1,721,031 research outputs found
Normative data for interpreting the SNOT-22
Get PDFObjectives: The Sino-Nasal Outcome Test 22 (SNOT-22) is a validated patient-reported outcome instrument to evaluate the health-related quality of life (HRQoL) in patients with chronic rhinosinusitis (CRS). There are no published normative SNOT-22 scores, limiting its interpretation. Methods: Symptom scores from 1,000 SNOT-22 questionnaires were analysed by principal component analysis (PCA) and exploratory factor analyses. Data were derived from a survey with 1,000 healthy Europeans (reference cohort) who were recruited using the Respondi panel for market and social science research. This subsample was quoted to the population distribution of the German Microcensus and selected from a non-probability panel. Results: The overall normative SNOT-22 score can be detected to be 20.2 ± 19.44. Male (18.49 ± 19.15) and older (> 50 years old; 18.3 ± 17.49) participants had overall lower SNOT-22 mean results than females (21.8 ± 19.6) and younger (21.4 ± 20.55) participants, indicating higher levels of satisfaction. PCA proposed two SNOT-22 domains ("physiological well-being" and "psychological well-being"), which explained 65% of the variance. Conclusions: These are the first published (German) normative scores for the SNOT-22 and provide a clinical reference point for the interpretation of data
Alternobaric vertigo - Really a hazard?
No full textObjective: To determine the prevalence of alternobaric vertigo (AV) in sport divers and to find out whether AV led to dangerous situations underwater. Furthermore, to examine whether objective neurootologic tests are associated with the manifestation of AV. Design: Retrospective cohort study. Participants: Sixty-three sport divers with an average diving experience of 10 years and 650 dives were questioned regarding their medical and diving history and the manifestation of vertigo during diving. Methods: Microscopic otoscopy, tympanometry, stapedius reflexes, hearing threshold for air and bone conduction, caloric video-oculography including analysis of the slow-phase velocity of the nystagmus, acoustic brain stem responses, and magnetic resonance imaging were performed to find possible differences between divers with and without AV. Results: We found 17 divers with AV (27%). There was no significant difference in all measured parameters apart from sex and history of middle ear equalization difficulty in divers with AV. Ten (59%) of 17 female divers and 7 (15%) of 46 male divers experienced AV, representing a significant sex difference (p < 0.001). Correlation with our divers' outpatient clinic revealed that female divers had a significantly higher incidence of middle ear equalization disorders which could be an explanation for the predominance of female divers with symptoms of AV. None of the divers reported any dangerous or life-threatening situations following AV. Whether AV leads to dangerous situations underwater remains unclear, but this hypothesis is not supported by our data. Conclusion: Alternobaric vertigo is a common finding in divers. In our study group, female divers had a four-time higher risk to suffer AV. Our data do not support the thesis that AV is a life-threatening condition. Key Words: Alternobaric vertigo-Divers-Diving-Diving accident-Eustachian tube dysfunction
Development and validation of the Tonsillectomy Outcome Inventory 14
No full textUntil now, no validated instrument to measure disease-specific, health-related quality of life (HR-QOL) in adults with chronic tonsillitis (CTO) exists. After an item reduction of the alpha-version of the Tonsillectomy Outcome Inventory (TOI), the TOI-14 resulted. In addition to the total score, it includes the subscales throat problems, overall health, resources, and social-psychological restrictions. In phase 2, the TOI-14 was prospectively validated on 108 adults with CTO, who had undergone a tonsillectomy. The TOI-14 had, on average, good reliability. It included all important aspects of the HR-QOL. Patients with CTO can be distinguished with high sensitivity from healthy subjects. All scores showed moderate to good correlation with the subjective limitation in quality of life. The sensitivity of the questionnaire demonstrated major effects postoperatively. The TOI-14 constitutes the first worldwide-validated, disease-specific instrument to measure HR-QOL in adults with CTO. Due to its ease of use, it can be utilized both in the outcome research and in clinical routine
Long-term outcomes and quality of life following parotidectomy for benign disease
Get PDFOBJECTIVE: Parotidectomy worsens quality of life (QoL) in the short-term, but the long-term impact is unknown. In this study, we analysed the long-term effects of parotidectomy on QoL. METHODS: In this prospective long-term follow-up study, participants were divided into three groups: short-term (ST) follow-up of six weeks, long-term (LT) follow-up of 13 years and short- and long-term (SLT) follow-up. QoL was assessed using the Parotidectomy Outcome Inventory (POI-8). Parotidectomies were classified based on whether the great auricular nerve (GAN) had been preserved or sacrificed. RESULTS: In total, 164 observations were analysed, 74 in the LT group, 57 in the ST group and 33 in the SLT group. Hypoaesthesia was a major problem and facial palsy was a minor problem. Pain (p < 0.01) and hypoaesthesia (p < 0.001) were significantly lower after 13 years compared with after six weeks, and QoL was higher after 13 years compared with after six weeks (p = 0.04). The disease-specific impairment rate decreased from 70% at short-term follow-up to 30% at long-term follow-up. Removal of the GAN was associated with hypoaesthesia in the ST group (p = 0.028). CONCLUSIONS: Hypoaesthesia has a long-term impact on the QoL, and this should be emphasised during preoperative discussions
