The first evaluation of the in vitro effects of silver(I)-N-heterocyclic carbene complexes on Encephalitozoon intestinalis and Leishmania major promastigotes.

Encephalitozoon intestinalis is an opportunistic microsporidian parasite that primarily infects immunocompromised individuals, such as those with HIV/AIDS or undergoing organ transplantation. Leishmaniasis is responsible for parasitic infections, particularly in developing countries. The disease has not been effectively controlled due to the lack of an effective vaccine and affordable treatment options. Current treatment options for E. intestinalis infection and leishmaniasis are limited and often associated with adverse side effects. There is no previous study in the literature on the antimicrosporidial activities of Ag(I)-N-heterocyclic carbene compounds. In this study, the in vitro antimicrosporidial activities of previously synthesized Ag(I)-N-heterocyclic carbene complexes were evaluated using E. intestinalis spores cultured in human renal epithelial cell lines (HEK-293). Inhibition of microsporidian replication was determined by spore counting. In addition, the effects of the compounds on Leishmania major promastigotes were assessed by measuring metabolic activity or cell viability using a tetrazolium reaction. Statistical analysis was performed to determine significant differences between treated and control groups. Our results showed that the growth of E. intestinalis and L. major promastigotes was inhibited by the tested compounds in a concentration-dependent manner. A significant decrease in parasite viability was observed at the highest concentrations. These results suggest that the compounds have potential anti-microsporidial and anti-leishmanial activity. Further research is required to elucidate the underlying mechanisms of action and to evaluate the efficacy of the compounds in animal models or clinical trials.

The effect of strabismus surgery on the dynamic balance in children with strabismus.

Purpose: To evaluate the effect of strabismus surgery on dynamic balance by using computerized dynamic posturography in children with strabismus. Methods: This study was designed as a prospective observational study. Hearing tests and complete ophthalmological examinations were performed for all subjects. Patients with moderate and severe amblyopia, hearing loss at any level, and/or any suspicion of balance impairment were excluded from the study. Postural stability evaluation was performed by computerized dynamic posturography including sensory organization test, adaptation test, and rhythmic weight shift test. All tests were applied preoperatively and in the postoperative 1st and 3rd months, respectively. Results: Fifteen female and twelve male pre-adolescents aged between 7 and 12 (9.67 ± 1.62 years) were included in the current study. In the sensory organization test, the preoperative visual ratio percentages (73.19 ± 14.95%) improved statistically significantly at the postoperative 1st and 3rd months (78.59 ± 16.21% and 81.44 ± 14.18; p = .026, p = .021, respectively). The preoperative toes up (110.66 ± 33,48) and toes down (81.46 ± 28.36) adaptation tests improved statistically significantly in the postoperative 3rd month (88.74 ± 20.94 and 63.36 ± 16.03; p < .001, p = .001, respectively). In the Rhythmic Weight Shift test, the postoperative 3rd-month directional control (forward-backward) value (74.25 ± 11.51%) was statistically significantly higher compared to the preoperative directional control (forward-backward) value (67.76 ± 11.38%) (p = .011). The postoperative 3rd-month directional control (forward-backward) value (74.25 ± 11.51%) was statistically significantly higher compared to the postoperative 1st-month directional control (forward-backward) value (68.43 ± 14.00%) (p = .028). Conclusion: Surgical treatment resulted in an improvement in the maintenance of dynamic balance in children with strabismus.

Effect of music integrated phonological awareness program on preschool cochlear implant users.

OBJECTIVES: Children with cochlear implants exhibit lower phonological awareness and sound discrimination skills compared to their normal-hearing peers. However, music training has been shown to have a positive effect on speech discrimination and awareness skills. METHODS: Our study included 23 cochlear implant users and 23 normal hearing participants aged 5-6 years with language skills. The aim was to observe the effect of a music-integrated phonological awareness program on cochlear implant users and to compare the phonological awareness skills of children with cochlear implants before and after online training with their normal hearing peers. RESULTS: Results showed that the trained study group scored higher on the Scale of Early Childhood Phonological Awareness (PASECP) after training than the control group (p < 0.05). In addition, SMRT scores increased between before and after training in the study group, and Mismatch Negativity (MMN) amplitudes increased and latencies decreased as a result of training (p < 0.05). CONCLUSIONS: The study suggests that phonological awareness training integrated with music can effectively improve the phonological awareness skills of children with cochlear implants and has the potential to enable them to achieve phonological awareness levels similar to or even better than their normal hearing peers.

