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Telepon: +62 21 4206675.
DAFTAR PUSTAKA
TOPIK 1 (HEMOFILIA)
1.
Corwin, Elizabeth J. 2001. Buku Saku Patofisiologi. Jakarta : Buku Kedokteran EGC
2.
Chuah, M.K. dkk. 2012. Recent Progress in Gene Theraphy for Hemophilia dalam
Pubmed (Online). Tersedia : http://www.ncbi.nlm.nih.gov/pubmed/22671033
(Diakses pada tanggal 15 September 2013).
3.
Gouw, S.C. dkk. 2013. Factor VII products and inhibitor development in severe
hemophilia A dalam Pubmed (Online). Tersedia :
http://www.ncbi.nlm.nih.gov/pubmed/23323899 (Diakses pada tanggal 15 September
2013).
4.
Khani, Francesca & Mikhail Roshal. 2012. A 24-Year-Old Man with Previously
Diagnosed Hemophilia. Tersedia : www.clinchem.org/content/58/7/1086.full.pdf.
(Diakses pada tanggal 15 September 2013).
TOPIK 2 (RUBELLA)
1.
2.
Corwin, Elizabeth J. 2001. Buku Saku Patofisiologi. Jakarta : Buku Kedokteran EGC
3.
Knuf, M. dkk. 2013. Antibody persistence for 3 years following two doses of
tetravalent measles-mumps-rubella-varicella vaccine in healthy children dalam
Ebscohost (Online). Tersedia : http://web.ebscohost.com/ehost/detail?sid=057639de81b7-4aac-8b8958ce017de9c2%40sessionmgr104&vid=1&hid=114&bdata=JnNpdGU9ZWhvc3QtbG
l2ZQ%3d%3d#db=mdc&AN=21935584 (Diakses pada tanggal 15 September 2013).
4.
Plotkin, Stanley A. 2006. The History of Rubella and Rubella Vaccination Leading to
Elimination dalam Oxford Journals (Online). Tesedia :
1.
Cassar, A. dkk. 2009. Chronic coronary artery disease: diagnosis and management
dalam Pubmed (Online). Tersedia : http://www.ncbi.nlm.nih.gov/pubmed/19955250
(Diakses pada tanggal 15 September 2013).
2.
Corrao, M. dkk. 2000. Alcohol and coronary heart disease: a meta-analysis dalam
Pubmed (Online). Tersedia : http://www.ncbi.nlm.nih.gov/pubmed/11070527 (Diakses
pada tanggal 15 September 2013).
3.
4.
TOPIK 4 (SKOLIOSIS)
1.
2.
3.
Corwin, Elizabeth J. 2001. Buku Saku Patofisiologi. Jakarta : Buku Kedokteran EGC
4.
TOPIK 5 (VERTIGO)
1.
Junaidi, Iskandar. 2013. Sakit Kepala, Migrain, & Vertigo. Jakarta : PT Bhuana Ilmu
Populer.
2.
3.
Strupp, M. dkk. 2013. The treatment and natural course of peripheral and central
vertigo dalam Pubmed (Online). Tersedia :
http://www.ncbi.nlm.nih.gov/pubmed/24000301 (Diakses pada tanggal 16 September
2013).
4.
Westhofen, M. 2013. [Indications for operative therapy of vestibular vertigo and the
associated success rates] dalam Pubmed (Online). Tersedia :
http://www.ncbi.nlm.nih.gov/pubmed/24002727 (Diakses pada tanggal 16 September
2013).
ARTICLE REVIEW
Hum Gene Ther. 2012 Jun;23(6):557-65. doi: 10.1089/hum.2012.088.
Recent progress in gene therapy for hemophilia.
RESEARCH
N Engl J Med. 2013 Jan 17;368(3):231-9. doi: 10.1056/NEJMoa1208024.
Factor VIII products and inhibitor development in severe hemophilia A.
Gouw SC, van der Bom JG, Ljung R, Escuriola C, Cid AR, Claeyssens-Donadel S, van Geet
C, Kenet G, Mkipernaa A, Molinari AC, Muntean W, Kobelt R,Rivard G, Santagostino
E, Thomas A, van den Berg HM; PedNet and RODIN Study Group.
