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Effects of heat exposure in a Finnish sauna on the pharmacokinetics and metabolism of midazolam.

OBJECTIVE: The effect of short-term heat exposure in a Finnish sauna on hepatic first-pass metabolism and the capacity to metabolize midazolam were studied in a crossover trial. Midazolam oral (15 mg) and intravenous (0.05 mg.kg-1) was given to 6 healthy young male volunteers, in random order, during a control session and a sauna bathing session (temperature 85-100 degrees C, relative humidity 25-30%). Blood samples for the determination of plasma midazolam and alpha-hydroxy midazolam concentrations were taken for 6 h after drug administration. RESULTS: After oral administration, the bioavailability and clearance of midazolam were not affected by sauna bathing, nor was there a significant difference in alpha-hydroxy midazolam plasma concentration or the alpha-hydroxy midazolam/midazolam AUC-ratio between the sessions. Midazolam Cmax was increased and its t1/2 beta was prolonged during the sauna session, but the clinical relevance of the findings appears to be modest. The pharmacokinetics of intravenous midazolam were not affected by sauna bathing. CONCLUSIONS: Short-term heat exposure may not affect the first-pass metabolism or hepatic capacity to metabolize midazolam.

Adult↗

Lungs and ventilation in sauna.

For over a hundred years Finnish sauna has been documented as a physiotherapeutic method in respiratory diseases. Physiological changes of ventilation remain small (about 10%) in the sauna. Heat load, sauna air and sympathetic stimulation generally do not cause problems to the lungs. Electron microscopic studies have not shown irreversible damages to the airway epithelium. Sauna takers should avoid bathing during acute respiratory infections. Sympathomimetic drugs may provoke tachycardia and arrhythmias in the sauna.

Humans↗

Sauna abuse as a clinical feature of bulimia nervosa.

The authors describe a series of 14 patients with bulimia nervosa who regularly spent long periods of time in saunas as a weight-control technique. This practice is probably more common in parts of the world where Finnish saunas are in widespread use. Many of these patients also engaged in other behaviors that resulted in dehydration, such as diuretic abuse and laxative abuse.

Adolescent↗

Free-time activities among seafarers on board Finnish cargo ships.

Seafarers' free time activities on board ship and on shore were investigated by means of a questionnaire sent to 507 seafarers working on 35 ships. All the seafarers were Finnish citizens and all the ships in Finnish ownership. The questionnaire was returned by 245 seafarers (22 of them were women) from a total of 34 ships. Reading was the most popular way of spending free time while on board ship. Next came watching television or listening to the radio; then chatting with friends and sleeping/keeping to oneself. About one in four put physical exercise and sauna baths among the three most common ways of spending free time. The most common ways of spending free time on shore were meeting friends and acquaintances and watching TV or listening to the radio. In third place were "other ways of spending leisure time", most of which included being out of door, hunting, going to the summer cottage and gardening. Physical exercise activity was greater on shore than on board ship. The respondents were grouped into four categories: A) reader/student/hobbyist: B) sociable: C) exercise enthusiast D) TV watcher/radio listener Group A considered the ship's atmosphere and the spirit of solidarity on board better than the others. Group B had more often a good friend on board ship and less often suffered from anxiety or depression. Group C more often considered their health and working capacity good. Group D had no positive differences over the other groups. More attention should be paid to developing the ways in which free time is spent not only on board but also during the compensatory free time on shore.

Adolescent↗

Polycyclic aromatic hydrocarbons in Finnish sauna air.

The concentrations of polycyclic aromatic hydrocarbons (PAH) in the air of three different types of wood-heated saunas were studied. The highest concentrations were found in the smoke sauna (total PAH 170-1550 micrograms/m3, benzo[a]pyrene 4.6-20 micrograms/m3) the second highest in the preheated sauna (total PAH 50-90 micrograms/m3, benzo[a]pyrene 3.4-4.5 micrograms/m3) and the lowest concentrations in the sauna heated by continuous burning of wood (total PAH 25 micrograms/m3, benzo[a]pyrene below 0.1 micrograms/m3). The results clearly indicate that regular bathing in the smoke sauna and in the pre-heated sauna increases the intake of PAH compounds (e.g. benzo[a]pyrene and benzo[a]anthracene).

Air Pollutants↗

The sauna, skin and skin diseases.

The aesthetic pleasure of the Finnish sauna may be disturbed by an intense itch caused by sweating in a few people with atopic dermatitis. The heat of the sauna may also initiate cholinergic urticaria. The sauna itself does not cause drying of the skin although incorrect washing habits may lead to this. The use of soap is adviced especially in the anogenital region and armpits, but the use of a washing brush and sponge is not adviced. Sauna bathing facilitates the removal of hyperkeratotic scales in psoriasis, and the use of petrolatum, emollient creams or topical antipsoriatic regimens has been found to be beneficial for many patients. Dermatophytes and other infective microorganisms are easily killed by the heat of the sauna. The pleasing sensations in the skin after sauna bathing are thus only very seldom disturbed by itches or some other unpleasant consequence.

