Incidence Of Autonomic Dysfunction Research Articles

Evolution of incidence of audiovestibular disorders during the pandemic COVID-19 period.

PurposeDespite sporadic case reports describing hearing problems in patients with coronavirus disease 2019 (COVID-19), whether COVID-19 affects the audiovestibular system remains unclear. This study assessed the evolution of incidence of audiovestibular disorders during the pandemic COVID-19 period.MethodThree audiovestibular disorders namely, sudden sensorineural hearing loss (SSHL), autonomic dysfunction, and Meniere’s disease (MD) were analyzed and compared from 2016 to 2020.ResultsThe annual new cases at our clinic comprised overall 2107, 1997, 1984, 2068, and 1829 from 2016 to 2020, respectively, and the respectively annual cases of SSHL were 54, 46, 42, 45 and 38. Accordingly, annual incidences of SSHL in relation to overall cases of audiovestibular disorders were 2.6%, 2.3%, 2.1%, 2.2% and 2.1% from 2016 to 2020, respectively, exhibiting a non-significant difference (p > 0.05). In contrast, incidence of autonomic dysfunction in the year 2020 was 15.3%, which revealed significantly higher than 8.5–13.1% from 2016 to 2019 (p < 0.001). Restated, the incidence of autonomic dysfunction in 2020 displayed a significantly higher percentage than the other 4 years. Conversely, the incidence of MD in 2020 was 9.8%, showing a significant decline compared with the other 4 years (12.6–15.6% from 2016 to 2019, p < 0.001),ConclusionEvolution of incidence of audiovestibular disorders during the pandemic COVID-19 period revealed increase in the incidence of autonomic dysfunction and decrease in that of MD, while incidence of SSHL remained unchanged from 2016 to 2020. Thus, the SARS-CoV-2 may less affect the audiovestibular system.

Clinical Study on Evaluation of Autonomic Nervous Dysfunction Based on Imaging Urodynamic Examination with Slow Filling and Synchronous Blood Pressure Monitoring in the Patients with Cervicothoracic Spinal Cord Injury

Objective: Explore the rule of autonomic nervous dysfunction in the patients with urination disorder after high level spinal cord injury, and seek a safe, objective and accurate method to evaluate autonomic nervous function. Patients and Method: 48 patients with dysuria after cervicothoracic SCI were selected. Before, during and after imaging urodynamic examination with slow filling in supine position, blood pressure and ECG were monitored simultaneously. The symptoms of sweating, shivering, headache, flushing and chills were observed and recorded. The study of the relationship among the changes of blood pressure, heart rate and urodynamic indexes and the above symptoms was analyzed. Results: They were divided into three groups: group A (no obvious abnormality), group B (hyperactivity) and group C (hypoactivity) according to their BP, HR and existing the symptoms or not. Conclusion: The incidence of autonomic dysfunction in the high level SCI patients with dysuria was very high (79.17%), most of them were hyperactivity, and a few were low function. The changes of SBP and DBP in the hypoactivity group all appeared an increasing and then declining trend, while the change of HR in the low function one was lower than normal and decreased continuously. The main inducements of AD are neurogenic detrusor overactivity, detrusor sphincter dyssynergia, elevated abdominal pressure and abnormal bladder sensitivity. The asymptomatic patients had a higher occurrence rate (43.75%). Only by imaging urodynamic examination with slow filling and synchronous blood pressure monitoring, can autonomic nervous function of the patients be evaluated safely, objectively, early and accurately.

