Imagen de la hipoacusia postraumática / Imaging of post-traumatic hearing loss

Objetivo. La hipoacusia es la complicación más frecuente del traumatismo del hueso temporal. El papel del radiólogo es de gran importancia; la adecuación y la selección de las pruebas radiológicas, así como su correcta interpretación, son cruciales para establecer el diagnóstico y el pronóstico, y para seleccionar el tratamiento idóneo. Con el objetivo de sistematizar los conceptos más relevantes en la valoración de los estudios de imagen en este contexto, se esquematizará el desarrollo del tema según el tipo de hipoacusia que condicione el traumatismo. De forma ordenada se valorarán las potenciales lesiones de sus componentes; en cada caso se sugerirá la técnica de imagen para su evaluación y se describirán e ilustrarán los hallazgos. Conclusión. En la hipoacusia postraumática, la tomografía computarizada es la técnica de elección inicial y permitirá la detección de alteraciones que condicionen hipoacusia conductiva; la resonancia magnética es útil en la valoración de la hipoacusia neurosensorial

Objective. Hearing loss is the most frequent complication of temporal bone trauma. The role of the radiologist is of great importance; the adequacy and selection of the imaging technique, as well as its correct interpretation, are crucial to establish the diagnosis, prognosis and enable the selection of appropriate treatment. With the aim of systematizing the most relevant concepts in the evaluation of image studies in this scenario, this review will be outlined according to the hearing loss type. The potential lesions of its components will be assessed; In each case the most appropriate imaging technique will be suggested and the findings will be described and depicted. Conclusion. In postraumatic hearing loss, computed tomography is the initial technique of choice and will allow the detection of alterations that cause conductive hearing loss; magnetic resonance imaging will be useful in the evaluation of sensorineural hearing loss

Imaging of post-traumatic hearing loss. / Imagen de la hipoacusia postraumática.

OBJECTIVE: Hearing loss is the most frequent complication of temporal bone trauma. The role of the radiologist is of great importance; the adequacy and selection of the imaging technique, as well as its correct interpretation, are crucial to establish the diagnosis, prognosis and enable the selection of appropriate treatment. With the aim of systematizing the most relevant concepts in the evaluation of image studies in this scenario, this review will be outlined according to the hearing loss type. The potential lesions of its components will be assessed; In each case the most appropriate imaging technique will be suggested and the findings will be described and depicted. CONCLUSION: In postraumatic hearing loss, computed tomography is the initial technique of choice and will allow the detection of alterations that cause conductive hearing loss; magnetic resonance imaging will be useful in the evaluation of sensorineural hearing loss.

Malformaciones del oído interno: una aproximación diagnóstica práctica / Inner ear malformations: a practical diagnostic approach

La hipoacusia neurosensorial pediátrica es una causa mayor de discapacidad. Pese a que solo en el 20-40% de los casos se identifica una malformación del oído interno, su detección es de vital importancia para el tratamiento de estos pacientes. En este artículo se repasan la anatomía y la embriogénesis del oído interno. Se valora el papel de la neuroimagen en la hipoacusia neurosensorial pediátrica y en el estudio preimplante coclear. Se destaca la necesidad de la utilización de un sistema universal de clasificación de las malformaciones del oído interno con implicaciones pronósticas y terapéuticas. Por último, se describen e ilustran de forma concisa los hallazgos radiológicos clave de cada tipo de malformación. La tomografía computarizada y la resonancia magnética desempeñan un papel crucial en la caracterización de las malformaciones del oído interno y permiten la valoración de las estructuras anatómicas que posibilitan la selección del tratamiento y del abordaje quirúrgico idóneos (AU)

Pediatric sensorineural hearing loss is a major cause of disability; although inner ear malformations account for only 20-40% of all cases, recognition and characterization will be vital for the proper management of these patients. In this article relevant anatomy and development of inner ear are surveyed. The role of neuroimaging in pediatric sensorineural hearing loss and cochlear preimplantation study are assessed. The need for a universal system of classification of inner ear malformations with therapeutic and prognostic implications is highlighted. And finally, the radiological findings of each type of malformation are concisely described and depicted. Computed tomography and magnetic resonance imaging play a crucial role in the characterization of inner ear malformations and allow the assessment of the anatomical structures that enable the selection of appropriate treatment and surgical approach (AU)

Inner ear malformations: a practical diagnostic approach. / Malformaciones del oído interno: una aproximación diagnóstica práctica.

