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1.
Intern Med J ; 48(8): 924-930, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29663620

RESUMEN

AIM: To evaluate New Zealand media articles on their coverage of key issues regarding health interventions and whether it is consistent with available evidence. METHODS: A retrospective analysis was carried out of all articles published in five New Zealand media sources over a 6-week period between 15 October and 26 November 2014. Articles were included if their primary focus was on health interventions involving medications, devices or in-hospital procedures. Articles were assessed for coverage of key issues using previously validated 10-point criteria. A literature review was performed to compare content with scientific evidence. RESULTS: We identified 30 articles for review. Only 4 of 30 articles covered indications, benefits and risks, and of these, two were consistent with available evidence (7%, 95% CI 1%-22%). For articles that discussed at least one of indications, benefits or risks, and there was corresponding evidence available, there was a high level of consistency with the evidence (89%, 95% CI 77%-95%). The overall mean value of coverage from the 10-point criteria was 51% (95% CI 45%-58%). Single questions regarding the potential harm, costs associated with the intervention and the availability of alternative options were particularly poorly covered. They were rated as 'satisfactory' in 13%, 23% and 33% of the 30 articles respectively. CONCLUSION: New Zealand news articles covering medical treatments and interventions are largely consistent with available evidence but are incomplete. Vital information is being consistently missed, especially around the potential harms and costs of medical interventions.


Asunto(s)
Intervención Médica Temprana/tendencias , Medios de Comunicación de Masas/tendencias , Intervención Médica Temprana/métodos , Intervención Médica Temprana/normas , Humanos , Medios de Comunicación de Masas/normas , Nueva Zelanda/epidemiología , Estudios Retrospectivos
2.
JAMA Otolaryngol Head Neck Surg ; 141(8): 757-60, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25996844

RESUMEN

IMPORTANCE: We report a new syndrome, which we are calling head-jolting nystagmus, that expands the differential diagnosis of head movement-induced paroxysmal vertigo. OBSERVATIONS: Two male patients (65 and 58 years old) described rotational vertigo after violent and brief (1- to 2-second) oscillations of the head (head jolting) that triggered intense horizontal nystagmus lasting 45 seconds. Accelerations of the head required to induce these episodes could only be achieved by the patients themselves. In case 1, the episodes gradually disappeared over a 6-year period. In case 2, magnetic resonance imaging (3-T) suggested a filling defect within the left horizontal semicircular canal. He underwent surgical canal plugging in March 2013 that resolved the symptoms. CONCLUSIONS AND RELEVANCE: We attribute head-jolting nystagmus to dislodged material within the horizontal semicircular canal and provide a mechanistic model to explain its origin.


Asunto(s)
Vértigo Posicional Paroxístico Benigno/diagnóstico , Movimientos de la Cabeza , Nistagmo Patológico/diagnóstico , Canales Semicirculares , Anciano , Vértigo Posicional Paroxístico Benigno/etiología , Humanos , Masculino , Persona de Mediana Edad , Nistagmo Patológico/etiología , Síndrome
3.
Brain ; 137(Pt 10): 2649-56, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25070514

RESUMEN

Cerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS) is a recently recognized neurodegenerative ganglionopathy. Prompted by the presence of symptomatic postural hypotension in two patients with CANVAS, we hypothesized that autonomic dysfunction may be an associated feature of the syndrome. We assessed symptoms of autonomic dysfunction and performed autonomic nervous system testing among 26 patients from New Zealand. After excluding three patients with diabetes mellitus, 83% had evidence of autonomic dysfunction; all patients had at least one autonomic symptom and 91% had more than two symptoms. We also found a higher rate of downbeat nystagmus (65%) than previously described in CANVAS. We confirmed that sensory findings on nerve conduction tests were consistent with a sensory ganglionopathy and describe two patients with loss of trigeminal sensation consistent with previous pathological descriptions of trigeminal sensory ganglionopathy. Our results suggest that autonomic dysfunction is a major feature of CANVAS. This has implications for the management of patients with CANVAS as the autonomic symptoms may be amenable to treatment. The findings also provide an important differential diagnosis from multiple system atrophy for patients who present with ataxia and autonomic failure.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Ataxia Cerebelosa/fisiopatología , Enfermedades del Sistema Nervioso Periférico/fisiopatología , Enfermedades Vestibulares/fisiopatología , Adolescente , Adulto , Edad de Inicio , Anciano , Anciano de 80 o más Años , Enfermedades del Sistema Nervioso Autónomo/complicaciones , Ataxia Cerebelosa/complicaciones , Mareo/fisiopatología , Femenino , Fuerza de la Mano/fisiología , Frecuencia Cardíaca/fisiología , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Examen Neurológico , Nueva Zelanda , Nistagmo Patológico/etiología , Nistagmo Patológico/fisiopatología , Enfermedades del Sistema Nervioso Periférico/complicaciones , Reflejo Vestibuloocular/fisiología , Síndrome , Maniobra de Valsalva , Enfermedades Vestibulares/etiología , Pruebas de Función Vestibular , Vitamina E/sangre , Adulto Joven
4.
J Clin Neurosci ; 19(7): 1042-4, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-22551585

RESUMEN

Reading epilepsy is a rare type of reflex epilepsy. The seizures often comprise facial twitching and alexia, but can be difficult to recognise and mistaken for non-epileptic events. Previous reports have identified reading of printed text, television and computer screens as inducing seizures, but hand-held digital media have not been implicated. We report a 44-year-old woman with difficulty using the text message function of her mobile phone with a long background of unrecognised reading-induced seizures.


Asunto(s)
Teléfono Celular , Epilepsia Refleja/fisiopatología , Convulsiones/etiología , Envío de Mensajes de Texto , Adulto , Electroencefalografía , Femenino , Humanos
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