scholarly journals The Relationship Between Paroxysmal Vertigoes and Right-To-Left Shunt: A Large Observational Study

Author(s):  
Kaiming Liu ◽  
Xiulin Tian ◽  
Wenwu Hong ◽  
Yujin Xiao ◽  
Juanyan Chen ◽  
...  

Abstract Background The association between paroxysmal vertigo and right-to-left shunt (RLS) is rarely reported. We investigated the incidence and correlation of RLS in patients with different paroxysmal vertigo diseases. Methods This large observational study included patients with paroxysmal vertigo from seven different hospitals in China from 2017 to 2021 (NCT04939922). Migraine patients within the same period were included for comparison. Demographic data and medical history were collected, contrast transthoracic echocardiography (cTTE) was performed, and the clinical features, dizziness handicap inventory, and incidence of RLS in each group were recorded. Results This study used a consecutive sampling of 4536 patients from seven centres, and a total of 2751 patients were enrolled. The proportion of RLS in patients with migraine with aura (MA), migraine without aura (MoA), vestibular migraine (VM) with headache, VM without headache, and benign recurrent vertigo (BRV) was significantly higher than that in patients with benign paroxysmal positional vertigo (BPPV), Meniere’s disease (MD), and vestibular paroxysmia (VP) (P<0.05). There was no statistical difference between the frequency of RLS in patients with BRV and those with MoA (P=0.931), MA (P=0.997), VM with migrainous headache (P=0.787), and VM without migrainous headache (P=0.754). There was a positive correlation between the RLS grade and the dizziness handicap inventory scores of VM and BRV patients (P<0.01). Conclusions RLS was significantly associated with BRV and VM. RLS may be involved in the pathogeneses of BRV and VM and may serve as a reference index for the differential diagnosis of central and peripheral vertigo. Trial registration: CHRS, NCT04939922, registered 14 June 2021- retrospectively registered, https://register.clinicaltrials.gov

2013 ◽  
Vol 4 (4) ◽  
pp. 233-240 ◽  
Author(s):  
Wenche Iglebekk ◽  
Carsten Tjell ◽  
Peter Borenstein

AbstractBackground and aimA diagnosis of chronic benign paroxysmal positional vertigo (BPPV) is based on brief attacks of rotatory vertigo and concomitant nystagmus elicited by rapid changes in head position relative to gravity. However, the clinical course of BPPV may vary considerably from a self-limiting to a persisting and/or recurrent disabling problem. The authors’ experience is that the most common complaints of patients with chronic BPPV are nautical vertigo or dizziness with other symptoms including neck pain, headache, widespread musculoskeletal pain, fatigue, and visual disturbances. Trauma is believed to be the major cause of BPPV in individuals younger than fifty years. Chronic BPPV is associated with high morbidity. Since these patients often suffer from pain and do not have rotatory vertigo, their symptoms are often attributed to other conditions. The aim of this study was to investigate possible associations between these symptoms and chronic BPPV.MethodsDuring 2010 a consecutive prospective cohort observational study was performed. Diagnostic criteria: (A) BPPV diagnosis confirmed by the following: (1) a specific history of vertigo/dizziness evoked by acceleration/deceleration, (2) nystagmus in the first position of otolith repositioning maneuvers, and (3) appearing and disappearing nystagmus during the repositioning maneuvers; (B) the disorder has persisted for at least six months. (C) Normal MRI of the cerebrum. Exclusion criteria: (A) Any disorder of the central nervous system (CNS), (B) migraine, (C) active Ménière’s disease, and (D) severe eye disorders. Symptom questionnaire (‘yes or no’ answers during a personal interview) and Dizziness Handicap Inventory (DHI) were used.ResultsWe included 69 patients (20 males and 49 females) with a median age of 45 years (range 21-68 years). The median duration of the disease was five years and three months. The video-oculography confirmed BPPV in more than one semicircular canal in all patients. In 15% there was a latency of more than 1 min before nystagmus occurred. The Dizziness Handicap Inventory (DHI) median score was 55.5 (score >60 indicates a risk of fall). Seventy-five percent were on 50-100% sick leave. Eighty-one percent had a history of head or neck trauma. Nineteen percent could not recall any history of trauma. In our cohort, nautical vertigo and dizziness (81%) was far more common than rotatory vertigo (20%). The majority of patients (87%) reported pain as a major symptom: neck pain (87%), headache (75%) and widespread pain (40%). Fatigue (85%), visual disturbances (84%), and decreased concentration ability (81%) were the most frequently reported symptoms. In addition, unexpected findings such as involuntary movements of the extremities, face, neck or torso were found during otolith repositioning maneuvers (12%). We describe one case, as an example, how treatment of his BPPV also resolved his chronic, severe pain condition.ConclusionThis observational study demonstrates a likely connection between chronic BPPV and the following symptoms: nautical vertigo/dizziness, neck pain, headache, widespread pain, fatigue, visual disturbances, cognitive dysfunctions, nausea, and tinnitus.ImplicationsPatients with complex pain conditions associated with nautical vertigo and dizziness should be evaluated with the Dizziness Handicap Inventory (DHI)-questionnaire which can identify treatable balance disorders in patients with chronic musculoskeletal pain.


