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1.
Can J Physiol Pharmacol ; 100(2): 192-196, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34597522

RESUMEN

Cannabidiol (CBD) can exert neuroprotective effects without being intoxicating, and in combination with Δ9-tetrahydrocannabinol (THC) CBD has shown to protect against THC psychosis. Acute concussion and post-concussion syndrome (PCS) can result in autonomic dysfunction in heart rate variability (HRV), but less information is available on blood pressure variability (BPV). Furthermore, the effects of phytocannabinoids on HRV and BPV in PCS are unknown. The purpose of this study was to observe the influence of daily administration of CBD or a combination of CBD and THC on HRV and BPV parameters in four female PCS participants. Participants completed a seated 5-min rest followed by six breaths-per-minute paced breathing protocol. Data was collected prior to phytocannabinoid intake and continued over 54 to 70 days. High frequency systolic BPV parameter increased every assessment period, unless altered due to external circumstances and symptoms. HRV parameters showed less consistent and varying responses. These results suggest that CBD can help to improve the altered autonomic dysfunction in those with PCS, and that responses to the drug administration was individualized. Double blinded, randomized controlled trials with greater sample sizes are required to better understand the influences of the varying dosages on human physiology and in PCS.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Presión Sanguínea/efectos de los fármacos , Cannabidiol/farmacología , Frecuencia Cardíaca/efectos de los fármacos , Fármacos Neuroprotectores , Fitoterapia , Síndrome Posconmocional/tratamiento farmacológico , Síndrome Posconmocional/fisiopatología , Adulto , Enfermedades del Sistema Nervioso Autónomo/etiología , Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Cannabidiol/administración & dosificación , Cannabidiol/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Síndrome Posconmocional/complicaciones
2.
Oxid Med Cell Longev ; 2021: 4889719, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34804367

RESUMEN

Numerous medicinal plants have been utilized for the treatment of different types of diseases and disorders including gastrointestinal (GI) diseases. GI diseases are the most common complaints that normally affects the largest proportion of children and adolescents with overlapping clinical manifestation in diagnosis and medical needs. Drugs with antispasmodic effects are normally applied for the symptomatic treatment of contraction and cramping of smooth muscles in gastrointestinal diseases as well as in other critical clinical situations. In alternative system of medicines, the antispasmodic herbs played a significant role in the cure of GI diseases. These medicinal plants and their herbal products are used from generation to generation because of multiple nutritional and therapeutic benefits. The multiple uses might be attributed to the presence on biologically active chemical constitutes. The main aim of this review is to focus on the medicinal potential of plants possessing antispasmodic activities with their proposed mechanism of action. Several databases such as Google Scholar, Cochrane database, Scopus, and PubMed were used to search the relevant literature regarding "plants with antispasmodic activities." This present study highlights the updated and quantified information on several medicinal plants with antispasmodic activity like Zanthoxylum armatum, Matricaria chamomilla, Foeniculum vulgare, Pycnocycla spinosa, Atropa belladonna, Lavandula angustifolia, Mentha pulegium, Glycyrrhiza ularensis, Anethum graveolens, and Origanum majorana. Moreover, recent studies on other medicinal plant species also have been included in this review article. Additionally, the study also revealed that the active compounds of all these plants possess significant spasmolytic effect which is safest, efficacious, and cost effective as compared to the available synthetic drugs.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Parasimpatolíticos/farmacología , Fitoquímicos/farmacología , Fitoterapia/métodos , Plantas Medicinales/química , Animales , Humanos
3.
Front Endocrinol (Lausanne) ; 11: 605681, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33329405

