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- Thomas, HS, et al.
(författare)
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- 2019
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swepub:Mat__t
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| 5. |
- Brantberg, K., et al.
(författare)
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Symptoms, findings and treatment in patients with dehiscence of the superior semicircular canal
- 2001
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 121:1, s. 68-75
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Tidskriftsartikel (refereegranskat)abstract
- Recently Minor and co-workers described patients with sound- and pressure-induced vertigo due to dehiscence of the superior semicircular canal. Identifying patients with this 'new' vestibular entity is important, not only because the symptoms are sometimes very incapacitating, but also because they can be treated. We present symptoms and findings in eight such patients, all of whom reported pressure-induced vertigo that increased during periods of upper respiratory infections. Pulse-synchronous tinnitus and gaze instability during head movements were also common complaints. All patients lateralized Weber's test to the symptomatic ear. In some of the patients the audiogram also revealed a small conductive hearing loss. However, the stapedius reflexes were always normal. A vertical/torsional eye movement related to the superior semicircular canal was seen in most of the patients in response to pressure changes and/or sound stimulation. One patient also had superior canal-related positioning nystagmus. Testing vestibular evoked myogenic potentials revealed in all patients a vestibular hypersensitivity to sounds. In the coronal high-resolution 1-mm section CT scans the dehiscence was visible on 1 to 4 sections. Moreover, the skull base was rather thin in this area and cortical bone separating the middle ear and the antrum from the middle cranial fossa was absent in many of the patients. Two of the patients have undergone plugging of the superior semicircular canal using a transmastoid approach and both patients were relieved of the pressure-induced symptoms.
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| 9. |
- Mendel, Arielle, et al.
(författare)
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Use of combined hormonal contraceptives among women with systemic lupus erythematosus with and without medical contraindications to oestrogen
- 2019
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Ingår i: Rheumatology (United Kingdom). - : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 58:7, s. 1259-1267
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To assess the prevalence of combined hormonal contraceptives (CHCs) in reproductive-age women with SLE with and without possible contraindications and to determine factors associated with their use in the presence of possible contraindications. Methods. This observational cohort study included premenopausal women ages 18-45 years enrolled in the SLICC Registry ≤15 months after SLE onset, with annual assessments spanning 2000-2017. World Health Organization Category 3 or 4 contraindications to CHCs (e.g. hypertension, aPL) were assessed at each study visit. High disease activity (SLEDAI score >12 or use of >0.5 mg/kg/day of prednisone) was considered a relative contraindication. Results. A total of 927 SLE women contributed 6315 visits, of which 3811 (60%) occurred in the presence of one or more possible contraindication to CHCs. Women used CHCs during 512 (8%) visits, of which 281 (55%) took place in the setting of one or more possible contraindication. The most frequently observed contraindications were aPL (52%), hypertension (34%) and migraine with aura (22%). Women with one or more contraindication were slightly less likely to be taking CHCs [7% of visits (95% CI 7, 8)] than women with no contraindications [9% (95% CI 8, 10)]. Conclusion. CHC use was low compared with general population estimates (>35%) and more than half of CHC users had at least one possible contraindication. Many yet unmeasured factors, including patient preferences, may have contributed to these observations. Further work should also aim to clarify outcomes associated with this exposure.
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| 10. |
- Söderman, M, et al.
(författare)
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Otorrhagia from the "aberrant internal carotid" artery in the middle ear. Surgical and endovascular aspects
- 1997
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Ingår i: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. - : SAGE Publications. - 1591-0199. ; 3:3, s. 231-8
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Tidskriftsartikel (refereegranskat)abstract
- Agenesis of the cervical portion of the internal carotid artery (ICA) may result in blood supply to the ipsilateral cerebral hemisphere being provided by an enlarged inferior tympanic branch of the ascending pharyngeal artery. This enlarged vessel, passing through Jacobson's canal and anastomosing with the likewise enlarged caroticotympanic branch of the ICA in front of the promontorium, may simulate a middle ear mass. We present five patients with this unusual anatomical variant, three of which underwent biopsy of what was believed to be a middle ear tumour. One patient experienced rupture of an arterial aneurysm in the middle ear successfully treated with endovascular application of detachable platinum coils. It is mandatory for ENT-surgeons and radiologists who perform head-and-neck examinations to recognize this anatomical variant, not mistaking it for a tumour, since biopsy of a large artery supplying the brain may have disastrous consequences. In patients with otorrhagia, an arterial aneurysm must be considered as a possible source of bleeding, in some cases amenable for treatment with an endovascular technique. The diagnosis of “aberrant internal carotid artery” is usually made with CT of the temporal bone or MR of the skull base. Cerebral angiography is in most cases not necessary, unless an endovascular procedure is planned.
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