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Fujita Y, Kamijo YI, Kinoshita T, Hashizaki T, Murai K, Yoshikawa T, Umemoto Y, Kaminaka C, Shibasaki M, Tajima F, Nishimura Y. Observations of cold-induced vasodilation in persons with spinal cord injuries. Spinal Cord 2024; 62:170-177. [PMID: 38388759 PMCID: PMC11003866 DOI: 10.1038/s41393-024-00960-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024]
Abstract
STUDY DESIGN Acute experimental study. OBJECTIVES Cold-induced vasodilation is a local mechanism of protection against frostbite in non-injured persons. We assessed whether an increase in skin blood flow (SkBF) during local cooling (LC) was observed in individuals with spinal cord injuries (SCIs) and if the response patterns differed between region levels or sites. SETTING Laboratory of Wakayama Medical University and the affiliated clinics, Japan. METHODS A local cooler device (diameter 4 cm) was placed on the chest (sensate) and right thigh (non-sensate) in persons with cervical (SCIC; n = 9) and thoracolumbar SCIs (SCITL; n = 9). After the surface temperature under the device was controlled at 33 °C for 10 min (baseline), LC (-0.045 °C/s) was applied and the skin temperature was maintained at 15 and 8 °C for 15 min of each stage. SkBF (laser Doppler flowmetry) was monitored using a 1-mm needle-type probe inserted into its center. RESULTS The percent change in SkBF (%ΔSkBF) on the chest remained unchanged until the end of 15 °C stage; thereafter, it increased to a level at least 70% greater than the baseline during the 8 °C stage in both groups. The %ΔSkBF on the thigh in both SCIC and SCITL notably increased from 8 and 6 min respectively, during the 8°C stage, compared to 1 min before the stage; however, it did not exceed the baseline level. CONCLUSIONS An increase in SkBF during LC was observed both in the sensate and non-sensate areas in SCIs, although the magnitude was larger in the sensate area.
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Affiliation(s)
- Yasuhisa Fujita
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yoshi-Ichiro Kamijo
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan.
- Department of Rehabilitation Medicine, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.
| | - Tokio Kinoshita
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takamasa Hashizaki
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kouta Murai
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Tatsuya Yoshikawa
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasunori Umemoto
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Chikako Kaminaka
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | | | - Fumihiro Tajima
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yukihide Nishimura
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
- Department of Rehabilitation Medicine, Iwate Medical University, Yahaba-cho, Japan
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Niclou A, Sarma M, Levy S, Ocobock C. To the extreme! How biological anthropology can inform exercise physiology in extreme environments. Comp Biochem Physiol A Mol Integr Physiol 2023; 284:111476. [PMID: 37423419 DOI: 10.1016/j.cbpa.2023.111476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
The fields of biological anthropology and exercise physiology are closely related and can provide mutually beneficial insights into human performance. These fields often use similar methods and are both interested in how humans function, perform, and respond in extreme environments. However, these two fields have different perspectives, ask different questions, and work within different theoretical frameworks and timescales. Biological anthropologists and exercise physiologists can greatly benefit from working together when examining human adaptation, acclimatization, and athletic performance in the extremes of heat, cold, and high-altitude. Here we review the adaptations and acclimatizations in these three different extreme environments. We then examine how this work has informed and built upon exercise physiology research on human performance. Finally, we present an agenda for moving forward, hopefully, with these two fields working more closely together to produce innovative research that improves our holistic understanding of human performance capacities informed by evolutionary theory, modern human acclimatization, and the desire to produce immediate and direct benefits.
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Affiliation(s)
- Alexandra Niclou
- Pennington Biomedical Research Center, Baton Rouge, LA, United States of America. https://twitter.com/fiat_luxandra
| | - Mallika Sarma
- Human Space Flight Lab, Johns Hopkins School of Medicine, Baltimore, MD, United States of America. https://twitter.com/skyy_mal
| | - Stephanie Levy
- Department of Anthropology, CUNY Hunter College, New York, NY, United States of America; New York Consortium in Evolutionary Primatology, New York, NY, United States of America. https://twitter.com/slevyscience
| | - Cara Ocobock
- University of Notre Dame Department of Anthropology, Notre Dame, IN, United States of America; Eck Institute for Global Health, Institute for Educational Initiatives, University of Notre Dame, United States of America.
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Sellers AJ, Khovalyg D, van Marken Lichtenbelt W. Thermoregulation of Tuvan pastoralists and Western Europeans during cold exposure. Am J Hum Biol 2023; 35:e23933. [PMID: 37314240 DOI: 10.1002/ajhb.23933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVES This study compared the metabolic and vascular responses, to whole-body and finger cold exposure, of a traditional population lifelong exposed to extreme cold winters with Western Europeans. METHODS Thirteen cold acclimatized Tuvan pastoralist adults (45 ± 9 years; 24.1 ± 3.2 kg/m2 ) and 13 matched Western European controls (43 ± 15 years; 22.6 ± 1.4 kg/m2 ) completed a whole-body cold (10°C) air exposure test and a cold-induced vasodilation (CIVD) test, which involved the immersion of the middle finger into ice-water for 30 min. RESULTS During the whole-body cold exposure, the durations until the onset of shivering for three monitored skeletal muscles were similar for both groups. Cold exposure increased the Tuvans' energy expenditure by (mean ± SD) 0.9 ± 0.7 kJ min-1 and the Europeans' by 1.3 ± 1.54 kJ min-1 ; these changes were not significantly different. The forearm-fingertip skin temperature gradient of the Tuvans was lower, indicating less vasoconstriction, than the Europeans during the cold exposure (0 ± 4.5°C vs. 8.8 ± 2.7°C). A CIVD response occurred in 92% of the Tuvans and 36% of the Europeans. In line, finger temperature during the CIVD test was higher in the Tuvans than the Europeans (13.4 ± 3.4°C vs. 3.9 ± 2.3°C). CONCLUSION Cold-induced thermogenesis and the onset of shivering were similar in both populations. However, vasoconstriction at the extremities was reduced in the Tuvans compared to the Europeans. The enhanced blood flow to the extremities could be beneficial for living in an extreme cold environment by improving dexterity, comfort, and reducing the risk of cold-injuries.
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Affiliation(s)
- Adam J Sellers
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Dolaana Khovalyg
- Laboratory of Integrated Comfort Engineering (ICE), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Wouter van Marken Lichtenbelt
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
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Keramidas ME, Kölegård R, Gäng P, Wilkins F, Elia A, Eiken O. Acral skin vasoreactivity and thermosensitivity to hand cooling following 5 days of intermittent whole-body cold exposure. Am J Physiol Regul Integr Comp Physiol 2022; 323:R1-R15. [PMID: 35502861 PMCID: PMC9190731 DOI: 10.1152/ajpregu.00021.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We sought to examine whether short-term whole-body cold acclimation would modulate finger vasoreactivity and thermosensitivity to localized cooling. Fourteen men were equally assigned to either the experimental (CA) or the control (CON) group. The CA group was immersed to the chest in 14°C water for ≤120 min daily over a 5-day period, while the skin temperature of the right-hand fingers was clamped at ~35.5°C. The CON group was instructed to avoid any cold exposure during this period. Before and after the intervention, both groups performed, on two different consecutive days, a local cold provocation trial consisting of a 30-min hand immersion in 8°C water, while immersed to the chest once in 21°C (mild-hypothermic trial; 0.5°C fall in rectal temperature from individual pre-immersion values) and on the other occasion in 35.5°C (normothermic trial). In the CA group, the cold-induced reduction in finger temperature was less (mild-hypothermic trial: P = 0.05; normothermic trial: P = 0.02), and the incidence of the cold-induced vasodilation episodes was greater (in normothermic trials: P = 0.04) in the post than in the pre-acclimation trials. The right-hand thermal discomfort was also attenuated (mild-hypothermic trial: P = 0.04; normothermic trial: P = 0.01). The finger temperature responses of the CON group did not vary between testing periods. Our findings suggest that repetitive whole-body exposure to severe cold within a week, may attenuate finger vasoreactivity and thermosensitivity to localized cooling. These regional thermo-adaptions were ascribed to central neural habituation produced by the iterative, generalized cold stimulation.
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Affiliation(s)
- Michail E Keramidas
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Roger Kölegård
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Pit Gäng
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Frederick Wilkins
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Antonis Elia
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Ola Eiken
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
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Camerone EM, Battista S, Benedetti F, Carlino E, Sansone LG, Buzzatti L, Scafoglieri A, Testa M. The Temporal Modulation of Nocebo Hyperalgesia in a Model of Sustained Pain. Front Psychiatry 2022; 13:807138. [PMID: 35401252 PMCID: PMC8983965 DOI: 10.3389/fpsyt.2022.807138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The direction and the magnitude of verbal suggestions have been shown to be strong modulators of nocebo hyperalgesia, while little attention has been given to the role of their temporal content. Here, we investigate whether temporal suggestions modulate the timing of nocebo hyperalgesia in an experimental model of sustained pain. METHODS Fifty-one healthy participants were allocated to one of three groups. Participants received an inert cream and were instructed that the agent had either hyperalgesic properties setting in after 5 (Nocebo 5, N5) or 30 (Nocebo 30, N30) minutes from cream application, or hydrating properties (No Expectation Group, NE). Pain was induced by the Cold Pressure Test (CPT) which was repeated before cream application (baseline) and after 10 (Test10) and 35 (Test35) minutes. Changes in pain tolerance and in HR at each test point in respect to baseline were compared between the three groups. RESULTS Tolerance change at Test 10 (Δ10) was greater in N5 (MED = -36.8; IQR = 20.9) compared to NE (MED = -5.3; IQR = 22.4; p < 0.001) and N30 (MED = 0.0; IQR = 23.1; p < 0.001), showing that hyperalgesia was only present in the group that expected the effect of the cream to set in early. Tolerance change at Test 35 (Δ35) was greater in N5 (MED = -36.3; IQR = 35.3; p = 0.002) and in N30 (MED = -33.3; IQR = 34.8; p = 0.009) compared to NE, indicating delayed onset of hyperalgesia in N30, and sustained hyperalgesia in N5. No group differences were found for HR. CONCLUSIONS Our study demonstrated that temporal expectations shift nocebo response onset in a model of sustained pain.
