Corticospinal excitability during motor preparation of upper extremity reaches reflects flexor muscle synergies: A novel principal component-based motor evoked potential analyses.

Background: Previous research has shown that noninvasive brain stimulation can be used to study how the central nervous system (CNS) prepares the execution of a motor task. However, these previous studies have been limited to a single muscle or single degree of freedom movements (e.g.

Association of DPP-4 Concentrations with the Occurrence of Gestational Diabetes Mellitus and Excessive Gestational Weight Gain.

Gestational diabetes mellitus (GDM) is considered one of the most common diseases that occur during pregnancy. In addition to increasing the risk of numerous complications throughout gestation, it is also believed to have a long-term potential to impact the risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular disease for the mother and her offspring. While there are clear guidelines for healthy weight gain in pregnancy depending on pre-pregnancy BMI, as well as dietary and training recommendations to achieve this, an increasing number of women are experiencing excessive gestational weight gain (EGWG).

Impact of Obesity and Diabetes in Pregnant Women on Their Immunity and Vaccination.

Pregnant women with obesity and diabetes are at increased risk of developing infections and other complications during pregnancy. Several mechanisms are involved in the immunological mechanisms that contribute to reduced immunity in these populations. Both obesity and diabetes are associated with chronic low-grade inflammation that can lead to an overactive immune response.

Microleakage in Class II composite restorations with margins below the CEJ: in vitro evaluation of different restorative techniques.

Objectives: The purpose of this in vitro study was to evaluate the microleakage in "deep" Class II composite restorations with gingival cavosurface margin below the CEJ (cemento-enamel junction) and restored with different techniques.

Study Design: Fifty human teeth were used. In each tooth two standardized Class II slot cavities (on mesial and on distal surfaces) were prepared: the buccolingual extension of the cavities was 4 mm; the gingival wall was located in dentin/cementum (2 mm beyond the CEJ).

Hyperinsulinemia increases placenta endothelin-converting enzyme-1 expression in trophoblasts.

Background: Exogenous hyperisulinemia causes pregnancy, induced hypertension and intrauterine growth restriction (IUGR) in pregnant rats. Hyperinsulinemia may increase production of endothelin-1 (ET-1), produced by sequential proteolysis of the big endothelin by the endothelin-converting enzyme (ECE)-1, the expression of which is examined here in the placenta, kidney, heart, and liver.

Methods: Rats were rendered hyperinsulinemic by subcutaneous insulin pellet, mated and followed to the twenty-first day of pregnancy.

The role of blood pressure variability in misdiagnosed clinic hypertension.

Blood pressure (BP) assessment may be vulnerable to bias by increased BP variability. Uncertainty in determining BP control is inherent to the clinic setting. We analyzed a registry of 3949 patients referred for ambulatory BP monitoring.

Intrauterine growth restriction and shallower implantation site in rats with maternal hyperinsulinemia are associated with altered NOS expression.

Nitric oxide synthase (NOS) plays an important role in hypertensive disorders of pregnancy. In the context of the known association between hyperinsulinemia and hypertension, we studied the expression of the 3 isoforms of NOS (neuronal-nNOS, inducible-iNOS, and endothelial-eNOS) in the placenta and implantation site of our insulin-induced intrauterine growth restriction (IUGR) rat model in which the normal gestational blood pressure decline is abrogated. The fetuses of hyperinsulinemic dams were significantly smaller than those of normal pregnant dams (male fetal weight=4.

The association of a simple blood pressure-independent parameter derived from ambulatory blood pressure variability with short-term mortality.

We explored the predictive ability of the blood pressure variability ratio (BPVR), defined as the ratio of 24-h ambulatory systolic blood pressure variability to diastolic variability, and evaluated its predictable relation with blood pressure and the Ambulatory Arterial Stiffness Index (AASI). A total of 3433 consecutive patients were followed up to 16 years for all-cause mortality. Blood pressure variability was expressed by the standard deviation.

Jim Peters' collapse in the 1954 Vancouver Empire Games marathon.

On 7 August 1954, the world 42 km marathon record holder, Jim Peters, collapsed repeatedly during the final 385 metres of the British Empire and Commonwealth Games marathon held in Vancouver, Canada. It has been assumed that Peters collapsed from heatstroke because he ran too fast and did not drink during the race, which was held in windless, cloudless conditions with a dry-bulb temperature of 28 degrees C. Hospital records made available to us indicate that Peters might not have suffered from exertional heatstroke, which classically produces a rectal temperature > 42 degrees C, cerebral effects and, usually, a fatal outcome without vigorous active cooling.

A modified ambulatory arterial stiffness index is independently associated with all-cause mortality.

Dependence of the ambulatory arterial stiffness index (AASI) on data scattering interferes with its potential clinical relevance. We assessed the correlates and all-cause mortality associations of a modified AASI (s-AASI). AASI was derived from the 24-h diastolic vs.

Sex differences in ambulatory blood pressure monitoring.

