RESUMO
BACKGROUND: Clinically significant CKD following surgery for kidney cancer is associated with increased morbidity and mortality, but identifying patients at increased CKD risk remains difficult. Simple methods to stratify risk of clinically significant CKD after nephrectomy are needed. METHODS: To develop a tool for stratifying patients' risk of CKD arising after surgery for kidney cancer, we tested models in a population-based cohort of 699 patients with kidney cancer in Queensland, Australia (2012-2013). We validated these models in a population-based cohort of 423 patients from Victoria, Australia, and in patient cohorts from single centers in Queensland, Scotland, and England. Eligible patients had two functioning kidneys and a preoperative eGFR ≥60 ml/min per 1.73 m2. The main outcome was incident eGFR <45 ml/min per 1.73 m2 at 12 months postnephrectomy. We used prespecified predictors-age ≥65 years old, diabetes mellitus, preoperative eGFR, and nephrectomy type (partial/radical)-to fit logistic regression models and grouped patients according to degree of risk of clinically significant CKD (negligible, low, moderate, or high risk). RESULTS: Absolute risks of stage 3b or higher CKD were <2%, 3% to 14%, 21% to 26%, and 46% to 69% across the four strata of negligible, low, moderate, and high risk, respectively. The negative predictive value of the negligible risk category was 98.9% for clinically significant CKD. The c statistic for this score ranged from 0.84 to 0.88 across derivation and validation cohorts. CONCLUSIONS: Our simple scoring system can reproducibly stratify postnephrectomy CKD risk on the basis of readily available parameters. This clinical tool's quantitative assessment of CKD risk may be weighed against other considerations when planning management of kidney tumors and help inform shared decision making between clinicians and patients.
Assuntos
Nefrectomia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Insuficiência Renal Crônica/etiologia , Medição de Risco/métodos , Índice de Gravidade de Doença , Idoso , Idoso de 80 Anos ou mais , Medicina Baseada em Evidências , Feminino , Taxa de Filtração Glomerular , Humanos , Neoplasias Renais/cirurgia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
This study aimed to report the bone-anchored hearing aid uptake rate and the reasons for their rejection by patients with conductive and mixed hearing losses. A retrospective review was performed of 113 consecutive patients with unilateral or bilateral conductive or mixed hearing loss referred to the Greater Manchester bone-anchored hearing aid (BAHA) programme between September 2008 and August 2011. 98 (86.7 %) patients were deemed audiologically suitable for BAHA implantation. Of these, 38 (38.8 %) had BAHA implanted; 60 (61.2 %) patients declined. Of those who declined, 27 (45 %) cited anxiety over surgery, 18 (30 %) cited cosmetic reasons, 16 (26.7 %) perceived limited benefit from the device and six (10 %) preferred conventional hearing aids. Our study highlights a 38.8 % BAHA uptake rate in audiologically suitable patients. The main reasons cited for rejection of BAHA were anxiety over surgery and cosmetic concerns. It is important that clinicians address these early during consultation with prospective BAHA recipients and avoid rushing to implant these patients with a bone-anchored hearing aid.
Assuntos
Auxiliares de Audição/psicologia , Perda Auditiva Condutiva/psicologia , Perda Auditiva Condutiva-Neurossensorial Mista/psicologia , Próteses e Implantes/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Perda Auditiva Condutiva/reabilitação , Perda Auditiva Condutiva-Neurossensorial Mista/reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: To present a structured approach for an outpatient consultation of a child with facial paralysis. METHOD: Review of literature and description of approach followed in our unit. CONCLUSION: A focused history and examination is key to establish the cause and draw a management plan for paediatric facial paralysis.
