A new audio processor for combined electric and acoustic stimulation for the treatment of partial deafness

Abstract

Conclusions. Modified vidian neurectomy combined with inferior turbinoplasty provided an optimal surgical outcome as a treatment for intractable chronic rhinitis as evidenced by a relatively long-term follow-up. Objective. The study was designed to determine the efficacy of submucosal reduction of the inferior turbinate and resection of the posterior nasal nerve for the treatment of resistant chronic rhinitis. Patients and methods. Fifty-six consecutive patients (37 males and 19 females; mean ± SD age, 26 ± 11 years) with resistant allergic rhinitis or nonallergic rhinitis with eosinophilia syndrome despite medical treatment. Symptomatic improvement including nasal obstruction, nasal discharge, sneezing, smell perception, and quality of life and objective evaluation of nasal airway resistance and nasal provocation test before and after surgery were investigated. Results. The patients showed a remarkable improvement of ≥80%, with the exception of two patients who had an approximately 50% reduction of the total symptomatic scores. Four of eight patients with anosmia subjectively improved whereas the other four patients felt unchanged. All patients who underwent rhinomanometry (n = 15) and nasal provocation testing (n = 15) both before and after surgery showed a significant improvement. There were no intraoperative complications. Postoperative epistaxis occurred in one patient. One patient complained of a transient hypesthesia of the soft palate and dry eye. Nasal mucosal tears were observed in approximately 30% of the patients who otherwise showed no severe synechia or persistent crusting.     

Measles-virus-neutralizing antibodies in intravenous immunoglobulins

Measles infection induces lifelong immunity; however, wild-type infection stimulates higher levels of measles-virus-neutralizing antibodies (mnAbs) than does vaccination. Because the proportion of the donor population with vaccine-induced measles immunity is increasing, this study was conducted to determine whether this shift in demographic characteristics affects mnAb levels in contemporary lots of Immune Globulin Intravenous (Human) (IGIV). When 166 lots of 7 IGIV products manufactured between 1998 and 2003 were assayed by plaque-reduction neutralization test, there was a progressive decrease in geometric mean titers in lots manufactured between 1999 and 2002. IGIV products manufactured from recovered plasma had significantly higher titers than did those manufactured from Source Plasma, which could reflect a change in donor demographic characteristics, because Source Plasma donors tend to be much younger. A reduction in mnAbs also correlated with the loss of either IgG1 and IgG3, possibly because of certain manufacturing procedures, or bivalent antibodies (i.e., intact IgG and F(ab')2), because of fragmentation.     

Theoretical and numerical analysis of different adequacy indices for hemodialysis and peritoneal dialysis

BACKGROUND: Apart from KT/V, equivalent urea clearance (EKR) and fractional solute removal (FSR) can also be used to assess the dialysis adequacy. Our objective was to analyze the relationships between these indices for different dialysis modalities and schedules, using urea kinetic modeling. METHODS: EKR and FSR were calculated for HD (three or six times per week), automatic nightly PD (ANPD) and CAPD using the following reference values of urea concentration and mass in the body: peak, peak average, time average and treatment time average. RESULTS: The standard KT/V approach is related to the treatment time average, whereas the standard EKR is related to the time average reference values. In spite of KT/V = 3.5 (K meaning dialyzer clearance or peritoneal diffusive mass transport coefficient), EKR and FSR were lower for ANPD and CAPD than for HD. The ratio of EKR to FSR was essentially the same for the different treatment modalities (range 3.48-4.07 ml/min). This could be explained by the theoretical analysis which predicts the value of EKR/FSR = V/Tc, independent of the treatment modality and schedules (V is a solute distribution volume, Tc is the time of the full dialysis cycle). CONCLUSION: Whereas the index KT/V in its standard form cannot be used to compare different dialysis regimens, EKR and FSR provide very similar evaluation of different dialysis modalities and schedules, and may be considered as equivalent measures for comparative studies of dialysis adequacy.     

