María Lavilla

Evaluación del implante coclear como técnica de tratamiento de la hipoacusia profunda en pacientes pre y post locutivos

Resumen Introduccion Los objetivos son los siguientes: 1. Evaluacion de los resultados en el ambito del lenguaje. 2. Impacto de los implantes cocleares (IC) en la calidad de vida. 3. Evaluacion de las complicaciones medicas y fallos tecnicos del IC. 4. Evaluacion de los costes directos e indirectos generados en las diferentes fases de un programa de IC. 5. Determinar factores que repercuten en la evolucion clinica y en el gasto economico Material y Metodos Se estudia una poblacion de 877 pacientes con hipoacusia pre o postlocutiva, ninos y adultos, tratados en 5 centros espanoles con programas de IC. Se han utilizado pruebas audiometricas y cuestionarios globales de calidad de vida. Se han contabilizado las complicaciones medicas y tecnologicas de los IC. Se han calculado los costes economicos directos e indirectos de una implantacion coclear Resultados Los pacientes postlocutivos alcanzaron umbrales de 40 dB SPL, estables a lo largo de 12 anos de evolucion. En Vocales pasaron de un 30% en el preoperatorio al 80-90%, en Bisilabas de un 10% a un 50-60% y en Frases CID de un 18% a un 60-70%. En la poblacion de prelocutivos la edad de implantacion influyo decisivamente en los resultados. Los mejores fueron los obtenidos en ninos implantados mas tempranamente. Asi, aquellos implantados entre 0 y 3 anos de edad en Vocales pasaron de un 0% en el preoperatorio a un 95%, en Bisilabas de un 0% a un 90% y en Frases CID de un 0% a un 90-95%. El desarrollo del lenguaje de la poblacion prelocutiva tambien estuvo marcado por la edad de implantacion. En torno al 80% de los pacientes adultos postlocutivos manifestaron haber mejorado su estado de animo y su sociabilidad. Su estado general de salud no se vio deteriorado, ni precisaron mas ayudas de familiares y amigos. Se registro un 3,42% de complicaciones medico-quirurgicas mayores, un 7,06% de complicaciones medico-quirurgicas menores y un 3,07% de fallos tecnicos en los componentes internos del IC. El costo de todo el proceso de implantacion en un adulto postlocutivo oscilo entre 36.912 y 37.048 euros y en ninos prelocutivos entre 37.689 y 44.273 euros Conclusiones Los IC benefician la capacidad de comunicacion de los pacientes implantados. Los resultados en la poblacion prelocutiva justifican la puesta en marcha de programas de deteccion precoz de la hipoacusia infantil. Los pacientes postlocutivos adultos se muestran satisfechos con los resultados obtenidos, aunque perciben limitaciones en ambientes acusticos no favorables. Se expone un analisis de costes directos e indirectos util para la realizacion de estudios coste-beneficio sobre IC en nuestro medio. El bajo indice de complicaciones indica unos margenes de seguridad adecuados. Entre los factores que mas influyen en la evolucion estan: la duracion de la hipoacusia, la edad de implantacion, la morfologia coclear y la funcionalidad de la via auditiva, la motivacion del paciente y de su familia y la coexistencia de otras minusvalias asociadas a la hipoacusia

Evaluation of indirect competitive and double antibody sandwich ELISA tests to determine β-lactoglobulin and ovomucoid in model processed foods

Abstract Enzyme-linked immunosorbent assay (ELISA) kits (indirect competitive and sandwich formats) to determine either β-lactoglobulin or ovomucoid were evaluated in model foods. A cut-off value was established for each kit to consider food samples as positive for milk or egg addition. Sausage and bread were positive at lower percentages of added milk using the sandwich format (0.005 and 0.05%) than the indirect competitive format (0.05 and 0.25%) and pâté was positive at 0.25% milk addition for both formats. Sausage was positive at 0.005%, and bread at 0.05% added egg for indirect competitive and sandwich formats, whereas pâté was positive at 0.25% egg only by the indirect competitive assay. The concentration of added milk and egg to give a positive result depends on heat treatment, being higher for pâté (sterilised), followed by bread (baked) and sausage (pasteurised). The particularities of each format and the heat processing applied influenced the determination by ELISA of allergenic proteins in foods.

