The Association between Aminoglycoside Exposure and Ototoxicity in Children with Cystic Fibrosis.

INTRODUCTION: Pulmonary exacerbations increase the requirement of aminoglycoside (AG) antibiotics in people with cystic fibrosis (pwCF). Several studies have shown that AGs have a cumulative effect on ototoxicity. We aimed to investigate the relationship between AG exposure and ototoxicity by using 3 different methods in patients with CF. MATERIALS/METHODS: The multicenter study included 121 pwCF aged between 5 and 18 years with a history of parenteral AG exposure. Standard pure-tone audiometry, extended high-frequency pure-tone audiometry (EHF-PTA), and distortion-product otoacoustic emissions (DPOAE) tests were performed. Mitochondrial mutation analysis for m1555G>A was performed in 61 patients. RESULTS: Median age was 12.85 years and 52.1% (n = 63) were male. 18.2% (n = 22) of the patients had received parenteral AGs more than 5 courses/lifetime. Ototoxicity was detected in at least one of the tests in 56.2% (n = 68) of the patients. Only 10.7% (n = 13) of the patients had reported a symptom indicating ototoxicity. 30.3% (n = 30) of the patients had ototoxicity in the low exposure group, while it was 45.5% (n = 10) in the high exposure group according to EHF-PTA (p > 0.05). Median number of parenteral amikacin courses was significantly higher in the ototoxic group (2 [1.25-5.75] vs. 2 [1-3]; p = 0.045). No m1555A>G mutation was detected in 61 patients who screened for mitochondrial mutation analysis. CONCLUSION: As AG ototoxicity occurs primarily at high frequencies, EHF-PTA is important in early detecting ototoxicity. EHF-PTA and DPOAE detected ototoxicity in some patients with normal PTA results. All pwCF with a history of AG exposure should be evaluated for hearing loss since symptoms may only be noticed in the late period.

Evaluation of patients' post-operative results operated for hip fracture with computerized dynamic posturography: Proximal femoral nailing versus hip arthroplasty.

BACKGROUND: Proximal femoral nailing (PFN) and hip arthroplasty (HA) are the two most often utilized surgical procedures for treating hip fractures in older patients. The post-operative postural balance and functional outcomes of patients may be significantly influenced by the technical distinctions between PFN and HA. This will influence the surgeon's preferred course of therapy. To examine the functional outcomes of patients treated with PFN and HA following a hip fracture, this study used computerized dynamic posturography (CDP). The aim of that study was to evaluate how the two treatment modalities affected patients' post-operative balance, postural stability, and functional rehabilitation. METHODS: A total of 26 patients who underwent proximal femoral surgery (15 patients PFN [58%] and 11 patients HA [42%]) due to hip fractures were evaluated at least 12 months postoperatively. They were tested by direct radiographs, hip joint examinations, Harris hip score (HHS), and CDP. RESULTS: Twelve (46%) of 26 patients were male and 14 (54%) were female. The mean age of the participants in the study was 67.9±14.2 years. The mean follow-up period was 24 (12-44) months. The average Harris score of PFN group was 79.3 (46.8-100) points and HA group was 83.7 (61.9-99.9) points. There was no significant difference between the groups in terms of Harris Score (P=0.54). The average of the mixed value of the balance results obtained with CDP (the Composite score) for PFN group was 70.5 (56-79) points, and for HA group was 71.9 (56-83) points. There was no significant difference between the groups in terms of the Composite Score (P=0.47). Accordingly, 12 (80%) of the patients who underwent PFN had good results and 3 (20%) of them had bad results. Eight (72.7%) of those who underwent HA had good results and 3 (27.3%) had bad results. There was no statistically significant difference (P=0.66). CONCLUSION: Comparing the composite score for balance results and HHS results for rehabilitation with the data of the patients who underwent PFN and HA, there was no statistically significant difference between these two techniques in terms of postural stabil-ity and balance as a result of CDP examination.

Evaluation of p300 and spectral resolution in children with attention deficit hyperactivity disorder and specific learning disorder.

This study aims to examine auditory processing, P300 values and functional impairment levels among children with Attention Deficit and Hyperactivity Disorder (ADHD), Specific Learning Disorder (SLD), ADHD+SLD and healthy controls. Children with ADHD (n = 17), SLD (n = 15), ADHD+SLD (n = 15), and healthy controls (n = 15) between the ages of 7-12 were evaluated with K-SADS, Weiss Functional Impairment Rating Scale, Turgay DSM-IV Disruptive Behavior Disorders Rating Scale, The Mathematics, Reading, Writing Assessment Scale and Children's Auditory Performance Scale (CHAPS). Auditory P300 event-related potentials and Spectral-Temporally Modulated Ripple Test (SMRT) were applied. Three patient groups were found to be riskier than healthy controls according to the CHAPS. There was no significant difference between the groups in the SMRT. In post-hoc analyses of P300 parietal amplitudes, ADHD, SLD, and ADHD+SLD were found to be significantly lower than the control group. The amplitudes of the ADHD+SLD were by far the lowest. It has been shown that auditory performance skills and p300 amplitudes are lower in children diagnosed with only ADHD or SLD compared to the control group, with the lowest values observed in ADHD+SLD. This study suggests that the difficulties with attention and cognitive functions in the ADHD+SLD are more severe than ADHD and/or SLD without comorbidity.

Direct Health Expenditure Analysis Related to Hearing Loss in Individuals Using Hearing Aids and Cochlear Implants.

Objective: This study aimed to investigate the expenditures related to hearing devices and compare the differences in expenditures in child and adult users. Methods: A preliminary questionnaire was developed and conducted amongst hearing aid and cochlear implant users. A total of 178 patients (57.3% were hearing aid users, 42.7% were cochlear implant users) were included in the study and grouped as adults (first group, 50 patients), and children 1< (second group, 123 patients). Results: The results of the study showed that individuals used approximately 4.5% of their annual income as health expenditure related to hearing loss. This rate was over 5% for child users, and about 2.7% for adult users. Moreover, the expenditure made by adult users was below the amount of expenditure made for children in all health expenditure indicators. Conclusion: Supporting the family budget for hearing loss expenditures not covered by the public health insurance will minimize the financial problems caused by the disability.

Comparison of Dynamic-Static Balance Parameters of Elite Ice Hockey Players and Normal Individuals.

INTRODUCTION: Our study aimed at stressing the significance of the vestibular system for ice hockey players, meanwhile focusing on the relation between the vestibular system and ice hockey for which balance is a significant factor. Our main aim was to compare the balance parameters of hockey players and normal individuals. METHODS: Our experimental group consisted of 37 professional elite ice hockey players, and our control group consisted of 37 young males who have not previously been involved in sports as professionals. Participants had been subject to sensor organization test, adaptation test, weight-bearing/squat, unilateral stance, rhythmic weight-shifting tests of computerized dynamic posturography device. RESULTS: Overall results indicate no significant difference between the control group and ice hockey players in the sensor organization test, which is caused by control group's comprising adolescents with amateur sport involvement. In adaptation test and unilateral stance test, a significant difference was found between experimental and control groups. DISCUSSION/CONCLUSIONS: This study determined the dynamic and static balance characteristics of ice hockey players. For this reason, it is useful to test the balance abilities of ice hockey players in static and dynamic conditions to evaluate their performance level. After testing individuals with vestibular problems with dynamic balance tests, appropriate sports exercises can be given to improve dynamic and static balance.