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Journal of the American Board of Family... 2012Does untreated cancer equal death? Does having a registered nurse versus a licensed practical nurse versus a medical assistant affect diabetes quality outcomes? Do...
Does untreated cancer equal death? Does having a registered nurse versus a licensed practical nurse versus a medical assistant affect diabetes quality outcomes? Do physicians caring for stressed patients experience vicarious traumatic stress? Oregon presents an operationalized definition of a patient-centered medical home for their state. Lots of important clinical topics in family medicine--adult attention deficit disorder office questionnaire; Bell palsy; cancer screening and treatment decisions; lubrication during Papanicolaou testing; changes in maternity care training by residencies; changing prescribing patterns for thiazide diuretics; and night sweats remain a mystery.
Topics: Comprehensive Health Care; Decision Support Techniques; Family Practice; Humans; Male; Patient-Centered Care; Primary Health Care; Prostatic Neoplasms; United States; Workforce
PubMed: 23136310
DOI: 10.3122/jabfm.2012.06.120249 -
PloS One 2017An association between AS03 adjuvanted pandemic influenza vaccine and the occurrence of Bell's palsy was found in a population based cohort study in Stockholm, Sweden....
BACKGROUND
An association between AS03 adjuvanted pandemic influenza vaccine and the occurrence of Bell's palsy was found in a population based cohort study in Stockholm, Sweden. To evaluate this association in a different population, we conducted a self-controlled case series in a primary health care database, THIN, in the United Kingdom. The aim of this study was to determine whether there was an increased risk of Bell's palsy following vaccination with any influenza vaccine containing A/California/7/2009 (H1N1)-like viral strains. Secondly, we investigated whether risks were different following pandemic influenza A(H1N1)pdm09 vaccines and seasonal influenza vaccines containing the influenza A(H1N1)pdm09 strain.
METHODS
The study population comprised all incident Bell's palsy cases between 1 June 2009 and 30 June 2013 identified in THIN. We determined the relative incidence (RI) of Bell's palsy during the 6 weeks following vaccination with either pandemic or seasonal influenza vaccine. All analyses were adjusted for seasonality and confounding variables.
RESULTS
We found an incidence rate of Bell's palsy of 38.7 per 100,000 person years. Both acute respiratory infection (ARI) consultations and pregnancy were found to be confounders. When adjusted for seasonality, ARI consultations and pregnancies, the RI during the 42 days after vaccination with an influenza vaccine was 0.85 (95% CI: 0.72-1.01). The RI was similar during the 42 days following seasonal vaccine (0.96, 95%CI: 0.82-1.13) or pandemic vaccine (0.73, 95%CI: 0.47-1.12).
CONCLUSION
We found no evidence for an increased incidence of Bell's palsy following seasonal influenza vaccination overall, nor for monovalent pandemic influenza vaccine in 2009.
Topics: Adult; Aged; Bell Palsy; Female; Humans; Influenza A Virus, H1N1 Subtype; Influenza Vaccines; Male; Middle Aged; Sweden
PubMed: 28467420
DOI: 10.1371/journal.pone.0175539 -
Incidence rate, risk factors, and management of Bell's palsy in the Qurayyat region of Saudi Arabia.PeerJ 2022Bell's palsy is an idiopathic facial nerve dysfunction causing temporary paralysis of muscles of facial expression. This study aimed to determine the incidence rate,...
BACKGROUND
Bell's palsy is an idiopathic facial nerve dysfunction causing temporary paralysis of muscles of facial expression. This study aimed to determine the incidence rate, common risk factors, and preferred treatment by the Saudi patients with Bell's palsy.
METHOD
This cross-sectional study was carried out in the Qurayyat region of Saudi Arabia. The retrospective medical records were searched from 2015-2020 of patients diagnosed with Bell's palsy at Qurayyat General Hospital and King Fahad hospital. A 28-item questionnaire was developed by a team of experts and pre-tested among patients with Bell's palsy before being sent to the eligible participants. The data were analyzed using summary statistics, Chi-square test, Fisher exact test and Likelihood ratio test.
