Studies showed that some classes of dyes, mainly azo dyes and the

Studies showed that some classes of dyes, mainly azo dyes and their by-products, exert adverse effects on humans and local biota, since the wastewater treatment systems and water treatment plants were found to be ineffective in removing the color and reducing toxicity click here of some dyes. In the present study, the toxicity of the azo dyes disperse orange 1 (DO1), disperse red 1 (DR1), and disperse red 13 (DR13) was evaluated in HepG2 cells grown in monolayers or in three dimensional (3D) culture. Hepatotoxicity of the dyes was measured using 3-(4,5-dimethylthiazol-2yl)2,5-diphenyltetrazolium (MTT) and cell counting kit 8 (CCK-8) assays after 24, 48, and 72 h of incubation of cells

with 3 different concentrations of the azo dyes. The dye DO1 only reduced the mitochondrial activity in HepG2 cells grown in a monolayer after 72 h incubation, while the dye DR1 showed this deleterious effect in both

monolayer and 3D culture. In contrast, dye DR13 decreased the mitochondrial activity after 24, 48, and 72 h of exposure in both monolayer and 3D culture. With respect to dehydrogenase activity, only the dye DR13 diminished the activity of this enzyme after 72 h of exposure in both monolayer and 3D culture. Our results clearly demonstrated that exposure to the studied dyes induced cytotoxicity in HepG2 cells.”
“A strong relationship between the clinical characteristics of epilepsy and the nature of cognitive impairments associated with the BAY 1895344 datasheet condition has been found, but the nature of this relationship appears to be quite complex and not well understood. This review presents a summary of the research on the interaction between cognition and epilepsy, surveyed from a mechanistic perspective with the aim of clarifying factors that contribute to the co-existence of both disorders. The physiological basis underpinning cognitive processing is first reviewed. The physiology of epilepsy is reviewed, with emphasis placed on interictal discharges and seizures. The nature of the impact of epilepsy on cognition is

described, with transient and prolonged PI3K inhibitor effects distinguished. Finally, the complexity of the co-morbidity between cognitive dysfunction and epilepsy is discussed in relation to childhood and adult-onset epilepsy syndromes and severe epileptic encephalopathies. Structural and functional abnormalities exist in patients with epilepsy that may underpin both the cognitive dysfunction and epilepsy, highlighting the complexity of the association. Research, possibly of a longitudinal nature, is needed to elucidate this multifactorial relationship between cognitive dysfunction and epilepsy. (C) 2012 Elsevier Ltd. All rights reserved.”
“Immunological memory has traditionally been regarded as a unique feature of the adaptive immune response, mediated in an antigen-specific manner by T and B lymphocytes.

We also included a group of gonadally intact females On the firs

We also included a group of gonadally intact females. On the first day of the experiment, all females were i.p. injected with the marker of DNA synthesis bromodeoxyuridine and were killed 16 days later. Blood was collected at sacrifice to determine Selleckchem LY411575 the plasma levels of E2 and P. The number of newborn neurons that arrived at the ICL of the AOB and the Gra of the main olfactory bulb (MOB) increased, relative to all other groups, only in the group that repeatedly mated under pacing conditions. No differences were found in E2 and P levels between supplemented groups indicating that our results are not influenced by changes in hormone concentrations.

JIB04 chemical structure We suggest that repeated paced mating promotes the arrival of more newborn neurons in the AOB and MOB. (C) 2012 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Aims: To assess the diversity and antimicrobial activity of culturable bacteria associated with two temperate-water marine sponges, Amphilectus fucorum and Eurypon major. Methods and Results: Sponge samples were collected in August 2008 and bacteria were cultured on several

different media. The 16S rRNA gene of representative strains was sequenced to allow classification. It was found that Proteobacteria were the dominant group of bacteria cultured from both sponges, but overall, the bacterial composition was diverse and distinct between the sponges. The most notable features were the significantly higher proportion of firmicutes

in E.major and the low frequency of actinobacteria in both sponges. Four bacterial isolates were identified as potentially novel species and will be characterised in future studies. Ferroptosis inhibitor Approximately 400 cultured bacteria were screened for antimicrobial activity against a collection of indicator strains, with only eight strains, all Pseudovibrio spp., displaying any such activity. These strains were active against Escherichia coli and Bacillus subtilis but not Staphylococcus aureus or a selection of fungal strains. Conclusions: Diverse and distinct populations of culturable bacteria are present in the coastal sponges A.fucorum and E.major. Only a minority of isolates produce antibacterial metabolites in culture, but this activity is common in Pseudovibrio spp. Significance and Impact of the Study: This study illustrates the diversity of sponge-associated bacteria and the need to increase our knowledge about the function of these symbiotic bacteria. The data suggest that production of antibacterial metabolites is restricted to a subset of species, with the majority involved in other functions. The importance of Pseudovibrio as a reservoir of antibacterial metabolites is also highlighted.

