Search

Background: Pulmonary infections by gram-negative organisms are important in cystic fibrosis (CF). Aminoglycosides (AG) are often part of the treatment regimen. However, they are a well-known cause of ototoxicity. Even minimal hearing impairment in children could have a future impact on functional well-being.We aimed to investigate the progression of sensorineural hearing loss (SNHL) over several years in pediatric CF patients, and to identify risk factors, such as the use of AG, including both intravenous (IV) and inhaled AG. Methods: Retrospective analyses of patient records from children and adolescents followed up at the CF clinic of the Antwerp University Hospital, Belgium, were performed. We collected data on age, sex, pure-tone audiometry, and the use of AG. Descriptive and binary logistic regression analyses, and if indicated generalized estimating equations (GEE) analyses were performed. Results: Forty pediatric patients were enrolled in the study taking part from 2013 to 2020. Pure-tone audiometry revealed an important rate of SNHL over several years, with a prevalence of 29 % for high-frequency SNHL (i.e. 8 kHz). Increasing age was identified as a significant risk factor for the development of SNHL at 8 kHz if 5 or more IV AG courses (p = 0.01) were reported or when IV AG were combined with inhaled AG (p = 0.002). Conclusions: Age combined with the use of IV AG (≥5 courses or in combination with inhaled AG) are predictive for developing high-frequency SNHL (i.e. 8 kHz). We suggest routine annual hearing screening (incl. high-frequency thresholds) in CF patients, starting from childhood.

Abstract Background Chronic tinnitus is a highly prevalent symptom, with many patients reporting considerable effects of tinnitus on quality of life. No clear evidence-based treatment options are currently available. While counseling-based methods are valuable in some cases, they are not sufficiently effective for all tinnitus patients. Neuromodulation techniques such as high-definition transcranial direct current stimulation (HD-tDCS) are proposed to have positive effects on tinnitus severity but, to date, these effects have not been proven conclusively. The proposed trial will investigate the hypothesis that chronic tinnitus patients receiving HD-tDCS will report a positive effect on the impact of tinnitus on daily life, as compared to patients receiving sham stimulation. Methods This study proposes a randomized, double-blind, placebo-controlled trial with parallel group design. A total of 100 chronic tinnitus patients will be randomly allocated to an experimental group or a sham group, with allocation stratified according to gender and tinnitus severity. Patient and researcher will be blinded to the patient’s allocation. Patients will undergo six sessions of sequential dual-site HD-tDCS of the left temporal area and the right dorsolateral prefrontal cortex. Evaluations will take place at baseline, immediately following treatment, and at three and six months after the start of the therapy. The primary outcome measure is the change in Tinnitus Functional Index (TFI) score. Secondary outcome measures include audiological measurements, cortical auditory evoked potentials, the Repeatable Battery for the Assessment of Neuropsychological Status adjusted for hearing-impaired individuals (RBANS-H), and supplementary questionnaires probing tinnitus severity and additional symptoms. By use of a linear regression model, the effects of HD-tDCS compared to sham stimulation will be assessed. Discussion The objective of this study is to evaluate whether HD-tDCS can reduce the impact of tinnitus on daily life in chronic tinnitus patients. To date, published trials on the effects of HD-tDCS on tinnitus suffer from a lack of standardization and few randomized controlled trials exist. The proposed study will be the first adequately powered trial to investigate the effects of sequential dual-site HD-tDCS on tinnitus severity. Trial registration ClinicalTrials.gov, NCT03754127. Registered on 22 November 2018.

A convivência entre marcapassos e desfibriladores está em vias de desaparecimento, mas ainda se impoe em alguns casos particulares. Este trabalho faz o balanço entre as compatibilidades e as incompatibilidades dos modelos recentes. O presente relato de caso refere-se a um paciente no qual o desfibrilador foi escolhido e posicionado atrás do grande peitoral esquerdo, de modo a separá-lo de um marcapasso de dupla-câmara implantado anteriormente. A programaçao de ambos, que eram da mesma marca, pôde ser efetuada pelo mesmo programador, mediante subterfúgios. Nenhuma interferência sobreveio entre os dois aparelhos, sendo necessário apenas corrigir algumas incompatibilidades na programaçao do marcapasso, passíveis de comprometer o funcionamento do desfibrilador.

A convivência entre marcapassos e desfibriladores está em vias de desaparecimento, mas ainda se impoe em alguns casos particulares. Este trabalho faz o balanço entre as compatibilidades e as incompatibilidades dos modelos recentes. O presente relato de caso refere-se a um paciente no qual o desfibrilador foi escolhido e posicionado atrás do grande peitoral esquerdo, de modo a separá-lo de um marcapasso de dupla-câmara implantado anteriormente. A programaçao de ambos, que eram da mesma marca, pôde ser efetuada pelo mesmo programador, mediante subterfúgios. Nenhuma interferência sobreveio entre os dois aparelhos, sendo necessário apenas corrigir algumas incompatibilidades na programaçao do marcapasso, passíveis de comprometer o funcionamento do desfibrilador.

A convivência entre marcapassos e desfibriladores está em vias de desaparecimento, mas ainda se impoe em alguns casos particulares. Este trabalho faz o balanço entre as compatibilidades e as incompatibilidades dos modelos recentes. O presente relato de caso refere-se a um paciente no qual o desfibrilador foi escolhido e posicionado atrás do grande peitoral esquerdo, de modo a separá-lo de um marcapasso de dupla-câmara implantado anteriormente. A programaçao de ambos, que eram da mesma marca, pôde ser efetuada pelo mesmo programador, mediante subterfúgios. Nenhuma interferência sobreveio entre os dois aparelhos, sendo necessário apenas corrigir algumas incompatibilidades na programaçao do marcapasso, passíveis de comprometer o funcionamento do desfibrilador.