We studied in 32 patients on maintenance hemodialysis (duration of treatment 6 to 133 months) whether duration of dialysis treatment affects blood pressure, plasma noradrenaline levels and alpha 2-adrenoceptor density (assessed in platelet membranes by 3H-yohimbine binding). Plasma noradrenaline levels were a significant inverse correlation to platelet alpha 2-adrenoceptor density. In addition, mean arterial blood-pressure, plasma noradrenaline levels and platelet alpha 2-adrenoceptor density were significantly related to the duration of treatment: with increasing duration of treatment plasma noradrenaline levels increased, whereas mean arterial blood-pressure and platelet alpha 2-adrenoceptor density decreased. Furthermore, changes in mean arterial blood-pressure were inversely related to plasma noradrenaline levels and positively to platelet alpha 2-adrenoceptor density. Platelet alpha 2-adrenoceptor changes were accompanied by similar alterations in (vascular) alpha 1-adrenoceptor responsiveness (assessed by blood pressure responses to i.v. injections of phenylephrine); in hypotensive hemodialysis patients, who had high, plasma noradrenaline levels and low, platelet alpha 2-adrenoceptor density, the dose of phenylephrine necessary to increase systolic blood pressure by 20 mm Hg was nearly twice as high as in normotensive dialysis patients and healthy controls. In autonomic tests, Valsalva-ratio was lower in hypotensive than in normotensive dialysis patients and healthy controls, whereas no differences were found in blood pressure and heart rate responses during sustained hand-grip exercise as well as in beat-to-beat variation during deep breathing.(ABSTRACT TRUNCATED AT 250 WORDS)

To build a sustainable workforce for long-term disaster relief and reconstruction, more effort must be made to promote local relief workers' mental health. We conducted 25 semistructured interviews with local relief officials 10 months after the 2008 earthquake in China to investigate the stress and coping experiences in their personal lives as survivors. We conducted thematic analysis of interview transcripts. Traumatic bereavement and grief, housing and financial difficulties, and work-family conflict were the three main sources of stress in the respondents' personal lives. The coping themes were finding meaning and purpose in life through relief work, colleagues' support and understanding, suppression or avoidance of grief, appreciation for life, hardiness, optimism, letting nature take its course, and making up for loss. We suggest that relief work has a double-edged-sword effect on workers' coping abilities. We discuss the implications of this effect for work-life balance measures and trauma and grief counseling services.

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We compared the effects of acute stimulation of sympathetic activity by dynamic exercise on a bicycle on lymphocyte beta 2-adrenoceptor density and 10 mumol/L (-)-isoprenaline-evoked lymphocyte cyclic adenosine monophosphate increases in normotensive volunteers with those in patients with essential hypertension. In normotensive subjects exercise increased lymphocyte beta 2-adrenoceptors by about 100%. This effect seems to be a beta 2-dependent process, since it is prevented by propranolol (5 mg administered intravenously) and the beta 2-selective antagonist ICI 118,551 (25 mg t.i.d. orally for 2 weeks) but not by the beta 1-selective antagonist bisoprolol (2.5 mg administered intravenously). In patients with essential hypertension who have elevated lymphocyte beta 2-adrenoceptors, dynamic exercise caused only marginal beta 2-adrenoceptor changes, suggesting an impairment of the acute beta-adrenoceptor regulation. Normalization of blood pressure by antihypertensive treatment resulted in a significant fall in lymphocyte beta 2-adrenoceptors and in a restoration of exercise-induced beta 2-adrenoceptor increases. It is concluded that in essential hypertension the impairment of beta-adrenoceptor regulation is directly linked to the elevated blood pressure.