[Neonatal hearing loss screening: our results three years after starting the program]. / Despistaje de la hipoacusia neonatal: resultados después de 3 años de iniciar nuestro programa.

Since the 90s there increasing interest in early detection of neonatal hearing loss due to the feasibility of universal neonatal screening as well as to the possibility of early intervention. This has led to set up neonatal screening programs based upon otoacoustic emissions and to a great increase in the number of publications in the field. Our hospital started a neonatal hearing loss screening program using otoacoustic emission in March 2000. We used a Capella Cochlear Emissions (MADSEN electronics) equipment. Until May 2003 we have performed the test in 6372 children with a median age of 71 days. In our study, the sensibility of the test was 90.9% and the specificity 99.7%. Our results are similar to those reported in the literature although the age of the children was higher and we have found an incidence of hearing loss lower than other studies.

[The effects of aging on the volume of human vestibular nuclei]. / Efectos del envejecimiento en el volumen de los núcleos vestibulares humanos.

Elderly persons often have balance disorders, with dizziness that sometimes leads to falls. Changes in the peripheral vestibular system with age, with loss of the hair cells and neurons of Scarpa's nucleus, have been studied for years. However, the changes in the vestibular nuclear complex with age have not been examined. We studied paraffin-embedded brainstems from nine persons of different ages in order to analyze possible changes with age. No abnormalities were observed in the volume or length of the vestibular nuclei, except for a decrease in both dimensions in the superior vestibular nucleus (SNV). All the main vestibular nuclei showed an increase in lipofuscin content with age that seemed to be less marked in the SNV. The low lipofuscin concentration in the SNV could be related with the conservation of vestibular reflexes, the center of which seems to be the SVN, in elderly persons.

[Risk factors in surgical wound infection in oncological surgery of the head and neck]. / Factores de riesgo en la infección de la herida quirúrgica en cirugía oncológica de cabeza y cuello.

Although the use of antibiotic prophylaxis has significantly reduced the frequency of postoperative wound infections, they continue to be a critical issue in head and neck cancer surgery. A study was made of possible risk factors for the development of these infections. A prospective study was made of 159 patients with pharyngo-laryngeal squamous-cell carcinoma who underwent open-pharynx surgery in order to analyze the factors associated with wound infections. Postoperative wound infection was defined as purulent drainage or mucocutaneous fistula formation, or both, in the first 10 days after surgery. Potential risk factors examined were age, medical illnesses, prior surgery and radiotherapy, TNM stage, type of operative procedure, method of reconstruction, and operative time. The overall wound infection rate was 23%. Although the incidence of wound infection was higher in patients who received preoperative radiotherapy, in patients with advanced stage disease, and in those who required flap reconstruction, the only preoperative factor that significantly increased the rate of wound infection was the concurrence of medical illnesses (chronic obstructive pulmonary disease and diabetes mellitus; p = 0.018). In conclusion, the presence of prior medical diseases was the main risk factor in the development of postoperative wound infections.

[Abnormality of the lower cranial nerves as a symptom of Chiari's syndrome]. / Alteración en los pares craneales bajos como sospecha de un síndrome de Chiari.

Dysfunction of the last cranial pairs can occur in some neurological diseases, such as Chiari's malformation. This entity causes herniation of the cerebellar amygdalas through the foramen magnum, producing descent of the brainstem and traction on the lower cranial pairs. This dysfunction occurs in 57-70% of patients with this malformation, which is why the disease may be diagnosed in the ENT clinic. Clinical suspicion of this entity after exhaustive examination of the patient, early disease diagnosis and correct selection of surgical treatment can alleviate major symptoms and prevent neurological complications in some cases.

[Non-surgical infections in patients undergoing oncological head and neck surgery]. / Infecciones no quirúrgicas en pacientes intervenidos de cirugía oncológica de cabeza y cuello.

A study was made of the incidence and predisposing factors in non-surgical infections in a group of 159 patients undergoing oncological head and neck surgery. The incidence of these infections was 5.7%; the most frequent was lung infection (3.8%), followed by septic phlebitis (1.3%) and urinary infection (0.6%). Risk factors for pulmonary infection included advanced tumor stage, prolonged surgery, and supraglottic laryngectomy. No relationship was found with age, previous illnesses, tumor site, or the antibiotic used in preoperative prophylaxis.

[Bacteriology of surgical wound infections in oncological head and neck surgery]. / Bacteriología de las infecciones de la herida quirúrgica en cirugía oncológica de cabeza y cuello.

Surgical wound infections are a frequent complication of head and neck cancer surgery. In a group of 159 consecutive patients we analyzed bacteriological cultures from 21 with suppurative draining from the wound. In 3 cases cultures were monomicrobial, in 12 cultures were polymicrobial, and in 6 no bacterial isolate was obtained from the cultured material. Gram-positive aerobes were the most frequent bacteria (54%), followed by gram-negative aerobes (38%) and anaerobes (8%). No relation was found between bacteriological profile, antibiotic prophylaxis, tumor site, tumor stage, or surgical procedure.

