Development Of Sensorineural Hearing Loss Research Articles

Genetically Predicted Sleep Traits and Sensorineural Hearing Loss: A Mendelian Randomization Study.

Observational studies suggest a potential association between sleep characteristics, sensorineural hearing loss (SNHL), and sudden SNHL (SSNHL), but causal evidence is scarce. We sought to clarify this issue using two-sample Mendelian randomization analysis. The inverse-variance weighted (IVW) method was performed as primary analysis to assess bidirectional causal associations between sleep traits (chronotype, sleep duration, insomnia, daytime sleepiness, and snoring) and SNHL/SSNHL using publicly available Genome-Wide Association Studies summary data from two large consortia (UK Biobank and FinnGen). Sensitivity analyses, including Mendelian randomization (MR)-Egger, Mendelian randomization pleiotropy residual sum and outlier, weight median, Cochran's Q test, leave-one-out analysis, and potential pleiotropy analysis, were conducted to ensure robustness. IVW analysis found suggestive associations of morning chronotype (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 1.01-1.16, p = 0.031) and daytime sleepiness (OR = 1.88, 95% CI = 1.24-2.87, p = 0.003) with SNHL onset. Additionally, morning chronotype was nominally associated with SSNHL onset using IVW method (OR = 1.37, 95% CI = 1.10-1.71, p = 0.006). However, there was no evidence for the causal effect of SNHL and SSNHL on different sleep traits (all p > 0.05). Sensitivity analysis showed that the results were stable. Within the MR limitations, morning chronotype and daytime sleepiness were underlying causal contributors to the burden of SNHL, indicating that optimal sleep might facilitate the prevention and development of SNHL. 3 Laryngoscope, 2024.

Assessment of the effect of a health-improving program to preserve the professional suitability of employees at a gas transportation enterprise in territories equated to the Far North

Introduction. At the Russian gas transportation enterprises, we traditionally consider a noise as the main harmful production factor. Long-term work activity under its influence is associated with the risk of developing sensorineural hearing loss, which, with progression, entails loss of professional suitability. Risk factors for the development of sensorineural hearing loss at an enterprise of this profile operating in territories equated to the Far North are also arterial hypertension and an increase in total cholesterol. In such a situation, the prevention of hearing loss, adapted to the specifics of the work of the leading professional groups of the gas transportation enterprise, is of particular importance. In connection with these circumstances, the researchers developed and tested a comprehensive program for the prevention of the development and progression of sensorineural hearing loss, which contributed to the correction of risk factors.
 The study aims to evaluate the effectiveness of the long-term implementation of a comprehensive medical program for the prevention of the development and progression of chronic sensorineural hearing loss, correction of arterial hypertension and total cholesterol levels in employees of the main production of a gas transportation enterprise operating in conditions equated to the Far North.
 Materials and methods. Over a 10-year period, we have tracked the dynamics of the health status of 120 employees of the main production, whose work activities took place under the influence of industrial noise with an intensity from 50 to 94 dBA during a comprehensive program of medical prevention of the development and progression of sensorineural hearing loss. Preventive measures consisted of: a course of drug therapy, physiotherapy procedures with the use of transcranial electrical stimulation, rational nutrition, phytotherapy, physical therapy, classes in the format of a "Healthy lifestyle School" in order to form the patient's motivation to lead a healthy lifestyle.
 Results. Out of 96 workers with normal hearing, six people (6.25%) had hearing loss up to the first degree, which does not yet entail loss of professional suitability. Among 24 specialists with initially reduced hearing (from signs of noise exposure to hearing loss by second degree), the audiogram did not change in 3 people, in 15 people specialists observed improvement within one degree, in 6 people — progression in the same dimension. The proportion of patients with arterial hypertension and hypercholesterolemia did not change significantly, but we observed a significant decrease in the proportion of obese patients.
 Conclusion. Thus, we have shown the possibility of preventing the persistent loss of professional of workers caused by the development of sensorineural hearing loss in the degree from moderate to higher.
 Limitations. At enterprises operating in other climatic zones and using less noise-hazardous equipment, other results may be obtained.

