Hearing disorders

The prevalence of minor physical anomalies was studied on a sample of 116 children with idiopathic hearing impairment (66 boys and 50 girls). The control group consisted of 246 children with normal hearing (123 boys and 123 girls) aged from 8 to 12 years. The number of minor anomalies found per child (W1) was compared and the sum of the weighted scores according to Waldrop (W2) in children with normal hearing (CNH) and children with impaired hearing (CIH). A higher minor physical anomalies score was determined per child in the CIH group. In the CNH group there were 4 or more (33.6%) with multiple anomalies, while in the CNH group there were only 7.7% with four or more anomalies. A high score (W2) of five or more anomalies was determined in 18.9% of children in the CIH group and not one subject in the control group. Differences between the CIH and CNH groups for the mean score W1 and W2 were highly significant. The mean score W1 for CIH was 2.90 and for CNH 1.70. The mean score W2 fo...

A cross-sectional study was conducted on patients attending a primary care facility to determine the prevalence of self reported hearing loss using a single question, "Do you have hearing loss?" Pure tone audiometry was performed to compare the accuracy of the self report. A total of 111 patients were recruited. The prevalence of self reported hearing loss using a single question and pure tone audiometry was 24.3% and 36.9% respectively. By using pure tone audiometry at a cut-off-level of 25 dBHL (decibels Hearing level), the single question yielded a sensitivity of 41.4% and specificity of 85.0%.The single question performed better at 40 dBHL pure tone audiometry with sensitivity of 55.0% and specificity of 82.0%. In conclusion, the prevalence of hearing loss in elderly was high and the single question self reported hearing loss performed satisfactorily with moderate hearing loss.

To identify the prevalence of hearing loss for the population in the urban area. A cross-sectional household survey based on the World Health Organization Ear and Hearing Disorders Survey Protocol was conducted in 298 households in the urban area of Monte Negro, Rondonia, Northern Brazil, from 2005 to 2007. Ear examinations, behavioral audiometry and pure tone audiometry were conducted on 577 individuals. The results showed that 3.8% (95%CI 2.17;5.45) of population were classifi ed in the disabling hearing impairment category. The prevalence of moderate hearing impairment was 3.4%; severe impairment was 0.4%; and profound hearing impairment was not found. The impairing hearing loss prevalence found in this study is within of the international prevalence for this level of hearing loss and smaller than observed in a previous study in the South region of Brazil.

To identify the prevalence of hearing loss for the population in the urban area. A cross-sectional household survey based on the World Health Organization Ear and Hearing Disorders Survey Protocol was conducted in 298 households in the urban area of Monte Negro, Rondonia, Northern Brazil, from 2005 to 2007. Ear examinations, behavioral audiometry and pure tone audiometry were conducted on 577 individuals. The results showed that 3.8% (95%CI 2.17;5.45) of population were classified in the disabling hearing impairment category. The prevalence of moderate hearing impairment was 3.4%; severe impairment was 0.4%; and profound hearing impairment was not found. The impairing hearing loss prevalence found in this study is within of the international prevalence for this level of hearing loss and smaller than observed in a previous study in the South region of Brazil.

Introduction: Toxoplasmosis is a zoonotic disease caused by the parasite Toxoplasma gondii, a protozoan that crosses the blood-brain barrier to reach the central nervous system. Numerous case-control epidemiological studies show a higher prevalence of T. gondii infestation in individuals with various psychiatric and behavioral disorders, including schizophrenia. Objectives: The objective of this study is to demonstrate the links between schizophrenia and T. gondii infestation, to establish the prevalence of toxoplasmosis in schizophrenic patients, and to compare the prevalence and contributing factors with the results of our laboratory and those in the literature. Methods: 46 blood samples were collected from patients with schizophrenia in our hospital, accompanied by a questionnaire on risk factors for toxoplasmosis (residence, education level, meat consumption, contact with cats, hygiene). Anti-toxoplasma IgG and IgM levels were measured using the ABBOT Architect analyzer. Results: The study shows that the seroprevalence of toxoplasmosis in schizophrenic subjects is 60.9%. A significant relationship between age and toxoplasma seroprevalence (P = 0.038) has been found. However, we did not find a link between other factors and toxoplasma seroprevalence among schizophrenia patients. Conclusions: The prevalence of toxoplasmosis is significant (60.9%) compared to the rate recorded in the general population, suggesting that brain cysts from a primary toxoplasma infection could be influencing psychiatric pathology/disorders.

Hearing and balance disorders, particularly tinnitus and vestibular dysfunction, present significant challenges for clinical practice and public health. This study explored bioanalytical perspectives by examining demographic and functional predictors of impairment using a secondary dataset of 1,000 individuals randomly sampled from an openaccess source. The mean age of participants was 51.4 ± 11.0 years, and the mean physical performance score was 32.9 ± 8.1. Impairment was identified in 616 individuals (61.6 percent), while 384 participants (38.4 percent) had normal results. Comparative analyses demonstrated that the impaired group was significantly older, with a mean age of 53.7 ± 10.2 years compared to 47.1 ± 11.2 years in the normal group (p < 0.001). Physical performance was also markedly reduced in the impaired group, with a mean score of 29.8 ± 7.2 compared to 37.6 ± 7.5 in the normal group (p < 0.001). Logistic regression confirmed that each additional year of age increased the odds of impairment by 4 percent (odds ratio 1.04, 95 percent confidence interval 1.02-1.06), while each one-unit increase in physical score reduced the odds of impairment by 12 percent (odds ratio 0.88, 95 percent confidence interval 0.86-0.91). These findings emphasize the predictive power of age and functional performance in identifying risk, supporting bioanalytical perspectives that integrate demographic, functional, and molecular markers to advance prevention and personalized management of auditory and vestibular disorders.