Peroxisome proliferator-activated receptor-gamma agonists diminish peritoneal functional and morphological changes induced by bioincompatible peritoneal dialysis solution

BACKGROUND: To evaluate if peroxisome proliferator-activated receptor-gamma (PPAR-gamma) agonists have a potential protective effect on the peritoneum changes induced by bioincompatible peritoneal dialysis (PD) solution in vivo. METHODS: Male Wistar rats were dialyzed three times daily for 28 days with 1.36% Dianeal (two groups: with (D+R) or without (D) rosiglitazone) or 1.36% Physioneal (two groups: with (P+R) or without (P) rosiglitazone). Peritoneal transport of fluid and small solutes was assessed. Nine rats that did not receive dialysis served as controls. RESULTS: Significant morphological changes were found in the D group compared with controls. Additional use of rosiglitazone in the D+R group resulted in less morphological changes and expression of collagen I as well as an increased drainage volume. The expression of VEGF was inhibited by rosiglitazone while no apparent effect was found regarding TGF/Smad pathway. CONCLUSIONS: The addition of rosiglitazone to standard dialysis fluids can maintain the peritoneal morphology and increase ultrafiltration in a PD rat model.     

Epidemiology of human trichinellosis in Poland--currently and in the past

Since the XIX century human trichinellosis has remained an unsolved problem of public healthcare in Poland. This paper describes the past situation and analyses current changes in the epidemiological pattern of trichinellosis in Poland. Epidemiological data from the last 60 years, point out that the number of human cases as well as the number of deaths caused by trichinellosis has decreased significantly. Up to 90s the main source of Trichinella infection for people was pork. Among other implemented control measures, the introduction of the artificial digestion method in the early 80s to detect trichinellosis in pigs resulted in a shift in the sources of Trichinella infection in humans - pork was replaced with wild boar meat. In the years 1990-1995 the number of outbreaks due to pork consumption was 3.5-times higher than in the years 2000-2005. In the early nineties pork was the source of infection causing about 71% of all outbreaks; in 2000-2005 that number has fallen to only 12%. On the other hand wild boar meat was responsible for 23% of the outbreaks in 1990-1995 and as many as 88% of all outbreaks in the years 2000-2005. Moreover the number of persons infected in the outbreaks significantly decreased. The study of wild animals demonstrated that wild boars in Poland are infected not only with T. spiralis but also with Trichinella britovi. These results and EU recommendations indicate a requirement of determining the Trichinella species which cause infections in outbreaks. In the 3 trichinellosis outbreaks in 2005 the infected meat products were examined with molecular tools. T. spiralis species larvae were the etiological agents of infection in all these outbreaks. The current epidemiological situation of trichinellosis in Poland indicates a need of increasing the awareness of risks related to wild boar meat consumption among the general public. Introducing the artificial digestion method as an obligatory method for wild boar meat examination is also necessary.     

Bone marrow versus sentinel lymph node involvement in breast cancer: a comparison of early hematogenous and early lymphatic tumor spread

The early spread of tumor cells in primary breast cancer patients may occur either through lymphatic or hematogenous dissemination. Lymph node (LN) status and presence of disseminated tumor cells (DTC) in bone marrow (BM) are independent predictors of poor outcome. It is unknown which factors determine one or the other route of tumor cell spread and whether lymphatic and hematogenous tumor cell dissemination are two independent processes. This study is aimed to compare the DTC status in clinically node-negative (N0) breast cancer patients with their sentinel LN status and to investigate predictors of BM and LN involvement. The DTC status of 1,345 clinically N0 breast cancer patients who underwent SLN biopsy during initial surgery was investigated. BM and LN status were compared and predictors of hematogenous and lymphatic tumor cell spread were investigated. DTCs were present in the BM of 181 (13%) patients. LN involvement was found in 348 (26%) patients. There was no correlation between LN and BM status: 137 of 997 nodal-negative patients (14%) had BM involvement and 44 of 348 nodal-positive patients (13%) were positive for DTCs (P = 0.649). The presence of DTCs was not influenced by tumorbiological factors. Conversely, a high correlation between nodal status and tumor size, histology, ER-status and lymph vessel invasion was found. Hematogenous and lymphatic tumor spread seem to be because of independent pathways of cancer progression.     

