Vestibular and oculomotor abnormalities among HIV-infected and HIV-uninfected men and women: A pilot study

2020 ◽  
Vol 30 (5) ◽  
pp. 329-334
Author(s):  
Matthew D. Pichert ◽  
Michael W. Plankey ◽  
Gayle Springer ◽  
Christopher Cox ◽  
Howard J. Hoffman ◽  
...  
Keyword(s):  
Viral Load ◽  
Pilot Study ◽  
Undetectable Viral Load ◽  
Hiv Disease ◽  
Vestibular Evoked Myogenic Potential ◽  
Men And Women ◽  
Caloric Testing ◽  
Myogenic Potential ◽  
Aging Men ◽  
Oculomotor Abnormalities

OBJECTIVE: To determine if middle-aged and aging men and women with HIV disease (HIV+) should be screened for vestibular and oculomotor dysfunction. METHODS: Age- and sociodemographically matched HIV+ and HIV– men and women were tested on vestibular evoked myogenic potential (VEMP), bi-thermic caloric testing, Dix-Hallpike maneuvers and saccades. RESULTS: HIV+ men had more caloric weakness than HIV– men. HIV+ subjects had more saccade abnormalities than HIV– subjects. A saccade abnormality was positively associated with being HIV+. Among the HIV+ sample, abnormalities were associated with increasing age, being male, ever taking monotherapy, and having an undetectable viral load. Only being male and having an undetectable viral load were statistically significant. Unilateral caloric weakness had a decreased prevalence with age per 10 years, and being HIV+ showed an increased prevalence. In HIV+ subjects only, these abnormalities decreased with age and being male but increased with undetectable viral load and ever taking antiretroviral monotherapy. No statistically significant differences were found. CONCLUSION: Women are at greater risk of vestibular and oculomotor abnormalities than men. HIV+ adults are at greater risk than HIV– adults. Physicians who care for HIV+ men and women should monitor the symptoms of vestibular and oculomotor impairment.

Vibration-Induced Nystagmus in Patients with Vestibular Disorders

2003 ◽  
Vol 129 (3) ◽  
pp. 255-258 ◽  
Author(s):  
Masafumi Ohki ◽  
Toshihisa Murofushi ◽  
Haruka Nakahara ◽  
Keiko Sugasawa
Keyword(s):  
Clinical Significance ◽  
Vestibular Dysfunction ◽  
Spontaneous Nystagmus ◽  
Clinical Test ◽  
Vestibular Disorders ◽  
Vestibular Evoked Myogenic Potential ◽  
Canal Paresis ◽  
Caloric Testing ◽  
Myogenic Potential ◽  
Healthy Side

OBJECTIVE: Our goal was to clarify the clinical significance of vibration-induced nystagmus (VIN). METHODS: One hundred patients with unilateral vestibulocochlear disorders were enrolled into this study. However, patients with spontaneous nystagmus were excluded. Vibratory stimuli (approximately 100 Hz) were presented to the mastoids and the forehead. Patients also underwent caloric testing and vestibular evoked myogenic potential testing. RESULTS: Of the 100 patients, 60 (60%) showed VIN. The nystagmus was mainly horizontal. VIN was more frequently evoked on the mastoids than the forehead. In the majority of patients, the direction of VIN was toward the healthy side, whereas some patients, especially patients with Meniere's disease, showed nystagmus toward the affected side. VIN was frequently evoked in patients with severe unilateral vestibular damages (canal paresis >50%) (39 of 43, or 90%). CONCLUSION: VIN testing is a simple and sensitive clinical test that indicates unilateral vestibular dysfunction.

An emerging severe leukoencephalopathy: is it due to HIV disease or highly active antiretroviral therapy?

