What/Why/When/Where/How Framework and Faculty Development Workshop to Improve the Utility of Narrative Evaluations for Assessing Internal Medicine Residents.

Introduction: Clinical competency committees (CCCs) rely on narrative evaluations to assess resident competency. Despite the emphasis on these evaluations, their utility is frequently hindered by lack of sufficient detail for use by CCCs. Prior resources have sought to improve specificity of comments and use of evaluations by residents but not their utility for CCCs in assessing trainee performance.

D-Cycloserine enhances the bidirectional range of NMDAR-dependent hippocampal synaptic plasticity.

The partial N-methyl-D-aspartate receptor (NMDAR) agonist D-Cycloserine (DCS) has been evaluated for the treatment of a wide variety of psychiatric disorders, including dementia, schizophrenia, depression and for the augmentation of exposure-based psychotherapy. Most if not all of the potential psychiatric applications of DCS target an enhancement or restitution of cognitive functions, learning and memory. Their molecular correlate is long-term synaptic plasticity; and many forms of synaptic plasticity depend on the activation of NMDA receptors.

Giving Voice to Cardiovocal Syndrome: A 26-Year-Old Woman With Hypophonia and Dysphagia.

Are children's hospitals only for children? Practically speaking, they and their associated specialty clinics often provide necessary medical and surgical care for patients older than 18 years, especially those with medical complexity. For this reason, pediatric practitioners must be familiar with both childhood-onset conditions and problems common in older and larger individuals. This case report describes a 26-year-old woman with CHARGE syndrome (coloboma/cranial nerve palsy, heart defects, atresia of the choanae, restricted development/growth, genitourinary abnormalities, ear abnormalities) who presented to a children's hospital with hypophonia and dysphagia and was ultimately diagnosed with left recurrent laryngeal nerve palsy due to untreated sleep apnea and uncontrolled congestive heart failure leading to pulmonary hypertension that exacerbated her congenital cardiovascular abnormalities.

Developing a Web-Based Asynchronous Case Discussion Format on Social Media to Teach Clinical Reasoning: Mixed Methods Study.

Background: Case-based learning conferences are valuable to trainees, but growing clinical demands hinder consistent attendance. Social media increasingly acts as a venue for trainees to supplement their education asynchronously. We designed and implemented a web-based asynchronous clinical case discussion series on the Twitter social media platform to fill this educational gap.

Tinnitus and mobile phone use.

Objectives: The mechanisms that produce tinnitus are not fully understood. While tinnitus can be associated with diseases and disorders of the ear, retrocochlear diseases and vascular pathologies, there are few known risk factors for tinnitus apart from these conditions. There is anecdotal evidence of an link between mobile phone use and tinnitus, but so far there have been no systematic investigations into this possible association.

Analysis of 60 patients after tympanotomy and sealing of the round window membrane after acute unilateral sensorineural hearing loss.

Objective: This retrospective study was performed to evaluate the effectiveness of tympanotomy and sealing of the round window membrane after unilateral acute hearing loss.

Design: All patients presenting idiopathic sudden hearing loss, acoustic, or barotrauma were treated with prednisolone and caroverine. Thirty-six patients had a mean pure tone hearing level worse than 70 dB.

7beta-hydroxycholesterol induces apoptosis and regulates cyclooxygenase 2 in head and neck squamous cell carcinoma.

Objective: To determine whether treatment with 7beta-hydroxycholesterol (7beta-HC) would trigger cell death in head and neck squamous cell carcinoma (HNSCC) cell lines in a dose-dependent fashion.

Design: In vitro study.

Subjects: The study included HNSCC cell lines SCC9, SCC25, CAL27, and FaDu.

Improved postural control after computerized optokinetic therapy based on stochastic visual stimulation in patients with vestibular dysfunction.

Balance is accomplished by the congruent integration of visual, vestibular and somatosensory input and the execution of adequate control movements. With increasing age, nonlinear dynamics of central control systems become more regular. In unilateral vestibular dysfunction, sensory input to central systems is similarly less complex, because of one sided reduction of information influx.

Multiple aspects related to self-awareness and the awareness of others: an electroencephalography study.

The effect of possessive pronouns on the encoding of pronoun-noun associations (e.g., my garden) was investigated using the electroencephalography (EEG).

Challenging a dogma--surgery yields superior long-term results for T1a squamous cell carcinoma of the glottic larynx compared to radiotherapy.

Aims: The aim of this study was to compare laser surgery, conventional endoscopic surgery and radiotherapy in the treatment of early T1a glottic cancer.

Methods: We conducted a retrospective analysis of patients with early vocal cord cancer (who underwent either conventional surgery via endoscopy or laryngofissur, or primary radiotherapy) at the Medical University of Vienna. By univariate and multivariate Cox regression models the influence of treatment and other parameters on survival and locoregional control were analysed.

Topical administration of Caroverine in somatic tinnitus treatment: proof-of-concept study.

This prospective study, which conformed with good clinical practice (GCP-conform), tested the concept that the topical transtympanic administration of the quinoxaline derivative Caroverine promises a new approach to the treatment of tinnitus. The rationale for the study is the hypothesis that tinnitus reflects sequelae of auditory neurotoxicity that can prevented and repaired by the neuroprotective and neuroregenerative activities of quinoxaline derivatives exhibited in previous preclinical tests. In a representative patient cohort, the probability of a long-lasting tinnitolytic effect of lipophilic eardrops containing 1% Caroverine as their active ingredient gained in significance, crossing from low-intensity levels to high-intensity levels of individual tinnitus sensations.

