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Orthostatic hypotension

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https://www.readbyqxmd.com/read/29136314/syncope-prognosis-based-on-emergency-department-diagnosis-a-prospective-cohort-study
#1
Cristian Toarta, Muhammad Mukarram, Kirtana Arcot, Soo-Min Kim, Sarah Gaudet, Marco L A Sivilotti, Brian H Rowe, Venkatesh Thiruganasambandamoorthy
OBJECTIVE: Relatively little is known about outcomes after disposition among syncope patients assigned various diagnostic categories during emergency department (ED) evaluation. We sought to measure the outcomes among these groups within 30 days of the initial ED visit. METHODS: We prospectively enrolled adult syncope patients at six EDs and excluded patients with pre-syncope, persistent mental status changes, intoxication, seizure, and major trauma. Patient characteristics, ED management, diagnostic impression (presumed vasovagal, orthostatic, cardiac, or other/unknown) at the end of the ED visit and physicians' confidence in assigning the etiology were collected...
November 14, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29133613/author-response-effects-of-orthostatic-hypotension-on-cognition-in-parkinson-disease
#2
Justin Centi, Roy Freeman, Christopher H Gibbons, Sandy Neargarder, Alexander O Canova, Alice Cronin-Golomb
No abstract text is available yet for this article.
November 14, 2017: Neurology
https://www.readbyqxmd.com/read/29133612/letter-re-effects-of-orthostatic-hypotension-on-cognition-in-parkinson-disease
#3
Pietro Guaraldi, Roberto Poda, Giovanna Calandra-Buonaura, Laura Solieri, Luisa Sambati, Roberto Gallassi, Pietro Cortelli
No abstract text is available yet for this article.
November 14, 2017: Neurology
https://www.readbyqxmd.com/read/29131019/utility-of-autonomic-function-tests-to-differentiate-dementia-with-lewy-bodies-and-parkinson-disease-with-dementia-from-alzheimer-disease
#4
Shuta Toru, Tadashi Kanouchi, Takanori Yokota, Yosuke Yagi, Akira Machida, Takayoshi Kobayashi
OBJECTIVE: We studied autonomic disturbance in patients with dementia with Lewy bodies (DLB), Parkinson disease with dementia (PDD), Alzheimer disease (AD), to determine whether autonomic function tests can be used to distinguish these disorders. METHODS: Autonomic function was tested in 56 patients with DLB, 37 patients with PDD, and 59 patients with AD by using the sympathetic skin response, coefficient of variation in R-R interval, the head-up tilt test, serum norepinephrine concentration, and 123I-meta-iodobenzylguanidine cardiac scintigraphy...
November 13, 2017: European Neurology
https://www.readbyqxmd.com/read/29126762/association-between-abnormal-nocturnal-blood-pressure-profile-and-dementia-in-parkinson-s-disease
#5
Ryota Tanaka, Yasushi Shimo, Kazuo Yamashiro, Takashi Ogawa, Kenya Nishioka, Genko Oyama, Atsushi Umemura, Nobutaka Hattori
BACKGROUND: Circadian blood pressure alterations are frequently observed in Parkinson's disease, but the association between these changes and dementia in the condition remains unclear. Here, we assess the relationship between abnormal nocturnal blood pressure profiles and dementia in Parkinson's disease. METHODS: We enrolled 137 patients with Parkinson's disease, who underwent 24 h ambulatory blood pressure monitoring, following cognitive and clinical assessment...
October 20, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/29124913/measurement-of-lying-and-standing-blood-pressure-in-hospital
#6
Shelagh O'Riordan, Naomi Vasilakis, Labib Hussain, Rowena Schoo, Julie Whitney, Julie Windsor, Khim Horton, Finbarr Martin
Measuring lying and standing blood pressure (BP) is an important clinical observation in older hospital inpatients. This is because a drop in BP on standing, known as orthostatic hypotension (OH) is common in older people and in acute illness and, therefore, in hospital patients. OH increases the risk of a fall in hospital. Simple measures such as changes in medication or rehydration can reduce this drop in BP and reduce the risk of falls. In a recent snapshot audit in England and Wales of 179 acute hospitals and 4,846 patients aged 65 years and over admitted with an acute illness, only 16% had a lying and standing BP recorded within 48 hours...
