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"Vagal Stimulation" OR "Vagal Maneuver" OR "Valsalva Maneuver" OR "Carotid Sinus Massage"

Signe T Andersen, Daniel R Witte, Jesper Fleischer, Henning Andersen, Torsten Lauritzen, Marit E Jørgensen, Troels S Jensen, Rodica Pop-Busui, Morten Charles
OBJECTIVE: To examine the course of cardiovascular autonomic neuropathy (CAN) and related cardiometabolic risk factors in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: CAN and cardiometabolic risk factors were assessed in the Danish arm of the Anglo-Danish-Dutch Study of Intensive Treatment in People With Screen Detected Diabetes in Primary Care (ADDITION-Denmark) at 6-year ( n = 777) and 13-year ( n = 443) follow-up examinations. Cardiovascular autonomic reflex tests (CARTs)-that is, lying to standing, deep breathing, and the Valsalva maneuver-and 2-min resting heart rate variability (HRV) indices were obtained as the main measures of CAN...
October 10, 2018: Diabetes Care
Zoltan Ungvari, Andriy Yabluchanskiy, Stefano Tarantini, Peter Toth, Angelia C Kirkpatrick, Anna Csiszar, Calin I Prodan
Multifocal cerebral microhemorrhages (CMHs, also known as "cerebral microbleeds"), which are associated with rupture of small intracerebral vessels, have been recognized as an important cause for cognitive decline in older adults. Although recent studies demonstrate that CMHs are highly prevalent in patients 65 and older, many aspects of the pathogenesis and clinical significance of CMHs remain obscure. In this longitudinal observational study, a case of a 77-year-old man with multifocal CMHs is described, in whom the rupture of intracerebral vessels could be linked to repeatedly performing extended Valsalva maneuvers...
October 4, 2018: GeroScience
Tao Yuan, Jiapei Li, Yong Fu, Tao Xu, Juan Li, Xiangqing Wang, Ying Zhou, Yingyue Dong, Weigang Zhao
BACKGROUNDS: Cardiac autonomic neuropathy is a common but always overlooked. More convenient diagnostic methods are needed. HYPOTHESIS: Cardiac autonomic neuropathy risk score evaluated by SUDOSCAN has a fine diagnostic efficacy detecting cardiac autonomic neuropathy. METHODS: This is a cross-sectional study among patients with diabetes mellitus. Subjects undertook SUDOSCAN tests and cardiac autonomic reflex tests, including heart rate variability due to Valsalva maneuver, heart rate response due to deep breathing and heart rate response due to standing up...
2018: PloS One
Enrica Olivola, Livia Brusa, Camilla Rocchi, Orazio Schillaci, Claudio Liguori, Rocco Cerroni, Mariangela Pierantozzi, Agostino Chiaravalloti, Alessandro Stefani, Fabrizio Stocchi
BACKGROUND: Despite its negative impact on quality of life, fatigue in Parkinson's disease (PD) remains an under-recognized issue and the underlying pathology is undetermined. OBJECTIVE: To contribute at understanding the pathogenesis of fatigue in a naturalistic cohort of cognitively intact PD patients. METHODS: In a Caucasian population of PD patients (n = 27), we evaluated to what extent fatigue (quantified as PFS-16 score) is associated with PD duration and with autonomic dysfunction, studied by both MIBG scintigraphy and autonomic nervous system testing...
September 25, 2018: Neurological Sciences
Rachel Y K Cheung, Symphorosa S C Chan, Ka-Lai Shek, Tony K H Chung, Hans Peter Dietz
OBJECTIVES: Ethnic differences have been suggested as a significant factor for pelvic organ prolapse; yet, the pelvic organ descent in various ethnic groups was not well studied, especially in Asian population. We aimed to compare prolapse stages, pelvic organ descent and hiatal dimensions of East Asian and Caucasian women presenting with symptoms of pelvic organ prolapse. METHODS: A prospective observation study was conducted in women who presented to tertiary urogynecology clinics with symptoms of pelvic organ prolapse in Hong Kong and Sydney...
September 23, 2018: Ultrasound in Obstetrics & Gynecology
Wenfei Han, Luis A Tellez, Matthew H Perkins, Isaac O Perez, Taoran Qu, Jozelia Ferreira, Tatiana L Ferreira, Daniele Quinn, Zhong-Wu Liu, Xiao-Bing Gao, Melanie M Kaelberer, Diego V Bohórquez, Sara J Shammah-Lagnado, Guillaume de Lartigue, Ivan E de Araujo
The gut is now recognized as a major regulator of motivational and emotional states. However, the relevant gut-brain neuronal circuitry remains unknown. We show that optical activation of gut-innervating vagal sensory neurons recapitulates the hallmark effects of stimulating brain reward neurons. Specifically, right, but not left, vagal sensory ganglion activation sustained self-stimulation behavior, conditioned both flavor and place preferences, and induced dopamine release from Substantia nigra. Cell-specific transneuronal tracing revealed asymmetric ascending pathways of vagal origin throughout the CNS...
