scholarly journals Does acute sensorineural deafness befall to urgent conditions?

2009 ◽  
Vol 66 (1) ◽  
pp. 35-38
Author(s):  
Ljiljana Cvorovic ◽  
Dragoslava Djeric ◽  
Ljubomir Pavicevic ◽  
Rudolf Probst ◽  
Stefan Hegemann
Keyword(s):  
Hearing Loss ◽  
Sensorineural Deafness ◽  
Sudden Hearing Loss ◽  
University Hospital ◽  
Hearing Level ◽  
Controversial Issues ◽  
Significant Recovery ◽  
Hearing Gain ◽  
Significant Difference ◽  
The University

Background/Aim. Idiopathic sudden sensorineural hearing loss (ISSHL) is one of the most controversial issues in otology. The aim of this study was to determine whether a delay in treatment has any influence on hearing recovery in ISSHL. Method. This study was designed as a retrospective evaluation of an electronic patient data base of the University Hospital Z?rich from January 1995 to August 2006. Five hundred and forty one patients with a sudden hearing loss were identified. The standard treatment was carbogen inhalation (95% O2 and 5% CO2 eight times per day in the duration of 30 minutes) and prednisone orally (100 mg in one morning dose) for 7 days. Factor that was analyzed included the interval between the onset of symptoms and the beginning of the treatment. The initial hearing loss was described using the pure tone average (PTA in dB) hearing level at 4 frequencies (0.5, 1, 2 and 4 kHz). Hearing gain was expressed either as absolute hearing gain (dB values from initial PTA minus dB values from final PTA) or as relative hearing gain (absolute hearing gain divided by initial PTA minus baseline PTA) ? 100. Significant recovery of hearing was defined as the final PTA ? 30 dB (or same as PTA of the opposite ear). Results. An absolute hearing gain between the initial audiogram and the final audiogram was 15.1 dB. The mean relative hearing gain was 47%. Three hundred one (57%) patients had a significant recovery of hearing, and 228 (43%) had not. If the patients received treatment in the first 24 hours after onset of symptoms, then the rate of significant recovery was 56%, and no significant difference existed between this group and the patients who received the therapy after 24 hours, but within seven days (?2 = 0.007, DF = 1, p > 0.01). Conclusion. These results suggest that it is not critical to begin the treatment of ISSHL immediately as an emergency, but within seven days.

Audiometric Comparison of Lassa Fever Hearing Loss and Idiopathic Sudden Hearing Loss: Evidence for Viral Cause

1992 ◽  
Vol 106 (3) ◽  
pp. 226-229 ◽  
Author(s):  
Been S. Liao ◽  
Frederick M. Byl ◽  
Kedar K. Adour
Keyword(s):  
Immune Response ◽  
Hearing Loss ◽  
Clinical Course ◽  
Sensorineural Deafness ◽  
Sudden Hearing Loss ◽  
Lassa Fever ◽  
Significant Difference ◽  
Hearing Recovery ◽  
Viral Illness ◽  
Clinically Significant

A recently published prospective study on acute sensorineural deafness in Lassa fever among a West African population showed the audiometric pattern of a known virally induced hearing loss. Using the audiometric data from the patients with Lassa fever in that study, we analyzed and classified the initial hearing loss and final recovery into three groups by pure-tone average values and then did the same for 222 patients with idiopathic sudden hearing loss (SHL) in our study. Statistical analyses of the severity of initial hearing loss and the hearing recovery pattern indicate that the clinical course of our 222 patients with idiopathic SHL showed no statistically significant differences from the clinical course of the patients with Lassa fever. We found a marked difference in age, however, and a clinically significant difference in the incidence of bilateral hearing loss. In reviewing the literature on sudden sensorineural hearing loss, we found no apparent relation between severity of viral illness and initial hearing loss or subsequent recovery. Cummins et al. suggest that virally induced hearing loss in Lassa fever is linked to the host's immune response and not to the viremia. We thus propose a virally induced immune response mechanism for idiopathic sensorineural SHL. Further prospective studies are needed for verification.

scholarly journals Comparing the first and second waves of COVID-19 in a tertiary university hospital in Barcelona

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1197
Author(s):  
Yolima Cossio ◽  
Marta-Beatriz Aller ◽  
Maria José Abadias ◽  
Jose-Manuel Domínguez ◽  
Maria-Soledad Romea ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Healthcare Systems ◽  
University Hospital ◽  
Emergency Rooms ◽  
Daily Number ◽  
Patient Demographics ◽  
Significant Difference ◽  
The University ◽  
Hospital Wards ◽  
Second Wave

