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https://www.readbyqxmd.com/read/28499865/implication-of-altered-autonomic-control-for-orthostatic-tolerance-in-sci
#1
REVIEW
Jill Maria Wecht, William A Bauman
Neural output from the sympathetic and parasympathetic branches of the autonomic nervous system (ANS) are integrated to appropriately control cardiovascular responses during routine activities of daily living including orthostatic positioning. Sympathetic control of the upper extremity vasculature and the heart arises from the thoracic cord between T1 and T5, whereas splanchnic bed and lower extremity vasculature receive sympathetic neural input from the lower cord between segments T5 and L2. Although the vasculature is not directly innervated by the parasympathetic nervous system, the SA node is innervated by post-ganglionic vagal nerve fibers via cranial nerve X...
May 3, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28228335/alterations-in-cardiac-autonomic-control-in-spinal-cord-injury
#2
REVIEW
Fin Biering-Sørensen, Tor Biering-Sørensen, Nan Liu, Lasse Malmqvist, Jill Maria Wecht, Andrei Krassioukov
A spinal cord injury (SCI) interferes with the autonomic nervous system (ANS). The effect on the cardiovascular system will depend on the extent of damage to the spinal/central component of ANS. The cardiac changes are caused by loss of supraspinal sympathetic control and relatively increased parasympathetic cardiac control. Decreases in sympathetic activity result in heart rate and the arterial blood pressure changes, and may cause arrhythmias, in particular bradycardia, with the risk of cardiac arrest in those with cervical or high thoracic injuries...
February 15, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28073153/reminder-rmssd-and-sd1-are-identical-heart-rate-variability-metrics
#3
Anthony B Ciccone, Jacob A Siedlik, Jill M Wecht, Jake A Deckert, Nhuquynh D Nguyen, Joseph P Weir
Assessment of heart rate variability (HRV) is a common approach to examine cardiac autonomic nervous system modulation that has been employed in a variety of settings. Frequently, both the root mean square of successive differences (RMSSD) and SD1, which is a Poincaré plot component, have been used to quantify short term heart rate variability. It is not typically appreciated however, that RMSSD and SD1 are identical metrics of HRV. As a reminder to clinicians and researchers who use and study HRV, we show both empirically and mathematically that RMSSD and SD1 are identical metrics...
January 10, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/27361552/autonomic-responses-to-orthostasis-after-acetylcholinesterase-inhibition-in-tetraplegia-2983-board-48-june-3-3-30-pm-5-00-pm
#4
Jill M Wecht, Christopher M Cirnigliaro, Frank Azarelo, Alexander T Lombard, William A Bauman, Steven C Kirshblum
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/26869679/effects-of-midodrine-and-l-name-on-systemic-and-cerebral-hemodynamics-during-cognitive-activation-in-spinal-cord-injury-and-intact-controls
#5
RANDOMIZED CONTROLLED TRIAL
Jill M Wecht, Joseph P Weir, Miroslav Radulovic, William A Bauman
We previously showed that increases in mean arterial pressure (MAP) following administration of midodrine hydrochloride (MH) and nitro-L-arginine methyl ester (L-NAME) resulted in increased mean cerebral blood flow velocity (MFV) during head-up tilt in hypotensive individuals with spinal cord injury (SCI) and question if this same association was evident during cognitive activation. Herein, we report MAP and MFV during two serial subtraction tasks (SSt) given before (predrug) and after (postdrug) administration of MH; (10 mg), L-NAME (1 mg/kg) or no drug (ND) in 15 subjects with SCI compared to nine able-bodied (AB) controls...
