[The 10-minute consultation. Benign paroxysmal positional vertigo].
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Diagnosis, Differential↗
Biomedical subjects
M Reiss
Publications and source records attributed to M Reiss.
Primary aspergillosis of the sphenoid sinus with pituitary invasion - a rare differential diagnosis of sellar lesions.
Aspergillosis belongs to the group of mycotic diseases of paranasal sinuses. The invasive forms, and particularly the fulminant forms, are potentially fatal. Isolated aspergillosis of the sphenoid sinus or the clivus is a difficult diagnosis, since the often misleading clinical manifestations of this rare disease develop late. These patients become apparent by neurological signs such as cavernous sinus syndrome, pseudotumor of the pituitary or the orbit. Diagnosis is often made intra-operatively or on histological examination. We report a case of invasive aspergillosis uniquely involving the sellar area revealed by clinical features suggesting a pseudotumor of the pituitary. Although such lesions are almost always seen in immune suppressed subjects, in our case, the patient was immune competent and had no past history of sinusitis.The question of whether, and when to perform limited or extensive surgery remains an issue for discussion, owing to the rarity of this disease honed by lack of experience. It depends on several factors: the kind of disease, the immunity, the subtype of invasive fungal sinusitis and the degree of tissue invasion.
Diagnosis, Differential↗
[Etiology and therapy of halitosis. From abscess to coated tongue].
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Abscess↗
[The new features of the bibliography database manager EndNote 6.0 and 7.0].
The bibliography database manager EndNote shows since 1999 a dramatically technical development. A new improved version is published every year. Because the version 7.0 was recently (June 2003) released, we want to describe some aspects of the new version. We also would like to examine, for which user the use of the respective version is recommendable. The use of the software package EndNote 6.0 and also 7.0 for Windows is described. The main reason for getting Endnote 6 is its clearly improved functions and features: Organize a variety of charts equations or pictures and the use of Microsoft-templates. The version 7.0 can be recommended especially to scientist who much works with a Palm particularly. It is also possible to work not only with Microsoft-Word but also with other word processors and creating a bibliography with topic headings. Altogether EndNote 6.0 and also 7.0 provides an excellent combination of features and ease of use. The versions 6.0 or 7.0 are useful especially for people, who every single day use EndNote. EndNote 7.0 is for user of a Palm a special recommendable version.
Databases, Bibliographic↗
["Comments on the contribution by B. Kramp und Sylke Graumüller: burning tongue--diagnosis and therapy". ].
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Diagnosis, Differential↗
[Burning mouth syndrome--etiology, differentialdiagnostical aspects and therapy].
Burning Mouth Syndrome (BMS) or glossodynia is a chronic pain syndrome that mainly affects middle-aged/elderly women. This condition is probably of multifactorial origin, often idiopathic, and its etiopathogenesis remains largely enigmatic. Visible pathologic lesions of the oral mucosa or processes are usually not evident. Etiologic factors that have been reported include several disorders (e. g. hematologic disorders, denture factors, the climacteric, infections, endocrinological, neurological or psychiatric disorders). On the other hand psychological factors, such as anxiety, depression and phobias have been reported to play a significant role at the beginning of this nosological entity. BMS related to nutritional deficiency is uncommon. A systemic approach to assessment is essential and the opinion of other specialities, particularly internal medicine, dentistry or neurology, may be of help. Treatment is of the underlying cause but in many cases no specific aetiological factor is identified. Non-indicated substitution therapy of suspected but unproved deficiency states must be avoided. Treatment approaches were divided into topical and systemic strategies. However, there is little research evidence that provides clear guidance for those treating patients with BMS.
Burning Mouth Syndrome↗
Wetting mechanisms of gel-based controlled-release fertilizers.
