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1.
Opt Express ; 31(24): 40557-40572, 2023 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-38041353

RESUMO

Ocean reflectance inversion algorithms provide many products used in ecological and biogeochemical models. While a number of different inversion approaches exist, they all use only spectral remote-sensing reflectances (Rrs(λ)) as input to derive inherent optical properties (IOPs) in optically deep oceanic waters. However, information content in Rrs(λ) is limited, so spectral inversion algorithms may benefit from additional inputs. Here, we test the simplest possible case of ingesting optical data ('seeding') within an inversion scheme (the Generalized Inherent Optical Property algorithm framework default configuration (GIOP-DC)) with both simulated and satellite datasets of an independently known or estimated IOP, the particulate backscattering coefficient at 532 nm (bbp(532)). We find that the seeded-inversion absorption products are substantially different and more accurate than those generated by the standard implementation. On global scales, seasonal patterns in seeded-inversion absorption products vary by more than 50% compared to absorption from the GIOP-DC. This study proposes one framework in which to consider the next generation of ocean color inversion schemes by highlighting the possibility of adding information collected with an independent sensor.

2.
Phys Rev Lett ; 131(22): 226503, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38101342

RESUMO

Our measurements of ^{125}Te NMR relaxations reveal an enhancement of electronic spin fluctuations above µ_{0}H^{*}∼15 T, leading to their divergence in the vicinity of the metamagnetic transition at µ_{0}H_{m}≈35 T, below which field-reinforced superconductivity appears when a magnetic field (H) is applied along the crystallographic b axis. The NMR data evidence that these fluctuations are dominantly longitudinal, providing a key to understanding the peculiar superconducting phase diagram in H∥b, where such fluctuations enhance the pairing interactions.

3.
Rev. argent. cir. plást ; 28(2): 67-70, 20220000. graf
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1413461

RESUMO

El cáncer de piel es el más frecuente de todos los tipos de cáncer del ser humano, por lo cual el conocimiento y diagnóstico correcto de la patología oncocutánea, así como la formación impartida a los especialistas de nuestra área, es de vital importancia a la hora de jerarquizar el diagnóstico temprano y lograr un adecuado tratamiento de forma oportuna. El correcto abordaje terapéutico del cáncer cutáneo y sus variantes es de primordial importancia en el manejo quirúrgico de los cirujanos plásticos, por lo cual la Comisión de Oncología Quirúrgica de tumores de piel de la Sociedad Argentina de Cirugía Plástica Estética y Reparadora (SACPER) decide realizar y difundir la siguiente encuesta anónima a los miembros de la SACPER. En esta encuesta evaluativa, se obtuvieron datos sobre el estado actual de formación de los cirujanos de nuestro país, la ejecución de las prácticas relacionadas con el abordaje, la resección o la reconstrucción posterior relacionados a dicha patología.


The knowledge and correct diagnosis of the oncocutaneous pathology, as well as the training provided to the specialists in our area, is of vital importance when prioritizing early diagnosis and achieving adequate treatment. The correct therapeutic approach to skin cancer and its variants is of paramount importance in the surgical management of plastic surgeons, for which we decided to carry out an anonymous survey of the members of the Argentine Society of Aesthetic and Reconstructive Plastic Surgery (SACPER). In this questionnaire, we obtained valuable information about the current state of training of surgeons in our country, the execution of practices related to the approach, resection, or subsequent reconstruction related to said pathology.


Assuntos
Humanos , Masculino , Feminino , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/diagnóstico , Inquéritos e Questionários , Capacitação Profissional , Cirurgiões
4.
Acta Oncol ; 60(9): 1091-1099, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34313177

