Ear, nose and throat manifestations in pemphigus vulgaris

Pemphigus vulgaris (PV) is an autoimmune disease characterized by mucocutaneous intraepithelial blisters and pathogenic autoantibodies against desmoglein 3. There are two clinical forms: mucosal (MPV) and mucocutaneous (MCPV). The frequency of ear, nose and throat (ENT) involvement in PV is not clearly defined. Only a few isolated individual cases have been reported. OBJECTIVES: The objective of our study was to determine the incidence of ENT involvement in patients with PV. PATIENTS: We studied prospectively all 16 patients diagnosed with PV and treated in the Department of Dermatology of the University Clinic of Navarra between 2001 and 2005. They were 10 cases of MPV and six cases of MCPV. All patients were evaluated for ENT manifestations by endoscopic examination. RESULTS: Of the 16 patients, 13 presented with throat symptoms (81%), 12 pharyngeal (75%) and seven laryngeal symptoms (44%). Fourteen patients (88%) had active PV lesions on endoscopic evaluation (eight patients had active lesions on both pharyngeal and laryngeal mucosa, four had PV lesions only on laryngeal mucosa and two had PV lesions on pharyngeal mucosa). Laryngeal lesions were most commonly present in MPV patients. The frequency of nasal symptoms (38%) was lower than active PV lesions (62%) found on ENT examination. Oral symptoms and oral active PV lesions were the most frequent findings (94%). Only three patients with MCPV showed erosions on the external auditory canal. CONCLUSIONS: As ENT endoscopy allows more extensive areas of mucosa to be examined than simple visual inspection, we recommend that it be included in the examination of all patients with PV. By obtaining more complete information concerning the extent of the disease, a more accurate diagnosis can be made, better choice of drug and dose may be decided and, ultimately, response to treatment may be improved

Revisión de los criterios audiométricos en el tratamiento de la hipoacusia neurosensorial mediante audífonos y prótesis auditivas implantables

Sensorineural hearing loss has a high incidence in our population; as a matter of fact, 50 % of people above 75 years of age suffer this impairment. Due to the advances in the devices to alleviate this condition and their verified efficacy, it is now appropriate to review the indications for these devices and provide a detailed description of the audioprosthetic systems used. These systems can be classified as external non-implantable devices (hearing aids) and implantable prostheses. The latter can be sub-divided into active implants in the external ear or middle ear, cochlear implants, and auditory brainstem implants (ABI). Indications for each group are determined by the type and location of the underlying condition as well as by the anatomic, functional, and social characteristics of each patient. It must be stressed that the selection and monitoring of the treatment is up to the specialist. Generally speaking, an attempt is made to facilitate the integration of the hypoacusic patients to their sound setting by enhancing their understanding of the spoken word and restoring binaurality, while at the same time, seeking to retain the plasticity of central auditory routes through the stimulation provided by any of these systems. In the course of this review, we refer to newly-emerging indications in both the field of cochlear implants (bimodal stimulation, implantation in patients with residual hearing, bilateral implants, etc) and in the area of ABI in patients with tumoural disease previously treated with radiosurgery or patients with non-tumour pathologies presenting malformations or bilateral cochlear ossification

Leveraging Static Analysis for Bug Repair

We propose a method combining machine learning with a static analysis tool (i.e. Infer) to automatically repair source code. Machine Learning methods perform well for producing idiomatic source code. However, their output is sometimes difficult to trust as language models can output incorrect code with high confidence. Static analysis tools are trustable, but also less flexible and produce non-idiomatic code. In this paper, we propose to fix resource leak bugs in IR space, and to use a sequence-to-sequence model to propose fix in source code space. We also study several decoding strategies, and use Infer to filter the output of the model. On a dataset of CodeNet submissions with potential resource leak bugs, our method is able to find a function with the same semantics that does not raise a warning with around 97% precision and 66% recall.Comment: 13 pages. DL4C 202

Support for UNRWA's survival

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides life-saving humanitarian aid for 5·4 million Palestine refugees now entering their eighth decade of statelessness and conflict. About a third of Palestine refugees still live in 58 recognised camps. UNRWA operates 702 schools and 144 health centres, some of which are affected by the ongoing humanitarian disasters in Syria and the Gaza Strip. It has dramatically reduced the prevalence of infectious diseases, mortality, and illiteracy. Its social services include rebuilding infrastructure and homes that have been destroyed by conflict and providing cash assistance and micro-finance loans for Palestinians whose rights are curtailed and who are denied the right of return to their homeland

Inducible Nitric Oxide Synthase Provides Protection Against Injury-Induced Thrombosis in Female Mice

Nitric oxide (NO) is an important vasoactive molecule produced by three NO synthase (NOS) enzymes: neuronal (nNOS), inducible (iNOS) and endothelial NOS (eNOS). While eNOS contributes to blood vessel dilation that is generally thought to protect against the development of hypertension, iNOS has been primarily implicated as a disease-promoting isoform leading to protein-bound 3-nitrotyrosine formation in aortic lesions and select organs during atherogenesis. Despite this, iNOS may also play a physiological role, via the modulation of cyclooxygenase and thromboregulatory eicosanoid production. Herein, we examined the role of iNOS in a murine model of thrombosis. Blood flow was measured in carotid arteries of male and female wild-type (WT) and iNOS-deficient mice following ferric chloride-induced thrombosis. Female WT mice were less susceptible to thrombotic occlusion than male counterparts, but this protection was lost upon iNOS deletion. In contrast, male mice (with and without iNOS deletion) were equally susceptible to thrombosis. The protective effect that iNOS affords female WT mice was not associated with a change in the balance of thromboxane A2 (TxA2) and antithrombotic prostacyclin (PGI2). Our findings, however, suggest that iNOS generates a protective source of NO in female WT mice that attenuates the effects of vascular injury. Thus, although iNOS is likely detrimental during atherogenesis, physiological iNOS levels may play a protective role in preventing thrombotic occlusion, a phenomenon that may be enhanced in female mice

