Sequential bilateral cochlear implantation improves working performance,quality of life,and quality of hearing

Conclusions: This prospective study shows that working performance, quality of life (QoL), and quality of hearing (QoH) are better with two compared with a single cochlear implant (CI). The impact of the second CI on the patient’s QoL is as significant as the impact of the first CI. Objectives: To evaluate the benefits of sequential bilateral cochlear implantation in working, QoL, and QoH. Methods: We studied working performance, work-related stress, QoL, and QoH with specific questionnaires in 15 patients with unilateral CI scheduled for sequential CI of another ear. Sound localization performance and speech perception in noise were measured with specific tests. All questionnaires and tests were performed before the second CI surgery and 6 and 12 months after its activation. Results: Bilateral CIs increased patients’ working performance and their work-related stress and fatigue decreased. Communication with co-workers was easier and patients were more active in their working environment. Sequential bilateral cochlear implantation improved QoL, QoH, sound localization, and speech perception in noise statistically significantly.     

Consensus statement on fiber-reinforced polymers: current status,future directions,and how they can be used to enhance dental care

The Second Scientific Fibre Reinforcement Symposium was held in Nijmegen, The Netherlands, on October 13th, 2001. The participants were invited speakers with extensive scientific and clinical backgrounds in glass fiber and polyethylene fiber research. The symposium reports focused on four areas of fiber reinforcement research: materials development, laboratory testing, clinical systems development, and clinical data. The consensus reached on the current status and future directions of this technology is reported here.     

Histopathology and immunohistochemical analysis of 5‐fluorouracil and triamcinolone treated keloids in double‐blinded randomized controlled trial

Keloids are a major complication related to surgical wound healing and very challenging condition to treat. Many treatment options are available, but the efficacy of the treatment is poor in most of cases and some keloids do not respond to the treatment at all. We compared the efficacy of intralesional 5‐fluorouracil (5‐FU) and triamcinolone (TAC) injections in a double‐blind randomized controlled trial (RCT). Forty‐three patients with 50 keloid scars were treated with either intralesional TAC or 5‐FU‐injections over 6 months. We wanted to find out whether biological features (cell density, cell proliferation rate, vascular density, myofibroblast numbers, steroid hormone receptor expression) in keloids could be used to predict the response to therapy and define the biological changes that take place in patients receiving a response. As there was no statistically significant difference in the remission rate between TAC and 5‐FU treatments, all patients were combined and analyzed as responders and nonresponders. Although responders have slightly more myofibroblasts than the nonresponders in their keloids in the pretreatment biopsy samples, we could not identify a single predictive factor that could identify those patients that respond to drug injections. The good clinical response to therapy is associated with the simultaneous reduction of myofibroblasts in the keloid. This study demonstrates that myofibroblasts are reduced in number in those keloids that were responsive to therapy, and that both 5‐FU and TAC injections are useful for keloid treatment.     

Hyperostosis of the spine in diabetes mellitus and acromegaly

Summary A series of 658 patients routinely examined in a medical clinic was studied for senile ankylosing hyperostosis of the spine. The disease was diagnosed from lateral views of the thorax, typical bridges between the vertebrae being regarded as the criterion. A total of 510 patients had diabetes mellitus, and hyperostosis was detected in 13 per cent of these. In the range 60–69 years there was a very significant difference between 122 diabetics and 148 non-diabetics in regard to the occurrence of hyperostosis. — In a series of 21 patients with acromegaly hyperostosis was detected in 6 cases. Eight patients were over 50 years old. Of these, 4 showed hyperostosis and 2 of the latter had diabetes. The results seem to indicate that the growth hormone may play a part in the development of hyperostosis. This observation is significant also from the standpoint of clinical practice.

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Hyperostosis der Wirbelsäule bei Diabetes mellitus und Akromegalie

Zusammenfassung Bei einer Gruppe von 658 routinemäßig in einer medizinischen Klinik untersuchten Patienten wurde besonderes Augenmerk auf eine senile ankylosierende Hyperostose der Wirbelsäule gerichtet. Die Diagnose wurde aus der seitlichen Thoraxansicht gestellt, wobei die typischen Brückenbildungen zwischen den Wirbeln als Kriterium angesehen werden. Insgesamt hatten 510 Patienten Diabetes mellitus, bei denen in 13% eine Hyperostose festgestellt wurde. Im Bezug auf die Häufigkeit der Erkrankung bestand bei den Patienten zwischen 60 und 69 Jahren zwischen 122 Diabetikern und 148 Nichtdiabetikern ein signifikanter Unterschied. — Bei einer Gruppe von 21 Patienten mit Akromegalie fanden sich 6 Fälle einer Hyperostose. Acht Patienten waren über 50 Jahre alt. Von diesen zeigten 4 eine Hyperostose, 2 davon außerdem einen Diabetes. Die Ergebnisse scheinen zu zeigen, daß möglicherweise das Wachstumshormon eine Rolle in der Entwicklung der Hyperostose spielt. Diese Beobachtung ist auch vom Standpunkt der klinischen Praxis bedeutsam.

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Hyperostose de la colonne vertébrale dans le diabète sucrè et l'acromégalie

Résumé. Un groupe de 658 patients, régulièrement examinés dans une clinique médicale, a été étudié pour hyperostose sénile ankylosante de la colonne vertébrale. La maladie a été diagnostiquée d'après des vues latérales du thorax, des ponts typiques entre les vertèbres étant considérés comme critères. 510 patients au total avaient un diabète sucré, et l'hyperostose fut décelée chez 13% d'entre eux. Parmi les patients âgés de 60 à 69 ans il y avait une différence très significative entre les 122 diabétiques et les 148 non diabétiques en ce qui concerne la fréquence de l'hyperostose. — Dans un groupe de 21 patients atteints d'acromégalie, l'hyperostose a été décelée dans 6 cas. Huit patients avaient plus de 50 ans. Parmi ceux-ci, 4 présentaient de l'hyperostose et 2 de ces derniers avaient un diabète. Les résultats semblent indiquer que l'hormone de croissance peut jouer un rôle dans le développement de l'hyperostose. Cette observation est également importante du point de vue de la pratique clinique.