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1.
J Pers Med ; 14(1)2024 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-38248791

RESUMO

BACKGROUND: The perceived impact of hearing loss varies considerably among those affected due to the heterogeneous types of hearing loss, their diverse etiologies, and the different rehabilitation possibilities. Therefore, assessing listening skills in a daily context using questionnaires is essential. This study aimed to investigate the validity and reliability of the adapted version of the Speech, Spatial and Qualities of Hearing Scale 12 (SSQ12) in the Romanian language. MATERIALS AND METHODS: The SSQ12 is a 12-item self-reporting questionnaire that assesses a range of everyday listening situations. The internal consistency, test-retest reliability, and validity of the r-SSQ12 questionnaire resulting from the adaptation of the original scale were investigated. RESULTS: The responses of 183 subjects aged between 11 and 79 years were evaluated. In total, 121 subjects had hearing loss (19 adolescents), and 62 subjects had normal hearing (11 adolescents). Significant differences were observed in the means of the overall score and for individual items between normal-hearing subjects and subjects with hearing loss. The SSQ12 had high internal consistency (Cronbach's alpha = 0.97), and the test-retest scores were highly correlated. CONCLUSIONS: The SSQ12 scale can be used to investigate the self-reporting of hearing quality in both general populations to identify hearing disorders and populations with hearing loss.

2.
Tissue Eng Part B Rev ; 30(1): 15-28, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-37440318

RESUMO

The incidence and prevalence of hearing loss is increasing globally at an accelerated pace. Hair cells represent the sensory receptors of auditory and vestibular systems. Hair cell absence, loss or degeneration due to congenital diseases, trauma, toxicity, infection or advancing age, results in disabling hearing loss. Regenerative medicine approaches consisting in stem cell-based hair cell rescue or regeneration, gene therapy, as well as cell and tissue engineering are expected to dramatically improve the therapeutic arsenal available for addressing hearing loss. Current strategies that are using different stem cell types to rescue or to induce hair cell proliferation and regeneration are presented. Gene and cell therapy methods that modulates transdifferentiation of surrounding cell types into hair cells are presented, together with their specific advantages and limitations. Several modalities for improving therapeutic targeting to the inner ear such as nanoparticle-mediated cell and gene delivery are introduced. Further steps in building more relevant high-throughput models for testing novel drugs and advanced therapies are proposed as a modality to accelerate translation to clinical settings.


Assuntos
Surdez , Perda Auditiva , Humanos , Regeneração , Perda Auditiva/terapia , Perda Auditiva/metabolismo , Surdez/metabolismo , Surdez/terapia , Células Ciliadas Auditivas/metabolismo , Células-Tronco
3.
Medicina (Kaunas) ; 59(8)2023 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-37629718

RESUMO

Polymicrobial meningitis is a rare entity in the adult population, especially in the antibiotic era. However, disorders such as chronic suppurative otitis media (CSOM) or even poor oral hygiene are considered risk factors for the development of such cerebral infection. We report a case of polymicrobial meningitis associated with oto-mastoiditis in a 64-year-old female patient known to have CSOM. The patient presented atypical symptoms for community-acquired meningitis, showing subacute evolution of headache, without fever or neck stiffness. The aerobe microorganisms Streptococcus anginosus and Corynebacterium spp., sensitive to beta-lactamines, and the anaerobe Prevotella spp., resistant to penicillin and metronidazole, were isolated from CSF specimens, while Proteus mirabilis and Enterococcus faecalis were identified from the ear drainage. The diversity of pathogens identified in our case led us to the hypothesis of two different sources of meningitis: otogenic and/or odontogenic. Favorable evolution was obtained after a multi-disciplinary approach, combining surgery and broad-spectrum antibiotics. In addition, we performed a literature review that highlights the low incidence of polymicrobial mixed aerobe-anaerobe meningitis.


