Search Results (59)

Sleep disorders and stroke are intricately linked through a complex, bidirectional relationship. Sleep disturbances such as obstructive sleep apnea (OSA), insomnia, and restless legs syndrome (RLS) not only increase the risk of stroke but also frequently emerge as consequences of cerebrovascular events. OSA, in particular, is associated with a two- to three-fold increased risk of incident stroke, primarily through mechanisms involving intermittent hypoxia, systemic inflammation, endothelial dysfunction, and autonomic dysregulation. Conversely, stroke can disrupt sleep architecture and trigger or exacerbate sleep disorders, including insomnia, hypersomnia, circadian rhythm disturbances, and breathing-related sleep disorders. These post-stroke sleep disturbances are common and significantly impair rehabilitation, cognitive recovery, and quality of life, yet they remain underdiagnosed and undertreated. Early identification and management of sleep disorders in stroke patients are essential to optimize recovery and reduce the risk of recurrence. Therapeutic strategies include lifestyle modifications, pharmacological treatments, medical devices such as continuous positive airway pressure (CPAP), and emerging alternatives for CPAP-intolerant individuals. Despite growing awareness, significant knowledge gaps persist, particularly regarding non-OSA sleep disorders and their impact on stroke outcomes. Improved diagnostic tools, broader screening protocols, and greater integration of sleep assessments into stroke care are urgently needed. This narrative review synthesizes current evidence on the interplay between sleep and stroke, emphasizing the importance of personalized, multidisciplinary approaches to diagnosis and treatment. Advancing research in this field holds promise for reducing the global burden of stroke and improving long-term outcomes through targeted sleep interventions. Full article

Measurement of nitric oxide (NO) concentration in exhaled breath (FeNO) is a quantitative, non-invasive, simple, and safe method for assessing airway inflammation. It serves as a complementary tool to other methods for evaluating airway diseases. However, little is known about the typical NO levels in healthy individuals, including individual differences and the influence of measurement timing. Therefore, this study classified measurement times into four periods and statistically analyzed NO levels in healthy individuals. The mean values among groups were compared using repeated measures ANOVA on six participants. The analysis showed large individual variations in NO levels, resulting in no significant difference (p = 0.29). Notably, greater fluctuations were observed in the morning. These findings align with previous studies suggesting the influence of circadian rhythms and the redundancy of repeated measurements. This study highlights the need to consider timing and individual variability when using FeNO as a physiological marker in healthy populations. Full article

With advancements in the miniaturization and lightweight design of computers and electronic devices, wearable sensors are now widely utilized in fields such as healthcare and medicine. Signals obtained from wearable sensors often contain a mix of biological signals and noise. Typically, wearable sensor measurements focus on a single signal of interest (SoI), treating other signals as noise. While methods for separating multiple signals exist, the stable tracking of frequency variations during signal separation remains an unresolved challenge. Biological signal and human motion measurements often face issues such as noise, temporal disconnections, dropouts, and frequency variations. To address these challenges, we developed a method that can stably separate and extract SoI from measurement data. We demonstrated the effectiveness of the proposed method through simulations replicating common measurement issues. By applying the method, we show that SoI frequency estimates can be obtained with a high accuracy. Furthermore, we confirm that the method can separate multiple SoIs from a single measurement dataset, highlighting its utility. Finally, we validate that the proposed method can reliably extract multiple SoIs, such as heart rate, walking rhythm, and breathing rate, from actual data measured using stretch sensors, achieving results consistent with simulations. Full article

