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British Medical Journal Apr 1958
Topics: Parasympatholytics; Peptic Ulcer
PubMed: 13523221
DOI: No ID Found -
The British Journal of Ophthalmology Oct 1970
Topics: Adrenergic alpha-Antagonists; Humans; Hydroquinones; Miotics; Mydriatics; Phenylephrine; Pupil
PubMed: 4394336
DOI: 10.1136/bjo.54.10.690 -
Anesthesiology 1968
Review
Topics: Acetylcholinesterase; Animals; Autonomic Agents; Axons; Cats; Mice; Monoamine Oxidase; Neural Conduction; Neurotransmitter Agents; Rats; Sensory Receptor Cells; Synapses; Synaptic Transmission; Transferases
PubMed: 4385686
DOI: 10.1097/00000542-196807000-00006 -
Revista de Gastroenterologia de Mexico 2012Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain, bloating, and changes in bowel habit. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain, bloating, and changes in bowel habit.
AIMS
To determine the clinical effectiveness of the antispasmodic agents available in Mexico for the treatment of IBS.
METHODS
We carried out a systematic review and meta-analysis of randomized controlled clinical trials on antispasmodic agents for IBS treatment. Clinical trials identified from January 1960 to May 2011 were searched for in MEDLINE, the Cochrane Library, and in the ClinicalTrials.gov registry. Treatment response was evaluated by global improvement of symptoms or abdominal pain, abdominal distention/bloating, and frequency of adverse events. The effect of antispasmodics vs placebo was expressed in OR and 95% CI.
RESULTS
Twenty-seven studies were identified, 23 of which fulfilled inclusion criteria. The studied agents were pinaverium bromide, mebeverine, otilonium, trimebutine, alverine, hyoscine, alverine/simethicone, pinaverium/simethicone, fenoverine, and dicyclomine. A total of 2585 patients were included in the meta-analysis. Global improvement was 1.55 (CI 95%: 1.33 to 1.83). Otilonium and the alverine/simethicone combination produced significant values in global improvement while the pinaverium/simethicone combination showed improvement in bloating. As for pain, 2394 patients were included with an OR of 1.52 (IC 95%: 1.28 a 1.80), favoring antispasmodics.
CONCLUSIONS
Antispasmodics were more effective than placebo in IBS, without any significant adverse events. The addition of simethicone improved the properties of the antispasmodic agents, as seen with the alverine/simethicone and pinaverium/simethicone combinations.
Topics: Drug Therapy, Combination; Humans; Irritable Bowel Syndrome; Parasympatholytics; Randomized Controlled Trials as Topic
PubMed: 22672854
DOI: 10.1016/j.rgmx.2012.04.002 -
Cardiovascular Diabetology Sep 2020The association between type 2 diabetes mellitus (T2DM) and heart failure (HF) is well established. Early in the course of the diabetic disease, some degree of impaired... (Review)
Review
The association between type 2 diabetes mellitus (T2DM) and heart failure (HF) is well established. Early in the course of the diabetic disease, some degree of impaired exercise capacity (a powerful marker of health status with prognostic value) can be frequently highlighted in otherwise asymptomatic T2DM subjects. However, the literature is quite heterogeneous, and the underlying pathophysiologic mechanisms are far from clear. Imaging-cardiopulmonary exercise testing (CPET) is a non-invasive, provocative test providing a multi-variable assessment of pulmonary, cardiovascular, muscular, and cellular oxidative systems during exercise, capable of offering unique integrated pathophysiological information. With this review we aimed at defying the cardiorespiratory alterations revealed through imaging-CPET that appear specific of T2DM subjects without overt cardiovascular or pulmonary disease. In synthesis, there is compelling evidence indicating a reduction of peak workload, peak oxygen assumption, oxygen pulse, as well as ventilatory efficiency. On the contrary, evidence remains inconclusive about reduced peripheral oxygen extraction, impaired heart rate adjustment, and lower anaerobic threshold, compared to non-diabetic subjects. Based on the multiparametric evaluation provided by imaging-CPET, a dissection and a hierarchy of the underlying mechanisms can be obtained. Here we propose four possible integrated pathophysiological mechanisms, namely myocardiogenic, myogenic, vasculogenic and neurogenic. While each hypothesis alone can potentially explain the majority of the CPET alterations observed, seemingly different combinations exist in any given subject. Finally, a discussion on the effects -and on the physiological mechanisms-of physical activity and exercise training on oxygen uptake in T2DM subjects is also offered. The understanding of the early alterations in the cardiopulmonary response that are specific of T2DM would allow the early identification of those at a higher risk of developing HF and possibly help to understand the pathophysiological link between T2DM and HF.
