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Struhal W, Mahringer C, Lahrmann H, Mörtl C, Buhl P, Huemer M, Ransmayr G. Heart Rate Spectra Confirm the Presence of Autonomic Dysfunction in Dementia Patients. J Alzheimers Dis 2018; 54:657-67. [PMID: 27567816 PMCID: PMC5366248 DOI: 10.3233/jad-160084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Recent data suggest autonomic dysfunction in patients suffering dementia. This study evaluated autonomic modulation in dementia patients with and without autonomic involvement, employing ECG spectral analysis in the time-frequency domain (wavelet transform) in supine resting and head-up tilt (HUT) position. Thirty-six patients were prospectively evaluated at the Department of Neurology and Psychiatry, General Hospital of the City of Linz, between 2009 and 2014. A standard cardiovascular autonomic test series (Ewing battery) was performed to screen for autonomic dysfunction. The Ewing battery diagnoses were used as reference standard and compared to the diagnostic results obtained by spectral analysis (time-frequency domain) of ECG recordings. Based on the Ewing battery results, 14 patients suffered autonomic dysfunction, while 22 did not. Time frequency domain was accessed by using the continuous wavelet transformation (CWT) with an analytical Morlet mother wavelet in supine resting and HUT position. Within each cohort the modification of spectral components from supine resting to HUT was analyzed reflecting the autonomic modulation. For patients without autonomic dysfunction, a significant increase of autonomic modulation was detected by wavelet transformed ECG recordings (8%, p < 0.05; low frequency content) during HUT compared to supine resting. There was no significant modulation between HUT and supine resting in patients suffering autonomic dysfunction. In dementia patients suffering autonomic dysfunction, CWT identified blunted autonomic regulation only by analysis of ECG recordings without the need to assess other biosignals or tests depending on the patient’s cooperation. Further studies are needed to evaluate whether CWT is a suitable method to support the standard Ewing battery in demented patients.
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Affiliation(s)
- Walter Struhal
- Department of Neurology 2, Kepler University Hospital, Med Campus III., Linz, Austria
| | - Christoph Mahringer
- Department of Biomedical Engineering, Kepler University Hospital, Med Campus III., Linz, Austria.,Institute of Signal Processing, Johannes Kepler University Linz, Linz, Austria
| | | | - Christoph Mörtl
- Department of Anesthesiology and Critical Care Medicine, Kepler University Hospital, Med Campus III., Linz, Austria
| | - Peter Buhl
- Department of Biomedical Engineering, Kepler University Hospital, Med Campus III., Linz, Austria
| | - Mario Huemer
- Institute of Signal Processing, Johannes Kepler University Linz, Linz, Austria
| | - Gerhard Ransmayr
- Department of Neurology 2, Kepler University Hospital, Med Campus III., Linz, Austria
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Giacone G, Handskemager L, Mouridsen H, Tjornelund J, Langer S, Buter J, Rasmussen A, Buhl P, Dahlstrom K, Grundtvig P. Treatment of anthracycline extravasation with dexrazoxane: Pharmacokinetics and update on efficacy and safety from three multicenter trials. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.2555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2555 Background: Dexrazoxane prevented tissue necrosis in 98% of patients (pts) with biopsy proven anthracycline extravasation (AEV) in two international multicenter studies, TT01 and TT02 (Mouridsen HT et al Ann Onc Advance Access Dec 21, 2006). However, the pharmacokinetics (PK) of IV dexrazoxane in the three-day schedule is not established. Study TT04 was initiated to investigate PK. Patients and methods: TT04 is a prospective, open-label, single-arm, multicenter studies in pts with AEV. Consecutive pts with AEV are treated with a three-day schedule of IV dexrazoxane (1,000, 1,000, and 500 mg/m2) starting within 6 hr of AEV. Primary objective: Establish PK of IV dexrazoxane in the three-day schedule. Secondary objectives: obtaining additional efficacy and safety data. Plasma samples at 0, 1, 2, 4 and 24 hr day 1–3 are analyzed by HPLC-MS. PK parameters were calculated by a non compartmental method. TT01 and TT02 were open-label, single-arm, multicenter studies enrolling pts with biopsy proven AEV from 24 EU centers. Primary objective was to avoid tissue necrosis leading to surgery. Secondary objectives were to minimize delay of planned chemotherapy, reduce hospitalization, and avoid long term sequelae. Results: Six pts have entered the PK study. The average elimination was T½ ± SD of 127 ± 23, 144 ± 21, and 107 ± 29 min, day 1, 2 and 3, respectively. Pre-dose concentrations day 2 and 3 are = LOQ. Average AUC 0-t ± SD are 193 ± 93 (t= 24 hr), 196 ± 101 (t= 24 hr), and 46 ± 24 μg hr/ml (t= 4 hr), on day 1, 2 and 3, respectively. Cumulative data from the 3 studies: Surgery was avoided in 59/60 pts (98.3%). No delay in planned chemotherapy in 71%. 41% were hospitalized (median 3 days) due to the EV or its treatment. Mild pain (19%) and mild sensory disturbances (17%) were the most frequent sequelae: Reversible CTC grade 3–4 leucopenia/neutropenia in 45%, thrombocytopenia in 21% of the pts. Conclusion: There was no accumulation of dexrazoxane during the three-day schedule. Dexrazoxane was well tolerated and highly effective against anthracycline extravasation. Updated results will be presented. No significant financial relationships to disclose.