Molecular investigation of Anaplasma phagocytophilum and related strains among sheep flocks from different parts of Türkiye; with a note of phylogenetic analyses of Anaplasma phagocytophilum- like 1.

Anaplasma phagocytophilum is a vector-borne zoonotic pathogen and can infect various vertebrate hosts, especially cattle, sheep, goats, horses, and dogs. Molecular-based studies have revealed that the agent has a high genetic diversity and closely related strains circulate in hosts. In this study, 618 sheep blood samples obtained from different geographic regions of Türkiye were researched for A.phagocytophilum and related strains with PCR, RFLP, and DNA sequence analyses. The DNA of these pathogens was detected in 110 (17.79%) samples. RFLP assay showed that all positive samples were infected with A.phagocytophilum-like 1, whereas A.phagocytophilum-like 2 and A.phagocytophilum were not detected. Partial parts of 16 S rRNA gene of seven randomly selected positive samples were sequenced. The phylogenetic analyses of these isolates revealed that at least two A.phagocytophilum-like 1 isolates circulate among hosts in Türkiye and around the world. A.phagocytophilum-related strains have been reported in molecular-based studies over the last few years, but there is a lack of data on the vector competence, epidemiology, clinical symptoms, and genetic diversity of these pathogens. Therefore, large-scale molecular studies are still needed to obtain detailed data on the above-mentioned topics.

Hearing loss in Takayasu's arteritis.

OBJECTIVES: Neurosensory hearing loss is well-documented in chronic autoimmune conditions such as systemic lupus erythematosus (SLE). However, the literature lacks data on the prevalence and characteristics of hearing impairment in Takayasu's arteritis (TAK). In this cross-sectional study, our principal objective was to systematically assess the auditory function of individuals diagnosed with TAK, against SLE patients and healthy controls (HC). METHODS: Age and gender matched TAK and SLE patients followed up in a tertiary centre along with healthy controls were included in a two-phase study. In the first phase, a questionnaire on ENT symptoms was administered to the patient (TAK: n=104 and SLE: n= 151) and HC (n=174) groups. In the second phase, patients (TAK: n=53 and SLE: n=33) and HC (n=45) underwent audiometric tests. RESULTS: The questionnaire survey revealed that both TAK and SLE patients reported hearing loss (27.9%, 25.8%, 7.4%, p<0.001), tinnitus (49%, 35.8%, 13.8%, p<0.001) and vertigo (46.2%, 33.8%, 16.7%, p<0.001) at significantly higher rates than HC. Audiometry results indicated that both TAK (30.2%) and SLE patients (18.2%) had increased hearing loss compared to HC (8.9%), however, only TAK patients were found to have significantly increased risk in age adjusted logistic regression analysis (OR= 3.915, 95%CI: 1.179-12.998, p=0.026). Hearing loss was mainly neurosensory in all groups. TAK patients were affected at both low (<6000 Hz) and high (>6000 Hz) frequencies, whereas SLE patients were affected only at high frequencies. Hearing loss was significantly associated only with older age. No association was observed with the anatomical location of vascular involvement or history of stroke. CONCLUSIONS: Our study reveals an increased prevalence of hearing loss in TAK. Further research is crucial to uncover the underlying causes.

Loudness Balancing Optimization for Better Speech Intelligibility, Music Perception, and Spectral Temporal Resolution in Cochlear Implant Users.

HYPOTHESIS: The behaviorally based programming with loudness balancing (LB) would result in better speech understanding, spectral-temporal resolution, and music perception scores, and there would be a relationship between these scores. BACKGROUND: Loudness imbalances at upper stimulation levels may cause sounds to be perceived as irregular, gravelly, or overly echoed and may negatively affect the listening performance of the cochlear implant (CI) user. LB should be performed after fitting to overcome these problems. METHODS: The study included 26 unilateral Med-EL CI users. Two different CI programs based on the objective electrically evoked stapedial reflex threshold (P1) and the behaviorally program with LB (P2) were recorded for each participant. The Turkish Matrix Sentence Test (TMS) was applied to evaluate speech perception; the Random Gap Detection Test (RGDT) and Spectral-Temporally Modulated Ripple Test (SMRT) were applied to evaluate spectral temporal resolution skills; the Mini Profile of Music Perception Skills (mini-PROMS) and Melodic Contour Identification (MCI) tests were applied to evaluate music perception, and the results were compared. RESULTS: Significantly better scores were obtained with P2 in TMS tests performed in noise and quiet. SMRT scores were significantly correlated with TMS in quiet and noise, and mini-PROMS sound perception results. Although better scores were obtained with P2 in the mini-PROMS total score and MCI, a significant difference was found only for MCI. CONCLUSION: The data from the current study showed that equalization of loudness across CI electrodes leads to better perceptual acuity. It also revealed the relationship between speech perception, spectral-temporal resolution, and music perception.

