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Orthostatic hypotension

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https://www.readbyqxmd.com/read/29348380/effect-of-nigella-sativa-seed-extract-for-hypertension-in-elderly-a-double-blind-randomized-controlled-trial
#1
Aulia Rizka, Siti Setiati, Aida Lydia, Esthika Dewiasty
BACKGROUND: Nigella sativa (NS) seed extract shows diuretic activity, inhibits sympathetic nervous system overactivity and increases the production of Nitric Oxide in in vivo studies, thus it has a potential use as an adjuvant antihypertensive for elderly population. This study aimed to determine the effect of Nigella sativa seed extract to systolic blood pressure (SBP) and diastolic blood pressure (DBP) of elderly patients with hypertension. METHODS: a double-blind, randomized controlled trial was conducted on elderly subjects with hypertension in three outpatient clinics in Cipto Mangunkusumo National Hospital Jakarta Indonesia from June to September 2011...
October 2017: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29343526/mutations-in-cyb561-causing-a-novel-orthostatic-hypotension-syndrome
#2
Maarten P van den Berg, Rowida Almomani, Italo Biaggioni, Martijn van Faassen, Pim van der Harst, Herman H Silljé, Irene Mateo Leach, Marc Hemmelder, Gerjan Navis, Gert-Jan Luijckx, Arjan P de Brouwer, Hanka Venselaar, Marcel M Verbeek, Paul A van der Zwaag, Jan D Jongbloed, J P van Tintelen, Ron A Wevers, Ido P Kema
Rationale: Orthostatic hypotension is a common clinical problem, but the underlying mechanisms have not been fully delineated. Objective: We describe two families, with four patients in total, suffering from severe life-threatening orthostatic hypotension due to a novel cause. Methods and Results: As in dopamine β-hydroxylase deficiency (DβH), concentrations of norepinephrine and epinephrine in the patients were very low. Plasma DβH activity, however, was normal and the DBH gene had no mutations. Molecular genetic analysis was performed to determine the underlying genetic cause...
January 17, 2018: Circulation Research
https://www.readbyqxmd.com/read/29342011/utility-of-time-and-frequency-domain-parameters-of-heart-rate-variability-in-the-context-of-autonomic-disorders-characterized-by-orthostatic-dysfunction
#3
Jacquie Baker, Juan M Racosta, Brittany Balint, Kurt Kimpinski
PURPOSE: The clinical significance of heart rate variability in the context of autonomic dysfunction continues to be a matter of debate. A consensus is lacking on the best heart rate variability measures for clinical purposes. Therefore, the purpose of this study was to investigate the utility of heart rate variability parameters in healthy versus autonomic dysfunction. METHODS: Healthy young (n = 134), healthy older (n = 32), and patients with mild (postural tachycardia syndrome; n = 25) and severe (neurogenic orthostatic hypotension; n = 34) autonomic dysfunction were included...
January 16, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29334945/blood-pressure-change-does-not-associate-with-center-of-pressure-movement-after-postural-transition-in-geriatric-outpatients
#4
Sjoerd T Timmermans, Esmee M Reijnierse, Jantsje H Pasma, Marijke C Trappenburg, Gerard J Blauw, Andrea B Maier, Carel G M Meskers
BACKGROUND: Orthostatic hypotension (OH), a blood pressure drop after postural change, is associated with impaired standing balance and falls in older adults. This study aimed to assess the association between blood pressure (BP) and a measure of quality of standing balance, i.e. Center of Pressure (CoP) movement, after postural change from supine to standing position in geriatric outpatients, and to compare CoP movement between patients with and without OH. METHODS: In a random subgroup of 75 consecutive patients who were referred to a geriatric outpatient clinic, intermittent BP measurements were obtained simultaneously with CoP measurements in mediolateral and anterior-posterior direction directly after postural change during 3 min of quiet stance with eyes open on a force plate...
January 15, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29329523/early-commitment-of-cardiovascular-autonomic-modulation-in-brazilian-patients-with-congenital-generalized-lipodystrophy
#5
Clarisse Mourão Melo Ponte, Virgínia Oliveira Fernandes, Maria Helane Costa Gurgel, Izabella Tamira Galdino Farias Vasconcelos, Lia Beatriz de Azevedo Souza Karbage, Christiane Bezerra Rocha Liberato, Carlos Antônio Negrato, Marília de Brito Gomes, Ana Paula Dias Rangel Montenegro, Renan Magalhães Montenegro Júnior
BACKGROUND: Metabolic abnormalities in congenital generalized lipodystrophy (CGL) are associated with microvascular complications. However, the evaluation of different types of neuropathy in these patients, including the commitment of cardiovascular autonomic modulation, is scarce. The objective of the present study was to determine the prevalence of cardiovascular autonomic neuropathy (CAN) in patients with CGL compared with individuals with type 1 diabetes and healthy subjects. METHODS: Ten patients with CGL, 20 patients with type 1 diabetes and 20 healthy subjects were included in the study...
