CYBERMED LIFE - ORGANIC  & NATURAL LIVING

Cybermedlife - Therapeutic Actions Therapeutic Breathing

A randomized controlled dosing study of Iyengar yoga and coherent breathing for the treatment of major depressive disorder: Impact on suicidal ideation and safety findings.

Abstract Title: A randomized controlled dosing study of Iyengar yoga and coherent breathing for the treatment of major depressive disorder: Impact on suicidal ideation and safety findings. Abstract Source: Complement Ther Med. 2018 Apr ;37:136-142. Epub 2018 Feb 23. PMID: 29609926 Abstract Author(s): Maren Nyer, Patricia L Gerbarg, Marisa M Silveri, Jennifer Johnston, Tammy M Scott, Maya Nauphal, Liz Owen, Greylin H Nielsen, David Mischoulon, Richard P Brown, Maurizio Fava, Chris C Streeter Article Affiliation: Maren Nyer Abstract: BACKGROUND: Yoga interventions offer promise for the treatment of major depressive disorder (MDD), yet their safety and potential impact on suicidal ideation (SI) have not been well documented. This study evaluated the safety of a randomized controlled dose-finding trial of Iyengar yoga plus coherent breathing for individuals with MDD, as well as the potential effects of the intervention on SI without intent. METHODS: Participants with Beck Depression Inventory-II (BDI-II) scores ≥14 and a diagnosis of MDD (using DSM-IV criteria) were randomized to either a low dose group (LDG) or high dose group (HDG) and received a 12-week manualized intervention. The LDG included two 90-min yoga classes plus three 30-min homework sessions weekly. The HDG offered three 90-min classesplus four 30-min homework sessions weekly. RESULTS: Thirty-two individuals with MDD were randomized, of which 30 completed the protocol. At screening, SI without intent was endorsed on the BDI-II by 9 participants; after completing the intervention, 8 out of 9 reported resolution of SI. There were 17 adverse events possibly-related and 15 definitely-related to the intervention. The most common protocol-related adverse event was musculoskeletal pain, which resolved over the course of the study. CONCLUSIONS: The Iyengar yoga plus coherent breathing intervention was associated with the resolution of SI in 8 out of 9 participants, with mild side effects that were primarily musculoskeletal in nature. This preliminary evidence suggests that this intervention may reduce SI without intent and be safe for use in those with MDD. Article Published Date : Mar 31, 2018

Treatment of Major Depressive Disorder with Iyengar Yoga and Coherent Breathing: A Randomized Controlled Dosing Study. 📎

Abstract Title: Treatment of Major Depressive Disorder with Iyengar Yoga and Coherent Breathing: A Randomized Controlled Dosing Study. Abstract Source: J Altern Complement Med. 2017 Mar ;23(3):201-207. Epub 2017 Feb 16. PMID: 28296480 Abstract Author(s): Chris C Streeter, Patricia L Gerbarg, Theodore H Whitfield, Liz Owen, Jennifer Johnston, Marisa M Silveri, Marysia Gensler, Carol L Faulkner, Cathy Mann, Mary Wixted, Anne Marie Hernon, Maren B Nyer, E Richard P Brown, John E Jensen Article Affiliation: Chris C Streeter Abstract: OBJECTIVES: The aims of this study were to assess the effects of an intervention of Iyengar yoga and coherent breathing at five breaths per minute on depressive symptoms and to determine optimal intervention yoga dosing for future studies in individuals with major depressive disorder (MDD). METHODS: Subjects were randomized to the high-dose group (HDG) or low-dose group (LDG) for a 12-week intervention of three or two intervention classes per week, respectively. Eligible subjects were 18-64 years old with MDD, had baseline Beck Depression Inventory-II (BDI-II) scores≥14, and were either on no antidepressant medications or on a stable dose of antidepressants for ≥3 months. The intervention included 90-min classes plus homework. Outcome measures were BDI-II scores and intervention compliance. RESULTS: Fifteen HDG (Mage = 38.4 ± 15.1 years) and 15 LDG (Mage = 34.7 ± 10.4 years) subjects completed the intervention. BDI-II scores at screening and compliance did not differ between groups (p = 0.26). BDI-II scores declined significantly from screening (24.6 ± 1.7) to week 12 (6.0 ± 3.8)for the HDG (-18.6 ± 6.6; p < 0.001), and from screening (27.7 ± 2.1) to week 12 (10.1 ± 7.9) in the LDG (-17.7 ± 9.3; p < 0.001). There were no significant differences between groups, based on response (i.e.,>50% decrease in BDI-II scores; p = 0.65) for the HDG (13/15 subjects) and LDG (11/15 subjects) or remission (i.e., number of subjects with BDI-II scores<14; p = 1.00) for the HDG (14/15 subjects) and LDG (13/15 subjects) after the 12-week intervention, although a greater number of subjects in the HDG had 12-week BDI-II scores ≤10 (p = 0.04). CONCLUSION: During this 12-week intervention of yoga plus coherent breathing, depressive symptoms declined significantly in patients with MDD in both the HDG and LDG. Both groups showed comparable compliance and clinical improvements, with more subjects in the HDG exhibiting BDI-II scores≤10 at week 12. Article Published Date : Feb 28, 2017

Effects of slow and regular breathing exercise on cardiopulmonary coupling and blood pressure.

