Rapid Gene Expression Changes in Peripheral Blood Lymphocytes upon Practice of a Comprehensive Yoga Program

One of the most common integrative medicine (IM) modalities is yoga and related practices. Previous work has shown that yoga may improve wellness in healthy people and have benefits for patients. However, the mechanisms of how yoga may positively affect the mind-body system are largely unknown. Here we have assessed possible rapid changes in global gene expression profiles in the peripheral blood mononuclear cells (PBMCs) in healthy people that practiced either a comprehensive yoga program or a control regimen. The experimental sessions included gentle yoga postures, breathing exercises, and meditation (Sudarshan Kriya and Related Practices – SK&P) compared with a control regimen of a nature walk and listening to relaxing music. We show that the SK&P program has a rapid and significantly greater effect on gene expression in PBMCs compared with the control regimen. These data suggest that yoga and related practices result in rapid gene expression alterations which may be the basis for their longer term cell biological and higher level health effects.     

Changes in P300 following alternate nostril yoga breathing and breath awareness

This study assessed the effect of alternate nostril yoga breathing (nadisuddhi pranayama) on P300 auditory evoked potentials compared to a session of breath awareness of equal duration, in 20 male adult volunteers who had an experience of yoga breathing practices for more than three months. Peak amplitudes and peak latencies of the P300 were assessed before and after the respective sessions. There was a significant increase in the P300 peak amplitudes at Fz, Cz, and Pz and a significant decrease in the peak latency at Fz alone following alternate nostril yoga breathing. Following breath awareness there was a significant increase in the peak amplitude of P300 at Cz. This suggests that alternate nostril yoga breathing positively influences cognitive processes which are required for sustained attention at different scalp sites (frontal, vertex and parietal), whereas breath awareness brings about changes at the vertex alone.     

Immediate Effect of Specific Nostril Manipulating Yoga Breathing Practices on Autonomic and Respiratory Variables

The effect of right, left, and alternate nostril yoga breathing (i.e., RNYB, LNYB, and ANYB, respectively) were compared with breath awareness (BAW) and normal breathing (CTL). Autonomic and respiratory variables were studied in 21 male volunteers with ages between 18 and 45 years and experience in the yoga breathing practices between 3 and 48 months. Subjects were assessed in five experimental sessions on five separate days. The sessions were in fixed possible sequences and subjects were assigned to a sequence randomly. Each session was for 40 min; 30 min for the breathing practice, preceded and followed by 5 min of quiet sitting. Assessments included heart rate variability, skin conductance, finger plethysmogram amplitude, breath rate, and blood pressure. Following RNYB there was a significant increase in systolic, diastolic and mean pressure. In contrast, the systolic and diastolic pressure decreased after ANYB and the systolic and mean pressure were lower after LNYB. Hence, unilateral nostril yoga breathing practices appear to influence the blood pressure in different ways. These effects suggest possible therapeutic applications.     

Ratio of active to passive muscle shortening in the canine diaphragm.

Active and passive shortening of muscle bundles in the canine diaphragm were measured with the objective of testing a consequence of the minimal-work hypothesis: namely, that the ratio of active to passive shortening is the same for all active muscles. Lengths of six muscle bundles in the costal diaphragm and two muscle bundles in the crural diaphragm of each of four bred-for-research beagle dogs were measured by the radiopaque marker technique during the following maneuvers: a passive deflation maneuver from total lung capacity to functional residual capacity, quiet breathing, and forceful inspiratory efforts against an occluded airway at different lung volumes. Shortening per liter increase in lung volume was, on average, 70% greater during quiet breathing than during passive inflation in the prone posture and 40% greater in the supine posture. For the prone posture, the ratio of active to passive shortening was larger in the ventral and midcostal diaphragm than at the dorsal end of the costal diaphragm. For both postures, active shortening during quiet breathing was poorly correlated with passive shortening. However, shortening during forceful inspiratory efforts was highly correlated with passive shortening. The average ratios of active to passive shortening were 1.23 +/- 0.02 and 1.32 +/- 0.03 for the prone and supine postures, respectively. These data, taken together with the data reported in the companion paper (T. A. Wilson, M. Angelillo, A. Legrand, and A. De Troyer, J. Appl. Physiol. 87: 554-560, 1999), support the hypothesis that, during forceful inspiratory efforts, the inspiratory muscles drive the chest wall along the minimal-work trajectory.     