The evoked otoacoustic emission (EOAE) test is a universally well-known and established procedure for screening the hearing of babies during the newborn period. It has been documented in foreign literature that the prevalence of hearing loss is significantly higher in high-risk neonates. In the Philippine General Hospital, 301 high-risk neonates and 105 non high-risk neonates were screened for hearing loss using the EOAE during a period of one year from March 2000 to March 2001. The initial failure rate in the high-risk population was 33% and 11% in the non high-risk population.

To estimate the prevalence of speech, language, and hearing disorders in patients with cleft palate with or without cleft lip. All data were retrieved from 384 medical records, transferred to case record forms and analyzed. The oronasal fistula rate was 15.25% (95% confidence interval: CI 11.49-19.02). The overall rates of delayed language development, articulation disorders, resonance disorders, voice disorders, and hearing disorders were 16.33% (95% CI = 12.65-20.69), 88.56% (84.47-92.65), 43.26% (95% CI = 36.58-49.93), 19.13% (95% CI = 14.26-24.82), and 79.49% (95% CI = 74.28-84.70), respectively. For speech and hearing, rates of abnormality were very high compared with those reported in the previous studies. Treatment protocols should receive more attention and intervention.

Directive 2003/10/EC sets the requirement for evaluating the effect of noise on accident risk. Accident risk is elevated for workers with a hearing handicap because of their reduced speech intelligibility and reduced capability to perceive the direction of incoming sound. An audiogram is not a good method for the evaluation of these functions. To reduce accident risk, organisational and personal solutions are needed. For both methods, efficiency must be evaluated through proper risk assessment. Because practical guidelines are not available, this paper presents principles for accident risk evaluation techniques.

The cochlear aqueduct (CA) is a narrow channel linking the basal turn of the cochlea to the subarachnoid space. It exhibits significant variation in appearance on CT imaging. Structurally, the CA is an osseous passage that extends from the posterior cranial fossa to the basal portion of the scala tympani of the cochlea. The CA is lined by connective tissue that forms the periotic duct, which serves as a conduit between the cerebrospinal fluid (CSF) in the subarachnoid space and the perilymph within the scala tympani. CA normally patents in humans and makes a balance among perilymphatic, endolymphatic, and CSF pressures. Enlargement of the CA can play a key role in dysfunctions of the inner ear. Anatomical anomalies of the CA and its accessory canals in the temporal bones of human beings have been studied with micro-CT and three-dimensional reconstruction techniques. A detailed understanding of these variations, especially near the basal turn of the cochlea and the round window niche, is crucial for preserving residual hearing and neural structures during cochlear implant procedures. There is little literature regarding CA and its clinical implications. This review article will discuss the embryology, clinical anatomy, functions, and clinical implications of CA.

Prevalencia de dependencia funcional y su asociación con caídas en una muestra de adultos mayores pobres en México. Salud Publica Mex 2011;53:26-33. Objetivo. Determinar la prevalencia de la dependencia funcional (DF) de los adultos mayores (AM) que viven en condiciones de pobreza en México, y estimar la asociación entre la DF y las caídas. Material y métodos. Se realizó una encuesta con tres etapas de selección, con estratificación según tipo de localidad (rural o urbana) y con representatividad nacional del padrón de Oportunidades 2006. La población objetivo estuvo conformada por individuos de 70 años y más, beneficiarios del Programa Oportunidades. Resultados. El 30.9% de los AM presentaron DF. Los resultados del modelo de regresión logística estratificado por sexo mostraron que, en el grupo de mujeres, la razón de momios RM para la asociación entre el incremento en el número de caídas y DF fue de 1.25 (IC:1.13-1.39), y en el grupo de hombres fue de 1.12 (IC:0.97-1.29). Conclusiones. Debido a las condiciones de vulnerabilidad en que viven estos adultos mayores, se muestra la necesidad de realizar intervenciones específicas para la prevención de caídas de manera que se disminuya el riesgo de dependencia funcional.

