Journal articles: 'Hearing clinics – Management – Swaziland'

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Caballero, Ana, Karen Muñoz, Karl White, Lauri Nelson, Melanie Domenech-Rodriguez, and Michael Twohig. "Pediatric Hearing Aid Management: Challenges among Hispanic Families." Journal of the American Academy of Audiology 28, no. 08 (September 2017): 718–30. http://dx.doi.org/10.3766/jaaa.16079.

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AbstractHearing aid fitting in infancy has become more common in the United States as a result of earlier identification of hearing loss. Consistency of hearing aid use is an area of concern for young children, as well as other hearing aid management challenges parents encounter that may contribute to less-than-optimal speech and language outcomes. Research that describes parent hearing aid management experiences of Spanish-speaking Hispanic families, or the extent of their needs, is not available. To effectively support parent learning, in a culturally sensitive manner, providers may benefit from having a better understanding of the needs and challenges Hispanic families experience with hearing aid management.The purpose of the current study was to describe challenges with hearing aid management and use for children from birth to 5 yr of age, as reported by Spanish-speaking parents in the United States, and factors that may influence hearing aid use.This study used a cross-sectional survey design.Forty-two Spanish-speaking parents of children up to 5 yr of age who had been fitted with hearing aids.Responses were obtained from surveys mailed to parents through early intervention programs and audiology clinics. Descriptive statistics were used to describe frequencies and variance in responses.Forty-seven percent of the parents reported the need for help from an interpreter during audiology appointments. Even though parents received information and were taught skills by their audiologist, many wanted to receive more information. For example, 59% wanted to know how to meet other parents of children who have hearing loss, although 88% had previously received this information; 56% wanted to know how to do basic hearing aid maintenance, although 71% had previously received instruction. The two most frequently reported hearing aid use challenges were fear of losing the hearing aids, and not seeing benefit from the hearing aids. Hearing aid use during all waking hours was reported by more parents (66%) when their child had a good day than when their child had a bad day (37%); during the previous two weeks, 35% of the parents indicated their child had all good days.Hispanic parents wanted more comprehensive information, concrete resources, and emotional support from the audiologist to overcome hearing aid management challenges. Understanding parents’ perspectives, experiences, and challenges is critical for audiologists to provide appropriate support in a culturally sensitive manner and to effectively address families’ needs.

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Scollie, Susan, Charla Levy, Nazanin Pourmand, Parvaneh Abbasalipour, Marlene Bagatto, Frances Richert, Shane Moodie, Jeff Crukley, and Vijay Parsa. "Fitting Noise Management Signal Processing Applying the American Academy of Audiology Pediatric Amplification Guideline: Verification Protocols." Journal of the American Academy of Audiology 27, no. 03 (March 2016): 237–51. http://dx.doi.org/10.3766/jaaa.15060.

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Background: Although guidelines for fitting hearing aids for children are well developed and have strong basis in evidence, specific protocols for fitting and verifying some technologies are not always available. One such technology is noise management in children’s hearing aids. Children are frequently in high-level and/or noisy environments, and many options for noise management exist in modern hearing aids. Verification protocols are needed to define specific test signals and levels for use in clinical practice. Purpose: This work aims to (1) describe the variation in different brands of noise reduction processors in hearing aids and the verification of these processors and (2) determine whether these differences are perceived by 13 children who have hearing loss. Finally, we aimed to develop a verification protocol for use in pediatric clinical practice. Study Sample: A set of hearing aids was tested using both clinically available test systems and a reference system, so that the impacts of noise reduction signal processing in hearing aids could be characterized for speech in a variety of background noises. A second set of hearing aids was tested across a range of audiograms and across two clinical verification systems to characterize the variance in clinical verification measurements. Finally, a set of hearing aid recordings that varied by type of noise reduction was rated for sound quality by children with hearing loss. Results: Significant variation across makes and models of hearing aids was observed in both the speed of noise reduction activation and the magnitude of noise reduction. Reference measures indicate that noise-only testing may overestimate noise reduction magnitude compared to speech-in-noise testing. Variation across clinical test signals was also observed, indicating that some test signals may be more successful than others for characterization of hearing aid noise reduction. Children provided different sound quality ratings across hearing aids, and for one hearing aid rated the sound quality as higher with the noise reduction system activated. Conclusions: Implications for clinical verification systems may be that greater standardization and the use of speech-in-noise test signals may improve the quality and consistency of noise reduction verification cross clinics. A suggested clinical protocol for verification of noise management in children’s hearing aids is suggested.

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Plyler, Erin, Ashley W. Harkrider, and John P. Little. "Three Cases of Recovery from Sensorineural Hearing Loss in the First Year of Life: Implications for Monitoring and Management." Journal of the American Academy of Audiology 32, no. 01 (January 2021): 054–68. http://dx.doi.org/10.1055/s-0040-1719129.

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Abstract Background Three infants with different risk factors, behavioral and physiologic audiometric histories, and diagnoses were fit with amplification between 3 and 8 months of age. Two of the three met criteria for cochlear implantation. Purpose This article aims to heighten awareness of the rare possibility of recovery from sensorineural hearing loss in infants with varying histories and emphasize the importance of a full diagnostic test battery in all infants diagnosed with sensorineural hearing loss every 3 months until objective and subjective thresholds are stable to ensure appropriate intervention. Research Design Case reports. Results All three infants demonstrated improvement or full recovery of hearing and cochlear function by approximately 12 months old. Their change in hearing was discovered due to frequent follow-up and/or caregiver report. One of these infants was tentatively scheduled to have cochlear implant surgery 2 months later. Conclusion Appropriate early intervention for infants with hearing loss is critical to ensure maximum accessibility to speech and language cues. The Federal Drug Administration approves cochlear implantation in infants as young as 12 months. When providing audiometric management of infants with sensorineural hearing loss, it is imperative to conduct a full diagnostic test battery every 3 months (including tympanometric, acoustic reflex, and otoacoustic emission measurement) until objective and subjective thresholds are stable. There was no apparent pattern of factors to predict that the infants highlighted in these cases would recover. Discussion among pediatric audiologists and otologists and comparison of data from clinics across the U.S. is needed to identify predictive patterns and determine appropriate, consistent monitoring of infants with sensorineural hearing loss.

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Henry, James A., Martin A. Schechter, Stephen M. Nagler, and Stephen A. Fausti. "Comparison of Tinnitus Masking and Tinnitus Retraining Therapy." Journal of the American Academy of Audiology 13, no. 10 (November 2002): 559–81. http://dx.doi.org/10.1055/s-0040-1716016.

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Two methods for treating tinnitus are compared. Tinnitus masking has been used for over 25 years, and although this method is used in clinics around the world, there are many misconceptions regarding the proper protocol for its clinical application. Tinnitus retraining therapy has been used clinically for over 12 years and has received considerable international attention. Although these methods are distinctive in their basic approach to tinnitus management, certain aspects of treatment appear similar. These aspects of treatment have created considerable confusion and controversy, especially regarding the use of "sound therapy" as a basic component of treatment. It is the objective of this article to clarify the major differences that exist between these two forms of treatment.

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Soberano, Spencer, Khaleeq Khan, Katrina Hueniken, Elyon Diekoloreoluwa Famoriyo, Joelle Soriano, Sarfraz Gill, Luna Jia Zhan, et al. "Barriers and facilitators to implementation of serial point-of-care hearing tests using a novel iPad-based audiometry in platinum chemotherapy-treated cancer patients (pts)." Journal of Clinical Oncology 38, no. 29_suppl (October 10, 2020): 223. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.223.

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223 Background: Platinum-based chemotherapy agents cause significant hearing loss in 40-80% of treated cancer pts. Lack of follow-up serial testing has created gaps in knowledge regarding hearing loss onset, progression, and possible recovery between treatment cycles. This study aims to determine barriers and facilitators to implementation of a tablet-based point-of-care hearing test, as a serial screening tool to address these knowledge gaps. Methods: From Jul 2019 to Mar 2020, 53 pts receiving high dose platinum agents were recruited from three clinics (Thoracic, head and neck, and testicular cancer) at a comprehensive cancer centre, to undergo serial audiometry testing. Baseline hearing tests, mid cycles (3,6, and 9 weeks), and post treatment tests (3,6,9,12, 19 and 24 months) were completed during the pts’ clinic appointments. Clinical research coordinators (CRCs) collected feedback from physicians, nurses, and pts to identify barriers and facilitators of implementing serial point-of-care hearing tests in these clinics. An inductive and iterative approach was used to identify themes. Implementation was tailored and mapped to the CIHR Knowledge to Action Framework (KTA). Results: Barriers: Logistical barriers included: locating quiet and accessible rooms to administer the test; pts being distracted or interrupted while completing the test; presence of family members adding to noise levels; concerns over the serial testing during treatment; length of each test; and clinic staff burden. Facilitators: User-friendly self-administered tests; increasing healthcare staff education and pt management. Adapting to the local context: Logistical barriers were resolved by CRCs designating quiet spaces for the study to occur, and meeting pts upon arrival to utilize their wait time. A ‘hearing test in progress’ sign put on exam room doors prevented interruptions. CRCs utilized the test’s ‘assisted mode’ feature to keep pts attentive and/or accelerate the process. Low noise level was emphasized to obtain accurate test results. Pt engagement in their test results facilitated retention in the study. Test length may be shortened in the future by omitting low frequency testing. Conclusions: Participants and stakeholders expressed support for in-clinic hearing tests and identified personal and systemic barriers to implementation. These findings suggest that implementation should focus on addressing concerns related to accessible rooms, pt time investment and overall clinic flow.

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Fordington, Surina, and Tamsin Holland Brown. "An evaluation of the Hear Glue Ear mobile application for children aged 2–8 years old with otitis media with effusion." DIGITAL HEALTH 6 (January 2020): 205520762096616. http://dx.doi.org/10.1177/2055207620966163.

