Comparison of Bone-Conducted Vibration for Eliciting Ocular Vestibular-Evoked Myogenic Potentials

2011 ◽  
Vol 146 (2) ◽  
pp. 289-294 ◽  
Author(s):  
Chia-Chen Tseng ◽  
Shou-Jen Wang ◽  
Yi-Ho Young
Keyword(s):  
Prospective Study ◽  
Study Design ◽  
Healthy Subjects ◽  
University Hospital ◽  
Vestibular Evoked Myogenic Potentials ◽  
Ménière’S Disease ◽  
Asymmetry Ratio ◽  
Significant Difference ◽  
The Asymmetry ◽  
The Right

Objective. This study compared bone-conducted vibration (BCV) stimuli at forehead (Fz) and mastoid sites for eliciting ocular vestibular-evoked myogenic potentials (oVEMPs). Study Design. Prospective study. Setting. University hospital. Methods. Twenty healthy subjects underwent oVEMP testing via BCV stimuli at Fz and mastoid sites. Another 50 patients with unilateral Meniere’s disease also underwent oVEMP testing. Results. All healthy subjects showed clear oVEMPs via BCV stimulation regardless of the tapping sites. The right oVEMPs stimulated by tapping at the right mastoid had earlier nI and pI latencies and a larger nI-pI amplitude compared with those stimulated by tapping at the Fz and left mastoid. Similar trends were also observed in left oVEMPs. However, the asymmetry ratio did not differ significantly between the ipsilateral mastoid and Fz sites. Clinically, tapping at the Fz revealed absent oVEMPs in 28% of Meniere’s ears, which decreased to 16% when tapping at the ipsilesional (hydropic) mastoid site, exhibiting a significant difference. Conclusion. Tapping at the ipsilateral mastoid site elicits earlier oVEMP latencies and larger oVEMP amplitudes when compared with tapping at the Fz site. Thus, tapping at the Fz site is suggested to screen for the otolithic function, whereas tapping at the ipsilesional mastoid site is suitable for evaluating residual otolithic function.

scholarly journals Independent Measures of Utricular Function: Ocular Vestibular Evoked Myogenic Potentials Do Not Correlate With Subjective Visual Vertical or Fundus Photographic Binocular Cyclorotation

2021 ◽  
Vol 12 ◽  
Author(s):  
Sarah Hösli ◽  
Dominik Straumann
Keyword(s):  
Diagnostic Tests ◽  
Diagnostic Workup ◽  
Vestibular Evoked Myogenic Potentials ◽  
Subjective Visual Vertical ◽  
Asymmetry Ratio ◽  
Visual Vertical ◽  
The Asymmetry ◽  
The Right ◽  
Utricular Function

Ocular vestibular evoked myogenic potentials (oVEMPs), subjective visual vertical (SVV), and fundus photographically measured binocular cyclorotation (BCR) are diagnostic tests to assess utricular function in patients with vertigo or dizziness. In 138 patients with chronic vertigo or dizziness, we asked whether the asymmetry ratio of oVEMP (normal, right side pathological, left side pathological) could predict the SVV deviation (normal, rightward deviation, leftward deviation) or BCR (normal, cyclorotation to the right, cyclorotation to the left). There was no correlation between oVEMP and SVV and between oVEMP and BCR, while SVV and BCR correlated highly. Although both oVEMP and SVV measure aspects of utricular function, our findings demonstrate that oVEMP and SVV are not redundant and may reflect different utricular pathologies. The role of fundus photographic BCR may be relegated to only confirm unclear SVV results in vestibular diagnostic workup.

scholarly journals Patients in intensive care unit for COVID-19 pneumonia: the lung ultrasound patterns at admission and discharge. An observational pilot study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Persona Paolo ◽  
Valeri Ilaria ◽  
Zarantonello Francesco ◽  
Forin Edoardo ◽  
Sella Nicolò ◽  
...  
Keyword(s):  
Intensive Care ◽  
Lung Ultrasound ◽  
Low Cost ◽  
Low Frequency ◽  
Specific Pattern ◽  
University Hospital ◽  
Left Hemithorax ◽  
Significant Difference ◽  
The Right ◽  
B Lines

