Autonomic Phenotypes in Chronic Fatigue Syndrome (CFS) Are Associated with Illness Severity: A Cluster Analysis

In this study we set out to define the characteristics of autonomic subgroups of patients with Chronic Fatigue Syndrome (CFS). The study included 131 patients with CFS (Fukuda criteria). Participants completed the following screening symptom assessment tools: Chalder Fatigue Scale, Fatigue Impact Scale, Fatigue Severity Scale, Epworth Sleepiness Scales, the self-reported Composite Autonomic Symptom Scale. Autonomic parameters were measured at rest with a Task Force Monitor (CNS Systems) and arterial stiffness using an Arteriograph (TensioMed Kft.). Principal axis factor analysis yielded four factors: fatigue, subjective and objective autonomic dysfunction and arterial stiffness. Using cluster analyses, these factors were grouped in four autonomic profiles: 34% of patients had sympathetic symptoms with dysautonomia, 5% sympathetic alone, 21% parasympathetic and 40% had issues with sympathovagal balance. Those with a sympathetic-dysautonomia phenotype were associated with more severe disease, reported greater subjective autonomic symptoms with sympathetic over-modulation and had the lowest quality of life. The highest quality of life was observed in the balance subtype where subjects were the youngest, ha

The impact of total sleep deprivation upon cognitive functioning in firefighters

Sławomir Kujawski,1 Joanna Słomko,1 Małgorzata Tafil-Klawe,2 Monika Zawadka-Kunikowska,1 Justyna Szrajda,1 Julia L Newton,3 Paweł Zalewski,1 Jacek J Klawe1 1Department of Hygiene, Epidemiology and Ergonomics, Nicolaus Copernicus University, Toruń, Poland; 2Department of Human Physiology, Nicolaus Copernicus University, Toruń, Poland; 3Institute for Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne, UK Introduction: Firefighters as a profession are required to maintain high levels of attention for prolonged periods. However, total sleep deprivation (TSD) could influence negatively upon performance, particularly when the task is prolonged and repetitive. Purpose: The aim of this study is to examine the influence of TSD on cognitive functioning in a group of firefighters. Subjects and methods: Sixty volunteers who were active male fire brigade officers were examined with a computerized battery test that consisted of simple reaction time (SRT) (repeated three times), choice reaction time, visual attention test, and delayed matching to sample. Six series of measurements were undertaken over a period of TSD. Results: Performance in the second attempt in SRT test was significantly worse in terms of increased number of errors and, consequently, decreased number of correct responses during TSD. In contrast, the choice reaction time number of correct responses as well as the visual attention test reaction time for all and correct responses significantly improved compared to initial time points. Conclusion: The study has confirmed that subjects committed significantly more errors and, consequently, noted a smaller number of correct responses in the second attempt of SRT test. However, the remaining results showed reversed direction of TSD influence. TSD potentially leads to worse performance in a relatively easy task in a group of firefighters. Errors during repetitive tasks in firefighting routines could potentially translate into catastrophic consequences. Keywords: constant routine protocol, simple reaction time, choice reaction time, visual attention test, delayed matching to sample mental functionin

The impact of total sleep deprivation upon cognitive functioning in firefighters

Sławomir Kujawski,1 Joanna Słomko,1 Małgorzata Tafil-Klawe,2 Monika Zawadka-Kunikowska,1 Justyna Szrajda,1 Julia L Newton,3 Paweł Zalewski,1 Jacek J Klawe1 1Department of Hygiene, Epidemiology and Ergonomics, Nicolaus Copernicus University, Toruń, Poland; 2Department of Human Physiology, Nicolaus Copernicus University, Toruń, Poland; 3Institute for Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne, UK Introduction: Firefighters as a profession are required to maintain high levels of attention for prolonged periods. However, total sleep deprivation (TSD) could influence negatively upon performance, particularly when the task is prolonged and repetitive. Purpose: The aim of this study is to examine the influence of TSD on cognitive functioning in a group of firefighters. Subjects and methods: Sixty volunteers who were active male fire brigade officers were examined with a computerized battery test that consisted of simple reaction time (SRT) (repeated three times), choice reaction time, visual attention test, and delayed matching to sample. Six series of measurements were undertaken over a period of TSD. Results: Performance in the second attempt in SRT test was significantly worse in terms of increased number of errors and, consequently, decreased number of correct responses during TSD. In contrast, the choice reaction time number of correct responses as well as the visual attention test reaction time for all and correct responses significantly improved compared to initial time points. Conclusion: The study has confirmed that subjects committed significantly more errors and, consequently, noted a smaller number of correct responses in the second attempt of SRT test. However, the remaining results showed reversed direction of TSD influence. TSD potentially leads to worse performance in a relatively easy task in a group of firefighters. Errors during repetitive tasks in firefighting routines could potentially translate into catastrophic consequences. Keywords: constant routine protocol, simple reaction time, choice reaction time, visual attention test, delayed matching to sample mental functionin

