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December 2006 News Archives
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December 2: Noisy toys pose dangers to young children, Post-Crescent
By Wendy Harris
Not only are they annoying, but noisy toys can also pose a risk to your child’s hearing.
For the ninth consecutive year, the Sight & Hearing Association has compiled its top 15 list of noisy toys that emit potentially dangerous sound levels.
"They can pose an actual risk to your child’s hearing, depending on how long they play with them," said Julee Sylvester, spokeswoman and toy finder for the association, a St. Paul–based nonprofit agency dedicated to preventing hearing loss and blindness.
"Five and under are the recommended ages for most of the (noisy) toys I find and the majority this year are 18 months, 3 years and 5 years," added Sylvester, who peruses toy store aisles with a decibel meter in search of loud toys. "It’s scary."
This year’s top offender is the Power Gear Neo Fazer, a toy gun that blasts at 116 decibels, loud enough to risk hearing damage is less than 30 seconds, the association says.
Meanwhile, three books intended for 18–month–olds — "The Wiggles Wiggly Jukebox," "The Wiggles Wiggly Songs," and "Help Along Sing a Song," measured at 114 dB, 113 dB and 112 dB, respectively. All three books are capable of causing hearing damage in less than a minute.
Sounds that are 85 dB or louder can permanently damage your ears. The National Institute for Occupational Safety and Health even mandates that employees wear ear protection if they are exposed to noise levels on the job that meet or exceed 85 dB.
The toys picked by Sylvester are turned over to University of Minnesota specialists, who test them in a soundproof chamber to ensure accurate measurements.
Dr. Seth Janus, an otolaryngologist at the University of Minnesota, tested this year’s toys.
"I was very surprised how loud the toys were up close," he said, in a prepared statement. "But they dropped down to reasonable levels when testing at 10 inches."
Six of them, however, remained above 85 dB when tested at about a foot away from the speaker.
Because of a child’s shorter arm span, children hold toys closer to their ears, making the noise more dangerous, Sylvester added.
When buying a toy, she suggests that parents listen to it first before buying it. Sylvester estimates that 80 percent of children’s toys make noise.
"If it says ’play me,’ put it up close to your ear," she said. "If it sounds loud to you, it’s definitely going to be too loud for your children."
But if it’s a must–have toy, or your child receives a noisy toy as a gift, put clear packing tape over the speaker, Sylvester suggests.
"It helps muffle the sound and helps bring it down to a lower level," she said.
Noise–induced hearing loss is escalating in the U.S. among several age groups and audiologists are particularly concerned about children.
"It’s certainly becoming more widespread and starting at an earlier age," said Robert Broeckert, an Appleton audiologist with Hearing Clinics of Wisconsin. "We live in a noisier world and research is showing that technology isn’t always helping our hearing."
Hearing loss typically occurs and accumulates gradually over time. The louder the sound, and the greater exposure time, the higher risk for damage.
For example, a sound at 85 dB may take as long as eight hours to cause damage, the Sight & Hearing association says. But a sound at 100 dB can cause permanent damage after just 30 minutes of listening.
With the ever–growing popularity of iPods and MP3 players, many audiologists fear widespread hearing loss among the next generation.
The players, on average, can reach about 105 to 110 dB at full volume.
"It can only take a matter of minutes at those levels when permanent damage can occur," Broeckert said.
Unfortunately, protecting children’s ears against the portable players isn’t as easy for parents as monitoring noisy toys.
Sylvester suggests awareness and vigilance.
"If you are trying to have a conversation with someone wearing ear buds and they can’t hear you, it’s too loud," she said.
Sylvester says she isn’t trying to be a "Scrooge" when it comes to kids’ toys. But once the damage is done, it’s irreversible, she stresses.
"We wouldn’t give our kids toys that would hurt, choke or strangle them," she said. "So why would we give them toys that would hurt their hearing?"
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December 2: In–Office Ultrasound Would Save Time, Money for Patients and Providers, Today’s SurgiCenter
According to a study published in the December issue of the journal Otolaryngology– Head and Neck Surgery, efforts to provide patients with convenient and cost–effective health care would be boosted by a greater reliance on office–based ultrasound of the head and neck, allowing patients and physicians one–stop care in cases requiring the diagnostic imaging tool.
