WorldWideScience

Sample records for vestibular side effects

  1. Side Effects

    Science.gov (United States)

    Side effects are problems that occur when cancer treatment affects healthy tissues or organs. Learn about side effects caused by cancer treatment. Know what signs and symptoms to call your doctor about. Learn about treatments for side effects.

  2. Vestibular neuritis: Evaluation and effect of vestibular rehabilitation.

    Science.gov (United States)

    Lorin, P; Donnard, M; Foubert, F

    2015-01-01

    Vestibular neuritis (VN) is a caloric vestibular areflexia that occurs suddenly, and whose compensation can take several weeks, sometimes several months. Usually these patients are rehabilitated, but the most affected patients (cervical vestibular evoked myogenic potential (cVEMP) absent) have a worse prognosis of vestibulo-ocular compensation. Thanks to symptomatic, videographic and posturographic evaluation tools, we objectify and quantify which factors influence the recovery or more accurately the compensation of this type of disorder. EQUIPMENT AND METHOD: We have colligated 34 observations of VN whose beginning could be precisely dated. These 34 unilateral caloric areflexic patients had a symptomatic evaluation (SE) with scales (vertigo symptom scale, dizziness handicap inventory, short form 36), an evaluation of the vestibulo-ocular reflex (VOR) (spontaneous nystagmus, head shaking test, mastoid bone skull vibration test, and finally an evaluation of the vestibulo-spinal function (VSF) on a dynamic posturography platform (DPY). On the other hand were evaluated eight elements supposed to influence (influence factors FI) the care and/or the outcome of the treatment (age, cVEMP absent, duration of deficiency, sports and walk practice, rehabilitation of VOR, rehabilitation of VSF, waiting period before application of rehabilitation, vertigo medications treatment). By comparing averages and with a Fischer's exact test, we can show here that the medical treatment, the waiting period before the application of the rehabilitation, the number of rehabilitation sessions or the type of rehabilitation influence only partially the state of health of neuritis. The age of the patients and absent cVEMP don't have a major influence either. However, patients with the most important physical activity feel better from a symptomatic point of view, over a long period after the episode. The effect of rehabilitation might be temporary if daily activity is minimal. The evaluation of

  3. Effects of vibrotactile vestibular substitution on vestibular rehabilitation - preliminary study,

    Directory of Open Access Journals (Sweden)

    Cibele Brugnera

    2015-12-01

    Full Text Available ABSTRACT INTRODUCTION: Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR. OBJECTIVE: To evaluate the effectiveness of Vertiguard(tm biofeedback equipment as a sensory substitution (SS of the vestibular system in patients who did not obtain sufficient improvement from VR. METHODS: This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG, which received the vibrotactile stimulus from Vertiguard(tm for ten days, and a control group (CG, which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT protocol of the Computerized Dynamic Posturography (CDP and two scales of balance self-perception, Activities-specific Balance Confidence (ABC and Dizziness Handicap Inventory (DHI, were used. RESULTS: After treatment, only the SG showed statistically significant improvement in C5 (p = 0.007 and C6 (p = 0.01. On the ABC scale, there was a significant difference in the SG (p= 0.04. The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p = 0.04. CONCLUSION: The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard(tm system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance.

  4. [Effectiveness of Self-efficacy Promoting Vestibular Rehabilitation Program for Patients with Vestibular Hypofunction].

    Science.gov (United States)

    Lee, Hyun Jung; Choi-Kwon, Smi

    2016-10-01

    In this study an examination was done of the effect of self-efficacy promoting vestibular rehabilitation (S-VR) on dizziness, exercise selfefficacy, adherence to vestibular rehabilitation (VR), subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness in patients with vestibular hypofunction. This was a randomized controlled study. Data were collected 3 times at baseline, 4 and 8 weeks after beginning the intervention. Outcome measures were level of dizziness, exercise self-efficacy, and level of adherence to VR. Subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness were also obtained. Data were analyzed using Windows SPSS 21.0 program. After 4 weeks of S-VR, there was no difference between the groups for dizziness, subjective and objective vestibular functions. However, exercise self-efficacy and adherence to VR were higher in the experimental group than in the control group. After 8 weeks of S-VR, dizziness (p=.018) exercise self-efficacy (pself-efficacy, subjective vestibular function and adherence to VR. Objective vestibular function and vestibular compensation were also improved in the experimental group at the end of 8 weeks of S-VR.

  5. Medications and Side Effects

    Science.gov (United States)

    ... to fully work. You might feel some side effects of your medication before your feel the benefits – ... as sleepiness, anxiety or headache) is a side effect or a symptom of your illness. Many side ...

  6. Vestibular neuritis.

    Science.gov (United States)

    Jeong, Seong-Hae; Kim, Hyo-Jung; Kim, Ji-Soo

    2013-07-01

    Vestibular neuritis is the most common cause of acute spontaneous vertigo. Vestibular neuritis is ascribed to acute unilateral loss of vestibular function, probably due to reactivation of herpes simplex virus in the vestibular ganglia. The diagnostic hallmarks of vestibular neuritis are spontaneous horizontal-torsional nystagmus beating away from the lesion side, abnormal head impulse test for the involved semicircular canals, ipsilesional caloric paresis, decreased responses of vestibular-evoked myogenic potentials during stimulation of the affected ear, and unsteadiness with a falling tendency toward the lesion side. Vestibular neuritis preferentially involves the superior vestibular labyrinth and its afferents. Accordingly, the function of the posterior semicircular canal and saccule, which constitute the inferior vestibular labyrinth, is mostly spared in vestibular neuritis. However, because the rare subtype of inferior vestibular neuritis lacks the typical features of vestibular neuritis, it may be misdiagnosed as a central vestibular disorder. Even in the patient with the typical pattern of spontaneous nystagmus observed in vestibular neuritis, brain imaging is indicated when the patient has unprecedented headache, negative head impulse test, severe unsteadiness, or no recovery within 1 to 2 days. Symptomatic medication is indicated only during the acute phase to relieve the vertigo and nausea/vomiting. Vestibular rehabilitation hastens the recovery. The efficacy of topical and systemic steroids requires further validation. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. Lack of effects of astemizole on vestibular ocular reflex, motion sickness, and cognitive performance in man

    Science.gov (United States)

    Kohl, Randall L.; Homick, Jerry L.; Cintron, Nitza; Calkins, Dick S.

    1987-01-01

    Astemizole was orally administered to 20 subjects in a randomized, double-blind design to assess the efficacy of this peripherally active antihistamine as an antimotion sickness drug possessing no central side-effects. Measures of vestibular ocular reflex (VOR) were made to evaluate the agent as a selective vestibular depressant. Following one week of orally administered astemizole (30 mg daily), a Staircase Profile Test, a VOR test, and a variety of tests of cognitive performance were administered. These tests revealed no statistically significant effects of astemizole. This leads to the conclusion that, although the drug probably reaches the peripheral vestibular apparatus in man by crossing the blood-vestibular barrier, a selective peripheral antihistamine (H1) action is inadequate to control motion sickness induced through cross-coupled accelerative semicircular canal stimulation in a rotating chair.

  8. Side Effects (Management)

    Science.gov (United States)

    ... cancer care is relieving side effects, called symptom management, palliative care, or supportive care. It is important ... treat them. To learn about the symptoms and management of the long-term side effects of cancer ...

  9. Three-dimensional head-mounted gaming task procedure maximizes effects of vestibular rehabilitation in unilateral vestibular hypofunction: a randomized controlled pilot trial.

    Science.gov (United States)

    Micarelli, Alessandro; Viziano, Andrea; Augimeri, Ivan; Micarelli, Domenico; Alessandrini, Marco

    2017-12-01

    Considering the emerging advantages related to virtual reality implementation in clinical rehabilitation, the aim of the present study was to discover possible (i) improvements achievable in unilateral vestibular hypofunction patients using a self-assessed head-mounted device (HMD)-based gaming procedure when combined with a classical vestibular rehabilitation protocol (HMD group) as compared with a group undergoing only vestibular rehabilitation and (ii) HMD procedure-related side effects. Therefore, 24 vestibular rehabilitation and 23-matched HMD unilateral vestibular hypofunction individuals simultaneously underwent a 4-week rehabilitation protocol. Both otoneurological measures (vestibulo-ocular reflex gain and postural arrangement by studying both posturography parameters and spectral values of body oscillation) and performance and self-report measures (Italian Dizziness Handicap Inventory; Activities-specific Balance Confidence scale; Zung Instrument for Anxiety Disorders, Dynamic Gait Index; and Simulator Sickness Questionnaire) were analyzed by means of a between-group/within-subject analysis of variance model. A significant post-treatment between-effect was found, and the HMD group demonstrated an overall improvement in vestibulo-ocular reflex gain on the lesional side, in posturography parameters, in low-frequency spectral domain, as well as in Italian Dizziness Handicap Inventory and Activities-specific Balance Confidence scale scores. Meanwhile, Simulator Sickness Questionnaire scores demonstrated a significant reduction in symptoms related to experimental home-based gaming tasks during the HMD procedure. Our findings revealed the possible advantages of HMD implementation in vestibular rehabilitation, suggesting it as an innovative, self-assessed, low-cost, and compliant tool useful in maximizing vestibular rehabilitation outcomes.

  10. Sensitivity and specificity of vestibular bed-side examination in detecting VIII cranial nerve schwannoma with sensorineural sudden unilateral hearing loss as presenting symptom.

    Science.gov (United States)

    Califano, L; Salafia, F; Melillo, M G; Mazzone, S

    2017-08-01

    The objectives of this study were to identify signs of vestibular nerve suffering through a bedside vestibular examination protocol in case of sudden sensorineural unilateral hearing loss without spontaneous signs of vestibular impairment and to propose a bed-side vestibular examination based protocol for the focused execution of gadolinium-enhanced magnetic resonance imaging (MRI) only if a vestibular schwannoma is suspected. 96 patients, 52 men, 44 women, mean age 57.73 +/- 12.85 years, suffering from sudden sensorineural unilateral hearing loss, which presented neither vertigo nor spontaneous nystagmus, were enrolled. Pure tone audiometry, tympanometry, measurement of acoustic reflexes and Anderson test to detect adaptation, bedside vestibular examination through head shaking test, vibration test, head impulse test, hyperventilation test and detection of nystagmus in supine and lateral decubitus to search for signs of vestibular impairment were performed. Patients with signs of vestibular impairment and pure tone audiometry threshold at high frequencies better than 70 dB nHL were subjected to auditory brainstem responses. Gadolinium enhanced MRI centred on internal acoustic canals was carried out in all patients with sudden sensorineural unilateral hearing loss. Main outcome measures were signs of vestibular impairment at vestibular bedside examination and presence of vestibular schwannoma on MRI. Signs of vestibular impairment were detected in 22/96 cases (22.9%); a vestibular schwannoma was detected by MRI in 5/96 cases (5.2%), always when vestibular impairment was present. In case of sudden sensorineural unilateral hearing loss, vestibular bedside examination seems to be useful to restrict the suspicion of a vestibular schwannoma to cases with signs of vestibular impairment, reducing the number of MRI exams, with considerable economic savings. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  11. Effects of Vestibular Rehabilitation Interventions in the Elderly with Chronic Unilateral Vestibular Hypofunction

    Directory of Open Access Journals (Sweden)

    Arash Bayat

    2017-07-01

    Full Text Available Introduction: Although vestibular rehabilitation therapy (VRT methods are relatively popular in treating patients with body balance deficits of vestibular origin, only limited studies have been conducted into customized exercises for unilateral vestibular hypofunction (UVH. Furthermore, very little evidence is available on the outcomes of VRT in the elderly population with chronic UVH. Materials and Methods: A total of 21 patients, aged 61 to 74 years, with UVH participated in this study. The dizziness handicap inventory (DHI was performed immediately before, and 2 and 8 weeks after treatment. Results: All patients showed a reduction in DHI scores during the study. The average decrease in DHI score was 25.98 points after 2 weeks’ intervention (P0.05. There were no relationships between the scores and gender. Conclusion: Our study demonstrates that VRT is an effective method for the management of elderly patients with UVH, and shows maximal effect on functional aspects.

  12. Side Effects: Appetite Loss

    Science.gov (United States)

    Cancer treatments may lower your appetite. Side effects such as nausea, fatigue, or mouth sores can also making eating difficult. Learn how to eat well to avoid losing weight or becoming dehydrated, so you stay strong during treatment.

  13. Side Effects: Fatigue

    Science.gov (United States)

    Fatigue is a common side effect of many cancer treatments such as chemotherapy, radiation therapy, immunotherapy, and surgery. Anemia and pain can also cause fatigue. Learn about symptoms and way to manage fatigue.

  14. Side Effects: Sleep Problems

    Science.gov (United States)

    Sleep problems are a common side effect during cancer treatment. Learn how a polysomnogram can assess sleep problems. Learn about the benefits of managing sleep disorders in men and women with cancer.

  15. Side Effects: Pain

    Science.gov (United States)

    Controlling pain is an important part of your cancer treatment plan. Learn how to track levels of pain. Find out how pain, a side effect of cancer treatment, is treated using acupuncture, biofeedback, and physical therapy.

  16. Side Effects: Diarrhea

    Science.gov (United States)

    Diarrhea, a side effect of cancer treatment, may cause symptoms such as loose, watery stools. Diarrhea can lead to dehydration and malnutrition in cancer patients. Learn about ways to treat and manage diarrhea during cancer treatment.

  17. Side Effects: Anemia

    Science.gov (United States)

    Anemia is a side effect of cancer treatments, including chemotherapy and radiation therapy. It can make women and men feel fatigued, dizzy, and short of breath. Learn how to manage fatigue caused by anemia during cancer treatment.

  18. [Psychoanalysis and Side Effect].

    Science.gov (United States)

    Shirahase, Joichiro

    2015-01-01

    A study of psychoanalysis from the perspective of side effects reveals that its history was a succession of measures to deal with its own side effects. This, however, does not merely suggest that, as a treatment method, psychoanalysis is incomplete and weak: rather, its history is a record of the growth and development of psychoanalysis that discovered therapeutic significance from phenomena that were initially regarded as side effects, made use of these discoveries, and elaborated them as a treatment method. The approach of research seen during the course of these developments is linked to the basic therapeutic approach of psychoanalysis. A therapist therefore does not draw conclusions about a patient's words and behaviors from a single aspect, but continues to make efforts to actively discover a variety of meanings and values from them, and to make the patient's life richer and more productive. This therapeutic approach is undoubtedly one of the unique aspects of psychoanalysis. I discuss the issue of psychoanalysis and side effects with the aim of clarifying this unique characteristic of psychoanalysis. The phenomenon called resistance inevitably emerges during the process of psychoanalytic treatment. Resistance can not only obstruct the progress of therapy; it also carries the risk of causing a variety of disadvantages to the patient. It can therefore be seen as an adverse effect. However, if we re-examine this phenomenon from the perspective of transference, we find that resistance is in fact a crucial tool in psychoanalysis, and included in its main effect, rather than a side effect. From the perspective of minimizing the character of resistance as a side effect and maximizing its character as a main effect, I have reviewed logical organization, dynamic evaluation, the structuring of treatment, the therapist's attitudes, and the training of therapists. I conclude by stating that psychoanalysis has aspects that do not match the perspective known as a side

  19. Pre-operative vestibular pattern and balance compensation after vestibular schwannoma surgery.

    Science.gov (United States)

    Parietti-Winkler, C; Gauchard, G C; Simon, C; Perrin, P P

    2011-01-13

    This longitudinal study aimed to assess the sensorimotor balance strategies before and after vestibular schwannoma (VS) surgery according to the degree of pre-operative vestibular lesion. Thirty-eight VS patients were split in three groups according to caloric vestibular test results before surgery; nine had a symmetrical vestibular response (vestibular normoreflexy), 19 with a decreased response of more than 20% of the affected side (vestibular hyporeflexy) and 10 with an absent caloric response on the side of the affected labyrinth (vestibular areflexy). They underwent pendular rotary vestibular testing (RVT), allowing to evaluate gain and directional preponderance of the vestibulo-ocular reflex, and a sensory organisation test (SOT), evaluating balance control in six conditions (C1 to C6). These tests were performed shortly before, and 8 and 90 days after surgery. Directional preponderance performances of patients with vestibular normoreflexy or hyporeflexy followed a classical time-course with a huge asymmetry just after surgery and a recovery to pre-operative performances at 90 days; patients with vestibular areflexy were relatively stable in time. Variation in SOT performances of patients with vestibular normoreflexy, especially in the more complex C4 to C6, followed a classical time-course with an important postural degradation just after surgery and a recovery to pre-operative performances at 90 days. Patients with vestibular areflexy showed no balance degradation just after surgery and a marked increase in performances at 90 days after surgery, especially in C5 and C6. Performances of patients with vestibular hyporeflexy were intermediate, close to performances of patients with vestibular normoreflexy before surgery and close to performances of patients with vestibular areflexy at 8 and 90 days after surgery. Pre-operative vestibular function alteration triggers an adaptive process, characterized by a restoration of the symmetry of the vestibular nuclei

  20. Late radiation effects on hearing, vestibular function, and taste in brain tumor patients

    International Nuclear Information System (INIS)

    Johannesen, Tom B.; Rasmussen, Kjell; Winther, Finn Oe.; Halvorsen, Ulf; Lote, Knut

    2002-01-01

    Purpose: To investigate late radiation effects on hearing, vestibular function, and taste after conventional radiotherapy in brain tumor patients. Methods and Materials: Hearing, vestibular function, and taste were assessed in 33 brain tumor patients irradiated unilaterally to the tumor-bearing hemisphere and the temporal bone. Median observation time after completion of radiotherapy was 13 years; the fraction dose was 1.8 Gy, and mean radiation dose was 53.1 Gy. Results: Deep ulceration in the external ear canal and osteoradionecrosis on the irradiated side was seen in three patients. Reduced hearing was found for air and bone conduction of the irradiated side compared to the opposite side (0.25-2 kHz: 6.1 dB, 4 kHz: 10.3 dB, 6 kHz: 15.6 dB, and 8 kHz: 16.5 dB). For bone conduction, the corresponding figures were 0.25-2 kHz: 5.5 dB and 4 kHz: 8.2 dB. Three patients had a canal paresis of the irradiated side, and three patients had affection of the chorda tympani. Conclusion: Irradiation of the temporal bone with doses usually given in the treatment of patients with brain tumors may cause osteoradionecrosis, sensorineural hearing loss, dysfunction of the vestibular inner ear, and loss of taste. Head-and-neck examination should be included in the follow-up of long-term survivors

  1. Effects of vestibular rehabilitation in the elderly complaining of dizziness

    Directory of Open Access Journals (Sweden)

    Andréa Paz-Oliveira

    2014-08-01

    Full Text Available Changes of body balance are among the most common complaints of the elderly. Vestibular rehabilitation is one of the most effective methods in the recovery of the body balance. The objective to investigate the effects of vestibular rehabilitation in body balance of a group of elderly people with dizziness complain through dizziness handicap inventory. The sample was comprised of 10 seniors (6 women and 4 men with mean age of 68.9 years. The elderly complaining of dizziness showed high score in the DHI in the physical, functional and emotional aspects in the condition pre-VR and these values decreased after vestibular rehabilitation program. Complaints of dizziness also decreased after the implementation of the programmee.  

  2. The effects of aging on clinical vestibular evaluations

    Directory of Open Access Journals (Sweden)

    Maxime eMaheu

    2015-09-01

    Full Text Available Balance disorders are common issues for aging populations due to the effects of normal aging on peripheral vestibular structures. These changes affect the results of vestibular function evaluations and make the interpretation of these results more difficult. The objective of this article is to review the current state of knowledge of clinically relevant vestibular measures. We will first focus on otolith function assessment methods cVEMP and oVEMP, then the caloric and vHIT methods for semi-circular canals assessment. cVEMP and oVEMP are useful methods, though research on the effects of age for some parameters are still inconclusive. vHIT results are largely independent of age as compared to caloric stimulation and should therefore be preferred for the evaluation of the semi-circular canals function.

  3. The Vestibular Effects of Repeated Low-Level Blasts.

    Science.gov (United States)

    Littlefield, Philip D; Pinto, Robin L; Burrows, Holly L; Brungart, Douglas S

    2016-01-01

    The objective of this study was to use a prospective cohort of United States Marine Corps (USMC) instructors to identify any acute or long-term vestibular dysfunction following repeated blast exposures during explosive breaching training. They were assessed in clinic and on location during training at the USMC Methods of Entry School, Quantico, VA. Subjects received comprehensive baseline vestibular assessments and these were repeated in order to identify longitudinal changes. They also received shorter assessments immediately following blast exposure in order to identify acute findings. The main outcome measures were the Neurobehavioral Symptom Inventory, vestibular Visual Analog Scale (VAS) of subjective vestibular function, videonystagmography (VNG), vestibular evoked myogenic potentials (VEMP), rotary chair (including the unilateral centrifugation test), computerized dynamic posturography, and computerized dynamic visual acuity. A total of 11 breachers and 4 engineers were followed for up to 17 months. No acute effects or longitudinal deteriorations were identified, but there were some interesting baseline group differences. Upbeat positional nystagmus was common, and correlated (p<0.005) with a history of mild traumatic brain injury (mTBI). Several instructors had abnormally short low-frequency phase leads on rotary chair testing. This study evaluated breaching instructors over a longer test period than any other study, and the results suggest that this population appears to be safe from a vestibular standpoint at the current exposure levels. Upbeat positional nystagmus correlated with a history of mTBI in this population, and this has not been described elsewhere. The data trends also suggest that this nystagmus could be an acute blast effect. However, the reasons for the abnormally short phase leads seen in rotary chair testing are unclear at this time. Further investigation seems warranted.

  4. Auditory, Vestibular and Cognitive Effects due to Repeated Blast Exposure on the Warfighter

    Science.gov (United States)

    2012-10-01

    competitions Prior disorders of hearing and balance including: o Meniere’s disease o Chronic migraine o Multiple sclerosis o Vestibular neuritis o...AD______________ AWARD NUMBER: W81XWH-08-2-0029 TITLE: Auditory, Vestibular and Cognitive...201 – 31 201 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Auditory, Vestibular and Cognitive Effects due to Repeated Blast Exposure on the

  5. Probiotics: Safety and Side Effects

    Science.gov (United States)

    ... turn JavaScript on. Feature: Probiotics Safety and Side Effects Past Issues / Winter 2016 Table of Contents What the Science Says About the Safety and Side Effects of Probiotics Whether probiotics are likely to be ...

  6. HIV Medicines and Side Effects

    Science.gov (United States)

    ... Apps skip to content Side Effects of HIV Medicines Home Understanding HIV/AIDS Fact Sheets HIV Medicines ... p.m. ET) Send us an email HIV Medicines and Side Effects Last Reviewed: October 9, 2017 ...

  7. Distinct vestibular effects on early and late somatosensory cortical processing in humans.

    Science.gov (United States)

    Pfeiffer, Christian; van Elk, Michiel; Bernasconi, Fosco; Blanke, Olaf

    2016-01-15

    In non-human primates several brain areas contain neurons that respond to both vestibular and somatosensory stimulation. In humans, vestibular stimulation activates several somatosensory brain regions and improves tactile perception. However, less is known about the spatio-temporal dynamics of such vestibular-somatosensory interactions in the human brain. To address this issue, we recorded high-density electroencephalography during left median nerve electrical stimulation to obtain Somatosensory Evoked Potentials (SEPs). We analyzed SEPs during vestibular activation following sudden decelerations from constant-velocity (90°/s and 60°/s) earth-vertical axis yaw rotations and SEPs during a non-vestibular control period. SEP analysis revealed two distinct temporal effects of vestibular activation: An early effect (28-32ms post-stimulus) characterized by vestibular suppression of SEP response strength that depended on rotation velocity and a later effect (97-112ms post-stimulus) characterized by vestibular modulation of SEP topographical pattern that was rotation velocity-independent. Source estimation localized these vestibular effects, during both time periods, to activation differences in a distributed cortical network including the right postcentral gyrus, right insula, left precuneus, and bilateral secondary somatosensory cortex. These results suggest that vestibular-somatosensory interactions in humans depend on processing in specific time periods in somatosensory and vestibular cortical regions. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Running away from side effects

    DEFF Research Database (Denmark)

    Casla, S; Hojman, P; Márquez-Rodas, I

    2015-01-01

    The number of breast cancer survivors increases every year, thanks to the development of new treatments and screening techniques. However, patients present with numerous side effects that may affect their quality of life. Exercise has been demonstrated to reduce some of these side effects, but in...... of how to design exercise interventions in patients with different side effects....

  9. Vestibular Perception following Acute Unilateral Vestibular Lesions

    Science.gov (United States)

    Cousins, Sian; Kaski, Diego; Cutfield, Nicholas; Seemungal, Barry; Golding, John F.; Gresty, Michael; Glasauer, Stefan; Bronstein, Adolfo M.

    2013-01-01

    Little is known about the vestibulo-perceptual (VP) system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO) and VP function in 25 patients with vestibular neuritis (VN) acutely (2 days after onset) and after compensation (recovery phase, 10 weeks). Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s2 and velocity steps of 90°/s (acceleration 180°/s2). We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any ‘perceptual noise’ added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced – asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of

  10. Vestibular perception following acute unilateral vestibular lesions.

    Directory of Open Access Journals (Sweden)

    Sian Cousins

    Full Text Available Little is known about the vestibulo-perceptual (VP system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO and VP function in 25 patients with vestibular neuritis (VN acutely (2 days after onset and after compensation (recovery phase, 10 weeks. Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s(2 and velocity steps of 90°/s (acceleration 180°/s(2. We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any 'perceptual noise' added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced - asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of

  11. Common Vestibular Disorders

    Directory of Open Access Journals (Sweden)

    Dimitrios G. Balatsouras

    2017-01-01

    Full Text Available The three most common vestibular diseases, benign paroxysmal positional vertigo (BPPV, Meniere's disease (MD and vestibular neuritis (VN, are presented in this paper. BPPV, which is the most common peripheral vestibular disorder, can be defined as transient vertigo induced by a rapid head position change, associated with a characteristic paroxysmal positional nystagmus. Canalolithiasis of the posterior semicircular canal is considered the most convincing theory of its pathogenesis and the development of appropriate therapeutic maneuvers resulted in its effective treatment. However, involvement of the horizontal or the anterior canal has been found in a significant rate and the recognition and treatment of these variants completed the clinical picture of the disease. MD is a chronic condition characterized by episodic attacks of vertigo, fluctuating hearing loss, tinnitus, aural pressure and a progressive loss of audiovestibular functions. Presence of endolymphatic hydrops on postmortem examination is its pathologic correlate. MD continues to be a diagnostic and therapeutic challenge. Patients with the disease range from minimally symptomatic, highly functional individuals to severely affected, disabled patients. Current management strategies are designed to control the acute and recurrent vestibulopathy but offer minimal remedy for the progressive cochlear dysfunction. VN is the most common cause of acute spontaneous vertigo, attributed to acute unilateral loss of vestibular function. Key signs and symptoms are an acute onset of spinning vertigo, postural imbalance and nausea as well as a horizontal rotatory nystagmus beating towards the non-affected side, a pathological headimpulse test and no evidence for central vestibular or ocular motor dysfunction. Vestibular neuritis preferentially involves the superior vestibular labyrinth and its afferents. Symptomatic medication is indicated only during the acute phase to relieve the vertigo and nausea

  12. Investigating the Effects of Vestibular Stimulation on Balance Performance in Children with Cerebral Palsy: A Randomized Clinical Trial Study

    Directory of Open Access Journals (Sweden)

    Seyed Ali Hosseini

    2015-06-01

    Full Text Available Background: Centre of pressure displacement is an indicator of postural control. Children with cerebral palsy have poor postural control. One common intervention to enhance their balance is vestibular stimulation. The aim of this research was to investigate the effect of vestibular stimulation on COP parameters in children with cerebral palsy (3-10 years old. Methods: This study was a randomized double-blind controlled clinical trial. Twenty children with cerebral palsy received vestibular stimulation, two sessions per week with a course of twelve sessions, based on vestibular stimulation protocol including anteroposterior, lateral, ascending–descending movements and spinning. One cerebral palsy group experienced current and conventional occupational therapy while the other received a period of vestibular stimulation during treatment. Force plate outcome measures were center of pressure displacement parameters as well as velocity, area, displacement in X and Y axes. Results: According to Mann-Whitney U test, means in post-tests in two groups with both conditions of eyes open and closed were significant in velocity parameter (eyes open P=0.036; eyes closed P=0.021 while Area parameter, COP displacement in X axis (Rang fore after, COP displacement in Y axis (Rang side way were not significant (P>0.05. Wilcoxon Test showed significant difference in the velocity parameter; eyes open (P=0.012 and eyes closed (P=0.018. Conclusion: Children who received vestibular stimulation are able to change and control COP displacement faster (according to changes in velocity parameters. So we suggest rehabilitation team members especially occupational therapist to apply vestibular stimulation during their treatment.

  13. Side Effects of Hormone Therapy

    Science.gov (United States)

    ... for PCF: Many vs Cancer Contact Us Side Effects of Hormone Therapy Testosterone is the primary male ... processes in the body. The list of potential effects of testosterone loss is long: hot flashes, decreased ...

  14. Coping – Late Side Effects

    Science.gov (United States)

    Cancer treatment can cause late side effects that may not show up for months or years after treatment. These late effects may include heart and lung problems, bone loss, eye and hearing changes, lymphedema, and other problems

  15. Side Effects of Chemotherapy

    Science.gov (United States)

    ... by finding a way to relax—listening to music, doing yoga or stretching exercises, taking a walk in the woods or on the beach, or watching a movie marathon on television. Effectively relieving stress will help contribute to the ultimate goal of ...

  16. Side Effects: Nausea and Vomiting

    Science.gov (United States)

    Types of nausea and vomiting caused by cancer treatment include: anticipatory, acute, and delayed. Controlling these side effects will help to prevent serious problems such as malnutrition and dehydration in people with cancer.

  17. Side Effects: Infection and Neutropenia

    Science.gov (United States)

    Infection and neutropenia can be serious side effects during cancer treatment. Chemotherapy can increase your risk. Learn how to prevent infection during treatment. Find out what signs and symptoms to call the doctor about.

  18. Side Effects: Hair Loss (Alopecia)

    Science.gov (United States)

    Hair loss, also called alopecia, is a side effect of cancer treatments, such as chemotherapy and radiation therapy. Learn how to cope with and manage hair loss. Listen to tips from others who have experienced hair loss.

  19. Side Effects and Their Management

    Science.gov (United States)

    ... tumors. Donate Now Subscribe for e-updates Please leave this field empty ... tumors and their treatments bring an array of possible side effects in to a patient’s life. Fatigue, cognitive changes, and mood changes are ...

  20. The effect of changes in perilymphatic K+ on the vestibular evoked potential in the guinea pig

    NARCIS (Netherlands)

    Kingma, C. M.; Wit, H. P.

    2010-01-01

    To investigate the effect on the functioning of the vestibular system of a rupture of Reissner's membrane, artificial endolymph was injected in scala media of ten guinea pigs and vestibular evoked potentials (VsEPs), evoked by vertical acceleration pulses, were measured. Directly after injection of

  1. The Effect of Galvanic Vestibular Stimulation on Postural Response of Down Syndrome Individuals on the Seesaw

    Science.gov (United States)

    Carvalho, R. L.; Almeida, G. L.

    2011-01-01

    In order to better understand the role of the vestibular system in postural adjustments on unstable surfaces, we analyzed the effects of galvanic vestibular stimulation (GVS) on the pattern of muscle activity and joint displacements (ankle knee and hip) of eight intellectually normal participants (control group--CG) and eight control group…

  2. Vestibular-somatosensory interactions: effects of passive whole-body rotation on somatosensory detection.

    Directory of Open Access Journals (Sweden)

    Elisa Raffaella Ferrè

    Full Text Available Vestibular signals are strongly integrated with information from several other sensory modalities. For example, vestibular stimulation was reported to improve tactile detection. However, this improvement could reflect either a multimodal interaction or an indirect interaction driven by vestibular effects on spatial attention and orienting. Here we investigate whether natural vestibular activation induced by passive whole-body rotation influences tactile detection. In particular, we assessed the ability to detect faint tactile stimuli to the fingertips of the left and right hand during spatially congruent or incongruent rotations. We found that passive whole-body rotations significantly enhanced sensitivity to faint shocks, without affecting response bias. Critically, this enhancement of somatosensory sensitivity did not depend on the spatial congruency between the direction of rotation and the hand stimulated. Thus, our results support a multimodal interaction, likely in brain areas receiving both vestibular and somatosensory signals.

  3. Long-term effects of vestibular compensation on balance control and sensory organisation after unilateral deafferentation due to vestibular schwannoma surgery.

    Science.gov (United States)

    Parietti-Winkler, Cécile; Gauchard, Gérome C; Simon, Claude; Perrin, Philippe P

    2010-08-01

    The time-course of central adaptive mechanisms after vestibular schwannoma surgical removal allows, 3 months after surgery (middle term), a satisfactory recovery of balance control. However, the long-term evolution of postural control beyond the end of usual medical follow-up remains unknown. This longitudinal prospective study aimed to assess the long-term effects of vestibular compensation on balance control and sensory organisation in patients operated on for vestibular schwannoma. Thirty-six patients with vestibular schwannoma underwent vestibular and sensory organisation tests, shortly before and 3 months, 6 months and 1 year after surgery. Postural control performances improved 3 months after surgery compared with before surgery; they continued to improve at 6 and 12 months after surgery, especially in conditions highly soliciting vestibular information. In the long term, strategies based on sensorimotor and/or behavioural substitution seem to be reinforced and fine-tuned, particularly in complex postural situations, for which only vestibular information is reliable to control balance.

  4. Managing Chemotherapy Side Effects: Constipation

    Science.gov (United States)

    ... Raw or cooked vegetables, such as broccoli, corn, green beans, peas, and spinach Snacks ••Granola ••Nuts ••Popcorn •• ... gov/livehelp NCI has a series of 18 Chemotherapy Side Effects Sheets at: www.cancer.gov/chemo- ...

  5. Finasteride and sexual side effects

    Directory of Open Access Journals (Sweden)

    Venkataram Mysore

    2012-01-01

    Full Text Available Finasteride, a 5-alpha reductase inhibitor, widely used in the medical management of male pattern hairloss, has been reported to cause sexual side effects. This article critically examines the evidence available and makes recommendations as to how a physician should counsel a patient while prescribing the drug.

  6. Metabolic Side Effects of Lithium

    Directory of Open Access Journals (Sweden)

    M. Cagdas Eker

    2010-04-01

    Full Text Available Lithium is an alkaline ion being used since 19th century. After its widespread use in psychiatric disorders, observed side effects caused skepticism about its therapeutic efficacy. Despite several disadvantages, lithium is one of the indispensible drugs used in affective disorders, especially in bipolar disorder. It became a necessity for physicians to recognize its side effects since lithium is still accepted as a gold standard in the treatment of bipolar disorder. Adverse effects of chronic administration of lithium on several organ systems are widely known. In this article metabolic effects of lithium on thyroid and parathyroid glands, body mass index and kidneys will be discussed along with their mechanisms, clinical findings, possible risk factors and treatment. One of the most common side effect of lithium is hypothyroidism. It has the same clinical and biochemical properties as primary hypothyroidism and observed as subclinical hypothyroidism in the first place. Hypothyroidism, even its subclinical form, may be associated with non-response or inadequate response and is indicated as a risk factor for development of rapid cycling bipolar disorder. Therefore, hypothyroidism should be screened no matter how severe it is and should be treated with thyroid hormone in the presence of clinical hypothyroidism. Weight gain due to lithium administration disturbs the compliance to treatment and negatively affects the course of the illness. Increased risk for diabetes, hypertension, ischemic heart disease and stroke because of weight gain constitute other centers of problem. Indeed, it is of importance to determine the risk factors before treatment, to follow up the weight, to re-organize nutritional habits and to schedule exercises. Another frequent problematic side effect of lithium treatment is renal dysfunction which clinically present as nephrogenic diabetes insipidus with the common symptoms of polyuria and polydipsia. Nephrogenic diabetes

  7. The effects of vestibular stimulation and fatigue on postural control in classical ballet dancers.

    Science.gov (United States)

    Hopper, Diana M; Grisbrook, Tiffany L; Newnham, Prudence J; Edwards, Dylan J

    2014-01-01

    This study aimed to investigate the effects of ballet-specific vestibular stimulation and fatigue on static postural control in ballet dancers and to establish whether these effects differ across varying levels of ballet training. Dancers were divided into three groups: professional, pre-professional, and recreational. Static postural control of 23 dancers was measured on a force platform at baseline and then immediately, 30 seconds, and 60 seconds after vestibular stimulation (pirouettes) and induction of fatigue (repetitive jumps). The professional dancers' balance was unaffected by both the vestibular stimulation and the fatigue task. The pre-professional and recreational dancers' static sway increased following both perturbations. It is concluded that professional dancers are able to compensate for vestibular and fatiguing perturbations due to a higher level of skill-specific motor training.

  8. Effects of conventional versus multimodal vestibular rehabilitation on functional capacity and balance control in older people with chronic dizziness from vestibular disorders: design of a randomized clinical trial.

    Science.gov (United States)

    Aquaroni Ricci, Natalia; Aratani, Mayra Cristina; Caovilla, Heloisa Helena; Freitas Ganança, Fernando

    2012-12-31

    There are several protocols designed to treat vestibular disorders that focus on habituation, substitution, adaptation, and compensation exercises. However, protocols that contemplate not only vestibular stimulation but also other components that are essential to the body balance control in older people are rare. This study aims to compare the effectiveness of two vestibular rehabilitation protocols (conventional versus multimodal) on the functional capacity and body balance control of older people with chronic dizziness due to vestibular disorders. A randomized, single-blind, controlled clinical trial with a 3 months follow-up period will be performed. The sample will be composed of older individuals with a clinical diagnosis of chronic dizziness resulting from vestibular disorders. The subjects will be evaluated at baseline, post-treatment and follow-up. Primary outcomes will be determined in accordance with the Dizziness Handicap Inventory (functional capacity) and the Dynamic Gait Index (body balance). Secondary outcomes include dizziness features, functional records, body balance control tests, and psychological information. The older individuals (minimum sample n = 68) will be randomized to either the conventional or multimodal Cawthorne&Cooksey protocols. The protocols will be performed during individual 50-minute sessions, twice a week, for 2 months (a total of 16 sessions). The outcomes of both protocols will be compared according to the intention-to-treat analysis. Vestibular rehabilitation through the Cawthorne&Cooksey protocol has already proved to be effective. However, the addition of other components related to body balance control has been proposed to improve the rehabilitation of older people with chronic dizziness from vestibular disorders. ACTRN12610000018011.

  9. The effect of fear of falling on vestibular feedback control of balance

    NARCIS (Netherlands)

    de Melker Worms, Jonathan L.A.; Stins, John F.; Beek, Peter J.; Loram, Ian D.

    2017-01-01

    Vestibular sensation contributes to cervical-head stabilization and fall prevention. To what extent fear of falling influences the associated vestibular feedback processes is currently undetermined. We used galanic vestibular stimulation (GVS) to induce vestibular reflexes while participants stood

  10. Cost-effective analysis of unilateral vestibular weakness investigation.

    Science.gov (United States)

    Gandolfi, Michele M; Reilly, Erin K; Galatioto, Jessica; Judson, Randy B; Kim, Ana H

    2015-02-01

    To evaluate the cost-effectiveness of obtaining a magnetic resonance imaging (MRI) in patients with abnormal electronystagmography (ENG) or videonystagmography (VNG) results. Retrospective chart review. Academic specialty center. Patients presenting with vertigo between January 1, 2010, and August 30, 2013. Patients who fit the following abnormal criteria were included in the study: unilateral caloric weakness (≥20%), abnormal ocular motor testing, and nystagmus on positional testing. Patients with abnormal findings who then underwent MRI with gadolinium were evaluated. Of the 1,996 charts reviewed, there were 1,358 patients who met the inclusion criteria. The average age of these patients was 62 years (12-94 yr). The male:female ratio was approximately 1:2. Of the 1,358 patients, 253 received an MRI with the following pathologies: four vestibular schwannomas, three subcortical/periventricular white matter changes suspicious for demyelinating disease, four acute cerebellar/posterior circulation infarct, two vertebral artery narrowing, one pseudomeningocele of internal auditory canal, and two white matter changes indicative of migraines. The positive detection rate on MRI was 5.5% based on MRI findings of treatable pathologies causing vertigo. Average cost of an MRI is $1,200, thereby making the average cost of identifying a patient with a positive MRI finding $15,180. In our study, those patients with a positive MRI had a constellation of symptoms and findings (asymmetric sensorineural hearing loss, tinnitus, vertigo, and abnormal ENG/VNG). Cost-effectiveness can be improved by ordering an MRI only when clinical examination and VNG point toward a central pathology. Clinical examination and appropriate testing should be factored when considering the cost-effectiveness of obtaining an MRI in patients with abnormal ENG/VNG findings.

  11. Effect of exercise intervention on vestibular related impairments in ...

    African Journals Online (AJOL)

    2011-02-07

    ... the efficacy of exercise interventions in the treatment of vestibular-related deficits in hearing-impaired children. Sources: Extensive search of computerized bibliographic databases (MEDLINE, CINHAL, EMBASE, SCOPUS, ISI of web science, Cochrane Library, and AMED) was performed from earliest to February 7, 2011.

  12. Insidious Side Effects of Design

    DEFF Research Database (Denmark)

    Vissonova, Karina

    2015-01-01

    The purpose of this paper is to propose a way of using the concept of sustainability in design of technical artefacts. Given the recent efforts in designing a more sustainable environment of the artificial, there is a need for an explication of the concept of sustainability as characteristic...... to the design of technical artefacts. I argue that technical artefacts are designed as sustainable based on the extent side effects are addressed with the design. I present necessary and sufficient conditions in the presence of which the design of technical artefacts falls under the concept of sustainability...... in design, and argue for the usefulness of the resulting conception of sustainability. The proposed paper is a philosophical approach to a conceptual analysis and as such is aimed at contributing to the epistemology of design....

  13. Effect of vestibular stimulation on auditory and visual reaction time in relation to stress

    Directory of Open Access Journals (Sweden)

    Archana Rajagopalan

    2017-01-01

    Full Text Available The present study was undertaken to provide scientific evidence and for beneficial effects of vestibular stimulation for the management of stress-induced changes in auditory and visual reaction time (RT. A total of 240 healthy college students of the age group of 18-24 of either gender were a part of this research after obtaining written consent from them. RT for right and left response was measured for two auditory stimuli (low and high pitch and visual stimuli (red and green were recorded. A significant decrease in the visual RT for green light and red light was observed and stress-induced changes was effectively prevented followed by vestibular stimulation. Auditory RT for high pitch right and left response was significantly decreased and stress-induced changes was effectively prevented followed by vestibular stimulation. Vestibular stimulation is effective in boosting auditory and visual RT and preventing stress-induced changes in RT in males and females. We recommend incorporation of vestibular stimulation by swinging in our lifestyle for improving cognitive functions.

  14. Investigations of the Effects of Altered Vestibular System Function on Hindlimb Anti-Gravity Muscles

    Science.gov (United States)

    Lowery, Mary Sue

    1998-01-01

    Exposure to different gravitational environments, both the microgravity of spaceflight and the hypergravity of centrifugation, result in altered vestibulo-spinal function which can be reversed by reacclimation to earth gravity (2). Control of orientation, posture, and locomotion are functions of the vestibular system which are altered by changes in gravitational environment. Not only is the vestibular system involved with coordination and proprioception, but the gravity sensing portion of the vestibular system also plays a major role in maintaining muscle tone through projections to spinal cord motoneurons that control anti-gravity muscles. I have been involved with investigations of several aspects of the link between vestibular inputs and muscle morphology and function during my work with Dr. Nancy Daunton this summer and the previous summer. We have prepared a manuscript for submission (4) to Aviation, Space, and Environmental Medicine based on work that I performed last summer in Dr. Daunton's lab. Techniques developed for that project will be utilized in subsequent experiments begun in the summer of 1998. I have been involved with the development of a pilot project to test the effects of vestibular galvanic stimulation (VGS) on anti-gravity muscles and in another project testing the effects of the ototoxic drug streptomycin on the otolith-spinal reflex and anti-gravity muscle morphology.

  15. Long-term side effects of glucocorticoids.

    Science.gov (United States)

    Oray, Merih; Abu Samra, Khawla; Ebrahimiadib, Nazanin; Meese, Halea; Foster, C Stephen

    2016-01-01

    Glucocorticoids represent the standard therapy for reducing inflammation and immune activation in various diseases. However, as with any potent medication, they are not without side effects. Glucocorticoid-associated side effects may involve most major organ systems. Musculoskeletal, gastrointestinal, cardiovascular, endocrine, neuropsychiatric, dermatologic, ocular, and immunologic side effects are all possible. This article analyzes English-language literature and provides an update on the most recent literature regarding side effects of systemic glucocorticoid treatment. The risk/benefit ratio of glucocorticoid therapy can be improved by proper use. Careful monitoring and using appropriate preventive strategies can potentially minimize side effects.

  16. Effects of modafinil on vestibular function during 24 hour sleep deprivation.

    Science.gov (United States)

    Zhan, Hao; Xie, Sujiang; Jia, Hongbo; Wei, Sihuang; Jing, Baisheng

    2007-05-01

    The aim of this research was to investigate the effects of modafinil, a new wake-promoting agent, on vestibular function during 24 h sleep deprivation (SD) so as to provide experimental evidence for the rational use of this drug among air crew. Eight young, healthy male volunteers were exposed to two 24 h periods of continuous wakefulness during the crossover experiment. Initially, 200 mg dose of modafinil was given, and one week later, a matching placebo was administered. The SD time started from 08:00 of the first day to 08:00 of the second day. Drugs were given at 0:00 on the second day. Vestibular function was tested at 21:00 on the first day and 1, 3, 5, 7 h after drug administration. The accuracy of saccade tracking and gains in visual-vestibular optokinetic reflex (VVOR) and optokinetic nystagmus (OKN) in the placebo group decreased during 24 h SD, especially at 01:00-05:00 on the second day, while OKN gains in the modafinil group increased significantly. There were no significant differences in the other vestibular functional indices between the modafinil group and placebo group. The 24 h SD can influence vestibular function to a certain degree, but modafinil may improve OKN.

  17. Drug therapy for peripheral vestibular vertigo

    Directory of Open Access Journals (Sweden)

    L. M. Antonenko

    2017-01-01

    Full Text Available The choice of effective treatments for vestibular vertigo is one of the important problems, by taking into account the high prevalence of peripheral vestibular diseases. Different drugs, such as vestibular suppressants for the relief of acute vertigo attacks and vestibular compensation stimulants for rehabilitation treatment, are used to treat vestibular vertigo. Drug therapy in combination with vestibular exercises is effective in patients with vestibular neuronitis, Meniere's disease, so is that with therapeutic maneuvers in patients with benign paroxysmal positional vertigo. The high therapeutic efficacy and safety of betahistines permit their extensive use for the treatment of various vestibular disorders.

  18. Acute endolymphatic hydrops has no direct effect on the vestibular evoked potential in the guinea pig

    NARCIS (Netherlands)

    Kingma, C. M.; Wit, H. P.

    2009-01-01

    To investigate the effect of an acute endolymphatic hydrops on the functioning of the vestibular system a hydrops was created by microinjection of artificial endolymph through the basilar membrane into scala media in 10 guinea pigs. To control for the effect of perforation of the basilar membrane,

  19. Vestibular stimulation after head injury: effect on reaction times and motor speech parameters

    DEFF Research Database (Denmark)

    Engberg, A

    1989-01-01

    Earlier studies by other authors indicate that vestibular stimulation may improve attention and dysarthria in head injured patients. In the present study of five severely head injured patients and five controls, the effect of vestibular stimulation on reaction times (reflecting attention) and some...... motor speech parameters (reflecting dysarthria) was investigated. After eight weeks with regular stimulation, it was concluded that reaction time changes were individual and consistent for a given subject. Only occasionally were they shortened after stimulation. However, reaction time was lengthened...... stimulation induced changes of reaction times or motor speech parameters, the changes were more pronounced in patients than in controls....

  20. Effectiveness of conventional versus virtual reality-based balance exercises in vestibular rehabilitation for unilateral peripheral vestibular loss: results of a randomized controlled trial.

    Science.gov (United States)

    Meldrum, Dara; Herdman, Susan; Vance, Roisin; Murray, Deirdre; Malone, Kareena; Duffy, Douglas; Glennon, Aine; McConn-Walsh, Rory

    2015-07-01

    To compare the effectiveness of virtual reality-based balance exercises to conventional balance exercises during vestibular rehabilitation in patients with unilateral peripheral vestibular loss (UVL). Assessor-blind, randomized controlled trial. Two acute care university teaching hospitals. Patients with UVL (N=71) who had dizziness/vertigo, and gait and balance impairment. Patients with UVL were randomly assigned to receive 6 weeks of either conventional (n=36) or virtual reality-based (n=35) balance exercises during vestibular rehabilitation. The virtual reality-based group received an off-the-shelf virtual reality gaming system for home exercise, and the conventional group received a foam balance mat. Treatment comprised weekly visits to a physiotherapist and a daily home exercise program. The primary outcome was self-preferred gait speed. Secondary outcomes included other gait parameters and tasks, Sensory Organization Test (SOT), dynamic visual acuity, Hospital Anxiety and Depression Scale, Vestibular Rehabilitation Benefits Questionnaire, and Activities Balance Confidence Questionnaire. The subjective experience of vestibular rehabilitation was measured with a questionnaire. Both groups improved, but there were no significant differences in gait speed between the groups postintervention (mean difference, -.03m/s; 95% confidence interval [CI], -.09 to .02m/s). There were also no significant differences between the groups in SOT scores (mean difference, .82%; 95% CI, -5.00% to 6.63%) or on any of the other secondary outcomes (P>.05). In both groups, adherence to exercise was high (∼77%), but the virtual reality-based group reported significantly more enjoyment (P=.001), less difficulty with (P=.009) and less tiredness after (P=.03) balance exercises. At 6 months, there were no significant between-group differences in physical outcomes. Virtual reality-based balance exercises performed during vestibular rehabilitation were not superior to conventional balance

  1. Insufficient evidence for the effect of corticosteroid treatment on recovery of vestibular neuritis.

    Science.gov (United States)

    Wegner, Inge; van Benthem, Peter Paul G; Aarts, Mark C J; Bruintjes, Tjasse D; Grolman, Wilko; van der Heijden, Geert J M G

    2012-11-01

    The authors studied the effect of corticosteroid treatment on clinical recovery and recovery of vestibular function in patients with vestibular neuritis. The comprehensive search (March 29, 2012) yielded 496 original papers, of which 5 (including 199 patients) during full-text screening satisfied our eligibility criteria. Methods assessment showed that 1 study (30 patients) provided direct evidence and carried low risk of bias. Two studies properly reported on their random and concealed allocation of treatment. In 1 study, patients were not randomly allocated to treatment. Blinding of outcomes was lacking in 2 studies, whereas outcome data were clearly incomplete for 2 studies. Given the wide variety in outcome measures and scales and follow-up duration, the meaning of the size of reported effects is not clear. Therefore, the reported effects cannot simply be compared between studies, and this precludes pooling of study results. Still, there are large differences between studies in the size of the reported absolute effects after the placebo treatment. Moreover, the difference in effects between treatments is rather small and does not always favor corticosteroids. The moderate to high risk of bias of studies precludes firm conclusions, whereas the reported short-term effects on symptom recovery and improvement of peripheral vestibular function are too small to be clinically important. No long-term effect on symptom recovery has been shown. Recommendations or decisions for corticosteroid treatment in patients with vestibular neuritis cannot be based on current best evidence and therefore should be discussed with the patient.

  2. Effects of high intensity noise on the vestibular system in rats.

    Science.gov (United States)

    Stewart, Courtney; Yu, Yue; Huang, Jun; Maklad, Adel; Tang, Xuehui; Allison, Jerome; Mustain, William; Zhou, Wu; Zhu, Hong

    2016-05-01

    Some individuals with noise-induced hearing loss (NIHL) also report balance problems. These accompanying vestibular complaints are not well understood. The present study used a rat model to examine the effects of noise exposure on the vestibular system. Rats were exposed to continuous broadband white noise (0-24 kHz) at an intensity of 116 dB sound pressure level (SPL) via insert ear phones in one ear for three hours under isoflurane anesthesia. Seven days after the exposure, a significant increase in ABR threshold (43.3 ± 1.9 dB) was observed in the noise-exposed ears, indicating hearing loss. Effects of noise exposure on vestibular function were assessed by three approaches. First, fluorescein-conjugated phalloidin staining was used to assess vestibular stereocilia following noise exposure. This analysis revealed substantial sensory stereocilia bundle loss in the saccular and utricular maculae as well as in the anterior and horizontal semicircular canal cristae, but not in the posterior semicircular canal cristae. Second, single unit recording of vestibular afferent activity was performed under pentobarbital anesthesia. A total of 548 afferents were recorded from 10 noise-treated rats and 12 control rats. Noise exposure produced a moderate reduction in baseline firing rates of regular otolith afferents and anterior semicircular canal afferents. Also a moderate change was noted in the gain and phase of the horizontal and anterior semicircular canal afferent's response to sinusoidal head rotation (1 and 2 Hz, 45°/s peak velocity). Third, noise exposure did not result in significant changes in gain or phase of the horizontal rotational and translational vestibulo-ocular reflex (VOR). These results suggest that noise exposure not only causes hearing loss, but also causes substantial damage in the peripheral vestibular system in the absence of immediate clinically measurable vestibular signs. These peripheral deficits, however, may lead to vestibular disorders

  3. Effects of Head Position on Perception of Gravity in Vestibular Neuritis and Lateral Medullary Infarction

    Directory of Open Access Journals (Sweden)

    Sung-Hee Kim

    2018-02-01

    Full Text Available ObjectiveInternal representation of gravity can be quantified by measuring the subjective visual vertical (SVV. Modulation of verticality perception during head tilts may be perturbed in vestibular disorders causing SVV tilts in the upright head position. This study aimed to determine the influence of head tilts on the estimation of SVV in acute vestibular disorders.MethodsWe measured the SVV in 37 patients with acute vestibular symptoms due to unilateral vestibular neuritis (VN (n = 28 and lateral medullary infarction (LMI (n = 9. Measurements of the SVV were performed under head upright, head tilt 30° and 60° in each direction. Seventeen normal subjects served as the control.ResultsIn controls, head tilt of 30° produced a contraversive shift of the SVV (the E-effect, and head tilt of 60° generated an ipsiversive shift (the A-effect. Patients with VN showed only the A-effect irrespective of the direction and amplitude of head tilt. Patients with LMI could estimate earth verticality accurately during head tilts. Patients with VN during the recovery phase showed the patterns of SVV modulation similar to those observed in the controls either with head upright or tilted.ConclusionGiven the absence of the E-effect in acute VN, the peripheral otolithic inputs appear to be essential in the perception of earth vertical during small static head tilts.

  4. Effects of Head Position on Perception of Gravity in Vestibular Neuritis and Lateral Medullary Infarction.

    Science.gov (United States)

    Kim, Sung-Hee; Kim, Ji-Soo

    2018-01-01

    Internal representation of gravity can be quantified by measuring the subjective visual vertical (SVV). Modulation of verticality perception during head tilts may be perturbed in vestibular disorders causing SVV tilts in the upright head position. This study aimed to determine the influence of head tilts on the estimation of SVV in acute vestibular disorders. We measured the SVV in 37 patients with acute vestibular symptoms due to unilateral vestibular neuritis (VN) ( n  = 28) and lateral medullary infarction (LMI) ( n  = 9). Measurements of the SVV were performed under head upright, head tilt 30° and 60° in each direction. Seventeen normal subjects served as the control. In controls, head tilt of 30° produced a contraversive shift of the SVV (the E-effect), and head tilt of 60° generated an ipsiversive shift (the A-effect). Patients with VN showed only the A-effect irrespective of the direction and amplitude of head tilt. Patients with LMI could estimate earth verticality accurately during head tilts. Patients with VN during the recovery phase showed the patterns of SVV modulation similar to those observed in the controls either with head upright or tilted. Given the absence of the E-effect in acute VN, the peripheral otolithic inputs appear to be essential in the perception of earth vertical during small static head tilts.

  5. Sexual side effects induced by psychotropic drugs

    DEFF Research Database (Denmark)

    Kristensen, Ellids

    2002-01-01

    The majority of psychotropic drugs entail sexual side effects. The sexual side effects may reduce quality of life and may give rise to non-compliance. For example, 30-60 per cent of patients treated with antidepressants are known to develop a sexual dysfunction. However, some psychotropic drugs...... with no or very few sexual side effects have begun to emerge. The treatment of sexual side effects induced by psychotropic drugs may consist of: modified sexual habits, reduction in dosage, switching to another medication, possibly in combination with different psychotropic agents, other varieties...

  6. Anticipating drug side effects by comparative pharmacology.

    Science.gov (United States)

    Garcia-Serna, Ricard; Mestres, Jordi

    2010-10-01

    Anticipating the likely side effect profile of drugs is an aspect of key importance in current drug discovery, development and marketing. It was recently shown that drug pairs having similar side effect profiles had also affinity for a common target. Acknowledging that most drugs have a rich polypharmacology, we provide proof that drugs related by side effect similarity have in fact affinities for multiple common targets beyond their primary targets and set the basis for the use of comparative pharmacology to anticipate drug side effects. Nomenclature issues to be able to identify and properly store drugs, targets and side effects from multiple public sources; the construction of drug networks from side effect similarity and the inference of common targets among them; polypharmacology and data completeness; methods for in silico target profiling; and comparative pharmacology and inference of common side effects. The reader is provided with a detailed step-by-step analysis of the entire process from predicting the target profile of a compound to anticipating its side effect profile, and a discussion on the particular needs and limitations found at each stage of the process through illustrative examples. Comparing preclinical pharmacology data obtained in vitro but also predicted in silico using modern virtual screening methods represents an attractive strategy to anticipate clinical drug side effects.

  7. Vestibular migraine

    DEFF Research Database (Denmark)

    Lempert, Thomas; Olesen, Jes; Furman, Joseph

    2012-01-01

    This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). The classification includes vestibular...... migraine and probable vestibular migraine. Vestibular migraine will appear in an appendix of the third edition of the International Classification of Headache Disorders (ICHD) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included...

  8. Avaliação do efeito da cafeína no teste vestibular Evaluation of the caffeine effect in the vestibular test

    Directory of Open Access Journals (Sweden)

    Lilian Felipe

    2005-12-01

    the suspension of this drink necessary. AIM: To evaluate the effect of caffeine in the vestibular test result. STUDY DESIGN: clinical with transversal cohort. MATERIAL AND METHOD: Seccional and matched research. The vestibular test was performed twice in the same patient, with five days interval between the exams. In the first test, the patient did not drink coffee 24 hours before the exam; in the second, the patient drunk coffee as usual. All of the participants had clinical indication for vestibular test and were used to drinking coffee. RESULTS: Nineteen women, medium age of 49,5 years, participated. The average coffee consumption was three cups per day. The complaints of anxiety and headache were associated with the submission to the vestibular test without coffee. The exams were not statistically different comparing the results of the tests performed with and without the coffee ingestion. CONCLUSION: The moderate ingestion of coffee was not shown to interfere in the results of the vestibular test. Considering that it is recommended that the patient be calm to be submitted to the vestibular test and that the half-life of the caffeine is only of six hours, we suggest that the orientation of complete and abrupt drinking coffee suspension of moderate dose before the vestibular test for the individuals used to daily drinking coffee be reevaluated.

  9. The effect of fear of falling on vestibular feedback control of balance.

    Science.gov (United States)

    de Melker Worms, Jonathan L A; Stins, John F; Beek, Peter J; Loram, Ian D

    2017-09-01

    Vestibular sensation contributes to cervical-head stabilization and fall prevention. To what extent fear of falling influences the associated vestibular feedback processes is currently undetermined. We used galanic vestibular stimulation (GVS) to induce vestibular reflexes while participants stood at ground level and on a narrow walkway at 3.85 m height to induce fear of falling. Fear was confirmed by questionnaires and elevated skin conductance. Full-body kinematics was measured to differentiate the whole-body centre of mass response (CoM) into component parts (cervical, axial trunk, appendicular short latency, and medium latency). We studied the effect of fear of falling on each component to discern their underlying mechanisms. Statistical parametric mapping analysis provided sensitive discrimination of early GVS and height effects. Kinematic analysis revealed responses at 1 mA stimulation previously believed marginal through EMG and force plate analysis. The GVS response comprised a rapid, anode-directed cervical-head acceleration, a short-latency cathode-directed acceleration (cathodal buckling) of lower extremities and pelvis, an anode-directed upper thorax acceleration, and subsequently a medium-latency anode-directed acceleration of all body parts. At height, head and upper thorax early acceleration were unaltered, however, short-latency lower extremity acceleration was increased. The effect of height on balance was a decreased duration and increased rate of change in the CoM acceleration pattern. These results demonstrate that fear modifies vestibular control of balance, whereas cervical-head stabilization is governed by different mechanisms unaffected by fear of falling. The mechanical pattern of cathodal buckling and its modulation by fear of falling both support the hypothesis that short-latency responses contribute to regulate balance. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological

  10. The effects of the D2 dopamine receptor antagonist, eticlopride, on attention following bilateral vestibular deafferentation in the rat.

    Science.gov (United States)

    Stiles, Lucy; Zheng, Yiwen; Darlington, Cynthia L; Smith, Paul F

    2012-01-11

    Loss of vestibular function has been associated with cognitive impairment, including attentional problems. The aim of this study was to investigate the effects of the D(2) dopamine receptor antagonist, eticlopride (0.02, 0.04 and 0.06 mg/kg; s.c.), on attention and impulsivity in rats at 2 months following bilateral vestibular deafferentation (BVD), using a 5 choice serial reaction time task (5CSRTT). The levels of the D(2) receptor protein in the frontal cortex were measured at 1 and 6 months post-BVD using western blotting. Eticlopride caused a dose-dependent decrease in response in the 5CSRTT, which was greater for sham than for BVD rats in terms of the percentage of correct responses and the number of perseverative responses. There were no changes in the amount of the D(2) receptor in the frontal cortex at 1 or 6 months post-BVD; however, D(2) receptor levels were significantly higher on the right side than the left in both sham and BVD animals. These results suggest that BVD causes an increase in perseverative behaviour that D(2) receptor blockade does not eliminate, but that D(2) receptors in the frontal cortex are unchanged. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Postural Effects of Vestibular Manipulation Depend on the Physical Activity Status.

    Directory of Open Access Journals (Sweden)

    Julien Maitre

    Full Text Available The purpose of this study was to compare the effects of galvanic vestibular stimulation (GVS on postural control for participants of different physical activity status (i.e. active and non-active. Two groups of participants were recruited: one group of participants who regularly practised sports activities (active group, n = 17, and one group of participants who did not practise physical and/or sports activities (non-active group, n = 17. They were compared in a reference condition (i.e bipedal stance with eyes open and four vestibular manipulation condition (i.e. GVS at 0.5 mA and 3 mA, in accordance with two designs lasting 20 seconds. The centre of foot pressure displacement velocities were compared between the two groups. The main results indicate that the regular practice of sports activities counteracts postural control disruption caused by GVS. The active group demonstrated better postural control than the non-active group when subjected to higher vestibular manipulation. The active group may have developed their ability to reduce the influence of inaccurate vestibular signals. The active participants could identify the relevant sensory input, thought a better central integration, which enables them to switch faster between sensory inputs.

  12. Does effect of rehabilitation based on sensory conflicts in patients with vestibular deficits exceed learning effect?

    Science.gov (United States)

    Pierchała, Katarzyna; Lachowska, Magdalena; Morawski, Krzysztof; Niemczyk, Kazimierz

    2014-01-01

    The purpose was to assess learning and rehabilitation effect and their influence on Sensory Organization Test results in young and elderly patients with peripheral, central and mixed vestibular pathology. 26 patients with different vestibular system deficits participated in this study. Rehabilitation was held five days a week, for two weeks. To assess learning effect, SOT was administered to each patient twice and compared: 1) on the day preceding the beginning of rehabilitation (SOT1), and 2) on the first day of rehabilitation (SOT2). To evaluate rehabilitation effect, results of SOT2 were compared to SOT3 (administered on the last day of rehabilitation). Learning effect showed similar improvement in CS in all groups but young. Rehabilitation caused further improvement in CS in all groups but central pathology. This improvement was similar between those groups. There was no significant difference found between learning and rehabilitation effect in CS. The results of our study indicate that none of the groups achieved significant benefit from rehabilitation based on sensory conflicts that would overcome the learning effect. However, the lack of significant advantage of rehabilitation over learning does not mean that it does not exist.

  13. European side markers effect on traffic safety

    NARCIS (Netherlands)

    Roelfsema, A.; Theeuwes, J.; Alferdinck, J.W.A.M

    1999-01-01

    In 1993 new European legislation regarding side-markers for passenger cars became effective. Volvo requested the TNO-Human Factors Research Institute (HFRI) to investigate the possible safety benefit of this European side-markers configuration. A test panel at TNO- HFRI was used to determine the

  14. A Quality Improvement Project in Balance and Vestibular Rehabilitation and Its Effect on Clinical Outcomes.

    Science.gov (United States)

    ALMohiza, Mohammad A; Sparto, Patrick J; Marchetti, Gregory F; Delitto, Anthony; Furman, Joseph M; Miller, Debora L; Whitney, Susan L

    2016-04-01

    Unwarranted variation in practice is among the principal contributors of suboptimal outcomes in health care. This variation can be minimized via quality improvement initiatives. However, quality improvement projects focus mostly on assessing processes, and less attention is given to the effect of the variation on clinical outcomes. An effective implementation of a clinical treatment algorithm (CTA) could improve care for individuals with balance and vestibular disorders. The first aim of this quality improvement project was to examine adherence to a CTA developed by physical therapists who treat persons with balance and vestibular disorders. The second aim was to examine the effect of adherence on patient outcomes. Twenty-three physical therapists who provided rehabilitation for individuals with balance and vestibular disorders participated in the quality improvement project. All physical therapists worked for the same health care provider, and developed the minimum data set and CTA. The physical therapists were cluster randomized into 2 groups; both groups received educational training and reminders regarding adherence to the CTA. The first group received the training and reminders after an 8-week baseline period (initial group), and the second group (delayed group) after a 12-week baseline period. The prescribed interventions were classified as being adherent or nonadherent to the CTA. Clinical outcomes, including the Activities-Specific Balance Confidence (ABC) scale, Dizziness Handicap Inventory (DHI), and the Global Rating of Change (GRC), were recorded at the initial evaluation and discharge for 454 individual with balance or vestibular disorders. Across the 16-week project, adherence rates improved significantly by 9% and 12% for the initial and delayed groups, respectively (P = 0.008), but there was no difference between groups related to the timing of the educational training and adherence reminders. Clinical outcomes improved for individuals, with balance

  15. Side Effects of Yttrium-90 Radioembolization

    Directory of Open Access Journals (Sweden)

    Ahsun eRiaz

    2014-07-01

    Full Text Available Limited therapeutic options are available for hepatic malignancies. Image guided targeted therapies have established their role in management of primary and secondary hepatic malignancies. Radioembolization with yttrium-90 (90Y microspheres is safe and efficacious for treatment of hepatic malignancies. The tumoricidal effect of radioembolization is predominantly due to radioactivity and not ischemia. This article will present a comprehensive review of the side effects that have been associated with radioembolization using 90Y microspheres. Some of the described side effects are associated with all transarterial procedures. Side effects specific to radioembolization will also be discussed in detail. Methods to decrease the incidence of these potential side effects will also be discussed.

