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Is there a physiological variability for albumin excretion rate? Study in patients with diabetes type 1 and non-diabetic individuals.

BACKGROUND: To determine the intraindividual coefficient of variation (CV(i)) of albumin excretion rate (AER). METHOD: We studied 76 patients with type 1diabetes and 66 non-diabetic subjects (ND) under routine clinical conditions providing three timed overnight urine samples for urinary albumin determination by radioimmunoassay. RESULTS: Patients and ND had similar CV(i) of AER (50.7+/-33.3 vs. 58.1+/-33.2% P=0.12). Intermittent microalbuminuric subjects (one out of 3 AER >20 microg/min) had higher CV(i) of AER than normoalbuminuric and persistent microalbuminuric patients, [84.9 (37.1-145. 3) vs. 39.8 (4.9-124.8) vs. 34.6 (12.1-116.5)% P=0.0007] without difference between the two latter groups. In patients, the independent factor associated with the CV(i) of AER in multiple regression analysis was age (r(2)=0.08; P=0.01). Sensitivity (95% CL) and specificity of first AER for diagnosing microalbuminuria was 85.7% (42.0-99.2) and 91.3% (81.4-96.4). CONCLUIONS: Our findings suggest the variability of AER was physiological, unrelated to diabetic condition. First AER could be used for screening of microalbuminuria followed by a second one when the patient has AER >20 microg/min in the first. This would result in low cost for screening and diagnosis of microalbuminuria, that is not always feasible in routine clinical practice in developing countries using three urine samples.

Adolescent↗

Temporal relationships of 21 physiological variables in horse and sheep.

Daily or circadian oscillation has been documented in a variety of physiological and behavioral processes. Although individual variables have been studied in great detail, very few studies have been conducted on the temporal relationships between the rhythms of different variables. It is not known whether the circadian pacemaker generates each and every rhythm individually or whether most rhythms are simply derived from a few clock-controlled rhythms. As a first step in elucidating this issue, 21 physiological variables were recorded simultaneously in horse and sheep. The results indicated that, in both species, different variables exhibit different degrees of daily rhythmicity and reach their daily peaks at different times of the day. The variables exhibiting strongest rhythmicity were locomotor activity, rectal temperature, and plasma concentrations of melatonin and glucose. Comparison of rhythmicity and acrophase in the various rhythms allowed inferences to be made about mechanisms of causation.

Animals↗

Familial similarities of changes in cognitive, behavioral, and physiological variables in a cardiovascular health promotion program.

A number of studies have demonstrated that physiological and behavioral cardiovascular disease (CVD) risk factors aggregate within families. This fact, and the potential mediating role that the family plays in behavior change, have led to the development of family-based CVD risk reduction programs, including the San Diego Family Health Project. The aggregation of behavioral, physiological, and cognitive changes within families was assessed during a 1-year intervention. We found evidence of modest but significant aggregation of change. There was more aggregation of change in behavioral variables than in physiological or cognitive variables. More significant correlations were found among 3-day food record measures than among 24-hour recall dietary measures, suggesting an influence of assessment method. Aggregation of change within families was stronger within generations than across generations. These data point to the importance of involving all age groups in health promotion programs.

Adult↗

Individual housing does not influence the adaptation of the pituitary-adrenal axis and other physiological variables to chronic stress in adult male rats.

Although the influence of housing conditions on the physiological response to stress has been extensively studied for several years, no attempts have been made to investigate the effect of this variable on the capacity for adaptation to chronic stress. To this end, adult male rats were housed either individually or in groups of four per cage and subjected to 2 hr of daily immobilization stress for 14 days. Housing did not influence any of the physiological variables measured either in unstressed or in stressed rats except the corticosterone response to stress which was higher in individually housed rats. Of the behavioral measures, individual housing significantly decreased defecation rate in the novel environment. Other behavioral measures were not influenced by housing. Chronic stress significantly reduced ambulation but no significant interaction between housing and chronic stress was observed. Taken together, these data indicate that a short period of individual housing did not affect the physiological and behavioral consequences of repeated exposure to chronic stress.

