The Combined Effect of Noise and Solvent Exposure on Hearing Loss in the Tire Factory Workers

xlomafota13 shared this article with you from Inoreader The Combined Effect of Noise and Solvent Exposure on Hearing Loss in the Tire Factory Workers Via Otolaryngology Indian Abstract Noise and organic solvents are common in many industries and both of them affect hearing. In this study, we estimated the concurrent effect of them on hearing by evaluating the existence of notch in audiograms of workers. The number of 540 persons were enrolled in this study after eliminating workers who had the exclusion criteria. We divided them into 4 groups based on their exposure status; no exposure, exposure to noise, exposure to solvent, exposure to both of them. The presence of notch in left, right, or both ears were assessed through Coles model. The rates of notch presence in both ears in the groups of noise and organic solvents exposure, noise exposure only, solvents exposure only were 11.72, 4.49, 1.86 times higher than the control group and sole solvent exposure didn't affect hearing significantly. The same pattern was seen for notch presence in left or right ear and the solvent-noise exposure group had the highest rate of notch presence. This study a ims to show the synergic effect of noise and organic solvents exposure on hearing loss. Hence, we recommend implementing a hearing protection program and a higher frequency of audiological assessments in the industries involved with concurrent exposure to noise and organic solvents. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical impact of radioactive iodine dose selection based on the number of metastatic lymph nodes in patients with papillary thyroid carcinoma: A multicenter retrospective cohort study

xlomafota13 shared this article with you from Inoreader Clinical impact of radioactive iodine dose selection based on the number of metastatic lymph nodes in patients with papillary thyroid carcinoma: A multicenter retrospective cohort study Via radioactive iodine Clin Endocrinol (Oxf). 2021 Jun 29. doi: 10.1111/cen.14544. Online ahead of print. ABSTRACT OBJECTIVE: The aim of this study is to investigate whether the number of metastatic lymph nodes (LNs) could be used as basis in the radioactive iodine (RAI) dose selection for patients with papillary thyroid carcinoma (PTC). PATIENTS: A total of 595 patients with PTC who received first RAI therapy after total or near total thyroidectomy and had no evidence of disease in treatment respo nse assessment were retrospectively enrolled from 5 hospitals. The patients were classified into two subgroups based on the number of metastatic LNs (> 5). The multivariate Cox-proportional hazard model was performed to identify the significant factors for recurrence prediction in each group as well as all enrolled patients. RESULTS: Overall, 22 (3.7%) out of 595 patients had recurrent disease during the follow-up period. The number of metastatic LNs (> 5) was only a significant factor for recurrence prediction in all enrolled patients (odds ratio: 7.834, P < 0.001). In the subgroup with ≤ 5 metastatic LNs, the presence of extrathyroidal extension was only associated with recurrence (odds ratio: 7.333, P = 0.024) in multivariate analysis. RAI dose was significantly associated with recurrence rate, in which the patients with high-dose RAI (3.7 GBq or higher) had less incidence of recurrence than those with low-dose RAI (1.11 GBq) in the subgroup with > 5 metastati c LNs (odds ratio: 6.533, P = 0.026). CONCLUSIONS: High-dose RAI (≥3.7 GBq) therapy significantly lowered the recurrence rate in patients with more than five metastatic LNs. Therefore, RAI dose should be determined based on the number of metastatic LNs as well as conventional risk factors. This article is protected by copyright. All rights reserved. PMID:34185324 | DOI:10.1111/cen.14544 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Free-Field Cortical Steady-State Evoked Potentials in Cochlear Implant Users

xlomafota13 shared this article with you from Inoreader Free-Field Cortical Steady-State Evoked Potentials in Cochlear Implant Users Via cortical auditory Brain Topogr. 2021 Jun 29. doi: 10.1007/s10548-021-00860-2. Online ahead of print. ABSTRACT Auditory steady-state evoked potentials (SS-EPs) are phase-locked neural responses to periodic stimuli, believed to reflect specific neural generators. As an objective measure, steady-state responses have been used in different clinical settings, including measuring hearing thresholds of normal and hearing-impaired subjects. Recent studies are in favor of recording these responses as a part of the cochlear implant (CI) device-fitting procedure. Considering these potential benefits, the goals of the present study were to assess the feasibility of recording free-field SS-EPs in CI users and to compare their characteristics between CI users and controls. By taking advantage of a recently developed dual-frequency tagging method, we attempted to record subcortical and cortical SS-EPs from adult CI users and controls and measured reliable subcortical and cor tical SS-EPs in the control group. Independent component analysis (ICA) was used to remove CI stimulation artifacts, yet subcortical responses of several CIs were heavily contaminated by these artifacts. Consequently, only cortical SS-EPs were compared between groups, which were found to be larger in the controls. The lower cortical SS-EPs' amplitude in CI users might indicate a reduction in neural synchrony evoked by the modulation rate of the auditory input across different neural assemblies in the auditory pathway. The brain topographies of cortical auditory SS-EPs, the time course of cortical responses, and the reconstructed cortical maps were highly similar between groups, confirming their neural origin and possibility to obtain such responses also in CI recipients. As for subcortical SS-EPs, our results highlight a need for sophisticated denoising algorithms to pinpoint and remove artifactual components from the biological response. PMID:34185222 | DOI:10.1007/s10548-021-00860-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative Dysphagieprävalenz bei Kopf-Hals-Tumorpatienten im akutstationären Setting

