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190. A system for hearing screening in newborns
e146
Society Proceedings / Clinical Neurophysiology 119 (2008) e99–e164
probability of damage to the nervous system is bigger. The present work shows the results of the early screening program of auditory losses in children with factors of risk. Were studied 538 children with factors of risk, by means of the techniques of click Auditory Brainstem Responses (ABR) to 70 and 30 dbnhl and Multiple Auditory Steady State Responses (MSSR) (0.5 and 2 kHz) to 50 db Hl. The children that failed this first study were mentioned at a second confirmatory study with ABR to click to 70 and 30 dbnhl and MSSR (0.5, 1, 2, and 4 kHz). The incidence detected by ABR was of 12% and of 11% for the MSSR. Attended the second study 64% of the screening patients, of these were positive 77% with 23% of false positive in the first screening. Both methods are effective in the early screening of the auditory losses in the populations in risk.
tem software was implemented using the integrated development environment Delphi 7 upon the specialized hardware AUDIX V (Neuronic S.A., Havana). The MSSR testing algorithm uses predefined settings built in the system. Except for EEG monitoring (that requires visual inspection) all sequential operations during the acquisition and analysis of the MSSR are totally automated. The software was designed to be user-friendly and easy to operate by non-professionals, providing objective PASS/FAIL results that require no other interpretation. Thus it can be easily operated by less skilled personal with a minimal training. This system can be a valid alternative for early detection of hearing impairments, and further developed could be the basis for a fully automated MSSR screening device. doi:10.1016/j.clinph.2008.04.207
doi:10.1016/j.clinph.2008.04.205
190. A system for hearing screening in newborns—E. Rodrı´guez, M. Sa´nchez, E. Santos, M.C. Pe´rez (Cuba) Auditory Steady State Responses (ASSR) has emerged as technique that can provide frequency specific hearing threshold estimates. This study presents the design of an auditory screening device using the ASSR technique. The core of this engineer solution is the use of a MSP430 microprocessor from Texas Instruments, which have DA and AD converters, DMA channels and Timer-Counters to facilitate the acquisition and stimulation control. The device firmware was implemented using standard C language compiled with IAR Embedded Workbench for TI MSP430 EW430 v3.0. The Personal Digital Assistant (PDA) software was implemented using the integrated development environment Visual Studio.NET (Microsoft Visual C#), including integrated support for the Microsoft.NET Compact Framework for mobile device and Bluetooth sdks. The equipment has an amplifier with band pass filter adjusted to modulation frequency and two audio channels that allow the independent presentation of the acoustic stimuli to each ear. The data acquired and processed are wire-less sent, using a Bluetooth interface, to a PDA that shows the final results of the test. Pass or Referred is the format of the test result. In light of its potential characteristics, this programming option is flexible enough to allow easily the change the processing strategy at any moment, as needed. This screening device combine MSSR technology with fully automated results and completely standardized pre-set screening parameters. doi:10.1016/j.clinph.2008.04.206
191. A semi automatic system for newborn hearing screening upon the electroaudiometer AUDIX V—E. Santos Febles, M.C. Pe´rez Abalo (Cuba) One of the most important applications for the auditory steady-state responses is in assessing hearing in newborn infants. The systems based on this technique can not be used in this context because of the duration of the test, and the difficult results interpretation. Accordingly, we decided to develop a new semi automatic system for hearing screening based on the recording of Multiple Auditory Steady-State Responses (MSSR). The sys-
192. Validation of a new semi-automatic system for the detection of hearing losses in newly born—D. Herrera (Cuba) In this work it is evaluated the diagnostic efficiency from a new semi-automated system for registration of Auditory Steady- State Responses by multiple frequency (MSSR) for the detection of hearing losses in newborn. Firstly, the MSSR thresholds were determined in 15 newborn healthy to show the detectability of the answer to 50 db HL this allowed establishing a practical approach of 50 db HL of stimulation intensity to estimate the audition in the newborn ones using the new semi-automated system as screening instrument. Later on, the values of sensibility specificity, were determined, as well as the duration of the new semi-automated system of registration of the MSSR. Finally, the times of duration of the registration were calculated and of global duration of the procedure. The stocking MSSR thresholds of calculated for 2000 Hz (35.5 ± 6 db HL) it was significantly smaller that the one calculated for 500 Hz (42.5 ± 7 db HL). The calculated sensibility was of 100%, the specificity of 97%. The times of duration of the registration and of global duration of the procedure were of 2.6 min and 17.8 min, respectively. We can conclude that the semi-automated system of registration of MSSR for the detection of hearing losses in newborn presents good diagnostic effectiveness. doi:10.1016/j.clinph.2008.04.208
193. Volumetry and EEG in patient with refractory mesial temporal lobe epilepsy—O. Tra´paga, L.M. Morales, R. Rodrı´guez, A. Sa´nchez, M. Zaldı´var (Cuba) The aim of this study was to evaluate the contribution of MRI volumetric analysis and EEG for the evaluation of patients with refractory MTLE candidates to surgery. Twelve volumetric studies were carried out using MRI and EEG from 6 patients with MTLE. For the study of the epileptogenic lesion and volume dried up a MRI quantitative analysis was implemented. Frequency of pre-surgery epileptic interictal discharges (FED/min) in the EEG was calculated in the irritative region. Clinical evaluations were carried out 1, 6, and 12 months after surgery. Presurgical volumetric analysis showed that inferior temporal lobes and
Society Proceedings / Clinical Neurophysiology 119 (2008) e99–e164
probability of damage to the nervous system is bigger. The present work shows the results of the early screening program of auditory losses in children with factors of risk. Were studied 538 children with factors of risk, by means of the techniques of click Auditory Brainstem Responses (ABR) to 70 and 30 dbnhl and Multiple Auditory Steady State Responses (MSSR) (0.5 and 2 kHz) to 50 db Hl. The children that failed this first study were mentioned at a second confirmatory study with ABR to click to 70 and 30 dbnhl and MSSR (0.5, 1, 2, and 4 kHz). The incidence detected by ABR was of 12% and of 11% for the MSSR. Attended the second study 64% of the screening patients, of these were positive 77% with 23% of false positive in the first screening. Both methods are effective in the early screening of the auditory losses in the populations in risk.
