Inner Ear Disease and Benign Paroxysmal Positional Vertigo: A Critical Review of Incidence, Clinical Characteristics, and Management

Background. This study is a review of the incidence, clinical characteristics, and management of secondary BPPV. The different subtypes of secondary BPPV are compared to each other, as well as idiopathic BPPV. Furthermore, the study highlights the coexistence of BPPV with other inner ear pathologies. Methods. A comprehensive search for articles including in the abstract information on incidence, clinical characteristics, and management of secondary BPPV was conducted within the PubMed library. Results. Different referral patterns, different diagnostic criteria used for inner ear diseases, and different patient populations have led to greatly variable incidence results. The differences regarding clinical characteristics and treatment outcomes may support the hypothesis that idiopathic BPPV and the various subtypes of secondary BPPV do not share the exact same pathophysiological mechanisms. Conclusions. Secondary BPPV is often under-diagnosed, because dizziness may be atypical and attributed to the primary inner ear pathology. Reversely, a limited number of BPPV patients may not be subjected to a full examination and characterized as idiopathic, while other inner ear diseases are underdiagnosed. A higher suspicion index for the coexistence of BPPV with other inner ear pathologies, may lead to a more integrated diagnosis and consequently to a more efficient treatment of these patients

Diagnosis of Single- or Multiple-Canal Benign Paroxysmal Positional Vertigo according to the Type of Nystagmus

Benign paroxysmal positional vertigo (BPPV) is a common peripheral vestibular disorder encountered in primary care and specialist otolaryngology and neurology clinics. It is associated with a characteristic paroxysmal positional nystagmus, which can be elicited with specific diagnostic positional maneuvers, such as the Dix-Hallpike test and the supine roll test. Current clinical research focused on diagnosing and treating various types of BPPV, according to the semicircular canal involved and according to the implicated pathogenetic mechanism. Cases of multiple-canal BPPV have been specifically investigated because until recently these were resistant to treatment with standard canalith repositioning procedures. Probably, the most significant factor in diagnosis of the type of BPPV is observation of the provoked nystagmus, during the diagnostic positional maneuvers. We describe in detail the various types of nystagmus, according to the canals involved, which are the keypoint to accurate diagnosis

Cement leakage in a symptomatic vertebral hemangioma: a case report and review of the literature

We present the case of a 50-year-old male with consistent back pain, not resolving with conservative treatment. Plain radiograms demonstrated a lytic lesion at the level of the 8th thoracic vertebra. Thorough examination with computerized tomography and magnetic resonance imaging revealed a hemangioma extending to the posterior third of the vertebral body, compressing the spinal cord at the level of 8th thoracic vertebra. A percutaneous vertebroplasty was performed. The post-operative computerized tomography scan demonstrated cement leakage. After thorough cement removal combined with extensive decompression and posterior stabilization, the patient reported gradual improvement of his symptoms and was able to return successfully to his work a few months later

Recurrent intra-articular osteoid osteoma of the hip after radiofrequency ablation: a case report and review of the literature

We present a case of a 53-year-old woman with recurrent intra-articular osteoid osteoma of the hip 6 months after initial treatment with percutaneous radiofrequency ablation. En bloc surgical excision of the osteoid osteoma and prophylactic internal fixation for impending stress fracture was performed. The patient is pain free, has returned to normal function and there is no sign of recurrence at the one-year follow-up. Intraarticular osteoid osteoma, present a diagnostic challenge and often they are misdiagnosed. Minimally invasive ablation techniques can fail in significant percentage and then surgical excision with histological confirmation remains the definitive treatment of choice

Transiently Evoked Otoacoustic Emissions in Children with Otitis Media with Effusion

Introduction. Otitis media with effusion is a common pediatric disease whose diagnosis is based on pneumatic otoscopy, pure-tone audiometry, and tympanometry. The aim of this study was to evaluate transiently evoked otoacoustic emissions in the diagnosis of otitis media with effusion as compared to tympanometry. Patients and Methods. 38 children with bilateral otitis media with effusion were studied. 40 normal children of similar age and sex were used as controls. All subjects underwent pneumatic otoscopy, standard pure-tone audiometry, tympanometry, and transiently evoked otoacoustic emissions. Results. In the group of children with bilateral otitis media, transiently evoked otoacoustic emissions were absent in 51 ears (67%). In the remaining 25 ears (33%) the mean emission amplitude was reduced, as compared to the mean value of the control group. Conclusions. Transiently evoked otoacoustic emissions should be included in the diagnostic workup of otitis media with effusion because it is a fast, reliable, and objective test. Transiently evoked otoacoustic emissions should always be used in conjunction with tympanometry, because a more meaningful interpretation of transiently evoked otoacoustic emissions measures is possible