Topics: Autonomic Nervous System Diseases; Bronchodilator Agents; Cardiotonic Agents; Diabetes Mellitus, Type 2; Diabetic Cardiomyopathies; Diabetic Neuropathies; Echocardiography, Stress; Exercise Test; Exercise Therapy; Exercise Tolerance; Heart; Humans; Microcirculation; Muscle, Skeletal; Oxygen Consumption; Pulmonary Ventilation; Sympatholytics; Vasodilator Agents
PubMed: 32891175
DOI: 10.1186/s12933-020-01109-1 -
Clinical Autonomic Research : Official... Jun 2017The blood pressure "error signal" represents the difference between an individual's mean diastolic blood pressure and the diastolic blood pressure at which 50% of...
PURPOSE
The blood pressure "error signal" represents the difference between an individual's mean diastolic blood pressure and the diastolic blood pressure at which 50% of cardiac cycles are associated with a muscle sympathetic nerve activity burst (the "T50"). In this study we evaluated whether T50 and the error signal related to the extent of change in blood pressure during autonomic blockade in young and older women, to study potential differences in sympathetic neural mechanisms regulating blood pressure before and after menopause.
METHODS
We measured muscle sympathetic nerve activity and blood pressure in 12 premenopausal (25 ± 1 years) and 12 postmenopausal women (61 ± 2 years) before and during complete autonomic blockade with trimethaphan camsylate.
RESULTS
At baseline, young women had a negative error signal (-8 ± 1 versus 2 ± 1 mmHg, p < 0.001; respectively) and lower muscle sympathetic nerve activity (15 ± 1 versus 33 ± 3 bursts/min, p < 0.001; respectively) than older women. The change in diastolic blood pressure after autonomic blockade was associated with baseline T50 in older women (r = -0.725, p = 0.008) but not in young women (r = -0.337, p = 0.29). Women with the most negative error signal had the lowest muscle sympathetic nerve activity in both groups (young: r = 0.886, p < 0.001; older: r = 0.870, p < 0.001).
CONCLUSIONS
Our results suggest that there are differences in baroreflex control of muscle sympathetic nerve activity between young and older women, using the T50 and error signal analysis. This approach provides further information on autonomic control of blood pressure in women.
Topics: Adult; Aged; Aging; Autonomic Agents; Baroreflex; Blood Pressure; Female; Ganglionic Blockers; Hemodynamics; Humans; Menopause; Middle Aged; Muscle, Skeletal; Postmenopause; Premenopause; Sympathetic Nervous System; Trimethaphan; Vasodilator Agents; Young Adult
PubMed: 28205011
DOI: 10.1007/s10286-017-0403-0 -
Age and gender difference in ST height at rest and after double autonomic blockade in normal adults.Annals of Noninvasive Electrocardiology... Jul 2006ST elevation is commonly seen in young, healthy men. The exact mechanisms that cause ST height to be greater in young men are not yet completely understood. The purpose...
BACKGROUND
ST elevation is commonly seen in young, healthy men. The exact mechanisms that cause ST height to be greater in young men are not yet completely understood. The purpose of the present study was to determine whether autonomic tone is responsible for age and gender differences in ST height.
METHODS
Gender and age differences in ST height were studied at rest and after double autonomic blockade (DAB) with atropine and propranolol. Fifty healthy men and women were included (16 men, 14 women, age 23-32 years; 9 men, 11 women, age 65-79 years). Twelve-lead ECGs were registered at rest and after DAB. Leads II and V(1)-V(4) were chosen for analysis. ST height (in mm) was measured manually at the J-point, and 40 ms and 80 ms after the J-point. Values were corrected for QRS amplitude.
RESULTS
Gender and age differences in ST height were seen in both rest and DAB data. Men had greater ST height compared to women at J-point, 40 and 80 ms after the J-point (P < or = 0.0001), and younger subjects had greater ST height than older subjects at J-point (P = 0.0140), 40 and 80 ms after the J-point (P < or = 0.0001). DAB did not change ST height at J-point or at 40 ms, but increased ST height at 80 ms. Women had less of an increase in ST height following DAB than men did.
CONCLUSIONS
ST elevation in the absence of structural or electrical heart disease is mainly seen in young men. Age and gender difference persist after DAB and thus are not due to differences in autonomic tone.
Topics: Adult; Age Factors; Aged; Atropine; Autonomic Agents; Electrocardiography; Female; Heart; Humans; Male; Middle Aged; Propranolol; Reference Values; Sex Factors
PubMed: 16846441
DOI: 10.1111/j.1542-474X.2006.00112.x -
Cleveland Clinic Journal of Medicine Nov 2019
Topics: Bronchodilator Agents; Humans; Pulmonary Disease, Chronic Obstructive
PubMed: 31710583
DOI: 10.3949/ccjm.86a.19027 -
Experimental Eye Research Jan 2010Accommodation and pupil constriction result from parasympathetic stimulation from the Edinger-Westphal (EW) nucleus of the midbrain resulting in release of acetylcholine...
