Early assessment of vestibular function after unilateral cochlear implant surgery

Introduction : Cochlear implantation (CI) has been reported to negatively effect on the vestibular function. The study of the vestibular function has variably been conducted by different types of diagnostic tools. The combined use of modern, rapidly performable diagnostic tools could reveal useful for standardizing the evaluation protocol. Methods: In a group of 28 subjects undergoing CI, the video Head Impulse Test (vHIT), the cervical Vestibular Evoked Myogenic Potentials (cVEMPS) and the short-form of Dizziness Handicap Inventory (DHI) questionnaire were investigated pre-operatively and post-operatively (implant on and off) in both the implanted and the contralateral, non-implanted ear. All surgeries were performed with a round window approach (RWA), except for three otosclerosis cases were the extended RWA (eRWA) was used. Results: The vHIT of the lateral semicircular canal showed a pre-operative vestibular involvement in nearly 50% of the cases, whilst the three canals were contemporarily affected in only 14% of them. In all the hypo-functional subjects, cVEMPs were absent. A low VOR gain in all the investigated SSCC was found in 4 subjects (14%). In those subjects, (21.7%) in whom cVEMPs were pre-operatively present and normal in the operated side, absence of response was post-operatives recorded. Discussion/Conclusion: The vestibular protocol applied for the study showed to be appropriate for distinguishing between the CI operated and the non-operated ear. In this regard, cVEMPs showed to be more sensitive than vHIT for revealing a vestibular sufferance after CI, although without statistical significance. Finally, the use of the RWA surgery was apparently not avoiding signs of vestibular impairment to occur

A note on a third order curvature invariant in static spacetimes

We consider here the third order curvature invariant $I=R_{\mu\nu\rho\sigma;\delta}R^{\mu\nu\rho\sigma;\delta}$ in static spacetimes ${\cal M}=R\times\Sigma$ for which $\Sigma$ is conformally flat. We evaluate explicitly the invariant for the $N$-dimensional Majumdar-Papapetrou multi black-holes solution, confirming that $I$ does indeed vanish on the event horizons of such black-holes. Our calculations show, however, that solely the vanishing of $I$ is not sufficient to locate an event horizon in non-spherically symmetric spacetimes. We discuss also some tidal effects associated to the invariant $I$.Comment: 5 pages, 3 figures. Extra material available at http://vigo.ime.unicamp.br/in

Event Reconstruction for a DIRC

Monte Carlo simulations were made for a possible DIRC at the WASA detector at COSY. A statistical method for pattern recognition is presented and the possible angle resolution and velocity precision achieved are discussed.Comment: Minor changes in text. Figures updated. accepted by JINS

Quality of ultrasound biometry obtained by local health workers in a refugee camp on the Thai-Burmese border.

Objective: In a refugee camp on the Thai–Burmese border, accurate dating of pregnancy relies on ultrasound measurements obtained by locally trained health workers. The aim of this study was to substantiate the accuracy of fetal biometry measurements performed by locally trained health workers by comparing derived reference equations with those published for Asian and European hospitals. Methods: This prospective observational study included 1090 women who had a dating crown–rump length (CRL) scan and one study-appointed ultrasound biometry scan between 16 and 40 weeks of gestation. The average of two measurements of each of biparietal diameter, head circumference, abdominal circumference and femur length was used in a polynomial regression model for the mean and SD against gestational age (GA). The biometry equations obtained were compared with published equations of professional sonographers from Asian and European hospitals by evaluation of the SD and Z-scores of differences between models. Results: Reference equations of biometric parameters were found to fit cubic polynomial models. The observed SD values, for any given GA, of fetal biometric measurements obtained by locally trained health workers were lower than those previously reported by centers with professional sonographers. For nearly the entire GA range considered, the mean values of the Asian and European equations for all four biometric measurements were within the 90% expected range (mean ± 1.645 SD) of our equations. Conclusion: Locally trained health workers in a refugee camp on the Thai–Burmese border can obtain measurements that are associated with low SD values and within the normal limits of published Asian and European equations. The fact that the SD values were lower than in other studies may be explained by the use of the average of two measurements, CRL dating or motivation of the locally trained sonographer

Poderá a Presença de Síndrome Metabólica Predizer a Presença de Doença Arterial?