September 29, 2017: Nursing Older People
https://www.readbyqxmd.com/read/29124548/development-of-an-experimental-and-digital-cardiovascular-arterial-model-for-transient-hemodynamic-and-postural-change-studies-a-preliminary-framework-analysis
#7
Rodward L Hewlin, John P Kizito
The ultimate goal of the present work is to aid in the development of tools to assist in the treatment of cardiovascular disease. Gaining an understanding of hemodynamic parameters for medical implants allow clinicians to have some patient-specific proposals for intervention planning. In the present work an experimental and digital computational fluid dynamics (CFD) arterial model consisting of a number of major arteries (aorta, carotid bifurcation, cranial, femoral, jejunal, and subclavian arteries) were fabricated to study: (1) the effects of local hemodynamics (flow parameters) on global hemodynamics (2) the effects of transition from bedrest to upright position (postural change) on hemodynamics, and (3) diffusion of dye (medical drug diffusion simulation) in the arterial system via experimental and numerical techniques...
November 9, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29123883/delayed-autonomic-neuropathy-in-a-patient-with-diethylene-glycol-poisoning-a-case-report
#8
Hiroki Kamada, Hideaki Suzuki, Saori Yamamoto, Ryosuke Nomura, Shigeki Kushimoto
Case: A 72-year-old man presented to our hospital after ingesting insecticide containing approximately 2 mL/kg diethylene glycol, which exceeded the lethal dose of 1 mL/kg. The patient recovered from critical symptoms on acute phase until day 3, but received artificial ventilation for muscle weakness secondary to sensorimotor neuropathy on days 11-54. Outcome: Even after marked improvement from sensorimotor neuropathy, the patient continued to complain of orthostatic hypotension...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122957/diminished-dynamic-cerebral-autoregulatory-capacity-with-forced-oscillations-in-mean-arterial-pressure-with-elevated-cardiorespiratory-fitness
#9
Lawrence Labrecque, Kevan Rahimaly, Sarah Imhoff, Myriam Paquette, Olivier Le Blanc, Simon Malenfant, Samuel J E Lucas, Damian M Bailey, Jonathan D Smirl, Patrice Brassard
The effect that cardiorespiratory fitness has on the dynamic cerebral autoregulatory capacity during changes in mean arterial pressure (MAP) remains equivocal. Using a multiple-metrics approach, challenging MAP across the spectrum of physiological extremes (i.e., spontaneous through forced MAP oscillations), we characterized dynamic cerebral autoregulatory capacity in 19 male endurance athletes and eight controls via three methods: (1) onset of regulation (i.e., time delay before an increase in middle cerebral artery (MCA) conductance [MCA blood velocity (MCAv)/MAP] and rate of regulation, after transient hypotension induced by sit-to-stand, and transfer function analysis (TFA) of MAP and MCAv responses during (2) spontaneous and (3) forced oscillations (5-min of squat-stand maneuvers performed at 0...
November 2017: Physiological Reports
https://www.readbyqxmd.com/read/29113606/nonmotor-symptoms-of-parkinson-s-disease-as-predictors-of-dementia
#10
Mohammed Wasif Hussain, Richard Camicioli
Some nonmotor symptoms (NMS) of Parkinson's disease (PD) have been shown to increase the risk of developing dementia. A total of 52 PD patients without dementia at baseline were examined for NMS over 36 months. Mini-Mental State Examination, Dementia Rating Scale-2, and caregiver-derived (Clinical Dementia Rating) scores were employed to rate patients as having either clear progression or not. Some 20 of 48 participants (41.7%) had clear cognitive decline. Univariate binary regression analysis was statistically significant for age (odds ratio [OR] (CI 95%)=1...
