Help For Hearing Loss Sufferers
There are several types and causes of hearing impairment. With conductive hearing impairment, sound waves are not transmitted completely from the outer and middle ear to the inner ear. This can occur when an eardrum is damaged as a result of an object being placed too far inside the ear, ear infections, a head injury, a sudden or extreme change in air pressure against the eardrum, or an explosion or gunshot. Conductive hearing problems can also occur because of abnormal development or growth of the ossicles, the tiny bones in the middle ear that work together to transmit sound from the eardrum to the inner ear. In sensorineural hearing impairment, the cochlea a tiny snail-shaped organ in the inner ear filled with liquid and covered with tiny hairs called cilia that stimulate nerves connected to the brain is damaged or destroyed, or there is a problem with the nerve connection from the cochlea to the brain. About 50 percent of cases of sen-sorineural deafness are the result of genetic...
The rediscovery of Mendel's laws about a century ago, and the knowledge that some congenital abnormalities were passed from parents to children, led to attempts to explain abnormalities in children based on genetic theory. However, Hale (1933) noticed that piglets born to sows fed a vitamin A-deficient diet were born without eyes. He concluded that a nutritional deficiency leads to a marked disturbance of the internal factors which control the mechanism of eye development. During a rubella epidemic in 1941, the Australian ophthalmologist Gregg observed that embryos exposed to the rubella virus often displayed abnormalities, such as cataracts, cardiac defects, deafness and mental retardation (Gregg 1941). Soon after it was discovered that the protozoon Toxoplasma, a unicellular parasite, could induce abnormalities such as hydrocephaly and vision disturbances in the unborn. These observations proved undeniably that the placenta is not an absolute barrier against external influences.
Albendazole is a highly effective broad-spectrum anthelmintic, structurally related to mebendazole. It also kills the parasite through inhibition of the glucose uptake. It is the first-line drug for the treatment of alveolar forms of echinococcosis (Echinococcus multilocularis), and also for the advanced cystic forms (Echinococcus granulosus). During a mass drug administration for lymphatic filiriasis in Ghana, 50 women were inadvertently (because their pregnancy was not recognized) treated with ivermectin and albendazole their pregnancy outcomes were compared with those of 293 women with a recognized pregnancy who were not treated. Of the 39 children who were exposed during the first trimester, 1 congenital malformation (a hearing impairment), versus 5 of the untreated group, was reported. The authors concluded that there was no evidence of increased risk after exposure to ivermectin and albendazole (Gyapong 2003). One Down syndrome was observed in a small prospective study of...
A single case of a female infant born at 36 weeks' gestation with multiple defects, including Ebstein's anomaly, was described in a 1989 report (12). In addition to the cardiac defect, other abnormalities noted were hypertelorism, epicanthal folds, low-set posteriorly rotated ears, a cleft uvula, medially rotated hands, deafness, and blindness. The mother had taken Lomotil (diphenoxylate and atropine) for diarrhea during the 10th week of gestation. Because exposure was beyond the susceptible stages of development for these defects, the drug combination was not considered causative. However, a possible viremia in the mother as a cause of the diarrhea could not be excluded as playing a role in the infant's anomalies.
There are about 28 publications about treatment during the second and third trimesters, administered as mono-drug Lherapy as well as multi-agent chemotherapy. Han (2005) reports two cases with apparently normal outcome after therapy with cisplatin, etoposide, and bleomycin. Ferrandina (2005) describes a healthy male premature baby after prenatal exposure to six cycles of cisplatin. Tomlinson (1997) reports a normal pregnancy using cisplatin and cyclophosphamide, and gives a summary on nine further cases, including a premature birth with neutropenia and reversible hair loss from day 10 onwards which had been exposed to cisplatin, bleomycin, and etoposide until 6 days prior to birth. At the age of 1 year, the child was apparently normal except for a moderate sensineural hearing loss bilaterally (Raffles 1989 see also case description in section 2.13.4). One case report describes a premature infant that developed cerebral atrophy with enlargement of the cerebral ventricles its mother had...
