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Infusion Tests (infusion + test)

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Medical Sciences	100%

Selected Abstracts

Mood states, sympathetic activity, and in vivo ,-adrenergic receptor function in a normal population

DEPRESSION AND ANXIETY, Issue 7 2008
Bum-Hee Yu M.D. Ph.D.
Abstract The purpose of this study was to examine the relationship between mood states and ,-adrenergic receptor function in a normal population. We also examined if sympathetic nervous system activity is related to mood states or ,-adrenergic receptor function. Sixty-two participants aged 25,50 years were enrolled in this study. Mood states were assessed using the Profile of Mood States (POMS). ,-adrenergic receptor function was determined using the chronotropic 25 dose isoproterenol infusion test. Level of sympathetic nervous system activity was estimated from 24-hr urine norepinephrine excretion. Higher tension-anxiety, depression-dejection, and anger-hostility were related to decreased ,-adrenergic receptor sensitivity (i.e., higher chronotropic 25 dose values), but tension-anxiety was the only remaining independent predictor of ,-adrenergic receptor function after controlling for age, gender, ethnicity, and body mass index (BMI). Urinary norepinephrine excretion was unrelated to either mood states or ,-adrenergic receptor function. These findings replicate previous reports that anxiety is related to decreased (i.e., desensitized) ,-adrenergic receptor sensitivity, even after controlling for age, gender, ethnicity, and body mass index. Depression and Anxiety 0:1,6, 2007. © 2007 Wiley-Liss, Inc. [source]

Fluid control in elderly patients with nocturia

INTERNATIONAL JOURNAL OF UROLOGY, Issue 3 2009
Osamu Natsume
Objectives: To investigate the pathophysiology of nocturnal polyuria associated with aging. Methods: Fifty patients (mean age 67.7 years, range 50,87) with nocturia were recruited for this prospective study. Patients were classified into nocturnal polyuria (NP) and non-nocturnal polyuria (non-NP) groups based on records of their frequency-volume charts. A hypertonic saline infusion test was carried out to evaluate individual osmotic and volume control. Results: In the NP group, there was a significantly increased nocturnal diuretic rate compared with the daytime diuretic rate. In the non-NP group, there was a significantly decreased nocturnal diuretic rate compared with the daytime rate. There was also a positive correlation between systolic blood pressure and nocturnal diuretic rate, and a negative correlation between systolic blood pressure and daytime diuretic rate in those with NP, but no correlation in those without NP. Thus, a close relationship between diuretic rates and systolic blood pressure was seen in NP patients. Moreover, a slight overall shift upward from the physiological range of plasma osmolality relative to arginine vasopressin after hypertonic saline loading was seen in those with NP compared with those without. An altered circadian rhythm was also seen in diurnal plasma arginine vasopressin levels in patients with and without NP. Conclusions: Patients with nocturnal polyuria are likely to have a more hypervolemic or vasoconstrictive condition. It is considered that non-osmotic control takes on a greater meaning in patients with nocturnal polyuria, though osmotic control contributes less to diuresis within the physiological plasma osmolality range with aging. [source]

Assessment of idiopathic normal pressure patients in neurological practice: the role of lumbar infusion testing for referral of patients to neurosurgery

EUROPEAN JOURNAL OF NEUROLOGY, Issue 6 2008
A. Brean
Background and purpose:, In neurological practice patients with tentative idiopathic normal pressure hydrocephalus (iNPH) usually are referred to neurosurgery based on clinical and radiological findings. Hydrodynamic assessment using lumbar infusion testing might be helpful in selecting patients. To retrospectively analyse lumbar infusion tests done in neurological practice in iNPH patients to see how infusion test results relate to the clinical course and shunt response. Materials and methods:, Sixty-three consecutive patients with Possible/Probable iNPH were tested during a 1-year period. The pre-operative lumbar infusion tests were assessed according to two strategies: (i) Determining the resistance to cerebrospinal fluid (CSF) outflow (Rout). (ii) Quantification of the CSF pressure (CSFP) pulsatility during lumbar infusion (Qpulse). The results were related to the prospectively followed clinical course and shunt response after 12 months. Results:, The lumbar infusion-derived parameters Rout and Qpulse related weakly. Shunt response after 12 months was not related to Rout, but was highly related to the Qpulse. False negative results of lumbar infusion testing were observed in 16% of the patients. Discussion:, In neurological practice lumbar infusion testing may be useful for determining which patients to refer to neurosurgery. Our data favour determination of CSFP pulsatility (Qpulse) rather than Rout for prediction of shunt response. [source]

In vivo assessment of hydrocephalus shunt

ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2009
G. Petrella
Objectives,,, Over a 3-year period, we have performed 312 tests in 197 shunted patients. The data have been analyzed retrospectively to: (1) investigate the parameters describing CSF dynamics that correlate with shunt under-drainage and (2) estimate accuracy of this method. Methods,,, Constant rate infusion tests into shunt prechamber were performed. Results,,, In 161 of the 312 infusion tests, results indicated under-draining shunts. Patients in the under-draining group had higher baseline and plateau CSF pressures, higher resistance to CSF outflow and higher levels of baseline pulse amplitude waveform. During the test, a significantly greater vasogenic waves and lower compensatory reserve was noticed in patients with blocked shunts. In 21 patients with suggestion of shunt blockage and who subsequently underwent operative revision of the shunt, reports of intraoperative shunt patency were available. Shunt blockage was confirmed intra-operatively during surgery in 19 cases. Conclusions,,,In vivo shunt testing is easy, safe and clinically useful, aiding decision in difficult clinical situations, where shunt malfunction is suspected but not certain. It also has satisfactory positive predictive power. [source]