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https://www.readbyqxmd.com/read/28101372/lessons-i-have-learned-from-my-patients-everyday-life-with-primary-orthostatic-tremor
#1
Marie Vidailhet, Emmanuel Roze, Lucie Maugest, Cécile Gallea
BACKGROUND: Primary orthostatic tremor is a rare disorder that is still under-diagnosed or misdiagnosed. Motor symptoms are fairly characteristics but the real impact on the patient's every day life and quality of life is under-estimated. The "how my patients taught me" format describes the impact on the patients' every day life with their own words, which is rarely done. CASE PRESENTATION: A 46 year old lady was diagnosed primary orthostatic tremor (POT) based on the cardinal symptoms: feelings of instability, leg tremor and fear of falling in the standing position, improvement with walking and disappearance while sitting, frequency of Tremor in the 13-18Hz range, normal neurological examination...
2017: Journal of Clinical Movement Disorders
https://www.readbyqxmd.com/read/28092986/a-review-of-the-treatment-of-primary-orthostatic-hypotension
#2
Genevieve M Hale, Jose Valdes, Michael Brenner
OBJECTIVE: To review the efficacy and safety of pharmacological and nonpharmacological strategies used to treat primary orthostatic hypotension (OH). DATA SOURCES: A literature review using PubMed and MEDLINE databases searching hypotension, non-pharmacological therapy, midodrine, droxidopa, pyridostigmine, fludrocortisone, atomoxetine, pseudoephedrine, and octreotide was performed. STUDY SELECTION AND DATA EXTRACTION: Randomized or observational studies, cohorts, case series, or case reports written in English between January 1970 and November 2016 that assessed primary OH treatment in adult patients were evaluated...
January 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28079571/spontaneous-intracranial-hypotension-with-site-of-leak-detected-only-after-111in-dtpa-cisternogram
#3
Sana Parsian, Manuela C Matesan, Sachin Shivaji Kumbhar, David H Lewis
A 54-year-old man with a 3-week history of orthostatic headache and acute on chronic subdural hematoma presented with imaging findings suggestive of spontaneous intracranial hypotension. Three myelograms were negative for leak, and nontargeted epidural blood patches did not result in symptom relief. A cerebrospinal fluid leak study using In-DTPA with SPECT/CT demonstrated a focal area of asymmetric activity at the left C2 nerve root. A left C2 root tie-off, targeted epidural blood patch, and Dura seal glue resulted in resolution of patient symptomatology highlighting the importance of fused SPECT/CT images in detection of an occult cerebral spinal fluid leak...
January 10, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28077421/aortic-wave-reflection-during-orthostatic-challenges-influence-of-body-position-and-venous-pooling
#4
William E Hughes, Darren P Casey
BACKGROUND: Aortic wave reflection (augmentation index; AIx) decreases during orthostatic challenges despite increased peripheral resistance, which is thought to be due to venous pooling. The purpose of this study was to examine if the decrease in AIx during an orthostatic challenge is due to venous pooling alone or body position manipulation. METHODS: Twenty-three young, healthy adults (11F/12M) participated in 3 separate orthostatic challenges (5 minutes each); 60° head-up tilt (HUT), 60° HUT with bilateral rhythmic blood pressure (BP) cuff inflation on calves (75 mm Hg) to minimize venous pooling, and lower body negative pressure (LBNP; -30 mm Hg) for venous pooling independent of body position...
February 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28076297/dynamics-of-the-cardiovascular-autonomic-regulation-during-orthostatic-challenge-is-more-relaxed-in-women
#5
Sina Reulecke, Sonia Charleston-Villalobos, Andreas Voss, Ramón González-Camarena, Jesús González-Hermosillo, Mercedes Gaitán-González, Guadalupe Hernández-Pacheco, Rico Schroeder, Tomás Aljama-Corrales
Linear dynamic analysis of cardiovascular and respiratory time series was performed in healthy subjects with respect to gender by shifted short-term segments throughout a head-up tilt (HUT) test. Beat-to-beat intervals (BBI), systolic (SYS) and diastolic (DIA) blood pressure and respiratory interval (RESP) time series were acquired in 14 men and 15 women. In time domain (TD), the descending slope of the auto-correlation function (ACF) (BBI_a31cor) was more pronounced in women than in men (p<0.05) during the HUT test and considerably steeper (p<0...
