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Orthostatic hypotension

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https://www.readbyqxmd.com/read/28814494/syncope-and-orthostatic-hypotension-early-markers-of-cardiac-disease-in-the-general-population
#1
EDITORIAL
Martin H Ruwald
No abstract text is available yet for this article.
August 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28808933/cardiovascular-disease-in-clozapine-treated-patients-evidence-mechanisms-and-management
#2
REVIEW
Kathlyn J Ronaldson
Myocarditis occurs in about 3% of those initiated on clozapine but monitoring reduces the risk of serious outcome. Cardiomyopathy may develop after myocarditis, or from prolonged tachycardia. Monitoring using echocardiography is not deemed cost effective. Tachycardia, orthostatic hypotension and reduced heart rate variability are a group of clozapine-related adverse effects associated with autonomic dysfunction and may have serious consequences in the long term. Elevated heart rate and poor heart rate variability can be treated with a β-blocker or a non-dihydropyridine calcium channel blocker, while orthostatic hypotension can be alleviated by increased fluid intake and abdominal binding, but may require pharmacological intervention...
August 14, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28807522/orthostatic-hypotension-a-practical-approach-to-investigation-and-management
#3
Amy C Arnold, Satish R Raj
The maintenance of blood pressure upon the assumption of upright posture depends on rapid cardiovascular adaptations driven primarily by the autonomic nervous system. Failure of these compensatory mechanisms can result in orthostatic hypotension (OH), defined as sustained reduction in systolic blood pressure > 20 mm Hg or diastolic blood pressure > 10 mm Hg within 3 minutes of standing or > 60° head-up tilt. OH is a common finding, particularly in elderly populations, associated with cardiovascular and cerebrovascular morbidity and mortality...
May 17, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28805574/nonmotor-symptoms-in-vascular-and-other-secondary-parkinsonism
#4
Oleg S Levin, Achcha Sh Chimagomedova, Natalia A Skripkina, Elena A Lyashenko, Olga V Babkina
Vascular parkinsonism (VP) is a relatively frequent variant of secondary parkinsonism caused by ischemic or hemorrhagic lesions of basal ganglia, midbrain, or their links with frontal cortex. According to different investigations, various forms of cerebrovascular disease cause 1%-15% of parkinsonism cases. Nonmotor symptoms are frequently found in VP and may negatively influence on quality of life. However, nonmotor symptoms such as hallucinations, orthostatic hypotension, REM-sleep behavior disorder, and anosmia are rarely revealed in VP, which may be noted to another diagnosis or mixed pathology...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28805564/deep-brain-stimulation-and-nonmotor-symptoms
#5
Elliot Hogg, Jeffrey Wertheimer, Sarah Graner, Michele Tagliati
Deep brain stimulation (DBS) is currently the treatment of choice for advanced Parkinson's disease (PD). Several brain targets, including the subthalamic nucleus and the globus pallidus internus, have been successfully employed, with excellent motor outcomes. Despite less established knowledge, DBS may be a powerful tool for managing a wide variety of nonmotor symptoms (NMS) in PD patients, either directly or indirectly due to motor benefit or reduction of dopaminergic drug load. After an assessment of global nonmotor outcomes of DBS, as measured by currently available clinical scales and questionnaires, this chapter will address DBS effects on four main NMS categories: neurobehavioral, including cognitive and neuropsychiatric symptoms, autonomic dysfunction, including orthostatic hypotension, constipation, and urinary dysfunction, sleep disturbances, including insomnia, REM sleep behavior disorder, and restless leg syndrome, to conclude with sensory symptoms, mainly focusing on pain...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28800338/a-guideline-for-parkinson-s-disease-nurse-specialists-with-recommendations-for%C3%A2-clinical-practice
#6
Herma Lennaerts, Marieke Groot, Berna Rood, Koen Gilissen, Hella Tulp, Erik van Wensen, Marten Munneke, Teus van Laar, Bastiaan R Bloem
BACKGROUND: Parkinson's Disease Nurse Specialists (PDNS) play an important role in the care for patients with Parkinson's disease (PD) and their caregivers. Until now, there were no nursing guidelines in PD, and interventions were based solely on daily clinical practice because there is no evidence to support the merits of nursing interventions. Consequently, there is little uniformity in current care delivery. OBJECTIVE: Developing a guideline for PDNS. METHODS: We developed a guideline based on a questionnaire among PDNS and a literature review, supplemented with expert opinion plus the input of patients and caregivers...
