Objectives: To describe the fluctuating high velocity vestibular ocular-reflex (VOR) during the Meniere's attacks and correlate those features with pathophysiology. Patients: A patient with unilateral Meniere's disease (MD) was evaluated closely during and after acute vertigo episodes. Main Outcome Measures: The spontaneous nystagmus and the dynamic VOR changes were measured by the video head impulse test (VHIT) at different stages of the vertigo crisis and during the quiescent phase of the condition. Results: During the Meniere's attack, the VOR gain showed large changes on the affected side; however, on recovery a return to the normal value was evident. The VOR gain also showed fluctuation on follow up, paralleling symptoms. The greatest reduction of the VOR was during the paralytic nystagmus phase. Conclusions: The present case documents rapid vestibular fluctuation documented with VHIT testing in MD. The ionic-chemical perilymphatic intoxication and the endolymphatic space collapse due to membrane rupture could explain those features. VHIT fluctuation is a promising tool for diagnosis of patients with episodic vestibular symptoms. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Τετάρτη 7 Δεκεμβρίου 2016
Pressurized Wideband Acoustic Stapedial Reflex Thresholds: Normal Development and Relationships to Auditory Function in Infants
Abstract
This study analyzed effects of pressurization on wideband acoustic stapedial-muscle reflex (ASR) tests in infants cared for in normal newborn (NN) and neonatal intensive care units (NICU). Effects of hearing-screening outcomes on ASR threshold measurements were also evaluated, and a subsequent longitudinal study established normative threshold ranges over the first year after birth. An initial experiment compared thresholds in newborns measured at ambient pressure in the ear canal and at the tympanometric peak pressure. ASR thresholds for broadband noise were higher for ears that did not pass newborn hearing screening and ASR threshold was 14 dB higher for real-ear compared to coupler conditions. Effects of pressurization were significant for ears that passed screening; thus, ASR testing in infants should be conducted at tympanometric peak pressure. ASR threshold was significantly higher for ears that referred on transient evoked otoacoustic emissions and Auditory Brainstem Response (ABR) screening tests and also for ears with conductive and sensorineural hearing loss diagnosed by ABR. Developmental ASR changes were significant over the first year for both normal and NICU infants. Wideband pressurized ASR thresholds are a clinically relevant measure of newborn hearing screening and diagnostic outcomes.
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Evidence for a Right-Ear Advantage in Newborn Hearing Screening Results
The aim of the present study was to investigate the effect of ear asymmetry, order of testing, and gender on transient-evoked otoacoustic emission (TEOAE) pass rates and response levels in newborn hearing screening. The screening results of 879 newborns, of whom 387 (study group) passed screening successfully in only one ear in the first TEOAE screening, but passed screening successfully in both ears thereafter, and 492 (control group) who passed screening successfully in both ears in the first TEOAE, were retrospectively examined for pass rates and TEOAE characteristics. Results indicated a right-ear advantage, as manifested by significantly higher pass rates in the right ear (61% and 39% for right and left ears, respectively) in the study group, and in 1.75 dB greater TEOAE response amplitudes in the control group. The right-ear advantage was enhanced when the first tested ear was the right ear (76%). When the left ear was tested first, pass rates were comparable in both ears. The right-ear advantage in pass rates was similar in females versus males, but manifested in 1.5 dB higher response amplitudes in females compared with males, regardless of the tested ear and order of testing in both study and control groups. The study provides further evidence for the functional lateralization of the auditory system at the cochlear level already apparent soon after birth in both males and females. While order of testing plays a significant role in the asymmetry in pass rates, the innate right-ear advantage seems to be a more dominant contributor.