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Affiliation(s)
- Eleonora Maria Camerone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy.,Department of Psychology, University of Milan-Bicocca, Milan, Italy.,Department of Physiotherapy, Human Physiology and Anatomy, Experimental Anatomy Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Simone Battista
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy
| | - Fabrizio Benedetti
- Department of Neuroscience, University of Turin Medical School, Turin, Italy.,Plateau Rosà Laboratories, Plateau Rosà, Switzerland
| | - Elisa Carlino
- Department of Neuroscience, University of Turin Medical School, Turin, Italy
| | - Lucia Grazia Sansone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy
| | - Luca Buzzatti
- Department of Physiotherapy, Human Physiology and Anatomy, Experimental Anatomy Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,School of Allied Health, Anglia Ruskin University (ARU), Cambridge, United Kingdom
| | - Aldo Scafoglieri
- Department of Physiotherapy, Human Physiology and Anatomy, Experimental Anatomy Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy.,Department of Physiotherapy, Human Physiology and Anatomy, Experimental Anatomy Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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6
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Tsai SH, Tung CS, Liu YP, Lin YC, Lin CC. Spectral analysis of cardiovascular oscillations in the 7-day regimen of losartan administration with and without cold stress. CHINESE J PHYSIOL 2022; 65:171-178. [DOI: 10.4103/0304-4920.354802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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7
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Heat acclimation enhances the cold-induced vasodilation response. Eur J Appl Physiol 2021; 121:3005-3015. [PMID: 34245332 PMCID: PMC8505386 DOI: 10.1007/s00421-021-04761-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 06/23/2021] [Indexed: 11/27/2022]
Abstract
Purpose It has been reported that the cold-induced vasodilation (CIVD) response can be trained using either regular local cold stimulation or exercise training. The present study investigated whether repeated exposure to environmental stressors, known to improve aerobic performance (heat and/or hypoxia), could also provide benefit to the CIVD response. Methods Forty male participants undertook three 10-day acclimation protocols including daily exercise training: heat acclimation (HeA; daily exercise training at an ambient temperature, Ta = 35 °C), combined heat and hypoxic acclimation (HeA/HypA; daily exercise training at Ta = 35 °C, while confined to a simulated altitude of ~ 4000 m) and exercise training in normoxic thermoneutral conditions (NorEx; no environmental stressors). To observe potential effects of the local acclimation on the CIVD response, participants additionally immersed their hand in warm water (35 °C) daily during the HeA/HypA and NorEx. Before and after the acclimation protocols, participants completed hand immersions in cold water (8 °C) for 30 min, followed by 15-min recovery phases. The temperature was measured in each finger. Results Following the HeA protocol, the average temperature of all five fingers was higher during immersion (from 13.9 ± 2.4 to 15.5 ± 2.5 °C; p = 0.04) and recovery (from 22.2 ± 4.0 to 25.9 ± 4.9 °C; p = 0.02). The HeA/HypA and NorEx protocols did not enhance the CIVD response. Conclusion Whole-body heat acclimation increased the finger vasodilatory response during cold-water immersion, and enhanced the rewarming rate of the hand, thus potentially contributing to improved local cold tolerance. Daily hand immersion in warm water for 10 days during HeA/Hyp and NorEx, did not contribute to any changes in the CIVD response.
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Yurkevicius BR, Alba BK, Seeley AD, Castellani JW. Human cold habituation: Physiology, timeline, and modifiers. Temperature (Austin) 2021; 9:122-157. [PMID: 36106151 PMCID: PMC9467574 DOI: 10.1080/23328940.2021.1903145] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Habituation is an adaptation seen in many organisms, defined by a reduction in the response to repeated stimuli. Evolutionarily, habituation is thought to benefit the organism by allowing conservation of metabolic resources otherwise spent on sub-lethal provocations including repeated cold exposure. Hypermetabolic and/or insulative adaptations may occur after prolonged and severe cold exposures, resulting in enhanced cold defense mechanisms such as increased thermogenesis and peripheral vasoconstriction, respectively. Habituation occurs prior to these adaptations in response to short duration mild cold exposures, and, perhaps counterintuitively, elicits a reduction in cold defense mechanisms demonstrated through higher skin temperatures, attenuated shivering, and reduced cold sensations. These habituated responses likely serve to preserve peripheral tissue temperature and conserve energy during non-life threatening cold stress. The purpose of this review is to define habituation in general terms, present evidence for the response in non-human species, and provide an up-to-date, critical examination of past studies and the potential physiological mechanisms underlying human cold habituation. Our aim is to stimulate interest in this area of study and promote further experiments to understand this physiological adaptation.
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Affiliation(s)
- Beau R. Yurkevicius
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Billie K. Alba
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Afton D. Seeley
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
- Oak Ridge Institute of Science and Education, Belcamp, MD, USA
| | - John W. Castellani
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
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Finger constrictor and thermoperceptual responsiveness to localised cooling following 5 weeks of intermittent regional exposures to moderately augmented transmural vascular pressure. Microvasc Res 2021; 137:104181. [PMID: 34015276 DOI: 10.1016/j.mvr.2021.104181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/15/2021] [Accepted: 05/13/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE To examine the effects of prolonged intermittent exposures to moderately increased transmural pressure on finger vasoreactivity and thermoperception to localised cooling. METHODS Eleven men completed a 5-week regimen (3 sessions·week-1; 55 min·session-1), during which the vasculature in one arm (EXP) was exposed intermittently (10-min exposure: 5-min pause) to increased transmural pressure (from +65 mmHg week-1 to +105 mmHg week-5). Before and after the regimen, finger cutaneous vascular conductance (CVC), temperature (Tavg), and thermoperception (thermal sensation, discomfort and pain) were monitored during a 30-min hand cold (8 °C water) provocation trial. The responses of the non-trained hand were examined during an additional cold trial. RESULTS After the regimen, baseline finger CVC and Tavg were higher in both hands (p ≤ 0.01). During cooling, neither finger CVC nor Tavg were modified (p > 0.05). Yet the magnitude of the cold-induced drop of CVC was augmented in both hands, and to a similar extent (p ≤ 0.02). The regimen alleviated thermal pain in both hands (p ≤ 0.02); the sensation of coldness and thermal discomfort were attenuated mainly in the EXP hand (p = 0.02). CONCLUSIONS Present findings indicate that iterative local exposures to augmented intravascular pressure do not alter finger vasoreactivity to localised cooling. The pressure training, however, might impair finger basal vasomotor tone, and aggravate the magnitude of constrictor responsiveness to cooling. The pressure training also elicits thermoperceptual desensitisation to noxious thermal stimulus. To large extent, these vascular and perceptual adjustments seem to be transferred to the cutaneous vasculature of the non-trained limb.
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Camerone EM, Wiech K, Benedetti F, Carlino E, Job M, Scafoglieri A, Testa M. 'External timing' of placebo analgesia in an experimental model of sustained pain. Eur J Pain 2021; 25:1303-1315. [PMID: 33619820 DOI: 10.1002/ejp.1752] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Research on placebo analgesia commonly focuses on the impact of information about direction (i.e., increase or decrease of pain) and magnitude of the expected analgesic effect, whereas temporal aspects of expectations have received little attention so far. In a recent study, using short-lasting, low-intensity stimuli, we demonstrated that placebo analgesia onset is influenced by temporal information. Here, we investigate whether the same effect of temporal suggestions can be found in longer lasting, high-intensity pain in a Cold Pressor Test (CPT). METHODS Fifty-three healthy volunteers were allocated to one of three groups. Participants were informed that the application of an (inert-)cream would reduce pain after 5 min (P5) or 30 min (P30). The third group was informed that the cream only had hydrating properties (NE). All participants completed the CPT at baseline and 10 (Test 10) and 35 min (Test 35) following cream application. Percentage change in exposure time (pain tolerance) from baseline to Test 10 (Δ10) and to Test 35 (Δ35) and changes in heart rate (HR) during CPT were compared between the three groups. RESULTS Δ10 was greater in P5 than in NE and P30, indicating that analgesia was only present in the group that was expecting an early onset of analgesia. Δ35 was greater in P5 and P30 compared to NE, reflecting a delayed onset of analgesia in P30 and maintained analgesia in P5. HR differences between groups were not significant. CONCLUSIONS Our data suggest that 'externally timing' of placebo analgesia may be possible for prolonged types of pain. SIGNIFICANCE Research on placebo effects mainly focuses on the influence of information about direction (i.e., increase or decrease of pain) and magnitude (i.e., strong or weak) of the expected effect but ignores temporal aspects of expectations. In our study in healthy volunteers, the reported onset of placebo analgesia followed the temporal information provided. Such 'external timing' effects could not only aid the clinical use of placebo treatment (e.g., in open-label placebos) but also support the efficacy of active drugs.
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Affiliation(s)
- Eleonora Maria Camerone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Science (DINOGMI), University of Genoa, Genoa, Italy
| | - Katja Wiech
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Fabrizio Benedetti
- Department of Neuroscience, University of Turin Medical School, Turin, Italy.,Plateau Rosà Laboratories, Plateau Rosà, Italy
| | - Elisa Carlino
- Department of Neuroscience, University of Turin Medical School, Turin, Italy
| | - Mirko Job
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Science (DINOGMI), University of Genoa, Genoa, Italy
| | - Aldo Scafoglieri
- Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussels, Brussels, Belgium
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Science (DINOGMI), University of Genoa, Genoa, Italy
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11
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Effects of acute dietary nitrate supplementation on cold-induced vasodilation in healthy males. Eur J Appl Physiol 2021; 121:1431-1439. [PMID: 33620545 DOI: 10.1007/s00421-021-04621-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/05/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Cold-induced vasodilation (CIVD) is a paradoxical rise in blood flow to the digits that occur during prolonged cold exposure. CIVD is thought to occur through active vasodilation and/or sympathetic withdrawal, where nitric oxide (NO) may play a key role in mediating these mechanisms. Beetroot juice (BRJ) is high in dietary nitrate (NO3-) which undergoes sequential reduction to nitrite (NO2-) and subsequently NO. Using a double-blind, randomized, crossover design, we examined the effect of acute BRJ supplementation on the CIVD response in 10 healthy males. METHODS Participants had a resting blood pressure measurement taken prior to ingesting 140 mL of nitrate-rich BRJ (13 mmol NO3-) or a NO3--free placebo (PLA). After 2 h, participants immersed their hand in neutral water (~ 35 °C) for 10 min of baseline before cold water immersion (~ 8 °C) for 30 min. Laser-Doppler fluxmetry and skin temperature were measured continuously on the digits. RESULTS Compared to PLA (100 ± 3 mmHg), acute BRJ supplementation significantly reduced mean arterial pressure at -30 min (96 ± 2 mmHg; p = 0.007) and 0 min (94 ± 2 mmHg; p = 0.008). Acute BRJ supplementation had no effect on Laser-Doppler fluxmetry during CIVD (expressed as cutaneous vascular conductance) measured as area under the curve (BRJ: 843 ± 148 PU mmHg-1 s; PLA: 1086 ± 333 PU mmHg-1 s), amplitude (BRJ: 0.60 ± 0.12 PU mmHg-1; PLA: 0.69 ± 0.14 PU mmHg-1), and duration (BRJ: 895 ± 60 s; PLA: 894 ± 46 s). CONCLUSION Acute BRJ supplementation does not augment the CIVD response in healthy males.