Abstract Title: Effects of slow and regular breathing exercise on cardiopulmonary coupling and blood pressure. Abstract Source: Med Biol Eng Comput. 2017 Feb ;55(2):327-341. Epub 2016 May 18. PMID: 27193228 Abstract Author(s): Zhengbo Zhang, Buqing Wang, Hao Wu, Xiaoke Chai, Weidong Wang, Chung-Kang Peng Article Affiliation: Zhengbo Zhang Abstract: Investigation of the interaction between cardiovascular variables and respiration provides a quantitative and noninvasive approach to assess the autonomic control of cardiovascular function. The aim of this paper is to investigate the changes of cardiopulmonary coupling (CPC), blood pressure (BP) and pulse transit time (PTT) during a stepwise-paced breathing (SPB) procedure (spontaneous breathing followed by paced breathing at 14, 12.5, 11, 9.5, 8 and 7 breaths per minute, 3 min each) and gain insights into the characteristics of slow breathing exercises. RR interval, respiration, BP and PTT are collected during the SPB procedure (48 healthy subjects, 27 ± 6 years). CPC is assessed through investigating both the phase and amplitude dynamics between the respiration-induced components from RR interval and respiration by the approach of ensemble empirical mode decomposition. It was found that even though the phase synchronization and amplitude oscillation of CPC were both enhanced by the SPB procedure, phase coupling does not increase monotonically along with the amplitude oscillation during the whole procedure. Meanwhile, BP was reduced significantly by the SPB procedure (SBP: from 122.0 ± 13.4 to 114.2 ± 14.9 mmHg, p < 0.001, DBP: from 82.2 ± 8.6 to 77.0 ± 9.8 mmHg, p < 0.001, PTT: from 172.8 ± 20.1 to 176.8 ± 19.2 ms, p < 0.001). Our results demonstrate that the SPB procedure can reduce BP and lengthen PTT significantly. Compared with amplitude dynamics, phase dynamics is a different marker for CPC analysis in reflecting cardiorespiratory coherence during slow breathing exercise. Our study provides a methodology topractice slow breathing exercise, including the setting of target breathing rate, change of CPC and the importance of regular breathing. The applications and usability of the study results have also been discussed. Article Published Date : Jan 31, 2017

Morning breathing exercises prolong lifespan by improving hyperventilation in people living with respiratory cancer. 📎

Abstract Title: Morning breathing exercises prolong lifespan by improving hyperventilation in people living with respiratory cancer. Abstract Source: Medicine (Baltimore). 2017 Jan ;96(2):e5838. PMID: 28079815 Abstract Author(s): Wei-Jie Wu, Shan-Huan Wang, Wei Ling, Li-Jun Geng, Xiao-Xi Zhang, Lan Yu, Jun Chen, Jiang-Xi Luo, Hai-Lu Zhao Article Affiliation: Wei-Jie Wu Abstract: Disturbance of oxygen-carbon dioxide homeostasis has an impact on cancer. Little is known about the effect of breath training on cancer patients. Here we report our 10-year experience with morning breathing exercises (MBE) in peer-support programs for cancer survivors.We performed a cohort study to investigate long-term surviving patients with lung cancer (LC) and nasopharyngeal cancer (NPC) who practiced MBE on a daily basis. End-tidal breath holding time (ETBHT) after MBE was measured to reflect improvement in alveolar O2 pressure and alveolar CO2 pressure capacity.Patients (female, 57) with a diagnosis of LC (90 patients) and NPC (32 patients) were included. Seventy-six of them were MBE trainees. Average survival years were higher in MBE trainees (9.8 ± 9.5) than nontrainees (3.3 ± 2.8). The 5-year survival rate was 56.6% for MBE trainees and 19.6% for nontrainees (RR = 5.371, 95% CI = 2.271-12.636, P < 0.001). Survival probability of the trainees further increased 17.9-fold for the 10-year survival rate. Compared with the nontrainees, the MBE trainees shows no significant differences in ETBHT (baseline, P = 0.795; 1-2 years, P = 0.301; 3-4 years, P = 0.059) at baseline and within the first 4 years. From the 5th year onwards, significant improvements were observed in ETBHT, aCO2%, PaCO2, and PaO2 (P = 0.028). In total, 18 trainees (40.9%) and 20 nontrainees (74.1%) developed new metastasis (RR = 0.315, 95% CI = 0.108-0.919, P = 0.031).MBE might benefit for the long-term survival in patients with LC and NPC due to improvement in hyperventilation. Article Published Date : Dec 31, 2016

Beneficial Effects of Yogasanas and Pranayama in limiting the Cognitive decline in Type 2 Diabetes. 📎

Abstract Title: Beneficial Effects of Yogasanas and Pranayama in limiting the Cognitive decline in Type 2 Diabetes. Abstract Source: Natl J Physiol Pharm Pharmacol. 2017 ;7(3):232-235. Epub 2016 Sep 24. PMID: 28299348 Abstract Author(s): Santhakumari Rajani, Rajagopalan Archana, Yogananda Reddy Indla, P Rajesh Article Affiliation: Santhakumari Rajani Abstract: BACKGROUND: Out of many complications that were observed in type 2 diabetes, cognitive impairment is the most neglected. AIM AND OBJECTIVES: The aim of the present study is to assess the cognitive decline in type 2 diabetes and to observe the role of yogasanas and pranayama in ameliorating the cognitive decline. MATERIALS AND METHODS: Sixty eight type 2 diabetic subjects were recruited in the study, 34 of them did specific yogasanas and pranayama (test group) for six months and the remaining age and sex matched 34 subjects were recruited as (control group) who were not on any specific exercise regimen. Glycaemic index was estimated by measuring the glycosylated haemoglobin (HbA1c) concentration with Bio-Rad apparatus and cognition was assessed by using Addenbrook's Cognitive Examination-Revised (ACE-R), which is a neuropsychological battery. STATISTICAL ANALYSIS: Data was analysed with unpaired student t test. P value<0.05 is considered as statistically significant. Validity was assessed by receiver operating characteristics. RESULTS: Analysis of data indicated more cognitive scores in the test group when compared with the control group. In test group six months practice of yogasanas and pranayama has also significantly brought down the high glycaemic values which were observed in the control group. CONCLUSION: These findings allow the study to conclude that regular practice of yogasanas and pranayama has a beneficial effect on cognitive performance in type 2 diabetic subjects by stabilizing blood glucose. Article Published Date : Dec 31, 2016

Laughter yoga versus group exercise program in elderly depressed women: a randomized controlled trial.