The authors of the study point out the current practice of out–of–office ultrasound forces increased patient travel, and often necessitates multiple appointments. Physicians are also inconvenienced by this time lapse, as well as by the absence of direct surveillance. The study finds that costs associated with establishing in–office ultrasound could be recouped within a year.
The study took into account the number of procedures performed over a five–year period, technology needs and cost to the physician, while creating billing and usage strategies that would improve the economics of in–office ultrasound.
Among the findings:
- Otolaryngologists are especially well suited for in–office ultrasound because of their expertise with anatomy and diseases of the head and neck.
- Ultrasound can be easily integrated into an office setting, providing a surgeon with real–time imaging that is more informative than X–rays.
- Ultrasound machines with the specifications needed for head and neck scans are readily available from almost all major manufacturers for under $40,000, a cost that can be offset within a year through appropriate billing practices.
The findings are published in the December edition of the AmericanAcademy of Otolaryngology – Head and Neck Surgery/Foundation’s (AAO–HNS/F) scientific journal, Otolaryngology – Head and Neck Surgery. The authors, Nadeem A. Akbar, MD, Donald L. Bodenner, MD, PhD, Lawrence T. Kim, MD, James Y. Suen, MD, and Mimi S. Kokoska, all based in Little Rock, Ark., first presented their findings at the annual meeting of the American Academy of Otolaryngology – Head and Neck Surgery/Foundation in September 2005.
Source: American Academy of Otolaryngology – Head and Neck Surgery/Foundation
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December 2: Dogs May Protect Kids From Allergies, CBS News
(WebMD) Infants who live in a house with multiple dogs may be less likely to develop allergies later in life, according to a new study.
Researchers found that infants who live in a home with two or more dogs and a high level of certain types of a bacterial substance were a third less likely to develop wheezing in the first year of life than those who didn’t live with dogs.
Wheezing in infants is associated with a higher risk of developing allergies and asthma later in life.
In the study, researchers looked at the effects of pet ownership on wheezing in more than 500 infants at high risk of developing allergies because at least one parent had them.
The results, published in the Journal of Allergy and Clinical Immunology, showed that wheezing was not independently associated with either dog or cat ownership, or a high level of indoor endotoxins.
Endotoxins are natural compounds produced by bacteria. Some believe exposure to these compounds may stimulate the immune system.
However, infants living in a household with two or more dogs and a high level of indoor endotoxins (measured from house dust) were a third less likely to develop wheezing than infants living without dogs.
"Our bodies are programmed to produce allergic responses early in life," says David Bernstein, M.D., professor of immunology at the University of Cincinnati, in a news release. "But there are environmental factors like bacterial endotoxins that may modify the immune system and block development of allergies early in life".
"We do not yet understand how and why exposure to high levels of bacterial endotoxins and multiple dogs in the home exert a protective effect in these high–risk infants from wheezing early in life," says Bernstein.
SOURCE: Campo, P. Journal of Allergy and Clinical Immunology, December 2006; Vol. 118. News release, University of Cincinnati.
By Jennifer Warner
Reviewed by Louise Chang, M.D.
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December 6: Study Disputes Cell Phone–Cancer Link, News
By LAURAN NEERGAARD AP Medical Writer
WASHINGTON (AP) – A huge study from Denmark offers the latest reassurance that cell phones don’t trigger cancer. Scientists tracked 420,000 Danish cell phone users, including 52,000 who had gabbed on the gadgets for 10 years or more, and some who started using them 21 years ago.
They matched phone records to the famed Danish Cancer Registry that records every citizen who gets the disease and reported Tuesday that cell–phone callers are no more likely than anyone else to suffer a range of cancer types.
The study, published in the Journal of the National Cancer Institute, is the largest yet to find no bad news about the safety of cell phones and the radiofrequency energy they emit.
But even the lead researcher doubts it will end the debate.
