Search PubMed⌕ Search

Biomedical subjects

E Aantaa

Publications and source records attributed to E Aantaa.

At least 19 recordsLinked to original sources

Prevalence of Meniere disease in Finland.

OBJECTIVES: To assess the prevalence of Meniere disease in the population of 5 million in Finland according to the criteria of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) recommendation. STUDY DESIGN: Retrospective investigation based on patient records of 306 patients treated for Meniere disease and recognized as such according to the International Statistical Classification of Diseases and Related Health Problems (ICD-9 or ICD-10) in seven Finnish hospitals serving a population of 1.5 million people. METHODS: Patients were selected from the computerized patient registers of outpatients and inpatients having received an appropriate diagnosis during the period from 1992 to 1996 and re-evaluated. Definite cases according to AAO-HNS guidelines were identified to calculate the prevalence of Meniere disease in Finland at the end of 1996. RESULTS: A total of 131 definite cases of Meniere disease were identified. The prevalence of at least 43 per 100,000 and an average annual incidence of 4.3 per 100,000 were obtained. The prevalence turned out to be higher (P<.001) in Northern areas (49/100,000) than in the south (38/100,000). The prevalence did not differ in the areas of university hospitals (44/100,000) from those of central hospitals (42/100,000). CONCLUSIONS: The prevalence and incidence in Finland is lower than could be expected from previous international surveys, most of which provide inadequate data for forming a real picture of the epidemiology of Meniere disease. Uniform diagnostic criteria are indispensable for further research.

Finland↗

Treatment of acute vestibular vertigo.

The alleviation of vestibular distress using drug therapy is a question of whether treatment with drugs is advisable at all or whether more emphasis should be directed towards active habituation therapy. Histamine and especially its derivative, betahistine, inhibit the massive impulses to the polysynaptic neurons of the lateral vestibular nucleus without having any sedative effect, as measured by saccadic eye movements. In the ENT Clinic of Turku University Hospital, betahistine has been used to treat 613 Meniere's patients at a dose of 8 mg three times daily. In about 80% of these patients, the results of therapy were positive. Betahistine is the current most effective drug in maintenance therapy of Meniere's disease, although it does not resolve all of the problem of this disorder. Betahistine can also be used in other forms of vestibular vertigo as maintenance therapy, because it only has minimal side-effects and it has not been shown to slow down habituation.

Acute Disease↗

Electronystagmographic findings and recovery of cochlear and vestibular function in patients suffering from sudden deafness with a special reference to the effect of anticoagulation.

The study included 80 patients treated for sudden deafness over the last 5-7 years. Case history, laboratory findings, pure-tone audiogram and electronystagmography (ENG) findings were noted. If any abnormalities had been recorded in ENG studies, the studies were redone. ORL status was redefined and audiograms were obtained in all patients. When becoming ill, the 80 patients had not differed from the normal population in common cardiovascular risk factors. None of them had had signs of viral infection (paired serum samples had been taken at 2-week intervals; routine examinations had been done for common viral antigens). As many as 31 of the 80 patients with acute hearing loss had had abnormalities such as spontaneous nystagmus (PN), hypoexcitability (HE) and directional preponderance (DP) in the bithermal caloric tests (+44 degrees C, + 30 degrees C) of their ENG studies. Twenty of the 31 patients still had abnormal ENG studies after 5-7 years. Only 1 subject had positional nystagmus, and none had subjective vertigo. Patients with an abnormal ENG study showed a poor recovery of the speech reception threshold, whereas those with a normal ENG study showed slightly significant (p less than 0.05) recovery.

Administration, Oral↗

Otoneurological and ultra low field MRI findings in multiple sclerosis patients.

