Individual assessment of antihypertensive response by self-starting cumulative sums.

A self-interpreted control chart, on an individualized basis, assesses the effect of a switch from beta-blockers to an angiotensin-converting enzyme (ACE)-inhibitor in a patient with occasional blood pressure (BP) excess. In dense and long data series, the BP and heart rate (HR) of this patient respond to the change in treatment by the test criterion of a self-starting Cumulative Sum (cusum), which reaches values outside a decision interval with a lowering of BP and an increase in HR and vice versa, at least for BP, after treatment cessation. Thereafter, minimal sampling requirements are sought in the same data by applying the same control chart approach to decimated data.

A conformal technique for irradiation of pituitary tumors.

We present a CT/MRI based conformal radiotherapy technique for irradiation of pituitary tumors. In this technique, the patient is treated with three isocentric non-coplanar 18 MV photon beams, with the patient in a natural supine position. The radiation ports are designed based on beam's eye view projections of the CT/MRI delineated target volume.

About-half-weekly (circasemiseptan) component of the endothelin-1 (ET-1) chronome and vascular disease risk.

Plasma ET-1 was measured around the clock on different calendar dates in healthy subjects and in subjects with diabetes and/or with high blood pressure and/or a history of vascular complications (HVDR). A transverse approach, with each subject contributing a single 24-h mean, assessed any about-weekly or half-weekly variation in ET-1. A circasemiseptan component resolved by single cosinor for nondiabetic (but not for diabetic) HVDR subjects (p = 0.

Endothelin-1's chronome indicates diabetic and vascular disease chronorisk.

Plasma endothelin-1 was measured around the clock in 72 subjects. Cosinor methods were used to assess circadian and other recurrent variation and trends, that is, the time structure (chronome) of this peptide. Multifactorial analyses of variance and linear regressions assessed chronome alterations associated with different risk factors: diabetes, obesity, high cholesterol, high blood pressure, vascular disease, smoking, and age.

Excessive circadian amplitude of blood pressure increases risk of ischaemic stroke and nephropathy.

After 48-h ambulatory blood pressure monitoring, the incidence of ischaemic stroke, nephropathy, coronary heart disease and retinopathy was prospectively assessed for 6 years in 297 subjects, including 176 treated patients with an elevated blood pressure mean (MESOR-hypertensives). The relative risk associated with an excessive circadian blood pressure amplitude is 8.2 (95% confidence interval 3.

Resonance of about-weekly human heart rate rhythm with solar activity change.

In several human adults, certain solar activity rhythms may influence an about 7-day rhythm in heart rate. When no about-weekly feature was found in the rate of change in sunspot area, a measure of solar activity, the double amplitude of a circadian heart rate rhythm, approximated by the fit of a 7-day cosine curve, was lower, as was heart rate corresponds to about-weekly features in solar activity and/or relates to a sunspot cycle.

Chronobiometric assessment of autogenic training effects upon blood pressure and heart rate.

Autogenic training, a method of self-hypnosis, lowers the extent of within-day variation of systolic blood pressure assessed by the circadian double amplitude. The blood pressure and heart rate of ten patients, conventionally diagnosed as having hypertension or white-coat hypertension, were automatically monitored at 30-min intervals for 7 days before autogenic training and again for 7 days, at 1 or 2 months after the start of autogenic training (practiced three times daily). The circadian double amplitude of systolic blood pressure of the patients investigated was 3 to 17 mm Hg lower on autogenic training.

Changes in human blood pressure with season, age and solar cycles: a 26 year record.

The record was studied of a 71-year-old, diurnally active (0700-2200 hours) male psychiatrist (G.N.) who self-measured systolic and diastolic blood pressure (BPS and BPD) mostly but not exclusively on Sunday mornings, from 1969 to 1994.

Clinical relevance of about-yearly changes in blood pressure and the environment.

Changes identified by inferential statistics from summer to winter of high to low arterial blood pressures (BP) have been quantified as a large predictable about-yearly BP swing. This condition of a large annual BP amplitude (LABPA) raises concern about hypotension as well as hypertension and raises new questions regarding appropriate guidelines for diagnosis and treatment. Recommendations made in the fall on the basis of data collected in the summer may be totally inadequate in dealing with the patient's condition in the winter.

The circadian rhythm of cortisol in the saliva of young pigs.

Single and population-mean cosinor analyses document a circadian rhythm in salivary cortisol of pigs (p < 0.001). The midline estimated statistic of rhythm, the MESOR (M), is 1.

[Chronobiology in medicine and surgery].

Chronobiology studies predictable variations, rhythms and trends in all forms of life. Each physiologic variable or system in an organism has a time structure which is genetically anchored and capable of being expressed in the absence of external cycles. However, it is normally adjusted by geophysical changes.

The pineal gland and cancer.

The pineal gland is considered today as one of the main organs involved in the transduction process which converts environmental light information into an endocrine response. The gland and its hormone melatonin seem to be important chronoimmunomodulators, and a reduction of the latter was associated with experimental and clinical immunodeficiencies and over the control of the neoplastic process. Moreover, melatonin can be an oncostatic or oncostimulating hormone, depending on the timing of its administration.

Evidence from a chronobiometric approach that chronic smokers, although normotensive, show an increase in diurnal blood pressure.

Objective: To investigate the effects of chronic smoking on the 24 h blood pressure and heart rate pattern in normotensive subjects.

