scholarly journals Symptom Frequencies and Correlations with Temperature Variations in Suspected Cases of Neuroleptic Malignant Syndrome (NMS)

2021 ◽  
Vol 3 (6) ◽  
pp. 51-57
Author(s):  
Varadaraj R. Velamoor ◽  
Stephan C. Mann ◽  
Michel A. Woodbury ◽  
Zack Z. Cernovsky
Keyword(s):  
Heart Rate ◽  
First Generation ◽  
Archival Data ◽  
Autonomic Instability ◽  
The Usa ◽  
Clinical Interest ◽  
Higher Temperature ◽  
Masked Facies ◽  
Relationship Of ◽  
Cardinal Symptom

Background: The incidence of NMS is rare. Relative frequencies of symptoms that are most valuable in making a diagnosis of NMS can be assessed statistically only if a large sample of suspected NMS cases is available. Similarly, the relationship of such NMS symptoms to temperature (a cardinal symptom of NMS) can be meaningfully evaluated only by studying large samples. Method: De-identified archival data on 212 suspected NMS cases were obtained from professionals across the USA and Canada or were extracted from studies published in medical journals. We recorded the symptoms frequencies. The patients’ temperature ranged from 37.20C to 43.00C, with the mean at 39.50 (SD=1.3). All cases were caused by older first-generation antipsychotics (FGAs). We evaluated the frequencies of symptoms reported in these cases. These included symptoms in the realm of mental status, rigidity, and autonomic symptoms. We calculated the frequency of abnormal blood pressure, respiration and heart rate, symptoms such as Dysarthria, Dysphagia, Rigidity, Focal Dystonia, Waxy Flexibility, Myoclonus, Masked Facies, Bradykinesia, Akinesia, Cogwheeling, Stupor, Coma, Obtundation, Mutism, Decrease in Consciousness, Disorientation, Diaphoresis, Sialorrhea, and Seizures. We also calculated their correlations with temperature elevations, the most spectacular symptom of this dangerous syndrome. Results: The highest symptom frequencies (those > 10%) were found for Rigidity (91.0% of patients), Autonomic Instability (66.5%), Diaphoresis (45.8%), Mutism (34.4%), Tremor (31.6%), Stupor (20.3%), Confusion (15.6%), Incontinence (15.6%), Sialorrhea (14.6%), Coma (13.2%), and Dysphagia (11.3%). Other symptoms were too rare within the sample of the 212 suspected NMS cases to calculate the statistical significances of their relationships to temperature. The only significant correlations found of temperature were to increased heart rate and to the severe cases of coma. Discussion and Conclusion: Besides the elevated temperature, the most frequently reported symptoms in this sample of suspected NMS caused by FGAs were Rigidity, Autonomic Instability, Diaphoresis, Mutism, and Tremor. Higher temperature was associated with tachycardia as well as profound impairment of consciousness or coma. Reviews and database studies of second generation antipsychotics (SGAs), also referred to as atypical antipsychotics, suggest a lower incidence of NMS and milder severity of symptoms such as hyperthermia and rigidity. It would be of clinical interest to generate similar de-identified files of archival data for suspected cases of NMS in patients treated with SGAs. Furthermore, a similar profile derived from archival data on milder or prodromal NMS cases could enhance our understanding of this syndrome from a spectrum perspective.

scholarly journals Impact of temperature and relative humidity on the transmission of COVID-19: a modelling study in China and the United States

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043863
Author(s):  
Jingyuan Wang ◽  
Ke Tang ◽  
Kai Feng ◽  
Xin Lin ◽  
Weifeng Lv ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Relative Humidity ◽  
Human Mobility ◽  
The United States ◽  
Reproductive Number ◽  
Cross Sectional ◽  
The Usa ◽  
Higher Temperature ◽  
Potential Impact ◽  
The Impact

ObjectivesWe aim to assess the impact of temperature and relative humidity on the transmission of COVID-19 across communities after accounting for community-level factors such as demographics, socioeconomic status and human mobility status.DesignA retrospective cross-sectional regression analysis via the Fama-MacBeth procedure is adopted.SettingWe use the data for COVID-19 daily symptom-onset cases for 100 Chinese cities and COVID-19 daily confirmed cases for 1005 US counties.ParticipantsA total of 69 498 cases in China and 740 843 cases in the USA are used for calculating the effective reproductive numbers.Primary outcome measuresRegression analysis of the impact of temperature and relative humidity on the effective reproductive number (R value).ResultsStatistically significant negative correlations are found between temperature/relative humidity and the effective reproductive number (R value) in both China and the USA.ConclusionsHigher temperature and higher relative humidity potentially suppress the transmission of COVID-19. Specifically, an increase in temperature by 1°C is associated with a reduction in the R value of COVID-19 by 0.026 (95% CI (−0.0395 to −0.0125)) in China and by 0.020 (95% CI (−0.0311 to −0.0096)) in the USA; an increase in relative humidity by 1% is associated with a reduction in the R value by 0.0076 (95% CI (−0.0108 to −0.0045)) in China and by 0.0080 (95% CI (−0.0150 to −0.0010)) in the USA. Therefore, the potential impact of temperature/relative humidity on the effective reproductive number alone is not strong enough to stop the pandemic.

