Effect of angioplasty and stent placement on sensorineural hearing loss and pulsatile tinnitus in a patient with severe internal carotid artery stenosis.

BACKGROUND: Pulsatile tinnitus occurs due to turbulent blood flow through a stenotic vessel including the internal carotid artery. The presence of sensorineural hearing loss suggests involvement of the posterior circulation vasculature. CLINICAL PRESENTATION: A 58-year-old woman presented to the ear, nose and throat clinic with acute onset of right ear pulsations and high-pitched tinnitus. An audiogram demonstrated mild sensorineural hearing loss in the right ear. Her computed tomography angiogram revealed moderate stenosis of the right internal carotid artery and she underwent revascularization with angioplasty and stent placement. A repeat audiogram demonstrated improvement in sensorineural hearing loss in the right. CONCLUSION: Pulsatile tinnitus and unilateral sensorineural hearing loss maybe a reversible manifestation of a stenotic internal carotid artery.

"Just not all ice users do that": investigating perceptions and potential harms of Australia's Ice Destroys Lives campaign in two studies.

BACKGROUND: In 2015, the Australian government launched the media campaign Ice Destroys Lives targeting crystal methamphetamine use. Previous research indicates mass media campaigns may have harmful effects for people engaged in drug use. This study investigated perceptions and harms of Ice Destroys Lives among adults with a history of injecting drugs and young people. METHODS: This analysis includes data from two studies: an online questionnaire with young people and in-depth interviews with adults who use crystal methamphetamine. Young people from Victoria, Australia, were recruited through Facebook. We collected data on drug use, campaign recognition and behaviours. Participants who recognised the campaign indicated whether they agreed with five statements related to Ice Destroys Lives. We compared campaign perceptions between young people who reported ever using crystal methamphetamine and those who did not. Adults who use crystal methamphetamine were sampled from the Melbourne injecting drug user cohort study. We asked participants if they recognised the campaign and whether it represented their experiences. RESULTS: One thousand twenty-nine young people completed the questionnaire; 71% were female, 4% had used crystal methamphetamine and 69% recognised Ice Destroys Lives. Three quarters agreed the campaign made them not want to use ice. Ever using crystal methamphetamine was associated with disagreeing with three statements including this campaign makes you not want to use ice (adjusted odds ratio (AOR) = 4.3, confidence interval (CI) = 1.8-10.0), this campaign accurately portrays the risks of ice use (AOR = 3.2, CI = 1.4-7.6) and this campaign makes you think that people who use ice are dangerous (AOR = 6.6, CI = 2.2-19.8). We interviewed 14 people who used crystal methamphetamine; most were male, aged 29-39 years, and most recognised the campaign. Participants believed Ice Destroys Lives misrepresented their experiences and exaggerated "the nasty side" of drug use. Participants felt the campaign exacerbated negative labels and portrayed people who use crystal methamphetamine as "violent" and "crazy". CONCLUSION: In our study, Ice Destroys Lives was widely recognised and delivered a prevention message to young people. However, for people with a history of crystal methamphetamine use, the campaign also reinforced negative stereotypes and did not encourage help seeking. Alternative evidence-based strategies are required to reduce crystal methamphetamine-related harms.

Enhancement of auricular composite graft survival with hyperbaric oxygen therapy.

OBJECTIVE: To continue investigation regarding the efficacy of hyperbaric oxygen (HBO) therapy in improving survival of reattached auricular composite grafts. DESIGN: A prospective, randomized, double-blind study using 20 New Zealand albino rabbits randomized to a treatment or control group. The treatment group received 30 HBO treatments over 19 days following amputation and reattachment of composite auricular grafts. The control group received standard care. Ears were examined grossly and microscopically on postoperative day 21 to determine the percentage of graft survival. RESULTS: The mean percentage of graft survival for the 2 separate grafts (a larger 1.5 x 4.0-cm and a smaller 1.0 x 3.0-cm graft) in the treatment group was 26.5% and 27.9%, respectively. The mean percentage of graft survival for the larger and smaller graft in the control group was 9.7% and 14.0%, respectively. An analysis of variance test was used to evaluate this difference, which was found to be statistically significant (P =.001). CONCLUSIONS: This study represents a continued investigation following a pilot study, which suggested some enhancement of composite graft survival with the use of HBO therapy in the rabbit ear. Both experiments have demonstrated a slight survival benefit using HBO therapy in auricular composite grafts in the rabbit model.