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Sample records for autonomic dysfunction presenting

  1. The treatment of autonomic dysfunction in tetanus

    African Journals Online (AJOL)

    may either be spontaneous or triggered by touch, visual, auditory or emotional stimuli.[7] Autonomic dysfunction may occur, and does not necessarily correlate with the severity of tetanus. Wassay et al.[8] reported autonomic dysfunction in a third of tetanus cases. Autonomic dysfunction presents as labile hypertension, ...

  2. Lateral medullary infarction with cardiovascular autonomic dysfunction: an unusual presentation with review of the literature.

    Science.gov (United States)

    Huynh, Tridu R; Decker, Barbara; Fries, Timothy J; Tunguturi, Ajay

    2018-01-24

    We report an unusual case of lateral medullary infarction presenting with orthostatic hypotension with pre-syncope without vertigo or Horner's syndrome. Case report with review of the literature. A 67-year-old man presented with pre-syncope and ataxia without vertigo. Initial brain CT and MRI were normal. Neurological evaluation revealed right-beating nystagmus with left gaze, vertical binocular diplopia, right upper-extremity dysmetria, truncal ataxia with right axial lateropulsion, and right-facial and lower extremity hypoesthesia. Bedside blood pressure measurements disclosed orthostatic hypotension. He had normal sinus rhythm on telemetry and normal ejection fraction on echocardiogram. A repeat brain MRI disclosed an acute right dorsolateral medullary infarct. Autonomic testing showed reduced heart rate variability during paced deep breathing, attenuated late phase II and phase IV overshoot on Valsalva maneuver, and a fall of 25 mmHg of blood pressure at the end of a 10-min head-up tilt with no significant change in heart rate. These results were consistent with impaired sympathetic and parasympathetic cardiovascular reflexes. He was discharged to acute rehabilitation a week later with residual right dysmetria and ataxia. Lateral medullary infarctions are usually reported as partial presentations of classical lateral medullary syndrome with accompanying unusual symptoms ranging from trigeminal neuralgias to hiccups. Pre-syncope from orthostatic hypotension is a rare presentation. In the first 3-4 days, absence of early DWI MRI findings is possible in small, dorsolateral medullary infarcts with sensory disturbances. Physicians should be aware of this presentation, as early diagnosis and optimal therapy are associated with good prognosis.

  3. Autonomic dysfunction in a Jack Russell terrier

    Science.gov (United States)

    Caines, Deanne; Pinard, Chantale L.; Kruth, Stephen; Orr, Jeremy; James, Fiona

    2011-01-01

    A 4-year-old Jack Russell terrier was presented with an array of clinical signs suggestive of autonomic dysfunction. Many of the clinical signs were consistent with a diagnosis of dysautonomia; however, both chronicity and resolution of signs contradicted a diagnosis of this disease. PMID:21629424

  4. The treatment of autonomic dysfunction in tetanus

    Directory of Open Access Journals (Sweden)

    T van den Heever

    2017-07-01

    Full Text Available We report a case of generalised tetanus in a 50-year-old female patient after sustaining a wound to her right lower leg. She developed autonomic dysfunction, which included labile hypertension alternating with hypotension and sweating. The autonomic dysfunction was treated successfully with a combination of morphine sulphate infusion, magnesium sulphate, and clonidine. She also received adrenaline and phenylephrine infusions as needed for hypotension. We then discuss the pathophysiology, clinical features and treatment options of autonomic dysfunction.

  5. Autonomic dysfunction in cirrhosis and portal hypertension

    DEFF Research Database (Denmark)

    Dümcke, Christine Winkler; Møller, Søren

    2008-01-01

    Liver cirrhosis and portal hypertension are frequently associated with signs of circulatory dysfunction and peripheral polyneuropathy, which includes defects of the autonomic nervous system. Autonomic dysfunction, which is seen in both alcoholic and non-alcoholic liver cirrhosis and increases wit...

  6. Autonomic dysfunction and neuropeptide Y in fibromyalgia.

    Science.gov (United States)

    Di Franco, M; Iannuccelli, C; Alessandri, C; Paradiso, M; Riccieri, V; Libri, F; Valesini, G

    2009-01-01

    Fibromyalgia (FM) is a syndrome associated with widespread pain and various other signs and symptoms. Several of these multisystem features could be explained on the basis of autonomic nervous system (ANS) dysfunction. The aim of the present study was to evaluate ANS dysfunction in FM based on time-domain heart rate variability (HRV) analysis and serum neuropeptide Y (NPY) levels in 51 patients with FM, 25 patients with systemic sclerosis (SSc), and 15 healthy controls (NHS). Compared with the SSc and NHS groups, the FM group had significantly higher NPY levels, and in the FM subgroup subjected to HRV analysis (25/51 patients, 49%), certain HRV indices were significantly reduced. In this subgroup, NPY was significantly correlated with the SDANN index and the NN50, but neither NPY or HRV parameters showed any significant correlation with clinical aspects of the FM. These findings suggest that autonomic dysfunction and NPY are crucial elements in the pathophysiology of FM. Additional studies are necessary to define the complex roles played by NPY and ANS in modulating pain and immunological functions of different diseases.

  7. Diabetic cardiac autonomic dysfunction. Parasympathetic versus sympathetic

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    Uehara, Akihiko; Kurata, Chinori; Sugi, Toshihiko; Mikami, Tadashi; Shouda, Sakae [Hamamatsu Univ. School of Medicine, Shizuoka (Japan)

    1999-04-01

    Diabetic cardiac autonomic dysfunction often causes lethal arrhythmia and sudden cardiac death. {sup 123}I-Metaiodobenzylguanidine (MIBG) can evaluate cardiac sympathetic dysfunction, and analysis of heart rate variability (HRV) can reflect cardiac parasympathetic activity. We examined whether cardiac parasympathetic dysfunction assessed by HRV may correlate with sympathetic dysfunction assessed by MIBG in diabetic patients. In 24-hour electrocardiography, we analyzed 4 HRV parameters: high-frequency power (HF), HF in the early morning (EMHF), rMSSD and pNN50. MIBG planar images and SPECT were obtained 15 minutes (early) and 150 minutes (late) after injection and the heart washout rate was calculated. The defect score in 9 left ventricular regions was scored on a 4 point scale (0=normal - 3=severe defect). In 20 selected diabetic patients without congestive heart failure, coronary artery disease and renal failure, parasympathetic HRV parameters had a negative correlation with the sum of defect scores (DS) in the late images (R=-0.47 to -0.59, p<0.05) and some parameters had a negative correlation with the washout rate (R=-0.50 to -0.55, p<0.05). In a total of 64 diabetic patients also, these parameters had a negative correlation with late DS (R=-0.28 to -0.35, p<0.05) and early DS (R=-0.27 to -0.32, p<0.05). The progress of diabetic cardiac parasympathetic dysfunction may parallel the sympathetic one. (author)

  8. Cardiac autonomic dysfunction in West syndrome.

    Science.gov (United States)

    Jansen, Katrien; Vandeput, Steven; Van Huffel, Sabine; Lagae, Lieven

    2012-12-01

    West syndrome is an age-dependent epileptic encephalopathy. Autonomic changes are increasingly being recognized in patients with epilepsy: cardiac autonomic function is mediated by sympathetic and parasympathetic efferent activity to the heart and can provide information on the functional state of the autonomic nervous system. The goal of the study is to evaluate the effect of an early epileptic encephalopathy on the autonomic nervous system by measuring heart rate variability. Cardiac autonomic function was evaluated in 13 patients with West syndrome by measuring heart rate variability during 5 min epochs of ECG in wake, stage 2 and slow wave sleep. In 5 patients who developed subsequently another type of epilepsy, a second evaluation was performed after 3 years of follow-up. Results showed a lower heart rate in stage 2 sleep in patients with West syndrome. Spectral components did not show significant differences compared to age matched controls at the moment of presentation. After follow-up of 3 years we were able to demonstrate higher low frequency (LF), lower high frequency (HF) and a higher LF/HF ratio during slow wave sleep. This study shows a lower heart rate in patients presenting with West syndrome, already at the onset of the syndrome and before ACTH treatment. The epileptic encephalopathy is not sufficient to alter spectral components of heart rate at the moment of presentation. However, already after 3 years of epilepsy, chronic autonomic changes appear. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Autonomic dysfunction in different subtypes of multiple system atrophy.

    Science.gov (United States)

    Schmidt, Claudia; Herting, Birgit; Prieur, Silke; Junghanns, Susann; Schweitzer, Katherine; Globas, Christoph; Schöls, Ludger; Reichmann, Heinz; Berg, Daniela; Ziemssen, Tjalf

    2008-09-15

    Multiple system atrophy (MSA) can clinically be divided into the cerebellar (MSA-C) and the parkinsonian (MSA-P) variant. However, till now, it is unknown whether autonomic dysfunction in these two entities differs regarding severity and profile. We compared the pattern of autonomic dysfunction in 12 patients with MSA-C and 26 with MSA-P in comparison with 27 age- and sex-matched healthy controls using a standard battery of autonomic function tests and a structured anamnesis of the autonomic nervous system. MSA-P patients complained significantly more often about the symptoms of autonomic dysfunctions than MSA-C patients, especially regarding vasomotor, secretomotor, and gastrointestinal subsystems. However, regarding cardiovascular, sudomotor pupil, urogenital, and sleep subsystems, there were no significant quantitative or qualitative differences as analyzed by autonomic anamnesis and testing. Our results suggest that there are only minor differences in the pattern of autonomic dysfunction between the two clinical MSA phenotypes. (c) 2007 Movement Disorder Society.

  10. The treatment of autonomic dysfunction in tetanus | Maryke Spruyt ...

    African Journals Online (AJOL)

    We report a case of generalised tetanus in a 50-year-old female patient after sustaining a wound to her right lower leg. She developed autonomic dysfunction, which included labile hypertension alternating with hypotension and sweating. The autonomic dysfunction was treated successfully with a combination of morphine ...

  11. Diastolic and autonomic dysfunction in early cirrhosis

    DEFF Research Database (Denmark)

    Dahl, Emilie Kristine; Møller, Søren; Kjær, Andreas

    2014-01-01

    cirrhosis during maximal β-adrenergic drive. MATERIAL AND METHODS. Nineteen patients with Child A (n = 12) and Child B cirrhosis (n = 7) and seven matched controls were studied during cardiac stress induced by increasing dosages of dobutamine and atropine. RESULTS. Pharmacological responsiveness was similar...... fraction was similar in patients and controls. Peak filling rate was longer in cirrhosis compared to controls (1.8 ± 0.4 and 1.4 ± 0.2 end-diastolic volume/s, p stress by 13% compared to 0% in controls, p ... indicate that patients with early stage cirrhosis exhibit early diastolic and autonomic dysfunction as well as elevated pro-ANP. However, the cardiac chronotropic and inotropic responses to dobutamine stress were normal. The dynamics of ventricular repolarization appears normal in patients with early stage...

  12. Cardiovascular Autonomic Dysfunction in Children and Adolescents With Rett Syndrome.

    Science.gov (United States)

    Kumar, Ajay; Jaryal, Ashok; Gulati, Sheffali; Chakrabarty, Biswaroop; Singh, Akanksha; Deepak, K K; Pandey, R M; Gupta, Neerja; Sapra, Savita; Kabra, Madhulika; Khajuria, Rajni

    2017-05-01

    Autonomic dysfunction is common in children with Rett syndrome. They usually manifest with agitation, persistent screaming, constipation, gastroesophageal reflux, aerophagia, hyperventilation, and breath-holding episodes. Cardiovascular autonomic dysfunction may result in fatal a arrhythmia. Many of these events are mistaken for seizures and treated with antiepileptics. The present study was conducted in a tertiary care teaching hospital in north India for more than a six month period. MeCP2 mutation positive, 24 cases with Rett syndrome and 24 age-matched healthy girls were evaluated for cardiovascular autonomic dysfunction (heart rate variability, head-up tilt test, and cold pressor test). The mean age was 9.06 years (±3.4) and 9.75 years (±3.13) for patients and control subjects, respectively. The heart rate variability contributed independently by parasympathetic and sympathetic nervous system was significantly reduced in cases compared with control subjects (P = 0.033 and P = 0.001, respectively). There was significant sympathovagal imbalance with sympathetic overactivity in cases compared with control subjects (P = 0.001). The mean longest QT c interval was significantly prolonged in cases compared with control subjects (P = 0.001). Cold pressor test and head-up tilt test could be done in 16 Rett syndrome patients (because of poor cooperation) and in all 24 control subjects. The change in blood pressure during cold pressor test and head-up tilt test was not significantly different in cases and control subjects. Children with Rett syndrome exhibited significant cardiovascular autonomic dysfunction in the form of sympathetic overactivity, parasympathetic underactivity, and sympathovagal imbalance. These findings have potentially important therapeutic- and outcome-related implications. Copyright © 2017. Published by Elsevier Inc.

  13. Cognitive and autonomic dysfunction in presymptomatic and early Huntington's disease.

    Science.gov (United States)

    Kobal, Jan; Melik, Ziva; Cankar, Ksenija; Strucl, Martin

    2014-06-01

    Huntington's disease is characterized by disorders of movement, cognition and behavior. Individuals with Huntington's disease display aberrant changes in the autonomic nervous system that are detected even before the onset of other symptoms. Subtle cognitive dysfunction may start before other clinical manifestations. The aim of the present study was to investigate the autonomic nervous system response to mental arithmetic and the relationship between the autonomic and cognitive/motor function in presymptomatic and early Huntington's disease. We examined 15 presymptomatic Huntington's disease gene carriers (PHD), 15 early Huntington's disease patients (EHD) and 30 healthy controls. PHD and EHD groups were determined according to Unified Huntington's Disease Rating Scale (UHDRS) motor score. ECG, heart rate, systolic and diastolic blood pressure, and cutaneous laser Doppler flux were measured during rest and during a simple mental arithmetic test. UHDRS cognitive test battery was applied to determine cognitive dysfunction. During mental arithmetic, the heart rate of PHD/EHD increased significantly less than that of controls. Decreased microvascular response to mental arithmetic was found in EHD. Significant correlations for the PHD/EHD group were found between laser Doppler flux response and Symbol Digit Modalities Test score, and between laser Doppler flux response and UHDRS motor score. It seems that central autonomic dysregulation of cardiovascular system in Huntington's disease goes along with the degeneration of other central neuronal systems. This finding is relevant as it could enable simple and noninvasive testing of disease progression.

  14. Autonomic dysfunction in primary Raynaud's phenomenon.

    Science.gov (United States)

    Koszewicz, M; Gosk-Bierska, I; Bilińska, M; Podemski, R; Budrewicz, S; Adamiec, R; Słotwiński, K

    2009-04-01

    The pathogenesis of Raynaud's phenomenon is still unclear. Neural and intravascular mechanisms are thought to be involved in the pathological process. The role of the autonomic nervous system is continually discussed, with particular attention to over-reactivity of the sympathetic part. The aim of this study was the clinical and electrophysiological analysis of autonomic nervous system function in patients with primary Raynaud's phenomenon. Thirty four patients with primary Raynaud's phenomenon and 31 sex and age-matched controls were examined. Neurological examination, modified Low's Questionnaire, orthostatic and sustained handgrip tests, conduction velocity study in three nerves, sympathetic skin response (SSR), and heart rate variability (HRV) during deep breathing and at rest with the fast Fourier transform were performed. In the clinical examinations, 35.3% of the primary Raynaud's patients presented sensory neuropathy, but this was not confirmed in the standard conduction velocity tests. The modified Low's Questionnaire revealed dysautonomy in 82% of the patients. Autonomic regulation during the orthostatic and handgrip tests were within the normal limits. HRV at rest and the E/I ratio were significantly lower in the patient group than in the controls, while HRV spectrum analysis revealed the predominance of the low-frequency band in the patients. These results indicate the presence of sympathetic dysregulation and impairment of parasympathetic modulation of heart function in primary Raynaud's patients. The different cardiovascular and sudomotor functions are not affected to the same degree. These observations might support the theory of a central impairment of autonomic function in primary Raynaud's phenomenon. Peripheral nerve lesion as a coexisting cause of the observed dysautonomy remains uncertain.

  15. Cardiac Autonomic Dysfunction in Children and Adolescents with ...

    African Journals Online (AJOL)

    Introduction: Autonomic neuropathy is less well documented in children with type 1 diabetes mellitus and has received less attention than other diabetic complications. Sudden death and cardio-respiratory arrest in patients with type 1 and type 2 diabetes mellitus have been attributed to cardiac autonomic dysfunction.

  16. Brainstem and Autonomic Nervous System Dysfunction: A Neurosurgical Point of View.

    Science.gov (United States)

    Martín-Gallego, A; González-García, L; Carrasco-Brenes, A; Segura-Fernández-Nogueras, M; Delgado-Babiano, A; Ros-Sanjuán, A; Romero-Moreno, L; Domínguez-Páez, M; Dawid-Milner, M S; Arráez-Sánchez, M A

    2017-01-01

    Central autonomic control nuclei and pathways are mainly integrated within the brainstem, especially in the medulla oblongata. Lesions within these structures can lead to central dysautonomia.Central autonomic control structures can be damaged by tumors, during surgery, or by other neurosurgical pathologies. These may elicit clinical or subclinical autonomic complications that can constitute a serious clinical problem.The authors present a broad review of the central autonomic nervous system, its possible dysfunctions, and the relation between neurosurgery and this "not-well-known system". Preliminary results of an autonomic study of brainstem lesions that is currently being carried out by the authors are also shown.

  17. Study of comparison between autonomic dysfunction and dyslipidemia in healthy postmenopausal women

    Directory of Open Access Journals (Sweden)

    Kavyach Yalamudi

    2017-01-01

    Full Text Available Background: Obesity, physical inactivity, and altered estrogen levels play an important role in contributing to disease risk profile and autonomic dysfunction in healthy postmenopausal women. This study was conducted to test the correlation between autonomic dysfunction and dyslipidemia in healthy postmenopausal women. Materials and Methods: This study was carried out on sixty healthy postmenopausal women before the age of 65 years, without any gross systemic disease. The following five autonomic functional tests were performed on the study group: heart rate response to deep breathing, heart rate response to Valsalva maneuver, heart rate response to standing up from supine position, blood pressure response to sustained hand grip, and blood pressure response to standing up from supine position. Fasting lipid profile of the study group was tested. Results and Conclusion: In the present study, autonomic dysfunction was found in 67% of healthy postmenopausal women. Among the sixty female healthy postmenopausal women included in the study, 68% were found to have dyslipidemia. In our study, there is a statistically significant correlation between autonomic dysfunction and dyslipidemia in healthy postmenopausal women. In these healthy postmenopausal women with increased serum cholesterol, serum low-density lipoprotein, and serum triglycerides, there was autonomic dysfunction which is statistically significant. There is no statistical significance on comparing serum high-density lipoprotein cholesterol with autonomic dysfunction in healthy postmenopausal women.

  18. Perioperative implications of the patient with autonomic dysfunction.

    Science.gov (United States)

    McGrane, Stuart; Atria, Nicklaus P; Barwise, John A

    2014-06-01

    The autonomic nervous system functions to control heart rate, blood pressure, respiratory rate, gastrointestinal motility, hormone release, and body temperature on a second-to-second basis. Here we summarize some of the latest literature on autonomic dysfunction, focusing primarily on the perioperative implications. The variety of autonomic dysfunction now extends to a large number of clinical conditions in which the cause or effect of the autonomic component is blurred. Methods for detecting dysautonomia can be as simple as performing a history and physical examination that includes orthostatic vital signs measured in both recumbent and vertical positions; however, specialized laboratories are required for definitive diagnosis. Heart rate variability monitoring is becoming more commonplace in the assessment and understanding of autonomic instability. Degenerative diseases of the autonomic nervous system include Parkinson's disease and multiple system atrophy, with the most serious manifestations being postural hypotension and paradoxical supine hypertension. Other conditions occur in which the autonomic dysfunction is only part of a larger disease process, such as diabetic autonomic neuropathy, traumatic brain injury, and spinal cord injury. Patients with dysautonomia often have unpredictable and paradoxical physiological responses to various perioperative stimuli. Knowledge of the underlying pathophysiology of their condition is required in order to reduce symptom exacerbation and limit morbidity and mortality during the perioperative period.

  19. Cardiac Autonomic Dysfunction in Offspring of Hypertensive Parents During Exercise.

    Science.gov (United States)

    Almeida, Leonardo Barbosa de; Peçanha, Tiago; Mira, Pedro Augusto de Carvalho; Souza, Livia Victorino de; da Silva, Lílian Pinto; Martinez, Daniel Godoy; Freitas, Isabelle Magalhães Guedes; Laterza, Mateus Camaroti

    2017-12-01

    Offspring of hypertensive parents present autonomic dysfunction at rest and during physiological maneuvers. However, the cardiac autonomic modulation during exercise remains unknown. This study tested whether the cardiac autonomic modulation would be reduced in offspring of hypertensive parents during exercise. Fourteen offspring of hypertensive and 14 offspring of normotensive individuals were evaluated. The groups were matched by age (24.5±1.0 vs. 26.6±1.5 years; p=0.25) and BMI (22.8±0.6 vs. 24.2±1.0 kg/m 2 ; p=0.30). Blood pressure and heart rate were assessed simultaneously during 3 min at baseline followed by 3-min isometric handgrip at 30% of maximal voluntary contraction. Cardiac autonomic modulation was evaluated using heart rate variability. Primary variables were subjected to two-way ANOVA (group vs. time). P valueexercise protocol. In contrast, offspring of hypertensive subjects showed a reduction of SDNN (Basal=34.8±3.5 vs. 45.2±3.7 ms; Exercise=30.8±3.3 vs. 41.5±3.9 ms; p group=0.01), RMSSD (Basal=37.1±3.7 vs. 52.0±6.0 ms; Exercise=28.6±3.4 vs. 41.9±5.3 ms; p group=0.02) and pNN50 (Basal=15.7±4.0 vs. 29.5±5.5%; Exercise=7.7±2.4 vs. 18.0±4.3%; p group=0.03) during the exercise protocol in comparison with offspring of normotensive parents. We concluded that normotensive offspring of hypertensive parents exhibit impaired cardiac autonomic modulation during exercise. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Autonomic dysfunction is a major feature of cerebellar ataxia, neuropathy, vestibular areflexia 'CANVAS' syndrome.

    Science.gov (United States)

    Wu, Teddy Y; Taylor, Jennifer M; Kilfoyle, Dean H; Smith, Andrew D; McGuinness, Ben J; Simpson, Mark P; Walker, Elizabeth B; Bergin, Peter S; Cleland, James C; Hutchinson, David O; Anderson, Neil E; Snow, Barry J; Anderson, Tim J; Paermentier, Laura A F; Cutfield, Nick J; Chancellor, Andrew M; Mossman, Stuart S; Roxburgh, Richard H

    2014-10-01

    Cerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS) is a recently recognized neurodegenerative ganglionopathy. Prompted by the presence of symptomatic postural hypotension in two patients with CANVAS, we hypothesized that autonomic dysfunction may be an associated feature of the syndrome. We assessed symptoms of autonomic dysfunction and performed autonomic nervous system testing among 26 patients from New Zealand. After excluding three patients with diabetes mellitus, 83% had evidence of autonomic dysfunction; all patients had at least one autonomic symptom and 91% had more than two symptoms. We also found a higher rate of downbeat nystagmus (65%) than previously described in CANVAS. We confirmed that sensory findings on nerve conduction tests were consistent with a sensory ganglionopathy and describe two patients with loss of trigeminal sensation consistent with previous pathological descriptions of trigeminal sensory ganglionopathy. Our results suggest that autonomic dysfunction is a major feature of CANVAS. This has implications for the management of patients with CANVAS as the autonomic symptoms may be amenable to treatment. The findings also provide an important differential diagnosis from multiple system atrophy for patients who present with ataxia and autonomic failure. © The Author (2014). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Autonomic Dysfunction Because of Severe Tetanus in an Unvaccinated Child

    Directory of Open Access Journals (Sweden)

    Ting-Syuan Lin

    2011-06-01

    Full Text Available Tetanus is rare in a country with a national vaccination program. When it does occur, the associated autonomic dysfunction is a challenge for physicians. We report here a case of an unvaccinated 5-year-old boy who suffered from tetanus complicated by autonomic dysfunction, which was successfully controlled by the infusion of magnesium sulfate. This is the first case that demonstrated the therapeutic effect of magnesium sulfate in a child with tetanus. This case highlights the importance of implementing a vaccination program.

  2. The Prevalence and Severity of Autonomic Dysfunction in Chronic Inflammatory Demyelinating Polyneuropathy.

    Science.gov (United States)

    Pasangulapati, Suresh Babu; Murthy, T V; Sivadasan, Ajith; Gideon, L Rynjah; Prabhakar, A T; Sanjith, Aaron; Mathew, Vivek; Alexander, Mathew

    2017-01-01

    In chronic inflammatory demyelinating polyneuropathy (CIDP), emphasis has been on motor disabilities, and autonomic dysfunction in these patients has not been addressed systematically. Autonomic function was prospectively analyzed in 38 patients with CIDP. Quantitative autonomic function testing was done using Finometer ® PRO and severity of adrenergic and cardiovagal dysfunction graded according to composite autonomic severity score and sudomotor dysfunction assessed using sympathetic skin response. Thirty-four (89%) patients had features of autonomic dysfunction. Thirty-three (86%) patients had cardiovagal dysfunction, 21 (55%) had adrenergic dysfunction, and 24 (63%) had sudomotor dysfunction. Autonomic dysfunction was mild to moderate in the majority (86%). Autonomic dysfunction in CIDP is underreported and potentially amenable to therapy. Our cohort had a high proportion of adrenergic dysfunction compared to previous studies.

  3. Syncope due to Autonomic Dysfunction: Diagnosis and Management.

    Science.gov (United States)

    Adkisson, Wayne O; Benditt, David G

    2015-07-01

    Syncope is one of several disorders that cause transient loss of consciousness. Cerebral hypoperfusion is the proximate cause of syncope. Transient or fixed autonomic nervous system dysfunction is a major contributor in many causes. A structured approach to the evaluation of syncope allows for more effective therapy. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Progression of cardiovascular autonomic dysfunction in Holmes-Adie syndrome.

    Science.gov (United States)

    Guaraldi, P; Mathias, C J

    2011-09-01

    The Holmes-Adie Syndrome (HAS) is a disorder of unknown aetiology comprising unilateral or bilateral tonic pupils with near light dissociation and tendon areflexia. Although considered to be benign, troublesome symptoms may result from autonomic disturbances, affecting vasomotor, sudomotor and respiratory function. It is unclear if the autonomic manifestations of the disease remain stable or progress, as longitudinal studies with detailed autonomic assessments have not been described. The authors report four HAS patients studied at intervals over 16, 8, 4 and 2 years with cardiovascular autonomic tests (head-up tilt, isometric exercise, mental arithmetic, cutaneous cold, deep breathing, Valsalva manoeuvre and standing). In each, there was progression of cardiovascular autonomic deficits with time, accompanied by symptomatic worsening. These observations in HAS, for the first time, indicate progression of cardiovascular autonomic dysfunction of clinical significance. This has a number of implications, including those relating to aetiology and prognosis. The authors recommend regular clinical and laboratory follow-up, especially of cardiovascular autonomic function, in patients with HAS.

  5. Association between autonomic dysfunction and fatigue in Parkinson disease.

    Science.gov (United States)

    Chou, Kelvin L; Gilman, Sid; Bohnen, Nicolaas I

    2017-06-15

    Fatigue is a disabling non-motor symptom in Parkinson disease (PD). We investigated the relationship between autonomic dysfunction and fatigue in PD while accounting for possible confounding factors. 29 subjects with PD (8F/21M; mean age 61.6±5.9; mean disease duration 4.8±3.0years), underwent clinical assessment and completed several non-motor symptom questionnaires, including a modified version of the Mayo Clinic Composite Autonomic Symptom Score (COMPASS) scale and the Fatigue Severity Scale (FSS). The mean modified COMPASS was 21.6±14.2 (range 1.7-44.2) and the mean FSS score was 3.3±1.6 (range 1.0-6.7). There was a significant bivariate relationship between the modified COMPASS and FSS scores (R=0.69, P<0.0001). Stepwise regression analysis was used to assess the specificity of the association between the modified COMPASS and FSS scores while accounting for possible confounder effects from other variables that were significantly associated with autonomic dysfunction. Results showed that the modified COMPASS (R 2 =0.52, F=28.4, P<0.0001) was highly associated with fatigue, followed by ESS (R 2 =0.13, F=8.4, P=0.008) but no other co-variates. Post-hoc analysis exploring the association between the different modified COMPASS autonomic sub-domain scores and FSS scores found significant regressor effects for the orthostatic intolerance (R 2 =0.45, F=21.2, P<0.0001) and secretomotor sub-domains (R 2 =0.09, F=4.8, P=0.04) but not for other autonomic sub-domains. Autonomic dysfunction, in particular orthostatic intolerance, is highly associated with fatigue in PD. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Autonomic Dysfunction in Cardiology: Pathophysiology, Investigation, and Management.

    Science.gov (United States)

    Arnold, Amy C; Ng, Jessica; Lei, Lucy; Raj, Satish R

    2017-12-01

    Presyncope and syncope are common medical findings, with a > 40% estimated lifetime prevalence. These conditions are often elicited by postural stress and can be recurrent and accompanied by debilitating symptoms of cerebral hypoperfusion. Therefore, it is critical for physicians to become familiar with the diagnosis and treatment of common underlying causes of presyncope and syncope. In some patients, altered postural hemodynamic responses result from a failure of compensatory autonomic nervous system reflex mechanisms. The most common presentations of presyncope and syncope secondary to this autonomic dysfunction include vasovagal syncope, neurogenic orthostatic hypotension, and postural tachycardia syndrome. The most sensitive method for diagnosis is a detailed initial evaluation with medical history, physical examination, and resting electrocardiogram to rule out cardiac syncope. Physical examination should include measurement of supine and standing blood pressure and heart rate to identify the pattern of hemodynamic regulation during orthostatic stress. Additional testing may be required in patients without a clear diagnosis after the initial evaluation. Management of patients should focus on improving symptoms and functional status and not targeting arbitrary hemodynamic values. An individualized structured and stepwise approach should be taken for treatment, starting with patient education, lifestyle modifications, and use of physical counter-pressure manoeuvres and devices to improve venous return. Pharmacologic interventions should be added only when conservative approaches are insufficient to improve symptoms. There are no gold standard approaches for pharmacologic treatment in these conditions, with medications often used off label and with limited long-term data for effectiveness. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  7. Autonomic dysfunction in HIV patients on antiretroviral therapy: studies of heart rate variability

    DEFF Research Database (Denmark)

    Lebech, Anne-Mette; Kristoffersen, Ulrik Sloth; Mehlsen, Jesper

    2007-01-01

    and decreased morbidity. At present it is not known whether introduction of ART also has decreased autonomic dysfunction. AIM: To evaluate whether autonomic dysfunction is present in an ART-treated HIV population. METHODS: HIV patients receiving ART for at least 3 years (n = 16) and an age-matched control group...... guidelines and data reported as median (interquartile range). RESULTS: The resting heart rate was higher in HIV patients compared with controls [69 (62-74) versus 57 (52-60); PTotal HRV measured as standard deviation of normal-to-normal (SONN) was lower in the HIV group compared with the controls...... [36 (25-55) versus 74 (57-84) ms; Psquare root of the mean squared difference of successive normal-to-normal intervals (RMSSD) [22 (9-30) versus 35 (24-62) ms; P

  8. Role of exercise training in cardiovascular autonomic dysfunction and mortality in diabetic ovariectomized rats

    OpenAIRE

    Souza, Silvia Beatriz Paulino Cavasin de [UNIFESP; Flues, Karin; Paulini, Janaina; Mostarda, Cristiano [UNIFESP; Rodrigues, Bruno; Souza, Leandro E.; Irigoyen, Maria Claudia [UNIFESP; De Angelis, Katia

    2007-01-01

    Diabetes and menopause markedly increase the risk of cardiovascular disease in women. the objective of the present study was to investigate the effects of exercise training on cardiovascular autonomic dysfunction and on total mortality in diabetic female rats undergoing ovarian hormone deprivation. Female Wistar rats were divided into ovariectomized groups: sedentary and trained controls and sedentary and trained diabetic rats (streptozotocin, 50 mg/kg IV). Trained groups were submitted to an...

  9. Cardiovascular Autonomic Dysfunction: Link Between Multiple Sclerosis Osteoporosis and Neurodegeneration.

    Science.gov (United States)

    Sternberg, Zohara

    2018-03-01

    The high prevalence of osteoporosis, observed in multiple sclerosis (MS) patients, has been attributed to reduced mobility and or the use of disease-modifying drugs. However, MS-impaired cardiovascular autonomic nervous system (ANS) function has the potential of reducing bone mass density (BMD) by altering the expression and/or function of the neuronal, systemic, and local mediators of bone remodeling. This review describes the complex regulation of bone homeostasis with a focus on MS, providing evidence that ANS dysfunction and low BMD are intertwined with MS inflammatory and neurodegenerative processes, and with other MS-related morbidities, including depression, fatigue, and migraine. Strategies for improving ANS function could reduce the prevalence of MS osteoporosis and slow the rate of MS progression, with a significant positive impact on patients' quality of life.

  10. Anxiety, depression and autonomic nervous system dysfunction in hypertension.

    Science.gov (United States)

    Bajkó, Zoltán; Szekeres, Csilla-Cecília; Kovács, Katalin Réka; Csapó, Krisztina; Molnár, Sándor; Soltész, Pál; Nyitrai, Erika; Magyar, Mária Tünde; Oláh, László; Bereczki, Dániel; Csiba, László

    2012-06-15

    This study examined the relationship between autonomic nervous system dysfunction, anxiety and depression in untreated hypertension. 86 newly diagnosed hypertensive patients and 98 healthy volunteers were included in the study. The psychological parameters were assessed with Spielberger State-Trait Anxiety Inventory and Beck Depression Inventory by a skilled psychologist. Autonomic parameters were examined during tilt table examination (10min lying position, 10min passive tilt). Heart rate variability (HRV) was calculated by autoregressive methods. Baroreflex sensitivity (BRS) was calculated by non-invasive sequence method from the recorded beat to beat blood pressure values and RR intervals. Significantly higher state (42.6±9.3 vs. 39.6±10.7 p=0.05) and trait (40.1±8.9 vs. 35.1±8.6, p<0.0001) anxiety scores were found in the hypertension group. There was no statistically significant difference in the depression level. LF-RRI (Low Frequency-RR interval) of HRV in passive tilt (377.3±430.6 vs. 494.1±547, p=0.049) and mean BRS slope (11.4±5.5 vs. 13.2±6.4, p=0.07) in lying position were lower in hypertensives. Trait anxiety score correlates significantly with sympatho/vagal balance (LF/HF-RRI) in passive tilt position (Spearman R=-0.286, p=0.01). Anxiety could play a more important role than depression in the development of hypertension. Altered autonomic control of the heart could be one of the pathophysiological links between hypertension and psychological factors. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. The symptom burden of autonomic dysfunction is positively associated with chronic rhinosinusitis status.

    Science.gov (United States)

    Chen, W C; Chang, Y T; Chen, S F; Lin, W C; Su, Y Y; Luo, S D

    2018-03-21

    Dysregulation of the autonomic system can affect sinonasal physiological function and may exacerbate the symptom burden associated with rhinosinusitis. However, the association between autonomic dysfunction and chronic rhinosinusitis (CRS) has seldom been studied. Here, we investigated the relationship between autonomic dysfunction and CRS. Patients with CRS who failed medical treatment were prospectively enrolled. All patients underwent pre-operative examinations and completed questionnaires, including the reflux symptom index (RSI) and the Sino-nasal Outcome Test-22 (SNOT-22). Autonomic dysfunction was scored using the 31-item Composite Autonomic Symptom Score (COMPASS 31), a validated simple instrument used to evaluate dysautonomia. We prospectively enrolled a total of 89 CRS patients, including 37 with polyps (CRSwNP) and 52 without polyps (CRSsNP). The most common dysautonomic symptoms were dry eye, dry mouth, postural dizziness, and a sensation of excessive fullness after meals. Significant positive correlations were evident between COMPASS 31 and SNOT-22 scores in CRSwNP patients. CRS-associated symptoms, including cough, post-nasal drip, sleep, and psychological dysfunction, were correlated with the level of autonomic dysfunction. We found a positive correlation between the symptom burdens of autonomic dysfunction and CRSwNP. The relationship between autonomic dysfunction and CRS is highly complex; further work is needed.

  12. Plasma DNA Mediate Autonomic Dysfunctions and White Matter Injuries in Patients with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Meng-Hsiang Chen

    2017-01-01

    Full Text Available Background. Cardiovascular autonomic dysfunction is well known in Parkinson’s disease (PD presentation and it produces hypoperfusion of vital organs. The association between cardiovascular autonomic dysfunction and oxidative stress was examined in previous animal models. Oxidative stress and neuroinflammation were thought to have roles in PD pathogenesis. Owing to the relative low intrinsic antioxidative properties, brain white matter (WM is vulnerable to the oxidative stress. This study is conducted to examine possible relationships by using a hypothesis-driven mediation model. Methods. Twenty-nine patients with PD and 26 healthy controls participated in this study, with complete examinations of cardiac autonomic parameters, plasma DNA level, and WM integrity. A single-level three-variable mediation model was used to investigate the possible relationships. Results. The elevated serum oxidative stress biomarkers include plasma nuclear DNA and mitochondrial DNA, and poorer cardiac autonomic parameters and multiple regional microstructural WM changes are demonstrated. Further mediation analysis shows that plasma nuclear DNA served as the mediators between poorer baroreflex sensitivity and mean diffusivity changes in cingulum. Conclusions. These results provide a possible pathophysiology for how the poor baroreflex sensitivity and higher oxidative stress adversely impacted the WM integrity. This model could provide us with a piece of the puzzle of the entire PD pathogenesis.

  13. Cardiovascular Autonomic Dysfunction in Patients with Morbid Obesity

    Science.gov (United States)

    de Sant Anna Junior, Maurício; Carneiro, João Regis Ivar; Carvalhal, Renata Ferreira; Torres, Diego de Faria Magalhães; da Cruz, Gustavo Gavina; Quaresma, José Carlos do Vale; Lugon, Jocemir Ronaldo; Guimarães, Fernando Silva

    2015-01-01

    Background Morbid obesity is directly related to deterioration in cardiorespiratory capacity, including changes in cardiovascular autonomic modulation. Objective This study aimed to assess the cardiovascular autonomic function in morbidly obese individuals. Methods Cross-sectional study, including two groups of participants: Group I, composed by 50 morbidly obese subjects, and Group II, composed by 30 nonobese subjects. The autonomic function was assessed by heart rate variability in the time domain (standard deviation of all normal RR intervals [SDNN]; standard deviation of the normal R-R intervals [SDNN]; square root of the mean squared differences of successive R-R intervals [RMSSD]; and the percentage of interval differences of successive R-R intervals greater than 50 milliseconds [pNN50] than the adjacent interval), and in the frequency domain (high frequency [HF]; low frequency [LF]: integration of power spectral density function in high frequency and low frequency ranges respectively). Between-group comparisons were performed by the Student’s t-test, with a level of significance of 5%. Results Obese subjects had lower values of SDNN (40.0 ± 18.0 ms vs. 70.0 ± 27.8 ms; p = 0.0004), RMSSD (23.7 ± 13.0 ms vs. 40.3 ± 22.4 ms; p = 0.0030), pNN50 (14.8 ± 10.4 % vs. 25.9 ± 7.2%; p = 0.0061) and HF (30.0 ± 17.5 Hz vs. 51.7 ± 25.5 Hz; p = 0.0023) than controls. Mean LF/HF ratio was higher in Group I (5.0 ± 2.8 vs. 1.0 ± 0.9; p = 0.0189), indicating changes in the sympathovagal balance. No statistical difference in LF was observed between Group I and Group II (50.1 ± 30.2 Hz vs. 40.9 ± 23.9 Hz; p = 0.9013). Conclusion morbidly obese individuals have increased sympathetic activity and reduced parasympathetic activity, featuring cardiovascular autonomic dysfunction. PMID:26536979

  14. Cardiovascular Autonomic Dysfunction in Patients with Morbid Obesity

    Energy Technology Data Exchange (ETDEWEB)

    Sant Anna Junior, Maurício de [Programa de Tratamento Multidisciplinar da Obesidade do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro, RJ (Brazil); Departamento de Fisioterapia do Centro Universitário Anhanguera Niterói - UNIAN, Niterói, RJ (Brazil); Programa de pós-graduação em Ciências Médicas, Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Carneiro, João Regis Ivar; Carvalhal, Renata Ferreira [Programa de Tratamento Multidisciplinar da Obesidade do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro, RJ (Brazil); Torres, Diego de Faria Magalhães [Programa de Tratamento Multidisciplinar da Obesidade do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro, RJ (Brazil); Departamento de Fisioterapia da Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ (Brazil); Cruz, Gustavo Gavina da; Quaresma, José Carlos do Vale [Programa de Tratamento Multidisciplinar da Obesidade do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro, RJ (Brazil); Lugon, Jocemir Ronaldo [Divisão de Nefrologia - Faculdade de Medicina da Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Guimarães, Fernando Silva, E-mail: fguimaraes_pg@yahoo.com.br [Departamento de Fisioterapia da Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ (Brazil); Programa de pós-graduação em Ciências da Reabilitação - Centro Universitário Augusto Motta, Rio de Janeiro, RJ (Brazil)

    2015-12-15

    Morbid obesity is directly related to deterioration in cardiorespiratory capacity, including changes in cardiovascular autonomic modulation. This study aimed to assess the cardiovascular autonomic function in morbidly obese individuals. Cross-sectional study, including two groups of participants: Group I, composed by 50 morbidly obese subjects, and Group II, composed by 30 nonobese subjects. The autonomic function was assessed by heart rate variability in the time domain (standard deviation of all normal RR intervals [SDNN]; standard deviation of the normal R-R intervals [SDNN]; square root of the mean squared differences of successive R-R intervals [RMSSD]; and the percentage of interval differences of successive R-R intervals greater than 50 milliseconds [pNN50] than the adjacent interval), and in the frequency domain (high frequency [HF]; low frequency [LF]: integration of power spectral density function in high frequency and low frequency ranges respectively). Between-group comparisons were performed by the Student’s t-test, with a level of significance of 5%. Obese subjects had lower values of SDNN (40.0 ± 18.0 ms vs. 70.0 ± 27.8 ms; p = 0.0004), RMSSD (23.7 ± 13.0 ms vs. 40.3 ± 22.4 ms; p = 0.0030), pNN50 (14.8 ± 10.4 % vs. 25.9 ± 7.2%; p = 0.0061) and HF (30.0 ± 17.5 Hz vs. 51.7 ± 25.5 Hz; p = 0.0023) than controls. Mean LF/HF ratio was higher in Group I (5.0 ± 2.8 vs. 1.0 ± 0.9; p = 0.0189), indicating changes in the sympathovagal balance. No statistical difference in LF was observed between Group I and Group II (50.1 ± 30.2 Hz vs. 40.9 ± 23.9 Hz; p = 0.9013). morbidly obese individuals have increased sympathetic activity and reduced parasympathetic activity, featuring cardiovascular autonomic dysfunction.

  15. Cardiovascular Autonomic Dysfunction in Patients with Morbid Obesity

    International Nuclear Information System (INIS)

    Sant Anna Junior, Maurício de; Carneiro, João Regis Ivar; Carvalhal, Renata Ferreira; Torres, Diego de Faria Magalhães; Cruz, Gustavo Gavina da; Quaresma, José Carlos do Vale; Lugon, Jocemir Ronaldo; Guimarães, Fernando Silva

    2015-01-01

    Morbid obesity is directly related to deterioration in cardiorespiratory capacity, including changes in cardiovascular autonomic modulation. This study aimed to assess the cardiovascular autonomic function in morbidly obese individuals. Cross-sectional study, including two groups of participants: Group I, composed by 50 morbidly obese subjects, and Group II, composed by 30 nonobese subjects. The autonomic function was assessed by heart rate variability in the time domain (standard deviation of all normal RR intervals [SDNN]; standard deviation of the normal R-R intervals [SDNN]; square root of the mean squared differences of successive R-R intervals [RMSSD]; and the percentage of interval differences of successive R-R intervals greater than 50 milliseconds [pNN50] than the adjacent interval), and in the frequency domain (high frequency [HF]; low frequency [LF]: integration of power spectral density function in high frequency and low frequency ranges respectively). Between-group comparisons were performed by the Student’s t-test, with a level of significance of 5%. Obese subjects had lower values of SDNN (40.0 ± 18.0 ms vs. 70.0 ± 27.8 ms; p = 0.0004), RMSSD (23.7 ± 13.0 ms vs. 40.3 ± 22.4 ms; p = 0.0030), pNN50 (14.8 ± 10.4 % vs. 25.9 ± 7.2%; p = 0.0061) and HF (30.0 ± 17.5 Hz vs. 51.7 ± 25.5 Hz; p = 0.0023) than controls. Mean LF/HF ratio was higher in Group I (5.0 ± 2.8 vs. 1.0 ± 0.9; p = 0.0189), indicating changes in the sympathovagal balance. No statistical difference in LF was observed between Group I and Group II (50.1 ± 30.2 Hz vs. 40.9 ± 23.9 Hz; p = 0.9013). morbidly obese individuals have increased sympathetic activity and reduced parasympathetic activity, featuring cardiovascular autonomic dysfunction

  16. Autonomic Dysfunction in Patients with Mild to Moderate Alzheimer's Disease

    DEFF Research Database (Denmark)

    Jensen-Dahm, Christina; Waldemar, Gunhild; Staehelin Jensen, Troels

    2015-01-01

    BACKGROUND: Autonomic function has received little attention in Alzheimer's disease (AD). AD pathology has an impact on brain regions which are important for central autonomic control, but it is unclear if AD is associated with disturbance of autonomic function. OBJECTIVE: To investigate autonomic...

  17. Autonomic dysfunction in Hodgkin and non-Hodgkin lymphoma. A paraneoplastic syndrome?

    Directory of Open Access Journals (Sweden)

    Franca Bilora

    2010-11-01

    Full Text Available We wanted to determine whether autonomic dysfunction in patients with lymphoma is related to chemotherapy or represent a paraneoplastic syndrome. 40 patients with current or cured Hodgkin or non-Hodgkin lymphoma and 40 healthy controls, matched for age, gender, hypertension and diabetes mellitus underwent autonomic evaluation (Deep Breath, Valsalva Maneuver, Hand Grip, Lying to Standing, Tilt Test. Current patients also suffering from diabetes or hypertension, or still on chemotherapy revealed autonomic changes, while cured or healthy subjects did not. Autonomic dysfunction in lymphoma is a transient manifestation of a paraneoplastic syndrome.

  18. Pupillary Light Reflexes are Associated with Autonomic Dysfunction in Bolivian Diabetics But Not Chagas Disease Patients.

    Science.gov (United States)

    Halperin, Anthony; Pajuelo, Monica; Tornheim, Jeffrey A; Vu, Nancy; Carnero, Andrés M; Galdos-Cardenas, Gerson; Ferrufino, Lisbeth; Camacho, Marilyn; Justiniano, Juan; Colanzi, Rony; Bowman, Natalie M; Morris, Tiffany; MacDougall, Hamish; Bern, Caryn; Moore, Steven T; Gilman, Robert H

    2016-06-01

    Autonomic dysfunction is common in Chagas disease and diabetes. Patients with either condition complicated by cardiac autonomic dysfunction face increased mortality, but no clinical predictors of autonomic dysfunction exist. Pupillary light reflexes (PLRs) may identify such patients early, allowing for intensified treatment. To evaluate the significance of PLRs, adults were recruited from the outpatient endocrine, cardiology, and surgical clinics at a Bolivian teaching hospital. After testing for Chagas disease and diabetes, participants completed conventional autonomic testing (CAT) evaluating their cardiovascular responses to Valsalva, deep breathing, and orthostatic changes. PLRs were measured using specially designed goggles, then CAT and PLRs were compared as measures of autonomic dysfunction. This study analyzed 163 adults, including 96 with Chagas disease, 35 patients with diabetes, and 32 controls. PLRs were not significantly different between Chagas disease patients and controls. Patients with diabetes had longer latency to onset of pupil constriction, slower maximum constriction velocities, and smaller orthostatic ratios than nonpatients with diabetes. PLRs correlated poorly with CAT results. A PLR-based clinical risk score demonstrated a 2.27-fold increased likelihood of diabetes complicated by autonomic dysfunction compared with the combination of blood tests, CAT, and PLRs (sensitivity 87.9%, specificity 61.3%). PLRs represent a promising tool for evaluating subclinical neuropathy in patients with diabetes without symptomatic autonomic dysfunction. Pupillometry does not have a role in the evaluation of Chagas disease patients. © The American Society of Tropical Medicine and Hygiene.

  19. Frequency of autonomic neuropathy in patients with erectile dysfunction in diabetes mellitus

    International Nuclear Information System (INIS)

    Ghafoor, A.; Zaidi, S.M.H.; Moazzam, A.

    2015-01-01

    Background: Among diabetic patients autonomic neuropathy (AN) is one of the most frequent complications. This affects peripheral nervous system and thus results into erectile dysfunction (ED). The main objectives of the study were to determine the frequency of autonomic neuropathy (AN) in diabetic patients with ED and to find out the associated risk factors. Method: In this descriptive case series, a total 200 consecutive patients of Diabetes Mellitus with erectile dysfunction attended the Department of Endocrinology and Metabolism (DEM), Services Hospital Lahore during three months (from June to August 2013), were included. For assessing erectile dysfunction (ED) and autonomic neuropathy (AN) International Index of Erectile Function (IIEF) and Composite Autonomic Scoring System (CASS) were used respectively. Other factors impacting the autonomic functions in diabetes like duration of diabetes, age of patient, body mass index (BMI), and glycaemic control (HbAlc), hypertension and smoking status were recorded. Results: Average age of the patients was 57.58±9.53 years (95 percentage C.I. 55.54-59.63). Frequency of autonomic neuropathy (AN) in ED patients was 86 (43 percentage). Duration of diabetes Mellitus and BMI were statistically significantly different among patients with severe, moderate and mild autonomic neuropathy. Conclusions: Autonomic neuropathy was very frequent in diabetic patients with erectile dysfunction. The associated risk factors are duration of disease and body mass index. (author)

  20. The Link Between Stress Disorders and Autonomic Dysfunction in Muscular Dystrophy

    OpenAIRE

    Rasna eSabharwal

    2014-01-01

    Muscular dystrophy is a progressive disease of muscle weakness, muscle atrophy and cardiac dysfunction. Patients afflicted with muscular dystrophy exhibit autonomic dysfunction along with cognitive impairment, severe depression, sadness, and anxiety. Although the psychological aspects of cardiovascular disorders and stress disorders are well known, the physiological mechanism underlying this relationship is not well understood, particularly in muscular dystrophy. Therefore, the goal of this p...

  1. The link between stress disorders and autonomic dysfunction in muscular dystrophy.

    Science.gov (United States)

    Sabharwal, Rasna

    2014-01-01

    Muscular dystrophy is a progressive disease of muscle weakness, muscle atrophy and cardiac dysfunction. Patients afflicted with muscular dystrophy exhibit autonomic dysfunction along with cognitive impairment, severe depression, sadness, and anxiety. Although the psychological aspects of cardiovascular disorders and stress disorders are well known, the physiological mechanism underlying this relationship is not well understood, particularly in muscular dystrophy. Therefore, the goal of this perspective is to highlight the importance of autonomic dysfunction and psychological stress disorders in the pathogenesis of muscular dystrophy. This article will for the first time-(i) outline autonomic mechanisms that are common to both psychological stress and cardiovascular disorders in muscular dystrophy; (ii) propose therapies that would improve behavioral and autonomic functions in muscular dystrophy.

  2. The Link Between Stress Disorders and Autonomic Dysfunction in Muscular Dystrophy

    Directory of Open Access Journals (Sweden)

    Rasna eSabharwal

    2014-01-01

    Full Text Available Muscular dystrophy is a progressive disease of muscle weakness, muscle atrophy and cardiac dysfunction. Patients afflicted with muscular dystrophy exhibit autonomic dysfunction along with cognitive impairment, severe depression, sadness, and anxiety. Although the psychological aspects of cardiovascular disorders and stress disorders are well known, the physiological mechanism underlying this relationship is not well understood, particularly in muscular dystrophy. Therefore, the goal of this perspective is to highlight the importance of autonomic dysfunction and psychological stress disorders in the pathogenesis of muscular dystrophy. This article will for the first time - (i outline autonomic mechanisms that are common to both psychological stress and cardiovascular disorders in muscular dystrophy; (ii propose therapies that would improve behavioral and autonomic functions in muscular dystrophy.

  3. The link between stress disorders and autonomic dysfunction in muscular dystrophy

    Science.gov (United States)

    Sabharwal, Rasna

    2014-01-01

    Muscular dystrophy is a progressive disease of muscle weakness, muscle atrophy and cardiac dysfunction. Patients afflicted with muscular dystrophy exhibit autonomic dysfunction along with cognitive impairment, severe depression, sadness, and anxiety. Although the psychological aspects of cardiovascular disorders and stress disorders are well known, the physiological mechanism underlying this relationship is not well understood, particularly in muscular dystrophy. Therefore, the goal of this perspective is to highlight the importance of autonomic dysfunction and psychological stress disorders in the pathogenesis of muscular dystrophy. This article will for the first time—(i) outline autonomic mechanisms that are common to both psychological stress and cardiovascular disorders in muscular dystrophy; (ii) propose therapies that would improve behavioral and autonomic functions in muscular dystrophy. PMID:24523698

  4. Cardiovascular autonomic dysfunction due to diabetes mellitus: An ...

    African Journals Online (AJOL)

    Cardiovascular autonomic neuropathy (CAN) is a common form of diabetes autonomic neuropathy, causes abnormalities in heart rate control as well as central and peripheral vascular dynamics, and may carry an increased risk of mortality. The aim of this article was to review the importance of identifying CAN and ...

  5. Autonomic Dysfunction in Children with Acute Community-Acquired Pneumonia and the Ways of Drug Treatment

    Directory of Open Access Journals (Sweden)

    S.L. Nyankovsky

    2012-02-01

    Full Text Available The paper deals with the features of clinical course, intensity of toxic, asthenic syndromes, autonomic functioning in children of 7 years old with signs of community-acquired pneumonia based on instrumental autonomic testing and EEG findings. The probiotic Enterol and metabolic medication Stimol included into the treatment scheme fasten normalization of clinical, instrumental and functional parameters, reduce autonomic dysfunction, improve physical condition, adaptive opportunities, stress resistance, reduce imbalance between humoral-metabolic and central ergotropic influence, normalize responsiveness of parasympathetic nervous system and balance of autonomic modulation of cardiac rhythm, improve EEG findings.

  6. Cardiovascular autonomic dysfunction in primary ovarian insufficiency: clinical and experimental evidence

    Science.gov (United States)

    Goldmeier, Silvia; De Angelis, Kátia; Rabello Casali, Karina; Vilodre, César; Consolim-Colombo, Fernanda; Belló Klein, Adriane; Plentz, Rodrigo; Spritzer, PoliMara; Irigoyen, Maria-Cláudia

    2014-01-01

    Objective: Women with primary ovarian insufficiency (POI) present an increased risk for cardiovascular disease. In this study we tested the hypothesis that POI in women under hormone therapy (HT) are associated with vascular vasodilatation attenuation and cardiovascular autonomic dysfunction and these impairments are related to changes in systemic antioxidant enzymes. Furthermore, the possibility that ovarian hormone deprivation can induce such changes and that HT cannot reverse all of those impairments was examined in an experimental model of POI. Methods: Fifteen control and 17 patients with primary ovarian insufficiency receiving HT were included in the study. To test the systemic and cardiac consequences of ovarian hormone deprivation, ovariectomy was induced in young female rats that were submitted or not to HT. Spectral analysis of RR interval and blood pressure signals were performed and oxidative stress parameters were determined. Results: POI women under HT have increased mean arterial pressure (94±10 vs. 86±5 mmHg) despite normal endothelial and autonomic modulation of vasculature. Additionally, they presented impaired baroreflex sensitivity (3.9±1.38 vs. 7.15±3.62 ms/mmHg) and reduced heart rate variability (2310±1173 vs. 3754±1921 ms2). Similar results obtained in ovariectomized female rats were accompanied by an increased lipoperoxidation (7433±1010 vs. 6180±289 cps/mg protein) and decreased antioxidant enzymes in cardiac tissue. As it was observed in women, the HT in animals did not restore hemodynamic and autonomic dysfunctions. Conclusion: These data provide clinical and experimental evidence that long term HT may not restore all cardiovascular risk factors associated with ovarian hormone deprivation. PMID:24349626

  7. Interleukin-6 blockade Improves Autonomic Dysfunction in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Ashit Syngle

    2015-01-01

    Full Text Available Autonomic nervous system (ANS involvement in rheumatoid arthritis (RA is well recognised and contributes to arrhythmia and sudden death. However, there is no study documented the therapeutic efficacy on autonomic neuropathy (AN in RA. This is the first reported observation of improvement in AN with interleukin-6 (IL-6 blockade with tocilizumab in RA. We report a case of 61-year old female with seropositive RA with severe disease activity, investigated for autonomic neuropathy. A battery of non invasive tests was used for accurate assessment of AN function based on assessment of peripheral sympathetic autonomic function and cardiovascular reflex tests. Tocilizumab 8mg/kg intravenous infusion at weeks 0, 4 and 8 was added to her treatment regimen. Cardiovascular autonomic function tests at baseline showed marked abnormalities of parasympathetic cardiovascular reflexes. After the first dose of tocilizumab there was a rapid improvement with normalization of parasympathetic autonomic activity with subsequent doses. IL-6 blockade with tocilizumab seems to have the potential to improve the vagus nerve mediated parasympathetic neuropathy and hence has the potential to restore cholinergic anti-inflammatory pathway.

  8. Autonomic and thermal sensory symptoms and dysfunction after stroke.

    Science.gov (United States)

    Naver, H; Blomstrand, C; Ekholm, S; Jensen, C; Karlsson, T; Wallin, G

    1995-08-01

    Symptoms interpreted as unilateral disturbances of autonomic function, such as coldness, dryness, sweating, and trophic changes, are well known but incompletely understood clinical problems after stroke. The present study provides data related to the incidence and mechanisms behind such symptoms. Temperature perception thresholds, skin temperatures, evaporation rates, and skin blood flow responses were measured bilaterally in 37 stroke patients aged 58 +/- 13 years (mean +/- SD) and in a control group of 15 patients aged 64 +/- 15 years with a single transient ischemic attack. Of the 37 stroke patients, 43% reported a sensation of coldness in the contralesional side of the body. Basal skin blood flow and temperature were relatively lower in the contralesional side. There was an excess of evaporation in the contralesional side after brain stem lesions and in the ipsilesional side after hemispheric lesions. Vasomotor reflex asymmetries occurred in 34% of the patients and were due to weak vasodilator or vasoconstrictor reflexes in the ipsilesional side. These abnormalities correlated significantly to sensations of unilateral coldness, hypalgesia, and thermohypesthesia in the contralesional side and anatomically to lesions in spinothalamo-cortical pathways. Focal central nervous system lesions due to stroke may result in symptoms and measurable evidence of unilateral disturbance of skin sympathetic function. Vasomotor asymmetries are probably due to lesions of vasomotor pathways descending uncrossed. Subjective coldness may be due to disturbed central processing.

  9. The association between autonomic dysfunction, inflammation and atherosclerosis in men under investigation for carotid plaques.

    Directory of Open Access Journals (Sweden)

    Marcus A Ulleryd

    Full Text Available Autonomic dysfunction is a risk factor for cardiovascular disease (CVD, however, the exact mechanism linking autonomic dysfunction to cardiovascular disease is not known. In this study we hypothesized that autonomic dysfunction increases inflammation, which subsequently accelerates atherosclerosis. The aim of the current study was to investigate the association between autonomic tone, inflammation and atherosclerosis.124 men under investigation for carotid atherosclerosis were examined for autonomic function (heart rate variability; HRV and baroreflex sensitivity; BRS, inflammatory markers (white blood cell count; WBCC and C-reactive protein; CRP and degree of carotid atherosclerosis. The direct or indirect associations between autonomic function, inflammatory parameters and carotid plaque area were investigated with multiple linear regressions.Male subjects with prevalent CVD showed larger carotid plaque area, higher WBCC, and reduced BRS compared to subjects with no history of CVD. Further, BRS was inversely associated with carotid plaque area (r = -0.21, p = 0.018 as well as inflammatory parameters WBCC and CRP (r = -0.29, p = 0.001, and r = -0.23, p = 0.009, respectively, whereas HRV only was inversely associated with WBCC (r = -0.22, p = 0.014. To investigate if inflammation could provide a link between autonomic function and carotid atherosclerosis we adjusted the associations accordingly. After adjusting for WBCC and CRP the inverse association between BRS and carotid plaque area was attenuated and did not remain significant, while both WBCC and CRP remained significantly associated with carotid plaque area, indicating that low-grade inflammation can possibly link BRS to atherosclerosis. Also, after adjusting for age, antihypertensive treatment and cardiovascular risk factors, BRS was independently inversely associated with both WBCC and CRP, and HRV independently inversely associated with WBCC. WBCC was the only inflammatory marker

  10. Autonomic dysfunction in muscular dystrophy: a theoretical framework for muscle reflex involvement.

    Science.gov (United States)

    Smith, Scott A; Downey, Ryan M; Williamson, Jon W; Mizuno, Masaki

    2014-01-01

    Muscular dystrophies are a heterogeneous group of genetically inherited disorders whose most prominent clinical feature is progressive degeneration of skeletal muscle. In several forms of the disease, the function of cardiac muscle is likewise affected. The primary defect in this group of diseases is caused by mutations in myocyte proteins important to cellular structure and/or performance. That being stated, a growing body of evidence suggests that the development of autonomic dysfunction may secondarily contribute to the generation of skeletal and cardio-myopathy in muscular dystrophy. Indeed, abnormalities in the regulation of both sympathetic and parasympathetic nerve activity have been reported in a number of muscular dystrophy variants. However, the mechanisms mediating this autonomic dysfunction remain relatively unknown. An autonomic reflex originating in skeletal muscle, the exercise pressor reflex, is known to contribute significantly to the control of sympathetic and parasympathetic activity when stimulated. Given the skeletal myopathy that develops with muscular dystrophy, it is logical to suggest that the function of this reflex might also be abnormal with the pathogenesis of disease. As such, it may contribute to or exacerbate the autonomic dysfunction that manifests. This possibility along with a basic description of exercise pressor reflex function in health and disease are reviewed. A better understanding of the mechanisms that possibly underlie autonomic dysfunction in muscular dystrophy may not only facilitate further research but could also lead to the identification of new therapeutic targets for the treatment of muscular dystrophy.

  11. Autonomic Dysfunction in Muscular Dystrophy: A Theoretical Framework for Muscle Reflex Involvement

    Directory of Open Access Journals (Sweden)

    Scott Alan Smith

    2014-02-01

    Full Text Available Muscular dystrophies are a heterogeneous group of genetically inherited disorders whose most prominent clinical feature is progressive degeneration of skeletal muscle. In several forms of the disease, the function of cardiac muscle is likewise affected. The primary defect in this group of diseases is caused by mutations in myocyte proteins important to cellular structure and/or performance. That being stated, a growing body of evidence suggests that the development of autonomic dysfunction may secondarily contribute to the generation of skeletal and cardio-myopathy in muscular dystrophy. Indeed, abnormalities in the regulation of both sympathetic and parasympathetic nerve activity have been reported in a number of muscular dystrophy variants. However, the mechanisms mediating this autonomic dysfunction remain relatively unknown. An autonomic reflex originating in skeletal muscle, the exercise pressor reflex, is known to contribute significantly to the control of sympathetic and parasympathetic activity when stimulated. Given the skeletal myopathy that develops with muscular dystrophy, it is logical to suggest that the function of this reflex might also be abnormal with the pathogenesis of disease. As such, it may contribute to or exacerbate the autonomic dysfunction that manifests. This possibility along with a basic description of exercise pressor reflex function in health and disease are reviewed. A better understanding of the mechanisms that possibly underlie autonomic dysfunction in muscular dystrophy may not only facilitate further research but could also lead to the identification of new therapeutic targets for the treatment of muscular dystrophy.

  12. Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Junqueira Junior

    2012-04-01

    Full Text Available INTRODUCTION: Exclusive or associated lesions in various structures of the autonomic nervous system occur in the chronic forms of Chagas disease. In the indeterminate form, the lesions are absent or mild, whereas in the exclusive or combined heart and digestive disease forms, they are often more pronounced. Depending on their severity these lesions can result mainly in cardiac parasympathetic dysfunction but also in sympathetic dysfunction of variable degrees. Despite the key autonomic effect on cardiovascular functioning, the pathophysiological and clinical significance of the cardiac autonomic dysfunction in Chagas disease remains unknown. METHODS: Review of data on the cardiac autonomic dysfunction in Chagas disease and their potential consequences, and considerations supporting the possible relationship between this disturbance and general or cardiovascular clinical and functional adverse outcomes. RESULTS: We hypothesise that possible consequences that cardiac dysautonomia might variably occasion or predispose in Chagas disease include: transient or sustained arrhythmias, sudden cardiac death, adverse overall and cardiovascular prognosis with enhanced morbidity and mortality, an inability of the cardiovascular system to adjust to functional demands and/or respond to internal or external stimuli by adjusting heart rate and other hemodynamic variables, and immunomodulatory and cognitive disturbances. CONCLUSIONS: Impaired cardiac autonomic modulation in Chagas disease might not be a mere epiphenomenon without significance. Indirect evidences point for a likely important role of this alteration as a primary predisposing or triggering cause or mediator favouring the development of subtle or evident secondary cardiovascular functional disturbances and clinical consequences, and influencing adverse outcomes.

  13. Autonomic dysfunction in pediatric patients with headache: migraine versus tension-type headache.

    Science.gov (United States)

    Rabner, Jonathan; Caruso, Alessandra; Zurakowski, David; Lazdowsky, Lori; LeBel, Alyssa

    2016-12-01

    To examine symptoms indicating central nervous system (CNS) autonomic dysfunction in pediatric patients with migraine and tension-type headache. A retrospective chart review assessed six symptoms (i.e. constipation, insomnia, dizziness, blurry vision, abnormal blood pressure, and cold and clammy palms and soles) indicating central nervous system (CNS) autonomic dysfunction in 231 patients, ages 5-18 years, diagnosed with migraine, tension-type headache (TTH), or Idiopathic Scoliosis (IS). Higher frequencies of "insomnia," "dizziness," and "cold and clammy palms and soles" were found for both migraine and TTH patients compared to the IS control group (P pediatric headache patients is discussed.

