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1.
Acta Otorhinolaryngol Ital ; 41(5): 467-473, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34734583

RESUMO

Objective: The treatment of choice for Ménière disease (MD) aims at preventing severity and frequency of vertigo attacks. The purpose of this study was to evaluate the effectiveness of ventilation tube (VT) placement on vertigo control in patients affected by MD with no response to standard medical therapy. Methods: 76 consecutive outpatients diagnosed with definite MD who failed medical therapy received VT insertion at the Department of Otolaryngology Head and Neck Surgery, "Ospedale del Mare", Naples, Italy, with a 3-year follow up. Results: Over the long term, VT placement was effective in controlling vertigo in 61.8% of patients. In the control group treated with standard preventive care (SPC) alone, all patients continued to experience recurrent vertigo during the entire study. Comparison of survival curves by using the log-rank test shows that significant differences in survival exist between subjects treated with VT placement and the control sample (p = 0.001). Conclusions: Our long-term follow-up confirms that VT placement is an effective and safe management option in intractable definite MD, especially in the elderly or in those refusing more invasive treatments.


Assuntos
Doença de Meniere , Idoso , Animais , Tontura , Feminino , Cavalos , Humanos , Itália , Ventilação da Orelha Média , Vertigem
2.
Neurol India ; 69(5): 1241-1246, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34747791

RESUMO

Background: Dizziness is a typical manifestation of vestibular pathologies. Clinical studies have shown that it affects 1.82% of young adults to more than 30% older adults. Habituation and compensation are some traditional rehabilitation protocols. Objective: Yoga is also known to have a significant effect on vestibulopathy. Hence, a need arises to compare the above two maneuvers. Materials and Methods: Participants were recruited (n = 32) after screening using the Dix-Hallpike and head impulse test. They were then divided into two groups (n = 16). The first one, Group A, received yogasanas, and the second one, Group B, received gaze stabilization and habituation exercises for 4 days a week for 3 weeks. Pre- and post intervention outcome measures were taken using the motion sensitivity quotient (MSQ) score and Dizziness Handicap Inventory (DHI) scale. Results: In reducing symptoms of dizziness, the between-group comparison shows that Group A has shown greater improvement (12.37% ±1.43%) in MSQ and Group B has shown greater improvement (16.12 ± 3.56) in DHI. Within-group comparison shows that both the interventions are effective in reducing symptoms of dizziness (P < 0.05). Conclusion: Both gaze stabilization along with habituation exercises and yogasanas are effective in improving the symptoms of dizziness in patients with peripheral vestibular dysfunction. When compared between the groups, yogasanas had a superior hand in the MSQ score, whereas gaze stabilization and habituation exercises had a superior hand in the DHI scale.


Assuntos
Tontura , Vestíbulo do Labirinto , Idoso , Tontura/terapia , Terapia por Exercício , Habituação Psicofisiológica , Humanos , Vertigem , Adulto Jovem
3.
J Prim Care Community Health ; 12: 21501327211030120, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34720013

RESUMO

BACKGROUND: The broad range of vestibular tests used to diagnose labyrinth diseases allows for a functional assessment of the vestibular system. Among the many tests performed, the caloric test is considered the gold standard by providing an objective measurement of the vestibular function for each labyrinth. OBJECTIVE: to correlate the different types of dizziness with the caloric test result. METHODS: a descriptive study was performed based on the previous records of vestibular tests performed on patients with body balance disorders evaluated at Audiology Service between 2000 and 2020. The variables evaluated were sex, age, hearing loss, tinnitus, and caloric test result. RESULTS: the sample was composed of 892 patients, 654 (73.4%) women, and 238 (26.6%) men. Normal results were obtained for 57.4% (N = 514) of the individuals, while peripheral disease 40.1% (N = 357), and central disease 2.5% (N = 21) accounted for the remaining. Complaint of vertigo was not common in central disorders (P = .02; OR = 0.17) and instability was associated with bilateral vestibular weakness (P = 0.02; OR = 5.92). Vertigo associated with tinnitus and/or hearing loss was more frequent in the caloric test with peripheral abnormality (P = 0.008). CONCLUSION: complaints of vertigo associated with tinnitus and/or hearing loss must be directed for clinical observation of unilateral peripheral lesion and instability to central disease or bilateral peripheral lesion.


