Colesteatoma congénito gigante en paciente octogenario / Giant congenital cholesteatoma in an octogenarian patient

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Accuracy of auditory steady state and auditory brainstem responses to detect the preventive effect of polyphenols on age-related hearing loss in Sprague-Dawley rats.

Aging causes histological, electrophysiological and molecular changes in the cochlea. The free radical theory of aging, has obtained consensus, and the mitochondrion is reported to play a key role in aging as a major source of reactive oxygen species. In the last years, there has been a significant increase in the interest in polyphenols because of the antioxidant properties and their role in the prevention of various diseases associated with oxidative stress, including aging. The aim of this study was to evaluate the preventive effect of different polyphenols on ARHL with auditory-evoked potentials. 100 Healthy female Sprague-Dawley (SD) rats were used for this study. Five groups were created based on the age of the rats, in months: 3, 6, 12, 18 and 24 months old. Two additional groups were created based on the treatment received. In the control group, 50 animals were assigned to no treatment. In the treated group, 50 animals were given a vehicle mixture of polyphenols for the half of the life before euthanization. Nine frequencies were tested (0.5-16 kHz) with ASSR and tone-burst ABR, performed on all of the rats prior to sacrifice. 100-µs auditory clicks ABRs were also recorded. A significant decrease in the audition was detected with ABR and ASSR in both treated and non-treated groups, as the different groups became older. This deterioration was more accurately measured at acute frequencies. Significantly lower thresholds were observed in the treated rats in the 6, 12 and 18-month-old group in the treated rats compared with the control group. All of the thresholds elicited using the ASSR technique were lower than the thresholds obtained using the ABR, regardless of the stimulus type. The present study demonstrated the benefits of the polyphenols, which generated a significant protection against ARHL, with significantly improved ASSR and tone-burst ABR auditory thresholds in rats receiving treatment with polyphenols.

Utility of auditory steady-state and brainstem responses in age-related hearing loss in rats.

CONCLUSIONS: The results support the idea that auditory steady-state response (ASSR) is a more accurate test for studying age-related hearing loss (ARHL) in Sprague-Dawley rats. Differences in the rat middle ear may explain the variations of the click properties, with a displacement of the energy toward the 8 and 10 kHz frequencies compared with humans. OBJECTIVES: The purpose of this study was to evaluate ARHL in older and younger Sprague-Dawley rats using auditory clicks and tone burst with auditory brainstem response (ABR), in addition to ASSR. METHODS: This was a prospective cohort study with 50 animals divided into 5 groups based on their age in months. A total of 100 registers were elicited from each one of the 3 auditory measurements systems in an electrically shielded, double-walled, sound-treated cabin. Nine frequencies, from 0.5 to 16 kHz were analyzed with the auditory steady-state response and compared with the results elicited by the clicks and tone-burst ABR. RESULTS: Comparisons between the different frequencies showed lower thresholds in those frequencies below 2 kHz, independently of their age in months. The ARHL was detected by each one of the three auditory measurement systems, but with lower thresholds with the ASSR test. Finally, auditory clicks showed better correlations with 8 and 10 kHz elicited by ASSR, which was different to what was expected, based on human studies.

Effectiveness, predictive response factors, and safety of anti-tumor necrosis factor (TNF) therapies in anti-TNF-naive rheumatoid arthritis.