Collaborators (35)
Source
Department of Pediatrics, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Abstract
BACKGROUND:
For previously untreated children with severe hemophilia A, it is unclear whether the type of
factor VIII product administered and switching among products are associated with the
development of clinically relevant inhibitory antibodies (inhibitor development).
METHODS:
We evaluated 574 consecutive patients with severe hemophilia A (factor VIII activity, <0.01
IU per milliliter) who were born between 2000 and 2010 and collected data on all clottingfactor administration for up to 75 exposure days. The primary outcome was inhibitor
development, which was defined as at least two positive inhibitor tests with decreased in vivo
recovery of factor VIII levels.
RESULTS:
Inhibitory antibodies developed in 177 of the 574 children (cumulative incidence, 32.4%);
116 patients had a high-titer inhibitory antibody, defined as a peak titer of at least 5 Bethesda
units per milliliter (cumulative incidence, 22.4%). Plasma-derived products conferred a risk
of inhibitor development that was similar to the risk with recombinant products (adjusted
hazard ratio as compared with recombinant products, 0.96; 95% confidence interval [CI],
0.62 to 1.49). As compared with third-generation full-length recombinant products (derived
from the full-length complementary DNA sequence of human factor VIII), second-generation
full-length products were associated with an increased risk of inhibitor development (adjusted
hazard ratio, 1.60; 95% CI, 1.08 to 2.37). The content of von Willebrand factor in the
products and switching among products were not associated with the risk of inhibitor
development.
CONCLUSIONS:
Recombinant and plasma-derived factor VIII products conferred similar risks of inhibitor
development, and the content of von Willebrand factor in the products and switching among
products were not associated with the risk of inhibitor development. Second-generation full-
length recombinant products were associated with an increased risk, as compared with thirdgeneration products. (Funded by Bayer Healthcare and Baxter BioScience).
CASE REPORT
Clinical Chemistry 58:7
10861090 (2012)
Case
Clinical
RESEARCH
Health economics of rubella: a systematic review to assess the value of rubella
vaccination.
Authors:
Author Address:
Source:
Publication Type:
Language:
Publisher: BioMed
Central Country
of
Publication: England NLM
ID: 100968562 Publication
Model: Electronic Cited
Medium: InternetISSN: 1471-2458
(Electronic) Linking
ISSN: 14712458 NLM
ISO
Abbreviation: BMC
Public
Health Subsets: In Process; MEDLINE
Background: Most cases of rubella and congenital rubella syndrome (CRS) occur in lowand middle-income countries. The World Health Organization (WHO) has recently
recommended that countries accelerate the uptake of rubella vaccination and the GAVI
Alliance is now supporting large scale measles-rubella vaccination campaigns. We performed
a review of health economic evaluations of rubella and CRS to identify gaps in the evidence
base and suggest possible areas of future research to support the planned global expansion of
rubella vaccination and efforts towards potential rubella elimination
And radication.
Methods: We performed a systematic search of on-line databases and identified articles
published between 1970 and 2012 on costs of rubella and CRS treatment and the costs, costeffectiveness or cost-benefit of rubella vaccination. We reviewed the studies and categorized
them by the income level of the countries in which they were performed, study design, and
research question answered. We analyzed their methodology, data sources, and other details.
We used these data to identify gaps in the evidence and to suggest possible future areas of
scientific study.
Results: We identified 27 studies: 11 cost analyses, 11 cost-benefit analyses, 4 costeffectiveness analyses, and 1 cost-utility analysis. Of these, 20 studies were conducted in
high-income countries, 5 in upper-middle income countries and two in lower-middle income
countries. We did not find any studies conducted in low-income countries. CRS was
estimated to cost (in 2012 US$) between $4,200 and $57,000 per case annually in middleincome countries and up to $140,000 over a lifetime in high-income countries. Rubella
vaccination programs, including the vaccination of health workers, children, and women had
CASE REPORT
Antibody persistence for 3 years following two doses of tetravalent measles-mumpsrubella-varicella vaccine in healthy children.
