The effects of whole body vibration on peripheral cardiovascular function

Exposure to acute bouts of whole body vibration (WBV), which can be employed as a novel form of exercise, has been reported to increase local skeletal muscle blood flow. However, the mechanism for this effect remains unclear. Therefore, this research aimed to explore the mechanism that would explain the effect of vibration on the peripheral cardiovascular function. Initially, the aim was to investigate the potential mechanism of the effect of WBV on the systemic blood flow, since there are currently no studies reporting any systemic effects of WBV on blood flow. The results did not demonstrate any systemic effects on blood flow (i.e. forearm blood flow) in response to acute unloaded and loaded squats with WBV. It was concluded that it was difficult to identify the effects of vibration on systemic cardiovascular function because, most likely due to the higher exercise intensity, skeletal muscle activation resulted in a decrement in blood flow from a distal site (i.e. forearm) to the main site (i.e. lower limb). Through the development of experimental methods involving applying vibration passively to the lower limbs, which avoids any influence of direct skeletal muscle activation and focuses solely on the mechanism inducing effects, it was demonstrated that ankle systolic blood pressure and ankle brachial pressure index substantially decreased in the post-vibration period. It was concluded that vibration has a direct effect on the peripheral cardiovascular function via increased vasodilatation; however, the mechanism underlying this effect remained unresolved. The effects of different durations of passive vibration on the peripheral circulation were also investigated and the results demonstrated that a longer duration of passive vibration (i.e. 8 minutes) resulted in a significantly higher lower leg blood flow during the recovery period than a shorter duration (i.e. 1, 2 and 4 minutes) of passive vibration. These data provide evidence for a greater effect of WBV occurring with a longer duration on the peripheral cardiovascular function, caused by the vasodilatation response throughout the recovery period. However, there might be a minimum effect of skeletal muscle activation occurring with a longer duration of passive vibration that leads to a direct response to localised heating. Furthermore, the thesis attempted to distinguish the effects of passive vibration on skeletal muscle activation from those on the peripheral vascular system. An experiment was designed in which passive vibration was applied with and without circulatory occlusion, to examine whether there was any underlying skeletal muscle activation. It was found that vibration with intact circulation produces more heat than the control, no vibration and occlusion, and occlusion plus vibration conditions. These effects were reflected by the higher skin temperature observed during exposure to vibration, and continuing into recovery. These data provide evidence that passive vibration does not appear to induce an increase in muscle activity. The data also suggest that the mechanism of the rise in skin temperature in response to passive vibration exposure is due to a vasodilatation that occurred in the lower limb via inducing an increase in shear stress at the blood vessels wall and led to an increase in circulating blood flow during exposure that continues into recovery. Overall, the results obtained demonstrate that vasodilatation occurs during and after vibration exposure and appears to be a process that is independent of skeletal muscle activation. It is postulated that the stimulus is a direct effect on the blood vessels via inducing an increase in shear stress that results in an increased vasodilatation, thereby increasing blood flow. Hence, these observations demonstrate that vibration stimulus has a direct effect on the muscle vascular bed as a primary effect and that there is no carry over effect into the systemic circulation. Thus, the results of this thesis indicate that vibration induced enhancement in the peripheral circulation could be using as a training stimulus and also could have a beneficial effect in assisting recovery routines from exertion

Herlyn-werner-wunderlich syndrome: MRI findings, radiological guide (two cases and literature review), and differential diagnosis

<p>Abstract</p> <p>Background</p> <p>Herlyn-Werner-Wunderlich (HWW) syndrome is a very rare congenital anomaly of the urogenital tract involving Müllerian ducts and Wolffian structures, and it is characterized by the triad of didelphys uterus, obstructed hemivagina and ipsilateral renal agenesis. It generally occurs at puberty and exhibits non-specific and variable symptoms with acute or pelvic pain shortly following menarche, causing a delay in the diagnosis. Moreover, the diagnosis is complicated by the infrequency of this syndrome, because Müllerian duct anomalies (MDA) are infrequently encountered in a routine clinical setting.</p> <p>Cases presentation</p> <p>two cases of HWW syndrome in adolescents and a differential diagnosis for one case of a different MDA, and the impact of magnetic resonance (MR) imaging technology to achieve the correct diagnosis.</p> <p>Conclusions</p> <p>MR imaging is a very suitable diagnostic tool in order to perform the correct diagnosis of HWW syndrome.</p