Recently, the possibility of a transgenerational effect of DES has been under discussion. Some studies have found an increased risk of hypospadias in the sons of women exposed to DES irt utero (Pons 2005, Klip 2002), but the results of an ongoing study of DES-exposed persons, with data from 3916 exposed and 1746 unexposed women, do not support this potential transgenerational effect (Palmer 2005). Likewise, following intrauterine exposure to DES there have been three cases of newborns with limb-reduction defects reported, and two cases with deafness in the second generation after intrauterine exposure to DES (Stoll 2003). Several mechanisms could be involved in this possible transgenerational effect, such as a genotoxic effect of DES upon the germ cells, or imprinting, or genetic or epigenetic changes in the primordial oocytes, among others. Nevertheless, more studies should be conducted to confirm this potential effect.
The immediate and long-term effects of perinatal infection are a major problem throughout the world. Perinatal infection is relatively common among the over 4 million births per year in the United States but the incidence is dependent upon the organism. One percent of newborn infants excrete cytomegalovirus. Fifteen percent are infected with Chlamydia trachomatis one-third develop conjunctivitis and one-sixth, pneumonia. One to eight per 1,000 live births develop bacterial sepsis. In utero or perinatal infection with herpes simplex virus, Toxoplasma gondii and varicella-zoster virus occurs in about 1 per 1,000 live births and the sequelae may be severe. In-utero acquired infection may result in resorption of the embryo, abortion, stillbirth, malformation, intrauterine growth retardation, prematurity, and the numerous untoward sequelae associated with chronic infection. Infection acquired at or soon after birth may lead to death or persistent postnatal infection. Some infections may be...
A hearing loss, or so-called sudden deafness, occasionally appears in the weeks after the birth. Therapeutically, intravenous hydroxy ethyl starch and other medications are proscribed that are said to promote circulation in the inner ear, None of these therapeutic measures have, as yet, been proven effective.
Often otitis media occurs because of clogging and dysfunction of the eustachian tubes due to viral infection and inflammation. The eustachian tubes are channels that normally allow air pressure to equalize between the middle ear and the throat. If they become clogged, air flow is poor and bacterial infection then can easily occur within the middle ear with buildup of pus and fluid pressure behind the eardrum. This prevents the eardrum from moving and vibrating normally, resulting in pain and often temporary hearing loss. Symptoms Symptoms include earache, fever, hearing loss, sometimes a discharge from the ear, and irritability. Infants and young children may grab or tug at their ears. These symptoms are often accompanied by signs of a respiratory infection, such as a runny or stuffy nose or a cough. Infections occurring in both ears are more likely to be viral infection of only one ear is more often due to a bacterial infection. Complications In some...
Complications If a pregnant woman becomes infected with the rubella virus, it can cause a miscarriage or stillbirth. If the fetus survives, the child may have retarded growth, retarded mental development, deafness, and birth defects of the heart, eyes, or brain. An estimated 10 percent of
Patients with many other monogenic forms of diabetes may occur in pregnant women (Table 61.3). In some patients the likelihood of pregnancy is reduced patients with severe insulin resistance may have reduced fertility as a result of the associated polycystic ovarian syndrome and some of the multi-system syndromes that include diabetes suffer from severe neurological defects. The commonest form of mono-genic diabetes in the diabetic pregnancy clinic outside the MODY genes is maternally inherited diabetes and deafness due to the mitochondrial 3243tRNA leucine mutation. Permanent neonatal diabetes has recently been shown to frequently result from mutations in the Kir6.2 gene. These are dealt with in more detail below. deafness (3243 mutation) Kir6.2 SUR1 permanent
Reports of long-term neurological deficits in the offspring of diabetic mothers include impaired visual motor function, Erb's palsy, seizure disorders, cerebral palsy, mental retardation, speech disturbances, reading difficulties, behavior disturbances and deafness.57-63 Mechanisms potentially involved in the occurrence of such problems are (1) birth trauma, especially trauma to the head and neck because of large infant size and shoulder dystocia 64 (2) prolonged, severe neonatal hypoglycemia, which may damage the central nervous system with potentially permanent deficits 65 (3) neonatal hyperbilirubinemia, which leads to kernicterus 57 and (4) abnormal fuel metabolism during gestation, which may cause long-term aberrations in neurological and psychological development.
