Hearing preservation and cochlear implants according to inner ear approach: multicentric evaluation

AbstractIntroductionElectroacoustic stimulation is an excellent option for people with residual hearing in the low frequencies, who obtain insufficient benefit with hearing aids. To be effective, the subject's residual hearing should be preserved during cochlear implant surgery.ObjectivesTo evaluate the hearing preservation in patients that underwent implant placement and to compare the results in accordance with the approach to the inner ear.Methods19 subjects underwent a soft surgical technique, and the electrode MED-EL FLEX™ EAS, designed to be atraumatic, was used. We evaluated pre- and postoperative tonal audiometric tests with an average of 18.4 months after implantation, to measure the rate of hearing preservation.Results17 patients had total or partial preservation of residual hearing; 5 had total hearing preservation and two individuals had no preservation of hearing. The insertion of the electrode occurred through a cochleostomy in 3 patients, and in 2 of these there was no hearing preservation; the other 16 patients experienced electrode insertion through a round window approach. All patients benefited from the cochlear implant, even those who are only using electrical stimulation.ConclusionThe hearing preservation occurred in 89.4% of cases. There was no significant difference between the forms of inner ear approach

Características físico-químicas e perfil lipídico do leite de cabras mestiças Moxotó alimentadas com dietas suplementadas com óleo de semente de algodão ou de girassol Physico-chemical characteristics and fatty acid profile of milk of crossbred Moxotó goats supplemented with cottonseed or sunflower oil

O efeito da suplementação com óleos de algodão e de girassol sobre a composição do leite foi testado em cabras mestiças Moxotó alimentadas com cinco dietas: controle, sem adição de óleo; adição de óleo de algodão a 3%; óleo de algodão a 5%; óleo de girassol a 3%; e óleo de girassol a 5% (%MS). Foram utilizadas dez cabras em lactação, confinadas, distribuídas em dois quadrados latinos (5 &times; 5), com 12 dias de adaptação e três dias de coleta em cada período. A suplementação com óleo de algodão a 5% MS elevou o teor de gordura (4,99%) e de extrato seco total (13,48%) do leite, mas não alterou a concentração dos demais componentes. A adição de 5% de óleo de girassol, no entanto, promoveu aumento na concentração do ácido linolênico (C18:3). A adição de óleo vegetal em dietas para cabras nativas promoveu aumento do percentual de gordura no leite e aumento nos teores de ácidos graxos insaturados resultando em um produto de melhor qualidade para a saúde humana.<br>The effects of cottonseed and sunflower oil supplementation on milk composition were tested using crossbred Moxotó goats. Experimental diets were as follows: control, without addition of oil; addition of 3% cottonseed oil; 5% cottonseed oil; 3% sunflower oil and 5% sunflower oil (%DM). Ten confined lactating goats were allotted to a double Latin square experimental design (5 &times; 5). Each period was comprised by 12 days of adaptation to the diet and three days of sampling in each period. Cottonseed oil supplementation at 5 %DM increased the fat content (4.99%) and the total solid (13.48%) of milk. However, the addition of sunflower oil at 5% promoted an increase in the linolenic acid (C18:3) concentrations. Therefore, the vegetal oil addition in diets for native goats promoted an increase in the percentage of milk fat and in unsaturated fatty acid contents in milk, resulting in a product of better quality for the human health

Intoxicações natural e experimental por amitraz em eqüídeos: aspectos clínicos Natural and experimental poisoning by amitraz in horses and donkey: clinical aspects

