Vasomotor Research Articles

Nonallergic Rhinopathy: A Comprehensive Review of Classification, Diagnosis, and Treatment

Chronic nonallergic rhinitis syndromes encompass various conditions, of which vasomotor rhinitis is the most common form, representing approximately 80% of patients, also referred to as nonallergic rhinopathy (NAR), nasal hyperreactivity, neurogenic rhinitis, or idiopathic rhinitis. Expert panels have recommended replacing vasomotor rhinitis terminology because it is more descriptive of this condition that is characterized by symptoms triggered by chemical irritants and weather changes through chemosensors, mechanosensors, thermosensors, and/or osmosensors activated through different transient receptor potential calcium ion channels. Elucidating the specific role of transient receptor potential vanilloid 1, triggered by capsaicin, has been an important advancement in better understanding the pathophysiology of NAR because it has now been shown that downregulation of transient receptor potential vanilloid 1 receptors by several therapeutic compounds provides symptomatic relief for this condition. The classification of NAR is further complicated by its association with allergic rhinitis referred to as mixed rhinitis, which involves both immunoglobulin E-mediated and neurogenic mechanistic pathways. Comorbidities associated with NAR, including rhinosinusitis, headaches, asthma, chronic cough, and sleep disturbances, underscore the need for comprehensive management. Treatment options for NAR include environmental interventions, pharmacotherapy, and in refractory cases, surgical options, emphasizing the need for a tailored approach for each patient. Thus, it is extremely important to accurately diagnose NAR because inappropriate therapies lead to poor clinical outcomes and unnecessary health care and economic burdens for these patients. This review provides a comprehensive overview of NAR subtypes, focusing on classification, diagnosis, and treatment approaches for NAR.

Актуальні аспекти взаємозв’язків між судиноруховою функцією ендотелію та артеріальним тиском В осіб з початковими проявами хронічної ішемії мозку

Вступ. Одним із найбільш агресивних судинних факторів ризику розвитку хронічної й гострої ішемії мозку є артеріальна гіпертензія (АГ), що тривалий час має асимптомний перебіг. Виявлення ознак ушкодження судинної системи під впливом судинних факторів ризику у вигляді ендотеліальної дисфункції (ЕД) на ранніх етапах розвитку патологічного процесу дає підставу для більш ретельного скринінгу ризиків та активних профілактичних заходів. Нами було проведено дослідження, метою якого стала оцінка судинорухової функції ендотелію при початкових проявах хронічної ішемії мозку відповідно до наявності, ступеня та стадії АГ. Матеріали й методи. Нами було обстежено 306 осіб з початковими проявами хронічної ішемії мозку — із судинними факторами ризику, відповідними клінічними проявами та нейровізуалізаційними ознаками ураження головного мозку легкого ступеня. Групу контролю становили 15 осіб без анамнестичних, клінічних, інструментальних та лабораторних ознак судинних та інших тяжких соматичних захворювань. Усім пацієнтам проводилися загальноклінічні, клініко-неврологічні, клініко-інструментальні та клініко-лабораторні обстеження. З метою оцінки судинорухової функції ендотелію проводилася компресійна проба на потокозалежну вазодилатацію (ПЗВД), а також визначалися рівні ендотеліну‑1 та нітриту (стабільного метаболіту NO) у сироватці крові пацієнтів. Результати та їх обговорення. Аналіз зв’язків між показниками судинорухової функції ендотелію в контрольній групі показав наявність значущих (р = 0,000) зв’язків між ними: між ЕТ‑1 і відсотком ПЗВД (обернений зв’язок, r = –0,74); нітритом і відсотком ПЗВД (прямий, r = 0,63); нітритом і ЕТ‑1 (обернений, r = –0,865).Тоді як зв’язок (за коефіцієнтом Спірмена) між наведеними показниками в основній клінічній групі був менш тісним, а саме: між відсотком ПЗВД і ЕТ‑1 — r = –0,278 (р = 0,002), відсотком ПЗВД і нітритом — r = 0,316 (р = 0,000), ЕТ‑1 і нітритом — r = –0,367 (р = 0,000), що оцінюється як слабка кореляція. У 202/306 (66,0 %) обстежених пацієнтів була виявлена АГ. У 124/202 (61,4 %) хворих визначалася АГ І ступеня (АТ = 140–159/90–99 мм рт.ст.), у 78/194 (38,6 %) пацієнтів — АГ ІІ ступеня (АТ = 160–179/100–109 мм рт.ст.). Пацієнти з АГ ІІІ ступеня у дослідження не включалися. У 86/202 (42,6 %) пацієнтів була виявлена І стадія АГ та у 116/202 (57,4 %) хворих — ІІ стадія АГ. Порівняння пацієнтів з початковими проявами хронічного інфаркту міокрада і з різними ступенями та стадіями АГ за показниками судинорухової функції ендотелію, а саме біохімічними показники та відсотком ПЗВД, показало, що групи невипадково відрізнялися між собою за деякими показниками, але для уточнення, за якими саме, проводилося попарне порівняння груп за допомогою критерію Манна — Уїтні. Виснов­ки. Виявлено, що початкові прояви хронічної ішемії мозку розвивалися на тлі порушення взаємозв’язків між протилежно направленими чинниками, що вивільняються з ендотеліоцитів. Було встановлено, що підвищення рівня ЕТ‑1 мало значення для ініціації АГ в осіб з початковими проявами хронічної ішемії мозку та відігравало значущу роль у субклінічному ураженні органів-мішеней на тлі АГ порівняно з особами без АГ та з початковими проявами хронічної ішемії мозку. Тоді як рівень нітриту та відсоток ПЗВД значущо знижувалися в міру підвищення ступеня АГ, особливо у пацієнтів з субклінічним ураженням органів-мішеней, порівняно з особами без АГ та субклінічного ураження органів-мішеней на тлі АГ.

