RESUMO
The psychophysiological coherence model proposes that a heart rhythm pattern, known as heart rhythm coherence (HRC), is associated with dominant parasympathetic activity and the entrainment of respiratory function, blood pressure, and heart rhythms. Although the HRC pattern has primarily been assessed during wakefulness, changes in cardiac and autonomic activity that occur during sleep stages can also be associated with the HRC pattern. The objective of this study was to examine whether any differences in the HRC pattern could be detected among various sleep stages. Eighteen healthy young individuals participated in this study. Two consecutive polysomnographic (PSG) recordings were obtained from each participant, several segments of cardiac activity were obtained from the second PSG. The HRC pattern was quantitatively evaluated by calculating the HRC ratio (HRCR). The highest peaks in the coherence band (Coher-Peak), 0.1-Hz index, respiratory sinus arrhythmia (RSA), and heart rate (HR) were evaluated. A Friedman test showed significant differences among sleep stages in the Coher-Peak, 0.1-Hz index, RSA, and HR; the Coher-Peak and RSA values were lower in rapid eye movement (REM) sleep, while the 0.1-Hz and HR values were higher in REM sleep. Post hoc analyses identified significant differences between the N2 and REM sleep stages. Among the various sleep stages, HR and RSA measurements behaved independently of the HRC pattern, and the HRC pattern did not appear to be associated with the 0.1 Hz frequency. Further studies are required to identify the characteristics of the HRC pattern during sleep.
Assuntos
Fases do Sono , Sono , Sistema Nervoso Autônomo , Frequência Cardíaca/fisiologia , Humanos , Projetos Piloto , Polissonografia , Sono/fisiologia , Fases do Sono/fisiologiaRESUMO
INTRODUCTION: México is the second place in overweight and obese adults. Acute appendicitis (AA), is the most common indication for an emergency surgery around the world, with an estimated lifetime incidence of 7-14%. Laparoscopic appendectomy (LA) has been described as a safe and good surgery approach for this group of patients. Nevertheless, in México, there is not any evidence supporting these outcomes in our population. METHODS: All the patients that came to the ER from July to December 2014 with age >16-year, body mass index (BMI) > 25 kg/m(2) (overweight) and, BMI >30 kg/m(2) (obese) were included in the study. We recorded the age, gender, BMI, grade of appendicitis, complications classified by the Clavien-Dindo Classification, and a follow-up period of 7-day, 30-day, 6-month, and 1-year. RESULTS: 27 patients met the inclusion criteria, five had overweight (18.5%), and twenty-two were obese (81.5%). No surgical conversion was needed. The overall complications rate was 29.6%%, with 22.2% mild complications and 7.4% of moderate complication. The average in-hospital cost for the procedure was $15,860 MXN (range $12,860-$22,860 MXN). The surgical time was ≈53.7 ± 19.93 h and the LOS ≈1.6 ± 0.6 days. CONCLUSION: The outcomes in the Mexican adult obese population with acute appendicitis when a laparoscopic appendectomy is performed are as good as reported in other countries.