RESUMO

BACKGROUND: Decisions regarding tumor staging, operability, resectability, and treatment strategy in patients with esophageal cancer are made at multidisciplinary team (MDT) conferences. We aimed to assess interobserver agreement from four national MDT conferences and whether this would have a clinical impact. METHODS: A total of 20 patients with esophageal cancer were included across all four upper gastrointestinal (GI) cancer centers. Fully anonymized patient data were distributed among the MDT conferences which decided on TNM category, resectability, operability, curability, and treatment strategy blinded to each other's decisions. The interobserver agreement was expressed as both the raw observer agreement and with Krippendorff's α values. Finally, a case-by-case evaluation was performed to determine if disagreement would have had a clinical impact. RESULTS: A total of 80 MDT evaluations were available for analysis. A moderate to near-perfect observer agreement of 79.2%, 55.8%, and 82.5% for TNM category was observed, respectively. Substantial agreement for resectability and moderate agreement for curability were found. However, an only fair agreement was observed for the operability category. The treatment strategies had a slight agreement which corresponded to disagreement having a clinical impact in 12 patients. CONCLUSIONS: Esophageal cancer MDT conferences had an acceptable interobserver agreement on resectability and TM categories; however, the operability assessment had a high level of disagreement. Consequently, the agreement on treatment strategy was reduced with a potential clinical impact. In future MDT conferences, emphasis should be on prioritizing the relevant information being readily available (operability, T & M categories) to minimize the risk of disagreement in the assessments and treatment strategies, and thus, delayed or suboptimal treatment.


Assuntos
Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Neoplasias de Cabeça e Pescoço , Neoplasias Esofágicas/terapia , Humanos , Equipe de Assistência ao Paciente , Estudos Prospectivos
5.
Acta Oncol ; 60(3): 353-360, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33522851

RESUMO

BACKGROUND: In radiotherapy (RT) of lung cancer, dose to functional lung (FL) volumes segmented with two different methods (perfusion SPECT (Q-SPECT) and 4D-CT (4D) ventilation (V)) have been shown to correlate with the incidence of radiation pneumonitis (RP). This study aims to compare the FL volumes identified by both methods. MATERIAL AND METHODS: Thirty lung cancer patients had a 4D and Q-SPECT prior to treatment. Seventeen of these patients also had a ventilation SPECT (V-SPECT). FL sub-volumes were segmented automatically, using cut-off values. The volumes were compared in terms of overlap fraction (OF) relative to the minimal volume, and intersection fraction (IF) of the FL volume relative to the total lung volume (VLung). RESULTS: Cut-off values suggested in literature for Q-SPECT and 4D-V resulted in volumes differing in size by a median 18% [6%;31%], and a median OF and IF of 0.48 [0.23;0.70] and 0.09 [0.02;0.25], respectively. Segmenting volumes of comparable size of about 1/3 of VLung (FL-m(1/3), m = method) resulted in a median OF and IF of 0.43 [0.23;0.58] and 0.12 [0.06;0.19], respectively. Twenty-five patients (83%) had a reasonable overlap between FL-Q(1/3) and FL-4D-V(1/3) volumes, with OF values above 0.33. IF increased significantly (p = .036) compared to using fixed cut-off values. Similarly, volumes of comparable size of about 1/3 VLung were produced for V-SPECT, and FL-Q(1/3), FL-V(1/3), and FL-4D-V(1/3) were compared. The overlaps and intersections of FL-V(1/3) with FL-Q(1/3) volumes were significantly (p<.001) larger than the corresponding overlaps and intersections of FL-Q(1/3) with FL-4D(1/3) and FL-V(1/3) with FL-4D(1/3). CONCLUSION: The Q-SPECT and 4D-V methods do not segment entirely the same FL volumes. A reasonable overlap of the volumes along with the findings of other studies that both correlate to RP incidence, suggests that a combination of both volumes, e.g. using the IF, may be useful in RT treatment planning.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Pneumonite por Radiação , Tomografia Computadorizada Quadridimensional , Humanos , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/radioterapia , Pneumonite por Radiação/etiologia , Tomografia Computadorizada de Emissão de Fóton Único
6.
HNO ; 69(8): 633-641, 2021 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-33502578

RESUMO

BACKGROUND: From spring 2020, SARS-CoV­2 began to spread worldwide, with what is now known as the first wave of the pandemic, starting in March 2020. This resulted in restructuring and shift of resources at many hospitals. The aim of our work was to detect the effects of the pandemic on the german Oto-Rhino-Laryngology (ORL) university hospitals in terms of research, student teaching and further specialist training. MATERIAL AND METHODS: The chairmen of the 39 ORL university hospitals in Germany were asked about the effects of the pandemic on research, student teaching and ORL specialist training (residency) in the period from March to April 2020 using a structured online survey. RESULTS: All 39 chairmen took part in the survey. Of these, 74.4% (29/39) stated that their research activities had deteriorated as a result of the pandemic. In 61.5% (24/39) pandemic-related research issues were addressed. All hospitals reported a restriction for in-house teaching and 97.5% (38/39) introduced new digital teaching methods. During the observation period, 74.4% of the chairmen did not see ORL specialist training (residency)at risk. CONCLUSION: Our results provide an insight into the heterogeneous effects of the pandemic. The fast processing of pandemic-related research topics and the introduction of innovative digital concepts for student teaching impressively demonstrates the great innovative potential and the ability of the ORL university hospitals to react quickly in order to maintain their tasks in research, student teaching and ORL specialist training in the best possible way even during the pandemic.


