Testing machine learning algorithms for the prediction of depositional fluxes of the radionuclides 7Be, 210Pb and 40K.

The monthly depositional fluxes of 7Be, 210Pb and 40K were measured at Malaga, (Southern Spain) from 2005 to 2018. In this work, the depositional fluxes of these radionuclides are investigated and their relations with several atmospheric variables have been studied by applying two popular machine learning methods: Random Forest and Neural Network algorithms. We extensively test different configurations of these algorithms and demonstrate their predictive ability for reproducing depositional fluxes. The models derived with Neural Networks achieve slightly better results, in average, although similar, having into account the uncertainties. The mean Pearson-R coefficients, evaluated with a k-fold cross-validation method, are around 0.85 for the three radionuclides using Neural Network models, while they go down to 0.83, 0.79 and 0.8 for 7Be, 210Pb and 40K, respectively, for the Random Forest models. Additionally, applying the Recursive Feature Elimination technique we determine the variables more correlated with the depositional fluxes of these radionuclides, which elucidates the main dependences of their temporal variability.

Procuramiento y uso de aloinjertos cutáneos de piel total criopreservados obtenidos de pacientes sometidas a abdominoplastía / Procurement and use of cryopreserved whole skin cutaneous allografts obtained from patients undergoing abdominoplasty

Resumen Introducción: Los aloinjerto cutáneos (AC) son excelentes sustitutos cutáneos temporales, sin embargo, la donación y procura de piel cadavérica, fuente habitual de AC, es baja. Objetivo: Evaluar la factibilidad de utilizar la piel proveniente de abdominoplastías como fuente de AC y su eficacia clínica. Materiales y Método: Entre el 17 de agosto de 2020 al 28 de febrero de 2021 se analizó una cohorte prospectiva de 14 pacientes femeninas sometidas a abdominoplastía por motivos estéticos, que aceptaron donar la piel del colgajo cutáneo abdominal redundante, la cual fue criopreservada. Se utilizaron los AC de piel total criopreservados (ACPTC) en 10 pacientes con diagnósticos de: pie diabético (4), laparostomía contenida (2) herida compleja extremidad inferior (2), sarcoma de cuero cabelludo recidivado (1) y melanoma (1). Resultados: Se obtuvieron 14 colgajos de piel total, los cuales fueron procesados obteniendo una superficie promedio de 302 cm2 y 8,3 láminas de distintos tamaños de utilidad clínica por paciente. En todos los pacientes en que se utilizó ACPTC hubo un prendimiento inicial del AC para posteriormente, en promedio 21 días, presentar una escara necrótica que al ser retirada presentaba un tejido vital adherido al receptor rico en fibroblastos, siendo algunos pacientes auto injertados y otros manejados con cicatrización por segunda intención como tratamiento definitivo. Discusión: Los ACPTC proporcionan una cobertura intermedia, pues una parte se integra en forma definitiva, actuando como un andamiaje biológico para la formación de una interfase sobre la cual se puede autoinjertar o dejar evolucionar con cicatrización por segunda intención y una parte es rechazada. Conclusión: La procura de piel de donante vivo, en pacientes sometidos a cirugías de contorno corporal es un proceso factible, fuente de ACPTC, los cuales permiten una nueva cobertura intermedia con múltiples aplicaciones clínicas.

Introduction: Skin allografts (SA) are outstanding temporary skin substitutes; however, cadaveric skin donation and procurement, a common source of SA, remains low. Aim: To evaluate the feasibility and clinical efficacy of using skin from abdominoplasties as a source of SA. Materials and Method: A prospective cohort was analyzed from August 17th, 2020 and February 28th, 2021, with 14 female patients submitted to abdominoplasty surgeries for aesthetic motives, who authorized skin donation from the redundant abdominal flap which was posteriorly cryopreserved. Cryopreserved total skin allografts (CTSA) was used in 10 patients with the following diagnoses: diabetic foot (4), contained laparostomy (2) complex wound of the lower limb (2), relapsing sarcoma of the scalp (1), and melanoma (1). Results: 14 CTSA were obtained, which were processed, obtaining an average area of 302 cm2 and 8.3 sheets of different sizes and clinical applications from each patient. In all patients who received CTSA, an initial attachment was observed, followed by the appearance of a necrotic scar in an average of21 days. The peeling of the latter revealed a vital tissue tightly adhered to the receptor and rich in fibroblasts. Some of the patients received autografts, and others were managed with secondary intention scarring as a definite treatment. Discussion: CTSA provide an intermediate coverage since one part is definitely adhered to, acting as a biologic scaffolding for the formation of an interface that can be autografted or left for a secondary intention scarring, and the host rejects the other portion. Conclusión: skin procurement from a living donor in patients submitted to body contour surgeries is a feasible process and significant source of CTSA, which permits a new intermediate coverage with multiple clinical uses.

