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https://www.readbyqxmd.com/read/28925529/cerebrovascular-response-to-the-cold-pressor-test-the-critical-role-of-carbon-dioxide
#1
Michael M Tymko, Thijs P Kerstens, Kevin W Wildfong, Philip N Ainslie
In addition to increasing sympathetic nervous activity, blood pressure, and cerebral blood flow (CBF), the cold pressor test (CPT) stimulates pain receptors, which may increase ventilation above metabolic demand; this response likely reduces the partial pressure of end-tidal carbon dioxide (PET CO2 ), and will attenuate elevations in CBF. We hypothesized: (1) CPT would elicit hyperventilation, effectively lowering PET CO2 ; (2) the CBF response will be elevated during an isocapnic (controlled PET CO2 ), compared to a poikilocapnic CPT (uncontrolled PET CO2 ); (3) In response to CPT, the common carotid artery (CCA) will vasodilatate, while the internal carotid artery (ICA) will remain unchanged to help regulate CBF...
September 19, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28918418/new-aspects-in-the-pathomechanism-of-diseases-of-civilization-particularly-psychosomatic-disorders-part-1-theoretical-background-of-a-hypothesis
#2
Andras Sikter, Zoltan Rihmer, Roberto de Guevara
The stress defence-cascade is mostly not biphasic as Cannon thought, the sympathicotonic stress response is preceded by a vagotonic phase called freeze response. Alteration of the carbon dioxide level plays an important role during defence-cascade as its changes interfere with stress hormones, e.g. with catecholamines, thus affecting the degree of arousal. In case of humans, learned behaviour dominates instead of instinctive, so the fight-or-flight often lags; the consequence can be persistent hypocapnia or hypercapnia...
June 2017: Neuropsychopharmacologia Hungarica
https://www.readbyqxmd.com/read/28913711/emergency-neurological-life-support-resuscitation-following-cardiac-arrest
#3
Jonathan Elmer, Kees H Polderman
Cardiac arrest is the most common cause of death in North America. An organized bundle of neurocritical care interventions can improve chances of survival and neurological recovery in patients who are successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an Emergency Neurological Life Support protocol. Key aspects of successful early post-arrest management include: prevention of secondary brain injury; identification of treatable causes of arrest in need of emergent intervention; and, delayed neurological prognostication...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28905530/nonspecific-bronchoprovocation-test
#4
REVIEW
Myoung Kyu Lee, Hyoung Kyu Yoon, Sei Won Kim, Tae Hyung Kim, Seoung Ju Park, Young Min Lee
Bronchial asthma is a disease characterized by the condition of airway hyper-responsiveness, which serves to produce narrowing of the airway secondary to airway inflammation and/or various spasm-inducing stimulus. Nonspecific bronchoprovocation testing is an important method implemented for the purpose of diagnosing asthma; this test measures the actual degree of airway hyper-responsiveness and utilizes direct and indirect bronchoprovocation testing. Direct bronchoprovocation testing using methacholine or histamine may have superior sensitivity as these substances directly stimulate the airway smooth muscle cells...
September 1, 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28895081/novel-de-novo-kcnd3-mutation-in-a-japanese-patient-with-intellectual-disability-cerebellar-ataxia-myoclonus-and-dystonia
#5
Masanori Kurihara, Hiroyuki Ishiura, Takuya Sasaki, Juuri Otsuka, Toshihiro Hayashi, Yasuo Terao, Takashi Matsukawa, Jun Mitsui, Juntaro Kaneko, Kazutoshi Nishiyama, Koichiro Doi, Jun Yoshimura, Shinichi Morishita, Jun Shimizu, Shoji Tsuji
Spinocerebellar ataxia 19/22 (SCA19/22) is a rare type of autosomal dominant SCA that was previously described in 11 families. We report the case of a 30-year-old Japanese man presenting with intellectual disability, early onset cerebellar ataxia, myoclonus, and dystonia without a family history. MRI showed cerebellar atrophy, and electroencephalograms showed paroxysmal sharp waves during hyperventilation and photic stimulation. Trio whole-exome sequencing analysis of DNA samples from the patient and his parents revealed a de novo novel missense mutation (c...
