Hearing in Children with Otitis Media with Effusion – Clinical Retrospective Study

Hearing loss accompanied with middle ear effusion was analyzed according to audiometric frequencies for different age group. Results for left and right ears were compared in/ and between study and control group. Pure tone audiometry for bone and air conduction and tympanometry was performed in study group of ninety-eight children with conductive hearing loss and otitis media with effusion Control group included fifty-seven children with hearing loss, enlarged adenoids, dysfunction of Eustachian tube and no present middle ear effusion served. Means of hearing loss thresholds for 250 Hz – 4 kHz were established and compared between groups of right vs. left ears of tested vs. control ears according to age subgroups: 1–3 yr, 4–6 yr, 7–9 yr, 10–12 yr, 13–15 yr. At age 1–3 yr otitis media with effusion children showed no ear side difference in hearing loss. Age groups of 4–6 and 7–9 yr otitis media with effusion children showed left ears with higher threshold of hearing loss across all of the tested frequencies than right ears in study and control ears. Right ears showed smaller hearing loss in study and control group and no age group predicted for hearing impairment. Higher hearing loss threshold for 4 kHz in adolescence in otitis media with effusion ears is early sign of sequels after repetitive episodes of middle ear effusion. Control groups showed no ear side or age group dependent difference of hearing loss threshold. Age group of 4–6 and 7–9 y have faster craniofacial structural change in soft tissue than bone base so ear side differences suggest being developmentally determined

Should MS be Treated by Escalation or Induction Therapy?

MS is a chronic, increasingly disabling disease whose long-term outcomes determine the key social, medical and economic impact of this disease. Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are prescribed to delay disease progression and to protect a patient’s functional capability. The concepts of escalation and induction immunotherapy in MS represent different therapeutic strategies for the treatment of MS. Both strategies may be valuable options for patients starting on DMT, however, induction therapy mainly focuses on patients with very aggressive course of MS from the onset. Using a patient unique approach to selection of treatment, MS can be effectively control disease and may delay or even prevent the development of secondary progressive MS

Predictors of Short-Term Neurocognitive Outcome Following Coronary Revascularisation (CABG) Depending on the Use of Cardiopulmonary Bypass

The purpose of our study was to investigate the association between perioperative cerebral microembolization, expressed as high-intensity transient signals (HITS) and postoperative dynamics of the neuromarker S100b in patients operated using cardiopulmonary bypass, and to assess their impact upon the neurocognitive function in the early postoperative stage. The study involved 62 consecutive male patients aged 60 or above, alls scheduled for elective aortocoronary bypass. The patients were recruited from two groups with respect to the use of CPB: on-pump group (CPB+, N=30) and off-pump group (CPB–, N=32). In all patients we performed intraoperative monitoring of cerebral haemodynamics using transcranial Doppler, with the goal of quantifying perioperative cerebral microembolization. The serum levels of the neuromarker S100b were measured immediately after surgery, and then 12, 24 and 48 hours after the surgery1. Neurocognitive status was assessed before and after the surgery and in three cognitive domains. Results of the study have shown that with respect to the short-term postoperative neurocognitive outcome there is no significant difference between the on-pump and off-pump surgical technique of coronary revascularization1. Perioperative cerebral microembolization was significantly more pronounced in the on-pump group yet it did not affect early postoperative neurocognitive function, while the increase in the neuromarker S100b serum level 48 hours after surgery may have prognostic value as a predictor of postoperative neurocognitive dysfunction

Electrophysiological Correlates Activated During the Wisconsin Card Sorting Test (WCST)

In the present study we investigated changes in Event-Related Potentials (ERPs) during the Wisconsin Card Sorting Test (WCST) in order to identify cognitive processes underlying the set-shifting aspects of the task and to determine test sensitivity for frontal and prefrontal cortical areas. ERP’s were recorded from a sample of 20 healthy adults while they performed a computerized version of the Grant & Berg (1948) version of the WCST, using 32-channel electroencephalogram recordings. The ERP waveforms were calculated for the set-shifting trials, or more precisely for the 2nd and the 3rd trials in the WCST series (set change condition) and compared to those associated with the last two trials in a series before the set change (set unchanged condition). The results indicated changes in central frontal and parietal electrodes during attentional set-shifting. More precisely, the P300 effect was replicated in this dataset, confirming the claim that theWCST measures function of prefrontal cortical areas of the brain. However, the obtained wave resembled P3b indicating the working memory component of the task. The results suggest that the frontal and parietal cortical activity is especially involved in set-shifting during WCST performance. Therefore, these electrophysiological results are not consistent with some recent studies that question the specificity of WCST as a measure of frontal and parietal lesions

Prevalence of the Metabolic Syndrome in the Old Institutionalized People in Zagreb, Croatia

