john herr psychologist los gatos saratoga california

On Sabbatical

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TITLE: Neurally mediated syncope and syncope due to autonomic failure: differences and similarities.
AUTHOR: Kaufmann H
AUTHOR AFFILIATION: Department of Neurology, Mount Sinai School of Medicine, New York, New York 10029, USA.
SOURCE: J Clin Neurophysiol 1997 May;14(3):183-96
NLM CIT. ID: 97386309
ABSTRACT: Syncope is a transient loss of consciousness and postural tone caused by a global reduction of blood flow to the brain. Abnormalities in autonomic cardiovascular control can impair blood supply to the brain and produce syncope in two different disorders: autonomic failure and neurally mediated syncope. In autonomic failure, sympathetic efferent activity is chronically impaired so that vasoconstriction is deficient, upon standing blood pressure always falls (i.e., orthostatic hypotension), and syncope or presyncope occurs. Conversely, in neurally mediated syncope, the failure of sympathetic efferent vasoconstrictor traffic (and hypotension) occurs episodically and in response to a trigger. Between syncopal episodes, patients with neurally mediated syncope have normal blood pressure and orthostatic tolerance. This article reviews the characteristics of autonomic failure and describes in more detail the pathophysiology, diagnosis, and treatment of neurally mediated syncope.
MAIN MESH SUBJECTS: Autonomic Nervous System Diseases/*COMPLICATIONS/DIAGNOSIS/ PHYSIOPATHOLOGY/THERAPY
Peripheral Nervous System Diseases/*COMPLICATIONS/DIAGNOSIS/ PHYSIOPATHOLOGY
Syncope/*ETIOLOGY/PHYSIOPATHOLOGY
ADDITIONAL MESH SUBJECTS: Cardiac Pacing, Artificial
Cerebrovascular Circulation
Circadian Rhythm/PHYSIOLOGY
Diagnosis, Differential
Human
Hypotension, Orthostatic/DIAGNOSIS/ETIOLOGY
Posture/PHYSIOLOGY
Syncope, Vasovagal/DIAGNOSIS
Tilt-Table Test
Vasoconstriction/PHYSIOLOGY
PUBLICATION TYPES: JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
LANGUAGE: Eng

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On Sabbatical!

When my office lease expired at the end of 2004, I decided to turn it into a "sabbatical" from my private practice. Many years ago, in my grandfather's 89th year of life, he told me, "John, it is important to smell the roses while you can still smell them." His life gave living a very good reputation. It is also true that the pursuit of that philosophy required my grandfather to to re-open his assay office/ore market in Wickenburg, Arizona as a 75-year-old because he had run a little short of retirement money. Thus, if blessed with his luck and health, I'll be back.. --jjh

Copyright 1998-2007  John J. Herr, Ph.D.                                   Please send comments to jjherr@clinicalpsychologist.com