RESULTS
We identified 279 cases of Bell's palsy from the medical records of the hospitals from the years 2015 to 2020, accounting for 46.5 cases per year and an incidence rate of 25.7 per 100,000 per year. Out of 279 patients with Bell's palsy, only 171 returned the questionnaire accounting for a response rate of 61.2%. Out of 171 patients with Bell's palsy, females ( = 147, 86.0%) accounted for the majority of cases. The most affected age group among participants with Bell's palsy was 21-30 years ( = 76, 44.4%). There were 153 (89.5%) cases who reported Bell's palsy for the first time. The majority of the participants experienced right-sided facial paralysis ( = 96, 56.1%). Likelihood ratio test revealed significant relationship between exposure to cold air and common cold with age groups ( (6, = 171) = 14.92, = 0.021), (6, = 171) = 16.35, pp = 0.012 respectively. The analyses revealed that participants in the age group of 20-31-years were mostly affected due to exposure to cold air and common cold than the other age groups. The main therapeutic approach preferred was physiotherapy ( = 149, 87.1%), followed by corticosteroids and antivirals medications ( = 61, 35.7%), acupressure ( = 35, 20.5%), traditional Saudi herb medicine ( = 32, 18.7%), cauterization by hot iron rod ( = 23, 13.5%), supplementary therapy ( = 2, 1.2%), facial cosmetic surgery ( = 1, 0.6%) and no treatment ( = 1, 0.6%). The most preferred combined therapy was physiotherapy (87.6%) with corticosteroid and antiviral drugs (35.9%), and acupressure (17.6%).
CONCLUSION
The rate of Bell's palsy was approximately 25.7 per 100,000 per year in the Qurayyat region of Saudi Arabia. Exposure to cold air and common cold were the significant risk factors associated with Bell's palsy. Females were predominantly affected by Bell's palsy in the Qurayyat region of Saudi Arabia. Bell's palsy most commonly occurred in the age group 21-30 years. The most favored treatment was physiotherapy following Bell's palsy.
Topics: Female; Humans; Young Adult; Adult; Bell Palsy; Facial Paralysis; Saudi Arabia; Incidence; Retrospective Studies; Common Cold; Cross-Sectional Studies; Antiviral Agents; Adrenal Cortex Hormones
PubMed: 36221264
DOI: 10.7717/peerj.14076 -
Scientific Reports Mar 2020The aim of this study was to investigate the association of body mass index (BMI), alcohol consumption, and smoking status with the occurrence of Bell's palsy. The...
The aim of this study was to investigate the association of body mass index (BMI), alcohol consumption, and smoking status with the occurrence of Bell's palsy. The Korean National Health Insurance Service-Health Screening Cohort of a ≥ 40-year-old population from 2000-2003 was used. A total of 5,632 Bell's palsy participants were matched with 22,528 control participants in terms of age, sex, income, region of residence, and past medical histories of hypertension, diabetes, and dyslipidemia. Bell's palsy was classified by a history of ≥2 diagnoses with ICD-10 code (G510) and steroid treatment. BMI (kg/m) was classified as <18.5 (underweight), ≥18.5 to <23 (normal), ≥23 to <25 (overweight), ≥25 to <30 (obese I), and ≥30 (obese II). Alcohol consumption was divided into non-drinkers and those who drank 2-3 times a month, 1-2 times a week, and ≥3 times a week. Smoking status was categorized as current smokers, past smokers, and non-smokers. The odds of obesity, alcohol consumption, and smoking with Bell's palsy were analyzed using logistic regression analysis. BMI showed proportionally positive associations with Bell's palsy (adjusted OR [95% CI] = 0.61 [0.47-0.79] for underweight, 1.16 [1.08-1.26] for normal, 1.24 [1.15-1.33] for obese I, and 1.61 [1.38-1.88] for obese II, P < 0.001). The odds of alcohol consumption with Bell's palsy were 0.90 (95% confidence interval [CI] = 0.82-0.99) for 2-3 times a month, 0.77 (95% CI = 0.69-0.85) for 1-2 times a week, and 0.79 (95% CI = 0.71-0.88) for ≥3 times a week compared to nondrinkers (P < 0.001). Smoking did not show a relationship with the occurrence of Bell's palsy. Obesity was related to the risk of Bell's palsy in the population over 40 years old. On the other hand, alcohol consumption was negatively associated with the occurrence of Bell's palsy.
Topics: Adult; Aged; Aged, 80 and over; Alcohol Drinking; Bell Palsy; Body Mass Index; Case-Control Studies; Disease Susceptibility; Female; Humans; Male; Middle Aged; Obesity; Odds Ratio; Public Health Surveillance; Risk Assessment; Risk Factors; Smoking
PubMed: 32144385
DOI: 10.1038/s41598-020-61240-7 -
BMJ Case Reports Jan 2021Here we present the case of a 37-year-old previously healthy man who developed fever, headache and a unilateral, painful neck swelling while working offshore. He had no...