Assuntos
Paralisia Facial/etiologia , Paralisia Facial/terapia , Anamnese , Exame Físico , Paralisia de Bell/diagnóstico , Paralisia de Bell/tratamento farmacológico , Contagem de Células Sanguíneas , Encéfalo/patologia , Criança , Paralisia Facial/classificação , Glucocorticoides/administração & dosagem , Testes Auditivos , Humanos , Imageamento por Ressonância Magnética , Soluções Oftálmicas/uso terapêutico , Prednisolona/administração & dosagem , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
This study aimed to investigate the relationship between outcome following cochlear implantation and auditory cortical activation. It also studied the effects of length of implant use and duration of deafness on the auditory cortical activations. Cortical activity resulting from auditory stimulation was measured using [(18)F]FDG positron emission tomography. In a group of 18 experienced adult cochlear implant users, we found a positive correlation between speech perception and activations in both the primary and association auditory cortices. This correlation was present in a subgroup of experienced implant users but absent in a group of new implant users with similar speech perception abilities. There was a significant negative correlation between duration of deafness and auditory cortical activation. This study gives insights into the relationship between implant speech perception and auditory cortical activation and the influence of duration of preceding deafness and implant experience.
Assuntos
Córtex Auditivo/fisiologia , Implantes Cocleares/psicologia , Surdez/fisiopatologia , Percepção da Fala/fisiologia , Estimulação Acústica , Adolescente , Adulto , Idoso , Surdez/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de PósitronsRESUMO
OBJECTIVES: To quantify rates of non- and partial-use of cochlear implants (CIs) in adolescent patients implanted in adolescence and childhood and identify factors influencing compliance. METHODS: A retrospective case note review undertaken at The Manchester Auditory Implant Centre. Adolescents were defined as young people aged 11-18 years. Individuals implanted in adolescence were defined as Group 1, individuals implanted in childhood under the age of 3 years and currently adolescents were defined as Group 2 and individuals implanted between the age of 3 and11 years and currently adolescents were defined as Group 3. Non-use was defined as not using the CI at all and partial use was defined as consistently using the CI less than full-time, or fluctuating periods of full and less than full-time use. RESULTS: In Group 1 there was 1 non-user (1.3%) and 11 partial-users (13.9%), with an overall non-compliance rate of 15.2%. In Group 2 there was one non-user (1.9%) and one partial-user (1.9%) with an overall non-compliance rate of 3.8%. In Group 3 there were no non-users and eight partial-users (9%), with an overall non-compliance rate of 9%. The factors influencing compliance differed between groups with the most common factor in Group 1 being a preference for the auditory input gained from the contralateral hearing aid (50%). In Groups 2 and 3 the main factors influencing compliance were behavioural and related to wearing the implant only at school (50 and 75%, respectively). CONCLUSIONS: Patients implanted during adolescence have higher rates of non- and partial-use compared with their adolescent counterparts who have been implanted during childhood. It is important to investigate factors influencing non-compliance so appropriate support may be provided to the patient and their family.
Assuntos
Implante Coclear/psicologia , Implantes Cocleares/psicologia , Surdez/cirurgia , Cooperação do Paciente/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Fatores Etários , Criança , Pré-Escolar , Feminino , Auxiliares de Audição/psicologia , Humanos , Lactente , Masculino , Preferência do Paciente , Estudos RetrospectivosRESUMO
When cultures of fibroblast-like cells from inbred mouse strains RBC/Dn and AEJ/GnRk were exposed to 5-fluorodeoxyuridine (FUdR), non-random strain-specific distributions of chromosome gaps, breaks and exchanges were observed. Throughout the genomes there appeared to be specific sites at which lesions occurred preferentially. Two strain-specific fragile sites were identified in strain RBC/Dn at G-band 15A2, and at G-band 19B in strain AEJ/GnRk. Constitutive fragile sites at G-bands 12A2 and 18A2 were identified in both strains. A strain-specific marker at G-band 9B was found in strain AEJ/GnRk. The fragile sites reported here provide an animal model for the study of chromosome fragility as well as polymorphic markers for linkage studies.
Assuntos
Fragilidade Cromossômica , Camundongos Endogâmicos/genética , Animais , Células Cultivadas , Bandeamento Cromossômico , Sítios Frágeis do Cromossomo , Floxuridina/farmacologia , Marcadores Genéticos , Camundongos , Especificidade da EspécieRESUMO
The incidence of sister chromatid exchange was determined in human leucocyte cultures treated with methylazoxymethanol acetate. In all individuals examined, treated cultures manifested a significantly higher frequency of sister chromatid exchanges than controls. Two concentrations of MAM AC were tested in blood cultures from nine individuals. The concentrations varied from individual to individual since they were determined by means of individual dose-response curves, which involved [3H]-thymidine incorporation in PHA-stimulated short-term lymphocyte cultures versus MAM AC contraction. The lower concentration was less than the TD50 dose. Compared to control cultures, the lower concentration caused a higher incidence of sister chromatid exchange in eight of nine individuals. The cumulative mean value for all control cultures was 5.32 exchanges per cell while that for cultures treated with the higher concentration was 10.73.
