Τετάρτη 18 Απριλίου 2018
Expert’s Comment concerning Grand Rounds case entitled “Idiopathic spinal cord herniation: consideration of its pathogenesis based on the histopathology of the dura mater’’ by S. Shimizu et al. (Eur Spine J; 2017. DOI 10.1007/s00586-017-5147-y)
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CD47 is a novel potent immunotherapy target in human malignancies: current studies and future promises
Future Oncology, Ahead of Print.
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Insights into the degradation of (CF3)2CHOCH3 and its oxidative product (CF3)2CHOCHO & the formation and catalytic degradation of organic nitrates
Publication date: June 2018
Source:Atmospheric Environment, Volume 183
Author(s): Feng-Yang Bai, Zi-Man Jia, Xiu-Mei Pan
In this work, a systematic investigation of the atmospheric oxidation mechanism of (CF3)2CXOCH3 and their oxidative products (CF3)2CXOCHO (X = H, F) initiated by OH radical or Cl atom is performed by density functional theory. This study reveals that the introduction of NO and O2 promotes the formation of organic nitrates, which are hygroscopic and are inclined to form secondary organic aerosols (SOA) and can affect the air quality. The rate constants of the individual reactions are found to be in agreement with the experimental results. One of the intriguing findings of this work is that the peroxynitrite of (CF3)2CHOCH2OONO formed from the subsequent reactions of (CF3)2CHOCH3 is more favorable to isomerize to organic nitrate (CF3)2CHOCH2ONO2 than to dissociate into alkoxy radical (CF3)2CHOCH2O and NO2 because of the lower energy barrier of isomerization. The second significant observation is that the organic nitrate can be degraded more favorably with the presence of NH3, CH3NH2, and CH3NHCH3 than its naked decomposition reaction (CF3)2CHOCH2ONO2→(CF3)2CHOCHO + HONO. The ammonium salt, a vital part of haze, is harmful to human health and can be formed in the existence of the NH3, CH3NH2, and CH3NHCH3. In addition, the toxic substance of peroxyalkyl nitrate (CF3)2CHOC(O)ONO2 which can reduce the visibility of the atmosphere is produced as the primary subsequent oxidation product of (CF3)2CHOCHO in a NO-rich environment. The main species detected experimentally are confirmed by this study. The computational results are crucial to risk assessment and pollution prevention of the volatile organic compounds (VOCs).
Graphical abstract
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Review of targeted therapy in chronic lymphocytic leukemia: what a radiologist needs to know about CT interpretation
Abstract
The last 5 years have been marked by profound innovation in the targeted treatment of chronic lymphocytic leukemia (CLL) and indolent lymphomas. Using CLL as a case study, we present a timeline and overview of the current treatment landscape for the radiologist, including an overview of clinical and radiological features of CLL, discussion of the targeted agents themselves, and the role of imaging in response and toxicity assessment. The goal is to familiarize the radiologist with multiple Food and Drug Administration (FDA)-approved targeted agents used in this setting and associated adverse events which are commonly observed in this patient population.
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Oral Health-related quality of life and clinical outcomes of immediately or delayed loaded implants in the rehabilitation of edentulous jaws: a retrospective comparative study.
| Related Articles |
Oral Health-related quality of life and clinical outcomes of immediately or delayed loaded implants in the rehabilitation of edentulous jaws: a retrospective comparative study.
Minerva Stomatol. 2018 Apr 16;:
Authors: Cosola S, Marconcini S, Giammarinaro E, Poli GL, Covani U, Barone A
Abstract
BACKGROUND: Patient-centred outcomes are being given great attention by the dental scientific community. The Oral Health Impact Profile -14 questionnaire (OHIP-14) has been introduced to address patients' success criteria when describing the impact of oral rehabilitations on quality of life (OHrQoL).
METHODS: Thirty-five patients wearing a full-arch implant-prosthesis being in place between 4 and 6 years before this analysis were considered eligible and then enrolled in the present retrospective study. According to their prosthetic anamnesis, two groups were defined: delayed loading group (IL-group) and immediate loading group (IL-group). At the moment of analysis, clinical and radiographic parameters were collected, and patients were asked to complete the Oral Health Impact Profile -14 questionnaire (OHIP-14) in order to measure their OHrQoL.
RESULTS: Independent t-test showed total OHIP-14 scores to be not significantly different between groups; however, the domains "Functional limitation" and "physical disability" resulted significantly higher in patients within the DL-group. On the contrary, social disability was higher in the IL-group. When the comparison was performed taking sex into account, no significant differences between groups were highlighted. Instead, the stratification for years of follow-up led to significant evidences. When the follow-up was shorter (less-than-5 years), the functional limitation reported scores were higher.
CONCLUSIONS: Within the limitations of this study, the analysis supports the absence of significant differences between immediate loading and delayed loading full-arch protocol in term of clinical, radiological parameters and OHrQoL.
PMID: 29660976 [PubMed - as supplied by publisher]
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A florid paranasal sinus reaction from a systemic disease
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): G. Barrett, N. Keates, E. Kyrodimou, H. Wilson
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Rho Kinase Inhibition by AT13148 Blocks Pancreatic Ductal Adenocarinoma Invasion and Tumor Growth
The high mortality of pancreatic cancer demands that new therapeutic avenues be developed. The orally available small molecule inhibitor AT13148 potently inhibits ROCK1 and ROCK2 kinases that regulate the actomyosin cytoskeleton. We previously reported that ROCK kinase expression increases with human and mouse pancreatic cancer progression and that conditional ROCK activation accelerates mortality in a genetically modified LSL-KrasG12D; LSL-p53R172H; Pdx1-Cre; (KPC) mouse pancreatic cancer model. In this study, we show that treatment of KPC mouse and human TKCC5 patient-derived pancreatic tumor cells with AT13148, as well as the ROCK selective inhibitors Y27632 and H1152, act comparably in blocking ROCK substrate phosphorylation. AT13148, Y27632, and H1152 induced morphological changes and reduced cellular contractile force generation, motility on pliable discontinuous substrates, and three-dimensional collagen matrix invasion. AT13148 treatment reduced subcutaneous tumor growth and blocked invasion of healthy pancreatic tissue by KPC tumor cells in vivo without affecting proliferation, suggesting a role for local tissue invasion as a contributor to primary tumor growth. These results suggest that AT13148 has anti-tumor properties that may be beneficial in combination therapies or in the adjuvant setting to reduce pancreatic cancer cell invasion and slow primary tumor growth. AT13148 might also have the additional benefit of enabling tumor resection by maintaining separation between tumor and healthy tissue boundaries.
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YAP/TAZ initiates gastric tumorigenesis via upregulation of MYC
YAP and TAZ play oncogenic roles in various organs, but the role of YAP/TAZ in gastric cancer remains unclear. Here we show that YAP/TAZ activation initiates gastric tumorigenesis in vivo and verify its significance in human gastric cancer. In mice, YAP/TAZ activation in the pyloric stem cell led to step-wise tumorigenesis. RNA sequencing identified MYC as a decisive target of YAP, which controls MYC at transcriptional and post-transcriptional levels. These mechanisms tightly regulated MYC in homeostatic conditions, but YAP activation altered this balance by impeding miRNA processing, causing a shift towards MYC upregulation. Pharmacological inhibition of MYC suppressed YAP-dependent phenotypes in vitro and in vivo, verifying its functional role as a key mediator. Human gastric cancer samples also displayed a significant correlation between YAP and MYC. We re-analyzed human transcriptome data to verify enrichment of YAP signatures in a subpopulation of gastric cancers and found that our model closely reflected the molecular pattern of patients with high YAP activity. Overall, these results provide genetic evidence of YAP/TAZ as oncogenic initiators and drivers for gastric tumors with MYC as the key downstream mediator. These findings are also evident in human gastric cancer, emphasizing the significance of YAP/TAZ signaling in gastric carcinogenesis.
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Enhancer remodeling and microRNA alterations are associated with acquired resistance to ALK inhibitors
Anaplastic lymphoma kinase (ALK) inhibitors are highly effective in ALK fusion-positive lung cancer patients, but acquired resistance invariably emerges. Identification of secondary mutations has received considerable attention, but most cases cannot be explained by genetic causes alone, raising the possibility of epigenetic mechanisms in acquired drug resistance. Here we investigated the dynamic changes in the transcriptome and enhancer landscape during development of acquired resistance to ALK inhibitors. Histone H3 lysine 27 acetylation (H3K27ac) was profoundly altered during acquisition of resistance, and enhancer remodeling induced expression changes in both miRNAs and mRNAs. Decreased H3K27ac levels and reduced miR-34a expression associated with the activation of target genes such as AXL. Panobinostat, a pan-histone deacetylase inhibitor, altered the H3K27ac profile and activated tumor suppressor miRNAs such as miR-449, another member of the miR-34 family, and synergistically induced anti-proliferative effects with ALK inhibitors on resistant cells, xenografts, and EML4-ALK transgenic mice. Paired analysis of patient samples before and after treatment with ALK inhibitors revealed that repression of miR-34a or miR-449a and activation of AXL were mutually exclusive of secondary mutations in ALK. Our findings indicate that enhancer remodeling and altered expression of miRNAs play key roles in cancer drug resistance and suggest that strategies targeting epigenetic pathways represent a potentially effective method for overcoming acquired resistance to cancer therapy.