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Objectives To evaluate the acceptability and usability of the Hear Glue Ear mobile application to guide families and support speech and language development in children with otitis media with effusion (OME). To assess the validity of the app’s game-based hearing test to estimate changes in hearing levels between audiology appointments. Method This evaluation examined 60 children aged 2–8 with and without OME, attending Cambridge Community Audiology clinics. Children’s performance in the app’s hearing test was compared to their pure tone average (PTA) obtained in clinic. Children and caregivers completed questionnaires after their first interaction with the app, and after one week of using it at home. 18 clinicians completed anonymous questionnaires after trialling the app. Results Results from the app’s hearing test show a significant correlation with clinic PTA values ([Formula: see text]). 73.1% of caregivers supported their child using the app regularly and 85% thought it enabled them to give more accurate reports to clinicians. After one week, 87.0% of families downloaded and used the app at home, and 85.7% of these felt it provided strategies to help their child. 100% of children liked the app and 93.3% found it easy to use. 77.8% of clinicians supported patients using the app regularly. Conclusions Hear Glue Ear is acceptable to children, caregivers and clinicians as part of OME management. The app’s hearing test provides a valid estimate of fluctuating hearing levels. Hear Glue Ear is a free, accessible and family-centred intervention to provide trusted information and support development, as NICE guidance recommends.

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Pellico, Linda H., Wesley P. Gilliam, Allison W. Lee, and Robert D. Kerns. "Hearing New Voices: Registered Nurses and Health Technicians Experience Caring for Chronic Pain Patients in Primary Care Clinics." Open Nursing Journal 8, no. 1 (September 9, 2014): 25–33. http://dx.doi.org/10.2174/1874434601408010025.

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Recent national estimates from the U.S. reveal that as many as one-third of all Americans experience chronic pain resulting in high prevalence rates of visits to primary care clinics (PCC). Indeed, chronic pain appears to be an emerging global health problem. Research has largely ignored the perspective of PCC staff other than physicians in providing care for patients with chronic pain. We wanted to gain insights from the experiences of Registered Nurses (RNs) and Health Technicians (HTs) who care for this patient population. Krippendorff’s method for content analysis was used to analyze comments written in an open-ended survey from fifty-seven primary care clinic staff (RNs-N=27 and HTs-N=30) respondents. This represented an overall response rate of 75%. Five themes emerged related to the experience of RNs and HTs caring for patients with chronic pain: 1) Primacy of Medications and Accompanying Clinical Quandaries; 2) System Barriers; 3) Dealing with Failure; 4) Primacy of Patient Centered Care; and 5) Importance of Team Based Care. This study demonstrates that nursing staff provide patient-centered care, recognize the importance of their role within an interdisciplinary team and can offer valuable insight about the care of patients with chronic pain. This study provides insight into strategies that can mitigate barriers to chronic pain management while sustaining those aspects that RNs and HTs view as essential for improving patient care for this vulnerable population in PCCs.

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Sowden, Jane C., Corné J. Kros, Tony Sirimanna, Waheeda Pagarkar, Ngozi Oluonye, and Robert H. Henderson. "Impact of sight and hearing loss in patients with Norrie disease: advantages of Dual Sensory clinics in patient care." BMJ Paediatrics Open 4, no. 1 (November 2020): e000781. http://dx.doi.org/10.1136/bmjpo-2020-000781.

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Norrie disease (ND) is a rare, X-linked condition of visual and auditory impairment, often presenting with additional neurological features and developmental delays of varying severity. While all affected patients are born blind, or lose their vision in infancy, progressive sensorineural hearing loss develops in the majority of cases and is typically detected in the second decade of life. A range of additional symptoms of ND, such as seizure disorders, typically appear from a young age, but it is difficult to predict the range of symptoms ND patients will experience. After growing up without vision, hearing loss represents the greatest worry for many patients with ND, as they may lose the ability to participate in previously enjoyed activities or to communicate with others.Dual sensory loss has a physical, psychosocial and financial impact on both patients with ND and their families. Routine monitoring of the condition is required in order to identify, treat and provide support for emerging health problems, leading to a large burden of medical appointments. Many patients need to travel long distances to meet with specialists, representing a further burden on time and finances. Additionally, the rare nature of dual sensory impairment in children means that few clinical environments are designed to meet their needs. Dual Sensory clinics are multidisciplinary environments designed for sensory-impaired children and have been suggested to alleviate the impact of diseases involving sensory loss such as ND.Here, we discuss the diagnosis, monitoring and management of ND and the impact it has on paediatric patients and their caregivers. We describe the potential for dual sensory clinics to reduce disease burden through providing an appropriate clinical environment, access to multiple clinical experts in one visit, and ease of monitoring for patients with ND.

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Anderson, Melinda C., Kathryn H. Arehart, and Pamela E. Souza. "Survey of Current Practice in the Fitting and Fine-Tuning of Common Signal-Processing Features in Hearing Aids for Adults." Journal of the American Academy of Audiology 29, no. 02 (February 2018): 118–24. http://dx.doi.org/10.3766/jaaa.16107.

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AbstractCurrent guidelines for adult hearing aid fittings recommend the use of a prescriptive fitting rationale with real-ear verification that considers the audiogram for the determination of frequency-specific gain and ratios for wide dynamic range compression. However, the guidelines lack recommendations for how other common signal-processing features (e.g., noise reduction, frequency lowering, directional microphones) should be considered during the provision of hearing aid fittings and fine-tunings for adult patients.The purpose of this survey was to identify how audiologists make clinical decisions regarding common signal-processing features for hearing aid provision in adults.An online survey was sent to audiologists across the United States. The 22 survey questions addressed four primary topics including demographics of the responding audiologists, factors affecting selection of hearing aid devices, the approaches used in the fitting of signal-processing features, and the strategies used in the fine-tuning of these features.A total of 251 audiologists who provide hearing aid fittings to adults completed the electronically distributed survey. The respondents worked in a variety of settings including private practice, physician offices, university clinics, and hospitals/medical centers.Data analysis was based on a qualitative analysis of the question responses. The survey results for each of the four topic areas (demographics, device selection, hearing aid fitting, and hearing aid fine-tuning) are summarized descriptively.Survey responses indicate that audiologists vary in the procedures they use in fitting and fine-tuning based on the specific feature, such that the approaches used for the fitting of frequency-specific gain differ from other types of features (i.e., compression time constants, frequency lowering parameters, noise reduction strength, directional microphones, feedback management). Audiologists commonly rely on prescriptive fitting formulas and probe microphone measures for the fitting of frequency-specific gain and rely on manufacturers’ default settings and recommendations for both the initial fitting and the fine-tuning of signal-processing features other than frequency-specific gain.The survey results are consistent with a lack of published protocols and guidelines for fitting and adjusting signal-processing features beyond frequency-specific gain. To streamline current practice, a transparent evidence-based tool that enables clinicians to prescribe the setting of other features from individual patient characteristics would be desirable.

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Newman, Craig W., Sharon A. Sandridge, and Gary P. Jacobson. "Assessing Outcomes of Tinnitus Intervention." Journal of the American Academy of Audiology 25, no. 01 (January 2014): 076–105. http://dx.doi.org/10.3766/jaaa.25.1.6.

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Background: It has been estimated that as many as 50 million Americans do experience or have experienced tinnitus. For approximately 12 million of these individuals, tinnitus makes it impossible for them to carry out normal everyday activities without limitation. These are the patients that present to audiology clinics for assessment and management. The tinnitus evaluation includes the measurement of acoustical characteristics of tinnitus and the impact that this impairment has on health-related quality of life (HRQoL). Tinnitus is a disorder that often occurs as a result of auditory system impairment. The impairment for some can impart an activity limitation and a participation restriction (i.e., tinnitus-related disability or handicap, respectively). The goal of tinnitus management is to reduce, or eliminate, activity limitations and participation restrictions by reducing or eliminating a patient’s perception of tinnitus or their reaction to tinnitus. Implicit in this statement is the assumption that there exist standardized measures for quantifying the patient’s tinnitus perception and their reaction to it. If there existed stable and responsive standardized tinnitus measures, then it would be possible to compare a patient’s tinnitus experience at different time points (e.g., before and after treatment) to assess, for example, treatment efficacy. Purpose: The purposes of the current review are to (1) describe psychometric standards used to select outcome measurement tools; (2) discuss available measurement techniques and their application to tinnitus evaluation and treatment-related assessment within the domains established by the World Health Organization’s International Classification of Functioning, Disability and Health; (3) list and briefly describe self-report tinnitus questionnaires; (4) describe how valuation of tinnitus treatment can be assessed using economic models of treatment effectiveness; and (5) provide future directions including the development of a tinnitus outcomes test battery and treatment-related study designs. Research Design: Retrospective literature review Conclusions: Although psychometrically robust measures of tinnitus HRQoL do exist, there is no unanimity in, for example, what tests should be included in the tinnitus assessment, and how studies of HRQoL should be conducted. The current authors suggest that future studies employ more rigorous designs and contain (minimally) the following characteristics: (1) utilization of randomized control groups and blinding; (2) appropriate statistical testing including “dropouts” that should be used in an “intention to treat” analysis rather than elimination from the final data set; (3) long-term follow-up assessment to evaluate responsiveness; (4) appropriate inclusion criteria to avoid “ceiling” and “floor” effects; and (5) suitable sample sizes based on the application of power analyses.

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Gazzin, Silvia, Matteo Dal Ben, Michele Montrone, Sri Jayanti, Andrea Lorenzon, Alessandra Bramante, Cristina Bottin, Rita Moretti, and Claudio Tiribelli. "Curcumin Prevents Cerebellar Hypoplasia and Restores the Behavior in Hyperbilirubinemic Gunn Rat by a Pleiotropic Effect on the Molecular Effectors of Brain Damage." International Journal of Molecular Sciences 22, no. 1 (December 30, 2020): 299. http://dx.doi.org/10.3390/ijms22010299.

