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1.
Chin J Physiol ; 64(2): 61-71, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33938816

RESUMO

Clinically typical dementia Alzheimer's disease (AD) is associated with abnormal auditory processing. However, possible molecular mechanisms responsible for the auditory pathology of AD patients are not known. According to our past research findings that the thresholds of auditory brainstem response, but not distortion product otoacoustic emissions, were significantly increased in AD mice from 9 months of age and thereafter. Thus, we further explored the possible mechanism of auditory degradation of 3×Tg-AD mice in this study. Our histochemical staining evidence showed the cochlear spiral ganglion neurons (SGN), but not the cochlear hair cells, were lost significantly in the cochlea of 3×Tg-AD mice from 9 months of age and thereafter. Our immunostaining and western blotting evidence showed that phosphorylated tau protein (p-Tau), p-glycogen synthase kinase 3, neurofilament, and apoptosis-related p53, Bcl2-associated X protein, cytochrome c, caspase-9, and caspase-3 were gradually increased, but B-cell lymphoma 2 was gradually decreased with age growth in the cochlea of 3×Tg-AD mice. We suggested that tau hyperphosphorylation and p-Tau 181 aggregation, and mitochondria- and endoplasmic reticulum stress-mediated apoptosis may play a role in the degeneration of SGN in the cochlea. Progressive SGN degeneration in the cochlea may contribute to hearing loss of aging 3×Tg-AD mice.


Assuntos
Doença de Alzheimer , Perda Auditiva , Animais , Apoptose , Modelos Animais de Doenças , Humanos , Camundongos , Camundongos Transgênicos , Fosforilação , Gânglio Espiral da Cóclea
2.
BMJ Case Rep ; 14(4)2021 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-33863766

RESUMO

Hearing loss is an unusual presenting feature of Cryptococcus gattii meningoencephalitis. Two cases of HIV-negative patients who presented with hearing loss are discussed and a literature review of published cases was conducted. Possible mechanisms for hearing loss with C. gattii infection are explored. This case series aims to raise awareness among clinicians that hearing loss can be a concerning feature in patients with persistent headache necessitating further investigation.


Assuntos
Criptococose , Cryptococcus gattii , Perda Auditiva , Meningoencefalite , Criptococose/complicações , Criptococose/diagnóstico , Cryptococcus gattii/isolamento & purificação , Perda Auditiva/microbiologia , Humanos , Meningoencefalite/complicações , Meningoencefalite/diagnóstico
3.
Medicine (Baltimore) ; 100(17): e25647, 2021 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-33907123

RESUMO

ABSTRACT: To understand the possible carrier status of genes associated with hereditary hearing loss (HHL) in the general population among local residents and to give genetic counseling for pregnant women.A total of 3541 subjects were recruited. We used multiplex PCR technology combined with next-generation sequencing technology to detect 100 hotspot mutations in 18 common deafness-related genes. The homozygous mutation screening results were verified using Sanger sequencing.Of the 3541 participants, 37 alleles of 8 deafness genes were detected. A total of 145 (4.09%) were found to be GJB2 gene mutation carriers, and the hotspot mutation was c.235delC (1.54%). Twenty three (0.65%) were found to be GJB3 gene mutation carriers. A total of 132 (3.37%) were found to be SLC26A4 gene mutation carriers, and the hotspot mutation was c.919-2A > G (0.49%). Forty four (1.24%) were found to be mitochondrial DNA mutation carriers. Sanger sequencing results verified that 2 cases were homozygous for the c.235delC mutation and that 1 case was homozygous for the c.754T > C mutation.Genetic testing for pregnant women and their partners allows early identification of the molecular etiology of hearing loss (HL). On the one hand, it could give genetic counseling for pregnant women, such as early diagnosis of delayed deafness and drug-susceptible deafness. On the other hand, it could be used to assess hearing conditions during pregnancy, leading to prevention and timely intervention for newborns.