The risk of breast cancer in women with a BRCA1 mutation from North America and Poland

Women with a BRCA1 mutation face a high lifetime risk of breast cancer. It is unknown to what extent environmental factors modify the inherent genetic risk. If women from different countries, but with similar mutations, experience different levels of cancer risk, nongenetic risk modifiers are likely to be present. Study subjects were a cohort of 1477 women with a BRCA1 mutation, from Canada (n = 358), the United States (n = 256) and Poland (n = 863). The women were followed for a mean of 4.3 years and 130 incident cases of breast cancer were recorded. Annual cancer incidence rates were calculated, and based on these, penetrance curves were constructed for women from North America and Poland. In a Cox proportional hazards model, residence in Poland, versus North America, was associated with an adjusted hazard ratio of 0.54 (95% CI 0.34-0.86; p = 0.01). The risk of breast cancer to age 70 was estimated to be 49% for women from Poland and 72% for women from North America. Among women with BRCA1 mutations, the risk of breast cancer in women who reside in Poland is less than that of women who reside in North America. The reasons for the difference are unknown, but this observation suggests that environmental factors or genetic modifiers are important in determining risk.     

Mafosfamide as a new anticancer agent: preclinical investigations and clinical trials

Mafosfamide (4-thioethane sulfonic acid salt of 4-hydroxy-cyclophosphamide, MAF) belongs to a new generation of the oxazaphosphorine agents. MAF is a cyclophosphamide analog which spontaneously degrades to 4-hydroxy-cyclophosphamide. The effects of MAF on various types of cancer cells were determined during preclinical investigations and clinical trials. The positive results from in vitro and in vivo anticancer studies promoted MAF to a good candidate for phase I trials. Clinical experience with intrathecal MAF, used for patients with neoplastic meningitis due to leukemia, lymphoma, and solid tumors, indicated good tolerability and efficacy. The recommended phase II doses of intrathecally administered MAF were determined. Clinical trials using intrathecal MAF are now underway. To obtain a better therapeutic index, a strategy to alternate dosing between the intraventricular and intralumbar routes is also being tested. MAF is an attractive agent for regional cancer therapy. The current available knowledge on MAF as a new anticancer agent is based on a collection of the original published studies, conference abstracts and relevant articles.     

Results of a phase II open-label, non-randomized trial of cisplatin chemotherapy in patients with BRCA1-positive metastatic breast cancer

ABSTRACT: INTRODUCTION: The purpose of this investigation was to evaluate the efficacy of cisplatin chemotherapy in BRCA1 mutation carriers with metastatic breast cancer. METHODS: In a phase II, open-label study, 20 patients with metastatic breast cancer who carried a mutation in BRCA1 were treated with cisplatin 75 mg/m2 intravenously every 3 weeks as part of a 21-day cycle for 6 cycles. Restaging studies to assess response were performed after cycles 2 and 6, and every three months thereafter. RESULTS: Between July 2007 and January 2009, 20 patients were enrolled. Baseline characteristics were as follows: 65% had prior adjuvant chemotherapy, 55% had prior chemotherapy for metastatic breast cancer; mean age was 48 years (ranges 32 to 70); 30% estrogen receptor (ER) or progesterone receptor (PR)+, 70% ER/PR/Human Epidermal Growth Factor Receptor 2 (HER2)- and 0% HER2+. Overall response rate was 80%; nine patients experienced a complete clinical response (45%) and seven experienced a partial response (35%). Overall survival was 80% at one year, 60% at two years and 25% at three years. Four of the 20 patients are alive four years after initiating treatment. The median time to progression was 12 months. The median survival from the start of cisplatinum treatment was 30 months. Cisplatin-related adverse events, including nausea (50%), anemia (5%) and neutropenia (35%) were mostly mild to moderate in severity. CONCLUSIONS: This phase II study demonstrates that cisplatin chemotherapy has high activity in women with a BRCA1 mutation and metastatic breast cancer and is generally well tolerated. TRIAL REGISTRATION: This trial is registered retrospectively on the clinical trials website ClinicalTrials.gov. The identifier is NCT01611727.