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PubMed1985

Plasma cortisol concentrations in women with menopausal flushes.

A wide variety of stressful stimuli has been shown to increase cortisol secretion. Women with post-menopausal flushes report that their flushes cause acute physical discomfort. We studied the effect of hot flushes on plasma cortisol concentrations in 7 women with frequent post-menopausal flushes. Subjects were monitored subjectively and objectively with a skin temperature recorder over a 3-h period (8:00-11:00 a.m.). The 8:00 a.m. cortisol levels were the highest. These were followed by a decline in plasma levels, suggesting the normal circadian variation in cortisol concentrations. No increase in plasma cortisol levels was found during or after the flush episodes. These results suggest that, in our experimental setting, post-menopausal flushes do not increase cortisol secretion.

Circadian Rhythm↗
PubMed2006

Niacin skin flushing in schizophrenic and depressed patients and healthy controls.

This study compares the skin reactions to the niacin flushing test of 16 schizophrenic patients with those of 17 depressed patients and 16 healthy controls. Methyl nicotinate (niacin) in a concentration of 0.1 M was applied to the forearm for 5 min. Significant differences could be observed between the group of schizophrenic patients (less flushing) in comparison to the other groups. There were no statistical differences in niacin flushing between patients with depression and healthy controls. Gender, age and the use of antipsychotic agents did not appear to be confounders. The differences in flushing within the group of schizophrenic patients were striking, however. Most patients showed little or no flushing, but some patients reacted strongly. Although the three groups could be differentiated by the niacin flushing test, to develop a reliable clinical application of this test, further research is necessary.

Adult↗
PubMed1996

Membrane fatty acids, niacin flushing and clinical parameters.

Clinical definitions of schizophrenia are unreliable and difficult to use. The niacin flush test, which involves prostaglandin-induced vasodilatation, offers a method of exploring essential fatty acid metabolism in schizophrenic patients and may serve to define a subgroup of patients. In a multicentre study of schizophrenic patients with negative symptoms, we have examined the clinical accompaniments of the niacin response. Patients failing to flush with niacin showed significantly reduced levels of arachidonic and docosahexaenoic acids. Conversion from non-flushing to flushing during the 6 month supplementation period was predicted by an increase in arachidonic acid levels in red blood cell membranes irrespective of nature of supplementation. In this study, patients were selected for their negative symptoms and, therefore, it was not surprising that further measures of negative or positive symptoms did not predict flushing. However, an increased score for affective symptoms was significantly associated with a positive flush response. The stability of the niacin test needs to be examined in relation to the periodicity of symptoms in schizophrenia and manic depressive illness. New information on the anandamide system suggests that it may be associated with periodic phenomena and should be investigated in relation to the niacin test.

Adult↗
PubMed1989

The skin-flushing response: autonomic, self-report, and conditioned responses to repeated administrations of alcohol in Asian men.

This study examined the skin-flushing response in Asian men, which is a low-risk factor for alcoholism. Asian men who did and did not flush to alcohol consumed 0.5 g/kg ethanol during three sessions with alcohol, and placebo in a fourth session. The results indicated that: (a) Asian men who flushed to alcohol showed pronounced cardiovascular changes that did not exhibit differential tolerance over 3 sessions, (b) there were surprisingly few self-reported mood differences in response to alcohol between those who did and did not flush, and (c) finger-pulse amplitude decreased and self-ratings of "boastful" increased significantly in response to placebo challenge in those men who did not flush. These results raise questions about the psychological mechanisms by which the skin-flushing response inhibits the development and expression of alcoholism.

Alcoholism↗
PubMed1987

Facial flushing and sweating mediated by the sympathetic nervous system.

