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Journal articles on the topic 'Autonomic neuropathy'

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Published: 4 June 2021
Last updated: 20 February 2023

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1

Wall, BJ. "Autonomic neuropathy." Journal of the American Podiatric Medical Association 77, no. 2 (February 1, 1987): 103–4. http://dx.doi.org/10.7547/87507315-77-2-103.

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2

Low, Phillip. "Autonomic Neuropathy." Seminars in Neurology 7, no. 01 (March 1987): 49–57. http://dx.doi.org/10.1055/s-2008-1041405.

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3

Dineen, Jennifer, and Roy Freeman. "Autonomic Neuropathy." Seminars in Neurology 35, no. 04 (October 6, 2015): 458–68. http://dx.doi.org/10.1055/s-0035-1558983.

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4

Pfeifer, M. A., S. Jung, G. Crain, and M. Schumer. "Autonomic Neuropathy." Diabetic Medicine 10, S2 (June 1993): 70S—73S. http://dx.doi.org/10.1111/j.1464-5491.1993.tb00204.x.

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5

Ryder, R. E. J., J. A. Atiea, J. P. Vora, and D. R. Owens. "Autonomic neuropathy." Practical Diabetes International 2, no. 4 (July 1985): 46. http://dx.doi.org/10.1002/pdi.1960020418.

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6

Koike, Haruki, and Gen Sobue. "Autoimmune autonomic ganglionopathy and acute autonomic and sensory neuropathy." Rinsho Shinkeigaku 53, no. 11 (2013): 1326–29. http://dx.doi.org/10.5692/clinicalneurol.53.1326.

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7

Ay, Seyid Ahmet, Fatih Bulucu, Murat Karaman, Kamil Başköy, Mustafa Çakar, Turgay Çelik, Şevket Balta, et al. "vCardiac Autonomic Neuropathy and Complications of Primary Hypertension: Is Autonomic Neuropathy a Cause or a Result?" Turkish Nephrology Dialysis Transplantation 25, no. 1 (January 22, 2016): 65–72. http://dx.doi.org/10.5262/tndt.2016.1001.07.

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8

Abdul- Aa'ama, Thaier Kareem, Saba Fathi Abd Al- Razaq, and Sarah Ali Al Kindy. "ASSESSMENT OF DIASTOLIC FUNCTION IN PATIENTS WITH DIABETIC NEUROPATHY." International Journal of Medical Sciences (IJMS) 2, no. 2 (June 15, 2022): 18–26. http://dx.doi.org/10.56981/m0000223.

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"Diastolic dysfunction" is thought to be an indication of "diabetic cardiomyopathy" ", and "diabetic cardiovascular autonomic neuropathy" is linked to increased mortality risk. The goal of this study was to see how "diastolic dysfunction" and "cardiovascular autonomic neuropathy" are linked both of which were diagnosed in accordance with the guidelines. Methods: We assessed at seventy three participants Whose elective coronary angiography was referred, Diabetes mellitus was present in twenty-six of them, and twenty four of whom had impaired glucose tolerance, the other twenty-three people had normal "glucose tolerance". To identify "cardiovascular autonomic neuropathy", "autonomic function" tests were done, and "tissue Doppler imaging echocardiography" was employed to confirm "diastolic dysfunction". Results Autonomical cardiovascular neuropathy has been detected with diabetes type 2 diabetes in (28.8%) and with glucose-impaired tolerance in 6 (12.5%) patients. "Diastolic dysfunction" was found in 81 and 33 percent of patients with and without "cardiovascular autonomic neuropathy", respectively (P <0.001). "Early diastolic relaxation velocity" (Em) was considerably less in comparison to the group without cardiovascular autonomic neuropathy. ("5.4 0.9 vs. 7.3 2.1 cm⁄ s;P; P 0.001"), Moreover, the E⁄Em ratio was much higher. ("13.6 4.6 vs. 10.3 3.4 cm⁄ s;P, 0.001"). The significance of these data remained after controlling for "age, gender, coronary artery disease, hypertension, and HbA1c". In individuals with and without "cardiovascular autonomic neuropathy", significant "diastolic dysfunction" was found in 33 and 15% of patients, accordingly (P = 0.001).
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9

Comlan Jules, Gninkoun, Fanou Joseph Soglo, Alassani Adebayo Sabi Cossi, and Djrolo François. "Cardiovascular Autonomic Neuropathy in Patients with Diabetes in Cotonou, Benin: A Cross-Sectional Study." Endocrinology and Disorders 5, no. 5 (September 16, 2021): 01–05. http://dx.doi.org/10.31579/2640-1045/083.

