Technical Feasibility of Acoustic Coordinated Reset Therapy for Tinnitus Delivered via Hearing Aids: A Case Study.

Primary tinnitus has a severe negative influence on the quality of life of a substantial portion of the general population. When acoustic coordinated reset (CR) neuromodulation stimuli are delivered for several hours per day over several weeks a clinically significant symptom reduction in patients with primary tonal tinnitus has been reported by several clinical sites. Here, we reported the first case where CR neuromodulation was delivered through a hearing aid. A 52-year-old man with chronic primary tonal tinnitus was previously considered untreatable with sound therapy. He initially received the classic CR treatment protocol with signals delivered with the separate proprietary device with his hearing aids removed during treatment. He was subsequently treated with the therapy being deployed through a set of contemporary hearing aids. After 5 months of classic CR treatment with the separate custom device, the THI and VASL/A scores worsened by 57% and 13%/14%, respectively. Using the hearing aid without CR treatment for 5 months no change in tinnitus symptoms was observed. However, after three months of CR treatment delivered through the hearing aids, the THI and VASL/A scores were reduced by 70% and 32%/32%, respectively.

Wearable lower limb haptic feedback device for retraining Foot Progression Angle and Step Width.

Technological developments in the last decade have enabled the integration of sensors and actuators into wearable devices for gait interventions to slow the progression of knee osteoarthritis. Wearable haptic gait retraining is one area which has seen promising results for informing modifications of gait parameters for reducing knee adduction moments (KAM) during walking. Two gait parameters which can be easily adjusted to influence KAM include foot progression angle (FPA) and step width (SW). The purpose of this study was to: (1) determine whether a custom haptic ankle bracelet using binary vibrotactile and tactile apparent movement feedback could retrain ten healthy subjects to walk with a modified FPA and SW within a short training session with 80% accuracy; and (2) whether there was a difference between the number of steps required to complete the retraining task based on the two feedback schemes being tested. Retraining multiple gait parameters using a single device was a novel aspect of this work and we found that nine out of ten subjects were able to retrain their gait using the ankle bracelet in both feedback schemes to within 2° and 39mm of target FPA and SW respectively. We also found no difference in the number steps required for completion between the two schemes (p>0.05). Future research will investigate the device performance with patients with knee osteoarthritis and the effective change in KAM by modifying a combination of FPA and SW.

Serological diagnosis of canine alveolar echinococcosis.

Canine alveolar echinococcosis (AE) is a rare liver disease caused by the larval stage (metacestode) of E. multilocularis. Its diagnosis so far is rather difficult and invasive. Imaging techniques for the diagnosis have been described recently and in this study, the serological diagnosis of canine AE was evaluated in 30 dogs with confirmed AE using ELISA based on seven different antigens (E. multilocularis-antigens: Em2G11, EmII/3-10, protoscolex (EmP), excretory/secretory and adult integument (EmAd/I); E. granulosus antigens: hydatid fluid (EgHF) and antigen B (EgAgB)) and by the detection of circulating Em2G11-antigen. EmII/3-10 and Em2G11-based tests detected AE in 50 and 53%. The combined serological investigation for specific circulating Em2G11-antigen and specific antibodies against this antigen showed a sensitivity of 77%. This strategy is useful in animals with large parasite masses and ascites. The highest sensitivities for AE were obtained by the EmAd/I and the EmP antigens (97 and 93% sensitivity) with high specificities in the control group of 76 dogs (100 and 98.7%, respectively). Heterologous E. granulosus antigens (EgHF and EgAgB) showed low sensitivities (43 and 50%, respectively) with high numbers of unspecific reactions (>16%) in the control group. In the follow-up of four dogs, the serological reaction patterns against the antigens Em2G11, EmP and EmAd/I showed some correlations with the development of the parasite mass. Intestinal infections cannot be differentiated from AE by most antigens (except EmII/3-10) and have to be excluded by the absence of coproantigens or DNA of E. multilocularis in faecal samples.

Radiographic, ultrasonographic, and computed tomographic appearance of alveolar echinococcosis in dogs.

Alveolar echinococcosis is a rare metacestodal infection of humans and domestic animals with Echinococcus multilocularis and predominantly affects the liver. In humans, diagnosis is based on serology, ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI), techniques that have not yet been validated for the diagnosis of alveolar echinococcosis in dogs. Therefore, the purpose of this retrospective study was to describe the radiographic, ultrasonographic, and CT appearance of canine alveolar echinococcosis. Eleven dogs with confirmed alveolar echinococcosis (PCR or histology from biopsy material of metacestode tissue) diagnosed between 1995 and 2003 were included in the study. The age of the dogs at initial presentation ranged from 7 months to 10.5 years. Abdominal radiographs were made in nine animals, abdominal ultrasonography was performed in 10 dogs, and two CT studies in one dog, respectively. The history, clinical presentation, and laboratory findings for the 11 dogs were unspecific, the most frequent clinical finding being nonpainful progressive abdominal distention. All radiographed dogs had large liver masses; they contained small mineralizations in five. The most frequent ultrasonographic finding was multiple large cavitary masses with or without wall mineralizations. Seven animals received surgical and subsequent medical therapy with albendazole (10mg/kg) and all went into clinical remission. This study reviewed for the first time imaging findings associated with alveolar echinococcosis. The disease has to be included in the list of differential diagnoses in dogs with large, cavitary liver masses, particularly when mineralization is noted.