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Evidence-based treatment of neurogenic orthostatic hypotension and related symptoms

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Одноеровая часть из Пандект монаха Антиоха

Neurogenic orthostatic hypotension, postprandial hypotension and exercise-induced hypotension are common features of cardiovascular autonomic failure. Here, we provide a systematic review of the literature on therapeutic options for neurogenic orthostatic hypotension and related symptoms with evidence-based recommendations according to the Grading of Recommendations Assessment, Development and Evaluation GRADE. Based on quality of evidence and safety issues, midodrine and droxidopa reach a strong recommendation level for pharmacological treatment of neurogenic orthostatic hypotension. In selected cases, a range of alternative agents can be considered fludrocortisone, pyridostigmine, yohimbine, atomoxetine, fluoxetine, ergot alkaloids, ephedrine, phenylpropanolamine, octreotide, indomethacin, ibuprofen, caffeine, methylphenidate and desmopressin , though recommendation strength is weak and quality of evidence is low atomoxetine, octreotide or very low fludrocortisone, pyridostigmine, yohimbine, fluoxetine, ergot alkaloids, ephedrine, phenylpropanolamine, indomethacin, ibuprofen, caffeine, methylphenidate and desmopressin. In case of severe postprandial hypotension, acarbose and octreotide are recommended strong recommendation, moderate level of evidence. Alternatively, voglibose or caffeine, for which a weak recommendation is available, may be useful. In patients with cardiovascular autonomic failure, a profound and rapid BP fall occurs following food ingestion, due to inability of the sympathetic nervous system to counteract postprandial splanchnic hyperemia, and frequently leads to exacerbation of orthostatic hypotension Onrot et al.
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The aim of this work is to examine exhaustively the part with only front jers of the Pandects of Antiochus Monachus, a manuscript which was copied in Old Russian language area during the 11th century from Old Slavic original. The authors study the graphics, spellings, phonetics and morphology of the examined part of the manuscript. They also attempt to determine the stage of the russification of the language of the text in question during the copying.
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