"There’s really no biological basis for you to be concerned about radio waves," said John Boice, a Vanderbilt University professor and scientific director of the International Epidemiology Institute in Rockville, Md. "Nonetheless, people are."
So Boice and colleagues at Copenhagen’s Danish Cancer Society plan to continue tracking the Danish callers until at least some have used the phones for 30 years.
This so–called Danish cohort "is probably the strongest study out there because of the outstanding registries they keep," said Joshua Muscat of Pennsylvania State University, who also has studied cell phones and cancer.
"As the body of evidence accumulates, people can become more reassured that these devices are safe, but the final word is not there yet," Muscat added.
Cell phones beam radiofrequency energy that can penetrate the brain’s outer edge, raising questions about cancers of the head and neck, brain tumors or leukemia. Most research has found no risk, but a few studies have raised questions. And while U.S. health officials insist the evidence shows no real reason for concern, they don’t give the phones a definitive clean bill of health, either, pending long–term data on slow–growing cancers.
For the latest study, personal identification numbers assigned to each Dane at birth allowed researchers to match people who began using cell phones between 1982 and 1995 with cancer records.
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December 10: Parents, Docs: Wait Out Ear Infections, CBS News
By JENNIFER C. YATES Associated Press Writer
(AP) That familiar tug on his ear or restless night sleep is usually the sign that little Baedden Pollett has another ear infection. The 2 1/2–year–old has had more of them than his parents can count.
Sometimes, his doctor prescribes antibiotics. But in many cases, his parents have waited it out, using Tylenol, warm baths and some extra tender loving care to ease him through it. And he recovers on his own.
More than ever, many parents and doctors these days are taking a "watchful waiting" approach with children older than 2 who have ear infections, the most common childhood illness. Many are foregoing antibiotics because of worries about drug resistance and evidence that most ear infections will heal on their own.
"My experience is that parents are often the driving motive behind not giving antibiotics. Parents are very, very concerned about the use of antibiotics," said Dr. Richard Rosenfeld, director of pediatric otolaryngology at Long Island College Hospital in Brooklyn and a consultant who helped write national guidelines on antibiotic use for ear infections.
Three out of four children will suffer from ear infections before the age of 3, according to the National Institute on Deafness and Other Communication Disorders. Ear infections occur when viruses or bacteria get inside the ear, usually the result of a cold or other illness. Fluid and mucus can become trapped deep inside the ear.
Antibiotics only work against bacterial infections, though some of the many bacteria that can cause ear infections have grown resistant to certain antibiotics. Doctors have no way of knowing if a virus or a bacteria is causing each individual infection.
Many parents recognize their child's earache symptoms – fussing, crying, loss of sleep and appetite and a tugging at the ear. Ear infections can result in hearing loss, though doctors say that’s usually temporary.
A visit to the doctor is advised if a child is sick for a few days and suddenly develops a fever, along with those other symptoms like ear–tugging and awaking at night.
"Observing is different than not treating," Rosenfeld said.
In May 2004, the American Academy of Pediatrics and the American Academy of Family Physicians released the first national guidelines on appropriate diagnosis and treatment for ear infections. Among other things, those recommend that pain medication be prescribed for most children and antibiotics used only if the conditions persist or don’t improve.
In an October study in the medical journal The Lancet, researchers found that antibiotics for ear infections are only beneficial to children under the age of 2 with both ears infected. Study leader Dr. Maroeska Rovers, of the University Medical Center Utrecht in the Netherlands, said that researchers found that in most other cases, watchful waiting is OK.
Rovers said that in countries like the Netherlands, watchful waiting has been an accepted practice since about 1990. Critics say the ear infections could develop into something more severe if untreated, but Rovers said studies have not backed that up.
Doctors are the front line in helping educate parents about the best course to take, Rovers said.
"They should not send the parents away by doing nothing, but they should listen carefully to these parents and prescribe sufficient analgesics to treat the pain and the fever in the first few days," Rovers said. Then, parents should be encouraged to come back in two to three days if things have not gotten better, he said.
At the Children’s Hospital of Pittsburgh, a team of researchers led by Dr. Alejandro Hoberman will lead a government–funded study of about 300 children to further test the watchful waiting vs. antibiotics strategies.
