Browsing by Author "Idiaquez, Juan"

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    Cardiovascular responses to isometric handgrip exercise in young patients with recurrent vasovagal syncope
    (2018) Idiaquez, Juan; Francisco Idiaquez, Juan; Iturriaga Agüera, Rodrigo
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    Hyperhidrosis in sleep disorders - A narrative review of mechanisms and clinical significance
    (WILEY, 2022) Idiaquez, Juan; Carlos Casar, Juan; Arnardottir, Erna S.; August, Elias; Santin, Julia; Iturriaga, Rodrigo
    Hyperhidrosis is characterized by excessive sweating beyond thermoregulatory needs that affects patients' quality of life. It results from an excessive stimulation of eccrine sweat glands in the skin by the sympathetic nervous system. Hyperhidrosis may be primary or secondary to an underlying cause. Nocturnal hyperhidrosis is associated with different sleep disorders, such as obstructive sleep apnea, insomnia, restless legs syndrome/periodic limb movement during sleep and narcolepsy. The major cause of the hyperhidrosis is sympathetic overactivity and, in the case of narcolepsy type 1, orexin deficiency may also contribute. In this narrative review, we will provide an outline of the possible mechanisms underlying sudomotor dysfunction and the resulting nocturnal hyperhidrosis in these different sleep disorders and explore its clinical relevance.
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    Recessive dystrophic epidermolysis bullosa results in painful small fibre neuropathy
    (2017) Von Bischhoffshausen, Sofia; Ivulic, Dinka; Alvarez, Paola; Schuffeneger, Victor C.; Idiaquez, Juan; Fuentes, Constanza; Morandé, Pilar; Fuentes, Ignacia; Palisson, Francis; Calvo Bascuñan, Margarita; Bennet, David L. H.
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    Sympathetic and electrochemical skin responses in the assessment of sudomotor function: a comparative study
    (2023) Idiaquez, Juan; Casar, Juan Carlos; Fadic, Ricardo; Iturriaga, Rodrigo
    Objectives: The sympathetic skin response (SSR) is a well-established test, whereas the electro-chemical skin conductance (ESC) is still under evaluation. Our aim was therefore to assess the diagnostic accuracy of ESC to detect abnormal sudomotor function, using SSR as a reference test.Methods: A cross sectional observational study was performed of 61 neurological patients assessed for possible sudomotor dysfunction and 50 age-matched healthy controls (HC). Patients with diagnoses of vasovagal syncope (VVS, n=25), Parkinson's disease (PD, n=15), multiple system atrophy (MSA, n=11) and peripheral neuropathies (PN, n=10) were included. Sudomotor function was assessed with SSR and ESC tests in all participants. The absence of SSR in the palms or soles indicates abnormal sudomotor function. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic value of the ESC. Cardiovascular autonomic (CV-Aut) function was evaluated through the Ewing score, based on the following tests: Heart rate change with deep breathing, Valsalva ratio, 30:15 ratio, blood pressure changes on standing and during isometric exercise. A Ewing score > 2 indicates the presence of CV-Aut dysfunction.Results: Mean SSR amplitudes and ESC values showed differences between HC and patients with MSA or PN (p < 0.05), but not in patients with VVS or PD. Absence of SSR was associated with abnormal ESC (p < 0.05). Patients with abnormal CV-Aut dysfunction had lower ESC (p< 0.05). Palm ESC (P-ESC) and sole ESC (S-ESC) assessment had a sensitivity of 0.91 and 0.95 to predict sudomotor dysfunction, with a specificity of 0.78 and 0.85, respectively. The area under ROC curve was 0.905 and 0.98, respectively.Conclusions: ESC in palms and soles has a high diagnostic accuracy for sudomotor dysfunction as detected by absent SSR in patients with MSA and PN. (c) 2022 Elsevier Masson SAS. All rights reserved.
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    Transient orthostatic hypertension after partial cerebellar resection
    (2011) Idiaquez, Juan; Fadic, Ricardo; Mathias, Christopher J.
    An effective baroreflex and autonomic pathways normally ensure that blood pressure (BP) is satisfactorily maintained, despite various stimuli in daily life that include postural changes. We describe a 20-year-old man with a cerebellar hematoma and acute hydrocephalus, who had a vermian and partial right cerebellar hemisphere resection followed by orthostatic hypertension (OHT) and mutism. On standing his systolic BP rose over 60 mmHg with a fivefold increase in plasma noradrenaline. After a period of 8 weeks, postural BP regulation improved along with his ability to communicate. We conclude that transient impairment of cerebellar autonomic modulation or dysfunction of the baroreflex medullary circuit, may have resulted in OHT.