November 8, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29112180/impaired-right-ventricle-function-as-predictor-of-early-mortality-in-patients-with-light-chain-cardiac-amyloidosis-assessed-in-the-cardiology-department
#11
Justyna Anna Szczygieł, Piotr Zbigniew Wieczorek, Joanna Drozd-Sokołowska, Piotr Michałek, Łukasz Mazurkiewicz, Marta Legatowicz-Koprowska, Ewa Walczak, Wiesław Wiktor Jędrzejczak, Jadwiga Dwilewicz-Trojaczek, Jacek Grzybowski
INTRODUCTION    Light-chain amyloidosis (AL amyloidosis) is the most common cardiac amyloidosis. Early mortality remains a substantial problem despite progress in treatment. OBJECTIVES    The aim of the study was to obtain a clinical profile of patients diagnosed with AL amyloidosis in the cardiology department, to define an early mortality cut-off point in this population, and to identify predictors of early mortality. PATIENTS AND METHODS    The analysis covered 30 patients (14 females, median age 61...
November 3, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29111543/syncope-in-young-women-broadening-the-differential-diagnosis
#12
Nachiket Patel, Naila Choudhary, Christine Tompkins, Khawaja Afzal Ammar, A Jamil Tajik, Krishnaswamy Chandrasekaran, Timothy E Paterick
Syncope is defined as a sudden transient loss of consciousness (TLOC) with concomitant loss of postural tone followed by spontaneous recovery. It is a subset of a broader class of medical conditions, including postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension, and neurally mediated syncope (NMS), that may result in TLOC. The overlap of these clinical conditions leads to confusion regarding syncope classification that can hinder evaluation strategies, and pose challenges for diagnosis and treatment, particularly in young women...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29111025/orthostatic-hypotension-associated-with-executive-dysfunction-in-mild-cognitive-impairment
#13
Christian Bocti, François Pépin, Maxime Tétreault, Philippe Cossette, Francis Langlois, Hélène Imbeault, Nadia Duval, Guy Lacombe, Tamas Fulop
INTRODUCTION: Midlife hypertension is associated with dementia in longitudinal studies while chronic hypotension in the elderly is associated with dementia onset. Orthostatic hypotension could influence cognitive performance in the elderly. The objective of this study was to assess the relationship between orthostatic hypotension and cognitive functions. METHODS: Consecutive participants with complete neuropsychological evaluation from a Memory Clinic were included...
November 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29107040/longitudinal-recovery-and-reduced-costs-after-120-sessions-of-locomotor-training-for-motor-incomplete-spinal-cord-injury
#14
Sarah A Morrison, Douglas Lorenz, Carol P Eskay, Gail F Forrest, D Michele Basso
OBJECTIVE: To determine the impact of long term, body weight supported locomotor training (BWSLT) after chronic, incomplete spinal cord injury (SCI). Also, health care costs were estimated related to lost recovery potential and preventable secondary complications that may have occurred due to visit limits imposed by insurers. DESIGN: Prospective observational cohort with longitudinal follow up. SETTING: Eight outpatient rehabilitation centers that participate in the Christopher & Dana Reeve Foundation NeuroRecovery Network® (NRN)...
October 26, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29103053/domperidone-for-hypotension-in-parkinson-s-disease-a-systematic-review
#15
Stephen Bacchi, Ivana Chim, Philippe Kramer, Ronald B Postuma
BACKGROUND: Domperidone is a proposed treatment of orthostatic hypotension (OH) in Parkinson's disease (PD). However, domperidone use in PD is tempered by concerns regarding QT prolongation and ventricular tachyarrhythmia and sudden cardiac death (VT/SCD). OBJECTIVE: The aim is to identify peer-reviewed studies in which either (1) the effect of domperidone on blood pressure in patients with PD, or (2) the adverse effects associated with domperidone use in PD patients has been reported...