Authors:
Author Address:
Source:
Publication Type:
Language:
Journal Info:
Abstract:
Unlabelled: Two doses of a varicella-containing vaccine in healthy children <12 years are
suggested to induce better protection than a single dose. Persistence of immunity against
measles, mumps, rubella, and varicella as well as varicella breakthrough cases were assessed
3 years after two-dose measles, mumps, rubella, and varicella (MMRV) vaccination or
concomitant MMR (Priorix) and varicella (Varilrix) vaccination. Four hundred ninetyfour healthy children, 12-18 months old at the time of the first dose, received either two doses
of MMRV vaccine (GlaxoSmithKline Biologicals) 42-56 days apart (MMRV, N=371) or one
dose of MMR and varicella vaccines administered simultaneously at separate sites, followed
by another MMR vaccination 42-56 days later (MMR + V, N=123). Three hundred-four
subjects participated in 3-year follow-up for persistence of immunity and occurrence of
breakthrough varicella (MMRV, N=225; MMR + V, N=79). Antibodies were measured by
ELISA (measles, mumps, rubella) and immunofluorescence (varicella). Contacts with
individuals with varicella or zoster and cases of breakthrough varicella disease were
recorded. Three years post-vaccination seropositivity rates in subjects seronegative before
vaccination were: MMRV-measles, 98.5% (geometric mean titer [GMT]=3,599.6); mumps,
97.4% (GMT=1,754.5); rubella, 100% (GMT=51.9); varicella, 99.4% (GMT=225.5);
MMR + V-measles, 97.0% (GMT=1,818.8); mumps, 93.8% (GMT=1,454.6); rubella, 100%
(GMT=53.8); and varicella, 96.8% (GMT=105.8). Of the subjects, 15-20% reported contact
with individuals with varicella/zoster each year.
After 3 years, the cumulative varicella breakthrough disease rate was 0.7% (two
cases) in the MMRV group and 5.4% (five cases) in the MMR + V group.
Conclusion: Immunogenicity of the combined MMRV vaccine was sustained 3 years postvaccination. (208136/041/NCT00406211).
ARTICLE REPORT
The History of Rubella and Rubella Vaccination Leading to Elimination
Stanley A. Plotkin
Reprints or correspondence: Dr. Stanley A. Plotkin, Sanofi Pasteur, 4650 Wismer Rd.,
Doylestown, PA 18901 (Stanley.Plotkin@Sanofipasteur.com).
Abstract
Congenital rubella syndrome (CRS) was discovered in the 1940s, rubella virus was
isolated in the early 1960s, and rubella vaccines became available by the end of the same
decade. Systematic vaccination against rubella, usually in combination with measles, has
eliminated both the congenital and acquired infection from some developed countries, most
recently the United States, as is confirmed by the articles in this supplement. The present
article summarizes the clinical syndrome of CRS, the process by which the vaccine was
developed, and the history leading up to elimination, as well as the possible extension of
elimination on a wider scale.
At first, cataracts, deafness, and congenital heart disease were the only identifying
characteristics of congenital rubella, but, in the spring of 1963, an epidemic of rubella started
in Europe and subsequently spread to the United States in 1964 and 1965, leaving thousands
of damaged infants in its wake. Studies of these infants revealed that congenital rubella
syndrome (CRS) has many manifestations and affects virtually all organ systems. In addition
to affecting 3 core organsthe optic lens, the cochlea, and the heartCRS was recognized
as a cause of pathology in the brain, lungs, liver, spleen, kidney, bone marrow, bones, and
endocrine organs. This anatomic pathology was associated with encephalitis, mental
retardation, pneumonia, hepatitis, thrombocytopenia, metaphyseal defects, diabetes mellitus,
and thyroiditis. Moreover, although cataracts, cochlear atrophy, and patent ductus arteriosus
were prevalent in typical CRS, other manifestations in the eye, ear, and heart were found to
occur frequently, including glaucoma, central auditory imperception, and peripheral pulmonic
stenosis.
Those of us who were practicing pediatrics or obstetrics during those years remember with
poignancy the many tragedies we witnessed as families struggled with decisions about
therapeutic abortions and severely damaged infants. In Philadelphia, I calculated that at the
height of the epidemic 1% of all births were affected.