Assessment of the central hearing system of sport divers
No full textObjective: To investigate the effect of regular scuba diving on central processing sequences of sport divers who have no history of noise exposure or ear-related accidents using a comprehensive topographic examination of the central hearing system. Design: Cross-sectional controlled comparison study Settings: General sports diving community Participants: 81 sport divers with a mean of 300 dives each were compared with a control group of 81 non-divers. Main outcome measure: The participants were classified into three age groups. Hearing test results were combined for both ears. Examination included brainstem evoked response audiometry (BERA), cortical evoked response audiometry (CERA) and dichotic listening tests to screen for retrocochlear and central hearing disorders. Testing of brainstem latencies was performed in a gender-dependent manner. Results: BERA showed a pathological extension of the I-V-latency in one diver. Magnetic tomographic imaging ruled out brainstem lesions. No reason for the measured latency could be detected. All other latencies (I-III. III-V and I-V) in both gender groups were within normal limits. No statistically significant differences between divers and non-divers could be detected. Dichotic listening showed no clinical abnormalities in any of the participants, but in the age group 18-29 years divers performed significantly better than non-divers (p= 0.01). CERA revealed no significant differences between divers and non-divers in the age group 18-29 years and 30-39 years, whereas divers in the age group 41-50 demonstrated significantly better test results (p=0.045) (difference of the means: 4.18 dB). Conclusion: Dichotic listening and CERA did not reveal a significant reduction of central hearing performance in divers. Persistent on-shore BERA wave latency prolongations that were present in one study could not be confirmed in our study group. This first comprehensive topographic examination of the central hearing system of divers showed no abnormalities
Does a closed reduction improve aesthetical and functional outcome after nasal fracture?
No full textBackground and purposes: How closed reduction (CR) to repair a nasal fracture affects the patient's quality of life (QoL) has not been investigated. Here, we assessed QoL before and after CR using disease-specific questionnaires and compared the QoL scores of patients with nasal fractures with normative scores from a reference cohort. Methods: This was a prospective study of 96 patients with nasal fractures undergoing CR. Patients were interviewed about aesthetic, functional, and QoL issues before and after surgery using the Functional Rhinoplasty Outcome Inventory (FROI-17) and the Rhinoplasty Outcome Evaluation (ROE). Photographs of the nasal area were taken before and after surgery and reviewed. Data were compared with those from a reference cohort (n = 1000). Results: Most fractures were type I (80.6%) and most were caused by sport-related accidents (36.5%). The ROE scores increased from 67.3 preoperatively to 73.4 postoperatively (p = 0.001). The FROI-17 also improved, indicating the overall effect of the nose on QoL (p = 0.002). Compared with the reference cohort, patients felt more affected by nasal symptoms before surgery (- 9.37, p = 0.02) than by more general aspects. ROE scores returned to normative values after surgery (p < 0.001). The postoperative cohort had lower scores for the FROI-17 item overall effects of the nose on QoL than the reference cohort did, although the nasal symptom score remained higher in patients than in reference controls. Conclusions: This study showed that CR can improve the aesthetical but not the functional outcome of the nose
Assessment of the peripheral hearing system of sport divers
No full textObjective: To investigate the effect of regular scuba diving on the hearing thresholds of sport divers who have no history of noise exposure or ear-related accidents. Comprehensive topographic examination of the peripheral hearing system of sport divers. Design: Cross-sectional study. Settings: General sport diving community. Participants: 81 sport divers with a mean of 300 dives each were compared to a control group of 81 non-divers. Main outcome measure: Participants were classified into three age groups. Examination included microscopic otoscopy, tympanometry, pure-tone audiometry (PTA) including air and bone conduction, speech audiometry and otoacoustic emissions (OAE). Results: PTA suggested significant differences of the hearing thresholds at several frequencies between sport divers and non-divers in all age groups, although a Bonferroni correction for multiple testing was applied. Interestingly, the results were contradictory. Divers obtained better hearing results in air conduction, whereas non-divers showed better results in bone conduction. Speech audiometry and OAE did not reveal significant differences. Conclusion: There are no published studies of the peripheral cochlear system of divers that have used a combination of PTA, speech audiometry and OAE. All studies suggesting hearing impairment in divers were based on PTA and might have been influenced by a lack of accuracy of PTA. Our results suggest that diving does not adversely affect the hearing system of sport divers. A thorough test battery of audiological methods implying PTA, speech audiometry and OAE may contribute to offer more reliable results to answer the question of whether commercial or military divers are at higher risk for hearing detonation
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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