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https://www.readbyqxmd.com/read/28345674/skeletal-muscle-pump-drives-control-of-cardiovascular-and-postural-systems
#1
Ajay K Verma, Amanmeet Garg, Da Xu, Michelle Bruner, Reza Fazel-Rezai, Andrew P Blaber, Kouhyar Tavakolian
The causal interaction between cardio-postural-musculoskeletal systems is critical in maintaining postural stability under orthostatic challenge. The absence or reduction of such interactions could lead to fainting and falls often experienced by elderly individuals. The causal relationship between systolic blood pressure (SBP), calf electromyography (EMG), and resultant center of pressure (COPr) can quantify the behavior of cardio-postural control loop. Convergent cross mapping (CCM) is a non-linear approach to establish causality, thus, expected to decipher nonlinear causal cardio-postural-musculoskeletal interactions...
March 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28339397/cognitive-status-gray-matter-atrophy-and-lower-orthostatic-blood-pressure-in-older-adults
#2
Celia O'Hare, Rose-Anne Kenny, Howard Aizenstein, Robert Boudreau, Anne Newman, Lenore Launer, Suzanne Satterfield, Kristine Yaffe, Caterina Rosano
BACKGROUND: Associations between orthostatic blood pressure and cognitive status (CS) have been described with conflicting results. OBJECTIVE: We hypothesize that long-term exposure to lower orthostatic blood pressure is related to having worse CS later in life and that atrophy of regions involved in central regulation of autonomic function mediate these associations. METHODS: Three-to-four measures of orthostatic blood pressure were obtained from 1997-2003 in a longitudinal cohort of aging, and average systolic orthostatic blood pressure response (ASOBPR) was computed as % change in systolic blood pressure from sit-to-stand measured at one minute post stand...
March 20, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28338807/is-orthostatic-hypotension-related-to-falling-a-meta-analysis-of-individual-patient-data-of-prospective-observational-studies
#3
Laura Caroline Hartog, Dennis Schrijnders, G W D Landman, Klaas Groenier, Nanne Kleefstra, Henk J G Bilo, Kornelis Johannes Jongers van Hateren
Background: orthostatic hypotension (OH) is one out of many risk factors believed to contribute to an increased fall risk in elderly subjects but it is unclear whether an independent association between OH and falling exists. Objectives: to perform an individual patient data (IPD) meta-analysis of prospective observational studies investigating the relationship between OH and falling. Design: MEDLINE, EMBASE, the Cochrane Library and the abstracts of annual meetings of selected hypertension societies were searched...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28331633/office-orthostatic-blood-pressure-measurements-and-ambulatory-blood-pressure-monitoring-in-the-prediction-of-autonomic-dysfunction
#4
Kawther F Alquadan, Girish Singhania, Abhilash Koratala, Abutaleb A Ejaz
BACKGROUND: In this retrospective analysis we investigated the predictive performance of orthostatic hypotension (OH) and ambulatory blood pressure monitoring (ABP) to predict autonomic dysfunction. METHODS: Statistical associations among the candidate variables were investigated and comparisons of predictive performances were performed using Receiver Operating Characteristics (ROC) curves. RESULTS: Ninety-four patients were included for analysis...
2017: Clinical Hypertension
https://www.readbyqxmd.com/read/28327122/midodrine-as-adjunctive-support-for-treatment-of-refractory-hypotension-in-the-intensive-care-unit-a-multicenter-randomized-placebo-controlled-trial-the-midas-trial
#5
Matthew H Anstey, Bradley Wibrow, Tharusan Thevathasan, Brigit Roberts, Khushi Chhangani, Pauline Yeung Ng, Alexander Levine, Alan DiBiasio, Todd Sarge, Matthias Eikermann
BACKGROUND: Patients admitted to intensive care units (ICU) are often treated with intravenous (IV) vasopressors. Persistent hypotension and dependence on IV vasopressors in otherwise resuscitated patients lead to delay in discharge from ICU. Midodrine is an oral alpha-1 adrenergic agonist approved for treatment of symptomatic orthostatic hypotension. This trial aims to evaluate whether oral administration of midodrine is an effective adjunct to standard therapy to reduce the duration of IV vasopressor treatment, and allow earlier discharge from ICU and hospital...
March 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28321775/presence-and-extent-of-cardiac-computed-tomography-angiography-defined-coronary-artery-disease-in-patients-presenting-with-syncope
#6
S Altintas, T Dinh, N G H M Marcks, M Kok, A J J Aerts, B Weijs, Y Blaauw, J E Wildberger, M Das, B L J H Kietselaer, H J G M Crijns
BACKGROUND: In syncope patients, presence of coronary artery disease (CAD) is associated with poor prognosis. However, data concerning CAD prevalence in syncope patients without known cardiovascular disease are lacking. Therefore, the aim of this study was to investigate presence and extent of CAD in syncope patients. METHODS: We included 142 consecutive patients presenting with syncope at the outpatient cardiology clinic who underwent coronary computed tomography (CT) angiography...
