Sudden sensorineural hearing loss: what can we learn from examining Reddit posts?

BACKGROUND: Many patients with sudden sensorineural hearing loss may seek hearing health information and social support online, although little is known about the online information seeking behaviour. OBJECTIVE: The present study aimed to examine the discussions around sudden sensorineural hearing loss in Reddit posts. METHOD: A total of 526 Reddit posts about sudden sensorineural hearing loss were extracted and analysed using qualitative and quantitative methods. RESULTS: The content analysis identified eight main categories. Most of the posts were on topics of: sharing personal experiences (34 per cent), describing symptoms (31 per cent), discussing treatment options (36 per cent) and discussing possible causes (19 per cent) of sudden sensorineural hearing loss. The sudden sensorineural hearing loss Reddit posts varied significantly in terms of linguistic variables when compared to baseline Reddit posts. Reddit posts by individuals with sudden sensorineural hearing loss had significantly higher engagement, higher authenticity and made more references to their body when compared to other users. CONCLUSION: The study results provide insights that can be helpful for professionals during clinical interactions.

Synthesis and pharmacology of site-specific cocaine abuse treatment agents: 2-(aminomethyl)-3-phenylbicyclo[2.2.2]- and -[2.2.1]alkane dopamine uptake inhibitors.

As part of a program to develop site-specific medications for cocaine abuse, a series of 2-(aminomethyl)-3-phenylbicyclo[2.2.2]- and -[2.2.1]alkane derivatives was synthesized and tested for inhibitory potency in [3H]WIN 35,428 binding and [3H]dopamine uptake assays using rat striatal tissue. Selected compounds were tested for their ability to substitute for cocaine in rat drug discrimination tests. Synthesis was accomplished by a series of Diels-Alder reactions, using cis- and trans-cinnamic acid derivatives (nitrile, acid, acid chloride) with cyclohexadiene and cyclopentadiene. Standard manipulations produced the aminomethyl side chain. Many of the compounds bound with high affinity (median IC50 = 223 nM) to the cocaine binding site as marked by [3H]WIN 35,428. Potency in the binding assay was strongly enhanced by chlorine atoms in the 3- and/or 4-position on the aromatic ring and was little affected by corresponding methoxy groups. In the [2.2.2] series there was little difference in potency between cis and trans compounds or between N, N-dimethylamines and primary amines. In the [2.2.1] series the trans exo compounds tended to be least potent against binding, whereas the cis exo compounds were the most potent (4-Cl cis exo: IC50 = 7.7 nM, 27-fold more potent than 4-Cl trans-exo). Although the potencies of the bicyclic derivatives in the binding and uptake assays were highly correlated, some of the compounds were 5-7-fold less potent at inhibiting [3H]dopamine uptake than [3H]WIN 35,428 binding (for comparison, cocaine has a lower discrimination ratio (DR) of 2.5). The DR values were higher for almost all primary amines and for the trans-[2.2.2] series as compared to the cis-[2.2.2]. Most of the compounds had Hill coefficients approaching unity, except for the [2. 2.2] 3,4-dichloro derivatives, which all had nH values of about 2.0. Two of the compounds were shown to fully substitute for cocaine in drug discrimination tests in rats, and one had a very long duration of action.

Cefuroxime axetil in the treatment of Salmonella typhi infection (enteric fever) in adults.

A study to evaluate the efficacy and safety of Cefuroxime Axetil in enteric fever was carried out in 30 adult hospitalised patients of either sex. A positive blood culture for S. typhi and sensitivity to cefuroxime axetil were confirmed prior to treatment. On admission, the baseline signs and symptoms were recorded and treatment initiated with cefuroxime axetil in a dose of 500 mg bd; which was continued for 7 days after normalization of temperature. The various clinical parameters were followed up daily during the treatment period and discharge permitted on normalization of temperature. Blood culture for S. typhi was repeated 3 days after stopping treatment. Follow-up Widal, stool and urine cultures were done wherever possible to check for relapse or carrier state. All the patients responded clinically to treatment and had bacteriologically negative blood cultures by the end of 14 days treatment. 87% of the patients responded within 7 days of treatment of which 60% were graded as Excellent responders as they responded within 4 days itself; while 13% took a longer time to respond. There were no relapses or carrier state as indicated by negative follow-up stool cultures. Only one patient reported a side-effect of mild headache confirming the safety of the drug. We conclude that Cefuroxime axetil in a dose of 500 mg bd is an effective and safe drug in the treatment of multi drug resistant enteric fever.

Cefoperazone monotherapy for serious infections in hospitalized patients--an initial Indian experience.

