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Article ; Online: What is new in perioperative dysglycemia?

Long, Micah T / Anderson, Alexandra L / Curry, Timothy B

2022 Volume 48, Issue 9, Page(s) 1230–1233

MeSH term(s)	Blood Glucose ; Humans ; Hyperglycemia
Chemical Substances	Blood Glucose
Language	English
Publishing date	2022-08-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-022-06829-4
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Article ; Online: Quantifying muscle blood flow: a transformative breakthrough in the science of human exercise physiology.

Olson, Thomas P / Smith, Joshua R / Curry, Timothy B

Clinical science (London, England : 1979)

2022 Volume 136, Issue 22, Page(s) 1653–1656

Abstract: Over 50 years ago, John Wahren and Lennart Jorfeldt published a manuscript in Clinical Science where they detailed a series of studies of leg blood flow during exercise. They used a novel approach to indicator dye dilution: continuous arterial infusions ... ...

Abstract	Over 50 years ago, John Wahren and Lennart Jorfeldt published a manuscript in Clinical Science where they detailed a series of studies of leg blood flow during exercise. They used a novel approach to indicator dye dilution: continuous arterial infusions of dye using venous samples. This technique allowed them to describe for the first time the fundamental relationships between large muscle group exercise, muscle blood flow, and pulmonary and muscle oxygen uptake. They also defined mechanical efficiency, a key measurement of muscle function. This paper formed the basis for research into muscle blood flow and exercise in health and disease and continued to be cited by modern research. In this commentary, we describe the innovations they made, the key observations that came out of their results, and the importance of this manuscript to current research.
MeSH term(s)	Humans ; Oxygen Consumption/physiology ; Regional Blood Flow/physiology ; Leg/blood supply ; Hemodynamics ; Muscles/metabolism
Language	English
Publishing date	2022-11-18
Publishing country	England
Document type	Journal Article
ZDB-ID	206835-7
ISSN	1470-8736 ; 0301-0538 ; 0009-0360 ; 0143-5221
ISSN (online)	1470-8736
ISSN	0301-0538 ; 0009-0360 ; 0143-5221
DOI	10.1042/CS20220101
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Article ; Online: Hypertension: is it more than just a numbers game?

Curry, Timothy B

The Journal of physiology

2013 Volume 591, Issue 23, Page(s) 5805–5806

MeSH term(s)	Amides/therapeutic use ; Antihypertensive Agents/therapeutic use ; Cardiovascular Diseases/prevention & control ; Fumarates/therapeutic use ; Humans ; Hypertension/drug therapy ; Renin/antagonists & inhibitors ; Sodium Chloride Symporter Inhibitors/therapeutic use
Chemical Substances	Amides ; Antihypertensive Agents ; Fumarates ; Sodium Chloride Symporter Inhibitors ; aliskiren (502FWN4Q32) ; Renin (EC 3.4.23.15)
Language	English
Publishing date	2013-11-29
Publishing country	England
Document type	Journal Article
ZDB-ID	3115-x
ISSN	1469-7793 ; 0022-3751
ISSN (online)	1469-7793
ISSN	0022-3751
DOI	10.1113/jphysiol.2013.266254
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Article ; Online: Towards a Lightweight Classifier to Detect Hypovolemic Shock.

Pramanik, Leena / Felton, Christopher L / Techentin, Robert W / Holmes, David R / Curry, Timothy B / Joyner, Michael J / Convertino, Victor A / Haider, Clifton R

Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference

2023 Volume 2023, Page(s) 1–5

Abstract: Predicting the ability of an individual to compensate for blood loss during hemorrhage and detect the likely onset of hypovolemic shock is necessary to permit early clinical intervention. Towards this end, the compensatory reserve metric (CRM) has been ... ...