RESUMEN

Background: Cardiovascular autonomic neuropathy (CAN) is associated with diabetes mellitus, increasing morbidity and mortality. Some cross-sectional studies associated CAN with low 25-hydroxyvitamin D levels. The aim of our study was to evaluate the effect of high-dose vitamin D (VD) supplementation on CAN in Type 1 Diabetes Mellitus (T1DM) patients. Methods: We performed a prospective study with 23 patients diagnosed with T1DM and CAN. Subjects with VD levels <30 ng/ml received 10,000 IU/day; the ones with VD levels between 30-60 ng/ml were given 4,000 IU/day for 12 weeks. Results: There was an improvement in CAN parameters related to resting heart rate variability, such as time domain parameters [Maximum RR interval (0.77 ± 0.11 vs 0.94 ± 0.51 s, p <0.05), Mean length of regular RR intervals (0.71 ± 0.10 vs 0.76 ± 0.09 s, p <0.05) and Standard deviation of all NN intervals (0.02 ± 0.01 vs 0.03 ± 0.02 s; p <0.01)] and frequency domain parameters [Low Frequency (1.9 ± 0.5 vs 2.5 ± 0.9 s, p < 0.001), Total Power (2.5 ± 0.4 vs 2.8 ± 0.6 s, p <0.05)]. In addition, there was a correlation between absolute VD level variation and posttreatment High Frequency (%), as well as among percent variation in VD level and end-of-study Low Frequency/High Frequency ratio (r=0.6, p<0.01; r= -0.5, p<0.05, respectively). Conclusion: Our pilot study is the first to suggest a strong association between high-dose vitamin D supplementation and improved cardiovascular autonomic neuropathy in T1DM patients. It occurred without any variation in HbA1C, blood pressure levels, lipids, and insulin dose. Clinical Trial Registration: http://www.isrctn.com/ISRCTN32601947, identifier ISRCTN32601947.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Enfermedades Cardiovasculares/tratamiento farmacológico , Diabetes Mellitus Tipo 1/complicaciones , Neuropatías Diabéticas/tratamiento farmacológico , Suplementos Dietéticos , Vitamina D/administración & dosificación , Adolescente , Adulto , Enfermedades del Sistema Nervioso Autónomo/etiología , Enfermedades del Sistema Nervioso Autónomo/patología , Glucemia/análisis , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/patología , Niño , Neuropatías Diabéticas/etiología , Neuropatías Diabéticas/patología , Femenino , Frecuencia Cardíaca , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Vitaminas/administración & dosificación , Adulto Joven
4.
Neurochem Int ; 141: 104890, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33122033

RESUMEN

Alzheimer's disease is a multifactorial neurodegenerative condition manifested through acute cognitive decline, amyloid plaque deposits and neurofibrillary tangles. Complete cure for this disease remains elusive as the conventional drugs address only a single molecular target while Alzheimer's disease involves a complex interplay of different sets of molecular targets and signaling networks. In this context, the possibility of employing multi-drug combinations to rescue neurons from the dysregulated metabolic changes is being actively investigated. The present work investigates a poly-herbal formulation, Brahmi Nei that has been traditionally used for anxiolytic disorders and immunomodulatory effects, for its efficiency in ameliorating cognitive decline through a combination of behavioral, biochemical, histopathological, gene and protein expression analyses. Our results reveal that the formulation shows excellent neuroregenerative properties, rescues neurons from inflammatory damage, reduces neuritic plaque deposits and improves working memory in rodent models with scopolamine-induced dementia. The microarray analysis shows that the formulation induces the expression of pro-survival pathways and positively modulates genes involved in memory consolidation, axonal growth and proliferation in a concentration-dependent manner with therapeutic concentrations restoring the normal conditions in the brain of the diseased animals. The neuritic spine morphology confirms the long-term memory potentiation through improved mushroom spine density, increased dendritic length and connectivity. Taken together, our study provides mechanistic evidence to prove that the traditional formulation can be a superior therapeutic strategy to treat cognitive decline when compared to the conventional mono-drug treatment.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Enfermedades del Sistema Nervioso Autónomo/psicología , Trastornos del Conocimiento/tratamiento farmacológico , Trastornos del Conocimiento/psicología , Medicina de Hierbas , Animales , Enfermedades del Sistema Nervioso Autónomo/complicaciones , Axones/efectos de los fármacos , Axones/patología , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Trastornos del Conocimiento/etiología , Dendritas/efectos de los fármacos , Dendritas/ultraestructura , Relación Dosis-Respuesta a Droga , Combinación de Medicamentos , Composición de Medicamentos , Masculino , Aprendizaje por Laberinto/efectos de los fármacos , Memoria a Corto Plazo/efectos de los fármacos , Regeneración Nerviosa/efectos de los fármacos , Neuritas/patología , Fitoterapia , Ratas , Ratas Wistar
5.
BMC Infect Dis ; 19(1): 737, 2019 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-31438878

