Search Results (219)

Background: Meniere’s disease is characterized by a triad of vertigo episodes, fluctuating hearing loss, and tinnitus. The disease is followed by a loss of quality of life in patients, with the severity depending on the individual and the stage of the disease. Since there are no quantitatively validated tests that connect all elements of the disease, the only source of subjective data that can be analyzed is the disease diary and questionnaires, among which the MDPOSI (Meniere’s Disease Patient-Oriented Symptom-Severity Index) stands out as a designated quality-of-life assessment tool. This study aims to evaluate the differences in the questionnaire depending on the clinical characteristics of the disease. Methods: The study recruited 60 patients, with clinical variables including age, gender, disease laterality, caloric testing results, and PTA results, the presence of spontaneous nystagmus, pathological values of calorimetric testing, or rotatory chair testing abnormalities. Results: The appearance of spontaneous nystagmus showed a significant association with worse hearing threshold values at 500 Hz (p = 0.036, OR 4.416) and higher. Worse SRT scores correlated with Q1 (p = 0.011), Q2 (p = 0.028), Q4 (p = 0.045), Q5 (p = 0.013), and the total MDPOSI score (p = 0.008, 0.339). Multivariate analysis showed that a higher total value of the MDPOSI questionnaire was statistically significantly associated with older age (p = 0.042) and spontaneous nystagmus (p = 0.037). Conclusions: There is a correlation between the clinical characteristics of Meniere’s disease and the MDPOSI questionnaire, making it useful for assessing quality of life and disease progression. Full article

Atmospheric climate science lacks the capacity to integrate thermodynamics with the gravitational potential of air in a classical quantum theory. To what extent can we identify Carnot’s ideal heat engine cycle in reversible isothermal and isentropic phases between dual temperatures partitioning heat flow with coupled work processes in the atmosphere? Using statistical action mechanics to describe Carnot’s cycle, the maximum rate of work possible can be integrated for the working gases as equal to variations in the absolute Gibbs energy, estimated as sustaining field quanta consistent with Carnot’s definition of heat as caloric. His treatise of 1824 even gave equations expressing work potential as a function of differences in temperature and the logarithm of the change in density and volume. Second, Carnot’s mechanical principle of cooling caused by gas dilation or warming by compression can be applied to tropospheric heat–work cycles in anticyclones and cyclones. Third, the virial theorem of Lagrange and Clausius based on least action predicts a more accurate temperature gradient with altitude near 6.5–6.9 °C per km, requiring that the Gibbs rotational quantum energies of gas molecules exchange reversibly with gravitational potential. This predicts a diminished role for the radiative transfer of energy from the atmosphere to the surface, in contrast to the Trenberth global radiative budget of ≈330 watts per square metre as downwelling radiation. The spectral absorptivity of greenhouse gas for surface radiation into the troposphere enables thermal recycling, sustaining air masses in Lagrangian action. This obviates the current paradigm of cooling with altitude by adiabatic expansion. The virial-action theorem must also control non-reversible heat–work Carnot cycles, with turbulent friction raising the surface temperature. Dissipative surface warming raises the surface pressure by heating, sustaining the weight of the atmosphere to varying altitudes according to latitude and seasonal angles of insolation. New predictions for experimental testing are now emerging from this virial-action hypothesis for climate, linking vortical energy potential with convective and turbulent exchanges of work and heat, proposed as the efficient cause setting the thermal temperature of surface materials. Full article

Background/Objectives: The line bisection task (LBT) is a well-known test in which a horizontal line is presented in front of the subject and the subject is asked to draw a mark vertically bisecting the line. We developed the new LBT using three-dimensionally transformed rectangles to enhance the sense of depth and evaluated the influence of vestibular dysfunction on the deviation. Methods: One hundred participants were recruited from patients referred to the vertigo outpatient clinic. The average deviation in the LBT was the leftward deviation in the figures viewed from the right side and the rightward deviation in the figures viewed from the left side, indicating that the figures were perceived three-dimensionally, with the division point deviating to the far side. Results: In multivariate analysis of variance (MANOVA) analyses, the significant leftward deviation was observed in the group with vestibular dysfunction in caloric testing, and the significant rightward deviation dependent on increasing age was also observed. In univariate analyses, the significant leftward deviation in the figure viewed from the left side (135 degrees) was observed in the group with vestibular dysfunction in caloric testing, and the significant leftward deviation was also observed in figures viewed from the center, left or right side (0, 15 and 165 degrees) in the group with vestibular dysfunction in vHIT evaluation. Conclusions: Vestibular dysfunction can alter the deviation in the new LBT, suggesting the potential of the new LBT as an assessment of vestibular dysfunction. Full article