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Background Diabetes mellitus is well known as a major risk factor for cardiovascular diseases. Cardiovascular autonomic neuropathy is one of the diabetes complications that has a major impact on cardiovascular morbidity and mortality in patients with diabetes. Aim : To determine the prevalence of cardiovascular autonomic neuropathy in patients with diabetes attending the diabetic center in Cotonou and to identify its risk factors. Materials and Methods : It was a cross-sectional study. Cardiovascular autonomic neuropathy was identified using deep breathing test, standind test and the blood pressure response to standing test (orthostatic hypotension). Chi square test was used for statistical analysis and différence was considered significant when p<0.05. Results : A total of 405 subjects were included in the study. Their mean age was 53.67±11,68 years and the mean diabetes duration was 6.66 years. The prevalence of cardiovascular autonomic neuropathy was 65.9%. Regarding the severity of the complication in neuropathic patients, 51.7% of them had an early neuropathy, 41.2% have presented a moderate neuropathy and 7.1% have presented a severe neuropathy. Factors associated with cardiovascular autonomic neuropathy were age of patients (p = 0.0002), diabetes duration (p = 0.0012), hypertension (p =0.0015), dyslipidemia (p = 0.027) and high pulsed blood pressure (p = 0.032) Conclusion : Cardiovascular autonomic neuropathy is a very frequent complication of diabetes mellitus. Unfortunately this complication of diabetes is not often explored in the patient's follow-up examination. As this complication is recognised to be associated with high cardiovascular morbidity and mortality, systematic screening can be recommanded in patients with long duration of diabetes or presenting an other cardiovascular risk factor.
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10

Deshpande, Alaka. "Diabetic Autonomic Neuropathy." MGM Journal of Medical Sciences 5, no. 2 (2018): 85–87. http://dx.doi.org/10.5005/jp-journals-10036-1190.

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11

Vinik, A. I., R. E. Maser, B. D. Mitchell, and R. Freeman. "Diabetic Autonomic Neuropathy." Diabetes Care 26, no. 5 (May 1, 2003): 1553–79. http://dx.doi.org/10.2337/diacare.26.5.1553.

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12

Maser, Raelene E., James M. Lenhard, and Stephen G. DeCherney. "Cardiovascular Autonomic Neuropathy." Endocrinologist 10, no. 1 (January 2000): 27–33. http://dx.doi.org/10.1097/00019616-200010010-00006.

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13

Morrison J.F.B., John F. B. "Diabetic Autonomic Neuropathy." International Journal of Diabetes and Metabolism 9, no. 1-2 (2001): 10–23. http://dx.doi.org/10.1159/000497535.

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14

Freeman, Roy. "Autonomic Peripheral Neuropathy." CONTINUUM: Lifelong Learning in Neurology 26, no. 1 (February 2020): 58–71. http://dx.doi.org/10.1212/con.0000000000000825.

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15

Mccarty, Niamh, and Barry Silverman. "Cardiovascular Autonomic Neuropathy." Baylor University Medical Center Proceedings 29, no. 2 (April 2016): 157–59. http://dx.doi.org/10.1080/08998280.2016.11929397.

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16

Low, Phillip. "Diabetic Autonomic Neuropathy." Seminars in Neurology 16, no. 02 (June 1996): 143–51. http://dx.doi.org/10.1055/s-2008-1040970.

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17

Parish, Roy C. "Diabetic Autonomic Neuropathy." Journal of Pharmacy Practice 12, no. 2 (April 1999): 142–54. http://dx.doi.org/10.1177/089719009901200207.

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Diabetic autonomic neuropathy (DAN) occurs in approximately half of Caucasian patients with diabetes and perhaps three-fourths of black diabetic patients. This may be asymptomatic for several years, but the majority of patients with DAN eventually exhibit symptoms of diarrhea, cardiac arrhythmias, sexual dysfunction, and abnormal sweating. Prolonged hyperglycemia results in damage to the autonomic nervous system (ANS), particularly the vagus nerve and other parts of the parasympathetic division. DAN is associated with increased risk of sudden death, high-risk cardiac arrhythmias, myocardial infarction, and death from other causes. Objective testing of autonomic nervous system function yields specific information that affects treatment decisions. Drug therapy can effect improvements in ANS function and reduce these risks. Complications of diabetes that result from ANS dysfunction can be partly reversed or their progress can be slowed by appropriate drug therapy. Features, implications, and therapy of the most common complications resulting from DAN are reviewed, and suggestions for pharmacist involvement in the care of these difficult patients are offered.
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18

Lincoln, Jill, and Hannah R. Shotton. "Diabetic Autonomic Neuropathy." Tzu Chi Medical Journal 20, no. 3 (September 2008): 161–68. http://dx.doi.org/10.1016/s1016-3190(08)60031-2.