Factors associated with quality of life of outpatients with breast cancer and gynecologic cancers and their family caregivers: a controlled study

<p>Abstract</p> <p>Background</p> <p>Quality of life (QOL) issues are of interest in cancer because effective methods of treatment and detection have led to an increase in the number of long-term survivors. The objectives of the study were: to assess the subjective QOL of stable Sudanese women cancer outpatients and their family caregivers, using the WHO 26-item QOL Instrument; compare with matched general population groups, as well as diabetic and psychiatric patient groups; examine patient-caregiver concordance in ratings; and assess the variables associated with their QOL, with a view to identifying factors that can enhance quality of care.</p> <p>Methods</p> <p>Responses of oncology outpatients with breast cancer (117), cervical cancer (46) and ovarian cancer (18) (aged 44.6, SD 11.5) were compared with those of their family caregivers and matched general population groups. Data were analyzed by univariate and multivariate statistics.</p> <p>Results</p> <p>The cancer groups had similar QOL domain scores, which were significantly lower than those of their caregivers, but higher than the control group as well as those of psychiatric and diabetic patients studied previously. Patients who were married, with higher education, better employment, and with longer duration of illness had higher QOL. Patients on radiotherapy and their caregivers had higher QOL scores. Correlations between patient's ratings and caregiver impression of patient's QOL were high. Caregiver impression was a significant predictor of patient's and caregiver's QOL. Other predictors for the patient were: currently feeling sick and duration of illness; for the caregiver: feeling sick, relationship to patient, and age.</p> <p>Conclusion</p> <p>Cancer patients in stable condition and with psychosocial support can hope to enjoy good QOL with treatment. The findings constitute an evidence base for the country's cancer care program, to boost national health education about prognosis in cancer. Families living with women cancer patients are vulnerable and need support if the patient is recently diagnosed, less educated, single, not formally employed; and the caregiver is female, parent, younger, less educated, unemployed and feels sick. Clinicians need to invest in the education and support of family caregivers. The patient-caregiver dyad should be regarded as a unit for treatment in cancer care.</p

IMAGE FUSION APPLIED TO SATELLITE IMAGERY FOR THE IMPROVED MAPPING AND MONITORING OF CORAL REEFS: A PROPOSAL

A coral reef ecosystem, one of the most complex marine environmental systems on the planet, is defined as biologically diverse and immense. It plays an important role in maintaining a vast biological diversity for future generations and functions as an essential spawning, nursery, breeding and feeding ground for many kinds of marine species. In addition, coral reef ecosystems provide valuable benefits such as fisheries, ecological goods and services and recreational activities to many communities. However, this valuable resource is highly threatened by a number of environmental changes and anthropogenic impacts that can lead to reduced coral growth and production, mass coral mortality and loss of coral diversity. With the growth of these threats on coral reef ecosystems, there is a strong management need for mapping and monitoring of coral reef ecosystems. Remote sensing technology can be a valuable tool for mapping and monitoring of these ecosystems. However, the diversity and complexity of coral reef ecosystems, the resolution capabilities of satellite sensors and the low reflectivity of shallow water increases the difficulties to identify and classify its features. This paper reviews the methods used in mapping and monitoring coral reef ecosystems. In addition, this paper proposes improved methods for mapping and monitoring coral reef ecosystems based on image fusion techniques. This image fusion techniques will be applied to satellite images exhibiting high spatial and low to medium spectral resolution with images exhibiting low spatial and high spectral resolution. Furthermore, a new method will be developed to fuse hyperspectral imagery with multispectral imagery. The fused image will have a large number of spectral bands and it will have all pairs of corresponding spatial objects. This will potentially help to accurately classify the image data. Accuracy assessment use ground truth will be performed for the selected methods to determine the quality of the information derived from image classification. The research will be applied to the Kuwait's southern coral reefs: Kubbar and Um Al-Maradim