Association of Glycemic Index Using HbA1c and Sensorineural Hearing Loss in Diabetes Mellitus Type 2 Patients: A Systematic Review and Meta-Analysis

ABSTRACT
 Objective: To systematically review the available evidence on the association of HBA1c levels and development of sensorineural hearing loss and to quantitatively analyze the available data on HBA1c levels in patients with type 2 diabetes mellitus and sensorineural hearing loss to determine an HbA1c level that may be associated with the risk of having sensorineural hearing loss.
 Methods:
 Design: Systematic Review and Meta-analysis Eligibility Criteria: Cross-sectional studies, or cohort studies which were limited to English language that investigated the correlation of glycemic index using HBA1c and sensorineural hearing loss among adult type 2 diabetic patients which were done from January 2010 to December 2021. Studies with no published outcome, incomplete data or that were ongoing as of August 1, 2022 were also excluded.
 Information Sources: MEDLINE (through PubMed), Cochrane Library, Scopus, Embase (through OVID@journal), Directory of Open Access Journals (DOAJ), Google Scholar and HERDIN Plus
 Risk of Bias: Risk of Bias was assessed using the Guidelines for Cochrane Collaboration Synthesis of Results: Results were presented using forest plots for representation.Results: A total of 8 studies were reviewed with 2,103 participants in all. Six articles compared hearing loss incidence between diabetic and non-diabetic patients. Overall, there were a total of 881 diabetic patients and 1222 non-diabetic patients. There was a significantly lower incidence of sensorineural hearing loss in non-diabetic patients with a risk ratio of 1.89, 95% CI [1.65, 2.16]. Three articles compared the HbA1c levels of diabetic patients with or without sensorineural hearing loss. Diabetic patients without sensorineural hearing loss had significantly lower HbA1c levels compared to those with sensorineural hearing loss with mean difference of 1.04, 95%CI [0.82, 1.25].Conclusion: In conclusion, this meta-analysis showed a higher prevalence rate of sensorineural hearing loss among patients with diabetes mellitus compared to non-diabetic patients. Moreover, poor glycemic control among diabetic patients with a glycemic index based on HbA1c of more than 8.3 (6.97-9.6) is associated with sensorineural hearing loss.

Leveraging real-world data to improve cochlear implant outcomes: Is the data available?

Objectives: A small but persistent proportion of individuals do not gain the expected benefit from cochlear implants(CI). A step-change in the understanding of factors affecting outcomes could come through data science. This study evaluates clinical data capture to assess the quality and utility of CI user's health records for data science, by assessing the recording of otitis media. Otitis media was selected as it is associated with the development of sensorineural hearing loss and may affect cochlear implant outcomes. Methods: A retrospective service improvement project evaluating the medical records of 594 people with a CI under the care of the University of Southampton Auditory Implant Service between 2014 and 2020. Results: The clinical records are suitable for data science research. Of the cohort studied 20% of Adults and more than 40% of the paediatric cases have a history of middle ear inflammation. Discussion: Data science has potential to improve cochlear implant outcomes and improve understanding of the mechanisms underlying poor performance, through retrospective secondary analysis of real-world data. Conclusion: Implant centres and the British Cochlear Implant Group National Hearing Implant Registry are urged to consider the importance of consistently and accurate recording of patient data over time for each CI user. Data where links to hearing loss have been identified, such as middle ear inflammation, may be particularly valuable in future analyses and to inform clinical trials.

