scholarly journals Investigation of autonomic dysfunction in primary Raynaud’s phenomenon with sympathetic skin response (SSR), R-R interval variation (RRIV) and composite autonomic symptom score (COMPASS)-31

2021 ◽  
Vol 26 (4) ◽  
pp. 693-698
Author(s):  
Hüseyin Sicim ◽  
Özgür Boyraz ◽  
Ertan Demirdas ◽  
Hakan Kartal ◽  
Gökhan Erol ◽  
...  
Keyword(s):  
Autonomic Dysfunction ◽  
Valsalva Maneuver ◽  
Raynaud’S Phenomenon ◽  
Sympathetic Skin Response ◽  
Raynaud's Phenomenon ◽  
Deep Breathing ◽  
Control Groups ◽  
Significant Difference ◽  
Skin Response ◽  
And Control

Background: In this study, we aimed to investigate the autonomic dysfunction in patients with primary Raynaud’s phenomenon with using sympathetic skin response (SSR) as a neurophysiologic test, R-R interval variation analysis and composite autonomic symptom score (COMPASS)-31 questionnaire. Methods: Palmar SSR to median nerve electrical stimulation was recorded in 38 patients with 36 healthy age and sex-matched control subjects. The SSR was recorded from the palmar surface of both left and right hands for patients and control groups. The amplitudes and latencies formed as a result of electrical stimulation were calculated and compared between the two groups. Additionally, R-R interval variability was examined during normal breathing, deep breathing, standing up and Valsalva maneuver in both groups. Furthermore, we asked to complete the COMPASS-31 questionnaire, a validated tool to assess symptoms of autonomic dysfunction. And by calculating total COMPASS-31 scores, the relationship between the two groups was investigated. Results: The Raynaud’s phenomenon and control groups were similar in age (37.4 ± 11.6 vs. 34.9 ± 13.0 years), had identical gender ratios and similar body mass index (24.5 ± 6.1 vs. 25.7 ± 4.6%). Palmar SSR to median nerve stimulation of RP patients shows significantly delayed latency (1890 ± 146) (p=0.03). And no difference between amplitudes in comparison to the control group. In the patient and control groups, R-R interval measurements were evaluated during rest and deep breathing, standing up and Valsalva maneuver. When the R-R interval measurements of the patient and control groups at rest and deep breathing were compared, there was no statistically significant difference between the groups. In addition, COMPASS-31 questionnaire scoring system was applied to both groups. The mean COMPASS-31 score was higher in patient group (22.8 ± 13.8), than from healthy controls (8.9 ± 7.8) (p=0.02) Conclusions: Autonomic dysfunction plays a role in the etiology of Raynaud’s phenomenon, due to latency prolongation in the sympathetic skin response and significant difference between COMPASS-31 tests, and these tests can be used in the diagnosis stage of this disease.

scholarly journals Is There Any Sympathetic Skin Response (SSR) Abnormality in Raynaud Phenomenon?

2021 ◽  
Author(s):  
Mohammad R. Emad ◽  
Hamid R. Farpour ◽  
Faisal Ahmed ◽  
Masoumeh Tayebi ◽  
Mohammadali Nazarinia ◽  
...  
Keyword(s):  
Raynaud’S Phenomenon ◽  
Sympathetic Skin Response ◽  
Raynaud's Phenomenon ◽  
Sympathetic System ◽  
Control Group ◽  
Raynaud Phenomenon ◽  
Unmyelinated Axons ◽  
Skin Response ◽  
The Mean ◽  
And Control