Assuntos
Meningites Bacterianas , Otite Média Supurativa , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Otite Média Supurativa/complicações , Meningites Bacterianas/complicações , Meningites Bacterianas/diagnóstico , Meningites Bacterianas/tratamento farmacológico , Pacientes , Antibacterianos/uso terapêutico , Drenagem
4.
Front Immunol ; 14: 1210961, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37600827

RESUMO

Background: Fully mature monocytes that express CD14, but not CD16, undergo phagocytosis within tissues, whereas non-classical monocytes, CD14-low CD16+, represent <11% of peripheral monocytes and have primary pro-inflammatory functions. Inflammation plays a major role in Covid-19 disease and adds to the inflammation caused by chronic hemodialysis. The aim of our study was to monitor monocyte subsets in five patients with end-stage kidney disease (ESKD) over a 1-year period after a mild Covid-19 infection. Five ESKD patients with a mild Covid-19 infection were monitored using CD14, CD16, CD300e, HLA-DR, CD64, and CD45 panels using a BD FACS Canto flow cytometer. Results: CD14-low CD16+ was dramatically (p=0,001) decreased in patients during Covid-19 infection, as previously described for patients without chronic renal failure. In addition, CD14-low CD16+ monocytes remained decreased for 10 months after recovery from Covid. Intermediate monocytes increased during Covid-19 infection and decreased 10 months after infection but this subtype of monocytes retained their inflammatory activity with a significant increase in HLA-DR expression after recovery from Covid infection. Conclusion: Our study shows that ESKD patients had a pro-inflammatory profile induced by Covid 19, but this status was prolonged significantly over a 10-month period. Thus, advanced renal failure treated by hemodialysis did not dramatically change the inflammatory response against to SARS Covid 2. It seems that monocytes retain their inflammatory status for many months in ESKD patients after a Covid-19 infection.


Assuntos
COVID-19 , Falência Renal Crônica , Humanos , Monócitos , SARS-CoV-2 , Diálise Renal , Falência Renal Crônica/terapia , Inflamação
5.
Medicina (Kaunas) ; 59(6)2023 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-37374261

RESUMO

Background and Objectives: The internal carotid artery (ICA) is a vascular structure that can be easily injured during sinus endoscopic procedures, and surgeons should be familiar with its anatomic variants. The aim of this study was to describe the anatomical variations in the internal carotid artery in relationship to sphenoidal sinuses, using computed tomography (CT). Materials and Methods: In this retrospective study, we evaluated the variations of the ICA in relationship to sphenoidal sinuses in a cohort of 600 patients who were assessed between January 2020 and December 2022 in 'Saint Spiridon' Emergency Hospital, Iasi, Romania. Descriptive statistics were used to characterize our data. Results: The most prevalent anatomical variant was represented by intrasinusal septa with posterior insertion on the ICA (58.6%), followed by procident ICA (58%) and dehiscent ICA (52%). We could not find any statistical significance regarding demographic characteristics among groups. Conclusions: A thorough CT examination should be performed before functional endoscopic sinus surgery, with the identification of anatomical variants of the ICA, in order to prevent its injury with potentially fatal consequences.


Assuntos
Artéria Carótida Interna , Seios Paranasais , Humanos , Estudos Retrospectivos , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/cirurgia , Seios Paranasais/cirurgia , Seio Esfenoidal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
6.
Medicina (Kaunas) ; 59(3)2023 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-36984588

