Autor dank Dr. Lan Qin und Shane Stanek für die Hilfe bei der Datenerhebung.

<ol>
	<li>Low, P. A., Denq, J. C., Opfer-Gehrking, T. L., Dyck, P. J., O'Brien, P. C., Slezak, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+age+and+gender+on+sudomotor+and+cardiovagal+function+and+blood+pressure+response+to+tilt+in+normal+subjects.">Effect of age and gender on sudomotor and cardiovagal function and blood pressure response to tilt in normal subjects.</a> Muscle Nerve. 20, 1561-1568 (1997).</li><li>Low, P. A., Denq, J. C., Opfer-Gehrking, T. L., Dyck, P. J., O'Brien, P. C., Slezak, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+age+and+gender+on+sudomotor+and+cardiovagal+function+and+blood+pressure+response+to+tilt+in+normal+subjects.">Effect of age and gender on sudomotor and cardiovagal function and blood pressure response to tilt in normal subjects.</a> Muscle Nerve. 20, 1561-1568 (1997).</li><li>Low, P. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Composite+autonomic+scoring+scale+for+laboratory+quantification+of+generalized+autonomic+failure.">Composite autonomic scoring scale for laboratory quantification of generalized autonomic failure.</a> Mayo Clin Proc. 68, 748-752 (1993).</li><li>Low, P. A., Low, P. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laboratory+evaluation+of+autonomic+function.">Laboratory evaluation of autonomic function.</a> Clinical Autonomic disorders. , 179-209 (1997).</li><li>Low, P. A., Low, P. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laboratory+evaluation+of+autonomic+failure.">Laboratory evaluation of autonomic failure.</a> Clinical Autonomic disorders. , 179-209 (2008).</li><li>Novak, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+sympathetic+index+from+Valsalva+maneuver.">Assessment of sympathetic index from Valsalva maneuver.</a> Neurology. , (2011).</li></ol>

Fallstricke Die Vollendung des vegetativen Tests ist in den meisten der Patienten einfach und kann innerhalb von 1 Stunde durchgeführt werden. Besondere Tücken der einzelnen Schritte des Tests wird im Folgenden erörtert. Equipment, Datenerfassung und-verarbeitung von autonomen Signale. Es gibt eine Reihe von Fallstricken betrafen in erster Linie die Qualität der Daten. Unzureichende Reinigung der Haut kann zu übermäßigem Lärm in der EKG-Signal, das zu machen Detektion von R-Zacke schwer führen können. Falsche Platzierung der Blutdruck-Sensor meiner falsche hohe oder niedrige Werte. Transkranielle Doppler-Signal von hoher Qualität kann schwierig sein, bei älteren Patienten aufgrund kleiner Knochen Fenster. Software für die Datenverarbeitung unter Umständen nicht robust genug, um Artefakte bei der Blutdruck zu unterscheiden, zum Beispiel bei Parkinson-Patienten mit Tremor. Tiefes Atmen <ol><li> Angst und abnormale Atmung, können die Ergebnisse der tiefen Atmung. Betreff sollte gut entspannt während der Prüfung. Ein guter Marker für die Angst ist die Herzfrequenz-Profil. Wenn Thema ist bestrebt, kann die Herzfrequenz erhöht werden. Vor dem Start tief zu atmen testen, stellen Sie sicher, dass die Herzfrequenz nicht Trending nach oben oder unten, wenn dies passiert warten, bis die mittlere Herzfrequenz bleibt flach. Die Ruhe-Atmung sollte normal sein, zB sollte es keine Hyperventilation (wie von endexspiratorischen CO 2 gemessen) oder Tachypnoe (Atemfrequenz über 11 pro Minute). </li><li> Die tiefe Atmung Test begrenzten Nutzen in bestimmten Herzrhythmusstörungen zB bei Vorhofflimmern oder wenn die Herzfrequenz wird durch Schrittmacher kontrolliert, weil die Vagusnerv-Modulation des Herzens wird entweder durch das Herz-generated Rhythmus oder durch einen Herzschrittmacher außer Kraft setzen. Grundlegende Kenntnisse der Herzrhythmusstörungen wird empfohlen. </li><li> Falsche Erkennung von R-Wellen durch Artefakte werden natürlich zu Fehlern in den Ergebnissen. Dies kann geschehen, wenn die R-Zacken zu klein, um zuverlässig erkannt werden, oder wenn das EKG Hintergrund ist laut z. B. aufgrund schlechter Hautkontakt. </li></ol> Valsalva-Manöver Valsalva-Manöver erfordert erhebliche Zusammenarbeit aus den Fächern Viele ältere oder gebrechliche Patienten nicht durchführen kann das Valsalva-Manöver korrekt. Häufigste Ursache ist die Schwäche der Mundmuskulatur, dass die Ergebnisse in Luftleck während der Atemwege belasten. In diesem Fall ist es effektiver, dichten die Luftleck um das Rohr sanft mit Finger 6. Evaluation der adrenerge Funktionen können nicht in ein Rechtecksignal Variante des Valsalva-Manöver (Abbildung 10) durchgeführt werden. Diese Reaktion ist selten, kann aber bei gesunden Probanden und bei Patienten mit kongestiver Herzinsuffizienz angesehen werden. Tilt Test Anzahl der Medikamente können sich auf die Neigung testrendering Interpretation der Test schwierig. Es ist nicht immer sinnvoll, Medikamente vor dem Test zu beenden. Es kann schwierig sein, gute Qualität Aufnahmen in Bewegungsstörungen Patienten zu erhalten, zum Beispiel bei Parkinson-Patienten mit Tremor. Sudomotorischer Prüfung (QSART) <ol><li> Unvollständige Entfernung von öligen Oberfläche oder zu viel Hautreizungen können sich auf Schweiß-Ausgang. </li><li> Lecks, wenn die Kapsel ist nicht wasserdicht oder Schmerzen aufgrund von zuviel engen Kapsel </li><li> Häufig verwendete Medikamente hat anticholinerge Wirkung, die mit dem Schweiß-Test stört. In vielen Fällen ist in unpraktisch, diese Medikamente machen die Interpretation der Ergebnisse schwierig einzustellen. </li></ol> Grading des vegetativen Beeinträchtigung über den Composite-Autonomic Severity Score (CASS). Generierung von CASS-Score ist recht umständlich, da es multiple Vergleiche in beide absolute und prozentuale Werte beinhaltet. Leider gibt es keine kommerzielle Software, die die Partitur automatisch berechnen kann. Am UMASS, verwenden wir proprietäre Software, die die CASS Partitur generiert automatisch. Beispiel für CASS Scores auf der Tabelle 8.

