Rose A Kenny

..Carotid sinus massage provoked 5.6 seconds asystole with symptom reproduction, and she has remained symptom-free after permanent pacemaker implantation for her carotid sinus syndrome and withdrawal of antiepileptic medications...

..Blood pressure behavior is abnormal in patients with carotid sinus syndrome as represented by altered nocturnal blood pressures and high prevalence of orthostatic hypotension...

..Drop attacks or non accidental falls should thus be investigated for causes of syncope. The most common causes of neurally mediated syncope in older adults are carotid sinus syndrome, orthostatic hypotension and vasovagal syncope...

..During head-up tilt testing, the patient had vasodepressor vasovagal syncope. Afterwards, she had amnesia from loss of consciousness. Her symptoms (falls) responded to the withdrawal of culprit medications...

..Activity and performance in 1999 were compared with peer inner-city teaching hospitals and with previous performance in 1990 at the Royal Victoria Infirmary to determine whether the facility had influenced emergency activity...

..The aim of the study was to determine whether cardiac pacing reduces falls in older adults with cardioinhibitory carotid sinus hypersensitivity (CSH)...

..These preliminary results from a local explanatory study are now being tested in a multicenter study entitled Syncope and Falls in the Elderly: Pacing and Carotid Sinus Evaluation (SAFE-PACE II)...

..07-0.54; p = 0.002) and less reduction in Mini-Mental State Examination score (p = 0.04, adjusted for baseline score). INTERPRETATION: Telomere length is a prognostic marker for poststroke cognitive decline, dementia, and death...

..Similar to other common dementias consensus criteria for VaD need unambiguous definition to impact on preventative and treatment strategies and are critical for selective recruitment to clinical trials...

..We sought to determine if autonomic function is impaired after stroke recovery in older patients...

..Although frequently used in the assessment of patients with falls, it is unclear whether 24-hour ambulatory electrocardiography contributes to their assessment in older persons...

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..This prospective study aimed to identify modifiable risk factors for falling in older people with mild to moderate dementia...

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..The association of MTA but not WMH with subsequent cognitive decline and increasing brain atrophy suggests a greater role for Alzheimer type than vascular pathology in delayed cognitive impairment after stroke...

..Longitudinal studies of changes in autonomic reflex abnormalities, autonomic symptom profiles, and motor severity might clarify these associations...

..Postural hypotension is a risk factor for falls. Falls are debilitating and a leading cause of morbidity and mortality in the elderly...

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..Poststroke cognitive impairment is frequent. There are, however, few longitudinal studies examining delayed changes in poststroke cognition...

..CONCLUSION: Attentional and executive impairments are underpinned by WMH in fronto-striato-thalamo-frontal circuits. Frontal atrophy is identified as a novel substrate of cognitive decline in stroke patients...

..The goal of this study was to compare the clinical characteristics of patients with carotid sinus syndrome who presented with falls with those who presented with syncope...

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..To determine the effectiveness of multifactorial intervention after a fall in older patients with cognitive impairment and dementia attending the accident and emergency department...

..Only a small number have severe carotid artery stenosis. Ultrasound will identify high-risk subjects and facilitate accurate diagnosis with carotid sinus massage in the majority...

..Early use of an implantable loop recorder may be more cost-effective. A dedicated investigation unit increases the likelihood of achieving positive diagnoses and significantly reduces hospital stay and health expenditure...

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..Easy-to-use algorithms can help reduce the number of patients admitted to acute medical services with falls and syncope while optimising the care of those managed as inpatients. The algorithms are provided for use by interested parties...

..06, 27.4). The front-loaded GTN protocol provided a higher diagnostic rate than passive tilt testing, and provides a rapid alternative to conventional methods, though false positivity rates are higher...

..To investigate the causes of recurrent drop attacks in older patients with a comprehensive battery of investigations in the largest series reported to date...

..Here we present the first study examining a potential genetic abnormality in VVS...

..The authors conclude that this is the first series that clearly shows a significant association between atrioventricular block, sick sinus syndrome, and falls. Further prospective studies are needed to substantiate these results...

..Further cardiovascular testing should be undertaken in this group to determine other causes of syncope...

..In this article, we review the possible mechanisms underlying a positive adenosine test, its safety, and a comprehensive examination of the literature supporting each of the putative causal diagnoses...

..We further challenged the model with biologically based interventions to ascertain if cortisol associated hippocampal dysfunction could be abrogated...

..This predicts overall fracture risk as effectively as dual X-ray at the spine and hip, although site specific measurements provide the best estimate of fracture risk at a particular location...

..CONCLUSION: Multifactorial intervention is effective at reducing the fall burden in cognitively intact older persons with recurrent falls attending Accident & Emergency, but does not reduce the proportion of subjects still falling...

..We therefore hypothesize that PD patients with orthostatic hypotension (OH) have a different cognitive profile compared to PD patients without OH...

..01). There was one cardiovascular and no neurological complications. CONCLUSION: This study included 10 times as many people as previous studies and demonstrates the safety of HUT in older people...

..CONCLUSION: The findings emphasize the importance of identifying early cognitive impairments to optimize rehabilitation, care planning, and secondary prevention of dementia in stroke patients...

..Clinical findings included an absence of any discernible cardiac or autonomic abnormalities and reproducible hypotension on tilt table testing in affected family members...

..This relationship was stronger for AB42 and in the entorhinal cortex. CONCLUSION: The anatomic location of amyloid deposition is an important factor-specific factor in memory impairment in AD and VaD...