Assuntos
Testes Genéticos/métodos , Perda Auditiva/diagnóstico , Perda Auditiva/genética , Diagnóstico Pré-Natal/métodos , Adulto , Alelos , Grupo com Ancestrais do Continente Asiático/genética , China , Conexina 26/genética , Conexinas/genética , Análise Mutacional de DNA , DNA Mitocondrial/genética , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Recém-Nascido , Masculino , Proteínas de Membrana/genética , Reação em Cadeia da Polimerase Multiplex , Mutação , Gravidez , Transportadores de Sulfato/genética
4.
Vestn Otorinolaringol ; 86(2): 4-9, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33929144

RESUMO

PURPOSE OF THE STUDY: To evaluate the effectiveness of the application of the web application "Automated system of primary hearing assessment" created by us for the diagnosis of hearing impairment in different age groups. MATERIAL AND METHODS: With the help of this web application, 712 patients were examined in 3 age groups: group 1 - patients aged 18 to 44 years, 196 people (average age 25.6±2.7 years), group 2 - patients aged 45 to 59 years, 265 people (mean age 46.3±3.6 years), 3rd group - patients 60 years old and older, 251 people (mean age 75.4±1.1 years). RESULTS: It was revealed that 61.8% of patients had risk factors for the development of hearing loss. In the 1st age group, one risk factor for hearing loss prevailed, in the 2nd and 3rd groups, up to 5-9 factors were simultaneously combined. Clinically significant hearing loss was found in 24.3% of patients. Hearing studies at frequencies of 10 and 12 kHz revealed latent hearing loss in 31.3% of patients, 57% of them had risk factors for the development of hearing loss. Comparative analysis in the groups showed that hearing impairment at high frequencies was found in 47.4% of patients in older age groups and in 15.8% of young people. The possibility of performing otoscopy images made it possible to identify changes in the tympanic membrane in 17.1% of patients, to give a correct conclusion about the state of their hearing and to propose an algorithm for further examination. It was found that the sensitivity of the study in the web application was 98%, the specificity - 99.9%. FINDINGS: The use of the web application allows assessing the risk factors for the development of hearing loss, identifying patients with latent hearing loss, objectifying the study with otoscopy images, and remotely obtaining a conclusion about the state of hearing from a specialist doctor.


Assuntos
Perda Auditiva , Adolescente , Adulto , Idoso , Audição , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Testes Auditivos , Humanos , Pessoa de Meia-Idade , Otoscopia , Membrana Timpânica , Adulto Jovem
5.
Vestn Otorinolaringol ; 86(2): 28-32, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33929148

RESUMO

THE AIM OF THE STUDY: To assess speech recognition in users of mono- and binaural hearing aids (HA) with dynamic environment control system (DECS). MATERIAL AND METHODS: 25 HA users with symmetrical bilateral moderate to severe sensorineural hearing loss and 10 individuals with normal hearing underwent speech audiometry in a free sound field by listening to an adaptive Russian matrix sentence test with a background noise. The testing was conducted for hearing impaired patients with one and two HA. The Speech Recognition Thresholds in noise (SRTN) using HA with DESC and using HA without DESC were compared. The dichotic digits test and the rapidly alternating speech perception test were performed to evaluate the central auditory system function. RESULTS: The SRTN in normal hearing listeners was -16.4±1.9 dB SNR. In the case of monaural using HA without DESC the SRTN was -2.5±4.4 dB SNR, using HA with DESC it was -5.8±4.0 dB SNR; in the case of using binaural HAs it was -6.3±3.8 dB SNR and -9.9±3.1 dB SNR accordingly. CONCLUSIONS: HAs with Dynamic Environment Control System are highly effective for speech perception in noisy environments. Binaural HA use is more effective than monaural HA use regardless of HA model. Speech recognition in noisy environments in cases of binaural HA use correlates significantly with results of tests assessing the central auditory system function.


Assuntos
Auxiliares de Audição , Perda Auditiva Neurossensorial , Perda Auditiva , Percepção da Fala , Limiar Auditivo , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/terapia , Humanos , Ruído/efeitos adversos , Federação Russa
7.
Artigo em Chinês | MEDLINE | ID: mdl-33832190