Objectives: Sympathetic skin response (SSR) is a technique for assessment of the damage of peripheral neuropathies and the disorders of the sympathetic system. This study aimed to evaluate SSR among patients with Raynaud phenomenon (RP). Methods: Between January 1, 2015 and December 30, 2018, about 20 patients with RP and 20 healthy subjects as the control group were recruited from patients referring to the Outpatient Clinics of Shiraz medical University. All the participants were clinically examined, and the SSR was performed using a standard protocol. SSR is abnormal when the latency is prolonged and/or the amplitude reduced. Results: Raynaud's group consisted of 19 women (95 %) and 1 male (5%). 3 patients (15 %) with primary Raynaud's phenomenon (PRP) and 17 patients (85%) with secondary Raynaud's phenomenon (SRP). The control group consisted of 16 women (80%) and 4 males (20%). The mean age of the Raynaud's group and control subjects was 43.1±9 and 36.7±8.6 years, respectively. The SSR to the electrical stimulus was absent in 3 patients (PRP patients). The total median nerve mean latencies in the upper limb were 1.9±0.57 and 1.19±0.52 seconds for the Raynaud's group and control groups, respectively (p <0.001). These findings revealed significantly prolonged SSR latencies in the Raynaud's group, while the mean amplitude showed no significant differences in both groups (p =0.756). Conclusion: Absence or prolonged latency of SSR was associated with the disorders of the unmyelinated axons in the sympathetic system. Our findings suggested the disorders of unmyelinated axons in Raynaud's phenomenon. Keywords: Raynaud Disease; Autonomic Nervous System; Electrodiagnosis; Sympathetic Fibers; Nerve Conduction.

Sympathetic skin response in primary Raynaud’s phenomenon

2009 ◽  
Vol 19 (6) ◽  
pp. 355-362 ◽  
Author(s):  
Mauro Mondelli ◽  
Renato de Stefano ◽  
Stefania Rossi ◽  
Alessandro Aretini ◽  
Clara Romano
Keyword(s):  
Raynaud’S Phenomenon ◽  
Sympathetic Skin Response ◽  
Raynaud's Phenomenon ◽  
Skin Response ◽  
Primary Raynaud’S Phenomenon

scholarly journals Interictal autonomic dysfunction in patients with epilepsy

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Kanar K. Shaker ◽  
Akram M. Al Mahdawi ◽  
Farqad B. Hamdan
Keyword(s):  
Temporal Lobe ◽  
Autonomic Function ◽  
Mental Arithmetic ◽  
Valsalva Maneuver ◽  
Sympathetic Skin Response ◽  
Deep Breathing ◽  
Unexpected Death ◽  
Hand Grip ◽  
Skin Response ◽  
Generalized Epilepsy

Abstract Background Autonomic nervous system (ANS) symptoms are frequently present in people with epilepsy (PwE). They are generally more prominent when they originate from the temporal lobe. We aim to investigate the alterations of autonomic functions during the interictal period in patient with temporal lobe epilepsy (TLE) and idiopathic generalized epilepsy (IGE) using heart-based tests, blood pressure (BP)-based tests and sympathetic skin response (SSR). Forty-eight PwE with disease duration ranging from 2 to 15 years and 51 healthy individuals were studied. Long-term electroencephalography (EEG) monitoring, the heart rate variability (HRV) during normal breathing, deep breathing, Valsalva maneuver and standing, BP responses during standing, to isometric hand grip and to mental arithmetic, and the SSR was recorded for all participants. Results 31 patients with TLE and 17 with IGE showed lower RR-IV values during deep breathing, Valsalva maneuver and standing, but not during rest, impaired BP responses during standing, isometric hand grip, and mental arithmetic. Also, prolonged SSR latencies. Within PwE group, no difference was noticed between males and females, nor between the left and right temporal lobes. Conclusion Abnormal autonomic (sympathetic and parasympathetic) regulatory functions suggest that epilepsy may alter the autonomic function and this is not only in TLE but rather in IGE too. These autonomic changes are irrespective of the localization of epilepsy between the two hemispheres. The ANS changes in epileptic patients, particularly those with autonomic symptoms, confirm that electrophysiologic measures of autonomic function may be of value in preventing sudden unexpected death in epilepsy.