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12
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Sera T, Kohno T, Nakashima Y, Uesugi M, Kudo S. Low-frequency oscillations of finger skin blood flow during the initial stage of cold-induced vasodilation at different air temperatures. J Physiol Anthropol 2020; 39:37. [PMID: 33228778 PMCID: PMC7684717 DOI: 10.1186/s40101-020-00248-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 11/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cold-induced vasodilation (CIVD) is known to be influenced by the ambient temperature. Frequency analysis of blood flow provides information on physiological regulation of the cardiovascular system, such as myogenic, neurogenic, endothelial nitric oxide (NO) dependent, and NO-independent activities. In this study, we hypothesized that the major origin of CIVD occurs prior to the CIVD event and investigated finger skin blood flow during the initial stage of CIVD at different ambient temperatures using frequency analysis. METHODS Eighteen healthy volunteers immersed their fingers in 5 °C water at air temperatures of 20 °C and 25 °C. Finger skin blood flow was measured using laser Doppler flowmetry and analyzed using Morlet mother wavelet. We defined the time when the rate of blood flow increased dramatically as the onset of CIVD, and defined three phases as the periods from the onset of cooling to minimum blood flow (vasoconstriction), from minimum blood flow to the onset of CIVD (prior to CIVD), and from the onset of CIVD to maximum blood flow (CIVD). RESULTS The increment ratio of blood flow at CIVD was significantly higher at 20 °C air temperature. In particular, at 20 °C air temperature, arteriovenous anastomoses (AVAs) might be closed at baseline, as finger skin temperature was much lower than at 25 °C air temperature, and endothelial NO-independent activity was significantly higher and neurogenic activity significantly lower during vasoconstriction than at baseline. Additionally, the differences in both activities between vasoconstriction and prior to CIVD were significant. On the other hand, there were no significant differences in endothelial NO-dependent activity between baseline and all phases at both air temperatures. CONCLUSIONS Our results indicated that the increase of endothelial NO-independent activity and the decrease of neurogenic activity may contribute to the high increment ratio of blood flow at CIVD at 20 °C air temperature.
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Affiliation(s)
- Toshihiro Sera
- Department of Mechanical Engineering, Faculty of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan.
| | - Taiki Kohno
- Department of Mechanical Engineering, Graduate School of Engineering, Kyushu University, Fukuoka, Japan
| | - Yusuke Nakashima
- Department of Mechanical Engineering, Graduate School of Engineering, Kyushu University, Fukuoka, Japan
| | - Musashi Uesugi
- Graduate School of Systems Life Science, Kyushu University, Fukuoka, Japan
| | - Susumu Kudo
- Department of Mechanical Engineering, Faculty of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
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13
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Zhang Y, Song J, Huang G. Comprehensive Treatment of Single Finger Frostbite: A Case Study. J Burn Care Res 2020; 42:555-559. [PMID: 33175155 DOI: 10.1093/jbcr/iraa168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Third- and fourth-degree frostbites usually result in loss of skin and tissue requiring amputation, and scarring. The 3- to 6-week waiting period is often necessary to determine the severity of the lesion. This period is also a critical time for the rescue of frostbitten tissue. This patient was a 30-year-old man who developed frostbite of his right index finger. He presented to our hospital 4 hours after injury with loss of sensation on the whole index finger and early signs of necrosis. The patient received a series of comprehensive treatments, including fasciotomy, injection of papaverine hydrochloride, baking lamp irradiation, and negative pressure treatment. At the time of discharge, he had re-epithelialization of the index finger by 21 days after injury. The conclusion of this paper is that the comprehensive treatments combined with negative pressure wound treatment has certain clinical application value for the rescue of deep frostbite tissues.
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Affiliation(s)
- Yonghu Zhang
- Department of Burns and Plastic Surgery & Department of Wound Repair, Central Hospital Affiliated to Shandong First Medical University, PR China
| | - Jintong Song
- Department of Natural Product Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University, PR China
| | - Guobao Huang
- Department of Burns and Plastic Surgery & Department of Wound Repair, Central Hospital Affiliated to Shandong First Medical University, PR China
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14
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Milliner BH, Brant-Zawadzki G, McIntosh SE. Effect of Calcium-Channel Blockade on the Cold-Induced Vasodilation Response. Wilderness Environ Med 2020; 31:312-316. [DOI: 10.1016/j.wem.2020.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 03/07/2020] [Accepted: 03/15/2020] [Indexed: 11/29/2022]
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15
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Mugele H, Oliver SJ, Gagnon D, Lawley JS. Integrative crosstalk between hypoxia and the cold: Old data and new opportunities. Exp Physiol 2020; 106:350-358. [DOI: 10.1113/ep088512] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/25/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Hendrik Mugele
- Department of Sport Science University of Innsbruck Innsbruck Austria
| | - Samuel J. Oliver
- Extremes Research Group School of Sport, Health and Exercise Sciences Bangor University Wales UK
| | - Daniel Gagnon
- Cardiovascular Prevention and Rehabilitation Centre Montreal Heart Institute Montréal Quebec Canada
- Department of Pharmacology and Physiology Faculty of Medicine Université de Montréal Montréal Quebec Canada
| | - Justin S. Lawley
- Department of Sport Science University of Innsbruck Innsbruck Austria
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16
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Ko Y, Seol SH, Kim GH, Yu HH, Lee JY. Effects of cold exposure discontinuation on finger cold-induced vasodilation of older retired Korean female divers 'Haenyeos'. J Therm Biol 2020; 91:102642. [PMID: 32716883 DOI: 10.1016/j.jtherbio.2020.102642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/17/2020] [Accepted: 06/11/2020] [Indexed: 11/29/2022]
Abstract
The purpose of the present study was to investigate the effects of cold exposure discontinuation on local cold tolerance of older retired female haenyeos in Korea. A total of 30 older women participated in this study: older retired haenyeos (89 ± 4 y in age, N = 10), active haenyeos (current divers) (75 ± 4 y, N = 10), and age-matched non-divers (75 ± 6 y, N = 10). Our criterion for local cold tolerance was cold-induced vasodilation (CIVD) of the finger. Active haenyeos showed greater local cold tolerance in terms of higher minimum temperature of the left finger during immersion and recovery than the other two groups (P < 0.05). Furthermore, active haenyeos showed higher skin temperatures of the right finger and left foot as well (P < 0.05). Older retired haenyeos displayed the second best minimum finger temperature both during immersion and during recovery (15 min and 20 min), whereas their local cold tolerance was evaluated as inferior to active haenyeos and the age-matched non-divers in CIVD frequency, finger pain sensation, thermal comfort, and finger temperature during the earlier period of recovery (5 min and 10 min). These results suggested that older retired haenyeos' cold tolerance in their extremities disappeared in terms of finger temperature in their initial recovery periods, but that they might still retain cold adaptation in terms of minimum finger temperature or later recovery responses, even though the attributes were not marked as much as those of active haenyeos.
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Affiliation(s)
- Yelin Ko
- College of Human Ecology, Seoul National University, Republic of Korea
| | - Seon-Hong Seol
- College of Human Ecology, Seoul National University, Republic of Korea
| | - Guk Hyeon Kim
- Korea Institute of Sports Science, Republic of Korea
| | - Hyeon Hui Yu
- College of Sports Sciences, Yong In University, Republic of Korea
| | - Joo-Young Lee
- College of Human Ecology, Seoul National University, Republic of Korea; Research Institute of Human Ecology, Seoul National University, Republic of Korea.
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17
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Tyler CJ, Lambert R, Kumar A, Stroud MA, Cheung SSS. Single-digit cold-induced vasodilation adaptations during an Antarctic expedition. Polar Biol 2020. [DOI: 10.1007/s00300-020-02659-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AbstractAn increasing number of people are spending time in Polar Regions for work and tourism and this can increase the risk of tissue injuries, e.g. frostbite. The risk would be reduced if beneficial peripheral blood flow adaptions occurred but data regarding the trainability of the cold-induced vasodilation (CIVD) response are equivocal. Five healthy males spent almost 8 months in Antarctica; five of them at a semi-permanent camp (− 44 °C; 2752 m). CIVD tests (30 min index finger immersion into 0 °C water) were performed on the 12th, 39–40th, 67–68th, 179th and 234th days of the expedition in a climate-controlled caboose. Heart rate (HR), thermal sensation of the finger, pain sensation, and mean arterial pressure (MAP) were recorded. Minimum, maximum, and mean finger temperature were greater, onset time was earlier (r = 0.34), and amplitude was greater (r = 0.55) on day 234 than day 12 suggesting that adaptation occurred. Time-point data suggested that the adaptations were progressive. Cardiovascular and perceptual data also showed some adaptation. MAP was lower on day 234 than day 12 (r = 0.47 and r = 0.47) but mean HR was higher (r = 0.55). Mean and peak thermal sensation (r = 0.31–0.59; r = 0.31) and perceived pain (r = 0.58; r = 0.36) both improved over the course of the expedition. Of interest to Polar Region visitors, beneficial peripheral and perceptual adaptations to prolonged Antarctic exposure can occur with 2 h of daily outdoor exposure although the rates at which adaptation occurs differ.
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18
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Balasubramanian G, Vas P, Chockalingam N, Naemi R. A Synoptic Overview of Neurovascular Interactions in the Foot. Front Endocrinol (Lausanne) 2020; 11:308. [PMID: 32528410 PMCID: PMC7256167 DOI: 10.3389/fendo.2020.00308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/22/2020] [Indexed: 12/13/2022] Open
Abstract
Diabetes is a worldwide public health concern as it is associated with various complications. One of the major complications of diabetes is diabetic foot syndrome that results in catastrophic events such as ulceration and amputation. Therefore, the main four strategies of diabetic foot care involve risk prediction, prevention, and early diagnosis and prompt intervention. The drivers of ulceration are multifactorial, and importantly, include microcirculatory changes in the diabetic skin. Cutaneous microcirculation on the foot is greatly influenced by the small fibers which mediate thermal sensation and pain perception in addition to sympathetic activities such as thermoregulation and vasodilation. The interdependence between the neurovascular elements means with the loss of small fiber functions, the corresponding microcirculatory responses may be compromised. Thus, it can be hypothesized that the impairment of the microcirculation may follow the order of the corresponding small fiber nerve dysfunction or vice versa. In this review, select neurovascular investigations that inform the cutaneous microcirculatory and small fiber nerve function in response to pain, cold, and heat and pressure stimuli are reviewed and discussed in this order of sensory loss: the loss of pain, cold, warmth, touch and deep pressure sensation. We also discuss the neurological and vascular characteristics of each of these neurovascular responses. This review highlights the influence of small fibers on cutaneous microcirculation and the need for prospective studies that can determine the course of microcirculatory impairment over time. This, in turn, may help clarify the exact role of microcirculatory changes in the pathway of ulceration. The insights from this review can be pertinent to understand key microcirculatory disturbances and given that the microcirculatory impairment develops at an early stage, relevant interventions can be implemented to possibly reverse or regress the course of the disease. Therefore, knowledge of the neurovascular interactions aids to map the disease progression for early diagnosis and prevention of adverse complications.
