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Objectives: To estimate the annual cost of Meniere’s disease and the cost per person in the UK population and to investigate the direct and indirect costs of the condition. Design: The authors utilized a multidata approach to provide the first estimate of the cost of Meniere’s. Data from the UK Biobank (a study of 500,000 individuals collected between 2007 and 2012), the Hospital Episode Statistics (data on all hospital admissions in England from 2008 to 2012) and the UK Meniere’s Society (2014) were used to estimate the cost of Meniere’s. Cases were self-reported in the UK Biobank and UK Meniere’s Society, within the Hospital Episode Statistics cases were clinician diagnosed. The authors estimated the direct and indirect costs of the condition, using count data to represent numbers of individuals reporting specific treatments, operations etc. and basic statistical analyses (χ2 tests, linear and logistic regression) to compare cases and controls in the UK Biobank. Results: Meniere’s was estimated to cost between £541.30 million and £608.70 million annually (equivalent to US $829.9 to $934.2 million), equating to £3,341 to £3,757 ($5112 to $5748) per person per annum. The indirect costs were substantial, with loss of earnings contributing to over £400 million per annum. Conclusions: For the first time, the authors were able to estimate the economic burden of Meniere’s disease. In the UK, the annual cost of this condition is substantial. Further research is required to develop cost–effective treatments and management strategies for Meniere’s to reduce the economic burden of the disease. These findings should be interpreted with caution due to the uncertainties inherent in the analysis.

Hypothesis: Meniere's disease significantly impacts on an individual's mental health and subjective well-being (SWB).Background: Meniere's disease is an unpredictable illness that impacts on mental health. The symptom triad of vertigo, tinnitus, and hearing loss all contribute to the disabling nature of the condition. To date, limited research has investigated the mental health and SWB impact of Meniere's disease.Methods: We investigated the mental health and SWB of 1,376 Meniere's sufferers in the UK Biobank and compared this to over 500,000 controls. Participants in the Biobank were asked 38 questions pertaining to mental health and SWB. We utilized crude and adjusted linear and logistic regression to investigate the association between Meniere's and mental health and SWB. We also investigated how mental health and SWB might be related to length of diagnosis to see whether people might adapt to Meniere's over time.Results: Meniere's was associated with increased frequency of depression, tiredness, tenseness, and unenthusiasm in the 2 weeks before recruitment. Meniere's was associated with longer periods of depression than controls (10.2 wk [95% CI: 5.2-15.2 wk]). Reduced health satisfaction was associated with Meniere's, but in other aspects of life (general happiness, work, family, friends, financial), individuals with Meniere's were as happy as controls. Mental health and SWB in individuals diagnosed for longer was better than in those who were recently diagnosed suggesting at least partial adaptation.Discussion: This is the largest population study investigating the mental health impact of Meniere's. Our findings suggest that Meniere's adversely impacts on mental health, an individual's emotional state, and their life satisfaction. However, our findings raise the importance of supporting social relations for people with Meniere's and that although a cure is not currently available, we can still learn much about the adaptation strategies developed by long-term sufferers to help individuals with new diagnoses.

Objectives: To investigate whether adverse intrauterine and/or childhood exposures, using established anthropometric measures (e.g., components of adult height, including total height, leg length, and trunk length) as a proxy for childhood exposures, are associated with self-reported Meniere's disease. Design: Cross-sectional data from the UK Biobank were used to compare 1,327 self-reported Meniere's cases with 479,500 controls. The authors used logistic regression models to investigate the relation of Meniere's disease with the components of adult height. Models were adjusted for a range of potential confounders including age, sex, body mass index, ethnicity, type 2 diabetes, coronary heart disease, and socioeconomic status. Results: In the UK Biobank, Meniere's was inversely associated with overall stature (odds ratio [OR] per standard deviation increase in height, 0.87; 95% confidence interval [CI], 0.80-0.94) and leg length (OR, 0.88; 95% CI, 0.82-0.94) in fully adjusted models. No association was noted in adjusted models with trunk length (OR, 0.94; 95% CI, 0.88-1.01). Conclusions: The specific association between leg length, a potential marker of adverse childhood environments, and Meniere's may suggest that early-life environmental exposures that influence skeletal growth may also influence the risk of developing Meniere's in later life.