  16. Side Effects of Chemotherapy and Radiation (For Parents)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Side Effects of Chemotherapy and Radiation KidsHealth / For Parents / Side ... contact your doctor right away. Duration of Side Effects Most side effects go away gradually once cancer ...

  17. Managing Chemotherapy Side Effects: Hair Loss (Alopecia)

    Science.gov (United States)

    ... C ancer I nstitute Managing Chemotherapy Side Effects Hair Loss (Alopecia) “Losing my hair was hard at first. Then ... and anywhere on your body may fall out. Hair loss is called alopecia. When will my hair start ...

  18. Neglected Side Effects After Radical Prostatectomy

    DEFF Research Database (Denmark)

    Frey, Anders Ullmann; Sønksen, Jens; Fode, Mikkel

    2014-01-01

    been shown to double the risk of OAP. PS occurs in 15-68% of RP patients. Nerve sparing and preservation of erectile function may help preserve penile length. With regard to all side effects, studies indicate that they are reduced over time. CONCLUSIONS: The sexually related side effects summarized......INTRODUCTION: A series of previously neglected sexually related side effects to radical prostatectomy (RP) has been identified over the recent years. These include orgasm-associated incontinence (OAI), urinary incontinence in relation to sexual stimulation (UISS), altered perception of orgasm......, orgasm-associated pain (OAP), penile shortening (PS), and penile deformity. AIM: The aim of this article is to conduct a systematic review of the literature regarding the above-mentioned side effects. METHODS: A predefined search strategy was applied in a thorough search of Medline, Web of science...

  19. Side Effects - Memory or Concentration Problems

    Science.gov (United States)

    Cancer treatments, such as chemo, may cause difficulty thinking, concentrating, or other cognitive problems. Learn about steps people with cancer can take to manage these side effects. See a list of helpful questions for families to ask the doctor.

  20. Side Effects: Mouth and Throat Problems

    Science.gov (United States)

    Cancer treatments may cause dental, mouth, and throat side effects such as changes in taste (dysgeusia), dry mouth (xerostomia), infections, mouth sores, pain or swelling in your mouth (oral mucositis), sensitivity to foods, and swallowing problems.

  1. Possible Side-Effects from Vaccines

    Science.gov (United States)

    ... Fever Varicella (Chickenpox) Yellow Fever Live Zoster (Shingles) Vaccine, ZVL Recombinant Zoster (Shingles) Vaccine, RZV Any vaccine can cause ... RZV side-effects What are the risks from recombinant shingles vaccine? With any medicine, including vaccines, there is a ...

  2. Sexual side effects induced by psychotropic drugs

    DEFF Research Database (Denmark)

    Kristensen, Ellids

    2002-01-01

    The majority of psychotropic drugs entail sexual side effects. The sexual side effects may reduce quality of life and may give rise to non-compliance. For example, 30-60 per cent of patients treated with antidepressants are known to develop a sexual dysfunction. However, some psychotropic drugs...... of pharmacologically active substances or specific products for the treatment of sexual dysfunction such as sildenafil. Above all, it should be acknowledged that relatively few data are available in this field and in particular that there is a lack of controlled studies....... with no or very few sexual side effects have begun to emerge. The treatment of sexual side effects induced by psychotropic drugs may consist of: modified sexual habits, reduction in dosage, switching to another medication, possibly in combination with different psychotropic agents, other varieties...

  3. Managing Chemotherapy Side Effects: Memory Changes

    Science.gov (United States)

    N ational C ancer I nstitute Managing Chemotherapy Side Effects Memory Changes What is causing these changes? Your doctor will work to find out what is causing these problems. They may be caused by ...

  4. Balance in Virtual Reality: Effect of Age and Bilateral Vestibular Loss.

    Science.gov (United States)

    Chiarovano, Elodie; Wang, Wei; Rogers, Stephen J; MacDougall, Hamish G; Curthoys, Ian S; de Waele, Catherine

    2017-01-01

    Quantitative balance measurement is used in clinical practice to prevent falls. The conditions of the test were limited to eyes open, eyes closed, and sway-referenced vision. We developed a new visual perturbation to challenge balance using virtual reality (VR), measuring postural stability by a Wii Balance Board (WBB). In this study, we recorded balance performance of 116 healthy subjects and of 10 bilateral vestibular loss patients using VR to assess the effect of age and the effect of total loss of vestibular function. We used several conditions: eyes open (normal visual inputs), eyes closed (no visual inputs), stable visual world (vision referenced), and perturbed visual world (visual perturbation) at different amplitudes of perturbation. Balance under these visual conditions was assessed on the WBB (stable support surface) and on the WBB plus foam rubber (unstable support surface). In healthy subjects, we found that the percentage of falls increased with age and with the amplitude of perturbation for both conditions: WBB or WBB + foam. Moreover, we can define a threshold for falls in each age group as the amplitude of perturbation which induced falls. For bilateral vestibular loss patients, on the WBB + foam, all of them failed with eyes closed and with perturbed visual world even at the minimal amplitude of perturbation. Finally, we observed that stable visual world induced fewer falls than eyes closed whatever the subject's group (healthy or bilateral vestibular loss) and whatever the age decade. VR allowed us to develop a useful new tool with a wide range of visual perturbations. Rather than only two levels of visual condition (eyes open and eyes closed), the VR stimulus can be continuously adjusted to produce a visual perturbation powerful enough to induce falls even in young healthy subjects and which has allowed us to determine a threshold for falls.

  5. Effect of noisy galvanic vestibular stimulation on center of pressure sway of static standing posture.

    Science.gov (United States)

    Inukai, Yasuto; Otsuru, Naofumi; Masaki, Mitsuhiro; Saito, Kei; Miyaguchi, Shota; Kojima, Sho; Onishi, Hideaki

    The vestibular system is involved in the control of standing balance. Galvanic vestibular stimulation (GVS) is a noninvasive technique that can stimulate the vestibular system. In recent years, noisy GVS (nGVS) using noise current stimulation has been attempted, but it has not been clarified whether it affects postural sway in open-eye standing. The purpose of this study was to clarify the influence of nGVS on the center of pressure (COP) sway measurement in open-eye standing postural control and identify the responders of nGVS. nGVS (0.1-640 Hz) was delivered at 0.4 and 1.0 mA over the bipolar mastoid. COP sway root mean square area, sway path length, medio-lateral (ML) mean velocity, and antero-posterior (AP) mean velocity before and during nGVS in an open-eye standing posture was measured. nGVS at 0.4 and 1.0 mA significantly reduced sway path length, mean velocity. The stimulation effect of nGVS was also large in subjects with a long sway path. For subjects with high COP sway of Baseline, nGVS was effective even with stimulation for a short duration (5 s). These findings suggest that nGVS improves postural sway in an open-eye standing posture among young subjects. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. The effects of bilateral vestibular loss on hippocampal volume, neuronal number and cell proliferation in rats

    Directory of Open Access Journals (Sweden)

    Yiwen eZheng

    2012-02-01

    Full Text Available Previous studies in humans have shown that bilateral loss of vestibular function is associated with a significant bilateral atrophy of the hippocampus, which correlated with the patients’ spatial memory deficits. More recently, patients who had recovered from unilateral vestibular neuritis have been reported to exhibit a significant atrophy of the left posterior hippocampus. Therefore, we investigated whether bilateral vestibular deafferentation (BVD would result in a decrease in neuronal number or volume in the rat hippocampus, using stereological methods. At 16 months post-BVD, we found no significant differences in hippocampal neuronal number or volume compared to sham controls, despite the fact that these animals exhibited severe spatial memory deficits. By contrast, using bromodeoxyuridine (BrdU as a marker of cell proliferation, we found that the number of BrdU-labelled cells significantly increased in the dentate gyrus of the hippocampus between 48 h and 1 week following BVD. Although a substantial proportion of these cells survived for up to 1 month, the survival rate was significantly lower in BVD animals when compared with that in sham animals. These results suggest a dissociation between the effects of BVD on spatial memory and hippocampal structure in rats and humans, which cannot be explained by an injury-induced increase in cell proliferation.

  7. Vestibular evoked myogenic potential in vestibular neuritis.

    Science.gov (United States)

    Nola, Giuseppe; Guastini, Luca; Crippa, Barbara; Deiana, Marco; Mora, Renzo; Ralli, Giovanni

    2011-11-01

    This study wants to show the diagnostic value of vestibular evoked myogenic potential (VEMP) in the diagnosis of vestibular neuritis (VN), independently of the caloric test results. Twenty patients were enrolled with acute vertigo caused by VN. VEMP was tested with the binaural simultaneous stimulation method. Surface electromyographic activity was recorded in the supine patients from symmetrical sites over the upper half of each sternocleidomastoid muscle, with a reference electrode on the lateral end of the upper sternum. During the acute attack, 8 days, 1 month and 3 months after the beginning of the acute attack, all the patients underwent the following examinations: Dix-Hallpike manoeuvre, Pagnini-McClure manoeuvre, head shaking test, pure-tone audiometry, tympanometry, caloric labyrinth stimulation according to the Fitzgerald-Hallpike method and VEMP. At the last visit, the 11 patients diagnosed with superior branch vestibular neuritis did not show any improvement at the caloric labyrinth stimulation and presented VEMP on both sides with normal amplitude and latency; in the 9 cases diagnosed with inferior branch vestibular neuritis, there was an improvement of the VEMP reflex and normal caloric test. Our experience highlights that VEMP recording is applicable for patients with VN as a screening test.

  8. Side effects from intense pulsed light

    DEFF Research Database (Denmark)

    Thaysen-Petersen, Daniel; Erlendsson, Andres M; Nash, J F

    2017-01-01

    BACKGROUND AND OBJECTIVE: Intense pulsed light (IPL) is a mainstream treatment for hair removal. Side effects after IPL are known, but risk factors remain to be investigated. The objective of this study was to assess the contribution of skin pigmentation, fluence level, and ultraviolet radiation...... exposure of UVR did not exacerbate side effects (P ≥ 0.180). Clinical findings were confirmed objectively by reflectance spectrometry and qualitatively by histological changes in skin architecture, inflammatory infiltration, and pigmentation. Marker of cellular DNA damage, that is, p53, did not increase...

  9. Vestibular Dysfunction in Patients with Enlarged Vestibular Aqueduct.

    Science.gov (United States)

    Zalewski, Chris K; Chien, Wade W; King, Kelly A; Muskett, Julie A; Baron, Rachel E; Butman, John A; Griffith, Andrew J; Brewer, Carmen C

    2015-08-01

    Enlarged vestibular aqueduct (EVA) is the most common inner ear malformation. While a strong correlative relationship between EVA and hearing loss is well established, its association with vestibular dysfunction is less well understood. In this study, we examine the effects of EVA on the vestibular system in patients with EVA. Prospective, cross-sectional study of a cohort ascertained between 1999 and 2013. National Institutes of Health Clinical Center, a federal biomedical research facility. In total, 106 patients with unilateral or bilateral EVA, defined as a midpoint diameter greater than 1.5 mm, were referred or self-referred to participate in a study of the clinical and molecular aspects of EVA. Clinical history was ascertained with respect to the presence or absence of various vestibular signs and symptoms and history of head trauma. Videonystagmography (VNG), cervical vestibular evoked myogenic potential (cVEMP), and rotational vestibular testing (RVT) were performed to assess the vestibular function. Of the patients with EVA, 45% had vestibular signs and symptoms, and 44% of tested patients had abnormal VNG test results. An increased number of vestibular signs and symptoms was correlated with the presence of bilateral EVA (P = .008) and a history of head injury (P VNG results also correlated with a history of head injury (P = .018). Vestibular dysfunction is common in patients with EVA. However, not all patients with vestibular signs and symptoms have abnormal vestibular test results. Clinicians should be aware of the high prevalence of vestibular dysfunction in patients with EVA. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  10. The Social Side Effects of Acetaminophen

    Science.gov (United States)

    Mischkowski, Dominik

    About 23% of all adults in the US take acetaminophen during an average week (Kaufman, Kelly, Rosenberg, Anderson, & Mitchell, 2002) because acetaminophen is an effective physical painkiller and easily accessible over the counter. The physiological side effects of acetaminophen are well documented and generally mild when acetaminophen is consumed in the appropriate dosage. In contrast, the psychological and social side effects of acetaminophen are largely unknown. Recent functional neuroimaging research suggests that the experience of physical pain is fundamentally related to the experience of empathy for the pain of other people, indicating that pharmacologically reducing responsiveness to physical pain also reduces cognitive, affective, and behavioral responsiveness to the pain of others. I tested this hypothesis across three double-blind between-subjects drug intervention studies. Two experiments showed that acetaminophen had moderate effects on empathic affect, specifically personal distress and empathic concern, and a small effect on empathic cognition, specifically perceived pain, when facing physical and social pain of others. The same two experiments and a third experiment also showed that acetaminophen can increase the willingness to inflict pain on other people, i.e., actual aggressive behavior. This effect was especially pronounced among people low in dispositional empathic concern. Together, these findings suggest that the physical pain system is more involved in the regulation of social cognition, affect, and behavior than previously assumed and that the experience of physical pain and responsiveness to the pain of others share a common neurochemical basis. Furthermore, these findings suggest that acetaminophen has unappreciated but serious social side effects, and that these side effects may depend on psychological characteristics of the drug consumer. This idea is consistent with recent theory and research on the context-dependency of neurochemical

  11. Recovery of Vestibular Ocular Reflex Function and Balance Control after a Unilateral Peripheral Vestibular Deficit

    OpenAIRE

    Allum, J. H. J.

    2012-01-01

    This review describes the effect of unilateral peripheral vestibular deficit (UPVD) on balance control for stance and gait tests. Because a UPVD is normally defined based on vestibular ocular reflex (VOR) tests, we compared recovery observed in balance control with patterns of recovery in VOR function. Two general types of UPVD are considered; acute vestibular neuritis (AVN) and vestibular neurectomy. The latter was subdivided into vestibular loss after cerebellar pontine angle tumor surgery ...

  12. Systemic side-effects of topical corticosteroids

    Directory of Open Access Journals (Sweden)

    Sandipan Dhar

    2014-01-01

    Full Text Available With the introduction of topical corticosteroids, a milestone has been achieved in dermatologic therapy; owing to its potent anti-inflammatory and ant proliferative effects, it became possible to treat some hitherto resistant dermatoses. But this magic drug can cause enough mischief if used inappropriately. Children are more susceptible to the systemic adverse effects because of enhanced percutaneous absorption through their tender skin. So, systemic side effects should be kept in mind while prescribing this therapeutically valuable topical medicament.

  13. Inferior vestibular neuritis.

    Science.gov (United States)

    Kim, Ji-Soo; Kim, Hyo Jung

    2012-08-01

    Vestibular neuritis (VN) mostly involves the superior portion of the vestibular nerve and labyrinth. This study aimed to describe the clinical features of VN involving the inferior vestibular labyrinth and its afferents only. Of the 703 patients with a diagnosis of VN or labyrinthitis at Seoul National University Bundang Hospital from 2004 to 2010, we retrospectively recruited 9 patients (6 women, age range 15-75) with a diagnosis of isolated inferior VN. Diagnosis of isolated inferior VN was based on torsional downbeating spontaneous nystagmus, abnormal head-impulse test (HIT) for the posterior semicircular canal (PC), and abnormal cervical vestibular-evoked myogenic potentials (VEMP) in the presence of normally functioning horizontal and anterior semicircular canals, as determined by normal HIT and bithermal caloric tests. All patients presented with acute vertigo with nausea, vomiting, and imbalance. Three patients also had tinnitus and hearing loss in the involved side. The rotation axis of torsional downbeating spontaneous nystagmus was best aligned with that of the involved PC. HIT was also positive only for the involved PC. Cervical VEMP was abnormal in seven patients, and ocular VEMP was normal in all four patients tested. Ocular torsion and subjective visual vertical tests were mostly within the normal range. Since isolated inferior VN lacks the typical findings of much more prevalent superior VN, it may be mistaken for a central vestibular disorder. Recognition of this rare disorder may help avoid unnecessary workups in patients with acute vestibulopathy.

  14. Factors effecting paint performance on wood siding

    Science.gov (United States)

    Christopher G. Hunt; R. Sam Williams; Mark Knaebe; Peter Sotos; Steven Lacher

    2009-01-01

    Several different studies are compared to assess the effectiveness of commercial water repellent preservatives (WRP’s) in the late 1990’s on vertical and horizontal siding. Besides WRP, variables included wood species, exposure location (Wisconsin or Mississippi), and solid color stain vs. primer + paint. Data on substrate checking and paint flaking are presented....

  15. Side effects of ambulatory blood pressure monitoring.

    NARCIS (Netherlands)

    Steen, M.S. van der; Lenders, J.W.M.; Thien, Th.

    2005-01-01

    OBJECTIVE: To study the experiences and complaints of patients who underwent 24 h blood pressure monitoring. METHODS: Two groups of hypertensive patients of a tertiary outpatient clinic were asked to fill in a nine-item questionnaire about the side effects of ambulatory blood pressure monitoring

  16. Side Effects of HIV Medicines: HIV and Rash

    Science.gov (United States)

    ... Drugs Clinical Trials Apps skip to content Side Effects of HIV Medicines Home Understanding HIV/AIDS Fact ... and Immunizations What is a Drug Interaction? Side Effects of HIV Medicines HIV Medicines and Side Effects ...

  17. Side effects of external tooth bleaching

    DEFF Research Database (Denmark)

    Bruzell, E.M.; Pallesen, Ulla; Thoresen, N.R.

    2013-01-01

    Objective The study was performed to assess the risk of at-home and in-office bleaching procedures, and to recognise potential predictors for side effects. Design Multi-centre, questionnaire-based prospective study with follow-ups at around 14 days and around one year post-treatment. Setting......-office = 39.3% [n = 28]; p >0.05; 95% CI [OR]: 0.198‑1.102) whereas prevalence of gingival irritation was higher after in-office treatment (at-home = 14.0%; in-office = 35.7%; p effects...... attributed to the bleaching treatment in the at-home and in-office groups, respectively. Predictors for side effects were tooth sensitivity, surface loss and gingivitis when observed at inclusion. Treatment-related predictors were bleaching concentration and contact between tray and gingiva. Conclusions...

  18. It is all me: the effect of viewpoint on visual-vestibular recalibration.

    Science.gov (United States)

    Schomaker, Judith; Tesch, Joachim; Bülthoff, Heinrich H; Bresciani, Jean-Pierre

    2011-09-01

    Participants performed a visual-vestibular motor recalibration task in virtual reality. The task consisted of keeping the extended arm and hand stable in space during a whole-body rotation induced by a robotic wheelchair. Performance was first quantified in a pre-test in which no visual feedback was available during the rotation. During the subsequent adaptation phase, optical flow resulting from body rotation was provided. This visual feedback was manipulated to create the illusion of a smaller rotational movement than actually occurred, hereby altering the visual-vestibular mapping. The effects of the adaptation phase on hand stabilization performance were measured during a post-test that was identical to the pre-test. Three different groups of subjects were exposed to different perspectives on the visual scene, i.e., first-person, top view, or mirror view. Sensorimotor adaptation occurred for all three viewpoint conditions, performance in the post-test session showing a marked under-compensation relative to the pre-test performance. In other words, all viewpoints gave rise to a remapping between vestibular input and the motor output required to stabilize the arm. Furthermore, the first-person and mirror view adaptation induced a significant decrease in variability of the stabilization performance. Such variability reduction was not observed for the top view adaptation. These results suggest that even if all three viewpoints can evoke substantial adaptation aftereffects, the more naturalistic first-person view and the richer mirror view should be preferred when reducing motor variability constitutes an important issue.

  19. The Effect of Vestibular Rehabilitation in the Treatment of Elderly Patients with Benign Paroxysmal Positional Vertigo

    Directory of Open Access Journals (Sweden)

    N. Saki

    2011-04-01

    Full Text Available Introduction & Objective: Vertigo in the elderly is relatively common, but only a few studies are available. Vestibular rehabilitation (VR therapy is an important therapeutic option in treating patients with significant balance deficits. The purpose of this study was to analyze the effect of vestibular rehabilitation on vertigo symptoms in elderly patients with benign paroxysmal positional vertigo (BPPV. Materials & Methods: In a cross sectional analytic design, 46 patients older than 60 years (aged 61 to 72 years with BPPV who referred to the ENT center of Imam Khomeini Hospital, Ahwaz, were studied. After an otologic evaluation, videonystagmography and dizziness handicap inventory (DHI evaluations were performed for each case. Then, vestibular rehabilitation (VR therapy was carried out by means of Epley maneuver. Efficacy of a VRT was tested by comparing pre-treatment with post-treatment VNG and DHI assessments. The data were analyzed by SPSS 16 software. Results: The average age of the patients was 67.28 ± 4.5 years. VR caused normal Hallpike findings in 31 (67.4 % and noticeable reduction in nystagmus amplitudes in 9 patients. We found a significant correlation between nystagmus amplitudes and DHI scores (r=0.77. The mean DHI scores decreased from 53.26±16.12 points to 15.36±9.23 points (p<0.001 at the end of the treatment course. Conclusion: Our investigation revealed that VR plays an important role in reducing vertigo in at-risk elderly patients. Lack of appropriate treatment in this population may cause a serious balance problem (such as bone fracture and long-term handicap that may interfere with their daily activities. (Sci J Hamadan Univ Med Sci 2011;18(1:33-36

  20. Informing patients about drug side effects

    Energy Technology Data Exchange (ETDEWEB)

    Morris, L.A.; Kanouse, D.E.

    1982-09-01

    Two hundred forty-nine newly diagnosed hypertensive patients prescribed thiazide medication were recruited for study. Two-thirds were given a leaflet or patient package insert (PPI) that described the drug and its possible side effects, and one-third were not. At a revisit about 1 month later, patients were asked whether they had experienced any of 17 different health problems. For each problem that they experienced, they were asked whether they thought the problem was related to the medicine they were taking. Ten of the health problems were taken verbatim from the PPI's list of possible drug side effects. Patients who received the PPI reported experiencing about the same number of side effects as the non-PPI subjects. However, those who received the PPI were more likely to attribute experienced reactions to the drug. This was true for both reactions specifically listed in the PPI and for similar reactions not listed. Results support the notion of an attribution-labeling process rather than a suggestion effect.

  1. Side effects after ambulatory lumbar iohexol myelography

    International Nuclear Information System (INIS)

    Sand, T.; Myhr, G.; Stovner, L.J.; Dale, L.G.; Tangerud, A.

    1989-01-01

    Side effect incidences after ambulatory (22G needle and two h bed rest) and after non-ambulatory (22 and 20G needles and 20 h bed rest) lumbar iohexol myelography have been estimated and compared. Headache incidence was significantly greater in ambulatory (50%, n=107) as compared to nonambulatory myelography (26%, n=58). Headaches in the ambulatory group tended to be of shorter duration and the difference between severe headaches in ambulatory and non-ambulatory groups was not significant. Serious adverse reactions did not occur and none of the ambulatory patients required readmission because of side effects. The headache was predominantly postural and occurred significantly earlier in the ambulatory group. Headache incidence was significantly greater after 20G needle myelography (44%, n=97) as compared to 22G needle iohexol myelography (26%, n=58). The results support the hypothesis that CSF leakage is a major cause of headache after lumbar iohexol myelography. (orig.)

  2. Side effects after lumbar iohexol myelography

    International Nuclear Information System (INIS)

    Sand, T.; Stovner, L.J.; Myhr, G.; Dale, L.G.

    1990-01-01

    Side effects of iohexol lumbar myelography have been analyzed with respect to the influence of the type of radiological abnormality, sex and age in a group of 200 patients. Headache, postural headache, nausea and back/leg pain were significantly more frequent in patients without definite radiological abnormalities. Postural headache, nausea, dizziness and mental symptoms were more frequent in women, while headache, postural headache, nausea, dizziness, minor mental symptoms (i.e. anxiety or depression) and pain became less frequent with age. This pattern is similar to that reported after lumbar puncture. Young women without definite clinical signs of nerve root lesions probably have the greatest risk of experiencing side effects after iohexol lumbar myelography. (orig.)

  3. Effects and side effects of inspections and accountability in education

    NARCIS (Netherlands)

    de Wolff, I.; Janssens, F.

    2005-01-01

    This paper presents an overview of studies into effects and side effects of control mechanisms in education. We focus on effects and side effects of inspection visits and public performance indicators. A first conclusion is that the studies do not provide us with a clear answer to the question of

  4. Intermediate Latency-Evoked Potentials of Multimodal Cortical Vestibular Areas: Galvanic Stimulation

    Directory of Open Access Journals (Sweden)

    Stefan Kammermeier

    2017-11-01

    Full Text Available IntroductionHuman multimodal vestibular cortical regions are bilaterally anterior insulae and posterior opercula, where characteristic vestibular-related cortical potentials were previously reported under acoustic otolith stimulation. Galvanic vestibular stimulation likely influences semicircular canals preferentially. Galvanic stimulation was compared to previously established data under acoustic stimulation.Methods14 healthy right-handed subjects, who were also included in the previous acoustic potential study, showed normal acoustic and galvanic vestibular-evoked myogenic potentials. They received 2,000 galvanic binaural bipolar stimuli for each side during EEG recording.ResultsVestibular cortical potentials were found in all 14 subjects and in the pooled data of all subjects (“grand average” bilaterally. Anterior insula and posterior operculum were activated exclusively under galvanic stimulation at 25, 35, 50, and 80 ms; frontal regions at 30 and 45 ms. Potentials at 70 ms in frontal regions and at 110 ms at all of the involved regions could also be recorded; these events were also found using acoustic stimulation in our previous study.ConclusionGalvanic semicircular canal stimulation evokes specific potentials in addition to those also found with acoustic otolith stimulation in identically located regions of the vestibular cortex. Vestibular cortical regions activate differently by galvanic and acoustic input at the peripheral sensory level.SignificanceDifferential effects in vestibular cortical-evoked potentials may see clinical use in specific vertigo disorders.

  5. The Effect of Peripheral Vestibular Recovery on Improvements in Vestibulo-ocular Reflexes and Balance Control After Acute Unilateral Peripheral Vestibular Loss.

    Science.gov (United States)

    Allum, John H J; Scheltinga, Alja; Honegger, Flurin

    2017-12-01

    Patients with an acute unilateral peripheral vestibular deficit (aUPVD), presumed to be caused by vestibular neuritis, show asymmetrical vestibular ocular reflexes (VORs) that improve over time. Questions arise regarding how much of the VOR improvement is due to peripheral recovery or central compensation, and whether differences in peripheral recovery influence balance control outcomes. Thirty patients were examined at aUPVD onset and 3, 6, and 13 weeks later with four different VOR tests: caloric tests; rotating (ROT) chair tests performed in yaw with angular accelerations of 5 and 20 degrees/s; and video head impulse tests (vHIT) in the yaw plane. ROT and vHIT responses and balance control of 11 patients who had a caloric canal paresis (CP) more than 90% at aUPVD onset and no CP recovery (no-CPR) at 13 weeks in caloric tests were compared with those of 19 patients with CP recovery (CPR) to less than 30%, on average. Balance control was measured with a gyroscope system (SwayStar) recording trunk sway during stance and gait tasks. ROT and vHIT asymmetries of no-CPR and CPR patients reduced over time. The reduction was less at 13 weeks (36.2% vs. 83.5% on average) for the no-CPR patients. The no-CPR group asymmetries at 13 weeks were greater than those of CPR patients who had normal asymmetries. The greater asymmetries were caused by weaker deficit side responses which remained deficient in no-CPR patients at 13 weeks. Contra-deficit side vHIT and ROT responses remained normal. For all balance tests, sway was slightly greater for no-CPR compared with CPR patients at aUPVD onset and 3 weeks later. At 13 weeks, only sway during walking eyes closed was greater for the no-CPR group. A combination of 5 degrees/s ROT and balance tests could predict at onset (90% accuracy) which patients would have no-CPR at 13 weeks. These results indicate that for ROT and vHIT tests, central compensation is observed in CPR and no-CPR patients. It acts primarily by increasing deficit

  6. Binocular cyclotorsion in superior vestibular neuritis.

    Science.gov (United States)

    Lapenna, R; Pellegrino, A; Ricci, G; Cagini, C; Faralli, M

    2017-11-30

    Conjugated cyclotorsion of the eyes toward the affected side can commonly be observed in vestibular neuritis. The aim of this study was to assess the differences in cyclotorsion between the ipsi- and contralesional eye during selective involvement of the superior branch of the vestibular nerve. We studied binocular cyclotorsion through ocular fundus photographs in 10 patients affected by acute superior vestibular neuritis (SVN). Cyclotorsion was also studied in 20 normal subjects. All SVN patients showed an ipsilesional cycloversion of the eyes. Normal subjects exhibited a constant mild excyclovergence (6.42 ± 2.34°). In SVN patients, contralateral incyclotorsion (8.4 ± 8.14°) was lower and not normally distributed compared to ipsilateral eye excyclotorsion (17.9 ± 4.36°) with no correlation between them. The interocular difference in cyclodeviation could be related to the starting physiological excyclovergence, to different tonic effects on the extraocular muscles of the two eyes and to the different influence of spontaneous nystagmus on cyclodeviation in the two eyes. We recommend referring only to ipsilateral excyclotorsion in the evaluation of utricular function during SVN and its subsequent compensation. Further studies are required to determine the binocular cyclotorsion in the case of other kinds of selective involvement of the vestibular nerve. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  7. The effect of jugular bulb-vestibular aqueduct dehiscence on hearing and balance.

    Science.gov (United States)

    Li, Shufeng; Shen, Na; Cheng, Yushu; Sha, Yan; Wang, Zhengmin

    2015-01-01

    This study suggests that jugular bulb-vestibular aqueduct dehiscence (JBVAD) does not affect the hearing or balance functions of the inner ear. Since JBVAD may cause impairment of the inner ear and induce hearing loss, tinnitus, and vertigo, this study was to investigate the effect of JBVAD on hearing and balance. Patients undergoing temporal bone computed tomography (TBCT) scans from May 2013 to December 2013 at a tertiary referral hospital were reviewed. The topographic relationship between the jugular bulb (JB) and the vestibular aqueduct was assessed. The findings were classified as normal when there was always a bony structure between the two structures and as dehiscent when the bony coverage separating the two structures was absent. Clinical data were collected via electronic records and clinical follow-up. A total of 1313 out of 8325 patients were diagnosed with a HJB. Forty-six patients showed JBVAD. The prevalence of dehiscence was 0.6% in patients undergoing temporal bone CT scans and 3.5% in patients with HJB. Of the 46 patients with JBVAD, 23 (50%) had sensorineural hearing loss, three (6.5%) had tinnitus, and two (4.3%) had vertigo. The correlation between JBVAD and these clinical symptoms did not achieve statistical significance.

  8. Differential diagnosis and treatment of vestibular vertigo

    Directory of Open Access Journals (Sweden)

    Vladimir Anatolyevich Parfenov

    2010-01-01

    Full Text Available Vertigo is a common complaint that leads patients to visit physicians of various specialties. Diseases resulting in vestibular vertigo are very diverse and may be caused by lesion of both the central parts of the vestibular system and the peripheral vestibular apparatus. In many cases, its diagnosis can be made from complaints and a history of disease and special bedside tests requiring no sophisticated equipment. Management of vestibular vertigo should aim at treating the underlying disease; vestibular dilators as symptomatic therapy can be effective for several days. Vestibular exercises the efficiency of which can be enhanced by betahistine and other drugs accelerating vestibular compensation should be further needed. Data on the efficacy of betaver (betahistine in patients with vestibular vertigo are given.

  9. EFFECT OF TOTAL VERTICAL VIBRATION ON FUNCTIONAL STATE OF THE VESTIBULAR APPARATUS IN GUINEA PIGS,

    Science.gov (United States)

    VESTIBULAR APPARATUS, VIBRATION), GUINEA PIGS , ELECTROMYOGRAPHY, STIMULATION(PHYSIOLOGY), EXPOSURE(PHYSIOLOGY), STRESS(PHYSIOLOGY), BLOOD CHEMISTRY, BODY WEIGHT, BODY TEMPERATURE, ELECTROPHYSIOLOGY, TABLES(DATA), USSR

  10. Predictors of development of chronic vestibular insufficiency after vestibular neuritis.

    Science.gov (United States)

    Adamec, Ivan; Krbot Skorić, Magdalena; Ozretić, David; Habek, Mario

    2014-12-15

    To evaluate the role of clinical parameters, MRI and ocular VEMP (oVEMP) and cervical VEMP (cVEMP) as predictors of development of chronic vestibular insufficiency after vestibular neuritis. Twenty-six patients with vestibular neuritis were included: 15 patients (58%) showed complete clinical recovery, and 11 patients (41%) were diagnosed with the syndrome of chronic vestibular insufficiency. Clinical parameters (vomiting, nystagmus, postural stability, and nausea) were assessed at diagnosis. MRI was performed within 3 months and VEMP within 6 days and at 1 year after the initial presentation. The amplitude asymmetry ratio (AR) was calculated using the following formula: AR=((healthy side-affected side)/(healthy side+affected side) × 100). Of all studied parameters, only chronic white matter supratentorial lesions present on brain MRI negatively correlated with clinical recovery (Phi coefficient=-0.637, p=0.001). The logistic regression analysis showed that positive brain MRI and older age reduced odds for clinical recovery. There was no correlation between clinical recovery and oVEMP AR recovery between groups (p=0.781). Seven patients showed improvement, and 19 showed worsening on oVEMP AR after a 1-year follow-up. Statistical regression model for predicting the outcome of clinical recovery using asymmetry score recovery, as an independent variable, was not statistically significant. Older age and chronic white matter lesions on brain MRI are positive predictors of development of chronic vestibular insufficiency after vestibular neuritis. VEMPs are not useful in predicting the development of chronic vestibular insufficiency. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Systemic side effects of locally used oxymetazoline

    OpenAIRE

    Dokuyucu, Recep; Gokce, Hasan; Sahan, Mustafa; Sefil, Fatih; Tas, Zeynel Abidin; Tutuk, Okan; Ozturk, Atakan; Tumer, Cemil; Cevik, Cengiz

    2015-01-01

    Objectives: The object of the study is to experimentally investigate the possible systemic side effects of Oxymetazoline including its nasal spray which has been in use for a long time both by the physicians and patients. There is no study in the literature to address the damages of oxymetazoline on the end organ. Materials and methods: The study conducted on 2 groups of rat. Group 1 (n = 8): Control; and Group 2 (n = 8): Oxymetazoline. During 4 week, the control group was applied with 2 drop...

  12. A side effect resource to capture phenotypic effects of drugs

    DEFF Research Database (Denmark)

    Kuhn, Michael; Campillos, Monica; Letunic, Ivica

    2010-01-01

    on this topic has been hampered by insufficient accessibility of data. Consequently, we have developed a public, computer-readable side effect resource (SIDER) that connects 888 drugs to 1450 side effect terms. It contains information on frequency in patients for one-third of the drug-side effect pairs. For 199......The molecular understanding of phenotypes caused by drugs in humans is essential for elucidating mechanisms of action and for developing personalized medicines. Side effects of drugs (also known as adverse drug reactions) are an important source of human phenotypic information, but so far research...... drugs, the side effect frequency of placebo administration could also be extracted. We illustrate the potential of SIDER with a number of analyses. The resource is freely available for academic research at http://sideeffects.embl.de....

  13. Modification of tenascin-R expression following unilateral labyrinthectomy in rats indicates its possible role in neural plasticity of the vestibular neural circuit.

    Science.gov (United States)

    Gaal, Botond; Jóhannesson, Einar Örn; Dattani, Amit; Magyar, Agnes; Wéber, Ildikó; Matesz, Clara

    2015-09-01

    We have previously found that unilateral labyrinthectomy is accompanied by modification of hyaluronan and chondroitin sulfate proteoglycan staining in the lateral vestibular nucleus of rats and the time course of subsequent reorganization of extracellular matrix assembly correlates to the restoration of impaired vestibular function. The tenascin-R has repelling effect on pathfinding during axonal growth/regrowth, and thus inhibits neural circuit repair. By using immunohistochemical method, we studied the modification of tenascin-R expression in the superior, medial, lateral, and descending vestibular nuclei of the rat following unilateral labyrinthectomy. On postoperative day 1, tenascin-R reaction in the perineuronal nets disappeared on the side of labyrinthectomy in the superior, lateral, medial, and rostral part of the descending vestibular nuclei. On survival day 3, the staining intensity of tenascin-R reaction in perineuronal nets recovered on the operated side of the medial vestibular nucleus, whereas it was restored by the time of postoperative day 7 in the superior, lateral and rostral part of the descending vestibular nuclei. The staining intensity of tenascin-R reaction remained unchanged in the caudal part of the descending vestibular nucleus bilaterally. Regional differences in the modification of tenascin-R expression presented here may be associated with different roles of individual vestibular nuclei in the compensatory processes. The decreased expression of the tenascin-R may suggest the extracellular facilitation of plastic modifications in the vestibular neural circuit after lesion of the labyrinthine receptors.

  14. Modification of tenascin-R expression following unilateral labyrinthectomy in rats indicates its possible role in neural plasticity of the vestibular neural circuit

    Directory of Open Access Journals (Sweden)

    Botond Gaal

    2015-01-01

    Full Text Available We have previously found that unilateral labyrinthectomy is accompanied by modification of hyaluronan and chondroitin sulfate proteoglycan staining in the lateral vestibular nucleus of rats and the time course of subsequent reorganization of extracellular matrix assembly correlates to the restoration of impaired vestibular function. The tenascin-R has repelling effect on pathfinding during axonal growth/regrowth, and thus inhibits neural circuit repair. By using immunohistochemical method, we studied the modification of tenascin-R expression in the superior, medial, lateral, and descending vestibular nuclei of the rat following unilateral labyrinthectomy. On postoperative day 1, tenascin-R reaction in the perineuronal nets disappeared on the side of labyrinthectomy in the superior, lateral, medial, and rostral part of the descending vestibular nuclei. On survival day 3, the staining intensity of tenascin-R reaction in perineuronal nets recovered on the operated side of the medial vestibular nucleus, whereas it was restored by the time of postoperative day 7 in the superior, lateral and rostral part of the descending vestibular nuclei. The staining intensity of tenascin-R reaction remained unchanged in the caudal part of the descending vestibular nucleus bilaterally. Regional differences in the modification of tenascin-R expression presented here may be associated with different roles of individual vestibular nuclei in the compensatory processes. The decreased expression of the tenascin-R may suggest the extracellular facilitation of plastic modifications in the vestibular neural circuit after lesion of the labyrinthine receptors.

  15. Novel Opioid Analgesics and Side Effects.

    Science.gov (United States)

    Del Vecchio, Giovanna; Spahn, Viola; Stein, Christoph

    2017-08-16

    Conventional opioids mediate analgesia as well as severe adverse effects via G-protein coupled opioid receptors (OR) in both inflamed (peripheral injured tissue) and healthy (brain, intestinal wall) environments. To exclude side effects, OR activation can be selectively achieved in damaged tissue by lowering the pK a of an opioid ligand to the acidic pH of inflammation. As a result, protonation of the ligand and consequent OR binding and activation of G-proteins is pH- and injury-specific. A novel compound (NFEPP) demonstrates the feasibility of this approach and displays blockade of pain transmission only at the peripheral site of injury, but with lack of central and gastrointestinal adverse effects. These findings suggest disease-specific receptor activation as a new strategy in drug design.

  16. Predicting Nonauditory Adverse Radiation Effects Following Radiosurgery for Vestibular Schwannoma: A Volume and Dosimetric Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hayhurst, Caroline; Monsalves, Eric; Bernstein, Mark; Gentili, Fred [Gamma Knife Unit, Division of Neurosurgery, University Health Network, Toronto (Canada); Heydarian, Mostafa; Tsao, May [Radiation Medicine Program, Princess Margaret Hospital, Toronto (Canada); Schwartz, Michael [Radiation Oncology Program and Division of Neurosurgery, Sunnybrook Hospital, Toronto (Canada); Prooijen, Monique van [Radiation Medicine Program, Princess Margaret Hospital, Toronto (Canada); Millar, Barbara-Ann; Menard, Cynthia [Radiation Oncology Program, Princess Margaret Hospital, Toronto (Canada); Kulkarni, Abhaya V. [Division of Neurosurgery, Hospital for Sick Children, University of Toronto (Canada); Laperriere, Norm [Radiation Oncology Program, Princess Margaret Hospital, Toronto (Canada); Zadeh, Gelareh, E-mail: Gelareh.Zadeh@uhn.on.ca [Gamma Knife Unit, Division of Neurosurgery, University Health Network, Toronto (Canada)

    2012-04-01

    Purpose: To define clinical and dosimetric predictors of nonauditory adverse radiation effects after radiosurgery for vestibular schwannoma treated with a 12 Gy prescription dose. Methods: We retrospectively reviewed our experience of vestibular schwannoma patients treated between September 2005 and December 2009. Two hundred patients were treated at a 12 Gy prescription dose; 80 had complete clinical and radiological follow-up for at least 24 months (median, 28.5 months). All treatment plans were reviewed for target volume and dosimetry characteristics; gradient index; homogeneity index, defined as the maximum dose in the treatment volume divided by the prescription dose; conformity index; brainstem; and trigeminal nerve dose. All adverse radiation effects (ARE) were recorded. Because the intent of our study was to focus on the nonauditory adverse effects, hearing outcome was not evaluated in this study. Results: Twenty-seven (33.8%) patients developed ARE, 5 (6%) developed hydrocephalus, 10 (12.5%) reported new ataxia, 17 (21%) developed trigeminal dysfunction, 3 (3.75%) had facial weakness, and 1 patient developed hemifacial spasm. The development of edema within the pons was significantly associated with ARE (p = 0.001). On multivariate analysis, only target volume is a significant predictor of ARE (p = 0.001). There is a target volume threshold of 5 cm3, above which ARE are more likely. The treatment plan dosimetric characteristics are not associated with ARE, although the maximum dose to the 5th nerve is a significant predictor of trigeminal dysfunction, with a threshold of 9 Gy. The overall 2-year tumor control rate was 96%. Conclusions: Target volume is the most important predictor of adverse radiation effects, and we identified the significant treatment volume threshold to be 5 cm3. We also established through our series that the maximum tolerable dose to the 5th nerve is 9 Gy.

  17. Effect of personal music system use on sacculocollic reflex assessed by cervical vestibular-evoked myogenic potential: A preliminary investigation

    Directory of Open Access Journals (Sweden)

    Niraj Kumar Singh

    2016-01-01

    Full Text Available Listening to music through a portable personal music system (PMS is a growing trend, especially among the youth. The preferred listening level in such kinds of PMS has been reported to cross the safe levels and its impact on the auditory system was demonstrated in several previous investigations. Owing to the commonality in several aspects between the auditory and the vestibular systems, it appears likely that the deleterious effects of PMS use could also be impinging on the vestibular system, which has never been investigated. The present study therefore, aimed at evaluating the effects of PMS use on the sacculocollic reflex assessed by the cervical vestibular-evoked myogenic potential (cVEMP technique. Thirty-two regular PMS users and 32 nonregular PMS users underwent cVEMP testing using alternating polarity 500 Hz tone bursts. The results revealed no significant group difference in latencies and interaural asymmetry ratio. However, the cVEMP was significantly reduced in the group of individuals in whom the diffused field equivalent sound pressure levels (SPLs were above the damage risk criteria (DRC compared to those with diffused field equivalent SPLs below it (P< 0.01. Therefore, the use of PMS at high levels of volume controls could be deleterious to the vestibular well-being of an individual.

  18. Effects of hypergravity on gene levels in anti-gravity muscle and bone through the vestibular system in mice.

    Science.gov (United States)

    Kawao, Naoyuki; Morita, Hironobu; Nishida, Kazuaki; Obata, Koji; Tatsumi, Kohei; Kaji, Hiroshi

    2017-09-07

    We recently reported that hypergravity with 3 g for 4 weeks affects muscle and bone through the vestibular system in mice. The purpose of this study was to investigate the effects of hypergravity with 2 g, which had no influence on circulating glucocorticoid level, on the gene levels in muscle and bone, as well as the roles of the vestibular system in those changes using vestibular lesioned (VL) mice. Hypergravity for 2 and 8 weeks or VL exerted little effects on the mRNA levels of muscle differentiation factors and myokines in the soleus muscle. Although hypergravity for 2 weeks significantly elevated alkaline phosphatase (ALP) and type I collagen mRNA levels in the tibia, VL significantly attenuated the levels of ALP mRNA enhanced by hypergravity. In conclusion, the present study suggests that a 2-g load for 2 weeks enhances osteoblast differentiation partly through the vestibular system in mice.

  19. Esomeprazole induced galactorrhea: a novel side effect.

    Science.gov (United States)

    Pipaliya, Nirav; Solanke, Dattatray; Rathi, Chetan; Patel, Ruchir; Ingle, Meghraj; Sawant, Prabha

    2016-02-01

    Proton pump inhibitors (PPIs) are one of the most frequently prescribed medications across the globe. Esomeprazole is the S-isomer of omeprazole, and it is currently the most widely prescribed PPI. The safety profile of esomeprazole is extremely favorable with only minor side effects, like headache and diarrhea, that are encountered in day to day practice. We report a case of a young female with symptoms of gastroesophageal reflux disease who developed galactorrhea after starting esomeprazole therapy. Resolution of galactorrhea after stopping the drug and self-rechallenge by the patient herself with reappearance of galactorrhea confirmed the culprit to be esomeprazole only. We postulate that esomeprazole may have a mild inhibitory effect on CYP3A4, which leads to decreased metabolism of estrogen, thereby increasing serum estrogen levels. Estrogen causes stimulation and production of prolactin release, which results in development of galactorrhea. This is the first case of esomeprazole induced galactorrhea, to the best of our knowledge.

  20. Vestibular Effects of a 7 Tesla MRI Examination Compared to 1.5 T and 0 T in Healthy Volunteers

    Science.gov (United States)

    Theysohn, Jens M.; Kraff, Oliver; Eilers, Kristina; Andrade, Dorian; Gerwig, Marcus; Timmann, Dagmar; Schmitt, Franz; Ladd, Mark E.; Ladd, Susanne C.; Bitz, Andreas K.

    2014-01-01

    Ultra-high-field MRI (7 Tesla (T) and above) elicits more temporary side-effects compared to 1.5 T and 3 T, e.g. dizziness or “postural instability” even after exiting the scanner. The current study aims to assess quantitatively vestibular performance before and after exposure to different MRI scenarios at 7 T, 1.5 T and 0 T. Sway path and body axis rotation (Unterberger's stepping test) were quantitatively recorded in a total of 46 volunteers before, 2 minutes after, and 15 minutes after different exposure scenarios: 7 T head MRI (n = 27), 7 T no RF (n = 22), 7 T only B0 (n = 20), 7 T in & out B0 (n = 20), 1.5 T no RF (n = 20), 0 T (n = 15). All exposure scenarios lasted 30 minutes except for brief one minute exposure in 7 T in & out B0. Both measures were documented utilizing a 3D ultrasound system. During sway path evaluation, the experiment was repeated with eyes both open and closed. Sway paths for all long-lasting 7 T scenarios (normal, no RF, only B0) with eyes closed were significantly prolonged 2 minutes after exiting the scanner, normalizing after 15 minutes. Brief exposure to 7 T B0 or 30 minutes exposure to 1.5 T or 0 T did not show significant changes. End positions after Unterberger's stepping test were significantly changed counter-clockwise after all 7 T scenarios, including the brief in & out B0 exposure. Shorter exposure resulted in a smaller alteration angle. In contrast to sway path, reversal of changes in body axis rotation was incomplete after 15 minutes. 1.5 T caused no rotational changes. The results show that exposure to the 7 Tesla static magnetic field causes only a temporary dysfunction or “over-compensation” of the vestibular system not measurable at 1.5 or 0 Tesla. Radiofrequency fields, gradient switching, and orthostatic dysregulation do not seem to play a role. PMID:24658179

  1. Vestibular effects of a 7 Tesla MRI examination compared to 1.5 T and 0 T in healthy volunteers.

    Directory of Open Access Journals (Sweden)

    Jens M Theysohn

    Full Text Available Ultra-high-field MRI (7 Tesla (T and above elicits more temporary side-effects compared to 1.5 T and 3 T, e.g. dizziness or "postural instability" even after exiting the scanner. The current study aims to assess quantitatively vestibular performance before and after exposure to different MRI scenarios at 7 T, 1.5 T and 0 T. Sway path and body axis rotation (Unterberger's stepping test were quantitatively recorded in a total of 46 volunteers before, 2 minutes after, and 15 minutes after different exposure scenarios: 7 T head MRI (n = 27, 7 T no RF (n = 22, 7 T only B0 (n = 20, 7 T in & out B0 (n = 20, 1.5 T no RF (n = 20, 0 T (n = 15. All exposure scenarios lasted 30 minutes except for brief one minute exposure in 7 T in & out B0. Both measures were documented utilizing a 3D ultrasound system. During sway path evaluation, the experiment was repeated with eyes both open and closed. Sway paths for all long-lasting 7 T scenarios (normal, no RF, only B0 with eyes closed were significantly prolonged 2 minutes after exiting the scanner, normalizing after 15 minutes. Brief exposure to 7 T B0 or 30 minutes exposure to 1.5 T or 0 T did not show significant changes. End positions after Unterberger's stepping test were significantly changed counter-clockwise after all 7 T scenarios, including the brief in & out B0 exposure. Shorter exposure resulted in a smaller alteration angle. In contrast to sway path, reversal of changes in body axis rotation was incomplete after 15 minutes. 1.5 T caused no rotational changes. The results show that exposure to the 7 Tesla static magnetic field causes only a temporary dysfunction or "over-compensation" of the vestibular system not measurable at 1.5 or 0 Tesla. Radiofrequency fields, gradient switching, and orthostatic dysregulation do not seem to play a role.

  2. Effects of deuterium oxide and galvanic vestibular stimulation on visual cortical cell function

    Energy Technology Data Exchange (ETDEWEB)

    Reinis, S.; Landolt, J.P.; Weiss, D.S.; Money, K.E.

    1984-03-01

    The spontaneous and evoked unit activities of complex visual cortical cells were recorded from Brodmann's area 18 in immobilized, unanesthetized cats before, during, and after stimulation of the vestibular system. The vestibular system was stimulated by intravenous injection of deuterium oxide (D2O)--a noted nystagmogenic agent--or by direct galvanic stimulation of the labyrinth. Measures of the receptive-field areas, poststimulus time histograms, directional preferences, and the optimal speed of the light bar stimulating the cell were obtained before and after the application of D2O. Directional preferences were determined in a novel manner, using a method derived from a hierarchical clustering technique. Data were collected and analyzed from a) visual cortical cells in cats with intact labyrinths, b) visual cortical cells in cats following bilateral labrinthectomies, and c) nonvisual cortical cells in cats with intact labyrinths. The other cellular characteristics were also altered by the D2O. Galvanic stimulation of the labyrinth resembles, in its effects, the injection of D2O. In labyrinth-intact cats, the time course of area 18 spontaneous activity dramatically increased 30 min or more after D2O was administered. It peaked 2-3 h later and still had not returned to preinjection levels even 7 h after the D2O administration. In bilaterally labyrinthectomized cats, the spontaneous activity of the visual cells did not change following D2O administration. In nonvisual cells from labyrinth-intact cats, the spontaneous activity demonstrated a slight but significant decrease over time after D2O injection. In pilot studies, the cats were injected with D2O. Within 8-10 min afterward, signs of positional nystagmus commenced; and within 30 min, problems in maintaining balance were noted. This continued for 7-8 h before disappearing. In the labyrinthectomized animals, such effects were not observed.

  3. Effects of deuterium oxide and galvanic vestibular stimulation on visual cortical cell function

    International Nuclear Information System (INIS)

    Reinis, S.; Landolt, J.P.; Weiss, D.S.; Money, K.E.

    1984-01-01

    The spontaneous and evoked unit activities of complex visual cortical cells were recorded from Brodmann's area 18 in immobilized, unanesthetized cats before, during, and after stimulation of the vestibular system. The vestibular system was stimulated by intravenous injection of deuterium oxide (D2O)--a noted nystagmogenic agent--or by direct galvanic stimulation of the labyrinth. Measures of the receptive-field areas, poststimulus time histograms, directional preferences, and the optimal speed of the light bar stimulating the cell were obtained before and after the application of D2O. Directional preferences were determined in a novel manner, using a method derived from a hierarchical clustering technique. Data were collected and analyzed from a) visual cortical cells in cats with intact labyrinths, b) visual cortical cells in cats following bilateral labrinthectomies, and c) nonvisual cortical cells in cats with intact labyrinths. The other cellular characteristics were also altered by the D2O. Galvanic stimulation of the labyrinth resembles, in its effects, the injection of D2O. In labyrinth-intact cats, the time course of area 18 spontaneous activity dramatically increased 30 min or more after D2O was administered. It peaked 2-3 h later and still had not returned to preinjection levels even 7 h after the D2O administration. In bilaterally labyrinthectomized cats, the spontaneous activity of the visual cells did not change following D2O administration. In nonvisual cells from labyrinth-intact cats, the spontaneous activity demonstrated a slight but significant decrease over time after D2O injection. In pilot studies, the cats were injected with D2O. Within 8-10 min afterward, signs of positional nystagmus commenced; and within 30 min, problems in maintaining balance were noted. This continued for 7-8 h before disappearing. In the labyrinthectomized animals, such effects were not observed

  4. Not all side effects associated with tricyclic antidepressant therapy are true side effects.

    Science.gov (United States)

    Thiwan, Syed; Drossman, Douglas A; Morris, Carolyn B; Dalton, Chris; Toner, Brenda B; Diamant, Nicholas E; Hu, J B; Whitehead, William E; Leserman, Jane; Bangdiwala, Shrikant I

    2009-04-01

    Patients with functional gastrointestinal disorders treated with tricyclic antidepressants sometimes report nongastrointestinal symptoms; it is unclear whether these are drug side effects or reflect a behavioral tendency to report symptoms. We evaluated whether symptoms reported before treatment with a tricyclic antidepressant (desipramine) increased in number or worsened in severity after 2 weeks of treatment and assessed the baseline factors that predispose patients to report symptoms. Female patients in a multicenter National Institutes of Health trial for functional bowel disorders completed a 15-item symptom questionnaire at baseline (before randomization), 2 weeks after they were given desipramine (n = 81) or placebo (n = 40), and at study completion (12 weeks). Patients were asked about the severity and frequency of 15 symptoms. Results were analyzed from 57 patients given desipramine who completed the questionnaires. Symptoms reported as side effects to have occurred more frequently and also worsened at week 2 in the group given desipramine included dizziness, dry mouth/thirstiness, lightheadedness, jittery feelings/tremors, and flushing. Symptoms that did not change in severity or showed improvement at week 2 in the group given desipramine included morning tiredness, nausea, blurred vision, headaches, appetite reduction, and trouble sleeping. Psychologic distress but not desipramine blood level correlated with symptom reporting. Most symptoms often attributed to side effects of desipramine were present before treatment; only a few, related to anticholinergic effects, worsened 2 weeks after treatment, suggesting that most so-called side effects were not associated specifically with desipramine use. Such symptoms might instead be associated with psychologic distress.

  5. Systemic side effects of locally used oxymetazoline.

    Science.gov (United States)

    Dokuyucu, Recep; Gokce, Hasan; Sahan, Mustafa; Sefil, Fatih; Tas, Zeynel Abidin; Tutuk, Okan; Ozturk, Atakan; Tumer, Cemil; Cevik, Cengiz

    2015-01-01

    The object of the study is to experimentally investigate the possible systemic side effects of Oxymetazoline including its nasal spray which has been in use for a long time both by the physicians and patients. There is no study in the literature to address the damages of oxymetazoline on the end organ. The study conducted on 2 groups of rat. Group 1 (n = 8): Control; and Group 2 (n = 8): Oxymetazoline. During 4 week, the control group was applied with 2 drops of saline water on each nasal cavity 3 times a day and the other group was applied with 2 drops of oxymetazoline HCl 3 times a day. At the end of experiment, samples from mandible, parotid and tails of the rats were taken in 10% formalin for histopathological investigations. In histopathological experiments, when compared with the control group, the oxymetazoline group showed significant increase in many of the histopathological parameters (ischemic changes: P = 0.0001; congestion: P = 0.0006; arterial thrombosis: P = Ns; PNL accumulations: P = 0.001; necrosis: P = 0.0001; and ulceration: P = 0.014). The results of histopathologic tests on the samples taken from mandible and parotid gland, in comparison with the control group, showed no significant increase (focal inflammation: P = Ns; and lymphocyte aggregation: P = Ns). Due to the damage that the long-term use of nasal spray including oxymetazoline, it may cause injury on the end organ, which we revealed in our histopathological experiments. We believe that it's essential for the physicians to provide information on the side effects of the medicine to their patients who use for a long term.

  6. Chemotherapy Side Effects: A Cause of Heart Disease?

    Science.gov (United States)

    ... A cause of heart disease? Can chemotherapy side effects increase the risk of heart disease? Answers from Timothy J. Moynihan, M.D. Chemotherapy side effects may increase the risk of heart disease, including ...

  7. Mesothelioma Treatment: Recovery, Side Effects, What to Expect

    Science.gov (United States)

    ... Treatment > Mesothelioma Treatment > Mesothelioma Treatment Recovery Side Effects Mesothelioma Treatment and Recovery Scenarios: e-News Signup Click ... questions. (877) END-MESO (877) 363-6376 Testimonials Mesothelioma Treatment: Recovery, Side Effects, What to Expect Mesothelioma ...

  8. A protective effect of 5-HT3 antagonist against vestibular deficit? Metoclopramide versus ondansetron at the early stage of vestibular neuritis: a pilot study.

    Science.gov (United States)

    Venail, F; Biboulet, R; Mondain, M; Uziel, A

    2012-04-01

    Ondansetron is an antiemetic 5-HT3 receptor antagonist with proven efficacy in central balance disorder. A pilot study investigated impact on acute unilateral vestibular neuritis. A randomized clinical trial included 20 vestibular neuritis patients. Subjects received methylprednisolone-valacyclovir, associated to 5 days' metoclopramide (30 mg/d; group M, n=10) or ondansetron (8 mg/d; group O, n=10). Assessment was based on early and 1 month videonystagmography, duration of hospital stay and time to first independent walking. Blinded intention-to-treat analysis used univariate (Student test) and multivariate (linear logistic regression) analysis. Early caloric vestibular deficit was significantly lower in group O than group M (56.53% versus 84.38%; P=0.03). Vestibular preponderance did not differ between groups (8.2°/s in O versus 10.34°/s in M). At 1 month, trends were observed for vestibular deficit (43% in O versus 63.4% in M; P=0.07) and preponderance (1.67°/s in O versus 1.74°/s in M; P=0.4). Hospital stay and time to first independent walking were significantly shorter in O (2.88 versus 4.5 days (P=0.03); and 1.25 versus 2.25 days (P=0.001), respectively). Early treatment with ondansetron associated to corticosteroids and antiviral treatment reduced vestibular deficit in acute-phase vestibular neuritis as compared to reference histamine H1 receptor antagonists. The treatment did not affect central compensation. Benefit includes improved tolerance of vertigo syndrome and reduced hospital stay. These results should be confirmed on a larger series, particularly to determine the mechanism of action of 5-HT3 antagonists on vestibular function. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  9. Vestibular rehabilitation outcomes in the elderly with chronic vestibular dysfunction.

    Science.gov (United States)

    Bayat, Arash; Pourbakht, Akram; Saki, Nader; Zainun, Zuraida; Nikakhlagh, Soheila; Mirmomeni, Golshan

    2012-11-01

    Chronic vestibular dysfunction is a frustrating problem in the elderly and can have a tremendous impact on their life, but only a few studies are available. Vestibular rehabilitation therapy (VRT) is an important therapeutic option for the neuro-otologist in treating patients with significant balance deficits. The purpose of this study was to assess the effect of vestibular rehabilitation on dizziness in elderly patients with chronic vestibular dysfunction. A total of 33 patients older than 60 years with chronic vestibular dysfunction were studied. Clinical and objective vestibular tests including videonystagmography (VNG) and dizziness handicap inventory (DHI) were carried out at their first visit, 2 weeks, and 8 weeks post-VRT. The VRT exercises were performed according to Cawthorne and Cooksey protocols. Oculomotor assessments were within normal limits in all patients. Nineteen patients (57.57%) showed abnormal canal paralysis on caloric testing which at follow-up sessions; CP values were decreased remarkably after VRT exercises. We found a significant improvement between pre-VRT and post-VRT total DHI scores (P < 0.001). This improvement was most prominent in functional subscore. Our study demonstrated that VRT is an effective therapeutic method for elderly patients with chronic vestibular dysfunction.

  10. Cardiovascular side effects of psychopharmacologic therapy.

    Science.gov (United States)

    Potočnjak, Ines; Degoricija, Vesna; Vukičević Baudoin, Dina; Čulig, Josip; Jakovljević, Miro

    2016-09-15

    WHO defined in 1976 psychopharmaca as drugs affecting psychological functions, behaviour and self-perception. Psychopharmacology is the study of pharmacological agents that affect mental and emotional functions. Creative approach to psychopharmacotherapy reflects a transdisciplinary, integrative and person-centered psychiatry. Psychiatric disorders often occur in cardiac patients and can affect the clinical presentation and morbidity. Cardiovascular (CV) side effects (SE) caused by psychopharmaceutic agents require comprehensive attention. Therapeutic approach can increase placebo and decrease nocebo reactions. The main purpose of this review is to comprehend CV SE of psychotropic drugs (PD). Critical overview of CV SE of PD will be presented in this review. Search was directed but not limited to CV effects of psychopharmacological substances, namely antipsychotics, anxiolytics, hypnotics, sedatives, antidepressants and stimulants. Literature review was performed and data identified by searches of Medline and PubMed for period from 2004 to 2015. Only full articles and abstracts published in English were included. SE of PD are organized according to the following types of CV effects: cardiac and circulatory effects, abnormalities of cardiac repolarisation and arrhythmias and heart muscle disease. There is wide spectrum and various CV effects of PD. Results of this review are based on literature research. The reviewed data came largely from prevalence studies, case reports, and cross-sectional studies. Psychopharmacotherapy of psychiatric disorders is complex and when concomitantly present with CV disease, presentation of drug SEs can significantly contribute to illness course. Further development of creative psychopharmacotherapy is required to deal with CV effects of PD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Role of subjective visual vertical test during eccentric rotation in the recovery phase of vestibular neuritis.

    Science.gov (United States)

    Byun, Jae Yong; Hong, Seok Min; Yeo, Seung Geun; Kim, Sang Hoon; Kim, Sung Wan; Park, Moon Suh

    2010-10-01

    By assessing unilateral utricular function at the acute and subacute stages, we sought to determine the ability of the subjective visual vertical (SVV) during eccentric rotation (dynamic SVV) in detecting latent abnormality of otolith dysfunction in unilateral vestibular neuritis. In addition, we compared the validity of the dynamic SVV with static SVV during the compensated recovery phase. The static SVV and dynamic SVV of 19 patients diagnosed with acute unilateral vestibular neuritis and 31 patients diagnosed with the subacute stage of vestibular neuritis were determined in this study. First, the static SVV was measured in a dark booth without rotation. The dynamic SVV was measured during rotation with an eccentric displacement of the head to 3.5cm from the vertical rotation axis during a constant velocity of 300 degrees /s. In the acute stage of vestibular neuritis, the static SVV showed an increase in deviation to the side of the lesion compared to findings in normal subjects. In the subacute stage, it did not differ significantly from that of the normal subjects. The dynamic SVV, however, had a statistically significant increase in deviation to the side of the lesion compared to normal subjects in both the acute and subacute stages. The dynamic SVV would be an effective method in detecting latent abnormality of otolith dysfunction in unilateral vestibular neuritis, compared to static SVV, especially compensated unilateral vestibular neuritis. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Comparison of side effects in myelography with iopamidol and metrizamide

    International Nuclear Information System (INIS)

    Lee, Yong; Kang, Heung Sik; Chang, Kee Hyun; Han, Seoul Heui; Kwon, Oh Sung; Myung, Ho Gin

    1986-01-01

    The study was conducted to compare the side effects in myelography of the two non-ionic water-soluble contrast medias, lopamidol (Niopam) and Metrizamide (Amipaque). A total of 111 patients were examined, 64 with lopamidol and 47 with Metrizamide. Side effects consisted of headache, nausea, vomiting, dizziness, urinary difficulty, muscular pain, seizure, neurobehavioral disturbance, neurological sign change, vital sign change and etc. The common side effects were headache, nausea, vomiting and dizziness in order of frequency. Most of the side effects were subsided within 24 hours following myelography. lopamidol myelography caused fewer and milder side effects than Metrizamide study. The side effects were more commonly observed in cervical, thoracic or total myelography than in lumbar myelography with either lopamidol or Metrizamide. There was no significant correlation between incidence of the side effects and premedication with phenobarbital or valium injection before myelography and CSF sampling during the procedure.

  13. ANTIPSYCHOTIC TREATMENT - SIDE-EFFECT AND/OR METABOLIC SYNDROME

    OpenAIRE

    Dadić-Hero, Elizabeta; Ružić, Klementina; Grahovac, Tanja; Žarković Palijan, Tija; Petranović, Duška; Šepić-Grahovac, Dubravka

    2011-01-01

    According to current medical opinion chronic mental diseases such as schizophrenia require life-long treatment. The choice of antipsychotics is an important treatment factor, since their side-effects often influence patients' compliance with treatment. Severe side-effects may cause the patients to reject such treatment, the latter being their right. In case a psychiatrist does not agree with the patient's decision to interrupt his antipsychotic treatment regardless its serious side-e...