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19

Freeman, Roy. "Autonomic peripheral neuropathy." Lancet 365, no. 9466 (April 2005): 1259–70. http://dx.doi.org/10.1016/s0140-6736(05)74815-7.

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20

Hussein, A., A. Ahmed, N. Ahmed, A. Siddig, and A. Siddig. "Diabetic autonomic neuropathy." Journal of the Neurological Sciences 381 (October 2017): 916. http://dx.doi.org/10.1016/j.jns.2017.08.2575.

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21

Vita, Giuseppe, Corrado Messina, Vincenzo Savica, and Guido Bellinghieri. "Uraemic autonomic neuropathy." Journal of the Autonomic Nervous System 30 (July 1990): S179—S184. http://dx.doi.org/10.1016/0165-1838(90)90127-5.

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22

Bennett, Terry. "Diabetic autonomic neuropathy." Metabolism 35, no. 11 (November 1986): 1078. http://dx.doi.org/10.1016/0026-0495(86)90047-8.

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23

Niakan, Enayat, Yadollah Harati, and John P. Comstock. "Diabetic autonomic neuropathy." Metabolism 35, no. 3 (March 1986): 224–34. http://dx.doi.org/10.1016/0026-0495(86)90205-2.

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24

Freeman, Roy. "Autonomic Peripheral Neuropathy." Neurologic Clinics 25, no. 1 (February 2007): 277–301. http://dx.doi.org/10.1016/j.ncl.2007.01.001.

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25

Watkins, P. J. "Diabetic Autonomic Neuropathy." New England Journal of Medicine 322, no. 15 (April 12, 1990): 1078–79. http://dx.doi.org/10.1056/nejm199004123221511.

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26

Bilous, R. W. "Diabetic autonomic neuropathy." BMJ 301, no. 6752 (September 22, 1990): 565–67. http://dx.doi.org/10.1136/bmj.301.6752.565.

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27

Kempler, P., A. Varadi, F. Szalay, and G. Tamas. "Diabetic autonomic neuropathy." BMJ 301, no. 6761 (November 17, 1990): 1161. http://dx.doi.org/10.1136/bmj.301.6761.1161-b.

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28

Lennon, Vanda A. "Autoimmune autonomic neuropathy." Clinical Autonomic Research 12, no. 4 (August 1, 2002): 225–27. http://dx.doi.org/10.1007/s10286-002-0048-4.

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29

Ziegler, Dan. "Diabetic autonomic neuropathy." Clinical Autonomic Research 12, no. 5 (October 1, 2002): 349–52. http://dx.doi.org/10.1007/s10286-002-0064-4.

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30

Stevens, Martin J., and Peter J. Watkins. "Diabetic autonomic neuropathy." Acta Diabetologica Latina 28, no. 1 (January 1991): 105–12. http://dx.doi.org/10.1007/bf02732120.

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31

Kumar, Jitendra, and Sushma Sharma. "Uremic autonomic neuropathy." Clinical Queries: Nephrology 3, no. 1 (January 2014): 15–19. http://dx.doi.org/10.1016/j.cqn.2014.03.008.

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32

Williams, J. G. "Diabetic autonomic neuropathy." Practical Diabetes International 2, no. 2 (March 1985): 4–5. http://dx.doi.org/10.1002/pdi.1960020203.

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33

Spallone, Vincenza, Luigi Uccioli, and Guido Menzinger. "Diabetic autonomic neuropathy." Diabetes / Metabolism Reviews 11, no. 3 (October 1995): 227–57. http://dx.doi.org/10.1002/dmr.5610110305.

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34

Sandroni, Paola, Steven Vernino, Caroline M. Klein, Vanda A. Lennon, Lisa Benrud-Larson, David Sletten, and Phillip A. Low. "Idiopathic Autonomic Neuropathy." Archives of Neurology 61, no. 1 (January 1, 2004): 44. http://dx.doi.org/10.1001/archneur.61.1.44.

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35

Hart, Robert G. "Acute Autonomic Neuropathy." Archives of Internal Medicine 150, no. 11 (November 1, 1990): 2373. http://dx.doi.org/10.1001/archinte.1990.00390220109022.

