kg, respectively) was administrated 10 min before induction of general anesthesia. In group C, equivalent saline was infused by the same way. We monitored heart rate (HR), blood pressure, and train-of-four (TOF) values of all subjects in the period of anesthesia. We recorded times to reach TOF value 0 (T0, from injection of ROC to disappearance of all four twitches) as the onset time and TOF value 25% (T25, ratio of fourth twitch to first twitch,) as clinical duration of neuromuscular blockade. A total of 81 patients were randomized, 75 of whom accepted treatment, including group D1 ( n = 25), D2 ( n = 25), and C ( n = 25). T0 time of three groups was found to be similar. The duration of action for ROC in group D2 was 62.76 ± 6.33 min, which was much longer than that in group D1 and group C, which were 42.64 ± 3.92 and 42.56 ± 4.04 min ( p < 0.05), respectively. At T2 (after DEX administration) and T4 time point (10 min after trachea intubation), compared with group C, the changes of heart rate (HR) and blood pressure in DEX groups (group D1 and group D2) show greatly differences. Otherwise, there were no obvious differences among different groups at the other monitoring point-in-time. DEX infusion in general anesthesia has no obvious effect on the onset of ROC, but it is capable of prolonging its clinical effect time, which can provide reference for rational application of DEX and ROC in general anesthesia.


2001 ◽  
Vol 6 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Harald Walach ◽  
Stefan Schmidt ◽  
Yvonne-Michelle Bihr ◽  
Susanne Wiesch

We studied the effect of experimenter expectations and different instructions in a balanced placebo design. 157 subjects were randomized into a 2 × 4 factorial design. Two experimenters were led to expect placebos either to produce physiological effects or not (pro- vs. antiplacebo). All subjects except a control group received a caffeine placebo. They were either made to expect coffee, no coffee, or were in a double-blind condition. Dependent measures were blood pressure, heart rate, well-being, and a cognitive task. There was one main effect on the instruction factor (p = 0.03) with the group “told no caffeine” reporting significantly better well-being. There was one main effect on the experimenter factor with subjects instructed by experimenter “proplacebo” having higher systolic blood pressure (p = 0.008). There was one interaction with subjects instructed by experimenter “proplacebo” to receive coffee doing worse in the cognitive task than the rest. Subjects instructed by experimenter “antiplacebo” were significantly less likely to believe the experimental instruction, and that mostly if they had been instructed to receive coffee. Contrary to the literature we could not show an effect of instruction, but there was an effect of experimenters. It is likely, however, that these experimenter effects were not due to experimental manipulations, but to the difference in personalities.


Author(s):  
Florian Arendt

A test was done to see if reading a newspaper which consistently overrepresents foreigners as criminals strengthens the automatic association between foreign country and criminal in memory (i.e., implicit cultivation). Further, an investigation was done to find out if reading articles from the same newspaper produces a short-term effect on the same measure and if (1) emotionalization of the newspaper texts, (2) emotional reactions of the reader (indicated by arousal), and (3) attributed text credibility moderate the short-term treatment effect. Eighty-five participants were assigned to one of three experimental conditions. Participants in the control group received short factual crime texts, where the nationality of the offender was not mentioned. Participants in the factual treatment group received the same texts, but the foreign nationality was mentioned. Participants in the emotionalized treatment group received emotionalized articles (i.e., texts which are high in vividness and frequency) covering the same crimes, with the foreign nationality mentioned. Supporting empirical evidence for implicit cultivation and a short-term effect was found. However, only emotionalized articles produced a short-term effect on the strength of the automatic association, indicating that newspaper texts must have a minimum of stimulus intensity to overcome an effect threshold. There were no moderating effects of arousal or credibility pertaining to the impact on the implicit measure. However, credibility moderated the short-term effect on a first-order judgment (i.e., estimated frequency of foreigners of all criminals). This indicates that a newspaper’s effect on the strength of automatic associations is relatively independent from processes of propositional reasoning.