2006 ◽  
Vol 17 (3) ◽  
pp. 205-207 ◽  
Author(s):  
Simon Rackstraw ◽  
Jeanette Meadway ◽  
James Bingham ◽  
Safa Al-Sarraj ◽  
Ian Everall
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Clinical Response ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Undetectable Viral Load ◽  
Hiv Disease ◽  
Good Clinical Response ◽  
Highly Active ◽  
The Brain

We report an individual who had HIV-associated dementia, but a good clinical response to antiretroviral therapy, with a rising CD4 count and undetectable viral load. A severe leukoencephalopathy was noted at postmortem; however, no HIV immunopositive cells were found in the brain, suggesting that this new severe leukoencephalopathy is associated with immune reconstitution.

Semicircular canal versus otolithic involvement in idiopathic sudden hearing loss

2009 ◽  
Vol 123 (12) ◽  
pp. 1325-1330 ◽  
Author(s):  
G Stamatiou ◽  
E Gkoritsa ◽  
J Xenellis ◽  
M Riga ◽  
S Korres
Keyword(s):  
Hearing Loss ◽  
Significant Relationship ◽  
Semicircular Canal ◽  
Sudden Hearing Loss ◽  
Standard Protocol ◽  
Healthy Controls ◽  
Vestibular Evoked Myogenic Potential ◽  
Caloric Testing ◽  
Clinical Appearance ◽  
Myogenic Potential

AbstractObjective:To evaluate the results of vestibular evoked myogenic potential testing in patients with idiopathic sudden hearing loss, and to correlate these results with the findings of caloric testing, the clinical appearance of vertigo and the influence of age.Materials and methods:Eighty-six patients with unilateral idiopathic sudden hearing loss and 35 healthy controls underwent a standard protocol of neurotological evaluation. Vestibular evoked myogenic potential responses were measured and compared with caloric responses.Results:On the affected side, 30.2 per cent of patients showed abnormal vestibular evoked myogenic potential responses, while 52.3 per cent had abnormal caloric responses. A statistically significant relationship was found between the results of these two tests. A statistically significant relationship was also found between the type of vestibular lesion and the occurrence of vertigo. Advancing age correlated statistically with more extensive labyrinthic lesions.Conclusions:A combination of vestibular evoked myogenic potential and electronystagmography testing indicated the existence of vestibular involvement in many patients with idiopathic sudden hearing loss. Both tests are necessary in order to obtain a more thorough and in-depth knowledge of the pathophysiology of idiopathic sudden hearing loss.

Inferior vestibular neuritis: a novel subtype of vestibular neuritis

2009 ◽  
Vol 124 (5) ◽  
pp. 477-481 ◽  
Author(s):  
D Zhang ◽  
Z Fan ◽  
Y Han ◽  
G Yu ◽  
H Wang
Keyword(s):  
Pure Tone Audiometry ◽  
Systematic Investigation ◽  
Vestibular Neuritis ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Caloric Testing ◽  
Myogenic Potential ◽  
Lower Amplitude ◽  
Cerebral Computed Tomography ◽  
Inferior Vestibular Nerve

AbstractObjective:To report eight cases of inferior vestibular neuritis, in order to raise awareness of this new subtype of vestibular neuritis.Materials and methods:We retrospectively analysed 216 patients (104 males and 112 females; age range 10–64 years; mean age 38.4 years) with full clinical documentation who had attended our hospital's vertigo clinic between May 2007 and December 2008. All patients underwent systematic investigation, including hearing tests, radiology, caloric testing and vestibular evoked myogenic potential testing.Results:Of 216 patients with vestibular neuritis, eight cases were diagnosed as inferior vestibular neuritis, based on comprehensive analysis of test data. The clinical features of these eight patients were consistent with the characteristics of vestibular neuritis. The results of pure tone audiometry and caloric testing were normal, and the possibility of central lesions was excluded by cerebral computed tomography or magnetic resonance imaging on admission. Six cases had unilateral loss of vestibular evoked myogenic potentials, whereas two had a unilateral lower amplitude of vestibular evoked myogenic potentials.Conclusions:Inferior vestibular neuritis is a novel subtype of vestibular neuritis, which involves the inferior vestibular nerve alone. Vestibular evoked myogenic potential testing is a useful aid to the diagnosis of inferior vestibular neuritis.

