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Saori Morozumi, Shigenori Kato, Keizo Yasui, Yasuhiro Hasegawa
We present the case of a 77-year-old man with a 10-year history of Parkinson disease (PD), who developed posterior reversible encephalopathy syndrome (PRES). We diagnosed the case as PRES based on clinical features and MRI findings. He experienced orthostatic hypotension and supine hypertension, including nocturnal hypertension. PRES may result from marked supine/nocturnal hypertension and fluctuation in blood pressure. In addition, exacerbated factors could be representative of neuroleptic malignant syndrome...
October 21, 2016: Rinshō Shinkeigaku, Clinical Neurology
Jennifer E Posey, Rebecca Martinez, Jeremy E Lankford, James R Lupski, Mohammed T Numan, Ian J Butler
BACKGROUND: Orthostatic intolerance is typically thought to be sporadic and attributed to cerebral autonomic dysfunction. We sought to identify families with inherited autonomic dysfunction manifest as symptomatic orthostatic intolerance to characterize mode of inheritance and clinical features. METHODS: Sixteen families with two or more first- or second-degree relatives with autonomic dysfunction and orthostatic intolerance were enrolled. A clinical diagnosis of autonomic dysfunction defined by symptomatic orthostatic intolerance diagnosed by head-up tilt table testing was confirmed for each proband...
September 24, 2016: Pediatric Neurology
Jonica Campolo, Renata De Maria, Lorena Cozzi, Marina Parolini, Stefano Bernardi, Paola Proserpio, Lino Nobili, Giorgio Gelosa, Immacolata Piccolo, Elio C Agostoni, Maria G Trivella, Paolo Marraccini
OBJECTIVES: We explored the role of oxidative stress and inflammatory molecules as potential Parkinson (PD) biomarkers and correlated biological with non-motor abnormalities (olfactory impairment and dysautonomia), in patients with idiopathic REM behavior disorder (iRBD) (prodromal PD) and established PD. METHODS: We recruited 11 iRBD and 15 patients with idiopathic PD (Hohen&Yahr 1-3, on L-DOPA and dopamine agonists combination therapy) and 12 age- and sex-matched controls (CTRL)...
November 15, 2016: Journal of the Neurological Sciences
Sunita Bijarnia-Mahay, Deepti Gupta, Yosuke Shigematsu, Seiji Yamaguchi, Renu Saxena, I C Verma
BACKGROUND: Ethylmalonic encephalopathy is a rare inborn error of metabolism characterized by neurodevelopmental delay / regression, recurrent petechiae, orthostatic acrocyanosis, and chronic diarrhea. CASE CHARACTERISTICS: 4-year-old boy with developmental regression, chronic diarrhea, petechial spots and acrocyanosis. MRI brain showed T2W/FLAIR hyperintensities in bilateral caudate and putamen. Abnormal acyl-carnitine profile and metabolites on urinary GC-MS analysis suggested the diagnosis...
October 8, 2016: Indian Pediatrics
Cees de Baat, Paul de Baat, Anneloes E Gerritsen, Karien A Flohil, Gert-Jan van der Putten, Claar D van der Maarel-Wierink
One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the older people's body, environment, behavior, and activities. An important health risk indicator is (orthostatic or postprandial) hypotension, which may induce cerebral hypoperfusion. Although the majority of falls remain without major consequences, 10% to 25% of falls in care homes result in bodily trauma...
October 22, 2016: Special Care in Dentistry
Deanna Gray-Miceli, Sarah J Ratcliffe, Arwin Thomasson, Patricia Quigley, Kang Li, William Craelius
BACKGROUND: Patients at greatest risk for fall-related injuries are older adults with orthostatic hypotension (OH), a condition which drops blood pressure. This study sought to determine salient demographic and patient-level factors increasing risk for OH among a sample of elderly fallers. METHODS: Data analysis for this retrospective study sought to assess the relationship between various demographic and clinical risk factors and the likelihood of OH. Because fallers could experience multiple falls, generalized estimating equations were used to account for patient-level correlations...
October 20, 2016: Journal of Patient Safety
David Herzig, Moreno Testorelli, Daniela Schäfer Olstad, Daniel Erlacher, Peter Achermann, Prisca Eser, Matthias Wilhelm
BACKGROUND/AIM: There is increasing popularity for athletes to use heart rate variability (HRV) to tailor training. A time-efficient method is HRV assessment during deep sleep. The aim was to validate the selection of deep sleep segments identified by RR-intervals with simultaneous electroencephalography (EEG) recordings and to compare HRV parameters of these segments with those of standard morning supine measurements. METHODS: In 11 world class alpine- skiers, RR-intervals were monitored during ten nights and simultaneous EEGs were recorded in 2-4 nights...