Sweating and flushing of the forehead and cheeks in response to body heating, embarrassment and strong gustatory stimulation were investigated in 23 patients with a unilateral lesion in the sympathetic pathway to the face. A lesion anywhere along this pathway impaired thermoregulatory sweating and flushing on the denervated side of the forehead in most patients and also of the cheek in some cases. Emotional sweating was also diminished on the denervated side of the forehead irrespective of the site of lesion, but impairment of emotional vasodilatation was noted only with peripheral (second or third neuron) lesions. These findings suggest that sympathetic vasodilator fibres accompany vasoconstrictor and sudomotor fibres through conventional sympathetic pathways to the face. Gustatory sweating and flushing were symmetrical in most patients but flushing was more marked on the denervated side in three cases. Gustatory sweating was accompanied by flushing on the denervated side of the forehead in one patient following section of the T2 and T3 roots. It is concluded that the cervical sympathetic outflow is the main pathway for thermoregulatory flushing and emotional blushing and that diminution or absence of such vasodilator reactions is a usual component of Horner's syndrome unless the responsible lesion is confined to the first thoracic root. Gustatory vasodilatation and sweating is preserved and becomes exaggerated in some instances.

Body Temperature Regulation↗
PubMed1983

Epidemiological study of prevalence of chlorpropamide alcohol flushing in insulin dependent diabetics, non-insulin dependent diabetics, and non-diabetics.

An epidemiological study was carried out to compare the prevalence of facial flushing in non-diabetics, patients with insulin dependent diabetes, and patients with non-insulin dependent diabetes in response to 40 ml sherry taken 12 hours after 250 mg chlorpropamide or placebo, administered double blind in randomised order. A flush after chlorpropamide but not placebo was reported by 6.2% of non-diabetics (17/273), 9.7% of insulin-dependent diabetics (14/145), and 10.5% of non-insulin dependent diabetics (25/239), excluding those receiving long term chlorpropamide treatment. The differences were not significant. This response was unrelated to age, sex, body mass index, and family history of diabetes in all three groups. Patients taking long term chlorpropamide, however, showed a significantly (p less than 0.01) higher prevalence of flushing after both chlorpropamide and placebo (56.3%; 9/16) compared with the rest of the non-insulin dependent diabetics (16.7%; 40/239), the insulin dependent diabetics (6.9%; 10/145), and the non-diabetics (5.9%; 16/273). Patients receiving long term chlorpropamide would be expected to flush with sherry after a placebo tablet because of therapeutic plasma concentrations of the drug. It is concluded that there is no evidence of an increased prevalence of chlorpropamide alcohol flushing in response to the single challenge test in non-insulin dependent diabetics compared with insulin dependent diabetics and non-diabetics except in selected patients taking chlorpropamide long term. This study does not support the hypothesis that the chlorpropamide alcohol flush is a specific marker for a subtype of non-insulin dependent diabetes.

Adult↗
PubMed2005

Disorders of flushing.

Disorders of flushing encompass a broad spectrum of diverse acquired and inherited conditions. Chemical mediators involved in the flushing response are incompletely understood. Flushing episodes rarely can be associated with significant morbidity and mortality. The goal of the physician is to separate benign from potentially life-threatening conditions. Accurate diagnosis requires a thorough history and physical examination emphasizing the age of the patient, temporal association of flushing with occupation, environmental, stress, food, or drug exposure, and the duration of the episode. In some cases, despite a thorough evaluation, the etiology for flushing remains unknown. Understanding the distinct mechanisms that lead to flushing helps provide a rational approach to treatment.

Alcohol Drinking↗
PubMed1992

The relationship between three subtypes of the flushing response and DSM-III alcohol abuse in Japanese.

This study examined the relationship between the flushing response and drinking patterns and DSM-III alcohol abuse among Japanese using data collected in the joint U.S.-Japan collaborative study. The flushing response was classified into the following three subtypes: typical flushing (always flushed in the face after drinking), atypical flushing (sometimes) and nonflushing (never). This study of male current drinkers showed that typical flushers drank less alcohol than did atypical and nonflushers, but there was no observed difference between the drinking patterns of atypical flushers and nonflushers. Although the relationship was less pronounced, a similar association was found for female current drinkers. The 12-month prevalence of DSM-III alcohol abuse was estimated to be highest among atypical flushers and lowest among typical flushers, with nonflushers in between for both genders. When daily alcohol consumption and other pertinent sociodemographic variables were controlled, logistic regression analyses revealed that the risk for alcohol abuse by men was approximately 3.0 times higher among atypical flushers and 1.7 times higher among nonflushers than among typical flushers. The corresponding risks for abuse by women were 7.8 (atypical flushers) and 2.8 (nonflushers) times higher. Possible explanations for these differences in drinking patterns and the risk for alcohol abuse among the three flushing subtypes and between genders are discussed.

