Adipokine levels in overweight women with early-onset gestational diabetes mellitus.

PURPOSE: The study of adipokines in overweight women with early-onset (diagnosed before 20 weeks) gestational diabetes mellitus (GDM) could help to understand the ethiopathological mechanisms of this disorder. Our aim was to assess adipokine levels in overweight pregnant women with early-onset GDM compared to patients with standard-onset (diagnosed at 24-28 weeks) GDM and to glucose-tolerant women at the same gestational ages. METHODS: This nested case-control study included 133 overweight pregnant women: 33 with early-onset (diagnosed < 20 weeks) GDM; 40 with standard-onset (diagnosed ≥ 24 weeks) GDM and 60 glucose-tolerant (normal oral glucose tolerance tests < 20 and ≥ 24 weeks). Adiponectin, leptin, resistin, visfatin and ghrelin serum levels were measured by ELISA. RESULTS: Adiponectin serum levels were significantly lower in early-onset GDM women than in standard-onset GDM patients or controls matched for gestational age. Leptin serum levels were significantly higher in women with early-onset GDM than in controls. Women with early-onset GDM had lower adiponectin/leptin ratio than those with standard-onset GDM. There were no significant differences in resistin, ghrelin and visfatin serum levels among the participants. CONCLUSIONS: Our results suggest that, compared to overweight glucose-tolerant women and patients with standard-onset GDM, overweight women with early-onset GDM have unbalanced adipokine levels, suggesting that they have a more inflammatory profile.

Hearing preservation and cochlear implants according to inner ear approach: multicentric evaluation / Preservação auditiva e implante coclear de acordo com a abordagem da orelha interna: avaliação multicêntrica

INTRODUCTION: Electroacoustic stimulation is an excellent option for people with residual hearing in the low frequencies, who obtain insufficient benefit with hearing aids. To be effective, the subject's residual hearing should be preserved during cochlear implant surgery. OBJECTIVES: To evaluate the hearing preservation in patients that underwent implant placement and to compare the results in accordance with the approach to the inner ear. METHODS: 19 subjects underwent a soft surgical technique, and the electrode MED-EL FLEX(tm) EAS, designed to be atraumatic, was used. We evaluated pre- and postoperative tonal audiometric tests with an average of 18.4 months after implantation, to measure the rate of hearing preservation. RESULTS: 17 patients had total or partial preservation of residual hearing; 5 had total hearing preservation and two individuals had no preservation of hearing. The insertion of the electrode occurred through a cochleostomy in 3 patients, and in 2 of these there was no hearing preservation; the other 16 patients experienced electrode insertion through a round window approach. All patients benefited from the cochlear implant, even those who are only using electrical stimulation. CONCLUSION: The hearing preservation occurred in 89.4% of cases. There was no significant difference between the forms of inner ear approach. .

INTRODUÇÃO: A estimulação eletroacústica é uma excelente opção para pessoas com audição residual nas baixas frequências, que obtêm benefício insuficiente com aparelhos auditivos. Para ser eficaz, a audição residual deve ser preservada durante a cirurgia de implante coclear. OBJETIVOS: Avaliar a preservação auditiva de pacientes implantados e comparar os resultados de acordo com a abordagem da orelha interna. MÉTODO: 19 indivíduos foram implantados com uma técnica cirúrgica para preservação auditiva, tendo sido utilizado o eletrodo MED-EL FLEXTM EAS, concebido para ser atraumático. Foram avaliados os exames audiométricos tonais no pré e pós-operatório, com uma média de 18,4 meses após o implante para medir a taxa de preservação da audição residual. RESULTADOS: 17 pacientes tiveram preservação total ou parcial da audição residual; cinco obtiveram preservação da audição total e dois indivíduos não tiveram preservação da audição. A inserção do eletrodo ocorreu por cocleostomia em 3 pacientes; em 2 destes pacientes não houve preservação da audição. Os outros 16 pacientes foram submetidos à abordagem pela janela redonda. Todos os pacientes foram beneficiados com o implante coclear, mesmo aqueles pacientes que utilizando apenas estimulação elétrica. CONCLUSÃO: A preservação auditiva ocorreu em 89,4% dos casos. Não houve diferença significativa entre as formas de abordagem da orelha interna. .

Hearing preservation and cochlear implants according to inner ear approach: multicentric evaluation.

INTRODUCTION: Electroacoustic stimulation is an excellent option for people with residual hearing in the low frequencies, who obtain insufficient benefit with hearing aids. To be effective, the subject's residual hearing should be preserved during cochlear implant surgery. OBJECTIVES: To evaluate the hearing preservation in patients that underwent implant placement and to compare the results in accordance with the approach to the inner ear. METHODS: 19 subjects underwent a soft surgical technique, and the electrode MED-EL FLEX™ EAS, designed to be atraumatic, was used. We evaluated pre- and postoperative tonal audiometric tests with an average of 18.4 months after implantation, to measure the rate of hearing preservation. RESULTS: 17 patients had total or partial preservation of residual hearing; 5 had total hearing preservation and two individuals had no preservation of hearing. The insertion of the electrode occurred through a cochleostomy in 3 patients, and in 2 of these there was no hearing preservation; the other 16 patients experienced electrode insertion through a round window approach. All patients benefited from the cochlear implant, even those who are only using electrical stimulation. CONCLUSION: The hearing preservation occurred in 89.4% of cases. There was no significant difference between the forms of inner ear approach.

Hearing Preservation after Cochlear Implantation: UNICAMP Outcomes.

Background. Electric-acoustic stimulation (EAS) is an excellent choice for people with residual hearing in low frequencies but not high frequencies and who derive insufficient benefit from hearing aids. For EAS to be effective, subjects' residual hearing must be preserved during cochlear implant (CI) surgery. Methods. We implanted 6 subjects with a CI. We used a special surgical technique and an electrode designed to be atraumatic. Subjects' rates of residual hearing preservation were measured 3 times postoperatively, lastly after at least a year of implant experience. Subjects' aided speech perception was tested pre- and postoperatively with a sentence test in quiet. Subjects' subjective responses assessed after a year of EAS or CI experience. Results. 4 subjects had total or partial residual hearing preservation; 2 subjects had total residual hearing loss. All subjects' hearing and speech perception benefited from cochlear implantation. CI diminished or eliminated tinnitus in all 4 subjects who had it preoperatively. 5 subjects reported great satisfaction with their new device. Conclusions. When we have more experience with our surgical technique we are confident we will be able to report increased rates of residual hearing preservation. Hopefully, our study will raise the profile of EAS in Brazil and Latin/South America.