Πέμπτη 12 Μαΐου 2022

Olfactory Impairment and Mortality

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The COVID-19 pandemic has elevated the world's attention to olfactory impairment (OI). As a cardinal symptom of the many early variants of the SARS-CoV-2 virus, we have never seen such global attention toward one of our most important senses. Although the prevalence of OI has increased dramatically with COVID-19, OIs have long been a significant health concern. Prior to the COVID-19 pandemic, the median length of time from onset of OI to evaluation by a clinician was 13 months, with many individuals waiting up to 3 years before seeking evaluation. During that time, patients did not receive treatment or counseling, compounding the potential associations of OI with patient health.
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Effects of Masker Envelope Fluctuations on the Temporal Effect

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This study tests the hypothesis that small or absent temporal effects for narrowband maskers are due to the inherent temporal envelope fluctuations of Gaussian noise. Temporal effects were measured for narrowband noise maskers with fluctuating ( "fluctuating maskers") and flattened ("flattened maskers") temporal envelopes as a function of masker level (Exp. I) and in the presence of fluctuating and flattened precursors (Exp. II). The temporal effect was absent for fluctuating narrowband maskers and as large as ~ 7 dB for flattene d narrowband maskers. The AC-coupled power of the temporal envelopes of precursors and maskers accounted for 94 % of the variance in probe detection thresholds measured with fluctuating and flattened precursors and maskers. These results suggest that m...
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Effects of 3,3 ′-Iminodipropionitrile on Hair Cell Numbers in Cristae of CBA/CaJ and C57BL/6J Mice

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This study examines absolute hair cell numbers in the cristae of C57BL/6J mice and CBA/CaJ mice from weaning to adulthood as well as the dose required for 3,3 ′-iminodiproprionitrile (IDPN)-injury of the cristae in C57BL/6J mice and CBA/CaJ mice, the two mouse strains most commonly used by inner ear researchers. In cristae of CBA/CaJ and C57BL/6J mice, no loss of hair cells was observed up to 24 weeks. In both strains, dose-dependent loss of hair cells was observed 7 days after IDPN treatment of 2-month-old mice (IC50 = 16.1 mmol/kg in C57BL/6J mice vs. 25.21 mmol/kg in CBA/CaJ mice). Four-month-old C57BL/6J mice exposed to IDPN developed dose-dependent vestibular dysfunction as indicated by increased activity and circling behavior in open field tests and by failure to swim 7 da...
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Association of APACHE‐II Scores With 30‐Day Mortality After Tracheostomy: A Retrospective Study

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Association of APACHE-II Scores With 30-Day Mortality After Tracheostomy: A Retrospective Study

An APACHE-II score of 30 and above is a potentially useful clinical indicator of increased risk of mortality within 30 days of tracheostomy in patients with ventilator-dependent respiratory failure (VDRF). This tool may prove a valuable resource for ICU physicians, surgeons, and families who are considering tracheostomy for patients with VDRF.


Objective

The objective of this study was to assess whether the Acute Physiology, Age, Chronic Health Evaluation II (APACHE-II) score is a reliable predictor of 30-day mortality in the setting of adult patients with ventilator-dependent respiratory failure (VDRF) who undergo tracheostomy.

Methods

This is a retrospective, single-institution study. Potential subjects were identified using the current procedural terminology codes for the tracheostomy procedure and International Classification of Diseases, 10th Revision, codes for VDRF. APACHE-II scores were retrospectively calculated. Tracheostomies were performed in our population over an 18-month period (November 2018 through April 2020). Our study population did not include patients with novel coronavirus. The primary outcome was mortality at 30 days after tracheostomy.

Results

A total of 238 patients with VDRF who had a tracheostomy were included in this study. Twenty-eight (11.8%) patients died within 30 days of tracheostomy. The mean (standard deviation) APACHE-II score was 22.5 (10.2) for patients who died within 30 days of tracheostomy and 19.8 (7.4) for patients living within 30 days of tracheostomy (p = 0.30). Patients with APACHE-II scores greater than or equal to 30 showed higher odds of death within 30 days of tracheostomy (odds ratio, 3.0; 95% CI, 1.14–7.89, p = 0.03).

Conclusion

An APACHE-II score of 30 and above is associated with mortality within 30 days of tracheostomy in patients with VDRF. APACHE-II scores may be a promising tool for assessing risk of mortality in patients with VDRF after tracheostomy.

Level of Evidence

3 Laryngoscope, 2022

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The Optimized Protocol of Hyperbaric Oxygen Therapy For Sudden Sensorineural Hearing Loss

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The Optimized Protocol of Hyperbaric Oxygen Therapy For Sudden Sensorineural Hearing Loss

When HBOT (10 sessions) was combined with corticosteroids as the initial therapy for SSNHL, a higher pressure (1.5 ATA vs. 2.5 ATA) provided better treatment result; however, increasing the duration (1 h vs. 2 h) did not result in a significant difference. The addition of 1.5 ATA HBOT showed similar results to the treatment without HBOT in our previous study.


Objective

This study aimed to determine the optimal protocol of hyperbaric oxygen therapy (HBOT) according to various treatment settings for sudden sensorineural hearing loss (SSNHL).

Methods

A 112 patients with SSNHL were enrolled in this prospective study. All patients were treated with systemic steroid therapy, intratympanic steroid therapy, and HBOT. According to the pressure and duration of HBOT (10 sessions in total), the patients were divided into three groups: group 1, 2.5 atmospheres absolute (ATA) for 1 h; group 2, 2.5 ATA for 2 h; and group 3, 1.5 ATA for 1 h. The pure-tone average (PTA), word discrimination score (WDS), and mean gain were compared.

Results

A total of 105 patients completed the 3-month follow-up, and 6 patients were excluded. Differences among groups were found in PTA, WDS, and mean gain. In the post-hoc analysis, group 3 had significantly lower WDS and mean gain than groups 1 and 2; however, group 2 showed no significant differences from group 1. The proportion of patients with hearing recovery after treatment was significantly higher in group 1 (57.6%) and group 2 (58.8%) than in group 3 (31.3%).

Conclusions

When HBOT (10 sessions) was combined with corticosteroids as the initial therapy for SSNHL, a higher pressure (1.5 ATA vs. 2.5 ATA) provided better treatment results; however, increasing the duration (1 h vs. 2 h) under 2.5 ATA did not result in a significant difference. Therefore, HBOT for SSNHL may be performed at 2.5 ATA for 1 h in 10 sessions. Laryngoscope, 2022

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