August 11, 2017: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/28799950/orthostatic-hypotension-in-patients-with-left-ventricular-assist-devices-acquired-autonomic-dysfunction
#7
Marat Fudim, Joseph G Rogers, Camille Frazier-Mills, Chetan B Patel
Contemporary left ventricular assist device (LVAD) technology uses nonphysiologic continuous flow to deliver blood into the circulation. This results in a reduction of pulsatility, which is implicated in some of the commonly associated side effects with LVAD therapy, including hypertension and gastrointestinal arterial-venous malformation with related bleeding. A less frequently observed side effect is orthostatic hypotension (OH) in patients supported with LVAD therapy. We present three cases of OH in patients with LVAD, followed by a discussion on how LVAD therapy may induce autonomic dysfunction...
August 8, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28798722/autonomic-neuropathy-and-albuminocytologic-dissociation-in-cerebrospinal-fluid-as-the-presenting-features-of-primary-amyloidosis-a-case-report
#8
Jingjing Li, Yi Li, Hongbing Chen, Shihui Xing, Huiyu Feng, Dawei Liu, Dilong Wang, Jinsheng Zeng, Yuhua Fan
OBJECTIVE: Primary amyloidosis is a disease with a poor prognosis and multi-organ involvement. Here, we report the clinical and pathological features of a patient with primary amyloidosis featuring autonomic neuropathy as the initial symptom and albuminocytologic dissociation in the cerebrospinal fluid (CSF). METHODS: The patient was a 60-year-old Chinese male with numbness, orthostatic hypotension, and gastrointestinal symptoms. For diagnosis, we performed an electromyogram (EMG), lumbar puncture, Bence Jones protein urine test, serum electrophoresis blood test, sural nerve and rectal membrane biopsies, transthyretin (TTR) gene sequencing, and bone marrow puncture...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28794253/efficacy-of-single-or-combined-midodrine-and-pyridostigmine-in-orthostatic-hypotension
#9
Jung-Ick Byun, Jangsup Moon, Do-Yong Kim, Hyerim Shin, Jun-Sang Sunwoo, Jung-Ah Lim, Tae-Joon Kim, Woo-Jin Lee, Han Sang Lee, Jin-Sun Jun, Kyung-Il Park, Soon-Tae Lee, Keun-Hwa Jung, Ki-Young Jung, Sang Kun Lee, Kon Chu
OBJECTIVE: To evaluate the long-term (for up to 3 months) efficacy and safety of single or combined therapy with midodrine and pyridostigmine for neurogenic orthostatic hypotension (OH). METHODS: This was a randomized, open-label clinical trial. In total, 87 patients with symptomatic neurogenic OH were enrolled and randomized to receive 1 of 3 treatments: midodrine only, pyridostigmine only, or midodrine + pyridostigmine. The patients were followed up at 1 and 3 months after treatment...
August 9, 2017: Neurology
https://www.readbyqxmd.com/read/28790007/targeted-epidural-blood-patch-under-o-arm-guided-stereotactic-navigation-in-patients-with-intracranial-hypotension-associated-with-a-spinal-csf-leak-and-ventral-dural-defect
#10
Keisuke Takai, Makoto Taniguchi
OBJECTIVE: Targeted epidural blood patch (EBP) at the site of a presumed cerebrospinal fluid leak reportedly has better outcomes than non-targeted EBP; however, it is associated with a higher risk of wrong-site injection such as iatrogenic subarachnoid or intramuscular injections, which lead to reintervention due to the insufficient coverage of injected blood. METHODS: Eight patients with intracranial hypotension due to a CSF leak diagnosed by myelographic CT and thin-cut MRI received an epidural blood patch under O-arm-guided stereotactic navigation...