February 2016: Physiological Reports
https://www.readbyqxmd.com/read/26860937/inter-day-reliability-of-blood-pressure-and-cerebral-blood-flow-velocities-in-persons-with-spinal-cord-injury-and-intact-controls
#6
Jill M Wecht, Joseph P Weir, William A Bauman
BACKGROUND: Due to interruption of cardiovascular autonomic control unstable blood pressure (BP) is common in individuals with spinal cord injury (SCI) above the sixth thoracic vertebral level. The impact of unstable BP on cerebral blood flow (CBF) is not well appreciated, but symptoms associated with altered cerebral perfusion are reported, which can negatively impact daily life activities. METHODS: We measured seated BP and CBF in participants with SCI and able-bodied (AB) controls on three laboratory visits to determine the inter-day reliability (intraclass correlation coefficient: ICC)...
March 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/25971935/biomarkers-of-inflammation-in-persons-with-chronic-tetraplegia
#7
Miroslav Radulovic, William A Bauman, Jill M Wecht, Michael LaFountaine, Nighat Kahn, Joshua Hobson, Kamaldeep Singh, Christopher Renzi, Christina Yen, Gregory J Schilero
In addition to lung volume restriction, individuals with chronic tetraplegia exhibit reduced airway caliber and bronchodilator responsiveness similar to persons with asthma. In asthma, airflow obstruction is closely linked to airway inflammation. Conversely, little is known regarding the airway inflammatory response in tetraplegia. To compare levels of biomarkers of inflammation in exhaled breath condensate (EBC) and serum in subjects with chronic tetraplegia, mild asthma, and able-bodied controls.Prospective, observational pilot study...
September 2015: Journal of Breath Research
https://www.readbyqxmd.com/read/25916633/orthostatic-responses-to-anticholinesterase-inhibition-in-spinal-cord-injury
#8
Jill M Wecht, Christopher M Cirnigliaro, Frank Azarelo, William A Bauman, Steven C Kirshblum
INTRODUCTION: Acetylcholine (Ach) is the pre-synaptic neurotransmitter of the sympathetic nervous system. Increased pre-synaptic Ach may augment post-synaptic release of norepinephrine, thereby increasing systemic blood pressure (BP). OBJECTIVES: The primary objective of this investigation was to determine the hemodynamic effect of pyridostigmine bromide (PYRIDO: 60 mg), an Ach inhibitor (AchI), compared to no-drug (NO-D) during head-up tilt (HUT) in individuals with spinal cord injury (SCI)...
June 2015: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/25660005/prevalence-of-abnormal-systemic-hemodynamics-in-veterans-with-and-without-spinal-cord-injury
#9
Jill M Wecht, Joseph P Weir, Marinella Galea, Stephanie Martinez, William A Bauman
OBJECTIVE: Increased prevalence of heart rate and blood pressure abnormalities are evident in persons with spinal cord injury (SCI), but age, comorbid medical conditions, and prescription medication use may contribute. To determine differences in the prevalence of cardiac acceleration (heart rate ≥80 beats per minute), hypotension (blood pressure ≤110/70mmHg), orthostatic hypotension (OH) (-20/-10mmHg with upright positioning), and hypertension (HTN) (blood pressure ≥140/90mmHg) in veterans with and without SCI...
June 2015: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/24723067/a-center-s-experience-pulmonary-function-in-spinal-cord-injury
#10
Gregory J Schilero, Miroslav Radulovic, Jill M Wecht, Ann M Spungen, William A Bauman, Marvin Lesser
Traumatic spinal cord injury (SCI) is associated with significant psychological and physical challenges. A multidisciplinary approach to management is essential to ensure recovery during the acute phase, and comprehensive rehabilitative strategies are necessary to foster independence and quality of life throughout the chronic phase of injury. Complications that beset these individuals are often a unique consequence of SCI, and knowledge of the effects of SCI upon organ systems is essential for appropriate management...
