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A Network approach to find poor orthostatic tolerance by simple tilt maneuvers.

The approach introduced by Network Physiology intends to find and quantify connectedness between close- and far related aspects of a person's Physiome. In this study I applied a Network-inspired analysis to a set of measurement data that had been assembled to detect prospective orthostatic intolerant subjects among people who were destined to go into Space for a two weeks mission. The advantage of this approach being that it is essentially model-free: no complex physiological model is required to interpret the data. This type of analysis is essentially applicable to many datasets where individ

Jingfang Granule promotes the tricarboxylic acid cycle to improve chronic fatigue syndrome by increasing the expression of Idh1 and Idh2.

ETHNOPHARMACOLOGICAL RELEVANCE: Chronic fatigue syndrome (CFS), as a complex, multisystemic, and multisystemic disorder affecting multiple organs and systems, often accompanies by symptoms such as post-exercise discomfort, sleep disorders, cognitive difficulties, and orthostatic intolerance. Jingfang Granule (JFG) is a traditional Chinese medicine that have significant protective effects on CFS, but the mechanism is still vague. AIM OF STUDY: This study was designed to evaluate the protective mechanism of JFG on mice with CFS. MATERIALS AND METHODS: The combined stimuli method was used to es…

Longitudinal cytokine and multi-modal health data of an extremely severe ME/CFS patient with HSD reveals insights into immunopathology, and disease severity.

INTRODUCTION: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) presents substantial challenges in patient care due to its intricate multisystem nature, comorbidities, and global prevalence. The heterogeneity among patient populations, coupled with the absence of FDA-approved diagnostics and therapeutics, further complicates research into disease etiology and patient managment. Integrating longitudinal multi-omics data with clinical, health,textual, pharmaceutical, and nutraceutical data offers a promising avenue to address these complexities, aiding in the identification of underlyi

Impaired Mitochondrial Bioenergetics Function in Pediatric Chronic Overlapping Pain Conditions with Functional Gastrointestinal Disorders.

BACKGROUND: Fatigue is often the primary complaint of children with functional gastrointestinal disorders (FGDI) and other chronic overlappi … ory, FDI). RESULTS: 19 HC and 31 COPC showed no statistically significant difference in age. FGID, orthostatic intolerance, migraine, sleep disturbance, and chronic fatigue were present in the majority of COPC subjects. BR, ECAR, and ATP-LC rates were lower in the COPC group. The low BR and ATP-LC suggest that mitochondria are stressed with decreased ability to produce …

Antihypertensive therapy in diabetic patients.

Diabetes mellitus (DM)-linked metabolic alterations and hypertension concomitantly accelerate or precipitate cerebrovascular and coronary heart disease, nephropathy, retinopathy and widespread macroangiopathy, thereby conferring to diabetic patients a very high risk of morbidity, disability and early death. Therefore, the long-term care for diabetic patients should be aimed at concomitant metabolic and blood pressure (BP) control. Dietary measures are indispensable; a high fibre, low fat, low salt diet is recommended, complemented with caloric restriction and physical exercise when body weight

Genetic variation in catechol-O-methyltransferase modifies effects of clonidine treatment in chronic fatigue syndrome.

Clonidine, an α2-adrenergic receptor agonist, decreases circulating norepinephrine and epinephrine, attenuating sympathetic activity. Although catechol-O-methyltransferase (COMT) metabolizes catecholamines, main effectors of sympathetic function, COMT genetic variation effects on clonidine treatment are unknown. Chronic fatigue syndrome (CFS) is hypothesized to result in part from dysregulated sympathetic function. A candidate gene analysis of COMT rs4680 effects on clinical outcomes in the Norwegian Study of Chronic Fatigue Syndrome in Adolescents: Pathophysiology and Intervention Trial (NorC

Awareness and Perception of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Among Pain Specialists: A Questionnaire-Based Study.

BACKGROUND: This study aims to explore the perceptions and clinical approaches of pain management specialists toward myalgic encephalomyelit … (65.9%) stated that they "occasionally" or "rarely" considered the relationship between fatigue and orthostatic intolerance. Additionally, 37.7% believed that this disease is a subtype of depression. The statement, "chronic fatigue decreases with intense aerobic exercise," was agreed upon by 50.9% of participants. This controversial statement was particularly more common …

Provocation of brachial plexus and systemic symptoms during the elevated arm stress test in individuals with myalgic encephalomyelitis/chronic fatigue syndrome or idiopathic chronic fatigue.