RESUMEN

BACKGROUND: Brainstem encephalitis is a serious complication of hand foot and mouth disease (HFMD) in children. Autonomic nervous system (ANS) dysregulation and hypertension may occur, sometimes progressing to cardiopulmonary failure and death. Vietnamese national guidelines recommend use of milrinone if ANS dysregulation with Stage 2 hypertension develops. We wished to investigate whether magnesium sulfate (MgSO4) improved outcomes in children with HFMD if used earlier in the evolution of the ANS dysregulation (Stage 1 hypertension). METHODS: During a regional epidemic we conducted a randomized, double-blind, placebo-controlled trial of MgSO4 in children with HFMD, ANS dysregulation and Stage 1 hypertension, at the Hospital for Tropical Diseases in Ho Chi Minh city. Study participants received an infusion of MgSO4 or matched placebo for 72 h. We also reviewed data from non-trial HFMD patients in whom milrinone failed to control hypertension, some of whom received MgSO4 as second line therapy. The primary outcome for both analyses was a composite of disease progression within 72 h - addition of milrinone (trial participants only), need for ventilation, shock, or death. RESULTS: Between June 2014 and September 2016, 14 and 12 participants received MgSO4 or placebo respectively, before the trial was stopped due to futility. Among 45 non-trial cases with poorly controlled hypertension despite high-dose milrinone, 33 received MgSO4 while 12 did not. There were no statistically significant differences in the composite outcome between the MgSO4 and the placebo/control groups in either study (adjusted relative risk (95%CI) of [6/14 (43%) vs. 6/12 (50%)], 0.84 (0.37, 1.92), p = 0.682 in the trial and [1/33 (3%) vs. 2/12 (17%)], 0.16 (0.01, 1.79), p = 0.132 in the observational cohort). The incidence of adverse events was similar between the groups. Potentially toxic magnesium levels occurred very rarely with the infusion regime used. CONCLUSION: Although we could not demonstrate efficacy in these studies, there were no safety signals associated with use of 30-50 mg/kg/hr. MgSO4 in severe HFMD. Intermittent outbreaks of HFMD are likely to continue across the region, and an adequately powered trial is still needed to evaluate use of MgSO4 in controlling hypertension in severe HFMD, potentially involving a higher dose regimen. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01940250 (Registered 22 AUG 2013). Trial sponsor: University of Oxford.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Enfermedad de Boca, Mano y Pie/tratamiento farmacológico , Sulfato de Magnesio/uso terapéutico , Animales , Sistema Nervioso Autónomo/efectos de los fármacos , Sistema Nervioso Autónomo/fisiología , Enfermedades del Sistema Nervioso Autónomo/etiología , Niño , Preescolar , Estudios de Cohortes , Progresión de la Enfermedad , Método Doble Ciego , Femenino , Enfermedad de Boca, Mano y Pie/complicaciones , Enfermedad de Boca, Mano y Pie/fisiopatología , Hemodinámica/efectos de los fármacos , Humanos , Lactante , Sulfato de Magnesio/efectos adversos , Masculino , Placebos
6.
Drug Discov Ther ; 13(3): 168-171, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31327791

RESUMEN

Paroxysmal sympathetic hyperactivity (PSH) is a clinical condition characterized by abnormal paroxysmal surges in sympathetic nervous system activity. PSH is known to occur after severe head injury and hypoxic encephalopathy. Cases of PSH that develop after stroke have been reported worldwide; however, PSH is not commonly reported in the field of stroke research in Japan. Some studies have suggested that gabapentin may improve the symptoms of PSH. To our knowledge, this is the first case report demonstrating the efficacy of trazodone for the treatment of PSH that developed after thalamic hemorrhage. A 45-year-old woman presented to our clinic with headache and paralysis of the left side of her body after experiencing right thalamic hemorrhage; a conservative treatment was initiated at our hospital. Immediately upon hospitalization, she developed high fever, tachycardia, tachypnea, constipation, and overactive bladder and had breathing difficulties. Blood sampling revealed elevated levels of myocardial escape enzymes; however, coronary angiography did not show any significant stenosis or occlusion. The patient's symptoms improved after the administration of trazodone. She was diagnosed with catecholamine cardiomyopathy associated with PSH after intracranial hemorrhage and was subsequently transferred to a recovery and rehabilitation hospital unit where the oral administration of trazodone continued. Prolonged PSH contributes significantly to the impairment of daily activities in patients with stroke; therefore, early diagnosis and treatment are critical. Here, we report on the efficacy of trazodone as an effective treatment option for improving clinical outcomes and reducing the stay in the stroke care unit.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Hemorragias Intracraneales/complicaciones , Accidente Cerebrovascular/diagnóstico , Trazodona/administración & dosificación , Femenino , Humanos , Hemorragias Intracraneales/tratamiento farmacológico , Japón , Persona de Mediana Edad , Accidente Cerebrovascular/etiología , Tálamo , Trazodona/uso terapéutico , Resultado del Tratamiento
7.
Phytomedicine ; 23(12): 1356-1364, 2016 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-27765355