June 2014: Lung
https://www.readbyqxmd.com/read/23941794/a-retrospective-chart-review-of-heart-rate-and-blood-pressure-abnormalities-in-veterans-with-spinal-cord-injury
#11
Carolyn Zhu, Marinella Galea, Elayne Livote, Dan Signor, Jill M Wecht
OBJECTIVE: Autonomic impairment may lead to increased prevalence of heart rate (HR) and blood pressure (BP) abnormalities in veterans with spinal cord injury (SCI). In addition, comorbid medical conditions and prescription medication use may influence these abnormalities, including bradycardia, and tachycardia, hypotension, hypertension as well as autonomic dysreflexia (AD), and orthostatic hypotension (OH). DESIGN: A retrospective review of clinical and administrative datasets in veterans with SCI and compared the prevalence rates between clinical values and ICD-9 diagnostic codes in individuals with tetraplegia (T: C1-C8), high paraplegia (HP: T1-T6), and low paraplegia (LP: T7 and below)...
September 2013: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/23941793/a-prospective-report-on-the-prevalence-of-heart-rate-and-blood-pressure-abnormalities-in-veterans-with-spinal-cord-injuries
#12
Jill M Wecht, Carolyn Zhu, Joseph P Weir, Christina Yen, Christopher Renzi, Marinella Galea
OBJECTIVE: Decentralized autonomic cardiovascular regulation may lead to increased prevalence of heart rate (HR) and blood pressure (BP) abnormalities in veterans with SCI. In addition, comorbid medical conditions and prescription medication use may increase HR and BP abnormalities. These abnormalities include bradycardia, and tachycardia, hypotension, hypertension as well as autonomic dysreflexia and orthostatic hypotension; the prevalence of which is unknown. DESIGN: HR and BP data were measured during a routine annual physical examination in 64 veterans with SCI...
September 2013: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/23809520/decentralized-cardiovascular-autonomic-control-and-cognitive-deficits-in-persons-with-spinal-cord-injury
#13
REVIEW
Jill M Wecht, William A Bauman
Spinal cord injury (SCI) results in motor and sensory impairments that can be identified with the American Spinal Injury Association (ASIA) Impairment Scale (AIS). Although, SCI may disrupt autonomic neural transmission, less is understood regarding the clinical impact of decentralized autonomic control. Cardiovascular regulation may be altered following SCI and the degree of impairment may or may not relate to the level of AIS injury classification. In general, persons with lesions above T1 present with bradycardia, hypotension, and orthostatic hypotension; functional changes which may interfere with rehabilitation efforts...
March 2013: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/23602882/hemodynamic-effects-of-l-threo-3-4-dihydroxyphenylserine-droxidopa-in-hypotensive-individuals-with-spinal-cord-injury
#14
Jill M Wecht, Dwindally Rosado-Rivera, Joseph P Weir, Adrian Ivan, Christina Yen, William A Bauman
OBJECTIVES: To determine the effect of an escalating dose of droxidopa (100, 200, and 400 mg) compared with placebo on seated blood pressure (BP) in hypotensive individuals with spinal cord injury (SCI). Secondarily, we aimed to determine the effect of droxidopa on (1) supine BP and heart rate, (2) the change in BP and heart rate when these individuals were transferred from the supine to the seated position, and (3) adverse event (AE) reporting. DESIGN: Open-label dose titration trial...
October 2013: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/23499779/impact-of-blood-pressure-dysregulation-on-health-related-quality-of-life-in-persons-with-spinal-cord-injury-development-of-a-conceptual-model
#15
MULTICENTER STUDY
Noelle E Carlozzi, Denise Fyffe, Kel G Morin, Rachel Byrne, David S Tulsky, David Victorson, Jin-Shei Lai, Jill M Wecht
OBJECTIVES: To identify medically relevant aspects of blood pressure dysregulation (BPD) related to quality of life in individuals with spinal cord injury (SCI), and to propose an integrated conceptual framework based on input from both individuals with SCI and their clinical providers. This framework will serve as a guide for the development of a patient-reported outcome (PRO) measure specifically related to BPD. DESIGN: Three focus groups with individuals with SCI and 3 groups with SCI providers were analyzed using grounded-theory based qualitative analysis to ascertain how blood pressure impacts health-related quality of life (HRQOL) in individuals with SCI...
