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RESULTS: We found 45 articles, 15 of these made up the study by fitting either the inclusion factors. CONCLUSION: VEMP may be useful as hearing recovery predictor in patients with sudden sensorineural hearing loss, justifying the implementation of such examination in this population. Sudden sensorineural hearing loss or sudden deafness is characterized as a hearing loss of abrupt onset, usually unilateral, with no known cause. It's an emergency in otology and affects mainly the fourth decade of life and affects 5 to 20 people out of 100 thousand individuals per year and it is estimated that there are about 4000 new cases per year in the United States and 15,000 worldwide, with equal distribution in relation to gender4-6. They are hypotheses to explain the etiology of sudden deafness as the vascular hypothesis, viral hypothesis, the autoimmune hypothesis and the membrane rupture hypothesis.
The Vestibular Evoked Myogenic Potential is an electrophysiological test that evaluates the goal via spinal hall. The history of this examination is relatively recent as though their first date back to 1964 reports, only in 1994 were published the first studies suggesting clinical application for Evoked Myogenic. For review of the vestibular pathway that cannot be analyzed by the other entrance exams, the exam has been gaining attention in the labial battery evaluation.
The aim of this study was to investigate the clinical applicability of Vestibular Evoked Myogenic Potentials in patients with sudden sensorineural hearing loss. This is a systematic review that followed the precepts of the Cochrane Handbook11 as the formulation of the question, location, selection and critical evaluation of the articles. Using the extracted descriptors of Medical Subject Headings (MeSH), was established the following advanced search strategy in PubMed, 'vestibular evoked myogenic potentials' associated by the Boolean operator AND to 'hearing loss, sudden'. In the LILACS and SciELO database, we used the indexed descriptors Descriptors in Health Sciences (MeSH), according to the following strategy: Perda auditiva subita AND Potenciais evocados.
It was considered as inclusion criteria articles in English, Portuguese or Spanish, published in the last two decades that associate sudden sensorineural hearing loss and vestibular evoked myogenic potentials. Abstracts of pre-selected articles were assessed by two reviewers, were selected for analysis those correlated descriptors. Data were tabulated covering the following information: authors, place and year of publication, sample size (n), objectives and type of study (Table 1). The 45 articles found, 11 were excluded due to language, to be present at duplicate or not correlate the descriptors. About the type of study 53% were prospective, 6 longitudinal studies10,12-16 and two transverse17,18, 33% were restrospectives19-23, 7% case study24 and 7% Bayesian cure rate model25.
The objective of 60% of the studies was to determine whether the Vestibular Evoked Myogenic Potential (VEMP) can be used as a predictor of hearing recovery in patients with PANSS10,12-16,19,20,23. Among the studies that have investigated the use of objective tests in the management of patients with PANSS some noteworthy. Study conducted in Japan, with 22 patients with PANSS and single episode of vertigo, revealed that 77% and 45% showed VEMP and caloric test changed, respectively.
Prognostic factors of patients with PANSS and worse hearing threshold than 70 dB, and its relationship with hearing and vestibular tests were investigated. Trying to minimize the uncertainties surrounding the hearing recovery of patients with sudden sensorineural hearing loss was developed a predictive model of evolution by reference audiological tests (audiometry, DPOAE, VEMP and ABR) and other variables considered as prognostic factors.
Many studies have sought to elucidate whether the Vestibular Evoked Myogenic Potential can be a useful predictor of hearing recovery in patients with sudden sensorineural hearing loss, which is a positive relationship in most of them, justifying the implementation of such examination in this population. Paper submitted to the ITJ-SGP (Publishing Management System) on December 21, 2014; and accepted on March 19, 2015. Items displaying this symbol are blind accessible.These items can be used without sighted assistance. International Shipping - items may be subject to customs processing depending on the item's declared value.