xlomafota13 shared this article with you from Inoreader Postoperative Dysphagieprävalenz bei Kopf-Hals-Tumorpatienten im akutstationären Setting Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1528-7584 Hintergrund Dysphagie bildet eine häufige postoperative Funktionsbeeinträchtigung bei Kopf-Hals-Tumorpatienten. Diese kann in Aspiration bzw. Penetration sowie Oralisierungseinschränkung resultieren und ist dadurch häufig versorgungsrelevant. In dieser Studie wurden die Prävalenz einer postoperativen Dysphagie und der Zusammenhang zwischen Ausprägungsgrad und Tumorstadium, Tumorlokalisation, Patientenalter und -geschlecht im akutstationären Setting untersucht. Material und Methoden Prospektiv wurden 201 erwachsene Kopf-Hals-Tumorpatienten (Altersdurchschnitt 63 Jahre) in 2 Universitätskliniken hinsichtlich Penetration/Aspiration, Oralisierungseinschränkung und Versorgungsrelevanz direkt nach der operativen Tumorbehandlung via FEES untersucht. In uni- und multivariaten Berechnungen wurde zudem der Einfluss der o. g. Patientenmerkmale auf diese 3 Parameter analysiert. Ergebnisse Eine versorgungsrelevante Schluckstörung bestand bei 66,7 % (134/201) der Patienten. 57,2 % der Patienten benötigten eine Nasogastral- oder PEG-Sonde bei therapierelevanter Oralisierungseinschränkung, weitere 45,3 % aspirierten, 38,5 % von diesen still. Als signifikante Einflussfaktoren erwiesen sich ein höheres Tumorstadium und Patientenalter sowie männliches Geschlecht, die Tumorlokalisation dagegen nur marginal. Schlussfolgerungen Die Studienergebnisse demonstrieren die klinische Bedeutung und die Notwendigkeit der konsequenten und systematischen Versorgung postoperativer Schluckstörungen bei Kopf-Hals-Tumorpatienten im akutstationären Aufenthalt zur Komplettierung moderner onkologischer Therapie. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Current Evidence for Biologic Therapy in Chronic Rhinosinusitis with Nasal Polyposis

xlomafota13 shared this article with you from Inoreader Current Evidence for Biologic Therapy in Chronic Rhinosinusitis with Nasal Polyposis Via Otolaryngologic Clinics of North America The problem surrounding the management of chronic rhinosinusitis with nasal polyposis (CRSwNP) has captivated practitioners for over 2 millennia. Derived from the Greek word πωλυποζ (pôlupos), meaning many feet, like an octopus, Hippocrates was among the first physicians to describe nasal polyposis and propose remedies including topical honey, iron cauterization, and snare polypectomy in his fabled text Diseases II.1 As understanding of CRSwNP pathophysiology expanded over time, modern treatment principles revolved around topical medications including intranasal corticosteroids and saline irrigations, as well as systemic drugs such as oral corticosteroids and antimicrobials for symptomatic flares. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pruebas monoaurales de habla de baja redundancia: Evaluación de la separación/cierre monoaural