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Affiliation(s)
- Gayathri Balasubramanian
- Centre for Biomechanics and Rehabilitation Technologies, Science Centre, Staffordshire University, Stoke-on-Trent, United Kingdom
| | - Prashanth Vas
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Science Centre, Staffordshire University, Stoke-on-Trent, United Kingdom
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Roozbeh Naemi
- Centre for Biomechanics and Rehabilitation Technologies, Science Centre, Staffordshire University, Stoke-on-Trent, United Kingdom
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19
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Bongers CCWG, Eijsvogels TMH, Thijssen DHJ, Hopman MTE. Thermoregulatory, metabolic, and cardiovascular responses during 88 min of full-body ice immersion - A case study. Physiol Rep 2019; 7:e14304. [PMID: 31883220 PMCID: PMC6934874 DOI: 10.14814/phy2.14304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 11/24/2022] Open
Abstract
Exposure to extreme cold environments is potentially life-threatening. However, the world record holder of full-body ice immersion has repeatedly demonstrated an extraordinary tolerance to extreme cold. We aimed to explore thermoregulatory, metabolic, and cardiovascular responses during 88 min of full-body ice immersion. We continuously measured gastrointestinal temperature (Tgi ), skin temperature (Tskin), blood pressure, and heart rate (HR). Oxygen consumption (VO2 ) was measured at rest, and after 45 and 88 min of ice immersion, in order to calculate the metabolic heat production. Tskin dropped significantly (28-34°C to 4-15°C) and VO2 doubled (5.7-11.3 ml kg-1 min-1 ), whereas Tgi (37.6°C), HR (72 bpm), and mean arterial pressure (106 mmHg) remained stable during the first 30 min of cold exposure. During the remaining of the trial, Tskin and VO2 remained stable, while Tgi gradually declined to 37.0°C and HR and mean arterial blood pressure increased to maximum values of 101 bpm and 115 mmHg, respectively. Metabolic heat production in rest was 169 W and increased to 321 W and 314 W after 45 and 80 min of ice immersion. Eighty-eight minutes of full-body ice immersion resulted in minor changes of Tgi and cardiovascular responses, while Tskin and VO2 changed markedly. These findings may suggest that our participant can optimize his thermoregulatory, metabolic, and cardiovascular responses to challenge extreme cold exposure.
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Affiliation(s)
- Coen C W G Bongers
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dick H J Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands.,Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
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20
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Keramidas ME, Kölegård R, Mekjavic IB, Eiken O. Interactions of mild hypothermia and hypoxia on finger vasoreactivity to local cold stress. Am J Physiol Regul Integr Comp Physiol 2019; 317:R418-R431. [PMID: 31241983 DOI: 10.1152/ajpregu.00103.2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We examined the interactive effects of mild hypothermia and hypoxia on finger vasoreactivity to local cold stress. Eight male lowlanders performed, in a counterbalanced order, a normoxic and a hypoxic (partial pressure of oxygen: ~12 kPa) hand cold provocation (consisting of a 30-min immersion in 8°C water), while immersed to the chest either in 21°C [cold trials; 0.5°C fall in rectal temperature (Trec) from individual preimmersion values], or in 35.5°C water, or while exposed to 27°C air. The duration of the trials was kept constant in each breathing condition. Physiological (Trec, skin temperature, cutaneous vascular conductance, oxygen uptake) and perceptual (thermal sensation and comfort, local pain, affective valence) reactions were monitored continually. Hypoxia accelerated the drop in Trec by ~14 min (P = 0.06, d = 0.67). In the air-exposure trials, hypoxia did not alter finger perfusion during the local cooling, whereas it impaired the finger rewarming response following the cooling (P < 0.01). During the 35.5°C immersion, the finger vasomotor tone was enhanced, especially in hypoxia (P = 0.01). Mild hypothermia aggravated finger vasoconstriction instigated by local cooling (P < 0.01), but the response did not differ between the two breathing conditions (P > 0.05). Hypoxia tended to attenuate the sensation of coldness (P = 0.10, r = 0.40) and thermal discomfort (P = 0.09, r = 0.46) in the immersed hand. Both in normoxia and hypoxia, the whole body thermal state dictates the cutaneous vasomotor reactivity to localized cold stimulus.
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Affiliation(s)
- Michail E Keramidas
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Roger Kölegård
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Igor B Mekjavic
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia.,Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Ola Eiken
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
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21
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Splenic Blood Flow Increases after Hypothermic Stimulus (Cold Pressor Test): A Perfusion Magnetic Resonance Study. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8437927. [PMID: 31240227 PMCID: PMC6556242 DOI: 10.1155/2019/8437927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/03/2019] [Accepted: 05/06/2019] [Indexed: 02/01/2023]
Abstract
The Cold Pressor Test (CPT) is a novel diagnostic strategy to noninvasively assess the myocardial microvascular endothelial-dependent function using perfusion magnetic resonance imaging (MRI). Spleen perfusion is modulated by a complex combination of several mechanisms involving the autonomic nervous system and vasoactive mediators release. In this context, the effects of cold temperature on splenic blood flow (SBF) still need to be clarified. Ten healthy subjects were studied by MRI. MRI protocol included the acquisition of GRE T1-weighted sequence (“first pass perfusion”) during gadolinium administration (0.1mmol/kg of Gd-DOTA at flow of 3.0 ml/s), at rest and after CPT. Myocardial blood flow (MBF) and SBF were measured by applying Fermi function deconvolution, using the blood pool input function sampled from the left ventricle cavity. MBF and SBF values after performing CPT were significantly higher than rest values (SBF at rest: 0.65 ± 0.15 ml/min/g Vs. SBF after CPT: 0.90 ± 0.14 ml/min/g, p: <0.001; MBF at rest: 0.90 ± 0.068 ml/min/g Vs. MBF after CPT: 1.22 ± 0.098 ml/min/g, p<0.005). Both SBF and MBF increased in all patients during the CPT. In particular, the CPT-induced increase was 43% ± 29% for SBF and 36.5% ± 17% for MBF. CPT increases SBF in normal subjects. The characterization of a standard perfusion response to cold might allow the use of the spleen as reference marker for the adequacy of cold stimulation during myocardial perfusion MRI.
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22
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Alba BK, Castellani JW, Charkoudian N. Cold‐induced cutaneous vasoconstriction in humans: Function, dysfunction and the distinctly counterproductive. Exp Physiol 2019; 104:1202-1214. [DOI: 10.1113/ep087718] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 04/30/2019] [Indexed: 01/03/2023]
Affiliation(s)
- Billie K. Alba
- Thermal & Mountain Medicine Division US Army Research Institute of Environmental Medicine Natick MA USA
- Oak Ridge Institute of Science and Education Belcamp MD USA
| | - John W. Castellani
- Thermal & Mountain Medicine Division US Army Research Institute of Environmental Medicine Natick MA USA
| | - Nisha Charkoudian
- Thermal & Mountain Medicine Division US Army Research Institute of Environmental Medicine Natick MA USA
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23
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Gorjanc J, Morrison SA, McDonnell AC, Mekjavic PJ, Blagus R, Mekjavic IB. Ski-Everest (8848 m) Expedition: Digit Skin Temperature Responses to Cold Immersion May Reflect Susceptibility to Cold Injury. Wilderness Environ Med 2019; 30:141-149. [PMID: 30979538 DOI: 10.1016/j.wem.2019.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 01/01/2019] [Accepted: 01/31/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION We tested the hypothesis that individual susceptibility to freezing cold injury might be reflected in an attenuated cold-induced vasodilatation (CIVD) response by comparing the CIVD responses of an elite alpinist with a history of freezing cold injury in the feet (case alpinist) with those of an age- and ability- matched noninjured alpinists control group (controls). According to this hypothesis, the vasomotor responses to a CIVD test of the case alpinist would represent a pathophysiological response when compared with the normal physiological response of a noninjured cohort. METHODS The case alpinist and the controls in the cohort group conducted a cold water immersion test comprising sequential immersion of a hand and foot for 5 min in 35°C water, followed by a 30-min immersion in 8°C water and a 10-min recovery period in room air. During this test we monitored the finger and toe skin temperatures. RESULTS The case alpinist had a significantly attenuated CIVD response and a lower skin temperature in all injured and noninjured digits during immersion (∼2°C lower than in the control group) and an attenuated recovery of finger skin temperatures (∼6°C lower than in the control group). CONCLUSIONS The attenuated CIVD response of the case alpinist may reflect a previously unrecognized enhanced susceptibility to frostbite. In addition to the poor vasomotor response observed in the injured toes, he also exhibited a poor vasomotor response in his noninjured fingers. The results of the present study indicate that a test of vasomotor activity during thermal stress may identify individuals predisposed to cold injury.
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Affiliation(s)
- Jurij Gorjanc
- Department of Surgery, Hospital of the Brothers of St. John of God, St.Veit/Glan, Austria.
| | | | - Adam C McDonnell
- Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia
| | | | - Rok Blagus
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Igor B Mekjavic
- Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia; Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada
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Norheim AJ, Borud E, Wilsgaard T, De Weerd L, Mercer JB. Variability in peripheral rewarming after cold stress among 255 healthy Norwegian army conscripts assessed by dynamic infrared thermography. Int J Circumpolar Health 2019; 77:1536250. [PMID: 30444464 PMCID: PMC6249548 DOI: 10.1080/22423982.2018.1536250] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Exposure to cold climate is an inevitable consequence of military training in Norway. Adequate peripheral microcirculation in the extremities is important to maintain temperature, and to protect against freezing cold injuries. The aim of this study was to investigate the variability in skin rewarming ability. The study subjects consisted of 260 healthy Norwegian army conscripts, following a mild cold provocation test (hands immersed in 20°C water for 1 min) using dynamic infrared thermography (DIRT). Thermal images were obtained to investigate any differences in skin rewarming ability of the hand (fingers). DIRT took place under standardised and stable study conditions. Conscripts were characterised as either slow, intermediate or rapid rewarmers. While 90% could recover, partially or completely, within 4 min to the skin temperature values before the provocation test, 10% showed a slow rewarming pattern. In the slow rewarmers, the rewarming ability was correlated with a low average temperature of the hands prior to the cooling test. The healthy young army conscripts in this study showed a large variability in their rewarming ability following a standardised mild cold provocation test.