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Bilirubin toxicity to the central nervous system (CNS) is responsible for severe and permanent neurologic damage, resulting in hearing loss, cognitive, and movement impairment. Timely and effective management of severe neonatal hyperbilirubinemia by phototherapy or exchange transfusion is crucial for avoiding permanent neurological consequences, but these therapies are not always possible, particularly in low-income countries. To explore alternative options, we investigated a pharmaceutical approach focused on protecting the CNS from pigment toxicity, independently from serum bilirubin level. To this goal, we tested the ability of curcumin, a nutraceutical already used with relevant results in animal models as well as in clinics in other diseases, in the Gunn rat, the spontaneous model of neonatal hyperbilirubinemia. Curcumin treatment fully abolished the landmark cerebellar hypoplasia of Gunn rat, restoring the histological features, and reverting the behavioral abnormalities present in the hyperbilirubinemic rat. The protection was mediated by a multi-target action on the main bilirubin-induced pathological mechanism ongoing CNS damage (inflammation, redox imbalance, and glutamate neurotoxicity). If confirmed by independent studies, the result suggests the potential of curcumin as an alternative/complementary approach to bilirubin-induced brain damage in the clinical scenario.

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Dritsakis, Giorgos, Dimitris Kikidis, Nina Koloutsou, Louisa Murdin, Athanasios Bibas, Katherine Ploumidou, Ariane Laplante-Lévesque, Niels Henrik Pontoppidan, and Doris-Eva Bamiou. "Clinical validation of a public health policy-making platform for hearing loss (EVOTION): protocol for a big data study." BMJ Open 8, no. 2 (February 2018): e020978. http://dx.doi.org/10.1136/bmjopen-2017-020978.

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IntroductionThe holistic management of hearing loss (HL) requires an understanding of factors that predict hearing aid (HA) use and benefit beyond the acoustics of listening environments. Although several predictors have been identified, no study has explored the role of audiological, cognitive, behavioural and physiological data nor has any study collected real-time HA data. This study will collect ‘big data’, including retrospective HA logging data, prospective clinical data and real-time data via smart HAs, a mobile application and biosensors. The main objective is to enable the validation of the EVOTION platform as a public health policy-making tool for HL.Methods and analysisThis will be a big data international multicentre study consisting of retrospective and prospective data collection. Existing data from approximately 35 000 HA users will be extracted from clinical repositories in the UK and Denmark. For the prospective data collection, 1260 HA candidates will be recruited across four clinics in the UK and Greece. Participants will complete a battery of audiological and other assessments (measures of patient-reported HA benefit, mood, cognition, quality of life). Patients will be offered smart HAs and a mobile phone application and a subset will also be given wearable biosensors, to enable the collection of dynamic real-life HA usage data. Big data analytics will be used to detect correlations between contextualised HA usage and effectiveness, and different factors and comorbidities affecting HL, with a view to informing public health decision-making.Ethics and disseminationEthical approval was received from the London South East Research Ethics Committee (17/LO/0789), the Hippokrateion Hospital Ethics Committee (1847) and the Athens Medical Center’s Ethics Committee (KM140670). Results will be disseminated through national and international events in Greece and the UK, scientific journals, newsletters, magazines and social media. Target audiences include HA users, clinicians, policy-makers and the general public.Trial registration numberNCT03316287; Pre-results.

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Ramisetty, Sai Ram, Angelo D'Amore, Ruth Chantler, Jane Greacen, David Campbell, and Eleanor Katherine Louise Mitchell. "What is learned from an Australian older person health assessment?" Australian Health Review 45, no. 4 (2021): 491. http://dx.doi.org/10.1071/ah20064.

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ObjectiveTo examine what new health information is identified at a patient’s most recent 75+HA compared with their standard GP consultations in the prior 24 months. MethodsParameters measured included newly identified chronic conditions, new management for previously diagnosed chronic conditions, medication management, referrals, vaccinations, and positive test results for the monitoring of previously diagnosed chronic conditions. A retrospective patient record study collecting data from two GP clinics in metropolitan and regional Victoria was undertaken. A total of 195 75+HA recipients were included. ResultsNo significant difference was found in the number of new chronic conditions recorded at patients’ most recent 75+HA compared with standard GP consultations in the prior 24 months. However, significant differences in the types of conditions were noted, with 75+HAs significantly more likely to record elevated lipids (P<0.001), vitamin D deficiencies (P=0.004), eye/vision-related (P=0.011), diabetes (P=0.019), and hearing conditions (P=0.045) compared with standard GP consultations. Significantly more referrals (P<0.001) and new management for previously diagnosed conditions (P=0.009) occurred at 75+HA than at standard GP consultations. Patients who were receiving their first 75+HA were significantly more likely to receive vaccinations than those receiving a subsequent 75+HA (P=0.022). Conclusion75+HAs fulfil a role in addressing chronic health problems otherwise overlooked during standard GP consultations. What is known about the topic?Since their introduction in 1999, uptake of 75+HAs has been low. Two studies from 2001 to 2002 have suggested benefits of conducting 75+HAs to identify new health problems. What does this paper add?When compared with standard GP consultations, 75+HAs identify different types of new health problems, including elevated lipids, vitamin D deficiencies, eye/vision-related conditions, diabetes, and hearing conditions. Furthermore, more referrals and new management of previously identified problems occur at 75+HA. What are the implications for practitioners?75+HAs fulfil a role in identifying and addressing chronic health problems in older patients that may otherwise have been overlooked at standard GP consultations. Suggestions of additions to the 75+HA template are made based on common chronic conditions detected in standard consultations but not included currently within the 75+HA.

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Schoonraad, Leilah, Amy Slogrove, Arnold Engelbrecht, and Michael F. Urban. "A 5-Year Retrospective Review of the Health Supervision Received by Children with Down Syndrome at a South African Regional Hospital." Journal of Tropical Pediatrics 66, no. 4 (January 14, 2020): 441–47. http://dx.doi.org/10.1093/tropej/fmz087.

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Abstract Introduction In 2011, the American Academy of Paediatrics (AAP) published revised health supervision guidelines for children with Down syndrome (DS). In the absence of South African guidelines, we described the health supervision received by children with DS at a rural regional hospital in the Western Cape, South Africa compared with the AAP guidelines. Methods This was a 5-year retrospective description of the implementation of the 2011 AAP guidelines at the DS clinic at Worcester Provincial Hospital (WPH), specifically related to screening for and management of cardiac, thyroid, hearing and haematological disorders. Results Sixty-two children received care at WPH DS clinic during the study period. Thirty-six (58%) children lived in Worcester while 26 (42%) children were referred from peripheral hospitals. The median age at first clinic visit was 0.5 years [inter-quartile range (IQR) 0.2–1.2], a total of 177 person-years of follow-up with a median duration of 1.8 years (IQR 0.3–4.8). Two deaths occurred during the study period. Forty-nine (79%) children had a screening echocardiogram performed, the median age at first echocardiogram was 0.8 years (IQR 0.2–1.4). Five (14%) children from WPH compared with no children from the peripheral hospitals received the echocardiogram within the first month of life in keeping with AAP guidance (p = 0.06). Those requiring cardiac surgery were operated on at a median age of 2 years (IQR 0.9–2.3). Compared with the AAP guidelines, within the first month of life 17 (27%) children had a thyroid screen, 20 (32%) children had a full blood count and 7 (11%) children had a hearing assessment. Conclusion AAP guidelines for health supervision in DS are challenging to achieve within our local health system. The development and advocacy for a South African DS health supervision guideline that can be applied not only in specialist clinics might improve the care of children with DS.

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Bruce, Iain, Nicola Harman, Paula Williamson, Stephanie Tierney, Peter Callery, Syed Mohiuddin, Katherine Payne, Elisabeth Fenwick, Jamie Kirkham, and Kevin O’Brien. "The management of Otitis Media with Effusion in children with cleft palate (mOMEnt): a feasibility study and economic evaluation." Health Technology Assessment 19, no. 68 (August 2015): 1–374. http://dx.doi.org/10.3310/hta19680.

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BackgroundCleft lip and palate are among the most common congenital malformations, with an incidence of around 1 in 700. Cleft palate (CP) results in impaired Eustachian tube function, and 90% of children with CP have otitis media with effusion (OME) histories. There are several approaches to management, including watchful waiting, the provision of hearing aids (HAs) and the insertion of ventilation tubes (VTs). However, the evidence underpinning these strategies is unclear and there is a need to determine which treatment is the most appropriate.ObjectivesTo identify the optimum study design, increase understanding of the impact of OME, determine the value of future research and develop a core outcome set (COS) for use in future studies.DesignThe management of Otitis Media with Effusion in children with cleft palate (mOMEnt) study had four key components: (i) a survey evaluation of current clinical practice in each cleft centre; (ii) economic modelling and value of information (VOI) analysis to determine if the extent of existing decision uncertainty justifies the cost of further research; (iii) qualitative research to capture patient and parent opinion regarding willingness to participate in a trial and important outcomes; and (iv) the development of a COS for use in future effectiveness trials of OME in children with CP.SettingThe survey was carried out by e-mail with cleft centres. The qualitative research interviews took place in patients’ homes. The COS was developed with health professionals and parents using a web-based Delphi exercise and a consensus meeting.ParticipantsClinicians working in the UK cleft centres, and parents and patients affected by CP and identified through two cleft clinics in the UK, or through the Cleft Lip and Palate Association.ResultsThe clinician survey revealed that care was predominantly delivered via a ‘hub-and-spoke’ model; there was some uncertainty about treatment strategies; it is not current practice to insert VTs at the time of palate repair; centres were in a position to take part in a future study; and the response rate to the survey was not good, representing a potential concern about future co-operation. A COS reflecting the opinions of clinicians and parents was developed, which included nine core outcomes important to both health-care professionals and parents. The qualitative research suggested that a trial would have a 25% recruitment rate, and although hearing was a key outcome, this was likely to be due to its psychosocial consequences. The VOI analysis suggested that the current uncertainty justified the costs of future research.ConclusionsThere exists significant uncertainty regarding the best management strategy for persistent OME in children with clefts, reflecting a lack of high-quality evidence regarding the effectiveness of individual treatments. It is feasible, cost-effective and of significance to clinicians and parents to undertake a trial examining the effectiveness of VTs and HAs for children with CP. However, in view of concerns about recruitment rate and engagement with the clinicians, we recommend that a trial with an internal pilot is considered.FundingThe National Institute for Health Research Health Technology Assessment programme. This study was part-funded by the Healing Foundation supported by the Vocational Training Charitable Trust who funded trial staff including the study co-ordinator, information systems developer, study statistician, administrator and supervisory staff.

