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Tilt table

Jennifer E Posey, Rebecca Martinez, Jeremy E Lankford, James R Lupski, Mohammed T Numan, Ian J Butler
BACKGROUND: Orthostatic intolerance is typically thought to be sporadic and attributed to cerebral autonomic dysfunction. We sought to identify families with inherited autonomic dysfunction manifest as symptomatic orthostatic intolerance to characterize mode of inheritance and clinical features. METHODS: Sixteen families with two or more first- or second-degree relatives with autonomic dysfunction and orthostatic intolerance were enrolled. A clinical diagnosis of autonomic dysfunction defined by symptomatic orthostatic intolerance diagnosed by head-up tilt table testing was confirmed for each proband...
September 24, 2016: Pediatric Neurology
Armando Lopes, Paulo Maló, Miguel de Araújo Nobre, Elena Sánchez-Fernández, Inês Gravito
BACKGROUND: There is a necessity of studies documenting the long-term outcome of full-arch flapless rehabilitations. PURPOSE: To evaluate the 7 years implant and prosthesis survival rate and 5-years marginal bone loss of full-arch fixed prosthetic rehabilitations supported by implants in immediate function with the All-on-4(®) treatment concept using a computer guided surgical protocol (NobelGuide(®) , Nobel Biocare). MATERIALS AND METHODS: This retrospective clinical study included 111 edentulous patients (n = 53 bruxers; n = 21 smokers; n = 59 systemically compromised), rehabilitated between February 2005 and November 2010 with 532 implants with the All-on-4(®) treatment concept using NobelGuide(®) ...
October 18, 2016: Clinical Implant Dentistry and related Research
Andrea Marchi, Vlasta Bari, Beatrice De Maria, Murray Esler, Elisabeth Lambert, Mathias Baumert, Alberto Porta
We propose a sympathetic baroreflex (sBR) sequence method for characterizing sBR from spontaneous beat-to-beat fluctuations of muscle sympathetic nerve activity (MSNA) and diastolic arterial pressure (DAP). The method exploits a previously defined MSNA variability quantifying the fluctuations of MSNA burst rate. The method is based on the detection of MSNA and DAP sequences characterized by the contemporaneous DAP increase and MSNA decrease or vice versa. The percentage of sBR sequences (SEQ%sBR) was taken as an indication of the degree of sBR solicitation and the average slope of the regression lines in the (DAP, MSNA) plane was taken as sBR sensitivity (sBRSSEQ) and expressed in bursts(...
2016: Frontiers in Physiology
David McWilliams, Gemma Atkins, James Hodson, Catherine Snelson
BACKGROUND: Early mobility within the ICU is associated with a number of positive outcomes including reductions in ICU and hospital length of stay and better functional recovery. The exact definition of 'early' mobility is still not defined, with the actual ability to mobilise limited by a number of perceived factors. The Sara Combilizer is a combined tilt table and stretcher chair, which allows passive transfer of patients out of bed. This study aimed to assess whether the introduction of the Sara Combilizer reduced time taken to first mobilise for patients mechanically ventilated for at least five days and at risk of ICU acquired weakness...
October 10, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Jessica Robinson-Papp, Sandeep K Sharma, Mary Catherine George, David M Simpson
PURPOSE: Urban, minority communities are disproportionately affected by the chronic diseases associated with autonomic neuropathy; however validated measures of autonomic symptoms have not been studied in these complex populations. We sought to validate the Autonomic Symptom Profile (ASP) in a low income, medically complex, urban patient population. METHODS: Ninety-seven adults were recruited from the outpatient neurology clinic of an academic medical center serving the East Harlem neighborhood of New York City...
October 12, 2016: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Joong Seok Kim, Dong Woo Ryu, Ju Hee Oh, Yang Hyun Lee, Sung Jin Park, Kipyung Jeon, Jong Yun Lee, Seong Hee Ho, Jungmin So, Jin Hee Im, Kwang Soo Lee
BACKGROUND AND PURPOSE: Recent studies have shown that several nonmotor symptoms differ between Parkinson's disease (PD) and drug-induced parkinsonism (DIP). However, there have been no reports on cardiovascular autonomic function in DIP, and so this study investigated whether cardiovascular autonomic function differs between PD and DIP patients. METHODS: This study consecutively enrolled 20 DIP patients, 99 drug-naïve PD patients, and 25 age-matched healthy controls who underwent head-up tilt-table testing and 24-h ambulatory blood pressure monitoring...