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36

SAKOVETS, T. G., and E. I. BOGDANOV. "Autonomic diabetic neuropathy." Practical medicine 20, no. 6 (2022): 128–30. http://dx.doi.org/10.32000/2072-1757-2022-6-128-130.

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Diabetes mellitus (DM) is widespread in Russia, which has caused an increase in the frequency of complications in this nosology, including diabetic autonomic neuropathy (DАN). DАN determines an increase in mortality and a decrease in life expectancy. The purpose — to study the clinical manifestations of diabetic autonomic neuropathy. Results. In DAN, a lesion of various organ systems is observed. Manifestations of DAN are usually preceded by the development of typical signs of distal sensorimotor polyneuropathy. In some patients, manifestations of damage to the autonomic nervous system may prevail over damage to somatic sensory and motor nerve fibers. It should be borne in mind that in more than half of cases, DAN is accompanied by a fatal outcome with a duration of DM of more than 10 years. Cardiovascular autonomic neuropathy (CAN), which determines life expectancy in DM, is most often studied in the modern Russian and foreign medical science. The studies of other DAN manifestations are presented with much less frequency. DAN is accompanied by damage to all parts of the autonomic nervous system and determines an increase in mortality in patients with DM, which requires early detection of signs of diabetic autonomic neuropathy. Conclusion. Thus, DAN can cause an increase in mortality, a persistent decrease in working capacity in patients with DM, which requires general practitioners to be aware of the features of clinical signs of this nosology.
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37

Haq, Tahniyah, Tofail Ahmed, Zafar A. Latif, Tohfa E. Ayub, Mohammad A. Sayeed, and Sheikh M. Ashrafuzzaman. "Accuracy of autonomic symptoms in detection of severe cardiac autonomic neuropathy." Bangabandhu Sheikh Mujib Medical University Journal 15, no. 1 (July 12, 2022): 11–15. http://dx.doi.org/10.3329/bsmmuj.v15i1.58421.

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Autonomic neuropathy is a troublesome complication of diabetes mellitus often is not addressed by the physicians. The aim was to see the accuracy of autonomic symptoms in the detection of severe cardiac autonomic neuropathy (CAN). This study was done in BIRDEM in 62 adult patients with type 2 diabetes mellitus and cardiac autonomic neuropathy. Cardiac autonomic neuropathy was detected clinically by heart rate and blood pressure change to maneuvers such as deep breathing, valsalva and standing. Eight symptoms of autonomic neuropathy, namely exercise intolerance, dizziness, dysphagia, abdominal bloating, constipa- tion, diarrhea, gustatory sweating and impotence were tested. In this study, impotence was the most common symptom (58%). There was no difference in the frequency of autonomic symptoms between severe and non-severe cardiac autonomic neuropathy. Taking clinical tests as gold standard, gustatory sweating had the highest specificity (96%) and constipation had the highest sensitivity (54.05%) in detection of severe cardiac autonomic neuropathy. Sensitivity increased to 78.37 when a constellation of symptoms were tested. Autonomic symptoms are common in patients with type 2 diabetes and cardiac autonomic neuropathy. Collection of symptoms was associated with a high sensitivity for detection of severe cardiac autonomic neuropathy. BSMMU J 2022; 15(1): 11-15
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38

Jirkovská, Alexandra, Petr Boucek, Stephanie Wu, Jana Hosová, Robert Bém, Vladimira Fejfarova, and Jelena Skibová. "Power Spectral Analysis of Heart Rate Variability in Patients with Charcot’s Neuroarthropathy." Journal of the American Podiatric Medical Association 96, no. 1 (January 1, 2006): 1–8. http://dx.doi.org/10.7547/0960001.

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Charcot’s or neuropathic osteoarthropathy is one of the most debilitating orthopedic sequelae of diabetes mellitus. Distinguishing Charcot’s neuroarthropathy from clinically similar conditions may be challenging. The neurovascular theory postulates that Charcot’s neuroarthropathy may be secondary to sympathetic denervation of the lower-extremity vasculature. A convenient method for assessing autonomic neuropathy in patients with Charcot’s neuroarthropathy is needed. Short-term power spectral analysis (PSA) of heart rate variability (HRV), a noninvasive and quantitative method for assessing autonomic neuropathy, may be advantageous compared with the traditionally used Ewing’s cardiovascular reflex tests. However, there are limitations to the clinical use of PSA of HRV because of poor standardization. We standardized PSA of HRV and assessed autonomic neuropathy in 17 people with acute Charcot’s neuroarthropathy using PSA of HRV versus Ewing’s tests. More patients with Charcot’s neuroarthropathy were diagnosed as having autonomic neuropathy with PSA of HRV than with Ewing’s tests (94% versus 82%); however, no significant difference between the two methods was found. The results of this study suggest that PSA of HRV requires minimal patient collaboration and time expenditure compared with Ewing’s tests and may be useful in detecting autonomic neuropathy in patients with Charcot’s neuroarthropathy. (J Am Podiatr Med Assoc 96(1): 1–8, 2006)
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39