Gallbladder Disease in Type-2 Diabetes Mellitus Patients

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Diabetes mellitus is a modern epidemic which leads to various complications over a period of time. Autonomic neuropathy is one such complication which may lead on to gallbladder dysmotility and gallbladder stones.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives:&lt;/strong&gt; To determine the incidence of gallbladder disorders in patients of type 2 diabetes mellitus and to find out the incidence of autonomic dysfunction in type 2 diabetes mellitus and correlate it with presence of gall bladder disorders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and Methods:&lt;/strong&gt; The present study was conducted in 50 cases of type 2 diabetes mellitus and 25 healthy age and sex matched normal individuals were taken as controls. The cases as well as the controls underwent ultrasonographic examination for gall bladder volume, wall thickness, intraluminal mass and contraction in response to fatty meal. Data thus collected was compared and analysed statistically by using students ‘t’ test and chi- square test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Mean postprandial gallbladder volume was 20.56±8.87 cm&lt;sup&gt;3&lt;/sup&gt; in diabetics with ANP with gallstones, 26.16±1.24 cm&lt;sup&gt;3&lt;/sup&gt; in diabetics with ANP with dysmotility 13.0±6.26 cm&lt;sup&gt;3&lt;/sup&gt; in diabetics with gallstones without ANP, 12.14±4.88 cm&lt;sup&gt;3&lt;/sup&gt; in normal diabetics and 13.60±5.95 cm&lt;sup&gt;3&lt;/sup&gt; in controls. The percentage contraction post fatty meal was calculated from these values and found to be 24.73±14.64% in diabetics with ANP with dysmotility, 26.38±17 .04% in diabetics with ANP with dysmotility, 43.48±8.45% in diabetics with gallstones without ANP, 56.84±9.02% in normal diabetics and 57 .64±9.92% in controls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; Incidence of gallbladder disease is much higher in type 2 diabetics (40%) as compared to normal healthy adults (4%). It was concluded that diabetics with ANP had significantly impaired gallbladder emptying. Poor control of diabetes, hypercholesterolemia and diabetic autonomic neuropathy are important risk factors for the development of gallbladder disease.&lt;/p&gt;

Classical autonomic function tests in patients with type 2 diabetes mellitus and healthy volunteers: A comparative study

Background: The incidence of autonomic dysfunction has increased in the setting of type 2 diabetes mellitus and various tools have been developed for assessing it. Classical autonomic function tests are one among them. Objective: To compare the classical autonomic function tests in type 2 diabetes mellitus patients and healthy volunteers Materials and methods: The present study was conducted at PSG Institute of Medical Sciences and Research, Coimbatore, Tamilnadu on 30 type 2 diabetic patients (cases) and 30 healthy volunteers (controls). Average age of the diabetic patients was 48.53 ± 5.12 (Mean ± SD) and that of volunteers was 47.10 ±3.59 (Mean ± SD). After obtaining informed, written consent Cardio-respiratory parameters such as resting heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured after 10 minutes of supine rest and autonomic function parameters (AFT) such as heart rate and blood pressure response to handgrip, deep breathing difference test and Valsalvo ratio were recorded in them. Results: Statistical analysis done by using independent Students 't’ test, showed a statistically significant impairment in heart rate response to handgrip (P

Effects of Stress or Personality Types on Ocular Dryness, Dizziness, and Autonomic Nervous Dysfunction of Healthy Subjects in the Workplace

Objectives: Numerous epidemiologic studies have been published on the relation between coronary diseases and personalities associated with stress. However, few reports have been published about stress-related autonomic dysfunction in the fields of ophthalmology and otolaryngology. We investigated the relationship between autonomic nerve dysfunction and personality types. Methods: The study group was comprised of 336 bank employees who completed a questionnaire that assessed personality type, daily anxieties, methods of relaxation, and other autonomic symptoms. The subjects were divided into three groups based on the frequencies with which they experienced each symptom. The scores of each questionnaire item were compared among the groups. Results: The individuals who often complained of dry eye had higher scores related to the type A personality than those who did not complain of dry eye (p=0.0003). The individuals who often complained of vestibular dysfunction had higher scores related to the self-resistant type personality compared with those did not complain of those symptoms (p=0.004). Our results also showed correlations between the escape type personality and the frequency of gastrointestinal symptoms (p=0.007) and between the personality types associated with stress and the frequency of circulatory symptoms (type A personality, p=0.009; self-resistant type personality, p=0.003; escape type personality, p=0.01). The incidence of tinnitus was not related to personality type. Daily anxiety and methods of relaxation were not strongly correlated with the incidence of autonomic dysfunction. Conclusions: We identified a correlation between stress and autonomic dysfunction. These results suggest that personality type affects subjects’ symptoms of autonomic dysfunction more strongly than daily anxiety or methods of relaxation.