Abstract Title: Laughter yoga versus group exercise program in elderly depressed women: a randomized controlled trial. Abstract Source: Int J Geriatr Psychiatry. 2010 Sep 16. Epub 2010 Sep 16. PMID: 20848578 Abstract Author(s): Mahvash Shahidi, Ali Mojtahed, Amirhossein Modabbernia, Mohammad Mojtahed, Abdollah Shafiabady, Ali Delavar, Habib Honari Article Affiliation: Department of Counseling, School of Psychology&Training Sciences, Allameh Tabatabai University, Tehran, Iran. Abstract: BACKGROUND: Laughter Yoga founded by M. Kataria is a combination of unconditioned laughter and yogic breathing. Its effect on mental and physical aspects of healthy individuals was shown to be beneficial. OBJECTIVE: The objective of this study was to compare the effectiveness of Kataria's Laughter Yoga and group exercise therapy in decreasing depression and increasing life satisfaction in older adult women of a cultural community of Tehran, Iran. METHODS: Seventy depressed old women who were members of a cultural community of Tehran were chosen by Geriatric depression scale (score > 10). After completion of Life Satisfaction Scale pre-test and demographic questionnaire, subjects were randomized into three groups of laughter therapy, exercise therapy, and control. Subsequently, depression post-test and life satisfaction post-test were done for all three groups. The data wereanalyzed using analysis of covariance and Bonferroni's correction. RESULTS: Sixty subjects completed the study. The analysis revealed a significant difference in decrease in depression scores of both Laughter Yoga and exercise therapy group in comparison to control group (p < 0.001 and p < 0.01, respectively). There was no significant difference between Laughter Yoga and exercise therapy groups. The increase in life satisfaction of Laughter Yoga group showed a significant difference in comparison with control group (p < 0.001). No significant difference was found between exercise therapy and either control or Laughter Yoga group. CONCLUSION: Our findings showed that Laughter Yoga is at least as effective as group exercise program in improvement of depression and life satisfaction of elderly depressed women. Copyright © 2010 John Wiley&Sons, Ltd. Article Published Date : Sep 16, 2010

Trained breathing-induced oxygenation acutely reverses cardiovascular autonomic dysfunction in patients with type 2 diabetes and renal disease.

Abstract Title: Trained breathing-induced oxygenation acutely reverses cardiovascular autonomic dysfunction in patients with type 2 diabetes and renal disease. Abstract Source: Acta Diabetol. 2016 Apr ;53(2):217-26. Epub 2015 May 9. PMID: 25956276 Abstract Author(s): Pasquale Esposito, Roberto Mereu, Giacomo De Barbieri, Teresa Rampino, Alessandro Di Toro, Per-Henrik Groop, Antonio Dal Canton, Luciano Bernardi Article Affiliation: Pasquale Esposito Abstract: AIMS: Cardiovascular autonomic dysfunction, evaluated as baroreflex sensitivity (BRS), could be acutely corrected by slow breathing or oxygen administration in patients with type 1 diabetes, thus suggesting a functional component of the disorder. We tested this hypothesis in patients with the type 2 diabetes with or without renal impairment. METHODS: Twenty-six patients with type 2 diabetes (aged 61.0 ± 0.8 years, mean ± SEM; duration of diabetes 10.5 ± 2 years, BMI 29.9 ± 0.7 kg/m(2), GFR 68.1 ± 5.6 ml/min) and 24 healthy controls (aged 58.5 ± 1.0 years) were studied. BRS was obtained from recordings of RR interval and systolic blood pressure fluctuations during spontaneous and during slow, deep (6 breaths/min) controlled breathing in conditions of normoxia or hyperoxia (5 l/min oxygen). RESULTS: During spontaneous breathing, diabetic patients had lower RR interval and lower BRS compared with the control subjects (7.1 ± 1.2 vs. 12.6 ± 2.0 ms/mmHg, p < 0.025). Deep breathing and oxygen administration significantly increased arterial saturation, reduced RR interval and increased BRS in both groups (to 9.6 ± 1.8 and 15.4 ± 2.4 ms/mmHg, respectively, p < 0.05, hyperoxia vs. normoxia). Twelve diabetic patients affected by chronic diabetic kidney disease (DKD) presented a significant improvement in the BRS during slow breathing and hyperoxia (p < 0.025 vs. spontaneous breathing during normoxia). CONCLUSIONS: Autonomic dysfunction present in patients with type 2 diabetes can be partially reversed by slow breathing, suggesting a functional role of hypoxia, also in patients with DKD. Interventions known to relieve tissue hypoxia and improve autonomic function, like physical activity, may be useful in the prevention and management of complications in patients with diabetes. Article Published Date : Mar 31, 2016

Breathing exercise combined with cognitive behavioural intervention improves sleep quality and heart rate variability in major depression.

Abstract Title: Breathing exercise combined with cognitive behavioural intervention improves sleep quality and heart rate variability in major depression. Abstract Source: J Clin Nurs. 2015 Nov ;24(21-22):3206-14. Epub 2015 Sep 25. PMID: 26404039 Abstract Author(s): Hui-Ching Chien, Yu-Chu Chung, Mei-Ling Yeh, Jia-Fu Lee Article Affiliation: Hui-Ching Chien Abstract: AIMS AND OBJECTIVES: The aim of this study was to investigate the effects of a cognitive behavioural intervention combined with a breathing relaxation exercise on sleep quality and heart rate variability in patients with major depression. BACKGROUND: Depression is a long-lasting illness with significant effects not only in individuals themselves, but on their family, work and social relationships as well. Cognitive behavioural therapy is considered to be an effective treatment for major depression. Breathing relaxation may improve heart rate variability, but few studies have comprehensively examined the effect of a cognitive behavioural intervention combined with relaxing breathing on patients with major depression. DESIGN: An experimental research design with a repeated measure was used. METHODS: Eighty-nine participants completed this study and entered data analysed. The experimental group (n = 43) received the cognitive behavioural intervention combined with a breathing relaxation exercise for four weeks, whereas the control group (n = 46) did not. Sleep quality and heart rate variability were measured at baseline, posttest1, posttest2 and follow-up. Data were examined by chi-square tests, t-tests and generalised estimating equations. RESULTS: After adjusting for age, socioeconomic status, severity of disease and psychiatric history, the quality of sleep of the experimental group improved, with the results at posttest achieving significance. Heart rate variability parameters were also significantly improved. CONCLUSIONS: This study supported the hypothesis that the cognitive behavioural intervention combined with a breathing relaxation exercise could improve sleep quality and heart rate variability in patients with major depression, and the effectiveness was lasting. RELEVANCE TO CLINICAL PRACTICE: The cognitive behavioural intervention combined with a breathing relaxation exercise that included muscle relaxation, deep breathing and sleep hygiene could be provided with major depression during hospitalisation. Through group practice and experience sharing, participants could modulate their heart rate variability and share feeling about good sleep as well relaxation. Article Published Date : Oct 31, 2015