Adaptation, Physiological↗

Physiological variables to use in the gender comparison in highly trained runners.

AIM: The aims of this investigation were to compare physiological characteristics between highly trained middle-distance and marathon male (n=17) and female (n=11) runners; to determine the most suitable variables to use in the gender comparison in these subjects, considering physical difference between genders; and to indicate some of the best predictors of performance in running events in which oxidative metabolism prevails. METHODS: Subjects performed a progressive maximal exercise on the treadmill to determine maximal oxygen uptake (VO(2max)) and velocities corresponding to a blood lactate concentration of 4 mmol x L(-1) (upsilon(OBLA)) and to the lactate threshold (upsilon(LT)). Cost of running (Cr) and maximal aerobic velocity (upsilon(a max)) were calculated from VO(2) measurements. RESULTS: Males presented higher VO(2max), upsilon(a max), upsilon(OBLA), upsilon(LT), and VO(2) @ upsilon(OBLA) and upsilon(LT) (p<0.001), but females had higher upsilon(OBLA) and upsilon(LT) (p<0.01) expressed as %VO(2max). upsilon(a max) correlated with performance time relative to the world record in both, females (r=-0.77, p<0.01) and males (r=-0.58, p<0.05); and upsilon(LT) with performance only in males (r=-0.59, p<0.05). CONCLUSION: In conclusion, female athletes seemed to compensate partly their aerobic profile with higher %VO(2max) @ u(OBLA) and u(LT), suggesting that both maximal and submaximal physiological variables should be considered when evaluating and comparing highly trained athletes of both genders. upsilon(a max) is one of the best predictors of performance in running events in which oxidative metabolism prevails.

Adult↗

Evidence that the pituitary-adrenal axis does not cross-adapt to stressors: comparison to other physiological variables.

The effects of previous chronic immobilization stress on the physiological responses of male rats to a novel chronic stressor (shock) were studied. Previous chronic exposure to immobilization reduced adrenocorticotropin (ACTH) and lactate responses to acute immobilization stress without altering the response to a novel acute stressor (tail shock). When subjected to chronic tail shock, body weight inhibition caused by chronic shock was greater in the rats not previously exposed to chronic immobilization, which suggests that there is cross-adaptation between different stressors. However, adrenocorticotropin adaptation to chronic shock was impaired by previous chronic immobilization. These data indicate that the existence of cross-adaptation to stressors might depend on the variable measured, the central nervous system pathways controlling the pituitary-adrenal axis being, apparently, resistant to cross-adaptation. This lack of cross-adaptation at certain levels can assure the maintenance of an adequate response to unknown environmental stimuli.

Adaptation, Physiological↗

Physiological variability of fluid-regulation hormones in young women.

We tested the physiological reliability of plasma renin activity (PRA) and plasma concentrations of arginine vasopressin (P[AVP]), aldosterone (P[ALD]), and atrial natriuretic peptide (P[ANP]) in the early follicular phase and midluteal phases over the course of two menstrual cycles (n = 9 women, ages 25 +/- 1 yr). The reliability (Cronbach's alpha >/=0.80) of these hormones within a given phase of the cycle was tested 1) at rest, 2) after 2.5 h of dehydrating exercise, and 3) during a rehydration period. The mean hormone concentrations were similar within both the early follicular and midluteal phase tests; and the mean concentrations of P[ALD] and PRA for the three test conditions were significantly greater during the midluteal compared with the early follicular phase. Although Cronbach's alpha for resting and recovery P[ANP] were high (0.80 and 0.87, respectively), the resting and rehydration values for P[AVP], P[ALD], and PRA were variable between trials for the follicular (alpha from 0.49 to 0.55) and the luteal phase (alpha from 0.25 to 0. 66). Physiological reliability was better after dehydration for P[AVP] and PRA but remained low for P[ALD]. Although resting and recovery P[AVP], P[ALD], and PRA were not consistent within a given menstrual phase, the differences in the concentrations of these hormones between the different menstrual phases far exceeded the variability within the phases, indicating that the low within-phase reliability does not prevent the detection of menstrual phase-related differences in these hormonal variables.

