Viewing an educational video can improve phosphorus control in patients on hemodialysis: a pilot study.

UNLABELLED: The objective of this single-arm interventional pilot study was to determine whether viewing an educational video about phosphorous and phosphorous control by patients on hemodialysis was associated with improved phosphorous values and improvement in knowledge and attitudes about the topics presented. METHOD: An educational video was shown to 150 patients at 16 dialysis centers. The change in serum phosphate levels before and after the viewing of an educational video was evaluated. RESULTS: Mean phosphorous levels for patients were lower in the month after viewing the educational video compared to their values over the three months before the video was shown (6.35 versus 6.82 g/dL). This difference was statistically significant on a per patient basis (-0.47 g/dL, p = 0.0006). Of these patients, all with phosphorus levels outside of the normal range (3.5 to 5.5 mg/dL) before viewing the video, 28.4% had phosphorus levels within the normal range within a month after viewing the video. CONCLUSION: Patients on hemodialysis who watched an educational video had improved phosphorous levels in the month after viewing the video when compared to phosphorus levels over the three months before the video was shown. The video intervention has the advantages of being simple, low-cost, and easy to implement, and is associated with improved phosphorous levels in patients undergoing hemodialysis. The video increased patient compliance with recommended self-care regimens.

Autoimmune sensorineural hearing loss: clinical course and treatment outcome.

BACKGROUND: Autoimmune sensorineural hearing loss (ASHL) originally was defined both by the presence of progressive hearing loss (with or without vertigo) and a positive response to glucocorticoid therapy. Subsequently, antibodies to a 68-kd inner-ear antigen were identified in a high percentage of patients with ASHL. OBJECTIVE: To analyze the disease progression and treatment outcome of ASHL. METHODS: Retrospective chart review of 30 patients with a diagnosis of ASHL referred to Texas Tech Rheumatology Clinic. All subjects were tested for anti-68-kd antibody, had audiometric evidence of hearing loss, and were treated with glucocorticoids. RESULTS: The median duration from onset of symptoms to audiometric testing was 25.5 weeks (mean, 144 weeks; range, 3-1,040 weeks), and to testing for anti-68-kd antibody was 40 weeks (mean, 157.3; range, 4-1,092 weeks). Ninety percent of subjects tested positive for anti-68-kd antibodies. By audiometric testing, 50% of subjects were steroid-responsive; minimal improvement or no change was recorded in 12%, and worsening occurred in 39% after steroid therapy. The 3 subjects who were anti-68-kd antibody-negative were steroid-unresponsive, and 1 progressed to complete deafness. CONCLUSIONS AND RELEVANCE: This series of patients with ASHL suggests a more variable and benign course with a better prognosis than previously reported. Immunosuppressive therapy other than steroids rarely was required, and rapid progression to complete hearing loss was very uncommon in this cohort.

Efficacy of porcine gonadotropins for repeated stimulation of ovarian activity for oocyte retrieval and in vitro embryo production and cryopreservation in Siberian tigers (Panthera tigris altaica).

A comparison of the amino acid sequences demonstrated that Siberian tiger gonadotropins are more homologous with those of porcine than any other commercially available preparation. The present study measured the efficacy of repeated ovarian stimulation with purified porcine gonadotropins on the follicular, hormonal, and immunogenic responses in Siberian tigers as well as on the ability of oocytes retrieved by laparoscopic follicular aspiration to fertilize and cleave in vitro. Controlled rate and vitrification cryopreservation methods were also compared for their ability to support ongoing cleavage following thawing of presumptive 2- to 4-cell tiger embryos generated in vitro. Vitrification supported continued embryonic cleavage in vitro while controlled rate freezing did not. Stereological microscopy indicated an excellent ovarian response with the recovery of quality cumulus-oocyte complexes that apparently fertilized and cleaved in vitro. However, ultrastructural and physiological examination revealed abnormal and unnatural responses such as the failure of some cumulus-oocyte complexes to reach maturity and progestagen levels to approach normalcy. At the same time, analyses of blood for antibodies failed to detect an immune reaction to these foreign gonadotropins in an assay that tested positive for the chorionic gonadotropin-stimulated domestic cat. Together, these observations suggest that porcine gonadotropins may be effective for the ovarian stimulation of tigers but that some modifications to administration protocols are needed to produce a more natural response.