March 20, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28319594/long-term-cardiovascular-autonomic-and-clinical-changes-after-immunoglobulin-g-immunoadsorption-therapy-in-autoimmune-autonomic-ganglionopathy
#7
Franca Barbic, Franca Dipaola, Francesca Andreetta, Enrico Brunetta, Laura Dalla Vecchia, Renato Mantegazza, Raffaello Furlan, Carlo Antozzi
A 63-year-old male was diagnosed with autoimmune autonomic ganglionopathy based on the finding of plasma antibodies to the nicotinic acetylcholine receptor (nAChR) of autonomic ganglia. He complained of mouth and eye dryness, dysphagia, severe constipation, erectile dysfunction, urgency, frequent urination, habitual orthostatic syncope and presyncope. A remarkable symptomatic orthostatic hypotension without changes in heart rate was present. We here describe the 3-year time course of the changes in spectral indices of cardiovascular autonomic control LF/HF and LFSAP, dysautonomia symptoms intensity and anti-nAChR antibodies following repetitive selective immunoadsorptions...
March 17, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28306636/blood-pressure-lowering-efficacy-and-safety-of-perindopril-indapamide-amlodipine-single-pill-combination-in-patients-with-uncontrolled-essential-hypertension-a-multicenter-randomized-double-blind-controlled-trial
#8
Jean-Jacques Mourad, Celso Amodeo, Martine de Champvallins, Romualda Brzozowska-Villatte, Roland Asmar
OBJECTIVES: This 4-month, double-blind, randomized, controlled trial was designed to demonstrate the superiority of perindopril/indapamide/amlodipine single pill over perindopril/indapamide after 1 month and to determine further up-titration efficacy and safety in patients with mild-to-moderate hypertension. METHODS: After a 1-month run-in period on perindopril/indapamide 5/1.25 mg, patients with SBP/DBP at least 150/95 mmHg and no diabetes or renal insufficiency received perindopril/indapamide/amlodipine 5/1...
March 16, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28302133/activin-b-is-a-novel-biomarker-for-chronic-fatigue-syndrome-myalgic-encephalomyelitis-cfs-me-diagnosis-a-cross-sectional-study
#9
Brett A Lidbury, Badia Kita, Donald P Lewis, Susan Hayward, Helen Ludlow, Mark P Hedger, David M de Kretser
BACKGROUND: Investigations of activin family proteins as serum biomarkers for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). CFS/ME is a disease with complex, wide-ranging symptoms, featuring persistent fatigue of 6 months or longer, particularly post exertion. No definitive biomarkers are available. METHODS: A cross-sectional, observational study of CFS/ME patients fulfilling the 2003 Canadian Consensus Criteria, in parallel with healthy non-fatigued controls, was conducted...
March 16, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28298654/standing-orthostatic-blood-pressure-measurements-cannot-be-replaced-by-sitting-measurements
#10
Anna C Breeuwsma, Laura C Hartog, Adriaan M Kamper, Klaas H Groenier, Henk Jg Bilo, Nanne Kleefstra, Kornelis Jj Van Hateren
As many elderly patients are not able to stand for several minutes, sitting orthostatic blood pressure (BP) measurements are sometimes used as an alternative. We aimed to investigate the difference in BP response and orthostatic hypotension (OH) prevalence between the standard postural change to the sitting and the standing position in a cross-sectional observational study. BP was measured with a continuous BP measurement device during two postural changes, from supine to the sitting and from supine to the standing position...
March 16, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28295143/impaired-orthostatic-blood-pressure-recovery-is-associated-with-unexplained-and-injurious-falls
#11
Ciarán Finucane, Matthew D L O'Connell, Orna Donoghue, Kathryn Richardson, George M Savva, Rose Anne Kenny
OBJECTIVES: Cardiovascular disorders are recognized as important modifiable risk factors for falls. However, the association between falls and orthostatic hypotension (OH) remains ambivalent, particularly because of poor measurement methods of previous studies. The goal was to determine for the first time to what extent OH (and variants) are risk factors for incident falls, unexplained falls (UF), injurious falls (IF) and syncope using dynamic blood pressure (BP) measurements in a population study...
March 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28294283/orthostatic-hypotension-and-falls
#12
EDITORIAL
Lewis A Lipsitz
No abstract text is available yet for this article.
March 10, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28290647/syncope-evaluation-and-differential-diagnosis
#13
Lloyd A Runser, Robert L Gauer, Alex Houser
Syncope is an abrupt and transient loss of consciousness caused by cerebral hypoperfusion. It accounts for 1% to 1.5% of emergency department visits, resulting in high hospital admission rates and significant medical costs. Syncope is classified as neurally mediated, cardiac, and orthostatic hypotension. Neurally mediated syncope is the most common type and has a benign course, whereas cardiac syncope is associated with increased morbidity and mortality. Patients with presyncope have similar prognoses to those with syncope and should undergo a similar evaluation...