Hoberman, chief of general academic pediatrics at the Pittsburgh hospital, said evidence shows that most infections clear up on their own.
"The key concern is how much longer will it take, and how much pain (and) crying, sleepless nights the child might have," Hoberman said.
Hoberman said a big part of this is helping doctors with techniques that more accurately diagnose the severity of the ear infections so the most appropriate course of action can be taken. Doctors can tell if an ear is infected by looking into the ear canal for redness or inflammation. But that observation isn’t always accurate, and in many cases antibiotics are unnecessarily prescribed, he said.
"I think parents are generally more receptive in 2006 and actually consider that antibiotics are not always needed," Hoberman said.
Baedden’s mom, Denise Pollett, said she and her husband have used many techniques to ease their son’s ear pain, including warm baths twice a day.
She’s also moved him to a different daycare center, hoping he'll get sick less often. Though ear infections are not contagious, colds are and can lead to ear infections.
"We weren’t that quick to run to the doctor when we knew he was probably getting one," said Pollett, who lives in the Pittsburgh suburb of Mount Lebanon.
Pollett said more than anything, they wanted to relieve his pain.
"I think sometimes that’s even more important than the antibiotics," she said.
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December 11: A more sound solution, Los Angeles Times
An experimental ‘hybrid’ device may give many with partial hearing loss the extra boost they need. It’s a new variation on the cochlear implant.
By Regina Nuzzo, Special to The Times
JEANNE YEOMAN had been dealing with her hearing loss for a couple of decades, but listening still exhausted her. And technology wasn't really helping her patience. She remembers driving down the road one day and coming close to just hurling her hearing aids out the window.
"Hearing aids made everything louder, not clearer. I didn't need amplification. I needed clarification."
Yeoman wasn’t deaf. So she was surprised to learn she was an ideal candidate for an experimental type of cochlear implant. Unlike hearing aids, cochlear implants communicate directly with the brain by converting sounds into electrical impulses and shooting them along the auditory nerve. Until now these devices have been used only for profoundly deaf people. But this new "hybrid" cochlear implant was designed specifically for partial hearing loss – so that users could enjoy both their own natural hearing plus bionic hearing for sounds where they need an extra boost.
Five years after surgery that implanted the device in her inner ear, 34–year–old Yeoman of Humboldt, Iowa, sometimes even forgets it’s turned on. "Everything sounds so crystal–clear," she says.
Good solutions are scarce for many people with hearing loss, including growing numbers of aging baby boomers. A large number of the 28 million hard–of–hearing Americans have what is known as a "ski–slope" loss, in which their ability to hear high–pitched sounds plummets dramatically. They can hear sounds such as "aah" and "ooh" quite plainly, but not "ssss" or "shhh." Unfortunately, the latter types of sounds give speech the lion’s share of its legibility. Speech doesn’t necessarily sound quiet; it sounds muddy.
Even at full blast, hearing aids often can’t help enough, says Dr. James Battey, director of the National Institute on Deafness and Other Communication Disorders at the National Institutes of Health. "This type of hearing loss can become extremely socially isolating," he says.
Traditional cochlear implants aren’t a good answer. By bypassing damaged inner ears to stimulate auditory nerve fibers directly, these devices can be a boon for some deaf people. But the procedure ’ which involves threading a tiny bundle of electronics into the inner ear through a hole in the skull – aims to replace a patient’s entire range of hearing. Any natural abilities usually get wiped out by the surgery.
With the new hybrid implant, however, surgeons hope simply to supplement natural hearing without destroying it, says Dr. Bruce Gantz, professor of otolaryngology at the University of Iowa and developer of the device.
The secret lies in the inner ear’s design. Normal hearing is sort of a Rube Goldberg process. First, sound waves enter the ear as rhythmic pulses, which set the eardrum vibrating in sync. This triggers quivering in three tiny bones, with the last bone hammering against the entrance to the inner ear. In response, fluid sloshes in rhythmic waves throughout the corridors of the snail–shaped cochlea, which alerts sensory cells to electrically stimulate auditory nerve fibers.