Investigation of Toxoplasma gondii Seroprevalence in Preeclampsic Pregnant.

Objective: Toxoplasma gondii is the causative agent of toxoplasmosis and is a parasite of high medical importance with a wide host variety. Bacterial, viral, and parasitic infections during pregnancy may predispose women to pregnancy complications. Preeclampsia of unknown etiology causes special conditions such as systemic vascular endothelial damage due to insufficient trophoblastic invasion and abnormal placentation. There are data of an association between various maternal infections and preeclampsia/eclampsias. The aim of the study was to compare and analyze the relationship between the presence of anti-Toxoplasma IgM and anti-Toxoplasma IgG antibodies in pregnant women with pre-eclampsia and in normotensive healthy pregnant women who were in the control group. Methods: In this study, 176 pregnant women who applied to our hospital between January 2019 and December 2020 were included. 88 (50%) of the pregnant women had pre-eclampsia and 88 (50%) were normotensive. The presence of anti-Toxoplasma IgM and IgG antibodies in blood taken from pregnant women with pre-eclampsia and control group was investigated using ELISA. Results: Because of the study, both groups were found to be seronegative in terms of anti-Toxoplasma IgM by ELISA. Anti-Toxoplasma IgG was found to be seropositive in 24 (27.3%) pregnant women with pre-eclampsia and 18 (20.5%) normotensive pregnant women. There was no statistically significant difference between the two groups in terms of anti-Toxoplasma IgM and anti-Toxoplasma IgG seropositivity (X2=0.289, p>0.05) (p<0.05). Conclusion: Because of the study, no statistically significant difference was found between pregnant women with pre-eclampsia and those with toxoplasmosis. It was thought that further studies should be conducted to discuss the hormonal, vascular, etc. factors occurring in the pathogenesis of preeclampsia of T. gondii effect of preparing the ground for the changes and to reveal the existence of a possible relationship between pre-eclampsia and T. gondii seropositivity.

Investigation of Toxoplasma gondii Seroprevalence in People Keeping Cats and Not Keeping Cats at Their Home in Sivas

Objective: Toxoplasma gondii (T. gondii) is an obligate intracellular protozoan and its definitive host is the Felidae family. Toxoplasmosis can be transmitted to humans in many ways. The purpose of the study was to investigate the anti-Toxoplasma IgM and anti-Toxoplasma IgG seropositivity with the ELISA method in people who have cats at home and do not have cats at home, and to reveal the possible relationship between toxoplasmosis and people who keep/contact cats for a long time for any reason at home. Methods: Between March 2021 and June 2021, blood samples were taken from 91 people who had a cat in their home for at least a year and 91 people who had never had a cat or had no contact with a cat, in Sivas province. Anti-Toxoplasma IgM and anti-Toxoplasma IgG antibodies were investigated in serum samples by the ELISA method. Age, gender, and other socio-demographic criteria were not considered. RESULTSResults: Because of the study, all samples were found to be negative for anti-Toxoplasma IgM. Anti-Toxoplasma IgG seropositivity was detected in 20 (22.0%) of those who had cats at home and 40 (44.0%) of those without cats at home. There was no statistically significant difference between the two groups in terms of anti-Toxoplasma IgM seropositivity. However, anti-Toxoplasma IgG seropositivity was found to be statistically significant (p=0.002) (p<0.01). Conclusion: Because of the study, anti-Toxoplasma IgG positivity was found to be higher in those who did not feed/contact cats at home and it was statistically significant. It brings to mind that the reason for the high rate of seropositivity in those without cats at home, may not be only the oocysts excreted from cats, but also the transmission by other non-cat transmission routes may still be important.

The Comparison of Narrow Band Imaging, White Light Laryngoscopy and Videolaryngostroboscopy in the Evaluation of Benign Vocal Fold Lesions.