Songiso, Mpimpa, and Fastone Goma. "A Study of Cardiovascular Autonomic Neuropathy in Adult Patients with Diabetes Mellitus at Levy Mwanawasa University Teaching Hospital." University of Zambia Journal of Agricultural and Biomedical Sciences 6, no. 1 (January 1, 2022): 18–33. http://dx.doi.org/10.53974/unza.jabs.6.1.776.

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Cardiac autonomic neuropathy (CAN) is the diminished capacity of autonomic regulation of the cardiovascular system occurring in the presence of diabetes mellitus (DM) and in the absence of other aetiologies. Diabetes mellitus is a well- known cause of peripheral neuropathy. However, in comparison to somatic neuropathy, autonomic neuropathy is an under-diagnosed and under-treated chronic complication of diabetes mellitus despite its serious and significant contribution to morbidity and mortality in the diabetes mellitus population. A variety of tests, based on evaluation of the cardiovascular reflexes triggered by performing specific provocative manoeuvres, have been proposed to measure autonomic function. This study used four cardiovascular reflex tests to estimate appropriate autonomic function by examining heart rate, heart rate variation and the baroreceptor reflex. The aim of this study was to determine the presence of cardiovascular autonomic neuropathy in adult patients with diabetes mellitus at Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia. Adult patients with diabetes mellitus, aged between 21 and 70 years, participated in this cross-sectional study. Four, non-invasive, cardiac autonomic reflex tests to assess for cardiac autonomic neuropathy were employed according to Ewing’s method. The parasympathetic function was analysed based on the heart rate response to paced deep breathing and to Valsalva manoeuvring. The sympathetic function was assessed by measuring heart rate and blood pressure response to postural change. Ewing`s criteria was used for the categorisation of cardiac autonomic neuropathy. Data were analysed using SPSS version 20. Continuous data were presented as means and standard deviation. Categorical data were analysed using a Fishers’ Exact Test (χ2) and a logistic regression was performed to verify the effects of diabetes mellitus’ duration, sex and age on the probability that the participants have cardiac autonomic neuropathy. A total of 52 patients participated in the study. The prevalence of Cardiac autonomic neuropathy was 48.1%. Out of 52 patients, 42.3% had definite cardiac autonomic neuropathy and 5.8% had severe cardiac autonomic neuropathy. Early cardiac autonomic neuropathy was observed in 34.6% of patients while 17.3% had no signs of cardiac autonomic neuropathy. The mean age of patients with cardiac autonomic neuropathy was 54.44 ± 10.90 years and the mean duration of diabetes mellitus from diagnosis was 5.36 ± 6.78 years. The probability of developing cardiac autonomic neuropathy increased with increasing age and hypertensive participants were more likely develop cardiac autonomic neuropathy (ѵ = 5.82, p = .001). In conclusion, cardiac autonomic neuropathy was present in a significant proportion of adult patients with diabetes mellitus at Levy Mwanawasa University Teaching Hospital, reflecting the increased morbidity encountered by this population. In order to improve patient quality of life and reduce disease burden, screening for cardiac autonomic neuropathy should be implemented using cardiovascular autonomic reflex tests which are relatively simple, safe and affordable.
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40

Zelenina, T. A., V. V. Salukhov, E. A. Volkova, and A. B. Zemlynoj. "Early diagnosis of diabetic cardiac autonomic neuropathy by method of high-frequency ultrasonic dopplerography." Regional blood circulation and microcirculation 18, no. 2 (July 12, 2019): 49–57. http://dx.doi.org/10.24884/1682-6655-2019-18-2-49-57.

