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51.
BACKGROUND: The endolymphatic sac has been proposed as a target organ responsible for inner-ear symptom in allergic subjects. This is a report of inner-ear symptoms in patients with nasal allergy. METHOD: Retrospective review of record charts of patients with known nasal allergy presenting to the otorhinolaryngology out-patient department of the University College Hospital, Ibadan in 5 years. RESULT: Ear symptoms were found in 95/144 (66%) subjects with nasal allergy. This comprises of 41 males and 44 females (M: F = 1:1). Of these, itching of the external ear canal, hearing loss and tinnitus accounted for 63 (66%), 55 (58%) and 39 (41%), respectively, while vertigo was found in 12 (13%). Peripheral vestibular signs of imbalance were seen in 11/95. The audiological assessment of 73 subjects revealed normal pure-tone average in 43 (59%), and sensorineural hearing loss (SHL) in 17 (23.3%). The severity of SHL was mild in 6/17, moderate in 7 and moderate-to-severe in 4. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were elevated in 10/15 (67%) and 6/15 (40%), while the skin sensitivity test showed reactions to dust in 32, cold in 25, cockroach in 7, perfume in 11, vegetable oil in 1 and insecticide in 2. The clinical diagnoses were idiopathic tinnitus in 25 (26.3%), Idiopathic SHL in 17 (18%), cochlear hydrop in 6 (6%) and autoimmune inner-ear disease in 6 (6%). CONCLUSION: This report suggests some peculiar predisposition to inner-ear pathology in patients with nasal allergy. However a longitudinal assessment of cochleovestibular features of nasal allergy subjects will help in its validation.  相似文献   
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Chronic headache is particularly prevalent in migraineurs and it can progress to a condition known as medication overuse headache (MOH). MOH is a secondary headache caused by overuse of analgesics or other medications such as triptans to abort acute migraine attacks. The worsening of headache symptoms associated with medication overuse (MO) generally ameliorates following interruption of regular medication use, although the primary headache symptoms remain unaffected. MO patients may also develop certain behaviors such as ritualized drug administration, psychological drug attachment, and withdrawal symptoms that have been suggested to correlate with drug addiction. Although several reviews have been performed on this topic, to the authors best knowledge none of them have examined this topic from the addiction point of view. Therefore, we aimed to identify features in MO and drug addiction that may correlate. We initiate the review by introducing the classes of analgesics and medications that can cause MOH and those with high risk to produce MO. We further compare differences between sensitization resulting from MO and from drug addiction, the neuronal pathways that may be involved, and the genetic susceptibility that may overlap between the two conditions. Finally, ICHD recommendations to treat MOH will be provided herein.  相似文献   
54.

Purpose

68Ga ligands targeting prostate-specific membrane antigen (PSMA) are rapidly emerging as a significant step forward in the management of prostate cancer. PSMA is a type II transmembrane protein with high expression in prostate carcinoma cells. We prospectively evaluated the use of 68Ga-PSMA positron emission tomography/computed tomography (PET/CT) in patients with prostate cancer and compared the results to those for technetium-99m (99mTc)-10-metacyloyloxydecyl dihydrogen phosphate (MDP) bone scintigraphy (BS).

Patients and Methods

A total 113 patients with biopsy-proven prostate cancer referred for standard-of-care BS were prospectively enrolled onto this study. 68Ga-PSMA PET/CT was performed after BS. Metastasis diagnosed on each technique was compared against a final diagnosis based on CT, magnetic resonance imaging, skeletal survey, clinical follow-up, and histologic correlation.

Results

Ninety-one bone lesions were interpreted as bone metastases in 25 men undergoing 68Ga-PSMA PET/CT compared to only 61 lesions in 19 men undergoing 99mTc-MDP BS. Of the 7 bone scans that missed skeletal metastases, 54% of these missed lesions were due to either marrow or lytic skeletal metastases. The median standardized uptake value in all malignant bone lesions was 13.84. 68Ga-PSMA PET/CT showed significantly higher sensitivity and accuracy than BS (96.2% vs. 73.1%, and 99.1% vs. 84.1%) for the detection of skeletal lesions. For extraskeletal lesions, 68Ga-PSMA PET/CT showed an additional 96 unexpected lesions with a median standardized uptake value of 17.6.

Conclusion

68Ga-PSMA PET/CT is superior to and can potentially replace bone scan in the evaluation for skeletal metastases in the clinical and trial setting because of its ability to detect lytic and bone marrow metastases.  相似文献   
55.

Purpose

The incidence of prostate cancer is 60% higher and the mortality rate is two- to three-times greater in black versus white men. We report on differences in 68Ga-PSMA-11 PET/CT imaging findings in 77 black South-African (BSAs) and 18 white South-African (WSAs) treatment-naïve primary prostate carcinoma (PPC) patients.