Tabelle 9 Empfohlene Ausrüstung. <table border="1"><tbody><tr><td> Bezeichnung des Geräts </td><td> Firma </td><td> Kommentare </td></tr><tr><td> Motorisierte Kipptisch </td><td> WR Medical Electronic </td><td> Eine Tabelle mit glatten Bewegung bis zu 70 Grad innerhalb von 5-10 Sekunden </td></tr><tr><td> EKG-Monitor </td><td></td><td> Jedes Gerät mit Analogausgang </td></tr><tr><td> Nichtinvasive beat-to-beat-Blutdruckmessgerät </td><td> Finapres Medical Systems </td><td> Mehrere Modelle stehen zur Verfügung, sind alle ähnlich </td></tr><tr><td> Q-Sweat </td><td> WR Medical Electronic </td><td></td></tr><tr><td> Transkranielle Doppler </td><td></td><td> Jedes Gerät mit Analogausgang </td></tr><tr><td> Recording-System </td><td> LabChart, ADInstruments </td><td> Einfache Programmierung </td></tr><tr><td> Recording-System </td><td> Labview </td><td> Komplexe Programmierung </td></tr><tr><td> Recording-System </td><td> Matlab </td><td> Komplexe Programmierung </td></tr><tr><td> Recording-System </td><td> WR Medical </td><td> Ready to use, aber begrenzte Flexibilität </td></tr><tr><td> CO2-Monitor </td><td></td><td> Viele Modelle für den Schlaf Studien verwendet </td></tr><tr><td> Respiratory-Monitor </td><td></td><td> Einfache Thermistor, um eine Aufnahme-System angeschlossen </td></tr></tbody></table>

