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Postural orthostatic

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https://www.readbyqxmd.com/read/29781516/cardiac-autonomic-modulation-and-long-term-use-of-amiodarone-in-patients-with-chronic-chagasic-cardiopathy
#1
Henriette Elana Fortes Silva, Renan Sandoval de Almeida, Danilo Batista Silveira, Maurício Llaguno, Luiz Antônio Pertili Rodrigues Resende, Valdo José Dias da Silva, Dalmo Correia
BACKGROUND: Patients with chronic Chagas cardiopathy (CCC), which may be associated with cardiac arrhythmias, frequently use amiodarone, an anti-arrhythmic drug that, experimentally, appears to modulate the cardiac autonomic function. OBJECTIVE: The present cross-sectional observational study aimed to evaluate autonomic cardiac modulation in patients with CCC undergoing chronic amiodarone therapy. METHODS: Three groups were investigated: Group 1 included patients with CCC not treated with amiodarone (n = 27); Group 2 included patients with CCC with prolonged use (at least 6 months) of amiodarone (n = 16); and Group 3 including non-chagasic control patients (n = 23)...
May 21, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29778304/postural-orthostatic-tachycardia-syndrome-in-children-and-adolescents
#2
REVIEW
Jeffrey R Boris
Postural orthostatic tachycardia syndrome (POTS) affects up to 3,000,000 people in the United States, with at least one-third of them developing POTS before the age of 18. POTS as a disorder is similar in adult and pediatric populations, but there are factors specific to pediatric patients that affect how it presents and how it is experienced that make pediatric POTS different. This review discusses the both the similarities in this population to their adult counterparts and the unique challenges faced by pediatric POTS patients, including management of schooling and education as well as the complex interactions between these pediatric patients and their parents...
May 12, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29767354/proprioceptive-muscle-tendon-stimulation-reduces-symptoms-in-primary-orthostatic-tremor
#3
M Wuehr, C Schlick, K Möhwald, R Schniepp
INTRODUCTION: Primary orthostatic tremor (OT) is characterized by high-frequency lower limb muscle contractions and a disabling sense of unsteadiness while standing. To date, therapeutic options for OT are limited. Here, we examined the effects of proprioceptive leg muscle stimulation via muscle tendon vibration (MTV) on tremor and balance control in patients with primary OT. METHODS: Tremor in nine patients with primary OT was examined during four conditions: standing (1), standing with MTV on the bilateral soleus muscles (2), lying (3), and lying with MTV (4)...
May 16, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29753556/pharmacotherapy-for-postural-tachycardia-syndrome
#4
REVIEW
Amanda J Miller, Satish R Raj
Postural tachycardia syndrome (POTS) is a disorder characterized by the presence of orthostatic symptoms (including lightheadedness, palpitations, nausea, dyspnea, and tremulousness) as well as excessive upright tachycardia. POTS predominantly affects women of childbearing age. Treating POTS involves a multi-faceted approach using non-pharmacological and pharmacological interventions. There are no pharmacological treatments that are currently United States Food and Drug Administration (FDA) approved for POTS due to lack of randomized controlled trials...
May 4, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29750732/the-patchy-tremor-landscape-recent-advances-in-pathophysiology
#5
Freek Nieuwhof, Pattamon Panyakaew, Bart P van de Warrenburg, Cecile Gallea, Rick C Helmich
PURPOSE OF REVIEW: We focus on new insights in the pathophysiology of Parkinson's disease tremor, essential tremor, tremor in dystonia, and orthostatic tremor. RECENT FINDINGS: Neuroimaging findings suggest that Parkinson's disease resting tremor is associated with dopaminergic dysfunction, serotonergic dysfunction, or both. Not all tremors in Parkinson's disease have the same pathophysiology: postural tremor in Parkinson's disease can be subdivided into pure postural tremor, which involves nondopaminergic mechanisms, and re-emergent tremor, which has a dopaminergic basis...