Increased cardio-respiratory coupling evoked by slow deep breathing can persist in normal humans. 📎

Abstract Title: Increased cardio-respiratory coupling evoked by slow deep breathing can persist in normal humans. Abstract Source: Respir Physiol Neurobiol. 2014 Dec 1 ;204:99-111. Epub 2014 Sep 28. PMID: 25266396 Abstract Author(s): Thomas E Dick, Joseph R Mims, Yee-Hsee Hsieh, Kendall F Morris, Erica A Wehrwein Article Affiliation: Thomas E Dick Abstract: Slow deep breathing (SDB) has a therapeutic effect on autonomic tone. Our previous studies suggested that coupling of the cardiovascular to the respiratory system mediates plasticity expressed in sympathetic nerve activity. We hypothesized that SDB evokes short-term plasticity of cardiorespiratory coupling (CRC). We analyzed respiratory frequency (fR), heart rate and its variability (HR&HRV), the power spectral density (PSD) of blood pressure (BP) and the ventilatory pattern before, during, and after a 20-min epoch of SDB. During SDB, CRC and the relative PSD of BP at fR increased; mean arterial pressure decreased; but HR varied; increasing (n = 3), or decreasing (n = 2) or remaining the same (n = 5). After SDB, short-term plasticity was not apparent for the group but for individuals differences existed between baseline and recovery periods. We conclude that a repeated practice, like pranayama, may strengthen CRC and evoke short-term plasticity effectively in a subset of individuals. Article Published Date : Nov 30, 2014

Paced breathing compared with usual breathing for hot flashes.

Abstract Title: Paced breathing compared with usual breathing for hot flashes. Abstract Source: Menopause. 2013 Feb ;20(2):179-84. PMID: 22990758 Abstract Author(s): Richa Sood, Amit Sood, Sherry L Wolf, Breanna M Linquist, Heshan Liu, Jeff A Sloan, Daniel V Satele, Charles L Loprinzi, Debra L Barton Article Affiliation: Richa Sood Abstract: OBJECTIVE: Paced breathing (slow, deep, diaphragmatic breathing) reduces central sympathetic activity and facilitates the relaxation response. The present study was designed to assess the feasibility of and to obtain initial efficacy estimates of two paced-breathing programs, compared with usual breathing, for the frequency and severity of hot flashes. METHODS: We designed a 9-week, randomized, three-arm, parallel-group, blinded (investigator) phase II clinical trial. Using an audio CD, participants in the active arms practiced paced breathing at 6 breaths/minute for 15 minutes, either once or twice a day, whereas the control arm practiced usual breathing at 14 breaths/minute for 10 minutes/day. Feasibility was assessed through self-report questionnaires; percent reduction and effect size estimates were determined using changes in hot flash frequency and scores within each group. RESULTS: Of the 92 eligible participants, 68 (74%) completed the study. Most women reported that the intervention was easy to do (79%) and of appropriate duration (71%). They could practice exercises as taught (61%) and could practice on most days (65%). Participants in all arms reported hot flash reductions during the 9 weeks: 52% for paced breathing twice a day, 42% for paced breathing once a day, and 46% for usual breathing. CONCLUSIONS: The paced-breathing intervention is feasible. Although paced breathing twice a day seems to be the most helpful dose, efforts to intensify paced breathing once a day may be more practical for widespread dissemination. The efficacy and overall clinical impact of paced-breathing exercises on hot flash reduction require further evaluation in an adequately powered, placebo-controlled, randomized phase III clinical trial. Article Published Date : Jan 31, 2013

Effect of yoga practices on pulmonary function tests including transfer factor of lung for carbon monoxide (TLCO) in asthma patients.

Abstract Title: Effect of yoga practices on pulmonary function tests including transfer factor of lung for carbon monoxide (TLCO) in asthma patients. Abstract Source: Indian J Physiol Pharmacol. 2012 Jan-Mar;56(1):63-8. PMID: 23029966 Abstract Author(s): Savita Singh, Ritu Soni, K P Singh, O P Tandon Article Affiliation: Department of Physiology, University College of Medical Sciences&Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India. Abstract: Prana is the energy, when the self-energizing force embraces the body with extension and expansion and control, it is pranayama. It may affect the milieu at the bronchioles and the alveoli particularly at the alveolo-capillary membrane to facilitate diffusion and transport of gases. It may also increase oxygenation at tissue level. Aim of our study is to compare pulmonary functions and diffusion capacity in patients of bronchial asthma before and after yogic intervention of 2 months. Sixty stable asthmatic-patients were randomized into two groups i.e group 1 (Yoga training group) and group 2 (control group). Each group included thirty patients. Lung functions were recorded on all patients at baseline, and then after two months. Group 1 subjects showed a statistically significant improvement (P<0.001) in Transfer factor of the lung for carbon monoxide (TLCO), forced vital capacity (FVC), forced expiratory volume in 1st sec (FEV1), peak expiratory flow rate (PEFR), maximum voluntary ventilation (MVV) and slow vital capacity (SVC) after yoga practice. Quality of life also increased significantly. It was concluded that pranayama&yoga breathing and stretching postures are used to increase respiratory stamina, relax the chest muscles, expand the lungs, raise energy levels, and calm the body. Article Published Date : Dec 31, 2011

Effect of pranayama&yoga-asana on cognitive brain functions in type 2 diabetes-P3 event related evoked potential (ERP).