Various degrees of sensory neural hearing loss can be seen in the progression of some hereditary periodic fever syndromes. Otoacoustic emission testing can help to establish the inner ear involvement at an early period of a periodic fever with a risk of hearing loss (Abdul Kadir et al. in J Int Adv Otol 9(2.79):08-11, 2014). Sensorineural hearing loss is the common most complication of bacterial meningitis in childhood (Richardson in Pediatrics 102(6): [1364][1365][1366][1367][1368] 1998). When present from birth, or acquired in the pre-school years, hearing loss of any degree, even mild hearing loss, interferes with speech and language development. In addition to obvious communication deficits, the consequences of hearing loss in children and adults include psychosocial problems, such as frustration, irritability, anxiety, the tendency to withdraw from social interactions, and even depression (Dhar and Hall in Otoacoustic emissions: principles, procedures, and protocols, Plural Publishing, San Diego, 2011). OAE are acoustic signals emitted from cochlea to the middle ear and into the external ear where they are recorded. Evoked OAE are undetectable when deafness is above 30-35 dB Sound pressure level (Biswas in Clinical audio-vestibulometry for otologists and neurologists, Bhalani Publishing House, Mumbai, 1995). OAEs permit early detection of inner ear abnormalities associated with a wide variety of diseases and disorders, including Alport syndrome etc. With early detection, the serious consequences of hearing loss can sometimes be prevented. With proper identification and diagnosis of hearing impairment, timely and effective management for the same can be taken. Data for this study was collected from children (5-14 years) attending the Department of Otorhinolaryngology and Paediatrics Outpatient departments in P.E.S.I.M.S.R, Kuppam. Among the study population 43 (57.3%) were male and 32 (42.7%) were females showing the slight male preponderance. study was done on children with temperature [ 1000 F, children with temperature were screened with OAE, and OAE was recorded in same children once fever has subsided and results were compared. This is a new study where we compared same group of children with fever and once fever has subsided. In most other studies, study group was compared to the healthy control group. In our study, children with fever having abnormal FDP values at f1were 9, they reverted back to base line once fever has subsided. This shows that there is no much damage to inner ear at lower frequencies. Almost 47 abnormal FDP values at f2 reverted back to normal. At higher frequencies (f3 and f4), there is no much change in abnormal FDPs with fever and after fever has subsided, this shows that there is more damage to inner ear at higher frequencies. This study demonstrated that hyperpyrexia causes hearing loss in children with fever probably due to cochlear involvement. We conclude that OAE can be used as a screening tool in detecting hearing loss among children because the technique is simple, reproducible, not expensive, not time consuming also effectively narrows down the children with high chances of hearing loss thereby effectively improves the chances of early diagnosis and hence children can be rehabilitated early, making a marked change in their future.

To investigate the effects of noise on mismatch negativity (MMN) responses and the possible benefits of an adaptive directional BEAM microphone in noise during MMN recordings, and to compare the cochlear implant-evoked potential results with normal hearing subjects. Materials and methods: /da/ and /di/ speech stimuli were used to elicit MMN responses in 11 Freedom cochlear implant users and in 11 normal hearing subjects. Speech noise was delivered at 80 dB sound pressure level (-10 dB signal-to-noise ratio). All subjects were tested in quiet and noisy conditions. To compare the microphone effects, MMN responses for the cochlear implant group were recorded with an omnidirectional and adaptive directional BEAM microphone mode in noise. The MMN responses of the cochlear implantees and the normal hearing group were remarkably similar in terms of latency, amplitude, and morphology in both quiet and noisy conditions. MMN peak latencies were significantly prolonged in the noisy conditions compared to the quiet conditions for both groups. There was a significant decrease in MMN latencies when using an adaptive directional microphone in noise. MMN could be a useful tool to evaluate postoperative cortical auditory performance. BEAM technology provides an ease of discrimination similar to quiet settings for cochlear implant recipients in noisy environments (BEAM and Freedom are trademarks of Cochlear Limited).

This article describes some of the factors relevant to the establishment of a universal newborn hearing screening (UNHS) program. First, the difficulty in providing precise estimates of test sensitivity and specificity are reviewed. This section is followed by hypothetical estimates of overall programmatic costs, first for a fixed number of babies to be screened and then as a function of the number of babies to be screened in a year. Included in these estimates are the costs for equipment, disposables, personnel, and follow-up testing. These estimates are provided for three different screening protocols: auditory brainstem response (ABR) alone, otoacoustic emission (OAE) alone, and OAE followed by ABR only for those babies who failed the OAE screening. If follow-up costs are not included, it is less expensive to screen newborns with OAEs compared with the other two protocols. However, once follow-up testing is included as part of the program costs and there are at least 400 births p...

Mitochondrial diseases are highly heterogeneous metabolic disorders caused by genetic alterations in the mitochondrial DNA (mtDNA) or in the nuclear genome. In this study, we investigated a panel of blood biomarkers in a cohort of 123 mitochondrial patients, with prominent neurological and muscular manifestations. These biomarkers included creatine, fibroblast growth factor 21 (FGF21) and growth/differentiation factor 15 (GDF-15), and the novel cell free circulating-mtDNA (ccf-mtDNA). All biomarkers were significantly increased in the patient group. After stratification by the specific phenotypes, ccf-mtDNA was significantly increased in the Mitochondrial Encephalomyopathy Lactic Acidosis Stroke-like episodes syndrome (MELAS) group, and FGF21 and GDF-15 were significantly elevated in patients with MELAS and Myoclonic Epilepsy Ragged Red Fibers syndrome. On the contrary, in our cohort, creatine was not associated to a specific clinical phenotype. Longitudinal assessment in four MELAS...

The aim was to describe the outcome of neonatal hearing screening (NHS) and audiological diagnosis in neonates in the NICU. The sample was divided into Group I: neonates who underwent NHS in one step and Group II: neonates who underwent a test and retest NHS. NHS procedure was automated auditory brainstem response. NHS was performed in 82.1% of surviving neonates. For GI, referral rate was 18.6% and false-positive was 62.2% (normal hearing in the diagnostic stage). In GII, with retest, referral rate dropped to 4.1% and false-positive to 12.5%. Sensorineural hearing loss was found in 13.2% of infants and conductive in 26.4% of cases. There was one case of auditory neuropathy spectrum (1.9%). Dropout rate in whole process was 21.7% for GI and 24.03% for GII. We concluded that it was not possible to perform universal NHS in the studied sample or, in many cases, to apply it within the first month of life. Retest reduced failure and false-positive rate and did not increase evasion, indic...