January 11, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28069417/standing-shock-index-an-alternative-to-orthostatic-vital-signs
#6
Michael D Witting
: Objective The lack of a sensitive, practical bedside test for hypovolemia has rekindled interest in the shock index (heart rate divided by systolic blood pressure). Here, we compare the effect of blood donation on standing shock index values with its effect on values for the supine shock index and orthostatic change in shock indicies (OCSI). METHODS: This is a re-analysis of data collected for an earlier report. Data were available from 292 adults below age 65 and 44 adults ages 65 and over, donating 450mL of blood...
December 23, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28055999/-role-of-the-sympathetic-nervous-system-in-vasovagal-syncope-and-rationale-for-beta-blockers-and-norepinephrine-transporter-inhibitors
#7
Manlio F Márquez, Jorge Rafael Gómez-Flores, Jesús A González-Hermosillo, Teresita de Jesús Ruíz-Siller, Manuel Cárdenas
Vasovagal or neurocardiogenic syncope is a common clinical situation and, as with other entities associated with orthostatic intolerance, the underlying condition is a dysfunction of the autonomic nervous system. This article reviews various aspects of vasovagal syncope, including its relationship with orthostatic intolerance and the role of the autonomic nervous system in it. A brief history of the problem is given, as well as a description of how the names and associated concepts have evolved. The response of the sympathetic system to orthostatic stress, the physiology of the baroreflex system and the neurohumoral changes that occur with standing are analyzed...
December 29, 2016: Medwave
https://www.readbyqxmd.com/read/28050656/the-recommendations-of-a-consensus-panel-for-the-screening-diagnosis-and-treatment-of-neurogenic-orthostatic-hypotension-and-associated-supine-hypertension
#8
REVIEW
Christopher H Gibbons, Peter Schmidt, Italo Biaggioni, Camille Frazier-Mills, Roy Freeman, Stuart Isaacson, Beverly Karabin, Louis Kuritzky, Mark Lew, Phillip Low, Ali Mehdirad, Satish R Raj, Steven Vernino, Horacio Kaufmann
Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson's disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, and peripheral neuropathies including amyloid or diabetic neuropathy. Due to the frequency of nOH in the aging population, clinicians need to be well informed about its diagnosis and management. To date, studies of nOH have used different outcome measures and various methods of diagnosis, thereby preventing the generation of evidence-based guidelines to direct clinicians towards 'best practices' when treating patients with nOH and associated supine hypertension...
January 3, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28045689/racial-differences-in-response-to-tilt-table-testing-in-patients-refered
#9
Jameel Ahmed, Peerawut Deeprasertkul, Kevin M Monahan, Paul LeLorier
BACKGROUND: Syncope is a common problem in the general population and results in significant societal and patient costs. Several small studies have demonstrated differences in orthostatic response, and possibly tolerance, between blacks and whites. Based on these observations, we retrospectively reviewed results from our tilt table database to identify potential differences in response to tilt-table testing with regards to race, between black and white patients. METHODS: The reports of 446 tilt-table tests performed on adults, older than 18 years of age, at Boston Medical Center, an urban, tertiary-care, academic hospital, were reviewed...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28045686/vibrio-mimicus-as-the-rare-cause-of-acute-diarrheal-illness
#10
Samuel Muller, Heather Chau, Kristi Boudreaux
Vibrio mimicus, although named for having many of the same virulent factors as Vibrio cholera, is a rare cause of significant gastrointestinal illness. Like many of the Vibrio species, the strongest risk factor for V. mimicus infection is seafood consumption. After consuming crabs, a 64-year-old male presented with a three day history of voluminous, non-bloody, water diarrhea. The severity of the diarrhea caused the patient to have orthostatic hypotension and acute kidney injury, which improved with fluid resuscitation...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28031220/pathological-ponto-cerebello-thalamo-cortical-activations-in-primary-orthostatic-tremor-during-lying-and-stance
#11
Florian Schöberl, Katharina Feil, Guoming Xiong, Peter Bartenstein, Christian la Fougére, Klaus Jahn, Thomas Brandt, Michael Strupp, Marianne Dieterich, Andreas Zwergal
Primary orthostatic tremor is a rare neurological disease characterized mainly by a high frequency tremor of the legs while standing. The aim of this study was to identify the common core structures of the oscillatory circuit in orthostatic tremor and how it is modulated by changes of body position. Ten patients with orthostatic tremor and 10 healthy age-matched control subjects underwent a standardized neurological and neuro-ophthalmological examination including electromyographic and posturographic recordings...