RESUMO

Objective: To investigate the clinical effects of single-stage auricular reconstruction and hearing rehabilitation in children with microtia and external auditory canal atresia. Methods: Sixty eight cases of microtia with external auditory canal atresia (53 males and 15 females, age from 7 to 12 years, with a median age of 8.8 years), who received operations in Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine from July 2017 to December 2019 were collected.A total of 28 cases received auricle reconstruction with high-density polyethylene (Medpor) framework and hearing reconstructions, among which 20 patients received the traditional external auditory canal and middle ear repair (EACR), and eight patients were implanted bone conduction device bone bridge(BB) simultaneously.In the control group, 40 patients only received Medpor frame implantation for auricle plasty. Postoperative changes in auricle morphology and auditory function and postoperative complications were evaluated. Results: After three to thirty months follow-ups, the auricles shape recovered well in all three groups. The average scores of 14 fine structures in the auricles were 9.43(EACR) and 10.67(BB) points. The average score of auricle symmetry were 6.83(EACR) and 6.00(BB) points. There was no significant difference compared to the auricle reconstruction group (8.23/6.20 points). P>0.05. After surgery, the average hearing improvement in the BB group was 43.33 dB HL and the average speech recognition threshold declined 42.28 dB HL. In the EACR group, the average hearing improvement was 4.13 dB HL and the average speech recognition threshold declined 11.36 dB HL. No vertigo, tinnitus, cerebrospinal fluid leakage and other complications occurred in all the patients. In the EACR group, sensorial hearing loss, auricle stent fracture, ear canal restenosis and ear canal atresia occurred in one patient respectively. In the auricle group, one auricle stent exposure and one facial branch nerve injury occurred. Nearly ten patients had difficulty in hair growth at scalp incisions. Conclusions: The operation of single-stage auricular reconstruction and hearing rehabilitation for microtia is feasible. The methods of hearing reconstruction should be determined by evaluating the development of the inner and middle ear of the patients. For those with poor mastoid development, bone bridge implantation is recommended to achieve a stable and significant hearing effect.


Assuntos
Microtia Congênita , Perda Auditiva , Procedimentos Cirúrgicos Reconstrutivos , Criança , China , Microtia Congênita/cirurgia , Feminino , Audição , Perda Auditiva/reabilitação , Humanos , Masculino , Polietilenos
9.
Artigo em Chinês | MEDLINE | ID: mdl-33794621

RESUMO

Hereditary deafness is divided into syndromic hearing loss and non-syndromic hearing loss according to whether it is accompanied by other system dysfunction. The early identification and diagnosis of syndromic hearing loss is very important, including clinical and molecular diagnosis. Early diagnosis can predict the progress of hearing loss, other systemic disorders and guide treatment. Thus otolaryngologists are likely to become the first doctors to treat children with syndromic hearing loss, it is more necessary to master the clinical and molecular diagnosis methods of common syndromic hearing loss, and cooperate with doctors of other relevant departments for early intervention and treatment. Therefore, this article reviewed the common features, molecular diagnostic methods and treatment strategies for syndromic hearing loss.


Assuntos
Surdez , Perda Auditiva Neurossensorial , Perda Auditiva , Criança , Perda Auditiva/diagnóstico , Perda Auditiva/terapia , Humanos , Mutação , Síndrome
10.
Arch. argent. pediatr ; 119(2): 123-128, abril 2021. tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1151871

RESUMO

Introducción. Los obstáculos en la comunicación entre médicos y personas sordas/hipoacúsicas pueden comportarse como factores de riesgo para la salud. El servicio de un intérprete profesional de Lengua de Señas Argentina (IPLSA), según la Ley N.º 26378, podría mitigar esto.Objetivo. Estimar la proporción de pediatras que conocen la Ley N.º 26378 y explorar si se asocia a recomendar a un IPLSA.Población y métodos. Estudio transversal con cuestionario electrónico autoadministrado a pediatras registrados en la Sociedad Argentina de Pediatría, que ejercían en la Ciudad Autónoma de Buenos Aires.Resultados. Se evaluaron 381 respuestas. El 15,1 % conocía la Ley, y esto se asoció con recomendar a un IPLSA (OR: 3,7; IC 95 %: 1,1-12,9; p < 0,05).Conclusiones. La proporción de pediatras de la Ciudad Autónoma de Buenos Aires que conocía la ley fue el 15,1 %. Esto se asoció significativamente con recomendar a un IPLSA


Introduction. Barriers in communication between physicians and Deaf or hard of hearing people may be risk factors for health. The services of a professional Argentine Sign Language interpreter (PASLI), by virtue of Act No. 26378, may mitigate this.Objective. To estimate the proportion of pediatricians who have knowledge of Act No. 26378 and whether this is associated with the recommendation of a PASLI.Population and methods. Cross-sectional study with a self-administered electronic questionnaire among pediatricians members of the Sociedad Argentina de Pediatría who practiced in the Autonomous City of Buenos Aires (CABA).Results. A total of 381 surveys were assessed. Of these, 15.1 % knew the Act, and this was associated with the recommendation of a PASLI (OR: 3.7; 95 % CI: 1.1-12.9; p < 0.05).Conclusions. The proportion of pediatricians working in CABA who knew the Act was 15.1 %. This was significantly associated with the recommendation of a PASLL.