  14. Effect on the disability index of adult patients with benign paroxysmal positional vertigo using vestibular rehabilitation and human movement

    OpenAIRE

    Chaverri Flores, Sofía; Chaverri Polini, Julián; Mora Campos, Andrea

    2007-01-01

    Objective: determine the effect on the disability index of adult patients with benign paroxysmal positional vertigo (BPPV) using vestibular rehabilitation therapy (VRT) and human movement. Subjects: six subjects with an average age of 49.5 ± 14.22 years who have been diagnosed with benign paroxysmal positional vertigo by an otolaryngologist. Instruments: the Dizziness Handicap Inventory and a questionnaire to determine impact on the quality of life of patients with this pathology (Ceballos an...

  15. Side effects of retinoid therapy on the quality of vision

    Directory of Open Access Journals (Sweden)

    Bergler-Czop Beata

    2016-12-01

    Full Text Available Retinoids are compounds chemically related to vitamin A, which are frequently used in dermatological practice (1. They are characterized by numerous mechanisms of action leading to normalization of keratinocyte proliferation and maturation. They have anti-seborrhoeic, immunomodulatory and anti-inflammatory effects (1, 2. A number of side effects to retinoid treatment have been recorded; one group of such side effects relates to eyes and vision. Dry eye syndrome and blepharoconjunctivitis are the most common side effects, appearing in 20-50 % of patients treated with retinoids. They often contribute to the occurrence of other side-effects such as eye discomfort and contact lens intolerance. Due to the widespread use in clinical practice, the adverse effects, including ocular side effects, should be studied. To confirm the variety of adverse effects of retinoids, several case reports of rare side-effects are presented.

  16. Peripheral Vestibular System Disease in Vestibular Schwannomas

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Hansen, Søren; Caye-Thomasen, Per

    2015-01-01

    with VS. METHODS: Retrospective analysis of vestibular system histopathology in temporal bones from 17 patients with unilateral VS. The material was obtained from The Copenhagen Temporal Bone Collection. RESULTS: Vestibular schwannomas were associated with atrophy of the vestibular ganglion, loss of fiber...... density of the peripheral vestibular nerve branches, and atrophy of the neuroepithelium of the vestibular end organs. In cases with small tumors, peripheral disease occurred only in the tissue structures innervated by the specific nerve from which the tumor originated. CONCLUSION: Vestibular schwannomas...... are associated with distinctive disease of the peripheral vestibular tissue structures, suggesting anterograde degeneration and that dizziness in these patients may be caused by deficient peripheral vestibular nerve fibers, neurons, and end organs. In smaller tumors, a highly localized disease occurs, which...

  17. Vestibular function after acute vestibular neuritis

    OpenAIRE

    Halmagyi, G M; Weber, K P; Curthoys, I S

    2010-01-01

    PURPOSE: To review the extent and mechanism of the recovery of vestibular function after sudden, isolated, spontaneous, unilateral loss of most or all peripheral vestibular function - usually called acute vestibular neuritis. METHODS: Critical review of published literature and personal experience. RESULTS: The symptoms and signs of acute vestibular neuritis are vertigo, vomiting, nystagmus with ipsiversive slow-phases, ipsiversive lateropulsion and ocular tilt reaction (the static symptoms) ...

  18. Target Essentiality and Centrality Characterize Drug Side Effects

    OpenAIRE

    Wang, Xiujuan; Thijssen, Bram; Yu, Haiyuan

    2013-01-01

    Author Summary The ultimate goal of medical research is to develop effective treatments for disease with minimal side effects. Currently, about 20% of drug candidates failed at clinical trial phases II and III due to safety issues. Therefore, understanding the determining factors of drug side effects is of paramount importance to human health and the pharmaceutical industry. Here, we present the first systematic study to uncover key factors leading to drug side effects within the framework of...

  19. Vestibular function after vestibular neuritis.

    Science.gov (United States)

    Manzari, L; Burgess, A M; MacDougall, H G; Curthoys, I S

    2013-10-01

    To measure horizontal semicircular canal function over days, weeks, and months after an acute attack of vestibular neuritis. The video head impulse test (vHIT) was used to measure the eye movement response to small unpredictable passive head turns at intervals after the attack. Two patients diagnosed with acute right unilateral vestibular neuritis. There was full restoration of horizontal canal function in one patient (A) as shown by the return of the slow phase eye velocity response to unpredictable head turns, while in the other patient (B) there was little or no recovery of horizontal canal function. Instead this second patient generated covert saccades during head turns. Despite the objective evidence of their very different recovery patterns, both patients reported, at the final test, being happy and feeling well recovered, even though in one of the patients there was clear absence of horizontal canal function. The results indicate covert saccades seem a successful way of compensating for loss of horizontal canal function after unilateral vestibular neuritis. Factors other than recovery of the slow phase eye velocity are significant for patient recovery.

  20. Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders

    Directory of Open Access Journals (Sweden)

    Andréa Manso

    2016-04-01

    Full Text Available ABSTRACT INTRODUCTION: Visual stimuli can induce vestibular adaptation and recovery of body balance. OBJECTIVE: To verify the effect of visual stimuli by digital images on vestibular and body balance rehabilitation of peripheral vestibular disorders. METHODS: Clinical, randomized, prospective study. Forty patients aged between 23 and 63 years with chronic peripheral vestibular disorders underwent 12 sessions of rehabilitation with visual stimuli using digital video disk (DVD (experimental group or Cawthorne-Cooksey exercises (control group. The Dizziness Handicap Inventory (DHI, dizziness analog scale, and the sensitized Romberg static balance and one-leg stance tests were applied before and after the intervention. RESULTS: Before and after the intervention, there was no difference between the experimental and control groups (p > 0.005 regarding the findings of DHI, dizziness analog scale, and static balance tests. After the intervention, the experimental and control groups showed lower values (p < 0.05 in the DHI and the dizziness analog scale, and higher values (p < 0.05 in the static balance tests in some of the assessed conditions. CONCLUSION: The inclusion of visual stimuli by digital images on vestibular and body balance rehabilitation is effective in reducing dizziness and improving quality of life and postural control in individuals with peripheral vestibular disorders.

  1. The Effect of Intravenous Dexamethasone on the Nausea Accompanying Vestibular Neuritis: A Preliminary Study.

    Science.gov (United States)

    Kim, Ji Chan; Cha, Wang Woon; Chang, Dong Sik; Lee, Ho Yun

    2015-11-01

    We undertook a preliminary assessment of the efficacy of administering intravenous dexamethasone (DEX) for relieving the nausea and dizziness accompanying vestibular neuritis (VN). Between November 2013 and October 2014, 26 patients with VN were prospectively enrolled in this study. The patients were randomly assigned to treatment with a combination of 20 mg/d of intravenous metoclopramide, 100 mg of oral dimenhydrinate, and 5 mg/d of intravenous DEX or 20 mg/d of intravenous metoclopramide, 100 mg of oral dimenhydrinate, and intravenous normal saline as a placebo therapy. Patients' subjective assessments of the severity of their nausea and dizziness were recorded using a visual analog scale on the day of admission and 2 days, 3 days, 1 month, and 3 months thereafter. Bedside examinations consisted of spontaneous nystagmus (SPN) assessment, the head shaking nystagmus test, and the head impulse test, which were performed at every follow-up visit. The severity of nausea and dizziness was significantly reduced over time (both P 0.05). The presence of SPN was solely associated with nausea (hazard ratio = 3.34; 95% CI, 1.85-6.02). The administration of intravenous DEX did not relieve nausea or dizziness any better than a placebo treatment. However, further research is required to confirm whether there is a dose-dependent effect of DEX on the control of nausea or dizziness in VN. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  2. Effects of galvanic vestibular stimulation on visual memory recall and EEG.

    Science.gov (United States)

    Lee, Jeong-Woo; Lee, Gi-Eun; An, Ji-Hyang; Yoon, Se-Won; Heo, Myoung; Kim, Hwang-Yong

    2014-09-01

    [Purpose] This study aimed to examine the effects of galvanic vestibular stimulation (GVS) on visual memory recall and EEG. [Subjects and Methods] In the present study, 42 adults were selected and divided equally into two groups of 21 adults, the GVS group and the Sham group. The error rate was calculated as a percentage based on the total number of errors in the answers to 24 questions after stimulation, while the reaction time was measured in intervals between the time the questions were asked and the time it took the subjects to answer the questions. EEG data were obtained by attaching electrodes to the Fz, Cz, and Pz points during the question and answer phase. [Results] The error rate showed statistically significant differences in the interaction involving the time of response and group. The reaction time showed no statistically significant differences in the interaction involving the time of response and group. When relative band power parameters were analyzed, alpha waves showed no statistically significant differences in the interaction involving the time of response and group, but only the Fz area of beta waves showed statistically significant differences in the interaction involving the time of response and group. [Conclusion] GVS may improve visual memory recall in relation to a flower, a person, an animal, or a building.

  3. Effects of Vestibular Loss on Orthostatic Responses to Tilts in the Pitch Plane

    Science.gov (United States)

    Wood, Scott J.; Serrador, Jorge M.; Black, F. Owen; Rupert,Angus H.; Schlegel, Todd T.

    2004-01-01

    The purpose of this study was to determine the extent to which vestibular loss might impair orthostatic responses to passive tilts in the pitch plane in human subjects. Data were obtained from six subjects having chronic bilateral vestibular loss and six healthy individuals matched for age, gender, and body mass index. Vestibular loss was assessed with a comprehensive battery including dynamic posturography, vestibulo-ocular and optokinetic reflexes, vestibular evoked myogenic potentials, and ocular counterrolling. Head up tilt tests were conducted using a motorized two-axis table that allowed subjects to be tilted in the pitch plane from either a supine or prone body orientation at a slow rate (8 deg/s). The sessions consisted of three tilts, each consisting of20 min rest in a horizontal position, tilt to 80 deg upright for 10 min, and then return to the horizontal position for 5 min. The tilts were performed in darkness (supine and prone) or in light (supine only). Background music was used to mask auditory orientation cues. Autonomic measurements included beat-to-beat recordings of blood pressure (Finapres), heart rate (ECG), cerebral blood flow velocity in the middle cerebral artery (transcranial Doppler), end tidal CO2, respiratory rate and volume (Respritrace), and stroke volume (impedance cardiography). For both patients and control subjects, cerebral blood flow appeared to exhibit the most rapid adjustment following transient changes in posture. Outside of a greater cerebral hypoperfusion in patients during the later stages of tilt, responses did not differ dramatically between the vestibular loss and control subjects, or between tilts performed in light and dark room conditions. Thus, with the 'exception of cerebrovascular regulation, we conclude that orthostatic responses during slow postural tilts are not substantially impaired in humans following chronic loss of vestibular function, a result that might reflect compensation by nonvisual graviceptor

  4. Vestibular function after acute vestibular neuritis.

    Science.gov (United States)

    Halmagyi, G M; Weber, K P; Curthoys, I S

    2010-01-01

    To review the extent and mechanism of the recovery of vestibular function after sudden, isolated, spontaneous, unilateral loss of most or all peripheral vestibular function - usually called acute vestibular neuritis. Critical review of published literature and personal experience. The symptoms and signs of acute vestibular neuritis are vertigo, vomiting, nystagmus with ipsiversive slow-phases, ipsiversive lateropulsion and ocular tilt reaction (the static symptoms) and impairment of vestibulo-ocular reflexes from the ipsilesional semicircular canals on impulsive testing (the dynamic symptoms). Peripheral vestibular function might not improve and while static symptoms invariably resolve, albeit often not totally, dynamic symptoms only improve slightly if at all. The persistent loss of balance that some patients experience after acute vestibular neuritis can be due to inadequate central compensation or to incomplete peripheral recovery and vestibular rehabilitation has a role in the treatment of both.

  5. Are peripheral opioid antagonists the solution to opioid side effects?

    LENUS (Irish Health Repository)

    Bates, John J

    2012-02-03

    Opioid medication is the mainstay of therapy for severe acute and chronic pain. Unfortunately, the side effects of these medications can affect patient comfort and safety, thus limiting their proven therapeutic potential. Whereas the main analgesic effects of opioids are centrally mediated, many of the common side effects are mediated via peripheral receptors. Novel peripheral opioid antagonists have been recently introduced that can block the peripheral actions of opioids without affecting centrally mediated analgesia. We review the clinical and experimental evidence of their efficacy in ameliorating opioid side effects and consider what further information might be useful in defining their role. IMPLICATIONS: The major analgesic effects of opioid medication are mediated within the brain and spinal cord. Many of the side effects of opioids are caused by activation of receptors outside these areas. Recently developed peripherally restricted opioid antagonists have the ability to block many opioid side effects without affecting analgesia.

  6. Vestibular hearing and neural synchronization.

    Science.gov (United States)

    Emami, Seyede Faranak; Daneshi, Ahmad

    2012-01-01

    Objectives. Vestibular hearing as an auditory sensitivity of the saccule in the human ear is revealed by cervical vestibular evoked myogenic potentials (cVEMPs). The range of the vestibular hearing lies in the low frequency. Also, the amplitude of an auditory brainstem response component depends on the amount of synchronized neural activity, and the auditory nerve fibers' responses have the best synchronization with the low frequency. Thus, the aim of this study was to investigate correlation between vestibular hearing using cVEMPs and neural synchronization via slow wave Auditory Brainstem Responses (sABR). Study Design. This case-control survey was consisted of twenty-two dizzy patients, compared to twenty healthy controls. Methods. Intervention comprised of Pure Tone Audiometry (PTA), Impedance acoustic metry (IA), Videonystagmography (VNG), fast wave ABR (fABR), sABR, and cVEMPs. Results. The affected ears of the dizzy patients had the abnormal findings of cVEMPs (insecure vestibular hearing) and the abnormal findings of sABR (decreased neural synchronization). Comparison of the cVEMPs at affected ears versus unaffected ears and the normal persons revealed significant differences (P < 0.05). Conclusion. Safe vestibular hearing was effective in the improvement of the neural synchronization.

  7. Building the process-drug–side effect network to discover the relationship between biological Processes and side effects

    Science.gov (United States)

    2011-01-01

    Background Side effects are unwanted responses to drug treatment and are important resources for human phenotype information. The recent development of a database on side effects, the side effect resource (SIDER), is a first step in documenting the relationship between drugs and their side effects. It is, however, insufficient to simply find the association of drugs with biological processes; that relationship is crucial because drugs that influence biological processes can have an impact on phenotype. Therefore, knowing which processes respond to drugs that influence the phenotype will enable more effective and systematic study of the effect of drugs on phenotype. To the best of our knowledge, the relationship between biological processes and side effects of drugs has not yet been systematically researched. Methods We propose 3 steps for systematically searching relationships between drugs and biological processes: enrichment scores (ES) calculations, t-score calculation, and threshold-based filtering. Subsequently, the side effect-related biological processes are found by merging the drug-biological process network and the drug-side effect network. Evaluation is conducted in 2 ways: first, by discerning the number of biological processes discovered by our method that co-occur with Gene Ontology (GO) terms in relation to effects extracted from PubMed records using a text-mining technique and second, determining whether there is improvement in performance by limiting response processes by drugs sharing the same side effect to frequent ones alone. Results The multi-level network (the process-drug-side effect network) was built by merging the drug-biological process network and the drug-side effect network. We generated a network of 74 drugs-168 side effects-2209 biological process relation resources. The preliminary results showed that the process-drug-side effect network was able to find meaningful relationships between biological processes and side effects in an

  8. The effects of hypergravity and substrate vibration on vestibular function in developing chickens.

    Science.gov (United States)

    Jones, S M; Warren, L E; Shukla, R; Browning, A; Fuller, C A; Jones, T A

    2000-12-01

    We used linear vestibular evoked potentials (VsEPs) to characterize peripheral and central vestibular function in birds following embryogenesis at 2G centrifugation or at elevated levels of vibration (+20dB re: background levels). Additionally, we characterized peripheral and central vestibular adaptation to 2G centrifugation in early post-hatch birds. Linear VsEP response peak latencies, amplitudes, thresholds and input/output functions were quantified and compared between experimental and control animals. Birds vibrated throughout embryogenesis and up to one-week post-hatch revealed no changes in linear VsEP response components compared to control siblings. Birds centrifuged at 2G throughout embryogenesis also evidenced no changes in the linear VsEP measured at hatch (P0). Significant changes were seen, however, for linear VsEPs of post-hatch birds placed at 2G for 7 days beginning on post-hatch day 5. Linear VsEPs for these animals displayed significant reductions in response amplitudes associated with peaks P2, N2 and P3, response peaks generated by central neural relays of gravity receptors. The earliest response components, generated by the peripheral vestibular nerve (i.e., P1, N1), were not significantly altered with the 7-day exposure to 2G. Thus, there was no evidence of generalized changes in peripheral gravity receptor excitability or in the rate of maturation in developing animals under increased levels of gravity or vibration. If gravity level plays a critical role in shaping peripheral vestibular ontogeny at magnitudes between 1 and 2G, then it may serve to stabilize function under changing G-fields or it may operate on physiological features that can not be resolved by the VsEP. In contrast, exposure to elevated gravity during post-hatch periods does alter central vestibular function thus providing direct evidence for central vestibular adaptation to the gravitational environment. The fact that central functional change was observed in hatchlings

  9. Side effects of vagus nerve stimulation during physical exercise

    NARCIS (Netherlands)

    Mulders, D.M.; de Vos, Cecilia Cecilia Clementine; Vosman, I.; Driesse, M.J.; van Putten, Michel Johannes Antonius Maria

    2012-01-01

    RATIONALE: Vagus nerve stimulation (VNS) is a treatment option in the case of refractory epilepsy. However, several side effects have been reported, including dyspnea, coughing and bradycardias [JCA 2010: 22;213-222]. Although some patients experience hardly any side effects from the stimulation

  10. Drugs with anticholinergic side-effects in primary care | Yayla ...

    African Journals Online (AJOL)

    Background: Anticholinergic drugs in elderly people have been associated with some serious side.effects. Patients in Turkey tend to attend primary care centers to have prescriptions of the drugs they chronically use. However, very little are known about how frequent that these drugs are prescribed and their side-effects in ...

  11. The SIDER database of drugs and side effects

    DEFF Research Database (Denmark)

    Kuhn, Michael; Letunic, Ivica; Jensen, Lars Juhl

    2016-01-01

    , targets and side effects into a more complete picture of the therapeutic mechanism of actions of drugs and the ways in which they cause adverse reactions. To this end, we have created the SIDER ('Side Effect Resource', http://sideeffects.embl.de) database of drugs and ADRs. The current release, SIDER 4...

  12. Antipsychotic Drug Side Effects for Persons with Intellectual Disability

    Science.gov (United States)

    Matson, Johnny L.; Mahan, Sara

    2010-01-01

    Antipsychotic drugs are the most frequently prescribed of the psychotropic drugs among the intellectually disabled (ID) population. Given their widespread use, efforts to systematically assess and report side effects are warranted. Specific scaling methods such as the "Matson Evaluation of Side Effects" ("MEDS"), the "Abnormal Inventory Movement…

  13. Systematic identification of proteins that elicit drug side effects

    DEFF Research Database (Denmark)

    Kuhn, Michael; Al Banchaabouchi, Mumna; Campillos, Monica

    2013-01-01

    Side effect similarities of drugs have recently been employed to predict new drug targets, and networks of side effects and targets have been used to better understand the mechanism of action of drugs. Here, we report a large-scale analysis to systematically predict and characterize proteins...... that cause drug side effects. We integrated phenotypic data obtained during clinical trials with known drug-target relations to identify overrepresented protein-side effect combinations. Using independent data, we confirm that most of these overrepresentations point to proteins which, when perturbed, cause......) is responsible for hyperesthesia in mice, which, in turn, can be prevented by a drug that selectively inhibits HTR7. Taken together, we show that a large fraction of complex drug side effects are mediated by individual proteins and create a reference for such relations....

  14. Multifaceted effects of noisy galvanic vestibular stimulation on manual tracking behavior in Parkinson’s disease

    Science.gov (United States)

    Lee, Soojin; Kim, Diana J.; Svenkeson, Daniel; Parras, Gabriel; Oishi, Meeko Mitsuko K.; McKeown, Martin J.

    2015-01-01

    Parkinson’s disease (PD) is a neurodegenerative movement disorder that is characterized clinically by slowness of movement, rigidity, tremor, postural instability, and often cognitive impairments. Recent studies have demonstrated altered cortico-basal ganglia rhythms in PD, which raises the possibility of a role for non-invasive stimulation therapies such as noisy galvanic vestibular stimulation (GVS). We applied noisy GVS to 12 mild-moderately affected PD subjects (Hoehn and Yahr 1.5–2.5) off medication while they performed a sinusoidal visuomotor joystick tracking task, which alternated between 2 task conditions depending on whether the displayed cursor position underestimated the actual error by 30% (‘Better’) or overestimated by 200% (‘Worse’). Either sham or subthreshold, noisy GVS (0.1–10 Hz, 1/f-type power spectrum) was applied in pseudorandom order. We used exploratory (linear discriminant analysis with bootstrapping) and confirmatory (robust multivariate linear regression) methods to determine if the presence of GVS significantly affected our ability to predict cursor position based on target variables. Variables related to displayed error were robustly seen to discriminate GVS in all subjects particularly in the Worse condition. If we considered higher frequency components of the cursor trajectory as “noise,” the signal-to-noise ratio of cursor trajectory was significantly increased during the GVS stimulation. The results suggest that noisy GVS influenced motor performance of the PD subjects, and we speculate that they were elicited through a combination of mechanisms: enhanced cingulate activity resulting in modulation of frontal midline theta rhythms, improved signal processing in neuromotor system via stochastic facilitation and/or enhanced “vigor” known to be deficient in PD subjects. Further work is required to determine if GVS has a selective effect on corrective submovements that could not be detected by the current analyses

  15. Multifaceted Effects of Noisy Galvanic Vestibular Stimulation on Manual Tracking Behavior in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Soojin eLee

    2015-02-01

    Full Text Available Parkinson’s disease (PD is a neurodegenerative movement disorder that is characterized clinically by slowness of movement, rigidity, tremor, postural instability, and often cognitive impairments. Recent studies have demonstrated altered cortico-basal ganglia rhythms in PD, which raises the possibility of a role for non-invasive stimulation therapies such as noisy galvanic vestibular stimulation (GVS. We applied noisy GVS to 12 mild-moderately affected PD subjects (Hoehn & Yahr 1.5-2.5 off medication while they performed a sinusoidal visuomotor joystick tracking task, which alternated between 2 task conditions depending on whether the displayed cursor position underestimated the actual error by 30% (‘Better’ or overestimated by 200% (‘Worse’. Either sham or subthreshold, noisy GVS (0.1-10 Hz, 1/f-type power spectrum was applied in pseudorandom order. We used exploratory (Linear Discriminant Analysis with bootstrapping and confirmatory (robust multivariate linear regression methods to determine if the presence of GVS significantly affected our ability to predict cursor position based on target variables. Variables related to displayed error were robustly seen to discriminate GVS in all subjects particularly in the Worse condition. If we considered higher frequency components of the cursor trajectory as noise, the signal-to-noise ratio of cursor trajectory was significantly increased during the GVS stimulation. The results suggest that noisy GVS influenced motor performance of the PD subjects, and we speculate that they were elicited through a combination of mechanisms: enhanced cingulate activity resulting in modulation of frontal midline theta rhythms, improved signal processing in neuromotor system via stochastic facilitation and/or enhanced vigor known to be deficient in PD subjects. Further work is required to determine if GVS has a selective effect on corrective submovements that could not be detected by the current analyses.

  16. Measuring side effects after radiotherapy for pharynx cancer

    DEFF Research Database (Denmark)

    Jensen, Kenneth

    2007-01-01

    Data on side effects after radiotherapy is needed to establish the benefits and drawbacks of new treatments, but side effects are not quantified as easily as survival or local control. Side effects may be quantified using physical measures. Unfortunately, only few endpoints exist where a physical...... measure is obtainable, and the case of a patient-relevant measure is even rarer. Radiotherapy is often followed by complex symptoms not easily quantifiable by the observer. Quantitative patient reported side effects can be retrieved using validated questionnaires, but this kind of data is often difficult...... to interpret and the correlation with clinically observable or measurable changes not straightforward. The exploitation of the possibilities of highly conformal radiotherapy and multimodality treatment depends on a better understanding of the correlation between dose, volume, modifying factors, and side...

  17. Side Flow Effect on Surface Generation in Nano Cutting.

    Science.gov (United States)

    Xu, Feifei; Fang, Fengzhou; Zhang, Xiaodong

    2017-12-01

    The side flow of material in nano cutting is one of the most important factors that deteriorate the machined surface quality. The effects of the crystallographic orientation, feed, and the cutting tool geometry, including tool edge radius, rake angle and inclination angle, on the side flow are investigated employing molecular dynamics simulation. The results show that the stagnation region is formed in front of tool edge and it is characterized by the stagnation radius R s and stagnation height h s . The side flow is formed because the material at or under the stagnation region is extruded by the tool edge to flow to the side of the tool edge. Higher stagnation height would increase the size of the side flow. The anisotropic nature of the material which partly determines the stagnation region also influences the side flow due to the different deformation mechanism under the action of the tool edge. At different cutting directions, the size of the side flow has a great difference which would finally affect the machined surface quality. The cutting directions of {100} , {110} , and {110}  are beneficial to obtain a better surface quality with small side flow. Besides that, the side flow could be suppressed by reducing the feed and optimizing the cutting tool geometry. Cutting tool with small edge radius, large positive rake angle, and inclination angle would decrease the side flow and consequently improve the machined surface quality.

  18. [Inferior vestibular neuritis].

    Science.gov (United States)

    Alzuphar, Stephen Jacques; Maire, Raphaël

    2017-10-04

    Inferior vestibular neuritis is a rare form of acute peripheral vestibular loss that only implies the lesion of the inferior vestibular nerve. The diagnosis is based on the observation of a spontaneous downbeating nystagmus, pathological head impulse test for the posterior semicircular canal and abnormal cervical vestibular-evoked myogenic potentials. Bithermal caloric testing and head impulse test for horizontal and anterior canals are normal, as well as the ocular vestibular-evoked myogenic potentials. The differential diagnosis of inferior vestibular neuritis includes the various central lesions that produce vertical down beating nystagmus (posterior fossa) and a cerebral magnetic resonance imaging is mandatory.

  19. In vivo assessment of antiretroviral therapy-associated side effects

    Directory of Open Access Journals (Sweden)

    Eduardo Milton Ramos-Sanchez

    2014-07-01

    Full Text Available Antiretroviral therapy has been associated with side effects, either from the drug itself or in conjunction with the effects of human immunodeficiency virus infection. Here, we evaluated the side effects of the protease inhibitor (PI indinavir in hamsters consuming a normal or high-fat diet. Indinavir treatment increased the hamster death rate and resulted in an increase in triglyceride, cholesterol and glucose serum levels and a reduction in anti-oxLDL auto-antibodies. The treatment led to histopathological alterations of the kidney and the heart. These results suggest that hamsters are an interesting model for the study of the side effects of antiretroviral drugs, such as PIs.

  20. [Opioid Therapy and Management of Side Effects Associated with Opioids].

    Science.gov (United States)

    Nakatani, Toshihiko

    2017-04-01

    Opioids are very useful medications to reduce suffering of cancer patients such as refractory pain and dyspnea. We physicians have to use opioids to have good management of pain and suffering associated with cancer including management of side effects caused by opioids. Opioids couple opioid receptors and affect several pharmacological effects. Other than analgesic effect, opioids have some side effects of constipation, nausea and vomiting, respiratory depression. In this chapter, I take important side effects of constipation, nausea and vomiting and respiratory depression. Next, serotonin syndrome caused by tramadol combined with anti-depressants is remarked as assignable syndrome. As advancing in chemotherapy for cancer treatment, cancer survivors live longer with opioid therapy. We have to pay attention to the side effects and another dysfunction caused by long use of opioids. It is important that we physician use opioids effectively to keep activity of daily living(ADL) of patients and families as team approach.

  1. Effectiveness of Otolith Repositioning Maneuvers and Vestibular Rehabilitation exercises in elderly people with Benign Paroxysmal Positional Vertigo: a systematic review

    Directory of Open Access Journals (Sweden)

    Karyna Figueiredo Ribeiro

    Full Text Available Abstract Introduction Benign Paroxysmal Positional Vertigo is highly prevalent in elderly people. This condition is related to vertigo, hearing loss, tinnitus, poor balance, gait disturbance, and an increase in risk of falls, leading to postural changes and quality of life decreasing. Objective To evaluate the outcomes obtained by clinical trials on the effectiveness of Otolith Repositioning Maneuver and Vestibular Rehabilitation exercises in the treatment of Benign Paroxysmal Positional Vertigo in elderly. Methods The literature research was performed using PubMed, Scopus, Web of Science and PEDro databases, and included randomized controlled clinical trials in English, Spanish and Portuguese, published during January 2000 to August 2016. The methodological quality of the studies was assessed by PEDro score and the outcomes analysis was done by critical revision of content. Results Six studies were fully reviewed. The average age of participants ranged between 67.2 and 74.5 years. The articles were classified from 2 to 7/10 through the PEDro score. The main outcome measures analyzed were vertigo, positional nystagmus and postural balance. Additionally, the number of maneuvers necessary for remission of the symptoms, the quality of life, and the functionality were also assessed. The majority of the clinical trials used Otolith Repositioning Maneuver (n = 5 and 3 articles performed Vestibular Rehabilitation exercises in addition to Otolith Repositioning Maneuver or pharmacotherapy. One study showed that the addition of movement restrictions after maneuver did not influence the outcomes. Conclusion There was a trend of improvement in Benign Paroxysmal Positional Vertigo symptomatology in elderly patients who underwent Otolith Repositioning Maneuver. There is sparse evidence from methodologically robust clinical trials that examined the effects of Otolith Repositioning Maneuver and Vestibular Rehabilitation exercises for treating Benign Paroxysmal

  2. Effectiveness of Otolith Repositioning Maneuvers and Vestibular Rehabilitation exercises in elderly people with Benign Paroxysmal Positional Vertigo: a systematic review.

    Science.gov (United States)

    Ribeiro, Karyna Figueiredo; Oliveira, Bruna Steffeni; Freitas, Raysa V; Ferreira, Lidiane M; Deshpande, Nandini; Guerra, Ricardo O

    2017-06-29

    Benign Paroxysmal Positional Vertigo is highly prevalent in elderly people. This condition is related to vertigo, hearing loss, tinnitus, poor balance, gait disturbance, and an increase in risk of falls, leading to postural changes and quality of life decreasing. To evaluate the outcomes obtained by clinical trials on the effectiveness of Otolith Repositioning Maneuver and Vestibular Rehabilitation exercises in the treatment of Benign Paroxysmal Positional Vertigo in elderly. The literature research was performed using PubMed, Scopus, Web of Science and PEDro databases, and included randomized controlled clinical trials in English, Spanish and Portuguese, published during January 2000 to August 2016. The methodological quality of the studies was assessed by PEDro score and the outcomes analysis was done by critical revision of content. Six studies were fully reviewed. The average age of participants ranged between 67.2 and 74.5 years. The articles were classified from 2 to 7/10 through the PEDro score. The main outcome measures analyzed were vertigo, positional nystagmus and postural balance. Additionally, the number of maneuvers necessary for remission of the symptoms, the quality of life, and the functionality were also assessed. The majority of the clinical trials used Otolith Repositioning Maneuver (n=5) and 3 articles performed Vestibular Rehabilitation exercises in addition to Otolith Repositioning Maneuver or pharmacotherapy. One study showed that the addition of movement restrictions after maneuver did not influence the outcomes. There was a trend of improvement in Benign Paroxysmal Positional Vertigo symptomatology in elderly patients who underwent Otolith Repositioning Maneuver. There is sparse evidence from methodologically robust clinical trials that examined the effects of Otolith Repositioning Maneuver and Vestibular Rehabilitation exercises for treating Benign Paroxysmal Positional Vertigo in the elderly. Randomized controlled clinical trials with

  3. Use of Galvanic Vestibular Feedback for a Balance Prosthesis

    OpenAIRE

    Peterka, Robert J.

    2012-01-01

    Activation of vestibular afferents by a bilateral bipolar galvanic vestibular stimulus (GVS) evokes medial-lateral (ML) body sway. By applying a GVS feedback signal that is a function of measured ML head motion, the potential exists for GVS to restore a useful vestibular contribution to ML balance control in vestibular-deficient subjects who remain responsive to GVS. A key to developing an effective balance prosthesis using GVS is to determine the functional relationship between GVS and its i...

  4. Sequence classification with side effect machines evolved via ring optimization.

    Science.gov (United States)

    McEachern, Andrew; Ashlock, Daniel; Schonfeld, Justin

    2013-07-01

    The explosion of available sequence data necessitates the development of sophisticated machine learning tools with which to analyze them. This study introduces a sequence-learning technology called side effect machines. It also applies a model of evolution which simulates the evolution of a ring species to the training of the side effect machines. A comparison is done between side effect machines evolved in the ring structure and side effect machines evolved using a standard evolutionary algorithm based on tournament selection. At the core of the training of side effect machines is a nearest neighbor classifier. A parameter study was performed to investigate the impact of the division of training data into examples for nearest neighbor assessment and training cases. The parameter study demonstrates that parameter setting is important in the baseline runs but had little impact in the ring-optimization runs. The ring optimization technique was also found to exhibit improved and also more reliable training performance. Side effect machines are tested on two types of synthetic data, one based on GC-content and the other checking for the ability of side effect machines to recognize an embedded motif. Three types of biological data are used, a data set with different types of immune-system genes, a data set with normal and retro-virally derived human genomic sequence, and standard and nonstandard initiation regions from the cytochrome-oxidase subunit one in the mitochondrial genome. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. Reported Sildenafil Side Effects in Pediatric Pulmonary Hypertension Patients

    Directory of Open Access Journals (Sweden)

    Stephanie Leigh Siehr

    2015-03-01

    Full Text Available Background: Sildenafil, a phosphodiestase type 5 inhibitor, was approved in 2005 for the treatment of pulmonary arterial hypertension (PAH in adults, and is commonly used off-label for pediatric patients. Little is known, however, about sildenafil’s side effects in this population.Methods: Single institution, longitudinal survey-based study performed in an outpatient pediatric cardiology clinic. Pediatric patients on sildenafil (alone or in combination with other PH therapies completed questionnaires regarding frequency of vascular, gastrointestinal, neurologic and hematologic side effects. Results: Between January 2011 and May 2014, 66 pediatric patients with PH on sildenafil filled out 214 surveys, 32 patients (96 surveys on monotherapy, and 43 patients (118 surveys on sildenafil plus an endothelin receptor antagonist (bosentan or ambrisentan and/or a prostacyclin (epoprostenol or treprostinil. Overall, 30% of respondents identified at least one side effect. For all patients on sildenafil, incidence of side effects by system was 37% gastrointestinal, 35% vascular and 22% neurologic. For patients on sildenafil monotherapy, incidence of side effects by system was 24% gastrointestinal, 21% vascular and 18% neurologic compared to patients on combination therapy who reported an incidence of 48% gastrointestinal, 45% vascular and 25% neurologic.Conclusion: Incidence of vascular, gastrointestinal and neurologic side effect in pediatric patients on sildenafil therapy for pulmonary arterial hypertension was 30%. Side effects were more common in patients on combination therapy with an endothelin receptor antagonist and/or prostacyclin than in patients on sildenafil monotherapy.

  6. Paediatric radiotherapy: Management and side effects

    International Nuclear Information System (INIS)

    Barare, C.

    2006-01-01

    This paper presents the general overview of management of children undergoing or who have undergone radiation therapy, and the associated effects. since the safe use of ionizing radiation in treatment of some children conditions is inevitable, the immediate and future effects need to be known and better understood for precise and accurate forecasting to benefit verses risk indicators. this is not withstanding the psychological trauma inflicted as some of the manifestations are visibly evident as the children grow

  7. The Effect of Otic Melanocyte Destruction on Auditory and Vestibular Function: a Study on Vitiligo Patients

    Directory of Open Access Journals (Sweden)

    Parvane Mahdi

    2016-03-01

    Full Text Available The hallmark of vitiligo is the disappearance of melanocytes from the skin. As a result, of melanocytes presence in the auditory and vestibular apparatus, the involvement of these systems in vitiligo which targets the melanocytes of the whole body is possible; suggesting that vitiligo is a systemic disease rather than a purely cutaneous problem. A total of 21 patients with vitiligo were enrolled in this study. A group of 20 healthy subjects served as a control group. Pure tone audiometry (PTA, auditory brainstem responses (ABR and vestibular evoked myogenic potentials (VEMP were carried out in all participants. High frequency sensory neural hearing loss was seen in 8 (38.09% patients. ABR analysis revealed 10 (47.61% had an abnormal increase in latency of wave III, and 6 (28.57% had an abnormal prolongation of IPL I-III, however, regarding our VEMP findings, there were no recorded responses on left ear of 1 (4.76% patient and latency of p13 was prolonged in 5(23.80% patients. There was no correlation between ages, duration of disease, and any of the recorded parameters (P>0.05. In the present survey, we highlighted the auditory and vestibular involvement in vitiligo patients.

  8. Major diseases manifesting by vestibular vertigo: Treatment and rehabilitation

    Directory of Open Access Journals (Sweden)

    V. A. Parfenov

    2015-01-01

    Full Text Available Betahistine hydrochloride is the drug of choice for the treatment of vestibular vertigo in the presence of benign paroxysmal positional vertigo, Meniere's disease, and vestibular neuronitis. Effective combination therapy regimens that contain, along with drugs from other pharmacological groups, betahistine hydrochloride that improves blood circulation in the vestibular structures, accelerates vestibular compensation, and prevents recurrent dizzy spells, have been elaborated to treat central vestibular vertigo in migraine-associated dizziness and in acute cerebrovascular accident. Of great importance is a combination of drug therapy and the current rehabilitation methods for vestibular diseases, which contribute to prompter and complete recovery of vestibular function. Biofeedback instrumental rehabilitation techniques using a stabilographic platformare highly effective. Successful treatment depends on the correctness of the established diagnosis. The diagnosis of peripheral and central vestibular vertigo frequently poses challenges. The essential reason for this is physicians’ unawareness about outpatient methods for the diagnosis of major vestibular diseases when the patient is at a doctor. It is important to follow a vestibular system study protocol since the use and correct assessment of diagnostic tests in most cases make it possible to estimate the degree of vestibular analyzer injury and to make an accurate diagnosis. The paper describes the diseases that are the most common causes of vestibular vertigo. The most effective methods for their treatment and current rehabilitation methods are discussed.

  9. What side effects are problematic for patients prescribed antipsychotic medication? The Maudsley Side Effects (MSE) measure for antipsychotic medication.

    Science.gov (United States)

    Wykes, T; Evans, J; Paton, C; Barnes, T R E; Taylor, D; Bentall, R; Dalton, B; Ruffell, T; Rose, D; Vitoratou, S

    2017-10-01

    Capturing service users' perspectives can highlight additional and different concerns to those of clinicians, but there are no up to date, self-report psychometrically sound measures of side effects of antipsychotic medications. Aim To develop a psychometrically sound measure to identify antipsychotic side effects important to service users, the Maudsley Side Effects (MSE) measure. An initial item bank was subjected to a Delphi exercise (n = 9) with psychiatrists and pharmacists, followed by service user focus groups and expert panels (n = 15) to determine item relevance and language. Feasibility and comprehensive psychometric properties were established in two samples (N43 and N50). We investigated whether we could predict the three most important side effects for individuals from their frequency, severity and life impact. MSE is a 53-item measure with good reliability and validity. Poorer mental and physical health, but not psychotic symptoms, was related to side-effect burden. Seventy-nine percent of items were chosen as one of the three most important effects. Severity, impact and distress only predicted 'putting on weight' which was more distressing, more severe and had more life impact in those for whom it was most important. MSE is a self-report questionnaire that identifies reliably the side-effect burden as experienced by patients. Identifying key side effects important to patients can act as a starting point for joint decision making on the type and the dose of medication.

  10. The Unexpected Side-Effects of Dissonance

    Science.gov (United States)

    Bodner, Ehud; Gilboa, Avi; Amir, Dorit

    2007-01-01

    The effects of dissonant and consonant music on cognitive performance were examined. Situational dissonance and consonance were also tested and determined as the state where one's opinion is contrasted or matched with the majority's opinion, respectively. Subjects performed several cognitive tasks while listening to a melody arranged dissonantly,…

  11. Membrane Transporters as Mediators of Cisplatin Effects and Side Effects

    Directory of Open Access Journals (Sweden)

    Giuliano Ciarimboli

    2012-01-01

    Full Text Available Transporters are important mediators of specific cellular uptake and thus, not only for effects, but also for side effects, metabolism, and excretion of many drugs such as cisplatin. Cisplatin is a potent cytostatic drug, whose use is limited by its severe acute and chronic nephro-, oto-, and peripheral neurotoxicity. For this reason, other platinum derivatives, such as carboplatin and oxaliplatin, with less toxicity but still with antitumoral action have been developed. Several transporters, which are expressed on the cell membranes, have been associated with cisplatin transport across the plasma membrane and across the cell: the copper transporter 1 (Ctr1, the copper transporter 2 (Ctr2, the P-type copper-transporting ATPases ATP7A and ATP7B, the organic cation transporter 2 (OCT2, and the multidrug extrusion transporter 1 (MATE1. Some of these transporters are also able to accept other platinum derivatives as substrate. Since membrane transporters display a specific tissue distribution, they can be important molecules that mediate the entry of platinum derivatives in target and also nontarget cells possibly mediating specific effects and side effects of the chemotherapeutic drug. This paper summarizes the literature on toxicities of cisplatin compared to that of carboplatin and oxaliplatin and the interaction of these platinum derivatives with membrane transporters.

  12. Neurophysiology of vestibular rehabilitation.

    Science.gov (United States)

    Hain, Timothy C

    2011-01-01

    The vestibular system is a sophisticated human control system. Accurate processing of sensory input about rapid head and postural motion is critical. Not surprisingly, the body uses multiple, partially redundant sensory inputs and motor outputs, combined with a very competent central repair capability. The system as a whole can adapt to substantial peripheral vestibular dysfunction. The Achilles' heel of the vestibular system is a relative inability to repair central vestibular dysfunction.

  13. Neurophysiology of vestibular rehabilitation

    OpenAIRE

    Hain Timothy, C.

    2011-01-01

    The vestibular system is a sophisticated human control system. Accurate processing of sensory input about rapid head and postural motion is critical. Not surprisingly, the body uses multiple, partially redundant sensory inputs and motor outputs, combined with a very competent central repair capability. The system as a whole can adapt to substantial peripheral vestibular dysfunction. The Achilles' heel of the vestibular system is a relative inability to repair central vestibular dysfunction.

  14. Evaluation of diagnostic tests of the otolith organs and their application in various vestibular pathologies

    NARCIS (Netherlands)

    Winters, S.M.

    2014-01-01

    Current vestibular testing is limited. The general function of the vestibular system on both sides of the head can be tested, and one part of the peripheral vestibular organ, the horizontal semicircular canal, can be tested unilaterally. However, recently a test for the function of the otolith

  15. Managing Chemotherapy Side Effects: Sexual and Fertility Changes in Men

    Science.gov (United States)

    ... I nstitute Managing Chemotherapy Side Effects Sexual and Fertility Changes in Men “I talked with my doctor ... learn what sexual changes or changes to your fertility you may have. The changes you may have ...

  16. Neonatal side effects of maternal labetalol treatment in severe preeclampsia

    NARCIS (Netherlands)

    Heida, Karst Y.; Zeeman, Gerda G.; Van Veen, Teelkien R.; Hulzebos, Christian V.

    Objective: Labetalol is often used in severe preeclampsia (PE). Hypotension, bradycardia and hypoglycemia are feared neonatal side effects, but may also occur in (preterm) infants regardless of labetalol exposure. We analyzed the possible association between intrauterine labetalol exposure and such

  17. Cancer treatment: fertility and sexual side effects in women

    Science.gov (United States)

    ... cancer Colorectal cancer Uterine cancer Vaginal cancer Breast cancer Bladder cancer Types of Sexual Side Effects For women, the ... used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed ...

  18. Side Effects of HIV Medicines: HIV and Hepatotoxicity

    Science.gov (United States)

    ... Apps skip to content Side Effects of HIV Medicines Home Understanding HIV/AIDS Fact Sheets HIV and ... Latent HIV Reservoir? HIV Testing FDA-Approved HIV Medicines What is an Investigational HIV Drug? What is ...

  19. Statin Side Effects: Weigh the Benefits and Risks

    Science.gov (United States)

    ... yellowing of your skin or eyes. Increased blood sugar or type 2 diabetes It's possible your blood ... high-blood-cholesterol/in-depth/statin-side-effects/ART-20046013 . Mayo Clinic Footer Legal Conditions and Terms ...

  20. Managing Chemotherapy Side Effects: Skin and Nail Changes

    Science.gov (United States)

    N ational C ancer I nstitute Managing Chemotherapy Side Effects Skin and Nail Changes “I was glad to learn that most skin and nail problems go away after treatment. For now, my nurse told me about ...

  1. Managing Chemotherapy Side Effects: Sexual and Fertility Changes in Women

    Science.gov (United States)

    N ational C ancer I nstitute Managing Chemotherapy Side Effects Sexual and Fertility Changes in Women “Talk with your doctor before you start treatment. Ask how chemotherapy could affect your ability to have children. ” Ask what ...

  2. SIDE EFFECTS OF TUBERCULOSIS TREATMENT WITH FIXED-DOSE COMBINATIONS.

    Science.gov (United States)

    Zhang, H Q; Xi, X E; Wang, Y L; Han, W; Zhang, C X; Jiao, J H

    2015-01-01

    This paper aimed to explore the therapeutic effect and safety of Fixed-dose Combinations (FDCs) on tuberculosis. A computer search was carried out to review the literature related to clinical randomized controlled trials (RCTs) and clinical controlled trails (CCTs) on the curative effect and safety of treating pulmonary tuberculosis with FDCs. The results demonstrated that, in the 22 studies examined, comparison of sputum negative conservation rate of treating smear-positive pulmonary tuberculosis with FDCs and single drug, the relative risk (RR) value and 95% confidence interval (CI) were 1.02 (1.01, 1.03) and 1.01 (1.00, 1.02), respectively, at the end of the 2nd month and 6th month (P0.05). No statistically significant differences were found between the two groups in total occurrence of the rates of side effects pertaining to skin reaction, gastrointestinal tract side reaction, occurrence rate of liver and gall side reaction or occurrence rate of drug withdrawal because of side effects (P>0.05). After sensitivity analysis, it was found that occurrence rate of gastrointestinal tract side effects and occurrence rate of liver and gall side effects were unstable. All the findings suggest that the curative effect of treating tuberculosis with FDCs is better than that of a single drug. More reliable evidence is required since the safety evaluation results are not stable.

  3. Elementary affine $lambda$-calculus with multithreading and side effects

    OpenAIRE

    Madet, Antoine; Amadio, Roberto M.

    2011-01-01

    Linear logic provides a framework to control the complexity of higher-order functional programs. We present an extension of this framework to programs with multithreading and side effects focusing on the case of elementary time. Our main contributions are as follows. First, we provide a new combinatorial proof of termination in elementary time for the functional case. Second, we develop an extension of the approach to a call-by-value $lambda$-calculus with multithreading and side effects. Thi...

  4. Side effects during subcutaneous immunotherapy in children with allergic diseases.

    Science.gov (United States)

    Tophof, Max A; Hermanns, Anne; Adelt, Thomas; Eberle, Peter; Gronke, Christine; Friedrichs, Frank; Knecht, Roland; Mönter, Ernst; Schöpfer, Helmut; Schwerk, Nicolaus; Steinbach, Jörg; Umpfenbach, Hans-Ulrich; Weißhaar, Christian; Wilmsmeyer, Brigitte; Bufe, Albrecht

    2017-12-16

    Allergen-specific immunotherapy is the only causal form of therapy for IgE-mediated allergic diseases. Subcutaneous immunotherapy (SCIT) is considered safe and well tolerated in adults, yet there is less evidence of safety in the pediatric population. A non-interventional prospective observing longitudinal study was carried out to determine the incidence of local and systemic side effects by SCIT, routinely performed in pediatric patients. A total of 581 pediatric patients were observed in 18 study centers between March 2012 and October 2014, recording 8640 treatments and 10 015 injections. A total of 54.6% of the patients experienced immediate local side effects at least once; delayed local side effects were seen in 56.1%. Immediate systemic adverse reactions occurred in 2.2% of patients; 7.4% experienced delayed systemic side effects. However, severe systemic side effects (grade III in the classification of Ring and Messmer) were seen in 0.03% of all treatments, all appearing within 30 minutes after the injections. No grade IV reactions were observed. In addition, many potential risk factors were investigated, yet only a few were found to be associated with the occurrence of side effects. Subcutaneous immunotherapy is a safe form of therapy in pediatric patients, with similar rates of local side effects compared to adult patients and low rates of severe systemic side effects. However, local and systemic reactions occurring later than 30 minutes after injection were observed more often than expected, which makes it essential to be attentive on behalf of pediatricians, patients, and parents. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  5. Beyond the technological fix. [Detrimental and unforeseen side effects

    Energy Technology Data Exchange (ETDEWEB)

    Weinberg, A.M.

    1978-03-01

    Both technological and social fixes are likely to bring with them deterimental and unforeseen side effects. Although the perceived side effects of nuclear energy can undoubtedly be ameliorated by improved technology, a permanent institutional infrastructure will probably also be required. It is pointed out that confinement of nuclear energy to relatively few large sites rather than many small sites may be a first step toward creating this permanent institutional infrastructure.

  6. Abnormal Involuntary Movements: Side-Effect of Neuroleptic Drugs

    OpenAIRE

    Oyewumi, L. K.

    1982-01-01

    Neuroleptics are antipsychotic drugs. In addition to their antipsychotic properties, many physicians use them as anti-anxiety or antiemetics. Indeed, most patients referred to psychiatrists would have been given one, or a combination, of these drugs. Physicians should therefore be aware of their side-effects. Abnormal involuntary movements, now recognized as side-effects of neuroleptics, are broadly classified as acute early occurring movement disorders and late appearing movement disorders. ...

  7. Recovery of Vestibular Ocular Reflex Function and Balance Control after a Unilateral Peripheral Vestibular Deficit

    Science.gov (United States)

    Allum, J. H. J.

    2012-01-01

    This review describes the effect of unilateral peripheral vestibular deficit (UPVD) on balance control for stance and gait tests. Because a UPVD is normally defined based on vestibular ocular reflex (VOR) tests, we compared recovery observed in balance control with patterns of recovery in VOR function. Two general types of UPVD are considered; acute vestibular neuritis (AVN) and vestibular neurectomy. The latter was subdivided into vestibular loss after cerebellar pontine angle tumor surgery during which a vestibular neurectomy was performed, and vestibular loss following neurectomy to eliminate disabling Ménière’s disease. To measure balance control, body-worn gyroscopes, mounted near the body’s center of mass (CoM), were used. Measurement variables were the pitch (anterior–posterior) and roll (lateral) sway angles and angular velocities of the lower trunk/pelvis. Both patient groups showed balance deficits during stance tasks on foam, especially with eyes closed when stable balance control is normally highly dependent on vestibular inputs. Deficits during gait were also present and were more profound for complex gait tasks such as tandem gait than simple gait tasks. Major differences emerged between the groups concerning the severity of the deficit and its recovery. Generally, the effects of acute neuritis on balance control were more severe but recovered rapidly. Deficits due to vestibular neurectomy were less severe, but longer lasting. These results mostly paralleled recovery of deficits in VOR function. However, questions need to be raised about the effect on balance control of the two modes of neural plasticity occurring in the vestibular system following vestibular loss due to neuritis: one mode being the limited central compensation for the loss, and the second mode being some restoration of peripheral vestibular function. Future work will need to correlate deficits in balance control during stance and gait more exactly with VOR deficits and

  8. Recovery of vestibular ocular reflex function and balance control after a unilateral peripheral vestibular deficit.

    Science.gov (United States)

    Allum, J H J

    2012-01-01

    This review describes the effect of unilateral peripheral vestibular deficit (UPVD) on balance control for stance and gait tests. Because a UPVD is normally defined based on vestibular ocular reflex (VOR) tests, we compared recovery observed in balance control with patterns of recovery in VOR function. Two general types of UPVD are considered; acute vestibular neuritis (AVN) and vestibular neurectomy. The latter was subdivided into vestibular loss after cerebellar pontine angle tumor surgery during which a vestibular neurectomy was performed, and vestibular loss following neurectomy to eliminate disabling Ménière's disease. To measure balance control, body-worn gyroscopes, mounted near the body's center of mass (CoM), were used. Measurement variables were the pitch (anterior-posterior) and roll (lateral) sway angles and angular velocities of the lower trunk/pelvis. Both patient groups showed balance deficits during stance tasks on foam, especially with eyes closed when stable balance control is normally highly dependent on vestibular inputs. Deficits during gait were also present and were more profound for complex gait tasks such as tandem gait than simple gait tasks. Major differences emerged between the groups concerning the severity of the deficit and its recovery. Generally, the effects of acute neuritis on balance control were more severe but recovered rapidly. Deficits due to vestibular neurectomy were less severe, but longer lasting. These results mostly paralleled recovery of deficits in VOR function. However, questions need to be raised about the effect on balance control of the two modes of neural plasticity occurring in the vestibular system following vestibular loss due to neuritis: one mode being the limited central compensation for the loss, and the second mode being some restoration of peripheral vestibular function. Future work will need to correlate deficits in balance control during stance and gait more exactly with VOR deficits and carefully

  9. Sleeptalking! Sleepwalking! Side Effects of Montelukast

    Directory of Open Access Journals (Sweden)

    Samer Alkhuja

    2013-01-01

    Full Text Available A 16-year-old Caucasian female presented to the pulmonary clinic for a followup on her asthma. Due to the worsening of allergy-related symptoms, therapy with montelukast 10 mg daily was started and resulted in good relief of the patient’s symptoms. In the nights following initiating therapy with montelukast, the patient’s mother reported daily parasomnias in the form of sleeptalking and sleepwalking. Montelukast was discontinued, and that resulted in absence of the parasomnias. In a second attempt montelukast was reinstituted to control the patient’s symptoms. Parasomnias were immediately reported after resuming therapy. Montelukast was then discontinued indefinitely. Our patient has never had any history of parasomnias, and since the discontinuation of montelukast, parasomnias were never reported again. Parasomnias in the form of sleeptalking or sleepwalking were not previously reported as adverse effects of montelukast. Alternative modalities to treat allergy-related symptoms in patients, who develop parasomnias while receiving montelukast, should be explored.

  10. Side effects of mercury in dental amalgam

    Directory of Open Access Journals (Sweden)

    Titiek Berniyanti

    2008-03-01

    Full Text Available Dental amalgam is an alloy composed of mixture of approximately equal parts of elemental liquid mercury and an alloy powder. The popularity of amalgam arises from excellent long term performance, ease of use and low cost. Despite the popularity of dental amalgam as restorative material, there have been concerns regarding the potential adverse health and environmental effects arising from exposure to mercury in amalgam. They have long been believed to be of little significance as contributors to the overall body burden of mercury, because the elemental form of mercury is rapidly consumed in the setting reaction of the restoration. In 1997, 80% of dentist in Indonesia still using amalgam as an alternative material, and 60% of them treat the rest of unused amalgam carelessly. In recent years, the possible environmental and health impact caused by certain routines in dental practice has attracted attention among regulators. As part of point source reduction strategies, the discharge of mercury/amalgam-contaminated wastes has been regulated in a number of countries, even though it has been documented that by adopting appropriate mercury hygiene measures, the impact of amalgam use in dentistry is minimal. The purpose of this paper is to examine on studies that relate mercury levels in human to the presence of dental amalgams. It is concluded that even though mercury used in filling is hazardous, if normal occupational recommendations for proper mercury hygiene routines and source of reduction strategies are followed, no occupational health risk can be assumed.

  11. Side effects after diagnostic lumbar puncture and lumbar iohexol myelography

    International Nuclear Information System (INIS)

    Sand, T.; Stovner, L.J.; Salvesen, R.; Dale, L.

    1987-01-01

    A prospective, controlled study was performed to compare side effect incidences after lumbar iohexol myelography (n=97) and diagnostic lumbar puncture (n=85). No significant side effect incidence differences (iohexol vs. controls) were found regarding number of patients with any side effect (63 vs. 73%), headache (44 vs. 54%), nausea, dizziness, visual, auditory, or psychic symptoms. Early-onset headache occurred significantly more often in the iohexol group (16 vs 5%), while postural headache occurred most frequently after lumbar puncture (25 vs. 41%). These results suggest that apart from the slight early-onset headache, most side effets after lumbar iohexol myelography are related to the puncture per se, not to the contrast agent. (orig.)

  12. Effects of Vestibular Rehabilitation on Balance Control in Older People with Chronic Dizziness: A Randomized Clinical Trial.

    Science.gov (United States)

    Ricci, Natalia Aquaroni; Aratani, Mayra Cristina; Caovilla, Heloísa Helena; Ganança, Fernando Freitas

    2016-04-01

    The aim of this study was to compare the effects of vestibular rehabilitation protocols on balance control in elderly with dizziness. This is a randomized clinical trial with 3-mo follow-up period. The sample was composed of 82 older individuals with chronic dizziness from vestibular disorders. The control group was treated according to the Conventional Cawthorne & Cooksey protocol (n = 40), and the experimental group was submitted to a Multimodal Cawthorne & Cooksey protocol (n = 42). Measures included Dynamic Gait Index, fall history, hand grip strength, Time Up-and-Go Test, sit-to-stand test, multidirectional reach, and static balance tests. With the exception of history of falls, Forward Functional Reach, Unipedal Right and Left Leg Eyes Closed, and Sensorial Romberg Eyes Open, all outcomes improved after treatments. Such results persisted at follow-up period, with the exception of the Tandem Eyes Open and the Timed Up-and-Go manual. The between-group differences for Sensorial Romberg Eyes Closed (4.27 secs) and Unipedal Left Leg Eyes Open (4.08 secs) were significant after treatment, favoring the Multimodal protocol. Both protocols resulted in improvement on elderly's balance control, which was maintained during a short-term period. The multimodal protocol presented better performance on specific static balance tests.

  13. Stereotactic radiotherapy for vestibular schwannoma

    DEFF Research Database (Denmark)

    Muzevic, Dario; Legcevic, Jelena; Splavski, Bruno

    2014-01-01

    BACKGROUND: Vestibular schwannomas (acoustic neuromas) are common benign tumours that arise from the Schwann cells of the vestibular nerve. Management options include observation with neuroradiological follow-up, microsurgical resection and stereotactic radiotherapy. OBJECTIVES: To assess...... the effect of stereotactic radiotherapy compared to observation, microsurgical resection, any other treatment modality, or a combination of two or more of the above approaches for vestibular schwannoma. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials; PubMed; EMBASE; CINAHL......; Web of Science; CAB Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the search was 24 July 2014. SELECTION CRITERIA: Randomised controlled trials (RCTs) exploring the efficacy of stereotactic radiotherapy compared with observation alone, microsurgical...

  14. Early and Late Side Effects Associated with Photo(chemotherapy

    Directory of Open Access Journals (Sweden)

    Günseli Öztürk

    2010-12-01

    Full Text Available Phototherapy (PUVA ve UVB is a widely used and effective treatment method for a variety of dermatological diseases. Adverse effects associated with phototherapy can be classified as acute and chronic side effects. Acute side effects are mostly related with UV doses and drug intolerance, and include itching, nausea, erythema, edema and phototoxic reactions that sometimes blister formation is seen. Acute side effects are usually moderate and transient. Chronic side effects of phototherapy are early aging of skin, pigmentary changes and increased risk of skin carcinogenesis. The major concern is development of skin cancer. This risk is especially related to long-term exposure and high cumulative doses of PUVA, increase in time and is persistent. Therefore, risk/advantage ratio of phototherapy should be carefully evaluated in each patient, and treatment protocols with minimal UV exposure should be chosen according to the phototherapy guides. Follow-up of the patients for long terms is important in prevention or in reduction of this risk by detecting and treating any premalignant or malignant lesion early. In this article, acute and chronic side effects of phototherapy are reviewed with recent literature findings.

  15. Galvanic vestibular stimulation speeds visual memory recall.

    Science.gov (United States)

    Wilkinson, David; Nicholls, Sophie; Pattenden, Charlotte; Kilduff, Patrick; Milberg, William

    2008-08-01

    The experiments of Alessandro Volta were amongst the first to indicate that visuo-spatial function can be altered by stimulating the vestibular nerves with galvanic current. Until recently, the beneficial effects of the procedure were masked by the high levels of electrical current applied, which induced nystagmus-related gaze deviation and spatial disorientation. However, several neuropsychological studies have shown that much weaker, imperceptible currents that do not elicit unpleasant side-effects can help overcome visual loss after stroke. Here, we show that visual processing in neurologically healthy individuals can also benefit from galvanic vestibular stimulation. Participants first learnt the names of eight unfamiliar faces and then after a short delay, answered questions from memory about how pairs of these faces differed. Mean correct reaction times were significantly shorter when sub-sensory, noise-enhanced anodal stimulation was administered to the left mastoid, compared to when no stimulation was administered at all. This advantage occurred with no loss in response accuracy, and raises the possibility that the procedure may constitute a more general form of cognitive enhancement.

  16. Evaluation of Galvanic Vestibular Stimulation System

    Science.gov (United States)

    Kofman, I. S.; Warren, E.; DeSoto, R.; Moroney, G.; Chastain, J.; De Dios, Y. E.; Gadd, N.; Taylor, L.; Peters, B. T.; Allen, E.; hide

    2017-01-01

    ) similar to what astronauts experience during transitions to new gravitational environments. Stochastic electrical stimulation can be applied to the vestibular system through electrodes placed over the mastoid process behind the ears in the binaural configuration resulting in stimulation in the mediolateral (side-to-side) plane. An additional electrode can be placed over the bony landmark of the tip of the c7 spinous process for the double monaural configuration, which will cause stimulation in the anteroposterior (forward-backward) plane. A portable constant current bipolar stimulator with subject isolation was designed and built to deliver the stimulus. The unit is powered using a 3.7 V battery pack and designed to produce currents up to 5 mA. The stimulator, controlled by a Raspberry Pi 3 computer, offers several stimulus signal generation options including a standalone mode, which uses onboard signal files stored on the flash memory card. Stochastic stimulation signals will be generated in 0-30 Hz frequency bandwidth. Stimulation amplitude can be increased incrementally to a maximum amplitude of 5.0 mA (e.g., 0, 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, 5.0 mA). In control trials, subjects will be experiencing vestibular stimulation with 0-mA current applied through the electrodes. The system will be evaluated at various levels of stimulation and in both the binaural and double monaural electrode configurations. One of the objectives is to identify stimulation levels producing effects most comparable to the post-flight disturbances. This is a pilot study that will set the stage for a larger, more comprehensive study that will investigate wider aspects of post-flight sensorimotor dysfunction and set sensorimotor standards for crew health.

  17. Side effects associated with current and prospective antimigraine pharmacotherapies.

    Science.gov (United States)

    González-Hernández, Abimael; Marichal-Cancino, Bruno A; MaassenVanDenBrink, Antoinette; Villalón, Carlos M

    2018-01-01

    Migraine is a neurovascular disorder. Current acute specific antimigraine pharmacotherapies target trigeminovascular 5-HT 1B/1D , 5-HT 1F and CGRP receptors but, unfortunately, they induce some cardiovascular and central side effects that lead to poor treatment adherence/compliance. Therefore, new antimigraine drugs are being explored. Areas covered: This review considers the adverse (or potential) side effects produced by current and prospective antimigraine drugs, including medication overuse headache (MOH) produced by ergots and triptans, the side effects observed in clinical trials for the new gepants and CGRP antibodies, and a section discussing the potential effects resulting from disruption of the cardiovascular CGRPergic neurotransmission. Expert opinion: The last decades have witnessed remarkable developments in antimigraine therapy, which includes acute (e.g. triptans) and prophylactic (e.g. β-adrenoceptor blockers) antimigraine drugs. Indeed, the triptans represent a considerable advance, but their side effects (including nausea, dizziness and coronary vasoconstriction) preclude some patients from using triptans. This has led to the development of the ditans (5-HT 1F receptor agonists), the gepants (CGRP receptor antagonists) and the monoclonal antibodies against CGRP or its receptor. The latter drugs represent a new hope in the antimigraine armamentarium, but as CGRP plays a role in cardiovascular homeostasis, the potential for adverse cardiovascular side effects remains latent.

  18. Effect of vestibular neuritis on postural control using wavelets and fractal analysis.

    Science.gov (United States)

    Lorin, P; Manceau, C; Foubert, F

    2010-01-01

    What is the status of postural control a few months after an attack of vestibular neuritis (VN)? Using dynamic posturography and stabilometric signal treatment with wavelets and fractal analysis, we tried to answer this question by isolating the pathological postural parameters of VN. The study involved a group of 15 patients (GP) who suffered from VN and were compared to a group of control subjects (GC). Both groups underwent videonystagmography (VNG), dynamic posturography (PDY), and assessment using symptomatic scales (ES). GP and GC were comparable in terms of age mean, sex-ratio, average height and weight. The differences between GP and GC were the following videonystagmography criteria: Spontaneous nystagmus (NS) (P= 0.005), head shaking test (HST) (p= 0.001), vibratory test (TVO) (p= 0.009). There were also differences in the symptomatic scales scores for the vertigo symptom scale (VSS) (p= 0.011), the dizziness handicap inventory (DHI) (p= 0.001), and the short form 36 (SF36) (p= 0.01). All the 84 new parameters of both GP and GC differ. This difference was significant (p conditions were found to be non-discriminating. Vestibular neuritis affects new stabilometric parameters. These parameters are more adapted to the present setup compared to previous parameters which are used to analyse non-periodic oscillations of posture. They are important in follow-up and rehabilitation of patients.

  19. Acute and long-term psychiatric side effects of mefloquine

    DEFF Research Database (Denmark)

    Ringqvist, Åsa; Bech, Per; Glenthøj, Birte

    2015-01-01

    psychiatric side effects were retrospectively assessed using the SCL-90-R and questions based on Present State Examination (PSE). Subjects reporting suspected psychotic states were contacted for a personal PSE interview. Electronic records of psychiatric hospitalizations and diagnoses were cross-checked. Long-term......BACKGROUND: The aim of the study was to explore the profile of acute and long-term psychiatric side effects associated with mefloquine. METHODS: Subjects (n = 73) reported to a Danish national register during five consecutive years for mefloquine associated side effects were included. Acute...... symptoms were found in 15% and were time-limited. Illusions/hallucinations were more frequently observed among women. Cases of hypomania/mania in the acute phase were 5.5%. Significant long-term mental health effects were demonstrated for the SF-36 subscales mental health (MH), role emotional (RE...