Strangely enough, the cochlea itself is laid out like a coiled piano keyboard: Cells along the corridors are tuned to particular frequencies entering the ear. In the case of a low–pitched sound, cells tucked away deep inside the cochlea alert the auditory nerve; cells that respond to high notes sit close to the cochlea’s entrance. That's fortunate – because cochlear regions where "ski–slope" patients need a boost are those most accessible to surgeons.
Compared with traditional implants, hybrid systems use a thinner, shorter bundle of electronics (10 millimeters in length compared with up to 28 millimeters for traditional implants). This short electrode is positioned just at the opening end of the cochlea, stimulating the auditory nerve only when high–frequency sound waves enter the ear. Since surgeons don’t need to probe as deeply into the delicate cochlea, tissue trauma is reduced. Preserved natural hearing, amplified with a hearing aid if necessary, gives patients an easier time in tough situations, such as crowded restaurants or concert halls. The added high–frequency electronic hearing clears up muddy speech.
Since 1999, about 80 patients have received the hybrid device, Gantz says, and clinical trials are underway at 15 U.S. sites. Preliminary results, released in November, reported that surgeons in the trial have been able to retain hearing in about 96% of the patients. Before surgery, patients were able to understand about one–third of words on standard hearing tests. After one year or more with the implant, scores increased to an average of 75%.
Hybrid implant users also function better than traditional implant users in noisy situations, says Christopher Turner, audiology professor at the University of Iowa and a study investigator. They are far more able to follow and appreciate music.
Researchers expect to continue the trial through at least next year before going to the Food and Drug Administration for approval, says Aaron Parkinson, coordinator of clinical studies at Cochlear Corp. in Denver, which manufactures the device. By some estimates, a successful hybrid device could eventually reach a population up to twice the size of the current implant market, he says. In the U.S. today, about 25,000 people use a traditional cochlear implant.
Still, hybrid users need to devote time and energy to re–learning how to hear, says Dawna Mills, an audiologist and clinical trials director at L.A.’s House Clinic, which is participating in the study. At first, human speech, full of new hisses and whistles, may not even be understandable. But with time and months of training, the brain seems to adapt to its new world of sound. "It’s not normal hearing," Mills says, "but it becomes normal for them."
Virginia Baker, 50, of Simi Valley says it did take effort to learn how to hear again. (Her high–frequency hearing had been declining for unknown reasons since age 19.) Still, that struggle was preferable to giving in to the social isolation that she had seen envelope her deaf grandmother.
Before surgery, Baker had quit her job substitute teaching in elementary schools because kids’ squeaky voices started to fall outside her hearing range. "I was almost afraid to go out," she says. With a hybrid implant, however, she felt secure enough in her new listening skills to get a part–time job as an office manager and go back to college, where she is earning As in her accounting courses. "The hybrid," she says, "allows me to go out there with the rest of the world and be a part of it."
Here are some other recent innovations in technology for hearing loss:
Cancel the noise: Clever signal processing in the latest hearing aids can decide how loud you need sounds to be. If the processor picks up a "clean" noise without a lot of distortion, it’s likely to be speech, music or maybe a fire alarm. The hearing aid will react and selectively turn up the volume for these sounds. "Degraded" signals are usually background noises such as a car engine hum, so the processor turns them down a tad.
Responsive mikes: Some new hearing aid microphones adapt to their environment. For example, in quiet situations they can pick up sounds from all directions. But if you walk into a party and start a conversation with the background babble behind you, they’ll automatically narrow their focus to just sounds in front of you.
No whining: When hearing aids start to squeal, new circuitry in some digital hearing aids analyze the feedback signal and generate a new sound. Then, in a cool trick of engineering, the two signals combine and automatically cancel each other out. Not only can you crank up the volume on your aids or hug your kids without setting off feedback, you can also wear more comfortable hearing aids that would otherwise kick up too much noise.
Sound gadgets: Even beyond hearing aids, plenty of extra high–tech help is available. Two notables: "third ear" technology (small, hand–held microphones that wirelessly communicate with your hearing aids) and "captioned telephones" (trained human operators use speech–to–text software to send real–time captions of your conversation straight to your telephone or computer).