OBJECTIVE: To evaluate the effectiveness and safety of anti-tumor necrosis factor (anti-TNF) therapies in rheumatoid arthritis (RA), and to identify the factors involved in this response. METHODS: Dynamic prospective cohort study of patients with RA treated with anti-TNF under clinical practice conditions. Effectiveness was evaluated using Disease Activity Score (DAS) 28, European League Against Rheumatism (EULAR) response, Health Assessment Questionnaire (HAQ), and time to treatment failure. Prior adherence was evaluated retrospectively and safety was evaluated by adverse events (AE). The analysis was restricted to anti-TNF-naive patients. RESULTS: The study included 161 patients treated for RA during 6 years (60 infliximab, 79 etanercept, and 22 adalimumab). At 6 months, 15% reached a good EULAR response and 38% a moderate response. A mean decrease of -1.5 (p < 0.0001) was observed in the DAS28 and of -0.34 in the HAQ (p < 0.0001); however, women showed poorer progress in terms of DAS and HAQ. In the first year, 64.3% did not experience treatment failure and this figure was 50.5% after 2 years. In one-third, glucocorticoids were withdrawn and in the remainder the dose was reduced by 50%. Adherence to treatment, selection of etanercept, and intensification of infliximab were associated with a lower probability of premature failure in the multivariate model. AE were similar to other those in studies and no outstanding differences in safety were found between the 3 anti-TNF therapies. CONCLUSIONS: Anti-TNF treatments are effective and safe, reducing the activity of the disease, disability, and the need for corticosteroids. Patients who displayed good adherence prior to the anti-TNF treatment and were treated with etanercept or with increasing doses of infliximab had the best chance of displaying a response.

[Peripheral facial palsy. Descriptive study at the university hospital in Getafe]. / Parálisis facial periférica. Estudio descriptivo en el Hospital Universitario de Getafe.

OBJECTIVE: Our aim is to validate a protocol for the diagnosis and treatment of peripheral facial palsy. MATERIAL AND METHOD: A cross-sectional and retrospective descriptive study was made of 63 patients diagnosed with facial palsy and given out-patient follow-up care. RESULTS: The average age was 41 years, with a 60 % preponderance of men, and the predominant side was the left one with a House-Brackmann degree of III on debut. The average time of evolution was 24 hours and the most frequent symptoms were mastoid pain and algiacusia. The treatment used was oral corticoids. Most were discharged in the first 60 days, without any relation with treatment or with the initial degree. CONCLUSIONS: Our protocol is valid and it allows suitable monitoring of this pathology. Most of the cases are resolved within the first 60 days. The tests habitually done have a low diagnostic yield, except for the electroneuronography, very useful within the first 21 days.

Parálisis facial periférica. Estudio descriptivo en el Hospital Universitario de Getafe / Peripheral facial palsy. Descriptive study at the University Hospital in Getafe

Objetivo: Nuestro objetivo es validar un protocolo diagnóstico y terapéutico de parálisis facial periférica. Material y método: Realizamos un estudio descriptivo, transversal y retrospectivo de 63 pacientes diagnosticados de parálisis facial, con seguimiento en consulta. Resultados: La media de edad fue de 41 años, con un 60 % de varones; el lado predominante fue el izquierdo, con grado III de House-Brackmann al inicio. El tiempo de evolución medio fue de 24 h y los síntomas más frecuentes fueron el dolor mastoideo y la algiacusia. El tratamiento utilizado fueron los corticoides orales. Se dio el alta a la mayoría en los primeros 60 días, sin relación con el tratamiento ni con el grado de inicio. Conclusiones: Nuestro protocolo es válido y permite un seguimiento de esta afección. La mayoría se resuelve dentro de los primeros 60 días. Las pruebas realizadas habitualmente tienen baja rentabilidad diagnóstica, salvo la electroneuronografía, de utilidad en los primeros 21 días

Objective: Our aim is to validate a protocol for the diagnosis and treatment of peripheral facial palsy. Material and method: A cross-sectional and retrospective descriptive study was made of 63 patients diagnosed with facial palsy and given out-patient follow-up care. Results: The average age was 41 years, with a 60 % preponderance of men, and the predominant side was the left one with a House-Brackmann degree of III on debut. The average time of evolution was 24 hours and the most frequent symptoms were mastoid pain and algiacusia. The treatment used was oral corticoids. Most were discharged in the first 60 days, without any relation with treatment or with the initial degree. Conclusions: Our protocol is valid and it allows suitable monitoring of this pathology. Most of the cases are resolved within the first 60 days. The tests habitually done have a low diagnostic yield, except for the electroneuronography, very useful within the first 21 days