  20. Subjective visual vertical perception in patients with vestibular neuritis and sudden sensorineural hearing loss.

    Science.gov (United States)

    Ogawa, Yasuo; Otsuka, Koji; Shimizu, Shigetaka; Inagaki, Taro; Kondo, Takahito; Suzuki, Mamoru

    2012-01-01

    To determine the subjective visual vertical (SVV) perception in patients with vestibular neuritis (VN) and sudden sensorineural hearing loss (SSHL) using the SVV test and other neuro-otological examinations, namely, the vestibular evoked myogenic potential (VEMP) and caloric tests, and to clarify which vestibular nerve function is associated with an SVV shift. We performed the SVV test in 36 VN patients and 80 SSHL patients. Thereafter, we investigated directional changes in the SVV in the VN and SSHL patients, and compared the results of the SVV test with those of the VEMP and caloric tests. Abnormal SVV (> 2° was found at a rate of 69.4% in the VN patients and 26.3% in the SSHL patients. In all except 1 VN patient, the SVV tilted to the lesion side. The rate of abnormal SVV was significantly higher in patients with complete canal paresis (CP) than in patients with partial CP. There was no significant relationship between the rates of abnormal SVV and VEMP. In the SSHL patients, neither the SVV nor the VEMP affected the hearing outcome and patients with abnormal VEMP tended to show abnormal SVV. VN patients showed a higher rate of abnormal SVV than SSHL patients. From the results, it is speculated that the superior vestibular nerve function mainly affects the SVV tilt, although the inferior vestibular nerve function may also have an effect.

  1. Unilateral vestibular loss impairs external space representation.

    Directory of Open Access Journals (Sweden)

    Liliane Borel

    Full Text Available The vestibular system is responsible for a wide range of postural and oculomotor functions and maintains an internal, updated representation of the position and movement of the head in space. In this study, we assessed whether unilateral vestibular loss affects external space representation. Patients with Menière's disease and healthy participants were instructed to point to memorized targets in near (peripersonal and far (extrapersonal spaces in the absence or presence of a visual background. These individuals were also required to estimate their body pointing direction. Menière's disease patients were tested before unilateral vestibular neurotomy and during the recovery period (one week and one month after the operation, and healthy participants were tested at similar times. Unilateral vestibular loss impaired the representation of both the external space and the body pointing direction: in the dark, the configuration of perceived targets was shifted toward the lesioned side and compressed toward the contralesioned hemifield, with higher pointing error in the near space. Performance varied according to the time elapsed after neurotomy: deficits were stronger during the early stages, while gradual compensation occurred subsequently. These findings provide the first demonstration of the critical role of vestibular signals in the representation of external space and of body pointing direction in the early stages after unilateral vestibular loss.

  2. Global University Rankings--Impacts and Unintended Side Effects

    Science.gov (United States)

    Kehm, Barbara M.

    2014-01-01

    In this article, global and other university rankings are critically assessed with regard to their unintended side effects and their impacts on the European and national landscape of universities, as well as on individual institutions. An emphasis is put on the effects of ranking logics rather than on criticising their methodology. Nevertheless,…

  3. Personal coping strategies for managing the side effects of ...

    African Journals Online (AJOL)

    This study describes the burden of side effects from ARV treatment as experienced by a sample of HIV/AIDS patients and identifies the personal strategies they used to cope with ... The most common adverse effects reported were tiredness, nightmares, mood swings, nausea, poor appetite, insomnia, vomiting and dizziness.

  4. Cutaneous side effects of chemotherapy in pediatric oncology patients.

    Science.gov (United States)

    Ceylan, Can; Kantar, Mehmet; Tuna, Arzu; Ertam, Ilgen; Aksoylar, Serap; Günaydın, Aslı; Çetingül, Nazan

    2015-01-01

    Pediatric oncology patients can present with various skin lesions related to both primary disease and immunosuppressive treatments. This study aimed to evaluate the cutaneous side effects of chemotherapy in pediatric oncology patients. Sixty-five pediatric oncology patients who were scheduled to undergo chemotherapy from May 2011 to May 2013 were included in the study. Three patients were excluded from the results, as 2 patients died during treatment and 1 patient withdrew from the study; therefore, a total of 62 patients were evaluated for mucocutaneous findings. Patients were grouped according to their oncological diagnoses and a statistical analysis was performed. There was no statistical significance in the incidence of cutaneous side effects of chemotherapy among the different diagnostic groups. Awareness among dermatologists of the possible cutaneous side effects of chemotherapy in pediatric patients and their causes can promote early diagnosis and treatment in this patient population.

  5. Side effects of curative radiotherapy of the prostatic cancer

    International Nuclear Information System (INIS)

    Ziegler, F.; Metzger, H.; Huebener, K.H.; Kurtz, B.

    1984-01-01

    The side effects of primary percutaneous radiotherapy in 100 patients with prostatic cancer were evaluated and classified into different degrees of gravity. It was shown that especially chronic side effects are benign in most of all cases. Severe - but not vitally dangerous - complications in bladder and intestine are rare (3%); their percentage corresponds roughly to the average mortality rate of surgical intervention (radical prostatectomy). Contrary to operation, troubles of the sexual function appear only in one third of the patients. Taking into consideration the similar therapeutic results of intervention and radiotherapy, radiotherapy is more favorable with respect to side effects. This essential aspects should be considered when making a decision whether to apply a surgical or radiotherapeutic treatment. (orig.) [de

  6. Effectiveness of a Vestibular Rehabilitation Protocol to Improve the Health-Related Quality of Life and Postural Balance in Patients with Vertigo.

    Science.gov (United States)

    Tsukamoto, Heloísa Freiria; Costa, Viviane de Souza Pinho; Silva, Rubens Alexandre da; Pelosi, Gislaine Garcia; Marchiori, Luciana Lozza de Moraes; Vaz, Cláudia Regina Sanches; Fernandes, Karen Barros Parron

    2015-07-01

    Introduction Dizziness can be characterized as a balance disorder that causes discomfort, leading to several functional limitations. Currently, vestibular rehabilitation has been highlighted as a possible treatment. Objective Analyze the effects of completing a vestibular rehabilitation treatment protocol on quality of life and postural balance in patients with vestibular complaints, as well as to compare these effects between the patients taking or not taking antivertigo drugs. Methods A nonrandomized controlled trial was performed with 20 patients previously diagnosed with vestibular diseases. Information regarding vertigo symptoms, quality of life as assessed through the Dizziness Handicap Inventory, visual analog scale of dizziness, and stabilometry using force platform was collected. Patients were treated for 12 weeks by a custom protocol. The sample was divided into two groups according to the use (medicated group, n = 9) or not (control group, n = 11) of antivertigo drugs. Results There was improvement in quality of life (p balance was observed through functional tests. However, no statistically significant difference was noted in stabilometry. When both groups were compared, no statistically significant differences between the variations of the variables analyzed were found in the re-evaluation session. Conclusion Quality of life and postural balance are improved with intervention. However, this improvement is not associated with pharmacologic treatment.

  7. Physiological principles of vestibular function on earth and in space

    Science.gov (United States)

    Minor, L. B.

    1998-01-01

    Physiological mechanisms underlying vestibular function have important implications for our ability to understand, predict, and modify balance processes during and after spaceflight. The microgravity environment of space provides many unique opportunities for studying the effects of changes in gravitoinertial force on structure and function of the vestibular system. Investigations of basic vestibular physiology and of changes in reflexes occurring as a consequence of exposure to microgravity have important implications for diagnosis and treatment of vestibular disorders in human beings. This report reviews physiological principles underlying control of vestibular processes on earth and in space. Information is presented from a functional perspective with emphasis on signals arising from labyrinthine receptors. Changes induced by microgravity in linear acceleration detected by the vestibulo-ocular reflexes. Alterations of the functional requirements for postural control in space are described. Areas of direct correlation between studies of vestibular reflexes in microgravity and vestibular disorders in human beings are discussed.

  8. Recovery of vestibular ocular reflex function and balance control after a unilateral peripheral vestibular deficit.

    Directory of Open Access Journals (Sweden)

    John eAllum

    2012-05-01

    Full Text Available This review describes the effect of unilateral peripheral vestibular deficit (UPVD on balance control as observed in stance and gait tests. Normally, a UPVD is defined based on vestibular ocular reflex (VOR function. Therefore, we compare recovery observed in balance control over time with similar patterns of recovery or lack thereof in VOR function. Three types of UPVD are considered; acute vestibular neuritis, vestibular loss prior to and after cerebellar pontine angle tumor (CPAT surgery during which a vestibular neurectomy was performed, and vestibular loss following neurectomy to eliminate disabling Ménière’s disease.To measure balance control, body-worn gyroscopes, mounted near the body’s centre of mass, were used for stance and gait tests. Measurement variables were the pitch (anterior-posterior and roll (lateral sway angles and angular velocities of the lower trunk-pelvis. All three groups showed balance deficits during stance tasks on foam, especially with eyes closed when stable control is highly dependent on vestibular inputs. Deficits in balance control during gait were present but were more profound for complex gait tasks such as tandem gait. Differences emerged between the groups concerning the severity of the deficit and its recovery. Generally, the effects of acute neuritis were more severe but recovered rapidly, deficits due to vestibular neurectomy were less severe but longer lasting. These results paralleled deficits in VOR function and raise questions about two modes of neural plasticity occurring in the vestibular system following vestibular loss: one mode being the limited central compensation for the loss, and the second mode being some restoration of peripheral vestibular function. Future work will need to correlate deficits in balance control during stance and gait more exactly with VOR deficits and carefully consider the differences between insufficient central compensation compared to inadequate peripheral

  9. Specific vestibular exercises in the treatment of vestibular neuritis

    OpenAIRE

    Komazec Zoran; Lemajić Slobodanka N.

    2004-01-01

    Introduction Vestibular neuritis rapidly damages unilateral vestibular periphery, inducing severe balance disorders. In most cases, such vestibular imbalance is gradually restored to within the normal level after clinical therapies. This successive clinical recovery occurs due to regeneration of vestibular periphery and/or accomplishment of central vestibular compensation. Rehabilitation The program of vestibular rehabilitation presents a major achievement in the field of treatment of balance...

  10. The Skull Vibration-Induced Nystagmus Test of Vestibular Function—A Review

    Science.gov (United States)

    Dumas, Georges; Curthoys, Ian S.; Lion, Alexis; Perrin, Philippe; Schmerber, Sébastien

    2017-01-01

    A 100-Hz bone-conducted vibration applied to either mastoid induces instantaneously a predominantly horizontal nystagmus, with quick phases beating away from the affected side in patients with a unilateral vestibular loss (UVL). The same stimulus in healthy asymptomatic subjects has little or no effect. This is skull vibration-induced nystagmus (SVIN), and it is a useful, simple, non-invasive, robust indicator of asymmetry of vestibular function and the side of the vestibular loss. The nystagmus is precisely stimulus-locked: it starts with stimulation onset and stops at stimulation offset, with no post-stimulation reversal. It is sustained during long stimulus durations; it is reproducible; it beats in the same direction irrespective of which mastoid is stimulated; it shows little or no habituation; and it is permanent—even well-compensated UVL patients show SVIN. A SVIN is observed under Frenzel goggles or videonystagmoscopy and recorded under videonystagmography in absence of visual-fixation and strong sedative drugs. Stimulus frequency, location, and intensity modify the results, and a large variability in skull morphology between people can modify the stimulus. SVIN to 100 Hz mastoid stimulation is a robust response. We describe the optimum method of stimulation on the basis of the literature data and testing more than 18,500 patients. Recent neural evidence clarifies which vestibular receptors are stimulated, how they cause the nystagmus, and why the same vibration in patients with semicircular canal dehiscence (SCD) causes a nystagmus beating toward the affected ear. This review focuses not only on the optimal parameters of the stimulus and response of UVL and SCD patients but also shows how other vestibular dysfunctions affect SVIN. We conclude that the presence of SVIN is a useful indicator of the asymmetry of vestibular function between the two ears, but in order to identify which is the affected ear, other information and careful clinical judgment are

  11. Cost-effectiveness analysis of a non-contrast screening MRI protocol for vestibular schwannoma in patients with asymmetric sensorineural hearing loss

    Energy Technology Data Exchange (ETDEWEB)

    Crowson, Matthew G.; Rocke, Daniel J.; Kaylie, David M. [Duke University Medical Center, Division of Otolaryngology-Head and Neck Surgery, Durham, NC (United States); Hoang, Jenny K. [Duke University Medical Center, Department of Radiology, Durham, NC (United States); Weissman, Jane L. [Oregon Health Sciences University, Professor Emerita of Diagnostic Radiology, Portland, OR (United States)

    2017-08-15

    We aimed to determine if a non-contrast screening MRI is cost-effective compared to a full MRI protocol with contrast for the evaluation of vestibular schwannomas. A decision tree was constructed to evaluate full MRI and screening MRI strategies for patients with asymmetric sensorineural hearing loss. If a patient were to have a positive screening MRI, s/he received a full MRI. Vestibular schwannoma prevalence, MRI specificity and sensitivity, and gadolinium anaphylaxis incidence were obtained through literature review. Institutional charge data were obtained using representative patient cohorts. One-way and probabilistic sensitivity analyses were completed to determine CE model threshold points for MRI performance characteristics and charges. The mean charge for a full MRI with contrast was significantly higher than a screening MRI ($4089 ± 1086 versus $2872 ± 741; p < 0.05). The screening MRI protocol was more cost-effective than a full MRI protocol with a willingness-to-pay from $0 to 20,000 USD. Sensitivity analyses determined that the screening protocol dominated when the screening MRI charge was less than $4678, and the imaging specificity exceeded 78.2%. The screening MRI protocol also dominated when vestibular schwannoma prevalence was varied between 0 and 1000 in 10,000 people. A screening MRI protocol is more cost-effective than a full MRI with contrast in the diagnostic evaluation of a vestibular schwannoma. A screening MRI likely also confers benefits of shorter exam time and no contrast use. Further investigation is needed to confirm the relative performance of screening protocols for vestibular schwannomas. (orig.)

  12. Performance in anxiety and spatial memory tests following bilateral vestibular loss in the rat and effects of anxiolytic and anxiogenic drugs.

    Science.gov (United States)

    Zheng, Yiwen; Cheung, Irene; Smith, Paul F

    2012-11-01

    Vestibular dysfunction in humans is associated with anxiety and cognitive disorders. However, various animal studies of the effects of vestibular loss have yielded conflicting results, from reduced anxiety to increased anxiety, depending on the particular model of vestibular dysfunction and the anxiety test used. In this study we revisited the question of whether rats with surgical bilateral vestibular deafferentation (BVD) exhibit changes in anxiety-related behaviour by testing them in the open field maze (OFM), elevated plus maze (EPM) and elevated T maze (ETM) in the presence of a non-sedating anxiolytic drug, buspirone, or an anxiogenic drug, FG-7142. We also tested the animals in a spatial T maze (STM) in order to evaluate their cognitive function under the same set of conditions. We found that BVD animals exhibited increased locomotor activity (P≤0.003), reduced supported and unsupported rearing (P≤0.02 and P≤0.000, respectively) and reduced thigmotaxis (P≤0.000) in the OFM, which for the most part the drugs did not modify. By contrast, there were no significant differences between BVD and sham control animals in the EPM and the BVD animals exhibited a marginally longer escape latency in the ETM (P≤0.03), with no change in avoidance latency. In the STM, the BVD animals demonstrated a large and significant decrease in accuracy compared to the sham control animals (P≤0.000), which was not affected by drug treatment. These results have replicated previous findings regarding increased locomotor activity, reduced rearing and thigmotaxis in the OFM, and impaired performance in the STM. However, they failed to replicate some previous results obtained using the EPM and ETM. Overall, they do not support the hypothesis that BVD animals exhibit increased anxiety-like behaviour and suggest that the cognitive deficits may be independent of the emotional effects of vestibular loss. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. The effect of age on improvements in vestibulo-ocular reflexes and balance control after acute unilateral peripheral vestibular loss.

    Directory of Open Access Journals (Sweden)

    Alja eScheltinga

    2016-02-01

    Full Text Available Background: An acute unilateral peripheral vestibular loss (aUVL initially causes severe gaze and balance control problems. However, vestibulo-ocular reflexes (VOR and balance control are nearly normal 3 months later as a result of peripheral recovery and/or central compensation. As pre-existing vestibular sensory loss is assumed to be greater in the healthy elderly, this study investigated whether improvements in VOR and balance function over time after aUVL are different for the elderly than for the young. Methods: 30 aUVL patients divided into 3 age groups were studied (8 age range 23-35, 10 with range 43-58 and 12 with range 60-74 years. To measure VOR function, eye movements during caloric irrigation, rotating chair (ROT and head impulse tests were performed. Balance control during stance and gait was recorded as lower trunk angular velocity in the pitch and roll planes. Measurements were taken at deficit onset, and 3, 6, and 13 weeks later.Results: There was one difference in VOR improvements over time between the age groups: Low acceleration ROT responses were less at onset in the elderly group. Deficit side VOR responses and asymmetries in each group improved to within ranges of healthy controls at 13 weeks. Trunk sway of the elderly was greater for stance and gait at onset when compared to healthy age-matched controls and the young and greater than that of the young and controls during gait tasks at 13 weeks. The sway of the young was not different from controls at either time point. Balance control for the elderly improved slower than for the young. Conclusions: These results indicate that VOR improvement after an aUVL does not differ with age, except for low accelerations. Recovery rates are different between age groups for balance control tests. Balance control in the elderly is more abnormal at aUVL onset for stance and gait tasks with the gait abnormalities remaining after 13 weeks. Thus we conclude that balance control in the

  14. The Effect of Age on Improvements in Vestibulo-Ocular Reflexes and Balance Control after Acute Unilateral Peripheral Vestibular Loss.

    Science.gov (United States)

    Scheltinga, Alja; Honegger, Flurin; Timmermans, Dionne P H; Allum, John H J

    2016-01-01

    An acute unilateral peripheral vestibular loss (aUVL) initially causes severe gaze and balance control problems. However, vestibulo-ocular reflexes (VOR) and balance control are nearly normal 3 months later as a result of peripheral recovery and/or central compensation. As pre-existing vestibular sensory loss is assumed to be greater in the healthy elderly, this study investigated whether improvements in VOR and balance function over time after aUVL are different for the elderly than for the young. Thirty aUVL patients divided into three age-groups were studied (8 age range 23-35, 10 with range 43-58, and 12 with range 60-74 years). To measure VOR function eye movements were recorded during caloric irrigation, rotating chair (ROT), and head impulse tests. Balance control during stance and gait was recorded as lower trunk angular velocity in the pitch and roll planes. Measurements were taken at deficit onset, and 3, 6, and 13 weeks later. There was one difference in VOR improvements over time between the age-groups: Low acceleration ROT responses were less at onset in the elderly group. Deficit side VOR responses and asymmetries in each group improved to within ranges of healthy controls at 13 weeks. Trunk sway of the elderly was greater for stance and gait at onset when compared to healthy age-matched controls and the young and greater than that of the young and controls during gait tasks at 13 weeks. The sway of the young was not different from controls at either time point. Balance control for the elderly improved slower than for the young. These results indicate that VOR improvement after an aUVL does not differ with age, except for low accelerations. Recovery rates are different between age-groups for balance control tests. Balance control in the elderly is more abnormal at aUVL onset for stance and gait tasks with the gait abnormalities remaining after 13 weeks. Thus, we conclude that balance control in the elderly is more affected by the UVL than

  15. Vestibular humanoid postural control.

    Science.gov (United States)

    Mergner, Thomas; Schweigart, Georg; Fennell, Luminous

    2009-01-01

    Many of our motor activities require stabilization against external disturbances. This especially applies to biped stance since it is inherently unstable. Disturbance compensation is mainly reactive, depending on sensory inputs and real-time sensor fusion. In humans, the vestibular system plays a major role. When there is no visual space reference, vestibular-loss clearly impairs stance stability. Most humanoid robots do not use a vestibular system, but stabilize upright body posture by means of center of pressure (COP) control. We here suggest using in addition a vestibular sensor and present a biologically inspired vestibular sensor along with a human-inspired stance control mechanism. We proceed in two steps. First, in an introductory review part, we report on relevant human sensors and their role in stance control, focusing on own models of transmitter fusion in the vestibular sensor and sensor fusion in stance control. In a second, experimental part, the models are used to construct an artificial vestibular system and to embed it into the stance control of a humanoid. The robot's performance is investigated using tilts of the support surface. The results are compared to those of humans. Functional significance of the vestibular sensor is highlighted by comparing vestibular-able with vestibular-loss states in robot and humans. We show that a kinematic body-space sensory feedback (vestibular) is advantageous over a kinetic one (force cues) for dynamic body-space balancing. Our embodiment of human sensorimotor control principles into a robot is more than just bionics. It inspired our biological work (neurorobotics: 'learning by building', proof of principle, and more). We envisage a future clinical use in the form of hardware-in-the-loop simulations of neurological symptoms for improving diagnosis and therapy and designing medical assistive devices.

  16. Anticipating and managing opioid side effects in the elderly.

    Science.gov (United States)

    Martin, Caren McHenry; Forrester, Charles Samuel

    2013-03-01

    Pain is a common complaint in the elderly, and opioids are useful agents for management of both acute and chronic pain. Opioids are known to cause a variety of adverse effects, and these adverse effects can be particularly problematic for the frail elderly patient and may limit their use. As a result, this can lead to undertreatment of pain and poor patient outcome. Understanding, anticipating, and managing opioid side effects is an important component of care for the elderly patient.

  17. Tamoxifen treatment and gynecologic side effects : A review

    NARCIS (Netherlands)

    Mourits, MJE; De Vries, EGE; Willemse, PHB; Ten Hoor, KA; Hollema, H; Van der Zee, AGJ

    Objective: To review the literature on tamoxifen side effects on the female genital tract and psychosexual function in premenopausal and postmenopausal women. Data Sources: We used the English-language literature in MEDLINE and reference lists from selected articles. Search terms included:

  18. Cancer Treatment for Women: Possible Sexual Side Effects

    Science.gov (United States)

    ... therapy for menopause — to reduce the sexual side effects you experience. Topical estrogen creams applied to the vaginal area also can be used. However, women with hormone-sensitive breast or ovarian cancer should carefully discuss any type of hormone therapy ...

  19. Side-effects of protein kinase inhibitors on ion channels

    Indian Academy of Sciences (India)

    2013-11-06

    Nov 6, 2013 ... In fact, the side-effects have precluded these inhibitors from being both useful experimental tools and therapeutically viable. ... protein kinases both for experimental tools and for therapeutic approaches. [Son YK, Park H, Firth AL ...... of MAPK-activated proteins by MAPK controls the expression of various ...

  20. Side effects of drugs used in directly observed treatment short ...

    African Journals Online (AJOL)

    Aim: The study assessed the side effects of drugs used in directly observed treatment short course in a newly diagnosed pulmonary tuberculosis patients at the chest unit of University of Nigeria Teaching Hospital in Enugu State, Nigeria. Methods: A retrospective study, involving a 3-year review of case files of TB patients ...

  1. Examining the Effect of Age on Visual-Vestibular Self-Motion Perception Using a Driving Paradigm.

    Science.gov (United States)

    Ramkhalawansingh, Robert; Keshavarz, Behrang; Haycock, Bruce; Shahab, Saba; Campos, Jennifer L

    2017-05-01

    Previous psychophysical research has examined how younger adults and non-human primates integrate visual and vestibular cues to perceive self-motion. However, there is much to be learned about how multisensory self-motion perception changes with age, and how these changes affect performance on everyday tasks involving self-motion. Evidence suggests that older adults display heightened multisensory integration compared with younger adults; however, few previous studies have examined this for visual-vestibular integration. To explore age differences in the way that visual and vestibular cues contribute to self-motion perception, we had younger and older participants complete a basic driving task containing visual and vestibular cues. We compared their performance against a previously established control group that experienced visual cues alone. Performance measures included speed, speed variability, and lateral position. Vestibular inputs resulted in more precise speed control among older adults, but not younger adults, when traversing curves. Older adults demonstrated more variability in lateral position when vestibular inputs were available versus when they were absent. These observations align with previous evidence of age-related differences in multisensory integration and demonstrate that they may extend to visual-vestibular integration. These findings may have implications for vehicle and simulator design when considering older users.

  2. The thickness effects of the side-grooved CCT specimen

    International Nuclear Information System (INIS)

    Machida, Kenji; Kikuchi, Masanori; Miyamoto, Hiroshi

    1988-01-01

    J IC tests were carried out on SUS 316 steel by means of the JSME R-curve method as well as the JSME stretched-zone width (SZW) method. The effects of side-grooves on the J in value at the onset of stable crack growth were investigated using CCT specimens of two thicknesses (B = 1 mm and 2 mm). The ratio of the net thickness to the gross thickness was maintained at 0.5. The J in values of the side-grooved CCT specimens of both thicknesses were considerably smaller than those of the 1 TCT specimen. The J in value of the side-grooved specimen of 2 mm thickness was smaller than that of the standard CCT specimen. Further, as the thickness of the specimen became thinner, the J in value decreased. In the case of 1 mm-thick CCT specimens with or without a side-groove, the contraction percentage of thickness was very large so that it was not appropriate to use these specimens for the fracture toughness test. In the case of the thin or side-grooved CCT specimens, the J-value, which is evaluated from the load versus displacement curve using Rice's formula, cannot estimate the J-integral at the central part of the specimen. Therefore, a J-integral estimation method would have to be established using 3-D elastic-plastic analysis. (author)

  3. Isolated central vestibular syndrome.

    Science.gov (United States)

    Kim, Sung-Hee; Park, Seong-Ho; Kim, Hyo-Jung; Kim, Ji-Soo

    2015-04-01

    Isolated vestibular syndrome may occur all along the vestibular pathways from the peripheral labyrinth to the brain. By virtue of recent developments in clinical neurotology and neuroimaging, however, diagnosis of isolated central vestibulopathy is increasing. Here, we review five distinct syndromes of isolated central vestibular syndrome from lesions restricted to the vestibular nuclei, the nucleus prepositus hypoglossi, the flocculus, the tonsil, and the nodulus, and introduce a new vestibular syndrome from isolated involvement of the inferior cerebellar peduncle. Decreased responses to head impulses do not exclude a central lesion as a cause of isolated vestibular syndrome. Brain imaging, including diffusion-weighted magnetic resonance imaging (MRI), may be falsely negative during the acute phase in patients with isolated vestibular syndrome because of a stroke. Central signs should be sought carefully in patients with isolated vertigo, even when the patients show the features of peripheral vestibulopathy and negative MRIs. Recognition of these isolated central vestibular syndromes would aid in defining the lesions responsible for various vestibular manifestations in central vestibulopathy. © 2015 New York Academy of Sciences.

  4. The Value of Vestibular Rehabilitation in Patients with Bilateral Vestibular Dysfunction.

    Science.gov (United States)

    Şahin, Ethem; Dinç, Mehmet Emre; Yayla Özker, Berna; Çöpürgensli, Canan; Konaklıoğlu, Mustafa; Özçelik, Tuncay

    2017-12-01

    The value of vestibular rehabilitation in patients with bilateral vestibular dysfunction was investigated. This study assessed 17 patients (9 males, 8 females) with bilateral vestibular dysfunction. Vestibular rehabilitation continued for 1.5 months. Videonystagmography tests (including oculomotor testing, positional testing, and caloric tests), vestibular evoked myogenic potential (VEMP) testing, and computerized dynamic posturography were performed during the pre-, mid-, and post-treatment periods. The patients underwent cranial and internal acoustic canal MRI. Consultant physicians from the neurology and physical medicine and rehabilitation departments reviewed all patients. The post-treatment anteroposterior somatosensorial (APSO), anteroposterior global (APGLO), mediolateral visual (MLVI), and mediolateral global values and anteroposterior and mediolateral trials and conditions were significantly higher than those measured in the pre-treatment period. Similarly, mid-treatment values of the APSO, APGLO, and the anteroposterior sensory organization test (SOT) 2 were significantly higher than those measured in the pre-treatment period. Vestibular rehabilitation was effective in patients with bilateral vestibular dysfunction. As the vestibular rehabilitation duration increased, so did the efficacy of the treatment.

  5. [Glucocorticoids in neurology: mechanism of action, applications and side effects].

    Science.gov (United States)

    Finsterer, J; Frank, M

    2014-06-01

    Glucocorticoids represent a cornerstone in the therapy for many neurological disorders. Even though their mechanism of action is still not completely understood, synthetic glucocorticoids are given as first line drugs in a number of immunological and non-immunological disorders of the central or peripheral nervous system. For most of these disorders, however, the level of evidence that glucocorticoids are truly effective is still not sufficient. This is why treatment with glucocorticoids cannot be recommended on an evidenced-based level for many of these disorders. Due to the huge number of acute or chronic side effects, it is essential that the effects are documented by more randomised placebo-controlled cross-over trials. Generally, glucocorticoids can no longer be omitted in the treatment of neurological disorders, the indication to apply glucocorticoids, however, needs to be thoroughly balanced in the light of their many side effects. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Cold shivering activity after unilateral destruction of the vestibular apparatus

    Science.gov (United States)

    Kuzmina, G. I.

    1980-01-01

    The bioelectric activity of muscles (flexors and extensors of the forelimbs and hindlimbs) during cold shivering after unilateral destruction of the vestibular apparatus. It was found, that unilateral delabyrinthing produces bilateral facilitation of cold shivering in the flexor extremities more pronounced on the ipsilateral side. In the extensor muscles there was an absence of bioelectric activity both before and after delabyrinthing. Enhancement of cold shivering in the flexor extremities following intervention was evidently conditioned by removal of the inhibiting effect of the vestibulary apparatus on the function of special centers.

  7. Glucocorticoids in nephrology I: pharmacology and side effects

    Directory of Open Access Journals (Sweden)

    Jernej Pajek

    2015-05-01

    Full Text Available Glucocorticoids have been used in clinical medicine since 1940s. Despite the time-long use they are still a subject of active ongoing research. We describe the mode of action, pharmacology and side effects to enable proper prescription of these drugs. Glucocorticoids exert genomic and non-genomic effects, the latter become important at higher doses. The nomenclature of dosage ranges and the principles of dosage adjustments are given. Glucocortioid use is associated with frequent and important side effects in numerous organ systems. Prophylactic treatments for osteoporosis and infections are described. The suppression of hypothalamic-hypophyseal hormonal axis determines the need for gradual glucocorticoid withdrawal and supplementation after discontinuation. Finally, glucocorticoid withdrawal syndrome is described.

  8. Cutaneous side-effects during therapy of melanoma by vemurafenib

    Directory of Open Access Journals (Sweden)

    Anna Ankudowicz

    2015-06-01

    Full Text Available Introduction. Vemurafenib is a selective inhibitor of serine-threonine kinase BRAF used in the treatment of advanced melanoma with BRAF mutation. Effectiveness of this drug was confirmed in a large clinical trial, which led to the increase of its usage. During treatment with vemurafenib, particular attention should be paid to the numerous side effects, including those concerning the skin. Vemurafenib is highly toxic to the skin. Skin lesions occurring during the treatment of melanoma with this medicament can be divided into: early (observed 3 to 6 weeks after beginning treatment, late (observed 6 weeks after beginning treatment and hypersensitivity reactions to vemurafenib. Objective. Presentation of vemurafenib toxic effects on the skin and side effects that can be caused by this drug. Case report. We present a 58-year-old woman with metastatic melanoma who was treated with vemurafenib. During the course of therapy, numerous adverse reactions, including inflammatory tumors, emergence of a number of melanocytic naevi, skin horns, alopecia, hyperkeratosis of the palms and soles, and palmar erythrodysesthesia were observed. She was treated with anti-inflammatory drugs, an antibiotic, circulation-improving preparations and local moisturizing and keratolytic treatment. The patient remains under the care of oncologists and dermatologists. Conclusions. The new generation anti-cancer drugs bring hope for a cure or prolongation of life, but can also significantly reduce the quality of life by inducing both general and local adverse side effects. Oncological patients should also be taken care of by dermatologists.

  9. Late side effects of Ruthenium 106 therapy for uveal melanomas

    International Nuclear Information System (INIS)

    Langmann, G.; Faulborn, J.; Poier, E.

    1994-01-01

    When effectiveness is evaluated in brachytherapy with Ruthenium 106 special emphasis has to be put on tumor destruction and late side effects responsible for the definite functional results. We evaluated the late side effects of 22 uveal melanomas, which had been treated with 106 Ruthenium plaques. The tumor prominences ranged from 3 to 10 mm, the diameter from 4 to 9 disc diameters. In 4 patients the tumor involved the posterior pole, 14 melanomas were located in the midperiphery of the fundus, 4 tumors were ciliary body melanomas. The total radiation dose of the apex ranged from 100 to 240 Gy with a corresponding dose to the sclera between 540 to 1000 Gy. Because of the short half life of the plaque we have been using different dose rates (1.6-11 Gy/h). In 17/22 eyes adequate regression could be achieved by Ruthenium therapy alone. In one case additional laser treatment of the macular part of the melanoma had to be performed, Gamma Knife therapy was necessary in another melanoma with 10 mm tumor prominence. 3 recurrences led to enucleation. The mean follow up was 4.8 years ranging from 1 to 7 years. In 2/22 patients opticopathy caused severe visual impairment, in another 2 patients radiation maculopathy and opticopathy was observed. 7/22 developed vasculopathy with neovascularization treated by photocoagulation. In one case of focal radiation maculopathy laser treatment could prevent further visual impairment. The following factors are responsible for a higher incidence of late side effects: 1. High dose rate of the plaques in combination with a high radiation dose to the sclera 2. Location of the tumor within a minimum distance of 2 disc diameters to the optic nerve or macula 3. Tumor location at the ciliary body Laser treatment in case of neovascularization and focal radiation maculopathy is the only effective treatment with regard to late side effects. Ischemic maculopathy and radiation opticopathy are responsible for late visual impairment. (authors)

  10. Ketamine for Pain Management-Side Effects & Potential Adverse Events.

    Science.gov (United States)

    Allen, Cheryl A; Ivester, Julius R

    2017-12-01

    An old anesthetic agent, ketamine is finding new use in lower doses for analgesic purposes. There are concerns stemming from its potential side effects-specifically psychomimetic effects. These side effects are directly related to dose amount. The doses used for analgesic purposes are much lower than those used for anesthesia purposes. A literature review was performed to ascertain potential side effects and/or adverse events when using ketamine for analgesia purposes. The search included CINAHL, PubMed, and Ovid using the search terms "ketamine," "ketamine infusion," "pain," "adverse events," "practice guideline," and "randomized controlled trial." Searches were limited to full-text, peer-reviewed articles and systematic reviews. Initially 1,068 articles were retrieved. The search was then narrowed by using the Boolean connector AND with various search term combinations. After adjusting for duplication, article titles and abstracts were reviewed, leaving 25 articles for an in-depth analysis. Specific exclusion criteria were then applied. The literature supports the use of ketamine for analgesic purposes, and ketamine offers a nonopioid option for the management of some pain conditions. Because ketamine is still classified as an anesthetic agent, health care institutions should develop their own set of policies and protocols for the administration of ketamine. By using forethought and understanding of the properties of ketamine, appropriate care may be planned to mitigate potential side effects and adverse events so that patients are appropriately cared for and their pain effectively managed. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  11. Metabolomics Based Profiling of Dexamethasone Side Effects in Rats

    Directory of Open Access Journals (Sweden)

    Abeer K. Malkawi

    2018-02-01

    Full Text Available Dexamethasone (Dex is a synthetic glucocorticoid that has anti-inflammatory and immunosuppressant effects and is used in several conditions such as asthma and severe allergy. Patients receiving Dex, either at a high dose or for a long time, might develop several side effects such as hyperglycemia, weight change, or osteoporosis due to its in vivo non-selectivity. Herein, we used liquid chromatography-tandem mass spectrometry-based comprehensive targeted metabolomic profiling as well as radiographic imaging techniques to study the side effects of Dex treatment in rats. The Dex-treated rats suffered from a ∼20% reduction in weight gain, hyperglycemia (145 mg/dL, changes in serum lipids, and reduction in total serum alkaline phosphatase (ALP (∼600 IU/L. Also, compared to controls, Dex-treated rats showed a distinctive metabolomics profile. In particular, serum amino acids metabolism showed six-fold reduction in phenylalanine, lysine, and arginine levels and upregulation of tyrosine and hydroxyproline reflecting perturbations in gluconeogenesis and protein catabolism which together lead to weight loss and abnormal bone metabolism. Sorbitol level was markedly elevated secondary to hyperglycemia and reflecting activation of the polyol metabolism pathway causing a decrease in the availability of reducing molecules (glutathione, NADPH, NAD+. Overexpression of succinylacetone (4,6-dioxoheptanoic acid suggests a novel inhibitory effect of Dex on hepatic fumarylacetoacetate hydrolase. The acylcarnitines, mainly the very long chain species (C12, C14:1, C18:1 were significantly increased after Dex treatment which reflects degradation of the adipose tissue. In conclusion, long-term Dex therapy in rats is associated with a distinctive metabolic profile which correlates with its side effects. Therefore, metabolomics based profiling may predict Dex treatment-related side effects and may offer possible novel therapeutic interventions.

  12. The effect of increased intracranial pressure on vestibular evoked myogenic potentials in superior canal dehiscence syndrome.

    Science.gov (United States)

    Janky, Kristen L; Zuniga, M Geraldine; Schubert, Michael C; Carey, John P

    2015-04-01

    To determine if vestibular evoked myogenic potential (VEMP) responses change during inversion in patients with superior canal dehiscence syndrome (SCDS) compared to controls. Sixteen subjects with SCDS (mean: 43, range 30-57 years) and 15 age-matched, healthy subjects (mean: 41, range 22-57 years) completed cervical VEMP (cVEMP) in response to air conduction click stimuli and ocular VEMP (oVEMP) in response to air conduction 500 Hz tone burst stimuli and midline tap stimulation. All VEMP testing was completed in semi-recumbent and inverted conditions. SCDS ears demonstrated significantly larger oVEMP peak-to-peak amplitudes in comparison to normal ears in semi-recumbency. While corrected cVEMP peak-to-peak amplitudes were larger in SCDS ears; this did not reach significance in our sample. Overall, there was not a differential change in o- or cVEMP amplitude with inversion between SCDS and normal subjects. Postural-induced changes in o- and cVEMP responses were measured in the steady state regardless of whether the labyrinth was intact or dehiscent. VEMP responses are blunted during inversion. Although steady-state measurements of VEMPs during inversion do not increase diagnostic accuracy for SCDS, the findings suggest that inversion may provide more general insights into the equilibration of pressures between intracranial and intralabyrinthine fluids. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  13. Nanomedicinal products: a survey on specific toxicity and side effects

    Directory of Open Access Journals (Sweden)

    Brand W

    2017-08-01

    Full Text Available Walter Brand,1,* Cornelle W Noorlander,1,* Christina Giannakou,2,3 Wim H De Jong,2 Myrna W Kooi,1 Margriet VDZ Park,2 Rob J Vandebriel,2 Irene EM Bosselaers,4 Joep HG Scholl,5 Robert E Geertsma2 1Centre for Safety of Substances and Products, 2Centre for Health Protection, National Institute for Public Health and the Environment (RIVM, Bilthoven, 3Department of Toxicogenomics, Maastricht University, Maastricht, 4Section Pharmacology, Toxicology and Pharmacokinetics, Medicines Evaluation Board (CBG-MEB, Utrecht, 5Research & Analysis Department, Netherlands Pharmacovigilance Centre Lareb, ‘s-Hertogenbosch, the Netherlands *These authors contributed equally to this work Abstract: Due to their specific properties and pharmacokinetics, nanomedicinal products (NMPs may present different toxicity and side effects compared to non-nanoformulated, conventional medicines. To facilitate the safety assessment of NMPs, we aimed to gain insight into toxic effects specific for NMPs by systematically analyzing the available toxicity data on approved NMPs in the European Union. In addition, by comparing five sets of products with the same active pharmaceutical ingredient (API in a conventional formulation versus a nanoformulation, we aimed to identify any side effects specific for the nano aspect of NMPs. The objective was to investigate whether specific toxicity could be related to certain structural types of NMPs and whether a nanoformulation of an API altered the nature of side effects of the product in humans compared to a conventional formulation. The survey of toxicity data did not reveal nanospecific toxicity that could be related to certain types of structures of NMPs, other than those reported previously in relation to accumulation of iron nanoparticles (NPs. However, given the limited data for some of the product groups or toxicological end points in the analysis, conclusions with regard to (a lack of potential nanomedicine-specific effects need to be

  14. Oseltamivir efficacy, side effects, and safety in children with influenza

    Directory of Open Access Journals (Sweden)

    Eun Sun Seo

    2010-01-01

    Full Text Available Purpose : Although oseltamivir is widely used for treatment of influenza, few clinical studies of its efficacy and resistance have been performed in Korea. We evaluated the safety, side effects, and efficacy of oseltamivir treatment in Korean pediatric patients. Methods : We analyzed 321 children diagnosed with influenza at Busan St. Mary's Medical Center, Korea, between January 2008 and June 2008 (first study period and November 2008 and January 2009 (second study period. Patients were divided into two groups: those receiving oseltamivir treatment for 5 days and those receiving only symptomatic treatment. We investigated clinical symptoms, side effects, and resistance to oseltamivir. We also identified influenza strains and evaluated resistance to oseltamivir using an influenza virus culture. Results : One hundred eighty-six patients were assigned to the treatment group, and 135 were assigned to the control group. The treatment group showed shorter admission duration (4.4 days compared with controls (5.0 days (P=0.000 and had fewer lower respiratory tract complications compared with controls (P&lt;0.05. No significant statistical difference in the virus antigenic type was observed between the groups. In the first study period, virus culture showed influenza B (41.7% vs. 49.6%, A/H3N2 (7.9% vs. 8.4%, and A/H1N1 (9.4% vs. 6.5%. In the second study period, only A/H1N1 (55.3% vs. 50.0% was isolated, except for one case of A (H3N2 in the treatment group. No differences in short- and long-term side effects, including neuropsychologic side effects, were noted between groups. There was no resistance to oseltamivir before or after treatment in the first study period. Conclusion : Based on our results, we suggest that osetalmivir therapy in pediatric patients is effective.

  15. Suspected side effects to the quadrivalent human papilloma vaccine

    DEFF Research Database (Denmark)

    Brinth, Louise; Theibel, Ann Cathrine; Pors, Kirsten

    2015-01-01

    INTRODUCTION: The quadrivalent vaccine that protects against human papilloma virus types 6, 11, 16 and 18 (Q-HPV vaccine, Gardasil) was included into the Danish childhood vaccination programme in 2009. During the past years, a collection of symptoms primarily consistent with sympathetic nervous...... system dysfunction have been described as suspected side effects to the Q-HPV vaccine. METHODS: We present a description of suspected side effects to the Q-HPV vaccine in 53 patients referred to our Syncope Unit for tilt table test and evaluation of autonomic nervous system function. RESULTS: All...... consistency in the reported symptoms as well as between our findings and those described by others. Our findings neither confirm nor dismiss a causal link to the Q-HPV vaccine, but they suggest that further research is urgently warranted to clarify the pathophysiology behind the symptoms experienced...

  16. Side effects of cancer therapies. International classification and documentation systems

    International Nuclear Information System (INIS)

    Seegenschmiedt, M.H.

    1998-01-01

    The publication presents and explains verified, international classification and documentation systems for side effects induced by cancer treatments, applicable in general and clinical practice and clinical research, and covers in a clearly arranged manner the whole range of treatments, including acute and chronic side effects of chemotherapy and radiotherapy, surgery, or combined therapies. The book fills a long-felt need in tumor documentation and is a major contribution to quality assurance in clinical oncology in German-speaking countries. As most parts of the book are bilingual, presenting German and English texts and terminology, it satisfies the principles of interdisciplinarity and internationality. The tabulated form chosen for presentation of classification systems and criteria facilitate the user's approach as well as application in daily work. (orig./CB) [de

  17. May disordered protein cause serious drug side effect?

    Science.gov (United States)

    Tou, Weng Ieong; Chen, Calvin Yu-Chian

    2014-04-01

    Insomnia is a self-reported disease where patients lose their ability to initiate and maintain sleep, leading to daytime performance impairment. Several drug targets to ameliorate insomnia symptoms have been discovered; however, these drug targets lead to serious side effects. Thus, we characterize the structural properties of these sleep-related receptors and the clock complex and discuss a possible drug design that will reduce side effects. Computational prediction shows that disordered property is shared. Over 30% of the structure of CLOCK, PER1/2/3, BMAL-1, muscarinic acetylcholine receptor-M1, melatonin receptor and casein kinase I are structurally disordered (the remaining proteins represent insomnia drugs might be closely related to the protein architecture. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Drug target identification using side-effect similarity

    DEFF Research Database (Denmark)

    Campillos, Monica; Kuhn, Michael; Gavin, Anne-Claude

    2008-01-01

    Targets for drugs have so far been predicted on the basis of molecular or cellular features, for example, by exploiting similarity in chemical structure or in activity across cell lines. We used phenotypic side-effect similarities to infer whether two drugs share a target. Applied to 746 marketed...... drugs, a network of 1018 side effect-driven drug-drug relations became apparent, 261 of which are formed by chemically dissimilar drugs from different therapeutic indications. We experimentally tested 20 of these unexpected drug-drug relations and validated 13 implied drug-target relations by in vitro...... binding assays, of which 11 reveal inhibition constants equal to less than 10 micromolar. Nine of these were tested and confirmed in cell assays, documenting the feasibility of using phenotypic information to infer molecular interactions and hinting at new uses of marketed drugs....

  19. Linezolid induced black hairy tongue: a rare side effect.

    Science.gov (United States)

    Aijazi, Ishma; Abdulla, Fadhil M

    2014-01-01

    Linezolid induced black hairy tongue is a rare benign reversible side effect of linezolid therapy. We report a case of a 61 year old diabetic lady who developed thrombocytopenia and black hairy discoloration of the tongue after being prescribed linezolid for foot osteomyelitis by the orthopaedic surgeon. Patient was encouraged to practice good oral dental hygiene, advised to use a soft tooth brush, regular mouth wash and baking soda containing tooth paste. The condition resolved four weeks after cessation of the antibiotic therapy.

  20. Neuropsychiatric side effects related to treatment with felbamate.

    Science.gov (United States)

    McConnell, H; Snyder, P J; Duffy, J D; Weilburg, J; Valeriano, J; Brillman, J; Cress, K; Cavalier, J

    1996-01-01

    Seven patients with refractory seizure disorders and neuropsychiatric symptoms believed secondary to felbamate are presented. Five were on concomitant valproic acid (and other agents). Anergia, apathy, bradyphrenia, and increased irritability were prominent. One patient on felbamate monotherapy had a new-onset psychosis. Felbamate's NMDA receptor antagonism and GABA potentiation (perhaps enhanced by valproic acid use) are discussed as possible mechanisms of these side effects.

  1. Ocular and cervical vestibular evoked myogenic potentials in response to bone-conducted vibration in patients with probable inferior vestibular neuritis.

    Science.gov (United States)

    Manzari, L; Burgess, A M; Curthoys, I S

    2012-07-01

    Previous evidence shows that the n10 component of the ocular vestibular evoked myogenic potential indicates utricular function, while the p13 component of the cervical vestibular evoked myogenic potential indicates saccular function. This study aimed to assess the possibility of differential utricular and saccular function testing in the clinic, and whether loss of saccular function affects utricular response. Following vibration conduction from the mid-forehead at the hairline, the ocular n10 component was recorded by surface electromyograph electrodes beneath both eyes, while the cervical p13-n23 component was recorded by surface electrodes over the tensed sternocleidomastoid muscles. Fifty-nine patients were diagnosed with probable inferior vestibular neuritis, as their cervical p13-n23 component was asymmetrical (i.e. reduced or absent on the ipsilesional side), while their ocular n10 component was symmetrical (i.e. normal beneath the contralesional eye). The sense organ responsible for the cervical and the ocular vestibular evoked myogenic potentials cannot be the same, as one response was normal while the other was not. Reduced or absent saccular function has no detectable effect on the ocular n10 component. On vibration stimulation, the ocular n10 component indicates utricular function and the cervical p13-n23 component indicates saccular function.

  2. Vestibular neuritis: three-dimensional videonystagmography and vestibular evoked myogenic potential results.

    Science.gov (United States)

    Chen, C W; Young, Y H; Wu, C H

    2000-10-01

    Eight patients diagnosed with vestibular neuritis received the newly developed three-dimensional videonystagmography (3D VNG) and vestibular evoked myogenic potential (VEMP) examination in order to localize the lesion site. Two (25%) of the 8 patients exhibited spontaneous nystagmus with 3 components, indicating that both the horizontal semicircular canal (HSCC) and anterior semicircular canal (ASCC) were affected. The remaining 6 patients (75%) displayed only horizontal nystagmus, meaning that only the HSCC was involved. Seven (88%) of the 8 patients had bilateral normal VEMPs, revealing sparing of the posterior semicircular canal (PSCC). In a comparative study, another seven patients with vestibular neuritis 1 year post-treatment also received the caloric test, 3D VNG and VEMP examination. Only one patient exhibited spontaneous nystagmus. An absent caloric response of the lesioned side persisted in 5 (71%) of the 7 patients. However, all patients showed normal VEMPs bilaterally. 3D VNG and VEMP examination indicates that vestibular neuritis mainly affects the superior division of the vestibular nerve, which innervates the HSCC and ASCC. Meanwhile, the function of the PSCC and saccule, innervated by the inferior vestibular nerve, is preserved.

  3. Deregulated genes in sporadic vestibular schwannomas

    DEFF Research Database (Denmark)

    Cayé-Thomasen, Per; Helweg-Larsen, Rehannah Holga Andrea; Stangerup, Sven-Eric

    2010-01-01

    In search of genes associated with vestibular schwannoma tumorigenesis, this study examines the gene expression in human vestibular nerve versus vestibular schwannoma tissue samples using microarray technology....

  4. The effect of virtual reality on visual vertigo symptoms in patients with peripheral vestibular dysfunction: a pilot study.

    Science.gov (United States)

    Pavlou, M; Kanegaonkar, R G; Swapp, D; Bamiou, D E; Slater, M; Luxon, L M

    2012-01-01

    Individuals with vestibular dysfunction may experience visual vertigo (VV), in which symptoms are provoked or exacerbated by excessive or disorientating visual stimuli (e.g. supermarkets). VV can significantly improve when customized vestibular rehabilitation exercises are combined with exposure to optokinetic stimuli. Virtual reality (VR), which immerses patients in realistic, visually challenging environments, has also been suggested as an adjunct to VR to improve VV symptoms. This pilot study compared the responses of sixteen patients with unilateral peripheral vestibular disorder randomly allocated to a VR regime incorporating exposure to a static (Group S) or dynamic (Group D) VR environment. Participants practiced vestibular exercises, twice weekly for four weeks, inside a static (Group S) or dynamic (Group D) virtual crowded square environment, presented in an immersive projection theatre (IPT), and received a vestibular exercise program to practice on days not attending clinic. A third Group D1 completed both the static and dynamic VR training. Treatment response was assessed with the Dynamic Gait Index and questionnaires concerning symptom triggers and psychological state. At final assessment, significant between-group differences were noted between Groups D (p=0.001) and D1 (p=0.03) compared to Group S for VV symptoms with the former two showing a significant 59.2% and 25.8% improvement respectively compared to 1.6% for the latter. Depression scores improved only for Group S (p=0.01) while a trend towards significance was noted for Group D regarding anxiety scores (p=0.07). Exposure to dynamic VR environments should be considered as a useful adjunct to vestibular rehabilitation programs for patients with peripheral vestibular disorders and VV symptoms.

  5. Bionic balance organs: progress in the development of vestibular prostheses.

    Science.gov (United States)

    Smith, Paul F

    2017-09-01

    The vestibular system is a sensory system that is critically important in humans for gaze and image stability as well as postural control. Patients with complete bilateral vestibular loss are severely disabled and experience a poor quality of life. There are very few effective treatment options for patients with no vestibular function. Over the last 10 years, rapid progress has been made in developing artificial 'vestibular implants' or 'prostheses', based on cochlear implant technology. As of 2017, 13 patients worldwide have received vestibular implants and the results are encouraging. Vestibular implants are now becoming part of an increasing effort to develop artificial, bionic sensory systems, and this paper provides a review of the progress in this area.

  6. Effects of primary caregiver participation in vestibular rehabilitation for unilateral neglect patients with right hemispheric stroke: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Dai CY

    2013-04-01

    Full Text Available Chin-Ying Dai,1,2 Yu-Hui Huang,3,4 Li-Wei Chou,5,6 Shiao-Chi Wu,7 Ray-Yau Wang,8 Li-Chan Lin9 1School of Nursing, National Yang Ming University, Taipei, Taiwan; 2Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan; 3Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan; 4School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 5Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 6School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 7Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; 8Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan; 9Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan, Republic of China Introduction: The current study aims to investigate the effects of primary caregiver participation in vestibular rehabilitation (VR on improving the measures of neglect, activities of daily living (ADL, balance, and falls of unilateral neglect (UN patients. Methods: This study is a single-blind randomized controlled trial. Both experimental (n = 24 and control groups (n = 24 received conventional rehabilitation. The experimental group undertook VR for a month. During the first and second weeks, a registered nurse trained the experimental group in VR. The primary caregivers in the experimental group supervised and guided their patients in VR during the third and fourth weeks. The outcome measures were neglect, ADL, balance, and falls. Results: The two groups of UN patients showed a significant improvement in neglect, ADL, and balance over time. Based on the generalized estimating equations model, an interaction was observed between groups and times. Significant interactions were observed between the VR group

  7. Paroxysmal positional vertigo despite complete vestibular impairment: the role of instrumental assessment.

    Science.gov (United States)

    Casani, A P; Cerchiai, N; Navari, E

    2018-02-28

    Lindsay and Hemenway syndrome is characterised by a posterior canal benign paroxysmal positional vertigo following a partial unilateral vestibular loss affecting the same side. The syndrome is caused by damage of structures innervated by the superior division of the vestibular nerve and perfused by the anterior vestibular artery; the detached otoconia can cause vertigo in the still intact posterior semicircular canal. The most recent vestibular instrumental techniques allow reaching an accurate topodiagnosis in case of peripheral vestibular failure. We report on two cases of Lindsay-Hemenway syndrome despite complete vestibular failure demonstrated by vestibular instrumental assessment. After making some critical considerations on these findings, we underline the importance of not disregarding the diagnosis of paroxysmal positional vertigo in an established complete labyrinthine loss of function. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  8. Vestibular neuritis: is there any evidence of an asymmetric distribution?

    Science.gov (United States)

    Reiß, Michael; Reiß, Gilfe

    2012-04-01

    Statistics in the literature showed that neuro-otological diseases (i.e. sudden hearing loss or tinnitus) occur predominantly in the left ear. In a seven-study meta-analysis of patients suffering from vestibular neuritis, Reiß found no clear dominance of one side (50.8% on the right side, 48.4% on the left side and 0.8% on both sides). The purpose of this study is to investigate the laterality of vestibular neuritis in a distinct population of patients. Lateralization of vestibular neuritis was studied in 160 patients treated at Elblandklinikum Radebeul from January 2004 to December 2009. There was a statistically non-significant dominance of the right side in the total sample, specifically in female patients (57% right vs. 40% left), but not in male patients. The study confirms the results of the meta-analysis: that there is no relevant side dominance in patients suffering from vestibular neuritis. In addition to the caloric test, the head impulse test was performed in 157 patients. In 92% of these patients, the disturbance of vestibular function could be confirmed with the head impulse test. This test is altogether a clinically useful instrument especially for follow-up, but also for diagnosis.

  9. "So far it's been choosing which side effects I want or I can deal with": A grounded theory of HIV treatment side effects among people living with HIV.

    Science.gov (United States)

    Gagnon, Marilou; Holmes, Dave

    2016-01-01

    Despite the availability of new antiretroviral drugs and the simplification of treatment options, side effects continue to affect people living with HIV. In this paper, we present the findings of a grounded theory study designed to gain a critical understanding of the experience of side effects. Three main categories emerged from the data: the side effects, the experience, and the connections. The first category suggests that we need to change how we think about side effects in order to take into account the context in which they are experienced as well as the types and nature of side effects. The second category puts forward the idea that the experience of side effects is composed of three interrelated processes: becoming with, living with, and dealing with. Finally, the third category points to new connections that are formed with people, things and systems in the presence of side effects.

  10. Phytochemicals that counteract the cardiotoxic side effects of cancer chemotherapy

    Directory of Open Access Journals (Sweden)

    Anita Piasek

    2009-04-01

    Full Text Available Almost all clinically used antitumor drugs exhibit toxic side effects affecting heart function. Because of cardiotoxicity during anticancer chemotherapy, effective doses of cytostatics have to be limited, which may worsen antitumor efficacy. The cardiotoxicity induced by cytostatics of the anthracycline group in particular results, among others, from massive stimulation of ROS. It has therefore been suggested that some phytochemicals with high antioxidant potential, when administered together with antitumor agents, could decrease the toxic side effects of chemotherapy and reduce the risk of heart failure. This review summarizes findings of studies undertaken to identify edible plants or phytochemicals isolated from them displaying cardioprotective properties during chemotherapy. Such properties have been shown for such foods as grapes, garlic, tomato, spinach, and beetroot. A protective role on the heart is also displayed by melatonin (a hormone synthesized by the pineal gland, but also present in many edible plants, chalcones (precursors of all known flavonoids, some herbal dietary supplements, vitamins A, C, and E, selenium, and semisynthetic flavonoid 7-monohydroxyethylrutoside (monoHER. Although to date only a limited number of investigations have been carried out, their results suggest that dietary intervention with antioxidants found in edible plants may be a safe and effective way of alleviating the toxicity of anticancer chemotherapy and preventing heart failure.

  11. Effects and side effects of inspections and accountability in education: an overview of empirical studies

    NARCIS (Netherlands)

    de Wolf, Inge F.; Janssens, F.J.G.

    This paper presents an overview of studies into effects and side effects of control mechanisms in education. We focus on effects and side effects of inspection visits and public performance indicators. A first conclusion is that the studies do not provide us with a clear answer to the question of

  12. Foreknowledge, Caring, and the Side-Effect Effect in Young Children

    Science.gov (United States)

    Pellizzoni, Sandra; Siegal, Michael; Surian, Luca

    2009-01-01

    Children and adults often judge that the side effects of the actions of an uncaring story agent have been intentional if the effects are harmful but not if these are beneficial, creating an asymmetrical "side-effect" effect. The authors report 3 experiments involving 4- and 5-year-olds (N = 188) designed to clarify the role of foreknowledge and…

  13. Effect of Communication Style on Perceptions of Medication Side Effect Risk among Pharmacy Students.

    Science.gov (United States)

    Sawant, Ruta V; Beatty, Collin R; Sansgiry, Sujit S

    2016-10-25

    Objective. To assess the effect of communication style, and frequency and severity of medication side-effects, on pharmacy students' perception of risk of experiencing side effects. Methods. One hundred responses from pharmacy students were obtained using an online survey. Participants were presented with a drug information box containing drug name, drug usage, and one side-effect associated with the drug. Information on side-effect for each drug was presented in one of eight experimental conditions, in a 2 (side-effect frequency: low, high), X2 (side-effect severity: mild, severe) X2 (communication style: verbal, verbal + natural frequency) factorial design. Risk perception of experiencing side effects was measured. Results. Communication style was found to have a significant impact on risk perception depending on the context of frequency and severity associated with the side effect. Conclusion. Communication style plays a significant role in formulating risk perceptions of medication side effects. Training in pharmaceutical counseling should include special emphasis on effective language use.

  14. Major side-effect of metrizamide. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Sonoda, Hiroshi; Yoshida, Akimasa; Ohtsuka, Tadahiro; Takaki, Shuichi; Matsukado, Yasuhiko

    1987-10-01

    We have presented a case showing a major side-effect following metrizamide CT cisternography. The patient was a 68-year-old woman who developed anaphylactic shock and a disturbance of consciousness 6 hours after metrizamide CT cisternography with a dose of 850 mg of iodine. In spite of vigorous therapy, she died 60 hours after the shock. Examples of anaphylactic shock by metrizamide administered intrathecally have been reported very rarely. The pathogenesis of this case was presumably due to anaphylactic shock, but other etiological factors, such as a hypothalamic dysfunction due to a disturbed glucose metabolism of the brain, may also be suspected.

  15. Are there side effects to watching 3D movies? A prospective crossover observational study on visually induced motion sickness.

    Science.gov (United States)

    Solimini, Angelo G

    2013-01-01

    The increasing popularity of commercial movies showing three dimensional (3D) images has raised concern about possible adverse side effects on viewers. A prospective carryover observational study was designed to assess the effect of exposure (3D vs. 2D movie views) on self reported symptoms of visually induced motion sickness. The standardized Simulator Sickness Questionnaire (SSQ) was self administered on a convenience sample of 497 healthy adult volunteers before and after the vision of 2D and 3D movies. Viewers reporting some sickness (SSQ total score>15) were 54.8% of the total sample after the 3D movie compared to 14.1% of total sample after the 2D movie. Symptom intensity was 8.8 times higher than baseline after exposure to 3D movie (compared to the increase of 2 times the baseline after the 2D movie). Multivariate modeling of visually induced motion sickness as response variables pointed out the significant effects of exposure to 3D movie, history of car sickness and headache, after adjusting for gender, age, self reported anxiety level, attention to the movie and show time. Seeing 3D movies can increase rating of symptoms of nausea, oculomotor and disorientation, especially in women with susceptible visual-vestibular system. Confirmatory studies which include examination of clinical signs on viewers are needed to pursue a conclusive evidence on the 3D vision effects on spectators.

  16. Are there side effects to watching 3D movies? A prospective crossover observational study on visually induced motion sickness.

    Directory of Open Access Journals (Sweden)

    Angelo G Solimini

    Full Text Available BACKGROUND: The increasing popularity of commercial movies showing three dimensional (3D images has raised concern about possible adverse side effects on viewers. METHODS AND FINDINGS: A prospective carryover observational study was designed to assess the effect of exposure (3D vs. 2D movie views on self reported symptoms of visually induced motion sickness. The standardized Simulator Sickness Questionnaire (SSQ was self administered on a convenience sample of 497 healthy adult volunteers before and after the vision of 2D and 3D movies. Viewers reporting some sickness (SSQ total score>15 were 54.8% of the total sample after the 3D movie compared to 14.1% of total sample after the 2D movie. Symptom intensity was 8.8 times higher than baseline after exposure to 3D movie (compared to the increase of 2 times the baseline after the 2D movie. Multivariate modeling of visually induced motion sickness as response variables pointed out the significant effects of exposure to 3D movie, history of car sickness and headache, after adjusting for gender, age, self reported anxiety level, attention to the movie and show time. CONCLUSIONS: Seeing 3D movies can increase rating of symptoms of nausea, oculomotor and disorientation, especially in women with susceptible visual-vestibular system. Confirmatory studies which include examination of clinical signs on viewers are needed to pursue a conclusive evidence on the 3D vision effects on spectators.

  17. Enlarged Vestibular Aqueducts and Childhood Hearing Loss

    Science.gov (United States)

    ... Infections, and Deafness Enlarged Vestibular Aqueducts and Childhood Hearing Loss On this page: What are vestibular aqueducts? How ... How are enlarged vestibular aqueducts related to childhood hearing loss? Research suggests that most children with enlarged vestibular ...

  18. Chulalongkorn vestibular balance exercise for rehabilitation in persons with various types of vestibular disorders.

    Science.gov (United States)

    Patarapak, Saowaros; Jarusripan, Paninee; Isipradit, Permsarp

    2015-01-01

    To study the efficiency of Chulalongkorn vestibular balance exercise for rehabilitation in persons with various types of vestibular disorders. Fifty-eight patients with various types of vestibular disorder were identified by a retrospective chart review. Thirty of the 58 patients met the inclusion criteria of having dizziness and unsteadiness post vestibular diseases with complete record of neuro-otologic examination; vestibular tests and had been followed-up for at least 3 month. These patients were treated with Chulalongkorn vestibular balance exercise and were evaluated for dizziness symptoms and balance bedside test at the beginning of treatment, one month and three months after the exercise. The average age of the patients was 50.34 ± 14.04 years. The average of duration of exercise program was 5.6 months. There were 6 cases of vestibular neuronitis; 5 cases of post acoustic neuroma removal; 4 cases of acute cochleovestibular loss; 3 cases of motion sickness; 2 cases of cerebellar atrophy; 3 cases of multisensory dizziness; 4 cases of post meningitis with deafness; and 3 cases of ototoxicity. After the exercise, improvement of dizziness symptoms could be found in all groups of the diseases at one month and three months. The objective of balance bedside test was improved in most cases except motion sickness, multisensory dizziness and cerebellar atrophy. The overall percentage of improvement of dizziness was statistically significant at one month and three months (p = 0.0373 and p balance bedside test was statistically improved at three months after the exercise (p = 0.034). Chulalongkorn vestibular balance exercise gave significantly effective results in the treatment of dizziness and unsteadiness from various types of vestibular disorder. This study demonstrated improvement of dizziness symptom post-exercise at one month and three months with statistical significance. The balance bedside test was also statistically significant improved at three months post-exercise.

  19. A review of the interrelationship between vestibular dysfunction ...

    African Journals Online (AJOL)

    functions, the effect of rehabilitation focused on the functioning of a specific canal, and the effect of different rehabilitation programmes on different vestibular deficiencies are suggested. Keywords: Vestibular dysfunction; Motor development; Learning disabilities; Posture; Rehabilitation and exercises. South African Journal ...

  20. Restricted loss of olivocochlear but not vestibular efferent neurons in the senescent gerbil (Meriones unguiculatus

    Directory of Open Access Journals (Sweden)

    Susanne eRadtke-Schuller

    2015-02-01

    Full Text Available Degeneration of hearing and vertigo are symptoms of age-related auditory and vestibular disorders reflecting multifactorial changes in the peripheral and central nervous system whose interplay remains largely unknown. Originating bilaterally in the brain stem, vestibular and auditory efferent cholinergic projections exert feedback control on the peripheral sensory organs, and modulate sensory processing. We studied age-related changes in the auditory and vestibular efferent systems by evaluating number of cholinergic efferent neurons in young adult and aged gerbils, and in cholinergic trigeminal neurons serving as a control for efferents not related to the inner ear. We observed a significant loss of olivocochlear neurons in aged compared to young adult animals, whereas the overall number of lateral superior olive cells was not reduced in aging. Although the loss of lateral and medial olivocochlear neurons was uniform and equal on both sides of the brain, there were frequency-related differences within the lateral olivocochlear neurons, where the decline was larger in the medial limb of the superior olivary nucleus (high frequency representation than in the lateral limb (middle-to-low frequency representation. In contrast, neither the number of vestibular efferent neurons, nor the population of motor trigeminal neurons were significantly reduced in the aged animals. These observations suggest differential effects of aging on the respective cholinergic efferent brainstem systems.