September 18, 2018: Cell
Anne-Frederique Minsart, François-Pierre Mongeon, Anne-Marie Laberge, Francine Morin, Annie Dore, Line Leduc
OBJECTIVE: To assess obstetric and aortic outcomes in women with Marfan Syndrome according to aortic root diameter, in view of recommendations for caesarean delivery when the aortic root diameter is ≥40 mm in the 2010 American guidelines versus >45 mm in the 2011 European guidelines. STUDY DESIGN: In this retrospective cohort study conducted at Sainte-Justine Mother and Child Tertiary Hospital, 27 pregnancies in 20 women with Marfan Syndrome as defined by the international criteria, were followed prospectively between 1994 and 2017, after excluding women with prior aortic surgery...
September 11, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Hina Arif-Tiwari, Christian O Twiss, Frank C Lin, Joel T Funk, Srinivasan Vedantham, Diego R Martin, Bobby T Kalb
PURPOSE: To evaluate the utility of a defecography phase (DP) sequence in dynamic pelvic floor MRI (DPMRI), in comparison to DPMRI utilizing only non-defecography Valsalva maneuvers (VM). MATERIALS AND METHODS: Inclusion criteria identified 237 female patients with symptoms and/or physical exam findings of pelvic floor prolapse. All DPMRI exams were obtained following insertion of ultrasound gel into the rectum and vagina. Steady-state free-precession sequences in sagittal plane were acquired in the resting state, followed by dynamic cine acquisitions during VM and DP...
August 23, 2018: Current Problems in Diagnostic Radiology
Samuel A Kosinski, Brian E Carlson, Scott L Hummel, Robert D Brook, Daniel A Beard
Functional metrics of autonomic control of heart rate, including baroreflex sensitivity, have been shown to be strongly associated with cardiovascular risk. A decrease in baroreflex sensitivity with aging is hypothesized to represent a contributing causal factor in the etiology of primary hypertension. To assess baroreflex function in human subjects, two complimentary methods to simulate the response in heart rate elicited by the Valsalva maneuver were developed and applied to data obtained from a cohort of healthy normal volunteers...
September 20, 2018: Journal of Applied Physiology
R Lu, Y Zhang, F R Dai, Y P Yu
Objective: To explore the application of transperineal pelvic floor ultrasonography in the diagnosis of female stress urinary incontinence(SUI). Methods: From March 2017 to December 2017, 60 patients diagnosed with SUI by department of gynecology, Xiangya Hospital of Central South University were selected as the case group, and 30 cases of normal women in the same period were selected as the control group. All subjects in both groups were examined by transperineal pelvic floor ultrasonography, that is, to be measured the bladder neck descent(BND), the urethral inclination angle(UIA), the posterior urethrovesical angle(PUVA) and the levator hiatus area(LHA) in resting state and during Valsalva maneuver...
September 4, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Aaron I Vinik, Carolina Casellini, Henri K Parson, Sheri R Colberg, Marie-Laure Nevoret
Autonomic nervous system (ANS) imbalance manifesting as cardiac autonomic neuropathy in the diabetic population is an important predictor of cardiovascular events. Symptoms and signs of ANS dysfunction, such as resting heart rate elevations, diminished blood pressure responses to standing, and altered time and frequency domain measures of heart rate variability in response to deep breathing, standing, and the Valsalva maneuver, should be elicited from all patients with diabetes and prediabetes. With the recognition of the presence of ANS imbalance or for its prevention, a rigorous regime should be implemented with lifestyle modification, physical activity, and cautious use of medications that lower blood glucose...
2018: Frontiers in Neuroscience
Magdalena Krbot Skorić, Luka Crnošija, Ivan Adamec, Barbara Barun, Tereza Gabelić, Tomislav Smoljo, Ivan Stanić, Tin Pavičić, Ivan Pavlović, Jelena Drulović, Tatjana Pekmezović, Mario Habek
OBJECTIVES: To investigate a possible association between autonomic dysfunction and fatigue in people with multiple sclerosis. METHODS: In 70 people with multiple sclerosis early in the disease course (51 females, mean age 33.8 ± 9.1), quantitative sudomotor axon reflex tests, cardiovascular reflex tests (heart rate and blood pressure responses to the Valsalva maneuver and heart rate response to deep breathing), and the tilt table test were performed. Participants completed the Composite Autonomic Symptom Score 31, the Modified Fatigue Impact Scale, and the Epworth Sleepiness Scale, as well as the Beck Depression Inventory...