  14. Autonomic dysfunction in children with sleep disordered breathing.

    Science.gov (United States)

    Walter, Lisa M; Nixon, Gillian M; Davey, Margot J; Anderson, Vicki; Walker, Adrian M; Horne, Rosemary S C

    2013-05-01

    Sleep disordered breathing (SDB) has adverse effects on cardiovascular health in adults, partly due to changes in autonomic activity. However, there have been limited studies in children. We analysed the impact of SDB and sleep stage on autonomic control of heart rate in 7-12-year-old children, utilizing spectral heart rate variability (HRV) as a measure of autonomic activity. Eighty children underwent overnight polysomnography. Subjects were grouped according to their obstructive apnoea-hypopnoea index (OAHI): controls, OAHI ≤1 event/h and no history of snoring; primary snorers (PS) OAHI ≤1, Mild (OAHI 1-5) and moderate/severe (MS) OAHI >5. HRV was analysed during Wake, nonrapid eye movement (NREM) 1&2, slow wave sleep (SWS) and REM. Compared with controls, total power, low (LF) and high frequency (HF) power were reduced in all SDB severities during REM. LF/HF ratio was less in MS SDB (median = 0.34; range, 0.20-0.49; p children with SDB, which may signify an overall depression of autonomic tone, perhaps a consequence of their elevated blood pressure during sleep coupled with repeated exposure to SDB event-related cardiovascular disturbance. Further research is warranted to elucidate the long-term effects on the cardiovascular system of subjects exhibiting impaired HRV and elevated BP in childhood.

  15. Gastrointestinal Autonomic Dysfunction in Patients with Parkinson’s Disease

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    Joong-Seok Kim

    2015-05-01

    Full Text Available Currently, gastrointestinal dysfunctions in Parkinson’s disease (PD are well-recognized problems and are known to be an initial symptom in the pathological process that eventually results in PD. Gastrointestinal symptoms may result from the involvement of either the central or enteric nervous systems, or these symptoms may be side effects of antiparkinsonian medications. Weight loss, excessive salivation, dysphagia, nausea/gastroparesis, constipation, and defecation dysfunction all may occur. Increased identification and early detection of these symptoms can result in a significant improvement in the quality of life for PD patients.

  16. Total autonomic blockage and primary sinus node dysfunction in a ...

    African Journals Online (AJOL)

    history confirmed the episodic headaches but there was no record of a similar incident. A Caesarean section done in 1996 had been uneventful. She apparently had ... dysfunction, the machine did not have a memory store for subsequent study, and moreover we were unable to confirm this diagnosis, as the hospital had no ...

  17. Regulation of cerebral blood flow in patients with autonomic dysfunction and severe postural hypotension

    DEFF Research Database (Denmark)

    Hesse, Birger; Mehlsen, Jesper; Boesen, Finn

    2002-01-01

    Whether cerebral blood flow (CBF) autoregulation is maintained in autonomic dysfunction has been debated for a long time, and the rather sparse data available are equivocal. The relationship between CBF and mean arterial blood pressure (MABP) was therefore tested in eight patients with symptoms...

  18. Cardiovascular autonomic dysfunction in Ehlers-Danlos syndrome-Hypermobile type.

    Science.gov (United States)

    Hakim, Alan; O'Callaghan, Chris; De Wandele, Inge; Stiles, Lauren; Pocinki, Alan; Rowe, Peter

    2017-03-01

    Autonomic dysfunction contributes to health-related impairment of quality of life in the hypermobile type of Ehlers-Danlos syndrome (hEDS). Typical signs and symptoms include tachycardia, hypotension, gastrointestinal dysmotility, and disturbed bladder function and sweating regulation. Cardiovascular autonomic dysfunction may present as Orthostatic Intolerance, Orthostatic Hypotension, Postural Orthostatic Tachycardia Syndrome, or Neurally Mediated Hypotension. The incidence, prevalence, and natural history of these conditions remain unquantified, but observations from specialist clinics suggest they are frequently seen in hEDS. There is growing understanding of how hEDS-related physical and physiological pathology contributes to the development of these conditions. Evaluation of cardiovascular symptoms in hEDS should include a careful history and clinical examination. Tests of cardiovascular function range from clinic room observation to tilt-table assessment to other laboratory investigations such as supine and standing catecholamine levels. Non-pharmacologic treatments include education, managing the environment to reduce exposure to triggers, improving cardiovascular fitness, and maintaining hydration. Although there are limited clinical trials, the response to drug treatments in hEDS is supported by evidence from case and cohort observational data, and short-term physiological studies. Pharmacologic therapy is indicated for patients with moderate-severe impairment of daily function and who have inadequate response or tolerance to conservative treatment. Treatment in hEDS often requires a focus on functional maintenance. Also, the negative impact of cardiovascular symptoms on physical and psycho-social well-being may generate a need for a more general evaluation and on-going management and support. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  19. Autonomic Dysfunction and Risk Factors Associated with Trypanosoma cruzi Infection among Children in Arequipa, Peru

    Science.gov (United States)

    Bowman, Natalie M.; Kawai, Vivian; Gilman, Robert H.; Bocangel, Cesar; Galdos-Cardenas, Gerson; Cabrera, Lilia; Levy, Michael Z.; Cornejo del Carpio, Juan Geny; Delgado, Freddy; Rosenthal, Lauren; Pinedo-Cancino, Vivian V.; Steurer, Francis; Seitz, Amy E.; Maguire, James H.; Bern, Caryn

    2011-01-01

    Chagas disease affects an estimated 8 million people in Latin America. Infected individuals have 20–30% lifetime risk of developing cardiomyopathy, but more subtle changes in autonomic responses may be more frequent. We conducted a matched case-control study of children in Arequipa, Peru, where triatomine infestation and Trypanosoma cruzi infection are emerging problems. We collected data on home environment, history, physical examination, electrocardiogram, and autonomic testing. Signs of triatomine infestation and/or animals sleeping in the child's room and household members with Chagas disease were associated with increased infection risk. Electrocardiogram findings did not differ between cases and controls. However, compared with control children, infected children had blunted autonomic responses by three different measures, the Valsalva maneuver, the cold pressor test, and the orthostatic test. T. cruzi-infected children show autonomic dysfunction, although the prognostic value of this finding is not clear. Sustained vector control programs are essential to decreasing future T. cruzi infections. PMID:21212207

  20. Neuromuscular abnormality and autonomic dysfunction in patients with cerebrotendinous xanthomatosis

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    Huang Chi-Ren

    2011-05-01

    Full Text Available Abstract Background Cerebrotendinous xanthomatosis (CTX is a rare lipid-storage disease. Neuromuscular abnormality and autonomic system (ANS dysfuction in CTX are rarely examined in large-scale studies in the literature. We studied the peripheral nervous system, myopathology, and autonomic system of four CTX patients and performed a literature review of the reported CTX patients with peripheral neuropathy. Methods Four biochemically and genetically confirmed CTX patients, belonging to two families, were included for study and all received nerve conduction study (NCS, muscle biopsy for histopathologic and ultrastructural study, skin biopsy for intraepidermal nerve fiber (INEF density measurement, autonomic testings including sympathetic skin response, R-R interval variation and head-up tilt test using an automated tilt table to record the changes of blood pressure and heart rate in different postures. The Q-Sweat test was also applied for the detection of sweat amount and onset time of response. The clinical characteristics, study methods and results of 13 studies of peripheral neuropathy in CTX patients in the literature were also recorded for analysis. Results The results of NCS study showed axonal sensory-motor polyneuropathy in three CTX cases and mixed axonal and demyelinating sensor-motor polyneuropathy in one. The myopathological and histopathologic studies revealed mild denervation characteristics, but the ultrastructural study revealed changes of mitochondria and the membranous system, and increased amounts of glycogen, lipofuscin and lipid deposition. The ANS study revealed different degrees of abnormalities in the applied tests and the INEF density measurement showed small fiber neuropathy in three of the four CTX patients. The literature review of peripheral neuropathy in CTX revealed different types of peripheral neuropathy, of which axonal peripheral neuropathy was the most common. Conclusions Peripheral neuropathy, especially the

  1. Role of interleukin-6 levels in cardiovascular autonomic dysfunction in type 2 diabetic patients

    International Nuclear Information System (INIS)

    Shinohara, Tetsuji; Takahashi, Naohiko; Kakuma, Tetsuya; Hara, Masahide; Yoshimatsu, Hironobu; Yufu, Kunio; Anan, Futoshi; Nakagawa, Mikiko; Saikawa, Tetsunori

    2008-01-01

    Increased serum interleukin-6 (IL-6) levels are associated with an increased risk of cardiovascular disease, and cardiovascular autonomic dysfunction is associated with high mortality in type 2 diabetic patients. However, the relationship between IL-6 levels and cardiovascular autonomic dysfunction has not been fully elucidated. The aim of this study was to determine whether serum IL-6 levels are associated with cardiovascular autonomic dysfunction in type 2 diabetic patients. Eighty type 2 diabetic patients who did not have organic heart disease were categorized into a high IL-6 group (>2.5 pg/ml, n= 0, age 59±12 years) or a non-high IL-6 group ( 123 I-metaiodobenzylguanidine (MIBG) scintigraphy. The body mass index values (BMI), fasting insulin levels and homeostasis model assessment index values were higher in the high IL-6 group than in the non-high IL-6 group (p 123 I-MIBG myocardial uptake values were lower (p 123 I-MIBG was higher (p 123 I-MIBG during the delayed phase. The results indicate that elevated IL-6 levels are associated with depressed cardiovascular autonomic function and obesity in type 2 diabetic patients. (orig.)

  2. Quantitative sensory and autonomic testing in male diabetic patients with erectile dysfunction.

    Science.gov (United States)

    Wellmer, A; Sharief, M K; Knowles, C H; Misra, V P; Kopelman, P; Ralph, D; Anand, P

    1999-01-01

    To correlate abnormalities of nerve fibres in the lower limbs with erectile dysfunction in male diabetic patients, using a range of quantitative sensory and autonomic function tests. The study included 68 male diabetic patients with symptomatic erectile dysfunction and 11 matched diabetics without erectile dysfunction; none had clinical evidence of peripheral vascular disease or psychological disorder. Patients were evaluated with a symptom questionnaire based on the Michigan Neuropathy Screening Instrument questionnaire and examined clinically. Sural and peroneal nerve-conduction studies, and quantitative sensory and autonomic tests (vibration, thermal, light-touch thresholds, sensory and autonomic cutaneous axon-reflexes) were used to detect nerve abnormalities in the lower limbs, which were correlated with erectile dysfunction. Symptoms of neuropathy were more common in the group with male erectile dysfunction (MED), but statistically significant only for neuropathic pain (53% MED, 18% nonMED, P<0.05, chi-square test) and gastroparesis (44% MED, 0% nonMED, P<0.05). Tests of unmyelinated afferents (warming perception and capsaicin-induced sensory axon-reflex vasodilatation) were most often abnormal, sometimes with no other abnormalities on tests or neurological examination. However, abnormality of warm perception was not significantly different between groups (81% MED, 70% nonMED), suggesting that it is a poorer discriminant than abnormal sensory axon-reflex vasodilatation (89% MED, 22% nonMED, P<0.001). The only other significant test difference was decreased sural nerve action potential (70% MED, 22% non-MED, P<0.01). There appeared to be preferential involvement of unmyelinated sensory fibres that mediate axon-reflex vasodilatation in the limbs of diabetic patients with erectile dysfunction. This test appears to be a helpful indicator of neurological involvement in erectile dysfunction, and may be used to monitor the effect of new treatments.

  3. Clozapine-Induced Cardiovascular Side Effects and Autonomic Dysfunction: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Jessica W. Y. Yuen

    2018-04-01

    Full Text Available Background: Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia and has minimal risk for extrapyramidal symptoms. Therapeutic benefits, however, are accompanied by a myriad of cardiometabolic side-effects. The specific reasons for clozapine's high propensity to cause adverse cardiometabolic events remain unknown, but it is believed that autonomic dysfunction may play a role in many of these.Objective: This systematic review summarizes the literature on autonomic dysfunction and related cardiovascular side effects associated with clozapine treatment.Method: A search of the EMBASE, MEDLINE, and EBM Cochrane databases was conducted using the search terms antipsychotic agents, antipsychotic drug*, antipsychotic*, schizophrenia, schizophren*, psychos*, psychotic*, mental ill*, mental disorder*, neuroleptic*, cardiovascular*, cardiovascular diseases, clozapine*, clozaril*, autonomic*, sympathetic*, catecholamine*, norepinephrine, noradrenaline, epinephrine, adrenaline.Results: The search yielded 37 studies that were reviewed, of which only 16 studies have used interventions to manage cardiovascular side effects. Side effects reported in the studies include myocarditis, orthostatic hypotension and tachycardia. These were attributed to sympathetic hyperactivity, decreased vagal contribution, blockade of cholinergic and adrenergic receptors, reduced heart rate variability and elevated catecholamines with clozapine use. Autonomic neuropathy was identified by monitoring blood pressure and heart rate changes in response to stimuli and by spectral analysis of heart rate variability. Metoprolol, lorazepam, atenolol, propranolol, amlodipine, vasopressin and norepinephrine infusion were used to treat tachycardia and fluctuations in blood pressure, yet results were limited to case reports.Conclusion: The results indicate there is a lack of clinical studies investigating autonomic dysfunction and a limited use of interventions to manage

  4. Pattern of Presentation of Multiple Organ Dysfunction Syndrome in ...

    African Journals Online (AJOL)

    Background: Multiple organ dysfunction syndrome is the sequential failure of several organ systems after a trigger event, like sepsis, massive transfusions, burns, trauma and cardiogenic shock. Aim and Objectives- The pattern of presentation of multiple organ dysfunction and the risk factors associated with multiple organ ...

  5. Overactive bladder and autonomic dysfunction: Lower urinary tract symptoms in females with postural tachycardia syndrome.

    Science.gov (United States)

    Kaufman, Melissa R; Chang-Kit, Laura; Raj, Satish R; Black, Bonnie K; Milam, Douglas F; Reynolds, W Stuart; Biaggioni, Italo; Robertson, David; Dmochowski, Roger R

    2017-03-01

    Postural Tachycardia Syndrome (POTS) represents an autonomic disorder predominantly affecting females between 15 and 50 years of age. POTS is a chronic disorder (>6 months) characterized by an excessive heart rate increment on standing (>30 beats/min) in the presence of characteristic symptoms of cerebral hypoperfusion or sympathetic activation. Patients have clinically been noted to describe lower urinary tract symptoms (LUTS), although urologic symptoms have not been methodically assessed in the POTS population. Herein, we present data from a pilot study designed to identify and quantitate overactive bladder (OAB) in patients diagnosed with POTS. Patients admitted to the Vanderbilt Autonomic Dysfunction Center between June 2009 and October 2010 for evaluation for the potential diagnosis of POTS completed a validated, standardized questionnaire for OAB (OAB-q) at presentation. Symptom score and subscale analyses were conducted. Subscale health related quality of life (HRQL) scores were transformed into a 0-100 scale, with higher scores reflecting superior HRQL. Data are presented as mean ± SD. Thirty-two females presented for evaluation of symptoms consistent with POTS. Twenty-nine women were subsequently diagnosed with POTS with 19 of these patients completing the OAB-q questionnaire (65.5% response rate). Average age was 33.5 ± 8.3 years. Symptom severity transformed score was 26.0 ± 16.4, with 13 of 19 patients (68.4%) meeting clinical criteria for diagnosis of probable clinically significant OAB. Nocturia was the most bothersome symptom, followed by increased daytime frequency and urgency. This pilot study describes bothersome lower urinary tract dysfunction in patients presenting with POTS as assessed by patient-reported questionnaire data. Nocturia demonstrated the greatest negative impact on health-related quality of life (HRQL), while social interaction was the least affected HRQL domain. In patients with dysautonomia, this data provides a

  6. Hereditary angioedema: Assessing the hypothesis for underlying autonomic dysfunction.

    Directory of Open Access Journals (Sweden)

    Maddalena A Wu

    Full Text Available Attacks of Hereditary Angioedema due to C1-inhibitor deficiency (C1-INH-HAEare often triggered by stressful events/hormonal changes.Our study evaluates the relationship between autonomic nervous system (ANS and contact/complement system activation.Twenty-three HAE patients (6 males, mean age 47.5±11.4 years during remission and 24 healthy controls (8 males, mean age 45.3±10.6 years were studied. ECG, beat-by-beat blood pressure, respiratory activity were continuously recorded during rest (10' and 75-degrees-head-up tilt (10'. C1-INH, C4, cleaved high molecular weight kininogen (cHK were assessed; in 16 patients and 11 controls plasma catecholamines were also evaluated. Spectral analysis of heart rate variability allowed extraction of low-(LF and high-(HF frequency components, markers of sympathetic and vagal modulation respectively.HAE patients showed higher mean systolic arterial pressure (SAP than controls during both rest and tilt. Tilt induced a significant increase in SAP and its variability only in controls. Although sympathetic modulation (LFnu increased significantly with tilt in both groups, LF/HF ratio, index of sympathovagal balance, increased significantly only in controls. At rest HAE patients showed higher noradrenaline values (301.4±132.9 pg/ml vs 210.5±89.6pg/ml, p = 0.05. Moreover, in patients tilt was associated with a significant increase in cHK, marker of contact system activation (49.5 ± 7.5% after T vs 47.1 ± 7.8% at R, p = 0.01.Our data are consistent with altered ANS modulation in HAE patients, i.e. increased sympathetic activation at rest and blunted response to orthostatic challenge. Tilt test-induced increased HK cleavage suggests a link between stress and bradykinin production.

  7. Role of exercise training in cardiovascular autonomic dysfunction and mortality in diabetic ovariectomized rats.

    Science.gov (United States)

    Souza, Silvia B C; Flues, Karin; Paulini, Janaina; Mostarda, Cristiano; Rodrigues, Bruno; Souza, Leandro E; Irigoyen, Maria-Cláudia; De Angelis, Kátia

    2007-10-01

    Diabetes and menopause markedly increase the risk of cardiovascular disease in women. The objective of the present study was to investigate the effects of exercise training on cardiovascular autonomic dysfunction and on total mortality in diabetic female rats undergoing ovarian hormone deprivation. Female Wistar rats were divided into ovariectomized groups: sedentary and trained controls and sedentary and trained diabetic rats (streptozotocin, 50 mg/kg IV). Trained groups were submitted to an exercise training protocol on a treadmill (8 weeks). The baroreflex sensitivity was evaluated by heart rate responses to arterial pressure changes. Heart rate variability was determined using the SD of the basal heart rate. Vagal and sympathetic tonus were evaluated by pharmacological blockade. Diabetes impaired baroreflex sensitivity ( approximately 55%), vagal tonus ( approximately 68%), and heart rate variability ( approximately 38%). Exercise training improved baroreflex sensitivity and heart rate variability in control and diabetic groups in relation to their sedentary groups. Trained control rats presented increased vagal tonus compared with that of sedentary ones. The sympathetic tonus was reduced in the trained diabetic group as compared with that of other studied groups. Significant correlations were obtained between heart rate variability and vagal tonus with baroreflex sensitivity. Mortality, assessed during the training period, was reduced in trained diabetic (25%) rats compared with mortality in sedentary diabetic rats (60%). Together, these findings suggest that decreases in baroreflex sensitivity and heart rate variability may be related to increased mortality in female diabetic subjects and that improved autonomic regulation induced by exercise training may contribute to decreased mortality in this population.

  8. Cardiovascular deconditioning: From autonomic nervous system to microvascular dysfunctions.

    Science.gov (United States)

    Coupé, M; Fortrat, J O; Larina, I; Gauquelin-Koch, G; Gharib, C; Custaud, M A

    2009-10-01

    Weightlessness induces an acute syndrome called the cardiovascular deconditioning, associating orthostatic intolerance with syncope, increase in resting heart rate and decrease in physical capability. Orthostatic intolerance occurs after short term and long term head down bed rest and after long term space flight. Both head down bed rest and space flight induce a significant decrease of the spontaneous baroreflex sensitivity. However, spontaneous baroreflex sensitivity only characterizes the cardiac baroreflex loop. To go further with the analysis of cardiovascular deconditioning we were interested in the microcirculation. As the endothelium plays a crucial role in the regulation of vascular homeostasis and local blood flow, we hypothesized that endothelial dysfunction is associated with bed rest induced changes. We investigated endothelial properties before and after 56 days of bed rest in 8 women of control group and in 8 women who regularly performed physical exercise as countermeasure. Our study shows that prolonged bed rest causes impairment of endothelium-dependent functions at the microcirculation level, along with an increase in circulating endothelial cells. Endothelium should be a target for countermeasures during periods of prolonged bed rest or exposure to weightlessness.

  9. Role of interleukin-6 levels in cardiovascular autonomic dysfunction in type 2 diabetic patients

    Energy Technology Data Exchange (ETDEWEB)

    Shinohara, Tetsuji; Takahashi, Naohiko; Kakuma, Tetsuya; Hara, Masahide; Yoshimatsu, Hironobu [Oita University, Department of Internal Medicine 1, Faculty of Medicine, Yuhu, Oita (Japan); Yufu, Kunio; Anan, Futoshi; Nakagawa, Mikiko; Saikawa, Tetsunori [Oita University, Department of Cardiovascular Science, Oita (Japan)

    2008-09-15

    Increased serum interleukin-6 (IL-6) levels are associated with an increased risk of cardiovascular disease, and cardiovascular autonomic dysfunction is associated with high mortality in type 2 diabetic patients. However, the relationship between IL-6 levels and cardiovascular autonomic dysfunction has not been fully elucidated. The aim of this study was to determine whether serum IL-6 levels are associated with cardiovascular autonomic dysfunction in type 2 diabetic patients. Eighty type 2 diabetic patients who did not have organic heart disease were categorized into a high IL-6 group (>2.5 pg/ml, n= 0, age 59{+-}12 years) or a non-high IL-6 group (<2.5 pg/ml, n=40, 61{+-}12 years). Cardiac autonomic function was assessed by baroreflex sensitivity, heart rate variability, plasma norepinephrine concentrations and {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy. The body mass index values (BMI), fasting insulin levels and homeostasis model assessment index values were higher in the high IL-6 group than in the non-high IL-6 group (p<0.01). Early and delayed {sup 123}I-MIBG myocardial uptake values were lower (p<0.01), and the percent washout rate of {sup 123}I-MIBG was higher (p<0.05) in the high IL-6 group than in the non-high IL-6 group. Furthermore, multiple regression analysis revealed that the IL-6 level was independently predicted by the BMI and the myocardial uptake of {sup 123}I-MIBG during the delayed phase. The results indicate that elevated IL-6 levels are associated with depressed cardiovascular autonomic function and obesity in type 2 diabetic patients. (orig.)

  10. Modulation of Cardiac Autonomic Dysfunction in Ischemic Stroke following Ayurveda (Indian System of Medicine Treatment

    Directory of Open Access Journals (Sweden)

    Sriranjini Sitaram Jaideep

    2014-01-01

    Full Text Available Objectives. Cardiac autonomic dysfunction in stroke has implications on morbidity and mortality. Ayurveda (Indian system of medicine describes stroke as pakshaghata. We intended to study the effect of Ayurveda therapies on the cardiac autonomic dysfunction. Methods. Fifty patients of ischemic stroke (middle cerebral artery territory (mean age 39.26 ± 9.88 years; male 43, female 7 were recruited within one month of ictus. All patients received standard allopathic medications as advised by neurologist. In addition, patients were randomized to receive physiotherapy (Group I or Ayurveda treatment (Group II for 14 days. Continuous electrocardiogram and finger arterial pressure were recorded for 15 min before and after treatments and analyzed offline to obtain heart rate and blood pressure variability and baroreflex sensitivity (BRS. Results were analysed by RMANOVA. Results. Patients in Group II showed statistically significant improvement in cardiac autonomic parameters. The standard deviation of normal to normal intervals,and total and low frequency powers were significantly enhanced (F=8.16, P=0.007, F=9.73, P=0.004, F=13.51, and P=0.001, resp.. The BRS too increased following the treatment period (F=10.129, P=0.004. Conclusions. The current study is the first to report a positive modulation of cardiac autonomic activity after adjuvant Ayurveda treatment in ischemic stroke. Further long term studies are warranted.

  11. Risk factors for autonomic and somatic nerve dysfunction in different stages of glucose tolerance.

    Science.gov (United States)

    Dimova, Rumyana; Tankova, Tsvetalina; Guergueltcheva, Velina; Tournev, Ivailo; Chakarova, Nevena; Grozeva, Greta; Dakovska, Lilia

    2017-03-01

    The present study evaluates autonomic and somatic nerve function in different stages of glucose tolerance and its correlation with different cardio-metabolic parameters. Four hundred seventy-eight subjects, mean age 49.3±13.7years and mean BMI 31.0±6.2kg/m2, divided according to glucose tolerance: 130 with normal glucose tolerance (NGT), 227 with prediabetes (125 with impaired fasting glucose (IFG) and 102 with isolated impaired glucose tolerance (iIGT)), and 121 with newly-diagnosed T2D (NDT2D), were enrolled. Glucose tolerance was studied during OGTT. Antropometric indices, blood pressure, HbA1c, serum lipids, hsCRP and albumin-to-creatinine ratio were assessed. Body composition was estimated by a bioimpedance method (InBody 720, BioSpace). Tissue AGEs accumulation was assessed by skin autofluorescence (AGE-Reader-DiagnOpticsTM). Electroneurography was performed by electromyograph Dantec Keypoint. Cardiovascular autonomic neuropathy (CAN) was assessed by ANX-3.0 method applying standard clinical tests. CAN was found in 12.3% of NGT, 19.8% of prediabetes (13.2% of IFG and 20.6% of iIGT), and 32.2% of NDT2D. The prevalence of diabetic sensory polyneuropathy (DSPN) was 5.7% in prediabetes and 28.6% in NDT2D. The panel of age, QTc interval, waist circumference, diastolic blood pressure, and 120-min plasma glucose was related to sympathetic activity (F [5451]=78.50, p<0.001). The panel of age, waist circumference, and QTc interval was related to parasympathetic power (F [3453]=132.26, p<0.001). HbA1c and age were related to sural SNAP (F [2454]=15.12, p<0.001). HbA1c and AGEs were related to sural SNCV (F [2454]=12.18, p<0.001). Our results demonstrate a high prevalence of autonomic and sensory nerve dysfunction in early stages of glucose intolerance. Age, postprandial glycemia, central obesity, diastolic blood pressure and QTc interval outline as predictive markers of CAN; hyperglycemia, glycation and age of DSPN. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Vitamin D in the Spectrum of Prediabetes and Cardiovascular Autonomic Dysfunction.

    Science.gov (United States)

    Dimova, Rumyana; Tankova, Tsvetalina; Chakarova, Nevena

    2017-09-01

    Vitamin D is a fat-soluble secosteroid hormone with pleiotropic effects. 1,25-Dihydroxyvitamin D coordinates the biosynthesis of neurotransmitters in the central nervous system, which regulate cardiovascular autonomic function and may explain its putative role in the development of cardiovascular autonomic neuropathy (CAN). CAN is an independent risk factor for mortality in patients with diabetes and prediabetes and is associated with an increased risk of developing type 2 diabetes and cardiovascular disease. Accumulating data indicate the presence of peripheral nerve injury at these early stages of dysglycemia and its multifactorial pathogenesis. Prediabetes is associated with vitamin D insufficiency. Vitamin D is proposed to prevent the progression of glucose intolerance. The putative underlying mechanisms include maintenance of the intracellular calcium concentration, direct stimulation of insulin receptor expression, and enhancement of the insulin response to glucose transporters. Vitamin D exerts a protective effect on peripheral nerve fibers by decreasing the demyelination process and inducing axonal regeneration. The effects of vitamin D supplementation on glucose tolerance and related autonomic nerve dysfunction have been a recent focus of scientific interest. Although well-designed observational studies are available, the causative relation between vitamin D deficiency, glucose intolerance, and CAN is still debatable. One reason might be that interventional studies are unpersuasive with regard to the beneficial clinical effects of vitamin D supplementation. Because of its favorable side effect profile, vitamin D supplementation might represent an attractive therapeutic option for treating the pandemic prevalence of prediabetes and vitamin D deficiency. Vitamin D supplementation can improve glucose tolerance and cardiovascular autonomic function and can thus reduce cardiovascular mortality among subjects with different stages of glucose intolerance and

  13. Diabetic retinopathy is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients

    International Nuclear Information System (INIS)

    Anan, Futoshi; Takayuki, Masaki; Takahashi, Naohiko; Nakagawa, Mikiko; Eshima, Nobuoki; Saikawa, Tetsunori; Yoshimatsu, Hironobu

    2009-01-01

    Diabetic retinopathy (DR) and cardiovascular autonomic dysfunction are associated with high mortality in type 2 diabetic patients. This preliminary study was therefore designed to test the hypothesis that DR is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients without insulin treatment. Seventy persons were diagnosed to have type 2 diabetes in the examination from June 2004 to May 2006. The study group consisted of 29 type 2 diabetic patients with DR (age: 58±6 years, mean±standard deviation (s.d.)) and 41 type 2 diabetic patients with no DR (NDR) (n=41, 58±5 years). Cardiovascular autonomic function was assessed by baroreflex sensitivity (BRS), heart rate variability, plasma norepinephrine concentration and cardiac 123 I-metaiodobenzylguanidine (MIBG) scintigraphic findings. DR patients had lower BRS, early and delayed 123 I-MIBG myocardial uptake values and higher percent washout rate (WR) of 123 I-MIBG than the NDR patients. With respect to metabolic findings, DR patients had higher fasting plasma insulin concentration (P 123 I-MIBG (P 123 I-MIBG are independently associated with DR in Japanese patients with type 2 diabetes mellitus. (author)

  14. Microglia PACAP and glutamate: Friends or foes in seizure-induced autonomic dysfunction and SUDEP?

    Science.gov (United States)

    Bhandare, Amol M; Kapoor, Komal; Farnham, Melissa M J; Pilowsky, Paul M

    2016-06-01

    Seizure-induced cardiorespiratory autonomic dysfunction is a major cause of sudden unexpected death in epilepsy (SUDEP), and the underlying mechanism is unclear. Seizures lead to increased synthesis, and release of glutamate, pituitary adenylate cyclase activating polypeptide (PACAP), and other neurotransmitters, and cause extensive activation of microglia at multiple regions in the brain including central autonomic cardiorespiratory brainstem nuclei. Glutamate contributes to neurodegeneration, and inflammation in epilepsy. PACAP has neuroprotective, and anti-inflammatory properties, whereas microglia are key players in inflammatory responses in CNS. Seizure-induced increase in PACAP is neuroprotective. PACAP produces neuroprotective effects acting on microglial PAC1 and VPAC1 receptors. Microglia also express glutamate transporters, and their expression can be increased by PACAP in response to harmful or stressful situations such as seizures. Here we discuss the mechanism of autonomic cardiorespiratory dysfunction in seizure, and the role of PACAP, glutamate and microglia in regulating cardiorespiratory brainstem neurons in their physiological state that could provide future therapeutic options for SUDEP. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Orthostatic intolerance and autonomic dysfunction following bariatric surgery: A retrospective study and review of the literature.

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    Ponnusamy, Vanessa; Owens, Andrew P; Purkayastha, Sanjay; Iodice, Valeria; Mathias, Christopher J

    2016-07-01

    The prevalence and costs of the obesity epidemic and obesity-related conditions, including diabetes mellitus, is consistently increasing worldwide. Bariatric medicine is attempting to address this with weight loss and exercise programmes, and with increasing frequency, various forms of bariatric surgery. There has been considerable success reported after bariatric surgery but not without. We describe 14 patients with orthostatic intolerance (OI) post bariatric surgery. We report on OI (postural dizziness, palpitations and fainting), the results of cardiovascular autonomic testing and the associated and/or causative findings as well as reviewing the literature to consider the possible mechanisms. Comprehensive autonomic testing revealed that 35.7% (Buchwald et al., 2004) of these patients fulfilled the criteria for the Postural Tachycardia Syndrome (PoTS), 57.1% (Cremieux et al., 2008) had low levels of basal BP and 42.9% (Cammisotto & Bendayan, 2007) patients were presyncopal and 14.3% (Billakanty et al., 2008) experienced syncope. We propose that the incidence of OI post-bariatric surgery is higher than considered, that certain cohorts may be more susceptible to complications, and that further research is needed to identify the prevalence and, ideally anticipate occurrence. With the increasing prevalence of obesity and required clinical interventions, further understanding of the pathophysiological processes causing autonomic dysfunction after bariatric interventions will aid management, which may differ in those with an underlying disposition to autonomic involvement, such as diabetics, in whom such procedures are increasingly used. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Cardiovascular autonomous dysfunction in diabetics: The influence of disease duration, glycoregulation degree and diabetes type

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    Ninković Vladan

    2008-01-01

    exists regarding the ratio of damage of the sympathetic part of the autonomous nervous system and the value of HbA1c, as well as the ratio of CAN, that is, the total score and HbA1c. Almost two- fold, a bigger coefficient of correlation between the sympathetic score and HbA1c in relation to the coefficient of correlation of the parasympathetic score and HbA1c, points to bigger sensitivity of the sympathetic part of the autonomous nervous system to subacute deterioration of glycoregulation. The correlation between the values of autonomous scores and diabetes type has not been noted. CONCLUSION Our results show that besides disease duration, the subacute deterioration of glycoregulation also leads to the appearance of cardiovascular autonomous dysfunction in diabetes. The sympathetic nervous tissue is functionally more sensitive than the parasympathetic one to metabolic disorders in diabetes. The cardiovascular autonomous dysfunction will occur independently of the type of diabetes.

  17. Cardiac Autonomic Dysfunction in Patients With Infantile Spasm and the Effect of Adrenocorticotropic Hormone Treatment.

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    Gencpinar, Pinar; Kocabas, Abdullah; Duman, Özgür; Dündar, Nihal Olgaç; Haspolat, Senay; Kardelen, Fırat

    2016-02-01

    Infantile spasm is an age-dependent epileptic-encephalopathy syndrome. Cardiac autonomic function is frequently altered in epilepsy. In this study, we examined heart rate variability in patients with infantile spasm before and after treatment. Nineteen patients with infantile spasm and 13 healthy comparisons were enrolled in the study. Cardiac rhythm was recorded with a Holter device for 24 hours before adrenocorticotropic hormone (ACTH) (Synacthen depot) and B6 vitamin administration and 1 month after treatment. Heart rate variability analysis found lower heart rate variability parameters in patients with infantile spasm at the onset of the syndrome, prior to treatment with ACTH. The time domain parameters of heart rate variability values showed a statistically significant increase following ACTH treatment. Our data suggest that patients with infantile spasm exhibit lower heart rate variability parameters, and the treatment of spasms with ACTH and B6 together diminished the autonomic dysfunction in our cohort. © The Author(s) 2015.

  18. [The role of dysfunction of the autonomic nervous system in idiopathic overactive urinary bladder in women].

    Science.gov (United States)

    Borisov, V V; Akarachkova, E S; Shvarkov, S B; Grigorashvili, I I; Romikh, V V

    2012-01-01

    A complex urological and neurological examination of female patients with idiopathic overactive bladder (IOAB) has detected clinical signs and neurophysiological correlates of vegetative dysfunction in the form of disturbed sympatho-parasympathic interrelations, failure of segmental and compensatory enhancement of suprasegmental mechanisms of regulation of lower urinary tract activity. The treatment with selective inhibitors of serotonin re-entry reduced severity ofpsychovegetative syndrome and symptoms of the lower urinary tract. This confirms an essential role of the autonomic nervous system in pathogenetic mechanisms of IOAB development and gives grounds for recommending selective inhibitors of serotonin re-entry for combined treatment of IOAB patients.

  19. A Case of Adrenoleukodystrophy Presenting as Progressive Cerebellar Dysfunction

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    Seunguk Jung

    2009-10-01

    Full Text Available X-linked adrenoleukodystrophy (X-ALD is a hereditary neurological disorder affecting the nervous system and adrenal cortex. The phenotype of X-ALD ranges from the rapidly progressive cerebral form to milder adrenomyeloneuropathy. However, cerebellar manifestations are rare. We report a case of adrenoleukodystrophy presenting as progressive cerebellar dysfunction resembling olivopontocerebellar degeneration, with a review of the literature

  20. Autonomic dysfunction and clinical severity of disease in children with allergic rhinitis.

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    Emin, Ozkaya; Esra, Gursoy; Ufuk, Erenberk; Demiri, Aysegül; Ayhan, Sogut; Rusen, Dundaroz M

    2012-08-01

    The involvement of autonomic imbalance has been reported in the pathogenesis of allergic diseases. To investigate the association between the clinical severity of childhood allergic rhinitis and autonomic nervous system (ANS) dysfunction, to define whether the severity of disease correlates with ANS activity. In this cross-sectional, case-control study, we evaluated the ANS testing by measuring sympathetic skin response (SRR) and heart rate (R-R) interval variation (RRIV) in 55 children with perennial allergic rhinitis (PAR), aged 7-12 yrs without any chronic co-morbidity, and the results were compared with 40 sex- and age-matched control subjects. The patients were divided into two groups according to the severity of allergic rhinitis. There were significant increase in calculated RRIV variables during at rest and deep breathing in children with PAR compared to controls, which reflect parasympathetic nervous system (PNS) activity (p0.05). Lower RRIV and the prolonged SSR latencies in children with AR were closely correlated with disease severity (r=-0.65, p<0.05, and r=-0.59, p<0.05 respectively). Combined use of these two tests, allows separate testing of PNS and SNS function, and are very sensitive methods in assessing of severity of disease in children with PAR. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Autonomic nervous system dysfunction and serum levels of neurotoxic and neurotrophic cytokines in patients with cobalamin deficiency

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    Özcan Çeneli

    2010-12-01

    Full Text Available neurotrophiccytokines epidermal growth factor (EGF and interleukin-6 (IL-6 plays a role in the pathogenesisof cobalamin (Cbl deficiency-induced neuropathy. The aim of this study was to evaluate autonomicnervous system dysfunction and to look for any relationship between autonomic nervous systemdisturbances and serum cytokine levels (TNF-

  2. Pinpointing brainstem mechanisms responsible for autonomic dysfunction in Rett syndrome: therapeutic perspectives for 5-HT1A agonists

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    Ana Paula Abdala

    2014-05-01

    Full Text Available Rett syndrome is a neurological disorder caused by loss of function of methyl-CpG-binding protein 2 (MeCP2. Reduced function of this ubiquitous transcriptional regulator has a devastating effect on the central nervous system. One of the most severe and life-threatening presentations of this syndrome is brainstem dysfunction, which results in autonomic disturbances such as breathing deficits, typified by episodes of breathing cessation intercalated with episodes of hyperventilation or irregular breathing. Defects in numerous neurotransmitter systems have been observed in Rett syndrome both in animal models and patients. Here we dedicate special attention to serotonin due to its role in promoting regular breathing, increasing vagal tone, regulating mood, alleviating Parkinsonian-like symptoms and potential for therapeutic translation. A promising new symptomatic strategy currently focuses on regulation of serotonergic function using highly selective serotonin type 1A (5-HT1A biased agonists. We address this newly emerging therapy for respiratory brainstem dysfunction and challenges for translation with a holistic perspective of Rett syndrome, considering potential mood and motor effects.

  3. Pinpointing brainstem mechanisms responsible for autonomic dysfunction in Rett syndrome: therapeutic perspectives for 5-HT1A agonists

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    Abdala, Ana P.; Bissonnette, John M.; Newman-Tancredi, Adrian

    2014-01-01

    Rett syndrome is a neurological disorder caused by loss of function of methyl-CpG-binding protein 2 (MeCP2). Reduced function of this ubiquitous transcriptional regulator has a devastating effect on the central nervous system. One of the most severe and life-threatening presentations of this syndrome is brainstem dysfunction, which results in autonomic disturbances such as breathing deficits, typified by episodes of breathing cessation intercalated with episodes of hyperventilation or irregular breathing. Defects in numerous neurotransmitter systems have been observed in Rett syndrome both in animal models and patients. Here we dedicate special attention to serotonin due to its role in promoting regular breathing, increasing vagal tone, regulating mood, alleviating Parkinsonian-like symptoms and potential for therapeutic translation. A promising new symptomatic strategy currently focuses on regulation of serotonergic function using highly selective serotonin type 1A (5-HT1A) “biased agonists.” We address this newly emerging therapy for respiratory brainstem dysfunction and challenges for translation with a holistic perspective of Rett syndrome, considering potential mood and motor effects. PMID:24910619

  4. Trained breathing-induced oxygenation acutely reverses cardiovascular autonomic dysfunction in patients with type 2 diabetes and renal disease.

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    Esposito, Pasquale; Mereu, Roberto; De Barbieri, Giacomo; Rampino, Teresa; Di Toro, Alessandro; Groop, Per-Henrik; Dal Canton, Antonio; Bernardi, Luciano

    2016-04-01

    Cardiovascular autonomic dysfunction, evaluated as baroreflex sensitivity (BRS), could be acutely corrected by slow breathing or oxygen administration in patients with type 1 diabetes, thus suggesting a functional component of the disorder. We tested this hypothesis in patients with the type 2 diabetes with or without renal impairment. Twenty-six patients with type 2 diabetes (aged 61.0 ± 0.8 years, mean ± SEM; duration of diabetes 10.5 ± 2 years, BMI 29.9 ± 0.7 kg/m(2), GFR 68.1 ± 5.6 ml/min) and 24 healthy controls (aged 58.5 ± 1.0 years) were studied. BRS was obtained from recordings of RR interval and systolic blood pressure fluctuations during spontaneous and during slow, deep (6 breaths/min) controlled breathing in conditions of normoxia or hyperoxia (5 l/min oxygen). During spontaneous breathing, diabetic patients had lower RR interval and lower BRS compared with the control subjects (7.1 ± 1.2 vs. 12.6 ± 2.0 ms/mmHg, p breathing and oxygen administration significantly increased arterial saturation, reduced RR interval and increased BRS in both groups (to 9.6 ± 1.8 and 15.4 ± 2.4 ms/mmHg, respectively, p breathing and hyperoxia (p breathing during normoxia). Autonomic dysfunction present in patients with type 2 diabetes can be partially reversed by slow breathing, suggesting a functional role of hypoxia, also in patients with DKD. Interventions known to relieve tissue hypoxia and improve autonomic function, like physical activity, may be useful in the prevention and management of complications in patients with diabetes.

  5. Cardiovascular Autonomic Neuropathy, Sexual Dysfunction, and Urinary Incontinence in Women With Type 1 Diabetes

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    Sarma, Aruna V.; Patel, Darshan P.; Braffett, Barbara H.; Cleary, Patricia A.; Feldman, Eva; Herman, William H.; Martin, Catherine L.; Jacobson, Alan M.; Wessells, Hunter; Pop-Busui, Rodica

    2016-01-01

    OBJECTIVE This study evaluated associations among cardiovascular autonomic neuropathy (CAN), female sexual dysfunction (FSD), and urinary incontinence (UI) in women with type I diabetes mellitus (T1DM). RESEARCH DESIGN AND METHODS We studied 580 women with T1DM in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC). CAN was defined as: 1) R-R variation 2) R-R variation of 15–19.9 plus Valsalva ratio ≤1.5 or a supine-to-standing drop of 10 mmHg in diastolic blood pressure. A Sandvik Severity Index of 3–12 defined UI, and a Female Sexual Function Index (FSFI-R) score ≥22.75 defined FSD. Multivariable models estimated associations among CAN, FSD, and UI. RESULTS At EDIC year 17, FSD was observed in 41% of women and UI in 30%. No statistically significant associations were observed between measures of CAN at DCCT closeout and subsequent report of FSD or UI. At EDIC year 16/17, there was a 53% increased odds of having UI with a Valsalva ratio ≤1.5. At both EDIC year 13/14 and EDIC year 16/17, a 5-unit increase in R-R variation was associated with a 1.11 greater odds of having FSD. CONCLUSIONS In women with T1DM in the DCCT/EDIC, we found significant increased odds of FSD and UI with specific measures of CAN. In long-standing T1DM, CAN may predict development of FSD and may be a useful surrogate for generalized diabetic autonomic neuropathy. PMID:27352953

  6. Cardiovascular Autonomic Neuropathy, Sexual Dysfunction, and Urinary Incontinence in Women With Type 1 Diabetes.

    Science.gov (United States)

    Hotaling, James M; Sarma, Aruna V; Patel, Darshan P; Braffett, Barbara H; Cleary, Patricia A; Feldman, Eva; Herman, William H; Martin, Catherine L; Jacobson, Alan M; Wessells, Hunter; Pop-Busui, Rodica

    2016-09-01

    This study evaluated associations among cardiovascular autonomic neuropathy (CAN), female sexual dysfunction (FSD), and urinary incontinence (UI) in women with type I diabetes mellitus (T1DM). We studied 580 women with T1DM in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC). CAN was defined as: 1) R-R variation 2) R-R variation of 15-19.9 plus Valsalva ratio ≤1.5 or a supine-to-standing drop of 10 mmHg in diastolic blood pressure. A Sandvik Severity Index of 3-12 defined UI, and a Female Sexual Function Index (FSFI-R) score ≥22.75 defined FSD. Multivariable models estimated associations among CAN, FSD, and UI. At EDIC year 17, FSD was observed in 41% of women and UI in 30%. No statistically significant associations were observed between measures of CAN at DCCT closeout and subsequent report of FSD or UI. At EDIC year 16/17, there was a 53% increased odds of having UI with a Valsalva ratio ≤1.5. At both EDIC year 13/14 and EDIC year 16/17, a 5-unit increase in R-R variation was associated with a 1.11 greater odds of having FSD. In women with T1DM in the DCCT/EDIC, we found significant increased odds of FSD and UI with specific measures of CAN. In long-standing T1DM, CAN may predict development of FSD and may be a useful surrogate for generalized diabetic autonomic neuropathy. © 2016 by the American Diabetes Association.

  7. Juvenile fibromyalgia syndrome: Blunted heart rate response and cardiac autonomic dysfunction at diagnosis.

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    Maia, Magda M; Gualano, Bruno; Sá-Pinto, Ana L; Sallum, Adriana M E; Pereira, Rosa M R; Len, Claudio A; Terreri, Maria T A; Barbosa, Cassia M; Roschel, Hamilton; Silva, Clovis A

    2016-12-01

    To assess aerobic capacity and cardiac autonomic modulation in juvenile fibromyalgia syndrome (JFM) patients at diagnosis in response to graded exercise text. A multicenter cross-sectional study included 25 JFM patients and 25 healthy controls. Both groups participated only in physical education classes at school. A treadmill graded cardiorespiratory test was performed and the heart-rate (HR) response during exercise was evaluated by the chronotropic reserve (CR). Pain, functional ability, and health-related quality of life (HRQL) were assessed. The median current age was similar in JFM and controls (15 vs. 15 years, p = 0.890), as well as body mass index (p = 0.332), female gender (p = 1.000), and Tanner stages (p = 0.822). The medians of HRQL parameters (total score/physical health/psychosocial health) were significantly lower in JFM vs. controls according to patient and parent self-reports (p < 0.001). The median of peak HR [181 (150-198) vs. 197 (181-202)bpm, p < 0.001], chronotropic reserve [84 (53-98) vs. 99 (84-103)%, p < 0.001], and resting to peak [96 (65-181) vs. 127 (61-185)bpm, p = 0.010] were significantly lower in JFM compared to controls. The median of ΔHRR1 [15 (3-39) vs. 35 (9-52)bpm, p < 0.001], ΔHRR2 [37 (20-57) vs. 51 (32-94)bpm, p < 0.001], peak VO 2 [32.34 (24.24-39.65) vs. 36.4 (28.56-52.71)ml/kg/min, p = 0.005], peak speed [5 (4-6.3) vs. 5.9 (4.0-6.3)mph, p = 0.001], time to exhaustion [11.5 (8.5-14.5) vs. 14 (11-18)min, p < 0.001], and working capacity on power [3.37 (2.04-5.6) vs. 3.89 (2.91-6.55)W/kg, p = 0.006] were significantly lower in JFM compared to controls. The frequency of chronotropic incompetence (≤80%) was significantly higher in JFM vs. controls (p = 0.0006). This study identified chronotropic incompetence and delayed HR recovery in JFM patients, indicating autonomic dysfunction. Aerobic exercise training should be considered in all JFM patients and may improve cardiac autonomic impairment, thus reducing cardiovascular

  8. Exercise training reverse autonomic dysfunction and hypertension in rats fed with high-fat diet

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    Carla Cristina de Sordi

    2017-12-01

    Full Text Available Abstract AIMS We evaluated whether exercise training ameliorates cardiovascular autonomic dysfunction in obesity-induced by high-fat diet (HFD in rats. METHODS Wistar male rats were assigned in normal diet, sedentary (ND-S and trained (ND-T and HFD, sedentary (HFD-S and trained (HFD-T. Blood pressure (BP, heart rate (HR, HR variability (HRV, BP variability (BPV, cardiac baroreflex and cardiac autonomic tonus were assessed. RESULTS HFD-S showed higher bodyweight increase (19.4% compared to all other groups (HFD-T: 13.2%, ND-S: 14% and ND-T: 12.4%. Relative epididymal, retroperitoneal and visceral fat was also greater in HFD-S compared to all other groups. Resting bradycardia in ND-T (339.5±10.6 bpm and HFD-T (341.0 ± 9.4 bpm was more pronounced than ND-S (438.4 ± 6.3 bpm; p<0.05 and HFD-S (448.5 ± 18.7 bpm; p<0.05. The HFD-T group showed lower systolic (125.3 ( 1.9 mmHg, diastolic (88.5 ( 2.0 mmHg and mean BP (100.3 ± 2.5 mmHg in comparison with HFD-S (153.8 ( 3.7; 103.5 ( 2.6 and 120.5 ± 3.7 mmHg; p<0.05, respectively. Lower variance of HRV and higher variance of diastolic BPV was observed in HFD-S compared to other groups while sympathetic modulation of HRV and BPV was higher in HFD-S, as well as the LF/HF ratio. HFD-T showed a decrease in sympathetic tonus compared to HFD-S. ND-T and HFD-T showed higher cardiac vagal tonus than respective sedentary groups. Analysis showed an association between visceral fat, sympathetic activity and BP. CONCLUSIONS HFD induces hypertension and is associated with autonomic imbalance in rats, while exercise training may reverse these harmful changes.

  9. The impact of autonomic dysfunction on survival in patients with dementia with Lewy bodies and Parkinson's disease with dementia.

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    Kajsa Stubendorff

    Full Text Available INTRODUCTION: Autonomic dysfunction is a well-known feature in neurodegenerative dementias, especially common in α-synucleinopathies like dementia with Lewy bodies and Parkinson's disease with dementia. The most common symptoms are orthostatic hypotension, incontinence and constipation, but its relevance in clinical practice is poorly understood. There are no earlier studies addressing the influence of autonomic dysfunction on clinical course and survival. The aim of this study was to investigate the frequency of the three most common features of autonomic dysfunction and analyze how it affects survival. METHODS: Thirty patients with dementia with Lewy bodies and Parkinson's disease with dementia were included in this prospective, longitudinal follow-up study. Presence of incontinence and constipation was recorded at baseline. Blood pressure was measured at baseline, after 3 months and after 6 months according to standardized procedures, with 5 measurements during 10 minutes after rising. Orthostatic hypotension was defined using consensus definitions and persistent orthostatic hypotension was defined as 5 or more measurements with orthostatic hypotension. Difference in survival was analyzed 36 months after baseline. RESULTS: There was a high frequency of persistent orthostatic blood pressure (50%, constipation (30% and incontinence (30%. Patients with persistent orthostatic hypotension had a significantly shorter survival compared to those with no or non-persistent orthostatic hypotension (Log rank x(2 = 4.47, p = 0.034. Patients with constipation and/or urinary incontinence, in addition to persistent orthostatic hypotension, had a poorer prognosis compared to those with isolated persistent orthostatic hypotension or no orthostatic hypotension (Log rank x(2 = 6.370, p = 0.041. DISCUSSION: According to our findings, the identification of autonomic dysfunction seems to be of great importance in clinical practice, not only to

  10. [A case of hereditary sensory and autonomic neuropathy type 1E with frontal lobe dysfunction as an initial symptom].

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    Watanabe, Masashi; Matsumoto, Yushi; Okamoto, Kensho; Okuda, Bungo; Mizuta, Ikuko; Mizuno, Toshiki

    2017-12-27

    A 49-year-old man had developed gradually personality change, gait disturbance, and hearing loss for five years. On admission, he presented with frontal release signs, stuttering, vertical gaze palsy, sensorineural deafness, muscle rigidity, ataxia, and sensory disturbance with areflexia in the lower extremities. Brain MRI demonstrated atrophy in the cerebellum and midbrain tegmentum as well as cerebral atrophy, predominantly in the frontal lobe. He was tentatively diagnosed as progressive supranuclear palsy on the basis of clinical features and imagings. On nerve conduction study, no sensory nerve action potentials were elicited in the upper and lower extremities. Details of family history revealed a hereditary sensory neuropathy with autosomal dominant inheritance in his relatives. Because genetic analysis showed a rare missense mutation (c.1483T>C, p.Y495H) in DNA methyltransferase 1 gene, we diagnosed him as having hereditary sensory and autonomic neuropathy type 1E (HSAN1E). In addition, p.M232R mutation in prion protein gene was detected. It should be kept in mind that there are some patients with HSAN1E presenting with frontal lobe dysfunction as an initial symptom and with clinical features mimicking progressive supranuclear palsy.

  11. Paediatric breath-holding spells are associated with autonomic dysfunction and iron deficiency may play a role.

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    Tomoum, H; Habeeb, N; Elagouza, I; Mobarez, H

    2018-04-01

    This study assessed cardiac performance and iron in subjects aged 12-36 months with breath-holding spells (BHSs). We consecutively recruited 40 subjects (55% male) experiencing BHSs from the general paediatric outpatients department at the Children's Hospital, Ain Shams University, Egypt, from 2015 to 2016. The 20 matched comparisons were mainly healthy siblings. The workup included iron levels and electrocardiograms. The age at the onset of BHSs was 5-24 months with a median monthly frequency of 13. Almost two-thirds of the patients had cyanotic spells, and one-third had pallid spells, lasting 25-90 seconds. Lower serum iron levels and higher QT dispersion and T-wave dispersion were recorded in patients than the comparison group, and 4.8% had dysrhythmia and bradycardia. We observed higher durations of bradycardia during attacks and higher occurrences of dysrhythmia during cyanotic spells, which were more frequent in patients with prolonged or frequent BHSs. Our study of patients aged 12-13 months supported the theory of autonomic dysfunction in BHSs. The ECG findings, especially in patients with prolonged or frequent spells, need to be studied further to evaluate the risk of life-threatening events. Iron deficiency may play a role in autonomic dysfunction in patients with BHSs. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  12. Sexual dysfunction among Ghanaian men presenting with various medical conditions

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    Quaye Lawrence

    2010-10-01

    Full Text Available Abstract Background Several medical conditions can affect and disrupt human sexuality. The alteration of sexuality in these medical conditions often hinder effective communication and empathy between the patients and their sexual partners because of cultural attitudes, social norms and negative feelings such as anxiety and guilt. Validated and standardized sexual inventories might therefore help resolve this problem. The objective of this cross-sectional study was to obtain data on the prevalence of male sexual dysfunction (SD among Ghanaians with various medical conditions residing in Kumasi. Methods The Golombok Rust Inventory of Sexual Satisfaction (GRISS was administered to 150 Ghanaian men with various medical conditions between 19 and 66 years old (mean ± standard deviation: 40.01 ± 12.32 years domiciled in the Kumasi metropolis. Results Out of the total 150 questionnaires administered, 105 (70.0% men returned the questionnaires. Questionnaires from 3 men were incomplete, leaving 102 complete and evaluable questionnaires, indicating a 68.0% response rate. Of the remaining 102 men, 88.2% were married, 70.6% had attained higher education, 88.2% were non-smokers. Whereas 54.9% were engaged in exercise, 61.8% indulged in alcoholic beverages. The prevalence of the various medical conditions include: diabetes (18%, hypertension (24.5%, migraine (11.8%, ulcer (7.8%, surgery (6.9%, STD (3.9 and others (26.5%. The prevalence of SD among the respondents in the study was 59.8%. The highest prevalence of SD was seen among ulcer patients (100%, followed by patients who have undergone surgery (75%, diabetes (70%, hypertension (50%, STD (50% and the lowest was seen among migraine patients (41.7%. Conclusions SD rate is high among Ghanaian men with medical conditions (about 60% and vary according to the condition and age.

  13. Diagnosis of coronary microvascular dysfunctionPresent status

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    S.R. Mittal

    2015-11-01

    Full Text Available Definite clinical diagnosis of microvascular angina is not possible with the existing knowledge. Resting electrocardiogram may be normal, and exercise electrocardiogram may be unremarkable. Echocardiography usually does not show regional wall motion abnormalities. Transthoracic Doppler echocardiography can satisfactorily evaluate only left anterior descending coronary artery and that too in some patients. Radio-isotope imaging can detect only severe localized disease. Noninvasive diagnosis needs high index of suspicion. At present, definite diagnosis is based on documentation of normal epicardial coronaries, coronary flow reserve less than 2.5 on adenosine induced hyperemia, and absence of spasm of epicardial coronaries on acetylcholine provocation. Invasive evaluation is costly, needs sophisticated equipments and expertise. Therapeutic and prognostic implications of various parameters remains to be evaluated. At present invasive evaluation is recommended only for patients with intractable symptoms with unconfirmed diagnosis, requiring repeated hospitalization and evaluation with failure of empirical therapy.

  14. Sellar plasmacytoma presenting with symptoms of anterior pituitary dysfunction

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    Ana G Ferreira

    2017-11-01

    Full Text Available Sellar plasmacytomas are rare and the differential diagnosis with non-functioning pituitary adenomas might be difficult because of clinical and radiological resemblance. They usually present with neurological signs and intact anterior pituitary function. Some may already have or eventually progress to multiple myeloma. We describe a case associated with extensive anterior pituitary involvement, which is a rare form of presentation. A 68-year-old man was referred to our Endocrinology outpatient clinic due to gynecomastia, reduced libido and sexual impotence. Physical examination, breast ultrasound and mammography confirmed bilateral gynecomastia. Blood tests revealed slight hyperprolactinemia, low testosterone levels, low cortisol levels and central hypothyroidism. Sellar MRI showed a heterogeneous sellar mass (56 × 60 × 61 mm, initially suspected as an invasive macroadenoma. After correcting the pituitary deficits with hydrocortisone and levothyroxine, the patient underwent transsphenoidal surgery. Histological examination revealed a plasmacytoma and multiple myeloma was ruled out. The patient was unsuccessfully treated with radiation therapy (no tumor shrinkage. Myeloma ultimately developed, with several other similar lesions in different locations. The patient was started on chemotherapy, had a bone marrow transplant and is now stable (progression free on lenalidomide and dexamethasone. The presenting symptoms and panhypopituitarism persisted, requiring chronic replacement treatment with levothyroxine, hydrocortisone and testosterone.

  15. The autonomic dysfunction in patients with lupus disease: An electrophysiological study.

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    Haghighat, Shila; Fatemi, Alimohammad; Andalib, Somayeh

    2016-01-01

    The aim of this study was to investigate autonomic nervous system (ANS) function by using electrophysiological tests in patients with systemic lupus erythematosus (SLE). This descriptive analytical study was done on 28 individuals with a history of lupus and ten age- and sex-matched healthy objects were being selected randomly. The autonomy questionnaire has been used to determine clinical symptom of ANS involvement. The electrophysiological assessments of ANS function were performed by sympathetic skin response (SSR). The mean values of sympathetic (SSR latency and amplitude) parameters were compared to determine any correlations between SSR parameters and clinical characteristics of ANS. 28 SLE patients (3 males, 25 females) with a mean age of 34.6 ± 9.74 years and 10 control subjects (4 males, 6 females) with a mean age of 36.8 ± 6.43 years were included in the study. Among patients 17 (60.7%) exhibited autonomic symptoms. Headache was the most common issue with the highest percentage rate (41.17%). The mean latency and amplitude of SSR were increased (1.52 ± 0.16 vs. 1.39 ± 0.16 and 107 ± 15.6 vs. 110 ± 15.6, respectively), compared to control. A significant difference was observed between the SSR test results of patients with lupus compared to normal healthy objects (P autonomy questionnaire scores and SSR (P system assessment.

  16. Exercise training improves hypertension-induced autonomic dysfunction without influencing properties of peripheral cardiac vagus nerve.

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    Neto, Octávio Barbosa; de Sordi, Carla Cristina; da Mota, Gustavo Ribeiro; Marocolo, Moacir; Chriguer, Rosângela Soares; da Silva, Valdo José Dias

    2017-12-01

    We examined the vagal transfer function of autonomic heart rate (HR) control in anesthetized sedentary and exercise-trained Spontaneously Hypertensive Rats (SHR). To this end, male SHR and Wystar-Kyoto (WKY) rats with 48-50weeks of age-old were divided into 4 groups: sedentary (SHR S , n=12) and trained (SHR T , n=14) hypertensive rats, sedentary (WKY S , n=13) and trained (WKY T , n=13) normotensive rats. The trained groups were submitted to swimming protocol for 9weeks. Blood pressure (BP), HR, HR variability (HRV), BP variability (BPV), baroreflex sensitivity and cardiac tonus were recorded in baseline conditions. Following, electric stimulation of peripheral vagus nerve was performed in anesthetized conditions. Resting bradycardia was observed in SHR T and WKY T when compared to their respective sedentary groups (pbaroreflex-mediated tachycardia values when compared to their respective sedentary counterparts (pBaroreflex bradycardic response in SHR T was higher than in SHR S (ptraining decreased BP in SHR and improved cardiovascular autonomic balance to the heart without changes in transduction properties of peripheral cardiac vagus nerve. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. [Idiopathic autonomic neuropathy (pandysautonomia)].

    Science.gov (United States)

    Jankowicz, E; Drozdowski, W; Pogumirski, J

    2001-01-01

    On the basis of current literature, clinical and neuropathologic features of idiopathic autonomic neuropathy is presented. Idiopathic autonomic neuropathy is a disease characterized by acute or subacute onset, monophasic course over a period of several years, it is often preceded by an infection. The spectrum of autonomic changes ranges from cholinergic or adrenergic dysfunction to pandysautonomia, leading to heterogeneity of its clinical features. Possible sympathetic system abnormalities found in autonomic neuropathy are: poor pupillary response to light in darkness, orthostatic hypotension leading to syncope, hypotension without compensatory tachycardia, ejaculation disturbances and vasomotor instability. Possible parasympathetic dysfunctions are: salivation and lacrimation disturbances, absent pupillary constriction to light and near gaze, gastrointestinal tract immobility and impairment of gastrointestinal function, atonic bladder with large residual volume, erectile impotence. Pandysautonomia is thought to result from an immune mediated mechanism and responds well to plasmaferesis and intravenous immunoglobin therapy leading to gradual, sometimes not full, recovery. Moreover in this article we pay attention to the clinical value of many tests like cardiovascular or pharmacological studies in the diagnosis of pandysautonomia and in differentiation of pre- and postganglionic changes. In order to diagnose idiopathic autonomic neuropathy one has to rule out a large number of diseases with autonomic dysfunction e.g.: diabetes, malignant neoplasms, acute intermittent porphyria, Shy-Drager syndrome, Riley-Day's dysautonomia, Parkinson's disease, amyloidosis and others.

  18. Cardiovascular autonomic dysfunction and carotid stiffness in adults with repaired tetralogy of Fallot.

    Science.gov (United States)

    Novaković, Marko; Prokšelj, Katja; Starc, Vito; Jug, Borut

    2017-06-01

    Adults after surgical repair of tetralogy of Fallot (ToF) may have impaired vascular and cardiac autonomic function. Thus, we wanted to assess interrelations between heart rate variability (HRV) and heart rate recovery (HRR), as parameters of cardiac autonomic function, and arterial stiffness, as a parameter of vascular function, in adults with repaired ToF as compared to healthy controls. In a case-control study of adults with repaired ToF and healthy age-matched controls we measured: 5-min HRV variability (with time and frequency domain data collected), carotid artery stiffness (through pulse-wave analysis using echo-tracking ultrasound) and post-exercise HRR (cycle ergometer exercise testing). Twenty-five patients with repaired ToF (mean age 38 ± 10 years) and 10 healthy controls (mean age 39 ± 8 years) were included. Selected HRR and HRV (time-domain) parameters, but not arterial stiffness were significantly reduced in adults after ToF repair. Moreover, a strong association between late/slow HRR (after 2, 3 and 4 min) and carotid artery stiffness was detected in ToF patients (r = -0.404, p = 0.045; r = -0.545, p = 0.005 and r = -0.545, p = 0.005, respectively), with statistical significance retained even after adjusting for age, gender, resting heart rate and β-blockers use (r = -0.393, p = 0.024 for HRR after 3 min). Autonomic cardiac function is impaired in patients with repaired ToF, and independently associated with vascular function in adults after ToF repair, but not in age-matched healthy controls. These results might help in introducing new predictors of cardiovascular morbidity in a growing population of adults after surgical repair of ToF.

  19. Utility of Time and Frequency Domain Parameters of Heart Rate Variability in the Context of Autonomic Disorders Characterized by Orthostatic Dysfunction.

    Science.gov (United States)

    Baker, Jacquie; Racosta, Juan M; Balint, Brittany; Kimpinski, Kurt

    2018-03-01

    The clinical significance of heart rate variability in the context of autonomic dysfunction continues to be a matter of debate. A consensus is lacking on the best heart rate variability measures for clinical purposes. Therefore, the purpose of this study was to investigate the utility of heart rate variability parameters in healthy versus autonomic dysfunction. Healthy young (n = 134), healthy older (n = 32), and patients with mild (postural tachycardia syndrome; n = 25) and severe (neurogenic orthostatic hypotension; n = 34) autonomic dysfunction were included. Time and frequency parameters during baseline, head-up tilt (HUT), and heart rate response to deep breathing (HRDB) were compared. Cardiovagal time parameters were significantly reduced during HUT in healthy young and postural tachycardia syndrome (P heart rate (HR) (61.4 ± 9.0 bpm vs. 76.8 ± 13.6 bpm; P Heart rate changes corroborated these findings. Resting HR was significantly lower in healthy older (62.6 ± 11.0 bpm vs. 70.7 ± 12.4 bpm), and [INCREMENT]HR during HRDB was significantly higher (15.9 ± 9.2 bpm vs. 3.9 ± 4.2 bpm; P heart rate variability have a greater utility than frequency parameters in clinical autonomic disorders.

  20. Effects of exercise training on autonomic dysfunction management in an experimental model of menopause and myocardial infarction.