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Will usually ship within 3 business days of receiving cleared payment - opens in a new window or tab. For Status of cannabis ("marijuana") in the region - whether for the medical benefits, the purposes of industrial hemp, or in general - see below. Puerto Rico (Spanish for "rich port") comprises an archipelago that includes the main island of Puerto Rico and a number of smaller islands, the largest of which are Vieques, Culebra, and Mona.

Originally populated for centuries by indigenous aboriginal peoples known as Tainos, the island was claimed by Christopher Columbus for Spain during his second voyage to the Americas on November 19, 1493.
The relationship between Puerto Rico and the United States dates back to the Spanish-American War, in which Spain, under the terms of the Treaty of Paris of 1898, ceded the island to the United States.
Marijuana is in Schedule IV of the Single Convention on Narcotic Drugs, making it subject to special restrictions. A Party shall, if in its opinion the prevailing conditions in its country render it the most appropriate means of protecting the public health and welfare, prohibit the production, manufacture, export and import of, trade in, possession or use of any such drug except for amounts which may be necessary for medical and scientific research only, including clinical trials therewith to be conducted under or subject to the direct supervision and control of the Party.
This provision, while apparently providing for the limitation of marijuana to research purposes only, also seems to allow some latitude for nations to make their own judgments.
The medical use of marijuana is surrounded by a cloud of social, political, and religious controversy, which obscures the facts that should be considered in the debate. Since marijuana is largely a folk medicine, not generally recognized by the medical establishment, the people who know most about it are those who use it on their own. This leaflet [link] is published by Health Canada for patients who have been authorized by Health Canada to possess dried marihuana. Cannabis's accepted medical use in the United States is increasingly recognized by health care professionals and the medical community, including the Institute of Medicine. The ICRS is a non-political and non-religious organization dedicated to scientific research in all fields of the cannabinoids, ranging from biochemical, chemical and physiological studies of the endogenous cannabinoid system to studies of the abuse potential of recreational cannabis. In addition to acting as a source for impartial information on cannabis and the cannabinoids, the main role of the ICRS is to provide an open forum for researchers to meet and discuss their results. Vestibular evoked myogenic potential (VEMP) estimates of the vestibular pathway that can not be analyzed by the other entrance examinations, which can be helpful in diagnosing the extent of hearing damage in these patients.
However, the current trend is to consider the sudden hearing loss as a disease of multifactorial etiology1.
The eliciting stimulus can be audible (click) or galvanic, activating the saccular macula and triggering the reflex pathway lowest labial nerve, lateral vestibular nucleus, spinal tract hall and finally ipsilateral motor neuron, being picked up by surface electrodes arranged on the sternocleidomastoid muscle7,8. Despite this, few studies have been published focusing on the Vestibular Evoked Myogenic Potential in inner ear disorders such as sudden deafness10. Of these, 67% found a positive relationship between the presence of VEMP and the degree of hearing recovery10,13,15,19,20,23. The authors suggest that the sacculus is most often struck in the case of the PANSS the horizontal semicircular canal function and its afferent. VEMP and ABR were positively correlated with a better prognosis, reaching 64% of full recovery in patients with hearing severe hearing loss20. The authors conclude that this is a useful method, however, point out that should only be used if the therapy used is the same adopted in the study25. Among patients with recurrent ipsilaterally PANSS, all had normal VEMP and had hearing recovery. Professor e Orientador do Programa de Pos Graduacao em Ciencias da Saude da Universidade de Brasilia (UnB-DF). Fonoaudiologa do Governo do Distrito Federal (GDF), Mestre em Ciencias da Saude (UnB-DF) e Doutoranda em Ciencias da Saude (UnB-DF). Contact the seller- opens in a new window or tab and request a shipping method to your location. If an item is misrepresented in this listing, please contact me within 5 days after receiving this item.
Under Spanish rule, the island was colonized and the indigenous population was forced into slavery and nearly wiped out due to, among other things, European infectious diseases. The official Commentary on the Single Convention indicates that Parties are expected to make that judgment in good faith.
