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The Conundrum of Dosimetry: Its Applications to Pharmacology and Biophysics Are Distinct
Published in Marko Markov, Dosimetry in Bioelectromagnetics, 2017
We would expect that an energetic pulse introduced into the body will create resonant harmonics among a multitude of different tissues. Given what we know from material sciences, those harmonics would be expected to impact the local environment. However, given current methodological limitations, the characterization of such harmonics is impossible to isolate and therefore measure with precision. That said, the impact of some energetic input may be measurable on the operation of the entire complex adaptive system as has been demonstrated with the use of the heart rate variability (HRV) technology. The body of data with regard to HRV is especially interesting as it provides a window into the clinical construct of homeostasis in the form of providing a quantitative measure of the operational balance between the sympathetic and parasympathetic systems. This is a particularly interesting example of how the dosimetry construct can be thought about in a manner that is distinct from how it is thought about in pharmacology. When a patient is diagnosed with dysautonomia, there is typically a component of their autonomic nervous system that is sufficiently dysfunctional to cause a clinical diagnosis. However, the pharmaceutical construct of dosimetry gives us no insight or tools, analogous to HRV with which to assess homeostasis in a broader systemic context (McCraty 2015).
Cardiac Sympathetic Neuroimaging
Published in Robert J. Gropler, David K. Glover, Albert J. Sinusas, Heinrich Taegtmeyer, Cardiovascular Molecular Imaging, 2007
Perhaps the clearest evidence for dysautonomia in PD has come from assessments of sympathetic noradrenergic innervation of the heart. At NIH, the OH is defined as a fall in systolic pressure of 20 mmHg or more and in diastolic pressure of 10 mm or more between lying supine for 15 minutes and then standing for five minutes. Depending on the definition used and the referral pattern to the evaluation center, OH occurs in one-fifth to up to one-half of patients with PD.
Tests for the identification of reflex syncope mechanism
Published in Expert Review of Medical Devices, 2023
Michele Brignole, Giulia Rivasi, Artur Fedorowski, Marcus Ståhlberg, Antonella Groppelli, Andrea Ungar
Among the tests used for the diagnosis of the mechanism of syncope, TT is the most comprehensive. Indeed, it allows for investigation of both hypotensive and bradycardic phenotypes and other dysautonomia syndromes, i.e. delayed orthostatic hypotension and postural orthostatic tachycardia syndrome. Routine practice time constraints and limited availability of TT on a large scale might negatively hamper its clinical use as a first-line diagnostic assessment. However, TT may provide a relevant contribution to the identification of both hypotensive and bradycardic phenotypes in the context of a multistep diagnostic work-up following the initial evaluation (Figure 2).