Voz del anciano

La vejez es en sí un fenómeno biológico que no implica necesariamente una enfermedad. Los fenómenos biológicos del envejecimiento se inician en edades muy tempranas y tiene la capacidad de modificarse, preveerse y compensarse. La educación y la preparación para posibles deterioros debe de ser contemplada desde un plano preventivo. En el ser humano la aparición del lenguaje y su vehículo habitual, la voz; representó la posibilidad de aumentar su longevidad. El deterioro vocal del anciano se conoce como presbifonía y en ocasiones interfiere significativamente en la capacidad de comunicación y en la calidad de vida de las personas ancianas. Al considerar la presbifonía o voz senil hay que distinguir dos situaciones clínicas distintas desde el punto de vista conceptual: la disfonía del anciano y la disfonía en el anciano. Se comentan los aspectos del envejecimiento en relación con la voz, la valoración y la caracterización de la voz en el anciano y las estrategias para prevenir el deterioro y tratar los trastornos específicos de la voz en las personas mayores, bien sea desde el punto de vista funcional o rehabilitación o bien mediante cirugía

Vibrato de la voz cantada. Caracterización acústica y bases fisiológicas

El vibrato es uno de los ornamentos más comunes del canto clásico occidental y de la música destinada a aquellos instrumentos que pueden producirlo. El vibrato vocal corresponde físicamente a una modulación periódica sinusoidal de frecuencia fundamental de la fonación. El vibrato hace que la voz suene agradable, viva, excitante, cálida, menos mecánica que aquella que se consigue al emitir un tono plano. Da naturalidad y expresividad al sonido vocal. La mayoría de los cantantes lo consideran un elemento deseable pero no todos son capaces de desarrollarlo. Parece que la aparición del vibrato depende de un nivel técnico determinado. Se revisan las consideraciones históricas, las propiedades físicas, acústicas y aerodinámicas del vibrato. Se establecen hipótesis en lo referente a su origen y se plantean estrategias dirigidas a facilitar su desarrollo y aprendizaje

Capabilities and Impact on Wind Analyses of the Hurricane Imaging Radiometer (HIRAD)

The Hurricane Imaging Radiometer (HIRAD) is a new airborne microwave remote sensor for hurricane observations that is currently under development by NASA Marshall Space Flight Center in partnership with the NOAA Atlantic Oceanographic and Meteorological Laboratory/Hurricane Research Division, the University of Central Florida, the University of Michigan, and the University of Alabama in Huntsville. The instrument is being test flown in January and is expected to participate in or collaborate with the tropical cyclone experiment GRIP (Genesis and Rapid Intensification Processes) in the 2010 season. HIRAD is designed to study the wind field in some detail within strong hurricanes and to enhance the real-time airborne ocean surface winds observation capabilities of NOAA and USAF Weather Squadron hurricane hunter aircraft currently using the operational Stepped Frequency Microwave Radiometer (SFMR). Unlike SFMR, which measures wind speed and rain rate along the ground track at a single point directly beneath the aircraft, HIRAD will provide images of the surface wind and rain field over a wide swath (approx.3 x the aircraft altitude) with approx.2 km resolution. See Figure 1, which depicts a simulated HIRAD swath versus the line of data obtained by SFMR

Granulocyte transfusions in severe aplastic anemia

Patients with severe aplastic anemia (SAA) are at high risk of morbidity and mortality due to severe infections. We aimed to characterize the role of granulocyte transfusions (GT) in SAA. Primary outcomes were survival after the first GT, including overall survival (OS) at last follow up, survival to discharge, and receipt of a hematopoietic stem cell transplant (HSCT) Secondary outcomes included evaluation of clinical response at 7 and 30 days after initiation of GT, using a clinical scoring system incorporating microbiological and radiographic response. Twenty-eight SAA patients underwent 30 GT courses with a per-dose median of 1.28x109 granulocytes/kilogram (range, 0.45-4.52x109). OS from initial GT to median last follow up (551 days) was 50%, with 39% (11/28) alive at last follow up. Sixty-four percent (18/28) of all patients survived to hospital discharge. Patients with a complete or partial response, or stable infection, at 30 days had significantly better OS compared to non-responders (P=0.0004). Eighty-six percent (18/21) of patients awaiting HSCT during GT underwent a transplant and 62% (13/21) survived to post-HSCT discharge. Sex, type of infection, and percentage of days with absolute neutrophil count >0.2x109/L during the course of GT were not predictive of survival (P=0.52, P=0.7 and P=0.28, respectively). Nine of 28 (32%) patients developed new or increased human leukocyte antigen alloimmunization during their GT course. GT in SAA may have an impact on survival in those patients with improvement or stabilization of their underlying infection. Alloimmunization can occur and OS in this population remains poor, but GT may be a useful tool to bridge patients to curative treatment with HSCT