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Background: While hearing aids for a contralateral routing of signals (CROS-HA) and bone conduction devices have been the traditional treatment for single-sided deafness (SSD) and asymmetric hearing loss (AHL), in recent years, cochlear implants (CIs) have increasingly become a viable treatment choice, particularly in countries where regulatory approval and reimbursement schemes are in place. Part of the reason for this shift is that the CI is the only device capable of restoring bilateral input to the auditory system and hence of possibly reinstating binaural hearing. Although several studies have independently shown that the CI is a safe and effective treatment for SSD and AHL, clinical outcome measures in those studies and across CI centers vary greatly. Only with a consistent use of defined and agreed-upon outcome measures across centers can high-level evidence be generated to assess the safety and efficacy of CIs and alternative treatments in recipients with SSD and AHL.Methods: This paper presents a comparative study design and minimum outcome measures for the assessment of current treatment options in patients with SSD/AHL. The protocol was developed, discussed, and eventually agreed upon by expert panels that convened at the 2015 APSCI conference in Beijing, China, and at the CI 2016 conference in Toronto, Canada.Results: A longitudinal study design comparing CROS-HA, BCD, and CI treatments is proposed. The recommended outcome measures include (1) speech in noise testing, using the same set of 3 spatial configurations to compare binaural benefits such as summation, squelch, and head shadow across devices; (2) localization testing, using stimuli that rove in both level and spectral content; (3) questionnaires to collect quality of life measures and the frequency of device use; and (4) questionnaires for assessing the impact of tinnitus before and after treatment, if applicable.Conclusion: A protocol for the assessment of treatment options and outcomes in recipients with SSD and AHL is presented. The proposed set of minimum outcome measures aims at harmonizing assessment methods across centers and thus at generating a growing body of high-level evidence for those treatment options. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether preoperative steroids can improve hearing outcomes in cochlear implantation (CI).Methods: This is a randomized controlled trial involving 30 postlingual deaf CI patients. Subjects had preoperative thresholds of better than or equal to 80 dB at 125 and 250 Hz, and better than or equal to 90 dB at 500 and 1,000 Hz. The subjects were randomized to a control group, an oral steroid group (receiving 1 mg/kg/day of prednisolone for 6 days prior to surgery), or a transtympanic steroid group (receiving a single dose of 0.5 mL of 10 mg/mL dexamethasone at 24 h prior to surgery).Results: The subjects receiving transtympanic steroids had a significant decrease in the pure tone average over 3 months compared to the control and oral steroid group, which persisted over 12 months (p < 0.05).Conclusion: A single dose of preoperative transtympanic steroids prior to CI appears to have a beneficial effect, at least in the short term, with minimal effects seen in the longer term. [ABSTRACT FROM AUTHOR]

Aims: This study aims to investigate the roles of the number of accelerations and rotation angle in the treatment of posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV).Methods: We enrolled 344 patients with unilateral PC-BPPV. Of these, 167 patients in the simple-step maneuver (SSM) group were accelerated twice and rotated 120° per step, whereas 177 patients in the multi-step maneuver (MSM) group were accelerated 4 times and rotated 60° per step. Dix-Hallpike (DH) tests were performed to categorize the treatment outcome as follows: 'symptom free' if the result was negative, 'symptom persistent' if the result remained positive after performing the maneuver 3 times or 'canal conversion' if horizontal nystagmus was evoked.Results: Of the patients in the SSM and MSM groups, 78.4 and 91.5% became symptom free, respectively, while canal conversion occurred in 13.8 and 5.1%, respectively (p = 0.003, χ(2) test). The success rate after performing the maneuver once was 57.1% in the MSM and 32.3% in the SSM symptom-free patients (p = 0.001, χ(2) test). One month after the treatment, 22.0 and 9.6% of the SSM and MSM patients had symptom relapse, respectively (p = 0.007, χ(2) test).Conclusions: More accelerations and a smaller rotation angle improved the effectiveness and efficiency of the repositioning maneuvers and reduced canal conversion. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of an experimental paste containing hydroxyapatite in nanoparticles (nano-HA)/fluoride on dental de-remineralisation in situ. Thirteen subjects took part in this crossover/randomised/double-blind study performed in 4 phases (14 days each). Four sound and 4 pre-demineralised specimens were worn intraorally at each phase corresponding to the following treatments: Nanop Plus (10% HA, 0.2% NaF, nano-HA/fluoride), MI Paste Plus (casein phosphopeptide-amorphous calcium phosphate, 0.2% NaF), F (0.2% NaF) and placebo. Two-hundred and forty enamel and 240 dentine specimens were selected by using surface microhardness; half of them were subjected to pre-demineralisation and the other half remained sound. Sound specimens were further exposed to severe cariogenic challenge (20% sucrose in biofilm) in situ, while pre-demineralised specimens were not. All specimens were exposed to fluoride dentifrice slurry 2×1 min/day. Thereafter, the treatments were done for 4 min. The de-remineralisation was quantified by transversal microradiography. The data were statistically analysed by repeated-measures ANOVA/Tukey's tests (p<0.05). Generally, no huge differences were found among the treatments. However, Nanop Plus was the only treatment able to significantly reduce dentine demineralisation (x0394;Z, integrated mineral loss) and to improve enamel remineralisation (x0394;x0394;Z, integrated mineral uptake) compared to placebo. No treatments were able to reduce enamel demineralisation, while for dentine remineralisation all treatments were similarly effective in improving x0394;x0394;Z compared to placebo. Nanop Plus seems to have a positive influence on dental de-remineralisation, which should be further confirmed. [ABSTRACT FROM AUTHOR]

