ABSTRACT
Previous studies have demonstrated the anti-inflammatory, anti-oxidant, and mucolytic nature of N-acetylcysteine (NAC). Theoretically, these properties make the substance ideal for therapeutic use against otitis media with effusion (OME). The disease is characterized as a sustained non-specific inflammation of the middle ear mucosa with secretory transformation of the epithelium resulting in accumulation of fluid in the middle ear space. To investigate the effects of instillation of NAC in the middle ear, a double-blind, placebo-controlled, randomized trial was carried out. A total of 75 children who were undergoing their first bilateral insertion of ventilation tubes (VT) due to OME were randomized to Mucomyst (NAC) or placebo (the vehicle) on one ear in relation to the VT insertion. The contralateral ear underwent VT insertion exclusively. Instillation of Mucomyst or placebo was repeated 3 and 7 days afterwards. The children were followed regularly for 11-39 months. Episodes of otorrhea, recurrence of OME after VT extrusion and re-insertion of VTs were registered as primary outcome parameters. The results demonstrated that Mucomyst significantly reduced the recurrence of OME and re-insertion of VTs (p < 0.025) and significantly increased the time until VT extrusion (p < 0.0167). In addition, the number of episodes of ear problems and visits at the ENT clinic were reduced significantly by NAC (p < 0.0383).
Subject(s)
Acetylcysteine/therapeutic use , Antioxidants/therapeutic use , Middle Ear Ventilation/methods , Otitis Media with Effusion , Child , Child, Preschool , Double-Blind Method , Female , Follow-Up Studies , Humans , Incidence , Infant , Male , Otitis Media with Effusion/drug therapy , Otitis Media with Effusion/epidemiology , Otitis Media with Effusion/surgery , Recurrence , Treatment OutcomeABSTRACT
Benign paroxysmal positional vertigo can be succesfully treated by means of the Epley manoeuvre and vibration. This is a simple, non-invasive and economic procedure for this group of patients, who are greatly affected by vertigo in their daily life and therefore have many sick days.
Subject(s)
Vertigo/therapy , Adult , Aged , Female , Head , Head-Down Tilt , Humans , Male , Middle Aged , Posture , Prospective Studies , Rotation , Semicircular Canals/physiology , Vertigo/diagnosis , Vertigo/physiopathology , VibrationABSTRACT
A material of 101 out of 111 premature infants admitted with gestational ages less than or equal to 35 weeks and birth weights less than or equal to 2,000 g to the Paediatric Department, Herning Central Hospital during the years 1977-1980 and 101 infants born at term and matched for age and sex were investigated with pure-tone audiometry in quiet surroundings and speech-audiometry in noisy surroundings in the Ringkøbing County Audiological Department in Holstebro. Where all frequencies were concerned, we found slightly more children from the premature group with hearing thresholds greater than 15 dB HL. One premature child had been equipped with a hearing aid (HA) at the age of 6 1/2 years on account of a hearing threshold in the best ear of 55 dB HL for all frequencies. Two children in the premature group had unrecognized hearing loss in the best ear between 30-40 dB HL for the average of the frequencies 500, 1,000 and 2,000 Hz. One of these children was equipped with a hearing aid. None of the children in the control group had hearing loss justifying a hearing aid. Good agreement was found between speech audiometry in noisy surroundings carried out with the Danish test material "Dantale" and pure-tone audiometry. In this group, speech-audiometry did not provide further information as compared with pure-tone audiometry. Although only few children with severe hearing defects were found, it is important that these are detected as soon as possible in view of their intellectual development. Premature infants constitute a risk group for defective hearing.
Subject(s)
Audiometry, Pure-Tone , Audiometry, Speech , Hearing Loss, Sensorineural/epidemiology , Child, Preschool , Denmark/epidemiology , Hearing Loss, Sensorineural/diagnosis , Humans , Infant , Infant, Newborn , Infant, Premature/physiology , Risk FactorsABSTRACT
The influence of experimental rhinitis on the absorption of buserelin, measured as the serum luteinizing hormone (LH) response, has been investigated. A single dose of 200 micrograms buserelin was given to 24 healthy male volunteers after induction of experimental rhinitis with histamine and after use of a saline spray (placebo control). Except on one occasion, when the pump-spray apparently was incorrectly operated, serum LH concentration rose after buserelin. There was no difference in the LH response between histamine-induced rhinitis and saline controls. It was concluded that intranasal application of buserelin represents a reliable mode of application and that modification of the administration route or a change in the dosage schedule during naturally-occurring nasal inflammations, such as the common cold and allergic rhinitis, is unnecessary in patients undergoing chronic treatment with intranasal buserelin, e.g. for prostatic cancer, endometriosis, precocious puberty, and contraception.
Subject(s)
Buserelin/pharmacology , Luteinizing Hormone/blood , Rhinitis/metabolism , Absorption , Administration, Intranasal , Adult , Airway Resistance/drug effects , Biological Availability , Buserelin/administration & dosage , Buserelin/adverse effects , Female , Histamine/pharmacology , Humans , Male , Random AllocationABSTRACT
A fourth case of leiomyosarcoma of the hypopharynx is reported. The histopathological diagnosis and treatment are discussed. Surgery is still the treatment of choice and, in combination with chemotherapy (especially Methotrexate) and radiotherapy, the recurrence rate can be reduced. However, randomized studies are required.
Subject(s)
Hypopharyngeal Neoplasms/pathology , Leiomyosarcoma/pathology , Pharyngeal Neoplasms/pathology , Combined Modality Therapy , Humans , Hypopharyngeal Neoplasms/therapy , Leiomyosarcoma/therapy , Male , Middle AgedABSTRACT
Fifty-six patients who had had tracheostomy of modified Björk type underwent follow-up examination with tracheal X-ray and endoscopy. In six patients the tracheal lumen was narrowed by one-fourth to one-half. No treatment was required in any case. Endoscopy seems to be the simplest and most reliable method for judging the degree of tracheal stenosis.
Subject(s)
Bronchoscopy , Tracheal Stenosis/pathology , Tracheotomy/methods , Adolescent , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications/pathology , Trachea/pathologyABSTRACT
Parameters of importance for the development of thrombosis were investigated in a patient with polyarteritis nodosa (PAN) and profound sensorineural hearing loss. During the acute phase, platelet hyperaggregability, shortened platelet survival, and decreased fibrinolytic activity were found. The possibility is discussed that the etiology of the acoustico-vestibular symptoms in this patient could be an inner ear thromboembolic disorder. It is suggested that platelet functions and fibrinolytic activity should be investigated in patients with acoustico-vestibular symptoms and PAN or other systemic diseases. If abnormalities are found, specific platelet inhibitory and/or fibrinolysis-increasing treatment should be considered as an addition to the conventional medical treatment.