BACKGROUND: The aim of the study was comparing the diagnostic role of the white light (WL) endoscopy, video laryngostroboscopy (VLS), and narrow-band imaging (NBI) in the evaluation of the benign vocal fold lesions. MATERIAL AND METHODS: From March 2018 to June 2019, a total of 118 cases were enrolled in this study. Ninety-eight patients were suspected with vocal fold nodules, cysts, polyps, and sulcus vocalis and 20 patients without a history of dysphonia. Each patient was examined by WL, VLS, and NBI endoscopy. Recorded images and videos were analyzed and scored by three otorhinolaryngologists who had at least 3 years of experience in phoniatrics field. The evaluation results were compared between the methods and the physicians. RESULTS: A total of 118 cases were grouped by their confirmed diagnosis, vocal fold nodules (n = 28), vocal fold cyst (n = 24), vocal fold polyp (n = 9), and sulcus vocalis (n = 37). When the correct diagnosis rates of the physicians were compared, the statistical significance was found between the physicians in the WL and VLS method (P= 0.014, P= 0.027). No statistically significant difference was found among physicians in NBI method (P = 0.368). The difference between the diagnostic methods was found to be statistically significant in reaching the accurate diagnosis for benign vocal fold lesions (P< 0.001). While the difference between NBI-WL and VLS-WL was statistically significant (P< 0.001 and P< 0.001). The difference between NBI-VLS was not statistically significant while evaluating the vocal fold nodules, cysts, and sulcus vocalis separately (P= 0.102, P = 0.026, P = 0.157). Otherwise, it was statistically significant (P= 0.002) while evaluating total benign lesions in the study. The difference between NBI-VLS combination and VLS, NBI-VLS combination and VLS-WL combination were statistically significant (P< 0.001 and P= 0.001). CONCLUSION: This study showed that NBI assessments have similar accuracy and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to VLS and have a higher value than WL endoscopy in reaching the diagnosis for benign vocal fold lesions. Therefore, NBI can be accepted as a promising approach to identify benign laryngeal lesions due to its optical properties.

Direct Health Expenditure Analysis Related to Hearing Loss in Individuals Using Hearing Aids and Cochlear Implants.

Objective: This study aimed to investigate the expenditures related to hearing devices and compare the differences in expenditures in child and adult users. Methods: A preliminary questionnaire was developed and conducted amongst hearing aid and cochlear implant users. A total of 178 patients (57.3% were hearing aid users, 42.7% were cochlear implant users) were included in the study and grouped as adults (first group, 50 patients), and children 1< (second group, 123 patients). Results: The results of the study showed that individuals used approximately 4.5% of their annual income as health expenditure related to hearing loss. This rate was over 5% for child users, and about 2.7% for adult users. Moreover, the expenditure made by adult users was below the amount of expenditure made for children in all health expenditure indicators. Conclusion: Supporting the family budget for hearing loss expenditures not covered by the public health insurance will minimize the financial problems caused by the disability.

Does size of the cochlear nerve affect postoperative auditory performance in pediatric cochlear implant patients with normal cochlear nerves? / O tamanho do nervo coclear afeta o desempenho auditivo pós-operatório em pacientes pediátricos com implante coclear e nervos cocleares normais?

Abstract Introduction Cochlear implantation is an effective treatment method for severe to profound hearing loss. Many factors that may influence cochlear implantation success have been explained in previous studies. Apart from those, minor differences in size of normal cochlear nerves may affect postoperative performance. Objective To investigate whether the minor differences in cochlear nerve size in normal cochlear nerves affect postoperative cochlear implant performance. Methods 30 pediatric prelingually deaf patients who were treated with cochlear implantation were included in this study. From the reconstructed parasagittal magnetic resonance images, the diameter and cross-sectional area of the cochlear nerve on the ipsilateral and contralateral side were measured. Auditory evaluations were performed 1, 3, 6 and 12 months following the first fitting. All the analysis was performed by using EARS®, evaluation of auditory responses to speech tool. Correlation between cochlear nerve diameter, cross-sectional area and postoperative auditory perception was analyzed to determine whether variation in cochlear nerve size contributes to postoperative auditory performance. Results The mean diameter of the cochlear nerve on the ipsilateral side was 718.4 μm (504.5 − 904.3 μm) and mean cross sectional area was 0.015 cm2 (0.012 − 0.018 cm2). On the contralateral side the mean cochlear nerve diameter was 714.4 μm (502.6 − 951.4 μm) and mean cross sectional area was 0.014 cm2 (0.011 − 0.019 cm2). The correlation between the diameter and cross-sectional area of the ipsilateral and contralateral cochlear nerve revealed no significance. Mean score at first month monosyllable-trochee-polysyllable test, MTP1, was 0.17 (0.08 − 0.33), at 6th month with 6 words test, 6th month MTP6 was 0.72 (0.39 − 1.0), at 6th month with 12 words, 6th month MTP 12 was 0.46 (0.17 − 0.75) and at 12th month with 12 words, 12th month MTP12 was 0.73 (0.25 − 1.0). There was no correlation between the monosyllable-trochee-polysyllable test, values at any time with the diameter of the ipsilateral cochlear nerve. However, the first month MTP, 6th month MTP6 and 12th month MTP12 correlated with the cross-sectional area of the ipsilateral cochlear nerve. Conclusion Measuring the cross sectional area of the normal- appearing cochlear nerve may give important prognostic knowledge on cochlear implant outcomes. In patients with a larger cross sectional area the auditory performance was better and faster. Although normal appearing, slight differences on cross sectional area of the cochlear nerve may affect performance. Measuring the size of the cochlear nerve on parasagittal magnetic resonance images may provide beneficial information on the postoperative rehabilitation process.