January 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28025409/a-case-of-acute-autonomic-and-sensory-neuropathy-aasn-with-antibody-against-a-mixture-of-galactocerebroside-and-phospholipids
#12
Teruyuki Ishikura, Kazushiro Takata, Makoto Kinoshita, Kei Fukada, Jinichi Sawada, Takanori Hazama
A 62-year-old woman presented with paresthesia of limbs, gait disturbance, urinary retention and constipation following upper respiratory infection. Neurological examination revealed gait disturbance due to loss of position sense in her extremities with intact muscle power, and autonomic failure represented by orthostatic hypotension, constipation and autonomic bladder. Cerebrospinal fluid analysis showed normal cell counts with elevated protein levels. Nerve conduction study showed sensory nerve impairment with almost normal motor nerve conduction in her upper and lower extremities...
December 23, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28024941/orthostatic-hypotension-after-continuous-flow-left-ventricular-assist-device-implantation-in-a-patient-with-longstanding-diabetes-mellitus
#13
Derek S Chew, Brett H Shaw, Debra L Isaac, Jonathan G Howlett, Satish R Raj
A continuous-flow left ventricular assist device (CF-LVAD) benefits patients with advanced heart failure as a bridge to cardiac transplantation. However, unanticipated complications may occur. We report a patient with end-stage heart failure and longstanding diabetes who experienced functionally debilitating orthostatic hypotension from autonomic insufficiency after CF-LVAD implantation. This case demonstrates a role for comprehensive autonomic function testing in the workup of orthostatic hypotension after LVAD implantation...
October 28, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28018469/type-i-chiari-malformation-presenting-orthostatic-syncope-who-treated-with-decompressive-surgery
#14
Hyun-Seung Shin, Jeong A Kim, Dong-Seok Kim, Joon Soo Lee
Chiari malformations are a congenital anomaly of the hindbrain. The most common, Chiari malformation type I (CM-I), is characterized by herniation of the cerebellar tonsils extending at least 3 mm below the plane of the foramen magnum. Consequently, CM-I is associated with hydrocephalus and symptoms involving compression of the cervicomedullary junction by ectopic tonsils. Several studies have reported the clinical symptoms associated with CM-I, including suboccipital headache, weakness in the upper extremities, facial numbness, loss of temperature sensation, ataxia, diplopia, dysarthria, dysphagia, vomiting, vertigo, nystagmus, and tinnitus...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28018240/distinctive-steady-state-heart-rate-and-blood-pressure-responses-to-passive-robotic-leg-exercise-and-functional-electrical-stimulation-during-head-up-tilt
#15
Amirehsan Sarabadani Tafreshi, Robert Riener, Verena Klamroth-Marganska
Introduction: Tilt tables enable early mobilization of patients by providing verticalization. But there is a high risk of orthostatic hypotension provoked by verticalization, especially after neurological diseases such as spinal cord injury. Robot-assisted tilt tables might be an alternative as they add passive robotic leg exercise (PE) that can be enhanced with functional electrical stimulation (FES) to the verticalization, thus reducing the risk of orthostatic hypotension. We hypothesized that the influence of PE on the cardiovascular system during verticalization (i...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/28017201/lower-body-mass-index-is-associated-with-orthostatic-hypotension-in-parkinson-s-disease
#16
Tomohiko Nakamura, Masashi Suzuki, Miki Ueda, Masaaki Hirayama, Masahisa Katsuno