Adult↗

Variability in methotrexate serum and cerebrospinal fluid pharmacokinetics in children with acute lymphocytic leukemia: relation to assay methodology and physiological variables.

Methotrexate (MTX) steady state concentrations were evaluated in 42 children who had received high-dose infusions (6-8 g/m2) for acute lymphocytic leukemia. Concentrations in serum and cerebrospinal fluid (CSF) measured by immunoassay were found to be highly variable. Reanalysis by a reference high-pressure liquid chromatography method ruled out analytical factors as a source of this variability. The correlation coefficient between the analytical methods was 0.77 for the serum data and 0.88 for the CSF data. The variability of serum and CSF concentrations was higher in younger patients (serum; P = 0.05 and CSF; P = 0.18), and the CSF concentration decreased with decreasing age and in later courses. Body surface area, body mass index, weight, and gender were not significantly related to MTX variability. We conclude that the pronounced pharmacokinetic variability seen during MTX infusions remains largely unexplained.

Antimetabolites, Antineoplastic↗

Comparison of nurse and computer charting of physiological variables in an intensive care unit.

OBJECTIVES: To compare charting of physiological parameters manually by nurses and automatically by computer and so decide whether this task could accurately be performed by computer. SUBJECTS/SETTING: 101 consecutive patients admitted for tertiary neonatal intensive care. DESIGN: Direct comparison of 48 hours of data collected by both methods. Computer data stored each second and the hourly median compared with the single hourly value noted by the nurse. METHODS: All patients were monitored by standard patient monitor and a computer. Four physiological parameters were compared between nurse and computer (both derived information from the standard patient monitor): heart rate, transcutaneous oxygen, mean blood pressure, central temperature. A random 51% of patients had the computer data displayed as trends at the cotside. Comparison of the hourly nurse observation and a computer hourly median value. Computer data was compared before and after the removal of artifact. In addition, the effects on nursing observations of either display or non display of the computer trend data was assessed. RESULTS: Nurse and computer observations were statistically significantly different (p < 0.001), though these were not clinically important. Nurses tended to note a higher figure than the computer median. The cotside display of computer data improved consistency between the nurse and computer observations. Artifact present in the data had little influence on the accuracy of the computer median value. CONCLUSIONS: Computer systems can accurately chart physiological data, providing a more flexible record with a minimal risk to data reliability from artifact.

Bias↗

Effect of low-dose temazepam on physiological variables and performance tests following a westerly flight across five time zones.

Rapid travel across multiple time zones disturbs circadian rhythms and induces "jet lag". The aims of this study were 1) to monitor a selection of subjective, physiological and performance variables in elite athletes and sedentary subjects following a westerly flight across five time zones, and 2) to examine whether the promotion of sleep by means of a low-dose benzodiazepine drug influences these responses to transmeridian travel. Subjects comprised eight members of the British men's gymnastics squad, aged 18-30 years, and nine members of the British Olympic Association's support staff, aged 24- 55 years (4 females, 5 males). Subjects were pair-matched for age, sex and athleticism (apart from one person) and assigned to either the treatment (n = 9) or placebo (n = 8) group. All subjects travelled from U.K., arriving at Tallahassee, Florida, at approximately 22:00 hours local time. A test battery was administered to the subjects at 07:00, 12:00, 17:00 and 21:00 hours on the first full day of arrival (this was designated day one) and then on alternate days (day 3, day 5 and day 7). Immediately before retiring to bed on days 1, 2 and 3, subjects were administered, in a double-blind fashion, either 10mg of temazepam or a placebo. Measures in the test battery included sleep quality, sleep length, subjective jet lag (one-to-ten simple analogue scale), tympanic temperature, one-, two-, four- and eight-choice reaction time, grip strength (left and right), leg strength and back strength. Over the 24 h of each test day, subjects also recorded the volume of each urine voided. Data were analysed with a repeated measures general linear model. Alpha was set at 0.01 to control for type I errors with multiple dependent variables. Mean subjective jet lag reduced from 4.6 units to baseline, and mean sleep quality improved by 2.0 units from day 1 to day 5 (P<0.001), after which no further alterations were noted. Subjective jet lag, left and right grip strength and choice reaction time all showed post-flight day x time of day interactions (P < 0.01). On day 1, these variables deteriorated as the day progressed to the worst recorded values. On days 3, 5 and 7, diurnal variations with the conventional high in the early evening and morning-to-evening differences of about 10% were evident. There was a trend for the reduction in subjective jet lag over the post-flight days to be more rapid following ingestion of a low dose of temazepam (P= 0.037). We cannot rule out the possibility that this could be a type I error, since none of the treatment by day interactions reached the alpha level of significance (set at 0.01). The morning-to-evening variations of body temperature and grip strength were greater in the young athletes than in the older sedentary support staff (P < 0.01). Sleep quality was greater in the athletic subjects after the first full day in Tallahassee. These results suggest that the nightly administration of a low dose (10 mg) of temazepam has little influence on the recovery of subjective, physiological and performance measures following a westward flight across five time zones. In both the treatment and control groups, subjective jet lag and performance were worst in the evening of the first full day after arrival, and the young athletes slept better than the older support staff that same night. This illustrates the importance of monitoring jet lag symptoms and performance variables at different times of day following a flight to a new time zone.

