The value of autonomic testing in postural tachycardia syndrome
ABSTRACT Postural tachycardia syndrome (POTS) is a fairly common condition that may or may not be associated with autonomic neuropathy. In a retrospective analysis, we compared two groups of patients based on clinical and autonomic criteria, those with POTS in isolation (POTS-Alone), and POTS with evidence of autonomic neuropathy (POTS-AN). Of 260 records reviewed, 57 patients met the criteria for POTS; 38 (67%) patients assigned to the POTS-Alone group and 19 (33%) patients assigned to the POTS-AN group. A decreased sweat output on the quantitative sudomotor axon reflex test is the most frequent abnormal finding in the POST-AN group suggesting sympathetic cholinergic neuropathy. Clinically, headache and gastrointestinal symptoms were more frequent among the POTS-AN group. Therefore, POTS may exist in isolation and may differ from those associated with AN.
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ABSTRACT: The pathophysiology of functional abdominal pain (FAP) is unknown. The upright portion of a tilt table test triggers typical symptoms in certain children. To compare the pathophysiology and treatment response of children with FAP whose gastrointestinal symptoms (GI) were replicated (RGI) by tilt table testing (TTT) to those in whom TTT did not have this effect (NRGI). An IRB-approved retrospective review of the autonomic laboratory database identified all children tested for GI complaints. We compared results of TTT, Valsalva maneuver, deep breathing and the axon reflex sweat test. Overall treatment response and that specific to fludrocortisone was ranked from 1 to 5, with 1 "much worse," 3 "neutral," and 5 "much better." 32/76 identified children had reproducible symptoms on TTT (RGI) and 44 did not (NRGI). The RGI group was younger, had a shorter duration of symptoms, more postural tachycardia syndrome (POTS) and benefited more from fludrocortisone (73% in RGI vs. 25% in NRGI). Dividing patients with FAP according to the effect of TTT on their symptoms appears to delineate 2 fundamentally different groups, with potentially different pathophysiologies and treatment responses. A prospective study is needed.Gastroenterology Research and Practice 02/2009; 2009:868496. DOI:10.1155/2009/868496 · 1.50 Impact Factor
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ABSTRACT: in the methods department. Study of the labor organization around an aerial conveyor crossing the whole plant. Mission: propose solutions in order to guaranty a regular flow of products to finishing stages. Collaboration with several departments in order to analyze the system. Results: identification of several problems and suggestion of solutions. MICHELIN: tires CLERMONT-FERRAND, FRANCE Two months placement as a blue-collar worker at a manufacturing machine in a plant for the regrooving of truck tires. Eric GAURY Room B434 Currently on leave at (until end May 1999): Tilburg University IFMA/LaReSP PO Box 90153 Campus des Czeaux 5000 LE Tilburg BP 265 The Netherlands 63175 Aubire Cedex Tel: +31-13 466 2262 France Fax: +31-13 466 3377 Tel: +33-4 73 28 85 31 (secretary) E-mail: firstname.lastname@example.org Fax: +33-4 73 28 81 00 Http://stuwww.kub.nl/~gaury E-mail: email@example.com Sept. 97 - Aug. 99 Sept. 93 - June 97 Sept. 95 - Jan. 96 Jan. - July 97 Aug. - Dec.