The effectiveness of the use of superelastic nitinol stapedial prostheses in comparison with titanium ones in the surgical treatment of patients with otosclerosis

This article presents the results of a comparative evaluation of surgical treatment of patients suffering from conductive and mixed hearing loss in various clinical forms of otosclerosis using titanium and nitinol stapedial prostheses.
 Materials and methods. In the department of surgical treatment of diseases of the ear and the base of the skull of the NMICO from 2017 to 2020, the functional results of stapedoplasty using titanium and nitinol prostheses were compared in the near (up to 3 months) and long-term (more than 6 months) postoperative period. The comparison groups included 50 patients who were divided into two equal in all major indicators groups that differ only in the type of prosthesis used (SE NiTiNOL/PTFE and Ti/PTFE). In the postoperative period (the average follow-up period was 3 years), the values of the bone-air interval in operated patients were evaluated; clinical and experimental comparison of computed tomography data obtained during the installation of titanium and nitinol prostheses was also carried out.
 Results. Functional results were assessed in the immediate (13 months) and long-term (6 months3 years) periods after surgery. The average postoperative CVI was 12.29 dB (SD 5 dB) in patients in the group with nitinol prostheses and 11.93 dB (SD 5 dB) in titanium. 88% and 80% of patients in both groups had an "excellent" or "good" result in hearing improvement.
 The cadaveric material was used to compare the CT data obtained during the installation of stapedial prostheses: in 4 cases, when installing a nitinol prosthesis, there were no artifacts, which made it possible to visualize the prosthesis attachment ring; in the other 4 cases with a titanium prosthesis, this was not possible to detect.
 Conclusions. The installation of a nitinol prosthesis has a number of advantages: it does not require additional fixation of its head on the long stem of the anvil in the form of a compression, which minimizes the risks of traumatizing the structures of the inner ear and, accordingly, the development of sensorineural hearing loss in the postoperative period, as well as the use of SENiTiNOL prostheses reduces the likelihood of developing aseptic necrosis of the long leg of the anvil due to the properties of the metal and a decrease in its thickness. Analyzing the data of computed tomograms of patients after stapedoplasty, only in the group with installed nitinol prostheses, it was possible to visualize the position of the prosthesis on the long stem of the incus, in the area of the vestibule, its length, the integrity of the long stem of the incus.

Galectin-3 protects auditory function in female mice

Sex differences in the development of sensorineural hearing loss have been recognized in various inner ear disorders, but the molecular basis for such differences is poorly understood. Autosomal genes have been shown to cause sex differences in disease susceptibility, but many genes exerting sex-dependent effects on auditory function remain to be identified. Galectin-3 (Gal-3), a protein encoded by the autosomal gene Lgals3, is a member of the β-galactoside-binding protein family, and has been linked to multiple biological processes, including immune responses, apoptosis, and cell adhesion. Here, we investigated auditory function and hair cell integrity in Gal-3 knockout (KO, Lgals3−/−) and wild-type (WT, Lgals3+/+) mice from age 1 to 6 months. KO mice show a more rapid age-related increase in ABR thresholds compared to WT mice. Noticeably, the threshold deterioration in female KO mice is significantly greater than in the male KO and WT mice. The ABR threshold elevation manifests over a broad frequency range in female KO mice, whereas the threshold elevations are confined to high frequencies in the male KO and WT mice. Moreover, DPOAE input/output functions reveal a similar pattern of auditory dysfunction, with the female KO mice displaying a significantly greater reduction in DPOAE amplitudes than male KO mice and WT mice of both sexes. Finally, age-related outer hair cell loss is greater for female KO mice compared to male KO mice and WT mice of both sexes. Together, these results indicate that Gal-3 deficiency exacerbates age-related cochlear degeneration and auditory dysfunction in female mice. Our study identifies Gal-3 as a sex-dependent molecule for maintaining female cochlear integrity.

Association of Outpatient Oral Macrolide Use With Sensorineural Hearing Loss in Children, Adolescents, and Young Adults

