Desarrollo de lenguaje en niños con implante coclear en centro terciario de salud: serie clínica / Language development in children with cochlear implant at a tertiary health care center: clinical series

Resumen Introducción: Desde la década de los 90, los implantes cocleares han progresado desde aplicaciones experimentales a un uso clínico estandarizado en niños con pérdida auditiva severa y profunda. Las investigaciones han producido cambios en la tecnología de los implantes y ha dado lugar a la expansión de los candidatos a implante para incluir a los niños menores de 2 años de edad. El objetivo principal de la implantación coclear pediátrica es facilitar el desarrollo del lenguaje hablado. A pesar de los avances en la tecnología de implantes y los cambios en el manejo de la pérdida auditiva, los resultados de lenguaje en niños son todavía muy variables, participando de este proceso tanto el tratamiento oportuno, la red familiar y nivel socioeconómico entre algunos de ellos. Objetivo: Describir resultados de niños menores 6 años sometidos a cirugía de implante coclear en un centro terciario de salud. Material y método: Estudio longitudinal de cohorte retrospectivo, análisis a 99 pacientes implantados en centro terciario de salud desde inicio programa en 1994 a 2015. Resultados: 99 pacientes, 57% hombres 43% mujeres, edad promedio implantación 16,3 meses. 54,8% casos origen congénito no especificado o prematurez. En 74,4% se objetivó presencia de lenguaje auditivo verbal. El nivel socioeconómico (NSE) mostró asociación con no desarrollo de lenguaje (p =0,009) evidenciando que pacientes de bajo NSE 20% no desarrolla lenguaje. La variable discapacidad asociada (p <0,001) y la variable NSE (p =0,036) se asociaron de manera independiente a lenguaje de señas o no desarrollo de lenguaje oral. Conclusión: Los implantes cocleares ofrecen una opción en la rehabilitación auditiva en hipoacusia sensorio neural profunda, para candidatos de todo el espectro de edad, sin embargo los resultados dependen en gran medida del entorno en el que se utilizan los implantes cocleares.

ABSTRACT Introduction: Since the 90s, cochlear implantation has progressed from experimental to standard clinical practice for children with severe and profound hearing loss. Research has produced changes in implant technology and has led to the expansion of implant candidacy to include children younger than 2 years of age. The primary goal of pediatric cochlear implantation is to facilitate spoken language development. Despite the advances in implant technology and the changes to the management of hearing loss, language outcomes for children are still highly variable, participating in this process both timely treatment, the family network and socio economic level among others. Aim: describe outcomes of patients younger than 6 years undergoing cochlear implant surgery in a tertiary care center. Material and method: retrospective longitudinal cohort study, 99 patients implanted in a tertiary health center since the program's inception in 1994 to 2015 was analyzed. Results: 99 patients, 57 % men 43 % women, average age of implantation 16.3 months. 54.8 % of cases were congenital or prematurity. In 74.4 % they had auditory verbal language. Socioeconomic status (SES) showed association with the lack of language development (p =0.009) demonstrating that low SES patients (20%) do not develop language. The disability associated variable (p <0.001) and the SES variable (p =0.036) were independently associated with sign language or no oral language development. Conclusions: Cochlear implants offer an option for hearing rehabilitation in profound hearing loss, for candidates of all ages, however the results depend largely on the environment in which cochlear implants are used.

Organisms associated with bacterial vaginosis in Nigerian women as determined by PCR-DGGE and 16S rRNA Gene Sequence

Background: Bacterial vaginosis (BV) is a condition with diverse etiology.This condition predisposes women to increased susceptibility to sexually transmitted diseases; including human immunodeficiency virus (HIV) infections and preterm birth. The diagnostic methods currently adopted in the evaluation of patient samples for BV are arguably Amsel criteria; and Nugent score that require microscopy and expert interpretation.These two methods are still subjective. Objective: The objective of this study was to determine the organisms present in the vagina of 34 HIV negative Nigerian women diagnosed as having bacterial vaginosis by using molecular techniques. Methods:The vaginal samples were subjected to DNA extraction; and amplified with eubacterial primers via PCR.The PCR products were separated using denaturing gradient gel electrophoresis (DGGE). Bands were excised; re-amplified; purified and sequenced. Sequence identification was performed using the BLAST algorithm and Genbank data base. Results: Mycoplasma hominis (12/34; 35) was the most common isolate and 9 (26) contained one of two clones of an unusual Rainbow Trout intestinal bacterium; while unculturable Streptococcus sp; and other bacteria made up the remaining isolates. Con-clusions:The findings indicate further diversity in the etiological agents associated with BV; and raise the question as to whether diagnosis and management of this condition needs to be re-evaluated in countries like Nigeria.There is some controversy over the clinical importance of BV; as it was once regarded as a disease caused by Gardnerella and presenting as an odourous discharge condition; but is now diagnosed without necessarily the presence of these organisms or signs. With the incidence of BV aligned to an increased risk of HIV in a country ravaged by this virus; the effective eradication of BV can only be achieved if appropriate therapies are delivered

Evaluation of the optimal inoculation of leishmania major culture-derived stationary phase promastigotes required to assess protective immune status in the vervet monkey model

"Vervet monkeys have been shown to be resistant to a homologous challenge of Leishmania major after an active infection followed by self cure responses. Confirmation of the protective immune status of such animals was demonstrated by exposing a group of 4 monkeys to multiple infected sandfly challenge. Two animals revealed small transient nodule formation while in the remaining two; no signs or symptoms were obvserved. In order to ascertain the level of promastigote challenge which was equivalent to such a ""natural"" fly challenge; 3 additional groups of immune vervet monkeys were challenged with 1x103; 1x104 and 105 stationary phase culture promastigotes in the presence of salivary gl and lysates. In all groups; there was no lesion development whatsoever. A second challenge of 1x106; 1x107 and 4x107 in these same animal groups; revealed self healing nodules in the group inoculated with 1x106 promastigotes whilst in the remaining 2 groups challeged at the higher levels; there was nodule formation which progressed to ulceration. A challenge dose of 1x105 culture promastigotes was thus considered to be optimal since this level of challenge in naive animals was demonstrated to result in ulcer formation when inoculated with salivary gland lysates."

The intestinal faunas of man and mountain gorillas in a shared habitat

The primate fauna of the Impenetrable (Bwindi) Forest in southwest Uganda includes both man and the mountain gorilla Gorilla gorilla beringei. The intestinal parasite faunas of these two species were described by examining faecal samples. Of 16 parasites in the combined fauna only one; Strongyloides fuelleborni; was shared by both host species