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The authors observed 6 cases of brain pseudotumours in children aged from 3 to 15 years. All patients had been referred with the diagnosis of brain tumour, with headaches, eye fundus changes fundus changes. Some children had nystagmus, squint, vomiting and dizziness. One child had pharyngitis, two had sinusitis. Contrast brain examinations gave normal results. Diet with salt and fluid restriction and oedema-reducing drugs (glycerol, mannitol, decadron) were used. In all patients the neurological and ophthalmological signs regressed within 3 to 12 weeks.
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PMID:[Pseudotumor cerebri in children]. 145 58

The endoscopic sinus surgery is probably the most exciting topics in rhinology. Not only is the technology new, but the approach to sinus disease has changed dramatically. In this paper, we tried to present how sinus endoscopy can be applied to the treatment of sinus diseases and more radical forms of sinus surgery. Three kinds of surgical procedures were performed, they were the functional anterior ethmoidectomy, total ethmoidectomy, and total sphenoethmoidectomy for treatment of chronic ethmoid sinusitis (2 cases), polysinusitis with polyps (16 cases), and pansinusitis with polyps (5 cases). The results showed that the pus disappeared in 14 cases (60.8%), the dizziness and headache improved in 22 cases (95%), the smell improved in 14 cases (70%). There were 4 complications: nasolacrimal duct injury in one, and lamina papyracea injury in three. All of them recovered after management.
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PMID:[Transnasal endoscopic sinus surgery]. 193 Nov 80

A routine X-ray examination of the sinuses of a patient complaining of regular bouts of dizziness may provide diagnostic information about a so-called sinugenic vertigo. In addition to the pathological X-ray findings in the maxillary sinuses, the patients presented either a positioning nystagmus or a head-shaking nystagmus, with disturbed vestibular spinal reaction as a pathological vestibular condition. Out of 15 patients in whom a sinusitis-induced (sinugenic) dizziness was diagnosed and who appeared regularly for the control checks, 14 patients said that they were relieved of the dizziness as a result of sinus therapy, often immediately afterwards. Interrelationships possibly exist between pathological trigeminus reflexes via the sphenopalatine ganglion brought about by maxillary sinusitis and a reflectory labyrinthine irritation, triggering the vertigo.
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PMID:Vertigo originating from inflammation of the paranasal sinuses (the so-called sinugenic vertigo). 732 57

It has been difficult to confirm that a given building is responsible for allergic symptomatology, exacerbation of asthma, or immunological dysfunction. In fact, in most studies, few objective immunological parameters have been studied and only rarely has there been any quantitation of IgE or secondary mediators. Furthermore, although many studies deal with rhinitis or respiratory tract irritation, there is a misconception that all such symptoms are allergic in nature, and studies attempting to prove that allergies are caused by buildings frequently neglect to prove that these are indeed true allergic responses. In addition, many of the symptoms that people attribute to sick building syndrome (SBS) or building-related illness, such as headaches, dizziness, fatigue, nausea, cough, and eye irritation, are subjective, and studies often fail to take into account other possible causes that may be inherent in the subjects, such as sinusitis, hyperventilation syndrome, or psychosomatic illness. Unfortunately, most clinical studies on SBS pay little attention to the preexisting conditions that a subject may have and discount the possibility that the inciting agent does not cause symptoms, but merely exacerbates a preexisting condition. Moreover, they offer no information about the nature of the mechanisms of action or pathophysiological relationships. Clearly, further studies are necessary to further explain the complexity of complaints that currently exist. Indeed, SBS might properly be paraphrased as "what is it?--if it is!"
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PMID:The sick building syndrome. I. Definition and epidemiological considerations. 833 Oct 40

Telithromycin is a new ketolide antimicrobial, specifically developed for the treatment of community-acquired respiratory tract infections. It has a wide spectrum of antibacterial activity against common respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes. It also has activity against atypical pathogens, such as Chlamydia pneumoniae, Legionella pneumophila and Mycoplasma pneumoniae. Telithromycin maintains activity against beta-lactam and macrolide-resistant respiratory tract pathogens and does not appear to induce cross-resistance to other members of the macrolide-lincosamide-streptogramin (MLS) group of antimicrobials. It demonstrates bactericidal activity against S. pneumoniae and H. influenzae and has a prolonged concentration-dependent post-antibiotic effect (PAE) in vitro. The drug has favourable pharmacokinetics following oral administration. It is well absorbed, achieves good plasma levels and is highly concentrated in pulmonary tissues and white blood cells. In clinical trials, telithromycin given orally at a dose of 800 mg once daily for 5 - 10 days was as effective as comparator antimicrobials for the treatment of adults with community-acquired pneumonia, acute exacerbations of chronic bronchitis, acute maxillary sinusitis and group A-beta-haemolytic streptococcal pharyngitis or tonsillitis. The adverse events and safety profile were similar to comparator antimicrobials. The most common adverse events were diarrhoea, nausea, headache and dizziness. Telithromycin should provide an effective, convenient and well-tolerated once-daily oral therapy for treatment of respiratory infections.
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PMID:Telithromycin: a new ketolide antimicrobial for treatment of respiratory tract infections. 1117 47