A administração oral e a aspersão com amitraz reproduziram experimentalmente em 17eqüinos e um asinino um quadro de intoxicação muito similar a outro que vinha ocorrendo em cavalos no Estado do Rio de Janeiro. O início dos sintomas após a administração oral variou entre 15min. e 2h05min., na aplicação por aspersão variou entre 6h28min. e 8h38min. A evolução nos casos de administração oral foi de 4 a 9 dias, nos de aspersão de 5 a 6 dias. Somente morreram animais que receberam a administração oral. Um animal aspergido com o amitraz foi sacrificado. Por via oral foram usadas dosagens de 5,5 mg/kg (uma administração), 5,8 mg/kg (duas administrações) e num terceiro animal, doses que variaram entre 7,2 e 36,4 mg/kg (cinco administrações). Nas aplicações por aspersão, a intoxicação foi reproduzida com soluções nas concentrações de 0,1 e 0,2%. Com relação ao sistema nervoso, os principais sinais observados foram apatia, sonolência, ptoses palpebral e auricular, dificuldade de apreensão, mastigação e deglutição do alimento, arrastar das pinças dos cascos no solo, exposição do pênis, sensibilidade cutânea diminuída/ausente, instabilidade em estação, abdução dos membros, cabeça baixa, incoordenação, bocejos, flacidez labial, exposição da língua, cruzamento dos membros ao caminhar, resposta postural diminuída após cruzar e abduzir os membros, reflexos do lábio superior, palatal, lingual, de deglutição e flexor diminuídos/ausentes, reflexos auricular, palpebral e de ameaça diminuídos e resposta ambulatória diminuída ao teste de girar em círculo de pequeno raio. No que se refere ao sistema digestivo, foram evidenciados, principalmente, hipomotilidade/atonia intestinal, edema dos lábios, distensão abdominal, deitar e levantar com freqüência, rolar no solo, olhar para o flanco, gemer e impactação do intestino grosso. Observaram-se ainda taquicardia, aumento do tempo de preenchimento capilar e mucosas congestas, estridor, taquipnéia, dispnéia, secreção nasal, bradipnéia e respiração abdominal. Todos os três casos naturais ocorreram após aspersão do amitraz. Os primeiros sintomas foram observados 2 e 3 dias após o banho. A evolução foi de 6, 7 e 17 dias. Um animal manifestou a maioria dos sinais referentes ao sistema nervoso observados nos experimentos, com exceção dos sinais de cruzamento dos membros ao caminhar, bocejos, lábios flácidos e exposição do pênis. Outro animal, intoxicado espontaneamente, manifestou somente sintomas digestivos como rolar, ''patear'', hipomotilidade/atonia intestinal e impactação do intestino grosso. Um terceiro animal, inicialmente manifestou sintomas digestivos caracterizados por patear, rolar, atonia intestinal e impactação do intestino grosso, com conseqüente desenvolvimento de laminite; na fase final exibiu acentuada sintomatologia nervosa mostrando compressão da cabeça contra obstáculos, incoordenação motora com cruzamento dos membros ao caminhar e relutância em se movimentar. Baseados no quadro clínico observado, são sugeridos possíveis locais de lesão no sistema nervoso.<br>Poisoning by amitraz was experimentally reproduced in 17 horses and a donkey. First symptoms were observed between 15 min. and 2 h 5 min. after oral administration, and between 6 h 28 min. and 8 h 38 min. after spraying with amitraz. The course of poisoning after oral administration was 4 to 9 days, and after spraying 5 to 6 days. Death of experimental animals occurred only after oral administration. One animal was euthanized after spraying. Doses of 5.5 mg/kg (1 administration), 5.8 mg/kg (2 administrations) and doses which varied between 7.2 and 36.4 mg/kg (5 administrations) were used when amitraz was given by mouth, all causing symptoms of poisoning. When the administration of amitraz was by spraying, poisoning was reproduced with solutions of 0.1 and 0.2 % . Regarding the nervous system, the main signs observed were recumbency, somnolence, palpebral and auricular ptosis, difficulties in apprehension, chewing and swallowing of food, dragging of the hooves, exposure of the penis, diminished or absent cutaneous sensibility, instability, abduction of the legs, lowering of the head, incoordination, jawning, labial flacity, exposure of the tongue, crossing of the legs when walking, diminished postural response after crossing or abducting the legs, diminished/absent reflex of the upper lip, palatal, tongue, flexor and swallowing reflex, diminished auricular, palpebral and menace reflex. The ambulatory response was diminished when tested by walking in circles of small radius. Regarding the digestive system, the signs were mainly intestinal hypomotility/atony, edema of the lips, abdominal distention, frequent lying down and standing up, rolling on the ground, looking at the flancs, groaning and impaction of the large bowel. Regarding the circulatory system, the main clinical signs were tachycardia, increase of the refilling time of capillaries, congested mucosa and splitting of the cardiac sounds. Regarding the respiratory system, stridor, tachypnoea, dyspnoea, nasal discharge, bradypnoea and abdominal respiration was observed. Beside these signs, there were alterations of the general condition, as apathy and hypothermia. All natural cases occurred after spraying with amitraz. First symptoms were seen 2 to 3 days after the application of amitraz. The course was 6, 7 and 17 days. One animal showed mainly the nervous signs as seen in the experiments, with exception of the signs of crossing the legs when walking, yawning and exposure of the penis. Another animal had only digestive symptoms as rolling, pawing, intestinal hypomotility/atony and impaction of the large bowel. A third animal initially showed digestive symptoms characterized by pawing, rolling, intestinal atony and impaction of the large bowel, followed by laminitis; in the final stage this animal showed severe nervous signs as pressing the head against obstacles, incoordination with crossing the legs when walking and reluctance to move. Possible location of lesions in the nervous system according to the clinical signs are suggested