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https://www.readbyqxmd.com/read/29773912/development-and-evaluation-of-a-novel-system-for-inducing-orthostatic-challenge-by-tilt-tests-and-lower-body-negative-pressure
#1
Łukasz Dziuda, Mariusz Krej, Maciej Śmietanowski, Aleksander Sobotnicki, Mariusz Sobiech, Piotr Kwaśny, Anna Brzozowska, Paulina Baran, Krzysztof Kowalczuk, Franciszek W Skibniewski
Lower body negative pressure (LBNP) is a method derived from space medicine, which in recent years has been increasingly used by clinicians to assess the efficiency of the cardiovascular regulatory mechanisms. LBNP with combined tilt testing is considered as an effective form of training to prevent orthostatic intolerance. We have developed a prototype system comprising a tilt table and LBNP chamber, and tested it in the context of the feasibility of the device for assessing the pilots' efficiency. The table allows for controlled tilting in the range from -45 to +80° at the maximum change rate of 45°/s...
May 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29767354/proprioceptive-muscle-tendon-stimulation-reduces-symptoms-in-primary-orthostatic-tremor
#2
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/29766366/consensus-statement-on-the-definition-of-neurogenic-supine-hypertension-in-cardiovascular-autonomic-failure-by-the-american-autonomic-society-aas-and-the-european-federation-of-autonomic-societies-efas-endorsed-by-the-european-academy-of-neurology-ean-and-the
#3
REVIEW
Alessandra Fanciulli, Jens Jordan, Italo Biaggioni, Giovanna Calandra-Buonaura, William P Cheshire, Pietro Cortelli, Sabine Eschlboeck, Guido Grassi, Max J Hilz, Horacio Kaufmann, Heinz Lahrmann, Giuseppe Mancia, Gert Mayer, Lucy Norcliffe-Kaufmann, Anne Pavy-Le Traon, Satish R Raj, David Robertson, Isabel Rocha, Walter Struhal, Roland Thijs, Konstantinos P Tsioufis, J Gert van Dijk, Gregor K Wenning
PURPOSE: Patients suffering from cardiovascular autonomic failure often develop neurogenic supine hypertension (nSH), i.e., high blood pressure (BP) in the supine position, which falls in the upright position owing to impaired autonomic regulation. A committee was formed to reach consensus among experts on the definition and diagnosis of nSH in the context of cardiovascular autonomic failure. METHODS: As a first and preparatory step, a systematic search of PubMed-indexed literature on nSH up to January 2017 was performed...
May 15, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29763267/top-20-research-studies-of-2017-for-primary-care-physicians
#4
Mark H Ebell, Roland Grad
Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29757831/a-patient-with-autonomic-imbalance-treating-symptomatic-neurogenic-orthostatic-hypotension
#5
Debra Turner
No abstract text is available yet for this article.
June 11, 2018: Nurse Practitioner
https://www.readbyqxmd.com/read/29753705/spinal-cord-injury-how-could-acupuncture-help
#6
REVIEW
Qianqian Fan, Omer Cavus, Lize Xiong, Yun Xia
Spinal cord injury (SCI) is one of the most common causes of death and disability worldwide, and it can result in both permanent disability and serial complications in patients. Research shows that patients with SCI complications are often interested in acupuncture for symptomatic relief. Therefore, the issue of physicians advising their patients regarding the use of acupuncture to alleviate SCI complications becomes pertinent. We review and summarize two types of relevant publications: (1) literature concerning acupuncture for SCI and its complications and (2) underlying mechanisms of acupuncture therapy for SCI...
May 10, 2018: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/29753556/pharmacotherapy-for-postural-tachycardia-syndrome
#7
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
#8
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/29738355/morning-blood-pressure-surge-is-associated-independently-with-orthostatic-hypotension-in-hypertensive-patients-under-treatment
#9
Hakan Caf, Yurdaer Dönmez, Emel Çeliker Güler, Onur Kaypakli, Yahya Kemal İçen, Mevlüt Koç
OBJECTIVE: Morning blood pressure surge (MBPS) and orthostatic hypotension (OH) play a role in the occurrence of cardiovascular events. We aimed to investigate the association between MBPS and OH in hypertensive patients under treatment. PATIENTS AND METHODS: We prospectively included 297 patients (mean age: 53.8±10.7 years, male/female: 101/196) with essential hypertension. Tilt table testing was performed for the diagnosis of OH. OH was classified into three groups as initial OH (0-15 s), classical OH (15 s to 3 min), and delayed OH (3-30 min)...