Yoga for bronchial asthma: a controlled study.

Fifty three patients with asthma underwent training for two weeks in an integrated set of yoga exercises, including breathing exercises, suryanamaskar, yogasana (physical postures), pranayama (breath slowing techniques), dhyana (meditation), and a devotional session, and were told to practise these exercises for 65 minutes daily. They were then compared with a control group of 53 patients with asthma matched for age, sex, and type and severity of asthma, who continued to take their usual drugs. There was a significantly greater improvement in the group who practised yoga in the weekly number of attacks of asthma, scores for drug treatment, and peak flow rate. This study shows the efficacy of yoga in the long term management of bronchial asthma, but the physiological basis for this beneficial effect needs to be examined in more detail.     

Statin-Associated Polymyalgia Rheumatica. An Analysis Using WHO Global Individual Case Safety Database: A Case/Non-Case Approach

Objective

To assess whether there is an association between statin use and the occurrence of polymyalgia rheumatic (PMR) in the spontaneous reporting database of the World Health Organisation (WHO).

Methods

We conducted a case/non-case study based on individual case safety reports (ICSR) in the WHO global ICSR database (VigiBase). Case reports containing the adverse event term polymyalgia rheumatica (WHOART or MedDRA Preferred Term) were defined as cases. Non-cases were all case reports containing other adverse event terms. Each case was matched to five non-cases by age, gender, and time of reporting. Case reports regarding a statin as suspected or concomitant drug were identified using the Anatomical Therapeutic Chemical (ATC) classification. Multivariate logistic regression was used to calculate reporting odds ratios (RORs) with 95% confidence intervals (CI).

Results

We identified 327 reports of PMR as cases and 1635 reports of other ADRs as non-cases. Among cases, statins were more frequently reported as suspected agent (29.4%) compared to non-cases (2.9%). After adjustment for several covariates, statins were significantly associated with reports of PMR (ROR 14.21; 95% CI 9.89–20.85).

Conclusion

The results of this study lends support to previous anecdotal case reports in the literature suggesting that the use of a statin may be associated with the occurrence of PMR. Further studies are needed to study the strength of the association in more detail and to elucidate the underlying mechanism.     

Case reports of adverse effects of herbal medicinal products (HMPs): A quality assessment

Background

Case reports provide essential information on adverse effects. Yet there is little consistency in the quality and format of reporting them.

Aim

In this study, we aimed to assess the quality of case reports of adverse effect of herbal medicinal products (HMPs) published during three time periods, 1986-1988, 1996-1998, and 2006-2008.

Methods

We conducted literature searches in four major databases: Medline, EMBASE, AMED, and CINALH. Each case report was subject to specific inclusion criteria related to the intervention (i.e. herbal medicine) and outcome measurement (i.e. adverse effect). A 21-item scale was used to assess the quality of all included reports. Each report was categorised into low quality (score between 0 and 14), lower medium quality (score between 15 and 21), upper medium quality (score between 22 and 28), and high quality (score between 29 and 42).

Results

In total, 137 case reports were included. The percentage of high quality case reports rose from 0% in 1986-1988 to 27.9% in 1996-1998 and 34.2% in 2006-2008; conversely, the percentages of low quality case reports dropped from 13.3% in 1986-1988 to 0% in 1996-1998 and 2.5% in 2006-2008.

Conclusion

These findings are consistent with the notion that the quality of case reports is improving. However, due to several caveats, our data should be interpreted with caution.     