Abstract Background During COVID-19 pandemic, optimization of the diagnostic resources is essential. Lung Ultrasound (LUS) is a rapid, easy-to-perform, low cost tool which allows bedside investigation of patients with COVID-19 pneumonia. We aimed to investigate the typical ultrasound patterns of COVID-19 pneumonia and their evolution at different stages of the disease. Methods We performed LUS in twenty-eight consecutive COVID-19 patients at both admission to and discharge from one of the Padua University Hospital Intensive Care Units (ICU). LUS was performed using a low frequency probe on six different areas per each hemithorax. A specific pattern for each area was assigned, depending on the prevalence of A-lines (A), non-coalescent B-lines (B1), coalescent B-lines (B2), consolidations (C). A LUS score (LUSS) was calculated after assigning to each area a defined pattern. Results Out of 28 patients, 18 survived, were stabilized and then referred to other units. The prevalence of C pattern was 58.9% on admission and 61.3% at discharge. Type B2 (19.3%) and B1 (6.5%) patterns were found in 25.8% of the videos recorded on admission and 27.1% (17.3% B2; 9.8% B1) on discharge. The A pattern was prevalent in the anterosuperior regions and was present in 15.2% of videos on admission and 11.6% at discharge. The median LUSS on admission was 27.5 [21–32.25], while on discharge was 31 [17.5–32.75] and 30.5 [27–32.75] in respectively survived and non-survived patients. On admission the median LUSS was equally distributed on the right hemithorax (13; 10.75–16) and the left hemithorax (15; 10.75–17). Conclusions LUS collected in COVID-19 patients with acute respiratory failure at ICU admission and discharge appears to be characterized by predominantly lateral and posterior non-translobar C pattern and B2 pattern. The calculated LUSS remained elevated at discharge without significant difference from admission in both groups of survived and non-survived patients.

Assessing post-exercise respiratory gas kinetics in clinical sample - a pilot study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Patti ◽  
Y Blumberg ◽  
KJ Moneghetti ◽  
D Neunhaeuserer ◽  
F Haddad ◽  
...  
Keyword(s):  
Heart Failure ◽  
Healthy Subjects ◽  
Cardiopulmonary Exercise Testing ◽  
University Hospital ◽  
Exercise Intolerance ◽  
Early Recovery ◽  
Post Exercise ◽  
Peak Vo2 ◽  
Significant Difference ◽  
Respiratory Gases

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiopulmonary exercise testing (CPX) is established in the evaluation of patients with cardiac and pulmonary diseases, and its clinical utility seems to be expanding.  Currently the most important diagnostic and prognostic ventilatory metrics of CPX rely on the exercise phase. Nevertheless, a consistent body of evidence suggests that important information can be derived from the recovery phase, especially in the first few minutes after exercise. In this context, patients with heart failure (HF) demonstrate a slower recovery of the oxygen consumption (VO2) compared with healthy individuals. Purpose: To comprehensively investigate the behavior of respiratory gases during recovery from CPX in a diverse cohort of HF patients. Methods: All individuals who performed CPX at the department of cardiology of Stanford University Hospital were eligible for the study. Patients were included in the experimental group if they (i) were recorded for five minutes after the exercise phase of CPX and (ii) had documented heart failure. They were excluded if they had other clinical diagnoses which may be responsible for exercise intolerance or symptoms or were unable to give informed consent. Healthy controls were recruited from the local community and were included if they did not have documented or suspected disease. Respiratory gases were collected on a breath-by-breath basis and analysed after applying a 30 second rolling average filter. Metrics were analyzed as absolute values, percentage change from peak and the half-time of recovery (T ½; i.e. the duration until a metric had returned to ½ of its value at peak). Data was analyzed over time within patients and averages between groups using parametric statistical methods. In accordance with previous studies, the amount of change in a metric after exercise is presented as the "magnitude" of overshoot. Results: 32 patients with HF (11 Female, 47 ± 13 yrs) and 30 healthy subjects (14 Female, 43 ± 12 yrs) were included. A comparison of ventilatory metrics during recovery between HF and controls is depicted in Figure 1. Peak VO2 was 1135 ± 419 mL/min (13.5 ± 3.8 mL/Kg/min) vs 2408 ± 787 mL/min (32.5 ± 9.0 mL/Kg/min); P <0.01. A significant difference between patients with HF and healthy subjects was found in T ½ of VO2 (111.3 ± 51.0s vs 58.0 ± 13.2s, p < 0.01) and VCO2 (132.0 ± 38.8s vs 74.3 ± 21.1s, p < 0.01). The magnitude of the overshoot was also found to be significantly reduced in patients with HF for VE/VO2 (41.9 ± 29.1% vs 62.1 ± 17.7%, P < 0.01), RQ (25.0 ± 13.6% vs 38.7 ± 15.1%, p < 0.01) and PETO2 (7.2 ± 3.3% vs 10.1 ± 4.6%, p < 0.01). Finally, the magnitude of the RQ overshoot showed a moderate correlation with peak VO2 (ϱ=0.58, p < 0.01). Conclusions: We observed that ventilatory kinetics measured in early recovery after CPX differ significantly between healthy subjects and patients with HF. The assessment of post exercise respiratory gases in a clinical setting may add to the prognostic and diagnostic value of CPX in heart failure. Abstract Figure.

