Assuntos
Hospedeiro Imunocomprometido , Síndrome da Aderência Leucocítica Deficitária/complicações , Mastoidite/complicações , Doença Aguda , Humanos , Lactente , Angiografia por Ressonância Magnética , Masculino , Processo Mastoide/cirurgia , Mastoidite/diagnóstico por imagem , Mastoidite/imunologia , Mastoidite/cirurgia , Tomografia Computadorizada por Raios XRESUMO
The click-evoked otoacoustic emission (EOAE) recording procedure is a simple and quick test to perform. Some suggest that the EOAE is a more efficient newborn hearing screening procedure than the auditory brain stem response (ABR). However, one shortcoming of the EOAE is a high false-positive rate in newborns, which is attributed to ear-canal debris. The purposes of this study were to assess the initial pass/fail rates of ABR and EOAE measurements and the effectiveness of repeated EOAE measurements as a method of reducing the false-positive rate. Fifty healthy, low-risk newborns sequentially underwent ABR, repeated EOAE, otoscopy, EOAE, and ABR if necessary. The initial ABR passing rate was 98%, whereas the EOAE passing rate was 61%. The EOAE passing rate improved with each retest and approximated the ABR rate by the fourth test. EOAE failures and the overall level of the EOAE were found to be significantly related to the amount of ear-canal debris. These results indicate that some newborns will require four or more tests before they eventually pass. Further study is needed to determine the overall cost-effectiveness of the EOAE as compared with the ABR before specific recommendations for a universal hearing screening program are proposed.
Assuntos
Percepção Auditiva/fisiologia , Cóclea/fisiologia , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Potenciais Evocados Auditivos/fisiologia , Recém-Nascido/fisiologia , Fatores Etários , Análise de Variância , Audiometria de Resposta Evocada/economia , Audiometria de Resposta Evocada/métodos , Cerume , Análise Custo-Benefício , Meato Acústico Externo/patologia , Endoscopia , Reações Falso-Positivas , Transtornos da Audição/prevenção & controle , Humanos , Estudos Prospectivos , Tempo de Reação , Verniz CaseosoAssuntos
Abscesso/etiologia , Terapia de Imunossupressão , Transplante de Rim/imunologia , Doenças da Laringe/etiologia , Lúpus Eritematoso Sistêmico/imunologia , Infecções por Pseudomonas/etiologia , Abscesso/diagnóstico , Adulto , Feminino , Humanos , Doenças da Laringe/diagnóstico , Lúpus Eritematoso Sistêmico/terapia , Infecções por Pseudomonas/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
Cyclic AMP production in response to agonists which act at a variety of receptors to either stimulate or inhibit cyclic AMP production has been studied in intact, dissected ciliary processes from rabbit eyes after unilateral surgical removal of the cervical ganglion. Cyclic AMP responses to stimulatory ligands vasoactive intestinal peptide (VIP), isoproterenol, and forskolin and inhibitory agonists neuropeptide Y (NPY), the synthetic somatostatin analogue SMS 201-995, and alpha-adrenergic agents were investigated in tissues from normal eyes and compared to the same responses in tissues from sympathetically denervated eyes. Neither stimulated cyclic AMP production nor inhibition of stimulated cyclic AMP production was significantly different in tissues from denervated vs. normal eyes. Inhibition of VIP-stimulated cyclic AMP production by epinephrine and paraaminoclonidine in tissues from both normal and denervated eyes was blocked by the alpha 2-adrenergic antagonist yohimbine but not by the alpha 1-adrenergic antagonist prazosin. These data indicate that the VIP, NPY, somatostatin, and alpha 2- and beta 2-adrenergic receptors which regulate cyclic AMP production in rabbit ciliary processes are postjunctional and suggest that ligands known to modulate cyclic AMP levels in this tissue may exert effects on aqueous humor formation independently of adrenergic innervation.