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Zhong, Zhiping, Lin Lin, and Ying Yang. "Study on the Health Status and Health Service Utilization for the Rural Elderly in the Metropolitan Suburb During the Urbanization Process: A Case for Mingxing Village, Guangzhou." Sustainability 12, no. 9 (April 27, 2020): 3560. http://dx.doi.org/10.3390/su12093560.

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Rapid urbanization development significantly accelerates residents’ income in China, but there still exists a series of problems in rural areas, especially the health status of the rural elderly in the metropolitan suburb, a crucial matter worthy of attention. Regarding the rural elderly in a suburb of Guangzhou as a research object, this paper focuses on comparison of the health status and health service utilization differences between the national and local rural area, and qualitatively analyze and explain it by the cumulative disadvantage theory during the life course. By random sampling in the study group, 122 seniors from Mingxing village in Guangzhou are selected for structured face-to-face interviews. Data analysis of questionnaires (collected by trained investigators) shows that, except for self-care ability, the elderly in the village exhibit more serious hearing, vision, movement disorder, daily activity, and pain problems than the national average. Regarding mental health, the proportion of anxiety and depression symptoms in Mingxing village is 21%, both over the national countryside average. The two-week prevalence, chronic disease prevalence, and inpatient out of hospital are 78%, 85%, and 53%, respectively, which are still higher than the 2013 national rural average. Research demonstrates that the elderly mainly choose village clinics for outpatient treatment, county hospitals for inpatient treatment. The two-week visiting rate is 33%, lower than that in 2013, and the hospitalization rate is 15%, close to 2013 level. In conclusion, the health status and health service utilization of the elderly in Mingxing village in Guangzhou is generally lower than the national average level. Daily living habits, traditional notions and willingness for medical treatment are indispensable factors in affecting the elderly health. Economic status, living environment and education level continue to be the main factors in influencing the health service utilization for the elderly in Mingxing village.

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Fernando, Adrian F., and Kenneth Z. Calavera. "Endoscopic Myringotomy and Ventilation Tube Insertion under Topical Anesthesia." Philippine Journal of Otolaryngology-Head and Neck Surgery 27, no. 1 (June 29, 2012): 41–43. http://dx.doi.org/10.32412/pjohns.v27i1.559.

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Dear Editor: Time has proven that endoscopy is generally a safe and effective tool in the diagnosis and treatment of various conditions. It offers superior visualization with markedly decreased morbidity and mortality. In Otolaryngology, otoendoscopy has been gaining acceptance in providing improved otoscopic visualization and video recording of the tympanic membrane. We describe a technique of myringotomy and ventilation tube insertion under endoscopic visualization using a rigid Hopkins rod scope previously described by other authors based on their accepted clinical guidelines for myringotomy. 1,2 The use of rigid endoscopes provides visualization of the entire tympanic membrane with excellent resolution, better fidelity of color with a well-angled or side-to-side vision. The procedure is generally safe, convenient and can be performed in an out-patient setting. Correspondingly, the video recordings could improve disease documentation for baseline and post-myringotomy evaluation. They can also be a tool to enable better understanding for patients.3 Materials and Methods A total of seven (n=7) patients with symptomatic and non-resolving otitis media with effusion (OME) previously managed conservatively for 3-6 months from October 2009 to March 2010 were included in the study. The patients also had disabling otalgia with 4 of the subjects having more than 30 dB hearing loss. Subjects who had poor pain threshold, were deemed non-cooperative and those in the pediatric age group were excluded from the study. Informed consent with strict compliance to institutional ethical standards was signed by all patients. The procedures were all performed by the junior author at the E.N.T Diagnostic Unit of a private tertiary university hospital. Materials used for the procedure were the same as with conventional myringotomy (eg. aural speculum, Kley or sickle knife, Hartmann ear forceps and ventilation tube/s). The anesthetic used was an Eutectic Mixture of Local Anesthesia (EMLA®) cream 5 % (Astra-Zeneca, Sodertalje, Sweden) in a 1 cc tuberculin syringe, and 20-25% aqueous form of phenol solution. A 0 degree 4mm x 107.5mm rigid endoscope (KARL STORZ GmbH & Co. KG Mittelstr., Tuttlingen, Germany) was used. (Figure 1) First an otoendoscopy was performed and the clinical indications and risks for myringotomy were thoroughly discussed with each patient. EMLA® cream was applied to the ear canal and to the external surface of the tympanic membrane using a 1 cc tuberculin syringe. After 60 minutes, the external ear canal was cleared for complete visualization of the tympanic membrane. (Figure 2) The patient was then positioned seated on the examining chair with head tilted to the opposite side. Using a 0 degree 4mm x 107.5mm rigid endoscope, the posterior third of the external auditory canal and the tympanic membrane was visualized. The scope was held with the left hand only up to the anterior portion of the cartilaginous canal to avoid involuntary activation of the Xth cranial nerve and to allow further advancement of other instruments to the posterior canal. A shorter rigid otoendoscope (4mm x 45mm) or a smaller diameter pediatric rigid endoscope (2.7mm x 107.5mm) may be used if available. A Kley knife or myringotomy knife was dipped lightly in phenol solution and carefully advanced to the tympanic membrane for the preferred myringotomy stab incision. (Figure 3) Care was taken to avoid contact of the phenol and knife tip with the canal wall to avoid stimulating unnecessary movement, canal abrasion or dermal irritation from the phenol solution during the entire procedure. (Figure 3) The myringotomy incisions were made at the posterior-inferior tympanic membrane quadrant for ease of access and drainage. (Figure 4) Evacuation of middle ear fluid was performed using a 2 and 3 mm Frazer middle ear suction tip. The myringotomy incision was made large enough to admit the ventilation tube in four subjects with copious effusions. In these four, the tube was introduced and adjusted using a 1 mm x 8 cm (working length) Hartmann ear forceps. A 1.14 mm I.D. Armstrong beveled fluoroplastic grommet ventilation tube (Xomed, Jocksonville, FL) was used in 3 subjects while a Sheehy collar button tube without wire (Micromedics Inc, St. Paul, Minnesota,USA) was used in one. The choice of tube depended mainly on the authors’ preference, taking tube designs available for specific ear conditions into consideration. (Figure 4) All subjects were instructed to avoid vigorous activities for the first 48 hours post-myringotomy, with strict water precautions. Ofloxacin otic drops were then prescribed. Results There were a total of 7 patients, 3 males and 4 females, with age ranging from 25 to 65 years (mean=50). All of them tolerated the procedure well. Ventilation tubes were inserted in 4 subjects with copious middle ear effusions. All had minimal intra-operative (PAS 2-5) and post-operative pain (PAS 0-2). The procedures were done on an out-patient basis. Co-morbid conditions were likewise treated (Table 1). Six out of the seven subjects experienced immediate subjective relief of otalgia and hearing loss after myringotomy while one subject had persistent complaint of ear fullness. The main indication for the procedure was otitis media with effusion with significant hearing loss, otalgia and ear fullness non-responsive to 3 months conservative management. All patients had significant contributing factors for OME such as frequent infectious rhinitis or chronic persistent allergic rhinitis. Six of the 7 subjects had markedly improved hearing. Four subjects with a preoperative pure-tone evaluation of >30-40 dB hearing loss had pure-tone average improvement to 10-15 dB after subsequent hearing examinations. All subjects were evaluated post-operatively with otoendoscopy. One case was unresponsive and subsequently diagnosed with adhesive otitis media and advised to undergo myringoplasty. Discussion Endoscopic myringotomy under topical anesthesia is a generally safe and practical procedure. Its indications are the same with conventional myringotomy with or without ventilation tube insertion such as Otitis Media with Effusion persisting beyond 3 months with associated significant hearing loss, impending mastoiditis or intracranial complications, recurrent episodes of acute otitis media (> 3 episodes in 6 months or > 4 episodes in 12 months), chronic tympanic membrane or pars flaccida, barotrauma, autophony (hearing body sounds; eg. breathing) due to patulous or widely open eustachean tube, craniofacial anomalies predisposing to middle ear dysfunction (e.g. cleft palate), and middle ear dysfunction due to head and neck radiation and skull base surgery.4 Endoscopic visualization of the tympanic membrane enables better patient understanding of their ear conditions. Such has been the basis for the procedure along with the use of 5% EMLA® to decrease the pain and discomfort of patients undergoing out-patient myringotomy procedures.5 Phenol on the other hand aids in faster creation of tympanic membrane incision and decreases post-operative bleeding through its tissue vaporizing chemical cauterization effect with negligible toxicity if given in minute amount.6 Furthermore for post-operative cases of middle ear surgeries, it can be used for surveillance and middle ear cleaning. This can improve post-operative follow-up and possibly decrease the need for second look surgery.7 Generally, endoscopic myringotomy provides a complete and enhanced visualization of the tympanic membrane and some middle ear structures that only appear as silhouettes with conventional otoscopy. Rigid endoscopes may have less illumination and magnification compared to an operating microscope traditionally used in myringotomy procedures but it can provide an angled or “off line-of-site” visualization of the tympanic membrane and canal wall advantageous in trans-canal visualization of the tympanic membrane. Just like the conventional out-patient myringotomy, endoscopic myringotomy under topical anesthesia is less costly than performing the procedure under general anesthesia or through sedation requiring a more controlled clinical setting. Smaller diameter and shorter endoscopes may be more feasible for diagnostic otoendoscopy, but a rigid 4 mm endoscope is more widely available in most local clinics. The major disadvantage of this procedure is the instrumentation in very young or uncooperative patients with a narrow external auditory canal. One-handed instrumentation and lens fogging may also be encountered but can be reduced with familiarity with the procedure. The indications for endoscopic myringotomy as with those for traditional myringotomy remain suggestions and do not represent the standard of care. Clinicians can modify them when medically necessary as treatment options should always be individualized to meet each patient’s need. Failure to improve hearing may suggest another middle ear condition that necessitates further evaluation. Some cases may need myringotomy tube replacement while surgery is reserved for failed tympanic membrane healing. Lastly, like any other surgical technique and instrumentation, the major key to a successful endoscopic myringotomy is still good patient selection.