If a pregnant woman is exposed to primary rubella infection, especially in the first trimester, the baby may be born with one or a number of serious clinical features, including deafness, retinopathy, encephalopathy, deafness or a heart defect. The risk of congenital abnormality is greatest if the fetus is exposed to infection during the first 8 weeks of pregnancy, and this is evident in 85 of such babies (Hull and Johnston 1993). The risk gradually reduces with increasing gestation and is negligible after 22 weeks of pregnancy. CMV is the most common intrauterine infection, occurring in 0.42.4 of all live births (Seidel et al. 1997). The virus persists after primary infection and can be reactivated. It is estimated that between 1 and 5 of pregnant women become infected, with approximately 50 of those pregnancies being affected by the virus. A wide range of malformations may be caused, including microcephaly, growth retardation and nerve deafness, but only 5 will have clinical signs...
Transient pancytopenia was reported in some children following exposure during the second third trimester (Hsu 1995, Murray 1994). One case report describes a premature baby that developed cerebral atrophy with enlargement of the cerebral ventricles its mother had been treated for an ovarian tumor and received 100mg m2 etoposide for 5 days in week 26 27 in combination with bleomycin and cisplatin (Flit 1999). Another premature baby (gestational age 27 weeks) whose mother had received multi-agent chemotherapy with etoposide, bleomycin, and cisplatin in week 26, developed severe leukopenia and anemia postnatally on day 3. At the age of 10 days, the infant was noted to be losing her scalp hair and there was an associated rapid loss of lanugo. Hair growth recovered after 12 weeks. Re-examination after a year showed normal neurodevelopmental progress, but there was moderate sensorineural hearing loss bilaterally (Rattles 1989).
Abnormalities described include abnonnalities of the central nervous system, e.g. agenesis of the corpus callosum, schizencephaly, meningocele, Dandy-Walker malformation, and optic atrophy, as welt as microcephaly, cerebral atrophy, hydrocephaly or ventriculomegaly, hearing loss, retardation, or slow development. Furthermore, there were a few cases reporting dysgenesis of the eye, cardiac defects (tetralogy of Fallot, persistent truncus arteriosus, and atrial septal defects), asplenia syndrome, absence of a kidney, cleft lip and palate, hypoplasia of the lungs with absence of the right diaphragm, and situs inversus. In addition, 13 cases of minor physical anomalies were reported, including low-set or poorly developed ears, a high-arched palate, hypertelorism, antimongoloid palpebral fissures, and widely spaced nipples.
Iodine needs increase during pregnancy for the synthesis of thyroid hormones. Maternal iodine deficiency during pregnancy can result in the enlargement of a woman's thyroid gland, development of goiter, and hypothyroidism. Maternal hypothyroidism increases the risk of a variety of poor fetal outcomes including stillbirth, spontaneous abortion, congenital anomalies, mental retardation, deafness, spastic dysplegia, and cretinism 3 . To avoid risk of harm to the fetus, maternal iodine deficiency should be corrected prior to conception.
Renal elimination of aminoglycosides is more rapid in pregnant women, and has been reported for gentamycin in obstetric patients by Zaske (1980). This may lead to subtherapeutic serum concentrations. Congenital hearing loss has been documented in association with prenatal exposure to streptomycin and kanamycin, but not with the use of gentamycin and tobramycin. However, a case of severe hearing loss after maternal use of gentamycin has been reported (Sanchez-Sainz-Trapaga 1998). The most sensitive period is the first 4 months of pregnancy.