RESUMEN

BACKGROUND: Ginkgo biloba extract (GBE)-a widely used nutraceutical-is reported to have diverse functions, including positive effects on memory and vasodilatory properties. Although numerous studies have assessed the neuroprotective properties of GBE in ischemia, only a few studies have investigated the neuro-pharmacological mechanisms of action of GBE in chronic cerebral hypoperfusion (CCH). PURPOSE: In the present study, we sought to determine the effects of GBE on CCH-induced neuroinflammation and cholinergic dysfunction in a rat model of bilateral common carotid artery occlusion (BCCAo). METHODS: Chronic BCCAo was induced in adult male Wistar rats to reflect the CCH conditions. On day 21 after BCCAo, the animals were treated orally with saline or GBE (5, 10, 20, and 40mg/kg) daily for 42 days. After the final treatment, brain tissues were isolated for the immunohistochemical analysis of glial markers and choline acetyltransferase (ChAT), as well as for the western blot analysis of proinflammatory cytokines, toll-like receptor (TLR)-related pathway, receptor for advanced glycation end products (RAGE), angiotensin-II (Ang-II), and phosphorylated mitogen-activated protein kinases (MAPKs). RESULTS: BCCAo increased glial proliferation in the hippocampus and white matter, whereas proliferation was significantly attenuated by GBE treatment. GBE also attenuated the BCCAo-related increases in the hippocampal expression of proinflammatory cytokines (TNF-α, IL-1ß, and IL-6), TLR4, myeloid differentiation primary response gene 88, RAGE, Ang-II, and phosphorylated MAPKs (ERK, p38, and JNK). Furthermore, GBE treatment restored the ChAT expression in the basal forebrain following BCCAo. CONCLUSIONS: These findings suggest that GBE has specific neuroprotective effects that may be useful for the treatment of CCH. The pharmacological mechanism of GBE partly involves the modulation of inflammatory mediators and the cholinergic system.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Trastornos Cerebrovasculares/tratamiento farmacológico , Ginkgo biloba , Inflamación/tratamiento farmacológico , Fármacos Neuroprotectores/uso terapéutico , Sistema Nervioso Parasimpático/efectos de los fármacos , Extractos Vegetales/uso terapéutico , Animales , Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Arteria Carótida Común , Estenosis Carotídea/tratamiento farmacológico , Estenosis Carotídea/fisiopatología , Proliferación Celular/efectos de los fármacos , Trastornos Cerebrovasculares/fisiopatología , Citocinas/metabolismo , Inflamación/fisiopatología , Masculino , Proteínas del Tejido Nervioso/biosíntesis , Proteínas del Tejido Nervioso/genética , Neuronas/efectos de los fármacos , Ratas , Ratas Wistar
8.
Integr Cancer Ther ; 15(1): 113-23, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26612784

RESUMEN

BACKGROUND: Kuan-Sin-Yin (KSY) is a traditional Chinese medicine (TCM) decoction, which has been shown to have cytostatic effects on cancer cells and involved in the TCM theory of promoting yin-yang balance.Sonce many cancer patients suffer from autonomic dysfunction (AD), which correspond to yin-yang imbalance in TCM. The aim of this study is to evaluate the possible effect of KSY in metastatic colon cancer (mCRC) patients with AD. METHODS: We conducted a single-group experiment. Total 52 qualified patients were enrolled. Participants took the KSY daily for 2 weeks. The primary outcome was KSY efficacy as reflected in the heart rate variability (HRV) and electrical conductivity (µA) over 12 meridian points. Autonomic function was examined before and after the KSY intervention. The vagal and sympathetic tone were recorded by HRV; 12 meridian energies were measured using a meridian energy analysis device. Secondary outcomes were cancer-related symptoms and patient quality of life (QoL). RESULTS: The results showed that the KSY intervention improved AD via increasing the vagal tone (HF: P = .041), but not the sympathetic tone (LF: P = .154); total autonomic activity was significantly enhanced (HRV activity: P = .013). Intriguingly, energy increased more over the yin meridian (P = .010) than over the yang meridian (P = .015). Cancer-related symptoms and QoL were significantly improved (P < .05). CONCLUSION: The safety and effectiveness of KSY in improving AD in mCRC patients are through regulating the vagal-sympathetic dynamic balance, which correspond to the TCM yin-yang concept of energy.


Asunto(s)
Fármacos del Sistema Nervioso Autónomo/uso terapéutico , Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Neoplasias del Colon/tratamiento farmacológico , Medicina Tradicional China/métodos , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Calidad de Vida , Yin-Yang , Adulto Joven
9.
Zhongguo Zhen Jiu ; 35(6): 557-60, 2015 Jun.
Artículo en Chino | MEDLINE | ID: mdl-26480551

RESUMEN

OBJECTIVE: To compare the clinical efficacy difference in dysantonomia between transcutaneous electrical stimulation at Renying(ST 9) combined with stellate ganglion block(SGB) and simple SGB. METHODS: Sixty patients in accord with the diagnostic criteria of dysantonomia were randomly divided into two groups,30 cases in each group. In the observation group,transcutaneous electrical stimulation at Renying(ST 9) combined with SGB were adopted; in the control group,simple SGB was applied. In the two groups, treatment was used three times a week,and nine treatments were considered as one course. There was an interval of one week between courses,and two courses were treated. Total seven weeks were required. Scores were evaluated according to subjective symptoms before treatment,one month and three months after treatment in the two groups. RESULTS: The scores of subjective symptoms were not statistically different before treatment in the two groups(P>0. 05). The scores of subjective symptoms one month and three months after treatment were all lower than those before treatment(all P< 0. 01), and subjective symptoms scores in the observation group were lower than those in the control group(both P<0. 01). CONCLUSION: Transcutaneous electrical stimulation at Renying(ST 9) combined with SGB could obviously enhance the clinical effects for dysantonomia, and the control and improvement for clinical symptoms are apparently superior to simple SGB.


