Cochlear Implantation Via the Middle Fossa Approach: Surgical and Programming Considerations

Objectives: To report the results of cochlear implantation via the middle fossa approach in 4 patients, discuss the complications, and present a detailed description of the programming specifications in these cases. Study Design: Retrospective case review. Setting: Tertiary-care referral center with a well-established cochlear implant program. Patients: Four patients with bilateral canal wall down mastoid cavities who underwent the middle fossa approach for cochlear implantation. Interventions: Cochlear implantation and subsequent rehabilitation. A middle fossa approach with cochleostomy was successfully performed on the most superficial part of the apical turn in 4 patients. A Nucleus 24 cochlear implant system was used in 3 patients and a MED-EL Sonata Medium device in 1 patient. The single electrode array was inserted through a cochleostomy from the cochlear apex and occupied the apical, middle, and basal turns. Telemetry and intraoperative impedance recordings were performed at the end of surgery. A CT scan of the temporal bones was performed to document electrode insertion for all of the patients. Main Outcome Measures: Complications, hearing thresholds, and speech perception outcomes were evaluated. Results: Neural response telemetry showed present responses in all but 1 patient, who demonstrated facial nerve stimulation during the test. Open-set speech perception varied from 30% to 100%, despite the frequency allocation order of the MAP. Conclusion: Cochlear implantation via the middle cranial fossa is a safe approach, although it is a challenging procedure, even for experienced surgeons.

Mudanças químicas e fitodisponibilidade de zinco estimada por método isotópico, em solo tratado com lodo de esgoto

Zn availability in Red Latossol (Rhodic Ferralsol) of different pH amended with different rates of sewage sludge was studied by the isotopic 65Zn L value method. Soil chemical properties were found to be altered by SS addition. Zn concentration and Zn derived from SS (ZnpfSS) in plant, and Zn phytoavailability (L value), were increased with increasing SS rates. The linear correlation coefficient of plant Zn with SS rates and with L value was significant at 1% probability. The L value proved an efficient method for predicting Zn phytoavailability in sewage sludge-amended soil with different pH under the soil conditions studied.

Lodo de esgoto como fonte de nitrogênio: concentração no perfil do solo e em plantas de milho

O objetivo deste trabalho foi avaliar a concentração de nitrogênio em plantas de milho e ao longo do perfil de um Latossolo Vermelho eutroférrico submetido a doses de lodo de esgoto e fertilizante mineral. O experimento foi instalado em delineamento experimental em blocos casualizados com 4 tratamentos (0,0; 55,0; 110,0 e 167,5 Mg.ha-1 de lodo de esgoto em doses acumuladas) e 5 repetições para um período de avaliação de 1 ano. A amostragem de solo foi realizada aos 60 dias após a emergência (d.a.e.) das plantas nas profundidades 0,0-0,1, 0,1-0,2, 0,2-0,4, 0,4-0,6, 0,6-0,8 e 0,8-1,0 m. Também aos 60, 80 e 128 d.a.e. foram coletadas, respectivamente, folha diagnose, planta inteira e grão. As maiores doses de lodo de esgoto proporcionaram maiores quantidades de nitrogênio no solo. O nitrogênio do solo, após a profundidade de 0,6 m, não diferiu entre as camadas avaliadas. Quanto maior a dose de lodo de esgoto, menor a proporção de nitrogênio em profundidade.

Produção de milho adubado residualmente com composto de lodo de esgoto e fosfato de Gafsa

Objetivou-se, com este trabalho, avaliar o efeito residual da adubação com composto de lodo de esgoto e fosfato natural de Gafsa sobre os teores de nutrientes no solo, na planta e na produtividade do milho. O trabalho foi realizado em Cambissolo Háplico. Os tratamentos, em esquema fatorial 2 x 4, corresponderam a 2 doses de fosfato de Gafsa (0 e 90 kg ha-1 de P2O5) e 4 doses de composto de lodo de esgoto (0; 25; 50 e 75 t ha-1, em base seca). O delineamento experimental utilizado foi em blocos casualizados, com 3 repetições. Em geral, a produtividade e os teores de nutrientes no solo e na planta no segundo cultivo sucessivo de milho não foram influenciados pela adubação com fosfato natural reativo. Entretanto, a produtividade de milho e os teores de nutrientes no solo e nas folhas de milho aumentaram com a dose de composto de lodo de esgoto ao solo, sendo a dose de 75 Mg ha-1, a de maior efeito residual. A produtividade do milho é menor no segundo cultivo sucessivo em razão do empobrecimento do solo em fósforo e potássio, recomendando-se novas adubações com lodo de esgoto, a cada cultivo realizado.

