Long-Term Follow-Up of Intratympanic Methylprednisolone Versus Gentamicin in Patients With Unilateral Menière's Disease

Objectives: To determine whether long term (>48 months) symptomatic vertigo control is sustained in patients with Menière's disease from a previous comparative trial of intratympanic methylprednisolone versus gentamicin, and if the two treatments remain nonsignificantly different at long-term follow-up. Study Design: Mail survey recording vertigo frequency in the previous one and six months, further intratympanic treatment received, and validated symptom questionnaires. Setting: Outpatient hospital clinic setting. Patients: Adult patients with definite unilateral refractory Menière's disease, who previously received intratympanic treatment in a comparative trial. Intervention: A survey of trial participants who received intratympanic gentamicin (40 mg/mL) or methylprednisolone (62.5 mg/mL). Outcome measures: Primary: number of vertigo attacks in the 6 months prior to receiving this survey compared with the 6 months before the first trial injection. Secondary number of vertigo attacks over the previous 1 month; validated symptom questionnaire scores of tinnitus, dizziness, vertigo, aural fullness, and functional disability. Results: Forty six of the 60 original trial patients (77%) completed the survey, 24 from the gentamicin and 22 from the methylprednisolone group. Average follow-up was 70.8 months (standard deviation 17.0) from the first treatment injection. Vertigo attacks in the 6 months prior to receiving the current survey reduce...
Source: Otology and Neurotology - Category: ENT & OMF Tags: VESTIBULAR DISORDERS Source Type: research

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Numerous studies have examined how alexithymia (difficulty identifying and describing one's emotions and a preference for externally oriented thinking) relates to chronic pain and associated disability. We conducted a systematic review and meta-analysis to summarize individual studies that either assessed alexithymia in individuals with chronic pain vs controls or related alexithymia to pain intensity, physical interference, depression, and anxiety. We searched MEDLINE, Embase, and PsycINFO from inception through June 2017; 77 studies met the criteria (valid assessment of alexithymia in adults or children with any chronic ...
Source: Pain - Category: Anesthesiology Tags: Systematic Review and Meta-Analysis Source Type: research
Rare pain-insensitive individuals offer unique insights into how pain circuits function and have led to the development of new strategies for pain control. We investigated pain sensitivity in humans with WAGR (Wilms tumor, aniridia, genitourinary anomaly, and range of intellectual disabilities) syndrome, who have variably sized heterozygous deletion of the 11p13 region. The deletion region can be inclusive or exclusive of the brain-derived neurotrophic factor (BDNF) gene, a crucial trophic factor for nociceptive afferents. Nociceptive responses assessed by quantitative sensory testing demonstrated reduced pain sensitivity ...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Pain-related diseases are the top leading causes of life disability. Identifying brain regions involved in persistent neuronal changes will provide new insights for developing efficient chronic pain treatment. Here, we showed that anterior nucleus of paraventricular thalamus (PVA) plays an essential role in the development of mechanical hyperalgesia in neuropathic and inflammatory pain models in mice. Increase in c-Fos, phosphorylated extracellular signal–regulated kinase, and hyperexcitability of PVA neurons were detected in hyperalgesic mice. Direct activation of PVA neurons using optogenetics and pharmacological a...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
The objectives of this study were to identify trajectories of SA/DP before and after strong and weak opioid initiation for noncancer pain and the factors associated with these trajectories. A longitudinal population-based study of 201,641 people (24-59 years) without cancer who initiated opioid analgesics in 2009 in Sweden was conducted. Trajectories of net annual SA/DP days in the 5 years before/after opioid initiation were estimated with group-based trajectory modelling. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with trajectory groups....
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Over the past decade, our field has observed rapidly rising rates of mental illness in children and adolescents. The numbers are sobering. Nearly 50% of teens 13 to 18 years of age meet DSM criteria for at least 1 disorder and 27.6% meet criteria for a “severe disorder.”1 Adverse childhood experiences affect more than 50% of children and predispose these individuals to not only academic and behavioral problems throughout their youth, but also future physical disability, such as obesity, hypertension, and diabetes, as adults.2 By 14 years of ag e, accidents, suicide, and homicide assert themselves as the leading...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - Category: Psychiatry Authors: Tags: Commentary Source Type: research
Authors: Chen R, Liou TH, Miao NF, Chang KH, Yen CF, Liao HF, Chi WC, Chou KR Abstract Little is known about the changes of people with schizophrenia disability in Taiwan who receive routine treatments under the current mental healthcare system. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to assess and track changes in the degree of disability in people with schizophrenia before and after 4 years of follow-up. Data on 4497 people with schizophrenia were acquired from the Taiwan Data Bank of Persons with Disability. The WHODAS 2.0 was used for disability assessment, and the...
Source: European Archives of Psychiatry and Clinical Neuroscience - Category: Psychiatry Tags: Eur Arch Psychiatry Clin Neurosci Source Type: research
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Source: Journal of Health Economics - Category: Health Management Source Type: research
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Source: Surgical Endoscopy - Category: Surgery Source Type: research
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Source: Frontiers in Neurology - Category: Neurology Source Type: research
Advanced Rejuvenation is using cutting edge therapies to stimulate hair cell (inner ear) regeneration through stem cell treatment, laser therapy and growth factor injections
Source: Disabled World - Category: Disability Tags: Tinnitus Source Type: news
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