2012 ◽  
Vol 32 (S 01) ◽  
pp. S39-S42 ◽  
Author(s):  
S. Kocher ◽  
G. Asmelash ◽  
V. Makki ◽  
S. Müller ◽  
S. Krekeler ◽  
...  

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1345-P
Author(s):  
JING WANG ◽  
LEISHEN WANG ◽  
SHUANG ZHANG ◽  
HUIKUN LIU ◽  
JUNHONG LENG ◽  
...  

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1433-P
Author(s):  
YUN SHEN ◽  
PENG WANG ◽  
LEISHEN WANG ◽  
SHUANG ZHANG ◽  
HUIKUN LIU ◽  
...  

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 594
Author(s):  
Teshome Sirak Bedaso ◽  
Buxin Han

This study aimed to examine attitude toward aging as a potential mediator of the relationship between personality factors and mental health in terms of depression and life satisfaction among older adults. A cross-sectional study was conducted with 438 Ethiopian elderly individuals aged 60 to 69. The results of the regression-based path analysis showed that after adjusting for demographic data, the relationship between agreeableness and depression in older adults was partially mediated by attitude toward aging. Likewise, attitude toward physical change due to aging and psychological growth subscales jointly mediated the correlation between neuroticism and depression. However, a significant direct path between neuroticism and depression persisted. On the contrary, openness had no significant direct association with depression apart from an indirect through psychosocial loss. The link between life satisfaction and agreeableness as well as openness to experience were partially mediated by psychosocial loss. Therefore, a person’s attitude toward aging and personality characteristics should be taken into consideration while designing interventions for managing mental health issues among older adults.


Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 936
Author(s):  
Milan Kojić ◽  
Branka Protić Gava ◽  
Milan Bajin ◽  
Marko Vasiljević ◽  
Jasmina Bašić ◽  
...  

Background: The research objective of the study is to determine the differences in the manifestation of the motor status of normally fed preschool test subjects, classified into groups according to foot status. Methods: This is a simple, comparative observational study. Preschool children included in this study have been subjected to anthropometric measurements in order to determine BMI, tests for motor skills assessment (running at 20 m from a high start, standing broad jump, backwards polygon, rectangular seated forward bend, plate tapping, sit-ups for 60 s, and bent arm hang), and a determination of foot status. The total sample was comprised of 202 test subjects who attended a regular sports program, aged 3.9 to 6.5 years of decimal age (M = 141; Age = 5.3 ± 0.74; Height = 117.3 ± 7.1; Weight = 22 ± 3.7; F = 61; Age = 5.1 ± 0.73; Height = 114.9 ± 7.4; Weight = 21.2 ± 3.8), of which 153 (75.7%) were normally fed, 6 (3%) were undernourished, 30 were overweight (14.9%), and 13 were obese (6.4%). Results: In the total sample, 30 (14.9%) subjects had normal arch feet, 90 (44.6%) high arched feet, and 41 (20.3%) flat feet. We found 41 (20.3%) subjects who had different left and right foot statuses within this sample. The data were processed by means of nonparametric tests (the Kruskal–Wallis and Mann–Whitney U tests) at a significance level p ≤ 0.05. Conclusion: The results show that there is a statistically significant difference between groups of subjects with different foot statuses in the manifestation of motor status in most tests, with a significance level of p ≤ 0.01, and in tests of sit-ups for 60 s and the bent arm hang, there is a statistically significant difference, the level of which is p ≤ 0.05. It is only in the inclination test of rectangular seated forward bend that no statistically significant difference was displayed.


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