Aging, Cognitive Decline and Hearing Loss: Effects of Auditory Rehabilitation and Training with Hearing Aids and Cochlear Implants on Cognitive Function and Depression among Older Adults

A growing interest in cognitive effects associated with speech and hearing processes is spreading throughout the scientific community essentially guided by evidence that central and peripheral hearing loss is associated with cognitive decline. For the present research, 125 participants older than 65 years of age (105 with hearing impairment and 20 with normal hearing) were enrolled, divided into 6 groups according to their degree of hearing loss and assessed to determine the effects of the treatment applied. Patients in our research program routinely undergo an extensive audiological and cognitive evaluation protocol providing results from the Digit Span test, Stroop color-word test, Montreal Cognitive Assessment and Geriatric Depression Scale, before and after rehabilitation. Data analysis was performed for a cross-sectional and longitudinal study of the outcomes for the different treatment groups. Each group demonstrated improvement after auditory rehabilitation or training on shortand long-term memory tasks, level of depression and cognitive status scores. Auditory rehabilitation by cochlear implants or hearing aids is effective also among older adults (median age of 74 years) with different degrees of hearing loss, and enables positive improvements in terms of social isolation, depression and cognitive performance

Exposições ocupacionais por fluidos corpóreos entre trabalhadores da saúde e sua adesão à quimioprofilaxia

Os objetivos do estudo foram investigar as características do acidente e do acidentado e avaliar a adesão à quimioprofilaxia e aos exames de controle e seguimento após o acidente ocupacional com risco de contaminação pelo vírus da imunodeficiência humana e vírus das hepatites B e C. Este é um estudo epidemiológico descritivo cujos dados foram coletados nas notificações realizadas em uma região administrativa da Secretaria de Estado da Saúde de São Paulo, Brasil, nos anos de 2000 e de 2001. Observou-se 7,3% de recusa à quimioprofilaxia contra o vírus da imunodeficiência humana por meio de anti-retroviral, e 40,6% dos trabalhadores que a aceitaram não completaram o tratamento no tempo previsto de quatro semanas. Em razão desse diagnóstico, evidencia-se a necessidade de que as instituições envolvidas estabeleçam estratégias que possibilitem um aumento da adesão dos trabalhadores da saúde a esses cuidados.This study was aimed at investigating the characteristics of occupational accidents and of the workers that suffered them, and at evaluating the adhesion to chemoprophylaxis and to control and follow up tests after occu-pational accidents with risk of contamination by the human immunodeficiency virus and of the hepatitis B and C virus. This is a descriptive epidemiological study whose data was collected from the notifications of one of the administrative regions of the State of São Paulo's Secretary of Health between 2000 and 2001. It was observed 7.3% of refusals for chemoprophylaxis against human immunodeficiency virus by antiretrovirals, and that 40.6% of the care workers who accepted the chemoprophylaxis did not complete the treatment in the four weeks estimated for it. This diagnosis highlights the need for the institutions involved to establish strategies that make possible an increase in the adherence of health workers to these care procedures.Los objetivos del estudio fueron investigar las características del accidente y del accidentado y evaluar la adhesión a la quimioprofilaxis y a los exámenes de control y seguimiento después del accidente ocupacional con riesgo de contaminación por el virus de la inmunodeficiencia humana y virus de las hepatitis B y C. Se trata de un estudio epidemiológico descriptivo cuyos datos fueron recolectados en las notificaciones realizadas en una región administrativa de la Secretaría de Estado de la Salud de Sao Paulo- Brasil, en los años 2000 y 2001. Se observó un 7,3% de rechazo a la quimioprofilaxis contra el virus de la inmunodeficiencia humana por medio de anti retroviral, y un 40,6% de los trabajadores que la aceptaron no completaron el tratamiento en el tiempo previsto de cuatro semanas. En razón de ese diagnóstico, se evidencia la necesidad de que las instituciones involucradas establezcan estrategias que posibiliten un aumento de la adhesión de los trabajadores de salud a esos cuidados

A prokineticin-like protein responds to immune challenges in the gastropod pest Pomacea canaliculata

