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Orthostatic intolerance

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https://www.readbyqxmd.com/read/28796366/adrenomedullin-and-galanin-responses-to-orthostasis-in-older-persons
#1
James Broadbent, Johannes Reichmuth, Irhad Trozic, Markus Kneihsl, Andreas Rössler, David A Green, Joel Rodriguez, Helmut Hinghofer-Szalkay, Franz Fazekas, Nandu Goswami
BACKGROUND: Neuroendocrine responses to orthostasis may be critical in the maintenance of mean arterial pressure in healthy individuals. A greater reduction in orthostatic tolerance with age may relate to modulation of hormonal responses such as adrenomedullin and galanin. Thus, we investigated 1) whether adrenomedullin and galanin concentrations increase during orthostatic challenge in older subjects, 2) whether adrenomedullin and galanin concentrations are higher in older females compared with older males when seated and during orthostatic challenge, and 3) whether postural changes in plasma concentrations of galanin are correlated with levels of adrenomedullin in either older females or males...
August 10, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28744844/suspected-adverse-effects-after-human-papillomavirus-vaccination-a-temporal-relationship-between-vaccine-administration-and-the-appearance-of-symptoms-in-japan
#2
Kazuki Ozawa, Akiyo Hineno, Tomomi Kinoshita, Sakiko Ishihara, Shu-Ichi Ikeda
INTRODUCTION: In Japan, after receiving human papillomavirus vaccination, a significant number of adolescent girls experienced various symptoms, the vast majority of which have been ascribed to chronic regional pain syndrome, orthostatic intolerance, and/or cognitive dysfunction. However, a causal link has not been established between human papillomavirus vaccination and the development of these symptoms. OBJECTIVE: The aim of this study was to clarify the temporal relationship between human papillomavirus vaccination and the appearance of post-vaccination symptoms...
July 25, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28738696/the-role-of-autoantibodies-in-the-syndromes-of-orthostatic-intolerance-a-systematic-review
#3
Mohammed Ruzieh, Lillian Batizy, Osama Dasa, Carson Oostra, Blair Grubb
Orthostatic intolerance is defined as the provocation of symptoms upon standing, commonly caused by neurogenic orthostatic hypotension (OH) and postural tachycardia syndrome (POTS), the etiology for which has not been fully uncovered yet. Many reports have described the occurrence of dysautonomia, orthostatic intolerance and POTS following febrile illness, presumably viral and post-vaccine. Furthermore, patients with dysautonomia have higher rates of autoimmune disorders such as Hashimoto thyroiditis and SLE...
July 24, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28738118/early-orthostatic-hypotension-and-orthostatic-intolerance-more-than-an-observation-or-annoyance
#4
Wolfgang Singer, Phillip A Low
No abstract text is available yet for this article.
July 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28720881/patients-with-orthostatic-intolerance-relationship-to-autonomic-function-tests-results-and-reproducibility-of-symptoms-on-tilt
#5
Hyung Lee, Phillip A Low, Hyun Ah Kim
This study was designed to investigate the frequency and pattern of orthostatic symptoms during head-up tilt (HUT) in patients with orthostatic intolerance during daily life, and to identify the relationship between the orthostatic symptoms during HUT and autonomic parameters. We prospectively collected autonomic data from 464 patients with orthostatic symptoms. Adrenergic and cardiovagal function tests including HUT were performed. Based on HUT results, we divided patients into orthostatic hypotension (OH), postural tachycardia syndrome (POTS), or normal HUT groups...
July 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28720463/incidence-rates-of-guillain-barr%C3%A3-gbs-chronic-fatigue-systemic-exertion-intolerance-disease-cfs-seid-and-postural-orthostatic-tachycardia-syndrome-pots-prior-to-introduction-of-human-papilloma-virus-hpv-vaccination-among-adolescent-girls-in-finland-2002-2012
#6
J Skufca, J Ollgren, E Ruokokoski, O Lyytikäinen, H Nohynek
BACKGROUND: In Finland a vaccination programme against human papillomavirus (HPV) was introduced in November 2013 for girls aged 11-12 years with a catchup for girls 13-15 years. Allegations that HPV vaccine is causing Guillain Barré syndrome (GBS) and non-specific diagnostic entities, such as chronic fatigue syndrome/systemic exertion intolerance disease (CFS/SEID) and postural orthostatic tachycardia syndrome (POTS), continue to surface. We examined population register-based incidence rates of CFS/SEID, GBS and POTS to provide baseline data for future HPV vaccine safety evaluations...