Florid Autonomic Features Associated with Medullary Lacunar Stroke

Introduction: Autonomic nuclei affection results in variations in hemodynamics, temperature, sweating and ECG. Medullary strokes are challenging in their presentation, bizarre clinical signs, work and neurological outcome. The commonest cause is infarction of the posterior inferior cerebellar artery (PICA). Anatomical areas affected include the inferior cerebellar peduncle, dorsolateral medulla, nuclei of the Trigeminal, vestibular nuclei, Ninth and Vagus nerves. The descending sympathetic tracts and spin thalamic tracts. Serious cardiopulmonary events can complicate 11% of cases. Case Presentation: A middle-aged female developed sub-acute dizziness associated with vomiting and right head pains. She was unable to walk but remained cognitively clear. Her gastrointestinal symptoms were disabling and this was the main factor for presenting to the emergency room. The risk factors included hypertension and diabetes mellitus. Imaging studies were essential for posterior circulation stroke diagnosis and follow-up. She manifested remarkable autonomic features regarding the skin and hemodynamics. Nevertheless, the hospital course was controllable. Discussion: This case report was consistent with relevant literature in the contra lateral vaso motor changes and drop in body temperature during the acute phase. Moreover, our patient developed clinical and radiological extension through double antiplatelets. Superiority of the magnetic resonance imaging (MRI) scans in this patient enabled better diagnostic accuracy in a brainstem stroke. Conclusion: The autonomic features, in this case, represent major symptomatology and clinical signs. The variation in the hemodynamics and persistence of symptoms is thought provoking. This increases the awareness of emergency doctors for acute stroke presenting with autonomic features will enable early detection and helps outcome.

Modified impression technique for extreme mouth-opening limitation caused by systemic scleroderma.

Systemic scleroderma is a relatively rare, autoimmune, chronic, and debilitating disease, and its etiology is unknown. The disease is characterized by vasomotor disturbances causing skin and mucosa hardening, hand stiffness, excess production of collagen fibers, and impairment of the internal organs associated with the immune system. Extreme mouth-opening limitation is one of the symptoms in the oral cavity, and compromises dental intervention. One of the fundamental steps when performing a dental procedure is dental arch impression. In the presented clinical case, limited mouth opening hindered the impression accuracy. The objective was to present an alternative impression technique for a patient affected by scleroderma, with limited mouth opening and the need for oral rehabilitation with a removable partial prosthesis in the maxillary arch. An individualized tray was developed with design characteristics that allowed access to the oral cavity and removal, after which it was possible to perform the oral impression, reproducing the areas of interest without causing injury to the oral tissues. The orientation plan was elaborated after obtaining the cast. The teeth were assembled, tested in the mouth, and sent to the laboratory for acrylization. The prosthesis was placed once ready. The alternative impression technique enabled oral rehabilitation of the patient despite the mouth-opening limitation, and provided an accurate impression and a good prosthetic result.

