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Amanda J Miller, Satish R Raj
Postural tachycardia syndrome (POTS) is a disorder characterized by the presence of orthostatic symptoms (including lightheadedness, palpitations, nausea, dyspnea, and tremulousness) as well as excessive upright tachycardia. POTS predominantly affects women of childbearing age. Treating POTS involves a multi-faceted approach using non-pharmacological and pharmacological interventions. There are no pharmacological treatments that are currently United States Food and Drug Administration (FDA) approved for POTS due to lack of randomized controlled trials...
May 4, 2018: Autonomic Neuroscience: Basic & Clinical
Adrian Sultana, David Torres, Roman Schumann
Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with or without sleep apnoea. A derivative technique is opioid sparing, where the same techniques are used but some opioid use is allowed...
December 2017: Best Practice & Research. Clinical Anaesthesiology
Nicholas T Kruse, William E Hughes, Kenichi Ueda, Satoshi Hanada, Andrew J Feider, Erika Iwamoto, Joshua M Bock, Darren P Casey
Contraction mediated blunting of postjunctional α-adrenergic vasoconstriction (functional sympatholysis) is attenuated in older males; however, direct confirmation of this effect remains unknown in postmenopausal women (PMW). The present study examined whether PMW exhibit augmented postjunctional α-adrenergic receptor vasoconstriction at rest and during forearm exercise compared to young women (YW). Eight YW (24 ± 1 yrs) and eight PMW (65 ± 1 yrs) completed a series of randomized experimental trials; 1) at rest 2) under high flow (adenosine infusion) conditions and 3) during 6-minutes of forearm exercise at relative (20% of maximum (MVC) and absolute (7 kg) intensities...
April 30, 2018: Journal of Physiology
Lasse Gliemann, Howard Carter
No abstract text is available yet for this article.
March 15, 2018: Journal of Physiology
Gregers W Munch, Ulrik W Iepsen, Camilla K Ryrsø, Jaya B Rosenmeier, Bente K Pedersen, Stefan P Mortensen
Breathlessness during daily activities is the primary symptom in patients with heart failure (HF). Poor correlation between the hemodynamic parameters of left ventricular performance and perceived symptoms suggests that other factors, such as skeletal muscle function, play a role in determining exercise capacity. We investigated the effect of 6 wk of high-intensity, one-legged cycling (HIC; 8 × 4 at 90% one-legged cycling max) on 1) the ability to override sympathetic vasoconstriction (arterial infusion of tyramine) during one-legged knee-extensor exercise (KEE), 2) vascular function (arterial infusion of ACh, sodium nitroprusside, tyramine, and ATP), and 3) exercise capacity in HF patients with reduced ejection fraction ( n = 8) compared with healthy individuals ( n = 6)...
March 1, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Malcolm Brock, Constantine Frangakis, Christos S Georgiades
PURPOSE: Primary hyperhidrosis (PH) typically involves the craniofacial (CF) or axillary-palmar (AP) region. Our purpose was to determine the safety and efficacy of CT-guided sympatholysis for treating PH. METHODS: In this prospective study, 39 consecutive patients with CF or AP PH were referred for percutaneous sympatholysis. Procedures were performed under CT guidance and minimal sedation. We treated level T2 for CF hyperhidrosis and T2, T3, and T4 for AP hyperhidrosis...
March 2018: Cardiovascular and Interventional Radiology
U W Iepsen, G W Munch, C K Ryrsø, N H Secher, P Lange, P Thaning, B K Pedersen, S P Mortensen
Sympathetic vasoconstriction is blunted in exercising muscle (functional sympatholysis) but becomes attenuated with age. We tested the hypothesis that functional sympatholysis is further impaired in chronic obstructive pulmonary disease (COPD) patients. We determined leg blood flow and calculated leg vascular conductance (LVC) during 1) femoral-arterial Tyramine infusion (evokes endogenous norepinephrine release, 1 µmol·min-1 ·kg leg mass-1 ), 2) one-legged knee extensor exercise with and without Tyramine infusion [10 W and 20% of maximal workload (WLmax )], 3) ATP (0...