Assuntos
Humanos , Línguas de Sinais , Comunicação , Direito Sanitário , Argentina , Relações Médico-Paciente , Conscientização , Epidemiologia Descritiva , Estudos Transversais , Inquéritos e Questionários , Perda Auditiva
11.
BMJ Case Rep ; 14(4)2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33811095

RESUMO

Chronic otorrhoea from a tympanic membrane perforation is common. We present the case of a patient who had already received seemingly adequate treatment for his condition in the past. Yet, he presented to our outpatient clinic with worsening otalgia and otorrhoea, progressive hearing loss and a new tympanic membrane perforation. After a thorough otological evaluation, the patient's medical history and the histological specimen from a previous operation were reviewed. The findings met the diagnostic criteria of eosinophilic otitis media. After treatment with topic triamcinolone through the perforated tympanic membrane, the patient's otalgia subsided, hearing levels were improved and the size of the tympanic membrane perforation decreased.


Assuntos
Perda Auditiva , Otite Média Supurativa , Otite Média , Perfuração da Membrana Timpânica , Timpanoplastia , Antibacterianos/uso terapêutico , Doença Crônica , Dor de Orelha/etiologia , Perda Auditiva/tratamento farmacológico , Perda Auditiva/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Otite Média/tratamento farmacológico , Otite Média Supurativa/complicações , Otite Média Supurativa/tratamento farmacológico , Otite Média Supurativa/cirurgia , Resultado do Tratamento , Perfuração da Membrana Timpânica/tratamento farmacológico , Perfuração da Membrana Timpânica/cirurgia
12.
Yonsei Med J ; 62(5): 446-452, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33908216

RESUMO

PURPOSE: To investigate the relationship between hearing loss and cognitive disorder with memory dysfunction in South Korea using data from the Korean Health Insurance claims database for 2009-2015. MATERIALS AND METHODS: We analyzed cross-sectional data of 66-year-old individuals who completed the Korea National Health and Nutrition Examination Surveys. Auditory function was evaluated using pure-tone audiometric testing. Cognitive disorder with memory dysfunction was assessed using standardized scores of the Prescreening Korean Dementia Screening Questionnaire. RESULTS: Among 1815835 participants at the age of 66 years, the prevalence of unilateral hearing loss was 5.84%, and that of bilateral hearing loss was 3.40%. The normal cognitive group comprised 86.35% of the participants, and the high-risk group for cognitive disorder with memory dysfunction totaled 13.65% of the participants. The bilateral hearing loss group had the highest percentage of subjects who responded "sometimes or frequently" to all five questions about cognitive disorder with memory dysfunction, compared to the normal hearing group or the unilateral hearing loss group. After adjusting for sex, smoking status, alcohol intake, exercise, income, diabetes, hypertension, dyslipidemia, and depression, the odds ratios for cognitive disorder with memory dysfunction was 1.183 [95% confidence interval (CI): 1.163-1.203] for bilateral hearing loss and 1.141 (95% CI: 1.126-1.156) for unilateral hearing loss, compared to the normal cognitive group. CONCLUSION: Hearing loss has a significant effect on cognitive function in the Korean population. In our study, individuals with bilateral hearing loss showed poorer cognitive function than those with unilateral hearing loss.