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Multi-kinase inhibitor CT-707 targets liver cancer by interrupting the hypoxia-activated IGF-1R-YAP axis
Given that YAP signaling acts as a critical survival input for hypoxic cancer cells in hepatocellular carcinoma (HCC), disruption of YAP function and the maintenance of hypoxia is an attractive way to treat HCC. Utilizing a cell-based YAP-TEAD luciferase reporter assay and functional analyses, we identified CT-707, a China-FDA approved multi-kinase inhibitor under clinical trial with remarkable inhibitory activity against YAP function. CT-707 exhibited prominent cytotoxicity under hypoxia on HCC cells, which was attributable to the inhibition of YAP signaling. CT-707 arrested tumor growth in HepG2-, Bel-7402-, and HCC patient-derived xenografts. Mechanistically, the inhibitory activity of CT-707 on YAP signaling was due to the interruption of hypoxia-activated IGF-1R. Overall, these findings not only identify CT-707 as a promising hypoxia-targeting agent against HCC, but they also unveil IGF-1R as a new modulator specifically regulating hypoxia-activated YAP signaling.
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Silencing of long non-coding RNA MIR22HG triggers cell survival/death signaling via oncogenes YBX1, MET, and p21 in lung cancer
The long non-coding RNA (lncRNA) MIR22HG has previously been identified as a prognostic marker in hepatocellular carcinoma. Here we performed a comprehensive analysis of lncRNA expression profiles from RNA-seq data and report that MIR22HG plays a similar role in lung cancer. Analysis of 918 lung cancer and normal lung tissues and lung cancer cell lines revealed that MIR22HG was significantly downregulated in lung cancer; this decreased expression was associated with poor patient survival. MIR22HG bound and stabilized the YBX1 protein. Silencing of MIR22HG triggered both cell survival and cell death signaling through dysregulation of the oncogenes YBX1, MET, and p21. In this MIR22HG network, p21 played an oncogenic role by promoting cell proliferation and anti-apoptosis in lung cancers. MIR22HG played a tumor suppressor role as indicated by inhibition of multiple cell cycle-related genes in human primary lung tumors. These data show that MIR22HG has potential as a new diagnostic and prognostic marker and as a therapeutic target for lung cancer.
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Targeting Merkel cell carcinoma by engineered T cells specific to T-antigens of Merkel cell polyomavirus
Purpose: The causative agent of most cases of Merkel cell carcinoma (MCC) has been identified as the Merkel cell polyomavirus (MCV). MCV-encoded T-antigens (Tags) are essential not only for virus-mediated tumorigenesis but also for maintaining MCC cell lines in vitro. MCV Tags are thus an appealing target for viral oncoprotein-directed T cell therapy for MCC. With this study, we aimed to isolate and characterize Tag-specific T cell receptors (TCR) for potential use in gene therapy clinical trials. Experimental Design: T cell responses against MCV Tag epitopes were investigated by immunizing transgenic mice that express a diverse human TCR repertoire restricted to HLA-A2. Human lymphocytes genetically engineered to express Tag-specific TCRs were tested for specific reactivity against MCC cell lines. The therapeutic potential of Tag-specific TCR gene therapy was tested in a syngeneic cancer model. Results: We identified naturally processed epitopes of MCV Tags and isolated Tag-specific TCRs. T cells expressing these TCRs were activated by HLA-A2-positive cells loaded with cognate peptide or cells that stably expressed MCV Tags. We showed cytotoxic potential of T cells engineered to express these TCRs in vitro and demonstrated regression of established tumors in a mouse model upon TCR gene therapy. Conclusions: Our findings demonstrate that MCC cells can be targeted by MCV Tag-specific TCRs. Although recent findings suggest that approximately half of MCC patients benefit from PD1 pathway blockade, additional patients may benefit if their endogenous T cell response can be augmented by infusion of transgenic MCV-specific T cells such as those described here.
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Laryngo-Rhino-Otologie 2018; S 02 Article in Thieme eJournals: Table of contents | Congress
Laryngo-Rhino-Otologie 2018; S 02
Article in Thieme eJournals:
Table of contents | Congress
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Etiology and Treatment of Congenital Festoons
Abstract
Background
Festoons and malar bags present a particular challenge to the plastic surgeon and commonly persist after the traditional lower blepharoplasty. They are more common than we think and a trained eye will be able to recognize them. Lower blepharoplasty in these patients requires addressing the lid-cheek junction and midcheek using additional techniques such as orbicularis retaining ligament (ORL) and zygomaticocutaneous ligament (ZCL) release, midface lift, microsuction, or even direct excision (Kpodzo e al. in Aesthet Surg J 34(2):235–248, 2014; Goldberg et al. in Plast Reconstr Surg 115(5):1395–1402, 2005; Mendelson et al. in Plast Reconstr Surg 110(3):885–896, 2002). The goal in these patients is to restore a smooth contour from the lower eyelid to the cheek. The review of literature shows the need for more than one surgery for treatment of the festoons (Furnas in Plast Reconstr Surg 61(4):540–546, 1978). One of the reasons WHY these cases are so challenging is that the festoons tend to persist even after surgical treatment. As Furnas said, "Malar mounds have acquired some notoriety for their persistence in the face of surgical efforts to remove them" (Furnas in Clin Plast Surg 20(2):367–385, 1993). This could be due to different etiology between acquired and congenital festoons. There are currently no cases of congenital festoons described in the literature. In the last 10 years, we have treated a total of 59 patients with festoons or malar mounds. We used the terminology of festoon for acquired cases and malar mound for congenital ones (Kpodzo et al. 2014). We were successful with treating 56 patients who developed acquired festoons later on in life; however, three cases required an additional treatment to improve residual puffiness that they had after the first operation. From the above findings, we hypothesized that there should be something common in patients with congenital festoons or malar mounds which are different from acquired festoons. All of these three patients had one thing in common, and that was a history of puffiness of the prezygomatic space since childhood. Each of these patients expressed that these conditions have been present since a young age but became worse with aging over time. To date, there are no descriptions of the cause or treatment for congenital festoons. Here, we present the first case series of three patients with congenital festoons. We discuss the possible etiology of congenital festoons, the physical exam, and the surgical approaches.
Methods
We performed a retrospective review of 59 patients who had surgical correction of festoons in the past 10 years, three of which were presented since childhood. In this paper, we will discuss the pathophysiology and the surgical treatments for congenital festoons. Only patients with festoons present since birth were included. The first two cases were treated with a subciliary blepharoplasty with release of the orbicularis retaining and zygomaticocutaneous ligaments and midface lift with canthopexy and orbicularis muscle suspension. The third case had a subciliary lower blepharoplasty approach, skin, and muscle flap and direct excision of the fat through the orbicularis from the subcutaneous space. In addition, each patient required further treatments to address supra-orbicularis fat by various methods.
Results
All patients with acquired festoons had successful results with one operation by subciliary skin muscle flap, release of the ORL and ZCL, midface lift, and muscle suspension. All three patients with congenital festoons had residual puffiness that required surgical and non-surgical treatments. There were no complications. Our first case required three surgical treatments for complete correction. The second and third cases required Kybella injections after their initial surgical treatments. The specimen of the first patient, Fig. 10, who had direct excision, showed localized fat collection immediately under the skin and above the orbicularis oculi muscle.
Conclusions
Correction of congenital festoons or malar mounds requires a combination of subciliary lower blepharoplasty with skin muscle flap, midface lift, and orbicularis muscle suspension, as well as addressing the supra-orbicularis fat via direct excision, off-label Kybella injection or liposuction.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Etiology and Treatment of Congenital Festoons
Abstract
Background
Festoons and malar bags present a particular challenge to the plastic surgeon and commonly persist after the traditional lower blepharoplasty. They are more common than we think and a trained eye will be able to recognize them. Lower blepharoplasty in these patients requires addressing the lid-cheek junction and midcheek using additional techniques such as orbicularis retaining ligament (ORL) and zygomaticocutaneous ligament (ZCL) release, midface lift, microsuction, or even direct excision (Kpodzo e al. in Aesthet Surg J 34(2):235–248, 2014; Goldberg et al. in Plast Reconstr Surg 115(5):1395–1402, 2005; Mendelson et al. in Plast Reconstr Surg 110(3):885–896, 2002). The goal in these patients is to restore a smooth contour from the lower eyelid to the cheek. The review of literature shows the need for more than one surgery for treatment of the festoons (Furnas in Plast Reconstr Surg 61(4):540–546, 1978). One of the reasons WHY these cases are so challenging is that the festoons tend to persist even after surgical treatment. As Furnas said, "Malar mounds have acquired some notoriety for their persistence in the face of surgical efforts to remove them" (Furnas in Clin Plast Surg 20(2):367–385, 1993). This could be due to different etiology between acquired and congenital festoons. There are currently no cases of congenital festoons described in the literature. In the last 10 years, we have treated a total of 59 patients with festoons or malar mounds. We used the terminology of festoon for acquired cases and malar mound for congenital ones (Kpodzo et al. 2014). We were successful with treating 56 patients who developed acquired festoons later on in life; however, three cases required an additional treatment to improve residual puffiness that they had after the first operation. From the above findings, we hypothesized that there should be something common in patients with congenital festoons or malar mounds which are different from acquired festoons. All of these three patients had one thing in common, and that was a history of puffiness of the prezygomatic space since childhood. Each of these patients expressed that these conditions have been present since a young age but became worse with aging over time. To date, there are no descriptions of the cause or treatment for congenital festoons. Here, we present the first case series of three patients with congenital festoons. We discuss the possible etiology of congenital festoons, the physical exam, and the surgical approaches.
Methods
We performed a retrospective review of 59 patients who had surgical correction of festoons in the past 10 years, three of which were presented since childhood. In this paper, we will discuss the pathophysiology and the surgical treatments for congenital festoons. Only patients with festoons present since birth were included. The first two cases were treated with a subciliary blepharoplasty with release of the orbicularis retaining and zygomaticocutaneous ligaments and midface lift with canthopexy and orbicularis muscle suspension. The third case had a subciliary lower blepharoplasty approach, skin, and muscle flap and direct excision of the fat through the orbicularis from the subcutaneous space. In addition, each patient required further treatments to address supra-orbicularis fat by various methods.