Prior publications have reported the sporadic development of sensorineural hearing loss (SNHL) after intravenous or high-dose macrolide therapy for adults with comorbid conditions, but investigations of the auditory effect of oral outpatient dosing for children, adolescents, and young adults have been limited. To determine whether broad-based outpatient use of oral macrolide therapy is associated with increased risk of pediatric SNHL through nationally representative analyses. A retrospective case-control study of 875 matched pairs of children, adolescents, and young adults was performed, matching on age, sex, and the time elapsed since prescription date. All eligible pediatric patients were included, with matched control participants from the TRICARE US military health insurance system who were evaluated between October 1, 2009, and September 30, 2014. Oral outpatient macrolide treatment compared with penicillin use among pediatric patients. The clinical outcome of interest was SNHL in children, adolescents, and young adults. Multivariable conditional logistic regression was used to compare the risk of prior macrolide exposure with penicillin exposure, adjusted for other risk factors and potential confounders. Four time frames between exposure and diagnosis were additionally assessed. There were 875 eligible matched pairs of children, adolescents, and young adults included. The mean (SD) age of the participants was 5.7 (4.9) years; 1082 participants were male (62%), 58 were Asian (3%), 254 were Black (15%), 1152 were White (66%), and 286 were of Native American and other (no further breakdown was available in the TRICARE database) race and ethnicity (16%). In multivariable analysis, participants who had SNHL had increased odds of having received a macrolide prescription compared with a penicillin prescription when all time frames from exposure were included (adjusted odds ratio, 1.31; 95% CI, 1.05-1.64). There were significantly higher odds of macrolide exposure than penicillin exposure when diagnosis and testing occurred more than 180 days after antibiotic exposure (adjusted odds ratio, 1.79; 95% CI, 1.23-2.60). In this case-control study of a nationally representative patient population, findings suggest that children, adolescents, and young adults with SNHL had increased odds of outpatient oral macrolide use compared with penicillin use, particularly when having received a diagnosis more than 180 days after exposure. Further study of the association of macrolides with SNHL in children, adolescents, and young adults is warranted.

MiR-106a facilitates the sensorineural hearing loss induced by oxidative stress by targeting connexin-43

ABSTRACT Sensorineural hearing loss (SNHL) is a common clinical side effect resulted from the overusing of aminoglycoside antibacterial drugs, such as gentamicin. Oxidative stress is recently evidenced to be an important inducer for SNHL, which is reported to be associated with the knockdown of connexin-43. MiR-106a is recently found as a regulator of connexin-43. The present study aims to investigate whether miR-106a is a vital mediator in the development of SNHL. Firstly, upregulated miR-106a was observed in the peripheral blood sample of SNHL patients. Glucose oxidase (GO) was utilized to induce oxidative injury in isolated rat cochlear marginal cells (MCs), followed by introducing the miR-106a inhibitor. We found that the declined proliferation ability, increased apoptosis, and activated oxidative stress in GO-stimulated MCs were dramatically abolished by the miR-106a inhibitor, accompanied by the upregulation of connexin-43. The targeting correlation between miR-106a and connexin-43 was predicted and confirmed by the dual luciferase gene reporter assay. Furthermore, the regulatory effect of miR-106a inhibitor against the proliferation, apoptosis, and oxidative stress in GO-treated MCs were dramatically abolished by the knockdown of connexin-43. Gentamicin was utilized to establish the SNHL model in rats, followed by the treatments of antagomir-106a and antagomir-106a combined with carbenoxolone, an inhibitor of connexin-43. The alleviated pathological state, reduced apoptosis, and ameliorated oxidative stress in cochlea tissues were observed in antagomir-106a treated SNHL rats, which were dramatically reversed by the co-administration of carbenoxolone. Collectively, miR-106a facilitated the SNHL induced by oxidative stress via targeting connexin-43.

AIRCRAFT NOISE AND METHODS OF ITS REDUCTION

Aircraft noise and methods of its reduction are considered. Brief information about noise sources and acceptable value are described. Regulatory documents, the noise standard established by ICAO are also considered. Recommendations for reducing aircraft noise are presented.
 The whole body is susceptible to noise. Even at a relatively low, but constant noise level, a person may experience discomfort, irritability, and headaches. Especially dangerous is sudden noise that violates the psychological comfort of a person (takeoff and landing, areas of the route of supersonic aircraft).
 The result of the specific effects of noise on the hearing organs are diseases such as sensorineural hearing loss, manifested by persistent hearing loss. The development of sensorineural hearing loss is associated with prolonged and regular levels of aircraft noise.
 Pilots are exposed to this noise level, the noise level fluctuates in the range of 90-109 dB, and in the cockpits of helicopters - in the range of 100-118 dB.
 Aircraft noise around airports and airways covers the entire area of ​​the territory, including the residential area. When the airport is close to the city, there are problems associated with a high level of aircraft noise, which creates discomfort for the human body.