    Science.gov (United States)

    Flores, Lucinar J; Figueroa, Diego; Sanches, Iris C; Jorge, Luciana; Irigoyen, Maria-Cláudia; Rodrigues, Bruno; De Angelis, Kátia

    2010-07-01

    The aim of this study was to investigate the effects of exercise training on cardiovascular autonomic dysfunction in ovariectomized rats submitted to myocardial infarction. Female Wistar rats were divided into the following ovariectomized groups: sedentary ovariectomized (SO), trained ovariectomized (TO), sedentary ovariectomized infarcted (SOI), and trained ovariectomized infarcted (TOI). Trained groups were submitted to an exercise training protocol on a treadmill (8 wk). Arterial baroreflex sensitivity was evaluated by heart rate responses to arterial pressure changes, and cardiopulmonary baroreflex sensitivity was tested by bradycardic and hypotension responses to serotonin injection. Vagal and sympathetic effects were calculated by pharmacological blockade. Arterial pressure was reduced in the TO in comparison with the SO group and increased in the TOI in relation to the SOI group. Exercise training improved the baroreflex sensitivity in both the TO and TOI groups. The TOI group displayed improvement in cardiopulmonary reflex sensitivity compared with the SOI group at the 16 microg/kg serotonin dose. Exercise training enhanced the vagal effect in both the TO (45%) and TOI (46%) animals compared with the SO and SOI animals and reduced the sympathetic effect in the TOI (38%) in comparison with the SOI animals. Significant correlations were obtained between bradycardic baroreflex responses and vagal (r = -0.7, P training in ovariectomized rats submitted to myocardial infarction improves resting hemodynamic status and reflex control of the circulation, which may be due to an increase in the vagal component. This suggests a homeostatic role for exercise training in reducing the autonomic impairment of myocardial infarction in postmenopausal women.

  1. Asymptomatic ST-depression during exercise testing in children and adolescents with type 1 diabetes mellitus and autonomic dysfunction

    Directory of Open Access Journals (Sweden)

    Dmitry Nikitich Laptev

    2015-04-01

    Full Text Available Aim. The aim of this study was to investigate cardiac autonomic function as assessed by ST dynamics during and post-exercise in children and adolescents with type 1 diabetes mellitus (T1DM.Materials and methods. The study included 71 young patients with T1DM. The patients were aged 9–18 years and had no history of macrovascular disease or renal disease, including microalbuminuria. Cardiac autonomic function was assessed using cardiovascular tests and 24-h ECG monitoring with automatic calculation of QT interval and heart rate variability parameters. Each patient underwent the physical working capacity 170 test.Results. The prevalence of cardiovascular autonomic neuropathy (CAN was 30.9%. The frequency of asymptomatic ST-segment depression increased during exercise in 10 (45.5% patients with CAN (CAN+ compared with 9 (18.4% patients without CAN (CAN-; p=0.042. During the recovery period, asymptomatic ST-segment depression was present in the first minute in 8 (36.4% CAN+ patients compared with 1 (2% CAN- patient (p=0.0003 and in the second minute in 5 (22.7% CAN+ patients compared with 1 (2% CAN- patient (p=0.0095.Conclusion. Children and adolescents with T1DM and impaired autonomic function have increased prevalence of asymptomatic ST-segment depression during and post-exercise. The presence of cardiovascular risk factors in children and adolescents with T1DM and CAN may contribute to the increased cardiovascular morbidity and mortality during adulthood in patients with T1DM.

  2. Autonomic Dysfunction Predicts Early Cardiac Affection in Patients with Systemic Sclerosis

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    Khaled M. Othman

    2010-01-01

    Full Text Available Objective To detect the early preclinical alterations in cardiac autonomic control as well as altered cardiac function in systemic sclerosis (SSc patients and their relevance to the clinical features of the disease using noninvasive methods. Methods 30 SSc patients and 15 healthy controls matched for age and sex underwent clinical examination, serological analysis, and echocardiographic assessment including Doppler flow imaging to evaluate cardiac function, and 24-hour Holter monitoring analyzed for arrhythmia and heart rate variability (HRV in the time and frequency domains. Results The trans-mitral Doppler of early to atrial wave (E/A ratio was reversed in five patients (16.6% and the tricuspid E/A ratio was reversed in 10 patients (33.3%. Holter analysis for SSc patients revealed an increased prevalence of premature ventricular contractions (PVC ≥ 10/h ( P = 0.02, supra-ventricular tachycardias (SVTs ( P = 0.2, and total PVC count ( P = 0.0000. Highly significant ( P = 0.000 impairment in all HRV parameters was demonstrated in the SSc patients. Total skin thickness score (TSS, Raynaud's phenomenon and anti-scleroderma 70 (anti-SCL70 showed significant positive correlations with all arrhythmia parameters, while showing a significant negative correlation with the impaired ventricular diastolic function and various HRV parameters. No correlation was found between arrhythmia and HRV parameters and disease duration, disease type, or presence of anti-centromere antibodies. Conclusion Low heart rate variability, increased TSS and the presence of anti-SCL70 are correlated with preclinical cardiac involvement in SSc patients and may predict the likelihood of malignant arrhythmia and sudden cardiac death. Therefore, noninvasive HRV evaluation before clinical cardiac involvement in these patients might be beneficial when added to the clinical and laboratory assessments in detecting high-risk patients, and may allow for implementation of preventive

  3. How is chronic pain related to sympathetic dysfunction and autonomic dysreflexia following spinal cord injury?

    Science.gov (United States)

    Walters, Edgar T

    2018-01-01

    Autonomic dysreflexia (AD) and neuropathic pain occur after severe injury to higher levels of the spinal cord. Mechanisms underlying these problems have rarely been integrated in proposed models of spinal cord injury (SCI). Several parallels suggest significant overlap of these mechanisms, although the relationships between sympathetic function (dysregulated in AD) and nociceptive function (dysregulated in neuropathic pain) are complex. One general mechanism likely to be shared is central sensitization - enhanced responsiveness and synaptic reorganization of spinal circuits that mediate sympathetic reflexes or that process and relay pain-related information to the brain. Another is enhanced sensory input to spinal circuits caused by extensive alterations in primary sensory neurons. Both AD and SCI-induced neuropathic pain are associated with spinal sprouting of peptidergic nociceptors that might increase synaptic input to the circuits involved in AD and SCI pain. In addition, numerous nociceptors become hyperexcitable, hypersensitive to chemicals associated with injury and inflammation, and spontaneously active, greatly amplifying sensory input to sensitized spinal circuits. As discussed with the aid of a preliminary functional model, these effects are likely to have mutually reinforcing relationships with each other, and with consequences of SCI-induced interruption of descending excitatory and inhibitory influences on spinal circuits, with SCI-induced inflammation in the spinal cord and in DRGs, and with activity in sympathetic fibers within DRGs that promotes local inflammation and spontaneous activity in sensory neurons. This model suggests that interventions selectively targeting hyperactivity in C-nociceptors might be useful for treating chronic pain and AD after high SCI. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. The somatic and autonomic innervation of the clitoris; preliminary evidence of sexual dysfunction after minimally invasive slings.

    Science.gov (United States)

    Bekker, Milou D; Hogewoning, Cornelis R C; Wallner, Chris; Elzevier, Henk W; DeRuiter, Marco C

    2012-06-01

    Vaginal sling procedures may have a negative effect on sexual function due to damage to vascular and/or neural genital structures. Even though autonomic innervation of the clitoris plays an important role in female sexual function, most studies on the neuroanatomy of the clitoris focus on the sensory function of the dorsal nerve of the clitoris (DNC). The autonomic and somatic pathways in relationship to sling surgery have up to the present not been described in detail. The aim of this study is to reinvestigate and describe the neuroanatomy of the clitoris, both somatic and autonomic, in relation to vaginal sling procedures for stress urinary incontinence. Serially sectioned and histochemically stained pelves from 11 female fetuses (10-27 weeks of gestation) were studied, and three-dimensional reconstructions of the neuroanatomy of the clitoris were prepared. Fourteen adult female hemipelves were dissected, after a tension-free vaginal tape (TVT) (7) or tension-free vaginal tape-obturator (TVT-O) (7) procedure had been performed. Three-dimensional (3-D) reconstruction and measured distance between the clitoral nerve systems and TVT/TVT-O. The DNC originates from the pudendal nerve in the Alcock's canal and ascends to the clitoral bodies. In the dissected adult pelves, the distance of the TVT-O to the DNC had a mean of 9 mm. The cavernous nerves originate from the vaginal nervous plexus and travel the 5 and 7 o'clock positions along the urethra. There, the autonomic nerves were found to be pierced by the TVT needle. At the hilum of the clitoral bodies, the branches of the cavernous nerves medially pass/cross the DNC and travel further alongside it. Just before hooking over the glans of the clitoris, they merge with DNC. The DNC is located inferior of the pubic ramus and was not disturbed during the placement of the TVT-O. However, the autonomic innervation of the vaginal wall was disrupted by the TVT procedure, which could lead to altered lubrication

  5. The first report of CADASIL in Peru: Olfactory dysfunction on initial presentation

    Directory of Open Access Journals (Sweden)

    Anastasia Vishnevetsky

    2016-12-01

    Full Text Available Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL is a rare, heritable, small vessel vascular disease caused by mutations in the Notch3 gene that is characterized by migraines, subcortical vascular events, cognitive decline, and mood disturbances. However, many CADASIL cases present with unusual symptoms such as status epilepticus, a movement disorder, or sensory dysfunction. This study describes the clinical, genetic, and radiologic characteristics of a Peruvian family with CADASIL in which multiple family members presented with severe olfactory deficits. Seven members of the family have symptoms suggestive of CADASIL, with genetic testing revealing R133C mutations in the two patients who underwent genetic testing. Cognitive testing and olfactory identification testing (Smell Identification Test were performed in three CADASIL patients revealing total anosmia in two tested patients and severe hyposmia in the other. Olfactory dysfunction has been associated with various neurologic and psychiatric conditions, though few studies have linked it with neurovascular disorders such as CADASIL. This first reported case of CADASIL in Peru emphasizes that symptomatic olfactory dysfunction may be an unusual presentation of CADASIL and that olfactory dysfunction is important to evaluate in CADASIL patients.

  6. Altered Behavioral and Autonomic Pain Responses in Alzheimer’s Disease Are Associated with Dysfunctional Affective, Self-Reflective and Salience Network Resting-State Connectivity

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    Paul A. Beach

    2017-09-01

    Full Text Available While pain behaviors are increased in Alzheimer’s disease (AD patients compared to healthy seniors (HS across multiple disease stages, autonomic responses are reduced with advancing AD. To better understand the neural mechanisms underlying these phenomena, we undertook a controlled cross-sectional study examining behavioral (Pain Assessment in Advanced Dementia, PAINAD scores and autonomic (heart rate, HR pain responses in 24 HS and 20 AD subjects using acute pressure stimuli. Resting-state fMRI was utilized to investigate how group connectivity differences were related to altered pain responses. Pain behaviors (slope of PAINAD score change and mean PAINAD score were increased in patients vs. controls. Autonomic measures (HR change intercept and mean HR change were reduced in severe vs. mildly affected AD patients. Group functional connectivity differences associated with greater pain behavior reactivity in patients included: connectivity within a temporal limbic network (TLN and between the TLN and ventromedial prefrontal cortex (vmPFC; between default mode network (DMN subcomponents; between the DMN and ventral salience network (vSN. Reduced HR responses within the AD group were associated with connectivity changes within the DMN and vSN—specifically the precuneus and vmPFC. Discriminant classification indicated HR-related connectivity within the vSN to the vmPFC best distinguished AD severity. Thus, altered behavioral and autonomic pain responses in AD reflects dysfunction of networks and structures subserving affective, self-reflective, salience and autonomic regulation.

  7. Autonomic Nervous System Disorders

    Science.gov (United States)

    Your autonomic nervous system is the part of your nervous system that controls involuntary actions, such as the beating of your heart ... breathing and swallowing Erectile dysfunction in men Autonomic nervous system disorders can occur alone or as the result ...

  8. Neurogenic bladder dysfunction presenting as urinary retention in neuronopathic Gaucher disease.

    Science.gov (United States)

    McNamara, Erin R; Sullivan, Jennifer; Nagaraj, Shashi K; Wiener, John S; Kishnani, Priya S

    2015-01-01

    Neuronopathic Gaucher disease can present as a continuum of clinical findings, including somatic symptoms of anemia, thrombocytopenia, hepatosplenomegaly, and bone disease as well as neurologic sequelae. There is a spectrum of neurologic symptoms ranging from oculomotor apraxia to severe convulsions. The heterozygosity of phenotypes makes it difficult to predict the disease course. We describe an 8-year-old male with neuronopathic type III Gaucher disease who developed bladder dysfunction and was unable to completely void. He also presented with hypertension and acute renal insufficiency, most likely secondary to urinary retention. A complete evaluation was done for causes of urinary retention and bladder dysfunction. A renal bladder ultrasound demonstrated marked hydroureteronephrosis. There was no clinical evidence of infection and cystoscopy revealed no anatomic obstruction. In addition, MRI showed no spinal abnormalities. His bladder dysfunction was managed operatively by creating a catheterizable stoma, using his appendix, to empty his bladder, and surgical findings were consistent with neurogenic bladder. He continues to be managed for his Gaucher disease and neurogenic bladder by genetics, nephrology and urology. This is the first clinical report of neurogenic bladder dysfunction in neuronopathic Gaucher disease.

  9. Neurogenic Bladder Dysfunction Presenting as Urinary Retention in Neuronopathic Gaucher Disease

    OpenAIRE

    McNamara, Erin R.; Sullivan, Jennifer; Nagaraj, Shashi K.; Wiener, John S.; Kishnani, Priya S.

    2014-01-01

    Neuronopathic Gaucher disease can present as a continuum of clinical findings, including somatic symptoms of anemia, thrombocytopenia, hepatosplenomegaly, and bone disease as well as neurologic sequelae. There is a spectrum of neurologic symptoms ranging from oculomotor apraxia to severe convulsions. The heterozygosity of phenotypes makes it difficult to predict the disease course. We describe an 8-year-old male with neuronopathic type III Gaucher disease who developed bladder dysfunction and...

  10. Physicians' response to sexual dysfunction presented by a younger vs. An older adult.

    Science.gov (United States)

    Gewirtz-Meydan, Ateret; Ayalon, Liat

    2017-12-01

    The aim of this study is to determine whether physicians have an age bias regarding sexual dysfunction presented by older vs. younger patients in terms of attributed diagnosis, etiology, proposed treatment and perceived prognosis. An on-line survey consisting of one of two, randomly administered, case vignettes, which differed only by the age of the patient (28 or 78). In both cases, the patient was described as suffering from occasional erectile dysfunction with a clear psychosocial indication. A total of 236 physicians responded to the survey. Overall, 110 physicians received an "old" vignette and 126 physicians received a "young" vignette. Even though both cases presented with a clear psychosocial etiology, the "older" vignette was more likely to be diagnosed with erectile dysfunction whereas the "younger" vignette was more likely to be diagnosed with performance anxiety. The "older" vignette's dysfunction was more likely to be attributed to hormonal changes, health problems and decreased sexual desire. Physicians were more likely to recommend testosterone replacement therapy (TRT) and PDE5 inhibitors (PDE5i; such as Sildenafil; Vardenafil; Tadalafil) as well as a referral to urology to the "older" vignette. In contrast, the "younger" vignette was more often referred to a sexologist and received a more positive prognosis than the older patient. This study demonstrates an age bias among physicians regarding sexuality in later life. Of particular note is the tendency to prescribe PDE5i to the older patient, despite the clear psychosocial indication presented in the case vignette. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  11. Dysautonomia (Autonomic Dysfunction)

    Science.gov (United States)

    ... See More About Research The NINDS supports and conducts research on dysautonomia. This research aims to discover ways to diagnose, treat, and, ultimately, prevent these disorders. ... Publications Definition Dysautonomia ...

  12. B-vitamin Supplementation Mitigates Effects of Fine Particles on Cardiac Autonomic Dysfunction and Inflammation: A Pilot Human Intervention Trial

    Science.gov (United States)

    Zhong, Jia; Trevisi, Letizia; Urch, Bruce; Lin, Xinyi; Speck, Mary; Coull, Brent A.; Liss, Gary; Thompson, Aaron; Wu, Shaowei; Wilson, Ander; Koutrakis, Petros; Silverman, Frances; Gold, Diane R.; Baccarelli, Andrea A.

    2017-04-01

    Ambient fine particle (PM2.5) pollution triggers acute cardiovascular events. Individual-level preventions are proposed to complement regulation in reducing the global burden of PM2.5-induced cardiovascular diseases. We determine whether B vitamin supplementation mitigates PM2.5 effects on cardiac autonomic dysfunction and inflammation in a single-blind placebo-controlled crossover pilot trial. Ten healthy adults received two-hour controlled-exposure-experiment to sham under placebo, PM2.5 (250 μg/m3) under placebo, and PM2.5 (250 μg/m3) under B-vitamin supplementation (2.5 mg/d folic acid, 50 mg/d vitamin B6, and 1 mg/d vitamin B12), respectively. At pre-, post-, 24 h-post-exposure, we measured resting heart rate (HR) and heart rate variability (HRV) with electrocardiogram, and white blood cell (WBC) counts with hematology analyzer. Compared to sham, PM2.5 exposure increased HR (3.8 bpm, 95% CI: 0.3, 7.4; P = 0.04), total WBC count (11.5%, 95% CI: 0.3%, 24.0%; P = 0.04), lymphocyte count (12.9%, 95% CI: 4.4%, 22.1%; P = 0.005), and reduced low-frequency power (57.5%, 95% CI: 2.5%, 81.5%; P = 0.04). B-vitamin supplementation attenuated PM2.5 effect on HR by 150% (P = 0.003), low-frequency power by 90% (P = 0.01), total WBC count by 139% (P = 0.006), and lymphocyte count by 106% (P = 0.02). In healthy adults, two-hour PM2.5 exposure substantially increases HR, reduces HRV, and increases WBC. These effects are reduced by B vitamin supplementation.

  13. Autonomic dysfunction in mild cognitive impairment: evidence from power spectral analysis of heart rate variability in a cross-sectional case-control study.

    Directory of Open Access Journals (Sweden)

    Paola Nicolini

    Full Text Available Mild cognitive impairment (MCI is set to become a major health problem with the exponential ageing of the world's population. The association between MCI and autonomic dysfunction, supported by indirect evidence and rich with clinical implications in terms of progression to dementia and increased risk of mortality and falls, has never been specifically demonstrated.To conduct a comprehensive assessment of autonomic function in subjects with MCI by means of power spectral analysis (PSA of heart rate variability (HRV at rest and during provocative manoeuvres.This cross-sectional study involved 80 older outpatients (aged ≥ 65 consecutively referred to a geriatric unit and diagnosed with MCI or normal cognition (controls based on neuropsychological testing. PSA was performed on 5-minute electrocardiographic recordings under three conditions--supine rest with free breathing (baseline, supine rest with paced breathing at 12 breaths/minute (parasympathetic stimulation, and active standing (orthosympathetic stimulation--with particular focus on the changes from baseline to stimulation of indices of sympathovagal balance: normalized low frequency (LFn and high frequency (HFn powers and the LF/HF ratio. Blood pressure (BP was measured at baseline and during standing. Given its exploratory nature in a clinical population the study included subjects on medications with a potential to affect HRV.There were no significant differences in HRV indices between the two groups at baseline. MCI subjects exhibited smaller physiological changes in all three HRV indices during active standing, consistently with a dysfunction of the orthosympathetic system. Systolic BP after 10 minutes of standing was lower in MCI subjects, suggesting dysautonomia-related orthostatic BP dysregulation.Our study is novel in providing evidence of autonomic dysfunction in MCI. This is associated with orthostatic BP dysregulation and the ongoing follow-up of the study population will

  14. Autonomic dysfunction independently predicts poor cardiovascular outcomes in asymptomatic individuals with type 2 diabetes in the DIAD study

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    Deborah A Chyun

    2015-02-01

    Full Text Available Objective: The primary aim of this secondary analysis was to determine whether cardiac autonomic neuropathy independently predicted adverse cardiac outcomes in asymptomatic individuals with type 2 diabetes. Additional aims include the determination of the correlation of standard autonomic testing measures and power spectral analysis of heart rate variability, and the association of diabetes-related and cardiac risk factors with cardiac autonomic neuropathy measures. Methods: Cardiac autonomic neuropathy was assessed at the study entry into the Detection of Ischemia in Asymptomatic Diabetics study, using autonomic heart rate and blood pressure testing, and power spectral analysis of heart rate variability. All participants were prospectively followed for the composite clinical outcome of cardiac death, acute coronary syndromes, heart failure, or coronary revascularization. Results: Over 5 years of follow-up, 94 of 1119 (8.4% subjects developed symptomatic cardiac disease. In unadjusted bivariate analyses, abnormalities in several cardiac autonomic neuropathy tests, including lower Valsalva and Standing Heart Rate Ratios, higher resting Heart Rate, greater systolic blood pressure decrease on standing, and lower low-frequency power, were predictive of symptomatic disease. Independent predictors of poor cardiac outcome were a lower Valsalva Heart Rate Ratio, non-Black ethnicity, longer diabetes duration, higher glycated hemoglobin (HbA1c, insulin use, reported numbness in the extremities, higher pulse pressure, family history of coronary artery disease, and higher waist-to-hip ratio. Clinical factors independently associated with a lower Valsalva Heart Rate Ratio were insulin use, clinical proteinuria, higher pulse pressure, use of angiotensin-converting enzyme inhibitor and non-Black ethnicity. Conclusion: Cardiac autonomic neuropathy predicted adverse cardiac outcomes in asymptomatic type 2 diabetes without known cardiac disease. Clinical

  15. Scintigraphic differentiation between two forms of primary dysautonomia early after onset of autonomic dysfunction: value of cardiac and pulmonary iodine-123 MIBG uptake

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    Reinhardt, M.J.; Juengling, F.D.; Krause, T.M. [Dept. of Nuclear Medicine, Freiburg University Hospital (Germany); Braune, S. [Dept. of Neurology, Freiburg University Hospital (Germany)

    2000-05-01

    Primary dysfunction of the autonomic nervous system can be observed in patients with Parkinson's disease and those with multiple system atrophy. However, the fate of the two diseases differs considerably and leads to different strategies for patient management. Differentiation of the two diseases currently requires a combination of several clinical and electrophysiological tests. First studies of myocardial innervation using iodine-123 metaiodobenzylguanidine (MIBG) indicated a possible role of scintigraphy for this purpose. An increase in the pulmonary uptake of {sup 123}I-MIBG has been reported in secondary dysautonomias. Whether sympathetic innervation of the lung is affected in primary dysautonomias is currently unknown. Therefore, cardiac and pulmonary uptake of {sup 123}I-MIBG was studied in 21 patients with Parkinson's disease, 7 patients with multiple system atrophy and 13 age- and sex-matched controls. Thoracic images were obtained in the anterior view 4 h after intravenous injection of 185 MBq {sup 123}I-MIBG, at which time the maximum neuronal uptake is reached. All patients with Parkinson's disease had significantly lower cardiac uptake of {sup 123}I-MIBG than patients with multiple system atrophy and controls. Sympathetic innervation of the lung was not affected in either disease. It is concluded that scintigraphy with {sup 123}I-MIBG appears to be a useful tool for differentiation between Parkinson's disease and multiple system atrophy early after onset of autonomic dysfunction. (orig.)

  16. Autonomic dysfunction and new-onset atrial fibrillation in patients with left ventricular systolic dysfunction after acute myocardial infarction: a CARISMA substudy

    DEFF Research Database (Denmark)

    Jøns, Christian; Raatikainen, Pekka; Gang, Uffe J

    2010-01-01

    Atrial fibrillation (AF) increases morbidity and mortality in patients with previous myocardial infarction and left ventricular systolic dysfunction. The purpose of this study was to identify patients with a high risk for new-onset AF in this population using invasive and noninvasive...

  17. Evaluation of sexual dysfunction in female patients presenting with faecal incontinence or defecation disorder.

    Science.gov (United States)

    Pellino, Gianluca; Ramage, Lisa; Simillis, Constantinos; Warren, Oliver; Kontovounisios, Christos; Tan, Emile; Tekkis, Paris

    2017-05-01

    Female patients with pelvic floor diseases may suffer from several sexual disorders and sexual life impairments. The aim of this manuscript was to evaluate sexual dysfunction in female patients presenting with faecal incontinence (FI) and defecation disorder (DD). A retrospective review was performed of a prospectively collected database of sexually active women referred to the pelvic floor clinic, who completed the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-12 (PISQ-12) at first visit. Statistical analysis was performed to evaluate and compare sexual dysfunction between patients with FI and DD and with published data on the general population. Regression analysis was used to identify predictors of sexual dysfunction and surgery. Three hundred thirteen patients were included, 192 (61%) with FI and 121 (39%) with DD. The patients with DD received more non-gynaecological surgical procedures (p = 0.023). More patients with DD received surgery for their current pelvic floor disease (p < 0.001). Major sexual impairment (PISQ-12 < 30) was found in 100 patients (31.9%). The mean PISQ-12 (33.2 ± 7.2) score was by 5 points lower than those reported in the general population from PISQ-validating studies. Prior anorectal surgery (odds ratio (OR) = 15.4), partner ejaculation problems (PISQ item 11, OR = 2.5), reduced sexual arousal (item 2, OR = 2.1), and orgasm perception (item 13, OR = 2.1) were the strongest predictors of worse sexual function in patients with FI. Patients with DD were almost 15 times more likely to receive subsequent surgery (OR = 14.6, p < 0.001), whereas fear of urine leakage almost doubled the risk. Sexual dysfunction is prevalent among patients suffering from FI and DD, and questionnaires are useful in recognizing these patients. Subsequent surgery is more common for patients with DD compared to those with FI.

  18. The somatosensory link in fibromyalgia: functional connectivity of the primary somatosensory cortex is altered by sustained pain and is associated with clinical/autonomic dysfunction.

    Science.gov (United States)

    Kim, Jieun; Loggia, Marco L; Cahalan, Christine M; Harris, Richard E; Beissner, Florian; Garcia, Ronald G; Kim, Hyungjun; Wasan, Ajay D; Edwards, Robert R; Napadow, Vitaly

    2015-05-01

    Fibromyalgia (FM) is a chronic functional pain syndrome characterized by widespread pain, significant pain catastrophizing, sympathovagal dysfunction, and amplified temporal summation for evoked pain. While several studies have demonstrated altered resting brain connectivity in FM, studies have not specifically probed the somatosensory system and its role in both somatic and nonsomatic FM symptoms. Our objective was to evaluate resting primary somatosensory cortex (S1) connectivity and to explore how sustained, evoked deep tissue pain modulates this connectivity. We acquired functional magnetic resonance imaging and electrocardiography data on FM patients and healthy controls during rest (the rest phase) and during sustained mechanical pressure-induced pain over the lower leg (the pain phase). Functional connectivity associated with different S1 subregions was calculated, while S1(leg) connectivity (representation of the leg in the primary somatosensory cortex) was contrasted between the rest phase and the pain phase and was correlated with clinically relevant measures in FM. During the rest phase, FM patients showed decreased connectivity between multiple ipsilateral and cross-hemispheric S1 subregions, which was correlated with clinical pain severity. Compared to the rest phase, the pain phase produced increased S1(leg) connectivity to the bilateral anterior insula in FM patients, but not in healthy controls. Moreover, in FM patients, sustained pain-altered S1(leg) connectivity to the anterior insula was correlated with clinical/behavioral pain measures and autonomic responses. Our study demonstrates that both somatic and nonsomatic dysfunction in FM, including clinical pain, pain catastrophizing, autonomic dysfunction, and amplified temporal summation, are closely linked with the degree to which evoked deep tissue pain alters S1 connectivity to salience/affective pain-processing regions. Additionally, diminished connectivity between S1 subregions during the rest

  19. The somatosensory link: S1 functional connectivity is altered by sustained pain and associated with clinical/autonomic dysfunction in fibromyalgia

    Science.gov (United States)

    Kim, Jieun; Loggia, Marco L.; Cahalan, Christine M.; Harris, Richard E.; Beissner, Florian; Garcia, Ronald G.; Kim, Hyungjun; Wasan, Ajay D.

    2015-01-01

    Objective Fibromyalgia (FM) is a chronic functional pain syndrome characterized by widespread pain, significant pain catastrophizing, sympathovagal dysfunction, and amplified temporal summation for evoked pain. While several studies have found altered resting brain connectivity in FM, studies have not specifically probed the somatosensory system, and its role in both somatic and non-somatic FM symptomatology. Our objective was to evaluate resting primary somatosensory cortex (S1) connectivity, and explore how sustained, evoked deep-tissue pain modulates this connectivity. Methods We acquired fMRI and electrocardiography data from FM patients and healthy controls (HC) during rest (REST) and sustained mechanical pressure pain (PAIN) over the lower leg. Functional connectivity associated with different S1 subregions was calculated, while S1leg (leg representation) connectivity was contrast between REST and PAIN, and correlated with clinically-relevant measures in FM. Results At REST, FM showed decreased connectivity between multiple ipsilateral and cross-hemispheric S1 subregions, which was correlated with clinical pain severity. PAIN, compared to REST, produced increased S1legconnectivity to bilateral anterior insula in FM, but not in HC. Moreover, in FM, sustained pain-altered S1legconnectivity to anterior insula was correlated with clinical/behavioral pain measures and autonomic responses. Conclusion Our study demonstrates that both somatic and non-somatic dysfunction in FM, including clinical pain, pain catastrophizing, autonomic dysfunction, and amplified temporal summation, are all closely linked with the degree to which evoked deep-tissue pain alters S1 connectivity to salience/affective pain processing regions. Additionally, diminished connectivity between S1 subregions at REST in FM may result from ongoing widespread clinical pain. PMID:25622796

  20. Autonomic Impairment in Borderline Personality Disorder: A Laboratory Investigation

    Science.gov (United States)

    Weinberg, Anna; Klonsky, E. David; Hajcak, Greg

    2009-01-01

    Recent research suggests that emotional dysfunction in psychiatric disorders can be reflected in autonomic abnormalities. The present study examines sympathetic and parasympathetic autonomic nervous system activity in individuals with Borderline Personality Disorder (BPD) before, during, and following a social stressor task. Data were obtained…

  1. Aerobic training normalizes autonomic dysfunction, HMGB1 content, microglia activation and inflammation in hypothalamic paraventricular nucleus of SHR.

    Science.gov (United States)

    Masson, Gustavo Santos; Nair, Anand R; Silva Soares, Pedro Paulo; Michelini, Lisete Compagno; Francis, Joseph

    2015-10-01

    Exercise training (ExT) is recommended to treat hypertension along with pharmaceutical antihypertensive therapies. Effects of ExT in hypothalamic content of high mobility box 1 (HMGB1) and microglial activation remain unknown. We examined whether ExT would decrease autonomic and cardiovascular abnormalities in spontaneously hypertensive rats (SHR), and whether these effects were associated with decreased HMGB1 content, microglial activation, and inflammation in the hypothalamic paraventricular nucleus (PVN). Normotensive Wistar-Kyoto (WKY) rats and SHR underwent moderate-intensity ExT for 2 wk. After ExT, cardiovascular (heart rate and arterial pressure) and autonomic parameters (arterial pressure and heart rate variability, peripheral sympathetic activity, cardiac vagal activity, and baroreflex function) were measured in conscious and freely-moving rats through chronic arterial and venous catheterization. Cerebrospinal fluid, plasma, and brain were collected for molecular and immunohistochemistry analyses of the PVN. In addition to reduced heart rate variability, decreased vagal cardiac activity and increased mean arterial pressure, heart rate, arterial pressure variability, cardiac, and vasomotor sympathetic activity, SHR had higher HMGB1 protein expression, IκB-α phosphorylation, TNF-α and IL-6 protein expression, and microglia activation in the PVN. These changes were accompanied by higher plasma and cerebrospinal fluid levels of HMGB1. The ExT + SHR group had decreased expression of HMGB1, CXCR4, SDF-1, and phosphorylation of p42/44 and IκB-α. ExT reduced microglial activation and proinflammatory cytokines content in the PVN, and improved autonomic control as well. Data suggest that training-induced downregulation of activated HMGB1/CXCR4/microglia/proinflammatory cytokines axis in the PVN of SHR is a prompt neural adaptation to counterbalance the deleterious effects of inflammation on autonomic control. Copyright © 2015 the American Physiological

  2. An unusual presentation of autonomic dysreflexia in a patient with cold abscess of cervical spine for anterolateral decompression

    Directory of Open Access Journals (Sweden)

    Susmita Sarangi

    2016-01-01

    Full Text Available A young female having complaints of quadriparesis along with bladder and bowel involvement, diagnosed to have osseous destruction of C 4 , C 6 , C 7 , T 2 vertebral bodies with pre- and para-vertebral abscess, was taken up for anterolateral decompression and fusion of cervical spine. She presented with anxiety, agitation, sweating and headache and was in hypertensive crisis which was refractory to antihypertensives, anxiolytics and analgesics but showed a reasonable response to intravenous dexmedetomidine and finally responded dramatically to rectal evacuation. Autonomic dysreflexia was suspected with stimulus arising from distended rectum as all other causes of hypertension were ruled out.

  3. Chronic prostatitis presenting with dysfunctional voiding and effects of pelvic floor biofeedback treatment.

    Science.gov (United States)

    He, Wei; Chen, Minfeng; Zu, Xiongbing; Li, Yuan; Ning, Keping; Qi, Lin

    2010-04-01

    To investigate the features of chronic prostatitis presenting with dysfunctional voiding (DV) and the effects of pelvic floor biofeedback (PFB). The study included 21 patients, diagnosed by having symptoms for > or =3 months, including urinary frequency and urgency, voiding difficulty, upper abdominal or perineal discomfort, and with a score of > or =1 on the first and second part of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). Patients with bacterial prostatitis, urethritis, interstitial cystitis, urethral stricture and neurogenic bladder were excluded. All patients had a urodynamic examination, to assess the uroflow curve, maximum urinary flow rate (Q(max)), maximum detrusor pressure during the storage phase (P(det.max)), maximum urethral pressure (MUP) and the maximum urethral closure pressure (MUCP) were recorded. PFB was carried out in patients with non-neurogenic detrusor sphincter dyssynergia, and the effects evaluated after 10 weeks. Before and after PFB treatment the mean (sd) Q(max), P(det.max), MUP, MUCP were 8.2 (4.1) vs 15.1 (7.3) mL/s, 125.1 (75.3) vs 86.3 (54.2) cmH(2)O, 124.3 (23.3) vs 65.4 (23.0) cmH(2)O and 101.5 (43.6) vs 43.5 (16.7) cmH(2)O, all significantly different (P PFB had satisfactory short-term effects on these patients.

  4. Vocal cord dysfunction in athletes: clinical presentation and review of the literature.

    Science.gov (United States)

    Al-Alwan, Ali; Kaminsky, David

    2012-05-01

    Vocal cord dysfunction (VCD) is a syndrome characterized by the intermittent, abnormal paradoxical adduction of the true vocal cords during respiration resulting in variable upper airway obstruction. It is also commonly referred to as paradoxical vocal fold motion disorder. Patients with VCD usually present with intermittent shortness of breath of varying intensity, wheezing, stridor, choking, throat tightness, voice changes, or cough, and these symptoms often resolve quickly after relaxation or cessation of activity. Since first described as a distinct clinical entity in 1983, VCD remains underrecognized and the underlying cause(s) is not fully understood. Several studies suggest psychogenic or laryngeal hyperresponsiveness as possible underlying causes. Although VCD may have many causes, it can be a unique problem, especially in athletes because it often mimics and can be easily mistaken for exercise-induced bronchospasm, which may result in unnecessary medical treatment and delay in diagnosis. A detailed history, physical examination, and pulmonary function tests with flow-volume loops are important for excluding other diagnoses; however, the gold standard method for diagnosing VCD is by observation of the vocal cords with flexible laryngoscopy. The mainstay of treatment includes behavioral management guided by a speech-language pathologist, but optimal therapy often requires a multidisciplinary team involving a variety of specialties, including certified athletic training, pulmonology, otolaryngology, speech-language pathology, gastroenterology, allergy and immunology, and psychology, as appropriate. We reviewed the medical literature for VCD specifically in athletes, and this article discusses in detail the definition, epidemiology, possible pathophysiology, diagnosis, and treatment options.

  5. Peripheral sympathetic dysfunction in patients with Parkinson's disease without autonomic failure is heart selective and disease specific

    International Nuclear Information System (INIS)

    Taki, Junichi; Nakajima, Kenichi; Hwang, Eui-Hyo; Matsunari, Ichiro; Tonami, Norihisa; Komai, Kiyonobu; Yoshita, Mitsuhiro; Sakajiri, Kenichi

    2000-01-01

    The study was undertaken to investigate by means of iodine-123-labelled metaiodobenzylguanidine (MIBG) scintigraphy the peripheral sympathetic function in patients with Parkinson's disease (PD) without autonomic failure and in patients with related neurodegenerative diseases with parkinsonism. Seventy patients (33 men and 37 women, mean age 63±9.7 years) with parkinsonism and ten control subjects underwent MIBG scintigraphy. Of these 70 patients, 41 were diagnosed as having idiopathic PD, 9 multiple system atrophy (MSA), 6 progressive supranuclear palsy (PSP) and 2 corticobasal degeneration (CBD); the remaining 12 were diagnosed as having neurodegenerative disease with parkinsonism (P-nism) that did not meet the diagnostic criteria of any specific disease. Cardiac planar and tomographic imaging studies and subsequent whole-body imaging were performed 20 min and 3 h after the injection of 111 MBq MIBG. The early MIBG heart to mediastinum (H/M) ratio in PD (1.61±0.29) was significantly lower than that in the control group (2.24±0.14, P<0.01), P-nism (2.15±0.31, P<0.01), MSA (2.08±0.31, P<0.05) and PSP (2.30±0.24, P<0.01). The delayed H/M ratio in PD (1.47±0.34) was also significantly lower than that in the control group (2.37±0.14, P<0.01), P-nism (2.13±0.38, P<0.01), PSP (2.36±0.36, P<0.01) and MSA (2.17±0.36, P<0.01). In patients with PD, early and delayed H/M ratios were significantly decreased in disease stages I, II and III (established using the Hoehn and Yahr criteria) as compared with control subjects, and there were no significant differences among the stages. Only PD showed a significantly higher washout rate (WR) than that in the control subjects (27%±8.0% vs 11%±4.2%, P<0.01). Early and delayed uptake ratios of the lung, parotid gland, thyroid gland, liver and femoral muscles in each of the patient groups were not significantly different from those in control subjects. Only the early and delayed uptake ratios of the lower leg muscles in MSA

  6. Interference with peroxisome proliferator-activated receptor-γ in vascular smooth muscle causes baroreflex impairment and autonomic dysfunction.

    Science.gov (United States)

    Borges, Giulianna R; Morgan, Donald A; Ketsawatsomkron, Pimonrat; Mickle, Aaron D; Thompson, Anthony P; Cassell, Martin D; Mohapatra, Durga P; Rahmouni, Kamal; Sigmund, Curt D

    2014-09-01

    S-P467L mice expressing dominant negative peroxisome proliferator-activated receptor-γ selectively in vascular smooth muscle exhibit impaired vasodilation, augmented vasoconstriction, hypertension, and tachycardia. We hypothesized that tachycardia in S-P467L mice is a result of baroreflex dysfunction. S-P467L mice displayed increased sympathetic traffic to the heart and decreased baroreflex gain and effectiveness. Carotid arteries exhibited inward remodeling but no changes in distensibility or stress/strain. Aortic depressor nerve activity in response to increased arterial pressure was blunted in S-P467L mice. However, the arterial pressure and heart rate responses to aortic depressor nerve stimulation were unaltered in S-P467L mice, suggesting that the central and efferent limbs of the baroreflex arc remain intact. There was no transgene expression in nodose ganglion and no change in expression of the acid-sensing ion channel-2 or -3 in nodose ganglion. There was a trend toward decreased expression of transient receptor potential vanilloid-1 receptor mRNA in nodose ganglion, but no difference in the immunochemical staining of transient receptor potential vanilloid-1 receptor in the termination area of the left aortic depressor nerve in S-P467L mice. Although there was no difference in the maximal calcium response to capsaicin in cultured nodose neurons from S-P467L mice, there was decreased desensitization of transient receptor potential vanilloid-1 receptor channels. In conclusion, S-P467L mice exhibit baroreflex dysfunction because of a defect in the afferent limb of the baroreflex arc caused by impaired vascular function, altered vascular structure, or compromised neurovascular coupling. These findings implicate vascular smooth muscle peroxisome proliferator activated receptor-γ as a critical determinant of neurovascular signaling. © 2014 American Heart Association, Inc.

  7. Prevalence of cardiac autonomic neuropathy in Asian Indian patients with fibrocalculous pancreatic diabetes

    Directory of Open Access Journals (Sweden)

    Amrit Nanaiah

    2012-01-01

    Full Text Available Background: It was formerly believed that since fibrocalculous pancreatic diabetes (FCPD is a secondary form of diabetes, specific diabetic complications were uncommon. This is no longer considered to be true. Our objective was to study the prevalence and pattern of cardiac autonomic neuropathy (CAN in patients with FCPD. Materials and Methods: A cross-sectional study on consecutive male patients with FCPD was performed. Using an automated CAN System Analyzer, heart rate response to deep breathing, Valsalva maneuver, standing and blood pressure response to standing were measured. The standard Ewing′s criteria were used to define normal, borderline, and abnormal values. Prevalence rates were calculated and the patients were defined to have normal autonomic function, parasympathetic, sympathetic, and combined dysfunction. Results: The prevalence of CAN in this study population was 63.3%. Isolated parasympathetic dysfunction (42.3% was the most common abnormality. Combined sympathetic and parasympathetic dysfunction was noted in 13.3% of patients. Isolated borderline dysfunction was noted among 13.3% of patients. CAN was detected in six patients with a duration of diabetes of less than 1 year after diagnosis. Patients with autonomic dysfunction were found to have a lower body mass index (BMI and low density lipoprotein (LDL-cholesterol when compared to those with normal autonomic functions, which was not statistically significant. Conclusion: The prevalence of abnormal cardiac autonomic function is as high as 63.3% in the present study population which warrants regular screening of patients with FCPD for autonomic dysfunction. Patients with FCPD and autonomic dysfunction were found to have a lower BMI and lower LDL-cholesterol, which may be indicators of malnutrition in the group with autonomic dysfunction. Whether this malnutrition contributes to autonomic dysfunction needs further exploration.

  8. Differential Patterns and Determinants of Cardiac Autonomic Nerve Dysfunction during Endotoxemia and Oral Fat Load in Humans.

    Science.gov (United States)

    Ziegler, Dan; Strom, Alexander; Strassburger, Klaus; Nowotny, Bettina; Zahiragic, Lejla; Nowotny, Peter J; Carstensen-Kirberg, Maren; Herder, Christian; Szendroedi, Julia; Roden, Michael

    2015-01-01

    The autonomic nervous system (ANS) plays an important role in regulating the metabolic homeostasis and controlling immune function. ANS alterations can be detected by reduced heart rate variability (HRV) in conditions like diabetes and sepsis. We determined the effects of experimental conditions mimicking inflammation and hyperlipidemia on HRV and heart rate (HR) in relation to the immune, metabolic, and hormonal responses resulting from these interventions. Sixteen lean healthy subjects received intravenous (i.v.) low-dose endotoxin (lipopolysaccharide [LPS]), i.v. fat, oral fat, and i.v. glycerol (control) for 6 hours, during which immune, metabolic, hormonal, and five HRV parameters (pNN50, RMSSD, low-frequency (LF) and high-frequency (HF) power, and LF/HF ratio) were monitored and energy metabolism and insulin sensitivity (M-value) were assessed. LPS infusion induced an increase (AUC) in HR and LF/HF ratio and decline in pNN50 and RMSSD, while oral fat resulted in elevated HR and a transient (hours 1-2) decrease in pNN50, RMSSD, and HF power. During LPS infusion, ΔIL-1ra levels and ΔIL-1ra and ΔIL-1ß gene expression correlated positively with ΔLF/HF ratio and inversely with ΔRMSSD. During oral fat intake, ΔGLP-1 tended to correlate positively with ΔHR and inversely with ΔpNN50 and ΔRMSSD. Following LPS infusion, lipid oxidation correlated positively with HR and inversely with pNN50 and RMSSD, whereas HRV was not related to M-value. In conclusion, suppression of vagal tone and sympathetic predominance during endotoxemia are linked to anti-inflammatory processes and lipid oxidation but not to insulin resistance, while weaker HRV changes in relation to the GLP-1 response are noted during oral fat load. ClinicalTrials.gov NCT01054989.

  9. Differential Patterns and Determinants of Cardiac Autonomic Nerve Dysfunction during Endotoxemia and Oral Fat Load in Humans.

    Directory of Open Access Journals (Sweden)

    Dan Ziegler

    Full Text Available The autonomic nervous system (ANS plays an important role in regulating the metabolic homeostasis and controlling immune function. ANS alterations can be detected by reduced heart rate variability (HRV in conditions like diabetes and sepsis. We determined the effects of experimental conditions mimicking inflammation and hyperlipidemia on HRV and heart rate (HR in relation to the immune, metabolic, and hormonal responses resulting from these interventions. Sixteen lean healthy subjects received intravenous (i.v. low-dose endotoxin (lipopolysaccharide [LPS], i.v. fat, oral fat, and i.v. glycerol (control for 6 hours, during which immune, metabolic, hormonal, and five HRV parameters (pNN50, RMSSD, low-frequency (LF and high-frequency (HF power, and LF/HF ratio were monitored and energy metabolism and insulin sensitivity (M-value were assessed. LPS infusion induced an increase (AUC in HR and LF/HF ratio and decline in pNN50 and RMSSD, while oral fat resulted in elevated HR and a transient (hours 1-2 decrease in pNN50, RMSSD, and HF power. During LPS infusion, ΔIL-1ra levels and ΔIL-1ra and ΔIL-1ß gene expression correlated positively with ΔLF/HF ratio and inversely with ΔRMSSD. During oral fat intake, ΔGLP-1 tended to correlate positively with ΔHR and inversely with ΔpNN50 and ΔRMSSD. Following LPS infusion, lipid oxidation correlated positively with HR and inversely with pNN50 and RMSSD, whereas HRV was not related to M-value. In conclusion, suppression of vagal tone and sympathetic predominance during endotoxemia are linked to anti-inflammatory processes and lipid oxidation but not to insulin resistance, while weaker HRV changes in relation to the GLP-1 response are noted during oral fat load.ClinicalTrials.gov NCT01054989.

  10. Renal tubular dysfunction presenting as recurrent hypokalemic periodic quadriparesis in systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    D Prasad

    2014-01-01

    Full Text Available We report recurrent hypokalemic periodic quadriparesis in a 30-year-old woman. Patient had also symptoms of multiple large and small joint pain, recurrent oral ulceration, photosensitivity and hair loss that were persisting since last 6 months and investigations revealed systemic lupus erythematosus (SLE with distal tubular acidosis. Our patient was successfully treated with oral potassium chloride, sodium bicarbonate, hydroxychloroquine and a short course of steroids. Thus, tubular dysfunction should be carefully assessed in patients with SLE.

  11. Paraganglioma of the Cauda Equina Presenting with Erectile and Sphincter Dysfunction

    Directory of Open Access Journals (Sweden)

    Wiesław Marcol

    2009-06-01

    Full Text Available Paragangliomas of the cauda equina are rare neuroepithelial tumors, usually manifesting clinically as sciatica. Here, we report a case of cauda equina paraganglioma with an unusual course in a 43-year-old man. His main complaints were erectile and sphincter dysfunction. The low back pain was initially ascribed to accidental injury. Magnetic resonance imaging revealed intradural tumor at the L2/L3 level. The patient underwent gross tumor resection, and the diagnosis of paraganglioma was based on neuropathologic examination. The symptoms completely resolved after tumor resection.

  12. Large vestibular aqueduct syndrome and endolymphatic hydrops: two presentations of a common primary inner-ear dysfunction?

    Science.gov (United States)

    Spiegel, J H; Lalwani, Anil K

    2009-08-01

    To present the theory that large vestibular aqueduct syndrome (i.e. the recognised existence of an enlarged vestibular aqueduct with progressive sensorineural hearing loss) and endolymphatic hydrops are due to a common primary dysfunction of inner-ear fluid homeostasis. Case report and review of the world literature concerning large vestibular aqueduct syndrome and endolymphatic hydrops. We report a family in which one sibling suffered from large vestibular aqueduct syndrome while the other had classic Ménière's disease. This suggests that large vestibular aqueduct syndrome and endolymphatic hydrops, in some cases, may be due to a common primary dysfunction of inner-ear fluid homeostasis. To our knowledge, this is the first report in the world literature to postulate that variation in the relative compliance of inner-ear membranes could be the factor that determines the manifestation of the disorder as either endolymphatic hydrops or large vestibular aqueduct syndrome.

  13. Erectile dysfunction as a manifestation of urogenital autonomic neuropathy in patients with type 1 diabetes: epidemiology, classification, pathophysiology, diagnosis and treatment options

    OpenAIRE

    Gagik Radikovich Galstyan; yana Grigor'evna Shwarts; Sergey Anatol'evich Dubsky; Aleksandr Evgen'evich Lepetukhin; Roman Viktorovich Rozhivanov; Dmitry Gennadievich Kurbatov

    2014-01-01

    Sexual dysfunction characterized by a significant decline in the quality of life of patients and leading to infertility and problems in social life is diagnosed in more than 40% of patients with diabetes mellitus (DM).Erectile dysfunction is the most common sexual disorder in DM patients. The article describes epidemiology, classification, pathophysiology, diagnostic and treatment of erectile dysfunction in T1DM patients.

  14. Erectile dysfunction as a manifestation of urogenital autonomic neuropathy in patients with type 1 diabetes: epidemiology, classification, pathophysiology, diagnosis and treatment options

    Directory of Open Access Journals (Sweden)

    Gagik Radikovich Galstyan

    2014-05-01

    Full Text Available Sexual dysfunction characterized by a significant decline in the quality of life of patients and leading to infertility and problems in social life is diagnosed in more than 40% of patients with diabetes mellitus (DM.Erectile dysfunction is the most common sexual disorder in DM patients. The article describes epidemiology, classification, pathophysiology, diagnostic and treatment of erectile dysfunction in T1DM patients.

  15. Trisomy 22pter-q12.3 presenting with hepatic dysfunction variability of cat-eye syndrome.

    Science.gov (United States)

    Jezela-Stanek, Aleksandra; Dobrzańska, Anna; Maksym-Gasiorek, Dorota; Trzeciakowski, Wojciech; Gutkowska, Anna; Olczak-Kowalczyk, Dorota; Gajdulewicz, Maria; Spodar, Krystyna; Czech-Kowalska, Justyna; Krajewska-Walasek, Małgorzata

    2009-01-01

    We describe the clinical characteristics of two patients with cat-eye syndrome (CES, MIM #115470) resulting from a supernumerary marker chromosome that includes 22pter-q12.3. They both presented a constellation of features typical of CES, including coloboma, auricular malformations, heart and renal anomalies, as well as hepatic dysfunction, which led to severe effects. In one case Pierre Robin sequence was diagnosed which has not been described earlier in this trisomy. Although CES is a well known, but infrequently diagnosed disorder, we draw attention both to its clinical overlaps with other disorders and, in view of the clinical variability being identified within the 22q11 region, to the importance of careful molecular examination of proximal 22q in patients with suggestive clinical signs.

  16. The role of autonomic testing in syncope.

    Science.gov (United States)

    Jones, Pearl K; Gibbons, Christopher H

    2014-09-01

    Syncope is a common presenting complaint in both the inpatient and outpatient settings. The main goals in the clinical evaluation of syncope are to identify an underlying etiology, to stratify risk and to guide plans for therapeutic intervention. Testing begins with an initial electrocardiogram to screen for any cardiac rhythm abnormalities. Heart rate variability to paced breathing provides a standard measure of cardiac parasympathetic function and offers clues towards an autonomic cause of syncope. A Valsalva maneuver is used to evaluate for parasympathetic dysfunction through the Valsalva ratio. In addition, sympathetic adrenergic function is assessed through evaluation of blood pressure response during the Valsalva maneuver. Abnormalities to the Valsalva maneuver can suggest clues towards an autonomic cause of syncope. Head-up tilt table testing is an important part of the autonomic evaluation of patients with syncope, and can be diagnostic for many disorders that result in syncope including orthostatic hypotension, neurally mediated syncope, postural tachycardia syndrome or delayed orthostatic hypotension. Autonomic function testing provides a safe and controlled environment for evaluation of patients, and plays a pivotal role in the diagnosis of syncope, particularly in challenging cases. While the initial clinical evaluation of syncope involves a detailed history and physical examination; in situations where the diagnosis is unknown, the addition of autonomic testing is complementary and can lead to identification of autonomic causes of syncope. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Diagnostic yield of MRI for audiovestibular dysfunction using contemporary referral criteria: correlation with presenting symptoms and impact on clinical management

    International Nuclear Information System (INIS)

    Vandervelde, C.; Connor, S.E.J.

    2009-01-01

    Aim: To investigate the diagnostic yield of T2-weighted magnetic resonance imaging (MRI) screening for vestibular schwannoma and other relevant conditions in the setting of audiovestibular symptoms, given the more liberal contemporary referral criteria. To determine whether presenting clinical symptoms correlate with imaging outcome in order to guide future protocols for MRI referral. Materials and methods: Eight hundred and eighty-one consecutive MRI examinations performed in patients with audiovestibular dysfunction were reviewed. Clinical indications and findings were recorded. Case notes were reviewed in patients with positive imaging findings. Two-way, cross-tabulation, Chi-square analysis was performed to assess the relationship between presenting symptoms and imaging outcome. Results: Twelve of the 881 (1.4%) were positive for vestibular schwannoma. A further four of 881 (0.4%) revealed other relevant conditions. Incidental conditions, felt to be irrelevant to the presenting symptoms, were noted in 12 of the 881 (1.4%). In all 12 cases that were positive for vestibular schwannoma, either tinnitus or hearing loss was present. Conclusion: The yield for T2-weighted MRI to diagnose vestibular schwannoma and other relevant retrocochlear conditions was lower than for previous studies, which is likely to reflect trends in referral criteria. No single audiovestibular symptom or combination of symptoms is a statistically significant predictor of imaging outcome

  18. Diagnostic yield of MRI for audiovestibular dysfunction using contemporary referral criteria: correlation with presenting symptoms and impact on clinical management

    Energy Technology Data Exchange (ETDEWEB)

    Vandervelde, C. [Department of Radiology, Guy' s and St Thomas' NHS Foundation Trust (United Kingdom)], E-mail: clivevandervelde@gmail.com; Connor, S.E.J. [Department of Radiology, Guy' s and St Thomas' NHS Foundation Trust (United Kingdom); Department of Neuroradiology, King' s College Hospital NHS Foundation Trust, London (United Kingdom)

    2009-02-15

    Aim: To investigate the diagnostic yield of T2-weighted magnetic resonance imaging (MRI) screening for vestibular schwannoma and other relevant conditions in the setting of audiovestibular symptoms, given the more liberal contemporary referral criteria. To determine whether presenting clinical symptoms correlate with imaging outcome in order to guide future protocols for MRI referral. Materials and methods: Eight hundred and eighty-one consecutive MRI examinations performed in patients with audiovestibular dysfunction were reviewed. Clinical indications and findings were recorded. Case notes were reviewed in patients with positive imaging findings. Two-way, cross-tabulation, Chi-square analysis was performed to assess the relationship between presenting symptoms and imaging outcome. Results: Twelve of the 881 (1.4%) were positive for vestibular schwannoma. A further four of 881 (0.4%) revealed other relevant conditions. Incidental conditions, felt to be irrelevant to the presenting symptoms, were noted in 12 of the 881 (1.4%). In all 12 cases that were positive for vestibular schwannoma, either tinnitus or hearing loss was present. Conclusion: The yield for T2-weighted MRI to diagnose vestibular schwannoma and other relevant retrocochlear conditions was lower than for previous studies, which is likely to reflect trends in referral criteria. No single audiovestibular symptom or combination of symptoms is a statistically significant predictor of imaging outcome.

  19. Insights into the background of autonomic medicine.

    Science.gov (United States)

    Laranjo, Sérgio; Geraldes, Vera; Oliveira, Mário; Rocha, Isabel

    2017-10-01

    Knowledge of the physiology underlying the autonomic nervous system is pivotal for understanding autonomic dysfunction in clinical practice. Autonomic dysfunction may result from primary modifications of the autonomic nervous system or be secondary to a wide range of diseases that cause severe morbidity and mortality. Together with a detailed history and physical examination, laboratory assessment of autonomic function is essential for the analysis of various clinical conditions and the establishment of effective, personalized and precise therapeutic schemes. This review summarizes the main aspects of autonomic medicine that constitute the background of cardiovascular autonomic dysfunction. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. The Mere Co-Presence: Synchronization of Autonomic Signals and Emotional Responses across Co-Present Individuals Not Engaged in Direct Interaction

    Science.gov (United States)

    Golland, Yulia; Arzouan, Yossi; Levit-Binnun, Nava

    2015-01-01

    Existing evidence suggests that in social contexts individuals become coupled in their emotions and behaviors. Furthermore, recent biological studies demonstrate that the physiological signals of interacting individuals become coupled as well, exhibiting temporally synchronized response patterns. However, it is yet unknown whether people can shape each other's responses without the direct, face-to-face interaction. Here we investigated whether the convergence of physiological and emotional states can occur among “merely co-present” individuals, without direct interactional exchanges. To this end, we measured continuous autonomic signals and collected emotional responses of participants who watched emotional movies together, seated side-by-side. We found that the autonomic signals of co-present participants were idiosyncratically synchronized and that the degree of this synchronization was correlated with the convergence of their emotional responses. These findings suggest that moment-to-moment emotional transmissions, resulting in shared emotional experiences, can occur in the absence of direct communication and are mediated by autonomic synchronization. PMID:26018597

  1. Functional profiles of SCN9A variants in dorsal root ganglion neurons and superior cervical ganglion neurons correlate with autonomic symptoms in small fibre neuropathy

    NARCIS (Netherlands)

    Han, C.; Hoeijmakers, J.G.; Liu, S.; Gerrits, M.M.; te Morsche, R.H.; Lauria, G.; Dib-Hajj, S.D.; Drenth, J.P.H.; Faber, C.G.; Merkies, I.S.; Waxman, S.G.

    2012-01-01

    Patients with small fibre neuropathy typically manifest pain in distal extremities and severe autonomic dysfunction. However, occasionally patients present with minimal autonomic symptoms. The basis for this phenotypic difference is not understood. Sodium channel Na(v)1.7, encoded by the SCN9A gene,

  2. Autonomic neuropathy-in its many guises-as the initial manifestation of the antiphospholipid syndrome.

    Science.gov (United States)

    Schofield, Jill R

    2017-04-01

    Autonomic disorders have previously been described in association with the antiphospholipid syndrome. The present study aimed to determine the clinical phenotype of patients in whom autonomic dysfunction was the initial manifestation of the antiphospholipid syndrome and to evaluate for autonomic neuropathy in these patients. This was a retrospective study of 22 patients evaluated at the University of Colorado who were found to have a disorder of the autonomic nervous system as the initial manifestation of antiphospholipid syndrome. All patients had persistent antiphospholipid antibody positivity and all patients who underwent skin biopsy were found to have reduced sweat gland nerve fiber density suggestive of an autonomic neuropathy. All patients underwent an extensive evaluation to rule out other causes for their autonomic dysfunction. Patients presented with multiple different autonomic disorders, including postural tachycardia syndrome, gastrointestinal dysmotility, and complex regional pain syndrome. Despite most having low-titer IgM antiphospholipid antibodies, 13 of the 22 patients (59%) suffered one or more thrombotic event, but pregnancy morbidity was minimal. Prothrombin-associated antibodies were helpful in confirming the diagnosis of antiphospholipid syndrome. We conclude that autonomic neuropathy may occur in association with antiphospholipid antibodies and may be the initial manifestation of the syndrome. Increased awareness of this association is important, because it is associated with a significant thrombotic risk and a high degree of disability. In addition, anecdotal experience has suggested that antithrombotic therapy and intravenous immunoglobulin therapy may result in significant clinical improvement in these patients.

  3. Dysfunctional Brain Networking among Autonomic Regulatory Structures in Temporal Lobe Epilepsy Patients at High Risk of Sudden Unexpected Death in Epilepsy.

    Science.gov (United States)

    Allen, Luke A; Harper, Ronald M; Kumar, Rajesh; Guye, Maxime; Ogren, Jennifer A; Lhatoo, Samden D; Lemieux, Louis; Scott, Catherine A; Vos, Sjoerd B; Rani, Sandhya; Diehl, Beate

    2017-01-01

    Sudden unexpected death in epilepsy (SUDEP) is common among young people with epilepsy. Individuals who are at high risk of SUDEP exhibit regional brain structural and functional connectivity (FC) alterations compared with low-risk patients. However, less is known about network-based FC differences among critical cortical and subcortical autonomic regulatory brain structures in temporal lobe epilepsy (TLE) patients at high risk of SUDEP. 32 TLE patients were risk-stratified according to the following clinical criteria: age of epilepsy onset, duration of epilepsy, frequency of generalized tonic-clonic seizures, and presence of nocturnal seizures, resulting in 14 high-risk and 18 low-risk cases. Resting-state functional magnetic resonance imaging (rs-fMRI) signal time courses were extracted from 11 bilateral cortical and subcortical brain regions involved in autonomic and other regulatory processes. After computing all pairwise correlations, FC matrices were analyzed using the network-based statistic. FC strength among the 11 brain regions was compared between the high- and low-risk patients. Increases and decreases in FC were sought, using high-risk > low-risk and low-risk > high-risk contrasts (with covariates age, gender, lateralization of epilepsy, and presence of hippocampal sclerosis). High-risk TLE patients showed a subnetwork with significantly reduced FC ( t  = 2.5, p  = 0.029) involving the thalamus, brain stem, anterior cingulate, putamen and amygdala, and a second subnetwork with significantly elevated FC ( t  = 2.1, p  = 0.031), which extended to medial/orbital frontal cortex, insula, hippocampus, amygdala, subcallosal cortex, brain stem, thalamus, caudate, and putamen. TLE patients at high risk of SUDEP showed widespread FC differences between key autonomic regulatory brain regions compared to those at low risk. The altered FC revealed here may help to shed light on the functional correlates of autonomic disturbances in epilepsy

  4. Central-Approach Surgical Repair of Coarctation of the Aorta with a Back-up Left Ventricular Assist Device for an Infant Presenting with Severe Left Ventricular Dysfunction

    Directory of Open Access Journals (Sweden)

    Tae Hoon Kim

    2015-12-01

    Full Text Available A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.

  5. Presentation

    Directory of Open Access Journals (Sweden)

    Eduardo Vicente

    2013-06-01

    Full Text Available In the present edition of Significação – Scientific Journal for Audiovisual Culture and in the others to follow something new is brought: the presence of thematic dossiers which are to be organized by invited scholars. The appointed subject for the very first one of them was Radio and the invited scholar, Eduardo Vicente, professor at the Graduate Course in Audiovisual and at the Postgraduate Program in Audiovisual Media and Processes of the School of Communication and Arts of the University of São Paulo (ECA-USP. Entitled Radio Beyond Borders the dossier gathers six articles and the intention of reuniting works on the perspectives of usage of such media as much as on the new possibilities of aesthetical experimenting being build up for it, especially considering the new digital technologies and technological convergences. It also intends to present works with original theoretical approach and original reflections able to reset the way we look at what is today already a centennial media. Having broadened the meaning of “beyond borders”, four foreign authors were invited to join the dossier. This is the first time they are being published in this country and so, in all cases, the articles where either written or translated into Portuguese.The dossier begins with “Radio is dead…Long live to the sound”, which is the transcription of a thought provoking lecture given by Armand Balsebre (Autonomous University of Barcelona – one of the most influential authors in the world on the Radio study field. It addresses the challenges such media is to face so that it can become “a new sound media, in the context of a new soundscape or sound-sphere, for the new listeners”. Andrew Dubber (Birmingham City University regarding the challenges posed by a Digital Era argues for a theoretical approach in radio studies which can consider a Media Ecology. The author understands the form and discourse of radio as a negotiation of affordances and

  6. Cognitive dysfunction and poor health literacy are common in veterans presenting with acute coronary syndrome: insights from the MEDICATION study

    Directory of Open Access Journals (Sweden)

    Marzec LN

    2015-06-01

    Full Text Available Lucas N Marzec,1 Evan P Carey,1 Anne C Lambert-Kerzner,1 Eric J Del Giacco,2 Stephanie D Melnyk,3 Chris L Bryson,4 Ibrahim E Fahdi,2 Hayden B Bosworth,3 Fran Fiocchi,5 P Michael Ho11Division of Cardiology, Denver VA Medical Center, Denver, CO, USA; 2Department of Medicine, Little Rock VA Medical Center, Little Rock, AR, USA; 3Department of Medicine, Durham VA Medical Center, Durham, NC, USA; 4Department of Medicine, Puget Sound VA Medical Center, Seattle, WA, USA; 5American College of Cardiology, Washington, DC, USABackground: Patient nonadherence to cardiac medications following acute coronary syndrome (ACS is associated with increased risk of recurrent events. However, the prevalence of cognitive dysfunction and poor health literacy among ACS patients and their association with medication nonadherence are poorly understood.Methods: We assessed rates of cognitive dysfunction and poor health literacy among participants of a clinical trial that tested the effectiveness of an intervention to improve medication adherence in patients hospitalized with ACS. Of 254 patients, 249 completed the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R survey, an assessment of risk for poor literacy, and the St Louis University Mental Status (SLUMS exam, a tool assessing for neurocognitive deficits, during ACS hospitalization. We assessed if SLUMS or REALM-R scores were associated with medication adherence.Results: Based on SLUMS score, 14% of patients were categorized as having dementia, and 52% with mild neurocognitive disorder (MNCD. Based on REALM-R score of ≤6, 34% of patients were categorized as at risk for poor health literacy. There was no association between poor health literacy and medication nonadherence. Of those with MNCD, 35.5% were nonadherent, compared to 17.5% with normal cognitive function and 6.7% with dementia. In multivariable analysis, cognitive dysfunction was associated with medication nonadherence (P=0.007, mainly due to

  7. Role of the functional status of the autonomic nervous system in the clinical course of purulent meningitis

    Directory of Open Access Journals (Sweden)

    D. A. Zadiraka

    2014-04-01

    Full Text Available Purulent meningitis is defined by high indices of sickness and lethality rates, a great risk of cerebral and extracerebral complications development, steady residual consequences formation. During neuroinfections, the state of adaptation mechanisms, which is characterized by exhaustion of regulatory systems with the development of decompensation, plays a crucial part. Heart rate variability clearly reflects the degree of regulatory system tension caused by the influence of both physiological and pathological factors. Research aim: to increase the autonomic dysfunction diagnostics efficiency for patients suffering from purulent meningitis in the disease dynamics based on the complex of clinical evidence and functional status of autonomic nervous system. Materials and methods. There were 60 patients with purulent meningitis under medical observation. Wein’s questionnaire was used for the detection of clinical presentations of autonomic dysfunction. Functional status of autonomic nervous system was diagnosed using the method of computer-based cardiointervalometry. The screening group was formed of 20 healthy individuals. Research findings and theirs discussion. Cerebral meningeal symptom was dominant among the patients suffering from purulent meningitis at the peak of the disease. At hospitalization every fifth person (23,3% had the objective evidence of autonomic dysfunction in the form of a postural tremor of upper limbs and eyelids. The analysis of autonomic nervous system parameters functional status among the patients suffering from purulent meningitis at the peak of disease showed heart rate variability decrease in the main branches of autonomic regulation and the presence of autonomic imbalance towards vagotonia. Since the second week, clinical signs of autonomic dysfunction prevailed in the dynamics of patients suffering from purulent meningitis in the course of standard treatment, which was proved by Wein’s survey of the patients. The

  8. Subclinical myocardial dysfunction and cardiac autonomic dysregulation are closely associated in obese children and adolescents: the potential role of insulin resistance.