scholarly journals AB0876-HPR NEUROFEEDBACK AND TEMPERATURE BIOFEEDBACK TRAINING IMPROVE MIRCOCIRCULATION IN PATIENTS WITH SYSTEMIC SCLEROSIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1461.2-1462
Author(s):  
R. Grekhoff
Keyword(s):  
Systemic Sclerosis ◽  
Morphological Changes ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Biofeedback Training ◽  
Nailfold Capillaroscopy ◽  
Adjunctive Treatment ◽  
Control Group ◽  
Control Groups ◽  
And Control

Background:Microcirculatory disorders including Raynaud’s phenomenon are one of the most important clinical symptoms of systemic sclerosis (SS).Objectives:We found it appropriate to evaluate the clinical efficacy of biofeedback (BFB) in the complex therapy of SS patients based on analysis of nailfold capillaroscopy.Methods:The study included 70 SS patients. 94% of patients we examined were women and 6% were men. The average age of the patients = 38±3,3 years, duration of illness = 14±2,6 years. Raynaud’s phenomenon (RP) was observed in all the patients and its severe form was seen in 80% of the patients. The effectiveness of BFB was analyzed by studying the dynamics of the measures from the nailfold capillaroscopy and comparing the data obtained from patients of the main and control groups.Results:Dynamics of capillaroscopic signs of therapy efficiency in main and control groups are summarized in the table:Analized signsMain group (n=40)Control group (n=30)before thetherapyafter thetherapybefore thetherapyafter thetherapySkin score, M±SD22,56±10,2414,99±9,44*21,04±12,0120,01±9,88Dilation of the capillaries, %34 (85)16 (40)*24 (80)17 (56,6)Avascular fields, %26 (65)24 (60)13 (43,3)17 (56,6)Morphological capillaries’ changes, %36 (90)22 (55)*22 (73,3)10 (33.3)*Hemorrhage, %25 (62,5)10 (25)*12 (40)7 (23.3)*- p < 0,05It was found that patients participated in BFB training, showed significant positive dynamics in the following signs of capillaroscopic picture: dilatation of the capillaries (x2 = 9,643; p = 0,026), morphological changes of the capillaries (x2 = 4,90; p = 0,027), and hemorrhage (x2 = 4,514; p = 0,034).Only one indicator of capillaroscopy showed significant change in the control group of patients, the presence of dilated capillaries (x2 = 5,833 with p = 0,016).Conclusion:These findings suggest that treatment results were significantly better in the main study group of SS patients.We suggest that biofeedback may be a useful adjunctive treatment for Raynaud’s syndrome in patients with SS.Disclosure of Interests:None declared

Effects of Virgin Coconut Oil as Adjunct Therapy in the Treatment of Allergic Rhinitis

2016 ◽  
Vol 1 (1) ◽  
pp. 22
Author(s):  
Nazli Zainuddin ◽  
Nurul Azira Mohd Shah ◽  
Rosdan Salim
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Coconut Oil ◽  
Test Group ◽  
Nasal Symptom ◽  
Control Group ◽  
Virgin Coconut Oil ◽  
Control Groups ◽  
Significant Difference ◽  
And Control

Introduction: The role of virgin coconut oil in the treatment of allergic rhinitis is controversial. Thus, the aim of the present study is to determine the effects of virgin coconut oil ingestion, in addition to standard medications, on allergic rhinitis. We also studied the side effects of consumption of virgin coconut oil. Methods: Fifty two subjects were equally divided into test and control groups. All subjects received a daily dose of 10mg of loratadine for 28 days. The test group was given 10ml of virgin coconut oil three times a day in addition to loratadine. The symptoms of allergic rhinitis were scored at the beginning and end of the study. Results:, the symptom score were divided into nasal and non-nasal symptom scores. Sneezing score showed a significant difference, however the score was more in control group than test group, indicating that improvement in symptom was more in control group. The rest of the nasal symptom and non-nasal symptom score showed no significant difference between test and control groups. Approximately 58% of the test subjects developed side effects from consumption of virgin coconut oil, mainly gastrointestinal side effects. Conclusion: In the present study, ingestion of virgin coconut oil does not improve the overall and individual symptoms of allergic rhinitis, furthermore it has side effects.