Although most research has concentrated on the link between sleep apnea and atrial fibrillation, obstructive sleep apnea (OSA) is also associated with ventricular arrhythmias. These cardiac arrhythmias can be triggered by repeated episodes of hypoxemia, hypercapnia, acidosis, intrathoracic pressure fluctuations, reoxygenation, and other mechanisms that occur during apnea and hypopnea. Studies show that OSA reduces the effectiveness of arrhythmia treatments, such as antiarrhythmic medications and radiofrequency current ablation. Several non-randomized studies indicate that treating sleep apnea syndrome with continuous positive airway pressure (CPAP) may help maintain sinus rhythm following electrical cardioversion and increase the success rates of catheter ablation. This review aims to thoroughly examine the role of OSA in the development of cardiac arrhythmias. Screening for OSA and arrhythmias in patients with OSA provides vital information on the need for additional interventions, such as CPAP therapy, anticoagulation, antiarrhythmic drug therapy, catheter ablation for specific arrhythmias, or device therapy. New therapies for OSA treatment have the potential to significantly influence arrhythmia development in patients with sleep-disordered breathing. However, further research is required to validate these findings and formulate comprehensive treatment protocols. Full article

Two-dimensional (2D) cine imaging is essential in routine clinical cardiac MR (CMR) exams for assessing cardiac structure and function. Traditional cine imaging requires patients to hold their breath for extended periods and maintain consistent heartbeats for optimal image quality, which can be challenging for those with impaired breath-holding capacity or irregular heart rhythms. This study aims to systematically assess the performance of a deep learning-based reconstruction (Sonic DL Cine, GE HealthCare, Waukesha, WI, USA) for accelerated cardiac cine acquisition. Multiple retrospective experiments were designed and conducted to comprehensively evaluate the technique using data from an MR-dedicated extended cardiac torso anatomical phantom (digital phantom) and healthy volunteers on different cardiac planes. Image quality, spatiotemporal sharpness, and biventricular cardiac function were qualitatively and quantitatively compared between Sonic DL Cine-reconstructed images with various accelerations (4-fold to 12-fold) and fully sampled reference images. Both digital phantom and in vivo experiments demonstrate that Sonic DL Cine can accelerate cine acquisitions by up to 12-fold while preserving comparable SNR, contrast, and spatiotemporal sharpness to fully sampled reference images. Measurements of cardiac function metrics indicate that function measurements from Sonic DL Cine-reconstructed images align well with those from fully sampled reference images. In conclusion, this study demonstrates that Sonic DL Cine is able to reconstruct highly under-sampled (up to 12-fold acceleration) cine datasets while preserving SNR, contrast, spatiotemporal sharpness, and quantification accuracy for cardiac function measurements. It also provides a feasible approach for thoroughly evaluating the deep learning-based method. Full article

(1) Background: Previous studies showed that neurofeedback and biofeedback could improve stress levels, enhance self-control over physiological factors, improve behavioral efficiency, and increase reaction speed to stimuli. Specifically, the sensorimotor rhythm stimulation (12–15 Hz) can enhance cognitive functions such as selective attention and working memory. However, there is no study that analyzes the effect of these interventions in chess players. (2) Methods: A Chess Woman Grandmaster and Chess International Master, with an ELO ranking higher than 2350 points, was selected to participate in this case study. The participant conducted a total of 14 sessions of biofeedback and neurofeedback, training in breathing, sensorimotor rhythm stimulation in Cz, skin conductance, temperature, and heart rate variability combined with chess work. Specific and non-specific tasks were designed to evaluate the intervention. (3) Results: The chess player enhanced the heart rate variability during specific and non-specific chess tasks: chess problems, 15 + 10 games, and puzzle rush games. In addition, the sensorimotor rhythm power decreased during the chess problem and increased during the 15 + 10 game and puzzle rush. Also, chess performance and anxiety levels improved after the intervention. (4) Conclusions: Neurofeedback and biofeedback training combined with chess training could improve the performance of chess players. Full article