— Regina Nuzzo
Source: Mark Ross of Gallaudet University
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December 13: Antibiotic ear drops more effective, United Press International
DALLAS – A U.S. study found that with children with ear tubes, there are better outcomes with antibiotic ear drops over antibiotics swallowed in pill or liquid form.
A study of 80 children 6 months to 12 years who had ear tubes, middle–ear infections and visible drainage in the ear showed that antibiotic ear drops performed better and faster in treating middle–ear infections in children with ear tubes than merely taking oral antibiotics such as swallowing a pill or liquid, according to researchers at the University of Texas Southwestern Medical Center in Dallas.
"With the use of ear drops, you can put more potent medicine just where you need it," said Dr. Peter Roland, chairman of otolaryngology at Southwestern Medical Center and one of the study's authors.
Both the oral and topical antibiotics cure the infections in more than 70 percent of cases, but the topical drops resolved the ear drainage three to five days faster and resulted in more clinical cures overall – 85 percent for those taking drops, compared to 59 percent for oral administration of medication, according to the study available online in the journal Pediatrics.
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December 18: Antibiotics Mostly Useless for Sinusitis, HealthDay News
If you develop a mild sinus infection this winter – or even a moderately severe one – antibiotics won’t necessarily speed your recovery, new research shows.
"In the vast majority of cases, rhinosinusitis is a self–limiting disease," said Dr. An De Sutter, of Ghent University Hospital in Belgium. "It can last 10 days or longer, but antibiotics do not influence the course of the disease."
So, if you don’t have signs of complications or severe infection, such as a high fever or extreme pain, your best bet is to forgo antibiotics, rely on symptomatic treatments and wait for a natural recovery, De Sutter said.
De Sutter estimates that 50 percent to 70 percent of sinusitis patients are prescribed antibiotics. Although the drugs can effectively treat patients who develop bacterial sinusitis, they are ineffective against viral sinusitis, which represents the majority of cases.
In the study, De Sutter and her colleagues looked at 300 patients with mild to moderately severe sinusitis, 218 of whom received sinus X–rays. They randomly assigned patients to receive either amoxicillin or a placebo, asked them to keep a symptom diary and observed them for 15 days.
The researchers found that neither typical sinusitis signs and symptoms nor abnormal X–rays had any value in predicting the course of the disease. They also found that the disease lasted as long in patients taking amoxicillin as it did in patients taking a placebo, and that 247 of the patients recovered within 15 days.
Only two subjective complaints – a general feeling of illness and reduced productivity – predicted a slower recovery from sinusitis. "In patients who feel ill or who do not feel able to work, recovery will take a few days longer," De Sutter said. "But antibiotic treatment does not speed recovery in these patients."
"We don’t know for sure why antibiotic treatment seemed to have no effect on the duration of the illness," De Sutter said. "But there two possible explanations: Either the illness and X–ray abnormalities were not caused by a bacterial infection, or if they were, the patients’ immune systems were able to overcome the infection just as quickly without antibiotics."
The results of the study are published in the November/December issue of the Annals of Family Medicine.
"We advise antibiotic treatment only when patients have severe symptoms such as high fever and bad pain or if they have impaired immune function," De Sutter said. "This is a very small minority of patients. For all others, we advise ’watchful waiting.’ "
Instead of prescribing antibiotics, doctors should focus on symptom relief: paracetamol for pain relief and intranasal decongestants in case of a blocked nose, De Sutter suggested. "Some patients experience subjective relief by inhaling hot steam," she added.
In a similar study in the same journal, researchers found the desire for pain relief was one of the main reasons why sore–throat patients demand antibiotics. They concluded that it may be preferable to treat such patients with pain medications instead of antibiotics.
In most sinusitis cases, De Sutter believes that doctors should resist patient demand for antibiotics. "Doctors should explain to patients that antibiotics do not make a difference in the speed of recovery and can cause side effects," De Sutter said. "In our trial, diarrhea was more frequent with antibiotics. Other known side effects include nausea, oral or vaginal mold or yeast infection, allergic reactions and colitis."
