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Biomedical subjects

R Fried

Publications and source records attributed to R Fried.

At least 19 recordsLinked to original sources

Integrating music in breathing training and relaxation: I. Background, rationale, and relevant elements.

Quasiformal reports of widespread use of music in counterarousal techniques abound despite little evidence of its psychophysiological effects. Some known effects are presented here, and they suggest, among other things, an influence on hemispheric dominance, changes in autonomic nervous system activity, and relaxation by paradoxical arousal patterns contrary to those in cognitive function and anxiety. Hypothetical subcortical reflexes are postulated as mediators. Different types of music and their effect are described. Of particular relevance is that some forms of music have been reliably shown to have a profound beneficial effect on breathing.

Anxiety

Integrating music in breathing training and relaxation: II. Applications.

Psychophysiological observations, especially PETCO2 and EEG, during relaxation training with deep-diaphragmatic breathing and mental imagery, suggest that the addition of certain types of music "deepens" breathing and quickens relaxation: PETCO2 "normalizes" with decreased respiration rate, and EEG shows decreased average theta and increased alpha. The combined psychophysiological indices suggest that music potentiates the hypometabolic counterarousal state. And clients unanimously report that they enjoy it.

Breathing Exercises

Effect of diaphragmatic respiration with end-tidal CO2 biofeedback on respiration, EEG, and seizure frequency in idiopathic epilepsy.

Breathing rate (RR), end-tidal percent CO2, and EEG were obtained in three groups: psychiatric referral subjects presenting with anxiety, panic phobia, depression and migraine; a group of idiopathic seizure sufferers; and a group of asymptomatic controls. Virtually all the noncontrol subjects were found to show moderate to severe hyperventilation and the accompanying EEG dysrhythmia. The seizure group subjects were taught diaphragmatic respiration with end-tidal percent CO2 biofeedback. The training normalized their respiration and altered their EEGs and seizure frequency.

Adolescent

Role of lung biopsy in patients undergoing a modified Fontan procedure.

Fifty-six patients undergoing a modified Fontan procedure from 1977 to 1985 had lung tissue available from the perioperative period (n = 51) or recent palliative procedure (n = 5) (37 biopsy, 12 autopsy, 7 biopsy and autopsy). Twenty-six patients had tricuspid atresia, and 30 had other causes of functional univentricular heart. Pulmonary arterial structure was classified by both the Heath-Edwards and morphometric scales. Biopsy and autopsy grades were identical except for a minor difference in Heath-Edwards scale in one case. Elevated preoperative mean pulmonary artery pressure (greater than 15 mm Hg) was associated with medial hypertrophy (p = 0.04), although six patients with normal pulmonary artery pressure had medial hypertrophy and six patients with mean pulmonary artery pressure greater than 15 mm Hg did not have medial hypertrophy. Medial hypertrophy was a possible risk factor in patients with univentricular heart: Patients with medial hypertrophy had a ninefold greater risk of death (p = 0.08). Controlling for confounding variables did not alter this result (0.06 less than or equal to p less than or equal to 0.10). Medial hypertrophy was not a risk factor for death in patients with tricuspid atresia: Four had this feature and each survived. Four patients with tricuspid atresia died and none had medial hypertrophy. A mean transpulmonary pressure gradient was measured on the first postoperative day in 45 patients. In patients with medial hypertrophy there was a trend toward a higher gradient (p = 0.13). All patients with medial hypertrophy who had this measurement (n = 9) had a transpulmonary pressure gradient of 7 mm Hg or greater, whereas this was true in only 18 of 36 without medial hypertrophy (p = 0.007). On the basis of an evaluation of medial hypertrophy, we conclude that biopsy does not aid in selection of patients with tricuspid atresia for a Fontan procedure; its role in patients with univentricular heart is uncertain.

Adolescent

Cardiac malformations in trisomy-18: a study of 41 postmortem cases.