Resumo Introdução O implante coclear é um método de tratamento eficaz para a perda auditiva grave a profunda. Muitos fatores que podem influenciar o sucesso do implante coclear foram explicados em estudos anteriores. Além desses fatores, pequenas diferenças no tamanho dos nervos cocleares normais podem afetar o desempenho pós-operatório. Objetivo Investigar se pequenas diferenças no tamanho dos nervos cocleares normais afetam o desempenho pós-operatório do implante coclear. Método Foram incluídos neste estudo 30 pacientes pediátricos surdos pré-linguais, tratados com implante coclear. A partir de imagens de ressonância magnética parassagitais reconstruídas, foram medidos o diâmetro e a área de seção transversal do nervo coclear no lado ipsilateral e contralateral. As avaliações auditivas foram feitas 1, 3, 6 e 12 meses após a primeira adaptação. Todas as análises foram feitas com a ferramenta EARS® (do inglês evaluation of auditory responses to speech). A correlação entre o diâmetro do nervo coclear, a área transversal e a percepção auditiva pós-operatória foi analisada para determinar se a variação no tamanho do nervo coclear contribui para o desempenho auditivo pós-operatório. Resultados O diâmetro médio do nervo coclear no lado ipsilateral foi de 718,4 μm (504,5 a 904,3 μm) e a área da seção transversal média foi de 0,015 cm2 (0,012-0,018 cm2). No lado contralateral, o diâmetro médio do nervo coclear foi de 714,4 μm (502,6 a 951,4 μm) e a área da seção transversal média foi de 0,014 cm2 (0,011 a 0,019 cm2). A correlação entre o diâmetro e a área transversal do nervo coclear ipsilateral e contralateral não revelou qualquer significância. O escore médio do teste monosyllable-trochee-polysyllable no primeiro mês, denominado MTP1, foi de 0,17 (0,08-0,33), no sexto mês com teste de 6 palavras, MTP6, foi de 0,72 (0,39-1,0), no sexto mês com 12 palavras, MTP12, foi de 0,46 (0,17-0,75) e no 12° mês com 12 palavras, MTP12, foi de 0,73 (0,25-1,0). Não houve correlação entre os valores do teste monosyllable-trochee-polysyllable em qualquer momento com o diâmetro do nervo coclear ipsilateral. Entretanto, o teste monosyllable-trochee-polysyllable do primeiro mês, do 6° mês, e o do 12° mês correlacionaram-se com a área transversal do nervo coclear ipsilateral. Conclusão Medir a área da secção transversal do nervo coclear de aparência normal pode fornecer conhecimento prognóstico importante sobre os resultados do implante coclear. Em pacientes com área da secção transversal maior, o desempenho auditivo foi melhor e mais rápido. Embora o nervo coclear pareça normal, pequenas diferenças na área da secção transversal do nervo coclear podem afetar o desempenho, de forma que a medida do tamanho do nervo coclear nas imagens de ressonância magnética na projeção parassagital pode fornecer informações benéficas sobre o processo de reabilitação pós-operatória.

Electrically Evoked Auditory Late Responses as a Novel Method for Cochlear Implant Programming.

HYPOTHESIS: Electrically evoked auditory late responses (eALR) are useful as an objective cochlear implant (CI) fitting method. BACKGROUND: Different objective and behavioral methods are used for CI fitting. However, there is no objective method that indicates that the electrical signal reaches the auditory cortex. eALR is an indicator that electrical signals reach the auditory cortex, so our aim was to investigate the use of eALR as an objective method for CI programming. METHODS: Two different programs were created for 21 unilateral Med-El CI users. In the first program, the most comfortable level (MCL) was adjusted with the electrical stapes reflex threshold (eSRT), and the threshold levels (THR) were behaviorally adjusted according to the user's feedback. In the second program, the MCL level was adjusted to a level where all the components of the eALR were clearly seen, and the user did not feel uncomfortable; the THR levels were adjusted to the lowest level where the eALR P1 wave could be seen. The results of the MCL and THR levels of the two programs and the free field tests conducted with both programs were compared. RESULTS: While MCL levels did not differ significantly between the two programs, a significant difference was observed between THR levels. In addition, no significant difference was found between hearing and speech tests with CI in the free field. CONCLUSION: The results revealed no significant performance difference between the two programs and that eALR could be preferred as an objective method for MCL determination.