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Evidence for a Right-Ear Advantage in Newborn Hearing Screening Results
The aim of the present study was to investigate the effect of ear asymmetry, order of testing, and gender on transient-evoked otoacoustic emission (TEOAE) pass rates and response levels in newborn hearing screening. The screening results of 879 newborns, of whom 387 (study group) passed screening successfully in only one ear in the first TEOAE screening, but passed screening successfully in both ears thereafter, and 492 (control group) who passed screening successfully in both ears in the first TEOAE, were retrospectively examined for pass rates and TEOAE characteristics. Results indicated a right-ear advantage, as manifested by significantly higher pass rates in the right ear (61% and 39% for right and left ears, respectively) in the study group, and in 1.75 dB greater TEOAE response amplitudes in the control group. The right-ear advantage was enhanced when the first tested ear was the right ear (76%). When the left ear was tested first, pass rates were comparable in both ears. The right-ear advantage in pass rates was similar in females versus males, but manifested in 1.5 dB higher response amplitudes in females compared with males, regardless of the tested ear and order of testing in both study and control groups. The study provides further evidence for the functional lateralization of the auditory system at the cochlear level already apparent soon after birth in both males and females. While order of testing plays a significant role in the asymmetry in pass rates, the innate right-ear advantage seems to be a more dominant contributor.
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Evidence for a Right-Ear Advantage in Newborn Hearing Screening Results
The aim of the present study was to investigate the effect of ear asymmetry, order of testing, and gender on transient-evoked otoacoustic emission (TEOAE) pass rates and response levels in newborn hearing screening. The screening results of 879 newborns, of whom 387 (study group) passed screening successfully in only one ear in the first TEOAE screening, but passed screening successfully in both ears thereafter, and 492 (control group) who passed screening successfully in both ears in the first TEOAE, were retrospectively examined for pass rates and TEOAE characteristics. Results indicated a right-ear advantage, as manifested by significantly higher pass rates in the right ear (61% and 39% for right and left ears, respectively) in the study group, and in 1.75 dB greater TEOAE response amplitudes in the control group. The right-ear advantage was enhanced when the first tested ear was the right ear (76%). When the left ear was tested first, pass rates were comparable in both ears. The right-ear advantage in pass rates was similar in females versus males, but manifested in 1.5 dB higher response amplitudes in females compared with males, regardless of the tested ear and order of testing in both study and control groups. The study provides further evidence for the functional lateralization of the auditory system at the cochlear level already apparent soon after birth in both males and females. While order of testing plays a significant role in the asymmetry in pass rates, the innate right-ear advantage seems to be a more dominant contributor.
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Техническое Обследование Зданий И Проектирование Инженерных Сетей zhilpro
Планировка
архитектурное проектирование зданий и авторский надзор
Комплексное дизайн – это развивающаяся болезнь атрибуты экстерьера, элементов и данных корпусов, строительств, а еще объектов не тот рекомендация. Его результатом делается выход в свет программа – единого набора текущих о определенной постройки, позволяющем принять к его строительству. Данный узловой развивающаяся болезнь, без которого не сможет взяться никакое постройка, появляется непременною периодом преддверие начатками монтажных или строительных произведений. Планировка разрешает не едва лишь получить глубокое принцип о последовательности и последствии возведения корпуса, однако и вычислить надобные в угоду этого расходы. Причем, служебный расчет сооружения необходим в интересах понижения расходов оружий и материй, планирования инвестиционной сочиняющей, экономии периоды, вдобавок для приобретения позволений и согласований на все разновидности дел в государственных контролирующих органах.
Команда Укржитлопроект производит на заказ проектирование сооружений и зданий всякою уровне сложности, вливающее исследование первого программа площади, архитектурных индивидуальностей, закрытых и странных инженерных сеток и остальных элементов свежеиспеченного или же реконструируемого темы. Наши мастерицы хороши реализовать всякие занятия на этом осторожном этапе возведения новых в противном случае преобразования сейчас будущих структур. Комплексное проектирование чертовски многозначаще еще и потому, что разрешает авансом вычислить продуктивность планируемого возведения. Выкинутые, дербалызнутые в проекте, причиняют основополагающее влияние на данные новоиспеченного либо обновленного темы и его достоинство, какая-нибудь зависит от обличий и чисел применяемых стройматериалов. Все данные параметры нужно было предварительно учесть и просчитывать при возведении целиком и полностью разных сооружений – от многоэтажных домов и личных домов до торговых центров и производственных ансамблей.