quantitative autonomic testing

Erkrankungen mit Störungen des autonomen Nervensystems verbunden sind, durchaus üblich, aber häufig unerkannt. Quantitative autonome Tests können unschätzbares Werkzeug für die Evaluierung dieser Erkrankungen, und zwar sowohl in Klinik und Forschung. Es gibt eine Reihe von autonomen Tests wurden jedoch nur wenige klinisch oder validiert sind quantitativ. Hier wird voll quantitative und klinisch validierten Protokoll zur Prüfung der autonomen Funktionen vorgestellt. Als absolutes Minimum der klinischen autonomen Labor sollte einen Kipptisch, EKG-Monitor, kontinuierliche nicht-invasive Überwachung des Blutdrucks, der Atemwege zu überwachen und eine mittlere für die Bewertung von sudomotorischer Domäne. Die Software für Aufzeichnung und Auswertung der autonomen Tests ist entscheidend für die korrekte Auswertung der Daten. Das vorgestellte Protokoll wertet 3 großen autonomen Domains: cardiovagal, adrenerge und sudomotorischer. Die Tests umfassen tiefe Atmung, Valsalva Manöver, Head-up-Neige-und quantitative sudomotorischer Axon-Test (QSART). Die Schwere und Verbreitung von dysautonomia wird quantifiziert mit Composite-Autonomic Severity Scores (CASS). Detaillierte Protokoll ist vorgesehen Hervorhebung wesentlicher Aspekte des Testens mit Betonung auf korrekte Datenerfassung, die Beschaffung der entsprechenden Parameter und unvoreingenommene Beurteilung der autonomen Signale. Die normative Daten und CASS-Algorithmus für die Interpretation der Ergebnisse sind ebenfalls vorhanden.

Watch this Scientific Journal Video about Quantitative Autonomic Testing at JoVE.com

Quantitative Autonomic Testing

Standardisierte, umfassende und vollständig quantitative Prüfung der autonomen Funktionen beschrieben. Das autonome Tests bestehen aus Evaluierung aller drei großen autonomen Domains einschließlich cardiovagal, adrenerge und sudomotorischer. Die Schwere und Verbreitung von dysautonomia wird quantifiziert mit Composite-Autonomic Severity Scores.

Disorders associated with dysfunction of autonomic nervous system are quite common yet frequently unrecognized. Quantitative autonomic testing can be ...

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Drugs Acting on Autonomic Nervous System: Cholinergic Agonists and Antagonists Agents

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56.3K Aufrufe.  University of Massachusetts Medical School. Standardisierte, umfassende und vollständig quantitative Prüfung der autonomen Funktionen beschrieben. Das autonome Tests bestehen aus Evaluierung aller drei großen autonomen Domains einschließlich cardiovagal, adrenerge und sudomotorischer. Die Schwere und Verbreitung von dysautonomia wird quantifiziert mit Composite-Autonomic Severity Scores.

Serie: Quantitative Autonomic Testing

Quantitative Analysis of Chromatin Proteomes in Disease

In the nucleus reside the proteomes whose functions are most intimately linked with gene regulation. Adult mammalian cardiomyocyte nuclei are unique due to the high percentage of binucleated cells,1 the predominantly heterochromatic state of the DNA, and the non-dividing nature of the cardiomyocyte which renders adult nuclei in a permanent state of interphase.2 Transcriptional regulation during development and disease have been well studied in this organ,3-5 but what remains relatively unexplored is the role played by the nuclear proteins responsible for DNA packaging and expression, and how these proteins control changes in transcriptional programs that occur during disease.6 In the developed world, heart disease is the number one cause of mortality for both men and women.7 Insight on how nuclear proteins cooperate to regulate the progression of this disease is critical for advancing the current treatment options.
Mass spectrometry is the ideal tool for addressing these questions as it allows for an unbiased annotation of the nuclear proteome and relative quantification for how the abundance of these proteins changes with disease. While there have been several proteomic studies for mammalian nuclear protein complexes,8-13 until recently14 there has been only one study examining the cardiac nuclear proteome, and it considered the entire nucleus, rather than exploring the proteome at the level of nuclear sub compartments.15 In large part, this shortage of work is due to the difficulty of isolating cardiac nuclei. Cardiac nuclei occur within a rigid and dense actin-myosin apparatus to which they are connected via multiple extensions from the endoplasmic reticulum, to the extent that myocyte contraction alters their overall shape.16 Additionally, cardiomyocytes are 40% mitochondria by volume17 which necessitates enrichment of the nucleus apart from the other organelles. Here we describe a protocol for cardiac nuclear enrichment and further fractionation into biologically-relevant compartments. Furthermore, we detail methods for label-free quantitative mass spectrometric dissection of these fractions-techniques amenable to in vivo experimentation in various animal models and organ systems where metabolic labeling is not feasible.