Assuntos
Perda Auditiva , Idoso , Audiometria de Tons Puros , Cognição , Estudos Transversais , Perda Auditiva/epidemiologia , Humanos , Prevalência , República da Coreia/epidemiologia
13.
Int J Mol Sci ; 22(6)2021 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-33799353

RESUMO

The identification of pathogenic variants in monogenic diseases has been of interest to researchers and clinicians for several decades. However, for inherited diseases with extremely high genetic heterogeneity, such as hearing loss and retinal dystrophies, establishing a molecular diagnosis requires an enormous effort. In this review, we use these two genetic conditions as examples to describe the initial molecular genetic identification approaches, as performed since the early 90s, and subsequent improvements and refinements introduced over the years. Next, the history of DNA sequencing from conventional Sanger sequencing to high-throughput massive parallel sequencing, a.k.a. next-generation sequencing, is outlined, including their advantages and limitations and their impact on identifying the remaining genetic defects. Moreover, the development of recent technologies, also coined "third-generation" sequencing, is reviewed, which holds the promise to overcome these limitations. Furthermore, we outline the importance and complexity of variant interpretation in clinical diagnostic settings concerning the massive number of different variants identified by these methods. Finally, we briefly mention the development of novel approaches such as optical mapping and multiomics, which can help to further identify genetic defects in the near future.


Assuntos
Proteínas do Olho/genética , Perda Auditiva/diagnóstico , Patologia Molecular , Distrofias Retinianas/diagnóstico , Heterogeneidade Genética , Perda Auditiva/genética , Perda Auditiva/patologia , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Mutação/genética , Distrofias Retinianas/genética , Distrofias Retinianas/patologia
14.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48066

RESUMO

Quase 2,5 bilhões de pessoas em todo o mundo ─ ou uma cada quatro pessoas ─ viverão com algum grau de perda auditiva até 2050, adverte o primeiro Relatório Mundial sobre Audição da Organização Mundial da Saúde (OMS), divulgado nesta terça-feira (2).


Assuntos
Perda Auditiva/etiologia , Organização Mundial da Saúde , Audição
15.
JAMA ; 325(12): 1223-1224, 2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33755065
16.
JAMA ; 325(12): 1224-1225, 2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33755069
17.
Trends Hear ; 25: 2331216520986303, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33663298

RESUMO

Residual inhibition, that is, the temporary suppression of tinnitus loudness after acoustic stimulation, is a frequently observed phenomenon that may have prognostic value for clinical applications. However, it is unclear in which subjects residual inhibition is more likely and how stable the effect of inhibition is over multiple repetitions. The primary aim of this work was to evaluate the effect of hearing loss and tinnitus chronicity on residual inhibition susceptibility. The secondary aim was to investigate the short-term repeatability of residual inhibition. Residual inhibition was assessed in 74 tinnitus subjects with 60-second narrow-band noise stimuli in 10 consecutive trials. The subjects were assigned to groups according to their depth of suppression (substantial residual inhibition vs. comparator group). In addition, a categorization in normal hearing and hearing loss groups, related to the degree of hearing loss at the frequency corresponding to the tinnitus pitch, was made. Logistic regression was used to identify factors associated with susceptibility to residual inhibition. Repeatability of residual inhibition was assessed using mixed-effects ordinal regression including poststimulus time and repetitions as factors. Tinnitus chronicity was not associated with residual inhibition for subjects with hearing loss, while a statistically significant negative association between tinnitus chronicity and residual inhibition susceptibility was observed in normal hearing subjects (odds ratio: 0.63; p = .0076). Moreover, repeated states of suppression can be stably induced, reinforcing the use of residual inhibition for within-subject comparison studies.


Assuntos
Perda Auditiva , Zumbido , Estimulação Acústica , Perda Auditiva/diagnóstico , Testes Auditivos , Humanos , Ruído , Zumbido/diagnóstico , Zumbido/terapia
18.
Trends Hear ; 25: 2331216521990288, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33787404

RESUMO

Ecological momentary assessment (EMA) was used in 24 adults with mild-to-moderate hearing loss who were seeking first hearing-aid (HA) fitting or HA renewal. At two stages in the aural rehabilitation process, just before HA fitting and after an average 3-month HA adjustment period, the participants used a smartphone-based EMA system for 3 to 4 days. A questionnaire app allowed for the description of the environmental context as well as assessments of various hearing-related dimensions and of well-being. In total, 2,042 surveys were collected. The main objectives of the analysis were threefold: First, describing the "auditory reality" of future and experienced HA users; second, examining the effects of HA fitting for individual participants, as well as for the subgroup of first-time HA-users; and third, reviewing whether the EMA data collected in the unaided condition predicted who ultimately decided for or against permanent HA use. The participants reported hearing-related disabilities across the full range of daily listening tasks, but communication events took the largest share. The effect of the HA intervention was small in experienced HA users. Generally, much larger changes and larger interindividual differences were observed in first-time compared with experienced HA users in all hearing-related dimensions. Changes were not correlated with hearing loss or with the duration of the HA adjustment period. EMA data collected in the unaided condition did not predict the cancelation of HA fitting. The study showed that EMA is feasible in a general population of HA candidates for establishing individual and multidimensional profiles of real-life hearing experiences.