Pediatric sensorineural hearing loss is a major cause of disability; although inner ear malformations account for only 20-40% of all cases, recognition and characterization will be vital for the proper management of these patients. In this article relevant anatomy and development of inner ear are surveyed. The role of neuroimaging in pediatric sensorineural hearing loss and cochlear preimplantation study are assessed. The need for a universal system of classification of inner ear malformations with therapeutic and prognostic implications is highlighted. And finally, the radiological findings of each type of malformation are concisely described and depicted. Computed tomography and magnetic resonance imaging play a crucial role in the characterization of inner ear malformations and allow the assessment of the anatomical structures that enable the selection of appropriate treatment and surgical approach.

Radiología del oído externo: indicaciones, anatomía normal y procesos patológicos / Radiology of external ear: indications, normal anatomy, and pathological processes

El oído externo (OE) es accesible al examen directo. En la mayor parte de las enfermedades, la historia clínica y la otoscopia son suficientes para su diagnóstico y tratamiento. Nuestro objetivo es describir la anatomía normal del OE, especificar las indicaciones de pruebas de imagen y revisar las manifestaciones clínicas y radiológicas de las enfermedades más frecuentes, que clasificaremos según su origen en patología congénita, inflamatoria e infecciosa, tumoral ósea benigna, traumática y tumoral maligna. Las pruebas de imagen no desempeñan un papel importante en la patología del OE, pero en determinados escenarios clínicos pueden ser cruciales para alcanzar el diagnóstico concreto y establecer el tratamiento idóneo. La tomografía computarizada es la técnica de elección para la mayor parte de las enfermedades. La resonancia magnética es complementaria, permite discriminar tejidos de diferente naturaleza y evaluar con precisión la extensión de la enfermedad (AU)

The external ear is accessible to direct examination; the clinical history and otoscopy are sufficient to diagnose and treat most diseases of the external ear. We aim to describe the normal anatomy of the external ear, specify the indications for imaging tests, and review the clinical and radiological manifestations of the most common diseases affecting the external ear. We classify these diseases according to their origin into congenital, inflammatory, infectious, or traumatic disease or benign bone tumors or malignant tumors. Imaging does not play an important role in diseases of the external ear, but in certain clinical scenarios it can be crucial for reaching a concrete diagnosis and establishing the best treatment. Computed tomography is the first-choice technique for most diseases. Magnetic resonance imaging complements computed tomography and makes it possible to differentiate among different tissue types and to evaluate the extension of disease accurately (AU)

Radiology of external ear: indications, normal anatomy, and pathological processes. / Radiología del oído externo: indicaciones, anatomía normal y procesos patológicos.

The external ear is accessible to direct examination; the clinical history and otoscopy are sufficient to diagnose and treat most diseases of the external ear. We aim to describe the normal anatomy of the external ear, specify the indications for imaging tests, and review the clinical and radiological manifestations of the most common diseases affecting the external ear. We classify these diseases according to their origin into congenital, inflammatory, infectious, or traumatic disease or benign bone tumors or malignant tumors. Imaging does not play an important role in diseases of the external ear, but in certain clinical scenarios it can be crucial for reaching a concrete diagnosis and establishing the best treatment. Computed tomography is the first-choice technique for most diseases. Magnetic resonance imaging complements computed tomography and makes it possible to differentiate among different tissue types and to evaluate the extension of disease accurately.

Use of dry citrus pulp or soybean hulls as a replacement for corn grain in energy and nitrogen partitioning, methane emissions, and milk performance in lactating Murciano-Granadina goats.