Assuntos
COVID-19 , Otolaringologia , Alemanha/epidemiologia , Hospitais Universitários , Humanos , Pandemias , SARS-CoV-2 , Estudantes , Ensino
7.
Eur Arch Otorhinolaryngol ; 278(8): 2781-2788, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32949303

RESUMO

OBJECTIVE: The ADHEAR system (MED-EL, Innsbruck, Austria) is a new adhesive bone conduction hearing aid. This study evaluates the audiological benefit and subjective satisfaction as well as the manageability in everyday life in children with unilateral conductive hearing loss. METHODS: Ten children with unilateral hearing loss of different origin were included in the study. The audiological assessment included sound field audiometry and speech intelligibility in quiet and in noise, which was tested unaided and after 4 weeks of wearing the hearing system. Subjective benefit and satisfaction with the system was assessed using the SSQ for parents. With a second system-specific questionnaire, suitability for everyday use and quality of life were queried. RESULTS: With ADHEAR, speech perception in quiet improved by 44%. The word recognition score in noise improved from 11.7% in the unaided situation to 46.7% with the ADHEAR system. The SSQ for parents demonstrates a subjective benefit and satisfaction with the system. CONCLUSION: ADHEAR is an effective treatment option for children with unilateral conductive hearing loss. Especially children who are not eligible for semi-implantable hearing systems or do not accept hearing devices on a softband can benefit from this device.


Assuntos
Auxiliares de Audição , Perda Auditiva Unilateral , Percepção da Fala , Áustria , Condução Óssea , Criança , Audição , Perda Auditiva Condutiva , Humanos , Satisfação Pessoal , Qualidade de Vida
8.
Laryngorhinootologie ; 99(10): 694-706, 2020 10.
Artigo em Alemão | MEDLINE | ID: mdl-32767296

RESUMO

INTRODUCTION: Since December 2019, the SARS-CoV-2 virus has been rapidly spreading worldwide. In Germany, an exponential increase in the number of infections was registered at the beginning of March 2020 and led to a call of the Ministry of Health to create more capacity for intensive medical treatment in hospitals. The aim of the present study was to determine the effects of the SARS-CoV-2 pandemic on Oto-Rhino-Laryngology (ORL) university hospitals regarding patient care. MATERIALS AND METHODS: An online survey was sent out to all chairmen of the 39 ORL university hospitals in Germany. The answers to the questions referred to the defined period from March 15th to April 15th 2020 and were carried out using the online survey tool "SurveyMonkey". 87 questions focused on general information, health care, and structural effects in the respective institution. RESULTS: All chairmen of the 39 university hospitals in Germany participated in the survey. The collected data prove the considerable impact on organizational, structural and medical aspects of patient care. For example, the surveyed clinics reported a decrease in outpatient cases by 73.8 % to 26.2 ±â€Š14.2 % and in surgical treatments by 65.9 % to 34.1 ±â€Š13.9 %. In contrast, emergency treatment remained unchanged or even increased in 80 % of the facilities and surgical treatment of emergency patients remained unchanged or even increased in more than 90 %. Emergency outpatient and surgical treatment of patients was provided throughout the pandemic in all facilities. In total, about 35 000 outpatients and about 12 000 surgical cases were postponed. As a result of the acute structural changes, the potential danger of falling below current treatment standards was seen in individual areas of patient care. DISCUSSION: The assessment of the impact of the SARS-CoV-2 pandemic is heterogeneous. The majority of the chairmen are critically aware of the risk of falling below current medical treatment standards or guidelines. In the phase of an exponential increase in the number of infections, significant changes in treatment processes had to be accepted for understandable reasons. However, with the currently significantly reduced number of infections, falling below treatment standards and guidelines should not be allowed to remain constant and tolerated. SUMMARY: This study shows a differentiated picture with regard to the effects of the SARS-CoV-2 pandemic on outpatient, inpatient and operative patient care at the ORL university hospitals in Germany and illustrates the importance of these institutions for ensuring patient care during this critical phase.