scholarly journals Compassionate Love as a Predictor of Reduced HIV Disease Progression and Transmission Risk

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Heidemarie Kremer ◽  
Gail Ironson ◽  
Lauren Kaplan ◽  
Rick Stuetzle ◽  
Mary A. Fletcher
Keyword(s):  
Viral Load ◽  
Disease Progression ◽  
Growth Curve ◽  
Free Choice ◽  
Undetectable Viral Load ◽  
Growth Curve Modeling ◽  
Transmission Risk ◽  
Hiv Disease ◽  
Compassionate Love ◽  
Curve Modeling

Objectives. This study examined if compassionate love (CL) predicts HIV disease progression and transmission risk. Scientific study of CL emerged with Underwood’s working model of other-centered CL, defining five criteria: free choice, cognitive understanding, valuing/empowering, openness/receptivity for spirituality, andresponse of the heart.Method. This 10-year cohort study collected 6-monthly interviews/essays on coping with HIV and trauma of 177 people with HIV in South Florida. Secondary qualitative content analysis on other-centered CL inductively added the component of CL towards self. Deductively, we coded the presence of the five criteria of CL and rated the benefit of CL for the recipient on a 6-point Likert scale. Growth-curve modeling (reduced to 4 years due to cohort effects) investigated if CL predicts CD4 slope (HIV disease progression) and cumulative viral load detection (transmission risk).Results. Valuing/empowering and cognitive understanding were the essential criteria for CL to confer long-term benefits. CL had a higher benefit for recipients if given out of free choice. High scores of CL towards self were reciprocal with receiving (93%) and giving (77%) other-centered CL. Conversely, those rated low on CL towards self were least likely to score high on receiving (38%) and giving (49%) other-centered CL. Growth-curve modeling showed that CL towards self predicted 4-year cumulative undetectable viral load (independent from sociocultural differences, substance use disorder, baseline CD4 and viral load). Those high versus low on CL self were 2.25 times more likely to have undetectable viral load at baseline and 1.49 times more likely to maintain undetectable viral load over time. CL towards self predicted CD4 preservation after controlling for differences in CL giving.Conclusions. CL towards self is potentially the seed of being expressive and receptive of CL. Health care professionals prepared to walk the extra mile for those who neglect and isolate themselves may break a vicious circle since those lacking CL self were least likely to receive CL from others. Future studies should examine whether any enhancement of CL towards self may translate into slower disease progression and reduction of transmission risk.

Vestibular-evoked myogenic potential in patients with unilateral vestibular neuritis: abnormal VEMP and its recovery

2003 ◽  
Vol 117 (2) ◽  
pp. 104-108 ◽  
Author(s):  
Kentaro Ochi ◽  
Toru Ohashi ◽  
Shoji Watanabe
Keyword(s):  
Time Course ◽  
Vestibular Nerve ◽  
Vestibular Neuritis ◽  
Nerve Function ◽  
Vestibular Evoked Myogenic Potential ◽  
Caloric Testing ◽  
Myogenic Potential ◽  
Inferior Vestibular Nerve

The incidence of inferior vestibular nerve disorders in patients suffering from unilateral vestibular neuritis and the recovery of these disorders were evaluated by monitoring the vestibular-evoked myogenic potential (VEMP). Eight patients ranged from 21 to 73 years that suffered from unilateral vestibular neuritis underwent VEMP and caloric testing. Abnormal VEMP was observed in two of the eight patients with unilateral vestibular neuritis. Two patients were diagnosed as having an inferior vestibular nerve disorder. One of these patients showed recovery of the inferior vestibular nerve function as assessed by the VEMP. Disorders of the inferior vestibular nerve function and their recovery was confirmed by our current results. The time course of recoveries of the superior and inferior vestibular nerve systems were similar in the two patients.

scholarly journals Treatment of HIV-associated facial lipoatrophy: impact on infection progression assessed by viral load and CD4 count

