Does stapes surgery improve tinnitus in patients with otosclerosis? / A estapedotomia melhora o zumbido em pacientes com otosclerose?

Abstract Introduction: Otosclerosis (OS) is the primary disease of the human temporal bone characterized by conductive hearing loss and tinnitus. The exact pathogenesis of tinnitus in otosclerosis patients is not known and factors affecting the tinnitus outcome in otosclerosis patients are still controversial. Objectives: To find the effect of stapedotomy on tinnitus for otosclerosis patients. Methods: Fifty-six otosclerosis patients with preoperative tinnitus were enrolled to the study. Pure tone average Air-Bone Gap values, preoperative tinnitus pitch, Air-Bone Gap closure at tinnitus frequencies were evaluated for their effect on the postoperative outcome. Results: Low pitch tinnitus had more favorable outcome compared to high pitch tinnitus (p = 0.002). Postoperative average pure tone thresholds Air-Bone Gap values were not related to the postoperative tinnitus (p = 0.213). There was no statistically significant difference between postoperative Air-Bone Gap closure at tinnitus frequency and improvement of high pitch tinnitus (p = 0.427). There was a statistically significant difference between Air-Bone Gap improvement in tinnitus frequency and low pitch tinnitus recovery (p = 0.026). Conclusion: Low pitch tinnitus is more likely to be resolved after stapedotomy for patients with otosclerosis. High pitch tinnitus may not resolve even after closure of the Air-Bone Gap at tinnitus frequencies.

Resumo Introdução: Otosclerose (OS) é a principal doença do osso temporal humano caracterizada por perda auditiva condutiva e zumbido. A patogenia exata do zumbido em pacientes com otosclerose não é conhecida e fatores que afetam o desfecho de zumbido em pacientes com otosclerose ainda são controversos. Objetivos: Encontrar o efeito da estapedotomia sobre o zumbido em pacientes com otosclerose. Método: Foram incluídos no estudo 56 pacientes com otosclerose com zumbido pré-operatório. Os valores médios tonais do gap aero-ósseo, o tom de zumbido no pré-operatório, o fechamento do gap nas frequências dos zumbidos foram avaliados quanto ao seu efeito sobre o desfecho pós-operatório. Resultados: O zumbido em tom grave teve desfecho mais favorável em comparação com o zumbido agudo (p = 0,002). Os valores médios dos gaps pós-operatórios não foram relacionados com o zumbido pós-operatório (p = 0,213). Não houve diferença estatisticamente significativa entre o fechamento pós-operatório do gap na frequência do zumbido e melhoria do zumbido de tom agudo (p = 0,427). Houve diferença estatisticamente significativa entre a melhoria no gap nas frequências do zumbido e recuperação do zumbido de tom mais grave (p = 0,026). Conclusão: O zumbido de tom mais grave parece ser mais bem resolvido depois de estapedotomia em pacientes com otosclerose. O zumbido de tom agudo pode não desaparecer, mesmo após o fechamento do gap nas frequências do zumbido.

Does stapes surgery improve tinnitus in patients with otosclerosis?

INTRODUCTION: Otosclerosis (OS) is the primary disease of the human temporal bone characterized by conductive hearing loss and tinnitus. The exact pathogenesis of tinnitus in otosclerosis patients is not known and factors affecting the tinnitus outcome in otosclerosis patients are still controversial. OBJECTIVES: To find the effect of stapedotomy on tinnitus for otosclerosis patients. METHODS: Fifty-six otosclerosis patients with preoperative tinnitus were enrolled to the study. Pure tone average Air-Bone Gap values, preoperative tinnitus pitch, Air-Bone Gap closure at tinnitus frequencies were evaluated for their effect on the postoperative outcome. RESULTS: Low pitch tinnitus had more favorable outcome compared to high pitch tinnitus (p=0.002). Postoperative average pure tone thresholds Air-Bone Gap values were not related to the postoperative tinnitus (p=0.213). There was no statistically significant difference between postoperative Air-Bone Gap closure at tinnitus frequency and improvement of high pitch tinnitus (p=0.427). There was a statistically significant difference between Air-Bone Gap improvement in tinnitus frequency and low pitch tinnitus recovery (p=0.026). CONCLUSION: Low pitch tinnitus is more likely to be resolved after stapedotomy for patients with otosclerosis. High pitch tinnitus may not resolve even after closure of the Air-Bone Gap at tinnitus frequencies.

Retrospective analysis of poisoning cases admitted to the emergency medicine.

