Treatment of recurrent,multiloculated, obstructive hydrocephalus with suprahepatic peritoneal catheter placement

The suprahepatic space represents a potential reservoir for cerebrospinal fluid absorption and becomes critical when extensive abdominal adhesions prevent passage of a peritoneal shunt catheter toward the pelvis. We present a patient with refractory hydrocephalus in which a multishunt system with drainage into the suprahepatic space was ultimately successful in decompressing the patient’s trapped ventricular spaces.     

Mild hypohydration impairs cycle ergometry performance in the heat: A blinded study

The aim of the present study was to observe the effect of mild hypohydration on exercise performance with subjects blinded to their hydration status. Eleven male cyclists (weight 75.8 ± 6.4 kg, VO_2peak: 64.9 ± 5.6 mL/kg/min, body fat: 12.0 ± 5.8%, Power_max: 409 ± 40 W) performed three sets of criterium‐like cycling, consisting of 20‐minute steady‐state cycling (50% peak power output), each followed by a 5‐km time trial at 3% grade. Following a familiarization trial, subjects completed the experimental trials, in counter‐balanced fashion, on two separate occasions in dry heat (30°C, 30% rh) either hypohydrated (HYP) or euhydrated (EUH). In both trials, subjects ingested 25 mL of water every 5 minutes during the steady‐state and every 1 km of the 5‐km time trials. In the EUH trial, sweat losses were fully replaced via intravenous infusion of isotonic saline, while in the HYP trial, a sham IV was instrumented. Following the exercise protocol, the subjects’ bodyweight was changed by ?0.1 ± 0.1% and ?1.8 ± 0.2% for the EUH and HYP trial, respectively (P < 0.05). During the second and third time trials, subjects averaged higher power output (309 ± 5 and 306 ± 5 W) and faster cycling speed (27.5 ± 3.0 and 27.2 ± 3.1 km/h) in the EUH trial compared to the HYP trial (Power: 287 ± 4 and 276 ± 5 W, Speed: 26.2 ± 2.9 and 25.5 ± 3.3 km/h, all P < 0.05). Core temperature (T_re) was higher in the HYP trial throughout the third steady‐state and 5‐km time trial (P < 0.05). These data suggest that mild hypohydration, even when subjects were unaware of their hydration state, impaired cycle ergometry performance in the heat probably due to greater thermoregulatory strain.     

Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation

Objective: To examine post-implantation benefit and time taken to acclimate to the cochlear implant for adult candidates with more hearing in the contralateral non-implanted ear than has been previously considered within local candidacy guidelines. Design: Prospective, within-subject experimental design. Study sample: Forty postlingual hearing-impaired adult subjects with a contralateral ear word score in quiet ranging from 27% to 100% (median 67%). Results: Post-implantation improvement of 2.4?dB and 4.0?dB was observed on a sentence in coincident babble test at presentation levels of 65 and 55?dB SPL respectively, and a 2.1?dB benefit in spatial release from masking (SRM) advantage observed when the noise location favoured the implanted side. Significant post-operative group mean change of between 2.1 and 3.0 was observed on the sub-scales of the speech, spatial, and qualities (SSQ) questionnaire. Degree of post-implantation speech reception threshold (SRT) benefit on the coincident babble test and on perception of soft speech and sounds in the environment was greater for subjects with less contralateral hearing. The degree of contralateral acoustic hearing did not affect time taken to acclimate to the device. Conclusions: The findings from this study support cochlear implantation for candidates with substantial acoustic hearing in the contralateral ear, and provide guidance regarding post-implantation expectations.     

Exploring the broader health and well-being outcomes of mining communities in low- and middle-income countries: A systematic review

Health and well-being outcomes in communities living in proximity to mining activity may be influenced by a broad spectrum of factors including population growth, economic instability or land degradation. This review aims to synthesise broader outcomes associated with mining activity and in doing so, further explore possible determinants in communities of low- and middle-income countries. Four databases were systematically searched and articles were included if the study targeted adults residing in proximity to mining activity, and measured individual or community-level health or well-being outcomes. Narrative synthesis was conducted. Twelve articles were included. Mining was perceived to influence health behaviours, employment conditions, livelihoods and socio-political factors, which were linked to poorer health outcomes. Family relationships, mental health and community cohesion were negatively associated with mining activity. High-risk health behaviours, population growth and changes in vector ecology from environmental modification were associated with increased infectious disease prevalence. This review presents the broader health and well-being outcomes and their determinants, and strengthens the evidence to improve measurement and management of the public health implications of mining. This will support the mining sector to make sustainable investments, and support governments to maximise community development and minimise negative impacts.