ミクチュリション・シンコペ. 再評価とは,再評価である
JAMA
|February 8, 1985
まとめ
ミクチュリション・シンコペは,2つの患者グループで異なる形で現れます. 高齢者,多くの場合多発性疾患と正規性低血圧を患っている女性は,以前は過小評価されていたより大きなグループを表しています.
科学分野:
- 心臓病学 心臓病学
- 神経学 神経学とは
- ゲリアトリクス ゲリアトリクス
背景:
- ミクチュリション・シンコペ (MS) は,排尿に伴う一時的な意識喪失である.
- 若くて健康な男性におけるMSは十分に記録されているが,他の患者集団については知られていない.
研究 の 目的:
- 多様な患者コホートにおけるのシンコープの特徴と臨床表現を調査する.
- 多発性硬化症とそれに関連する危険因子を持つ患者グループを特定する.
主な方法:
- ミクトゥリション・シンコープと診断された33人の患者を対象とした前向きな研究.
- 患者データ収集には,年齢,性別,併発性疾患,薬剤,身体検査結果 (特に静止性低血圧) が含まれていました.
- 再発性シンコペまたは有害事象に対するフォローアップ評価は,平均15.3ヶ月間にわたって行われました.
主要な成果:
- 8人の若くて健康な男性 (平均年齢25歳),正常な評価と25人の高齢患者 (平均年齢60歳),主に女性 (16/25) を含む2つの異なるグループが特定されました.
- 高齢者グループは,平均3.8件の併発症および患者1人当たり3.5種類の薬剤で,より高い疾患負担を示した.
- 25人の高齢患者のうち22人に正静性低血圧が検出され,正静性を標的とした治療が開始されました.
- フォローアップ期間中,全研究コホートで再発性排泄症症の昏睡や突然の死は観察されなかった.
結論:
- ミクチュリション症候群は,2つの主要グループに分類することができます:若い健康な男性と,高齢者のより大きなコホート,しばしば女性.
- MSの高齢患者は,多くの場合,複数の併発性疾患と,高頻度の正静性低血圧を発症します.
- 矯正機能の改善に焦点を当てた管理戦略は,この集団における再発性シンコープと有害な結果の予防に有効であるようです.
関連する概念動画
The Micturition Reflex
Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...
Acute Respiratory Failure-III
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
Imaging Studies VI: Voiding Cystourethrography and Cystography
Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
Urodynamic Studies: Uroflowmetry
Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
Transient Ischemic Attack l: Introduction
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...