Assuntos
Compostos Azo/farmacologia , Troca Genética , Acetato de Metilazoximetanol/farmacologia , Adulto , Células Cultivadas , Aberrações Cromossômicas , Relação Dose-Resposta a Droga , Humanos , Leucócitos/efeitos dos fármacos , MasculinoRESUMO
OBJECTIVE: This study describes our experience of cochlear implantation (CI) with hearing preservation in adolescents. Our aim was to determine if hearing preservation is successful in this population, if the preserved hearing is maintained, and what the potential benefit of preserving hearing in this population is. PATIENTS: Fourteen profoundly deaf adolescents with preservation of low-frequency hearing (125, 250, and 500 Hz). INTERVENTION: Twelve adolescents had a single-sided CI, and two had bilateral CI. All were having their first implantation, and all patients had hearing preservation surgery (soft surgery). MAIN OUTCOME MEASURES: Hearing preservation was measured with preoperative and postoperative pure-tone audiograms. Speech audiometry was performed before implantation and at subsequent follow-up appointments. RESULTS: Hearing preservation (measurable hearing thresholds) was achieved in 13 of 14 patients. Average follow-up was 2 years 10 months (range, 4 mo-4 yr 9 mo). Three of 13 patients with initial successful hearing preservation had deterioration of their hearing at subsequent follow-up. The addition of naturally preserved hearing to the cochlear implant improved speech audiometry scores compared with using the implants in isolation. CONCLUSION: This study demonstrates that residual hearing can be consistently preserved and maintained in adolescents during the short-/medium-term using a soft surgical technique to insert standard-length electrodes. The potential benefit of preserving residual low-frequency hearing seems to be improvement in speech discrimination in challenging hearing conditions, although larger studies are required.
Assuntos
Implante Coclear/métodos , Perda Auditiva Neurossensorial/cirurgia , Audição/fisiologia , Adolescente , Audiometria de Tons Puros , Audiometria da Fala , Limiar Auditivo/fisiologia , Criança , Implantes Cocleares , Feminino , Humanos , Masculino , Período Pós-Operatório , Estudos Retrospectivos , Percepção da FalaRESUMO
OBJECTIVE: To examine the outcome of cochlear implantation in children with syndromic deafness, who are increasingly being considered for cochlear implants and who represent a unique challenge to the cochlear implant team. METHOD: In this retrospective case series in a tertiary referral cochlear implant centre, we describe a series of 38 children with a clinical syndrome causing deafness who have undergone cochlear implantation. The outcome measures are Bench-Kowal-Bamford (BKB) speech reception score (range 0-100%) and speech perception ability using the Geers and Moog Speech Reception Score (SRS) (range from 0; no speech perception, to 6; open set recognition of words). RESULTS: The syndromes identified were Waardenburg syndrome (n = 10), Usher syndrome (n = 9), Pendred syndrome (n = 7), Jervell and Lange-Nielsen syndrome (n = 5), CHARGE syndrome (n = 2), and 1 each of Stickler, CINCA (Chronic Infantile Neurological Cutaneous and Articular), Bartter, Down, and Donnai-Barrow syndromes. After a minimum of 19 months following implantation, BKB was measurable in 20 of 38 patients, and ranged from 46 to 100% in quiet (median 87%, mean 81%). Eighteen children (55%) achieved a SRS at level six, and a further 8 (24%) achieved level five. There was significant variation of outcome between and within syndrome groups. CONCLUSIONS: Additional disabilities are frequently encountered when considering children for cochlear implantation, and may be part of a recognised syndrome. Outcome is often excellent but can be variable even within the same syndrome group, and such children are therefore assessed on an individual basis to ensure a realistic expectation.