Given the difficulties of replicating lifelong calorie restrictio

Given the difficulties of replicating lifelong calorie restriction within human populations, we have sought to assess the effects of short-term adult-onset calorie restriction upon acute excitotoxic insults in the rat hippocampus. Adult animals (approximately 6 months of age) underwent calorie restriction (alternate day feeding) for 7-10 weeks. Utilizing both electrophysiological and immunocytochemical techniques, we report that calorie restriction had no effect upon long-term

potentiation (LTP), a measure of neuronal function. In control animals, application of kainic acid JPH203 datasheet (20 mu M) resulted in only 35% recovery of CA1 population spikes post-insult. However calorie-restricted animals showed significantly improved recovery after kainic acid treatment (64%). This data was supported by immunocytochemical studies which noted widespread loss of microtubule-associated protein (MAP 2)

immunoreactivity in control slices following treatment with kainic acid; however MAP 2 staining was preserved in the CA1 and CA3 regions of calorie-restricted animals. Interestingly there was no significant difference in the recovery of population spikes between groups when slices were treated with N-methyl-D-aspartate (15 mu M). We conclude that short-term adult-onset calorie restriction does not alter normal neuronal function and serves to protect the hippocampus from acute kainic acid excitotoxicity. (c) 2007 Elsevier Ireland Ltd. All rights reserved.”
“Traumatic brain injury is accompanied by glial cell activation around the site of the injury. In this 17DMAG mw study, we investigated the role of toll-like receptor 2 (TLR2) in glial cell activation using a stab-wound injury (SWI) model with TLR2 knock-out mice. Penetration of a normal mouse brain with a 26-G needle using a stereotaxic instrument Etoposide in vitro resulted in an 18- and 4-fold upregulation

of GFAP and CD11b mRNA, respectively, along the needle track in the injury area. However, in the TLR2 knock-out mice, the induced expression of these genes was reduced by 70% and 40%, respectively. Likewise, there was a reduction in the area of activated glial cells detected by immunohistochemistry and the glial cells had a less-activated morphology in the TLR2 knock-out mice. In addition, the expression of the heme oxygenase-1 (HO-1) gene, a glia-expressing wound-responsive gene, was reduced after SWI in TLR2 knock-out mice. Taken together, these data argue that TLR2 contributes to the glial cell activation and HO-1 gene expression associated with traumatic brain injury. (c) 2007 Elsevier Ireland Ltd. All rights reserved.”
“Rather than attempt to provide a comprehensive account of air quality risk assessment, as might be found in a textbook or manual, this article discusses some issues that are of current importance in the United Kingdom and the rest of Europe, with special emphasis on risk assessment in the context of policy formulation, and emerging scientific knowledge.

However, microinjection of 1-BnTIQ into the substantia nigra pars

However, microinjection of 1-BnTIQ into the substantia nigra pars compacta increased the extracellular dopamine levels in the striatum. Locomotor activity was increased by systemic administration of a single dose of 1-BnTIQ in a dose-dependent manner. This 1-BnTIQ-induced locomotor activity was attenuated by pre-treatment with SCH23390 (R(+)-7-Chloro-8-hydroxy-3-methyl-1-phenyl-2,3,4,5-tetrahydro-1H-3-benzazepine hydrochlodride) and raclopride, D(1) and D(2) dopaminergic receptor antagonists, respectively. Moreover, 1-BnTIQ induced ipsilateral

rotational behavior in 6-hydroxydopamine-lesioned rats. These results suggest that systemic administration of a single dose of 1-BnTIQ increases striatal extracellular dopamine concentration through activation of click here dopaminergic nigra striatal neurons via the dopamine transporter. (C) 2009 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Purpose: We present outcome and Erastin price quality of life analyses for the treatment of post-radical prostatectomy bladder neck contracture with urethral wall stent insertion and subsequent artificial urinary sphincter

placement.