March 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28290633/proteinuria-in-children-evaluation-and-differential-diagnosis
#14
Alexander K C Leung, Alex H C Wong, Stefani S N Barg
Although proteinuria is usually benign in the form of transient or orthostatic proteinuria, persistent proteinuria may be associated with more serious renal diseases. Proteinuria may be an independent risk factor for the progression of chronic kidney disease in children. Mechanisms of proteinuria can be categorized as glomerular, tubular, secretory, or overflow. A history, a physical examination, and laboratory tests help determine the cause. Transient (functional) proteinuria is temporary. It can occur with fever, exercise, stress, or cold exposure, and it resolves when the inciting factor is removed...
February 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28289649/hypothermia-presenting-in-wernicke-encephalopathy-a-case-report
#15
Seok Hyun Hong, Ju Sun Oh, Chang Hyun Lee, Jae Ho Oh
Wernicke encephalopathy (WE) is a neurologic disorder characterized by clinical symptoms, such as nystagmus, ataxia, and mental confusion. Hypothermia in patients with WE is a rare complication, and its pathogenic mechanism and therapy are yet to be ascertained. Herein, we presented a case of a 61-year-old man who was diagnosed with WE 3 months earlier. We investigated the cause of hypothermia (35.0℃) that occurred after an enema (bowel emptying). Brain magnetic resonance imaging revealed mammillary body and hypothalamus atrophy...
February 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28286774/orthostatic-intolerance-and-postural-orthostatic-tachycardia-syndrome-in-joint-hypermobility-syndrome-ehlers-danlos-syndrome-hypermobility-type-neurovegetative-dysregulation-or-autonomic-failure
#16
Claudia Celletti, Filippo Camerota, Marco Castori, Federica Censi, Laura Gioffrè, Giovanni Calcagnini, Stefano Strano
Background. Joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type (JHS/EDS-HT), is a hereditary connective tissue disorder mainly characterized by generalized joint hypermobility, skin texture abnormalities, and visceral and vascular dysfunctions, also comprising symptoms of autonomic dysfunction. This study aims to further evaluate cardiovascular autonomic involvement in JHS/EDS-HT by a battery of functional tests. Methods. The response to cardiovascular reflex tests comprising deep breathing, Valsalva maneuver, 30/15 ratio, handgrip test, and head-up tilt test was studied in 35 JHS/EDS-HT adults...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28279509/-medical-and-surgical-treatment-of-parkinson-s-disease
#17
Luc Defebvre, Caroline Moreau
The treatment of Parkinson's disease is symptomatic with the use of dopaminergic medications: levodopa, dopaminergic agonists and enzymatic inhibitors. At the initial stage, the main goals are to improve the quality of life of patients and delay the onset of motor complications, using a combination of these therapies taking into account both clinical disability and tolerance of different treatments. At the stage of motor and non-motor fluctuations inhibitors of MAO-B and COMT are proposed; amantadine may limit moderate dyskinesias...
March 6, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28273361/transcatheter-aortic-valve-implantation-improves-carotid-and-vertebral-arterial-blood-flow-in-patients-with-severe-aortic-stenosis-practical-role-of-orthostatic-stress-test
#18
Pawel Kleczyński, Pawel Petkow Dimitrow, Artur Dziewierz, Andrzej Surdacki, Dariusz Dudek
BACKGROUND: There are no data on the impact of transcatheter aortic valve implantation (TAVI) on carotid and vertebral arterial blood flow. Our aim was to assess the effects of the orthostatic stress test on carotid and vertebral artery blood flow in patients with severe aortic stenosis (AS) undergoing TAVI. HYPOTHESIS: TAVI may have beneficial effect on carotid and vertebral artery flow in patients with severe aortic stenosis. METHODS: Thirty carefully selected patients with severe AS undergoing TAVI were enrolled...
March 8, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28271534/patient-after-renal-transplantation-with-syncope-role-of-echocardiography-in-upright-position
#19
Paweł Petkow Dimitrow, Danuta Sorysz, Rafał Hładij, Bernadeta Chyrchel, Barbara Dudzik, Władysław Sułowicz, Andrzej Surdacki
In Doppler echocardiography, testing left ventricular outflow tract (LVOT) gradient in the supine position (as is done in everyday practice) does not reflect the pathophysiology of this dynamic abnormality during the daily activities that trigger the symptoms (eg, syncope). LVOT obstruction is a dynamic phenomenon, strongly dependent on the left ventricular cavity size, geometric configuration of hypertrophy, load variability, contractility, and mitral apparatus abnormalities. LVOT gradient may develop not only in hypertrophic cardiomyopathy but also in various heart diseases...
March 8, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28268875/a-model-based-method-to-measure-baroreflex-sensitivity
#20
Yu Meng, Zhipei Huang, Jiangkang Wu, Xinxia Cai
This paper proposes a model-based method to quantitatively measure baroreflex sensitivity in autonomic nervous regulation of cardiovascular system. The method measures the continuous blood pressure and heart rate in orthostatic scenario, models dynamics of the baroreflex firing rate, solves parameters by optimization of measured blood pressure and heart rate variations. With this model, we can get the baroreflx sensitivity (BRS) inner indicators to evaluate the status of the autonomic nervous regulation system...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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