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Introduction. Diabetic neuropathy is the most wide-spread complication of diabetes mellitus and neuropathy is steadily progressing even with compensation of the underlying disease. The search of the new methods of treatment and diagnosis of neuropathy is required. Diabetic autonomic neuropathy lies in the base of early morbidity and mortality of diabetic patients.We estimated the potential of High-frequency Ultrasonic Dopplerography for diagnosis of autonomic neuropathy. Material and methods. 26 diabetic patients with sensorimotor neuropathy were examined. Microvascular blood flow of finger skin was assessed at rest as well as in functional tests: with cold impact and occlusion (cuff). Cardiac autonomic neuropathy was assessed using several cardiovascular autonomic reflex tests as a gold standard of diagnosis. Diagnostic values of microvascular blood flow test in detecting of cardiac autonomic neuropathy staging were evaluated in comparing with traditional modalities.Results. Cardiac autonomic neuropathy was found for all patients and definite/confirmed staging in 61.5 % cases. Initial parameters of microvascular blood flow velocity were significantly decreased in all patients in comparing with control (Vam= = (1.9±0.22); (1.7±0.51) and (6.7±0.51) sm/s in patients with early cardiac autonomic neuropathy, definite/confirmed staging and control subjects respectively, p<0.05). Microvascular blood flow functional testes had great informational content for diagnosis of autonomic neuropathy (sensitivity – 100 and 58 %, specify – 50 and 80 % respectively). The algorithm of diabetic patients examination was offered for early diagnosis of autonomic neuropathy staging.Conclusions. High-frequency Ultrasonic Dopplerography allowed to separate of cardiac autonomic neuropathy stages. This study is necessary to continue for revealing of all method possibilities.
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41

Sakovets, T. G. "Diabetic autonomic neuropathy as a risk factor for emergencies." Kazan medical journal 97, no. 6 (December 15, 2016): 931–34. http://dx.doi.org/10.17750/kmj2016-931.

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Diabetic autonomic neuropathy includes damage of various organ systems. The manifestations of autonomic neuropathy usually occur in setting of distal sensory motor polyneuropathy but autonomic disorders may be presented disproportionately compared to sensory and motor disorders. Diabetic autonomic neuropathy increases the risk of cardiac arrhythmias and sudden death, significantly reduces the patients’ quality of life, and exacerbates other vascular complications of diabetes mellitus. There are cardiovascular, gastrointestinal and urogenital forms of diabetic autonomic neuropathy and damaged function of autonomic nerve fibers involving respiratory system, pupils, sudoriferous glands, thermoregulatory and endocrine system. Cardiovascular autonomic neuropathy is the most studied, clinically meaningful and prognostically pejorative form of autonomic neuropathy. Autonomous diabetic neuropathy can cause frequent emergency admissions of patients with this pathology, increased mortality in patients with diabetes, which requires informing of general practitioners, endocrinologists, and intensivists about the features of the clinical manifestations and course of this disease.
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42

Farheen, Amtul, William Jens, Cunfeng Pu, and Aiesha Ahmed. "Sjogren’s syndrome related sensory motor neuropathy and autonomic neuropathy: A Case report." RRNMF Neuromuscular Journal 1, no. 5 (November 30, 2020): 25–28. http://dx.doi.org/10.17161/rrnmf.v1i5.14526.

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Neurologic involvement has been reported in primary Sjogren’s syndrome (SS) in approximately 10–25% of cases 1, 2, 3. Peripheral neuropathy is a major neurological manifestation of Sjögren's syndrome 4 and its etiology has been considered to be vasculitis in the peripheral nerves 2. While neuropathic symptoms of SS can be varied, it is unusual to have two different types of neuropathic presentations simultaneously in a patient. We describe a case of Sjogren’s syndrome presenting with autonomic symptoms who was noted to have large fiber neuropathy on EMG and inflammatory changes on nerve biopsy.
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43

Vernino, Steven, Phillip A. Low, and Vanda A. Lennon. "Experimental Autoimmune Autonomic Neuropathy." Journal of Neurophysiology 90, no. 3 (September 2003): 2053–59. http://dx.doi.org/10.1152/jn.00408.2003.