2019 ◽  
Vol 70 (5) ◽  
pp. 1754-1757
Author(s):  
Marius Toma Papacocea ◽  
Ioana Anca Badarau ◽  
Mugurel Radoi ◽  
Ioana Raluca Papacocea

Traumatic brain injuries (TBI) represent a high impact public health problem due to a high rate of death , long term disability and occurrence especially in young adults. Despite several promising animal studies, several parameters were proposed as biological markers and were assessed for this aim. Our study proposes the study of the early biochemical changes in association to hematological parameters for severe TBI patients prognosis. 43 patients with acute TBI were included in study based on clinical, laboratory and imagistic findings. The severity of the TBI was established by Glasgow Coma Scale GCS 3-8. In all patients were evaluated hematologic parameters (Red blood cell count - RBC, Hematocrit, blood Hemoglobin, White blood cell - WBC, Platelet count and biochemical parameters (glucose, urea, creatinine, electrolytes). Outcome was expressed as Glasgow Outcome Scale (GOS), between 1-5. Values were compared to control group -15 cases. Significant early differences in body temperature, heart rate, and systolic blood pressure were observed in TBI group versus control (p[0.05). After correlation, laboratory findings significantly associated to severe outcome - GOS = 1, 2 - (p[0.05) were plasma Na decrease and significant glucose increase. An early increase of temperature and decrease of Na may predict a severe outcome in patients with acute TBI; association with shifts in heart rate and blood pressure, imposes aggressive treatment measures.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Chacko ◽  
A Martinez-Naharro ◽  
T Kotecha ◽  
R Martone ◽  
D Hutt ◽  
...  

Abstract Background Cardiac involvement is the main driver of outcome in ATTR amyloidosis. Advances in therapeutics hold potential in transforming the course of the disease but the impact on cardiac amyloid load is unknown. The aim of this study was to evaluate the impact of patisiran, a new double stranded RNA based gene silencing therapy and a stabilizer, diflunisal, on cardiac amyloid load as measured by CMR and T1 mapping, in patients with ATTR amyloidosis. Methods and results Thirty-two patients with hereditary cardiac amyloidosis were studied. Sixteen patients received treatment with patisiran, and sixteen control subjects did not receive any disease modifying treatment. Patients were assessed with echocardiogram, CMR, NT-proBNP and six-minute walk time measurements at baseline and at 1 year (Mean interval 11.45±3.08 months in treatment group, mean interval 12.82±5.06 months in the control group). CMR analysis comprised LV volumes, T1 mapping to measure the extracellular volume (ECV) occupied by amyloid, T2 mapping and late gadolinium enhancement imaging. At 1-year follow-up, there was a substantial reduction in cardiac amyloid burden, in keeping with cardiac amyloid regression in 45% of patients on treatment. Overall the treatment group showed a reduction in ECV at 1 year follow up compared to an increase in ECV at 1 year in the control group (−1.37%, 95% CI: −3.43 to 0.68% versus 5.02%, 95% CI: 2.86% to 7.18% respectively, p&lt;0.001). The treatment group also showed an improvement in change in 6MWT at 1 year follow up compared to 6MWT at 1 year in the control group (−8.12 meters, 95% CI: −50.8 to 34.6 meters in the treatment group versus −132.27 meters, 95% CI: −216 to −48.6 meters in the control group, p=0.002). The treatment group showed a reduction in BNP at 1 year follow up compared to an increase in the control group (−567.87, 95% CI: −1288.90 to 153.15 in the treatment group versus 2004, 95% CI: 12.82 to 3995.45 in the control group, p&lt;0.001). There was no significant difference from baseline and 1-year data between the control and treatment groups for the difference in echocardiographic parameters, native T1, T2. There was a significant reduction in the percentage of injected dose by 99Tc-DPD scintigraphy in treated patients at 1 year compared to baseline. Conclusions These findings provide the first compelling evidence of substantial cardiac amyloid regression in ATTR amyloidosis, as well as the potential for CMR to be used to track response in treated patients with ATTR cardiac amyloidosis. Combination therapy with transthyretin knock down and stabilizing agents may well be synergistic given enhanced stoichiometry of stabilizers in the face of much reduced plasma transthyretin concentration. Funding Acknowledgement Type of funding source: None


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xin Ye ◽  
Dawei Zhu ◽  
Siyuan Chen ◽  
Xuefeng Shi ◽  
Rui Gong ◽  
...  

