Mostrando entradas con la etiqueta Darío Roitman. Mostrar todas las entradas
Mostrando entradas con la etiqueta Darío Roitman. Mostrar todas las entradas

domingo, 7 de julio de 2013

Acúfenos: Sección Acúfenos en las Artes: Música Clásica: Los 3 meses de acúfenos del pianista Till Fellner



Hearing Things. The Wrong Kind of Things.

Published: January 28, 2007
 
 Till Fellner. Image from: www.bach-cantatas.com
IT happens all the time. In 2005 Till Fellner, an Austrian pianist then rising quickly, canceled an appearance in the Mostly Mozart Festival at Lincoln Center because of illness. A cold? The flu? A sprained finger?

This time the matter was not so simple. Mr. Fellner had developed tinnitus, an ear affliction that rendered him extremely uncomfortable.

“I couldn’t play because everything — traffic, people talking — seemed much too loud to me,” Mr. Fellner said recently from his home in Vienna. “I couldn’t bear listening to anything, so even teaching wasn’t possible.”

Neil Cherian MD. 
Tinnitus can be caused by exposure to sounds that damage the delicate hair cells in the inner ear, said Dr. Neil Cherian, a neurologist and the director of the Center for Performance Medicine at the Cleveland Clinic. One result can be a persistent ringing, hissing or buzzing.

What causes the condition is not always obvious, nor is it necessarily clear what allows normal ear function to return. “There is no consistent method to help this,” Dr. Cherian said, noting that many tinnitus sufferers recover simply by avoiding reinjury and allowing their ears time to heal.

Ear ailments are well known in classical music.


The most famous sufferer was Beethoven, whose decline into deafness has been recounted not only in books and monographs but also in plays and movies — recently, “Copying Beethoven,” with Ed Harris.
Imagen: es.wikipedia.org

Schumann too endured an ear affliction at least for a time. In the book “Schumann: The Inner Voices of a Musical Genius,” Peter Ostwald quotes Schumann’s wife, Clara, describing her husband’s troubles as a “constant singing and rushing in his ears.”

Dr. Peter F. Ostwald, an author, professor of psychiatry and the founding director of the Health Program for Performing Artists at the University of California at San Francisco, died on Saturday 05-30-1996 at his home. He was 68 and lived in San Francisco.
Dr. Ostwald was recognized internationally for his work on the interaction between music and psychiatry. 
He was the author of a pioneering biography on Robert Schumann, "Schumann: The Inner Voices of a Musical Genius" (1985), the first work to attempt an exact diagnosis of Schumann's severe mental disorders as they related to his compositions and creative life.


As for Mr. Fellner, the ailment disappeared with treatment after an agonizing three months, and he resumed his career without making the matter public.

“Normally I don’t talk about it,” he said. “In Europe nobody knows about it.”

Now after an absence of more than two years from New York, Mr. Fellner is set to return, playing a program of Bach, Beethoven and Schubert at the Metropolitan Museum on Feb. 8.

“I enjoy playing even more than before,” Mr. Fellner said. “There was a lot of thinking going on, but I realized how important it is to me, playing the piano. So I’m very happy I could continue.”

Mr. Fellner, 34 and a native of Vienna, first performed in the United States in 1995, then appeared regularly in New York and with major orchestras like the Chicago Symphony and the Los Angeles Philharmonic.

Still he has yet to achieve the fame of other pianists of his generation like Leif Ove Andsnes and Hélène Grimaud.

Part of the reason may be his self-effacing manner.

He has been compared to Tobey Maguire, the star of the Spider-Man films, though he does not so much resemble Mr. Maguire as embody his typical on-screen persona: the awkward boy next door, lanky, a bit goofy and unfailingly earnest.

Still there is nothing tentative about Mr. Fellner’s playing. It is assured, fluid and musical.

“To my mind he has all the ingredients to be on the top,” Alfred Brendel, the elder statesman among Austrian pianists and Mr. Fellner’s best-known teacher, said from his home in London.

“It has impressed me how ambitiously he has developed his repertory from Bach to the present, being equally at home in solo and concerto repertoire, chamber music and lieder.”

The conductor Kent Nagano, who has worked with Mr. Fellner steadily since 1997, is also an admirer. “When you perform with him, you share the feeling of music as a language beyond technical expression,” Mr. Nagano wrote in an e-mail message. “For me, his music-making has a special kind of truth and natural character.”

