Radiological evaluation of the postsurgical middle ear.

OBJECTIVE: The radiological evaluation of the postsurgical middle ear is complex due to the intricate anatomy of this region and the wide variety of procedures and materials used iin middle ear surgery. Knowledge of these factors will enable normal postsurgical changes to be differentiated from complications. This article describes the most common surgical procedures in the middle ear, their indications, and the normal radiological appearance after these procedures. It reviews the most common causes of failure in stapes surgery, in surgery for chronic otitis media, and in surgery for cholesteatoma, suggesting the best imaging method to assess the middle ear in each case. CONCLUSION: Computed tomography enables the evaluation of prostheses and the aeration of the cavities, whereas magnetic resonance imaging makes it possible to characterize the possible occupation of the cavities and is the technique of choice for the follow-up of closed mastoidectomy for cholesteatomas.

Prevalence and predictive factors of Chlamydia trachomatis genital infection in inmates 25 to 65 years old in four Catalan prisons.

OBJECTIVES: Determine the prevalence of Chlamydia trachomatis (CT) infection, the risk factors for infection in inmates aged 25 to 65 years old in four Catalan prisons. MATERIALS AND METHODS: This is a cross sectional study conducted in four Catalan prisons chosen at convenience with a random stratified sample of the penitentiary population 25 to 65 years old taken within these centres. A urine specimen was analysed using the Anyplex CT/NG Seegene technique. An ad hoc questionnaire was used to determine sociodemographic and behavioural risk factors for infection within the previous year. The prevalence estimates of CT were calculated. Crude and adjusted odds ratios (ORs) and 95% Confidence Intervals (CIs) were used to estimate associations between infection and risk factor. RESULTS: Out of 1,469 participants, 15 men tested positive for CT (prevalence: 1.02%). We explored age, country of birth, education, occupation, sexual orientation, age initiation sexual activity, number and type of sexual partners (sporadic vs. stable) in a year, concurrency of sexual partners, preservative use in previous sexual relationship, etc. The only factor independently associated with infection was being heterosexual man having sexual relationships with different sporadic partners. Among those who had had an STI (Sexually Transmitted Infection) in life 27% did not notify to all their partners and the main reason was not being able to retrieve them. CONCLUSIONS: CT prevalence in inmates 25 to 65 years old is very low in four prisons of Catalonia. No systematic screening of infection is justified although prisoners having different sporadic sexual partners may need more sexual infection prevention advice.

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.

The course of inflammatory bowel disease during pregnancy and postpartum: a prospective European ECCO-EpiCom Study of 209 pregnant women.

BACKGROUND: The impact of pregnancy on the course of IBD is still controversial. AIM: To investigate the impact of pregnancy on IBD and to search for factors with potential impact on remission. METHODS: Pregnant IBD women from 12 European countries were enrolled between January 2003 and December 2006 and compared at conception (1:1) with nonpregnant IBD women. Data on disease course were prospectively collected at each trimester during pregnancy and in the postpartum (6 months) using a standardised questionnaire. RESULTS: A total of 209 pregnant IBD women were included: 92 with Crohn's disease (CD; median age 31 years, range 17-40) and 117 with ulcerative colitis (UC; median age 32 years, range 19-42). No statistically significant difference in disease course during pregnancy and postpartum was observed between pregnant and nonpregnant CD women. Longer disease duration in CD and immunosuppressive therapy were found to be risk factors for activity during pregnancy. Pregnant UC women were more likely than nonpregnant UC women to relapse both during pregnancy (RR 2.19; 95% CI: 1.25-3.97, 0.004) and postpartum (RR 6.22; 95% CI: 2.05-79.3, P = 0.0004). During pregnancy, relapse was mainly observed in the first (RR 8.80; 95% CI 2.05-79.3, P < 0.0004) and the second trimester (RR 2.84, 95% CI 1.2-7.45, P = 0.0098). CONCLUSIONS: Pregnant women with Crohn's disease had a similar disease course both during pregnancy and after delivery as the nonpregnant women. In contrast, pregnant women with ulcerative colitis were at higher risk of relapse during pregnancy and in the postpartum than nonpregnant ulcerative colitis women.