Adult↗

[Heart rate variability--physiology, methods of registration and application in pediatric sleep laboratory].

Heart rate variability (HRV) has become the focus of interest of a multitude of investigations being a parameter that can easily be recorded. Accepted clinical indications in adults include evaluation of diabetic neuropathy and prediction of prognosis after myocardial infarction in adults. In children, HRV is regularly being registered in the pediatric sleep laboratory in sleep related breathing disorders, after apparent life threatening events, or in infants with assumed increased risk for sudden infant death syndrome. However, uniform interpretation criteria have not been established in these situations, at least partially due to insufficient understanding of physiology and pathophysiology of HRV in this age group. In this overview, current knowledge on HRV in infants and children is summarized and its clinical relevance discussed. In addition, technical requirements and methods of analysis which have a major impact on calculated parameters are being presented.

Austria↗

Decreased physiologic variability as a generalized response to human endotoxemia.

OBJECTIVE: To test the effect in normal human volunteers of transient systemic inflammation on the variability in time-series behaviors of widely divergent physiologic measures of the human inflammatory response. DESIGN: Prospective study of human volunteers who were tested on 2 consecutive days, a control day and a treatment day. Each participant served as his or her own control. SETTING: Critical care facility of a university medical center. SUBJECTS: Subjects were eight healthy human volunteers. INTERVENTIONS: Participant subjects were tested on both a baseline day with no intervention and on a treatment day when they received 4 ng/kg intravenous Escherichia coli endotoxin. MEASUREMENTS AND MAIN RESULTS: Continuous electrocardiographic recordings and serial blood sampling (performed every 5 mins) were used to create time-series of heart rate (R-R intervals), neutrophil function (phagocytosis), and plasma cortisol concentrations. For each primary measure, we recorded a significant increase in the regularity (decreased variability) of the functional measurement as assessed by the statistical entity, approximate entropy. CONCLUSIONS: Increased regularity, or decreased variability, of organ functions is a generalized response to systemic inflammation that occurs in widely divergent systems during endotoxemia.

Adult↗

Effect of consuming fungus-infected and fungus-free tall fescue and ergotamine tartrate on selected physiological variables of cattle in environmentally controlled conditions.

Two experiments were conducted to determine the physiological responses of consuming a fungus-free (FF) or fungus-infected (INF) tall fescue diet (Exp. 1) or the FF diet plus ergotamine tartrate at 30 ppm (FF/ET, Exp. 2) in a thermoneutral (21 degrees C) or heat-stressed environment (32 degrees C, dry bulb; 10 degrees C dew point). Treatment periods lasted 28 d after a 10-d adaptation period. Experiment 1 was replicated three times, and Exp. 2 was replicated twice, with eight Holstein steers in each replicate (mean BW = 185 kg). Feed intake (FI), rectal temperature (RT), and respiration rate (RR) were recorded daily, and heart rate (HR) and infrared temperatures at the ear canal (ECT), ear tip (ETT), pastern (PT), coronary band (CBT), and tail tip (TTT) were recorded weekly. Consumption of INF and FF/ET compared with FF diets decreased (P less than .10) FI, HR, ECT, PT, CBT, and TTT and elevated (P less than .10) RT and RR by 2.8, 2.77 kg/d; 17, 23 beats/min; .8, 1.1 degrees C; .9, 1.1 degrees C; .8, .9 degrees C; 1.1, 2.6 degrees C; .3, .5 degrees C; and 8, 8 breaths/min; respectively. Ear-tip temperature was reduced (P less than .10) 1.6 degrees C by consumption of INF but not by consumption of FF/ET. Reduction of peripheral temperatures is indicative of reduced blood flow to peripheral areas as a result of vasoconstriction.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Feed↗