RESUMO

Introduction and Background: Based on stem cells, bioactive molecules and supportive structures, regenerative medicine (RM) is promising for its potential impact on field of hearing loss by offering innovative solutions for hair cell rescue. Nanotechnology has recently been regarded as a powerful tool for accelerating the efficiency of RM therapeutic solutions. Adipose-derived mesenchymal cells (ADSCs) have already been tested in clinical trials for their regenerative and immunomodulatory potential in various medical fields; however, the advancement to bedside treatment has proven to be tedious. Innovative solutions are expected to circumvent regulatory and manufacturing issues related to living cell-based therapies. The objectives of the study were to test if human primary ADSCs preconditioned with magnetic nanoparticles coated with citric acid and functionalized with antioxidant protocatechuic acid (MNP-CA-PCA) retain their phenotypic features and if conditioned media elicit immune responses in vitro. MNP-CA-PCA was synthesized and characterized regarding size, colloidal stability as well as antioxidant release profile. Human primary ADSCs preconditioned with MNP-CA-PCA were tested for viability, surface marker expression and mesenchymal lineage differentiation potential. Conditioned media (CM) from ADSCs treated with MNP-CA-PCA were tested for Il-6 and IL-8 cytokine release using ELISA and inhibition of lectin-stimulated peripheral blood monocyte proliferation. Results: MNP-CA-PCA-preconditioned ADSCs display good viability and retain their specific mesenchymal stem cell phenotype. CM from ADSCs conditioned with MNP-CA-PCA do not display increased inflammatory cytokine release and do not induce proliferation of allergen-stimulated allogeneic peripheral blood monocytes in vitro. Conclusions: While further in vitro and in vivo tests are needed to validate these findings, the present results indicated that CM from ADSCs preconditioned with MNP-CA-PCA could be developed as possible cell-free therapies for rescuing auditory hair cells.


Assuntos
Audiologia , Nanopartículas de Magnetita , Humanos , Tecido Adiposo/metabolismo , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Antioxidantes/metabolismo , Meios de Cultivo Condicionados/farmacologia , Nanopartículas de Magnetita/uso terapêutico , Citocinas/metabolismo , Proliferação de Células , Diferenciação Celular
7.
Diagnostics (Basel) ; 12(7)2022 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-35885504

RESUMO

The maxillary sinus is a structure at the border of specialties: otorhinolaryngology and maxillofacial surgery. Due to this fact, regarding etiology, it can be affected by both the rhinogenic and odontogenic path and can impose diagnostic difficulties. The etiopathogenic mechanisms that can affect the Schneiderian membrane are mainly inflammatory, iatrogenic, traumatic, and tumorous in nature. From a microbiological point of view, the bacteriology is polymorphic, including both aerobic and anaerobic species in acute OS, the predominating species in acute OS being aerobic, and in chronic anaerobic germs. The role of fungi in the determination of this pathology and in the production of the biofilm that leads to resistance to antibiotic treatment is also discussed. The present paper aims to present the etiopathogenesis, bacteriology, clinical manifestations, as well as treatment of odontogenic sinusitis (OS) from an updated perspective through reviewing the literature. If unilateral maxillary sinusitis is usually due to odontogenic causes, this does not clinically exclude the possibility of strictly rhinogenic causes in the occurrence of sinusitis. This underlines the important role of complex oral and rhinological clinical examination as well as the role of preclinical examinations in specifying the certainty diagnosis. Simple radiography, orthopantomography, CT, and CBCT are compared in terms of diagnostic accuracy. The treatment of OS is complex, involving medication, dental, and surgical measures. The value of endoscopic surgery is emphasized, comparing its advantages over the classic Caldwell-Luc technique.

8.
Healthcare (Basel) ; 11(1)2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36611533

RESUMO

Quality of life is a widely used concept that tends to become an important part of clinical management. The present study performs an analysis of the impact of suppurative chronic otitis media with and without cholesteatoma on quality of life, using the COMQ-12 questionnaire. It was applied to a group of 40 healthy people and to 40 patients before surgery, and the answers to the questions were analyzed and correlated with socioeconomic factors. After the confirmation of the diagnosis based on clinical and imaging information, the patients completed the COMQ-12 questionnaire. It was observed that the chronic ear problems had negative impacts of varying degrees on daily and long-term activities. The evaluation and analysis of information can be used in setting therapeutic targets.