October 7, 2016: Journal of Clinical Neurology
Dennis P Dimaculangan, Jonathan A Mazer, Luiz F Maracaja-Neto
OBJECTIVE: To find the position that provided the most comfort, as well as the widest L3-L4 interlaminar space opening. DESIGN: Pilot study. SETTING: Operating room. PATIENTS: Thirty-two healthy volunteers. INTERVENTIONS: L3-L4 interlaminar space was measured on volunteers assuming a baseline position (sitting upright) and 5 study positions: (1) sitting in fetal position, (2) sitting on a table tilted at 30°, (3) sitting while hugging an exercise ball, (4) sitting with midcalves on the table's edge, and (5) lying on one side in fetal position...
November 2016: Journal of Clinical Anesthesia
Laure Mathevon, Nicolas Leroux, Céline Piscicelli, Emmanuelle Clarac, Shenhao Dai, Patrice Davoine, Paul Krack, Dominic Perennou
OBJECTIVE: To take care of postural disorders is a major issue in Parkinson's disease (PD). We present a documented observation suggesting the existence of a biased representation of verticality in PD, resulting in a severe retropulsion and recurrent falls. A rehabilitation program aimed to modulate verticality perception dramatically improved the postural perception of the vertical, trunk posture and balance abilities, and reduced retropulsion as well as lastingly fall frequency. OBSERVATIONS: A 68 year-old patient with Parkinson's disease fall backward 3 times a day...
September 2016: Annals of Physical and Rehabilitation Medicine
Sylvain Fazilleau
OBJECTIVE: Early verticalization in ICU is recommended [1] but not documented in brain-damaged people. Using a verticalization table involves risks and stresses in this context. The main objective was to determine the safety and feasibility of in-bed verticalization in neurological intensive care. Secondary objectives were to study the immediate, hemodynamic, and respiratory impacts, as well as the effects on awakening. MATERIAL/PATIENTS AND METHODS: Observational study in a neurological intensive care unit...
September 2016: Annals of Physical and Rehabilitation Medicine
Kathryn A Pitt, Philipp D Mayhew, Michele A Steffey, William T N Culp, Mark C Fuller, Ann Della Maggiore, Richard W Nelson
OBJECTIVE: To report the surgical technique and outcome of dogs undergoing laparoscopic adrenalectomy for removal of unilateral noninvasive pheochromocytoma. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs with unilateral noninvasive adrenal tumors (n=10). METHODS: Medical records of dogs that underwent laparoscopic adrenalectomy for histologically confirmed pheochromocytoma were reviewed. Dogs were positioned in lateral recumbency with the table tilted up to create a semi-sternal position...
September 23, 2016: Veterinary Surgery: VS
Xiaojun Wu, Anne-Laure Calendron, Koustuban Ravi, Chun Zhou, Michael Hemmer, Fabian Reichert, Dongfang Zhang, Huseyin Cankaya, Luis E Zapata, Nicholas H Matlis, Franz X Kärtner
We demonstrate the generation of 100 GHz single-cycle pulses with up to 10 MW of peak power using optical rectification and broadband phase matching via the tilted pulse front (TPF) technique in lithium niobate. The optical driver is a cryogenically cooled Yb:YAG amplifier providing tens of mJ energy, ~5 ps long laser pulses. We obtain a high THz pulse energy up to 65 µJ with 31.6 MV/m peak electric field when focused close to its diffraction limit of 2.5 mm diameter. A high optical-to-THz energy conversion efficiency of 0...
September 5, 2016: Optics Express
Jittima Saengsuwan, Lucia Berger, Corina Schuster-Amft, Tobias Nef, Kenneth J Hunt
BACKGROUND: Exercise testing devices for evaluating cardiopulmonary fitness in patients with severe disability after stroke are lacking, but we have adapted a robotics-assisted tilt table (RATT) for cardiopulmonary exercise testing (CPET). Using the RATT in a sample of patients after stroke, this study aimed to investigate test-retest reliability and repeatability of CPET and to prospectively investigate changes in cardiopulmonary outcomes over a period of four weeks. METHODS: Stroke patients with all degrees of disability underwent 3 separate CPET sessions: 2 tests at baseline (TB1 and TB2) and 1 test at follow up (TF)...
2016: BMC Neurology
Meihua Kang, Yi Xu, Runmei Zou, Lijia Wu, Ping Lin, Fang Li, Cheng Wang
OBJECTIVE: To explore the differences of Chinese people's age and gender in orthostatic hypertension (OHT) by a single-center experience study.
 METHODS: A total of 2 994 patients with unexplained syncope and dizziness, who were outpatients or had been hospitalized in Second Xiangya Hospital, Central South University from January 2000 to August 2012, were chosen and subjected to the head-up tilt table test (HUTT). Their ages ranged from 2.00 to 78.00 years old, with an average at 19...