Results
All patients with acquired festoons had successful results with one operation by subciliary skin muscle flap, release of the ORL and ZCL, midface lift, and muscle suspension. All three patients with congenital festoons had residual puffiness that required surgical and non-surgical treatments. There were no complications. Our first case required three surgical treatments for complete correction. The second and third cases required Kybella injections after their initial surgical treatments. The specimen of the first patient, Fig. 10, who had direct excision, showed localized fat collection immediately under the skin and above the orbicularis oculi muscle.
Conclusions
Correction of congenital festoons or malar mounds requires a combination of subciliary lower blepharoplasty with skin muscle flap, midface lift, and orbicularis muscle suspension, as well as addressing the supra-orbicularis fat via direct excision, off-label Kybella injection or liposuction.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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A Case of Septicemia due to Nonocclusive Mesenteric Ischemia Occurring in Induction Chemotherapy
In nonocclusive mesenteric ischemia (NOMI), mesenteric ischemia and intestinal necrosis occur despite the absence of organic blockage in mesenteric blood vessels. As abdominal pain is often absent and few characteristic findings are seen in blood biochemistry, imaging diagnosis or other examinations, discovery is often delayed. With a mortality rate of 56–79%, NOMI is a very serious disease. However, few reports have described this pathology in association with chemotherapy regimens such as those used for malignant head and neck tumors. We encountered a case of NOMI during induction therapy combining cisplatin, docetaxel, and 5-fluorouracil. The patient was a 74-year-old man receiving chemotherapy for T2N2bM0 stage IVA oropharyngeal carcinoma. Febrile neutropenia appeared on treatment day 8. An antibacterial agent and a granulocyte colony-stimulating factor were administered, but septic shock developed and he was transferred to the intensive care unit. Abdominal distension was present and contrast-enhanced computed tomography of the abdomen suggested NOMI. Emergency surgery on day 9 resected the necrotized small intestine and created a single-hole ileostomy. The patient subsequently recovered with 2 weeks of continuous hemodiafiltration and other intensive therapies. Otolaryngological surgeons seldom encounter intestinal diseases, which are thus easily overlooked. The present case report may help in achieving early diagnosis.
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Nested case–control study of telomere length and lung cancer risk among heavy smokers in the β-Carotene and Retinol Efficacy Trial
Nested case–control study of telomere length and lung cancer risk among heavy smokers in the β-Carotene and Retinol Efficacy Trial
Nested case–control study of telomere length and lung cancer risk among heavy smokers in the β-Carotene and Retinol Efficacy Trial, Published online: 19 April 2018; doi:10.1038/s41416-018-0075-0
Nested case–control study of telomere length and lung cancer risk among heavy smokers in the β-Carotene and Retinol Efficacy Trial
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Paracrine roles of cellular senescence in promoting tumourigenesis
Paracrine roles of cellular senescence in promoting tumourigenesis
Paracrine roles of cellular senescence in promoting tumourigenesis, Published online: 19 April 2018; doi:10.1038/s41416-018-0066-1
Paracrine roles of cellular senescence in promoting tumourigenesis
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The surgical intelligent knife distinguishes normal, borderline and malignant gynaecological tissues using rapid evaporative ionisation mass spectrometry (REIMS)
The surgical intelligent knife distinguishes normal, borderline and malignant gynaecological tissues using rapid evaporative ionisation mass spectrometry (REIMS)
The surgical intelligent knife distinguishes normal, borderline and malignant gynaecological tissues using rapid evaporative ionisation mass spectrometry (REIMS), Published online: 19 April 2018; doi:10.1038/s41416-018-0048-3
The surgical intelligent knife distinguishes normal, borderline and malignant gynaecological tissues using rapid evaporative ionisation mass spectrometry (REIMS)
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A Case of Septicemia due to Nonocclusive Mesenteric Ischemia Occurring in Induction Chemotherapy
In nonocclusive mesenteric ischemia (NOMI), mesenteric ischemia and intestinal necrosis occur despite the absence of organic blockage in mesenteric blood vessels. As abdominal pain is often absent and few characteristic findings are seen in blood biochemistry, imaging diagnosis or other examinations, discovery is often delayed. With a mortality rate of 56–79%, NOMI is a very serious disease. However, few reports have described this pathology in association with chemotherapy regimens such as those used for malignant head and neck tumors. We encountered a case of NOMI during induction therapy combining cisplatin, docetaxel, and 5-fluorouracil. The patient was a 74-year-old man receiving chemotherapy for T2N2bM0 stage IVA oropharyngeal carcinoma. Febrile neutropenia appeared on treatment day 8. An antibacterial agent and a granulocyte colony-stimulating factor were administered, but septic shock developed and he was transferred to the intensive care unit. Abdominal distension was present and contrast-enhanced computed tomography of the abdomen suggested NOMI. Emergency surgery on day 9 resected the necrotized small intestine and created a single-hole ileostomy. The patient subsequently recovered with 2 weeks of continuous hemodiafiltration and other intensive therapies. Otolaryngological surgeons seldom encounter intestinal diseases, which are thus easily overlooked. The present case report may help in achieving early diagnosis.
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Wachter: Why Home Hospitals Are Not a Threat
The future of hospitalists is safe because factors other than the lower cost of care seem to be affecting the uptake of the home hospital, experts report.
Medscape Medical News
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PACHE Spotlight: Yamilé Molina, Ph.D.
Dr. Yamilé Molina, an Assistant Professor at the University of Illinois-Chicago, discusses her work comparing intervention approaches' effects on cancer disparities. Dr. Molina also describes what CRCHD diversity training programs, including PACHE, have meant to her career.
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Ultrasound-Guided Shoulder Injection or Ultrasound Guides the Shoulder Injection?: Standard Versus State-of-the-Art
Exploring the Use of Educational Material About Shoulder Dysfunction: A Quality Improvement Project in People With Amyotrophic Lateral Sclerosis
Shoulder pain is a common secondary complication of amyotrophic lateral sclerosis (ALS) that can contribute to functional decline and decreased participation in daily activities. The purpose of this study was to assess the effectiveness of an educational brochure aimed at improving knowledge regarding shoulder pain and dysfunction in people with ALS. Participants completed a preintervention survey with questions regarding their knowledge of how ALS may affect their shoulders. After completing the presurvey, they were mailed a brochure that described shoulder health and range of motion and stretching exercises. Four weeks after receiving the brochure, participants were then asked to determine the effectiveness of the educational materials in terms of impact on shoulder-related knowledge and self-efficacy with regard to prevention of shoulder pain and dysfunction. More than 50% of participants reported pain, decreased range of motion, or weakness in at least one shoulder since being diagnosed with ALS. All participants were interested in receiving educational materials, and all agreed that the brochure was easy to interpret and understand, with most (87%) reporting that it was helpful. Educational brochures are one strategy to improve awareness about shoulder health and to educate patients with ALS about exercises that may help reduce shoulder pain and dysfunction.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2Hxp3bG
Changes in Basic Movement Ability and Activities of Daily Living After Hip Fractures: Correlation Between Basic Movement Scale and Motor-Functional Independence Measure Scores
Objective The aim of this study was to examine the correlation between basic movement ability and activities of daily living (ADL) in elderly patients after hip fracture surgery and predict ADL outcomes from changes in basic movement ability. Design Fifty-four patients receiving rehabilitation after hip fracture surgery were collected prospectively. Ambulatory ability was evaluated using a Basic Movement Scale (BMS), and ADL was evaluated using the motor subscale of the Functional Independence Measure (motor-FIM). From the results of evaluating BMS and motor-FIM weekly, the important postoperative period to regain ADL was investigated. Results There was a close correlation between BMS and motor-FIM scores at each evaluation point (r = 0.971, Pfrom #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2EZyT0n
The Link Between Cerebrovascular Hemodynamics and Rehabilitation Outcomes After Aneurysmal Subarachnoid Hemorrhage
Objective The aim of the study was to assess the relation between cerebrovascular function early after aneurysmal subarachnoid hemorrhage onset and functional and rehabilitation outcomes. Design Observational cohort study of subarachnoid hemorrhage patients (n = 133) admitted to rehabilitation (n = 49), discharged home (n = 52), or died before discharge (n = 10). We obtained hemodynamic markers of cerebral autoregulatory function from blood flow velocities in the middle cerebral artery and arterial pressure waveforms, recorded daily on days 2–4 after symptom onset, and functional independence measure (FIM) scores and FIM efficiency for those admitted to acute rehabilitation. Results Compared to those discharged home, the range of pressures within which autoregulation is effective was lower in patients admitted to rehabilitation (4.6 [0.2] vs. 3.9 [0.2] mm Hg) and those who died (2.7 [0.4], P = 0.04). For those admitted to rehabilitation, autoregulatory range and the ability of cerebrovasculature to increase flow were related to discharge FIM score (R2 = 0.33 and 0.43, Pfrom #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2qIcBfn
Disability and Health Consequences of Traumatic Brain Injury: National Prevalence
Objective The aim of the study was to measure the prevalence of traumatic brain injury (TBI)-related disability and health status in the general population. Design The French National Survey, conducted in households and institutions, assessed 33,896 adults. Data included sequelae from TBI, impairments, current health conditions, and uses of health services. Analyses, adjusted for age and sex, compared subjects who declared sequelae from TBI (n = 479) with the remaining survey population (n = 33,287). Use of weighting factors ensured that results were representative of the national population. Results Prevalence of persistent sequelae from TBI in France was 704/100,000. Median time since injury was 14 yrs. For all Core Set items of the International Classification of Functioning, subjects with TBI reported more impairments than the control population: adjusted odds ratios from 1.7 (behavioral difficulties) to 8.6 (motor difficulties). Rates of cardiovascular, respiratory, musculoskeletal, digestive, urological, neurological, and psychiatric conditions were higher in the TBI population. Use of health services was greater, and women with TBI had higher rates of unmet health needs. Conclusions Persistent sequelae from TBI significantly affect health in the general population. Planning of post-TBI care should address the chronic needs of these persons.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2EZCY4S
Feasibility of Early, Motor-Assisted Cycle Ergometry in Critically Ill Neurological Patients With Upper Limb Weakness and Variable Cognitive Status: A Case Series