Influencia de un programa de psicoprofilaxis del climaterio en la sintomatología climatérica de mujeres atendidas en un hospital de Huaraz, 2016

Objetivo: Evaluar la influencia de la aplicación de un programa de psicoprofilaxis del climaterio en la intensidad de la sintomatología de mujeres climatéricas atendidas en el Hospital “Nuestra Señora de las Mercedes” de Carhuaz, en Huaraz, durante el año 2016. Material y métodos: Se realizó un estudio cuasi experimental, en una muestra total de 30 mujeres donde el grupo experimental y el control presentaron igual proporción. Se implementaron 5 sesiones de psicoprofilaxis del climaterio dictado por los obstetras. Se utilizó el cuestionario de la escala cubana para clasificar la intensidad de la sintomatología del climaterio. La información se procesó mediante el programa SPSS, utilizándose para el análisis la prueba de diferencia de proporciones y el chi cuadrado de Stuart-Maxwell. Resultados: Luego de la intervención se evidenció un aumento en el número de mujeres asintomáticas con respecto a los síntomas vasomotores (33,4%), psicológicos (40%), genitourinarios (36,7%), generales (40%) y clínicos (36,7%); encontrando que el programa propuesto influyó significativamente (p<0.05) en la reducción de la sintomatología en todas las dimensiones estudiadas. Conclusiones: Se concluyó que la aplicación del programa de psicoprofilaxis del climaterio influye significativamente en la reducción de la intensidad de la sintomatología de mujeres climatéricas en el Hospital “Nuestra Señora de las Mercedes” de Carhuaz.

A utilização de fitoterápicos no manejo de mulheres no climatério/menopausa

O objetivo do presente estudo foi analisar os efeitos da utilização de fitoterápicos por mulheres saudáveis sobre os sinais e sintomas do climatério e menopausa. Trata-se de uma revisão integrativa, cuja operacionalização possibilita a síntese do conhecimento já produzido no período de janeiro de 2015 a dezembro de 2019, a coleta de dados foi realizada por meio das seguintes bibliotecas virtuais: SciELO e BVS com acesso através das bases de dados BDENF, LILACS e MEDLINE via Pubmed. Foram analisados 24 artigos que demonstraram que os fitoterápicos são efetivos para a redução dos sinais e sintomas vasomotores, neuropsíquicos, disfunção sexual, alterações urogenitais e distúrbios metabólicos decorrentes da menopausa. Dentre os fitoterápicos mais utilizados observou-se as isoflavonas de soja, foeniculum vulgare, trigonella foenum-graecum e o tribulus terrestris. Os fitoterápicos abordados apresentaram resultados significativos para as queixas climatéricas manifestadas em mulheres saudáveis, podendo desta forma ser uma boa alternativa terapêutica para o seu tratamento específico.

Selective Neurokinin 3 Receptor Antagonist May Relieve Menopausal Vasomotor Symptoms

Although vasomotor symptoms (VMS) occur in as many as 80% of postmenopausal women, the only approved agents — estrogen and paroxetine — cannot or will

Estrogen-Progestin Therapy Elevates Risk for Breast Cancer — Should This Influence Clinical Practice?

Hormone therapy (HT) is the most effective treatment for bothersome menopausal vasomotor symptoms. However, after initial publication of findings from

Further Reassurance That Vaginal Estrogen Use Is Safe

Unlike vasomotor symptoms, genitourinary syndrome of menopause (GSM) tends to progress if not treated. Although vaginal estrogen (VE) is effective for

Effect of foot reflexology adjunct to paced respiration on vasomotor symptoms during menopause: randomized-controlled trail

