R Freeman

..These variables were highly related in both subject groups, indicating that blood volume is a strong physiological correlate of peak oxygen consumption in patients with CFS...

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..Autonomic dysfunction can occur in association with specific infections. The availability of sensitive and reproducible measures of autonomic function has improved physicians' ability to diagnose these disorders...

..Some patients with AAG report cognitive impairment of unclear etiology despite treatment of autonomic symptoms...

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..To evaluate topiramate treatment on nerve function using electrophysiologic methods and a non-inferiority clinical trial design...

..The features associated with an autonomic neuropathy include impairment of cardiovascular, gastrointestinal, urogenital, thermoregulatory, sudomotor, and pupillomotor autonomic function...

..To examine the efficacy and safety of tramadol/acetaminophen (APAP) for the management of painful diabetic peripheral neuropathy (DPN)...

..Awareness of the diverse autonomic manifestations of epilepsy will enhance diagnosis and lead to more effective therapy of these patients...

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..Recent advances in the understanding of pain mechanisms at multiple central nervous system levels should pave the way toward more effective treatment modalities with less prominent side effects...

..Recent advances in the understanding of pain mechanisms at multiple central nervous system levels should pave the way toward more effective treatment modalities...

..If unsuccessful there are several supplementary agents with different mechanisms of action that may provide an additive effect...

..To differentiate the quantitative sensory testing (QST) results of subjects simulating small and large fiber sensory loss from those of normal subjects and subjects with sensory peripheral neuropathy...

..Prospective studies to investigate the prevalence of other disorders that might be responsible for a peripheral neuropathy in individuals with diabetes are warranted...

..Reduced compliance may limit the dynamic response to orthostatic change and thereby contribute to symptoms of orthostatic intolerance in this population group...

..Autonomic dysfunction occurs more frequently and with greater severity in patients with AIDS; however, it may be present in the early stages of HIV infection and appears to progress during the illness...

..To study the therapeutic effect and mechanism of action of 3,4-DL-threodihydroxyphenylserine (DL-DOPS) in neurogenic orthostatic hypotension...

..Midodrine hydrochloride, an alpha-agonist, could improve orthostatic BP by increasing vasomotor and venomotor tone...

..We tested the hypothesis that prior exposure to hypoglycemia leads to impaired cardiovascular autonomic function...

..To describe the natural history, clinical, neurophysiological, and histological features, and outcomes of diabetic patients presenting with acute painful neuropathy associated with glycemic control, also referred to as insulin neuritis...

..The severity of dysfunction also can be determined to guide therapy and aid in prognostication for individual patients...

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..To elucidate the mechanisms whereby postural tachycardia syndrome (POTS) patients maintain orthostatic blood pressure and explain the greater prevalence of female cases in POTS cohorts...

..To determine the relationships among large, small, and autonomic fiber neurophysiological measures in a cross-sectional study of patients with diabetes...

..The TCM style improved nerve sensation according to quantitative sensory testing while the Japanese style had a more equivocal effect. No evident changes were observed in glucose control or heart rate variability in either group...

..Two pivotal 12-month phase III trials are underway in diabetic patients with symptomatic peripheral neuropathy to confirm the therapeutic effects of rhNGF. Results from these trials are expected in 2000...

..These four patients comprised 2.4% of patients referred for autonomic testing in one year. Thus the frequency of coeliac disease is similar to that reported in idiopathic peripheral neuropathy...

..We review the biochemistry, pharmacokinetics, and possible mechanisms of action and clinical utility of this agent in the treatment of neurogenic orthostatic hypotension...

..There are rare patients who will require additional agents to treat their symptoms. A small group of patients remain refractory to all therapeutic modalities...

..L-DOPS may benefit patients with severe orthostatic intolerance and be particularly effective in patients with ganglionic NiAchR antibodies...

..Symptomatic and immunomodulatory therapy has provided limited clinical benefit in small uncontrolled studies...

..Previous clinical studies and observations in animal models suggest that AAG is an antibody-mediated neurologic disorder...

..Reduced expression of ecNOS may be a major contributing factor for endothelial dysfunction. These data provide support for a close association of neuropathy and microcirculation in the pathogenesis of foot ulceration...

..Treatment with levetiracetam is efficacious, and levetiracetam-treated patients require significantly lower doses of immunosuppressant medications to achieve an equivalent antirejection effect...

..05). In this study, dyspnea was frequently associated with OH. Ventilation perfusion mismatch, due to inadequate perfusion of ventilated lung apices may be the most likely underlying cause of orthostatic dyspnea in patients with OH...

..Our results suggest that sudomotor fibers can be rapidly and reproducibly quantified, and results correlate well with physical exam findings...

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..Because hypoglycemia is also associated with adverse outcomes, we tested the hypothesis that hypoglycemia increases IL-6...

..To describe the biology of phantom sweating, a novel autonomic neuropathy symptom, based on a description of a patient with a small fiber and autonomic neuropathy...

..The steep low-pressure phase of the compliance curve extends to higher pressures in the calf than in the forearm, thereby enlarging the range of pressures over which hemodynamic regulation by the calf venous circulation occurs...

..At this stage, C-fiber and smooth muscle function are still preserved. These data suggest that endothelial abnormalities precede and may contribute to the pathogenesis of the neuropathy associated with AL amyloidosis...

..In patients with neurogenic orthostatic hypotension (NOH), the availability of the sympathetic neurotransmitter norepinephrine (NE) in the synaptic cleft is insufficient to maintain blood pressure while in the standing posture...

..These findings suggest that the functional abnormalities in diabetic peripheral neuropathy are not homogeneous and that C-fiber subclasses are differentially affected in type 1 and 2 diabetes mellitus...

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..Preliminary data suggest that water drinking may improve orthostatic tolerance. Abdominal belts may also be effective in highly symptomatic subjects with reflex syncope...

..None of these agents has shown a consistent therapeutic benefit in clinical trials...

..Finally, knowledge of early autonomic dysfunction can encourage patient and physician to improve metabolic control and to use therapies such as ACE inhibitors and beta-blockers, proven to be effective for patients with CAN...

..To examine by meta-analysis the relationship between cardiovascular autonomic neuropathy (CAN) and risk of mortality in individuals with diabetes...

..There are studies in progress that suggest that autonomic nerves can be induced to regenerate, and the future for patients with diabetic autonomic neuropathy is brighter...

..We will measure the response to therapy and the role played by neuropathy and nitric oxide in determining this response. ..

..Thus, the broad long term objectives of the proposal are to fully understand the mechanisms and consequences of hypoglycemia associated autonomic failure with the ultimate goal of finding an efficacious treatment. ..

..The relationships between these variables and role of covariates such as the level of physical activity and psychiatric state, determined with standardized instruments, will be analyzed using multivariate statistics. ..

..The relationships between these variables and the role of covariates such as the level of physical activity and psychiatric state, determined with standardized instruments, are to be analyzed using multivariate statistics. ..

..We will measure the response to therapy and the role played by neuropathy and nitric oxide in determining this response. ..