Upper limb paresis, common in many neurological conditions, is a major contributor of long-term disability and decreased quality of life. Evidence shows that repetitive, bilateral arm movement improves upper limb coordination after neurological injury. However, it is difficult to integrate upper limb interventions into very early rehabilitation of critically ill neurological patients because of patient arousal and medical acuity. This report describes the safety and feasibility of bilateral upper limb cycling in critically ill neurological patients with bilateral or unilateral paresis. Patients were included in this pilot observational series if they used upper limb cycle ergometry with occupational therapy while in the neurocritical care unit between May and August 2016. Patient demographics, neurological function, and hemodynamic status were recorded precycling and postcycling. Cycling parameters including duration and active and/or passive cycling were collected. No significant changes in hemodynamic or respiratory status were noted postintervention. No adverse effects or safety events were noted. In this series, upper limb cycle ergometry was a safe and feasible intervention for early rehabilitation in critically ill patients in the neurocritical care unit. Future studies will prospectively measure the impact of early upper limb cycle ergometry on neurological recovery and functional outcome in this population.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2qD77mf
Immediate Effects of Simultaneous Application of Transcutaneous Electrical Nerve Stimulation and Ultrasound Phonophoresis on Active Myofascial Trigger Points: A Randomized Controlled Trial
Objective The aim of the study was to investigate the efficacy of phonophoresis with combined therapy on active myofascial trigger points. Participants One hundred participants with acute mechanical neck pain and at least one active myofascial trigger point in the upper trapezius were randomly assigned into four equal groups. Intervention Groups consisted of diclofenac phonophoresis with combined therapy, diclofenac phonophoresis, ultrasound (US) with coupling gel, and sham US and applied for 10 mins over myofascial trigger points. Measurements Measurements included pressure pain threshold and active cervical lateral flexion. Results There were statistically significant improvements in postintervention pressure pain threshold and range of motion values in treatment groups (P 0.05). Bonferroni correction test revealed that there was a significant difference between all the four groups in pressure pain threshold values (P 0.05) for range of motion. Conclusions Diclofenac phonophoresis with combined therapy, phonophoresis, and US were all effective in increasing pressure pain threshold values and range of motion. In addition, phonophoresis with combined therapy was shown to be superior over phonophoresis, and phonophoresis was superior over US in terms of reducing pain sensitivity. However, none of the treatment groups were found to be superior over the other in increasing range of motion.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2HdcS0b
Diffusion Tensor Tractography for Decompressive Operation Decisions in Patients With Intracerebral Hemorrhage
No abstract availablefrom #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2qH30W7
Priming With 1-Hz Repetitive Transcranial Magnetic Stimulation Over Contralesional Leg Motor Cortex Does Not Increase the Rate of Regaining Ambulation Within 3 Months of Stroke: A Randomized Controlled Trial
Background The potential benefits of repetitive transcranial magnetic stimulation (rTMS), applied either alone or as a combination treatment, on recovery of lower limbs after stroke have been insufficiently studied. Objective The aim of the study was to evaluate the effect of priming with 1-Hz repetitive transcranial magnetic stimulation over contralesional leg motor area with a double-cone coil before physical therapy on regaining ambulation. Methods Thirty-eight subacute stroke patients with significant leg disabilities were randomly assigned into the experimental group or control group to receive a 15-min real or sham 1-Hz repetitive transcranial magnetic stimulation, respectively, over the contralesional motor cortex representing the quadriceps muscle followed by 45-min physical therapy for 15 sessions for 3 wks. Functional measures, motor evoked potentials, and quality of life were assessed. Results There was no significant difference between experimental group and control group regarding the recovery in ambulation, balance, motor functions, and activity of daily living. No significant difference was found in other functional measures and the quality of life. Only the control group displayed significantly increased cortical excitability of the contralesional hemisphere after the intervention. Conclusions The present study found that insufficient evidence that contralesional priming with 1-Hz repetitive transcranial magnetic stimulation improves ambulatory and other motor functions among patients with a severe leg dysfunction in subacute stroke.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2EXBE2v
Contralateral Involvement of Congenital Muscular Torticollis and Clavicular Fracture
Congenital muscular torticollis (CMT) is known to concur with some conditions such as developmental dysplasia of the hip or brachial plexus injury, which gives us some insights for pathogenesis of CMT. Although clavicular fracture is the most common fracture in newborns, little is known about concurrence of CMT and clavicular fracture. Our clinical experience led us to realize that concurrence of CMT and clavicular fracture tended to occur on the contralateral side for each other rather than the ipsilateral side. This study aimed to verify contralateral concurrence of CMT and clavicular fracture. This is a retrospective cohort study in a tertiary hospital, including 996 subjects with CMT. Concurrent clavicular fracture was found in 20 of 996 subjects with CMT, with the concurrence rate being 2.01%. Concurrent clavicular fracture and clavicular fracture occurred on the contralateral side for each other in 18 subjects (90%) rather than the ipsilateral side. This contralateral concurrence between side of CMT and clavicular fracture was significant (P = 0.001), with an odds ratio of 81 (P = 0.0032). Concurrent clavicular fracture and clavicular fracture seem to occur significantly more on the contralateral side for each other. Underlying mechanism for consistent contralateral concurrence needs to be verified in the near future.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2qHjca1
The Natural History of Idiopathic Scoliosis During Growth: A Meta-Analysis
Objective The aim of the study was to provide a meta-analysis of current literature concerning the natural history of idiopathic scoliosis during growth. Design A comprehensive search of Medline, Embase, And Scopus databases was conducted up to November 2016. Eligible works were prospective or retrospective studies that enrolled patients with infantile idiopathic scoliosis, juvenile idiopathic scoliosis, or adolescent idiopathic scoliosis, followed up without any treatment from the time of detection. A meta-analysis for proportion was performed. The following studies were grouped per diagnosis: infantile idiopathic scoliosis, juvenile idiopathic scoliosis, and adolescent idiopathic scoliosis. Results Of the 1797 citations screened, we assessed 61 full-text articles and included 13 of these (2301 participants). Three studies included infantile idiopathic scoliosis patients (347 participants), five studies included a mixed population of juvenile idiopathic scoliosis and adolescent idiopathic scoliosis (1330 participants), and five studies included adolescent idiopathic scoliosis patients only (624 participants). The random pooled estimated progression rate was 49% (95% confidence interval = 1%–97%) for infantile idiopathic scoliosis, 49% in a mixed group of patients affected by juvenile idiopathic scoliosis or adolescent idiopathic scoliosis (95% confidence interval = 19%–79%), and 42% in adolescent idiopathic scoliosis (95% confidence interval = 11%–73%). Conclusions During growth, idiopathic scoliosis tends to progress in a high percentage of cases. The progression rate varies according to the age at diagnosis, with infantile scoliosis being the most unpredictable. There are many confounders, such as age, Risser sign and baseline Cobb angles that were not consistent among studies, making the data very heterogeneous.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2EYWOgv
Two Unique Cases of Ciprofloxacin-Associated Avulsion of Ligament and Tendon
Ciprofloxacin is recognized to have a deleterious relationship with tendons, particularly Achilles tendinopathy, which makes up most case reports. Tendinopathy seems to occur because of induction of collagen-degrading enzymes causing damage and ischemia of the poorly vascularized regions preventing repair. The focus on the relationship of ciprofloxacin and the Achilles tendon leaves patients on fluoroquinolones with non-Achilles tendinopathy symptoms at risk of misdiagnosis. There have not been any documented instances of ligament damage with ciprofloxacin administration in the literature, although ligament and tendon compositions are similar and should have similar susceptibility. This report includes two cases, one presenting with right lateral thumb pain and a medical history of gastroenteritis treated with ciprofloxacin. Physical examination showed swelling of the right metacarpophalangeal joint and ultrasound confirmed disruption of the radial collateral ligament at insertion on first metacarpal; the second case is of a woman presenting with right hip pain in setting of chronic recurrent diverticulitis treated with ciprofloxacin. She received work-up for lumbar disc disease and spondylosis. After standard therapy with pharmacotherapy and physical therapy for radiculopathy failed, magnetic resonance imaging was performed showing near complete avulsion of the right hamstring tendons from the ischial tuberosity.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2qGgWjg
Effect of Stretching Combined With Ultrashort Wave Diathermy on Joint Function and Its Possible Mechanism in a Rabbit Knee Contracture Model
Objective The aim of this study was to investigate the therapeutic effect of stretching combined with ultrashort wave on joint contracture and explore its possible mechanism. Design Thirty-two rabbits underwent unilateral immobilization of a knee joint at full extension to cause joint contracture. At 6 wks after immobilization, the rabbits were randomly divided into the following four groups: natural recovery group, stretching treatment group, ultrashort wave treatment group, and combined treatment group. For comparison, eight control group animals of corresponding age were also examined. The effect of stretching and ultrashort wave treatment on joint contracture was assessed by measuring the joint range of motion, evaluating the collagen deposition of joint capsule and assessing the mRNA and protein levels for transforming growth factor β1 in the joint capsule. Results The combined treatment group led to the best recovery of joint function. The combined treatment with stretching and ultrashort wave was more effective than stretching or ultrashort wave treatment alone against the synovial thickening of suprapatellar joint capsule, the collagen deposition of anterior joint capsule, and the elevated expression of transforming growth factor β1 in the joint capsule. Conclusions Stretching combined with ultrashort wave treatment was effective in improving joint range of motion, reducing the biomechanical, histological, and molecular manifestations of joint capsule fibrosis in a rabbit model of extending joint contracture.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2HdqZCL
Radial Extracorporeal Shock Wave Therapy in an Individual With Primary Trigeminal Neuralgia: A Case Report and Literature Review
A patient with primary trigeminal neuralgia exhibited pain relief without medication after radial extracorporeal shock wave therapy. The 52-yr-old woman had a 3-yr history of primary trigeminal neuralgia, involving the right maxillary division (V2) and the mandibular division (V3). She became refractory to carbamazepine and exhibited hepatic dysfunction. She hence received 3000 to 6000 impulses of craniofacial radial extracorporeal shock wave therapy to the region centered on the surface projection of the trigeminal ganglion and pain areas at 10 Hz; the intensity ranged from 1.4 to 4.5 bars twice per week for 8 wks. At baseline, and 1, 2, and 5 mos after treatment, the Barrow Neurological Institute scores were IV, IIIa, II, and II, and the visual analog scale scores were 8, 3, 1, and 1, respectively. No complications or adverse effects were observed. The hepatic function returned to normal after the discontinuation of carbamazepine. This case report demonstrates the feasibility of radial extracorporeal shock wave therapy for primary trigeminal neuralgia without complications or adverse effects with careful regulation of the therapy intensity.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2qHly8K
Does a Rehabilitation Program of Aerobic and Progressive Resisted Exercises Influence HIV-Induced Distal Neuropathic Pain?