VESTIBULAR AFFERENTS POPULATION ACTIVATED BY VARIOUS MODES FOR ELICITING OCULAR AND CERVICAL VESTIBULAR-EVOKED MYOGENIC POTENTIALS

2011 ◽  
Vol 23 (06) ◽  
pp. 527-532 ◽  
Author(s):  
Shou-Jen Wang ◽  
Fu-Shan Jaw ◽  
Yi-Ho Young
Keyword(s):  
Healthy Subjects ◽  
Mean Amplitude ◽  
Vestibular Evoked Myogenic Potentials ◽  
Force Level ◽  
Characteristic Parameters ◽  
Stimulation Mode ◽  
Vestibular Afferents ◽  
Significant Difference ◽  
The Mean

This study compared cervical and ocular vestibular-evoked myogenic potentials (cVEMPs and oVEMPs) between air-conducted sound (ACS) and bone-conducted vibration (BCV) modes to determine whether these two stimulation modes activate the same population of primary vestibular afferents. Fifteen healthy subjects underwent cVEMP and oVEMP tests using ACS stimuli at 127 dB pe SPL and BCV stimuli at 128 dB force level. The characteristic parameters of cVEMPs and oVEMPs were compared between ACS and BCV modes. The mean p13 and n23 latencies of ACS-cVEMPs were significantly longer than those of BCV-cVEMPs. Likewise, the mean nI and pI latencies for ACS-oVEMPs were also significantly longer than those for BCV-oVEMPs. There was no significant difference in the mean amplitude of cVEMPs between the ACS and BCV modes. However, comparing the oVEMP amplitude, a relationship: (Amplitude of BCV-oVEMP) = 2.3 x (Amplitude of ACS-oVEMP) was demonstrated. In conclusion, the population of primary vestibular afferents activated by ACS and BCV stimuli is similar for cVEMPs. In contrast with oVEMPs, BCV mode activates more number of primary vestibular afferents than ACS mode does. In interpreting oVEMP and cVEMP results, stimulation mode should be checked first.

scholarly journals Incidental finding of bronchial diverticula in a non-smoker population: evaluation on thin-section CT

2016 ◽  
Vol 81 (1-2) ◽  
Author(s):  
Federica Ciccarese ◽  
Giorgio Garzillo ◽  
Anna Maria Chiesa ◽  
Antonio Poerio ◽  
Serena Baroncini ◽  
...  
Keyword(s):  
Thin Section ◽  
Healthy Subjects ◽  
Respiratory Symptoms ◽  
Incidental Finding ◽  
Radiological Finding ◽  
Chest Ct ◽  
Lobe Bronchus ◽  
Significant Difference ◽  
The Right

