Does cochlear implantation influence postural stability in patients with hearing loss?

BACKGROUND: Cochlear implantation (CI) procedure carries the potential risk for vestibular system insult or stimulation with resultant dysfunction due to its proximity to the cochlea. The vestibular system plays an essential role in crucial tasks such as postural control, gaze stabilization and spatial orientation. RESEARCH QUESTION: How does standard cochlear implantation influence postural stability in patients with hearing loss? METHODS: The study included 21 individuals (age 51 ± 18 years) qualified to undergo CI due to severe or profound hearing loss. Participants were qualified for both groups by a physician based on an interview, an otoneurological examination and vestibular tests. The first group included patients without vestibular dysfunction, whereas the other group consisted of persons with vestibular dysfunction. The research methodology included medical examinations, anthropometric measurements and stabilometry on the Biodex Balance System SD (BBS) platform. The examinations were carried out twice, i.e. prior to and 3 months post implantation. The recorded data was compared between the first and the second examination using a non-parametric Wilcoxon test. The analysis of variance (ANOVA) and Tukey's post-hoc HSD unequal sample sizes were performed for patients with and without vestibular dysfunction. RESULTS AND SIGNIFICANCE: Study showed that 52.4% of the participants obtained results within the norm, while 47.6% scored below it. The comparison of stability indices of the examined individuals, with and without vestibular dysfunction, did not reveal statistically significant differences. The only difference was the anterior-posterior stability index assessed in static conditions. Three months after the implantation, no changes in the majority of indices were noted, with the exception of anterior-posterior stability index, which improved following the implantation. CI does not affect postural stability changes in the study participants.

Assessing Gait Stability before and after Cochlear Implantation.

BACKGROUND: It is known that cochlear implantation may alter the inner ear and induce vestibular disorders. RESEARCH QUESTION: How does cochlear implantation influence gait stability? Material and Methods. An experimental group of twenty-one subjects scheduled for cochlear implantation underwent gait testing twice, on the day before cochlear implantation (BCI) and three months after cochlear implantation (ACI), using a motion capture system. A control group of 30 age-matched healthy individuals were also tested. RESULTS: In the experimental group, the gait stability ratio (GSR) was found to improve in 17 subjects after implantation, by an average of 6%. Certain other parameters also showed statistically significant improvement between the two experimental group tests: step time (p<0.001), single-support phase walking speed (p<0.05), and center of mass (CoM) (p<0.05). Using the CoM results of the control group, we devised a stability classification system and applied it to the pre- and postimplantation subjects. After implantation, increases were seen in the number of subjects classified in interval II (strong stability) and III (weak stability). The number of subjects in interval I (perfect stability) decreased by 1 and in interval IV (no stability) by 4. SIGNIFICANCE: (1) Although cochlear implantation intervenes in the vestibular area, we found evidence that gait stability improves in most subjects after the surgery, reducing the risk of falls. (2) We found statistically significant improvements in individual parameters (such as single-support phase time), in GSR, and in CoM. (3) Based on CoM results, we proposed a new rule-of-thumb way of classifying patients into gait stability intervals, for use in rehabilitation planning and monitoring.

Effects of anthropometric factors on postural stability in individuals with hearing impairment.

PURPOSE: Identification of factors that affect postural stability may help to improve diagnostic accuracy and enhance the quality of treatment and rehabilitation. This study sought to assess the relationship between postural stability parameters and anthropometric factors of persons with hearing impairment (HI). METHODS: The study included 128 individuals - 42 subjects with HI and 86 without HI (healthy controls). Research methodology included an interview and a medical examination, anthropometric measurements and stabilometric tests on platforms with stable and unstable surfaces. RESULTS: In the group of female study participants with HI, significant correlations were only noted between body height and the Fall Risk Index (FRI). In the group of male subjects with HI, the study revealed significant correlations between FRI and body mass, BMI, % MM (muscle mass percentage) and % FAT (fat percentage). Moreover, moderate correlation was found between COP path with eyes open and body mass, while high correlation was observed between COP path with eyes open and BMI, % MM and % FAT. No significant correlation was noted between FRI and body height in men with HI. CONCLUSIONS: The examination of correlations between postural stability and body build of persons with HI did not confirm the effects of body height on postural stability in the examined group of individuals with HI, but revealed a greater influence of somatic parameters (body mass, BMI, % MM, % FAT) on postural stability in hearing-impaired men.