INTRODUCTION: Metabolic syndrome (MS) is an independent predictor of acute cardiovascular events. However, few studies have addressed the relationship between MS and stable angiographic coronary artery disease (CAD), which has a different pathophysiological mechanism. We aimed to study the independent predictors for significant CAD, and to analyze the impact of MS (by the AHA/NHLBI definition) on CAD. METHODS: We prospectively included 300 patients, mean age 64±9 years, 59% male, admitted for elective coronary angiography (suspected ischemic heart disease), excluding patients with known cardiac disease. All patients underwent assessment of demographic, anthropometric, and laboratory data and risk factors, and subsequently underwent coronary angiography. RESULTS: In the study population, 23.0% were diabetic, 40.5% had MS (and no diabetes) and 36.7% had neither diagnosis. Significant CAD was present in 51.3% of patients. CAD patients were older and more frequently male and diabetic, with increased triglycerides and glucose and lower HDL cholesterol. Abdominal obesity was also less prevalent. MS was not associated with the presence of CAD (OR 0.94, 95% CI 0.59-1.48, p=0.778). Of the MS components, the most important predictors of CAD were increased glucose and triglycerides. Abdominal obesity was associated with a lower risk of CAD. In a multivariate logistic regression model for CAD, independent predictors of CAD were age, male gender, glucose and triglycerides. Body mass index had a protective effect. CONCLUSIONS: Although MS is associated with cardiovascular events, the same was not found for stable angiographically proven CAD. Age, gender, diabetes and triglycerides are the most influential factors for CAD, with abdominal obesity as a protective factor

Pengembangan Ekowisata Berbasis Masyarakat di Pulau Harapan Taman Nasional Kepulauan Seribu, Jakarta

Implementation of research activities conducted in the area of Hope Island Thousand Islands National Park . The purpose of this research is ( i ) Identify the potential of tourism in Hope Island TNKpS , ( ii ) Identify the readiness of the community in the development of community-based ecotourism ( iii ) Developing a community-based ecotourism in the area of Hope Island TNKpS . Data on the public , managers and visitors obtained by distributing questionnaires and interviews . Respondent data retrieval community and visitors conducted by interview and questionnaire , sampling methods conducted by purposive sampling method . Purposive sampling method used to obtain data on natural resources and human resources at the Hope Island , while the data on perception , motivation , participation and public interest is taken by using the questionnaire . Meanwhile , the development of community-based ecotourism in Hope Island , formulated using SWOT analysis approach . Data were analyzed using SWOT table .Research results indicate that the potential for ecotourism resources contained in the Hope Island which can be used as a tourist attraction and cultural landscape of the Hope Island itself, from the readiness of the community , the majority of the community supports the development of ecotourism in Hope Island , based on the SWOT matrix , strategy higher in priority to the development of ecotourism activities in Hope Island is a strategy that combines the strengths and opportunities is developing a program of community-based ecotourism activities that combine the potential of nature and culture of Hope Island to attract visitor

Carotid Intima-Media Thickness and Carotid Plaques Improves Prediction of Obstructive Angiographic Coronary Artery Disease in Women

Does carotid intima-media thickness (cIMT), a surrogate marker of cardiovascular events, have predictive incremental value over established risk factors for stable coronary artery disease (CAD)? Prospective study of 300 patients, with suspected stable CAD, admitted for an elective coronary angiography and carotid ultrasound. The CAD patients had a higher cIMT, which showed a modest predictive accuracy for CAD (area under the receiver-operating characteristic curve 0.638, 95% confidence interval 0.576-0.701, P < .001). The cIMT was an independent predictor of CAD, together with age, gender, and diabetes. C-statistic for CAD prediction by traditional risk factors was not significantly different from a model that included cIMT, carotid plaque presence, or both. However, in women, it was significantly increased by the addition of cIMT or carotid plaque presence. Although cIMT cannot be used as a sole indicator of CAD, it should be considered in the panel of investigations that is requested, particularly in women who are candidates for coronary angiography