Mr. Fellner’s big break, if the term applies, came three years ago, with the release of his recording of Book 1 of Bach’s “Well-Tempered Clavier” by ECM.

The praise from critics was almost universal. Anthony Tommasini, in The New York Times, called the album “a major achievement” and later listed it among the best classical CDs of 2004: “one of the most substantive and rewarding recordings of the year.” (Mr. Fellner has yet to follow up that success, though he is scheduled to record Bach’s Two- and Three-Part Inventions for ECM in July.)

In addition to Bach, Mr. Fellner performs many Classical and Romantic standards, Mozart’s concertos prominently among them, and continues to expand his range.

He recently performed Chopin’s F minor Concerto for the first time, and Beethoven will soon fill his days. He plans to present complete cycles of the Beethoven sonatas in Vienna and London over two seasons, beginning next year.

He also plays less familiar music, including Schoenberg’s solo pieces and the demanding sonata of Julius Reubke, a talented pupil of Liszt who died young.

He is especially fond of the music of Gyorgy Kurtag, the contemporary Hungarian composer. “Except for Anton Webern, he is the only composer who can express himself in so few notes,” Mr. Fellner said.


Mr. Fellner has played other contemporary music as well. In 2002 he and the cellist Heinrich Schiff gave the first performance of “Mumien” by the Austrian composer Thomas Larcher. And last summer Mr. Fellner and Adrian Brendel, a cellist and Alfred Brendel’s son, performed “Lied,” a short work by the British composer Harrison Birtwistle written in honor of the elder Mr. Brendel’s 75th birthday. Mr. Fellner is scheduled for premieres by both composers this year.

“His choice of repertory will seem highbrow to some people,” Mr. Brendel said, “but I applaud him for it. And don’t mistake him for a predominantly intellectual player. I heard him do the best live performance of Liszt’s ‘Années de Pèlerinage.’ ”

Mr. Brendel and Mr. Fellner met in 1990, when Mr. Fellner, then 20, was studying at the Vienna Conservatory.

“I listened to Till, and he sounded promising,” Mr. Brendel said. “It was evident that he was very intelligent.” They have since met two or three times a year, discussing repertory and playing on two pianos.

“He’s a wonderful teacher,” Mr. Fellner said. “Normally he demonstrates a lot. On one hand, he’s looking for all the details. But on the other, he gives you a view over the whole piece. What he says is always very precise, very concrete.”

For his part Mr. Brendel said: “It is really a matter of a very valuable friendship. I like to share my experience with young concert pianists who are able to help themselves, and to check them out once in a while, to see whether they remain on course.”

Mr. Fellner, having overcome a physical setback, seems to have done just that.

Fuente: The New York times
 http://www.nytimes.com/2007/01/28/arts/music/28merm.html

jueves, 4 de julio de 2013

Charla gratuita: Acúfenos

Charla gratuita: Acúfenos

Jueves, 04 Julio 2013 00:43

4 de julio, a las 18.30 Hs, Quintana 161 CABA.

 A cargo del Dres. Darío Roitman (otorrinolaringólogo) y Matías Bonanni (psiquiatra)

¿Qué es ese ruido molesto en mi oído?

Hay algunas veces que repentinamente escuchamos un ruido extraño que no procede de ninguna fuente externa, como si fuera un zumbido grave o agudo, un ronroneo, un silbido, un cantar de grillos, entre otros sonidos.
Estos fenómenos son conocidos como acúfenos.

La Fundación para la Investigación en las Neurociencias Aplicadas a la Clínica (FINAC); invita el próximo jueves 4 de julio, a las 18.30 horas, a una charla grauita para conocer qué es esta problemática, sus causas y tratamientos.

Los expositores del encuentro serán el Dr. Darío Roitman, médico otorrinolaringólogo y el Dr. Matías Bonanni, médico psiquiatra.

En Av. Quintana 161, CABA.

Para inscripciones y consultas, favor llamar de lunes a viernes de 8 a 20 horas al 011-4824-1962.