The cardiac malformations in 41 karyotyped and autopsy cases of trisomy-18 are presented in detail. The salient findings were a ventricular septal defect in all cases; tricuspid valve anomalies in 33 cases (80%); pulmonary valve anomalies in 30 (70%); aortic valve malformations in 28 (68%); mitral valve anomalies in 27 (66%); polyvalvular disease (that is, malformations of more than one valve) in 38 (93%); a subpulmonary infundibulum (conus) in 40 (98%); a bilateral conus with a short subaortic infundibulum in 1 case with double outlet right ventricle (this being the only documented case of bilateral infundibulum in trisomy-18); double outlet right ventricle in 4 cases (10%), three having a subpulmonary infundibulum only and all 4 having mitral atresia; tetralogy of Fallot in 6 cases (15%), 2 having pulmonary atresia; and a striking absence of transposition of the great arteries and inversion at any level (visceral or cardiac), findings that appear to be characteristic of all trisomies. These data suggest that excessive chromosomal material (as in trisomies) may result in situs solitus at all levels. The malformations of the atrioventricular and semilunar valves were characterized by redundant or thick myxomatous leaflets, long chordae tendineae and hypoplastic or absent papillary muscles. The ventricular septal defect was associated with anterosuperior conal septal malalignment in 25 cases (61%). On the basis of the characteristic valvular lesions, the type of ventricular septal defect and the absence of transposition or inversions, two-dimensional echocardiographic diagnosis of trisomy-18 in the fetus may become possible.

Chromosomes, Human, Pair 18

Witch doctors and AIDS.

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Acquired Immunodeficiency Syndrome

[Preventive use of vitamin D and fluoride in Austria].

The implementation of the recommended daily vitamin D and fluoride supplements for infants in Austria has been investigated during a nationwide infant nutrition survey (n = 1069). 93.9% of the infants received daily vitamin D supplements, whereas only 38% received fluroide. Rejection of fluoride supplemtation was most common among mothers aged between 30 and 45 years and mothers with university education. In Carinthia, Vorarlberg and Styria only 2 out of 10 infants received fluoride supplements. It seems necessary to reconsider the recommendations for fluoride supplementation in Austria.

Adult

In vivo phosphorus 31 magnetic resonance spectroscopy of rat hind limb skeletal muscle during sepsis.

High-energy phosphate metabolism in skeletal muscle is altered during sepsis, although the chronology of events is uncertain. Phosphorus 31 magnetic resonance spectroscopy was used to measure changes in muscle energy stores of the left hind limb musculature of adult male rats during sepsis. Following control scans, cecal ligation and puncture were performed and scanning was repeated 6, 24, and 48 hours after surgery. The ratios of phosphocreatine (PCr) to inorganic phosphate (Pi), a measure of energy stores, and adenosine triphosphate (ATP) to Pi ratio, a measure of the energy available for immediate use, were determined from peak heights. Intracellular pH was calculated using the distance between Pi and PCr peaks. In surviving animals, a 40% decrease in PCr/Pi ratio (+/- SEM) was observed by 24 hours (22.3 +/- 3.0 at time 0 vs 13.3 +/- 2.8 at 24 hours), whereas energy availability (beta-ATP/Pi) was statistically unchanged (18.2 +/- 2.2 at time 0 vs 15.2 +/- 1.2 at 48 hours). Intracellular pH did not change. Both PCr/Pi and ATP/Pi ratios were inversely correlated with time. In this model of documented peritonitis, skeletal muscle energy metabolism is rapidly altered following severe infection, and these changes can be detected using 31P magnetic resonance spectroscopy.

Adenosine Triphosphate

Biofeedback.

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Biofeedback, Psychology

Developmental changes in proton magnetic resonance relaxation times of cardiac and skeletal muscle.

Proton magnetic resonance relaxation time measurements were used to study developmental changes in rabbit cardiac and skeletal muscles during the last days of gestation and at several postnatal times. Tissue water content decreased steadily during late fetal and early postnatal stages of development. During this period T1 and T2 for cardiac and skeletal muscles also decreased. The relaxation times stabilized after the 20th postnatal day, and at this juncture the T1 and T2 values for myocardium remained consistently higher than for skeletal muscle. The developmental changes in proton relaxation time probably represent changes in water distribution and mobility as well as macromolecular structure during muscle maturation.

Animals

Relaxation with biofeedback-assisted guided imagery: the importance of breathing rate as an index of hypoarousal.

Fifteen men and 35 women, suffering from a number of psychological and somatic disorders, were taught to relax by biofeedback-assisted deep-diaphragmatic breathing together with guided mental imagery. No instructions were given about rate. Breathing rate and pattern, PETCO2, and EEG were monitored before training and after the first three 2-minute training trials (session 1). In 27 subjects (54%), breathing patterns and rate were noted to resemble those reported by meditation practitioners (3 to 5 b/min). The PETCO2 and EEG changes support a hypothesis of metabolic hypoarousal. Four subjects spontaneously reported experiencing altered awareness. A centrally mediated hypoarousal response is tentatively implicated.

Adult