Background: Hospitals have constituted the limiting resource of the healthcare systems for the management of the COVID-19 pandemic. As the pandemic progressed, knowledge of the disease improved, and healthcare systems were expected to be more adapted to provide a more efficient response. The objective of this research was to compare the flow of COVID-19 patients in emergency rooms and hospital wards, between the pandemic's first and second waves at the University Hospital of Vall d’Hebron (Barcelona, Spain), and to compare the profiles, severity and mortality of COVID-19 patients between the two waves. Methods: A retrospective observational analysis of COVID-19 patients attending the hospital from February 24 to April 26, 2020 (first wave) and from July 24, 2020, to May 18, 2021 (second wave) was carried out. We analysed the data of the electronic medical records on patient demographics, comorbidity, severity, and mortality. Results: The daily number of COVID-19 patients entering the emergency rooms (ER) dropped by 65% during the second wave compared to the first wave. During the second wave, patients entering the ER were significantly younger (61 against 63 years old p<0.001) and less severely affected (39% against 48% with a triage level of resuscitation or emergency; p<0.001). ER mortality declined during the second wave (1% against 2%; p<0.000). The daily number of hospitalised COVID-19 patients dropped by 75% during the second wave. Those hospitalised during the second wave were more severely affected (20% against 10%; p<0.001) and were referred to the intensive care unit (ICU) more frequently (21% against 15%; p<0.001). Inpatient mortality showed no significant difference between the two waves. Conclusions: Changes in the flow, severity and mortality of COVID-19 patients entering this tertiary hospital during the two waves may reflect a better adaptation of the health care system and the improvement of knowledge on the disease.

Single Centre Experience in Patients with Primary Hyperparathyroidism: Sporadic, Lithium-associated and in Multiple Endocrine Neoplasia

2019 ◽  
Vol 128 (10) ◽  
pp. 693-698
Author(s):  
Sabine Dillenberger ◽  
Detlef K. Bartsch ◽  
Elisabeth Maurer ◽  
Peter Herbert Kann
Keyword(s):  
Primary Hyperparathyroidism ◽  
Multiple Endocrine Neoplasia ◽  
University Hospital ◽  
Primary Surgery ◽  
Endocrine Neoplasia ◽  
Single Centre Experience ◽  
Significant Difference ◽  
History Of ◽  
The University

Abstract Purpose It is assumed that primary hyperparathyroidism (pHPT) in Multiple Endocrine Neoplasia (MEN) and lithium-associated pHPT (LIHPT) are associated with multiple gland disease (MGD), persistence and recurrence. The studies purpose was to determine frequencies, clinical presentation and outcome of sporadic pHPT (spHPT), LIHPT and pHPT in MEN. Additional main outcome measures were the rates of MGD and persistence/recurrence. Methods Retrospective analysis of medical records of 682 patients with pHPT who had attended the University Hospital of Marburg between 01–01–2004 and 30–06–2013. All patients were sent a questionnaire asking about their history of lithium medication. Results Out of 682 patients, 557 underwent primary surgery (532 spHPT, 5 LIHPT, 20 MEN), 38 redo-surgery (31 spHPT, 7 MEN), 55 were in follow-up due to previous surgery (16 spHPT, 1 LIHPT, 38 MEN) and 37 were not operated (33 spHPT, 1 LIHPT, 3 MEN). Primary surgeries were successful in 97.4%, revealed singular adenomas in 92.4%, double adenomas in 2.9% and MGD in 3.4% of the cases. Rates of MGD in MEN1 (82.35%) were significantly higher than in spHPT (3.8%), while there was no significant difference between LIHPT (20%) and spHPT. Rates of persistence/recurrence did not significantly differ due to type of surgery (bilateral/unilateral) or type of HPT (spHPT/LIHPT/MEN). Conclusions History of lithium medication is rare among pHPT patients. While MGD is common in MEN1, rates of MGD, persistence or recurrence in LIHPT were not significantly higher than in spHPT.