Otoneurological and ultra low field MRI findings in multiple sclerosis patients: 22 patients suffering from multiple sclerosis (MS) underwent thorough neurological and otological examination, extensive ENG testing and Magnetic Resonance Imaging (MRI) examination of the central nervous system. All patients fulfilled the Schumacher criteria for a diagnosis of definitive MS. 20 of the patients had been included in previous otoneurological studies three to five years ago. The general disability assessed according to Hyllested's scale was: Class 1-7, Class 2-4, Class 3-6, Class 4-3, Class 5-2 patients. Thus 11 patients had none or only slight disability. Nevertheless, all patients showed abnormal findings when classified according to the Kurtzke disability scale, which reflects the involvement of separate neuronal entities. The ENG examination revealed abnormal findings in all patients. The most common abnormalities found were as follows: abnormal pendular test 19, ocular fixation index 18, optokinetic nystagmus 14, saccadic eye movements 14 and spontaneous nystagmus 12. 14 patients had uni- or bilateral abnormally slow adduction movements in the saccadic test consistent with internuclear ophthalmoplegia (INO), which is caused by a lesion of the brain stem. MRI examination of the 21 patients studied revealed abnormal findings consistent with MS in sixteen cases. The lesions were unilateral in 5 and bilateral in 11 patients. The most common location for these abnormal findings consistent with MS plaques were in the white matter around the lateral ventricles. Plaques in the brain stem and/or cerebellum were found in only two cases despite numerous clinical and otoneurological findings that indicated the presence of functional lesions in these areas.

Adult↗

Analysis of saccadic eye movements with a microcomputer.

This analysis of saccadic eye movements has found use in clinical diagnosis. Saccades are induced by a microcomputer-controlled TV stimulator and are recorded by electro-oculography. The analysis algorithm detects saccades by the velocity profile of eye position and then computes the principal saccadic parameters, peak velocity and amplitude. In addition, the saccades are presented on the VDU screen, together with the computed results of the analysis; they may be edited if necessary. The programs have been implemented in Pascal and Assembler languages.

Computers↗

A comparison of the soft gelatin capsule and the tablet form of temazepam.

Pharmacokinetics and pharmacodynamics of the soft gelatin capsule and tablet form of temazepam were compared. In a single blind study, six healthy volunteers, in the supine position, took either a tablet of temazepam 20 mg or a soft gelatin capsule of temazepam 20 mg. Sixty gynaecological in-patients received either a tablet or a soft gelatin capsule of temazepam 20 mg the night before surgery as premedication. Subjective parameters were assessed in the morning. The soft gelatin capsule yielded clearly higher serum concentrations during the first hour after administration. In the pharmacodynamic parameters there were slight but insignificant differences in favour of the capsule form. As a premedicant the capsule resulted in a significantly (P less than 0.01) shorter delay in the onset of sedative action and to an almost significant (P less than 0.05) delay in falling asleep; also an almost significantly (P less than 0.05) longer action of sleep in comparison with the tablet.

Adult↗

Importance of the interaction of midazolam and cimetidine.

Six healthy volunteers were given in an open study 15 mg of midazolam orally, and a couple of weeks later the same treatment preceded by 400 mg of cimetidine orally. We followed midazolam serum concentrations and the following pharmacodynamic parameters for five hours: subjective sedation, Maddox wing readings, critical flicker fusion frequency and peak velocity of saccadic eye movements. A statistically significant change was found in Cmax and total AUC between the two sessions. The pharmacodynamic responses differed also clearly from each other suggesting a significant change in midazolam effect even after a single oral dose of cimetidine.

Adult↗

Saccadic eye movements in determination of the residual effects of flunitrazepam.

Saccadic eye movements and the subjective assessments of the volunteers were used in the determination of the residual effects of a single evening dose of flunitrazepam 0.5 mg, 1 mg and 2 mg or placebo. Sleep inducing and maintaining effects were subjectively assessed, too. Flunitrazepam at all three dose levels possessed sleep inducing and increasing effects (n = 9), but in the number of nocturnal awakenings and sedation in the morning (10 hrs after drug intake), no significant differences between placebo and the active medications were reported. However, saccadic eye movement recording could differentiate the residual effects produced by placebo or the active medication. No correlation was detected between the serum levels (radioreceptor assay) and saccadic eye movement recordings.

Adult↗

Saccadic eye movements in determination of the residual effects of the benzodiazepines.

