RESUMEN
Cochlear implantation (CI) is a new form of treatment in the rehabilitation of single-sided deafness. The patient requires thorough initial examination and a full explanation of alternative treatment options prior to determining the indication for CI treatment. To date, we have treated 28 patients with CI, of whom data are available for 11 after 12 months. We examined speech comprehension in background noise and localisation ability 12 months after CI implantation compared to conventional CROS (contralateral routing of signal) hearing aids, BAHA (bone-anchored hearing aid) and hearing in untreated patients. In addition, we determined the subjective handicap (HHIE, hearing handicap inventory for the elderly) and the subjective success (IOI-HA, international outcome inventory for hearing aids; SSQ, spatial and qualities of hearing scale) of each treatment option. After 12 months' experience, the results show a significantly better localisation ability and an improvement in speech comprehension in background noise with CI than with the other treatment options. Subjective results also show a clear benefit with CI. Careful patient selection is a decisive factor for successful treatment of this patient group. Under these conditions, CI is a treatment option with which significant improvement in speech comprehension and localization ability in single-sided deafness is possible.
Asunto(s)
Implantación Coclear/métodos , Implantes Cocleares , Pérdida Auditiva Unilateral/diagnóstico , Pérdida Auditiva Unilateral/terapia , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Radiation synovectomy by intra-articular injection of beta-emitting radionuclides is a reliable and easy-to-perform therapy without harmful side effects for the treatment of inflammatory rheumatoid as well as degenerative joint diseases. The indication for radiation synovectomy is based on both clinical symptoms and on proven hyperperfusion, with active synovitis being seen on a pre-therapeutic three-phase bone scan. In this study, the clinical response after 6-18 months, evaluated by a standardized questionnaire, was compared with the reduction of synovitis seen on three-phase bone scintigraphy after treatment of 475 joints in 151 patients. The best clinical results were obtained in cases of true rheumatoid arthritis (73.4%), with less in other kinds of arthritis (48.8%) such as psoriatic or reactive arthritis. Because of the inflamed synovium being the main target tissue, clinical results in osteoarthritis with severe bone destruction are poorer (33.9%). However, synovitis can be markedly reduced (in approximately 70%), regardless of the underlying diagnosis, as shown by post-therapeutic three-phase bone scanning. Radiation synovectomy can be recommended in all kinds of arthritis. It should also be considered in cases of osteoarthritis as a last therapeutic option prior to joint replacement.
Asunto(s)
Artritis Reumatoide/radioterapia , Membrana Sinovial , Medronato de Tecnecio Tc 99m/análogos & derivados , Adulto , Anciano , Anciano de 80 o más Años , Artritis Reumatoide/diagnóstico por imagen , Huesos/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Cintigrafía , Radiofármacos , Estudios Retrospectivos , Sinovitis/diagnóstico por imagenRESUMEN
Rats were raised in large (14/dam), medium (8/dam) and small (4/dam) litters. The rate of in vitro synthesis of cholesterol from 3H2O in the proximal and distal parts of the small intestine decreased from birth to a low 14 days later and then increased again by day 21. The rate of synthesis in both parts of the gut on day 6 after birth was lowest in the 14/dam group. On day 21 after birth the rate was highest in the 14/dam group in the proximal and lowest in the distal gut. Thus in the early postnatal period low rates of intestinal cholesterol synthesis correlate with low plasma cholesterol values. In white adipose tissue the low rate of cholesterol synthesis remained unaltered up to day 21 in the 8/dam, and 4/dam groups. However, it continuously increased in the 14/dam group being about threefold higher than in the other two groups on day 21.