Background: Cachexia worsens prognosis, quality of life and chemotherapy treatment compliance of patients with lung cancer. Chemotherapy-induced cachexia has also been implicated in lowered mortality. This study aimed to evaluate the frequency of cachexia-related measures and symptoms as outcomes in lung cancer chemotherapy trial protocols and to examine how key trial characteristics influence them. Method: We conducted a cross-sectional data analysis of randomised controlled chemotherapy trials of lung cancer registered in four public trial registries between 2012 and 2023. Trial outcome measures included overall survival, treatment toxicity/side effects and cachexia-related indicators such as physical activity, weight/body mass index (BMI), dietary limitations, caloric intake and lean muscle mass. Symptom-related outcomes, including appetite loss, diarrhoea, pain, fatigue/insomnia, constipation, nausea, vomiting, dysphagia, dyspnoea and oral mucositis, were also extracted. Additionally, the number and type of performance status and assessment tool were recorded. Data were summarised descriptively. Chi-square tests were used to examine associations between trial outcomes and characteristics including cancer type, trial location, lead investigator/funding source, assessment tools and trial commencement year. A p < 0.05 was considered statistically significance. Results: Of the 335 trial protocols (non-small cell (87.2%) and small cell (12.8%)), most were from Europe (50.4%). The trial lead investigator was from industry (56.7%) followed by academia (25.1%). Allied health professional involvement was minimal (0.6%). Trial protocols mostly recorded overall survival (96.4%) and toxicity (83.9%). However, physical activity, weight/BMI, dysphagia, dyspnoea and oral mucositis were recorded in <30%, with dietary limitations, caloric intake and lean muscle mass recorded in <3% of the trials. Measures and symptoms were not associated with cancer type. Trial location was associated with the measures toxicity, physical activity and caloric intake and all symptoms. Lead investigator was associated with the measures toxicity and weight/BMI and all symptoms except for dyspnoea. Performance status and assessment tools were mentioned in 93.4% and 41.8% of the trials, respectively, with significant associations between assessment tools and outcomes, except for weight/BMI, dietary limitations, lean muscle mass, dysphagia and oral mucositis. There was a significant trend with trial commencement year for the measures physical activity (p = 0.002) and weight/BMI (p = 0.000) and all symptoms, except for appetite loss (p = 0.115) and pain (p = 0.433). Conclusions: While the reporting of measures and outcomes was generally higher compared to gastrointestinal chemotherapy cancer trials, it still faced significant under-reporting. Assessment tools should include cachexia-specific symptoms to accurately assess the quality of life in patients with lung cancer undergoing chemotherapy clinical trials. Full article

This study aimed to investigate the effect of the type of sweetener used (xylitol, stevia, cane sugar) on the quality of liqueurs made from Vaccinium myrtillus L. and Vaccinium corymbosum L. fruits. The quality assessment was performed based on selected organoleptic and physicochemical features, with particular emphasis on the health-promoting potential of the produced beverages. The liqueurs were assessed in terms of their physicochemical parameters: pH, total acidity, density, total soluble solids, color, ethanol and polyphenol contents, and redox potential. Antioxidant capacities were determined by a 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical scavenging capacity assay and ferric reducing antioxidant power (FRAP). The Qualitative Descriptive Analysis method was employed for their sensory assessment. The sensory profiling method was used to determine the intensity of the flavor sensations. The study results showed that the type of sweetener did not affect the antioxidative properties of the liqueur. The ABTS test yielded values from 1081.88 to 1238.13 μmol Tx/100 mL, the DPPH test from 348.8 to 367.88 μmol Tx/100 mL, and the FRAP test from 594.20 to 653.20 μmol FeSO₄/100 mL. However, the sweetening substrate affected the content of polyphenolic compounds in the resulting products, but by no more than 15%. The liqueur sweetened with xylitol had a comparable extract content to that sweetened with cane sugar. All three variants of liqueurs were accepted by the evaluation panel, and their overall qualities were comparable in the sensory assessment. It is, therefore, possible to produce a high-quality liqueur with a reduced caloric value, which will potentially increase its attractiveness for consumers. Full article