Abstract	Predicting the ability of an individual to compensate for blood loss during hemorrhage and detect the likely onset of hypovolemic shock is necessary to permit early clinical intervention. Towards this end, the compensatory reserve metric (CRM) has been demonstrated to directly correlate with an individual's ability to maintain compensatory mechanisms during loss of blood volume from onset (one-hundred percent health) to exsanguination (zero percent health). This effort describes a lightweight, three-class predictor (good, fair, poor) of an individual's compensatory reserve using a linear support-vector machine (SVM) classifier. A moving mean filter of the predictions demonstrates a feasible model for implementation of real-time hypovolemia monitoring on a wearable device, requiring only 408 bytes to store the models' coefficients and minimal processor cycles to complete the computations.
MeSH term(s)	Humans ; Shock/diagnosis ; Hypovolemia/diagnosis ; Blood Volume ; Hemorrhage/diagnosis ; Wearable Electronic Devices
Language	English
Publishing date	2023-12-11
Publishing country	United States
Document type	Journal Article
ISSN	2694-0604
ISSN (online)	2694-0604
DOI	10.1109/EMBC40787.2023.10340949
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Article ; Online: Sympathetic transduction to blood pressure during euglycemic-hyperinsulinemia in young healthy adults: role of burst amplitude.

Young, Benjamin E / Padilla, Jaume / Shoemaker, J Kevin / Curry, Timothy B / Fadel, Paul J / Limberg, Jacqueline K

American journal of physiology. Regulatory, integrative and comparative physiology

2023 Volume 324, Issue 4, Page(s) R536–R546

Abstract: Insulin acts centrally to stimulate sympathetic vasoconstrictor outflow to skeletal muscle and peripherally to promote vasodilation. Given these divergent actions, the "net effect" of insulin on the transduction of muscle sympathetic nerve activity (MSNA) ...

Abstract	Insulin acts centrally to stimulate sympathetic vasoconstrictor outflow to skeletal muscle and peripherally to promote vasodilation. Given these divergent actions, the "net effect" of insulin on the transduction of muscle sympathetic nerve activity (MSNA) into vasoconstriction and thus, blood pressure (BP) remains unclear. We hypothesized that sympathetic transduction to BP would be attenuated during hyperinsulinemia compared with baseline. In 22 young healthy adults, MSNA (microneurography), and beat-to-beat BP (Finometer or arterial catheter) were continuously recorded, and signal-averaging was performed to quantify the mean arterial pressure (MAP) and total vascular conductance (TVC; Modelflow) responses following spontaneous bursts of MSNA at baseline and during a euglycemic-hyperinsulinemic clamp. Hyperinsulinemia significantly increased MSNA burst frequency and mean burst amplitude (baseline: 46 ± 6 au; insulin: 65 ± 16 au,
MeSH term(s)	Humans ; Adult ; Blood Pressure/physiology ; Arterial Pressure ; Vasoconstrictor Agents ; Hyperinsulinism ; Insulin ; Muscle, Skeletal/innervation ; Sympathetic Nervous System ; Heart Rate/physiology
Chemical Substances	Vasoconstrictor Agents ; Insulin
Language	English
Publishing date	2023-02-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	603839-6
ISSN	1522-1490 ; 0363-6119
ISSN (online)	1522-1490
ISSN	0363-6119
DOI	10.1152/ajpregu.00162.2022
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Article ; Online: Arthroscopic assisted brachial plexus catheter placement: an alternative to the percutaneous interscalene approach.

He, Amy / Handlogten, Kathryn S / Kor, Benjamin T / Brown, Michael J / Elhassan, Bassem T / Curry, Timothy B / Kor, Todd M / Stewart, Thomas M

JSES international

2023 Volume 8, Issue 2, Page(s) 310–316

Abstract: Background: Brachial plexus catheter placement at the interscalene level is beneficial for shoulder analgesia but presents logistical challenges due to the superficial nature of the plexus at this level, increased patient movement in the neck, and ... ...

Abstract	Background: Brachial plexus catheter placement at the interscalene level is beneficial for shoulder analgesia but presents logistical challenges due to the superficial nature of the plexus at this level, increased patient movement in the neck, and therefore higher likelihood for catheter dislodgement. Methods: Patients requiring shoulder arthroscopy and suprascapular nerve decompression were identified. Under arthroscopic guidance, a catheter was placed percutaneously into the scalene medius muscle next to the suprascapular nerve and the upper trunk of the brachial plexus. Patients were followed postoperatively for perioperative analgesic outcomes. Results: Ten patients were identified and consented for intraoperative brachial plexus catheter placement. Patient demographics and surgical details were determined. Postoperative adjunctive pain management and pain scores were variable. Two patients required catheter replacement using ultrasound guidance in the perioperative anesthesia care unit due to poorly controlled pain. There were no incidents of catheter failure due to dislodgement. Discussion: This study presents the first description of arthroscopically-assisted brachial plexus catheter placement. This method may present an alternative to traditional ultrasound guided interscalene catheter placement. Further study is needed to determine if analgesic outcomes, block success, and dislodgement rates are improved with this method.
Language	English
Publishing date	2023-12-15
Publishing country	United States
Document type	Journal Article
ISSN	2666-6383
ISSN (online)	2666-6383
DOI	10.1016/j.jseint.2023.11.013
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Article ; Online: Pharmacogenomics education and perceptions: is there a gap between internal medicine resident and attending physicians?

