Incidence Of Presyncope Research Articles

Effects observation of colposcopic cervical biopsy in the company of nurses

Objective To investigate the effects of nurse companion on reducing complications of colposcopic cervical biopsy and improving satisfaction. Methods 724 patients who had cervical biopsy by colposcopy during August of 2014 in Maternal and Child Health Care Hospital of Wuxi were collected as control group, and another 932 cases in August of 2015 were sampled as observation group. Same doctor conducted the biopsy for all the patients in two groups. Each patient in observation group were accompanied by one nurse during the procedure. Results There were significant differences between the two groups on the incidence of pre-syncope, syncope, vaginal bleeding and patients′ satisfaction (P<0.05). Conclusions Nurse companion can reduce the incidence of pre-syncope, syncope, vaginal bleeding greatly during colposcopic cervical biopsy and improve patients′ satisfaction. Key words: Colposcopy; Cervical biopsy; Company of nurses

Menstrual cycle phase does not affect sympathetic neural activity in women with postural orthostatic tachycardia syndrome.

Women with the postural orthostatic tachycardia syndrome (POTS) report fluctuations in orthostatic tolerance throughout the menstrual cycle. The mechanism(s) underlying blood pressure control across the menstrual cycle in women with POTS are unknown. The findings of the present study indicate that the menstrual cycle does not affect muscle sympathetic nerve activity but modulates blood pressure and vasoconstriction in POTS women during orthostatic stress. Factors other than sympathetic neural activity are likely responsible for the symptoms of orthostatic intolerance across the menstrual cycle in women with POTS. Patients with the postural orthostatic tachycardia syndrome (POTS) are primarily premenopausal women, which may be attributed to female sex hormones. We tested the hypothesis that hormonal fluctuations of the menstrual cycle alter sympathetic neural activity and orthostatic tolerance in POTS women. Ten POTS women were studied during the early follicular (EF) and mid-luteal (ML) phases of the menstrual cycle. Haemodynamics and muscle sympathetic nerve activity (MSNA) were measured when supine, during 60deg upright tilt for 45min or until presyncope, and during the cold pressor test (CPT) and Valsalva manoeuvres. Blood pressure and total peripheral resistance were higher during rest and tilting in the ML than EF phase; however, heart rate, stroke volume and cardiac output were similar between phases. There were no mean±SD differences in MSNA burst frequency (8±8 EF phase vs. 10±10burstsmin(-1) ML phase at rest; 34±15EF phase vs. 36±16burstsmin(-1) ML phase at 5min tilt), burst incidence or total activity, nor any differences in the cardiovagal and sympathetic baroreflex sensitivities between phases under any condition. The incidence of presyncope was also the same between phases. There were no differences in haemodynamic or sympathetic responses to CPT or Valsalva. These results suggest that the menstrual cycle does not affect sympathetic neural activity but modulates blood pressure and vasoconstriction in POTS women during tilting. Thus, factors other than sympathetic neural activity are probably responsible for the symptoms of orthostatic intolerance across the menstrual cycle in women with POTS.

Compression Garments as Countermeasures to Orthostatic Intolerance

All astronauts experience some degree of orthostatic intolerance following spaceflight, ranging from tachycardia to orthostatic hypotension and syncope. The purpose of this study was to evaluate the ability of two compression garments, the National Aeronautics and Space Administration's inflatable antigravity suit (AGS) and the Russian Federal Space Agency's non-inflatable compression garment (Kentavr), to prevent hypovolemia-related orthostatic intolerance. To mimic the plasma volume loss experienced by astronauts during spaceflight 19 healthy subjects received an intravenous dose of a diuretic, furosemide (0.5 mg x kg(-1)), and then consumed a low-salt diet for 36 h. Thereafter, subjects participated in a 15-min 80 degrees head-up tilt test wearing either the AGS (N = 9) or Kentavr (N = 10). Compression garments were used in the fashion recommended by the respective agencies, delivering approximately 78 mmHg and approximately 30 mmHg of compression in the AGS and Kentavr, respectively. Incidence of presyncope and hemodynamic responses during upright tilt were compared to a separate group of hypovolemic control subjects (N = 16). Subjects wearing the AGS or Kentavr completed the full 15 min of upright tilt without incidence of orthostatic hypotension or presyncope. In contrast, only 9 control subjects (56%) were able to complete the tilt test. In addition, both types of compression garments maintained systolic blood pressure and significantly reduced tilt-induced tachycardia and reductions in stroke volume. Although both garments successfully countered hypovolemia-induced orthostatic intolerance, the Kentavr provided protection by using lower levels of compression. Determining the optimal compression level required for protection of intolerance may improve crewmember comfort and decrease restrictions on physical activities after spaceflight.