Assuntos
Anormalidades Múltiplas/cirurgia , Implante Coclear , Perda Auditiva Neurossensorial/complicações , Perda Auditiva Neurossensorial/terapia , Anormalidades Múltiplas/patologia , Anormalidades Múltiplas/psicologia , Adolescente , Criança , Pré-Escolar , Implante Coclear/reabilitação , Implantes Cocleares , Feminino , Perda Auditiva Neurossensorial/patologia , Humanos , Masculino , Estudos Retrospectivos , Percepção da Fala , Síndrome , Resultado do TratamentoRESUMO
OBJECTIVE AND IMPORTANCE: Charcot-Marie-Tooth (CMT) disease is the most common hereditary motor and sensory neuropathy and can result in profound sensori-neural hearing loss with deficiency in speech perception out of proportion to that which would be expected if the loss was cochlear in origin. This study investigates whether the reintroduction of auditory synchrony by means of cochlear implantation will improve speech perception in those with dys-synchrony related to impairment of temporal processing abilities secondary to CMT. CLINICAL PRESENTATION: A 67-year-old male presented with a gradual but significant decrease in his hearing as part of a slowly progressing demyelinating peripheral neuropathy. On open-set speech discrimination he scored 0%. INTERVENTION: A Med-el Flex(SOFT) cochlear implant (CI) was fully inserted into the left ear with no surgical complications. The CI speech processor was fitted 1 month post-implantation and standardized speech assessments conducted at 1 week, 3 months, 9 months, and 21 months following initial fitting, gave open-set speech discrimination scores of 0, 0, 53, and 54%, respectively. CONCLUSION: This report demonstrates that cochlear implantation is an option to rehabilitate severe-to-profound hearing loss in adults with auditory dys-synchrony secondary to CMT disease. Progress post-implantation is likely to be slower than for the average CI user.
Assuntos
Transtornos da Percepção Auditiva/cirurgia , Doença de Charcot-Marie-Tooth/cirurgia , Implante Coclear/métodos , Surdez/cirurgia , Percepção da Fala , Idoso , Audiometria de Tons Puros , Implantes Cocleares , Potenciais Microfônicos da Cóclea , Seguimentos , Humanos , Masculino , Emissões Otoacústicas Espontâneas , Desenho de Prótese , Reflexo Acústico , Testes de Discriminação da FalaRESUMO
OBJECTIVE AND IMPORTANCE: Jervell and Lange-Nielsen (JLN) syndrome is a rare cause of congenital profound hearing loss associated with a prolonged QT interval on the electrocardiogram. Children presenting for cochlear implantation with this condition may be asymptomatic but are at risk of sudden death. SCREENING AND SUBSEQUENT: careful management is therefore required to ensure a successful outcome. We present our experience of cochlear implantation in children with JLN syndrome, including two who died unexpectedly, and suggest a protocol for management of such cases. Clinical presentation Four cases of cochlear implantation in JLN syndrome are described. None had any previous cardiological family history. Two were diagnosed pre-operatively but, despite appropriate management under a cardiologist, died from cardiac arrest; the first in the perioperative period following reimplantation for infection, and the second unrelated to his cochlear implant surgery. The other two patients were diagnosed only subsequent to their implantation and continue to use their implants successfully. CONCLUSION: These cases highlight the variation in presentation of JLN syndrome, and the spectrum of disease severity that exists. Our protocol stresses the importance of careful assessment and counselling of parents by an experienced implant team.