June 2017: Papillomavirus Research
https://www.readbyqxmd.com/read/28707024/experience-of-immediate-ambulation-and-early-discharge-after-tumescent-anesthesia-and-propofol-infusion-in-cosmetic-breast-augmentation
#7
Weiwu Pang, John M Chois, Diana Lambie, Richard Ming-Hui Lin, Zao-Ming Shih
INTRODUCTION: Current cosmetic breast augmentation relies on general anesthesia that normally requires 40 min to total recovery. With experience, the surgical procedure can be completed expediently in 20 min under tumescent anesthesia and propofol full sedation to achieve immediate postoperative ambulation and home discharge readiness, and thus improve patient satisfaction and reduce cost. We retrospectively examined the outcomes of the protocol. MATERIALS AND METHODS: Per protocol, 1200 female patients underwent simple cosmetic breast augmentation accomplished with tumescent anesthesia, immediate mobilization, and early home discharge readiness after surgery...
July 13, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28683089/the-composite-autonomic-symptom-scale-31-is-a-useful-screening-tool-for-patients-with-parkinsonism
#8
Younsoo Kim, Jin Myoung Seok, Jongkyu Park, Kun-Hyun Kim, Ju-Hong Min, Jin Whan Cho, Suyeon Park, Hyun-Jin Kim, Byoung Joon Kim, Jinyoung Youn
Differentiation of multiple system atrophy with predominant parkinsonism (MSA-P) and Parkinson's disease (PD) is important, but an effective tool for differentiation has not been identified. We investigated the efficacy of the composite autonomic symptom scale 31 (COMPASS 31) questionnaire as a tool for evaluating autonomic function in parkinsonism patients. In this study, we enrolled drug-naïve patients with MSA-P and PD, and administered the COMPASS-31 and an objective autonomic dysfunction test (AFT). Demographic and clinical data, including parkinsonism and autonomic dysfunction, were compared between the two groups...
2017: PloS One
https://www.readbyqxmd.com/read/28681121/indexes-of-cerebral-autoregulation-do-not-reflect-impairment-in-syncope-insights-from-head-up-tilt-test-of-vasovagal-and-autonomic-failure-subjects
#9
Pedro Castro, João Freitas, Rosa Santos, Ronney Panerai, Elsa Azevedo
PURPOSE: The study of dynamic cerebral autoregulation (CA), which adapts cerebral blood flow to arterial blood pressure (ABP) fluctuations, has been limited in orthostatic intolerance syndromes, mainly due to its stationary prerequisites hardly to meet during maneuvers to provoke syncope itself. New techniques of continuous estimates of CA could overcome this pitfall. We aimed to evaluate CA during head-up tilt test in common conditions causing syncope. METHODS: We compared three groups: eight controls; eight patients with autonomic failure due to familial amyloidotic polyneuropathy; eight patients with vasovagal syncope (VVS)...
July 5, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28674681/myalgic-encephalomyelitis-chronic-fatigue-syndrome-diagnosis-and-management-in-young-people-a-primer
#10
REVIEW
Peter C Rowe, Rosemary A Underhill, Kenneth J Friedman, Alan Gurwitt, Marvin S Medow, Malcolm S Schwartz, Nigel Speight, Julian M Stewart, Rosamund Vallings, Katherine S Rowe
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex disease that affects children and adolescents as well as adults. The etiology has not been established. While many pediatricians and other health-care providers are aware of ME/CFS, they often lack essential knowledge that is necessary for diagnosis and treatment. Many young patients experience symptoms for years before receiving a diagnosis. This primer, written by the International Writing Group for Pediatric ME/CFS, provides information necessary to understand, diagnose, and manage the symptoms of ME/CFS in children and adolescents...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28674628/syndromes-of-orthostatic-intolerance-and-syncope-in-young-adults
#11
Viktor Hamrefors, Jasmina Medic Spahic, David Nilsson, Martin Senneby, Richard Sutton, Olle Melander, Artur Fedorowski
OBJECTIVE: To explore the clinical and neuroendocrine characteristics of syndromes of orthostatic intolerance and syncope in young adults. METHODS: Two hundred and thirty-six patients aged 18-40 years with orthostatic intolerance and/or syncope were examined by head-up tilt test (HUT). Plasma levels of epinephrine, norepinephrine, renin, C-terminal-pro-arginine-vasopressin (CT-proAVP), C-terminal-endothelin-1 and mid-regional-fragment of pro-atrial-natriuretic-peptide (MR-proANP) were analysed...