9.
Exp Ther Med ; 22(5): 1226, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34539822

RESUMO

Inflammatory mediators play an important role in the pathogenesis of otitis media by initiating and maintaining an inflammatory response to infection. The presence of inflammatory mediators may be one of the reasons, in some patients, for acute otitis media transforming into chronic otitis media. The present study included 60 patients admitted to the Clinical Rehabilitation Hospital, Iasi, Romania, for surgery. The control group comprised 30 healthy individuals. Serum levels of interleukin 1α (IL-1α), interleukin 6 (IL-6) and interleukin 8 (IL-8) were measured prior to surgery and were compared among patients with chronic suppurative otitis media (CSOM), cholesteatoma and cholesteatoma recidivism and the control group. High serum levels of interleukins were recorded in all the groups compared to the healthy control group. IL-6 and IL-8 had the highest value in patients with CSOM and IL-1α had the highest value in patients with cholesteatoma recidivism. Thus, we can consider that inflammatory mediators play a central role in the pathogenesis of CSOM and cholesteatoma by maintaining a systemic and local inflammatory response.

10.
Molecules ; 26(16)2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34443480

RESUMO

Within this study, new materials were synthesized and characterized based on polysiloxane modified with different ratios of N-acetyl-l-cysteine (NAC) and crosslinked via UV-assisted thiol-ene addition, in order to obtain efficient membranes able to resist bacterial adherence and biofilm formation. These membranes were subjected to in vitro testing for microbial adherence against S. pneumoniae using standardized tests. WISTAR rats were implanted for 4 weeks with crosslinked siloxane samples without and with NAC. A set of physical characterization methods was employed to assess the chemical structure and morphological aspects of the new synthetized materials before and after contact with the microbiological medium.


Assuntos
Antibacterianos/química , Materiais Revestidos Biocompatíveis/química , Implantes Cocleares/microbiologia , Otite/tratamento farmacológico , Polímeros/química , Siloxanas/química , Acetilcisteína/química , Acetilcisteína/farmacologia , Acetilcisteína/uso terapêutico , Animais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Aderência Bacteriana/efeitos dos fármacos , Biofilmes/efeitos dos fármacos , Materiais Revestidos Biocompatíveis/farmacologia , Materiais Revestidos Biocompatíveis/uso terapêutico , Implantes Cocleares/efeitos adversos , Polímeros/farmacologia , Polímeros/uso terapêutico , Ratos Wistar , Siloxanas/farmacologia , Siloxanas/uso terapêutico , Streptococcus pneumoniae/efeitos dos fármacos , Compostos de Sulfidrila/química , Propriedades de Superfície
11.
Genes (Basel) ; 11(12)2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33333757

RESUMO

BACKGROUND: We have investigated the main genetic causes for non-syndromic hearing impairment (NSHI) in the hearing impairment individuals from the North-Eastern Romania and proposed a cost-effective diagnosis protocol. METHODS: MLPA followed by Sanger Sequencing were used for all 291 patients included in this study. RESULTS: MLPA revealed abnormal results in 141 cases (48.45%): 57 (40.5%) were c.35delG homozygous, 26 (18.44%) were c.35delG heterozygous, 14 (9.93%) were compound heterozygous and 16 (11.35%) had other types of variants. The entire coding region of GJB2 was sequenced and out of 150 patients with normal results at MLPA, 29.33% had abnormal results: variants in heterozygous state: c.71G>A (28%), c.457G>A (20%), c.269T>C (12%), c.109G>A (12%), c.100A>T (12%), c.551G>C (8%). Out of 26 patients with c.35delG in heterozygous state, 38.46% were in fact compound heterozygous. CONCLUSIONS: We identified two variants: c.109G>A and c.100A>T that have not been reported in any study from Romania. MLPA is an inexpensive, rapid and reliable technique that could be a cost-effective diagnosis method, useful for patients with hearing impairment. It can be adaptable for the mutation spectrum in every population and followed by Sanger sequencing can provide a genetic diagnosis for patients with different degrees of hearing impairment.