September 11, 2017: Cerebellum
https://www.readbyqxmd.com/read/28883532/patterns-of-oxygen-pulse-curve-in-response-to-incremental-exercise-in-patients-with-chronic-obstructive-pulmonary-disease-an-observational-study
#6
Ming-Lung Chuang, I-Feng Lin, Shih-Feng Huang, Meng-Jer Hsieh
In COPD, pulmonary hyperinflation causes decreased stroke volume thereby decreased oxygen pulse (O2P). While O2P flattening is related to myocardial ischemia in cardiac patients, O2P patterns have seldom been explored in COPD. The aims of the study were to investigate O2P-curve patterns and associated factors in COPD. Seventy-five patients with stable COPD were enrolled. The demographics, cardiac size, physiological measurements and stress EKG were compared among O2P-curve pattern groups. An algorithm to identify O2P-curve patterns was developed in 28 patients...
September 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28860775/a-case-of-paroxysmal-kinesigenic-dyskinesia-which-exhibited-the-phenotype-of-anxiety-disorder
#7
Yasuto Kunii, Nozomu Matsuda, Hirooki Yabe
BACKGROUND: Paroxysmal kinesigenic dyskinesia (PKD) is a rare heritable neurologic disorder characterized by attacks of involuntary movement induced by sudden voluntary movements. No previous reports have described cases showing comorbidity with psychiatric disease or symptoms. In this case, we showed a patient with PKD who exhibited several manifestations of anxiety disorder. CASE: A 35-year-old Japanese man with PKD had been maintained on carbamazepine since he was 16 years of age without any attacks...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28847139/swimming-three-ice-miles-within-fifteen-hours
#8
Mirko Stjepanovic, Pantelis T. Nikolaidis, Beat Knechtle
Ice Mile swimming (1608 m in water of below 5 °Celsius) is becoming increasingly popular. This case study aimed to identify body core temperature and selected haematological and biochemical parameters before and after repeated Ice Miles. An experienced ice swimmer completed three consecutive Ice Miles within 15 h. Swim times, body core temperatures, and selected urinary and haematological parameters were recorded. Body core temperature reached its maximum between 5, 8 and 15 min after immersion (37.7°C, 38...
August 31, 2017: Chinese Journal of Physiology
https://www.readbyqxmd.com/read/28841575/relation-of-insulin-resistance-to-neurocognitive-function-and-electroencephalography-in-obese-children
#9
Onur Akın, İbrahim Eker, Mutluay Arslan, Süleyman Tolga Yavuz, Sevil Akman, Mehmet Emre Taşçılar, Bülent Ünay
BACKGROUND: Childhood obesity may lead to neuronal impairment in both the peripheral and the central nervous system. This study aimed to investigate the impact of obesity and insulin resistance (IR) on the central nervous system and neurocognitive functions in children. METHODS: Seventy-three obese children (38 male and 35 female) and 42 healthy children (21 male and 21 female) were recruited. Standard biochemical indices and IR were evaluated. The Wechsler Intelligence Scale for Children-Revised (WISC-R) and electroencephalography (EEG) were administered to all participants...
August 25, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28839003/acute-hypoxia-in-a-simulated-high-altitude-airdrop-scenario-due-to-oxygen-system-failure
#10
William Ottestad, Tor Are Hansen, Gaurav N Pradhan, Jan Stepanek, Lars Øivind Høiseth, Jan Ivar Kåsin
High Altitude High Opening (HAHO) is a military operational procedure in which parachute jumps are performed at high altitude requiring supplemental oxygen, putting personnel at risk of acute hypoxia in the event of oxygen equipment failure. This study was initiated by the Norwegian Army in order to evaluate potential outcomes during failure of oxygen supply, and to explore physiology during acute severe hypobaric hypoxia. A simulated HAHO without supplemental oxygen was carried out in a hypobaric chamber with decompression to 30 000 ft (9144 m) and then recompression to ground level with a descent rate of 1000 ft/min (305 m/min)...