Stick Figure and Think, Talk And Write: Integrating Media With Teaching Strategy For A Better Writing Competence

2017 ◽  
Vol 2 (1) ◽  
pp. 46
Author(s):  
Eva Sudarwati ◽  
Shynta Amalia
Keyword(s):  
Teaching Strategy ◽  
T Test ◽  
Narrative Writing ◽  
Control Groups ◽  
Stick Figure ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Mean Differences ◽  
And Control ◽  
Writing Competence

Abstract This study attempts to see the effect of Think, Talk, and Write strategy on the students’ narrative writing competence. Considering the importance of the use of teaching media, this study tries to integrate Stick Figure as a teaching media in Think, Talk, and Write Strategy. A quasi experimental study was conducted to see the improvement of the students’ narrative writing competence. It involved 42 students who were selected on the basis of convenience sampling and assigned into two groups; experimental and control groups. The statistical analyses of paired sample t-test in experimental group showed that there was significant improvement on the students’ writing competence before (M=5.77, SD= 2.342) and after (M= 11.79, SD= 2.342), t(21)=12.059, p<0.05.Moreover, the result of independent t-test between experimental and control groups showed a significant difference. It can be seen that the mean differences was 3.79545 and the significance value is lower than 0.05, 0.000<0.05.

Impact of intrawound vancomycin powder on prevention of surgical site infection after posterior spinal surgery

2021 ◽  
pp. 1-9
Author(s):  
Hiroki Ushirozako ◽  
Tomohiko Hasegawa ◽  
Yu Yamato ◽  
Go Yoshida ◽  
Tatsuya Yasuda ◽  
...  
Keyword(s):  
Propensity Score ◽  
Spinal Surgery ◽  
Control Group ◽  
Control Groups ◽  
Propensity Score Model ◽  
Significant Difference ◽  
Surgical Data ◽  
Vancomycin Powder ◽  
Vancomycin Group ◽  
And Control

OBJECTIVESurgical site infection (SSI) after posterior spinal surgery is one of the severe complications that may occur despite administration of prophylactic antibiotics and the use of intraoperative aseptic precautions. The use of intrawound vancomycin powder for SSI prevention is still controversial, with a lack of high-quality and large-scale studies. The purpose of this retrospective study using a propensity score–matched analysis was to clarify whether intrawound vancomycin powder prevents SSI occurrence after spinal surgery.METHODSThe authors analyzed 1261 adult patients who underwent posterior spinal surgery between 2010 and 2018 (mean age 62.3 years; 506 men, 755 women; follow-up period at least 1 year). Baseline and surgical data were assessed. After a preliminary analysis, a propensity score model was established with adjustments for age, sex, type of disease, and previously reported risk factors for SSI. The SSI rates were compared between patients with intrawound vancomycin powder treatment (vancomycin group) and those without (control group).RESULTSIn a preliminary analysis of 1261 unmatched patients (623 patients in the vancomycin group and 638 patients in the control group), there were significant differences between the groups in age (p = 0.041), body mass index (p = 0.013), American Society of Anesthesiologists classification (p < 0.001), malnutrition (p = 0.001), revision status (p < 0.001), use of steroids (p = 0.019), use of anticoagulation (p = 0.033), length of surgery (p = 0.003), estimated blood loss (p < 0.001), and use of instrumentation (p < 0.001). There was no significant difference in SSI rates between the vancomycin and control groups (21 SSIs [3.4%] vs 33 SSIs [5.2%]; OR 0.640, 95% CI 0.368–1.111; p = 0.114). Using a one-to-one propensity score–matched analysis, 444 pairs of patients from the vancomycin and control groups were selected. There was no significant difference in the baseline and surgical data, except for height (p = 0.046), between both groups. The C-statistic for the propensity score model was 0.702. In the score-matched analysis, 12 (2.7%) and 24 (5.4%) patients in the vancomycin and control groups, respectively, developed SSIs (OR 0.486, 95% CI 0.243–0.972; p = 0.041). There were no systemic complications related to the use of vancomycin.CONCLUSIONSThe current study showed that intrawound vancomycin powder was useful in reducing the risk of SSI after posterior spinal surgery by half, without adverse events. Intrawound vancomycin powder use is a safe and effective procedure for SSI prevention.