Do middle ear muscles trigger attacks of Menière's disease?

Objective: Current surgical methods for treating Ménière's disease (MD), e.g. endolymphatic sac surgery, mastoidectomy or insertion of middle ear ventilation tubes, only improve vertigo and fail to influence the hearing threshold.

The quinoxaline derivative caroverine in the treatment of sensorineural smell disorders: a proof-of-concept study.

The treatment of non-conductive olfactory disorders is to a large extent an unsolved problem. This proof-of-concept study focused on possible effects of the N-methyl-D-aspartate (NMDA) antagonist caroverine. Potential mechanisms for the hypothesized effect included reduced feedback inhibition in the olfactory bulb as a consequence of NMDA antagonistic actions and antagonism of an excitotoxic action of glutamate.

The antioxidant activity of caroverine.

Caroverine, 1-(2-diethylaminoethyl)-3-(p-methoxy benzyl)-1,2-dihydro-2-quinoxalin-2-on-hydrochloride, is a class B calcium-channel-blocker and antiglutamatergic agent with significant effects on the brain function. Caroverine exhibits competitive AMPA antagonism, and at higher concentrations, noncompetitive NMDA antagonism. In clinical practice caroverine is used as a spasmolytic and otoneuroprotective agent.

Change of complexity patterns in human posture during aging.

Human posture is a prototypical example of a complex control system. The joint output of several physiological - most likely nonlinearly interacting - processes leads to correctional movements which enable us to stand upright. These correctional body movements reflect some features of the underlying control mechanisms.

Role of substance P in the peripheral vestibular and auditory system.

The central role of substance P (SP) has attracted growing interest in the past two decades. One of the important physiological functions of SP and other tachykinins is that of a neurotransmitter in primary afferent neurons. Recent immunocytochemical, biochemical and electrophysiological investigations on various neurotransmitters support the hypothesis that SP has a similar function in the vestibular and auditory systems of all mammals including humans.

Different action of memantine and caroverine on glutamatergic transmission in the mammalian cochlea.

Glutamate is the major transmitter candidate between inner hair cells and the afferent neurons of the mammalian cochlea. We investigated the action of memantine (1-amino-3,5-dimethyl-adamantane) and the quinoxaline derivative caroverine [1-diethylaminoethyl-3,8-(p-methoxybenzyl)-1,2-dihydro-quinoxaline-dione] on the glutamatergic transmission in the guinea pig cochlea utilizing extracellular recording techniques and microiontophoretic ejection of substances. While memantine was able to inhibit the NMDA (N-methyl-D-aspartate)-induced firing, the AMPA (alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid)-stimulated activity was unaffected.

Clinical experience with caroverine in inner ear diseases.

The glutamatergic synapses between the cochlear inner hair cells and their afferent neurons seem to be mostly involved in the pathophysiology of the cochlea. Glutamatergic neurotoxicity is characterized by a mitochondrial overproduction of free oxygen radicals damaging lipid membranes and DNA structures of the postsynaptic neuron followed by the clinical symptoms of hearing loss and tinnitus. In preclinical tests, quinoxaline derivatives antagonized these deleterious consequences of too high an amount of free radicals.

Skin test results but not serology reflect immediate type respiratory sensitivity: a study performed with recombinant allergen molecules.

The diagnosis of type I allergy, an IgE-antibody-mediated hypersensitivity disease affecting more than 25% of the population, is based on the measurement of allergen-specific serum IgE levels and provocation testing. Whether the determination of allergen- specific serum IgE levels can replace in vivo provocation testing for allergy diagnosis is a controversial issue. We used purified recombinant timothy grass and birch pollen allergens to compare by skin prick and nasal provocation testing as well as by serology in vivo sensitivity with antibody-binding capacity in 24 pollen allergic patients and eight control individuals.

Scaling-violation phenomena and fractality in the human posture control systems.

By analyzing the movements of quiet standing persons by means of wavelet statistics, we observe multiple scaling regions in the underlying body dynamics. The use of the wavelet-variance function opens the possibility to relate scaling violations to different modes of posture control. We show that scaling behavior becomes close to perfect, when correctional movements are dominated by the vestibular system.

[Intraoperative navigation in paranasal sinus surgery with the Philips "Neuroguide" system].

Objective: To investigate the feasibility, precision and usefulness of computer aided surgery in ENT-sinus surgery.

Material And Methods: 5 Patients with chronic sinus pathology and an indication for sinus surgery were elected. For intraoperative navigation we used a Philips "NEUROGUIDE" system and surgical instruments with LED's.

Metabotropic glutamate receptors group I are involved in cochlear neurotransmission.

All three types of ionotropic glutamate receptors, AMPA, NMDA and kainate, contribute to the neurotransmission between inner hair cells (IHC) and afferent neurons in the mammalian cochlea. We used microiontophoretic techniques to investigate whether metabotropic glutamate receptors group I (mGluR I) are also involved in the transmission of IHC afferents of the guinea pig. The mGluR I agonist DHPG produced an increase in afferent firing, which lasted significantly longer than that of the ionotropic agonists AMPA and NMDA.