Origins of heart rate variability: relationship of heart rate burst morphology to work duration and load

1999 ◽  
Vol 277 (4) ◽  
pp. H1491-H1497
Author(s):  
Daniel Roach ◽  
Robert Haennel ◽  
Mary Lou Koshman ◽  
Robert Sheldon
Keyword(s):  
Heart Rate ◽  
Burst Duration ◽  
Heart Period ◽  
Quantal Response ◽  
Ambulatory Ecg ◽  
Work Duration ◽  
Baroreceptor Activation ◽  
Relationship Of ◽  
Electrocardiogram Ecg ◽  
The Impact

We are developing a lexicon of specific heart period changes, or lexons, that recur frequently and whose physiological meaning can be read into ambulatory electrocardiogram (ECG). The transient, reversible “burst” of tachycardia induced by exercise initiation can also be seen on ambulatory ECG. We hypothesized that burst morphology depended on the work that preceded it and on baroreceptor activation. Ten subjects with mean age 38 yr (range 17–69 yr) underwent two protocols of semisupine cycling in which load and duration were varied. Burst duration increased with longer cycling times (median values of 18.0, 25.5, and 23.7 s with 1, 3, and 5 s of cycling, respectively; P= 0.033). Burst shape as assessed by heart period exponential decay constant and burst magnitude did not change. To assess the impact of workload, subjects cycled for 5 s at loads of 0, 25, 50, and 75 W. No significant differences were seen in burst duration, burst magnitude, or burst shape. Tachycardia preceded hypotension by 4.6 ± 2.2 s, which is inconsistent with baroreceptor involvement in the onset of burst tachycardia. Because burst morphology is a nearly quantal response to the initiation of exercise, the presence of a burst on an ambulatory ECG implies the onset of exercise.

Nocturnal headache: systemic arterial pressure and heart rate during sleep

Cephalalgia ◽  
1983 ◽  
Vol 3 (1_suppl) ◽  
pp. 54-57 ◽  
Author(s):  
Fabio Cirignotta ◽  
Giorgio Coccagna ◽  
Tommaso Sacquegna ◽  
Emiliana Sforza ◽  
Giuseppe Lamontanara ◽  
...  
Keyword(s):  
Heart Rate ◽  
Arterial Pressure ◽  
Rem Sleep ◽  
Continuous Monitoring ◽  
Systemic Arterial Pressure ◽  
Fréquence Cardiaque ◽  
The Awakening ◽  
Sono Stati ◽  
Autonomic Instability ◽  
Polygraphic Recording

In order to evaluate autonomic nervous system changes occurring before nocturnal headache attacks, we studied three subjects (one male, two females) suffering from chronic migraine. All three patients underwent a nocturnal polygraphic recording including continuous monitoring of systemic arterial pressure and heart rate. Two subjects showed increases and irregularities of arterial pressure before awakening with headache. These changes began during N–REM sleep and lasted during REM sleep preceding the awakening with headache. Heart rate did not change before the attacks. These findings do not support the hypothesis that autonomic instability during REM sleep represents the precipitating factor of the attacks. On a étudié avec des méthodes polygrafiques trois sujets (1 homme et deux femmes) souffrant d'hémicranie chronique avec des crises nocturnes. Chez deux malades les crises étaient précédées d'augmentation et d'irrégularité de la tension artérielle. Ces modifications commençaient pendant le sommeil N-REM et contineaient pendant le sommeil REM qui précédait le réveil avec hémicranie. La fréquence cardiaque n'a pas subi de modification avant les crises. Les résultats obtenus ne confirment l'hypothèse selon laquelle le facteur causant les crises est l'instabilité anticronique à la fase REM. Sono stati studiati con metodiche poligrafiche 3 soggetti (1 maschio e 2 femmine) affetti da emicrania cronica con attacchi notturni. In 2 di essi gli attacchi erano preceduti da incrementi ed irregolarità della pressione arteriosa. Tali modificazioni iniziavano durante il sonno N-REM e perduravano nel corso del sonno REM che precedeva il risveglio con cefalea. La frequenza cardiaca non si modificava prima dell'attacco. I risultati ottenuti non confermano l'ipotesi che il fattore precipitante gli attacchi emicranici sia l'instabilità anticronica della fase REM.