Assuntos
Perda Auditiva , Vestíbulo do Labirinto , Testes Calóricos , Tontura/diagnóstico , Tontura/etiologia , Feminino , Perda Auditiva/diagnóstico , Humanos , Masculino , Vertigem/diagnóstico
4.
Orv Hetil ; 162(47): 1891-1896, 2021 11 21.
Artigo em Húngaro | MEDLINE | ID: mdl-34801982

RESUMO

Összefoglaló. Bevezetés: A szédülés idoskorban gyakori panasz, amely jelentosen befolyásolja az életminoséget. Háttere sok esetben multifaktoriális, egyes esetekben azonban jól meghatározott ok kimutatható. Célkituzés: Kutatásunk célja az idoskori szédülo populáció panaszainak, valamint életminoségének felmérése volt. Anyag és módszer: Kutatásunkba 36 (13 férfi, 23 nobeteg, átlagéletkor ± SD, 72,78 év ± 4,6), Otoneurológiai Ambulanciánkon szédülés miatt vizsgált, 65 év feletti beteget vontunk be. Ok az általunk összeállított, panaszokkal és rizikófaktorokkal kapcsolatos kérdoív mellett a Dizziness Handicap Inventory-t is kitöltötték. Az utóbbi alapján meghatározható volt az életminoség-romlás, illetve annak mértéke. A statisztikai elemzést az IBM SPSS V24 szoftver segítségével végeztük, Mann-Whitney U-teszt és khi-négyzet-próba alapján. Minden esetben p<0,05 értéket tekintettünk szignifikáns különbségnek. Eredmények: A leggyakoribb diagnózisként a Ménière-betegséget, valamint a centrális vestibularis eltéréseket detektáltuk. A betegek visszajelzése alapján a szédülés volt a legdominánsabb tünet, amely a leggyakrabban órákig, illetve napokig tartott, és fele arányban volt forgó jellegu. Emellett a fülzúgás, a halláscsökkenés, valamint a vegetatív tünetek is dominánsak voltak. A leggyakoribb társbetegségek közül gyakoriságuk miatt kiemelendok a mozgásszervi, illetve szemészeti eltérések, a hypertonia, valamint a pszichiátriai betegségek. A betegek 77,8%-a jelzett valamilyen mértéku életminoség-romlást, és kiemelendo, hogy 30%-uk a súlyos kategóriába esett. A Dizziness Handicap Inventory kérdoívek alapján a fizikális, funkcionális, valamint emocionális részpontszámok hasonló értéket mutattak. Következtetés: Az idoskori szédülés lényeges a beteg romló életminosége szempontjából. A társuló komorbiditások mellett a háttérben álló vestibularis eltérések kizárása, illetve diagnosztizálása fontos feladat. Ennek függvényében tervezheto a terápia, amely kapcsán a kíséro tünetekre is fontos hangsúlyt fektetni. Így az érintett betegek életminosége javítható. Orv Hetil. 2021; 162(47): 1891-1896. INTRODUCTION: Vertigo is a common complaint in elderly, which has significant influence on the patients' quality of life. In many cases its background is complex, although, in some cases specific diagnosis can be made. OBJECTIVE: Our study aimed to analyze the symptoms and quality of life of old-age vertiginous population. MATERIAL AND METHOD: 36 patients (13 males, 23 females, mean age ± SD, 72.78 years ± 4.6) over 65 years, examined due to vertigo at our Neurotologic Department, were enrolled. A questionnaire including questions regarding the symptoms, risk factors, along with the Dizziness Handicap Inventory was used. Statistical analysis was carried out using IBM SPSS V24 software. Mann-Whitney U and chi square tests were used. Statistical significance was defined as p<0.05. RESULTS: Ménière's disease and central vestibular disorders were found as the most frequent diagnoses. Vertigo was the most tormenting symptom, which usually lasted for hours or days, and was defined as rotatory in 50%. Tinnitus, hearing loss and vegetative symptoms were also dominant. The most frequent comorbidities were musculoskeletal disorders, hypertension, ophthalmological diseases and psychiatric disorders. 77.8% of the patients have reported worsened quality of life, of which 30% was detected as severe. Based on the Dizziness Handicap Inventory, physical, functional and emotional scores showed similar results. CONCLUSION: Vertigo in elderly is important due to its influence on patients' quality of life. Besides comorbidities, the diagnosis of vestibular pathologies is of great importance. Therefore, therapy planning is possible, and patients' quality of life can be improved. Orv Hetil. 2021; 162(47): 1891-1896.