xlomafota13 shared this article with you from Inoreader Pruebas monoaurales de habla de baja redundancia: Evaluación de la separación/cierre monoaural Via Otorrinolaringología y cirugía de cabeza y cuello Resumen La separación y el cierre monoaural son mecanismos del procesamiento auditivo que permiten mantener interacciones comunicativas significativas en ambientes reales, con condiciones acústicas adversas, ruido competitivo e interlocutores no ideales. Estas habilidades dependen de la redundancia intrínseca, que está determinada por las estructuras y fisiología del sistema nervioso auditivo central, y de la redundancia extrínseca, que está determinada por las pistas acústicas, lingüísticas y contextuales de la señal auditiva. Estos procesos se han evaluado a través de distintas formas de degradación de la redundancia extrínseca, dando origen a tres categorías de prueba: pruebas de habla filtrada de pasa baja, pruebas de habla en ruido y pruebas de habla de tiempo comprimido. Últimamente, se han popularizado las pruebas de habla en ruido, sin embargo, las tres categorías cuentan con documentación que avalan su utilidad, se encuentran disponi-bles en español y es posible aplicarlas tanto en niños como en adultos. A pesar de que algunas cuentan con valores normativos establecidos, es necesario interpretar los resultados considerando su validez ecológica y algunas variables como escolaridad, nivel socio-económico y otros determinantes sociales de la salud que podrían influenciar el rendimiento. Abstract Monaural separation and closure are auditory processing mechanisms that allow to maintain significant communicative interactions in real environments, with adverse acoustic conditions, competitive noise and non-ideal speakers. These skills depend on intrinsic redundancy, which is determined by the structures and physiology of the central auditory nervous system, and extrinsic redundancy, which is determined by the acoustic, linguistic and contextual cues of the auditory signal. These processes have been assessed through different forms of degradation of extrinsic redundancy, giving rise to three test categories: low-pass filtered sp eech tests, speech in noise tests and time-compressed speech tests. Speech in noise tests have become popular in recent years, however, all three categories have documentation to support their usefulness, are available in Spanish and can be applied to both children and adults. Although some have established normative values, it is necessary to interpret the results considering their ecological validity and some variables such as schooling, socioeconomic status and other social determinants of health that could influence performance. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Actualización en carcinoma escamoso orofaríngeo

xlomafota13 shared this article with you from Inoreader Actualización en carcinoma escamoso orofaríngeo Via Otorrinolaringología y cirugía de cabeza y cuello Resumen El carcinoma escamoso de orofaringe (CEOF) ha tenido un aumento en su incidencia en las últimas décadas, explicándose por el aumento sustancial de su tipo relacionado con el virus papiloma humano (VPH). Existen diferencias clínicas y pronósticas entre los dos grupos de CEOF según su relación etiológica con VPH. Por un lado, los relacionados con VPH se presentan en una población más joven, con menos prevalencia de tabaquismo y consumo de alcohol; además de presentar un tamaño pequeño del tumor primario, con un compromiso linfonodal temprano. Además, aquellos relacionados con VPH presentan un mejor pronóstico que su contraparte no relacionada con el virus, presentando en algunos estudios hasta un 58% menos riesgo de muerte independiente de la modalidad de tratamiento. Actualmente, el sistema de clasificación TNM en su 8va edición presenta un sistema diferente de clasificación y etapificación para ambos grupos. A pesar de aquello, a la fecha el tratamien to habitual no difiere entre ambos, lo que ha llevado a la realización de estudios que buscan responder si la deintensificación de la terapia en aquellos grupos relacionados con VPH y con bajo riesgo de metástasis a distancia, mantendría los buenos resultados oncológicos, disminuyendo las complicaciones a corto y largo plazo asociadas al tratamiento. Sin embargo, aún no existe evidencia que avale consistentemente esta práctica. Finalmente, la prevención primaria a través de la vacuna contra VPH es un elemento prometedor, sin embargo, no existe evidencia que confirme su utilidad. Abstract Oropharyngeal squamous cell carcinoma (OPSCC) has suffered an increase in its incidence in recent decades, explained by the increase in its type related to the human papilloma virus (HPV). There are clinical and prognostic differences between the two groups of OPSCC according to their etiological relationship with HPV. On the one hand, those related to HPV appear in a younger population, with a lower prevalence of smoking and alcohol consumption; in addition to presenting a small size of the primary tumor, with early lymph node involvement. Furthermore, those related to HPV have a better prognosis than their non-virus counterpart, presenting in some studies up to 58% less risk of death, independent of treatment used. Currently, the TNM classification system in its 8th edition presents a different classification for both groups. Despite this, the treatment does not differ between the two, which has led to studies that seek to answer whether the de-escalation of therapy in the group associated to HPV and with a low risk of distant metastasis would maintain the reported good oncological results, reducing early and long-term complications associated with treatment, however, there is still no evidence to support its use. Finally, primary prevention through the HPV vaccine is a promising element, however there is no evidence to confirm its usefulness. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Uso de profilaxis antibiótica en el taponamiento nasal, una revisión actualizada