<p>Bronchial diverticula have been described as a common radiological finding in smoker patients with COPD, but the specificity of this sign should be further investigated. Thus, the aim of our study was to evaluate the prevalence of diverticula in a cohort of non-smoker subjects. Between February and July 2012, 2438 patients were admitted to our Radiology Unit to undergo a chest CT. Among them, we enrolled 121 non-smoking patients (78/121-64.5% females, 43/121-35.5% males), of different age (57.0±20.7 years-range: 12-88), without any respiratory symptoms, submitted to chest CT for several reasons (oncologic evaluation: 59/121-48.8%; follow up of lung nodules: 27/121-22.3%; screening in connectivitis: 12/121-9.9%; others: 23/121-19.0%). We considered thin-section CT scan on axial, coronal and sagittal plans to evaluate prevalence, numbers and level of bronchial diverticula. Diverticula were found in 41/121-33.9% patients, with a slight major prevalence in males (p=0.048), but no significant difference on age. In 31/41-75.6% the number was &lt;3, whereof 17/31-54.8% with just one diverticulum assessed. Regarding the level, in 30/41-73.2% they were subcarinal, but they were also detected in mainstem (2/41-4.9%) and lobar bronchi (with the right upper lobe bronchus most frequently involved- 12/41-29.3%). Bronchial diverticula can be observed in non-smokers, as well as in smoker patients with COPD. However, their prevalence seems to be lower than in smokers and they tend to be isolated and subcarinal. The age of patients does not influence their finding. More studies should be proposed to better define a cut-off between smokers and healthy subjects.</p>

Prognostic value of mean platelet volume on tinnitus

2015 ◽  
Vol 130 (2) ◽  
pp. 162-165 ◽  
Author(s):  
O Kemal ◽  
T Müderris ◽  
F Başar ◽  
G Kutlar ◽  
F Gül
Keyword(s):  
Mean Platelet Volume ◽  
Healthy Subjects ◽  
Clinical Findings ◽  
University Hospital ◽  
Control Group ◽  
Study Group ◽  
Pathophysiological Mechanism ◽  
Platelet Volume ◽  
Significant Difference ◽  
Healthy Control

AbstractObjective:This study aimed to determine whether there was any relationship between tinnitus and mean platelet volume.Methods:This retrospective study was conducted between January 2013 and January 2014 in Ankara Atatürk Hospital and Ondokuz Mayıs University Hospital, Turkey, on a study group of 86 patients with tinnitus and a control group of 84 healthy subjects. Mean platelet volume was recorded and comparisons were made between the two groups.Results:Mean (± standard deviation) platelet volume was 7.67 ± 0.83 μm3 in the study group and 7.28 ± 0.56 μm3 in the control group. There was a statistically significant difference in mean platelet volume between the tinnitus patients and the healthy subjects (p < 0.05).Conclusion:The clinical findings indicated that tinnitus patients had a higher mean platelet volume than the healthy control subjects; however, the pathophysiological mechanism remains unclear.

scholarly journals Right-sided lateralization of skin temperature in healthy young persons

2016 ◽  
Vol 39 (6) ◽  
pp. 121 ◽  
Author(s):  
Havva Demirel ◽  
Arzu Bahar ◽  
Nurcan Gokgoz ◽  
Muzeyyen Arslan ◽  
Senol Dane
Keyword(s):  
Lymph Node ◽  
Immune System ◽  
Skin Temperature ◽  
Healthy Subjects ◽  
The Body ◽  
Node Distribution ◽  
Significant Difference ◽  
Close Relationship ◽  
The Right ◽  
Relationship Of

