Phonetic analysis during treatment with rapid maxillary expander.

OBJECTIVES: To investigate possible changes and/or device-related impairments in phonetic habits produced by rapid maxillary expansion (RME). MATERIALS AND METHODS: Thirty-five patients scheduled for RME were divided into two groups: Group A (banded two-arm Hyrax) and Group B (banded four-arm Hyrax). Speech samples were collected at six time points, before, during and after RME removal. Acoustical analysis was performed using PRAAT and BioVoice analysis tools. Ten volunteers completed a questionnaire on the acceptability of patient's speech. Maxillary dimensions and palatal volume were measured on dental casts before and after expansion using a digital gauge. RESULTS: Voice analysis showed an increase in the peak frequency of fricative consonants (/s/,/ʃ/) after expansion, whereas there was no change of formant frequencies of palatal consonants (/ɲ/,/ʎ/). Vowel /i/ displayed a lowering of the first formant frequency, and an increase in the second and third formant frequencies. After bonding, Group B showed both a greater reduction in the peak frequency of fricatives and a greater increase in the formant frequencies of palatal consonants than Group A. CONCLUSION: Rapid maxillary expansion causes a slight phonetic change in the acoustical parameters of both consonants and vowels. The two-arm Hyrax caused less speech impairment than the four-arm Hyrax during the treatment.

Effect of local blood flow in thermal regulation in diabetic patient.

The presence of dysautonomia in diabetic neuropathy is correlated with impairment of vasomotor activity that drives blood microcirculation. Microcirculation, in turn, plays an important role in thermoregulation. In this work, we investigate the changes between two different physiological conditions of diabetic patients, induced by FREMS application, in the control of skin temperature, using a minimally invasive experiment. Skin is warmed up to a fixed temperature (44 °C) for a few minutes, then the heat source is turned off, letting the skin recover its physiological temperature. Both temperature and local blood flow, the latter measured with laser Doppler, are monitored during the experiment. A simple model of the cooling phase is used to evaluate the time constants involved in the process. Results indicate that significant differences exist in the model parameters between the two conditions.

Enhanced activity of a hydrogen sulphide-releasing derivative of mesalamine (ATB-429) in a mouse model of colitis.

BACKGROUND AND PURPOSE: Mesalamine is the first-line therapy for colitis, but it lacks potency and is only effective for mild-to-moderate forms of this disease. Hydrogen sulphide has been shown to be a potent, endogenous anti-inflammatory substance, modulating leukocyte-endothelial adhesion and leukocyte migration. The purpose of this study was to determine if an H(2)S-releasing derivative of mesalamine (ATB-429) would exhibit increased potency and effectiveness in a mouse model of colitis. EXPERIMENTAL APPROACH: Colitis was induced in mice with trinitrobenzene sulphonic acid and the effects of ATB-429 and mesalamine were compared in several treatment regimens. The severity of colitis was determined using several indices, including a disease activity score (comprised of scores for diarrhea, weight loss and fecal blood), colonic myeloperoxidase activity and macroscopic/microscopic scoring of tissue injury. KEY RESULTS: Irrespective of the treatment regiment, ATB-429 was more effective than mesalamine in reducing the severity of colitis. ATB-429 was particularly effective in reducing granulocyte infiltration into the colonic tissue (by approximately 70%), as well as reducing the expression of mRNA for several key proinflammatory cytokines/chemokines (e.g., TNFalpha, IFNgamma). Treatment with ADT-OH, the H(2)S-releasing moiety of ATB-429, did not affect severity of colitis. CONCLUSIONS AND IMPLICATIONS: ATB-429 exhibits a marked increase in anti-inflammatory activity and potency in a murine model of colitis, as compared to mesalamine. These results are consistent with recently described anti-inflammatory effects of H(2)S. ATB-429 may represent an attractive alternative to mesalamine for the treatment of inflammatory bowel disease.

Smartphones Offer New Opportunities in Clinical Voice Research.

Smartphone technology provides new opportunities for recording standardized voice samples of patients and sending the files by e-mail to the voice laboratory. This drastically improves the collection of baseline data, as used in research on efficiency of voice treatments. However, the basic requirement is the suitability of smartphones for recording and digitizing pathologic voices (mainly characterized by period perturbations and noise) without significant distortion. In this experiment, two smartphones (a very inexpensive one and a high-level one) were tested and compared with direct microphone recordings in a soundproof room. The voice stimuli consisted in synthesized deviant voice samples (median of fundamental frequency: 120 and 200 Hz) with three levels of jitter and three levels of added noise. All voice samples were analyzed using PRAAT software. The results show high correlations between jitter, shimmer, and noise-to-harmonics ratio measured on the recordings via both smartphones, the microphone, and measured directly on the sound files from the synthesizer. Smartphones thus appear adequate for reliable recording and digitizing of pathologic voices.