Патогенетичні механізми сенсоневральної втрати слуху в пацієнтів з COVID-19 і методи їх корекції

У статті описані основні патогенетичні механізми розвитку гострої сенсоневральної втрати слуху, у тому числі інфекційного генезу. Розглянуто можливі чинники й механізми розвитку сенсоневральної втрати слуху на фоні коронавірусної інфекції, спричиненої вірусом SARS-CoV-2. Описані випадки зниження слуху в пацієнтів з COVID-19. Наведений патогенетично обґрунтований терапевтичний підхід у лікуванні таких пацієнтів, що заснований на оптимізації ацетилхолінової нейромедіації в структурах головного мозку, які беруть участь у проведенні й сприйнятті слухового імпульсу.

ROS-Induced Oxidative Damage and Mitochondrial Dysfunction Mediated by Inhibition of SIRT3 in Cultured Cochlear Cells.

Sensorineural hearing loss (SNHL) is one of the most common causes of disability worldwide. Previous evidence suggests that reactive oxygen species (ROS) may play an important role in the occurrence and development of SNHL, while its mechanism remains unclear. We cultured dissected organs of Corti in medium containing different concentrations (0, 0.25, 0.5, 0.75, 1, and 1.25 mM) of hydrogen peroxide (H2O2) and established a four-concentration model of 0, 0.5, 0.75, and 1 mM to study different degrees of damage. We examined ROS-induced mitochondrial damage and the role of sirtuin 3 (SIRT3). Our results revealed that the number of ribbon synapses and hair cells appeared significantly concentration-dependent decrease with exposure to H2O2. Outer hair cells (OHCs) and inner hair cells (IHCs) began to be lost, and activation of apoptosis of hair cells (HCs) was observed at 0.75 mM and 1 mM H2O2, respectively. In contrast with the control group, the accumulation of ROS was significantly higher, and the mitochondrial membrane potential (MMP) was lower in the H2O2-treated groups. Furthermore, the expression of SIRT3, FOXO3A, and SOD2 proteins declined, except for an initial elevation of SIRT3 between 0 and 0.75 mM H2O2. Administration of the selective SIRT3 inhibitor 3-(1H-1,2,3-triazol-4-yl) pyridine resulted in increased damage to the cochlea, including loss of ribbon synapses and hair cells, apoptosis of hair cells, more production of ROS, and reduced mitochondrial membrane potential. Thoroughly, our results highlight that ROS-induced mitochondrial oxidative damage drives hair cell degeneration and apoptosis. Furthermore, SIRT3 is crucial for preserving mitochondrial function and protecting the cochlea from oxidative damage and may represent a possible therapeutic target for SNHL.

Intracochlear macrophages are involved in the development of sensorineural hearing loss by decreasing inner hair cell synapses

Intracochlear macrophages are involved in the development of sensorineural hearing loss by decreasing inner hair cell synapses