Purpose Hearing loss is associated with changes in brain volume in regions supporting auditory and cognitive processing. The purpose of this study was to determine whether there is a systematic association between hearing ability and brain volume in cross-sectional data from a large nonclinical cohort of middle-aged adults available from the UK Biobank Resource ( http://www.ukbiobank.ac.uk ). Method We performed a set of regression analyses to determine the association between speech reception threshold in noise (SRTn) and global brain volume as well as predefined regions of interest (ROIs) based on T1-weighted structural images, controlling for hearing-related comorbidities and cognition as well as demographic factors. In a 2nd set of analyses, we additionally controlled for hearing aid (HA) use. We predicted statistically significant associations globally and in ROIs including auditory and cognitive processing regions, possibly modulated by HA use. Results Whole-brain gray matter ...

Chinese-speaking older adults usually do not perceive a hearing problem until audiometric thresholds exceed 45 dB HL, and the audiometric thresholds of the average hearing-aid (HA) user often exceed 60 dB HL. The purpose of this study was to examine the relationships between cognitive and hearing functions (measured as audiometric or speech reception thresholds) in older Chinese adults with HAs and with untreated hearing loss (HL). Participants were 49 Chinese older adults who used HAs and had moderate to severe HL (HA group), and 46 older Chinese who had mild to moderately severe HL but did not use HAs (untreated; or UT group). Multiple linear regression analysis was employed to evaluate how well age, education level, audiometric thresholds, and speech perception in noise were related to performance on general cognitive function, working memory, executive function, attention, and verbal learning tests. Results showed that speech perception in noise alone accounted for 13-25% of the variance in general cognitive function, working memory, and executive function in the UT group, and 9-21% of the variance in general cognitive function and verbal learning in the HA group (i.e., medium effect sizes). Audiometric thresholds did not explain any proportion of the variance in cognitive functioning in the HA or UT group. Thus, speech perception in noise accounts for more variance in cognitive performance than audiometric thresholds, and is significantly associated with different cognitive functions in older Chinese adults with HAs and with untreated HL.

Chinese-speaking older adults usually do not perceive a hearing problem until audiometric thresholds exceed 45 dB HL, and the audiometric thresholds of the average hearing-aid (HA) user often exceed 60 dB HL. The purpose of this study was to examine the relationships between cognitive and hearing functions (measured as audiometric or speech reception thresholds) in older Chinese adults with HAs and with untreated hearing loss (HL). Participants were 49 Chinese older adults who used HAs and had moderate to severe HL (HA group), and 46 older Chinese who had mild to moderately severe HL but did not use HAs (untreated; or UT group). Multiple linear regression analysis was employed to evaluate how well age, education level, audiometric thresholds, and speech perception in noise were related to performance on general cognitive function, working memory, executive function, attention, and verbal learning tests. Results showed that speech perception in noise alone accounted for 13–25% of the...

The mirror neuron system (MNS) is a trimodal system composed of neuronal populations that respond to motor, visual, and auditory stimulation, such as when an action is performed, observed, heard or read about. In humans, the MNS has been identified using neuro-imaging techniques (such as fMRI and mu suppression in the EEG). It reflects an integration of motor-auditory-visual information processing related to aspects of language learning including action understanding and recognition. Such integration may also form the basis for language-related constructs such as theory of mind. In this article, we review the MNS system as it relates to the cognitive development of language in typically developing children and in children at-risk for communication disorders, such as children with autism spectrum disorder (ASD) or hearing impairment. Studying MNS development in these children may help illuminate an important role of the MNS in children with communication disorders. Studies with deaf children are especially important because they offer potential insights into how the MNS is reorganized when one modality, such as audition, is deprived during early cognitive development, and this may have long-term consequences on language maturation and theory of mind abilities. Learning outcomes-Readers will be able to (1) understand the concept of mirror neurons, (2) identify cortical areas associated with the MNS in animal and human studies, (3) discuss the use of mu suppression in the EEG for measuring the MNS in humans, and (4) discuss MNS dysfunction in children with (ASD).

The mirror neuron system (MNS) is a trimodal system composed of neuronal populations that respond to motor, visual, and auditory stimulation, such as when an action is performed, observed, heard or read about. In humans, the MNS has been identified using neuro-imaging techniques (such as fMRI and mu suppression in the EEG). It reflects an integration of motor-auditory-visual information processing related to aspects of language learning including action understanding and recognition. Such integration may also form the basis for language-related constructs such as theory of mind. In this article, we review the MNS system as it relates to the cognitive development of language in typically developing children and in children at-risk for communication disorders, such as children with autism spectrum disorder (ASD) or hearing impairment. Studying MNS development in these children may help illuminate an important role of the MNS in children with communication disorders. Studies with deaf children are especially important because they offer potential insights into how the MNS is reorganized when one modality, such as audition, is deprived during early cognitive development, and this may have long-term consequences on language maturation and theory of mind abilities. Learning outcomes-Readers will be able to (1) understand the concept of mirror neurons, (2) identify cortical areas associated with the MNS in animal and human studies, (3) discuss the use of mu suppression in the EEG for measuring the MNS in humans, and (4) discuss MNS dysfunction in children with (ASD).

The aim of this exploratory study was to describe audiologist communication behaviours during appointments for hearing device monitoring and management before and after participation in counselling skills training. The study used a longitudinal design with three assessment points over 6 months. The sample included 10 audiologists and audiology graduate students interacting in a professional setting with their clients. Audiologists reported improvement in their counselling skills from pre-training to follow-up, which was consistent with objective findings that audiologist relative speaking time decreased from pre-training to post-training as well as from pre-training to follow-up. Observer-rated scores of participants&#39; counselling skills; however, yielded no significant differences across time. Some improvement was noted in audiologists&#39; counselling behaviour following a 1-day communication skills workshop and continued learning support. It is evident; however, that further t...