Objective Distal symmetrical polyneuropathy is a common neurological sequela after HIV, which leads to neuropathic pain and functional limitations. Rehabilitation programs with exercises are used to augment pharmacological therapy to relieve pain but appropriate and effective exercises are unknown. This study explored the safety and effect of moderate-intensity aerobic exercises and progressive resisted exercises for HIV-induced distal symmetrical polyneuropathy neuropathic pain. Design A randomized pretest, posttest of 12 wks of aerobic exercise or progressive resisted exercise compared with a control. Outcome measures were assessed using the subjective periphery neuropathy, brief peripheral neuropathy screening, and numeric pain rating scale. Pain was assessed at baseline, 6 and 12 wks. Data between groups were compared using Kruskal-Wallis, Mann-Whitney U test, and within-groups Friedman and Wilcoxon signed rank tests. Results There were 136 participants (mean [SD] age = 36.79 [8.23] yrs) and the exercise groups completed the protocols without any adverse effects. Pain scores within and between aerobic exercise and progressive resisted exercise groups showed significant improvement (P 0.05). Conclusions This study supports a rehabilitation program of moderate-intensity aerobic exercise and progressive resisted exercise being safe and effective for reducing neuropathic pain and is beneficial with analgesics for HIV-induced distal symmetrical polyneuropathy.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2HdAr9h
Response to the Letter to the Editor on “Point-of-Care Ultrasonography Findings and Care Use Among Patients Undergoing Ultrasound-Guided Shoulder Injections”
Lactotripeptides Supplementations Alleviate the Decrease in Maximal Isometric Force After High-Intensity Eccentric Exercise: A Randomized, Placebo-Controlled, Double-Blind Clinical Trial
Objective The aim of the study was to investigate whether lactotripeptides supplementations alleviate the decrease in the maximal isometric force, an indirect marker of muscle damage, after eccentric exercise (ECC). Design Twenty-two young men performed 50 ECC of the elbow flexors using an isokinetic dynamometer. The subjects were randomly assigned to either the placebo or lactotripeptides group and were each given a 4.5 mg/d placebo or lactotripeptides thrice on the exercise day and the day after. Maximal isometric force and brachial arterial diameter were assessed before and 2 days after the ECC. Results The interaction of time and group on maximal isometric force was significant (Pfrom #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2HcO3S6
Heart-Shaped Sign: A Rare Stroke Syndrome
No abstract availablefrom #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2qNx2b5
Open-Fit Domes and Children with Bilateral High-Frequency Sensorineural Hearing Loss: Benefits and Outcomes.
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Open-Fit Domes and Children with Bilateral High-Frequency Sensorineural Hearing Loss: Benefits and Outcomes.
J Am Acad Audiol. 2018 Apr;29(4):348-356
Authors: Johnstone PM, Yeager KR, Pomeroy ML, Hawk N
Abstract
BACKGROUND: Open-fit domes (OFDs) coupled with behind-the-ear (BTE) hearing aids were designed for adult listeners with moderate-to-severe bilateral high-frequency hearing loss (BHFL) with little to no concurrent loss in the lower frequencies. Adult research shows that BHFL degrades sound localization accuracy (SLA) and that BTE hearing aids with conventional earmolds (CEs) make matters worse. In contrast, research has shown that OFDs enhance spatial hearing percepts in adults with BHFL. Although the benefits of OFDs have been studied in adults with BHFL, no published studies to date have investigated the use of OFDs in children with the same hearing loss configuration. This study seeks to use SLA measurements to assess efficacy of bilateral OFDs in children with BHFL.
PURPOSE: To measure SLA in children with BHFL to determine the extent to which hearing loss, age, duration of CE use, and OFDs affect localization accuracy.
RESEARCH DESIGN: A within-participant experimental design using repeated measures was used to determine the effect of OFDs on localization accuracy in children with BHFL. A between-participant experimental design was used to compare localization accuracy between children with BHFL and age-matched controls with normal hearing (NH).
STUDY SAMPLE: Eighteen children with BHFL who used CE and 18 age-matched NH controls. Children in both groups were divided into two age groups: older children (10-16 yr) and younger children (6-9 yr).
DATA COLLECTION AND ANALYSIS: All testing was done in a sound-treated booth with a horizontal array of 15 loudspeakers (radius of 1 m). The stimulus was a spondee word, "baseball": the level averaged 60 dB SPL and randomly roved (±8 dB). Each child was asked to identify the location of a sound source. Localization error was calculated across the loudspeaker array for each listening condition.
RESULTS: A significant interaction was found between immediate benefit from OFD and duration of CE usage. Longer CE usage was associated with degraded localization accuracy using OFDs. Regardless of chronological age, children who had used CEs for <6 yr showed immediate localization benefit using OFDs, whereas children who had used CEs for >6 yr showed immediate localization interference using OFDs. Development, however, may play a role in SLA in children with BHFL. When unaided, older children had significantly better localization acuity than younger children with BHFL. When compared to age-matched controls, children with BHFL of all ages showed greater localization error. Nearly all (94% [17/18]) children with BHFL spontaneously reported immediate own-voice improvement when using OFDs.
CONCLUSIONS: OFDs can provide sound localization benefit to younger children with BHFL. However, immediate benefit from OFDs is reduced by prolonged use of CEs. Although developmental factors may play a role in improving localization abilities over time, children with BHFL will rarely equal that of peers without early use of minimally disruptive hearing aid technology. Also, the occlusion effect likely impacts children far more than currently thought.
PMID: 29664727 [PubMed - in process]
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Measurement of the Electrically Evoked Stapedial Reflex Response with Wideband Acoustic Reflectance Measurement.
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Measurement of the Electrically Evoked Stapedial Reflex Response with Wideband Acoustic Reflectance Measurement.
J Am Acad Audiol. 2018 Apr;29(4):337-347
Authors: Wolfe J, Gifford R, Schafer E
Abstract
BACKGROUND: The electrically evoked stapedial reflex threshold (ESRT) has been shown to be a good predictor of upper stimulation level for cochlear implant recipients. Previous research has shown that the ESRT may be recorded at lower stimulation levels and with a higher incidence of success with the use of higher frequency probe tones (e.g., 678 and 1000 Hz) relative to the use of the conventional 226-Hz probe tone. Research has also shown that the acoustic reflex may be recorded at lower stimulus levels with the use of wideband reflectance when compared to the acoustic reflex threshold recorded with a conventional acoustic immittance measurement.
PURPOSE: The objective of this study was to compare the ESRT recorded with acoustic immittance and wideband reflectance measurements.
RESEARCH DESIGN: A repeated measures design was used to evaluate potential differences in ESRTs with stimulation at an apical, middle, and basal electrode contact with the use of two different techniques, acoustic immittance measurement and wideband reflectance.
STUDY SAMPLE: Twelve users of Cochlear Nucleus cochlear implants were included in the study.
DATA COLLECTION AND ANALYSIS: Participants' ESRTs were evaluated in response to simulation at three different electrode contact sites (i.e., an apical, middle, and basal electrode contact) with the use of two different middle ear measurement techniques, acoustic immittance with the use of a 226-Hz probe tone and wideband reflectance with the use of a chirp stimulus.
RESULTS: The mean ESRT recorded with wideband reflectance measurement was significantly lower when compared to the ESRT recorded with acoustic immittance. For one participant, the ESRT was not recorded with acoustic immittance before reaching the participant's loudness discomfort threshold, but it was successfully recorded with the use of wideband reflectance.
CONCLUSIONS: The ESRT may potentially be recorded at lower presentation levels with the use of wideband reflectance measures relative to the use of acoustic immittance with a 226-Hz probe tone. This may allow for the ESRT to be obtained at levels that are more comfortable for the cochlear implant recipient, which may also allow for a higher incidence in the successful recording of the ESRT.
PMID: 29664726 [PubMed - in process]
from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2HIkZ61
Expectations for Tinnitus Treatment and Outcomes: A Survey Study of Audiologists and Patients.
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Expectations for Tinnitus Treatment and Outcomes: A Survey Study of Audiologists and Patients.
J Am Acad Audiol. 2018 Apr;29(4):313-336
Authors: Husain FT, Gander PE, Jansen JN, Shen S
Abstract
BACKGROUND: Roughly 10-15% of the general population is affected by tinnitus and this percentage is estimated to rise in future. Because there is currently no cure for tinnitus, treatment is limited and is primarily achieved through management of symptoms and counseling.