Heart Rate Variability,Flow, Mood and Mental Stress During Yoga Practices in Yoga Practitioners,Non-yoga Practitioners and People with Metabolic Syndrome

Heart Rate Variability (HRV) and respiratory sinus arrhythmia are directly associated with autonomic flexibility, self-regulation and well-being, and inversely associated with physiological stress, psychological stress and pathology. Yoga enhances autonomic activity, mitigates stress and benefits stress-related clinical conditions, yet the relationship between autonomic activity and psychophysiological responses during yoga practices and stressful stimuli has not been widely explored. This experimental study explored the relationship between HRV, mood states and flow experiences in regular yoga practitioners (YP), non-yoga practitioners (NY) and people with metabolic syndrome (MetS), during Mental Arithmetic Stress Test (MAST) and various yoga practices. The study found that the MAST placed a cardio-autonomic burden in all participants with the YP group showing the greatest reactivity and the most rapid recovery, while the MetS group had significantly blunted recovery. The YP group also reported a heightened experience of flow and positive mood states compared to NY and MetS groups as well as having a higher vagal tone during all resting conditions. These results suggest yoga practitioners have a greater homeostatic capacity and autonomic, metabolic and physiological resilience. Further studies are now needed to determine if regular yoga practice may improve autonomic flexibility in non-yoga practitioners and metabolic syndrome patients. Clinical Trial No ‘ACTRN 2614001075673’     

Oxygen Consumption and Respiration During and After two Yoga Relaxation Techniques

Cyclic meditation (CM) is a technique which combines ‘stimulating’ and ‘calming’ practices, based on a statement in ancient yoga texts suggesting that such a combination may be especially helpful to reach a state of mental equilibrium. The oxygen consumption, breath rate and breath volume of 50 male volunteers (group mean age±SD, 27±6.3 years) were assessed before, during, and after sessions of CM and sessions of supine rest in the corpse posture (shavasana, SH). The sessions were one day apart and the order was alternated. The oxygen consumption, breath rate and breath volume increased during the ‘stimulating’ practices of CM, returned to the baseline during the ‘calming’ practices, and the oxygen consumption decreased by 19.3 percent below baseline values after CM. During the SH session the oxygen consumption, breath rate and breath volume reduced; however the decrease in oxygen consumption after SH was less than after CM (i.e., 4.8 percent). The results support the idea that a combination of yoga postures with supine rest (in CM) reduces the oxygen consumption more than resting supine alone does.     

Effect of two yoga-based relaxation techniques on memory scores and state anxiety

Background  

A yoga practice involving cycles of yoga postures and supine rest (called cyclic meditation) was previously shown to improve performance in attention tasks more than relaxation in the corpse posture (shavasana). This was ascribed to reduced anxiety, though this was not assessed.     

Yoga as steadiness training: effects on motor variability in young adults

Exercise training programs can increase strength and improve submaximal force control, but the effects of yoga as an alternative form of steadiness training are not well described. The purpose was to explore the effect of a popular type of yoga (Bikram) on strength, steadiness, and balance. Young adults performed yoga training (n = 10, 29 +/- 6 years, 24 yoga sessions in 8 weeks) or served as controls (n = 11, 26 +/- 7 years). Yoga sessions consisted of 1.5 hours of supervised, standardized postures. Measures before and after training included maximum voluntary contraction (MVC) force of the elbow flexors (EF) and knee extensors (KE), steadiness of isometric EF and KE contractions, steadiness of concentric (CON) and eccentric (ECC) KE contractions, and timed balance. The standard deviation (SD) and coefficient of variation (CV, SD/mean force) of isometric force and the SD of acceleration during CON and ECC contractions were measured. After yoga training, MVC force increased 14% for KE (479 +/- 175 to 544 +/- 187 N, p < 0.05) and was unchanged for the EF muscles (219 +/- 85 to 230 +/- 72 N, p > 0.05). The CV of force was unchanged for EF (1.68 to 1.73%, p > 0.05) but was reduced in the KE muscles similarly for yoga and control groups (2.04 to 1.55%, p < 0.05). The variability of CON and ECC contractions was unchanged. For the yoga group, improvement in KE steadiness was correlated with pretraining steadiness (r = -0.62 to -0.84, p < 0.05); subjects with the greatest KE force fluctuations before training experienced the greatest reductions with training. Percent change in balance time for individual yoga subjects averaged +228% (19.5 +/- 14 to 34.3 +/- 18 seconds, p < 0.05), with no change in controls. For young adults, a short-term yoga program of this type can improve balance substantially, produce modest improvements in leg strength, and improve leg muscle control for less-steady subjects.     