Fertilidade do solo, estado nutricional e produtividade de girassol, em função da aplicação de lodo de esgoto

O lodo de esgoto é um resíduo urbano-industrial que tem causado preocupação, quanto ao uso agrícola. Sua utilização pode ser viável, após a devida suplementação potássica, em substituição a fertilizantes minerais, especialmente em culturas como a do girassol. O presente trabalho objetivou avaliar a produtividade e nutrição mineral do girassol cv. CATISSOL 01, além da fertilidade de um Latossolo Vermelho eutroférrico adubado com lodo de esgoto, em comparação à adubação mineral, por dois anos consecutivos. O experimento utilizou delineamento em blocos casualizados, com 4 tratamentos (fertilização mineral, 5 t ha-1 ano-1, 10 t ha-1 ano-1 e 20 t ha-1 ano-1 de lodo de esgoto) e 5 repetições. Foram analisadas a produtividade de grãos de girassol, a concentração de macro e micronutrientes na folha diagnóstico e a fertilidade do solo. A produtividade de sementes do girassol adubado com o resíduo, em todas as doses, foi equivalente à adubação mineral, e os teores foliares situaram-se na faixa adequada, tanto para macro quanto para micronutrientes. O uso de lodo de esgoto, com suplementação potássica, mostrou-se eficiente na substituição total ou parcial da adubação mineral, sem prejudicar a produtividade da cultura do girassol.

Tratamento de lodo de ETA em ETE por sistema de lodo ativado operando em MBBR

Apresentação em evento

Avaliação comparativa entre custos dos processos MBBR/IFAS e lodo ativado para o tratamento de esgoto sanitário

O processo MBBR/IFAS, Moving Bed Biofilm Reactor/Integrated Fixed Film Activated Sludge, é uma tecnologia recente para o tratamento de esgoto que incorpora tanto biomassa em suspensão como aderida. Seus parâmetros de controle são os mesmos aplicados ao processo de lodo ativado, observadas algumas especificidades. Como objetivo principal deste trabalho, apresenta-se uma análise comparativa entre os custos de implantação de uma unidade IFAS e de lodo ativado operando sob alta taxa, na faixa convencional e com aeração prolongada, para populações de 50.000 e 500.000 habitantes. Os resultados mostraram que, sob as hipóteses assumidas para a implantação dos reatores, o custo do processo de lodo ativado foi de 36% até 100% do custo do processo IFAS, dependendo da carga orgânica aplicada, do preço do terreno ou do custo do meio suporte.

Is there a relationship between the total volume of load lifted in bench press exercise and the rating of perceived exertion?

Aim. The purpose of the study was to investigate the relationship between the total volume of load lifted (TVLL) and the rating of perceived exertion (RPE) measures during different resistance training (RT) schemes using the bench press exercise. Methods. The present study was divided into two experiments. In the first experiment, 18 healthy men performed three different RT schemes: a strength oriented scheme (SS), a muscular endurance oriented scheme (ES) and a hypertrophy oriented scheme (HS). TVLL was calculated for each scheme. Mean-RPE and session-RPE were assessed. In the second experiment, 23 men performed two resistance exercise bouts at different intensities (50 %-1RM and 75%-1RM) with matched TVLL. Mean-RPE and session-RPE were also assessed. Results. SS and HS showed higher TVLL and greater RPE scores as compared to ES (P<0.05). No significant difference was observed between SS and HS. It was verified significant positive correlations between TVLL and session-RPE (SS r=0.63, HS r=0.64, ES r=0.56; P<0.05), and between mean-RPE and TVLL (SS r=0.55, HS r=0.52, ES r=0.47; P<0.05) for all schemes. No differences were observed for mean-RPE, session-RPE and TVLL between the 50%-1RM and 75%1RM. Significant positive relationships between TVLL and session-RPE (50 %-1RM r=0.61, 75 %-1RM r=0.66; p<0.05) and between TVLL and mean-RPE (50 %-1RM r=0.51, 75%1RM r=0.49; P<0.05) were observed. Conclusion. The results of this study have shown that the TVLL in RT influences RPE measures. These findings corroborates the existence of a relationship between total work performed (external training load) and perception of effort (internal training load).