PURPOSE: This study compared audiologists' and patients' responses to related survey questions about their expectations regarding tinnitus treatment. Two separate surveys were created, one for patients with tinnitus, and one for practicing audiologists who may treat such patients. The surveys included several related questions, such that comparison of the two could reveal where patients' and audiologists' expectations for tinnitus care were in agreement and areas in which they differed.
RESEARCH DESIGN: The surveys for audiologists and adults with tinnitus were 31- and 38-item questionnaires, respectively. Both surveys comprised demographic questions followed by several tinnitus-related questions in either multiple-choice or Likert-scale format.
STUDY SAMPLE: We received 230 completed Patient Surveys and 68 completed Audiologist Surveys.
DATA COLLECTION AND ANALYSIS: All survey recruitment was completed online. Responses were collected via the Survey Monkey web tool (https://ift.tt/fUqr8B). Responses were analyzed within and between surveys and grouped into topical categories (assessment, counseling, current available tinnitus information, satisfaction and expectations, improving tinnitus management). For data within each survey, descriptive statistics and correlation analyses were used. For selected comparisons between surveys, cross-tabulations were used. Hierarchical regression modeling was conducted to further explore (1) the perceived effectiveness of treatment received, and (2) how each group defined treatment success.
RESULTS: Differences were noted between the two groups' responses to the question on the definition of treatment success; audiologists reported decreased awareness (77%), stress/anxiety relief (63%), and increased knowledge of tinnitus (63%) most commonly, whereas patients reported reduction of tinnitus loudness (63%) and complete elimination of tinnitus (57%) most often. The topic of greatest agreement was the desire for more information on tinnitus; 62% of patients felt more information from their healthcare provider would be the most important factor for improved tinnitus management, and 67% of audiologists reported currently having "some access" or less to appropriate resources for tinnitus treatment. Modeling results for effective tinnitus management and definitions of treatment success highlighted the importance of resource access and information sharing for both audiologists and patients.
CONCLUSIONS: Patients and audiologists differed in terms of their expectations for successful treatment, with the patients focusing on perceptual factors and the audiologists on the reaction to the sound. Patient satisfaction with tinnitus treatment may be improved through access to more information, specifically, more information about current tinnitus treatment options and how these focus on the patient's reaction to the tinnitus rather than the percept itself. Providing credible tinnitus information resources to audiologists, and focusing resources on training a small number of tinnitus specialist audiologists could greatly improve patient satisfaction with the current state of tinnitus palliative care.
PMID: 29664725 [PubMed - in process]
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Factors Affecting Hearing Aid Adoption and Use: A Qualitative Study.
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Factors Affecting Hearing Aid Adoption and Use: A Qualitative Study.
J Am Acad Audiol. 2018 Apr;29(4):300-312
Authors: Gallagher NE, Woodside JV
Abstract
BACKGROUND: Despite a high prevalence of age-related hearing loss in older people, there is an unexplained low level of hearing aid adoption and use. Further research is required to determine the reason because hearing aids can vastly improve the quality of life for those with hearing loss.
PURPOSE: The aim of this study was to explore factors associated with hearing aid adoption and use, and to determine whether these differed between groups with different hearing aid use behaviors.
RESEARCH DESIGN: Individual face-to-face semistructured interviews.
STUDY SAMPLE: Three groups of older people with hearing loss in Northern Ireland were recruited: (1) regular hearing aid users (n = 12), (2) irregular hearing aid users (n = 10), and (3) hearing aid nonowners (n = 10).
DATA COLLECTION AND ANALYSIS: Qualitative thematic analysis, using principles of grounded theory, was used to code the data and extract emerging themes for each of the three groups to distinguish similarities and differences between the groups. One-way analysis of variance and χ² tests were used to determine the difference in continuous and categorical variables, respectively, between the three groups.
RESULTS: Similar themes emerged across the three groups: the complexity of low hearing aid use and attitudes to hearing loss/hearing aid use. A third theme, inadequacy of audiology services, was identified in both groups using hearing aids. Older age people having more severe hearing loss and longer duration of hearing aid ownership were associated with greater hearing aid adoption and use.
CONCLUSIONS: Similar themes emerged from qualitative analysis across groups of people with hearing loss. More information for those with hearing loss and those with hearing aids and scheduled follow-up appointments for those with hearing aids are essential to improve hearing aid adoption and use in older people. Further research should focus on the most suitable methods of distributing this information and how often follow-up appointments should take place to achieve optimal hearing aid adoption and use.
PMID: 29664724 [PubMed - in process]
from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2HbM7JB
The Value of Electrically Evoked Stapedius Reflex in Determining the Maximum Comfort Level of a Cochlear Implant.
| Related Articles |
The Value of Electrically Evoked Stapedius Reflex in Determining the Maximum Comfort Level of a Cochlear Implant.
J Am Acad Audiol. 2018 Apr;29(4):292-299
Authors: de Andrade KCL, Muniz LF, Menezes PL, Neto SDSC, Carnaúba ATL, Leal MC
Abstract
BACKGROUND: One of the most important steps for good user performance with a cochlear implant (CI) is activation and programming, aimed at determining the dynamic range. In adults, current levels are determined by psychophysical measures. In babies, small children, or individuals with multiple disorders, this procedure requires techniques that may provide inconsistent responses because of auditory inexperience or the age of the child, making it a very difficult process that demands the collaboration of both the patient and the family.
PURPOSE: To study the relationship between the electrically evoked stapedius reflex threshold (ESRT) and maximum comfort level for stimulating electrodes (C-level) in postoperative CI users.
RESEARCH DESIGN: Cross-sectional analytical observational case series study.
STUDY SAMPLE: We assessed 24 patients of both sexes, aged between 18 and 68 yr, submitted to CI surgery.
INTERVENTION: Otoscopy and immittance. Next, an implant speech processor connected to an Itautec® computer containing the manufacturer's software (custom sound Ep 3-2) was used, as well as an AT 235h probe inserted into the ear contralateral to the CI to capture the stapedius reflex, obtaining electrically evoked stapedius reflex thresholds.
DATA COLLECTION AND ANALYSIS: Data from the last programming, defining C-levels for each electrode studied, were extracted from the databank of each patient. The manual decay function of the AT 235h middle ear analyzer was used to observe ESRT response in a same window for a longer response capture time. Electrodes 22, 16, 11, 6, and 1 were tested when active, with the aim of using electrodes over the entire length of the CI, and ESRT was considered present when compliance was ≥0.05 ml. Stimuli, in current units, were always initiated at 20 cu above the C-level. The analysis of variance parametric test, Tukey's honest significant difference test, the t-test, Wilcoxon nonparametric test, and the Kolmogorov-Smirnov test examined whether significant relationships existed between these other factors.
RESULTS: The results demonstrate that all the electrodes selected for the study exhibited higher mean reflex threshold values than their mean C-level counterparts. However, there was no significant difference between them, for electrodes 1, 6, 11, and 16. The data provided allow the use of ESRT to define C-level values and make it possible to stipulate a correction factor ranging between 6 and 25.6 electrical units.
CONCLUSION: The use of electrically evoked stapedius reflex thresholds can help the team in charge of programming CIs, making the process faster and safer, mainly for infants, small children, or individuals with multiple disorders.
PMID: 29664723 [PubMed - in process]
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Using a Digital Language Processor to Quantify the Auditory Environment and the Effect of Hearing Aids for Adults with Hearing Loss.
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Using a Digital Language Processor to Quantify the Auditory Environment and the Effect of Hearing Aids for Adults with Hearing Loss.
J Am Acad Audiol. 2018 Apr;29(4):279-291
Authors: Klein KE, Wu YH, Stangl E, Bentler RA
Abstract
BACKGROUND: Auditory environments can influence the communication function of individuals with hearing loss and the effects of hearing aids. Therefore, a tool that can objectively characterize a patient's real-world auditory environments is needed.
PURPOSE: To use the Language Environment Analysis (LENA) system to quantify the auditory environments of adults with hearing loss, to examine if the use of hearing aids changes a user's auditory environment, and to determine the association between LENA variables and self-report hearing aid outcome measures.
RESEARCH DESIGN: This study used a crossover design.
STUDY SAMPLE: Participants included 22 adults with mild-to-moderate hearing loss, age 64-82 yr.
INTERVENTION: Participants were fitted with bilateral behind-the-ear hearing aids from a major manufacturer.
DATA COLLECTION AND ANALYSIS: The LENA system consists of a digital language processor (DLP) that is worn by an individual and records up to 16 hr of the individual's auditory environment. The recording is then automatically categorized according to time spent in different types of auditory environments (e.g., meaningful speech and TV/electronic sound) by the LENA algorithms. The LENA system also characterizes the user's auditory environment by providing the sound levels of different auditory categories. Participants in the present study wore a LENA DLP in an unaided condition and aided condition, which each lasted six to eight days. Participants wore bilateral hearing aids in the aided condition. Percentage of time spent in each auditory environment, as well as median levels of TV/electronic sounds and speech, were compared between subjects' unaided and aided conditions using paired sample t tests. LENA data were also compared to self-report measures of hearing disability and hearing aid benefit using Pearson correlations.
RESULTS: Overall, participants spent the greatest percentage of time in silence (∼40%), relative to other auditory environments. Participants spent ∼12% and 26% of their time in meaningful speech and TV/electronic sound environments, respectively. No significant differences were found between mean percentage of time spent in each auditory environment in the unaided and aided conditions. Median TV/electronic sound levels were on average 2.4 dB lower in the aided condition than in the unaided condition; speech levels were not significantly different between the two conditions. TV/electronic sound and speech levels did not significantly correlate with self-report data.