Influencia de las zonas cocleares muertas sobre la autopercepción de las habilidades auditivas en adultos con hipoacusia sensorioneural bilateral / Influence of cochlear dead regions on self-perception hearing abilities in adults with bilateral sensorineural hearing loss

RESUMEN Introducción: Las zonas cocleares muertas son áreas de la membrana basilar donde las células ciliadas y/o fibras del nervio auditivo no son funcionales, lo que puede alterar el análisis temporal de una señal acústica. Los efectos funcionales que podrían generar aún no son claros, y establecerlos a través del uso de cuestionarios de autopercepción, proporcionaría información de utilidad para el manejo audiológico de los pacientes. Objetivo: Determinar la relación entre la presencia de zonas cocleares muertas y la autopercepción de las habilidades auditivas en adultos con hipoacusia sensorioneural bilateral. Material y método: Se evaluaron 20 sujetos con hipoacusia bilateral simétrica, entre 51 y 75 años, sin antecedentes de uso de audífonos. Las zonas cocleares muertas fueron evaluadas mediante la prueba TEN en 1, 2, 3 y 4 kHz; y la autopercepción de habilidades auditivas fue medida en los participantes a través del cuestionario de doce preguntas, IROS12. Resultados: La presencia de zonas cocleares muertas se observó en 10 pacientes. No existiendo una diferencia significativa entre grupos, sin embargo, se observaron puntuaciones más bajas de IROS12 en sujetos con zonas cocleares muertas. Conclusiones: La percepción de dificultades auditivas de individuos que presentan una hipoacusia sensorioneural bilateral simétrica moderada, con presencia de zonas cocleares muertas, no difiere significativamente de aquellos individuos que no presentan zonas cocleares muertas.

ABSTRACT Introduction: Cochlear dead regions are areas of the basilar membrane where the hair cells and/or auditory nerve fibers are not functional, which can alter the temporal analysis of an acoustic signal. The functional effects that could generate still are not entirely clear, and set through the use of self-perception questionnaires, provide useful information for audiological management of patients. Aim: To investigate the relationship between the presence of cochlear dead regions and the self-reported of listening difficulties of adults with bilateral sensorineural hearing loss. Material and Method: Twenty adults with symmetric bilateral sensorineural hearing loss, aged 51 to 75 years were tested, without previous story of use of hearing aids. Cochlear dead regions were tested using the TEN test at 1, 2, 3 and 4 kHz. The questionnaire of twelve questions, IROS12, was applied to the participants. Results: Cochlear dead regions were present in 10 participants. No significant differences were observed between groups, however lower IROS12 scores were observed in those who had present of dead regions. Conclusion: The perception of hearing difficulties in individuals with bilateral sensorineural hearing loss with cochlear dead regions did not differ significantly from those individuals without cochlear dead regions.

7Be, 210Pb and 40K depositions over 11 years in Málaga.

The monthly bulk depositional fluxes of three natural radionuclides (7Be, 210Pb and 40K) were measured at a Mediterranean coastal station (Málaga) over an 11-year period from 2005 to 2015. The mean annual depositional fluxes of 7Be, 210Pb and 40K were 1215, 144 and 67 Bq m-2 year-1 respectively, showing a clear seasonal trend with minimum values recorded during summer and maximum values in winter. The rainfall regime with dry summers allows estimating the dry deposition. Assuming constant dry deposition through each year, 7Be, 210Pb and 40K would account for 12.5, 26.5 and 33% of the bulk fallout respectively which indicates that deposition for 210Pb and 40K are significantly higher than 7Be. The precipitation-normalized enrichment factor alpha used to explain seasonal variations in the depositional fluxes of radionuclides with respect the rainfall, indicates higher depositional fluxes during spring and summer than expected from the amount of rainfall. Despite their different origin, 210Pb and 7Be monthly depositional fluxes have strong correlation. The atmospheric deposition fluxes of 7Be, 210Pb and 40K were controlled mainly by the amount of rainfall (r = 0.89, 0.91 and 0.66 respectively). Moreover, principal component analysis was applied to the datasets and deposition of radionuclides and rainfall in the same component highlighting the importance of the washout mechanism. The mean depositional velocity of aerosols evaluated using 7Be and 210Pb are similar and are compared to other published values.