Examinations of the methods used to power supply of different light sources and their effect on bioelectrical brain activity.

OBJECTIVE: The article represents the preliminary study, with the aim of the experiment being to examine whether different types of light sources used commonly in building interiors combined with various color temperature have an effect on EEG activity. The effect of frequency pulsation and color temperature on brain activity in EEG examinations in the beta 2 band was assumed. MATERIAL/PARTICIPANTS: Twenty healthy men aged 19-25 years participated in the experiment. METHODS: The research stand was lit by: LED diodes with color temperatures of 3000K, 4200K, 6500K, with the power supplied using the pulse width modulation (PWM) method with the current frequency of 122Hz, linear fluorescent tubes (3000K, 6500K), with the power supplied with the frequency of 50Hz and 52kHz from the electromagnetic and electronic ballasts, and the conventional light bulb, with the power supplied directly from the mains electricity, used as a reference light. System Flex 30 apparatus with TrueScan software was used to record the EEG signal. The examination used two factors (speed and accuracy) of the Kraepelin's work curve to describe changes in work performance for various types of lighting. RESULTS: The results demonstrate that the use of different types of emission of light and color temperature of the light have an effect on bioelectrical brain activity and work performance. CONCLUSIONS: The highest activity of brain waves concerns the beta band in the frequency range of 21-22Hz, regardless of the type of the light source (LED, fluorescent tube). The methods used to supply power and color temperature of fluorescent tubes do not significantly affect bioelectrical brain activity during "work", but previous lighting with fluorescent tubes during work has an essential effect on bioelectrical brain activity during rest. Regardless of the color temperature, LED lighting with PWM power supply leads to the highest bioelectrical activity (mainly in the range of 21-22Hz) in the brain during work and rest, which might suggests the usefulness of this method of supplying power for everyday work. Incandescent light does not affect the bioelectrical brain activity during work and rest.

Meningitis, clinical presentation of tetanus.

Background. Tetanus is an acute disease caused by a neurotoxin produced by Clostridium tetani. Tetanus immunization has been available since the late 1930s but sporadic cases still occur, usually in incompletely vaccinated or unvaccinated individuals. Case Report. An elderly previously vaccinated female contracted tetanus following foot injury. Clinically she presented with meningitis causing diagnostic and therapeutic delays. Why Should Physician Be Aware of This? Even in developed countries the differential diagnosis of meningitis, especially in the elderly, should include tetanus. Treatment in intensive care unit is required. General population might benefit from vaccine boosters and education on this potentially fatal disease.

Pain control in patients with chronic back pain syndrome.

BACKGROUND: Back pain syndrome is a common problem, not only orthopedic, but also psychological, social and economic. In research and clinical practice, the tendency to differentiate between physiological aspects of pain and the psychological, social and economic factors related to pain is dominant. The goal of this paper is to evaluate pain control perception in patients with chronic back pain syndrome. MATERIAL AND METHODS: The sample consisted of 57 subjects, including 41 females and 16 males suffering from back pain syndrome. The mean age of the subjects was 60 years and the mean period of the disease was 10 years. Pain intensity and motor activity limitation were assessed using a modified Laitinen questionnaire and BPCQ questionnaire developed by S.Skevington. RESULTS: 66% of the subjects reported very intense and intense pain; almost half of the respondents reported limitation of their everyday activities resulting from pain. Among the studied 3 dimensions of pain control perception, external control (powerful doctors) and chance loci were dominant. A detailed analysis of pain control factors revealed great diversity in the replies; none of the reported loci of control was dominant. As compared to the cited English study, the powerful doctors locus was far more seldom reported by our study subjects. CONCLUSIONS: Every third subject reported the desired dimensions of pain control (internal strong or undifferentiated strong types). The obtain results suggest helplessness and lack of self-control of pain among the studied sample.

[Cilliary neurotrophic factor in tick-borne encephalitis]. / Rzeskowy czynnik neurotrtropowy w kleszczowym zapaleniu mózgu.

