Peculiarities of the VEMP test in children

Vestibular evoked myogenic potential (VEMP) is an addi-tional test for the otolith organs of the vestibular system. The VEMP test is relatively easy to perform and well-tolerated by patients of all ages. VEMP has been studied well for adults but studies involving children are insufficient. cVEMP has been successfully registered and reported for newborns aged between three and five days. oVEMP have been noted for children over the age of two

STRUCTURE AND VASCULARIZATION OF THE PERICARDIUM AND EPICARDIUM IN MAN

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Vestibular evoked myogenic potentials testing for diagnosing Sudden Sensorineural Hearing Loss

Sudden sensorineural hearing loss is an emergency condition in otolaryngology. In most cases it manifests as a unilateral reduction in hearing. In addition to hearing loss in one ear, patients often have symptoms such as vertigo and/or tinnitus. The follow-up of patients with sudden sensorineural hearing loss should include not only testing of the hearing system but also diagnosis of the vestibular apparatus. VEMP is an objective method for assessment of the vestibular function through the reaction of the reflex muscle in response to high-intensity acoustic stimulation.Materials and methods: The subject of study are 12 patients with sudden hearing loss where 5 of the followed patients also complaining of vertigo and instability. After taking a history, the following are performed: examination of ENT organs, pure-tone audiometry, OAE, tympanometry with acoustic reflex, otoneurological examination, VEMP tests, CT (MRI).Results: Patients with severe sudden hearing loss have deviations in their VEMP tests. The hearing recovery percentage is lower with abnormal VEMP than in those with normal VEMP. Conclusion: Patients with deviations in VEMP tests can have vestibular disorders in addition to lesions in the organ of Corti, including stria vascularis and the tectorial membrane. There is an association between pathological VEMP and the level of hearing reduction. Abnormal VEMP can be used to predict subsequent incomplete hearing recovery

Targeting Efficiency: The Effects of Video Modeling and Feedback on Instructors’ Acquisition and Generalization of Behavior Analytic Skills

Applied behavior analysis (ABA) is a highly effective, evidence-based treatment for individuals with autism spectrum disorder. Low treatment integrity could greatly compromise the delivery of effective ABA interventions, but instructors who hold no formal training make up the larger portion of employees within the special education field. Designing efficient and effective training for these employees is important because schools have limited resources for caregiver training. This study used a non-concurrent multiple baseline design across three novice ABA instructors to evaluate the effects of a training protocol consisting of video and in-vivo modeling and feedback, a training algorithm, and multiple exemplars training on the acquisition of five ABA procedures (i.e., discrete trial teaching, multiple stimulus without replacement, echoic mand training, stimulus-stimulus pairing, and graphing percentage data). After the instructors mastered these skills the experimenter also evaluated if instructors’ showed generalized teaching skills when implementing novel ABA procedures. The results showed that the training protocol was effective in increasing instructors’ treatment integrity on all five procedures up to mastery criterion as well as producing some generalized teaching skills. The implications of these results are discussed in light of creating more efficient training protocols for ABA settings

A Case of Familial External Auditory Canal Atresia

Introduction: Congenital аural аtresia (CAA) can occur as an isolated congenital malformation or as part of a monogenic and chromosomal syndromes. CAA can be associated with several syndromes. An 18q deletion is frequently seen in CAA. The subject of the study are three individuals from one family (mother, son and daughter). Methods:After taking a detailed history, an examination of ENT organs, tone audiometry testing, auditory brain stem responses, brain CT, external auditory canal and middle ear were performed. Results: The conducted tone audiometry testing and auditory brain stem response found bilateral sound conduction hearing loss.Conclusion: Bilateral atresia is treated surgically. Surgical treatment is difficult and not always successful, it is preferable to perform it at age 4-5

Sales and Price Effects of Pre-announced Consumption Tax reforms: Micro-level Evidence from Europoean VAT

This paper studies the effects of consumption tax reforms on prices and the time path of consumption spending in EU countries utilizing micro-level data on the monthly unit sales and prices of consumer durables. The identification strategy exploits the trading of identical products in multiple countries. The results show that tax-rate changes are fully and quickly shifted into prices and strongly affect the time path of consumption. The empirical findings for consumption spending indicate that tax rate changes exert temporary effects shortly before implementation, which are more than reverted after implementation. Quantitatively, we find that sales increase by about 2.5% in the last month before and drop by almost 5% after implementation if the tax rate increases by one percentage point

VASCULARIZATION OF THE UPPER LIMB ARTERIES

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COMPARATIVE STUDIES OF THE LIPIDS AND ACID MUCOPOLYSACCHARIDES IN THE WALL OF AORTA AND PULMONARY TRUNK IN EXPERIMENTAL ATHEROSCLEROSIS IN RABBITS

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REGULARITIES OF THE VASCULARIZATION OF HUMAN ARTERIAL VESSELS

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The Bonebridge system – Our clinical experience /Case report/

Introduction: Bone conduction implants are a standard treatment option for patients with conductive or mixed, hearing loss. The Bonebridge system was introduced by MED-EL in 2012, and two years after its debut, it was used in more than 200 centers worldwide (6). For the first time the Bonebridge system was implanted in Bulgaria in 2015 by associated professor P. Rouev. The main audiological criteria for placement is conductive hearing loss, which is caused by atresia of the auditory canal or diseases of the middle ear with preserved bone conduction (below 45 dB), as well as unilateral hearing loss above 70 dB (contralateral hearing loss not more than 20 dB). The system does not penetrate the skin and consists of an internal part - an implant, which is placed completely under the skin, and an external part - a processor. The acoustic signal from the environment is transformed into mechanical vibrations that are transmitted to the mastoid bone. The expected results are an improved hearing threshold and better hearing in noisy environments.Methods: Our clinical experience with the Bonebridge system is based on three operated patients aged between 56 and 73 years. All three patients had evidence of bilateral conductive hearing loss. Here we present one of these cases.Results: Test results showed significant improvement in hearing sensitivity especially in frequencies round 1000 Hz.Conclusions: Bone conduction implants such as the Bonebridge system are an excellent treatment option for patients with bilateral conductive deafness. Bonebridge has good hearing results, relative simplicity, and low rate of complications. Experience has shown that the Bonebridge system is easy to use and highly reliable. The use of Bonebridge conduction implant system leads to a significant improvement in the quality of life