Prácticas audiológicas en Chile: encuesta online para tecnólogos médicos mención otorrinolaringología / Audiological practices in Chile: an internet based survey for medical technologist with mayor in otorhinolaryngology

Introducción: A nivel internacional existen diversas instituciones que sugieren los estándares mínimos para la realización de los procedimientos audiológicos. Esto tiene como objetivo asegurar la calidad de las evaluaciones auditivas. Esto resulta de importancia en Chile debido a la implementación de programas de salud auditiva en el marco de las garantías explicitas de salud (GES). Objetivo: Documentar las prácticas comunes dentro de Tecnólogo Médico c/m Otorrinolaringología con la finalidad de obtener información para la creación y desarrollo de protocolos estandarizados para la evaluación audiológica. Material y método: Se aplicó un cuestionario de 38 preguntas distribuido a partir de una plataforma online a través de redes sociales y por correo electrónico a los socios de la Sociedad Chilena de Audiología y Otoneurología. Resultados: Se analizaron 121 encuestas finalizadas. Sobre el 70% de los encuestados que ejerce en la zona central. Procedimientos como audiometría de tonos puros, impedanciometría y logoaudiometría son frecuentemente realizados dentro de los encuestados. Estos procedimientos son realizados de acuerdo a lo sugerido dentro de estos profesionales. Conclusión: Existe una alta adherencia de las conductas sugeridas por instituciones internacionales para la realización de los procedimientos más comunes realizados en clínica por parte de los Tecnólogos Médicos c/m Otorrinolaringología.

Introduction: Internationally several institutions suggest minimum standards for the conduct of audiological procedures. This aims to ensure the quality of auditory assessments. This is of importance in Chile due to the implementation of hearing programs under the Explicit Health Guarantees (EHG). Aim: To document common audiological practices of Medical Technologist in order to development standardized protocols for audiological assessment. Material and method: An online-based questionnaire with 38 questions was provided through social networks and by email to members of the Chilean Society of Audiology and Otoneurology. Results: One hundred and twenty one completed surveys were analysed. About 70% of respondents work in the central region of Chile. Procedures such as pure audiometry, tympanometry and speech audiometry were frequently performed by respondents. Respondents followed international guidelines. Conclusion: There is a high adherence to international recommendations when conducting the most common procedures performed in audiology clinics in Chile by the Medical Technologists who responded to the survey.

Diagnostic reference levels and complexity indices in interventional radiology: a national programme.

OBJECTIVES: To propose national diagnostic reference levels (DRLs) for interventional radiology and to evaluate the impact of the procedural complexity on patient doses. METHODS: Eight interventional radiology units from Spanish hospitals were involved in this project. The participants agreed to undergo common quality control procedures for X-ray systems. Kerma area product (KAP) was collected from a sample of 1,649 procedures. A consensus document established the criteria to evaluate the complexity of seven types of procedures. DRLs were set as the 3rd quartile of KAP values. RESULTS: The KAP (3rd quartile) in Gy cm2 for the procedures included in the survey were: lower extremity arteriography (n = 784) 78; renal arteriography (n = 37) 107; transjugular hepatic biopsies (THB) (n = 30) 45; biliary drainage (BD) (n = 314) 30; uterine fibroid embolization (UFE) (n = 56) 214; colon endoprostheses (CE) (n = 31) 169; hepatic chemoembolization (HC) (n = 269) 303; femoropopliteal revascularization (FR) (n = 62) 119; and iliac stent (n = 66) 170. The complexity involved the increases in the following KAP factors from simple to complex procedures: THB x4; BD x13; UFE x3; CE x3; HC x5; FR x5 and IS x4. CONCLUSIONS: The evaluation of the procedure complexity in patient doses will allow the proper use of DRLs for the optimization of interventional radiology. KEY POINTS: • National DRLs for interventional procedures have been proposed given level of complexity • For clinical audits, the level of complexity should be taken into account. • An evaluation of the complexity levels of the procedure should be made.

Study of 7Be and ²¹°Pb as radiotracers of African intrusions in Malaga (Spain).

The relationship between the particulate matter in the atmosphere of Malaga and the origin of air masses with special attention to African intrusions was analyzed. The concentrations of PM10 and the activities of some radionuclides ((7)Be and (210)Pb) as tracers of these intrusions are discussed. The origin of these radiotracers is completely different. (210)Pb is a good tracer of air masses traveling close to the ground and come from inland areas. On the other hand, the production of (7)Be is very low in the vicinity of the Earth's surface, and increases with altitude, making it a great tracer of stratospheric air masses in the troposphere. Studies of radionuclide activities in aerosol particles provide a means for evaluating the integrated effects of transport and meteorology on the atmospheric loadings of substances with different sources. Measurements of aerosol mass concentration and specific activities of (7)Be and (210)Pb in aerosols at Malaga (36° 43' 40″ N; 4° 28' 8″ W) for the period 2009-2011 were used to obtain the relationships between radionuclide activities and airflow patterns by comparing the data grouped by air mass trajectory. The average concentration values of (7)Be and (210)Pb over the 3-year period have been found to be 5.05 and 0.55 mBq m(-3), respectively, with mean aerosol mass concentration of 53.6 µg m(-3). Taking into account the outbreaks of the daily values limits of PM10 in the study period (2009-2011), the origin of air masses is studied to explain three different situations of both radionuclides (7)Be and (210)Pb: 1) high concentrations of (7)Be and low concentrations of (210)Pb; 2) high concentrations of (210)Pb and low concentrations of (7)Be and 3) high concentrations of (7)Be and (210)Pb.