Assuntos
Implante Coclear/métodos , Morte Súbita Cardíaca/etiologia , Doenças do Prematuro/cirurgia , Síndrome de Jervell-Lange Nielsen/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/mortalidade , Criança , Pré-Escolar , Protocolos Clínicos , Evolução Fatal , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Doenças do Prematuro/diagnóstico , Doenças do Prematuro/mortalidade , Síndrome de Jervell-Lange Nielsen/diagnóstico , Síndrome de Jervell-Lange Nielsen/mortalidade , Masculino , Programas de Rastreamento , Falha de Prótese , Infecções Relacionadas à Prótese/mortalidade , Infecções Relacionadas à Prótese/cirurgia , Reoperação , Fatores de RiscoRESUMO
OBJECTIVE AND IMPORTANCE: Donnai-Barrow syndrome is a rare autosomal recessive disorder associated with severe sensorineural hearing loss (SNHL). Several ocular abnormalities have also been described in this syndrome, including hypertelorism, down-slanting palpebral fissures, myopia and retinal detachment. The condition is also associated with diaphragmatic hernia, exomphalos, absent corpus callosum and developmental delay. We describe the first recorded case of cochlear implantation in this rare disorder. CLINICAL PRESENTATION: This case of Donnai-Barrow syndrome was identified from our paediatric cochlear implant database. A case-note review was performed identifying patient demographics, operative findings and surgical outcome. In addition, pre- and post-operative auditory and communication performance was analysed. INTERVENTION: The child initially received a right cochlear implant at 39 months of age, but unfortunately the device failed 4 years post-operatively. Subsequently, bilateral simultaneous cochlear implantation was performed. BKB scores were 98% for bilateral implant use when tested 2 years post-operatively. Individual testing revealed a score of 94% for the right ear alone, and 80% for the left. The child achieved a 100% score on sound localisation testing using 3 speakers. CONCLUSIONS: Donnai-Barrow syndrome is a rare cause of SNHL compounded by the potential for visual impairment. To our knowledge this is the first report of cochlear implantation to rehabilitate hearing loss in this condition.
Assuntos
Implantes Cocleares , Anormalidades Craniofaciais/diagnóstico , Perda Auditiva Neurossensorial/cirurgia , Miopia/diagnóstico , Proteinúria/diagnóstico , Qualidade de Vida , Percepção da Fala/fisiologia , Agenesia do Corpo Caloso , Limiar Auditivo , Pré-Escolar , Implante Coclear/métodos , Anormalidades Craniofaciais/cirurgia , Seguimentos , Perda Auditiva Neurossensorial/diagnóstico , Hérnias Diafragmáticas Congênitas , Humanos , Desenvolvimento da Linguagem , Imageamento por Ressonância Magnética/métodos , Masculino , Miopia/cirurgia , Cuidados Pós-Operatórios/métodos , Falha de Prótese , Proteinúria/cirurgia , Erros Inatos do Transporte Tubular Renal , Reoperação/métodos , Resultado do TratamentoRESUMO
OBJECTIVE: Few studies have looked at the outcomes of children with complex needs following cochlear implantation. Increasing evidence supports the case for implantation in these children. To date there is very little evidence available evaluating the role of cochlear implantation in children with cerebral palsy. In this paper we look at the Manchester Cochlear Implant Programme's experience of implantation in 36 children with cerebral palsy. METHODS: A retrospective review of prospectively collected data for all children with cerebral palsy was undertaken. Cognitive and physical disability was scored by members of the cochlear implant team. A modified version of Geers and Moogs 1987 Speech Reception Score was used to assess outcome. Data was analysed looking at the relationship between cognitive and physical impairment, age at implantation and the SRS outcomes. RESULTS: This study demonstrated that children with cerebral palsy and a mild cognitive impairment do significantly better following implantation than those with a severe impairment (p=0.008). Children with mild physical impairment did not appear to do significantly better than those with moderate or severe impairments (mild versus severe p=0.13). Age at implantation was not a significant prognostic factor in this study group. CONCLUSIONS: Children with complex needs are increasingly being referred for consideration of cochlear implantation. Further research is required to help guide candidacy, but each case must be considered individually. Higher functioning does appear to be the most important prognostic indicator regarding outcome but the effect of modest improvement in sound perception should not be underestimated.