Investigation of the Association Between Carotid Artery Intima-Media Thickness (IMT) and Cardiac Risk Factors in Patients with Systemic Lupus Erythematosus

2020 ◽  
Vol 16 (2) ◽  
pp. 125-133
Author(s):  
Zahra Rezaieyazdi ◽  
Sima Sedighi ◽  
Masoumeh Salari ◽  
Mohammadreza H. Fard ◽  
Mahmoud R. Azarpazhooh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Lupus Erythematosus ◽  
Serum Insulin ◽  
Venous Blood ◽  
Test Group ◽  
Control Groups ◽  
Significant Difference ◽  
The Mean ◽  
And Control

Background: The relationship between SLE and traditional risk factors for cardiovascular events was evaluated. Methods: The data regarding sixty patients with SLE and 30 healthy controls (age and sex matched) were gathered using SLEDAI forms. Venous blood (10mL) from all the participants was examined for hs-CRP, homocysteine, VCAM1, CBC, anti-DNA antibody, C3, C4, low-density lipoprotein (LDL), cholesterol, FBS and triglyceride. : The IMT of carotid arteries was determined bilaterally by ultrasound. Other measurements included insulin levels via Elisa (Linco/Millipore Corp) and the HOMA-IR index for insulin resistance. Results: The mean age (in years) in the test and control groups was 28.8±10.3 (18-52) and 33.8±9.13 (18-48), respectively. Results: The mean age (in years) in the test and control groups was 28.8±10.3 (18-52) and 33.8±9.13 (18-48), respectively. : The average IMT in the test group was directly related to serum levels of VCAM1 (p<0.001), homocysteine (p<0.001), cholesterol (p<0.009), LDL (p<0.001), TG (p<0.001), and FPG (p=0.004). The association between other risk factors, insulin resistance, carotid IMT and SLEDAI, was nonexistent. Mean insulin and insulin resistance levels in all the participants were 0.43±2.06 µU/mL and 0.09±0.44, respectively. There was no significant difference between the test and control groups regarding serum insulin and insulin resistance levels (p=0.42 and p=0.9, respectively). None of the risk factors, such as hsCRP, VCAM1, or homocysteine, were shown to be related to insulin resistance (p=0.6, p=0.6, p=0.09, respectively). Conclusion:: Our findings did not show an increase in the prevalence of atherosclerosis in patients with SLE. There was no association between IMT and insulin resistance. However, the former was associated with FPG, total cholesterol, LDL, TG, homocystein and VCAM1.

The possible regulatory mechanisms of aqueous, ethyl acetate and nhexane fractions of the Ribes khorassanicum extract on acute hypertension in rats

2020 ◽  
Vol 20 ◽  
Author(s):  
Reza Mohebbati ◽  
Yasamin Kamkar-De ◽  
Mohammad Naser Shafei
Keyword(s):  
Ethyl Acetate ◽  
Antihypertensive Effect ◽  
Cardiovascular Responses ◽  
Regulatory Mechanisms ◽  
Hypertensive Rats ◽  
Control Groups ◽  
Acute Hypertension ◽  
The North ◽  
Significant Difference ◽  
And Control

