Processing of Acoustic Cues in Lexical-Tone Identification by Pediatric Cochlear-Implant Recipients.

Purpose: The objective was to investigate acoustic cue processing in lexical-tone recognition by pediatric cochlear-implant (CI) recipients who are native Mandarin speakers. Method: Lexical-tone recognition was assessed in pediatric CI recipients and listeners with normal hearing (NH) in 2 tasks. In Task 1, participants identified naturally uttered words that were contrastive in lexical tones. For Task 2, a disyllabic word (yanjing) was manipulated orthogonally, varying in fundamental-frequency (F0) contours and duration patterns. Participants identified each token with the second syllable jing pronounced with Tone 1 (a high level tone) as eyes or with Tone 4 (a high falling tone) as eyeglasses. Results: CI participants' recognition accuracy was significantly lower than NH listeners' in Task 1. In Task 2, CI participants' reliance on F0 contours was significantly less than that of NH listeners; their reliance on duration patterns, however, was significantly higher than that of NH listeners. Both CI and NH listeners' performance in Task 1 was significantly correlated with their reliance on F0 contours in Task 2. Conclusion: For pediatric CI recipients, lexical-tone recognition using naturally uttered words is primarily related to their reliance on F0 contours, although duration patterns may be used as an additional cue.

RISK OF RETINAL VEIN OCCLUSION IN PATIENTS WITH PSORIASIS: A Population-Based Cohort Study.

PURPOSE: To investigate the risk of developing retinal vein occlusion (RVO) in patients with psoriasis. METHODS: In this retrospective population-based cohort study, 30,198 patients with psoriasis (Psoriasis((+)) group) and 30,198 controls without psoriasis (Psoriasis((−)) group) between 2001 and 2006 from the Taiwan National Health Insurance Research Database were selected. RESULTS: The incidence of RVO was 1.46 times higher in the Psoriasis((+)) group than in the Psoriasis((−)) group (3.61 vs. 2.47/10,000 person-years) (adjusted hazard ratio = 1.50; 95% confidence interval = 1.07-2.10) calculated using Cox proportional hazard regression. Age was an independent risk factor for RVO (adjusted hazard ratio: 11.9 for patients 65 years or older vs. 1.00 for those 0-49 years old). In the 65 years or older Psoriasis((+)) group, the incidence of developing RVO was 1.97 times higher (95% confidence interval = 1.19-3.26) than in the 65 years or older Psoriasis((−)) group. In Psoriasis((+)) women, the incidence of developing RVO was 1.82 times higher (95% = 1.05-3.14) than in Psoriasis((−)) women. For the subgroup with comorbid hypertension, the incidence of developing RVO was 2.07 times higher (95% confidence interval = 1.22-3.50) in the Psoriasis((+)) group than in the Psoriasis((−)) group. CONCLUSION: Psoriasis was significantly associated with a higher risk of developing RVO.

Nutritional factors in herpes zoster, postherpetic neuralgia, and zoster vaccination.

Herpes zoster (HZ) results from a reactivation of latent varicella-zoster virus (VZV). HZ and its most common complication, termed postherpetic neuralgia (PHN), often cause long-term psychological distress and physical disabilities leading to profoundly negative impacts on the quality of patients' lives. The incidence and severity of HZ and PHN increase with advanced age as a consequence of declining cell-mediated immunity. Aging has been linked to progressive senescence of the immune system and also is associated with a greater susceptibility to nutritional deficiencies. Suppressing VZV reactivation depends on intact cell-mediated immunity, which requires adequate nutrients to maintain its efficient function. Contrarily, nutritional deficiencies may lead to dysfunction of the host immune responses. Recently, micronutrient deficiencies have been shown to increase the risk of HZ and PHN and to affect the immune response to vaccinations, whereas nutritional supplements effectively reduce herpetic pain and pain in patients with PHN. As the elderly population grows, the incidence and severity of HZ and PHN are expected to increase and cause a substantial financial burden on the health care system. Thus, enhancing knowledge of the risk factors of HZ and PHN and developing better interventions to treat and prevent HZ and PHN are important to public health. This article provides an overview of the present understanding of the association among nutritional deficiencies, diminished cell-mediated immunity, and the risk of HZ and PHN, and then illustrates the potential of nutritional intervention in the prevention, vaccination, and management of HZ and PHN.