The release mechanism of gel-based controlled release fertilizers (CRFs) involves water penetration into dry mixtures of fertilizers and gel forming polymers. Water penetration provides an upper limit to the whole release process. Where wetting prediction is often based on models that describe the flow of the liquid phase, vapor motion may become significant when a sharp wetting front exists. In this study we examine the role of vapor and fluid flows in the wetting process of CRFs consisting of urea or KNO(3) mixed with polyacrylamide (PAM). Vapor adsorption isotherms were obtained for typical fertilizer-PAM mixtures. Wetting and release experiments were conducted by dividing the CRFs into regions alternately filled with a pure fertilizer and mixtures of PAM and fertilizer. The experiments were designed in such a way that when the wetting front reaches a mixtures interface, its motion depends on the gradient imposed by the difference in osmotic potential (OP). The coupled equations of vapor and liquid flow in initially dry conditions were solved numerically to demonstrate the conceptual understanding gained by the experiments. The results show that wetting front motion is affected by transport and adsorption of vapor. It was also shown that the release rate is different when wetting is governed by vapor flow or by liquid flow. The release pattern from a multi-regions device was consistent with the wetting pattern, demonstrating the possibility to tailor the release according to periods of peak demand.
Adsorption↗
[Manual lymph drainage as therapy of edema in the head and neck area].
Depending on its genesis, edema must be treated by medication or diet. Simultaneous application of lymph drainage may be beneficial in some cases, especially in combined edema. The manual lymphdrainage is a special method of massage. In some kinds of edema, in particular lymphedema, only therapeutic lymph drainage introduced into medicine by Vodder, Asdonk and Kuhnke can attain an improvement, since there is no drug which acts on the lymphatic system. We report about primary and secondary lymphedemas of the face and head. Secondary lymphedemas are a result of surgical therapy, cancer therapy, irradiation or are caused of tumors or their metastases respectively. Depending on the state of the edema a lymphatic drainage treatment is indicated palliatively.
Drainage↗
[Ototoxicity of aminoglycoside antibiotics].
In gram-negative infections aminoglycosides still remain to present a first-line antibiotic. Their use is limited by the high risk for side effects and especially nephrotoxicity and ototoxicity. The more recently developed members of this group, although purporting to be less ototoxic, are also capable of producing inner ear damage in sufficiently high doses. This paper reviews the morphological, histochemical, and electrophysiological evidence concerning the mode of action of aminoglycosides on the auditory and vestibular systems and discusses the available methods for the detection of possible clinical ototoxicity. With recent advances in aminoglycoside monitoring techniques, the risk of toxicity has been greatly reduced. Guidelines are proposed about the prevention of ototoxicity and the management of patients with established auditory or vestibular dysfunction.
Aminoglycosides↗
[References for communication, social contacts and career choice. Making life easier for the hearing impaired patient].
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Career Choice↗
[EndNote 5 reference manager--functions--improvements--personal experiences].
Bibliography database managers are used to manage information recourses: specifically, to maintain a database to references and create bibliographies and reference lists for written works. A good reference management program should make it easy to read and to record the elements that a reference comprises, e.g. authors name, year of publication, title of article etc. It should offer tools that let you find and retrieve references quickly, and it should be able to produce the bibliography in the format required for a particular publication. You can create your database reference by reference or you can download batches of references from one of the popular searching services (e.g. MEDLINE) and you can search in the Internet. When you want to cite a reference you simply paste the reference wherever you want your intext citation to appear. There are many computer programs, but very few stands out as truly useful, time saving, and work enhancing. One of them is EndNote. The reference manager EndNote 5.0 was recently released in Germany. As long-time fans of this excellent program, we upgraded from the previous version. The use of the software package EndNote 5.0 for Windows is described. The main reason for getting EndNote 5.0 is its clearly improved functions and features: especially the co-operation with Microsoft Word (cite while you write) and the spelling examination. Altogether EndNote 5.0 provides also an excellent combination of features and ease of use.
Database Management Systems↗
[Ear drops--therapeutic aspects and application].
Ear drops are widely used in the topical treatment of inflammatory disorders of the external meatus and the eardrum. This paper gives some aspects of the therapeutic effects and installation of ear drops. The role of topical ear drops as a possible cause of ototoxicity is reviewed. Although experimental data confirm the presence of ototoxicity due to topical ear drops, the clinical relevance still remains debatable. The fact that currently used ear drops may produce a sensorineural hearing loss should not be ignored.
Administration, Topical↗
[Diagnosis of allergic rhinitis].