Rohrer Vitek, Carolyn R / Giri, Jyothsna / Caraballo, Pedro J / Curry, Timothy B / Nicholson, Wayne T

Pharmacogenomics

2021 Volume 22, Issue 4, Page(s) 195–201

Abstract: Aim: ...

Abstract	Aim:
MeSH term(s)	Attitude of Health Personnel ; Health Knowledge, Attitudes, Practice ; Humans ; Internal Medicine/education ; Internship and Residency ; Pharmacogenetics/education ; Physicians ; Precision Medicine ; Surveys and Questionnaires
Language	English
Publishing date	2021-02-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2019513-8
ISSN	1744-8042 ; 1462-2416
ISSN (online)	1744-8042
ISSN	1462-2416
DOI	10.2217/pgs-2020-0141
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Article ; Online: Influence of locomotor muscle group III/IV afferents on cardiovascular and ventilatory responses in human heart failure during submaximal exercise.

Smith, Joshua R / Joyner, Michael J / Curry, Timothy B / Borlaug, Barry A / Keller-Ross, Manda L / Van Iterson, Erik H / Olson, Thomas P

Journal of applied physiology (Bethesda, Md. : 1985)

2022 Volume 132, Issue 4, Page(s) 903–914

Abstract: The purpose of this study is to determine the influence of locomotor muscle group III/IV afferent inhibition on central and peripheral hemodynamics at multiple levels of submaximal cycling exercise in patients with heart failure with reduced ejection ... ...

Abstract	The purpose of this study is to determine the influence of locomotor muscle group III/IV afferent inhibition on central and peripheral hemodynamics at multiple levels of submaximal cycling exercise in patients with heart failure with reduced ejection fraction (HFrEF). Eleven patients with HFrEF and nine healthy matched controls were recruited. The participants performed a multiple stage [i.e., 30 W, 50%peak workload (WL), and a workload eliciting a respiratory exchange ratio (RER) of ∼1.0] exercise test with lumbar intrathecal fentanyl (FENT) or placebo (PLA). Cardiac output ([Formula: see text]tot) was measured via open-circuit acetylene wash-in technique and stroke volume was calculated. Leg blood flow ([Formula: see text]l) was measured via constant infusion thermodilution and leg vascular conductance (LVC) was calculated. Radial artery and femoral venous blood gases were measured. For HFrEF, stroke volume was higher at the 30 W (FENT: 110 ± 21 vs. PLA: 100 ± 18 mL), 50%peak WL (FENT: 113 ± 22 vs. PLA: 103 ± 23 mL), and RER = 1.0 (FENT: 119 ± 28 vs. PLA: 110 ± 26 mL) stages, whereas heart rate and systemic vascular resistance were lower with fentanyl than with placebo (all,
MeSH term(s)	Cardiovascular System ; Exercise/physiology ; Heart Failure/drug therapy ; Humans ; Muscle, Skeletal/physiology ; Stroke Volume
Language	English
Publishing date	2022-02-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	219139-8
ISSN	1522-1601 ; 0021-8987 ; 0161-7567 ; 8750-7587
ISSN (online)	1522-1601
ISSN	0021-8987 ; 0161-7567 ; 8750-7587
DOI	10.1152/japplphysiol.00371.2021
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Article ; Online: The relationship between muscle sympathetic nerve activity and systemic hemodynamics is altered in women with uterine fibroids.

Harvey, Ronée E / Laughlin-Tommaso, Shannon K / Stewart, Elizabeth A / Limberg, Jacqueline K / Curry, Timothy B / Joyner, Michael J / Barnes, Jill N

Physiological reports

2022 Volume 10, Issue 18, Page(s) e15445

Abstract: Women with uterine fibroids (UF), benign tumors of the myometrium, have a higher prevalence of hypertension than women without UF. The cause for this relationship is unclear. Muscle sympathetic nerve activity (MSNA) is a regulator of arterial blood ... ...