Gallbladder Disease in Type-2 Diabetes Mellitus Patients

Background: Diabetes mellitus is a modern epidemic which leads to various complications over a period of time. Autonomic neuropathy is one such complication which may lead on to gallbladder dysmotility and gallbladder stones. Objectives: To determine the incidence of gallbladder disorders in patients of type 2 diabetes mellitus and to find out the incidence of autonomic dysfunction in type 2 diabetes mellitus and correlate it with presence of gall bladder disorders. Material and Methods: The present study was conducted in 50 cases of type 2 diabetes mellitus and 25 healthy age and sex matched normal individuals were taken as controls. The cases as well as the controls underwent ultrasonographic examination for gall bladder volume, wall thickness, intraluminal mass and contraction in response to fatty meal. Data thus collected was compared and analysed statistically by using students ‘t’ test and chi- square test. Results: Mean postprandial gallbladder volume was 20.56±8.87 cm 3 in diabetics with ANP with gallstones, 26.16±1.24 cm 3 in diabetics with ANP with dysmotility 13.0±6.26 cm 3 in diabetics with gallstones without ANP, 12.14±4.88 cm 3 in normal diabetics and 13.60±5.95 cm 3 in controls. The percentage contraction post fatty meal was calculated from these values and found to be 24.73±14.64% in diabetics with ANP with dysmotility, 26.38±17 .04% in diabetics with ANP with dysmotility, 43.48±8.45% in diabetics with gallstones without ANP, 56.84±9.02% in normal diabetics and 57 .64±9.92% in controls. Conclusion: Incidence of gallbladder disease is much higher in type 2 diabetics (40%) as compared to normal healthy adults (4%). It was concluded that diabetics with ANP had significantly impaired gallbladder emptying. Poor control of diabetes, hypercholesterolemia and diabetic autonomic neuropathy are important risk factors for the development of gallbladder disease.

Heart rate variability and cardiac autonomic function in systemic lupus erythematosus.

The cardiac autonomic function was evaluated in 23 patients with Systemic Lupus Erythematosus (SLE) without clinical expression of dysautonomia and in 14 healthy volunteer subjects as a control group, by analysis of Heart Rate Variability (HRV) from 24h ambulatory electrocardiography. All the patients were taking corticosteroids and 10 of them also Ciclosporin A (CsA). The following parameters of HRV were performed: Time domain: standard deviation of the RR intervals average (SDNN) and percentage of RR adjacent intervals differing from each other more than 50 msec (pNN50). Frequency domain: low frequencies (LF) and high frequencies (HF). Significant lower values were detected in SLE patients vs controls: SDNN = 69.40 vs 127.72; pNN50 = 16.44 vs 25.95; LF = 8.34 vs 34.97; HF = 3.21 vs 12.18. The incidence of autonomic dysfunction in our SLE population evaluated by considering intervals of normality is approximately 78% for SDNN; 17% for pNN50; 91% for LF and, finally, 56% for HF. The analysis of HRV may be a valuable technique in the study of the incidence of dysautonomia for these patients.

Sympathetic skin response in patients with cerebellar degeneration.

Sudomotor function was studied based on sympathetic skin responses (SSRs) in 87 patients with various types of cerebellar degeneration. Evaluations of orthostatic hypotension and the R-R interval variation were also performed in these patients. The respective incidences of SSR abnormality and orthostatic hypotension were 44 (50.6%) of 87 and 39 (44.8%) of 87. Fourteen percent of the patients with abnormal SSRs did not have orthostatic hypotension, but 8% of the patients with normal SSRs did have orthostatic hypotension. Sympathetic skin responses were abnormal in most patients with Shy-Drager syndrome, sporadic olivopontocerebellar atrophy (OPCA), and striatonigral degeneration, whereas SSRs were normal in patients with familial OPCA, sporadic cerebellar atrophy, and familial cerebellar atrophy. We demonstrated that SSR can be used to evaluate sudomotor function in degenerative disorders of the central nervous system as well as in peripheral neuropathies. The vasomotor and sudomotor functions usually are both disturbed in patients with cerebellar degeneration, and the SSR can detect autonomic dysfunction as sensitively as does the head-up tilt test. We also concluded that sporadic OPCA differs from familial OPCA in that it has a much higher incidence of autonomic dysfunction and that degeneration of the cerebellar cortex did not affect the autonomic regulation.

Diabetic autonomic neuropathy

The incidence of autonomic dysfunction as a complication of diabetes mellitus is reported to be as high as 20% to 40%. Symptoms of diabetic autonomic neuropathy (DAN) are often vague, and signs difficult to detect on routine physical examination. The early diagnosis of DAN is possible by utilizing several simple noninvasive tests, which may also be helpful in localizing the lesion(s) to specific autonomic pathways. DAN may affect multiple organ systems, to include cardiovascular, gastrointestinal, genitourinary and/or neuroendocrine, and may, in fact, be life-threatening. The same metabolic disturbances of somatic peripheral nerve may also be responsible for DAN. Like somatosensory neuropathy, definitive therapy for DAN is not yet satisfactory, although multiple chemotherapeutic agents have been tried and warrant further investigation.