This is very serious in the first trimester (Wang & Smaill 1989), with an 80 rate of infection in babies. Fetuses infected in the first 8 weeks run a high risk of abnormality, including eye defects and deafness. Spontaneous abortion may occur. Deafness can also occur with infection after 14 weeks. Intrauterine growth retardation is common and the baby may be born with abnormalities. It is important to note that a baby born with infection can excrete rubella in its urine for up to 10 years, and so can continue to be a risk to pregnant women. Women are screened antenatally for rubella and are offered rubella vaccination if they do not have immunity.
Quinine is the oldest antimalarial agent. It has a good and rapid sch-izonticide activity against the erythrocytic forms of all Plasmodium species. In spite of relatively high toxicity and a narrow therapeutic range, it is used more often for the treatment of chloroquine-resistant malaria today. Concentrations in the fetus are just as high as in the mother, and arc potentially toxic. There are some reports describing eye defects and hearing loss in children after use of quinine in pregnancy. However, in those cases considerably higher doses had generally been administered than are used nowadays for the treatment of acute malaria. There is no evidence of an increased risk of abortion or preterm delivery with the use of a standard dosage of quinine for treatment of acute malaria (Philips-Howard 1996). In a study on the use of quinine for the treatment of Plasmodium falciparum infection during the first trimester of pregnancy (n 165) these findings were confirmed, as no increased rates...
It is estimated that up to 3 infants per 1,000 born in the United States have significant hearing loss. Studies have shown, however, that significant hearing problems present at birth are often not diagnosed until the child's second or third year of life. This is unfortunate because the earlier a hearing loss is recognized and treatment is begun, the better the outlook for the child's learning and for development of speech and language skills.
Complications Most children completely recover from viral meningitis. Severe cases can result in seizures and intellectual, motor, hearing, visual, and psychiatric problems. In bacterial infections, the mortality rate in infants (after the newborn period) and children is 1 to 8 percent. Significant neurological and developmental problems occur in 10 to 20 percent of patients surviving the infection, including hearing loss, mental retardation, seizures, delay in speaking, visual impairment, and behavioral problems.
A dose-response relationship for the effects of methylmercury on adults has been established, with paresthesias occurring at the lowest levels. Ataxia, dysarthria, deafness, and eventually death manifest at progressively higher levels. Overt signs and symptoms of organic mercury poisoning generally take weeks or months to occur, even in cases of lethal doses.
Complications With congenital toxoplas-mosis, aside from premature birth and low birthweight, infants are also at risk for eye damage involving the retina. Some have brain and nervous system abnormalities that can result in seizures, limp muscle tone, feeding difficulties, hearing loss, and mental retardation. They may be born with an unusually small or large head (see Chapter 32, Health Problems in Early Childhood, for more information about hydrocephalus).
There is no single test for autism, and because the symptoms vary widely, it can be difficult to diagnose. The doctor will rule out other conditions that may be associated with similar symptoms such as hearing loss, speech problems, mental retardation, and other brain disorders.
Associated medical problems such as seizures, speech or communication problems, learning disabilities, and mental retardation. Other medical problems may include visual impairment or blindness, hearing loss, bladder and bowel difficulties, feeding and nutritional problems, aspiration (inhaling of food or fluid into the lungs), vomiting, tooth decay, sleep disorders, and behavior problems.
Infant with the CHARGE association. Occurrence is non-random and is characterized by coloboma, heart disease, atresia of the choanae, retarded postnatal growth and development, genitourinary anomalies, and ear anomalies and deafness. Most infants have some degree of mental deficiency. The coloboma commonly involves the retina but may range in severity from an isolated coloboma of the iris to anophthalmos. Figure 3.10. Infant with the CHARGE association. Occurrence is non-random and is characterized by coloboma, heart disease, atresia of the choanae, retarded postnatal growth and development, genitourinary anomalies, and ear anomalies and deafness. Most infants have some degree of mental deficiency. The coloboma commonly involves the retina but may range in severity from an isolated coloboma of the iris to anophthalmos.
Hearing Aids Inside Out
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