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Affiliation(s)
- Arne Johan Norheim
- a The National Research Centre in Complementary and Alternative Medicine - NAFKAM Department of Community Medicine, Health Sciences , UiT - The Arctic University of Norway , Tromsø , Norway.,b Institute of Military Medicine and Epidemiology , Norwegian Armed Forces Joint Medical Services , Sessvollmoen , Norway
| | - Einar Borud
- b Institute of Military Medicine and Epidemiology , Norwegian Armed Forces Joint Medical Services , Sessvollmoen , Norway.,c Department of Community Medicine, Health Sciences , UiT - The Arctic University of Norway , Tromsø , Norway
| | - Tom Wilsgaard
- c Department of Community Medicine, Health Sciences , UiT - The Arctic University of Norway , Tromsø , Norway
| | - Louis De Weerd
- d Department of Plastic Surgery and Hand Surgery , University Hospital North Norway , Tromsø , Norway.,e Medical Imaging Group, Department of Clinical Medicine , UiT The Arctic University of Norway , Tromsø , Norway
| | - James B Mercer
- e Medical Imaging Group, Department of Clinical Medicine , UiT The Arctic University of Norway , Tromsø , Norway.,f Department of Medical Physiology, Health Sciences , UiT - The Arctic University of Norway , Tromsø , Norway.,g Department of Radiology , University Hospital North Norway , Tromsø , Norway
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25
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Tirloni AS, Dos Reis DC, Dias NF, Moro ARP. The Use of Personal Protective Equipment: Finger Temperatures and Thermal Sensation of Workers' Exposure to Cold Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112583. [PMID: 30463195 PMCID: PMC6265722 DOI: 10.3390/ijerph15112583] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 12/05/2022]
Abstract
This study analyzed the finger temperatures of poultry slaughterhouse workers and its association with personal and organizational variables, bodily discomfort perception, and cold thermal sensation. The study included 143 poultry slaughterhouse workers. A thermograph was used to measure finger temperature and an interview to collect worker data. There were two groups: workers who used a tool and those without. The binary logistic regression, Friedman and Wilcoxon tests were used (p ≤ 0.05). Most workers presented at least one finger with an average temperature ≤15 °C (66.4%) and ≤24 °C (99.3%), perceived their cold hands, and wore three overlapping gloves (57.3%). There were no associations between finger temperatures (≤15 °C) and the analyzed variables. The chance of feeling cold for a worker who used a tool was greater than for a worker who did not (OR = 3.19, 95% CI 1.46; 6.94). There was a difference between the finger temperatures of each hand on both surfaces and the analyzed groups (p < 0.01). The temperature of each finger with its respective contralateral was different in the little fingers (no tool), index, middle, ring, and little fingers (using a tool) (p < 0.05). The use of several overlapping gloves was not sufficient to promote thermal insulation of the hands.
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Affiliation(s)
- Adriana Seára Tirloni
- Tecnological Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88040-370, Brazil.
| | - Diogo Cunha Dos Reis
- Tecnological Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88040-370, Brazil.
- Biomechanic's Laboratory, CDS, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88040-900, Brazil.
| | - Natália Fonseca Dias
- Tecnological Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88040-370, Brazil.
| | - Antônio Renato Pereira Moro
- Tecnological Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88040-370, Brazil.
- Biomechanic's Laboratory, CDS, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88040-900, Brazil.
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26
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Gorjanc J, Morrison SA, McDonnell AC, Mekjavic IB. Koroška 8000 Himalayan expedition: digit responses to cold stress following ascent to Broadpeak (Pakistan, 8051 m). Eur J Appl Physiol 2018; 118:1589-1597. [PMID: 29797057 DOI: 10.1007/s00421-018-3890-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/12/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Cold-induced vasodilatation (CIVD) is a peripheral blood flow response, observed in both the hands and feet. Exercise has been shown to enhance the response, specifically by increasing mean skin temperatures (Tsk), in part due to the increased number of CIVD waves. In contrast, hypobaric hypoxia has been suggested to impair digit skin temperature responses, particularly during subsequent hand rewarming following the cold stimulus. This study examined the combined effect of exercise and hypobaric hypoxia on the CIVD response. We compared the CIVD responses in the digits of both the hands and feet of a team of alpinists (N = 5) before and after a 35-day Himalayan expedition to Broadpeak, Pakistan (8051 m). METHODS Five elite alpinists participated in hand and foot cold water immersion tests 20 days before and immediately upon return from their expedition. RESULTS The alpinists summited successfully without supplemental oxygen. Post-expedition, all alpinists demonstrated higher minimum Tsk in their hands (pre: 9.9 ± 1.1, post: 10.1 ± 0.7 °C, p = 0.031). Four alpinists had either greater CIVD waves, and, consequently, higher mean Tsk in their hands, or higher recovery temperatures (pre: 26.0 ± 5.5 °C post: 31.0 ± 4.1 °C, p = 0.052), or faster rewarming rate (pre: 2.6 ± 0.5 °C min-1 post: 3.1 ± 0.4 °C min-1,p = 0.052). In the feet, the responses varied: 1/5 had higher wave amplitudes and 1/5 had higher passive recovery temperatures, whereas 3/5 had lower mean toe temperatures during cold exposure. CONCLUSIONS The results of the cold stress test suggest after a 35-day Himalayan expedition, alpinists experienced a slight cold adaptation of the hands, but not the feet.
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Affiliation(s)
- Jurij Gorjanc
- St. John of God Hospital, Spitalgasse 26, 9300, St. Veit/Glan, Austria.
| | - Shawnda A Morrison
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310, Izola, Slovenia
| | - Adam C McDonnell
- Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Jamova 39, 1000, Ljubljana, Slovenia
| | - Igor B Mekjavic
- Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Jamova 39, 1000, Ljubljana, Slovenia.,Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada
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Kim S, Lee JY. L-Menthol attenuates the magnitude of cold-induced vasodilation on the extremities of young females. J Physiol Anthropol 2018; 37:14. [PMID: 29739454 PMCID: PMC5941682 DOI: 10.1186/s40101-018-0174-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/19/2018] [Indexed: 11/20/2022] Open
Abstract
Background Menthol chemically triggers cold-sensitive receptors in the skin without conductive skin cooling. We investigated the effects of menthol-induced activation of cutaneous cold receptors on the cold-induced vasodilation (CIVD) of the finger. We hypothesized that the menthol application would attenuate typical CIVD responses. Methods 1.5% l-menthol was fully applied over the left hand and forearm, and then, the middle finger of the left hand was immersed into 4 °C water for 30 min. A trial consisted of 10-min rest followed by 30-min immersion and 20-min recovery in 28 °C air temperature with 20% relative humidity. Another trial without the menthol application was carried out as a control. Seventeen females (24.2 ± 2.6 years in age, 160.5 ± 5.1 cm in height, and 51.2 ± 5.7 kg in body weight) participated in the two trials. Results The results showed that the maximum and average temperatures of the finger during the water immersion were lower in the menthol application when compared to control (P < 0.05), whereas no significant differences appeared in the onset time of CIVD, the frequency of CIVD, and minimum finger temperature. These results imply that stronger stimulation of cold receptors without additional conductive skin cooling did not attenuate the triggering of CIVD responses but intensified vasoconstriction after the first occurrence of CIVD. Conclusion It is suggested that substantial and conductive heat loss through the skin along with activation of cold receptors may be required to retain rewarming at a certain level.
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Affiliation(s)
- Siyeon Kim
- COM:FORT Laboratory, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Joo-Young Lee
- COM:FORT Laboratory, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea. .,Research Institute of Human Ecology, Seoul National University, Seoul, Korea.
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Heinonen I, Laukkanen JA. Effects of heat and cold on health, with special reference to Finnish sauna bathing. Am J Physiol Regul Integr Comp Physiol 2018; 314:R629-R638. [DOI: 10.1152/ajpregu.00115.2017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Environmental stress such as extremely warm or cold temperature is often considered a challenge to human health and body homeostasis. However, the human body can adapt relatively well to heat and cold environments, and recent studies have also elucidated that particularly heat stress might be even highly beneficial for human health. Consequently, the aim of the present brief review is first to discuss general cardiovascular and other responses to acute heat stress, followed by a review of beneficial effects of Finnish sauna bathing on general and cardiovascular health and mortality as well as dementia and Alzheimer's disease risk. Plausible mechanisms included are improved endothelial and microvascular function, reduced blood pressure and arterial stiffness, and possibly increased angiogenesis in humans, which are likely to mediate the health benefits of sauna bathing. In addition to heat exposure with physiological adaptations, cold stress-induced physiological responses and brown fat activation on health are also discussed. This is important to take into consideration, as sauna bathing is frequently associated with cooling periods in cold(er) environments, but their combination remains poorly investigated. We finally propose, therefore, that possible additive effects of heat- and cold-stress-induced adaptations and effects on health would be worthy of further investigation.
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Affiliation(s)
- Ilkka Heinonen
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku, Finland
- Division of Experimental Cardiology, Thoraxcenter, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jari A. Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Central Finland Health Care District, Jyväskylä, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Gorjanc J, Morrison SA, Blagus R, Mekjavic IB. Cold Susceptibility of Digit Stumps Resulting from Amputation After Freezing Cold Injury in Elite Alpinists. High Alt Med Biol 2018; 19:185-192. [PMID: 29608373 DOI: 10.1089/ham.2017.0134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Gorjanc, Jurij, Shawnda A. Morrison, Rok Blagus, and Igor B. Mekjavic. Cold susceptibility of digit stumps resulting from amputation after freezing cold injury in elite alpinists. High Alt Med Biol. 19:185-192, 2018. AIM The aim of the study was to assess whether previous freezing cold injury in fingers and/or toes might predispose alpinists to greater risk of further freezing cold injury, primarily due to a greater vasoconstrictor response to cold, resulting in a lower perfusion, reflected in lower skin temperature. METHODS Ten elite alpinists (N = 10; 8 male and 2 female) with amputations after freezing cold injury participated in a cold-water (8°C) immersion stress test of the hands and feet. Digit skin temperatures of amputated digits, their noninjured counterparts, noninjured digits of the affected side and noninjured digits of the corresponding side were measured. The skin temperatures were compared during three consecutive phases of the cold stress test: prewarming, cold water immersion, and passive heating. RESULTS Amputated toes cooled much faster compared to their uninjured counterparts (n = 26, p < 0.001), and attained lower skin temperatures during the cold exposure test (n = 26, p < 0.001). Higher cooling rate was observed in all the toes on the injured limb compared with the toes on the uninjured limb (n = 40, p < 0.001). In contrast to the toes, the fingers on the injured limb after freezing cold injury were warmer during cooling phase compared to uninjured fingers (n = 15, p < 0.001). CONCLUSIONS The lower digit temperatures observed in affected toe stumps during the cold stress test compared to the nonamputated toes may indicate a heightened risk of future freezing cold injury with subsequent cold exposures, as a consequence of less perfusion, reflected in the lower skin temperature. This relationship was not confirmed in the fingers.