    Directory of Open Access Journals (Sweden)

    Domenico Cozzolino

    Full Text Available The prevalence of obesity is increasing among children/adolescents. Subtle cardiovascular abnormalities, responsible for a higher mortality later in life, have been reported in obese children/adolescents. The aims of the study were to evaluate cardiovascular autonomic regulation, by means of spectrum analysis of R-R interval variability, and myocardial function, by means of standard and tissue Doppler echocardiography, in a group of non-hypertensive asymptomatic obese children and adolescents; furthermore, the influence of insulin resistance was tested.R-R interval variability was analyzed during both the 70° head-up tilt and 24-hour electrocardiographic holter monitoring. Spectrum analysis of R-R interval variability provided the indices of sympathetic (low frequency [LFRR] and vagal (high frequency [HFRR] modulation of the sinoatrial node. Homeostasis model assessment of insulin resistance (HOMA-IR was used to classify obese children/adolescents (n=72 as insulin resistant (n=37 and non-insulin resistant (n=35.In obese subjects: a left ventricular mass was significantly (p<0.05 increased, whereas both the e/a ratio and the e'/a' ratio were decreased; b at rest, HFRR was lower, and the LFRR/HFRR ratio was higher; c during tilting, magnitude of tilt-induced inhibition of HFRR was lower; d during 24-hour electrocardiographic holter monitoring, LFRR and the LFRR/HFRR ratio were higher, whereas HFRR was lower; e HOMA-IR inversely correlated with both the e'/a' ratio (r=-0.655; p<0.001 and the tilt-induced LFRR/HFRR ratio (r=-0.933; p<0.001; and, f the e'/a' ratio correlated with the tilt-induced LFRR/HFRR ratio (r=0.501; p<0.001. Moreover, HFRR at rest, magnitude of tilt-induced HFRR reduction, and the e'/a' ratio in insulin resistant obese children/adolescents were markedly lower when compared with the remaining subjects.Subclinical abnormalities of myocardial function and of cardiac autonomic regulation were closely associated in obese children

  9. Association between Diastolic Dysfunction with Inflammation and Oxidative Stress in Females ob/ob Mice

    Science.gov (United States)

    Sartori, Michelle; Conti, Filipe F.; Dias, Danielle da Silva; dos Santos, Fernando; Machi, Jacqueline F.; Palomino, Zaira; Casarini, Dulce E.; Rodrigues, Bruno; De Angelis, Kátia; Irigoyen, Maria-Claudia

    2017-01-01

    Objective: To evaluate autonomic and cardiovascular function, as well as inflammatory and oxidative stress markers in ob/ob female mice. Methods: Metabolic parameters, cardiac function, arterial pressure (AP), autonomic, hormonal, inflammatory, and oxidative stress markers were evaluated in 12-weeks female wild-type (WT group) and ob/ob mice (OB group). Results: OB animals showed increased body weight, blood glucose, and triglyceride levels, along with glucose intolerance, when compared to WT animals. Ejection fraction (EF) and AP were similar between groups; however, the OB group presented diastolic dysfunction, as well as an impairment on myocardial performance index. Moreover, the OB group exhibited important autonomic dysfunction and baroreflex sensitivity impairment, when compared to WT group. OB group showed increased Angiotensin II levels in heart and renal tissues; decreased adiponectin and increased inflammatory markers in adipose tissue and spleen. Additionally, OB mice presented a higher damage to proteins and lipoperoxidation and lower activity of antioxidant enzymes in kidney and heart. Correlations were found between autonomic dysfunction with angiotensin II and inflammatory mediators, as well as between inflammation and oxidative stress. Conclusions: Our results showed that female adult ob/ob mice presented discrete diastolic dysfunction accompanied by autonomic disorder, which is associated with inflammation and oxidative stress in these animals. PMID:28878683

  10. Association between Diastolic Dysfunction with Inflammation and Oxidative Stress in Females ob/ob Mice

    Directory of Open Access Journals (Sweden)

    Michelle Sartori

    2017-08-01

    Full Text Available Objective: To evaluate autonomic and cardiovascular function, as well as inflammatory and oxidative stress markers in ob/ob female mice.Methods: Metabolic parameters, cardiac function, arterial pressure (AP, autonomic, hormonal, inflammatory, and oxidative stress markers were evaluated in 12-weeks female wild-type (WT group and ob/ob mice (OB group.Results: OB animals showed increased body weight, blood glucose, and triglyceride levels, along with glucose intolerance, when compared to WT animals. Ejection fraction (EF and AP were similar between groups; however, the OB group presented diastolic dysfunction, as well as an impairment on myocardial performance index. Moreover, the OB group exhibited important autonomic dysfunction and baroreflex sensitivity impairment, when compared to WT group. OB group showed increased Angiotensin II levels in heart and renal tissues; decreased adiponectin and increased inflammatory markers in adipose tissue and spleen. Additionally, OB mice presented a higher damage to proteins and lipoperoxidation and lower activity of antioxidant enzymes in kidney and heart. Correlations were found between autonomic dysfunction with angiotensin II and inflammatory mediators, as well as between inflammation and oxidative stress.Conclusions: Our results showed that female adult ob/ob mice presented discrete diastolic dysfunction accompanied by autonomic disorder, which is associated with inflammation and oxidative stress in these animals.

  11. Autonomic neuropathy in Fabry disease: a prospective study using the Autonomic Symptom Profile and cardiovascular autonomic function tests

    NARCIS (Netherlands)

    Biegstraaten, Marieke; van Schaik, Ivo N.; Wieling, Wouter; Wijburg, Frits A.; Hollak, Carla E. M.

    2010-01-01

    ABSTRACT: BACKGROUND: Fabry patients have symptoms and signs compatible with autonomic dysfunction. These symptoms and signs are considered to be due to impairment of the peripheral nervous system, but findings indicative of autonomic neuropathy in other diseases, such as orthostatic intolerance and

  12. Exacerbation of myocardial dysfunction and autonomic imbalance contributes to the estrogen-dependent chronic hypotensive effect of ethanol in female rats.

    Science.gov (United States)

    el-Mas, Mahmoud M; Abdel-Rahman, Abdel A

    2012-03-15

    Our previous studies showed that the hypotensive effect of chronic ethanol in female rats is reduced by ovariectomy (OVX) rats and was restored after estrogen replacement (OVXE(2)). Further, in randomly cycling rats, chronic ethanol increased cardiac parasympathetic dominance and subsequently reduced myocardial contractility and blood pressure (BP). In this study, we tested the hypothesis that alterations in myocardial contractility and sympathovagal control account for the E(2) exacerbation of the hemodynamic effects of ethanol. BP, myocardial contractility (+dP/dt(max)), and spectral cardiovascular autonomic profiles were evaluated in radiotelemetered OVX, and OVXE(2) rats receiving liquid diet with or without ethanol (5%, w/v) for 13 weeks. In OVX rats, ethanol caused modest hypotension along with significant increases in +dP/dt(max) during weeks 2-5. The high-frequency (IBI(HF), 0.75-3 Hz) and low-frequency (IBI(LF), 0.25-0.75 Hz) bands of interbeat intervals were briefly increased and decreased, respectively, by ethanol. Compared with its effects in OVX rats, chronic treatment of OVXE(2) rats with ethanol elicited significantly greater and more sustained reductions in systolic (SBP) and diastolic (DBP) blood pressures and +dP/dt(max). Altered sympathovagal balance and parasympathetic overactivity were more evident in ethanol-treated OVXE(2) rats as suggested by the sustained: (i) increases in high-frequency bands of interbeat intervals (IBI(HF), 0.75-3 Hz), and (ii) decreases in low-frequency IBI bands (IBI(LF), 0.25-0.75 Hz), IBI(LF/HF) ratio and +dP/dt(max). The plasma ethanol concentration was not affected by changes in the hormonal milieu. These findings suggest that estrogen exacerbates the ethanol-evoked reductions in myocardial contractility and BP and the associated parasympathetic overactivity in female rats. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Autonomic neuropathies

    Science.gov (United States)

    Low, P. A.

    1998-01-01

    A limited autonomic neuropathy may underlie some unusual clinical syndromes, including the postural tachycardia syndrome, pseudo-obstruction syndrome, heat intolerance, and perhaps chronic fatigue syndrome. Antibodies to autonomic structures are common in diabetes, but their specificity is unknown. The presence of autonomic failure worsens prognosis in the diabetic state. Some autonomic neuropathies are treatable. Familial amyloid polyneuropathy may respond to liver transplantation. There are anecdotal reports of acute panautonomic neuropathy responding to intravenous gamma globulin. Orthostatic hypotension may respond to erythropoietin or midodrine.

  14. Autonomic epileptic seizures, autonomic effects of seizures, and SUDEP.

    Science.gov (United States)

    Moseley, Brian; Bateman, Lisa; Millichap, John J; Wirrell, Elaine; Panayiotopoulos, Chrysostomos P

    2013-03-01

    Many generalized tonic-clonic seizures are accompanied by profound autonomic changes. However, autonomic seizures and autonomic status epilepticus can also be seen with specific electroclinical syndromes (Panayiotopoulos syndrome), etiologies, and localizations. Such autonomic symptoms may impact cardiorespiratory function. While it is likely that several factors contribute to SUDEP, further study of both ictal respiratory and cardiac changes and underlying neuroanatomical mechanisms involved in autonomic seizure semiology are likely to provide important data to improve our understanding of the pathophysiology of this devastating condition. This paper will review the association between autonomic symptoms and epileptic seizures and will highlight the work of three young investigators. Drs. Lisa Bateman and Brian Moseley will review their work on cardiorespiratory effects of recorded seizures and how this assists in our understanding of SUDEP. Dr. John Millichap will review autonomic seizures and autonomic dysfunctions related to childhood epilepsy and will discuss the importance of expanded research efforts in this field. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Autonomous houses. Autonomous house

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, S. (Tokai University, Tokyo (Japan). Faculty of Engineering)

    1991-09-30

    Self-sufficiency type houses are outlined. On condition that people gain a certain amount of income in relation with the society, they self-suffice under the given environment, allowing themselves to accept a minimum of industrial products with small environmental load. Ordinary supply from outside of fossil energy and materials which depend on it is minimized. Types are classified into three: energy, energy materials and perfect self-sufficiency. A study project for environment symbiotic houses is progressing which is planned by the Ministry of Construction and Institute of Building Energy Conservation and is invested by a private company. Its target is making a house for halving an environmental load by CO{sub 2}, for the purpose of creating the environment symbiotic house which is nice to and in harmony with the global environment and human beings. As a part of the studies on energy-saving and resource conservation on houses, introduced is a plan of an autonomous house at Izu-Atagawa. The passive method and high thermal-insulation are used for air conditioning, and hot spring water for hot water supply. Electric power is generated by hydroelectric power generation using mountain streams and by solar cells. Staple food is purchased, while subsidiary food is sufficed. 17 refs., 4 figs., 1 tab.

  16. Altered balance in the autonomic nervous system in schizophrenic patients

    DEFF Research Database (Denmark)

    Nielsen, B M; Mehlsen, J; Behnke, K

    1988-01-01

    .05). Heart-rate response to inspiration was greater in non-medicated schizophrenics compared to normal subjects (P less than 0.05), whereas no difference was found between medicated and non-medicated schizophrenics. The results show that the balance in the autonomic nervous system is altered in schizophrenic...... patients with a hyperexcitability in both the sympathetic and the parasympathetic division. Our study has thus indicated a dysfunction in the autonomic nervous system per se and the previous interpretations of attentional orienting responses in schizophrenia is questioned. Medication with neuroleptics......The aim of the present study was to evaluate the autonomic nervous function in schizophrenic patients. Twenty-eight patients (29 +/- 6 years) diagnosed as schizophrenics and in stable medication were included, together with ten schizophrenic patients (25 +/- 5 years) who were unmedicated. Eleven...

  17. Autonomic changes in fibromyalgia: Clinical and ...

    African Journals Online (AJOL)

    Background: Autonomic nervous system (ANS) dysfunction is one of the suggested pathophysiological mechanisms of fibromyalgia (FM). Its dysfunction may contribute to enhanced pain and other clinical problems associated with FM. Previous studies showed conflicting results regarding ANS function in FM. Some studies ...

  18. Pulmonary and right ventricular dysfunction are frequently present in heart failure irrespective of left ventricular ejection fraction

    Science.gov (United States)

    Robaeys, Wouter; Bektas, Sema; Boyne, Josiane; van Empel, Vanessa; Uszko-Lencer, Nicole; Knackstedt, Christian; Brunner-La Rocca, Hans-Peter

    2017-01-01

    Background Heart failure (HF) may influence the lungs and vice versa. However, this interaction and the influence on right ventricular function (RVF) are insufficiently described in patients with HF divided into the recent groups based on left ventricular ejection fraction (LVEF): HF with reduced, midrange and preserved ejection fraction (HFrEF, HFmrEF and HFpEF, respectively). Methods Overall, 186 consecutive stable patients with HF seen in our outpatient clinic were retrospectively divided into HFrEF (n=70), HFmrEF (n=55) and HFpEF (n=61). Airflow limitation and gas exchange disturbance were measured by spirometry (forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) (%)) and diffusion capacity of the lungs for carbon monoxide (DLCO). Standard echocardiography was performed to measure RV structure (RV diameter) and function (tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP)). Correlations were used to assess possible relations between pulmonary dysfunction and measurements of the RV. Results None of the investigated parameters differed significantly between the three groups (all p>0.1); FEV1/FVC was 70%±12%, 70%±13% and 74%±10% in patients with HFrEF, HFmrEF and HFpEF (p=0.12) and DLCO was 5.7±1.6, 5.7±1.8 and 5.6±1.6 mmol/min/kPa, respectively (p=0.95). RV structure and function did not differ either (TAPSE/PASP 0.58, 0.60 and 0.57, respectively (p=0.84)). There was a correlation of DLCO with RV function (r=0.34, p<0.001). Conclusion The investigated cardiopulmonary parameters were comparable in the three HF groups. Diffusion capacity was impaired in more than half of the stable HF population independently of the LVEF and showed a correlation with RV function. PMID:29467838

  19. Cardiovascular adaptation in people with multiple sclerosis following a twelve week exercise programme suggest deconditioning rather than autonomic dysfunction caused by the disease. Results from a randomized controlled trial.

    Science.gov (United States)

    Feltham, M G; Collett, J; Izadi, H; Wade, D T; Morris, M G; Meaney, A J; Howells, K; Sackley, C; Dawes, H

    2013-12-01

    Guidelines for optimal exercise doses in people with multiple sclerosis (MS) have to be established. We need to ascertain the basic physiological and perceptual response and adaptation to different exercise doses in this clinical population. The aim of this paper was to explore the response during maximal and sub-maximal exercise in people with MS prior to and following two different twelve week exercise programmes. Sub-analysis of per protocol exercise data of a two group, single blinded, randomised control trial. Multicentre (community leisure and rehabilitation centres). Participants with MS assigned to a continuous (N.=12; mean±SE age=52.3±2.08; Barthel index median & range=19&13-20) or interval (N.=9; mean±SE age=49.3±3.5; Barthel index median & range=19&18-20) exercise programme. Cardiovascular, respiratory and perceptual exercise response and adaption was measured at maximal and sub-maximal levels of physical exercise prior to and following a twelve week exercise programme, delivered at different intensities. Irrespective of the type of exercise programme followed, there was a significant increase in peak power (z=-1.98; P=0.05) and normalised oxygen uptake during unloaded cycling (z =-2.00; P=0.05). At discharge from the exercise programmes, the cardiovascular response to sub-maximal exercise had significantly changed (t(360) =-4.62; pphysical exercise following a twelve week programme is analogous to non-diseased adults. Cardiovascular adaptation in people with MS following a twelve week exercise programme suggests deconditioning rather than autonomic dysfunction caused by the disease.

  20. Implantable cardiac monitors in high-risk post-infarction patients with cardiac autonomic dysfunction and moderately reduced left ventricular ejection fraction: Design and rationale of the SMART-MI trial.

    Science.gov (United States)

    Hamm, Wolfgang; Rizas, Konstantinos D; Stülpnagel, Lukas von; Vdovin, Nikolay; Massberg, Steffen; Kääb, Stefan; Bauer, Axel

    2017-08-01

    Most deaths after myocardial infarction (MI) occur in patients with left ventricular ejection fraction (LVEF) >35%, for whom no specific prophylactic strategies exist. Deceleration capacity (DC) of heart rate and periodic repolarization dynamics (PRD) are noninvasive electrophysiological markers depending on the vagal and sympathetic tone. The combination of abnormal DC and/or PRD identifies a new high-risk group among postinfarction patients with LVEF 36%-50%. This new high-risk group has similar characteristics with respect to prognosis and patient numbers to those of the established high-risk group identified by LVEF ≤ 35%. The SMART-MI trial is an investigator-initiated randomized prospective multicenter trial that tests the efficacy of implantable cardiac monitors (ICM) in this new high-risk group. The study will enroll approximately 1,600 survivors of acute MI with sinus rhythm and an LVEF of 35%-50% in 17 centers in Germany who will be tested for presence of cardiac autonomic dysfunction. Four hundred patients with either abnormal DC (≤2.5 ms) and/or PRD (≥5.75deg 2 ) will be randomized in a 1:1 fashion to intensive follow-up via telemonitoring using an ICM device (experimental arm) or conventional follow-up (control arm). For the ICM arm, specific treatment paths have been developed according to current guidelines. The primary end point is time to detection of predefined serious arrhythmic events during follow-up, including atrial fibrillation ≥6minutes, nonsustained ventricular tachycardia (cycle length≤320 ms; ≥40 beats), atrioventricular block ≥IIb, and sustained ventricular tachycardia/ventricular fibrillation. The median follow-up period is 18months with a minimum follow-up of 6months. The effect of remote monitoring on clinical outcomes will be tested as secondary outcome measure (ClinicalTrials.gov NCT02594488). Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Presentations

    International Nuclear Information System (INIS)

    2007-01-01

    The presented materials consist of presentations of international workshop which held in Warsaw from 4 to 5 October 2007. Main subject of the meeting was progress in manufacturing as well as research program development for neutron detector which is planned to be placed at GANIL laboratory and will be used in nuclear spectroscopy research

  2. Autonomous search

    CERN Document Server

    Hamadi, Youssef; Saubion, Frédéric

    2012-01-01

    Autonomous combinatorial search (AS) represents a new field in combinatorial problem solving. Its major standpoint and originality is that it considers that problem solvers must be capable of self-improvement operations. This is the first book dedicated to AS.

  3. Algunas consideraciones de la disfunción endotelial en pacientes con hiperprolactinemia Some considerations of endothelial dysfunction in patients presenting with hyperprolactinemia

    Directory of Open Access Journals (Sweden)

    Maité Cabrera Gámez

    2012-04-01

    Full Text Available Se realizó una revisión de las publicaciones a nuestro alcance de la actualidad sobre el tema disfunción endotelial en pacientes con hiperprolactinemia: existencia, mecanismos de producción y consecuencias. Teniendo en cuenta que la hiperprolactinemia tiene hoy un nuevo enfoque relacionado con la disfunción endotelial, nos propusimos realizar la revisión siguiente. La disfunción endotelial es una alteración en la relajación vascular inducida por la reducción de los factores de relajación derivados del endotelio, principalmente el óxido nítrico, que causa un aumento del estímulo vasoconstrictor con tendencia protrombótica de la vasculatura. La resistencia a la insulina actúa como principal factor de disfunción endotelial asociado o no con la diabetes mellitus. Hasta el presente, el estado hiperprolactinémico se asocia con trastornos de la tolerancia a la glucosa (tolerancia a la glucosa disminuida con hiperinsulinemia. Existe disfunción endotelial en mujeres hiperprolactinémicas y puede deberse a su relación con resistencia a la insulina, a la disminución de los estrógenos y a la propia hiperprolactinemia. También se han encontrado marcadores de inflamación (como la proteína C reactiva elevada en pacientes con esta enfermedad. La hiperprolactinemia se asocia con resistencia a la insulina, disfunción endotelial y bajo grado de inflamación, parámetros que son determinantes en el proceso de aterosclerosis, por lo que esta enfermedad puede ser un factor predisponente de aterosclerosis, y por tanto, un riesgo de morbilidad y mortalidad cardiovasculares.A review of the publications available of current situation on the subject related to endothelial dysfunction in patients with hyperprolactinemia: existence, production mechanisms and consequences. Taking into account that the hyperprolactinemia has a new approach related to endothelial dysfunction authors made present review. Above mentioned dysfunction is a alteration in

  4. Myocardial Contractile Dysfunction is Present Without Histopathology in a Mouse Model of Limb-Girdle Muscular Dystrophy-2F and is Prevented after Claudin-5 Virotherapy

    Directory of Open Access Journals (Sweden)

    Nima Milani-Nejad

    2016-12-01

    Full Text Available AbstractMutations in several members of the dystrophin glycoprotein complex lead to skeletal and cardiomyopathies. Cardiac care for these muscular dystrophies consists of management of symptoms with standard heart medications after detection of reduced whole heart function. Recent evidence from both Duchenne muscular dystrophy patients and animal models suggests that myocardial dysfunction is present before myocardial damage or deficiencies in whole heart function, and that treatment prior to heart failure symptoms may be beneficial. To determine whether this same early myocardial dysfunction is present in other muscular dystrophy cardiomyopathies, we conducted a physiological assessment of cardiac function at the tissue level in the δ-sarcoglycan null mouse model (Sgcd-/- of Limb-girdle muscular dystrophy type 2F. Baseline cardiac contractile force measurements using ex vivo intact linear muscle preparations, were severely depressed in these mice without the presence of histopathology. Virotherapy with claudin-5 prevents the onset of cardiomyopathy in another muscular dystrophy model. After virotherapy with claudin-5, the cardiac contractile force deficits in Sgcd-/- mice are no longer significant. These studies suggest that screening Limb-girdle muscular dystrophy patients using methods that detect earlier functional changes may provide a longer therapeutic window for cardiac care.

  5. Diastolic dysfunction characterizes cirrhotic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Piyush O. Somani

    2014-11-01

    Conclusions: Present study shows that although diastolic dysfunction is a frequent event in cirrhosis, it is usually of mild degree and does not correlate with severity of liver dysfunction. There are no significant differences in echocardiographic parameters between alcoholic and non-alcoholic cirrhosis. HRS is not correlated to diastolic dysfunction in cirrhotic patients. There is no difference in survival at one year between patients with or without diastolic dysfunction. Diastolic dysfunction in cirrhosis is unrelated to circulatory dysfunction, ascites and HRS.

  6. Presentations

    International Nuclear Information System (INIS)

    2007-01-01

    The PARIS meeting held in Cracow, Poland from 14 to 15 May 2007. The main subjects discussed during this meeting were the status of international project dedicated to gamma spectroscopy research. The scientific research program includes investigations of giant dipole resonance, probe of hot nuclei induced in heavy reactions, Jacobi shape transitions, isospin mixing and nuclear multifragmentation. The mentioned programme needs Rand D development such as new scintillations materials as lanthanum chlorides and bromides as well as new photo detection sensors as avalanche photodiodes - such subjects are also subjects of discussion. Additionally results of computerized simulations of scintillation detectors properties by means of GEANT- 4 code are presented

  7. Chagas' disease and the involvement of the autonomic nervous system.

    Science.gov (United States)

    da Cunha, Ademir Batista

    2003-06-01

    Chagas' disease is a major endemic disease in Latin America and a great cause for concern due to its high incidence: it afflicts 16 to 18 million individuals and places over 90 million people at risk of infection. At present, five mechanisms can be proposed to explain the pathogenesis of chronic Chagas cardiopathy: 1. direct lesion of the tissue by Trypanosoma cruzi; 2. dysfunction of the autonomic nervous system (neurogenic concept); 3. microvascular disease; 4. immunologic reaction; 5. alterations in the extracellular matrix. The neurogenic concept is the most attractive explanation for the pathogenesis of chronic Chagas cardiopathy through the involvement of the autonomic nervous system, an issue that has been prominent ever since Chagas first initiated research in the field. Köberle, in his pioneering studies on the role of the autonomic nervous system in Chagas patients in the 1950s, adopted the technique of neuron counts, whereby he registered a reduction in parasympathetic nerve cells, and thus considered Chagas cardiopathy a "parasympathetic reduction" with predominance of the sympathetic. In the 1960s, systematic studies on autonomic function, organized by Professor Dalmo Amorim, were initiated in the School of Medicine in Ribeirão Preto. Several aspects of cardiac autonomic control were later described independently by teams in Brazil (Ribeirão Preto and Brasília), Argentina (Cordoba) and Venezuela (Mérida). In general, the studies performed in Ribeirăo Preto by Amorim and Marin Neto and in Brasília by Junqueira Jr. reflected the functional involvement of the parasympathetic system, while the studies performed in Córdoba were linked with the view of cardiovascular sympathetic dysfunction. In Brazil, the involvement of the sympathetic system, with relation to the functional aspect of sympathetic denervation, is well characterized by Marin Neto through the assessment of heart rate using the tilt test in both Chagas and control groups. Further

  8. Autonomic nervous system function in Huntington's disease.

    Science.gov (United States)

    Andrich, J; Schmitz, T; Saft, C; Postert, T; Kraus, P; Epplen, J T; Przuntek, H; Agelink, M W

    2002-06-01

    To investigate whether Huntington's disease (HD) affects autonomic nervous system (ANS) functioning. Twenty patients with HD who had positive genetic test results underwent standardised ANS function tests including sympathetic skin responses (SSRs) of the hands and feet, measurements of heart rate variability (HRV), both during five minutes of resting and deep respiration, and an orthostatic blood pressure test. Patients were classified according to the motor subscale of the unified Huntington's disease rating scale (UHDRS; mean (SD) score 26.4 (13.6)) and divided into two subgroups: UHDRS or =25 points (mid stages, M-HD). Autonomic indices were compared with those obtained for a group of well matched healthy controls (n=60). Overall, patients showed lower HRV indices than controls. Multivariate analysis with the independent factor of "group" (controls, E-HD, M-HD) showed a significant group effect on both the high frequency power (F=4.32, p=0.017) and the coefficient of variation (F=4.23, p=0.018), indicating a significant reduction in vagal modulation in the M-HD group. There was a shift in autonomic neurocardiac balance towards sympathetic predominance in the M-HD group compared with controls (F=2.89, p=0.062). Moreover, we found an inverse correlation between the severity of clinical HD symptoms (assessed by the UHDRS) and the modulation of cardiovagal activity (p=0.028). Vagal dysregulation was present in two patients; one of them also showed a pathological blood pressure test and a latency prolongation in the SSRs of the hands. Two other patients had pathologically reduced SSR amplitudes. Only patients of the M-HD group were affected. Autonomic dysfunction is present even in the middle stages of HD and affects both the sympathetic and parasympathetic branch of the ANS.

  9. Neurogenic voiding dysfunction.

    Science.gov (United States)

    Georgopoulos, Petros; Apostolidis, Apostolos

    2017-05-01

    This review aims to analyze and discuss all recently published articles associated with neurogenic voiding discussion providing readers with the most updated knowledge and trigger for further research. They include the proposal of a novel classification system for the pathophysiology of neurogenic lower urinary tract dysfunction (NLUTD) which combines neurological defect in a distinct anatomic location, and data on bowel dysfunction, autonomic dysreflexia and urine biomarkers; review of patient-reported outcome measures in NLUTD; review of the criteria for the diagnosis of clinically significant urinary infections; novel research findings on the pathophysiology of NLUTD; and review of data on minimally and more invasive treatments. Despite the extended evidence base on NLUTD, there is a paucity of high-quality new research concerning voiding dysfunction as opposed to storage problems. The update aims to inform clinicians about new developments in clinical practice, as well as ignite discussion for further clinical and basic research in the aforementioned areas of NLUTD.

  10. Gastrointestinal dysfunction in idiopathic Parkinsonism: A narrative review

    Directory of Open Access Journals (Sweden)

    Mehri Salari

    2016-01-01

    Full Text Available Currently, gastrointestinal (GI dysfunctions in Parkinson's disease (PD are well-recognized problems and are known to be the initial symptoms in the pathological process that eventually results in PD. Many types of PD-associated GI dysfunctions have been identified, including weight loss, nausea, hypersalivation, dysphagia, dyspepsia, abdominal pain, intestinal pseudo-obstruction, constipation, defecatory dysfunction, and small intestinal bacterial overgrowth. These symptoms can influence on other PD symptoms and are the second most significant predictor of the quality of life of these patients. Recognition of GI symptoms requires vigilance on the part of clinicians. Health-care providers should routinely ask direct questions about GI symptoms during office visits so that efforts can be directed at appropriate management of these distressing manifestations. Multiple system atrophy (MSA and progressive supranuclear palsy are two forms of neurodegenerative Parkinsonism. Symptoms of autonomic dysfunctions such as GI dysfunction are common in patients with parkinsonian disorders. Despite recent progress in the recognition of GI dysfunctions, there are a few reviews on the management of GI dysfunction and GI symptoms in idiopathic Parkinsonism. In this review, the clinical presentation, pathophysiology, and treatment of each GI symptom in PD, MSA, and prostate-specific antigen will be discussed.

  11. Energy homeostasis, autonomic activity and obesity

    NARCIS (Netherlands)

    Scheurink, AJW; Balkan, B; Nyakas, C; vanDijk, G; Steffens, AB; Bohus, B

    1995-01-01

    Obesity is often accompanied by alterations in both sympathetic and parasympathetic autonomic functions. The present paper summarizes the results of a number of studies designed to investigate autonomic functioning in normal, genetically, and experimentally obese rats, Particular emphasis is given

  12. Autonomic symptoms in idiopathic REM behavior disorder

    DEFF Research Database (Denmark)

    Ferini-Strambi, Luigi; Oertel, Wolfgang; Dauvilliers, Yves

    2014-01-01

    to study the disorders of the autonomic nervous system in Parkinson's disease (PD) patients, the SCOPA-AUT, was administered to all the patients and controls. The SCOPA-AUT consists of 25 items assessing the following domains: gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor......Patients with idiopathic REM sleep behavior disorder (iRBD) are at very high risk of developing neurodegenerative synucleinopathies, which are disorders with prominent autonomic dysfunction. Several studies have documented autonomic dysfunction in iRBD, but large-scale assessment of autonomic...... symptoms has never been systematically performed. Patients with polysomnography-confirmed iRBD (318 cases) and controls (137 healthy volunteers and 181 sleep center controls with sleep diagnoses other than RBD) were recruited from 13 neurological centers in 10 countries from 2008 to 2011. A validated scale...

  13. Cardiovascular Autonomic Neuropathy in Systemic Lupus Erythematosus.

    Science.gov (United States)

    Alam, Md Mahboob; Das, Pinaki; Ghosh, Parasar; Zaman, Md Salim Uz; Boro, Madhusmita; Sadhu, Manika; Mazumdar, Ardhendu

    2015-01-01

    Objective is to evaluate cardiovascular autonomic function in SLE by simple non-invasive tests. A case control study was carried out involving 18-50 yrs old previously diagnosed SLE patients and same number of age and sex-matched controls. Parasympathetic function was assessed by heart rate (HR) response to Valsalva maneuver, deep breathing and standing. Sympathetic function was evaluated by blood pressure response to standing and sustained hand-grip test (HGT). There were 50 female SLE patients. They had significantly higher minimum resting HR and diastolic blood pressure (DBP). HR variation with deep breathing, expiratory inspiratory ratio, 30:15 ratio and DBP change in response to HGT were significantly lower inpatients compared to controls. Thirty patients (60%) had at least one abnormal or two borderline test results indicating autonomic impairment of which 27 had parasympathetic dysfunction and 7 had sympathetic dysfunction. Autonomic dysfunction is common in SLE with higher prevalence of parasympathetic impairment.

  14. Autonomic Function in Neurodegenerative Diseases

    DEFF Research Database (Denmark)

    Sørensen, Gertrud Laura; Jennum, Poul Jørgen

    2013-01-01

    the method by applying standardized methods to measure the autonomic function based on heart rate variability (HRV) measures. 3) Based on the results, assess the validity of autonomic dysfunction as an early marker of a neurodegenerative disease. 4) Evaluate the influence of hypocretin loss in narcolepsy...... areas, which is consistent with the Braak hypothesis. In the narcolepsy patients, it was shown that a reduced HRR to arousals was primarily predicted by hypocretin deficiency in both rapid-eye-movement (REM) and non-REM sleep, independent of cataplexy and other factors. The results confirm...... that hypocretin deficiency affects the autonomic nervous system of patients with narcolepsy and that the hypocretin system is important for proper heart rate modulation at rest.Furthermore, it was shown that hypocretin deficiency and cataplexy are associated with signs of destabilized sleep-wake and REM sleep...

  15. [Autonomic nervous system alteration in multiple sclerosis patients with urinary symptoms. Clinical, urodynamic and cardiovascular study].

    Science.gov (United States)

    Amarenco, G; Raibaut, P; Hubeaux, K; Jousse, M; Sheikh Ismaël, S; Lapeyre, E

    2013-12-01

    To assess symptoms related to autonomic nervous system alteration in a population of patients suffering from multiple sclerosis (MS) and presenting with urinary symptoms. We investigated 65 patients (mean age 47.5 years) suffering from MS, and presenting with urological dysfunction by means of symptom scores, urodynamic investigation, cardiovascular autonomic function tests (orthostatic hypotension testing, Valsalva test, deep breath test, cold pressor test) and sympathetic skin responses. Forty-five (69%) patients suffered from overactive bladder, 48 (73%) from voiding dysfunction, 14 (21%) from urinary retention and 13 (20%) from fecal incontinence. Urodynamic investigation demonstrated overactive detrusor in 46 (70%) cases, and underactive detrusor in four (6%) cases. Twenty-five (38%) patients had dysautonomia without correlation neither with clinical or urodynamic data, nor gravity of multiple sclerosis (EDSS). In this series, the prevalence of dysautonomia was high in patients suffering from MS and presenting with urinary disorders. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. Impact of yoga in a case of vocal cord dysfunction with dysautonomia

    Directory of Open Access Journals (Sweden)

    Rozina Wadhwania

    2017-01-01

    Full Text Available A 23-year-old female with a past medical history of gastroesophageal reflux disease presented with shortness of breath induced by exercise and certain odors. She reported the symptoms of autonomic dysfunction including fatigue, chest pain, lightheadedness, headaches, numbness/tingling in the arms and legs, and exercise intolerance. Vital signs were significant for orthostatic intolerance. Volume flow loop in the pulmonary function tests showed a flattening of the inspiratory portion characteristic of vocal cord dysfunction. Laryngoscopy showed dyskinesia of the left vocal cord, especially after exercise. Multifactorial approach was used including increased fluid intake and breathing exercises. After 6 weeks of breathing and isometric exercises, the patient reported improvement in dyspnea after exercise. This case report demonstrates the therapeutic role of breathing and isometric exercises in the management of vocal cord and autonomic dysfunction.

  17. Impact of yoga in a case of vocal cord dysfunction with dysautonomia.

    Science.gov (United States)

    Wadhwania, Rozina

    2017-01-01

    A 23-year-old female with a past medical history of gastroesophageal reflux disease presented with shortness of breath induced by exercise and certain odors. She reported the symptoms of autonomic dysfunction including fatigue, chest pain, lightheadedness, headaches, numbness/tingling in the arms and legs, and exercise intolerance. Vital signs were significant for orthostatic intolerance. Volume flow loop in the pulmonary function tests showed a flattening of the inspiratory portion characteristic of vocal cord dysfunction. Laryngoscopy showed dyskinesia of the left vocal cord, especially after exercise. Multifactorial approach was used including increased fluid intake and breathing exercises. After 6 weeks of breathing and isometric exercises, the patient reported improvement in dyspnea after exercise. This case report demonstrates the therapeutic role of breathing and isometric exercises in the management of vocal cord and autonomic dysfunction.

  18. Effects of hypothermia and rewarming on cardiovascular autonomic control in vivo.

    Science.gov (United States)

    Dietrichs, Erik Sveberg; Håheim, Brage; Kondratiev, Timofei; Traasdahl, Erik; Tveita, Torkjel

    2017-12-21

    Rewarming from accidental hypothermia is associated with cardiovascular dysfunction that complicates rewarming and contributes to a high mortality rate. We investigated autonomic cardiovascular control, as well as the separate effects of cooling, hypothermia and rewarming on hemodynamic function, aiming to provide knowledge of the pathophysiology causing such complications in these patients. A rat model designed for circulatory studies during cooling, hypothermia (15{degree sign}C) and rewarming was used. Spectral analysis of diastolic arterial pressure and heart rate allowed assessment of the autonomic nervous system. Hemodynamic variables were monitored using a conductance catheter in the left ventricle and a pressure transducer connected to the left femoral artery. Sympathetic cardiovascular control was reduced after rewarming. Stroke volume (SV) increased during cooling, but decreased during stable hypothermia and did not normalize during rewarming. Despite autonomic dysfunction, total peripheral resistance increased during cooling and did not normalize after rewarming. The present data show that sympathetic cardiovascular control is reduced by hypothermia and rewarming. A simultaneous systolic dysfunction is seen in rewarmed animals, caused by reduced filling of the left ventricle and impaired contractile function, in presence of normal diastolic function. These findings show that dysfunction of the efferent sympathetic nervous system could be instrumental in development of rewarming shock.

  19. Oral sildenafil (Viagra™ in male erectile dysfunction: use, efficacy and safety profile in an unselected cohort presenting to a British district general hospital.

    Directory of Open Access Journals (Sweden)

    Boustead Gregory

    2002-04-01

    Full Text Available Abstract Introduction Sildenafil (Viagra® is one of the drugs used in the first line therapy of male erectile dysfunction (MED. We have recorded outcomes, adverse events and acceptability of Sildenafil (Viagra therapy in an unselected group of men presenting with ED to a British district general hospital. Methods In this prospective observational study, 147 men with ED were seen since Oct 1999. Study patients were reviewed at 4, 12 and 52 weeks. All the patients filled the International Index of Erectile Function (IIEF questionnaire and were asked about their willingness to pay (WTP for treatment. Results All suitable men accepted Viagra as first line therapy. 91% of our patients found sildenafil treatment successful. 80% of these patients were willing to continue with sildenafil therapy. Side effect profile of sildenafil was different in this study with much higher incidence of headache, dyspepsia, flushing and abnormal vision. 92% of men with ED expect to be treated by the NHS. Of those men eligible for treatment in the NHS, 30% qualify under the clinical categories and 18% under the 'distress' category. Only 55% of those with cardiovascular risk factors qualify for NHS treatment. Conclusions Sildenafil is widely accepted as first line therapy among British men with ED and has a success rate of 91%. Nearly half of men with ED qualify for NHS treatment. Nearly half of those with vascular risk factors do not qualify for NHS treatment. Most men with ED could possibly be managed in primary care.

  20. Autonomic manifestations of epilepsy | Asindi | Nigerian Journal of ...

    African Journals Online (AJOL)

    Abstract: An epileptic fit does not only manifest as bizarre motor activity but can destabilize autonomic functions. Abnormal electrical discharge originating from the cerebral cortex can spreads to involve the autonomic system thus creating a dysfunction of the sympathetic and the parasympathetic which modulate the ...

  1. Autonomic reactivity in muscle pain : clinical and experimental assessment

    OpenAIRE

    Kalezic, Nebojsa

    2006-01-01

    There are numerous indications of possible involvement of the autonomic nervous system in the genesis of chronic pain. The possibility exists that sympathetic activation is related to motor dysfunction and changes in sensory processing, which have otherwise been implicated in musculoskeletal disorders. The primary aim of the thesis has been to investigate autonomic regulation at rest and in response to laboratory tests of autonomic function in subjects suffering from chronic pain in different...

  2. Sexual and urinary dysfunction following laparoscopic total mesorectal excision in male patients: A prospective study

    Directory of Open Access Journals (Sweden)

    Deepak George

    2018-01-01

    Full Text Available Aims: Even with the use of nerve-sparing techniques, there is a risk of bladder and sexual dysfunction after total mesorectal excision (TME. Laparoscopic TME is believed to improve this autonomic nerve dysfunction, but this is not demonstrated conclusively in the literature. In Indian patients generally, the stage at which the patients present is late and presumably the risk of autonomic nerve injury is more; however, there is no published data in this respect. Materials and Methods: This prospective study in male patients who underwent laparoscopic TME evaluated the bladder and sexual dysfunction using objective standardised scores, measuring residual urine and post-voided volume. The International Prostatic Symptom Score (IPSS and International Index of Erectile Function score were used respectively to assess the bladder and sexual dysfunction preoperatively at 1, 3, 6 months and at 1 year. Results: Mean age of the study group was 58 years. After laparoscopic TME in male patients, the moderate to severe bladder dysfunction (IPSS <8 is observed in 20.4% of patients at 3 months, and at mean follow-up of 9.2 months, it was seen only in 2.9%. There is more bladder and sexual dysfunction in low rectal tumours compared to mid-rectal tumours. At 3 months, 75% had sexual dysfunction, 55% at median follow-up of the group at 9.2 months. Conclusion: After laparoscopic TME, bladder dysfunction is seen in one-fifth of the patients, which recovers in the next 6 months to 1 year. Sexual dysfunction is observed in 75% of patients immediately after TME which improves to 55% over 9.2 months.

  3. Autonomic nervous system and lipid metabolism: findings in anxious-depressive spectrum and eating disorders.

    Science.gov (United States)

    Pistorio, Elisabetta; Luca, Maria; Luca, Antonina; Messina, Vincenzo; Calandra, Carmela

    2011-10-28

    To correlate lipid metabolism and autonomic dysfunction with anxious-depressive spectrum and eating disorders. To propose the lipid index (LI) as a new possible biomarker. 95 patients and 60 controls were enrolled from the University Psychiatry Unit of Catania and from general practitioners (GPs). The patients were divided into four pathological groups: Anxiety, Depression, Anxious-Depressive Disorder and Eating Disorders [Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) official/appendix criteria]. The levels of the cholesterol, triglycerides and apolipoproteins A and B were determined. The LI, for each subject, was obtained through a mathematical operation on the values of the cholesterol and triglycerides levels compared with the maximum cut-off of the general population. The autonomic functioning was tested with Ewing battery tests. Particularly, the correlation between heart rate variability (HRV) and lipid metabolism has been investigated. Pathological and control groups, compared among each other, presented some peculiarities in the lipid metabolism and the autonomic dysfunction scores. In addition, a statistically significant correlation has been found between HRV and lipid metabolism. Lipid metabolism and autonomic functioning seem to be related to the discussed psychiatric disorders. LI, in addition, could represent a new possible biomarker to be considered.

  4. Autonomic nervous system and lipid metabolism: findings in anxious-depressive spectrum and eating disorders

    Directory of Open Access Journals (Sweden)

    Messina Vincenzo

    2011-10-01

    Full Text Available Abstract Objective To correlate lipid metabolism and autonomic dysfunction with anxious-depressive spectrum and eating disorders. To propose the lipid index (LI as a new possible biomarker. Methods 95 patients and 60 controls were enrolled from the University Psychiatry Unit of Catania and from general practitioners (GPs. The patients were divided into four pathological groups: Anxiety, Depression, Anxious-Depressive Disorder and Eating Disorders [Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR official/appendix criteria]. The levels of the cholesterol, triglycerides and apolipoproteins A and B were determined. The LI, for each subject, was obtained through a mathematical operation on the values of the cholesterol and triglycerides levels compared with the maximum cut-off of the general population. The autonomic functioning was tested with Ewing battery tests. Particularly, the correlation between heart rate variability (HRV and lipid metabolism has been investigated. Results Pathological and control groups, compared among each other, presented some peculiarities in the lipid metabolism and the autonomic dysfunction scores. In addition, a statistically significant correlation has been found between HRV and lipid metabolism. Conclusions Lipid metabolism and autonomic functioning seem to be related to the discussed psychiatric disorders. LI, in addition, could represent a new possible biomarker to be considered.

  5. Impact of yoga in a case of vocal cord dysfunction with dysautonomia

    OpenAIRE

    Wadhwania, Rozina

    2017-01-01

    A 23-year-old female with a past medical history of gastroesophageal reflux disease presented with shortness of breath induced by exercise and certain odors. She reported the symptoms of autonomic dysfunction including fatigue, chest pain, lightheadedness, headaches, numbness/tingling in the arms and legs, and exercise intolerance. Vital signs were significant for orthostatic intolerance. Volume flow loop in the pulmonary function tests showed a flattening of the inspiratory portion character...

  6. Bowel Dysfunction

    Science.gov (United States)

    ... to PCF? Featured Fundraise for PCF: Many vs Cancer Contact Us Bowel Dysfunction The broad term of bowel dysfunction includes ... immodium) can be used to help with loose bowel movements. Increasing fiber intake through whole grains, ... mission 82% Join the fight against prostate ...

  7. A STUDY ON CARDIOVASCULAR AUTONOMIC FUNCTIONS IN CAREGIVERS OF STROKE PATIENTS

    Directory of Open Access Journals (Sweden)

    Ghouse Mubarak

    2017-08-01

    Full Text Available BACKGROUND Stroke (cerebrovascular accident is an important cause of disability in countries like India and longterm care of these bedridden patients is usually undertaken by the family members. A caregiver is a person who takes responsibility for those who cannot completely care for themselves. Taking care of a chronically ill member in the family usually causes stress to the caregiver causing disturbances in the autonomic function. Thus, the present study is undertaken to find out the effect of longterm caregiving on cardiovascular autonomic functions in a caregiver. MATERIALS AND METHODS 57 caregivers of post-stroke bedridden patients, both male and female, were included in this longitudinal study. Parasympathetic activity was assessed by observing the heart rate changes to immediate standing from lying down position, heart rate changes during deep breathing and heart rate changes during Valsalva manoeuvre. Sympathetic activity was assessed by observing blood pressure changes on immediate standing from lying down position and blood pressure changes during sustained hand grip. RESULTS The results of the present study showed statistically significant decrease in Valsalva ratio, decrease in the heart rate following deep breathing and statistically significant increase in systolic blood pressure in response to immediate standing suggestive of autonomic imbalance. CONCLUSION Our findings suggest that longterm caregiving is accompanied by dysfunction of the cardiac autonomic nervous system, and these individuals are more prone to autonomic neuropathy.

  8. Laryngeal Dysfunction: Assessment and Management for the Clinician.

    Science.gov (United States)

    Hull, James H; Backer, Vibeke; Gibson, Peter G; Fowler, Stephen J

    2016-11-01

    The larynx is one of the most highly innervated organs in humans and serves a number of vitally important, complex, and highly evolved biological functions. On a day-to-day basis, the larynx functions autonomously, addressing several roles including airway protection, swallowing, and phonation. In some situations the larynx appears to adopt a functional state that could be considered maladaptive or "dysfunctional." This laryngeal dysfunction can underpin and account for a number of respiratory symptoms that otherwise appear incongruous with a clinical disease state and/or contribute to the development of symptoms that appear "refractory" to treatment. These include conditions associated with a heightened tendency for inappropriate laryngeal closure (e.g., inducible laryngeal obstruction), voice disturbance, and chronic cough. Recognition of laryngeal dysfunction is important to deliver targeted treatment and failure to recognize the condition can lead to repeated use of inappropriate treatment. Diagnosis is not straightforward, however, and many patients appear to present with symptoms attributable to laryngeal dysfunction, but in whom the diagnosis has been overlooked in clinical work-up for some time. This review provides an overview of the current state of knowledge in the field of laryngeal dysfunction, with a focus on pragmatic clinical assessment and management.

  9. Evaluation of cardiac autonomic function in overweight males: A cross-sectional study

    OpenAIRE

    Debasish Das; Himel Mondal

    2017-01-01

    Background and Aim: Cardiovascular autonomic function tests (CAFTs) are non-invasive tests that can assess both sympathetic and parasympathetic autonomic functions. Autonomic dysfunction may be considered as a risk factor for obesity and vice versa. For measurement of obesity, body mass index (BMI) is a simple, valid and inexpensive method. Hence, this study was designed to evaluate the effect of obesity based on BMI criteria on autonomic nervous system based on CAFT in young adult males. Met...

  10. The Phantom in our opera - or the hidden ways of the autonomic nervous system in cardiac patients.

    Science.gov (United States)

    van Tellingen, C

    2004-11-01

    The role of the autonomic nervous system in the understanding of pathophysiological mechanisms in a variety of cardiovascular clinico-pathological conditions is highlighted from a clinician's point of view with the focus on coronary mimicry, enhanced sympathetic tone and syndrome X. A unique case is presented where sinus node dysfunction in pandysautonomia seemed to be an early sign of hypothalamic glioblastoma. In addition, relevant literature on this topic is addressed to put distinct clinical patterns into a broader perspective.

  11. Nature's Autonomous Oscillators

    Science.gov (United States)

    Mayr, H. G.; Yee, J.-H.; Mayr, M.; Schnetzler, R.

    2012-01-01

    Nonlinearity is required to produce autonomous oscillations without external time dependent source, and an example is the pendulum clock. The escapement mechanism of the clock imparts an impulse for each swing direction, which keeps the pendulum oscillating at the resonance frequency. Among nature's observed autonomous oscillators, examples are the quasi-biennial oscillation and bimonthly oscillation of the Earth atmosphere, and the 22-year solar oscillation. The oscillations have been simulated in numerical models without external time dependent source, and in Section 2 we summarize the results. Specifically, we shall discuss the nonlinearities that are involved in generating the oscillations, and the processes that produce the periodicities. In biology, insects have flight muscles, which function autonomously with wing frequencies that far exceed the animals' neural capacity; Stretch-activation of muscle contraction is the mechanism that produces the high frequency oscillation of insect flight, discussed in Section 3. The same mechanism is also invoked to explain the functioning of the cardiac muscle. In Section 4, we present a tutorial review of the cardio-vascular system, heart anatomy, and muscle cell physiology, leading up to Starling's Law of the Heart, which supports our notion that the human heart is also a nonlinear oscillator. In Section 5, we offer a broad perspective of the tenuous links between the fluid dynamical oscillators and the human heart physiology.

  12. When do the symptoms of autonomic nervous system malfunction appear in patients with Parkinson's disease?

    Science.gov (United States)

    De Luka, Silvio R; Svetel, Marina; Pekmezović, Tatjana; Milovanović, Branislav; Kostić, Vladimir S

    2014-04-01

    Dysautonomia appears in almost all patients with Parkinson's disease (PD) in a certain stage of their condition. The aim of our study was to detect the development and type of autonomic disorders, find out the factors affecting their manifestation by analyzing the potential association with demographic variables related to clinical presentation, as well as the symptoms of the disease in a PD patient cohort. The patients with PD treated at the Clinic of Neurology in Belgrade during a 2-year period, divided into 3 groups were studied: 25 de novo patients, 25 patients already treated and had no long-term levodopa therapy-related complications and 22 patients treated with levodopa who manifested levodopa-induced motor complications. Simultaneously, 35 healthy control subjects, matched by age and sex, were also analyzed. Autonomic nervous system malfunction was defined by Ewing diagnostic criteria. The tests, indicators of sympathetic and parasympathetic nervous systems, were significantly different in the PD patients as compared with the controls, suggesting the failure of both systems. However, it was shown, in the selected groups of patients, that the malfunction of both systems was present in two treated groups of PD patients, while de novo group manifested only sympathetic dysfunction. For this reason, the complete autonomic neuropathy was diagnosed only in the treated PD patients, while de novo patients were defined as those with the isolated sympathetic dysfunction. The patients with the complete autonomic neuropathy differed from the subjects without such neuropathy in higher cumulative and motor unified Parkinson's disease rating score (UPDRS) (p nervous system disturbances among PD patients from the near onset of disease, with a predominant sympathetic nervous system involvement. The patients who developed complete autonomic neuropathy (both sympathetic and parasympathetic) were individuals with considerable level of functional failure, more severe clinical

  13. Vocal cord dysfunction.

    Science.gov (United States)

    Deckert, James; Deckert, Linda

    2010-01-15

    Vocal cord dysfunction involves inappropriate vocal cord motion that produces partial airway obstruction. Patients may present with respiratory distress that is often mistakenly diagnosed as asthma. Exercise, psychological conditions, airborne irritants, rhinosinusitis, gastroesophageal reflux disease, or use of certain medications may trigger vocal cord dysfunction. The differential diagnosis includes asthma, angioedema, vocal cord tumors, and vocal cord paralysis. Pulmonary function testing with a flow-volume loop and flexible laryngoscopy are valuable diagnostic tests for confirming vocal cord dysfunction. Treatment of acute episodes includes reassurance, breathing instruction, and use of a helium and oxygen mixture (heliox). Long-term management strategies include treatment for symptom triggers and speech therapy.

  14. Cerebral amyloid angiopathy-related inflammation presenting with steroid-responsive higher brain dysfunction: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Maeda Yasushi

    2011-09-01

    Full Text Available Abstract A 56-year-old man noticed discomfort in his left lower limb, followed by convulsion and numbness in the same area. Magnetic resonance imaging (MRI showed white matter lesions in the right parietal lobe accompanied by leptomeningeal or leptomeningeal and cortical post-contrast enhancement along the parietal sulci. The patient also exhibited higher brain dysfunction corresponding with the lesions on MRI. Histological pathology disclosed β-amyloid in the blood vessels and perivascular inflammation, which highlights the diagnosis of cerebral amyloid angiopathy (CAA-related inflammation. Pulse steroid therapy was so effective that clinical and radiological findings immediately improved. CAA-related inflammation is a rare disease, defined by the deposition of amyloid proteins within the leptomeningeal and cortical arteries associated with vasculitis or perivasculitis. Here we report a patient with CAA-related inflammation who showed higher brain dysfunction that improved with steroid therapy. In cases with atypical radiological lesions like our case, cerebral biopsy with histological confirmation remains necessary for an accurate diagnosis.

  15. Erectile Dysfunction

    Science.gov (United States)

    ... rigid. Medications The oral medications for erectile dysfunction, sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), relax the muscles ... to begin working; the erection helping effects of sildenafil and vardenafil last for about 8 hours and ...

  16. Implementing a Cloud Platform for Autonomous Driving

    OpenAIRE

    Liu, Shaoshan; Tang, Jie; Wang, Chao; Wang, Quan; Gaudiot, Jean-Luc

    2017-01-01

    Autonomous driving clouds provide essential services to support autonomous vehicles. Today these services include but not limited to distributed simulation tests for new algorithm deployment, offline deep learning model training, and High-Definition (HD) map generation. These services require infrastructure support including distributed computing, distributed storage, as well as heterogeneous computing. In this paper, we present the details of how we implement a unified autonomous driving clo...

  17. Laryngeal Dysfunction

    DEFF Research Database (Denmark)

    Hull, James H; Backer, Vibeke; Gibson, Peter G

    2016-01-01

    The larynx is one of the most highly innervated organs in humans and serves a number of vitally important, complex, and highly evolved biological functions. On a day-to-day basis, the larynx functions autonomously, addressing several roles including airway protection, swallowing, and phonation...

  18. [Autonomic peripheral neuropathy].

    Science.gov (United States)

    Adams, David; Cauquil, Cecile; Lozeron, Pierre

    2012-11-01

    The mechanisms of dysautonomic disturbances are varied and mostly acquired. They can result from lesions of sympathetic or parasympathetic vegetative fibers located in the peripheral contingent, or in the somatic contingent by demyelination or axonal loss; or more rarely by cellular bodies in the sympathetic or parasympathetic ganglia. Several chronic peripheral neuropathies can be associated with dysautonomia. Only some causes need to be known because they can be clinically significant. Dysautonomia may be seen during chronic acquired neuropathies but also acute or subacute ones. The most frequent cause in the world is the dysautonomia of the diabetes; it affects all the systems; the cardiovascular dysfunction has an impact on the prognosis for survival when it is severe. Hereditary autonomic neuropathies are rare; they can declare themselves very early during the Riley-Day syndrome or very late during amyloid polyneuropathies due to transthyretin gene mutation. The diagnosis can be confirmed by molecular biology. The dysautonomia is frequent and often severe. These neuropathies justify symptomatic treatment to improve quality of life. For some of them, a specific treatment can be proposed to treat the causal affection to try to stop the progression of the disease. Copyright © 2012. Published by Elsevier Masson SAS.

  19. Evaluating the autonomic nervous system in patients with laryngopharyngeal reflux.

    Science.gov (United States)

    Huang, Wan-Ju; Shu, Chih-Hung; Chou, Kun-Ta; Wang, Yi-Fen; Hsu, Yen-Bin; Ho, Ching-Yin; Lan, Ming-Ying

    2013-06-01

    The pathogenesis of laryngopharyngeal reflux (LPR) remains unclear. It is linked to but distinct from gastroesophageal reflux disease (GERD), which has been shown to be related to disturbed autonomic regulation. The aim of this study is to investigate whether autonomic dysfunction also plays a role in the pathogenesis of LPR. Case-control study. Tertiary care center. Seventeen patients with LPR and 19 healthy controls, aged between 19 and 50 years, were enrolled in the study. The patients were diagnosed with LPR if they had a reflux symptom index (RSI) ≥ 13 and a reflux finding score (RFS) ≥ 7. Spectral analysis of heart rate variability (HRV) analysis was used to assess autonomic function. Anxiety and depression levels measured by the Beck Anxiety Inventory (BAI) and Beck Depression Inventory II (BDI-II) were also conducted. In HRV analysis, high frequency (HF) represents the parasympathetic activity of the autonomic nervous system, whereas low frequency (LF) represents the total autonomic activity. There were no significant differences in the LF power and HF power between the 2 groups. However, significantly lower HF% (P = .003) and a higher LF/HF ratio (P = .012) were found in patients with LPR, who demonstrated poor autonomic modulation and higher sympathetic activity. Anxiety was also frequently observed in the patient group. The study suggests that autonomic dysfunction seems to be involved in the pathogenesis of LPR. The potential beneficial effect of autonomic nervous system modulation as a therapeutic modality for LPR merits further investigation.

  20. Chronic pelvic floor dysfunction.

    Science.gov (United States)

    Hartmann, Dee; Sarton, Julie

    2014-10-01

    The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. HIV and thyroid dysfunction.

    Science.gov (United States)

    Parsa, Alan A; Bhangoo, Amrit

    2013-06-01

    Human Immunodeficiency virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS) are associated with dysfunction of many endocrine organs and their axis. HIV infectivity leads to altered metabolism, poor oral intake and increased prevalence of weight loss and wasting which may have a role in thyroid dysfunction. Overt thyroid dysfunction occurs at similar rates as the general population while subclinical disease such as nonthyroidal illness (sick euthyroid syndrome), subclinical hypothyroidism and isolated low T4 levels are more frequent. Moreover, HAART therapy can complicate thyroid function further through drug interactions and the immune reconstitution inflammatory syndrome (IRIS). In this review we report the common thyroid dysfunctions associated with HIV before and after HAART therapy. We discuss presentation, diagnostic work up, treatment and follow up in each condition.

  2. [Neurology and the bladder: how to assess and manage neurogenic bladder dysfunction. With particular references to neural control of micturition].

    Science.gov (United States)

    Sakakibara, Ryuji; Kishi, Masahiko; Tsuyusaki, Yohei; Tateno, Fuyuki; Uchiyama, Tomoyuki; Yamamoto, Tatsuya

    2013-01-01

    Bladder dysfunctions are one of the most common features seen in the failure of the autonomic nervous system. Among those, overactive bladder (urinary urgency and frequency) worsens quality of life of the patients, and a large amount of post-voiding residual urine or urinary retention causes urinary tract infection, kidney dysfunction, and may bring renal failure. In the present paper we discussed neural control of micturition and how to assess it. Also, we proposed appropriate management of bladder dysfunction in elderly white matter lesions (a common cause of OAB) and diabetic neuropathy (a usual pathology underlying urinary retention). For OAB, anti-cholinergics are the mainstay, whereas for the pathological post-voiding residual urine or urinary retention, alpha-blockers, cholinergic agents and clean, intermittent self-catheterization are the choice. Treatment of bladder dysfunctions is the important target for maximizing patients' quality of life.

  3. Menopause and autonomic control of heart

    OpenAIRE

    Arunima Chaudhuri; Nirmala G Borade

    2012-01-01

    Menopause is associated with decreased heart rate variability, which is due to reduced parasympathetic or increased sympathetic outflow to the heart. Acute myocardial infarction may be accompanied by decreased heart rate variability. The causes of autonomic dysfunction in postmenopausal women may be multi-factorial i.e., dyslipidemia, increased body fat percentage, aging and loss of female sex hormones. The cardiac vagotonic and sympatholytic effects of estrogen can explain, at least in part,...

  4. Erectile Dysfunction

    Science.gov (United States)

    ... cut out alcohol. Excess alcohol can contribute to erectile dysfunction. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for men older than age 65, and up to two drinks ...

  5. Endothelial dysfunction

    OpenAIRE

    Yaylalı, Yalın Tolga; Küçükaslan, Mete

    2011-01-01

    Endothelium is a multi-functional cluster of cells within the vascular system consisting of a single layer ofsquamous epithelium. Physiologically, endothelium performs various arrangement and protection functions.However, when these functions are disturbed toward derangement, endothelium also mediates pathologicalfunctions with negative effects on the body. Endothelial dysfunction is mediated by several mediators (nitricoxide, endothelins, prostaglandins, angiotensin 2, etc). Endothelial dysf...

  6. The Bering Autonomous Target Detection

    DEFF Research Database (Denmark)

    Jørgensen, John Leif; Denver, Troelz; Betto, Maurizio

    2003-01-01

    An autonomous asteroid target detection and tracking method has been developed. The method features near omnidirectionality and focus on high speed operations and completeness of search of the near space rather than the traditional faint object search methods, employed presently at the larger...... telescopes. The method has proven robust in operation and is well suited for use onboard spacecraft. As development target for the method and the associated instrumentation the asteroid research mission Bering has been used. Onboard a spacecraft, the autonomous detection is centered around the fully...

  7. Autonomic Nervous System in Paralympic Athletes with Spinal Cord Injury.

    Science.gov (United States)

    Walter, Matthias; Krassioukov, Andrei V

    2018-05-01

    Individuals sustaining a spinal cord injury (SCI) frequently suffer from sensorimotor and autonomic impairment. Damage to the autonomic nervous system results in cardiovascular, respiratory, bladder, bowel, and sexual dysfunctions, as well as temperature dysregulation. These complications not only impede quality of life, but also affect athletic performance of individuals with SCI. This article summarizes existing evidence on how damage to the spinal cord affects the autonomic nervous system and impacts the performance in athletes with SCI. Also discussed are frequently used performance-enhancing strategies, with a special focus on their legal aspect and implication on the athletes' health. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Effects of glucose ingestion on autonomic and cardiovascular measures during rest and mental challenge

    NARCIS (Netherlands)

    Synowski, S.J.; Kop, W.J.; Warwick, Z.S.; Waldstein, S.R.

    2013-01-01

    Background High levels of dietary sugar consumption may result in dysregulated glucose metabolism and lead to elevated cardiovascular disease risk via autonomic nervous system and cardiovascular dysfunction. Altered cardiovascular function can be examined using perturbation tasks such as mental

  9. Na+/K+-ATPase is present in scrapie-associated fibrils, modulates PrP misfolding in vitro and links PrP function and dysfunction.

    Directory of Open Access Journals (Sweden)

    James F Graham

    a key link between PrP function, dysfunction and misfolding.

  10. Simulation of Aircraft Sortie Generation Under an Autonomic Logistics System

    Science.gov (United States)

    2016-12-01

    kind of on-board artificial autonomic nervous system which is vital for AL operations. Through the use of intelligent reasoners, PHM detects, isolates...SIMULATION OF AIRCRAFT SORTIE GENERATION UNDER AN AUTONOMIC LOGISTICS SYSTEM THESIS Gunduz...Government. AFIT-ENS-MS-16-D-052 SIMULATION OF AIRCRAFT SORTIE GENERATION UNDER AN AUTONOMIC LOGISTICS SYSTEM THESIS Presented to

  11. Bladder, Bowel, and Sexual Dysfunction in Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Ryuji Sakakibara

    2011-01-01

    Full Text Available Bladder dysfunction (urinary urgency/frequency, bowel dysfunction (constipation, and sexual dysfunction (erectile dysfunction (also called “pelvic organ” dysfunctions are common nonmotor disorders in Parkinson's disease (PD. In contrast to motor disorders, pelvic organ autonomic dysfunctions are often nonresponsive to levodopa treatment. The brain pathology causing the bladder dysfunction (appearance of overactivity involves an altered dopamine-basal ganglia circuit, which normally suppresses the micturition reflex. By contrast, peripheral myenteric pathology causing slowed colonic transit (loss of rectal contractions and central pathology causing weak strain and paradoxical anal sphincter contraction on defecation (PSD, also called as anismus are responsible for the bowel dysfunction. In addition, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. The pathophysiology of the pelvic organ dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in differential diagnosis. Anticholinergic agents are used to treat bladder dysfunction in PD, although these drugs should be used with caution particularly in elderly patients who have cognitive decline. Dietary fibers, laxatives, and “prokinetic” drugs such as serotonergic agonists are used to treat bowel dysfunction in PD. Phosphodiesterase inhibitors are used to treat sexual dysfunction in PD. These treatments might be beneficial in maximizing the patients' quality of life.

  12. Development of a Commercially Viable, Modular Autonomous Robotic Systems for Converting any Vehicle to Autonomous Control

    Science.gov (United States)

    Parish, David W.; Grabbe, Robert D.; Marzwell, Neville I.

    1994-01-01

    A Modular Autonomous Robotic System (MARS), consisting of a modular autonomous vehicle control system that can be retrofit on to any vehicle to convert it to autonomous control and support a modular payload for multiple applications is being developed. The MARS design is scalable, reconfigurable, and cost effective due to the use of modern open system architecture design methodologies, including serial control bus technology to simplify system wiring and enhance scalability. The design is augmented with modular, object oriented (C++) software implementing a hierarchy of five levels of control including teleoperated, continuous guidepath following, periodic guidepath following, absolute position autonomous navigation, and relative position autonomous navigation. The present effort is focused on producing a system that is commercially viable for routine autonomous patrolling of known, semistructured environments, like environmental monitoring of chemical and petroleum refineries, exterior physical security and surveillance, perimeter patrolling, and intrafacility transport applications.

  13. Effect of exercise training and detraining in autonomic modulation and cardiorespiratory fitness in breast cancer survivors.