Икебана исследовании проектной документации
Проектные труда стартуют с отпуска заказчиком инженерам особенного техзадания. К нему также прилагаются кой-какие приготовленные наперед паспорта, таковые как – волчий аттестат о законодательстве собственности на земельные поле, информации об инженерных занятиях, технические притязании на присоединения к проектирование жилых зданий всяческим сетками и иное. Тз на планировка может быть составлено и при отзывчивости инженера-проектировщика, но при нынешнем он полно едва лишь конкретизировать и уточнять задания и пожелания заказчика постройки. Что касается содержания разглядываемых документов, то оно зависит от такого, коею предмет короче возведен или реконструирован. Проектировщики зачисляют в вещь нечеловечески тот совершенный модификация технического задания, какой сначала ратифицирован заказчиком.
Техзадание в пользу проектирования хранит придерживающиеся текущие:
Азбуки перво-наперво исследовании программа;
Выступлению об необычных требованиях сооружения;
Наиважнейшие экономические и технические данные иметься в наличии объектов;
Ключевые запросы к архитектурным, планировочным, а еще конструктивным укокошениям в угоду строительств и помещений;
Меры, которые необходимо хлебнуть для благосостояния пожарной безобидности, защиты природы и иную сходную сведение.
Нужно будет сохранять в голове, что от такого, насколько подробно и качественно соединено техзадание, зависит часто периоды, какое-нибудь потребуется в угоду исследовании программа. Всегда имеется чуток стадий проектирования построек и помещений. Их число зависит от сложности четкого темы. Особо зачастую программы разрабатываются в 1 в противном случае 2-е периода, которые будут живописаны ниже.
2-е стадии проектирования:
Промискуитет «Проект» (П) – разрабатывается в пользу одобрения и согласования. При настоящем без сущей детализации складываются главнейшие архитектурные, конструктивные и планировочные выводы с целью темы, которые имеют все шансы трогать и генерального намерения. Родственные не детализированные резолюция принимаются и по различному нефтегазооборудованию, вдобавок инженерным сетям. А там все специализированные паспорта следуют на экспертизу в пропорциональные правительственные органы, расценивающие расписание и формирующие критические замечания к нему. Вслед за тем того, как исполнители удаляют определенные специализированными службами пробелы, возникает вкалывание над следующим стадием исследовании;
Формация «Рабочая документация» (РД) – разрабатывается перво-наперво возведения. На этом этапе проектирования совершается деталь и детализация всех от мала до велика решений в угоду объекта, которые были обусловлены на этапа П. Причем, инженеры сочиняют рабочие чертежи, не этот и сметную незаменимую документацию, тот или другой полноте задействована в угоду исполнению строительно-монтажных служб. Нынешний облик грамот зажигает таковые составляющие:
Наемный рабочий чертежи, разработанные сообразно с требованиями государственных стандартов;
Удостоверяющий личность документ отделочных дел;
Сметную документацию;
Табель объемов строительных, а также монтажных служб;
Сборники спецификаций сельхозоборудования, произведений и мануфактур;
Опросные листы и габаритные чертежи на обычные внешности уснащения и другие создания;
Отправные условия в интересах разработки конструкторской документации на уснащение неординарного приготовления, подсоединяющее также нестандартизированное и нетипичное.
Преобладающим преимуществом двухстадийного проектирования представляется минимизация тратов, необходимых с целью привнесения различий в документацию с целью темы, в тех случаях, в случае если предварительные ответа инженеров угадают злополучными то есть важные поправки будут вписаны в техзадание.