September 12, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Toshihiro Matsui, Takuya Okada, Kenro Kawada, Masahumi Okuda, Taichi Ogo, Yutaka Nakajima, Yuichiro Kume, Tairo Ryotokuji, Akihiro Hoshino, Yutaka Tokairin, Yasuyuki Michi, Hiroyuki Harada, Yasuaki Nakajima, Tatsuyuki Kawano
Objective: To assess the usefulness of modified esophagogastroduodenoscopy (EGD) for the detection of second primary malignancies of the esophagus or hypopharynx in patients with oral squamous cell carcinoma and determine the association between the oral lesion subsite and esophageal or hypopharyngeal lesion occurrence. Study Design: Retrospective review. Methods: In total, 166 patients with oral squamous cell carcinoma without any established symptoms of esophageal or hypopharyngeal squamous cell carcinoma underwent modified EGD based on the Valsalva maneuver and U-turn method, image-enhanced endoscopy, and chromoendoscopy using Lugol's iodine for diagnosis...
August 2018: Laryngoscope Investigative Otolaryngology
Xiaopeng Song, Bhaswati Roy, Gregg C Fonarow, Mary A Woo, Rajesh Kumar
Heart failure (HF) patients show inability to regulate autonomic functions in response to autonomic challenges. The autonomic deficits may stem from brain tissue injury in central autonomic regulatory areas, resulting from ischemic and hypoxic processes accompanying the condition. However, the direct evaluation of correlations between brain structural injury and functional timing and magnitude of neural signal patterns within affected areas, which may lead to impaired autonomic outflow, is unclear. In this study, we evaluate neural responses to the Valsalva maneuver with blood oxygen level-dependent functional magnetic resonance imaging in 29 HF patients and 35 control subjects and brain structural changes using diffusion tensor imaging-based mean diffusivity in a subsample of 19 HF and 24 control subjects...
September 2018: Journal of Neuroscience Research
José Carlos Pachón Mateos
No abstract text is available yet for this article.
July 2018: Arquivos Brasileiros de Cardiologia
Tan Chen Wu, Denise T Hachul, Francisco Carlos da Costa Darrieux, Maurício I Scanavacca
BACKGROUND: Carotid sinus hypersensitivity (CSH) is a frequent finding in the evaluation of syncope. However, its significance in the clinical setting is still dubious. A new criterion was proposed by Solari et al. with a symptomatic systolic blood pressure (SBP) cut-off value of ≤ 85 mmHg to refine the vasodepressor (VD) response diagnosis. OBJECTIVE: To determine and compare the response to carotid sinus massage (CSM) in patients with and without syncope according to standard and proposed criteria...
July 2018: Arquivos Brasileiros de Cardiologia
Asim Ahmed, Brad Clark, Parin J Patel, Eric N Prystowsky
No abstract text is available yet for this article.
August 14, 2018: Journal of Cardiovascular Electrophysiology
Cheng Feng, Tingting Luo, Yongfang Luo, Ningbo Zhao, Kun Huang, Chang Xiao
OBJECTIVE: To investigate the detection rate of patent foramen ovale-right to left shunt (PFO-RLS) and/or pulmonary-right to left shunt (P-RLS) via contrast-enhanced transthoracic echocardiography (c-TTE) in healthy participants, patients suffering from cryptogenic stroke and migraine with aura. METHODS: Initially, 20 healthy volunteers, 21 cases with cryptogenic stroke, and 18 cases with migraine aura were randomly selected, and all of them received c-TTE and transesophageal echocardiography (TEE) examinations...
September 2018: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
Stephen A Klassen, Jacqueline K Limberg, Sarah E Baker, Wayne T Nicholson, Timothy B Curry, Michael J Joyner, J Kevin Shoemaker
KEY POINTS: The mechanisms affecting recruitment patterns of postganglionic sympathetic nerves remain unclear. The divergent and convergent preganglionic innervation patterns of postganglionic neurons and the presence of differently sized postganglionic nerves suggest that the ganglia may participate in modifying the discharge patterns of single sympathetic postganglionic neurons innervating the skeletal muscle circulation. Whether the ganglia affect the ordered behaviour of varying sized postganglionic sympathetic neurons in humans has not been studied...
September 2018: Journal of Physiology
Meirav Braverman, Ixora Kamisan Atan, Friyan Turel, Talia Friedman, Hans Peter Dietz
OBJECTIVES: Translabial ultrasound (US) imaging is an emerging method for the evaluation of pelvic organ prolapse (POP). Normative data to date are limited to imaging in the supine position. The purpose of this study was to evaluate the effect of posture changes on US pelvic organ mobility. METHODS: This work was a retrospective study of 175 women seen in a tertiary urogynecologic center for symptoms of lower urinary tract and pelvic floor dysfunction. All underwent a standardized interview, POP quantification prolapse assessment, and 4-dimensional translabial US examination in supine and standing positions...
July 19, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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