August 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28775101/cardiovascular-risk-after-hospitalisation-for-unexplained-syncope-and-orthostatic-hypotension
#11
Ekrem Yasa, Fabrizio Ricci, Martin Magnusson, Richard Sutton, Sabina Gallina, Raffaele De Caterina, Olle Melander, Artur Fedorowski
OBJECTIVE: To investigate the relationship of hospital admissions due to unexplained syncope and orthostatic hypotension (OH) with subsequent cardiovascular events and mortality. METHODS: We analysed a population-based prospective cohort of 30 528 middle-aged individuals (age 58±8 years; males, 40%). Adjusted Cox regression models were applied to assess the impact of unexplained syncope/OH hospitalisations on cardiovascular events and mortality, excluding subjects with prevalent cardiovascular disease...
August 3, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28774576/synthesis-and-biological-investigation-of-tetrahydropyridopyrimidinone-derivatives-as-potential-multireceptor-atypical-antipsychotics
#12
Hainimu Xiamuxi, Zhen Wang, Jianfeng Li, Yu Wang, Chunhui Wu, Feipu Yang, Xiangrui Jiang, Yongjian Liu, Qingjie Zhao, Weiming Chen, Jian Zhang, Yuanchao Xie, Tianwen Hu, Mingshuo Xu, Shuang Guo, Haji Akber Aisa, Yang He, Jingshan Shen
In the present study, a series of tetrahydropyridopyrimidinone derivatives, possessing potent dopamine D2, serotonin 5-HT1A and 5-HT2A receptors properties, was synthesized and evaluated as potential antipsychotics. Among them, 3-(2-(4-(benzo[b]thiophen-4-yl)piperazin-1-yl)ethyl)-9-hydroxy-2-methyl-6,7,8,9-tetrahydro-4H-pyrido[1,2-a]pyrimidin-4-one (10d) held the best pharmacological profile. It not only exhibited potent and balanced activities for D2, 5-HT1A, and 5-HT2A receptors, but was also endowed with low activities for α1A, 5-HT2C, H1 receptors and hERG channels, suggesting a low propensity for inducing orthostatic hypotension, weight gain and QT prolongation...
July 24, 2017: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/28766755/does-baseline-depression-increase-the-risk-of-unexplained-and-accidental-falls-in-a-cohort-of-community-dwelling-older-people-data-from-the-irish-longitudinal-study-on-ageing-tilda
#13
Robert Briggs, Sean P Kennelly, Rose Anne Kenny
BACKGROUND: Depression independently increases the risk of falls in older people, but the mechanism for this relationship, as well as the specific falls type involved, remains unclear. Accidental falls (AFs) are due to slips or trips, while the cause of unexplained falls (UFs) is not immediately apparent and can include unrecognised syncope. METHOD: This longitudinal study examines the relationship between baseline depression and subsequent falls, both accidental and unexplained, at 2-year follow-up in a cohort of community dwelling adults aged ≥50 years...
August 2, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28765629/subthalamic-nucleus-stimulation-and-levodopa-modulate-cardiovascular-autonomic-function-in-parkinson-s-disease
#14
Kai Li, Rocco Haase, Heinz Rüdiger, Manja Reimann, Heinz Reichmann, Martin Wolz, Tjalf Ziemssen
We aimed to explore the effects of bilateral subthalamic nucleus stimulation and levodopa on cardiovascular autonomic function in Parkinson's disease. Twenty-six Parkinson's disease patients with bilateral subthalamic nucleus stimulation in a stable state were tested under stimulation off and dopaminergic medication off (OFF-OFF), stimulation on and dopaminergic medication off (ON-OFF), and stimulation on and medication (levodopa) on (ON-ON) conditions by recording continuously blood pressure, ECG, and respiration at rest, during metronomic deep breathing, and head-up tilt test...