Assuntos
Hipertensão , Qualidade de Vida , Idoso , Tontura/etiologia , Feminino , Humanos , Masculino , Inquéritos e Questionários , Vertigem/etiologia
5.
Sensors (Basel) ; 21(22)2021 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-34833641

RESUMO

Vertigo is a sensation of movement that results from disorders of the inner ear balance organs and their central connections, with aetiologies that are often benign and sometimes serious. An individual who develops vertigo can be effectively treated only after a correct diagnosis of the underlying vestibular disorder is reached. Recent advances in artificial intelligence promise novel strategies for the diagnosis and treatment of patients with this common symptom. Human analysts may experience difficulties manually extracting patterns from large clinical datasets. Machine learning techniques can be used to visualize, understand, and classify clinical data to create a computerized, faster, and more accurate evaluation of vertiginous disorders. Practitioners can also use them as a teaching tool to gain knowledge and valuable insights from medical data. This paper provides a review of the literatures from 1999 to 2021 using various feature extraction and machine learning techniques to diagnose vertigo disorders. This paper aims to provide a better understanding of the work done thus far and to provide future directions for research into the use of machine learning in vertigo diagnosis.


Assuntos
Inteligência Artificial , Tontura , Diagnóstico Diferencial , Tontura/diagnóstico , Humanos , Aprendizado de Máquina , Vertigem/diagnóstico
6.
Zhonghua Yi Xue Za Zhi ; 101(37): 2925-2929, 2021 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-34638183

RESUMO

As we know, benign paroxysmal positional vertigo is a peripheral vestibular disorder,while vestibular migraine is a central vestibular disease. Although they are two different independent diseases, patients often choose to consult otolaryngology and neurology. The clinical manifestations of some patients with these two diseases are similar and the diagnosis is easy to be confused, but the treatment methods are completely different, and incorrect treatment methods will inevitably affect the curative effect and prognosis. Vestibular migraine is characterized by a diversity of clinical manifestations and signs, and the migraine symptoms of some patients do not match with the vestibular symptoms. There are 30% of vestibular migraine patients who showed isolated paroxysmal vertigo/dizziness and nystagmus, which is easily confused with benign paroxysmal positional vertigo and needs to be identified. Under the framework of the international classification of vestibular diseases, according to the new guideline of nystagmus examination and classification issued by Barany Association and new diagnostic criteria of two diseases, differential diagnosisof benign paroxysmal positional vertigo from vestibular migrainecan make up for one-sided understanding caused by the specialization of disciplines, improve thediagnosis and treatment of vestibular diseases, and thus reduce the misdiagnosis and mistreatment.