  1. Vestibular function testing.

    LENUS (Irish Health Repository)

    Lang, E E

    2010-06-01

    Vestibular symptoms of vertigo, dizziness and dysequilibrium are common complaints which can be disabling both physically and psychologically. Routine examination of the ear nose and throat and neurological system are often normal in these patients. An accurate history and thorough clinical examination can provide a diagnosis in the majority of patients. However, in a subgroup of patients, vestibular function testing may be invaluable in arriving at a correct diagnosis and ultimately in the optimal treatment of these patients.

  2. HPV vaccination: vaccine acceptance, side effects and screening intentions.

    Science.gov (United States)

    Paul-Ebhohimhen, Virginia; Huc, Sara; Tissington, Helen; Oates, Ken; Stark, Cameron

    2010-06-01

    As part of an evaluation of the introductory campaign of human papilloma virus (HPV) vaccine in a Scottish health board, self-administered questionnaires were offered to all 5007 eligible girls in school following the third dose of HPV to identify side-effects, reasons for non-vaccination and future cervical screening intentions, and 2775 (56.2%) replied. In all, 630 (23.5%) of vaccinated girls reported side effects to the vaccination, about half of which were common injection-site reactions. Main reported reasons for non-vaccination related to perceived inadequate evidence for HPV safety and efficacy, and lack of perceived need or desire to be vaccinated. A total of 2430 (89.2%) of the girls expressed plans to take up cervical screening when older. Reasons for not planning to take up cervical smear were lack of knowledge about cervical screening, anticipated discomfort or embarrassment with the process and no perceived need for a cervical smear. Unvaccinated girls were less likely to report planning to attend for cervical smears in later life (Yates chi-square = 24.30, p HPV with schoolage girls. The relationship between vaccination and screening intention, and its implications for widening the gap in health inequalities, also requires careful attention in local implementation of the national HPV vaccination programme.

  3. Local Side Effects of Sublingual and Oral Immunotherapy.

    Science.gov (United States)

    Passalacqua, Giovanni; Nowak-Węgrzyn, Anna; Canonica, Giorgio Walter

    Sublingual immunotherapy (SLIT) is increasingly used worldwide, and several products have been recently registered as drugs for respiratory allergy by the European Medicine Agency and the Food and Drug Administration. Concerning inhalant allergens, the safety of SLIT is overall superior to that of subcutaneous immunotherapy in terms of systemic adverse events. No fatality has been ever reported, and episodes of anaphylaxis were described only exceptionally. Looking at the historical and recent trials, most (>90%) adverse events are "local" and confined to the site of administration. For this reason, a specific grading system has been developed by the World Allergy Organization to classify and describe local adverse events. There is an increasing amount of literature concerning oral desensitization for food allergens, referred to as oral immunotherapy. Also, in this case, local side effects are predominant, although systemic adverse events are more frequent than with inhalant allergens. We review herein the description of local side effects due to SLIT, with a special focus on large trials having a declared sample size calculation. The use of the Medical Dictionary for Regulatory Activities nomenclature for adverse events is mentioned in this context, as recommended by regulatory agencies. It is expected that a uniform classification/grading of local adverse events will improve and harmonize the surveillance and reporting on the safety of SLIT. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  4. Unintended Side Effects of Digital Transition: Perspectives of Japanese Experts

    Directory of Open Access Journals (Sweden)

    Masahiro Sugiyama

    2017-11-01

    Full Text Available The core of the digital transition is the representation of all kinds of real-world entities and processes and an increasing number of cognitive processes by digital information and algorithms on computers. These allow for seemingly unlimited storage, operation, retrieval, and transmission capacities that make digital tools economically available for all domains of society and empower human action, particularly combined with real-world interfaces such as displays, robots, sensors, 3D printers, etc. Digital technologies are general-purpose technologies providing unprecedented potential benefits for sustainability. However, they will bring about a multitude of potential unintended side effects, and this demands a transdisciplinary discussion on unwanted societal changes as well as a shift in science from analog to digital modeling and structure. Although social discourse has begun, the topical scope and regional coverage have been limited. Here, we report on an expert roundtable on digital transition held in February 2017 in Tokyo, Japan. Drawing on a variety of disciplinary backgrounds, our discussions highlight the importance of cultural contexts and the need to bridge local and global conversations. Although Japanese experts did mention side effects, their focus was on how to ensure that AI and robots could coexist with humans. Such a perspective is not well appreciated everywhere outside Japan. Stakeholder dialogues have already begun in Japan, but greater efforts are needed to engage a broader collection of experts in addition to stakeholders to broaden the social debate.

  5. Inferior vestibular neuritis: a novel subtype of vestibular neuritis.

    Science.gov (United States)

    Zhang, D; Fan, Z; Han, Y; Yu, G; Wang, H

    2010-05-01

    To report eight cases of inferior vestibular neuritis, in order to raise awareness of this new subtype of vestibular neuritis. We retrospectively analysed 216 patients (104 males and 112 females; age range 10-64 years; mean age 38.4 years) with full clinical documentation who had attended our hospital's vertigo clinic between May 2007 and December 2008. All patients underwent systematic investigation, including hearing tests, radiology, caloric testing and vestibular evoked myogenic potential testing. Of 216 patients with vestibular neuritis, eight cases were diagnosed as inferior vestibular neuritis, based on comprehensive analysis of test data. The clinical features of these eight patients were consistent with the characteristics of vestibular neuritis. The results of pure tone audiometry and caloric testing were normal, and the possibility of central lesions was excluded by cerebral computed tomography or magnetic resonance imaging on admission. Six cases had unilateral loss of vestibular evoked myogenic potentials, whereas two had a unilateral lower amplitude of vestibular evoked myogenic potentials. Inferior vestibular neuritis is a novel subtype of vestibular neuritis, which involves the inferior vestibular nerve alone. Vestibular evoked myogenic potential testing is a useful aid to the diagnosis of inferior vestibular neuritis.

  6. Effects of Stochastic Vestibular Galvanic Stimulation and LDOPA on Balance and Motor Symptoms in Patients With Parkinson's Disease.

    Science.gov (United States)

    Samoudi, Ghazaleh; Jivegård, Maria; Mulavara, Ajitkumar P; Bergquist, Filip

    2015-01-01

    Balance problems contribute to reduced quality of life in Parkinson's disease (PD) and available treatments are often insufficient for treating axial and postural motor symptoms. To investigate the safety of use and possible effects of stochastic vestibular stimulation (SVS) alone and combined with LDOPA in patients with PD. SVS or sham stimulation was administered to 10 PD patients in a double-blind placebo controlled cross-over pilot study. Motor symptoms and balance were evaluated in a defined off-medication state and after a 200 mg test dose of LDOPA, using UPDRS-III, Posturo-Locomotor-Manual (PLM) movement times (MT), static posturography and force plate measurements of the correcting response to a balance perturbation. Patients did not detect when SVS was active, but SVS increased nausea after LDOPA in two patients. Mixed model analysis demonstrated that SVS improved balance corrections after a backward perturbation and shortened the postural response time. In static posturography there was significant interaction between effects of SVS, medication and proprioceptive input (standing on foam vs. on hard support) and SVS decreased the total sway-path with eyes closed and off medication. As expected, LDOPA improved the UPDRS-III scores and MT. There was an interaction between the effect of SVS and LDOPA on UPDRS-III partly because of reduced UPDRS-III scores with SVS in the off-medication state. Short term use of SVS is safe, improves corrective postural responses and may have a small positive effect on motor symptoms in PD patients off treatment. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Deregulated genes in sporadic vestibular schwannomas

    DEFF Research Database (Denmark)

    Cayé-Thomasen, Per; Helweg-Larsen, Rehannah Holga Andrea; Stangerup, Sven-Eric

    2010-01-01

    In search of genes associated with vestibular schwannoma tumorigenesis, this study examines the gene expression in human vestibular nerve versus vestibular schwannoma tissue samples using microarray technology.......In search of genes associated with vestibular schwannoma tumorigenesis, this study examines the gene expression in human vestibular nerve versus vestibular schwannoma tissue samples using microarray technology....

  8. Ageusia as a side effect of clopidogrel treatment

    Science.gov (United States)

    Ksouda, Kamilia; Affes, Hanen; Hammami, Boutheyna; Sahnoun, Zouheir; Atheymen, Rim; Hammami, Serria; Zeghal, Khaled Mounir

    2011-01-01

    Clopidogrel is prescribed in cardiac and extracardiac vascular diseases. It is generally well tolerated; however, few cases of taste disorders have been reported. We present a case of clopidogrel-induced ageusia notified in Sfax pharmacovigilance center on March 13, 2009. A 46-year-old patient developed ageusia with decreased appetite five weeks after starting clopidogrel. Other etiologies including ear nose throat (ENT) examination were ruled out. Five months after reduction of clopidogrel dose, ageusia partially decreased. Clopidogrel was strongly suspected as a causal drug. According to the French imputation method, score of imputability was considered as plausible (C2S2) I2. Physiopathology of this side effect is not yet understood. However, it seems to be a reversible and dose-related event. Although it is not life-threatening, loss of taste can have significant effect on the quality of life of patients. PMID:21713046

  9. Depression as a side effect of the contraceptive pill.

    Science.gov (United States)

    Kulkarni, Jayashri

    2007-07-01

    Millions of women worldwide use the combined oral contraceptive pill as an effective form of contraception. However, the focus on its side effects to date has mainly been on physical aspects, even though the most commonly stated reason for discontinuation is depression. There are surprisingly few large studies investigating depression related to oral contraceptive use. A pilot study was conducted showing that women using the combined oral contraceptive pill were significantly more depressed than a matched group who were not. More research is needed to better inform women and doctors about depression related to oral contraceptive use, and clinical guidelines are needed regarding the different types of oral contraceptives and their potential depressogenic properties.

  10. Ocular side effect of tinidazole: A rare case report

    Directory of Open Access Journals (Sweden)

    Hina Kauser

    2014-01-01

    Full Text Available Ocular side effects in the form of punctate epithelial erosions with the use of tinidazole - a 5-nitroimidazole group of drugs is very rare. A 32-year-old male was prescribed tablet tinidazole for the treatment of amoebiasis but developed adverse effects in the form of blisters on both upper and lower lips with itching and burning sensation, itching and burning on penile and anal area associated with punctate epithelial erosions of cornea of both the eyes. All these are rare manifestations but punctate epithelial erosions of cornea has never been reported in the literature so far. Punctate epithelial erosions of cornea have not previously been reported and should be added to the list of complications of tinidazole. Hence, this case is being reported .

  11. Gastrointestinal Side Effects of Antiarrhythmic Medications: A Review of Current Literature.

    Science.gov (United States)

    Amjad, Waseem; Qureshi, Waqas; Farooq, Ali; Sohail, Umair; Khatoon, Salma; Pervaiz, Sarah; Narra, Pratyusha; Hasan, Syeda M; Ali, Farman; Ullah, Aman; Guttmann, Steven

    2017-09-03

    Antiarrhythmic drugs are commonly prescribed cardiac drugs. Due to their receptor mimicry with several of the gastrointestinal tract receptors, they can frequently lead to gastrointestinal side effects. These side effects are the most common reasons for discontinuation of these drugs by the patients. Knowledge of these side effects is important for clinicians that manage antiarrhythmic drugs. This review focuses on the gastrointestinal side effects of these drugs and provides a detailed up-to-date literature review of the side effects of these drugs. The review provides case reports reported in the literature as well as possible mechanisms that lead to gastrointestinal side effects.

  12. Compensation of Vestibular Function and Plasticity of Vestibular Nucleus after Unilateral Cochleostomy

    OpenAIRE

    Suh, Myung-Whan; Hyun, Jaihwan; Lyu, Ah-Ra; Kim, Dong Woon; Park, Sung Jae; Choi, Jin Woong; Hur, Gang Min; Park, Yong-Ho

    2016-01-01

    Dizziness and vertigo frequently occur after cochlear implantation (CI) surgery, particularly during the early stages. It could recover over time but some of the patients suffered from delayed or sustained vestibular symptoms after CI. This study used rat animal models to investigate the effect of unilateral cochleostomy on the vestibular organs over time. Twenty-seven Sprague Dawley rats underwent cochleostomy to evaluate the postoperative changes in hearing threshold, gain and symmetry of t...

  13. Corticoterapia: minimizando efeitos colaterais Glucocorticoid therapy: minimizing side effects

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Longui

    2007-11-01

    Full Text Available OBJETIVO: Ressaltar os principais efeitos indesejáveis durante a corticoterapia, o mecanismo de seu desencadeamento e as medidas necessárias para minimizar os efeitos colaterais. FONTES DOS DADOS: Experiência do autor, complementada com trabalhos publicados no MEDLINE. SÍNTESE DOS DADOS: Os princípios para que se minimizem os efeitos indesejáveis da corticoterapia incluem: a indicação rígida em que o uso do glicocorticóide seja essencial; b evitar o uso de glicocorticóides de ação prolongada, preferindo glicocorticóide de ação curta ou intermediária; c reduzir ao m��nimo necessário a duração do tratamento, visto que tratamentos com duração entre 5 e 7 dias apresentam poucos efeitos colaterais e rápida recuperação do eixo hipotalâmico-hipofisário; d preferir glicocorticóides de ação local, como glicocorticóides inalatórios; e associação com outros fármacos, em especial outros antiinflamatórios ou imunossupressores mais específicos, buscando efeitos sinérgicos que permitam evitar o uso de glicocorticóides ou reduzir a dose e o tempo da corticoterapia; f oferecer a menor dose necessária para o efeito desejado, respeitando a sensibilidade de cada indivíduo aos glicocorticóides. CONCLUSÕES: o conhecimento das características farmacológicas e ações biológicas dos glicocorticóides permite a melhor opção terapêutica quanto à indicação, dose, via de administração e duração da corticoterapia.OBJECTIVE:To describe the main undesirable side effects of glucocorticoid therapy, mechanisms of action and the necessary measures to minimize side effects. SOURCES: Author's experience, supplemented with papers published in MEDLINE. SUMMARY OF THE FINDINGS: The principles for minimizing undesirable side effects of glucocorticoid therapy include: a only use glucocorticoids if they are essential; b avoid the use of long-acting glucocorticoids, using short- and intermediate-acting glucocorticoids instead; c

  14. Effects of Electrical Stimulation of the Rat Vestibular Labyrinth on c-Fos Expression in the Hippocampus.

    Science.gov (United States)

    Hitier, Martin; Sato, Go; Zhang, Yan-Feng; Besnard, Stephane; Smith, Paul F

    2018-04-22

    Several studies have demonstrated that electrical activation of the peripheral vestibular system can evoke field potential, multi-unit neuronal activity and acetylcholine release in the hippocampus (HPC). However, no study to date has employed the immediate early gene protein, c-Fos, to investigate the distribution of activation of cells in the HPC following electrical stimulation of the vestibular system. We found that vestibular stimulation increased the number of animals expressing c-Fos in the dorsal HPC compared to sham control rats (P ≤ 0.02), but not in the ventral HPC. c-Fos was also expressed in an increased number of animals in the dorsal dentate gyrus (DG) compared to sham control rats (P ≤ 0.0001), and to a lesser extent in the ventral DG (P ≤ 0.006). The results of this study show that activation of the vestibular system results in a differential increase in the expression of c-Fos across different regions of the HPC. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. The effect of bevacizumab on vestibular schwannoma tumour size and hearing in patients with neurofibromatosis type 2

    DEFF Research Database (Denmark)

    Alanin, Mikkel Christian; Klausen, Camilla; Caye-Thomasen, Per

    2015-01-01

    The hallmark of neurofibromatosis type 2 (NF2) is bilateral vestibular schwannomas (VS) and severe hearing loss is common in NF2 patients. Vascular endothelial growth factor (VEGF) expression level in NF2 correlates with tumour growth rate and bevacizumab, a VEGF-binding antibody, has previously...

  16. Neuromuscular responses to incremental caffeine doses: performance and side effects.

    Science.gov (United States)

    Pallarés, Jesús G; Fernández-Elías, Valentín E; Ortega, Juan F; Muñoz, Gloria; Muñoz-Guerra, Jesús; Mora-Rodríguez, Ricardo

    2013-11-01

    The purpose of this study was to determine the oral dose of caffeine needed to increase muscle force and power output during all-out single multijoint movements. Thirteen resistance-trained men underwent a battery of muscle strength and power tests in a randomized, double-blind, crossover design, under four different conditions: (a) placebo ingestion (PLAC) or with caffeine ingestion at doses of (b) 3 mg · kg(-1) body weight (CAFF 3mg), (c) 6 mg · kg(-1) (CAFF 6mg), and (d) 9 mg · kg(-1) (CAFF 9mg). The muscle strength and power tests consisted in the measurement of bar displacement velocity and muscle power output during free-weight full-squat (SQ) and bench press (BP) exercises against four incremental loads (25%, 50%, 75%, and 90% one-repetition maximum [1RM]). Cycling peak power output was measured using a 4-s inertial load test. Caffeine side effects were evaluated at the end of each trial and 24 h later. Mean propulsive velocity at light loads (25%-50% 1RM) increased significantly above PLAC for all caffeine doses (5.4%-8.5%, P = 0.039-0.003). At the medium load (75% 1RM), CAFF 3mg did not improve SQ or BP muscle power or BP velocity. CAFF 9mg was needed to enhance BP velocity and SQ power at the heaviest load (90% 1RM) and cycling peak power output (6.8%-11.7%, P = 0.03-0.05). The CAFF 9mg trial drastically increased the frequency of the adverse side effects (15%-62%). The ergogenic dose of caffeine required to enhance neuromuscular performance during a single all-out contraction depends on the magnitude of load used. A dose of 3 mg · kg(-1) is enough to improve high-velocity muscle actions against low loads, whereas a higher caffeine dose (9 mg · kg(-1)) is necessary against high loads, despite the appearance of adverse side effects.

  17. Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo?

    OpenAIRE

    A. Greco; G. F. Macri; A. Gallo; M. Fusconi; A. De Virgilio; G. Pagliuca; C. Marinelli; M. de Vincentiis

    2014-01-01

    Objectives. To review the current knowledge of the aetiology of vestibular neuritis including viral infections, vascular occlusion, and immunomediated mechanisms and to discuss the pathogenesis with relevance to pharmacotherapy. Systematic Review Methodology. Relevant publications on the aetiology and treatment of vestibular neuritis from 1909 to 2013 were analysed. Results and Conclusions. Vestibular neuritis is the second most common cause of peripheral vestibular vertigo and is due to a su...

  18. Effects of balance Vestibular Rehabilitation Therapy in elderly with Benign Paroxysmal Positional Vertigo: a randomized controlled trial.

    Science.gov (United States)

    Ribeiro, Karyna Myrelly Oliveira Bezerra de Figueiredo; Freitas, Raysa Vanessa de Medeiros; Ferreira, Lidiane Maria de Brito Macedo; Deshpande, Nandini; Guerra, Ricardo Oliveira

    2017-06-01

    To evaluate short-term effects of balance Vestibular Rehabilitation Therapy (VRT) on balance, dizziness symptoms and quality of life of the elderly with chronic Benign Paroxysmal Positional Vertigo (BPPV). In this randomized, single-blind and controlled trial, older adults with chronic BPPV were randomized into two groups, the experimental group (n = 7, age: 69 (65-78) years) and the control group (n = 7, age: 73 (65-76) years). Patients in the experimental group underwent balance VRT (50 min per session, two times a week) and Canalith Repositioning Maneuver (CRM) as required, for 13 weeks. The control group was treated using only CRM as required. Standing and dynamic balance, dizziness symptoms and quality of life were measured at the baseline, and at one, five, nine and thirteen weeks. There were no between-group differences in dizziness, quality of life and standing balance over the 13 weeks. Significant differences were observed in dynamic balance measures between groups (p CRM. Implications for Rehabilitation The findings that balance VRT in addition to CRM improves dynamic balance in elderly people with BPPV should be useful in guiding rehabilitation professionals' clinical decision making to design interventions for seniors suffering from BPPV; Improvements in tests of dynamic balance suggest that the risk of adverse consequences of BPPV in the elderly such as falls and fractures can be potentially reduced through implementation of CRM in conjunction with balance VRT; Lack of additional improvement in Visual Analogue Scale of dizziness and Dizziness Handicap Index suggests that addition of balance VRT does not influence dizziness symptomatology, per se, and CRM alone is effective to ameliorate vertiginous symptoms and potentially improve quality of life.

  19. Price Competition in Two-Sided Markets with Heterogeneous Consumers and Network Effects

    NARCIS (Netherlands)

    Filistrucchi, L.; Klein, T.J.

    We model a two-sided market with heterogeneous customers and two heterogeneous network effects. In our model, customers on each market side care differently about both the number and the type of customers on the other side. Examples of two-sided markets are online platforms or daily newspapers. In

  20. Optic and otic side effects of molecular targeted therapies.

    Science.gov (United States)

    O'Leary, Colleen

    2014-08-01

    To discuss the optic and otic toxicities associated with molecular targeted therapies including description, presentation, grading, and management of these toxicities. PubMed, CINAHL, the Cochrane Library and nursing text books. Although targeted therapies often do not have the same systemic toxicities as chemotherapy, they have their own unique side effects. Optic and otic toxicities are seen with a variety of targeted therapies and, although these are not life-threatening toxicities, they do have the potential to severely impair a patient's quality of life. Baseline optic and otic assessments along with periodic assessments throughout treatment can lead to early recognition of problems with the eyes or ears. Recognition and treatment of these problems will help maintain the patient's quality of life. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Psychiatric side effects of mefloquine: applications to forensic psychiatry.

    Science.gov (United States)

    Ritchie, Elspeth Cameron; Block, Jerald; Nevin, Remington Lee

    2013-01-01

    Mefloquine (previously marketed in the United States as Lariam®) is an antimalarial medication with potent psychotropic potential. Severe psychiatric side effects due to mefloquine intoxication are well documented, including anxiety, panic attacks, paranoia, persecutory delusions, dissociative psychosis, and anterograde amnesia. Exposure to the drug has been associated with acts of violence and suicide. In this article, we discuss the history of mefloquine use and describe plausible mechanisms of its psychotropic action. Mefloquine intoxication has not yet been successfully advanced in legal proceedings as a defense or as a mitigating factor, but it appears likely that it eventually will be. Considerations for the application of claims of mefloquine intoxication in forensic settings are discussed.

  2. Side-effects of improving CERN's spam filter

    CERN Multimedia

    2004-01-01

    To further improve the fight against spam (unsolicited email), CERN implemented in June a mechanism that returns electronic mail messages to the sender if the originating server is wrongly configured. This "reverse DNS lookup" is an increasingly widespread technique to identify whether the sending e-mail server is legitimate and has a valid host name. This change has nearly doubled the spam rejection efficiency at CERN. However, it has a known side-effect. A small number of correspondents are sending legitimate electronic mail to CERN from mail servers that are incorrectly configured (in technical terms, they do not have a reverse DNS registration). These persons will have their messages returned to them with an error message, provided their sender address is valid. The typical error message that the correspondent receives in such cases is "Relaying denied. No reverse DNS configured for IP". If a correspondent complains to you that emails they are sending you at CERN are being returned with...

  3. Top- and side-gated epitaxial graphene field effect transistors

    Energy Technology Data Exchange (ETDEWEB)

    Li, Xuebin; Wu, Xiaosong; Sprinkle, Mike; Ming, Fan; Ruan, Ming; Hu, Yike; De Heer, Walt A. [Georgia Institute of Technology, School of Physics, Atlanta, GA (United States); Berger, Claire [Georgia Institute of Technology, School of Physics, Atlanta, GA (United States); CNRS-Institut Neel, Grenoble (France)

    2010-02-15

    Three types of first generation epitaxial graphene (EG) field effect transistors (FET) are presented and their relative merits are discussed. Graphene is epitaxially grown on both the carbon and silicon faces of hexagonal silicon carbide and patterned with electron beam lithography. The channels have a Hall bar geometry to facilitate magnetoresistance measurements. FETs patterned on the Si-face exhibit off-to-on channel resistance ratios that exceed 30. C-face FETs have lower off-to-on resistance ratios, but their mobilities (up to 5000 cm{sup 2}/Vs) are much larger than that for Si-face transistors. Initial investigations into all-graphene side-gate FET structures are promising. Conductivity (left panel) and transport resistances {rho}{sub xx} and {rho}{sub xy} of a top gate graphene Hall bar on SiC Si-face, showing a sign reversal of the hall coefficient at the resistance peak. (Abstract Copyright [2010], Wiley Periodicals, Inc.)

  4. Imitations and Transformations: On Side Effects of the ADHD Epidemic.

    Science.gov (United States)

    Nielsen, Bjarke

    2017-04-01

    The attention deficit hyperactivity disorder epidemic has been the subject of much scrutiny, especially in relation to the medicalization of children, and, to a lesser degree, to the use of Ritalin as a performance enhancer or party drug (e.g., Keane 2008; Whitaker 2010; Bowden 2013). In this article, my focus is on non-investigated side effects of this epidemic, namely the use of (prescription) Ritalin among heavy drug users. Based on fieldwork conducted in one of the largest cities in Denmark, in this article I trace the spread of intravenous use of Ritalin, and examine how different ways of ingesting Ritalin transform the drug itself, and, with this, transform treatment practices, parts of the drug scene, and the bodies of users. In my analysis, I draw on insights from anthropological theories on imitation and from material semiotics.

  5. Measles Vaccine : A Study On Seroconversion And Side Effects

    Directory of Open Access Journals (Sweden)

    Malik Abida

    1998-01-01

    Full Text Available Research Question: 1. What is the extent of immune response of Edmonston Zagreb Strain in children? 2. What are the side effects of this vaccine? Objectives: 1. To follow up children after Edmonston Zagreb strain vaccination for evaluation of seroconverstion. Study: Cross sectional Setting: Well Baby Clinic of pediatrics OPD at J.N. Medical College, A.M.U., Aigarh (U.P participants: Children between 9-15 months. Sample Size: 100 consecutive children coming for routine immunization. Study variable: Malnourished and poor socio-economic status Outcome variable: Extent of seroconversion with no statistical significant difference between malnourished and socio-economically poor children. 26% showed minor self-limiting post vaccination reactions in all age groups. Recommendations: Edmonston Zagreb measles vaccine is recommended since it has very good immunogenic activity and post vaccination reactions.

  6. CT study in infantile spasms. Side effects of ACTH therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kumagai, K.; Ota, H.; Tamai, I.; Hotta, H.; Kubo, M. (Jikei Univ., Tokyo (Japan). School of Medicine)

    1981-05-01

    For reevaluation of ACTH therapy for infantile spasms, side effects of the therapy were investigated. 1) Susceptibility to diseases: Eight of 16 patients developed serious infectious diseases within one to two months after initiation of the therapy. 2) Electrolyte metabolism: Evaluation of 13 cases revealed the low serum-P concentration and the high serum-Na concentration. 3) Cerebral contraction: Cerebral contraction was noted in all of the ten cases which were examined by CT. Serial CT scanning in one case revealed a remarkable contraction of the brain 6 weeks after initiation of the therapy, nevertheless seizures disappeared and EEG recovered. CT findings recovered to normal 4 months after withdrawal of ACTH therapy.

  7. Radiotherapy and "new" drugs-new side effects?

    Science.gov (United States)

    2011-01-01

    Background and purpose Targeted drugs have augmented the cancer treatment armamentarium. Based on the molecular specificity, it was initially believed that these drugs had significantly less side effects. However, currently it is accepted that all of these agents have their specific side effects. Based on the given multimodal approach, special emphasis has to be placed on putative interactions of conventional cytostatic drugs, targeted agents and other modalities. The interaction of targeted drugs with radiation harbours special risks, since the awareness for interactions and even synergistic toxicities is lacking. At present, only limited is data available regarding combinations of targeted drugs and radiotherapy. This review gives an overview on the current knowledge on such combined treatments. Materials and methods Using the following MESH headings and combinations of these terms pubmed database was searched: Radiotherapy AND cetuximab/trastuzumab/panitumumab/nimotuzumab, bevacizumab, sunitinib/sorafenib/lapatinib/gefitinib/erlotinib/sirolimus, thalidomide/lenalidomide as well as erythropoietin. For citation crosscheck the ISI web of science database was used employing the same search terms. Results Several classes of targeted substances may be distinguished: Small molecules including kinase inhibitors and specific inhibitors, antibodies, and anti-angiogenic agents. Combination of these agents with radiotherapy may lead to specific toxicities or negatively influence the efficacy of RT. Though there is only little information on the interaction of molecular targeted radiation and radiotherapy in clinical settings, several critical incidents are reported. Conclusions The addition of molecular targeted drugs to conventional radiotherapy outside of approved regimens or clinical trials warrants a careful consideration especially when used in conjunction in hypo-fractionated regimens. Clinical trials are urgently needed in order to address the open question in regard

  8. Adverse side effects of statins in the oral cavity.

    Science.gov (United States)

    Pascual Cruz, Montserrat; Chimenos Küstner, Eduardo; García Vicente, José António; Mezquiriz Ferrero, Xavier; Borrell Thio, Eulalia; López López, José

    2008-02-01

    Increased plasma levels of cholesterol are high risk factors of cardiovascular disease. Statins are drugs that inhibit cholesterol synthesis at both pancreatic and extrahepathic levels, being the treatment of choice for hypercholesterolemia. To analyze the side effects of statins in the mouth cavity, and to analyze the symptoms after interruption of the treatment. Observational study, preliminary. Patients aged 50-70, diagnosed with hypercholesterolemia and undergoing treatment with statins, referred from their primary care physician to the dentist's office. Anamnesis over oral symptoms was performed in the first visit. Statin treatment was discontinued, followed by lab tests and control visits seven and fifteen days later. We monitored the improvement and/or remission of oral symptoms. Statin treatment was resumed, sending out a report of the patient evolution to the PCP. Symptoms were registered in sheet specially designed for the study. patient refusal, use of drugs for dry mouth treatment, Sjögren's syndrome. n=26 patients. Dry mouth patients: improvement in 17 out of 23 patients (88.5%). Itchiness: 6 out of 15 cases improved (57.7%). Bitterness: improvement in 13 out of 14 patients (53.8%). Cough: improvement in 11 out of 12 patients (46.1%). A high percentage of oral symptoms are associated to treatment with statins. There is a marked improvement after temporary interruption of the treatment. Little is known regarding the side effects of oral treatment with statins. This preliminary study includes a relatively small number of patients. The design of experimental treatments will be required to establish a true correlation between statin treatment and oral symptoms.

  9. Radiotherapy and "new" drugs-new side effects?

    Directory of Open Access Journals (Sweden)

    Niyazi Maximilian

    2011-12-01

    Full Text Available Abstract Background and purpose Targeted drugs have augmented the cancer treatment armamentarium. Based on the molecular specificity, it was initially believed that these drugs had significantly less side effects. However, currently it is accepted that all of these agents have their specific side effects. Based on the given multimodal approach, special emphasis has to be placed on putative interactions of conventional cytostatic drugs, targeted agents and other modalities. The interaction of targeted drugs with radiation harbours special risks, since the awareness for interactions and even synergistic toxicities is lacking. At present, only limited is data available regarding combinations of targeted drugs and radiotherapy. This review gives an overview on the current knowledge on such combined treatments. Materials and methods Using the following MESH headings and combinations of these terms pubmed database was searched: Radiotherapy AND cetuximab/trastuzumab/panitumumab/nimotuzumab, bevacizumab, sunitinib/sorafenib/lapatinib/gefitinib/erlotinib/sirolimus, thalidomide/lenalidomide as well as erythropoietin. For citation crosscheck the ISI web of science database was used employing the same search terms. Results Several classes of targeted substances may be distinguished: Small molecules including kinase inhibitors and specific inhibitors, antibodies, and anti-angiogenic agents. Combination of these agents with radiotherapy may lead to specific toxicities or negatively influence the efficacy of RT. Though there is only little information on the interaction of molecular targeted radiation and radiotherapy in clinical settings, several critical incidents are reported. Conclusions The addition of molecular targeted drugs to conventional radiotherapy outside of approved regimens or clinical trials warrants a careful consideration especially when used in conjunction in hypo-fractionated regimens. Clinical trials are urgently needed in order to

  10. Minoxidil use in dermatology, side effects and recent patents.

    Science.gov (United States)

    Rossi, Alfredo; Cantisani, Carmen; Melis, Luca; Iorio, Alessandra; Scali, Elisabetta; Calvieri, Stefano

    2012-05-01

    Minoxidil, a vasodilator medication known for its ability to slow or stop hair loss and promote hair regrowth, was first introduced, exclusively as an oral drug, to treat high blood pressure. It was however discovered to have the important side-effect of increasing growth or darkening of fine body hairs; this led to the development of a topical formulation as a 2% concentration solution for the treatment of female androgenic alopecia or 5% for treating male androgenic alopecia. Measurable changes disappear within months after discontinuation of treatment. The mechanism by which it promotes hair growth is not fully understood. Minoxidil is a potassium channel opener, causing hyperpolarization of cell membranes and it is also a vasodilator, it is speculated that, by widening blood vessels and opening potassium channels, it allows more oxygen, blood and nutrients to the follicle. This can also cause follicles in the telogen phase to shed, usually soon to be replaced by new, thicker hairs in a new anagen phase. It needs to be applied regularly, once or twice daily, for hair gained to be maintained, and side effects are common. The most common adverse reactions of the topical formulation are limited to irritant and allergic contact dermatitis on the scalp. There have been cases of allergic reactions to the nonactive ingredient propylene glycol, which is found in some topical solution especially if they are galenic. Increased hair loss which can occur during Minoxidil use, is due to the synchronization of the hair cycle that the treatment induces. In this review, we described its mechanism of action, use in dermatology and some patents related to alternative treatment of allergic reactions due to its use.

  11. Hereditary familial vestibular degenerative diseases.

    NARCIS (Netherlands)

    Sun, J.; Alphen, A.M. van; Wagenaar, M.; Huygen, P.L.M.; Hoogenraad, C.C.; Hasson, T.; Koekkoek, S.K.; Bohne, B.A.; Zeeuw, C.I. de

    2001-01-01

    Identification of genes involved in hereditary vestibular disease is growing at a remarkable pace. Mutant mouse technology can be an important tool for understanding the biological mechanism of human vestibular diseases.

  12. Genetic contribution to vestibular diseases.

    Science.gov (United States)

    Gallego-Martinez, Alvaro; Espinosa-Sanchez, Juan Manuel; Lopez-Escamez, Jose Antonio

    2018-03-26

    Growing evidence supports the contribution of allelic variation to vestibular disorders. Heritability attributed to rare allelic variants is found in familial vestibular syndromes such as enlarged vestibular aqueduct syndrome or familial Meniere disease. However, the involvement of common allelic variants as key regulators of physiological processes in common and rare vestibular diseases is starting to be deciphered, including motion sickness or sporadic Meniere disease. The genetic contribution to most of the vestibular disorders is still largely unknown. This review will outline the role of common and rare variants in human genome to episodic vestibular syndromes, progressive vestibular syndrome, and hereditary sensorineural hearing loss associated with vestibular phenotype. Future genomic studies and network analyses of omic data will clarify the pathway towards a personalized stratification of treatments.

  13. Revisão sistemática sobre os efeitos da reabilitação vestibular em adultos de meia-idade e idosos A systematic review about the effects of the vestibular rehabilitation in middle-age and older adults

    Directory of Open Access Journals (Sweden)

    Natalia A. Ricci

    2010-10-01

    ELO, Cochrane, ISI Web of Knowledge and virtual libraries of theses and dissertations. Randomized controlled trials published in the last 10 years and written in English, Portuguese or Spanish were included. The methodological quality of the studies was assessed by the PEDro scale. Results from the included studies were analyzed through a critical review of content. RESULTS: Nine studies were included in the review. Four studies reported on participants aged over 40 years (middle-aged and elderly and five studies consisted exclusively of elderly subjects (over 60 years. Findings of vestibular dysfunction were diverse and the most common complaints were body imbalance or postural instability (3 studies, and vertigo or dizziness (3 studies. The Visual Analogue Scale (VAS was the most commonly used instrument to assess subjective perception of symptoms of vestibular dysfunction (4 studies. According to the PEDro scale, four studies were considered to be of good quality. The most common experimental intervention was the Cawthorne & Cooksey protocol (4 studies. For most outcome measures, the studies comparing VR with another type of intervention showed no differences between the groups after the therapy. CONCLUSIONS: The studies included in this review provide evidence for the positive effects of VR in elderly and middle-aged adults with vestibular disturbances.

  14. A unified frame of predicting side effects of drugs by using linear neighborhood similarity.

    Science.gov (United States)

    Zhang, Wen; Yue, Xiang; Liu, Feng; Chen, Yanlin; Tu, Shikui; Zhang, Xining

    2017-12-14

    Drug side effects are one of main concerns in the drug discovery, which gains wide attentions. Investigating drug side effects is of great importance, and the computational prediction can help to guide wet experiments. As far as we known, a great number of computational methods have been proposed for the side effect predictions. The assumption that similar drugs may induce same side effects is usually employed for modeling, and how to calculate the drug-drug similarity is critical in the side effect predictions. In this paper, we present a novel measure of drug-drug similarity named "linear neighborhood similarity", which is calculated in a drug feature space by exploring linear neighborhood relationship. Then, we transfer the similarity from the feature space into the side effect space, and predict drug side effects by propagating known side effect information through a similarity-based graph. Under a unified frame based on the linear neighborhood similarity, we propose method "LNSM" and its extension "LNSM-SMI" to predict side effects of new drugs, and propose the method "LNSM-MSE" to predict unobserved side effect of approved drugs. We evaluate the performances of LNSM and LNSM-SMI in predicting side effects of new drugs, and evaluate the performances of LNSM-MSE in predicting missing side effects of approved drugs. The results demonstrate that the linear neighborhood similarity can improve the performances of side effect prediction, and the linear neighborhood similarity-based methods can outperform existing side effect prediction methods. More importantly, the proposed methods can predict side effects of new drugs as well as unobserved side effects of approved drugs under a unified frame.

  15. Use of galvanic vestibular feedback for a balance prosthesis.

    Science.gov (United States)

    Peterka, Robert J

    2012-01-01

    Activation of vestibular afferents by a bilateral bipolar galvanic vestibular stimulus (GVS) evokes medial-lateral (ML) body sway. By applying a GVS feedback signal that is a function of measured ML head motion, the potential exists for GVS to restore a useful vestibular contribution to ML balance control in vestibular-deficient subjects who remain responsive to GVS. A key to developing an effective balance prosthesis using GVS is to determine the functional relationship between GVS and its influence on the brain's internal estimate of head motion. We describe how a model-based interpretation of GVS-evoked body sway can be used to identify this functional relationship. Results indicate that the GVS-evoked internal motion estimate is effectively a low-pass filtered version of the GVS current. With preliminary data, we demonstrate that GVS feedback, compensated for the identified low-pass characteristics, can either remove the ability of a subject with normal vestibular function to use vestibular information for balance control, or can restore the ability of a subject with bilateral vestibular loss to maintain balance in a condition requiring vestibular information for balance control.

  16. Female sterilization: update on clinical efficacy, side effects and contraindications.

    Science.gov (United States)

    Gizzo, Salvatore; Bertocco, Anna; Saccardi, Carlo; Di Gangi, Stefania; Litta, Pietro Salvatore; D'antona, Donato; Nardelli, Giovanni Battista

    2014-10-01

    The aim of this review is to compare studies concerning female sterilization in order to define the most suitable approach and device for each patient considering timing, safety, cost-effectiveness, failure rate, complication rate and patient satisfaction. A systematic literature search was conducted in electronic databases MEDLINE-EMBASE-Sciencedirect and Cochrane Library between 2000 and 2012. All original descriptions, case reports, retrospective and review articles on tubal sterilization methods have been considered. Outcome measures were effectiveness, tolerability, procedure complications and female satisfaction. The ideal female sterilization system should be a simple, safe, highly efficient, easily learned, inexpensive, one-time procedure without negative side-effects. Nowadays, the trans-cervical approach is associated with minimal postoperative pain, allowing short hospitalization and fast resumption of daily activities. Laparoscopic and laparotomic approaches are considered second choices, since, particularly in developing countries, the transcervical hysteroscopic methods will increasingly spread within gynaecological clinical practice. Safety issues, hospital stay, costs and surgeons' experience are important factors in decision-making of the method for female sterilization. Hysteroscopic devices should be preferred when possible. The counselling time remains a fundamental step in choice. The decision concerning method depends on the setting, the surgeon's experience, the country's economical development and the woman's preference.

  17. A self-rating scale for patient-perceived side effects of inhaled corticosteroids

    NARCIS (Netherlands)

    Foster, Juliet M.; van Sonderen, Eric; Lee, Amanda J.; Sanderman, Robbert; Dijkstra, Antoon; Postma, Dirkje S.; van der Molen, Thys

    2006-01-01

    Background: Patient-reported side effect questionnaires offer a simple method for the systematic measurement of drug-related side effects. In order to measure patients' inhaled corticosteroids (ICS) related side effect perceptions the 14-day retrospective Inhaled Corticosteroid Questionnaire (ICQ)

  18. Vestibular Dysfunctions in Cochlear Implant Patients; A Vestibular Evoked Myogenic Potential Study

    Directory of Open Access Journals (Sweden)

    Masoud Motasaddi Zarandy

    2011-12-01

    Full Text Available Background and Aim: Vestibular evoked myogenic potential in response to click or short tone burst stimuli have been used as a clinical test for distinguish saccule and inferior vestibular nerve diseases. Different studies show that cochlear implant could have inverse effects on vestibular structures. We aimed to investigate vestibular evoked myogenic potential in unilateral cochlear implanted individuals in compare to normal individuals.Methods: Thirty-three unilateral cochlear implanted patients (mean age 19.96 years and 30 normal hearing individuals (mean age 24-27 years as control group were enrolled in this cross- sectional study. Absolute latencies and amplitudes of myogenic potential responses were measured and compared in both groups.Results: Myogenic potential recorded in both ears of all controls were normal. No response could be recorded in 16 patients (48.48% from both ears. In three patients, responses were recorded in both ears though the amplitude of waves was reduced in implanted ear. Unilateral response could be recorded in 14 patients only in their non-implanted ear.Conclusion: Vestibular evoked myogenic potential test is a useful tool for assessing saccular function in cochlear implant patients. Damages of osseous spiral lamina and basilar membrane after cochlear implantation could result in dysfunctions of vestibular organs specially saccule. It seems that saccule could be easily damaged after cochlear implantation. This would cause absence or reduced amplitudes in myogenic potential.

  19. Contrasting results of tests of peripheral vestibular function in patients with bilateral large vestibular aqueduct syndrome.

    Science.gov (United States)

    Zhou, Yu-Juan; Wu, Yong-Zhen; Cong, Ning; Yu, Jing; Gu, Jun; Wang, Jing; Chi, Fang-Lu

    2017-08-01

    To analyze and summarize the effect of bilateral large vestibular aqueducts in peripheral vestibular organ function. Eighteen patients with bilateral large vestibular aqueduct syndrome (LVAS; Study Group) and 18 healthy volunteers (Control Group) were investigated using audiometry, caloric test, sensory organization test (SOT), and vestibular-evoked myogenic potential (VEMP) tests. All 18 patients (36 ears) exhibited sensorineural hearing loss. For cervical VEMP (cVEMP), the Study Group showed lower thresholds (Study Group vs. 71.4vs. 75.3dBnHL; p=0.006), N1 latencies (24.1vs. 25.2ms; p=0.026) and shorter P1 (15.3vs. 16.6ms; p=0.003), and higher amplitudes (400.7vs. 247.2µV; pvestibular test in otolithic organs and the hypofunction of vestibular test in semicircular canals, as well as the dysfunction in the balance test were demonstrated in patients with LVAS. Our findings can help clinicians gain a better understanding of the characteristics of vestibular organ function in patients with LVAS, which can facilitate optimal targeted treatment. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  20. Vestibular stimulation for management of premenstrual syndrome.

    Science.gov (United States)

    Johny, Minu; Kumar, Sai Sailesh; Rajagopalan, Archana; Mukkadan, Joseph Kurien

    2017-01-01

    The present study was undertaken to observe the effectiveness of vestibular stimulation in the management of premenstrual syndrome (PMS). The present study was an experimental study; twenty female participants of age group 18-30 years were recruited in the present study. Conventional swing was used to administer vestibular stimulation. Variables were recorded before and after vestibular stimulation and compared. Depression and stress scores are significantly decreased after 2 months of intervention. Anxiety scores decreased followed by vestibular stimulation. However, it is no statistically significant. Serum cortisol levels significantly decreased after 2 months of intervention. WHOQOL-BREF-transformed scores were not significantly changed followed by the intervention. However, psychological domain score (T2) and social relationships domain score (T3) were increased followed by intervention. Systolic blood pressure was significantly decreased after 2 months of intervention. No significant change was observed in diastolic pressure and pulse rate. Pain score was significantly decreased after 2 months of intervention. Mini mental status examination scores and spatial and verbal memory score were significantly improved followed by intervention. The present study provides preliminary evidence for implementing vestibular stimulation for management of PMS as a nonpharmacological therapy. Hence, we recommend further well-controlled, detailed studies in this area with higher sample size.

  1. [The effect of millimeter-range electromagnetic radiation on the evoked potentials from the vestibular cortical area of the cerebral hemispheres (an experimental study)].

    Science.gov (United States)

    Mal'tsev, A E; Abakarov, A T

    1994-01-01

    Acute experiments on 20 cats showed that EHF waves of nonthermal intensity can influence evoked potentials (EP) of the exposed vestibular zone of the cerebral hemispheres. Cerebral cortical exposure to low-frequency EHF waves stimulates negative EP component. Higher frequencies (78.33-118 GHz) reduce the above component amplitude. Changes in the positive EP component were minimal. It is suggested that different effects of millimetric waves diverse frequencies are related to the depth of the radiation penetration into the live tissue. The findings can be used in new techniques of physiotherapy.

  2. Immediate side effects of stereotactic radiotherapy and radiosurgery

    International Nuclear Information System (INIS)

    Werner-Wasik, Maria; Rudoler, Shari; Preston, Peter E.; Hauck, Walter W.; Downes, Beverly M.; Leeper, Dennis; Andrews, David; Corn, Benjamin W.; Curran, Walter J.

    1999-01-01

    Purpose: Despite increased utilization of fractionated stereotactic radiation therapy (SRT) or stereotactic radiosurgery (SRS), the incidence and nature of immediate side effects (ISE) associated with these treatment techniques are not well defined. We report immediate side effects from a series of 78 patients. Materials and Methods: Intracranial lesions in 78 adult patients were treated with SRT or SRS, using a dedicated linear accelerator. Those lesions included 13 gliomas, 2 ependymomas, 19 metastatic tumors, 15 meningiomas, 12 acoustic neuromas, 4 pituitary adenomas, 1 optic neuroma, 1 chondrosarcoma, and 11 arteriovenous malformations (AVM). SRT was used in 51 and SRS in 27 patients. Mean target volume was 9.0 cc. Eleven patients received prior external-beam radiation therapy within 2 months before SRT/SRS. Any side effects occurring during and up to 2 weeks after the course of radiation were defined as ISE and were graded as mild, moderate, or severe. The incidence of ISE and the significance of their association with several treatment and pretreatment variables were analyzed. Results: Overall, 28 (35%) of 78 patients experienced one or more ISE. Most of the ISE (87%) were mild, and consisted of nausea (in 5), dizziness/vertigo (in 5), seizures (in 6), and new persistent headaches (in 17). Two episodes of worsening neurological deficit and 2 of orbital pain were graded as moderate. Two patients experienced severe ISE, requiring hospitalization (1 seizure and 1 worsening neurological deficit). ISE in 6 cases prompted computerized tomography of the brain, which revealed increased perilesional edema in 3 cases. The incidence of ISE by diagnosis was as follows: 46% (6 of 13) for gliomas, 50% (6 of 12) for acoustic neuromas, 36% (4 of 11) for AVM, 33% (5 of 15) for meningiomas, and 21% (4 of 19) for metastases. A higher incidence of dizziness/vertigo (4 of 12 = 33%) was seen among acoustic neuroma patients than among other patients (p < 0.01). There was no

  3. EFFECT OF SHOULDER SIDE PACK ON DYNAMIC POSTURAL STABILITY IN YOUNG HEALTHY FEMALE

    Directory of Open Access Journals (Sweden)

    Enas ELsayed Mohamed Abutaleb

    2016-06-01

    Full Text Available Background: Control of balance is a complex motor skill that involves integration of sensory inputs and the planning and execution of flexible movement patterns. Carrying side packs is famous in our society especially shoulder side packs. Most students carry shoulder side packs and they don't care about the way to carry them to be more balanced. The purpose of the study is to investigate the effect of carrying shoulder side pack on dynamic postural stability and to determine the best way of carrying a shoulder side pack either on the dominant side or non-dominant side that doesn’t affect dynamic postural stability in young healthy female. Methods: Sixty female volunteers aged from 18 to 25 years old participated in the study. Biodex balance system was used to measure the dynamic postural stability in three different occasions (without carrying a shoulder side pack, with carrying a shoulder side pack on the dominant side, and on the non-dominant side with a rest period in between. Results: Repeated measure analysis of variance (ANOVA followed by Bonferroni post hoc test were used to compare dynamic posture balance without carrying and during carrying a shoulder side pack on dominant and non-dominant sides. Analysis revealed that overall, anteroposterior and mediolateral stability indexes reduced significantly (P<0.0001 when carrying shoulder side pack on dominant side in comparison with when carrying shoulder side pack on non-dominant side and without carrying bag. Conclusion: It was concluded that carrying a shoulder side pack on the non-dominant side didn't disturb the postural stability when compared to carrying on the dominant side so, we recommend the students to carry shoulder side packs on the non-dominant side.

  4. Psychiatric side effects and antiepileptic drugs: Observations from prospective audits.

    Science.gov (United States)

    Stephen, Linda J; Wishart, Abbie; Brodie, Martin J

    2017-06-01

    Psychiatric comorbidities are common in people with epilepsy. A retrospective study of characteristics associated with withdrawal due to psychiatric side effects was undertaken in patients with treated epilepsy participating in prospective audits with new antiepileptic drugs (AEDs). A total of 1058 treated patients with uncontrolled seizures (942 focal-onset seizures, 116 generalized genetic epilepsies [GGEs]) participated in eight prospective, observational audits from 1996 to 2014. These patients were prescribed adjunctive topiramate (n=170), levetiracetam (n=220), pregabalin (n=135), zonisamide (n=203), lacosamide (n=160), eslicarbazepine acetate (n=52), retigabine (n=64), or perampanel (n=54). Doses were titrated according to efficacy and tolerability to optimize zeizure outcomes and reduce side effects. Psychiatric comorbidities were recorded prior to and after the addition of each AED. At baseline, patients with focal-onset seizures (189 of 942; 20.1%) were statistically more likely to have psychiatric diagnoses compared to patients with GGEs (14 of 116, 12.1%; p=0.039). Following adjunctive AED treatment, neuropsychiatric adverse effects led to AED withdrawal in 1.9-16.7% of patients. Patients with a pre-treatment psychiatric history (22 of 209; 10.5%) were statistically more likely to discontinue their new AED due to psychiatric issues compared to patients with no previous psychiatric diagnosis (50 of 849; 5.9%; p=0.017). Patients receiving sodium channel blocking AEDs (4 of 212, 1.9%) were statistically less likely to develop intolerable psychiatric problems, compared to those on AEDs possessing other mechanisms of action (68 of 846, 8.0%; p=0.012). Depression was the commonest problem, leading to discontinuation of AEDs in 2.8% (n=30) patients. Aggression was statistically more common in men (11 of 527, 2.1%) compared to women (1 of 531, 0.2%; p=0.004). Patients with learning disability (12 of 122, 9.8%; p=0.0015) were statistically less likely to have

  5. Extravasational side effects of cytotoxic drugs: A preventable catastrophe

    Directory of Open Access Journals (Sweden)

    Thakur Jagdeep

    2008-01-01

    Full Text Available In addition to their therapeutic effects on malignant cells, cytotoxic agents have the potential of causing destruction of healthy, normal cells. Extravasation of the drug can produce extensive necrosis of the skin and subcutaneous tissue. Management of these extravasational effects differs from one centre to another and prevention is usually strongly emphasized. We analyzed our management of 12 patients referred to us over five years with extravasation of cytotoxic drugs and reviewed the literature for different approaches with regard to prophylaxis and management of extravasational effects. Materials and Methods: This study was done in the department of plastic surgery of a medical college. Five years of retrospective data were studied of patients referred to our department with extravasation of cytotoxic drugs. Results: We managed 12 cases referred to our department with extravasation of cytotoxic drugs. Mitomycin C was used in seven cases (58.33%, vincristine in two cases (16.66%, 5-Florouracil in another two cases while doxorubicin was responsible for extravasational side effects in one case (8.33%. The size of necrosis ranged from 3.75 cm 2 to 25 cm 2 with average size of 9.6 cm 2 . In terms of the area involved, the dorsum of the hand was involved in five cases (41.66%, the wrist in another five cases (41.66%, and the cubital fossa in the remaining two cases (16.66%. All cases were treated with daily debridement of necrotic tissue, saline dressing, and split skin grafting. Conclusion: Extravasation of cytotoxic drugs further increases the suffering of cancer patients. This catastrophe can only be avoided by vigilance and immediate application of antidotes. Once the local toxicity of the drugs takes effect, morbidity is unavoidable

  6. The balance of feelings: vestibular modulation of bodily sensations.

    Science.gov (United States)

    Ferrè, Elisa R; Bottini, Gabriella; Iannetti, Gian Domenico; Haggard, Patrick

    2013-03-01

    The vestibular system processes information about head movement and orientation. No unimodal vestibular cortex has been identified in the mammalian brain. Rather, vestibular inputs are combined with many other sensory signals in the cortex. This arrangement suggests that vestibular input could influence processing in other sensory modalities. Here we show that vestibular stimulation differentially modulates two submodalities of the somatosensory system, increasing sensitivity to tactile input, and independently reducing sensitivity to nociceptive input. These modulations of touch and pain can clearly be distinguished from supramodal attentional effects of vestibular stimulation, because they are bilateral and operate in different directions. Outside the artificial conditions of laboratory stimulation, the vestibular system codes movements of the head, indicating a new relation between the body and the external world. We suggest the vestibular system participates in a form of sensory signal management, changing the balance between the various sensory systems as the relation between the body and the external environment changes. This sensory rebalancing may be a crucial element in the brain's capacity to reorient towards novel or salient features in the environment. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. An Examination of Psychotropic Medication Side Effects: Does Taking a Greater Number of Psychotropic Medications from Different Classes Affect Presentation of Side Effects in adults with ID?

    Science.gov (United States)

    Mahan, Sara; Holloway, Jodie; Bamburg, Jay W.; Hess, Julie A.; Fodstad, Jill C.; Matson, Johnny L.

    2010-01-01

    This study examined whether the number of psychotropic medications an individual is taking across classes influences side effects among adults with Intellectual Disability (ID). Participants were 80 adults diagnosed with ID. Dependent variables were the composite score and domain scores of the "Matson Evaluation of Drug Side-Effects" ("MEDS"),…

  8. Central diabetes insipidus: a previously unreported side effect of temozolomide.

    Science.gov (United States)

    Faje, Alexander T; Nachtigall, Lisa; Wexler, Deborah; Miller, Karen K; Klibanski, Anne; Makimura, Hideo

    2013-10-01

    Temozolomide (TMZ) is an alkylating agent primarily used to treat tumors of the central nervous system. We describe 2 patients with apparent TMZ-induced central diabetes insipidus. Using our institution's Research Patient Database Registry, we identified 3 additional potential cases of TMZ-induced diabetes insipidus among a group of 1545 patients treated with TMZ. A 53-year-old male with an oligoastrocytoma and a 38-year-old male with an oligodendroglioma each developed symptoms of polydipsia and polyuria approximately 2 months after the initiation of TMZ. Laboratory analyses demonstrated hypernatremia and urinary concentrating defects, consistent with the presence of diabetes insipidus, and the patients were successfully treated with desmopressin acetate. Desmopressin acetate was withdrawn after the discontinuation of TMZ, and diabetes insipidus did not recur. Magnetic resonance imaging of the pituitary and hypothalamus was unremarkable apart from the absence of a posterior pituitary bright spot in both of the cases. Anterior pituitary function tests were normal in both cases. Using the Research Patient Database Registry database, we identified the 2 index cases and 3 additional potential cases of diabetes insipidus for an estimated prevalence of 0.3% (5 cases of diabetes insipidus per 1545 patients prescribed TMZ). Central diabetes insipidus is a rare but reversible side effect of treatment with TMZ.

  9. [Sleep related eating disorders as a side effect of zolpidem].

    Science.gov (United States)

    Valiensi, Stella Maris; Cristiano, Edgardo; Martínez, Oscar A; Reisin, Ricardo C; Alvarez, Florencia

    2010-01-01

    Zolpidem is a hypnotic drug used in sleep disorders. It binds selectively to alpha 1 subunit of the GABA A benzodiazepine receptor. Zolpidem reduces sleep latency, number of arousals and increases the total time of sleep. However, it is considered that it may increase phase 3 of non rapid eye movement sleep, where somnambulism can take place. Our aim is to report 8 cases of sleep related eating disorders associated with the use of this drug. We have evaluated the medical history of 8 patients who had received zolpidem for sleeping disorders and who have presented sleep related eating disorders. Eight patients (6 women, 2 men) aged between 32 to 72 years old, which received 10 mg of zolpidem/night except 1 that received 12.5 mg, were presented. They have referred strange eating behavior compatible to sleep related eating disorder. Symptoms appeared at a mean of 39.8 days after starting the medication. The numbers of nocturnal episodes recorded by the family or by the patient were 1 to 8 episodes of nocturnal eating per night. The morning after, patients found leftovers from the night before which they did not recall to have eaten. The remission was complete after discontinuing zolpidem. Zolpidem may induce sleep related eating disorder in about 1% of patients, although we consider there may be a subdiagnosis of this phenomenon. It will be important to bear in mind and look for this side effect because all the episodes could easily be controlled by withdrawing the drug.

  10. [Vascular calcifications, the hidden side effects of vitamin K antagonists].

    Science.gov (United States)

    Bennis, Youssef; Vengadessane, Subashini; Bodeau, Sandra; Gras, Valérie; Bricca, Giampiero; Kamel, Saïd; Liabeuf, Sophie

    2016-09-01

    Despite the availability of new oral anticoagulants, vitamin K antagonists (VKA, such as fluindione, acenocoumarol or warfarin) remain currently the goal standard medicines for oral prevention or treatment of thromboembolic disorders. They inhibit the cycle of the vitamin K and its participation in the enzymatic gamma-carboxylation of many proteins. The VKA prevent the activation of the vitamin K-dependent blood clotting factors limiting thus the initiation of the coagulation cascade. But other proteins are vitamin K-dependent and also remain inactive in the presence of VKA. This is the case of matrix Gla-protein (MGP), a protein that plays a major inhibitory role in the development of vascular calcifications. Several experimental and epidemiological results suggest that the use of the VKA could promote the development of vascular calcifications increasing thus the cardiovascular risk. This risk seems to be higher in patients with chronic kidney disease or mellitus diabetes who are more likely to develop vascular calcifications, and may be due to a decrease of the MGP activity. This review aims at summarizing the data currently available making vascular calcifications the probably underestimated side effects of VKA. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  11. Early and Late Onset Side Effects of Photodynamic Therapy

    Directory of Open Access Journals (Sweden)

    Francesco Borgia

    2018-01-01

    Full Text Available Photodynamic Therapy (PDT is a non-invasive treatment successfully used for neoplastic, inflammatory and infectious skin diseases. One of its strengths is represented by the high safety profile, even in elderly and/or immuno-depressed subjects. PDT, however, may induce early and late onset side effects. Erythema, pain, burns, edema, itching, desquamation, and pustular formation, often in association with each other, are frequently observed in course of exposure to the light source and in the hours/days immediately after the therapy. In particular, pain is a clinically relevant short-term complication that also reduces long-term patient satisfaction. Rare complications are urticaria, contact dermatitis at the site of application of the photosensitizer, and erosive pustular dermatosis. Debated is the relationship between PDT and carcinogenesis: the eruptive appearance of squamous cell carcinoma (SCC in previously treated areas has been correlated to a condition of local and/or systemic immunosuppression or to the selection of PDT-resistant SCC. Here we review the literature, with particular emphasis to the pathogenic hypotheses underlying these observations.

  12. Alcoolismo: efeitos no aparelho vestíbulo-coclear Alcoholism: effects on the cochleo-vestibular apparatus

    Directory of Open Access Journals (Sweden)

    Marcieli Bellé

    2007-02-01

    Full Text Available Diversas drogas ototóxicas causam efeitos nocivos ao ser humano, como zumbido, várias formas de deficiência auditiva e vertigem. Dentre os principais agentes considerados ototóxicos, encontra-se o álcool. OBJETIVO: Verificar as influências do alcoolismo no aparelho vestíbulo-coclear. FORMA DE ESTUDO: Estudo de coorte contemporânea com corte transversal. MATERIAL E MÉTODO: A amostra compreendeu 37 indivíduos para o grupo experimental, freqüentadores do grupo de Alcoólicos Anônimos da cidade de Santa Maria-RS e 37 indivíduos não alcoólicos, com a mesma idade e sexo, de cada indivíduo do estudo, a fim de formar o grupo controle. Todos foram submetidos à anamnese, exame otorrinolarigológico, avaliação audiológica básica e avalição vectoeletronistagmográfica. RESULTADOS: Observou-se que 67,57% dos indivíduos do Grupo Experimental apresentaram alteração na audiometria e 24,32% apresentaram alteração na vectoeletronistagmografia computadorizada. Nos indivíduos do grupo Controle, 27,03% apresentaram audiometria alterada e 10,81% apresentaram resultados alterados na vectoeletronistagmografia computadorizada. CONCLUSÃO: O álcool interfere na audição e no equilíbrio do indivíduo, causando efeito deletério no organismo humano.Several ototoxic drugs are harmful to the human being and lead to problems such as tinnitus, many types of hearing loss, and vertigo. Alcohol is among the main agents considered ototoxic. AIM: To study the effects of alcoholism in the vestibular-cochlear system. STUDY DESIGN: cross-sectional contemporary cohort. MATERIALS AND METHODS: The sample comprehended 37 individuals in the Experimental Group, members of Alcoholics Anonymous of the City Santa Maria-RS, and 37 non-alcoholic individuals in the Control Group, age and gender matching. All of the individuals examined were submitted to anamnesis, otorhinolaryngological examination, basic hearing evaluation, and vecto-electronystamography. RESULTS

  13. [Metabolic side effects of risperidone in early onset schizophrenia].

    Science.gov (United States)

    Goeb, J-L; Marco, S; Duhamel, A; Kechid, G; Bordet, R; Thomas, P; Delion, P; Jardri, R

    2010-06-01

    Atypical antipsychotics have a favourable risk/benefit profile in early onset schizophrenia (EOS). However, despite increasing use of psychotropic medication in children and adolescents, their endocrine and metabolic side-effects (weight gain, obesity, and related metabolic abnormalities such as hyperglycaemia and dyslipidemia) are of particular concern, especially within this paediatric population that appears to be at greater risk as compared with adults for antipsychotic-induced metabolic adverse effects. In addition to medication, many factors contribute to weigh gain in psychiatric patients, including sedentary lifestyle and poor diet. Excessive weigh gain has several deleterious effects in psychiatric patients, including stigmatization and further social withdrawal, and non compliance with medication. Furthermore, excessive corpulence may evolve to a metabolic syndrome with a high-risk state for future cardiovascular morbidity and mortality in adult age. Because youths are still developing at the time of psychotropic drug exposure, in a context of physiological changes in hormonal and endocrines levels and body composition, most reference values need to be adjusted for gender, age and growth charts. Hence, sex- and age-adjusted BMI percentiles and BMI Z scores are crucial to assess weight gain in children and adolescents. Obesity thresholds have been proposed to define "at risk" categories of patients. In recently issued guidelines, thresholds for antipsychotic-induced weight gain in adults have been set at a 5% increase or one point increase in BMI unit. To date, no definition has reached a consensus in childhood and adolescence. However, some at risk states requiring action are proposed in literature: more than 5% increase in weight within a three-month period; more than half a point increase in BMI Z score; between 85th and 95th BMI percentile plus one adverse health consequence (i.e. hyperglycaemia, dyslipidemia, hyperinsulinemia, hypertension, or

  14. Sodium arsanilate-induced vestibular dysfunction in rats: effects on open-field behavior and spontaneous activity in the automated digiscan monitoring system.

    Science.gov (United States)

    Ossenkopp, K P; Prkacin, A; Hargreaves, E L

    1990-08-01

    Vestibular dysfunction was chemically induced in Long-Evans rats by intratympanic injections (30 mg per side) of sodium arsanilate (atoxyl). Following a one-week recovery period the rats were behaviorally assayed for integrity of the labyrinthine systems. All subjects were tested for presence of the air-righting reflex, the contact-righting reflex (by lightly holding a sheet of Plexiglas against the soles of the rat's feet), and body rotation-induced nystagmus. All animals were then tested for their ability to remain on a small (15 x 15 cm) platform. Next, the subjects were given two 10-min open-field tests during which ambulation, rearing, grooming, and defecation responses were recorded. Four to five weeks later all rats were tested twice (60 min per session) in the automated Digiscan Activity Monitor which provides a multivariate assessment of spontaneous motor activity. The rats with vestibular dysfunction (Group VNX) took significantly less time to fall off the platform (p less than 0.01). They also exhibited significantly more open-field ambulation but fewer rearing responses (ps less than 0.01). An examination of group correlation coefficients for open-field variables and the platform test scores revealed some interesting group differences (ps less than 0.05). In the Digiscan tests the atoxyl-treated rats exhibited fewer number of horizontal movements, but increased speed for these movements (ps less than 0.05). Vertical movements did not differ significantly in incidence, but these movements were greatly reduced in duration (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Reported side effects of intravenous midazolam sedation when used in paediatric dentistry: a review.

