Non-flat audiograms in sensorineural hearing loss and speech perception

OBJECTIVE:

The audibility thresholds for the sound frequency of 137 upward- and downward-sloping audiograms showing sensorineural hearing loss were selected and analyzed in conjunction with speech recognition thresholds obtained from individuals seen at a public otolaryngology clinic to determine which frequencies in slope audiograms best represent speech recognition thresholds.

METHOD:

The linear regression model and mean square error were used to determine the associations between the threshold values.

RESULT:

The mean square error identified larger errors when using thresholds of 500, 1000, and 2000 Hz than when using audibility thresholds of 500, 1000, 2000, and 4000 Hz. The linear regression model showed a higher correlation (91%) between the audiogram thresholds for frequencies of 500, 1000, 2000, and 4000 Hz than for the frequencies of 500, 1000, and 2000 Hz (88%).

CONCLUSION:

Frequencies of 500, 1000, 2000, and 4000 Hz were the most significant in predicting the speech recognition threshold.     

Changes in masticatory mandibular movements in growing individuals: a six-year follow-up

The pattern of mandibular movement during chewing is influenced by several central and peripheral factors. The aim of the present study was to determine whether changes in masticatory function, characterized by mandibular velocity and displacement, occurred during individuals' normal growth. Forty-seven children, 9-15 years of age, were followed over a 6-year period. All had an Angle Class I occlusion with no obvious orthodontic problems. Oral motor function with respect to mandibular displacement, duration, and velocity was monitored 3-dimensionally with an opto-electronic method. The chewing cycle was divided into an opening, closing, and occlusal phase. Total body height was measured. During the follow-up period, all masticatory variables except the 3-dimensional opening distance showed significant changes. The total chewing cycle duration, the opening and occlusal time of the chewing cycle, and the 3-dimensional closing distance increased during the growth period, while the closing time of the chewing cycle, the 2-dimensional lateral and vertical distances and both the opening and closing velocity decreased. The children who grew proportionally most in height during the 6-year period, i.e. the youngest children in the group studied, showed a significantly larger decrease in the opening velocity. From this study it becomes evident that the variables of the chewing cycle undergo a continuous process of change during growth. This is possibly a reflection of anatomical changes, maturation of the central nervous system, and altered functional demands.     

Use of Heparin-bonded Circuits in Cardiopulmonary Bypass Improves Clinical Outcome

Objective : The use of heparin-coated surfaces in cardiopulmonary bypass has been shown to decrease the inflammatory response imposed by the contact between blood and artificial surfaces. One would expect this reaction to improve clinical outcome. However, this has been difficult to verify. This investigation is based on an aggregation of two randomized studies from our institution and highlights possible effects of heparin coating on a number of clinically oriented parameters. Design : Departmental analysis of patients subjected to coronary artery bypass surgery using heparin-coated circuits. Cardiopulmonary bypass was employed using either the Carmeda or Duraflo heparin coatings compared with a control. The systemic heparin dose was reduced in the heparin-coated groups (ACT > 250 s) vs control group patients (ACT > 480 s). The effects of heparin coating related to clinical outcome were studied. Results : The use of heparin-coated circuits reduced the mean length of stay in hospital from 7.8 &#45 2.5 to 7.3 &#45 1.8 days ( p = 0.040) and postoperative ventilation time from 9.7 &#45 9.2 to 8.2 &#45 8.5 h ( p = 0.018), blood loss 8 h post surgery from 676 &#45 385 to 540 &#45 245 ml ( p = 0.001), individual perioperative change of haemoglobin loss ( p = 0.001), leukocyte count ( p = 0.000) and creatinine elevation ( p = 0.000), proportion of patients exposed to allogenous blood transfusions 39.2 vs 23.9% ( p = 0.001), postoperative coagulation disturbances 4.4 vs 0.4% ( p = 0.006), postoperative deviations from the normal postoperative course 47.2 vs 36.7% ( p = 0.035), neurological deviations 9.4 vs 3.9% ( p = 0.021) and atrial fibrillation 26.4 vs 18.0% ( p = 0.041). No effects were found with respect to perioperative platelet count, postoperative fever reaction and 5-year survival. Conclusion : Based on several indicators, the use of heparin coating in cardiopulmonary bypass is associated with improved clinical results.     