Assuntos
Transtornos de Enxaqueca , Nistagmo Patológico , Atenção , Vertigem Posicional Paroxística Benigna/diagnóstico , Tontura , Humanos , Transtornos de Enxaqueca/diagnóstico
8.
Artigo em Chinês | MEDLINE | ID: mdl-34628805

RESUMO

The diagnostic criteria for "Vestibular Migraine of Childhood", "Probable Vestibular Migraine of Childhood" and "Recurrent Vertigo of Childhood" is put forth by the Committee for the Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification subgroup of the International Headache Society at the beginning of 2021. It provides directions for the diagnosis and treatment of these syndromes to international community of pediatricians, otolaryngologists, neurologists, neurosurgeons, neuro-otologists physiotherapists, neurophysiologists, and audiologists. The paper concludes the current situation and research progress of diagnosis and treatment of children vertigo diseases.


Assuntos
Transtornos de Enxaqueca , Doenças Vestibulares , Criança , Consenso , Tontura , Humanos , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/terapia , Vertigem/diagnóstico , Vertigem/terapia , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/terapia
9.
Artigo em Chinês | MEDLINE | ID: mdl-34628819

RESUMO

The concept and diagnostic standard of persistent postural-perceptual dizziness(PPPD) improve the ability of clinical workers to recognize these diseases to some extent. However, the diagnosis of PPPD mainly depends on the identification of postural symptoms and the elimination of structural vestibular diseases, so the subjectivity is relatively strong. Moreover, the lack of objective criteria and a slight carelessness will lead to generalized diagnosis or omission diagnosis and misdiagnosis. At present, there is a lack of domestic large sample epidemiological investigation and other related studies, therefore it is a problem for diagnosing generalization of persistent posture perception dizziness and needed to be alert and corrected. Only those items meeting the criteria of the diagnostic standards can be carried out for diagnosis. The treatment needs to ensure sufficient dose and full therapy course. Generally, the medication should not be less than half a year.


Assuntos
Tontura , Doenças Vestibulares , Tontura/diagnóstico , Tontura/terapia , Humanos , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/terapia
10.
J Int Adv Otol ; 17(5): 417-421, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34617892

RESUMO

OBJECTIVE: Benign Paroxysmal Positional Vertigo (BPPV) as the most common vestibular disorder can affect the quality of life. This study aimed to compare the effectiveness of the half somersault maneuver (HSM) as a treatment to that of the Epley maneuver (EM) as a clinical-based treatment in subjects with PC-BPPV. METHODS: In this randomized study, 43 participants with unilateral posterior canal BPPV were recruited. The experimental group received the HSM, whereas the control group received the EM. All participants were asked to fill in the Vestibular Rehabilitation Benefit Questionnaire (VRBQ), Dizziness Handicap Inventory (DHI), and Vertigo Symptom Scale (VSS) questionnaires at pretreatment and at 48 hours, 1 week, and 1 month posttreatment. The severity of residual dizziness was determined by the visual analog scale (VAS) weekly for up to 4 weeks after treatment. The success rate and the recurrence rate were assessed after the 3-month follow-up. RESULTS: The differences between the results of pretreatment and post-treatment questionnaires for both groups were significant. However, the differences were not significant between the 2 groups for the DHI scores, the total, dizziness, motion-provoked dizziness, and symptom subscale scores of the VRBQ, and the anxiety subscale scores of the VSS. There were significant differences between the 2 groups for VAS, the total VSS and vertigo subscale scores, and the VRBQ anxiety subscale scores. CONCLUSION: Even though both maneuvers are significantly effective in the treatment of PC-BPPV, subjects in the HSM group reported more improvement in terms of psychometric symptoms and residual dizziness compared to the EM group.


Assuntos
Vertigem Posicional Paroxística Benigna , Qualidade de Vida , Vertigem Posicional Paroxística Benigna/terapia , Tontura/terapia , Humanos , Posicionamento do Paciente , Inquéritos e Questionários
11.
BMC Neurol ; 21(1): 394, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34641808

