| 1 | A comparative study of two methods for treatment of benign paroxysmal positional vertigo in the emergency department显示文摘Introduction: Posterior canal benign paroxysmal positional vertigo (PC-BPPV) is considered the mostcommon cause of peripheral vertigo in the emergency department (ED). Although the canalith repositioning maneuver (CRM) is the standard of care, the most effective method to deliver it in the ED hasbeen poorly studied.Objective: To compare two protocols of the Epley maneuver for the treatment of PC-BPPV.Patients and methods: We prospectively recruited 101 patients with unilateral PC-BPPV on physical examination, randomizing them to either a single Epley maneuver (EM) (n ¼ 46) or multiple maneuvers(n ¼ 55) on the same visit. Measured outcomes included presence/absence of positional nystagmus,resolution of vertigo, and score on the dizziness handicap inventory (DHI) at follow-up evaluations. TheDHI was stratified into mild ( 30) and moderate-severe (>30).Results: Normalization of the Dix-Hallpike maneuver at day 5 was observed in 38% of the single EMgroup and 44.4% in the multiple EM group (p ¼ 0.62). The DHI showed reduction from 42.2 (SD 18.4) to31.9 (SD 23.7) in the single EM group and from 43.7 (SD 22.9) to 33.5 (SD 21.5) in the multiple EM group(p ¼ 0.06). A higher number of patients improved from moderate-severe to mild DHI (p ¼ 0.03) in thesingle EM group compared to the multi-EM group (p ¼ 0.23).Conclusion: There was no statistically significant difference between performing a single EM versusmultiple EMs for treatment of PC-BPPV in the emergency department. The single EM approach isassociated with shorter physical contact between patients and examiner, which is logically safer in apandemic context. | D.Giardino M.Musazzi M.Perez Akly M.Cherchi D.A.Yacovino | 2021 | Journal of Otology2021，16，4： | 2 |
| 2 | Liver injury and dietary supplements:Does hydroxycitric acid trigger hepatotoxicity?显示文摘Rising rates of obesity has increased the global use of herbal supplements intended to control weight.However,taking these preparations without appropriate medical supervision could increase the risk of manifestation of side effects,especially at the hepatic level.In literature,different cases of acute liver injury consequent to the use of food supplements containing Garcinia cambogia and hydroxycitric acid are reported.This letter aims to review the most recent literature that analysed the herb-induced liver disease due to the use of hydroxycitric acid,from the first alert coming from the European Food and Drug Administration in 2009,to the last recent European food alerts from 2020 to 2021.It is noteworthy that in some cases it demonstrated the relationship between hydroxycitric acid and hepatotoxicity.Therefore,there is a need to draw more attention to the relationship between a safe use and a more awareness in the intake of these supplements,to preserve the safety of the consumers who increasingly purchase food supplements,products that have only nutritive properties and are never curative. | Andrea Zovi Roberto Langella Andrea Nisic Antonio Vitiello Umberto M.Musazzi a | 2022 | Journal of Integrative Medicine2022，20，5： | 0 |
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