Assuntos
Perda Auditiva/genética , Reação em Cadeia da Polimerase Multiplex , Adolescente , Adulto , Audiometria/métodos , Criança , Pré-Escolar , Conexina 26/genética , Análise Custo-Benefício , Feminino , Estudos de Associação Genética , Genótipo , Perda Auditiva/diagnóstico , Perda Auditiva/economia , Perda Auditiva/epidemiologia , Perda Auditiva Bilateral/genética , Humanos , Lactente , Masculino , Programas de Rastreamento , Proteínas de Membrana/genética , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex/economia , Mutação Puntual , Romênia/epidemiologia , Análise de Sequência de DNA , Adulto Jovem
12.
Rom J Morphol Embryol ; 61(1): 113-119, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32747901

RESUMO

Vestibular sensorial input is essential for psychomotor development of the very small children. In consequence, possible vestibular impairment induced by cochlear implantation in deaf children could affect the balance and walking learning process. Some of cochlear implanted children can present congenital vestibular deficit. The anatomical and embryological relation between auditory and vestibular system explains why congenital neurosensorial hearing loss may associate vestibular impairment. The cochlear implant surgery presents a vestibular lesion risk. Bilateral vestibulopathy, as it appears in early childhood, has a poor prognosis for the psychomotor and cognitive development. Even probably rare, bilateral vestibulopathy induced by simultaneous bilateral cochlear implantation can delay the acquisition of motor skills. This pathology can be avoided by an appropriate surgical indication related to the vestibular preoperative status. This study reports the vestibular saccular functional modifications after the cochlear implantation in children. The cervical vestibular evoked myogenic potentials (cVEMPs) were performed in children before and after the cochlear implantation. Since previous studies report different vestibular impairment related to the portelectrode insertion approach, another objective of our study was to assess the saccular postoperative status depending of the insertion by cochleostomy (CO) or through the round window (RW). We performed cVEMPs for 80 patients (135 cochlear implanted ears) before and after cochlear implantation. We have detected preoperative saccular areflexia in 33 (24.4%) ears. In the group of 102 (75.6%) ears with preoperative normal saccular function, 72 (70.6%) ears preserved the cVEMP response after the surgery, while in 30 (29.4%) ears the cVEMP response was lost. Reporting our findings to the portelectrode insertion method, we found normal saccular function in 73.3% of the cochlear implanted ears by RW surgical approach and in 68.42% ears by CO approach. These results suggest that the RW portelectrode insertion is the recommended strategy in order to avoid the saccular vestibular impairment.


Assuntos
Implante Coclear/métodos , Surdez/cirurgia , Sáculo e Utrículo/fisiopatologia , Pré-Escolar , Feminino , Humanos , Masculino
13.
Rom J Morphol Embryol ; 60(3): 769-773, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31912085

RESUMO

BACKGROUND: Human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) has been recognized as a distinct disease entity associated with oral HPV infection with high-risk serotypes, mainly among white man at younger age. Lifetime number of oral sex partners of HPV-positive OPSCC patients is the strongest risk factor associated. HPV type 16 is now established as oncogenic and it is the main cause (over the 80%) of this type of OPSCC, followed by HPV 18 (3%). Nowadays, it is reported a dramatic rising of HPV-positive OPSCC, mainly in developed countries, including Australia, Canada, Denmark, Netherlands, Norway, Sweden, Poland, Slovakia, Switzerland, Estonia, France, Japan, United States (US) and United Kingdom. At present, the yearly number of new incidence OPSCC cases given to HPV worldwide has been estimated of 29 000 by the International Agency for Research on Cancer (IARC). If incidence trends continue, the annual number of HPV-positive oropharyngeal cancers is expected to overcome the annual number of cervical cancers by the year 2020, in the US. AIM: The aim of this paper is to review the recent data about several topics including risk factors of HPV-positive OPSCCs, guidelines in diagnostic evaluation, treatment, prognosis and prevention strategies, through prophylactic HPV vaccine on both sexes. Nowadays, HPV detection is a clinical standard of care for oropharyngeal malignancy by reporting tumors as HPV positive or p16 positive.