January 12, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29324345/synthesis-and-biological-evaluation-of-a-series-of-multi-target-n-substituted-cyclic-imide-derivatives-with-potential-antipsychotic-effect
#6
Mingshuo Xu, Yu Wang, Feipu Yang, Chunhui Wu, Zhen Wang, Bin Ye, Xiangrui Jiang, Qingjie Zhao, Jianfeng Li, Yongjian Liu, Junchi Zhang, Guanghui Tian, Yang He, Jingshan Shen, Hualiang Jiang
In the present study, a series of multi-target N-substituted cyclic imide derivatives which possessed potent dopamine D2, serotonin 5-HT1A and 5-HT2A receptors properties were synthesized and evaluated as potential antipsychotics. Among these compounds, (3aR,4R,7S,7aS)-2-(4-(4-(benzo[b]thiophen-4-yl)piperazin-1-yl)butyl)-3a,4,7,7a-tetrahydro-1H-4,7-methanoisoindole-1,3(2H)-dione hydrochloride (3d) held a promising pharmacological profile. 3d not only showed potent and balanced in vitro activities on D2/5-HT1A/5-HT2A receptors, but also endowed with low to moderate activities on 5-HT2C, H1, α1A, M3 receptors and hERG channel, suggesting a low liability to induce side effects such as weight gain, orthostatic hypotension and QT prolongation...
January 4, 2018: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29313153/first-symptoms-in-multiple-system-atrophy
#7
Jake H McKay, William P Cheshire
PURPOSE: The initial symptoms of multiple system atrophy (MSA) and, in particular, early autonomic symptoms, have received less attention than motor symptoms. Whereas pathognomonic motor signs are essential to diagnostic specificity, early symptoms important to recognition of a neurodegenerative disorder may be less apparent or diagnostically ambiguous. This observational study sought to identify the very earliest symptoms in the natural history of MSA. METHODS: Detailed clinical histories focusing on early symptoms were obtained from 30 subjects recently diagnosed with MSA...
January 8, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29306636/clinical-correlates-of-cerebral-white-matter-abnormalities-in-patients-with-parkinson-s-disease
#8
Bibet L Ten Harmsen, Anouke van Rumund, Marjolein B Aerts, Mayra I Bergkamp, Rianne A J Esselink, Edo Richard, Frederick J A Meijer, Bastiaan R Bloem, Daniel J van Wamelen
OBJECTIVE: To determine if autonomic dysfunction, cognitive disorders or axial disability are associated with white matter lesions (WML) in Parkinson disease (PD). METHODS: We performed a retrospective cross-sectional review study on 204 consecutive PD patients who underwent cerebral MRI in our center between January 2012 and July 2016. For each patient, we scored the severity of WML and PV (periventricular) WML using the Fazekas score and using the ARWMC scale for WML and BG (basal ganglia) and clinical characteristics such as neurogenic orthostatic hypotension and cognitive function...
December 27, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/29300435/orthostatic-hypotension-and-associated-factors-among-home-care-clients-aged-75-years-or-older-a-population-based-study
#9
A Luukkonen, M Tiihonen, T Rissanen, S Hartikainen, I Nykänen
OBJECTIVES: The aim of this study was to examine orthostatic hypotension (OH) and associated factors among home care clients aged 75 years or older. DESIGN: Non-randomised controlled study. SETTING AND PARTICIPANTS: The study sample included 244 home care clients aged 75 years or older living in Eastern and Central Finland. MEASUREMENTS: Nurses, nutritionists and pharmacists collected clinical data including orthostatic blood pressure, depressive symptoms (15-item Geriatric Depression Scale GDS-15), nutritional status (Mini Nutritional Assessment MNA), drug use, self-rated health, daily activities (Barthel ADL Index and Lawton and Brody IADL scale) and self-rated ability to walk 400 metres...
2018: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29297596/neuropathology-of-autonomic-dysfunction-in-synucleinopathies
#10
REVIEW
Elizabeth A Coon, Jeremy K Cutsforth-Gregory, Eduardo E Benarroch
The synucleinopathies-Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, and pure autonomic failure-result from distinct patterns of abnormal α-synuclein aggregation throughout the nervous system. Autonomic dysfunction in these disorders results from variable involvement of the central and peripheral autonomic networks. The major pathologic hallmark of Parkinson's disease and dementia with Lewy bodies is Lewy bodies and Lewy neurites; of multiple system atrophy, oligodendroglial cytoplasmic inclusions; and of pure autonomic failure, peripheral neuronal cytoplasmic inclusions...