Background The most common vasomotor symptoms (VMS) are hot flashes and night sweats, which occur in as many as 68.5% of women as a result of menopause. Symptoms caused by fluctuating levels of estrogen may be alleviated by hormone therapy (HT), but a marked global decline in its use has resulted from concerns about the risks and benefits of HT. Consequently, many women in the postmenopausal period search for alternative natural treatment options to manage menopause. As large numbers of women are choosing not to take HT, it is increasingly important to identify evidence-based foot reflexology with paced respiration that has the potential to reduce vasomotor menopausal symptoms. Aim To examine the combined effect of foot reflexology with paced respiration versus paced respiration on VMS in symptomatic menopausal women. Patients and methods A total of 50 women of menopausal age, 45–55 years were studied; their BMI was less than 30 kg/m2. They were allocated randomly to two groups with equal numbers of participants (A and B). The participants in group A received foot reflexology in addition to paced respiration, whereas the participants in group B received the paced respiration training only. The treatment program was conducted three times per week for 8 weeks. Assessment of all participants in both groups (A and B) was carried out before and after the treatment program throughout by determining blood cortisol level in addition to the use of the menopause rating scale (MRS). Results Both groups (A and B) showed a significant reduction in their blood cortisol and MRS values after the end of the 8 weeks of the training program. The mean values of blood cortisol after treatment were 15.40±1.47, 16.32±1.70 in both groups A and B, respectively. The mean values of total MRS were 8.12±2.19, 12.56±2.96 in both groups A and B, respectively. However, the participants who received foot reflexology plus paced respiration, group A, showed a greater reduction in the blood cortisol value and total MRS (P Conclusion It could be concluded that foot reflexology in addition to paced respiration are more effective than paced respiration only in decreasing blood cortisol level as well as VMS in symptomatic menopausal women.

Changes in the vasoactive effects of nitric oxide, hydrogen sulfide and the structure of the rat thoracic aorta: the role of age and essential hypertension.

Several studies have already confirmed the specific vasomotor effect of hydrogen sulfide (H2S) and its interaction with the nitric oxide (NO) system in normotensive rats, but results in spontaneously hypertensive rats (SHRs) are limited. the aim of this study was to describe the age- and blood pressure-dependent effects of endogenous NO and exogenous Na2S and their interaction in vasomotor responses of the thoracic aorta (TA) in normotensive Wistar rats and SHRs. the systolic blood pressure (sBP), vasoactivity, NO-synthase (NOS) expression and activity, cystathionine gamma-lyase (CSE) expression, and geometry of the isolated TA were evaluated at 4 and 16 weeks of age. Although hypertrophy of the heart was observed in young and adult SHRs, the sBP was increased only in adulthood. the contractile responses were decreased in young as in adult SHRs with the key participation of the endogenous NO system. however, the hypotrophy in the young and the hypertrophy (mainly at the expense of extracellular matrix) in the adult SHRs were found in the TA. While unchanged in young SHRs, in adult SHRs, partially impaired endothelial function was confirmed. Nevertheless, the NO-dependent component of acetylcholine-induced relaxation was higher in both young and adult SHRs. Consistently, even though there was an age-dependent decrease in NOS activity in both strains, NOS activity was higher in both young and adult SHRs compared to age-matched normotensive rats. Application of exogenous Na2S evoked a concentration-dependent dual vasoactive effect of TAs in both strains, regardless of age. Increased sensitivity in favor of vasorelaxant responses of Na2S in prehypertensive SHRs, and an enhanced maximal vasorelaxation in adult SHR was observed. the acute NO inhibition generally increased the relaxant phase of Na2S responses; nevertheless, the development of hypertension potentiated this effect. the TA of the SHRs is endowed with a unique inherent predisposition of vasoactive mechanisms, which serve as compensatory processes during the developed stage of hypertension: the NO component and H2S signaling pathways are implicated. the decreased contractility seems to be a deleterious effect. the increased participation of the H2S system on vasorelaxation after acute NO inhibition could be considered a reserved mechanism in case of endogenous NO deficiency.