Assuntos
Neoplasias Orofaríngeas/virologia , Papillomaviridae/patogenicidade , Infecções por Papillomavirus/complicações , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
Rom J Morphol Embryol ; 60(3): 793-802, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31912089

RESUMO

Pathological wound healing states, such as hypertrophic scarring and keloids, represent a huge clinical and financial burden on healthcare system. The complex biological mechanisms occurring in hypertrophic scarring are still barely understood. To date, there is no satisfactory description of hypertrophic fibroblasts. Therefore, in the present study we focused on the comparatively characterization of the fibroblasts residing in different regions of hypertrophic scars. To achieve this aim, fibroblasts were isolated from normal skin samples (n=4) and hypertrophic scars (n=4). These cell populations were further were used for the evaluation of proliferation and migration capacity, for the gene and protein expression of extracellular matrix protein type I collagen and fibronectin and for the presence of myofibroblasts. Our results demonstrated that perilesional and intralesional fibroblasts isolated from hypertrophic scars could be considered as distinct populations, having different properties. Thus, the intralesional fibroblasts had an increased proliferation capacity and increased gene and protein expression of collagen I and fibronectin. However, the perilesional fibroblasts had augmented mobility as revealed by in vitro scratch test and contained a higher percentage of myofibroblasts [alpha-smooth muscle actin (α-SMA)high cells], in comparison to the intralesional population. In conclusion, our data could provide an explanation regarding the inconsistent efficacy of topic therapies for hypertrophic scars.


Assuntos
Fibroblastos/metabolismo , Pele/fisiopatologia , Cicatriz Hipertrófica/patologia , Humanos , Imuno-Histoquímica , Queloide/patologia
15.
Rom J Morphol Embryol ; 60(3): 853-859, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31912096

RESUMO

The aim of this study is to enhance knowledge regarding the behavior of human papilloma virus (HPV)-associated malignancies between two territories - maxillofacial and otorhinolaryngology. The HPV status and genotype, p16 and p53 expression were performed in 50 patients with malignancies located at the junction between the oropharynx and retromolar trigone alone or oropharynx spread to the junction. These were correlated with the treatment response, prognosis and survival of this kind of tumor located in oral posterior region, marking the transition between two territories (maxillofacial and otorhinolaryngology) of the selected cases. Results showed better treatment outcome and improved prognosis in HPV-positive compared to HPV-negative patients, and a strong link between HPV presence and p16 expression. Multimodal treatment including surgery, radiotherapy and chemotherapy provided the best results, although surgery was only an option in a limited number of cases, due to the advanced stage at presentation and extension in the surrounding tissues, considering the complex anatomy of the area. In the context of the increasing incidence of HPV-positive head and neck cancer, HPV testing together with molecular profiling for p16 and p53 tumor markers could help diagnose malignancies in the initial stages, and also provide important clues towards a targeted, more efficient treatment.


Assuntos
Carcinoma de Células Escamosas/genética , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Neoplasias Orofaríngeas/genética , Proteína Supressora de Tumor p53/metabolismo , Adulto , Idoso , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Orofaríngeas/patologia , Prognóstico
16.
J Clin Hypertens (Greenwich) ; 20(11): 1587-1594, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30295011

RESUMO

Accumulating evidence indicates that higher levels of salt intake are associated with higher blood pressure levels. The aim of our analysis was to test the hypothesis that the effect of urinary sodium excretion (UNaV) on systolic blood pressure (SBP) is mediated through estimated glomerular filtration rate (eGFR) and arterial stiffness and also to test the direction of the relationship between eGFR and arterial stiffness, in both hypertensive and normotensive patients. We assessed the potential for connection between UNaV and SBP and mediators (eGFR and pulse wave velocity [PWV]) of this relationship using structural equation models of data from 1599 adults ≥18 years of age and without chronic kidney disease who participated in the Third Epidemiologic Study concerning the Prevalence of Arterial Hypertension and Cardiovascular Risk in Romania (SEPHAR III). In hypertensive patients, the indirect effect, mediated through PWV, of UNaV on SBP was 23.9% and 27.7% of the total effect of UNaV on SBP, while in normotensive patients the contribution of PWV to the total effect of UNaV on SBP was slightly lower (15.9% and 18.3% of the total effect of UNaV on SBP). Taken together, our findings support the conclusion that UNaV influences SBP, both directly and indirectly, through the effect on PWV.