Materials and Methods: A retrospective analysis from June 2001 to September 2007 identified 25 consecutive men who underwent urethral wall stent placement for severe, recurrent bladder neck contracture despite aggressive transurethral resection after radical prostatectomy. Assessment of symptoms and quality of life impact from urinary incontinence was conducted with a self-administered, standardized questionnaire. Nonparametric testing was used for comparing covariates among groups. Univariate Cox proportional hazards modeling was used to assess predictors of treatment failure. Interleukin-3 receptor P values are double-sided and are considered statistically significant if <= 0.05.

Results: Etiology of recurrent bladder neck contracture was radical prostatectomy in all patients. Concurrent severe stress incontinence before treatment of bladder neck contracture was noted in 23 of 25 patients (92%).

Before urethral wall stent insertion a median of 3 (IQR 2 to 5) failed endoscopic treatments were performed. Bladder neck contracture stabilization with insertion of 1 urethral wall stent was noted in 13 of 25 (52%) patients with a median followup of 2.9 years from last urethral wall stent insertion. Multiple urethral wall stent insertions (range 2 to 4) salvaged an additional 6 of 25 (24%) patients and failure to obtain patency was observed in 6 of 25 (24%). All patients responded to the questionnaire and quality of life improvement was noted in 23 of 25 patients (92%).

Conclusions: Urethral wall stent and delayed artificial urinary sphincter placement for treatment of severe, recurrent bladder neck contracture and incontinence after radical prostatectomy is associated with improvement in quality of life.

Results There were 4905 attendees in Europe4, 1094 in Estonia, 1

Results. There were 4905 attendees in Europe4, 1094 in Estonia, 1221 in The Netherlands and 2825 in Chile. In the algorithm four variables were fixed characteristics (sex, age, lifetime depression screen, family history of psychological difficulties); three current status (Short Form 12 physical health subscale

and mental health subscale scores, and unsupported difficulties in paid and/or unpaid work); one concerned country; and one time of follow-up. The overall C-index in Europe4 was 0.752 [95% confidence interval (CI) 0.724-0.780]. The effect www.selleckchem.com/products/PD-0332991.html size for difference in predicted log odds between developing and not developing anxiety was 0.972 (95% CI 0.837-1.107). The validation of predictA resulted in C-indices of 0.731 (95% CI 0.654-0.809) in Estonia, 0.811 (95% CI 0.736-0.886) in The Netherlands and 0.707 (95% CI 0.671-0.742) in Chile.

Conclusions. PredictA accurately predicts the risk of anxiety syndromes. The algorithm is strikingly

similar to the predictD algorithm for major depression, suggesting considerable overlap in the concepts of anxiety and depression.”
“Purpose: We investigated trends in urinary diversion use and surgeon characteristics in the performance of incontinent and continent urinary diversion selleck kinase inhibitor using American Board of Urology data.

Materials and Methods: Annualized case log data for urinary diversion were obtained from the American Board of Urology for urologists who certified or recertified from 2002 to 2010. We evaluated the association between surgeon characteristics and the performance of any urinary diversion or the type of urinary diversion.

Results: Of the 5,096 certifying or recertifying urologist case logs examined 1,868 (37%) urologists performed any urinary diversion. The median number of urinary diversions was

4 per year (IQR 2, 6) and 222 urologists (4%) performed 10 or more per year. On multivariate analysis younger urologists, those self-identified as oncologists or female urologists, those who certified in more recent years and those in larger practice areas or outside the Northeast region of the United States were more likely to perform any urinary diversion. Only 9% of the total cohort (471 urologists) performed any continent urinary diversion. The likelihood of performing any continent urinary diversion Fossariinae increased with the number of urinary diversions (p < 0.0001). As urinary diversion volume increased, the proportion representing continent urinary diversion also increased (p < 0.0005). Surgeons in private practice settings and those in the Northeast were less likely to perform continent urinary diversion.

Conclusions: Few urologists perform any urinary diversion. Continent urinary diversion is most frequently done by high volume surgeons. The type of urinary diversion that a patient receives may depend in part on surgeon characteristics.”
“Background.