    Science.gov (United States)

    Papineni McIntosh, Arathi; Ashley, Paul Francis; Lourenço-Matharu, Liege

    2015-05-01

    Intravenous (IV) midazolam may be of value as an alternative paediatric dental sedation technique, but there is some apprehension concerning its routine use due to a lack of evidence regarding its safety and side effects. To review all available literature reporting the side effects of IV midazolam in children undergoing dental procedures. Both randomised controlled trials (RCT) and non-randomised studies were reviewed. Reported side effects were categorised as either significant or minor, and the percentage prevalence of significant or minor side effects per episode of treatment was calculated. Five RCTs were included, in which no significant side events were reported; however, minor side effects were recorded (n = 33, 19.5%), with paradoxical reaction being the most common (n = 11, 6.5%). Six non-randomised studies were included, in which no significant side effects were reported; however, minor side effects were reported (n = 118, 16.8%) with paradoxical reaction being the most common (n = 89, 12.7%). Although no significant side effects were recorded, of the minor side effects reported paradoxical reaction was the most common. Due to inconsistency in side effect reporting, the authors suggest the application of a standardised adverse event reporting tool for future studies of sedation in paediatric dentistry. © 2014 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Auditory brainstem response – a valid and cost-effective screening tool for vestibular schwannoma?

    DEFF Research Database (Denmark)

    Rafique, Irfan; Wennervaldt, Kasper; Melchiors, Jacob

    2016-01-01

    Abstract: Conclusion: Contemporary auditory brainstem response (ABR) is not valid as a screening tool for VS, when considering the sensitivity of 80%, the specificity of 77%, and the positive predictive value of 3.4%, MRI screening is superior to ABR in Denmark when considering cost-effectiveness......Abstract: Conclusion: Contemporary auditory brainstem response (ABR) is not valid as a screening tool for VS, when considering the sensitivity of 80%, the specificity of 77%, and the positive predictive value of 3.4%, MRI screening is superior to ABR in Denmark when considering cost...

  17. Immediate side effects of stereotactic radiotherapy and radiosurgery

    International Nuclear Information System (INIS)

    Werner-Wasik, Maria; Rudoler, Shari; Preston, Peter E.; Downes, Beverly M.; Andrews, David; Corn, Benjamin W.; Rosenstock, Jeffrey; Curran, Walter J.

    1996-01-01

    Purpose/Objective: Despite increased utilization of fractionated stereotactic radiation therapy (SRT) or stereotactic radiosurgery (SRS), the incidence and nature of immediate side effects (ISE) associated with these treatment techniques is not well defined. Materials and Methods: Intracranial lesions in 78 adult patients were treated with SRT or SRS, using a dedicated linear accelerator. They comprised 13 gliomas, 2 ependymomas, 19 metastatic tumors, 15 meningiomas, 12 acoustic neuromas, 4 pituitary adenomas, 1 optic neuroma, 1 chondrosarcoma and 11 arteriovenous malformations (AVM). SRT was used in 51 and SRS in 27 patients. Mean target volume was 9.0 cc. Eleven patients received prior external beam radiation therapy within 2 months before SRT/SRS. Any side effects occurring during and up to two weeks after radiation course were defined as ISE and were graded as mild, moderate or severe. The incidence of ISE and the significance of their association with several pretreatment variables were analyzed. Results: Overall, (28(78)) (35%) patients experienced one or more ISE. Most of ISE (87%) were mild and consisted of nausea (5), dizziness/vertigo (5), seizures (7) and new persistent headaches (17). Two episodes of worsening neurological deficit and 2 of orbital pain were graded as moderate. Two patients experienced severe ISE, requiring hospitalization (1 seizure and 1 worsening neurological deficit). ISE in 5 cases prompted computerized tomography of the brain which revealed increased perilesional edema in 3 cases. The incidence of ISE by diagnosis was as follows: 46% ((6(13))) for gliomas, 50% ((6(12))) for acoustic neuromas, 36% ((4(11))) for AVM, 33% ((5(15))) for meningiomas and 21% ((4(19))) for metastases. Increasing dose to the margin and increasing maximum dose were associated with a higher incidence of ISE (p=0.02 and 0.005, respectively). Prior recent conventional external beam radiation therapy, target volume, number of isocenters, collimator size, dose

  18. Effects of utility demand-side management programs on uncertainty

    International Nuclear Information System (INIS)

    Hirst, E.

    1994-01-01

    Electric utilities face a variety of uncertainties that complicate their long-term resource planning. These uncertainties include future economic and load growths, fuel prices, environmental and economic regulations, performance of existing power plants, cost and availability of purchased power, and the costs and performance of new demand and supply resources. As utilities increasingly turn to demand-side management (DSM) programs to provide resources, it becomes more important to analyze the interactions between these programs and the uncertainties facing utilities. This paper uses a dynamic planning model to quantify the uncertainty effects of supply-only vs DSM + supply resource portfolios. The analysis considers four sets of uncertainties: economic growth, fuel prices, the costs to build new power plants, and the costs to operate DSM programs. The two types of portfolios are tested against these four sets of uncertainties for the period 1990 to 2010. Sensitivity, scenario, and worst-case analysis methods are used. The sensitivity analyses show that the DSM + supply resource portfolio is less sensitive to unanticipated changes in economic growth, fuel prices, and power-plant construction costs than is the supply-only portfolio. The supply-only resource mix is better only with respect to uncertainties about the costs of DSM programs. The base-case analysis shows that including DSM programs in the utility's resource portfolio reduces the net present value of revenue requirements (NPV-RR) by 490 million dollars. The scenario-analysis results show an additional 30 million dollars (6%) in benefits associated with reduction in these uncertainties. In the worst-case analysis, the DSM + supply portfolio again reduces the cost penalty associated with guessing wrong for both cases, when the utility plans for high needs and learns it has low needs and vice versa. 20 refs

  19. Thermogenic side effects to migratory predisposition in shorebirds.

    Science.gov (United States)

    Vézina, François; Jalvingh, Kirsten M; Dekinga, Anne; Piersma, Theunis

    2007-03-01

    In the calidrine sandpiper red knot (Calidris canutus), the weeks preceding takeoff for long-distance migration are characterized by a rapid increase in body mass, largely made up of fat but also including a significant proportion of lean tissue. Before takeoff, the pectoral muscles are known to hypertrophy in preparation for endurance flight without any specific training. Because birds facing cold environments counterbalance heat loss through shivering thermogenesis, and since pectoral muscles represent a large proportion of avian body mass, we asked the question whether muscle hypertrophy in preparation for long-distance endurance flight would induce improvements in thermogenic capacity. We acclimated red knots to different controlled thermal environments: 26 degrees C, 5 degrees C, and variable conditions tracking outdoor temperatures. We then studied within-individual variations in body mass, pectoral muscle size (measured by ultrasound), and metabolic parameters [basal metabolic rate (BMR) and summit metabolic rate (M(sum))] throughout a 3-mo period enclosing the migratory gain and loss of mass. The gain in body mass during the fattening period was associated with increases in pectoral muscle thickness and thermogenic capacity independent of thermal acclimation. Regardless of their thermal treatment, birds showing the largest increases in body mass also exhibited the largest increases in M(sum). We conclude that migratory fattening is accompanied by thermoregulatory side effects. The gain of body mass and muscle hypertrophy improve thermogenic capacity independent of thermal acclimation in this species. Whether this represents an ecological advantage depends on the ambient temperature at the time of fattening.

  20. Are more of my patients developing side effects than expected?

    Science.gov (United States)

    Bowen, Claire McKay; Liu, Fang; Wheeler, James

    2015-01-01

    Modern radiation oncology treatments are typically associated with a certain level of acute or long-term complications. Whenever a new treatment is introduced into clinical practice, a clinician may have reason to question whether certain side effects occur more frequently in his or her patients than reported in the published literature. However, the clinician, lacking rigorous statistical methods to answer this question, may not draw the correct conclusion until treating a larger number of patients than necessary. We propose a Bayesian framework to calculate (1) the probability that the rate of an adverse event (AE) is above a certain threshold and (2) the number of AEs to be observed before we can conclude with a certain confidence level that the AE rate is above a threshold. Both questions will be answered based on the formulation of a posterior distribution of the AE rate given the observed data. The proposed method does not rely on large sample assumptions, and the computation of the solution is quick and straightforward. The proposed methods are illustrated in 2 clinical scenarios. We tabulated the probability that an AE rate is greater than a threshold for a given number of patients experiencing events from an observed number of patients. In addition, we developed a free online interactive tool to facilitate the implementation of the method. The proposed method, including the presented tables and the online tool, provides clinicians with a practical means of determining if his or her patients are experiencing a greater (or lower) number of complications than expected. How to use the statistical result to guide a clinical decision depends upon the specifics of the clinical condition and the available treatment alternatives.

  1. Grounding as a Side-Effect of Grounding.

    Science.gov (United States)

    Larsson, Staffan

    2018-01-22

    In relation to semantics, "grounding" has (at least) two relevant meanings. "Symbol grounding" is the process of connecting symbols (e.g., words) to perception and the world. "Communicative grounding" is the process of interactively adding to common ground in dialog. Strategies for grounding in human communication include, crucially, strategies for resolving troubles caused by various kinds of miscommunication. As it happens, these two processes of grounding are closely related. As a side-effect of grounding an utterance, dialog participants (DPs) may adjust the meanings they assign to linguistic expressions, in a process of semantic coordination. Meanings of at least some expressions (e.g., concrete nouns) include perceptual aspects which enable DPs to classify entities as falling under the expression or not based on their perception of those entities. We show how perceptual grounding of symbols can be achieved in a process of interactively adding to common ground. This requires that perceptual aspects of meaning can be updated as a result of participating in linguistic interaction, thereby enabling fine-grained semantic coordination of perceptually grounded linguistic meanings. A formal semantics for low-level perceptual aspects of meaning is presented, tying these together with the logical-inferential aspects of meaning traditionally studied in formal semantics. The key idea is to model perceptual meanings as classifiers of perceptual input. This requires a framework where intensions are (a) represented independently of extensions, and (b) structured objects which can be modified as a result of learning. We use Type Theory with Records (TTR), a formal semantics framework which starts from the idea that information and meaning are founded on our ability to perceive and classify the world, that is, to perceive objects and situations as being of types. As an example of our approach, we show how a simple classifier of spatial information based on the Perceptron can

  2. Allicin protects against cisplatin-induced vestibular dysfunction by inhibiting the apoptotic pathway.

    Science.gov (United States)

    Wu, Xianmin; Cai, Jing; Li, Xiaofei; Li, He; Li, Jianfeng; Bai, Xiaohui; Liu, Wenwen; Han, Yuechen; Xu, Lei; Zhang, Daogong; Wang, Haibo; Fan, Zhaomin

    2017-06-15

    Cisplatin is an anticancer drug that causes the impairment of inner ear function as side effects, including hearing loss and balance dysfunction. The purpose of this study was to investigate the effects of allicin against cisplatin-induced vestibular dysfunction in mice and to make clear the mechanism underlying the protective effects of allicin on oto-vestibulotoxicity. Mice intraperitoneally injected with cisplatin exhibited vestibular dysfunction in swimming test, which agreed with impairment in vestibule. However, these impairments were significantly prevented by pre-treatment with allicin. Allicin markedly reduced cisplatin-activated expression of cleaved-caspase-3 in hair cells and vascular layer cells of utricule, saccule and ampulla, but also decreased AIF nuclear translocation of hair cells in utricule, saccule and ampulla. These results showed that allicin played an effective role in protecting vestibular dysfunction induced by cisplatin via inhibiting caspase-dependent and caspase-independent apoptotic pathways. Therefore, allicin may be useful in preventing oto-vestibulotoxicity mediated by cisplatin. Copyright © 2017. Published by Elsevier B.V.

  3. Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Dara Meldrum

    2012-03-01

    Full Text Available Abstract Background Unilateral peripheral vestibular loss results in gait and balance impairment, dizziness and oscillopsia. Vestibular rehabilitation benefits patients but optimal treatment remains unkown. Virtual reality is an emerging tool in rehabilitation and provides opportunities to improve both outcomes and patient satisfaction with treatment. The Nintendo Wii Fit Plus® (NWFP is a low cost virtual reality system that challenges balance and provides visual and auditory feedback. It may augment the motor learning that is required to improve balance and gait, but no trials to date have investigated efficacy. Methods/Design In a single (assessor blind, two centre randomised controlled superiority trial, 80 patients with unilateral peripheral vestibular loss will be randomised to either conventional or virtual reality based (NWFP vestibular rehabilitation for 6 weeks. The primary outcome measure is gait speed (measured with three dimensional gait analysis. Secondary outcomes include computerised posturography, dynamic visual acuity, and validated questionnaires on dizziness, confidence and anxiety/depression. Outcome will be assessed post treatment (8 weeks and at 6 months. Discussion Advances in the gaming industry have allowed mass production of highly sophisticated low cost virtual reality systems that incorporate technology previously not accessible to most therapists and patients. Importantly, they are not confined to rehabilitation departments, can be used at home and provide an accurate record of adherence to exercise. The benefits of providing augmented feedback, increasing intensity of exercise and accurately measuring adherence may improve conventional vestibular rehabilitation but efficacy must first be demonstrated. Trial registration Clinical trials.gov identifier: NCT01442623

  4. Corticosteroids for the treatment of idiopathic acute vestibular dysfunction (vestibular neuritis).

    Science.gov (United States)

    Fishman, Jonathan M; Burgess, Chris; Waddell, Angus

    2011-05-11

    Idiopathic acute vestibular dysfunction (vestibular neuritis) is the second most common cause of peripheral vertigo after benign paroxysmal positional vertigo (BPPV) and accounts for 7% of the patients who present at outpatient clinics specialising in the treatment of dizziness. The exact aetiology of the condition is unknown and the effects of corticosteroids on the condition and its recovery are uncertain. To assess the effectiveness of corticosteroids in the management of patients with idiopathic acute vestibular dysfunction (vestibular neuritis). We searched the Cochrane ENT Group Trials Register; CENTRAL; PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 28 December 2010. Randomised controlled trials comparing corticosteroids with placebo, no treatment or other active treatments, for adults diagnosed with idiopathic acute vestibular dysfunction. Two authors independently selected studies from the search results and extracted data. Three authors independently assessed risk of bias. Four trials, involving a total of 149 participants, compared the effectiveness of oral corticosteroids against placebo. All the trials were small and of low methodological quality. Although there was an overall significant effect of corticosteroids compared with placebo medication on complete caloric recovery at one month (risk ratio (RR) of 2.81; 95% confidence interval (CI) 1.32 to 6.00, P = 0.007), no significant effect was seen on complete caloric recovery at 12 months (RR 1.58; 95% CI 0.45 to 5.62, P = 0.48), or on the extent of caloric recovery at either one month (mean difference (MD) 9.60%; 95% CI -20.66 to 39.86, P = 0.53) or at 12 months (MD 6.83%; 95% CI -27.69 to 41.36, P = 0.70). In addition, there was no significant difference between corticosteroids and placebo medication in the symptomatic recovery of vestibular function

  5. Anti-tumor effects of cold atmospheric pressure plasma on vestibular schwannoma demonstrate its feasibility as an intra-operative adjuvant treatment.

    Science.gov (United States)

    Yoon, Yeo Jun; Suh, Michelle J; Lee, Hyun Young; Lee, Hae June; Choi, Eun Ha; Moon, In Seok; Song, Kiwon

    2018-02-01

    Vestibular schwannoma (VS), although a benign intracranial tumor, causes morbidities by brainstem compression. Since chemotherapy is not very effective in most Nf2-negative schwannomas, surgical removal or radiation therapy is required. However, depending on the size and site of the tumor, these approaches may cause loss of auditory or vestibular functions, and severely decrease the post-surgical wellbeing. Here, we examined the feasibility of cold atmospheric pressure plasma (CAP) as an intra-operative adjuvant treatment for VS after surgery. Cell death was efficiently induced in both human HEI-193 and mouse SC4 VS cell lines upon exposure to CAP for seven minutes. Interestingly, both apoptosis and necroptosis were simultaneously induced by CAP treatment, and cell death was not completely inhibited by pan-caspase and receptor-interacting serine/threonine-protein kinase 1 (RIK1) inhibitors. Upon CAP exposure, cell death phenotype was similarly observed in patient-derived primary VS cells and tumor mass. In addition, CAP exposure after the surgical removal of primary tumor efficiently inhibited tumor recurrence in SC4-grafted mouse models. Collectively, these results strongly suggest that CAP should be developed as an efficient adjuvant treatment for VS after surgery to eliminate the possible remnant tumor cells, and to minimize the surgical area in the brain for post-surgical wellbeing. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. STATE ANXIETY, SUBJECTIVE IMBALANCE AND HANDICAP IN VESTIBULAR SCHWANNOMA

    Directory of Open Access Journals (Sweden)

    Yougan Saman

    2016-07-01

    Full Text Available ABSTRACTEvidence is emerging of a significant clinical and neuro-anatomical relationship between balance and anxiety. Research has suggested a potentially priming effect with anxiety symptoms predicting a worsening of balance function in patients with underlying balance dysfunction. We propose to show that a vestibular stimulus is responsible for an increase in state anxiety and there is a relationship between increased state anxiety and worsening balance function. Aims1.To quantify state anxiety following a vestibular stimulus in patients with a chronic vestibular deficit.2.To determine if state anxiety during a vestibular stimulus would correlate with the severity of chronic balance symptoms and handicap. MethodsTwo separate cohorts Vestibular Schwannoma (VS patients underwent vestibular tests (electronystagmography, cervical and ocular vestibular evoked myogenic potentials and caloric responses and questionnaire assessment (Vertigo handicap Questionnaire, Vertigo Symptom Scale, State Trait Anxiety InventoryFifteen post resection Vestibular schwannoma patients, with complete unilateral vestibular deafferentation, were assessed at a minimum of 6 months after surgery in Experiment 1 (Aim 1. Forty-five patients with VS in-situ and with preserved vestibular function formed the cohort for Experiment 2 (Aim 2. Experiment 1: VS subjects (N=15 with a complete post-resection unilateral vestibular deafferentation completed a State anxiety questionnaire before caloric assessment and again afterwards with the point of maximal vertigo as the reference (Aim 1. Experiment 2: State anxiety measured at the point of maximal vertigo following a caloric assessment was compared between two groups of presenting with balance symptoms (Group 1 N=26 and without balance symptoms (Group 2 N=11 (Aim 2. The presence of balance symptoms was defined as having a positive score on the VSS-VER.ResultsIn experiment 1, a significant difference (p<0.01 was found when comparing

  7. Corticosteroids and vestibular exercises in vestibular neuritis. Single-blind randomized clinical trial.

    Science.gov (United States)

    Goudakos, John K; Markou, Konstantinos D; Psillas, George; Vital, Victor; Tsaligopoulos, Miltiadis

    2014-05-01

    IMPORTANCE The management of patients with unilateral acute vestibular neuritis (VN) has not been established to date. OBJECTIVE To compare the use of vestibular exercises vs corticosteroid therapy in the recovery of patients with acute VN. DESIGN, SETTING, AND PARTICIPANTS Prospective, single-blind, randomized clinical trial at a primary referral center. Among all patients with acute vertigo, those having VN were eligible for inclusion in the study. INTERVENTIONS Forty patients with acute VN were randomly assigned to perform vestibular exercises or to receive corticosteroid therapy. After a baseline examination, follow-up evaluations were performed at 1, 6, and 12 months. MAIN OUTCOMES AND MEASURES Efficacy outcomes included clinical, canal, and otolith recovery. Scores on the European Evaluation of Vertigo Scale and the Dizziness Handicap Inventory were used for the evaluation of clinical recovery. Findings of caloric irrigation and vestibular evoked myogenic potentials indicated canal and otolith improvement, respectively. RESULTS Comparing the 2 treatment groups, no statistically significant differences were found in clinical, canal, or otolith recovery. At the 6-month examination, the number of patients with complete disease resolution in the corticosteroids group was significantly higher than that in the vestibular exercises group. However, at the end of the follow-up period, 45%(9 of 20) of patients in the vestibular exercises group and 50% (10 of 20) of patients in the corticosteroids group had complete disease resolution (P > .05). CONCLUSIONS AND RELEVANCE Treating patients who have acute VN with vestibular exercises seems equivalently effective as treating them with corticosteroid therapy in clinical, caloric, and otolith recovery. Corticosteroid therapy seems to enhance earlier complete acute VN resolution, with no added benefit in the long-term prognosis.

  8. Vestibular neuritis affects both superior and inferior vestibular nerves.

    Science.gov (United States)

    Taylor, Rachael L; McGarvie, Leigh A; Reid, Nicole; Young, Allison S; Halmagyi, G Michael; Welgampola, Miriam S

    2016-10-18

    To characterize the profiles of afferent dysfunction in a cross section of patients with acute vestibular neuritis using tests of otolith and semicircular canal function sensitive to each of the 5 vestibular end organs. Forty-three patients fulfilling clinical criteria for acute vestibular neuritis were recruited between 2010 and 2016 and studied within 10 days of symptom onset. Otolith function was evaluated with air-conducted cervical and bone-conducted ocular/vestibular evoked myogenic potentials and the subjective visual horizontal test. Canal-plane video head impulse tests (vHITs) assessed the function of each semicircular canal. Patterns of recovery were investigated in 16 patients retested after a 6- to 12-month follow-up period. Rates of horizontal canal (97.7%), anterior canal (90.7%), and utricular (72.1%) dysfunction were significantly higher than rates of posterior canal (39.5%) and saccular (39.0%) dysfunction (p vestibular nerve divisions; 18 patients (41.9%) had superior neuritis; and 1 patient (2.3%) had inferior neuritis. A test battery that included horizontal and posterior canal vHIT and the cervical/vestibular evoked myogenic potentials identified superior or inferior neuritis in all patients tested acutely. Eight of 16 patients who were retested at follow-up had recovered a normal vestibular evoked myogenic potential and vHIT profile. Acute vestibular neuritis most often affects both vestibular nerve divisions. The horizontal vHIT alone identifies superior nerve dysfunction in all patients with vestibular neuritis tested acutely, whereas both cervical/vestibular evoked myogenic potentials and posterior vHIT are necessary for diagnosing inferior vestibular nerve involvement. © 2016 American Academy of Neurology.

  9. Effect of sound stimulion reciprocal interaction of antagonist muscles of lowe extremities in humans under vestibular loadе

    Directory of Open Access Journals (Sweden)

    I. V. Dregval

    2015-05-01

    Full Text Available Results of the research are evidence of changing muscles reflex activity of human lower extremity under the influence of sound stimulus of various frequency range together with the vestibular burden. The most change of the H-reflex was observed under the sound stimulus of 800 hertz. Not only the proprioceptive but auditory sensory system takes part in the regulation of the brain reflex activity. Existence of different labyrinths actions, according to the situation, on the interneuronic inhibitory ways of the postsynaptic inhibition of the salens muscle’s motoneurons is supposed.

  10. Optimal visuo-vestibular integration for self-motion perception in patients with unilateral vestibular loss.

    Science.gov (United States)

    Kaliuzhna, Mariia; Gale, Steven; Prsa, Mario; Maire, Raphael; Blanke, Olaf

    2018-03-01

    Unilateral vestibular loss (UVL) is accompanied by deficits in processing of visual and vestibular self-motion cues. The present study examined whether multisensory integration of these two types of information is, nevertheless, intact in such patients. Patients were seated on a rotating platform with a screen simulating 3D rotation in front of them and asked to judge the relative magnitude of two successive rotations in the yaw plane in three conditions: vestibular stimulation, visual stimulation and bimodal stimulation (congruent stimuli from both modalities together). Similar to findings in healthy controls, UVL patients exhibited optimal multisensory integration during both ipsi- and contralesional rotations. The benefit of multisensory integration was more pronounced on the ipsilesional side. These results show that visuo-vestibular integration for passive self-motion is automatic and suggests that it functions without additional cognitive mechanisms, unlike more complex multisensory tasks such as postural control and spatial navigation, previously shown to be impaired in UVL patients. Copyright © 2018. Published by Elsevier Ltd.

  11. Vestibular and balance issues following sport-related concussion.

    Science.gov (United States)

    Valovich McLeod, Tamara C; Hale, Troy D

    2015-01-01

    To review relevant literature regarding the effect of concussion on vestibular function, impairments, assessments and management strategies. REASONING: Dizziness and balance impairments are common following sport-related concussion. Recommendations regarding the management of sport-related concussion suggest including tests of balance within the multifactorial assessment paradigm for concussive injuries. The literature was searched for guidelines and original studies related to vestibular impairments following concussion, oculomotor and balance assessments and treatment or rehabilitation of vestibular impairments. The databases searched included Medline, CINAHL, Sport Discus and the Cochrane Database of Systematic Reviews through October 2013. Dizziness following concussion occurs in ∼67-77% of cases and has been implicated as a risk factor for a prolonged recovery. Balance impairments also occur after concussion and last 3-10 days post-injury. Assessments of balance can be done using both clinical and instrumented measures with success. Vestibular rehabilitation has been shown to improve outcomes in patients with vestibular impairments, with one study demonstrating success in decreasing symptoms and increasing function following concussion. Best practices suggest that the assessment of vestibular function through cranial nerve, oculomotor and balance assessments are an important aspect of concussion management. Future studies should evaluate the effectiveness of vestibular rehabilitation for improving patient outcomes.

  12. Cross-Modal Calibration of Vestibular Afference for Human Balance.

    Science.gov (United States)

    Héroux, Martin E; Law, Tammy C Y; Fitzpatrick, Richard C; Blouin, Jean-Sébastien

    2015-01-01

    To determine how the vestibular sense controls balance, we used instantaneous head angular velocity to drive a galvanic vestibular stimulus so that afference would signal that head movement was faster or slower than actual. In effect, this changed vestibular afferent gain. This increased sway 4-fold when subjects (N = 8) stood without vision. However, after a 240 s conditioning period with stable balance achieved through reliable visual or somatosensory cues, sway returned to normal. An equivalent galvanic stimulus unrelated to sway (not driven by head motion) was equally destabilising but in this situation the conditioning period of stable balance did not reduce sway. Reflex muscle responses evoked by an independent, higher bandwidth vestibular stimulus were initially reduced in amplitude by the galvanic stimulus but returned to normal levels after the conditioning period, contrary to predictions that they would decrease after adaptation to increased sensory gain and increase after adaptation to decreased sensory gain. We conclude that an erroneous vestibular signal of head motion during standing has profound effects on balance control. If it is unrelated to current head motion, the CNS has no immediate mechanism of ignoring the vestibular signal to reduce its influence on destabilising balance. This result is inconsistent with sensory reweighting based on disturbances. The increase in sway with increased sensory gain is also inconsistent with a simple feedback model of vestibular reflex action. Thus, we propose that recalibration of a forward sensory model best explains the reinterpretation of an altered reafferent signal of head motion during stable balance.

  13. Is vestibular neuritis an immune related vestibular neuropathy inducing vertigo?

    Science.gov (United States)

    Greco, A; Macri, G F; Gallo, A; Fusconi, M; De Virgilio, A; Pagliuca, G; Marinelli, C; de Vincentiis, M

    2014-01-01

    To review the current knowledge of the aetiology of vestibular neuritis including viral infections, vascular occlusion, and immunomediated mechanisms and to discuss the pathogenesis with relevance to pharmacotherapy. Relevant publications on the aetiology and treatment of vestibular neuritis from 1909 to 2013 were analysed. Vestibular neuritis is the second most common cause of peripheral vestibular vertigo and is due to a sudden unilateral loss of vestibular function. Vestibular neuronitis is a disorder thought to represent the vestibular-nerve equivalent of sudden sensorineural hearing loss. Histopathological studies of patients who died from unrelated clinical problems have demonstrated degeneration of the superior vestibular nerve. The characteristic signs and symptoms include sudden and prolonged vertigo, the absence of auditory symptoms, and the absence of other neurological symptoms. The aetiology and pathogenesis of the condition remain unknown. Proposed theories of causation include viral infections, vascular occlusion, and immunomediated mechanisms. The management of vestibular neuritis involves symptomatic treatment with antivertiginous drugs, causal treatment with corticosteroids, and physical therapy. Antiviral agents did not improve the outcomes.

  14. Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo?

    Directory of Open Access Journals (Sweden)

    A. Greco

    2014-01-01

    Full Text Available Objectives. To review the current knowledge of the aetiology of vestibular neuritis including viral infections, vascular occlusion, and immunomediated mechanisms and to discuss the pathogenesis with relevance to pharmacotherapy. Systematic Review Methodology. Relevant publications on the aetiology and treatment of vestibular neuritis from 1909 to 2013 were analysed. Results and Conclusions. Vestibular neuritis is the second most common cause of peripheral vestibular vertigo and is due to a sudden unilateral loss of vestibular function. Vestibular neuronitis is a disorder thought to represent the vestibular-nerve equivalent of sudden sensorineural hearing loss. Histopathological studies of patients who died from unrelated clinical problems have demonstrated degeneration of the superior vestibular nerve. The characteristic signs and symptoms include sudden and prolonged vertigo, the absence of auditory symptoms, and the absence of other neurological symptoms. The aetiology and pathogenesis of the condition remain unknown. Proposed theories of causation include viral infections, vascular occlusion, and immunomediated mechanisms. The management of vestibular neuritis involves symptomatic treatment with antivertiginous drugs, causal treatment with corticosteroids, and physical therapy. Antiviral agents did not improve the outcomes.

  15. [Vestibular neuritis: treatment and prognosis].

    Science.gov (United States)

    Reinhard, A; Maire, R

    2013-10-02

    Vestibular neuritis is a sudden unilateral peripheral vestibular deficit of unknown origin without associated hearing loss. It is the second cause of peripheral vertigo after Benign Paroxysmal Positional Vertigo (BPPV). The etiology remains unclear and some treatments are still controversial. The prognosis is good. The differential diagnosis of the disease mainly includes an acute vertigo of central origin. This article summarizes the management and prognosis of vestibular neuritis.

  16. Pharmacogenomic and clinical data link non-pharmacokinetic metabolic dysregulation to drug side effect pathogenesis

    DEFF Research Database (Denmark)

    Zielinski, Daniel C.; Filipp, F. V.; Bordbar, A.

    2015-01-01

    Drug side effects cause a significant clinical and economic burden. However, mechanisms of drug action underlying side effect pathogenesis remain largely unknown. Here, we integrate pharmacogenomic and clinical data with a human metabolic network and find that non-pharmacokinetic metabolic pathways...... the relationships between the cellular response to drugs, genetic variation of patients and cell metabolism may help managing side effects by personalizing drug prescriptions and nutritional intervention strategies....

  17. The Effect of Material and Side Walls on Hull Deflection during a Blast Event

    Science.gov (United States)

    2017-12-13

    ARL-CR-0822 ● DEC 2017 US Army Research Laboratory The Effect of Material and Side Walls on Hull Deflection during a Blast Event...Army Research Laboratory The Effect of Material and Side Walls on Hull Deflection during a Blast Event prepared by Danielle Abell SURVICE...2. REPORT TYPE Contractor Report 3. DATES COVERED (From - To) June 2016–September 2017 4. TITLE AND SUBTITLE The Effect of Material and Side

  18. Optomotor behaviour in Xenopus laevis tadpoles as a measure of the effect of gravity on visual and vestibular neural integration

    Science.gov (United States)

    Pronych, S. P.; Souza, K. A.; Neff, A. W.; Wassersug, R. J.

    1996-01-01

    The ability of aquatic vertebrates to maintain their position requires integration of visual and vestibular sensory information. To understand better how aquatic animals integrate such information, we measured the optomotor behaviour of Xenopus laevis tadpoles raised in growth chambers in microgravity (behaviour of tadpoles. This research represents the first time that the optomotor behaviour of an organism raised from fertilization in microgravity has been tested. Significant differences were observed in the optomotor behaviour among the four gravity treatments. When first exposed to normal gravity, the microgravity-raised tadpoles exhibited the strongest (or most positive) optomotor behaviour, while the 3 g centrifuge tadpoles showed no optomotor response. Some abnormal behaviours (such as erratic swimming, lying motionless and abnormal swimming posture) were observed in the tadpoles raised in altered gravity on the initial day of testing. One day later, the tadpoles raised in hypergravity did not differ significantly in their optomotor behaviour from control tadpoles raised in normal gravity. However, tadpoles raised in microgravity still displayed an exaggerated optomotor response. One week after the tadpoles had been introduced to normal gravity, there was no longer a significant difference in optomotor behaviour among the different gravity treatments. This convergence of optomotor behaviour by tadpoles from the different treatment reflects the acclimation of their vestibular systems to normal gravity.

  19. Passive motion reduces vestibular balance and perceptual responses.

    Science.gov (United States)

    Fitzpatrick, Richard C; Watson, Shaun R D

    2015-05-15

    With the hypothesis that vestibular sensitivity is regulated to deal with a range of environmental motion conditions, we explored the effects of passive whole-body motion on vestibular perceptual and balance responses. In 10 subjects, vestibular responses were measured before and after a period of imposed passive motion. Vestibulospinal balance reflexes during standing evoked by galvanic vestibular stimulation (GVS) were measured as shear reaction forces. Perceptual tests measured thresholds for detecting angular motion, perceptions of suprathreshold rotation and perceptions of GVS-evoked illusory rotation. The imposed conditioning motion was 10 min of stochastic yaw rotation (0.5-2.5 Hz ≤ 300 deg s(-2) ) with subjects seated. This conditioning markedly reduced reflexive and perceptual responses. The medium latency galvanic reflex (300-350 ms) was halved in amplitude (48%; P = 0.011) but the short latency response was unaffected. Thresholds for detecting imposed rotation more than doubled (248%; P vestibular sensations of rotation evoked by GVS (mean 113 deg for 10 s at 1 mA) by 44% (P vestibular sensory autoregulation exists and that this probably involves central and peripheral mechanisms, possibly through vestibular efferent regulation. We propose that failure of these regulatory mechanisms at different levels could lead to disorders of movement perception and balance control during standing. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.

  20. "There is a chain of connections": using syndemics theory to understand HIV treatment side effects.

    Science.gov (United States)

    Gagnon, Marilou

    2018-03-12

    Side effects are central to the experience of living longer with HIV but rarely have they been studied alone. Unlike other aspects of that experience, like quality of life, treatment adherence, chronicity, episodic disability, aging, health, and viral load suppression, side effects have not benefited from the same level of empirical and theoretical engagement from qualitative researchers. In this paper, we draw on syndemics theory and 50 qualitative interviews to better understand the experience of HIV treatment side effects. Two main categories were identified in the data: side effects as a product and side effects as a risk factor. The first category suggests that side effects are not just the product of taking antiretroviral drugs. They are also the product of particular conditions and tend to cluster with other health problems. The second category puts forward the idea that side effects can act as a syndemic risk factor by exposing PLWH to a greater risk of developing health problems and creating conditions in which psychosocial issues are more likely to emerge. The paper concludes by calling for more research on the complex nature of side effects and for the development of comprehensive approaches for the assessment and management of side effects.

  1. Angiogenesis in vestibular schwannomas

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Werther, Kim; Nalla, Amarnadh

    2010-01-01

    targets the angiogenic process by investigation of tumor expression of MMP-2, MMP-9, and tissue inhibitors of metalloproteinase (TIMP)-1. A possible correlation with gender, patient age, symptom duration, tumor size, and the absolute and relative growth rate is explored.......Vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) are potent mediators of tumor angiogenesis. It has been demonstrated that vestibular schwannoma VEGF expression correlates with tumor growth pattern, whereas knowledge on the expression of MMPs is lacking. This study...

  2. Clinical characteristics of inferior vestibular neuritis.

    Science.gov (United States)

    Chihara, Yasuhiro; Iwasaki, Shinichi; Murofushi, Toshihisa; Yagi, Masato; Inoue, Aki; Fujimoto, Chisato; Egami, Naoya; Ushio, Munetaka; Karino, Shotaro; Sugasawa, Keiko; Yamasoba, Tatsuya

    2012-12-01

    Inferior vestibular neuritis (IVN) is a relatively minor subtype of vestibular neuritis (VN) and its clinical characteristics are unique. To clarify clinical characteristics of IVN in comparison with conventional VN. This was a retrospective case series review. Caloric responses and cervical vestibular evoked myogenic potential (cVEMP) responses were measured in 71 patients with VN. The patients were classified into three groups: (1) IVN group, who showed only asymmetrical cVEMP responses; (2) superior VN (SVN) group, who showed only asymmetrical caloric responses; (3) total VN (TVN) group, who showed asymmetrical responses in both tests. The clinical records of time course of subjective symptoms (duration of attack, duration of hospitalization, and time to remission) were reviewed and other profiles (age, sex, affected side, acute symptoms, and sequelae) were evaluated. Of the 71 patients with VN, 13 (18%) were classified as having IVN. The mean age and time to remission of patients with IVN (44.2 ± 4.8 years, 0.9 ± 0.5 months) were significantly lower and shorter, respectively, than those of patients with TVN (57.3 ± 2.5 years, 4.9 ± 4.7 months). There were no significant differences in other symptoms and profiles among the three groups. No patients with IVN showed benign paroxysmal positional vertigo as a sequela.

  3. Explaining Effects and Side Effects of School Inspections: A Path Analysis

    Science.gov (United States)

    Penninckx, Maarten; Vanhoof, Jan; De Maeyer, Sven; Van Petegem, Peter

    2016-01-01

    There are large differences between schools with regard to how they are affected by a school inspection. This study provides quantitative evidence about the extent to which perceived effects and side effects of an inspection are related to the inspection's judgement on the school, to features of the inspection, and to school features. This study…

  4. Norms Inform Mental State Ascriptions: A Rational Explanation for the Side-Effect Effect

    Science.gov (United States)

    Uttich, Kevin; Lombrozo, Tania

    2010-01-01

    Theory of mind, the capacity to understand and ascribe mental states, has traditionally been conceptualized as analogous to a scientific theory. However, recent work in philosophy and psychology has documented a "side-effect effect" suggesting that moral evaluations influence mental state ascriptions, and in particular whether a behavior is…

  5. The effect that side dominance has on barbell power symmetry during the hang power clean.

    Science.gov (United States)

    Lake, Jason P; Lauder, Mike A; Smith, Neal A

    2010-11-01

    The aim of this study was to examine whether ground reaction force (GRF) side differences were transmitted and related to bar end power output asymmetries during hang power clean (HPC) performance and whether progressive loading would intensify this effect. Differences between the dominant (D) and nondominant (ND) side average GRFs (AGRFs) of both feet and average bar end power outputs were recorded simultaneously from 15 recreationally trained male volunteers at 30, 60, and 90% 1RM using 2 force platforms and 3 high-speed digital cameras, quantifying side dominance from perceived handedness (left- or right-side dominance [LRSD]), GRF side dominance (force side dominance [FSD]), and bar end power output side dominance (barbell side dominance [BSD]). With the exception of the LRSD condition, differences between the D and ND side AGRFs were significant (FSD: 1.8-4.3%; BSD: 5.1-6.4%, p the 30% equivalents. Average GRF side differences were not related to bar end power output side differences. Because of the consistent side difference of 4-6% investigators and strength and conditioning practitioners should exercise caution when interpreting changes in bar end power output.

  6. Estimation of Optimum Stimulus Amplitude for Balance Training using Electrical Stimulation of the Vestibular System

    Science.gov (United States)

    Goel, R.; Rosenberg, M. J.; De Dios, Y. E.; Cohen, H. S.; Bloomberg, J. J.; Mulavara, A. P.

    2016-01-01

    Sensorimotor changes such as posture and gait instabilities can affect the functional performance of astronauts after gravitational transitions. Sensorimotor Adaptability (SA) training can help alleviate decrements on exposure to novel sensorimotor environments based on the concept of 'learning to learn' by exposure to varying sensory challenges during posture and locomotion tasks (Bloomberg 2015). Supra-threshold Stochastic Vestibular Stimulation (SVS) can be used to provide one of many challenges by disrupting vestibular inputs. In this scenario, the central nervous system can be trained to utilize veridical information from other sensory inputs, such as vision and somatosensory inputs, for posture and locomotion control. The minimum amplitude of SVS to simulate the effect of deterioration in vestibular inputs for preflight training or for evaluating vestibular contribution in functional tests in general, however, has not yet been identified. Few studies (MacDougall 2006; Dilda 2014) have used arbitrary but fixed maximum current amplitudes from 3 to 5 mA in the medio-lateral (ML) direction to disrupt balance function in healthy adults. Giving this high level of current amplitude to all the individuals has a risk of invoking side effects such as nausea and discomfort. The goal of this study was to determine the minimum SVS level that yields an equivalently degraded balance performance. Thirteen subjects stood on a compliant foam surface with their eyes closed and were instructed to maintain a stable upright stance. Measures of stability of the head, trunk, and whole body were quantified in the ML direction. Duration of time they could stand on the foam surface was also measured. The minimum SVS dosage was defined to be that level which significantly degraded balance performance such that any further increase in stimulation level did not lead to further balance degradation. The minimum SVS level was determined by performing linear fits on the performance variable

  7. Reirradiation on recurrent cervical cancer case: Treatment response and side effects

    Science.gov (United States)

    Siregar, M. F.; Supriana, N.; Nuranna, L.; Prihartono, J.

    2017-08-01

    Management of recurrent cervical cancer by reirradiation after radiation treatment remains controversial. In Indonesia, there is currently no data about reirradiation tumor response and side effects. This study aims to assess the tumor response to and side effects of reirradiation, the effect of time interval between first radiation treatment and cancer recurrence on the tumor response and side effects, and the effect of tumor size on tumor response. A cohort retrospective study with no comparison was done with the Radiotherapy Department at Cipto Mangunkusumo General Hospital, Jakarta. Participants were recurrent cervical cancer patients undergoing reirradiation. Data was collected from patients’ medical records and follow-up phone calls. Twenty-two patients participated in this study. Nine patients (40.9%) had complete responses, 10 patients (45.5%) had partial responses, 1 patient (4.5%) had a stable response, and 2 patients (9.1%) had tumor progressions. In general, 15 patients (68.2%) had no to light side effects (grade 0-2 RTOG) and 7 patients (31.8%) had severe side effects (grade 3-4 RTOG). Four patients (18.1%) had severe gastrointestinal acute side effects, 6 patients (27.3%) had severe gastrointestinal late side effects, 2 patients (9.1%) had severe urogenital side effects, and there were no patients had severe urogenital late side effects. There was no significant difference in tumor response between patients with time interval between first radiation treatment and recurrence of 4 cm. Reirradiation can be considered as a modality in recurrent cervical cancer management since good tumor response was achieved and the majority of patients had no to light side effects (grade 0-2 RTOG). This study found no correlation between tumor response, side effects, and time gap between first radiation treatment and recurrence of 4 cm.

  8. Influence of body laterality on recovery from subjective visual vertical tilt after vestibular neuritis.

    Science.gov (United States)

    Toupet, Michel; Van Nechel, Christian; Bozorg Grayeli, Alexis

    2014-01-01

    The subjective visual vertical (SVV) is an indicator of vestibular otolithic function and mainly processed by the nondominant parietal cortex. We investigated the hypothesis that recovery from SVV tilt after vestibular neuritis can be influenced by the body's lateral preference. This prospective cohort follow-up study included 254 consecutive adult patients with vestibular neuritis. The recovery from SVV tilt was faster in patients with a left hand or eye dominance than in those with a right dominance. While in left-handers the side of the neuritis did not affect the speed of recovery, in right-handed subjects, the recovery from a right-sided neuritis was significantly slower than from a left-sided affection. These observations suggest that subjects with a left sensorimotor dominance have developed more significant midline-crossing projections to the parietal cortex, allowing them to cope faster with a unilateral vestibular deficit.

  9. Cross-sectional vestibular nerve analysis in vestibular neuritis.

    Science.gov (United States)

    Fundakowski, Christopher E; Anderson, Joshua; Angeli, Simon

    2012-07-01

    We examined the association between the size and cross-sectional area of the superior vestibular nerve as measured on constructive interference in steady-state (CISS) parasagittal magnetic resonance imaging (MRI) and the vestibular nerve function as measured by electronystagmography. The retrospective observational cohort study took place at an academic tertiary referral center. Twenty-six patients who met established clinical and electronystagmographic criteria for vestibular neuritis and who underwent parasagittal CISS MRI were identified. Two blinded investigators measured vestibular nerve height and width bilaterally at the level of the fundus of the internal auditory canal and calculated the cross-sectional nerve areas. The inter-rater reliability and agreement were analyzed. Symptom duration, age, and gender were also examined. A statistically significant decrease was observed in both vestibular nerve cross-sectional area and height as compared to the contralateral vestibular nerve. A non-statistically significant trend was observed for a relative decreased cross-sectional nerve area with increased age, as well as a decrease in nerve area with an increase in symptom duration. Decreases in both vestibular nerve cross-sectional area and height are observed in patients with unilateral vestibular neuritis as measured on parasagittal CISS MRI.

  10. Effect of Rotational Speed on the Stability of Two Rotating Side-by-side Circular Cylinders at Low Reynolds Number

    Science.gov (United States)

    Dou, Huashu; Zhang, Shuo; Yang, Hui; Setoguchi, Toshiaki; Kinoue, Yoichi

    2018-04-01

    Flow around two rotating side-by-side circular cylinders of equal diameter D is numerically studied at the Reynolds number 40≤ Re ≤200 and various rotation rate θ i . The incoming flow is assumed to be two-dimensional laminar flow. The governing equations are the incompressible Navier-Stokes equations and solved by the finite volume method (FVM). The ratio of the center-to-center spacing to the cylinder diameter is T/D=2. The objective of the present work is to investigate the effect of rotational speed and Reynolds number on the stability of the flow. The simulation results are compared with the experimental data and a good agreement is achieved. The stability of the flow is analyzed by using the energy gradient theory, which produces the energy gradient function K to identify the region where the flow is the most prone to be destabilized and the degree of the destabilization. Numerical results reveal that K is the most significant at the separated shear layers of the cylinder pair. With Re increases, the length of the wake is shorter and the vortex shedding generally exhibits a symmetrical distribution for θ i < θ crit . It is also shown that the unsteady vortex shedding can be suppressed by rotating the cylinders in the counter-rotating mode.

  11. Effects of multi-directional vibrotactile feedback on vestibular-deficient postural performance during continuous multi-directional support surface perturbations.

    Science.gov (United States)

    Sienko, K H; Balkwill, M D; Oddsson, L I E; Wall, C

    2008-01-01

    Single-axis vibrotactile feedback of trunk tilt provided in real-time has previously been shown to significantly reduce the root-mean-square (RMS) trunk sway in subjects with vestibular loss during single-axis perturbation. This research examines the effect of multi-directional vibrotactile feedback on postural sway during continuous multi-directional surface perturbations when the subjects' eyes are closed. Eight subjects with vestibular loss donned a multi-axis feedback device that mapped body tilt estimates onto their torsos with a 3-row by 16-column array of tactile actuators (tactors). Tactor row indicated tilt magnitude and tactor column indicated tilt direction. Root-mean-square trunk tilt, elliptical fits to trunk sway trajectory areas, percentage of time spent outside a no vibrotactile feedback zone, RMS center of pressure, and anchoring index parameters indicating intersegmental coordination were used to assess the efficacy of the multi-directional vibrotactile balance aid. Four tactor display configurations in addition to the tactors off configuration were evaluated. Subjects had significantly reduced RMS trunk sway, significantly smaller elliptical fits of the trajectory area, and spent significantly less time outside of the no feedback zone in the tactors on versus the tactors off configuration. Among the displays evaluated in this study, there was not an optimal tactor column configuration for standing tasks involving continuous surface perturbations. Furthermore, subjects performed worse when erroneous information was displayed. Therefore, a spatial resolution of 90 degrees (4 columns) seems to be as effective as a spatial resolution of 22.5 degrees (16 columns) for control of standing.

  12. Auditory-pupillary responses in patients with vestibular neuritis.

    Science.gov (United States)

    Kitajima, Naoharu; Kobayashi, Noriko; Otsuka, Koji; Ogawa, Yasuo; Inagaki, Taro; Ichimura, Akihide; Suzuki, Mamoru

    2013-01-01

    Pupillary dilation in response to sound stimuli is well established and generally represents a startle reflex to sound. We previously reported that auditory-pupillary responses (APRs) persist with bilateral deafness, and that the pathways mediating APRs involve not only the cochlea but also otolith organs, especially the saccule. Here, we evaluated the vestibulo-autonomic responses in vestibular neuritis (VN) by assessing APRs. Twelve young healthy volunteers without a history of hearing and equilibrium problems and 10 VN patients participated. To clarify the relationship between APRs and vestibular function, especially otolith function, we performed caloric and vestibular-evoked myogenic response testing on VN patients. In normal subjects, we examined APRs when delivering sound stimuli to both sides. In VN patients, we examined APRs when delivering stimuli simultaneously to both sides, to the affected side alone, and then to the unaffected side alone. With binaural stimulation, the pupillary index (PI) - the rate of dilation - of VN patients significantly differed from those of normal subjects. Moreover, in VN patients, PIs of the affected sides were significantly larger than those of the unaffected sides. Our study provides evidence that examining APRs may be useful for evaluating vestibulo-autonomic reflexes, especially otolith-autonomic reflexes.

  13. Nursing-led management of side effects of radiation: evidence-based recommendations for practice

    Directory of Open Access Journals (Sweden)

    Poirier P

    2013-03-01

    Full Text Available Patricia PoirierUniversity of Maine School of Nursing, Orono, ME, USAAbstract: It has been estimated that 50%–60% of patients diagnosed with cancer will receive radiation therapy at some point in their treatment. Although radiation therapy can play a significant role in the cure or control of cancer, and the palliation of symptoms, it also has side effects. Side effects of radiation therapy can interfere with patient quality of life and daily functioning. Severe side effects can lead to delays in treatment, potentially affecting the outcome of treatment. All patients receiving radiation therapy are at risk of fatigue and skin reactions in the area of the body being treated. Other side effects of radiation therapy are specific to the part of the body being treated. Radiation therapy to the head and neck area may cause oral mucositis, dryness, and nutritional deficiencies. Radiation therapy to the chest or lung area may lead to difficulty in swallowing and eating. Radiation therapy to the pelvis frequently causes diarrhea. There are many nursing interventions available to manage the side effects of treatment based on best available evidence and expert opinion. Nurses in all settings are essential in helping patients manage the side effects of treatment and maintain their quality of life. The purpose of this review is to provide nurses with evidence-based recommendations and suggestions for managing common acute side effects of radiation therapy.Keywords: evidence-based practice, radiation therapy, side effects, nursing management

  14. Family Planning in a Sub-district near Kumasi, Ghana: Side Effect ...

    African Journals Online (AJOL)

    Erah

    Family Planning in a Sub-district near Kumasi, Ghana: Side Effect. Fears, Unintended Pregnancies and ... regulating and implementing the correct use of Primolut N tablets, addressing real and perceived side effects of family planning practices through properly trained ...... string of color-coded beads. This method is 95.

  15. Comparison of the Efficacy and Side Effects of Chlorhexidine Mouthrinses with (Hexidine and without (Epimax Alcohol

    Directory of Open Access Journals (Sweden)

    Ahmad Mogharehabed

    2016-01-01

    Conclusion: Although Epimax mouthwash did not show any side effects, it was less suitable and caused more dental stain. Ethanol-free Hexidine mouthwash seems to be more proper for gingivitis, but its side effects are required to be taken into consideration.

  16. Underreporting of side effects of standard first-line ART in the routine ...

    African Journals Online (AJOL)

    Malawi Medical Journal; 23(4): 116-118 December 2011. Side effects of standard first line in ART 116. Underreporting of side effects of standard first-line. ART in the routine setting in Blantyre, Malawi. Abstract. Introduction. In the Malawi ART programme, 92% of 250,000 patients are using the standard first-line regime of ...

  17. Side effects of antidepressants during long-term use in a naturalistic setting

    NARCIS (Netherlands)

    Bet, Pierre M.; Hugtenburg, Jacqueline G.; Penninx, Brenda W. J. H.; Hoogendijk, Witte J. G.

    2013-01-01

    Side effects of antidepressants are usually underreported in clinical trials and large scale naturalistic studies are restricted to six months of use. We examined the prevalence and nature of patient-perceived side effects and their determinants during long-term antidepressant use in a naturalistic

  18. The vestibular implant: Quo vadis?

    Directory of Open Access Journals (Sweden)

    Raymond eVan De Berg

    2011-08-01

    Full Text Available AbstractObjective: to assess the progress of the development of the vestibular implant and its feasibility short-term. Data sources: a search was performed in Pubmed, Medline and Embase. Key words used were vestibular prosth* and vestibular implant. The only search limit was language: English or Dutch. Additional sources were medical books, conference lectures and our personal experience with per-operative vestibular stimulation in patients selected for cochlear implantation.Study selection: all studies about the vestibular implant and related topics were included and evaluated by two reviewers. No study was excluded since every study investigated different aspects of the vestibular implant. Data extraction and synthesis: data was extracted by the first author from selected reports, supplemented by additional information, medical books conference lectures. Since each study had its own point of interest with its own outcomes, it was not possible to compare data of different studies. Conclusion: to use a basic vestibular implant in humans seems feasible in the very near future. Investigations show that electric stimulation of the canal nerves induces a nystagmus which corresponds to the plane of the canal which is innervated by the stimulated nerve branch. The brain is able to adapt to a higher baseline stimulation, while still reacting on a dynamic component. The best response will be achieved by a combination of the optimal stimulus (stimulus profile, stimulus location, precompensation, complemented by central vestibular adaptation. The degree of response will probably vary between individuals, depending on pathology and their ability to adapt.

  19. Artificial balance: restoration of the vestibulo-ocular reflex in humans with a prototype vestibular neuroprosthesis.

    Science.gov (United States)

    Perez Fornos, Angelica; Guinand, Nils; van de Berg, Raymond; Stokroos, Robert; Micera, Silvestro; Kingma, Herman; Pelizzone, Marco; Guyot, Jean-Philippe

    2014-01-01

    The vestibular system plays a crucial role in the multisensory control of balance. When vestibular function is lost, essential tasks such as postural control, gaze stabilization, and spatial orientation are limited and the quality of life of patients is significantly impaired. Currently, there is no effective treatment for bilateral vestibular deficits. Research efforts both in animals and humans during the last decade set a solid background to the concept of using electrical stimulation to restore vestibular function. Still, the potential clinical benefit of a vestibular neuroprosthesis has to be demonstrated to pave the way for a translation into clinical trials. An important parameter for the assessment of vestibular function is the vestibulo-ocular reflex (VOR), the primary mechanism responsible for maintaining the perception of a stable visual environment while moving. Here we show that the VOR can be artificially restored in humans using motion-controlled, amplitude modulated electrical stimulation of the ampullary branches of the vestibular nerve. Three patients received a vestibular neuroprosthesis prototype, consisting of a modified cochlear implant providing vestibular electrodes. Significantly higher VOR responses were observed when the prototype was turned ON. Furthermore, VOR responses increased significantly as the intensity of the stimulation increased, reaching on average 79% of those measured in healthy volunteers in the same experimental conditions. These results constitute a fundamental milestone and allow us to envision for the first time clinically useful rehabilitation of patients with bilateral vestibular loss.

  20. Side Effects of Adjuvant Radiotherapy in Patients With Testicular Seminoma Stage I

    International Nuclear Information System (INIS)

    Gamulin, M.; Grgic, M.

    2011-01-01

    In the present study the side effects of adjuvant radiotherapy of testicular seminoma stage I patients were followed up in the period between 13 to 84 months (median 28 months). The most frequent side effects in these patients during radiotherapy were gastrointestinal problems (nausea/vomiting), psychologic and cognitive problems and minor sexual problems. The reported side effects were treated by antimmimetics and anxiolytics. After radiotherapy, the side effects persisted in 6 % of patients but therapy was needed only in few. Healthy children were born to 76 % of patients in the age group 18 - 39 years after radiotherapy. The present study shows that adjuvant irradiation of paraaortal lymph nodes with total a dose of 24 Gy in 16 daily fractions in testicular seminoma patients causes acceptable side effects with acceptable quality of life and fertility, however in conditions of individual approach and family consulting. (author)

  1. About the pathophysiology of acute unilateral vestibular deficit - vestibular neuritis (VN) or peripheral vestibulopathy (PVP)?

    Science.gov (United States)

    Uffer, Denis S; Hegemann, Stefan C A

    2016-07-02

    To determine whether patients with acute unilateral peripheral vestibulopathy (PVP), often called "vestibular neuritis/neuronitis or neuropathy" (VN) have a vestibular lesion pattern consistent with the distribution of the neurological afferents. Much is known about the clinical nature of PVP, however less so about its etiology and pathogenesis. Due to the frequency with which VN is used to describe the syndrome, an inflammation of the vestibular nerve or of one of its branches is often assumed to be the cause of PVP, though there is insufficient data so far to support this assumption. We conducted a retrospective study of 25 patients who had presented to our clinic with PVP and had all vestibular receptor organs tested shortly after start of symptoms. We analysed their vestibular lesion patterns in order to determine whether they were consistent with the neuritis hypothesis (NH). The lesion patterns varied conspicuously. 76% did not follow an innervation pattern, thereby contradicting the NH and only 24% had a lesion pattern that either definitely (16%) or probably (8%) supported the NH. These results should remind us to be careful before jumping to quick conclusions about the pathogenetic nature of PVP. With any reason to question VN as the only cause of PVP, we should reconsider the treatment approach to PVP. If the cause probably or even possibly lies inside the vestibular labyrinth, an intratympanic steroid injection might prove to be a more effective measure, even in first-line treatment. If the etiology is unsure, a combination of systemic and intratympanic steroid treatment may be adequate.

  2. Vestibular control of standing balance is enhanced with increased cognitive load.

    Science.gov (United States)

    McGeehan, Michael A; Woollacott, Marjorie H; Dalton, Brian H

    2017-04-01

    When cognitive load is elevated during a motor task, cortical inhibition and reaction time are increased; yet, standing balance control is often unchanged. This disconnect is likely explained by compensatory mechanisms within the balance system such as increased sensitivity of the vestibulomotor pathway. This study aimed to determine the effects of increased cognitive load on the vestibular control of standing balance. Participants stood blindfolded on a force plate with their head facing left and arms relaxed at their sides for two trials while exposed to continuous electrical vestibular stimulation (EVS). Participants either stood quietly or executed a cognitive task (double-digit arithmetic). Surface electromyography (EMG) and anterior-posterior ground-body forces (APF) were measured in order to evaluate vestibular-evoked balance responses in the frequency (coherence and gain) and time (cumulant density) domains. Total distance traveled for anterior-posterior center of pressure (COP) was assessed as a metric of balance variability. Despite similar distances traveled for COP, EVS-medial gastrocnemius (MG) EMG and EVS-APF coherence and EVS-TA EMG and EVS-MG EMG gain were elevated for multiple frequencies when standing with increased cognitive load. For the time domain, medium-latency peak amplitudes increased by 13-54% for EVS-APF and EVS-EMG relationships with the cognitive task compared to without. Peak short-latency amplitudes were unchanged. These results indicate that reliance on vestibular control of balance is enhanced when cognitive load is elevated. This augmented neural strategy may act to supplement divided cortical processing resources within the balance system and compensate for the acute neuromuscular modifications associated with increased cognitive demand.

  3. Vestibular dysfunction in Turner syndrome: a case report.

    Science.gov (United States)

    Baxter, Michael; Agrawal, Yuri

    2014-02-01

    Turner syndrome is a well-known cause of sensorineural hearing loss, and the lack of estrogen has been implicated in cochlear dysfunction. It has never been associated with vestibular dysfunction. We report a case of a patient with Turner syndrome who was found to have bilateral vestibular dysfunction based on video-oculography (VOG) testing. A single patient with a history of Turner syndrome who was found to have significant bilateral vestibular dysfunction. After noticing a deficit in the vestibulo-ocular reflexes on qualitative horizontal head impulse examination, the patient underwent VOG testing. VOG testing quantatively measures angular vestibulo-ocular reflex (AVOR) gain in the horizontal semicircular canal plane. AVOR gain represents the eye movement response to a head movement; in normal individuals the eye movement is fully compensatory and gain values are close to unity. VOG results showed AVOR gains of 0.29 and 0.36 on the right and left sides, respectively. We have presented a case of a woman with Turner syndrome with asymptomatic vestibular dysfunction demonstrated with VOG testing. Although there is a documented relationship between Turner syndrome and sensorineural hearing loss, there are no previous studies or case reports linking Turner syndrome and vestibular dysfunction. Additional research and added vigilance in monitoring Turner syndrome patients may be warranted.

  4. Influence of cochlear implantation on peripheral vestibular receptor function.

    Science.gov (United States)

    Krause, Eike; Louza, Julia P R; Wechtenbruch, Juliane; Gürkov, Robert

    2010-06-01

    The objectives of this study were 1) to assess the influence of a cochlear implantation on peripheral vestibular receptor function in the inner ear in the implant and in the nonimplant side, and 2) to analyze a possible correlation with resulting vertigo symptoms. Prospective clinical study. Cochlear implant center at tertiary referral hospital. A total of 32 patients, aged 15 to 83 years, undergoing cochlear implantation were assessed pre- and postoperatively for caloric horizontal semicircular canal response and vestibular-evoked myogenic potentials of the sacculus, and postoperatively for subjective vertigo symptoms. Patients with vertigo were compared with patients without symptoms with regard to the findings of the vestibular function tests. Cochlear implantation represents a significant risk factor for horizontal semicircular canal impairment (P 0.05). Cochlear implantation is a relevant risk factor for damage of peripheral vestibular receptor function. Therefore, preservation not only of residual hearing function but also of vestibular function should be aimed for, by using minimally invasive surgical techniques. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

  5. Pharmacogenomic study of side-effects for antidepressant treatment options in STAR*D.

    Science.gov (United States)

    Clark, S L; Adkins, D E; Aberg, K; Hettema, J M; McClay, J L; Souza, R P; van den Oord, E J C G

    2012-06-01

    Understanding individual differences in susceptibility to antidepressant therapy side-effects is essential to optimize the treatment of depression. We performed genome-wide association studies (GWAS) to search for genetic variation affecting the susceptibility to side-effects. The analysis sample consisted of 1439 depression patients, successfully genotyped for 421K single nucleotide polymorphisms (SNPs), from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Outcomes included four indicators of side-effects: general side-effect burden, sexual side-effects, dizziness and vision/hearing-related side-effects. Our criterion for genome-wide significance was a prespecified threshold ensuring that, on average, only 10% of the significant findings are false discoveries. Thirty-four SNPs satisfied this criterion. The top finding indicated that 10 SNPs in SACM1L mediated the effects of bupropion on sexual side-effects (p = 4.98 × 10(-7), q = 0.023). Suggestive findings were also found for SNPs in MAGI2, DTWD1, WDFY4 and CHL1. Although our findings require replication and functional validation, this study demonstrates the potential of GWAS to discover genes and pathways that could mediate adverse effects of antidepressant medication.

  6. Cardiovascular side effects related with use of synthetic cannabinoids “bonzai” : two case reports

    OpenAIRE

    Atik, Sezen Ugan; Dedeoğlu, Reyhan; Varol, Fatih; Çam, Halit; Eroğlu, Ayşe Güler; Saltık, Levent

    2015-01-01

    Information about the effects of synthetic cannabinoids “bonzai” on the cardiovascular system is limited. In this article, two patients in whom different cardiological side effects were observed following use of synthetic cannabinoids ‘bonzai’ were presented.

  7. Vestibular Function in Adults With Epilepsy of Unknown Etiology.

    Science.gov (United States)

    Hamed, Sherifa A; Tohamy, Amal M; Oseilly, Amira M

    2017-09-01

    This study aimed to evaluate vestibular function in adults with chronic epilepsy of unknown etiology in the inter-ictal period. Epilepsy is a chronic medical disorder. Life-long therapy may be required in one-third of patients. Epilepsy is associated with comorbid somatic conditions which impairs patients' quality of life. This cross-sectional study included 28 with generalized tonic clonic (GTC) convulsions and 14 and 3 with temporal (TLE) and frontal lobe (FLE) epilepsies with secondary generalization (all were on regular carbamazepine therapy) and 40 healthy control subjects. The patients' mean age was 34.97 ± 7.35 years and the duration of illness was 18.75 ± 7.99 years. All underwent videonystagmography (VNG). Compared with controls, patients had frequent vestibular symptoms including dizziness (62.22%) (p = 0.0001) and sense of imbalance (44.44%) (p = 0.0001). Eleven patients (24.44%) had central vestibular dysfunction (p = 0.0001); 9 (20%) had mixed vestibular dysfunction and one (2.22%) had peripheral vestibular dysfunction (p = 0.0001). Abnormalities were observed in saccadic (44.4%) and pursuit (42.2%) eye movements, optokinetic nystagmus (42.2%) and positioning/positional (11.11%) and caloric (13.33%) testing. TLE and FLE were associated with more VNG abnormalities than GTC. No significant differences were observed in the demographic and clinical characteristics between patients with and without VNG abnormalities. Vestibular manifestations are frequent in patients with epilepsy. This may be a result of the permanent damaging effect of chronic epilepsy on the vestibular cortical areas and/or a toxic effect from prolonged carbamazepine therapy on the peripheral and central vestibular systems.

  8. State Anxiety Subjective Imbalance and Handicap in Vestibular Schwannoma.

    Science.gov (United States)

    Saman, Yougan; Mclellan, Lucie; Mckenna, Laurence; Dutia, Mayank B; Obholzer, Rupert; Libby, Gerald; Gleeson, Michael; Bamiou, Doris-Eva

    2016-01-01

    Evidence is emerging for a significant clinical and neuroanatomical relationship between balance and anxiety. Research has suggested a potentially priming effect with anxiety symptoms predicting a worsening of balance function in patients with underlying balance dysfunction. We propose to show that a vestibular stimulus is responsible for an increase in state anxiety, and there is a relationship between increased state anxiety and worsening balance function. (1) To quantify state anxiety following a vestibular stimulus in patients with a chronic vestibular deficit. (2) To determine if state anxiety during a vestibular stimulus would correlate with the severity of chronic balance symptoms and handicap. Two separate cohorts of vestibular schwannoma (VS) patients underwent vestibular tests (electronystagmography, cervical and ocular vestibular evoked myogenic potentials, and caloric responses) and questionnaire assessments [vertigo handicap questionnaire (VHQ), vertigo symptom scale (VSS), and state-trait anxiety inventory (STAIY)]. Fifteen post-resection VS patients, with complete unilateral vestibular deafferentation, were assessed at a minimum of 6 months after surgery in Experiment 1 (Aim 1). Forty-five patients with VS in situ formed the cohort for Experiment 2 (Aim 2). Experiment 1: VS subjects (N = 15) with a complete post-resection unilateral vestibular deafferentation completed a state anxiety questionnaire before caloric assessment and again afterward with the point of maximal vertigo as the reference (Aim 1). Experiment 2: state anxiety measured at the point of maximal vertigo following a caloric assessment was compared between two groups of patients with VS in situ presenting with balance symptoms (Group 1, N = 26) and without balance symptoms (Group 2, N = 11) (Aim 2). The presence of balance symptoms was defined as having a positive score on the VSS-VER. In Experiment 1, a significant difference (p vestibular deafferentation. In

  9. How the vestibular system interacts with somatosensory perception: a sham-controlled study with galvanic vestibular stimulation.