May 9, 2018: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29721015/a-comparative-assessment-of-cardiovascular-autonomic-reflex-testing-and-cardiac-123-i-metaiodobenzylguanidine-imaging-in-patients-with-type-1-diabetes-mellitus-without-complications-or-cardiovascular-risk-factors
#6
Triantafyllos Didangelos, Efstratios Moralidis, Eleni Karlafti, Konstantinos Tziomalos, Charalambos Margaritidis, Zisis Kontoninas, Ioannis Stergiou, Maria Boulbou, Marianthi Papagianni, Emmanouel Papanastasiou, Apostolos I Hatzitolios
Aim: To compare the cardiovascular autonomic reflex tests (CARTs) with cardiac sympathetic innervation imaging with 123 I-metaiodobenzylguanidine (MIBG) in patients with type 1 diabetes mellitus (T1DM). Patients and Methods: Forty-nine patients (29 males, mean age 36 ± 10 years, mean T1DM duration 19 ± 6 years) without cardiovascular risk factors were prospectively enrolled. Participants were evaluated for autonomic dysfunction by assessing the mean circular resultant (MCR), Valsalva maneuver (Vals), postural index (PI), and orthostatic hypotension (OH)...
2018: International Journal of Endocrinology
https://www.readbyqxmd.com/read/29705015/evaluation-of-postural-tachycardia-syndrome-pots
#7
REVIEW
Brent P Goodman
The diagnostic evaluation of a patient with suspected postural tachycardia syndrome (POTS) requires a thoughtful diagnostic approach utilizing a careful clinical history and examination, laboratory, and autonomic testing. This article outlines the importance of a thorough history in identifying mechanism of symptom onset, clinical features, associated clinical conditions or disorders, and factors that may result in symptom exacerbation. The clinical examination involves an assessment of pupillary responses, an evaluation for sudomotor and vasomotor signs, and an assessment for joint hypermobility...
April 22, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29701190/-relationship-between-unexplained-palpitation-in-children-and-head-up-tilt-test
#8
Tuoyu Gan, Lijia Wu, Runmei Zou, Ping Lin, Fang Li, Hong Yang, Ping Liu, Xiaohui Gong, Cheng Wang
To explore the relationship between unexplained palpitation in children and head-up tilt test (HUTT).
 Methods: A total of 142 children with the main symptom of unexplained palpitation were admitted to the Specialist Out-Patient Clinic of Children's Cardiovascular Disease from Sept. 2008 to Feb. 2017 in the Second Xiangya Hospital, Central South University. Among them, 63 cases were male, 79 cases were female, with the mean age of (10.12±2.88) years old. The detailed history, physical examinations, conventional 12 electrocardiogram, chest X-ray, echocardiography, myocardial enzymes and thyroid function were all examined...
March 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29696346/orthostatic-intolerance-and-postural-tachycardia-syndrome-new-insights-into-pathophysiology-and-treatment
#9
REVIEW
Mohammed Ruzieh, Blair P Grubb
Orthostatic intolerance is characterized by symptoms of light-headedness or syncope that is provoked upon standing or in an upright posture. It is most commonly caused by postural orthostatic tachycardia syndrome (POTS) or orthostatic hypotension (OH). Its pathophysiology is complex and commonly involves abnormal autonomic nervous system regulation, autoimmunity, a hyperadrenergic state, and hypovolemia. This article reviews the pathophysiology underlying orthostatic intolerance, as well as the current treatment available...
April 25, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29687025/autoimmune-postural-orthostatic-tachycardia-syndrome
#10
Mari Watari, Shunya Nakane, Akihiro Mukaino, Makoto Nakajima, Yukiko Mori, Yasuhiro Maeda, Teruaki Masuda, Koutaro Takamatsu, Yanosuke Kouzaki, Osamu Higuchi, Hidenori Matsuo, Yukio Ando
The aim of this study was to evaluate the association between postural orthostatic tachycardia syndrome (POTS) and circulating antiganglionic acetylcholine receptor (gAChR) antibodies. We reviewed clinical assessments of Japanese patients with POTS, and determined the presence of gAChR antibodies in serum samples from those patients. Luciferase immunoprecipitation systems detected anti-gAChR α 3 and β 4 antibodies in the sera from POTS (29%). Antecedent infections were frequently reported in patients in POTS patients...