Meanwhile, the cell culture revolution that began after the Second World War was
applied to the study of rubella in the early 1960s. Two laboratories succeeded in detecting the
presence of rubella virus: that of Weller and Neva in Boston and that of Parkman, Buescher,
and Artenstein in Bethesda. In Boston, rubella virus was isolated by detecting subtle changes
in human amnion cells, whereas in Bethesda the workers used a novel technique of viral
interference. When samples containing rubella virus were inoculated on cultures of African
green monkey kidney (AGMK) cells, the virus grew without cytopathic effect, but the cells
secreted interferon. Challenge of the AGMK cultures with enteroviruses such as echovirus 11
revealed interference with their readily detected cytopathic effect. This technique became
widely used in virology laboratories.
Fortunately, the isolation of rubella virus came just before the 19631965 rubella
epidemic, permitting accurate virologic and serologic diagnosis and elucidation of disease
pathogenesis. Many key features of rubella and CRS were recognized, including the
following
ARTICLE REVIEW
Mayo Clin Proc. 2009 Dec;84(12):1130-46. doi: 10.4065/mcp.2009.0391.
Chronic coronary artery disease: diagnosis and management.
Cassar A, Holmes DR Jr, Rihal CS, Gersh BJ.
Source
Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905,
USA.
Abstract
Coronary artery disease (CAD) is the single most common cause of death in the developed
world, responsible for about 1 in every 5 deaths. The morbidity, mortality, and socioeconomic
importance of this disease make timely accurate diagnosis and cost-effective management of
CAD of the utmost importance. This comprehensive review of the literature highlights key
elements in the diagnosis, risk stratification, and management strategies of patients with
chronic CAD. Relevant articles were identified by searching the PubMed database for the
following terms: chronic coronary artery disease or stable angina. Novel imaging modalities,
pharmacological treatment, and invasive (percutaneous and surgical) interventions have
revolutionized the current treatment of patients with chronic CAD. Medical treatment
remains the cornerstone of management, but revascularization continues to play an important
role. In the current economic climate and with health care reform very much on the horizon,
the issue of appropriate use of revascularization is important, and the indications for
revascularization, in addition to the relative benefits and risks of a percutaneous vs a surgical
approach, are discussed.
RESEARCH
Addiction. 2000 Oct;95(10):1505-23.
Alcohol and coronary heart disease: a meta-analysis.
Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen K.
Source
Department of Statistics, University of Milan-Bicocca, Italy. giovanni.corrao@unimib.it
Abstract
OBJECTIVE:
To estimate parameters of the function relating alcohol consumption with the risk of coronary
heart disease and to identify the sources of heterogeneity in the parameter estimates.
METHODS:
A search of the epidemiological literature from 1966 to 1998 was performed using several
bibliographic databases. Meta-regression models were fitted to evaluate non-linear effects of
alcohol intake on the relative risk. The effects of some characteristics of the studies, including
an index of their quality, were considered as putative sources of heterogeneity of the
estimates. Publication bias was also investigated.
FINDINGS:
Among the 196 initially reviewed articles, 51 were selected. Since qualitative characteristics
of the studies were significant sources of heterogeneity, the pooled dose-response functions
were based on the 28 cohort studies with higher quality. Risk decreased from 0 to 20 g/day
(RR = 0.80; 95% CI: 0.78, 0.83); there was evidence of a protective effect up to 72 g/day (RR
= 0.96; 95% CI: 0.92, 1.00) and increased risk above > or = 89 g/day (RR = 1.05; 95% CI:
1.00, 1.11). Lower protective effects and harmful effects were found in women, in men living
in countries outside the Mediterranean area and in studies where fatal events were used as the
outcome. Evidence of publication bias for moderate intakes and of heterogeneity of the
estimates across studies for higher intakes were found.
CONCLUSIONS:
The degree of protection from moderate doses of alcohol should be reconsidered. Further
research investigating the effect of drinking patterns on the risk of coronary heart disease
should be performed. Caution in making general recommendations is needed.
CASE REPORT
A CASE REPORT OF CORONARY ARTERY DISEASE IN A TEENAGE GIRL
N. Maghami-Pour* and N. Safaie
Department of Cardiac Surgery, Shahid Madani Hospital, School of Medicine, Tabriz
University
of Medical Sciences, Tabriz, Iran
Abstract- Atherosclerosis is the leading cause of death in most parts of the world. This
disorder affects mostly patients above the age 40 years. This case report introduces a 17 years
old girl with early development of coronary artery disease who had severe coronary
atherosclerosis that did not respond to medical and interventional treatment and underwent
surgical operation in cardiac surgery department of Shahid Madani Hospital, Tabriz, Iran.
