history of angina, myocardial infarction, heart failure, stroke, peripheral vascular disease) in this predominantly African American patient population. We conducted a cross-sectional study involving 41 African American patients (14 M, 27 F; 60 Ϯ 16 years) who were on hemodialysis Ն 3 months. Patient demographics and medical histories were obtained. Predialysis serum PAI-1 (ELISA) and serum carnitine levels (spectrophotometry) were measured. Other markers of inflammation and oxidative stress, including C-reactive protein (CRP), IL-6, IL-10, and TNF-␣, were also measured (ELISA). The subjects were divided into two groups: group 1 (n = 36) -low total serum carnitine (< 31 µmol/L for women and < 42 µmol/L for men) and group 2 (n = 5) -normal total serum carnitine (Ն 31 µmol/L for women and Ն 42 µmol/L for men). There were no significant differences in mean age (60 Ϯ 16 years vs 64 Ϯ 13 years; p = ns), gender, presence of hypertension or diabetes, etiology of CKD or serum levels of CRP, IL-6, IL-10, or TNF-␣ between the groups. PAI-1 levels were significantly higher in subjects in group 1 as compared to group 2 (62 Ϯ 24 IU/mL vs 37 Ϯ 21 IU/mL; p = .03). Nine subjects in group 1 had a composite cardiovascular end point as compared to none in group 2. In this population, patients with low carnitine levels had higher levels of PAI-1 as compared to patients with normal carnitine levels. This study was limited by small sample size and the high prevalence of low carnitine levels in hemodialysis patients. More studies are needed to further clarify this observation and the association with cardiovascular disease. Purpose: ASPECTS is a robust method for quantifying acute stroke hypodensity on noncontrast CT (NCCT) and helps predict clinical outcome. Whole brain source images obtained with CT angiography (CTA-SI) may increase ischemic brain conspicuity. We sought to determine if CTA-SI is more sensitive than NCCT in detecting acute middle cerebral artery (MCA) infarction and in predicting final infarct size using a modified ASPECT score for lesion delineation. Materials and Methods: After informed consent, we reviewed NCCT and CTA-SI scans of 51 patients with suspected MCA stroke, imaged within 12 hours of symptoms onset, enrolled in a dual-center cohort study. Two blinded neuroimagers rated presence and extent of NCCT and CTA-SI hypodensity using modified ASPECTS. Level of certainty for hypodensity detection was graded on admission and follow-up images using a 5-point scale (5 = definitely present; 1 = definitely absent). Linear regression and receiver operator characteristic (ROC) analyses were performed. Results: Thirty-three patients had confirmed infarction at follow-up (mean 6.5 days). Using certainty levels Ն 4 (probable/definite) for ischemic hypodensity, sensitivity for acute stroke detection was 49% with NCCT and 70% with CTA-SI (p = .04, ROC analysis); specificity was 100% for both. Linear regression showed R 2 = .42 (p < .0001) for the correlation between acute NCCT modified ASPECTS and follow-up modified ASPECTS, ...
It is estimated that less than 1% of the newborns present hearing loss during infancy. The Government of Puerto Rico instituted recently the Hearing Screening Law considering that from 55,000 live-born babies in the island, approximately 174 new cases of auditory loss are identified yearly. Hearing loss is one of the conditions directly affecting the development of the premature infant. Given the conditions and challenges that these infants have to overcome to survive and to adapt to their new environment, it is necessary to consider the factors and variables that can precipitate the acquisition of auditory loss.PurposeIdentify hearing loss in preterm infants and describe the characteristics of this group of patients.MethodsAutomated auditory brainstem response (A-ABR) was performed in a group of preterm infants admitted to the neonatal intensive care unit during a 1-year period.ResultsA total of 103 newborns were included in the study. The mean gestational age was 30 weeks and mean birth weight was 1,030 g. Twelve babies presented hearing loss (11%). Most of the babies with hearing loss were females (75%), had low APGAR scores (78%), and required resuscitation at the delivery room (75%). Retinopathy of prematurity was prevalent in this group of babies (73%).ConclusionHearing loss is more prevalent in preterm infants when compared to the general population of newborns. Risk factors for hearing loss in this group of infants need to be identified in order to prevent and/or identify it so that early intervention can be instituted.This study was supported by a grant from the State Council for Developmental Disabilities.
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