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Anquiloglosia y problemas de succión, tratamiento multidisciplinar: terapia miofuncional orofacial, sesiones de lactancia materna y frenotomía
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Tomasa Pastor-Vera, Paula Rodriguez-Alessi, Elvira Ferrés-Amat, Eduard Ferrés-Padró
IntroducciónLa limitación de la movilidad lingual en neonatos puede ocasionar problemas en la lactancia, entre ellos: dolor-grietas-mastitis en la madre, mal progreso de peso del neonato y duración excesivamente larga de las tomas. El objetivo de este trabajo es evaluar la efectividad de los tratamientos realizados en los pacientes con anquiloglosia y trastornos de succión.Material y métodosEstudio descriptivo preliminar de la efectividad del circuito establecido entre los servicios de Cirugía Oral y Maxilofacial, Logopedia y Rehabilitación Orofacial y Lactancia Materna para el tratamiento de los pacientes que acuden con problemas de lactancia materna y se les diagnostica anquiloglosia.ResultadosSe trató a 61 pacientes de edades entre 0 y 6meses con anquiloglosia asociada a problemas clínicos relacionados con la lactancia: 20 niñas (32.8%) y 41 niños (67.2%). Se establecieron 3 grupos según el tratamiento realizado: grupo1 (n=6) únicamente las sesiones de lactancia materna (SLM), grupo2 (n=19) terapia miofuncional (TMF) y asesoramiento en SLM, y grupo3 (n=36) frenotomía y siguieron TMF y asesoramiento de SLM. La anquiloglosia tipoiii es el frenillo lingual más frecuente (57.4%). En el total de la muestra se observaron mejorías en los parámetros que valoran la efectividad y el confort de la lactancia materna.ConclusionesMejorar la succión es posible; se recomienda estimular la succión con terapia miofuncional antes y después de la frenotomía, y también en aquellos casos en los que no será necesaria la cirugía.IntroductionThe limitation of lingual mobility in newborns can cause problems in lactation. Among these problems are, soreness, cracked nipples or mastitis in the mother, poor weight gain of the newborn, and an excessively prolonged period of time in each breastfeed. The aim of this study is evaluate the effectiveness of the treatment received by the newborns with breastfeeding problems and ankyloglossia.Material and methodsA preliminary study of the effectiveness of the circuit established between the Oral and Maxillofacial Surgery, Speech Therapy and Orofacial Rehabilitation and the Breastfeeding Department to treat patients that attended the hospital with breastfeeding problems and were diagnosed with ankyloglossia.ResultsA total of 61 patients with ages between 0 and 6 months had ankyloglossia were seen due to clinical problems related to breastfeeding. Of these, 20 (32.8%) were girls and 41 (67.2%) were boys. Three groups were established in accordance with the treatment carried out: group1 (n=6) solely from the Breastfeeding Sessions (BFS), group2 (n=19) Myofunctional Therapy (MFT) and BFS, and group3 (n=36) Frenotomy, followed by MFT and BFS. Ankyloglossia type3 was the most frequent lingual frenulum (57.4%). From the total sample, improvements were observed in the parameters that assessed the effectiveness and comfort of breastfeeding.ConclusionsImproving breastfeeding is possible, and in some cases, surgery should not be necessary. If surgery is required, it is recommended to stimulate suction before and after the frenotomy with myofunctional therapy.