September 2013: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/23460763/international-standards-to-document-remaining-autonomic-function-after-spinal-cord-injury-isafsci-first-edition-2012
#16
Andrei Krassioukov, Chair Fin Biering-Sorensen, William Donovan, Michael Kennelly, Steven Kirshblum, Klaus Krogh, Marca Sipski Alexander, Lawrence Vogel, Jill And Wecht
No abstract text is available yet for this article.
2012: Topics in Spinal Cord Injury Rehabilitation
https://www.readbyqxmd.com/read/23459498/31st-g-heiner-sell-lectureship-secondary-medical-consequences-of-spinal-cord-injury
#17
William A Bauman, Mark A Korsten, Miroslav Radulovic, Gregory J Schilero, Jill M Wecht, Ann M Spungen
Persons with spinal cord injury (SCI) have secondary medical consequences of paralysis and/or the consequences of extreme inactivity. The metabolic changes that result from reduced activity include insulin resistance with carbohydrate disorders and dyslipidemia. A higher prevalence of coronary artery calcification was found in persons with SCI than that in matched able-bodied controls. A depression in anabolic hormones, circulating testosterone and growth hormone, has been described. Adverse soft tissue body composition changes of increased adiposity and reduced skeletal muscle are appreciated...
2012: Topics in Spinal Cord Injury Rehabilitation
https://www.readbyqxmd.com/read/23343764/testosterone-replacement-therapy-improves-qtavi-in-hypogonadal-men-with-spinal-cord-injury
#18
MULTICENTER STUDY
Michael F La Fountaine, Jill M Wecht, Christopher M Cirnigliaro, Steven C Kirshblum, Ann M Spungen, William A Bauman
AIM: To determine the effect of a 12-month intent-to-treat testosterone (T) replacement therapy (TRT) trial on QTa interval variability (QTaVI) in hypogonadal (HG) men with spinal cord injury (SCI). METHOD: A prospective, controlled 12-month TRT trial was completed in 22 healthy, chronic, nonambulatory men with SCI. Based on serum T concentration, subjects were designated as HG (≤ 11.3 nmol/l) or eugonadal (EG ≥ 11.4 nmol/l). Digital 3-lead electrocardiograms were performed...
2013: Neuroendocrinology
https://www.readbyqxmd.com/read/22925746/international-standards-to-document-remaining-autonomic-function-after-spinal-cord-injury
#19
Andrei Krassioukov, Fin Biering-Sørensen, William Donovan, Michael Kennelly, Steven Kirshblum, Klaus Krogh, Marca Sipski Alexander, Lawrence Vogel, Jill Wecht
This is the first guideline describing the International Standards to document remaining Autonomic Function after Spinal Cord Injury (ISAFSCI). This guideline should be used as an adjunct to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) including the ASIA Impairment Scale (AIS), which documents the neurological examination of individuals with SCI. The Autonomic Standards Assessment Form is recommended to be completed during the evaluation of individuals with SCI, but is not a part of the ISNCSCI...
July 2012: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/21903013/comparison-of-24-hour-cardiovascular-and-autonomic-function-in-paraplegia-tetraplegia-and-control-groups-implications-for-cardiovascular-risk
#20
COMPARATIVE STUDY
Dwindally Rosado-Rivera, M Radulovic, John P Handrakis, Christopher M Cirnigliaro, A Marley Jensen, Steve Kirshblum, William A Bauman, Jill Maria Wecht
BACKGROUND: Fluctuations in 24-hour cardiovascular hemodynamics, specifically heart rate (HR) and blood pressure (BP), are thought to reflect autonomic nervous system (ANS) activity. Persons with spinal cord injury (SCI) represent a model of ANS dysfunction, which may affect 24-hour hemodynamics and predispose these individuals to increased cardiovascular disease risk. OBJECTIVE: To determine 24-hour cardiovascular and ANS function among individuals with tetraplegia (n=20; TETRA: C4-C8), high paraplegia (n=10; HP: T2-T5), low paraplegia (n=9; LP: T7-T12), and non-SCI controls (n=10)...
2011: Journal of Spinal Cord Medicine
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