Humans↗

Transdermal oestrogen replacement therapy in a Finnish population.

In an open, multicentre study, transdermal administration of oestradiol (E2) by means of skin patches was investigated in a Finnish patient population suffering from typical post-menopausal symptoms. A total of 249 women applied a patch twice weekly for 6 months. Whereas 85% of the subjects were experiencing hot flushes and 83.5% sweating before therapy, only 5.7% and 11.8%, respectively, reported these symptoms at the end of the trial. Furthermore, 97.6%, 95.7% and 94.8% of the subjects reported that depression, headache and sleep disturbances, respectively, had disappeared during therapy. Skin irritation occurred in 18.2% of these predominantly fair-skinned women. Frequent sauna bathing did not interfere with the patch therapy. General acceptance of the treatment was excellent, 84.8% of the patients completing the treatment, of whom 78% were willing to continue the treatment after the trial. These results show that transdermal administration of E2 is effective in relieving post-menopausal symptoms. Local tolerability was good and the majority of the patients considered the transdermal treatment to be superior to their previous oral replacement therapy.

Administration, Cutaneous↗

Sauna habits and related symptoms in Finnish children.

Fifteen hundred randomly chosen Finnish children aged 0-15 years were studied by a questionnaire about their sauna habits and possible abnormal symptoms during or immediately after the sauna. A total of 1247 families (83%) answered. Almost all children visited the sauna (98.5%), most of them "with pleasure" (83%). Nearly half of the children were in the sauna as often as 2-3 times a week, and over 90% at least once a week. The children's sauna visits began quite early, in 70% during infancy. The time spent in a hot steam bath increased with age. Symptoms were rare and were not serious. Transient symptoms (dizziness, nausea etc.) were the most common. Of the children, 17% had some chronic or recurring disorder, most commonly atopic dermatitis or middle ear infections. In half of the cases of atopic dermatitis it became worse in the sauna. Sauna is a very common practice in Finland, also among children. It does not seem to cause any significant immediate harm to healthy children.

Adolescent↗

Effects of a Finnish sauna on the pharmacokinetics and haemodynamic actions of propranolol and captopril in healthy volunteers.

The effects of a Finnish sauna on propranolol pharmacokinetics and on the pharmacodynamics of propranolol and captopril were studied in healthy, young volunteers (2 males, 6 females) in a double-blind, cross-over trial. The subjects received single oral doses of placebo, propranolol (40 mg) or captopril (12.5 mg) in sauna and control sessions at a one-week interval. The sauna sessions consisted of three repetitive 10-min stays in a sauna (85-100 degrees C, relative humidity 25-35%) separated by two 5-min rest periods in a cool room. Sauna bathing started 35, 50 and 65 min after ingestion of the drugs. Venous blood for plasma propranolol measurement were collected before and 15, 30, 45, 60, 75, 90 min and 2, 3, 4, 5, 7 and 24 h after drug intake. The sauna significantly increased the maximum concentration (Cmax 41 vs. 28 ng.ml-1) of propranolol and the mean plasma propranolol concentration 60 and 90 min, and 2 and 3 h after drug administration. It also significantly increased the AUC0-5h (119 vs 71 micrograms.h.l-1) of propranolol from 0 to 5 hours tmax, t1/2 beta and AUC0-24h of propranolol did not differ between the control and sauna sessions. The higher propranolol levels during and after the cessation of sauna bathing did not lead to significant changes in blood pressure or heart rate compared to the control period. Captopril had no major effects on these parameters during the post-sauna phase.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Adenohypophyseal hormone levels during hyperthermia.

The effect of hyperthermia on some adenohypophyseal hormone levels (prolactin, growth hormone, adrenocorticotropin, thyrotropin) in plasma was studied. The levels of prolactin increased significantly (310%) during Finnish sauna. The growth hormone levels increased slightly, whereas the levels of adrenocorticotropin and thyrotropin were unaltered. The increase in prolactin levels during hyperthermia resembled the changes in the levels of prolactin which have been found during stress and exercise.

Adrenal Cortex↗

Cupping as a part of living finnish traditional healing. A remedy against pain.