August 24, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28830028/increased-rates-of-intermittent-rhythmic-delta-and-theta-activity-in-the-electroencephalographies-of-adult-patients-with-attention-deficit-hyperactivity-disorder
#11
Dominique Endres, Simon Maier, Bernd Feige, Nora Bel Mokhtar, Kathrin Nickel, Peter Goll, Simon A Meyer, Swantje Matthies, Dieter Ebert, Alexandra Philipsen, Evgeniy Perlov, Ludger Tebartz van Elst
INTRODUCTION: Adult attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. In subgroups of patients with a (para)epileptic pathomechanism, this might be due to intermittent rhythmic delta or theta activity (IRDA/IRTA). PARTICIPANTS AND METHODS: Using a fully data-driven analysis, we compared the IRDA/IRTA rates in the resting electroencephalography (EEG) results of 97 adult patients with ADHD and 30 control subjects. The IRDA/IRTA rates before hyperventilation (HV) and for HV difference (difference between IRDA/IRTA rate after and before HV) were compared between groups using a linear model...
August 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28821991/transcranial-doppler-in-autonomic-testing-standards-and-clinical-applications
#12
REVIEW
Lucy Norcliffe-Kaufmann, Brahyan Galindo-Mendez, Ana-Lucia Garcia-Guarniz, Estibaliz Villarreal-Vitorica, Vera Novak
When cerebral blood flow falls below a critical limit, syncope occurs and, if prolonged, ischemia leads to neuronal death. The cerebral circulation has its own complex finely tuned autoregulatory mechanisms to ensure blood supply to the brain can meet the high metabolic demands of the underlying neuronal tissue. This involves the interplay between myogenic and metabolic mechanisms, input from noradrenergic and cholinergic neurons, and the release of vasoactive substrates, including adenosine from astrocytes and nitric oxide from the endothelium...
August 18, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28807986/a-turbine-driven-ventilator-improves-adherence-to-advanced-cardiac-life-support-guidelines-during-a-cardiopulmonary-resuscitation-simulation
#13
Scott G Allen, Lara Brewer, Erik S Gillis, Nathan L Pace, Derek J Sakata, Joseph A Orr
BACKGROUND: Research has shown that increased breathing frequency during cardiopulmonary resuscitation is inversely correlated with systolic blood pressure. Rescuers often hyperventilate during cardiopulmonary resuscitation (CPR). Current American Heart Association advanced cardiac life support recommends a ventilation rate of 8 -10 breaths/min. We hypothesized that a small, turbine-driven ventilator would allow rescuers to adhere more closely to advanced cardiac life support (ACLS) guidelines...
August 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28795057/side-effects-of-indomethacin-in-refractory-post-traumatic-intracranial-hypertension-a-comprehensive-case-study-and-review
#14
REVIEW
Daniel Agustín Godoy, Pablo David Guerrero Suarez, Luis Rafael Moscote-Salazar, Mario Di Napoli
Intracranial hypertension (IH) is one of the final pathways of acute brain injury. In severe traumatic brain injury (sTBI), it independently predicts poor outcomes. Its control represents a key aspect of the management. Lack of response to conventional therapies signals a state of ''refractory IH'', with an associated mortality rate of 80-100%. In such cases, hypothermia, barbiturates at high doses (BBT), decompressive craniectomy (DC), and extreme hyperventilation are utilized. However, none of them has proven efficacy...
July 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28782910/eucapnic-voluntary-hyperventilation-test-in-children
#15
Janne Burman, Heikki Lukkarinen, Varpu Elenius, Sami Remes, Tom Kuusela, Tuomas Jartti
BACKGROUND: In children, exercise-induced dyspnea is a common symptom that can be due to dysfunctional breathing. EVH test has bee used especially in elite athletes as bronchoprovocation test. Currently, there are only few studies on the EVH test. New research methods are required alongside the traditionally used tests especially due to dysfunctional breathing disorder. PURPOSE: The purpose of the "pilot study" was to study the usability of the EVH test with real time biofeedback in children of 10-16 years of age in the diagnostics of exercise-induced dyspnea...