Background: Retapamulin is a novel pleuromutilin antibacterial developed for topical use. Objective: To compare the efficacy and safety of retapamulin ointment, 1% (twice daily for 5 days), with sodium fusidate ointment, 2% (3 times daily for 7 days), in impetigo. Methods: A randomized (2:1 retapamulin to sodium fusidate), observer-blinded, noninferiority, phase III study in 519 adult and pediatric (aged > or = 9 months) subjects. Results: Retapamulin and sodium fusidate had comparable clinical efficacies (per-protocol population: 99.1 and 94.0%, respectively; difference: 5.1%, 95% confidence interval: 1.1-9.0%, p = 0.003; intent-to-treat population: 94.8 and 90.1%, respectively; difference: 4.7%, 95% confidence interval: -0.4 to 9.7%, p = 0.062). Bacteriological efficacies were similar. Success rates in the small numbers of sodium-fusidate-, methicillin- and mupirocin-resistant Staphylococcus aureus were good for retapamulin (9/9, 8/8 and 6/6, respectively). Both drugs were well tolerated. Conclusion: Retapamulin is a highly effective and convenient new treatment option for impetigo, with efficacy against isolates resistant to existing therapies. [ABSTRACT FROM AUTHOR]

Background: Immune function decreases with age, rendering the elderly more susceptible to infection and tumor development. In addition, intense exercise has been shown to decrease immune function in some populations. Few studies have examined the effects of exercise on immune function in the elderly and, to our knowledge, no studies have examined the effects of exercise on a population of active, but nonexercising elderly.Objective: The purpose of this study was to examine the effects of a 10-week endurance training program on selected parameters of immune function in active elderly women.Methods: A total of 29 healthy, active women, aged 70-87, were randomly assigned to either an exercise (76 +/- 5 years, n = 15) or control (77 +/- 6 years, n = 14) group. The exercise group walked 3 days/week at 70% heart rate reserve (HRR). The duration on day 1 was 20 min and it was increased by 5 min each day until subjects were walking for 50 min (week 3). It remained at 50 min for the duration of the study, while controls maintained normal activity. Blood samples were obtained from both groups at rest, and from the exercise group after 20 min of walking at 70% HRR and after 2 h of recovery. Blood samples were collected prior to endurance training and again after 10 weeks of endurance training.Results: There was a significant decrease in 1-mile walk times as well as heart rate at completion of the walk in the exercise group. Natural cell-mediated cytotoxicity (NCMC) was significantly higher post-exercise, compared to pre-exercise both before and after training. After training it remained significantly elevated 2 h post-exercise. The resting NCMC was significantly decreased in controls at week 10 but not in the exercise group.Conclusion: Ten weeks of endurance training resulted in a significant decrease in both the 1-mile walk time and the post-walk heart rate in the exercisers but not the controls, without resulting in either an acute or chronic suppression of immune function. Further, endurance training may lead to an attenuation of the decrease in cellular immune measures which occurs during the winter, since the control group experienced a decrease in NCMC and the exercisers did not. [ABSTRACT FROM AUTHOR]