Defective natural killer cell activity in puerperal hyperprolactinemia.

Prolactin (PRL) influences immune reactivity in animals and in humans and both T-cell abnormalities and reduced natural killer (NK) cell activity have been reported in women with pathological hyperprolactinemia. To investigate further the possible interactions between PRL and the immune system in humans, we analysed T-cell phenotypes and NK cell activity in 15 women with physiological hyperprolactinemia of the puerperium and in 45 age-matched healthy normal cycling women. Puerperal women displayed a normal T-cell phenotype but a significant reduction in the number of Leu-7+ and Leu-11+ cells, associated with a decreased NK cell activity, as measured against K-562 target cells. There was a significant inverse correlation between the raised serum PRL levels and both the number of Leu-7+ cells and NK cell activity. These data confirm an important immunoregulatory role for PRL in humans and suggest a direct inhibitory effect of the chronically raised PRL concentrations on the maturation of NK cells.

Changes in serum and lipoprotein lipids, and apolipoprotein B and A-I, in patients with different types of primary hyperlipoproteinaemia treated with gemfibrozil.

Gemfibrozil was given at the dose of 600 mg twice daily to 16 type IIa, 13 type IIb and 11 type IV hyperlipoproteinaemic patients for four months. At the end of the fourth month of therapy low-density lipoprotein (LDL) cholesterol decreased on the average by 18% in type IIa, by 11% in type IIb and increased by 37% in type IV patients. Very-low-density lipoprotein (VLDL) cholesterol and triglycerides fell by 57% in type IIb and by 58% and 76% respectively in type IV subjects. High-density lipoprotein (HDL) cholesterol rose in all groups of patients owing to the increase of the HDL2 subfraction. However, in type IIa the change did not reach the level of statistical significance. Apoprotein B decreased in type IIa and in type IIb patients and apoprotein A-I significantly increased in type IIb and IV patients. The individual changes in total VLDL and LDL lipids and in apoprotein B could be related to their pretreatment level. The cholesterol triglyceride ratio significantly increased in LDL and HDL fractions and the effect was greater in the subgroup of patients with the greatest abnormality in lipoprotein lipid composition. On the whole the differential effects of gemfibrozil on serum lipoprotein concentration and composition in the various types of hyperlipoproteinaemia can be regarded as a trend toward a normalization and may be explained by the multiple effects of the drug on lipid metabolism.

[Balanced beta--alpha-blocker treatment with carvedilol in mild-moderate arterial hypertension]. / Trattamento beta-alpha-bloccante bilanciato con carvedilolo nell'ipertensione arteriosa lieve-moderata.

The search for the ideal antihypertensive drug is ongoing. Carvedilol is a new beta-adrenoceptor antagonist which also causes peripheral vasodilation primarily via alpha 1-adrenergic blockade. Twenty patients with mild to moderate essential hypertension and previous intolerance and side effects to other antihypertensive drugs were studied. After initial baseline assessment, patients received 25 mg carvedilol orally q.d. The treatment lasted 60 days. In our study carvedilol was well tolerated and no important side effect was recorded. Blood pressure decreased significantly to normal values, without orthostatic blood pressure decreases. Heart rate decreased significantly too, but no significant bradycardia was induced. No negative effects on serum lipids and no clinical evidence of increase in peripheral resistance were observed. Ventricular arrhythmia on Holter monitoring were significantly reduced after treatment with carvedilol.

[Clinico-statistical review of 74 cases of subcutaneous rupture of the Achilles tendon]. / Revisione clinico-statistica di 74 casi di rottura sottocutanea del tendine di Achille.

The Authors report 74 cases of subcutaneous hole of Achille's tendon that were treated surgically. 52 patients were clinically controlled at a distance from 1 to 5 years. The functional result at a distance is good in 67,3% of cases, satisfactory in 25%, insufficient in 4%. They point out an hig incidence of local post-operating complications (29,8%), especially when the paratendinea medial incision has been made. The authors suggest to opt for a paratendinea lateral incision and, experimentally, to drop the use of hemostatic string.

Automatic newborn cry analysis: a non-invasive tool to help autism early diagnosis.