The Real-World Treatment of Polycythemia Vera: Adherence to Treatment Guidelines and Outcomes

Background The aim of therapy for polycythemia vera (PV), a myeloproliferative neoplasm, is to reduce cardiovascular risk without increasing the risk of bleeding or hematological transformation. Current consensus guidelines suggest low dose aspirin and phlebotomy for patients at low-risk for thrombosis ( Methods We performed a retrospective cohort study of newly diagnosed JAK2V617F positive PV patients over the age of 18 between January 1, 2005 and January 1, 2017 in Hamilton, Ontario, Canada. The primary outcome was all-cause mortality. Secondary outcomes were non-fatal cardiovascular events, major bleeding, and hematological progression. Statistical analysis was performed in STATA using Cox proportional hazard models, and Poisson regression. Results A total of 112 patients (58.0% female) met inclusion criteria. The mean (SD) age at diagnosis was 70 (14) years. Median follow-up was 3.38 years (Range = 0.04-11.89). At diagnosis, 82.1% of patients were classified as high risk for thrombosis. At diagnosis cardiovascular risk factors were present in 69.6% of patients including previous thrombotic events in 27.5%. Symptoms of PV (e.g. pruritus, vasomotor, fatigue) were found in 52.7% of patients at diagnosis. Patients received treatment with phlebotomy (90.2%), aspirin (87.5%), and hydroxyurea (74.1%). Monotherapy was used in 6 (24%) of the non-guideline patients and was not found in the guideline group. Anticoagulants were used in 17.2% of patients. Overall, only 77.7% of patients received treatment that was consistent with guidelines regarding aspirin and hydroxyurea use. A total of 22 (19.6%) of patients died during follow-up; increasing white blood cell count at diagnosis, increasing age at diagnosis, history of diabetes and history of congestive heart failure were associated with higher risk of death (Table 1). Patients who were not treated according to the guideline recommendations at any point during follow-up had an increased risk of death (HR, 2.88; 95% CI, 1.03-8.05; P Conclusion This contemporary North American PV patient cohort study showed that the majority of newly diagnosed PV patients were older adults at high risk of thrombosis consistent with previous studies. The presence of cardiovascular comorbidities at diagnosis appeared to increase the risk of death. About three-quarters of patients in our cohort received treatment according to consensus guideline recommendations. Although the reasons for discordance with guidelines are uncertain, those who did not receive recommended therapy appeared to have an increased risk of death. The results of this study should be interpreted with caution due to the possibility of confounding by other factors that influence mortality. Future research regarding the barriers and facilitators of PV treatment guideline use, and the optimal strategy for assessment and management of cardiovascular risk factors may provide opportunities to improve care and patient outcomes. Disclosures Siegal: Novartis: Other: Focus Group; Bayer: Other: Focus group; BMS-pfizer: Other: Presentation; Servier: Other: Focus Group; Portola Pharmaceuticals: Other: Presentation. Hillis: Celgene: Other: Personal fees; Novartis Oncology: Research Funding; Bristol-Myers Squibb: Other: Personal Fees.

August 2016 - This Month in JoVE: Sampling in Suspension Feeders, Staining Three-Dimensional Skin, Spasms in the Heart Vasculature, and Emotional Reponses to Beverages

Here's a look at what's coming up in the August 2016 issue of JoVE: The Journal of Visualized Experiments. In JoVE Environment, we take a look at aquatic organisms that feed on particles floating in the water around them, aptly named suspension feeders. Most studies involving these animals require their housing in laboratory settings, which can disrupt behavior. So Morganti et al.present a method to build an apparatus-modified for scuba diving-that can be used to collect water inhaled or exhaled by suspension feeders in their natural environments. Samples gathered with this method can then be analyzed, helping us better understand the roles these organisms play within their ecosystems, for example in nutrient cycling. Researchers are also exploring the roles different cells perform in their environments-such as the organs they might help comprise. As a result, tissue samples are being processed in new ways that maintain their three-dimensional structure. This month, JoVE Biology highlights one such staining protocol developed by Liang et al., which allows for the visualization of proteins within individual cells present in full-thickness mouse skin. Due to its use of whole mount samples, this effective procedure can help elucidate interactions between the different layers of this important regenerative organ, including those that may contribute to skin cancer. Disease diagnosis can rely on analyses of protein expression, as well as direct observations of a patient and their physiological responses. For example, angina-or chest pain-is a topic of interest in JoVE Medicine, and may be a symptom of vasomotor disorders, which include spasms of the vasculature supplying blood to the heart. Here, Ong et al. describe a method to diagnose such disorders that relies on the sequential administration of increasing concentrations of a neurotransmitter, assessing a patient's electrocardiograms, and looking for any constrictions in the coronary arteries. This method provides a convenient protocol that can be implemented in clinical settings, with limited risk to a patient. Finally, we switch gears in JoVE Behavior, where an analysis of individuals' emotional responses to different types of beverages is featured. How a person reacts to a drink can be distinguished-in part-by facial muscle movements, which can be recorded using video. In this study, Crist et al.present a standardized protocol to collect such data, and interpret it using Automated Facial Expression Analysis software. Importantly, this method can be extended to other applications, like interpreting how an individual responds to product packaging. You've just had a sneak peek of the Aug 2016 issue of JoVE. Visit the website to see the full-length articles, plus many more, in JoVE: The Journal of Visualized Experiments.

