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https://www.readbyqxmd.com/read/28717053/pure-autonomic-failure
#1
REVIEW
Thomas P Brown
Pure autonomic failure is a degenerative disorder of the peripheral autonomic nervous system. Patients experience symptomatic hypotension that requires them to sit, squat or lie down to prevent syncope. It is associated with characteristic histopathological findings, resulting in neuronal cytoplasmic inclusions in the peripheral autonomic nerves. These lesions are responsible for defects in the synthesis and release of norepinephrine from sympathetic nerve terminals, resulting in significant hypotension. Patients with autonomic failure also have exaggerated blood pressure responses to common stimuli such as food or fluid intake, heat, exercise and medications...
July 17, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28645449/high-incidence-of-st-t-changes-in-women-during-tilt-table-testing
#2
Prakash Goutham Suryanarayana, Jagdesh Kandala, Frank I Marcus
INTRODUCTION: We have observed electrocardiographic (ECG) changes primarily in women during tilt table testing. METHODS: We reviewed 12 lead ECGs during tilt studies between 2012 and 2016 for changes in ST segments and T waves during tilt table testing. Patients with distinctly abnormal baseline ECGs were excluded. RESULTS: Of the 180 tilt studies, 117 (65%) were in women. There were 32 patients with ECG changes during tilting. Of these, 28 (87...
June 9, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28644253/spectrum-of-autonomic-nervous-system-impairment-in-sj%C3%A3-gren-syndrome
#3
Brent P Goodman, Amy Crepeau, Priya S Dhawan, Julie A Khoury, Lucinda A Harris
OBJECTIVE: To describe the spectrum of autonomic dysfunction in a uniformly evaluated cohort of patients with Sjögren syndrome. METHODS: A series of 13 patients underwent a comprehensive evaluation for suspected autonomic impairment, including a neurological examination, autonomic testing, and laboratory studies. A diagnosis of Sjögren syndrome was established as the cause of autonomic dysfunction in all. Clinical features, findings on autonomic testing, and laboratory results are described...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28617840/a-new-test-for-diagnosing-vasovagal-syncope-standing-after-treadmill-test-with-sublingual-nitrate-administration
#4
Tae-Hoon Kim, Ho-Jun Jang, Sihun Kim, Sung Yun Cho, Kyung Sun Song, Christopher Pickett, Heiko J Schmitt, Juyong Lee
INTRODUCTION: Increased adrenergic tone might be an additional trigger of orthostatic stress of vasovagal syncope (VVS). Exercise before standing might provide increased sensitivity compared to standing using a sublingual nitroglycerines protocol during tilt table testing. The aim of this study was to evaluate the diagnostic value of treadmill testing before standing with nitroglycerin administration. METHODS AND RESULTS: A total of 36 patients with syncope or presyncope were enrolled for the test...
2017: PloS One
https://www.readbyqxmd.com/read/28616731/renal-nerve-stimulation-for-treatment-of-neurocardiogenic-syncope-a-review-from-perspective-of-commercialization-potential
#5
REVIEW
B O'Brien, H Zafar, F Sharif
A strong evidence of outcomes for vasovagal syncope is not easily identified. It would seem reasonable that the proposed Mayo Clinic technology would be reserved for cases with severe recurrent or refractory syncope. However, recurrence levels are relatively low, and while some predictive methods have been proposed, recurrence is also influenced by the interaction that occurs during screening and examinations, i.e. recurrence diminishes once an initial diagnosis has been made. Finally, a key factor in being able to identify suitable patients relates to understanding the relative significance of the vasodepression and cardioinhibitory components-the therapy is best suited to patients that have a significant level of both components...
June 14, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28585146/deceleration-capacity-a-novel-measure-for-autonomic-nervous-system-in-patients-with-vasovagal-syncope-on-tilt-table-testing
#6
Fen Huang, Chun-Fang Xu, Xiao-Yan Deng, Ping Zuo, Fan Lin, Jing-Jing Fan, Wen-Jia Xu, Xiao-Yun Yang
This study was to investigate the changes of autonomic nerve function and hemodynamics in patients with vasovagal syncope (VVS) during head-up tilt-table testing (HUT). HUT was performed in 68 patients with unexplained syncope and 18 healthy subjects served as control group. According to whether bradycardia, hypotension or both took place during the onset of syncope, the patients were divided during the test into three subgroups: vasodepressor syncope (VD), cardioinhibitory syncope (CI) and mixed syncope (MX) subgroups...
June 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28494046/traditional-postextractive-implant-site-preparation-compared-with-pre-extractive-interradicular-implant-bed-preparation-in-the-mandibular-molar-region-using-an-ultrasonic-device-a-randomized-pilot-study
#7
Antonio Scarano
PURPOSE: The immediate placement of single postextractive implants is increasing in the everyday clinical practice. Due to insufficient bone tissue volume, proper primary stability, essential for subsequent osseointegration, is sometimes not reached. The aim of this work was to compare two different approaches: implant bed preparation before and after root extraction. MATERIALS AND METHODS: Twenty-two patients of both sexes were selected who needed an implant-prosthetic rehabilitation of the fractured first mandibular molar or presented an untreatable endodontic pathology...