Oxygen Consumption and Respiration Following Two Yoga Relaxation Techniques

The present study was conducted to evaluate a statement in ancient yoga texts that suggests that a combination of both calming and stimulating measures may be especially helpful in reaching a state of mental equilibrium. Two yoga practices, one combining calming and stimulating measures (cyclic meditation) and the other, a calming technique (shavasan), were compared. The oxygen consumption, breath rate, and breath volume of 40 male volunteers (group mean ± SD, 27.0 ± 5.7 years) were assessed before and after sessions of cyclic meditation (CM) and before and after sessions of shavasan (SH). The 2 sessions (CM, SH) were 1 day apart. Cyclic meditation includes the practice of yoga postures interspersed with periods of supine relaxation. During SH the subject lies in a supine position throughout the practice. There was a significant decrease in the amount of oxygen consumed and in breath rate and an increase in breath volume after both types of sessions (2-factor ANOVA, paired t test). However, the magnitude of change on all 3 measures was greater after CM: (1) Oxygen consumption decreased 32.1% after CM compared with 10.1% after SH; (2) breath rate decreased 18.0% after CM and 15.2% after SH; and (3) breath volume increased 28.8% after CM and 15.9% after SH. These results support the idea that a combination of yoga postures interspersed with relaxation reduces arousal more than relaxation alone does.     

The metabolic cost of hatha yoga

To determine the metabolic and heart rate (HR) responses of hatha yoga, 26 women (19-40 years old) performed a 30-minute hatha yoga routine of supine lying, sitting, and standing asanas (i.e., postures). Subjects followed identical videotaped sequences of hatha yoga asanas. Mean physiological responses were compared to the physiological responses of resting in a chair and walking on a treadmill at 93.86 m.min(-1) [3.5 miles per hour (mph)]. During the 30-minute hatha yoga routine, mean absolute oxygen consumption (Vo(2)), relative Vo(2), percentage maximal oxygen consumption (%Vo(2)R), metabolic equivalents (METs), energy expenditure, HR, and percentage maximal heart rate (%MHR) were 0.45 L.min(-1), 7.59 ml.kg(-1).min(-1), 14.50%, 2.17 METs, 2.23 kcal.min(-1), 105.29 b.min(-1), and 56.89%, respectively. When compared to resting in a chair, hatha yoga required 114% greater O(2) (L.min(-1)), 111% greater O(2)(ml.kg(-1).min(-1)), 4,294% greater %Vo(2)R, 111% greater METs, 108% greater kcal.min(-1), 24% greater HR, and 24% greater %MHR. When compared to walking at 93.86 m.min(-1), hatha yoga required 54% lower O(2)(L.min(-1)), 53% lower O(2)(ml.kg(-1).min(-1)), 68% lower %Vo(2)R, 53% lower METs, 53% lower kcal.min(-1), 21% lower HR, and 21% lower %MHR. The hatha yoga routine in this study required 14.50% Vo(2)R, which can be considered a very light intensity and significantly lighter than 44.8% Vo(2)R for walking at 93.86 m.min(-1) (3.5 mph). The intensity of hatha yoga may be too low to provide a training stimulus for improving cardiovascular fitness. Although previous research suggests that hatha yoga is an acceptable form of physical activity for enhancing muscular fitness and flexibility, these data demonstrate that hatha yoga may have little, if any, cardiovascular benefit.     

Intraocular Pressure Rise in Subjects with and without Glaucoma during Four Common Yoga Positions

Purpose

To measure changes in intraocular pressure (IOP) in association with yoga exercises with a head-down position.

Methods

The single Center, prospective, observational study included 10 subjects with primary open-angle glaucoma and 10 normal individuals, who performed the yoga exercises of Adho Mukha Svanasana, Uttanasana, Halasana and Viparita Karani for two minutes each. IOP was measured by pneumatonometry at baseline and during and after the exercises.