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Affiliation(s)
| | | | - Rok Blagus
- 3 Faculty of Medicine, Institute for Biostatistics and Medical Informatics, University of Ljubljana , Ljubljana, Slovenia
| | - Igor B Mekjavic
- 4 Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute , Ljubljana, Slovenia .,5 Department of Biomedical Physiology and Kinesiology, Simon Fraser University , Burnaby, British Columbia, Canada
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Payne S, Macintosh A, Stock J. The thermoregulatory function of the human hand: How do palm and digit proportions affect heat loss? AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 166:803-811. [PMID: 29603137 DOI: 10.1002/ajpa.23469] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 03/07/2018] [Accepted: 03/07/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The current study assessed whether ecogeographical patterns seen in hand proportions correlate with heat loss directly. Using a brief severe cold immersion experiment on the hand, the influence of hand and digit dimensions on heat loss was evaluated. MATERIALS AND METHODS A sample of 113 living individuals were tested. Two-dimensional and three-dimensional scanning techniques were used to assess hand and digit dimensions. Thermal imaging analysis was used to quantify heat loss during a 3-min ice-water immersion of the hands. RESULTS When body size was accounted for, hand width and digit length relative to total hand length were significant predictors of heat loss from the hand. DISCUSSION The current study provides empirical evidence to support the link between thermodynamic principles relating to surface area-to-volume ratio, and ecogeographical patterns associated with temperature.
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Affiliation(s)
- Stephanie Payne
- PAVE Research Group, Department of Archaeology, University of Cambridge, Cambridgeshire, CB2 3EX, United Kingdom
| | - Alison Macintosh
- PAVE Research Group, Department of Archaeology, University of Cambridge, Cambridgeshire, CB2 3EX, United Kingdom
| | - Jay Stock
- PAVE Research Group, Department of Archaeology, University of Cambridge, Cambridgeshire, CB2 3EX, United Kingdom.,Department of Anthropology, University of Western Ontario, London, Ontario, N6A 5C2, Canada
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Hodges GJ, Mallette MM, Cheung SS. Cutaneous neural activity and endothelial involvement in cold-induced vasodilatation. Eur J Appl Physiol 2018; 118:971-978. [DOI: 10.1007/s00421-018-3832-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 02/24/2018] [Indexed: 10/17/2022]
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32
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Kounalakis SN, Keramidas ME, Amon M, Eiken O, Mekjavic IB. A 10-day confinement to normobaric hypoxia impairs toe, but not finger temperature response during local cold stress. J Therm Biol 2017; 64:109-115. [DOI: 10.1016/j.jtherbio.2017.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/20/2017] [Accepted: 01/23/2017] [Indexed: 10/20/2022]
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Cheung SS, Lee JKW, Oksa J. Thermal stress, human performance, and physical employment standards. Appl Physiol Nutr Metab 2017; 41:S148-64. [PMID: 27277564 DOI: 10.1139/apnm-2015-0518] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Many physically demanding occupations in both developed and developing economies involve exposure to extreme thermal environments that can affect work capacity and ultimately health. Thermal extremes may be present in either an outdoor or an indoor work environment, and can be due to a combination of the natural or artificial ambient environment, the rate of metabolic heat generation from physical work, processes specific to the workplace (e.g., steel manufacturing), or through the requirement for protective clothing impairing heat dissipation. Together, thermal exposure can elicit acute impairment of work capacity and also chronic effects on health, greatly contributing to worker health risk and reduced productivity. Surprisingly, in most occupations even in developed economies, there are rarely any standards regarding enforced heat or cold safety for workers. Furthermore, specific physical employment standards or accommodations for thermal stressors are rare, with workers commonly tested under near-perfect conditions. This review surveys the major occupational impact of thermal extremes and existing employment standards, proposing guidelines for improvement and areas for future research.
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Affiliation(s)
- Stephen S Cheung
- a Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Jason K W Lee
- b Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore.,c Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,d Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Juha Oksa
- e Finnish Institute of Occupational Health, Physical Work Capacity team, Oulu, Finland
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Lucas SJE, Helge JW, Schütz UHW, Goldman RF, Cotter JD. Moving in extreme environments: extreme loading; carriage versus distance. EXTREME PHYSIOLOGY & MEDICINE 2016; 5:6. [PMID: 27110357 PMCID: PMC4840901 DOI: 10.1186/s13728-016-0047-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 04/01/2016] [Indexed: 12/17/2022]
Abstract
This review addresses human capacity for movement in the context of extreme loading and with it the combined effects of metabolic, biomechanical and gravitational stress on the human body. This topic encompasses extreme duration, as occurs in ultra-endurance competitions (e.g. adventure racing and transcontinental races) and expeditions (e.g. polar crossings), to the more gravitationally limited load carriage (e.g. in the military context). Juxtaposed to these circumstances is the extreme metabolic and mechanical unloading associated with space travel, prolonged bedrest and sedentary lifestyle, which may be at least as problematic, and are therefore included as a reference, e.g. when considering exposure, dangers and (mal)adaptations. As per the other reviews in this series, we describe the nature of the stress and the associated consequences; illustrate relevant regulations, including why and how they are set; present the pros and cons for self versus prescribed acute and chronic exposure; describe humans' (mal)adaptations; and finally suggest future directions for practice and research. In summary, we describe adaptation patterns that are often U or J shaped and that over time minimal or no load carriage decreases the global load carrying capacity and eventually leads to severe adverse effects and manifest disease under minimal absolute but high relative loads. We advocate that further understanding of load carrying capacity and the inherent mechanisms leading to adverse effects may advantageously be studied in this perspective. With improved access to insightful and portable technologies, there are some exciting possibilities to explore these questions in this context.
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Affiliation(s)
- Samuel J. E. Lucas
- />School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT UK
- />Department of Physiology, University of Otago, Dunedin, New Zealand
| | - Jørn W. Helge
- />Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Uwe H. W. Schütz
- />Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Ulm, Germany
- />Orthopaedic Consulting Office at the Green Tower and Medical Pain Centre Lake Constance–Upper Swabia, Ravensburg, Germany
| | | | - James D. Cotter
- />School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
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Park J, Lee JY. Relationships of self-identified cold tolerance and cold-induced vasodilatation in the finger. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:521-529. [PMID: 26266483 DOI: 10.1007/s00484-015-1048-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 07/15/2015] [Accepted: 08/01/2015] [Indexed: 06/04/2023]
Abstract
This study was conducted to investigate relationships of self-identified cold tolerance and cold-induced vasodilatation (CIVD) in the finger. Nine males and 34 females participated in the following 2 tests: a CIVD test and a self-reported survey. The CIVD test was conducted 30-min cold-water immersion (3.8 ± 0.3 °C) of the middle finger at an air temperature of 27.9 ± 0.1 °C. The self-reported questionnaire consisted of 28 questions about whole and local body cold and heat tolerances. By a cluster analysis on the survey results, the participants were divided into two groups: high self-identified cold tolerance (HSCT, n = 25) and low self-identified cold tolerance (LSCT, n = 18). LSCT had lower self-identified cold tolerance (P < 0.001), preferred hot thermal stimulation (P = 0.006), and wore heavier clothing during daily life (P < 0.001) than HSCT. LSCT had significantly lower maximal finger temperatures (T max) (P = 0.040), smaller amplitude (P = 0.029), and delayed onset time of CIVD (P = 0.080) when compared to HSCT. Some questions examining the self-identified cold or heat tolerance had relationships with cold tolerance index, T max, and amplitude (P < 0.1). These results indicate that self-identified cold tolerance classified through a standardized survey could be a good index to predict physiological cold tolerance.
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Affiliation(s)
- Joonhee Park
- Research Institute of Human Ecology, Seoul National University, Seoul, South Korea
| | - Joo-Young Lee
- Research Institute of Human Ecology, Seoul National University, Seoul, South Korea.
- College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, Republic of Korea.
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36
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Daanen HAM, Van Marken Lichtenbelt WD. Human whole body cold adaptation. Temperature (Austin) 2016; 3:104-18. [PMID: 27227100 PMCID: PMC4861193 DOI: 10.1080/23328940.2015.1135688] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/14/2015] [Accepted: 12/14/2015] [Indexed: 11/05/2022] Open
Abstract
Reviews on whole body human cold adaptation generally do not distinguish between population studies and dedicated acclimation studies, leading to confusing results. Population studies show that indigenous black Africans have reduced shivering thermogenesis in the cold and poor cold induced vasodilation in fingers and toes compared to Caucasians and Inuit. About 40,000 y after humans left Africa, natives in cold terrestrial areas seems to have developed not only behavioral adaptations, but also physiological adaptations to cold. Dedicated studies show that repeated whole body exposure of individual volunteers, mainly Caucasians, to severe cold results in reduced cold sensation but no major physiological changes. Repeated cold water immersion seems to slightly reduce metabolic heat production, while repeated exposure to milder cold conditions shows some increase in metabolic heat production, in particular non-shivering thermogenesis. In conclusion, human cold adaptation in the form of increased metabolism and insulation seems to have occurred during recent evolution in populations, but cannot be developed during a lifetime in cold conditions as encountered in temperate and arctic regions. Therefore, we mainly depend on our behavioral skills to live in and survive the cold.