Here we present the case of a 37-year-old previously healthy man who developed fever, headache and a unilateral, painful neck swelling while working offshore. He had no known contact with anyone with COVID-19; however, due to the ongoing pandemic, a nasopharyngeal swab was performed, which was positive for the virus. After transfer to hospital for assessment his condition rapidly deteriorated, requiring admission to intensive care for COVID-19 myocarditis. One week after discharge he re-presented with unilateral facial nerve palsy. Our case highlights an atypical presentation of COVID-19 and the multifaceted clinical course of this still poorly understood disease.
Topics: Adult; Alkalosis, Respiratory; Bell Palsy; Blood Gas Analysis; C-Reactive Protein; COVID-19; Echocardiography; Edema; Electrocardiography; Humans; Hypotension; Lymphadenitis; Magnetic Resonance Imaging; Male; Myocarditis; Natriuretic Peptide, Brain; Neck; Oxygen Inhalation Therapy; Peptide Fragments; Procalcitonin; Recovery of Function; SARS-CoV-2; Troponin T; Vasoconstrictor Agents
PubMed: 33431479
DOI: 10.1136/bcr-2020-240095 -
Acta Neurologica Belgica Dec 2023Although an association between COVID-19 vaccination and Bell's palsy (BP) has been reported, a clear causal relationship has not been elucidated. We investigated the...
BACKGROUND
Although an association between COVID-19 vaccination and Bell's palsy (BP) has been reported, a clear causal relationship has not been elucidated. We investigated the risk and clinical characteristics of BP after COVID-19 vaccination.
METHODS
This retrospective chart review evaluated the association between COVID-19 vaccination and BP by comparing the number of patients diagnosed with BP during the pre-COVID-19 vaccination period (March 2018-February 2021) and the COVID-19 mass vaccination period (March 2021-February 2022). We then compared vaccine-related (time between vaccination and BP onset < 42 days) and -unrelated (time interval ≥ 42 days or non-vaccination) clinical characteristics in newly diagnosed patients with BP.
RESULTS
BP occurred more during the COVID-19 vaccination period than in the previous three pre-vaccination years. Thirteen patients developed BP within 42 days of vaccination. All patients, except one, developed BP after mRNA-based vaccination, with most cases (9/13, 69.2%) occurring after the second or third dose. Thirteen patients with vaccine-related BP were younger (age 43.92 ± 13.14 vs. 54.32 ± 16.01 years; p = 0.033) and more frequently experienced taste changes (58.8% vs. 10.9%; p = 0.002) than 52 patients with vaccine-unrelated BP. Patients with vaccine-related BP had a greater likelihood of good and faster (p = 0.042) facial nerve function recovery than those with vaccine-unrelated BP (100% vs. 78%).
CONCLUSION
COVID-19 vaccines, especially mRNA-based vaccines, may be associated with BP cases with distinctive clinical characteristics, which occur more frequently in young individuals, are frequently accompanied by taste changes, and have fast and good recovery.
Topics: Adult; Humans; Middle Aged; Bell Palsy; COVID-19; COVID-19 Vaccines; Facial Paralysis; Retrospective Studies; RNA, Messenger; Vaccination
PubMed: 36781626
DOI: 10.1007/s13760-023-02204-2 -
Journal of Neurology Oct 2021
Topics: Bell Palsy; COVID-19; COVID-19 Vaccines; Humans; SARS-CoV-2; Vaccination
PubMed: 33611630
DOI: 10.1007/s00415-021-10462-4 -
BMC Neurology Sep 2023Paralysis of the facial nerve (CN VII) is one of the most debilitating issues that any patient can encounter. Bell's palsy is the most commonly seen mononeuropathy....
BACKGROUND
Paralysis of the facial nerve (CN VII) is one of the most debilitating issues that any patient can encounter. Bell's palsy is the most commonly seen mononeuropathy. Although usually self-limited, symptomatology can persist for decades in persistent cases. The non-surgical alternative therapies discussed in this study are successful without reconstruction and are regenerative.
OBJECTIVE AND DESIGN
We sought to determine a safe new treatment could be developed to restore facial nerve function using extracellular vesicles (EVs) in patients who have been unable to return to normal under a variety of conditions. We performed a pilot safety study of 7 patients with idiopathic and secondary facial paralysis to determine if any functional restoration was possible. Each patient had symptomology for varying periods of time, with diverse House-Brackmann scores. They were all treated with the same protocol of extracellular vesicles (EVs) over a 4-week period of time and were evaluated both before and after treatment.