BACKGROUND: We have noted that some adolescents and young adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) report dif … 13 to 50]). Of the 64, 50 (78%) had ME/CFS, 13 (20%) had idiopathic chronic fatigue with associated orthostatic intolerance (OI), and one had idiopathic chronic fatigue without OI. Of the 64, 58% had evidence of joint hypermobility. Local symptoms were provoked by EAST in 62/64 (97%) within a median of 20 s. During EAST, 26/64 (41%) reported systemic symptoms (1 had only …

Preliminary evaluation of a mindfulness intervention program in women with long COVID dysautonomia symptoms.

BACKGROUND: The symptom burden for patients with Long COVID-associated dysautonomia is high, yet there are currently no effective treatments. Mindfulness programs reduce psychological and physical symptoms as well as inflammatory gene expression in a variety of medical conditions. The study aim was to evaluate the effect of a six-week mindfulness program in women with Long COVID dysautonomia symptoms. METHODS: Using a single arm, pre- and posttest design, women aged 18-54 years with Long COVID and orthostatic intolerance suggestive of dysautonomia were recruited from a single center. Particip…

Clinical features and autonomic testing predict survival in multiple system atrophy.

Multiple system atrophy is characterized by autonomic failure along with motor symptoms of parkinsonism and/or cerebellar ataxia. There are … (iii) urinary catheterization within 3 years of symptom onset (hazard ratio 1.67, P < 0.003); (iv) orthostatic intolerance within 1 year of symptom onset (hazard ratio 1.28, P < 0.014); (v) older age of onset (hazard ratio 1.02, P = 0.001); and (vi) degree of autonomic failure as measured by a validated composite autonomic severity score (hazard ratio 1.07, P < 0.0023). …

Impact of Prolonged Spaceflight on Cardiac Structure and Function: An Exploratory Longitudinal Observational Study.

BACKGROUND: Gravitational gradients, ranging from the surface of the Earth (1 G) to the microgravity of spaceflight (0 G), including interme … on relative to the upright posture on Earth in a simulated Martian gravity landing, suggesting that orthostatic intolerance may be unlikely to occur on Mars after a 6-month transport with appropriate exercise countermeasures.

Respiratory modulation of human autonomic function: long-term neuroplasticity in space.

KEY POINTS: We studied healthy astronauts before, during and after the Neurolab Space Shuttle mission with controlled breathing and apnoea, to identify autonomic changes that might contribute to postflight orthostatic intolerance. Measurements included the electrocardiogram, finger photoplethysmographic arterial pressure, respiratory carbon dioxide levels, tidal volume and peroneal nerve muscle sympathetic activity. Arterial pressure fell and then rose in space, and drifted back to preflight levels after return to Earth. Vagal metrics changed in opposite directions: vagal baroreflex gain and t…

Pacemaker current inhibition in experimental human cardiac sympathetic activation: a double-blind, randomized, crossover study.

Hyperpolarization-activated, cyclic nucleotide-gated 4 (HCN4) channels comprise the final pathway for autonomic heart rate (HR) regulation. We hypothesized that HCN4 inhibition could reverse autonomic imbalance in a human model of cardiac sympathetic activation. Nineteen healthy men ingested oral metoprolol+reboxetine, ivabradine+reboxetine, or placebo+reboxetine in a double-blind, randomized, crossover fashion. We assessed HR, blood pressure (BP), stroke volume, and cardiac output during rest and profound orthostatic stress. HR variability, BP variability, and baroreflex sensitivity were anal

[Association of vitamin D deficiency with severity of symptoms in children with vasovagal syncope].

Objective: To investigate the correlation between vitamin D deficiency and the severity of symptoms in children with vasovagal syncope (VVS) … examination, and level determination of serum 25 (OH) D. Children in the VVS group were scored for orthostatic intolerance (OI) symptoms including 10 symptoms: syncope, dizziness, nausea, palpitation, headache, tremor, chest tightness, blurred vision, profuse perspiration, and attention deficit. The differences in the age, gender, body mass index, blood pressure, and se …

Advancements and Challenges in the Preoperative Management of Pheochromocytoma in a Low- and Middle-Income Country (LMIC): A Nationwide Survey.

BACKGROUND: Pheochromocytomas are rare catecholamine-producing neoplasms of the adrenal medulla that present considerable perioperative management challenges. Despite advances in pharmacologic protocols and surgical techniques, clinical variability, particularly in drug availability (e.g., phenoxybenzamine vs. doxazosin), lack of standardized titration protocols, and inconsistent multidisciplinary planning continue to affect management. OBJECTIVE: This study examines contemporary trends in the preoperative management of pheochromocytoma through a national survey of surgical professionals in P

Regulation of body fluid volume and electrolyte concentrations in spaceflight.