Galvanic vestibular evoked myogenic potentials: normative data and the effect of age.

INTRODUCTION: Galvanic vestibular evoked myogenic potentials evaluate vestibular nerve responses using electric stimulation by records collected from the sternocleidomastoid muscle. A normal vestibular evoked myogenic potential response consists of the first positive, P1, and negative, N1, peaks. The response can be affected by factors such as age and gender and is also consequential in the diagnosis of pathologies. OBJECTIVES: The present study was performed to obtain normative data on healthy adults, to help in diagnosis by establishing clinical norms as well as to investigate changing test parameters with age in galvanic vestibular evoked myogenic potentials. METHODS: A total of 100 healthy participants were included in the study. Galvanic vestibular evoked myogenic potential (current 3 mA, duration 1 ms) was performed randomly on both ears of each participant. The participants between the ages of 18-65 (mean age 39.7 ±â€¯13.9) were divided into 5 groups according to their ages. Normative data of galvanic vestibular evoked myogenic potentials parameters were calculated in groups and in total, and age-related changes were examined. RESULTS: The galvanic vestibular evoked myogenic potential waveform was elicited from all participants (200 ears). The latency of P1 and N1 was 7.82 ±â€¯3.29 ms and 22.06 ±â€¯3.95 ms, respectively. The P1-N1 amplitude value was 66.64 ±â€¯24.5 µV. The percentage of vestibular asymmetry was 16.29 ±â€¯11.99%. The latencies of P1 and N1 and P1-N1 amplitude values demonstrated significant differences among different age groups (p < 0.01). CONCLUSIONS: The results of this study show that as age increased, latencies were prolonged, and amplitudes gradually decreased. The normative data aids in the diagnosis of retrolabyrinthine lesions and the increase in the clinical use of galvanic vestibular evoked myogenic potentials.

Does size of the cochlear nerve affect postoperative auditory performance in pediatric cochlear implant patients with normal cochlear nerves?

INTRODUCTION: Cochlear implantation is an effective treatment method for severe to profound hearing loss. Many factors that may influence cochlear implantation success have been explained in previous studies. Apart from those, minor differences in size of normal cochlear nerves may affect postoperative performance. OBJECTIVE: To investigate whether the minor differences in cochlear nerve size in normal cochlear nerves affect postoperative cochlear implant performance. METHODS: 30 pediatric prelingually deaf patients who were treated with cochlear implantation were included in this study. From the reconstructed parasagittal magnetic resonance images, the diameter and cross-sectional area of the cochlear nerve on the ipsilateral and contralateral side were measured. Auditory evaluations were performed 1, 3, 6 and 12 months following the first fitting. All the analysis was performed by using EARS®, evaluation of auditory responses to speech tool. Correlation between cochlear nerve diameter, cross-sectional area and postoperative auditory perception was analyzed to determine whether variation in cochlear nerve size contributes to postoperative auditory performance. RESULTS: The mean diameter of the cochlear nerve on the ipsilateral side was 718.4 µm (504.5 - 904.3 µm) and mean cross sectional area was 0.015 cm2 (0.012 - 0.018 cm2). On the contralateral side the mean cochlear nerve diameter was 714.4 µm (502.6 - 951.4 µm) and mean cross sectional area was 0.014 cm2 (0.011 - 0.019 cm2). The correlation between the diameter and cross-sectional area of the ipsilateral and contralateral cochlear nerve revealed no significance. Mean score at first month monosyllable-trochee-polysyllable test, MTP1, was 0.17 (0.08 - 0.33), at 6th month with 6 words test, 6th month MTP6 was 0.72 (0.39 - 1.0), at 6th month with 12 words, 6th month MTP 12 was 0.46 (0.17 - 0.75) and at 12th month with 12 words, 12th month MTP12 was 0.73 (0.25 - 1.0). There was no correlation between the monosyllable-trochee-polysyllable test, values at any time with the diameter of the ipsilateral cochlear nerve. However, the first month MTP, 6th month MTP6 and 12th month MTP12 correlated with the cross-sectional area of the ipsilateral cochlear nerve. CONCLUSION: Measuring the cross sectional area of the normal- appearing cochlear nerve may give important prognostic knowledge on cochlear implant outcomes. In patients with a larger cross sectional area the auditory performance was better and faster. Although normal appearing, slight differences on cross sectional area of the cochlear nerve may affect performance. Measuring the size of the cochlear nerve on parasagittal magnetic resonance images may provide beneficial information on the postoperative rehabilitation process.