La función ejecutiva en los adolescentes con síndrome de Down / No disponible

La función ejecutiva en las personas con síndrome de Down se había evaluado hasta ahora sólo en los adultos, encontrándose deteriorada; pero no se había analizado en edades anteriores, por lo que el deterioro podría deberse al envejecimiento precoz propio de este síndrome. En el este estudio se analiza en 15 adolescentes la función ejecutiva mediante el pase de una batería de pruebas que evalúan el cambio de contexto, la capacidad de planificación y resolver problemas, la memoria operacional, la capacidad para inhibirse y para mantener la atención. Los resultados muestran un deterioro generalizado, según se desprende de las pruebas que analizan el cambio de contexto, la planificación y resolución de problemas, la memoria operacional y la constancia en la atención. Se trata, pues, de una alteración propia del síndrome en sí, no del envejecimiento (AU)

No disponible

Executive function in adolescents with Down Syndrome.

BACKGROUND: The present work is aimed at analysing executive function (EF) in adolescents with Down Syndrome (DS). So far, EF has been analysed mainly in adults with DS, showing a pattern of impairment. However, less is known about children and adolescents with this syndrome. Studying adolescents with DS might help us better understand whether performances on EF tasks of individuals with DS are determined by age or by Alzheimer disease, as some studies suggest, or whether their performances are directly related to DS cognitive profile. METHOD: A battery of EF tasks assessing set shifting, planning/problem-solving, working memory, inhibition/perseveration and fluency, as well as a tasks assessing sustained attention has been administered to a group of 15 adolescents with DS and 15 typically developing children matched for mental age. All EF tasks were selected from previous studies with individuals with intellectual disabilities or from developmental literature and are thought to be useful for the samples considered. RESULTS: The present results revealed that the group of individuals with DS performed at a significantly lower level on tasks assessing set shifting, planning/problem-solving, working memory and inhibition/perseveration, but not on the tasks assessing fluency. In addition, individuals with DS demonstrated a greater number of errors and less strategy use for the sustained attention task. CONCLUSIONS: The results suggest a broad impairment in EF in adolescents with DS, and are consistent with several similar studies conducted with adults with DS. We assume that EF deficit is a characteristic of DS.

Interaction between rifaximin and dietary fibre in patients with diverticular disease.

BACKGROUND: Cyclic administration of rifaximin in association with dietary fibre achieves symptomatic relief in uncomplicated diverticular disease (DD) by means of a still undefined mechanism. AIM: To investigate the effects of a combination of rifaximin and fibre on both hydrogen production by intestinal microflora and oro-anal transit time. METHODS: In a controlled, double-blind crossover trial, 64 patients with uncomplicated DD were given bran (20 g/day) and randomly treated with rifaximin (1200 mg/day) or a placebo for 14 days. Evaluation was based on clinical status, breath test, oro-anal transit time and faecal weight. RESULTS: The global symptomatic score was significantly reduced after rifaximin (7.1 +/- 4.1 to 4.1 +/- 3.3; P < 0.005) but not after placebo (6.8 +/- 3.8 to 6.1 +/- 3.5). Hydrogen production significantly increased after placebo from 198 +/- 134 to 267 +/- 161 ppm/min, while Rifaximin reduced it from 222 +/- 187 to 166 +/- 131 ppm/min (P = 0.05). The total oro-anal transit time decreased from 56.1 +/- 28.2 to 51.3 +/- 28.0 h in placebo and from 54.4 +/- 31.9 to 45.1 +/- 32.4 h (P < 0.05) in rifaximin-treated patients. CONCLUSIONS: The administration of rifamixin improves the benefits of dietary fibre in uncomplicated DD by preventing its bacterial degradation.