Abstract	Women with uterine fibroids (UF), benign tumors of the myometrium, have a higher prevalence of hypertension than women without UF. The cause for this relationship is unclear. Muscle sympathetic nerve activity (MSNA) is a regulator of arterial blood pressure, and it is possible that variations in MSNA predispose women with UF to develop hypertension. The purpose of this study was to assess baseline blood pressure and MSNA and the relationships between MSNA and systemic hemodynamics in women with and without UF. We measured blood pressure (brachial intra-arterial line), MSNA (microneurography), and systemic hemodynamics (total peripheral resistance and cardiac output) at rest in 14 healthy, normotensive, premenopausal women with UF (42 ± 2 years old) and 9 healthy, normotensive, premenopausal women without UF (41 ± 2 years old). Baseline blood pressure and MSNA did not differ between groups (p > 0.05 for both). In women with UF, there was a positive correlation between MSNA and total peripheral resistance (r = 0.75, p = 0.02), as well as a negative correlation between MSNA and cardiac output (r = -0.73, p = 0.03). In contrast, these relationships were not seen in women without UF (p > 0.05 for both relationships). These data suggest that autonomic interactions with systemic hemodynamics, and thus blood pressure regulation, are different in healthy women with UF compared to healthy women without UF.
MeSH term(s)	Adult ; Female ; Hemodynamics/physiology ; Humans ; Hypertension ; Leiomyoma ; Muscles ; Sympathetic Nervous System/physiology
Language	English
Publishing date	2022-09-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	2724325-4
ISSN	2051-817X ; 2051-817X
ISSN (online)	2051-817X
ISSN	2051-817X
DOI	10.14814/phy2.15445
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Article ; Online: Non-invasive biomarkers for detecting progression toward hypovolemic cardiovascular instability in a lower body negative pressure model.

Murphy, Ethan K / Bertsch, Spencer R / Klein, Samuel B / Rashedi, Navid / Sun, Yifei / Joyner, Michael J / Curry, Timothy B / Johnson, Christopher P / Regimbal, Riley J / Wiggins, Chad C / Senefeld, Jonathon W / Shepherd, John R A / Elliott, Jonathan Thomas / Halter, Ryan J / Vaze, Vikrant S / Paradis, Norman A

Scientific reports

2024 Volume 14, Issue 1, Page(s) 8719

Abstract: Occult hemorrhages after trauma can be present insidiously, and if not detected early enough can result in patient death. This study evaluated a hemorrhage model on 18 human subjects, comparing the performance of traditional vital signs to multiple off- ... ...

Abstract	Occult hemorrhages after trauma can be present insidiously, and if not detected early enough can result in patient death. This study evaluated a hemorrhage model on 18 human subjects, comparing the performance of traditional vital signs to multiple off-the-shelf non-invasive biomarkers. A validated lower body negative pressure (LBNP) model was used to induce progression towards hypovolemic cardiovascular instability. Traditional vital signs included mean arterial pressure (MAP), electrocardiography (ECG), plethysmography (Pleth), and the test systems utilized electrical impedance via commercial electrical impedance tomography (EIT) and multifrequency electrical impedance spectroscopy (EIS) devices. Absolute and relative metrics were used to evaluate the performance in addition to machine learning-based modeling. Relative EIT-based metrics measured on the thorax outperformed vital sign metrics (MAP, ECG, and Pleth) achieving an area-under-the-curve (AUC) of 0.99 (CI 0.95-1.00, 100% sensitivity, 87.5% specificity) at the smallest LBNP change (0-15 mmHg). The best vital sign metric (MAP) at this LBNP change yielded an AUC of 0.6 (CI 0.38-0.79, 100% sensitivity, 25% specificity). Out-of-sample predictive performance from machine learning models were strong, especially when combining signals from multiple technologies simultaneously. EIT, alone or in machine learning-based combination, appears promising as a technology for early detection of progression toward hemodynamic instability.
MeSH term(s)	Humans ; Hypovolemia/diagnosis ; Lower Body Negative Pressure ; Vital Signs ; Cardiovascular System ; Biomarkers
Chemical Substances	Biomarkers
Language	English
Publishing date	2024-04-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-59139-8
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