Study of Allergic Rhinitis in Childhood

Allergic rhinitis is common among children and quite often represents a stage of the atopic march. Although sensitization to food and airborne allergens may appear in infancy and early childhood, symptoms of the disease are usually present after age 3. The aim of this study was to determine the most frequent food and indoor and outdoor respiratory allergens involved in allergic rhinitis in children in the region of Piraeus. The study was performed in the outpatient clinic of otolaryngologic allergy of a general hospital. Fifty children (ranged 6–14 ) with symptoms of allergic rhinitis and positive radioallergosorbent test (RAST) for IgE antibodies or skin prick tests were included in the study. Thirty six (72%) of the subjects of the study had intermittent allergic rhinitis. The most common aeroallergens determined were grass pollens and Parietaria, whereas egg and milk were the food allergens identified. The detection of indoor and outdoor allergens in the region of Piraeus, based on skin prick tests and RAST tests, showed high incidence of grasses and food allergens, which is similar to other Mediterranean countries

Halogen-free flame-retardant compounds. Thermal decomposition and flammability behavior for alternative polyethylene grades

The effect of six halogen-free flame retardant (FR) formulations was investigated on the thermal stability of two low-density polyethylenes (LDPE) and one linear low-density polyethylene (LLDPE), by means of thermogravimetric analysis (TGA) under nitrogen and air atmosphere. The relative data were combined with flammability properties and the overall performance of the FRs was correlated with the type of branching in the polyethylene grades and to their processing behavior. The thermal degradation kinetics was further determined based on the Kissinger and Coats-Redfern methods. In terms of flammability, the addition of a triazine derivative and ammonium polyphosphate at a loading of 35 wt. %. was found to be the most efficient, leading to UL 94 V0 ranking in the case of the LDPE grade produced in an autoclave reactor. - 2019 by the authors.Funding: This publication was made possible by the NPRP award [NPRP 9-161-1-030] from the Qatar National Research Fund (a member of The Qatar Foundation). The statements made herein are solely the responsibility of the author(s)

Two-loop Sudakov form factor in ABJM

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Cultivars to face climate change effects on crops and weeds: a review

International audienceAbstractClimate change is caused by the release of greenhouse gases in the atmosphere. Climate change will impact many activities, but its effects on agricultural production could be acute. Estimates of annual damages in agriculture due to temperature increase or extended periods of drought will be more costly than damages in other activities. Yield losses are caused both by direct effects of climate change on crops and by indirect effects such as increased inputs in crop production for weed control. One possible solution to counteract the effects of climate change is to seek crop cultivars that are adapted to highly variable, extreme climatic conditions and pest changes. Here we review the effects of climate change on crop cultivars and weeds. Biomass increase will augment marketable yield by 8–70 % for C3 cereals, by 20–144 % for cash and vegetable crops, and by 6–35 % for flowers. Such positive effects could however be reduced by decreasing water and nutrient availability. Rising temperature will decrease yields of temperature-sensitive crops such as maize, soybean, wheat, and cotton or specialty crops such as almonds, grapes, berries, citrus, or stone fruits. Rice, which is expected to yield better under increased CO2, will suffer serious yield losses under high temperatures. Drought stress should decrease the production of tomato, soybean, maize, and cotton. Nevertheless, reviews on C4 photosynthesis response to water stress in interaction with CO2 concentration reveal that elevated CO2 concentration lessens the deleterious effect of drought on plant productivity. C3 weeds respond more strongly than C4 types to CO2 increases through biomass and leaf area increases. The positive response of C3 crops to elevated CO2 may make C4 weeds less competitive for C3 crops, whereas C3 weeds in C4 or C3 crops could become a problem, particularly in tropical regions. Temperature increases will mainly affect the distribution of weeds, particularly C4 type, by expanding their geographical range. This will enhance further yield losses and will affect weed management systems negatively. In addition, the expansion of invasive weed species such as itchgrass, cogongrass, and witchweed facilitated by temperature increases will increase the cost for their control. Under water or nutrient shortage scenarios, an r-strategist with characteristics in the order S-C-R, such as Palmer amaranth, large crabgrass, johnsongrass, and spurges, will most probably prevail. Selection of cultivars that secure high yields under climate change but also by competing weeds is of major importance. Traits related with (a) increased root/shoot ratio, (b) vernalization periods, (c) maturity, (d) regulation of node formation and/or internode distance, (e) harvest index variations, and (f) allelopathy merit further investigation. The cumulative effects of selecting a suitable stress tolerator-competitor cultivar will be reflected in reductions of environmental pollution, lower production costs, and sustainable food production