Atmospheric Pressure and Onset of Episodes of Meniere’s Disease - A Repeated Measures Study

External changes of air pressure are transmitted to the middle and inner ear and may be used therapeutically in Menière's disease, one of the most common vertigo disorders. We analyzed the possible relationship of atmospheric pressure and other meteorological parameters with the onset of MD vertigo episodes in order to determine whether atmospheric pressure changes play a role in the occurrence of MD episodes.Patients of a tertiary outpatient dizziness clinic diagnosed with MD were asked to keep a daily vertigo diary to document MD episodes (2004-2009). Local air pressure, absolute temperature and dew point temperature were acquired on an hourly basis. Change in meteorological parameters was conceptualized as the maximum difference in a 24 hour time frame preceding each day. Effects were estimated using additive mixed models with a random participant effect. We included lagged air parameters, age, sex, weekday and season in the model.A total of 56 persons (59% female) with mean age 54 years were included. Mean follow-up time was 267 days. Persons experienced on average 10.3 episodes during the observation period (median 8). Age and change in air pressure were significantly associated with vertigo onset risk (Odds Ratio = 0.979 and 1.010). We could not show an effect of sex, weekday, season, air temperature, and dew point temperature.Change in air pressure was significantly associated with onset of MD episodes, suggesting a potential triggering mechanism in the inner ear. MD patients may possibly use air pressure changes as an early warning system for vertigo attacks in the future

Intra-tympanic injections in Meniere’s disease

Meniere's disease is a relatively common, sometimes disabling, disease. Pre-referral anti-vertiginous medication is common practice among family physicians. The objective of this review is to present the next level treatment of Meniere disease, beyond conservative management. Major databases such as the Pubmed were searched for recent publications on the management of Meniere’s disease. The findings emphasised that the use of intra-tympanic steroid injections, among other measures, is an extensively researched treatment modality for Meniere’s disease that is unresponsive to conservative management. In conclusion, referring physicians need to go beyond anti-vertiginous medications which family physicians usually prescribe. Aside from other medical treatments, intra-tympanic steroid injection is a simple, safe and reliable treatment option which needs to be further deployed in developing world practice

Middle ear pressure therapy with the EFET01 device: Study on the inner ear pressure changes in guinea pigs model and evaluation of effects for patients with intractable definite Ménière’s disease and delayed endolymphatic hydrops over a two-year follow-up in Japan

富山大学博士（医学）Article富山大学・富医薬博甲第447号・DO TRAM ANH・2024/03/22doctoral thesi

USSR Space Life Sciences Digest, volume 1, no. 4

An overview of the developments and direction of the USSR Space Life Sciences Program is given. Highlights of launches, program development, and mission planning are given. Results of ground-based research and space flight studies are summarized. Topics covered include: space medicine and physiology; space biology, and life sciences and technology

Meniere’s disease in Finland : An epidemiological and clinical study on occurrence, clinical picture and policy

