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Author: admin, 26.04.2015
Join tens of thousands of doctors, health professionals and patients who receive our newsletters. This is an image of the (intact) organ of Corti, with three rows of outer hair cells, and one row of inner hair cells, separated by a row of pillar cells.
Seeking to stem the tide of permanent hearing loss from the use of life-saving antibiotics, researchers at Oregon Health & Science University have found that patients stricken with dangerous bacterial infections are at greater risk of hearing loss than previously recognized. Aminoglycosides, antimicrobials that are indispensable to treating life-threatening bacterial infections, are toxic to the ear. When Steyger and colleagues gave healthy mice a low amount of aminoglycoside, the rodents experienced a small degree of hearing loss. The study lays the groundwork for improving the standard of care guidelines for patients receiving aminoglycosides.
Due to their widespread availability and low cost, aminoglycosides are used frequently worldwide.
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Sensorineural Hearing Loss is a hearing loss due to impairment or degeneration of the cochlear (inner ear) resulting in an irreversible hearing loss.
Bilateral Hearing Loss is a hearing loss, either sensorineural or conductive, in both ears.
Unilateral Hearing Loss is a hearing loss, either sensorineural or conductive, in one ear only. A 10-year-old boy is brought by his mother for evaluation of persistent “acne” that started when the boy was a baby. CDCa€™s activities in the area of hearing loss provide a good example of the public health cycle in action.TrackingTracking (also called surveillance) is a powerful tool used to determine who among the general population has a particular condition or disability and how many such individuals are affected. Inflammation from the bacterial infections substantially increased susceptibility to hearing impairment by increasing the uptake of aminoglycoside antibiotics into the inner ear, the researchers report. Relied on by physicians to treat meningitis, bacteremia and respiratory infections in cystic fibrosis, aminoglycosides kill the sensory cells in the inner ear that detect sound and motion. Each year, approximately 80 percent of 600,000 admissions into NICUs in the United States receive aminoglycosides.
If the mice had an inflammation that is typical of the infections treated with aminoglycosides in humans, the mice experienced a vastly greater degree of hearing loss.

To shield patients' hearing, the researchers called for the development of more targeted aminoglycosides and urged clinicians to choose more targeted, non-ototoxic antibiotics or anti-infective drugs to treat patients stricken with severe infections.
Clinical use of aminoglycosides is limited due to the known risk of acute kidney poisoning and permanent hearing loss, yet are crucial life-savers in cases with potentially fatal infections. Sensorineural hearing loss can be caused by aging, noise exposure, birth defects, medication and viral or bacterial infections.
This can be caused by impacted cerumen (wax), punctured eardrum, birth defects or otosclerosis.
His history included profound sensorineural hearing loss, (for which he had received cochlear implants) and congenital heart disease (a small ventricular septal defect, subaortic ridge, right ventricular conduction delay, and mild left ventricular dilatation). He had a relatively large head compared with his body; head circumference was 54 cm (about the 95th percentile).
There is no cure for this type of hearing ,loss; however, most patients with sensorineural hearing loss can be helped with hearing aids.
Surgery or medication can be an appropriate therapy for conductive hearing loss in some cases. Both the hearing loss and the cardiac disorders had been diagnosed during the neonatal period. How about an easy, affordable way to promote your business, class reunion or favorite hobby? While the findings of the tracking studies that we at CDC conduct often identify research questions to pursue, results from these efforts also can directly inform intervention and prevention strategies. He also had multiple lentigines (present since birth), caf au lait spots, and ocular hypertelorism. These studies tell CDC who might be more at risk for developing a condition or what might make someone less likely to have it.
This child has LEOPARD syndrome (also known as multiple lentigines syndrome, cardiocutaneous syndrome, Moynahan syndrome, lentiginosis profusa syndrome, and progressive cardiomyopathic lentiginosis). When we understand who is at risk or what protects someone from a condition, then we have a better idea of what prevention or intervention programs will work. The acronym LEOPARD stands for multiple Lentigines, ECG abnormalities, Ocular hypertelorism, Pulmonary stenosis, Abnormal genitalia, growth Retardation, and sensorineural Deafness.1 Other cutaneous (caf au lait spots, schwannomas) and noncutaneous (renal agenesis, absence or duplication of ureter) abnormalities have also been reported. The public health cycle begins again when we use tracking to help us monitor the effects of a particular intervention or prevention program.In the early 1980s, CDC implemented the first population-based tracking of multiple developmental disabilities (including hearing loss) in the United Statesa€”the Metropolitan Atlanta Developmental Disabilities Study (MADDS). This condition is transmitted in an autosomal dominant manner with high penetrance and variable expression.
MADDS found that approximately 1 of every 1,000 children 10 years of age had a bilateral hearing loss of more than 40 decibels.1By the early 1990s, CDC had built upon the success of MADDS to implement ongoing tracking of selected developmental disabilities.

The Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP) continued the work of MADDS in tracking hearing loss, vision loss, cerebral palsy, and intellectual disability. Scientists at CDC recognized the utility of MADDSP in learning the age of first identification among children with hearing loss in an effort to promote the importance of early identification.
Diagnosis requires the presence of multiple lentigines and at least 2 other clinical criteria.
If lentigines are absent, the diagnosis requires at least 3 other clinical criteria plus 1 immediate relative with the syndrome. Those findings were used to support the initiation of programs and legislation to promote universal newborn hearing screening to assess hearing function of infants before they leave the hospital. LEOPARD syndrome has been linked to a mutation in the PTPN11 gene, which is also present in about 40% of patients with Noonan syndrome.2 Despite this association, genetic testing is not necessary for diagnosis. Currently, there is extensive evidence supporting the importance of early intervention for children with hearing loss in improving language skills and communication.ResearchIn addition to tracking the prevalence and characteristics of serious hearing loss among school-aged children, we at CDC are able to use MADDSP information to examine potential risk factors for hearing loss and how these factors change over time. For example, improvements in obstetrical and neonatal care have led to higher rates of survival among low birthweight infants in developed countries.
Knowing that low birthweight children are at higher risk for hearing loss has guided researchers to take the next steps to determine if more children are being diagnosed with hearing loss over time and, if so, whether the increase is related to the improved survival rate among low birthweight infants. Knowing about this risk also means that parents and health care providers are more aware of the need to test for hearing problems among low birthweight children.Intervention and PreventionMADDSP is the only population-based tracking program for hearing loss in the United States.
We are able to use tracking tools, through MADDSP, to measure the effects of prevention and intervention efforts on the prevalence of hearing loss and use of special education services. Early Hearing and Detection Intervention (EHDI) programs promote early infant hearing screening, timely follow-up evaluations, and early intervention services.
In addition to state efforts, EHDI is supported by a wide range of federal agencies, advocacy groups, professional groups, and the public.
Early identification and intervention can help children with hearing loss to maximize their communication and language development.References1.
Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Universal screening for hearing loss in newborns: US Preventive Services Task Force recommendation statement. Relative and attributable risks for moderate to profound bilateral sensorineural hearing impairment associated with lower birth weight in children 3 to 10 years old.

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