Metabolic syndrome (MeS) is defined by a cluster of abnormalities comprising obesity, hypertension, carbohydrate intolerance and dyslipidemia. MeS increases the risk of developing various diseases, including coronary heart disease, stroke, peripheral angiopathy and type 2 diabetes1,2. In our study, the subjects were 561 persons, residents of 11 homes for the elderly in Zagreb, Croatia. There were 160 men (28,5%) and 401 women (71.5%), aged from 56 to 96 years (the average being 79 years). Physical examination was conducted, which included blood pressure measurement, and body height and weight. Blood samples were taken for biochemical analysis. Along with other biochemical parameters, the levels of glucose, triglycerides and cholesterol (LDL, HDL-C) were also measured. The results have shown the prevalence of MeS in the elderly instutionalised people to be in the range of 20.8%, according to WHO criteria. The most common MeS component was hypertension, and it was significantly more frequent in women than in men; also, the elevated triglyceride levels were more often found in women; the difference between men and women was also statistically significant. MeS is a serious and growing health problem not only in Croatia but worldwide as well. Further studies are needed to verify the prevalence of MeS in Croatia, as it is a major risk for CVD and many other severe diseases

After 40 Years Gossypiboma Caused Spleen Abscess

We report a case of spleen abscess cased by foreign body (gossypiboma) after 40 years. After physical examination, laboratory, ultrasonography and CT findings with diagnosis of acute abdomen, 73 years old woman had undergone laparatomy. Operation revealed intraabdominal spleen abscess. Capsulotomy and drainage of the collection was performed before splenectomy. Histological examination showed foreign body material surrounded by chronic inflammation, foreign body-type multinucleated giant cells, extravasated red blood cells and fibroblastic proliferation. From anamnesis we found that woman was operated only once during a life with diagnosis of extrauterine pregnancy, 40 years ago. Spleen abscess caused by gossypiboma after 40 years was never described before. However, diagnosis like this is very well known but rarely published because medical-legal implication. Education, professionalism and cooperation of all persons involved in surgical procedure are very important to prevent accidentally mistakes

Hearing in Children with Otitis Media with Effusion – Clinical Retrospective Study

Hearing loss accompanied with middle ear effusion was analyzed according to audiometric frequencies for different age group. Results for left and right ears were compared in/ and between study and control group. Pure tone audiometry for bone and air conduction and tympanometry was performed in study group of ninety-eight children with conductive hearing loss and otitis media with effusion Control group included fifty-seven children with hearing loss, enlarged adenoids, dysfunction of Eustachian tube and no present middle ear effusion served. Means of hearing loss thresholds for 250 Hz – 4 kHz were established and compared between groups of right vs. left ears of tested vs. control ears according to age subgroups: 1–3 yr, 4–6 yr, 7–9 yr, 10–12 yr, 13–15 yr. At age 1–3 yr otitis media with effusion children showed no ear side difference in hearing loss. Age groups of 4–6 and 7–9 yr otitis media with effusion children showed left ears with higher threshold of hearing loss across all of the tested frequencies than right ears in study and control ears. Right ears showed smaller hearing loss in study and control group and no age group predicted for hearing impairment. Higher hearing loss threshold for 4 kHz in adolescence in otitis media with effusion ears is early sign of sequels after repetitive episodes of middle ear effusion. Control groups showed no ear side or age group dependent difference of hearing loss threshold. Age group of 4–6 and 7–9 y have faster craniofacial structural change in soft tissue than bone base so ear side differences suggest being developmentally determined

Hearing in children with otitis media with effusion--clinical retrospective study [Oštećenje sluha kod djece sa sekretornim otitisom]

Hearing loss accompanied with middle ear effusion was analyzed according to audiometric frequencies for different age group. Results for left and right ears were compared in/and between study and control group. Pure tone audiometry for bone and air conduction and tympanometry was performed in study group of ninety-eight children with conductive hearing loss and otitis media with effusion. Control group included fifty-seven children with hearing loss, enlarged adenoids, dysfunction of Eustachian tube and no present middle ear effusion served. Means of hearing loss thresholds for 250 Hz-4 kHz were established and compared between groups of right vs. left ears of tested vs. control ears according to age subgroups: 1-3 yr, 4-6 yr, 7-9 yr, 10-12 yr, 13-15 yr. At age 1-3 yr otitis media with effusion children showed no ear side difference in hearing loss. Age groups of 4-6 and 7-9 yr otitis media with effusion children showed left ears with higher threshold of hearing loss across all of the tested frequencies than right ears in study and control ears. Right ears showed smaller hearing loss in study and control group and no age group predicted for hearing impairment. Higher hearing loss threshold for 4 kHz in adolescence in otitis media with effusion ears is early sign of sequels after repetitive episodes of middle ear effusion. Control groups showed no ear side or age group dependent difference of hearing loss threshold. Age group of 4-6 and 7-9 y have faster craniofacial structural change in soft tissue than bone base so ear side differences suggest being developmentally determined