RESUMO

BACKGROUND: Persistent postural-perceptual dizziness (PPPD) is the most common functional vestibular disorder. A multisensory mismatch altered by psychological influences is considered to be an important pathophysiological mechanism. Increased cortical and subcortical excitability may play a role in the pathophysiology of PPPD. We hypothesized that decreased motion perception thresholds reflect one mechanism of the abnormal vestibular responsiveness in this disorder. We investigated the vestibular perception thresholds and the vestibular ocular reflex with a rotatory chair experiment to gain insights in the processing and adaption to vestibular provocation. METHODS: In this cross-sectional study 26 female PPPD patients and 33 healthy female age matched controls (HC) were investigated sitting in a motorized rotary chair shielded regarding visual and acoustic stimuli. The chair was rotated for 20 minutes with slowly increasing velocity to a maximum of 72°/s. We functionally tested motion perception thresholds and vegetative responses to rotation as well as vestibular-ocular reflex thresholds. We additionally investigated several psychological comorbidities (i.e. depression, anxiety, somatosensory amplification) using validated scores. Conventional dizziness scores were obtained to quantify the experienced dizziness and impact on daily life. RESULTS: PPPD patients showed a significant reduced vestibulo-perceptual threshold (PPPD: 10.9°/s vs. HC: 29.5°/s; p<0.001) with increased motion sensitivity and concomitant vegetative response during and after the chair rotation compared to healthy controls. The extent of increased vestibular sensitivity was in correlation with the duration of the disease (p=0.043). No significant difference was measured regarding nystagmus parameters between both groups. CONCLUSION: PPPD patients showed increased vegetative response as well as decreased vestibulo-perceptual thresholds which are related to disease duration. This is of interest as PPPD might be sustained by increased vestibular excitability leading to motion intolerance and induction of dizziness when exposed to movement.


Assuntos
Tontura , Doenças Vestibulares , Estudos Transversais , Feminino , Humanos , Percepção , Vertigem
12.
BMC Med Educ ; 21(1): 532, 2021 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-34649532

RESUMO

BACKGROUND: Vertigo and dizziness (VD) are among the most frequently seen symptoms in clinics and are important for medical students, especially for those in Chinese standardized residency training (SRT). The aim of our study was to examine the PAL method's feasibility in the clinical teaching of VD-related diseases for SRT students in China. METHODS: This is a randomized, controlled, multicenter study. A total of 228 residents were invited to participate in this study, of which 198 completed the program. The students were randomized into two groups, and VD-related diseases were taught using lecture-based learning (control group) or peer-assisted learning (PAL). An examination paper and a rating scale were used to evaluate students' performance in the mastery of VD-related theoretical knowledge and clinical skills, meanwhile students' perceptions, satisfaction, and risk of burnout were also analyzed using a questionnaire. Independent-samples t-test and chi-square analysis were performed to evaluate statistical significance for continuous variables and categorical variables, respectively, using SPSS 18.0 software. RESULTS: The PAL group performed better in mastering theoretical knowledge and clinical skills than the control group. And more students believed that PAL could help improve their personal qualities such as teamwork skills. However, more students reported that PAL increased the risk of burnout. CONCLUSIONS: PAL was a suitable and effective method in the clinical teaching of some specialized diseases, especially it was recommended for students who had gained initial knowledge and skills, such as Chinese SRT students. However, we should draw attention to the increased risk of burnout if PAL is intended to be widely used in clinical teaching. TRIAL REGISTRATION: ISRCTN registry, ISRCTN53773239 , 05/07/2021, retrospectively registered.


Assuntos
Educação de Graduação em Medicina , Internato e Residência , Estudantes de Medicina , China , Tontura , Humanos , Grupo Associado , Ensino , Vertigem/diagnóstico
14.
Health Qual Life Outcomes ; 19(1): 231, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34600557

