1. The effect of a variation in inspiration and expiration times on heart rate variability was studied in 12 healthy subjects (mean age 30+/-6 years; five females). 2. Two 2 min trials of controlled breathing, with either short inspiration followed by long expiration or long inspiration followed by short expiration, were compared. Average expiration/inspiration time ratios were 1.0 and 3.4, respectively. The respiration rate in both trials was approximately 10 cycles/min. 3. In trials with short inspiration followed by long expiration, respiratory sinus arrhythmia (RSA; as measured by mean absolute differences and by the high frequency band) was significantly larger than in trials with long inspiration followed by short expiration. This effect could not be accounted for by differences in respiration rate or respiratory amplitude. The higher RSA during fast/slow respiration is primarily due to a more pronounced phasic heart rate increase during inspiration, indicating that inspiratory vagal blockade is sensitive to the steepness of inspiration. 4. Respiration rate and tidal volume are respiratory variables known to modulate RSA. The results of the present study indicate that RSA can also be modulated by a third respiratory variable, the expiratory/inspiratory time ratio.

The objective of this paper was to study the change of well-being associated with vacation and the effect of vacation related variables on these changes. Fifty-three employees (16 women, 37 men) of a medium sized aluminium hardware manufacturer in Austria participated. Measures were taken 10 days before and 3 days after vacation. A small follow-up group at 5 weeks post-vacation was included. Three days after vacation, physical complaints, the quality of sleep and mood had improved as compared to before vacation. Average life satisfaction did not change during vacation. Five weeks after vacation subjects still reported less physical complaints than before vacation. The experienced recuperation during vacation explained 56% of the variance regarding the change of well-being. Moderating variables of recuperation were the amount of personally available time and vacation satisfaction. Furthermore, the number of stressful days at home were associated negatively, while the number of non-stressful days at home and the number of days away from home correlated moderately positively with recuperation. The study indicates that vacation may improve well-being on a short term basis.

We showed that the melatonin receptor subtype, MT1, is expressed in healthy and diseased human coronary arteries. As studies in experimental animals suggest that the MT2 melatonin receptor subtype is also present in the vasculature, we investigated whether the MT2 is expressed in human aorta and coronary arteries. Additionally, MT2 expression in human ventricular specimens was analysed, as melatonin was shown to affect myocyte function. Expression of the MT2-receptor was studied in sections of isolated coronary arteries, aorta and left ventricular specimens from healthy heart donors (control) and patients with dilated or ischemic cardiomyopathy. MT2 expression was found by reverse transcriptase (RT)-nested-polymerase chain reaction (PCR) in all of the specimens (aorta, left ventricle and coronary arteries) derived from controls. Also, visible evidence for receptor expression was found in 12 of 15 samples from cardiomyopathy patients and 10 of 15 of coronary heart disease patients. Additionally, the expression of MT2-receptor between aorta, left ventricle and coronary arteries varied among the individuals, some of them showing highest expression in the aorta while in others principal expression sites were coronary arteries or left ventricles. In conclusion, the MT2-receptor subtype is present in human arteries and left ventricles and it is suggested that in coronary heart disease MT2-receptor expression is altered. Furthermore, there is evidence for heterogeneous MT2 expression patterns in individual patients.

To study the influence of a 3-week hiking vacation at moderate (1700 m) and low altitude (LA) (200 m) on key-markers of the metabolic syndrome, 71 male volunteers (age 36-66 yr old) with the metabolic syndrome [according to the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) - or World Health Organization (WHO) - definition] participated in the study and were randomly assigned into a moderate altitude (MA) group (1700 m, no. 36) and a low altitude (LA) group (200 m, no. 35). The 3-week vacation program included 12 moderate- intensity guided hiking tours [4 times/week, 55-65% heart rate maximum (HRmax)] with a total exercise time of 29 h plus moderate recreational activities. Both study groups had a comparable and balanced nutrition with no specific dietary restrictions. Anthropometric, metabolic and cardiovascular parameters were measured 10-14 days before vacation, several times during the 3-week vacation, 7-10 days and 6-8 weeks after return. All participants tolerated the vacation without any adverse effects. Body weight, body fat, waist-circumference, fasting glucose, total cholesterol, LDL-cholesterol (LDL-C), plasma fibrinogen, resting systolic and diastolic blood pressure were significantly decreased over time in both study groups. In the LA group, fasting insulin and homeostasis model assessment (HOMA)-index were significantly decreased one week after return. Relative cycle ergometry performance was significantly increased after return compared to baseline. In both study groups, waist-to-hip ratio (WHR), 2-h oral glucose tolerance test (OGTT), HDL-cholesterol (HDL-C), and triglycerides remained unchanged. The 3-week vacation intervention at moderate and LA had a positive influence on all key-markers of the metabolic syndrome. No clinically relevant differences could be detected between the study groups. A hiking vacation at moderate and LA can be recommended for people with stable, controlled metabolic and cardiovascular risk factors.