April 2018: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29682372/from-postural-orthostatic-tachycardia-syndrome-to-radiologically-isolated-syndrome
#11
Richa Tripathi, Evanthia Bernitsas
Background: Autonomic dysfunction is common in Multiple Sclerosis (MS) patients. Most spinal cord lesions entail some degree of autonomic nervous system dysfunction. MS patients may develop autonomic dysfunction later in their disease course. Methods: We report a patient with no prior history of MS presenting with orthostatic symptoms and diagnosed initially with postural orthostatic tachycardia syndrome (POTS). Four months later, she was diagnosed with radiologically isolated syndrome (RIS)...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29628432/cognitive-and-psychological-issues-in-postural-tachycardia-syndrome
#12
REVIEW
Vidya Raj, Morwenna Opie, Amy C Arnold
Postural tachycardia syndrome (POTS) is one of the most common forms of chronic orthostatic intolerance. In addition to orthostatic symptoms, many POTS patients report incapacitating cognitive dysfunction or "brain fog" even while lying down or seated. Consistent with these subjective reports, there is accruing objective evidence of specific cognitive difficulties in POTS, with studies showing mild to moderate cognitive impairment using standardized neuropsychological assessment batteries. The precise profile of cognitive dysfunction in POTS patients has been shown to vary among these studies potentially due to the neuropsychological tests used, postural position, comorbidities and length of illness, inclusion of adolescent versus adult patients, and sites of recruitment...
March 27, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29623050/linear-and-nonlinear-analyses-of-the-cardiac-autonomic-control-in-children-with-developmental-coordination-disorder-a-case-control-study
#13
Jorge L Cavalcante Neto, Antonio R Zamunér, Bianca C Moreno, Ester Silva, Eloisa Tudella
Children with Developmental Coordination Disorder (DCD) and children at risk for DCD (r-DCD) present motor impairments interfering in their school, leisure and daily activities. In addition, these children may have abnormalities in their cardiac autonomic control, which together with their motor impairments, restrict their health and functionality. Therefore, this study aimed to assess the cardiac autonomic control, by linear and nonlinear analysis, at supine and during an orthostatic stimulus in DCD, r-DCD and typically developed children...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29618472/angiotensin-ii-type-1-receptor-autoantibodies-in-postural-tachycardia-syndrome
#14
Xichun Yu, Hongliang Li, Taylor A Murphy, Zachary Nuss, Jonathan Liles, Campbell Liles, Christopher E Aston, Satish R Raj, Artur Fedorowski, David C Kem
BACKGROUND: Both the adrenergic and renin-angiotensin systems contribute to orthostatic circulatory homeostasis, which is impaired in postural orthostatic tachycardia syndrome (POTS). Activating autoantibodies to the α1-adrenergic and β1/2-adrenergic receptors have previously been found in sera from patients with POTS. We hypothesized that patients with POTS might also harbor activating autoantibodies to the angiotensin II type 1 receptor (AT1R) independently of antiadrenergic autoimmunity...
April 4, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29609870/-prevalence-and-relations-of-orthostatic-hypotension-in-patients-80-years-old-and-over-from-a-primary-care-unit
#15
Francisco Javier Formigo Couceiro, Marta Pena Seijo, Antonio Pose Reino, José Manuel Mayán Santos, Francisco Javier Ayape Amigot, Jesús Sueiro Justel
OBJECTIVE: To estimate the prevalence of orthostatic hypotension (OH) in patients 80 years old and over attending a primary care unit. To relate OH to the most prevalent pathologies and to the most used drugs. DESIGN: Transversal observational study. LOCATION: Primary care unit, Santiago de Compostela. PARTICIPANTS: Eighty one patients 80 years old or over representative of a primary care unit were recruited. Ten patients were excluded...
