Coronary artery bypass grafting and sensorineural hearing loss, a cohort study

BACKGROUND: Sudden sensorineural hearing loss is routinely encountered by the otologist. The etiology is varied and often identifiable. One of the relatively less frequent causes is surgery. Apart from being an established entity with otological surgeries, sensorineural hearing loss has also been known to occur after non-otological procedures under general anesthesia. Commonest amongst these procedures is cardiopulmonary bypass, an association that has long been recognized. However, despite the proposition of diverse hypotheses in the past, the pathophysiology remains unclear. METHODS: The study is a prospective matched cohort study that will be carried out in Aga Khan University Hospital, Karachi, Pakistan. Participants among exposed would include all those patients who would be undergoing coronary artery bypass surgery in the hospital who fall under the criteria for inclusion. Unexposed group would comprise of patients undergoing a non-bypass procedure of similar duration under the same type of anesthesia who meet the selection criteria. Both these groups will undergo audiometric testing at our hospital on three different occasions during the course of this study. Initially before the procedure to test the baseline hearing capacity; then one week after the procedure to assess any changes in hearing ability following the surgery; and finally a third audiogram at six weeks follow-up to assess further changes in any hearing deficits noted during the second phase of testing. Certain variables including the subjects' demographics and those concerning the procedure itself will be noted and used later for risk factors analysis. A detailed past medical and surgical history will also be obtained. Data analysis would include calculation of relative risk and significance of the results, by running the chi-square test. Other statistical tests like Fisher exact test may then be employed to facilitate data interpretation. Continuous scale may then be employed and multivariate linear regression used. DISCUSSION: This study is planned to obtain a better understanding of the correlation between sudden sensorineural hearing loss and cardiopulmonary bypass. Being the first major cohort trial in this line of investigation, the project is designed to identify the existence of any significant relationship between cardiopulmonary bypass and sensorineural hearing deficit

Annual Report 2011 Operation and Utilisation of the High Flux Reactor

The High Flux Reactor (HFR) at Petten is managed by the Institute for Energy and Transport (IET) of the EC - DG JRC and operated by NRG who are also licence holder and responsible for commercial activities. The HFR operates at 45 MW and is of the tank-in-pool type, light water cooled and moderated. It is one of the most powerful multi-purpose materials testing reactors in the world and one of the world leaders in target irradiation for the production of medical radioisotopes.JRC.F-Institute for Energy and Transport (Petten

Operation and Utilisation of the High Flux Reactor: Annual Report 2013

The High Flux Reactor (HFR) at Petten is managed by the Institute for Energy and Transport (IET) of the European Commission's Joint Research Centre (JRC) and operated by the Nuclear Research and consultancy Group (NRG) which is also the licence holder and responsible for its commercial activities. The High Flux Reactor (HFR) operates at 45 MW and is of the tank-in-pool type, light water cooled and moderated. It is one of the most powerful multi-purpose materials testing reactors in the world and one of the world's leaders in target irradiation for the production of medical radioisotopes.JRC.F.4-Innovative Technologies for Nuclear Reactor Safet

Operation and Utilisation of the High Flux Reactor - Annual Report 2012

The High Flux Reactor (HFR) at Petten is managed by the Institute for Energy and Transport (IET) of the European Commission's Joint Research Centre (JRC) and operated by the Nuclear Research and consultancy Group (NRG) which is also the licence holder and responsible for its commercial activities. The High Flux Reactor (HFR) operates at 45 MW and is of the tank-in-pool type, light water cooled and moderated. It is one of the most powerful multi-purpose materials testing reactors in the world and one of the world's leaders in target irradiation for the production of medical radioisotopes.JRC.F.4-Nuclear Reactor Integrity Assessment and Knowledge Managemen

Deep Brain Stimulation Reveals a Dissociation of Consummatory and Motivated Behaviour in the Medial and Lateral Nucleus Accumbens Shell of the Rat

Following the successful application of deep brain stimulation (DBS) in the treatment of Parkinson's disease and promising results in clinical trials for obsessive compulsive disorder and major depression, DBS is currently being tested in small patient-populations with eating disorders and addiction. However, in spite of its potential use in a broad spectrum of disorders, the mechanisms of action of DBS remain largely unclear and optimal neural targets for stimulation in several disorders have yet to be established. Thus, there is a great need to examine site-specific effects of DBS on a behavioural level and to understand how DBS may modulate pathological behaviour. In view of the possible application of DBS in the treatment of disorders characterized by impaired processing of reward and motivation, like addiction and eating disorders, we examined the effect of DBS of the nucleus accumbens (NAcc) on food-directed behavior. Rats were implanted with bilateral stimulation electrodes in one of three anatomically and functionally distinct sub-areas of the NAcc: the core, lateral shell (lShell) and medial shell (mShell). Subsequently, we studied the effects of DBS on food consumption, and the motivational and appetitive properties of food. The data revealed a functional dissociation between the lShell and mShell. DBS of the lShell reduced motivation to respond for sucrose under a progressive ratio schedule of reinforcement, mShell DBS, however, profoundly and selectively increased the intake of chow. DBS of the NAcc core did not alter any form of food-directed behavior studied. DBS of neither structure affected sucrose preference. These data indicate that the intake of chow and the motivation to work for palatable food can independently be modulated by DBS of subregions of the NAcc shell. As such, these findings provide important leads for the possible future application of DBS as a treatment for eating disorders such as anorexia nervosa