January 3, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29295851/proteomic-profiling-for-cardiovascular-biomarker-discovery-in-orthostatic-hypotension
#11
Madeleine Johansson, Fabrizio Ricci, Nay Aung, Richard Sutton, Olle Melander, Artur Fedorowski
Orthostatic hypotension (OH) has been linked with higher incidence of cardiovascular disease, but little is known about the mechanisms behind this association. We aimed to identify cardiovascular disease biomarkers associated with OH through a proteomic profiling approach. Seven hundred seventy-eight patients with unexplained syncope or orthostatic intolerance underwent head-up tilt test and supine blood samples. Of these, 220 met diagnostic criteria of OH, and 179 demonstrated normal hemodynamic response during head-up tilt test...
January 2, 2018: Hypertension
https://www.readbyqxmd.com/read/29290367/relation-of-orthostatic-hypotension-with-new-onset-atrial-fibrillation-from-the-framingham-heart-study
#12
Darae Ko, Sarah R Preis, Steven A Lubitz, David D McManus, Ramachandran S Vasan, Naomi M Hamburg, Emelia J Benjamin, Gary F Mitchell
Previous studies have reported that orthostatic hypotension (OH) is associated with increased risk of atrial fibrillation (AF). We sought to determine whether the association persists after adjusting for hypertension and other cardiovascular risk factors. We studied the Framingham Heart Study Original cohort participants evaluated between 1981 and 1984 without baseline AF. OH was defined as drop in standing systolic blood pressure (BP) of at least 20 mm Hg or standing diastolic BP of at least 10 mm Hg from their supine values after standing for 2 minutes...
December 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29282699/dizziness-in-the-emergency-department-an-update-on-diagnosis
#13
Rainer Spiegel, Mark Kirsch, Christiane Rosin, Heiko Rust, Thomas Baumann, Raoul Sutter, Hergen Friedrich, Martina Göldlin, René Müri, Roger Kalla, Roland Bingisser, Georgios Mantokoudis
This review aims to assist emergency physicians in finding the underlying aetiology when a patient presents with dizziness to the emergency department. After reading this review, the emergency physician will be able to consider the most relevant differential diagnoses and have an idea about dangerous aetiologies that require immediate action. The emergency physician will also know what diagnostic steps need to be taken at what time, such as the three-component HINTS Test (Head Impulse, Nystagmus, and Test-of-Skew), which helps with distinguishing central from peripheral causes of the acute vestibular syndrome...
December 28, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29280036/seronegative-autoimmune-autonomic-neuropathy-a-distinct-clinical-entity
#14
Elisabeth P Golden, Meredith A Bryarly, Steven Vernino
PURPOSE: Autoimmune autonomic ganglionopathy (AAG) is associated with ganglionic acetylcholine receptor (gAChR) antibodies. We describe a similar but distinct series of patients with autoimmune autonomic failure lacking this antibody. METHODS: Retrospective chart review. RESULTS: Six patients presented with subacute autonomic failure, seronegative for gAChR antibodies. Orthostatic hypotension and gastrointestinal complaints were common. Autonomic testing revealed predominant sympathetic failure and no premature pupillary redilation...
December 26, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29278286/autonomic-dysfunction-in-parkinson-s-disease-a-prospective-cohort-study
#15
Aristide Merola, Alberto Romagnolo, Michela Rosso, Ritika Suri, Zoe Berndt, Simona Maule, Leonardo Lopiano, Alberto J Espay
BACKGROUND: Dysautonomia is a frequent and disabling complication of PD, with an estimated prevalence of 30-40% and a significant impact on the quality of life. OBJECTIVES: To evaluate the rate of progression of dysautonomia and, in particular, orthostatic hypotension, in a cohort of unselected PD patients, and assess the extent to which the progression of dysautonomia affects activities of daily living, health-related quality of life, and health care utilization in PD...
December 26, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29260408/practical-treatment-of-lewy-body-disease-in-the-clinic-patient-and-physician-perspectives
#16
Elisabet Londos
This article describes the practical considerations in the clinical medical treatment in dementia with Lewy body (DLB) patients. It is illustrated with the voice of a DLB sufferer and his wife. According to our experience, emanating from a 15 year collaboration between a doctor and a nurse at a memory clinic, there are several possible therapeutical entrances. However, the order in which the medication is introduced is of great importance to avoid aggravation of other DLB symptoms. We start the treatment with cholinesterase inhibitor and memantine, and; thereafter, we treat the most disturbing symptom...