Results

All yoga poses were associated with a significant (P<0.01) rise in IOP within one minute after assuming the yoga position. The highest IOP increase (P<0.01) was measured in the Adho Mukha Svanasana position (IOP increase from 17±3.2 mmHg to 28±3.8 mmHg in glaucoma patients; from 17±2.8 mmHg to 29±3.9 mmHg in normal individuals), followed by the Uttanasana position (17±3.9 mmHg to 27±3.4 mmHg (glaucoma patients) and from 18±2.5 mmHg to 26±3.6 mmHg normal individuals)), the Halasana position (18±2.8 mmHg to 24±3.5 mmHg (glaucoma patients); 18±2.7 mmHg to 22±3.4 mmHg (normal individuals)), and finally the Viparita Kirani position (17±4 mmHg to 21±3.6 mmHg (glaucoma patients); 17±2.8 to 21±2.4 mmHg (normal individuals)). IOP dropped back to baseline values within two minutes after returning to a sitting position. Overall, IOP rise was not significantly different between glaucoma and normal subjects (P = 0.813), all though glaucoma eyes tended to have measurements 2 mm Hg higher on average.

Conclusions

Yoga exercises with head-down positions were associated with a rapid rise in IOP in glaucoma and healthy eyes. IOP returned to baseline values within 2 minutes. Future studies are warranted addressing whether yoga exercise associated IOP changes are associated with similar changes in cerebrospinal fluid pressure and whether they increase the risk of glaucoma progression.

Trial Registration

ClinicalTrials.gov #{"type":"clinical-trial","attrs":{"text":"NCT01915680","term_id":"NCT01915680"}}NCT01915680     

Cardiorespiratory and Metabolic Changes during Yoga Sessions: The Effects of Respiratory Exercises and Meditation Practices

The novelty of this study was to investigate the changes in cardiorespiratory and metabolic intensity brought about by the practice of pranayamas (breathing exercises of yoga) and meditation during the same hatha-yoga session. The technique applied was the one advocated by the hatha-yoga system. Nine yoga instructors-five females and four males, mean age of 44+/-11, 6, were subjected to analysis of the gases expired during three distinct periods of 30 min: rest, respiratory exercises and meditative practice. A metabolic open circuit computerized system was applied (VO2000, MedGraphics-USA). The oxygen uptake (VO(2)) and the carbon dioxide output (VCO(2)) were statistically different (P 相似文献   

Referral patterns to an ophthalmic outpatient clinic by general practitioners and ophthalmic opticians and the role of these professionals in screening for ocular disease.

Case notes of 1113 consecutive new patients referred to a consultant ophthalmologist at a district general hospital were reviewed to determine the source and efficacy of referrals and the current screening practices of general practitioners and ophthalmic opticians. General practitioners initiated referral in 546 cases (49%) and ophthalmic opticians referral in 439 (39%). Visual loss or visual disturbance was the most important single reason for referral (345 cases; 31%), followed by suspected glaucoma (145 cases; 13%), abnormalities of binocular vision (140; 12.5%), disorders of eyelids or ocular adnexa (127; 11%), and red eye (86; 8%). General practitioners referred many more patients with disorders of the eyelids and adnexa and ophthalmic opticians many more patients with suspected glaucoma. Ophthalmic opticians were far more likely than general practitioners to refer patients with suspected glaucoma correctly. A total of 180 patients (16%) were referred from ocular screening, in 149 cases by ophthalmic opticians and in 10 by general practitioners. Seventy patients had glaucoma or incomplete features of glaucoma, all of them referred by ophthalmic opticians. Of eight diabetic patients referred by ophthalmic opticians, three had asymptomatic disease and in two diabetes was diagnosed as a result of ocular screening. No patient was referred for asymptomatic diabetic retinopathy from screening by general practitioners. Ophthalmic opticians were more likely than general practitioners to diagnose retinopathy requiring photocoagulation. Use of a community based service to screen for glaucoma could save unnecessary consultant outpatient appointments. A similar service could facilitate detection of diabetic retinopathy at a stage when treatment is most effective.     

Calibration of respiratory inductive plethysmograph during natural breathing

We describe a single-posture method for deriving the proportionality constant (K) between rib cage (RC) and abdominal (AB) amplifiers of the respiratory inductive plethysmograph (RIP). Qualitative diagnostic calibration (QDC) is based on equations of the isovolume maneuver calibration (ISOCAL) and is carried out during a 5-min period of natural breathing without using mouthpiece or mask. In this situation, K approximates the ratio of standard deviations (SD) of the uncalibrated changes of AB-to-RC volume deflections. Validity of calibration was evaluated by 1) analyzing RIP waveforms during an isovolume maneuver and 2) comparing changes of tidal volume (VT) amplitude and functional residual capacity (FRC) level measured by spirometry (SP) with RIP values. Comparisons of VT(RIP) to VT(SP) were also obtained in a variety of postures during natural (uninstructed) preferential RC and AB breathing and with voluntary changes of VT amplitude and FRC level. VT(RIP)-to-VT(SP) comparisons were equal to or closer than published reports for single posture, ISOCAL, multiple- and linear-regression procedures. QDC of RIP in supine posture with comparisons to SP in that posture and others showed better accuracy in horizontal than upright postures.     