Abstract Title: Effect of pranayama&yoga-asana on cognitive brain functions in type 2 diabetes-P3 event related evoked potential (ERP). Abstract Source: Indian J Med Res. 2010 May;131:636-40. PMID: 20516534 Abstract Author(s): Tenzin Kyizom, Savita Singh, K P Singh, O P Tandon, Rahul Kumar Article Affiliation: Department of Physiology, University College of Medical Sciences&Guru Teg Bahadur Hospital, Delhi, India. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND&OBJECTIVES:Electrophysiological evidence of delayed cognition as measured by P300, an evoked potential is observed in Diabetes mellitus. P300 (or P3) is a component of endogenous cerebral evoked response that assesses higher functions of the brain. Our study aims to see the role of pranayama and yoga-asana on P300 latency and amplitude in type 2 diabetic patients. METHODS: Sixty patients of type 2 diabetes were recruited from diabetic clinic and divided into two groups - control group on only conventional medical therapy and yoga-group on conventional medical therapy along with pranayama and yoga-asana. Basal recordings of P300 and blood glucose were taken at the time of recruitment and second recordings repeated after forty five days for both the groups. P300 was recorded on Nihon Kohden Neuropack mu MEB 9100 using auditory "odd-ball paradigm". The data were analysed using repeated measures analysis of variance (ANOVA) followed by Tukey's test at 5 per cent level of significance. RESULTS: Statistically significant improvement in the latency and the amplitude of N200, P300 was observed in the yoga group as compared to the control group. INTERPRETATION&CONCLUSION: Our data suggest that yoga has a beneficial effect on P300 and thus can be incorporated along with the conventional medical therapy for improving cognitive brain functions in diabetes. Article Published Date : May 01, 2010

Effect of two breathing exercises (Buteyko and pranayama) in asthma: a randomised controlled trial. 📎

Abstract Title: Effect of two breathing exercises (Buteyko and pranayama) in asthma: a randomised controlled trial. Abstract Source: Phytother Res. 2009 Dec 2. PMID: 12885982 Abstract Author(s): S Cooper, J Oborne, S Newton, V Harrison, J Thompson Coon, S Lewis, A Tattersfield Article Affiliation: Division of Respiratory Medicine, City Hospital, Nottingham NG5 1PB, UK. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND: Patients with asthma are interested in the use of breathing exercises but their role is uncertain. The effects of the Buteyko breathing technique, a device which mimics pranayama (a yoga breathing technique), and a dummy pranayama device on bronchial responsiveness and symptoms were compared over 6 months in a parallel group study. METHODS: Ninety patients with asthma taking an inhaled corticosteroid were randomised after a 2 week run in period to Eucapnic Buteyko breathing, use of a Pink City Lung Exerciser (PCLE) to mimic pranayama, or a PCLE placebo device. Subjects practised the techniques at home twice daily for 6 months followed by an optional steroid reduction phase. Primary outcome measures were symptom scores and change in the dose of methacholine provoking a 20% fall in FEV(1) (PD(20)) during the first 6 months. RESULTS: Sixty nine patients (78%) completed the study. There was no significant difference in PD(20) between the three groups at 3 or 6 months. Symptoms remained relatively stable in the PCLE and placebo groups but were reduced in the Buteyko group. Median change in symptom scores at 6 months was 0 (interquartile range -1 to 1) in the placebo group, -1 (-2 to 0.75) in the PCLE group, and -3 (-4 to 0) in the Buteyko group (p=0.003 for difference between groups). Bronchodilator use was reduced in the Buteyko group by two puffs/day at 6 months; there was no change in the other two groups (p=0.005). No difference was seen between the groups in FEV(1), exacerbations, or ability to reduce inhaled corticosteroids. CONCLUSION: The Buteyko breathing technique can improve symptoms and reduce bronchodilator use but does not appear to change bronchial responsiveness or lung function in patients with asthma. No benefit was shown for the Pink City Lung Exerciser. Article Published Date : Dec 02, 2009

Diaphragmatic Breathing Reduces Exercise-induced Oxidative Stress. 📎

Abstract Title: Diaphragmatic Breathing Reduces Exercise-induced Oxidative Stress. Abstract Source: Evid Based Complement Alternat Med. 2009 Oct 29. PMID: 19875429 Abstract Author(s): Daniele Martarelli, Mario Cocchioni, Stefania Scuri, Pierluigi Pompei Abstract: Diaphragmatic breathing is relaxing and therapeutic, reduces stress, and is a fundamental procedure of Pranayama Yoga, Zen, transcendental meditation and other meditation practices. Analysis of oxidative stress levels in people who meditate indicated that meditation correlates with lower oxidative stress levels, lower cortisol levels and higher melatonin levels. It is known that cortisol inhibits enzymes responsible for the antioxidant activity of cells and that melatonin is a strong antioxidant; therefore, in this study, we investigated the effects of diaphragmatic breathing on exercise-induced oxidative stress and the putative role of cortisol and melatonin hormones in this stress pathway. We monitored 16 athletes during an exhaustive training session. After the exercise, athletes were divided in two equivalent groups of eight subjects. Subjects of the studied group spent 1 h relaxing performing diaphragmatic breathing and concentrating on their breath in a quiet place. The other eight subjects, representing the control group, spent the same time sitting in an equivalent quite place. Results demonstrate that relaxation induced by diaphragmatic breathing increases the antioxidant defense status in athletes after exhaustive exercise. These effects correlate with the concomitant decrease in cortisol and the increase in melatonin. The consequence is a lower level of oxidative stress, which suggests that an appropriate diaphragmatic breathing could protect athletes from long-term adverse effects of free radicals. Article Published Date : Oct 29, 2009

The effect of biofeedback on function in patients with heart failure.