Advances in mass spectrometry have allowed the high throughput analysis of protein expression and modification in a host of tissues. Combined with subcellular fractionation and disease models, quantitative mass spectrometry and bioinformatics can reveal new properties in biological systems. The method described herein analyzes chromatin-associated proteins in the setting of heart disease and is readily applicable to other in vivo models of human disease.

Quantitative Analyse von Chromatin Proteome in Disease

In the nucleus reside the proteomes whose functions are most intimately linked with gene regulation. Adult mammalian cardiomyocyte nuclei are unique due ...

Forschung

Medizin

Measuring Cardiac Autonomic Nervous System (ANS) Activity in Children

The autonomic nervous system (ANS) controls mainly automatic bodily functions that are engaged in homeostasis, like heart rate, digestion, respiratory rate, salivation, perspiration and renal function. The ANS has two main branches: the sympathetic nervous system, preparing the human body for action in times of danger and stress, and the parasympathetic nervous system, which regulates the resting state of the body.
ANS activity can be measured invasively, for instance by radiotracer techniques or microelectrode recording from superficial nerves, or it can be measured non-invasively by using changes in an organ's response as a proxy for changes in ANS activity, for instance of the sweat glands or the heart. Invasive measurements have the highest validity but are very poorly feasible in large scale samples where non-invasive measures are the preferred approach. Autonomic effects on the heart can be reliably quantified by the recording of the electrocardiogram (ECG) in combination with the impedance cardiogram (ICG), which reflects the changes in thorax impedance in response to respiration and the ejection of blood from the ventricle into the aorta. From the respiration and ECG signals, respiratory sinus arrhythmia can be extracted as a measure of cardiac parasympathetic control. From the ECG and the left ventricular ejection signals, the preejection period can be extracted as a measure of cardiac sympathetic control. ECG and ICG recording is mostly done in laboratory settings. However, having the subjects report to a laboratory greatly reduces ecological validity, is not always doable in large scale epidemiological studies, and can be intimidating for young children. An ambulatory device for ECG and ICG simultaneously resolves these three problems.
Here, we present a study design for a minimally invasive and rapid assessment of cardiac autonomic control in children, using a validated ambulatory device 1-5, the VU University Ambulatory Monitoring System (VU-AMS, Amsterdam, the Netherlands,<a href="http://www.vu-ams.nl" target="_blank"> www.vu-ams.nl</a>).

Measuring Cardiac Autonomic Nervous System ANS Activity in Children

Measurement of autonomic nervous system activity usually confines the researcher and participant to the laboratory, which may provide an intimidating environment to children. The VU University Ambulatory Monitoring System (VU-AMS) device can record cardiac autonomic control in any setting. The VU-AMS proved very amenable to testing in children.

Mess-Cardiac Autonomic Nervous System (ANS) Aktivität bei Kindern

The autonomic nervous system (ANS) controls mainly automatic bodily functions that are engaged in homeostasis, like heart rate, digestion, respiratory ...

Minimal Erythema Dose (MED) Testing

Ultraviolet radiation (UV) therapy is sometimes used as a treatment for various common skin conditions, including psoriasis, acne, and eczema. The dosage of UV light is prescribed according to an individual's skin sensitivity. Thus, to establish the proper dosage of UV light to administer to a patient, the patient is sometimes screened to determine a minimal erythema dose (MED), which is the amount of UV radiation that will produce minimal erythema (sunburn or redness caused by engorgement of capillaries) of an individual's skin within a few hours following exposure. This article describes how to conduct minimal erythema dose (MED) testing. There is currently no easy way to determine an appropriate UV dose for clinical or research purposes without conducting formal MED testing, requiring observation hours after testing, or informal trial and error testing with the risks of under- or over-dosing. However, some alternative methods are discussed.

Minimal Erythema Dose MED Testing

This article describes how to conduct minimal erythema dose (MED) testing in order to determine the lowest dose of ultraviolet radiation that will cause erythema (burning) when administered to an individual.

Minimal Erythema Dosis (MED) Testing

Ultraviolet radiation (UV) therapy is  sometimes used as a treatment for various common skin conditions, including  psoriasis, acne, and eczema. The ...

