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Common cause of peripheral vertigo/dizziness.
Source publication
Vestibular disorders may generate complex signs and symptoms, which may alter pa-tients' balance and the quality of life. Dizziness and vertigo can strongly affect daily activities and relations. Despite the presence of conventional drugs, maneuvers, and surgery, another interesting therapeutic opportunity is offered by nutraceuticals. These molecu...
Contexts in source publication
Context 1
... affects approximately 20-30% of the general population [8]. The most common causes of peripheral vertigo/dizziness are benign paroxysmal positional vertigo (BPPV), vestibular neuritis (or acute unilateral peripheral vestibulopathy), Ménière's disease (MD), and bilateral vestibulopathy (BV) [7,9] (Table 1). Vertigo, nausea, light headiness. ...Context 2
... 17,18] MD is characterized by hearing loss (sensorineural, in the low and middle frequencies), vertigo attacks, tinnitus, and aural fullness (Table 1). [9,[17][18][19]. ...Context 3
... neuritis (acute unilateral peripheral vestibulopathy) is characterized by nystagmus, posture alteration, or gait abnormalities (Table 1). Vestibular suppressants and antiemetics are very useful, whereas steroids, despite the absence of solid evidence, can have a certain effect [7,9,10]. ...Context 4
... paroxysmal positional vertigo affects the inner ear and causes frequent and sudden attacks of positional vertigo (Table 1). Risk factors include advanced age, ear and dental surgery, vitamin D deficiency, menopause, and vascular disorders [11][12][13][14]. ...Context 5
... vestibulopathy is characterized by postural imbalance and unsteadiness of gait, both of which worsen in darkness and on uneven ground. Head or body movementinduced oscillopsia is also present in some patients, in particular during walking, which engenders head movements with high frequency spectral content, particularly during each heel strike (Table 1) [7,25,26]. ...Citations
... Several investigations have suggested the impact of omega-3 therapeutic interventions on both peripheral and central components of the auditory system through animal [28][29][30][31][32][33][34][35][36][37][38][39][40] and human studies [21,[41][42][43][44][45][46][47]. However, limited studies have been conducted on the potential influence of omega-3 FAs on the vestibular system and balance [48][49][50][51][52]. A comprehensive review study has yet to be undertaken in this area. ...
... Meniere's disease [49,50] High abundance of FRR2 receptor in vestibular nuclei and cerebellum Potential mediator of DHA/RvD1 activity in balance control Future research focus [52] Animal studies (perinatal) Supplementation with DHA/EPA (omega-3 1 g/kg body weight with 27%DHA and 53% EPA formula) improves balance and motor coordination While determining the optimal effective dose remains crucial to avoid potential adverse effects [21, 34, 35, 41, 43, 60-62, 64, 93-95], emerging evidence from both human and animal studies illuminates the therapeutic potential of omega-3, suggesting its ability to not only improve postnatal auditory neural impairment [28,38] but also protect against age-related hearing loss [31,36,41,42,77]. ...
Purpose
The purpose of this study was to comprehensively review animal and human studies that explore the role of omega-3 PUFAs in maintaining the health of the auditory organ across all life stages.
Methods
This narrative review involved searching Scopus, PubMed, Google Scholar, and Cochrane Library databases for relevant articles from December 1980 to July 2023.
Results
some animal and human studies suggest that both deficiency and excessive intake of long-chain omega-3 PUFAs, particularly docosahexaenoic acid (DHA), can lead to auditory neural conduction impairment and reduced hearing acuity from fetal development to old age (presbycusis). These effects are likely to be dependent on the dosage. Some research indicates that an excessive intake of omega-3, rather than a deficiency, can result in nutritional toxicity and hearing impairments. Animal studies highlight the positive impact of omega-3 supplements with high DHA content in addressing hearing damage, but human research on this subject is limited. Furthermore, certain studies propose that omega-3 PUFAs may prevent or delay age-related hearing loss, with high plasma omega-3 concentration, particularly long-chain omega-3 PUFA, linked to reduced hearing loss. Additionally, consuming fish more than twice a week may be associated with a lower risk of hearing loss in adulthood, with these effects potentially influenced by age and gender. However, the majority of studies have been conducted on animals, and clinical trials are scarce. Research on the influence of omega-3 PUFAs on the peripheral and central vestibular systems remains limited.
