Vascular Loops: The Innocent Bystander for Vestibular Paroxysmia

2021 ◽  
pp. 000348942110372
Author(s):  
Carren Sui-Lin Teh ◽  
Siti Hajar Noordiana ◽  
Shanmugalingam Shamini ◽  
Narayanan Prepageran

Introduction: Vestibular paroxysmia (VP) is a condition with recurrent short bouts of vertigo and is thought to be part of a neurovascular compression syndrome caused by the vascular loop. However, this is still being debated as vascular loops are considered as normal variants with limited studies involving vertiginous patients. Objectives: The aim of this paper is to study the association between audiovestibular symptoms and the presence of vascular loops and to study the association between vestibular paroxysmia and vascular loops. Design: This is a retrospective analysis of clinical, audiological and MRI findings of patients with and without vascular loops and vestibular paroxysmia from 2000 to 2020. Results: A total of 470 MRI Internal Auditory Meatus scans were performed during the study period of which, 71 (15.1%) had vascular loops and 162 (34.5%) had normal MRI which were used as controls. From the 233 subjects recruited, there were 37 subjects with VP and 196 non VP subjects were used as controls. There was no association between the vascular loop and control groups in terms of co-morbidity and audiovestibular symptoms. The VP group had a significantly older mean age of 51.8 (SD ± 10.3) as compared to the non VP group with the mean age of 45.6 (SD ± 15.5). The VP group had higher number of patients presenting with hearing loss at 97.3% when compared with those without VP (80.1%) ( P = .01). The odds of having a vascular loop giving rise to VP was not statistically significant at 0.82 (95% CI 0.3735-1.7989) P = .62. Conclusion: The vascular loop is a normal variant which may or may not give rise to audiovestibular symptoms or vestibular paroxysmia. Clinical assessment is still most important tool in deriving a diagnosis of VP and MRI may be useful to rule out other central causes.

2020 ◽  
Vol 16 (2) ◽  
pp. 125-133
Author(s):  
Zahra Rezaieyazdi ◽  
Sima Sedighi ◽  
Masoumeh Salari ◽  
Mohammadreza H. Fard ◽  
Mahmoud R. Azarpazhooh ◽  
...  

Background: The relationship between SLE and traditional risk factors for cardiovascular events was evaluated. Methods: The data regarding sixty patients with SLE and 30 healthy controls (age and sex matched) were gathered using SLEDAI forms. Venous blood (10mL) from all the participants was examined for hs-CRP, homocysteine, VCAM1, CBC, anti-DNA antibody, C3, C4, low-density lipoprotein (LDL), cholesterol, FBS and triglyceride. : The IMT of carotid arteries was determined bilaterally by ultrasound. Other measurements included insulin levels via Elisa (Linco/Millipore Corp) and the HOMA-IR index for insulin resistance. Results: The mean age (in years) in the test and control groups was 28.8±10.3 (18-52) and 33.8±9.13 (18-48), respectively. Results: The mean age (in years) in the test and control groups was 28.8±10.3 (18-52) and 33.8±9.13 (18-48), respectively. : The average IMT in the test group was directly related to serum levels of VCAM1 (p<0.001), homocysteine (p<0.001), cholesterol (p<0.009), LDL (p<0.001), TG (p<0.001), and FPG (p=0.004). The association between other risk factors, insulin resistance, carotid IMT and SLEDAI, was nonexistent. Mean insulin and insulin resistance levels in all the participants were 0.43±2.06 µU/mL and 0.09±0.44, respectively. There was no significant difference between the test and control groups regarding serum insulin and insulin resistance levels (p=0.42 and p=0.9, respectively). None of the risk factors, such as hsCRP, VCAM1, or homocysteine, were shown to be related to insulin resistance (p=0.6, p=0.6, p=0.09, respectively). Conclusion:: Our findings did not show an increase in the prevalence of atherosclerosis in patients with SLE. There was no association between IMT and insulin resistance. However, the former was associated with FPG, total cholesterol, LDL, TG, homocystein and VCAM1.


