Notes

The range associated with photosensitivity and it is ramifications with regard to light polluting of the environment.
In all four patients, ictal nystagmus resolved, and examination findings returned to baseline.

This study suggests nVNS may ameliorate vertigo and headache, as well as nystagmus associated with VM attacks. Larger, sham device-controlled studies are needed to elucidate the benefits of nVNS in VM.
This study suggests nVNS may ameliorate vertigo and headache, as well as nystagmus associated with VM attacks. Larger, sham device-controlled studies are needed to elucidate the benefits of nVNS in VM.
1 Describe subacute facial nerve paralysis after salvage stereotactic radiosurgery (SRS). 2 To analyze predictors of facial nerve weakness after dual modality treatment.

Adult patients with Vestibular Schwannoma who underwent sub-total resection (STR) followed by salvage radiation.

Microsurgical resection of VS, stereotactic radiosurgery, intensity-modulated radiotherapy, proton radiotherapy.

Serial facial nerve function (House-Brackmann scale).

Thirteen patients who underwent dual modality treatment for large VS were included (mean age = 43.6 years, 77% females). The mean pre-operative tumor volume was 11.7 cm3 (SD = 6.5) and the immediate mean post-operative remnant volume was 1.5 cm3 (SD = 1.4) with a mean extent of resection of 86.7% (SD = 9.5). The mean salvage-free interval was 20.8 months (SD = 13.3). All patients had excellent one-year FN outcome (HB grade 1, 2) after resection. Three patients developed subacute facial nerve weakness after salvage SRS (4.2-9.4 months after SRS). This paralysis responded to high dose systemic steroids and no surgical interventions for facial rehabilitation were required. At last follow up (mean 61.6 months, SD = 28.5), facial nerve function was favorable (HB grade 1-2 in 12 patients and HB grade 3 in 1 patient). There were no significant associations between various predictors and subacute deterioration of facial nerve function after SRS.

Sub-acute transient facial nerve dysfunction can develop infrequently over a variable time frame after post-operative salvage SRS and usually responds to steroids. Patients should be adequately counseled about potential of transient deterioration of facial nerve function after salvage SRS.
Sub-acute transient facial nerve dysfunction can develop infrequently over a variable time frame after post-operative salvage SRS and usually responds to steroids. Patients should be adequately counseled about potential of transient deterioration of facial nerve function after salvage SRS.
Cochlear implantation (CI) carries a risk of loss of vestibular function following surgery. Thus, vestibular assessment presurgery is used to identify vestibulopathy that may contraindicate implantation and guide in selecting the candidate ear. The aim of this study was to evaluate the clinical implications of preoperative vestibular assessment, and to identify challenges in performing vestibular testing in patients with profound hearing loss, i.e., CI candidates.

Retrospective study of all CI recipients implanted since the introduction of a vestibular screening program.

Tertiary referral center in 2013.

CI candidates routinely underwent testing with the video head impulse test (VHIT) and the cervical vestibular evoked myogenic potential (cVEMP) test as a part of the CI work up.

Three hundred thirty-five individuals were screened before the first CI and 74 individuals before the second CI. In 301 cases (73.6%), the vestibular function was considered normal and consequently carried no contraindicatio% of cases for the cVEMP and 5.9% for the VHIT. The most common reasons for test failure were neck immobility, communication issues, and problems of pupil tracking.
Vestibular screening is an important part of the clinical workup with respect to selection of candidate ear for cochlear implantation, as 15.2% of CI candidates present with unilateral vestibulopathy. Challenges in performing the vestibular tests are not uncommon, as test failure occurred in 15.9% of cases for the cVEMP and 5.9% for the VHIT. The most common reasons for test failure were neck immobility, communication issues, and problems of pupil tracking.
To compare the difference in pre- to postoperative speech performance of patients qualifying for a cochlear implant (CI) in quiet, +10 dB signal-to-noise ratio (SNR), and +5 dB SNR.

Retrospective.

Tertiary referral center.

Fifty-eight post-lingually deafened, unilateral CI recipients from three Groups were included 1) those who met CI candidacy criteria with AzBio sentences in quiet, 2) in noise at +10 dB SNR but not in quiet, 3) and in noise at +5 dB SNR but not in quiet or +10 dB SNR.

Unilateral CI.

Pre- and 1 year postoperative speech recognition scores.

Best-aided AzBio speech recognition of individuals in Group 1 improved significantly for all test conditions and improved significantly for Groups 2 and 3 in the +10 and +5 dB SNR test conditions postoperatively. When tested with their CI alone however, while AzBio speech recognition of individuals in Group 1 and Group 2 improved significantly in the quiet and +10 dB SNR conditions, speech recognition was not significantly changed postoperatively under any testing condition for individuals in Group 3.