Waardenburg syndrome is an autosomal-dominant trait resulting from mutations occurring in different genes. It is often characterized by varying degrees of: congenital hearing loss; dystopia canthorum; synophrys; broad nasal root; depigmentation of hair (white forelock), skin or both; and heterochromic or hypochromic irides.A retrospective case study was done to assess speech perception, speech production, general intelligence and educational setting in six profoundly hearing-impaired children with Waardenburg syndrome (four with type I, one with type II and one with type III) ranging in age from two years to 14 years, seven months (mean = six years, six months). None of the patients had malformation of the cochlea and were implanted using Nucleus 22/24 and Med-el combi40+. Five out of the six cases were of average intelligence and one had a borderline intelligence quotient. The follow-up period ranged from one year, 10 months to six years, six months (mean = three years, six months)...

Hearing loss, the most common neurological disorder and the fourth leading cause of years lived with disability, can have profound effects on quality of life. The impact of this &quot;invisible disability,&quot; with significant consequences, economic and personal, is most substantial in low- and middle-income countries, where &gt;80% of affected people live. Given the importance of hearing for communication, enjoyment, and safety, with up to 500 million affected globally at a cost of nearly $800 billion/year, research on new approaches toward prevention and treatment is attracting increased attention. The consequences of noise pollution are largely preventable, but irreversible hearing loss can result from aging, disease, or drug side effects. Once damage occurs, treatment relies on hearing aids and cochlear implants. Preventing, delaying, or reducing some degree of hearing loss may be possible by avoiding excessive noise and addressing major contributory factors such as cardiovasc...

Newborn screening has evolved to include an increasingly complex spectrum of diseases, raising concerns that screening should be optional and require parental consent. Early detection of disorders like PKU and MCAD is essential to prevent serious disability and death in affected children. These are examples of high benefit-risk ratio disorders because of the irrefutable health benefits of early detection, coupled with the low risks of treatment. The dire consequences of not diagnosing an infant with a treatable disorder because of parental refusal to screen are wholly unacceptable. Thus, we believe that newborn screening for disorders with high benefit-risk ratios should continue to be mandatory.

This intergroup trial was developed to determine the toxicity of relatively low doses of difluoromethylornithine (DFMO) administered to humans for 1 year. The goal was to find an appropriate DFMO dose for use in human chemoprevention trials. Patients with resected superficial bladder cancers were studied. Following stratification, they were randomized to daily DFMO doses of 0.125, 0.25, 0.5, or 1.0 g/day for a planned period of 1 year. Patients were followed closely for evidence of drug toxicity. Seventy-six patients were evenly randomized (19 per group) to receive each dose of DFMO. Forty-nine patients received DFMO for more than 200 days while 35 received the drug for &gt; or = 350 days. No substantial drug-related toxicity was observed at any dose. DFMO doses of &gt; or = 1 g/day for periods up to 1 year appear to be without significant toxicity in most patients. This dose range may be appropriate for use in future human cancer chemoprevention trials.

Anorexia nervosa (AN) is characterized by restricted eating, emaciation, and distorted body image and tends to be a chronic and deadly disorder with a high risk of developing a relapsing course described as a severe and enduring anorexia. This case study reports a patient with AN with comorbid depression and anxiety who was treated by repetitive transcranial magnetic stimulation (rTMS). Our patient's first hospitalization in our ED clinic was at the age of 25 in 2012. Her anorexia symptoms have been developing over 1.5 years. The body mass index (BMI) at admission was 12.21 kg/m 2 . She was stimulated by use of a MAGSTIM Super Rapid 2 device, every Monday through Friday (5 days a week) with the frequency 10 Hz, 15 trains/day, 100 pulses/train, intertrain interval 107 s for 10 days. The specific spot of stimulation was over the left DLPFC. The therapy was evaluated, both by the team and by the patient, as ineffective. Shortly after the therapy was finished, the patient was discharged with final weight of 46 kg and BMI 13.15 kg/m 2 . We showed, that despite our positive clinical experiences with rTMS therapy in depression and anxiety, the treatment of AN and comorbid depressive disorder with anxious distress, our patient's anorexic, anxious, and depressive symptoms remained unaffected. In this case, only invasive medical intervention helped the patient to reach normal weight, but without any significant changes in her psychology. This case study shows the need for further investigation of the influence that body weight might have and whether the number of sessions has an effect on rTMS efficacy.

During the normal course of aging, perception of speech-on-speech or “cocktail party” speech and use of working memory (WM) abilities change. Musical training, which is a complex activity that integrates multiple sensory modalities and higher-order cognitive functions, reportedly benefits both WM performance and speech-on-speech perception in older adults. This mini-review explores the relationship between musical training, WM and speech-on-speech perception in older age (&gt; 65 years) through the lens of the Ease of Language Understanding (ELU) model. Linking neural-oscillation literature associating speech-on-speech perception and WM with alpha-theta oscillatory activity, we propose that two stages of speech-on-speech processing in the ELU are underpinned by WM-related alpha-theta oscillatory activity, and that effects of musical training on speech-on-speech perception may be reflected in these frequency bands among older adults.