Biomimetic restorative protocols aim to preserve natural tooth structure while enhancing restoration longevity. This in vitro study aimed to evaluate the shear bond strength (SBS) in the repair of additively and subtractively manufactured CAD/CAM materials using bulk-fill resin composites and to assess the effect of thermocycling. Forty rectangular specimens (14.5 × 7 × 3 mm) were prepared from Grandio Blocs (GB, VOCO) and VarseoSmile Crown^Plus (VS, BEGO), and thermocycled (5000 cycles, 5–55 °C, 20 s dwell time). All surfaces were roughened with 50 μm Al₂O₃. Samples were repaired using VisCalor (VCB, VOCO) and Charisma Bulk Flow One (CBO, Kulzer) composites (n = 10 per group) with their respective adhesives. Each group was further divided into immediate and post-thermocycling subgroups. All specimens were tested under shear force until failure, and failure types were examined under a stereomicroscope. Representative samples were examined by SEM to evaluate filler morphology. Statistical analysis was performed with SPSS v23 (p < 0.05). No statistically significant differences in SBS were found between groups (p > 0.05). Mean SBS values were highest in VS-CBO and lowest in GB-CBO. Cohesive failures were more frequent in immediate groups, while adhesive failures predominated after thermocycling. Bulk-fill composites did not influence the repair bond strength of indirect materials. Thermocycling affected the failure type, though not the SBS values. Full article

Background: Postmenopausal women face a higher risk of obesity and related chronic diseases. While lifestyle interventions improve cardiometabolic health and physical function, their effects on cognitive function remain understudied, especially in diverse populations. This study examined the impact of a lifestyle intervention combining caloric restriction and exercise on cognitive function in a diverse sample of postmenopausal women with overweight or obesity and functional limitations. Methods: This study represents a secondary analysis of a previously conducted pilot trial, in which 34 participants were randomly assigned to a 24-week intervention: (i) caloric restriction plus exercise (CR + E; n = 17) or (ii) educational control (EC; n = 17). In the CR + E group, participants engaged in group-based weight management focused on caloric restriction and three weekly exercise sessions, including walking and lower-body resistance training. The EC group attended monthly health education lectures. Changes in cognitive scores were assessed using the Digit Symbol Substitution Test (DSST) and the Controlled Oral Word Association (COWA) test. Additionally, we explored the correlation between changes in cognitive scores and physical function in the CR + E group. Results: In the CR + E group, DSST scores significantly improved compared to the EC group (p < 0.05). There were no significant changes in COWA scores for either group compared to their baseline value or between groups. Furthermore, changes in DSST or COWA were not significantly correlated with changes in walking speed or physical function. Conclusions: The preliminary results of this study suggest that CR + E may improve complex attention in functionally limited postmenopausal women with overweight or obesity but does not appear to significantly affect verbal fluency. Full article