Assuntos
Infecções por Coronavirus , Otolaringologia , Pandemias , Pneumonia Viral , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/terapia , Betacoronavirus , COVID-19 , Alemanha , Hospitais Universitários , Humanos , SARS-CoV-2
9.
PLoS One ; 15(5): e0231823, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32369494

RESUMO

Intramedullary nailing of diaphyseal femoral fractures is a commonly used treatment method in dogs because of its biological and biomechanical advantages compared to bone plating. To achieve adequate resistance of the intramedullary nail against torsional and axial compressive forces, additional application of transcortical screws is needed. As these interlocking screws represent a frequent cause of post-operative complications, a new expandable intramedullary nail (EXPN) was developed, which was designed to provide adequate fracture stabilisation without the need for transcortical fixation. The evaluation of the biomechanical properties of the new EXPN with regard to torsional, compressive and bending stability as well as direct comparison to the biomechanical properties of conventional Steinmann (STMN)- and interlocking (ILN) nails was carried out with different biomechanical test arrangements. No significant statistical differences regarding the torsional and bending resistance between the EXPN and ILN group were seen, which indicates that rotatory as well as bending stability of the innovative EXPN is similar to the conventional ILN. Nevertheless, the percentage deviation between the attempted and successfully reached physiological compressive forces was significantly higher (p = 0.045) in the EXPN group compared to the ILN group, which indicates that the compressive stability of the innovative EXPN might be weaker compared to the ILN. In summary, the new EXPN represents an interesting alternative to conventional intramedullary nails. However, in direct comparison to conventional interlocking nails, the EXPN has shown weaknesses in the neutralization of axial compressive forces, which indicates that at least biomechanically the interlocking nail seems advantageous. Further in-vitro and in-vivo investigations are required before clinical use can be recommended.


Assuntos
Fraturas do Fêmur/fisiopatologia , Fraturas do Fêmur/cirurgia , Fixação Intramedular de Fraturas/instrumentação , Animais , Fenômenos Biomecânicos , Parafusos Ósseos , Cães , Fixação Intramedular de Fraturas/veterinária
11.
Rev Med Chil ; 147(1): 41-46, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-30848763

RESUMO

BACKGROUND: Pelvic venous insufficiency may cause pelvic congestion syndrome that is characterized by chronic pelvic pain exacerbated by prolonged standing, sexual activity or menstrual cycle. It may be treated by embolizing the dysfunctional pelvic venous drainage and sometimes resecting vulvar, perineal and thigh varices. AIM: To assess the results of embolization of insufficient pelvic or ovarian veins on pelvic congestion syndrome. MATERIAL AND METHODS: Analysis of 17 female patients aged 32 to 53 years, who underwent subjected to a selective coil embolization of insufficient pelvic and/or ovarian veins through the jugular, basilic or cephalic veins. In the preoperative period, all patients had a lower extremity venous duplex pelvic ultrasound examination and some had an abdominal and pelvic CT angiogram. RESULTS: The technical success of the procedure was 100% and no complications were registered. During a 32 month follow up, no patient had symptoms of pelvic venous insufficiency or relapse of vulvar or thigh varices. CONCLUSIONS: Embolization of insufficient pelvic and ovarian veins is a safe and successful procedure for the treatment of pelvic venous insufficiency or vulvar varices.