Adolescent↗
PubMed1987

Increased compliance of niceritrol treatment by addition of aspirin: relationship between changes in prostaglandins and skin flushing.

The relation of plasma levels of prostaglandins to the occurrence of flushing induced by niceritrol was investigated. Niceritrol increased plasma levels of PGE2 (p less than 0.01) and 6 keto-PGF1 alpha (p less than 0.05) in 10 male subjects and aspirin reduced the level of PGE2 (p less than 0.01). Five of 10 subjects had flushing, and aspirin reduced flushing in 4 subjects. On the basis of the above study, we treated 35 hyperlipidemic patients with niceritrol in combination with aspirin, investigating the effect of the treatment of serum lipids and postheparin lipolytic activity. None of the 12 cases given aspirin from the start of the treatment experienced flushing, whereas 9 of the 23 cases not given aspirin experienced flushing, which was suppressed by adding aspirin in prescription in all cases except one. Niceritrol decreased serum cholesterol, triglyceride and atherogenic index. It also increased HDL2 cholesterol and decreased HDL3 cholesterol. The LPL activity in postheparin plasma increased in all cases after niceritrol treatment. In conclusion, aspirin increased compliance of niceritrol by reducing the occurrence of flushing probably due to the decreased levels of prostaglandins, yielding favorable results for the long-term treatment of hyperlipidemia with a sufficient doses of niceritrol.

6-Ketoprostaglandin F1 alpha↗
PubMed1998

Saline flush during excimer laser angioplasty: short and long term effects in the rabbit femoral artery.

BACKGROUND AND OBJECTIVE: In this study, the effect of flushing saline on arterial wall damage (medial ruptures and necrosis), intimal hyperplasia, and arterial remodeling was determined. During excimer laser coronary angioplasty saline is flushed to reduce the size of explosive water vapor bubbles formed by intraluminal delivery of excimer laser pulses in blood. METHODS: In the femoral artery of the rabbit, 600 excimer laser pulses (308 nm, 50 mJ/mm2 per pulse, 20 Hz) were delivered coaxially over a length of 20 mm in 10 bursts of 3 seconds each. In 24/48 procedures, saline was flushed (0.2 ml/s) via the guidewire channel. After 2 and 56 days, microscopic and angiographic results were compared. RESULTS: At 2 days, as compared to lasing in blood, saline flush had drastically reduced the incidence of dissections (2/12 vs. 11/12, P < 0.002), but had increased the extent of medial and adventitial necrosis. The latter is attributed to direct irradiation of the arterial wall. After 56 days, in the saline group, in the middle-distal part of treated segments, medial necrosis without intimal hyperplasia was observed. However, at the edges of these lesions, intimal hyperplasia and arterial shrinkage reduced the lumen. CONCLUSION: Flushing saline during coaxial excimer laser pulse delivery significantly reduced the incidence of vessel wall ruptures, and prevented intimal hyperplasia formation in part of the lesion. The histologic findings at 56 days are attributed to the optical window which the saline flush provides for direct ultraviolet light irradiation of the arterial wall.

Angiography↗
PubMed1990

Development of preimplantation rabbit embryos in uterine flushing-supplemented culture media.

The development of cultured rabbit preimplantation embryos grown in standard media (Ham's F-10 or BSM II supplemented with bovine serum albumin (BSA) or homologous serum) or in Ham's medium supplemented with uterine flushings was compared. The uterine flushings derived from donors of 0.5-6 years of age. Uterine flushing supplemented media were used natively or after treatments like sterilization by filtration, lyophilization, three times freezing/thawing, heat denaturation, dialysis, or ultrafiltration. Compared with in vivo controls, embryonic growth was substantially reduced during in vitro culture, demonstrably by smaller diameters and impaired cell proliferation (measured by thymidine incorporation). The growth retardation was more pronounced in blastocysts (recovered at day 4 post coitum [p.c.]) than in morulae (recovered at day 3 p.c.). Development in uterine flushing media was notably better than in standard media but did not comply with in vivo development. Highest thymidine incorporation was observed in media with increased concentrations of uterine secretions and after sequential supplementation of flushings from subsequent progestational stages. Advanced donor ages, heating up to 80 degrees C, freezing, and lyophilizing did not affect incorporation data statistically significantly, whereas sterilization by filtration, ultrafiltration, and dialysis led to a significantly reduced thymidine incorporation in the cultured embryos. The positive effects of uterine flushing supplementation are attributed to the supply of components more adjusted to the needs of the cultured embryos and/or to a reduction of pathological effects in vitro like washing out of nutritive and regulatory components from the embryo into the surrounding culture medium.

