Benign paroxysmal positional vertigo after radiologic scanning: a case series

<p>Abstract</p> <p>Introduction</p> <p>Benign paroxysmal positional vertigo (BPPV) is the most common type of vertigo. It is frequently seen in elderly patients, and the course of the attack may easily mimic cerebrovascular disease. A BPPV attack after a radiologic examination has not been reported previously. We report the cases of two patients who had BPPV attacks after radiologic imaging.</p> <p>Case presentation</p> <p>The first patient with headache and tremor was admitted to the radiology department for cranial computed tomography (CT) imaging. During scanning, she was asked to lie in the supine position with no other head movements for approximately 10 minutes. After the cranial CT imaging, she stood up rapidly, and suddenly experienced a vertigo attack and nausea. The second patient was admitted to the radiology department for evaluation of his renal arteries. During the renal magnetic resonance angiography, he was in the supine position for 20 minutes and asked not to move. After the examination, he stood up rapidly with the help of the technician and suddenly experienced a vertigo attack with nausea and vomiting. The results of standard laboratory analyses and their neurologic examinations were within normal limits and Dix-Hallpike tests showed rotatory nystagmus in both cases. An Epley maneuver was performed to the patients. The results of a control Dix-Hallpike tests after 1 Epley maneuver were negative in both patients.</p> <p>Conclusion</p> <p>Radiologists and clinicians must keep in mind that after radiologic imaging in which the patient is still for some time in the supine position and then helped to stand up rapidly, a BPPV attack may occur.</p

Pleomorphic Carcinoma of the Lung with High Serum Beta-human Chorionic Gonadotropin Level and Gynecomastia

Although gynecomastia is a well-defined paraneoplastic syndrome in patients with non-small cell lung cancer, the association with pleomorphic carcinoma has not been reported. A 50-yr-old man presented with bilateral gynecomastia and elevated serum beta-human chorionic gonadotropin (βhCG) level. Chest tomography showed a mass in the right middle lobe. Right middle lobectomy and mediastinal lymph node dissection were performed. βhCG levels decreased rapidly after surgery. Histological examination revealed pleomorphic carcinoma with positive immunostaining for βhCG. Serum βhCG levels began to increase gradually on postoperatively 4th month. Computed tomography detected recurrence and chemotherapy was started. After second cycle of chemotherapy, βhCG levels decreased dramatically again and tomography showed regression in mass. Patient died 6 months later due to brain metastasis. βhCG expression may be associated with aggressive clinical course and increased risk of recurrence, also βhCG levels may be used to evaluate therapy response in patients with pleomorphic carcinoma

Benign Paroxysmal Positional Vertigo in Pregnancy

Benign paroxysmal positional vertigo (BPPV) is a clinical entity characterized by acute, brief paroxysmal attacks of rotational vertigo induced by head position changes. It is the most common peripheral vestibular pathology and is seen more frequently in women. However, to our knowledge, there is very limited data on the association between BPPV and pregnancy in both English and Turkish literature. We present four pregnant women diagnosed with BPPV for the first time during gestation and revise the etiological factors of BPPV and the role of pregnancy-related changes in BPPV

Benign Paroxysmal Positional Vertigo Diagnosed in a Patient with Idiopathic Cervical Dystonia

Idiopathic cervical dystonia (CD) is a focal dystonia characterized by involuntary contraction of the muscles of the neck causing twisting movements and abnormal head and neck postures. Its etiology is unclear: however. intracerebral neuronal circuit pathologies are highly considered. On the contrary, benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo diagnosed. We present a patient with CD suffering from severe vertigo who was diagnosed with BPPV. This is a very unique case representing the co-occurrence of a rare central nervous system pathology and a peripheral inner ear disease. The cause and effect relation between two pathologies is under scope. We present a 55-year-old woman with CD attended our clinic with severe vertigo and nausea. Left posterior semicircular canal BPPV (PSCC BPPV) was diagnosed. Involuntary head and neck muscle contractions caused by CD appear to have contributed to the development of BPPV in this case. However, increased neuronal activities causing CD could also have led to BPPV in the vestibular nuclear level. Further investigations are essential. Peripheral vestibular pathologies and their association with CD are not clearly determined in the literature so far. To our knowledge, there are no other cases reported regarding this co-occurrence