Conclusion
This article delves into the impact of omega-3 on the auditory-vestibular system, exploring its influence on neurodevelopment, protection, and treatment. It not only highlights specific research gaps but also offers valuable insights for potential future studies.
... The antiemetic power of ginger, on the other hand, has been known since antiquity. The last component is ViNitrox, a synergistic combination of apple and grape polyphenols that has been demonstrated to have a remarkable vasodilator effect through endothelial nitric oxide synthase (NOS) and antioxidant activity [62]. The combination seems effective in at least partially restoring the microvascular impairment in these patients and also improving cognitive function. ...
Benign paroxysmal positional vertigo (BPPV) represents the most frequent cause of peripheral vertigo. In most cases, it is successfully treated using the canalith repositioning procedure, but it is often followed by continuous lightheadedness in the absence of vertigo or nystagmus (residual dizziness, RD). Our aim is to describe the clinical effectiveness and the urine metabolomics profile of treating these patients with polyphenol compound supplementation. We enrolled 30 patients reporting RD after BPPV of the posterior semicircular canal (PSC) successfully treated using the Semont maneuver. Supplementation with a polyphenol compound was administered for 60 days, and patients were evaluated after 30 and 60 days of treatment using self-administered questionnaires (Visual Analog Scales for Dizziness and Nausea, Dizziness Handicap Inventory, DHI) and urine metabolomics analysis performed using 1H-NMR spectroscopy and multivariate followed by univariate analysis. Most patients reported excellent or good efficacy in the treatment of RD with a significant decrease in VAS and DHI values. The metabolomics analysis identified six significant metabolites related to the treatment, namely 1-methylnicotinamide, anserine, hippurate, lysine, methyl succinate and urea, indicating the inflammatory activities and antioxidant properties of the polyphenol compound. These preliminary data suggest that supplementation with a polyphenol compound could induce some metabolic changes that can help in recovery from RD. However, future steps will require confirmation with a more significant cohort of patients and an extension of the metabolomics evaluation to other problems concerning the different clinical aspects of BPPV, such as the high rate of relapse.
... Eliminating caffeine, chocolate, and alcohol may reduce symptoms; hence, the need to avoid or limit them in their diet. Not smoking and reducing stress also may help lessen the symptoms [64]. SPC (special processed cereals, in flakes) show a significant reduction in vertigo spells and a positive effect on tinnitus severity [65]. ...
Food, not nutrients, is the fundamental unit in nutrition, and edible mushrooms are fungi that supply unique biological bioactive compounds, different from plant or animal origin, which significantly impact human health status. However, to date all these concepts are interpreted in different ways, with rapidly increasing knowledge on nutrition, medicine, molecular biology, and plant biotechnology changing the concepts of food, health, and agriculture. The bioactive elements conveyed by foodstuffs as nutrients or non-nutrients interfere with human metabolism and have influence on health, aging, and well-being. The influence of edible mushrooms on medicinal interventions has been known and studied for many years and their latest role in neurodegenerative disorders has been recently investigated, while their significance on many other diseases has been well demonstrated. Despite considerable research, the etiology and pathogenesis of Ménière’s disease remains controversial and undefined, although usually associated with allergic, genetic, or trauma sources, and with viral infections and/or immune system-mediated mechanisms. With treatment still unknown, our attention is towards the eventual impact of complementary dietary interventions, synthesizing the recent knowledge of some edible mushrooms and preparations on Ménière’s disease, which is a lifelong condition that can develop at any age, but most commonly emerges between 40 and 60 years of age. It is demonstrated that the oral administration of a biomass preparation, with 3 g/day of the mushroom Coriolus versicolor for 2 to 6 months, on some 40 human Ménière’s disease patients reduced systemic oxidative stress and cellular stress response, decreased the number of crises and their duration, and the frequency of symptoms, improving the clinical grading of tinnitus severity.
... Patients with comorbidity showed an increase in polytherapy with an increased risk of drug Salicylates and other less used NSAIDs (e.g., phenylbutazone) may displace phenytoin from plasma proteins. Aspirin may obstruct valproic acid metabolism, and salicylates act also on valproic acid binding sites, resulting in higher concentration 110 Aspirin and other NSAID association Risk for aspirin reduced effect 111 Antihypertensive drugs due to kidney damage and inhibition of natriuretic response to diuretic, impaired synthesis of prostaglandins, sodium and water retention, suppression of plasma renin activity 112,113 Increase of blood pressure levels; minor interactions are described with calcium antagonists 109 Anticoagulants, antiaggregant drugs, corticosteroids, SSRIs, and even nutraceuticals/supplements like Ginkgo Biloba [114][115][116] Increase of hemorrhagic risk. Warfarin may be released form albumin after NSAID coadministration. ...