Facial and Auditory Recognition Abilities of Implanted Primary Schoolers.

OBJECTIVE: Emotions are often conveyed via visual and together with the auditory mode in social interaction. We aimed to investigate the ability to recognize facial and/or auditory emotions in school-aged children with cochlear implantation and healthy controls. METHODS: All participants were asked to respond to facial emotions of Ekman and Friesen's pictures, then auditory emotions, and last, they were asked to respond to video-based dynamic synchronous facial and auditory emotions. RESULTS: The mean accuracy rates in recognizing anger (p = 0.025), surprise (p = 0.029), and neutral (p = 0.029) faces were significantly worse in children with cochlear implants (CIs) than in healthy controls. They were significantly worse than healthy controls in recognizing all auditory emotions except auditory emotion of fear (p = 0.067). The mean accuracy rates in recognizing video-based auditory/facial emotions of surprise (p = 0.031) and neutral (p = 0.029) emotions were significantly worse in children with CIs. CONCLUSION: The children with hearing loss were poorer in recognizing surprise, anger, and neutral facial emotions than healthy children; they had similar performance in recognizing anger emotions when both stimuli were given synchronously which may have a positive effect on social behaviors. It seems beneficial that emotion recognition training should be included in rehabilitation programs.

A novel diagnostic method for myasthenia gravis.

INTRODUCTION/AIMS: Videonystagmography (VNG) which directly records eye movements using infrared video goggles with mini-cameras, is used to measure nystagmus. Our aim is to explore whether VNG can be used to detect a decrement in the extraocular muscle (EOM) activity of patients with myasthenia gravis (MG). METHODS: Thirty-four patients with MG, including 13 with ocular-predominant and 21 with generalized MG, and 23 healthy controls participated. Using VNG we recorded the velocity of the eye movements of the patients as they followed a moving target. We then calculated the gain by dividing the eye movement velocity (degrees/second) by the target velocity (degrees/second). RESULTS: In MG subjects, the mean initial gain (maximum gain) was 1.23 ± 0.31 (range: 0.63-2.15) for the right eye and 1.22 ± 0.37 (range; 0.60-2.28) for the left eye. The mean minimum gain was 0.11 ± 0.12 (0.01-0.58) for the right and 0.14 ± 0.5 (0.02-0.55) for the left. Due to fatigue, the movement gain was reduced by 91.7% in the right eye and 88.2% in the left eye. After reaching minimum velocity, gain remained at a minimum for a mean of 1.08 ± 0.52 (0.3-2.4) s for the right and 1.49 ± 0.85 (0.4-3.6) s for the left, before the velocity increased again. There was no fatigue-induced decrement in healthy subjects. DISCUSSION: Our study documents a decrement in EOM activity recorded by VNG in patients with MG which begins to improve within 1-2 s after reaching minimum velocity, analogous to traditional low-frequency repetitive nerve stimulation testing and its U-shaped pattern. Thus, VNG may be a promising diagnostic test for MG.

Factors Affecting the Prevalence of House Dust Mite in Tekirdag and Istanbul Provinces in Comparison with House Dust Mite Population of Sivas Province During the Same Period

Objective: This study aimed to examine the frequency of house dust mite according to various variables and determine the house dust mite population in these provinces in house dust samples collected in the same period from Istanbul and Tekirdag provinces, which is located on the coastal part of the Marmara Region, and Sivas province, which has different climatic and geographic characteristics from these provinces. A comparison was done from each province. Methods: Between May and August 2018, a total of 100 powder samples were prepared by a lactic acid precipitation method that was examined microscopically. Besides, some variables in Tekirdag and Istanbul provinces were applied to participants by face-to-face interview method from a questionnaire. Results: House dust mite was found with a rate of 66.7% in Istanbul and 61.5% in Tekirdag; however, house dust mite was not found in Sivas province. According to survey results, the frequency of house dust mite detection is 1-4. It increased according to the fact that it is located between floors, cleaning was every 15 days, no smoking at home and insufficient sun exposure. No statistically significant difference was found according to the presence of plants and/or animals in the house and way of heating. Conclusion: Measures to be taken against house a dust mite, which is the most essential component of house dust with allergic content, are observed to be important in reducing complaints of sensitive people by especially considering the climate, geographic characteristics and general hygienic conditions. According to investigations, Baloghella melis, one of the mites detected in dust samples taken from Istanbul, has been determined to be a new record in Turkey. This study will contribute to Turkey with this aspect fauna of house dust mites.