Asunto(s)
Puntos de Acupuntura , Anestésicos/administración & dosificación , Bloqueo Nervioso Autónomo , Enfermedades del Sistema Nervioso Autónomo/terapia , Estimulación Eléctrica Transcutánea del Nervio , Adulto , Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Terapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ganglio Estrellado/efectos de los fármacos , Ganglio Estrellado/fisiopatología , Adulto Joven
10.
Artículo en Ruso | MEDLINE | ID: mdl-25042489

RESUMEN

OBJECTIVE: To determine the efficacy and tolerability of tanakan in the treatment of memory and attention impairments in young patients. MATERIAL AND METHODS: We studied 30 outpatients (24 women and 6 men, mean age 33,5±7,5 years) with headache, memory and attention impairments and decrease in mental working capacity. Treatment duration was 90 days. Patients received tanakan in dose 40 mg 3 times per day to restore cognitive function. The study design included 4 visits during which patients completed questionnaires and scales. RESULTS: All patients reported positive changes in mood, memory, information learning and working capacity. Headaches of tension decreased by 50%, vertigo and noise in ears became less intense, autonomic disturbances practically disappeared. No effect on the frequency of migrainous attacks was found. CONCLUSION: Tanakan is effective and safe for symptomatic therapy of cognitive impairment in any age, including young patients.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Trastornos del Conocimiento/tratamiento farmacológico , Trastornos de Cefalalgia/tratamiento farmacológico , Trastornos de la Memoria/tratamiento farmacológico , Extractos Vegetales/uso terapéutico , Adulto , Atención , Femenino , Ginkgo biloba , Humanos , Masculino
11.
Rinsho Shinkeigaku ; 53(11): 1382-5, 2013.
Artículo en Japonés | MEDLINE | ID: mdl-24291998

RESUMEN

Gastrointestinal motility dysfunctions including anorexia, nausea, heartburn, bloating, etc. are common and frequent complication of Parkinson's disease (PD). Degeneration of enteric nerves system is supposed to be a pathogenesis of these symptoms. Impairment of gastric emptying (GE) leads to retardation of the drug delivery from stomach to jejunum, so that PD patients with GE impairment show the delayed elevation of plasma L-dopa concentration. Disturbance of L-dopa absorption will result in wearing-off and delayed-on, and these are called motor fluctuation. In our investigation, 69% of PD patients who exhibited delayed elevation of plasma L-dopa concentration complicated GE impairment, whereas only 22% of patients with normal L-dopa level showed GE retardation (p = 0.0044, χ(2)-test). Serotonin 5-HT4 agonist and dopamine D2 antagonist are useful to improve GE impairment in PD. These drugs stimulate the postganglionic cholinergic fiber to release acetylcholine amongst the enteric nerves system and facilitate the gastrointestinal tract. Rikkunshi-to, dietary herbal medicine, is also administered to ameliorate gastrointestinal symptoms in PD. Rikkunshi-to is reported to improve erratic GE and reduce the variation of plasma L-dopa level. Recently, intestinal continuous L-dopa administration is expected as the potential solution for L-dopa induced motor fluctuation in advanced PD.


Asunto(s)
Antiparkinsonianos/administración & dosificación , Antiparkinsonianos/sangre , Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Enfermedades Gastrointestinales/fisiopatología , Levodopa/administración & dosificación , Levodopa/sangre , Enfermedad de Parkinson/tratamiento farmacológico , Antiparkinsonianos/farmacocinética , Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Enfermedades del Sistema Nervioso Autónomo/etiología , Tolerancia a Medicamentos , Medicamentos Herbarios Chinos/farmacología , Medicamentos Herbarios Chinos/uso terapéutico , Vaciamiento Gástrico/efectos de los fármacos , Vaciamiento Gástrico/fisiología , Enfermedades Gastrointestinales/tratamiento farmacológico , Enfermedades Gastrointestinales/etiología , Humanos , Levodopa/farmacocinética , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/metabolismo , Fitoterapia
12.
Brain Res ; 1514: 75-82, 2013 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-23535448