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for the management of fever, pain, and inflammation. However, they have always been considered to have a double-faced role, according to their capacity to manage inflammation but also their possible reduction of immune system response and diagnosis delay. This last point could favor a dramatic increase of viral infection diffusion, possibly leading to a more severe outcome. The advent of severe acute respiratory syndrome coronavirus 2 excluded the use of NSAIDs, particularly ibuprofen, and then indicated this drug as the better NSAID to manage infected outpatients and prevent complications. Several authors described the role of NSAIDs and ibuprofen in preventing cytokine storm and modulating the immune system. However, the development of both adverse drug reactions (i.e., gastrointestinal, renal, hepatic, and cardiovascular) and drug interaction recalled the necessity of prescribing the better NSAID for each patient. In this narrative review, we describe the role of NSAIDs, particularly of ibuprofen, in the management of viral symptoms, suggesting that the NSAID may be chosen considering the characteristics of the patient, the comorbidity, and the polytherapy.
... Anticoagulants, antiaggregant drugs, corticosteroids, SSRIs, and even nutraceuticals/supplements such as Ginkgo Biloba [57][58][59] Increase in hemorrhagic risk. Warfarin may be released from albumin after NSAID coadministration. ...
... The PubMed, Embase, and Cochrane library databases were searched for articles published until 10 January 2023, in agreement with our recent papers [55,57,[85][86][87][88]. The secondary search included articles cited in the reference lists of papers identified with the primary search. ...
In agreement with the International Association for the Study of Pain, chronic pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. To date, there are several types of pain: nociceptive, neuropathic, and nociplastic. In the present narrative review, we evaluated the characteristics of the drugs used for each type of pain, according to guidelines, and their effects in people with comorbidity to reduce the development of severe adverse events.
... The PubMed, Embase, and Cochrane library databases were searched for articles published until 10 December in agreement with our recent papers [23][24][25][26][27]. The secondary search included articles cited in the reference lists of papers identified by the primary search. ...
Matrix metalloproteinases (MMPs) are a large family of zinc-dependent proteolytic enzymes associated with extracellular matrix protein turnover and tissue degradation. They participate to many different physiological reactions but are also hyperactivated in several diseases. Various literature studies have documented that MMPs play a role in the modulation of neuropathic and nociceptive pain. The heterogeneity of clinical and pre-clinical data is an important issue in this experimental context. Despite the presence of a good number of studies on MMP inhibitors, these drugs showed scarce efficacy and relevant side effects. In the present manuscript, we reviewed studies in the literature that define a possible role of MMPs in pain and the effects of their modulation.
... Now-a-days various probiotic products are available in market. They are containing adequate amount of probiotic cultures which cure them against pathogens therefore a variety of diseases related to human body can be treated (Chiarella, 2021). ...
Various waste products from different fields like industrial, agricultural, household, sewage and other fields are increasing in high amounts in large bulk every day. Today, most countries consider organic edible molecules to be useful as dietary supplements. Bacterial isolates from different wastes have the capacity for the production of nutraceutical. They can be useful as a functional food to the consumer, helpful in lifetime surveillance of human health. Because of multiple benefits, zestful action, and popularity of nutraceutical organic molecules in different fields of medical and dietitians worldwide are using this product in large bulk. A variety of extraction methods are also available for the extraction of secondary metabolites and vitamins. A lack of nutrients can also cause cancer, heart disease, diabetes, osteoporosis, acne, macular degeneration, cataracts, insomnia, digestive upsets, constipation, and osteoporosis to develop. Nutraceuticals also prevent cancer, heart disease, and other diseases. Fungal metabolites are useful in aging-associated non-transmissible chronic disease (NTCD) like neurodegenerative disorders have been dared through several approaches including consumption of healthy food and the rational drug discovery for subsisting diseases. Macro fungal species are also useful for their ability production of dietary fiber sugars as food supplements. The current study is useful for the study of versatile uses of macrofungi species in different fields. 226 Biomolecules of Fungi
... VN has recently been related to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, but this association is still uncertain and definitive evidence is lacking (8)(9)(10). Other supposed etiologies include vascular, immunologic, and inflammatory (11,12). Stroke affects the brain circle, resulting in the death of neurons, according to oxygen and nutrients deprivation (13). ...
