scholarly journals AUTONOMIC NERVOUS SYSTEM DYSFUNCTION IN BREAST CANCER PATIENTS

2021 ◽  
pp. 73-88
Author(s):  
Yu.D. Udalov ◽  
L.A. Belova ◽  
V.V. Mashin ◽  
L.A. Danilova ◽  
A.A. Kuvayskaya
Keyword(s):  
Breast Cancer ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Drug Therapy ◽  
Autonomic Neuropathy ◽  
Scientific Information ◽  
Disease Process ◽  
Medical Rehabilitation ◽  
Breast Cancer Patients ◽  
Autonomic Nervous

When studying oncology diseases, it is necessary not only to assess their nature, progress and outcome depending on the local disease process, but also to take into account overall health, since multiple organ damage has a prognostic value and determines the disease outcome. All mechanisms and structures that have an integrative and homeostatic effect on the overall health should be considered. One of these structures is the autonomic nervous system. Traditionally, the autonomic nervous system has been considered in terms of 3 components: sympathetic, parasympathetic and intestinal. However, in recent years, ideas about neuroendocrine and neuroimmune systems have come to the fore, justifying the expansion of the concept "autonomy of the nervous system." In case of autonomous dysfunction, dysregulation of the involuntary body functions occurs, and autonomic neuropathy develops. There are cardiovascular, gastrointestinal, urogenital, and sudomotor forms of autonomic neuropathy, which are characterized by certain changes in various pathological states, especially in malignant processes. We pay attention to breast cancer, which ranks first in the structure of oncology diseases in the Russian Federation. Nowadays, there are only a few studies devoted to the changes in the autonomic nervous system in patients with breast cancer during anticancer drug therapy, taking into account the disease progress and clinical features, as well as methods for dysfunction remodeling. The article analyzes a number of scientific information sources that can help to study various forms of autonomic neuropathy in patients with breast cancer and allow assessing the use of medical rehabilitation for such patients. Key words: autonomic nervous system, autonomic neuropathy, breast cancer, antitumor drug therapy. При изучении онкологического заболевания необходимо не только оценивать его характер, течение и исход в зависимости от локального процесса, но и учитывать общее состояние организма, так как множественное поражение органов имеет прогностическое значение и определяет исход заболевания. Следует рассматривать все механизмы и структуры, которые оказывают интегративное и гомеостатическое действие на организм в целом. Одной из таких структур является вегетативная нервная система. Традиционно вегетативная нервная система рассматривалась в аспекте 3 составляющих: симпатической, парасимпатической и кишечной. Однако в последнее время на первый план вышли представления о нейроэндокринных и нейроиммунных системах, обосновывающие расширение значения понятия «автономность нервной системы». При поражении автономной нервной системы возникает дисрегуляция непроизвольных функций организма, развивается автономная нейропатия. Выделяют кардиоваскулярную, гастроинтестинальную, урогенитальную, судомоторную формы автономной нейропатии, которые характеризуются определенными изменениями при различных патологических состояниях организма, особенно при злокачественных процессах. Фокус нашего научного внимания был направлен на рак молочной железы, который занимает первое место в структуре онкологических заболеваний в Российской Федерации. В литературе представлены немногочисленные исследования, отражающие изменения состояния вегетативной нервной системы у больных раком молочной железы в процессе противоопухолевой лекарственной терапии с учётом характера течения и клинических особенностей болезни, а также методы рациональной коррекции её дисфункции. В статье приведен анализ ряда научных источников, которые могут помочь в исследовании различных форм автономной нейропатии у больных раком молочной железы и позволят оценить возможность применения медицинской реабилитации для данной категории пациентов. Ключевые слова: вегетативная (автономная) нервная система, автономная нейропатия, рак молочной железы, противоопухолевая лекарственная терапия.