May 7, 2018: Blood Pressure Monitoring
https://www.readbyqxmd.com/read/29737501/safety-of-tamsulosin-a-systematic-review-of-randomized-trials-with-a-focus-on-women-and-children
#10
REVIEW
Steven A Kaplan, Bilal I Chughtai
INTRODUCTION: Although tamsulosin is indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH), it has also been assessed in clinical studies for other conditions/symptoms and in other populations such as women and children. In this systematic review of randomized studies, the overall safety of tamsulosin was assessed, focusing on these understudied populations. METHODS: Literature searches were conducted using Embase, Medline, and PubMed (inception-December 2015)...
May 8, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29736422/cerebral-microbleeds-and-blood-pressure-abnormalities-in-parkinson-s-disease
#11
Kazuo Yamashiro, Ryota Tanaka, Yasushi Shimo, Genko Oyama, Takashi Ogawa, Atsushi Umemura, Nobutaka Hattori
Blood pressure abnormalities are frequently observed in patients with Parkinson's disease (PD), and are associated with cerebrovascular diseases such as white matter hyperintensities and carotid atherosclerosis. We assessed the relationship between blood pressure abnormalities and cerebral microbleeds (CMBs), a marker of cerebral small vessel disease, in 128 patients with PD. We examined supine and orthostatic blood pressures and used 24-hour ambulatory blood pressure monitoring to assess the presence or absence of orthostatic hypotension (OH), supine hypertension (SH), nocturnal hypertension (NH), and loss of nocturnal blood pressure dips (non-dipping)...
March 2018: ENeurologicalSci
https://www.readbyqxmd.com/read/29735525/orthostatic-hypotension-and-risk-of-clinical-and-subclinical-cardiovascular-disease-in-middle-aged-adults
#12
Stephen P Juraschek, Natalie Daya, Lawrence J Appel, Edgar R Miller, John William McEvoy, Kunihiro Matsushita, Christie M Ballantyne, Elizabeth Selvin
BACKGROUND: Although orthostatic hypotension (OH) is a well-recognized manifestation of neuropathy and hypovolemia, its contribution to cardiovascular disease (CVD) risk is controversial. METHODS AND RESULTS: Participants with OH, defined as a decrease in blood pressure (systolic ≥20 mm Hg or diastolic ≥10 mm Hg) from the supine to standing position, were identified during the first visit of the ARIC (Atherosclerosis Risk in Communities) Study (1987-1989) within 2 minutes of standing...
May 7, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29735491/a-case-of-platypnoea-orthodeoxia-following-laproscopic-cholecystectomy
#13
Timothy Riddles, James Brown, Daniel Judge
Platypnoea Orthodeoxia syndrome is defined by dyspnoea and hypoxaemia exacerbated by orthostatic positioning and alleviated in recumbency. This condition has been reported in association with pulmonary, hepatic and cardiac disease. We describe a case herein of a 79 year old female who developed severe hypoxaemia and dyspnoea post laparoscopic cholecystectomy. A difference in arterial blood gas oxygen tension was demonstrated in the supine and erect positions on arterial blood gas analysis. A Patent Foramen Ovale (PFO) with a right to left shunt was evident on echocardiogram employing colour doppler and agitated normal saline studies...
May 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29728329/survival-analysis-and-prognostic-nomogram-model-for-multiple-system-atrophy
#14
Bei Cao, Lingyu Zhang, Yutong Zou, Qianqian Wei, Ruwei Ou, Yongping Chen, Hui-Fang Shang
OBJECTIVE: The purpose of our study was to explore the factors associated with the survival of multiple system atrophy (MSA) patients and to produce a prognostic nomogram to predict survival in an individual MSA patient. METHODS: 220 probable MSA patients were included from 2009 to 2013. Disease severity was measured by the Unified Multiple System Atrophy Rating Scale (UMSARS). The univariate and multivariable Cox regression analyses were used to identify factors associated with survival in MSA patients...