February 1, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Malcolm Brock, Christos S Georgiades
Compensatory hyperhidrosis (CH) is common after sympathectomy, and most treatments are ineffective. We present a 36-year-old man whose CH was effectively treated with percutaneous sympatholysis. The patient's axillary-palmar hyperhidrosis had been treated with T3-4 sympathetic ligation. The patient developed CH involving the head, face, back, torso and feet and was referred for computed tomography-guided percutaneous T2 sympatholysis for craniofacial symptoms, after which the patient experienced resolution of CH (complete face/neck/feet and partial back/torso), despite the treated level being above the previous ligation...
December 1, 2017: European Journal of Cardio-thoracic Surgery
Nicholas T Kruse, William E Hughes, Satoshi Hanada, Kenichi Ueda, Joshua M Bock, Erika Iwamoto, Darren P Casey
Habitual aerobic exercise attenuates elevated vasoconstriction during acute exercise (functional sympatholysis) in older men; however, this effect remains unknown in postmenopausal women (PMW). This study tested the hypothesis that PMW who participate in habitual aerobic exercise demonstrate a greater functional sympatholysis compared with their untrained counterparts. Nineteen PMW (untrained n = 9 vs. trained n = 10) performed 5 min of steady-state (SS) forearm exercise at relative [10% and 20% of maximum voluntary contraction (MVC)] and absolute (5 kg) contraction intensities...
March 1, 2018: Journal of Applied Physiology
Christopher M Hearon, Frank A Dinenno
No abstract text is available yet for this article.
November 2, 2017: Channels
Stephen J Ives, Song Young Park, Oh Sung Kwon, Jayson R Gifford, Robert H I Andtbacka, John R Hyngstrom, Russell S Richardson
What is the central question of this study? We sought to determine whether human skeletal muscle feed arteries (SFMAs) express TRPV1 channels and what role they play in modulating vascular function. What is the main finding and its importance? Human SMFAs do express functional TRPV1 channels that modulate vascular function, specifically opposing α-adrenergic receptor-mediated vasocontraction and potentiating vasorelaxation, in an endothelium-dependent manner, as evidenced by the α1 -receptor-mediated responses...
September 1, 2017: Experimental Physiology
Nicholas T Kruse, William E Hughes, Kenichi Ueda, Darren P Casey
PURPOSE: The aim of this study was to examine whether independent effects exist between contractile work and metabolic demand (VO2m) on vasoconstrictor responsiveness (i.e., functional sympatholysis) under different contraction durations matched for total contractile work in exercising human skeletal muscle. METHODS: Ten young men performed rhythmic forearm contractions at 10 and 15% of maximum voluntary contraction (MVC) which consisted of muscle contractions using the same duty cycle but altering the duration of the contraction-relaxation cycles of exercise and included: 1) fast frequency contractions at 10% MVC (FFC10%) using a contraction relaxation cycle at 1:2 s; 2) slow frequency contractions at 10% MVC (SFC10%) at 2:4 s; and 3) SFC at 15% MVC (SFC15%) at 2:4 s...
August 2017: European Journal of Applied Physiology
Christopher M Hearon, Jennifer C Richards, Mathew L Racine, Gary J Luckasen, Dennis G Larson, Michael J Joyner, Frank A Dinenno
KEY POINTS: Intravascular ATP attenuates sympathetic vasoconstriction (sympatholysis) similar to what is observed in contracting skeletal muscle of humans, and may be an important contributor to exercise hyperaemia. Similar to exercise, ATP-mediated vasodilatation occurs via activation of inwardly rectifying potassium channels (KIR ), and synthesis of nitric oxide (NO) and prostaglandins (PG). However, recent evidence suggests that these dilatatory pathways are not obligatory for sympatholysis during exercise; therefore, we tested the hypothesis that the ability of ATP to blunt α1 -adrenergic vasoconstriction in resting skeletal muscle would be independent of KIR , NO, PGs and Na(+) /K(+) -ATPase activity...