Assuntos
Embolização Terapêutica/métodos , Ovário/irrigação sanguínea , Dor Pélvica/terapia , Pelve/irrigação sanguínea , Varizes/terapia , Adulto , Dor Crônica , Feminino , Humanos , Pessoa de Meia-Idade , Ovário/diagnóstico por imagem , Dor Pélvica/diagnóstico por imagem , Pelve/diagnóstico por imagem , Flebografia/métodos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Síndrome , Resultado do Tratamento , Varizes/diagnóstico por imagem
12.
Rev. méd. Chile ; 147(1): 41-46, 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-991371

RESUMO

Background: Pelvic venous insufficiency may cause pelvic congestion syndrome that is characterized by chronic pelvic pain exacerbated by prolonged standing, sexual activity or menstrual cycle. It may be treated by embolizing the dysfunctional pelvic venous drainage and sometimes resecting vulvar, perineal and thigh varices. Aim: To assess the results of embolization of insufficient pelvic or ovarian veins on pelvic congestion syndrome. Material and Methods: Analysis of 17 female patients aged 32 to 53 years, who underwent subjected to a selective coil embolization of insufficient pelvic and/or ovarian veins through the jugular, basilic or cephalic veins. In the preoperative period, all patients had a lower extremity venous duplex pelvic ultrasound examination and some had an abdominal and pelvic CT angiogram. Results: The technical success of the procedure was 100% and no complications were registered. During a 32 month follow up, no patient had symptoms of pelvic venous insufficiency or relapse of vulvar or thigh varices. Conclusions: Embolization of insufficient pelvic and ovarian veins is a safe and successful procedure for the treatment of pelvic venous insufficiency or vulvar varices.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Ovário/irrigação sanguínea , Pelve/irrigação sanguínea , Varizes/terapia , Dor Pélvica/terapia , Embolização Terapêutica/métodos , Ovário/diagnóstico por imagem , Pelve/diagnóstico por imagem , Síndrome , Varizes/diagnóstico por imagem , Flebografia/métodos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento , Dor Pélvica/diagnóstico por imagem , Dor Crônica
13.
Phys Rev Lett ; 121(17): 177202, 2018 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-30411922

RESUMO

The coupled spin-1 chains material NiCl_{2}-4SC(NH_{2})_{2} (DTN) doped with Br impurities is expected to be a perfect candidate for observing many-body localization at high magnetic field: the so-called "Bose glass," a zero-temperature bosonic fluid, compressible, gapless, incoherent, and short-range correlated. Using nuclear magnetic resonance, we critically address the stability of the Bose glass in doped DTN, and find that it hosts a novel disorder-induced ordered state of matter, where many-body physics leads to an unexpected resurgence of quantum coherence emerging from localized impurity states. An experimental phase diagram of this new "order-from-disorder" phase, established from nuclear magnetic resonance T_{1}^{-1} relaxation rate data in the 13±1% Br-doped DTN, is found to be in excellent agreement with the theoretical prediction from large-scale quantum Monte Carlo simulations.

14.
Acta Physiol (Oxf) ; 223(3): e13068, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29575508

RESUMO

Precise spatiotemporal regulation of intracellular pH (pHi ) is a prerequisite for normal cell function, and changes in pHi or pericellular pH (pHe ) exert important signalling functions. It is well established that proliferation of mammalian cells is dependent on a permissive pHi in the slightly alkaline range (7.0-7.2). It is also clear that mitogen signalling in nominal absence of HCO3- is associated with an intracellular alkalinization (~0.3 pH unit above steady-state pHi ), which is secondary to activation of Na+ /H+ exchange. However, it remains controversial whether this increase in pHi is part of the mitogenic signal cascade leading to cell cycle entry and progression, and whether it is relevant under physiological conditions. Furthermore, essentially all studies of pHi in mammalian cell proliferation have focused on the mitogen-induced G0-G1 transition, and the regulation and roles of pHi during the cell cycle remain poorly understood. The aim of this review is to summarize and critically discuss the possible roles of pHi and pHe in cell cycle progression. While the focus is on the mammalian cell cycle, important insights from studies in lower eukaryotes are also discussed. We summarize current evidence of links between cell cycle progression and pHi and discuss possible pHi - and pHe sensors and signalling pathways relevant to mammalian proliferation control. The possibility that changes in pHi during cell cycle progression may be an integral part of the checkpoint control machinery is explored. Finally, we discuss the relevance of links between pH and proliferation in the context of the perturbed pH homoeostasis and acidic microenvironment of solid tumours.