Ménière’s disease and chronic cerebrovascular diseases

Ménière’s disease (MD) is an idiopathic inner ear disease, which is characterized by noise in the ears, periodic attacks of vertigo and the development of sensorineural hearing loss. MD is characterized by endolymphatic hydrops – an increase in the volume of endolymph that fills the membered labyrinth of the inner ear. Currently highlighted subtypes MD. The first subtype meets most often and is characterized by classical manifestations of MD. The second subtype is characterized by the development of sensorineural hearing loss, to which only after a long time are joined by the episodes of dizziness. The third subtype of MD includes family cases of the disease. The fourth and fifth subtypes of MD is observed in patients with migraine and autoimmune diseases. The diagnosis of definite MD is based on the 2 or more spontaneous episodes of vertigo with each lasting 20 minutes to 12 hours, low-to medium-frequency sensorineural hearing loss in one ear, fluctuating aural symptoms (fullness, hearing, tinnitus) located in the affected ear, and lack of data for other reasons for dizziness. There are no effective treatment for auditory disorders MD, therapy is aimed at preventing dizziness attacks. The first line of MD’s therapy includes a dietary salt restriction, the use of betahistine and diuretics. Betahistine (Betaserc) is usually used in a daily dose of 48 mg for 3–6 months to reduce the frequency of vertigo. For long-term treatment, it is convenient to use a betahistine modified-released (Betaserc Long) 48 mg, taken once a day. With the ineffectiveness of conservative therapy, other methods of therapy are possible: intratympanic administration of corticosteroids or gentamicin, labyrinthectomy or vestibular neurectomy. Unfortunately, many patients suffering from BM mistakenly makes a diagnosis of cerebrovascular disease, vertebrobasilar insufficiency, cervical osteochondrosis. Diagnostic errors are usually caused by the fact that the patients with MD are not conducted audiometry, vestibular tests, and the signs of cerebral microangiopathy identified when MRI brain are mistakenly regarded as confirmation of vascular dizziness genesis.

The level of peripheral myelin protein and vitamin D in blood serum among patients suffering diabetes mellitus type II and hearing impairment

The level of peripheral myelin protein and vitamin D in blood serum among patients suffering diabetes mellitus type II and hearing impairment

The correlation between neonatal parameters and late-onset inner ear disorders in congenital cytomegalovirus infection: a 10-year population-based cohort study.

To evaluate the correlation of neonatal parameters with late-onset sensorineural hearing loss (SNHL) and vestibular dysfunction in individuals with congenital cytomegalovirus (cCMV) infection using the National Health Insurance Research Database (NHIRD) in Taiwan. Retrospective cohort study. The whole Taiwanese population. Patients with related diagnostic codes and examinations in their records were regarded as having cCMV infection. Each subject in that group was matched to 10 control individuals with noncongenital CMV infection on the basis of several neonatal parameters, including low gestational age, low birth weight, low Apgar score, maternal history of CMV infection and prolonged cCMV infection. A total of 5893 and 58930 participants were enrolled in the study and control groups, respectively. The main outcomes were the development of SNHL and the development of vestibular dysfunction within one year after birth as reflected by diagnostic codes and specific examinations. Cox proportional hazard regression was used to calculate the adjusted hazard ratio (HR) and 95% confidence interval (CI) of each primary outcome between the two groups. Overall, 109 and 397 episodes of SNHL developed in the study group and the control group, respectively, and the study group demonstrated a significantly higher incidence of SNHL (adjusted HR: 2.56; 95% CI: 2.07-3.18). In addition, similar incidence rates of vestibular dysfunction were found in the study group and the control group, with 7 and 90 events, respectively (adjusted HR: 0.77; 95% CI: 0.36-1.67). In subgroup analyses, a higher incidence of SNHL was correlated with lower gestational age (GA) (adjusted HR: 2.09; 95% CI: 1.29-3.39), lower birth weight (BW) (adjusted HR: 2.05; 95% CI: 1.28-3.30) and prolonged cCMV infection (adjusted HR: 3.92; 95% CI: 1.95-7.88). Low GA, low BW and a long disease course are significantly correlated with late-onset SNHL in cCMV infection.

English

Chronic kidney disease (CKD) is becoming a major health concern due to its increasing incidence among adults. There are few studies that suggest the possible relation between hearing loss and chronic kidney disease. So far only a small number of large population - based studies have assessed the relation between CKD and hearing loss. The global prevalence of CKD was 9.1 % (697.5 million cases) in 2017. The age and sex wise global prevalence of CKD was higher in women (9.5 %) than in men (7.3 %). In India, prevalence of sensorineural hearing loss (SNHL) is around 28 % to 77 % among CKD patients. Studies found that the incidence was 77 % for mild to very mild hearing loss and the incidence was 46 % for moderate to severe hearing loss. Various theories behind SNHL in CKD patients are structural similarity between ear and kidney, increased blood viscosity because of hypertension and finally electrolyte imbalance which are all thought to play a role in development of SNHL in CKD patients. Major risk factors for SNHL in CKD patients are duration of CKD, hypertension, diabetes mellitus, serum urea and creatinine levels, electrolyte imbalance, packed cell volume (PCV), ototoxic drugs. CKD being a long-term illness and majority of cases of SNHL in CKD patients are permanent, it has a great negative impact on the patient’s quality of life adding to the disability burden.