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Affiliation(s)
- G. Giacone
- Free University Hospital, Amsterdam, The Netherlands; TopoTarget A/S, Copenhagen, Denmark; Copenhagen University Hospital, Copenhagen, Denmark; Copenhagen University Hospital, Herlev, Denmark; Roskilde Hospital, Roskilde, Denmark
| | - L. Handskemager
- Free University Hospital, Amsterdam, The Netherlands; TopoTarget A/S, Copenhagen, Denmark; Copenhagen University Hospital, Copenhagen, Denmark; Copenhagen University Hospital, Herlev, Denmark; Roskilde Hospital, Roskilde, Denmark
| | - H. Mouridsen
- Free University Hospital, Amsterdam, The Netherlands; TopoTarget A/S, Copenhagen, Denmark; Copenhagen University Hospital, Copenhagen, Denmark; Copenhagen University Hospital, Herlev, Denmark; Roskilde Hospital, Roskilde, Denmark
| | - J. Tjornelund
- Free University Hospital, Amsterdam, The Netherlands; TopoTarget A/S, Copenhagen, Denmark; Copenhagen University Hospital, Copenhagen, Denmark; Copenhagen University Hospital, Herlev, Denmark; Roskilde Hospital, Roskilde, Denmark
| | - S. Langer
- Free University Hospital, Amsterdam, The Netherlands; TopoTarget A/S, Copenhagen, Denmark; Copenhagen University Hospital, Copenhagen, Denmark; Copenhagen University Hospital, Herlev, Denmark; Roskilde Hospital, Roskilde, Denmark
| | - J. Buter
- Free University Hospital, Amsterdam, The Netherlands; TopoTarget A/S, Copenhagen, Denmark; Copenhagen University Hospital, Copenhagen, Denmark; Copenhagen University Hospital, Herlev, Denmark; Roskilde Hospital, Roskilde, Denmark
| | - A. Rasmussen
- Free University Hospital, Amsterdam, The Netherlands; TopoTarget A/S, Copenhagen, Denmark; Copenhagen University Hospital, Copenhagen, Denmark; Copenhagen University Hospital, Herlev, Denmark; Roskilde Hospital, Roskilde, Denmark
| | - P. Buhl
- Free University Hospital, Amsterdam, The Netherlands; TopoTarget A/S, Copenhagen, Denmark; Copenhagen University Hospital, Copenhagen, Denmark; Copenhagen University Hospital, Herlev, Denmark; Roskilde Hospital, Roskilde, Denmark
| | - K. Dahlstrom
- Free University Hospital, Amsterdam, The Netherlands; TopoTarget A/S, Copenhagen, Denmark; Copenhagen University Hospital, Copenhagen, Denmark; Copenhagen University Hospital, Herlev, Denmark; Roskilde Hospital, Roskilde, Denmark
| | - P. Grundtvig
- Free University Hospital, Amsterdam, The Netherlands; TopoTarget A/S, Copenhagen, Denmark; Copenhagen University Hospital, Copenhagen, Denmark; Copenhagen University Hospital, Herlev, Denmark; Roskilde Hospital, Roskilde, Denmark
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Mutter JC, Carbotte SM, Su W, Xu L, Buhl P, Detrick RS, Kent GM, Orcutt JA, Harding AJ. Seismic Images of Active Magma Systems Beneath the East Pacific Rise Between 17°05′ and 17°35′S. Science 1995; 268:391-5. [PMID: 17746545 DOI: 10.1126/science.268.5209.391] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Seismic reflection data from the East Pacific Rise between 17 degrees 05' and 17 degrees 35'S image a magma lens that varies regularly in depth and width as ridge morphology changes, confirming the notion that axial morphology can be used to infer ridge magmatic state. However, at 17 degrees 26'S, where the ridge is locally shallow and broad, the magma lens is markedly shallower and wider than predicted from regional trends. In this area, submersible dives reveal recent volcanic eruptions. These observations indicate that it is where the width and depth of the magma chamber differ from regional trends, indicating an enhanced magmatic budget, that is diagnostic of current magmatism.
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