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Giri, Neelam, Dalia Batista, Constantine Stratakis, Ekaterini T. Tsilou, Hung J. Kim, and Blanche P. Alter. "NCI Fanconi’s Anemia Cohort: Hematology and Beyond." Blood 106, no. 11 (November 16, 2005): 1057. http://dx.doi.org/10.1182/blood.v106.11.1057.1057.

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Abstract Fanconi’s anemia (FA) is an inherited DNA repair disorder with very high risks of aplastic anemia (AA), myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), and squamous cell carcinomas (SCC). Patients with FA often have physical anomalies, and may develop endocrinopathies; these phenotypic features may be associated with adverse outcomes. While most of these abnormalities have been previously-reported, only prospective follow-up of a meticulously-characterized cohort can accurately quantify the prevalence and natural history of each, and determine whether specific abnormalities are strongly predictive of adverse outcomes; such information will be invaluable for evidence-based management of FA patients. To begin our formal investigation of these associations, we reviewed the medical records of 42 study participants with FA, and began prospective evaluation of a subset of 20 patients who underwent multidisciplinary evaluation at the NIH Clinical Center (FA Clinical Center Cohort - CC). The remaining 22 patients were in the FA Field Cohort (FC). We studied 17 males and 25 females. The CC and FC subjects were similar except that the former were older at the time of study (median 21.5 vs 14.3 yrs in the FC, p=0.01) and had later onset of aplastic anemia (11.8 vs 7.2 yrs, p=0.03). 36/42 (86%) had at least one FA-related congenital anomaly. 11 patients were FANCA, 9 FANCC, and 1 each FANCD1/BRCA2, FANCF, and FANCJ. 34/42 (81%) had aplastic anemia; 10 had mild to moderate and 24 had severe AA. 13/33 (38 %) had clonal cytogenetic bone marrow abnormalities, some for >3 years. 8/42 (19%) developed MDS, one of whom evolved to AML. 12 (29%) underwent BMT, 9 of whom are alive (median 4 yrs, range 9 mo-21 yrs). 3 patients were hematopoietic somatic mosaics, in whom the diagnosis of FA was confirmed by detection of chromosome breakage in skin fibroblasts; all 3 had mutations in FANCA. 23/36 (64%) had hearing loss, 4 of whom had surgery for middle ear bony abnormalities. 28/32 had microcornea, 20 microophthalmia, 21 myopia, and 4 had ptosis. 32/36 (89%) had multiple café-au-lait spots and hyper/hypopigmented areas, and 2 had Sweet’s syndrome with MDS. 9/19 (47%) had leukoplakia; 1 biopsy was positive for SCC. 29/42 (69%) had one or more endocrinopathy, including short stature, hypothyroidism, growth hormone deficiency, glucose intolerance, diabetes, dyslipidemia and metabolic syndrome. 5 patients had mid-line structural anomalies of the brain, and 1 each had a lipoma and a brain tumor. 2 patients had nonalcoholic steatohepatitis, 1 had transfusional hemosiderosis and 1 had a liver adenoma. 7/8 adult females had infertility and premature ovarian failure; 5 males had hypogenitalia. 7/7 females and 2/4 males older than 18 yrs had osteopenia or osteoporosis. 9 patients had 12 prevalent cancers at a median age of 29 yrs (range 5–44), including 5 head and neck, 4 vulvar, and 1 each nasopharyngeal, skin and brain tumor. One of the head and neck SCC occurred 13 years after BMT. Prospective screening at the NIH identified recurrent head and neck SCC in 3 patients. We conclude that FA patients need to be examined frequently in comprehensive subspecialty clinics to identify and treat significant co-morbidities, including hematologic, endocrine, and neoplastic disorders. Analysis of genotype/phenotype/cancer correlations in FA will require thorough evaluations of the type outlined here, involving larger numbers of patients; accrual to, and follow-up of, our FA cohort continues.

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Petrocchi-Bartal, Luisa, and Katijah Khoza-Shangase. "Hearing screening procedures and protocols in use at immunisation clinics in South Africa." South African Journal of Communication Disorders 61, no. 1 (June 27, 2014). http://dx.doi.org/10.4102/sajcd.v61i1.66.

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Background: There exists a need for context-relevant research aimed at facilitating the efficacious provision of early hearing detection and intervention services in South Africa.Objectives: This study aimed to determine the hearing screening procedures and protocols as well as referral protocols in use at maternal child woman’s health (MCWH) immunisation clinics in South Africa.Method: Thirty primary health care immunisation clinic managers or acting managers were interviewed in two South African sample groups. An exploratory, non-experimental,qualitative research design was employed incorporating both quantitative and qualitative information. An interview using a questionnaire was administered with all participants. The questionnaire encompassed areas such as work contexts, hearing screening contexts and information management systems, as well as quality control measures in place at these clinics.Content analysis was then used to code emergent themes into specific categories. Frequency calculations of these themes were calculated and results described qualitatively.Results: No primary health care (PHC) clinics placed within the identified sites provided formalised new-born/infant hearing screening and none of these facilities had equipment to do so. Most sites attributed the lack of formalised hearing screening to budgetary and human resource issues, staff training in particular. Non-formalised hearing screening protocols in place demonstrated inconsistencies in application across districts and none complied with Health Professions Council of South Africa (HPCSA) clinic guidelines or any international guidelines.Conclusion: Results from the current study have assisted in identifying procedural and logistical assets and barriers to implementation of HPCSA clinic guidelines for early hearing detection and intervention (EHDI) at immunisation clinics in South Africa.

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Sukati, Velibanti Nhlanhla, Vannesa Raquel Moodley, and Khathutshelo Percy Mashige. "A situational analysis of eye care services in Swaziland." Journal of Public Health in Africa 9, no. 3 (December 21, 2018). http://dx.doi.org/10.4081/jphia.2018.892.

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Compared to other African countries, Swaziland performs the worst in terms of providing eye health care services. A priority goal of the World Health Organization (WHO) is to alleviate childhood blindness, particularly in low-income countries such as Swaziland, where many people live in poverty, which is a contributor to poor health outcomes. A mixed method approach that entailed a document review, key informant interviews and clinical facility assessment questionnaires was used. Hospitals and mission clinics offering ophthalmic services were identified through the website of the Ministry of Health and verified during key informant interviews. A saturated sampling procedure was applied due to the few facilities that offer eye care services. Six framework components from the WHO for analysing health systems were utilised in an eye health care service context: leadership and governance, eye health services, eye health workforce, eye health financing systems, eye health medical supplies and technologies, and eye health information systems. Poor management, lack of accountability, poor monitoring and evaluation mechanisms, weak coordination and ineffective private-public sector regulations were identified as factors that lead to poor eye care in the country. The optometrists indicated that refractive services are the most rendered ophthalmic services. The exodus of healthcare practitioners has contributed to the downfall of the public health sector in the country. Five government eye care facilities, 3 government hospitals, 1 non-governmental organization (NGO) and a church mission clinic were included in this analysis. The eye services distribution favors the more affluent areas, particularly the more urban Hhohho Region, which is also where most of the eye health professionals are located. No campaigns have been conducted to prevent childhood blinding diseases or create awareness about getting children’s eyes tested for refractive correction. The burden of eye diseases among children in Swaziland remains unknown. More eye health care personnel and equipped facilities are needed throughout the country, and the eye health care program needs to be adopted.

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Mallinson, R. Kevin, Bongani T. Sibandze, Naji Alqahtani, and Josephine M. Amberpeta. "Evaluation of a Nurse-managed Wellness Centre for Healthcare Workers in Swaziland." Africa Journal of Nursing and Midwifery 20, no. 2 (October 19, 2018). http://dx.doi.org/10.25159/2520-5293/3557.

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Southern Africa is experiencing unprecedented levels of morbidity and mortality as a result of the HIV pandemic. Healthcare workers (HCWs) living with HIV infection may be at risk from illness and death, but may not access needed services within their workplace facility. The Swaziland Wellness Centre for Health Care Workersâ was designed to enhance the health and well-being of HCWs through a nurse-managed, community-based clinic. The purpose of the parent mixed-methods study was to describe the enrolment of clients into care over the first 10 years of the clinic’s operation and assess the HCWs’ perceptions of the Centre and its services. This report describes the findings from a retrospective review of medical records used to describe the characteristics of the clients, enrolment patterns, and services delivered. The Centre enrolled HCWs (n = 2,562) and their dependents (n = 2,571) into primary care. The HCW clients represented a variety of cadres across the health sector; nurses (29%) were the largest single cadre enrolled. The Centre nurses initiate antiretroviral and/or antitubercular treatments and provide ongoing monitoring. The database was not designed for evaluation purposes and written documentation of client care was often incomplete or illegible. The enrolment and treatment patterns suggest that nurse-managed clinics can successfully integrate HIV and tuberculosis care with primary care services for HCWs in southern Africa. Recommendations include improving the written documentation and electronic management of services provided to support ongoing evaluations.

