Cardio-respiratory interaction and autonomic dysfunction in obesity.

We aimed to test whether the evaluation of the cardio-respiratory interaction using the analysis of heart rate and blood pressure variabilities and respiratory maneuvers can reveal cardiovagal dysfunction in obese adolescents 12-18 years old. The spectral power in high frequency band of the heart rate variability (HRV) reflecting respiratory sinus arrhythmia was used as an index of the cardiac vagal control, and the spectral power in high frequency band of the blood pressure variability (BPV) as an indicator of mechanical effects of respiration. The deep breathing test and Valsalva maneuver were applied. The obese group had a reduction in spectral power in high frequency band of the HRV. Differences in high frequency band spectral power of the BPV between the obese and control groups were not found. The finding of lower respiratory sinus arrhythmia, indicating a cardiovagal dysfunction in obese adolescents, can provide important diagnostic information about early subclinical autonomic dysfunction in obesity.

Heart rate variability and cardiovascular tests in young patients with diabetes mellitus type 1.

The aim of this study was to obtain information about parameters of heart rate variability (HRV) in three frequency bands (high frequency - HF, low frequency - LF and very low frequency - VLF), the sensitivity of cardiovascular tests, and subjective feelings depending on autonomic nervous system balance in a group of young patients with diabetes mellitus type 1 (IDDM). Sixty-four subjects were examined: 32 patients with diabetes with a mean age of 16.1 +/- 0.7 years and a mean duration of IDDM of 6.3 +/- 0.8 years, and 32 healthy controls matched for age, sex and BMI. Shorter R-R intervals and abnormal values reflecting HRV were found in the diabetic group. In particular, parameters of total power, and HF and LF bands were reduced. The ratio VLF/HF power revealed predominance of sympathetic tone in the diabetic subjects. Although relative power VLF was increased in the supine position, the reactive rise of the VLF band activity in orthostasis was lower in the IDDM group. Using cardiovascular tests (deep breathing, Valsalva, orthostasis), significant differences in reactions were found only in the deep breathing test. Evaluation of sympathetic:parasympathetic:indifferent subjective feelings by questionnaire did not reveal any differences between the diabetic and healthy groups.

[Psychotherapy in the treatment of encopresis in children with idiopathic megacolon]. / Psychoterapia v liecbe enkoprézy u detí s idiopatickým megakolonom.

The authors treated by psychotherapy 70 children aged 3 to 15 years with encopresis and constipation. In all irrigographic examination revealed idiopathic megacolon. In the course of treatment and after treatment 93.1% of the children are free from complaints, of these 48% are without any treatment, the others are given intermitently small doses of lactulose and Clavigrenin. 4.6% of children have occasional problems, 2.3% of the patients did not improve. Improvement of the condition depends on the cooperation of the parents, in particular the mothers. In mothers of the treated children by means of Knobloch's test a higher score of neuroticism was found, as compared with mothers of children with common infections.