The over–prescription of antibiotics, especially in children, also can cause the upper respiratory tract to become colonized with antibiotic–resistant bacteria such as S. pneumoniae, De Sutter said. "These resistant bacteria may cause infections that are more difficult to treat and may be passed on to other people."
"This is an interesting study because it looked at a large population of people with acute sinusitis," said Dr. David Sherris, chairman of otolaryngology at the University at Buffalo in New York.
"Most people do not need antibiotic therapy unless symptoms persist for more than seven to 10 days," Sherris said. "Plain X–rays of the sinuses add little or nothing to the diagnosis and treatment of acute sinusitis."
But that doesn’t mean that imaging is of no value in sinusitis cases, he added. With prolonged or recurrent sinusitis or complications, computed tomography (CT) is the test of choice and works well, he noted.
"Early referral to an otolaryngologist is indicated in the most severe cases or where symptoms are out of proportion with findings," Sherris said. "The specialist can perform nasal endoscopy and accurately assess the most subtle CT scan findings."
Although the new study confirms some observations that Sherris has made during years of clinical practice, it would have been stronger if it had used the symptom system from the American Academy of Otolaryngology Head and Neck Surgery, Sherris said. "It is more complete than the one presented in this article, and though not infallible, is better to diagnose acute sinusitis."
Sherris also faulted the researchers’ choice of antibiotics. "Amoxicillin, unless used in very high doses, is not a good first line antibiotic in acute sinusitis," he said. "Amoxicillin–clavulanate [augmentin] is a better choice, and is now generic in the United States. If there is an allergy to penicillin, physicians should consider azithromycin or a respiratory quinolone."
More information
For more on rhinitis, head to the U.S. Centers for Disease Control and Prevention.
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December 18: Tinnitus Type Affects Severity, Symptoms, HealthDay News
The ringing or buzzing in the ears known as tinnitus varies among patients according to the condition’s clinical characteristics, German researchers report.
People with tinnitus have ringing, buzzing or whistling sounds in one or both ears. The condition, which can be due to a medical disease or unknown causes, can be constant or intermittent, chronic or acute, according to background information in the article.
This study of more than 4,900 people with tinnitus was published in the December issue of the journalArchives of Otolaryngology–-Head & Neck Surgery.
According to the researchers, more than 8 percent of patients rated their condition as grade I (weak degree of tinnitus loudness), close to 60 percent as grade II (medium degree of loudness), and just over 32 percent as grade III (strong degree of loudness).
In terms of annoyance with tinnitus, about 39 percent said they were mildly distressed, nearly 24 percent said they severely distressed, and about 13 percent were most severely distressed.
Most of the people with grade I conditions reported mild tinnitus distress, those with grade II were split, and about two–thirds of people with grade III conditions had severe or very severe distress. The findings indicated a moderate correlation between tinnitus loudness and annoyance, the researchers said.
"In particular, higher levels of severity were found in men, older adults, binaural (in both ears) and centrally perceived tinnitus, increase in tinnitus sensitivity since onset, sensitivity to loud external noise, continuous tinnitus (as opposed to intermittent tinnitus), and the coexistence of hearing loss, vertigo and hyperacusis (abnormal sensitivity to sounds)," wrote the team from the University of Mainz and the Roseneck Center of Behavioral Medicine in Prien.
"We need studies that investigate the determinants of tinnitus loudness and annoyance to understand more deeply how patients react to their tinnitus and which factors contribute to the long–term maintenance of distress," they added.
More information
The American Tinnitus Association has more about tinnitus.
SOURCES: JAMA/Archives journals, news release, Dec. 18, 2006
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December 19: Soldier noise-reducing earmuffs advised, United Press International
Researchers in Poland suggest soldiers adopt noise–reducing earmuffs to prevent permanent long–term hearing loss due to gunshot exposure.
Researchers at the Medical University of Lodz measured the impact of "impulse noise" – short bursts of acoustic energy – on 80 subjects with no history of hearing disorders by using short–term exposure to the impulse noise generated by five gunshots from a kbk AKMS rifle, commonly known as an AK–47.