2017: Open Heart
https://www.readbyqxmd.com/read/28626082/significant-role-of-the-cardio-postural-interaction-in-blood-pressure-regulation-during-standing
#12
Da Xu, Ajay Verma, Amanmeet Garg, Michelle Bruner, Reza Fazel-Rezai, Andrew P Blaber, Kouhyar Tavakolian
Cardiovascular and postural control systems have been studied independently despite the increasing evidence showing the importance of cardio-postural interaction in blood pressure regulation. In this study, we aimed to assess the role of cardio-postural interaction in relation to cardiac baroreflex in blood pressure regulation under orthostatic stress before and after mild exercise. Physiological variables representing cardiovascular control (heart rate and systolic blood pressure), lower limb muscle activation (electromyography), and postural sway (center of pressure derived from force and moment data during sway) were measured from 17 healthy participants (25±2 years; 8 females) during a sit-to-stand test before and after sub-maximal exercise...
June 16, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28607335/the-surgical-stress-response-and-the-potential-role-of-preoperative-glucocorticoids-on-post-anesthesia-care-unit-recovery
#13
Kristin J Steinthorsdottir, Henrik Kehlet, Eske K Aasvang
The immediate postoperative course in the post-anaesthesia care unit (PACU) remains a challenge across surgical procedures. Postoperative pain, sedation/cognitive dysfunction, nausea and vomiting (PONV), circulatory and respiratory problems and orthostatic intolerance constitute the bulk of the difficulties that may delay the postoperative recovery. A common feature in the observed organ dysfunctions is the inflammatory response to surgery during the acute postoperative recovery phase, suggesting that control of inflammation may improve outcomes and reduce complications...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28604343/breathing-100-oxygen-during-water-immersion-improves-postimmersion-cardiovascular-responses-to-orthostatic-stress
#14
John P Florian, Ki H Chon, Luca Faes, Barbara E Shykoff
Physiological compensation to postural stress is weakened after long-duration water immersion (WI), thus predisposing individuals to orthostatic intolerance. This study was conducted to compare hemodynamic responses to postural stress following exposure to WI alone (Air WI), hyperbaric oxygen alone in a hyperbaric chamber (O2 HC), and WI combined with hyperbaric oxygen (O2 WI), all at a depth of 1.35 ATA, and to determine whether hyperbaric oxygen is protective of orthostatic tolerance. Thirty-two healthy men underwent up to 15 min of 70° head-up tilt (HUT) testing before and after a single 6-h resting exposure to Air WI (N = 10), O2 HC (N = 12), or O2 WI (N = 10)...
December 2016: Physiological Reports
https://www.readbyqxmd.com/read/28591231/association-of-blood-pressure-variability-with-orthostatic-intolerance-symptoms
#15
Jun-Sang Sunwoo, Tae-Won Yang, Do-Yong Kim, Jung-Ah Lim, Tae-Joon Kim, Jung-Ick Byun, Jangsup Moon, Soon-Tae Lee, Keun-Hwa Jung, Kyung-Il Park, Ki-Young Jung, Manho Kim, Sang Kun Lee, Kon Chu
The short-term blood pressure variability (BPV) reflects autonomic regulatory mechanisms. However, the influence of BPV in orthostatic intolerance (OI) is unknown. Herein, we assessed BPV profiles in patients with OI and determined their association with orthostatic symptoms. In this cross-sectional study, we prospectively enrolled 126 patients presenting with OI at the Seoul National University Hospital from December 2014 to August 2016. Among them, those with other neurological diseases (n = 8) and insufficient BP measurements (n = 15) were excluded...