xlomafota13 shared this article with you from Inoreader Uso de profilaxis antibiótica en el taponamiento nasal, una revisión actualizada Via Otorrinolaringología y cirugía de cabeza y cuello Resumen El uso de profilaxis antibiótica en el taponamiento nasal es una práctica ampliamente usada por el eventual riesgo de síndrome de shock tóxico o complicaciones infecciosas locales. En los últimos años, se ha cuestionado su real impacto tomando en cuenta los riesgos asociados al uso de antibióticos y la baja o casi nula incidencia de las complicaciones infecciosas. Se realizó una revisión exhaustiva de la literatura sobre el uso de profilaxis antibiótica en taponamiento nasal. Se observó que no existían diferencias estadísticamente significativas en la incidencia de complicaciones infecciosas y no hubo reportes de síndrome de shock tóxico en ninguno de los grupos con y sin profilaxis antibiótica. No hubo diferencias significativas en los cultivos de los pacientes con o sin antibióticos en taponamiento nasal por epistaxis. El uso de profilaxis antibiótica en taponamiento nasal es una práctica cuestionable y se requieren más estudios al respecto. Abs tract Antibiotic prophylaxis in nasal packing is a widely used practice due to the possible risk of toxic shock syndrome and infectious complications. Lately, its real impact has been questioned due to the associated risks with antibiotic use and low incidence of infectious complications. A comprehensive review of the literature on the use of antibiotic prophylaxis in nasal packing was performed. No statistically significant differences in the incidence of infectious complications and no reports of toxic shock syndrome were reported in any of the groups with and without antibiotic prophylaxis. There were no significant differences in the antibiotic cultures of patients with or without prophylactic antibiotics in nasal packing due to epistaxis. The use of antibiotic prophylaxis in nasal packing is a questionable practice and further studies are required. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Manifestaciones otorrinolaringológicas en la infección por virus de inmunodeficiencia humana

xlomafota13 shared this article with you from Inoreader Manifestaciones otorrinolaringológicas en la infección por virus de inmunodeficiencia humana Via Otorrinolaringología y cirugía de cabeza y cuello Resumen La infección por el virus de la inmunodeficiencia humana (VIH) es una pandemia global que afecta a 38 millones de personas en el mundo. En Chile, se ha visto un alza sostenida en la incidencia de VIH, aumentando un 57% entre 2010 y 2019, reportándose 74.000 personas que viven con VIH en el país. Las manifestaciones en cabeza y cuello ascienden a un 80% de los pacientes con VIH. Éstas pueden presentarse durante el síndrome retroviral agudo, en etapas más avanzadas, incluso como forma de debut, o aparecer en casos de falla de tratamiento o complicaciones derivadas del síndrome inflamatorio de reconstitución inmune. Con la mayor cobertura de terapia antirretroviral (TARV) se ha visto a lo largo del tiempo un cambio en la frecuencia de las manifestaciones otorrinolaringológicas. Las lesiones de la cavidad oral han representado un signo de avance de la enfermedad o de falla al tratamiento, siendo más frecuentes la candidiasis y la leucoplasia vellosa. En el área r inosinusal predominan la rinitis y rinosinusitis, en el cuello las linfadenopatías e hipertrofia parotídea, y en el oído la hipoacusia, alteraciones vestibulares y del oído medio. Para la especialidad de otorrinolaringología es fundamental conocer estas manifestaciones para mantener un alto índice de sospecha del diagnóstico. De esta forma, se permite un diagnóstico precoz y tratamiento oportuno para así mejorar la calidad de vida del paciente. Además, se requiere un seguimiento cercano de forma de detectar signos tempranos de falla al tratamiento o progresión a etapas más avanzadas. Abstract The human immunodeficiency virus (HIV) infection is a global pandemic, affecting 38 million people worldwide. In Chile, its incidence has risen continuously, increasing to 57% from 2010 to 2019, with 74,000 infected people in the country. Head and neck manifestations account to 80% of HIV patients. These manifestations may be present during the acute retroviral syndrome, in more advanced stages, even as a debut, or appear in treatment failure or complications secondary to the immune reconstitution inflammatory syndrome. With the increase in antiretroviral therapy (ART) coverage, the prevalence of otorhinolaryngological manifestations has changed. Oral lesions may be an early sign for advanced stages or treatment failure, with a predominance of candidiasis and hairy leukoplakia. Rhinitis and rhinosinusitis are the main manifestations in the sinonasal area, lymphadenopathy and parotid hypertrophy in the neck, and hearing loss, vestibular and middle ear disorders in the ear. It is essential for otorhinolaryngologists to be aware of these manifestations in order to maintain a high index of clinical suspicion, allowing an early diagnosis and opportune treatment to improve the patient's quality of life. In addition, a close follow-up is required to identify early signs of treatment failure or progression to more advanced stages. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cirugía del sueño: Definición de una especialidad emergente, propuesta de una clasificación anatomofuncional integral e indicaciones