    Science.gov (United States)

    Ferrè, Elisa R; Day, Brian L; Bottini, Gabriella; Haggard, Patrick

    2013-08-29

    The vestibular system has widespread interactions with other sensory modalities. Here we investigate whether vestibular stimulation modulates somatosensory function, by assessing the ability to detect faint tactile stimuli to the fingertips of the left and right hand with or without galvanic vestibular stimulation (GVS). We found that left anodal and right cathodal GVS, significantly enhanced sensitivity to mild shocks on either hand, without affecting response bias. There was no such effect with either right anodal and left cathodal GVS or sham stimulation. Further, the enhancement of somatosensory sensitivity following GVS does not strongly depend on the duration of GVS, or the interval between GVS and tactile stimulation. Vestibular inputs reach the somatosensory cortex, increasing the sensitivity of perceptual circuitry. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Genome-wide pharmacogenomic study of citalopram-induced side effects in STAR*D.

    Science.gov (United States)

    Adkins, D E; Clark, S L; Åberg, K; Hettema, J M; Bukszár, J; McClay, J L; Souza, R P; van den Oord, E J C G

    2012-07-03

    Affecting about 1 in 12 Americans annually, depression is a leading cause of the global disease burden. While a range of effective antidepressants are now available, failure and relapse rates remain substantial, with intolerable side effect burden the most commonly cited reason for discontinuation. Thus, understanding individual differences in susceptibility to antidepressant therapy side effects will be essential to optimize depression treatment. Here we perform genome-wide association studies (GWAS) to identify genetic variation influencing susceptibility to citalopram-induced side effects. The analysis sample consisted of 1762 depression patients, successfully genotyped for 421K single-nucleotide polymorphisms (SNPs), from the Sequenced Treatment Alternatives to Relieve Depression (STAR(*)D) study. Outcomes included five indicators of citalopram side effects: general side effect burden, overall tolerability, sexual side effects, dizziness and vision/hearing side effects. Two SNPs met our genome-wide significance criterion (qeffects of citalopram on vision/hearing side effects (P=3.27 × 10(-8), q=0.026). The second genome-wide significant finding, representing a haplotype spanning ∼30 kb and eight genotyped SNPs in a gene desert on chromosome 13, was associated with general side effect burden (P=3.22 × 10(-7), q=0.096). Suggestive findings were also found for SNPs at LAMA1, AOX2P, EGFLAM, FHIT and RTP2. Although our findings require replication and functional validation, this study demonstrates the potential of GWAS to discover genes and pathways that potentially mediate adverse effects of antidepressant medications.

  11. Dynamics of energy-related CO2 emissions in China during 1980-2002: the relative importance of energy supply-side and demand-side effects

    International Nuclear Information System (INIS)

    Libo Wu; Kaneko, Shinji; Matsuoka, Shunji

    2006-01-01

    Based on a newly developed model that integrates energy production, transformation and consumption processes, this paper compares the relative importance of some traditionally recognized factors operating on the energy demand side with a body of newly defined factors on the supply side, in terms of their contribution to trends in China's CO 2 emissions related to the total primary energy supply (C-TPES). Before 1996, changes in China's C-TPES were mainly driven by changes on the energy demand side. Factors operating on the energy supply side played trivial roles. During the period 1996-2000, however, increasing demand-side effects declined dramatically and at the same time decreasing effects from supply side expanded significantly. Such changes resulted directly in a decline in the C-TPES. The decreasing effects from international trade as well as statistical imbalances between supply and demand reinforced the declining trend. The shrinkage of demand side effects mainly arose from the slowdown of economic growth and speed of decrease in energy intensity. The expansion of supply-side effects was principally attributed to the speed of decrease in gross unit consumption in transformation sectors, especially in electricity sector. Therefore, the acceleration of efficiency improvements in end-use and transformation sectors accounted for the decline in the C-TPES over the period 1996-2000. (author)

  12. Presbivértigo: ejercicios vestibulares Presbivertigo: vestibular exercises

    OpenAIRE

    Esther Bernal Valls; Víctor Faus Cuñat; Raquel Bernal Valls

    2006-01-01

    El uso de ejercicios en el tratamiento de pacientes con déficit vestibular crónico está incrementándose de forma notable, lo que evidencia que se trata de un procedimiento que resulta beneficioso para este tipo de pacientes. Los buenos resultados que se obtienen sugieren que los ejercicios vestibulares dan lugar a una estabilidad postural y a una disminución de la sensación de desequilibrio.The use of exercises in the treatment of patients with vestibular deficits is increasing in a represent...

  13. Exhibition of Stochastic Resonance in Vestibular Perception

    Science.gov (United States)

    Galvan-Garza, R. C.; Clark, T. K.; Merfeld, D. M.; Bloomberg, J. J.; Oman, C. M.; Mulavara, A. P.

    2016-01-01

    Astronauts experience sensorimotor changes during spaceflight, particularly during G-transitions. Post flight sensorimotor changes include spatial disorientation, along with postural and gait instability that may degrade operational capabilities of the astronauts and endanger the crew. A sensorimotor countermeasure that mitigates these effects would improve crewmember safety and decrease risk. The goal of this research is to investigate the potential use of stochastic vestibular stimulation (SVS) as a technology to improve sensorimotor function. We hypothesize that low levels of SVS will improve sensorimotor perception through the phenomenon of stochastic resonance (SR), when the response of a nonlinear system to a weak input signal is enhanced by the application of a particular nonzero level of noise. This study aims to advance the development of SVS as a potential countermeasure by 1) demonstrating the exhibition of stochastic resonance in vestibular perception, a vital component of sensorimotor function, 2) investigating the repeatability of SR exhibition, and 3) determining the relative contribution of the semicircular canals (SCC) and otolith (OTO) organs to vestibular perceptual SR. A constant current stimulator was used to deliver bilateral bipolar SVS via electrodes placed on each of the mastoid processes, as previously done. Vestibular perceptual motion recognition thresholds were measured using a 6-degree of freedom MOOG platform and a 150 trial 3-down/1-up staircase procedure. In the first test session, we measured vestibular perceptual thresholds in upright roll-tilt at 0.2 Hz (SCC+OTO) with SVS ranging from 0-700 µA. In a second test session a week later, we re-measured roll-tilt thresholds with 0, optimal (from test session 1), and 1500 µA SVS levels. A subset of these subjects, plus naive subjects, participated in two additional test sessions in which we measured thresholds in supine roll-rotation at 0.2 Hz (SCC) and upright y-translation at 1 Hz

  14. Side Effects to Antidepressant Treatment in Patients With Depression and Comorbid Panic Disorder.

    Science.gov (United States)

    Shankman, Stewart A; Gorka, Stephanie M; Katz, Andrea C; Klein, Daniel N; Markowitz, John C; Arnow, Bruce A; Manber, Rachel; Rothbaum, Barbara O; Thase, Michael E; Schatzberg, Alan F; Keller, Martin B; Trivedi, Madhukar H; Kocsis, James H

    2017-04-01

    Side effects to antidepressant medication can affect the efficacy of treatment, but few predictors foretell who experiences side effects and which side effects they experience. This secondary data analysis examined whether depressed patients with comorbid panic disorder were more likely to experience side effects than those without panic disorder. The study also examined whether greater burden of side effects predicted a poorer treatment course for patients with panic disorder than those without panic disorder. To examine the specificity of these effects, analyses also examined 2 other anxiety disorders-social phobia and generalized anxiety disorder (GAD). Between 2002 and 2006, a large sample (N = 808) of chronically depressed individuals (assessed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders [SCID-IV]) received antidepressants according to a predetermined algorithm for 12 weeks. Every 2 weeks, depressive symptoms (per the Hamilton Depression Rating Scale) and side effects (specific side effects as well as several indicators of side effect burden) were assessed. Lifetime diagnosis of panic disorder (assessed using the SCID-IV) at baseline was associated with higher likelihood of gastrointestinal (OR = 1.6 [95% CI, 1.0-2.6]), cardiac (OR = 1.8 [95% CI, 1.1-3.1]), neurologic (OR = 2.6 [95% CI, 1.6-4.2]), and genitourinary side effects (OR = 3.0 [95% CI, 1.7-5.3]) during treatment. Increases in side effect frequency, intensity, and impairment over time were more strongly associated with increases in depressive symptoms for patients with panic disorder compared to those without panic disorder. Neither social phobia nor GAD was associated with these effects. Potentially due to heighte​ned interoceptive awareness of changes in their body, chronically depressed individuals with panic disorder may be at greater risk than those without panic disorder for antidepressant side effects and to experience a worsening of depressive symptoms as a result

  15. Vestibular feedback maintains reaching accuracy during body movement

    Science.gov (United States)

    Reynolds, Raymond F.

    2016-01-01

    position. These corrections mimicked those evoked when chair velocity was altered without any galvanic vestibular stimulation, indicating a compensatory arm response to a sensation of altered body motion. In stark contrast, corrections were completely absent during the body‐fixed task, despite the same chair movement profile and arm posture. These effects persisted when we controlled for differences in limb kinematics between the two tasks. Our results demonstrate that vestibular control of the upper limb maintains reaching accuracy during unpredictable body motion. The observation that such responses occurred only when reaching within an earth‐fixed reference frame confirms the functional nature of vestibular‐evoked arm movement. PMID:27730646

  16. Focal increase of blood flow in the cerebral cortex of man during vestibular stimulation

    DEFF Research Database (Denmark)

    Friberg, L; Olsen, T S; Roland, P E

    1985-01-01

    . On the rCBF display this area was located in the superior temporal region posterior to the auditory area, probably in the superior temporal gyrus. It is suggested that this area represents the primary projection area of the vestibular nerve and that it is the activation of this area during caloric...... meatus was irrigated with water at body temperature as a control to vestibular stimulation. During vestibular stimulation there was only a single cortical area, located in the superior temporal region, which showed a consistent focal activation in the hemisphere contralateral to the stimulated side...

  17. Symptoms and side effects in chronic non-cancer pain: patient report vs. systematic assessment

    DEFF Research Database (Denmark)

    Jonsson, Torsten; Christrup, Lona Louring; Højsted, J

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment....... We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics....

  18. Symptoms and side effects in chronic non-cancer pain:patient report vs. systematic assessment

    DEFF Research Database (Denmark)

    Jonsson, Torsten; Christrup, Lona Louring; Højsted, Jette

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment....... We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics....

  19. Lymphadenitis as a Rare Side Effect of H1N1 Vaccine in a Child

    Directory of Open Access Journals (Sweden)

    Zuhal Gundogdu

    2010-01-01

    Full Text Available We present a 5-year-old boy who had the complaint of swelling and pain on the right vaccine shot and right axillary areas. The right axillary area was diagnosed as reactive lymphadenitis, which we believe is a rare local side effect of the swine flu vaccine. The key message to take away from this case is that the patient had lymphadenitis as a local side effect of the swine flu vaccine. Lymphadenitis should be reported as a possible local side effect of the swine flu vaccine.

  20. Side Effects of HIV Medicines: HIV and Lipodystrophy

    Science.gov (United States)

    ... lipodystrophy can be upsetting and affect a person’s self-esteem. Because of lipodystrophy, a person may decide to ... the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV: Adverse Effects of Antiretroviral Agents ...

  1. ANTIPSYCHOTICS SIDE EFFECTS' INFLUENCE ON STIGMA OF MENTAL ILLNESS: FOCUS GROUP STUDY RESULTS

    OpenAIRE

    Novak, Lan; Švab, Vesna

    2009-01-01

    Background: Little research was done on the influence of antipsychotics’ side effects on stigma of mental illness. An overview of studies shows that people with mental illness state that because of medication side effects they feel discriminated in the field of employment, observe worsening of family relations and tend to skip or discontinue their regular medication. It is difficult to discriminate between stigmatizing effects of antipsychotics and other stigma related factors such as illness...

  2. Extravasational side effects of cytotoxic drugs: A preventable catastrophe

    OpenAIRE

    Thakur, Jagdeep S.; Chauhan, C. G. S.; Diwana, Vijay K.; Chauhan, Dayal C.; Thakur, Anamika

    2008-01-01

    In addition to their therapeutic effects on malignant cells, cytotoxic agents have the potential of causing destruction of healthy, normal cells. Extravasation of the drug can produce extensive necrosis of the skin and subcutaneous tissue. Management of these extravasational effects differs from one centre to another and prevention is usually strongly emphasized. We analyzed our management of 12 patients referred to us over five years with extravasation of cytotoxic drugs and reviewed the lit...

  3. An Unusual Side Effect of Etonogestrel Implant: Facial Paralysis

    OpenAIRE

    İkbal Kaygusuz; İlknur İnegöl Gümüş; Alevtina Ersoy; Aydın Kosus; Serap Simavlı; Hasan Kafalı; Nilgün Öztürk Turhan

    2011-01-01

    Etonogestrel single rod subdermal implant provides an effective contraceptive protection for up to 3 years with no reported pregnancies in clinical trials Unfortunately, similar to other long-term progestinonly contraceptives, Implanon® leads to irregular uterine bleeding in the majority of users. Bleeding disturbances are the main reason for discontinuation of therapy. Other reported nonmenstrual adverse effects of Implanon® include headache, acne, weight gain, and mastalgia. In this pape...

  4. On visual-vestibular interaction

    Science.gov (United States)

    Young, L. R.

    1973-01-01

    Experimental evidence is presented regarding visual vestibular interaction, and the results of three studies on the subject are briefly noted. An attempt to put together some of these observations with elementary notions of a visual vestibular interaction program is shown in the form of a flow chart representation of a possible model. This is a nonlinear model in which visual and vestibular influences are linearly weighted when they are in relative agreement but switch to the more believable one when they are in disagreement. A solution to the human space orientation problem is depicted by a schema for optimal subjective orientation based on several sensory modalities.

  5. Rescue of peripheral vestibular function in Usher syndrome mice using a splice-switching antisense oligonucleotide.

    Science.gov (United States)

    Vijayakumar, Sarath; Depreux, Frederic F; Jodelka, Francine M; Lentz, Jennifer J; Rigo, Frank; Jones, Timothy A; Hastings, Michelle L

    2017-09-15

    Usher syndrome type 1C (USH1C/harmonin) is associated with profound retinal, auditory and vestibular dysfunction. We have previously reported on an antisense oligonucleotide (ASO-29) that dramatically improves auditory function and balance behavior in mice homozygous for the harmonin mutation Ush1c c.216G > A following a single systemic administration. The findings were suggestive of improved vestibular function; however, no direct vestibular assessment was made. Here, we measured vestibular sensory evoked potentials (VsEPs) to directly assess vestibular function in Usher mice. We report that VsEPs are absent or abnormal in Usher mice, indicating profound loss of vestibular function. Strikingly, Usher mice receiving ASO-29 treatment have normal or elevated vestibular response thresholds when treated during a critical period between postnatal day 1 and 5, respectively. In contrast, treatment of mice with ASO-29 treatment at P15 was minimally effective at rescuing vestibular function. Interestingly, ASO-29 treatment at P1, P5 or P15 resulted in sufficient vestibular recovery to support normal balance behaviors, suggesting a therapeutic benefit to balance with ASO-29 treatment at P15 despite the profound vestibular functional deficits that persist with treatment at this later time. These findings provide the first direct evidence of an effective treatment of peripheral vestibular function in a mouse model of USH1C and reveal the potential for using antisense technology to treat vestibular dysfunction. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Presbivértigo: ejercicios vestibulares Presbivertigo: vestibular exercises

    Directory of Open Access Journals (Sweden)

    Esther Bernal Valls

    2006-12-01

    Full Text Available El uso de ejercicios en el tratamiento de pacientes con déficit vestibular crónico está incrementándose de forma notable, lo que evidencia que se trata de un procedimiento que resulta beneficioso para este tipo de pacientes. Los buenos resultados que se obtienen sugieren que los ejercicios vestibulares dan lugar a una estabilidad postural y a una disminución de la sensación de desequilibrio.The use of exercises in the treatment of patients with vestibular deficits is increasing in a representative way, what evidences this is a profitable process for this kind of patients. The good results suggest that vestibular exercises permit a postural stability and a decrease in the perception of disequilibrium.

  7. Side effects of antiviral therapy in hepatitis C virus infection-sarcoidosis - case report.

    Science.gov (United States)

    Teodor, D; Teodor, Andra; Grigore, Lucia; Jugănariu, Gabriela; Dorobăţ, Carmen Mihaela; Miftode, Egidia; Azoicăi, Doina

    2012-01-01

    Standard therapy in chronic hepatitis C virus infection is still a combination of peginterferon alfa2a/2b and ribavirin for 48 weeks. As of side effects, there are organic side effects, such as hematologic disorders, and functional side effects, reflected in the quality of life of hepatitis C patients. Up to 30% of the patients develop specific side effects such as headache, fever, fatigue. Sarcoidosis, known as a granulomatous disease of uncertain cause, is an uncommon finding in this category of patients. This cause-effect relation is accounted for by the convergent action of peginterferon and ribavirin of stimulating type 1 T helper cells and reducing type 2 helper T cells activation. We present the case of male patient known with chronic hepatitis C who developed pulmonary sarcoidosis following antiviral therapy. The first manifestation of the disease was unexplained fever accompanied by pulmonary tract disease. The diagnosis was established by immunophenotyping in bronchial aspirate

  8. Reabilitação vestibular no tratamento da tontura e do zumbido Vestibular rehabilitation in the treatment of dizziness and tinnitus

    Directory of Open Access Journals (Sweden)

    Bianca Simone Zeigelboim

    2008-01-01

    Full Text Available OBJETIVO: Verificar a efetividade dos exercícios de reabilitação vestibular na melhora do zumbido e da tontura por meio de avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI e Tinnitus Handicap Inventory (THI, ambos adaptados à população brasileira. MÉTODOS: Avaliaram-se seis pacientes (dois do sexo masculino e quatro do sexo feminino, na faixa etária de 43 a 70 anos. Os pacientes foram submetidos aos seguintes procedimentos: anamnese, inspeção otológica, avaliação vestibular por meio da vectoeletronistagmografia e aplicação dos questionários pré e pós-reabilitação vestibular, utilizando-se o protocolo de Cawthorne e Cooksey. RESULTADOS: a com relação às queixas mais referidas, observou-se desequilíbrio à marcha (83,3%, dor de cabeça (66,6% e depressão (66,6%; b no exame vestibular todos os pacientes apresentaram alteração na prova calórica, sendo a maior freqüência das síndromes vestibulares periféricas irritativas (83,3%; c constataram-se no exame vestibular dois casos de síndrome vestibular periférica irritativa, dois casos de síndrome vestibular periférica irritativa unilateral; um caso de síndrome vestibular periférica irritativa bilateral e um caso de síndrome vestibular periférica deficitária unilateral; d na aplicação do DHI, observou-se melhora nos aspectos: funcional e emocional, mantendo-se inalterado o aspecto físico; e na aplicação do THI, observou-se melhora em todos os aspectos avaliados. CONCLUSÃO: O protocolo utilizado de reabilitação vestibular promoveu diminuição do zumbido e da tontura, melhorando a qualidade de vida dos pacientes.PURPOSE: To verify the effectiveness of vestibular rehabilitation exercises in the improvement of tinnitus and dizziness through an evaluation carried out before and after the administration of the Dizziness Handicap Inventory (DHI and the Tinnitus Handicap Inventory (DHI questionnaires, both adapted to the

  9. Backreaction effects on the matter side of Einstein's field equations

    CERN Document Server

    Floerchinger, Stefan; Wiedemann, Urs Achim

    2015-01-01

    Recently, we have derived a novel and compact expression for how perturbations in the matter fields of the cosmological fluid can lead to deviations from the standard Friedmann equations. Remarkably, the dissipative damping of velocity perturbations by bulk and shear viscosity in the dark sector can modify the expansion history of the universe on arbitrarily large scales. In universes in which this effect is sufficiently sizeable, it could account for the acceleration of the cosmological expansion. But even if dark matter should be less viscous and if the effect would be correspondingly smaller, it may have observable consequences in the era of precision cosmology. Here, we review the origin of this backreaction effect and possibilities to constrain it further.

  10. [Side effects of drugs on the oral cavity].

    Science.gov (United States)

    Bascones-Martínez, Antonio; Muñoz-Corcuera, Marta; Bascones-Ilundain, Cristina

    2015-02-02

    Although drugs are the most powerful therapeutic tools we have for improving the quality of life of the population, their use is not free of adverse effects. Today there are many polymedicated patients, and it is difficult to find the cause of their adverse effects that increase exponentially when more than 4 drugs are combined. There are a large number of drugs that can result in numerous adverse effects in the oral cavity. The most common are xerostomia, altered taste, gingival enlargement and mucositis caused by cancer treatment. We also review other disorders of the salivary glands, oral mucosal changes, pigmentations, halitosis, osteonecrosis, opportunistic infections and bleeding diathesis. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  11. Correlation effects in side-coupled quantum dots

    International Nuclear Information System (INIS)

    Zitko, R; Bonca, J

    2007-01-01

    Using Wilson's numerical renormalization group (NRG) technique, we compute zero-bias conductance and various correlation functions of a double quantum dot (DQD) system. We present different regimes within a phase diagram of the DQD system. By introducing a negative Hubbard U on one of the quantum dots, we simulate the effect of electron-phonon coupling and explore the properties of the coexisting spin and charge Kondo state. In a triple quantum dot (TQD) system, a multi-stage Kondo effect appears where localized moments on quantum dots are screened successively at exponentially distinct Kondo temperatures

  12. Paciente com cefaleia e síndrome vestibular periférica: relato de caso Patient with headache and peripheral vestibular dysfunction: case report

    Directory of Open Access Journals (Sweden)

    Tatiane Maria Rossi

    2009-01-01

    Full Text Available TEMA: a Reabilitação Vestibular constitui-se numa opção de tratamento para pacientes portadores de síndrome vestibular periférica e cefaleia. PROCEDIMENTOS: o paciente, do sexo feminino com 26 anos de idade apresentava síndrome vestibular periférica acompanhada de crises de cefaleia. Foi realizada avaliação e terapia fonoaudiológica com exercícios de habituação vestibular além de fisioterapia e dieta recomendada pelo nutricionista. RESULTADOS: no período de 3 meses com reabilitação vestibular realizada semanalmente observou-se melhora no quadro vertiginoso e da cefaleia da paciente. CONCLUSÕES: evidenciou-se boa eficácia clínica para o tratamento desta paciente através da reabilitação vestibular com exercícios de habituação vestibular. Salienta-se a eficácia da reabilitação para a melhora na qualidade de vida da paciente e minimização das crises de cefaleia.BACKGROUND: vestibular rehabilitation is an option for treating peripheral vestibular syndrome and headache patients. PROCEDURES: the patient is a 29-year old woman and has Peripheral Vestibular Syndrome along with headache attacks. Evaluation and Phonoaudiological therapy with exercises of habituation tests with physical and nutritional therapy were carried out. RESULTS: in 3 month period with weekly vestibular rehabilitation therapy, we observed an improvement in the condition of the patient's vertigo and migraine. CONCLUSIONS: it was evident that the patient's treatment through the rehabilitation test with habituation test exercises had good efficiency. Please note the effectiveness of the rehabilitation for the improvement in the patient's life quality and minimization of headache attacks.

  13. Prevalence and side effects of pediatric home tube feeding

    NARCIS (Netherlands)

    Krom, Hilde; van Zundert, Suzanne M. C.; Otten, Marie-Anne G. M.; van der Sluijs Veer, Liesbeth; Benninga, Marc Alexander; Kindermann, Angelika

    2018-01-01

    Tube feeding ensures growth, but can have negative effects on health and psychosocial functioning, resulting in health related costs. The aims of this study were to determine the prevalence of pediatric home tube feeding in the Netherlands and to assess the clinical characteristics of tube fed

  14. Performance outcomes and unwanted side effects associated with energy drinks.

    Science.gov (United States)

    Mora-Rodriguez, Ricardo; Pallarés, Jesús G

    2014-10-01

    Energy drinks are increasingly popular among athletes and others. Advertising for these products typically features images conjuring great muscle power and endurance; however, the scientific literature provides sparse evidence for an ergogenic role of energy drinks. Although the composition of energy drinks varies, most contain caffeine; carbohydrates, amino acids, herbs, and vitamins are other typical ingredients. This report analyzes the effects of energy drink ingredients on prolonged submaximal (endurance) exercise as well as on short-term strength and power (neuromuscular performance). It also analyzes the effects of energy drink ingredients on the fluid and electrolyte deficit during prolonged exercise. In several studies, energy drinks have been found to improve endurance performance, although the effects could be attributable to the caffeine and/or carbohydrate content. In contrast, fewer studies find an ergogenic effect of energy drinks on muscle strength and power. The existing data suggest that the caffeine dose given in studies of energy drinks is insufficient to enhance neuromuscular performance. Finally, it is unclear if energy drinks are the optimal vehicle to deliver caffeine when high doses are needed to improve neuromuscular performance. © 2014 International Life Sciences Institute.

  15. Side effects of pain and analgesia in animal experimentation.

    Science.gov (United States)

    Jirkof, Paulin

    2017-03-22

    This review highlights selected effects of untreated pain and of widely used analgesics such as opioids, non-steroid anti-inflammatory drugs and antipyretics, to illustrate the relevance of carefully planned, appropriate and controlled analgesia for greater reproducibility in animal experiments involving laboratory rodents.

  16. NEW APPLICATIONS OF ADAPTOGENS TO REDUCE RADIATION SIDE EFFECTS.

    Science.gov (United States)

    Alekseeva, S N; Antipina, U D; Arzhakova, L I; Protodyakonov, S V

    2015-01-01

    One of the live medical issues today is to find medication to prevent adverse effects of ionizing radiation on the immune and hematopoietic systems. In Yakutia where in most of its regions the overall environmental situation is getting worse due to the development of natural deposits including radioactive deposits, this problem remains vital. The purpose of this work is to study radioprotective properties of adaptogens in the case of the hematopoietic system under irradiation. The studies were conducted on certain groups of hybrid mice. We used the methods of radiation exposure by a radiological apparatus RUM-25 on hybrid mice followed by studying the cellularity of bone marrow, spleen and thymus. The functional activity of all compartments of early hematopoiesis (bone marrow hematopoiesis) was identified by the exogenous colony forming method. The study found that the extracts of reindeer and moose antlers have a stimulating effect on the functional activity of the hematopoietic precursors in response to radiation. The study medication stimulates regeneration processes in the thymus and bone marrow after irradiation. Further, the adaptogens stimulatory effect on CFU functional activity was identified. The most pronounced effect has the extracts of reindeer antlers "Epsorin".

  17. Side-effects of protein kinase inhibitors on ion channels

    Indian Academy of Sciences (India)

    2013-11-06

    Nov 6, 2013 ... including PKA, PKG, ribosomal S6 kinase, and epidermal growth factor receptor kinase (EGFRK) in an ATP- competitive manner, while having no effect on other kinases such as CK1, CK2, MAP kinase, and CSK (Meggio et al. 1995). The necessity for more specific inhibitors of PKC led to the discovery of ...

  18. Ayurveda for chemo-radiotherapy induced side effects in cancer patients.

    Science.gov (United States)

    Metri, Kashinath; Bhargav, Hemant; Chowdhury, Praerna; Koka, Prasad S

    2013-01-01

    Chemotherapy drugs and radiotherapy are highly toxic and both damage adjacent healthy cells. Side effects may be acute (occurring within few weeks after therapy), intermediate or late (occurring months or years after the therapy). Some important side effects of chemotherapy are: nausea, vomiting, diarrhea, mucositis, alopecia, constipation etc; whereas radiation therapy though administered locally, can produce systemic side effects such as fatigue, anorexia, nausea, vomiting, alteration in the taste, sleep disturbance, headache, anemia, dry skin, constipation etc. Late complications of these therapies also include pharyngitis, esophagitis, laryngitis, persistent dysphagia, fatigue, hepatotoxicity, infertility and cognitive deficits. These arrays of side effects have a devastating effect on the quality of life of cancer survivors. Due to the inadequacy of most of the radio-protectors and chemo-protectors in controlling the side effects of conventional cancer therapy the complementary and alternative medicines have attracted the view of researchers and medical practitioners more recently. This review aims at providing a comprehensive management protocol of above mentioned chemo-radiotherapy induced side effects based on Ayurveda, which is an ancient system of traditional medicine practiced in Indian peninsula since 5000 BC. When the major side effects of chemo-radiotherapy are looked through an ayurvedic perspective, it appears that they are the manifestations of aggravated pitta dosha, especially under the group of disorders called Raktapitta (haemorrhage) or Raktadushti (vascular inflammation). Based on comprehensive review of ancient vedic literature and modern scientific evidences, ayurveda based interventions are put forth. This manuscript should help clinicians and people suffering from cancer to combat serious chemo-radiotherapy related side effects through simple but effective home-based ayurveda remedies. The remedies described are commonly available and

  19. Identifying the affected branches of vestibular nerve in vestibular neuritis.

    Science.gov (United States)

    Lin, Chi-Maw; Young, Yi-Ho

    2011-09-01

    The inner ear monitoring system is useful for identifying the affected branches of the vestibular nerve in cases of vestibular neuritis, providing insight about the interval for the relief of vertigo. This study conducted an inner ear monitoring system including audiometry, and caloric, ocular vestibular evoked myogenic potential (oVEMP), and cervical VEMP (cVEMP) tests in cases of vestibular neuritis for assessing the affected branches of the vestibular nerve. Twenty patients with vestibular neuritis underwent caloric, oVEMP, and cVEMP tests. Type I indicates that one of the three tests is abnormal; type II indicates that two test results are abnormal; and type III indicates that no test result is normal. All patients had normal hearing, bilaterally. Nineteen (95%) of 20 patients had abnormal caloric responses, 11 patients (55%) had abnormal oVEMPs, and 5 patients (25%) had abnormal cVEMPs. Restated, of all 20 patients, 8 patients were classified as type I, 9 were type II, and 3 were type III. The mean intervals between presentation and relief of vertigo were significantly different among the three types. One year after treatment, caloric, oVEMP, and cVEMP tests returned to normal responses in three (60%) of five patients.

  20. Task, muscle and frequency dependent vestibular control of posture

    NARCIS (Netherlands)

    Forbes, P.A.; Siegmund, G.P.; Schouten, A.C.; Blouin, J.S.

    2015-01-01

    The vestibular system is crucial for postural control; however there are considerable differences in the task dependence and frequency response of vestibular reflexes in appendicular and axial muscles. For example, vestibular reflexes are only evoked in appendicular muscles when vestibular

  1. Side effects and risks of radioiodine treatment of benign thyroid diseases

    International Nuclear Information System (INIS)

    Becker, W.; Hohenberger, W.; Wolf, F.; Erlangen-Nuernberg Univ., Erlangen

    1990-01-01

    Radioiodine treatment is considered to be the treatment of choice in benign thyroid diseases because of its very low side effects. Real and hypothetic risks and side effects have to be differentiated. Both may occur early and late after the treatment. Radioiodinethyroiditis in small volumes at high doses is very rare. Exacerbation of a thyroid storm (0.34%) as well as local compressions accompanied with reactive edema of the thyroid are early real side effects of radioiodine treatment. Late real side effects are failure of treatment (7-30% of thyrotoxicosis) and induction of hypothyroidism (4-20% of functional autonomy and increasing frequency in Graves' diseases with time). Late hypothetic risks are somatic (1-9/10000 bis 1-9/100000) or genetic (1-9/100000). An early risk might be the misdiagnosis of an additional thyroid carcinoma. (orig.) [de

  2. The frequency of occurrence and severity of side-effects of immersion virtual reality.

    Science.gov (United States)

    Regan, E C; Price, K R

    1994-06-01

    Virtual reality (VR) has become increasingly well-known over the last few years. However, little is known about the side-effects of prolonged immersion in VR. This study set out to investigate the frequency of occurrence and severity of side-effects of using an immersion VR system. Out of 146 subjects, 61% reported symptoms of malaise at some point during a 20-min immersion and 10-min post-immersion period. These ranged from symptoms such as dizziness, stomach awareness, headaches, eyestrain and lightheadedness to severe nausea. These symptoms caused 5% of the subjects to withdraw from the experiment before completing their 20-min immersion period. Further research needs to be conducted that attempts to identify those factors that play a causative role in the side-effects of the VR system, and that looks for methods of reducing these side-effects.

  3. Effect of road side dust pollution on the growth and total chlorophyll ...

    African Journals Online (AJOL)

    Effect of road side dust pollution on the growth and total chlorophyll contents in Vitis vinifera L. (grape). Saadullah Khan Leghari, Mudassir Asrar Zaid, Atta Muhammed Sarangzai, Muhammed Faheem, Gulam Razaq Shawani ...

  4. Unfavorable side effects to first line anti-tuberculosis drugs

    OpenAIRE

    N. A. Stepanova; E. N. Streltsova; Kh. M. Galimzyanov; B. I. Kantemirova

    2016-01-01

    The article presents the study of frequency of unfavorable side effects to anti-tuberculosis drugs in new pulmonary tuberculosis patients in Regional Clinical TB Dispensary in Astrakhan in 2012-2013. The study reflects the type and nature of unfavorable side effects to specific drugs. It has been found out that side effect occur more often in case of combination of TB drugs compared to one TB drugs. The efficiency of specific therapy in case of side effects has been demonstrated....

  5. Managing radiation therapy side effects with complementary medicine.

    Science.gov (United States)

    Thomas, Jerah; Beinhorn, Curtiss; Norton, Dena; Richardson, Michael; Sumler, Sat-Siri; Frenkel, Moshe

    2010-01-01

    Over one-third of Americans use complementary and alternative medicine (CAM). The prevalence among cancer patients may even be higher. Complementary therapies may reduce possible symptom burdens caused by conventional cancer treatments. Integrating CAM therapies has become more common and more accepted in clinical oncology. However, little research is available on beneficial CAM therapies for radiation therapy patients. This article reviews potential CAM therapies that have been shown to be effective in decreasing the symptom burden related to radiation therapy treatments and includes clinical observations from CAM practitioners in a comprehensive cancer center.

  6. Self-Limited Kleptomania Symptoms as a Side Effect of Duloxetine

    OpenAIRE

    Miller, Christopher W. T.; Gallagher, Keith E.

    2016-01-01

    Introduction. Impulse control disorders (ICDs) have been described as a side effect of dopamine agonists, frequently used in neurodegenerative conditions affecting the nigrostriatal pathway. Serotonin-norepinephrine reuptake inhibitors (e.g., duloxetine) have dose-dependent differential affinity for monoaminergic transporters, inhibiting the dopamine transporter at higher doses, thus increasing availability of synaptic dopamine, with the potential for similar impulse control side effects. Cas...

  7. Integrative relational machine-learning for understanding drug side-effect profiles.

    Science.gov (United States)

    Bresso, Emmanuel; Grisoni, Renaud; Marchetti, Gino; Karaboga, Arnaud Sinan; Souchet, Michel; Devignes, Marie-Dominique; Smaïl-Tabbone, Malika

    2013-06-26

    Drug side effects represent a common reason for stopping drug development during clinical trials. Improving our ability to understand drug side effects is necessary to reduce attrition rates during drug development as well as the risk of discovering novel side effects in available drugs. Today, most investigations deal with isolated side effects and overlook possible redundancy and their frequent co-occurrence. In this work, drug annotations are collected from SIDER and DrugBank databases. Terms describing individual side effects reported in SIDER are clustered with a semantic similarity measure into term clusters (TCs). Maximal frequent itemsets are extracted from the resulting drug x TC binary table, leading to the identification of what we call side-effect profiles (SEPs). A SEP is defined as the longest combination of TCs which are shared by a significant number of drugs. Frequent SEPs are explored on the basis of integrated drug and target descriptors using two machine learning methods: decision-trees and inductive-logic programming. Although both methods yield explicit models, inductive-logic programming method performs relational learning and is able to exploit not only drug properties but also background knowledge. Learning efficiency is evaluated by cross-validation and direct testing with new molecules. Comparison of the two machine-learning methods shows that the inductive-logic-programming method displays a greater sensitivity than decision trees and successfully exploit background knowledge such as functional annotations and pathways of drug targets, thereby producing rich and expressive rules. All models and theories are available on a dedicated web site. Side effect profiles covering significant number of drugs have been extracted from a drug ×side-effect association table. Integration of background knowledge concerning both chemical and biological spaces has been combined with a relational learning method for discovering rules which explicitly

  8. An Elementary affine λ-calculus with multithreading and side effects (extended version)

    OpenAIRE

    Madet, Antoine; Amadio, Roberto M.

    2011-01-01

    Linear logic provides a framework to control the complexity of higher-order functional programs. We present an extension of this framework to programs with multithreading and side effects focusing on the case of elementary time. Our main contributions are as follows. First, we provide a new combinatorial proof of termination in elementary time for the functional case. Second, we develop an extension of the approach to a call-by-value $lambda$-calculus with multithreading and side effects. Thi...

  9. Cutaneous Side Effects and Transepidermal Water Loss To Gefitinib: A Study of 11 Patients

    OpenAIRE

    Chandra, Franky; Sandiono, Dendi; Sugiri, Unwati; Suwarsa, Oki; Gunawan, Hendra

    2016-01-01

    Introduction Cutaneous side effects caused by epidermal growth factor receptor (EGFR) inhibitors occurred in 45?100% of patients which may lead to therapy modification or interruption. This study aimed to evaluate cutaneous side effects and transepidermal water loss (TEWL) values in non-small cell lung carcinoma (NSCLC) patients who received gefitinib EGFR inhibitor. Methods A descriptive observational study with cross-sectional design and a consecutive sampling method was conducted from 1 Fe...

  10. Antiepileptic drug behavioral side effects and baseline hyperactivity in children and adolescents with new onset epilepsy.

    Science.gov (United States)

    Guilfoyle, Shanna M; Follansbee-Junger, Katherine; Smith, Aimee W; Combs, Angela; Ollier, Shannon; Hater, Brooke; Modi, Avani C

    2018-01-01

    To examine baseline psychological functioning and antiepileptic drug (AED) behavioral side effects in new onset epilepsy and determine, by age, whether baseline psychological functioning predicts AED behavioral side effects 1 month following AED initiation. A retrospective chart review was conducted between July 2011 and December 2014 that included youths with new onset epilepsy. As part of routine interdisciplinary care, caregivers completed the Behavior Assessment System for Children, 2nd Edition: Parent Rating Scale to report on baseline psychological functioning at the diagnostic visit and the Pediatric Epilepsy Side Effects Questionnaire to identify AED behavioral side effects at the 1-month follow-up clinic visit following AED initiation. Children (age = 2-11 years) and adolescents (age = 12-18 years) were examined separately. A total of 380 youths with new onset epilepsy (M age  = 8.9 ± 4.3 years; 83.4% Caucasian; 34.8% focal epilepsy, 41.1% generalized epilepsy, 23.7% unclassified epilepsy) were included. Seventy percent of youths had at-risk or clinically elevated baseline psychological symptoms. Children had significantly greater AED behavioral side effects (M = 25.08 ± 26.36) compared to adolescents (M = 12.36 ± 17.73), regardless of AED. Valproic acid demonstrated significantly greater behavioral side effects compared to all other AEDs, with the exception of levetiracetam. Higher hyperactivity/impulsivity at baseline significantly predicted higher AED behavioral side effects 1 month after AED initiation in both age groups. Younger children seem to be more prone to experience behavioral side effects, and these are likely to be higher if youths with epilepsy have baseline hyperactivity/impulsivity. Baseline psychological screening, specifically hyperactivity, can be used as a precision medicine tool for AED selection. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  11. [Exogenous Cushing's syndrome as a serious side-effect of therapy with ritonavir an inhaled fluticasone].

    Science.gov (United States)

    Machala, Ladislav; Kréze, Alexander; Jilich, David; Rozsypal, Hanuš

    2011-06-01

    Inhalation of fluticasone is usually devoid of systemic side-effects. The authors describe a case of a young HIV positive woman treated concomitantly with fluticasone and inhibitors of HIV protease ritonavir and lopinavir in which developed a serious endocrine side-effect - an iatrogenic Cushing's syndrome. Plasma concentration of cortisol Cushing's syndrome, and the substitution therapy with hydrocortisone was terminated. Two years later became the patient pregnant and gave birth to a healthy child.

  12. Study of ageing side effects in the DELPHI HPC calorimeter

    CERN Document Server

    Bonivento, W

    1997-01-01

    The readout proportional chambers of the HPC electromagnetic calorimeter in the DELPHI experiment are affected by large ageing. In order to study the long-term behaviour fo the calorimeter, one HPC module was extracted from DELPHI in 1992 and was brought to a test area where it was artificially aged during a period of two years; an ageing level exceeding the one expected for the HPC at the end of the LEP era was reached. During this period the performance of the module was periodically tested by means of dedicated beam tests whose results are discussed in this paper. These show that ageing has no significant effects on the response linearity and on the energy resolution for electromagnetic showers, once the analog response loss is compensated for by increasing the chamber gain through the anode voltage.

  13. Side effects of endoscopic variceal ligation by using Indonesian Endoscopic Ligator versus Endoscopic Variceal Sclerotherapy.

    Science.gov (United States)

    Simadibrata, Marcellus; Syam, Ari F; Fauzi, Achmad; Abdullah, Murdani; Rani, Abdul A

    2011-01-01

    to investigate the side effects and survival of endoscopic variceal ligation by using Indonesian Endoscopic Ligator versus Endoscopic Variceal Sclerotherapy. we studied the medical records and endoscopy reports of patients who underwent endoscopic variceal ligation (EVL) or endoscopic sclerotherapy (EST) from January 2003 until December 2006. EST was done using ethoxysclerol injection; and ligation was done using a home-made Indonesian endoscopic ligating device. Patient characteristics, side effects of EVL and EST, as well as survival and length of stay were collected. Data of side effects was analyzed by chi-square test. there were no statistically significant differences of patients characteristics among both groups. The side effects in EVL group (29.2%) were less frequent than the EST group (60.9%) (p = 0.009). The death side effect in the EVL group (1.0%) was less frequent than in the EST group (21.7%) (pEVL and EST were 91.7% and 16.7%, respectively (pEVL had fewer side effects than EST in the treatment of esophageal varices bleeding. Death in the EVL group was lower than in the EST group.

  14. Elevated eating disorder symptoms in women with a history of oral contraceptive side effects.

    Science.gov (United States)

    Bird, Jessica L; Oinonen, Kirsten A

    2011-08-01

    Previous research suggests a link between gonadal hormones and eating disorder symptomatology. This study examined the role of gonadal hormones and hormonal sensitivity in eating disorder (ED) symptoms by using oral contraceptive (OC) side effect history as an indicator of hormonal sensitivity. A questionnaire containing two scales of the Eating Disorder Inventory-2 and an OC side effect scale was completed by 174 healthy women who had used OCs. Histories of emotional and physical OC side effects were evaluated as predictors of body dissatisfaction and drive for thinness. Women with a history of negative OC side effects had higher levels of ED symptoms. After controlling for body mass index (BMI) and depression scores, OC side effect history remained a significant predictor of body dissatisfaction and drive for thinness. The experience of OC side effects may indicate a greater risk for increased eating disorder symptoms. The findings provide further support for a hormonal link to ED symptoms, as women who are more "sensitive" to exogenous gonadal hormones also experience more ED symptoms.

  15. Image-guided conformation arc therapy for prostate cancer: Early side effects

    International Nuclear Information System (INIS)

    Soete, Guy; Verellen, Dirk; Michielsen, Dirk; Rappe, Bernard; Keuppen, Frans; Storme, Guy

    2006-01-01

    Purpose: To evaluate early side effects in prostate cancer patients treated with image-guided conformation arc therapy (IGCAT) using a minimultileaf collimator and daily X-ray-assisted patient positioning. Methods and Materials: Between May 2000 and November 2004, 238 cT1-T3N0M0 tumors were treated with doses of 70 or 78 Gy. Seventy patients also received neoadjuvant or concurrent hormonal treatment. Median follow-up is 18 months (range, 4-55 months). Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer toxicity scoring system was used to evaluate early side effects. Results: Grade 1, 2, and >2 acute side effects occurred in 19, 6, and 0% (gastrointestinal) and 37, 16, and 0% (genitourinary) of the patients. No relation between radiation dose and early side effects was observed. Conclusion: Patients treated with image-guided conformation arc therapy experience a low rate of Grade 2 (i.e., requiring medication) early side effects. The definitive evaluation of late side effects and biochemical control requires further follow-up

  16. Effect of Elevated Intracranial Pressure on Amplitudes and Frequency Tuning of Ocular Vestibular Evoked Myogenic Potentials Elicited by Bone-Conducted Vibration.

    Science.gov (United States)

    Gürkov, Robert; Speierer, Guillaume; Wittwer, Luis; Kalla, Roger

    Recently, it could be demonstrated that an increased intracranial pressure causes a modulation of the air conducted sound evoked ocular vestibular evoked myogenic potential (oVEMP). The mechanism for this modulation is not resolved and may depend on a change of either receptor excitability or sound energy transmission. oVEMPs were elicited in 18 healthy subjects with a minishaker delivering 500 and 1000 Hz tone bursts, in supine and tilted positions. The study could confirm the frequency tuning of oVEMP. However, at neither stimulus frequency could a modulating effect of increased intracranial pressure be observed. These data suggest that the observed modulation of the oVEMP response by an increased intracranial pressure is primarily due to the effect of an increased intralabyrinthine pressure onto the stiffness of the inner ear contents and the middle ear-inner ear junction. Future studies on the effect of intracranial pressure on oVEMP should use air-conducted sound and not bone-conducted vibration.

  17. Meningococcal vaccine--do some children experience side effects?

    Science.gov (United States)

    Hood, D A; Edwards, I R

    1989-02-22

    In order to stop an outbreak of group A meningococcal meningitis, 130,000 Auckland children were immunised. During the month following vaccination there were 546 reports of unusual clinical events reported by parents and practitioners, together with 40 specialist paediatric assessments of children presenting with neurological symptoms. In 25 of these latter there was complete agreement between the history as presented by parents in the initial telephone report and the paediatrician's subsequent summarised history. Of the 546 reports, 217 either had too little detail for an assessment or the symptoms were clearly attributable to other causes. Of the remaining reports, there were 152 cases of fever with or without other symptoms; 85 were of rash and local reactions within 24h of vaccination; 63 reports were of headache, stiff neck and myalgia within 48h of vaccination. There were 92 reports of apparent peripheral nerve involvement, including 80 reports of unexplained weakness and 57 reports of paraesthesia or dysaesthesia. Both motor and sensory symptoms occurred in some children; none were permanent. The effects of adverse publicity during the campaign on the genesis of some symptoms is acknowledged, but the possibility that short term neurological symptoms occur after vaccination seems likely and has not been previously reported.

  18. Spatial Cognition, Body Representation and Affective Processes: The Role of Vestibular Information beyond Ocular Reflexes and Control of Posture

    Directory of Open Access Journals (Sweden)

    Fred W Mast

    2014-05-01

    Full Text Available A growing number of studies in humans demonstrate the involvement of vestibular information in tasks that are seemingly remote from well-known functions such as space constancy or postural control. In this review article we point out three emerging streams of research highlighting the importance of vestibular input: 1 Spatial Cognition: Modulation of vestibular signals can induce specific changes in spatial cognitive tasks like mental imagery and the processing of numbers. This has been shown in studies manipulating body orientation (changing the input from the otoliths, body rotation (changing the input from the semicircular canals, in clinical findings with vestibular patients, and in studies carried out in microgravity. There is also an effect in the reverse direction; top-down processes can affect perception of vestibular stimuli. 2 Body Representation: Numerous studies demonstrate that vestibular stimulation changes the representation of body parts, and sensitivity to tactile input or pain. Thus, the vestibular system plays an integral role in multisensory coordination of body representation. 3 Affective Processes and Disorders: Studies in psychiatric patients and patients with a vestibular disorder report a high comorbidity of vestibular dysfunctions and psychiatric symptoms. Recent studies investigated the beneficial effect of vestibular stimulation on psychiatric disorders, and how vestibular input can change mood and affect. These three emerging streams of research in vestibular science are – at least in part – associated with different neuronal core mechanisms. Spatial transformations draw on parietal areas, body representation is associated with somatosensory areas, and affective processes involve insular and cingulate cortices, all of which receive vestibular input. Even though a wide range of different vestibular cortical projection areas has been ascertained, their functionality still is scarcely understood.

  19. Side effects of oxysterols: cytotoxicity, oxidation, inflammation, and phospholipidosis

    Directory of Open Access Journals (Sweden)

    A. Vejux

    2008-07-01

    Full Text Available Oxysterols are 27-carbon atom molecules resulting from autoxidation or enzymatic oxidation of cholesterol. They are present in numerous foodstuffs and have been demonstrated to be present at increased levels in the plasma of patients with cardiovascular diseases and in atherosclerotic lesions. Thus, their role in lipid disorders is widely suspected, and they might also be involved in important degenerative diseases such as Alzheimer's disease, osteoporosis, and age-related macular degeneration. Since atherosclerosis is associated with the presence of apoptotic cells and with oxidative and inflammatory processes, the ability of some oxysterols, especially 7-ketocholesterol and 7β-hydroxycholesterol, to trigger cell death, activate inflammation, and modulate lipid homeostasis is being extensively studied, especially in vitro. Thus, since there are a number of essential considerations regarding the physiological/pathophysiological functions and activities of the different oxysterols, it is important to determine their biological activities and identify their signaling pathways, when they are used either alone or as mixtures. Oxysterols may have cytotoxic, oxidative, and/or inflammatory effects, or none whatsoever. Moreover, a substantial accumulation of polar lipids in cytoplasmic multilamellar structures has been observed with cytotoxic oxysterols, suggesting that cytotoxic oxysterols are potent inducers of phospholipidosis. This basic knowledge about oxysterols contributes to a better understanding of the associated pathologies and may lead to new treatments and new drugs. Since oxysterols have a number of biological activities, and as oxysterol-induced cell death is assumed to take part in degenerative pathologies, the present review will focus on the cytotoxic activities of these compounds, the corresponding cell death signaling pathways, and associated events (oxidation, inflammation, and phospholipidosis.

  20. Cardiac Side-effects From Breast Cancer Radiotherapy.

    Science.gov (United States)

    Taylor, C W; Kirby, A M

    2015-11-01

    Breast cancer radiotherapy reduces the risk of cancer recurrence and death. However, it usually involves some radiation exposure of the heart and analyses of randomised trials have shown that it can increase the risk of heart disease. Estimates of the absolute risks of radiation-related heart disease are needed to help oncologists plan each individual woman's treatment. The risk for an individual woman varies according to her estimated cardiac radiation dose and her background risk of ischaemic heart disease in the absence of radiotherapy. When it is known, this risk can then be compared with the absolute benefit of the radiotherapy. At present, many UK cancer centres are already giving radiotherapy with mean heart doses of less than 3 Gy and for most women the benefits of the radiotherapy will probably far outweigh the risks. Technical approaches to minimising heart dose in breast cancer radiotherapy include optimisation of beam angles, use of multileaf collimator shielding, intensity-modulated radiotherapy, treatment in a prone position, treatment in deep inspiration (including the use of breath-hold and gating techniques), proton therapy and partial breast irradiation. The multileaf collimator is suitable for many women with upper pole left breast cancers, but for women with central or lower pole cancers, breath-holding techniques are now recommended in national UK guidelines. Ongoing work aims to identify ways of irradiating pan-regional lymph nodes that are effective, involve minimal exposure of organs at risk and are feasible to plan, deliver and verify. These will probably include wide tangent-based field-in-field intensity-modulated radiotherapy or arc radiotherapy techniques in combination with deep inspiratory breath-hold, and proton beam irradiation for women who have a high predicted heart dose from intensity-modulated radiotherapy. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  1. Dose-related patterns of glucocorticoid-induced side effects.

    Science.gov (United States)

    Huscher, D; Thiele, K; Gromnica-Ihle, E; Hein, G; Demary, W; Dreher, R; Zink, A; Buttgereit, F

    2009-07-01

    To identify patterns of self-reported health problems relating to dose and duration of glucocorticoid intake in unselected patients with rheumatoid arthritis from routine practice. Data from 1066 patients were analysed. The clinical status and drug treatment were reported by the physician, health problems during the past 6 months by the patient using a comprehensive list of symptoms. Patients with ongoing glucocorticoid treatment for more than 6 months and current doses of less than 5, 5-7.5 and over 7.5 mg/day prednisone equivalent were compared with a group without any glucocorticoid treatment for at least 12 months. The frequency of self-reported health problems was lowest in the group without glucocorticoid exposition and increased with dosage. Two distinct dose-related patterns of adverse events were observed. A "linear" rising with increasing dose was found for cushingoid phenotype, ecchymosis, leg oedema, mycosis, parchment-like skin, shortness of breath and sleep disturbance. A "threshold pattern" describing an elevated frequency of events beyond a certain threshold value was observed at dosages of over 7.5 mg/day for glaucoma, depression/listlessness and increase in blood pressure. Dosages of 5 mg/day or more were associated with epistaxis and weight gain. A very low threshold was seen for eye cataract (<5 mg/day). The associations found are in agreement with biological mechanisms and clinical observations. As there is a paucity of real-life data on adverse effects of glucocorticoids prescribed to unselected groups of patients, these data may help the clinician to adapt therapy with glucocorticoids accordingly and improve the benefit-risk ratio.

  2. Prevalence of vestibular disorder in older people who experience dizziness

    Directory of Open Access Journals (Sweden)

    Allan T Chau

    2015-12-01

    Full Text Available Dizziness and imbalance are clinically poorly defined terms, which affect ~30% of people over 65 years of age. In these people it is often difficult to define the primary cause of dizziness, as it can stem from cardiovascular, vestibular, psychological and neuromuscular causes. However, identification of the primary cause is vital in determining the most effective treatment strategy for a patient. Our aim was to accurately identify the prevalence of: Benign Paroxysmal Positional Vertigo (BPPV, peripheral, and central vestibular hypofunction in people aged over 50 years who had experienced dizziness within the past year. Seventy six participants aged 51 to 92 (mean ± SD = 69 ± 9.5 years were tested using the Head Thrust Dynamic Visual Acuity (htDVA test, Dizziness Handicap Inventory (DHI, as well as sinusoidal and unidirectional rotational chair testing, in order to obtain data for: htDVA score; DHI score; sinusoidal (whole-body, 0.1 - 2 Hz with peak-velocity at 30deg/s Vestibulo-Ocular Reflex (VOR gain and phase; transient (whole-body, acceleration at 150deg/s/s to a constant velocity rotation of 50deg/s VOR gain and time constant; OptoKinetic Nystagmus (OKN gain and time constant (whole-body, constant velocity rotation at 50deg/s. We found that BPPV, peripheral and central vestibular hypofunction were present in 38% and 1% of participants respectively, suggesting a likely vestibular cause of dizziness in these people. Of those with a likely vestibular cause, 63% had BPPV; a figure higher than previously reported in dizziness clinics of ~25%. Our results indicate that htDVA, sinusoidal (particularly 0.5 - 1 Hz and transient VOR testing were the most effective at detecting people with BPPV or vestibular hypofunction, whereas DHI and OKN were effective at only detecting non-BPPV vestibular hypofunction.

  3. Vestibular findings in fibromyalgia patients

    Directory of Open Access Journals (Sweden)

    Zeigelboim, Bianca Simone

    2011-07-01

    Full Text Available Introduction: Fibromyalgia (FM is a non-inflammatory musculoskeletal chronic syndrome, whose etiology is unknown, characterized by a diffuse pain, increase in palpation sensitivity and such symptoms as tiredness, insomnia, anxiety, depression, cold intolerance and otologic complaints. Objective: Evaluate the vestibular behavior in fibromyalgia patients. Method: A retrospective transversal study was performed. 25 patients aged between 26 and 65 (average age - 52.2 and standard deviation - 10.3 were evaluated and submitted to the following procedures: anamnesis, otorhinolaryngologic and vestibular evaluation by way of vector electronystamography. Results: a The most evident otoneurologic symptoms were: difficulty or pain when moving the neck and pain was spread to an arm or shoulder (92.0% in each, dizziness (84.0% and headache (76.0%. The different clinical symptoms mostly reported were: depression (80.0%, anxiety (76.0% and insomnia (72.0%; b vestibular examination showed an alteration in 12 patients (48.0% in the caloric test; c an alteration in the peripheral vestibular system prevailed, and d deficient peripheral vestibular disorders were prevalent. Conclusion: This study enabled the importance of the labyrinthic test to be verified, thus emphasizing that this kind of people must be studied better, since a range of rheumatologic diseases can cause severe vestibular changes as a result of their manifestations and impairment areas.

  4. The effect of mental alerting on peripheral vestibular nystagmus during spontaneous, gaze (30 degrees left, 30 degrees right) and body positional (left & right lateral lying) testing using electronystagmography (ENG).

    Science.gov (United States)

    McGovern, Tracey N; Fitzgerald, John E

    2008-10-01

    The performance of mental alerting during caloric testing has always been considered important, however its use/benefit during electronystagmography (ENG)/videonystagmography (VNG) testing has been questioned. The aim of this study was to investigate the effect of mental alerting tasks on peripheral type vestibular nystagmus recorded during ENG. Thirty patients with significant spontaneous/gaze or positional nystagmus (slow phase velocity >or= 6 degrees /s) were recruited from consecutive referrals for vestibular assessment. Nystagmus was recorded by ENG both in the presence and absence of mental alerting for each patient. Investigation of nystagmus by analysis of variance (ANOVA) revealed significantly larger nystagmus (higher value SPV) with mental alerting than with no alerting (p<0.001), and for some patients nystagmus traces were reduced to a flat line (no nystagmus) with no alerting. The study demonstrates the importance of mental alerting in helping overcome central suppression of nystagmus and highlights its importance to help identify peripheral type nystagmus during ENG.

  5. Identifying deficits in balance control following vestibular or proprioceptive loss using posturographic analysis of stance tasks.

    NARCIS (Netherlands)

    Horlings, C.G.; Kung, U.M.; Bloem, B.R.; Honegger, F.; Alfen, N. van; Engelen, B.G.M. van; Allum, J.H.

    2008-01-01

    OBJECTIVE: To distinguish between normal and deficient balance control due to vestibular loss (VL) or proprioceptive loss (PL) using pelvis and shoulder sway measures. METHODS: Body-worn gyroscopes measured pelvis and shoulder sway in pitch (anterior-posterior) and roll (side-to-side) directions in

  6. Metabolic Side-Effects of the Novel Second-Generation Antipsychotic Drugs Asenapine and Iloperidone: A Comparison with Olanzapine

    OpenAIRE

    Boyda, Heidi N.; Procyshyn, Ric M.; Pang, Catherine C. Y.; Hawkes, Erin; Wong, Daniel; Jin, Chen Helen; Honer, William G.; Barr, Alasdair M.

    2013-01-01

    Background The second generation antipsychotic (SGA) drugs are widely used in psychiatry due to their clinical efficacy and low incidence of neurological side-effects. However, many drugs in this class cause deleterious metabolic side-effects. Animal models accurately predict metabolic side-effects for SGAs with known clinical metabolic liability. We therefore used preclinical models to evaluate the metabolic side-effects of glucose intolerance and insulin resistance with the novel SGAs asena...

  7. Quantitative prediction of drug side effects based on drug-related features.

    Science.gov (United States)

    Niu, Yanqing; Zhang, Wen

    2017-09-01

    Unexpected side effects of drugs are great concern in the drug development, and the identification of side effects is an important task. Recently, machine learning methods are proposed to predict the presence or absence of interested side effects for drugs, but it is difficult to make the accurate prediction for all of them. In this paper, we transform side effect profiles of drugs as their quantitative scores, by summing up their side effects with weights. The quantitative scores may measure the dangers of drugs, and thus help to compare the risk of different drugs. Here, we attempt to predict quantitative scores of drugs, namely the quantitative prediction. Specifically, we explore a variety of drug-related features and evaluate their discriminative powers for the quantitative prediction. Then, we consider several feature combination strategies (direct combination, average scoring ensemble combination) to integrate three informative features: chemical substructures, targets, and treatment indications. Finally, the average scoring ensemble model which produces the better performances is used as the final quantitative prediction model. Since weights for side effects are empirical values, we randomly generate different weights in the simulation experiments. The experimental results show that the quantitative method is robust to different weights, and produces satisfying results. Although other state-of-the-art methods cannot make the quantitative prediction directly, the prediction results can be transformed as the quantitative scores. By indirect comparison, the proposed method produces much better results than benchmark methods in the quantitative prediction. In conclusion, the proposed method is promising for the quantitative prediction of side effects, which may work cooperatively with existing state-of-the-art methods to reveal dangers of drugs.

  8. Effects of small-sided games on physical conditioning and performance in young soccer players.

    Science.gov (United States)

    Katis, Athanasios; Kellis, Eleftherios

    2009-01-01

    The purpose of this study was to examine, first, the movement actions performed during two different small-sided games and, second, their effects on a series of field endurance and technical tests. Thirty-four young soccer players (age: 13 ± 0.9 yrs; body mass: 62.3 ± 15.1 kg; height: 1.65 ± 0.06 m) participated in the study. Small-sided games included three-a-side (3 versus 3 players) and six-a-side (6 versus 6 players) games consisting of 10 bouts of 4 min duration with 3 min active recovery between bouts. Soccer player performance was evaluated using five field tests: a) 30m sprint, b) throw-in for distance, c) Illinois Agility Test, d) dribbling the ball and e) horizontal jump before, in the middle and after the implementation of both game situations. Heart rate was monitored during the entire testing session. Each game was also filmed to measure soccer movements within the game. The ANOVA analysis indicated that the three-a- side games displayed significantly higher heart rate values compared with the six-a-side games (p game condition (p games, there was a significant decline in sprint and agility performance (p game conditions significant alterations in the throw-in and the horizontal jump performance were observed (p games provide higher stimulus for physical conditioning and technical improvement than six-a-side games and their use for training young soccer players is recommended. Key pointsThree-a-side games display higher HR compared with six-a-side games.In the three-a-side games players performed more short passes, kicks, dribbles, tackles and scored more goals compared with the six-a-side games.Impairment in endurance and field test performance was observed mainly after three-a-side games.The use of the three-a-side games to develop physical fitness and technique in young soccer players is recommended.

  9. Potential climate engineering effectiveness and side effects during a high carbon dioxide-emission scenario.

    Science.gov (United States)

    Keller, David P; Feng, Ellias Y; Oschlies, Andreas

    2014-02-25

    The realization that mitigation efforts to reduce carbon dioxide emissions have, until now, been relatively ineffective has led to an increasing interest in climate engineering as a possible means of preventing the potentially catastrophic consequences of climate change. While many studies have addressed the potential effectiveness of individual methods there have been few attempts to compare them. Here we use an Earth system model to compare the effectiveness and side effects of afforestation, artificial ocean upwelling, ocean iron fertilization, ocean alkalinization and solar radiation management during a high carbon dioxide-emission scenario. We find that even when applied continuously and at scales as large as currently deemed possible, all methods are, individually, either relatively ineffective with limited (effects and cannot be stopped without causing rapid climate change. Our simulations suggest that the potential for these types of climate engineering to make up for failed mitigation may be very limited.

  10. Side-effects of cowpea treatment with botanical insecticides on two parasitoids of Callosobruchus maculatus

    NARCIS (Netherlands)

    Boeke, S.J.; Sinzogan, A.A.C.; Almeida, de R.P.; Boer, de P.W.M.; Jeong, G.S.; Kossou, D.K.; Loon, van J.J.A.

    2003-01-01

    Studies on the protective effect of botanical products against pest insects have infrequently been extended to side-effects on natural enemies. Indirect effects of botanicals on the storability of seeds could occur through their possible negative impact on biological control agents. Four plant

  11. Relationships among morphine metabolism, pain and side effects during long-term treatment

    DEFF Research Database (Denmark)

    Andersen, Gertrud; Christrup, Lona Louring; Sjøgren, Per

    2003-01-01

    found evidence for a contributory effect of M6G to the overall effects observed after morphine administration. Several studies have demonstrated that administration of M6G is accompanied by fewer and a milder degree of opioid-like side effects than observed after morphine administration, but most...

  12. Erythropoietin as an add-on treatment for cognitive side effects of electroconvulsive therapy

    DEFF Research Database (Denmark)

    Schmidt, Lejla Sjanic; Petersen, Jeff Zarp; Vinberg, Maj

    2018-01-01

    infusions are administered at weekly intervals immediately after ECT sessions 1, 4, and 7. Cognition assessments are conducted at baseline, after the final EPO/saline infusion (3 days after eight ECT sessions), and at a 3 months follow-up after ECT treatment completion. The neuronal substrates for potential......Background Electroconvulsive therapy (ECT) is the most effective treatment for severe depression, but its use is impeded by its cognitive side effects. Novel treatments that can counteract these side effects may therefore improve current treatment strategies for depression. The present randomized...... trial investigates (1) whether short-term add-on treatment with erythropoietin (EPO) can reduce the cognitive side -effects of ECT and (2) whether such effects are long-lasting. Further, structural and functional magnetic resonance imaging (MRI) will be used to explore the neural underpinnings...

  13. Risperidone-Induced Renal Damage and Metabolic Side Effects: The Protective Effect of Resveratrol

    Directory of Open Access Journals (Sweden)

    Sedat Bilgiç

    2017-01-01

    Full Text Available Objective. The aim of the study was to investigate the possible protective qualities of resveratrol (RSV against the side effects of risperidone (RIS in an experimental model in rat kidneys with histologic and biochemical assessments. Materials and Methods. Experimental procedures were performed on 35 female Sprague Dawley rats. Rats were randomly divided into five groups: control, untreated rats (n=7 were in group 1; group 2 was given 2 mg/kg/day RIS (n=7; group 3 was treated with 2 mg/kg/day RIS and 20 mg/kg/day RSV (n=7; group 4 was treated with 2 mg/kg/day RIS and 40 mg/kg/day RSV (n=7; and group 5 was treated with 2 mg/kg/day RIS and 80 mg/kg/day RSV (n=7. All treatments were administered for two weeks by gavage. On treatment day 15, kidney tissues were removed for analysis. Results. The results showed that RSV treatment reduced weight gain induced by RIS. In addition, RSV increased the total antioxidant status (TAS and decreased serum creatinine (Cr, blood urea nitrogen (BUN, oxidative stress index (OSI, and total oxidant status (TOS levels significantly (p<0.05. Conclusion. This study revealed that treatment with RSV might protect kidney tissues against the side effects of RIS. RSV could be an effective course of therapy to enhance therapeutic efficacy.

  14. Experimental research on end-to-side anastomosis of peripheral nerves and effect of FK506 on end-to-side anastomosis.