Pteridines ◽  
2020 ◽  
Vol 31 (1) ◽  
pp. 55-60
Author(s):  
Haoyu Jiang ◽  
Ying Zheng ◽  
Chang Liu ◽  
Ying Bao

AbstractBackground To evaluate sulfentanyl combined with dexmedetomidine hydrochloride on postoperative analgesia in patients who received video-assisted thoracic surgery (VATS) and its effects on serum norepinephrine (NE), dopamine (DA), 5-hydroxytryptamine (5-HT), and prostaglandin (PGE2).Material and Methods Ninety-nine non-small cell lung cancer (NSCLC) patients who received VATS were included in the study. All the patients received intravenous inhalation compound anesthesia. Of the 99 cases, 49 subjects (control group) received sulfentanyl for patient controlled intravenous analgesia (PICA) and other 50 cases (experiment group) received sulfentanyl combined with dexmedetomidine hydrochloride for PICA after operation of VATS. The analgesic effects of the two groups were evaluated according to Visual Analogue Scales (VAS) and the Bruggrmann Comfort Scale (BCS). The serum pain mediator of NE, DA, 5-HT, and PGE2 were examined and compared between the two groups in the first 24 h post-surgery.Results The VAS scores for the experiment group were significant lower than that of control group on the time points of 8, 16, and 24 h post-surgery (pall<0.05), and the BCS scores of the experiment group in the time points of 8, 16, and 24 h were significantly higher than that of controls (p<0.05). However, the VAS and BCS scores were not statistical differently in the time point of 1, 2, and 4 h post-surgery (pall>0.05). The mean sulfentanyl dosage was 63.01 ± 5.14 μg and 67.12 ± 6.91 μg for the experiment and control groups respectively with significant statistical difference (p<0.05). The mean analgesic pump pressing times were 4.30 ± 1.31 and 5.31 ± 1.46 for experiment and control groups respectively with significant statistical difference (p<0.05). The serum NE, DA, 5-HT, and PGE2 levels were significantly lower in the experimental group compared to that of control group in the time point of 12 h post-surgery (pall<0.05). The side effects of nausea, vomiting, delirium, rash, and hypotension atrial fibrillation were not statistically different between the two groups (pall>0.05).Conclusion Patient controlled intravenous analgesia of sulfentanyl combined with dexmedetomidine hydrochloride was effective in reducing the VAS score and serum pain mediators in NSCLC patients who received VAST.


2020 ◽  
pp. bmjstel-2020-000657
Author(s):  
Rebecca Singer ◽  
Grace Leo ◽  
Tessa Davis ◽  
Ben Lawton ◽  
Henry Goldstein ◽  
...  

Previous research has examined the utilisation of musical cues to improve the performance of cardiopulmonary resuscitation (CPR) delivered in training environments. We postulated a musical cue that is both contemporary and transcends cultures may improve CPR performance. Our aim was to establish whether chest compressions are performed with improved rate and depth if a song of a fixed beat (PinkFong’s ‘Baby Shark’ with a tempo of 115 beats per minute (bpm) and 15 beats in each verse) is played to a healthcare professional immediately before undertaking CPR compared to whale noises (a non-metronomic rhythm). 58 Participants of a paediatric conference (majority doctors) were randomly assigned to listen to a minute of Baby Shark (28) or whale song (30) and then undertake a minute of CPR. There was no significant difference in the mean compression rate between the Baby Shark and control groups, with the groups achieving 121 and 125 bpm, respectively (p=0.18). In relation to compression depth within the target zone, the Baby Shark group had more compressions completed within the target zone (55%) than the control group (39%) although this difference was not significant (p=0.08). Listening to Baby Shark prior to undertaking simulated CPR does not improve overall performance, but there is a potential tendency to improve adequate compression depth which may be beneficial in training exercises.


2020 ◽  
Vol 48 (12) ◽  
pp. 030006052095093
Author(s):  
Hua-Biao Chen ◽  
Hong-Bo Wu ◽  
Min Chen ◽  
Yu-Liang Huang

Background Femoral head collapse and coxa vara lead to internal fixator failure in elderly patients with hip fracture. External fixator application is an optimal choice; however, the existing methods have many disadvantages. Methods Type 31-A1.3 hip fracture models were developed in nine pairs of 1-year-old fresh bovine corpse femur specimens. Each left femur specimen was fixed by a dynamic hip screw (control group), and each right femur specimen was fixed by the slide-poking external fixator (experimental group). Vertical loading and torsion tests were then performed in both groups. Results In the vertical loading experiment, a 1000-N load was implemented. The mean vertical downward displacement of the femoral head in the experimental and control groups was 1.49322 ± 0.116280 and 2.13656 ± 0.166374 mm, respectively. In the torsion experiment, when the torsion was increased to 10.0 Nm, the mean torsion angle in the experimental and control groups was 7.9733° ± 1.65704° and 15.4889° ± 0.73228°, respectively. The slide-poking external fixator was significantly more resistant to compression and rotation than the dynamic hip screw. Conclusion The slide-poking external fixator for hip fractures that was designed and developed in this study can provide sufficient stability to resist compression and rotation in hip fractures.


