Articles

Background: Vitamin D deficiency in pregnancy increases several risks of breastfed mothers. To prevent these adverse events, vitamin D supplementation during pregnancy and lactation is recommended, but suggested dose ranges vary. Objective: To determine whether vitamin D3 1,800 IU/d supplementation in lactating mothers improves the vitamin D status of their breastfed infants. Materials and Methods: A randomized, placebo–controlled trial with Thai pregnant women was conducted. Lactating mothers (n=72) and their breastfed infants with insufficient maternal 25 hydroxyvitamin D (25(OH)D) levels in the third trimester were randomly assigned to two groups, one of which received 1,800 IU/d vitamin D supplementation and the other a placebo. Maternal serum 25(OH)D during lactation, cord blood, and 6-week breastfed infant serum were measured using LC-MS/MS. Results: Mean maternal age (±SD) was 27±5 years, and pre-gestational BMI was 22.29±5 kg/m2. Maternal serum 25(OH)D at baseline was 22.29±7.15 nmol/L. At 6 weeks, both maternal 25(OH)D and infant 25 (OH)D levels had increased significantly in the vitamin D supplement group of mothers and infants (68.30±15.40, 40.40±12.56 nmol/L) compared to those in placebo groups (55.15±13.57, 24.28±17.20 nmol/L) (p <0.001, p<0.001). The changes in infant 25(OH)D levels increased substantially in the vitamin D supplement group but decreased in placebo(17.49±16.27 ng/ml compared to -1.34±19.23 nmol/L in the placebo group, p<0.001). The change of maternal 25(OH)D were positively correlation to the change of 25(OH)D level in breastmilk mothers and infants by r=0.697, p<0.001 and r=0.379, p=0.003 respectively. Conclusions: Vitamin D3 supplementation to breastfed mother during lactation can increase serum 25(OH)D level in Thai breastfed mother and infants. Further work is needed to determine the optimum duration of vitamin D supplementation to normalized breastfed infants with 25(OH)D level >75 nmol/L.

Introduction: Lipoprotein (a) [Lp(a)] is a marker for cardiovascular disease, involved in pathogenesis and progression of atherosclerosis. In selected high-risk patients, lipoprotein-apheresis could optimize secondary prevention and improve prognosis. Aim: We presented the case of a 49-year-old man with high lipoprotein (a) levels and recurrent cardiac adverse events, despite maximal pharmacological therapy. Case report: Four years before the admission at our Centre, he presented an anterior STEMI, treated with angioplasty and implantation of a drug eluting stent on left anterior descending artery, at the age of 47 years, in September 2012; one month later, the patients presented a new episode of angina, and exams showed a critical stenosis in the right coronary artery, treated by angioplasty and implantation of drug eluting stent. Because of high Lp(a) plasma levels, patient was subsequently on regularly 7-10 day lipoprotein apheresis. Results and discussion: A thrombophilic screening was performed, showing the simultaneous presence of heterozygous V Leiden mutation and prothrombin G20210A mutation. He referred to our Centre in order to optimize therapy; we performed an endothelial function assessment showing a severe dysfunctional pattern. Because of these findings, we prescribed dual antiplatelet therapy, and we added omega-3 fatty acids and association with nicotinic acid/laropiprant. According with current guidelines, considering the high risk of bleeding, we preferred not to administer anticoagulant therapy. At 6-month and 1-year follow up the patient continued lipoprotein apheresis and was asymptomatic for other cardiovascular events. Conclusions: The assessment for the eventual presence of thrombophilia might become a useful tool in clinical practice for high-risk selected patients.

Noise is widespread in everyday life and can cause both auditory and non-auditory health impacts. Noise-induced hearing loss remains highly prevalent in occupational settings and is now increasingly caused by exposure to social and environmental noise. Incidence of noise-induced hearing loss (NIHL) has been observed to increase substantially in the recent years. Several advances have taken place in past few years for understanding the molecular basis of NIHL. Our understanding of molecular mechanisms implicated in noise-induced hair-cell and nerve damage has significantly increased. Research in the field of genetics is also advancing at a rapid speed, and several genes linked to NIHL have been discovered. This could help in developing preventive and treatment strategies. This review article focuses on the current research and future trends on auditory effects and consequences of noise pollution in humans, stressing the importance of adequate noise prevention and mitigation strategies as a public health measures.