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Antibodies specific for the neuronal ganglionic nicotinic acetylcholine receptor (nAChR) are found in high titer in serum of patients with subacute autonomic failure. This clinical disorder is known as autoimmune autonomic neuropathy (AAN). Rabbits immunized with a neuronal nAChR α3 subunit fusion protein produce ganglionic nAChR antibodies and develop autonomic failure (experimental AAN, or EAAN). We used quantitative measures of autonomic function to demonstrate that this animal model of neuronal nAChR autoimmunity recapitulates the cardinal autonomic features of AAN in humans. The severity of dysautonomia in the rabbit ranges from isolated cardiovagal impairment to severe panautonomic failure with fixed mydriasis, gastroparesis, dry eyes, impaired heart rate variability, hypotension, and low plasma catecholamines. The severity of autonomic failure correlates with serum antibody levels. Immunohistochemical staining of superior cervical ganglia and myenteric plexus neurons demonstrates intact presynaptic nerve terminals and intact postsynaptic neurons containing cytoplasmic nAChR, but lacking surface nAChR. These findings define the autonomic physiology and histopathology of this novel animal model and support the concept that AAN in humans is a disorder of ganglionic cholinergic synaptic transmission caused by ganglionic nAChR antibodies.
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44

Pauli, Paul, Lydia Hartl, Christian Marquardt, Henrica Stalmann, and Friedrich Strian. "Heartbeat and arrhythmia perception in diabetic autonomic neuropathy." Psychological Medicine 21, no. 2 (May 1991): 413–21. http://dx.doi.org/10.1017/s0033291700020523.

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SYNOPSISA comparative study of diabetics with autonomic neuropathy (N = 13) as against non-neuropathic diabetics (N = 16) and healthy control persons (N = 20) was carried out with respect to heart rate both at rest and under stress, frequency of cardiac arrhythmias in a 24-h ECG and accuracy of heartbeat and arrhythmia perception. In the subjects with diabetic autonomic neuropathy, the spontaneous variability and stress-induced reactivity of the heart rate as well as the number of tachycardic episodes were reduced, whereas the frequency of ventricular extrasystoles was somewhat increased. Impaired heartbeat perception and a complete loss of perception of arrhythmias as a consequence of neuropathic deafferentation could be demonstrated. Cardiac perception disorders also play a vital role in other clinical problems, e.g. silent myocardial infarction and lack of awareness of hypoglycaemia in diabetes mellitus.
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45

Stewart, AG, JC Waterhouse, and P. Howard. "Cardiovascular autonomic nerve function in patients with hypoxaemic chronic obstructive pulmonary disease." European Respiratory Journal 4, no. 10 (November 1, 1991): 1207–14. http://dx.doi.org/10.1183/09031936.93.04101207.

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Intraneural hypoxaemia is recognized as a pathogenic mechanism in diabetic neuropathy. A similar pathophysiological process may occur in chronic obstructive pulmonary disease (COPD). Autonomic neuropathy is not recognized in COPD. We compared 96 patients with hypoxaemic COPD to 22 age-matched control subjects to see whether autonomic dysfunction occurs in COPD and whether there was any correlation with the severity of hypoxaemia. The cardiovascular autonomic tests consisted of heart rate responses (mainly parasympathetic function) to a Valsalva manoeuvre, deep breathing and postural change and blood pressure responses (mainly of sympathetic origin) to postural change and sustained handgrip. Early autonomic neuropathy is defined as one abnormal test and definite autonomic neuropathy as two abnormal tests according to the normal range. These autonomic tests were reproducible in our study population. Although the symptoms and signs of autonomic neuropathy were rare, definite autonomic dysfunction was found in 35%, and early autonomic neuropathy in a further 47%, of patients whose arterial oxygen tension (PaO2) was less than 8 kPa (60 mmHg). Only 18% of the control group had evidence of an age-related early autonomic dysfunction. Parasympathetic autonomic dysfunction was significantly correlated with PaO2 whilst the sympathetic tests were relatively normal. Correction of hypoxaemia for one hour or administration of ipratropium bromide or terbutaline had no effect on autonomic function. Subclinical autonomic neuropathy is a feature of hypoxaemic COPD. Its importance in the disease process and its role in prognosis needs evaluation.
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46

Simon, Chantal. "Peripheral Neuropathy." InnovAiT: Education and inspiration for general practice 2, no. 9 (August 26, 2009): 538–45. http://dx.doi.org/10.1093/innovait/inp129.

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Peripheral neuropathy is defined as dysfunction of the structure and function of peripheral motor, sensory and autonomic nerves. Although many individual causes of peripheral neuropathy are rare, it is estimated that up to 8% of the population have some degree of peripheral neuropathy or a total of 4.7 million people in the UK alone. There are many different types of peripheral neuropathy but the most common cause is diabetes and up to 60% of diabetic patients have a peripheral neuropathy of some sort. Peripheral neuropathy not only causes problems with everyday functioning but also in many cases causes severe, disabling neuropathic pain. This article aims to provide a simple overview of peripheral neuropathy and its management in primary care.
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47

Birajdar, Sidheshwar Virbhadraappa, Sheshrao Sakharam Chavan, Sanjay A. Munde, and Yuvraj P. Bende. "A Study of autonomic nervous system dysfunction among patient with diabetes mellitus: a cross sectional study." International Journal of Advances in Medicine 4, no. 2 (March 23, 2017): 406. http://dx.doi.org/10.18203/2349-3933.ijam20170967.