CASE PRESENTATIONS
All patients in this study received treatment by their private physicians prior to entering the study. A record review was completed, with independent physical examinations. House-Brackmann scores and Facial Disability Indices were obtained prior to, and after completing the study. EVs were injected into the area of the main trunk of the facial nerve on the affected side, and an intravenous drip of EVs on visits during weeks 1, 2, and 4.
CONCLUSIONS
All seven patients enrolled in the study improved with this treatment protocol. After the second week of treatment, we saw a progression of independent motion of the affected eyelid, brow motion, and commissure. Although all patients began at different House-Brackman starting points, almost all ended at the same endpoint on the scale over the same period of time - four weeks. No adverse effects were encountered. Clearly, the duration of the treatment protocol needs to be longer than one month. The pathomechanism is still unknown. But it appears that the mechanism is reversible. At last, these patients can have hope.
TRIAL REGISTRATION
The Institute of Regenerative and Cellular Medicine IRB approval number: IRCM-2021-304.
Topics: Humans; Bell Palsy; Facial Paralysis; Facial Nerve; Acupuncture Therapy; Extracellular Vesicles
PubMed: 37770834
DOI: 10.1186/s12883-023-03400-6 -
PloS One 2015Acupuncture has emerged as an alternative therapy for Bell's palsy in both adults and children. However, the use of acupuncture is controversial. We conducted a... (Meta-Analysis)
Meta-Analysis Review
Acupuncture has emerged as an alternative therapy for Bell's palsy in both adults and children. However, the use of acupuncture is controversial. We conducted a systematic review and meta-analysis to assess the efficacy of acupuncture for Bell's palsy. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials, irrespective of any language restrictions. Randomized controlled trials comparing acupuncture with other therapies for Bell's palsy in adults or children were included. Fourteen randomized controlled trials involving 1541 individuals were included in this meta-analysis. Significant association was observed in acupuncture with a higher effective response rate for Bell's palsy (relative risk, 1.14; 95% confidence interval, 1.04-1.25; P = 0.005) but there was a heterogeneity among the studies (I2 = 87%). An assessment of the included studies revealed a high risk of bias in methodological quality. An evaluation of the incidence of complications was not available, owing to incomplete data. Acupuncture seems to be an effective therapy for Bell's palsy, but there was insufficient evidence to support the efficacy and safety of acupuncture. However, the results should be interpreted cautiously, because of the poor quality and heterogeneity of the included studies.
Topics: Acupuncture Therapy; Adolescent; Adult; Aged; Bell Palsy; Child; Humans; Middle Aged; Publication Bias; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 25974022
DOI: 10.1371/journal.pone.0121880 -
European Archives of... Apr 2021The aim of this study was to evaluate the frequency of various otolaryngological symptoms in patients with COVID-19 with regard to age, gender and pneumonia-related...
PURPOSE
The aim of this study was to evaluate the frequency of various otolaryngological symptoms in patients with COVID-19 with regard to age, gender and pneumonia-related thorax CT characteristics.
METHODS
This is a retrospective study conducted between March 25, 2020 and April 25, 2020. The anamnesis and medical files of 155 patients who applied to our outpatient COVID-19 clinic were evaluated. Patients with positive PCR tests for COVID-19 who were aged between 18-72 years were divided into groups according to the presence of otolaryngological symptoms. The differences between the two groups were examined.
RESULTS
Of the 155 patients, 89 (57.4%) had otolaryngological symptoms. The mean age of the patients was 36.3 ± 8.1 years. Ninety-one (58.7%) patients were female, and 64 (42.2%) were male. Fifty-eight (37.4%) patients had received a clinical diagnosis of viral pneumonia with ground glass findings in tomography. The frequency of otolaryngological symptoms was higher in females than males (p: 0.029). The otolaryngological symptoms were also observed to be more frequent in the 18-30 age group (p: 0.013) compared to other age groups.
CONCLUSIONS
Tinnitus, gingivitis, sudden hearing loss, Bell's palsy, and hoarseness can be seen in COVID-19, albeit rarely. Revealing the otolaryngological symptoms of COVID-19, and obtaining more information about the extent of disease will be useful in managing patients and their complaints associated with otolaryngology.
Topics: Adolescent; Adult; Aged; Ageusia; Bell Palsy; COVID-19; COVID-19 Nucleic Acid Testing; COVID-19 Testing; Female; Gingivitis; Hearing Loss, Sudden; Hoarseness; Humans; Male; Middle Aged; Olfaction Disorders; Pandemics; Polymerase Chain Reaction; Retrospective Studies; SARS-CoV-2; Smell; Taste; Tinnitus; Young Adult
PubMed: 32875391
DOI: 10.1007/s00405-020-06319-7