August 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28748633/depression-and-anxiety-in-multiple-system-atrophy
#15
L-Y Zhang, B Cao, Y-T Zou, Q-Q Wei, R-W Ou, B Zhao, Y Wu, H-F Shang
BACKGROUND: It has been noticed that the patients with multiple system atrophy (MSA) can accompany with depression and anxiety. This study aimed to establish the incidence and determinants of depression and anxiety symptoms in Chinese MSA patients. METHODS: A total of 237 MSA patients were enrolled in the study. Neuropsychological assessment was performed using Hamilton Depression Rating Scale-24 items and Hamilton Anxiety Rating Scale. RESULTS: We found that 62...
July 26, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28739492/efficacy-and-safety-of-citalopram-compared-to-atypical-antipsychotics-on-agitation-in-nursing-home-residents-with-alzheimer-dementia
#16
Giovanni Viscogliosi, Iulia Maria Chiriac, Evaristo Ettorre
OBJECTIVE: To assess efficacy and safety of citalopram compared to quetiapine and olanzapine for the treatment of agitation in patients with Alzheimer disease (AD). DESIGN: Longitudinal, 6-month study. SETTING: Nursing home (NH). PARTICIPANTS: 75 NH residents with AD and agitation, randomized to citalopram (n = 25), quetiapine (n = 25), or olanzapine (n = 25). MEASUREMENTS: Changes in Neuropsychiatric Inventory (NPI) agitation subscale score and the modified Alzheimer Disease Cooperative Study-Clinical Global Impression of Change (mADCS-CGIC) were used to assess treatment efficacy...
July 21, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28738696/the-role-of-autoantibodies-in-the-syndromes-of-orthostatic-intolerance-a-systematic-review
#17
Mohammed Ruzieh, Lillian Batizy, Osama Dasa, Carson Oostra, Blair Grubb
Orthostatic intolerance is defined as the provocation of symptoms upon standing, commonly caused by neurogenic orthostatic hypotension (OH) and postural tachycardia syndrome (POTS), the etiology for which has not been fully uncovered yet. Many reports have described the occurrence of dysautonomia, orthostatic intolerance and POTS following febrile illness, presumably viral and post-vaccine. Furthermore, patients with dysautonomia have higher rates of autoimmune disorders such as Hashimoto thyroiditis and SLE...
July 24, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28738139/association-of-history-of-dizziness-and-long-term-adverse-outcomes-with-early-vs-later-orthostatic-hypotension-assessment-times-in-middle-aged-adults
#18
Stephen P Juraschek, Natalie Daya, Andreea M Rawlings, Lawrence J Appel, Edgar R Miller, B Gwen Windham, Michael E Griswold, Gerardo Heiss, Elizabeth Selvin
Importance: Guidelines recommend assessing orthostatic hypotension (OH) 3 minutes after rising from supine to standing positions. It is not known whether measurements performed immediately after standing predict adverse events as strongly as measurements performed closer to 3 minutes. Objective: To compare early vs later OH measurements and their association with history of dizziness and longitudinal adverse outcomes. Design, Setting, and Participants: This was a prospective cohort study of middle-aged (range, 44-66 years) participants in the Atherosclerosis Risk in Communities Study (1987-1989)...
July 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28738118/early-orthostatic-hypotension-and-orthostatic-intolerance-more-than-an-observation-or-annoyance
#19
Wolfgang Singer, Phillip A Low
No abstract text is available yet for this article.
July 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28730326/infectious-diseases-causing-autonomic-dysfunction
#20
REVIEW
Francisco Javier Carod Artal
OBJECTIVES: To review infectious diseases that may cause autonomic dysfunction. METHODS: Review of published papers indexed in medline/embase. RESULTS: Autonomic dysfunction has been reported in retrovirus (human immunodeficiency virus (HIV), human T-lymphotropic virus), herpes viruses, flavivirus, enterovirus 71 and lyssavirus infections. Autonomic dysfunction is relatively common in HIV-infected patients and heart rate variability is reduced even in early stages of infection...
July 20, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
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