The golden apple snail Pomacea canaliculata is an invasive pest originating from South America. It has already been found in Asia, the southern United States and more recently in the EU. Aiming to target the immune system of the snail as a way to control its spreading, we have developed organ-specific transcriptomes and looked for molecules controlling replication and differentiation of snail hemocytes. The prokineticin domain-containing protein Astakine 1 is the only cytokine known thus far capable of regulating invertebrate hematopoiesis, and we analyzed the transcriptomes looking for molecules containing a prokineticin domain. We have identified a prokineticin-like protein (PlP), that we called Pc-plp and we analyzed by real-time PCR (qPCR) its expression. In control snails, highest levels of Pc-plp were detected in the digestive gland, the ampulla (i.e., a hemocyte reservoir) and the pericardial fluid (i.e., the hematopoietic district). We tested Pc-plp expression after triggering hematopoiesis via multiple hemolymph withdrawals, or during bacterial challenge through LPS injection. In both cases a reduction of Pc-plp mRNA was observed. The multiple hemolymph withdrawals caused a significant decrease of Pc-plp mRNA in pericardial fluid and circulating hemocytes, while the LPS injection promoted the Pc-plp mRNA drop in anterior kidney, mantle and gills, organs that may act as immune barrier in molluscs. Our data indicate an important role for prokineticin domain-containing proteins as immunomodulators also in gastropods and their dynamic expression may serve as a biosensor to gauge the effectiveness of immunological interventions aimed at curtailing the spreading of the gastropod pest P. canaliculata

Exposições ocupacionais por fluidos corpóreos entre trabalhadores da saúde e sua adesão à quimioprofilaxia Exposiciones ocupacionales por fluidos corporales entre trabajadores de la salud y sy adhesión a la quimioprofilaxis Occupational exposure of health care workers to organic fluids and adhesion to chemorprophilaxis

Os objetivos do estudo foram investigar as características do acidente e do acidentado e avaliar a adesão à quimioprofilaxia e aos exames de controle e seguimento após o acidente ocupacional com risco de contaminação pelo vírus da imunodeficiência humana e vírus das hepatites B e C. Este é um estudo epidemiológico descritivo cujos dados foram coletados nas notificações realizadas em uma região administrativa da Secretaria de Estado da Saúde de São Paulo, Brasil, nos anos de 2000 e de 2001. Observou-se 7,3% de recusa à quimioprofilaxia contra o vírus da imunodeficiência humana por meio de anti-retroviral, e 40,6% dos trabalhadores que a aceitaram não completaram o tratamento no tempo previsto de quatro semanas. Em razão desse diagnóstico, evidencia-se a necessidade de que as instituições envolvidas estabeleçam estratégias que possibilitem um aumento da adesão dos trabalhadores da saúde a esses cuidados.<br>Los objetivos del estudio fueron investigar las características del accidente y del accidentado y evaluar la adhesión a la quimioprofilaxis y a los exámenes de control y seguimiento después del accidente ocupacional con riesgo de contaminación por el virus de la inmunodeficiencia humana y virus de las hepatitis B y C. Se trata de un estudio epidemiológico descriptivo cuyos datos fueron recolectados en las notificaciones realizadas en una región administrativa de la Secretaría de Estado de la Salud de Sao Paulo- Brasil, en los años 2000 y 2001. Se observó un 7,3% de rechazo a la quimioprofilaxis contra el virus de la inmunodeficiencia humana por medio de anti retroviral, y un 40,6% de los trabajadores que la aceptaron no completaron el tratamiento en el tiempo previsto de cuatro semanas. En razón de ese diagnóstico, se evidencia la necesidad de que las instituciones involucradas establezcan estrategias que posibiliten un aumento de la adhesión de los trabajadores de salud a esos cuidados.<br>This study was aimed at investigating the characteristics of occupational accidents and of the workers that suffered them, and at evaluating the adhesion to chemoprophylaxis and to control and follow up tests after occu-pational accidents with risk of contamination by the human immunodeficiency virus and of the hepatitis B and C virus. This is a descriptive epidemiological study whose data was collected from the notifications of one of the administrative regions of the State of São Paulo's Secretary of Health between 2000 and 2001. It was observed 7.3% of refusals for chemoprophylaxis against human immunodeficiency virus by antiretrovirals, and that 40.6% of the care workers who accepted the chemoprophylaxis did not complete the treatment in the four weeks estimated for it. This diagnosis highlights the need for the institutions involved to establish strategies that make possible an increase in the adherence of health workers to these care procedures

Is very early hearing assessment always reliable in selecting patients for cochlear implants? A case series study