Health-related vacation outcome is significantly affected by the way an individual organizes his or her vacation.

Research is scarce on ways to enhance the effect of rest breaks during mentally demanding tasks. The present study investigated the effectiveness of two rest-break interventions on well-being during an academic lecture. Sixty-six students (53 females, mean age 22.5 years) enrolled in two different university classes of 4-hr duration participated in the study. Two measures of well-being (fatigue and vigor) were assessed immediately before, after, and 20 minutes after the break. A control condition without a break as well as an unstructured break was compared with breaks either encompassing physical activity or a relaxation exercise. Compared with the nonbreak condition, the unstructured rest break led to an increase in vigor, the exercise break as well as the relaxation break both to an increase in vigor and a decrease in fatigue at 20-min post break. Compared with the unstructured break, exercise led to an (additional) increase in vigor and relaxation to an (additional) decrease in fatigue at 20-min post break. Thus, the effects of rest breaks during mentally demanding tasks can be enhanced by engaging in physical activity or relaxation exercises, with effects lasting at least as long as 20 min into the continuation of the task.

The present study investigated the changes of quality of life, mood, and the tumor marker CA 15-3 associated with a 3-week inpatient breast cancer rehabilitation program incorporating spa therapy. One hundred forty-nine women, 32 to 82 years, participated in the study 3 to 72 months after breast cancer surgery. Quality of life (QoL, EORTC QLQ-C30), anxiety, and depression (HADS) were measured 2 weeks before, at the end, and 6 months after rehabilitation; CA 15-3 at the beginning, end, and at 6 months follow-up. Patients received an individualized rehabilitation program incorporating manual lymph drainage, exercise therapy, massages, psychological counseling, relaxation training, carbon dioxide baths, and mud packs. Quality of life and mood improved significantly, the greatest short-term improvements found for mood-related aspects of quality of life, the most lasting improvements found for physical complaints (eg, fatigue). Also, the tumor marker CA 15-3 declined significantly to follow-up. Patient characteristics, as well as the time since surgery, moderated rehabilitation outcome to a limited extent. Older patients, nonobese patients, patients with a greater lymphedema, and patients with an active coping style showed slightly greater improvements. Hot mud packs inducing hyperthermia did not affect CA 15-3. In conclusion, the combination of inpatient rehabilitation with spa therapy provides a promising approach for breast cancer rehabilitation.

Background: Due to possible antiinflammatory effects, sulfur baths are widely used for the treatment of rheumatic diseases. Previously it was demonstrated that drinking cures with sulfur can improve the antioxidative defense system and lower the peroxide levels of patients with chronic degenerative osteoarthritis. Objective: This study therefore sought to investigate the effect of 3-week therapy with sulfur baths on antioxidative defense systems, peroxide concentrations, and lipid levels in patients with degenerative osteoarthritis. Patients and Methods: After randomization one group of patients (n = 19) received sulfur baths during their stay at a health resort (sulfur group), whereas the other age-matched patient group served as controls (n = 19, control group), only receiving spa therapy. Total cholesterol levels, HDL, LDL, triglycerides and the antioxidative status, glutathione peroxidase, and superoxide dismutase (SOD) activities, and peroxide concentration, as an oxidative stress parameter, were evaluated at the begin and end of therapy. Results: A 17.2% decline in peroxide concentrations (p = 0.10, n.s.) and significant lower SOD activities (p < 0.001) were detected in the sulfur group at the end of the therapy. Until the end of therapy total cholesterol levels changed differentially (p = 0.007) in the sulfur group (from 229.11 ± 34.47 mg/dl to 217.46 ± 40.45 mg/dl) and in the control group (from 197.63 ± 34.66 mg/dl to 207.95 ± 33.02 mg/dl). A similar significant group difference was found for LDL (p = 0.017), with a 5.9% reduction in the sulfur group and a 6.1% increase in the control group. Triglyceride concentrations were nonsignificantly reduced in both groups after 3 weeks at the health resort (sulfur group 11.2%, control group 20.2%). HDL values only minimally changed in both groups. Conclusions: The results presented here suggest that a sulfur bath therapy could cause a reduction in oxidative stress, alterations of SOD activities, and a tendency towards improvement of lipid levels.