2013 ◽  
Vol 88 (4) ◽  
pp. 570-577 ◽  
Author(s):  
Flávia Machado Gonçalves Soares ◽  
Izelda Maria Carvalho Costa
Keyword(s):  
Viral Load ◽  
Disease Progression ◽  
Statistical Significance ◽  
Undetectable Viral Load ◽  
Fat Distribution ◽  
Cd4 Count ◽  
Before And After ◽  
Facial Lipoatrophy ◽  
A Prospective Study ◽  
The Impact

BACKGROUND: HIV/AIDS-Associated Lipodystrophy Syndrome includes changes in body fat distribution, with or without metabolic changes. The loss of fat from the face, called facial lipoatrophy, is one of the most stigmatizing signs of the syndrome.OBJECTIVES:To evaluate the effect of FL treatment using polymethylmethacrylate (PMMA) implants on disease progression, assessed by viral load and CD4 cell count.METHODS: This was a prospective study of 44 patients treated from July 2009 to December 2010. Male and female patients, aged over 18 years, with clinically detectable FL and who had never been treated were included in the study. PMMA implantation was done to fill atrophic areas. Laboratory tests were conducted to measure viral load and CD4 count before and after treatment.RESULTS: Of the 44 patients, 72.72% were male and 27.27% female, mean age of 44.38 years. Before treatment, 82% of patients had undetectable viral load, which increased to 88.6% after treatment, but without statistical significance (p = 0.67). CD4 count before treatment ranged from 209 to 1293, averaging 493.97. After treatment, the average increased to 548.61. The increase in CD4 count after treatment was statistically significant with p = 0.02.CONCLUSION: The treatment of FL with PMMA implants showed a statistically significant increase in CD4 count after treatment, revealing the impact of FL treatment on disease progression. Viral load before and after treatment did not vary significantly.

Factors associated with HIV care and treatment cascade in Rio Grande do Sul, Brazil, 2014–2017: A cross-sectional study

2021 ◽  
pp. 095646242097594
Author(s):  
Guilherme B Shimocomaqui ◽  
Craig S Meyer ◽  
Maria L Ikeda ◽  
Elson Romeu Farias ◽  
Tonantzin R Gonçalves ◽  
...  
Keyword(s):  
Viral Load ◽  
Rio Grande ◽  
Undetectable Viral Load ◽  
Cross Sectional Study ◽  
Hiv Care ◽  
Rio Grande Do Sul ◽  
Sectional Study ◽  
Cross Sectional ◽  
Treatment Cascade ◽  
Care And Treatment

In 2018, Rio Grande do Sul (RS) had some of the highest HIV/AIDS rates in Brazil, and we did not find any studies about the HIV care and treatment cascade (HCTC) related to this state. We aimed to estimate the indicators of HCTC of RS, Brazil, and associated factors. A cross-sectional study with all people living with HIV (PLWH) in RS between 1 January 2014 and 31 December 2017 was conducted using a national database which registers all HIV notifications, CD4 and viral load laboratory data and antiretroviral therapy (ART) usage in the public health system. We considered sex, age, education, race, year of HIV diagnosis, and health region as predictor factors, and defined linkage to care, retention to care, being on ART, and having undetectable viral load as the HCTC indicators. Descriptive analysis and multivariable logistic regression were performed using Stata 15.2. A total of 116,121 PLWH were diagnosed, 79,959 were linked to care, 72,117 retained in care, 69,219 on ART, and 54,857 had undetectable viral load from 2014 to 2017. We observed greatest attrition for younger age, non-white, and lower education in all HCTC indicators. Women are more likely to have undetectable viral load (OR = 1.04, 95% CI: 1.01–1.07), even though they are less likely to be retained to care (OR = 0.92; 95% CI: 0.89–0.96) and on ART (OR = 0.82; 95% CI: 0.78–0.86). Although all HCTC indicators have increased over the period and the “test and treat” policy indicates improvements in ART and in undetectable viral load outcomes, evidence suggests specific attrition and disparities such as those related to HIV healthcare facilities should be addressed. These findings may be used by researchers, health professionals, and policymakers in order to investigate and implement interventions to better engage PLWH across the HCTC.

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