Objective: Our previous studies showed the antihypertensive effect of Ribes khorassanicum (R. khorassanicum), a medicinal herb growing in the North Khorasan Province of Iran. For further evaluation, the present study investigated the effect of n-hexane (HX), ethyl acetate (EA), and aqueous (AQ) fractions of hydroalcoholic R. khorassanicum extract on cardiovascular responses in angiotensin II (AngII) and NG-nitro-L-arginine methyl ester (L-NAME) hypertensive rats. Methods: Wistar rats were randomly divided into 11 groups (n=5): 1) control, 2) AngII (50 ng/kg, i.v), 3) AngII + losartan (10 mg/kg, i.p), 4) L-NAME (10 mg/kg, i.v), 5) L-NAME+ sodium nitroprusside (SNP) (50 mg/kg, i.p), 6,7,8) one dose of each fraction of R. khorassanicum (AQ/EA/HX (50 mg/kg, i.p)) +AngII, and 9,10,11) one dose of each fraction of R. khorassanicum (AQ/EA/HX (50 mg/kg, i.p)) + L-NAME. Treated rats received three fractions 30 min before the injection of L-NAME and AngII in separate groups. The cardiovascular parameters were recorded by the Power Lab instrument via an angiocath inserted into the femoral artery. The peak changes (∆) of mean arterial pressure (MAP), systolic blood pressure (SBP), and heart rate (HR) in treated groups were compared with those of the hypertensive and control groups. Result: AngII and L-NAME significantly increased ∆MAP and ∆SBP and attenuated by pretreatment of LOS and SNP, respectively. Pretreatment with polar (AQ) and semipolar (EA) fractions of R. khorassanicum reduced the peak changes of MAP and SBP in both AngII and L-NAME-treated groups. Only the fraction of the herb attenuated the HR increased in the L-NAME group. The HR in other groups did not demonstrate any significant difference. Conclusion: All fractions of R. khorassanicum have an antihypertensive effect. However, the effect of polar fractions is more salient. It is also conceivable that the antihypertensive effect of fractions is mostly mediated by the inhibition of AngII.

scholarly journals Ayurveda Body–Mind Constitutional Types and Role of Yoga Intervention Among Type 2 Diabetes Mellitus Population of Chandigarh and Panchkula Regions

2021 ◽  
pp. 097275312110000
Author(s):  
Madhava Sai Sivapuram ◽  
Vinod Srivastava ◽  
Navneet Kaur ◽  
Akshay Anand ◽  
Raghuram Nagarathna ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Lipid Profiles ◽  
Control Groups ◽  
Yoga Intervention ◽  
Positive Effects ◽  
Study Results ◽  
Significant Difference ◽  
And Control

Background: Type 2 diabetes needs a better understanding of etiological factors and management strategies based on lifestyle and constitutional factors, given its high association rate with many cardiovascular, neurological disorders, and COVID-19 infection. Purpose: The present study was undertaken to investigate the effect of Diabetes-specific integrated Yoga lifestyle Protocol (DYP) on glycemic control and lipid profiles of diabetic adults. Along with the DYP intervention, the individuals residing in Chandigarh and Panchkula union territories in the northern part of India were assessed for Ayurveda-based body–mind constitutional type. Ayurveda describes body–mind constitution as “ prakriti,” which has been discussed from two angles, namely physiological and psychological as body and mind are correlated. Methods: Cluster sampling of waitlist control study subjects was used as the sampling method for the study. A total of 1,215 registered subjects (81 diabetic) responded in randomly selected clusters in Chandigarh and Panchkula. Ayurveda physicians did Ayurveda body–mind constitutional assessment called prakriti assessment (physiological body–mind constitution assessment) in 35 participants (23 diabetic, 12 prediabetic) as a part of the study. Results: A group of 50 subjects was randomly selected for yoga intervention out of 81 diabetes mellitus adults, and 31 subjects were enrolled as waitlist controls. A significant decrease in the glycosylated hemoglobin levels from 8.49 ± 1.94% to 7.97 ± 2.20% in the intervention group was noticed. The lipid profiles of the DYP intervention and control groups were monitored. Three-month follow-up results of lipid profile diagnostic tests in intervention and control groups showed a significant difference between the two groups ( P < 0.05). Most diabetic and prediabetic individuals were found to have pitta dosha ( pitta controls all heat, metabolism, and transformation in the mind and body) as dominant constitution type. Conclusion: The study results demonstrated significant positive effects of yoga in diabetic individuals. This study has indicated the evidence for the safety and efficacy of the validated DYP for community-level interventions to prevent maladies like brain damage and stroke.

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