FUENTE : www.inac.org.ar y www.acufeno.com

viernes, 9 de noviembre de 2012

1 ª Conferencia Internacional sobre la hiperacusia: Causas, Evaluación, Diagnóstico y Tratamiento


Cuándo: 1-2 marzo, 2013
Dónde: Birkbeck College, Universidad de Londres, Londres, Reino Unido
E-Mail: rsc-tr.audiologyseminars @ nhs.net
 


Información detallada:
http://www.royalsurrey.nhs.uk/advanced-audiology-seminars

 1st International Conference on Hyperacusis: Causes, Evaluation, Diagnosis and Treatment
Dates: Friday 1st and Saturday 2nd March 2013
Venue: Birkbeck College, University of London, London, UK

Organizer: Tinnitus and Hyperacusis Therapy Clinic, Audiology Department, Royal Surrey County Hospital, Guildford  

Confirmed speakers and abstracts
  1. Richard Salvi (USA)
  2. Richard S. Tyler (USA)
  3. Craig Formby (USA)
  4. Ray Meddis (UK)
  5. Pawel Jastreboff (USA)
  6. Margaret Jastreboff (USA)
  7. Claudia Coelho (Brazil)
  8. Deepak Prasher (UK)
  9. Michael Zazzio (Sweden)
  10. Hashir Aazh (UK)
     


Registration Fee:
Before 15th December 2012:    £295
After 15th December 2012:       £395
   

viernes, 5 de octubre de 2012

Hyphoteses:Perilymph fistula: A cause of auditory, vestibular, neurological and psychiatric disorder


A.G. Gordon
32B Love Walk, London SE5 8AD, England.


 Abstract

It is suggested that damage by mild trauma, viruses or bone disease to the otic capsule or to the membranes between the cochlea and the middle ear is common, and involved in many syndromes of obscure etiology. 

The clinical perilymph fistula (PF) syndrome can consist of any combination of the following: tinnitus, deafness, phonophobia, vertigo, ataxia, otalgia, facial palsy, headache, diplopia, blackouts, psychological distress. 

The following testable hypotheses are proposed: 
  1. otitis media is due to perilymph in the middle ear, with secondary changes resulting from infection or inflammation:
  2. otosclerosis results from a slow leak in the presence of enzymes promoting bone growth: 
  3. Meniere's syndrome follows reduced perilymph support for the endolymphatic system: 
  4. Bell's palsy results from a perilymph provoked oedema in the bony facial nerve canal: 
  5. PFs may be responsible for progressive rubella deafness, and for some cases of migraine, epilepsy, anxiety neurosis and hysteria: psychiatric sequelae of the PF syndrome predominate in the post-concussional syndrome and infantile autism:
  6. organisms can pass from the throat into the spinal fluid, causing meningitis or encephalitis. 
  7. The tinnitus and vertigo are caused by random labyrinthine fluid movements, the headache and diplopia by reduced spinal fluid pressure.


Fuente :Medical Hypotheses,
Volume 2, Issue 4, July–August 1976, 
Pages  125–134
http://dx.doi.org/10.1016 /0306-9877(76)90067-0,

los ácidos grasos Omega-3 : ¿un tratamiento prometedor posible para la enfermedad de Ménière y otros trastornos del oído interno de origen desconocido?


Omega-3 fatty acids: A promising possible treatment for Meniere’s Disease and other inner ear disorders of unknown origin?

  • a Department of Internal Medicine and Ageing, University of Bologna, Italy
  • b Department of Specialist Surgical and Anesthesiological Sciences, University of Bologna, Italy

Abstract

A consolidated therapy for “idiopathic” acute disorders of the inner ear, including Meniere’s Disease (MD), does not exist despite the long-lasting and widespread attempts: this lack is strictly linked to pathogenic uncertainties. 
According to the theoretical model that our group developed and tested over the years, a possible cause of labyrinthine damage could be identified in systemic hemodynamic changes followed by an abnormal peripheral vasoconstriction: the latter could be responsible for a more or less prolonged ischemia able to threaten a highly energy-requiring and complicated organ as the inner ear. 

A possible way to treat MD attacks – as well as other inner ear disorders that possibly share the same origin – according to our model should be addressed to modulate the peripheral circulation and to maintain the balance of ion exchange, acting both on systemic hemodynamics and on cell and organelle membranes. 

Despite the absence of such a proposal in the English literature, a reliable solution could derive from the supplementation of the intake of a nutritional principle as Omega-3 (omega-3) polyunsaturated fatty acids (PUFAs) that seem to theoretically fulfil all the requirements necessary to achieve a homeostasis of the inner ear.