Purpose: Previous studies reported a peripheral immune asymmetry and lateralization of different paired organ cancers. Because of the close relationship of immune system with body temperature, the aim of the study was to test the possible lateralization of skin temperature. Materials and Methods: Four hundred sixty three healthy subjects (325 women, 138 men) with an average age of 23.62 years (SD = 8.65) participated in this study. All skin temperature measurements were done 8:00-9:00 a.m. Skin temperature was assessed for three different points in skin: axillary, thumb and external auditory. Results: Skin temperature was statistically significantly higher on the right side of the body than on the left side, when measured by axillary and thumb temperatures. But there was no statistically significant difference in external auditory temperature. Conclusion: The asymmetry of skin temperature may result from the peripheral immune asymmetry or the asymmetric lymph node distribution.

scholarly journals Location of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Zone III Using External Landmark Without Fluoroscopy: A CTA-based Retrospective Study

2020 ◽  
Author(s):  
Danlei Weng ◽  
Anyu Qian ◽  
Qijing Zhou ◽  
Jiefeng Xu ◽  
Shanxiang Xu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Average Length ◽  
Safety Margin ◽  
Balloon Occlusion ◽  
University Hospital ◽  
Xiphoid Process ◽  
Significant Difference ◽  
The Right ◽  
External Landmark ◽  
Endovascular Balloon Occlusion

Abstract Background Resuscitative endovascular balloon occlusion of the aorta (REBOA) can timely prevent the wounded from massive hemorrhage. We aim to study whether the combination of the xiphoid process and the umbilicus could guide the placement of REBOA in zone III without fluoroscopy. Methods We conducted a retrospective study in a university hospital that included 57 subjects who underwent contrast-enhanced computed tomography (CT) from April to December in 2019. External distances and intravascular lengths were measured by three-dimensional reconstruction CT images on the workstation, including the distances from the femoral artery to the xiphoid process (FA-Xi), the midpoint between the xiphoid process and the umbilicus (FA-mXU), the umbilicus (FA-Ui), the midpoint of the zone III (FA-mZIII), the lowest renal artery (FA-LRA), and aortic bifurcation (FA-AB). The relationship between external landmarks and REBOA catheter positioning in zone III was studied, involving the quartering distances between the xiphoid process and the umbilicus, the distance below the xiphoid process and that above the umbilicus. The predicted accuracy and safety margin of the balloon (distal and proximal) were calculated by curvature plane reconstruction. The probability of balloon positioning in zone III using these three methods was compared by Chi square test. Results The average length of aortic zone III was 9.4 cm (SD = 10.0), and that of FA-mZIII on the right and left sides were 24.4 cm (SD = 2.1) ,23.8 cm (SD = 2.1), respectively. FA-Xi was significantly longer than FA-LRA, and FA-Ui was significantly shorter than FA-AB (P < 0.05). Using the quartering distances between the xiphoid and the umbilicus, the distance below the xiphoid, the distance above the umbilicus to predict the length of REBOA catheter positioning in zone III showed no statistically significant difference. Using FA-mXU to predict the accuracy of catheter positioning in zone III on the left and right sides were 84.2% and 86%. Although there was a little difference between the left side of FA-mZIII and FA-mXU, there were no statistical differences on the right side. Conclusions The midpoint between the xiphoid process and the umbilicus is a good external landmark to guide the placement of REBOA in zone III without fluoroscopy.

scholarly journals Prevalence of vitamin D deficiency in a North London antenatal population

2011 ◽  
Vol 4 (3) ◽  
pp. 113-116 ◽  
Author(s):  
M Parisaei ◽  
A Govind ◽  
J Clements ◽  
P Arora ◽  
H Lashkari ◽  
...  
Keyword(s):  
Vitamin D ◽  
Prospective Study ◽  
Vitamin D Deficiency ◽  
Study Design ◽  
University Hospital ◽  
High Prevalence ◽  
A Prospective Study ◽  
North London

Objective We evaluated the prevalence of vitamin D deficiency in the antenatal patients attending North Middlesex University Hospital between March 2008 and March 2009. Study design A prospective study of maternal levels of vitamin D at booking. Results The prevalence of both deficient and insufficient levels of 25[OH]D was 87.6% across all included patients. Conclusion There is a high prevalence of asymptomatic vitamin D deficiency in the antenatal booking population.

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