tem software was implemented using the integrated development environment Delphi 7 upon the specialized hardware AUDIX V (Neuronic S.A., Havana). The MSSR testing algorithm uses predefined settings built in the system. Except for EEG monitoring (that requires visual inspection) all sequential operations during the acquisition and analysis of the MSSR are totally automated. The software was designed to be user-friendly and easy to operate by non-professionals, providing objective PASS/FAIL results that require no other interpretation. Thus it can be easily operated by less skilled personal with a minimal training. This system can be a valid alternative for early detection of hearing impairments, and further developed could be the basis for a fully automated MSSR screening device. doi:10.1016/j.clinph.2008.04.207
doi:10.1016/j.clinph.2008.04.205
190. A system for hearing screening in newborns—E. Rodrı´guez, M. Sa´nchez, E. Santos, M.C. Pe´rez (Cuba) Auditory Steady State Responses (ASSR) has emerged as technique that can provide frequency specific hearing threshold estimates. This study presents the design of an auditory screening device using the ASSR technique. The core of this engineer solution is the use of a MSP430 microprocessor from Texas Instruments, which have DA and AD converters, DMA channels and Timer-Counters to facilitate the acquisition and stimulation control. The device firmware was implemented using standard C language compiled with IAR Embedded Workbench for TI MSP430 EW430 v3.0. The Personal Digital Assistant (PDA) software was implemented using the integrated development environment Visual Studio.NET (Microsoft Visual C#), including integrated support for the Microsoft.NET Compact Framework for mobile device and Bluetooth sdks. The equipment has an amplifier with band pass filter adjusted to modulation frequency and two audio channels that allow the independent presentation of the acoustic stimuli to each ear. The data acquired and processed are wire-less sent, using a Bluetooth interface, to a PDA that shows the final results of the test. Pass or Referred is the format of the test result. In light of its potential characteristics, this programming option is flexible enough to allow easily the change the processing strategy at any moment, as needed. This screening device combine MSSR technology with fully automated results and completely standardized pre-set screening parameters. doi:10.1016/j.clinph.2008.04.206
191. A semi automatic system for newborn hearing screening upon the electroaudiometer AUDIX V—E. Santos Febles, M.C. Pe´rez Abalo (Cuba) One of the most important applications for the auditory steady-state responses is in assessing hearing in newborn infants. The systems based on this technique can not be used in this context because of the duration of the test, and the difficult results interpretation. Accordingly, we decided to develop a new semi automatic system for hearing screening based on the recording of Multiple Auditory Steady-State Responses (MSSR). The sys-
192. Validation of a new semi-automatic system for the detection of hearing losses in newly born—D. Herrera (Cuba) In this work it is evaluated the diagnostic efficiency from a new semi-automated system for registration of Auditory Steady- State Responses by multiple frequency (MSSR) for the detection of hearing losses in newborn. Firstly, the MSSR thresholds were determined in 15 newborn healthy to show the detectability of the answer to 50 db HL this allowed establishing a practical approach of 50 db HL of stimulation intensity to estimate the audition in the newborn ones using the new semi-automated system as screening instrument. Later on, the values of sensibility specificity, were determined, as well as the duration of the new semi-automated system of registration of the MSSR. Finally, the times of duration of the registration were calculated and of global duration of the procedure. The stocking MSSR thresholds of calculated for 2000 Hz (35.5 ± 6 db HL) it was significantly smaller that the one calculated for 500 Hz (42.5 ± 7 db HL). The calculated sensibility was of 100%, the specificity of 97%. The times of duration of the registration and of global duration of the procedure were of 2.6 min and 17.8 min, respectively. We can conclude that the semi-automated system of registration of MSSR for the detection of hearing losses in newborn presents good diagnostic effectiveness. doi:10.1016/j.clinph.2008.04.208
193. Volumetry and EEG in patient with refractory mesial temporal lobe epilepsy—O. Tra´paga, L.M. Morales, R. Rodrı´guez, A. Sa´nchez, M. Zaldı´var (Cuba) The aim of this study was to evaluate the contribution of MRI volumetric analysis and EEG for the evaluation of patients with refractory MTLE candidates to surgery. Twelve volumetric studies were carried out using MRI and EEG from 6 patients with MTLE. For the study of the epileptogenic lesion and volume dried up a MRI quantitative analysis was implemented. Frequency of pre-surgery epileptic interictal discharges (FED/min) in the EEG was calculated in the irritative region. Clinical evaluations were carried out 1, 6, and 12 months after surgery. Presurgical volumetric analysis showed that inferior temporal lobes and