Detection of Clostridium tyrobutyricum spores using polyclonal antibodies and flow cytometry

Aims:  The present work investigates the feasibility of using flow cytometry (FCM) combined with fluorescent‐labelled specific polyclonal antibodies for the detection and presumptive identification of Clostridium tyrobutyricum spores in bovine milk.

Pepsin Degradation of Cry1A(b) Protein Purified from Genetically Modified Maize (Zea mays)

The aim of this work was to study the in vitro digestion of Cry1A(b) protein by pepsin. To perform this work, a protein fraction purified from transgenic maize by immunoadsorption was employed. The undigested fraction showed several bands of molecular weight ranging between 14 and 70 kDa when assayed by SDS-PAGE. These bands were identified as corresponding to Cry1A(b) protein by immunochemical techniques and mass spectrometry. The rate of degradation of the purified fraction by pepsin estimated by ELISA was found to be about 75% within 30 min, and the protein concentration remained constant up to 4 h. In all treated samples, the full-length protein and fragments present in Cry1A(b) fraction were absent and peptides of less than 8.5 kDa were mainly found by SDS-PAGE and mass spectrometry. These peptides did not react with antiserum against Cry1A(b) protein by Western blotting. These results suggest that Cry1A(b) fraction purified from transgenic maize is rapidly and extensively degraded by pepsin, giving peptides of low molecular mass.

Production of polyclonal antibodies against spores of Clostridium tyrobutyricum, a contaminant affecting the quality of cheese: characterisation of the immunodominant protein

Abstract The effect of different treatments in the production of polyclonal antibodies against Clostridium tyrobutyricum spores and its immunodetection was studied. Moreover, the main protein that causes the immunological response has been characterised. Antisera from rabbits immunised with non-treated, heated or sonicated spores were tested by ELISA. Heated and sonicated spores gave a faster increase in antibody titre than non-treated spores a long time after immunisation. Heat treatment improved reactivity when it was applied to the spores prior to immunodetection. However, when the highest titre was reached, the treatment effect was not observed either in the immune response or in the immunodetection. The immunodominant protein was identified in a spore extract by transfer-blotting, analysed by on-line liquid chromatography tandem mass spectrometry, and characterised by comparison of its peptide fragmentation spectrum with the NCBI database. Five proteins from the family of chaperonins were shown related to the immunodominant protein of C. tyrobutyricum spore extract.

Guía clínica sobre implantes cocleares

INTRODUCTION In the last decade numerous hospitals have started to work with patients who are candidates for a cochlear implant (CI) and there have been numerous and relevant advances in the treatment of sensorineural hearing loss that extended the indications for cochlear implants. OBJECTIVES To provide a guideline on cochlear implants to specialists in otorhinolaryngology, other medical specialities, health authorities and society in general. METHODS The Scientific Committees of Otology, Otoneurology and Audiology from the Spanish Society of Otolaryngology and Head and Neck Surgery (SEORL-CCC), in a coordinated and agreed way, performed a review of the current state of CI based on the existing regulations and in the scientific publications referenced in the bibliography of the document drafted. RESULTS The clinical guideline on cochlear implants provides information on: a) Definition and description of Cochlear Implant; b) Indications for cochlear implants; c) Organizational requirements for a cochlear implant programme. CONCLUSIONS A clinical guideline on cochlear implants has been developed by a Committee of Experts of the SEORL-CCC, to help and guide all the health professionals involved in this field of CI in decision-making to treathearing impairment.

Implantes activos de oído medio

Active middle ear implants are surgically implanted prosthesis, which intend to stimulate the ossicular chain or the inner ear fluids through the oval or round windows. These implants may be useful for the treatment of certain patients with sensorineural hearing loss as well as for conductive or mixed hearing loss. This clinical guide attempts to summarize the current knowledge concerning the basic characteristics and indications of the most commonly used middle ear implants, including Vibrant Soundbrige (Med-el, Innsbruck), Carina (Cochlear, Australia), and CodacsTM. (Cochlear, Australia).