Animals↗
PubMed1990

The menopausal hot flush: symptom reports and concomitant physiological changes.

Hot flushes are the most frequently reported menopausal symptom. The primary study goal was to develop criteria for the identification of hot flushes that ultimately could be applied independent of symptom report. Twenty-one postmenopausal women each underwent psychophysiological monitoring. Physiological activity accompanying their 93 subjective flush reports was compared with activity during nonflush periods, and a discriminant function analysis was carried out. The Physiological Flush Profile (PFP), developed on the basis of these analyses, consists of peripheral vasodilation plus an increase in skin conductance (sternal and/or palmar), both of a specified magnitude. The PFP was shown to be both a specific and a sensitive measure of hot flushes. Notably, change in sternal skin conductance was highly positively correlated with subjective flush severity ratings. Potential applications of the PFP toward delineating the role of psychological factors in the reporting of menopausal symptomatology are discussed.

Adult↗
PubMed1995

The accuracy of the flowrate in flush-devices of disposable pressure transducers.

BACKGROUND: Arterial and venous pressure is commonly measured using fluid filled catheters. To avoid obstruction they are continuously spilled by a flush-device. The accuracy of the flowrate has not been investigated previously. METHODS: The accuracy of 5 different flush-devices available in Switzerland was checked for flowrate when factory new, after a single sterilization with ethylen-oxide, in a long-term test over 96 hours, after repeated handling of the integrated bypass and under application of a pulsing counter-pressure. RESULTS: Flow is linearly related to differential-pressure and is constant over time. The flow of each flush-device at 200 mmHg differential-pressure was below the indicated 3 ml per hour (1.69 - 2.49 ml/h). Sterilization in two types produced a significant but not relevant difference in flowrate. Longtime-use, bypass actuation and pulsing pressure did not alter the flowrate significantly (p <0.05). In two factory-new flush-devices and 4 re-used ones a plugged capillary induced cessation of flow. CONCLUSIONS: Flowrate in flush-devices is accurate under sterilization, longtime use, bypass-actuation and pulsing counter pressure. A plugged capillary occurred in a few new and reused flush-devices, which can be the explanation for clotted catheters in clinical use.

Blood Pressure Determination↗
PubMed1987

The physiology and measurement of hot flushes.

Hot flushes occur in the vast majority of women at menopause or after bilateral oophorectomy. Yet only in the last decade have the physiologic changes associated with hot flushes been identified. It is now clear that hot flushes occur together with pulsatile release of luteinizing hormone. Available data implicate the anterior hypothalamus in the pathogenesis of the hot flush and suggest involvement of catecholamines and endogenous opiates. Estrogen withdrawal appears to be the stimulus to the development of hot flushes in susceptible women, and likewise estrogen is the most effective agent in reducing the frequency and intensity of the hot flush.

Catecholamines↗
PubMed1984

Experimental observations on the mode of action of "intracellular" flush solution.

Experiments were conducted using rabbit kidneys stored on ice for 48 hr to elucidate the mode of action of "intracellular" flush solutions. Measurements were made of renal function on a shunt and they were correlated with blood flow and the efficiency of the mechanical expulsion of red cells. By comparison with unflushed, ice-stored kidneys, near complete mechanical expulsion of blood by 30 to 60 min of continuous perfusion with hypertonic Ringer's albumin resulted in significantly higher blood flow with little gain in function. Similarly, increasing the content of nonelectrolyte in Ringer's albumin improved blood flow but not function. A simple flush with a low ionic strength sodium solution (LIE), containing impermeant anions and glucose was superior to that with Ringer's albumin. A high-potassium version of the low ionic strength solution (LIC) was in turn significantly better than LIE for kidney preservation by simple flushing and ice storage. These results were interpreted to mean that whereas mechanical flushing is a relatively minor component of the action of flush solutions, the major benefit results from a reduced sodium and elevated potassium content in the presence of impermeant anions. The primary importance of prevention of cell swelling by the inclusion of nonelectrolytes in "extracellular" flush solutions, is questioned.

