Down syndrome, or trisomy 21, is the most common genetic alteration in humans. The syndrome presents with several features, including hearing loss and changes in the central nervous system, which may affect language development in children and lead to school difficulties. The present study aimed to investigate group differences in the central auditory system by long-latency auditory evoked potentials and cognitivepotential. An assessment of 23 children and adolescents with Down syndrome was performed, and a control group composed of 43 children and adolescents without genetic and/or neurological changes was used for comparison. All children underwent evaluation with pure tone and vocal audiometry, acoustic immitance measures, longlatency auditory evoked potentials, and cognitive potential. Longer latencies of the waves were found in the Down syndrome group than the control group, without significant differences in amplitude, suggesting that individuals with Down syndrome have difficulty in discrimination and auditory memory. It is, therefore, important to stimulate and monitor these children in order to enable adequate development and improve their life quality. We also emphasize the importance of the application of auditory evoked potentials in clinical practice, in order to contribute to the early diagnosis of hearing alterations and the development of more research in this area.central auditory evaluation, Down syndrome, electrophysiology, event-related potentials, evoked potentials, hearing, trisomy 21
Introduction Individuals with autism spectrum disorder (ASD) have abnormalities in auditory perception and sensitivity. The mismatch negativity (MMN) component of the evoked potential demonstrates a brain detection response to an auditory change due to memory, and enables the identification of changes in the auditory system. Objective To analyze MMN responses in children and adolescents with ASD and compare them with those of a control group. Methods Cross-sectional and comparative study. The sample was composed of 68 children and adolescents, divided into study group (SG), which contained those diagnosed with ASD, and the control group (CG), which contained those with typical development, normal hearing thresholds, and without hearing complaints. All participants were submitted to peripheral and central electrophysiological auditory evaluations. For the electrophysiological auditory evaluation and MMN recording, the electrodes were fixed in the following positions: Fz (active electrode), M1 and M2 (reference electrodes), and on the forehead (ground electrode). Auditory stimuli were presented in both ears simultaneously, with a frequency of 1,000 Hz for the frequent stimulus, and of 2,000 Hz for the rare stimulus, in an intensity of 80 dBNA. Results Latency and amplitude values were increased in the SG, with a statistically significant difference in comparison with the CG. In the MMN analysis, there was no statistically significant difference in the comparison between right and left ears and between genders. Conclusion Children and adolescents with ASD had higher latency and amplitude values in the MMN component than the individuals in the CG.
IntroductionAbdominal surgery with small bowel (SB) resection may require delayed anastomosis with the formation of a temporary defunctioning end stoma and mucous fistula (MF). If sited proximally, this may result in a short bowel in the proximal limb with redundant longer bowel in the distal limb. Oral/nasogastric (NG) intake may induce uncontrolled stomal fluid (>2.5 l/day) and electrolyte losses leading to prolonged hospital admission or parenteral support. The distal bowel can be utilised for absorption of nutrition, fluids and electrolytes if sufficient in length and accessible via the MF. However, the viability and safety of small bowel MF enteral support has been poorly reported. We present a case series of our experience in a busy district general hospital.MethodsReferred post-operative patients with a MF who demonstrated metabolic and nutritional instability on oral/NG intake due to uncontrolled stoma losses were assessed for MF feeding. A 14 French Foley catheter was inserted into the MF through a universal catheter access port placed into a windowed stoma bag and connected to standard enteral feeding apparatus. Elemental feed, rehydration fluids, electrolytes or nutritional supplements were administered to meet the patient's requirements using standard methods of jejunal feeding. Proximal stoma output was monitored and oral dietary intake reduced if necessary.ResultsBetween February 2007 and October 2008 eight patients were found to be appropriate for a trial of MF feeding. All patients had undergone SB resection with residual proximal small bowel length ranging from 75 to 150 cm (mean 116 cm) from the DJ flexure; all had distal SB length >1 m with a viable large bowel in continuity. Patients reported initial difficulties in assembling the feeding tube and access port via the stoma window, however with training all gained competency allowing home discharge with telephone and clinic support. The universal catheter access port allowed a water tight seal, and leakage around the feeding tube was negligible. There were no major metabolic complications of MF feeding including those patients who remained on controlled oral intake. All patients received enteral support for a minimum of 3 months prior to assessment for surgical anastomosis. In our study group 5 patients had delayed anastomosis and three died of causes unrelated to MF feeding.ConclusionMF feeding is a safe and effective method for nutritional support in appropriate patients and may allow home discharge in the presence of a high output proximal stoma. The use of a Foley catheter as a feeding tube and a simple catheter port allowed inexpensive and simple means of access. However, dedicated training, support and monitoring may be required to allow home discharge.
Introduction Nasogastric (NG) pump feeding is associated with risks of aspiration and subsequent pneumonia with previous studies in adult inpatients suggesting 2.4 aspiration episodes per 1000 tube-feeding days. However, there is little published data on outcomes of patients receiving home NG feeding. We analysed our long term home NG feeding cohort for evidence of aspiration related hospital admission. Methods This was a retrospective service evaluation of the home enteral tube feeding cohort at Portsmouth Hospitals NHS Trust. Data was obtained from hospital electronic databases, patient clinical notes and PAS patient management software. Data was analysed in SPSS 20. Results A total of 117 patients who had received home NG feeding over previous 5 years were evaluated. 30 patients (26%) were excluded due to incomplete datasets. 87 patients were recruited (Male [48%], Female [52%], age [mean 55.6; 95% confidence interval 51.8–59.2]) with a total of 12957 tube-feeding days (mean 150; 95% confidence interval 110–191 days). Indications include upper aerodigestive tract cancer, 32; malnutrition, 25; neurodegenerative disorders, 6; connective tissue disorders, 2; stroke, 1; lymphoma, 1; metabolic stabilisation of short bowel and or high output stoma, 16. Eight hospital admissions in separate patients were recorded; however, only 1 episode of pneumonia was recorded (0.08 aspiration episodes per 1000 tube-feeding days). There were no hospital admissions relating to misplaced/displaced NG tubes. Conclusion Home NG pump feeding represents a safe long-term alternative to gastrostomy feeding when supported by a robust specialist enteral tube feeding support service (ETFSS), in those deemed unsuitable for gastrostomy placement. A 30-fold lower incidence of aspiration episodes compared with published inpatient literature (0.08 vs. 2.4 episodes/1000 tube feeding days) reflects expertise of clinical nutrition nurse specialists within the ETFSS, with appropriate patient selection and outreach management. A daytime walk in service prevents unplanned hospital admissions through tube displacement. Disclosure of Interest None Declared
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
334 Leonard St
Brooklyn, NY 11211
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.