September 26, 2016: International Journal of Sports Physiology and Performance
Keiko Yamada, Junhui Yuan, Tomoo Mano, Hiroshi Takashima, Masahiko Shibata
BACKGROUND: Hereditary sensory and autonomic neuropathy (HSAN) type II with WNK1/HSN2 gene mutation is a rare disease characterized by early-onset demyelination sensory loss and skin ulceration. To the best of our knowledge, no cases of an autonomic disorder have been reported clearly in a patient with WNK/HSN2 gene mutation and only one case of a Japanese patient with the WNK/HSN2 gene mutation of HSAN type II was previously reported. CASE PRESENTATION: Here we describe a 54-year-old woman who had an early childhood onset of insensitivity to pain; superficial, vibration, and proprioception sensation disturbances; and several symptoms of autonomic failure (e...
October 21, 2016: BMC Neurology
Elżbieta Lorenc-Koci, Anna Czarnecka, Kinga Kamińska, Joanna Knutelska, Małgorzata Zygmunt, Magdalena Dudek
BACKGROUND: Interaction between dopaminergic and nitrergic neurotransmission in the brain plays a crucial role in the control of motor function and in the regulation of blood pressure (BP). In Parkinson's disease (PD), dopaminergic denervation of the striatum leads to disturbances in the nitrergic system in the basal ganglia. Recently, it has been demonstrated that addition of a low dose of the nitric oxide donor molsidomine to l-DOPA therapy improves dopaminergic neurotransmission in the denervated nigrostriatal system and weakens dyskinesias in rodent models of the disease...
September 28, 2016: Pharmacological Reports: PR
Eline S de Bruïne, Esmee M Reijnierse, Marijke C Trappenburg, Jantsje H Pasma, Oscar J de Vries, Carel G M Meskers, Andrea B Maier
BACKGROUND: Orthostatic hypotension (OH) is common in older adults and associated with increased morbidity and mortality, loss of independence and high health-care costs. Standing up slowly is a recommended non-pharmacological intervention. However, the effectiveness of this advice has not been well studied. OBJECTIVES: The aim of this study was to investigate whether standing up slowly antagonises posture-related blood pressure (BP) decrease in a clinically relevant population of geriatric outpatients...
October 19, 2016: Gerontology
Stephen Harrap, Angela Lamantia, James Ziogas, Jane Bourke
OBJECTIVE: Glyceryl trinitrate (GTN) is used to treat angina and lower blood pressure. The enzyme mitochondrial aldehyde dehydrogenase-2 (ALDH2) can activate GTN. The polymorphism (Gly504Lys) in the gene encoding ALDH2 is associated with significantly reduced enzyme activity and potentially diminished responses to GTN. DESIGN AND METHOD: Systolic blood pressure (SBP) was measured continuously (Finometer Midi) during 2 orthostatic challenges in 493 healthy young adults (mean age 22 y), 390 of whom took 300 μg GTN sublingually 5 min prior to the second challenge and 103 subjects of whom were untreated...
September 2016: Journal of Hypertension
George Bakris
Resistant hypertension is defined as a blood pressure above 140/90 mmHg despite adherence to a combination of at least three optimally dosed antihypertensive medications, one of which is a diuretic. Chronic kidney disease (CKD) is one of the more common patient comorbidities associated with resistant hypertension. Recommended low-salt diet and triple antihypertensive drug regimens that include a diuretic, should be complemented by the sequential addition of other antihypertensive drugs. CKD is associated with premature vascular ageing, characterized by accelerated arteriosclerosis or atherosclerosis and endothelial dysfunction...
September 2016: Journal of Hypertension
Michael Weber
: Age is the most powerful cardiovascular risk factor. Based on a meta-analysis of a million control patients in hypertension trials, the Clinical Trialists Collaboration has estimated that doubling of major cardiac and stroke events occurs with age increments of < 10 years (1). Data from the ACCOMPLISH trial, which will be presented at this ISH meeting for the first time, show that patients aged > 70 (mean: 75.2), compared with those < 70 (mean: 63.7), had a 2.82-fold greater event rate for cardiovascular death and a 2...