INTRODUCTION: This study concerns a case series of 23 infants with a diagnosis of severe-to-profound hearing loss at 3 months old, who significantly improved (even reaching a normal auditory threshold) within their first year of life. METHODS: All infants were routinely followed up with audiological tests every 2 months after being fitted with hearing aids as necessary. A reliable consistency between the various test findings (DPOAE, ABR, behavioral responses, CAEP and ECoG) clearly emerged in most cases during the follow-up, albeit at different times after birth. RESULTS: The series of infants included 7 cases of severe prematurity, 6 of cerebral or complex syndromic malformations, 5 healthy infants, 2 with asymptomatic congenital CMV infection, and 1 case each of hyperbilirubinemia, hypoxia, and sepsis. All term-born infants showed a significant improvement over their initial hearing threshold by 6 months of age, while in most of those born prematurely the first signs of threshold amelioration occurred beyond 70 weeks of gestational age, and even beyond 85 weeks in one case. CONCLUSIONS: Cochlear implantation (CI) should only be considered after a period of auditory stimulation and follow-up with electrophysiological and behavioral tests, and an accurate analysis of their correlation. In our opinion, CI can be performed after a period of 8 months in all term-born infants with persistent severe-to-profound hearing loss without risk of diagnostic error, whereas the follow-up for severely preterm infants should extend to at least 80 weeks of gestational age

Cochlear implantation in the elderly: Surgical and hearing outcomes

BACKGROUND: At the present time, 50 to 60% of the population above 70 years of age suffers from a hearing impairment and from 0.6 to 1.1% has a severe to profound loss, which cannot benefit from an hearing aid. Moreover, it is expected that this prevalence will grow by more than two-fold in the next 40 years. There is strong evidence that hearing loss in older adults is associated with both cognitive load and social isolation, which in turn, are associated with cognitive and physical functioning. Cochlear implant (CI) dramatically improves sound audibility and speech understanding. The aim of this paper was to analyze outcome and complications of CI treatment in elderly patients. METHODS: A retrospective study on 17 patients, aged at implantation between 65 and 79 years (mean = 70.47 ± 3.94), unilaterally implanted for severe to profound bilateral hearing loss. The following data were statistically evaluated: pre-implant pure-tone threshold and tests of speech recognition, both with hearing aid that without; post-implant threshold and speech perception with CI off and on. Moreover, statistical correlations of PTA improvement between two age groups (65 to 70 and over 70 years) were carried out. RESULTS: Mean PTA improved from 111.25 (± 17.51) (pre-implant) to 43.81 (± 9.27) (post-implant); and the mean SRT improved from 90 dB to 65 dB. Moreover there was no statistical difference in PTA improvement between the two age groups (65 to 70 and over 70 years). No severe per- or post-operative surgical complications were noted. DISCUSSION: In the elderly, CI is a safe procedure that significantly improves hearing threshold (p < 0.00001) and speech perception (p < 0.01). Support of family and professionals, as well as duration of deafness and pre-implant scores greatly influence the results of rehabilitation and its perceived benefit. CI should not be denied in older individuals who are otherwise in good health

Effects of LPS injection on Pc-astakine expression in the gastropod Pomacea canaliculata

Astakine-1 is a prokineticin-containing factor and the first hematopoietic cytokine described in invertebrates. Astakine-1 was firstly retrieved in the freshwater crayfish Pacifastacus leniusculus, and recent experiments have demonstrated the presence of astakine-like molecules also in insects and molluscs, including the freshwater snail, Pomacea canaliculata. In control conditions Pcastakine is expressed in several organs, especially in the ampulla (reservoir of hemocytes and potential district of hemocyte maturation) and in the pericardial fluid (i.e. the hematopoietic tissue). By mean of qPCR experiments, we have analyzed the effects of the injection of 50 \ub5g LPS on the expression of the gene Pc-astakine. Our observations indicate that 24 h after the injection, the major modification of the Pc-astakine expression was evident in the anterior kidney, a potential hemocyte reservoir, in which the expression of the gene decreased to almost undetectable level. In the pericardial fluid, ampulla and circulating hemocytes, the expression of Pc-astakine dropped to less than 50 % with respect to the sham-injected control snails. The drop in the amount of mRNA detected by qPCR could reflect an increased rate of translation and consequent degradation of the available mRNA, rather than a decrease of the transcription rate. Similarly, in the bivalve Crassostrea gigas, it has been suggested that accumulated Cg-astakine transcripts are largely translated under some environment stress, including immune stimuli. On the whole, our results indicate that the expression of Pc-astakine and the translation rate of its mRNA may be influenced by immune stimuli, and support the hypothesis that PcAstakine may be involved in Pomacea hematopoiesis and/or may have immune-related functions, as well