Evidence for cardiovascular autonomic dysfunction in foetal programming of hypertension following a maternal high fat or high sucrose diet

Studies support the hypothesis that a maternal high fat (HFD) or high sucrose (HSU) diet during pregnancy is associated with hypertension in offspring due to mechanisms of fetal programming. In this study we tested the programming effect of a HFD and HSU diet on cardiovascular and autonomic responses at rest and in response to dehydration (DS) and air jet (AJ) stress. Pregnant rat dams were placed on a HFD (59% fat), HSU (10%w/v) or control (5% fat) diet. At 6 months the offspring were implanted with telemetry blood pressure transmitters. BP and derived spontaneous baroreflex sensitivity, heart rate variability and BP variability were measured at rest, during DS and during AJ. Offspring from a maternal HF diet show elevated BP at rest compared to controls. In response to AJ and DS, all animals showed an increase in cardiovascular variables, however, the magnitude of increase in cardiovascular variables were similar between groups in both male and female rats. We found limited evidence of altered autonomic function in the HFD rats, despite their higher blood pressure. Offspring from a maternal HSU diet showed no differences in cardiovascular or autonomic responses at rest or in response to either DS or AJ

Foraging gene expression patterns in eusocial sweat bees using qRT-PCR

In nine patients with unilateral deafness and normal hearing in the contralateral ear, measurements of sound localization and speech perception were obtained before intervention, with a conventional contralateral routing of sound (CROS) hearing aid and later with a bone-anchored hearing aid (BAHA) implanted in the deaf ear. Sound localization did not show any differences between the three conditions. Speech perception using short, everyday sentences showed a reduction in the head-shadow effect of 2 dB for both the conventional CROS hearing aid and the BAHA in comparison to the unaided condition. Patients' real-life experiences of the three conditions were evaluated using the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. The results showed a significant benefit with the BAHA in situations involving background noise and reverberation and a reduced aversion to loud sounds in comparison to the unaided and conventional CROS conditions

Speech acoustics before and after cochlear implantation in post-lingually deafened adults

Contains fulltext : 180508.pdf (publisher's version ) (Open Access)5 juli 201

Angular Electrode Insertion Depth and Speech Perception in Adults With a Cochlear Implant: A Systematic Review

Item does not contain fulltextOBJECTIVE: By discussing the design, findings, strengths, and weaknesses of available studies investigating the influence of angular insertion depth on speech perception, we intend to summarize the current status of evidence; and using evidence based conclusions, possibly contribute to the determination of the optimal cochlear implant (CI) electrode position. DATA SOURCES: Our search strategy yielded 10,877 papers. PubMed, Ovid EMBASE, Web of Science, and the Cochrane Library were searched up to June 1, 2018. Both keywords and free-text terms, related to patient population, predictive factor, and outcome measurements were used. There were no restrictions in languages or year of publication. STUDY SELECTION: Seven articles were included in this systematic review. Articles eligible for inclusion: (a) investigated cochlear implantation of any CI system in adults with post-lingual onset of deafness and normal cochlear anatomy; (b) investigated the relationship between angular insertion depth and speech perception; (c) measured angular insertion depth on imaging; and (d) measured speech perception at, or beyond 1-year post-activation. DATA EXTRACTION AND SYNTHESIS: In included studies; quality was judged low-to-moderate and risk of bias, evaluated using a Quality-in-Prognostic-Studies-tool (QUIPS), was high. Included studies were too heterogeneous to perform meta-analyses, therefore, effect estimates of the individual studies are presented. Six out of seven included studies found no effect of angular insertion depth on speech perception. CONCLUSION: All included studies are characterized by methodological flaws, and therefore, evidence-based conclusions regarding the influence of angular insertion depth cannot be drawn to date

Post-implantation clinical cost analysis between transcutaneous and percutaneous bone conduction devices