RESUMO

BACKGROUND: Dizziness is a common complaint among older adults and may affect quality of life in a negative way. The aim of this study was to assess health-related quality of life (HRQL), sense of coherence (SOC), self-rated health (SRH) and comorbidity in relation to dizziness, among older persons from an urban population. METHODS: The study is part of the Gothenburg H70 Birth Cohort Studies (H70). A cross-sectional population-based sample including 662 79-years-olds (404 women, 258 men, 62% response rate) were surveyed with questions regarding dizziness, imbalance, comorbidities and general health. HRQL was assessed using the 36-item Short Form-36 Health Survey (SF-36) and SOC with the 13-items questionnaire Sense of Coherence (SOC-13). RESULTS: Half of the participants reported problems with dizziness (54%). Dizziness was negatively associated with HRQL, including after adjusting for comorbidities, especially in the physical domains of SF-36. Having dizziness was also associated with poorer SRH, tiredness and comorbidity among both men and women. SOC (mean total score), however, did not differ between dizzy and non-dizzy participants. CONCLUSIONS: Dizziness was negatively associated with HRQL, also after adjusting for comorbidities. Identification and treatment of dizziness, when possible, are important because reduction of dizziness symptoms may potentially help to enhance overall well-being in this age group.


Assuntos
Tontura , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Tontura/epidemiologia , Feminino , Humanos , Masculino , Inquéritos e Questionários , População Urbana
15.
Zhonghua Yi Xue Za Zhi ; 101(39): 3244-3247, 2021 Oct 26.
Artigo em Chinês | MEDLINE | ID: mdl-34689538

RESUMO

The clinical data of 47 patients [41 males, 6 females, aged (62±7) years] treated at the Department of Neurology of the Sixth Medical Center of PLA General Hospital from October 2018 to October 2020 who were diagnosed with severe bilateral vertebral artery stenosis/occlusion through Digital Subtraction Angiography (DSA) were retrospectively collected, and the characteristics of the compensatory pathways of collateral circulation were determined. Results showed that there were 8 intracranial and extracranial compensatory pathways, with posterior communicating artery as the major type (21 cases) for intracranial ones and deep carotid artery as the major type (16 cases) for extracranial ones. As the establishment of the compensatory pathway is closely related to the lesion site, DSA assessment for patients with severe bilateral vertebral artery stenosis/occlusion is helpful for clinicians to make judgement on prognosis of patients and choose individualized treatment plans.


Assuntos
Estenose das Carótidas , Insuficiência Vertebrobasilar , Angiografia Digital , Artéria Carótida Interna , Circulação Cerebrovascular , Circulação Colateral , Tontura/etiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Artéria Vertebral/diagnóstico por imagem
16.
Nutrients ; 13(10)2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34684646

RESUMO

Vestibular disorders may generate complex signs and symptoms, which may alter patients' balance and the quality of life. Dizziness and vertigo can strongly affect daily activities and relations. Despite the presence of conventional drugs, maneuvers, and surgery, another interesting therapeutic opportunity is offered by nutraceuticals. These molecules are often used in the treatment of dizziness and vertigo, but the rationale of their application is not always solidly demonstrated by the scientific evidence. Several substances have shown a variable level of efficacy/usefulness in this field, but there is lack of important evidence for most of them. From a medico-legal point of view, specific information must be provided to the patient regarding the efficacy and possibilities that the use of these preparations can allow. Administering the right nutraceutical to the proper patient is a fundamental clinical skill. Integrating conventional drug treatment with nutraceutical administration seems to be easy, but it may be difficult considering the (in part unexplored) pharmacodynamics and pharmacokinetics of nutraceuticals. The aim of the scientific community should be to elevate nutraceuticals to the same law and technical dignity of conventional drugs.


Assuntos
Suplementos Nutricionais , Legislação como Assunto , Vestíbulo do Labirinto/patologia , Suplementos Nutricionais/efeitos adversos , Tontura/etiologia , Humanos , Vertigem/etiologia
17.
J Int Med Res ; 49(9): 3000605211044207, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34528471

