简介:Theetiologyofneurodegenerativediseasesisdiverse,howevermostofthemsharecommoncharacteristics:accumulationofmisfoldedproteins,chronicandsustainedneuroinflammation,andthedysfunctionanddeathofcertainpopulationsofneurons.ThebrainofAlzheimer’sdisease(AD)patientspresents
简介:Objective:Toinvestigatesurgicalindications,operativetechniques,complicationsandauditoryandspeechrehabilitationforcochlearimplant(CI)inchildrenwithotitismediawitheffusion(OME).Materia!andmethods:Thisisaretrospectivereviewofrecordsof24childrenwithbilateralprofoundsensorineuralhearinglossandOMEwhowereimplantedduringJanuary2011toNovember2014intheDepartmentofOtorhinolaryngologyandHeadandNeckSurgeryatthePLAHospital,usingone-stageimplantationviathefacialrecessapproachandroundwindowinsertion.Theincuswasremovedin8casesduringtheimplantationprocedure.Localinfiltrationofdexamethasoneandadrenalineinthemiddleearwasalsoperformed.Postoperativecomplicationswereexamined.PreoperativeandpostoperativequestionnairesincludingCategoriesofAuditoryPerformance(CAP).SpeechIntelligibilityRating(SIR),andtheMeaningfulAuditoryIntegrationScale(MAIS)werecollected.Results:Allelectrodeswereimplantedsuccessfullywithoutanyimmediateordelayedcomplications.Inllammatorychangesofmiddleearmucosawitheffusionwerenotedinallimplantedears.Thescoresofpost-implantCAPandSIRincreasedsignilicantlyinall24cases(t=-25.95and-14.09.respectivelyforCAPandSIR.p<0.05).Conclusions:One-stageCIviathefacialrecessapproachwithroundwindowinsertionissafeandeffectiveincochlearimplantcandidateswithOME,asseeninthe24childreninourstudywhoachievedimprovedauditoryperformanceandspeechintelligibilityafterCI.
简介:BackgroundThecoronarycollateralcirculationhasapositiveeffectontheischemicmyocardium.Butitislimitedforpatientsmissingthetimewindowoftotalocclusionofthecoronaryarteryelectivepercutaneouscoronaryintervention(PCI).Theeffectofcollateralcirculationonleftcardiacfunctionhasbeenlessstudied.MethodsAtotalof34patientswithoneormorecoronaryarteryocclusionwhounderwentcoronaryangiographyandRentrop'smethodweredividedinto2groups:Goodcollateralcirculation(Agroups,Rentropscore2-3,n=19)and(Bgroups,Rentropscore1-2,n=15).Theimprovementofleftventricularenddiastolicvolume(LVEDV)andleftventricularejectionfraction(LVEF)werecomparedbetweenthetwogroupsbeforeandafterPCI.ResultsIngoodcollateralcirculationgroup,leftventricularejectionfraction(LVEF)wassignificantlyhigherafterPCI(P<0.05).Inpoorcollateralcirculationgroup,leftventricularenddiastolicvolumeindex(LVEDV)wassignificantlyincreasedafterPCI(P<0.05).ConclusionsGoodcollateralcirculationhasasignificantprotectiveeffectonleftventricularfunction.PCIoperationcansignificantlyimprovetheprognosisofpatientswithgoodcollateralcirculationofcoronaryarteryocclusion.
简介:Background:Currently,thereisasignificantlackofdataconcerninglong-termoutcomesfollowingpaediatriccochlearimplantationintermsofqualityoflife.Thereisaneedforalong-term,prospectivestudyinthisregard.Thisstudyaimsathighlightingthepreliminaryresults,oneyearpostsurgeryofafiveyearprospectivestudy.Methods:TheCochlearTMPaediatricImplantedRecipientObservationalStudy(P-IROS)isaprospective,patientoutcomesregistryforroutinelyimplantedchildren.Thestudycollectsdatausingquestionnairespost-surgeryandatregularintervalsuptofiveyears.Results:AtourCentre,159cochlearimplantsurgeryprocedureswerecarriedoutbetweenJanuary2014andDecember2014.CategoryofAuditoryPerformanceIIscoreincreasedfrom‘0’to‘3’atsixmonthsandto‘5’at12monthsforchildrenaged0—3years,althoughthiswasnotstatisticallysignificant.However,thesametrendwasstatisticallysignificantfortheage3—6yearandage6—10yearbrackets.Thequalityoflifeofthechildimprovedsignificantly.Analysisofcommunicationmoderevealedastatisticallysignificantoverallshifttotheauditory-oralmodefromtotalcommunication.Conclusion:Cochlearimplantationisalife-changingintervention.Theevidenceinsupportofwhatitcanachievesafelyisclear.However,thecostsassociatedwithitraisethequestionifitwillremainaneffectiveoptionforlifeinallchildren.TheCochlearP-IROSisanattempttoanswerthesameoverafiveyearperiod.OurstudyinNewDelhi,sofarconcludesthatcochlearimplantationinapopulationwithlimitedaccesstofundsisveryeffective,oneyearaftersurgery.