2017: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/29102451/autonomic-dysfunction-in-cardiology-pathophysiology-investigation-and-management
#16
REVIEW
Amy C Arnold, Jessica Ng, Lucy Lei, Satish R Raj
Presyncope and syncope are common medical findings, with a > 40% estimated lifetime prevalence. These conditions are often elicited by postural stress and can be recurrent and accompanied by debilitating symptoms of cerebral hypoperfusion. Therefore, it is critical for physicians to become familiar with the diagnosis and treatment of common underlying causes of presyncope and syncope. In some patients, altered postural hemodynamic responses result from a failure of compensatory autonomic nervous system reflex mechanisms...
September 14, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29101940/rem-sleep-behavior-disorder-diagnosis-clinical-implications-and-future-directions
#17
REVIEW
Erik K St Louis, Bradley F Boeve
Rapid eye movement sleep behavior disorder (RBD) is diagnosed by a clinical history of dream enactment accompanied by polysomnographic rapid eye movement sleep atonia loss (rapid eye movement sleep without atonia). Rapid eye movement sleep behavior disorder is strongly associated with neurodegenerative disease, especially synucleinopathies such as Parkinson disease, dementia with Lewy bodies, and multiple system atrophy. A history of RBD may begin several years to decades before onset of any clear daytime symptoms of motor, cognitive, or autonomic impairments, suggesting that RBD is the presenting manifestation of a neurodegenerative process...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29081004/cardiovascular-autonomic-dysfunction-in-patients-with-idiopathic-diabetes-insipidus
#18
Mattia Barbot, Filippo Ceccato, Marialuisa Zilio, Nora Albiger, Riccardo Sigon, Giuseppe Rolma, Marco Boscaro, Carla Scaroni, Franca Bilora
INTRODUCTION: Central diabetes insipidus (DI) is a rare disease characterized by the excretion of excessive volumes of dilute urine due to reduced levels of the antidiuretic hormone arginine vasopressin (AVP), caused by an acquired or genetic defect in the neurohypophysis. The aim of this study was to identify any autonomic dysfunction (AD) in patients with DI as a possible cofactor responsible for their reportedly higher mortality. METHODS: The study involved 12 patients (6 females) with central idiopathic DI and a well-controlled electrolyte balance, and 12 controls matched for age, sex and cardiovascular risk factors, who were assessed using the tilt, lying-to-standing, hand grip, deep breath, Valsalva maneuver and Stroop tests...
October 28, 2017: Pituitary
https://www.readbyqxmd.com/read/29080629/coenzyme-q10-supplementation-in-orthostatic-hypotension-and-multiple-system-atrophy-a-report-on-7-cases
#19
Christopher M Rembold
BACKGROUND: Multiple-system atrophy is a neurologic disorder characterized by orthostatic hypotension, Parkinsonian signs, and cerebellar signs. Mutations in COQ2, an enzyme involved in coenzyme Q10 (CoQ10) synthesis were recently associated with familial and sporadic cases of multiple-system atrophy. I hypothesized that people with orthostatic hypotension with or without other symptoms of multiple-system atrophy might benefit from oral CoQ10 administration. METHODS: Seven patients with symptomatic orthostatic hypotension were treated in an unrandomized manner with 257±37 mg CoQ10 daily for 10±3 months...
October 25, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29076058/pharmacotherapy-of-cardiovascular-autonomic-dysfunction-in-parkinson-disease
#20
REVIEW
Cyndya A Shibao, Horacio Kaufmann
Cardiovascular autonomic dysfunctions, including neurogenic orthostatic hypotension, supine hypertension and post-prandial hypotension, are relatively common in patients with Parkinson disease. Recent evidence suggests that early autonomic impairment such as cardiac autonomic denervation and even neurogenic orthostatic hypotension occur prior to the appearance of the typical motor deficits associated with the disease. When neurogenic orthostatic hypotension develops, patients with Parkinson disease have an increased risk of mortality, falls, and trauma-related to falls...
October 26, 2017: CNS Drugs
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