Cefoperazone sodium is a broad spectrum third generation Cephalosporin recently introduced in India. This was used as a monotherapy to treat severe infections in hospitalized patients. These infections were due to various gram positive and gram negative organisms. Of the 22 evaluable patients, 21 (95%) were clinically cured and 1 (5%) improved. 18 pathogens were isolated from 17 patients. Microbiologic eradication was 100%. Symptomatic improvement occurred within 48-72 hours of onset of therapy with complete relief by 4-5 days. Dual mode of excretion makes this drug safe in presence of renal insufficiency. Anti-microbial activity against a wide spectrum of organisms and twice daily dosage schedule qualify Cefoperazone as a single antibiotic of choice in severe infections in critically ill patients.

Corrected formula for estimating peripheral blood flow by impedance plethysmography.

In this paper, the limitations of the conventional formula for the computation of peripheral blood flow from impedance plethysmograms are highlighted, and a correction to the formula is suggested. A conductivity cell experiment is described to show the dependence of the value of the blood flow index (BFI), obtained from the conventional formula, on the mean resistivity of the cell. It is also shown that the value of the corrected BFI is independent of the mean resistivity. Anomalies observed in the amplitude of systolic waves in impedance plethysmograms of patients with oedema are explained.

Differential expression of the myocyte enhancer factor 2 family of transcription factors in development: the cardiac factor BBF-1 is an early marker for cardiogenesis.

In the present study, we have used single chicken blastoderms of defined early developmental stages, beginning with the prestreak stage, stage 1 (V. Hamburger and H. L. Hamilton, J. Morphol. 88:49-92, 1951), to analyze the onset of cardiac myogenesis by monitoring the appearance of selected cardiac muscle tissue-specific gene transcripts and the functional expression of the myocyte enhancer factor 2 (MEF-2) proteins. Using gene-specific oligonucleotide primers in reverse transcriptase PCR assay, we have demonstrated that the cardiac myosin light-chain 2 (MLC2) and alpha-actin gene transcripts appear as early as stage 5, i.e., immediately after the cardiogenic fate assignment at stage 4. Consistent with this observation is the developmental expression pattern of DNA-binding activity of BBF-1, a cardiac muscle-specific member of the MEF-2 protein family, which also begins at stage 5 prior to MEF-2. Differential expression of DNA-binding complexes is also observed with another AT-rich DNA sequence (CArG box) as probe, but the binding pattern with the ubiquitous TATA-binding proteins remains unchanged during the same developmental period. Thus, the cardiogenic commitment and differentiation of the precardiac mesoderm, as exemplified by the appearance of cardiac MEF-2, MLC2, and alpha-actin gene products, occur earlier than previously thought and appear to be closely linked. The onset of skeletal myogenic program follows that of the cardiogenic program with the appearance of skeletal MLC2 at stage 8. We also observed that mRNA for the MEF-2 family of proteins appears as early as stage 2 and that for CMD-1, the chicken counterpart of MyoD, appears at stage 5. The temporal separation of activation of cardiac and skeletal MLC2 genes, which appears immediately after the respective fate assignments, and those of cardiac MEF-2 and CMD-1, which occur before, are consistent with the established appearance of the myogenic programs and with the acquisition pattern of the two tissue-specific morphological characteristics in the early embryo. The preferential appearance of BBF-1 activity in precardiac moesderm, relative to that of MEF-2, indicates that these two protein factors are distinct members of the MEF-2 family and provides a compelling argument in support of the potential role of BBF-1 as a regulator of the cardiogenic cell lineage determination, while cardiac MEF-2 might be involved in maintenance of the cardiac differentiative state.

Multi drug resistant Salmonella typhi in Bombay.

An outbreak called 'Dombivali fever' started in March 1990 and spread rapidly all over Bombay and adjoining area. A concomitant and steady increase in multidrug resistant Salmonella typhi isolation was observed. Later this outbreak called 'Dombivali fever' was proved to be resistant typhoid fever only. The present paper deals with comparison of this outbreak with previous two years laboratory data from Sir J.J. Hospital, Bombay. A very high isolation rate of S. typhi (215 isolates) in 1990 as compared to 62 isolates in the last two years (1988-89), was observed in this laboratory. The incidence of multidrug resistance in cases of enteric fever (EF) was also very high (67.6%) in 1990, as compared to 6.2% in 1988 and 23.3% in 1989. All the strains tested in 1990 were sensitive to ciprofloxacin.

Impedance plethysmography of thoracic region: impedance cardiography.

Impedance plethysmograms were recorded from thoracic region in 254 normal subjects, 183 patients with coronary artery disease, 391 patients with valvular heart disease and 107 patients with congenital septal disorder. The data in 18 normal subjects and 55 patients showed that basal impedance decreases markedly during exercise in patients with ischaemic heart disease. Estimation of cardiac index by this technique in a group of 99 normal subjects has been observed to be more consistent than that of the stroke volume. Estimation of systolic time index from impedance plethysmograms in 34 normal subjects has been shown to be as reliable as that from electrocardiogram, phonocardiogram and carotid pulse tracing. Changes in the shape of plethysmographic waveform produced by valvular and congenital heart diseases are briefly described and the role of this technique in screening cardiac patients has been highlighted.