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Background: Neuropathy is a common complication of diabetes mellitus and it may affect both the peripheral nerves and autonomic nervous system. It’s prevalence ranges from 1% to 90%. The present study is therefore designed to investigate autonomic nervous system involvement in diabetes mellitus by using simple bedside tests and to study its association with other diabetic angiopathies.Methods: 100 patients of diabetes mellitus were selected in the study. In Autonomic function tests for evaluating parasympathetic damage E: I ratio, 30:75 ratio and Valsalva ratio test was performed. Sympathetic damage was diagnosed by Blood pressure response to standing test and Blood pressure response to sustained handgrip test.Results: Abnormal E:I ratio was noticed in only 24 patients. The 30:15 ratio was found to be abnormal in 38 patients while the Valsalva Ratio was abnormal in 34 patients. Postural hypotension was observed in only 8% patients. The sustained hand grip test was abnormal in 10 patients. The prevalence of cardiac autonomic neuropathy was 58%. The association between the presence of autonomic neuropathy and peripheral neuropathy was statistically significant. However, the association between autonomic neuropathy and retinopathy and nephropathy was not statistically significant.Conclusions: The overall prevalence of autonomic neuropathy in diabetes mellitus was 58%. There was parasympathetic preponderance over sympathetic nervous system in the involvement of diabetic autonomic neuropathy. There was statistically significant association of diabetic autonomic neuropathy with peripheral neuropathy as compared to retinopathy and nephropathy.
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48

Siddique, Furhaj Mueen, Imran Ahmed Moinuddin, Maida Nazir, Muhammad Kashif, Muhammad Mubeen Akhtar, and Asma Jabeen. "Frequency of Cardiac Autonomic Neuropathy and its Various Grades in Type 2 Diabetes Mellitus." Pakistan Journal of Medical and Health Sciences 16, no. 7 (July 30, 2022): 403–5. http://dx.doi.org/10.53350/pjmhs22167403.

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Introduction: Cardiovascular autonomic neuropathy (CAN) is a common and one of the major complication of diabetes mellitus. It is also the most under diagnosed and least understood diabetic complication4. Objective: To determine the frequency of cardiac autonomic neuropathy and its various grades in type 2 diabetes mellitus. Study Design: Cross Sectional Study. Setting: Medical OPD as well as from diabetic clinic of Services Hospital, Lahore. Methodology: Total 195 patients of either sex or age between 18 to 60 with at least 10 years duration of type 2 Diabetes Mellitus were enrolled. Cardiac Autonomic Neuropathy was determined using Ewing’s criteria. Frequency of CAN and its severity grades was recorded. Result: Mean age of sampled population was 54.42 ± 2.925 ranged from 44 to 60 years. There were 77 (39.5%) female and 118(60.5%) patients (60.5%) were male. Out of 195, 99 (50.8%) patients had cardiac autonomic neuropathy, 34 (17.4%) patients had early, 56 (28.7%) had definite, 8 (4.1%) had severe & 1 patient had atypical cardiac autonomic neuropathy. It was associated with advancing age but gender and duration of diabetes had no effect. Conclusion: The study concludes that frequency of cardiac autonomic neuropathy is quite high (50.8%) in patients with more than ten years duration of type II diabetes. Thirty four (17.4%) had early level, 56 patients (28.7%) had definite, 8 patients (4.1%) had severe and 1 patient had Atypical cardiac autonomic neuropathy. Keywords: Cardiac Autonomic Neuropathy, Diabetes, Insulin resistance, Autonomic instability, Neuropathy
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49

Vinik, Aaron I., and Gary L. Murray. "Autonomic Neuropathy Is Treatable." US Endocrinology 04, no. 02 (2008): 82. http://dx.doi.org/10.17925/use.2008.04.2.82.

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50

Schönauer, Martin, Andreas Thomas, Stephan Morbach, Josef Niebauer, Ulrike Schönauer, and Holger Thiele. "Cardiac autonomic diabetic neuropathy." Diabetes and Vascular Disease Research 5, no. 4 (January 2008): 336–44. http://dx.doi.org/10.3132/dvdr.2008.047.

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