xlomafota13 shared this article with you from Inoreader Cirugía del sueño: Definición de una especialidad emergente, propuesta de una clasificación anatomofuncional integral e indicaciones Via Otorrinolaringología y cirugía de cabeza y cuello Resumen Los trastornos respiratorios del sueño (ronquido primario y síndrome de apnea-hipopnea obstructiva del sueño) han sido tratados mediante múltiples modalidades a lo largo de la historia. Sin embargo, la cirugía de la vía aérea superior siempre ha estado presente, dando cabida a la aparición de múltiples técnicas para este fin. El estudio adecuado de los sitios anatómicos de estrechez o colapso de la vía aérea superior y sus contribuyentes (bajo el concepto de topodiagnóstico) y el mejor entendimiento de los mecanismos de acción de los diferentes procedimientos descritos, ha permitido el nacimiento de una nueva disciplina, dedicada al manejo quirúrgico planificado de este grupo de patologías: la cirugía del sueño. Abstract Sleep-related breathing disorders (primary snoring and obstructive sleep apnea-hypopnea syndrome) have been treated with multiple modalities throughout history. However, upper airway surgery has always been present, giving appearan ce of multiple techniques for this purpose. The adequate study of the anatomical sites of upper airway narrowness or collapse and its contributors (under the concept of topodiagnosis) and a better understanding of the different procedures, has allowed the birth of a new discipline, dedicated to a planned surgical management for this group of pathologies: sleep surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aspectos psicosociales de los programas de salud de personas mayores con hipoacusia y su impacto en la adherencia al uso de audífonos: una revisión narrativa

xlomafota13 shared this article with you from Inoreader Aspectos psicosociales de los programas de salud de personas mayores con hipoacusia y su impacto en la adherencia al uso de audífonos: una revisión narrativa Via Otorrinolaringología y cirugía de cabeza y cuello Resumen El envejecimiento progresivo de la población mundial es una preocupación reconocida por la mayoría de las propuestas de políticas públicas en diversas áreas, incluida salud. La persona mayor pertenece a un grupo social vulnerable, que requiere ser considerado en las intervenciones y políticas de salud pública. Existe una considerable pérdida de las capacidades sensoriales y motrices que suponen una disminución de la autonomía, la que si se asocia a la realidad de las personas mayores con menos ingresos, dificulta un acceso oportuno a prestaciones de salud para poder enfrentar la discapacidad de manera apropiada. Las consecuencias de la pérdida de la capacidad auditiva en la persona mayor se manifiestan en problemas de la comprensión del habla, deterioro cognitivo y trastornos de la salud mental como ansiedad y depresión. Lamentablemente, las intervenciones para aumentar la adherencia de los usuarios al uso de audífonos no han mostrado muchos resultados fa vorables. Un correcto diagnóstico permite tener una orientación y rehabilitación adecuada a través de la generación de programas y estrategias enfocadas en la integración social, permitiendo que la calidad de vida se mantenga o mejore no solo en las personas con hipoacusia. Implementar un abordaje que busque tener un impacto positivo en la adherencia al uso de audífonos debe incluir y desarrollar programas de rehabilitación auditiva que consideren aspectos de contexto como vivienda, red de apoyo e integración social, entre otros. Abstract Progressive aging of the world population is a concern recognized by most public policy proposals in various areas, including health. The elderly belongs to a vulnerable social group, which requires consideration in public health interventions and policies. There is a considerable loss of sensory and motor capacities that decreases autonomy, which if associated with lesser income in older adults, hinders timely access to health benefits and its possibility to face disability appropriately. The consequences of hearing loss in the elderly are manifested in problems of speech comprehension, cognitive deterioration, and mental health disorders such as anxiety and depression. Unfortunately, interventions to increase user adherence to hearing aid use have not shown many positive results. A correct diagnosis allows to have an adequate orientation and rehabilitation through the generation of programs and strategies focused on social integration, allowing the quality of life to be maintained or improved not only in people with hearing loss. Implementing an approach that seeks to have a positive impact on adherence to hearing aid use should include and develop auditory rehabilitation programs that consider contextual aspects such as housing, support network and social integration, among others. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.