Presence of risk factors for atherosclerosis were evaluated and the only findings were positive
family history of cardiac death in her uncle at about 52 years of age and
high level of lipoprotein (a) in one of her sisters. In follow up evaluation of this patient, high
levels of lipoprotein (a) was documented which was controlled with medical therapy. We
concluded that high level of lipoprotein (a) was the probable cause of atherosclerosis in this
patient. This case report emphasizes the need to screen siblings of patients with premature
myocardial infarction.
Acta Medica Iranica, 43(5): 369-371; 2005
CASE REPORT
The patient was a 17 years old non obese girl with normal general appearance who was
referred to cardiologist because of typical exertional chest pain which radiated to her left arm.
On primary admission all laboratory data were normal. ETT and myocardial perfusion scan
were positive and angiography was done which revealed coronary artery disease (Fig. 1).
Attempt to do balloon angioplasty failed, LV gram showed normal ejection fraction and
anteroapical hypokinesia. The patient was discharged with medical follow up. Since patient
did not respond to medical treatment, we repeat angiography 10 months later which showed
severe diffuse CAD. She was referred for operation. On surgery with the aid of
cardiopulmonary by pass, grafts to all the coronary arteries were done. After operation chest
pain improved and patient was followed with medical treatment such as aspirin and
lovastatin.
About 20 months after the operation again patient was referred with recurrence of the
exertional chest pain. At this time laboratory data were all normal except for high level of
Lp(a). ETT and myocardial perfusion scan again showed signs of ischemia so drug therapy
for Lp(a) with atorvastatin and gemfibrozil was started. After 3 months, the level of Lp(a)
decreased and exertional chest pain improved.
ARTICLE REVIEW
BMC Musculoskelet Disord. 2013 Sep 5;14(1):261.
CONTRAIS: CONservative TReatment for Adolescent Idiopathic Scoliosis: a
randomised controlled trial protocol.
Abbott A, Mller H, Gerdhem P.
Abstract
BACKGROUND:
Idiopathic scoliosis is a three-dimensional structural deformity of the spine that occurs in
children and adolescents. Recent reviews on bracing and exercise treatment have provided
some evidence for effect of these interventions. The purpose of this study is to improve the
evidence base regarding the effectiveness of conservative treatments for preventing curve
progression in idiopathic scoliosis.Methods/design: Patients: Previously untreated girls and
boys with idiopathic scoliosis, 9 to 17 years of age with at least one year of remaining growth
and a curve Cobb angle of 25--40 degrees will be included. A total of 135 participants will be
randomly allocated in groups of 45 patients each to receive one of the three
interventions.Interventions: All three groups will receive a physical activity prescription
according to the World Health Organisation recommendations. One group will additionally
wear a hyper-corrective night-time brace. One group will additionally perform postural
scoliosis-specific exercises.Outcome: Participation in the study will last until the curve has
progressed, or until cessation of skeletal growth. Outcome variables will be measured every 6
months. The primary outcome variable, failure of treatment, is defined as progression of the
Cobb angle more than 6 degrees, compared to the primary x-ray, seen on two consecutive
spinal standing x-rays taken with 6 months interval. Secondary outcome measures include the
SRS-22r and EQ5D-Y quality of life questionnaires, the International Physical Activity
Questionnaire (IPAQ) short form, and Cobb angle at end of the study.
DISCUSSION:
This trial will evaluate which of the tested conservative treatment approaches that is the most
effective for patients with adolescent idiopathic scoliosis.Trial registration: NCT01761305.
RESEARCH
Spine (Phila Pa 1976). 2006 Feb 1;31(3):262-8.
CONCLUSION:
The data in this study show the ability of a ligament tether attached to a bone anchor to
correct scoliosis modestly in the coronal plane, but not in the sagittal or transverse plane. In
addition, although a significant decrease in the deformity score was shown initially in this
group (P < 0.001), the effect was lost over time. The final deformity in the bone
anchor/ligament tether group wassignificantly less than either the stapled or untreated groups
(P < 0.03). Further study is warranted to provide a better understanding of the 3-D effects of
fusionless scoliosis treatments.
CASE REPORT
CASE REPORT
Otol Neurotol. 2003 Sep;24(5):807-11.