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Patel, Amisha, and Vaghela D. B. "Effect of Honey in the Management of Otomycosis." International Journal of Ayurvedic Medicine 8, no. 2 (June 25, 2017). http://dx.doi.org/10.47552/ijam.v8i2.945.

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Otomycosis is a fungal infection of External ear, characterized by earache, pruritus, ear blockage, discharge, hearing loss and ringing in ear.Â It is the most common clinical entity in the ENT clinics. The disease is more common in hot and humid climate. Its worldwide prevalence is 5.2 % and 9 % in India. 5-25 % of otitis externa cases are due to otomycosis. Bactericidal and fungicidal activity of Honey is proved previously by in vitro study. Honey has high osmolarity and acidic pH. And fungus does not grow in acidic media. With this background, present study is aimed to know the efficacy of the Honey in the management of Otomycosis. This randomized clinical control trial including two groups, one is intervention group (group A) and second is control group (group B). Pt is advised to instill three drops of Honey thrice a day for 7 days in Group A and three drops of Clotrimazole thrice a day for 7 days in Group B. There is statistically highly significant results was observed in all signs and symptoms except hearing loss which is significant in both Groups. Statistically insignificant difference was found between both Groups.Â

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Findlen, Ursula M., Jonathan Grischkan, Sandra Alston, Lauren Durinka, and Adriane Baylis. "Assessing Adherence to Audiologic Parameters of Care for Children With Cleft Palate: A Quality Improvement Initiative." Cleft Palate-Craniofacial Journal, July 8, 2021, 105566562110295. http://dx.doi.org/10.1177/10556656211029526.

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Objective: To evaluate and increase adherence to an evidence-based audiologic management protocol for children with cleft palate. Design: Prospective, multidisciplinary quality improvement initiative. Setting: Tertiary pediatric hospital. Patients, Participants: Children with cleft palate (with or without cleft lip) between the ages of 0 and 5 years (n = 205). Interventions: A multidisciplinary team identified key drivers for nonadherence to recommended audiological follow-up and implemented interventions to improve adherence. Key drivers included provider practices and preferences, clinic logistics and flow, and patient/family awareness and education. Several interventions were implemented between 2016 and 2020, including developing an evidence-based audiologic protocol, maximizing access to audiologic clinic visits across multiple departments, cleft team education, and improved team communication. Main Outcome Measure(s): Completion of recommended audiologic assessment at 5 separate care milestones. Results: After implementation of interventions between 2016 and 2020, adherence to recommended audiologic follow-up increased from 59% to 84%. Analysis of individual care milestones revealed that increased access to audiologic testing during team clinics resulted in the largest increase in adherence to recommended follow-up. Additionally, cause-effect analysis revealed that nonadherence due to provider-related causes decreased over the project period to a greater extent than patient/family-related causes. Conclusions: Implementation of an evidence-based audiologic care protocol and improvements in access to early hearing care are feasible in a high-volume multidisciplinary cleft clinic. Adherence to recommended audiologic management can be improved by establishing strategies to improve access to care, team member and family education, and enhanced team communication.

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Telmesani, Laila M., Nithreen M. Said, Mahmoud M. Mahrous, and Danah F. Alrusayyis. "The Difficulties Encountered by Pediatric Cochlear Implant Patients and Their Parents during the COVID-19 Pandemic." Audiology and Neurotology, August 5, 2021, 1–8. http://dx.doi.org/10.1159/000517148.

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Introduction: The daily escalation in incidence and mortality caused by Coronavirus disease (COVID-19) has mandated forced curfew in our country (same as many other countries) to limit the spread of infection. This is predicted to have a more negative impact on cochlear implant (CI) patients since this group of patients needs a unique type of psychological, medical, and technical care in addition to a daily rehabilitation program. Methods: A cross-sectional study based on Arabic questionnaire that looked into the collateral consequences of COVID-19 on the pediatric CI patients. The questionnaire was designed to highlight different problems such as exposure to head trauma or ear infection, difficulties in device maintenance and getting spare parts, impacts of the delay of programing or switch on appointments, and the impacts of missing rehabilitation sessions. Different ways of management of these problems are presented and discussed. Results: A total of 174 parents responded to the questionnaire. The main problem met by the patients was missing their device programing and rehabilitation sessions. Many children had device maintenance and spare parts problems. Virtual clinics were helpful in solving different problems. Additionally, children who needed device programing were scheduled for remote programing sessions. Conclusion: Although the inevitable consequences of the COVID-19 pandemic are catastrophic, they are forcing the medical field to explore new opportunities by sitting up an infrastructure for future usage of telemedicine. Telemedicine is cost-effective and more convenient and enables health-care providers to be immune to future circumstances.

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Sogebi, OA, and EA Oyewole. "A Facility-based Study of Preauricular Sinus Among Adults in Southwest Nigeria." Annals of Health Research, March 3, 2021, 29–38. http://dx.doi.org/10.30442/ahr.0701-04-113.

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Background: Preauricular sinus (PAS) is common among the blacks and it presents in different manners. The perceptions of adult patients with PAS may influence the management strategies deployed. Objectives: To determine the perceptions of adult patients who have PAS about the disorder and describe the modalities of presentation. Methods: A descriptive study was conducted at the ENT Clinics over nine months. Using a questionnaire, socio-demographic information, perception of patients on the cause, concerns, modality of treatment, inclination to surgery and perceived complications of surgery were explored. Examination findings of the sinuses, including results of audiological investigations were recorded. Results: The prevalence of PAS was 7.4% (56/754) and the mean age of the subjects was 43.9±10.6 years. Multiple causes of PAS were perceived by 58.5% of the patients, 13.2% were not concerned but intermittent symptom was experienced by 43.3% of the patients. More than half (52.8%) believed the sinus could be treated medically with drugs, 86.8% perceived complications from surgical excision while 73.6% abhorred surgical excision. Half of the PAS was in the left ear while 11.3% were bilateral. Audiological evaluation revealed 46.4% of patients had evidence of sensorineural hearing loss while 56.5% had abnormal middle ear functions. Conclusions: Some adult patients had wrong perceptions of PAS and most patients abhorred surgical excision. The clinical presentations were mostly of the classical type, with almost two-thirds violated. There may be a need for genetic studies on PAS in future research.

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Cheung, Po-Yin, Morteza Hajihosseini, Irina A. Dinu, Heather Switzer, Ari R. Joffe, Gwen Y. Bond, and Charlene M. T. Robertson. "Outcomes of Preterm Infants With Congenital Heart Defects After Early Surgery: Defining Risk Factors at Different Time Points During Hospitalization." Frontiers in Pediatrics 8 (January 28, 2021). http://dx.doi.org/10.3389/fped.2020.616659.

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Background: Compared with those born at term gestation, infants with complex congenital heart defects (CCHD) who were delivered before 37 weeks gestational age and received neonatal open-heart surgery (OHS) have poorer neurodevelopmental outcomes in early childhood. We aimed to describe the growth, disability, functional, and neurodevelopmental outcomes in early childhood of preterm infants with CCHD after neonatal OHS. Prediction models were evaluated at various timepoints during hospitalization which could be useful in the management of these infants.Study Design: We studied all preterm infants with CCHD who received OHS within 6 weeks of corrected age between 1996 and 2016. The Western Canadian Complex Pediatric Therapies Follow-up Program completed multidisciplinary comprehensive neurodevelopmental assessments at 2-year corrected age at the referral-site follow-up clinics. We collected demographic and acute-care clinical data, standardized age-appropriate outcome measures including physical growth with calculated z-scores; disabilities including cerebral palsy, visual impairment, permanent hearing loss; adaptive function (Adaptive Behavior Assessment System-II); and cognitive, language, and motor skills (Bayley Scales of Infant and Toddler Development-III). Multiple variable logistic or linear regressions determined predictors displayed as Odds Ratio (OR) or Effect Size (ES) with 95% confidence intervals.Results: Of 115 preterm infants (34 ± 2 weeks gestation, 2,339 ± 637 g, 64% males) with CCHD and OHS, there were 11(10%) deaths before first discharge and 21(18%) deaths by 2-years. Seven (6%) neonates had cerebral injuries, 7 had necrotizing enterocolitis; none had retinopathy of prematurity. Among 94 survivors, 9% had cerebral palsy and 6% had permanent hearing loss, with worse outcomes in those with syndromic diagnoses. Significant predictors of mortality included birth weight z-score [OR 0.28(0.11,0.72), P = 0.008], single-ventricle anatomy [OR 5.92(1.31,26.80), P = 0.021], post-operative ventilation days [OR 1.06(1.02,1.09), P = 0.007], and cardiopulmonary resuscitation [OR 11.58 (1.97,68.24), P = 0.007]; for adverse functional outcome in those without syndromic diagnoses, birth weight 2,000–2,499 g [ES −11.60(−18.67, −4.53), P = 0.002], post-conceptual age [ES −0.11(−0.22,0.00), P = 0.044], post-operative lowest pH [ES 6.75(1.25,12.25), P = 0.017], and sepsis [ES −9.70(−17.74, −1.66), P = 0.050].Conclusions: Our findings suggest preterm neonates with CCHD and early OHS had significant mortality and morbidity at 2-years and were at risk for cerebral palsy and adverse neurodevelopment. This information may be important for management, parental counseling and the decision-making process.