RESUMEN

It is well known that many of the actions of estrogens in the central nervous system are mediated via intracellular receptor/transcription factors that interact with steroid response elements on target genes. But there is also a compelling evidence for the involvement of membrane estrogen receptors in hypothalamic and other CNS functions. However, it is not well understood how estrogens signal via membrane receptors, and how these signals impact not only membrane excitability but also gene transcription in neurons. Indeed, it has been known for sometime that estrogens can rapidly alter neuronal activity within seconds, indicating that some cellular effects can occur via membrane delimited events. In addition, estrogens can affect second messenger systems including calcium mobilization and a plethora of kinases within neurons to alter cellular functions. Therefore, this brief review will summarize our current understanding of rapid membrane-initiated and intracellular signaling by estrogens in the hypothalamus, the nature of receptors involved and how these receptors contribute to maintenance of homeostatic functions, many of which go awry in menopausal states. This article is part of a Special Issue entitled Hormone Therapy.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Enfermedades del Sistema Nervioso Autónomo/etiología , Estrógenos/uso terapéutico , Hipogonadismo/complicaciones , Receptores de Estrógenos/metabolismo , Transducción de Señal/efectos de los fármacos , Animales , Estrógenos/farmacología , Humanos , Hipotálamo/efectos de los fármacos , Hipotálamo/metabolismo
13.
Turk Kardiyol Dern Ars ; 38(4): 285-9, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20935439

RESUMEN

We present a 30-year-old male with complex and predominantly cardiovascular autonomic dysfunction. He had frequent syncopal attacks and paroxysmal atrial fibrillation (PAF). Physical, electrocardiographic, and echocardiographic findings were unremarkable. Syncopal attacks were precipitated by emotional stress, upright position, and micturition. Electrocardiograms obtained immediately after syncopal events revealed PAF with a low ventricular rate, which spontaneously returned to sinus rhythm without any medication. Syncopal events were suggestive of postural orthostatic tachycardia syndrome (POTS), were induced during upright position, and were associated with a sudden increase in heart rate to approximately 140 beats per minute and a sudden drop in blood pressure. Syncope was also induced during carotid sinus massage (CSM) in the upright position. It was thought that cardiac autonomic dysfunction, with POTS as the main component, was responsible for this clinical condition. Syncopal episodes increased in frequency during treatment with metoprolol. Treatment with ivabradine (5 mg twice a day) resulted in disappearance of syncopal episodes both during upright position and CSM. During six months of follow-up, the patient remained asymptomatic without syncope or atrial fibrillation.


Asunto(s)
Fibrilación Atrial/etiología , Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Benzazepinas/uso terapéutico , Síndrome de Taquicardia Postural Ortostática/etiología , Síncope/etiología , Adulto , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/tratamiento farmacológico , Enfermedades del Sistema Nervioso Autónomo/complicaciones , Electrocardiografía , Humanos , Ivabradina , Masculino , Síndrome de Taquicardia Postural Ortostática/tratamiento farmacológico , Síncope/prevención & control
16.
Breast ; 16 Suppl 2: S182-9, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17983942

RESUMEN

Many patients with a history of breast cancer (BC) will suffer from vasomotor symptoms, which can be induced or exacerbated by treatment with tamoxifen or aromatase inhibitors. The LIBERATE trial was designed as a randomized, double-blind, multicenter trial to demonstrate that tibolone 2.5mg/day (Livial) is non-inferior to placebo regarding BC recurrence in women with vasomotor symptoms surgically treated for primary BC within the last 5 years. Secondary objectives are effects on vasomotor symptoms as well as overall survival, bone mineral density and health-related quality of life. Mean age at randomization was 52.6 years, and the mean time since surgery was 2.1 years. The mean daily number of hot flushes and sweating episodes was 7.3 and 6.1, respectively. For the primary tumor, Stage IIA or higher was reported for >70% of the patients. In subjects whose receptor status was known, 78.2% of the tumors were estrogen receptors positive. At randomization, tamoxifen was given to 66.2% of all patients and aromatase inhibitors to 7%. Chemotherapy was reported by 5% at randomization. The adjuvant tamoxifen use in LIBERATE allows a comparison with the Stockholm trial (showing no risk of BC recurrence associated with hormone therapy), which was stopped prematurely subsequent to HABITS. The LIBERATE trial is the largest, ongoing, well-controlled study for treatment of vasomotor symptoms in BC patients.