BACKGROUND: We aimed herein to assess demographic, etiological, and clinical characteristics of patients presenting to our hospital's emergency department with acute poisoning. METHOD: This study included a total of 509 (0.27%) patients diagnosed with poisoning at our emergency department within a 3-year period. This was a retrospective study.  RESULTS: Seventy-one point three (n = 363) percent of the patients were female. The majority of the victims were in the 18-25 years age group (P < 0.001). The poisoning incident was for suicidal purposes in 83.7% of patients. Among the patients presenting with prescription drug poisoning, 92.9% were poisoned in a suicide attempt while 73.2% of patients presenting with poisoning with non-medical substances were poisoned accidentally. Suicidal poisonings were more common in young age group and females (P < 0.001). The most common poisoning agent was antidepressants (17.6%) followed by analgesics (12.8%), and other psychotropic drugs (6.1%). Antidepressant drugs were the most common prescription drugs taken for suicidal purposes (P < 0.001). Poisonings occurred with a single agent in 72.5% of cases and with two or more agents in 27.5% of cases.  Analysis of duration of hospital stay revealed that 52.6% (n = 60) of patients stayed in hospital for 2 days. The mortality rate was 0.4%. CONCLUSION: The majority of poisonings were with prescription drugs, for suicidal purposes, in young age group, and in females. In our study, the three most common agents causing poisoning were antidepressants, analgesics, and other psychotropic substances.

Retrospective analysis of whole-body multislice computed tomography findings taken in trauma patients.

OBJECTIVES: Using whole-body multislice computed tomography (MSCT) excessively or with irrelevant indications can be seen in many centers. The aim of this study was to analyze retrospectively the MSCT findings in trauma patients admitted to the emergency department. METHODS: Records of the patients who have applied to the emergency department due to blunt trauma in a 12 month period and whose whole body MSCT images have been taken, were evaluated using the "Nucleus Medical Information System". RESULTS: The most frequent type of trauma was traffic accidents in 61.4%, falling down from the height in 22.4%, and motorcycle accidents in 11.4% of patients. Of the patients, 25.2% were discharged from the emergency, while 73.8% were hospitalized. At least one CT findings associated with trauma was present in 61.4% of our patients. Pathological findings in MSCT were most frequently detected in the head and face (35.3%) and thoracic (28.6%) regions, respectively. The most common finding in the head and face region was fractures. The most common pathological findings in the thoracic region were pulmonary contusion and rib fractures. A significant relationship was detected between trauma type and spinal MSCT result (p < 0.001). In a large percentage of the patients, MSCT findings were normal in the abdominal region and genitourinary system. Vertebral fractures were most frequently detected in the thoracolumbar region. CONCLUSIONS: In our study, our rate of negative CT was found to be 38.6%, which is a higher ratio compared to other studies conducte on this topic.

[The relationship between epicardial adipose tissue and endothelial dysfunction in patients with type 2 diabetes mellitus]. / Tip 2 diyabetli hastalarda epikart yag yastikçigi ile endotel fonksiyon bozuklugunun iliskisi.

OBJECTIVES: Epicardial adipose tissue (EAT) has been shown to be related to cardiovascular risk. The aim of the present study was to investigate the relationship between EAT and endothelial function in patients with type 2 diabetes mellitus (DM). STUDY DESIGN: Type 2 DM patients were divided into two groups according to their brachial flow-mediated dilatation (FMD) values. The endothelial dysfunction (ED) group consisted of 46 patients with FMD change of <7%, while 46 patients with FMD change of >7% were accepted as the non-ED group. EAT thickness was measured on the right ventricular free wall from the transthoracic echocardiographic parasternal long- and short-axis views. The patients' demographic, anthropometric and laboratory findings were recorded. RESULTS: The mean diameter of EAT was 8.0±1.8 cm in the ED group and 6.6±1.2 cm in the non-ED group (p<0.001). The HbA1c levels were significantly higher in the ED group than non-ED group (8.55 [7.30-9.80], 7.45 [6.50-9.30], respectively; p=0.042). There were a negative correlation between FMD values and EAT (r=-0.437, p<0.001). The FMD values were weakly and negatively correlated with DM duration and HbA1c levels (r=-0.216, p=0.038; r=-0.266, p=0.010, respectively). EAT thickness was strongly correlated with body mass index (BMI) and waist length (r=0.405, p<0.001; r=0.515, p<0.001, respectively). The neutrophil count was significantly higher in the ED group than in the non-ED group. In multivariate logistic regression analysis, HbA1c and EAT diameters were found as predictors of ED in type 2 DM (odds ratio (OR): 1.887, 95% confidence interval (CI): 1.298-2.743, p=0.001; OR: 1.485, 95% CI: 1.054-2.093). CONCLUSION: EAT thickness predicts ED in patients with type 2 DM.