 




Resumen

No existe una terapia consolidada para los  trastornos agudos del oído interno idiopáticos, incluyendo la enfermedad de Ménière (MD),  a pesar de los intentos de larga
y generalizada duración: esta falta está estrictamente ligada a incertidumbres sobre la etipatogenia.  

De acuerdo con el modelo teórico que nuestro grupo ha desarrollado y probado con los años, una posible causa de daño laberíntico se pudo identificar en cambios hemodinámicos sistémicos seguidos por una vasoconstricción periférica anormal: esta última podría ser la responsable de una isquemia más o menos prolongada, que estaría en condiciones de amenazar a un órgano que requiere de alto consumo de energía  y es complicado como el oído interno.  

Una posible manera de tratar los ataques de Meniere -, así como otros trastornos del oído interno que posiblemente comparten el mismo origen - según nuestro modelo debería ser dirigida a modular la circulación periférica y  mantener el equilibrio de intercambio iónico, actuando tanto sobre la hemodinámica sistémica como sobre las membranas celulares y orgánulos. 

A pesar de la ausencia de una propuesta en la literatura Inglésa, una solución fiable pudiera derivarse de la suplementación de la ingesta nutricional con un principio como el Omega-3 (omega-3) (ácidos grasos poliinsaturados (AGPI) que parecen teóricamente cumplir con todos los requisitos necesarios para alcanzar una homeostasia del oído interno.

Fuente:Medical Hypotheses,Volume 79, Issue 4, October 2012, Pages 468–470

 

Target-based selection of flavonoids for neurodegenerative disorders



  • 1 Department of Pharmacology, Faculty of Medicine, 1459 Oxford Street, Dalhousie University, Halifax, Nova Scotia, Canada B3H 4R2
  • 2 Department of Environmental Sciences, Faculty of Agriculture, Dalhousie University, B.O. Box 550, Truro, Nova Scotia, Canada B2N 5E3
  • 3 Department of Psychiatry, 5909 Veterans’ Memorial Lane, 8th floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada B3H 2E2

Selección de flavonoides basada en objetivos para los trastornos neurodegenerativos

Se sabe que el consumo habitual de flavonoides dietéticos puede  mejorar la bioenergética mitocondrial e inhibir diversas fuentes secundarias de especies reactivas de oxígeno (ROS) y reducir el riesgo de trastornos neurodegenerativos como la enfermedad de Parkinson (EP), los accidentes cerebrovasculares, y la enfermedad de Alzheimer (AD). 
 

La combinación de flavonoides dietéticos específicos seleccionados sobre la base de su biodisponibilidad oral, su penetración en el cerebro, y su inhibición de procesos múltiples responsables de la producción excesiva de ROS puede ser un enfoque viable para la prevención y tratamiento de trastornos neurodegenerativos.

La inclusión de los flavonoides que elevan los niveles de cAMP en el cerebro pueden ser de beneficio adicional al reducir la producción de mediadores proinflamatorios y provocar la estimulación de la maquinaria de transcripción necesaria para la biosíntesis mitocondrial.

Los modelos preclínicos sugieren que los flavonoides reducen la pérdida de audición que resulta del tratamiento con Cisplatino oponiéndose a la producción excesiva de ROS y los mediadores proinflamatorios implicados en la enfermedad de Parkinson, derrame cerebral, y la AD. 

Las combinaciones de flavonoides optimizados por su eficacia en modelos de pérdida de audición inducida por cisplatino (CIHL) por lo tanto, pueden tener utilidad terapéutica en trastornos neurodegenerativos.





Habitual consumption of dietary flavonoids known to improve mitochondrial bioenergetics and inhibit various secondary sources of reactive oxygen species (ROS) reduces the risk for neurodegenerative disorders such as Parkinson's disease (PD), stroke, and Alzheimer's disease (AD). Combining specific dietary flavonoids selected on the basis of oral bioavailability, brain penetration, and the inhibition of multiple processes responsible for excessive ROS production may be a viable approach for the prevention and treatment of neurodegenerative disorders. Inclusion of flavonoids that raise cAMP levels in the brain may be of additional benefit by reducing the production of proinflammatory mediators and stimulating the transcriptional machinery necessary for mitochondrial biosynthesis. Preclinical models suggest that flavonoids reduce hearing loss resulting from treatment with the chemotherapeutic drug cisplatin by opposing the excessive production of ROS and proinflammatory mediators implicated in PD, stroke, and AD. Flavonoid combinations optimized for efficacy in models of cisplatin-induced hearing loss (CIHL) may therefore have therapeutic utility for neurodegenerative disorders.