The first modern solitary Agariciidae (Anthozoa, Scleractinia) revealed by molecular and microstructural analysis

Dactylotrochus cervicornis (= Tridacophyllia cervicornis Moseley, 1881), which occurs in Indo-Pacific waters between 73 and 852 m, was originally described as an astraeid but was later transferred to the Caryophylliidae. Assumed to be solitary, this species has no stolons and only one elongated fossa, and is unique among azooxanthellate scleractinians in often displaying extremely long thecal extensions that are septate and digitiform. Based on both molecular phylogenetic analyses (partial mitochondrial CO1 and 16S rDNA, and partial nuclear 28S rDNA) and morphological characteristics, we propose the transfer of D. cervicornis from the Caryophylliidae to the Agariciidae, making it the first extant representative of the latter family that is solitary and from deep water (azooxanthellate). The basal position of D. cervicornis within the agariciids implied by our analyses strengthens the case for inclusion of fossil species that were solitary, such as Trochoseris, in this family and suggests that the ancestor of this scleractinian family, extant members of which are predominantly colonial and zooxanthellate, may have been solitary and azooxanthellate.

Changes in FDB and soleus muscle activity after a train of stimuli during upright stance

Background: Evidence of self-sustained muscle activation following a brief electrical stimulation has been reported in the literature for certain muscles. Objectives: This report shows that the foot muscle (Flexor Digitorum Brevis - FDB) shows a self-sustained increase in muscle activity during upright stance in some subjects following a train of stimuli to the tibial nerve. Methods: Healthy subjects were requested to stand upright and surface EMG electrodes were placed on the FDB, Soleus and Tibialis Anterior muscles. After background muscle activity (BGA) acquisition, a 50 Hz train of stimuli was applied to the tibial nerve at the popliteal fossa. The root mean square values (RMS) of the BGA and the post-stimulus muscle activation were computed. Results: There was a 13.8% average increase in the FDB muscle EMG amplitude with respect to BGA after the stimulation was turned off. The corresponding post-stimulus Soleus EMG activity decreased by an average of 9.2%. We hypothesize that the sustained contraction observed in the FDB following stimulus may be evidence of persistent inward currents (PIC) generated in FDB spinal motoneurons. The post-stimulus decrease in soleus activity may have occurred due to the action of inhibitory interneurons caused by the PICs, which were triggered by the stimulus train. Conclusions: These sustained post-stimulation changes in postural muscle activity, found in different levels in different subjects, may be part of a set of possible responses that contribute to overall postural control.

Permanent anosmia and ageusia after resection of a left temporoinsular low-grade glioma: anatomofunctional considerations

Five percent of the general population has olfactory or gustatory disorders, although most do not complain about it. However, in some cases, these symptoms can be disabling and may affect quality of life. Anosmia was reported as a possible complication following head injury and neurosurgical procedures, particularly after the resection of tumors located in the anterior fossa and the treatment of aneurysms in the anterior circulation. Nonetheless, in all of these situations, olfactory dysfunction could be explained by damage to the peripheral olfactory system. Here, the authors report a case of complete anosmia associated with ageusia following awake resection of a low-grade glioma involving the left temporoinsular region, with no recovery during a follow-up of 3 years. The frontal lobe was not retracted, and the olfactory tract was not visualized during surgery; therefore, postoperative anosmia and ageusia are likely explained by damage to the cortex and central pathways responsible for these senses. The authors suggest that the patient might have had a subclinical right hemianosmia before surgery, which is a common condition. After resection of the central structures critical for smell and taste processing in the left hemisphere, the patient could have finally had bilateral and complete olfactory and gustatory loss. This is the first known report of permanent anosmia and ageusia following glioma surgery. Because these symptoms might have been underestimated, more attention should be devoted to olfaction and taste, especially with regard to possible subclinical preoperative deficit. (http://thejns.org/doi/abs/10.3171/2012.2.JNS111982)

Assessment of variations of the mandibular canal through cone beam computed tomography

The neurovascular bundle may be vulnerable during surgical procedures involving the mandible, especially when anatomical variations are present. Increased demand of implant surgeries, wider availability of three-dimensional exams, and lack of clear definitions in the literature indicate that features of anatomical variations should be revisited. The objective of the study was to evaluate features of anatomical variations related to mandibular canal (MC), such as bifid canals, anterior loop of mental nerve, and corticalization of MC. Additionally, bone trabeculation at the submandibular gland fossa region (SGF) was assessed and related to visibility of MC. Cone beam computed tomography exams from 100 patients (200 hemimandibles) were analyzed and the following parameters were registered: diameter and corticalization of MC; trabeculation in SGF region; presence of bifid MC, position of bifurcations, diameter, and direction of bifid canals; and measurement of anterior loops by two methods. Corticalization of the MC was observed in 59% of hemimandibles. In 23%, MC could be identified despite absence of corticalization. Diameter of MC was between 2.1 and 4 mm for nearly three quarters of the sample. In 80% of the sample trabeculation at the SGF was either decreased or not visible, and such cases showed correlation with absence of MC corticalization. Bifid MC affected 19% of the patients, mostly associated with additional mental foramina. Clinically significant anterior loop (> 2 mm of anterior extension) was observed in 22-28%, depending on the method. Our findings, together with previously reported limitations of conventional exams, draw attention to the unpredictability related to anatomical variations in neurovascularization, showing the contribution of individual assessment through different views of three-dimensional imaging prior to surgical procedures in the mandible.