Despite a number of difficulties in performing experiments during weightlessness, a great deal of information has been obtained concerning t … ed in the development of countermeasures that are only partly successful in reducing the postflight orthostatic intolerance experienced by astronauts and cosmonauts. More complete knowledge of these processes can be expected to produce countermeasures that are even more successful, as well as expand our comprehension of the range of adaptability of human physiologic proc …

Supraventricular Tachycardia and Postural Orthostatic Tachycardia Syndrome Overlap: A Retrospective Study.

Postural orthostatic tachycardia syndrome (POTS) and supraventricular tachycardia (SVT) are disease states with distinctive features but overlapping clinical manifestations. Currently, studies on the presence of underlying SVT in patients with POTS are lacking. This retrospective study analyzed 64 patients [mean age: 43 years; 41 (61%) women] who had a POTS diagnosis and were found to have concomitant SVT during rhythm monitoring from September 1, 2013 to September 30, 2019 at our Syncope and Autonomic Disorders Clinic. The outcomes assessed were changes in disease severity, frequency of sympt

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… Robertson D The epidemic of orthostatic tachycardia and orthostatic intolerance Am J Med Sci 1999 317 2 75 77 [CrossRef] [PubMed] 10037110 10.1097/00000441-199902000-00001 3. … Jordan J Shannon JR Diedrich A Black BK Robertson D Increased sympathetic activation in idiopathic orthostatic intolerance: role of systemic adrenoreceptor sensitivity Hypertension 2002 39 1 173 178 [CrossRef] [PubMed] 11799098 10.1161/hy1201.097202 15. …

Посттуральный ортостатический синдром тахикардии и ортостатическое гипотезирование после трансплантации стволовых клеток.

СПРАВОЧНИК: Посттуральная ортопедическая тахикардия (POTS) и ортостатическая гипотензия (OH), как правило, происходят после трансплантации стволовых клеток (HSCT). ЦЕЛИ: Данное исследование было направлено на определение распространенности ПОТС и ОЖ до ХОСТ и числа новых случаев после ХОСТ. МЕТОДЫ: В этом одном центре перспективного исследования была проведена оценка пациентов. 30 за несколько дней до 30 и 100 Через несколько дней после HSCT. Кровяное давление, сердечный ритм и уровень плазменного норепинефрина измерялись в суперном положении и после 10-minute испытание активного стенда для оц

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… Orthostatic intolerance syndromes after hematopoietic cell transplantation: clinical characteristics and therapeutic interventions in a single-center experience. Cardiooncology. 2021;7:40–46. doi: 10.1186/s40959-021-00126-7. 9. Rosenfeld M., Pruitt A. … Postural orthostatic tachycardia syndrome in patients of orthostatic intolerance symptoms: an ambispective study. AIMS Neurosci. 2020;8(1):74–85. doi: 10.3934/Neuroscience.2021004. 13. Juraschek S., Taylor A., Wright J., Jr., et al. …

AGA Clinical Practice Update on GI Manifestations and Autonomic or Immune Dysfunction in Hypermobile Ehlers-Danlos Syndrome: Expert Review.

DESCRIPTION: The purpose of this Clinical Practice Update Expert Review is to describe key principles in the evaluation and management of pa … testing should be considered in patients with hEDS/HSDs and refractory GI symptoms who also report orthostatic intolerance after exclusion of medication side effects and appropriate lifestyle or behavioral modifications (eg, adequate hydration and physical exercise) have been attempted but is not required for all patients with hEDS/HSDs who report GI symptoms alone. BES …

Unmasking orthostatic hypotension after cellular therapy: risk factors, implications, and clinical significance.

PURPOSE: Orthostatic hypotension (OH) is a common complication in cancer care, increasing the risk of falls. However, in hematopoietic cell transplantation (HCT) and cellular therapy, few studies have focused on OH, and its incidence and risk factors remain unclear. METHODS: This single-center retrospective study included 297 (autologous, 153; allogeneic, 127; and CAR-T, 17) patients. Blood pressure and heart rate were measured with the patient supine, and again at 1 min and at 3 min after standing. Data were collected to calculate OH incidence by day 30 post-infusion. RESULTS: The cumulativ

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… A, Thomas G, Bressi E, Bonaventura A, Canada JM, Chuquin D et al (2021) Orthostatic intolerance syndromes after hematopoietic cell transplantation: clinical characteristics and therapeutic interventions in a single-center experience. … Christou GA Kiortsis DN The effects of body weight status on orthostatic intolerance and predisposition to noncardiac syncope Obes Rev 2017 18 3 370 379 10.1111/obr.12501 28112481 Christou GA, Kiortsis DN (2017) The effects of body weight status on orthostatic intolerance and predisposition to noncardiac …