Assuntos
Hipertensão/fisiopatologia , Cloreto de Sódio na Dieta/efeitos adversos , Sódio/efeitos adversos , Rigidez Vascular/fisiologia , Adulto , Idoso , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial/métodos , Doenças Cardiovasculares/epidemiologia , Sistema Cardiovascular/fisiopatologia , Taxa de Filtração Glomerular , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Pessoa de Meia-Idade , Análise de Onda de Pulso/métodos , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/fisiopatologia , Fatores de Risco , Romênia/epidemiologia , Sódio/administração & dosagem , Sódio/urina , Cloreto de Sódio na Dieta/administração & dosagem , Sístole
17.
Rom J Morphol Embryol ; 59(1): 105-112, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29940617

RESUMO

Patients with hearing loss who underwent cochlear implantation can present symptomatic or asymptomatic vestibular damages earlier or later after the surgery. The vestibular permanent lesions could be acute, produced by surgical trauma or could be progressive due to local morphological changes made by the presence of the portelectrode in the inner ear (fibrosis related, ossification, basilar membrane distortion, endolymphatic hydrops). Besides histopathological findings in inner ear of cochlear implanted patients, the vestibular permanent damages could be found by assessment of clinical vestibular status. This study reports the sensorial vestibular functional findings for adults in cochlear implanted ears related to the electrode insertion type (cochleostomy or round window approach) and comparing to non-implanted deaf ears. A total of 20 adult patients with 32 cochlear implanted ears (12 patients with binaural cochlear implant and eight with monoaural) were selected for postoperatory vestibular examination by cervical and ocular vestibular myogenic potentials and vestibular caloric tests. The same tests were made for a control group of 22 non-implanted deaf ears. Functional testing results were reported related to the electrode insertion approach. For the cochleostomy group, we found different deficits: in 40% for saccular function, 44% for utricular function, and 12% horizontal canal dysfunction. In round window group, the deficit was present in 14.29% for saccular function, 28.57% for utricular function, and 28.58% for horizontal canal. In 46.88% of implanted ears, the vestibular function was completely preserved on all tested sensors. In conclusion, the vestibular functional status after inner ear surgery presents sensorial damages in 53.12% ears compare with the vestibular dysfunction existing in 50% of deaf non-operated ears. Round window insertion allows for better conservation of the vestibular function.


Assuntos
Implante Coclear/métodos , Surdez/cirurgia , Orelha Interna/patologia , Perda Auditiva/cirurgia , Adolescente , Adulto , Idoso , Surdez/terapia , Feminino , Perda Auditiva/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
18.
Eur Arch Otorhinolaryngol ; 270(4): 1507-12, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23161275

RESUMO

Over the past decade, the adoption of universal hearing screening in newborns has led to earlier detection of hearing problems and significant lowering of the age of first cochlear implantation. As a consequence, recipients are now expected to keep their cochlear implants (CIs) for a longer period of time. Comprehensive longitudinal information on CI reliability is essential for device choice. The aim of this study was to assess the reliability (in children and adults) of the latest generation of the Digisonic(®) SP CI launched in 2006 by Neurelec. Failure rate (FR) and cumulative survival rate (CSR) for a 5-year period were calculated. This survey is a multicenter retrospective study. A questionnaire was sent to nine CI centers requesting information about patients implanted with Neurelec Digisonic(®) SP CIs. FR and CSR over a 5-year period were calculated on this group. Collaborating centers collected data on 672 patients (362 children and 310 adults) implanted between March 2006 and March 2011. The overall rate of explantation was 2.23 % (15 cases): six devices were explanted due to device failure (0.89 %) and nine were explanted for medical reasons (1.34 %). Four patients were lost to follow-up. The CSR at 5 years was 98.51 % on all patients, 98.48 % for children and 98.57 % for adults. FR was 0.97 % for adults and 0.83 % for children. This first independent study that assesses FR and CSR on the current generation of Digisonic(®) SP CI represents an important resource that can help clinicians and patients during their device choice.