Assessment of the health risk of workers in the extractive industries when exposed to noise above 80 Dba

Introduction. Currently, it is important to develop preventive measures aimed at preserving and strengthening the health of employees, including those developed taking into account the results of occupational risk. The aim of study is to calculate the individual health risk of workers in the mining and oil-producing industries caused by exposure to industrial noise, taking into account the severity of the disease. Materials and methods. Mathematical models reflecting the "exposure-response" relationship were used to assess the probability of responses from the impact of factors of the production environment and the labor process, as well as to determine the probability of deviation of predictor indicators. The individual health risk of employees was calculated by multiplying the probability of a response to its severity. For probable occupational diseases, the risk was calculated taking into account the probability of developing the disease in employees with a deviation of tread indicators. Results. The values of individual risk to the health of mining workers due to the development of sensorineural hearing loss ranged from 1.18∙10-2 to 1.46∙10-1. The risk to the health of oil industry workers caused by the occurrence of production-related arterial hypertension exceeds the permissible level of 13% of people from the observation group and ranges from 1∙10-3 to 24∙10-3. Conclusions. The analysis of changes in the value of occupational risk in employees over time, conducted on the basis of mathematical models, allows you to predict the long-term consequences associated with the impact of production factors. The results of this analysis can be used in the development of preventive measures at both the group and individual levels.

Revisiting short- and long-term outcome after fetal first-trimester primary cytomegalovirus infection in relation to prenatal imaging findings.

To determine the short- and long-term outcome of pregnancies with proven first-trimester fetal cytomegalovirus (CMV) infection in a large prospective cohort. This was a prospective cohort study of pregnancies with documented primary maternal CMV infection in the first trimester and evidence of fetal infection, referred for further evaluation between January 2011 and January 2018. Maternal serological diagnosis of primary CMV infection was documented by seroconversion. Vertical CMV transmission was identified by amniocentesis with polymerase chain reaction (PCR) for the CMV genome. After birth, fetal infection was re-tested by PCR in neonatal urine or saliva samples. All patients underwent serial prenatal ultrasound scans and fetal magnetic resonance imaging (MRI) at 32-33 weeks' gestation. All neonates underwent ocular fundus examination, an ultrasound brain scan and hearing evaluation, and were followed periodically for a median of 2 years (range, 6 months to 10 years). Follow-up information was obtained from hospital charts and by telephone interviews with parents. The CMV-associated outcomes assessed were sensorineural hearing loss (SNHL), neurodevelopmental abnormality, composite clinical outcome (including SNHL and neurodevelopmental abnormality) and composite outcome (additionally including termination of pregnancy (TOP)). The association between prenatal ultrasound or MRI findings and abnormal outcome was assessed. Primary CMV infection in the first trimester occurred in 123 patients. The rate of an abnormal ultrasound finding was 30.9%, and the rate of an abnormal MRI finding was 30.1% overall and 14.1% in the subgroup of patients with normal ultrasound. Of the 85 patients with normal ultrasound, 12 had an abnormal MRI finding, of whom five (5.9%) had true anatomical findings. Fifteen patients decided to terminate the pregnancy owing to abnormal prenatal findings on either ultrasound or MRI. Overall, the rate of CMV-associated postnatal and childhood sequelae was 27.8%, with a rate of 16.7% for SNHL and 11.1% for neurodevelopmental abnormalities, mostly slight motor or verbal delay. Approximately half of the cases with CMV-associated sequelae did not have any abnormal prenatal imaging findings. Abnormal prenatal findings on ultrasound were not associated significantly with SNHL, neurodevelopmental delay or composite clinical outcome (P = 0.084, 0.109 and 0.176, respectively), but they were associated with the composite outcome including TOP (P < 0.001). We identified a non-significant trend for a higher rate of SNHL in the group with abnormal ultrasound than in those with normal ultrasound. For abnormal MRI findings, we found a correlation only with neurodevelopmental abnormality and composite outcome (P = 0.014 and P < 0.001, respectively). The risk of childhood sequelae after first-trimester fetal CMV infection is most often associated with abnormal prenatal imaging findings. However, normal imaging does not rule out the development of SNHL and minor neurodevelopmental abnormalities. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Risk factors for bacterial infection to cause sensorineural hearing loss in eosinophilic otitis media