Abstract Background Hearing loss is quite prevalent and can be related to people’s quality of life. To our knowledge, there are limited studies assessing the efficacy of hearing interventions on quality of life in adults. Therefore, we aim to conduct a randomized controlled trial (RCT) to determine the impact and cost-effectiveness of community-based hearing rehabilitation on quality of life among Chinese adults with hearing loss. Methods/design In this two-arm feasibility study, participants aged 16 and above with some degree of hearing loss (n = 464) will be recruited from Linyi City, Shandong Province. They are randomly assigned to the treatment group or the control group. Those in the treatment group are prescribed with hearing aids, while those in the control group receive no intervention. Reinstruction in use of devices is provided for the treatment group during booster visits held 12 months post-randomization or unscheduled interim visits when necessary. Data are collected at baseline and the follow-up 20 months later. The primary outcome is changes in quality of life over a 20-month study period. Secondary outcomes include sub-dimensions in quality of life, physical functioning, chronic diseases, cognitive function, depression, social support, hospitalizations, falls, and healthcare costs. Finally, we will evaluate whether hearing aids intervention is cost-effective to apply in a large scale. Discussion The trial is designed to evaluate the impact and cost-effectiveness of a community-based rehabilitation intervention on quality of life among Chinese adults with hearing loss. We hope that it would help improve the well-being for Chinese adults and provide references in policy and practice for China and other countries. Trial registration Chinese Clinical Trial Registry ChiCTR1900024739. Registered on 26 July 2019.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Menglu Jiang ◽  
Jiawei Ji ◽  
Xin Li ◽  
Zhenqing Liu

Abstract Background Endotracheal intubation and extubation may cause undesirable hemodynamic changes. Intravenous oxycodone has recently been introduced and used for relieving hemodynamic alterations in response to intubation, but there is insufficient information regarding its application in stabilizing hemodynamics during extubation in the patients emerging from general anesthesia. Methods One hundred patients, who had undergone assorted laparoscopic surgeries under general anesthesia, were randomly assigned to Control group (saline injection, 50 cases) and Study group (intravenous injection of 0.08 mg/kg oxycodone immediately after completion of the surgical procedure, 50 cases). Blood pressure, heart rate, blood oxygen saturation (SpO2) as well as blood concentrations of epinephrine, norepinephrine, and cortisol were recorded or measured immediately before extubation (T0), during extubation (T1), as well as one minute (T2), 5 min (T3), and 10 min after extubation (T4). In addition, coughing and restlessness, time of eye-opening, and duration from completing surgery to extubation as well as Ramsay Sedation Scale were analyzed. Results Blood pressure and heart rate as well as blood concentrations of epinephrine, norepinephrine, and cortisol were significantly higher in the Control group compared with the Study group at the time of extubation as well as 1, 5, and 10 min after extubation (P < 0.05). When the patients emerged from general anesthesia, 70 % of the Control group had cough, which was significantly higher than that of Study group (40 %, P < 0.05). Significantly higher number of patients manifested restlessness in the Control group before (40 %) and after extubation (20 %) compared with that in the Study group (20 and 2 %, respectively, P < 0.05). In addition, patients of Control group had lower Ramsay score at extubation (1.7 ± 0.7) as well as 30 min after extubation (2.4 ± 0.9) compared to that of the patients of Study group (2.2 ± 0.9, and 3.0 ± 0.8, respectively, P = 0.003 and 0.001). Conclusions Intravenous oxycodone attenuated alterations of hemodynamics and blood hormones associated with extubation during emergence from general anesthesia. Trial registration Chinese Clinical Trial Registry: ChiCTR2000040370 (registration date: 11-28-2020) “‘retrospectively registered”.


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