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Affiliation(s)
- Hein A M Daanen
- MOVE Research Institute, Faculty of Behavioral and Movement Sciences, VU University Amsterdam, The Netherlands; TNO, Soesterberg, The Netherlands; Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Wouter D Van Marken Lichtenbelt
- Department of Human Biology/Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University , The Netherlands
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Del Pozzi AT, Miller JT, Hodges GJ. The effect of heating rate on the cutaneous vasomotion responses of forearm and leg skin in humans. Microvasc Res 2016; 105:77-84. [PMID: 26808211 DOI: 10.1016/j.mvr.2016.01.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 01/19/2016] [Accepted: 01/20/2016] [Indexed: 11/19/2022]
Abstract
We examined skin blood flow (SkBF) and vasomotion in the forearm and leg using laser-Doppler fluxmetry (LDF) and spectral analysis to investigate endothelial, sympathetic, and myogenic activities in response to slow (0.1 °C·10 s(-1)) and fast (0.5 °C·10 s(-1)) local heating. At 33 °C (thermoneutral) endothelial activity was higher in the legs than the forearms (P ≤ 0.02). Fast-heating increased SkBF more than slow heating (P=0.037 forearm; P=0.002 leg). At onset of 42 °C, endothelial (P=0.043 forearm; P=0.48 leg) activity increased in both regions during the fast-heating protocol. Following prolonged heating (42 °C) endothelial activity was higher in both the forearm (P=0.002) and leg (P<0.001) following fast-heating. These results confirm regional differences in the response to local heating and suggest that the greater increase in SkBF in response to fast local heating is initially due to increased endothelial and sympathetic activity. Furthermore, with sustained local skin heating, greater vasodilatation was observed with fast heating compared to slow heating. These data indicate that this difference is due to greater endothelial activity following fast heating compared to slow heating, suggesting that the rate of skin heating may alter the mechanisms contributing to cutaneous vasodilatation.
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Affiliation(s)
- Andrew T Del Pozzi
- Integrative Exercise Physiology Laboratory, School of Kinesiology, Ball State University, Muncie, IN 47306, United States
| | - James T Miller
- Exercise Physiology Laboratory, Department of Kinesiology, The University of Alabama, Tuscaloosa, AL 35487, United States
| | - Gary J Hodges
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON L2S 3A1, Canada.
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Raimundo AM, Oliveira AVM, Gaspar AR, Quintela DA. Thermal conditions in freezing chambers and prediction of the thermophysiological responses of workers. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1623-1632. [PMID: 25691118 DOI: 10.1007/s00484-015-0969-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Revised: 01/29/2015] [Accepted: 01/29/2015] [Indexed: 06/04/2023]
Abstract
The present work is dedicated to the assessment of the cold thermal strain of human beings working within freezing chambers. To obtain the present results, both field measurements and a numerical procedure based on a modified version of the Stolwijk thermoregulation model were used. Eighteen freezing chambers were considered. A wide range of physical parameters of the cold stores, the workers clothing insulation, and the working and recovering periods were observed. The combination of these environmental and individual parameters lead to different levels of thermal stress, which were grouped under three categories. Some good practices were observed in the field evaluations, namely situations with appropriate level of clothing protection and limited duration of exposure to cold avoiding unacceptable level of hypothermia. However, the clothing ensembles normally used by the workers do not provide the minimum required insulation, which suggests the possibility of the whole body cooling for levels higher than admissible. The numerical predictions corroborate the main conclusions of the field survey. The results obtained with both methodologies clearly show that, for the low temperature of the freezing chambers, the clothing insulation is insufficient, the exposure periods are too long, and the recovering periods are inadequate. Thus, high levels of physiological strain can indeed be reached by human beings under such working environments.
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Affiliation(s)
- A M Raimundo
- ADAI-LAETA, Department of Mechanical Engineering, University of Coimbra, Rua Luís Reis Santos, Pólo II, 3030-788, Coimbra, Portugal.
| | - A V M Oliveira
- ADAI-LAETA, Department of Mechanical Engineering, University of Coimbra, Rua Luís Reis Santos, Pólo II, 3030-788, Coimbra, Portugal
- Department of Mechanical Engineering, Coimbra Institute of Engineering, Polytechnic Institute of Coimbra, Rua Pedro Nunes, Quinta da Nora, 3030-199, Coimbra, Portugal
| | - A R Gaspar
- ADAI-LAETA, Department of Mechanical Engineering, University of Coimbra, Rua Luís Reis Santos, Pólo II, 3030-788, Coimbra, Portugal
| | - D A Quintela
- ADAI-LAETA, Department of Mechanical Engineering, University of Coimbra, Rua Luís Reis Santos, Pólo II, 3030-788, Coimbra, Portugal
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Lim YH, Park MS, Kim Y, Kim H, Hong YC. Effects of cold and hot temperature on dehydration: a mechanism of cardiovascular burden. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1035-43. [PMID: 25344017 DOI: 10.1007/s00484-014-0917-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 10/02/2014] [Accepted: 10/05/2014] [Indexed: 05/25/2023]
Abstract
The association between temperature (cold or heat) and cardiovascular mortality has been well documented. However, few studies have investigated the underlying mechanism of the cold or heat effect. The main goal of this study was to examine the effect of temperature on dehydration markers and to explain the pathophysiological disturbances caused by changes of temperature. We investigated the relationship between outdoor temperature and dehydration markers (blood urea nitrogen (BUN)/creatinine ratio, urine specific gravity, plasma tonicity and haematocrit) in 43,549 adults from Seoul, South Korea, during 1995-2008. We used piece-wise linear regression to find the flexion point of apparent temperature and estimate the effects below or above the apparent temperature. Levels of dehydration markers decreased linearly with an increase in the apparent temperature until a point between 22 and 27 °C, which was regarded as the flexion point of apparent temperature, and then increased with apparent temperature. Because the associations between temperature and cardiovascular mortality are known to be U-shaped, our findings suggest that temperature-related changes in hydration status underlie the increased cardiovascular mortality and morbidity during high- or low-temperature conditions.
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Affiliation(s)
- Youn-Hee Lim
- Institute of Environmental Medicine, Seoul National University Medical Research Center, 103 Daehakro, Jongro-gu, Seoul, 110-799, Republic of Korea
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Tyler CJ, Reeve T, Cheung SS. Cold-induced vasodilation during single digit immersion in 0°C and 8°C water in men and women. PLoS One 2015; 10:e0122592. [PMID: 25886576 PMCID: PMC4401544 DOI: 10.1371/journal.pone.0122592] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 02/11/2015] [Indexed: 11/19/2022] Open
Abstract
The present study compared the thermal responses of the finger to 0 and 8°C water immersion, two commonly used temperatures for cold-induced vasodilation (CIVD) research. On two separate and counterbalanced occasions 15 male and 15 female participants immersed their index finger in 20°C water for 5 min followed by either 0 or 8°C water for 30 min. Skin temperature, cardiovascular and perceptual data were recorded. Secondary analyses were performed between sexes and comparing 0.5, 1 and 4°C CIVD amplitude thresholds. With a 0.5°C threshold, CIVD waves were more prevalent in 8°C (2 (1 – 3) than in 0°C (1.5 (0 – 3)), but the amplitude was lower (4.0 ± 2.3 v 9.2 ± 4.0°C). Mean, minimum and maximum finger temperatures were lower in 0°C during the 30 min immersion, and CIVD onset and peak time occurred later in 0°C. Thermal sensation was lower and pain sensation was higher in 0°C. There were no differences between males and females in any of the physiological or CIVD data with the exception of SBP, which was higher in males. Females reported feeling higher thermal sensations in 8°C and lower pain sensations in 0°C and 8°C compared to males. Fewer CIVD responses were observed when using a 4°C (1 (0 – 3)) threshold to quantify a CIVD wave compared to using a 1°C (2 (0 – 3)) or 0.5°C (2 (0 – 3)) amplitude. In conclusion, both 0 and 8 °C can elicit CIVD but 8°C may be more suitable when looking to optimise the number of CIVD waves while minimising participant discomfort. The CIVD response to water immersion does not appear to be influenced by sex. Researchers should consider the amplitude threshold that was used to determine a CIVD wave when interpreting previous data.
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Affiliation(s)
| | - Tom Reeve
- Department of Life Sciences, University of Roehampton, London, United Kingdom
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Morrison SA, Gorjanc J, Eiken O, Mekjavic IB. Finger and Toe Temperature Responses to Cold After Freezing Cold Injury in Elite Alpinists. Wilderness Environ Med 2015; 26:295-304. [PMID: 25754904 DOI: 10.1016/j.wem.2014.12.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 12/17/2014] [Accepted: 12/30/2014] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess whether previous freezing cold injuries (FCI) would affect digit skin temperatures and rewarming rates during a follow-up cold stress test protocol. DESIGN Nonrandomized control trial. METHODS Twenty elite alpinists participated; alpinists with previous FCI requiring digit amputations (injured, INJ: n = 10 total, n = 8 male) were compared with ability-matched, uninjured alpinists (control, CON: n = 10, all male). Digit skin temperature was measured using infrared thermography as an index of peripheral digit perfusion after a cold stress test, which consisted of 30 minutes of immersion in 8°C water. RESULTS The INJ alpinists' injured toes were warmer (approximately 6%) than their uninjured toes immediately after cold immersion (95% CI, 0.01°C to 1.00°C; P = .05); there were no differences between the rates of rewarming of injured and uninjured toes (INJ, 0.5° ± 0.1°C/min; CON, 0.7° ± 0.3°C/min; P = .16). Although the INJ alpinists had colder injured fingers immediately after the 35°C warm bath compared with their own uninjured fingers (32.2° ± 2.0°C vs 34.5° ± 0.5°C; P = .02), there were no differences observed between the rates of rewarming of injured and uninjured fingers after cold exposure (INJ, 1.1° ± 0.2°C/min; CON, 1.3° ± 0.5°C/min; P = .22). CONCLUSIONS Even after FCI that requires digit amputation, there is no evidence of different tissue rates of rewarming between the injured and uninjured fingers or toes of elite alpinists.
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Affiliation(s)
- Shawnda A Morrison
- Environmental Physiology and Ergonomics Laboratory, Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia (Drs Morrison and Mekjavic).
| | - Jurij Gorjanc
- Department of Surgery, Hospital of the Brothers of St. John of God, St.Veit/Glan, Austria (Dr Gorjanc)
| | - Ola Eiken
- Department of Environmental Physiology, School of Technology and Health, Royal Institute of Technology, Stockholm, Sweden (Dr Eiken)
| | - Igor B Mekjavic
- Environmental Physiology and Ergonomics Laboratory, Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia (Drs Morrison and Mekjavic)
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Cheung SS. Responses of the hands and feet to cold exposure. Temperature (Austin) 2015; 2:105-20. [PMID: 27227009 PMCID: PMC4843861 DOI: 10.1080/23328940.2015.1008890] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 01/09/2015] [Accepted: 01/09/2015] [Indexed: 11/19/2022] Open
Abstract
An initial response to whole-body or local exposure of the extremities to cold is a strong vasoconstriction, leading to a rapid decrease in hand and foot temperature. This impairs tactile sensitivity, manual dexterity, and muscle contractile characteristics while increasing pain and sympathetic drive, decreasing gross motor function, occupational performance, and survival. A paradoxical and cyclical vasodilatation often occurs in the fingers, toes, and face, and this has been termed the hunting response or cold-induced vasodilatation (CIVD). Despite being described almost a century ago, the mechanisms of CIVD are still disputed; research in this area has remained largely descriptive in nature. Recent research into CIVD has brought increased standardization of methodology along with new knowledge about the impact of mediating factors such as hypoxia and physical fitness. Increasing mechanistic analysis of CIVD has also emerged along with improved modeling and prediction of CIVD responses. The present review will survey work conducted during this century on CIVD, its potential mechanisms and modeling, and also the broader context of manual function in cold conditions.