New onset vasomotor symptoms but not musculoskeletal symptoms associate with clinical outcomes on extended adjuvant letrozole – Analyses from NCIC CTG MA.17

PurposeNew onset symptoms on adjuvant aromatase inhibitors for hormone receptor positive early breast cancer may associate with clinical outcomes. We performed this exploratory analysis of the association of new onset musculoskeletal (MSK) and vasomotor (VM) symptoms with clinical outcomes in the NCIC CTG MA.17 trial 5 years of extended adjuvant endocrine therapy with letrozole after tamoxifen. MethodsSymptoms were collected at baseline, 1, 6, and every 12 months on study. Multivariate Cox Models adjusting for age, nodal status, duration of tamoxifen and prior chemotherapy were used to compare disease-free survival (DFS), distant disease-free survival (DDFS), and overall survival (OS) based on data collected before, and after, the unblinding between women with VM or MSK symptoms and those without. ResultsData post-unblinding showed new VM symptoms on extended letrozole significantly improved DFS and DDFS when occurring 1 month (DFS HR 0.52, 95% CI, 0.28–0.96; p = 0.04; DDFS HR 0.49, 95% CI, 0.24–0.99; p = 0.046) and 6 months (DFS HR 0.43, 95% CI, 0.24–0.78; p = 0.006; DDFS HR 0.44, 95% CI, 0.22–0.85; p = 0.02) after treatment initiation. Those with new VM symptoms at 12 months also had a significantly better DFS (HR 0.47, 95% CI 0.26, 0.84; P = 0.01) and a trend in improved DDFS. Only a trend to improved OS was found for those with VM symptoms 6 month after treatment. No significant improvement was found for those with new MSK symptoms at any time point or for any endpoint. ConclusionsNew onset VM symptoms with extended letrozole may be useful in predicting treatment benefit.

Sympathetic Vasomotor Activation To Different Targets In A Model Of Hypertension Induced By Nitric Oxide Synthase Blockade

High blood pressure is a global public health problem. Several factors are involved in the generation and maintenance of hypertension, such as increased sympathetic nerve activity (SNA), although controversies have been reported. Our aims were to evaluate sympathetic activation to two targets, the kidneys (rSNA) and other visceral bed, the splanchnic (sSNA), in animals with hypertension induced by nitric oxide synthase blockade (L‐NAME). Wistar rats were treated with L‐NAME (20mg/kg/day, once a day, for 8 days). L‐NAME‐treated group presented increased blood pressure (154±13 mmHg, N=16), compared with control group (102±2 mmHg, N= 10). Both rSNA (156±37.4 spikes/s, N=16) and sSNA (145±42.7 spike/s, N=16) were higher in L‐NAME‐treated group, compared with control group (111±20.6, N=10 and 63±20.6 spikes/s, N=10, respectively). Taken altogether, our data show that the hypertension induced by nitric oxide synthase blockade is characterized by sympathoexcitation to more than one bed and that can be involved in the generation and/or maintenance of high blood pressure.Support or Funding InformationCAPES, CNPq, Universidad Nacional de Honduras (UNAH).