August 7, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28777017/how-to-take-arms-against-central-apneas-in-heart-failure
#16
Chiara Borrelli, Alberto Aimo, Gianluca Mirizzi, Claudio Passino, Giuseppe Vergaro, Michele Emdin, Alberto Giannoni
Introduction Despite being a risk mediator in several observational studies, central apneas are currently orphan of treatment in heart failure. After the neutral effects on survival of two randomized controlled trials (RCTs) based on the use of positive airway pressure (the CANPAP and SERVE-HF trials), two alternative hypotheses have been formulated: 1) Periodic breathing/Cheyne-Stokes respiration (PB/CSR) in HF is protective. Indeed, the Naughton's hypothesis assumes that hyperventilation leads to increased cardiac output, lung volume, oxygen storage and reduced muscle sympathetic nerve activity, while central apnea to respiratory muscle rest and hypoxia-induced erythropoiesis...
August 23, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28769857/hyperventilation-therapy-for-control-of-posttraumatic-intracranial-hypertension
#17
REVIEW
Daniel Agustín Godoy, Ali Seifi, David Garza, Santiago Lubillo-Montenegro, Francisco Murillo-Cabezas
During traumatic brain injury, intracranial hypertension (ICH) can become a life-threatening condition if it is not managed quickly and adequately. Physicians use therapeutic hyperventilation to reduce elevated intracranial pressure (ICP) by manipulating autoregulatory functions connected to cerebrovascular CO2 reactivity. Inducing hypocapnia via hyperventilation reduces the partial pressure of arterial carbon dioxide (PaCO2), which incites vasoconstriction in the cerebral resistance arterioles. This constriction decrease cerebral blood flow, which reduces cerebral blood volume and, ultimately, decreases the patient's ICP...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28766085/influence-of-sex-menstrual-cycle-and-oral-contraceptives-on-the-cerebrovascular-response-to-paced-deep-breathing
#18
Misha Nili, Syed Abidi, Stephania Serna, Simon Kim, Heather Edgell
PURPOSE: Deep breathing assesses autonomic function; however, many researchers/clinicians do not account for hyperventilation, brain blood flow or blood pressure. METHODS: Men and women (with/without oral contraceptives) participated. women participated during low and high hormone phases of the menstrual cycle. Blood pressure, end-tidal carbon dioxide, middle cerebral artery velocity and cerebrovascular resistance were assessed. RESULTS: Deep breathing decreased end-tidal carbon dioxide and middle cerebral artery velocity while increasing cerebrovascular resistance in all participants; blood pressure decreased in men...
August 1, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28765190/reversible-central-neural-hyperexcitability-an-electroencephalographic-clue-to-hypocalcaemia
#19
Bhagyadhan A Patel, Rahul T Chakor, Kaumil V Kothari, Swaleha Nadaf
A 23-year-old male patient presented with cognitive decline and seizures. Examination revealed Chvostek's and Trousseau's signs. Investigations revealed hypocalcaemia, hyperphosphatemia and normal intact parathyroid hormone levels. Imaging showed calcifications in bilateral basal ganglia, thalamus and dentate nuclei. Interictal electroencephalogram showed theta range slowing of background activity and bilateral temporo-occipital, irregular, sharp and slow wave discharges, which accentuated during hyperventilation, photic stimulation and eye closure...
August 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28749752/high-anion-gap-metabolic-acidosis-induced-by-cumulation-of-ketones-l-and-d-lactate-5-oxoproline-and-acute-renal-failure
#20
Laura Heireman, Boris Mahieu, Mark Helbert, Wim Uyttenbroeck, Jan Stroobants, Marian Piqueur
INTRODUCTION: Frequent causes of high anion gap metabolic acidosis (HAGMA) are lactic acidosis, ketoacidosis and impaired renal function. In this case report, a HAGMA caused by ketones, L- and D-lactate, acute renal failure as well as 5-oxoproline is discussed. CASE PRESENTATION: A 69-year-old woman was admitted to the emergency department with lowered consciousness, hyperventilation, diarrhoea and vomiting. The patient had suffered uncontrolled type 2 diabetes mellitus, underwent gastric bypass surgery in the past and was chronically treated with high doses of paracetamol and fosfomycin...
July 27, 2017: Acta Clinica Belgica
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