Characterization of heart rate changes associated with autonomic dysreflexia during penile vibrostimulation and urodynamics
Bibliographic record
Abstract
ABSTRACT Purpose Autonomic dysreflexia, often accompanied by heart rate changes, increases the risk of cardio-cerebrovascular complications in individuals with spinal cord injury. Thus, our aim was to characterize these changes during penile vibrostimulation and urodynamics. Materials and Methods We analyzed the cardiovascular (i.e. blood pressure and heart rate) data from two prospective studies, i.e. 21 individuals with chronic spinal cord injuries and history of autonomic dysreflexia, who underwent penile vibrostimulation (n=11, study 1) or urodynamics (n=10, study 2). Results The cohort’s median age was 41 years (range 22 −53). Overall 47 episodes of autonomic dysreflexia were recorded (i.e. penile vibrostimulation n=37, urodynamics n=10), while at least one episode was recorded in each participant. At the threshold of autonomic dysreflexia, bradycardia was observed during penile vibrostimulation and urodynamics in 43% and 30% of all episodes, respectively. At the peak of autonomic dysreflexia during penile vibrostimulation and urodynamics, bradycardia was observed in 65% and 50%, respectively. In contrast, tachycardia was detected only once during urodynamics. Conclusion Our findings reveal that heart rate changes associated with autonomic dysreflexia during penile vibrostimulation and urodynamics appear to be related to the magnitude of systolic blood pressure increases. Thus, highly elevated systolic blood pressure associated with bradycardia suggest the presence of severe autonomic dysreflexia, which can lead to devastating cerebro-cardiovascular consequences. Therefore, we recommend cardiovascular monitoring during penile vibrostimulation and urodynamics to detect autonomic dysreflexia and stop assessments before systolic blood pressure is dangerously increasing, thereby reducing the risk of potentially life-threatening complications in this cohort.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".