Predictors of short-term neurocognitive outcome following coronary revascularisation (CABG) depending on the use of cardiopulmonary bypass [Prediktori kratkoročnog neurokognitivnog ishoda nakon koronarne revaskularizacije (CABG) ovisno o upotrebi izvantjelesnog krvotoka]

The purpose of our study was to investigate the association between perioperative cerebral microembolization, expressed as high-intensity transient signals (HITS) and postoperative dynamics of the neuromarker S100P in patients operated using cardiopulmonary bypass, and to assess their impact upon the neurocognitive function in the early postoperative stage. The study involved 62 consecutive male patients aged 60 or above, alls scheduled for elective aortocoronary bypass. The patients were recruited from two groups with respect to the use of CPB: on-pump group (CPB+, N = 30) and off-pump group (CPB-, N = 32). In all patients we performed intraoperative monitoring of cerebral haemodynamics using transcranial Doppler, with the goal of quantifying perioperative cerebral microembolization. The serum levels of the neuromarker S100l were measured immediately after surgery, and then 12, 24 and 48 hours after the surgery. Neurocognitive status was assessed before and after the surgery and in three cognitive domains. Results of the study have shown that with respect to the short-term postoperative neurocognitive outcome there is no significant difference between the on-pump and off-pump surgical technique of coronary revascularization'. Perioperative cerebral microembolization was significantly more pronounced in the on-pump group yet it did not affect early postoperative neurocognitive function, while the increase in the neuromarker S100beta serum level 48 hours after surgery may have prognostic value as a predictor of postoperative neurocognitive dysfunction

Prediktori kratkoročnog neurokognitivnog ishoda nakon koronarne revaskularizacije (CABG) ovisno o upotrebi izvantjelesnog krvotoka

The purpose of our study was to investigate the association between perioperative cerebral microembolization, expressed as high-intensity transient signals (HITS) and postoperative dynamics of the neuromarker S100P in patients operated using cardiopulmonary bypass, and to assess their impact upon the neurocognitive function in the early postoperative stage. The study involved 62 consecutive male patients aged 60 or above, alls scheduled for elective aortocoronary bypass. The patients were recruited from two groups with respect to the use of CPB: on-pump group (CPB+, N = 30) and off-pump group (CPB-, N = 32). In all patients we performed intraoperative monitoring of cerebral haemodynamics using transcranial Doppler, with the goal of quantifying perioperative cerebral microembolization. The serum levels of the neuromarker S100l were measured immediately after surgery, and then 12, 24 and 48 hours after the surgery. Neurocognitive status was assessed before and after the surgery and in three cognitive domains. Results of the study have shown that with respect to the short-term postoperative neurocognitive outcome there is no significant difference between the on-pump and off-pump surgical technique of coronary revascularization'. Perioperative cerebral microembolization was significantly more pronounced in the on-pump group yet it did not affect early postoperative neurocognitive function, while the increase in the neuromarker S100beta serum level 48 hours after surgery may have prognostic value as a predictor of postoperative neurocognitive dysfunction.Istraživanje je provedeno sa svrhom ispitivanja povezanosti perioperacijske cerebralne mikroembolizacije (HITS) i poslijeoperacijske dinamike neurobiljega S100b s primjenom izvantjelesnog krvotoka (CPB), te utvrđivanjem njihovog učinka na neurokognitivnu funkciju u ranom poslijeoperacijskom razdoblju. U ispitivanje su uključena 62 konsekutivna muška bolesnika starija od 60 godina predviđena za elektivnu operaciju aortokoronarnog premoštenja. Bolesnici su regrutirani iz dvije skupine s obzirom na uporabu CPB: on-pump skupina (CPB+, N=30) i off-pump skupina (CPB–, N=32). Kod svih ispitanika provedeno je intraoperacijsko monitoriranje cerebralne hemodinamike transkranijskim doplerom u cilju kvantificiranja perioperacijske cerebralne mikroembolizacije. Serumske razine neurobiljega S100b mjerene su prije operacije, neposredno nakon operacije te 12, 24 i 48 sati od operacije. Neurokognitivni status se ocjenjivao prije i poslijeoperacijski u tri kognitivne domene. Rezultati istraživanja pokazuju da nema značajne razlike između on-pump i off-pump kirurške tehnike koronarne revaskularizacije s aspekta kratkoročnog poslijeoperacijskog neurokognitivnog ishoda. Perioperacijska cerebralna mikroembolizacija značajno je izraženija uz primjenu izvantjelesnog krovotoka ali ne utječe na ranu poslijeoperacijsku neurokognitivnu funkciju, dok porast serumske razine neurobiljega S100b 48 sati nakon operacije može imati prognostičku vrijednost kao mogući prediktor poslijeoperacijske neurokognitivne disfunkcije