Behavior of ambient concentrations of natural radionuclides (7)Be, (210)Pb, (40)K in the Mediterranean coastal city of Málaga (Spain).

During a 4-year period (January 2009-December 2012), the (7)Be, (210)Pb, and (40)K activity concentrations in airborne particulate matter were weekly determined at the Málaga (Spain) located in the southern Iberian Peninsula. Totally 209 polypropylene filters were analyzed in the mentioned period. In 100% of the filters, (7)Be and (40)K activity concentrations were detected while (210)Pb activity concentration was detected in 96% of the filters. The results from individual measurements of (7)Be, (210)Pb, and (40)K concentrations were analyzed to derive the statistical estimates characterizing the distributions. Principal components analysis (PCA) was applied to the datasets and the results of the study reveal that aerosol behavior is represented by two principal components which explain 73.2% of total variance. Components PC1 and PC2 respectively explain 46.0 and 27.2% of total variance. PC1 was related positively to dust content, (7)Be and (40)K concentrations and negatively to sunspot numbers. In contrast, PC2 was related positively to temperature and (210)Pb activity and negatively to precipitation and relative humidity. The (7)Be levels showed a significant correlation with sunspot numbers due to the cosmogenic origin. (40)K activities showed a good correlation with dust deposition in filters mainly because it was transported to the air as resuspended particle from the soil. An inverse relationship was observed between the (210)Pb concentrations and monthly rainfall, indicating washout of atmospheric aerosols carrying these radionuclides and a pronounced positive correlation with the average monthly temperature of air.

Potenciales evocados auditivos de corteza: complejo P1-N1-P2 y sus aplicaciones clínicas / Auditory cortex evoked potentials: P1-N1-P2 complex and clinical applications

Los potenciales evocados de corteza prometen ser una herramienta útil en la evaluación de las funciones auditivas, proporcionando información sobre la funcionalidad e integridad de estructuras auditivas centrales. Dentro de sus posibles usos encontramos: estimación del umbral auditivo en adultos permitiendo una mayor precisión en comparación a otras técnicas electrofisiológicas, como herramienta de evaluación y seguimiento del entrenamiento auditivo, evaluación de la amplificación (especialmente utilizando estímulos complejos como el habla) relacionado con la detección del estímulo auditivo amplificado a nivel de la corteza y de la plasticidad auditiva como lo podría ser la monitorización de los cambios producidos por la estimulación auditiva. Sin embargo aún presentan algunas limitaciones que deben ser resueltas antes de ser incorporados dentro de la batería de pruebas audiológicas de uso clínico habitual, factores propios del sujeto, de la técnica utilizada y condiciones de evaluación (ej. diferentes tipos de audífonos) pueden hacer que estas respuestas presenten una variabilidad que podría dificultar su uso rutinario.

Cortical auditory evoked potentials have the potential to be a tool for the assessment of auditory functions, providing information on the functionality and integrity of central auditory structures. Among its possible uses are: hearing threshold estimation on adults that are more accurate compared to other electrophysiological techniques; a tool for assessment and monitoring of auditory training; evaluation of amplification (especially using complex stimuli such as speech) related to the detection of an amplified sound at the level of the auditory cortex; and monitoring plasticity via the changes produced by an auditory stimulation. However there are still some limitations to be resolved before incorporating cortical auditory evoked potentials in to the battery of audiological tests used in clinics. Factors related to the subject and the technique and assessment conditions (e.g. different types of hearing aids), may vary these responses and hinder its reliability and use.

Efectos de la variación de la intensidad de los tonos primarios sobre las amplitudes de Emisiones Otoacústicas Producto de Distorsión (EOApd) en sujetos con audición dentro de rangos de normalidad / Effects of varying the intensity of the primary tones on the amplitudes of Distortion Product Otoacoustic Emissions (OAEdp) in patients with normal hearing