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Anquiloglosia y problemas de succión, tratamiento multidisciplinar: terapia miofuncional orofacial, sesiones de lactancia materna y frenotomía
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Tomasa Pastor-Vera, Paula Rodriguez-Alessi, Elvira Ferrés-Amat, Eduard Ferrés-Padró
IntroducciónLa limitación de la movilidad lingual en neonatos puede ocasionar problemas en la lactancia, entre ellos: dolor-grietas-mastitis en la madre, mal progreso de peso del neonato y duración excesivamente larga de las tomas. El objetivo de este trabajo es evaluar la efectividad de los tratamientos realizados en los pacientes con anquiloglosia y trastornos de succión.Material y métodosEstudio descriptivo preliminar de la efectividad del circuito establecido entre los servicios de Cirugía Oral y Maxilofacial, Logopedia y Rehabilitación Orofacial y Lactancia Materna para el tratamiento de los pacientes que acuden con problemas de lactancia materna y se les diagnostica anquiloglosia.ResultadosSe trató a 61 pacientes de edades entre 0 y 6meses con anquiloglosia asociada a problemas clínicos relacionados con la lactancia: 20 niñas (32.8%) y 41 niños (67.2%). Se establecieron 3 grupos según el tratamiento realizado: grupo1 (n=6) únicamente las sesiones de lactancia materna (SLM), grupo2 (n=19) terapia miofuncional (TMF) y asesoramiento en SLM, y grupo3 (n=36) frenotomía y siguieron TMF y asesoramiento de SLM. La anquiloglosia tipoiii es el frenillo lingual más frecuente (57.4%). En el total de la muestra se observaron mejorías en los parámetros que valoran la efectividad y el confort de la lactancia materna.ConclusionesMejorar la succión es posible; se recomienda estimular la succión con terapia miofuncional antes y después de la frenotomía, y también en aquellos casos en los que no será necesaria la cirugía.IntroductionThe limitation of lingual mobility in newborns can cause problems in lactation. Among these problems are, soreness, cracked nipples or mastitis in the mother, poor weight gain of the newborn, and an excessively prolonged period of time in each breastfeed. The aim of this study is evaluate the effectiveness of the treatment received by the newborns with breastfeeding problems and ankyloglossia.Material and methodsA preliminary study of the effectiveness of the circuit established between the Oral and Maxillofacial Surgery, Speech Therapy and Orofacial Rehabilitation and the Breastfeeding Department to treat patients that attended the hospital with breastfeeding problems and were diagnosed with ankyloglossia.ResultsA total of 61 patients with ages between 0 and 6 months had ankyloglossia were seen due to clinical problems related to breastfeeding. Of these, 20 (32.8%) were girls and 41 (67.2%) were boys. Three groups were established in accordance with the treatment carried out: group1 (n=6) solely from the Breastfeeding Sessions (BFS), group2 (n=19) Myofunctional Therapy (MFT) and BFS, and group3 (n=36) Frenotomy, followed by MFT and BFS. Ankyloglossia type3 was the most frequent lingual frenulum (57.4%). From the total sample, improvements were observed in the parameters that assessed the effectiveness and comfort of breastfeeding.ConclusionsImproving breastfeeding is possible, and in some cases, surgery should not be necessary. If surgery is required, it is recommended to stimulate suction before and after the frenotomy with myofunctional therapy.
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Anquiloglosia y problemas de succión, tratamiento multidisciplinar: terapia miofuncional orofacial, sesiones de lactancia materna y frenotomía
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Tomasa Pastor-Vera, Paula Rodriguez-Alessi, Elvira Ferrés-Amat, Eduard Ferrés-Padró
IntroducciónLa limitación de la movilidad lingual en neonatos puede ocasionar problemas en la lactancia, entre ellos: dolor-grietas-mastitis en la madre, mal progreso de peso del neonato y duración excesivamente larga de las tomas. El objetivo de este trabajo es evaluar la efectividad de los tratamientos realizados en los pacientes con anquiloglosia y trastornos de succión.Material y métodosEstudio descriptivo preliminar de la efectividad del circuito establecido entre los servicios de Cirugía Oral y Maxilofacial, Logopedia y Rehabilitación Orofacial y Lactancia Materna para el tratamiento de los pacientes que acuden con problemas de lactancia materna y se les diagnostica anquiloglosia.ResultadosSe trató a 61 pacientes de edades entre 0 y 6meses con anquiloglosia asociada a problemas clínicos relacionados con la lactancia: 20 niñas (32.8%) y 41 niños (67.2%). Se establecieron 3 grupos según el tratamiento realizado: grupo1 (n=6) únicamente las sesiones de lactancia materna (SLM), grupo2 (n=19) terapia