Search

BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is one of the most frequently diagnosed cause of dizziness among older adults. OBJECTIVE: To investigate the prevalence of BPPV and positional symptoms of dizziness and nystagmus among 75-year-olds and to identify factors associated with BPPV and positional dizziness and nystagmus. METHODS: In this cross-sectional population-based study of 75-78-year-olds in Gothenburg, 887 participants were examined with questions regarding dizziness and health and social factors. A total of 681 participants underwent the Dix-Hallpike test or the side-lying test for BPPV using Video Frenzel goggles. RESULTS: In total 32% reported problems with dizziness (n = 887). The prevalence of BPPV was 4% in the unweighted and 4.5% in the weighted analyses, compensating for selective attrition of women and participants with previous positional dizziness. Positional dizziness without nystagmus was found in 2% and nystagmus without dizziness was found in 9%. Individuals with BPPV and positional dizziness experienced more dizziness in everyday life compared with those with normal tests, while those with positional nystagmus did not. CONCLUSIONS: The estimated prevalence of BPPV among 75-year-olds was 4.5%. Despite weighted analyses, the true prevalence may be higher since many participants with dizziness refused testing. Dizziness was associated with fear and discomfort so strong that around 20% of the participants declined testing. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare older adults reporting dizziness to those not reporting dizziness regarding health‐related quality of life (HRQL), distress due to dizziness, and balance confidence. A secondary aim was to investigate potential association between HRQL, number of falls, balance confidence, and distress due to dizziness. Methods: Patients coming for bone density measurements answered questions regarding occurrence of dizziness. Patients reporting dizziness on a daily or weekly basis were considered eligible and invited for investigation at the Ear, Nose and Throat clinic at Södra Älvsborg Hospital, Sweden. Patients not reporting dizziness were considered eligible as controls. All patients answered the Dizziness Handicap Inventory (DHI), Activity Balance Confidence Scale (ABC‐scale), and Euro‐QoL‐5D‐3L questionnaires. Results: A total of 55 dizzy patients came for physical investigation and answered the questionnaires and 47 non‐dizzy participants only answered the questionnaires. The dizzy participants reported lower levels of balance confidence, lower HRQL, more prior falls, and higher levels of distress due to dizziness than the non‐dizzy controls. Lower levels of balance confidence and higher level of distress due to dizziness were each associated with lower HRQL. Conclusion: Dizziness, unsteadiness, and low balance confidence are associated with HRQL in a negative way. This is important to consider when measuring HRQL in a senior population, since a sensation of unsteadiness may indirectly contribute to low HRQL together with other symptoms. Level of evidence: 2b. [ABSTRACT FROM AUTHOR]

The article focuses on understanding the aggressive behavior in dogs which allows for more effective and humane treatment. It states that aggressive behavior in dogs is related to dominance, which is called dominance-related aggression. It notes that aggression starts because of confusion. It is suggested that owners must learn to communicate their intentions to their dogs and must train their dogs to respond to many cues which may increase communication and predictability in the relationship.

The outbreak of SARS-CoV-2 has led to a sharp rise in intensive care unit (ICU) admissions and consequently a need to perform tracheotomies on patients with Covid-19. A number of guidelines have been published with recommendations for the timing of tracheostomy in Covid-19 patients, suggesting tracheotomy should be delayed until day 14-21 of mechanical ventilation.  We present the first 66 patients treated in the ICU at Södra Älvsborg hospital in Sweden as a result of Covid-19. A total of 29 patients received a tracheostomy, median time 9 days post oral intubation, which is earlier than recommended. The mortality rate was 21%, which is slightly lower than reported from The Swedish Intensive Care Registry (25%). None of the doctors performing tracheotomies developed Covid-19 linked to the tracheotomy procedure.