Saccadic eye movements and the volunteers' subjective assessments were used in the determination of the residual effects of a single high evening dose of flunitrazepam 2 mg, midazolam 30 mg, and lorazepam 2.5 mg as well as in that of placebo. Sleep inducing and maintaining effects were subjectively assessed, too. Both flunitrazepam 2 mg, midazolam 30 mg, and lorazepam 2.5 mg possessed sleep inducing and increasing effects (n = 9), but in the number of nocturnal awakenings and quality of sleep no significant differences between placebo and the active medications were reported. Flunitrazepam 2 mg and lorazepam 2.5 mg produced distinct subjective residual effects thus differing from placebo and midazolam 30 mg. Despite this, saccadic eye movement recording could further differentiate midazolam 30 mg from placebo in this respect 10 hours after drug intake. After three repeated 2 mg evening doses, flunitrazepam accumulated in the serum of the volunteers (n = 6), but the effect on saccadic eye movements as well as subjective side effects began to decrease already after one day's treatment. Thus, saccadic eye movement recording proved to be a useful tool in determining the residual effects and development of tolerance of benzodiazepines. No correlation was detected between the serum levels (radioreceptor assay) and saccadic eye movement recordings or subjective residual sequelae.

Benzodiazepines↗

Vestibular neuronitis; a neurological and neurophysiological evaluation.

Neurological and neurophysiological findings were retrospectively reviewed in a group of 50 patients with vestibular neuronitis (VN). The onsets of VN were found to be clustered in the period from August to January. A preceding infection was reported by 36% of the patients. Neurological examinations did not reveal any other relevant signs than a spontaneous nystagmus during the acute phase. The results of routine laboratory tests and cerebrospinal fluid tests were within normal limits. EEG was recorded in 37 patients; 15 patients had a definitely abnormal EEG, with a slowing of the dominant occipital rhythm or more generalized diffuse slowing in 12 cases. 5 patients, 3 of them without slowing of the background activity, had a distinct focal disturbance of intermittent slow activity in the temporal region. In control recordings, an improvement was seen in the slowing of the background activity but not in the focal disturbances. Brainstem auditory evoked responses (BSER) were recorded in 12 patients, 5 of whom had abnormal responses. The seasonal clustering of VN onsets and the association of VN with overt infections further suggest its infectious pathogenesis. The observed EEG and BSER disturbances suggest a subclinical brainstem involvement in some cases of VN.

Adolescent↗

Studies of vestibular cortical areas with short-living 15O2 isotopes.

The oxygen-15 inhalation technique has been applied to the quantification of regional cerebral blood flow and metabolism with positron emission tomography. These findings support the notion that vestibular cortex is not only one small area in the temporal or parietal cortex but a wider area in the temporoparietal cortex. During caloric reactions cortical potential changes were found on the contralateral temporoparietal cortex. The recent development of positron emission tomography (PET) is theoretically capable of changing considerably the research of the pathophysiology in central vestibular disturbances. Validity of the 15O2 inhalation model and the feasibility of the PET technique does have - like any physiological measurement - some limitations, but it obviously has a tremendous clinical potential.

Adult↗

Audiological and vestibular findings in long-term hormonal treatment.

93 patients receiving long-term hormonal treatment at the Hormonal Outpatient Clinic of the Department of Gynecology were examined audiologically and electronystagmographically. The patients had different hormonal disturbances including Turner's syndrome. Electronystagmography showed normal values with the exception of lower slow-component speeds in Turner syndrome patients and a shift of all directional preponderances to the left. Audiologically 13% showed pathological values in the filtered speech test. This phenomenon may be partially connected to a central gnostic hearing lesion. More studies on sensitized speech tests are necessary in patients using steroid hormones.

Adolescent↗

Myringotomy in the treatment of acute otitis media in children.

The treatment of acute otitis media was studied in 158 children. All children (mean age 4 years) received penicillin orally 80 000--100 000 IU per day for 10 days. Myringotomy was performed on 68 children at the time of the diagnosis. The other 90 children were treated with penicillin and ear drops. The bacteriological findings from the nasopharynx at the time of diagnosis were equivalent in both groups. After 2 weeks, 42% of the children without myringotomy and 71% of the children with myringotomy were cured. The children who were not cured were treated with amoxicillin for 10 days. Four weeks after diagnosis 71% and 90% of the children respectively were cured. The differences between the two groups are significant. The observations indicate that myringotomy clearly accelerates the recovery from acute otitis media.

Acute Disease↗