Wet cupping appears to be a living reminiscence of the traditional Finnish healing methods. Fifteen persons practicing or having practiced cupping were interviewed in Savo Province, Eastern Finland. The knowledge and skills of cupping appear to be transferred by personal apprenticeship within a family or from a neighbour. No written material is nowadays available and known to be used in learning. Cupping is considered by healers to be useful in the treatment of aching and pains of teeth, head, neck, shoulders, back and legs. Cuppers report cupping effective also in hypertension and skin diseases. On the other hand, the method is not regarded to be useful in problems of internal organs. Cupping is done after a sauna and bathing of the patient in a warm environment (in sauna). It is often preceded by massage. The small wounds in the cupping sites are made with the aid of a small knife. The healers have the opinion that bad blood must be removed from the superficial areas of the ailing parts of the body, The cupping sites were more or less specific to the ailments of the patient and the number of cups varied from patient to patient depending on the condition and size.

Adult↗

[Rhinomanometric studies of thermal modification of nasal ventilation].

Elevation of nasal resistance has been described as an effect of increased air temperature by different authors. The aim of this study was to evaluate the effect of high environmental temperature on congestion of the nasal mucosa. In all, 102 volunteers were studied and included normal controls, heart rehabilitation patients and high performance sportsmen. Rhinomanometric examinations were carried out before and after 10 min in a dry Finnish sauna at a 90 degrees C temperature. Computerized active anterior rhinomanometry was used. A uniform response pattern to the increased temperature could not be observed: i.e., some individuals had an elevated resistance immediately after the sauna while resistance was decreased in others. The relationship between the reaction of the nasal mucosa to body work and temperature is discussed.

Acclimatization↗

Clinical studies with a vascular vasopressin antagonist.

The effect of circulating arginine vasopressin (AVP) on blood pressure, heart rate, and skin blood flow was assessed in normotensive subjects, mild hypertensive patients, and patients with congestive heart failure, utilizing the specific antagonist of AVP at the vascular receptor level, d(CH2)5Tyr(Me)AVP (5 micrograms/kg i.v.). The renin system of the normal volunteers treated with the AVP antagonist was either intact or acutely blocked with the angiotensin converting-enzyme inhibitor captopril (25 mg p.o.). In some volunteers, the cardiovascular effect of AVP released by Finnish sauna or cigarette smoking was studied. In patients with congestive heart failure, hemodynamic measurements (pressures and cardiac output) were obtained invasively. Acute blockade of AVP vascular receptors produced no cardiovascular effect unless plasma AVP levels were markedly elevated. In our experience, abnormally high circulating AVP appears to be responsible for the decrease in skin blood flow induced by cigarette smoking and to some extent for the maintenance of vascular tone in the rare patients with particularly severe congestive heart failure.

Angiotensin II↗

Treatment with thiamine hydrochloride and astaxanthine for the prevention of yolk-sac mortality in Baltic salmon fry (M74 syndrome).

Two practical methods are reported for treating feral Baltic salmon with thiamine hydrochloride against M74 syndrome (abnormally high yolk-sac fry mortality of the Baltic salmon). Both bathing of the yolk-sac fry in thiamine hydrochloride (1000 mg l-1, 1 h) and a single intraperitoneal injection given to the female brood fish (100 mg kg-1 fish) during the summer 3 mo before stripping were shown to elevate the whole body total thiamine concentration in the fry. Both treatments were also shown to be effective in preventing mortality due to M74 syndrome. The effect of bathing the yolk-sac fry was shown to be dose-dependent. The results support the view that there is a causal relationship between the thiamine status of the yolk-sac fry and M74 mortality. An intraperitoneal injection of astaxanthine suspension administered to the female brood fish (11 mg kg-1 fish) in the summer 3 mo before stripping elevated the astaxanthine concentration in the eggs but did not affect mortality due to M74 syndrome. An interaction between astaxanthine and thiamine may occur in the developing embryo or yolk-sac fry, however. No association could be demonstrated between the various thiamine hydrochloride treatment practices and hepatic cytochrome P450 dependent 7-ethoxyresorufin-O-deethylase (EROD) activity in the yolk-sac fry. An injection of thiamine hydrochloride into the peritoneal cavity of wild Baltic salmon females could be used to raise thiamine concentrations in their offspring in the rivers. The effect on smolt production in Finnish Baltic salmon rivers needs to be investigated further, however.

Adjuvants, Immunologic↗

Sauna and congenital defects.

To test a recent hypothesis on the causal relationship between sauna-induced hyperthermia and congenital defects, 100 consecutive cases of defects of the central nervous system and 202 cases of orofacial clefts were singled out from the Finnish Registry of Malformations. The mothers and their time-area-matched referents were interviewed for their sauna habits. Almost every pregnant mother (98.5%) had visited the sauna regularly, and yet, the incidence of the CNS defects in Finland is among the lowest ever reported. No differences in the sauna habits were observed between the case and referent mothers. It is concluded that the relatively mild, temporal hyperthermia caused by the sauna should not be considered hazardous for the developing embryo.

Body Temperature↗