This study attempts to answer the question if any level of head and neck circulation takes a part in development of Age-Related Macular Degeneration (ARMD) and hearing and equilibrium impairments. Condition of large blood vessels was examined by Color-Doppler ultrasound, and carotid and ophthalmic arteries were included. The microcirculatory changes were examined directly by fundus photography and fluorescein angiography and indirectly testing hearing and equilibrium. The study group included 40 patients (21 females, 19 males) aging from 53 to 84 years with different stages of ARMD. The control group included 40 patients (18 females, 22 males) aging from 51 to 82 years without ARMD. Patients were inhabitants of Primorsko-Goranska County. There was no relationship between ARMD and condition of large blood vessels because significant stenosis of carotid arteries was found in 2 patients (5%) in study group and 3 patients (7.5%) in the control group (p &gt; 0.05). On the contrary, we fo...

Although there are numerous publications in the literature describing the wide range of diagnosis, classifications and treatment of malformations of the hearing apparatus, even more variations can be found in clinical practice. Indeed, each individual case is unique as far as concerns pathogenesis, clinical course and treatment. The case reported herein describes a 12-year-old boy affected by cranio-facial dysmorphism and monolateral conductive hearing loss in the right ear: followed from radiological diagnosis--carried out to study a malformation of the ear pinna--to surgical treatment.

Introduction In pregnancy, the mother and fetus share body structures based on the maternal organism. Exposure to psychoactive drugs in this period may have repercussions on the baby's hearing. Therefore, it is necessary to investigate this association. Aim Analyze the results of newborn hearing screening (NHS), the occurrence of associated risk factors, and the incidence of hearing loss in newborn exposed to psychoactive drugs during pregnancy. Methods This is an observational retrospective study done from a database analysis. From this database, records were selected about the use of psychoactive drugs by mothers during pregnancy, then the neonates were divide into two groups: the study group (146 babies exposed to drugs) and the control group (500 babies not exposed to drugs). The NHS failure rate, the presence of risk factors for hearing loss, and need for audiological diagnosis were analyzed in both groups. From these variables, absolute frequency and prevalence rates were calculated and the results compared between groups. Results There was no statistically significant difference in the comparison of NHS failure rates between the groups (p ¼ 0.267). The occurrence of risk factors for hearing loss was greater in babies exposed to drugs (p < 0.0001). There was only one diagnosis of hearing loss, which occurred in the control group (p ¼ 0.667). Conclusion The use of psychoactive drugs by mothers during pregnancy did not affect the NHS failure rate of this sample. However, the occurrence of significant risk factors in the study group showed a possible sensitivity of babies exposed to psychoactive drugs during pregnancy.

Background The impact of excessive screen time with personal listening devices (PLDs) on vision, hearing, balance, and overall health among adults has been reported in the literature. However, its impact on children is not well documented. A survey was undertaken to highlight the possible effects of screen time combined with transducers on vision, hearing, balance, and overall health complaints in children via parental proxy. This cross-sectional survey consisted of questions divided into four domains: vision, hearing, balance, and overall health. It was conducted online using social media to avail total maximum responses. Results A total of 136 responses were obtained from the parents of children studying from grade 1 to 8 through the survey conducted in south India. Increased negative impact on vision was observed in more than 50% of children. Similarly, the hearing and balance domain reported 16% ear pain, 4.4% tinnitus, 9.6% dizziness, 8.8% nausea, and 2.2% imbalance while walking. Likewise, the overall stress domain reported 26.5% general body discomfort, 37.5% neck pain and stiffness, 29.4% headaches, 43.4% lack of concentration, 39.7% overall changes in child's health and 46.3% behavioral issues with various severity markings (slight to severe). Conclusions Longer periods of screen exposure have various negative impacts on vision, hearing, balance system, and overall health. These effects have to be managed for the health of our children.

Background The impact of excessive screen time with personal listening devices (PLDs) on vision, hearing, balance, and overall health among adults has been reported in the literature. However, its impact on children is not well documented. A survey was undertaken to highlight the possible effects of screen time combined with transducers on vision, hearing, balance, and overall health complaints in children via parental proxy. This cross-sectional survey consisted of questions divided into four domains: vision, hearing, balance, and overall health. It was conducted online using social media to avail total maximum responses. Results A total of 136 responses were obtained from the parents of children studying from grade 1 to 8 through the survey conducted in south India. Increased negative impact on vision was observed in more than 50% of children. Similarly, the hearing and balance domain reported 16% ear pain, 4.4% tinnitus, 9.6% dizziness, 8.8% nausea, and 2.2% imbalance while walki...

Birth is a biological process that involves the emergence of an offspring. A seasonal variation in the frequency of births is reported as a universal phenomenon in the human population. In review to outline of birth, newborns may yield seasonality in the occurrence of congenital hearing loss. Congenital hearing loss is one of the most common birth defects affecting ∼3/1000 newborns. The aim of this study was to rule out seasonality of birth and percentage of hearing loss in early days of newborns. Seasonality of birth was analyzed across the years and newborns born per month were numbered to surpass the subjective and objective Universal Neonatal Hearing Screening Program before 1 month of age.Combined results of the subjective and objective tests were analyzed and compared to make the final decision as Pass or Refer. Statistical analysis revealed that birth frequency and newborn hearing loss do not follow seasonality pattern. Similarly, there was no correlation between the birth frequency and percentages of newborns with refer impression.