... Vestibular rehabilitation has an important role in patient with longterm symptoms and seems to be comparable to corticosteroids in the main early outcomes (11,33,39). Nutraceuticals, including Ginkgo biloba, Salvia officinalis, Melissa officinalis, and Zingiber officinalis, may improve patient's conditions with a low amount of side effects (12). We previously treated these drugs' mechanism of actions, interactions, and side effects in a narrative review (35). ...
... An interesting therapeutic opportunity is also offered by nutraceuticals, especially in the intercritical phases of the disease or in the recovery of residual imbalance in some subjects. These are safe and effective compounds that can be administered without associated drugs or in combination to decrease their dosage (12,141). The prognosis in patients with VN is generally good, but residual dizziness may remain in some patients after the acute phase, similar to persistent disabling imbalance after successful repositioning maneuvers for BPPV. ...
Acute vestibular syndrome (AVS) represents a clinical picture that involves urgent management due to the important procession of symptoms accompanying the event, which can be positively or negatively influenced by therapeutic choices and intervention timing. This forces a differential diagnosis and therapeutic choices to be made in conditions that are not always favorable and often not in the specialist field. In this work, we will examine in detail the pharmacological therapeutic possibilities, correlating them to the differential and, as far as possible, to the etiological diagnosis. In particular, the pharmacological possibilities for the two main conditions we can face will be investigated, namely, vestibular neuritis and posterior circulation stroke.
... However, some patients recover later than others and some of these still present symptoms after 1 and 2 months. [32][33][34] Conclusions BPPV is the most frequent pathology of the posterior labyrinth and only rarely affects AC, with an incidence between 2 and 3% of cases in the various series. Although some forms of AC-BPPV may be the consequence of the migration of otolithic debris from other canals after physical maneuvers, in some cases AC involvement appears to be primitive. ...
... Several works show that legislation on telemedicine activity is lacking if not completely absent in many cases [24]. The Italian Ministry of Health underlined the importance of the use of telemedicine at national level to frame the guidelines, and during the COVID-19 pandemic, more than ever, a very fragmented picture appeared [45]. In the absence of direct physical interaction, it can be difficult for doctors, through telecommunication tools, to verify the identity of patients (especially new patients) and establish a solid doctor -patient relationship based on trust and respect. ...
... On the subject of informed consent in Italy, the reference legislation is provided by the Law, n. 219/2017 [45], although the MCHK guidelines do not foresee specific written consent. For the visit in telemedicine, it was established that all necessary information related to telemedicine must be fully explained to the patient in a clear and understandable way, in order to obtain free and informed consent. ...
... In accordance with the aforementioned legislation, informed consent must be written or provided through audio-video recordings and must be inserted in each medical record. Obtaining informed consent is also a prerequisite for treatment provided by telemedicine [45]. In this regard, it should be mentioned that the Italian Society of Ophthalmology developed a customized informed consent statement. ...
Background:
The digital revolution is redesigning the healthcare model, and telemedicine offers a good example of the best cost-effectiveness ratio. The COVID-19 pandemic has catalysed the use of the telemedicine. The aim of this review is to describe and discuss the role and the main applications of telemedicine in the ophthalmic clinical practice as well as the related medico-legal aspects.
Methods:
45 original articles and 5 reviews focused on this topic and published in English language from 1997 and 2021 were searched on the online databases of Pubmed, Scopus, Web of Sciences and Embase, by using the following key words: "telemedicine", "privacy", "ophthalmology", "COVID-19" and "informed consent".
Results:
Telemedicine is able to guarantee patient care using information and communication technologies. Technology creates an opportunity to link doctors with the aim of assessing clinical cases and maintaining high standards of care while performing and saving time as well. Ophthalmology is one of the fields in which telemedicine is most commonly used for patient management.
Conclusions:
Telemedicine offers benefits to patients in terms of saving time and costs and avoiding physical contact; however, it is necessary to point out significant limitations such as the absence of physical examinations, the possibility of transmission failure and potential violations of privacy and confidentiality.
