Head orientation benefit to speech intelligibility in noise for cochlear implant users and in realistic listening conditions

Cochlear implant (CI) users suffer from elevated speech-reception thresholds and may rely on lip reading. Traditional measures of spatial release from masking quantify speech-reception-threshold improvement with azimuthal separation of target speaker and interferers and with the listener facing the target speaker. Substantial benefits of orienting the head away from the target speaker were predicted by a model of spatial release from masking. Audio-only and audio-visual speech-reception thresholds in normal-hearing (NH) listeners and bilateral and unilateral CI users confirmed model predictions of this head-orientation benefit. The benefit ranged 2–5 dB for a modest 30� orientation that did not affect the lip-reading benefit. NH listeners’ and CI users’ lip-reading benefit measured 3 and 5 dB, respectively. A head-orientation benefit of �2 dB was also both predicted and observed in NH listeners in realistic simulations of a restaurant listening environment. Exploiting the benefit of head orientation is thus a robust hearing tactic that would benefit both NH listeners and CI users in noisy listening conditions

Перебіг анемії вагітних у хворих на туберкульоз легень

В статье представлены данные течения анемии беременных и нарушения фетоплацентарного комплекса у 86 женщин, больных туберкулезом легких. Выявлено, что анемия на фоне туберкулезного процесса приводит к существенным функциональным и морфологическим нарушениям в плаценте. показано диагностическое значение оценки плацентарной дисфункции для профилактики и лечения анемии у данного контингента женщин.The article presents the data of course of pregnancy anemia and failures of fetoplacental complex in 86 women with pulmonary tuberculosis. It is found that anemia under tuberculous process leads to significant functional and morphological disturbances in placenta. Diagnostic significance of assessment of placental dysfunction for the prevention and treatment of anemia in this contingent of women is shown

How to think about health promotion ethics

Health promotion ethics is moral deliberation about health promotion and its prac­ tice. Although academics and practitioners have been writing about ethics, and especially values, in health promotion for decades, health promotion ethics is now regaining attention within the broader literature on public health ethics. Health promotion is difficult to define, and this has implications for health promotion ethics. Health promotion can be approached in two complementary ways: as a normative ideal, and as a practice. We consider the normative ideal of health promotion to be that aspect of public health practice that is particularly concerned with the equity of social arrangements: it imagines that social arrangements can be altered to make things better for everyone, whatever their health risks, and seeks to achieve this in collaboration with citizens.This raises two main ethical questions. First: what is a good society? And then: what should health promotion contribute to a good society? The practice of health promotion varies widely. Discussion of its ethical implications has addressed four main issues: the potential for health promotion to limit or increase the freedom of individuals; health promotion as a source of collective benefit; the possibility that health promotion strategies might “blame the victim” or stigmatise those who are disabled, sick or at higher risk of disease; and the importance of distributing the benefits of health promotion fairly. Different people will make different moral evaluations on each of these issues in a way that is informed by, and informs, their vision of a good society and their understanding of the ends of health promotion. We conclude that future work in health promotion ethics will require thoughtfully connecting social and political philosophy with an applied, empirically informed ethics of practice. Key Words:Ethics, health education, health promotion, moral philosophy, political philosophy, public healthNHMR

Phagocyte-derived catecholamines enhance acute inflammatory injury

It is becoming increasingly clear that the autonomic nervous system and the immune system demonstrate cross-talk during inflammation by means of sympathetic and parasympathetic pathways(1,2). We investigated whether phagocytes are capable of de novo production of catecholamines, suggesting an autocrine/paracrine self-regulatory mechanism by catecholamines during inflammation, as has been described for lymphocytes(3). Here we show that exposure of phagocytes to lipopolysaccharide led to a release of catecholamines and an induction of catecholamine-generating and degrading enzymes, indicating the presence of the complete intracellular machinery for the generation, release and inactivation of catecholamines. To assess the importance of these findings in vivo, we chose two models of acute lung injury. Blockade of alpha(2)-adrenoreceptors or catecholamine-generating enzymes greatly suppressed lung inflammation, whereas the opposite was the case either for an alpha(2)-adrenoreceptor agonist or for inhibition of catecholamine-degrading enzymes. We were able to exclude T cells or sympathetic nerve endings as sources of the injury-modulating catecholamines. Our studies identify phagocytes as a new source of catecholamines, which enhance the inflammatory response.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62733/1/nature06185.pd

Phase I/II trial of doxorubicin and fixed dose-rate infusion gemcitabine in advanced soft tissue sarcomas: a GEIS study

The aim of the study was to determine the dose-limiting toxicity and maximum tolerated dose of a first-line combination of doxorubicin and gemcitabine in adult patients with advanced soft tissue sarcomas and to explore its activity and toxicity, and the presence of possible interactions between these agents. Patients with measurable disease were initially treated with doxorubicin 60 mg m−2 by i.v. bolus on day 1 followed by gemcitabine at 800 mg m−2 over 80 min on days 1 and 8, every 21 days. Concentrations of gemcitabine and 2′,2′-difluorodeoxyuridine in plasma, and gemcitabine triphosphate levels in peripheral blood mononuclear cells were determined during 8 h after the start of gemcitabine infusion. Myelosuppression and stomatitis were limiting toxicities, and the initial dose level was applied for the Phase II trial, where grade 3–4 granulocytopenia occurred in 70% of patients, grade 3 stomatitis in 46% and febrile neutropenia in 20%. Objective activity in 36 patients was 22% (95% CI: 9–35%), and a 50% remission rate was noted in leiomyosarcomas. Administration of doxorubicin preceding gemcitabine significantly reduced the synthesis of gemcitabine triphosphate. Clinical activity, similar to that of single-agent doxorubicin, and the toxicity encountered do not justify further studies with this schedule of administration