The aim of this study was to assess the effect of substitution of dietary corn grain by dry citrus pulp or soybean hulls on energy and nitrogen partitioning, substrate oxidation, methane emission, and milk performance in dairy goats during midlactation. Twelve multiparous Murciano-Granadina goats of similar body weight (41.7 ± 2.8 kg) were split in 3 groups in an incomplete crossover design. One group of 4 goats was fed a mixed ration with 605 g/kg of dry matter of corn grain (CRG), another group replaced corn grain with dry citrus pulp (CTP), and the last with soybean hulls (SYH). The goats were allocated to individual metabolism cages. After 14 d of adaptation, feed intake, total fecal and urine output, and milk yield were recorded daily over a 5-d period. Then, gas exchange measurements were recorded by a mobile open-circuit indirect calorimetry system using a head box. Dry matter intake was similar for all 3 groups (1.53 kg/d, on average). Total replacement of the concentrate with fibrous by-products increased fiber apparent digestibility. The metabolizable energy intake was significantly greater for diet CRG than SYH (1,193 vs. 1,079 kJ/kg of BW°·75, respectively), CTP showed an intermediate value. The heat production was higher for the fiber diet than starchy diet (908 vs. 843 kJ/kg of BW°·75 for SYH and CRG, respectively). The efficiency of use of metabolizable energy for milk production obtained by regression was 0.59. Goats fed CTP and SYH diets produced similar CH4 emissions (34.8 g/d, on average), significantly higher compared with goats fed the CRG diet (24.7 g/d). Goats of the 3 treatments were in negative energy balance, so the oxidation of fat was greater than for carbohydrates. No significant differences were observed for milk production (1.72 kg/d), and milk fat was significantly greater for a more fibrous diet compared with a starchy diet (6.57 vs. 4.95% in SYH and CRG, respectively).

Dental flat panel conebeam CT in the evaluation of patients with inflammatory sinonasal disease: Diagnostic efficacy and radiation dose savings.

BACKGROUND AND PURPOSE: CT is the imaging modality of choice to study the paranasal sinuses; unfortunately, it involves significant radiation dose. Our aim was to assess the diagnostic validity, image quality, and radiation-dose savings of dental conebeam CT in the evaluation of patients with suspected inflammatory disorders of the paranasal sinuses. MATERIAL AND METHODS: We prospectively studied 40 patients with suspected inflammatory disorders of the sinuses with dental conebeam CT and standard CT. Two radiologists analyzed the images independently, blinded to clinical information. The image quality of both techniques and the diagnostic validity of dental conebeam CT compared with the reference standard CT were assessed by using 3 different scoring systems. Image noise, signal-to-noise ratio, and contrast-to-noise ratio were calculated for both techniques. The absorbed radiation dose to the lenses and thyroid and parotid glands was measured by using a phantom and dosimeter chips. The effective radiation dose for CT was calculated. RESULTS: All dental conebeam CT scans were judged of diagnostic quality. Compared with CT, the conebeam CT image noise was 37.3% higher (P < .001) and the SNR of the bone was 75% lower (P < .001). The effective dose of our conebeam CT protocol was 23 µSv. Compared with CT, the absorbed radiation dose to the lenses and parotid and thyroid glands with conebeam CT was 4%, 7.8%, and 7.3% of the dose delivered to the same organs by conventional CT (P < .001). CONCLUSIONS: Dental conebeam CT is a valid imaging procedure for the evaluation of patients with inflammatory sinonasal disorders.

Angiopatía amiloide inflamatoria / Inflammatory amyloid angiopathy

No disponbile

The influence of broiler activity, growth rate, and litter on carbon dioxide balances for the determination of ventilation flow rates in broiler production.