Assuntos
Correção de Deficiência Auditiva , Auxiliares de Audição , Perda Auditiva , Adulto , Avaliação Momentânea Ecológica , Perda Auditiva/diagnóstico , Testes Auditivos , Humanos
19.
Anticancer Res ; 41(3): 1439-1444, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33788735

RESUMO

BACKGROUND/AIM: Chemopreventative therapeutics may be helpful in familial adenomatous polyposis (FAP) management; however, prospective chemopreventative studies are complicated by potential ototoxicity and pre-existing hearing loss. The aim of this study was to establish and compare baseline hearing status of children and adolescents with FAP and their unaffected siblings. PATIENTS AND METHODS: Twenty FAP pediatric patients with documented mutation of the adenomatous polyposis coli (APC) gene and nine unaffected sibling controls underwent baseline hearing evaluation, including audiometry, speech perception testing, and middle and inner ear physiologic measures. Results of the FAP cohort were compared to the unaffected sibling cohort. RESULTS: Two (5%) children with FAP presented with baseline hearing loss of unknown etiology, likely unrelated to their FAP diagnosis. No significant differences were found in any of the hearing measures between groups. CONCLUSION: Mutation of the APC gene is not necessarily indicative of higher risk for baseline hearing loss in the pediatric population.


Assuntos
Proteína da Polipose Adenomatosa do Colo/genética , Polipose Adenomatosa do Colo/genética , Perda Auditiva/genética , Audição/genética , Mutação , Polipose Adenomatosa do Colo/fisiopatologia , Adolescente , Audiometria/métodos , Criança , Estudos de Coortes , Feminino , Testes Auditivos , Humanos , Masculino , Fatores de Risco , Irmãos
20.
BMC Infect Dis ; 21(1): 254, 2021 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-33691624

RESUMO

BACKGROUND: The World Health Organization recommends intravenous amikacin for the treatment of MDR-TB at a dose of 15 mg/kg. However, higher doses are associated with significant toxicity. METHODS: Patients with MDR-TB treated at our institution receive amikacin at 8-10 mg/kg, with dose adjustment based on therapeutic drug monitoring. We conducted a retrospective cohort study of patients with MDR-TB who received amikacin between 2010 and 2016. RESULTS: Forty-nine patients were included in the study. The median starting dose of amikacin was 8.9 mg/kg (IQR 8, 10), and target therapeutic drug levels were achieved at a median of 12 days (IQR 5, 26). The median duration of amikacin treatment was 7.2 months (IQR 5.7, 8), and median time to sputum culture conversion was 1 month (IQR 1,2). Six patients (12.2%) experienced hearing loss based on formal audiometry testing (95% CI 4.6-24.8%); 22.2% had subjective hearing loss (95% CI 11.2-37.1%) and 31.9% subjective tinnitus (95% CI 19.1-47.1%). Ten patients (23%) had a significant rise in serum creatinine (95% CI 11.8-38.6%), but only 5 patients had a GFR < 60 at treatment completion. 84% of patients had a successful treatment outcome (95% CI 84-99%). CONCLUSIONS: Low dose amikacin is associated with relatively low rates of aminoglycoside-related adverse events. We hypothesize that low-dose amikacin can be used as a safe and effective treatment for MDR-TB in situations where an adequate regimen cannot be constructed with Group A and B drugs, and where careful monitoring for adverse events is feasible.


Assuntos
Amicacina/uso terapêutico , Antituberculosos/uso terapêutico , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Adulto , Amicacina/efeitos adversos , Estudos de Coortes , Monitoramento de Medicamentos , Feminino , Perda Auditiva/induzido quimicamente , Humanos , Masculino , Estudos Retrospectivos , Zumbido/induzido quimicamente , Resultado do Tratamento , Organização Mundial da Saúde
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