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Cengiz, Fevzi. "+45T>G single nucleotide polymorphism of adiponectin gene: Is it a factor in childhood obesity? Original Article September 2018 537 Views Aim: Childhood obesity is increasing in incidence and is strongly associated with obesity in adulthood. Several studies to explain the role of genetics in the pathogenesis of obesity have been performed. The aim of this study was to investigate the relation between +45T>G single nucleotide polymorphism (SNP) and childhood obesity. Material and Method: 268 obese and 185 healthy (control) children… Additional Info Recieved 02.02.2018 Accepted 11.03.2018 Published Online 13.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5735 Author Tuba Kasap, Ömer Ateş, Samet Özer, Ali Gül, Resul Yılmaz, Ergün Sönmezgöz, Osman Demir, Emel Ensari Identifier J Clin Anal Med 2018;9(5): 376-80 Index Page 376-80 Citations in Google Scholar Google Scholar How to Cite Tuba Kasap, Ömer Ateş, Samet Özer, Ali Gül, Resul Yılmaz, Ergün Sönmezgöz, Osman Demir, Emel Ensari. +45T>G single nucleotide polymorphism of adiponectin gene: Is it a factor in childhood obesity? J Clin Anal Med 2018;9(5): 376-80 Running Title Childhood obesity Download attachments: JCAM-5735.pdf Read more... Healthcare staff’s attitude on hand hygiene and exposure to contaminated materials Original Article September 2018 485 Views Aim: Healthcare staff may be exposed to many risks as part of their profession. Infection control and prevention measures aim to reduce risks to the hospital and healthcare staff. This study evaluated knowledge and attitudes of healthcare staff for hand hygiene and exposure to contaminated materials. Material and Method: The descriptive study was conducted among healthcare staff who volunteered to… Additional Info Recieved 21.02.2018 Accepted 10.03.2018 Published Online 13.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5781 Author Yeşim Alpay Identifier J Clin Anal Med 2018;9(5): 416-20 Index Page 416-20 Citations in Google Scholar Google Scholar How to Cite Yeşim Alpay . Healthcare staff’s attitude on hand hygiene and exposure to contaminated materials. J Clin Anal Med 2018;9(5): 416-20 Running Title Healthcare staff’s attitude on hygiene Download attachments: JCAM-5781_1.pdf Read more... Prognostic value of soluble factors of angiogenesis and adhesion processes in head and neck squamous cell carcinomas Original Article September 2018 479 Views Aim: In this study, we aimed to define the prognostic value of two factors related to angiogenesis and adhesion processes of head and neck squamous cell carcinomas. The prominent angiogenesis molecule is vascular endothelial growth factor (VEGF). The vascular cell adhesion molecule (VCAM) first attracted attention more than two decades ago as endothelial adhesion receptor with key function for leukocyte… Additional Info Recieved 26.02.2018 Accepted 12.03.2018 Published Online 28.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5788 Author Taylan Gün, Aykut İkinciogullari, Osman Fatih Boztepe, Serdar Ensari, Huseyin Dere Identifier J Clin Anal Med 2018;9(5): 421-4 Index Page 421-4 Citations in Google Scholar Google Scholar How to Cite Taylan Gün, Aykut İkinciogullari, Osman Fatih Boztepe, Serdar Ensari, Huseyin Dere. Prognostic value of soluble factors of angiogenesis and adhesion processes in head and neck squamous cell carcinomas. J Clin Anal Med 2018;9(5): 421-4 Running Title Head and neck squamous cell carcinomas Download attachments: JCAM-5788.pdf Read more... Assessment of auditory brainstem responses in hypothyroidism and hyperthyroidism Original Article September 2018 460 Views Aim: This study aimed to determine the effect of thyroid hormone changes on hearing pathways by assessing audiometry and auditory brainstem responses of hypothyroid and hyperthyroid patients and to determine whether hypothyroidism and hyperthyroidism patients are at risk for hearing loss. Material and Method: Between June 2008-July 2009, 25 hyperthyroidism (Graves, Multinodular Goitre) and 25 hypothyroidism (Hashimato hypothyroidism) patients who… Additional Info Recieved 20.02.2018 Accepted 12.03.2018 Published Online 28.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5780 Author Elif Karalı, Ender Güçlü Identifier J Clin Anal Med 2018;9(5): 411-5 Index Page 411-5 Citations in Google Scholar Google Scholar How to Cite Elif Karalı, Ender Güçlü. Assessment of auditory brainstem responses in hypothyroidism and hyperthyroidism. J Clin Anal Med 2018;9(5): 411-5 Running Title Evaluation of hearing in thyroid disease Download attachments: JCAM-5780.pdf Read more... The impact of liver transplantation on quality of life and the psychiatric consequences in one year Original Article September 2018 482 Views Aim: Liver transplantation (LT) is a challenging operation with a burden affecting patients, families, and donors. The aim of the study was to compare the prevalence of psychiatric disorders and symptoms, and the quality of life of patients waiting for LT, with patients one year after transplantation. Material and Method: The patients in the LT waiting list (n: 68), and… Additional Info Recieved 20.02.2018 Accepted 15.03.2018 Published Online 28.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5770 Author Ceyhun Can, Can Cimilli, Yarkın Özenli, Gül Ergör, Elif Onur Aysevener, Tarkan Ünek, İbrahim Astarcıoğlu Identifier J Clin Anal Med 2018;9(5): 396-401 Index Page 396-401 Citations in Google Scholar Google Scholar How to Cite Ceyhun Can, Can Cimilli, Yarkın Özenli, Gül Ergör, Elif Onur Aysevener, Tarkan Ünek, İbrahim Astarcıoğlu. The impact of liver transplantation on quality of life and the psychiatric consequences in one year. J Clin Anal Med 2018;9(5): 396-401 Running Title Liver transplantation and quality of life Download attachments: JCAM-5770.pdf Read more... Procalcitonin, c-reactive protein, leukocyte, mean platelet volume levels in bloodstream infections Original Article September 2018 497 Views Aim: Levels of Serum Procalcitonin (PCT), C-Reactive Protein (CRP), Leukocyte (WBC) and Mean Platelet Volume (MPV) were evaluated in sepsis patients. We evaluated the diagnostic accuracy of different inflammatory markers to discriminate sepsis caused by different pathogens. Material and Method: In this study we included 126 episodes of bacteremia from 126 patients with sepsis. Medical records of patients who had… Additional Info Recieved 13.02.2018 Accepted 21.03.2018 Published Online 28.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5766 Author Arzu İrvem, Sebahat Aksaray Identifier J Clin Anal Med 2018;9(5): 391-5 Index Page 391-5 Citations in Google Scholar Google Scholar How to Cite Arzu İrvem, Sebahat Aksaray. Procalcitonin, C-Reactive Protein, Leukocyte, Mean Platelet Volume in Early Diagnosis of Sepsis Caus. J Clin Anal Med 2018;9(5): 391-5 Running Title Sepsis Download attachments: JCAM-5766.pdf Read more... Relationship Between Neutrophil to Lymphocyte Ratio with Scoring Systems of Pneumonia Severity Original Article September 2018 480 Views Aim: Today, community-acquired pneumonia remains one of the causes of high mortality and morbidity. In this study, we aimed to demonstrate the relationship between NLR, which was found to be a marker related to the systemic inflammation in the recent studies, and PSI, CURB-65, and PIRO, which were developed to predict hospitalization, being taken to an intensive care unit, and… Additional Info Recieved 12.03.2018 Accepted 30.03.2018 Published Online 04.04.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5817 Author Yasemin Kaya, Nilay Taş, Ebru Çanakçı, Zübeyir Cebeci, Muhammet Özbilen, Havva Keskin, Berna Botan Yıldırım Identifier J Clin Anal Med 2018;9(5): 452-7 Index Page 452-7 Citations in Google Scholar Google Scholar How to Cite Yasemin Kaya, Nilay Taş, Ebru Çanakçı, Zübeyir Cebeci, Muhammet Özbilen, Havva Keskin, Berna Botan Yıldırım. Relationship Between Neutrophil to Lymphocyte Ratio with Scoring Systems of Pneumonia Severity. J Clin Anal Med 2018;9(5): 452-7 Running Title Relation of neutrophil to lymphocyte ratio and pneumonia severity Download attachments: JCAM-5817.pdf Read more... Impact of resistive exercise versus aerobic exercise on bone mineral density in postmenopausal women Original Article September 2018 468 Views Aim: Osteoporosis is a major public health problem and the most common skeletal disorder. It has been described as a silent disease affecting millions worldwide. This study was aimed to determine the impact of resistive exercise versus aerobic exercises on bone mineral density in post-menopausal women. Material and Method: Forty post-menopausal women participated in this study, ranging in age from… Additional Info Recieved 10.03.2018 Accepted 30.03.2018 Published Online 04.04.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5814 Author Engy Mohamed El Nahas, Heba Mohamed Embaby, Amir Arabi Gabr, Hamada Ahmed Hamada, Saud Mashi Alrawaili Identifier J Clin Anal Med 2018;9(5): 442-6 Index Page 442-6 Citations in Google Scholar Google Scholar How to Cite Engy Mohamed El Nahas, Heba Mohamed Embaby, Amir Arabi Gabr, Hamada Ahmed Hamada, Saud Mashi Alrawaili. Impact of resistive exercise versus aerobic exercise on bone mineral density in postmenopausal women. J Clin Anal Med 2018;9(5): 442-6 Running Title Impact of resistive exercise versus aerobic exercise on bone mineral density Download attachments: JCAM-5814.pdf Read more... Comparison of liquid based cytology cervical smears with histopathological findings Original Article September 2018 432 Views Aim: Cervical cancer is still a health problem in countries where cervical cancer screening is not routinely performed. A significant decrease in the rate of mortality from cervical cancer has been observed since the Pap test was introduced. Within the last decade liquid-based cytology (LBC) has replaced the Pap test. Our aim is to compare cervical smears prepared with the… Additional Info Recieved 22.02.2018 Accepted 28.03.2018 Published Online 04.04.