Three cases of cochleosaccular endolymphatic hydrops without vertigo
revealed by furosemide-loading vestibular evoked myogenic potential
test.
Seo T, Node M, Miyamoto A, Yukimasa A, Terada T, Sakagami M.
Source
Department of Otolaryngology, Hyogo College of Medicine, Hyogo, Japan. tseo@hyomed.sc.jp
Abstract
OBJECTIVE:
To describe possible cases of cochleosaccular endolymphatic hydrops without vertigo.
STUDY DESIGN:
Retrospective case report.
SETTING:
University hospital.
PATIENTS:
Three patients with possible cochleosaccular hydrops without vertigo were studied. The basis
of diagnosis was positive result of the furosemide-loading vestibular evoked myogenic
potential test, no canal paresis in the caloric test, and recurrent cochlear symptoms or
fluctuating low-tone hearing loss.
CASE REPORT:
In case 1, a 47-year-old woman had recurrent left aural fullness and tinnitus and a few weeks
later complained of a floating sensation and could not stand up. The furosemide-loading
vestibular evoked myogenic potential test showed a positive result in the left ear. In case 2, a
24-year-old woman complained of a backward falling sensation lasting several seconds;
subsequently, a severe floating sensation persisted and she could not stand up for several
days. Audiography showed fluctuating low-tone hearing loss in the left ear, and the
furosemide-loading vestibular evoked myogenic potential test showed a positive result. In
case 3, a 41-year-old woman had a floating sensation while walking and subsequently
complained of tinnitus in the left ear. She could not stand up because of a severe floating
sensation and, moreover, complained of a sudden falling sensation lasting for several
seconds. The furosemide-loading vestibular evoked myogenic potential test indicated a
positive result in the left ear.
CONCLUSIONS:
The patients in cases 2 and 3 complained of a short-lasting sensation of falling down. Severe
disequilibrium that prohibited standing up was noted in all cases. It was suggested that these
symptoms were caused by saccular hydrops.
RESEARCH
Dtsch Arztebl Int. 2013 Jul;110(29-30):505-16. doi: 10.3238/arztebl.2013.0505. Epub 2013
Jul 22.
The treatment and natural course of peripheral and central vertigo.
Strupp M, Dieterich M, Brandt T.
Source
Department of Neurology and German Center for Vertigo and Balance Disorders (IFB),
Institute for Clinical Neurosciences, Ludwig-Maximilians University of Munich, Klinikum
Grohadern.
Abstract
BACKGROUND:
Recent studies have extended our understanding of the pathophysiology, natural course, and
treatment of vestibular vertigo. The relative frequency of the different forms is as follows:
benign paroxysmal positional vertigo (BPPV) 17.1%; phobic vestibular vertigo 15%; central
vestibular syndromes 12.3%; vestibular migraine 11.4%; Menire's disease 10.1%; vestibular
neuritis 8.3%; bilateral vestibulopathy 7.1%; vestibular paroxysmia 3.7%.
METHODS:
Selective literature survey with particular regard to Cochrane reviews and the guidelines of
the German Neurological Society.
RESULTS:
In more than 95% of cases BPPV can be successfully treated by means of liberatory
maneuvers (controlled studies); the long-term recurrence rate is 50%. Corticosteroids
improve recovery from acute vestibular neuritis (one controlled, several noncontrolled
studies); the risk of recurrence is 2-12%. A newly identified subtype of bilateral
vestibulopathy, termed cerebellar ataxia, neuropathy, and vestibular areflexia syndrome
(CANVAS), shows no essential improvement in the long term. Long-term high-dose
treatment with betahistine is probably effective against Menire's disease (noncontrolled
studies); the frequency of episodes decreases spontaneously in the course of time (> 5 years).
The treatment of choice for vestibular paroxysmia is carbamazepine (noncontrolled study).
Aminopyridine, chlorzoxazone, and acetyl-DL-leucine are new treatment options for various
cerebellar diseases.
CONCLUSION:
Most vestibular syndromes can be treated successfully. The efficacy of treatments for
Menire's disease, vestibular paroxysmia, and vestibular migraine requires further research.
ARTICLE REVIEW
syndrome and disease is 70-88%, ablative procedures are effective in >90% of cases and
occlusion of the superior or posterior canals is successful in >95% of patients.