Nutrient deficiencies as a risk factor in Taiwanese patients with postherpetic neuralgia.

Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ). The aim of the present study was to compare the nutritional status of PHN patients with that of healthy controls, and then to identify risk factors for PHN using multivariate multiple logistic regressions. In the present cross-sectional study, we prospectively enrolled fifty PHN patients for at least 3 months and fifty healthy controls. We selected nine circulating nutrients including ionised Ca, Zn, retinol, folic acid, vitamin B12, vitamin C, α-tocopherol, γ-tocopherol and lycopene associated with both immunity and the modulation of neuropathic pain, and measured their concentrations in plasma/serum. Concentrations of ionised Ca, Zn, vitamin C and vitamin B12 were significantly lower in PHN patients than in controls after excluding those patients receiving supplements since the outbreak of HZ. The prevalence of either mild/marginal or severe deficiencies for any of the nine selected circulating nutrients in PHN patients (92 %) was much higher than that in controls (46 %) (P < 0·001). Lower concentrations of vitamin C ( ≤ 45·0 µmol/l), ionised Ca ( ≤ 1·05 mmol/l) and Zn ( ≤ 0·91 g/l) were found to increase independently the risk of PHN using binary variable (dichotomy) analyses with both PHN patients and controls in a multivariate logistic regression analysis. No significant correlations existed between the risks of PHN and the concentrations of retinol, folic acid, vitamin B12, lycopene or α:γ-tocopherol ratios. Thus, lower concentrations of circulating nutrients, namely vitamin C, ionised Ca or Zn, are probably a risk factor in Taiwanese patients with PHN.

Discrepancy of the effects of zinc supplementation on the prevention of radiotherapy-induced mucositis between patients with nasopharyngeal carcinoma and those with oral cancers: subgroup analysis of a double-blind, randomized study.

The purpose of this study was to determine the effect of zinc supplementation on radiation-induced mucositis in patients with nasopharyngeal carcinoma (NPC) and those with oral cancers (OC). A total of 100 patients with head and neck cancers engaged in a randomized double blind study. All participants were placed into two randomized groups (experimental and control). The experimental group received a standard dose of zinc supplements, and the control group was given a placebo. Subgroup analyses were performed between 40 NPC and 43 OC patients. It was found that patients with OC in the control group developed Grade 2 and Grade 3 mucositis sooner than those in the experimental group. However, the benefits were not found to extend to patients with NPC. The results indicated that zinc supplementation prescribed in conjunction with radiotherapy postponed the development of severe mucositis solely for patients with OC. The pretreatment oral mucosa condition and areca chewing habit might account for such discrepancy.

Effects of zinc supplementation on the survival of patients who received concomitant chemotherapy and radiotherapy for advanced nasopharyngeal carcinoma: follow-up of a double-blind randomized study with subgroup analysis.

OBJECTIVES/HYPOTHESIS: Dietary zinc has been reported to have positive effects on treating carcinoma. This study examined the effects of zinc supplementation on the improved survival of patients with advanced nasopharyngeal carcinoma receiving concomitant chemotherapy and radiotherapy (CCRT). STUDY DESIGN: A double-blind, placebo-controlled clinical study with subgroup analysis. METHODS: Thirty-four patients with stages III and IV nasopharyngeal carcinoma were selected from a double-blind, placebo-controlled clinical study. All the patients were randomized to receive a standard dose (75 mg/day for 2 months) of zinc supplements or placebo, in conjunction with CCRT. The overall local recurrence, metastasis, and disease-free survivals were defined as the period between the time of first treatment to the time of death, local recurrence, or distant metastases occurred. RESULTS: Patients in the experimental group exhibited a higher 5-year overall local-free and disease-free survival rate than the patients in the placebo group (P = .044, P = .007, and P = .033, respectively). However, no significant differences were found between both patient groups for the 5-year metastases-free survival rate (P = .149). CONCLUSIONS: Zinc supplementation prescribed in conjunction with CCRT effects attenuating local tumor recurrence and improves the overall survival of patients with advanced nasopharyngeal carcinoma. The failure to reduce distant metastasis survival might have been related in part to the more advanced disease stages in our patients.