A Novel Application of Musculoskeletal Ultrasound Imaging

Ultrasound is an attractive modality for imaging muscle and tendon motion during dynamic tasks and can provide a complementary methodological approach for biomechanical studies in a clinical or laboratory setting. Towards this goal, methods for quantification of muscle kinematics from ultrasound imagery are being developed based on image processing. The temporal resolution of these methods is typically not sufficient for highly dynamic tasks, such as drop-landing. We propose a new approach that utilizes a Doppler method for quantifying muscle kinematics. We have developed a novel vector tissue Doppler imaging (vTDI) technique that can be used to measure musculoskeletal contraction velocity, strain and strain rate with sub-millisecond temporal resolution during dynamic activities using ultrasound. The goal of this preliminary study was to investigate the repeatability and potential applicability of the vTDI technique in measuring musculoskeletal velocities during a drop-landing task, in healthy subjects. The vTDI measurements can be performed concurrently with other biomechanical techniques, such as 3D motion capture for joint kinematics and kinetics, electromyography for timing of muscle activation and force plates for ground reaction force. Integration of these complementary techniques could lead to a better understanding of dynamic muscle function and dysfunction underlying the pathogenesis and pathophysiology of musculoskeletal disorders.

We describe a new ultrasound-based vector tissue Doppler imaging technique to measure muscle contraction velocity, strain and strain rate with sub-millisecond temporal resolution during dynamic activities. This approach provides complementary measurements of dynamic muscle function and could lead to a better understanding of mechanisms underlying musculoskeletal disorders.

A Novel Anwendung von Muskel-Skelett-Ultraschall-Bildgebung

Ultrasound is an attractive modality for imaging muscle and tendon  motion during dynamic tasks and can provide a complementary methodological  approach ...

Cerebrospinal Fluid MicroRNA Profiling Using Quantitative Real Time PCR

MicroRNAs (miRNAs) constitute a potent layer of gene regulation by guiding RISC to target sites located on mRNAs and, consequently, by modulating their translational repression. Changes in miRNA expression have been shown to be involved in the development of all major complex diseases. Furthermore, recent findings showed that miRNAs can be secreted to the extracellular environment and enter the bloodstream and other body fluids where they can circulate with high stability. The function of such circulating miRNAs remains largely elusive, but systematic high throughput approaches, such as miRNA profiling arrays, have lead to the identification of miRNA signatures in several pathological conditions, including neurodegenerative disorders and several types of cancers. In this context, the identification of miRNA expression profile in the cerebrospinal fluid, as reported in our recent study, makes miRNAs attractive candidates for biomarker analysis.
There are several tools available for profiling microRNAs, such as microarrays, quantitative real-time PCR (qPCR), and deep sequencing. Here, we describe a sensitive method to profile microRNAs in cerebrospinal fluids by quantitative real-time PCR. We used the Exiqon microRNA ready-to-use PCR human panels I and II V2.R, which allows detection of 742 unique human microRNAs. We performed the arrays in triplicate runs and we processed and analyzed data using the GenEx Professional 5 software.
Using this protocol, we have successfully profiled microRNAs in various types of cell lines and primary cells, CSF, plasma, and formalin-fixed paraffin-embedded tissues.

We describe a protocol of real time PCR to profile microRNAs in the cerebrospinal fluid (CSF). With the exception of RNA extraction protocols, the procedure can be extended to RNA extracted from other body fluids, cultured cells, or tissue specimens.

Liquor microRNA Profiling mittels quantitativer Real-Time PCR

MicroRNAs (miRNAs) constitute a potent layer of gene regulation by guiding RISC to target sites located on mRNAs and, consequently, by modulating their ...

Development of an Algorithm to Perform a Comprehensive Study of Autonomic Dysreflexia in Animals with High Spinal Cord Injury Using a Telemetry Device

Spinal cord injury (SCI) is a debilitating neurological condition characterized by somatic and autonomic dysfunctions. In particular, SCI above the mid-thoracic level can lead to a potentially life-threatening hypertensive condition called autonomic dysreflexia (AD) that is often triggered by noxious or non-noxious somatic or visceral stimuli below the level of injury. One of the most common triggers of AD is the distension of pelvic viscera, such as during bladder and bowel distension or evacuation. This protocol presents a novel pattern recognition algorithm developed for a JAVA platform software to study the fluctuations of cardiovascular parameters as well as the number, severity and duration of spontaneously occurring AD events. The software is able to apply a pattern recognition algorithm on hemodynamic data such as systolic blood pressure (SBP) and heart rate (HR) extracted from telemetry recordings of conscious and unrestrained animals before and after thoracic (T3) complete transection. With this software, hemodynamic parameters and episodes of AD are able to be detected and analyzed with minimal experimenter bias.