December 19, 2017: Neurology and Therapy
https://www.readbyqxmd.com/read/29235746/clinical-problem-solving-a-tobacco-merchant-who-can-t-spit
#17
Sandra Benizri, Nancy Agmon-Levin, Noam D Kitrey, Dan Carter, Elinor Goshen, Yehonathan Sharabi
A 47 year old man presented with a combination of dry mouth and lightheadedness while standing. His medical background was unremarkable except for cigarette smoking and hyperlipidemia. Sjögren's syndrome was ruled out, and he was referred for evaluation of orthostatic hypotension, which by then included syncopal episodes and injuries. Additional symptoms included dry eyes, constipation, reduced sweating, and erectile dysfunction. After excluding medications and structural cardiac abnormalities as causes of orthostatic hypotension, a clinical autonomic evaluation was performed...
December 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29225249/acute-tetraparesis-with-respiratory-failure-after-steroid-administration-in-a-patient-with-a-dural-arteriovenous-fistula-at-the-craniocervical-junction-a-case-report
#18
Hisashi Takahashi, Taiki Ueshima, Daiki Goto, Tadashi Kimura, Natsuko Yuki, Yasuo Inoue, Akira Yoshioka
A 63-year-old man developed vomiting, paraparesis, dysuria, bulbar palsy, and orthostatic hypotension over a period of 5 months. Neuroradiological examinations showed a swollen lower brainstem with a dural arteriovenous fistula at the craniocervical junction (DAVF-CCJ). A steroid was administered intravenously in the hospital to relieve brainstem edema. A few hours later, however, the patient developed acute tetraparesis with respiratory failure. Recently, there have been several reports describing the acute worsening of paraparesis in patients with a spinal dural arteriovenous fistula after steroid treatment...
December 8, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29222399/pediatric-disorders-of-orthostatic-intolerance
#19
REVIEW
Julian M Stewart, Jeffrey R Boris, Gisela Chelimsky, Phillip R Fischer, John E Fortunato, Blair P Grubb, Geoffrey L Heyer, Imad T Jarjour, Marvin S Medow, Mohammed T Numan, Paolo T Pianosi, Wolfgang Singer, Sally Tarbell, Thomas C Chelimsky
Orthostatic intolerance (OI), having difficulty tolerating an upright posture because of symptoms or signs that abate when returned to supine, is common in pediatrics. For example, ∼40% of people faint during their lives, half of whom faint during adolescence, and the peak age for first faint is 15 years. Because of this, we describe the most common forms of OI in pediatrics and distinguish between chronic and acute OI. These common forms of OI include initial orthostatic hypotension (which is a frequently seen benign condition in youngsters), true orthostatic hypotension (both neurogenic and nonneurogenic), vasovagal syncope, and postural tachycardia syndrome...
January 2018: Pediatrics
https://www.readbyqxmd.com/read/29215823/validation-of-the-korean-version-of-the-scales-for-outcomes-in-parkinson-s-disease-sleep
#20
Young Hee Sung, Hee Jin Kim, Seong Beom Koh, Joong Seok Kim, Sang Jin Kim, Sang Myung Cheon, Jin Whan Cho, Yoon Joong Kim, Hyeo Il Ma, Mee Young Park, Jong Sam Baik, Phil Hyu Lee, Sun Ju Chung, Jong Min Kim, In Uk Song, Han Joon Kim, Ji Young Kim, Do Young Kwon, Jae Hyeok Lee, Jee Young Lee, Ji Seon Kim, Ji Young Yun, Jin Yong Hong, Mi Jung Kim, Jinyoung Youn, Ji Sun Kim, Eung Seok Oh, Hui Jun Yang, Won Tae Yoon, Sooyeoun You, Kyum Yil Kwon, Hyung Eun Park, Su Yun Lee, Younsoo Kim, Hee Tae Kim, Tae Beom Ahn
BACKGROUND: Sleep problems commonly occur in patients with Parkinson's disease (PD), and are associated with a lower quality of life. The aim of the current study was to translate the English version of the Scales for Outcomes in Parkinson's Disease-Sleep (SCOPA-S) into the Korean version of SCOPA-S (K-SCOPA-S), and to evaluate its reliability and validity for use by Korean-speaking patients with PD. METHODS: In total, 136 patients with PD from 27 movement disorder centres of university-affiliated hospitals in Korea were enrolled in this study...
January 8, 2018: Journal of Korean Medical Science
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