May 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/28472974/benefit-of-dual-chamber-pacing-with-closed-loop-stimulation-in-tilt-induced-cardio-inhibitory-reflex-syncope-biosync-trial-study-protocol-for-a-randomized-controlled-trial
#8
Michele Brignole, Marco Tomaino, Arnaud Aerts, Fabrizio Ammirati, Félix Alejandro Ayala-Parades, Jean-Claude Deharo, Attilio Del Rosso, Mohamed H Hamdan, Maurizio Lunati, Angel Moya, Alessio Gargaro
BACKGROUND: The efficacy of dual-chamber cardiac pacing in neuro-mediated reflex syncope with a cardio-inhibitory response to the Tilt-Table test (TT) has not been definitively assessed so far. The lack of reproducibility of results from previous studies may be partially explained by discrepancies in subject selection and some weaknesses in design and methods. The European Society of Cardiology (ESC) has set a class IIb indication to pacemaker implantation in this population recommending further research...
May 4, 2017: Trials
https://www.readbyqxmd.com/read/28429690/-our-experience-in-the-diagnosis-and-treatment-of-postural-orthostatic-tachycardia-syndrome-vasovagal-syncope-and-inappropriate-sinus-tachycardia-in-children
#9
Sezen Ugan Atik, Reyhan Dedeoğlu, Aida Koka, Funda Öztunç
OBJECTIVES: The aim of this study was to share our experience in the diagnosis and treatment of patients who presented at our clinic with syncope, pre-syncope, dizziness, and palpitations. STUDY DESIGN: Patients who were treated at pediatric cardiology clinic for complaints of syncope, dizziness, and palpitations between 2014 and 2016 were enrolled in the study. Detailed history of the patients, physical examination findings, laboratory and electrocardiogram results were recorded...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28341843/multistructure-index-characterization-of-heart-rate-and-systolic-blood-pressure-reveals-precursory-signs-of-syncope
#10
Danuta Makowiec, Beata Graff, Zbigniew R Struzik
Recurrent syncope - abrupt loss of consciousness - can have a serious impact on patients' quality of life, comparable with chronic illnesses. Vasovagal syncope (VVS) is a specific reflex syncope, in which an inappropriate reaction of the autonomic nervous system (ANS) plays a key role in the pathophysiology. In syncope diagnosis, an ideal diagnostic method should positively identify vasovagal sensitive patients, without the need to perform a specialised head-up tilt table (HUTT) test. We apply a novel methodology of multistructure index (MI) statistics for seamlessly evaluating the size spectrum of the asymmetry properties of magnitudes of neural reflexes responsible for maintaining the homeostatic dynamics of autonomic control...
March 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28268475/a-multivariate-time-frequency-approach-for-tracking-qt-variability-changes-unrelated-to-heart-rate-variability
#11
Michele Orini, Peter Taggart, Pier D Lambiase
The beat-to-beat variability of the QT interval (QTV) is a marker of ventricular repolarization (VR) dynamics and it has been suggested as an index of sympathetic ventricular outflow and cardiac instability. However, QTV is also affected by RR (or heart rate) variability (RRV), and QTV due to RRV may reduce QTV specificity as a VR marker. Therefore, it would be desirable to separate QTV due to VR dynamics from QTV due to RRV. To do that, previous work has mainly focused on heart rate corrections or time-invariant autoregressive models...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28243824/do-we-need-to-evaluate-diastolic-blood-pressure-in-patients-with-suspected-orthostatic-hypotension
#12
Artur Fedorowski, Viktor Hamrefors, Richard Sutton, J Gert van Dijk, Roy Freeman, Jacques Wm Lenders, Wouter Wieling
PURPOSE: The contribution of diastolic blood pressure measurement to the diagnosis of classical orthostatic hypotension is not known. We aimed to explore the prevalence of isolated systolic and diastolic orthostatic hypotension components in patients with syncope and orthostatic intolerance. METHODS: A total of 1520 patients aged >15 years with suspected syncope and/or symptoms of orthostatic intolerance were investigated in a tertiary center using tilt-table testing and continuous non-invasive blood pressure monitoring...
June 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28240408/tilt-table-testing-to-diagnose-pseudosyncope-in-the-pediatric-population
#13
Jeffrey A Robinson, Jill K Shivapour, Christopher S Snyder
OBJECTIVE: Pseudosyncope can be difficult to distinguish from true syncope. Often, pediatric patients with pseudosyncope undergo multiple tests and referrals before the appropriate diagnosis is reached. The purpose is to describe the utility of the head-up tilt table test to elicit the diagnosis of pseudosyncope in the pediatric population. DESIGN: Retrospective chart review from November 2012 to December 2015 of patients age ≤23 years referred for 30-minute, 80-degree tilt table test...
