Clinical Predictors of Streptomycin-Vestibulotoxicity.
Identifieur interne : 000134 ( Main/Exploration ); précédent : 000133; suivant : 000135Clinical Predictors of Streptomycin-Vestibulotoxicity.
Auteurs : Miraj Ahmed [Inde] ; Anupam Mishra [Inde] ; Kamal Kumar Sawlani [Inde] ; Veerendra Verma [Inde] ; Rajiv Garg [Inde] ; Hitendra Prakash Singh [Inde] ; Sunil Kumar [Inde]Source :
- Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India [ 2231-3796 ] ; 2016.
Abstract
The Global tuberculosis control is challenged with a growing resistance to antitubercular treatment (ATT) culminating in resistant (MDR/XDR) strains; an important factor being premature withdrawal of streptomycin owing to its morbidity particularly nephrotoxicity and cochleotoxicity as guidelines for their prevention exist. An attempt is made here to address the least recognized and most debilitating vestibular toxic effects of streptomycin and defining a vestibular-protocol for its early detection and progression. Thirty two prospective patients (treatment-failures, relapse and default cases) undergoing ATT (24 shots of IM streptomycin 15-20 mg/kg over 8 weeks) underwent complete vestibular workup including vestibulo-ocular and vestibulo-spinal reflex assessment with an attempt to closely follow them. Four categories (I: No-, II: Occult-, III: Delayed-Manifest- and IV: Manifest-vestibulotoxicity) were defined. The DHI and casual gait abnormality clearly differentiated III/IV from I/II. The occilopsia and head thrust tests significantly differentiated II from I. Rotation and bithermal calorics significantly differentiated I from II and II from III/IV. The Fukuda, Rhomberg, Tandem-Rhomberg and CTSIB were significant in differentiating I from II and II from III/IV. Dix-Hallpike and Positional tests were of no significance in the entire study. The Occilopsia and Head-Thrust tests that showed 100 % positivity for II to IV are more likely to better predict 'manifest' or 'occult' -vestibulotoxicity while DHI and casual gait assessment may be carried out by a paramedic at a peripheral center to suspect vestibulotoxicity. Since we found absolute compliance with our series we feel that vestibulotoxicity may not be a deciding factor for termination of streptomycin provided an in-built mechanism for patient support/counseling be incorporated in management schedule.
DOI: 10.1007/s12070-015-0949-x
PubMed: 27508140
PubMed Central: PMC4961644
Affiliations:
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Otolaryngology and Head and Neck Surgery, King George Medical University, Shahmeena Road, Lucknow, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Departments of Otolaryngology and Head and Neck Surgery, King George Medical University, Shahmeena Road, Lucknow</wicri:regionArea><wicri:noRegion>Lucknow</wicri:noRegion></affiliation></author><author><name sortKey="Mishra, Anupam" sort="Mishra, Anupam" uniqKey="Mishra A" first="Anupam" last="Mishra">Anupam Mishra</name><affiliation wicri:level="1"><nlm:affiliation>Departments of Otolaryngology and Head and Neck Surgery, King George Medical University, Shahmeena Road, Lucknow, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Departments of Otolaryngology and Head and Neck Surgery, King George Medical University, Shahmeena Road, Lucknow</wicri:regionArea><wicri:noRegion>Lucknow</wicri:noRegion></affiliation></author><author><name sortKey="Sawlani, Kamal Kumar" sort="Sawlani, Kamal Kumar" uniqKey="Sawlani K" first="Kamal Kumar" last="Sawlani">Kamal Kumar Sawlani</name><affiliation wicri:level="1"><nlm:affiliation>Departments of Internal Medicine, King George Medical University, Lucknow, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Departments of Internal Medicine, King George Medical University, Lucknow</wicri:regionArea><wicri:noRegion>Lucknow</wicri:noRegion></affiliation></author><author><name sortKey="Verma, Veerendra" sort="Verma, Veerendra" uniqKey="Verma V" first="Veerendra" last="Verma">Veerendra Verma</name><affiliation wicri:level="1"><nlm:affiliation>Departments of Otolaryngology and Head and Neck Surgery, King George Medical University, Shahmeena Road, Lucknow, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Departments of Otolaryngology and Head and Neck Surgery, King George Medical University, Shahmeena Road, 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type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The Global tuberculosis control is challenged with a growing resistance to antitubercular treatment (ATT) culminating in resistant (MDR/XDR) strains; an important factor being premature withdrawal of streptomycin owing to its morbidity particularly nephrotoxicity and cochleotoxicity as guidelines for their prevention exist. An attempt is made here to address the least recognized and most debilitating vestibular toxic effects of streptomycin and defining a vestibular-protocol for its early detection and progression. Thirty two prospective patients (treatment-failures, relapse and default cases) undergoing ATT (24 shots of IM streptomycin 15-20 mg/kg over 8 weeks) underwent complete vestibular workup including vestibulo-ocular and vestibulo-spinal reflex assessment with an attempt to closely follow them. Four categories (I: No-, II: Occult-, III: Delayed-Manifest- and IV: Manifest-vestibulotoxicity) were defined. The DHI and casual gait abnormality clearly differentiated III/IV from I/II. The occilopsia and head thrust tests significantly differentiated II from I. Rotation and bithermal calorics significantly differentiated I from II and II from III/IV. The Fukuda, Rhomberg, Tandem-Rhomberg and CTSIB were significant in differentiating I from II and II from III/IV. Dix-Hallpike and Positional tests were of no significance in the entire study. The Occilopsia and Head-Thrust tests that showed 100 % positivity