The catheter of a telemetry device is implanted into the abdominal aorta in order to continuously collect beat-by-beat hemodynamic data from animals pre and post-high thoracic spinal cord transection. A novel JAVA software was employed to analyze hemodynamic parameters as well as frequency and intensity of spontaneous episodes of autonomic dysreflexia.

Entwicklung eines Algorithmus einer umfassenden Studie von Autonomic Dysreflexie in Tiere zu Führen mit hoher Rückenmark-Verletzung ein Telemetrie-Gerät verwenden

Spinal cord injury (SCI) is a debilitating neurological condition characterized by somatic and autonomic dysfunctions. In particular, SCI above the ...

Measuring Cardiac Autonomic Nervous System (ANS) Activity in Toddlers - Resting and Developmental Challenges

The autonomic nervous system (ANS) consists of two branches, the parasympathetic and sympathetic nervous systems, and controls the function of internal organs (e.g., heart rate, respiration, digestion) and responds to everyday and adverse experiences 1. ANS measures in children have been found to be related to behavior problems, emotion regulation, and health 2-7. Therefore, understanding the factors that affect ANS development during early childhood is important. Both branches of the ANS affect young children&#8217;s cardiovascular responses to stimuli and have been measured noninvasively, via external monitoring equipment, using valid and reliable measures of physiological change 8-11. However, there are few studies of very young children with simultaneous measures of the parasympathetic and sympathetic nervous systems, which limits understanding of the integrated functioning of the two systems. In addition, the majority of existing studies of young children report on infants&#8217; resting ANS measures or their reactivity to commonly used mother-child interaction paradigms, and less is known about ANS reactivity to other challenging conditions. We present a study design and standardized protocol for a non-invasive and rapid assessment of cardiac autonomic control in 18 month old children. We describe methods for continuous monitoring of the parasympathetic and sympathetic branches of the ANS under resting and challenge conditions during a home or laboratory visit and provide descriptive findings from our sample of 140 ethnically diverse toddlers using validated equipment and scoring software. Results revealed that this protocol can produce a range of&#160;physiological responses to both resting and developmentally challenging conditions, as indicated by changes in heart rate and indices of parasympathetic and sympathetic activity. Individuals demonstrated&#160;variability in resting levels, responses to challenges, and challenge reactivity, which provides additional evidence that this protocol is useful for the examination of ANS individual differences for toddlers.

Measuring Cardiac Autonomic Nervous System ANS Activity in Toddlers - Resting and Developmental Challenges

We describe the methods for continuous monitoring of the autonomic nervous system under resting and challenge conditions with 18 month old children. Results revealed that this protocol can produce meaningful physiological responses in both branches of the autonomic nervous system and elicit significant individual variability in patterns of responses.

Mess Cardiac Autonomic Nervous System (ANS) Aktivität in Kleinkinder - Ruhe- und Entwicklungs Herausforderungen

The autonomic nervous system (ANS) consists of two branches, the parasympathetic and sympathetic nervous systems, and controls the function of internal ...

Proximal Cadaveric Femur Preparation for Fracture Strength Testing and Quantitative CT-based Finite Element Analysis

Cadaveric fracture testing is routinely used to understand factors that affect proximal femur strength. Because ex vivo biological tissues are prone to lose their mechanical properties over time, specimen preparation for experimental testing must be performed carefully to obtain reliable results that represent in vivo conditions. For that reason, we designed a protocol and a set of fixtures to prepare the femoral specimens such that their mechanical properties experienced minimal changes. The femora were kept in a frozen state except during preparation steps and mechanical testing. The relevant clinical measures of total hip and femoral neck bone mineral density (BMD) were obtained with a clinical dual X-ray absorptiometry (DXA) bone densitometer, and the 3D geometry and distribution of bone mineral were obtained using CT with a calibration phantom for quantitative estimations based on the greyscale values. Any possible bone disease, fracture, or the presence of implants or artifacts affecting the bone structure, was ruled out with X-ray scans. For preparation, all bones were carefully cleaned of excess soft tissue, and were cut and potted at the internal rotation angle of interest. A cutting fixture allowed the distal end of the bone to be cut off leaving the proximal femur at a desired length. To allow positioning of the femoral neck at prescribed angles during later CT scanning and mechanical testing, the proximal femoral shafts were potted in polymethylmethacrylate (PMMA) using a fixture designed specifically for desired orientations. The data collected from our experiments were then used for validation of quantitative computed tomography (QCT)-based finite element analysis (FEA), as described in a different protocol. In this manuscript, we present the protocol for the precise bone preparation for mechanical testing and subsequent QCT/FEA modeling. The current protocol was successfully applied to prepare about 200 cadaveric femora over a 6-year time period.

