The impact of rehabilitation on quality of life after hearing loss: a systematic review.

PURPOSE: Hearing loss is a major health problem and is associated with several negative outcomes such as difficulties in communicating and poor quality of life. The aim of this study was to conduct a systematic literature review to evaluate the impact of different types of hearing rehabilitation after hearing loss and their impact on quality of life. METHODS: A systematic literature search was conducted on Pubmed which retrieved 549 articles. Of these, 29 articles regarding cochlear implants, bone anchored hearing devices and traditional amplification hearing aids have been systematically reviewed. The search was limited to articles published from 1960/01/01 to 2017/05/22, included human participants and available in English. RESULTS: The main finding was that hearing rehabilitation is beneficial in all types of hearing loss and treatment regarding quality of life. However, bone-anchored hearing devices and cochlear implants were shown to produce greater improvements in terms of quality of life than conventional hearing aids. CONCLUSION: From these findings, we concluded that hearing rehabilitation does have a positive impact on quality of life after hearing loss.

Pseudoangiomatous stromal hyperplasia causing massive unilateral breast enlargement-a case report.

Background: Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon mesenchymal benign breast neoplasm. PASH may present as a rapidly growing mass in pre-menopausal women. It is important to rule out other causes of a breast lump including fibroadenoma, hamartoma, phyllodes tumour and invasive adenocarcinoma. To our knowledge this is the largest case of PASH tumour in the English literature and the first to be managed with mastectomy and immediate breast implant reconstruction. Case Description: A 45-year-old woman with a history of bilateral breast augmentation for cosmesis and no other co-morbidities, presented with gross asymmetry between her right and left breasts on 13th December 2020. She complained about pain and the noticeable difference in clothing. She underwent triple assessment (history and examination, imaging, and biopsy). Bilateral mammograms showed the right breast had a possible mass. On ultrasound imaging there was evidence of extensive ill-defined hypoechoic changes. Core biopsies and a vacuum assisted core biopsy were taken from the mass and came back as PASH/fibrocystic change on 12th January 2021. Surgical options were discussed, and after some consideration she decided on mastectomy and immediate implant reconstruction on 15th March 2021. She underwent the operation on 9th September 2021 and the specimen weight was 1.911 kg and measured 27 cm × 22.6 cm × 7.4 cm which is the largest reported PASH tumour. She made an uncomplicated recovery and was seen in clinic 4 weeks later and was happy with the cosmetic outcome. PASH can present as incidental microscopic foci in biopsies to diffuse enlargement of the breast. PASH has no specific radiological or diagnostic features, therefore is diagnosed based on histology. PASH is not associated with an increased risk of malignancy and the management is dependent on the presentation. When PASH is discovered incidentally or is asymptomatic it can be followed up with serial mammography to assess growth. If there are any suspicious features or discordance following triple assessment or symptoms such as discomfort surgical excision is indicated. Conclusions: PASH should be considered as part of the differential diagnosis for rapid breast enlargement. Treatment options should be discussed early with the patient to prevent progression. For rapid breast enlargement mastectomy and immediate reconstruction should be considered and discussed with the patient.

Prevalence of respiratory conditions among people who use illicit opioids: a systematic review.

BACKGROUND AND AIMS: There are growing concerns over the respiratory health of people who use illicit opioids due to high rates of opioid inhalation and tobacco smoking in this group. This study aimed to summarize the evidence relating illicit opioid use with poor respiratory health. METHODS: A systematic review of the literature on the association between illicit opioid use and respiratory health was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance (PROSPERO ID = CRD42017059953). Electronic searches of MEDLINE, Embase, PsycINFO, CINAHL and the Cochrane Library databases were undertaken (English language, published January 1980-November 2018). All study designs excluding case studies were considered. Studies were undertaken in community and hospital settings in the United States (n = 23), United Kingdom (n = 7), Australia (n = 7), the Netherlands (n = 2), Canada (n = 2), Ireland (n = 1), Spain (n = 1) and Iran (n = 1). Measurements of respiratory disease, including asthma and chronic obstructive pulmonary disease (COPD) and related symptoms were extracted. Data on respiratory-related deaths and hospital admissions were also extracted. Meta-analysis of prevalence data was undertaken using a random effects meta-analysis model with parameters estimated using Markov chain Monte Carlo simulation. RESULTS: Meta-analyses estimated prevalence of asthma in people who inject illicit opioids as 8.5% [95% predictive interval (PrI) = 0.2%, 74.0%] and as 20.2% (95% PrI = 4.2%, 59.2%) in people who inhale illicit opioids. Prevalence of COPD in people who inject illicit opioids was estimated as 2.7% (95% PrI = 0.0%, 50.4%) and as 17.9% (95% PrI = 0.6%, 89.5%) in people who inhale illicit opioids. There was evidence of moderate to extreme heterogeneity across studies. CONCLUSIONS: There is evidence of increased burden of respiratory diseases in people who use illicit opioids. Due to the heterogeneity of study design and samples, it is difficult to gain accurate estimates of the prevalence of respiratory disease in this population.

Generic Quality of Life in Persons With Hearing Loss: A Review of the Recent Literature.

BACKGROUND: It is unknown whether persons with hearing loss (HL) have reduced generic quality of life (QoL) and to what extent a hearing aid (HA) might improve QoL. The main aim of the study was to review studies about the relationship between HL and QoL. A supporting aim was to study the association between distress and HL. METHODS: Literature databases (CINAHL, Pub Med, and Web of Science) were searched for relevant articles published from January 2000 to March 17, 2016. A primary search was performed regarding the relationship between HL, HA, and QoL (search one) followed by a supporting search about the relationship between distress/mood/anxiety and HL (search two). After removing duplications and screening the titles of the articles, the abstracts of the remaining articles were read and those that met the inclusion criteria were included. RESULTS: The two searches yielded a total of 4,188 journal articles. Twenty journal articles were included in the present review: 13 from search one, and 7 from search two. The literature shows distressed persons tend to have a lowered generic QoL. Some studies suggest an improved generic QoL following the use of HA. Other studies suggest that HA use is one of several possible factors that contribute to improved generic QoL. CONCLUSION: Most of the studies suggest that HL is associated with reduced generic QoL. Using HA seems to improve general QoL. Further research is needed to explore the relationship between HL and generic QoL, in addition to the importance of influencing variables on this relationship.