Impact of prognostic factors on recovery from sudden hearing loss

2007 ◽  
Vol 121 (11) ◽  
pp. 1035-1040 ◽  
Author(s):  
A Ceylan ◽  
F Çelenk ◽  
Y K Kemaloğlu ◽  
Y A Bayazıt ◽  
N Göksu ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Prognostic Factors ◽  
Recovery Rate ◽  
Pure Tone ◽  
Degrees Of Freedom ◽  
Sudden Hearing Loss ◽  
Systemic Diseases ◽  
Speech Discrimination ◽  
Hearing Gain ◽  
Pre Treatment

AbstractObjective:To define the impact of patient-related and audiovestibular parameters on the prognosis of sudden hearing loss.Methods:Eighty-three patients were included in this retrospective study. All were treated medically. We recorded the patients' demographic parameters, systemic diseases, time elapsed between onset of sudden hearing loss and initiation of treatment, tinnitus, vestibular symptoms, type of initial audiogram, pure tone averages and speech discrimination scores. For all patients, audiological measurements were performed on initial admission and at the completion of treatment on the 10th day.Results:There was no correlation between the hearing gain and recovery rate scores and patients' gender or age (p>0.05). However, a correlation was found between gender and relative hearing gain. Vertigo was not correlated with hearing gain and recovery rate scores (p<0.05). However, relative hearing gain correlated negatively with the presence of vertigo (−r=0.05, 81 degrees of freedom,p=0.043). Patients with <40 dB hearing loss on admission showed a better relative hearing gain (r=0.55, 81 degrees of freedom,p=0.03). Relative hearing gain correlated positively with better pre-treatment speech discrimination scores (r=0.82, 81 degrees of freedom,p=0.009) and negatively with poorer pre-treatment pure tone averages (−r=0.082, 81 degrees of freedom,p=0.009). There was no correlation between the scores for hearing gain, relative hearing gain and recovery rate and: systemic diseases (p>0.05); time elapsed between onset of sudden hearing loss and initiation of treatment (p>0.05); type of audiogram on initial admission (p>0.05), except for midfrequency type of audiogram; and tinnitus (p>0.05).Conclusions:The outcome of sudden hearing loss was unaffected by systemic disease, tinnitus or type of audiogram (except for midfrequency type). The following were poor prognostic factors in the outcome of sudden hearing loss: female gender, presence of vertigo, initiation of treatment more than seven days after onset of hearing loss, and >40 dB hearing loss on admission.

scholarly journals Seasonal variability in the incidence of carcinomatous meningitis

2015 ◽  
Vol 122 (3) ◽  
pp. 543-546 ◽  
Author(s):  
Angelos Koutras ◽  
Minas Sakellakis ◽  
Thomas Makatsoris ◽  
Charalabia Psachoulia ◽  
Maria Kardari ◽  
...  
Keyword(s):  
Seasonal Variability ◽  
Warm Season ◽  
Cold Climate ◽  
University Hospital ◽  
Carcinomatous Meningitis ◽  
Warm Climate ◽  
Significant Difference ◽  
The University ◽  
Official Data ◽  
Median Interval

OBJECT The aim of the study was to investigate whether there are seasonal differences in the occurrence of carcinomatous meningitis (CM), with a greater prevalence of the disease in months with higher temperatures. METHODS The authors searched the records of all patients with a diagnosis of CM from 1998 until 2013 at the University Hospital of Patras, Greece. The date of hospitalization was extracted for each patient. The cases were divided into 2 categories depending on the time of CM diagnosis. Based on the official data regarding the annual temperature distribution in this region, the authors divided the patients into 2 groups. The first group consisted of cases diagnosed with CM from October 15 to April 15 (cold climate and shorter daytime duration), whereas the second group comprised patients diagnosed between April 15 and October 15 (warm climate and longer daytime duration). RESULTS Overall, 44 confirmed cases of CM were found. The most common type of malignancy associated with the development of CM was breast cancer (27 patients), while the second most common tumor was lung carcinoma (11 patients). The median interval between the time of initial cancer diagnosis and CM was 4.5 years. Thirty-one patients were diagnosed with CM during the period between April 15 and October 15, while the remaining 13 patients developed CM between October 15 and April 15, a significant difference (p = 0.01). CONCLUSIONS Significantly more patients developed CM during the warm season of the year. To the authors' knowledge, this is the first study to provide evidence for the potential seasonal variability in CM incidence. However, these results should be validated prospectively in larger cohorts.

scholarly journals Intra-abdominal hypertension in the ICU – a prospective epidemiological study

2015 ◽  
Vol 88 (2) ◽  
pp. 188-195 ◽  
Author(s):  
Georgi M. Arabadzhiev ◽  
Valentina G. Tzaneva ◽  
Katya G. Peeva
Keyword(s):  
Elective Surgery ◽  
Treatment Options ◽  
Point Of View ◽  
University Hospital ◽  
Abdominal Pressure ◽  
Medical Patients ◽  
Invasive Treatment ◽  
Abdominal Hypertension ◽  
Significant Difference ◽  
The University