Energy expenditure by elite midget male ice hockey players in small-sided games

2017 ◽  
Vol 12 (4) ◽  
pp. 504-513 ◽  
Author(s):  
Charles-Mathieu Lachaume ◽  
François Trudeau ◽  
Jean Lemoyne
Keyword(s):  
Heart Rate ◽  
Oxygen Consumption ◽  
Energy Expenditure ◽  
Ice Hockey ◽  
Training Method ◽  
Hockey Players ◽  
Treadmill Testing ◽  
Effective Training ◽  
Relationship Of ◽  
The Relationship

The purpose of this study was to investigate the energy expenditure and heart rate responses elicited in elite male midget ice hockey players during small-sided games. Nine players (aged 15.89 ± 0.33 years) participated in the study. Maximal progressive treadmill testing in the laboratory measured the relationship of oxygen consumption ([Formula: see text]) to heart rate before on-ice assessments of heart rate during six different small-sided games: 1v1, 2v2, 2v2 with support player, 3v3 with support player, 3v3 with transitions, and 4v4 with two support players. Heart rate was recorded continuously in each game. 3v3 T small-sided game was the most intense for all four intensity markers. All six small-sided games reached 89% HRmax or more with heart rate peaks in active effort repetition. These findings demonstrate that such small-sided games are considered as high intensity games and are an effective training method for ice hockey players.

"Identity Negotiation and Alien Residency"

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Kathleen Phillips Lewis
Keyword(s):  
First Generation ◽  
Identity Negotiation ◽  
The State ◽  
Specific Reference ◽  
African Origin ◽  
Caribbean Immigrants ◽  
Essential Nature ◽  
The Usa ◽  
Elizabeth Nunez

In her memoir, Not for Everyday Use (2014), and her novel Anna in Between (2009) and its sequel, Boundaries (2011), Elizabeth Nunez explores the nature of the migrant experience for first generation Afro-Caribbean immigrants to the USA. With specific reference to the use of language, characterization, history, imagery, and the interweaving of history, she analyzes the complexities of that reality as they attempt to adjust to a host locale (USA) that has had, from its inception, a very contentious relationship with blackness that fragments potential solidarity of blackness. Extrapolating from the lives her protagonists as filtered through the prism of her own migrant journey, Nunez sees them as existing in a permanent state of liminality from which there is no escape. Despite the finality of the act of migration, Caribbean-Americanlives are forever in a state of flux over which they can exert only limited control. Migration promises freedom and yet denies its full efflorescence; it offers the excitement of choice but only provides the exercise of it remains within the confines of fixed circumferences; it encourages belonging, yet castigates the complacency that belonging engenders. This paper will show that Nunez clearly represents the Afro-Caribbean immigrant life in America as uneasy existence in unsafe space, yet sends a firm message that the disillusionment of that reality is more palatable than the idea of return. The state of in-betweenity, therefore, while not static in essential nature, is as permanent and unavoidable as is the act of migration itself. In order to feel more at ease the migrant must quickly learn the balancing act of becoming yet never being; the migrant must come to appreciate the complex dance between commonality and contestation even within a diaspora of shared African origin.

scholarly journals Analysis of the Relationship of Professionals towards the Vertical Equity of the Slovenian Tax System and Its Comparison with Croatia, Bosnia and Herzegovina and the USA

2018 ◽  
Vol 15 (3-4) ◽  
pp. 145-166
Author(s):  
Jelena Klopčič ◽  
Maja Klun
Keyword(s):  
Bosnia And Herzegovina ◽  
The United States ◽  
Vertical Equity ◽  
Tax System ◽  
Equity Principle ◽  
The Usa ◽  
Survey Results ◽  
The Individual ◽  
Relationship Of ◽  
The Relationship

Vertical equity states that taxpayers whose positions are not the same should be treated differently while taking into consideration all the relevant characteristics. The main purpose of using the vertical equity principle is to require the redistribution of income in a way that reduces the income inequality of the society. The presented research aims to check the opinion of Slovenian tax system professionals on the principle of vertical equity. Slovenian results have been compared to a similar analysis carried out in Croatia, and partly with survey results from Bosnia and Herzegovina and the United States of America. The results show that the professional public agrees with the principle of vertical equity in the implementation of tax systems. All of the compared countries are similarly favourable towards vertical equity. However, this is also affected by the current tax arrangements of the individual countries.