Survivors of childhood bacterial meningitis (BM) often develop hearing impairment (HI). In low- and middle-income countries (LMICs), BM continues to be a significant cause of hearing disability. We assessed hearing among BM survivors using auditory steady-state responses (ASSR), providing frequency-specific estimated audiograms, and examined whether ASSR would provide a greater understanding of BM-induced HI. Survivors from two prospective BM trials (ISRCTN62824827; NCT01540838) from Luanda Children’s Hospital were examined in a follow-up visit with a median duration of 26 months after BM. The hearing of 50 BM survivors and 19 control children was evaluated using ASSR and auditory brainstem response (ABR) after interview and neurological and otorhinolaryngological examinations. The median age of survivors was 80 (IQR 86) months. We diagnosed HI (better ear hearing ≥ 26 dB) in 9/50 (18%) children. Five of the fifty survivors (10%) and 14/100 ears (14%) had profound HI (&gt;80 dB). Se...

New evidence suggests that children with chronic conditions may be predisposed to overweight and obesity. This study provides prevalence estimate of obesity for children and adolescents with select chronic conditions. We analyzed reported height and weight and the corresponding BMI from 46,707 subjects aged 10–17 years collected by the National Survey of Children&#39;s Health (NSCH‐2003). Our main outcome measure was the prevalence of obesity (defined as ≥95th percentile of the sex‐specific BMI for age growth charts), adjusted for underlying demographic and socioeconomic factors. We found that the prevalence of obesity among children 10–17 years of age without a chronic condition was 12.2% (95% confidence interval (CI) 11.5–13.0); the prevalence of obesity for children with asthma was 19.7% (19.5–19.9); with a hearing/vision condition was 18.4% (18.2–18.5); with learning disability was 19.3% (19.2–19.4); with autism was 23.4% (23.2–23.6); and with attention‐deficit/hyperactivity dis...

Introduction: An increased number of otic capsule dehiscence (OCD) variants relying on the third window pathomechanism have been reported lately. Therefore, a characterization of the anatomical structures involved and an accurate radiological description of the third window (TW) interface location have become essential for improving the diagnosis and appropriate therapeutic modalities. The purpose of this article is to propose a classification based on clinical, anatomical, and radiological data of third mobile window abnormalities (TMWA) and to discuss the alleged pathomechanism in lesser-known clinical variants.Materials and Methods: The imaging records of 259 patients who underwent, over the last 6 years, a high-resolution CT (HRCT) of the petrosal bone for conductive hearing loss were analyzed retrospectively. Patients with degenerative, traumatic, or chronic infectious petrosal bone pathology were excluded. As cases with a clinical presentation similar to those of a TW syndrome...

sets out very clearly the membership of the Clinical Standards Advisory Group, the operation of the group, and its current remits.' The section with which I take issue, however, is that entitled "Emphasising the multidisci- plinary approach." Anybody with any knowledge of the clinical manpower of the health service will see immediately that although the medical and nursing professions are well represented, a substantial group -namely the professions allied to medicine -are not represented. With due respect, the group cannot therefore reflect true multidisciplinary clinical standards, and if the remit areas are inspected closely, concern must be expressed that standards in cystic fibrosis and diabetes are being discussed without the input of the dietetic and physiotherapy professions.

Previous studies of frequency selectivity have suggested a strong positive correlation between age and the width of auditory filters [Patterson et al., J. Acoust. Soc. Am. 72, 1788–1803 (1982)]. However, given that absolute thresholds are generally higher in older listeners, it is unclear whether the broader filter shapes are a consequence of aging per se or are associated with changes in absolute sensitivity. To dissociate the effects of hearing loss and increased age on changes in frequency selectivity, this study measured auditory filter shapes at 2 kHz in (1) normal-hearing young subjects; (2) elderly (over age 65) subjects with normal 2-kHz thresholds; (3) young subjects with 2-kHz thresholds elevated either 20 or 40 dB by a narrow-band masker; and (4) elderly subjects with varying degrees of hearing loss at 2 kHz. Rounded exponential filter shapes were derived from the data using the method described by Patterson [J. Acoust. Soc. Am. 59, 640–654 (1976)]. Equivalent rectangular...

A theoretical criterion for preliminary prescription of hearing aid gain and frequency response was formulated on the basis of Zwicker's loudness model, modified for impaired auditory frequency resolution in cochlear hearing losses. The procedure was designed to restore normal relative loudness contributions from each frequency band of input speech. Prescribed frequency responses had less steep bass cut than recommended by either the Prescription of Gain/Output or the National Acoustic Laboratories' procedures, regardless of various model assumptions. Prescribed overall gain depended on the loudness growth assumed in the model. In cases where auditory filters are wider than normal and loudness recruitment is complete, the procedure yielded a nonlinear relation between hearing aid gain and hearing loss: Required insertion gain (in dB) was 25 to 30% of hearing threshold loss (in dB HL) for mild to moderate losses, but this percentage increased for more severe impairments. For cases with incomplete loudness recruitment, the model prescribed that insertion gain should be 40 to 50% of hearing threshold loss for a wide range of impairments (Ear Hear 12 4:242-250).