    Science.gov (United States)

    Dias Reis, Andréa; Silva Garcia, João B; Rodrigues Diniz, Renata; Silva-Filho, Antonio C; Dias, Carlos J; Leite, Richard D; Mostarda, Cristiano

    2017-01-01

    Breast cancer is one of the leading causes of death worldwide. Heart rate variability (HRV) has attracted scientific community attention in different pathologies, becoming thus an ultimate importance tool in both clinical and research setting, being a good predictor of cardiac events and mortality risk and also used in physical exercise and sports in general. The aim of the present study was to evaluate 12 weeks of exercise training and six weeks of detraining in cardiorespiratory capacity, and autonomic modulation in breast cancer patients. The sample was composed of 18 females (9 controls and 9 exercised), (aged 30-60 years). The HRV in the time and frequency domain was performed using an electrocardiogram before, after 12 weeks of the session of exercise training and after six weeks of detraining. Shapiro-Wilk and Mann-Whitney tests were made. No significant changes in time domain were found. In the frequency domain, 12 weeks of exercise training promote a decrease in LF (nu) and decrease in HF (nu) Index. The exercise training period promoted a decrease in LF/HF. The autonomic data returned to baseline levels after the detraining period. However, cardiorespiratory capacity remained increased after the detraining period. These data demonstrated that exercise training can be used to prevent autonomic dysfunction in breast cancer patients, but detraining promotes loss of all autonomic benefits.

  14. Autonomic stress reactivity and craving in individuals with problematic Internet use.

    Science.gov (United States)

    Moretta, Tania; Buodo, Giulia

    2018-01-01

    The link between autonomic stress reactivity and subjective urge/craving has been less systematically examined in behavioral addictions (i.e. problematic Internet use) than in substance use disorders. The present study investigated whether problematic Internet users (PU) show enhanced autonomic stress reactivity than non-PU, indexed by lower Heart Rate Variability (HRV) and higher Skin Conductance Level (SCL) reactivity during the Trier Social Stress Test (TSST), whether greater reactivity is related to stronger Internet craving, and whether problematic Internet usage is associated with some dysfunctional psychological features. Based on their Internet Addiction Test scores, participants were divided into PU (N = 24) and non-PU (N = 21). Their heart rate and skin conductance were continuously recorded during baseline, social stressors, and recovery. Craving for Internet usage were collected using a Likert scale before and after the TSST. The SDNN, an overall measure of HRV, was significantly lower in PU than non-PU during baseline, but not during and after stressful task. Furthermore, only among PU a significant negative correlation emerged between SDNN during recovery and craving ratings after the test. No group differences emerged for SCL. Lastly, PU endorsed more mood, obsessive-compulsive, and alcohol-related problems. Our findings suggest that problems in controlling one's use of the Internet may be related to reduced autonomic balance at rest. Moreover, our results provide new insights into the characterization of craving in PIU, indicating the existence of a relationship between craving for Internet usage and reduced autonomic flexibility.

  15. Low intensity resistance training improves systolic function and cardiovascular autonomic control in diabetic rats.

    Science.gov (United States)

    Mostarda, Cristiano T; Rodrigues, Bruno; de Moraes, Oscar Albuquerque; Moraes-Silva, Ivana C; Arruda, Paula Barros Olinto; Cardoso, Ruymar; Scapini, Katia Bilhar; Dos Santos, Fernando; De Angelis, Kátia; Irigoyen, Maria Cláudia

    2014-01-01

    We evaluated the effects of low intensity resistance training (RT) on left ventricular (LV) function, baroreflex sensitivity (BRS), and cardiovascular autonomic control of streptozotocin-induced diabetic rats. Male Wistar rats were divided into (n=8 each group): sedentary control (SC), trained control (TC), sedentary diabetic (SD), and trained diabetic (TD). Trained groups underwent low intensity RT (40%-50% 1 repetition maximum) for 10 weeks. Echocardiographic evaluation, arterial pressure (AP), heart rate (HR), BRS, and autonomic measurements were performed. Diabetes induced an increase in glycemia and a reduction in body weight in diabetics when compared with control animals. Diabetic rats displayed cardiac dysfunction, reduced systolic AP and HR, impaired BRS and autonomic derangement when compared to control rats. RT improved ejection fraction (SD: 68%±1.3% vs. TD: 75%±3.0%) and velocity of circumferential fiber shortening (SD: 0.32±0.02 vs. TD: 0.40±0.01 circ/seg.10(-4)). Trained diabetic rats presented increased AP (+10.2%), HR (+10.4%), and BRS after RT protocol. Low intensity RT induced an increase in systolic function in diabetic rats. This may be due to positive LV remodeling and BRS improvement, which may have played an important role in the attenuation of hemodynamic impairment and cardiac autonomic neuropathy in streptozotocin-diabetic rats. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Intelligent autonomous systems 12. Vol. 2. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sukhan [Sungkyunkwan Univ., Gyeonggi-Do (Korea, Republic of). College of Information and Communication Engineering; Yoon, Kwang-Joon [Konkuk Univ., Seoul (Korea, Republic of); Cho, Hyungsuck [Daegu Gyeongbuk Institute of Science and Technology, Daegu (Korea, Republic of); Lee, Jangmyung (eds.) [Pusan National Univ. (Korea, Republic of). Dept. of Electronics Engineering

    2013-02-01

    Recent research in Intelligent and Autonomous Systems. Volume 2 of the proceedings of the 12th International Conference IAS-12, held June 26-29, 2012, jeju Island, Korea. Written by leading experts in the field. Intelligent autonomous systems are emerged as a key enabler for the creation of a new paradigm of services to humankind, as seen by the recent advancement of autonomous cars licensed for driving in our streets, of unmanned aerial and underwater vehicles carrying out hazardous tasks on-site, and of space robots engaged in scientific as well as operational missions, to list only a few. This book aims at serving the researchers and practitioners in related fields with a timely dissemination of the recent progress on intelligent autonomous systems, based on a collection of papers presented at the 12th International Conference on Intelligent Autonomous Systems, held in Jeju, Korea, June 26-29, 2012. With the theme of ''Intelligence and Autonomy for the Service to Humankind, the conference has covered such diverse areas as autonomous ground, aerial, and underwater vehicles, intelligent transportation systems, personal/domestic service robots, professional service robots for surgery/rehabilitation, rescue/security and space applications, and intelligent autonomous systems for manufacturing and healthcare. This volume 2 includes contributions devoted to Service Robotics and Human-Robot Interaction and Autonomous Multi-Agent Systems and Life Engineering.

  17. Autonomous Mission Operations

    Data.gov (United States)

    National Aeronautics and Space Administration — The AES Autonomous Mission Operations project will develop understanding of the impacts of increasing communication time delays on mission operations and develop...

  18. Sexual dysfunction associated with infertility'

    African Journals Online (AJOL)

    1989-07-15

    Jul 15, 1989 ... In the present study 50% of women had a statistically increased incidence of sexual dysfunction during the fertile phase compared with the non-fertile phase. Loss of libido was found to be the most common dysfunction in 45% either alone or in combination with a decreased frequency of orgasm in.

  19. Client attributions for sexual dysfunction.

    Science.gov (United States)

    Fichten, C S; Spector, I; Libman, E

    1988-01-01

    This investigation examined attributions for sexual dysfunctions made by 63 individuals and 21 of their partners who presented at a sex therapy service for the following problems: erectile dysfunction, premature ejaculation, and female orgasmic dysfunctions. All participants completed measures of marital adjustment, locus of control, depression and a questionnaire which assessed: attributions of responsibility for the sexual problem, perceived control over sexual functioning, distress, effort made to improve the sexual relationship, and expectations about the efficacy of sex therapy for the problem. Results indicate that both identified patients and their partners, regardless of the dysfunction, blamed the sexual problem on the "dysfunctional individual" rather than on the circumstances or the partner. With respect to the partners, husbands of women with orgasmic dysfunction were more likely to blame themselves than the circumstances, while the opposite was true for wives of males with erectile difficulties. Individuals experiencing the dysfunction perceived themselves and their partners as having little, but equal control over the identified patient's sexuality. Correlational analyses indicate that in identified patients, the better the quality of the marital relationship, the greater the self-blame and the lower the partner blame. Those with happy marriages also made greater efforts to improve their sexual relationship and had higher expectations of success with therapy. The implications of the results for research on the role of attributions in sexual dysfunction and for assessment of cognitive factors in sexually dysfunctional individuals and their partners is discussed.

  20. Autonomous component carrier selection

    DEFF Research Database (Denmark)

    Garcia, Luis Guilherme Uzeda; Pedersen, Klaus; Mogensen, Preben

    2009-01-01

    management and efficient system operation. Due to the expected large number of user-deployed cells, centralized network planning becomes unpractical and new scalable alternatives must be sought. In this article, we propose a fully distributed and scalable solution to the interference management problem......Low-power base stations such as e.g. Femto-cells are one of the candidates for high data rate provisioning in local areas, such as residences, apartment complexes, business offices and outdoor hotspot scenarios. Unfortunately, the benefits are not without new challenges in terms of interference...... in local areas, basing our study case on LTE-Advanced. We present extensive network simulation results to demonstrate that a simple and robust interference management scheme, called autonomous component carrier selection allows each cell to select the most attractive frequency configuration; improving...

  1. [The role of enteral oxygen-therapy in the correction of functional disturbances in the autonomic nervous system of the children presenting with chronic diseases of the respiratory organs].

    Science.gov (United States)

    Konova, O M; Namazova-Baranova, L S; Dmitrienko, E G; Davydova, I V

    2014-01-01

    Vegetative dysfunction is observed in 60-90% of the children presenting with chronic respiratory diseases. Its timely identification and correction increases the effectiveness of the combined rehabilitative treatment of such patients. The vegetative regulation was dynamically evaluated by the analysis of the heart rate variability in 95 patients presenting with bronchial asthma and chronic nonspecific lung diseases. The age of the patients varied from 7 to 16 years. Sixty children received the combined treatment including enteral oxygen therapy, the control group was comprised of 35 patients. The enteral oxygen therapy eliminated the vegetative disbalance in 80.0% of the children with bronchial asthma and in 88,0% of those suffering from chronic nonspecific lung diseases. The results of the spectral analysis of heart rate variability indicate that the total spectrum power (TSP) was significantly increased in the patients of the study group. This effect was accompanied by the restructuring of wave frequency ranges pointing out to the enhancement of the activity of the sympathetic-adrenal system. The integral index of adaptive reserves (AR) increased from 2.0±0,6 to 4.7±0,6 points (p0.05). More manifest pronounced positive dynamics was observed in the patients presenting with initial vagotonia and the severe or moderate form of the disease. The present study has demonstrated the favourable influence of enteral oxygen therapy on the vegetative regulation mechanisms and the adaptive potential of the organism. Analysis of the heart rate variability may be a screening method for the evaluation of the effectiveness of the proposed therapeutic modality.

  2. Semi-Autonomous Systems Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — VisionThe Semi-Autonomous Systems Lab focuses on developing a comprehensive framework for semi-autonomous coordination of networked robotic systems. Semi-autonomous...

  3. Executive Dysfunction

    Science.gov (United States)

    Rabinovici, Gil D.; Stephens, Melanie L.; Possin, Katherine L.

    2015-01-01

    Purpose of Review: Executive functions represent a constellation of cognitive abilities that drive goal-oriented behavior and are critical to the ability to adapt to an ever-changing world. This article provides a clinically oriented approach to classifying, localizing, diagnosing, and treating disorders of executive function, which are pervasive in clinical practice. Recent Findings: Executive functions can be split into four distinct components: working memory, inhibition, set shifting, and fluency. These components may be differentially affected in individual patients and act together to guide higher-order cognitive constructs such as planning and organization. Specific bedside and neuropsychological tests can be applied to evaluate components of executive function. While dysexecutive syndromes were first described in patients with frontal lesions, intact executive functioning relies on distributed neural networks that include not only the prefrontal cortex, but also the parietal cortex, basal ganglia, thalamus, and cerebellum. Executive dysfunction arises from injury to any of these regions, their white matter connections, or neurotransmitter systems. Dysexecutive symptoms therefore occur in most neurodegenerative diseases and in many other neurologic, psychiatric, and systemic illnesses. Management approaches are patient specific and should focus on treatment of the underlying cause in parallel with maximizing patient function and safety via occupational therapy and rehabilitation. Summary: Executive dysfunction is extremely common in patients with neurologic disorders. Diagnosis and treatment hinge on familiarity with the clinical components and neuroanatomic correlates of these complex, high-order cognitive processes. PMID:26039846

  4. The psychological profile of women presenting to a multidisciplinary clinic for chronic pelvic pain: high levels of psychological dysfunction and implications for practice.

    Science.gov (United States)

    Bryant, Christina; Cockburn, Rebecca; Plante, Anne-Florence; Chia, Angela

    2016-01-01

    Chronic pelvic pain (CPP) is widely acknowledged as a common problem with significant consequences for those diagnosed with this condition. There is a lack of studies with good sample size that provide a comprehensive psychological profile of women presenting to specialist chronic pain clinics. Therefore, the objective of this study was to describe the psychological profile of a representative sample of women presenting with CPP at a tertiary referral center. This was a cross-sectional study. Women were asked to complete a questionnaire assessing symptoms of anxiety and depression, pain severity and interference, pain self-efficacy and catastrophizing beliefs, and sexual functioning. One-hundred and seventy-five women with CPP were recruited when they attended their initial assessment at a specialist CPP clinic of the Royal Women's Hospital, a public hospital in Melbourne, Australia. Over 75% of the participants had experienced pain for longer than 2 years. Fifty-three percent of women experienced either moderate or severe anxiety, and 26.7% experienced moderate-to-severe depression. There were strong correlations between depressive symptoms and pain interference, pain catastrophizing and self-efficacy beliefs. Our findings confirm previous evidence for high levels of psychological distress and functional impairment associated with this condition, and extend these findings by including measures that are highly relevant to treatment planning, such as thinking styles and pain self-efficacy. Therefore, treatment of this complex condition needs to be holistic, and a multidisciplinary approach is likely to be the best way to achieve this.

  5. Testing for autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J

    1984-01-01

    of the disease, and may be nonspecific. A number of recently developed quantifiable and reproducible autonomic nerve function tests are reviewed, with emphasis on the physiological basis of the tests and on practical applicability. Finally, diagnostic criteria, based on autonomic nerve function tests...

  6. Effects of Deep Brain Stimulation on Autonomic Function

    Directory of Open Access Journals (Sweden)

    Adam Basiago

    2016-08-01

    Full Text Available Over the course of the development of deep brain stimulation (DBS into a well-established therapy for Parkinson’s disease, essential tremor, and dystonia, its utility as a potential treatment for autonomic dysfunction has emerged. Dysfunction of autonomic processes is common in neurological diseases. Depending on the specific target in the brain, DBS has been shown to raise or lower blood pressure, normalize the baroreflex, to alter the caliber of bronchioles, and eliminate hyperhidrosis, all through modulation of the sympathetic nervous system. It has also been shown to improve cortical control of the bladder, directly induce or inhibit the micturition reflex, and to improve deglutition and gastric emptying. In this review, we will attempt to summarize the relevant available studies describing these effects of DBS on autonomic function, which vary greatly in character and magnitude with respect to stimulation target.

  7. Research of autonomous landing control of unmanned combat air vehicle

    Science.gov (United States)

    Li, Shaoyan; Chen, Zongji

    2003-09-01

    This paper is to present a robust controller design method for developing autonomous landing systems of Unmanned Combat Air Vehicle (UCAV). We first analyze the characteristic of autonomous landing of UCAV, and put forward its landing performance specifications. Structure singular value μ| synthesis is used to develop autonomous landing systems to accurately follow the pre-designed ideal landing track or online generated optimal landing track. The robust performance of system is analyzed. The simulation results demonstrate that the designed autonomous landing system satisfies the performance requirements of autonomous landing of UCAV when there are uncertainties of UCAV aircraft model, measurement noises and exogenous disturbances.

  8. Reversible diencephalic dysfunction as presentation of deep cerebral venous thrombosis due to hyperhomocysteinemia and protein S deficiency: Documentation of a case

    Directory of Open Access Journals (Sweden)

    Kaukab Maqbool Hassan

    2013-01-01

    Full Text Available A 45-year-old man presented with global headache, vomiting and abnormal behavior after cross-country run at high altitude. There was no seizure, loss of consciousness, fever or head injury. He was conscious, abulic and uncooperative with normal vitals. There was no focal neurological deficit. Non contrast computed tomography scan of head was normal. Magnetic resonance imaging of brain showed venous infarct in bilateral thalami, left basal ganglia and periventricular white matter. Magnetic resonance venography revealed thrombosis involving internal cerebral veins, septal veins, thalamostriate veins, vein of Galen and proximal portion of straight sinus. His condition steadily improved on low molecular weight heparin bridged with oral anticoagulation for one year. At two months, serum homocysteine was 31.51 μmol/l (5.46-16.2 μmol/l and protein S was 49.00% (77-143.00%. He received methylcobalamin, pyridoxine and folic acid. After 16 months, he was asymptomatic with partially recanalized deep cerebral veins and serum homocysteine falling to 16.50 μmol/l (5.46-16.2 μmol/l.

  9. Oculo-Visual Dysfunction in Parkinson’s Disease

    Science.gov (United States)

    Armstrong, R.A.

    2015-01-01

    This review describes the oculo-visual problems likely to be encountered in Parkinson’s disease (PD) with special reference to three questions: (1) are there visual symptoms characteristic of the prodromal phase of PD, (2) is PD dementia associated with specific visual changes, and (3) can visual symptoms help in the differential diagnosis of the parkinsonian syndromes, viz. PD, progressive supranuclear palsy (PSP), dementia with Lewy bodies (DLB), multiple system atrophy (MSA), and corticobasal degeneration (CBD)? Oculo-visual dysfunction in PD can involve visual acuity, dynamic contrast sensitivity, colour discrimination, pupil reactivity, eye movement, motion perception, and visual processing speeds. In addition, disturbance of visuo-spatial orientation, facial recognition problems, and chronic visual hallucinations may be present. Prodromal features of PD may include autonomic system dysfunction potentially affecting pupil reactivity, abnormal colour vision, abnormal stereopsis associated with postural instability, defects in smooth pursuit eye movements, and deficits in visuo-motor adaptation, especially when accompanied by idiopathic rapid eye movement (REM) sleep behaviour disorder. PD dementia is associated with the exacerbation of many oculo-visual problems but those involving eye movements, visuo-spatial function, and visual hallucinations are most characteristic. Useful diagnostic features in differentiating the parkinsonian symptoms are the presence of visual hallucinations, visuo-spatial problems, and variation in saccadic eye movement dysfunction. PMID:26599301

  10. HRVanalysis: a free software for analyzing cardiac autonomic activity

    Directory of Open Access Journals (Sweden)

    Vincent Pichot

    2016-11-01

    Full Text Available Since the pioneering studies of the 1960s, heart rate variability (HRV has become an increasingly used non-invasive tool for examining cardiac autonomic functions and dysfunctions in various populations and conditions. Many calculation methods have been developed to address these issues, each with their strengths and weaknesses. Although its interpretation may remain difficult, this technique provides, from a non-invasive approach, reliable physiological information that was previously inaccessible, in many fields including death and health prediction, training and overtraining, cardiac and respiratory rehabilitation, sleep-disordered breathing, large cohort follow-ups, children’s autonomic status, anesthesia, or neurophysiological studies. In this context, we developed HRVanalysis, a software to analyse HRV, used and improved for over 20 years and, thus, designed to meet laboratory requirements. The main strength of HRVanalysis is its wide application scope. In addition to standard analysis over short and long periods of RR intervals, the software allows time-frequency analysis using wavelet transform as well as analysis of autonomic nervous system status on surrounding scored events and on preselected labeled areas. Moreover, the interface is designed for easy study of large cohorts, including batch mode signal processing to avoid running repetitive operations. Results are displayed as figures or saved in TXT files directly employable in statistical softwares. Recordings can arise from RR or EKG files of different types such as cardiofrequencemeters, holters EKG, polygraphs, and data acquisition systems. HRVanalysis can be downloaded freely from the Web page at: anslabtools.univ-st-etienne.fr. HRVanalysis is meticulously maintained and developed for in-house laboratory use. In this article, after a brief description of the context, we present an overall view of HRV analysis and we describe the methodological approach of the different

  11. Cardiac autonomic testing and treating heart disease. 'A clinical perspective'

    Directory of Open Access Journals (Sweden)

    Nicholas L. DePace

    2014-12-01

    Full Text Available Background Coronary heart disease (CHD is a major health concern, affecting nearly half the middle-age population and responsible for nearly one-third of all deaths. Clinicians have several major responsibilities beyond diagnosing CHD, such as risk stratification of patients for major adverse cardiac events (MACE and treating risks, as well as the patient. This second of a two-part review series discusses treating risk factors, including autonomic dysfunction, and expected outcomes. Methods Therapies for treating cardiac mortality risks including cardiovascular autonomic neuropathy (CAN, are discussed. Results While risk factors effectively target high-risk patients, a large number of individuals who will develop complications from heart disease are not identified by current scoring systems. Many patients with heart conditions, who appear to be well-managed by traditional therapies, experience MACE. Parasympathetic and Sympathetic (P&S function testing provides more information and has the potential to further aid doctors in individualizing and titrating therapy to minimize risk. Advanced autonomic dysfunction (AAD and its more severe form cardiovascular autonomic neuropathy have been strongly associated with an elevated risk of cardiac mortality and are diagnosable through autonomic testing. This additional information includes patient-specific physiologic measures, such as sympathovagal balance (SB. Studies have shown that establishing and maintaining proper SB minimizes morbidity and mortality risk. Conclusions P&S testing promotes primary prevention, treating subclinical disease states, as well as secondary prevention, thereby improving patient outcomes through (1 maintaining wellness, (2 preventing symptoms and disorder and (3 treating subclinical manifestations (autonomic dysfunction, as well as (4 disease and symptoms (autonomic neuropathy.

  12. Current challenges in autonomous vehicle development

    Science.gov (United States)

    Connelly, J.; Hong, W. S.; Mahoney, R. B., Jr.; Sparrow, D. A.

    2006-05-01

    The field of autonomous vehicles is a rapidly growing one, with significant interest from both government and industry sectors. Autonomous vehicles represent the intersection of artificial intelligence (AI) and robotics, combining decision-making with real-time control. Autonomous vehicles are desired for use in search and rescue, urban reconnaissance, mine detonation, supply convoys, and more. The general adage is to use robots for anything dull, dirty, dangerous or dumb. While a great deal of research has been done on autonomous systems, there are only a handful of fielded examples incorporating machine autonomy beyond the level of teleoperation, especially in outdoor/complex environments. In an attempt to assess and understand the current state of the art in autonomous vehicle development, a few areas where unsolved problems remain became clear. This paper outlines those areas and provides suggestions for the focus of science and technology research. The first step in evaluating the current state of autonomous vehicle development was to develop a definition of autonomy. A number of autonomy level classification systems were reviewed. The resulting working definitions and classification schemes used by the authors are summarized in the opening sections of the paper. The remainder of the report discusses current approaches and challenges in decision-making and real-time control for autonomous vehicles. Suggested research focus areas for near-, mid-, and long-term development are also presented.

  13. Asociación de la microalbuminuria con la disfunción ventricular izquierda en personas normotensas con diabetes mellitus tipo 1 Microalbuminuria and its association with left ventricular dysfunction in normotensive subjects presenting with type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Manuel Emiliano Licea Puig

    2009-04-01

    Full Text Available ANTECEDENTES: la disfunción ventricular izquierda es una complicación frecuente en las personas con diabetes mellitus 1. OBJETIVO: determinar si la excreción urinaria de albúmina se asocia a la presencia de disfunción ventricular izquierda en personas normotensas con diabetes mellitus 1 de largo tiempo de evolución. MÉTODOS: se realizó un estudio transversal y descriptivo en 80 diabéticos normotensos tipo 1 con 10 años o más de evolución de la diabetes mellitus 1, atendidos consecutivamente en nuestro centro, en edades entre los 15 y los 40 años. Se excluyeron otras enfermedades o condiciones que provoquen por sí mismas disfunción ventricular izquierda y proteinuria. Se estudió: edad, sexo, índice de masa corporal, hábito de fumar, presión arterial, evolución de la diabetes mellitus 1, retinopatía diabética, nefropatía diabética incipiente, glucemia en ayunas y posprandial de 2 h, hemoglobina glucosilada (HbA1, excreción urinaria de albúmina de 24 h, creatinina, electrocardiograma y ecocardiograma modo M bidimensional con Doppler pulsado. RESULTADOS: se comprobó disfunción ventricular izquierda en el 26,3 % y alteraciones estructurales en el 16,2. La frecuencia de nefropatía diabética incipiente fue mayor (pBACKGROUNDS: left ventricular dysfunction is a frequent complication in persons presenting with type 1 diabetes mellitus. OBJECTIVE: to determine if albumin urinary excretion is associated with the presence of left ventricular dysfunction (LVD in normotensive persons presenting with type diabetes mellitus of a long evolution. METHODS: we made a descriptive and cross-sectional study in 80 normotensive type 1 diabetic patients aged between 15 and 40 with a ³10 years of type 1 diabetes mellitus evolution seen in a consecutive way in our service. Other diseases were excluded or those conditions provoking per se left ventricular dysfunction and proteinuria. Study includes: age, sex, body mass index (BMI, smoking

  14. Longitudinal Control for Mengshi Autonomous Vehicle via Gauss Cloud Model

    Directory of Open Access Journals (Sweden)

    Hongbo Gao

    2017-12-01

    Full Text Available Dynamic robustness and stability control is a requirement for self-driving of autonomous vehicle. Longitudinal control technique of autonomous vehicle is basic theory and one key complex technique which must have the reliability and precision of vehicle controller. The longitudinal control technique is one of the foundations of the safety and stability of autonomous vehicle control. In our paper, we present a longitudinal control algorithm based on cloud model for Mengshi autonomous vehicle to ensure the dynamic stability and tracking performance of Mengshi autonomous vehicle. The longitudinal control algorithm mainly uses cloud model generator to control the acceleration of the autonomous vehicle to achieve the goal that controls the speed of Mengshi autonomous vehicle. The proposed longitudinal control algorithm based on cloud model is verified by real experiments on Highway driving scene. The experiments results of the acceleration and speed show that the algorithm is validity and stability.

  15. Autonomous nutrient detection for water quality monitoring

    OpenAIRE

    Maher, Damien; Cleary, John; Cogan, Deirdre; Diamond, Dermot

    2012-01-01

    The ever increasing demand for real time environmental monitoring is currently being driven by strong legislative and societal drivers. Low cost autonomous environmental monitoring systems are required to meet this demand as current monitoring solutions are insufficient. This poster presents an autonomous nutrient analyser platform for water quality monitoring. Results from a field trial of the nutrient analyser are reported along with current work to expand the range of water quality targ...

  16. Impact of malnutrition on cardiac autonomic modulation in children

    Directory of Open Access Journals (Sweden)

    Gláucia Siqueira Carvalho Barreto

    2016-11-01

    Conclusion: Malnourished children present changes in cardiac autonomic modulation, characterized by reductions in both sympathetic and parasympathetic activity, as well as increased heart rate and decreased blood pressure.

  17. Contour Tracking Control for the REMUS Autonomous Underwater Vehicle

    National Research Council Canada - National Science Library

    Van Reet, Alan R

    2005-01-01

    In the interest of enhancing the capabilities of autonomous underwater vehicles used in US Naval Operations, controlling vehicle position to follow depth contours presents exciting potential for navigation...

  18. Menopause and autonomic control of heart

    Directory of Open Access Journals (Sweden)

    Arunima Chaudhuri

    2012-01-01

    Full Text Available Menopause is associated with decreased heart rate variability, which is due to reduced parasympathetic or increased sympathetic outflow to the heart. Acute myocardial infarction may be accompanied by decreased heart rate variability. The causes of autonomic dysfunction in postmenopausal women may be multi-factorial i.e., dyslipidemia, increased body fat percentage, aging and loss of female sex hormones. The cardiac vagotonic and sympatholytic effects of estrogen can explain, at least in part, why premenopausal women compared with postmenopausal women have a lower coronary heart disease incidence and mortality rate.

  19. Autonomous Systems and Operations

    Data.gov (United States)

    National Aeronautics and Space Administration — The AES Autonomous Systems and Operations (ASO) project will develop an understanding of the impacts of increasing communication time delays on mission operations,...

  20. Autonomous Systems: Habitat Automation

    Data.gov (United States)

    National Aeronautics and Space Administration — The Habitat Automation Project Element within the Autonomous Systems Project is developing software to automate the automation of habitats and other spacecraft. This...

  1. Autonomous Propellant Loading Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The AES Autonomous Propellant Loading (APL) project consists of three activities. The first is to develop software that will automatically control loading of...

  2. Health, autonomic financing and transferences

    Directory of Open Access Journals (Sweden)

    David Cantarero Prieto

    2002-01-01

    Full Text Available The present paper has as objective to study the whole relative problem to the autonomous communities and regional heath care expenditure financing in Spain. This article has a dual purpose. First, the financing of the current health care attendance is approached in the Spanish regions passing magazine to its possible variants and we observe that the balance of our system is clearly inclined towards the side of the integration in the general pattern of financing («Fiscal Room» with specific conditions («Mixed System». Secondly, we examine the new situation in the mark of health care and its corresponding financing in the new model approved in 2001, in terms of the effects of tax assignment on autonomous communities.

  3. Highly Autonomous Systems Workshop

    OpenAIRE

    Doyle, Richard; Rasmussen, Robert; Man, Guy; Patel, Keyur

    1998-01-01

    Researchers and technology developers from the National Aeronautics and Space Administration (NASA), other government agencies, academia, and industry recently met in Pasadena, California, to take stock of past and current work and future challenges in the application of AI to highly autonomous systems. The meeting was catalyzed by new opportunities in developing autonomous spacecraft for NASA and was in part a celebration of the fictional birth year of the HAL-9000 computer.

  4. Autonomous Intersection Management

    Science.gov (United States)

    2009-12-01

    and analyzing my algorithms for correctness and rigor. Third, Tarun Nimmagadda, for creating the first mixed simulation using my simulator. In addition...Agent Systems, 10(2):131–164, March 2005. [Beeson et al., 2008] Patrick Beeson, Jack O’Quin, Bartley Gillan, Tarun Nimma- gadda, Mickey Ristroph, David...autonomous vehicles at intersections. IEEE Intelligent Systems, 13(3):82–86, May 1998. [Nimmagadda, 2009] Tarun Nimmagadda. Building an autonomous ground

  5. Autonomous Star Tracker Algorithms

    DEFF Research Database (Denmark)

    Betto, Maurizio; Jørgensen, John Leif; Kilsgaard, Søren

    1998-01-01

    Proposal, in response to an ESA R.f.P., to design algorithms for autonomous star tracker operations.The proposal also included the development of a star tracker breadboard to test the algorithms performances.......Proposal, in response to an ESA R.f.P., to design algorithms for autonomous star tracker operations.The proposal also included the development of a star tracker breadboard to test the algorithms performances....

  6. Autonomic neuropathy in diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Alberto eVerrotti

    2014-12-01

    Full Text Available Diabetic autonomic neuropathy (DAN is a serious and common complication of diabetes, often overlooked and misdiagnosed. It is a systemic-wide disorder that may be asymptomatic in the early stages. The most studied and clinically important form of DAN is cardiovascular autonomic neuropathy (CAN defined as the impairment of autonomic control of the cardiovascular system in patients with diabetes after exclusion of other causes. The reported prevalence of DAN varies widely depending on inconsistent definition, different diagnostic method, different patient cohorts studied. The pathogenesis is still unclear and probably multifactorial. Once DAN becomes clinically evident, no form of therapy has been identified which can effectively stop or reverse it. Prevention strategies are based on strict glycemic control with intensive insulin treatment, multifactorial intervention and lifestyle modification including control of hypertension, dyslipidemia, stop smoking, weight loss and adequate physical exercise. The present review summarizes the latest knowledge regarding clinical presentation, epidemiology, pathogenesis and management of DAN, with some mention to childhood and adolescent population.

  7. Control of autonomous ground vehicles: a brief technical review

    Science.gov (United States)

    Babak, Shahian-Jahromi; Hussain, Syed A.; Karakas, Burak; Cetin, Sabri

    2017-07-01

    This paper presents a brief review of the developments achieved in autonomous vehicle systems technology. A concise history of autonomous driver assistance systems is presented, followed by a review of current state of the art sensor technology used in autonomous vehicles. Standard sensor fusion method that has been recently explored is discussed. Finally, advances in embedded software methodologies that define the logic between sensory information and actuation decisions are reviewed.

  8. The Human Element and Autonomous Ships

    Directory of Open Access Journals (Sweden)

    Sauli Ahvenjärvi

    2016-09-01

    Full Text Available The autonomous ship technology has become a “hot” topic in the discussion about more efficient, environmentally friendly and safer sea transportation solutions. The time is becoming mature for the introduction of commercially sensible solutions for unmanned and fully autonomous cargo and passenger ships. Safety will be the most interesting and important aspect in this development. The utilization of the autonomous ship technology will have many effects on the safety, both positive and negative. It has been announced that the goal is to make the safety of an unmanned ship better that the safety of a manned ship. However, it must be understood that the human element will still be present when fully unmanned ships are being used. The shore-based control of a ship contains new safety aspects and an interesting question will be the interaction of manned and unmanned ships in the same traffic area. The autonomous ship technology should therefore be taken into account on the training of seafarers. Also it should not be forgotten that every single control algorithm and rule of the internal decision making logic of the autonomously navigating ship has been designed and coded by a human software engineer. Thus the human element is present also in this point of the lifetime navigation system of the autonomous ship.

  9. Autonomous power networks based power system

    International Nuclear Information System (INIS)

    Jokic, A.; Van den Bosch, P.P.J.

    2006-01-01

    This paper presented the concept of autonomous networks to cope with this increased complexity in power systems while enhancing market-based operation. The operation of future power systems will be more challenging and demanding than present systems because of increased uncertainties, less inertia in the system, replacement of centralized coordinating activities by decentralized parties and the reliance on dynamic markets for both power balancing and system reliability. An autonomous network includes the aggregation of networked producers and consumers in a relatively small area with respect to the overall system. The operation of an autonomous network is coordinated and controlled with one central unit acting as an interface between internal producers/consumers and the rest of the power system. In this study, the power balance problem and system reliability through provision of ancillary services was formulated as an optimization problem for the overall autonomous networks based power system. This paper described the simulation of an optimal autonomous network dispatching in day ahead markets, based on predicted spot prices for real power, and two ancillary services. It was concluded that large changes occur in a power systems structure and operation, most of them adding to the uncertainty and complexity of the system. The introduced concept of an autonomous power network-based power system was shown to be a realistic and consistent approach to formulate and operate a market-based dispatch of both power and ancillary services. 9 refs., 4 figs

  10. Preoperative radiation therapy and pelvic autonomic nerve-preserving operation for rectal carcinoma; Especially regarding preoperative radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sarashina, Hiromi; Saito, Norio; Nunomura, Masao (Chiba Univ. (Japan). School of Medicine) (and others)

    1992-12-01

    Results of pelvic plexus nerves and/or hypogastric nerves-preserving operation in combination with preoperative radiation for advanced rectal cancer were examined. Roentogenographically, preoperative radiation had marked effect on the reduction of tumor volume, which was closely related to histological effect. Histologically, high risk factors of local recurrence, such as depth of invasion, ew (defined as the distance between the external surgical surface and the deepest site of invasion) and lymph nodal involvement, have been successfully changed after radiation therapy. Especially, cases in which tumor was limited to within mucosa and proper muscle but not exposed on to the serosal surface did not show positive lymph nodes in the lateral side of the pelvic cavity. These findings suggested that autonomic nerve preserving operation should be undertaken in such cases that demonstrated marked tumor reduction after preoperative radiation therapy. The present study also confirmed that autonomic nerves preserving operation have obviously decreased the incidence of sexual as well as urinary dysfunction. (author).

  11. AUTONOMOUS GAUSSIAN DECOMPOSITION

    International Nuclear Information System (INIS)

    Lindner, Robert R.; Vera-Ciro, Carlos; Murray, Claire E.; Stanimirović, Snežana; Babler, Brian; Heiles, Carl; Hennebelle, Patrick; Goss, W. M.; Dickey, John

    2015-01-01

    We present a new algorithm, named Autonomous Gaussian Decomposition (AGD), for automatically decomposing spectra into Gaussian components. AGD uses derivative spectroscopy and machine learning to provide optimized guesses for the number of Gaussian components in the data, and also their locations, widths, and amplitudes. We test AGD and find that it produces results comparable to human-derived solutions on 21 cm absorption spectra from the 21 cm SPectral line Observations of Neutral Gas with the EVLA (21-SPONGE) survey. We use AGD with Monte Carlo methods to derive the H i line completeness as a function of peak optical depth and velocity width for the 21-SPONGE data, and also show that the results of AGD are stable against varying observational noise intensity. The autonomy and computational efficiency of the method over traditional manual Gaussian fits allow for truly unbiased comparisons between observations and simulations, and for the ability to scale up and interpret the very large data volumes from the upcoming Square Kilometer Array and pathfinder telescopes

  12. Is paramecium swimming autonomic?

    Science.gov (United States)

    Bandyopadhyay, Promode R.; Toplosky, Norman; Hansen, Joshua

    2010-11-01

    We seek to explore if the swimming of paramecium has an underlying autonomic mechanism. Such robotic elements may be useful in capturing the disturbance field in an environment in real time. Experimental evidence is emerging that motion control neurons of other animals may be present in paramecium as well. The limit cycle determined using analog simulation of the coupled nonlinear oscillators of olivo-cerebellar dynamics (ieee joe 33, 563-578, 2008) agrees with the tracks of the cilium of a biological paramecium. A 4-motor apparatus has been built that reproduces the kinematics of the cilium motion. The motion of the biological cilium has been analyzed and compared with the results of the finite element modeling of forces on a cilium. The modeling equates applied torque at the base of the cilium with drag, the cilium stiffness being phase dependent. A low friction pendulum apparatus with a multiplicity of electromagnetic actuators is being built for verifying the maps of the attractor basin computed using the olivo-cerebellar dynamics for different initial conditions. Sponsored by ONR 33.

  13. AUTONOMOUS GAUSSIAN DECOMPOSITION

    Energy Technology Data Exchange (ETDEWEB)

    Lindner, Robert R.; Vera-Ciro, Carlos; Murray, Claire E.; Stanimirović, Snežana; Babler, Brian [Department of Astronomy, University of Wisconsin, 475 North Charter Street, Madison, WI 53706 (United States); Heiles, Carl [Radio Astronomy Lab, UC Berkeley, 601 Campbell Hall, Berkeley, CA 94720 (United States); Hennebelle, Patrick [Laboratoire AIM, Paris-Saclay, CEA/IRFU/SAp-CNRS-Université Paris Diderot, F-91191 Gif-sur Yvette Cedex (France); Goss, W. M. [National Radio Astronomy Observatory, P.O. Box O, 1003 Lopezville, Socorro, NM 87801 (United States); Dickey, John, E-mail: rlindner@astro.wisc.edu [University of Tasmania, School of Maths and Physics, Private Bag 37, Hobart, TAS 7001 (Australia)

    2015-04-15

    We present a new algorithm, named Autonomous Gaussian Decomposition (AGD), for automatically decomposing spectra into Gaussian components. AGD uses derivative spectroscopy and machine learning to provide optimized guesses for the number of Gaussian components in the data, and also their locations, widths, and amplitudes. We test AGD and find that it produces results comparable to human-derived solutions on 21 cm absorption spectra from the 21 cm SPectral line Observations of Neutral Gas with the EVLA (21-SPONGE) survey. We use AGD with Monte Carlo methods to derive the H i line completeness as a function of peak optical depth and velocity width for the 21-SPONGE data, and also show that the results of AGD are stable against varying observational noise intensity. The autonomy and computational efficiency of the method over traditional manual Gaussian fits allow for truly unbiased comparisons between observations and simulations, and for the ability to scale up and interpret the very large data volumes from the upcoming Square Kilometer Array and pathfinder telescopes.

  14. [Thyroid dysfunction and amiodarone].

    Science.gov (United States)

    Lima, Jandira; Carvalho, Patrícia; Molina, M Auxiliadora; Rebelo, Marta; Dias, Patrícia; Vieira, José Diniz; Costa, José M Nascimento

    2013-02-01

    Although most patients remain clinically euthyroid, some develop amiodarone-induced hyperthyroidism (HPEAI) or hypothyroidism (HPOAI). The authors present a retrospective analysis of ten patients with amiodarone-induced thyroid dysfunction. Six patients were female and mean amiodarone intake was 17.7 months. HPOIA was more common (six patients). From all the patients with HPEAI, two had type 2, one had type 1, and one had type 3 hyperthyroidism. Symptoms suggestive of thyroid dysfunction occurred in five patients, most of them with HPOAI. In HPEAI, the most frequent symptom was exacerbation of arrhythmia (three patients). Discontinuation of amiodarone and treatment with levothyroxine was chosen in 83.3% of the HPOAI cases, while thyonamide treatment with corticosteroids and without amiodarone was the option in 75% of the HPEAI cases. There were three deaths, all in patients with HPEAI. HPEAI is potentially fatal. The clinical picture may be vague, so the thyroid monitoring is mandatory.

  15. Neurovascular and Autonomic Dysfunction Associated with Gulf War Illness Pain

    Science.gov (United States)

    2016-10-01

    reports from multiple laboratories of disturbances in mAChR expression in the CNS after exposure to chlorpyrifos, PB and other agents, in various...bloodstream, they compete for entry into hepatic pathways that ultimately process them to inactive metabolites. Because there are often multiple...represents a distinction between the sensory and motor manifestations of exposure to GWI chemicals. Summary and Conclusions DEET

  16. Neurovascular and Autonomic Dysfunction Associated with Gulf War Illness Pain

    Science.gov (United States)

    2017-10-01

    PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland, 21702-5012 DISTRIBUTION STATEMENT: Approved for Public ...years in which we have used this GWI model, rate of movement has been the most consistent measure of persistent and delayed deficits that appear...A). Exclusion of PB from the exposure set significantly altered the pattern of behavioral outcomes. In the absence of PB, ambulation deficits

  17. The treatment of autonomic dysfunction in tetanus | Maryke Spruyt ...

    African Journals Online (AJOL)

    The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more information about how to print, save, and work with PDFs, Highwire Press provides a helpful Frequently Asked Questions about PDFs.

  18. Advancing Autonomous Operations for Deep Space Vehicles

    Science.gov (United States)

    Haddock, Angie T.; Stetson, Howard K.

    2014-01-01

    Starting in Jan 2012, the Advanced Exploration Systems (AES) Autonomous Mission Operations (AMO) Project began to investigate the ability to create and execute "single button" crew initiated autonomous activities [1]. NASA Marshall Space Flight Center (MSFC) designed and built a fluid transfer hardware test-bed to use as a sub-system target for the investigations of intelligent procedures that would command and control a fluid transfer test-bed, would perform self-monitoring during fluid transfers, detect anomalies and faults, isolate the fault and recover the procedures function that was being executed, all without operator intervention. In addition to the development of intelligent procedures, the team is also exploring various methods for autonomous activity execution where a planned timeline of activities are executed autonomously and also the initial analysis of crew procedure development. This paper will detail the development of intelligent procedures for the NASA MSFC Autonomous Fluid Transfer System (AFTS) as well as the autonomous plan execution capabilities being investigated. Manned deep space missions, with extreme communication delays with Earth based assets, presents significant challenges for what the on-board procedure content will encompass as well as the planned execution of the procedures.

  19. [Construction and clinical evaluation of novel methods for detecting autoinomic dysfunction].

    Science.gov (United States)

    Obayashi, Konen

    2012-05-01

    The autonomic nervous system innervates every organ in the body. Since autonomic disturbances affect patient survival, an understanding of and recognition of these disturbances are important. We adopted several new methods to evaluate autonomic function accurately for detecting the onset of small-fiber neuropathy, such as laser-Doppler flowmetry, ultrasonography, 123I-MIBG scintigraphy, electrogastrography, cystometry, glucose-tolerance test, near-infrared spectrophotoscopy, blood pressure tests, and evaluation of sweating. After these examinations, we applied potential effective treatments to improve the survival and daily activity of these patients. We also evaluated the effect of liver transplantation on autonomic dysfunction of familial amyloidotic polyneuropathy (FAP) patients using our tools. Liver transplantation not only prevents the progression of autonomic dysfunction in these patients but also improves some autonomic symptoms in the early stage after the operation. As all domino-liver transplantation-induced amyloid neuropathies, including our cases, were of the sensory type rather than with autonomic involvement, assessment of the pain threshold by preferential stimulation of A delta fibers is a particularly useful tool for diagnosing the onset of small-fiber neuropathies in these patients in addition to autonomic testing. Analyses and comparison of patients with FAP and domino-liver-transplanted patients with autonomic, sensory and motor dysfunction may give a clue to elucidate the pathogenesis and treatment of neuropathy in FAP. As autonomic disturbances play an important role in the symptomatology of small-fiber neuropathy, liver-transplanted FAP, and domino-liver-transplanted patients, further studies of autonomic dysfunction in these patients may lead to the pathogenesis of the disease.

  20. An Electerophisioligic Study Of Autonomic Nervous System In Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Noorolahi Moghaddam H

    2003-11-01

    Full Text Available Autonomic nervous system dysfunction in diabetics can occur apart from peripheral sensorimotor polyneuropathy and sometimes leads to complaints which may be diagnosed by electrodiagnostic methods. Moreover glycemic control of these patients may prevent such a complications."nMaterials and Methods: 30 diabetic patients were compared to the same number of age and sex-matched controls regarding to electrophysiologic findings of autonomic nervous system. Symptoms referable to autonomic disorder including nightly diarrhea, dizziness, urinary incontinence, constipation, nausea, and mouth dryness were recorded in all diabetic patients. Palmar and plantar SSR and expiration to inspiration ratio (E: I and Valsalva ratio were recorded in all diabetics and control individuals by electromyography device. In addition NCS was performed on two sensory and two motor nerves in diabetic patients."nResults: There was no relation between age of diabetics and abnormal D: I ratio, Valsalva ratio and degree of electrophysiologic autonomic impairment. Also no relation between peripheral sensorimotor polyneuropathy and electrophysiologic autonomic impairment was found. Plantar SSR was absent in 80% of diabetics with orthostatic hypotension (p~ 0.019. Palmar and plantar SSR were absent in many diabetics in comparison to control group (for palmar SSR p~ 0.00 and for plantar SSR p< 0.015. There was no relation between diabetes duration since diagnosis and electrophysiologic autonomic impairment."nConclusion: According to the above mentioned findings diabetic autonomic neuropathy develops apart from peripheral sensorimotor polyneuropathy and probably with different mechanisms. Remarkable absence of palmar SSR in diabetics with orthostatic hypotension can be due to its sympathetic origin. Absence of any relation between diabetes duration and electrophysiologic autonomic impairment can be due to late diagnosis of type 2 diabetes or no pathophysiologic relation between chronic

  1. Autonomous sensor manager agents (ASMA)

    Science.gov (United States)

    Osadciw, Lisa A.

    2004-04-01

    Autonomous sensor manager agents are presented as an algorithm to perform sensor management within a multisensor fusion network. The design of the hybrid ant system/particle swarm agents is described in detail with some insight into their performance. Although the algorithm is designed for the general sensor management problem, a simulation example involving 2 radar systems is presented. Algorithmic parameters are determined by the size of the region covered by the sensor network, the number of sensors, and the number of parameters to be selected. With straight forward modifications, this algorithm can be adapted for most sensor management problems.

  2. Functional Imaging of Autonomic Regulation: Methods and Key Findings

    Directory of Open Access Journals (Sweden)

    Paul M Macey

    2016-01-01

    Full Text Available Central nervous system processing of autonomic function involves a network of regions throughout the brain which can be visualized and measured with neuroimaging techniques, notably functional magnetic resonance imaging (fMRI. The development of fMRI procedures has both confirmed and extended earlier findings from animal models, and human stroke and lesion studies. Assessments with fMRI can elucidate interactions between different central sites in regulating normal autonomic patterning, and demonstrate how disturbed systems can interact to produce aberrant regulation during autonomic challenges. Understanding autonomic dysfunction in various illnesses reveals mechanisms that potentially lead to interventions in the impairments. The objectives here are to: 1 describe the fMRI neuroimaging methodology for assessment of autonomic neural control, 2 outline the widespread, lateralized distribution of function in autonomic sites in the normal brain which includes structures from the neocortex through the medulla and cerebellum, 3 illustrate the importance of the time course of neural changes when coordinating responses, and how those patterns are impacted in conditions of sleep-disordered breathing, and 4 highlight opportunities for future research studies with emerging methodologies. Methodological considerations specific to autonomic testing include timing of challenges relative to the underlying fMRI signal, spatial resolution sufficient to identify autonomic brainstem nuclei, blood pressure and blood oxygenation influences on the fMRI signal, and the sustained timing, often measured in minutes of challenge periods and recovery. Key findings include the lateralized nature of autonomic organization, which is reminiscent of asymmetric motor, sensory and language pathways. Testing brain function during autonomic challenges demonstrate closely-integrated timing of responses in connected brain areas during autonomic challenges, and the involvement with

  3. Design of an Autonomous Transport System for Coastal Areas

    Directory of Open Access Journals (Sweden)

    Andrzej Lebkowski

    2018-03-01

    Full Text Available The article presents a project of an autonomous transport system that can be deployed in coastal waters, bays or between islands. Presented solutions and development trends in the transport of autonomous and unmanned units (ghost ships are presented. The structure of the control system of autonomous units is discussed together with the presentation of applied solutions in the field of artificial intelligence. The paper presents the concept of a transport system consisting of autonomous electric powered vessels designed to carry passengers, bikes, mopeds, motorcycles or passenger cars. The transport task is to be implemented in an optimal way, that is, most economically and at the same time as safe as possible. For this reason, the structure of the electric propulsion system that can be found on such units is shown. The results of simulation studies of autonomous system operation using simulator of marine navigational environment are presented.

  4. Iodine-induced thyroid dysfunction

    Science.gov (United States)

    Leung, Angela M.; Braverman, Lewis E.

    2017-01-01

    Purpose of review To summarize the mechanisms of iodine-induced hypothyroidism and hyperthyroidism, identify the risk factors for thyroid dysfunction following an iodine load, and summarize the major sources of excess iodine exposure. Recent findings Excess iodine is generally well tolerated, but individuals with underlying thyroid disease or other risk factors may be susceptible to iodine-induced thyroid dysfunction following acute or chronic exposure. Sources of increased iodine exposure include the global public health efforts of iodine supplementation, the escalating use of iodinated contrast radiologic studies, amiodarone administration in vulnerable patients, excess seaweed consumption, and various miscellaneous sources. Summary Iodine-induced thyroid dysfunction may be subclinical or overt. Recognition of the association between iodine excess and iodine-induced hypothyroidism or hyperthyroidism is important in the differential diagnosis of patients who present without a known cause of thyroid dysfunction. PMID:22820214

  5. Mitochondrial dysfunction in obesity.

    Science.gov (United States)

    de Mello, Aline Haas; Costa, Ana Beatriz; Engel, Jéssica Della Giustina; Rezin, Gislaine Tezza

    2018-01-01

    Obesity leads to various changes in the body. Among them, the existing inflammatory process may lead to an increase in the production of reactive oxygen species (ROS) and cause oxidative stress. Oxidative stress, in turn, can trigger mitochondrial changes, which is called mitochondrial dysfunction. Moreover, excess nutrients supply (as it commonly is the case with obesity) can overwhelm the Krebs cycle and the mitochondrial respiratory chain, causing a mitochondrial dysfunction, and lead to a higher ROS formation. This increase in ROS production by the respiratory chain may also cause oxidative stress, which may exacerbate the inflammatory process in obesity. All these intracellular changes can lead to cellular apoptosis. These processes have been described in obesity as occurring mainly in peripheral tissues. However, some studies have already shown that obesity is also associated with changes in the central nervous system (CNS), with alterations in the blood-brain barrier (BBB) and in cerebral structures such as hypothalamus and hippocampus. In this sense, this review presents a general view about mitochondrial dysfunction in obesity, including related alterations, such as inflammation, oxidative stress, and apoptosis, and focusing on the whole organism, covering alterations in peripheral tissues, BBB, and CNS. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Autonomous surveillance for biosecurity.

    Science.gov (United States)

    Jurdak, Raja; Elfes, Alberto; Kusy, Branislav; Tews, Ashley; Hu, Wen; Hernandez, Emili; Kottege, Navinda; Sikka, Pavan

    2015-04-01

    The global movement of people and goods has increased the risk of biosecurity threats and their potential to incur large economic, social, and environmental costs. Conventional manual biosecurity surveillance methods are limited by their scalability in space and time. This article focuses on autonomous surveillance systems, comprising sensor networks, robots, and intelligent algorithms, and their applicability to biosecurity threats. We discuss the spatial and temporal attributes of autonomous surveillance technologies and map them to three broad categories of biosecurity threat: (i) vector-borne diseases; (ii) plant pests; and (iii) aquatic pests. Our discussion reveals a broad range of opportunities to serve biosecurity needs through autonomous surveillance. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  7. When do the symptoms of autonomic nervous system malfunction appear in patients with Parkinson’s disease?

    Directory of Open Access Journals (Sweden)

    De Luka Silvio R.

    2014-01-01

    Full Text Available Background/Aim. Dysautonomia appears in almost all patients with Parkinson’s disease (PD in a certain stage of their condition. The aim of our study was to detect the development and type of autonomic disorders, find out the factors affecting their manifestation by analyzing the potential association with demographic variables related to clinical presentation, as well as the symptoms of the disease in a PD patient cohort. Methods. The patients with PD treated at the Clinic of Neurology in Belgrade during a 2-year period, divided into 3 groups were studied: 25 de novo patients, 25 patients already treated and had no long-term levodopa therapy-related complications and 22 patients treated with levodopa who manifested levodopa-induced motor complications. Simultaneously, 35 healthy control subjects, matched by age and sex, were also analyzed. Results. Autonomic nervous system malfunction was defined by Ewing diagnostic criteria. The tests, indicators of sympathetic and parasympathetic nervous systems, were significantly different in the PD patients as compared with the controls, suggesting the failure of both systems. However, it was shown, in the selected groups of patients, that the malfunction of both systems was present in two treated groups of PD patients, while de novo group manifested only sympathetic dysfunction. For this reason, the complete autonomic neuropathy was diagnosed only in the treated PD patients, while de novo patients were defined as those with the isolated sympathetic dysfunction. The patients with the complete autonomic neuropathy differed from the subjects without such neuropathy in higher cumulative and motor unified Parkinson’s disease rating score (UPDRS (p < 0.01, activities of daily living scores (p < 0.05, Schwab-England scale (p < 0.001 and Hoehn-Yahr scale. There was no difference between the patients in other clinical-demographic characteristics (sex, age at the time of diagnosis, actual age, duration of

  8. Autonomous Cryogenic Load Operations: KSC Autonomous Test Engineer

    Science.gov (United States)

    Shrading, Nicholas J.

    2012-01-01

    The KSC Autonomous Test Engineer (KATE) program has a long history at KSC. Now a part of the Autonomous Cryogenic Load Operations (ACLO) mission, this software system has been sporadically developed over the past 20+ years. Originally designed to provide health and status monitoring for a simple water-based fluid system, it was proven to be a capable autonomous test engineer for determining sources of failure in. the system, As part.of a new goal to provide this same anomaly-detection capability for a complicated cryogenic fluid system, software engineers, physicists, interns and KATE experts are working to upgrade the software capabilities and graphical user interface. Much progress was made during this effort to improve KATE. A display ofthe entire cryogenic system's graph, with nodes for components and edges for their connections, was added to the KATE software. A searching functionality was added to the new graph display, so that users could easily center their screen on specific components. The GUI was also modified so that it displayed information relevant to the new project goals. In addition, work began on adding new pneumatic and electronic subsystems into the KATE knowledgebase, so that it could provide health and status monitoring for those systems. Finally, many fixes for bugs, memory leaks, and memory errors were implemented and the system was moved into a state in which it could be presented to stakeholders. Overall, the KATE system was improved and necessary additional features were added so that a presentation of the program and its functionality in the next few months would be a success.

  9. Autonomous Cryogenic Load Operations: Knowledge-Based Autonomous Test Engineer

    Science.gov (United States)

    Schrading, J. Nicolas

    2013-01-01

    The Knowledge-Based Autonomous Test Engineer (KATE) program has a long history at KSC. Now a part of the Autonomous Cryogenic Load Operations (ACLO) mission, this software system has been sporadically developed over the past 20 years. Originally designed to provide health and status monitoring for a simple water-based fluid system, it was proven to be a capable autonomous test engineer for determining sources of failure in the system. As part of a new goal to provide this same anomaly-detection capability for a complicated cryogenic fluid system, software engineers, physicists, interns and KATE experts are working to upgrade the software capabilities and graphical user interface. Much progress was made during this effort to improve KATE. A display of the entire cryogenic system's graph, with nodes for components and edges for their connections, was added to the KATE software. A searching functionality was added to the new graph display, so that users could easily center their screen on specific components. The GUI was also modified so that it displayed information relevant to the new project goals. In addition, work began on adding new pneumatic and electronic subsystems into the KATE knowledge base, so that it could provide health and status monitoring for those systems. Finally, many fixes for bugs, memory leaks, and memory errors were implemented and the system was moved into a state in which it could be presented to stakeholders. Overall, the KATE system was improved and necessary additional features were added so that a presentation of the program and its functionality in the next few months would be a success.

  10. Longitudinal Control for Mengshi Autonomous Vehicle via Cloud Model

    Science.gov (United States)

    Gao, H. B.; Zhang, X. Y.; Li, D. Y.; Liu, Y. C.

    2018-03-01

    Dynamic robustness and stability control is a requirement for self-driving of autonomous vehicle. Longitudinal control method of autonomous is a key technique which has drawn the attention of industry and academe. In this paper, we present a longitudinal control algorithm based on cloud model for Mengshi autonomous vehicle to ensure the dynamic stability and tracking performance of Mengshi autonomous vehicle. An experiments is applied to test the implementation of the longitudinal control algorithm. Empirical results show that if the longitudinal control algorithm based Gauss cloud model are applied to calculate the acceleration, and the vehicles drive at different speeds, a stable longitudinal control effect is achieved.

  11. Overview of the Autonomic Nervous System

    Science.gov (United States)

    ... be reversible or progressive. Anatomy of the autonomic nervous system The autonomic nervous system is the part of ... organs they connect with. Function of the autonomic nervous system The autonomic nervous system controls internal body processes ...

  12. Autonomic skin responses in females with Fabry disease

    DEFF Research Database (Denmark)

    Møller, Anette Torvin; Bach, Flemming W.; Feldt-Rasmussen, Ulla

    2009-01-01

    Fabry disease is a genetic lysosomal disorder with dysfunction of the lysosomal enzyme alpha-galactosidase A causing accumulation of glycolipids in multiple organs including the nervous system and with neuropathy as a prominent manifestation. Neurological symptoms include pain and autonomic...... dysfunction. This study examined peripheral autonomic nerve function in 19 female patients with Fabry disease and 19 sex and age-matched controls by measuring (1) sweat production following acetylcholine challenge; (2) the sympathetically mediated vasoconstrictor responses to inspiratory gasp, stress......, and the cold pressor test; and (3) cutaneous blood flow following capsaicin. The vasoconstrictor response to inspiratory gasp was increased in Fabry patients compared to controls (p = 0.03), while the response to cold and mental stress did not change. Female patients with Fabry disease had a reduced sweat...

  13. A mission planner for an autonomous tractor

    DEFF Research Database (Denmark)

    Bochtis, Dionysis; Vougioukas, S.G.; Griepentrog, Hans W.

    2009-01-01

    In this article, a mission planner of field coverage operations for an autonomous agricultural tractor is presented. Missions for a particular autonomous tractor are defined using an XML (extendible markup language) formatted file that can be uploaded to the tractor through the user interface...... and formulated, via semantic representations, as a vehicle routing problem (VRP). By using this approach, the total non-working distance can be reduced by up to 50% compared to the conventional non-optimized method. Three sets of experiments are presented. In the first set, three fields were separately covered...

  14. The pattern of autonomic tone disorder and its correction in children with overactive bladder

    Directory of Open Access Journals (Sweden)

    S. L. Morozov

    2014-01-01

    Full Text Available Autonomic nervous system dysregulation is one of the leading components in the pathogenesis of neurogenic bladder dysfunction. These disorders lead to diverse changes in the functions of the sympathetic and parasympathetic systems with disordered release of mediators (norepinephrine, acetylcholine, hormones of the adrenal cortex and other endocrine glands, a number of biologically active substances (polypeptides, prostaglandins, as well as to the impaired sensitivity of vascular a- and p-adrenoceptors. Children with dysuria concurrently develop visceral, CNS, and circulatory system dysfunctions and metabolic disturbances. The paper describes the clinical trial of children with overactive bladder, which demonstrates the autonomic tone in these patients (и=44. The findings point to the important involvement of the autonomic nervous system in the pathogenesis of the disease and provide a rationale for the incorporation of vegetotropic drugs normalizing the autonomic nervous system into the combination therapy of overactive bladder.

  15. Autonomous Forest Fire Detection

    NARCIS (Netherlands)

    Breejen, E. den; Breuers, M.; Cremer, F.; Kemp, R.A.W.; Roos, M.; Schutte, K.; Vries, J.S. de

    1998-01-01

    Forest fire detection is a very important issue in the pre-suppression process. Timely detection allows the suppression units to reach the fire in its initial stages and this will reduce the suppression costs considerably. The autonomous forest fire detection principle is based on temporal contrast

  16. Towards autonomous vehicles.

    Science.gov (United States)

    2013-11-01

    We are moving towards an age of autonomous vehicles. Cycles of innovation initiated in the public and private sectors : have led one into another since the 1990s; and out of these efforts have sprung a variety of Advanced Driver Assistance : Systems ...

  17. Experimental Autonomous Vehicle Systems

    DEFF Research Database (Denmark)

    Ravn, Ole; Andersen, Nils Axel

    1998-01-01

    The paper describes the requirements for and a prototype configuration of a software architecture for control of an experimental autonomous vehicle. The test bed nature of the system is emphasised in the choice of architecture making re-configurability, data logging and extendability simple...

  18. ADAM: ADaptive Autonomous Machine

    NARCIS (Netherlands)

    van Oosten, Daan C.; Nijenhuis, Lucas F.J.; Bakkers, André; Vervoort, Wiek

    1996-01-01

    This paper describes a part of the development of an adaptive autonomous machine that is able to move in an unknown world extract knowledge out of the perceived data, has the possibility to reason, and finally has the capability to exchange experiences and knowledge with other agents. The agent is

  19. Depressed cardiac autonomic modulation in patients with chronic kidney disease

    OpenAIRE

    Oliveira, Carlos Alberto de; Brito Junior, Helio Lima de; Bastos, Marcus Gomes; Oliveira, Felipe Gomes de; Casali, Thais Gomes; Bignoto, Tiago Costa; Fernandes, Natalia Maria da Silva; Beraldo, Antonio Fernando de Castro Alves; Paula, Rogério Baumgratz de

    2014-01-01

    Introduction: A dysfunctional autonomic nervous system (ANS) has also been recognized as an important mechanism contributing to the poor outcome in CKD patients, with several studies reporting a reduction in heart rate variability (HRV). Objective: Evaluate the sympathovagal balance in patients with chronic kidney disease on conservative treatment. Methods: In a cross-sectional study, patients with CKD stages 3, 4 and 5 not yet on dialysis (CKD group) and age-matched healthy subjects (CON...

  20. Autonomic evaluation of hepatitis C virus infected patients

    Directory of Open Access Journals (Sweden)

    Bruno Mattos Coutinho

    2013-08-01

    Full Text Available There are few studies reporting the association between hepatitis C virus (HCV infection and disautonomia. We have evaluated the autonomic cardiovascular function in 12 patients with sensory small-fiber polyneuropathy infected by HCV. The mean age was 49±13 years old. The mean infection time was 9.6 years in six (50% patients. Thermal and pinprick hypoesthesia was observed in distal legs in all patients. Autonomic symptoms were referred by eight (66.7% patients. Among patients with abnormal autonomic cardiovascular test, five (41.7% showed abnormal results in two or more tests. Valsalva maneuver was abnormal in seven (58.3% patients. We can consider that there is an association of both parasympathetic and sympathetic efferent cardiovascular dysfunction in this group of patients.

  1. Using dynamic pupillometry as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study.

    Science.gov (United States)

    Ferrari, Giselle L; Marques, Jefferson L B; Gandhi, Rajiv A; Heller, Simon R; Schneider, Fábio K; Tesfaye, Solomon; Gamba, Humberto R

    2010-06-17

    Autonomic neuropathy is a common and serious complication of diabetes. Early detection is essential to enable appropriate interventional therapy and management. Dynamic pupillometry has been proposed as a simpler and more sensitive tool to detect subclinical autonomic dysfunction. The aim of this study was to investigate pupil responsiveness in diabetic subjects with and without cardiovascular autonomic neuropathy (CAN) using dynamic pupillometry in two sets of experiments. During the first experiment, one flash was administered and the pupil response was recorded for 3 s. In the second experiment, 25 flashes at 1-s interval were administered and the pupil response was recorded for 30 s. Several time and pupil-iris radius-related parameters were computed from the acquired data. A total of 24 diabetic subjects (16 without and 8 with CAN) and 16 healthy volunteers took part in the study. Our results show that diabetic subjects with and without CAN have sympathetic and parasympathetic dysfunction, evidenced by diminished amplitude reflexes and significant smaller pupil radius. It suggests that pupillary autonomic dysfunction occurs before a more generalized involvement of the autonomic nervous system, and this could be used to detect early autonomic dysfunction. Dynamic pupillometry provides a simple, inexpensive, and noninvasive tool to screen high-risk diabetic patients for diabetic autonomic neuropathy.

  2. Using dynamic pupillometry as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study

    Directory of Open Access Journals (Sweden)

    Schneider Fábio K

    2010-06-01

    Full Text Available Abstract Background Autonomic neuropathy is a common and serious complication of diabetes. Early detection is essential to enable appropriate interventional therapy and management. Dynamic pupillometry has been proposed as a simpler and more sensitive tool to detect subclinical autonomic dysfunction. The aim of this study was to investigate pupil responsiveness in diabetic subjects with and without cardiovascular autonomic neuropathy (CAN using dynamic pupillometry in two sets of experiments. Methods During the first experiment, one flash was administered and the pupil response was recorded for 3 s. In the second experiment, 25 flashes at 1-s interval were administered and the pupil response was recorded for 30 s. Several time and pupil-iris radius-related parameters were computed from the acquired data. A total of 24 diabetic subjects (16 without and 8 with CAN and 16 healthy volunteers took part in the study. Results Our results show that diabetic subjects with and without CAN have sympathetic and parasympathetic dysfunction, evidenced by diminished amplitude reflexes and significant smaller pupil radius. It suggests that pupillary autonomic dysfunction occurs before a more generalized involvement of the autonomic nervous system, and this could be used to detect early autonomic dysfunction. Conclusions Dynamic pupillometry provides a simple, inexpensive, and noninvasive tool to screen high-risk diabetic patients for diabetic autonomic neuropathy.