August 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Yoshitomo Yanagimoto, Makoto Yamasaki, Hirotsugu Nagase, Takashi Kanemura, Shigeyoshi Higashi, Yasuhiro Miyazaki, Tomoki Makino, Tsuyoshi Takahashi, Yukinori Kurokawa, Hiroshi Miyata, Shuji Takiguchi, Masaki Mori, Yuichiro Doki, Kiyokazu Nakajima
Background and study aims: Gastric reflux into the remnant esophagus after subtotal or partial esophagectomy is associated with impairment in patient quality of life. We evaluated the feasibility, safety, and potential effectiveness of a novel procedure using a new endoscopic suturing device to create an anti-reflux valve (funnel) in pigs after esophagectomy with gastric tube reconstruction. Methods: The endoscopic procedure was performed in four pigs using a semi-full-thickness endoscopic suturing system (OverStitch; Apollo Endosurgery, Austin, Texas, USA)...
August 30, 2016: Endoscopy
Russell K McAllister, Robert T Booth, Timothy M Bittenbinder
Operating room surgical table failure is a rare event but can lead to a dangerous situation when it does occur. The dangers can be compounded in the presence of obesity, especially in the anesthetized or sedated patient. We present a case of a near-miss fall of a morbidly obese patient while turning the patient in preparation to transfer from the operating room table to the hospital bed when 2 fractured bolts in the tilt cylinder mechanism led to an operating room table failure.
September 2016: Journal of Clinical Anesthesia
Alberto Porta, Beatrice De Maria, Vlasta Bari, Andrea Marchi, Luca Faes
OBJECTIVE: We test the hypothesis that the linear model-based (MB) approach for the estimation of conditional entropy (CE) can be utilized to assess the complexity of the cardiac control in healthy individuals. METHODS: A MB estimate of CE was tested in an experimental protocol (i.e. the graded head-up tilt) known to produce a gradual decrease of cardiac control complexity as a result of the progressive withdrawal and concomitant sympathetic activation. The MB approach was compared with traditionally exploited nonlinear model-free (MF) techniques such as corrected approximate entropy, sample entropy, corrected CE, two k-nearest-neighbor CE procedures and permutation CE...
August 16, 2016: IEEE Transactions on Bio-medical Engineering
Geoffrey L Heyer, Dara V F Albert, Amanda Weber, Satyanarayana Gedela, Jorge Vidaurre
We sought to characterize the clinical features of tilt-induced psychogenic nonsyncopal collapse (PNSC) from a cohort of young patients and to compare the semiologies between PNSC and EEG-confirmed psychogenic nonepileptic seizures (PNES). A PNSC diagnosis was made if a clinical event occurred during tilt-table testing that the patient regarded as fainting, but neither hypotension nor EEG changes were present. A diagnosis of PNSC was made in 17.6% of all patients referred during the 15-month study period. Cohorts with psychogenic nonsyncopal collapse (n=40) and PNES (n=40) did not differ in age (15...
September 2016: Epilepsy & Behavior: E&B
Giuseppe Frazzitta, Ilaria Zivi, Roberto Valsecchi, Sara Bonini, Sara Maffia, Katia Molatore, Luca Sebastianelli, Alessio Zarucchi, Diana Matteri, Giuseppe Ercoli, Roberto Maestri, Leopold Saltuari
BACKGROUND AND OBJECTIVE: Verticalization was reported to improve the level of arousal and awareness in patients with severe acquired brain injury (ABI) and to be safe in ICU. We evaluated the effectiveness of a very early stepping verticalization protocol on their functional and neurological outcome. METHODS: Consecutive patients with Vegetative State or Minimally Conscious State were enrolled in ICU on the third day after an ABI. They were randomized to undergo conventional physiotherapy alone or associated to fifteen 30-minute sessions of verticalization, using a tilt table with robotic stepping device...
2016: PloS One
B Yilmaz, S Göktepe, E Yaşar, S Kesikburun, E Adıgüzel
STUDY DESIGN: Case-control study. OBJECTIVES: To investigate the level of autonomic nervous system dysfunction in patients with spinal cord injury and to determine its effect on the basal metabolic rate and oxygen consumption during daily living activities. SETTING: Turkish Armed Forces Rehabilitation Center, Ankara, Turkey. METHODS: Thirty-six patients with chronic spinal cord injury (SCI) were allocated into two groups according to the presence of autonomic nervous system dysfunction...
July 19, 2016: Spinal Cord
Funda Oztunc, Sezen Ugan Atik, Reyhan Dedeoglu, Firuze Erbek Alp, Selman Gokalp
Postural orthostatic tachycardia syndrome (POTS) is an abnormal heart rate response to a positional change. Several potential mechanisms for pathophysiology of POTS are defined. This syndrome can coexist with different clinical situations. In our report, the first case was a 13-year-old female who has been followed up for diagnosis of homocystinuria. She was admitted to our outpatient clinic with complaints of dizziness after suddenly moving from supine to upright position and chest pain after exercise. Tilt table test was performed to evaluate dizziness...
2016: Case Reports in Pediatrics
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