Background: This study aimed to evaluate the impact of physical activity levels on selected biochemical markers (glucose, insulin, cholesterol, triglycerides, interleukin-6 [IL-6]), brain-derived neurotrophic factor (BDNF), cognitive functions, and additional macronutrient intake in postmenopausal women. Method: A total of 72 generally healthy women aged 55–73 from western Poland participated in the study. Physical activity levels were assessed using the International Physical Activity Questionnaire (IPAQ), resulting in two distinct groups: 56 women in the lower activity level group and 16 in the higher activity level group. We calculated body mass index (BMI), measured body composition and blood pressure, and conducted cognitive assessments, including the Mini-Mental State Examination (MMSE), motor and psychomotor skills tests, the Clock Drawing Test, and the Geriatric Depression Scale (GDS). Nutritional intake was evaluated using a detailed 3-day food record to analyze macronutrient consumption and total caloric intake. Results: A statistically significant difference in total blood cholesterol levels (p = 0.0277) was observed between the two groups, with the higher physical activity group showing elevated cholesterol levels. Although no other biochemical markers showed statistically significant differences, variations in BDNF, glucose, triglycerides, IL-6, and insulin levels were noted between groups. Moreover, correlations between these markers and cognitive performance, like motor and psychomotor speeds, varied depending on physical activity level. The analyzed dietary pattern of the studied group shows slight deviations from current nutritional recommendations. Conclusions: The findings suggest that physical activity level may influence certain biochemical markers and cognitive functions in postmenopausal women. While these results highlight the potential benefits of physical activity, further research is needed to clarify underlying mechanisms and to validate physical activity as an effective strategy for improving postmenopausal health. Full article

Background: There is limited knowledge about nutritional intake and energy needs during the post-intensive care unit (ICU) period and their relationship with clinical outcomes and physical recovery. Aims and Methods: Thus, this observational multicenter study (Azienda Ospedaliero-Universitaria “Santa Maria”, Terni and “Madonna del Soccorso” General hospital, San Benedetto del Tronto, Italy) aimed, firstly, to measure energy expenditure via indirect calorimetry (IC) (Q-NRG+^® Metabolic Monitor, Cosmed, Rome, Italy), derived respiratory quotient (R/Q1) and, malnutrition risk via Mini Nutritional Assessment (MNA) test and body composition through bioimpedance vector analysis (BIVA-Akern, Pontassieve, Italy); secondly, to assess their effect on energy needs, body composition and physical rehabilitation steps in critically ill adults after ICU discharge. The provision of nutrients (PIS test) was also recorded. Oral nutritional supplementation was used to reach the optimal nutritional intake. All patients followed a standardized rehabilitation program. Results: A total of 43 patients were enrolled from January 2024 until February 2025 at the beginning of their post-ICU period. The mean age was 65.7 ± 1.0 years, the mean BMI was 20.73 ± 0.8 kg/m² at the recovery ward, and 60.4% (n = 26) were male. The mean admission period was 19.5 ± 1.7 days. The resting energy expenditure (mREE) was 1591 ± 71.2 at the admission and 1.856 ± 62.7 kcal/kg/d at the discharge (p < 0.05). The median phase angle value was 4.33 ± 0.15 at the admission and 5.05 ± 0.17° at the discharge (p < 0.05); R/Q1 at the admission was 0.7 ± 0.1 and 1.086± 0.11 at the discharge (p < 0.05). Improved energy expenditure significantly correlated with R/Q1 and phase angle (r = 0.81 and r = 0.72, respectively). Interestingly, there was no significant correlation between improved metabolism and improved PIS test scores (r = 0.18). Improved metabolism and nutritional status showed a tendency to correlate with shorter post-ICU courses and earlier physical recovery, without reaching statistical significance. Conclusions: Measurement of energy expenditure and caloric intake, along with the assessment of body composition is feasible and provides an objective tool to guide and possibly enhance the functional recovery in patients during the post-ICU period. Full article

Background/Objectives: To evaluate the clinical characteristics and diagnostic significance of dissociation between bithermal caloric test and video head impulse test (vHIT) in patients presenting with dizziness. Methods: We retrospectively reviewed 644 patients who underwent bithermal caloric testing and vHIT at a university-affiliated general hospital. Patients were classified into concordant and discordant groups based on test results. The discordant group was further subdivided into those with abnormal caloric test and normal vHIT, and those with normal caloric test and abnormal vHIT. Demographic data, vestibular function test outcomes, and clinical diagnoses were analyzed. Results: Discordant results were observed in 36.5% of patients. Among these, 31.8% had abnormal caloric responses with normal vHIT, and 4.7% had normal caloric responses with abnormal vHIT. Most patients in both discordant subgroups were diagnosed with peripheral vestibular disorders, such as Ménière’s disease and unilateral vestibulopathy. The abnormal caloric/normal vHIT pattern was more common and associated with low-frequency dysfunction. The normal caloric/abnormal vHIT pattern, though less frequent, also involved predominantly peripheral etiologies. Conclusions: Dissociation between caloric and vHIT results is not uncommon and provides important diagnostic insights. Employing both tests in a complementary manner enhances the identification of frequency-specific vestibular deficits and supports more accurate diagnosis and management of vestibular disorders. Full article