  3. Linear and Nonlinear Analyses of the Cardiac Autonomic Control in Children With Developmental Coordination Disorder: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Jorge L. Cavalcante Neto

    2018-03-01

    Full Text Available Children with Developmental Coordination Disorder (DCD and children at risk for DCD (r-DCD present motor impairments interfering in their school, leisure and daily activities. In addition, these children may have abnormalities in their cardiac autonomic control, which together with their motor impairments, restrict their health and functionality. Therefore, this study aimed to assess the cardiac autonomic control, by linear and nonlinear analysis, at supine and during an orthostatic stimulus in DCD, r-DCD and typically developed children. Thirteen DCD children (11 boys and 2 girls, aged 8.08 ± 0.79 years, 19 children at risk for DCD (13 boys and 6 girls, aged 8.10 ± 0.96 years and 18 typically developed children, who constituted the control group (CG (10 boys and 8 girls, aged 8.50 ± 0.96 years underwent a heart rate variability (HRV examination. R-R intervals were recorded in order to assess the cardiac autonomic control using a validated HR monitor. HRV was analyzed by linear and nonlinear methods and compared between r-DCD, DCD, and CG. The DCD group presented blunted cardiac autonomic adjustment to the orthostatic stimulus, which was not observed in r-DCD and CG. Regarding nonlinear analysis of HRV, the DCD group presented lower parasympathetic modulation in the supine position compared to the r-DCD and CG groups. In the within group analysis, only the DCD group did not increase HR from supine to standing posture. Symbolic analysis revealed a significant decrease in 2LV (p < 0.0001 and 2UV (p < 0.0001 indices from supine to orthostatic posture only in the CG. In conclusion, r-DCD and DCD children present cardiac autonomic dysfunction characterized by higher sympathetic, lower parasympathetic and lower complexity of cardiac autonomic control in the supine position, as well as a blunted autonomic adjustment to the orthostatic stimulus. Therefore, cardiovascular health improvement should be part of DCD children's management, even in cases of

  4. Influence of hydrotherapy on clinical and cardiac autonomic function in migraine patients

    OpenAIRE

    M U Sujan; M Raghavendra Rao; Ravikiran Kisan; Hulegar A Abhishekh; Atchayaram Nalini; Trichur R Raju; T N Sathyaprabha

    2016-01-01

    BACKGROUND: Migraine is associated with autonomic symptoms. The growing body of literature suggests that the dysfunctional autonomic nervous system might play a pivotal role in the pathogenesis of migraine. Thermal therapies have been hypothesized to modulate these changes and alleviate pain. However, data regarding the efficacy of hydrotherapy in migraine remain scant. We evaluated the effect of add on hydrotherapy procedure (a hot arm and foot bath with ice massage to head) in migraine pati...

  5. Cardioprotection afforded by exercise training prior to myocardial infarction is associated with autonomic function improvement.

    Science.gov (United States)

    Rodrigues, Fernando; Feriani, Daniele Jardim; Barboza, Catarina Andrade; Abssamra, Marcos Elias Vergilino; Rocha, Leandro Yanase; Carrozi, Nicolle Martins; Mostarda, Cristiano; Figueroa, Diego; Souza, Gabriel Inacio Honorato; De Angelis, Kátia; Irigoyen, Maria Cláudia; Rodrigues, Bruno

    2014-07-14

    It has been suggested that exercise training (ET) protects against the pathological remodeling and ventricular dysfunction induced by myocardial infarction (MI). However, it remains unclear whether the positive adjustments on baroreflex and cardiac autonomic modulations promoted by ET may afford a cardioprotective mechanism. The aim of this study was to evaluate the effects of aerobic ET, prior to MI, on cardiac remodeling and function, as well as on baroreflex sensitivity and autonomic modulation in rats. Male Wistar rats were divided into 4 groups: sedentary rats submitted to Sham surgery (C); trained rats submitted to Sham surgery (TC); sedentary rats submitted to MI (I), trained rats submitted to MI (TI). Sham and MI were performed after ET period. After surgeries, echocardiographic, hemodynamic and autonomic (baroreflex sensitivity, cardiovascular autonomic modulation) evaluations were conducted. Prior ET prevented an additional decline in exercise capacity in TI group in comparison with I. MI area was not modified by previous ET. ET was able to increase the survival and prevent additional left ventricle dysfunction in TI rats. Although changes in hemodynamic evaluations were not observed, ET prevented the decrease of baroreflex sensitivity, and autonomic dysfunction in TI animals when compared with I animals. Importantly, cardiac improvement was associated with the prevention of cardiac autonomic impairment in studied groups. Prior ET was effective in changing aerobic capacity, left ventricular morphology and function in rats undergoing MI. Furthermore, these cardioprotective effects were associated with attenuated cardiac autonomic dysfunction observed in trained rats. Although these cause-effect relationships can only be inferred, rather than confirmed, our study suggests that positive adaptations of autonomic function by ET can play a vital role in preventing changes associated with cardiovascular disease, particularly in relation to MI.

  6. Modeling of an autonomous microgrid for renewable energy sources integration

    DEFF Research Database (Denmark)

    Serban, I.; Teodorescu, Remus; Guerrero, Josep M.

    2009-01-01

    The frequency stability analysis in an autonomous microgrid (MG) with renewable energy sources (RES) is a continuously studied issue. This paper presents an original method for modeling an autonomous MG with a battery energy storage system (BESS) and a wind power plant (WPP), with the purpose...

  7. Learner Behaviors and Perceptions of Autonomous Language Learning

    Science.gov (United States)

    Bekleyen, Nilüfer; Selimoglu, Figen

    2016-01-01

    The purpose of the present study was to investigate the learners' behaviors and perceptions about autonomous language learning at the university level in Turkey. It attempts to reveal what type of perceptions learners held regarding teachers' and their own responsibilities in the language learning process. Their autonomous language learning…

  8. R1 autonomic nervous system in acute kidney injury.

    Science.gov (United States)

    Hering, Dagmara; Winklewski, Pawel J

    2017-02-01

    Acute kidney injury (AKI) is a rapid loss of kidney function resulting in accumulation of end metabolic products and associated abnormalities in fluid, electrolyte and acid-base homeostasis. The pathophysiology of AKI is complex and multifactorial involving numerous vascular, tubular and inflammatory pathways. Neurohumoral activation with heightened activity of the sympathetic nervous system and renin-angiotensin-aldosterone system play a critical role in this scenario. Inflammation and/or local renal ischaemia are underlying mechanisms triggering renal tissue hypoxia and resultant renal microcirculation dysfunction; a common feature of AKI occurring in numerous clinical conditions leading to a high morbidity and mortality rate. The contribution of renal nerves to the pathogenesis of AKI has been extensively demonstrated in a series of experimental models over the past decades. While this has led to better knowledge of the pathogenesis of human AKI, therapeutic approaches to improve patient outcomes are scarce. Restoration of autonomic regulatory function with vagal nerve stimulation resulting in anti-inflammatory effects and modulation of centrally-mediated mechanisms could be of clinical relevance. Evidence from experimental studies suggests that a therapeutic splenic ultrasound approach may prevent AKI via activation of the cholinergic anti-inflammatory pathway. This review briefly summarizes renal nerve anatomy, basic insights into neural control of renal function in the physiological state and the involvement of the autonomic nervous system in the pathophysiology of AKI chiefly due to sepsis, cardiopulmonary bypass and ischaemia/reperfusion experimental model. Finally, potentially preventive experimental pre-clinical approaches for the treatment of AKI aimed at sympathetic inhibition and/or parasympathetic stimulation are presented. © 2016 John Wiley & Sons Australia, Ltd.

  9. Female Sexual Dysfunction

    Science.gov (United States)

    ... medically as female sexual dysfunction. Many women experience problems with sexual function at some point. Female sexual dysfunction can occur at any stage of life. It can be lifelong or be acquired later in life. It can ...

  10. Postanesthetic temporomandibular joint dysfunction.

    OpenAIRE

    Knibbe, M. A.; Carter, J. B.; Frokjer, G. M.

    1989-01-01

    Internal derangements, myofascial pain dysfunction, and chronic dislocation of the temporomandibular joint (TMJ) are three common sequelae resulting from mandibular trauma. Etiologic factors include prolonged dental and otolaryngologic procedures, and intraoperative use of the laryngoscope and bronchoscope. Three cases are reported to document postanesthetic TMJ dysfunction arising from normal preoperative joints. Four types of TMJ dysfunction are discussed: anterior meniscus dislocation with...

  11. Effects of Weekly Low-Frequency rTMS on Autonomic Measures in Children with Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Manuel Fernando Casanova

    2014-10-01

    Full Text Available The term autism spectrum disorder (ASD describes a range of conditions characterized by impairments in social interactions, communication, and by restricted and repetitive behaviors. ASD may also present with symptoms suggestive of autonomic nervous system (ANS dysfunction. The objective of this study was to determine the effect of 18 sessions of low frequency repetitive transcranial magnetic stimulation (rTMS on autonomic function in children with ASD by recording electrocardiogram (EKG and electrodermal activity pre-, post- and during each rTMS session. The autonomic measures of interest in this study were R-R cardiointervals in EKG (R-R, time and frequency domain measures of heart rate variability (HRV and skin conductance level (SCL. HRV measures such as R-R intervals, standard deviation of cardiac intervals, pNN50 (percentage of cardiointervals>50 ms different from preceding interval, power of high frequency (HF and low frequency (LF components of HRV spectrum, LF/HF ratio, were then derived from the recorded EKG. We expected that the course of 18 weekly inhibitory low-frequency rTMS applied to the dorsolateral prefrontal cortex (DLPFC would enhance autonomic balance by facilitating frontal inhibition of limbic activity thus resulting in decreased overall heart rate, increased HRV (in a form of increased HF power, decreased LF power (resulting in decreased LF/HF ratio, and decreased SCL. Behavioral evaluations post-18 TMS showed decreased irritability, hyperactivity, stereotype behavior and compulsive behavior ratings while autonomic measures indicated a significant increase in cardiac interval variability and a decrease of tonic SCL. The results suggest that 18 sessions of low frequency rTMS in ASD results in increased cardiac vagal control and reduced sympathetic arousal.

  12. Advanced control architecture for autonomous vehicles

    Science.gov (United States)

    Maurer, Markus; Dickmanns, Ernst D.

    1997-06-01

    An advanced control architecture for autonomous vehicles is presented. The hierarchical architecture consists of four levels: a vehicle level, a control level, a rule-based level and a knowledge-based level. A special focus is on forms of internal representation, which have to be chosen adequately for each level. The control scheme is applied to VaMP, a Mercedes passenger car which autonomously performs missions on German freeways. VaMP perceives the environment with its sense of vision and conventional sensors. It controls its actuators for locomotion and attention focusing. Modules for perception, cognition and action are discussed.

  13. Autonomous control of distributed storages in microgrids

    DEFF Research Database (Denmark)

    Loh, Poh Chiang; Blaabjerg, Frede

    2011-01-01

    Operation of distributed generators in microgrids has widely been discussed, but would not be fully autonomous, if distributed storages are not considered. Storages in general are important, since they provide energy buffering to load changes, energy leveling to source variations and ride......-through enhancement to the overall microgrids. Recognizing their importance, this paper presents a scheme for sharing power among multiple distributed storages, in coordination with the distributed sources and loads. The scheme prompts the storages to autonomously sense for system conditions, requesting for maximum...

  14. Autonomous operation of distributed storages in microgrids

    DEFF Research Database (Denmark)

    Loh, Poh Chiang; Chai, Yi Kai; Li, Ding

    2014-01-01

    Operation of distributed generators in microgrids has been widely discussed, but would not be fully autonomous if distributed energy storages are not considered. Storages are important since they provide energy buffering to load changes, energy levelling to source variations and ride......-through enhancement to the microgrids. Recognising their importance, this study presents a scheme for sharing power among multiple distributed storages in coordination with the distributed sources and loads. The scheme prompts the storages to autonomously sense for local operating conditions, requesting for maximum...

  15. Applying Energy Autonomous Robots for Dike Inspection

    OpenAIRE

    Dresscher, Douwe; de Vries, Theodorus J.A.; Stramigioli, Stefano

    2015-01-01

    This article presents an exploratory study of an energy-autonomous robot that can be deployed on the Dutch dykes. Based on theory in energy harvesting from sun and wind and the energy-cost of locomotion an analytic expression to determine the feasible daily operational time of such a vehicle is composed. The parameters in this expression are identified using lab results and weather statistics. After an evaluation of the “Energy autonomous robot in the Netherlands‿ case, the results are genera...

  16. Progressive posterior cortical dysfunction

    Directory of Open Access Journals (Sweden)

    Fábio Henrique de Gobbi Porto

    Full Text Available Abstract Progressive posterior cortical dysfunction (PPCD is an insidious syndrome characterized by prominent disorders of higher visual processing. It affects both dorsal (occipito-parietal and ventral (occipito-temporal pathways, disturbing visuospatial processing and visual recognition, respectively. We report a case of a 67-year-old woman presenting with progressive impairment of visual functions. Neurologic examination showed agraphia, alexia, hemispatial neglect (left side visual extinction, complete Balint's syndrome and visual agnosia. Magnetic resonance imaging showed circumscribed atrophy involving the bilateral parieto-occipital regions, slightly more predominant to the right . Our aim was to describe a case of this syndrome, to present a video showing the main abnormalities, and to discuss this unusual presentation of dementia. We believe this article can contribute by improving the recognition of PPCD.

  17. Sexual Dysfunction and Intimacy for Ostomates.

    Science.gov (United States)

    Albaugh, Jeffrey A; Tenfelde, Sandi; Hayden, Dana M

    2017-07-01

    Sex and intimacy presents special challenges for the ostomate. Since some colorectal surgery patients will require either temporary or permanent stomas, intimacy and sexuality is a common issue for ostomates. In addition to the stoma, nerve damage, radiotherapy, and chemotherapy are often used in conjunction with stoma creation for cancer patients, thereby adding physiological dysfunction to the personal psychological impact of the stoma, leading to sexual dysfunction. The purpose of this paper is to describe the prevalence, etiology, and the most common types of sexual dysfunction in men and women after colorectal surgery and particularly those patients with stomas. In addition, treatment strategies for sexual dysfunction will also be described.

  18. Autonomous Robot Retrieval System

    OpenAIRE

    Ahern, S.

    2015-01-01

    Mobile robots are increasingly being deployed in environments hazardous to humans. However, many of these robots require remote control operation or are tethered, requiring the human operator to remain within a potentially hazardous radius of the area of operation. To resolve this issue an Autonomous Robot Retrieval System (ARRS) utilising Open RatSLAM based on the Lego NXT 2.0 robotics platform is proposed but could not be implemented due to memory limitations of the hardware. An occupancy g...

  19. Control algorithms for autonomous robot navigation

    International Nuclear Information System (INIS)

    Jorgensen, C.C.

    1985-01-01

    This paper examines control algorithm requirements for autonomous robot navigation outside laboratory environments. Three aspects of navigation are considered: navigation control in explored terrain, environment interactions with robot sensors, and navigation control in unanticipated situations. Major navigation methods are presented and relevance of traditional human learning theory is discussed. A new navigation technique linking graph theory and incidental learning is introduced

  20. Sleep restriction progress to cardiac autonomic imbalance ...

    African Journals Online (AJOL)

    Since it's more difficult to maintain adequate sleep duration among night watchmen during their working schedule, hence the purpose of our present study was to investigate whether mental stress or fatigue over restricted sleep period in night shift, affects HRV, in order to elucidate on cardiac autonomic modulation among ...

  1. Control algorithms for autonomous robot navigation

    Energy Technology Data Exchange (ETDEWEB)

    Jorgensen, C.C.

    1985-09-20

    This paper examines control algorithm requirements for autonomous robot navigation outside laboratory environments. Three aspects of navigation are considered: navigation control in explored terrain, environment interactions with robot sensors, and navigation control in unanticipated situations. Major navigation methods are presented and relevance of traditional human learning theory is discussed. A new navigation technique linking graph theory and incidental learning is introduced.

  2. Autonomous droop scheme with reduced generation cost

    DEFF Research Database (Denmark)

    Nutkani, Inam Ullah; Loh, Poh Chiang; Blaabjerg, Frede

    2013-01-01

    DGs are usually of different types unlike synchronous generators. This paper presents an autonomous droop scheme that takes into consideration the operating cost, efficiency and emission penalty of each DG since all these factors directly or indirectly contributes to the Total Generation Cost (TGC...

  3. Applying Energy Autonomous Robots for Dike Inspection

    NARCIS (Netherlands)

    Dresscher, Douwe; de Vries, Theodorus J.A.; Stramigioli, Stefano

    2015-01-01

    This article presents an exploratory study of an energy-autonomous robot that can be deployed on the Dutch dykes. Based on theory in energy harvesting from sun and wind and the energy-cost of locomotion an analytic expression to determine the feasible daily operational time of such a vehicle is

  4. Requirement analysis for autonomous systems and intelligent ...

    African Journals Online (AJOL)

    user

    This control architecture is based upon the requirements identified in the first part. We also present development of a software framework to test such flexible control architectures. Keywords: Electric power system, distributed control, autonomous systems, intelligent agents. 1. Introduction. Electric power systems is one of the ...

  5. Autonomous Robotic Inspection in Tunnels

    Science.gov (United States)

    Protopapadakis, E.; Stentoumis, C.; Doulamis, N.; Doulamis, A.; Loupos, K.; Makantasis, K.; Kopsiaftis, G.; Amditis, A.

    2016-06-01

    In this paper, an automatic robotic inspector for tunnel assessment is presented. The proposed platform is able to autonomously navigate within the civil infrastructures, grab stereo images and process/analyse them, in order to identify defect types. At first, there is the crack detection via deep learning approaches. Then, a detailed 3D model of the cracked area is created, utilizing photogrammetric methods. Finally, a laser profiling of the tunnel's lining, for a narrow region close to detected crack is performed; allowing for the deduction of potential deformations. The robotic platform consists of an autonomous mobile vehicle; a crane arm, guided by the computer vision-based crack detector, carrying ultrasound sensors, the stereo cameras and the laser scanner. Visual inspection is based on convolutional neural networks, which support the creation of high-level discriminative features for complex non-linear pattern classification. Then, real-time 3D information is accurately calculated and the crack position and orientation is passed to the robotic platform. The entire system has been evaluated in railway and road tunnels, i.e. in Egnatia Highway and London underground infrastructure.

  6. Maladaptive autonomic regulation in PTSD accelerates physiological aging

    Directory of Open Access Journals (Sweden)

    John B Williamson

    2015-01-01

    Full Text Available A core manifestation of posttraumatic stress disorder is a disconnection between physiological state and psychological and behavior processes necessary to adequately respond to environmental demands. Patients with PTSD experience oscillations in autonomic states that support either fight and flight behaviors or withdrawal, immobilization, and dissociation without an intervening calm state that would provide opportunities for positive social interactions. This defensive autonomic disposition is adaptive in dangerous and life threatening situations, but in the context of every-day life may lead to significant psychosocial distress and deteriorating social relationships. The perpetuation of these maladaptive autonomic responses, may contribute to the development of comorbid mental health issues such as depression, loneliness, and hostility that further modify the nature of cardiovascular behavior in the context of internal and external stressors. Over time, changes in autonomic, endocrine, and immune function contribute to deteriorating health, which is potently expressed in brain dysfunction and cardiovascular health. In this theoretical review paper, we review the literature on the chronic health effects of post-traumatic stress disorder. We discuss the brain networks underlying post-traumatic stress disorder in the context of autonomic efferent and afferent contributions and how disruption of these networks leads to poor health outcomes. Finally, we discuss treatments based on our theoretical model of posttraumatic stress disorder.

  7. Sexual Dysfunction in Interstitial Cystitis.

    Science.gov (United States)

    Tonyali, Senol; Yilmaz, Mehmet

    2017-11-01

    Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a debilitating disease characterized with urgency, frequency, and pelvic pain affecting especially women. Sexual dysfunction in female patients with IC/BPS consists of dyspareunia, altered sexual desire and orgasm frequency and insufficient lubrication is reported to negatively affect the patient's quality of life. In the present study, we aimed to determine the association between IC/BPS and sexual dysfunction and improvement in sexual dysfunction related to given treatments. A PubMed/Medline and EMBASE search was conducted using keywords: "interstitial cystitis", "sexual dysfunction", and "bladder pain syndrome". Several studies have been conducted to determine the relation between IC/BPS and sexual dysfunction. And also limited studies focusing on IC/BPS specific treatments reported significant improvements in sexual function after either oral or intravesical treatment. However, given the used different questionnaires, study protocols, patient characteristics, previous treatments and follow-up period, it is not possible to make a head-to-head comparison of the treatment effects on sexual function. Further, randomized controlled studies are needed to confirm these results and make a comparison between effects of various treatment modalities on sexual functioning in IC/BPS.

  8. Dysautonomia in prodromal α-synucleinopathy: peripheral versus central autonomic degeneration.

    Science.gov (United States)

    Dahms, C; Guenther, A; Schwab, M; Schultze, T; Nowack, S; Hoyer, D; Ehrhardt, J; Witte, O W; Mayer, G; Rupprecht, S

    2016-05-01

    There is an urgent need for early predictive markers for the course of disease in prodromal α-synucleinopathies such as idiopathic rapid eye movement (REM) sleep behaviour disorder. Autonomic cardiac/vascular dysfunction is a prominent feature in advanced α-synucleinopathies, but its diagnostic value as an early neurodegenerative marker remains unclear. The latter may be complicated since synuclein-mediated neurodegeneration may involve central and peripheral components of the autonomic nervous system. The diagnostic value of autonomic symptoms and central and peripheral autonomic markers of blood pressure and heart rate regulation were prospectively evaluated in 20 subjects with idiopathic REM sleep behaviour disorder and 20 age-matched healthy controls. Although subjects with REM sleep behaviour disorder showed no clinical autonomic symptoms, blood pressure (P ≤ 0.035) and heart rate response (P ≤ 0.065) were slightly diminished during orthostatic challenge. Autonomic dysregulation was distinctively reflected in lower resting heart rate (all components, P ≤ 0.05) and blood pressure variability (low frequency component, P ≤ 0.024) indicating peripheral cardiac/vascular denervation. In contrast, baroreflex sensitivity and central cardiac autonomic outflow (sympathovagal balance) were well preserved indicating intact central autonomic regulation. Heart rate variability [very low frequency component, receiver operating characteristic (ROC) area under the curve (AUC) 0.80, P ≤ 0.001] and blood pressure variability (low frequency component ROC AUC 0.73, P ≤ 0.01) but not baroreflex sensitivity and sympathovagal balance showed an excellent diagnostic accuracy in identifying subjects with REM sleep behaviour disorder and healthy controls. Cardiac/vascular dysfunction in prodromal α-synucleinopathy arises from peripheral rather than from central autonomic degeneration. Autonomic indices encoded in heart rate and blood pressure variability are precise

  9. Are Turkish University Students Autonomous or Not?

    Directory of Open Access Journals (Sweden)

    Büşra Kırtık

    2017-01-01

    Full Text Available The present study tried to determine Turkish learners’ attitudes, and the Turkish education system’s approach towards learner autonomy with regard to three main points: 1 whether Turkish university students are aware of learner autonomy or not 2 whether Turkish university students have the characteristics of autonomous learners (whether they are autonomous learners or not, and 3 if the Turkish education system is suitable for fostering learner autonomy or not from the viewpoint of the participants. Participants were 50 second grade learners in the English Language Teaching Departments of Hacettepe University (N=10, Mehmet Akif Ersoy University (N=10, and Uludag University (N=30 who had already taken courses about learner autonomy.  The data were collected by means of a questionnaire which had two Likert-scale sections and an open-ended questions section. The first Likert-scale section contained 15 characteristics of autonomous learners each of which was rated by the participants in a scale from strongly disagree to agree, from 1 to 5. In the second Likert-scale section, the participants were asked to rate the Turkish education system’s five basic elements such as school curriculums, course materials, approaches used by the teachers in classrooms, learning activities, and classroom settings. Additionally, learners’ opinions about their awareness and understanding of learner autonomy were gathered by five open ended questions. The results proposed that the participants were aware of learner autonomy, and had the characteristics of autonomous learners. On the other hand, results showed that the Turkish education system was not suitable for autonomous learners and did not foster learner autonomy. The findings suggested that the Turkish education system should be designed again in such a way to support the autonomous learners and to foster learner autonomy in all sections of the education.

  10. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, Judith E.; Brennan, Mike T.; Leeuw, Irma M. Verdonck-de; Gibson, Rachel J.; Eilers, June G.; Waltimo, Tuomas; Bots, Casper P.; Michelet, Marisol; Sollecito, Thomas P.; Rouleau, Tanya S.; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C.; Silverman, Sol; Spijkervet, Fred K. L.

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  11. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, J.E.; Brennan, M.T.; Verdonck- de Leeuw, I.M.; Gibson, R.J.; Eilers, J.G.; Waltimo, T.; Bots, C.P.; Michelet, M.; Sollecito, T.P.; Rouleau, T.S.; Sewnaik, A.; Bensadoun, R.J.; Fliedner, M.C.; Silverman, S.; Spijkervet, F.K.L.

    2012-01-01

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  12. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, J.E.; Brennan, M.T.; de Leeuw, I.M.; Gibson, R.J.; Eilers, J.G.; Waltimo, T.; Bots, C.P.; Michelet, M.; Sollecito, T.P.; Rouleau, T.S.; Sewnaik, A.; Bensadoun, R.J.; Fliedner, M.C.; Silverman, S.; Spijkervet, F.K.L.

    2012-01-01

    Purpose: Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  13. Examining accident reports involving autonomous vehicles in California

    Science.gov (United States)

    Nader, Nazanin; Eurich, Sky O.; Tripp, Michelle; Varadaraju, Naresh

    2017-01-01

    Autonomous Vehicle technology is quickly expanding its market and has found in Silicon Valley, California, a strong foothold for preliminary testing on public roads. In an effort to promote safety and transparency to consumers, the California Department of Motor Vehicles has mandated that reports of accidents involving autonomous vehicles be drafted and made available to the public. The present work shows an in-depth analysis of the accident reports filed by different manufacturers that are testing autonomous vehicles in California (testing data from September 2014 to March 2017). The data provides important information on autonomous vehicles accidents’ dynamics, related to the most frequent types of collisions and impacts, accident frequencies, and other contributing factors. The study also explores important implications related to future testing and validation of semi-autonomous vehicles, tracing the investigation back to current literature as well as to the current regulatory panorama. PMID:28931022

  14. Examining accident reports involving autonomous vehicles in California.

    Science.gov (United States)

    Favarò, Francesca M; Nader, Nazanin; Eurich, Sky O; Tripp, Michelle; Varadaraju, Naresh

    2017-01-01

    Autonomous Vehicle technology is quickly expanding its market and has found in Silicon Valley, California, a strong foothold for preliminary testing on public roads. In an effort to promote safety and transparency to consumers, the California Department of Motor Vehicles has mandated that reports of accidents involving autonomous vehicles be drafted and made available to the public. The present work shows an in-depth analysis of the accident reports filed by different manufacturers that are testing autonomous vehicles in California (testing data from September 2014 to March 2017). The data provides important information on autonomous vehicles accidents' dynamics, related to the most frequent types of collisions and impacts, accident frequencies, and other contributing factors. The study also explores important implications related to future testing and validation of semi-autonomous vehicles, tracing the investigation back to current literature as well as to the current regulatory panorama.

  15. Examining accident reports involving autonomous vehicles in California.

    Directory of Open Access Journals (Sweden)

    Francesca M Favarò

    Full Text Available Autonomous Vehicle technology is quickly expanding its market and has found in Silicon Valley, California, a strong foothold for preliminary testing on public roads. In an effort to promote safety and transparency to consumers, the California Department of Motor Vehicles has mandated that reports of accidents involving autonomous vehicles be drafted and made available to the public. The present work shows an in-depth analysis of the accident reports filed by different manufacturers that are testing autonomous vehicles in California (testing data from September 2014 to March 2017. The data provides important information on autonomous vehicles accidents' dynamics, related to the most frequent types of collisions and impacts, accident frequencies, and other contributing factors. The study also explores important implications related to future testing and validation of semi-autonomous vehicles, tracing the investigation back to current literature as well as to the current regulatory panorama.

  16. 12th International Conference on Intelligent Autonomous Systems (IAS-12)

    CERN Document Server

    Yoon, Kwang-Joon; Lee, Jangmyung; Frontiers of Intelligent Autonomous Systems

    2013-01-01

    This carefully edited volume aims at providing readers with the most recent progress on intelligent autonomous systems, with its particular emphasis on intelligent autonomous ground, aerial and underwater vehicles as well as service robots for home and healthcare under the context of the aforementioned convergence. “Frontiers of Intelligent Autonomous Systems” includes thoroughly revised and extended papers selected from the 12th International Conference on Intelligent Autonomous Systems (IAS-12), held in Jeju, Korea, June 26-29, 2012. The editors chose 35 papers out of the 202 papers presented at IAS-12 which are organized into three chapters: Chapter 1 is dedicated to autonomous navigation and mobile manipulation, Chapter 2 to unmanned aerial and underwater vehicles and Chapter 3 to service robots for home and healthcare. To help the readers to easily access this volume, each chapter starts with a chapter summary introduced by one of the editors: Chapter 1 by Sukhan Lee, Chapter 2 by Kwang Joon Yoon and...

  17. 12th International Conference on Intelligent Autonomous Systems

    CERN Document Server

    Cho, Hyungsuck; Yoon, Kwang-Joon; Lee, Jangmyung

    2013-01-01

    Intelligent autonomous systems are emerged as a key enabler for the creation of a new paradigm of services to humankind, as seen by the recent advancement of autonomous cars licensed for driving in our streets, of unmanned aerial and underwater vehicles carrying out hazardous tasks on-site, and of space robots engaged in scientific as well as operational missions, to list only a few. This book aims at serving the researchers and practitioners in related fields with a timely dissemination of the recent progress on intelligent autonomous systems, based on a collection of papers presented at the 12th International Conference on Intelligent Autonomous Systems, held in Jeju, Korea, June 26-29, 2012. With the theme of “Intelligence and Autonomy for the Service to Humankind, the conference has covered such diverse areas as autonomous ground, aerial, and underwater vehicles, intelligent transportation systems, personal/domestic service robots, professional service robots for surgery/rehabilitation, rescue/security ...

  18. Autonomic Neuropathy in Diabetes Mellitus

    OpenAIRE

    Verrotti, Alberto; Prezioso, Giovanni; Scattoni, Raffaella; Chiarelli, Francesco

    2014-01-01

    Diabetic autonomic neuropathy (DAN) is a serious and common complication of diabetes, often overlooked and misdiagnosed. It is a systemic-wide disorder that may be asymptomatic in the early stages. The most studied and clinically important form of DAN is cardiovascular autonomic neuropathy defined as the impairment of autonomic control of the cardiovascular system in patients with diabetes after exclusion of other causes. The reported prevalence of DAN varies widely depending on inconsistent ...

  19. Baroreflex deficit blunts exercise training-induced cardiovascular and autonomic adaptations in hypertensive rats.

    Science.gov (United States)

    Moraes-Silva, I C; De La Fuente, R N; Mostarda, C; Rosa, K; Flues, K; Damaceno-Rodrigues, N R; Caldini, E G; De Angelis, K; Krieger, E M; Irigoyen, M C

    2010-03-01

    1. Baroreceptors regulate moment-to-moment blood pressure (BP) variations, but their long-term effect on the cardiovascular system remains unclear. Baroreceptor deficit accompanying hypertension contributes to increased BP variability (BPV) and sympathetic activity, whereas exercise training has been associated with an improvement in these baroreflex-mediated changes. The aim of the present study was to evaluate the autonomic, haemodynamic and cardiac morphofunctional effects of long-term sinoaortic baroreceptor denervation (SAD) in trained and sedentary spontaneously hypertensive rats (SHR). 2. Rats were subjected to SAD or sham surgery and were then further divided into sedentary and trained groups. Exercise training was performed on a treadmill (five times per week, 50-70% maximal running speed). All groups were studied after 10 weeks. 3. Sinoaortic baroreceptor denervation in SHR had no effect on basal heart rate (HR) or BP, but did augment BPV, impairing the cardiac function associated with increased cardiac hypertrophy and collagen deposition. Exercise training reduced BP and HR, re-established baroreflex sensitivity and improved both HR variability and BPV. However, SAD in trained SHR blunted all these improvements. Moreover, the systolic and diastolic hypertensive dysfunction, reduced left ventricular chamber diameter and increased cardiac collagen deposition seen in SHR were improved after the training protocol. These benefits were attenuated in trained SAD SHR. 4. In conclusion, the present study has demonstrated that the arterial baroreflex mediates cardiac disturbances associated with hypertension and is crucial for the beneficial cardiovascular morphofunctional and autonomic adaptations induced by chronic exercise in hypertension.

  20. Lack of awareness of erectile dysfunction in many men with risk factors for erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Magee Michelle

    2010-11-01

    Full Text Available Abstract Background Men with erectile dysfunction often have concurrent medical conditions. Conversely, men with these conditions may also have underlying erectile dysfunction. The prevalence of unrecognized erectile dysfunction in men with comorbidities commonly associated with erectile dysfunction was determined in men invited to participate in a double-blind, randomized, placebo-controlled trial of sildenafil citrate. Methods Men ≥30 years old presenting with ≥1 erectile dysfunction risk factor (controlled hypertension, hypercholesterolemia, smoking, metabolic syndrome, stable coronary artery disease, diabetes, depression, lower urinary tract symptoms, obesity [body mass index ≥30 kg/m2] or waist circumference ≥40 inches, and not previously diagnosed with erectile dysfunction were evaluated. The screening question, "Do you have erectile dysfunction?," with responses of "no," "yes," and "unsure," and the Erectile Function domain of the International Index of Erectile Function (IIEF-EF were administered. Results Of 1084 men screened, 1053 answered the screening question and also had IIEF-EF scores. IIEF-EF scores indicating erectile dysfunction occurred in 71% (744/1053, of whom 54% (399/744 had moderate or severe erectile dysfunction. Of 139 answering "yes," 526 answering "unsure," and 388 answering "no," 96%, 90%, and 36%, respectively, had some degree of erectile dysfunction. The mean±SD (range number of risk factors was 2.9 ± 1.7 (3-8 in the "yes" group, 3.2 ± 1.7 (3-9 in the "unsure" group, and 2.6 ± 1.5 (2-8 in the "no" group. Conclusion Although awareness of having erectile dysfunction was low, most men with risk factors had IIEF-EF scores indicating erectile dysfunction. Erectile dysfunction should be suspected and assessed in men with risk factors, regardless of their apparent level of awareness of erectile dysfunction. Trial registration ClinicalTrials.gov Identifier NCT00343200.

  1. Autonomous Orbit Navigator Development, Using GPS, Applied to Autonomous Orbit Control

    Science.gov (United States)

    Galski, Roberto Luiz

    2002-01-01

    include the systematic error imposed to the GPS geometric solution due to changes in the set of satellites which are visible to the receiver. The improved outputs of this process will then be used in the implementation of an autonomous control system for the Longitude Phase Drift of the spacecraft orbit (parameter which presents the higher frequency of corrective maneuvers application for heliosynchronous orbits in phase with the earth's rotation, as is the case for the CBERS series satellites. Finally, the performance of the proposed autonomous control procedure will be analyzed and compared with the other results achieved by autonomous control systems previously studied at Instituto Nacional de Pesquisas Espaciais (INPE), that directly use the coarse GPS navigation solution

  2. Diabetic cardiovascular autonomic neuropathy: clinical implications.

    Science.gov (United States)

    Karayannis, Georgios; Giamouzis, Gregory; Cokkinos, Dennis V; Skoularigis, John; Triposkiadis, Filippos

    2012-06-01

    Diabetic cardiovascular autonomic neuropathy (DCAN), the impairment of the autonomic balance of the cardiovascular system in the setting of diabetes mellitus (DM), is frequently observed in both Type 1 and 2 DM, has detrimental effects on the quality of life and portends increased mortality. Clinical manifestations include: resting heart rate disorders, exercise intolerance, intraoperative cardiovascular lability, orthostatic alterations in heart rate and blood pressure, QT-interval prolongation, abnormal diurnal and nocturnal blood pressure variation, silent myocardial ischemia and diabetic cardiomyopathy. Clinical tests for autonomic nervous system evaluation, heart rate variability analysis, autonomic innervation imaging techniques, microneurography and baroreflex analysis are the main diagnostic tools for DCAN detection. Aldose reductase inhibitors and antioxidants may be helpful in DCAN therapy, but a regular, more generalized and multifactorial approach should be adopted with inclusion of lifestyle modifications, strict glycemic control and treatment of concomitant traditional cardiovascular risk factors, in order to achieve the best therapeutic results. In the present review, the authors provide aspects of DCAN pathophysiology, clinical presentation, diagnosis and an algorithm regarding the evaluation and management of DCAN in DM patients.

  3. Autonomic Fuselet Specification and Composition

    National Research Council Canada - National Science Library

    Mills, Peter H

    2006-01-01

    A framework for autonomic fuselet business logic development was developed, using semantic web services and workflow technologies to specify fuselet information needs, to define an executable workflow...

  4. Robotics and Autonomous Systems Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: Provides an environment for developing and evaluating intelligent software for both actual and simulated autonomous vehicles. Laboratory computers provide...

  5. Postanesthetic temporomandibular joint dysfunction.

    Science.gov (United States)

    Knibbe, M. A.; Carter, J. B.; Frokjer, G. M.

    1989-01-01

    Internal derangements, myofascial pain dysfunction, and chronic dislocation of the temporomandibular joint (TMJ) are three common sequelae resulting from mandibular trauma. Etiologic factors include prolonged dental and otolaryngologic procedures, and intraoperative use of the laryngoscope and bronchoscope. Three cases are reported to document postanesthetic TMJ dysfunction arising from normal preoperative joints. Four types of TMJ dysfunction are discussed: anterior meniscus dislocation with reduction, anterior meniscus dislocation without reduction, dislocation/subluxation of the mandibular condyle, and myofascial pain dysfunction syndrome. Preoperative screening of mandibular function is recommended in identifying patients as either normal or having potential TMJ dysfunction. Failure to recognize postoperative TMJ dysfunction can lead to long-term symptoms that are difficult to alleviate. Litigation is a common sequel in these cases. Images Figure 3 PMID:2604053

  6. Morally autonomous practice?

    Science.gov (United States)

    Scott, P A

    1998-12-01

    The structures and contexts within which nurses work results in the moral agency and moral autonomy of the nurse being compromised. This claim results from a confusion of (1) the concept of autonomy with those of freedom and independence; and (2) a confusion of the notion of moral autonomy with that of autonomous professional practice. The drawing of appropriate distinctions allows clarification of the relevant concepts. It also underlines the responsibility of practitioners to recognize the moral dimension of their practice, and the moral implications of their actions, as they attempt to meet the health care needs of their patients and develop practice professionally.

  7. Burden of Sexual Dysfunction.

    Science.gov (United States)

    Balon, Richard

    2017-01-02

    Similar to the burden of other diseases, the burden of sexual dysfunction has not been systematically studied. However, there is growing evidence of various burdens (e.g., economic, symptomatic, humanistic) among patients suffering from sexual dysfunctions. The burden of sexual dysfunction has been studied a bit more often in men, namely the burden of erectile dysfunction (ED), premature ejaculation (PE) and testosterone deficiency syndrome (TDS). Erectile dysfunction is frequently associated with chronic conditions such as cardiovascular disease, diabetes, and depression. These conditions could go undiagnosed, and ED could be a marker of those diseases. The only available report from the United Kingdom estimated the total economic burden of ED at £53 million annually in terms of direct costs and lost productivity. The burden of PE includes significant psychological distress: anxiety, depression, lack of sexual confidence, poor self-esteem, impaired quality of life, and interpersonal difficulties. Some suggest that increase in female sexual dysfunction is associated with partner's PE, in addition to significant interpersonal difficulties. The burden of TDS includes depression, sexual dysfunction, mild cognitive impairment, and osteoporosis. One UK estimate of the economic burden of female sexual dysfunctions demonstrated that the average cost per patient was higher than the per annum cost of ED. There are no data on burden of paraphilic disorders. The burden of sexual dysfunctions is underappreciated and not well studied, yet it is significant for both the patients and the society.

  8. Iatrogenic causes of salivary gland dysfunction

    International Nuclear Information System (INIS)

    Schubert, M.M.; Izutsu, K.T.

    1987-01-01

    Saliva is important for maintaining oral health and function. There are instances when medical therapy is intended to decrease salivary flow, such as during general anesthesia, but most instances of iatrogenic salivary gland dysfunction represent untoward or unavoidable side-effects. The clinical expression of the salivary dysfunction can range from very minor transient alteration in saliva flow to a total loss of salivary function. The most common forms of therapy that interfere with salivation are drug therapies, cancer therapies (radiation or chemotherapy), and surgical therapy. These therapies can affect salivation by a number of different mechanisms that include: disruption of autonomic nerve function related to salivation, interference with acinar or ductal cell functions related to salivation, cytotoxicity, indirect effects (vasoconstriction/dilation, fluid and electrolyte balance, etc.), and physical trauma to salivary glands and nerves. A wide variety of drugs is capable of increasing or decreasing salivary flow by mimicking autonomic nervous system actions or by directly acting on cellular processes necessary for salivation: drugs can also indirectly affect salivation by altering fluid and electrolyte balance or by affecting blood flow to the glands. Ionizing radiation can cause permanent damage to salivary glands, damage that is manifest as acinar cell destruction with subsequent atrophy and fibrosis of the glands. Cancer chemotherapy can cause changes in salivation, but the changes are usually much less severe and only transient. Finally, surgical and traumatic injuries interfere with salivation because of either disruption of gland innervation or gross physical damage (or removal) of glandular tissue (including ducts)

  9. Autonomous Industrial Mobile Manipulation (AIMM) - maturation, exploitation and implementation

    DEFF Research Database (Denmark)

    Hvilshøj, Mads

    This thesis introduces the Autonomous Industrial Mobile Manipulator ”Little Helper”, a robotic co-worker which extends the potential of industrial robotics by combining locomotion and manipulation capabilities. The thesis presents promising findings for industrial maturation, exploitation...

  10. Towards autonomous vehicular clouds

    Directory of Open Access Journals (Sweden)

    Stephan Olariu

    2011-09-01

    Full Text Available The dawn of the 21st century has seen a growing interest in vehicular networking and its myriad potential applications. The initial view of practitioners and researchers was that radio-equipped vehicles could keep the drivers informed about potential safety risks and increase their awareness of road conditions. The view then expanded to include access to the Internet and associated services. This position paper proposes and promotes a novel and more comprehensive vision namely, that advances in vehicular networks, embedded devices and cloud computing will enable the formation of autonomous clouds of vehicular computing, communication, sensing, power and physical resources. Hence, we coin the term, autonomous vehicular clouds (AVCs. A key feature distinguishing AVCs from conventional cloud computing is that mobile AVC resources can be pooled dynamically to serve authorized users and to enable autonomy in real-time service sharing and management on terrestrial, aerial, or aquatic pathways or theaters of operations. In addition to general-purpose AVCs, we also envision the emergence of specialized AVCs such as mobile analytics laboratories. Furthermore, we envision that the integration of AVCs with ubiquitous smart infrastructures including intelligent transportation systems, smart cities and smart electric power grids will have an enormous societal impact enabling ubiquitous utility cyber-physical services at the right place, right time and with right-sized resources.

  11. Autonomous Formation Flight

    Science.gov (United States)

    Schkolnik, Gerard S.; Cobleigh, Brent

    2004-01-01

    NASA's Strategic Plan for the Aerospace Technology Enterprise includes ambitious objectives focused on affordable air travel, reduced emissions, and expanded aviation-system capacity. NASA Dryden Flight Research Center, in cooperation with NASA Ames Research Center, the Boeing Company, and the University of California, Los Angeles, has embarked on an autonomous-formation-flight project that promises to make significant strides towards these goals. For millions of years, birds have taken advantage of the aerodynamic benefit of flying in formation. The traditional "V" formation flown by many species of birds (including gulls, pelicans, and geese) enables each of the trailing birds to fly in the upwash flow field that exists just outboard of the bird immediately ahead in the formation. The result for each trailing bird is a decrease in induced drag and thus a reduction in the energy needed to maintain a given speed. Hence, for migratory birds, formation flight extends the range of the system of birds over the range of birds flying solo. The Autonomous Formation Flight (AFF) Project is seeking to extend this symbiotic relationship to aircraft.

  12. The CASCADAS Framework for Autonomic Communications

    Science.gov (United States)

    Baresi, Luciano; Ferdinando, Antonio Di; Manzalini, Antonio; Zambonelli, Franco

    An interesting approach to the design and development of the future Internet foresees a networked service eco-system capable of seamlessly offering services for human-to-human, human-to-machine and machine-to-machine interactions. This chapter builds in this direction by describing a distributed component-ware framework for autonomic and situation-aware communication developed within the CASCADAS project. The core of this framework is the Autonomic Communication Element (ACE), an innovative software abstraction capable of providing dynamically adaptable services that can be built, composed, and let evolve according to autonomic principles. Services are capable of adapting their logic to the dynamically changing context they operate in without human intervention. As a result, whenever the need arises, ACEs can be federated autonomously and produce new services on a situation-aware basis. Systems and, in particular, eco-systems can thus be conceived as collections of ACEs. The chapter introduces the concept of ACE and its different facets. It also presents the architecture of a prototype ACE-based platform and exemplifies the different concepts through a future Pervasive Behavioral Advertisement scenario.

  13. Diabetes and sexual dysfunction: current perspectives

    Directory of Open Access Journals (Sweden)

    Maiorino MI

    2014-03-01

    Full Text Available Maria Ida Maiorino,1 Giuseppe Bellastella,1 Katherine Esposito2 1Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, Naples, Italy; 2Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy Abstract: Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It has been associated with sexual dysfunction, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, as compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction are less conclusive, although most studies have reported a higher prevalence of female sexual dysfunction in diabetic women as compared with nondiabetic women. Female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. Hyperglycemia, which is a main determinant of vascular and microvascular diabetic complications, may participate in the pathogenetic mechanisms of sexual dysfunction in diabetes. Moreover, diabetic people may present several clinical conditions, including hypertension, overweight and obesity, metabolic syndrome, cigarette smoking, and atherogenic dyslipidemia, which are themselves risk factors for sexual dysfunction, both in men and in women. The adoption of healthy lifestyles may reduce insulin resistance, endothelial dysfunction, and oxidative stress – all of which are desirable achievements in diabetic patients. Improved well-being may further contribute to reduce and prevent sexual dysfunction in both sexes. Keywords: diabetes mellitus, diabetes complications, erectile dysfunction, female sexual dysfunction, lifestyle changes

  14. Overview of the Autonomic Nervous System

    Science.gov (United States)

    ... process. Autonomic disorders may be reversible or progressive. Anatomy of the autonomic nervous system The autonomic nervous ... with acetylcholine and placed on the legs and forearm. Then, the volume of sweat is measured to ...

  15. Behavioural domain knowledge transfer for autonomous agents

    CSIR Research Space (South Africa)

    Rosman, Benjamin S

    2014-11-01

    Full Text Available , and Behavior Transfer in Autonomous Robots, AAAI 2014 Fall Symposium Series, 13-15 November 2014 Behavioural Domain Knowledge Transfer for Autonomous Agents Benjamin Rosman Mobile Intelligent Autonomous Systems Modelling and Digital Science Council...

  16. Autonomous Learner Model Resource Book

    Science.gov (United States)

    Betts, George T.; Carey, Robin J.; Kapushion, Blanche M.

    2016-01-01

    "Autonomous Learner Model Resource Book" includes activities and strategies to support the development of autonomous learners. More than 40 activities are included, all geared to the emotional, social, cognitive, and physical development of students. Teachers may use these activities and strategies with the entire class, small groups, or…

  17. Prevalence and Predictors of Erectile Dysfunctions among Men on ...

    African Journals Online (AJOL)

    viral therapies (ART) and different degrees of sexual dysfunction in men.[1-3] The highest rates of dysfunction are associated with Indinavir and the lowest with Nevirapine.[2] ... Abstract. Background: Erectile dysfunctions (EDs) are common presentations among men on ..... of old age could also explain this phenomenon.

  18. Effect of surface spinal stimulation on autonomic nervous system in the patients with spinal cord injury

    Directory of Open Access Journals (Sweden)

    Bhavkiran Kaur

    2014-01-01

    Full Text Available Background: The Autonomic Nervous System (ANS plays a key role in the regulation of many physiological processes, mediated by supraspinal control from centers in the central nervous system. Spinal cord injury (SCI decreases the ability to sympathetically control blood pressure and to regulate body temperature. Bladder dysfunction has been reported as a serious medical complication following SCI. The purpose of study is to find the effect of surface spinal stimulation on autonomic nervous system i.e., bladder function, skin resistance, and skin temperature. Materials and Methods: Five traumatic spinal cord injury subjects were selected for experimental pilot study; surface spinal stimulation for 45 minute period applied to the skin in T11-L2 area, with a carrier frequency of 2500Hz and modulated to beats frequency of 20Hz. Stimulation amplitude was raised to cause sensory stimulation. The pre- and post-stimulation values using the values of urodynamics testing, galvanic skin response, and infra-red thermometer compared in same patients and results were obtained. Results: Result of the present study indicates that four of five subjects demonstrate a decrease in the infused fluid volume, improved bladder sensation, but shown no effect over the bladder capacity. The skin resistance of the right lower limb was increased post-stimulation, but the improvement was not significant, and skin temperature of thigh and foreleg improved significantly. Conclusion: According to our results, surface spinal stimulation was effective to improve non-reflexive bladder, skin resistance and skin temperature, but further research is needed.

  19. Erectile Dysfunction (ED)

    Science.gov (United States)

    ... men older than 75 years of age. Is erectile dysfunction just a part of old age? ED doesn’t have to be a part of getting older. It’s true that as you get older, you may need more ... Symptoms of erectile dysfunction The primary symptom of ED is not ...

  20. Loneliness and Sexual Dysfunctions.

    Science.gov (United States)

    Mijuskovic, Ben

    1987-01-01

    Argues that sexual dysfunctions result from early childhood experiences which were originally nonsexual in nature. Contends that psychological difficulties centered around problems of loneliness tend to generate certain sexual dysfunctions. Extends and explores suggestion that genesis of sexual conflicts is in nonsexual infant separation anxiety…

  1. Advanced Autonomous Systems for Space Operations

    Science.gov (United States)

    Gross, A. R.; Smith, B. D.; Muscettola, N.; Barrett, A.; Mjolssness, E.; Clancy, D. J.

    2002-01-01

    otherwise possible, as well as many more efficient and low cost applications. In addition, utilizing component and system modeling and reasoning capabilities, autonomous systems will play an increasing role in ground operations for space missions, where they will both reduce the human workload as well as provide greater levels of monitoring and system safety. This paper will focus specifically on new and innovative software for remote, autonomous, space systems flight operations. Topics to be presented will include a brief description of key autonomous control concepts, the Remote Agent program that commanded the Deep Space 1 spacecraft to new levels of system autonomy, recent advances in distributed autonomous system capabilities, and concepts for autonomous vehicle health management systems. A brief description of teaming spacecraft and rovers for complex exploration missions will also be provided. New on-board software for autonomous science data acquisition for planetary exploration will be described, as well as advanced systems for safe planetary landings. A new multi-agent architecture that addresses some of the challenges of autonomous systems will be presented. Autonomous operation of ground systems will also be considered, including software for autonomous in-situ propellant production and management, and closed- loop ecological life support systems (CELSS). Finally, plans and directions for the future will be discussed.

  2. Loss of MeCP2 Causes Urological Dysfunction and Contributes to Death by Kidney Failure in Mouse Models of Rett Syndrome.

    Directory of Open Access Journals (Sweden)

    Christopher S Ward

    Full Text Available Rett Syndrome (RTT is a neurodevelopmental disorder characterized by loss of acquired skills during development, autonomic dysfunction, and an increased risk for premature lethality. Clinical experience identified a subset of individuals with RTT that present with urological dysfunction including individuals with frequent urinary tract infections, kidney stones, and urine retention requiring frequent catheterization for bladder voiding. To determine if urologic dysfunction is a feature of RTT, we queried the Rett Syndrome Natural History Study, a repository of clinical data from over 1000 individuals with RTT and found multiple instances of urological dysfunction. We then evaluated urological function in a mouse model of RTT and found an abnormal pattern of micturition. Both male and female mice possessing Mecp2 mutations show a decrease in urine output per micturition event. Furthermore, we identified signs of kidney failure secondary to urethral obstruction. Although genetic strain background significantly affects both survival and penetrance of the urethral obstruction phenotype, survival and penetrance of urethral obstruction do not directly correlate. We have identified an additional phenotype caused by loss of MeCP2, urological dysfunction. Furthermore, we urge caution in the interpretation of survival data as an endpoint in preclinical studies, especially where causes of mortality are poorly characterized.

  3. Loss of MeCP2 Causes Urological Dysfunction and Contributes to Death by Kidney Failure in Mouse Models of Rett Syndrome.

    Science.gov (United States)

    Ward, Christopher S; Huang, Teng-Wei; Herrera, José A; Samaco, Rodney C; Pitcher, Meagan R; Herron, Alan; Skinner, Steven A; Kaufmann, Walter E; Glaze, Daniel G; Percy, Alan K; Neul, Jeffrey L

    2016-01-01

    Rett Syndrome (RTT) is a neurodevelopmental disorder characterized by loss of acquired skills during development, autonomic dysfunction, and an increased risk for premature lethality. Clinical experience identified a subset of individuals with RTT that present with urological dysfunction including individuals with frequent urinary tract infections, kidney stones, and urine retention requiring frequent catheterization for bladder voiding. To determine if urologic dysfunction is a feature of RTT, we queried the Rett Syndrome Natural History Study, a repository of clinical data from over 1000 individuals with RTT and found multiple instances of urological dysfunction. We then evaluated urological function in a mouse model of RTT and found an abnormal pattern of micturition. Both male and female mice possessing Mecp2 mutations show a decrease in urine output per micturition event. Furthermore, we identified signs of kidney failure secondary to urethral obstruction. Although genetic strain background significantly affects both survival and penetrance of the urethral obstruction phenotype, survival and penetrance of urethral obstruction do not directly correlate. We have identified an additional phenotype caused by loss of MeCP2, urological dysfunction. Furthermore, we urge caution in the interpretation of survival data as an endpoint in preclinical studies, especially where causes of mortality are poorly characterized.

  4. Research Institute for Autonomous Precision Guided Systems

    National Research Council Canada - National Science Library

    Rogacki, John R

    2007-01-01

    ... vehicles, cooperative flight of autonomous aerial vehicles using GPS and vision information, cooperative and sharing of information in search missions involving multiple autonomous agents, multi-scale...

  5. Evolutionary Autonomous Health Monitoring System (EAHMS) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — For supporting NASA's Robotics, Tele-Robotics and Autonomous Systems Roadmap, we are proposing the "Evolutionary Autonomous Health Monitoring System" (EAHMS) for...

  6. Science, technology and the future of small autonomous drones

    Science.gov (United States)

    Floreano, Dario; Wood, Robert J.

    2015-05-01

    We are witnessing the advent of a new era of robots -- drones -- that can autonomously fly in natural and man-made environments. These robots, often associated with defence applications, could have a major impact on civilian tasks, including transportation, communication, agriculture, disaster mitigation and environment preservation. Autonomous flight in confined spaces presents great scientific and technical challenges owing to the energetic cost of staying airborne and to the perceptual intelligence required to negotiate complex environments. We identify scientific and technological advances that are expected to translate, within appropriate regulatory frameworks, into pervasive use of autonomous drones for civilian applications.

  7. Science, technology and the future of small autonomous drones.

    Science.gov (United States)

    Floreano, Dario; Wood, Robert J

    2015-05-28

    We are witnessing the advent of a new era of robots - drones - that can autonomously fly in natural and man-made environments. These robots, often associated with defence applications, could have a major impact on civilian tasks, including transportation, communication, agriculture, disaster mitigation and environment preservation. Autonomous flight in confined spaces presents great scientific and technical challenges owing to the energetic cost of staying airborne and to the perceptual intelligence required to negotiate complex environments. We identify scientific and technological advances that are expected to translate, within appropriate regulatory frameworks, into pervasive use of autonomous drones for civilian applications.

  8. Autonomous Martian flying rover

    Science.gov (United States)

    1990-01-01

    A remotely programmable, autonomous flying rover is proposed to extensively survey the Martian surface environment. A Mach .3, solar powered, modified flying wing could cover roughly a 2000 mile range during Martian daylight hours. Multiple craft launched from an orbiting mother ship could provide near-global coverage. Each craft is envisioned to fly at about 1 km above the surface and measure atmospheric composition, pressure and temperature, map surface topography, and remotely penetrate the near subsurface looking for water (ice) and perhaps evidence of life. Data collected are relayed to Earth via the orbiting mother ship. Near surface guidance and control capability is an adaptation of current cruise missile technology. A solar powered aircraft designed to fly in the low temperature, low density, carbon dioxide Martian atmosphere near the surface appears feasible.

  9. Small fiber dysfunction in patients with Wilson's disease

    Directory of Open Access Journals (Sweden)

    Francisco de Assis A. Gondim

    2014-08-01

    Full Text Available Objective: Patients with Wilson’s disease (WD may develop a wide variety of neuropsychiatric symptoms, but there are few reports of autonomic dysfunction. Here, we described evidence of small fiber and/or autonomic dysfunction in 4 patients with WD and levodopa-responsive parkinsonism. Method: We reviewed the charts of 4 patients with WD who underwent evaluation for the presence of neuromuscular dysfunction and water-induced skin wrinkling test (SWT. Results: Two men and 2 women (33±3.5 years with WD were evaluated. They all had parkinsonism at some point during their disease course. Parkinsonism on patient 4 almost completely subsided with treatment of WD. Two patients had significant sensory and 2 significant autonomic complaints, including syncopal spells. NCS/EMG was normal in all but SWT was abnormal in half of them (mean 4-digit wrinkling of 0.25 and 1. Discussion: A subset of patients with WD exhibit evidence of abnormal skin wrinkling test (small fiber neuropathy.

  10. Genetics Home Reference: surfactant dysfunction

    Science.gov (United States)

    ... Email Facebook Twitter Home Health Conditions Surfactant dysfunction Surfactant dysfunction Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Surfactant dysfunction is a lung disorder that causes breathing ...

  11. Experimental Autonomous Road Vehicle with Logical Artificial Intelligence

    Directory of Open Access Journals (Sweden)

    Sergey Sergeevich Shadrin

    2017-01-01

    Full Text Available This article describes some technical issues regarding the adaptation of a production car to a platform for the development and testing of autonomous driving technologies. A universal approach to performing the reverse engineering of electric power steering (EPS for the purpose of external control is also presented. The primary objective of the related study was to solve the problem associated with the precise prediction of the dynamic trajectory of an autonomous vehicle. This was accomplished by deriving a new equation for determining the lateral tire forces and adjusting some of the vehicle parameters under road test conductions. A Mivar expert system was also integrated into the control system of the experimental autonomous vehicle. The expert system was made more flexible and effective for the present application by the introduction of hybrid artificial intelligence with logical reasoning. The innovation offers a solution to the major problem of liability in the event of an autonomous transport vehicle being involved in a collision.

  12. Role of Exercise Training on Autonomic Changes and Inflammatory Profile Induced by Myocardial Infarction

    Science.gov (United States)

    Rodrigues, Bruno; Lira, Fabio S.; Consolim-Colombo, Fernanda M.; Rocha, Juraci A.; Caperuto, Erico C.; De Angelis, Kátia; Irigoyen, Maria-Cláudia

    2014-01-01

    The cardiovascular autonomic imbalance in patients after myocardial infarction (MI) provides a significant increase in mortality rate, and seems to precede metabolic, hormonal, and immunological changes. Moreover, the reduction in the parasympathetic function has been associated with inflammatory response in different pathological conditions. Over the years, most of the studies have indicated the exercise training (ET) as an important nonpharmacological tool in the management of autonomic dysfunction and reduction in inflammatory profile after a myocardial infarction. In this work, we reviewed the effects of ET on autonomic imbalance after MI, and its consequences, particularly, in the post-MI inflammatory profile. Clinical and experimental evidence regarding relationship between alterations in autonomic regulation and local or systemic inflammation response after MI were also discussed. PMID:25045212

  13. Role of Exercise Training on Autonomic Changes and Inflammatory Profile Induced by Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Bruno Rodrigues

    2014-01-01

    Full Text Available The cardiovascular autonomic imbalance in patients after myocardial infarction (MI provides a significant increase in mortality rate, and seems to precede metabolic, hormonal, and immunological changes. Moreover, the reduction in the parasympathetic function has been associated with inflammatory response in different pathological conditions. Over the years, most of the studies have indicated the exercise training (ET as an important nonpharmacological tool in the management of autonomic dysfunction and reduction in inflammatory profile after a myocardial infarction. In this work, we reviewed the effects of ET on autonomic imbalance after MI, and its consequences, particularly, in the post-MI inflammatory profile. Clinical and experimental evidence regarding relationship between alterations in autonomic regulation and local or systemic inflammation response after MI were also discussed.

  14. The Emerging Threats From Autonomous Systems [video

    OpenAIRE

    Center for Homeland Defense and Security Naval Postgraduate School

    2017-01-01

    Video presentation at the 2017 APEX workshop (Alumni Professional Exchange). Rob Sen. Self-described “serial entrepreneur” Robi Sen, Chief Technology Officer with the company Department 13, offered attendees a glimpse into the future and implications of autonomous systems and artificial intelligence. Sen traces the history and the future prospects of these systems. Benefits could include fewer accidents, finely tailored personalized medicine, reduced natural resource use, opening of areas for...

  15. Somatic DNA Damages in Cardiovascular Autonomic Neuropathy

    OpenAIRE

    Supriya Simon, A.; Dinesh Roy, D.; Jayapal, V.; Vijayakumar, T.

    2010-01-01

    Cardiovascular autonomic neuropathy (CAN) is one of the most clinically significant complications of diabetes mellitus. Even though many ethological factors have been attributed for the pathogenesis of this disease no attempts were made to correlate DNA damage as a causative factor. Hence the present study was undertaken to asses the extent of somatic DNA damages by cytokinesis-block micronuclei assay (CBMN). An attempt is also being made to correlate the habits and/or risk factors and socioe...

  16. Integrating autonomous Problem Resolution Models with Remedy

    OpenAIRE

    Marquina, M A; Padilla, J; Ramos, R

    2000-01-01

    This paper briefly defines the concept of Problem Resolution Model and shows possible approaches to the issues which may arise when integrating various PRMs to present a consistent view to the end user, despite of the peculiarities of each physical implementation. Integration refers to various autonomous PRMs having to interact as problems pass from one to another in the resolution flow. This process should be transparent to the user and internally there must be a way to track in which stage ...

  17. Development of autonomous vehicles’ testing system

    Science.gov (United States)

    Ivanov, A. M.; Shadrin, S. S.

    2018-02-01

    This article describes overview of automated and, in perspective, autonomous vehicles’ (AV) implementation risks. Set of activities, actual before the use of AVs on public roads, minimizing negative technical and social problems of AVs’ implementation is presented. Classification of vehicle’s automated control systems operating conditions is formulated. Groups of tests for AVs are developed and justified, sequence of AVs’ testing system formation is proposed.

  18. Task sequencing for autonomous robotic vacuum cleaners

    Science.gov (United States)

    Gorbenko, Anna; Popov, Vladimir

    2017-07-01

    Various planning problems for robotic systems are of considerable interest. One of such problems is the problem of task sequencing. In this paper, we consider the problem of task sequencing for autonomous vacuum floor cleaning robots. We consider a graph model for the problem. We propose an efficient approach to solve the problem. In particular, we use an explicit reduction from the decision version of the problem to the satisfiability problem. We present the results of computational experiments for different satisfiability algorithms.

  19. Thyroid dysfunction in Down's syndrome.

    OpenAIRE

    Loudon, M M; Day, R E; Duke, E M

    1985-01-01

    One hundred and sixteen children with Down's syndrome, living in the community, were examined for clinical or laboratory evidence of thyroid dysfunction. Three were hypothyroid and one was hyperthyroid. Twenty eight (29%) had thyroid autoantibodies. Autoimmune conditions were present in first or second degree relatives of 35 (30%) of the children, and in 17 (15%) this was a thyroid disorder. The families of normal control children also showed a 30% incidence of overt autoimmune conditions, an...

  20. Cybersecurity for aerospace autonomous systems

    Science.gov (United States)

    Straub, Jeremy

    2015-05-01

    High profile breaches have occurred across numerous information systems. One area where attacks are particularly problematic is autonomous control systems. This paper considers the aerospace information system, focusing on elements that interact with autonomous control systems (e.g., onboard UAVs). It discusses the trust placed in the autonomous systems and supporting systems (e.g., navigational aids) and how this trust can be validated. Approaches to remotely detect the UAV compromise, without relying on the onboard software (on a potentially compromised system) as part of the process are discussed. How different levels of autonomy (task-based, goal-based, mission-based) impact this remote characterization is considered.

  1. Energy autonomous sensors in the automobile; Energieautarke Sensorik im Automobil

    Energy Technology Data Exchange (ETDEWEB)

    Kuehne, Ingo [Hochschule Heilbronn (Germany). Studiengang Energieoekologie; Schreiter, Matthias [Siemens AG, Muenchen (Germany); Li, Xiaoming [Daimler AG, Sindelfingen (Germany); Hehn, Thorsten [Hahn-Schickard-Gesellschaft fuer angewandte Forschung e.V., Freiburg (Germany). HSG-IMIT, Inst. fuer Mikro- und Informationstechnik; Thewes, Marcell; Scholl, Gerd [Helmut-Schmidt-Univ., Univ. der Bundeswehr, Hamburg (Germany); Wagner, Dieter [Continental Automotive GmbH, Regensburg (Germany); Manoli, Yiannos [Univ. Freiburg (Germany). IMTEK; Frey, Alexander [Hochschule Augsburg (Germany). Fakultaet Elektrotechnik

    2013-04-01

    A brief outline of energy autonomous sensors in the automobile is given. For this purpose the variety of sensors in today's automotive vehicles is reported. The rationale for the deployment of energy autonomous sensors is given. In addition the potential of using environmental energy and the possibilities of their energy conversion are presented. As part of the funded project ASYMOF, two pioneer applications - a tire pressure monitoring and an anti-theft alarm system - are studied and discussed.

