Propranolol and venlafaxine for vestibular migraine prophylaxis: A randomized controlled trial.

OBJECTIVES/HYPOTHESIS: We compared the effectiveness of venlafaxine and propranolol for the prophylaxis of vestibular migraine (VM). STUDY DESIGN: Prospective, randomized, controlled clinical trial. METHODS: Sixty-four subjects with definite VM were enrolled. The subjects were randomly assigned to receive propranolol (group P, n = 33) or venlafaxine (group V, n = 31) for VM prophylaxis. Dizziness Handicap Inventory (DHI) scores, the Vertigo Severity Score (VSS), and the number of vertiginous attacks were recorded before and 4 months after treatment. The Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) scores were also recorded to monitor the resolution of psychiatric symptoms. RESULTS: At 4 months after treatment, the DHI total score decreased from 55.8 ± 2.7 to 31.3 ± 3.7 and from 50.9 ± 2.5 to 19.9 ± 2.9 (P < .001), the mean number of total vertiginous attacks decreased from 12.6 ± 1.8 to 1.9 ± 0.7 and from 12.2 ± 1.8 to 2.6 ± 1.1 (P < .001), and VSS decreased from 7.3 ± 0.3 to 2.1 ± 0.4 and from 7.9 ± 0.3 to 1.8 ± 0.5 (P < .001) in groups P and V, respectively. However, the treatment effects were similar in both groups (P > .05). BAI scores significantly decreased in both groups, whereas BDI scores decreased only in group V. CONCLUSIONS: This study provided evidence that venlafaxine and propranolol show equal effectiveness as prophylactic drugs for ameliorating vertiginous symptoms in VM patients. However, venlafaxine may be superior to propranolol in ameliorating depressive symptoms.

Olfactory dysfunction and olfactory bulb volume reduction in patients with leprosy.

To ascertain the level and rate of olfactory dysfunction in patients with leprosy and to determine whether olfactory bulb volume is affected by the pathophysiology. Olfactory bulb (OB) volume, measured using magnetic resonance imaging (MRI), was compared in 15 patients with leprosy and 15 healthy controls. All of the participants were evaluated using a detailed history to identify the probable causes of the smell dysfunction. Those who had a disease other than leprosy that may have caused the smell dysfunction were excluded from the study. OB volumes were calculated by manually tracing the OB on coronal sections. Orthonasal olfaction testing was used to assess smell function. The orthonasal olfaction testing indicated that all patients with leprosy were anosmic or severely hyposmic. The smell function test indicated that the OB volume of the patient group was significantly lower than that of the control group. No within-group difference was detected between right and left OB volume in either group. The patients in the leprosy group were severely hyposmic or anosmic and their olfactory bulb volume was significantly lower than that of the control group. To our knowledge, this study is the first to show a reduction in olfactory bulb volume among leprosy patients.

[Total thyroidectomy in benign thyroid diseases]. / Selim tiroid hastaliklarinda total tiroidektomi.

OBJECTIVES: In this retrospective study, we reviewed the data from patients who had total thyroidectomy for benign thyroid disease and evaluated the safety of this surgery. PATIENTS AND METHODS: Three hundred and twenty three patients (49 males, 274 females; mean age 42.6+/-14.1 years; range 13 to 80 years) who underwent total thyroidectomy between 2002 and 2008 were included in the study. In the preoperative studies, patients with suspicion of thyroid cancer were excluded. Indications for total thyroidectomy, cancer incidence and complication rates were evaluated. Two hundred and eighty three patients (87.6%) were operated on due to bilateral multinodular goiter, 17 (5.3%) due to toxic goiter, 23 (7.1%) due to thyroiditis. RESULTS: In our study, it was found that the incidences of permanent recurrent laryngeal nerve palsy and permanent hypoparathyroidism were 0.6% and 1.86%, respectively. Postoperative hemorrhage requiring repeat surgery occurred in 0.6% of the patients. There was no recurrence during follow-up. CONCLUSION: The present study shows that total thyroidectomy is a safe procedure with a low incidence of permanent complications. Total thyroidectomy is an acceptable surgical alternative for benign multinodular or diffuse goiters.