September 2016: Journal of Hypertension
Michael Bursztyn, Aliza Hammerman-Rozenberg, Jeremy Jacobs, Jochanan Stessman
OBJECTIVE: To investigate the prevalence, characteristics, and association with mortality of orthostatic hypertension (OHYPER) amongst the oldest old. DESIGN AND METHOD: Two waves from the Jerusalem Longitudinal Study of community dwelling residents born in 1920-21 were examined at age of 85 (n = 1004), and 90 (n = 437). Sitting blood pressure (BP) was measured three times on two occasions, averaged and compared to 1 minute standing BP. OHYPER, orthostatic hypotension (OHYPO) or normotension (ONT) were classified if the difference of standing-sitting SBP either increased or decreased by ≥20mmHg, or not...
September 2016: Journal of Hypertension
Francine Marques, Nina Eikelis, Richard Bayles, Nora Straznicky, Dagmara Hering, Murray Esler, Geoffrey Head, Markus Schlaich, Gavin Lambert
OBJECTIVE: Noradrenaline released from sympathetic nerves is removed from the neuroeffector junction via the action of the noradrenaline transporter (NET). NET impairment is evident in several clinically important conditions including essential hypertension, major depressive disorder, panic disorder and the postural orthostatic tachycardia syndrome. Only in rare instances, however, do coding single nucleotide polymorphisms (SNPs) seem to account for a defect in NET. The aim of this study was to determine whether rs7194256 (C/T), a SNP in the 3' untranslated region (UTR) of the NET gene, is associated with diseases associated with NET dysfunction, and to elucidate the mechanism involved...
September 2016: Journal of Hypertension
Yusuke Kobayashi, Hideo Kobayashi, Hiroaki Ishiguro, Keisuke Yatsu, Tetsuya Fujikawa, Satoshi Umemura
OBJECTIVE: Though both carotid bulb and aortic arch are known to play important roles in regulation of blood pressure through modulation in baroreflex function, few studies have investigated the association of carotid bulb atherosclerosis and large arterial stiffness and orthostatic blood pressure change. DESIGN AND METHOD: Patients with metabolic disorder such as hypertension, dyslipidemia and diabetes mellitus underwent measurement of segment-specific carotid intima-media thickness (IMT) (as an index of atherosclerosis of carotid bulb), cardio-ankle vascular index (CAVI) (as an index for large arterial stiffness), heart rate variability (HRV) (as an index of baroreflex function) and sit-to-stand orthostatic blood pressure change (as a simple method for detecting orthostatic hypotension)...
September 2016: Journal of Hypertension
Ebru Yalın İmamoğlu, Ayşe Güler Eroğlu
AIM: To investigate ventricular arrhythmias in children with primary mitral valve prolapse and to evaluate its relation with QT length, QT dispersion, autonomic function tests and heart rate variability measurements. MATERIAL AND METHODS: Fourty two children with mitral valve prolapse and 32 healthy children were enrolled into the study. Twelve-lead electrocardiograms, autonomic function tests, echocardiography and 24-hour rhythm Holter tests were performed. Electrocardiograms were magnified digitally...
September 2016: Türk Pediatri Arşivi
R Wells, A Tonkin
Patients with autonomic dysfunction may present with a variety of seemingly unrelated symptoms, both generalised and involving specific systems, including fatigue, difficulty concentrating, orthostatic intolerance, palpitations, constipation or diarrhoea, early satiety, urinary retention or incontinence and erectile dysfunction. Failure to connect the diverse symptoms with a single underlying mechanism may lead to incorrect diagnoses, inappropriate interventions and frustration on the part of both doctors and patients...
October 2016: Internal Medicine Journal
Susan Mayor
No abstract text is available yet for this article.
October 11, 2016: BMJ: British Medical Journal
Joong Seok Kim, Dong Woo Ryu, Ju Hee Oh, Yang Hyun Lee, Sung Jin Park, Kipyung Jeon, Jong Yun Lee, Seong Hee Ho, Jungmin So, Jin Hee Im, Kwang Soo Lee
BACKGROUND AND PURPOSE: Recent studies have shown that several nonmotor symptoms differ between Parkinson's disease (PD) and drug-induced parkinsonism (DIP). However, there have been no reports on cardiovascular autonomic function in DIP, and so this study investigated whether cardiovascular autonomic function differs between PD and DIP patients. METHODS: This study consecutively enrolled 20 DIP patients, 99 drug-naïve PD patients, and 25 age-matched healthy controls who underwent head-up tilt-table testing and 24-h ambulatory blood pressure monitoring...
October 7, 2016: Journal of Clinical Neurology
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