Assuntos
Implantes Cocleares , Desenho de Prótese , Adolescente , Adulto , Criança , Implante Coclear , Remoção de Dispositivo , Análise de Falha de Equipamento , Feminino , Humanos , Masculino , Reoperação , Estudos Retrospectivos , Inquéritos e Questionários , Análise de Sobrevida
19.
Int J Pediatr Otorhinolaryngol ; 76(1): 90-4, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22070872

RESUMO

OBJECTIVE: Hearing loss is one of the major public health problems, with a genetic etiology in more than 60% of cases. Connexin 26 and connexin 30 mutations are the most prevalent causes of deafness. The aim of this study is to characterize and to establish the prevalence of the GJB2 and GJB6 gene mutations in a population of cochlear implanted recipients from Eastern Romania, this being the first report of this type in our country. METHODS: We present a retrospective study that enrolled 45 Caucasian cochlear implanted patients with non-syndromic sensorineural severe to profound, congenital or progressive with early-onset idiopathic hearing loss. We performed sequential analysis of exon 1 and the coding exon 2 of the GJB2 gene including also the splice sites and analysis of the deletions del(GJB6-D13S1830), del(GJB6-D13S1854) and del(chr13:19,837,343-19,968,698). RESULTS: The genetic analysis of the GJB2 gene identified connexin 26 mutations in 22 patients out of 45 (12 homozygous for c.35delG, 6 compound heterozygous and 4 with mutations only on one allele). We found 6 different mutations, the most prevalent being c.35delG - found on 32 alleles, followed by p.W24* - found on 2 alleles. We did not identify the deletions del(GJB6-D13S1830), del(GJB6-D13S1854) and del(chr13:19,837,343-19,968,698). CONCLUSIONS: Although the most prevalent mutation was c.35delG (80% from all types of mutations), unexpectedly we identified 5 more different mutations. The presence of 6 different mutations on the GJB2 gene has implications in hearing screening programs development in our region and in genetic counseling.


Assuntos
Implantes Cocleares , Conexinas/genética , Perda Auditiva Neurossensorial/genética , Perda Auditiva Neurossensorial/cirurgia , Mutação/genética , Criança , Pré-Escolar , Implante Coclear/métodos , Estudos de Coortes , Conexina 26 , Conexina 30 , Análise Mutacional de DNA , Feminino , Aconselhamento Genético , Predisposição Genética para Doença/epidemiologia , Perda Auditiva Neurossensorial/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Estudos Retrospectivos , Medição de Risco , Romênia/epidemiologia
20.
Rev Med Chir Soc Med Nat Iasi ; 115(3): 826-33, 2011.
Artigo em Romano | MEDLINE | ID: mdl-22046794

RESUMO

UNLABELLED: Nowadays. cochelar implant is the only choice of treatment in deep bilateral deafness. AIM: To evaluate the benefits of binaural implantation of a single receiver-stimulator device by using audiometric tests at 3 and 6 months intervals. MATERIAL AND METHODS: The study included 3 patients with bilateral sensorineural deafness of cochlear origin. Following implantation they were assessed by pure tone audiometry (PTA), speech audiometry (SA), and sound localization tests (LT). RESULTS: PTA showed a significant decrease in hearing thresholds level during the 6-month interval following implantation. As to the degree of speech discrimination in both quiet and noisy environment, SA showed evident progress at 6 months compared to the results at 3 month. The location tests revealed improved sound localization in both ears at 6 months compared to the results at 3 months. CONCLUSIONS: Compared to unilateral implant, the binaural cochlear implant has the advantage of stereophonic hearing, facilitating the communication through a better understanding of speech in both quiet and noisy environment, and improving the quality of life by the location of sounds similar to natural hearing.


Assuntos
Implante Coclear , Implantes Cocleares , Perda Auditiva Bilateral/cirurgia , Perda Auditiva Neurossensorial/cirurgia , Audiometria de Tons Puros , Audiometria da Fala , Implante Coclear/métodos , Seguimentos , Humanos , Localização de Som , Resultado do Tratamento
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