Carbon dioxide balances are useful in determining ventilation rates in livestock buildings. These balances need an accurate estimation of the CO(2) produced by animals and their litter to determine the ventilation flows. To estimate the daily variation in ventilation flow, it is necessary to precisely know the daily variation pattern of CO(2) production, which mainly depends on animal activity. The objective of this study was to explore the applicability of CO(2) balances for determining ventilation flows in broiler buildings. More specifically, this work aimed to quantify the amount of CO(2) produced by the litter, as well as the amount of CO(2) produced by the broilers, as a function of productive parameters, and to analyze the influence of broiler activity on CO(2) emissions. Gas concentrations and ventilation flows were simultaneously measured in 3 trials, with 1 under experimental conditions and the other 2 in a commercial broiler farm. In the experimental assay, broiler activity was also determined. At the end of the experimental trial, on the day after the removal of the broilers, the litter accounted for 20% of the total CO(2) produced, and the broilers produced 3.71 L/h of CO(2) per kg of metabolic weight. On the commercial farm, CO(2) production was the same for the 2 cycles (2.60 L/h per kg of metabolic weight, P > 0.05). However, substantial differences were found between CO(2) and broiler activity patterns after changes in light status. A regression model was used to explain these differences (R(2) = 0.52). Carbon dioxide increased with bird activity, being on average 3.02 L/h per kg of metabolic weight for inactive birds and 4.73 L/h per kg of metabolic weight when bird activity was highest. Overall, CO(2) balances are robust tools for determining the daily average ventilation flows in broiler farms. These balances could also be applied at more frequent intervals, but in this case, particular care is necessary after light status changes because of discrepancy between animal activity and CO(2) production.

Characterization of gas emissions from a Mediterranean broiler farm.

Gas emissions from broiler production have been the subject of intensive research. However, little experimental information exists for farms under the particular management and environmental conditions of the European Mediterranean area. In this study, ammonia, carbon dioxide, methane, and nitrous oxide concentrations and emissions were measured in a commercial broiler farm located in Spain. Gas concentrations were measured using a photoacoustic gas monitor, whereas the ventilation flow was evaluated by controlling the operation status of each fan. Two rearing periods were studied, one in summer and one in winter. All gas emissions increased with bird age. Ammonia emission rates averaged 19.7 and 18.1 mg/h per bird in the summer and winter, respectively, and increased with indoor temperature (r(2) = 0.51 in summer; r(2) = 0.42 in winter). Average CO(2) emission rates were 3.84 and 4.06 g/h per bird, CH(4) emission was 0.44 and 1.87 mg/h per bird, and N(2)O emission was 1.74 and 2.13 mg/h per bird in summer and winter, respectively. A sinusoidal daily variation pattern was observed in all emissions except for CH(4). These patterns were characterized in terms of time of maximum emission and amplitude of the daily variation.

The influence of the lighting program on broiler activity and dust production.

Among the factors influencing dust production on the farms, animal activity is probably the least studied. Animal activity is strongly affected by circadian rhythms and it is altered by the rearing conditions, especially the management of light and the feeding strategy. In this study, a broiler flock was evaluated until 35 d of age with the general objective of studying the factors influencing the production of dust, particularly the effect of animal activity, as affected by the lighting program. In an experimental room, 2 daily dark periods of 6 and 4 h with 158 birds divided in 12 groups, reared on wood shavings, were evaluated. A TEOM analyzer was used to measure dust concentrations, whereas animal activity was determined by observation of birds on video tapes. Animal activity was defined by an activity index, which was determined by direct evaluation of birds on video tapes. The animal activity index was closely related to the lighting program (0.084 and 0.556 during dark and light periods, respectively) and was maximum at wk 4 of the rearing period. The dust concentrations during light periods were on average 4 times higher than during dark periods, with a maximum average concentration of 2.82 mg x m(-3) during the last week of the cycle. Particulate matter emission was on average 2.08 mg x animal(-1) x hour(-1). Dust concentration increased linearly with bird weight and daily variations in dust production were characterized. As a result, a direct cause-effect relationship between animal activity and dust concentration was obtained (r(2) = 0.89).

Longitudinal analysis of human cytomegalovirus glycoprotein B (gB)-specific and neutralizing antibodies in AIDS patients either with or without cytomegalovirus end-organ disease.

