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Do we need to evaluate diastolic blood pressure in patients with suspected orthostatic hypotension?

Purpose The contribution of diastolic blood pressure measurement to the diagnosis of classical orthostatic hypotension is not known. We aimed to explore the prevalence of isolated systolic and diastolic orthostatic hypotension components in patients with syncope and orthostatic intolerance. Methods A total of 1520 patients aged >15 years with suspected syncope and/or symptoms of...

Predictors of placebo response in peripheral neuropathic pain: insights from pregabalin clinical trials

Predictors of placebo response in peripheral neuropathic pain: insights from pregabalin clinical trials Roy Freeman,1 Birol Emir,2 Bruce Parsons2 1Autonomic and Peripheral Nerve Laboratory

High-Pass Filter Characteristics of the Baroreflex – A Comparison of Frequency Domain and Pharmacological Methods

Pharmacological methods to assess baroreflex sensitivity evoke supra-physiological blood pressure changes whereas computational methods use spontaneous fluctuations of blood pressure. The relationships among the different baroreflex assessment methods are still not fully understood. Although strong advocates for each technique exist, the differences between these methods need...

The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension

Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson’s disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, and peripheral neuropathies including amyloid or diabetic neuropathy. Due to the frequency of nOH in the aging population, clinicians need to be well informed about its diagnosis...

Structural and Functional Small Fiber Abnormalities in the Neuropathic Postural Tachycardia Syndrome

ObjectiveTo define the neuropathology, clinical phenotype, autonomic physiology and differentiating features in individuals with neuropathic and non-neuropathic postural tachycardia syndrome (POTS). MethodsTwenty-four subjects with POTS and 10 healthy control subjects had skin biopsy analysis of intra-epidermal nerve fiber density (IENFD), quantitative sensory testing (QST) and...

Generating productive dialogue between consulting statisticians and their clients in the pharmaceutical and medical research settings

Cabrera,4 Roy Freeman,5 David Madigan,6 Ha Nguyen,1 Ed Whalen11Primary Care Business Unit, Pfizer, Inc., New York, NY, USA; 2Nonclinical Statistics and Computing, Johnson & Johnson, Raritan, NJ, USA

Diabetic Neuropathy: A cross-sectional study of the relationships among tests of neurophysiology

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

Efficacy, Safety, and Tolerability of Pregabalin Treatment for Painful Diabetic Peripheral Neuropathy: Findings from seven randomized, controlled trials across a range of doses

ROY FREEMAN EDITH DURSO-DECRUZ PHD BIROL EMIR PHD R e v i e w s / C o m m e n t a r i e s / A D A OBJECTIVE - To evaluate the efficacy, safety, and tolerability of pregabalin across the effective

Hypoglycemia Increases Serum Interleukin-6 Levels in Healthy Men and Women

OBJECTIVE—Inflammation may have a major role in the pathogenesis and prognosis of critical illness. Hyperglycemia increases levels of the inflammatory cytokine interleukin-6 (IL-6) and is associated with increased risks of morbidity and mortality. Because hypoglycemia is also associated with adverse outcomes, we tested the hypothesis that hypoglycemia increases IL-6. RESEARCH...

Antecedent Hypoglycemia Impairs Autonomic Cardiovascular Function: Implications for Rigorous Glycemic Control

Gail K. Adler Istvan Bonyhay Hannah Failing Elizabeth Waring Sarah Dotson Roy Freeman OBJECTIVE-Glycemic control decreases the incidence and progression of diabetic complications but increases the

Surgical Decompression for Diabetic Sensorimotor Polyneuropathy

decompression should not be recommended for patients with diabetic sensorimotor polyneuropathy. AARON VINIK, MD, PHD, FCP, MACP2 EVA FELDMAN, MD, PHD3 ROY FREEMAN, MD4 ANDREW J.M. BOULTON, MD, FRCP5,6

Efficacy and Safety of Antioxidant Treatment With α-Lipoic Acid Over 4 Years in Diabetic Polyneuropathy: The NATHAN 1 trial

DAN ZIEGLER FRCPE PHILLIP A. LOW WILLIAM J. LITCHY ANDREW J.M. BOULTON AARON I. VINIK MACP ROY FREEMAN RUSTEM SAMIGULLIN HANS TRITSCHLER PHD ULLRICH MUNZEL PHD JOACHIM MAUS KLEMENS SCHTTE BSC PETER J

The Association Between Cardiovascular Autonomic Neuropathy and Mortality in Individuals With Diabetes: A meta-analysis

OBJECTIVE—To examine by meta-analysis the relationship between cardiovascular autonomic neuropathy (CAN) and risk of mortality in individuals with diabetes. RESEARCH DESIGN AND METHODS—We searched Medline for English-language articles published from 1966 to 2001. Fifteen studies having a baseline assessment of cardiovascular autonomic function and mortality follow-up were...

Diabetic Autonomic Neuropathy

Diabetic autonomic neuropathy (DAN) is a serious and common complication of diabetes. Despite its relationship to an increased risk of cardiovascular mortality and its association with multiple symptoms and impairments, the significance of DAN has not been fully appreciated. The reported prevalence of DAN varies widely depending on the cohort studied and the methods of assessment...

Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments

, New Orleans, Louisiana; Eva Feldman, MD, PhD, Department of Neurology, University of Michigan, Ann Arbor, Michigan; Roy Freeman, MD, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston

Diabetic Neuropathies: A statement by the American Diabetes Association

ANDREW J.M. BOULTON ARTHUR I. VINIK PHD JOSEPH C. AREZZO PHD VERA BRIL EVA L. FELDMAN PHD ROY FREEMAN MB CHB RAYAZ A. MALIK PHD MRCP RAELENE E. MASER PHD JAY M. SOSENKO MS DAN ZIEGLER R e v i e w s

Anti-Sympathetic Nervous System Autoantibodies: Diminished Catecholamines With Orthostasis

for publication 9 March 1989 and accepted in revised form 28 April 1989 1 FLORENCE M. BROWN , STUART J. BRINK, ROY FREEMAN, AND STEVEN L. RABINOWE - The etiology of autonomic neuropathy in