Assuntos
Ciclo Celular , Proliferação de Células , Animais , Homeostase , Humanos , Concentração de Íons de Hidrogênio , Biossíntese de Proteínas , Transdução de Sinais
15.
Theriogenology ; 114: 14-24, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-29574305

RESUMO

Proliferation and apoptosis play an important role in cyclic changes in the healthy canine endometrium. Proteins of the Bcl-2-family are known to be involved in the regulation of apoptosis. However, only few reports mention their expression patterns during cystic endometrial hyperplasia (CEH). In order to correlate proliferative and apoptotic processes, expression of the apoptosis-regulatory proteins Bcl-2 (anti-apoptotic) and Bax (pro-apoptotic) in healthy and cystic hyperplastic endometrial tissue as well as in pyometra was investigated. Uteri from 33 bitches were assigned to three groups: group 1 - healthy endometrium (n = 12), group 2 - CEH (n = 17) and group 3 - pyometra (n = 4). Markers for proliferation (Ki-67) and apoptosis (activated caspase-3 and TUNEL-method) as well as expression of Bcl-2 and Bax were determined in all endometrial layers. For groups 1 and 2 this was done during endometrial gland secretion in mid and late luteal phase (mLP, lLP), endometrial reparation in early anestrus (eAE) and in the regenerated endometrium in late anestrus (lAE). For group 3 only the late luteal phase was investigated. In group 1, cyclic proliferation patterns were found predominantly in superficial glands (SG) and stroma, whereas progesterone-mediated low expression levels coincided with high apoptosis rates in the basal glands (BG). In eAE, higher apoptotic activity was detected compared to lLP and lAE. Bcl-2 and Bax expression levels showed an inverse cyclic relationship in all tissue layers. In the stroma, in eAE, a rise in proliferative activity and concomitant increase in anti-apoptotic Bcl-2 expression levels was found, indicating that this layer serves as a source for endometrial regeneration. In CEH, no or limited cyclic patterns of proliferation, apoptosis, Bcl-2 and Bax were found. Increased proliferation rates coincided with deregulated apoptosis. Besides the glandular compartments, the stroma played an important role in the pathogenesis of canine CEH. In case of pyometra, both proliferation and apoptosis increased, indicating irreversible damage of the inflamed canine endometrium. In conclusion Bcl-2 and Bax play a role both in the physiological regenerative processes of the cyclic canine endometrium and in deregulating proliferation and apoptosis in CEH and pyometra.


Assuntos
Apoptose , Proliferação de Células , Doenças do Cão/patologia , Hiperplasia Endometrial/veterinária , Endométrio/citologia , Animais , Cães , Hiperplasia Endometrial/patologia , Endométrio/patologia , Feminino , Regulação da Expressão Gênica , Humanos , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Proteína X Associada a bcl-2/genética , Proteína X Associada a bcl-2/metabolismo
16.
Clin Otolaryngol ; 43(1): 240-248, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28772342

RESUMO

OBJECTIVE: Development of the 'Otology Questionnaire Amsterdam' (OQUA), a patient reported outcome measure (PROM), measuring the severity and impact of ear complaints of patients visiting an ENT surgeon. DESIGN: Multicenter, cross-sectional study. Phase 1: qualitative research. In-depth interviews (N = 16) to identify relevant types of ear complaints and to formulate items. Pilot study of the first and second draft of the OQUA (N = 32, N = 39). Phase 2: quantitative research. Field-testing of the OQUA (N = 352). Item reduction based on inter-item correlation, factor analysis and expert opinion. SETTING: Two secondary and two tertiary ENT clinics. PARTICIPANTS: Patients over the age of sixteen visiting an ENT surgeon with an ear complaint. MAIN OUTCOME MEASURES: Phase 1: meaning units and frequency of selected descriptions. Phase 2: inter-item correlation, factor loading and Cronbach's Alpha (α). RESULTS: Phase 1: eight relevant types of ear complaints were identified: earache, pressure in ear, hearing loss, tinnitus, otorrhoea, itch, dizziness and loss of taste. Phase 2: factor analysis generated a factor 'impact' (α = 0.913). The current version of the OQUA consists of 34 items, covers eight types of ear complaints and consists of two constructs: complaints and impact. CONCLUSION: The OQUA is a generic, otologic PROM designed to evaluate the severity of ear complaints and their impact on patients lives.