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Petr Horak ◽  
Michal Mara ◽  
Pavel Dundr ◽  
Kristyna Kubinova ◽  
David Kuzel ◽  
...  

Aim. To determine if hormonal treatment induces apoptosis in uterine fibroids.Methods. Immunohistochemical examination of fibroid tissue, using avidin-biotin complex and cleaved caspase-3 antibody for detecting apoptosis, was performed in premenopausal women who underwent 12-week treatment with oral SPRM (6 patients with 5 mg and 5 patients with 10 mg of ulipristal acetate per day) or gonadoliberin agonist (GnRHa, 17 patients) and subsequent myomectomy or hysterectomy for symptomatic uterine fibroids. Ten patients with no presurgical hormonal treatment were used as controls.Results. Apoptosis was present in a significantly higher proportion of patients treated with ulipristal acetate compared to GnRHa (P=0.01) and to patients with no hormonal treatment (P=0.01). In contrast to an AI of 158.9 in SPRM patients, the mean AI was 27.5 and 2.0 in GnRHa and control groups, respectively. No statistical difference in the AI was observed between the two groups of patients treated with ulipristal acetate (5 mg or 10 mg).Conclusion. Treatment with ulipristal acetate induces apoptosis in uterine fibroid cells. This effect of SPRM may contribute to their positive clinical effect on uterine fibroids.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Fatima M Ezzeddine ◽  
Antoine N Saliba ◽  
Vaibhav Jain ◽  
Hector R Villarraga ◽  
Joerg Herrmann ◽  
...  

Introduction: Several chemotherapy agents, especially anthracyclines, are associated with the development of non-ischemic cardiomyopathy. When chemotherapy-induced cardiomyopathy (CHIC) is associated with left bundle branch block (QRS >150 ms) and a left ventricular ejection fraction (LVEF) of 35% or lower, cardiac resynchronization therapy (CRT) is often utilized to improve cardiac function and relieve symptoms. Hypothesis: CRT is associated with improvement in left ventricular strain in patients with CHIC. Methods: The study included 22 patients with CHIC and 44 age- and gender-matched controls with other types of NIC who underwent CRT implantation between 2004 and 2017. LVEF, left ventricular global longitudinal strain (GLS), systolic strain rate (SRS), and early diastolic strain rate (SRE) were assessed at baseline and 6-18 months after CRT. CRT response was defined as LVEF improvement by >5% after CRT. Results: CRT responders had a significant improvement in left ventricular GLS as compared to CRT non-responders in the control group, but not in the CHIC group (Table 1). The mean change in LVEF after CRT was similar between the CHIC and control groups (10 ± 10% versus 11 ± 11%, p= 0.67). The mean change in GLS after CRT was also similar between the two groups (-2.15 ± 4.32 versus -3.57 ± 4.02, p= 0.19). The proportion of patients whose LVEF increased by more than 5% was similar between the two groups (59% in the CHIC group versus 68% in the control group, p= 0.46). The mean changes in LV myocardial systolic and early diastolic strain rates were similar between the CHIC and control groups. Mean SRS decreased by 0.13 ± 0.14 in the CHIC group and by 0.34 ± 1.28 in the control group (p=0.45). Mean SRE increased by 0.06 ± 0.18 in the CHIC group and by 0.07 ± 0.22 in the control group (p=0.86). Conclusions: CRT is associated with improvement in left ventricular strain in patients with CHIC. Prospective studies are needed to further evaluate the echocardiographic strain outcomes of CRT in CHIC.


2010 ◽  
Vol 92 (6) ◽  
pp. 463-465 ◽  
Author(s):  
James McDaid ◽  
Claire Reichl ◽  
Ihsan Hamzah ◽  
Samantha Fitter ◽  
Laura Harbach ◽  
...  

