Auditory brainstem implant outcomes and MAP parameters: Report of experiences in adults and children

The auditory brainstem implant (ABI) was first developed to help neurofibromatosis type 2 patients. Recently, its use has been recently extended to adults with non-tumor etiologies and children with profound hearing loss who were not candidates for a cochlear implant (Cl). Although the results has been extensively reported, the stimulation parameters involved behind the outcomes have received less attention. Objective: The aim of this study is to describe the audiologic outcomes and the MAP parameters in ABI adults and children at our center. Methods: Retrospective chart review. Five adults and four children were implanted with the ABI24M from September 2005 to June 2009. In the adult patients, four had Neurofibromatosis type 2, and one had postmeningitic deafness with complete ossification of both cochleae. Three of the children had cochlear malformation or dysplasia, and one had complete ossified cochlea due to meningitis. Map parameters as well as the intraoperative electrical auditory brainstem responses were collected. Evaluation was performed with at least six months of device use and included free-field hearing thresholds, speech perception tests in the adult patients and for the children, the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and (ESP) were used to evaluate the development of auditory skills, besides the MUSS to evaluate. Results: The number of active electrodes that did not cause any non-auditory sensation varied from three to nineteen. All of them were programmed with SPEAK strategy, and the pulse widths varied from 100 to 300 mu s. Free-field thresholds with warble tones varied from very soft auditory sensation of 70 dBHL at 250 Hz to a pure tone average of 45 dBHL. Speech perception varied from none to 60% open-set recognition of sentences in silence in the adult population and from no auditory sensation at all to a slight improvement in the IT-MAIS/MAIS scores. Conclusion: We observed that ABI may be a good option for offering some hearing attention to both adults and children. In children, the results might not be enough to ensure oral language development. Programming the speech processor in children demands higher care to the audiologist. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Measures of quality of life in children with cochlear implant: systematic review

The use of cochlear implant (CI) in children enables the development of listening and communication skills, allowing the child's progress in school and to be able to obtain, maintain and carry out an occupation. However, the progress after the CI has different results in some children, because many children are able to interact and participate in society, while others develop limited ability to communicate verbally. The need for a better understanding of CI outcomes, besides hearing and language benefits, has spurred the inclusion of quality of life measurements (QOL) to assess the impact of this technology. OBJECTIVE: Identify the key aspects of quality of life assessed in children with cochlear implant. METHOD: Through a systematic literature review, we considered publications from the period of 2000 to 2011. CONCLUSION: We concluded that QOL measurements in children include several concepts and methodologies. When referring to children using CI, results showed the challenges in broadly conceptualizing which quality of life domains are important to the child and how these areas can evolve during development, considering the wide variety of instruments and aspects evaluated.

The impact of healing time before loading on orthodontic mini-implant stability: a histomophometric study in minipigs

Objective: To evaluate healing time before loading, areas compression and tension and location of insertion on mini-implant stability. Design: Six minipigs were used. Each animal received 3 mini-implants in each quadrant: 1 mini-implant was used as an unloaded control (G1, n = 24); the other 2 were loaded with 150 g-force at three time intervals (G2: immediate loading, G3: after 15 days and G4: after 30 days), with 16 mini-implant in each experimental group. After 120 days, tissue blocks of the areas of interest were harvested. Clinical analysis (exact Fisher test) determined the survival rate. Histological analysis (Kontron KS 300TM, Zeiss) quantified the fractional bone-toimplant contact (%BIC) and bone area (%BA) at each healing time point, areas of interest, and insertion site (ANOVA and t tests for dependent and independent samples). Results: The mini-implant survival rates were G1: 71%, G2: 50%, G3: 75% and G4: 63%, with no statistical differences between them. The groups presented similar %BIC and %BA. There were no differences between the compression and tension sides or maxillary and mandibular insertion sites. Conclusions: These results suggest that low-intensity immediate or early orthodontic loading does not affect mini-implant stability, because similar histomorphometric results were observed for all the groups, with partial osseointegration of the mini-implants present.