Rapid Changes of Body Weight after a Headstand: A Metrological Analysis

Despite recent rules from amateur wrestling sport-governing bodies intended to discourage extreme weight loss measures, wrestling culture still includes varied methods to make weight, including holding a headstand position immediately before stepping on the scale. The procedure, according to the notion, will reduce reported mass anywhere between 250 and 500g (weight between 2.45 and 4.89 N). The aim of this study was to compare any possible differences between the headstand procedure (HS) and a normal (CON) weight measure, using a metrological approach defined by the European Association of National Metrology Institutes. Seventeen adult men were weighed on a force plate before and after doing a headstand or standing normally for 30s. The order of treatment application was assigned randomly. Post-test weight was significantly larger than pre-test (mean±s.d.) (640.7±62.8 N and 640.3±62.7 N, respectively, p<0.0001) under both treatments. No treatment vs. time of test interaction was found. No significant difference was found between CON and HS weight (640.6±62.8 N and 640.9±62.9 N, respectively, p=0.3815). The metrological tests suggest that the statistical differences found are related to the force plate measuring errors in every pre-established time interval. The 45g (0.44 N) difference found between pretest and post-test lies within the uncertainty range identified for the equipment (±110 g or 1.08 N). In conclusion, a 30-second headstand has no significant effect on registered body weight. The small variations obtained were due to equipment-associated measuring errors. This experiment offers systematic empirical evidence to aid in the elimination of this unjustified practice among the wrestling community.     

Increased Case Notification through Active Case Finding of Tuberculosis among Household and Neighbourhood Contacts in Cambodia

Background

Globally, there has been growing evidence that suggests the effectiveness of active case finding (ACF) for tuberculosis (TB) in high-risk populations. However, the evidence is still insufficient as to whether ACF increases case notification beyond what is reported in the routine passive case finding (PCF). In Cambodia, National TB Control Programme has conducted nationwide ACF with Xpert MTB/RIF that retrospectively targeted household and neighbourhood contacts alongside routine PCF. This study aims to investigate the impact of ACF on case notifications during and after the intervention period.

Methods

Using a quasi-experimental cluster randomized design with intervention and control arms, we compared TB case notification during the one-year intervention period with historical baseline cases and trend-adjusted expected cases, and estimated additional cases notified during the intervention period (separately for Year 1 and Year 2 implementation). The proportion of change in case notification was compared between intervention and control districts for Year 1. The quarterly case notification data from all intervention districts were consolidated, aligning different implementation quarters, and separately analysed to explore the additionality. The effect of the intervention on the subsequent case notification during the post-intervention period was also assessed.

Results

In Year 1, as compared to expected cases, 1467 cases of all forms (18.5%) and 330 bacteriologically-confirmed cases (9.6%) were additionally notified in intervention districts, whereas case notification in control districts decreased by 2.4% and 2.3%, respectively. In Year 2, 2737 cases of all forms (44.3%) and 793 bacteriologically-confirmed cases (38%) were additionally notified as compared to expected cases. The proportions of increase in case notifications from baseline cases and expected cases to intervention period cases were consistently higher in intervention group than in control group. The consolidated quarterly data showed sharp rises in all forms and bacteriologically-confirmed cases notified during the intervention quarter, with 64.6% and 68.4% increases (compared to baseline cases), and 46% and 52.9% increases (compared to expected cases), respectively. A cumulative reduction of case notification for five quarters after ACF reached more than -200% of additional cases.

Conclusions

The Cambodia’s ACF with Xpert MTB/RIF that retrospectively targeted household and neighbourhood contacts resulted in the substantial increase in case notification during the intervention period and reduced subsequent case notification during the post-intervention period. The applicability of retrospective contact investigation in other high-burden settings should be explored.