Autism Spectrum Disorders (ASD) are complex developmental disabilities that cause problems with social interaction and communication. ASD are associated with motor development problems, more or less blurred, and with perceptual and sensory brain areas. Crying is the infant's earliest form of communication and recent studies connect this original "language" form with autism disturbs. Being completely non-invasive, cry analysis is an appealing approach for early ASD diagnosis to improve rehabilitation. To this aim, we have developed an automatic system to record newborn cry and movements, during the first six months of life with a specific recording protocol. In this work we present first results of acoustic cry analysis in newborns classified as high-risk subjects being siblings of children already diagnosed as autistics. The work aims at finding possible early ASD signs in high-risk subjects as compared to a group of control subjects based on the fundamental frequency and the vocal tract resonance frequencies. Also, voiced and unvoiced parts of signal and cry-episodes duration are analyzed.

High-resolution cry analysis in preterm newborn infants.

Infant monitoring is a common procedure in clinical practice in neonatal critical care units. A number of vital functions are monitored, such as heart beat, breathing, blood flow, etc. Specifically, preterm and/or low-birth-weight infants often present respiratory problems that require monitoring. These may range from insufficient ventilation to apnoea. One of the most common events that may affect the respiratory flow is crying, a physiological action made by the infant to communicate and draw attention, but, for a preterm infant, this action requires great effort, which may cause distress and even may have an adverse impact on blood oxygenation. Acoustic analysis of newborn infant cry is thus of importance, since it is related to other basic neuro-physiological parameters. Being easy to perform, cheap and completely non-invasive, it can be successfully applied in many circumstances. The newborn infant cry is characterised by very high fundamental frequency (F(0)) and resonance frequency (RFs) values, with abrupt changes and voiced/unvoiced features of very short duration in a single utterance. To deal with such signals, a new user-friendly software tool has been developed, that allows robust tracking of main acoustic parameters on very short and time-varying signal frames. The software developed provides the user with a high-resolution picture of the cry signal characteristics.

Non-invasive distress evaluation in preterm newborn infants.

With the increased survival of very preterm infants, there is a growing concern for their developmental outcomes. Infant cry characteristics reflect the development and possibly the integrity of the central nervous system. In this paper, relationships between fundamental frequency (F(0)) and vocal tract resonance frequencies (F(1)-F(3)) are investigated for a set of preterm newborns, by means of a multi-purpose voice analysis tool (BioVoice), characterised by high-resolution and tracking capabilities. Also, first results about possible distress occurring during cry in preterm newborn infants, as related to the decrease of central blood oxygenation, are presented. To this aim, a recording system (Newborn Recorder) has been developed, that allows synchronised, non-invasive monitoring of blood oxygenation and audio recordings of newborn infant's cry. The method has been applied to preterm newborns at the Intensive Care Unit, A.Meyer Children Hospital, Firenze, Italy.

[The treatment of loose diaphyseal fractures of the humeral diaphysis using the hanging cast method]. / Sul trattamento delle fratture diafisarie scomposte della diafisi omerale col metodo gel gesso pendente.

A personal series of loose diaphyseal fractures of the humeral diaphysis, treated with the hanging plaster case method, has been examined in order to assess results. These were positive in most treated cases, with a complication percentage comparable to that obtainable with other methods. Although it is not considered that the usual treatment of reduction and plaster cast thoraco-brachial immobilisation should be abandoned, it is considered that the hanging cast is an equally valid alternative in all cases in which the patient's general condition represents a contraindication to the application of a bulky chest-extended cast.

[Surgical treatment of calcaneal spurs]. / Considerazioni sul trattamento chirurgico dello sprone calcaneare inferiore.

74 operations for the removal of calcaneal spurs at the "G. Pini" Orthopaedic Clinic in Milan over the post 20 years have been examined. After a brief summary of the main aetiopathogenetic theories, the symptomatological picture and various surgical techniques, and the data on the cases encountered are analysed. A high percentage of failures is reported. It is hoped that all cases of talalgia due to calcaneal spur will initially be given conservative therapy. Only if this fails should surgery be considered.

[Hohmann's operation in the treatment of humeral epitrochleitis]. / L'intervento di Hohmann nel trattamento dell'epitrocleite omerale.

7 cases of epicondylitis surgically treated by a Hohmann operation and perforations were checked. These were the only cases of epicondylitis to be operated at the G. Pini Orthopaedic Institute, Milan, over a decade. Careful evaluation of the results showed complete success in all cases. The association of the Hohmann operation and perforations is therefore to be recommended in the rare forms of epicondylitis which do not respond to nonsurgical treatment.