Aesthetic analysis of an implant-supported denture at the cleft area

Objective: To evaluate the aesthetics of an implant-supported denture at the cleft area, comparing the peri-implant tissues and prosthetic crown with the contralateral tooth. Settings: Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, São Paolo, Brazil. Patients: A total of 39 individuals of both genders, with complete unilateral cleft lip and palate, who received secondary alveolar bone graft and were rehabilitated with single implant-supported dentures at the area of the missing maxillary lateral incisor after completion of orthodontic treatment. Interventions: The following parameters were analyzed in follow-up sessions: length and width of prosthetic crown and contralateral tooth, characteristics of implants, filling of interproximal space by the papilla, and smile height of the patients. Results: The implant-supported prosthetic crowns were longer than the contralateral tooth (p < .001). Among the 78 papillae analyzed, 29 (37.17%) received a score of 3; 32 (41.02%) papillae had a score of 2; and 17 (21.79%) received a score of 1. Concerning the smile height, among the 39 patients analyzed, 23 (56.41%) had a medium smile, 15 (38.46%) had a high smile, and two (5.12%) presented a low smile. Conclusion: The use of dental implants to rehabilitate the edentulous cleft area is an excellent option. However, adequate evaluation of the bone quantity and quality, positioning and shape of adjacent teeth, smile height, and patient expectations should be considered to achieve success and avoid aesthetic deformities such as elongated teeth and absence of gingival papillae.

Galaxy triplets in Sloan Digital Sky Survey Data Release 7: II. A connection with compact groups?

We analyse a sample of 71 triplets of luminous galaxies derived from the work of O’Mill et al. We compare the properties of triplets and their members with those of control samples of compact groups, the 10 brightest members of rich clusters and galaxies in pairs. The triplets are restricted to have members with spectroscopic redshifts in the range 0.01 ≤ z ≤ 0.14 and absolute r-band luminosities brighter than Mr = −20.5. For these member galaxies, we analyse the stellar mass content, the star formation rates, the Dn(4000) parameter and (Mg − Mr) colour index. Since galaxies in triplets may finally merge in a single system, we analyse different global properties of these systems. We calculate the probability that the properties of galaxies in triplets are strongly correlated. We also study total star formation activity and global colours, and define the triplet compactness as a measure of the percentage of the system total area that is filled by the light of member galaxies. We concentrate in the comparison of our results with those of compact groups to assess how the triplets are a natural extension of these compact systems. Our analysis suggests that triplet galaxy members behave similarly to compact group members and galaxies in rich clusters. We also find that systems comprising three blue, star-forming, young stellar population galaxies (blue triplets) are most probably real systems and not a chance configuration of interloping galaxies. The same holds for triplets composed of three red, non-star-forming galaxies, showing the correlation of galaxy properties in these systems. From the analysis of the triplet as a whole, we conclude that, at a given total stellar mass content, triplets show a total star formation activity and global colours similar to compact groups. However, blue triplets show a high total star formation activity with a lower stellar mass content. From an analysis of the compactness parameter of the systems we find that light is even more concentrated in triplets than in compact groups. We propose that triplets composed of three luminous galaxies, should not be considered as an analogous of galaxy pairs with a third extra member, but rather they are a natural extension of compact groups.

Mass extinctions, galactic orbits in the solar neighborhood and the Sun: a connection?

The orbits of the stars in the disk of the Galaxy, and their passages through the Galactic spiral arms, are a rarely mentioned factor of biosphere stability which might be important for long-term planetary climate evolution, with a possible bearing on mass extinctions. The Sun lies very near the co-rotation radius, where stars revolve around the Galaxy in the same period as the density wave perturbations of the spiral arms. conventional wisdom generally considers that this status makes for few passages through the spiral arms. Controversy still surrounds whether time spent inside or around spiral arms is dangerous to biospheres and conductive to mass extinctions. Possible threats include giant molecular clouds disturbing the Oort comet cloud and provoking heavy bombardment: a higher exposure to cosmic rays near star forming regions triggering increased cloudiness in Earth atmosphere and ice ages; and the desctruction of Earth's ozone layer posed by supernova explosiosn. We present detailed calculations of the history of spiral arm passages for all 212 solar-type stars nearer than 20 parsecs, including the total time spent inside armsin the last 500 Myr, when the spiral arm position can be traced with good accuracy. We found that there is a large diversity of stellar orbits in the solar neighborhood, and the time fraction spent inside spiral arms can vary from a few percent to nearly half the time. The Sun, despite its proximity to the galactic co-rotation radius, has exceptionally low eccentricity and a low vertical velocity component, and therefore spends 30% of its lifetime crossing the spiral arms, more than most nearby stars. We discuss the possible implications of this fact to the long-term habitability of the Earth, and possible correlations of the Sun's passage through the spiral arms with the five great mass extinctions of the Earth's biosphere from the Late Ordovician to the Cretaceous-Tertiary.