CONCLUSIONS: The LENA system can provide rich data to characterize the everyday auditory environments of older adults with hearing loss. Although TV/electronic sound level was significantly lower in the aided than unaided condition, the use of hearing aids seemed not to substantially change users' auditory environments. Because there is no significant association between objective LENA variables and self-report questionnaire outcomes, these two types of measures may assess different aspects of communication function. The feasibility of using LENA in clinical settings is discussed.
PMID: 29664722 [PubMed - in process]
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Effect of Adaptive Compression and Fast-Acting WDRC Strategies on Sentence Recognition in Noise in Mandarin-Speaking Pediatric Hearing Aid Users.
| Related Articles |
Effect of Adaptive Compression and Fast-Acting WDRC Strategies on Sentence Recognition in Noise in Mandarin-Speaking Pediatric Hearing Aid Users.
J Am Acad Audiol. 2018 Apr;29(4):273-278
Authors: Liu H, Liu Y, Li Y, Jin X, Li J, Zhou Y, Ge W, Ni X
Abstract
BACKGROUND: Wide dynamic range compression (WDRC) has been widely used in hearing aid technology. However, several reports indicate that WDRC may improve audibility at the expense of speech intelligibility. As such, a modified amplification compression scheme, named adaptive compression, was developed. However, the effect of compression strategies on speech perception in pediatric hearing aid users has not been clearly reported.
PURPOSE: The purpose of the present study was to investigate the effect of adaptive compression and fast-acting WDRC processing strategies on sentence recognition in noise with Mandarin, pediatric hearing aid users.
RESEARCH DESIGN: This study was set up using a double-blind, within-subject, repeated-measures design.
STUDY SAMPLE: Twenty-six children who spoke Mandarin Chinese as their primary language and had bilateral sensorineural hearing loss participated in the study.
DATA COLLECTION AND ANALYSIS: Sentence recognition in noise was evaluated in behind-the-ear technology with both adaptive compression processing and fast-acting WDRC processing and was selected randomly for each child. Percent correct sentence recognition in noise with fast-acting WDRC and adaptive compression was collected from each participant. Correlation analysis was performed to examine the effect of gender, age at assessment, and hearing threshold of the better ear on signal-to-noise ratio, and a paired-samples t test was employed to compare the performance of the adaptive compression strategy and fast-acting WDRC processing.
RESULTS: The mean percentage correct of sentence recognition in noise with behind-the-ear technology with fast-acting WDRC and adaptive compression processing were 62.24% and 68.71%, respectively. The paired-samples t test showed that the performance of the adaptive compression strategy was significantly better than the fast-acting WDRC processing (t = 3.190, p = 0.004).
CONCLUSIONS: Compared with the fast-acting WDRC, adaptive compression provided better sentence recognition in noise for Mandarin pediatric hearing aid users.
PMID: 29664721 [PubMed - in process]
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Functional Outcomes in Audiology: There is Room for Improvement.
| Related Articles |
Functional Outcomes in Audiology: There is Room for Improvement.
J Am Acad Audiol. 2018 Apr;29(4):272
Authors: McCaslin DL
PMID: 29664720 [PubMed - in process]
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Open-Fit Domes and Children with Bilateral High-Frequency Sensorineural Hearing Loss: Benefits and Outcomes.
| Related Articles |
Open-Fit Domes and Children with Bilateral High-Frequency Sensorineural Hearing Loss: Benefits and Outcomes.
J Am Acad Audiol. 2018 Apr;29(4):348-356
Authors: Johnstone PM, Yeager KR, Pomeroy ML, Hawk N
Abstract
BACKGROUND: Open-fit domes (OFDs) coupled with behind-the-ear (BTE) hearing aids were designed for adult listeners with moderate-to-severe bilateral high-frequency hearing loss (BHFL) with little to no concurrent loss in the lower frequencies. Adult research shows that BHFL degrades sound localization accuracy (SLA) and that BTE hearing aids with conventional earmolds (CEs) make matters worse. In contrast, research has shown that OFDs enhance spatial hearing percepts in adults with BHFL. Although the benefits of OFDs have been studied in adults with BHFL, no published studies to date have investigated the use of OFDs in children with the same hearing loss configuration. This study seeks to use SLA measurements to assess efficacy of bilateral OFDs in children with BHFL.
PURPOSE: To measure SLA in children with BHFL to determine the extent to which hearing loss, age, duration of CE use, and OFDs affect localization accuracy.
RESEARCH DESIGN: A within-participant experimental design using repeated measures was used to determine the effect of OFDs on localization accuracy in children with BHFL. A between-participant experimental design was used to compare localization accuracy between children with BHFL and age-matched controls with normal hearing (NH).
STUDY SAMPLE: Eighteen children with BHFL who used CE and 18 age-matched NH controls. Children in both groups were divided into two age groups: older children (10-16 yr) and younger children (6-9 yr).
DATA COLLECTION AND ANALYSIS: All testing was done in a sound-treated booth with a horizontal array of 15 loudspeakers (radius of 1 m). The stimulus was a spondee word, "baseball": the level averaged 60 dB SPL and randomly roved (±8 dB). Each child was asked to identify the location of a sound source. Localization error was calculated across the loudspeaker array for each listening condition.
RESULTS: A significant interaction was found between immediate benefit from OFD and duration of CE usage. Longer CE usage was associated with degraded localization accuracy using OFDs. Regardless of chronological age, children who had used CEs for <6 yr showed immediate localization benefit using OFDs, whereas children who had used CEs for >6 yr showed immediate localization interference using OFDs. Development, however, may play a role in SLA in children with BHFL. When unaided, older children had significantly better localization acuity than younger children with BHFL. When compared to age-matched controls, children with BHFL of all ages showed greater localization error. Nearly all (94% [17/18]) children with BHFL spontaneously reported immediate own-voice improvement when using OFDs.
CONCLUSIONS: OFDs can provide sound localization benefit to younger children with BHFL. However, immediate benefit from OFDs is reduced by prolonged use of CEs. Although developmental factors may play a role in improving localization abilities over time, children with BHFL will rarely equal that of peers without early use of minimally disruptive hearing aid technology. Also, the occlusion effect likely impacts children far more than currently thought.
PMID: 29664727 [PubMed - in process]
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Measurement of the Electrically Evoked Stapedial Reflex Response with Wideband Acoustic Reflectance Measurement.
| Related Articles |
Measurement of the Electrically Evoked Stapedial Reflex Response with Wideband Acoustic Reflectance Measurement.
J Am Acad Audiol. 2018 Apr;29(4):337-347
Authors: Wolfe J, Gifford R, Schafer E
Abstract
BACKGROUND: The electrically evoked stapedial reflex threshold (ESRT) has been shown to be a good predictor of upper stimulation level for cochlear implant recipients. Previous research has shown that the ESRT may be recorded at lower stimulation levels and with a higher incidence of success with the use of higher frequency probe tones (e.g., 678 and 1000 Hz) relative to the use of the conventional 226-Hz probe tone. Research has also shown that the acoustic reflex may be recorded at lower stimulus levels with the use of wideband reflectance when compared to the acoustic reflex threshold recorded with a conventional acoustic immittance measurement.
PURPOSE: The objective of this study was to compare the ESRT recorded with acoustic immittance and wideband reflectance measurements.
RESEARCH DESIGN: A repeated measures design was used to evaluate potential differences in ESRTs with stimulation at an apical, middle, and basal electrode contact with the use of two different techniques, acoustic immittance measurement and wideband reflectance.
STUDY SAMPLE: Twelve users of Cochlear Nucleus cochlear implants were included in the study.
DATA COLLECTION AND ANALYSIS: Participants' ESRTs were evaluated in response to simulation at three different electrode contact sites (i.e., an apical, middle, and basal electrode contact) with the use of two different middle ear measurement techniques, acoustic immittance with the use of a 226-Hz probe tone and wideband reflectance with the use of a chirp stimulus.
RESULTS: The mean ESRT recorded with wideband reflectance measurement was significantly lower when compared to the ESRT recorded with acoustic immittance. For one participant, the ESRT was not recorded with acoustic immittance before reaching the participant's loudness discomfort threshold, but it was successfully recorded with the use of wideband reflectance.
CONCLUSIONS: The ESRT may potentially be recorded at lower presentation levels with the use of wideband reflectance measures relative to the use of acoustic immittance with a 226-Hz probe tone. This may allow for the ESRT to be obtained at levels that are more comfortable for the cochlear implant recipient, which may also allow for a higher incidence in the successful recording of the ESRT.
PMID: 29664726 [PubMed - in process]
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Factors Affecting Hearing Aid Adoption and Use: A Qualitative Study.
| Related Articles |
Factors Affecting Hearing Aid Adoption and Use: A Qualitative Study.
J Am Acad Audiol. 2018 Apr;29(4):300-312
Authors: Gallagher NE, Woodside JV
Abstract
BACKGROUND: Despite a high prevalence of age-related hearing loss in older people, there is an unexplained low level of hearing aid adoption and use. Further research is required to determine the reason because hearing aids can vastly improve the quality of life for those with hearing loss.
PURPOSE: The aim of this study was to explore factors associated with hearing aid adoption and use, and to determine whether these differed between groups with different hearing aid use behaviors.
RESEARCH DESIGN: Individual face-to-face semistructured interviews.
STUDY SAMPLE: Three groups of older people with hearing loss in Northern Ireland were recruited: (1) regular hearing aid users (n = 12), (2) irregular hearing aid users (n = 10), and (3) hearing aid nonowners (n = 10).
DATA COLLECTION AND ANALYSIS: Qualitative thematic analysis, using principles of grounded theory, was used to code the data and extract emerging themes for each of the three groups to distinguish similarities and differences between the groups. One-way analysis of variance and χ² tests were used to determine the difference in continuous and categorical variables, respectively, between the three groups.