for II to IV are more likely to better predict 'manifest' or 'occult' -vestibulotoxicity while DHI and casual gait assessment may be carried out by a paramedic at a peripheral center to suspect vestibulotoxicity. Since we found absolute compliance with our series we feel that vestibulotoxicity may not be a deciding factor for termination of streptomycin provided an in-built mechanism for patient support/counseling be incorporated in management schedule. </div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">27508140</PMID><DateCompleted><Year>2016</Year><Month>08</Month><Day>10</Day></DateCompleted><DateRevised><Year>2020</Year><Month>10</Month><Day>01</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">2231-3796</ISSN><JournalIssue CitedMedium="Print"><Volume>68</Volume><Issue>3</Issue><PubDate><Year>2016</Year><Month>Sep</Month></PubDate></JournalIssue><Title>Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India</Title><ISOAbbreviation>Indian J Otolaryngol Head Neck Surg</ISOAbbreviation></Journal><ArticleTitle>Clinical Predictors of Streptomycin-Vestibulotoxicity.</ArticleTitle><Pagination><MedlinePgn>359-66</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s12070-015-0949-x</ELocationID><Abstract><AbstractText>The Global tuberculosis control is challenged with a growing resistance to antitubercular treatment (ATT) culminating in resistant (MDR/XDR) strains; an important factor being premature withdrawal of streptomycin owing to its morbidity particularly nephrotoxicity and cochleotoxicity as guidelines for their prevention exist. An attempt is made here to address the least recognized and most debilitating vestibular toxic effects of streptomycin and defining a vestibular-protocol for its early detection and progression. Thirty two prospective patients (treatment-failures, relapse and default cases) undergoing ATT (24 shots of IM streptomycin 15-20 mg/kg over 8 weeks) underwent complete vestibular workup including vestibulo-ocular and vestibulo-spinal reflex assessment with an attempt to closely follow them. Four categories (I: No-, II: Occult-, III: Delayed-Manifest- and IV: Manifest-vestibulotoxicity) were defined. The DHI and casual gait abnormality clearly differentiated III/IV from I/II. The occilopsia and head thrust tests significantly differentiated II from I. Rotation and bithermal calorics significantly differentiated I from II and II from III/IV. The Fukuda, Rhomberg, Tandem-Rhomberg and CTSIB were significant in differentiating I from II and II from III/IV. Dix-Hallpike and Positional tests were of no significance in the entire study. The Occilopsia and Head-Thrust tests that showed 100 % positivity for II to IV are more likely to better predict 'manifest' or 'occult' -vestibulotoxicity while DHI and casual gait assessment may be carried out by a paramedic at a peripheral center to suspect vestibulotoxicity. Since we found absolute compliance with our series we feel that vestibulotoxicity may not be a deciding factor for termination of streptomycin provided an in-built mechanism for patient support/counseling be incorporated in management schedule. </AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ahmed</LastName><ForeName>Miraj</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Departments of Otolaryngology and Head and Neck Surgery, King George Medical University, Shahmeena Road, Lucknow, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mishra</LastName><ForeName>Anupam</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Departments of Otolaryngology and Head and Neck Surgery, King George Medical University, Shahmeena Road, Lucknow, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sawlani</LastName><ForeName>Kamal Kumar</ForeName><Initials>KK</Initials><AffiliationInfo><Affiliation>Departments of Internal Medicine, King George Medical University, Lucknow, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Verma</LastName><ForeName>Veerendra</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Departments of Otolaryngology and Head and Neck Surgery, King George Medical University, Shahmeena Road, Lucknow, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Garg</LastName><ForeName>Rajiv</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Departments of Pulmonary Medicine, King George Medical University, Lucknow, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Singh</LastName><ForeName>Hitendra Prakash</ForeName><Initials>HP</Initials><AffiliationInfo><Affiliation>Departments of Otolaryngology and Head and Neck Surgery, King George Medical University, Shahmeena Road, Lucknow, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kumar</LastName><ForeName>Sunil</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Departments of Otolaryngology and Head and Neck Surgery, King George Medical University, Shahmeena Road, Lucknow, India.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>12</Month><Day>19</Day></ArticleDate></Article><MedlineJournalInfo><Country>India</Country><MedlineTA>Indian J Otolaryngol Head Neck Surg</MedlineTA><NlmUniqueID>9422551</NlmUniqueID><ISSNLinking>2231-3796</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Streptomycin</Keyword><Keyword MajorTopicYN="N">Tuberculosis</Keyword><Keyword 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sortKey="Sawlani, Kamal Kumar" sort="Sawlani, Kamal Kumar" uniqKey="Sawlani K" first="Kamal Kumar" last="Sawlani">Kamal Kumar Sawlani</name><name sortKey="Singh, Hitendra Prakash" sort="Singh, Hitendra Prakash" uniqKey="Singh H" first="Hitendra Prakash" last="Singh">Hitendra Prakash Singh</name><name sortKey="Verma, Veerendra" sort="Verma, Veerendra" uniqKey="Verma V" first="Veerendra" last="Verma">Veerendra Verma</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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