Accommodation and pupil constriction result from parasympathetic stimulation from the Edinger-Westphal (EW) nucleus of the midbrain resulting in release of acetylcholine at the neuromuscular junctions of the ciliary muscle and iris. Cholinergic and adrenergic drugs can be applied topically to evaluate the effects on the pupil and accommodative system without input from the EW nucleus. This study is directed at characterizing how topical low dose echothiophate, an anti-cholinesterase inhibitor (i.e., an indirect cholinergic agonist), epinephrine, an adrenergic agonist, and timolol maleate, a beta adrenergic antagonist, affect pupil diameter, resting refraction and accommodative amplitude and dynamics in rhesus monkeys. The effects of 0.015% echothiophate, 2% epinephrine, 0.5% timolol maleate and saline on pupil diameter and resting refraction were measured in one eye each of four normal rhesus monkeys for 60-90 min following topical instillation. Pupil diameter was measured with infrared videography and refraction was measured with a Hartinger coincidence refractometer. Effects on static and dynamic EW stimulated accommodation were studied in three iridectomized monkeys (ages 5, 6 and 12 years) with permanent indwelling stimulating electrodes in the EW nucleus. Dynamic accommodative responses were measured with infrared photorefraction for increasing current amplitudes before and during the course of action of the pharmacological agents. Echothiophate caused a significant decrease in pupil diameter of 3.07 +/- 0.65 mm (mean +/- SEM, p < 0.01), and a myopic shift in resting refraction of 1.30 +/- 0.39 D (p < 0.05) 90 min after instillation. Epinephrine caused a 2.76 +/- 0.38 mm (p < 0.01) increase in pupil diameter with no change in resting refraction 60 min after instillation. Timolol maleate resulted in no significant change in either pupil diameter or resting refraction 60 min after instillation. There was no significant change in maximum EW stimulated accommodative amplitude after any agent tested. The amplitude vs. peak velocity relationship for accommodation was significantly different after echothiophate and timolol maleate, and for disaccommodation after echothiophate, epinephrine and timolol maleate. In conclusion, when tested objectively in anesthetized monkeys, epinephrine and timolol maleate did not alter resting refraction or accommodative amplitude, but did have small, significant affects on accommodative dynamics. This suggests that there is an adrenergic component to the accommodative system. Low dose echothiophate had significant effects on pupil diameter and resting refraction, with only small effects on the dynamics of the accommodative response.
Topics: Accommodation, Ocular; Administration, Topical; Adrenergic Agonists; Adrenergic beta-Antagonists; Animals; Autonomic Agents; Autonomic Nervous System; Cholinesterase Inhibitors; Echothiophate Iodide; Epinephrine; Iridectomy; Iris; Macaca mulatta; Pupil; Refraction, Ocular; Timolol; Video Recording
PubMed: 19782072
DOI: 10.1016/j.exer.2009.09.015 -
Pediatric Pulmonology Sep 2022Preterm-born children have their normal in-utero lung development interrupted, thus are at risk of short- and long-term lung disease. Spirometry and exercise capacity...
INTRODUCTION
Preterm-born children have their normal in-utero lung development interrupted, thus are at risk of short- and long-term lung disease. Spirometry and exercise capacity impairments have been regularly reported in preterm-born children especially those who developed chronic lung disease of prematurity (CLD) in infancy. However, specific phenotypes may be differentially associated with exercise capacity. We investigated exercise capacity associated with prematurity-associated obstructive (POLD) or prematurity-associated preserved ratio of impaired spirometry (pPRISm) when compared to preterm- and term-controls with normal lung function.
MATERIALS AND METHODS
Preterm- and term-born children identified through home screening underwent in-depth lung function and cardiorespiratory exercise testing, including administration of postexercise bronchodilator, as part of the Respiratory Health Outcomes in Neonates (RHiNO) study.
RESULTS
From 241 invited children, aged 7-12 years, 202 underwent exercise testing including 18 children with POLD (percent predicted (%)FEV and FEV /FVC < LLN); 12 pPRISm (%FEV < LLN and FEV /FVC ≥ LLN), 106 preterm-controls (PT , %FEV ≥ LLN) and 66 term-controls (T , %FEV > 90%). POLD children had reduced relative workload, peak O uptake, CO production, and minute ventilation compared to T , and used a greater proportion of their breathing reserve compared to both control groups. pPRISm and PT children also had lower O uptake compared to T . POLD children had the greatest response to postexercise bronchodilator, improving their %FEV by 19.4% (vs 6.3%, 6% 6.3% in pPRISm PT T , respectively; p < .001).
CONCLUSION
Preterm-born children with obstructive airway disease had the greatest impairment in exercise capacity, and significantly greater response to postexercise bronchodilators. These classifications can be used to guide treatment in children with POLD.
Topics: Bronchodilator Agents; Bronchopulmonary Dysplasia; Forced Expiratory Volume; Humans; Infant, Newborn; Lung; Lung Diseases, Obstructive; Spirometry
PubMed: 35638186
DOI: 10.1002/ppul.26019