Efficacy and safety of fluocinolone acetonide 0.025% otic solution in patients with otic eczema: a randomized, double-blind, placebo-controlled clinical trial.

Objectives To assess the efficacy and safety of fluocinolone acetonide 0.025% otic solution versus placebo in treating patients with otic eczema. Methods In this multicentre, randomized, double-blind, parallel-group phase 3 clinical trial, conducted at 12 Spanish centres between March 2012 and March 2013, patients received fluocinolone acetonide 0.025% or placebo otic solution twice daily for 7 days (days 1-7) with an 8-day follow-up (days 9-15). Outcome measures included change in itching from baseline (day 1) to study days 4-8 and 9-15, and change in otoscopic signs (erythema, oedema, and scaling) from baseline to the end of treatment (day 8) and end of follow-up (day 15). Results Patients treated with fluocinolone acetonide 0.025% (n = 66), as compared with placebo-treated patients (n = 69), showed significantly higher reductions in itching from baseline to study days 4-8 and 9-15, and in individual and global otoscopic signs from baseline to the end of treatment (day 8) and end of follow-up (day 15). Incidence and severity of adverse events was similar between the fluocinolone and placebo groups. Conclusions Fluocinolone acetonide 0.025% otic solution, administered twice daily for 7 days, is an effective and safe treatment for otic eczema.

Tracking the evolution of waste recycling research using overlay maps of science.

Tracking the evolution of research in waste recycling science (WRS) can be valuable for environmental agencies, as well as for recycling businesses. Maps of science are visual, easily readable representations of the cognitive structure of a branch of science, a particular area of research or the global spectrum of scientific production. They are generally built upon evidence collected from reliable sources of information, such as patent and scientific publication databases. This study uses the methodology developed by Rafols et al. (2010) to make a "double overlay map" of WRS upon a basemap reflecting the cognitive structure of all journal-published science, for the years 2005 and 2010. The analysis has taken into account the cognitive areas where WRS articles are published and the areas from where it takes its intellectual nourishing, paying special attention to the growing trends of the key areas. Interpretation of results lead to the conclusion that extraction of energy from waste will probably be an important research topic in the future, along with developments in general chemistry and chemical engineering oriented to the recovery of valuable materials from waste. Agricultural and material sciences, together with the combined economics, politics and geography field, are areas with which WRS shows a relevant and ever increasing cognitive relationship.

Manejo de la patología quirúrgica de la glándula parótida: revisión de 54 casos / Management of the surgical pathology of the parotid gland: A review of 54 cases

Introducción y objetivos: El abordaje de la patología quirúrgica de la glándula parótida y los resultados obtenidos son relativamente uniformes. Sin embargo, tanto en la vertiente diagnóstica como en la terapéutica, existen algunos aspectos controvertidos cuya discusión planteamos a partir de la experiencia reciente de nuestro servicio. Métodos: Se realizó un estudio descriptivo retrospectivo sobre pacientes sometidos a parotidectomía por cualquier indicación entre julio de 2004 y junio de 2009 (5 años). Resultados: Se realizaron 54 parotidectomías en 52 pacientes. La TC fue el estudio de imagen preoperatorio más utilizado. La validez de la PAAF fue del 93,3%. El 76% fueron procesos benignos; entre ellos el 7,3% de causa inflamatoria. Todas las intervenciones se realizaron con monitorización electrofisiológica del nervio facial a partir de abril de 2005. Se realizó parotidectomía superficial en el 75,6% de los procesos benignos. La incidencia de paresias faciales transitorias en patología benigna fue del 14,6% (todas grados II y III). Dos casos (ambos con parotidectomía total) tuvieron secuelas permanentes de movilidad facial. La incisión de ritidectomía se utilizó preferentemente en mujeres jóvenes. Conclusiones: Identificamos como puntos de controversia, bien por discrepancia con la evidencia científica o por evidencia insuficiente: el papel diagnóstico de la RM, la validez y utilidad de la PAAF, las indicaciones del tratamiento quirúrgico, la necesidad de monitorización del nervio facial, y la consideración de los aspectos cosméticos, en particular las indicaciones de la incisión de ritidectomía (AU)

Introduction and aim of the study: The management of the surgical pathology of the parotid gland and its results are relatively uniform. However, both in the diagnostic and the therapeutic aspects, there are some controversial issues which we discuss from the point of view of recent experience at our department. Methods: A descriptive and retrospective study was conducted on patients who underwent parotidectomy for any indication between July 2004 and June 2009 (5 years). Results: Fifty four parotidectomies were performed in 52 patients. CT was the most commonly used preoperative diagnostic imaging study. The accuracy of FNAB was 93.3%. 76% were benign processes; among them 7.3% with inflammatory causes. All of the surgical procedures from April 2005 onwards were performed with electrophysiological monitoring of the facial nerve. Superficial parotidectomy was performed in 75.6% of benign cases. The incidence of transient facial paresis in benign pathologies was of 14.6% (all of them of grades II and III). Two cases (both with total parotidectomy) had permanent facial mobility sequelae. The rhytidectomy incision was used preferentially in young women. Conclusions: The controversial issues identified, due either to discrepancies or lack of enough evidence, were: the diagnostic role of MRI, the validity and usefulness of FNAB, the indications of surgical treatment, the need for facial nerve monitoring and the consideration of cosmetic aspects, in particular the indications of rhytidectomy incision (AU)

[Management of the surgical pathology of the parotid gland: A review of 54 cases]. / Manejo de la patología quirúrgica de la glándula parótida: revisión de 54 casos.