Diabetic Autonomic Neuropathy

1999 ◽  
Vol 12 (2) ◽  
pp. 142-154
Author(s):  
Roy C. Parish
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Drug Therapy ◽  
Autonomic Neuropathy ◽  
Cardiac Arrhythmias ◽  
Diabetic Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Specific Information ◽  
Autonomic Nervous ◽  
Increased Risk

Diabetic autonomic neuropathy (DAN) occurs in approximately half of Caucasian patients with diabetes and perhaps three-fourths of black diabetic patients. This may be asymptomatic for several years, but the majority of patients with DAN eventually exhibit symptoms of diarrhea, cardiac arrhythmias, sexual dysfunction, and abnormal sweating. Prolonged hyperglycemia results in damage to the autonomic nervous system (ANS), particularly the vagus nerve and other parts of the parasympathetic division. DAN is associated with increased risk of sudden death, high-risk cardiac arrhythmias, myocardial infarction, and death from other causes. Objective testing of autonomic nervous system function yields specific information that affects treatment decisions. Drug therapy can effect improvements in ANS function and reduce these risks. Complications of diabetes that result from ANS dysfunction can be partly reversed or their progress can be slowed by appropriate drug therapy. Features, implications, and therapy of the most common complications resulting from DAN are reviewed, and suggestions for pharmacist involvement in the care of these difficult patients are offered.

Vital Force and homœopathy

1948 ◽  
Vol 38 (01) ◽  
pp. 32-45
Author(s):  
C.F. Hacker
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Disease Process ◽  
Autonomic Nerve ◽  
Vital Force ◽  
Autonomic Nervous ◽  
Autonomic Functioning ◽  
Acid Base Equilibrium ◽  
Sensory Consciousness ◽  
Ph Level

Summary1. A connection is found between Hahnemann's conception of Vital Force and that of Cannon's “homœostasis”, which is maintained by the autonomic nervous system.2. Vital Force is traced to source in the embryo as it builds its body. It is seen laying down the “dynamic determination” on the multiplying tissue cells, and operating from the central mesodermal column, the notochord, to induct the Individuation Field of the elongating gastrula and differentiating neurula.3. A vital link between the notochord and the diencephalic centres isemphasized.4. The period of functional development sees the embryonic strugglebetween the autonomic system and the gene award. Such conflict is causative of defective autonomic balance, and the results have been noted by Hahnemann as the miasma, the psora, the sycoses.5. The thalamus, as the seat of sensory consciousness receiving both visceral and somatic sensory impulses transmits the sensory tone of the underlying autonomic fluster to the cerebral cortex for cognition. Such cognition is reported as symptoms, “I. …, My …”, thus giving the homœopathic picture of the “abnormally disturbed Vital Force”.6. The factors required in the blood's biochemical changes to maintain constant its pH level are given. The varying balance of the NaHCO3/H2CO3 content and Ca/K ratio may be related to Schuessler's “tissue remedies”.7. Such acid-base equilibrium is dependent on the autonomic functioning, which if impaired in the embryonic conflict is causative of allergy.8. Investigation of allergic factors produces an interesting formula ofhomœopathic significance, that shows the selected homœopathic remedy to be the catalyst key which declutches the autonomic imbalance.9. The varying bioelectric potential across the autonomic nerve gangliabetween diencephalic centres and fluid matrix brings about their functional activity and depression.10. A plea is made for a biochemical test of autonomic functioning.The autonomic nervous system is the meeting-ground of the homœopathicand allopathic divisions of medicine.If the disease process is acute or prolonged without permitting adequate intervals of functional rest to enable regrowth of its essential chromatin store, neurone degeneration follows. Such changes are not related to any specific bacterial action, but result from continuous functioning to exhaustion.The initial build-up of the autonomic path in reaction-response to externalstimuli is the essential basis of the individual's “modalities”.

scholarly journals A Study of autonomic nervous system dysfunction among patient with diabetes mellitus: a cross sectional study