AbstractThe symptom complex originating from the inner ear, known as Meniere’s disease, was studied especially from the epidemiologic point of view. A total of 442 patients’ charts were retrospectively analysed in several hospital districts of Finland. The period of 1992–1996 was covered. The main focus was on the epidemiological assessment of the disease in Finland. To clarify the epidemiological figures, the validity of the diagnostic assessment was examined using the latest guidelines (1995) of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology — Head and Neck Surgery (AAO-HNS) as a gold standard.The diagnostic tools used in the different hospitals were documented and evaluated, and diagnostic accuracy at the different levels of the health care system was evaluated. The clinical picture of Meniere’s disease was characterised, and the therapeutic modalities used were evaluated. The audiometric configurations were classified according to two principles. The prognosis of hearing impairment was specified by creating a multivariable model.Half of the patients (N = 221) fulfilled the AAO-HNS criteria for definite disease. The prevalence and incidence of definite cases of Meniere’s disease appeared to be lower in Finland than could be expected based on previous international studies. A prevalence of at least 43 per 100,000 and an average annual incidence of 4.3 per 100,000 were obtained. The prevalence rates in the catchment areas of the university and central hospitals did not differ statistically, but a significant (p Fluctuation of hearing in repeated audiometric measurements appeared to be a highly sensitive (94%) diagnostic test to detect definite Meniere’s disease. According to the multivariable model created in this study, the hearing impairment in Meniere’s disease affects equally males and females, and the deterioration is about 1 dB per year due to the duration of the disease and 0.5 dB per year due to aging. The disease was controlled conservatively in 69% of the cases. A gently sloping high-frequency audiometric pattern was most prevalent according to the EU Work Group classification and a flat pattern according to the mid-frequency-based classification.The variability of diagnostic criteria, diagnostic tools and therapeutic modalities shows an evident need for up-to-date therapy recommendations for Meniere’s disease in Finland.Academic Dissertation to be presented with the assent of the Faculty of Medicine, University of Oulu, for public discussion in the Auditorium 7 of the University Hospital of Oulu, on October 17th, 2003, at 12 noon.Abstract The symptom complex originating from the inner ear, known as Meniere’s disease, was studied especially from the epidemiologic point of view. A total of 442 patients’ charts were retrospectively analysed in several hospital districts of Finland. The period of 1992–1996 was covered. The main focus was on the epidemiological assessment of the disease in Finland. To clarify the epidemiological figures, the validity of the diagnostic assessment was examined using the latest guidelines (1995) of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology — Head and Neck Surgery (AAO-HNS) as a gold standard. The diagnostic tools used in the different hospitals were documented and evaluated, and diagnostic accuracy at the different levels of the health care system was evaluated. The clinical picture of Meniere’s disease was characterised, and the therapeutic modalities used were evaluated. The audiometric configurations were classified according to two principles. The prognosis of hearing impairment was specified by creating a multivariable model. Half of the patients (N = 221) fulfilled the AAO-HNS criteria for definite disease. The prevalence and incidence of definite cases of Meniere’s disease appeared to be lower in Finland than could be expected based on previous international studies. A prevalence of at least 43 per 100,000 and an average annual incidence of 4.3 per 100,000 were obtained. The prevalence rates in the catchment areas of the university and central hospitals did not differ statistically, but a significant (p < 0.001) difference was found between the average prevalences in the northern and southern Finnish hospital districts. Fluctuation of hearing in repeated audiometric measurements appeared to be a highly sensitive (94%) diagnostic test to detect definite Meniere’s disease. According to the multivariable model created in this study, the hearing impairment in Meniere’s disease affects equally males and females, and the deterioration is about 1 dB per year due to the duration of the disease and 0.5 dB per year due to aging. The disease was controlled conservatively in 69% of the cases. A gently sloping high-frequency audiometric pattern was most prevalent according to the EU Work Group classification and a flat pattern according to the mid-frequency-based classification. The variability of diagnostic criteria, diagnostic tools and therapeutic modalities shows an evident need for up-to-date therapy recommendations for Meniere’s disease in Finland

The dizzy patient: A review of etiology, differential diagnosis and management

Introduction: Dizziness is a lay term used to describe a variety of sensations. Unfortunately, the term dizziness does not have a precise medical definition, so additional information is typically required to further define the patient\u27s problem. Classifications: When dizziness is a presenting complaint, distinctions must be made between vertigo (a sense of false movement), near-syncope (a feeling of impending faint), disequilibrium (loss of balance), and ill-defined lightheadedness (an inability to concentrate or focus the mind, e.g. , a dazed feeling). Etiologies: Possible causes of dizziness include conflicts between visual and vestibular information, vascular problems, medication adverse reactions, psychological difficulties, systemic disease, and the effects of aging. Management: Dizziness is a symptom of a physiological or psychological illness, therefore management is typically directed toward treatment of the underlying illness. However, in some cases the cause of the dizziness cannot be found or is untreatable. In these cases, management is directed toward symptom reduction. Summary: Dizziness is a relatively common problem that can arise from a variety of causes. In many cases, optometrists can participate in the diagnosis and management patients with complaints of dizziness