RESUMO

OBJECTIVE: To analyze recovery from dizziness in patients with acute vestibular neuritis (AVN) after applying the "Dizziness & Fall Risk Assessment and Intervention (DFRAI)". METHODS: This prospective study involved patients with AVN who underwent a survey of dizziness and fall risk. The patients received medical treatment and customized vestibular rehabilitation, and vestibular function was evaluated at the initial attack and 3 months later. RESULTS: Forty-one patients underwent subjective questionnaire assessments, which showed significant improvement in visual analog scale-dizziness handicap inventory-fear of falling (VAS-DHI-FOF) results from the initial vertigo attack to 3 months later. In the sensory organization test (SOT), the initial composite score was 63 ± 13.1, which improved to 77.5 ± 4.9 3 months later. In caloric testing, the canal paresis (CP) score was 42.9 ± 35.2, which improved to 29.9 ± 23.5 3 months later. CONCLUSIONS: Subjective improvement in dizziness and objective recovery of vestibular function were confirmed. DFRAI is a comprehensive solution for dizziness, and appropriate application of the DFRAI is expected to have a positive effect on recovery from dizziness and fall prevention in patients with AVN.


Assuntos
Neuronite Vestibular , Acidentes por Quedas/prevenção & controle , Tontura , Medo , Humanos , Equilíbrio Postural , Estudos Prospectivos , Neuronite Vestibular/diagnóstico
18.
Physiother Res Int ; 26(4): e1923, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34585499

RESUMO

BACKGROUND AND PURPOSE: Associations between dizziness, health-related quality of life, and musculoskeletal pain have not been systematically explored in patients with vestibular disorders. Such knowledge may be important for choice of treatments. The study objectives were to examine the extent and localization of musculoskeletal pain and explore whether pain was associated with dizziness and health-related quality of life. METHODS: The cross-sectional study investigated anonymized data from an earlier survey on patients with long-lasting dizziness (>3 months) examined in an oto-rhino-laryngological department. The sample includes patient between 18 and 70 years with Ménière's disease, vestibular schwannoma, benign positional paroxysmal vertigo, vestibular neuritis, non-otogenic dizziness, and cervicogenic dizziness. General musculoskeletal, that is, pain in muscles, tendons, and joints was registered by a yes/no question. A pain drawing registered localization of pain. Multiple binary logistic regression models were used to determine the association between pain and vertigo-balance and autonomic-anxiety related dizziness by the short Vertigo Symptom Scale (VSS) and sub-scales (VSS-V, VSS-A), and between pain and health-related quality of life by the SF-36, mental and physical component summary scale (SF-36 MCS, SF-36 PCS). RESULTS: The sample consisted of 503 patients, 60.2% were women, the median age was 50 years. General musculoskeletal pain was reported by 72.8% of patients, neck pain by 59.2% and widespread pain by 21.9%. Multiple binary logistic regression models demonstrated that all the pain measures were significantly associated with VSS-V and VSS-A and SF-36 PCS, but not SF-36 MCS. DISCUSSIONS: Musculoskeletal pain is prevalent in patients with long-lasting dizziness. The strong associations between pain, VSS, and SF-36 PCS could result in a self-sustaining complex condition. The findings imply that in addition to assessing and treating the vestibular symptoms, musculoskeletal symptoms and physical health should be addressed.


Assuntos
Tontura , Qualidade de Vida , Estudos Transversais , Tontura/diagnóstico , Tontura/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Cervicalgia/diagnóstico , Cervicalgia/epidemiologia , Vertigem/diagnóstico , Vertigem/epidemiologia
19.
Otolaryngol Pol ; 75(5): 9-15, 2021 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-34552021

RESUMO

In the daily practice of an otolaryngologist, we encounter cases where the symptoms are not the result of disease but result from pharmacotherapy. In the case of symptoms such as hearing loss, tinnitus, or dizziness, polytherapy may be used as the basis for their occurrence, which, due to the lack of rationality in combining drugs, leads to symptoms that the patient and the doctor very often interpret as a new disease syndrome. The aim of the study is to show and to raise awareness of the fact that the symptoms of hearing organ impairment are frequently drug-related and only a modification of the currently used pharmacotherapy is a rational procedure in such cases. This paper describes 30 cases who developed side effects of polypharmacy in the form of hearing disorders, dizziness, and tinnitus. The causes of drug-related complications were discussed, as well as effective methods of their prevention.


