Identification and Management of Paroxysmal Sympathetic Hyperactivity After Traumatic Brain Injury
Paroxysmal sympathetic hyperactivity (PSH) has predominantly been described after traumatic brain injury (TBI), which is associated with hyperthermia, hypertension, tachycardia, tachypnea, diaphoresis, dystonia (hypertonia or spasticity), and even motor features such as extensor/flexion posturing. Despite the pathophysiology of PSH not being completely understood, most researchers gradually agree that PSH is driven by the loss of the inhibition of excitation in the sympathetic nervous system without parasympathetic involvement. Recently, advances in the clinical and diagnostic features of PSH in TBI patients have reached a broad clinical consensus in many neurology departments. These advances should provide a more unanimous foundation for the systematic research on this clinical syndrome and its clear management. Clinically, a great deal of attention has been paid to the definition and diagnostic criteria, epidemiology and pathophysiology, symptomatic treatment, and prevention and control of secondary brain injury of PSH in TBI patients. Potential benefits of treatment for PSH may result from the three main goals: eliminating predisposing causes, mitigating excessive sympathetic outflow, and supportive therapy. However, individual pathophysiological differences, therapeutic responses and outcomes, and precision medicine approaches to PSH management are varied and inconsistent between studies. Further, many potential therapeutic drugs might suppress manifestations of PSH in th...
In conclusion, oculomotor impairment is a common component of disability in MS patients and should be considered when managing this type of patients. More research is still needed to know the real impact of this disease on binocular vision and accommodation. PMID: 32228341 [PubMed - as supplied by publisher]
Purpose of review In 2013, the association between T-Box factor 4 (TBX4) variants and pulmonary arterial hypertension (PAH) has first been described. Now – in 2020 – growing evidence is emerging indicating that TBX4 variants associate with a wide spectrum of lung disorders. Recent findings TBX4 variants are enriched in both children and adults with PAH. The clinical phenotype associated with a TBX4 variant seems to be milder than that in other PAH-associated gene mutations. Further, TBX4 variants have increasingly been associated with a variety of clinical and histopathological phenotypes, including lethal...
Publication date: Available online 1 April 2020Source: Social Science &MedicineAuthor(s): Patricia East, Jenalee Doom, Erin Delker, Estela Blanco, Raquel Burrows, Paulina Correa-Burrows, Betsy Lozoff, Sheila Gahagan
CONCLUSION: The hypertension burden would decrease from 244.5 million persons to 127.5-182.3 million persons in China if the two-visit strategy was applied. PMID: 32224596 [PubMed - as supplied by publisher]
Conditions: Hypertension, Essential; β-hydroxybutyrate Intervention: Other: dietary restriction (salt restriction) Sponsor: Sulaiman AlRajhi Colleges Not yet recruiting
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Conditions: COVID-19; Hypertension; Cardiovascular Diseases Intervention: Sponsor: Societa Italiana dell'Ipertensione Arteriosa Recruiting
Contributors : Lesha Zhang ; Bing ShenSeries Type : Expression profiling by high throughput sequencingOrganism : Rattus norvegicusWe utilized high-throughput sequencing and subsequent signaling pathway analyses to find 2 fold change or greater upregulated expression of 230 transcripts and downregulated expression of 165 transcripts in basilar artery smooth muscle cells derived from rats fed a high-salt diet compared with those from control rats.
Paroxysmal sympathetic hyperactivity (PSH) has predominantly been described after traumatic brain injury (TBI), which is associated with hyperthermia, hypertension, tachycardia, tachypnea, diaphoresis, dystonia (hypertonia or spasticity), and even motor fe...
Conclusion: Early fever after TBI may signal impending autonomic dysfunction.