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Affiliation(s)
- Stephen S Cheung
- Environmental Ergonomics Laboratory; Department of Kinesiology ; Brock University; St. Catharines , Canada
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Chan WY, Moonesamy V, Devaraj VS. Osteoarthritis after cold injuries. EUROPEAN JOURNAL OF PLASTIC SURGERY 2014. [DOI: 10.1007/s00238-014-0971-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Wilson TE, Klabunde RE, Monahan KD. Using thermal stress to model aspects of disease states. J Therm Biol 2014; 43:24-32. [DOI: 10.1016/j.jtherbio.2014.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 03/14/2014] [Accepted: 03/21/2014] [Indexed: 10/25/2022]
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Kim BJ, Seo Y, Kim JH, Lee DT. Effect of caffeine intake on finger cold-induced vasodilation. Wilderness Environ Med 2014; 24:328-36. [PMID: 24238217 DOI: 10.1016/j.wem.2013.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 04/25/2013] [Accepted: 06/19/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of the study was to investigate the effect of caffeine intake on finger cold-induced vasodilation (CIVD). METHODS Ten healthy men underwent 6 experimental trials characterized by control (NCAFF) or caffeine intake (CAFF) via chewing gum (300 mg of caffeine) while resting on a chair or performing submaximal (70% maximal oxygen consumption) or maximal (100% maximal oxygen consumption) treadmill exercise (Bruce protocol) followed by immersion of the middle finger in a water bath (5°C) for 20 minutes. Finger temperature (Tf ) and time parameters of the first CIVD cycle and post-test norepinephrine were measured. RESULTS Exercise duration for submaximal and maximal exercise was 8.9 ± 0.9 and 12.4 ± 0.8 minutes, respectively. CAFF had no effect on Tf, but exercise increased minimal Tf in NCAFF (9.08 ± 1.27°C, 13.02 ± 2.13°C, and 13.25 ± 1.63°C in rest, submaximal, and maximal exercise, respectively) and CAFF (8.76 ± 1.39°C, 12.50 ± 1.91°C, and 12.79 ± 1.20°C). Maximal Tf was significantly higher in NCAFF (15.98 ± 1.04°C, 16.18 ± 1.56°C, and 15.14 ± 1.52°C) than in CAFF (13.56 ± 1.19°C, 15.52 ± 1.31°C, and 14.39 ± 1.43°C), resulting in a significant difference between minimal and maximal Tf in rest (NCAFF, 6.89 ± 1.56°C and CAFF, 4.79 ± 1.23°C), but not in exercise conditions. CAFF had no effect on CIVD time responses, but exercise significantly shortened CIVD onset and peak time compared with rest in both NCAFF and CAFF. Norepinephrine concentration was significantly greater in CAFF (290.6 ± 113.0 pg/mL, 278.1 ± 91.4 pg/mL, and 399.8 ± 125.5 pg/mL) than NCAFF (105.6 ± 29.5 pg/mL, 199.6 ± 89.6 pg/mL, and 361.5 ± 171.3 pg/mL). CONCLUSIONS Caffeine intake before finger immersion in cold water does not result in a thermogenic effect and adversely affects CIVD responses, whereas exercise modifies CIVD temperature and time responses.
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Affiliation(s)
- Byeong Jo Kim
- College of Physical Education, Kookmin University, Seoul, South Korea
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Keramidas ME, Kölegård R, Mekjavic IB, Eiken O. Acute effects of normobaric hypoxia on hand-temperature responses during and after local cold stress. High Alt Med Biol 2014; 15:183-91. [PMID: 24666109 DOI: 10.1089/ham.2013.1131] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The purpose was to investigate acute effects of normobaric hypoxia on hand-temperature responses during and after a cold-water hand immersion test. Fifteen males performed two right-hand immersion tests in 8°C water, during which they were inspiring either room air (Fio2: 0.21; AIR), or a hypoxic gas mixture (Fio2: 0.14; HYPO). The tests were conducted in a counterbalanced order and separated by a 1-hour interval. Throughout the 30-min cold-water immersion (CWI) and the 15-min spontaneous rewarming (RW) phases, finger-skin temperatures were measured continuously with thermocouple probes; infrared thermography was also employed during the RW phase to map all segments of the hand. During the CWI phase, the average skin temperature (Tavg) of the fingers did not differ between the conditions (AIR: 10.2 ± 0.5°C, HYPO: 10.0 ± 0.5°C; p = 0.67). However, Tavg was lower in the HYPO than the AIR RW phase (AIR: 24.5 ± 3.4°C; HYPO: 22.0 ± 3.8°C; p = 0.002); a response that was alike in all regions of the immersed hand. Accordingly, present findings suggest that acute exposure to normobaric hypoxia does not aggravate the cold-induced drop in hand temperature of normothermic males. Still, hypoxia markedly impairs the rewarming responses of the hand.
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Affiliation(s)
- Michail E Keramidas
- 1 Department of Environmental Physiology, School of Technology and Health, Royal Institute of Technology , Stockholm, Sweden
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Morrison SA, Gorjanc J, Mekjavic IB. Mount Everest and Makalu Cold Injury Amputation: 40 Years On. High Alt Med Biol 2014; 15:78-83. [DOI: 10.1089/ham.2013.1069] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Shawnda A Morrison
- 1 Environmental Physiology and Ergonomics Laboratory, Department of Automation, Biocybernetics, and Robotics, Jožef Stefan Institute , Ljubljana, Slovenia
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Akkurt ZM, Ucmak D, Yildiz K, Yürüker SK, Celik HÖ. Chilblains in Turkey: a case-control study. An Bras Dermatol 2014; 89:44-50. [PMID: 24626647 PMCID: PMC3938353 DOI: 10.1590/abd1806-4841.20142376] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 02/12/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Chilblains are rather common in winter months in our country. OBJECTIVES Determination of demographical and clinical characteristics of patients presenting with chilblains in Diyarbakir, Turkey. Evaluation of body mass index (BMI) as risk factor for development of chilblains. METHODS Sixty-nine patients who were diagnosed as chilblains at our outpatient clinics were included in this study. No exclusion criteria were sought. Demographical data including height and weight and answers to questions related to personal history were recorded. A control group consisting of 108 controls were chosen from among patients presenting with complaints of hair loss. Statistical analyses were conducted using SPSS 17.0. RESULTS Of the 69 patients with chilblains, 45 (65.2%) were females and 24 (34.8%) were males. Mean age (± SD) of the patients was 21 ± 9. 71.2% of the patients complained of itching, 51.6% of pain, 31.3% of burning in the lesions. 61.3% of the patients reported recurrence of the lesions every winter season. Mean BMI of the patients was 20.5 ± 2.9. Mean BMI of the controls was 22.4 ± 3.7 and the difference was statistically significant (p=0.01). CONCLUSIONS Low BMI may be a risk factor contributing to development of chilblains in persons exposed to cold weather conditions. Apart from external factors, there seems to be a personal tendency to develop lesions, as many patients report recurrences every year. Diagnosis of chilblains requires wariness, as history of cold exposure may not be evident.
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Affiliation(s)
- Z Meltem Akkurt
- Assist. Prof. Dicle University Faculty of Medicine, Department of
Dermatology - Diyarbakir, Turkey
| | - Derya Ucmak
- Assist. Prof. Dicle University Faculty of Medicine, Department of
Dermatology - Diyarbakir, Turkey
| | - Kenan Yildiz
- MD - Specialist in Dermatology - Diyarbakir Training and Research
Hospital - Diyarbakir, Turkey
| | - Safiye Kutlu Yürüker
- MD - Specialist in Dermatology - Diyarbakir Training and Research
Hospital - Diyarbakir, Turkey
| | - Heybet Özkaya Celik
- MD - Specialist in Dermatology - Diyarbakir Training and Research
Hospital - Diyarbakir, Turkey
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Smits ES, Duraku LS, Niehof SP, Daanen HAM, Hovius SER, Selles RW, Walbeehm ET. Cold-induced vasodilatation in cold-intolerant rats after nerve injury. J Plast Reconstr Aesthet Surg 2013; 66:1279-86. [PMID: 23660280 DOI: 10.1016/j.bjps.2013.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Revised: 03/25/2013] [Accepted: 04/10/2013] [Indexed: 12/19/2022]
Abstract
PURPOSE Cold-induced vasodilatation (CIVD) is a cyclic regulation of blood flow during prolonged cooling of protruding body parts. It is generally considered to be a protective mechanism against local cold injuries and cold intolerance after peripheral nerve injury. The aim of this study was to determine the role of the sympathetic system in initiating a CIVD response. METHODS Eight rats were operated according to the spared nerve injury (SNI) model, eight underwent a complete sciatic lesion (CSL) and six underwent a sham operation. Prior to operation, 3, 6 and 9 weeks postoperatively, both hind limbs were cooled and the skin temperature was recorded to evaluate the presence of CIVD reactions. Cold intolerance was determined using the cold plate test and mechanical hypersensitivity measured using the Von Frey test. RESULTS No significant difference in CIVD was found comparing the lateral operated hind limb for time (preoperatively and 3, 6 and 9 weeks postoperatively; p = 0.397) and for group (SNI, CSL and Sham; p = 0.695). SNI and CSL rats developed cold intolerance and mechanical hypersensitivity. CONCLUSION Our data show that the underlying mechanisms that initiate a CIVD reaction are not affected by damage to a peripheral nerve that includes the sympathetic fibres. We conclude that the sympathetic system does not play a major role in the initiation of CIVD in the hind limb of a rat. CLINICAL RELEVANCE No substantial changes in the CIVD reaction after peripheral nerve injury imply that the origin of cold intolerance after a traumatic nerve injury is initiated by local factors and has a more neurological cause. This is an important finding for future developing treatments for this common problem, as treatment focussing on vaso-regulation may not help diminish symptoms of cold-intolerant patients.
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Affiliation(s)
- E S Smits
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Cold-induced vasodilation and vasoconstriction in the finger of tropical and temperate indigenes. J Therm Biol 2013. [DOI: 10.1016/j.jtherbio.2012.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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