A 67-year-old man started treatment due to frequent asymptomatic premature ventricular complexes (PVCs) accidentally being registered during a preventive examination by a specialist, because of which he was referred to cardiologist. During the initial 24-hour (h) ECG monitoring, 4.5% PVCs and one episode of asymptomatic non-sustained ventricular tachycardia (NSVT) with three PVCs in row, at a frequency of 150 beats per minute (bpm), were detected. After the introduction of beta blockers into therapy, a lower number of PVCs, without NSVT, were recorded in the control 24 h Holter ECG, while transthoracic echocardiography (TTE) showed normal left ventricular (LV) systolic function without cardiomyopathy. So, an exercise test was indicated, and it was interrupted in the third minute at 120 beats per minute (bpm) due to fatigue and pain in the hips, without malignant arrhythmias, angina or dyspneic complaints. During the rest period, a significant inferolateral depression of the ST junction was observed, which recovered in the ninth minute. Immediately after the ECG monitoring stopped, the patient lost consciousness; his pulse was not palpable, but breathing was audible, so cardiac massage was started. After he had regained consciousness, the ECG showed alternating sinus and junctional rhythm with the lowest frequency of 33 bpm, which was accompanied by marked hypotension (80/50 mmHg). The patient was immediately hospitalized; coronary angiography and repeated TTE were completely normal, while continuous ECG monitoring did not confirm malignant rhythm disorders or asystole. It was concluded that it was vasovagal syncope (VVS), most likely caused by the Bezold–Jarisch reflex (BJR). Full article

(1) Background: Exploring the relationship between spontaneous breathing patterns and aerobic and anerobic running exercise performance can greatly improve our understanding of optimizing physical fitness. Spontaneous breathing patterns refer to how the rhythm and depth of breathing affect performance and physical adaptation during exercise. (2) Methods: This study aimed to investigate this relationship by enrolling 240 college students (120 males and 120 females, aged 18–22). We evaluated their resting respiratory rate (RR), the combined total of abdominal and thoracic movements (AM+TM), the proportion of abdominal movement to the overall respiratory movement (AM/(AM+TM)), and the inhalation to exhalation ratio (I/E ratio). Additionally, their performance in a 50 m sprint (measuring anerobic capability), an 800- or 1000 m run (assessing mixed aerobic and anerobic capacity), and a 12 min distance run (evaluating aerobic capacity) was recorded. (3) Results: Our findings, through both correlational and comparative analyses, indicate that a larger AM+TM is predictive of a greater distance covered in the 12 min run, suggesting enhanced aerobic capacity. Interestingly, among female participants, a lower body mass index (BMI) coupled with a higher proportion of abdominal movement (AM/(AM+TM)) was linked to better performance in the 800 m run, indicative of superior mixed aerobic and anerobic capacities. These results imply that women with a larger tidal volume and those with a lower BMI but higher abdominal contribution to breathing at rest may exhibit better aerobic and mixed exercise capacities, respectively. (4) Conclusions: Based on these findings, we recommend that healthcare professionals and physical education instructors incorporate respiratory pattern assessments into their practices to potentially improve the physical health of their clients and students, with a particular emphasis on female populations. This study underscores the importance of understanding the intricate relationship between spontaneous respiratory patterns and exercise capabilities in enhancing overall physical fitness and health. Full article

Craniosacral rhythm is a manual therapy technique that focuses on the subtle, rhythmic movement of cerebrospinal fluid as it flows through the central nervous system and musculoskeletal system. Through light and delicate manipulation of the cranial bones, membranes and soft tissues of the head and neck, it promotes rebalancing and release from tension in the body, improving the circulation of the cerebrospinal fluid and the individual’s health. In the field of prosthetic dentistry, in rare cases, such as a full arch or removable partial denture, the patient perceives a sensation of constriction even though all procedures have been used correctly. In this work, a new design fora removable partial denture is proposed that does not interfere with the primary respiratory mechanism, reducing the sensation of constriction in the patient. The materials used are the same as those used for a normal removable partial denture, and the technique used is the “lost wax” one: the novelty is that the prosthesis is made in two separate parts that are joined by a central connection; the result is a removable partial denture with a small central thickening in the main joint represented by the connection of the two pieces. Craniosacral breathing movements are favored with this prosthesis as the metal structure is hyperstatic towards intrusion movements, more or less virtual in the opposite direction, i.e., extrusion towards the vestibule. Full article