2017: PloS One
https://www.readbyqxmd.com/read/28522756/influence-of-sex-menstrual-cycle-and-oral-contraceptives-on-cerebrovascular-resistance-and-cardiorespiratory-function-during-valsalva-or-standing
#16
Syed Abidi, Misha Nili, Stephania Serna, Simon Kim, Christopher Hazlett, Heather Edgell
Women experience orthostatic intolerance more than men, and experience faintness more in the early follicular (i.e. low hormone (LH)) compared to the luteal (i.e. high hormone (HH)) phase of the menstrual cycle. Men (n=13, age: 25.8±1.8) and women in the LH (day 2-5; placebo) and HH) (day 18-24; high dose) phases of the menstrual cycle with (OC; n=14, age: 22.0±0.8) or without oral contraceptives (NOC; n=12, age: 21.8±0.5) underwent the Valsalva maneuver and a supine-sit-stand protocol. Blood pressure, normalized stroke volume (SVi), cardiac output index (Qi), heart rate (HR), end-tidal carbon dioxide (ET-CO2), and middle cerebral artery blood velocity (MCA) were measured...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28499865/implication-of-altered-autonomic-control-for-orthostatic-tolerance-in-sci
#17
REVIEW
Jill Maria Wecht, William A Bauman
Neural output from the sympathetic and parasympathetic branches of the autonomic nervous system (ANS) are integrated to appropriately control cardiovascular responses during routine activities of daily living including orthostatic positioning. Sympathetic control of the upper extremity vasculature and the heart arises from the thoracic cord between T1 and T5, whereas splanchnic bed and lower extremity vasculature receive sympathetic neural input from the lower cord between segments T5 and L2. Although the vasculature is not directly innervated by the parasympathetic nervous system, the SA node is innervated by post-ganglionic vagal nerve fibers via cranial nerve X...
May 3, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28441964/fecal-metagenomic-profiles-in-subgroups-of-patients-with-myalgic-encephalomyelitis-chronic-fatigue-syndrome
#18
Dorottya Nagy-Szakal, Brent L Williams, Nischay Mishra, Xiaoyu Che, Bohyun Lee, Lucinda Bateman, Nancy G Klimas, Anthony L Komaroff, Susan Levine, Jose G Montoya, Daniel L Peterson, Devi Ramanan, Komal Jain, Meredith L Eddy, Mady Hornig, W Ian Lipkin
BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is characterized by unexplained persistent fatigue, commonly accompanied by cognitive dysfunction, sleeping disturbances, orthostatic intolerance, fever, lymphadenopathy, and irritable bowel syndrome (IBS). The extent to which the gastrointestinal microbiome and peripheral inflammation are associated with ME/CFS remains unclear. We pursued rigorous clinical characterization, fecal bacterial metagenomics, and plasma immune molecule analyses in 50 ME/CFS patients and 50 healthy controls frequency-matched for age, sex, race/ethnicity, geographic site, and season of sampling...
April 26, 2017: Microbiome
https://www.readbyqxmd.com/read/28431150/the-natural-history-of-children-with-joint-hypermobility-syndrome-and-ehlers-danlos-hypermobility-type-a-longitudinal-cohort-study
#19
Mark C Scheper, Lesley L Nicholson, Roger D Adams, Louise Tofts, Verity Pacey
Objectives.: The objective of the manuscript was to describe the natural history of complaints and disability in children diagnosed with joint hypermobility syndrome (JHS)/Ehlers-Danlos-hypermobility type (EDS-HT) and to identify the constructs that underlie functional decline. Methods.: One hundred and one JHS/EDS-HT children were observed over 3 years and assessed at three time points on the following: functional impairments, quality of life, connective tissue laxity, muscle function, postural control and musculoskeletal and multi-systemic complaints...
April 18, 2017: Rheumatology
https://www.readbyqxmd.com/read/28414396/postural-tachycardia-syndrome-diagnosis-and-management-in-adolescents-and-young-adults
#20
Geoffrey L Heyer
Postural tachycardia syndrome (POTS) represents a common form of orthostatic intolerance that disproportionately affects young women from puberty through adulthood. Patients with POTS have day-to-day orthostatic symptoms with the hallmark feature of an excessive, sustained, and symptomatic rise in heart rate during orthostatic testing. Although considerable overlap exists, three subtypes of POTS have been described: neuropathic, hyperadrenergic, and hypovolemic forms. The wide spectrum of symptoms and comorbidities can make treatment particularly challenging...
April 1, 2017: Pediatric Annals
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