This document discusses cochlear implants, including their history from early experiments to FDA approval and advances in technology. It covers implant components, indications for use in adults and children, surgical technique, postoperative management, and rehabilitation. Results of implantation can vary widely but tend to be best when implantation occurs early, before age 6 for prelingually deafened children, and when patients receive aural/oral education and are highly motivated. Future areas of research include partial implants, bilateral implantation, and minimally invasive surgery techniques.
Being invited to Florence, Italy to address an international medical meeting about our work for
head and neck tumors was a great honor. The symposium – organized under the auspices of
the President of Italy was held in a once-ancient hospital that is now a museum in the historic
city of Tuscany.
Being invited to Florence, Italy to address an international medical meeting about our work for
head and neck tumors was a great honor. The symposium – organized under the auspices of
the President of Italy was held in a once-ancient hospital that is now a museum in the historic
city of Tuscany.
Opportunities for kids with Hearing loss dougbackous
This is a short review of new opportunities for children with hearing loss aimed at primary care doctors. Parents can learn from it as well. Presented at the Swedish Pediatric education 1/21/11.
Opportunities for kids with Hearing lossdougbackous
This is a short review of new opportunities for children with hearing loss aimed at primary care doctors. Parents can learn from it as well. Presented at the Swedish Pediatric education 1/21/11.
Hearing loss is one of the most frequent sensory deficient in human population. It affects more than 360 million people.
Consequences of hearing impairment include reduced ability to communicate, economic and educational disadvantage, social isolation and stigmatization.
we will talk also about the common types & causes of hearing loss and the possible applicable methods to treat these conditions.
Opportunities for kids with Hearing loss dougbackous
This is a short review of new opportunities for children with hearing loss aimed at primary care doctors. Parents can learn from it as well. Presented at the Swedish Pediatric education 1/21/11.
Opportunities for kids with Hearing lossdougbackous
This is a short review of new opportunities for children with hearing loss aimed at primary care doctors. Parents can learn from it as well. Presented at the Swedish Pediatric education 1/21/11.
Hearing loss is one of the most frequent sensory deficient in human population. It affects more than 360 million people.
Consequences of hearing impairment include reduced ability to communicate, economic and educational disadvantage, social isolation and stigmatization.
we will talk also about the common types & causes of hearing loss and the possible applicable methods to treat these conditions.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Grand Rounds
1. Cochlear Implants
Glen T. Porter, MD
Faculty Advisor: Arun K. Gadre, MD
Department of Otolaryngology, Head & Neck Surgery
The University of Texas Medical Branch
Galveston, Texas
Grand Rounds Presentation
February 3, 2003
2. History of Cochlear Implants
Volta
Djourno and Eyries
House, Doyle,
Simmons
1972 Single-channel
implant
1984 FDA approval
1990’s
Beyond
9. Sensorineural Hearing Loss
Death of hair cells vs. ganglion
cells
Otte, et al estimated we need
10,000 ganglion cells with 3,000
apically to have good speech
discrimination
Apical ganglion cells tend to
survive better (?acoustic
trauma)
Central neural system plasticity
14. Anatomy of Speech
Mix of frequencies
Speech recognition is “top-down” process
Formant frequencies: frequency maximum
based on vocal tract
F0 is fundamental frequency
F1 & F2—contribute to vowel identification
F3—l,r (lateral and retroflex glides)
F4 & F5—higher frequency speech sounds
Some speech based on amplitude—k, f, l, s
17. Types of Cochlear Implants
Single vs. Multiple channels
Audio example of how a cochlear implant sounds with
varying number of channels
Monopolar vs. Bipolar
Speech processing strategies
Spectral peak (Nucleus)
Continuous interleaved sampling (Med-El, Nucleus,
Clarion)
Advanced combined encoder (Nucleus)
Simultaneous analog strategy (Clarion)
19. Indication for Cochlear Implant
Adults
18 years old and older (no limitation by age)
Bilateral severe-to-profound sensorineural
hearing loss (70 dB hearing loss or greater
with little or no benefit from hearing aids for 6
months)
Psychologically suitable
No anatomic contraindications
Medically not contraindicated
20. Indications for Cochlear
Implantation -- Children
12 months or older
Bilateral severe-to-profound sensorineural hearing loss
with PTA of 90 dB or greater in better ear
No appreciable benefit with hearing aids (parent survey
when <5 yo or 30% or less on sentence recognition
when >5 yo)
Must be able to tolerate wearing hearing aids and show
some aided ability
Enrolled in aural/oral education program
No medical or anatomic contraindications
Motivated parents
21. Contraindications
Incomplete hearing loss
Neurofibromatosis II, mental retardation, psychosis,
organic brain dysfunction, unrealistic expectations
Active middle ear disease
CT findings of cochlear agenesis (Michel deformity) or
small IAC (CN8 atresia)
Dysplasia not necessarily a contraindication, but
informed consent is a must
H/O CWD mastoidectomy
Labyrinthitis ossificans—follow scans
Advanced otosclerosis
23. General Workup
Audiologic exam with binaural
amplification
CT scan/MRI of temporal bones
Trial of high-powered hearing aids
Psychological evaluation
Medical evaluation
Any necessary tests to discover etiology of
hearing loss
27. Postoperative Management
Complication rate only 5%
Wound infection/breakdown
Yu, et al showed good response to Abx, I&D
Facial nerve injury/stimulation, CSF leak,
Meningitis
CDC recommendations
Vertigo (Steenerson reported 75%)
Device failure—re-implantation usually
successful
Avoid MRI
28. Postoperative Rehabilitation
Necessary part of implantation
Different focus depends on patient’s
previous experience with sound
Goal is to enable children to be able to
learn passively from the environment
Program addresses receptive as well as
expressive language skills
Multidisciplinary, dedicated group
necessary
29. Results of Implantation
Wide range of outcomes
Improvement is long-term (Waltzman, et al. 5-15 yr f/u)
Implantation is cost effective—even in the elderly
(Francis, et al)
Research indicates recipe for success includes:
Short length of time from deafness to implantation (Sharma
showed <3.5 years regain normal latencies within 6 mos. After 7
years, little plasticity remains)
Experience with language before onset of deafness
Implantation before age six for prelingually deafened children
(Govaerts, et al showed 90% of children implanted <2yo were
integrated into mainstream vs. only 20-30% if implanted after
age 4)
Aural/oral education
Highly motivated patients/parents
30. A Look to the Future
Partial implants with hearing aid
Those with residual low-frequency hearing
Intraoperative mapping
Bilateral implantation
One vs. two speech processors
Implantation for asymmetric SNHL
“Softip” array
Minimally invasive implantation