Objectives:To evaluate hearing outcome of salvage treatment with intratympanic steroids(ITS)in idiopathic sudden sensorineural hearing loss(ISSNHL)refractory to initial systemic steroid(SS)therapy.Material and methods...Objectives:To evaluate hearing outcome of salvage treatment with intratympanic steroids(ITS)in idiopathic sudden sensorineural hearing loss(ISSNHL)refractory to initial systemic steroid(SS)therapy.Material and methods:A retrospective medical chart review was conducted on 54 consecutive patients with ISSNHL refractory to SS.Salvage treatment with a low dose intratympanic dexamethasone(4 mg/ml)was offered after one week of primary treatment.Patients were divided into two groups:25 patients accepted ITS(treatment group)and 29 patients did not undergo additional treatment(control group).A pure tone average(PTA)gain of at least 10 dB was considered hearing improvement.Results:Hearing improvement rate was higher in ITS group compared to control group(40%vs.13.8%,p=0.035).A mean PTA improvement of 8.6±9.8 dB was observed in the ITS group and,whereas the control group had an average hearing gain of 0.7±2 dB(p<0.001).Audiometric analysis revealed a significant hearing gain in ITS group at all tested frequencies compared to control group(p<0.05).Analysis of the selected variables,identified intratympanic steroid treatment as the only independent prognostic factor for hearing improvement(OR=4.2,95%CI:1.1e15.7;p=0.04).Conclusion:Intratympanic low dose dexamethasone is effective in patients with incomplete hearing recovery after primary systemic steroid treatment.展开更多
A large number of papers published in the last decades are related to the effect of ozone exposure on mortality worldwide. Several studies have been performed to investigate the effect of ozone on mortality in Madrid ...A large number of papers published in the last decades are related to the effect of ozone exposure on mortality worldwide. Several studies have been performed to investigate the effect of ozone on mortality in Madrid （Spain）, but the findings of these local reports were focused only on the Madrid city. The association of daily concentrations of ozone with daily mortality was investigated using autoregressive Poisson regression models. This study explores the effects of ozone on all causes except accidents, cardiovascular and respiratory short-term mortality in two areas of the Madrid region： an urban area constituted by the Madrid municipality and an industrial sub-urban area surrounding the city. Using three years of daily data （2003-2005）, it was analyzed the all-ages populations and the over-64 age groups. The average ozone concentrations over the study period were 54.07 ± 27.17 μg/m3 in the Madrid municipality and 70.09 ± 32.96 μg/m3 in the sub-urban municipalities surrounding the city. Our results in the all-ages group indicated that 0.69% of all causes except accidents, 1.15% of cardiovascular and 1.56% of respiratory daily deaths, respectively, could be attributed to exposure to ozone in the Madrid city, whereas 11.69% of daily respiratory deaths were attributable to ozone exposure in the Madrid sub-urban surroundings. Our results show a clear association between mortality and ozone exposure. The spatial heterogeneity of ozone effects on short-term mortality throughout the Madrid region may have implications for local environmental policies and also for social and health services planning.展开更多
文摘Objectives:To evaluate hearing outcome of salvage treatment with intratympanic steroids(ITS)in idiopathic sudden sensorineural hearing loss(ISSNHL)refractory to initial systemic steroid(SS)therapy.Material and methods:A retrospective medical chart review was conducted on 54 consecutive patients with ISSNHL refractory to SS.Salvage treatment with a low dose intratympanic dexamethasone(4 mg/ml)was offered after one week of primary treatment.Patients were divided into two groups:25 patients accepted ITS(treatment group)and 29 patients did not undergo additional treatment(control group).A pure tone average(PTA)gain of at least 10 dB was considered hearing improvement.Results:Hearing improvement rate was higher in ITS group compared to control group(40%vs.13.8%,p=0.035).A mean PTA improvement of 8.6±9.8 dB was observed in the ITS group and,whereas the control group had an average hearing gain of 0.7±2 dB(p<0.001).Audiometric analysis revealed a significant hearing gain in ITS group at all tested frequencies compared to control group(p<0.05).Analysis of the selected variables,identified intratympanic steroid treatment as the only independent prognostic factor for hearing improvement(OR=4.2,95%CI:1.1e15.7;p=0.04).Conclusion:Intratympanic low dose dexamethasone is effective in patients with incomplete hearing recovery after primary systemic steroid treatment.
文摘A large number of papers published in the last decades are related to the effect of ozone exposure on mortality worldwide. Several studies have been performed to investigate the effect of ozone on mortality in Madrid （Spain）, but the findings of these local reports were focused only on the Madrid city. The association of daily concentrations of ozone with daily mortality was investigated using autoregressive Poisson regression models. This study explores the effects of ozone on all causes except accidents, cardiovascular and respiratory short-term mortality in two areas of the Madrid region： an urban area constituted by the Madrid municipality and an industrial sub-urban area surrounding the city. Using three years of daily data （2003-2005）, it was analyzed the all-ages populations and the over-64 age groups. The average ozone concentrations over the study period were 54.07 ± 27.17 μg/m3 in the Madrid municipality and 70.09 ± 32.96 μg/m3 in the sub-urban municipalities surrounding the city. Our results in the all-ages group indicated that 0.69% of all causes except accidents, 1.15% of cardiovascular and 1.56% of respiratory daily deaths, respectively, could be attributed to exposure to ozone in the Madrid city, whereas 11.69% of daily respiratory deaths were attributable to ozone exposure in the Madrid sub-urban surroundings. Our results show a clear association between mortality and ozone exposure. The spatial heterogeneity of ozone effects on short-term mortality throughout the Madrid region may have implications for local environmental policies and also for social and health services planning.