Serum neutralizing and glycoprotein B (gB)-specific antibody levels were monitored prospectively in AIDS patients who either did or did not develop human cytomegalovirus (HCMV) end-organ disease, to delineate further the role of antibodies in protecting against HCMV disease. Antibody levels declined substantially (at least 4-fold) only in patients who developed HCMV disease; this decline in turn occurred concurrently with antigenemia. Nevertheless, AIDS patients who remained free of HCMV disease and did not become antigenemic during the follow-up period maintained stable levels of serum antibodies, with only minor fluctuations. The impact of HAART on the levels of functional anti-HCMV antibodies was investigated in a number of AIDS patients. Serum levels and kinetics of gB and neutralizing antibodies did not differ significantly between patients who responded biologically and virologically to therapy and those who failed to respond. In addition, CD4 + cell counts and HIV viral RNA levels did not correlate with anti-HCMV antibody titers.

Large choledochocoele: difficulties in radiological diagnosis.

BACKGROUND: A choledochocoele is a dilatation of the intramural portion of the distal common bile duct within the duodenal wall. It usually presents with recurrent crises of right upper quadrant pain, hyperamylasaemia or jaundice. MATERIALS AND METHODS: We present a 12-year-old boy with a choledochocoele that was missed on several US examinations despite its large size. RESULTS: Findings on US, IV cholangiography, upper gastrointestinal contrast studies, ERCP and surgery are shown. The histological findings as well as the usual differential diagnosis are discussed.

Antibody response to human cytomegalovirus (HCMV) glycoprotein B (gB) in AIDS patients with HCMV end-organ disease.

Human cytomegalovirus (HCMV)-specific antibody responses in HIV-1 infected individuals either with or without HCMV end-organ disease were examined to determine the whether development of HCMV disease was associated with a particular deficit in the antibody response. Antiwhole HCMV, anti-glycoprotein B (gB), and neutralizing antibody levels were higher in HIV-1 infected individuals than in healthy immunocompetent subjects, particularly in patients with AIDS either with or without HCMV-associated disease. Irrespective of location and spread of HCMV disease, patients who had received anti-HCMV therapy prior to sampling exhibited significantly higher anti-gB and neutralizing antibody titers than those who remained untreated. Likewise, patients with HCMV disease who were antigenemic or viremic had significantly lower anti-gB and neutralizing antibody titers than those who tested negative in either assay. Patients with untreated HCMV disease had significantly lower antibody titers than AIDS patients without disease. Analysis of the IgG subclass antibody responses to gB revealed no significant differences among HIV-1 infected individuals. These results suggest that levels of detectable anti-gB and HCMV neutralizing antibodies are inversely related to systemic viral load. Thus, antibodies with such specificities may be relevant in preventing the establishment of HCMV-associated disease or in modulating its progression.

Idiopathic progressive osteolysis of craniofacial bones.

We present the case report of a diabetic 51-year-old male, who presented with painless mobilization of the superior incisor teeth. The X-ray study showed osteolysis, without any soft tissue mass, in craniofacial and orbital bones. In the control X-ray studies performed during the 2 years' evolution, a progressive increase in the intensity and extension of the osteolysis was observed. The diagnosis of progressive idiopathic osteolysis is one of exclusion, based mainly on clinico-radiological findings, evolution and compatible histological findings.

Plasma cell granuloma of the lung in childhood: atypical radiologic findings and association with hypertrophic osteoarthropathy.

Three cases of pulmonary plasma cell granuloma in the pediatric age group are presented. Although rare, it is the most frequent primary lung tumor in childhood. In two of the cases, there was a close adherence between the tumor and the surrounding mediastinal structures and diaphragm, a very uncommon feature in these tumors. In the other case, plasma cell granuloma of the lung was seen in association with a clinical-radiological picture of hypertrophic osteoarthropathy, which resolved after excision of the mass. Such an association has not, to date, been reported in the literature, and could constitute an additional finding useful in the differential diagnosis of primary lung tumors in childhood. The literature concerning this issue has been reviewed.