Reflex Decay Test Can Reveal Ear Involvement in Fabry Disease.

OBJECTIVES: Fabry disease (FD) is an X-linked lysosomal storage disorder that causes multisystem involvement, including ear disease. In this study, we aimed to investigate the nature of auditory issues in FD using a wide spectrum of audiological tests. DESIGN: This cross-sectional study was conducted between June 2017 and December 2018. We collected the clinical and laboratory data of 40 eligible FD patients, 45 healthy subjects, and 26 diabetic controls. All patients and controls completed audiologic evaluations that included tympanometry, acoustic reflex threshold test, reflex decay test, pure-tone audiometry, speech audiometry, transient otoacoustic emissions (TEOAEs), high-frequency audiometry, and distortion product otoacoustic emission (DPOAE). RESULTS: In our study population, hearing was reduced at higher frequencies starting at 4 kHz in both the FD and diabetic groups. Regarding the acoustic reflex threshold test, FD and diabetic patients had similar results. In all frequencies, positive decay was significantly more frequent in FD patients when compared with the diabetic patients and healthy controls (p < 0.001 for each ear). The FD patients and healthy controls had similar results for DPOAE testing. CONCLUSIONS: We showed that FD patients had a higher rate of reflex decay, indicating retrocochlear involvement. Thus, further investigation of factors associated with retrocochlear involvement could be investigated, such as ABR and speech in noise tests.

Changes in electrically evoked auditory brainstem responses in children with sequential bilateral cochlear implants.

OBJECTIVES: The primary aim of this study is to investigate whether the electrical stimulation of the second ear causes a difference in electrically evoked auditory brainstem responses (eABR) between two ears over time. METHODS: The study included thirteen subjects under the age of five who used cochlear implants for at least six months in the first ear prior to the sequential cochlear implantation. Postoperative eABRs were conducted on the 1st (first fitting of the second speech processor), 3rd, and 6th months of the second implantation in the basal, medial, and apical electrode positions. The recording was started with the second cochlear implant (CI2), and then the first cochlear implant (CI1) was tested. Sound field audiometry and receptive/expressive language assessments were also performed at 1 and 6 months after the second cochlear implantation. RESULTS: eABR results indicate that when eV wave latencies are examined for all electrodes, CI2 is significantly longer than CI1 (p < 0.05). When eV wave amplitudes are examined for all electrodes, CI1 is significantly higher than the CI2 (p < 0.05). eV latency and amplitude changes between both implants were examined up to six months after implantation. Statistically significant changes were observed in the basal, medial, apical electrode for eV wave latencies, and only in the medial electrode for eV wave amplitudes (p < 0.05). Average sound field thresholds and receptive/expressive language scores improved statistically significantly for all subjects at the end of the study (p < 0.05). CONCLUSION: The postoperative eABR test is a valuable test battery that provides the clinician with important ideas about the estimated threshold, comfortable and audible sound level, CI performance, and auditory pathways up to the brainstem. Since the maturation is still ongoing, an extended period longer than six months is needed to evaluate interaural differences.

The Effect of Galvanic Vestibular Stimulation in the Rehabilitation of Patients with Vestibular Disorders.

INTRODUCTION: The aim of the study was to increase the participants' satisfaction with the unilateral peripheral vestibular pathology, in addition to the exercise program, with galvanic vestibular stimulation (GVS). METHODS: Participants were divided into 2 groups: study group (41 subjects) and control group (32 subjects). Participants who underwent videonystagmography and sensory organization testing, which were objective test methods at the beginning, were invited to check in every week for 6 weeks to perform GVS and/or exercise in the exercise program. Objective tests were repeated at the end of the sixth week. A visual analog scale (VAS) was administered every week. RESULTS: Unilateral weakness, balance scores 4, 5, 6; visual, vestibular, preference and strategy scores 5, 6; center of gravity 1, 2, 3, 4, 5, 6; composite scores were different between the groups after rehabilitation (p < 0.05). In terms of VAS, the study group began to feel better at the end of the first week than the control group (p < 0.01). DISCUSSION/CONCLUSION: It was found that the study group benefited both from an objective and a subjective point of view more than participants in the control group.