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5763 Author Seyhan Özakkoyunlu Hasçiçek, Tuba Oğuzsoy, Kamile Gülçin Eken, Fevziye Kabukçuoğlu Identifier J Clin Anal Med 2018;9(5): 359-62 Index Page 359-62 Citations in Google Scholar Google Scholar How to Cite Seyhan Özakkoyunlu Hasçiçek, Tuba Oğuzsoy, Kamile Gülçin Eken, Fevziye Kabukçuoğlu. Comparison of liquid based cytology cervical smears with histopathological findings. J Clin Anal Med 2018;9(5): 359-62 Running Title Comparison of cervical cytology with histopathology Download attachments: JCAM-5763.pdf Read more... Deep vein thrombosis after sodium hyaluronate injection to knee joint: a case report Case Report September 2018 658 Views Hyaluronic acid is widely used in medical procedures such as intra-articular injections. In addition to some risks of this procedure such as sepsis and injury to neighboring structures, deep vein thrombosis and pulmonary embolism should be kept in mind as rare complications. For this reason it is recommended that intra-articular injection of hyaluronic acid be performed by the ultrasound guidance… Additional Info Recieved 20.03.2018 Accepted 29.03.2018 Published Online 02.04.2018 Printed 01.09.201 DOI 10.4328/JCAM.5831 Author Özgür Altınbaş, Hakan Çomaklı Identifier J Clin Anal Med 2018;9(5): 466-8 Index Page 466-8 Citations in Google Scholar Google Scholar How to Cite Altınbaş Ö, Çomaklı H.Deep vein thrombosis after sodium hyaluronate injection to knee joint: a case report. J Clin Anal Med 2018;9(5): 466-8 Running Title Deep vein thrombosis due to sodium hyaluronate Download attachments: JCAM-5831.pdf Read more... The evaluation of thyroid function tests in patients presenting to the family medicine clinics Original Article September 2018 481 Views Aim: Publications concerning the effects in society of recommendations regarding iodine supplementation over the last approximately 30 years are inconsistent. In addition to studies suggesting that iodine supplementation is insufficient, others report that it can lead to hyperthyroidism. We planned this study in order to investigate the results of iodine supplementation in our region through the retrospective screening of records… Additional Info Recieved 10.03.2018 Accepted 30.03.2018 Published Online 02.04.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5812 Author Yılmaz Sezgin, Ali Emre Akgün Identifier J Clin Anal Med 2018;9(5): 439-41 Index Page 439-41 Citations in Google Scholar Google Scholar How to Cite Sezgin Y, Akgün AE. The evaluation of thyroid function tests in patients presenting to the family medicine clinics. J Clin Anal Med 2018;9(5): 439-41 Running Title The evaluation of thyroid function tests Download attachments: JCAM-5812.pdf Read more... Rapid and sensitive determination of carnitine profiling by tandem mass spectrometry can be a diagnostic marker of paroxysmal atrial fibrillation Original Article September 2018 378 Views Aim: Paroxysmal atrial fibrillation (PAF), which is in the sub-group of atrial fibrillation that spontaneously resolves within 48 hours and does not last more than 7 days, is one of the most important causes of cryptogenic stroke. Other than ECG findings, there are no biochemical diagnostic criteria for PAF. Early diagnosis of PAF reduces the risk of morbidity and mortality.… Additional Info Recieved 13.03.2018 Accepted 29.03.2018 Published Online 02.04.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5815 Author Ismail Koyuncu, Ataman Gonel Identifier J Clin Anal Med 2018;9(5): 447-51 Index Page 447-51 Citations in Google Scholar Google Scholar How to Cite Koyuncu İ, Gönel A. Rapid and sensitive determination of carnitine profiling by tandem mass spectrometry can be a diagnostic marker of paroxysmal atrial fibrillation. J Clin Anal Med 2018;9(5): 447-51 Running Title Carnitine profiling and PAF Download attachments: JCAM-5815.pdf Read more... Linear fractures of the cranium: follow-up and management results of 442 cases Original Article September 2018 481 Views Aim: We aimed to evaluate the clinical and radiological follow-up of cases with isolated linear fractures detected in the cranium in the post-traumatic period, to determine on which cases and when to perform control radiological examinations and to suggest follow-up protocol. Material and Method: 442 cases with isolated linear cranium fracture were evaluated in the study. Imaging examinations and clinical… Additional Info Recieved 25.02.2018 Accepted 29.03.2018 Published Online 02.04.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5792 Author Ziya Asan, Haci Mehmet Calıskan, Yahya Sahın, Canan Sahın, Fatih Durna Identifier J Clin Anal Med 2018;9(5): 425-9 Index Page 425-9 Citations in Google Scholar Google Scholar How to Cite Asan Z, Calıskan HM, Sahin Y, Sahin C, Durna F. Linear fractures of the cranium: follow-up and management results of 442 cases. J Clin Anal Med 2018;9(5): 425-9 Running Title Linear fractures of cranium Download attachments: JCAM-5792.pdf Read more... Prognostic value of hematological parameters Original Article September 2018 580 Views Aim: Acute bacterial and viral infections are usually associated with elevations of the mean platelet volume. We correlated infection with influenza changes in mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), to determine whether these might be predictors for the duration of hospitalization or mortality. Material and Method: A total of 122 influenza patients (54 males and… Additional Info Recieved 24.01.2018 Accepted 10.03.2018 Published Online 13.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5719 Author Songul Ozyurt, Yasin Yildiz, Ugur kostakoglu, Aysegul Copur-Cicek, İlknur Esen Yildiz, Ayse Erturk Identifier J Clin Anal Med 2018;9(5): 363-8 Index Page 363-8 Citations in Google Scholar Google Scholar How to Cite Ozyurt S, Yildiz Y, Kostakoglu U, Copur-Cicek A, Yildiz İE, Erturk A. Prognostic Value of Hematological Parameters. J Clin Anal Med 2018;9(5): 363-8 Running Title Influenza Download attachments: JCAM-5719.pdf Read more... Prevalence and characteristics of CAAs in the black sea region Original Article September 2018 537 Views Aim: To date there has been no data about the prevalence of coronary artery anomaly (CAA) in the Turkish population of the Black Sea Region who underwent trans-radial coronary angiography. We aimed to determine the frequency and characteristics of CAA in our patients. Material and Method: All the coronary angiographies performed from September 2015 to September 2016 in our hospital… Additional Info Recieved 26.01.2018 Accepted 04.03.2018 Published Online 08.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5731 Author Osman Kayapinar, Ahmet Egemen Sayin, Adnan Kaya, Cem Ozde, Muhammed Keskin Identifier J Clin Anal Med 2018;9(5): 369-75 Index Page 369-75 Citations in Google Scholar Google Scholar How to Cite Kayapinar O, Sayin AE, Kaya A, Ozde C, Keskin M. Prevalence and characteristics of CAAs in the black sea region. J Clin Anal Med 2018;9(5): 369-75 Running Title CAAs in the black sea region Download attachments: JCAM-5731.pdf Read more... Modified mini-incision surgery for carpal tunnel syndrome: Results of 131 interventions Original Article September 2018 607 Views Aim: The aim was the presentation of results from 131 interventions in which a quick and practical modified surgical approach was applied in carpal tunnel syndrome surgery. Material and Method: In total, 131 surgical interventions were made in 121 cases. 22 cases were male, 99 cases were female. Boston Carpal Tunnel Syndrome Questionnaire scores were obtained on the postoperative 12th-14th… Additional Info Recieved 03.02.2018 Accepted 05.03.2018 Published Online 09.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5751 Author Ziya Asan Identifier J Clin Anal Med 2018;9(5): 381-5 Index Page 381-5 Citations in Google Scholar Google Scholar How to Cite Asan Z. Modified mini-incision surgery for carpal tunnel syndrome: Results of 131 interventions. J Clin Anal Med 2018;9(5): 381-5 Running Title Carpal tunnel syndrome surgery Download attachments: JCAM-5751.pdf Read more... The predictive role of computed tomography on respiratory complications following coronary artery bypass surgery Original Article September 2018 450 Views Aim: Pulmonary complications are frequently seen complications following especially after coronary artery bypass grafting. Attempts are made to detect those complications preoperatively by pulmonary function tests and clinical evaluation.In our study, we investigated the effect of computed tomography findings in predicting postoperative complications in patients with normal respiratory function tests. Material and Method: Between January 2012 and August 2017, imaging… Additional Info Recieved 19.02.2018 Accepted 05.03.2018 Published Online 11.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5775 Author Özlem Erçen Diken, Adem İlkay Diken, Adnan Yalçınkaya, Sertan Özyalçın, Muhammed Onur Hanedan Identifier J Clin Anal Med 2018;9(5): 402-6 Index Page 402-6 Citations in Google Scholar Google Scholar How to Cite Diken ÖE, Diken Aİ, Yalçınkaya A, Özyalçın S, Hanedan MO. The Predictive Role of Computed Tomography on Respiratory Complications Following Coronary Artery Bypass Surgery. J Clin Anal Med 2018;9(5): 402-6 Running Title Pulmonary risk and coronary surgery Download attachments: JCAM-5775.pdf Read more... Endoscopic extirpation of a fork after three days; Case report and review of the literature." Journal of Clinical and Analytical Medicine 9, no. 5 (September 1, 2018). http://dx.doi.org/10.4328/jcam.5790.

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Journal articles on the topic 'Hearing clinics – Management – Swaziland'

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