Improved speech and language development after unilateral cochlear implantation in children with a potentially useable contralateral ear

Objectives: Increasingly, children are considered for a unilateral cochlear implant (CI), even if the contralateral ear falls outside current audiological guidelines, especially if they are not considered to be reaching their educational potential. Here we present the outcomes of CI in children with potentially useable hearing in the contralateral ear.

Methods: A retrospective case note review was performed for a total of 57 patients. Primary outcome was speech and language (SaL) development, as measured by the Manchester Speech and Language Development Scale (MSLDS) and SaL age equivalent. Secondary outcomes were auditory perception, perceived parental benefit and compliance; respectively measured by Categories of Auditory Performance (CAP), Brief Assessment of Parental Perception (BAPP) and reported use.

Results: SaL development improved after CI with a mean pre-operative MSLDS score of 5.8 to a postoperative score of 8.0 (n?=?57) and a mean SaL age equivalent of 14 months in a one-year period (n?=?14). Furthermore, CAP scores improved from 4.9 to 7.0 (n?=?57). Analysis of BAPP scores showed improved quality of life in 18/19 patients (94.7%). With regards to compliance, 50/57 (87.7%) are fulltime users of both their CI and their HA.

Conclusion: The present study indicates that despite one ear having potentially useable hearing outside national audiological criteria, the majority of participants received benefit from a CI in the poorer hearing ear. We suggest that assessment of each ear separately and treatment with the most appropriate amplification device, has given these children a benefit they may not otherwise have acquired if they only had bilateral HA.     

Immunologic significance of respirable atmospheric starch granules containing major birch allergen Bet v 1

BACKGROUND: Birch-pollen allergens are an important cause of early spring hay fever and allergic asthma. Recently, we reported a mechanism for the release of respirable allergenic particles from birch pollen containing the major allergen Bet v 1. In this study, we aimed to assess the immunologic significance of the released Bet v 1-containing starch granules in the environment. METHODS: A two-site monoclonal antibody-based assay (ELISA) was employed to quantitate Bet v 1 in high-volume air sampler filter extracts, and immunogold-labelling was used on sections of these extracts to localize Bet v 1. Immunoblot analyses were performed with pooled sera from patients sensitive to birch pollen. RESULTS: Atmospheric starch granules contained Bet v 1, and the concentration increased upon light rainfall. Sera from patients allergic to birch allergens recognized extracts from isolated starch granules. CONCLUSIONS: The clinical implications of these findings are that starch granules released from birch pollen are potentially able to trigger allergic asthmatic reactions to Bet v 1, since the allergen occurs in respirable particles. Thus, clinicians can advise asthma patients to remain indoors on days of light rainfall during the birch-pollen season to avoid high levels of allergen exposure.     

血透对慢性肾功能衰竭患者心脏结构和功能的影响

目的 探讨慢性肾功能衰竭（ＣＲＦ）患者心脏结构和功能的改变及血液透析对心脏的影响。方法 ４０例正常对照及２０例慢性肾衰患者血透前后分别用彩色多普勒超声心动图（ＵＣＧ）进行心脏结构和功能的测定,并监测透析前后血压、肾功能的变化。结果 ＣＲＦ患者与正常对照组相比,ＳＢＰ显著升高（Ｐ〈０．０１）,ＡＯＥ降低,ＬＡＤ、ＲＡＡ、ＩＶＳＴ、ＬＶＰＷＴ及ＬＶＭＩ均明显增高（Ｐ〈０．０１）,心脏收缩功能代偿性增强     

彩色多普勒超声评价肾外肾动静脉瘘所致复杂血流动力学改变

目的 应用彩色多普勒超声主人肾外肾动静肪 所致血流动力学改变。方法 采用Ｇａｔｅｗａｙ ＦＸ彩色多普勒超声仪进行检查,对腹部受累血管进行观察、测量和分析,并与ＤＳＡ和手术结果进行对照。结果 彩超能够显示肾外肾动静脉瘘的瘘口和血流动力学改变,受累脏器的缺血性改变,以及心脏的结构和功能的改变。结论 彩超可较好地评价发生于腹部大血管的动静脉瘘的血流动力学改变,并很好地与动脉瘤、囊性病变和管道扩张等进行鉴     

Scoring approaches to the recognition of cases of sudden infant death syndrome

The aim of this study was to create a scoring method to distinguish between sudden infant death syndrome (SIDS) and cases of sudden death resulting from life-threatening conditions (LTC). Four hundred infants less than one year old who died suddenly out of hospital in St Petersburg between 1983 and 1990 and who underwent a complete autopsy, were entered into the study. In 200 cases, the main diagnosis was SIDS, while in the remaining 200 cases, death was interpreted as resulting from LTC; 115 clinical and 240 morphological signs and symptoms were evaluated in each case. The statistical approach was based on the method of stepwise logistic regression analysis and it helped to identify 6 clinical and 12 morphological signs which, combined, made it possible to distinguish between SIDS and non-SIDS (LTC) cases most accurately.