The Sino-nasal outcome test (SNOT22) has been widely adopted in clinical practice and has been declared as the most suitable sinonasal outcome scoring system. It is simple disease specific encompassing 22 symptoms reflecting health burden of the rhino- logical patients. Each item quantifies symptoms severity from 0(no problem) to 5 (worst symptom). The sum of each item results in a maximum score of 110. High score indicates poor outcome.

The National Programme for Prevention and Control of Deafness (NPCD) was launched in 2006 by Government of India, but despite its phase wise implementation, the community oriented ear care has not been properly realized in view of existing IPHS Standards 2012 at PHC Level. So understanding of its real impact after implementation is desired. Therefore the Impact of Implementation status of community oriented ear care at the primary health system level on NPCD in India needs exploration.

Introduction: Disabling hearing loss refers to hearing thresholds superior than 40 dB in the better ear in the adults. The main cause of hearing loss in the elderly is the age-related hearing loss, also called presbycusis. This type of hearing impairment occurs as individuals grow older and is usually sensorineural hearing disorder greater for high-pitched sounds and affects both ears equally. It is estimated that 466 million people worldwide have disabling hearing loss, one third of which are over 65 years old. Objective: To analyze the prevalence of disabling hearing loss in the elderly of Juiz de Fora. Methods: Cross-sectional study with 122 patients. Pure tone audiometry was performed after meticulous physical examination of the external ear. Results: Out of 122 older adults, 85 (69,6%) presented disabling hearing loss. Conclusion: Hearing loss, specially disabling hearing loss, is a frequent condition in the elderly and has a big impact on their quality of life. For that it should be promptly diagnosed so treatment can be initiated.

Objective Study: Whether the narrow-band CE-Chirp ASSR test in the sound field is an objective evaluation method for the hearing aid compensation effect, and whether there is a difference in children with different hearing loss levels. Methods: 39 children (67 ears) wearing full digital hearing aids with good rehabilitation effect and ability to cooperate with behavioral audiometry were selected. The narrow-band CE-Chirp ASSR test group in the sound field was set as the experimental group, and the sound field behavioral audiometry after hearing aid was set as the control group. According to the degree of hearing loss, it was divided into moderate hearing loss group, severe hearing loss group and extremely severe hearing loss group. The difference between test results of experimental group and control group was compared. Results: There were no significant differences between the experimental group and the control group in the moderate hearing loss group and the extremely severe hearing loss group at 0.5, 1, 2, and 4kHz (P > 0.05). The results of the experimental group and the control group in the severe hearing loss group, There was no significant difference at 0.5, 1, 2kHz (P > 0.05), there was a significant difference at 4kHz (P < 0.05), and the mean difference was - 6.4dB HL. When the degree of hearing loss was not grouped, there was no significant difference between the experimental group and the control group at 0.5, 1, 2kHz (P > 0.05), 4kHz was significantly different (P < 0.05), and the mean difference was -3.2dB HL. Conclusion: It is clinically feasible to evaluate the hearing aid compensation effect of the narrow-band CE-Chirp ASSR in the hearing-impaired children. The grouping according to the degree of hearing loss can be more accurate in evaluating the hearing aid compensation effect. The narrow-band CE-Chirp in the sound field of children with moderate and very severe hearing loss ASSR results can be directly used to assess the hearing aid compensation effect, while children with severe hearing loss need to apply correction values at 4kHz.

Chronic rhinosinusitis (CRS) is an inflammatory condition involving nasal passages and the paranasal sinuses for 12 weeks or longer [1]. It can be subdivided into three types: CRS with nasal polyposis (CRS with NP), CRS without nasal polyposis (CRS without NP), and Allergic fungal rhinosinusitis (AFRS). To diagnose CRS we require at least two of four of its cardinal signs/symptoms (nasal obstruction, mucopurulent discharge, facial pain/pressure, and decreased sense of smell). In addition, direct visualization or imaging for objective documentation of mucosal inflammation is required. CRS therapy is aimed to reduce its symptoms and improve quality of life as it cannot be cured in most patients. Thus, the goals of its therapy include the following:

Subglottic hemangioma is the most common vascular tumor of the larynx of pediatrics; in contrast, it is relatively uncommon, accounting for an estimated 1.5% of congenital laryngeal anomalies [1].

To facilitate understanding some issues of cochlear implantation for new beginners we wrote 1- “The Instruction for audiologists and cochlear implanted patients” and created 2-Demo-program MIMIC. Here are opinions of readers of “The Instruction” and participants of MIMIC. All the ratings are from positive to enthusiastic.