THE PURPOSE OF THIS STUDY: To evaluate concentrations of cilliary neutrophic factor (CNTF) in serum and cerebrospinal fluid of patients with tick-borne encephalitis (TBE) and bacterial meningitis. MATERIAL AND METHODS: 49 patients (14 females and 35 males), aged 19 to 62 were examined. Patients were divided into three groups: group I--23 patients (47%) with diagnosed TBE, group II--16 patients (33%) with bacterial meningitis and 10 (20%) healthy individuals as control group. The examination was performed twice before and after 4-weeks treatment. In achieved results CNTF concentration in serum from group I and II in both examinations was significantly higher compared to control group. RESULTS: Patients with TBE showed higher serum CNTF concentration compared to group with bacterial meningitis in both examinations as well. In examination 1 cerebrospinal fluid CNTF concentration of both groups was significantly higher in comparison to control group. Examined cytokine CSF concentration was higher in group with bacterial meningitis. After treatment CNTF concentration decreased significantly in group I and II. In group I CNTF concentration was comparable to control group. CONCLUSION: Concentration of CNTF in csf could be used as a marker of the inflammatory process in the central nervous system.

[Tropical malaria--danger for persons visiting endemic areas]. / Zimnica tropikalna--problem osób wyjezdzajacych na tereny endemiczne zimnicy.

Malaria continues to be a wide-spread infection in tropical areas. According to World Health Organization, malaria is present in over 100 countries, populated by over 3 bln people. Malaria morbidity in these areas is difficult to estimate. Tropical malaria caused by Plasmodium falciparum is responsible for more than 95% of fatal cases. Other Plasmodium species able to infect humans are P. vivax, P. ovale and P. malariae, typically responsible for more prolonged course of the disease, with possibility of late relapse, but rarely resulting in fatal outcome. We present a case of tropical malaria, illustrating wide spectrum of complications associated with P. falciparum infection, especially in cases of massive parasitemia.

Tick-borne encephalitis in north-eastern Poland in 1997-2001: a retrospective study.

The aim of this study was to characterize the epidemiology and clinical features of tick-borne encephalitis in north-eastern Poland. Clinical and epidemiological data were analysed of patients hospitalized with the diagnosis in the Department of the Infectious Diseases and Neuroinfections of the Medical University in Bialystok in 1997-2001. Tick-borne encephalitis was diagnosed in 152 patients: 51 (34%) presented with meningitis, 89 (59%) with meningoencephalitis and 12 (8%) with meningoencephalomyelitis. Headache (84%) and fever (81%) were the most common symptoms. Meningeal signs were present in 137 patients (90%). Most common neurological abnormalities were: Oppenheim and Babinski signs (74 patients, 49%), ataxia (37, 24%), impaired consciousness (37, 24%) and pareses (16, 10%). Of patients examined, 146 (96%) had raised pleiocytosis, frequently accompanied by high cerebrospinal fluid protein concentration (90%), raised erythrocyte sedimentation rate (65%), peripheral blood leucocytosis (26%) and increased aminotransferase activity (16%). There was only 1 forest worker among the patients. Tick-borne encephalitis remains common in north-eastern Poland but, possibly because of effective vaccination, it has virtually disappeared among forest employees. The diagnosis appears difficult in some cases, as meningeal signs may not be present and laboratory findings may not be suggestive of a viral infection.

[The course of the tick-born encephalitis (TBE) in patients hospitalized at the Department of Infectious Diseases in Bialystok in the year 2001]. / Przebieg kleszczowego zapalenia mózgu (kzm) u chorych hospitalizowanych w klinice chorób zakaznych i neuroinfekcji AMB w roku 2001.

AIM: To characterize epidemiological and clinical features of TBE in the Northeastern Poland. METHODS: Analysis of clinical and epidemiological data of patients hospitalized with the diagnosis of TBE in the Department of the Infectious Diseases and Neuroinfections of the Medical University in Bialystok in 2001. MAIN OBSERVATIONS: TBE was diagnosed in 48 patients. From that number 18 (37.5%) presented symptoms of meningitis, 24 (50.0%) meningoencephalitis, 5 (10.4%) meningoencephalomyelitis and 1 (2.1%) meningoencephaloradiculitis. RESULTS: Headache (100%) and fever (87.5%) were the most common complaints. Signs of meningitis were observed in 35 patients (72.9%). Common neurological abnormalities were Oppenheim and Babinski signs (18 patients, 37.5%), pareses (8; 16.7%), ataxia (7; 14.58%) and impaired consciousness (6; 12.5%). Cytosis in cerebrospinal fluid (csf) was observed in all patients, frequently accompanied by high csf protein concentration, raised erythrocyte sedimentation rate (61.5%), leucocytosis (31.25%) and aminotrasferase activity (12.5%). There were no professional forest workers among the patients.