Syncope is defined as a sudden temporary loss of consciousness and postural tone that is associated with spontaneous recovery. Vasovagal or neurocardiogenic syncope is a common and usually benign cause of syncope. The mechanism may be cardioinhibitory, vasodepressor, or both. Diagnosis is usually made by a typical patient history with a definite trigger. Although vasovagal syncope is considered...

OBJECTIVES We sought to test the hypothesis that activation of the serotonergic system in patients with vasovagal syndrome during the head-up tilt test provokes syncope. BACKGROUND Central serotonergic activation participates in the pathogenesis of neurocardiogenic syncope. Drugs increasing serotonin (5-HT) in the central nervous system have not been tested as drug challenges during the head-...

The modified Thomas test was developed to assess the presence of hip flexion contracture and to measure hip extensibility. Despite its widespread use, to the authors' knowledge, its criterion reference validity has not yet been investigated. The purpose of this study was to assess the criterion reference validity of the modified Thomas test for measuring peak hip extension angle and hip extensi...

Thirty-five teenage patients with a history of presyncope or syncope underwent a passive head-up tilting to reproduce symptoms of syncope. If tilting alone did not induce syncope, isoproterenol infusion was given to increase heart rate to 150 to 160 beats per minute. In 80% of patients with a history of syncope, identical symptoms could be reproduced during tilting: an abrupt fall in blood pres...

Syncope is a common clinical presentation. Although most commonly benign, it may herald a pathology with a poor prognosis. The work-up of syncope includes a careful history, physical examination, electrocardiogram, risk stratification, and appropriately directed testing. The key factor in the investigation of syncope is the presence (or absence) of structural heart disease or an abnormal electr...

CONTEXT Patients with chronic fatigue syndrome (CFS) are more likely than healthy persons to develop neurally mediated hypotension (NMH) in response to prolonged orthostatic stress. OBJECTIVE To examine the efficacy of fludrocortisone acetate as monotherapy for adults with both CFS and NMH. DESIGN Randomized, double-blind, placebo-controlled trial conducted between March 1996 and February 1...

The design and implementation of a high-speed direct digital frequency synthesizer are presented. A modified Brent-Kung parallel adder is combined with pipelining technique to improve the speed of the system. A gated clock technique is proposed to reduce the number of registers in the phase accumulator design. The quarter wave symmetry technique is used to store only one quarter of the sine wav...

BACKGROUND Intermittent pneumatic compression (IPC) has been successfully used in the treatment of venous ulcers, although the optimal setting of pressure, inflation and deflation times has not yet been established. The aim of this study was to compare the effect of two different combinations of IPC pump settings (rapid vs slow) in the healing of venous ulcers. MATERIAL/METHODS 104 patients w...

Psychogenic pseudosyncope (PPS) is a common cause of apparent transient loss of consciousness (TLOC) with a dramatic impact on the quality of life. This review aims to give an overview of the definition, incidence, etiology, diagnosis, treatment, and prognosis of PPS based on a combination of literature data and personal experience. The limited literature on the subject suggests that PPS is rel...

OBJECTIVE To evaluate foot and ankle function in a series of patients undergoing fibula microvascular free tissue transfer. STUDY DESIGN A nonrandomized, nonblinded analysis was performed using the ankle-hindfoot scale as well as radiographic analysis to determine donor site morbidity. RESULTS Overall, foot ankle function was deemed to be good in this series of patients. Average ankle-hindf...