INTRODUCTION We observed that a number of patients presenting to our clinic with diverticular fistulation were taking nicorandil for angna. Recognised side effects of nicorandil include gastrointestinal and genital ulceration. The aim of our study was to determine whether nicorandil is an aetiological agent in diverticular fistulation. PATIENTS AND METHODS We conducted a case-control study of patients with diverticular disease related enteric fistulae. Two patient groups were identified: a study group of patients with diverticular fistulae, and a control group with uncomplicated diverticular disease. The proportion of patients who had ever used nicorandil was compared between the two groups. RESULTS A total of 153 case notes were analysed, 69 patients with fistulae and 84 control patients with uncomplicated diverticular disease. Female to male ratio in both groups was 2:1. The mean age was 71 years in the fistula group and 69 years in the control diverticular disease group (P = ns). Of those with colonic fistulae, 16% were taking nicorandil compared with 2% of the control group (odds ratio 7.8; 95% confidence interval 1.5–39.1; P = 0.008). There was no significant difference in rates of ischaemic heart disease between fistula and control groups. CONCLUSIONS Nicorandil is associated with fistula formation in diverticular disease.


Author(s):  
Kareen Lynn E. Negado

This study evaluates the growth performance of lettuce (Lactuca sativa L.) utilizing various fermented products as organic fertilizers. Growth performance is determined through the plant’s weight and leaves and significant differences in growth among various treatments: (a) fish trash, (b) scrap seaweeds, (c) kangkong, and control groups urea (positive) and water (negative) was also determined. Kangkong leaves are fermented for 10 days, fish trash for 14 days and 1 month for seaweeds. Lettuce seeds are sown before transplanting (15 days after germination) into pots and placed in raised beds. Randomized complete block design is utilized in the experiment. Growth performance is measured through the number of leaves 10, 20, and 30 days after transplant and mass of plant upon harvest. After 30 days, the lettuce was harvested. Based on the findings, the soil and fermented products are acidic and the needed organic matter for optimum growth of lettuce are not sufficient as well as some nutrients of the fermented products. Among the organic fertilizers, kangkong at 30 ml performs best in terms of the growth performance of lettuce. Urea performs best in terms of the mass upon harvest. Significant differences exist in the mean number of leaves of lettuce treated with various amounts of organic fertilizers with the plants that receive urea. Lettuce produce more number of leaves and with the highest mass upon harvest when treated with urea compared with organic fertilizers applied after 30 days from transplant. Keywords: fermented kangkong; fish trash; growth performance; lettuce; scrap seaweeds


Author(s):  
Mohammed bin Majed bin Shariah al - Shammari

The aim of this study was to identify the effectiveness of teaching role playing strategy in developing dialogue skills in the immortal language of the intermediate third grade students. To achieve the objectives of the study, the researcher used the semi-experimental method by designing the two equal groups. The sample contains 51 students, 26 students for the control group and 25 students for the experimental group. The researcher used the statistical treatments using the SPSS program, The study has resulted in The results showed that the level of dialogue skills on the student scale among the average third-grade students in the experimental and control groups was medium. The mean of the two groups was on all dialogue skills (2.23). The skill of expressing the opinion is one of the most common dialogue skills, (2.25), while the skill of listening and listening is second, with an average of (2.24), followed by self-esteem in third place with an average of 2.23. Finally, ). In addition, there were statistically significant differences at the level of α 0.05 0.05 in post-performance in all dialogue skills (self-esteem, good listening and listening, respect for others, expression of opinion). In the light of its findings, the researcher made a number of recommendations.


Author(s):  
Salim Ahmed Saif Al-rashdi

    The present study aimed at uncovering the effectiveness of employing the enrichment activities for mental thinking on the development of mathematical thinking and achievement among Grade 7 students. To achieve the research objectives, the researcher used the semi experimental design known as the design of the control group with the tribal and remote tests. In light of the experimental design, the average Grade 7 students tested the sample of the study in the second semester of 30 students who were divided into 15 students for the experimental group and 15 students for the control group after checking the validity and stability of the tools. The results showed that there was a statistically significant difference at (0.05) between the mean scores of the experimental and control groups in the cognitive achievement test related to the unit of Engineering in the second semester and the mathematical thinking test for the average of the experimental group. The results also showed a statistically significant difference) between the average scores of the experimental group students in the tribal and remote applications in the cognitive achievement test and the mathematical thinking test, and in favor of the average post-implementation. In the light of these results, the study presented a number of recommendations and suggestions.   ، ، ، ،


Sign in / Sign up

Export Citation Format

Share Document