February 27, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28226648/a-multivariate-time-frequency-approach-for-tracking-qt-variability-changes-unrelated-to-heart-rate-variability
#14
Michele Orini, Peter Taggart, Pier D Lambiase, Michele Orini, Peter Taggart, Pier D Lambiase, Peter Taggart, Michele Orini, Pier D Lambiase
The beat-to-beat variability of the QT interval (QTV) is a marker of ventricular repolarization (VR) dynamics and it has been suggested as an index of sympathetic ventricular outflow and cardiac instability. However, QTV is also affected by RR (or heart rate) variability (RRV), and QTV due to RRV may reduce QTV specificity as a VR marker. Therefore, it would be desirable to separate QTV due to VR dynamics from QTV due to RRV. To do that, previous work has mainly focused on heart rate corrections or time-invariant autoregressive models...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225644/a-narrative-synthesis-of-nintendo-wii-fit-gaming-protocol-in-addressing-balance-among-healthy-older-adults-what-system-works
#15
Donald G Manlapaz, Gisela Sole, Prasath Jayakaran, Cathy M Chapple
BACKGROUND: Balance is crucial in performing functional tasks particularly among older adults. Exergaming is gaining attention as a novel approach to enhance balance in a number of clinical populations. OBJECTIVES: The aim of this review was to synthesize and present published evidence for Nintendo Wii Fit™ gaming system protocols. These include game preference, intervention setting, and exercise dosage for improving balance in healthy older adults. Commonly used outcome measures were also identified...
April 2017: Games for Health
https://www.readbyqxmd.com/read/28217221/byung-gyu-kim-et-al-reduced-systemic-vascular-resistance-is-the-underlying-hemodynamic-mechanism-in-nitrate-stimulated-vasovagal-syncope-during-head-up-tilt-table-test
#16
Arttu Eräranta, Antti Tikkakoski, Ilkka H Pörsti
No abstract text is available yet for this article.
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28188470/modeling-the-effect-of-tilting-passive-leg-exercise-and-functional-electrical-stimulation-on-the-human-cardiovascular-system
#17
Amirehsan Sarabadani Tafreshi, Jan Okle, Verena Klamroth-Marganska, Robert Riener
Long periods of bed rest negatively affect the human body organs, notably the cardiovascular system. To avert these negative effects and promote functional recovery in patients dealing with prolonged bed rest, the goal is to mobilize them as early as possible while controlling and stabilizing their cardiovascular system. A robotic tilt table allows early mobilization by modulating body inclination, automated passive leg exercise, and the intensity of functional electrical stimulation applied to leg muscles (inputs)...
February 10, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28182163/which-is-preferable-for-orthostatic-hypotension-diagnosis-in-older-adults-active-standing-test-or-head-up-tilt-table-test
#18
Ali Ekrem Aydin, Pinar Soysal, Ahmet Turan Isik
BACKGROUND: Correct evaluation of orthostatic hypotension (OH) is crucial in geriatric practice, since OH is associated with mortality and morbidity. The study aimed to determine the most appropriate method for measuring blood pressure in transition from supine to upright position in order to diagnose OH in older adults. METHODS: Active standing test (AST) and head-up tilt table (HUT) test as well as comprehensive geriatric assessment (CGA), including mini-mental state examination or the cognitive state test, mini-nutritional assessment, basic and instrumental activities of daily living, and Tinetti performance-oriented mobility assessment indexes, were performed in 290 geriatric patients...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28160388/cardiovascular-autonomic-dysfunction-in-ehlers-danlos-syndrome-hypermobile-type
#19
Alan Hakim, Chris O'Callaghan, Inge De Wandele, Lauren Stiles, Alan Pocinki, Peter Rowe
Autonomic dysfunction contributes to health-related impairment of quality of life in the hypermobile type of Ehlers-Danlos syndrome (hEDS). Typical signs and symptoms include tachycardia, hypotension, gastrointestinal dysmotility, and disturbed bladder function and sweating regulation. Cardiovascular autonomic dysfunction may present as Orthostatic Intolerance, Orthostatic Hypotension, Postural Orthostatic Tachycardia Syndrome, or Neurally Mediated Hypotension. The incidence, prevalence, and natural history of these conditions remain unquantified, but observations from specialist clinics suggest they are frequently seen in hEDS...
February 4, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28143709/arterial-hypertension-in-migraine-role-of-familial-history-and-cardiovascular-phenotype
#20
Laura Babayan, Oleg V Mamontov, Alexander V Amelin, Mikhail Bogachev, Alexei A Kamshilin
Recent studies indicate that migraine is associated with increased risk of cardiovascular diseases. However, links between autonomic cardiovascular regulation, arterial hypertension (AH) and migraine are still little explored. In this study, we evaluated autonomic regulation in migraine patients with and without hypertension. We studied 104 patients with migraine, aged 34±10 y, including 28 with and 76 without hypertension (M+AH and M-AH groups, respectively). The control group consisted of 88 healthy volunteers matched by age and sex...
January 25, 2017: Autonomic Neuroscience: Basic & Clinical
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