The purpose of this article is to review the endoscopic management of cerebrospinal fluid (CSF) leaks and encephaloceles, with particular emphasis on safety and efficacy, by retrospective assessment utilizing the results of a mailed questionnaire. Surveys were mailed to members of the American Rhinologic Society with practices in both academic centers and/or private settings. Survey results were then assessed and tabulated. There were 635 mailings, with 197 responses (31%). Seventy-two (36% of respondents) indicated that they performed endoscopic management of CSF leaks and encephaloceles, while 125 (64% of respondents) did not. Respondents reported approximately 522 cases of CSF leaks and approximately 128 cases of encephaloceles managed by endoscopy. Success rates after a single procedure were estimated at 90% for CSF leaks and 93% for encephaloceles. Success rates after a secondary procedure were estimated at 86% and 97%, respectively; 29% of respondents have, at some point, made a referral to neurosurgery. A total of 13 complications related to endoscopic repairs were reported (2.5%). For CSF leak repair, complications included seizures, 0.2%; meningitis, 1.1%; and one reported case each of cavernous sinus thrombosis, temporary visual problems, sinusitis, and intracranial hypertension/bleed. There was only one reported death in the approximately 522 cases. Eleven complications following encephalocele repairs (8.5%) included seizures, 3.1%; meningitis, 2.3%; and one reported case each of brain abscess, sinusitis, false aneurysm of middle cerebral artery, and mild dizziness. No deaths following encephalocele repair were reported. The endoscopic management of CSF leaks and encephaloceles has become increasingly popular and has proven to have low morbidity and mortality with high success. Overall, our results confirm that in the hands of the skilled endoscopist, endoscopic management of CSF leaks and encephaloceles is highly efficacious and has a very low incidence of significant complication.
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PMID:Safety and efficacy of endoscopic repair of CSF leaks and encephaloceles: a survey of the members of the American Rhinologic Society. 1125 50

Respiratory tract infections (RTIs), the most common indication for outpatient antimicrobial therapy, impose a heavy medical and societal burden and present a difficult therapeutic challenge in the face of increasing pathogen resistance worldwide. Gatifloxacin is a new broad-spectrum fluoroquinolone with excellent activity against prevalent respiratory bacteria, including penicillin-resistant Streptococcus pneumoniae and atypical pathogens. A multicenter, open-label, noncomparative surveillance study carried out in Mexico evaluated the safety and efficacy of oral gatifloxacin 400 mg once daily in 17,923 adult outpatients with community-acquired pneumonia (CAP) (n = 3322), acute exacerbations of chronic bronchitis (AECB) (n = 5885), and acute bacterial sinusitis (n = 8716). Voluntary, unpaid physician participation contributed to an unbiased study design. Physician-assessed global rate of cure or improvement was 96.3%; efficacy was 95.8% in CAP, 96.1% in AECB, and 96.4% in sinusitis. The incidences of relapse (1.5%) and therapeutic failure (0.7%) were low. The most commonly reported adverse events, nausea (2.76%), headache (2.20%), and dizziness (1.33%), were generally mild and self-limited. Oral gatifloxacin 400 mg once daily is effective and safe for patients with CAP, AECB, and acute sinusitis.
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PMID:Multicenter evaluation of the efficacy and safety of gatifloxacin in Mexican adult outpatients with respiratory tract infections. 1131 29