Effects of SIRT3 deficiency on vasomotor function and atherosclerotic plaque composition in mice

Excess mitochondrial reactive oxygen species can drive endothelial dysfunction and vascular calcification in atherosclerosis. Recently, SIRT3 has been linked to the activity of the ROS‐degrading enzyme MnSOD through regulation of protein acetylation levels. It remains unclear, however, whether SIRT3 protects against endothelial dysfunction and osteogenic signaling in hypercholesterolemia. We hypothesized, that reduction of SIRT3 will impair endothelial function, decrease mitochondrial antioxidant capacity, and increase osteogenic signaling in hypercholesterolemic mice. We used Ldlr−/−/ApoB100/100 (LA) mice that were either wild‐type (LA‐SIRT3+/+) or null for SIRT3 (LA‐SIRT3−/−). After 12 months of western diet feeding, we assessed endothelial function in aorta using isolated organ chamber baths and measured changes in gene expression using qRT‐PCR. As expected, SIRT3 gene expression was significantly reduced in LA‐SIRT3+/− mice compared to LA‐SIRT3+/+ mice, and undetectable in LA‐SIRT3−/−. Surprisingly, endothelial‐dependent relaxation to acetylcholine (MRAch) was unchanged between LA‐SIRT3+/+ and LA‐SIRT3−/− (37.0±4.4%, 38.2±4.4%). Endothelial‐independent relaxation (sodium nitroprusside) was also unchanged. MnSOD expression was reduced in LA‐SIRT3−/− compared to LA‐SIRT3+/+ (0.80 ± 0.02 vs 1.0±0.08, p < 0.05). In contrast, the late‐stage osteoblast marker, osterix, tended to increase in LA‐SIRT3−/− (1.3 fold) but failed to reach statistical significance. Collectively, these results suggest that losses of SIRT3 do not impact endothelial function in advanced atherosclerosis, but may contribute to augmentation of osteogenic signaling and accelerated progression of vascular calcification.Support or Funding InformationNHLBI

Hormone Therapy for Relieving Postmenopausal Vasomotor Symptoms: A Systematic Review.

Menopause is a critical phenomenon in women's life. After cardiac diseases, menopause is the second major cause of living with a disability in 45-60 year old women. The majority of women will experience bothersome vasomotor symptoms (VMS). Menopausal hormone therapy (MHT) is the most effective treatment for these symptoms. The objective of this review is to focus on hormone therapy for relieving postmenopausal vasomotor symptoms. For this systematic review, we primarily explored 125 papers published about hormone therapy for VMS from 2001 to 2015 by searching with combinations of the keywords in various databases. Among those, 59 papers met the initial search criteria and among them, 9 papers were potentially retrievable and reviewed. All included studies used estrogen formulations in the management of VMS. Nine studies met all inclusion criteria. All studies assessed the effects of hormone replacement therapy on VSM. The results showed that low-dose oral and transdermal estrogen in all dose ranges were more likely than placebo to decrease the frequency of VMS. Indeed, the nanostructured formulation was safe and effective in relieving the symptoms of menopause. The mean daily decrease in the number of hot flashes from baseline was found in the studies. MHT has a complex pattern. Understanding the natural history of VMS, and the risks and benefits of both hormonal therapies, helps to individualize management plans. Low-dose estrogen-based therapies can be the most effective regimens to relieve VMS. These medications can be used by different administration routes and formulations.

Antidepressants Do Not Impair the Anticancer Effects of Tamoxifen

Antidepressants are commonly used for depression and vasomotor symptoms in breast cancer patients treated with tamoxifen. However, many antidepressants

The analysis of cardio-respiratory signals and cerebral autoregulation based on CO2 reactivity with healthy subjects and Parkinson's patients.

Current paper focus on Parkinson's patients with autonomic dysfunction and how their interactions between cerebral autoregulation and ventilatory control are affected. The experimental data of dynamic CA assessment from the ANS Laboratory of CCGH was accessed for further processing and analysis. The subjects were classified into the groups of healthy and with Parkinson's disease. Based on the accessed ventilation and CBF data, the percentage changes in ventilation and CBF responses to PETCO2 were examined. To minimize effects of changes in ABP on cerebral vasomotor reactivity (CVMR) estimation, cerebrovascular conductance index (CVCi) was calculated, and CBFV-PETCO2 and CVCi-PETCO2 relationships were quantified by nonlinear logistic regression. The interaction between ventilation responses and CBF autoregulation will be modeled and parameters will be validated.

And the Heat Goes On

Up to 80% of women experience vasomotor symptoms (VMS) during the menopause transition (MT). Traditional wisdom is that the symptoms resolve after a few years, although at least one study found them to be longer lasting (NEJM JW Womens Health Jun 2011 and Obstet Gynecol 2011; 117:1095). Now, findings from the Study of Women's Health Across the Nation (SWAN), …