Health and fitness benefits of a resistance training intervention performed in the workplace

Zavanela, PM, Crewther, BT, Lodo, L, Florindo, AA, Miyabara, EH, and Aoki, MS. Health and fitness benefits of a resistance training intervention performed in the workplace. J Strength Cond Res 26(3): 811-817, 2012-This study examined the effects of a workplace-based resistance training intervention on different health-, fitness-, and work-related measures in untrained men (bus drivers). The subjects were recruited from a bus company and divided into a training (n = 48) and control (n = 48) groups after initial prescreening. The training group performed a 24-week resistance training program, whereas the control group maintained their normal daily activities. Each group was assessed for body composition, blood pressure (BP), pain incidence, muscular endurance, and flexibility before and after the 24-week period. Work absenteeism was also recorded during this period and after a 12-week follow-up phase. In general, no body composition changes were identified in either group. In the training group, a significant reduction in BP and pain incidence, along with improvements in muscle endurance and flexibility were seen after 24 weeks (p < 0.05). There were no changes in these parameters in the control group, and the between-group differences were all significant (p < 0.05). A reduction in worker absenteeism rate was also noted in the training (vs. control) group during both the interventional and follow-up periods (p < 0.05). In conclusion, it was found that a periodized resistance training intervention performed within the workplace improved different aspects of health and fitness in untrained men, thereby potentially providing other work-related benefits. Thus, both employers and employees may benefit from the setup, promotion, and support of a work-based physical activity program involving resistance training.

Effects of feeding a multivalent polyclonal antibody preparation on feedlot performance, carcass characteristics, rumenitis, and blood gas profile in Bos indicus biotype yearling bulls

The objective of this study was to evaluate effects of feeding monensin (MON) or a multivalent polyclonal antibody preparation (PAP) against several rumen microorganisms on feedlot performance, carcass characteristics, blood gas profile, and rumenitis of Bos indicus biotype (BT) yearling bulls. The study was designed as a completely randomized design with a 3 x 2 factorial arrangement, replicated 4 times, in which 32 yearling bulls of each of 3 BT evaluated (3-way-cross, TC; Canchim, CC; and Nellore, NE) were fed diets containing either MON at 300 mg.d(-1) or PAP at 10 mL.d(-1) across 3 different periods. No significant (P > 0.10) feed additive (FA) main effects were observed for any of the feedlot performance variables and carcass characteristics with the exception of dressing percentage. Yearling bulls receiving PAP had a decreased (P = 0.047) dressing percentage when compared with yearling bulls receiving MON. Significant (P < 0.05) BT main effects were observed for all feedlot performance variables and carcass characteristics with the exception of kidney-pelvic fat expressed in kilograms (P = 0.49) and LM lipids content (P = 0.45). Crossbred yearling bulls (TC and CC) had greater (P < 0.001) ADG, DMI in kilograms, DMI as % of BW, and improved (P = 0.001) G: F when compared with NE yearling bulls. A tendency (P = 0.072) for a FA main effect was observed for rumenitis scores, in which yearling bulls receiving PAP had lesser rumenitis scores than those receiving MON. When the data were disposed as frequency percentage, 55.6% and 45.7% of the rumens from yearling bulls fed PAP and MON were scored between 0 and 1, respectively (0 = no lesions, 10 = severe lesions). Likewise, a significant BT main effect was observed (P = 0.008), where NE yearling bulls had greater rumenitis scores than those of crossbred yearling bulls (TC and CC). No signifi cant FA main effects were observed (P > 0.10) for any of the fatty acids measured in the subcutaneous adipose tissue, with the exception that yearling bulls receiving MON had greater (P < 0.05) concentrations of palmitic acid (16: 0), margaric acid (17: 0), docosapentaenoic acid (22: 5), and docosahexaenoic acid (22: 6) than those yearling bulls receiving PAP. Feeding PAP tended to decrease incidence of rumen lesions and led to similar feedlot performance compared with feeding MON. Thus, PAP is a new technology that presents a possible alternative for ionophores.

Endonasal endoscopic exposure of the internal carotid artery: An anatomical study

Objectives/Hypothesis: The aim of this work was to define the anatomical landmarks, limitations, and difficulties of obtaining internal carotid artery (ICA) exposure via endonasal endoscopic approaches (EEA).