Modeling age using cognitive, psychosocial and physiological variables: the Boston Normative Aging Study.

A structural equation model is computed for 36 variables from eight domains of data using 100 healthy male subjects whose age varies between 30 and 80 years. Chronological age is required to be an exogenous variable while cognitive function variables are required to be an ultimate endogenous or outcome set. The model suggests that the direct effect of age on cognition is substantially reduced when social, life style, physiological, and brain state variables are allowed to become intervening variables. The study also finds that there is an association between cognitive function and psychosocial measures relating to general psychiatric symptomatology and social support systems.

Adult↗

An approach to prediction of performance using behavioral and physiological variables.

10 male, middle-distance runners selected for their potential or actual success in running 1500 metres were subjected to laboratory tests of VO2 max and run time at 85% VO2 max. Using the Eysenck Personality Inventory (Eysenck, 1962), data were collected from the runners from which they were given a score on the Extraversion/Introversion dimension of personality. Pearson product-moment correlations were computed between 1500 m. run times and VO2 max, 85% utilization of VO2 max, and Extraversion scores. The highest correlation was between Extraversion and the 1500-m. run (r = .75). The multiple correlation between times for the 1500-m. run and Extraversion with VO2 max was .77. The results support the value of building comprehensive profiles for the athlete which include not only physiological and anatomical variables but behavioral measures as well.

Extraversion, Psychological↗

Measurement reliability of highly variable physiological responses to experimentally-manipulated gas fractions.

Ventilatory and cardiac responses to changing inhaled gas fractions are notoriously variable within individuals. Such variation can confound clinical diagnoses and hypotheses about human adaptation. In this study we use a cardiac (HHR) and a ventilatory (HVR) measure of physiological sensitivity to an experimentally manipulated oxygen concentration (8% O2), to compare variation (a) within and between individuals, (b) within and between days and (c) within and between physiological parameters. To explore the sources of variation, we use the coefficient of variation (CV, %), repeatability (R, intraclass correlation coefficient, %) and repeated-measures analyses of variance. Both the HVR and the HHR are significantly repeatable (HVR: R = 0.76-0.92; HHR: R = 0.35-0.76) and equally variable within and between days. Its high R suggests that the HVR displays greater between-individual variation relative to within-individual variation than does the HHR. The HVR is thus a more reliable measure of physiological sensitivity to hypoxia than is the HHR. We suggest how these results may inform experimental design, and suggest how to avoid stochastic and experimental artefacts when investigating ventilatory and cardiac physiological responses to hypoxia.

Administration, Inhalation↗

The relation between acute physiological variables and outcome on the Glasgow Outcome Scale and Disability Rating Scale following severe traumatic brain injury.

The relation between outcome and duration of adverse physiological events was studied, using suggested critical physiological values. Subjects were 184 patients with severe traumatic brain injury who received continuous monitoring of intracranial pressure (ICP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP), and jugular venous oxygen saturation. Longer durations of adverse physiological events were significantly related to Glasgow Outcome Scale (GOS) scores and Disability Rating Scale (DRS) scores for all variables at all timepoints postinjury. When analyses excluded patients who died, the relation between adverse physiological events and GOS was nonsignificant; however, duration of ICP, MAP, and CPP still accounted for a significant portion of the variance in DRS scalres. The relative sensitivity of the GOS and DRS is discussed.

Acute Disease↗