The aim of this prospective study is to examine the frequency and the severity of intra-abdominal hypertension in a mixed ICU of the University hospital.Methods: A closed system for intravesical intermittent measurement of IAP was constructed.Results: The frequency and the severity of IAH were examined in the period from June 2009 to December 2012 in 240 ICU patients divided into 3 groups (patients submitted to elective surgery, emergency surgery, and medical patients) in the University Hospital. In the elective surgery group there was 12.5% IAH, while in the emergency group IAH was 43.75%, and in the medical patients it was 42.5%. There was no statistical significant difference in the frequency of IAH among the mixed population of patients we examined and those studied by other authors with the same type of population.Conclusions. The standardized measurement of intra-abdominal pressure is fundamental for defining intra-abdominal hypertension and abdominal compartment syndrome. The measurement of intra-abdominal pressure should be a part of the basic monitoring of patients at risk of intra-abdominal hypertension. Our point of view is that before there are indications for a surgical decompression, less invasive treatment options should be optimized.

scholarly journals Rhythms and prognosis of patients with cardiac arrest, emphasis on pseudo-pulseless electrical activity: another reason to use ultrasound in emergency rooms in Colombia

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
German Devia Jaramillo ◽  
Norberto Navarrete Aldana ◽  
Zaira Rojas Ortiz
Keyword(s):  
Cardiac Arrest ◽  
Electrical Activity ◽  
Cardiac Activity ◽  
Pulseless Electrical Activity ◽  
Cardiac Arrest Patient ◽  
University Hospital ◽  
Bedside Ultrasound ◽  
Emergency Rooms ◽  
Significant Difference ◽  
The University

Abstract Background The cardiac arrest is still an emergency with a bad prognosis. The growing adoption of bedside ultrasound allowed to classify PEA in two groups: the true PEA and the pseudo-PEA. pPEA is used to describe a patient who has a supposed PEA in the absence of pulse, with evidence of some cardiac activity on the bedside ultrasound. Objective This work aims to assess the bedside ultrasound use as a predictor for ROSC and survival at discharge in cardiac arrest patients and compare the pseudo-pulseless electrical activity to other cardiac arrest rhythms, including shockable rhythms. Materials and methods This is an observational, historic cohort study carried out in the emergency room of the University Hospital Mayor Méderi. Data were collected from all the adult patients treated for cardiac arrest from June 2018 to 2019. An ultrasound was performed to every cardiac arrest patient. Results Of a total of 108 patients, the median of the age was 71 years, 65.8% were male subjects, and the most frequent cause for cardiac arrest was the cardiogenic shock (32.4%). ROSC was observed in 41 cases (37.9%) and survival at discharge was 18 cases (16.7%). VF/VT and pPEA were the two rhythms that showed the highest ROSC and survival at discharge. For the pPEA group, we were able to conclude that the cardiac activity type is related to ROSC. Conclusion There is a significant difference for ROSC and survival at discharge prognosis among the cardiac arrest rhythms, with better outcomes for VF/VT and pPEA. Among patients with PEA, a routine ultrasound assessment is recommended. The type of cardiac activity recorded during the ultrasound of the cardiac arrest patient might be related to the ROSC and survival at discharge prognosis.

Effectiveness of hyperbaric oxygen therapy in idiopathic sudden hearing loss

2006 ◽  
Vol 120 (8) ◽  
pp. 665-669 ◽  
Author(s):  
B Satar ◽  
Y Hidir ◽  
S Yetiser
Keyword(s):  
Hearing Loss ◽  
Hyperbaric Oxygen ◽  
Pure Tone ◽  
Sudden Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Improvement Rate ◽  
Hearing Gain ◽  
Pure Tone Average ◽  
Number Of Patients ◽  
Age Stratification

The aim of this study was to investigate the efficacy of hyperbaric oxygen (HBO) therapy in idiopathic sudden sensorineural hearing loss (ISSHL) by comparing hearing gain and improvement rate in patients who have been placed on both HBO and medical treatment (MT) (37 patients), and patients who have received MT only (17 patients). Both groups were compared with reference to pure tone average (PTA) and the number of patients who experienced hearing gain. Of 37 patients (40 ears) who received HBO + MT, 24 (60 per cent) experienced ≥ 10 decibels (dB) improvement in PTA compared to 13 (76.4 per cent) of 17 patients who were placed on MT only. Inter- or intra-group comparison of age stratification (<50 and ≥50 ages) did not produce significant differences in PTA and in the number of patients who experienced hearing gain.Although there are numerous studies showing efficacy of HBO therapy; this study did not reveal a trend in favour of HBO therapy.

scholarly journals Influence of Gender in Selecting Fixed and Removable Prosthesis