Abstract Title: The effect of biofeedback on function in patients with heart failure. Abstract Source: Appl Psychophysiol Biofeedback. 2009 Jun;34(2):71-91. Epub 2009 Feb 10. PMID: 19205870 Abstract Author(s): Kimberly S Swanson, Richard N Gevirtz, Milton Brown, James Spira, Ermina Guarneri, Liset Stoletniy Abstract: Decreased HRV has been consistently associated with increased cardiac mortality and morbidity in HF patients. The aim of this study is to determine if a 6-week course of heart rate variability (HRV) biofeedback and breathing retraining could increase exercise tolerance, HRV, and quality of life in patients with New York Heart Association Class I-III heart failure (HF). Participants (N = 29) were randomly assigned to either the treatment group consisting of six sessions of breathing retraining, HRV biofeedback and daily practice, or the comparison group consisting of six sessions of quasi-false alpha-theta biofeedback and daily practice. Exercise tolerance, measured by the 6-min walk test (6MWT), HRV, measured by the standard deviation of normal of normal beats (SDNN), and quality of life, measured by the Minnesota Living with Congestive Heart Failure Questionnaire, were measured baseline (week 0), post (week 6), and follow-up (week 18). Cardiorespiratory biofeedback significantly increased exercise tolerance (p = .05) for the treatment group in the high (>or=31%) left ventricular ejection fraction (LVEF) category between baseline and follow-up. Neither a significant difference in SDNN (p = .09) nor quality of life (p = .08), was found between baseline and follow-up. A combination of HRV biofeedback and breathing retraining may improve exercise tolerance in patients with HF with an LVEF of 31% or higher. Because exercise tolerance is considered a strong prognostic indicator, cardiorespiratory biofeedback has the potential to improve cardiac mortality and morbidity in HF patients. Article Published Date : Jun 01, 2009
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Removal of Gross Artifacts of Transcranial Alternating Current Stimulation in Simultaneous EEG Monitoring.

Related Articles Removal of Gross Artifacts of Transcranial Alternating Current Stimulation in Simultaneous EEG Monitoring. Sensors (Basel). 2019 Jan 07;19(1): Authors: Kohli S, Casson AJ Abstract Transcranial electrical stimulation is a widely used non-invasive brain stimulation approach. To date, EEG has been used to evaluate the effect of transcranial Direct Current Stimulation (tDCS) and transcranial Alternating Current Stimulation (tACS), but most studies have been limited to exploring changes in EEG before and after stimulation due to the presence of stimulation artifacts in the EEG data. This paper presents two different algorithms for removing the gross tACS artifact from simultaneous EEG recordings. These give different trade-offs in removal performance, in the amount of data required, and in their suitability for closed loop systems. Superposition of Moving Averages and Adaptive Filtering techniques are investigated, with significant emphasis on verification. We present head phantom testing results for controlled analysis, together with on-person EEG recordings in the time domain, frequency domain, and Event Related Potential (ERP) domain. The results show that EEG during tACS can be recovered free of large scale stimulation artifacts. Previous studies have not quantified the performance of the tACS artifact removal procedures, instead focusing on the removal of second order artifacts such as respiration related oscillations. We focus on the unresolved challenge of removing the first order stimulation artifact, presented with a new multi-stage validation strategy. PMID: 30621077 [PubMed - indexed for MEDLINE]

Multiple part umbilical cord entanglement and neonatal outcomes.

Related Articles Multiple part umbilical cord entanglement and neonatal outcomes. Taiwan J Obstet Gynecol. 2018 Oct;57(5):672-676 Authors: Mariya T, Fujibe Y, Shinkai S, Sugita N, Suzuki M, Endo T, Saito T Abstract OBJECTIVE: Umbilical cord entanglement is known to be a major cause of fetal hypoxia and to be correlated with several neonatal complications, but almost all of the previous reports were restricted to nuchal cord. In this study, we retrospectively examined the correlation between multiple part cord entanglement and pregnancy outcomes. MATERIALS AND METHODS: A total of 2156 cases were recruited from term deliveries in our hospital from 2008 to 2012. We counted umbilical cord loop numbers not only for nuchal cord but also for trunk and limb cord entanglement. We classified the cases into three groups: no loop, single loop and multiple loops group. We statistically analyzed pregnancy outcomes statistically in the three groups. RESULTS: One thousand, four hundred and fifty-eight cases had no cord entanglement, 594 cases had single loop entanglement and 104 cases had multiple loops entanglement. Values of umbilical artery blood, pH (p = 0.002) and base excess (p < 0.001) showed significantly unfavorable status in entanglement cases, especially in the multiple loops group. A significantly larger percentage of neonates in the multiple loops group needed for oxygen (p < 0.001). CONCLUSION: Multiple umbilical cord entanglement is highly correlated with early neonatal unfavorable status and need for resuscitation. PMID: 30342649 [PubMed - indexed for MEDLINE]

Pharmacokinetics and physiologic/behavioral effects of buprenorphine administered sublingually and intravenously to neonatal foals.

Related Articles Pharmacokinetics and physiologic/behavioral effects of buprenorphine administered sublingually and intravenously to neonatal foals. J Vet Pharmacol Ther. 2019 Jan;42(1):26-36 Authors: Grubb TL, Kurkowski D, Sellon DC, Seino KK, Coffey T, Davis JL Abstract Buprenorphine is absorbed following sublingual administration, which would be a low-stress delivery route in foals. However, the pharmacokinetics/pharmacodynamics are not described in foals. Six healthy foals <21 days of age participated in a blinded, randomized, 3-period, 5-sequence, 3-treatment crossover prospective study. Foals received 0.01-0.02 mg/kg buprenorphine administered SL or IV with an equivalent volume of saline administered by the opposite route. Blood was collected from the cephalic vein for pharmacokinetic analysis. Physiologic parameters (HR, RR, body temperature, GI sounds), locomotion (pedometer), and behavioral data (activity level, nursing time, response to humans) were recorded. Plasma concentration of buprenorphine exceeded a presumed analgesic level (0.6 ng/ml) in five foals in the IV group and one in the SL group but only for a very brief time. Pharmacokinetic analysis following IV administration demonstrated a short elimination half-life (t1/2β 1.95 ± 0.7 hr), large volume of distribution (6.46 ± 1.54 L/kg), and a high total clearance (55.83 ± 23.75 ml/kg/min), which differs from adult horses. Following SL administration, maximum concentrations reached were 0.61 ± 0.11 ng/ml and bioavailability was 25.1% ± 10.9%. In both groups, there were minor statistical differences in HR, RR, body temperature, locomotion, and time spent nursing. However, these differences were clinically insignificant in this single dose study, and excitement, sedation, or colic did not occur. PMID: 30242851 [PubMed - indexed for MEDLINE]

Propensity score-matching analyses on the effectiveness of integrated prospective payment program for patients with prolonged mechanical ventilation.