Fuente:
Trends in Pharmacological Sciences 

Microsystems technologies for drug delivery to the inner ear


Authors:

  • a Charles Stark Draper Laboratory, 555 Technology Square, Cambridge, MA 02139, USA
  • b Rochester Institute of Technology, Department of Electrical and Microelectronic Engineering, 79 Lomb Memorial Drive, Rochester, NY 14623, USA

Abstract
The inner ear represents one of the most technologically challenging targets for local drug delivery, but its clinical significance is rapidly increasing. 

The prevalence of sensorineural hearing loss and other auditory diseases, along with balance disorders and tinnitus, has spurred broad efforts to develop therapeutic compounds and regenerative approaches to treat these conditions, necessitating advances in systems capable of targeted and sustained drug delivery. 

The delicate nature of hearing structures combined with the relative inaccessibility of the cochlea by means of conventional delivery routes together necessitate significant advancements in both the precision and miniaturization of delivery systems, and the nature of the molecular and cellular targets for these therapies suggests that multiple compounds may need to be delivered in a time-sequenced fashion over an extended duration. 

Here we address the various approaches being developed for inner ear drug delivery, including micropump-based devices, reciprocating systems, and cochlear prosthesis-mediated delivery, concluding with an analysis of emerging challenges and opportunities for the first generation of technologies suitable for human clinical use. 

These developments represent exciting advances that have the potential to repair and regenerate hearing structures in millions of patients for whom no currently available medical treatments exist, a situation that requires them to function with electronic hearing augmentation devices or to live with severely impaired auditory function. 

These advances also have the potential for broader clinical applications that share similar requirements and challenges with the inner ear, such as drug delivery to the central nervous system.

Graphical abstract

Keywords


Figures and tables from this article:
Full-size image (98 K)
Fig. 1. (a.) A mid-modiolar section from a human temporal bone indicates the coiled structure of the cochlea as it winds around a central modiolius. Each segment (b.) contains 3 fluid filled structures, the scala tympani (ST) scala media (SM) and scala vestibuli (SV). The organ of Corti (OC) is shown at the base of the SM.
Used with permission from Elsevier [47].
Full-size image (40 K)
Fig. 2. a. A schematic drawing of the reciprocating delivery system showing the flexible membrane and actuator. b. Photograph of wearable device for guinea pig studies. The device measures 5.5 × 4.0 × 3.8 cm.
Used with permission from Karger AG Basel and Springer  and .
Full-size image (80 K)
Fig. 3. CAP threshold shifts due to DNQX delivery at various frequencies. Three flow rate profiles are shown with higher flow rates causing increased threshold rises. Multiple experiments for each flow rate are shown.
Used with permission from Elsevier [56].
Full-size image (46 K)
Fig. 4. Theoretical flow path within the cochlea and vestibular system for a cochleostomy-only infusion (green), and a cochleostomy-plus-canalostomy perfusion (red). Pressure driven flow is depicted with solid lines while dotted lines represent diffusion mechanisms. Cochlear aqueduct (ca); scala tympani (st), scala vestibuli (sv). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Used with permission from Elsevier [9].
Full-size image (52 K)
Fig. 5. Frequency dependent DPOAE threshold shifts. Surgery and infusion of artificial perilymph had insignificant impact on thresholds, while frequency dependent threshold shifts were observed with 10 mM salicylate. Statistical comparison of peak threshold shifts to baseline for each frequency and each surgical approach is shown in the figure (*p < 0.05, **p < 0.01, ***p < 0.001). Data are plotted as mean ± SEM (n = 8 animals for each approach).
Used with permission from Elsevier [9].
Full-size image (21 K)
Fig. 6. Illustration of drug delivery enabled by laser-drilled holes of 50 μm diameter to enable enhanced drug distribution in the cochlea.
Used with permission from Elsevier [64].

Full-size image (31 K)
Fig. 8. SEM of the side of the microfluidic chip with small diameter (140-μm OD) tubing exiting in-plane.
Used with permission from IEEE [67].
Corresponding author contact information
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