miofuncional (TMF) y asesoramiento en SLM, y grupo3 (n=36) frenotomía y siguieron TMF y asesoramiento de SLM. La anquiloglosia tipoiii es el frenillo lingual más frecuente (57.4%). En el total de la muestra se observaron mejorías en los parámetros que valoran la efectividad y el confort de la lactancia materna.ConclusionesMejorar la succión es posible; se recomienda estimular la succión con terapia miofuncional antes y después de la frenotomía, y también en aquellos casos en los que no será necesaria la cirugía.IntroductionThe limitation of lingual mobility in newborns can cause problems in lactation. Among these problems are, soreness, cracked nipples or mastitis in the mother, poor weight gain of the newborn, and an excessively prolonged period of time in each breastfeed. The aim of this study is evaluate the effectiveness of the treatment received by the newborns with breastfeeding problems and ankyloglossia.Material and methodsA preliminary study of the effectiveness of the circuit established between the Oral and Maxillofacial Surgery, Speech Therapy and Orofacial Rehabilitation and the Breastfeeding Department to treat patients that attended the hospital with breastfeeding problems and were diagnosed with ankyloglossia.ResultsA total of 61 patients with ages between 0 and 6 months had ankyloglossia were seen due to clinical problems related to breastfeeding. Of these, 20 (32.8%) were girls and 41 (67.2%) were boys. Three groups were established in accordance with the treatment carried out: group1 (n=6) solely from the Breastfeeding Sessions (BFS), group2 (n=19) Myofunctional Therapy (MFT) and BFS, and group3 (n=36) Frenotomy, followed by MFT and BFS. Ankyloglossia type3 was the most frequent lingual frenulum (57.4%). From the total sample, improvements were observed in the parameters that assessed the effectiveness and comfort of breastfeeding.ConclusionsImproving breastfeeding is possible, and in some cases, surgery should not be necessary. If surgery is required, it is recommended to stimulate suction before and after the frenotomy with myofunctional therapy.
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Talk to Your Plants, but Don’t Scare Them
People from large spans of the globe saw an interesting doodle if they happened to be on Google’s search page on November 30, 2016.
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Differential Expression of Bcl-2 in the Cochlea and Auditory Cortex of a Mouse Model of Age-Related Hearing Loss
Bcl-2, the first gene shown to be involved in apoptosis, is a potent regulator of cell survival and known to have protective effects against a variety of age-related diseases. However, the possible relationship between hearing and Bcl-2 expression in the cochlea or auditory cortex of C57BL/6 mice, a mouse model of age-related hearing loss, is still unknown. Using RT-PCR, immunohistochemistry, and Western blot analysis, our results show that Bcl-2 is strongly expressed in the inner hair cells and spiral ganglion neurons of young mice. In addition, moderate Bcl-2 expression is also detected in the outer hair cells and in the neurons of the auditory cortex. A significant reduction of Bcl-2 expression in the cochlea or auditory cortex is also associated with elevated hearing thresholds and hair cell loss during aging. The expression pattern of Bcl-2 in the peripheral and central auditory systems suggests that Bcl-2 may play an important role in auditory function serving as a protective molecule against age-related hearing loss.
Audiol Neurotol 2016;21:326-332
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Audiol Neurotol 2016;21:326-332
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The role of stress and word size in Spanish speech segmentation
In English, the predominance of stressed syllables as word onsets aids lexical segmentation in degraded listening conditions. Yet it is unlikely that these findings would readily transfer to languages with differing rhythmic structure. In the current study, the authors seek to examine whether listeners exploit both common word size (syllable number) and stress cues to aid lexical segmentation in Spanish. Forty-seven Spanish-speaking listeners transcribed two-word Spanish phrases in noise. As predicted by the statistical probabilities of Spanish, error analysis revealed that listeners preferred two- and three-syllable words with penultimate stress in their attempts to parse the degraded speech signal. These findings provide insight into the importance of stress in tandem with word size in the segmentation of Spanish words and suggest testable hypotheses for cross-linguistic studies that examine the effects of degraded acoustic cues on lexical segmentation.
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