Measures of quality of life in children with cochlear implant: systematic review

The use of cochlear implant (CI) in children enables the development of listening and communication skills, allowing the child's progress in school and to be able to obtain, maintain and carry out an occupation. However, the progress after the CI has different results in some children, because many children are able to interact and participate in society, while others develop limited ability to communicate verbally. The need for a better understanding of CI outcomes, besides hearing and language benefits, has spurred the inclusion of quality of life measurements (QOL) to assess the impact of this technology.ObjectiveIdentify the key aspects of quality of life assessed in children with cochlear implant.MethodThrough a systematic literature review, we considered publications from the period of 2000 to 2011.ConclusionWe concluded that QOL measurements in children include several concepts and methodologies. When referring to children using CI, results showed the challenges in broadly conceptualizing which quality of life domains are important to the child and how these areas can evolve during development, considering the wide variety of instruments and aspects evaluated.     

Sealing ability of MTA, Super EBA, Vitremer and amalgam as root-end filling materials

This study evaluated the root-end sealing ability of mineral trioxide aggregate (MTA Angelus), reinforced zinc oxide-eugenol cement (Super EBA), resin-modified glass ionomer (Vitremer) and zinc-free amalgam (GS-80) (control). The root canals of eighty human lower molars were accessed, cleansed, shaped and obturated. Apexes were resected and cavities were prepared. Teeth were divided into 4 groups of 40 cavities, root-end filled with the materials, and immersed in methylene blue for 72 h at 37 degrees C. Roots were then sectioned transversally at each millimeter and evaluated under magnification, observing the dye penetration in each section. Data were evaluated using Kruskal-Wallis test at a 5% level of significance, showing the differences among all materials (p < 0.001). The crescent order of microleakage was MTA < Vitremer < Super EBA < amalgam. Higher leakage levels were observed in the first millimeter sections of amalgam, Vitremer and MTA, when compared with the third millimeter section (p < 0.05).     

Is procalcitonin useful to differentiate rejection from bacterial infection in the early post‐operative period of liver transplantation in children?

Abstract: PCT is a protein that is recognized as an acute marker of inflammation. Previous studies performed in adults who underwent liver or heart transplantation indicated that PCT plasmatic levels help to differentiate between rejection and infection. The objective of this study was to evaluate whether PCT has the same role in liver‐transplanted children. Thirty‐six patients were studied between the first and the thirtieth post‐operative days, and PCT determinations were prospectively performed according to the clinical status of the patient. In the non‐complicated patients, PCT measurements performed on the first and second post‐operative days revealed a median value of 1.60 ng/mL (mean 5.68 ± 7.05; range 0.69–18.30). After the fourth day of transplantation, PCT plasma concentrations decreased to a median value of 0.21 ng/mL (mean 0.47 ± 0.59; range 0.05–2.00; normal values are less than 0.5 ng/mL). In infected patients, PCT plasma levels demonstrated a significant increase, differing from the patients with acute liver rejection whose levels were similar to those of non‐complicated patients. In conclusion, we could demonstrate that in the early post‐operative period of liver transplantation in children, measuring PCT plasmatic levels might be a useful tool for differentiation between bacterial infection and acute liver rejection.     

Sutureless lamellar keratoplasty: a modified approach for fibrin glue application

PURPOSE: To report a case where fibrin glue was applied with a modified approach to secure the graft to the host bed in lamellar keratoplasty. METHODS: One patient with epithelial membrane dystrophy, Salzmann nodular degeneration, and amyloid deposits in the cornea underwent lamellar keratoplasty by using fibrin glue. The glue components were applied separately: the fibrin component on the stromal bed and thrombin component on the stromal side of the lamellar graft. Tissue adhesion, corneal condition, and visual acuity were evaluated postoperatively. RESULTS: Best-corrected visual acuity 4 months after surgery was 20/30. The graft remained clear and well positioned 9 months after surgery. CONCLUSIONS: We report a case of visual acuity improvement and efficient adhesion of the lamellar graft after lamellar keratoplasty by using fibrin adhesive. The components of the glue can be applied separately, allowing more time to position the graft on the stromal bed.     

Molecular profiling of isolated histological components of wilms tumor implicates a common role for the Wnt signaling pathway in kidney and tumor development

Wilms tumor (WT), a tumor composed of three histological components - blastema (BL), epithelia and stroma - is considered an appropriate model system to study the biological relationship between differentiation and tumorigenesis. To investigate molecular associations between nephrogenesis and WT, the gene expression pattern of individual cellular components was analyzed, using a customized platform containing 4,608 genes. WT gene expression patterns were compared to genes regulated during kidney differentiation. BL had a closer gene expression pattern to the earliest stage of normal renal development. The BL gene expression pattern was compared to that of fetal kidney (FK) and also between FK and mature kidney, identifying 25 common deregulated genes supposedly involved in the earliest events of WT onset. Quantitative RT-PCR was performed, confirming the difference in expression levels for 13 of 16 genes (81.2%) in the initial set and 8 of 13 (61.5%) in an independent set of samples. An overrepresentation of genes belonging to the Wnt signaling pathway was identified, namely PLCG2, ROCK2 and adenomatous polyposis coli (APC). Activation of the Wnt pathway was confirmed in WT, using APC at protein level and PLCG2 at mRNA and protein level. APC showed positive nuclear immunostaining for an independent set of WT samples, similarly to the FK in week 11. Lack of PLCG2 expression was confirmed in WT and in FK until week 18. Taken together, these results provided molecular evidence of the recapitulation of the embryonic kidney by WT as well as involvement of the Wnt pathway in the earliest events of WT onset.     

Is maintenance of the ileocecal valve important to the intestinal adaptation mechanisms in a weaning rat model of short bowel?

Purpose

To evaluate the role of maintenance of the ileocecal valve (ICV) in intestinal adaptation mechanisms, in a weaning rat experimental model of short bowel.

Methods

Forty animals were operated on to produce short bowel syndrome. They were divided into five groups: maintenance (MV) or resection of ICV (RV), kill after 4 days (MV4 and RV4) or 21 days (MV21 and RV21), and a control group (21-day-old rats). Body weights, small bowel and colon lengths and diameters, villus heights, crypt depths, lamina propria and muscle layer thickness, as well as the apoptosis index of villi and crypts and expression of pro- and anti-apoptotic genes, were studied.

Results

Preservation of the ICV promoted increased weight gain (p?=?0.0001) and intestinal villus height after 21 days; crypt depth was higher in comparison to controls. It was verified a higher expression of Ki-67 in bowel villi and crypts (p?=?0.018 and p?=?0.015, respectively) in RV4 group and a higher expression in bowel villi of MV4 group animals (p?=?0.03). The maintenance of ICV promoted late increased expression of the anti-apoptotic gene Bcl-XL in the colon (p?=?0.043, p?=?0.002, p?=?0.01).

Conclusion

The maintenance of the ICV led to positive changes in this model.