Introducción: Las emisiones otoacústicas (EOA) son sonidos generados por las células ciliadas externas (CCE). Se ha visto que la generación y registro de las EOA evocadas depende de factores técnicos de evaluación como el nivel de intensidad de los tonos primarios, relación frecuencial entre los tonos, etc. Objetivos: Estudiar el efecto de la variación de la intensidad de los tonos primarios en la amplitud de la respuesta de las EOA producto de distorsión (pd) en individuos con audición normal. Material y método: Se evaluaron 35 individuos a los cuales se les midieron EOApd utilizando diferentes intensidades de tonos primarios: Intensidad baja (I1=50dBSPL e I2=50dBSPL), intensidad media (I1=55dBSPL e I2=65dBSPL) e intensidad alta (I1=70dBSPL e I2=70dBSPL). Resultados: Se observó que para tonos primarios a bajas intensidades (I1=50dBSPL e I2=50dBSPL) existe una disminución tanto en amplitud y presencia de las EOApd, mientras que para tonos primarios a intensidades mayores (I1=55dBSPL e I2=65dBSPL - I1=70dBSPL e I2=70dBSPL) se evidenció un aumento en amplitud y presencia de EOApd en los sujetos estudiados. Conclusión: Se evidencian diferencias estadísticamente significativas en la amplitud de las EOApd al variar la intensidad de los tonos primarios. Por lo cual se puede establecer que las intensidades medias-altas son las más adecuadas para la evaluación de EOApd en sujetos con audición normal.

Introduction: Otoacoustic emissions (OAE) are sounds produced by outer hair cells. The generation and recording of evoked OAE depends on technical factors such as level of intensity of primary tones, frequency relationship between the tones, etc. Aim: To study the effect of varying the intensity of primary tones in the amplitude of the response of Distortion Product OAE (DP) in individuals with normal hearing. Material and method: 35 individuals were measured using different intensities OAEdp primary tones: Low Intensity (I1= I2 =50dBSPL 50dBSPL e), Medium Intensity (11= I2 =65dBSPL 55dBSPL e) and High Intensity (I1 =70dBSPL and I2 =70dBSPL). Results: Using Low primary tones (I1 =I2 =50dBSPL 50dBSPL) there is a decrease in amplitude and presence of DPOAE, while for primary tones at higher intensities (I1 and I2 = = 55dBSPL 65dBSPL -11 =70dBSPL and I2 =70dBSPL) an increase in amplitude and presence of OAEdp in subjects with normal hearing was observed . Conclusion: There are statistically significant differences in OAEdp amplitude by varying the intensity of the primary tones. Therefore medium-high intensities are best suited for the evaluation of OAEdp in subjects with normal hearing.

Efectos de la edad sobre el procesamiento auditivo / Effect of aging on auditory processing

En la actualidad existe un cúmulo de información teórica y experimental sobre los cambios de la percepción del habla relacionado con las edades. Se ha establecido que esta dificultad en la comunicación producto de la edad se debería a tres grandes factores; a) déficit de las habilidades cognitivas, b) cambios en la función auditiva periférica y c) cambios en una o más de las funciones auditivas centrales. Si bien es cierto la pérdida auditiva generada con la edad (presbiacusia) es responsable en parte de estas dificultades, no es posible atribuirle a solo este factor los déficits observados en poblaciones de mayor edad. Es posible evidenciar alteraciones en la representación neural de la información acústica, en especial cuando asta es de mayor complejidad como lo podría ser el habla, a su vez tambi6n es posible observar alteraciones en las funciones auditivas y esto evidenciado a través de las pruebas conductuales, como aquellas que utilizan el escucha dicótica. Por lo anterior es importante considerar estos efectos al momento de planificar el proceso de rehabilitación de un adulto mayor.

There is theoretical and experimental information on changes in speech perception related to the age. It has been established that this dufficulty in communication due to aging is due to three main factors: a) cognitive skills, b) changes in peripheral auditory function and c) changes in one or more of the central auditory functions. Although hearing loss generated with age (presbycusis) is partly responsible for these difficulties is not possible to attribute to this factor alone deficits observed in older populations. It is possible for alterations in the neural representation of acoustic information especially when it is more complex as speech, it is also possible to observe changes in auditory functions evidenced through behavioral tests such as those using dichotic listening. Therefore it is important to consider these effects when planning the rehabilitation in elderly.

Evaluación del programa de detección precoz de hipoacusia en recién nacidos prematuros extremos (RNPE), experiencia Hospital Padre Hurtado / Hearing screening in infants with very low birth weight (VLBW), Padre Hurtado experience