March 30, 2018: Atencion Primaria
https://www.readbyqxmd.com/read/29605837/pathophysiology-of-noncardiac-syncope-in-athletes
#16
REVIEW
Georgios A Christou, Konstantinos A Christou, Dimitrios N Kiortsis
The most frequent cause of syncope in young athletes is noncardiac etiology. The mechanism of noncardiac syncope (NCS) in young athletes is neurally-mediated (reflex). NCS in athletes usually occurs either as orthostasis-induced, due to a gravity-mediated reduced venous return to the heart, or in the context of exercise. Exercise-related NCS typically occurs after the cessation of an exercise bout, while syncope occurring during exercise is highly indicative of the existence of a cardiac disorder. Postexercise NCS appears to result from hypotension due to impaired postexercise vasoconstriction, as well as from hypocapnia...
March 31, 2018: Sports Medicine
https://www.readbyqxmd.com/read/29588088/the-etiologic-relation-between-disequilibrium-and-orthostatic-intolerance-in-patients-with-myalgic-encephalomyelitis-chronic-fatigue-syndrome
#17
Kunihisa Miwa, Yukichi Inoue
BACKGROUND: Orthostatic intolerance (OI) causes a marked reduction in the activities of daily living in patients with myalgic encephalomyelitis (ME) or chronic fatigue syndrome. Most symptoms of OI are thought to be related to cerebral hypo-perfusion and sympathetic activation. Because postural stability is an essential element of orthostatic tolerance, disequilibrium may be involved in the etiology of OI. METHODS AND RESULTS: The study comprised 44 patients with ME (men, 11 and women, 33; mean age, 37±9 years), who underwent neurological examinations and 10-min standing and sitting tests...
March 24, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29579161/orthostatic-hypotension-and-cognitive-function-cross-sectional-results-from-the-elsa-brasil-study
#18
Claudia K Suemoto, Cristina P Baena, Jose G Mill, Itamar S Santos, Paulo A Lotufo, Isabela Benseñor
Background: The association between orthostatic hypotension (OH) and cognitive impairment is controversial, and most studies have investigated older white adults from Western Europe and the United States. Therefore, we investigated the association between OH and cognitive performance in a large and racially diverse sample of adults using cross-sectional data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods: OH was defined when systolic blood pressures (SBP) decreased 20 mmHg and/or diastolic blood pressure (DBP) decreased 10 mmHg from supine to standing position...
March 20, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29578939/diminished-dynamic-physical-performance-is-associated-with-orthostatic-hypotension-in-geriatric-outpatients
#19
Eline S de Bruïne, Esmee M Reijnierse, Marijke C Trappenburg, Jantsje H Pasma, Oscar J de Vries, Carel G M Meskers, Andrea B Maier
BACKGROUND AND PURPOSE: Orthostatic hypotension (OH), a blood pressure drop after postural change, is a highly prevalent and disabling syndrome in older adults. Yet, the association between physical performance and OH is not clearly established. The aim of this study was to determine whether different types of physical performance are associated with OH in a clinically relevant population of geriatric outpatients. METHODS: This cross-sectional study included 280 geriatric outpatients (mean age: 82...
March 23, 2018: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/29567873/-two-cases-of-difficult-to-treat-acute-epidural-hematoma-and-a-review-of-decompressive-craniectomy-with-hematoma-evacuation
#20
Takanari Okamoto, Kunihiko Umezawa, Syogo Ogita, Kunikazu Kurosaki, Tetsuro Takegami, Satoshi Kimura
INTRODUCTION: Decompressive craniectomy(DC)with craniotomy for acute epidural hematoma(AEDH)removal is controversial. Here, we summarized two difficult AEDH cases where DC was performed. CASE 1:A 26-year-old man sustained a head injury in a bicycle accident, with a Japan Coma Scale(JCS)score of 200, right pupil mydriasis, and a left decerebrate posture on admission. Computed tomography(CT)revealed right AEDH with a midline shift. Craniotomy was performed without DC. Postoperatively, his consciousness level and anisocoria improved(JCS score, 30)...
March 2018: No Shinkei Geka. Neurological Surgery
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