While individuals qualifying for a CI only in the +5 dB SNR condition may derive significant benefit from implantation in best aided conditions, speech understanding outcomes can be more variable thus warranting additional counseling before implantation and case-by-case consideration of listening needs and goals.
While individuals qualifying for a CI only in the +5 dB SNR condition may derive significant benefit from implantation in best aided conditions, speech understanding outcomes can be more variable thus warranting additional counseling before implantation and case-by-case consideration of listening needs and goals.
Preoperative expectations affect patient outcomes in many health conditions, but expectations are rarely assessed in adult cochlear implant (CI) users. This study is a first step in assessing the contribution of preoperative expectations to postoperative CI outcomes, including speech recognition, CI quality of life (CIQOL), and CI satisfaction.

Cross-sectional study.

Tertiary medical center.

Fourty one adult CI patients.

Preoperative expectation questionnaire results, pre- and postoperative speech recognition (CNC and AzBio) scores, postoperative CIQOL domain scores and global scores, and CI satisfaction scores using a visual analog scale (VAS). Cohen's d was used to express effect size.

Overall, patients with lower preoperative CI performance expectations showed higher postoperative QOL. This effect was large for the emotional, entertainment, and social domains (d = 0.85-1.02) of the CIQOL-35 and medium for the communication, listening effort domains, and the Global score (d = 0.55-0.63). Preoperother outcomes, but not postoperative speech recognition. This suggests that an increased emphasis should be placed on measuring and counseling expectations in CI candidates. This assumption needs to be confirmed with additional research with larger sample sizes, more sensitive satisfaction measures, and a prospective design.
This study aims to explore and determine the effectiveness of current pharmacologic agents for the prevention of noise-induced hearing loss (NIHL) via a systematic review.

The PubMed, Scopus, ClinicalTrials.gov, and Cochrane Library databases were searched from inception through February 6, 2020.

Full-text, English-language articles detailing prospective randomized and nonrandomized clinical trials with pharmacological interventions administered to prevent NIHL were included in accordance with PRISMA guidelines. The detailed search terms are included in the Appendix, http//links.lww.com/MAO/B67.

Eleven articles were included in this review with 701 patients receiving a pharmacologic prevention for various noise exposures. Various regimens included administration of alpha-lipoic acid, ambient oxygen, beta-carotene, carbogen, ebselen, Mg-aspartate, N-acetylcysteine, and vitamins C, E, and B12. A number of studies demonstrated statistically significant amelioration of NIHL with pharmacologic intervention. Two studies demonstrated significantly better hearing outcomes for pharmacological prophylaxis with carbogen or ebselen as compared with placebo for the 4 kHz frequency, where the noise-notch is most likely to be encountered. Given the considerable heterogeneity in agents and methodologies, however, it was not possible to conduct a meta-analysis.

While several heterogenous articles demonstrated promising results for Mg-aspartate, carbogen, vitamin B12, and alpha-lipoic acid, the clinical significance of these pharmaceuticals remains unclear. Initial data from this study alongside future clinical trials might potentially contribute to the generation of clinical practice guidelines to prevent NIHL.

2.
2.
Immune-checkpoint inhibitors have improved treatment outcomes for metastatic nonsmall cell lung cancer (NSCLC). NXY-059 Whether this therapeutic potential might also translate into survival gains in earlier stages is an area of active research. Based on preclinical rationale the neoadjuvant administration of immunotherapeutic agents is of special interest. This review is intended to summarize the existing background, published early clinical evidence, and provide perspective on future developments regarding neoadjuvant immunotherapy in NSCLC.

Preclinical data and early clinical trials suggest promising efficacy of immune-checkpoint inhibitors in early-stage NSCLC when administered in a neoadjuvant manner. Compared to historical controls, the rates of pathologic and radiographic regression seem to be improved, in particular when immunotherapy is combined with standard platinum-based chemotherapy. These favorable treatment effects are accompanied by a moderate toxicity profile without impairing surgical outcomes. Several phase III trials are underway to provide definitive evidence.

Neoadjuvant immunotherapy has the potential to substantially improve outcomes in early-stage NSCLC and therefore to change daily clinical practice in the near future.
Neoadjuvant immunotherapy has the potential to substantially improve outcomes in early-stage NSCLC and therefore to change daily clinical practice in the near future.
Targets for treatment of raised intracranial pressure or decreased cerebral perfusion pressure in pediatric neurocritical care are not well defined. Current pediatric guidelines, based on traumatic brain injury, suggest an intracranial pressure target of less than 20 mm Hg and cerebral perfusion pressure minimum of 40-50 mm Hg, with possible age dependence of cerebral perfusion pressure. We sought to define intracranial pressure and cerebral perfusion pressure thresholds associated with inhospital mortality across a large single-center pediatric neurocritical care cohort.

Retrospective chart review.

PICU, single quaternary-care center.

Individuals receiving intracranial pressure monitoring from January 2012 to December 2016.

None.

Intracranial pressure and cerebral perfusion pressure measurements from 262 neurocritical care patients (87 traumatic brain injury and 175 nontraumatic brain injury; 63% male; 8.3 ± 5.8 yr; mortality 11.1%). Mean intracranial pressure and cerebral perfusion pressure had area under the receiver operating characteristic curves of 0.
Website: https://www.selleckchem.com/products/NXY-059.html