2017 ◽  
Vol 4 (2) ◽  
pp. 406 ◽  
Author(s):  
Sidheshwar Virbhadraappa Birajdar ◽  
Sheshrao Sakharam Chavan ◽  
Sanjay A. Munde ◽  
Yuvraj P. Bende
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Peripheral Neuropathy ◽  
Autonomic Neuropathy ◽  
Blood Pressure Response ◽  
Pressure Response ◽  
Diabetic Autonomic Neuropathy ◽  
Autonomic Nervous

Background: Neuropathy is a common complication of diabetes mellitus and it may affect both the peripheral nerves and autonomic nervous system. It’s prevalence ranges from 1% to 90%. The present study is therefore designed to investigate autonomic nervous system involvement in diabetes mellitus by using simple bedside tests and to study its association with other diabetic angiopathies.Methods: 100 patients of diabetes mellitus were selected in the study. In Autonomic function tests for evaluating parasympathetic damage E: I ratio, 30:75 ratio and Valsalva ratio test was performed. Sympathetic damage was diagnosed by Blood pressure response to standing test and Blood pressure response to sustained handgrip test.Results: Abnormal E:I ratio was noticed in only 24 patients. The 30:15 ratio was found to be abnormal in 38 patients while the Valsalva Ratio was abnormal in 34 patients. Postural hypotension was observed in only 8% patients. The sustained hand grip test was abnormal in 10 patients. The prevalence of cardiac autonomic neuropathy was 58%. The association between the presence of autonomic neuropathy and peripheral neuropathy was statistically significant. However, the association between autonomic neuropathy and retinopathy and nephropathy was not statistically significant.Conclusions: The overall prevalence of autonomic neuropathy in diabetes mellitus was 58%. There was parasympathetic preponderance over sympathetic nervous system in the involvement of diabetic autonomic neuropathy. There was statistically significant association of diabetic autonomic neuropathy with peripheral neuropathy as compared to retinopathy and nephropathy.

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

2014 ◽  
Vol 71 (4) ◽  
pp. 346-351 ◽  
Author(s):  
Luka De ◽  
Marina Svetel ◽  
Tatjana Pekmezovic ◽  
Branislav Milovanovic ◽  
Vladimir Kostic
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Autonomic Neuropathy ◽  
Rating Scale ◽  
Clinical Presentation ◽  
De Novo ◽  
The Body ◽  
Factors Affecting ◽  
Autonomic Nervous ◽  
Sympathetic Dysfunction

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 disease, involved side of the body, pain and freezing), but mini mental status (MMS) score and Hamilton depression and anxiety rating scale were significantly lower (p < 0.05). Conclusion. Our results confirm a high prevalence of autonomic 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 presentation and the existing anxiety and depression.

Effect of a 3-month Exercise Intervention on Physical Performance, Body Composition, Depression and Autonomic Nervous System in Breast Cancer Survivors: A Pilot Study

2020 ◽  
Author(s):  
Marie Crhová ◽  
Iva Hrnčiříková ◽  
Radka Střeštíková ◽  
Klára Šoltés-Mertová ◽  
Martin Komzák ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Nervous System ◽  
Body Composition ◽  
Autonomic Nervous System ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Exercise Intervention ◽  
Total Power ◽  
Autonomic Nervous ◽  
Home Group