Facteurs associés aux perdus de vue des patients sous traitement antirétroviral dans un centre de traitement ambulatoire du VIH à Conakry,Guinée

Background

Late or inadequate therapeutic management increases the risk of mortality associated with HIV/AIDS. The aim of this study was to analyze the proportion and factors associated with loss of follow-up in HIV patients who receiving antiretroviral therapy at Conakry.

丙泊酚与睡眠障碍

睡眠是维持人体正常生理功能的一个重要生理活动,随着人们生活节奏的加快,睡眠障碍的人数也在逐渐增多。目前许多研究表明全身麻醉药可以通过作用于睡眠‐觉醒环路引起意识消失,从而在短时间内对人体的睡眠产生一定的影响。丙泊酚是全身麻醉药的一种,进一步观察和研讨丙泊酚对睡眠障碍患者产生的影响,有助于了解丙泊酚对患者预后和康复产生的影响,但是丙泊酚与睡眠障碍关系的研究却少之又少。文章通过介绍睡眠产生的机制和调节因素、睡眠障碍产生的机制和影响因素,总结丙泊酚对睡眠的影响及导致意识消失的分子靶点,综述丙泊酚对睡眠障碍可能产生的影响及机制。     

Space perception,movement, and insight: attuning to the space of everyday life after major weight loss

Physiotherapists are well placed to help people adjust and engage meaningfully with the world following major weight loss. Recent research indicates that the body size a patient has lived with for years can continue to affect movement and perception even after largescale weight loss. This article explores this discrepancy in depth from the perspective of phenomenology and space perception and through the concepts of body image, body schema, and affordances. It draws on an empirical example in which a nautical engineer described his lived experience of returning to work following bariatric surgery and the discrepancies he experienced while adjusting to his new situation, particularly when moving his smaller body around the ship’s engine room, previously inaccessible to him. Analysis of this empirical example suggests that transitions in weight and size following bariatric surgery are both highly explicit in awareness (i.e., body image) and outside awareness (i.e., body schema). Major weight loss can open up new affordances and possibilities of being in the world, but only after adjustments in body image and body schema. The article suggests ways in which such insights can contribute to physiotherapists’ clinical development and practice when working with patients undergoing major weight loss.     

微卫星与肺重复癌的研究进展

微卫星（microsatellite,MS）是指以少数几个核苷酸（多为2～4个）为单位多次串联重复的DNA序列。肺重复癌（肺多原发癌,multiple primary lung cancer）是指一侧肺或两侧肺的不同部位发生两个或两个以上原发癌,其组织类型相同或不同,但各肿瘤之间无从属关系,每个肿瘤的发生有着各自独立的成瘤因素。微卫星异常与肺重复癌的发生及发展密切相关。本文主要综述：1微卫星的概念及产生机制;2微卫星异常;3肺重复癌的概念及分类;4微卫星对肺重复癌的早期诊断和预后治疗的影响。     

Surgeons often underestimate the amount of blood loss in replacement surgeries

Objective：To assess the accuracy of the clinically estimated blood loss （EBL） when compared with the actual blood loss （ABL） in replacement surgeries.Methods：This prospective study was done in Sri Ramachandra Medical Centre from April 2011 to April 2013.Altogether 140 patients undergoing total hip replacement or total knee replacement were included with the inclusion criteria being patients with haemoglobin higher than 100 g/ml and coagulation profile within normal limits.Exclusion criteria were intake of antiplatelet drug or anti-coagulant,bleeding disorders,thrombotic episode,and haematological disorders.There were 65 men and 75 women.In this study,the consultants were free to use any clinical method to estimate the blood loss,including counting the blood-soaked mops and gauze pieces （estimating the volume of blood carded in all the mops and gauzes）,measuring blood lost to suction bottles and blood in and around the operative field.The ABL was calculated based on a modification of the Gross＇s formula using haematocrit values.Results：In 42 of the 140 cases,the EBL exceeded the ABL.These cases had a negative difference in blood loss （or DIFF-BL＜0） and were included in the overestimation group,which accounted for 30％ of the study population.Of the remaining 98 cases （70％）,the ABL exceeded the EBL.Therefore they were put into the underestimation group who had a positive difference in blood loss （DIFF-BL＞0）.We found that when the average blood loss was small,the accuracy of estimation was high.But when the average blood loss exceeded 500 ml,the accuracy rate decreased significantly.This suggested that clinical estimation is inaccurate with the increase of blood loss.Conclusion：This study has shown that using clinical estimation alone to guide blood transfusion is inadequate.In this study,70％ of patients had their blood loss underestimated,proving that surgeons often underestimate blood loss in replacement surgeries.