Introducción: En julio de 2005 se implementó en Chile un programa de pesquisa precoz de hipoacusia en recién nacidos menores de 32 semanas de edad gestacional y/ o con peso de nacimiento menor a 1.500 grs. Objetivo: Evaluar la ejecución de este programa en el Hospital Padre Hurtado, durante el período julio 2005 y diciembre 2009. Material y método: Se utilizaron potenciales auditivos evocados de tronco automatizado (PEATa) en dos etapas (pesquisa). Los pacientes que fallaron fueron estudiados mediante potenciales evocados auditivos extendidos (PEAe). Para el diagnóstico de hipoacusia sensorioneural (HSN) se consideró dos PEAe (click) alterados y audiometría de refuerzo visual concordante. Resultados: En el período se evaluaron 166 RNPE. La tasa de referencia fue de 7,9 por ciento (13 pacientes), considerando las fallas uni y bilaterales en dos PEATa. La tasa de HSN de esta población correspondió a 1,8 por ciento. Conclusiones: La tasa de referencia (7,9 por ciento) así como de prevalencia de HSN de la población estudiada (1,8 por ciento) está dentro de lo descrito en la literatura para recién nacidos de alto riesgo. Se sugiere una etapa de pesquisa en 2 fases, estudio de los pacientes que refieren tanto bilateralmente como unilateralmente y el seguimiento audiológico de los pacientes previamente diagnosticados.

Introduction: In July 2005, Chile implemented a hearing screening program in newborns under 32 weeks gestational age and/or birth weight less than 1500 g. Aim: Evaluate the implementation of this program in the Hospital Padre Hurtado, during the period July 2005 and December 2009. Material and method: We used automated auditory brainstem response (AABR) in two stages (screening). Patients who failed were studied using click auditory brainstem response (ABR). For the diagnosis of sensorineural hearing loss (SNHL) are considered two ABR altered and consistent visual reinforcement audiometry. Results: A total of 166 were evaluated VLBW. The reference rate was 7.9 percent (13 patients), whereas failures in two uni-and bilateral AABR. SNHL rate of this population accounted for 1.8 percent. Conclusions: The reference rate (7.9 percent) and HSN prevalence of the study population (1.8 percent) is within that described in the literature for high-risk newborns. It suggests a period of research in two phases, a study of patients referred both bilaterally and unilaterally and audiological monitoring of patients previously diagnosed.

Estudio electrofisiológico y electroacústico de un desorden del espectro de neuropatía auditiva: reporte de un caso en recién nacido de alto riesgo / Electrophysiology and electroacoustic study of spectrum disorder of auditory neuropathy: report of a case in high-risk newborn

El desorden del espectro de neuropatía auditiva (DENA) describe una condición en la cual se observa o se ha observado emisiones otoacústicas (EOA) junto con potenciales evocados auditivos de tronco (PEAT) anormales o ausentes. Su identificación se basa en la presencia de potencial microfónico coclear (PMIC) junto con un PEAT anormal o ausente y EOA presentes o antecedentes de su presencia. Los umbrales tonales pueden encontrarse entre los rangos de normalidad hasta pérdidas auditivas profundas. El reconocimiento del habla generalmente se encuentra afectado particularmente en presencia de ruido de fondo, sin embargo en algunos individuos se mantiene conservado (sin ruido). Se presenta caso clínico de un recién nacido de sexo femenino de pretérmino de 29 semanas y 810 grs (GIII), apgar 7/8, presenta displasia broncopulmonar, sospecha de infección connatal tratada, hiperbilirrubinemia (max 11 mg/dl) tratada con fototerapia. Es derivada al Servicio de Otorrinolaringología para su evaluación auditiva. La evaluación auditiva realizada corresponde a potenciales evocados auditivos de tronco (PEAT), impedanciometria, audiometría de campo de respuesta reflejas y emisiones oto-acústicas. Los resultados obtenidos concuerdan con lo descrito en la literatura para un DENA.

Auditory neuropathy spectrum disorder (ANSD) describes a condition in which it is possible to find otoacoustic emissions (OAE) in presence of abnormal or absent auditory brainstem evoked potentials (ABR). The pure tone thresholds may show a spectrum from normal to profound hearing loss. Speech recognition is often affected in presence of background noise, but in some individuals remains intact. We report a case of a pre term newborn (female) of 29 weeks and 810 grams, Apgar 7/8, bronchopulmonary dysplasia, suspected connatal infection, and hyperbilirubinemia (max 11 mg / dl). She was referred to Hospital Padre Hurtado for hearing assessment. The hearing test performed were an ABR, tympanometry & acoustic reflex, visual reinforcement audiometry and otoacoustic emissions. The results are consistent with those described in the literature for ANSD.

Procesamiento auditivo en adultos mayores: reporte de casos / Auditory processing in elderly: case reports

La disminución de la capacidad de comprensión del habla en los adultos mayores puede ser producida por la interacción de diferentes factores como: a) pérdida auditiva periférica, b) alteraciones cognitivas y c) déficit del procesamiento auditivo. En la actualidad existen pruebas audiológicas que nos permiten evidenciar los déficits del procesamiento auditivo en esta población permitiendo así ayudar en los procesos de selección y adaptación de audífonos tanto en forma monoaural como biaural.