August 1, 2017: Journal of Physiology
Miguel Sá, José Miguel Cardoso, Hugo Reis, Marta Esteves, José Sampaio, Isabel Gouveia, Pilar Carballada, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: The quadratus lumborum block was initially described in 2007 and aims at blocking the same nerves as the ones involved on the Transverse Abdominis Plane block, while accomplishing some visceral enervation as well due to closer proximity with the neuroaxis and sympathetic trunk. Given its versatility, we have successfully used it in a wide range of procedures. We report two cases where we believe the dispersion of local anesthetic is likely to have led to a previously undescribed complication...
May 23, 2017: Revista Brasileira de Anestesiologia
Timothy P Just, Darren S DeLorey
Sex differences in the neurovascular control of blood pressure and vascular resistance have been reported. However, the mechanisms underlying the modulatory influence of sex have not been fully elucidated. Nitric oxide (NO) has been shown to inhibit sympathetic vasoconstriction in resting and contracting skeletal muscle, and estrogen modulates NO synthase (NOS) expression and NO bioavailability. Therefore NO-mediated inhibition of sympathetic vasoconstriction may be enhanced in females. Thus the purpose of the present study was to investigate the hypothesis that sympathetic vasoconstrictor responsiveness would be blunted and NO-mediated inhibition of sympathetic vasoconstriction would be enhanced in females compared with males...
July 1, 2017: Journal of Applied Physiology
Jere H Mitchell
During both dynamic (e.g., endurance) and static (e.g., strength) exercise there are exaggerated cardiovascular responses in hypertension. This includes greater increases in blood pressure, heart rate, and efferent sympathetic nerve activity than in normal controls. Two of the known neural factors that contribute to this abnormal cardiovascular response are the exercise pressor reflex (EPR) and functional sympatholysis. The EPR originates in contracting skeletal muscle and reflexly increases sympathetic efferent nerve activity to the heart and blood vessels as well as decreases parasympathetic efferent nerve activity to the heart...
June 1, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Sepideh Vahabi, Yaser Rafieian, Abolfazl Abbas Zadeh
BACKGROUND: Esmolol an ultrashort acting cardioselective β1-adrenergic receptor antagonist), has been successfully employed for perioperative sympatholysis. In this study, we tested the hypothesis that perioperative esmolol administration resulted in decreased postoperative pain and improves the hemodynamic balance in patients with rhinoplasty. METHODS: In this clinical trial study, fifty-six patients (56) undergoing rhinoplasty surgery were randomly distributed into two groups (Group E and Group C)...
April 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Jason A Ferreira, Brittany D Bissell
The spectrum of sepsis and septic shock remains a highly prevalent disease state, carrying a high risk of morbidity and mortality. The sympathetic nervous system (SNS) plays an important role in this initial cascade, enabling the host to respond to invading pathogens; however, prolonged activation can become pathological. The potential for unregulated sympathetic tone to become of detriment in patients with sepsis has fueled interest in the role and impact of sympatholysis, the selective inhibition of sympathetic tone...
February 2018: Journal of Intensive Care Medicine
Steven S Segal
No abstract text is available yet for this article.
December 15, 2016: Journal of Physiology
Ankur Khandelwal, Rudrashish Haldar, Arun Srivastava, Prabhat K Singh
The existence of neural connection between the limbic system (hypothalamus, hippocampus, amygdala, and other adjacent areas) and the autonomic nervous system has been postulated to trigger severe hemodynamic responses. The hemodynamic consequences of stimulation of amygdala or hippocampus have been sporadically reported in animal studies and adult patients. However, the effect of this stimulation in pediatric patients is scarce. We present our experience of three cases of sympatholysis during intraoperative manipulation of amygdalohippocampus and review the pertinent literature...
July 2016: Journal of Pediatric Neurosciences
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