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Background: This study investigates the test-retest reliability, aging effects, and differences in horizontal semicircular canals gain values between the head impulse paradigm and suppression head impulse paradigm. Methods: Sixty healthy adult subjects aged 22-76-year-old (mean ± standard deviation = 47.27 ± 18.29) participated in the head impulse paradigm and suppression head impulse paradigm using the video head impulse test. The Head impulse paradigm was used to assess all 6 semicircular canals, while suppression head impulse paradigm measured only the horizontal canals. Twenty subjects aged 22-40-year-old (25.25 ± 4.9) underwent a second session for the test-retest reliability. Results: There were good test-retest reliability for both measures (right horizontal head impulse paradigm, intraclass correlation coefficient = 0.80; left horizontal head impulse paradigm, intraclass correlation coefficient = 0.77; right anterior head impulse paradigm, intraclass correlation coefficient = 0.86; left anterior head impulse paradigm, intraclass correlation coefficient = 0.78; right posterior head impulse paradigm, intraclass correlation coefficient = 0.78; left posterior head impulse paradigm, intraclass correlation coefficient = 0.75; right horizontal suppression head impulse paradigm, intraclass correlation coefficient = 0.76; left horizontal suppression head impulse paradigm, intraclass correlation coefficient = 0.79). The test-retest reliability for suppression head impulse paradigmanti-compensatory saccade latency and amplitude were moderate (right latency, intraclass correlation coefficient = 0.61; left latency, intraclass correlation coefficient = 0.69; right amplitude, intraclass correlation coefficient = 0.69; left amplitude, intraclass correlation coefficient = 0.58). There were no significant effects of age on head impulse paradigm and suppression head impulse paradigm vestibulo-ocular reflex gain values and suppression head impulse paradigmsaccade latency. However, the saccade amplitude became smaller with increasing age, P < .001. The horizontal suppression head impulse paradigm vestibulo-ocular reflex gain values were significantly lower than the head impulse paradigm for both sides (right, P = .004; left, P = .004). Conclusion: There was good test-retest reliability for both measures, and the gain values stabilized with age. However, suppression head impulse paradigm anti-compensatory saccade latency and amplitude had lower test-retest reliability than the gain. The suppression head impulse paradigm vestibulo-ocular reflex gain was lower than the head impulse paradigm and its anti-compensatory saccade amplitude reduced with increasing age.

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Calcinosis universalis (CU) is characterised by diffuse deposition of insoluble calcium salt in the skin, subcutaneous tissue or organs. Calcium deposits in the breast may be associated with an increased risk for developing breast cancer. We present a case of a 65-year-old woman diagnosed with CU secondary to undifferentiated connective tissue disease. She developed progressive calcification of her skin, which did not improve with oral medications aimed at reducing the calcification. Investigations to look for possible causes of calcification were all unremarkable. During follow-up, calcification was also found in both her breasts. Initial mammography was reported as fibroadenoma. However, 3 years later, she returned with metastatic breast cancer which presented with a massive pleural effusion of the right lung. Calcinosis universalis should now be considered as a risk factor for breast cancer.

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