An overview of chemical contaminants and other undesirable chemicals in alcoholic beverages and strategies for analysis.

The presence of chemical contaminant in alcoholic beverages is a widespread and notable problem with potential implications for human health. With the complexity and wide variation in the raw materials, production processes, and contact materials involved, there are a multitude of opportunities for a diverse host of undesirable compounds to make their way into the final product-some of which may currently remain unidentified and undetected. This review provides an overview of the notable contaminants (including pesticides, environmental contaminants, mycotoxins, process-induced contaminants, residues of food contact material [FCM], and illegal additives) that have been detected in alcoholic products thus far based on prior reviews and findings in the literature, and will additionally consider the potential sources for contamination, and finally discuss and identify gaps in current analytical strategies. The findings of this review highlight a need for further investigation into unwanted substances in alcoholic beverages, particularly concerning chemical migrants from FCMs, as well as a need for comprehensive nontargeted analytical techniques capable of determining unanticipated contaminants.

Longitudinal Changes in Electrically Evoked Auditory Event-Related Potentials in Children With Auditory Brainstem Implants: Preliminary Results Recorded Over 3 Years.

OBJECTIVES: This preliminary study aimed (1) to assess longitudinal changes in electrically evoked auditory event-related potentials (eERPs) in children with auditory brainstem implants (ABIs) and (2) to explore whether these changes could be accounted for by maturation in the central auditory system of these patients. DESIGN: Study participants included 5 children (S1 to S5) with an ABI in the affected ear. The stimulus was a train of electrical pulses delivered to individual ABI electrodes via a research interface. For each subject, the eERP was repeatedly measured in multiple test sessions scheduled over up to 41 months after initial device activation. Longitudinal changes in eERPs recorded for each ABI electrode were evaluated using intraclass correlation tests for each subject. RESULTS: eERPs recorded in S1 showed notable morphological changes for five ABI electrodes over 41 months. In parallel, signs or symptoms of nonauditory stimulation elicited by these electrodes were observed or reported at 41 months. eERPs could not be observed in S2 after 9 months of ABI use but were recorded at 12 months after initial stimulation. Repeatable eERPs were recorded in S3 in the first 9 months. However, these responses were either absent or showed remarkable morphological changes at 30 months. Longitudinal changes in eERP waveform morphology recorded in S4 and S5 were also observed. CONCLUSIONS: eERP responses in children with ABIs could change over a long period of time. Maturation of the central auditory system could not fully account for these observed changes. Children with ABIs need to be closely monitored for potential changes in auditory perception and unfavorable nonauditory sensations. Neuroimaging correlates are needed to better understand the emergence of nonauditory stimulation over time in these children.

Responsiveness of the Electrically Stimulated Cochlear Nerve in Children With Cochlear Nerve Deficiency.

OBJECTIVES: This study aimed to (1) investigate the responsiveness of the cochlear nerve (CN) to a single biphasic-electrical pulse in implanted children with cochlear nerve deficiency (CND) and (2) compare their results with those measured in implanted children with normal-size CNs. DESIGN: Participants included 23 children with CND (CND1 to CND23) and 18 children with normal-size CNs (S1 to S18). All subjects except for CND1 used Cochlear Nucleus cochlear implants with contour electrode arrays in their test ears. CND1 was implanted with a Cochlear Nucleus Freedom cochlear implant with a straight electrode array in the test ear. For each subject, the CN input/output (I/O) function and the refractory recovery function were measured using electrophysiological measures of the electrically evoked compound action potential (eCAP) at multiple electrode sites across the electrode array. Dependent variables included eCAP threshold, the maximum eCAP amplitude, slope of the I/O function, and time-constants of the refractory recovery function. Slopes of I/O functions were estimated using statistical modeling with a sigmoidal function. Recovery time-constants, including measures of the absolute refractory period and the relative refractory period, were estimated using statistical modeling with an exponential decay function. Generalized linear mixed-effect models were used to evaluate the effects of electrode site on the dependent variables measured in children with CND and to compare results of these dependent variables between subject groups. RESULTS: The eCAP was recorded at all test electrodes in children with normal-size CNs. In contrast, the eCAP could not be recorded at any electrode site in 4 children with CND. For all other children with CND, the percentage of electrodes with measurable eCAPs decreased as the stimulating site moved in a basal-to-apical direction. For children with CND, the stimulating site had a significant effect on the slope of the I/O functions and the relative refractory period but showed no significant effect on eCAP threshold and the maximum eCAP amplitude. Children with CND had significantly higher eCAP thresholds, smaller maximum eCAP amplitudes, flatter slopes of I/O functions, and longer absolute refractory periods than children with normal-size CNs. There was no significant difference in the relative refractory period measured in these two subject groups. CONCLUSIONS: In children with CND, the functional status of the CN varied along the length of the cochlea. Compared with children with normal-size CNs, children with CND showed reduced CN responsiveness to electrical stimuli. The prolonged CN absolute refractory period in children with CND might account for, at least partially, the observed benefit of using relatively slow pulse rate in these patients.

Morphology and Ciliary Motion of the Middle Ear Mucosa of Neonatal and Adult Gerbils.

BACKGROUND/AIMS: Since the middle ear cavity plays an important role in middle ear effusion, the goal of this study is to examine the morphological and functional development of the middle ear mucosa in neonatal and adult gerbils. METHODS: Gerbils aged between postnatal day 1 (P1) and P26 were used for the experiments. The morphological development of the middle ear cavity was measured by using the celloidin embedding method and scanning electronic microscope. Ciliary motion was determined and calibrated by a photodiode-based measurement system. RESULTS: The area of the middle ear increased significantly from 0.42 ± 0.02 mm2 (n = 8) at P1 to 2.6 ± 0.03 mm2 (n = 8) at P26. At P1, all regions were covered by densely populated ciliated cells. A significant reduction of the density of ciliated cells was found between P8 and P18 (p < 0.05). The beat frequency at P1 is not statistically different from that of P8 (p > 0.05). However, the beat frequency increased significantly between P8 and P18 (p < 0.05). CONCLUSION: Middle ear mucosa underwent a significant change between P1 and P18. The cilia morphology and function (ciliary motion) are fully mature at P18. This may explain the high incidence of middle ear effusion in the neonatal period in humans.

A Case of Pharyngeal-Cervical-Brachial Variant of Guillain-Barré Syndrome With Bilateral Glossopharyngeal Paralysis.

Guillain-Barré Syndrome (GBS) is a rapidly evolving autoimmune inflammatory disease of the peripheral nerves. It classically presents with progressive symmetrical ascending muscle weakness and hyporeflexia. The pharyngeal-cervical-brachial (PCB) variant is a rare variant of GBS that is characterized by axonal rather than demyelinating neuropathy and presents with rapidly progressive oropharyngeal (facial palsy, dysarthria) and cervicobrachial weakness, associated upper limb weakness, and hyporeflexia. Because it is rare, the PCB variant of GBS is unfamiliar to many neurologists and it is often misdiagnosed as stroke, myasthenia gravis, or botulism. The prevalence of this variant is estimated to be about 3% of all GBS patients. We describe the only known case presentation of the PCB variant of GBS that presents with bilateral glossopharyngeal paralysis. A 39-year-old African American female presented with progressive oropharyngeal and cervicobrachial weakness along with bilateral glossopharyngeal paralysis. The patient was diagnosed based on clinical suspicion, presentation, and serum ganglioside antibodies.