Telithromycin is the first member of a new family of the macrolide-lincosamide-streptogramin-B (MLS(B)) class of antimicrobials, the ketolides. It has a good spectrum of activity against respiratory pathogens, including penicillin- and erythromycin-resistant pneumococci, as well as intracellular and atypical bacteria. Furthermore, it has a low potential to select for resistance or induce cross-resistance among other MLS(B) antimicrobials. At the recommended dosage of 800 mg orally once daily, telithromycin reaches maximal plasma concentrations of about 2 mg/L. It penetrates rapidly into bronchopulmonary, tonsillar, sinus and middle ear tissues and/or fluids and achieves high concentrations at sites of infection. It also concentrates within polymorphonuclear neutrophils. In clinical trials in patients with community-acquired pneumonia (CAP), acute exacerbations of chronic bronchitis (AECB) or pharyngitis/tonsillitis caused by group A beta-haemolytic streptococci, telithromycin 800 mg once daily achieved clinical cure rates of 86 to 95%. In acute maxillary sinusitis (AMS), cure rates were 73 to 91%. A 7- to 10-day regimen of telithromycin was as effective as a 10-day course of amoxicillin 1000 mg 3 times daily, clarithromycin 500 mg twice daily or a 7- to 10-day course of trovafloxacin 200 mg once daily for treating CAP. A 5-day regimen of telithromycin was as effective as a 10-day regimen of cefuroxime axetil 500 mg twice daily or amoxicillin/clavulanic acid 500/125 mg 3 times daily in AECB. A 5-day regimen of telithromycin was as effective as a 10-day regimen of clarithromycin 250 mg twice daily or phenoxymethylpenicillin 500 mg 3 times daily in pharyngitis/tonsillitis, or a 10-day regimen of amoxicillin/clavulanic acid 500/125 mg 3 times daily in patients with AMS. Telithromycin was well tolerated across all patient populations. Adverse events associated with telithromycin were generally mild to moderate in intensity and seldom led to treatment discontinuation. The most frequent adverse events were diarrhoea (13.3%) and nausea (8.1%). Other adverse events included dizziness and vomiting.
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PMID:Telithromycin. 1139 13

(1) Macrolides are an alternative to beta-lactam agents for treating uncomplicated community-acquired pneumonia, acute exacerbations of chronic bronchitis, sinusitis and throat infections. The choice of macrolides is based mainly on the risk of interactions, which is lowest with spiramycin. (2) Telithromycin is a macrolide antibiotic derived from erythromycin. It was first marketed in France in 2002, for the above indications. (3) Telithromycin is no more effective than the antibiotics with which it has been compared, namely amoxicillin and clarithromycin in non life-threatening pneumonia; amoxicillin-clavulanate and cefuroxime axetil in acute exacerbations of chronic bronchitis and acute sinusitis; and clarithromycin and phenoxymethylpenicillin (penicillin V) in pharyngotonsillitis. (4) In clinical trials, telithromycin was not more effective than comparator antibiotics on infections thought to be due to pneumococcal strains resistant to penicillin and/or erythromycin. Cases of erythromycin cross-resistance have been observed. (5) The adverse effects of telithromycin are the same as those of other macrolides, mainly gastrointestinal disturbances, headache, dizziness, and hepatotoxicity. Telithromycin also carries a risk of torsades de pointes, and seems to cause more visual problems than other macrolides. (6) Telithromycin inhibits cytochrome P450 isoenzymes, so there is a high risk of drug interactions. (7) In practice, spiramycin remains the standard option when a macrolide is indicated for the treatment of common ENT and pulmonary infections.
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PMID:Telithromycin: new preparation. A needless addition to the other macrolides. 1260 73

Patulous eustachian tube is a pathological condition which exists more often than we make a diagnosis, and a patient is not often aware of his disease. This disease can be manifested with various symptoms: respiratory synchrony noises in the ear, because of the penetration of the air current through the eustachian tube and with the movement of the eardrum outwards and inside, with autophony, reduction of the hearing, the buzzing, dizziness and disturbance of the balance. Two patients are presented. The first one was sick for many years from various chronics exhausted diseases: Jackson's epilepsy, temporary vascular brain disturbances, tuberculosis of lung, stomach ulcer, heart diseases, the patient is from low class, on one side, and also suffers from some local diseases: a paralysis of soft palate and palatal arcs, a chronic catarrhal rhinitis and sinusitis, a deviation of nasal dividing wall and hindered breathing through the nose, on the other side. Many years the patient didn't know for patological condition in the ears and in the eustachian tubes. After improving the hygienic conditions, the physical condition and local therapy, the patient felt much better. The second patient, with considerable shorter evolution of the disease and mild symptomatology, showed the amplified symptoms of the disease of the Eustachian tube in the course of the acute otitis. It is attained a satisfying calming of the manifestative symptoms by remedy therapie. Man must thing about possibility of the appearance of this pathology condition in various disease or conditions, which can take to the fast lost of the weight and physical and moral exhaustion of the patient, i.e. an adult, first as the protection of the appearance of the disease (condition) and afterwards, eventually early and regulary treatment in order to prevent various possible, above mentioned complications.
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PMID:[Patulous eustachian tube]. 1629 37


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