The decline in speech understanding ability in older adults can be caused by the interaction of different factors including: a) peripheral hearing loss, b) cognitive and c) auditory processing deficits. There are currently audio logical tests that allow us to demonstrate auditory processing deficits in this population and assist in allowing the processes of selection and hearing aid fitting in both monaural and binaural way.

Neuropatía auditiva, diagnóstico y manejo audiológico / Auditory neuropathy / dyssychrony, assessment and audiologic management

Los hallazgos clínicos que definen una neuropatía/des sincronía (NA/DA) son la integridad de las células ciliadas evidenciado, mediante la presencia de emisiones otoacústicas evocadas (EOAe) y/o la presencia de potenciales microfónicos cocleares (PMIC), junto con la ausencia de actividad neural evocada a nivel del VIII par craneano (potencial de acción compuesto) y tronco cerebral (potencial evocado auditivo de tronco (PEAT)). Las condiciones clínicas relacionadas con una NA/DA incluyen a la hiperbilirrubinemia, enfermedades neurovegetativas (ejemplo ataxia de Friedreich), síndrome de Charcot-Marie-Tooth así como otras neuropatías sensoriomotoras, desórdenes mitocondriales y neuropatías isquémica-hipóxicas como resultados de asfixia. El desarrollo de las habilidades auditivas y comunicacionales pueden estar comprometidas en forma importante en los niños con aparición prelingual de una NA/DA, mayor es aún este compromiso al no existir un perfil pronóstico preestablecido del desarrollo y resultados en el tratamiento de este desorden. En la actualidad existen múltiples estudios en donde se ha observado que hasta 50 por ciento de los pacientes con NA/DA presentan algún grado de beneficio al usar audífonos por lo que se sugiere que sistemas de amplificación como los audífonos o incluso implante coclear deberían ser el primer paso en el proceso de (re)habilitación.

The clinical findings that define an auditory neuropathy/dyssynchrony (AN/Dys) are the integrity of the outer hair cells demonstrated by the presence of evoked otoacoustics emissions (OAEe) and/or the presence of cochlear microphonic potential (CMP) along with the absence of neural activity evoked at level of VIII nerve (action potential compound) and brainstem (Auditory Brainstem Response, ABR). The clinical conditions related to an AN they include hiperbilirrubinemia, neurodegenerative diseases (eg ataxia of Friedreich), Charcot-Marie-Tooth syndrome as well as other sensoriomotor neuropathies, mitocondrial disorders and hypoxic neuropathy as perinatal asphyxia. The development of the auditory and communicational abilities can be compromise in children with prelingual onset of an AN/Dys, the development and results of treatment of this disorder is still this commitment when not existing a profile prognosis. At the present time multiple studies have been observed that until a 50 percent of the patients with AN present some degree of benefit using hearing aids, reason why it suggests amplification systems as the hearing aids or even cochlear implant would have to be the first step in the process of (re) habilitation of these patients.

Descripción de factores no audiológicos asociados en adultos mayores del programa de audífonos año 2006, Hospital Padre Hurtado, Santiago / Description of nonaudiologic associated factors in older adults from the 2006 hearing aid program at the Padre Hurtado Hospital in Santiago

Introducción: En los últimos años se ha sugerido incorporar factores no audiológico en los programas de rehabilitación auditiva del adulto mayor. Objetivo: Conocer factores sociales, familiares y de salud general de los adultos mayores (AM) beneficiarios del programa de audífonos año 2006 del Hospital Padre Hurtado, Santiago. Material y método: Se entrevistaron pacientes cuya edad fue >65 a±os atendidos en el Servicio de Otorrinolaringología durante el año 2006 que recibieron audífonos. Resultados: Se realizó la entrevista al 87 por ciento de los beneficiados. El rango de edad de los pacientes fue de 65 a 98 años (x =77,6). Los resultados observados fueron los siguientes; a) en el 63 por ciento> de los entrevistados el cuidador es un hijo (a), b) el 66 por ciento> de los Individuos presentaban limitaciones físicas (visuales o motrices, con o sin tratamiento) c) el 78 por ciento> presenta algún tipo de Ingreso económico (ejemplo pensión de vejez) sólo 2 por ciento> no presenta ingreso, d) el 7 por ciento> de los entrevistados son analfabetos, e) el 37 por ciento> asiste a los controles médicos con su hijo (a), y f) sólo el 19 por ciento participa en actividades sociales dentro de su comuna. Conclusión: Los programas actuales de rehabilitación auditiva plantean la necesidad de considerar factores no audiológicos al momento de evaluar un paciente que requiere de algún tipo de ayuda técnica auditiva.