Methods: Twenty-five smokers and 25 age-, weight- and height-matched non-smokers, who were all clinically healthy young men, gave their informed consent to undergo non-invasive, automated, ambulatory blood pressure monitoring for 24 h. The smokers in this study consumed on average 25.

[From Pavlov's recording of time and conditioned reflexes to the chronophysiology of human nutrition].

That I. P. Pavlov understood how important to record the time factor allowed him to anticipate the chronobiological approach in physiology.

Suprachiasmatic nuclei lesions eliminate the group circadian rhythm of systolic arterial pressure but not of heart rate in rats.

The aim of this study was to evaluate the participation of the suprachiasmatic nuclei (SCN) in the generation and synchronization of cardiovascular rhythms. Seven sham-operated and 11 SCN-lesioned animals maintained under 12/12 hr light/dark cycle were used. Systolic arterial pressure (SAP) and heart rate (HR) were measured indirectly during 24-hour periods at 3-4 hour intervals.

[Role of biological clocks in normal conditions, pathology, and in therapy. 2. Clinical chronoradiotherapy of lung cancer].

The present study tests whether body core temperature can serve as a marker rhythm for guiding the timing of the radiotherapy of lung cancer. It was shown that the treatment by radiation at the time of peak core temperature has more effectively then treatment at other circadian stages here investigated.

[The role of biological clocks in formation of standards, pathology, and in therapy. 1. Chronobiological aspects of formation of blood pressure in children with positive and negative family history of relatively high blood pressure].

There are a difference in average values and in amplitudes of about-7 and monthly rhythms of infants' blood pressure with positive and negative family history to the hypertension. Chronobiological approach to these problem can reveal hypertension risk at the early stage of life.

Circadian rhythm of sister chromatid exchanges in human chromosomes.

Since sister chromatid exchange (SCE) relates directly to DNA synthesis which is circadian periodic, this study examines whether a circadian rhythm also characterizes SCEs. In 4-hourly blood samples collected for 48 hours on three diurnally active, nocturnally resting subjects with no family history of chromosome aberrations or instability, a circadian rhythm is demonstrable with an acrophase occurring around 14:45. The circadian amplitude is only of the order of 10% of the MESOR in untreated cultures or in cultures exposed to cefodizime.

Toward salivary-urinary chronosensitivity testing: chronomes of OVX1, M-CSF and CA130.

Several rhythmic components were previously mapped for salivary and/or urinary CA125 and CA130. On the background of such reference standards, OVX1 and M-CSF were assayed on 242 urine samples and 160 saliva samples provided by a 71-year-old patient with a Müllerian/ovarian adenocarcinoma. Serum OVX1 correlates with serum CA125 (P = 0.

Chronometaanalysis: circasemiseptan (3.5-day) pattern in mitotic activity of murine sarcoma after treatment with cyclophosphamide.

This note focuses attention upon infradians in mitotic activity of a murine sarcoma. Starting on day 8 after the inoculation of mice with a sarcoma, three different doses of cyclophosphamide, one dose at three different circadian times, were injected and tumor was sampled with serial independence, mostly at 12-hour intervals during the 4 ensuing days. A metachronanalysis of these heterogeneous data, collected for a different purpose with different doses and at different circadian times, reveals the presence of a circasemiseptan pattern (P < 0.

X-irradiation chronosensitivity and circadian rhythmic proliferation in healthy and sarcoma-carrying rats' bone marrow.

Mitotic activity of bone marrow and tumor of sarcoma-bearing rats and of bone marrow of healthy controls is circadian periodic. Whereas the circadian rhythm in mitotic activity of bone marrow is similar for intact and tumor-bearing rats, with a peak occurring shortly after the onset of the dark (activity) span, the circadian rhythm in mitotic activity of tumor has a much smaller amplitude and a different acrophase occurring late in the dark span. This difference in acrophase of mitotic activity of bone marrow and tumor has important implications for scheduling the administration of oncotherapy.

Circasemiseptan (about-half-weekly) and/or circaseptan (about-weekly) pattern in human mitotic activity?

This review and metachronanalysis was prompted by the presence of a circasemiseptan pattern (P < 0.05) found by population-mean cosinor in published data characterizing murine malignant growth after treatment with cyclophosphamide (1-4). For cancer chronotherapy (5-9), the analyses serve to suggest the desirability to extend the focus beyond circadian aspects of drug timing and drug effect to a broader view that takes into account as much of the body's make-up in time as is practical.

Chronome of urinary 6-sulfoxy-melatonin excretion, circulating CA125, cancer progression and therapeutic response.

The longitudinal follow-up of a patient with an advanced adenocarcinoma of the ovary sheds new light on the involvement of the pineal in carcinogenesis. The changes in the circadian MESOR of 6-sulfoxy-melatonin following a course of chemotherapy may differ in relation to the success or failure of treatment, yet the MESOR does not correlate with tumor burden assessed by circulating CA125. By contrast, the ratio of circaseptan-to-circadian amplitudes involving two chronome components correlates with the cancer marker.

Physical chemistry and the biologic week in the perspective of chrono-oncology.

The computation of spectra and cross-spectra yielding coherences suggests that there exist certain relationships between rhythmicities and electromagnetic fields that are external to the biologic structure studied. Models are here provided which may prompt further investigation by allowing at least tentative, quantitative temporal insights into physico-chemical aspects of the biologic week. On the basis of empirical data, a computation of the oscillating frequency during the diffusion of ions in a magnetic field can be performed.