001) Calculi and oncology subspecialist distributions suggest gr

001). Calculi and oncology subspecialist distributions suggest greater overall risk. Complaint types also varied among subspecialists (p = 0.02). There was no association between top decile urologists and complaint

type profile (p = 0.19).

Conclusions: Unsolicited patient complaints were nonrandomly distributed among PCI 32765 urologists and urological subspecialties. Monitoring patient complaints may allow for early identification of and intervention with high risk urologists before malpractice claims accumulate.”
“Slowly adapting pulmonary stretch receptors (SARs) provide the respiratory and cardiovascular control systems with information regarding the rate and depth of breathing Previous information theoretical analysis demonstrated that SAR spike count provides a reliable representation of lung distension This study examines whether SAR spike patterns may also provide information about selleck kinase inhibitor lung distension. To investigate this, artificial spike trains were generated with the same number of spikes (but randomized intervals) as those recorded from SARs in response to three different lung inflation volumes in urethane-anesthetized

rabbits Three different spike train classification methods were applied to estimate which stimulus evoked them, and the accuracy with which artificial spike trains were classified was compared to that of real SAR spike trains using the same methods Because real SAR spike trains were classified with higher accuracies than artificial ones containing the same number of spikes, we conclude that SAR spike patterns, in addition to spike counts, contain information concerning the amplitude of lung distension. (C) 2010 Elsevier Ireland Ltd All rights reserved”
“Purpose: The average American adult reads at a fifth to eighth-grade level, with wide variability, presenting challenges for the assessment of self-reported health related quality of life. We identified the health related quality of life instruments used in patients with urological diseases and evaluated their Thiamine-diphosphate kinase readability.

Materials and Methods: We focused on the most burdensome urological diseases, based on total expenditures

in the United States. We then identified disease specific instruments by systematically searching PubMed (R), the Cochrane Database of Systematic Reviews, Googlel (TM), Google Scholar (TM), the Patient Reported Outcome and Quality of Life Instruments Database (Mapi Research Institute, Lyon, France) and Yahoo!(R) for health related quality of life studies in patients with these urological conditions. Where disease specific instruments were lacking, we noted the general health related quality of life measures most commonly used. For each instrument, we calculated the median Flesch-Kincaid grade level, the proportion of questionnaire items below an eighth-grade reading level, the mean Flesch Reading Ease, and the mean number of words per sentence and characters per word, all of which are validated measures of readability.

These data suggest that the spontaneous circling and hyperactivit

These data suggest that the spontaneous circling and hyperactivity of the ckr mouse may allow screening of candidate antipsychotic compounds, distinguishing compounds with aripriprazole-like profiles. (C) 2010 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Purpose: Multiple small

case series have reported sperm in the ejaculate and spontaneous pregnancies in patients with nonobstructive azoospermia after varicocele Cediranib repair. We hypothesized that men with favorable testicular histopathology on testis biopsy such as maturation arrest or hypospermatogenesis would have a higher probability of success than those with more ablative pathology, eg Sertoli-cell-only.

Materials and Methods: A review of the literature on varicocele repair in patients with nonobstructive azoospermia was performed and 11 publications from the previous 20 years were evaluated. Histopathological data were presented in 8 publications, and were categorized as Sertoli-cell-only, maturation arrest and hypospermatogenesis. Maturation arrest Was further differentiated by 4 publications. Early maturation arrest was defined as maturation ending at the secondary spermatocyte and late maturation arrest was defined as maturation ending at the spermatid without spermatozoa present.

Success after repair was defined as having sperm in the ejaculate or spontaneous pregnancy.

Results: A total of 233 patients were analyzed. After varicocele repair 91 (39.1%) patients

had motile sperm in the ejaculate and 14 spontaneous pregnancies were reported. Success rates in patients with maturation arrest (42.1%) or hypospermatogenesis (54.5%) were significantly higher than in those see more with Sertoli-cell-only (11.3%, p < 0.001 in both groups). Patients with late maturation arrest had a higher probability of success (45.8%) than those with early maturation Carbohydrate arrest (0%, p = 0.007).