    Science.gov (United States)

    Yang, L M; Wu, Y X; Zhang, X P; Li, X H

    2014-01-01

    To study the effects of end-to-side anastomosis of initially-denatured nerves at different times. 60 male Wistar albino rats were used to fabricate animal models for the experiment on end-to-side anastomosis of peripheral nerves and 50 female Wistar albino rats were used to fabricate animal models for the experiment on the effect of FK506 on end-to-side anastomosis. Bilateral common peroneal nerve, tibialis anterior muscle electrophysiological and histological examinations, tibialis anterior muscle wet muscle weight determination, and motor end plate examination were performed 3 months after operation. All recovery rates of action potential, single muscle contraction force and tetanic contraction force of the FK506 experimental group are significantly higher than those of the control group and the sectional area of muscle fiber is also higher than that of the control group of normal saline. The best time for end-to-side anastomosis of nerves should be controlled within 2 weeks and the effect of end-to-side anastomosis of nerves will gradually become unsatisfactory. FK506 plays a role in promoting functional rehabilitation following nerve end-to-side anastomosis (Tab. 7, Fig. 4, Ref. 31).

  15. Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis

    Science.gov (United States)

    ... Infections, and Deafness Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis On this page: What is a vestibular schwannoma ( ... are usually associated with a genetic disorder called neurofibromatosis type 2 (NF2). Half of affected individuals have ...

  16. The protective effects of trace elements against side effects induced by ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Hosseinimehr, Seyed Jaial [Dept. of Radiopharmacy, Faculty of Pharmacy, Pharmaceutical Sciences Research Center, Mazandaran University of Medical Sciences, Sari (Iran, Islamic Republic of)

    2015-06-15

    Trace elements play crucial role in the maintenance of genome stability in the cells. Many endogenous defense enzymes are containing trace elements such as superoxide dismutase and metalloproteins. These enzymes are contributing in the detoxification of reactive oxidative species (ROS) induced by ionizing radiation in the cells. Zinc, copper, manganese, and selenium are main trace elements that have protective roles against radiation-induced DNA damages. Trace elements in the free salt forms have protective effect against cell toxicity induced by oxidative stress, metal-complex are more active in the attenuation of ROS particularly through superoxide dismutase mimetic activity. Manganese-complexes in protection of normal cell against radiation without any protective effect on cancer cells are more interesting compounds in this topic. The aim of this paper to review the role of trace elements in protection cells against genotoxicity and side effects induced by ionizing radiation.

  17. Side effects of rational dose iodine-131 therapy for metastatic well-differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Van Nostrand, D.; Neutze, J.; Atkins, F.

    1986-01-01

    Benua, Leeper, and others (BEL) have advocated the estimation of radiation exposure to the blood to select a more rational maximum safe dose of radioiodine (dosimetry) to treat metastatic functioning well-differentiated thyroid carcinoma. After adopting the BEL dosimetry approach, we reviewed the immediate (during hospitalization) and intermediate (from discharge up to 3 mo) side effects after our initial 15 therapies in ten patients. The doses ranged from 51 mCi (1887 MBq) to 450 mCi (16.65 GBq). Immediate side effects were observed in 12/15 (80%), are described in detail, and were as follows: gastrointestinal 10/15, salivary 9/15, nonsalivary neck pain, swelling, etc. 2/15, pulmonary 0/15. Intermediate side effects were observed in 10/15 (67%), are described in detail, and were as follows: gastrointestinal 0/15, salivary 3/15, nonsalivary neck pain, swelling, etc. 3/15, nasal complaints 2/15, transient bone marrow suppression 9/10, pulmonary 0/15. No patient required blood transfusions or had complications secondary to reduced blood counts. All patient complaints resolved; however, several patients may have reduced baseline blood counts one year after therapy. No other long-term side effect has been noted but the mean follow-up has been only 15 mo. In our opinion, we have not observed any side effect to date which would contraindicate the continued use and evaluation of the BEL dosimetry approach

  18. Side effects of rational dose iodine-131 therapy for metastatic well-differentiated thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Van Nostrand, D.; Neutze, J.; Atkins, F.

    1986-10-01

    Benua, Leeper, and others (BEL) have advocated the estimation of radiation exposure to the blood to select a more rational maximum safe dose of radioiodine (dosimetry) to treat metastatic functioning well-differentiated thyroid carcinoma. After adopting the BEL dosimetry approach, we reviewed the immediate (during hospitalization) and intermediate (from discharge up to 3 mo) side effects after our initial 15 therapies in ten patients. The doses ranged from 51 mCi (1887 MBq) to 450 mCi (16.65 GBq). Immediate side effects were observed in 12/15 (80%), are described in detail, and were as follows: gastrointestinal 10/15, salivary 9/15, nonsalivary neck pain, swelling, etc. 2/15, pulmonary 0/15. Intermediate side effects were observed in 10/15 (67%), are described in detail, and were as follows: gastrointestinal 0/15, salivary 3/15, nonsalivary neck pain, swelling, etc. 3/15, nasal complaints 2/15, transient bone marrow suppression 9/10, pulmonary 0/15. No patient required blood transfusions or had complications secondary to reduced blood counts. All patient complaints resolved; however, several patients may have reduced baseline blood counts one year after therapy. No other long-term side effect has been noted but the mean follow-up has been only 15 mo. In our opinion, we have not observed any side effect to date which would contraindicate the continued use and evaluation of the BEL dosimetry approach.

  19. Metoclopramide neurological side effects screening; a pharmacovigilence study in Romanian community pharmacies

    Directory of Open Access Journals (Sweden)

    Emil Ștefănescu

    2015-04-01

    Full Text Available Background. Metoclopramide is a pharmacological agent frequently used in therapy against nausea and vomiting that can occur in indigestion, motion sickness, gastric ulcer, pyloric spasm and after surgery as a side effect of some anesthetics. Knowing the frequency and intensity of metoclopramide neurological side effects is essential for an efficient management of the dysfunctions it addresses. Material and method. Based on a standard questionnaire containing questions regarding metoclopramide therapy, we analyzed the answers given by 1000 patients or patient tutors in 20 open circuit pharmacies situated all over Bucharest. All subjects freely consented to participate in this study that was coordinated only by pharmacists. Results. Our study highlights the fact that in certain situations having to do with the age of patients, with the use of multiple drugs or with the tendency to self medicate, the neurological side effects of metoclopramide can reach dangerous levels. In some cases it might even be necessary to immediately interrupt metoclopramide therapy, despite its positive benefit/ risk ratio. Conclusions. Respecting the physician’s recommendations, avoiding self medication and reporting side effects as quickly as possible, are essential elements for minimizing the consequences of metoclopramide side effects.

  20. Side effects of adjuvant radiotherapy in men with testicular seminoma stage I

    International Nuclear Information System (INIS)

    Gamulin, M.; Grgic, M.; Bisof, V.

    2011-01-01

    In this study we followed up the side effects of adjuvant radiotherapy in patients with testicular seminoma stage I over a period from 13 to 84 months (median 28 months). The most frequent side effects during radiotherapy were gastrointestinal (nausea/vomiting), psychological, cognitive, and minor sexual problems. The reported side effects were treated by antiemetics and anxiolytics. After radiotherapy, the side effects persisted in 6 % of patients, but only a few of them required additional treatment. Healthy children were born to 76 % of patients in the 18 to 39 years age group. This study shows that adjuvant radiotherapy of the para-aortic lymph nodes with the total dosage of 24 Gy in 16 daily fractions administered to testicular seminoma patients causes acceptable side effects, does not adversely affect quality of life and fertility, if the approach to treatment is individual and family consulting is provided. This makes adjuvant radiotherapy of the para-aortic lymph nodes an acceptable treatment for testicular seminoma stage I patients. (authors)

  1. Impaired math achievement in patients with acute vestibular neuritis.

    Science.gov (United States)

    Moser, Ivan; Vibert, Dominique; Caversaccio, Marco D; Mast, Fred W

    2017-12-01

    Broad cognitive difficulties have been reported in patients with peripheral vestibular deficit, especially in the domain of spatial cognition. Processing and manipulating numbers relies on the ability to use the inherent spatial features of numbers. It is thus conceivable that patients with acute peripheral vestibular deficit show impaired numerical cognition. Using the number Stroop task and a short math achievement test, we tested 20 patients with acute vestibular neuritis and 20 healthy, age-matched controls. On the one hand, patients showed normal congruency and distance effects in the number Stroop task, which is indicative of normal number magnitude processing. On the other hand, patients scored lower than healthy controls in the math achievement test. We provide evidence that the lower performance cannot be explained by either differences in prior math knowledge (i.e., education) or slower processing speed. Our results suggest that peripheral vestibular deficit negatively affects numerical cognition in terms of the efficient manipulation of numbers. We discuss the role of executive functions in math performance and argue that previously reported executive deficits in patients with peripheral vestibular deficit provide a plausible explanation for the lower math achievement scores. In light of the handicapping effects of impaired numerical cognition in daily living, it is crucial to further investigate the mechanisms that cause mathematical deficits in acute PVD and eventually develop adequate means for cognitive interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Intentions to use Hypnosis to Control the Side Effects of Cancer and its Treatment

    Science.gov (United States)

    Sohl, Stephanie J.; Stossel, Lauren; Schnur, Julie B.; Tatrow, Kristin; Gherman, Amfiana; Montgomery, Guy H.

    2013-01-01

    Evidence suggests that hypnosis is an effective intervention for reducing distress, pain and other side effects associated with cancer and its treatment. However, hypnosis has failed to be adopted into standard clinical practice. This study (n=115) investigated overall intentions to use hypnosis to control side effects of cancer and its treatment, as well as demographic predictors of such intentions among healthy volunteers. Results suggest that the vast majority of patients (89%) would be willing to use hypnosis to control side effects associated with cancer treatment. Mean intention levels did not differ by gender, ethnicity, education or age. These results indicate that in the general public, there is a willingness to consider the use of hypnosis, and that willingness is not determined by demographic factors. This broad acceptance of hypnosis argues for more widespread dissemination. PMID:21049742

  3. [Inferior vestibular neuritis: diagnosis using VEMP].

    Science.gov (United States)

    Walther, L E; Repik, I

    2012-02-01

    Vestibular evoked myogenic potentials (VEMP) are a new method to establish the functional status of the otolith organs. The sacculocollic reflex of the cervical VEMP to air conduction (AC) reflects predominantly saccular function due to saccular afferents to the inferior vestibular nerve. We describe a case of inferior vestibular neuritis as a rare differential diagnosis of vestibular neuritis. Clinical signs were a normal caloric response, unilaterally absent AC cVEMPs and bilaterally preserved ocular VEMPs (AC oVEMPs).

  4. Aging of the Human Vestibular System

    OpenAIRE

    Zalewski, Christopher K.

    2015-01-01

    Aging affects every sensory system in the body, including the vestibular system. Although its impact is often difficult to quantify, the deleterious impact of aging on the vestibular system is serious both medically and economically. The deterioration of the vestibular sensory end organs has been known since the 1970s; however, the measurable impact from these anatomical changes remains elusive. Tests of vestibular function either fall short in their ability to quantify such anatomical deteri...

  5. “So far it’s been choosing which side effects I want or I can deal with”: A grounded theory of HIV treatment side effects among people living with HIV

    Directory of Open Access Journals (Sweden)

    Marilou Gagnon

    2016-01-01

    Full Text Available Despite the availability of new antiretroviral drugs and the simplification of treatment options, side effects continue to affect people living with HIV. In this paper, we present the findings of a grounded theory study designed to gain a critical understanding of the experience of side effects. Three main categories emerged from the data: the side effects, the experience, and the connections. The first category suggests that we need to change how we think about side effects in order to take into account the context in which they are experienced as well as the types and nature of side effects. The second category puts forward the idea that the experience of side effects is composed of three interrelated processes: becoming with, living with, and dealing with. Finally, the third category points to new connections that are formed with people, things and systems in the presence of side effects.

  6. [Vestibular-spinal reflex in patients with vestibular-ataxic syndrome of different genesis].

    Science.gov (United States)

    Kuznetsova, E A; Iakupov, E Z

    2010-01-01

    The article presents the results of investigation of vestibular-spinal reflex (vestibular myogenic evoked potentials) in healthy subjects and patients with vestibular-ataxic syndrome. The inhibition of vestibular-spinal reflex with the P13 latency increase was shown to be the most characteristic of demyelinating and traumatic brain diseases. The P13 latency increase was not pathognomic for any disease of the nervous system but was indicative of conduction delay in vestibular-spinal tracts.

  7. Missed Anterior Inferior Cerebellar Artery Aneurysm Mimicking Vestibular Neuritis-Clues to Prevent Misdiagnosis.

    Science.gov (United States)

    Willms, Jan-Folkard; Baltsavias, Gerasimos; Burkhardt, Jan-Karl; Ernst, Silvia; Tarnutzer, Alexander A

    2016-12-01

    We discuss a case with combined vestibulocochlear and facial neuropathy mimicking a less urgent peripheral vestibular pattern of acute vestibular syndrome (AVS). With initial magnetic resonance imaging read as normal, the patient was treated for vestibular neuropathy until headaches worsened and a diagnosis of subarachnoid hemorrhage was made. On conventional angiography, a ruptured distal right-sided aneurysm of the anterior inferior cerebellar artery was diagnosed and coiled. Whereas acute vestibular loss usually points to a benign peripheral cause of AVS, combined neuropathy of the vestibulocochlear and the facial nerve requires immediate neuroimaging focusing on the cerebellopontine angle. Imaging should be assessed jointly by neuroradiologists and the clinicians in charge to take the clinical context into account. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. The parietal lobe and the vestibular system.

    Science.gov (United States)

    Dieterich, Marianne; Brandt, Thomas

    2018-01-01

    The vestibular cortex differs in various ways from other sensory cortices. It consists of a network of several distinct and separate temporoparietal areas. Its core region, the parietoinsular vestibular cortex (PIVC), is located in the posterior insula and retroinsular region and includes the parietal operculum. The entire network is multisensory (in particular, vestibular, visual, and somatosensory). The peripheral and central vestibular systems are bilaterally organized; there are various pontomesencephalic brainstem crossings and at least two transcallosal connections of both hemispheres, between the PIVC and the motion-sensitive visual cortex areas, which also mediate vestibular input. Structural and functional vestibular dominance characterizes the right hemisphere in right-handers and the left hemisphere in left-handers. This explains why right-hemispheric lesions in right-handers more often generally cause hemispatial neglect and the pusher syndrome, both of which involve vestibular function. Vestibular input also contributes to cognition and may determine individual lateralization of brain functions such as handedness. Bilateral organization is a major key to understanding cortical functions and disorders, for example, the visual-vestibular interaction that occurs in spatial orientation. Although the vestibular cortex is represented in both hemispheres, there is only one global percept of body position and motion. The chiefly vestibular aspects of the multiple functions and disorders of the parietal lobe dealt with in this chapter cannot be strictly separated from various multisensory vestibular functions within the entire brain. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Age-related differences in renal side-effects of radiation and chemotherapy in the rat

    NARCIS (Netherlands)

    M.H.T.M. Jongejan (Mieke)

    1988-01-01

    textabstractThe improved life-expectancy of cancer patient has brought to light late sequelae of oncology therapy. This is especially true for pediatric patients. Renal damage is one of the adverse side-effects of anti-tumor therapy that may occur. Studies conceming damaging effects of

  10. Assessing Side Effects of Pharmacotherapy Treatment of Bipolar Disorder: A 20-Year Review of the Literature

    Science.gov (United States)

    Matson, Johnny L.; Gonzalez, Melissa L.; Smith, Kimberly R.; Terlonge, Cindy; Thorson, Ryan T.; Dixon, Dennis R.

    2006-01-01

    A substantial literature on the effective treatment of bipolar disorder has begun to appear, particularly in the last 20 years.The majority of treatments studied have employed medications, particularly mood stabilizers, a typical antipsychotics and antidepressants. Most treatments produce side effects and medications are no exception. A review of…

  11. Metabolic and Endocrine Side Effects of Atypical Antipsychotic Drugs in Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Aysegul Tahiroglu

    2011-03-01

    Full Text Available omorbid psychiatric disorders, frequent hospitalization, multiple outpatient treatment, prior history of hypertension, obesity and lipid dysregulation are associated with higher risk of metabolic syndrome in children. Side effects of antipsychotic drugs and their management have recently become a major subject of research due to enhanced antipsychotic drug usage in child and adolescents. Prevention strategies are usually preferred to secondary or tertiary strategies in the management of metabolic syndrome associated with antipsychotic drugs. Clinicians should present multidisciplinary approach to endocrine and metabolic side effects due to antipsychotic use in pediatric patient groups and avoid multiple drug use in such patients. In this paper, we briefly reviewed metabolic side effects of second generation antipsychotic drugs in child and adolescent population, possible mechanisms of susceptibility to metabolic syndrome and pharmacological and non pharmacological treatment approach to prevention of weight gain.

  12. Side effects of anabolic androgenic steroids: pathological findings and structure-activity relationships.

    Science.gov (United States)

    Büttner, Andreas; Thieme, Detlef

    2010-01-01

    Side effects of anabolic steroids with relevance in forensic medicine are mainly due to life-threatening health risks with potential fatal outcome and cases of uncertain limitations of criminal liability after steroid administration. Both problems are typically associated with long-term abuse and excessive overdose of anabolic steroids. Side effects may be due to direct genomic or nongenomic activities (myotrophic, hepatotoxic), can result from down-regulation of endogenous biosynthesis (antiandrogenic) or be indirect consequence of steroid biotransformation (estrogenic).Logically, there are no systematic clinical studies available and the number of causally determined fatalities is fairly limited. The following compilation reviews typical abundant observations in cases where nonnatural deaths (mostly liver failure and sudden cardiac death) were concurrent with steroid abuse. Moreover, frequent associations between structural characteristics and typical side effects are summarized.

  13. [Randomised study on histaminelike side-effects of 5 common plasmasubstitutes in orthopedic surgery (author's transl)].

    Science.gov (United States)

    Schöning, B; Koch, H

    1975-12-01

    Preceding anaesthesia 750 randomised patients, sub-divided into 5 different age groups, were given 500 ml of a standard plasma-substitute at a flow rate of 25-30 ml/min. There was direct correlation (p=0.1%) of the frequency of side-effects to the substance used; none, however, to the age or general surgical risk. Side-effects were observed in 21.3% with derivates of gelatin as compared to 3.7% with Macrodex and Plasmasteril combined. The rate of more serious anaphylactoid reactions was 6% with Haemaccel, 1.3% with Gelifundol-S, 0.67% with Macrodex and less than 0.67% with Neo-Plasmagel. The study reveals that serious side-effects may be expected in orthopaedictic patients after application of plasma substitutes. As a prophylactic procedure for those patients we recommend, therefore, the application of these substances only after careful consideration of the indications for their use.

  14. Cardiovascular Side Effects of Atomoxetine and Its Interactions with Inhibitors of the Cytochrome P450 System

    Directory of Open Access Journals (Sweden)

    Pashtoon Murtaza Kasi

    2011-01-01

    Full Text Available Attention deficit hyperactivity disorder (ADHD is one of the most common neurobehavioral disorders of childhood and adolescence. Classically, stimulants have been used in the treatment of this condition. Atomoxetine (Strattera; Eli Lilly and Company is a selective norepinephrine reuptake inhibitor (SNRI, one of the first medications in the nonstimulant class of medications that has been approved by the FDA for the treatment of ADHD. Atomoxetine is a phenoxypropylamine derivative and is structurally related to the antidepressant fluoxetine. The common side effects reported with the use of atomoxetine include mainly GI disturbances. Cardiovascular side effects are less commonly reported. The increase in the noradrenergic tone may explain some of the side effects noted with the use of this medication. Here, we present a case of a patient who presented with syncope, orthostatic hypotension, and tachycardia and discuss the various clinical implications based on the pharmacokinetics and pharmacodynamics of the drug.

  15. Visual gravitational motion and the vestibular system in humans

    Directory of Open Access Journals (Sweden)

    Francesco eLacquaniti

    2013-12-01

    Full Text Available The visual system is poorly sensitive to arbitrary accelerations, but accurately detects the effects of gravity on a target motion. Here we review behavioral and neuroimaging data about the neural mechanisms for dealing with object motion and egomotion under gravity. The results from several experiments show that the visual estimates of a target motion under gravity depend on the combination of a prior of gravity effects with on-line visual signals on target position and velocity. These estimates are affected by vestibular inputs, and are encoded in a visual-vestibular network whose core regions lie within or around the Sylvian fissure, and are represented by the posterior insula/retroinsula/temporo-parietal junction. This network responds both to target motions coherent with gravity and to vestibular caloric stimulation in human fMRI studies. Transient inactivation of the temporo-parietal junction selectively disrupts the interception of targets accelerated by gravity.

  16. Vestibular Schwannoma or acoustic neuroma

    Directory of Open Access Journals (Sweden)

    Hekmatara M

    1997-04-01

    Full Text Available Vestibular schwannoma is the most common tumor of the posterior fossa of the skull. Patients referred with the primary otologic symptoms such as hearing loss, tinnitus, vertigo, imbalance, and the cranial nerve palsy. Thirty-three patients were operated and treated by a team of otolaryngologist and neurosurgeon, anudiometrist, and internist. Patients'chiefcomplaint was due to 94% hearing loss and 27% tinnitus. They scarcely complain of vertigo. If a patient refers with the palsy or paralysis of facial nerve preoperation, we must think of the facial nerve schwannoma or hemangioma or congential cholestoma or malignant metastases rather than acoustic neuroma. The best way for preoperative diagnosis is audiometry, ABR (Auditory Brain Response, and SDS (speech discrimination score with 90% success, but computer Tomography (CT scan and MRI (Magnetic Resonance Image are the valuable anatomic diagnostic radiographic devices. The best method of operation is translabirynthine approach (TLA, since it has the advantages such as an easy access to nerve paths and being the nearest path to CPA (Cerebellopontine Angle. Physicians ought to talk to patients about the importance of the microscopic surgery, surgical methods, and their probable diverse effects such as hearing loss, facial nerve palsy, and intracranial problems.

  17. Clozapine-Induced Cardiovascular Side Effects and Autonomic Dysfunction: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Jessica W. Y. Yuen

    2018-04-01

    Full Text Available Background: Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia and has minimal risk for extrapyramidal symptoms. Therapeutic benefits, however, are accompanied by a myriad of cardiometabolic side-effects. The specific reasons for clozapine's high propensity to cause adverse cardiometabolic events remain unknown, but it is believed that autonomic dysfunction may play a role in many of these.Objective: This systematic review summarizes the literature on autonomic dysfunction and related cardiovascular side effects associated with clozapine treatment.Method: A search of the EMBASE, MEDLINE, and EBM Cochrane databases was conducted using the search terms antipsychotic agents, antipsychotic drug*, antipsychotic*, schizophrenia, schizophren*, psychos*, psychotic*, mental ill*, mental disorder*, neuroleptic*, cardiovascular*, cardiovascular diseases, clozapine*, clozaril*, autonomic*, sympathetic*, catecholamine*, norepinephrine, noradrenaline, epinephrine, adrenaline.Results: The search yielded 37 studies that were reviewed, of which only 16 studies have used interventions to manage cardiovascular side effects. Side effects reported in the studies include myocarditis, orthostatic hypotension and tachycardia. These were attributed to sympathetic hyperactivity, decreased vagal contribution, blockade of cholinergic and adrenergic receptors, reduced heart rate variability and elevated catecholamines with clozapine use. Autonomic neuropathy was identified by monitoring blood pressure and heart rate changes in response to stimuli and by spectral analysis of heart rate variability. Metoprolol, lorazepam, atenolol, propranolol, amlodipine, vasopressin and norepinephrine infusion were used to treat tachycardia and fluctuations in blood pressure, yet results were limited to case reports.Conclusion: The results indicate there is a lack of clinical studies investigating autonomic dysfunction and a limited use of interventions to manage

  18. Parent perceptions of managing child behavioural side-effects of cancer treatment: a qualitative study.

    Science.gov (United States)

    Williams, L K; McCarthy, M C

    2015-07-01

    Very little research has examined the role of parenting in managing behavioural side-effects of cancer treatment. The purpose of this paper was to explore parent perceptions of (a) parenting in the context of childhood cancer; (b) the parenting strategies used in the context of managing child behavioural side-effects of cancer treatment; and (c) the perceived impact that cancer-specific parenting strategies have on child behaviour. Participants were 15 mothers of children aged 2-6 years in the maintenance phase of treatment for acute lymphoblastic leukaemia at the Royal Children's Hospital Children's Cancer Centre, Melbourne, Australia. Mothers participated in a one-on-one semi-structured telephone interview using an interview guide which included questions on parenting in the context of childhood cancer, specifically in relation to behavioural side-effects (problems with behaviour, sleep and eating) and any perceived impact cancer-specific parenting may have on the ill child. Many parents reported that following their child's cancer diagnosis, they had to implement a suite of 'new' strategies that 'pre-diagnosis' were used only in moderation, if at all. The most salient theme that emerged was parents' perception that their parenting became more lax since their child's diagnosis. Parents further reported specific parenting strategies for each of the main child behavioural side-effects of cancer treatment. Data from the current qualitative exploratory study highlight the role of specific parenting strategies in managing or assisting child behavioural side-effects of cancer treatment. Further quantitative research is needed to more fully examine the association between parenting and child behavioural outcomes in order to develop modifiable approaches to improving child behavioural side-effects in a paediatric oncology context. © 2014 John Wiley & Sons Ltd.

  19. Side-group size effects on interfaces and glass formation in supported polymer thin films

    Science.gov (United States)

    Xia, Wenjie; Song, Jake; Hsu, David D.; Keten, Sinan

    2017-05-01

    Recent studies on glass-forming polymers near interfaces have emphasized the importance of molecular features such as chain stiffness, side-groups, molecular packing, and associated changes in fragility as key factors that govern the magnitude of Tg changes with respect to the bulk in polymer thin films. However, how such molecular features are coupled with substrate and free surface effects on Tg in thin films remains to be fully understood. Here, we employ a chemically specific coarse-grained polymer model for methacrylates to investigate the role of side-group volume on glass formation in bulk polymers and supported thin films. Our results show that bulkier side-groups lead to higher bulk Tg and fragility and are associated with a pronounced free surface effect on overall Tg depression. By probing local Tg within the films, however, we find that the polymers with bulkier side-groups experience a reduced confinement-induced increase in local Tg near a strongly interacting substrate. Further analyses indicate that this is due to the packing frustration of chains near the substrate interface, which lowers the attractive interactions with the substrate and thus lessens the surface-induced reduction in segmental mobility. Our results reveal that the size of the polymer side-group may be a design element that controls the confinement effects induced by the free surface and substrates in supported polymer thin films. Our analyses provide new insights into the factors governing polymer dynamics in bulk and confined environments.

  20. Autism and Obesity: Co-Occurring Conditions or Drug Side Effects

    Science.gov (United States)

    2015-10-01

    AWARD NUMBER: W81XWH-14-1-0374 TITLE: Autism and Obesity: Co-Occurring Conditions or Drug Side Effects? PRINCIPAL INVESTIGATOR: Zohreh...SUBTITLE Autism and Obesity: Co-Occurring Conditions or Drug Side Effects? 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0374 5c. PROGRAM ELEMENT...project is to better understand the relationship between autism and obesity. It is not clear if obesity is co-occurring with autism or is related to

  1. Anti-Stigma HIV-Related Social Advertising: No Evidence for Side Effects on Condom Use.

    Science.gov (United States)

    Arendt, Florian; Hauck, Patricia; Mayr, Johanna; Negwer, Flavia

    2017-10-17

    Recent campaigns try to reduce social stigma associated with persons living with HIV. For example, a German campaign raised awareness that infection is unlikely in low-risk day-to-day interactions. Research has yet to show that there are no harmful side effects. This is essential because such messages promote a less threatening picture of HIV and thus may unintentionally increase complacency. We tested the possible side effects on the willingness to have sex without condoms. An experiment was conducted in which participants were exposed to anti-stigma messages or not. Anti-stigma messages did not elicit an increase in the willingness to have sex without condoms.

  2. [Infrared videonystagmography in vestibular diagnosis].

    Science.gov (United States)

    Frisina, A; Piazza, F; Quaranta, N

    2000-01-01

    Vestibular examination relied upon electronystagmography (ENG) for more than 50 years. This method is based on recording of nystagmus (Ny) without any possibility to see the ocular movements directly. More recently, infrared videonystagmography (VNG) entered the diagnostic protocol of vestibular disorders. VNG permits to record and visualize Ny, both in the darkness and with open eyes. Aim of the present study was to verify the possible advantages of VNG versus ENG for functional evaluation of the vestibular system in patients suffering from otoneurological disorders. To that purpose, VNG and ENG tracings were recorded in 12 patients. The preliminary results show that there are not significant differences in quantitative evaluation of Ny between the two methods. Anyhow, VNG has some technical and clinical advantages that make it the method of choice.

  3. Use of Virtual Reality Tools for Vestibular Disorders Rehabilitation: A Comprehensive Analysis.

    Science.gov (United States)

    Bergeron, Mathieu; Lortie, Catherine L; Guitton, Matthieu J

    2015-01-01

    Classical peripheral vestibular disorders rehabilitation is a long and costly process. While virtual reality settings have been repeatedly suggested to represent possible tools to help the rehabilitation process, no systematic study had been conducted so far. We systematically reviewed the current literature to analyze the published protocols documenting the use of virtual reality settings for peripheral vestibular disorders rehabilitation. There is an important diversity of settings and protocols involving virtual reality settings for the treatment of this pathology. Evaluation of the symptoms is often not standardized. However, our results unveil a clear effect of virtual reality settings-based rehabilitation of the patients' symptoms, assessed by objectives tools such as the DHI (mean decrease of 27 points), changing symptoms handicap perception from moderate to mild impact on life. Furthermore, we detected a relationship between the duration of the exposure to virtual reality environments and the magnitude of the therapeutic effects, suggesting that virtual reality treatments should last at least 150 minutes of cumulated exposure to ensure positive outcomes. Virtual reality offers a pleasant and safe environment for the patient. Future studies should standardize evaluation tools, document putative side effects further, compare virtual reality to conventional physical therapy, and evaluate economical costs/benefits of such strategies.

  4. Use of Virtual Reality Tools for Vestibular Disorders Rehabilitation: A Comprehensive Analysis

    Science.gov (United States)

    Bergeron, Mathieu; Lortie, Catherine L.; Guitton, Matthieu J.

    2015-01-01

    Classical peripheral vestibular disorders rehabilitation is a long and costly process. While virtual reality settings have been repeatedly suggested to represent possible tools to help the rehabilitation process, no systematic study had been conducted so far. We systematically reviewed the current literature to analyze the published protocols documenting the use of virtual reality settings for peripheral vestibular disorders rehabilitation. There is an important diversity of settings and protocols involving virtual reality settings for the treatment of this pathology. Evaluation of the symptoms is often not standardized. However, our results unveil a clear effect of virtual reality settings-based rehabilitation of the patients' symptoms, assessed by objectives tools such as the DHI (mean decrease of 27 points), changing symptoms handicap perception from moderate to mild impact on life. Furthermore, we detected a relationship between the duration of the exposure to virtual reality environments and the magnitude of the therapeutic effects, suggesting that virtual reality treatments should last at least 150 minutes of cumulated exposure to ensure positive outcomes. Virtual reality offers a pleasant and safe environment for the patient. Future studies should standardize evaluation tools, document putative side effects further, compare virtual reality to conventional physical therapy, and evaluate economical costs/benefits of such strategies. PMID:26556560

  5. Use of Virtual Reality Tools for Vestibular Disorders Rehabilitation: A Comprehensive Analysis

    Directory of Open Access Journals (Sweden)

    Mathieu Bergeron

    2015-01-01

    Full Text Available Classical peripheral vestibular disorders rehabilitation is a long and costly process. While virtual reality settings have been repeatedly suggested to represent possible tools to help the rehabilitation process, no systematic study had been conducted so far. We systematically reviewed the current literature to analyze the published protocols documenting the use of virtual reality settings for peripheral vestibular disorders rehabilitation. There is an important diversity of settings and protocols involving virtual reality settings for the treatment of this pathology. Evaluation of the symptoms is often not standardized. However, our results unveil a clear effect of virtual reality settings-based rehabilitation of the patients’ symptoms, assessed by objectives tools such as the DHI (mean decrease of 27 points, changing symptoms handicap perception from moderate to mild impact on life. Furthermore, we detected a relationship between the duration of the exposure to virtual reality environments and the magnitude of the therapeutic effects, suggesting that virtual reality treatments should last at least 150 minutes of cumulated exposure to ensure positive outcomes. Virtual reality offers a pleasant and safe environment for the patient. Future studies should standardize evaluation tools, document putative side effects further, compare virtual reality to conventional physical therapy, and evaluate economical costs/benefits of such strategies.

  6. Vestibular brain changes within 70 days of head down bed rest.

    Science.gov (United States)

    Yuan, Peng; Koppelmans, Vincent; Reuter-Lorenz, Patricia; De Dios, Yiri; Gadd, Nichole; Wood, Scott; Riascos, Roy; Kofman, Igor; Bloomberg, Jacob; Mulavara, Ajitkumar; Seidler, Rachael

    2018-03-12

    Head-down-tilt bed rest (HDBR) is frequently utilized as a spaceflight analog research environment to study the effects of axial body unloading and fluid shifts that are associated with spaceflight in the absence of gravitational modifications. HDBR has been shown to result in balance changes, presumably due to sensory reweighting and adaptation processes. Here, we examined whether HDBR results in changes in the neural correlates of vestibular processing. Thirteen men participated in a 70-day HDBR intervention; we measured balance, functional mobility, and functional brain activity in response to vestibular stimulation at 7 time points before, during, and after HDBR. Vestibular stimulation was administered by means of skull taps, resulting in activation of the vestibular cortex and deactivation of the cerebellar, motor, and somatosensory cortices. Activation in the bilateral insular cortex, part of the vestibular network, gradually increased across the course of HDBR, suggesting an upregulation of vestibular inputs in response to the reduced somatosensory inputs experienced during bed rest. Furthermore, greater increase of activation in multiple frontal, parietal, and occipital regions in response to vestibular stimulation during HDBR was associated with greater decrements in balance and mobility from before to after HDBR, suggesting reduced neural efficiency. These findings shed light on neuroplastic changes occurring with conditions of altered sensory inputs, and reveal the potential for central vestibular-somatosensory convergence and reweighting with bed rest. © 2018 Wiley Periodicals, Inc.

  7. Short-term side effects and patient-reported outcomes of bleomycin sclerotherapy in vascular malformations.

    Science.gov (United States)

    Mack, Joana M; Richter, Gresham T; Becton, David; Salem, Omar; Hill, Sarah E M; Crary, Shelley E

    2018-06-01

    Vascular malformations (VM) are congenital lesions that can be debilitating and cause significant aesthetic and functional limitations. The chemotherapeutic agent bleomycin has been utilized as a sclerosant, directly injected percutaneously into the VM. Unfortunately, little is known about the benefits and short-term side effects of bleomycin with intralesional injections. An IRB approved, retrospective chart review was performed on patients with VM who had been treated with intralesional bleomycin. Data included type of VM, number of treatments, total bleomycin dose per m², and adverse effects. A questionnaire was administered to available patients to assess subjective outcomes and side effects. Forty-six patients were treated with 141 procedures of bleomycin sclerotherapy for VM. Patient ages ranged from 1 to 20 years (median age 10 years). The median cumulative bleomycin dose was 16.3 units/m²/person (range of 1.7-97.0 units/m²/person). Sixty-three percent of patients were reached for a questionnaire to assess short-term side effects. Ninety percent of patients surveyed were satisfied to very satisfied with the results from the procedure. About 24% of patients experienced transient nausea, vomiting and/or local hyperpigmentation. Bleomycin sclerotherapy can be an effective treatment of VM with repeat exposure with minor risk of short-term side effects, however, long-term risks are of great concern. Further studies are required to assess systemic absorption and long-term risks. © 2018 Wiley Periodicals, Inc.

  8. Vertical eye movements during horizontal head impulse test: a new clinical sign of superior vestibular neuritis.

    Science.gov (United States)

    D'Onofrio, F

    2013-12-01

    In some patients suffering from acute unilateral peripheral vestibular deficit, the head impulse test performed towards the affected side reveals the typical catch-up saccade in the horizontal plane, and an oblique, mostly vertical, upward catch-up saccade after the rotation of the head towards the healthy side. Three cases are reported herein, which have been studied using slow motion video analysis of the eye movements captured by a high-speed webcam (90 fps). The clinical evidence is discussed and a pathophysiological explanation is proposed, consisting in a selective hypofunction of the superior semicircular canal during superior vestibular neuritis.

  9. Secondary-side feed-and-bleed effectiveness in pressurized water reactors

    International Nuclear Information System (INIS)

    Annunziato, A.

    1994-01-01

    An analysis is presented of physical phenomena occurring during secondary-side feed-and-bleed, which is being considered as an accident management procedure for pressurized water reactors. Problem areas related to the reliability of this procedure are identified and discussed. Secondary-side feed-and-bleed, as examined in the LOBI (which is the Light Water Reactor Off-Normal Behavior Investigation) integral system test facility, was not successful because of a delay in the secondary-side heat removal caused by the release of stored heat from the steam generator downcomer wall. Countercurrent flow limiting in the hot leg was another major phenomenon that can influence the effectiveness of this procedure. The discussion of the experimental results is complemented by relevant calculations by RELAP5/MOD3. In general, it was found that the effectiveness of the feed-and-bleed procedure is maximized if the number of steam generators used to implement it is reduced

  10. Real World Data Driven Evolution of Volvo Cars’ Side Impact Protection Systems and their Effectiveness

    Science.gov (United States)

    Jakobsson, Lotta; Lindman, Magdalena; Svanberg, Bo; Carlsson, Henrik

    2010-01-01

    This study analyses the outcome of the continuous improved occupant protection over the last two decades for front seat near side occupants in side impacts based on a real world driven working process. The effectiveness of four generations of improved side impact protection are calculated based on data from Volvo’s statistical accident database of Volvo Cars in Sweden. Generation I includes vehicles with a new structural and interior concept (SIPS). Generation II includes vehicles with structural improvements and a new chest airbag (SIPSbag). Generation III includes vehicles with further improved SIPS and SIPSbag as well as the new concept with a head protecting Inflatable Curtain (IC). Generation IV includes the most recent vehicles with further improvements of all the systems plus advanced sensors and seat belt pretensioner activation. Compared to baseline vehicles, vehicles of generation I reduce MAIS2+ injuries by 54%, generation II by 61% and generation III by 72%. For generation IV effectiveness figures cannot be calculated because of the lack of MAIS2+ injuries. A continuous improved performance is also seen when studying the AIS2+ pelvis, abdomen, chest and head injuries separately. By using the same real world driven working process, future improvements and possibly new passive as well as active safety systems, will be developed with the aim of further improved protection to near side occupants in side impacts. PMID:21050597

  11. Real World Data Driven Evolution of Volvo Cars' Side Impact Protection Systems and their Effectiveness.

    Science.gov (United States)

    Jakobsson, Lotta; Lindman, Magdalena; Svanberg, Bo; Carlsson, Henrik

    2010-01-01

    This study analyses the outcome of the continuous improved occupant protection over the last two decades for front seat near side occupants in side impacts based on a real world driven working process. The effectiveness of four generations of improved side impact protection are calculated based on data from Volvo's statistical accident database of Volvo Cars in Sweden. Generation I includes vehicles with a new structural and interior concept (SIPS). Generation II includes vehicles with structural improvements and a new chest airbag (SIPSbag). Generation III includes vehicles with further improved SIPS and SIPSbag as well as the new concept with a head protecting Inflatable Curtain (IC). Generation IV includes the most recent vehicles with further improvements of all the systems plus advanced sensors and seat belt pretensioner activation. Compared to baseline vehicles, vehicles of generation I reduce MAIS2+ injuries by 54%, generation II by 61% and generation III by 72%. For generation IV effectiveness figures cannot be calculated because of the lack of MAIS2+ injuries. A continuous improved performance is also seen when studying the AIS2+ pelvis, abdomen, chest and head injuries separately. By using the same real world driven working process, future improvements and possibly new passive as well as active safety systems, will be developed with the aim of further improved protection to near side occupants in side impacts.

  12. Balancing opioid-induced gastrointestinal side effects with pain management: Insights from the online community.

    Science.gov (United States)

    Whitman, Cynthia B; Reid, Mark W; Arnold, Corey; Patel, Haridarshan; Ursos, Lyann; Sa'adon, Roee; Pourmorady, Jonathan; Spiegel, Brennan M R

    2015-01-01

    Opioids cause gastrointestinal (GI) symptoms such as nausea, vomiting, pain, and (in 40 percent) constipation that diminish patients' quality of life. Outside traditional surveys, little is known about the opioid-induced constipation (OIC) patient experience and its impact on pain management. The purpose of this study was to use data from social media platforms to qualitatively examine patient beliefs about OIC and other prominent GI side effects, their impact on effective pain management and doctor-patient interaction. The authors collected Tweets from March 25 to July 31, 2014, and e-forum posts from health-related social networking sites regardless of timestamp. The authors identified specific keywords related to opioids and GI side effects to locate relevant content in the dataset, which was then manually coded using ATLAS.ti software. The authors examined 2,519,868 Tweets and more than 1.8 billion e-forum posts, of which, 88,586 Tweets and 9,767 posts satisfied the search criteria. Three thousand three individuals experienced opioidinduced GI side effects, mostly related to phenanthrenes (n = 1,589), and 1,274 (42.4 percent) individuals described constipation. Over-the-counter medications and nonevidence-based natural approaches were most commonly used to alleviate constipation. Many individuals questioned, rotated, reduced, or stopped their opioid treatments as a result of their GI side effects. Investigation of social media reveals a struggle to balance pain management with opioid-induced GI side effects, especially constipation. Individuals are often unprepared to treat OIC, to modify opioid regiments without medical advice, and to resort to using natural remedies and treatments lacking scientific evidence of effectiveness. These results identify opportunities to improve physician-patient communication and explore effective treatment alternatives.

  13. Symptoms and side effects in chronic non-cancer pain: patient report vs. systematic assessment.

    Science.gov (United States)

    Jonsson, T; Christrup, L L; Højsted, J; Villesen, H H; Albjerg, T H; Ravn-Nielsen, L V; Sjøgren, P

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment. We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics. patients treated with either opioids and/or adjuvant analgesics were asked to report their symptoms spontaneously, followed by a 41-item investigator-developed symptom checklist. A control group also filled in the checklist. a total of 62 patients and 64 controls participated in the study. The numbers of symptoms reported by the patients (9.9 ± 5.9) were significantly higher than those reported by the controls (3.2 ± 3.9) (Pside effects due to analgesics was: (1) Dry mouth (42%); (2) Sweating (34%); (3) Weight gain (29%); (4) Memory deficits (24%); (5) Fatigue (19%); and (6) Concentration deficits (19%). the number of symptoms reported using systematic assessment was eightfold higher than those reported voluntarily. Fatigue, cognitive dysfunction, dry mouth, sweating and weight gain were the most frequently reported. The patients reported the side effects of their analgesics to contribute substantially to the reported symptoms. 2010 The Acta Anaesthesiologica Scandinavica Foundation.

  14. Supplementation with Vitamin B6 Reduces Side Effects in Cambodian Women Using Oral Contraception

    Directory of Open Access Journals (Sweden)

    Chivorn Var

    2014-08-01

    Full Text Available Hormonal contraceptives may produce side effects that deter women from their use as a method of family planning. In nutritionally vulnerable populations these effects may be more pronounced due to micronutrient deficiencies and health status. Previous studies have been unable to resolve whether micronutrient supplementation may reduce such side effects. Aim: In a longitudinal study, 1011 women obtaining oral contraception through the public health system in rural Cambodia were allocated to either intervention or control groups, receiving either daily Vitamin B6 supplement or care as usual (without placebo. Results: The intervention participants (n = 577 reported fewer side effects in three categories: nausea/no appetite, headache, and depression compared with control group participants (n = 434. Conclusion: Women taking Vitamin B6 supplement were less likely to report side effects in a nutritionally vulnerable population. Underlying nutrition status should be considered by clinicians and reproductive health policy makers in the context of providing contraceptive services. Further investigation into micronutrient supplementation, particularly with B6, in reproductive-aged women using hormonal contraception should be conducted in other settings to determine the potential for widespread adoption.

  15. Supplementation with vitamin B6 reduces side effects in Cambodian women using oral contraception.

    Science.gov (United States)

    Var, Chivorn; Keller, Sheryl; Tung, Rathavy; Freeland, Dylan; Bazzano, Alessandra N

    2014-08-26

    Hormonal contraceptives may produce side effects that deter women from their use as a method of family planning. In nutritionally vulnerable populations these effects may be more pronounced due to micronutrient deficiencies and health status. Previous studies have been unable to resolve whether micronutrient supplementation may reduce such side effects. In a longitudinal study, 1011 women obtaining oral contraception through the public health system in rural Cambodia were allocated to either intervention or control groups, receiving either daily Vitamin B6 supplement or care as usual (without placebo). The intervention participants (n = 577) reported fewer side effects in three categories: nausea/no appetite, headache, and depression compared with control group participants (n = 434). Women taking Vitamin B6 supplement were less likely to report side effects in a nutritionally vulnerable population. Underlying nutrition status should be considered by clinicians and reproductive health policy makers in the context of providing contraceptive services. Further investigation into micronutrient supplementation, particularly with B6, in reproductive-aged women using hormonal contraception should be conducted in other settings to determine the potential for widespread adoption.

  16. Frontal plane knee moments in golf: effect of target side foot position at address.

    Science.gov (United States)

    Lynn, Scott K; Noffal, Guillermo J

    2010-01-01

    Golf has the potential to keep people active well into their later years. Injuries to the target side knee have been reported in golfers, yet no mechanisms for these injuries have been proposed. The loads on the knee during the golf swing may be insufficient to cause acute injury, yet they may be a factor in the progression of overuse/degenerative conditions; therefore, research developing swing modifications that may alter loading of the knee is warranted. It has been suggested that the proper golf set-up position has the target-side foot externally rotated but no reasoning for this modification has been provided. Frontal plane knee moments have been implicated in many knee pathologies. Therefore, this study used a 3-dimensional link segment model to quantify the frontal plane knee moments during the golf swing in a straight (STR) and externally rotated (EXT) target-side foot position. Subjects were 7 collegiate golfers and knee moments were compared between conditions using repeated measures T-tests. The golf swing knee moment magnitudes were also descriptively compared to those reported for two athletic maneuvers (drop jump landing, side-step cutting) and activities of daily living (gait, stair ascent). The EXT condition decreased the peak knee adduction moment as compared to the STR condition; however, foot position had no effect on the peak knee abduction moment. Also, the magnitude of the knee adduction moments during the two activities of daily living were 9-33% smaller than those experienced during the two different golfing conditions. The drop jump landing and golf swing knee moments were of similar magnitude (STR= - 5%, EXT= + 8%); however, the moments associated with side- step cutting were 50-71% larger than those on the target side knee during the golf swing. The loading of the target side knee during the golf swing may be a factor in the development and progression of knee pathologies and further research should examine ways of attenuating these loads

  17. Antipsychotic medication in children and adolescents: a descriptive review of the effects on prolactin level and associated side effects.

    NARCIS (Netherlands)

    Roke, Y.; Harten, P.N. van; Boot, A.M.; Buitelaar, J.K.

    2009-01-01

    OBJECTIVE: This review reports the incidence of hyperprolactinemia, its relationship with genotype, and prolactin-related side effects in children and adolescents treated with antipsychotics. METHOD: Data on prolactin levels were available for haloperidol, pimozide, risperidone, olanzapine,

  18. Antipsychotic Medication in Children and Adolescents : A Descriptive Review of the Effects on Prolactin Level and Associated Side Effects

    NARCIS (Netherlands)

    Roke, Yvette; van Harten, Peter N.; Boot, Annemieke M.; Buitelaar, Jan K.

    Objective: This review reports the incidence of hyperprolactinemia, its relationship with genotype, and prolactin-related side effects in children and adolescents treated with antipsychotics. Method: Data on prolactin levels were available for haloperidol, pimozide, risperidone, olanzapine,

  19. PREVENTION OF CUTANEOUS SIDE EFFECTS OF TOPICAL TRETINOIN: USE OF ORAL VITAMINE E

    Directory of Open Access Journals (Sweden)

    G FAGHIHI

    2001-03-01

    Full Text Available Introduction: Acne vulgaris is an inflammatory disease of pilosebaceous folicles. Tretinoin is used as one of the topical treatments for acne vulgaris. It has different cutaneous side effects such as erythema, scaling, irritation and photosensitivity. The aim of this study was to evaluate the efficacy of oral Vitamine E in preventing the cutaneous side effects of topical tretinoin in acne patients.
    Methods: A clinical trial was performed in AI-Zahra Hospital in Isfahan for six months in 2000. 80 patients with mild to moderate facial acne were randomized into 2 groups. Group 1 (controls received topical solution of tretinoin 0.05 percent nightly and group 2 (cases received daily oral 100mg of Vit. E in addition. All patients were followed at 1, 4 and 6 weeks after initiation of treatment. Children under 12 years old, pregnant or lactating women were excluded.
    Results: At the end of one week, no cutaneous side effects were observed in 25 percent (10 of group 1 and 15 percent (6 of group 2 (P > 0.05. At the end of 4 weeks, 25 percent (10 of group 1 and 60 percent (24 of group 2 were without any cutaneous complications, while at the end of 6 weeks, 35 percent (14 of group 1 in comparison to 75 percent (30 of group 2 were free of any cutaneous side effects (P < 0.05. The most common side effect in both groups was exfoliation.
    Discussion: Daily oral 100 mg of Vit. E has been effective in preventing cutaneous complications of topical tretinoin in acne management, but there is a delay of one week in its onset of action. Meanwhile, Vitamine E is a safe modality with no undesirable effects in acne patients.

  20. Perception of Side Effects of Chemotherapy among Cancer Patients in B.P. Koirala Memorial Cancer Hospital Bharatpur, Nepal

    Directory of Open Access Journals (Sweden)

    Sharmila Gurung

    2016-01-01

    Full Text Available jdjBackground & Objectives: These side effects of chemotherapy affect the patients’ daily life and quality of life adversely. It affects the different body system resulting in physical and non physical (psychosocial side effects. Cancer patients demand information to understand chemotherapy-related adverse effects and actions to be taken. The aim of the study is to find out the perception of side effects of chemotherapy among cancer patients.Materials and methods: A descriptive cross-sectional study was conducted among 200 cancer patients, using purposive sampling technique and data was collected via face to face interview. Descriptive as well as inferential statistics (T-test was used to see the significant difference between dependent and independent variables.Results: The overall perceived side effects of chemotherapy include: affects work and home duties (non physical side effect, followed by anxiety, loss of appetite, affects family, affect partner, feel constantly tired (fatigue, affects social activities, feel irritable, nausea and constipation respectively. There is significant difference between perception of side effects of chemotherapy and gender of respondents.Conclusion: The perceptions of side effects of chemotherapy are different from individual to individual. Patient’s perception of side effects of chemotherapy is concerned with non physical side effects rather than physical side effects.Journal of College of Medical Sciences-Nepal, Vol.11(4 2015: 14-19

  1. Treatment side effects and follow-up of malignant melanoma; Therapienebenwirkungen und Nachsorge bei malignem Melanom

    Energy Technology Data Exchange (ETDEWEB)

    Stahl, T. [Klinikum der Stadt Ludwigshafen gGmbH, Zentralinstitut fuer diagnostische und interventionelle Radiologie, Ludwigshafen (Germany); Loquai, C. [Universitaetsmedizin der Johannes-Gutenberg Universitaet Mainz, Hautklinik und Poliklinik, Mainz (Germany)

    2015-01-30

    Side effects in the therapy of malignant melanoma are primarily of importance for radiologists in advanced tumor stages. The available treatment options and their respective side effect profiles have undergone a profound change in recent years after the introduction of modern oncological therapies (e.g. immunotherapy and targeted therapy) with an increasing focus on individual tumor biology and differ significantly from those of classical chemotherapy. The immunotherapeutic agents, in particular ipilimumab, take on a special position because of their specific immune-mediated mechanisms of action and the associated side effects, so-called immune-related adverse events (irAE). The majority of the treatment effects are manifested on the skin (> 50 %) and are generally not detectable by diagnostic radiology. Only a comparatively small proportion of treatment side effects is detectable with diagnostic imaging (15-20 %) but as in the example of therapy-induced colitis with ipilimumab, may be rapidly fatal. In addition to colitis (10-20 %) further therapy side effects apparent in diagnostic imaging are hypophysitis (1.8-17 %), thyroiditis (0.8 %), myositis (1.7 %), fasciitis and sarcoid-like lymph node alterations (6.8 %). To detect radiologically detectable side effects early on and to delineate them especially from tumor progression and (opportunistic) infections, detailed knowledge of the therapeutic methods for melanoma, the mechanisms of action and in particular the sometimes very specific side effects is imperative for radiologists. (orig.) [German] Nebenwirkungen der Therapie des malignen Melanoms sind fuer den Radiologen primaer in fortgeschrittenen Tumorstadien von Bedeutung. Die zur Verfuegung stehenden Therapieoptionen und ihre jeweiligen Nebenwirkungsprofile haben sich in den letzten Jahren nach Einfuehrung moderner onkologischer Therapieoptionen, die sich zunehmend an der individuellen Tumorbiologie orientieren (zielgerichtete Therapie, Immuntherapie), einem

  2. Herbal medicines for the treatment of cancer chemotherapy-induced side effects

    OpenAIRE

    Ohnishi, Shunsuke; Takeda, Hiroshi

    2015-01-01

    Accumulating evidence suggests that Japanese herbal medicines, called Kampo, have beneficial effects on cancer chemotherapy-induced side effects. Rikkunshito ameliorates cisplatin-induced anorexia through an antagonistic effect on the 5-HT receptors and by increasing the serum ghrelin levels. Hangeshashinto improves irinotecan-induced diarrhea and chemotherapy-induced mucositis by inhibiting the activity of β-glucuronidase as well as the synthesis of prostaglandin E2. Goshajinkigan prevents o...

  3. Vestibular rehabilitation for dizziness and balance disorders after concussion.

    Science.gov (United States)

    Alsalaheen, Bara A; Mucha, Anne; Morris, Laura O; Whitney, Susan L; Furman, Joseph M; Camiolo-Reddy, Cara E; Collins, Michael W; Lovell, Mark R; Sparto, Patrick J

    2010-06-01

    Management of dizziness and balance dysfunction is a major challenge after concussion. The purpose of this study was to examine the effect of vestibular rehabilitation in reducing dizziness and to improve gait and balance function in people after concussion. A retrospective chart review of 114 patients (67 children aged 18 years and younger [mean, 16 years; range, 8-18 years]; 47 adults older than 18 years [mean, 41 years; range, 19-73 years]) referred for vestibular rehabilitation after concussion was performed. At the time of initial evaluation and discharge, recordings were made of outcome measures of self-report (eg, dizziness severity, Activities-specific Balance Confidence Scale, and Dizziness Handicap Inventory) and gait and balance performance (eg, Dynamic Gait Index, gait speed, and the Sensory Organization Test). A mixed-factor repeated-measures analysis of variance was used to test whether there was an effect of vestibular rehabilitation therapy and age on the outcome measures. The median length of time between concussion and initial evaluation was 61 days. Of the 114 patients who were referred, 84 returned for at least 1 visit. In these patients, improvements were observed in all self-report, gait, and balance performance measures at the time of discharge (P Vestibular rehabilitation may reduce dizziness and improve gait and balance function after concussion. For most measures, the improvement did not depend on age, indicating that vestibular rehabilitation may equally benefit both children and adults. Vestibular rehabilitation should be considered in the management of individuals post concussion who have dizziness and gait and balance dysfunction that do not resolve with rest.

  4. Plasticity during vestibular compensation: the role of saccades

    Directory of Open Access Journals (Sweden)

    Hamish Gavin MacDougall

    2012-02-01

    Full Text Available This paper is focussed on one major aspect of compensation: the recent behavioural findings concerning oculomotor responses in human vestibular compensation and their possible implications for recovery after unilateral vestibular loss (UVL. New measurement techniques have provided new insights into how patients recover after UVL and have given clues for vestibular rehabilitation. Prior to this it has not been possible to quantify the level of function of all the peripheral vestibular sense organs. Now it is. By using vestibular-evoked myogenic potentials to measure utricular and saccular function and by new video head impulse testing to measure semicircular canal function to natural values of head accelerations. With these new video procedures it is now possible to measure both slow phase eye velocity and also saccades during natural head movements. The present evidence is that there is little or no recovery of slow phase eye velocity responses to natural head accelerations. It is doubtful as to whether the modest changes in slow phase eye velocity to small angular accelerations are functionally effective during compensation. On the other hand it is now clear that saccades can play a very important role in helping patients compensate and return to a normal lifestyle. Preliminary evidence suggests that different patterns of saccadic response may predict how well patients recover. It may be possible to train patients to produce more effective saccadic patterns in the first days after their unilateral loss. Some patients do learn new strategies, new behaviours, to conceal their inadequate VOR but when those strategies are prevented from operating by using passive, unpredictable, high acceleration natural head movements, as in the head impulse test, their vestibular loss can be demonstrated. It is those very strategies which the tests exclude, which may be the cause of their successful compensation.

  5. Immune responses and side effects of five different oil-based adjuvants in mice

    NARCIS (Netherlands)

    Leenaars, M.; Koedam, M.A.; Hendriksen, C.F.M.; Claassen, E.

    1998-01-01

    In this study, five different oil based adjuvants were compared to assess efficacy and side effects. Mice were injected subcutaneously (s.c.) or intraperitoneally (i.p.) with a weak immunogen (synthetic peptide) emulsified in Freund's adjuvant (FA), Specol, RIBI, TiterMax or Montanide ISA50.

  6. Positive Side Effects of a Job-Related Training Program for Older Adults in South Korea

    Science.gov (United States)

    Lee, Minhong; Choi, Jae-Sung

    2012-01-01

    The objective of the current study was to evaluate empirically positive side effects of a job-related training program on older adults' self-esteem, depression, and social networks. A total of 70 older adults participated in the study after completing the Older Paraprofessional Training Program developed and provided by the Continuing Education…

  7. Are sexual side effects of prolactin-raising antipsychotics reducible to serum prolactin?

    NARCIS (Netherlands)

    Knegtering, Henderikus; van den Bosch, Rob; Castelein, Stynke; Bruggeman, Richard; Sytema, Sjoerd; van Os, Jim

    Objective: To assess the degree to which sexual side effects (SSE) are associated with prolactin-raising antipsychotics, and to what degree such SSE are reducible to serum prolactin levels. Method: A large sample (n = 264) of patients treated for 6 weeks with protactin-raising and prolactin-sparing

  8. Novel Profiling Model and Side Effects of Helical Scan Silicon Heads

    NARCIS (Netherlands)

    Hozoi, A.; Groenland, J.P.J.; Albertini, J.B.; Lodder, J.C.

    2002-01-01

    Partial erasure of track edges was directly measured from triple-track patterns using a novel model to interpret the output profiles. The model is based on representing the read head as the sum of a reference width, wavelength independent, and two side reading effective widths that are wavelength

  9. The role of hypothalamic pathways in the metabolic side effects of Olanzapine

    NARCIS (Netherlands)

    Girault, E.M.

    2013-01-01

    Atypical antipsychotic drugs such as Olanzapine (Ola) induce weight gain and metabolic changes associated with the development of type 2 diabetes. The mechanisms underlying these undesired side effects are currently unknown. In this thesis, we showed that both acute and chronic administration of Ola

  10. Spontaneous Recovery of Previously Extinguished Behavior as an Alternative Explanation for Extinction-Related Side Effects

    Science.gov (United States)

    Waller, Raymond J.; Mays, Nicole M.

    2007-01-01

    Extinction is accepted as a viable intervention for behaviors that are hypothesized to be maintained by contingent attentional reinforcement. However, it is frequently acknowledged that extinction has potential numerous side effects, including the generation of aggressive behavior. This explanation does not provide a behavioral conceptualization…

  11. Cutaneous Side Effects and Transepidermal Water Loss To Gefitinib: A Study of 11 Patients.

    Science.gov (United States)

    Chandra, Franky; Sandiono, Dendi; Sugiri, Unwati; Suwarsa, Oki; Gunawan, Hendra

    2017-03-01

    Cutaneous side effects caused by epidermal growth factor receptor (EGFR) inhibitors occurred in 45-100% of patients which may lead to therapy modification or interruption. This study aimed to evaluate cutaneous side effects and transepidermal water loss (TEWL) values in non-small cell lung carcinoma (NSCLC) patients who received gefitinib EGFR inhibitor. A descriptive observational study with cross-sectional design and a consecutive sampling method was conducted from 1 February to 4 March 2016. Eleven NSCLC patients with EGFR mutation who visited the Hemato-Oncology Clinic/Internal Medicine Department, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, were assessed through history taking, physical examination, and TEWL examination using Tewameter. Ten of the eleven patients experienced cutaneous side effects. The most frequently observed was xerosis cutis (8/10 patients), followed by acneiform eruptions (7/10 patients), and paronychia (3/10 patients). None of these patients experienced hair changes, mucositis, or drug hypersensitivity. Mean TEWL value of these patients was higher than normal (11.205 ± 1.881 g/m 2 /h). Patients who received gefitinib EGFR inhibitor experienced cutaneous side effects including xerosis cutis, acneiform eruptions, and paronychia, and have mean TEWL values higher than normal. Therefore, it might affect the skin barrier function.

  12. Family Planning in a Sub-district near Kumasi, Ghana: Side Effect ...

    African Journals Online (AJOL)

    Family Planning in a Sub-district near Kumasi, Ghana: Side Effect Fears, Unintended Pregnancies and Misuse of a Medication as Emergency Contraception. ... Alternatively, you can download the PDF file directly to your computer, from where it can be opened using a PDF reader. To download the PDF, click the Download ...

  13. Side Effects of Radiation in Bone and Cartilage: An FT-IR Analysis.

    Science.gov (United States)

    Mavrogenis, Andreas F; Megaloikonomos, Panayiotis D; Panagopoulos, George N; Papagelopoulos, Panayiotis J; Theophanides, Theofilos; Anastassopoulou, Jane

    2015-01-01

    Although radiation therapy is an essential treatment of cancers, it is associated with unwanted complications. The purpose of this review is to summarize the current knowledge regarding the side effects of radiation in bone and articular cartilage and to recommend Fourier transform infrared spectroscopy to monitor the differences in infrared spectra between healthy and irradiated bone and cartilage.

  14. Pharmacokinetic-pharmacodynamic modeling of severity levels of extrapyramidal side effects with markov elements

    NARCIS (Netherlands)

    Pilla Reddy, V; Petersson, K J; Suleiman, A A; Vermeulen, An; Proost, J H; Friberg, L E

    2012-01-01

    A major problem in the treatment of schizophrenic patients with current antipsychotic drugs, mainly acting as dopamine-2 receptor antagonists, is the occurrence of side effects such as extrapyramidal symptoms (EPS). Meta-analyses of summary data of EPS occurrence, and receptor occupancies inferred

  15. Pharmacy customers' knowledge of side effects of purchased medicines in Mexico

    NARCIS (Netherlands)

    Wirtz, Veronika J.; Taxis, Katja; Dreser, Anahi

    To analyse pharmacy customers' knowledge and information sources about side effects of medicines they purchased and factors associated with this knowledge. Cross-sectional survey and semi-structured interviews with customers of 52 randomly selected community pharmacies in Morelos state, Mexico.

  16. Pharmacy customers' knowledge of side effects of purchased medicines in Mexico.

    Science.gov (United States)

    Wirtz, Veronika J; Taxis, Katja; Dreser, Anahi

    2009-01-01

    To analyse pharmacy customers' knowledge and information sources about side effects of medicines they purchased and factors associated with this knowledge. Cross-sectional survey and semi-structured interviews with customers of 52 randomly selected community pharmacies in Morelos state, Mexico. Customers were included if they were older than 18 years, bought at least one drug either with or without medical prescription, and agreed to take part in the survey. Data were analysed using a multinomial logistic regression model. A total of 1445 customers buying 1946 drugs were surveyed (age 42.9 +/- 15.7 years, 56.9% female); 627 (59%) of 1055 customers who purchased prescription-only medicines (POM) did so without a prescription. Of all customers interviewed, 172 (11.9%) affirmed that the bought medicine(s) could cause harm. Only half of those (87 or 6%) were able to identify correctly at least one side effect of the purchased medicines. The majority received the information about side effects from a physician. Customers in semirural areas knew less about side effects (odds ratio: 0.26; 95% CI: 0.11-0.61; P = 0.00); whereas customers buying medicines for chronic pain, hypertension or diabetes knew more (odds ratio 2.63; 95% CI: 1.44-4.80; P = 0.00). The overall majority of customers did not know that medicines they bought could be harmful. This is particularly alarming because they frequently used POM without consulting a physician.

  17. 21 CFR 209.11 - Dispensing and distributing the side effects statement.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Dispensing and distributing the side effects statement. 209.11 Section 209.11 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL REQUIREMENT FOR AUTHORIZED DISPENSERS AND PHARMACIES TO DISTRIBUTE A...

  18. Gastrointestinal ulceration as a possible side effect of bevacizumab which may herald perforation

    NARCIS (Netherlands)

    Tol, J.; Cats, A.; Mol, L.; Koopman, M.; Bos, M. M. E. M.; van der Hoeven, J. J. M.; Antonini, N. F.; van Krieken, J. H. J. M.; Punt, C. J. A.

    2008-01-01

    Chemotherapy plus bevacizumab is currently considered as the standard 1st line treatment of advanced colorectal cancer (ACC). Whereas GI perforation is a known side effect of bevacizumab, the development of GI ulcers has not been reported. We identified 18 patients with ACC who participated in a

  19. Side-effects of oral misoprostol in the third stage of labour – a ...

    African Journals Online (AJOL)

    Background. Misoprostol, an irlexpensive, stable, orally active prostaglandirl analogue, has been suggested for use in the prevention of postpartum haemorrhage. Potential side-effects, however, need to be quantified. Objective. To compare the rate of postpartum shivering and pyrexia following oral misoprostol 600 pg and ...

  20. Side effects after radiotherapy of age-related macular degeneration with the Nijmegen technique.

    NARCIS (Netherlands)

    Hoyng, C.B.; Tromp, A.I.; Meulendijks, C.F.M.; Leys, A.; Maazen, R.W.M. van der; Deutman, A.F.; Vingerling, J.R.

    2002-01-01

    BACKGROUND: In a randomized trial concerning radiotherapy for age-related macular degeneration, fluorescein angiograms were taken of controls and patients. In this study the frequency of side effects in eyes receiving radiotherapy with the Nijmegen technique is compared with the findings in the eyes