scholarly journals Heart Rate Dependency and Inter-Lead Variability of the T Peak – T End Intervals

2020 ◽  
Vol 11 ◽  
Author(s):  
Irena Andršová ◽  
Katerina Hnatkova ◽  
Martina Šišáková ◽  
Ondřej Toman ◽  
Peter Smetana ◽  
...  
Keyword(s):  
Heart Rate ◽  
Three Dimensional ◽  
Rate Dependency ◽  
Rate Dependent ◽  
Heart Rate Correction ◽  
Ecg Leads ◽  
Relationship Of ◽  
The Relationship ◽  
Vector Magnitude

The electrocardiographic (ECG) assessment of the T peak–T end (Tpe) intervals has been used in many clinical studies, but several related physiological aspects have not been reported. Specifically, the sources of the Tpe differences between different ECG leads have not been systematically researched, the relationship of Tpe duration to underlying heart rate has not been firmly established, and little is known about the mutual correspondence of Tpe intervals measured in different ECG leads. This study evaluated 796,620 10-s 12-lead ECGs obtained from long-term Holters recorded in 639 healthy subjects (311 female) aged 33.8 ± 9.4 years. For each ECG, transformation to orthogonal XYZ lead was used to measure Tpe in the orthogonal vector magnitude (used as a reference for lead-to-lead comparisons) and to construct a three-dimensional T wave loop. The loop roundness was expressed by a ratio between its circumference and length. These ratios were significantly related to the standard deviation of Tpe durations in different ECG leads. At the underlying heart rate of 60 beats per minute, Tpe intervals were shorter in female than in male individuals (82.5 ± 5.6 vs 90.0 ± 6.5 ms, p < 0.0001). When studying linear slopes between Tpe intervals measured in different leads and the underlying heart rate, we found only minimal heart rate dependency, which was not systematic across the ECG leads and/or across the population. For any ECG lead, positive Tpe/RR slope was found in some subjects (e.g., 79 and 25% of subjects for V2 and V4 measurements, respectively) and a negative Tpe/RR slope in other subjects (e.g., 40 and 65% for V6 and V5, respectively). The steepest positive and negative Tpe/RR slopes were found for measurements in lead V2 and V4, respectively. In all leads, the Tpe/RR slope values were close to zero, indicating, on average, Tpe changes well below 2 ms for RR interval changes of 100 ms. On average, longest Tpe intervals were measured in lead V2, the shortest in lead III. The study concludes that the Tpe intervals measured in different leads cannot be combined. Irrespective of the measured ECG lead, the Tpe interval is not systematically heart rate dependent, and no heart rate correction should be used in clinical Tpe investigations.

scholarly journals Srdeční frekvence sportovců s mentálním postižením během zápasů národního turnaje ve stolním tenise Českého hnutí speciálních olympiád: pilotní studie

2019 ◽  
Vol 12 (2) ◽  
pp. 26-32 ◽  
Author(s):  
Marta Gimunová ◽  
Hana Válková ◽  
Tomáš Kalina
Keyword(s):  
Heart Rate ◽  
Intellectual Disabilities ◽  
Correlation Coefficients ◽  
The Body ◽  
Table Tennis ◽  
Special Olympics ◽  
Individual Fitness ◽  
Relationship Of ◽  
Overweight Or Obesity ◽  
Mean Heart Rate

Heart rate values are considered to be a significant indicator of individual fitness, intensity of exerciseand sympathetic activation. There are few studies in Czech literature focused on the heart rate in athleteswith intellectual disabilities. The aim of this study was to describe the characteristics of heart rateduring fifteen table tennis matches within the 23rd national tournament of the Czech Special OlympicsMovement. Ten participants (6 males, 4 females) who for at least 3 years train regularly and participatein table tennis competitions under the Special Olympics rules, were observed. Their heart rate wasmeasured using a sports tester Forerunner® 15, Garmin Ltd, which was fastened on the participant’schest during their game day. Heart rate values during the matches were statistically processed alongwith the matches’ duration and the resulting match scores. Correlation coefficients obtained from scatterplots show a statistically significant relationship of mean heart rate values during the match withthe resulting score, probably influenced by emotion and psychological stress associated with the matchloss. The effect of match duration on the heart rate was not statistically significant during observedmatches. Subsequent analysis of the body composition of the athletes showed that sixty percent ofthem were in the category of overweight or obesity. These results highlight the need to promote healthylifestyle and physical activity in the population with intellectual disabilities.

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