[Fear paralysis--still a possible cause of crib death].

There is overwhelming evidence that prone sleeping entails more risk of sudden infant death than supine sleeping does. However, no generally accepted biological explanation of this phenomenon has been found. In a viewpoint article in Acta Paediatrica in 1994 the author has re-emphasized that the fear paralysis reflex (tonic immobility) could be a cause of sudden infant death.

Why is there an increased risk for sudden infant death in prone sleeping? Fear paralysis and atrial stretch reflexes implicated?

A number of recent reports have indicated a higher risk of sudden infant death syndrome (SIDS) in the prone sleeping position, compared with the supine position. However, the biological mechanisms for this increased risk have not been established. For this report, two biological explanations are proposed, each of which may be influenced by altered sleeping position in such a way that they may create conditions for increased triggering of SIDS.

[The Chinese runners' revolution].

Scientists are discussing possible explanations of the fantastic improvement in physical performance achieved by Chinese female runners in 1993. Some untraditional procedure must have been used in addition to intense training. The author points out that a study conducted almost a decade ago, and reported in Acupuncture and Electro-Therapeutics Research (1984; 9: 165-80), showed a marked increase in physical performance following low-frequency (2 Hz) transcutaneous electrical nerve stimulation (TENS) in athletes competing in swimming, running and cycling events.

Low-frequency transcutaneous nerve stimulation in mild/moderate hypertension.

Low-frequency peripheral nerve stimulation may induce widespread cutaneous and muscular vasodilatation in animals and humans due to sympatho-inhibition. This response has in humans been shown to be associated with a lowering of the systemic vascular resistance and arterial pressure. In the present study the effectiveness of low-frequency (2 Hz) transcutaneous electrical nerve stimulation (TNS) has been examined in 46 patients, all 41-43 years of age, with a primary diagnosis of uncomplicated mild/moderate hypertension (90-115 mmHg diastolic pressure).

[Sudden infant death--an emotional trigger mechanism].

Southall and coworkers have demonstrated in a recent study that attacks of lifelessness with sudden and severe hypoxemia and cyanosis are caused by a combination of respiratory arrest in expiration, and a right-to-left shunting of the blood through the lungs due to increased pulmonary vascular resistance. This mechanism is thought to be the cause of death. They have also defined the precipitating factors which are sudden, naturally occurring stimuli causing fear, anger or pain.

Transcutaneous nerve stimulation in patients with coronary arterial disease: haemodynamic and biochemical effects.

Low-frequency transcutaneous nerve stimulation (TNS) is known to produce widespread and prolonged vasodilation in skin and muscles. In the present study the effects of low-frequency TNS on coronary and systemic haemodynamics, myocardial blood flow, myocardial oxygen consumption, myocardial free fatty acid and lactate uptake were measured at rest in 16 normotensive patients, with coronary heart disease, undergoing diagnostic cardiac catheterization. In addition, vasoactive intestinal polypeptides (VIP) and noradrenaline were measured in the coronary sinus and the aorta.

Sudden infant death syndrome during weekends and holidays in Norway in 1967-1985.

A few previous studies have revealed an increased risk for sudden infant death syndrome (SIDS) during weekends and holidays suggesting environmental factors as potential trigger mechanisms for death. In the present study, the weekend/holiday effect has been assessed on the basis of 1480 SIDS cases in 19 Norwegian counties during a 19-year period (1967-85). The phenomenon has been confirmed for 17 of the 19 counties.

Effects of an angiotensin converting enzyme (ACE) inhibitor on plasma endorphin level.

1. In addition to their antihypertensive effect, ACE inhibitors have been reported to increase general well-being, general health and vitality and work performance. The cause of these effects is not known.

[Treatment of fibromyalgia by low-frequency transcutaneous nerve stimulation].

Fibromyalgia is a syndrome of a non-inflammatory nature characterized first and foremost by great pain in a number of tendons and muscles. The syndrome has only recently been delineated as a separate entity, the criteria for which are still being discussed. Recent studies have revealed reduced oxygenation in the trigger points, apparently a result of reduced microcirculation due to sympatho-inhibition (5).

Electrocardiac responses associated with the fear paralysis reflex in infant rabbits and rats. Relation to sudden infant death.