Related Articles Propensity score-matching analyses on the effectiveness of integrated prospective payment program for patients with prolonged mechanical ventilation. Health Policy. 2018 Sep;122(9):970-976 Authors: Liu CJ, Kung PT, Chu CC, Chou WY, Wang YH, Tsai WC Abstract OBJECTIVES: An integrated delivery system with a prospective payment program (IPP) for prolonged mechanical ventilation (PMV) was launched by Taiwan's National Health Insurance (NHI) due to the costly and limited ICU resources. This study aimed to analyze the effectiveness of IPP and evaluate the factors associated with successful weaning and survival among patients with PMV. METHODS: Taiwan's NHI Research Database was searched to obtain the data of patients aged ≥17 years who had PMV from 2006 to 2010 (N=50,570). A 1:1 propensity score matching approach was used to compare patients with and without IPP (N=30,576). Cox proportional hazards modeling was used to examine the factors related to successful weaning and survival. RESULTS: The related factors of lower weaning rate in IPP participants (hazard ratio [HR]=0.84), were older age, higher income, catastrophic illness (HR=0.87), and higher comorbidity. The effectiveness of IPP intervention for the PMV patients showed longer days of hospitalization, longer ventilation days, higher survival rate, and higher medical costs (in respiratory care center, respiratory care ward). The 6-month mortality rate was lower (34.0% vs. 32.9%). The death risk of IPP patients compared to those non-IPP patients was lower (HR=0.91, P<0.001). CONCLUSIONS: The policy of IPP for PMV patients showed higher survival rate although it was costly and related to lower weaning rate. PMID: 30097352 [PubMed - indexed for MEDLINE]

Effects of heart rate variability biofeedback training in athletes exposed to stress of university examinations.

Related Articles Effects of heart rate variability biofeedback training in athletes exposed to stress of university examinations. PLoS One. 2018;13(7):e0201388 Authors: Deschodt-Arsac V, Lalanne R, Spiluttini B, Bertin C, Arsac LM Abstract INTRODUCTION: Heart rate variability biofeedback (HRV-BFB) training, a method whereby one controls an unusually low breathing rate to reach cardiac coherence, has been shown to reduce anxiety and improve cardiac autonomic markers in diseased people, but much less is known about HRV-BFB benefits in healthy people. Here we investigated potential benefits in young competitors experiencing stress during university examinations as well as persistence of benefits after HRV-BFB training cessation. METHODS: A group of sports students (n = 12) practiced 5-min HRV-BFB training twice a day for 5-weeks using URGOfeel® (URGOTECH) and was compared to a control group (n = 6). University examinations occurred immediately after HRV-BFB training (Exam1), then 12-weeks later (Exam2). Anxiety markers and cardiac autonomic markers were assessed at baseline, Exam1 and Exam2. Principal Component Analyses (PCA) that combined all these markers were computed at Exam1 and Exam2 to emphasize covariations. RESULTS: At Exam 1, immediately after HRV-BFB training cessation, the experimental group demonstrated greater autonomic markers but similar states of anxiety when compared to the Control group. Twelve weeks later at Exam2, autonomic markers were greater and anxiety scores were lesser among the experimental group. PCA highlighted covariations only within cardiac autonomic markers at Exam1. Rather, variations in cardiac markers were associated with anxiety markers at Exam2. CONCLUSION: Short sessions of HRV-BFB training for a brief period of 5 weeks bring substantial benefits to autonomic markers and anxiety levels in young competitors. Here beneficial effects persisted for 12 weeks. Dissociated profiles of anxiety and cardiac autonomic adaptations shed new light on the role of the amygdala in heart-brain interactions after cardiac coherence training. PMID: 30048519 [PubMed - indexed for MEDLINE]

Complications associated with surgical treatment of sleep-disordered breathing among hospitalized U.S. adults.

Related Articles Complications associated with surgical treatment of sleep-disordered breathing among hospitalized U.S. adults. J Craniomaxillofac Surg. 2018 Aug;46(8):1303-1312 Authors: Beydoun HA, Beydoun MA, Cheng H, Khan A, Eid SM, Alvarez-Garriga C, Anderson-Smits C, Zonderman AB, Marinac-Dabic D Abstract The purpose of this cross-sectional study is to examine the relationship between surgical treatments for sleep-disordered breathing (SDB) and composite measure of surgical complications in a nationally representative sample of hospital discharges among U.S. adults. We performed secondary analyses of 33,679 hospital discharges from the 2002-2012 Nationwide Inpatient Sample that corresponded to U.S. adults (≥18 years) who were free of head-and-neck neoplasms, were diagnosed with SDB and had undergone at least one of seven procedures. Multivariate logistic regression models were constructed to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI), controlling for age, sex, race/ethnicity, obstructive sleep apnea (OSA) and obesity diagnoses. Positive associations were found between composite measure of surgical complications and specific procedures: palatal procedure (aOR = 12.69, 95% CI: 11.91,13.53), nasal surgery (aOR = 6.47, 95% CI: 5.99,6.99), transoral robotic assist (aOR = 5.06, 95% CI: 4.34-5.88), tongue base/hypopharynx (aOR = 4.24, 95% CI: 3.88,4.62), maxillomandibular advancement (MMA) (aOR = 3.24, 95% CI: 2.74,3.84), supraglottoplasty (aOR = 2.75, 95% CI: 1.81,4.19). By contrast, a negative association was found between composite measures of surgical complications and tracheostomy (aOR = 0.033, 95% CI: 0.031,0.035). In conclusion, most procedures for SDB, except tracheostomy, were positively associated with complications, whereby palatal procedures exhibited the strongest and supraglottoplasty exhibited the weakest association. PMID: 29803366 [PubMed - indexed for MEDLINE]

Objective Sleep Measures in Inpatients With Subacute Stroke Associated With Levels and Improvements in Activities of Daily Living.