Purpose: Referral to ambulatory blood pressure monitoring may have bearing upon blood pressure control and prognosis. We describe sex-related differences in referral for ambulatory monitoring and their prognostic impact.

Methods: Between 1991 and 2005, 3957 patients were monitored in our ambulatory monitoring service, of whom 2114 (53%) were women.

The white coat phenomenon is benign in referred treated patients: a 14-year ambulatory blood pressure mortality study.

Objective: Previous reports on the prognosis of white coat hypertension are ambiguous. We aimed to determine the prognostic implications of the white coat phenomenon in treated patients.

Methods: Our 14-year hospital-based ambulatory blood pressure (BP) monitoring prospective database was analyzed for all-cause mortality.

Blunted heart rate dip during sleep and all-cause mortality.

Background: Although it has been somewhat overlooked, resting heart rate is an established predictor of cardiovascular and noncardiovascular outcome. We assessed the determinants and mortality associations of heart rate measured during ambulatory blood pressure monitoring (ABPM) to evaluate its informativeness during activity and sleep.

Methods: We studied a cohort of 3957 patients aged 55 +/- 16 (mean +/- SD) years (58% treated for hypertension) who were referred for ABPM during 1991 to 2005.

Predictors of all-cause mortality in clinical ambulatory monitoring: unique aspects of blood pressure during sleep.

The prognostic value of sleep blood pressure reported by recent studies is variable. Our aim was to examine the relationship of sleep blood pressure, measured by 24-hour ambulatory blood pressure monitoring, with all-cause mortality. We studied a cohort of 3957 patients aged 55+/-16 (58% treated) referred for ambulatory monitoring (1991-2005).

Lack of association between body-mass index and white-coat hypertension among referred patients.

Objective: The association between body-mass index and ambulatory blood pressure variables is not straightforward. Specifically, there are contradicting data regarding the correlation between obesity and white-coat hypertension. The aim of this report was to study the relationship between body-mass index and the white-coat effect, defined by ambulatory monitoring.

Reproducibility of white-coat and masked hypertension in ambulatory BP monitoring.

Background: White-coat hypertension and masked hypertension have clinical and prognostic consequences. However, reproducibility of these phenomena is unknown. We examined the reproducibility of the white-coat and masking effects with real-life ambulatory blood pressure monitoring (ABPM).

How should patients treated with alpha-blockers be followed? Insights from an ambulatory blood pressure monitoring database.

Objective: Adrenergic alpha-antagonists have been suggested to confer lesser protection, compared to diuretics, when used as first agents for hypertension. While differences in clinic blood pressure may be partly responsible, this inferiority is unexpected in light of the metabolic advantages of alpha-blockade. The aim of this study was to evaluate the relationship between use of alpha-blockers and blood pressure dipping.

Normal ambulatory blood pressure: a clinical-practice-based analysis of recent American Heart Association recommendations.

Purpose: The American Heart Association Council on High Blood Pressure Research recently issued recommendations for blood pressure measurement in humans. According to these recommendations, normal 24-hour ambulatory blood pressure is defined as less than 130/80 mm Hg. Concurrently, normal daytime and nighttime blood pressure levels are defined as less than 135/85 mm Hg and less than 120/70 mm Hg, respectively.

In clinical practice, masked hypertension is as common as isolated clinic hypertension: predominance of younger men.

Background: The prevalence and implications of masked hypertension are under investigation. The aim of this study was to investigate the clinical characteristics associated with masked hypertension in subjects referred for ambulatory blood pressure (BP) monitoring.

Methods: We analyzed 1494 BP monitoring sessions.

Normal ambulatory blood pressure: a clinical practice-based comparison of two recently published definitions.

The European Society of Hypertension (ESH) has issued guidelines for the detection and treatment of hypertension. According to these guidelines, normal 24-h ambulatory blood pressure (ABP) is defined as lower than 125/80 mmHg. Another publication of ESH recommendations for blood pressure (BP) measurement defines normal awake and asleep blood pressure as lower than 135/85 and 120/70 mmHg, respectively.

Blood pressure dipping is reproducible in clinical practice.

Objective: Blood pressure dipping pattern has clinical and prognostic consequences. However, reproducibility of night-time blood pressure fall during 24-h ambulatory blood pressure monitoring is considered limited. This limited reproducibility is possibly a result of inadequate day-night definitions.

Pulse pressure is more susceptible to the white coat effect than is systolic blood pressure: observations from real-life ambulatory blood pressure monitoring.

Background: Pulse pressure is a derivative of arterial stiffness. We have previously demonstrated ambulatory pulse pressure to be relatively independent from the blood pressure (BP) lowering during sleep, and thus of a neurogenic effect. On the other hand, white coat BP effects are thought to involve neurogenic activation.

Ambulatory pulse pressure is a relatively sleep-independent variable.

Objectives: Characterization of sleep-induced pulse and mean arterial pressure (MAP) dip.

Design: Prospective study of consecutive referred patients.

Setting: Hypertension unit of community university hospital.