INTRODUCTION: Lower body mass index (BMI) is associated with orthostatic hypotension (OH) in the general population, especially in the elderly; however, no studies have addressed this issue in Parkinson's disease (PD). METHODS: We investigated the results of the head-up tilt test and BMI of patients with PD, and evaluated whether BMI is related to orthostatic systolic blood pressure (SBP) change during the head-up tilt test. PD patients were divided into male and female groups, and further divided into middle-aged (age<65years) and elderly (age≥65years) subgroups in each sex...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28013357/physical-activity-but-not-sedentary-activity-is-reduced-in-primary-sj%C3%A3-gren-s-syndrome
#17
Wan-Fai Ng, Ariana Miller, Simon J Bowman, Elizabeth J Price, George D Kitas, Colin Pease, Paul Emery, Peter Lanyon, John Hunter, Monica Gupta, Ian Giles, David Isenberg, John McLaren, Marian Regan, Annie Cooper, Steven A Young-Min, Neil McHugh, Saravanan Vadivelu, Robert J Moots, David Coady, Kirsten MacKay, Bhaskar Dasgupta, Nurhan Sutcliffe, Michele Bombardieri, Costantino Pitzalis, Bridget Griffiths, Sheryl Mitchell, Samira Tatiyama Miyamoto, Michael Trenell
The aim of the study was to evaluate the levels of physical activity in individuals with primary Sjögren's syndrome (PSS) and its relationship to the clinical features of PSS. To this cross-sectional study, self-reported levels of physical activity from 273 PSS patients were measured using the International Physical Activity Questionnaire-short form (IPAQ-SF) and were compared with healthy controls matched for age, sex and body mass index. Fatigue and other clinical aspects of PSS including disease status, dryness, daytime sleepiness, dysautonomia, anxiety and depression were assessed using validated tools...
December 24, 2016: Rheumatology International
https://www.readbyqxmd.com/read/28013227/a-prospective-study-of-the-association-between-orthostatic-hypotension-and-falls-definition-matters
#18
Claire McDonald, Mark Pearce, Simon R Kerr, Julia Newton
BACKGROUND: falls are a common cause of morbidity and mortality in older people. Orthostatic hypotension (OH) is considered an important risk factor for falls, but longitudinal studies have failed to show a clear association. This disparity may be because conventional methods of measuring blood pressure (BP) changes are too imprecise and/or the diagnostic criteria for OH are inappropriate. Over recent years, beat-to-beat BP monitoring techniques, which enabled accurate measurement of vasodepression, have become widely used and in 2011 the American Academy of Neurology produced revised diagnostic criteria for OH...
December 23, 2016: Age and Ageing
https://www.readbyqxmd.com/read/28011746/the-pharmacology-of-autonomic-failure-from-hypotension-to-hypertension
#19
REVIEW
Italo Biaggioni
Primary neurodegenerative autonomic disorders are characterized clinically by loss of autonomic regulation of blood pressure. The clinical picture is dominated by orthostatic hypotension, but supine hypertension is also a significant problem. Autonomic failure can result from impairment of central autonomic pathways (multiple system atrophy) or neurodegeneration of peripheral postganglionic autonomic fibers (pure autonomic failure, Parkinson's disease). Pharmacologic probes such as the ganglionic blocker trimethaphan can help us in the understanding of the underlying pathophysiology and diagnosis of these disorders...
January 2017: Pharmacological Reviews
https://www.readbyqxmd.com/read/28009704/hospital-admissions-for-orthostatic-hypotension-and-syncope-in-later-life-insights-from-the-malm%C3%A3-preventive-project
#20
Fabrizio Ricci, Lamberto Manzoli, Richard Sutton, Olle Melander, Maria E Flacco, Sabina Gallina, Raffaele De Caterina, Artur Fedorowski
OBJECTIVE(S): We explored incidence, predictors, and long-term prognosis of hospital admissions attributed to reflex syncope and orthostatic hypotension. METHODS: We analyzed a cohort of 32 628 individuals (68.2% men; age, 45.6 ± 7.4 years) without prevalent cardiovascular disease over a follow-up period of 26.6 ± 7.5 years. RESULTS: One thousand and fourteen persons (3.1%, 1.2 per 1000 person-years) had at least 1 hospitalization for orthostatic hypotension (n = 462, 1...
December 22, 2016: Journal of Hypertension
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