Methods

68Ga-PSMA-11 PET/CT imaging findings were compared to histological, biochemical and morphological imaging data. Patients were grouped into three Gleason grade groups (GG), GG 1 (scores 3 + 3 and 3 + 4), GG2 (scores 4 + 3 and 4 + 4) and GG3 (scores 9 and 10), and the PSA difference among the groups was determined. Inter-racial difference in SUVmax of the primary tumor as well as its correlation with serum PSA were also determined.

Results

Ninety-three out of 95 PPC where readily identified on 68Ga-PSMA-11 PET/CT imaging. Median PPC SUVmax and serum PSA values proved significantly higher (p = 0.033 and p = 0.003) in GG3 patients (median 16.4 and 180 ng/ml) when compared to GG1 patients (median 9.6 and 25.1 ng/ml) or GG2 patients (median 8.8 and 46.2 ng/ml). SUVmax significantly correlated with serum PSA-values (r = 0.377 (p = 0.0001)). Age, frequency of lymph node involvement and distant metastases, and GGs (p ≥ 0.153) were similar in BSAs and WSAs, both median serum PSA-values as well as SUVmax values proved significantly higher in BSAs when compared to WSAs, respectively, 81.6 ng/ml versus 14.5 ng/ml (p = 0.0001) and 11.9 versus 4.38 (p = 0.004). Moreover, Gleason-score normalized median SUVmax values proved 2.5 times higher in BSAs when compared to WSAs (p = 0.005).

Conclusion

SUVmax values proved significantly related to GG and to be significantly higher in BSAs when compared to WSAs. Also, SUVmax significantly correlated with serum PSA values, which was significantly higher in BSAs when compared with WSAs.
  相似文献   
56.

Objective

To determine the added value of CT over planar and SPECT-only imaging in the diagnosis of musculoskeletal infection using 99mTc-UBI 29-4.

Materials and methods

184 patients with suspected musculoskeletal infection who underwent planar and SPECT/CT imaging with 99mTc-UBI 29-41 were included. Planar, SPECT-only and SPECT/CT images were reviewed by two independent analysts for presence of bone or soft tissue infection. Final diagnosis was confirmed with tissue cultures, surgery/histology or clinical follow-up.

Results

99mTc-UBI 29-41 was true positive in 105/184 patients and true negative in 65/184 patients. When differentiating between soft tissue and bone infection, planar?+?SPECT-only imaging had a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 95.0, 74.3, 84.8, 91.3 and 86.9%, respectively, versus 99.0, 94.5, 92.5, 98.5 and 94.5% for SPECT/CT. SPECT/CT resulted in a change in reviewers’ confidence in the final diagnosis in 91/184 patients. Inter-observer agreement was better with SPECT/CT compared with planar?+?SPECT imaging (kappa 0.87, 95% CI 0.71–0.85 versus kappa 0.81, 95% CI 0.58–0.75).

Conclusion

Addition of CT to planar and SPECT-only imaging led to an increase in diagnostic performance and an improvement in reviewers’ confidence and inter-observer agreement in differentiating bone from soft tissue infection.
  相似文献   
57.
The effect of synthetic salmon calcitonin was studied on adjuvant arthritis, pertussis vaccine edema, tuberculin skin reaction, passive direct Arthus reaction and nystatin edema. The results show that calcitonin inhibits these inflammatory processes.  相似文献   
58.

Introduction

In Western and Asian literature, the measurement of percentage free prostate specific antigen (%fPSA) has been known to enhance the predictive role of total prostate specific antigen (tPSA) in early prostate cancer (Ca-P) detection. Relationship between the tPSA and Ca-P are known to be influenced by race. To the best of our knowledge, the relationship between %fPSA and Ca-P has not been studied in sub-Saharan Africa using current established biopsy protocol.

Objective

To evaluate the usefulness of %fPSA in indigenous West African men and determine the appropriate cut-off values that may be used as indication for prostate biopsy in men with tPSA of 4–10 ng/ml.

Subjects and methods

A total 169 consecutive patients with tPSA of 4–10 ng/ml with non-suspicious findings on digital rectal examination (DRE) had a transrectal ultrasound (TRUS) guided 10-core prostate biopsy. The technique of PSA analysis was the Access hybritech assay technique using the Beckman's Access autoimmuno analyser. The rates of prostate cancer in different %fPSA ranges were evaluated. Receiver operating characteristic curve (ROC) was used to evaluate the efficiency of %fPSA in the diagnosis of prostate cancer.

Results

A reduction %fPSA was associated with a higher detection rate of Ca-P. There was a 62% prevalence of Ca-P with %fPSA  10% while there was a zero prevalence in patients with fPSA above 20%. At a %fPSA cut off of 20% the sensitivity and specificity were 100% and 45%, respectively. Using the ROC curve, the area under the curve (AUC) was 0.76 while the ROC decision plot showed that a %fPSA cut off 15% was associated with the highest ability to discriminate between benign and malignant diseases.

Conclusion

The %fPSA is an effective discriminating tool in determining the need for prostate biopsy in indigenous West African men with PSA 4–10 ng/ml. A cut off of 15% was associated with the highest performance.  相似文献   
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