INTRODUCTION AND AIM OF THE STUDY: The management of the surgical pathology of the parotid gland and its results are relatively uniform. However, both in the diagnostic and the therapeutic aspects, there are some controversial issues which we discuss from the point of view of recent experience at our department. METHODS: A descriptive and retrospective study was conducted on patients who underwent parotidectomy for any indication between July 2004 and June 2009 (5 years). RESULTS: Fifty four parotidectomies were performed in 52 patients. CT was the most commonly used preoperative diagnostic imaging study. The accuracy of FNAB was 93.3%. 76% were benign processes; among them 7.3% with inflammatory causes. All of the surgical procedures from April 2005 onwards were performed with electrophysiological monitoring of the facial nerve. Superficial parotidectomy was performed in 75.6% of benign cases. The incidence of transient facial paresis in benign pathologies was of 14.6% (all of them of grades II and III). Two cases (both with total parotidectomy) had permanent facial mobility sequelae. The rhytidectomy incision was used preferentially in young women. CONCLUSIONS: The controversial issues identified, due either to discrepancies or lack of enough evidence, were: the diagnostic role of MRI, the validity and usefulness of FNAB, the indications of surgical treatment, the need for facial nerve monitoring and the consideration of cosmetic aspects, in particular the indications of rhytidectomy incision.

[Is universal newborn hearing screening more efficient with auditory evoked potentials compared to otoacoustic emissions?]. / Cribado universal de la hipoacusia neonatal: ?es más eficiente con potenciales evocados auditivos que con emisiones otoacústicas?

INTRODUCTION AND OBJECTIVES: Cost-effectivity of universal newborn hearing screening programmes is under constant review. In this context, the aim of the present study is to evaluate the performance of brainstem response audiometry (BERA) compared to otoacoustic emissions (OAE) as screening tools. METHODS: Observational and retrospective study on a universal screening programme started in 1998. We perform a comparative analysis between two groups of newborns evaluated in consecutive periods of time. We analyze outcome measures of the programme as a measure of effectivity, and dedicated resources to weight the costs. RESULTS: We compare a group of 862 newborns from year 2003, screened with transient evoked OAE with a clinical device, with a group of 2300 newborns from years 2005 and 2006, screened with automated BERA. We find a statistically significant difference in the percentage of pass in the first step, favoring BERA (99.7 % vs 91.8 %; P< .0005). The median of exploration time with BERA was 276 seconds. Costs evaluation points to a progressively decreasing difference between both tools. CONCLUSIONS: There are data indicating that BERA could be more cost-effective as initial screening tool. This advantage should be added to the already known more comprehensive evaluation of the auditory pathway, which could lead to the recommendation of its preferential use in auditory screening programmes.

Cribado universal de la hipoacusia neonatal: ¿es más eficiente con potenciales evocados auditivos que con emisiones otoacústicas? / Is universal newborn hearing screening more efficient with auditory evoked potentials compared to otoacoustic emissions?

Introducción y objetivos: La relación coste-efectividad de los programas de cribado universal de la hipoacusia infantil es objeto de una constante revisión. En este contexto, el objetivo del presente trabajo es valorar el rendimiento de los potenciales evocados auditivos de tronco cerebral (PEATC) frente a las emisiones otoacústicas (EOA) como prueba de cribado. Métodos: Estudio observacional retrospectivo sobre un programa de cribado universal iniciado en 1998. Realizamos un análisis comparativo entre dos grupos de recién nacidos evaluados en períodos consecutivos, separados por una transición tecnológica. Analizamos los indicadores de resultados del programa como medida de efectividad y los recursos invertidos para valoracion de costes. Resultados: Se compara un grupo de 862 neonatos del año 2003, cribados con EOA transitorias con un equipo clínico, con otro de 2.300 neonatos de 2005 y 2006, cribados con PEATC automatizados. Encontramos una diferencia estadísticamente significativa en el porcentaje de paso en primera fase favorable a los PEATC (el 99,7 frente al 91,8 %; p < 0,0005). El tiempo de exploración con PEATC tuvo una mediana de 276 s. La evaluación de costes apunta a una diferencia cada vez más ajustada entre ambas pruebas. Conclusiones: Hay datos que indican que los PEATC podrían ser más coste-efectivos como prueba inicial de cribado. Esta ventaja se añadiría a la ya existente de evaluación más completa de la vía auditiva, y podría llevar a la recomendación de su uso preferente en los programas de cribado auditivo

Introduction and objectives: Cost-effectivity of universal newborn hearing screening programmes is under constant review. In this context, the aim of the present study is to evaluate the performance of brainstem response audiometry (BERA) compared to otoacoustic emissions (OAE) as screening tools. Methods: Observational and retrospective study on a universal screening programme started in 1998. We perform a comparative analysis between two groups of newborns evaluated in consecutive periods of time. We analyze outcome measures of the programme as a measure of effectivity, and dedicated resources to weight the costs. Results: We compare a group of 862 newborns from year 2003, screened with transient evoked OAE with a clinical device, with a group of 2300 newborns from years 2005 and 2006, screened with automated BERA. We find a statistically significant difference in the percentage of pass in the first step, favoring BERA (99.7 % vs 91.8 %; P<.0005). The median of exploration time with BERA was 276 seconds. Costs evaluation points to a progressively decreasing difference between both tools. Conclusions: There are data indicating that BERA could be more cost-effective as initial screening tool. This advantage should be added to the already known more comprehensive evaluation of the auditory pathway, which could lead to the recommendation of its preferential use in auditory screening programmes