Assuntos
Otolaringologia , Preparações Farmacêuticas , Zumbido , Tontura/induzido quimicamente , Humanos , Zumbido/induzido quimicamente , Vertigem/induzido quimicamente
20.
Am J Physiol Gastrointest Liver Physiol ; 321(5): G513-G526, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34523347

RESUMO

Postprandial orthostasis activates mechanisms of cardiovascular homeostasis to maintain normal blood pressure (BP) and adequate blood flow to vital organs. The underlying mechanisms of cardiovascular homeostasis in postprandial orthostasis still require elucidation. Fourteen healthy volunteers were recruited to investigate the effect of an orthostatic challenge (60°-head-up-tilt for 20 min) on splanchnic and systemic hemodynamics before and after ingesting an 800-kcal composite meal. The splanchnic circulation was assessed by ultrasonography of the superior mesenteric and hepatic arteries and portal vein. Systemic hemodynamics were assessed noninvasively by continuous monitoring of BP, heart rate (HR), cardiac output (CO), and the pressor response to an intravenous infusion on increasing doses of phenylephrine, an α1-adrenoceptor agonist. Neurohumoral regulation was assessed by spectral analysis of HR and BP, plasma catecholamine and aldosterone levels and plasma renin activity. Postprandial mesenteric hyperemia was associated with an increase in CO, a decrease in SVR and cardiac vagal tone, and reduction in baroreflex sensitivity with no change in sympathetic tone. Arterial α1-adrenoceptor responsiveness was preserved and reduced in hepatic sinusoids. Postprandial orthostasis was associated with a shift of 500 mL of blood from mesenteric to systemic circulation with preserved sympathetic-mediated vasoconstriction. Meal ingestion provokes cardiovascular hyperdynamism, cardiac vagolysis, and resetting of the baroreflex without activation of the sympathetic nervous system. Meal ingestion also alters α1-adrenoceptor responsiveness in the hepatic sinusoids and participates in the redistribution of blood volume from the mesenteric to the systemic circulation to maintain a normal BP during orthostasis.NEW & NOTEWORTHY A unique integrated investigation on the effect of meal on neurohumoral mechanisms and blood flow redistribution of the mesenteric circulation during orthostasis was investigated. Food ingestion results in cardiovascular hyperdynamism, reduction in cardiac vagal tone, and baroreflex sensitivity and causes a decrease in α1-adrenoceptor responsiveness only in the venous intrahepatic sinusoids. About 500-mL blood shifts from the mesenteric to the systemic circulation during orthostasis. Accordingly, the orthostatic homeostatic mechanisms are better understood.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Sistema Cardiovascular/fisiopatologia , Tontura/fisiopatologia , Hemodinâmica , Período Pós-Prandial , Receptores Adrenérgicos alfa 1/metabolismo , Circulação Esplâncnica , Agonistas de Receptores Adrenérgicos alfa 1/administração & dosagem , Adulto , Sistema Nervoso Autônomo/efeitos dos fármacos , Sistema Nervoso Autônomo/metabolismo , Velocidade do Fluxo Sanguíneo , Sistema Cardiovascular/inervação , Tontura/diagnóstico por imagem , Tontura/metabolismo , Feminino , Voluntários Saudáveis , Hemodinâmica/efeitos dos fármacos , Artéria Hepática/diagnóstico por imagem , Artéria Hepática/fisiopatologia , Humanos , Infusões Intravenosas , Masculino , Artéria Mesentérica Superior/diagnóstico por imagem , Artéria Mesentérica Superior/fisiopatologia , Pessoa de Meia-Idade , Fenilefrina/administração & dosagem , Veia Porta/diagnóstico por imagem , Veia Porta/fisiopatologia , Receptores Adrenérgicos alfa 1/efeitos dos fármacos , Transdução de Sinais , Fatores de Tempo , Adulto Jovem
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