Audio-Vestibular Findings in Increased Intracranial Hypertension Syndrome

OBJECTIVE: Idiopathic intracranial hypertension (IIH) can be manifested by audiological and vestibular complaints. The aim of the present study is to determine the audio-vestibular pathologies and their pathophysiologies in this syndrome by performing current audio-vestibular tests. MATERIALS and METHODS: The study was performed prospectively on 40 individuals (20 IIH patients, 20 healthy volunteers). Pure tone audiometry, tympanometry, vestibular evoked myogenic potentials, and electronystagmography tests were performed in both groups and the results were compared. RESULTS: The mean age of both groups was found to be 30.2 +/- 18.7. There were 11 females and 9 males in each group. The study group patients had significantly worse hearing levels. Pure tone averages were significantly higher in both ears of the study group (p<0.05). Ten patients (50%) in the study group and one healthy volunteer (5%) had pathologic ENG, possibly related to central pathologies (p=0.008). Eight patients (40%) and one (5%) control had variable abnormal VEMP records (p=0008). CONCLUSION: Many IIH patients initially visit otolaryngology clinics since cochlear and vestibular systems are frequently affected in this condition. Our test results suggest inner ear pathologies in these patients. Higher incidence of inferior vestibular nerve and/or saccule dysfunction is detected as a novelty. Increased intracranial pressure may affect the inner ear with similar mechanisms as in hydrops

Bacteriophage cocktail as a promising bio-enhancer for methanogenic activities in anaerobic membrane bioreactors

© 2022 Elsevier B.V.This study aimed to explore the effect of a bacteriophage cocktail, pyophage, on the treatment of wastewater containing antibiotics in an anaerobic membrane bioreactor (AnMBR). During the operational period, performance of the AnMBR was monitored through the changes in chemical oxygen demand (COD), antibiotic removal, transmembrane pressure, and biogas production. Microbial community structure and composition, as well as the occurrence of antibiotic resistance genes were analyzed through shotgun metagenomics analysis. When exposed to pyophage, COD removal efficiency was enhanced up to 96%, whereas membrane fouling was delayed by 25%. Average biogas production was doubled from 224.2 mL/d in control with antibiotics to 447.3 mL/d when exposed to pyophage cocktail with considerable alterations to the archaeal and bacterial community structures. Most notably, the methanogenic community shifted from dominance of Methanothermobacter to Methanoculleus, along with syntrophic bacteria. The results provide insight into the synergistic effects of phage-bacteria and methanogenic communities and illustrate the potential of bacteriophages as bio-enhancers

Selection and Molecular Characterization of Promising Plum Rootstocks (Prunus cerasifera L.) among Seedling-Origin Trees

The plum (Prunus cerasifera Ehrh) has been used worldwide both as a genetic source for breeding new rootstocks and as clonal rootstock for many Prunus species. Considering situations where wild relatives of plums are endangered, in-depth characterization of rootstock traits of genetic diversity of plum germplasm of Turkey with many ecogeographical locations is crucial. In the present study, therefore, three steps were followed for the selection of rootstock candidates among the plum germplasm grown in the Middle Euphrates. This region is characterized by an extremely hot climate with extremely warm summers and very low precipitation in summers. Initially, 79 rootstock candidates were selected based on rootstocks traits, and Myrobalan 29C was also used for the control rootstock in all steps. Hardwood cuttings were taken from each rootstock candidate, and after the rooting process in rootstock candidates, 39 rootstock candidates outperforming other candidates were selected according to root characteristics. Based on rooting ability, forty rootstock candidates with the longest root length below 33.50 mm, root number below 3.00, and rooting cutting number below 30.00% were eliminated. The second step of the study focused on the dwarfing characteristics of 39 rootstock candidates, and 13 and Myrobalan 29C out of 39 rootstock candidates’ dwarfing traits showed value higher compared to the other 26 rootstock candidates. Results indicated that the vigor of rootstock candidates was usually found to be strong (26), intermediate (4), and weak (9). Moreover, 13 out of 39 rootstock candidates’ dwarfism trait was better than the other 26 rootstock candidates. In Step 3, some morphological, physiological, and molecular evaluations were conducted in 13 rootstock candidates and the Myrobalan 29C clone, and there were significant differences between both rootstock candidates and the parameters evaluated. PCA has also been indicated that the reference rootstock Myrobalan 29C was grouped with 63B62, 63B69, and 63B14. The highest genetic similarity was found between 63B11 and 63B16, as well as between 63B76 and 63B66, while the lowest genetic similarity was observed between 63B72 and 63B61 candidates. Overall, the findings presented here provide valuable information about the level of rootstock candidates that could potentially be superior among previously uncharacterized plum cultivars in this plum-growing region of Turkey