Conclusions: Infertile men with nonobstructive azoospermia can have improvement in semen analysis and achieve spontaneous pregnancy after repair of clinical varicoceles. This meta-analysis demonstrates that men with late maturation arrest and hypospermatogenesis have a higher probability of success and, therefore, histopathology should be considered before varicocele repair in men with nonobstructive azoospermia.”
“Previous electrophysiological studies revealed that human faces elicit an early visual event-related potential (ERP) within the occipito-temporal cortex, the N170 component. Although face perception has been proposed to rely on automatic processing, the impact of selective attention on N170 remains controversial both in young and elderly individuals. Using early visual ERP and alpha power analysis, we assessed the influence of aging on selective attention to faces during delayed-recognition tasks for face and letter stimuli, examining 36 elderly and 20 young adults with preserved cognition. Face recognition performance worsened with age.

However, the 10-day MS welding fume inhalation did not cause any

However, the 10-day MS welding fume inhalation did not cause any changes in dopamine and its metabolites or GABA in dopaminergic brain regions nor did it produce overt neural cell damage as assessed by histopathology. In summary, short-term MS welding fume exposure led to translocation

of Mn to specific brain regions and induced subtle changes in cell markers of neuroinflammatory and astrogliosis. The neurofunctional significance of these findings currently is being investigated in longer, more chronic welding fume exposure studies. Published by Elsevier Inc.”
“Objective: Myocardial viability and left ventricular dyssynchrony SB431542 clinical trial are important predictors of long-term outcomes in patients with ischemic left ventricular dysfunction. The objective of this study was to test the hypothesis that assessment of myocardial viability and left ventricular dyssynchrony will predict perioperative mortality in high-risk patients with ischemic left ventricular dysfunction

having coronary artery bypass surgery.

Methods: The study consisted of 79 consecutive patients with ischemic cardiomyopathy (age 65 +/- 9 years; 81% men; ejection fraction 30% +/- 6%) and logistic European system for cardiac operative risk evaluation > 10% having coronary artery bypass surgery. Myocardial viability was assessed by delayed contrast-enhanced magnetic GSK2126458 cost resonance imaging. Left ventricular dyssynchrony was calculated using tissue Doppler from measurements of regional electromechanical coupling times in left ventricular basal segments before coronary artery bypass surgery.

Results: Twenty (25.3%) Florfenicol patients died within 30 days following coronary artery bypass surgery. Survivors (n = 59) showed a larger extent of viable myocardium (6.9 +/- 3.6 viable segments vs 3.4 +/- 3.3 viable segments, P < .001) and smaller left ventricular dyssynchrony (75 +/- 5 ms vs 179 +/- 83 ms, P < .001) than nonsurvivors. The presence of significant dyssynchrony (>= 105 ms) and absence of myocardial viability (<5 viable segments) independently predicted 30-day mortality

with hazard ratio 3.26, 95% confidence interval 1.61 to 8.33 (P < .01) and hazard ratio 1.72, 95% confidence interval 1.59 to 1.89 (P < .01), respectively. All but 2 patients (94.1%) with viable myocardium and without left ventricular dyssynchrony survived coronary artery bypass surgery as compared with only 12 (52.2%) patients with nonviable myocardium and severe dyssynchrony (P < .001).

Conclusions: In high-risk patients with ischemic left ventricular dysfunction having coronary artery bypass surgery, both myocardial viability and left ventricular dyssynchrony are important predictors of perioperative outcome. Assessment of myocardial viability and left ventricular dyssynchrony should be a routine part of the preoperative evaluation of these patients.

One mechanism through which estradiol activates male sexual behav

One mechanism through which estradiol activates male sexual behavior is through the potentiation of DA activity in the MPOA. In the hypothalamus, estradiol has also been found to act in concert with DA, through the activation of similar intracellular signaling pathways, in order to stimulate female sexual behavior. Finally, recent evidence suggests that some effects of estradiol are mediated by direct action of estradiol on the mesolimbic