Albumins↗
PubMed1979

Effects of preliminary normothermic flushing on hypothermic renal preservation.

Flushing of harvested kidneys with hypothermic perfusates is presumed to cause inappropriate circulation due to vasospasm. Effects of initial normothermic flushing prior to hypothermic flushing and cold preservation were tested in canine kidneys. Analysis of the perfusion characteristics revealed that a brief initial flushing with solutions at 37 degrees C. eliminates vasoconstriction and even facilitates subsequent hypothermic flushing. In amounts not exceeding 100 cc. it was not deleterious to transplant function. Larger volumes of normothermic flushing were proved to cause endothelial injury and resulted in poor transplant survival.

Animals↗
PubMed1980

A study of prostaglandin F2 alpha as the luteolysin in swine: V. Comparison of prostaglandin F, progestins, estrone and estradiol in uterine flushings from pregnant and nonpregnant gilts.

Uterine flushings were collected from 38 gilts representing Days 6,8,10,12,14,15,16 and 18 of the estrous cycle and pregnancy. The same group of gilts were represented within each of the respective days of the estrous cycle and pregnancy, i.e., three to six gilts per day per status. Uterine flushings (about 40ml) were assayed for prostaglandin F (PGF), estrone (E1), estradiol (E2), progestins (P) and protein. Nonpregnant gilts had higher (P < .01) concentrations of P in uterine flushings than pregnant gilts, but pregnant gilts had higher (P < .01) E1 and E2 concentrations. Significant day by status interactions were detected for E1 (P < .05), but not for E2 concentrations in uterine flushings. Total recoverable PGF and PGF concentrations in uterine flushings were greater (P < .01) in pregnant than nonpregnant gilts and significant (P < .01) day by status interactions were detected. In nonpregnant gilts, PGF increased between Days 12 and 16, i.e., during the period of corpora lutea (CL) regression. In pregnant gilts, PGF in uterine flushings increased markedly between Days 10 and 18. Total recoverable PGF on Day 18 of the estrous cycle was only 464.5 +/- 37.6 ng as compared to 22,688.1 +/- 1772.4 ng on Day 18 of pregnancy. Total recoverable protein was also higher (P < .01) in pregnant gilts. These data indicate that PGF synthesis and secretion by the uterine endometrium and/or conceptuses is not inhibited during pregnancy and suggest that PGF is sequestered within the uterine lumen of pregnant gilts, as is the total protein component of endometrial secretions referred to as histotroph.

Animals↗
PubMed1989

Hot flushes during Gn-RH analogue administration despite normal serum oestradiol levels.

Five out of 6 normally-menstruating women who were treated with a potent gonadotropin-releasing hormone (Gn-RH) agonist in order to achieve medical hypophysectomy developed hot flushes despite having normal oestradiol (E2) levels. The Gn-RH agonist was administered subcutaneously for 6 days and then intranasally for a further 14 days. A dose of 2 mg of E2 benzoate was injected intramuscularly once a week for 2 consecutive weeks. This combined treatment resulted in low peripheral gonadotropin levels but normal serum E2 concentrations. Four (4) women developed mild to moderate hot flushes and there was 1 case of flushes severe enough to necessitate cessation of treatment. The flushes occurred in the second week of Gn-RH analogue treatment when the level of serum luteinizing hormone (LH) was low and the pituitary was unresponsive to provocative tests, despite the fact that the patients' E2 levels were normal (mean 250 +/- 25 pg/ml). It is suggested that neither LH pulsatility nor low peripheral E2 levels are mainly responsible for the development of hot flushes. It is possible that Gn-RH, a hypothalamic decapeptide, may play a major role or act as a mediator in the aetiology of hot flushes.

Administration, Intranasal↗