  2. Exercise-induced ventricular arrhythmias and vagal dysfunction in Chagas disease patients with no apparent cardiac involvement

    Directory of Open Access Journals (Sweden)

    Henrique Silveira Costa

    2015-04-01

    Full Text Available INTRODUCTION : Exercise-induced ventricular arrhythmia (EIVA and autonomic imbalance are considered as early markers of heart disease in Chagas disease (ChD patients. The objective of the present study was to verify the differences in the occurrence of EIVA and autonomic maneuver indexes between healthy individuals and ChD patients with no apparent cardiac involvement. METHODS : A total of 75 ChD patients with no apparent cardiac involvement, aged 44.7 (8.5 years, and 38 healthy individuals, aged 44.0 (9.2 years, were evaluated using echocardiography, symptom-limited treadmill exercise testing and autonomic function tests. RESULTS : The occurrence of EIVA was higher in the chagasic group (48% than in the control group (23.7% during both the effort and the recovery phases. Frequent ventricular contractions occurred only in the patient group. Additionally, the respiratory sinus arrhythmia index was significantly lower in the chagasic individuals compared with the control group. CONCLUSIONS : ChD patients with no apparent cardiac involvement had a higher frequency of EIVA as well as more vagal dysfunction by respiratory sinus arrhythmia. These results suggest that even when asymptomatic, ChD patients possess important arrhythmogenic substrates and subclinical disease.

  3. Simulating autonomous driving styles: Accelerations for three road profiles

    Directory of Open Access Journals (Sweden)

    Karjanto Juffrizal

    2017-01-01

    Full Text Available This paper presents a new experimental approach to simulate projected autonomous driving styles based on the accelerations at three road profiles. This study was focused on the determination of ranges of accelerations in triaxial direction to simulate the autonomous driving experience. A special device, known as the Automatic Acceleration and Data controller (AUTOAccD, has been developed to guide the designated driver to accomplish the selected accelerations based on the road profiles and the intended driving styles namely assertive, defensive and light rail transit (LRT. Experimental investigations have been carried out at three different road profiles (junction, speed hump, and corner with two designated drivers with five trials on each condition. A driving style with the accelerations of LRT has also been included in this study as it is significant to the present methodology because the autonomous car is predicted to accelerate like an LRT, in such a way that it enables the users to conduct activities such as working on a laptop, using personal devices or eating and drinking while travelling. The results demonstrated that 92 out of 110 trials of the intended accelerations for autonomous driving styles could be achieved and simulated on the real road by the designated drivers. The differences between the two designated drivers were negligible, and the rates of succeeding in realizing the intended accelerations were high. The present approach in simulating autonomous driving styles focusing on accelerations can be used as a tool for experimental setup involving autonomous driving experience and acceptance.

  4. Spinal Cord Dysfunction (SCD)

    Data.gov (United States)

    Department of Veterans Affairs — The Spinal Cord Dysfunction (SCD) module supports the maintenance of local and national registries for the tracking of patients with spinal cord injury and disease...

  5. Sexual Dysfunction in Urogynaecology

    NARCIS (Netherlands)

    A.M.E. Roos (Anne-Marie)

    2014-01-01

    markdownabstract__abstract__ This thesis is dedicated to enhance understanding of sexual dysfunction in the field of urogynaecology, focussing on the prevalence of sexual problems in urogynaecology clinics, the clinical attention of the urogynaecologist to female sexual dyfunction, the impact

  6. Autonomic Function Impairment and Brain Perfusion Deficit in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Wei-Che Lin

    2017-06-01

    Full Text Available IntroductionAutonomic disorders have been recognized as important Parkinson’s disease (PD components. Some vulnerable structures are related to the central autonomic network and have also been linked to autonomic function alterations. The aims of the study are to evaluate the severity of the autonomic dysfunction and the cortical hypoperfusion using arterial spin labeling (ASL MRI. And then, possible relationships of significant between-group differences in perfusion pattern to clinical variables and autonomic functions were examined to determine the pharmaceutical effects of dopaminergic treatment on cerebral blood flow (CBF in patients with PD.MethodsBrain ASL MRI was carried out in 20 patients with PD (6 men and 14 women, mean age: 63.3 ± 6.4 years and 22 sex- and age-matched healthy volunteers to assess whole-brain CBF and the effects of dopaminergic therapy on perfusion. All subjects underwent a standardized evaluation of cardiovagal and adrenergic function including a deep breathing, Valsalva maneuver, and 5-min head-up tilt test. Perfusion MRI data were acquired on a 3.0 T scanner with a pulsed continuous ASL technique. The CBF, autonomic parameters, and clinical data were analyzed after adjusting for age and sex.ResultsPatients exhibited a decline in autonomic function (rapid heart rate in response to deep breathing, low baroreflex sensitivity, high systolic and diastolic pressure, and altered tilting test response, widespread low CBF, and robust response to dopaminergic therapy. Lower perfusion in the middle frontal gyrus was associated with increased clinical disease severity (Unified Parkinson’s Disease Rating Scale I score, P < 0.001. Lower perfusion in autonomic control areas, such as the frontal lobe and insula, were significantly associated with autonomic impairment (P < 0.001.ConclusionsOur study indicates that PD is a progressive neurodegenerative disorder that changes the perfusion of central nervous system

  7. Cranial Autonomic Symptoms in Migraine

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-11-01

    Full Text Available Cranial autonomic symptoms (CAS in patients with migraine and cluster headaches (CH were characterized and compared in a prospective study of consecutive patients attending a headache clinic at Taipei Veterans General Hospital, Taiwan.

  8. Catecholamines and diabetic autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J

    1995-01-01

    of plasma catecholamine measurements is not due to changes in the clearance of catecholamines in diabetic autonomic neuropathy. The physiological responses to infused adrenaline and to noradrenaline are enhanced, for noradrenaline mainly cardiovascular responses. Adrenoceptors (alpha and beta adrenoceptors...

  9. Forced synchronization of autonomous dynamical Boolean networks

    International Nuclear Information System (INIS)

    Rivera-Durón, R. R.; Campos-Cantón, E.; Campos-Cantón, I.; Gauthier, Daniel J.

    2015-01-01

    We present the design of an autonomous time-delay Boolean network realized with readily available electronic components. Through simulations and experiments that account for the detailed nonlinear response of each circuit element, we demonstrate that a network with five Boolean nodes displays complex behavior. Furthermore, we show that the dynamics of two identical networks display near-instantaneous synchronization to a periodic state when forced by a common periodic Boolean signal. A theoretical analysis of the network reveals the conditions under which complex behavior is expected in an individual network and the occurrence of synchronization in the forced networks. This research will enable future experiments on autonomous time-delay networks using readily available electronic components with dynamics on a slow enough time-scale so that inexpensive data collection systems can faithfully record the dynamics

  10. 13th International Conference Intelligent Autonomous Systems

    CERN Document Server

    Michael, Nathan; Berns, Karsten; Yamaguchi, Hiroaki

    2016-01-01

    This book describes the latest research accomplishments, innovations, and visions in the field of robotics as presented at the 13th International Conference on Intelligent Autonomous Systems (IAS), held in Padua in July 2014, by leading researchers, engineers, and practitioners from across the world. The contents amply confirm that robots, machines, and systems are rapidly achieving intelligence and autonomy, mastering more and more capabilities such as mobility and manipulation, sensing and perception, reasoning, and decision making. A wide range of research results and applications are covered, and particular attention is paid to the emerging role of autonomous robots and intelligent systems in industrial production, which reflects their maturity and robustness. The contributions have been selected through a rigorous peer-review process and contain many exciting and visionary ideas that will further galvanize the research community, spurring novel research directions. The series of biennial IAS conferences ...

  11. Wavefront Propagation and Fuzzy Based Autonomous Navigation

    Directory of Open Access Journals (Sweden)

    Adel Al-Jumaily

    2005-06-01

    Full Text Available Path planning and obstacle avoidance are the two major issues in any navigation system. Wavefront propagation algorithm, as a good path planner, can be used to determine an optimal path. Obstacle avoidance can be achieved using possibility theory. Combining these two functions enable a robot to autonomously navigate to its destination. This paper presents the approach and results in implementing an autonomous navigation system for an indoor mobile robot. The system developed is based on a laser sensor used to retrieve data to update a two dimensional world model of therobot environment. Waypoints in the path are incorporated into the obstacle avoidance. Features such as ageing of objects and smooth motion planning are implemented to enhance efficiency and also to cater for dynamic environments.

  12. Forced synchronization of autonomous dynamical Boolean networks

    Energy Technology Data Exchange (ETDEWEB)

    Rivera-Durón, R. R., E-mail: roberto.rivera@ipicyt.edu.mx; Campos-Cantón, E., E-mail: eric.campos@ipicyt.edu.mx [División de Matemáticas Aplicadas, Instituto Potosino de Investigación Científica y Tecnológica A. C., Camino a la Presa San José 2055, Col. Lomas 4 Sección, C.P. 78216, San Luis Potosí, S.L.P. (Mexico); Campos-Cantón, I. [Facultad de Ciencias, Universidad Autónoma de San Luis Potosí, Álvaro Obregón 64, C.P. 78000, San Luis Potosí, S.L.P. (Mexico); Gauthier, Daniel J. [Department of Physics and Center for Nonlinear and Complex Systems, Duke University, Box 90305, Durham, North Carolina 27708 (United States)

    2015-08-15

    We present the design of an autonomous time-delay Boolean network realized with readily available electronic components. Through simulations and experiments that account for the detailed nonlinear response of each circuit element, we demonstrate that a network with five Boolean nodes displays complex behavior. Furthermore, we show that the dynamics of two identical networks display near-instantaneous synchronization to a periodic state when forced by a common periodic Boolean signal. A theoretical analysis of the network reveals the conditions under which complex behavior is expected in an individual network and the occurrence of synchronization in the forced networks. This research will enable future experiments on autonomous time-delay networks using readily available electronic components with dynamics on a slow enough time-scale so that inexpensive data collection systems can faithfully record the dynamics.

  13. Autonomous Energy Grids: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Kroposki, Benjamin D [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Dall-Anese, Emiliano [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Bernstein, Andrey [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Zhang, Yingchen [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Hodge, Brian S [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-10-04

    With much higher levels of distributed energy resources - variable generation, energy storage, and controllable loads just to mention a few - being deployed into power systems, the data deluge from pervasive metering of energy grids, and the shaping of multi-level ancillary-service markets, current frameworks to monitoring, controlling, and optimizing large-scale energy systems are becoming increasingly inadequate. This position paper outlines the concept of 'Autonomous Energy Grids' (AEGs) - systems that are supported by a scalable, reconfigurable, and self-organizing information and control infrastructure, can be extremely secure and resilient (self-healing), and self-optimize themselves in real-time for economic and reliable performance while systematically integrating energy in all forms. AEGs rely on scalable, self-configuring cellular building blocks that ensure that each 'cell' can self-optimize when isolated from a larger grid as well as partaking in the optimal operation of a larger grid when interconnected. To realize this vision, this paper describes the concepts and key research directions in the broad domains of optimization theory, control theory, big-data analytics, and complex system modeling that will be necessary to realize the AEG vision.

  14. Auditory Dysfunction in Patients with Cerebrovascular Disease

    Directory of Open Access Journals (Sweden)

    Sadaharu Tabuchi

    2014-01-01

    Full Text Available Auditory dysfunction is a common clinical symptom that can induce profound effects on the quality of life of those affected. Cerebrovascular disease (CVD is the most prevalent neurological disorder today, but it has generally been considered a rare cause of auditory dysfunction. However, a substantial proportion of patients with stroke might have auditory dysfunction that has been underestimated due to difficulties with evaluation. The present study reviews relationships between auditory dysfunction and types of CVD including cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, cerebrovascular malformation, moyamoya disease, and superficial siderosis. Recent advances in the etiology, anatomy, and strategies to diagnose and treat these conditions are described. The numbers of patients with CVD accompanied by auditory dysfunction will increase as the population ages. Cerebrovascular diseases often include the auditory system, resulting in various types of auditory dysfunctions, such as unilateral or bilateral deafness, cortical deafness, pure word deafness, auditory agnosia, and auditory hallucinations, some of which are subtle and can only be detected by precise psychoacoustic and electrophysiological testing. The contribution of CVD to auditory dysfunction needs to be understood because CVD can be fatal if overlooked.

  15. Autonomous assistance navigation for robotic wheelchairs in confined spaces.

    Science.gov (United States)

    Cheein, Fernando Auat; Carelli, Ricardo; De la Cruz, Celso; Muller, Sandra; Bastos Filho, Teodiano F

    2010-01-01

    In this work, a visual interface for the assistance of a robotic wheelchair's navigation is presented. The visual interface is developed for the navigation in confined spaces such as narrows corridors or corridor-ends. The interface performs two navigation modus: non-autonomous and autonomous. The non-autonomous driving of the robotic wheelchair is made by means of a hand-joystick. The joystick directs the motion of the vehicle within the environment. The autonomous driving is performed when the user of the wheelchair has to turn (90, 90 or 180 degrees) within the environment. The turning strategy is performed by a maneuverability algorithm compatible with the kinematics of the wheelchair and by the SLAM (Simultaneous Localization and Mapping) algorithm. The SLAM algorithm provides the interface with the information concerning the environment disposition and the pose -position and orientation-of the wheelchair within the environment. Experimental and statistical results of the interface are also shown in this work.

  16. Trichotillomania In A Patient With Sexual Dysfunction

    Directory of Open Access Journals (Sweden)

    Aswathi Krishna

    2016-10-01

    Full Text Available Trichotillomania is a chronic psychiatric disorder characterized by pulling out one's own hair, which results in an obvious loss of hair. Hair pulling was first described in Henri Allopeau in 1889. The term "trichotillomania" comes from the Greek words "thrix" - hair, "tillein" - to pull and "Mania" madness or frenzy. 30 year old man presented with complaints of hairpulling behavior and associated erectile dysfunction. His hairpulling behavior improved on treating his sexual dysfunction.

  17. Service recovery following dysfunctional consumer participation

    OpenAIRE

    Hibbert, SA; Piacentini, Maria; Hogg, Margaret

    2012-01-01

    This article introduces the notion of dysfunctional consumer participation. It advances a theoretical model of service recovery for contexts in which the smooth functioning of a service has been disrupted by consumers’ dysfunctional contributions, founded on justice theory and cognitive appraisal theory. The model presents perceived justice as the core element of the evaluation of service recovery encounters. Stressful appraisal evokes emotions in consumers and influences the cooperative or re...

  18. Temporomandibular Joint Dysfunction: A Dental Overview

    OpenAIRE

    Hillier, Clyde D.

    1985-01-01

    Temporomandibular joint dysfunction is common and often acutely painful. Because of the large and diverse symptom complex created by this disorder, patients frequently first seek relief from their physician rather than their dentist. In this article temporomandibular joint (TMJ) dysfunction is defined and the presenting signs and symptoms are discussed. Their etiology is described in relation to the anatomy of the temporomandibular joint. Examination techniques can help in the differential di...

  19. Autonomous power system: Integrated scheduling

    Science.gov (United States)

    Ringer, Mark J.

    1992-01-01

    The Autonomous Power System (APS) project at NASA Lewis Research Center is designed to demonstrate the abilities of integrated intelligent diagnosis, control and scheduling techniques to space power distribution hardware. The project consists of three elements: the Autonomous Power Expert System (APEX) for fault diagnosis, isolation, and recovery (FDIR), the Autonomous Intelligent Power Scheduler (AIPS) to determine system configuration, and power hardware (Brassboard) to simulate a space-based power system. Faults can be introduced into the Brassboard and in turn, be diagnosed and corrected by APEX and AIPS. The Autonomous Intelligent Power Scheduler controls the execution of loads attached to the Brassboard. Each load must be executed in a manner that efficiently utilizes available power and satisfies all load, resource, and temporal constraints. In the case of a fault situation on the Brassboard, AIPS dynamically modifies the existing schedule in order to resume efficient operation conditions. A database is kept of the power demand, temporal modifiers, priority of each load, and the power level of each source. AIPS uses a set of heuristic rules to assign start times and resources to each load based on load and resource constraints. A simple improvement engine based upon these heuristics is also available to improve the schedule efficiency. This paper describes the operation of the Autonomous Intelligent Power Scheduler as a single entity, as well as its integration with APEX and the Brassboard. Future plans are discussed for the growth of the Autonomous Intelligent Power Scheduler.

  20. Flocking algorithm for autonomous flying robots.

    Science.gov (United States)

    Virágh, Csaba; Vásárhelyi, Gábor; Tarcai, Norbert; Szörényi, Tamás; Somorjai, Gergő; Nepusz, Tamás; Vicsek, Tamás

    2014-06-01

    Animal swarms displaying a variety of typical flocking patterns would not exist without the underlying safe, optimal and stable dynamics of the individuals. The emergence of these universal patterns can be efficiently reconstructed with agent-based models. If we want to reproduce these patterns with artificial systems, such as autonomous aerial robots, agent-based models can also be used in their control algorithms. However, finding the proper algorithms and thus understanding the essential characteristics of the emergent collective behaviour requires thorough and realistic modeling of the robot and also the environment. In this paper, we first present an abstract mathematical model of an autonomous flying robot. The model takes into account several realistic features, such as time delay and locality of communication, inaccuracy of the on-board sensors and inertial effects. We present two decentralized control algorithms. One is based on a simple self-propelled flocking model of animal collective motion, the other is a collective target tracking algorithm. Both algorithms contain a viscous friction-like term, which aligns the velocities of neighbouring agents parallel to each other. We show that this term can be essential for reducing the inherent instabilities of such a noisy and delayed realistic system. We discuss simulation results on the stability of the control algorithms, and perform real experiments to show the applicability of the algorithms on a group of autonomous quadcopters. In our case, bio-inspiration works in two ways. On the one hand, the whole idea of trying to build and control a swarm of robots comes from the observation that birds tend to flock to optimize their behaviour as a group. On the other hand, by using a realistic simulation framework and studying the group behaviour of autonomous robots we can learn about the major factors influencing the flight of bird flocks.

  1. Olfactory dysfunction and cardiovascular dysautonomia in Parkinson's disease.

    Science.gov (United States)

    Oka, Hisayoshi; Toyoda, Chizuko; Yogo, Makiko; Mochio, Soichiro

    2010-06-01

    Several studies have reported that olfactory dysfunction is an early neuropathological manifestation of Parkinson's disease (PD). Reduced cardiac meta-iodobenzylguanidine ((123)I-MIBG) uptake may be one of the earliest signs of PD. We studied the relation of olfactory dysfunction to cardiovascular dysautonomia in patients with PD. The study group comprised 66 patients with PD (70.5 years) and 26 controls (70.3 years) for olfactory assessment, 21 controls (72.1 years) for cardiac (123)I-MIBG scintigraphy and heart rate variability (HRV), assessed using the coefficient of variation for RR intervals (HRV), and 23 controls (69.2 years) for orthostatic blood pressure response. Olfactory function was assessed by the odor stick identification test Japan (OSIT-J), and cardiovascular autonomic function was evaluated by (123)I-MIBG scintigraphy of the heart, the fall in orthostatic blood pressure, and HRV. Patients with PD had a significantly lower OSIT-J score than did the controls (4.1 +/- 3.0 vs. 9.9 +/- 1.7, p = 0.001). The OSIT-J score was unrelated to variables other than gender, including age, disease duration, motor score on the unified Parkinson's disease rating scale, score on the mini-mental state examination, motor phenotype, visual hallucinations, and dopaminergic medication on multiple regression and logistic regression analyses. The OSIT-J score was related to the heart/mediastinum ratio of cardiac (123)I-MIBG uptake, the fall in orthostatic blood pressure, and HRV, after adjustment for other clinical variables. Olfactory dysfunction in PD was, thus, significantly related to both cardiac sympathetic and parasympathetic dysfunction, as well as vascular sympathetic dysfunction. As non-motor symptoms of PD, olfactory dysfunction and autonomic network failure appear to be closely related in PD.

  2. Autonomous Byte Stream Randomizer

    Science.gov (United States)

    Paloulian, George K.; Woo, Simon S.; Chow, Edward T.

    2013-01-01

    Net-centric networking environments are often faced with limited resources and must utilize bandwidth as efficiently as possible. In networking environments that span wide areas, the data transmission has to be efficient without any redundant or exuberant metadata. The Autonomous Byte Stream Randomizer software provides an extra level of security on top of existing data encryption methods. Randomizing the data s byte stream adds an extra layer to existing data protection methods, thus making it harder for an attacker to decrypt protected data. Based on a generated crypto-graphically secure random seed, a random sequence of numbers is used to intelligently and efficiently swap the organization of bytes in data using the unbiased and memory-efficient in-place Fisher-Yates shuffle method. Swapping bytes and reorganizing the crucial structure of the byte data renders the data file unreadable and leaves the data in a deconstructed state. This deconstruction adds an extra level of security requiring the byte stream to be reconstructed with the random seed in order to be readable. Once the data byte stream has been randomized, the software enables the data to be distributed to N nodes in an environment. Each piece of the data in randomized and distributed form is a separate entity unreadable on its own right, but when combined with all N pieces, is able to be reconstructed back to one. Reconstruction requires possession of the key used for randomizing the bytes, leading to the generation of the same cryptographically secure random sequence of numbers used to randomize the data. This software is a cornerstone capability possessing the ability to generate the same cryptographically secure sequence on different machines and time intervals, thus allowing this software to be used more heavily in net-centric environments where data transfer bandwidth is limited.

  3. Diverse autonomic regulation of pupillary function and the cardiovascular system during alcohol withdrawal.

    Science.gov (United States)

    Jochum, Thomas; Hoyme, Johannes; Schulz, Steffen; Weißenfels, Markus; Voss, Andreas; Bär, Karl-Jürgen

    2016-02-01

    Previous research indicated the complexity of autonomic dysfunction during acute alcohol withdrawal. This study aimed to investigate the pupillary light reflex as an indicator of midbrain and brainstem regulatory systems in relation to cardiovascular autonomic function. Thirty male patients were included in the study. They were investigated during acute alcohol withdrawal syndrome and 24h later during clomethiazole treatment and compared to healthy controls. Parameters of pupillary light reflex of both eyes as well as heart rate variability, blood pressure variability and baroreflex sensitivity (BRS) were studied. We observed significantly reduced sympathetic (small diameter, e.g., left eye: 5.00 in patients vs. 5.91 mm in controls) and vagal modulation (e.g., prolonged latencies, left eye: 0.28 vs. 0.26 ms) regarding both pupils during acute alcohol withdrawal syndrome. Cardiovascular parameters showed reduced vagal modulation (e.g., b-slope of BRS: 7. 57 vs. 13.59 ms/mm Hg) and mixed results for sympathetic influence. After 24h, autonomic dysfunction improved significantly, both for the pupils (e.g., left diameter: 5.38 mm) and the heart (e.g., b-slope of BRS: 9.34 ms/mm Hg). While parameters obtained from the pupil correlated with cardiac autonomic function (e.g, BRS and left diameter: r=0.564) in healthy controls, no such pattern was observed in patients. Results obtained from the pupil during acute alcohol withdrawal do not simply mirror autonomic dysfunction regarding the heart. Pupillary and cardiovascular changes after 24h indicate state dependencies of the results. The findings are discussed with respect to autonomic mechanisms and potentially involved brain regions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Autonomic symptoms in idiopathic REM behavior disorder: a multicentre case-control study.

    Science.gov (United States)

    Ferini-Strambi, Luigi; Oertel, Wolfgang; Dauvilliers, Yves; Postuma, Ronald B; Marelli, Sara; Iranzo, Alex; Arnulf, Isabelle; Högl, Birgit; Birgit, Högl; Manni, Raffaele; Miyamoto, Tomoyuki; Fantini, Maria-Livia; Puligheddu, Monica; Jennum, Poul; Sonka, Karel; Santamaria, Joan; Zucconi, Marco; Rancoita, Paola M V; Leu-Semenescu, Smeranda; Frauscher, Birgit; Terzaghi, Michele; Miyamoto, Masayuki; Unger, Marcus; Stiasny-Kolster, Karin; Desautels, Alex; Wolfson, Christina; Pelletier, Amélie; Montplaisir, Jacques

    2014-06-01

    Patients with idiopathic REM sleep behavior disorder (iRBD) are at very high risk of developing neurodegenerative synucleinopathies, which are disorders with prominent autonomic dysfunction. Several studies have documented autonomic dysfunction in iRBD, but large-scale assessment of autonomic symptoms has never been systematically performed. Patients with polysomnography-confirmed iRBD (318 cases) and controls (137 healthy volunteers and 181 sleep center controls with sleep diagnoses other than RBD) were recruited from 13 neurological centers in 10 countries from 2008 to 2011. A validated scale to study the disorders of the autonomic nervous system in Parkinson's disease (PD) patients, the SCOPA-AUT, was administered to all the patients and controls. The SCOPA-AUT consists of 25 items assessing the following domains: gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor, and sexual dysfunction. Our results show that compared to control subjects with a similar overall age and sex distribution, patients with iRBD experience significantly more problems with gastrointestinal, urinary, and cardiovascular functioning. The most prominent differences in severity of autonomic symptoms between our iRBD patients and controls emerged in the gastrointestinal domain. Interestingly, it has been reported that an altered gastrointestinal motility can predate the motor phase of PD. The cardiovascular domain SCOPA-AUT score in our study in iRBD patients was intermediate with respect to the scores reported in PD patients by other authors. Our findings underline the importance of collecting data on autonomic symptoms in iRBD. These data may be used in prospective studies for evaluating the risk of developing neurodegenerative disorders.

  5. Compact autonomous navigation system (CANS)

    Science.gov (United States)

    Hao, Y. C.; Ying, L.; Xiong, K.; Cheng, H. Y.; Qiao, G. D.

    2017-11-01

    Autonomous navigation of Satellite and constellation has series of benefits, such as to reduce operation cost and ground station workload, to avoid the event of crises of war and natural disaster, to increase spacecraft autonomy, and so on. Autonomous navigation satellite is independent of ground station support. Many systems are developed for autonomous navigation of satellite in the past 20 years. Along them American MANS (Microcosm Autonomous Navigation System) [1] of Microcosm Inc. and ERADS [2] [3] (Earth Reference Attitude Determination System) of Honeywell Inc. are well known. The systems anticipate a series of good features of autonomous navigation and aim low cost, integrated structure, low power consumption and compact layout. The ERADS is an integrated small 3-axis attitude sensor system with low cost and small volume. It has the Earth center measurement accuracy higher than the common IR sensor because the detected ultraviolet radiation zone of the atmosphere has a brightness gradient larger than that of the IR zone. But the ERADS is still a complex system because it has to eliminate many problems such as making of the sapphire sphere lens, birefringence effect of sapphire, high precision image transfer optical fiber flattener, ultraviolet intensifier noise, and so on. The marginal sphere FOV of the sphere lens of the ERADS is used to star imaging that may be bring some disadvantages., i.e. , the image energy and attitude measurements accuracy may be reduced due to the tilt image acceptance end of the fiber flattener in the FOV. Besides Japan, Germany and Russia developed visible earth sensor for GEO [4] [5]. Do we have a way to develop a cheaper/easier and more accurate autonomous navigation system that can be used to all LEO spacecraft, especially, to LEO small and micro satellites? To return this problem we provide a new type of the system—CANS (Compact Autonomous Navigation System) [6].

  6. Vaccination-related shoulder dysfunction.

    Science.gov (United States)

    Bodor, Marko; Montalvo, Enoch

    2007-01-08

    We present two cases of shoulder pain and weakness following influenza and pneumococcal vaccine injections provided high into the deltoid muscle. Based on ultrasound measurements, we hypothesize that vaccine injected into the subdeltoid bursa caused a periarticular inflammatory response, subacromial bursitis, bicipital tendonitis and adhesive capsulitis. Resolution of symptoms followed corticosteroid injections to the subacromial space, bicipital tendon sheath and glenohumeral joint, followed by physical therapy. We conclude that the upper third of the deltoid muscle should not be used for vaccine injections, and the diagnosis of vaccination-related shoulder dysfunction should be considered in patients presenting with shoulder pain following a vaccination.

  7. Simvastatin-induced cardiac autonomic control improvement in fructose-fed female rats

    Directory of Open Access Journals (Sweden)

    Renata Juliana da Silva

    2011-01-01

    Full Text Available OBJECTIVE: Because autonomic dysfunction has been found to lead to cardiometabolic disorders and because studies have reported that simvastatin treatment has neuroprotective effects, the objective of the present study was to investigate the effects of simvastatin treatment on cardiovascular and autonomic changes in fructose-fed female rats. METHODS: Female Wistar rats were divided into three groups: controls (n=8, fructose (n=8, and fructose+ simvastatin (n=8. Fructose overload was induced by supplementing the drinking water with fructose (100 mg/L, 18 wks. Simvastatin treatment (5 mg/kg/day for 2 wks was performed by gavage. The arterial pressure was recorded using a data acquisition system. Autonomic control was evaluated by pharmacological blockade. RESULTS: Fructose overload induced an increase in the fasting blood glucose and triglyceride levels and insulin resistance. The constant rate of glucose disappearance during the insulin intolerance test was reduced in the fructose group (3.4+ 0.32%/min relative to that in the control group (4.4+ 0.29%/min. Fructose+simvastatin rats exhibited increased insulin sensitivity (5.4+0.66%/min. The fructose and fructose+simvastatin groups demonstrated an increase in the mean arterial pressure compared with controls rats (fructose: 124+2 mmHg and fructose+simvastatin: 126 + 3 mmHg vs. controls: 112 + 2 mmHg. The sympathetic effect was enhanced in the fructose group (73 + 7 bpm compared with that in the control (48 + 7 bpm and fructose+simvastatin groups (31+8 bpm. The vagal effect was increased in fructose+simvastatin animals (84 + 7 bpm compared with that in control (49 + 9 bpm and fructose animals (46+5 bpm. CONCLUSION: Simvastatin treatment improved insulin sensitivity and cardiac autonomic control in an experimental model of metabolic syndrome in female rats. These effects were independent of the improvements in the classical plasma lipid profile and of reductions in arterial pressure. These results

  8. Voiding dysfunction - A review

    Directory of Open Access Journals (Sweden)

    Sripathi V

    2005-01-01

    Full Text Available In a child who is toilet trained the sudden onset of daytime wetting with frequency or urgency is alarming to the parents. Initially this subject was subdivided into a number of descriptive clinical conditions which led to a lot of confusion in recognition and management. Subsequently, the term elimination dysfunction was coined by Stephen Koff to emphasise the association between recurrent urinary infection, wetting, constipation and bladder overactivity. From a urodynamic point of view, in voiding dysfunction, there is either detrusor overactivity during bladder filling or dyssynergic action between the detrusor and the external sphincter during voiding. Identifying a given condition as a ′filling phase dysfunction′ or ′voiding phase dysfunction′ helps to provide appropriate therapy. Objective clinical criteria should be used to define voiding dysfunction. These include bladder wall thickening, large capacity bladder and infrequent voiding, bladder trabeculation and spinning top deformity of the urethra and a clinically demonstrated Vincent′s curtsy. The recognition and treatment of constipation is central to the adequate treatment of voiding dysfunction. Transcutaneous electric nerve stimuation for the treatment of detrusor overactivity, biofeedback with uroflow EMG to correct dyssynergic voiding, and behavioral therapy all serve to correct voiding dysfunction in its early stages. In established neurogenic bladder disease the use of Botulinum Toxin A injections into the detrusor or the external sphincter may help in restoring continence especially in those refractory to drug therapy. However in those children in whom the upper tracts are threatened, augmentation of the bladder may still be needed.

  9. Mitochondrial dysfunction and organophosphorus compounds

    International Nuclear Information System (INIS)

    Karami-Mohajeri, Somayyeh; Abdollahi, Mohammad

    2013-01-01

    Organophosphorous (OPs) pesticides are the most widely used pesticides in the agriculture and home. However, many acute or chronic poisoning reports about OPs have been published in the recent years. Mitochondria as a site of cellular oxygen consumption and energy production can be a target for OPs poisoning as a non-cholinergic mechanism of toxicity of OPs. In the present review, we have reviewed and criticized all the evidences about the mitochondrial dysfunctions as a mechanism of toxicity of OPs. For this purpose, all biochemical, molecular, and morphological data were retrieved from various studies. Some toxicities of OPs are arisen from dysfunction of mitochondrial oxidative phosphorylation through alteration of complexes I, II, III, IV and V activities and disruption of mitochondrial membrane. Reductions of adenosine triphosphate (ATP) synthesis or induction of its hydrolysis can impair the cellular energy. The OPs disrupt cellular and mitochondrial antioxidant defense, reactive oxygen species generation, and calcium uptake and promote oxidative and genotoxic damage triggering cell death via cytochrome C released from mitochondria and consequent activation of caspases. The mitochondrial dysfunction induced by OPs can be restored by use of antioxidants such as vitamin E and C, alpha-tocopherol, electron donors, and through increasing the cytosolic ATP level. However, to elucidate many aspect of mitochondrial toxicity of Ops, further studies should be performed. - Highlights: • As a non-cholinergic mechanism of toxicity, mitochondria is a target for OPs. • OPs affect action of complexes I, II, III, IV and V in the mitochondria. • OPs reduce mitochondrial ATP. • OPs promote oxidative and genotoxic damage via release of cytochrome C from mitochondria. • OP-induced mitochondrial dysfunction can be restored by increasing the cytosolic ATP

  10. Mitochondrial dysfunction and organophosphorus compounds

    Energy Technology Data Exchange (ETDEWEB)

    Karami-Mohajeri, Somayyeh [Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Kerman University of Medical Sciences, Kerman (Iran, Islamic Republic of); Abdollahi, Mohammad, E-mail: Mohammad.Abdollahi@UToronto.Ca [Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of)

    2013-07-01

    Organophosphorous (OPs) pesticides are the most widely used pesticides in the agriculture and home. However, many acute or chronic poisoning reports about OPs have been published in the recent years. Mitochondria as a site of cellular oxygen consumption and energy production can be a target for OPs poisoning as a non-cholinergic mechanism of toxicity of OPs. In the present review, we have reviewed and criticized all the evidences about the mitochondrial dysfunctions as a mechanism of toxicity of OPs. For this purpose, all biochemical, molecular, and morphological data were retrieved from various studies. Some toxicities of OPs are arisen from dysfunction of mitochondrial oxidative phosphorylation through alteration of complexes I, II, III, IV and V activities and disruption of mitochondrial membrane. Reductions of adenosine triphosphate (ATP) synthesis or induction of its hydrolysis can impair the cellular energy. The OPs disrupt cellular and mitochondrial antioxidant defense, reactive oxygen species generation, and calcium uptake and promote oxidative and genotoxic damage triggering cell death via cytochrome C released from mitochondria and consequent activation of caspases. The mitochondrial dysfunction induced by OPs can be restored by use of antioxidants such as vitamin E and C, alpha-tocopherol, electron donors, and through increasing the cytosolic ATP level. However, to elucidate many aspect of mitochondrial toxicity of Ops, further studies should be performed. - Highlights: • As a non-cholinergic mechanism of toxicity, mitochondria is a target for OPs. • OPs affect action of complexes I, II, III, IV and V in the mitochondria. • OPs reduce mitochondrial ATP. • OPs promote oxidative and genotoxic damage via release of cytochrome C from mitochondria. • OP-induced mitochondrial dysfunction can be restored by increasing the cytosolic ATP.

  11. Assessment of autonomic function after acute spinal cord injury using heart rate variability analyses

    DEFF Research Database (Denmark)

    Malmqvist, Lasse; Biering-Sørensen, Tor; Bartholdy, Kim

    2015-01-01

    OBJECTIVES: Spinal cord injury (SCI) often results in severe dysfunction of the autonomic nervous system. C1-C8 SCI affects the supraspinal control to the heart, T1-T5 SCI affects the spinal sympathetic outflow to the heart, and T6-T12 SCI leaves sympathetic control to the heart intact. Heart rate....... CONCLUSIONS: The rise in SDANN in the incomplete C1-T5 patients could be due to spontaneous functional recovery caused by synaptic plasticity or remodelling of damaged axons. That the autonomic nervous system function differs between C1-C8, T1-T5 and T6-T12 patients suggest that the sympathovagal balance...

  12. [A role of the autonomic nervous system in cerebro-cardiac disorders].

    Science.gov (United States)

    Basantsova, N Yu; Tibekina, L M; Shishkin, A N

    The authors consider anatomical/physiological characteristics and a role of different autonomic CNS regions, including insula cortex, amygdala complex, anterior cingulate cortex, ventral medial prefrontal cortex, hypothalamus and epiphysis, involved in the regulation of cardiovascular activity. The damage of these structures, e.g., due to the acute disturbance of cerebral blood circulation, led to arrhythmia, including fatal arrhythmia, in previously intact myocardium; systolic and diastolic dysfunction, ischemic changes considered in the frames of cerebro-cardial syndrome. On the cellular level, the disturbance of autonomic regulation resulted in catechol amine excitotoxicity, oxidative stress and free radical myocardium injury.

  13. Sepsis and myocardial dysfunction

    Directory of Open Access Journals (Sweden)

    Rafaela Deczka Morsch

    2006-12-01

    Full Text Available Sepsis and septic shock are prevalent in the intensive care setting,accounting for more than 40% of mortality in this scenario. Theappropriate management and recognition of sepsis-inducedmyocardial dysfunction are paramount for its proper treatmentand probably impact mortality rates. The objective of this articleis to review its definition, pathophysiologic mechanisms, possibletreatments and current research on the subject according to acritical view.Cellular signaling involved in myocardial depression is not fullyunderstood. Disturbances in calcium homeostasis,cardiodepressant circulating factors, inflammatory mediators,nitric oxide and apoptosis act as synergistic pathways that leadto severely depressed cardiac function. The diagnosis ofmyocardial dysfunction during sepsis carries a worse prognosisand increased mortality.Myocardial dysfunction plays an important role in morbidity andmortality rate of critically ill patients. Current research in thisarea will continue to evolve; we will, therefore, soon have moreinsights into potential novel therapies that can change its mortalityrates.

  14. Autonomous Landing on Moving Platforms

    KAUST Repository

    Mendoza Chavez, Gilberto

    2016-08-01

    This thesis investigates autonomous landing of a micro air vehicle (MAV) on a nonstationary ground platform. Unmanned aerial vehicles (UAVs) and micro air vehicles (MAVs) are becoming every day more ubiquitous. Nonetheless, many applications still require specialized human pilots or supervisors. Current research is focusing on augmenting the scope of tasks that these vehicles are able to accomplish autonomously. Precise autonomous landing on moving platforms is essential for self-deployment and recovery of MAVs, but it remains a challenging task for both autonomous and piloted vehicles. Model Predictive Control (MPC) is a widely used and effective scheme to control constrained systems. One of its variants, output-feedback tube-based MPC, ensures robust stability for systems with bounded disturbances under system state reconstruction. This thesis proposes a MAV control strategy based on this variant of MPC to perform rapid and precise autonomous landing on moving targets whose nominal (uncommitted) trajectory and velocity are slowly varying. The proposed approach is demonstrated on an experimental setup.

  15. MODELING, CONTROL AND NAVIGATION OF AN AUTONOMOUS QUAD-ROTOR HELICOPTER

    Directory of Open Access Journals (Sweden)

    Damir Šoštarić

    2016-06-01

    Full Text Available Autonomous outdoor quad-rotor helicopters increasingly attract the attention of potential researchers. Several structures and configurations have been developed to allow 3D movements. The quadrotor helicopter is made of a rigid cross frame equipped with four rotors. The autonomous quad-rotor architecture has been chosen for this research for its low dimension, good manoeuvrability, simple mechanics and payload capability. This article presents the modelling, control and navigation of an autonomous outdoor quad-rotor helicopter.

  16. Knowledge-based and integrated monitoring and diagnosis in autonomous power systems

    Science.gov (United States)

    Momoh, J. A.; Zhang, Z. Z.

    1990-01-01

    A new technique of knowledge-based and integrated monitoring and diagnosis (KBIMD) to deal with abnormalities and incipient or potential failures in autonomous power systems is presented. The KBIMD conception is discussed as a new function of autonomous power system automation. Available diagnostic modelling, system structure, principles and strategies are suggested. In order to verify the feasibility of the KBIMD, a preliminary prototype expert system is designed to simulate the KBIMD function in a main electric network of the autonomous power system.

  17. Negotiating the Traffic: Can Cognitive Science Help Make Autonomous Vehicles a Reality?

    Science.gov (United States)

    Chater, Nick; Misyak, Jennifer; Watson, Derrick; Griffiths, Nathan; Mouzakitis, Alex

    2018-02-01

    To drive safely among human drivers, cyclists and pedestrians, autonomous vehicles will need to mimic, or ideally improve upon, humanlike driving. Yet, driving presents us with difficult problems of joint action: 'negotiating' with other users over shared road space. We argue that autonomous driving provides a test case for computational theories of social interaction, with fundamental implications for the development of autonomous vehicles. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Autonomic Nervous System Responses to Concussion: Arterial Pulse Contour Analysis

    Directory of Open Access Journals (Sweden)

    Michael F La Fountaine

    2016-02-01

    Full Text Available The arterial pulse wave (APW has a distinct morphology whose contours reflect dynamics in cardiac function and peripheral vascular tone as a result of sympathetic nervous system (SNS control. With a transition from rest to increased metabolic demand, the expected augmentation of SNS outflow will not only affect arterial blood pressure and heart rate, it will also induce changes to the contours of the APW. Following a sports concussion, a transient state cardiovascular autonomic dysfunction is present. How this state affects the APW, has yet to be described. A prospective, parallel-group study on cardiovascular autonomic control (i.e., digital electrocardiogram and continuous beat-to-beat blood pressure was performed in the seated upright position in ten athletes with concussion and 7 non-injured control athletes. Changes in APW were compared at rest and during the first 60 seconds (F60 of an isometric handgrip test (IHGT in concussed athletes and non-injured controls within 48 hours (48hr and 1 week (1wk of injury. The concussion group was further separated by the length of time until they were permitted to return to play (RTP>1wk; RTP≤1wk. SysSlope, an indirect measurement of stroke volume, was significantly lower in the concussion group at rest and during F60 at 48hr and 1wk; a paradoxical decline in SysSlope occurred at each visit during the transition from rest to IHGT F60. The RTP>1wk group had lower SysSlope (405±200; 420±88; 454±236 mmHg/s, respectively at rest 48hr compared to the RTP≤1wk and controls. Similarly at 48hr rest, several measurements of arterial stiffness were abnormal in RTP>1wk compared to RTP≤1wk and controls: Peak-to-Notch Latency (0.12±0.04; 0.16±0.02; 0.17±0.05, respectively, Notch Relative Amplitude (0.70±0.03; 0.71±0.04; 0.66±0.14, respectively and Stiffness Index (6.4±0.2; 5.7±0.4; 5.8±0.5, respectively. Use of APW revealed that concussed athletes have a transient increase in peripheral artery

  19. Relationship between cardiovascular dysfunction and hyperglycemia in streptozotocin-induced diabetes in rats

    Directory of Open Access Journals (Sweden)

    Schaan B.D.

    2004-01-01

    Full Text Available Streptozotocin (STZ-induced diabetes in rats is characterized by cardiovascular dysfunction beginning 5 days after STZ injection, which may reflect functional or structural autonomic nervous system damage. We investigated cardiovascular and autonomic function, in rats weighing 166 ± 4 g, 5-7, 14, 30, 45, and 90 days after STZ injection (N = 24, 33, 27, 14, and 13, respectively. Arterial pressure (AP, mean AP (MAP variability (standard deviation of the mean of MAP, SDMMAP, heart rate (HR, HR variability (standard deviation of the normal pulse intervals, SDNN, and root mean square of successive difference of pulse intervals (RMSSD were measured. STZ induced increased glycemia in diabetic rats vs control rats. Diabetes reduced resting HR from 363 ± 12 to 332 ± 5 bpm (P < 0.05 5 to 7 days after STZ and reduced MAP from 121 ± 2 to 104 ± 5 mmHg (P = 0.007 14 days after STZ. HR and MAP variability were lower in diabetic vs control rats 30-45 days after STZ injection (RMSSD decreased from 5.6 ± 0.9 to 3.4 ± 0.4 ms, P = 0.04 and SDMMAP from 6.6 ± 0.6 to 4.2 ± 0.6 mmHg, P = 0.005. Glycemia was negatively correlated with resting AP and HR (r = -0.41 and -0.40, P < 0.001 and with SDNN and SDMMAP indices (r = -0.34 and -0.49, P < 0.01. Even though STZ-diabetic rats presented bradycardia and hypotension early in the course of diabetes, their autonomic function was reduced only 30-45 days after STZ injection and these changes were negatively correlated with plasma glucose, suggesting a metabolic origin.

  20. Intelligent (Autonomous) Power Controller Development for Human Deep Space Exploration

    Science.gov (United States)

    Soeder, James; Raitano, Paul; McNelis, Anne

    2016-01-01

    As NASAs Evolvable Mars Campaign and other exploration initiatives continue to mature they have identified the need for more autonomous operations of the power system. For current human space operations such as the International Space Station, the paradigm is to perform the planning, operation and fault diagnosis from the ground. However, the dual problems of communication lag as well as limited communication bandwidth beyond GEO synchronous orbit, underscore the need to change the operation methodology for human operation in deep space. To address this need, for the past several years the Glenn Research Center has had an effort to develop an autonomous power controller for human deep space vehicles. This presentation discusses the present roadmap for deep space exploration along with a description of conceptual power system architecture for exploration modules. It then contrasts the present ground centric control and management architecture with limited autonomy on-board the spacecraft with an advanced autonomous power control system that features ground based monitoring with a spacecraft mission manager with autonomous control of all core systems, including power. It then presents a functional breakdown of the autonomous power control system and examines its operation in both normal and fault modes. Finally, it discusses progress made in the development of a real-time power system model and how it is being used to evaluate the performance of the controller and well as using it for verification of the overall operation.

  1. Pathophysiology of Motor Dysfunction in Parkinson’s Disease as the Rationale for Drug Treatment and Rehabilitation

    Directory of Open Access Journals (Sweden)

    Francesca Magrinelli

    2016-01-01

    Full Text Available Cardinal motor features of Parkinson’s disease (PD include bradykinesia, rest tremor, and rigidity, which appear in the early stages of the disease and largely depend on dopaminergic nigrostriatal denervation. Intermediate and advanced PD stages are characterized by motor fluctuations and dyskinesia, which depend on complex mechanisms secondary to severe nigrostriatal loss and to the problems related to oral levodopa absorption, and motor and nonmotor symptoms and signs that are secondary to marked dopaminergic loss and multisystem neurodegeneration with damage to nondopaminergic pathways. Nondopaminergic dysfunction results in motor problems, including posture, balance and gait disturbances, and fatigue, and nonmotor problems, encompassing depression, apathy, cognitive impairment, sleep disturbances, pain, and autonomic dysfunction. There are a number of symptomatic drugs for PD motor signs, but the pharmacological resources for nonmotor signs and symptoms are limited, and rehabilitation may contribute to their treatment. The present review will focus on classical notions and recent insights into the neuropathology, neuropharmacology, and neurophysiology of motor dysfunction of PD. These pieces of information represent the basis for the pharmacological, neurosurgical, and rehabilitative approaches to PD.

  2. Transient erectile dysfunction associated with intramuscular injection of botulinum toxin type A.

    Science.gov (United States)

    Papadonikolakis, Anastasios S; Vekris, Marios D; Kostas, John P; Korompilias, Anastasios V; Soucacos, Panayotis N

    2002-01-01

    Autonomic nervous system dysfunction occurs rarely after botulinum toxin type A (BTX-A) intramuscular injections. We report a case of a 23-year-old man with spastic diplegia who had transient erectile dysfunction after intramuscular injection of BTX-A (total dosage, 300 IU, body weight 95 kg) in both hamstring muscles. Some investigators believe that the local spread of the toxin is responsible for autonomic dysfunction, while others believe that the transportation of the toxin to the spinal cord via retrograde flow or via the blood flow after entering the circulation are possible mechanisms of neurologic side effects. On the basis of our case, a retrograde axoplasmic flow to the spinal cord could probably occur because the spinal cord level of hamstring muscles is close to spinal cord levels responsible for erection control.

  3. Complicações microvasculares e disfunção autonômica cardíaca em pacientes com diabete melito tipo 1 Complicaciones microvasculares y disfunción autonómica cardíaca en pacientes con diabetes mellittus tipo 1 Microvascular complications and cardiac autonomic dysfunction in patients with diabetes mellitus type 1

    Directory of Open Access Journals (Sweden)

    Fernando K Almeida

    2011-06-01

    hallazgos sugestivos de NAC durante la realización de la prueba ergométrica (PE y nefropatía y retinopatía en pacientes con DM tipo 1. METHODS: Realizamos un estudio transversal con 84 pacientes con DM tipo 1. Todos los pacientes fueron sometidos a evaluación clínica y laboratorial y llevaron a cabo PE, siendo que aquellos que presentaron hallazgos sugestivos de isquemia miocárdica fueron excluidos del análisis de los datos (n = 3. La evaluación de complicaciones microvasculares (retinopatía y nefropatía se realizó en la muestra. RESULTS: Los pacientes con nefropatía y aquellos con retinopatía alcanzaron una frecuencia cardíaca (FC durante el nivel máximo de ejercicio (FC máxima menor y presentaron aumento menor de FC con relación al reposo (ΔFC pico cuando comparados con aquellos sin estas complicaciones. Estos pacientes también presentaron una menor reducción de la FC en el segundo y 4º minutos tras el final de la prueba (ΔFC recuperación 2 y 4 minutos. Tras la realización de análisis multivariado con control para los posibles factores de confusión, los ΔFC recuperación en dos y 4 minutos, FC máxima y el ΔFC pico permanecieron significativamente asociados a la retinopatía; y los ΔFC recuperación en el segundo y 4º minutos permanecieron asociados a la presencia de nefropatía. CONCLUSION: Se puede considerar la PE como un instrumento adicional para la detección precoz de NAC y para identificar pacientes en un mayor riesgo para complicaciones microvasculares de la diabetes.BACKGROUND: The presence of cardiac autonomic neuropathy (CAN in patients with diabetes mellitus (DM is associated with increased mortality and chronic microvascular complications of diabetes. OBJECTIVE: To investigate a possible association between specific findings of CAN during exercise testing (ET and nephropathy and retinopathy in patients with type 1 DM. METHODS: We conducted a cross-sectional study of 84 patients with type 1 DM. All patients underwent clinical

  4. Political accountability and autonomous weapons

    Directory of Open Access Journals (Sweden)

    James Igoe Walsh

    2015-09-01

    Full Text Available Autonomous weapons would have the capacity to select and attack targets without direct human input. One important objection to the introduction of such weapons is that they will make it more difficult to identify and hold accountable those responsible for undesirable outcomes such as mission failures and civilian casualties. I hypothesize that individuals can modify their attribution of responsibility in predicable ways to accommodate this new technology. The results of a survey experiment are consistent with this; subjects continue to find responsible and hold accountable political and military leaders when autonomous weapons are used, but also attribute responsibility to the designers and programmers of such weapons.

  5. Autonomic Regulation of Splanchnic Circulation

    Directory of Open Access Journals (Sweden)

    Kathleen A Fraser

    1991-01-01

    Full Text Available The role of the autonomic nervous system in circulatory regulation of the splanchnic organs (stomach, small intestine, colon, liver, pancreas and spleen is reviewed. In general, the sympathetic nervous system is primarily involved in vasoconstriction, while the parasympathetic contributes to vasodilation. Vasoconstriction in the splanchnic circulation appears to be mediated by alpha-2 receptors and vasodilation by activation of primary afferent nerves with subsequent release of vasodilatory peptides, or by stimulation of beta-adrenergic receptors. As well, an important function of the autonomic nervous system is to provide a mechanism by which splanchnic vascular reserve can be mobilized during stress to maintain overall cardiovascular homeostasis.

  6. Structural Discrimination and Autonomous Vehicles

    DEFF Research Database (Denmark)

    Liu, Hin-Yan

    2016-01-01

    This paper examines the potential for structural discrimination to be woven into the fabric of autonomous vehicle developments, which remain underexplored and undiscussed. The prospect for structural discrimination arises as a result of the coordinated modes of autonomous vehicle behaviour...... discrimination looms with the possibility of crash optimisation impulses in which a protective shield is cast over those individuals in which society may have a vested interest in prioritising or safeguarding. A stark dystopian scenario is introduced to sketch the contours whereby personal beacons signal...

  7. Sensing and control for autonomous vehicles applications to land, water and air vehicles

    CERN Document Server

    Pettersen, Kristin; Nijmeijer, Henk

    2017-01-01

    This edited volume includes thoroughly collected on sensing and control for autonomous vehicles. Guidance, navigation and motion control systems for autonomous vehicles are increasingly important in land-based, marine and aerial operations. Autonomous underwater vehicles may be used for pipeline inspection, light intervention work, underwater survey and collection of oceanographic/biological data. Autonomous unmanned aerial systems can be used in a large number of applications such as inspection, monitoring, data collection, surveillance, etc. At present, vehicles operate with limited autonomy and a minimum of intelligence. There is a growing interest for cooperative and coordinated multi-vehicle systems, real-time re-planning, robust autonomous navigation systems and robust autonomous control of vehicles. Unmanned vehicles with high levels of autonomy may be used for safe and efficient collection of environmental data, for assimilation of climate and environmental models and to complement global satellite sy...

  8. Hypertension and sexual dysfunction

    African Journals Online (AJOL)

    Review Article: Hypertension and sexual dysfunction. 117. Vol 54 No 2. S Afr Fam Pract 2012. Introduction. Hypertension is a major independent cardiovascular risk factor, and also a marker of survival risk. Quality of life during the treatment of hypertension is an important health issue, as one in every five treated patients ...

  9. Temporomandibular Joint Dysfunction

    Science.gov (United States)

    The temporomandibular joint (TMJ) connects your jaw to the side of your head. When it works well, it enables you to talk, chew, and yawn. For people with TMJ dysfunction, problems with the joint and muscles around it may cause Pain that travels through the face, jaw, ...

  10. Postirradiation cardiovascular dysfunction

    International Nuclear Information System (INIS)

    Hawkins, R.N.; Cockerham, L.G.

    1987-01-01

    Cardiovascular dysfunction may be defined as the inability of any element of the cardiovascular system to perform adequately upon demand, leading to inadequate performance and nutritive insufficiency of various parts of the body. Exposure to supralethal doses of radiation (accidental and therapeutic) has been show to induce significant alterations in cardiovascular function in man. These findings indicate that, after irradiation, cardiovascular function is a major determinant of continued performance and even survival. For the two persons who received massive radiation doses (45 and 88 Gy, respectively) in criticality accidents, the inability to maintain systematic arterial blood pressure (AP) was the immediate cause of death. In a study of cancer patients given partial-body irradiation, two acute lethalities were attributed to myocardial infarction after an acute hypotensive episode during the first few hours postexposure. Although radiation-induced cardiovascular dysfunction has been observed in many species, its severity, duration, and even etiology may vary with the species, level of exposure, and dose rate. For this reason, our consideration of the effects of radiation on cardiovascular performance is limited to the circulatory derangements that occur in rat, dog, and monkey after supralethal doses and lead to radiation-induced cardiovascular dysfunction in these experimental models. The authors consider other recent data as they pertain to the etiology of cardiovascular dysfunction in irradiated animals

  11. Female sexual dysfunction

    DEFF Research Database (Denmark)

    Giraldi, Annamaria; Wåhlin-Jacobsen, Sarah

    2016-01-01

    Female sexual dysfunction (FSD) is a controversial condition, which has prompted much debate regarding its aetiology, components, and even its existence. Our inability to work together as clinicians, psychologists, patients, and advocates hinders our understanding of FSD, and we will only improve...

  12. Mitochondrial dysfunction in epilepsy

    Czech Academy of Sciences Publication Activity Database

    Folbergrová, Jaroslava; Kunz, W.S.

    2012-01-01

    Roč. 12, č. 1 (2012), s. 35-40 ISSN 1567-7249 R&D Projects: GA ČR(CZ) GA309/05/2015; GA ČR GA309/08/0292 Institutional research plan: CEZ:AV0Z50110509 Keywords : epilepsy * mitochondrial dysfunction * neurodegeneration Subject RIV: FH - Neurology Impact factor: 4.025, year: 2012

  13. Mitochondrial Dysfunction in Gliomas

    Czech Academy of Sciences Publication Activity Database

    Katsetos, C.D.; Anni, H.; Dráber, Pavel

    2013-01-01

    Roč. 20, č. 3 (2013), s. 216-227 ISSN 1071-9091 R&D Projects: GA MŠk LH12050 Institutional support: RVO:68378050 Keywords : gliomas * mitochondrial dysfunction * microtubule proteins Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.883, year: 2013

  14. Hyposensitivity of C-fiber afferents at the distal extremities as an indicator of early stages diabetic bladder dysfunction in type 2 diabetic women.

    Directory of Open Access Journals (Sweden)

    Wei-Chia Lee

    Full Text Available PURPOSE: To investigate the relationship between distal symmetric peripheral neuropathy and early stages of autonomic bladder dysfunction in type 2 diabetic women. MATERIALS AND METHODS: A total of 137 diabetic women with minimal coexisting confounders of voiding dysfunction followed at a diabetes clinic were subject to the following evaluations: current perception threshold (CPT tests on myelinated and unmyelinated nerves at the big toe for peroneal nerve and middle finger for median nerve, uroflowmetry, post-void residual urine volume, and overactive bladder (OAB symptom score questionnaire. Patients presenting with voiding difficulty also underwent urodynamic studies and intravesical CPT tests. RESULTS: Based on the OAB symptom score and urodynamic studies, 19% of diabetic women had the OAB syndrome while 24.8% had unrecognized urodynamic bladder dysfunction (UBD. The OAB group had a significantly greater mean 5 Hz CPT test value at the big toe by comparison to those without OAB. When compared to diabetic women without UBD, those with UBD showed greater mean 5 Hz CPT test values at the middle finger and big toe. The diabetic women categorized as C-fiber hyposensitivity at the middle finger or big toe by using CPT test also had higher odds ratios of UBD. Among diabetic women with UBD, the 5 Hz CPT test values at the big toe and middle finger were significantly associated with intravesical 5 Hz CPT test values. CONCLUSIONS: Using electrophysiological evidence, our study revealed that hyposensitivity of unmyelinated C fiber afferents at the distal extremities is an indicator of early stages diabetic bladder dysfunction in type 2 diabetic women. The C fiber dysfunction at the distal extremities seems concurrent with vesical C-fiber neuropathy and may be a sentinel for developing early diabetic bladder dysfunction among female patients.

  15. Paradoxical vocal cord dysfunction: when a wheeze is not asthma.

    Science.gov (United States)

    Chiang, W C; Goh, A; Ho, L; Tang, J P L; Chay, O M

    2008-04-01

    Vocal cord dysfunction (VCD) is an uncommon condition which often mimics asthma in presentation and severity. We present nine- and 11-year-old female siblings with vocal cord dysfunction, which is a dysfunction of the larynx involving unintentional paradoxical adduction of the vocal cords during inspiration. We evaluated the use of exercise testing in conjunction with pulmonary function testing in suspected vocal cord dysfunction. Although normal pulmonology function tests were elicited with the patient at rest, exercise testing revealed blunting of the expiratory loop with attenuation of the inspiratory loop unique to VCD. The child underwent video laryngoscopy in the specialised voice clinic, which confirmed vocal cord dysfunction. Exercise testing is a rapid and noninvasive means of diagnosing vocal cord dysfunction in a small subset of patients, but video laryngoscopy, with training manoeuvres to elicit paradoxical vocal cord movements in VCD, remains the gold standard of diagnosis of VCD.

  16. Connected and autonomous vehicles 2040 vision.

    Science.gov (United States)

    2014-07-01

    The Pennsylvania Department of Transportation (PennDOT) commissioned a one-year project, Connected and Autonomous : Vehicles 2040 Vision, with researchers at Carnegie Mellon University (CMU) to assess the implications of connected and : autonomous ve...

  17. Autonomous valve for detection of biopolymer degradation

    DEFF Research Database (Denmark)

    Keller, Stephan Urs; Noeth, Nadine-Nicole; Fetz, Stefanie

    2009-01-01

    We present a polymer microvalve that allows the detection of biopolymer degradation without the need of external energy. The valve is based on a polymer container filled with a colored marker solution and closed by a thin lid. This structure is covered by a film of poly(L-lactide) and degradation...... of the biopolymer triggers the release of the color which is detected visually. The autonomous valve has potential for the fast testing of biopolymer degradation under various environmental conditions or by specific enzymes....

  18. [Dirofilariasis in the Autonomous Republic of Crimea].

    Science.gov (United States)

    Korolev, V A; Romashova, M F

    2005-01-01

    The paper presents data on the prevalence of dirofilariasis in the Autonomous Republic of Crimea during 5 years from 1999 to 2003. The nematode Dirofilaria repens is a causative agent of the disease. Sporadic cases of helminthiasis are annually registered in some urban and rural areas on the plain of the peninsula. The disease is absent on the foothills and Black sea coast of the southern and eastern parts of Crimea. The localization of the parasite is typical of this helminthiasis. Dirofilariasis in Crimea may be regarded as a transmissible helminthiasis with natural focal trends.

  19. A Diversified Investment Strategy Using Autonomous Agents

    Science.gov (United States)

    Barbosa, Rui Pedro; Belo, Orlando

    In a previously published article, we presented an architecture for implementing agents with the ability to trade autonomously in the Forex market. At the core of this architecture is an ensemble of classification and regression models that is used to predict the direction of the price of a currency pair. In this paper, we will describe a diversified investment strategy consisting of five agents which were implemented using that architecture. By simulating trades with 18 months of out-of-sample data, we will demonstrate that data mining models can produce profitable predictions, and that the trading risk can be diminished through investment diversification.

  20. ROBERT autonomous navigation robot with artificial vision

    International Nuclear Information System (INIS)

    Cipollini, A.; Meo, G.B.; Nanni, V.; Rossi, L.; Taraglio, S.; Ferjancic, C.

    1993-01-01

    This work, a joint research between ENEA (the Italian National Agency for Energy, New Technologies and the Environment) and DIGlTAL, presents the layout of the ROBERT project, ROBot with Environmental Recognizing Tools, under development in ENEA laboratories. This project aims at the development of an autonomous mobile vehicle able to navigate in a known indoor environment through the use of artificial vision. The general architecture of the robot is shown together with the data and control flow among the various subsystems. Also the inner structure of the latter complete with the functionalities are given in detail

  1. Antidepressant induced sexual dysfunction, part 1: epidemiology ...

    African Journals Online (AJOL)

    ... their compliance with medication and ultimately the prognosis of their illness. This review will be presented in two parts. The first part focuses on the prevalence of antidepressant induced sexual dysfunction and its clinical presentation both generally and in the case of individual classes of antidepressants. The second part ...

  2. CORRECTION OF PSYCHO-AUTONOMIC DISORDERS IN WOMEN WITH ARTERIAL HYPERTENSION DURING POSTMENOPAUSAL PERIOD

    Directory of Open Access Journals (Sweden)

    G. G. Semenkova

    2009-01-01

    Full Text Available Aim. To assess an efficacy of adaptol in women with arterial hypertension (HT during postmenopausal period.Material and methods. Postmenopausal women (n=60 with HT were examined. Patients of the active group (n=30 received adaptol 500 mg BID during 2 months additionally to basic antihypertensive therapy with enalapril and hydrochlorothiazide (Renipril HT. Patients of control group (n=30 received only basic therapy. Clinical conditions, anxiety level, autonomic dysfunction, quality of life (QoL were estimated.Results. Addition of adaptol to the antihypertensive therapy improved one’s well-being and QoL, reduced anxiety level and autonomic dysfunction.Conclusions. Some advantages of therapy including adaptol were found in postmenopausal women with HT.

  3. Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease.

    Science.gov (United States)

    Brudey, Chevelle; Park, Jeanie; Wiaderkiewicz, Jan; Kobayashi, Ihori; Mellman, Thomas A; Marvar, Paul J

    2015-08-15

    Stress- and anxiety-related disorders are on the rise in both military and general populations. Over the next decade, it is predicted that treatment of these conditions, in particular, posttraumatic stress disorder (PTSD), along with its associated long-term comorbidities, will challenge the health care system. Multiple organ systems are adversely affected by PTSD, and PTSD is linked to cancer, arthritis, digestive disease, and cardiovascular disease. Evidence for a strong link between PTSD and cardiovascular disease is compelling, and this review describes current clinical data linking PTSD to cardiovascular disease, via inflammation, autonomic dysfunction, and the renin-angiotensin system. Recent clinical and preclinical evidence regarding the role of the renin-angiotensin system in the extinction of fear memory and relevance in PTSD-related immune and autonomic dysfunction is also addressed. Copyright © 2015 the American Physiological Society.

  4. Evaluating Autonomous Ground-Robots

    Science.gov (United States)

    2012-06-14

    Evaluating Autonomous Ground-Robots 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Anthony Finn; Adam Jacoff; Mike...these metrics against the detailed choreography of the challenge to prevent teams ‘gaming’ the result (i.e. devising technical solutions that were

  5. Hazard Map for Autonomous Navigation

    DEFF Research Database (Denmark)

    Riis, Troels

    This dissertation describes the work performed in the area of using image analysis in the process of landing a spacecraft autonomously and safely on the surface of the Moon. This is suggested to be done using a Hazard Map. The correspondence problem between several Hazard Maps are investigated...

  6. Computing architecture for autonomous microgrids

    Science.gov (United States)

    Goldsmith, Steven Y.

    2015-09-29

    A computing architecture that facilitates autonomously controlling operations of a microgrid is described herein. A microgrid network includes numerous computing devices that execute intelligent agents, each of which is assigned to a particular entity (load, source, storage device, or switch) in the microgrid. The intelligent agents can execute in accordance with predefined protocols to collectively perform computations that facilitate uninterrupted control of the .

  7. QFD-based conceptual design of an autonomous underwater robot

    Directory of Open Access Journals (Sweden)

    Thip Pasawang

    2015-12-01

    Full Text Available Autonomous underwater robots in the past few years have been designed according to the individual concepts and experiences of the researchers. To design a robot, which meets all the requirements of potential users, is an advanced work. Hence, a systematic design method that could include users’ preferences and requirements is needed. This paper presents the quality function deployment (QFD technique to design an autonomous underwater robot focusing on the Thai Navy military mission. Important user requirements extracted from the QFD method are the ability to record videos, operating at depth up to 10 meters, the ability to operate remotely with cable and safety concerns related to water leakages. Less important user requirements include beauty, using renewable energy, operating remotely with radio and ability to work during night time. The important design parameters derived from the user requirements are a low cost-controller, an autonomous control algorithm, a compass sensor and vertical gyroscope, and a depth sensor. Of low-importance ranked design parameters include the module design, use clean energy, a low noise electric motor, remote surveillance design, a pressure hull, and a beautiful hull form design. The study results show the feasibility of using QFD techniques to systematically design the autonomous underwater robot to meet user requirements. Mapping between the design and expected parameters and a conceptual drafting design of an autonomous underwater robot are also presented.

  8. Dysfunctions in public psychiatric bureaucracies.

    Science.gov (United States)

    Marcos, L R

    1988-03-01

    The author describes common dysfunctions in public psychiatric organizations according to the model of bureaucracy articulated by Max Weber. Dysfunctions are divided into the categories of goal displacement, outside interference, unclear authority structure and hierarchy, and informal relations in the work place. The author emphasizes the bureaucratic nature of public psychiatry and the need for mental health professionals to understand the dysfunctions of the organizations in which they work, including the impact of these dysfunctions on the provision of quality care.