Background: The exploration of optimizing cardiopulmonary function and athletic performance through high-intensity metabolic exercises (HIMEs) is paramount in sports science. Despite the acknowledged efficacy of HIMEs in enhancing cardiopulmonary endurance, the high metabolic stress imposed on the cardiopulmonary system, especially for amateurs, necessitates a scaled approach to training. Objective: The aim of this study is to ascertain whether adjustments in the initiation posture and the adoption of an appropriate breathing strategy can effectively mitigate the cardiopulmonary stress induced by HIMEs without compromising training efficacy. Methods: Twenty-two subjects were recruited into this study. The post-exercise heart rate (PHR) and post-exercise oxygen consumption rate (POCR) were collected within 30 min after exercise. A two-way ANOVA, multi-variable Cox regression, and random survival forest machine learning algorithm were used to conduct the statistical analysis. Results: Under free breathing, only the maximum POCR differed significantly between standing and prone positions, with prone positions showing higher stress (mean difference = 3.15, p < 0.001). In contrast, the regulated breathing rhythm enhanced performance outcomes compared to free breathing regardless of the starting position. Specifically, exercises initiated from prone positions under regulated breathing recorded a significantly higher maximum and average PHR than those from standing positions (maximum PHR: mean difference = 13.40, p < 0.001; average PHR: mean difference = 6.45, p < 0.001). The multi-variable Cox regression highlighted the starting position as a critical factor influencing the PHR and breathing rhythm as a significant factor for the POCR, with respective variable importances confirmed by the random survival forest analysis. These results underscore the importance of controlled breathing and starting positions in optimizing HIME outcomes. Conclusions: Regulated breathing in high-intensity exercises enhances performance and physiological functions, emphasizing the importance of breathing rhythm over starting position. Effective training should balance exercise volume and technique to optimize performance and minimize stress, reducing overtraining and injury risks. Full article

Iron deficiency (ID) and restlessness are associated with sleep/wake-disorders (e.g., restless legs syndrome (RLS)) and neurodevelopmental disorders (attention deficit/hyperactivity and autism spectrum disorders (ADHD; ASD)). However, a standardized approach to assessing ID and restlessness is missing. We reviewed iron status and family sleep/ID history data collected at a sleep/wake behavior clinic under a quality improvement/quality assurance project. Restlessness was explored through patient and parental narratives and a ‘suggested clinical immobilization test’. Of 199 patients, 94% had ID, with 43% having a family history of ID. ADHD (46%) and ASD (45%) were common conditions, along with chronic insomnia (61%), sleep-disordered breathing (50%), and parasomnias (22%). In unadjusted analysis, a family history of ID increased the odds (95% CI) of familial RLS (OR: 5.98, p = 0.0002, [2.35–15.2]), insomnia/DIMS (OR: 3.44, p = 0.0084, [1.37–8.64]), and RLS (OR: 7.00, p = 0.01, [1.49–32.93]) in patients with ADHD, and of insomnia/DIMS (OR: 4.77, p = 0.0014, [1.82–12.5]), RLS/PLMS (OR: 5.83, p = 0.009, [1.54–22.1]), RLS (OR: 4.05, p = 0.01, [1.33–12.3]), and familial RLS (OR: 2.82, p = 0.02, [1.17–6.81]) in patients with ASD. ID and restlessness were characteristics of ADHD and ASD, and a family history of ID increased the risk of sleep/wake-disorders. These findings highlight the need to integrate comprehensive blood work and family history to capture ID in children and adolescents with restless behaviors. Full article

Sudden, unexpected deaths are extremely difficult for families, especially when the victim is a child. Most sudden deaths occur due to cardiovascular issues, and a smaller number (approximately one-quarter) are attributed to other causes, such as epilepsy. The medicinal and non-medicinal use of the synthetic opioid fentanyl, which can cause breathing problems, is frequently involved in these deaths. It is also being found more often in autopsies of sudden death cases, and the number of overdose deaths from illicit drugs containing fentanyl is increasing. There are cases in which it is mixed with other drugs. A gene known as the KCNH2 gene or human ether-a-go-go-related gene (hERG), involved in the heart’s electrical activity, can be related to abnormal heart rhythms. This gene, along with others, may play a role in sudden deaths related to fentanyl use. In response, we have examined the scientific literature on genetic variations in the KCNH2 gene that can cause sudden death, the impact of fentanyl on this process, and the potential benefits of genetic testing for the victims to offer genetic counseling for their family members. Full article