It is a controversial issue whether non-hereditary prolonged cardiac repolarization (increased QT-interval in ECG) is a cause of sudden infant death syndrome (SIDS). The QT-interval has, however, been found to be normal at rest. The present experiments on infant rats and infant and adult rabbits demonstrate a transient QT-prolongation during the innate fear paralysis reflex elicited by a variety of frightening stimuli.

[Nocebo--the opposite of placebo].

It is well documented that placebo represents Pavlovian conditioned reflexes activated by positive anticipation of healing. The pain-relieving effects of placebo are due to a psychical activation of the endogenous opioid-serotonergic, pain-inhibitory descending system. The opposite effect is nocebo, a term introduced in 1961 by Kennedy (10).

[Sudden infant death--the QT interval in ECG and bradyarrhythmias].

Prolongation of ventricular repolarization, as evidenced from an increased QT-interval, makes the ventricles more susceptible to fibrillation. The theory has previously been advanced that some cases of sudden infant death syndrome may be due to a non-hereditary QT-prolongation, resulting in fibrillation and cardiac death. This theory has been seriously doubted, since in subsequent long series of recordings in newborns the QT-interval has been found normal at rest.

[Nocebo--the antipode to placebo].

It is well documented that placebo represents Pavlovian conditioned reflexes activated by positive anticipation of healing. The pain-relieving effects of placebo are due to a psychical activation of the endogenous opioid-serotonergic, pain-inhibitory descending system. The opposite effect is nocebo, a term introduced in 1961 by Kennedy.

Transcutaneous nerve stimulation (TNS) in tinnitus.

Low-frequency (2 Hz) TNS applied distally to peripheral nerves of the upper extremity is known to induce a wide-spread, non-segmental and prolonged relief of pain and an increased microcirculation due to sympatho-inhibition in a number of vascular beds. Such stimulation was administered in 29 tinnitus patients of various etiology. Reduction of tinnitus was encountered in 9 subjects in response to a 45-min TNS-session.

Increase of plasma beta-endorphins in connective tissue massage.

1. Connective tissue massage produces relief of pain and increases microcirculation in a number of vascular beds. 2.

Promoted healing of leprous ulcers by transcutaneous nerve stimulation.

Low-frequency (2 Hz) transcutaneous electrical nerve stimulation (TNS) may produce widespread and prolonged increases in skin temperature in patients with peripheral vascular insufficiency due to improved microcirculation. The method has previously been used successfully to potentiate healing of chronic ulcers of various etiology. The present report describes a similar study, using TNS treatment in attempts to accelerate healing of chronic leprous ulcers that had resisted treatment for several months or years.

Successful treatment of esophageal dysmotility and Raynaud's phenomenon in systemic sclerosis and achalasia by transcutaneous nerve stimulation. Increase in plasma VIP concentration.

Dysphagia has been successfully treated by low-frequency transcutaneous nerve stimulation (TNS) in two patients with achalasia and in six patients with systemic sclerosis. A 30- to 45-min stimulation session was followed by augmentation of peristalsis in the lower half of the esophagus and relaxation of the gastroesophageal sphincter, with relief of dysphagia. The sclerotic patients were also relieved of invaliding Raynaud's phenomenon.

The sudden infant death syndrome induced by "the fear paralysis reflex'?

The sudden infant death syndrome (SIDS) is the greatest single cause of death between one month and one year of age in industrial countries. Its etiology still remains a mystery despite extensive research during the past decades. The outstanding problem is to define the trigger mechanism leading to death.

Vasoactive intestinal polypeptides in connective tissue massage. With a note on VIP in heat pack treatment.

The vasoactive intestinal polypeptide (VIP) is a powerful dilatator in a number of vascular beds. Plasma VIP is increased in active physical exercise and in transcutaneous nerve stimulation. Plasma VIP has in this study been measured during other physiotherapeutic procedures causing skin vasodilatation, such as connective tissue massage and heat packs.

Successful treatment of itching and atopic eczema by transcutaneous nerve stimulation.

Low-frequency (2 Hz) transcutaneous electrical nerve stimulation (TNS) may produce prolonged and widespread sympatho-inhibition resulting in improved skin microcirculation with increased skin temperature in patients with peripheral vascular insufficiency. The method has previously been used successfully to improve peripheral circulation in such patients and to accelerate healing of chronic skin ulcers of various etiology. The present report deals with healing of atopic eczema and relief of pruritus by low-frequency TNS treatment in a patient who was followed for 2 years, the first 8 months with daily recordings of the effects, and then for an additional 16 months during which period TNS only occasionally was used.