Asunto(s)
Antineoplásicos Hormonales/farmacología , Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Neoplasias de la Mama/tratamiento farmacológico , Norpregnenos/farmacología , Sistema Vasomotor/efectos de los fármacos , Antineoplásicos Hormonales/efectos adversos , Antineoplásicos Hormonales/uso terapéutico , Inhibidores de la Aromatasa/efectos adversos , Inhibidores de la Aromatasa/farmacología , Inhibidores de la Aromatasa/uso terapéutico , Enfermedades del Sistema Nervioso Autónomo/inducido químicamente , Densidad Ósea , Método Doble Ciego , Femenino , Humanos , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Norpregnenos/uso terapéutico , Calidad de Vida , Análisis de Supervivencia , Tamoxifeno/efectos adversos , Tamoxifeno/farmacología , Tamoxifeno/uso terapéutico , Resultado del Tratamiento
17.
Auton Neurosci ; 132(1-2): 103-6, 2007 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-17118713

RESUMEN

We present a case history of a 24 years old male who developed autonomic dysfunction, intestinal pseudo-obstruction and anemia due to lead poisoning. Concomitant recording of blood levels of lead and autonomic function showed a gradual decline in blood lead level (98.8 microg/dL at week 0, 56 microg/dL at week 6, and 40 microg/dL at week 52) and gradual improvement in autonomic functions. Decrease in blood lead levels with DMSA (Meso-2, 3-dimercaptosuccinic acid) therapy showed improvement in autonomic functions. At week 0, the patient had severe loss of autonomic tone and autonomic reactivity which improved at week 6. At the 52nd week, most of the autonomic parameters had normalized except for the persistence of mild loss of parasympathetic reactivity.


Asunto(s)
Anemia/etiología , Enfermedades del Sistema Nervioso Autónomo/etiología , Seudoobstrucción Intestinal/etiología , Intoxicación del Sistema Nervioso por Plomo en Adultos/complicaciones , Intoxicación del Sistema Nervioso por Plomo en Adultos/fisiopatología , Adulto , Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Quelantes/uso terapéutico , Disfunción Eréctil/tratamiento farmacológico , Humanos , Plomo/sangre , Intoxicación del Sistema Nervioso por Plomo en Adultos/tratamiento farmacológico , Masculino , Medicina Ayurvédica , Plantas Medicinales/efectos adversos , Succímero/uso terapéutico
18.
Gastroenterology ; 131(5): 1592-6, 2006 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17101331

RESUMEN

BACKGROUND & AIMS: Autoimmune gastrointestinal dysmotility (AGID) is a limited form of autoimmune autonomic neuropathy occurring idiopathically or in a paraneoplastic context. This disorder is considered rare, but is underrecognized as a cause for GI dysmotilities of varying anatomic extent, severity, and duration. We describe the diagnosis and management of an instructive case. METHODS: A 60-year-old (nondiabetic) woman presented with a 15-year history of severe isolated gastroparesis. Paraneoplastic autoantibody evaluation aided the diagnosis of AGID. This included indirect immunofluorescence (neuronal nuclear and cytoplasmic antibodies), radioimmunoprecipitation assays (neuronal and muscle plasma membrane cation channel antibodies), and enzyme-linked immunosorbent assay (muscle striational antibodies). RESULTS: Serologic testing revealed both ganglionic neuronal acetylcholine receptor and N-type voltage-gated calcium channel autoantibodies. This profile was consistent with AGID and, despite the long history, raised the possibility of lung, breast, or ovarian carcinoma or thymoma. An underlying neoplasm was excluded by appropriate investigations. In a 1-month trial of oral pyridostigmine therapy, the patient's GI symptoms improved and her weight stabilized. Pyridostigmine was continued at a low dose, and was supplemented by tegaserod. CONCLUSIONS: Autoimmune serology is a valuable adjunct to the diagnosis and guide to management of patients with AGID. The favorable response to acetylcholinesterase inhibitors, despite a 15-year history, suggests an immunopharmacologic rather than an inflammatory cytotoxic pathology. Immunomodulatory therapy may not always be required. Of numerous autoantibodies currently recognized as biomarkers of AGID, the ganglionic acetylcholine receptor autoantibody is the only proven pathophysiologic effector. Certain neuronal nuclear and cytoplasmic autoantibodies are highly predictive of an underlying malignancy.