OBJECTIVES: The aims of this study were to estimate the prevalence of Meniere's disease and investigate its relationship with: demographic factors; symptoms and conditions that are known or hypothesized to be associated with Meniere's disease; other physical diseases; mental health. DESIGN: The authors used cross-sectional data from the UK Biobank to compare 1376 self-reported Meniere's participants with over 500,000 without Meniere's. The data set has comprehensive anthropometric measures, questionnaire data investigating health, well-being, diet, and medical and drug-prescribing history for each participant. The authors used logistic regression models to investigate the relationship of Meniere's disease with: demographic factors; symptoms and conditions that are known or hypothesized to be associated with Meniere's disease; other physical diseases; and mental health. RESULTS: Meniere's disease was more common in participants who were older (adjusted odds ratio per 10-year increase: 1.5 [95% confidence interval:1.4-1.6]), white (odds ratio: 1.7;1.2-2.3), female (1.4;1.3-1.6), and having higher body mass index categories (p < 0.001). The Meniere's group had greater odds of hearing difficulty (10.9;9.6-12.5), current tinnitus (68.3;47.8-97.5), and had fallen more than once in the last year (2.1;1.8-2.5). Meniere's participants had greater odds of reporting at least one disease from each grouping of allergic, immune dysfunction, or autonomic dysfunction (2.2;1.8-2.6), and poor mental health (2.1;1.8-2.5). CONCLUSIONS: This study provides an evidence base that improves understanding of Meniere's disease. Associations were noted with a number of diseases, and the authors hypothesize a role for the autonomic nervous system and immune system dysfunction in Menie re's etiology. The study also highlights the physical and mental health correlates of the condition.

Background: Cardiac hypertrophy accompanying pregnancy has generally been categorized as physiologic hypertrophy similar to that seen with exercise, however a reduction in cardiac function in late pregnancy has been suggested. Furthermore, the hemodynamic stress of pregnancy can induce a maladaptive, pathologic hypertrophy in a small number of women. This study seeks to characterize the contractile properties of late-pregnant myocardium. Methods and Results: Late Pregnancy (LP) Female Swiss-Webster mice were bred then studied at near term (Embryonic day 17-19) and compared to age-matched, non-pregnant (NP) controls. Individual cardiac myocytes were isolated using collagenase-based perfusion technique. Two-dimensional Surface Area measured in quiescent cells was elevated (p2 ) vs NP myocytes (NPM) (2736± 88u 2 ), and this increase was due to increases in both length (8.5%) and width (15.6%). Western Blot analysis showed a reduction in Ryanodine Receptor protein in LP, but no differences in L-type Ca Channel, SERCA or Phospholamban levels. Sarcomere length (light diffraction) and Ca 2+ transients (fluo-3) were measured at pacing rates of 1 Hz and at bath [Ca] of 2mM. Duration of twitch contraction was prolonged (p-7 M Isoproterenol (ISO) was used to determine the responsiveness to adrenergic stimulation. ISO induced significantly enhanced contractility in both LPM and NPM, and the response was heightened in LPM such that the presence of ISO normalized the differences in the duration of twitch contraction between LPM and NPM. Conclusions: These results suggest that hypertrophied LPM have characteristics of both physiologic and pathologic hypertrophy including enhanced responsiveness to ISO and a prolonged relaxation phase. The prolongation of relaxation is not seen in physiologic hypertrophy induced by exercise and may contribute to the diastolic dysfunction reported in some pregnancies. Enhanced response to ISO suggests an increased cardiac reserve in LPM.