Effect of pulmonary circulation on vector impedance cardiogram.

Vector impedance cardiograms in horizontal lead configuration [VICG(H)] were recorded in 34 normal subjects, 18 patients with mitral stenosis, 9 patients with mitral regurgitation, 14 patients with aortic regurgitation and 13 patients with non- cyanotic septal disorders. Data in normal subjects revealed that most of the phase reversal points in VICG(H) waveform did not coincide with those of conventional impedance cardiogram. The shape of VICG(H) waveform and values of VICG indices were observed to be markedly affected in patients having significant alteration in the pulmonary circulation and the changes observed were specific of the type of the disorder. The results of the study suggested that right side of the heart had dominant contribution in generation of VICG(H) waveform.

Diagnosis of peripheral arterial occlusive diseases using impedance plethysmography.

Impedance plethysmographic observations have been compared with arteriographic findings in 216 patients with peripheral arterial occlusive diseases. Impedance plethysmographic diagnosis in these patients was obtained by Parulkar's method without apriori knowledge of arteriographic diagnosis. But for minor discrepancy in the anatomical location of the block in few patients, impedance plethysmographic observations correlated very well with arteriographic findings. Impedance plethysmographic diagnosis was found to be correct in 312, wrong in 53, false negative in 8 limbs respectively, yielding a sensitivity of 97.5% and specificity of 98.1% of this technique.

Impedance plethysmographic observations in thoracic outlet syndrome.

Forty patients with symptoms of neuro-vascular compression in the upper extremities were subjected to impedance plethysmographic study using Parulkar's method. Two patients recorded decreased blood flow (BFI) in supine position and were diagnosed as having partial occlusion at subclavian level. Sixteen of the patients recorded decreased BFI on 90 degrees abduction and hyper-abduction. Twelve of these patients had radiological evidence of anomalous cervicle ribs. In remaining four patients extrinsic impression on the subclavian artery due to fibrous deposits was confirmed by arteriography. Remaining 22 patients recorded normal impedance plethysmograms. Impedance plethysmography thus provided a non-invasive modality for confirmation of vascular compression in thoracic outlet syndrome.

Physiological correlates of impedance plethysmographic waveform.

A review of investigations into the origin of impedance plethysmographic waveform is presented in this article. Attempts made by several investigators in the comparison of impedance plethysmographic estimations of peripheral blood flow with that obtained by standard methods are briefly described. Investigations indicating the negligible contribution from contact impedance at body electrode interface are highlighted. Temporal correlation of impedance plethysmographic waveform recorded from thorax with various important events of the cardiac cycle is summarised and various hypotheses on the genesis of this waveform are presented.

Diagnosis of aortic occlusive diseases using impedance plethysmography.

Impedance plethysmographic observations have been correlated with aortographic observations in 57 patients suspected of aortic occlusive diseases. Aortic occlusions have been characterised by marked decrease in blood flow index and significant increase in differential pulse arrival time at thigh level bilaterally. Atherosclerotic affection of the aorta has been featured by a bilateral decrease in the value of blood flow index as well as differential pulse arrival time at thigh level. Leriche's syndrome, however, has been found to decrease the blood flow index moderately at thigh in both the legs without any significant change in differential pulse arrival time. Aortography in all the patients has confirmed the diagnosis made by impedance plethysmography.

Expression of the murine interferon gamma receptor in Xenopus laevis oocytes.

This study describes the isolation of mRNA for the murine interferon gamma receptor and its expression in frog oocytes. The binding properties and apparent molecular weight of the murine interferon gamma receptor protein synthesized in frog oocytes is similar to that found on mouse cells. This is the first report of a functional receptor for a polypeptide ligand (interferon gamma) expressed in and directly assayed on frog oocytes.

Insulin induction of Xenopus laevis oocyte maturation is inhibited by monoclonal antibody against p21 ras proteins.

Microinjection of transforming p21 ras protein induces maturation of Xenopus laevis oocytes, and the induction is blocked by coinjection of monoclonal antibody (Y13-259) against p21 ras proteins. Similar to other inducing agents, the effect of p21 ras protein is mediated via the appearance of maturation or meiosis-promoting factor activity. In addition, the neutralizing antibody markedly reduces oocyte maturation after insulin induction, whereas it fails to inhibit progesterone induction. Our results suggest that insulin induces maturation of oocytes via a different pathway than that of steroidal agents. The induction by insulin is ras dependent, and the action of ras may be directed at the steps before meiosis-promoting factor autocatalytic activation. These results suggest a role of p21 ras protein in the events associated with amphibian oocyte maturation.