Assuntos
Paralisia Cerebral/diagnóstico , Implante Coclear/métodos , Perda Auditiva Neurossensorial/cirurgia , Qualidade de Vida , Percepção da Fala , Fatores Etários , Percepção Auditiva , Paralisia Cerebral/complicações , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Seguimentos , Perda Auditiva Neurossensorial/complicações , Perda Auditiva Neurossensorial/diagnóstico , Humanos , Desenvolvimento da Linguagem , Masculino , Estudos Retrospectivos , Índice de Gravidade de Doença , Inteligibilidade da Fala , Resultado do Tratamento , Reino UnidoRESUMO
OBJECTIVES/HYPOTHESIS: Congenital cytomegalovirus (cCMV) infection is a common cause of sensorineural hearing loss (SNHL). The incidence of SNHL is higher in symptomatic cCMV infants and is usually identified early. By contrast, the incidence of SNHL is lower in children with asymptomatic cCMV, and the hearing loss can be delayed in onset and progressive. The objective was to compare the outcome of cochlear implantation in children deafened by cCMV with a control group of children with implants who do not have the condition. STUDY DESIGN: Retrospective review of case notes and data base. METHODS: Retrospective review of 14 children with asymptomatic cCMV who underwent cochlear implantation. Their outcome measures were compared with those of a matched population by using standard assessment tools. RESULTS: In the study group, the Modified Categories of Auditory Performance (M-CAP) score (range, 1-7) ranged from 2 to 7 (mean, 4.2). In the control group, the M-CAP ranged from 5 to 7 (mean, 6.0). In the study group, the Manchester Spoken Language Development Scale (MSLDS) score (range, 1-10) ranged from 1 to 9 (mean, 5.4). In the control group, the MSLDS ranged from 3 to 10 (mean, 8.1). CONCLUSIONS: Children with asymptomatic deafness caused by cCMV benefit from cochlear implantation but perform less well than a comparable group of children with implants who do not have cCMV. There is a range of performance in the cCMV group that may relate to the degree of motor or cognitive disabilities.
Assuntos
Implante Coclear , Infecções por Citomegalovirus/congênito , Infecções por Citomegalovirus/complicações , Perda Auditiva Neurossensorial/cirurgia , Doenças Assintomáticas , Criança , Pré-Escolar , Infecções por Citomegalovirus/diagnóstico , Feminino , Perda Auditiva Neurossensorial/complicações , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Neurossensorial/virologia , Testes Auditivos , Humanos , Deficiências da Aprendizagem/etiologia , Masculino , Resultado do TratamentoRESUMO
This study, using positron emission tomography, investigates the cortical activation generated by auditory stimulation in two congenitally blind cochlear implant users. In the patient with a relatively short history of deafness, activity increased in both auditory cortices and fell in the visual cortices. The patient with a longer period of deafness had greater activation of the visual cortices than the auditory cortices. A similar pattern of activity was seen when this patient subsequently had a second cochlear implant inserted into the opposite ear. The neural pathways formed after the restoration of auditory input in the congenitally blind can activate either the auditory or visual cortices. We suggest that the visual cortical activation demonstrated is of functional significance.
Assuntos
Córtex Auditivo/fisiopatologia , Implantes Cocleares , Surdocegueira/fisiopatologia , Surdocegueira/reabilitação , Plasticidade Neuronal , Córtex Visual/fisiopatologia , Estimulação Acústica , Adulto , Humanos , Tomografia por Emissão de PósitronsRESUMO
Lymphocytes from 5 individuals were cultured to study the effect of mestranol and norethindrone on sister chromatid exchange (SCE), blast transformation, mitotic index and micronuclei formation. Four combinations of the drugs were compared to water and ethanol controls. Some steroid combinations increased the SCE frequency compared to ethanol controls. There was no uniform effect on blast transformation or mitotic index. In 3 individuals, micronuclei formation was reduced in treated cultures. In conclusion, contraceptive steroids may be mutagenic in some individuals.
Assuntos
Anticoncepcionais Orais/farmacologia , Linfócitos/efeitos dos fármacos , Mutagênicos , Adulto , Núcleo Celular/efeitos dos fármacos , Feminino , Humanos , Técnicas In Vitro , Ativação Linfocitária/efeitos dos fármacos , Mestranol/farmacologia , Mitose/efeitos dos fármacos , Noretindrona/farmacologia , Troca de Cromátide Irmã/efeitos dos fármacosRESUMO
The ultrastructure of Symbiodinium microadriaticum in vitro and in the type host Condylactis and Casseopeia is described and contrasted with previous observations on symbionts from Anemonia sulcata and the Pacific Tridacnidae. Its type description is emended with new electron microscopic observations and with a list of alternate hosts, including their distributions.