Before patients with bipolar disorder (BD) can begin to perform balanced physical activity, they have to overcome many difficulties. The aim of this study was to examine the acceptance of pedometers as a self-assessment tool in people with BD. Patients who participated in an intervention study with body-oriented groups and psychoeducation groups at the Medical University of Graz/ Department of Psychiatry were invited to use pedometers on a daily basis and keep pedometer diaries over a period of 24 weeks. Most of the patients were satisfied with the pedometers and found them helpful for their health. The difficulties in the study were to recruit patients for this exercise trial, their lack of adherence to the programme and a high dropout rate. Out of the 130 invited patients, 41 came to the baseline investigation, 27 of them took part in the group interventions and 14 used pedometers and handed in the pedometer diaries. For clinical practice, specific motivational interventions are recommended to stimulate individuals with BD to engage in regular physical exercise.
BackgroundRecent studies suggest a reciprocal relationship between pain and sleeping disorders among adult patients [1] and different biological mechanisms are being proposed [2,3].Data with regard to this topic is very limited in pediatric patients.The present study aims to serve as an exploratory pilot study regarding the relationship between pain and sleep in children and adolescents.
The clinical relevance of borderline mean pulmonary arterial pressure (mPAP: 21-24mmHg) is not entirely clear. We retrospectively analyzed hemodynamic measurements at rest and during exercise of patients with resting mPAP We included n=141 patients (borderline: n=32). Borderline patients were older (65.8±12.5yr vs. 57.3±12.5yr, p=0.001) and had more often an underlying cardiac (53% vs. 15%, p Patients with “borderline PH” represent a distinct group of patients with higher resistance, lower compliance and decreased exercise capacity compared to patients with resting mPAP≤20mmHg. Borderline PH is often associated with a mild respiratory or left heart disease.
Up to 50% of preterm infants admitted to intensive care units require cardiocirculatory support. The aim of the present study was to assess whether simultaneous monitoring of cerebral tissue oxygenation index (cTOI) and peripheral tissue oxygenation index (pTOI) using near-infrared spectroscopy (NIRS) in combination with dedicated intervention guidelines may help avoiding arterial hypotension and catecholamine administration in preterm neonates.Preterm neonates <37 weeks of gestation were included in a single center randomized controlled study. Blood pressure was measured non-invasively or invasively. In the NIRS group, simultaneous cTOI and pTOI monitoring was used starting within 6 h after birth for 24 h to calculate changes in cTOI/pTOI ratio over time. Depending on these changes, interventions including echocardiography, administration of volume or patent ductus arteriosus treatment were performed. In the control group, only routine monitoring and treatment were performed and NIRS signals were not visible. The primary outcome was burden of hypotension within 48 h after initiation of NIRS monitoring.49 preterm neonates were included in each group: NIRS group 33.1 (32.0-34.0) (median: 25-75 centile) weeks of gestation and control group 33.4 (32.3-34.3) weeks of gestation. In the NIRS group, echocardiography was performed in 17 preterm neonates due to NIRS measurements, whereby six neonates received further treatment. Percentage of neonates with any hypotensive episode during the 48-h observational period was 32.6% in the NIRS group and 44.9% in the control group (p = 0.214). Burden of hypotension (i.e., %mmHg of mean arterial pressure < gestational age) was 0.0 (0.0-2.1) mmHg h in the NIRS group and 0.4 (0.0-3.3) mmHg h in the control group (p = 0.313), with observed burden of hypotension being low in both groups. No severe adverse reactions were observed.In preterm neonates using simultaneous peripheral and cerebral NIRS measurements for early detection of centralization followed by predefined interventions led to a non-significant reduction in burden of arterial hypotension.www.ClinicalTrials.gov, identifier: NCT01910467.