Introduction: Bone conduction devices (BCD) are effective for hearing rehabilitation in patients with conductive and mixed hearing loss or single-sided deafness. Transcutaneous bone conduction devices (tBCD) seem to lead to fewer soft tissue complications than percutaneous BCDs (pBCD) but have other drawbacks such as MRI incompatibility and higher costs. Previous cost analyses have shown a cost advantage of tBCDs. The purpose of this study is to compare long-term post-implantations costs between percutaneous and transcutaneous BCDs. Materials and methods: Retrospective data from 77 patients implanted in a tertiary referral centre with a pBCD (n = 34), tBCD (n = 43; passive (tpasBCD; n = 34) and active (tactBCD; n = 9) and a reference group who underwent cochlear implantation (CI; n = 34), were included in a clinical cost analysis. Post-implantation costs were determined as the sum of consultation (medical and audiological) and additional (all post-operative care) costs. Median (cumulative) costs per device incurred for the different cohorts were compared at 1, 3 and 5 years after implantation. Results: After 5 years, the total post-implantation costs of the pBCD vs tpasBCD were not significantly different (€1550.7 [IQR 1174.6–2797.4] vs €2266.9 [IQR 1314.1–3535.3], p = 0.185), nor was there a significant difference between pBCD vs tactBCD (€1550.7 [1174.6–2797.4] vs €1428.8 [1277.3–1760.4], p = 0.550). Additional post-implantation costs were significantly highest in the tpasBCD cohort at all moments of follow-up. Conclusion: Total costs related to post-operative rehabilitation and treatments are comparable between percutaneous and transcutaneous BCDs up to 5 years after implantation. Complications related to passive transcutaneous bone conduction devices appeared significantly more expensive after implantation due to more frequent explantations.</p

Post-implantation clinical cost analysis between transcutaneous and percutaneous bone conduction devices

Introduction: Bone conduction devices (BCD) are effective for hearing rehabilitation in patients with conductive and mixed hearing loss or single-sided deafness. Transcutaneous bone conduction devices (tBCD) seem to lead to fewer soft tissue complications than percutaneous BCDs (pBCD) but have other drawbacks such as MRI incompatibility and higher costs. Previous cost analyses have shown a cost advantage of tBCDs. The purpose of this study is to compare long-term post-implantations costs between percutaneous and transcutaneous BCDs. Materials and methods: Retrospective data from 77 patients implanted in a tertiary referral centre with a pBCD (n = 34), tBCD (n = 43; passive (tpasBCD; n = 34) and active (tactBCD; n = 9) and a reference group who underwent cochlear implantation (CI; n = 34), were included in a clinical cost analysis. Post-implantation costs were determined as the sum of consultation (medical and audiological) and additional (all post-operative care) costs. Median (cumulative) costs per device incurred for the different cohorts were compared at 1, 3 and 5 years after implantation. Results: After 5 years, the total post-implantation costs of the pBCD vs tpasBCD were not significantly different (€1550.7 [IQR 1174.6–2797.4] vs €2266.9 [IQR 1314.1–3535.3], p = 0.185), nor was there a significant difference between pBCD vs tactBCD (€1550.7 [1174.6–2797.4] vs €1428.8 [1277.3–1760.4], p = 0.550). Additional post-implantation costs were significantly highest in the tpasBCD cohort at all moments of follow-up. Conclusion: Total costs related to post-operative rehabilitation and treatments are comparable between percutaneous and transcutaneous BCDs up to 5 years after implantation. Complications related to passive transcutaneous bone conduction devices appeared significantly more expensive after implantation due to more frequent explantations.</p

A Clinical Evaluation of Minimally Invasive Ponto Surgery With a Modified Drill System for Inserting Bone-Anchored Hearing Implants

To compare 6-months outcomes of the modified minimally invasive Ponto surgery (m-MIPS) to both the linear incision technique with soft tissue preservation (LIT-TP), and original MIPS (o-MIPS) for inserting bone-anchored hearing implants (BAHIs). STUDY DESIGN: Exploratory pilot study with one test group and two historical control groups. SETTING: Tertiary referral center. PATIENTS: In the test group, 24 patients (25 implants) were prospectively included. Each control group comprised 25 patients (25 implants) who participated in previously conducted clinical trials. INTERVENTIONS: The test group received a BAHI using m-MIPS. The two control groups underwent surgery using the LIT-TP and o-MIPS, respectively. MAIN OUTCOME MEASURES: Implant survival, implant stability, and surgery-related variables were compared between the test and control groups. Soft tissue status, skin sensibility, and subjective numbness were compared between m-MIPS and LIT-TP only. RESULTS: Implant survival was comparable between m-MIPS and LIT-TP, whereas implant stability measurements were slightly lower for m-MIPS. M-MIPS resulted in comparable adverse skin reactions and skin sensibility, significantly reduced surgical time and slightly improved subjective numbness, compared with LIT-TP. Between m-MIPS and o-MIPS, no statistically significant differences in implant survival, implant stability and surgical time were observed. CONCLUSIONS: A trend toward lower implant loss rates after m-MIPS was observed, when compared with o-MIPS. M-MIPS seems to be a good alternative to LIT-TP for inserting BAHIs, since most clinical outcomes were either comparable or slightly better for m-MIPS. Upon deciding on which technique to use, larger studies on implant survival should be performed. Furthermore, other aspects such as costs, training aspects and surgical experience should be evaluated