DA system. (C) 2010 Elsevier Ltd. All rights reserved.”
“Schizophrenia is a severe mental illness that afflicts nearly 1% of the world’s population. One of the cardinal pathological features of schizophrenia is perturbation in synaptic connectivity. Although the etiology of schizophrenia is unknown, it appears to be a developmental disorder involving the interaction of a potentially large number of risk genes, with no one gene producing https://www.selleckchem.com/products/PF-2341066.html a strong effect except rare, highly

penetrant copy number variants. The purpose of this review is to detail how putative schizophrenia risk genes (DISC-1, neuregulin/ErbB4, dysbindin, Akt1, BDNF, and the NMDA receptor) are involved in regulating neuroplasticity and how alterations in their expression may contribute to the disconnectivity observed in schizophrenia. Moreover, this review highlights how many of these risk genes converge to regulate common neurotransmitter systems and signaling pathways. Future studies aimed at elucidating the functions of these risk genes will provide new insights into the pathophysiology of schizophrenia and will likely lead to the nomination of novel therapeutic targets for restoring proper synaptic connectivity PD0332991 in the brain in schizophrenia and related disorders. Published by Elsevier Ltd.”
“It is always difficult to interpret null results. But as a research method, transcranial magnetic stimulation (TMS) has so many degrees of freedom that null results are often dismissed as meaningless. We feel that this may be unnecessary, if not

counterproductive. Null results seem to inherently fulfill an important role in brain mapping. In fact, without null results, neuroimaging as an enterprise would not make sense. We argue that null results are similarly important in TMS research. By itself, neuroimaging Dimethyl sulfoxide research leaves room for doubt concerning whether or not an activated region is actually necessary for intact task performance. Interference methods such as TMS can therefore complement brain research by testing the functional relevance of that region. However, if then only positive TMS results are taken seriously, the brain interference paradigm seems less informative than promised. But how can null results inform us if they only constitute absence of evidence? We suggest that three main arguments contravene interpretation of null results in TMS. These we call the localization argument, the neural efficacy argument, and the power argument.

8 points There were no recurrent ischemic priapism episodes afte

8 points. There were no recurrent ischemic priapism episodes after withdrawal of ketoconazole and prednisone, Selleckchem Momelotinib and no reported symptoms of hypogonadism.

Conclusions: Ketoconazole and prednisone therapy was well tolerated in these 8 patients with recurrent ischemic priapism, and with testosterone monitoring and dose titration it was successful in preventing recurrent episodes while preserving sexual function.”
“OBJECTIVE: Medically refractory epilepsy is amenable to neurosurgical

intervention if the epileptogenic focus is accurately localized. If the scalp video-electroencephalography (EEG) and magnetic resonance imaging are nonlateralizing, yet a single focus is suspected, video-EEG monitoring with bilateral intracranial electrode placement is helpful to lateralize the ictal onset zone. We describe the indications, risks, and utility of such bilateral Surveys at our institution.

METHODS: We retrospectively reviewed 26 patients with medically refractory seizures who were treated over a 5-year

period and underwent bilateral placement of intracranial electrodes. Subdural strips were used in all cases, and additional stereotactic implantation of depth electrodes into mesial temporal lobes occurred in 50%. The mean patient age was 37.7 years, and 65.4% of patients were male.

RESULTS:The most common indication for bilateral invasive monitoring was bilateral ictal onsets on surface video-EEG (76.9%), followed MK-4827 purchase by frequent interictal these spikes contralateral to a single ictal focus (7.7%). Intracranial monitoring lasted an average of 8.2 days, with ictal events recorded in all cases. Ten patients (38.5%) subsequently underwent more extensive unilateral monitoring via implantation of subdural and depth electrodes through a craniotomy. A therapeutic procedure was performed in 17 patients (65.4%), whereas 1 patient underwent a palliative corpus callosotomy (3.8%). Nine patients underwent a resection without unilateral invasive

mapping. Reasons for no therapeutic surgery (n = 8) included multifocal onsets, failing the Wada test, refusal of further treatment, and negative intraoperative electrocorticogram. There was 1 surgical complication, involving a retained electrode fragment that was removed in a separate minor procedure. Of the 26 patients, 15 (57.7%) are now seizure-free or have seizure disorders that have substantially improved (modified Engel classes I and II). Of the 17 patients who underwent a potentially curative surgery, 13 (76.5%) were Engel classes I and II.

CONCLUSION: Bilateral placement of subdural strip and depth electrodes for epilepsy monitoring in patients with nonlateralizing scalp EEG and/or discordant imaging studies but clinical suspicion for focal seizure origin is both safe and effective. Given the safety and efficacy of this procedure, epileptologists should have a low threshold to consider bilateral implants for suitable patients.