Atrial fibrillation (AF) is the most common heart rhythm disorder in the Western world. Between the years 2010 and 2019, the global prevalence of AF rose from 33.5 million to 59 million, highlighting the importance of developing equitable treatments for patients. The disease is associated with symptoms such as palpitations, dizziness, fatigue, shortness of breath, and cognitive dysfunction. In addition, AF increases the risk of developing a stroke and heart failure. Despite new insights into risk factors that can lead to the development of AF, the success of current treatments is suboptimal. Numerous risk factors, such as hypertension, diabetes, and obesity, have been associated with the development and progression of AF. As these can be lifestyle-related risk factors, lifestyle modification may be a solution to reduce AF-related symptoms as well as episodes. Research results show that certain dietary changes can reduce AF and numerous risk factors for AF. Increasing attention is being given to Mediterranean and whole, plant-based eating patterns, which emphasize eating grains, legumes, vegetables, fruits, and nuts, while excluding most—or all—animal products. Hence, what are the beneficial aspects of a Mediterranean and plant-based diet which consists mainly of unprocessed foods? In the current review, we discuss the outcomes of diet-based treatments. Moreover, other diet-related treatments, brought up by patient initiatives, are highlighted. These patient-initiated studies include L-glutamine and electrolytes as options to manage AF. Also, we highlight the emerging importance of valuing patient needs and a quality-of-life-centered approach to medicine. As indicated by recent studies and patient experiences, citizen science can create inclusive solutions that lead to patient empowerment and a holistic approach for AF management. Full article

An 80-year-old man presented to the cardiology outpatient clinic due to shortness of breath. His past medical history included alcohol intake, hypertension, inferior wall myocardial infarction (five years ago), an ischemic stroke, and permanent atrial fibrillation (diagnosed three years before the current examination). A physical exam revealed a decreased intensity of S1 and S2, irregular rate and rhythm, and no murmurs nor friction rub. X-rays, Computed Tomography, and echocardiography exhibited pericardial calcification, involving mostly the inferior wall and protruding into the left ventricle. A diagnosis of constrictive pericarditis due to pericardial calcification was established and considered idiopathic. Even when it may be related to ischemic heart disease, post-infarction pericarditis could explain how the calcification extended to adjacent territory perfused by the circumflex coronary artery. Combined imaging studies were crucial not only for identifying calcium deposits in the pericardium but also in assessing a patient inherently prone to co-existing and exacerbating conditions. Even though pericardiectomy allows for removal of the clinical manifestations of congestive pericarditis in the most symptomatic patients with pericardial calcification, among patients like ours, with tolerable symptoms, cardiologists should discuss the therapeutic options considering the patient’s choices, potentially including a rehabilitation plan as part of non-pharmacological management. Full article

Running is a popular sport throughout the world. Breathing strategies like stable breathing and slow breathing can positively influence the runner’s physiological and psychological experiences. Sonic breathing instructions are an established, unobtrusive method used in contexts such as exercise and meditation. We argue sound to be a viable approach for administering breathing strategies whilst running. This paper describes two laboratory studies using within-subject designs that investigated the usage of sonic breathing instructions with novice female runners. The first study (N = 11) examined the effect of information richness of five different breathing instruction sounds on adherence and user experience. The second study (N = 11) explored adherence and user experience of sonically more enriched sounds, and aimed to increase the sonic experience. Results showed that all sounds were effective in stabilizing the breathing rate (study 1 and 2, respectively: mean absolute percentage error = 1.16 ± 1.05% and 1.9 ± 0.11%, percent time attached = 86.81 ± 9.71% and 86.18 ± 11.96%). Information-rich sounds were subjectively more effective compared to information-poor sounds (mean ratings: 7.55 ± 1.86 and 5.36 ± 2.42, respectively). All sounds scored low (mean < 5/10) on intention to use. Full article