[The selection of cervical vessels recipients in reconstructive surgery of head and neck with free flaps]. / Elección de vasos receptores cervicales en la cirugía reconstructiva de cabeza y cuello con colgajos libres.

One of the most important parameters for success in free tissue transfer to the head and neck are a proper and careful recipient vessel dissection and meticulous vascular microanastomotic technique. The principle that govern vessel positioning in the head and neck are more complex than those used in extremity free flap transfers. In this report the vascular selection as well as technical details are discussed, based on the literature data and our own experience in 20 patients.

Effect of denervation on lamellar cells of Meissner-like sensory corpuscles of the rat. An immunohistochemical study.

The denervation-induced changes on S-100 protein, glial fibrillary acidic protein (GFAP) and vimentin immunoreactivity (IR) of the lamellar cells from cutaneous Meissner-like sensory nerve formations (SNF), or corpuscles, of the adult rat hind limb foot-pads were studied, using combined immunohistochemical and image analysis (optic microdensitometry) techniques. Animals were allowed to survive for 1, 3 and 7 days following sciatic and saphenous nerves transection. Lamellar cells of Meissner-like corpuscles displayed S-100 protein- and vimentin-IR, but not GFAP-IR. Denervation caused a marked time-dependent decrease of S-100 protein IR whereas vimentin-IR did not change or weakly increased. No positive GFAP-IR was observed in denervated SNF. These findings suggest that continuity of SNF with nerve fibers supplying them is necessary to maintain some of the immunohistochemical characteristics of the non-neuronal cells of SNF.

Nerve growth factor receptor immunoreactivity in non-nervous structures of the adult rat brain.

The non-neuronal distribution of nerve growth factor receptors (NGFr) in the adult rat brain was investigated immunohistochemically using an anti-NGFr monoclonal antibody (192-IgG). In addition to the neurons known to be NGF-dependent or containing NGF binding-sites, a moderate to strong NGFr immunoreactivity was observed in several non-nervous tissues such as the ependymal cells, the epithelial cells of the choroid plexus, the leptomeninge and the cerebral blood vessels. Vascular immunoreactivity for NGFr occurs in the adventitia and muscular layers of the large arteries (circle of Willis) and, apparently, in all the wall layers of the intermediate or small (pial-arachnoid) arteries. The present results provide direct evidence for the presence of non-neuronal NGFr in the brain of adult rats, and suggest a possible involvement of NGF in roles other than those classically thought.

Immunohistochemical localization of S-100 protein subunits (alpha and beta) in dorsal root ganglia of the rat.

The distribution of S-100 protein and their subunits (alpha and beta) in lumbar dorsal root ganglia of adult rat was investigated immunohistochemically using monoclonal antibodies against the S-100 protein, alpha-subunit and beta-subunit of S-100 protein. The conventional S-100 protein antibody stained both neurons (large and intermediate in size; 20.3% and 41 +/- 3.2 microns of diameter) and glial cells (satellite cells and Schwann cells). The immunoreaction for the alpha-subunit was observed in the perikarya of some large and intermediate sized neurons (17.2%, 45.6 +/- 6.1 microns of diameter), satellite cells and Schwann cells, whereas the beta-subunit immunoreactivity was found principally in glial cells, and in a scarce number of large and intermediate sized neurons (2.8%, 43.3 +/- 5 microns of diameter) Our results demonstrate that a subpopulation of large and intermediate sized neurons of lumbar DRG contain alpha- and beta-subunits of S-100 protein, being alpha-subunit predominant. Furthermore, the satellite glial and Schwann cells contain also the two subunits but mainly beta-subunit. These data confirm previous studies about the presence of S-100 protein in neurons of the central and peripheral nervous system.

Expression of glial fibrillary acidic protein-like and S-100 protein like immunoreactivities on cartilages of the rat vestibulum nasi. Post-natal development changes.

The cartilages of vestibulum nasi in rats of different ages (newborns, 1 week, 1 month and 12 months old) were studied immunohistochemically using monoclonal antibodies against glial fibrillary acidic protein (GFAP) and S-100 protein. The immunoreaction for both GFAP and S-100 protein results positive in a variable number of chondrocytes. The number of chondrocytes displaying GFAP-like immunoreaction does not change during development and maturation, whereas those showing S-100 protein-like immunoreactivity increase from birth to the adult state. The formation of cartilaginous tissue from neuroectodermic cells of neural crest has been postulated by several authors and our results strongly support these opinions; moreover, according to present findings S-100 protein could be involved in chondroid tissue formation.