We present a robust protocol on how to carefully preserve and prepare cadaveric femora for fracture testing and quantitative computed tomography imaging. The method provides precise control over input conditions for the purpose of determining relationships between bone mineral density, fracture strength, and defining finite element model geometry and properties.

Proximale Cadaveric Femur Vorbereitung für die Bruchfestigkeit Prüfung und quantitative CT-basierte Finite-Elemente-Analyse

Cadaveric fracture testing is routinely used to understand factors that affect proximal femur strength.  Because ex vivo biological tissues are prone to ...

A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery

Chronic pain following surgery, persistent postsurgical pain, is an important highly prevalent condition contributing to significant symptom burden and lower quality of life. Persistent postsurgical pain is relatively refractory to treatment hence generating a high need for preventive strategies and treatments. Therefore, the identification of patients at risk of developing persistent pain is an area of active ongoing research. Recently it was demonstrated that peri-operative disruptions in central pain processing may be able to predict persistent postsurgical pain at long term follow-up in breast cancer patients. The aim of the current report is to present a short protocol to obtain pain thresholds to different stimuli at multiple sites and a measure of endogenous analgesia in breast cancer patients. We have used this method successfully in a clinical context and detail some representative results from a clinical study.

Persistent postsurgical pain may be related to changes in pain processing. By assessing pain in response to standardized stimuli, changes in pain processing can be elucidated. We present methods to obtain pain thresholds to different stimuli and a measure of endogenous analgesia in patients undergoing breast cancer surgery.

Eine Quantitative sensorische Tests Paradigma zu Maßnahmen der Schmerzen bei Patienten mit Brustkrebschirurgie Verarbeitung

Chronic pain following surgery, persistent postsurgical pain, is an important highly prevalent condition contributing to significant symptom burden and ...

Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology

Participation in organized sports makes a significant contribution to youth development, but places youth at a higher risk for sustaining a concussion. To date, return-to-activity decision-making has been anchored in the monitoring of self-reported concussion symptoms and neurocognitive testing. However, multi-modal assessments that corroborate objective physiological measures with traditional subjective symptom reporting are needed and can be valuable. Heart rate variability (HRV) is a non-invasive physiological indicator of the autonomic nervous system, capturing the reciprocal interplay between the sympathetic and parasympathetic nervous systems. There is a dearth of literature exploring the effect of concussion on HRV in youth athletes, and developmental differences preclude the application of adult findings to a pediatric population. Further, the current state of HRV methodology has primarily included short-term (5-15 min) recordings, by using resting state or short-term physical exertion testing to elucidate changes following concussion. The novelty in utilizing a 24 h&#160;recording methodology is that it has the potential to capture natural variation in autonomic function, directly related to the activities a youth athlete performs on a regular basis. Within a prospective, longitudinal research setting, this novel approach to quantifying autonomic function can provide important information regarding the recovery trajectory, alongside traditional self-report symptom measures. Our objectives regarding a 24 h recording methodology were to (1) evaluate the physiological effects of a concussion in youth athletes, and (2) describe the trajectory of physiological change, while considering the resolution of self-reported post-concussion symptoms. To achieve these objectives, non-invasive sensor technology was implemented. The raw beat-to-beat time intervals captured can be transformed to derive time domain and frequency domain measures, which reflect an individual&#39;s ability to adapt and be flexible to their ever-changing environment. By using non-invasive heart rate technology, autonomic function can be quantified outside of a traditional controlled research setting.

We demonstrate a 24 h heart rate recording methodology to evaluate the influence of concussion across the recovery trajectory in youth athletes, within an ecologically valid context.

Autonome Funktion nach Gehirnerschütterung bei Jugendlichen Sportlern: eine Erforschung der Herzfrequenz-Variabilität mit 24-Stunden-Aufnahme Methodik

Participation in organized sports makes a significant contribution to youth development, but places youth at a higher risk for sustaining a concussion. To ...