Background/Objectives: To compare the outcomes of low-dose intratympanic gentamicin injection (ITGM) in managing intractable Meniere’s disease (MD) between patients receiving a single injection versus multiple injections, and to explore the optimal number of ITGM repetitions. Methods: This retrospective study was conducted at a single tertiary medical center. Clinical charts of patients diagnosed with definite MD between 2015 and 2020 and given low-dose ITGM for intractable vertigo attacks were reviewed. A total of 33 patients were divided into two groups based on the number of ITGM procedures: the single injection group (SG, n = 14) and the multiple injection group (MG, n = 19). In the MG, additional ITGM was performed up to four times. Audiograms, caloric responses, and video head impulse tests (vHIT) were reviewed at each repetition of ITGM. Results: After the first ITGM, both the SG and MG showed significant decreases in caloric responses and vHIT gains, without deterioration in hearing. In the MG group, a second ITGM was needed on average 8.1 ± 6.4 months after the initial ITGM due to persistent vertigo attacks. After the second ITGM, 8 out of 19 MG patients showed additional benefits in terms of reduced vertigo and further decreases in caloric responses. However, after the third and fourth ITGM, no further significant decline in vestibular function was observed, and there was no improvement in subjective dizziness. In the MG, gradual deterioration of hearing was observed. Conclusions: This finding suggests that performing additional low-dose ITGM in poorly responding or recurrent cases appears reasonable up to the second injection. For those who continue to experience vertigo episodes after two ITGM procedures, alternative therapeutic approaches should be considered to preserve hearing. Full article

Background/Objectives: Vestibular dysfunction is one of the main complications after cochlear implant (CI) surgery, and there are currently no standardized protocols for vestibular assessment in CI candidates. Our objectives were to investigate the incidence of vestibular impairment after CI surgery, anamnestic (age, known systemic pathologies and cause of deafness) and surgical (intraoperative complications, malposition of the CI) risk factors, and the role of vestibular assessment in the selection of the suitable ear for implantation. Methods: We included 68 adult patients (80 ears) affected by moderate-to-profound SNHL undergoing CI. The dizziness handicap inventory (DHI), the video head impulse test (VHIT), the caloric test, and dynamic posturography (DP) were used to study the vestibular function and balance before and one month after CI. The DHI was also administered 24 h after surgery. Results: Despite significative impairment 24 h after surgery (29.6 ± 30), the mean DHI score returned to preoperative values (17.9 ± 26) after one month. Dizziness persisted in case of age ≥ 65 years old, surgical difficulties, simultaneous bilateral CI, Meniere’s disease and otosclerosis, comorbidities ≥ 3, anxiety/depression, and neurological diseases. The VHIT significantly worsened in 25% of ears, while the caloric test SPV nystagmus significantly decreased in 30% of ears. In cases of preoperative unilateral weakness, the implantation of the better ear was significantly related to higher DHI scores. Only 4/68 patients had a significant persistent reduction in the postural composite score after surgery, with an increased risk of falls. Conclusions: Medical history and vestibular assessment predict the risk of vestibular damage and help to choose the CI’s side and to manage vertigo after surgery. Full article