Introduction: In recent years it has been suggested to include non audiologic factors in the rehabilitation programs for older adults. Aim: The purpose of this study was to describe social, familial and general health factors affecting older adults (OA) beneficiaries of the 2006 hearing aid program at the Padre Hurtado Hospital in Santiago. Material and Method: Patients, 65year old or older, that received hearing aids at the ORL Department during 2006, were interviewed. Results: 87 percent of patients that received a hearing aid were interviewed. Age range was 65 to 98 years old (x=77.6). Results can be summarized as follows: a) In 63 percent of the Interviewed patients, the main caretaker was a son or daughter, b) 66 percent> presented some kind of physical limitations (visual or motor, treated or non-treated), c) 78 percent> had an Income of some sort (pension, for example); only2 percent> had no income of any type, d) 7 percent> of the Interviewed Individuals were Illiterate, e) 37 percent> attend medical controls accompanied by a son or daughter, and f) only 19 percent assists regularly to social activities within their neighbourhood. Conclusions: Current auditory rehabilitation programs pose the need of considering non audiologic factors when evaluating a patient that requires some type of hearing aid.

Effects of collector types in sampling of atmospheric depositional fluxes.

The bulk gross alpha, gross beta and (7)Be depositional fluxes were measured in Málaga (36.7 degrees N, 4.5 degrees W), a coastal Mediterranean station in the south of Spain for one whole year. In order to quantify the local variation of deposition rates, we have analysed the monthly results from two deposition collectors: a "pot "collector with a continuous water-covered surface and a "funnel" collector. In general, the alpha and beta depositional fluxes from the funnel collector were approximately two times lower than the pot collector. Whereas for the cosmogenic (7)Be, the depositional flux of (7)Be from funnel collector was also approximately two times lower than the pot collector. A good correlation of the depositional flux of (7)Be has been obtained from both collectors.

Effects of inspiratory muscle training on exercise capacity and spontaneous physical activity in elderly subjects: a randomized controlled pilot trial.

Inspiratory muscle training (IMT) has been shown to improve exercise capacity in diseased populations. We chose to examine the effects of eight weeks of IMT on exercise capacity and spontaneous physical activity in elderly individuals. Eighteen moderately active elderly subjects (68.1 +/- 6.8 years [mean +/- SD]; range 58 - 78 years) were randomly assigned to either an experimental group (n = 9) or a control group (n = 9) in a double-blind manner. All subjects underwent inspiratory muscle testing, treadmill exercise testing and a four-day measurement period of spontaneous physical activity (using accelerometry) both pre- and post-intervention. The experimental group underwent eight weeks of incremental IMT using a pressure threshold device, while the control group underwent sham training using identical devices. After IMT training, inspiratory muscle strength (mean + 21.5 cm H (2)O; 95 % CI: 9.3, 33.7; p = 0.002), V.O (2peak) (+ 2.8 ml x min (-1) x kg (-1); 95 % CI: 0.5, 5.2; p = 0.022), time to exhaustion during a fixed workload treadmill test (+ 7.1 min; 95 % CI: 1.8, 2.4; p = 0.013) and time engaged in moderate-to-vigorous physical activity (+ 59 min; 95 % CI: 15, 78; p = 0.008) improved. Except for a decline in moderate-to-vigorous physical activity, no significant changes were seen in the control group. Therefore, IMT may be a useful technique for positively influencing exercise capacity and physical activity in elderly individuals.

Exhalation of (222)Rn from phosphogypsum piles located at the Southwest of Spain.

Phosphogypsum (PG) is a waste product of the phosphoric acid production process and contains, generally, high activity concentrations of uranium series radionuclides. It is stored in piles formed over the last 40 years close to the town of Huelva (Southwest of Spain). The very broad expanse of the PG piles (about 1200 ha) produces a local, but unambiguous, radioactive impact to their surroundings. In 1992, the regional government of Andalusia restored an area of 400 ha by covering it with a 25-cm thick layer of natural soil and, currently, there is an additional zone of 400 ha in course of restoration (unrestored) and the same area of active PG stacks. Due to the high activity concentration of (226)Ra in active PG stacks (average 647 Bq kg(-1)), a significant exhalation of (222)Rn could be produced from the surface of the piles. Measurements have been made of (222)Rn exhalation from active PG stacks and from restored and unrestored zones. The (222)Rn exhalation from unrestored zones is half of that of the active PG stacks. Following restoration, the (222)Rn exhalation is approximately eight times lower than the active PG stacks. The activity concentrations of natural radionuclides ((226)Ra, (40)K, (232)Th) in the mentioned zones have been determined. This study was also conducted to determine the effect of (226)Ra activity concentration on the (222)Rn exhalation, and a good correlation was obtained between the (222)Rn exhalation and (226)Ra activity, porosity and density of soil.