RESULTS: Similar themes emerged across the three groups: the complexity of low hearing aid use and attitudes to hearing loss/hearing aid use. A third theme, inadequacy of audiology services, was identified in both groups using hearing aids. Older age people having more severe hearing loss and longer duration of hearing aid ownership were associated with greater hearing aid adoption and use.
CONCLUSIONS: Similar themes emerged from qualitative analysis across groups of people with hearing loss. More information for those with hearing loss and those with hearing aids and scheduled follow-up appointments for those with hearing aids are essential to improve hearing aid adoption and use in older people. Further research should focus on the most suitable methods of distributing this information and how often follow-up appointments should take place to achieve optimal hearing aid adoption and use.
PMID: 29664724 [PubMed - in process]
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The Value of Electrically Evoked Stapedius Reflex in Determining the Maximum Comfort Level of a Cochlear Implant.
| Related Articles |
The Value of Electrically Evoked Stapedius Reflex in Determining the Maximum Comfort Level of a Cochlear Implant.
J Am Acad Audiol. 2018 Apr;29(4):292-299
Authors: de Andrade KCL, Muniz LF, Menezes PL, Neto SDSC, Carnaúba ATL, Leal MC
Abstract
BACKGROUND: One of the most important steps for good user performance with a cochlear implant (CI) is activation and programming, aimed at determining the dynamic range. In adults, current levels are determined by psychophysical measures. In babies, small children, or individuals with multiple disorders, this procedure requires techniques that may provide inconsistent responses because of auditory inexperience or the age of the child, making it a very difficult process that demands the collaboration of both the patient and the family.
PURPOSE: To study the relationship between the electrically evoked stapedius reflex threshold (ESRT) and maximum comfort level for stimulating electrodes (C-level) in postoperative CI users.
RESEARCH DESIGN: Cross-sectional analytical observational case series study.
STUDY SAMPLE: We assessed 24 patients of both sexes, aged between 18 and 68 yr, submitted to CI surgery.
INTERVENTION: Otoscopy and immittance. Next, an implant speech processor connected to an Itautec® computer containing the manufacturer's software (custom sound Ep 3-2) was used, as well as an AT 235h probe inserted into the ear contralateral to the CI to capture the stapedius reflex, obtaining electrically evoked stapedius reflex thresholds.
DATA COLLECTION AND ANALYSIS: Data from the last programming, defining C-levels for each electrode studied, were extracted from the databank of each patient. The manual decay function of the AT 235h middle ear analyzer was used to observe ESRT response in a same window for a longer response capture time. Electrodes 22, 16, 11, 6, and 1 were tested when active, with the aim of using electrodes over the entire length of the CI, and ESRT was considered present when compliance was ≥0.05 ml. Stimuli, in current units, were always initiated at 20 cu above the C-level. The analysis of variance parametric test, Tukey's honest significant difference test, the t-test, Wilcoxon nonparametric test, and the Kolmogorov-Smirnov test examined whether significant relationships existed between these other factors.
RESULTS: The results demonstrate that all the electrodes selected for the study exhibited higher mean reflex threshold values than their mean C-level counterparts. However, there was no significant difference between them, for electrodes 1, 6, 11, and 16. The data provided allow the use of ESRT to define C-level values and make it possible to stipulate a correction factor ranging between 6 and 25.6 electrical units.
CONCLUSION: The use of electrically evoked stapedius reflex thresholds can help the team in charge of programming CIs, making the process faster and safer, mainly for infants, small children, or individuals with multiple disorders.
PMID: 29664723 [PubMed - in process]
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Using a Digital Language Processor to Quantify the Auditory Environment and the Effect of Hearing Aids for Adults with Hearing Loss.
| Related Articles |
Using a Digital Language Processor to Quantify the Auditory Environment and the Effect of Hearing Aids for Adults with Hearing Loss.
J Am Acad Audiol. 2018 Apr;29(4):279-291
Authors: Klein KE, Wu YH, Stangl E, Bentler RA
Abstract
BACKGROUND: Auditory environments can influence the communication function of individuals with hearing loss and the effects of hearing aids. Therefore, a tool that can objectively characterize a patient's real-world auditory environments is needed.
PURPOSE: To use the Language Environment Analysis (LENA) system to quantify the auditory environments of adults with hearing loss, to examine if the use of hearing aids changes a user's auditory environment, and to determine the association between LENA variables and self-report hearing aid outcome measures.
RESEARCH DESIGN: This study used a crossover design.
STUDY SAMPLE: Participants included 22 adults with mild-to-moderate hearing loss, age 64-82 yr.
INTERVENTION: Participants were fitted with bilateral behind-the-ear hearing aids from a major manufacturer.
DATA COLLECTION AND ANALYSIS: The LENA system consists of a digital language processor (DLP) that is worn by an individual and records up to 16 hr of the individual's auditory environment. The recording is then automatically categorized according to time spent in different types of auditory environments (e.g., meaningful speech and TV/electronic sound) by the LENA algorithms. The LENA system also characterizes the user's auditory environment by providing the sound levels of different auditory categories. Participants in the present study wore a LENA DLP in an unaided condition and aided condition, which each lasted six to eight days. Participants wore bilateral hearing aids in the aided condition. Percentage of time spent in each auditory environment, as well as median levels of TV/electronic sounds and speech, were compared between subjects' unaided and aided conditions using paired sample t tests. LENA data were also compared to self-report measures of hearing disability and hearing aid benefit using Pearson correlations.
RESULTS: Overall, participants spent the greatest percentage of time in silence (∼40%), relative to other auditory environments. Participants spent ∼12% and 26% of their time in meaningful speech and TV/electronic sound environments, respectively. No significant differences were found between mean percentage of time spent in each auditory environment in the unaided and aided conditions. Median TV/electronic sound levels were on average 2.4 dB lower in the aided condition than in the unaided condition; speech levels were not significantly different between the two conditions. TV/electronic sound and speech levels did not significantly correlate with self-report data.
CONCLUSIONS: The LENA system can provide rich data to characterize the everyday auditory environments of older adults with hearing loss. Although TV/electronic sound level was significantly lower in the aided than unaided condition, the use of hearing aids seemed not to substantially change users' auditory environments. Because there is no significant association between objective LENA variables and self-report questionnaire outcomes, these two types of measures may assess different aspects of communication function. The feasibility of using LENA in clinical settings is discussed.
PMID: 29664722 [PubMed - in process]
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Effect of Adaptive Compression and Fast-Acting WDRC Strategies on Sentence Recognition in Noise in Mandarin-Speaking Pediatric Hearing Aid Users.
| Related Articles |
Effect of Adaptive Compression and Fast-Acting WDRC Strategies on Sentence Recognition in Noise in Mandarin-Speaking Pediatric Hearing Aid Users.
J Am Acad Audiol. 2018 Apr;29(4):273-278
Authors: Liu H, Liu Y, Li Y, Jin X, Li J, Zhou Y, Ge W, Ni X
Abstract
BACKGROUND: Wide dynamic range compression (WDRC) has been widely used in hearing aid technology. However, several reports indicate that WDRC may improve audibility at the expense of speech intelligibility. As such, a modified amplification compression scheme, named adaptive compression, was developed. However, the effect of compression strategies on speech perception in pediatric hearing aid users has not been clearly reported.
PURPOSE: The purpose of the present study was to investigate the effect of adaptive compression and fast-acting WDRC processing strategies on sentence recognition in noise with Mandarin, pediatric hearing aid users.
RESEARCH DESIGN: This study was set up using a double-blind, within-subject, repeated-measures design.
STUDY SAMPLE: Twenty-six children who spoke Mandarin Chinese as their primary language and had bilateral sensorineural hearing loss participated in the study.
DATA COLLECTION AND ANALYSIS: Sentence recognition in noise was evaluated in behind-the-ear technology with both adaptive compression processing and fast-acting WDRC processing and was selected randomly for each child. Percent correct sentence recognition in noise with fast-acting WDRC and adaptive compression was collected from each participant. Correlation analysis was performed to examine the effect of gender, age at assessment, and hearing threshold of the better ear on signal-to-noise ratio, and a paired-samples t test was employed to compare the performance of the adaptive compression strategy and fast-acting WDRC processing.
RESULTS: The mean percentage correct of sentence recognition in noise with behind-the-ear technology with fast-acting WDRC and adaptive compression processing were 62.24% and 68.71%, respectively. The paired-samples t test showed that the performance of the adaptive compression strategy was significantly better than the fast-acting WDRC processing (t = 3.190, p = 0.004).
CONCLUSIONS: Compared with the fast-acting WDRC, adaptive compression provided better sentence recognition in noise for Mandarin pediatric hearing aid users.
PMID: 29664721 [PubMed - in process]
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Functional Outcomes in Audiology: There is Room for Improvement.
| Related Articles |
Functional Outcomes in Audiology: There is Room for Improvement.
J Am Acad Audiol. 2018 Apr;29(4):272
Authors: McCaslin DL
PMID: 29664720 [PubMed - in process]
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Hydroxyapatite Calvaria Graft Repair In Experimental Diabetes Mellitus In Rats
Among the systemic conditions that impact negatively on the planning and execution of surgical procedures, diabetes mellitus (DM) is the primary clinical condition responsible for complications. This study investigated bone formation in critical defects surgically filled with hydroxyapatite (HA) in diabetic rats. A descriptive, randomized sample and blinded analysis were conducted to test bone regeneration in critical bone defects surgically performed in rat calvaria. Twenty adult male Wistar rats were randomly divided into two groups: control, normoglycemic animals (CG); and test, streptozotocin-induced hyperglycemic animals (TG).
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Onlay grafting with bovine bone mineral block for horizontal reconstruction of severely atrophic alveolar ridges in anterior maxillae: A 6-year prospective study
The aim of this prospective study was to evaluate the efficacy and long-term outcomes of onlay grafting with bovine bone mineral block for reconstruction of horizontal alveolar ridge defects in anterior maxillae.
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