Measuring scales used for assessment of patients with traumatic brain injury: multicenter studies

Robert Ślusarz,1 Renata Jabłońska,1 Agnieszka Królikowska,1 Beata Haor,1 Ewa Barczykowska,2 Monika Biercewicz,3 Mariola Głowacka,2 Justyna Szrajda4 1Neurological and Neurosurgical Nursing Department, 2Nursing Department, 3Clinic of Geriatrics, 4Department of Hygiene and Epidemiology, Collegium Medicum, Nicolaus Copernicus University, Torun, PolandBackground: Application of adequate numeric scales is essential for assessment of a patient’s condition. The scales most commonly used by the therapeutic team for assessment of a patient with traumatic brain injury (TBI) include deficit scales, functional scales, and scales assessing quality of life. The purpose of this study was to establish the relationships between the particular scales used for assessment of patients with TBI.Methods: This multicenter study included 159 patients with TBI. The direct observation technique was used. Two measurements were made (at hospital admission and discharge) using standardized assessment scales, ie, the Glasgow Coma Scale (GCS), the Functional Capacity Scale (FCS), the Functional Index “Repty” (FIR), and the Glasgow Outcome Scale.Results: Patients with mild impairment of consciousness were most numerous in the examined group at both admission and discharge, ie, 118 (78.8%) and 134 patients (89.3%), respectively. The mean score for functional capacity measured with the FCS was 34.41 points (71.7%) on the day of admission and 41.87 points (87.2%) on the day of discharge from hospital. A significant correlation was found between results obtained using the GCS and results on the FIR, on both the day of admission [R t(n-2) =7.612=0.530; P=0.00] and the day of discharge [R t(n-2) =8.998=0.595; P=0.00]. Further, a high correlation was found between the FCS and the FIR (rs= -0.854 on day of admission and rs= -0.840 on day of discharge).Conclusion: The majority of examined patients had mild impairment of consciousness. A moderate correlation was found between the GCS and the scales assessing activities of daily living. A high correlation was found between FCS and FIR, which may result from the similarities between the analyzed tools in the scope of their construction and application.Keywords: head trauma, assessment tools, numeric scale

Cardiovascular and Thermal Response to Dry-Sauna Exposure in Healthy Subjects

Dry-sauna is a strong thermal stimulus and is commonly used all over the world. The aim of this experiment was to comprehensively analyse cardiovascular and autonomic changes that result from an increase in core body temperature during sauna bath. The study included 9 healthy men with mean age 26.7 ± 3.0 years and comparable anthropomorphical characteristics. Each subject was exposed to one 15-minute session of dry-sauna treatment at 100°C and 30–40% humidity. The autonomic and baseline cardiovascular (i.e., hemodynamic and contractility) parameters were measured noninvasively with Task Force Monitor. Cardiovascular autonomic functions were assessed using baroreceptor reflex sensitivity (BRS) and spectral analysis of heart rate (HRV) and blood pressure (BPV) variability. Measurements were performed four times, at the following stages “before sauna,” “after sauna,” “sauna + 3 h,” and “sauna + 6 h.” The first recording constituted a baseline for the subsequent three measurements. The changes in core body temperature were determined with the Vital Sense telemetric measurement system. Results show that exposure to the extreme external environmental conditions of dry-sauna does not compromise homeostasis in healthy persons. The hemodynamic changes induced by heating are efficiently compensated by the cardiovascular system and do not exert negative effects upon its short-term regulatory potential