Allergic diseases remains an important problem that affects people of all ages. The prevalence of allergic rhinitis amounts to 10 to 16% in Central Europe with a tendency to be on the rise. Allergic rhinitis constitutes one of the commonest causes for visits to a general practitioner. Correct diagnosis is important for optimal management. A thorough history should be taken, followed by general and endoscopic examinations and confirmatory investigations. Careful examination should reveal obvious alternative causes of symptoms, such as polyps or tumours. If allergy is suspected, this can be confirmed by further tests, particularly the skin-prick test, measurements of serum specific IgE, the nasal provocation test of allergens or zytological examination.
Adult↗
[Rhinitis in old age].
The chronic rhinitis is a frequent problem with age. In the nose, normal physiologic changes of aging include loss of nasal tip support, atrophy of mucus-producing mucosal glands, and decreased olfaction. The fragmentation and weakening of the cartilage of the septum also causes airflow changes contributing to nasal stuffiness. These changes contribute to geriatric rhinitis, the symptoms of which are often attributed by the older patient to "allergies" or "sinus trouble". An understanding of these anatomic changes, linked with a thorough history and physical examination, allows the physician to properly manage geriatric rhinitis. Earnest causes like tumors or mycosis must be excluded. The treatment depends on the etiology of the rhinitis and also the symptoms of the patient. Therapy includes avoidance of all sorts of allergens (dust, fumes, sprays) and appropriate attention to minimizing home environmental and occupational exposures. Pharmacotherapy most often involves liquifying--not drying--nasal secretions with oral and topical preparations. Conservative surgical treatment is occasionally indicated.
Adrenal Cortex Hormones↗
[Why 2 ears?].
Having two ears instead of just one is advantageous in several respects. The danger of deafness is decreased, the auditory field is enlarged, spatial perception is possible on the basis of binaural disparities. Auditory deprivation presents as loss of discrimination over time in the unaided ear of individuals with a unilateral hearing loss. Earedness and ear preference ensure the choice of the dominant ear for definite actions like eavesdropping, telephone or listen.
Auditory Pathways↗
[The importance of tuning forks].
Turning fork tests are used routinely by many otologists. A different group of otologists find the tests inconsistent and unreliable. This controversy has probably developed because the audiometer has replaced the tuning fork in hearing measurement. Some principles of the Weber- and Rinne-tuning fork test are shortly described. The necessary control of pure tone audiometry by tuning forks is pointed out. The value particularly in the diagnosis of conductive hearing loss, and the tuning fork's limitations are discussed.
Audiometry↗
[Medical problems of handedness].
Handedness is one example of many forms of behavioral lateralization seen in humans. In the present review the practical relevance and the problems of left-handedness are discussed. Left-handedness has existed in a small subset of the human population, approximately 8%, since the origin of man. The incidence of left-handedness as usually defined is consistent among human populations. An understanding of handedness may lead to valuables clues as to how the brain becomes organised in the way it does. Several authors suggested a pathological handedness explaining the origin of laterality in man. There is a general agreement that sinistrality can occur as a result of pre- or perinatal damage to the left hemisphere. A disproportionate number of sinistrals is found in clinical populations. The review indicates that there is no sure evidence to suggest that left-handedness is a pathological sign.
Brain↗
[Etiology and diagnosis of otalgia].
Otalgia is the sensation of pain in the ear, while referred otalgia is pain felt in the ear but originating from a nonotologic source. Ear pain is a diagnostic problem when examination of the ear shows no pathology. Pain in the ear can be caused by inflammation of the external meatus or the middle ear. Nonotogenic otalgia may be due to referred or reflex pain, neuralgia, or to a psychogenic problem. Otalgia may be referred also from primary carcinoma of the head and neck. A thorough understanding of the anatomy of the head and neck is required. Referred pain is due to irritative lesions involving the fifth, ninth, or tenth cranial nerves and spinal nerves C2 and C3. If pathologic problems in the area supplied by these nerves have been ruled out, the neuralgia should be considered in the differential diagnosis. Psychogenic factors must be identified and treated before any type of surgical therapy is recommended. A basic knowledge of neuroanatomy, with emphasis on the cranial nerves, their course, distribution, and function, is also necessary. The complexity of this field may sometimes require the treating physician to call for consultations from colleagues in the fields of oral surgery, neurology, or neurosurgery. The therapy depends of the causes of the ear-ache.
Diagnosis, Differential↗