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 268-272
Author(s):  
Abigail Ranasinghe ◽  
Keerthi Sasanka ◽  
Raghu Sandhya
Keyword(s):  
Tooth Loss ◽  
University Hospital ◽  
Negative Effects ◽  
Chi Square ◽  
Fixed Partial Denture ◽  
Masticatory Efficiency ◽  
Significant Difference ◽  
Removable Prosthesis ◽  
Chi Square Test ◽  
The University

Tooth loss is a common dental problem. Impairment of oral functions and masticatory efficiency is a result of tooth loss. The negative effects of tooth loss can be managed by the fixed and removable prosthesis. This study was conducted to determine the influence of gender in selecting prosthesis. This study was a retrospective observational study conducted in a university hospital in Chennai. Data collection was done with the help of the electronic dental record of the university- Dental information archiving software (DIAS). It records all patients data from initial visit to last visit chronologically. This was followed by Excel tabulation. Data was analysed using SPSS Software. The association of study variables was calculated using the Chi-Square test. Within the limits of the study, female patients were willing for replacement of teeth than male patients (55%). There was a significant difference in choosing the type of prosthetic treatment. It was seen that fixed partial denture was chosen over removable prosthesis (59.8%).

scholarly journals Incidence, characteristics and prognosis of different cardiac etiologies underlying cardiac syncope

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Lopez Ayala ◽  
D Flores ◽  
T Zimmermann ◽  
J Du Fay De Lavallaz ◽  
T Nestelberger ◽  
...  
Keyword(s):  
Cardiac Disease ◽  
Vasovagal Syncope ◽  
University Hospital ◽  
Funding Source ◽  
Cardiac Syncope ◽  
Significant Difference ◽  
Structural Disease ◽  
The University ◽  
Long Term Mortality

Abstract Background Cardiac syncope has been shown to carry the highest hazard for all-cause death compared to other causes of syncope including vasovagal and orthostatic syncope. However, little is known about the incidence, characteristics and prognosis of different cardiac etiologies underlying cardiac syncope. Purpose To evaluate the incidence, characteristics and prognosis of different cardiac etiologies underlying cardiac syncope. Methods We enrolled patients presenting to the emergency department (ED) with syncope in a large prospective international multicentre study. The cause of syncope (cardiac vs non-cardiac) including the detailed cardiac aetiology (if cardiac) was centrally adjudicated by two independent cardiologists based on detailed in-hospital as well as outpatient cardiac work-up during 360 days following presentation. Cardiac syncope was classified into four groups: bradyarrhythmia, tachyarrhythmia, structural disease and other (cardiopulmonary and great vessels), as recommended in the ESC Syncope Guidelines. All-cause death during 2-years follow-up was the primary outcome. Results Among 2025 patients presenting with syncope to the ED, cardiac syncope was the final adjudicated diagnoses in 318 (15.7%) patients. The incidence rate of all-cause death among cardiac syncope patients was 103 cases per 1000 person-years. Bradyarrhythmia was the most frequent primary cause of cardiac syncope (n=146, 45.9%) followed by tachyarrhythmia (n=75, 23.6%), structural disease (n=64, 20.1%) and other cardiac (n=26, 8.2%). Patients were 37% female with a median age of 77 years (IQR 67–83) showing no statistically significant difference between subgroups. Clinical characteristics differed significantly among the four subgroups. E.g. syncope occurred during exercise in 12 patients (8.2%) with bradyarrhythmia, 10 patients (13.3%) with tachyarrhythmia, 16 patients (25%) with structural disease, and 5 patients (19%) with other cardiac (p&lt;0.01). Likely of most importance, long-term mortality differed significantly among the four different cardiac subgroups. The multivariable-adjusted hazard ratios (HR) among patients with bradyarrhythmia, tachyarrhythmia, structural disease and other cardiac as compared to patients with vasovagal syncope, the HR were 1.3 (95% CI 0.7–2.5), 4.6 (95% CI 2.3–9.1), 3.1 (95% CI 1.5–6.4) and 5.9 (95% CI 2.3–15.2), respectively (Figure 1). Conclusions Bradyarrhythmia, tachyarrhythmia, and structural cardiac disease are the dominant causes of cardiac syncope. Interestingly, with the appropriate therapy initiated long-term mortality of bradyarrhythmia is comparable to that of vasovagal syncope, while long-term mortality of tachyarrhythmia and structural cardiac disease were substantially increased 3 to 5 fold. Figure 1. Kaplan-Meier curve Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Swiss National Science Foundation, the Swiss Heart Foundation, the Stiftung für kardiovaskuläre Forschung Basel, the University of Basel and the University Hospital Basel.

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