Purpose: Breast cancer patients are at increased risk of developing comorbidities such as lymphedema, sarcopenia, osteoporosis and cardiovascular disease after breast cancer treatment. These complications contribute to a decrease in quality of life, cardiorespiratory fitness and muscle strength. Regular and long-term physical activity is an effective non-pharmacological strategy that can improve physical, psychological and social outcomes. The aim of our research was to evaluate the effect of various modes of an exercise intervention on physical performance, body composition, depression and autonomic nervous system in breast cancer survivors. Methods: 16 women after surgery with hormonal treatment enter the research. Thirteen of them completed the controlled, quasi-experimental study (54 ± 9 yrs, 164cm ± 6cm, 72 ± 12kg) and were divided into 3 groups according to their place of living: trained under supervision (n=5) (SUPERV), trained at home without supervision by videos (n=7) (HOME) and with no prescribed physical activity (n=4) (CON). Exercise intervention lasted 3 months and comprised of 60 min training units 3 × week (aerobic with resistant exercise in a 2 : 1 mode combined with regular weekly yoga and breathing exercises). The exercise intensity was set individually at 65–75% of HRR based on spiroergometry and was continuously controlled by heart rate monitors. The same principles applied to the HOME group, which, in addition to heart rate monitors, recorded frequency, length, HRmax, HRavg, and Borg scale of intensity perception. VO2max, BMI, fat mass, depression level (Beck’s depression inventory) and the power of the autonomic nervous system (total power and sympatho-vagal balance) were analyzed. For data evaluation we used descriptive statistics and Cohens d effect size. Results: 3 women dropped out of research because of medical reason. In all groups VO2max values increased. The largest increase in VO2max values was in SUPERV group by 36%, in HOME group by 20% and in CON group by 2%. Body weight decreased for groups SUPERV (˗1.2 kg) and CON (-0.1kg), for HOME group there was an increase (+0.2 kg). Body mass index decreased for SUPERV group (-0.4), for HOME and CON it increased (both +0.1). Total power decreased in SUPERV (-0.6) and HOME group (-0.2), in CON has not changed. The same results were achieved by the sympatho-vagal balance, only the CON group increased. Values from Beck’s depression inventory decreased for all groups, most for CON group. Conclusion: A 3-months of supervised and controlled exercise had a significant effect on physical fitness and body composition in comparison with non-supervised home-based physical intervention. Our results indicate that it is strongly advisable to apply a supervised exercise program to induce positive physiological changes in breast cancer survivors as part of aftercare.

Cardiovascular Reflexes and Autonomic Neuropathy

1978 ◽  
Vol 55 (4) ◽  
pp. 321-327 ◽  
Author(s):  
D. J. Ewing
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Autonomic Neuropathy ◽  
Autonomic Dysfunction ◽  
Postural Hypotension ◽  
Systemic Disease ◽  
Cardiovascular Reflexes ◽  
Diabetic Patients ◽  
Pharmacological Agents ◽  
Autonomic Nervous

Clinical features of autonomic neuropathy include postural hypotension, sweating abnormalities, disturbance of body temperature regulation, gastric fullness and nausea, intermittent nocturnal diarrhoea, constipation, bladder problems and impotence. In diabetic patients, gustatory sweating and hypoglycaemic unawareness also sometimes occur (Johnson & Spalding, 1974). The onset of symptoms is usually insidious and permanent, but may occasionally be acute and reversible (Young, Asbury, Corbett & Adams, 1975). Autonomic dysfunction can arise from three main causes: first, those where the damage to the autonomic nervous system is isolated, as in primary postural hypotension (Bannister, Sever & Gross, 1977) and familial dysautonomia (Brunt & McKusick, 1970); secondly, those caused by toxic or pharmacological agents which interfere with autonomic reflexes; thirdly, those associated with systemic disease, of which diabetes mellitus is the most common. Other diseases which may cause autonomic dysfunction include amyloidosis, porphyria, tetanus, polyneuritis, tabes dorsalis, parkinsonism, chronic renal failure and alcoholism, and occasionally autonomic neuropathy has been associated with carcinoma of the bronchus or the pancreas (Johnson & Spalding, 1974). Although it is possible to localize lesions within the autonomic nervous system to afferent or efferent sympathetic or parasympathetic pathways (Johnson & Spalding, 1974; Moskowitz, 1977), many of the available tests are complex and invasive and often lack adequate control measurements (Young et al., 1975). Because of the patchy nature of autonomic neuropathy, current interest has centred around the search for bedside tests that are ‘global’, reproducible and non-invasive. This review summarizes the present state of knowledge of simple tests of cardiovascular reflex function in the clinical evaluation of autonomic neuropathy, particularly in diabetic subjects.

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