It is a scientific society advocating the improvement of the legal situation for the use of the hemp plant (Cannabis sativa L.) and its pharmacologically most important active compounds, the cannabinoids, for therapeutic applications through promotion of research and dissemination of information. The purpose of our website is to gain access to that body of knowledge so that we can share it with potential patients and physicians.
This brochure is intended to help doctors, patients and policymakers better understand how marijuana—or "cannabis" as it is more properly called—may be used as a treatment for people with serious medical conditions.
They support the rights of patients to have a legal and safe access to the therapeutic use of cannabis. Currently its route and method are well defined and the latter studies devoted to clinical applications9.
Of these, 15 articles were included in the study by fitting either the inclusion factors (Table 2).

Others studies despite having different objectives pointed VEMP as helpful tool in the management of patients with sudden sensorineural hearing loss17,18,21,22,25. They add that the creation of the VEMP associated with caloric test is useful in the evaluation of these patients as they relate to the degree of hearing recovery23.
Since patients with contralateral applicant PANSS, 80% had altered VEMP, showing no hearing recovery after treatment. Ocular vestibular evoked myogenic potentials induced by bone-conducted vibration in patients with unilateral inner ear disease. Subjective visual vertical perception in patients with vestibular neuritis and sudden sensorineural hearing loss. Distortion product otoacoustic emissions as a prognostic factor for idiopathic sudden sensorineural hearing loss.
Saccular damage in patients with idiopathic sudden sensorineural hearing loss without vertigo.
Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging in sudden sensorineural hearing loss: correlations with audiologic and vestibular testing. Correlation between audiovestibular function tests and hearing outcomes in severe to profound sudden sensorineural hearing loss. Difference in the nature of dizziness between vestibular neuritis and sudden sensorineural hearing loss with vertigo. Abnormal vestibular evoked myogenic potentials in the presence of normal caloric responses. Extent of lesions in idiopathic sudden hearing loss with vertigo: study using click and galvanic vestibular evoked myogenic potentials. If you reside in an EU member state besides UK, import VAT on this purchase is not recoverable. Even though there are no refund with this item, but if it is misrepresented, I will issue a refund within 48 hours. However, it ranks third in population amongst that group of four islands, which also include Cuba, Hispaniola (Dominican Republic and Haiti), and Jamaica. A new medical journal released in 2001 focuses on the medicinal use of cannabis and cannabinoids. The mission of their organization, a 501 (c) 3 non-profit, is the education of health care professionals and the public about the therapeutic use of cannabis. It was concluded that VEMP can be used as a prognostic factor in recurrent PANSS in order that their presence would indicate a high probability of hearing recovery19. Due to its location, Puerto Rico enjoys a tropical climate and also experiences the Atlantic hurricane season. Spain possessed Puerto Rico for over 400 years, despite attempts at capture of the island by the French, Dutch, and British. National clinical conferences on the medicinal use of cannabis have been held in the United States in 2000 and 2002 and are scheduled to continue on a biennial basis. Their leadership is composed of medical and nursing professionals with expertise in the clinical applications of cannabis and five of the seven patients (two wish to remain anonymous) who receive their medical cannabis from the US government.
The Spanish Crown, in an attempt to keep Puerto Rico from gaining its independence, revived the Royal Decree of Graces of 1815. Most importantly, data on the number of physicians currently recommending therapeutic marijuana use to their patients demonstrate its acceptance by the medical community in the United States.
Patients Out of Time is the only national non-profit in the United States that focuses only on therapeutic cannabis issues. The decree was printed in three languages — Spanish, English and French — and it fostered the immigration of hundreds of non-Spanish European families.
The island's current political status, including the possibility of statehood or independence, is widely debated in Puerto Rico. A referendum on statehood, independence, or continuance of the status quo will be held on November 6, 2012.

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