April 22, 2018: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/29726456/achieving-interoperability-between-arden-syntax-based-clinical-decision-support-and-openehr-based-data-systems
#15
Martin Spineth, Andrea Rappelsberger, Klaus-Peter Adlassnig
BACKGROUND: Arden Syntax is an international standard for medical knowledge representation and processing. The openEHR Foundation publishes specifications for the creation of electronic health records based on interoperable data models. OBJECTIVES: To perform a feasibility study showing how Arden Syntax medical logic modules (MLMs) can access openEHR data. METHODS: Medexter's ArdenSuite was applied as an implementation of an Arden-Syntax-based clinical decision support framework, and Marand's EhrScape as an implementation of an openEHR system, for the purpose of data exchange...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29725320/cardiovascular-autonomic-neuropathy-and-glucose-variability-in-patients-with-type-1-diabetes-is-there-an-association
#16
Szabolcs Nyiraty, Fruzsina Pesei, Andrea Orosz, Sara Coluzzi, Orsolya Eszter Vági, Csaba Lengyel, György Ábrahám, Simona Frontoni, Peter Kempler, Tamás Várkonyi
Introduction: The oxidative stress associated with glucose variability might be responsible for neuronal damage while autonomic neuropathy (AN) has a detrimental effect on metabolism. The aim of the study was to find relationship between AN and GV in type 1 diabetic patients and to identify further factors that affect GV. Patients and methods: Twenty type 1 diabetic patients were involved (age: 39.5 ± 3.4 years, duration of diabetes: 17.5 ± 2.5 years; HbA1c: 8...
2018: Frontiers in Endocrinology
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
#17
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/29720797/the-spectrum-of-autonomic-dysfunction-in-myasthenic-crisis
#18
Rohit Ninan Benjamin, Sanjith Aaron, Ajith Sivadasan, Suresh Devasahayam, Amalan Sebastin, Mathew Alexander
Background: Autoimmune autonomic dysfunction is described in Myasthenia Gravis. In myasthenic crisis, the spectrum of autonomic dysfunction is hitherto uncharacterized. Objective: The objective of this study is to describe the spectrum of autonomic dysfunction in myasthenic crises using the composite autonomic symptom scale 31 (COMPASS 31) autonomic symptom questionnaire and power spectral analysis of heart rate variability (HRV), which is a simple way of estimating general autonomic dysfunction...
January 2018: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/29720343/-neurogenic-autonomic-dysfunction-in-adults
#19
Astrid Juhl Terkelsen, John Hansen, Anja Klostergaard, Marit Otto, Henning Mølgaard, Christian Lodberg Hvas, Klaus Krogh, Hans Jørgen Kirkeby, Henning Andersen, Troels Staehelin Jensen
Neurogenic autonomic dysfunction (NAD) is underdiagnosed, and it is likely in patients, who have orthostatic hypotension and symptoms from multiple organ systems as well as abnormal results from a neurological examination. A clinical and neurophysiological examination of the autonomic nervous system combined with a standardised paraclinical evaluation should be performed. NAD may be present in neurodegenerative disorders, vitamin deficiency, toxicity, infection, and in paraneoplastic, metabolic, hereditary and immune-mediated conditions...
April 30, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29716566/active-aging-resilience-and-external-support-as-modifiers-of-the-disablement-outcome-agnes-cohort-study-protocol
#20
Taina Rantanen, Milla Saajanaho, Laura Karavirta, Sini Siltanen, Merja Rantakokko, Anne Viljanen, Timo Rantalainen, Katja Pynnönen, Anu Karvonen, Inna Lisko, Lotta Palmberg, Johanna Eronen, Eeva-Maija Palonen, Timo Hinrichs, Markku Kauppinen, Katja Kokko, Erja Portegijs
BACKGROUND: Population aging increases the need for knowledge on positive aspects of aging, and contributions of older people to their own wellbeing and that of others. We defined active aging as an individual's striving for elements of wellbeing with activities as per their goals, abilities and opportunities. This study examines associations of health, health behaviors, health literacy and functional abilities, environmental and social support with active aging and wellbeing. We will develop and validate assessment methods for physical activity and physical resilience suitable for research on older people, and examine their associations with active aging and wellbeing...
May 2, 2018: BMC Public Health
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