ObjectiveEosinophilic otitis media (EOM) is an intractable type of otitis media in which sensorineural hearing loss (SNHL) progresses over time. Clinically, bacterial infection complicates the course of EOM, making it challenging to control otorrhea/middle ear effusion (MEE) from infected ears, and accelerates the progression of SNHL. In this study, we focused on infection, one of the risk factors for SNHL in EOM, and analyzed factors associated with it. MethodsIn this cohort study, we evaluated 144 ears of 72 patients diagnosed with bilateral EOM. Patients visited our hospital once every 1–3 months and received intratympanic or systematic administration of steroids when otorrhea/MEE was observed. Several investigations, including blood tests, otorrhea/MEE cytology, bacterial culture tests, and respiratory function tests, were performed. In the otorrhea/MEE cytology, the leukocyte fraction was measured. ResultsTwo risk factors for SNHL in EOM were middle ear mucosal thickening (p <0.01) and infection (p <0.05). Compared to the group with <40% neutrophils in otorrhea/MEE samples, groups with 40–70% and ≥70% neutrophils had a significantly higher bone conduction hearing level (p <0.01, p <0.05, respectively). Two risk factors associated with the occurrence of infection in EOM were tympanic membrane (TM) perforation (p <0.01) and the coincidence of otorrhea/MEE and rhinorrhea in bacterial culture test results (p <0.001). A positive correlation was observed between TM perforation and infection (p <0.001). Our analysis of the relationship between the frequency of intratympanic corticosteroids administration and the time-period until the occurrence of TM perforation showed that >4 intratympanic administrations/year significantly increased the risk of perforation (p<0.001). Pseudomonas aeruginosa was isolated from otorrhea/MEE samples, while Pseudomonas aeruginosa and fungi, detected in cultures of rhinorrhea samples, were significantly related to the deterioration of bone conduction hearing levels. ConclusionThe risk factors associated with the occurrence of infection in patients with EOM were TM perforation and the coincidence of otorrhea/MEE and rhinorrhea in bacterial culture test results. Since TM perforation is likely to occur even due to intratympanic corticosteroids administration, it is necessary to confirm whether the frequency of treatment is appropriate and try a less invasive technique of administration. Furthermore, Pseudomonas aeruginosa infection poses a high risk for the development of SNHL, and clinicians should be alert to this possibility, even if the bacteria were identified only in cultures of rhinorrhea samples.

Blood genome expression profiles in infants with congenital cytomegalovirus infection

Congenital CMV infection (cCMVi) affects 0.5–1% of all live births worldwide, making it the leading cause of sensorineural hearing loss (SNHL) in childhood. The majority of infants with cCMVi have normal hearing at birth, but are at risk of developing late-onset SNHL. Currently, we lack reliable biomarkers to predict the development of SNHL in these infants. Here, we evaluate blood transcriptional profiles in 80 infants with cCMVi (49 symptomatic, 31 asymptomatic), enrolled in the first 3 weeks of life, and followed for 3 years to assess emergence of late-onset SNHL. The biosignatures of symptomatic and asymptomatic cCMVi are indistinguishable, suggesting that immune responses of infants with asymptomatic and symptomatic cCMVi are not different. Random forest analyses of initial samples in infants with cCMVi, irrespective of their clinical classification, identify a 16-gene classifier signature associated with the development of SNHL with 92% accuracy, suggesting its potential value as a biomarker.