Asunto(s)
Enfermedades Autoinmunes/tratamiento farmacológico , Inhibidores de la Colinesterasa/uso terapéutico , Motilidad Gastrointestinal/efectos de los fármacos , Bromuro de Piridostigmina/uso terapéutico , Autoanticuerpos/sangre , Enfermedades Autoinmunes/inmunología , Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Enfermedades del Sistema Nervioso Autónomo/inmunología , Diabetes Mellitus Tipo 1/fisiopatología , Femenino , Humanos , Persona de Mediana Edad
19.
Brain Res Bull ; 71(1-3): 37-44, 2006 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-17113926

RESUMEN

Reactive oxygen species (ROS) have been shown to modulate neuronal synaptic transmission and may play a role on the autonomic control of the cardiovascular system. In this study we investigated the effects produced by hydrogen peroxide (H(2)O(2)) injected alone or combined with the anti-oxidant agent N-acetil-l-cysteine (NAC) or catalase into the fourth brain ventricle (4th V) on mean arterial pressure and heart rate of conscious rats. Moreover the involvement of the autonomic nervous system on the cardiovascular responses to H(2)O(2) into the 4th V was also investigated. Male Holtzman rats (280-320 g) with a stainless steel cannula implanted into the 4th V and polyethylene cannulas inserted into the femoral artery and vein were used. Injections of H(2)O(2) (0.5, 1.0 and 1.5 micromol/0.2 microL, n=6) into the 4th V produced transient (for 10 min) dose-dependent pressor responses. The 1.0 and 1.5 micromol doses of H(2)O(2) also produced a long lasting bradycardia (at least 24 h with the high dose of H(2)O(2)). Prior injection of N-acetyl-l-cysteine (250 nmol/1 microL/rat) into the 4th V blockade the pressor response and attenuated the bradycardic response to H(2)O(2) (1 micromol/0.5 microL/rat, n=7) into the 4th V. Intravenous (i.v.) atropine methyl bromide (1.0 mg/kg, n=11) abolished the bradycardia but did not affect the pressor response to H(2)O(2). Prazosin hydrochloride (1.0 mg/kg, n=6) i.v. abolished the pressor response but did not affect the bradycardia. The increase in the catalase activity (500 UEA/1 microL/rat injected into the 4th V) also abolished both, pressor and bradycardic responses to H(2)O(2). The results suggest that increased ROS availability into 4th V simultaneously activate sympathetic and parasympathetic outflow inducing pressor and bradycardic responses.


Asunto(s)
Fenómenos Fisiológicos Cardiovasculares/efectos de los fármacos , Peróxido de Hidrógeno/farmacología , Sistema Nervioso Parasimpático/efectos de los fármacos , Sistema Nervioso Simpático/efectos de los fármacos , Animales , Antihipertensivos/farmacología , Antioxidantes/farmacología , Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Enfermedades del Sistema Nervioso Autónomo/metabolismo , Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Bradicardia/inducido químicamente , Bradicardia/fisiopatología , Catalasa/metabolismo , Catalasa/farmacología , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Interacciones Farmacológicas/fisiología , Peróxido de Hidrógeno/metabolismo , Hipertensión/tratamiento farmacológico , Hipertensión/metabolismo , Hipertensión/fisiopatología , Masculino , Oxidantes/metabolismo , Oxidantes/farmacología , Sistema Nervioso Parasimpático/fisiología , Parasimpatolíticos/farmacología , Ratas , Ratas Sprague-Dawley , Especies Reactivas de Oxígeno/metabolismo , Especies Reactivas de Oxígeno/farmacología , Sistema Nervioso Simpático/fisiología
20.
Int Rev Psychiatry ; 18(2): 107-18, 2006 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-16777665

RESUMEN

Mechanisms by which aggressive and depressive disorders may be exacerbated by nutritional deficiencies in omega-3 fatty acids are considered. Early developmental deficiencies in docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) may lower serotonin levels at critical periods of neurodevelopment and may result in a cascade of suboptimal development of neurotransmitter systems limiting regulation of the limbic system by the frontal cortex. Residual developmental deficits may be manifest as dysregulation of sympathetic responses to stress including decreased heart rate variability and hypertension, which in turn have been linked to behavioral dysregulation. Little direct data are available to disentangle residual neurodevelopmental effects from reversible adult pathologies. Ensuring optimal intakes of omega-3 fatty acids during early development and adulthood shows considerable promise in preventing aggression and hostility.


Asunto(s)
Agresión/fisiología , Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Encéfalo/fisiopatología , Discapacidades del Desarrollo/fisiopatología , Ácidos Grasos Omega-3/fisiología , Adulto , Agresión/efectos de los fármacos , Nivel de Alerta/efectos de los fármacos , Nivel de Alerta/fisiología , Enfermedades del Sistema Nervioso Autónomo/tratamiento farmacológico , Encéfalo/efectos de los fármacos , Niño , Discapacidades del Desarrollo/tratamiento farmacológico , Ácidos Grasos Omega-3/administración & dosificación , Lóbulo Frontal/efectos de los fármacos , Lóbulo Frontal/fisiopatología , Hostilidad , Humanos , Sistema Límbico/efectos de los fármacos , Sistema Límbico/fisiopatología , Red Nerviosa/efectos de los fármacos , Red Nerviosa/fisiopatología , Serotonina/fisiología , Violencia/psicología
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