Assuntos
Perda Auditiva/diagnóstico , Medidas de Resultados Relatados pelo Paciente , Psicometria/métodos , Inquéritos e Questionários , Zumbido/diagnóstico , Vertigem/diagnóstico , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Perda Auditiva/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Projetos Piloto , Reprodutibilidade dos Testes , Zumbido/epidemiologia , Vertigem/epidemiologia , Adulto Jovem
17.
Clin Otolaryngol ; 43(3): 828-834, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29281765

RESUMO

OBJECTIVES: This study aimed to examine the psychosocial health status of adult cochlear implant (CI) users, compared to that of hearing aid (HA) users, hearing-impaired adults without hearing aids and normally hearing adults. DESIGN: Cross-sectional observational study, using both self-reported survey data and a speech-in-noise test. SETTING: Data as collected within the Netherlands Longitudinal Study on Hearing (NL-SH) between September 2011 and June 2016 were used. PARTICIPANTS: Data from 1254 Dutch adults (aged 23-74), selected in a convenience sample design, were included for analyses. MEAN OUTCOME MEASURES: Psychosocial health measures included emotional and social loneliness, anxiety, depression, distress and somatisation. Psychosocial health, hearing status, use of hearing technology and covariates were measured by self-report; hearing ability was assessed through an online digit triplet speech-in-noise test. RESULTS: After adjusting for the degree of hearing impairment, HA users (N = 418) and hearing-impaired adults (N = 247) had significantly worse scores on emotional loneliness than CI users (N = 37). HA users had significantly higher anxiety scores than CI users in some analyses. Non-significant differences were found between normally hearing (N = 552) and CI users for all psychosocial outcomes. CONCLUSIONS: Psychosocial health of CI users is not worse than that of hearing-impaired adults with or without hearing aids. CI users' level of emotional loneliness is even lower than that of their hearing-impaired peers using hearing aids. A possible explanation is that CI patients receive more professional and family support, and guidance along their patient journey than adults who are fitted with hearing aids.


Assuntos
Implantes Cocleares , Emoções , Perda Auditiva/psicologia , Qualidade de Vida , Comportamento Social , Adulto , Idoso , Estudos de Casos e Controles , Estudos de Coortes , Estudos Transversais , Feminino , Nível de Saúde , Perda Auditiva/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Adulto Jovem
19.
Clin Neurophysiol ; 128(10): 2014-2021, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28837907

RESUMO

OBJECTIVE: Anaesthesia-induced dynamics in EEG are dependent on age and level of anaesthesia, but distinct characterisation in children is incomplete. Here we analyse EEG dynamics in children related to age and level of anaesthesia. METHODS: Frontal EEG recordings were obtained from 93 children (0-19years) during routine clinical anaesthesia. EEG segments were selected at four different levels of anaesthesia: emergence, light anaesthesia, deep anaesthesia, and very deep anaesthesia. RESULTS: Total power differed significantly over age at deep (R2=0.314; p<0.0001) and very deep anaesthesia (R2=0.403; p<0.0001). Relative beta band power at light anaesthesia increased linearly with age (R2=0.239; p<0.0001). Level of anaesthesia caused significant differences for relative delta band power (increasing with anaesthetic depth), for relative beta band power and for spectral edge frequency (decreasing with anaesthetic depth) for all children (p<0.0001). CONCLUSIONS: EEG parameterin children were primary dependent on anaesthetic depth, where beta band power, delta band power and spectral edge frequency showed a linear relation. Age-dependency during anaesthesia procedure were only seen for single EEG parameters. SIGNIFICANCE: Different levels of anaesthesia can be identified by relative beta band power, relative delta band power and spectral edge frequency irrespective of the children's age.


Assuntos
Anestesia Geral/métodos , Anestésicos/administração & dosagem , Eletroencefalografia/efeitos dos fármacos , Eletroencefalografia/métodos , Adolescente , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos
20.
Phys Rev Lett ; 118(24): 247201, 2017 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-28665634

RESUMO

We report a ^{51}V nuclear magnetic resonance investigation of the frustrated spin-1/2 chain compound LiCuVO_{4}, performed in pulsed magnetic fields and focused on high-field phases up to 56 T. For the crystal orientations H∥c and H∥b, we find a narrow field region just below the magnetic saturation where the local magnetization remains uniform and homogeneous, while its value is field dependent. This behavior is the first microscopic signature of the spin-nematic state, breaking spin-rotation symmetry without generating any transverse dipolar order, and is consistent with theoretical predictions for the LiCuVO_{4} compound.

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