Related Articles Objective Sleep Measures in Inpatients With Subacute Stroke Associated With Levels and Improvements in Activities of Daily Living. Arch Phys Med Rehabil. 2018 04;99(4):699-706 Authors: Huang RJ, Lai CH, Lee SD, Pai FY, Chang SW, Chung AH, Chang YF, Ting H Abstract OBJECTIVE: To investigate whether objective polysomnographic measures of prevalent sleep problems such as sleep-disordered-breathing (SDB) and insomnia are associated with activities of daily living levels in inpatients at rehabilitation units. DESIGN: Retrospective and observational study. SETTING: Single rehabilitation center. PARTICIPANTS: Inpatients with subacute stroke (N=123) (61.6±13.1 years; 23.8±3.4 kg/m2; 33% women; 90.5±36.7 days post-stroke) underwent a 1-night polysomnographic study and a 1-month inpatient rehabilitation program. MAIN OUTCOME MEASURES: Admission and discharge Barthel Index (BI) scores and its change scores. RESULTS: One hundred three (92%) patients had moderate-to-severe SDB (46.7±25.1 events/h in the apnea-hypopnea index), and 24 (19.5%) patients had acceptable continuous positive airway pressure adherence. Diverse values were found for total sleep time (259±71 min), sleep efficiency (69.5%±19.3%), sleep latency (24.3±30.9 min), and wakefulness after sleep onset (93.1±74.2 min). Admission BI scores and the BI change scores were 33.8±23.2 and 10.1±9.2, respectively. The National Institutes of Health Stroke Scale (NIHSS, 10.2±5.6), available in 57 (46%) patients, was negatively associated with admission levels and gains in BI change scores (P<.001, =0.002, respectively) in a univariate analysis. In regression models with backward selection, excluding NIHSS score, both age (P=.025) and wakefulness after sleep onset (P<.001) were negatively associated (adjusted R2=0.260) with admission BI scores. Comorbidity of hypertension; sleep latency percentage of stage 1, non-rapid eye movement sleep; and desaturation events ≥4% (P<.001, 0.001, 0.021, and 0.043, respectively; adjusted R2=0.252) were negatively associated with BI score gains. CONCLUSIONS: Based on objective sleep measures, insomnia rather than SDB in inpatients with subacute stroke was associated negatively with admission levels of activity of daily living and its improvement after a 1-month rehabilitation course. PMID: 29339206 [PubMed - indexed for MEDLINE]

Effects of Respiratory Training on Heart Rate Variability and Baroreflex Sensitivity in Individuals With Chronic Spinal Cord Injury.

Related Articles Effects of Respiratory Training on Heart Rate Variability and Baroreflex Sensitivity in Individuals With Chronic Spinal Cord Injury. Arch Phys Med Rehabil. 2018 03;99(3):423-432 Authors: Legg Ditterline BE, Aslan SC, Randall DC, Harkema SJ, Castillo C, Ovechkin AV Abstract OBJECTIVE: To evaluate the effects of pressure threshold respiratory training (RT) on heart rate variability and baroreflex sensitivity in persons with chronic spinal cord injury (SCI). DESIGN: Before-after intervention case-controlled clinical study. SETTING: SCI research center and outpatient rehabilitation unit. PARTICIPANTS: Participants (N=44) consisted of persons with chronic SCI ranging from C2 to T11 who participated in RT (n=24), and untrained control subjects with chronic SCI ranging from C2 to T9 (n=20). INTERVENTIONS: A total of 21±2 RT sessions performed 5 days a week during a 4-week period using a combination of pressure threshold inspiratory and expiratory devices. MAIN OUTCOME MEASURES: Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and beat-to-beat arterial blood pressure and heart rate changes during the 5-second-long maximum expiratory pressure maneuver (5s MEP) and the sit-up orthostatic stress test, acquired before and after the RT program. RESULTS: In contrast to the untrained controls, individuals in the RT group experienced significantly increased FVC and FEV1 (both P<.01) in association with improved quality of sleep, cough, and speech. Sympathetically (phase II) and parasympathetically (phase IV) mediated baroreflex sensitivity both significantly (P<.05) increased during the 5s MEP. During the orthostatic stress test, improved autonomic control over heart rate was associated with significantly increased sympathetic and parasympathetic modulation (low- and high-frequency change: P<.01 and P<.05, respectively). CONCLUSIONS: Inspiratory-expiratory pressure threshold RT is a promising technique to positively affect both respiratory and cardiovascular dysregulation observed in persons with chronic SCI. PMID: 28802811 [PubMed - indexed for MEDLINE]

[Intensive care treatment of traumatic brain injury in multiple trauma patients : Decision making for complex pathophysiology].

Related Articles [Intensive care treatment of traumatic brain injury in multiple trauma patients : Decision making for complex pathophysiology]. Unfallchirurg. 2017 Sep;120(9):739-744 Authors: Trimmel H, Herzer G, Schöchl H, Voelckel WG Abstract Traumatic brain injury (TBI) and hemorrhagic shock due to uncontrolled bleeding are the major causes of death after severe trauma. Mortality rates are threefold higher in patients suffering from multiple injuries and additionally TBI. Factors known to impair outcome after TBI, namely hypotension, hypoxia, hypercapnia, acidosis, coagulopathy and hypothermia are aggravated by the extent and severity of extracerebral injuries. The mainstays of TBI intensive care may be, at least temporarily, contradictory to the trauma care concept for multiple trauma patients. In particular, achieving normotension in uncontrolled bleeding situations, maintenance of normocapnia in traumatic lung injury and thromboembolic prophylaxis are prone to discussion. Due to an ongoing uncertainty about the definition of normotensive blood pressure values, a cerebral perfusion pressure-guided cardiovascular management is of key importance. In contrast, there is no doubt that early goal directed coagulation management improves outcome in patients with TBI and multiple trauma. The timing of subsequent surgical interventions must be based on the development of TBI pathology; therefore, intensive care of multiple trauma patients with TBI requires an ongoing and close cooperation between intensivists and trauma surgeons in order to individualize patient care. PMID: 28389734 [PubMed - indexed for MEDLINE]
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