To investigate the effects of noise on mismatch negativity (MMN) responses and the possible benefits of an adaptive directional BEAM microphone in noise during MMN recordings, and to compare the cochlear implant-evoked potential results with normal hearing subjects. Materials and methods: /da/ and /di/ speech stimuli were used to elicit MMN responses in 11 Freedom cochlear implant users and in 11 normal hearing subjects. Speech noise was delivered at 80 dB sound pressure level (-10 dB signal-to-noise ratio). All subjects were tested in quiet and noisy conditions. To compare the microphone effects, MMN responses for the cochlear implant group were recorded with an omnidirectional and adaptive directional BEAM microphone mode in noise. The MMN responses of the cochlear implantees and the normal hearing group were remarkably similar in terms of latency, amplitude, and morphology in both quiet and noisy conditions. MMN peak latencies were significantly prolonged in the noisy conditions compared to the quiet conditions for both groups. There was a significant decrease in MMN latencies when using an adaptive directional microphone in noise. MMN could be a useful tool to evaluate postoperative cortical auditory performance. BEAM technology provides an ease of discrimination similar to quiet settings for cochlear implant recipients in noisy environments (BEAM and Freedom are trademarks of Cochlear Limited).

An optimal approach to auditory display design for commercial aircraft would utilize both spatialized (3-D) audio techniques and active noise cancellation for safer operations. Results from several aircraft simulator studies conducted at NASA Ames Research Center are reviewed, including Traffic alert and Collision Avoidance System (TCAS) warnings, spoken orientation &quot;beacons&quot; for gate identification and collision avoidance on the ground, and hardware for improved speech intelligibility. The implications of hearing loss among pilots is also considered.

South Africa currently lacks a pre-recorded South African English (SAE) specific speech discrimination test. In the absence of such a test, the SAE speaker recording (Tygerberg recording) of the American (USA) English (AE) CID W22 wordlists - in combination with the original American CID W22 normative data - is the most widely used alternative. The reliability and validity of this method, however, has never been formally assessed. This study assessed the performance of 15 normal hearing, female, first language SAE speakers on the first two full-lists of Tygerberg CID W22 recording at 20, 30, 40, 50, 60 and 70 dBSPL, and compared their scores to the American CID W22 wordlist normative data. Overall, the South African subjects performed worse than the original American normative data at the lower presentation intensities( 40 dBSPL), however, was considered a viable option. These results reiterate the need for large scale, South African specific normative studies for the CID W22 wordli...

Zadatak istraživanja bila je evaluacija učestalosti dentalnih anomalija kod predškolske i školske djece u Sarajevskom kantonu te diferencijacija relativnog udjela nasljednih i nenasljednih čimbenika u fenotipskoj ekspresiji dentalnih anomalija. Ispitanici i postupci: Za uzorak su odabrana djeca predškolske i školske dobi obaju spolova iz šest vrtića i šest osnovnih škola u Sarajevskom kantonu. Pregledano ih je ukupno 740 -od njih je 270 bilo predškolske dobi (123 dječaka i 147 djevojčica), a 470 školske dobi (231 dječak i 239 djevojčica). Prevalencija dentalnih anomalija procjenjivala se prema tome koliko je česta pojava anomalija u uzorku. Kako bi se prevalencije određenih dentalnih anomalija usporedile s europskim i svjetskim populacijama, bio je odabran test razlike proporcija, varijanta χ 2 testa s granicom statističke značajnosti od p<0,05. Primjenom istog testa bila je obavljena i procjena značajnosti razlike u spolnoj strukturi ispitanika. U statističkim analizama koristili smo se znanstveno verificiranim softverom MedCalc Ver. 9.2.0.0. Rezultati: Na temelju promatranog uzorka djece predškolske dobi uočena je tendencija porasta dentalnih anomalija kod djevojčica i ustanovljena u postotcima sljedeća zastupljenost dentalnih anomalija: makrodoncija (27%), fuzija (24%), AI hipoplastični tip (13%), mikrodoncija (13%), AI hipokalcifikacijski tip (10%), hipodoncija (8%) i geminacija (5%). U uzorku djece školske dobi bila je u postotcima sljedeća zastupljenost pojedinih dentalnih anomalija: hipodoncija (42%), makrodoncija (27%), mikrodoncija (25%), AI hipoplastični tip (4%) i fuzija (2%). Zaključak: Od ukupnog broja ispitanika u uzorku predškolske djece, kod njih 14,8 posto uočene su dentalne anomalije, a kod školske djece taj postotak iznosi 11,7. Postotak dentalnih anomalija kod djece u Sarajevskom kantonu okviru je očekivanoga, nakon što je uspoređen s referentnim podacima iz svjetske literature.

Meniere's disease that affects the inner ear is characterised by episodes of vertigo, varying degrees of hearing loss, and tinnitus. It manifests as a result of the inner ear's endolymph (fluid) not being properly regulated. As a result, it is also known as endolymphatic hydrops in pathological terms. Meniere's disease can be effectively treated using homoeopathic drugs, even in its most severe forms. Depending on the disease's severity, a carefully chosen homoeopathic remedy can regulate or even drastically lessen the severity and frequency of the symptoms.

Study Aims: To compare the correlation of two screening protocols using otoacoustic emissions (OAE) is screening and auditory brainstem response (ABR) in infants requires intensive care. Methods: Three hundred newborns in NICU were tested using both OAE and ABR at the ages of 3 days, 42 days, and 3 months. Results: At the age of 3 days, OAE referral rates were significantly higher than the rates of abnormal ABR (χ 2 =8.75, p<0.05). At 42 days and 3 months, there were no significant differences between the OAE referral rate and the rate of abnormal ABR (χ 2 =0.19, P>0.05; χ 2 =0.15, P>0.05). Conclusion: We demonstrated that there is significantly difference between the OAE referral rate and the rate of abnormal ABR of infants in the NICU at 3 days after birth. The difference became smaller with age. So combined OAE/ABR can be considered an efficient hearing screening method for NICU infants at risk from the first hearing screen at 3 days after birth.