  9. Autonomous Duffing-Holmes Type Chaotic Oscillator

    DEFF Research Database (Denmark)

    Tamaševičius, A.; Bumelienė, S.; Kirvaitis, R.

    2009-01-01

    We have designed and built a novel Duffing type autonomous 3rd-order chaotic oscillator. In comparison with the common non-autonomous DuffingHolmes type oscillator the autonomous circuit has an internal positive feedback loop instead of an external periodic drive source. In addition...

  10. CAAD: Computer Architecture for Autonomous Driving

    OpenAIRE

    Liu, Shaoshan; Tang, Jie; Zhang, Zhe; Gaudiot, Jean-Luc

    2017-01-01

    We describe the computing tasks involved in autonomous driving, examine existing autonomous driving computing platform implementations. To enable autonomous driving, the computing stack needs to simultaneously provide high performance, low power consumption, and low thermal dissipation, at low cost. We discuss possible approaches to design computing platforms that will meet these needs.

  11. Pacemaker Placement in Patients with Stroke-Mediated Autonomic Dysregulation

    Directory of Open Access Journals (Sweden)

    Ali A. Alsaad

    2017-01-01

    Full Text Available Lateral medullary syndrome (LMS is an ischemic disease of the medulla oblongata, which involves the territory of the posterior inferior cerebellar artery. Lateral medullary syndrome is often missed as the cause of autonomic dysregulation in patients with recent brain stem stroke. Due to the location of the baroreceptor regulatory center in the lateral medulla oblongata, patients with LMS occasionally have autonomic dysregulation-associated clinical manifestations. We report a case of LMS-associated autonomic dysregulation. The case presented as sinus arrest and syncope, requiring permanent pacemaker placement. A dual-chamber pacemaker was placed, after failure of conservative measures to alleviate the patient’s symptoms. Our case shows the importance of recognizing LMS as a potential cause for life-threatening arrhythmias, heart block, and symptomatic bradycardia. Placement of permanent pacemaker may be necessary in some patients with LMS presenting with syncope, secondary to sinus arrest.

  12. Parasympathetic nervous system dysfunction, as identified by pupil light reflex, and its possible connection to hearing impairment

    OpenAIRE

    Wang, Yang; Zekveld, Adriana A.; Naylor, Graham; Ohlenforst, Barbara; Jansma, Elise P.; Lorens, Artur; Lunner, Thomas; Kramer, Sophia E.

    2016-01-01

    Context\\ud Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown.\\ud \\ud Objectives\\ud To 1) review the evidence for the pupil light reflex being a sensitive meth...

  13. Evaluation of autonomic nervous system function in children with overactive bladder syndrome.

    Science.gov (United States)

    Demir, Aysegul Dogan; Gursoy, Azize Esra; Goknar, Nilufer; Uzuner, Selcuk; Ozkaya, Emin; Erenberk, Ufuk; Vehapoglu, Aysel; Dundaroz, Mehmet Rusen; Oktem, Faruk

    2017-03-01

    We aimed to evaluate the autonomic nervous system activity in children with overactive bladder (OAB) syndrome. Included in the study were 40 children with overactive bladder and 28 healthy controls. Autonomic tests were performed on all participants, including heart rate interval variation (RRIV), heart rate response to valsalva maneuver, and sympathetic skin response (SSR). Mean valsalva rates in the overactive bladder and control groups were 1.53 ± 0.29 and 1.30 ± 0.18, respectively, a statistically significant difference (P  0.05). This study demonstrated a parasympathetic hyperactivity in children with OAB, results suggesting a dysfunction in their autonomic nervous systems. Neurourol. Urodynam. 36:673-676, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. Hormonal and cardiovascular reflex assessment in a female patient with pure autonomic failure

    Directory of Open Access Journals (Sweden)

    Lopes Heno Ferreira

    2000-01-01

    Full Text Available We report the case of a 72-year-old female with pure autonomic failure, a rare entity, whose diagnosis of autonomic dysfunction was determined with a series of complementary tests. For approximately 2 years, the patient has been experiencing dizziness and a tendency to fall, a significant weight loss, generalized weakness, dysphagia, intestinal constipation, blurred vision, dry mouth, and changes in her voice. She underwent clinical assessment and laboratory tests (biochemical tests, chest X-ray, digestive endoscopy, colonoscopy, chest computed tomography, abdomen and pelvis computed tomography, abdominal ultrasound, and ambulatory blood pressure monitoring. Measurements of catecholamine and plasmatic renin activity were performed at rest and after physical exercise. Finally the patient underwent physiological and pharmacological autonomic tests that better diagnosed dysautonomia.

  15. Insulin Resistance and Mitochondrial Dysfunction.

    Science.gov (United States)

    Gonzalez-Franquesa, Alba; Patti, Mary-Elizabeth

    2017-01-01

    Insulin resistance precedes and predicts the onset of type 2 diabetes (T2D) in susceptible humans, underscoring its important role in the complex pathogenesis of this disease. Insulin resistance contributes to multiple tissue defects characteristic of T2D, including reduced insulin-stimulated glucose uptake in insulin-sensitive tissues, increased hepatic glucose production, increased lipolysis in adipose tissue, and altered insulin secretion. Studies of individuals with insulin resistance, both with established T2D and high-risk individuals, have consistently demonstrated a diverse array of defects in mitochondrial function (i.e., bioenergetics, biogenesis and dynamics). However, it remains uncertain whether mitochondrial dysfunction is primary (critical initiating defect) or secondary to the subtle derangements in glucose metabolism, insulin resistance, and defective insulin secretion present early in the course of disease development. In this chapter, we will present the evidence linking mitochondrial dysfunction and insulin resistance, and review the potential for mitochondrial targets as a therapeutic approach for T2D.

  16. Autonomous distributed self-organizing and self-healing hardware architecture - The eDNA concept

    DEFF Research Database (Denmark)

    Boesen, Michael Reibel; Madsen, Jan; Keymeulen, Didier

    2011-01-01

    This paper presents the current state of the autonomous distributed self-organizing and self-healing electronic DNA (eDNA) hardware architecture (patent pending). In its current prototype state, the eDNA architecture is capable of responding to multiple injected faults by autonomously reconfiguri...

  17. Autonomous gathering of livestock using a multi-functional sensor network platform

    Science.gov (United States)

    In this paper we develop algorithms and hardware for the autonomous gathering of cattle. We present a comparison of three different autonomous gathering algorithms that employ sound and/or electric stimuli to guide the cattle. We evaluate these algorithms in simulation by extending previous behavior...

  18. Burnout versus work engagement in their effects on 24-hour ambulatory monitored cardiac autonomic function

    NARCIS (Netherlands)

    L.J.P. van Doornen (Lorenz); J.H. Houtveen (Jan); S. Langelaan (Saar); A.B. Bakker (Arnold); W. van Rhenen (Willem); W.B. Schaufeli (Wilmar)

    2009-01-01

    textabstractBurnout has been associated with increased risk of cardiovascular disease. This relationship may be mediated by a stress-related disruption in cardiac autonomic activity. The aim of the present study was to assess cardiac autonomic activity (sympathetic and parasympathetic) during a

  19. La formación del universitario en la autonomía de aprendizaje

    OpenAIRE

    Ruiz de Zarobe, Leyre

    1997-01-01

    El objeto del presente trabajo es llevar a cabo una reflexión sobre la denominada autonomía de aprendizaje en ámbito universitario, y presentar alguna experiencia realizada en dicho ámbito, con objeto de sensibilizar a los estudiantes a actividades que pretenden educarles en una mayor autonomía de aprendizaje.

  20. Analysis of Heart Rate Variability and Cardiac Autonomic Nerve Remodeling in Streptozotocin-induced Diabetic Rats.

    Science.gov (United States)

    Li, X; Jiang, Y-H; Jiang, P; Lin, H-Q; Yang, J-L; Ma, D-f; Wang, X; Yang, C-H

    2015-05-01

    Diabetes mellitus (DM) is associated with both cardiovascular and autonomic nervous system dysfunction. Spectral analysis of heart rate variability (HRV) can be used to monitor changes in response to autonomic innervation and stimulation of the heart. In this study, conducted in a rat model of diabetes, HRV and changes in associated neurotransmitters and neurotrophic factors in the right atrium (RA) were monitored. Diabetes was induced by streptozotocin (STZ) (60 mg/kg) in male Wistar rats, and HRV data were collected for 10 weeks by telemetry. Time and frequency domains of HRV data were analyzed using established metrics. The levels of various neural enzymes in the RA were determined by enzyme-linked immunosorbent assay (ELISA) and immunofluorescence to characterize autonomic nerve remodeling. Insulin and methycobal were used to block the effects of STZ. HRV parameters reflecting parasympathetic tone (SDNN, RMSSD and HF domains) sharply decreased in the first 3 weeks after STZ administration; measures of sympathetic tone (SDANN) increased. After a series of adjustments, cardiac autonomic nerve innervation reached a new equilibrium, with a dominance of sympathetic tone. RA levels of tyrosine hydroxylase (TH) increased, and choline acetyltransferase (ChAT) decreased, indicating autonomic nerve remodeling. Levels of growth associated protein-43 (GAP43) and nerve growth factor (NGF) increased during the period of diabetes-induced cardiac-nerve damage; however, the level of ciliary neurotrophic factor (CNTF) decreased. The physical condition and indexes of rats were normalized in different degree after administration of the insulin and methycobal, but not completely recovered. STZ-induced diabetes was associated with cardiac autonomic nerve dysfunction at both the organ and molecular levels. Parasympathetic nerves exhibited severe damage and/or weak recovery; remodeling of sympathetic nerves predominated during 10-weeks of STZ-induced diabetes. © Georg Thieme Verlag

  1. The Role of the Autonomic Nervous System in the Pathophysiology of Obesity

    Directory of Open Access Journals (Sweden)

    Daniela Guarino

    2017-09-01

    Full Text Available Obesity is reaching epidemic proportions globally and represents a major cause of comorbidities, mostly related to cardiovascular disease. The autonomic nervous system (ANS dysfunction has a two-way relationship with obesity. Indeed, alterations of the ANS might be involved in the pathogenesis of obesity, acting on different pathways. On the other hand, the excess weight induces ANS dysfunction, which may be involved in the haemodynamic and metabolic alterations that increase the cardiovascular risk of obese individuals, i.e., hypertension, insulin resistance and dyslipidemia. This article will review current evidence about the role of the ANS in short-term and long-term regulation of energy homeostasis. Furthermore, an increased sympathetic activity has been demonstrated in obese patients, particularly in the muscle vasculature and in the kidneys, possibily contributing to increased cardiovascular risk. Selective leptin resistance, obstructive sleep apnea syndrome, hyperinsulinemia and low ghrelin levels are possible mechanisms underlying sympathetic activation in obesity. Weight loss is able to reverse metabolic and autonomic alterations associated with obesity. Given the crucial role of autonomic dysfunction in the pathophysiology of obesity and its cardiovascular complications, vagal nerve modulation and sympathetic inhibition may serve as therapeutic targets in this condition.

  2. Apraxia and motor dysfunction in corticobasal syndrome.

    Science.gov (United States)

    Burrell, James R; Hornberger, Michael; Vucic, Steve; Kiernan, Matthew C; Hodges, John R

    2014-01-01

    Corticobasal syndrome (CBS) is characterized by multifaceted motor system dysfunction and cognitive disturbance; distinctive clinical features include limb apraxia and visuospatial dysfunction. Transcranial magnetic stimulation (TMS) has been used to study motor system dysfunction in CBS, but the relationship of TMS parameters to clinical features has not been studied. The present study explored several hypotheses; firstly, that limb apraxia may be partly due to visuospatial impairment in CBS. Secondly, that motor system dysfunction can be demonstrated in CBS, using threshold-tracking TMS, and is linked to limb apraxia. Finally, that atrophy of the primary motor cortex, studied using voxel-based morphometry analysis (VBM), is associated with motor system dysfunction and limb apraxia in CBS. Imitation of meaningful and meaningless hand gestures was graded to assess limb apraxia, while cognitive performance was assessed using the Addenbrooke's Cognitive Examination - Revised (ACE-R), with particular emphasis placed on the visuospatial subtask. Patients underwent TMS, to assess cortical function, and VBM. In total, 17 patients with CBS (7 male, 10 female; mean age 64.4+/- 6.6 years) were studied and compared to 17 matched control subjects. Of the CBS patients, 23.5% had a relatively inexcitable motor cortex, with evidence of cortical dysfunction in the remaining 76.5% patients. Reduced resting motor threshold, and visuospatial performance, correlated with limb apraxia. Patients with a resting motor threshold apraxia correlated with atrophy of the pre-motor and parietal cortices. Cortical dysfunction appears to underlie the core clinical features of CBS, and is associated with atrophy of the primary motor and pre-motor cortices, as well as the thalamus, while apraxia correlates with pre-motor and parietal atrophy.

  3. Autonomous Cryogenics Loading Operations Simulation Software: Knowledgebase Autonomous Test Engineer

    Science.gov (United States)

    Wehner, Walter S., Jr.

    2013-01-01

    Working on the ACLO (Autonomous Cryogenics Loading Operations) project I have had the opportunity to add functionality to the physics simulation software known as KATE (Knowledgebase Autonomous Test Engineer), create a new application allowing WYSIWYG (what-you-see-is-what-you-get) creation of KATE schematic files and begin a preliminary design and implementation of a new subsystem that will provide vision services on the IHM (Integrated Health Management) bus. The functionality I added to KATE over the past few months includes a dynamic visual representation of the fluid height in a pipe based on number of gallons of fluid in the pipe and implementing the IHM bus connection within KATE. I also fixed a broken feature in the system called the Browser Display, implemented many bug fixes and made changes to the GUI (Graphical User Interface).

  4. Autonomic computing enabled cooperative networked design

    CERN Document Server

    Wodczak, Michal

    2014-01-01

    This book introduces the concept of autonomic computing driven cooperative networked system design from an architectural perspective. As such it leverages and capitalises on the relevant advancements in both the realms of autonomic computing and networking by welding them closely together. In particular, a multi-faceted Autonomic Cooperative System Architectural Model is defined which incorporates the notion of Autonomic Cooperative Behaviour being orchestrated by the Autonomic Cooperative Networking Protocol of a cross-layer nature. The overall proposed solution not only advocates for the inc

  5. Autonomous vehicles: from paradigms to technology

    Science.gov (United States)

    Ionita, Silviu

    2017-10-01

    Mobility is a basic necessity of contemporary society and it is a key factor in global economic development. The basic requirements for the transport of people and goods are: safety and duration of travel, but also a number of additional criteria are very important: energy saving, pollution, passenger comfort. Due to advances in hardware and software, automation has penetrated massively in transport systems both on infrastructure and on vehicles, but man is still the key element in vehicle driving. However, the classic concept of ‘human-in-the-loop’ in terms of ‘hands on’ in driving the cars is competing aside from the self-driving startups working towards so-called ‘Level 4 autonomy’, which is defined as “a self-driving system that does not requires human intervention in most scenarios”. In this paper, a conceptual synthesis of the autonomous vehicle issue is made in connection with the artificial intelligence paradigm. It presents a classification of the tasks that take place during the driving of the vehicle and its modeling from the perspective of traditional control engineering and artificial intelligence. The issue of autonomous vehicle management is addressed on three levels: navigation, movement in traffic, respectively effective maneuver and vehicle dynamics control. Each level is then described in terms of specific tasks, such as: route selection, planning and reconfiguration, recognition of traffic signs and reaction to signaling and traffic events, as well as control of effective speed, distance and direction. The approach will lead to a better understanding of the way technology is moving when talking about autonomous cars, smart/intelligent cars or intelligent transport systems. Keywords: self-driving vehicle, artificial intelligence, deep learning, intelligent transport systems.

  6. Endothelial dysfunction in diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Hadi AR Hadi

    2008-01-01

    incompletely understood. A number of trials have demonstrated that statins therapy as well as angiotensin converting enzyme inhibitors is associated with improvements in endothelial function in diabetes. Although antioxidants provide short-term improvement of endothelial function in humans, all studies of the effectiveness of preventive antioxidant therapy have been disappointing. Control of hyperglycemia thus remains the best way to improve endothelial function and to prevent atherosclerosis and other cardiovascular complications of diabetes. In the present review we provide the up to date details on this subject.Keywords: endothelial dysfunction, diabetes mellitus, hyperglycemia, insulin resistance microalbumiuria

  7. Morphologic Changes in Autonomic Nerves in Diabetic Autonomic Neuropathy

    Directory of Open Access Journals (Sweden)

    Heung Yong Jin

    2015-12-01

    Full Text Available Diabetic neuropathy is one of the major complications of diabetes, and it increases morbidity and mortality in patients with both type 1 diabetes mellitus (T1DM and type 2 diabetes mellitus (T2DM. Because the autonomic nervous system, for example, parasympathetic axons, has a diffuse and wide distribution, we do not know the morphological changes that occur in autonomic neural control and their exact mechanisms in diabetic patients with diabetic autonomic neuropathy (DAN. Although the prevalence of sympathetic and parasympathetic neuropathy is similar in T1DM versus T2DM patients, sympathetic nerve function correlates with parasympathetic neuropathy only in T1DM patients. The explanation for these discrepancies might be that parasympathetic nerve function was more severely affected among T2DM patients. As parasympathetic nerve damage seems to be more advanced than sympathetic nerve damage, it might be that parasympathetic neuropathy precedes sympathetic neuropathy in T2DM, which was Ewing's concept. This could be explained by the intrinsic morphologic difference. Therefore, the morphological changes in the sympathetic and parasympathetic nerves of involved organs in T1DM and T2DM patients who have DAN should be evaluated. In this review, evaluation methods for morphological changes in the epidermal nerves of skin, and the intrinsic nerves of the stomach will be discussed.

  8. An Experimental Platform for Autonomous Bus Development

    Directory of Open Access Journals (Sweden)

    Héctor Montes

    2017-11-01

    Full Text Available Nowadays, with highly developed instrumentation, sensing and actuation technologies, it is possible to foresee an important advance in the field of autonomous and/or semi-autonomous transportation systems. Intelligent Transport Systems (ITS have been subjected to very active research for many years, and Bus Rapid Transit (BRT is one area of major interest. Among the most promising transport infrastructures, the articulated bus is an interesting, low cost, high occupancy capacity and friendly option. In this paper, an experimental platform for research on the automatic control of an articulated bus is presented. The aim of the platform is to allow full experimentation in real conditions for testing technological developments and control algorithms. The experimental platform consists of a mobile component (a commercial articulated bus fully instrumented and a ground test area composed of asphalt roads inside the Consejo Superior de Investigaciones Científicas (CSIC premises. This paper focuses also on the development of a human machine interface to ease progress in control system evaluation. Some experimental results are presented in order to show the potential of the proposed platform.

  9. Autonomes und interkulturelles Lernen im Fremdsprachenunterricht – unvereinbar oder untrennbar?

    Directory of Open Access Journals (Sweden)

    Klaus-Börge Boeckmann

    2015-10-01

    The discussion on learner autonomy has intensified considerably in the last two decades, but autonomous learning in the intercultural field has remained a fairly marginal topic. This paper examines  the compatibility of intercultural and autonomous learning and starts by presenting two approaches that come to contradicting conclusions. The hypothesis that both learning fields are compatible, or indeed inseparable, appears better founded and more popular, however. Considering the broad scope of the discussion, the paper continues by focussing on learner-centredness as an important element of autonomy. The rationale for and advantages of learner-centred concepts of teaching and learning are discussed. In reflecting on the application of learner-centred concepts in the field of intercultural competence the emphasis is laid on attitudes as an area of competence. Some examples show how autonomous and intercultural learning can be interlaced in project-type learning tasks.

  10. La autonomía personal y la perspectiva comunitarista

    Directory of Open Access Journals (Sweden)

    Álvarez, Silvina

    1999-11-01

    Full Text Available Not available

    El presente artículo analiza el planteamiento que algunos autores comunitaristas han hecho de la noción de autonomía personal. En primer lugar centraré la atención en la formulación kantiana de la autonomía y en las posteriores reformulaciones que se han hecho de la propuesta original. En la segunda parte expondré algunos aspectos generales de la teoría comunitarista para luego desarrollar la propuesta de Charles Taylor, específicamente la ética de la autenticidad. En el análisis se destacan los problemas que surgen de entender la autonomía desde la perspectiva de una ética comprehensiva que concibe al sujeto como continuador de una tradición moral colectiva.

  11. Expert system isssues in automated, autonomous space vehicle rendezvous

    Science.gov (United States)

    Goodwin, Mary Ann; Bochsler, Daniel C.

    1987-01-01

    The problems involved in automated autonomous rendezvous are briefly reviewed, and the Rendezvous Expert (RENEX) expert system is discussed with reference to its goals, approach used, and knowledge structure and contents. RENEX has been developed to support streamlining operations for the Space Shuttle and Space Station program and to aid definition of mission requirements for the autonomous portions of rendezvous for the Mars Surface Sample Return and Comet Nucleus Sample return unmanned missions. The experience with REMEX to date and recommendations for further development are presented.

  12. Towards Competitive Commercial Autonomous Robots: The Configuration Problem

    DEFF Research Database (Denmark)

    Kjærgaard, Morten; Andersen, Nils Axel; Ravn, Ole

    2011-01-01

    knowledge about the underlying algorithms. The framework also makes it possible for the robot to autonomously calibrate itself, resulting in higher stability of the robot and less development time required. The work is a result of an industrial research project aimed at lowering development costs......This article presents a framework for configuring the individual components used in component based robot control systems. Using smart parameters that adapt to the respective robot system makes it possible to obtain optimal parameter values while reusing the software components, without expert...... and improving robustness of autonomous robot applications....

  13. Heart rate responses to autonomic challenges in obstructive sleep apnea.

    Directory of Open Access Journals (Sweden)

    Paul M Macey

    Full Text Available Obstructive sleep apnea (OSA is accompanied by structural alterations and dysfunction in central autonomic regulatory regions, which may impair dynamic and static cardiovascular regulation, and contribute to other syndrome pathologies. Characterizing cardiovascular responses to autonomic challenges may provide insights into central nervous system impairments, including contributions by sex, since structural alterations are enhanced in OSA females over males. The objective was to assess heart rate responses in OSA versus healthy control subjects to autonomic challenges, and, separately, characterize female and male patterns. We studied 94 subjects, including 37 newly-diagnosed, untreated OSA patients (6 female, age mean ± std: 52.1 ± 8.1 years; 31 male aged 54.3 ± 8.4 years, and 57 healthy control subjects (20 female, 50.5 ± 8.1 years; 37 male, 45.6 ± 9.2 years. We measured instantaneous heart rate with pulse oximetry during cold pressor, hand grip, and Valsalva maneuver challenges. All challenges elicited significant heart rate differences between OSA and control groups during and after challenges (repeated measures ANOVA, p<0.05. In post-hoc analyses, OSA females showed greater impairments than OSA males, which included: for cold pressor, lower initial increase (OSA vs. control: 9.5 vs. 7.3 bpm in females, 7.6 vs. 3.7 bpm in males, OSA delay to initial peak (2.5 s females/0.9 s males, slower mid-challenge rate-of-increase (OSA vs. control: -0.11 vs. 0.09 bpm/s in females, 0.03 vs. 0.06 bpm/s in males; for hand grip, lower initial peak (OSA vs. control: 2.6 vs. 4.6 bpm in females, 5.3 vs. 6.0 bpm in males; for Valsalva maneuver, lower Valsalva ratio (OSA vs. control: 1.14 vs. 1.30 in females, 1.29 vs. 1.34 in males, and OSA delay during phase II (0.68 s females/1.31 s males. Heart rate responses showed lower amplitude, delayed onset, and slower rate changes in OSA patients over healthy controls, and impairments may be more pronounced in

  14. Sleep restriction progress to cardiac autonomic imbalance

    Directory of Open Access Journals (Sweden)

    Arbind Kumar Choudhary

    2018-06-01

    Full Text Available Previous studies have shown that night shift work is thought to be a risk factor for cardiovascular disease and inadequate sleep is a common feature of night shift work. Since it’s more difficult to maintain adequate sleep duration among night watchmen during their working schedule, hence the purpose of our present study was to investigate whether mental stress or fatigue over restricted sleep period in night shift, affects HRV, in order to elucidate on cardiac autonomic modulation among nigh watchmen. With the purpose of this, autonomic activity determined from the levels of the heart rate variability (HRV, and also measured, body mass index (BMI, body fat percentage from skin fold thickness (biceps, triceps, and sub-scapular, supra-iliac among normal sleep watchmen (n = 28 and restricted sleep watchmen (n = 28 at first (1st day, fourth (4th day and seventh (7th day of restricted sleep period. We observed that among restricted sleep individuals, sleepiness was significant increase at 4th day and 7th day when compare to normal sleep individuals, and, there was significant increase in, mean NN, VLF, LF, LF(nu, LF/HF AND significant decrease in SDNN, RMSSD, TSP, HF, and HF(nu at 4th and 7th day of restricted sleep period. In addition to, this variable was more significant increase on 7th day, when compare with 4th day. As well as there was significant negative correlation between LF(nu and HF(nu at subsequent 4th day [r (48 = −0.84; P = 0.01] and 7th day[r (48 = −0.95; P = 0.01] of restricted sleep period. However we didn’t observe any significant variation in BMI, and body fat percentage among restricted sleep individuals when compare to normal sleep individuals with in this restricted sleep periods. Hence we concluded that partial sleep loss may cause autonomic imbalance represented by increased sympathetic and decreased parasympathetic activity; as revealed by altered HRV indices observed in this study. Keywords: Sleep

  15. PTSD and Sexual Dysfunction in Men and Women.

    Science.gov (United States)

    Yehuda, Rachel; Lehrner, Amy; Rosenbaum, Talli Y

    2015-05-01

    Difficulties in sexual desire and function often occur in persons with posttraumatic stress disorder (PTSD), but many questions remain regarding the mechanisms underlying the occurrence of sexual problems in PTSD. The aim of this review was to present a model of sexual dysfunction in PTSD underpinned by an inability to regulate and redirect the physiological arousal needed for healthy sexual function away from aversive hyperarousal and intrusive memories. A literature review pertaining to PTSD and sexual function was conducted. Evidence for the comorbidity of sexual dysfunction and PTSD is presented, and biological and psychological mechanisms that may underlie this co-occurrence are proposed. This manuscript presents evidence of sexual dysfunction in conjunction with PTSD, and of the neurobiology and neuroendocrinology of PTSD and sexual function. Sexual dysfunction following trauma exposure may be mediated by PTSD-related biological, cognitive, and affective processes. The treatment of PTSD must include attention to sexual dysfunction and vice versa. © 2015 International Society for Sexual Medicine.

  16. Thyroid dysfunction in type 2 diabetics seen at the University ...

    African Journals Online (AJOL)

    Thyroid dysfunction complicates the metabolic derangement observed in Diabetes Mellitus (DM). It is necessary to recognize and treat it when present in order to achieve stability of metabolic control in these patients. The prevalence of thyroid dysfunction in type-2 diabetics in our environment is not known. This study was ...

  17. Thyroid dysfunction in type 2 diabetics seen at the University ...

    African Journals Online (AJOL)

    Chigo Okwuosa

    Summary:Thyroid dysfunction complicates the metabolic derangement observed in Diabetes Mellitus (DM). It is necessary to recognize and treat it when present in order to achieve stability of metabolic control in these patients. The prevalence of thyroid dysfunction in type-2 diabetics in our environment is not known.

  18. Salivary Gland Dysfunction and Xerostomia in Sjogren's Syndrome

    NARCIS (Netherlands)

    Jensen, Siri Beier; Vissink, Arjan

    In this article, salivary gland dysfunction and xerostomia in Sjogren's syndrome (SS) are discussed, with a focus on the pathophysiology of salivary dysfunction in SS, the clinical presentation of dry mouth in SS, how to assess salivary gland hypofunction and xerostomia in SS, and the impact of

  19. Multiple organ dysfunction caused by parathyroid adenoma‑induced ...

    African Journals Online (AJOL)

    We present a 27‑year‑old male with multiple organ dysfunction caused by parathyroid adenoma‑induced primary hyperparathyroidism (PHPT). Initially, the patient experienced a sudden onset of gastrointestinal symptoms, polyuria, polydipsia, bone pain, renal dysfunction, nephrolithiasis, and acute pancreatitis, symptoms ...

  20. Autonomous Agents as Artistic Collaborators

    DEFF Research Database (Denmark)

    Kadish, David

    In this paper, I ask whether it is possible to exert creative direction on the emergence of large scale patterns from the actions of autonomous or semi-autonomous actors. As an artist and an engineer, I undertake installations and projects with an intent to create, to make art or innovative...... structures. At the same time, one of my artistic interests is in ceding a great deal of creative control to a cluster of robotic actors, in the process interrogating the lack of control that we, as a species, exert over the world. Here, I explore this idea in the context of an ongoing project called...... which innovations at large (galactic systems) and small (DNA) scales emerged were happy accidents of physics and chemistry. This raises the fundamental questions that my work explores, interrogating the relationship between the creativity of emergent processes on the micro- and macro- scales...

  1. Autonomously managed high power systems

    International Nuclear Information System (INIS)

    Weeks, D.J.; Bechtel, R.T.

    1985-01-01

    The need for autonomous power management capabilities will increase as the power levels of spacecraft increase into the multi-100 kW range. The quantity of labor intensive ground and crew support consumed by the 9 kW Skylab cannot be afforded in support of a 75-300 kW Space Station or high power earth orbital and interplanetary spacecraft. Marshall Space Flight Center is managing a program to develop necessary technologies for high power system autonomous management. To date a reference electrical power system and automation approaches have been defined. A test facility for evaluation and verification of management algorithms and hardware has been designed with the first of the three power channel capability nearing completion

  2. Autonomous Industrial Mobile Manipulation (AIMM)

    DEFF Research Database (Denmark)

    Hvilshøj, Mads; Bøgh, Simon; Nielsen, Oluf Skov

    2012-01-01

    Purpose - The purpose of this paper is to provide a review of the interdisciplinary research field Autonomous Industrial Mobile Manipulation (AIMM), with an emphasis on physical implementations and applications. Design/methodology/approach - Following an introduction to AIMM, this paper investiga......Purpose - The purpose of this paper is to provide a review of the interdisciplinary research field Autonomous Industrial Mobile Manipulation (AIMM), with an emphasis on physical implementations and applications. Design/methodology/approach - Following an introduction to AIMM, this paper......; sustainability, configuration, adaptation, autonomy, positioning, manipulation and grasping, robot-robot interaction, human-robot interaction, process quality, dependability, and physical properties. Findings - The concise yet comprehensive review provides both researchers (academia) and practitioners (industry...... Manipulation (AIMM)....

  3. Affective mechanisms linking dysfunctional behavior to performance in work teams : a moderated mediation study

    NARCIS (Netherlands)

    Cole, M.S.; Walter, F.; Bruch, H.

    The present study examines the association between dysfunctional learn behavior and team performance. Data included measures of teams' dysfunctional behavior and negative affective tone as well as supervisors' ratings of teams' (nonverbal) negative emotional expressivity and performance. Utilizing a

  4. Screening for cognitive dysfunction in unipolar depression

    DEFF Research Database (Denmark)

    Ott, Caroline Vintergaard; Bjertrup, Anne Juul; Jensen, Johan Høy

    2016-01-01

    BACKGROUND: Persistent cognitive dysfunction in unipolar depression (UD) contributes to socio-occupational impairment, but there are no feasible methods to screen for and monitor cognitive dysfunction in this patient group. The present study investigated the validity of two new instruments...... to screen for cognitive dysfunction in UD, and their associations with socio-occupational capacity. METHOD: Participants (n=53) with UD in partial or full remission and healthy control persons (n=103) were assessed with two new screening instruments, the Danish translations of the Screen for Cognitive...... Impairment in Psychiatry (SCIP-D) and Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) and with established neuropsychological and self-assessment measures. Depression symptoms and socio-occupational function were rated with the Hamilton Depression Rating Scale and Functional Assessment...

  5. Autonomic computing meets SCADA security

    OpenAIRE

    Nazir, S; Patel, S; Patel, D

    2017-01-01

    © 2017 IEEE. National assets such as transportation networks, large manufacturing, business and health facilities, power generation, and distribution networks are critical infrastructures. The cyber threats to these infrastructures have increasingly become more sophisticated, extensive and numerous. Cyber security conventional measures have proved useful in the past but increasing sophistication of attacks dictates the need for newer measures. The autonomic computing paradigm mimics the auton...

  6. Dysfunctional uterine bleedings of a climacteric period

    International Nuclear Information System (INIS)

    Prilepskaya, V.N.

    1993-01-01

    Climacteric period of some women is complicated by dysfunctional uterine bleedings (DUB). Bearing in mind the fact that DUBS are caused by disorder of estrin rhysmic secretion, the paper presents the methods of differential diagnostics for investigations into functional disorders in the hypothalamus -hypophysis - ovaries - uterus system. The preference is given to roentgenologic and radioimmunologic diagnostic methods

  7. Left atrial myxoma with biventricular dysfunction

    Directory of Open Access Journals (Sweden)

    Monish S. Raut

    2016-09-01

    Full Text Available Occurrence of left atrial myxoma with severe ventricular dysfunction without any obstructive coronary artery disease, as presented in our case, is very rare. It may be due to undiagnosed concomitant dilated cardiomyopathy or unknown cardiodepressant effect of myxoma which warrants further research.

  8. Left atrial myxoma with biventricular dysfunction.

    Science.gov (United States)

    Raut, Monish S; Shad, Sujay; Maheshwari, Arun

    2016-09-01

    Occurrence of left atrial myxoma with severe ventricular dysfunction without any obstructive coronary artery disease, as presented in our case, is very rare. It may be due to undiagnosed concomitant dilated cardiomyopathy or unknown cardiodepressant effect of myxoma which warrants further research. Copyright © 2016 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  9. Antidepressant induced sexual dysfunction Part 1: epidemiology ...

    African Journals Online (AJOL)

    Adele

    Part 2 will focus on the assessment and management of AISD. Antidepressant induced sexual dysfunction Part 1: epidemiology and clinical presentation .... Poor self esteem. SOCIAL. Cultural issues. Religious issues. Environmental issues. Interpersonal conflicts. Partner specific. Sexual activity specific. Pregnancy and ...

  10. Advances in Autonomous Systems for Missions of Space Exploration

    Science.gov (United States)

    Gross, A. R.; Smith, B. D.; Briggs, G. A.; Hieronymus, J.; Clancy, D. J.

    applications. One notable example of such missions are those to explore for the existence of water on planets such as Mars and the moons of Jupiter. It is clear that water does not exist on the surfaces of such bodies, but may well be located at some considerable depth below the surface, thus requiring a subsurface drilling capability. Subsurface drilling on planetary surfaces will require a robust autonomous control and analysis system, currently a major challenge, but within conceivable reach of planned technology developments. This paper will focus on new and innovative software for remote, autonomous, space systems flight operations, including flight test results, lessons learned, and implications for the future. An additional focus will be on technologies for planetary exploration using autonomous systems and astronaut-assistance systems that employ new spoken language technology. Topics to be presented will include a description of key autonomous control concepts, illustrated by the Remote Agent program that commanded the Deep Space 1 spacecraft to new levels of system autonomy, recent advances in distributed autonomous system capabilities, and concepts for autonomous vehicle health management systems. A brief description of teaming spacecraft and rovers for complex exploration missions will also be provided. New software for autonomous science data acquisition for planetary exploration will also be described, as well as advanced systems for safe planetary landings. Current results of autonomous planetary drilling system research will be presented. A key thrust within NASA is to develop technologies that will leverage the capabilities of human astronauts during planetary surface explorations. One such technology is spoken dialogue interfaces, which would allow collaboration with semi-autonomous agents that are engaged in activities that are normally accomplished using language, e.g., astronauts in space suits interacting with groups of semi-autonomous rovers and other

  11. Guillain–Barré syndrome presenting with Raynaud’s phenomenon: a case report

    Science.gov (United States)

    2014-01-01

    Background Guillain–Barré syndrome is an immune mediated acute inflammatory polyradiculo-neuropathy involving the peripheral nervous system. Commonest presentation is acute or subacute flaccid ascending paralysis of limbs. Rarely autonomic dysfunction can be the presenting feature of Guillain–Barré syndrome. Raynaud’s phenomenon, although had been described in relation to many disease conditions, has not been described in association with Guillain–Barré syndrome up to date. Case presentation We report the first case of Guillain–Barré syndrome presenting with Raynaud’s phenomenon in a 21-year-old previously well boy. New onset Raynaud’s phenomenon was experienced followed by acute ascending flaccid paralysis of lower limbs and upper limbs together with palpitations and postural giddiness. Nerve conduction studies showed acute inflammatory demyelinating polyneuropathy with cerebrospinal fluid cyto-protein dissociation. He was treated with intravenous immunoglobulin and showed a satisfactory clinical recovery of muscle weakness, Raynaud’s phenomenon and autonomic disturbances. Conclusion Guillain–Barré syndrome presenting with Raynaud’s phenomenon is not being reported in literature previously. Although the underlying mechanism is not fully understood, Raynaud’s phenomenon should prompt the physician to consider Guillain–Barré syndrome with a complimentary clinical picture. PMID:25182165

  12. Semi autonomous mine detection system

    Energy Technology Data Exchange (ETDEWEB)

    Douglas Few; Roelof Versteeg; Herman Herman

    2010-04-01

    CMMAD is a risk reduction effort for the AMDS program. As part of CMMAD, multiple instances of semi autonomous robotic mine detection systems were created. Each instance consists of a robotic vehicle equipped with sensors required for navigation and marking, a countermine sensors and a number of integrated software packages which provide for real time processing of the countermine sensor data as well as integrated control of the robotic vehicle, the sensor actuator and the sensor. These systems were used to investigate critical interest functions (CIF) related to countermine robotic systems. To address the autonomy CIF, the INL developed RIK was extended to allow for interaction with a mine sensor processing code (MSPC). In limited field testing this system performed well in detecting, marking and avoiding both AT and AP mines. Based on the results of the CMMAD investigation we conclude that autonomous robotic mine detection is feasible. In addition, CMMAD contributed critical technical advances with regard to sensing, data processing and sensor manipulation, which will advance the performance of future fieldable systems. As a result, no substantial technical barriers exist which preclude – from an autonomous robotic perspective – the rapid development and deployment of fieldable systems.

  13. A* planning in discrete configuration spaces of autonomous systems

    NARCIS (Netherlands)

    Trovato, K.I.

    1996-01-01

    This thesis presents a powerful, modular framework that uses the A* algorithm to plan motions for an autonomous system. We also introduce Differential A*, a new and complementary method that can be used in the framework for quickly addressing changes in the environment.

  14. An agent-based simulation model for autonomous trailer docking

    NARCIS (Netherlands)

    Gerrits, Berry; Mes, Martijn; Schuur, Peter Cornelis

    2018-01-01

    This paper presents a simulation model of a generic automated planning and control system for the pick-up and docking of semi-trailers by means of autonomous Yard Tractors (YTs) in a collision- and conflict free environment. To support the planning and control of the YTs, we propose a Multi-Agent

  15. load loss performance of an autonomous self-excited induction ...

    African Journals Online (AJOL)

    ES Obe

    This paper presents a dynamic analysis of an autonomous Self-Excited Induction. Generator (SEIG) showing dynamic loss of load ... for wind energy conversion and also in small hydro plants [1, 2]. This has also increased the level of .... MATLAB/SIMULINK package is used to simulate the machine characteristics of phase.

  16. Adaptive Control System for Autonomous Helicopter Slung Load Operations

    DEFF Research Database (Denmark)

    Bisgaard, Morten; la Cour-Harbo, Anders; Bendtsen, Jan Dimon

    2010-01-01

    This paper presents design and verification of an estimation and control system for a helicopter slung load system. The estimator provides position and velocity estimates of the slung load and is designed to augment existing navigation in autonomous helicopters. Sensor input is provided by a vision...

  17. Guidance and control for an autonomous soaring UAV

    Science.gov (United States)

    Allen, Michael J. (Inventor)

    2008-01-01

    The present invention provides a practical method for UAVs to take advantage of thermals in a manner similar to piloted aircrafts and soaring birds. In general, the invention is a method for a UAV to autonomously locate a thermal and be guided to the thermal to greatly improve range and endurance of the aircraft.

  18. Load Loss Performance of an Autonomous Self-Excited Induction ...

    African Journals Online (AJOL)

    This paper presents a dynamic analysis of an autonomous Self-Excited Induction Generator (SEIG) showing dynamic loss of load performance. In stand-alone operation of the SEIG, especially when supplying a low power utility, an interesting performance of the SEIG observed for various power factor loads can be ...

  19. Bowel Dysfunction Related to Spina Bifida: Keep It Simple.

    Science.gov (United States)

    Brochard, Charlène; Peyronnet, Benoît; Dariel, Anne; Ménard, Hélène; Manunta, Andréa; Ropert, Alain; Neunlist, Michel; Bouguen, Guillaume; Siproudhis, Laurent

    2017-11-01

    Although care of urological disorders in spina bifida is well established, there is yet no agreement on a standardized approach to bowel dysfunction in this population. The purpose of this study was to assess bowel dysfunction using validated instruments and the risk factors in adults with spina bifida. A multidisciplinary team prospectively collected patient data, focusing on anorectal and urological symptoms. The study was conducted with data from a French referral center for spina bifida. A total of 228 adults with spina bifida (sex ratio men:women, 92 (40%):136 (60%)) with a median age of 34.7 years (range, 26.8-44.7 y) were assessed. Factors associated with severe fecal incontinence (Cleveland Clinic Incontinence Score ≥9) and severe bowel dysfunction (Neurogenic Bowel Dysfunction score ≥14) were assessed in a multivariate analysis model. The prevalence rates of severe fecal incontinence and severe bowel dysfunction were 60% (130/217) and 42% (71/168). Bowel dysfunction was the second most common major concern of patients after lower urinary tract dysfunction. Male sex, obesity, urinary incontinence, and a Knowles-Eccersley-Scott symptom constipation score ≥10 were independently associated with severe fecal incontinence. Patients with soft stools had significantly less severe bowel dysfunction. Neither neurologic level nor other neurologic features of spina bifida were associated with severe fecal incontinence or severe bowel dysfunction. The recruitment of patients with spina bifida through a national referral center might have resulted in selection bias, and some data were missing especially regarding BMI and Neurogenic Bowel Dysfunction score (21% and 26% of missing data). The prevalence rates of severe fecal incontinence and severe bowel dysfunction in adults with spina bifida were high and were adequately perceived by the patients. The present study emphasized the association of bowel dysfunction and fecal incontinence with obesity, urologic

  20. Effects of Kefir on the Cardiac Autonomic Tones and Baroreflex Sensitivity in Spontaneously Hypertensive Rats.

    Science.gov (United States)

    Klippel, Brunella F; Duemke, Licia B; Leal, Marcos A; Friques, Andreia G F; Dantas, Eduardo M; Dalvi, Rodolfo F; Gava, Agata L; Pereira, Thiago M C; Andrade, Tadeu U; Meyrelles, Silvana S; Campagnaro, Bianca P; Vasquez, Elisardo C

    2016-01-01

    It has been previously shown that the probiotic kefir (a symbiotic matrix containing acid bacteria and yeasts) attenuated the hypertension and the endothelial dysfunction in spontaneously hypertensive rats (SHR). In the present study, the effect of chronic administration of kefir on the cardiac autonomic control of heart rate (HR) and baroreflex sensitivity (BRS) in SHR was evaluated. SHR were treated with kefir (0.3 mL/100 g body weight) for 60 days and compared with non-treated SHR and with normotensive Wistar-Kyoto rats. Cardiac autonomic vagal (VT) and sympathetic (ST) tones were estimated through the blockade of the cardiac muscarinic receptors (methylatropine) and the blockade of β1-adrenoceptor (atenolol). The BRS was evaluated by the tachycardia and bradycardia responses to vasoactive drug-induced decreases and increases in arterial blood pressure (BP), respectively. Additionally, spontaneous BRS was estimated by autoregressive spectral analysis. Kefir-treated SHR exhibited significant attenuation of basal BP, HR, and cardiac hypertrophy compared to non-treated SHR (12, 13, and 21%, respectively). Cardiac VT and ST were significantly altered in the SHR (~40 and ~90 bpm) compared with Wistar rats (~120 and ~30 bpm) and were partially recovered in SHR-kefir (~90 and ~25 bpm). SHR exhibited an impaired bradycardic BRS (~50%) compared with Wistar rats, which was reduced to ~40% in the kefir-treated SHR and abolished by methylatropine in all groups. SHR also exhibited a significant impairment of the tachycardic BRS (~23%) compared with Wistar rats and this difference was reduced to 8% in the SHR-kefir. Under the action of atenolol the residual reflex tachycardia was smaller in SHR than in Wistar rats and kefir attenuated this abnormality. Spectral analysis revealed increased low frequency components of BP (~3.5-fold) and pulse interval (~2-fold) compared with Wistar rats and these differences were reduced by kefir-treatment to ~1.6- and ~1.5-fold, respectively

  1. Imaging Systemic Dysfunction in Parkinson's Disease.

    Science.gov (United States)

    Borghammer, Per; Knudsen, Karoline; Brooks, David J

    2016-06-01

    Parkinson's disease is now widely recognized to be a multisystem disorder affecting the brain and peripheral autonomic nerves. Extensive pathology is present in both the sympathetic and parasympathetic nervous system and the intrinsic gastrointestinal plexuses in patients. Autonomic pathology and symptoms such as constipation can predate the clinical diagnosis by years or decades. Imaging studies have contributed greatly to our understanding of Parkinson's disease but focused primarily on imaging cerebral pathology. However, given the importance of understanding the nature, chronology, and functional consequences of peripheral pathology, there has been renewed interest in imaging peripheral organs in Parkinson's disease. Suitable imaging tools can be divided into two types: radiotracer studies that directly estimate loss of sympathetic or parasympathetic nerve terminals, and imaging modalities to quantitate dysphagia, gastric emptying, esophageal and intestinal transit times, and anorectal dyssynergia. In this review, we summarize current knowledge about peripheral imaging in Parkinson's disease.

  2. An Autonomous Omnidirectional Robot

    Directory of Open Access Journals (Sweden)

    Yanfei Liu

    2010-01-01

    Full Text Available RoboCup is an international research and education initiative, which aims to foster artificial intelligence and robotics research by using competitive soccer as a standard problem. This paper presents a detailed engineering design process and the outcome for an omni-directional mobile robot platform for the Robocup Middle Size League competition. A prototype that can move omnidirectionally with kicking capability was designed, built, and tested by a group of senior students. The design included a mechanical base, pneumatic kicking mechanism, a DSP microcontroller-based control system, various sensor interfacing units, and the analysis of omnidirectional motions. The testing results showed that the system was able to move omnidirectionally with a speed of ∼2 m/s and able to kick a size 5 FIFA soccer ball for a distance of at least 5 meters.

  3. The sympathetic skin response in diabetic neuropathy and its relationship to autonomic symptoms

    International Nuclear Information System (INIS)

    Al-Moallem, Mansour A.; Zaidan, Radwan M.; Alkali, Nura H.

    2008-01-01

    Objective was to examine the utility of the sympathetic skin response (SSR) as a measure of impaired autonomic function among diabetic patients in Saudi Arabia. In this case-control study, baseline SSR was obtained from 18 healthy subjects, followed by nerve conduction studies and SSR testing on a consecutive cohort of 50 diabetic patients with peripheral neuropathy. The SSR in diabetic patients was compared between those with autonomic neuropathy and those without autonomic neuropathy. This study was conducted at the King Khalid University Hospital, Riyadh, Saudi Arabia, from June 2006 to June 2007. The SSR was present in all healthy subjects and in 32 diabetic patients. Among 16 patients with autonomic neuropathy, the SSR was absent in 14 and present in 2, while 4 of 34 patients lacking evidence of autonomic neuropathy had absent SSR. Using Fisher's exact test, we found a strong association between absent SSR and autonomic neuropathy (p<0.001), however, not with age or duration of diabetes mellitus. As a diagnostic test of autonomic neuropathy, the SSR had a sensitivity of 87.5%, a specificity of 88.2%, a positive predictive value of 77.8%, and a negative predictive value of 93.7%. Absence of the SSR is a reliable indicator of autonomic neuropathy among patients with diabetes mellitus in Saudi Arabia. (author)

  4. Safety analysis of autonomous excavator functionality

    International Nuclear Information System (INIS)

    Seward, D.; Pace, C.; Morrey, R.; Sommerville, I.

    2000-01-01

    This paper presents an account of carrying out a hazard analysis to define the safety requirements for an autonomous robotic excavator. The work is also relevant to the growing generic class of heavy automated mobile machinery. An overview of the excavator design is provided and the concept of a safety manager is introduced. The safety manager is an autonomous module responsible for all aspects of system operational safety, and is central to the control system's architecture. Each stage of the hazard analysis is described, i.e. system model creation, hazard definition and hazard analysis. Analysis at an early stage of the design process, and on a system that interfaces directly to an unstructured environment, exposes certain issues relevant to the application of current hazard analysis methods. The approach taken in the analysis is described. Finally, it is explained how the results of the hazard analysis have influenced system design, in particular, safety manager specifications. Conclusions are then drawn about the applicability of hazard analysis of requirements in general, and suggestions are made as to how the approach can be taken further

  5. Diastolic dysfunction in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Wiese, Signe Skovgaard; Halgreen, Hanne

    2016-01-01

    stiffness of the cirrhotic heart may decrease the compliance and result in DD. The prevalence of DD in cirrhotic patients averages about 50 %. It can be evaluated by transmitral Doppler echocardiography, tissue Doppler echocardiography, and cardiac magnetic resonance imaging. There seems to be a relation...... between DD and the severity of liver dysfunction and the presence of ascites. After liver transplantation, DD worsens the prognosis and increases the risk of graft rejection, but DD improves after few months. Insertion of a transjugular intrahepatic portosystemic shunt increases left ventricular diastolic...

  6. Osteopontin and osteoprotegerin levels in type 2 diabetes and their association with cardiovascular autonomic function.

    Science.gov (United States)

    Maser, Raelene E; Lenhard, M James; Pohlig, Ryan T; Balagopal, P Babu

    2016-04-01

    Osteopontin (OPN) and osteoprotegerin (OPG) are bone metabolism biomarkers potentially associated with nerve function. We evaluated the association of cardiovascular autonomic nerve function, OPN, and OPG in 50 individuals with type 2 diabetes mellitus (T2DM). RR-variation during deep breathing (i.e., mean circular resultant (MCR) and expiration/inspiration (E/I) ratio) was used to assess parasympathetic nerve function. Participants' demographics, HbA1c, 25-hydroxyvitamin D (25(OH)D), BMI, HOMA-IR, calcium, parathyroid hormone, creatinine, OPN, and OPG were determined. Using stepwise multiple linear regression analysis with MCR or E/I ratio as the dependent variable, OPN was independently associated with reduced autonomic function. A previous report showed a significant association of cardiovascular autonomic function with age, 25(OH)D insufficiency, and the interaction of age×25(OH)D insufficiency. Here we report a novel association for OPN and its interaction with age indicating that for those who are younger, elevated OPN levels are related to a greater loss of autonomic function (MCR model R2=0.598, p<0.001; E/I model R2=0.594, p<0.001). Our results suggest that OPN is associated with reduced parasympathetic function, particularly in younger individuals with T2DM. Further studies are needed to determine if OPN is neuroprotective, involved in the pathogenesis of autonomic dysfunction, or a bystander. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Cardiac autonomic neuropathy, estimated cardiovascular risk, and circadian blood pressure pattern in diabetes mellitus.

    Science.gov (United States)

    Cabezas-Cerrato, Jose; Hermida, Ramon Carmelo; Cabezas-Agricola, Jose Manuel; Ayala, Diana Elva

    2009-07-01

    This study was designed to investigate potential factors involved in the disruption of the circadian blood pressure (BP) pattern in diabetes mellitus, as well as the relation between BP, cardiac autonomic neuropathy, and estimated cardiovascular risk. We studied 101 diabetic patients (58% with type 2 diabetes; 59% men), age 21-65 yrs, evaluated by 48 h BP monitoring. We performed three autonomic tests in a single session: deep breathing, Valsalva maneuver, and standing up from a seated position. Patients were classified according to the number of abnormal tests and their 10 yr risk of coronary heart disease or stroke. The prevalence of non-dipping 24 h patterning ranged from 47.6% in type 1 to 42.4% in type 2 diabetes. The awake/asleep ratio of systolic BP (SBP) was comparable between patients with or without abnormal autonomic tests. Pulse pressure (PP) was significantly higher in patients with > or =1 abnormal autonomic test (p risk of coronary heart disease (p Patients with higher stroke-risk had higher SBP but lower diastolic BP, and thus an elevated ambulatory PP by 9 mmHg, compared to those with lower risk (p diabetes mellitus. The most significant finding from this study is the high ambulatory PP found in patients with either cardiac autonomic dysfunction or high risk for coronary heart disease or stroke. After correcting for age, this elevated PP level emerged as the main cardiovascular risk factor in diabetes mellitus.

  8. Autonomous driving in NMR.

    Science.gov (United States)

    Perez, Manuel

    2017-01-01

    The automatic analysis of NMR data has been a much-desired endeavour for the last six decades, as it is the case with any other analytical technique. This need for automation has only grown as advances in hardware; pulse sequences and automation have opened new research areas to NMR and increased the throughput of data. Full automatic analysis is a worthy, albeit hard, challenge, but in a world of artificial intelligence, instant communication and big data, it seems that this particular fight is happening with only one technique at a time (let this be NMR, MS, IR, UV or any other), when the reality of most laboratories is that there are several types of analytical instrumentation present. Data aggregation, verification and elucidation by using complementary techniques (e.g. MS and NMR) is a desirable outcome to pursue, although a time-consuming one if performed manually; hence, the use of automation to perform the heavy lifting for users is required to make the approach attractive for scientists. Many of the decisions and workflows that could be implemented under automation will depend on the two-way communication with databases that understand analytical data, because it is desirable not only to query these databases but also to grow them in as much of an automatic manner as possible. How these databases are designed, set up and the data inside classified will determine what workflows can be implemented. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Continuous Cardiac Autonomic and Hemodynamic Responses to Isometric Exercise.

    Science.gov (United States)

    Taylor, Katrina A; Wiles, Jonathan D; Coleman, Damian D; Sharma, Rajan; Oʼdriscoll, Jamie M

    2017-08-01

    Elevated arterial blood pressure (BP) is associated with autonomic dysfunction and impaired hemodynamic control mechanisms. Isometric exercise (IE) training has been demonstrated effective at reducing BP; however, the continuous cardiovascular responses during IE are underinvestigated. We hypothesized that reflex autonomic cardiovascular control is an important mediator in reducing BP. To test our hypothesis, we investigated continuous cardiac autonomic modulation and baroreceptor reflex sensitivity (BRS) in response to IE. Twenty-five prehypertensive participants performed a single IE wall squat training session. Total power spectral density (PSD) of HR variability (HRV) and associated low-frequency (LF) and high-frequency (HF) power spectral components were recorded in absolute (ms) and normalized units (nu) before, during, and after an IE session. HR was recorded via electrocardiography and BRS via the sequence method. Continuous BP was recorded via the vascular unloading technique and stroke volume via impedance cardiography. Total peripheral resistance was calculated according to Ohm's law. During IE, there were significant reductions in HRV (P < 0.05) and BRS (P < 0.05) and significant increases in HR (P < 0.001), systolic, diastolic, and mean BP (all P < 0.001). In recovery from IE, HRV (P < 0.001), HFnu (P < 0.001), and BRS (P < 0.001) significantly increased with a significant decrease in LFnu (P < 0.001) and LF:HF ratio (P < 0.001), indicative of predominant parasympathetic over sympathetic activity. This autonomic response was associated with a significant reduction in systolic (23.2 ± 18.1 mm Hg, P < 0.001), diastolic (18.7 ± 16.9 mm Hg, P < 0.001), and mean (15.8 ± 15.5 mm Hg, P < 0.001) BP, below baseline and a significant reduction in total peripheral resistance (P < 0.001). A single IE session is associated with improved cardiac autonomic modulation and hemodynamic cardiovascular control in prehypertensive males. These acute responses may be

  10. The hypertension of autonomic failure and its treatment

    Science.gov (United States)

    Shannon, J.; Jordan, J.; Costa, F.; Robertson, R. M.; Biaggioni, I.

    1997-01-01

    We studied the incidence and severity of supine hypertension in 117 patients with severe primary autonomic failure presenting to a referral center over a 9-year period. Patients were uniformly characterized by disabling orthostatic hypotension, lack of compensatory heart rate increase, abnormal autonomic function tests, and unresponsive plasma norepinephrine. Fifty-four patients had isolated autonomic impairment (pure autonomic failure). Sixty-three patients had central nervous system involvement in addition to autonomic impairment (multiple-system atrophy). Patients were studied off medications, in a metabolic ward, and on a controlled diet containing 150 mEq of sodium. Fifty-six percent of patients had supine diastolic blood pressure > or =90 mm Hg. The prevalence of hypertension was slightly greater in females (63%) than in males (52%). Potential mechanisms responsible for this hypertension were investigated. No correlation was found between blood volume and blood pressure. Similarly, plasma norepinephrine (92+/-15 pg/mL) and plasma renin activity (0.3+/-0.05 ng/mL per hour) were very low in the subset of patients with pure autonomic failure and supine hypertension (mean systolic/diastolic pressure, 177 +/- 6/108 +/- 2 mm Hg, range 167/97 to 219/121). Supine hypertension represents a challenge in the treatment of orthostatic hypotension. We found these patients to be particularly responsive to the hypotensive effects of transdermal nitroglycerin. Doses ranging from 0.025 to 0.1 mg/h decreased systolic blood pressure by 36+/-7 mm Hg and may effectively treat supine hypertension overnight, but the dose should be individualized and used with caution.

  11. Managing female sexual dysfunction.

    Science.gov (United States)

    Buster, John E

    2013-10-01

    Female sexual dysfunctions (FSDs) range from short-term aggravations to major emotional disturbances adversely affecting family and workplace. This review highlights diagnosis and management of the four most widely diagnosed FSDs. It initially focuses on hypoactive sexual desire disorder (HSDD) as a driving force at the heart of all other FSDs; nothing happens without sexual desire. Successful resolution of HSDD frequently facilitates resolution of other disorders. Central to understanding HSDD is the impact of aging female sexual endocrinology and its effect on both prevalence and expression patterns of FSD. Advances in this field have enabled introduction of some the most effective treatments yet described for HSDD. Sexual arousal disorder, though commonly affected by the same factors as HSDD, is heavily associated with psychotropic drugs and mood elevators. Orgasmic disorder is frequently the downstream result of other sexual dysfunctions, particularly HSDD, or the result of a major psychosexual trauma. Successful management of the underlying disorder often resolves orgasmic disorder. Sexual pain disorder is frequently the result of a gynecologic disorder, such as endometriosis, that can be substantially managed through successful treatment of that disorder. This article ends with the article's most important note: how to initiate the conversation. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  12. Guillain-Barré syndrome presenting with Raynaud's phenomenon: a case report.

    Science.gov (United States)

    Gunatilake, Sonali Sihindi Chapa; Wimalaratna, Harith

    2014-09-03

    Guillain-Barré syndrome is an immune mediated acute inflammatory polyradiculo-neuropathy involving the peripheral nervous system. Commonest presentation is acute or subacute flaccid ascending paralysis of limbs. Rarely autonomic dysfunction can be the presenting feature of Guillain-Barré syndrome. Raynaud's phenomenon, although had been described in relation to many disease conditions, has not been described in association with Guillain-Barré syndrome up to date. We report the first case of Guillain-Barré syndrome presenting with Raynaud's phenomenon in a 21-year-old previously well boy. New onset Raynaud's phenomenon was experienced followed by acute ascending flaccid paralysis of lower limbs and upper limbs together with palpitations and postural giddiness. Nerve conduction studies showed acute inflammatory demyelinating polyneuropathy with cerebrospinal fluid cyto-protein dissociation. He was treated with intravenous immunoglobulin and showed a satisfactory clinical recovery of muscle weakness, Raynaud's phenomenon and autonomic disturbances. Guillain-Barré syndrome presenting with Raynaud's phenomenon is not being reported in literature previously. Although the underlying mechanism is not fully understood, Raynaud's phenomenon should prompt the physician to consider Guillain-Barré syndrome with a complimentary clinical picture.

  13. Predictors of Erectile Dysfunction in Men with Type 2 Diabetes Mellitus Referred to a Tertiary Healthcare Centre

    Directory of Open Access Journals (Sweden)

    Theophilus Ugwu

    2016-01-01

    Full Text Available Background. The frequency of erectile dysfunction (ED complicating diabetes mellitus (DM is reportedly high. However, its risk factors have not been well studied. Methods. This was a cross-sectional study of 160 male type 2 DM adults, aged 30–70 years, attending a tertiary healthcare clinic. Demographic and relevant clinical information was documented. Erectile function was assessed using an abridged version of the International Index of Erectile Function (IIEF-5. All subjects were evaluated for central obesity, glycemic control, peripheral arterial disease (PAD, autonomic neuropathy, dyslipidemia, and testosterone deficiency. Results. 152 (95% patients with a mean age of 60.3 ± 8.8 years completed the study. 71.1% had varying degrees of ED, while 58.3% suffered from a moderate-to-severe form. Independent predictors of ED [presented as adjusted odds ratio (95% confidence interval] were longer duration of DM, 1.14 (1.02–1.28, PAD, 3.87 (1.28–11.67, autonomic neuropathy, 3.51 (1.82–6.79, poor glycemic control, 7.12 (2.49–20.37, and testosterone deficiency, 6.63 (2.61–16.83. Conclusion. The prevalence of ED and its severe forms was high in this patient population. Poor glycemic control and testosterone deficiency were the strongest risk factors for ED, making it possibly a preventable condition.

  14. Psychopathy: cognitive and neural dysfunction

    Science.gov (United States)

    R. Blair, R. James

    2013-01-01

    Psychopathy is a developmental disorder marked by emotional deficits and an increased risk for antisocial behavior. It is not equivalent to the diagnosis Antisocial Personality Disorder, which concentrates only on the increased risk for antisocial behavior and not a specific cause—ie, the reduced empathy and guilt that constitutes the emotional deficit. The current review considers data from adults with psychopathy with respect to the main cognitive accounts of the disorder that stress either a primary attention deficit or a primary emotion deficit. In addition, the current review considers data regarding the neurobiology of this disorder. Dysfunction within the amygdala's role in reinforcement learning and the role of ventromedial frontal cortex in the representation of reinforcement value is stressed. Data is also presented indicating potential difficulties within parts of temporal and posterior cingulate cortex. Suggestions are made with respect to why these deficits lead to the development of the disorder. PMID:24174892

  15. Towards the Development of Autonomous Ferries

    OpenAIRE

    Bitar, Glenn Ivan

    2017-01-01

    Autonomous ships is at the moment a heavily researched topic in the maritime industry. Development to introduce autonomous ferries in the Norwegian fjords is under way. This thesis is a study of technical and formal challenges related to autonomous ferries. The thesis goes into topics such as industrial control systems for ships, path planning and collision avoidance algorithms, as well as automatic docking. Additionally, information and statistics regarding ferry activities in Norway are pre...

  16. The Human Element and Autonomous Ships

    OpenAIRE

    Sauli Ahvenjärvi

    2016-01-01

    The autonomous ship technology has become a “hot” topic in the discussion about more efficient, environmentally friendly and safer sea transportation solutions. The time is becoming mature for the introduction of commercially sensible solutions for unmanned and fully autonomous cargo and passenger ships. Safety will be the most interesting and important aspect in this development. The utilization of the autonomous ship technology will have many effects on the safety, both positive and negativ...

  17. Autonomous Exploration Using an Information Gain Metric

    Science.gov (United States)

    2016-03-01

    navigation goals, serving to drive an autonomous system. By continually moving to these navigation goals and taking measurements, the system works to...ARL-TR-7638 ● MAR 2016 US Army Research Laboratory Autonomous Exploration Using an Information Gain Metric by Nicholas C Fung...Laboratory Autonomous Exploration Using an Information Gain Metric by Nicholas C Fung, Jason M Gregory, and John G Rogers Computational and

  18. DARTS: Deceiving Autonomous Cars with Toxic Signs

    OpenAIRE

    Sitawarin, Chawin; Bhagoji, Arjun Nitin; Mosenia, Arsalan; Chiang, Mung; Mittal, Prateek

    2018-01-01

    Sign recognition is an integral part of autonomous cars. Any misclassification of traffic signs can potentially lead to a multitude of disastrous consequences, ranging from a life-threatening accident to a large-scale interruption of transportation services relying on autonomous cars. In this paper, we propose and examine realistic security attacks against sign recognition systems for Deceiving Autonomous caRs with Toxic Signs (we call the proposed attacks DARTS). Leveraging the concept of ad...

  19. Design of an Autonomous Forklift Using Kinect

    OpenAIRE

    Abdellatif Mohamed; Shoeir Metwali; Talaat Omar; Gabalah Mahmoud; Elbably Mohamed; Saleh Saleh

    2018-01-01

    Material handling is a necessary, but expensive activity in factories. Autonomous robot technology can help reduce the cost and relax humans from the exhaustive job of driving forklifts. In this paper, we describe the mechatronics design and implementation of an autonomous forklift. The robot can perceive the 3D dynamic world and can plan its motion autonomously to lift materials from a source to target locations. Dynamic map of the world is built using data from a Microsoft Kinect head and r...

  20. [Deficits in medical counseling in olfactory dysfunction].

    Science.gov (United States)

    Haxel, B R; Nisius, A; Fruth, K; Mann, W J; Muttray, A

    2012-05-01

    Olfactory dysfunctions are common with a prevalence of up to 20% in the population. An impaired sense of smell can lead to specific dangers, therefore, counseling and warning of hazardous situations to raise patient awareness is an important medical function. In this study 105 patients presenting to the University of Mainz Medical Centre with dysosmia were evaluated using a questionnaire. For quantification of the olfactory dysfunction a standardized olfactory test (Sniffin' Sticks) was used. Of the patients 46% were hyposmic and 40% were functionally anosmic. The median duration of the olfactory impairment was 10 months and the main causes of dysosmia were upper respiratory tract infections and idiopathic disorders. More than 90% of the patients consulted an otorhinolaryngologist and 60% a general practitioner before presenting to the University of Mainz Medical Center. More than two thirds of the patients conducted a professional activity, 95% of patients reported that they had not received any medical counseling and 6% of the subjects were forced to discontinue their profession because of olfactory dysfunction. In patients with olfactory dysfunctions appropriate diagnostics, including olfactometry should be performed. Furthermore, correct medical counseling concerning necessary additional arrangements (e.g. installation of smoke or gas detectors, precautions while cooking or for hygiene) has to be performed. For patients in a profession an analysis of the hazards at work is crucial.