Background and Clinical Significance: Kidney transplantation remains the most effective method of renal replacement therapy. Living donor transplantation offers several advantages—reduced cardiovascular risk, better graft survival, and preemptive intervention. However, donor obesity is a growing concern, as it is usually associated with perioperative and long-term complications, which can affect donor eligibility. Bariatric surgery is a standard recommendation for patients with a BMI over 35 kg/m². There are limited data on the use of pharmacological agents for weight reduction in kidney donors. This case presents a successful conservative treatment with GLP-1 receptor agonist in an obese woman wishing to donate a kidney to her son. Case Presentation: We are presenting the case of a 63-year-old woman with grade II obesity who was initially denied being a kidney donor to her son because of her weight. Under these circumstances, she underwent comprehensive lifestyle modification in the cardio-obesitology clinic (caloric restriction, physical activity, and pharmacological treatment with liraglutide). During the 3-month follow-up, she decreased her BMI to 33.4 kg/m², and subsequent examinations confirmed no surgical contraindications to donating a kidney. Despite hematuria, biopsy and genetic testing revealed a benign carrier condition of Alport syndrome, which, without proteinuria or renal impairment, allowed successful kidney donation. Conclusions: This case demonstrates that conservative pharmacological treatment for body weight reduction with GLP-1 receptor agonists may be an alternative to bariatric surgery for selected obese kidney donor candidates. The presented case highlights the importance of a multidisciplinary and personalized approach. Full article

Peruvian carrot is a root with a pleasant taste but a short shelf life. Developing Peruvian carrot snacks with appealing sensory characteristics, a crunchy texture, and reduced lipid content aligns with modern consumer demands and represents an innovative approach to food diversification. To ensure product quality, snacks must have a low water content to prevent microbial growth and maintain crispness. Therefore, optimizing process variables through pre-treatments is essential to achieving the desired characteristics. This study aimed to evaluate the influence of frying conditions on the water content, lipid absorption, and sensory acceptance of Peruvian carrot snacks. The preparation process involved sanitizing and slicing the roots, air-drying them at room temperature, and frying them according to an experimental design. The optimal frying conditions were 160 °C for 18 s and 174 °C for 30 s. Three different treatments were tested: two with edible coatings made from Peruvian carrot starch at concentrations of 3:20 and 5:10 (starch %/glycerol %) and one control sample without a coating. Sensory evaluation showed significant differences between coated and uncoated snacks, with all samples receiving high consumer acceptance. Notably, coated snacks exhibited a 50% reduction in lipid absorption compared to the control while also retaining a lower water content, key factors in maintaining texture, preserving quality, and extending shelf life. Furthermore, the application of edible coatings proved effective in reducing the caloric content of the snacks, making them a healthier alternative. Full article

Introduction: Masseter vestibular evoked myogenic potentials (M-VEMPs) are a recent tool for assessing a vestibulo-trigeminal pathway departing from the saccule, similarly to cervical VEMPs (C-VEMPs), that evaluate saccular function via the sternocleidomastoid muscle. M-VEMPs may offer a complementary diagnostic value in vestibular neuritis (VN). Methods: This retrospective study analysed M-VEMPs and C-VEMPs in 28 monolateral patients and 1 bilateral (30 ears) diagnosed with VN between 2023 and 2024. Diagnostic evaluation included video head impulse tests (VHIT), caloric tests, ocular VEMPs, and, in a few cases, electromyography (EMG) of the sternocleidomastoid muscle. M-VEMPs were elicited using 500 Hz tone bursts at 97 dB nHL. Results were compared based on the topography of vestibular involvement and muscle response concordance. Results: M-VEMPs were always present in patients with superior VN and intact saccular function, showing consistent results with normal C-VEMPs. In some cases, with saccular dysfunction, M-VEMPs were preserved despite the absence of C-VEMPs, suggesting greater robustness. One patient with herpes zoster (HZ) involving both the VIII and trigeminal nerves showed absent M-VEMPs, indicating trigeminal pathway involvement. Edentulous patients showed reduced or absent M-VEMPs due to compromised masseter muscle electromyography activity. Conclusions: M-VEMPs are reliable and often concordant with C-VEMPs in VN but may reveal additional diagnostic information in discordant or complex cases. They are particularly useful in identifying trigeminal involvement but are limited in patients with poor masseter muscle function. Further studies are needed to clarify their full diagnostic potential. Full article