In the study, soldiers using hearing protection did not have their hearing affected. Soldiers without hearing protection experienced the expected levels of hearing loss. Common estimates are that 10 percent to 15 percent of soldiers returning from active military service without the use of hearing protection develop acoustic trauma, according to the researchers.
The study recommends the military adopt hearing protectors that will muffle the most harmful frequencies while still enabling soldiers to communicate with each other. The authors note that most military personnel are young and at the beginning stages of their careers, and would be negatively impacted by a loss of hearing as they enter the civilian workforce.
The findings are published in the January issue of the medical journal Otolaryngology – Head & Neck Surgery.
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December 19: Firm designs nasal spray to fight obesity, Reuters
By Jason Szep
BOSTON (Reuters) – Dieters may find some welcome assistance from a new nasal spray that could help resist the appetizing aromas of cinnamon bun stands, pizza parlors or tempting bakeries.
Compellis Pharmaceuticals of Cambridge, Massachusetts said it will begin human trials next year of a nasal spray designed to fight obesity by blocking the senses of smell and taste. It won a patent for the product this month.
"The pleasurable effect of eating is all stimulated by smell and taste," Christopher Adams, the company’s founder and chief executive, told Reuters on Tuesday.
"The premise is that olfactory activity that controls both smell and taste is a trigger and a feedback mechanism to eat. If you have some kind of reduced sense of smell or taste, you tend to eat less," he said.
The product, known as CP404, is among the latest devices and treatments under development in the multibillion–dollar fight against obesity.
An estimated 65 percent of adult Americans are overweight or obese, putting them at higher risk of heart disease, diabetes and other conditions that account for more than $100 billion of the country's $1.9 trillion annual healthcare bill.
French drug maker Sanofi–Aventis began marketing its obesity pill Acomplia in Britain in June and expects to receive U.S. government approval by April to sell the drug in the United States. The pill switches off the same brain circuits that make people hungry when they smoke cannabis.
Medtronic Inc., the world’s biggest maker of medical devices, is developing a battery–powered gastric pacemaker that causes the stomach to contract, sending signals of satiety to the appetite center in the brain.
Enteromedics Inc. of Minneapolis is working with the Mayo Clinic on a device known as "Maestro" that uses electricity to paralyze the stomach, reducing or stopping contractions that churn food as part of the digestion process.
Those last two devices, like CP404, are still years away from reaching consumers.
Adams said he would seek Food and Drug Administration approval in about three years after human trials begin in 2007. He also expects to tap the stock market to raise $25 million to $50 million in an initial public offering if human trials are successful, with the spray expected to hit the market in 2010.
The nasal spray treatment would retail at $500 to $1,000 a year.
The Obesity Action Coalition, a Tampa, Florida–based nonprofit organization, cautioned that any such spray should be accompanied by other treatments and a change in lifestyle to be effective.
"There are a lot of reasons why obesity exists, and it’s not always a case of food addiction," said James Zervios, a spokesman for the coalition.
"People still need to eat. Every time they get hungry I don’t think they could just use the spray," he said. "People need to be taught what are the better foods to eat – what’s high on protein, what’s low on fat."
Bariatric surgery, including gastric bands like the Lapband, is the only effective permanent solution, doctors say. Gastric bypass surgery makes the stomach smaller so patients can eat less and cuts out a long stretch of small intestine so fewer nutrients are absorbed.
But the Agency for Healthcare Research and Quality, a unit of the federal government’s Public Health Service, has warned that four of every 10 patients who undergo weight–loss surgery develop complications within six months.
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December 17: UC Irvine Study Sheds Light On Why Cochlear Implant Users Have Difficulty Understanding Tonal Languages, Medical News Today
It’s been shown that the left side of the brain processes language and the right side processes music; but what about a language like Mandarin Chinese, which is musical in nature with wide tonal ranges.
UC Irvine researcher Fan’Gang Zeng and Chinese colleagues studied brain scans of subjects as they listened to spoken Mandarin. They found that the brain processes the music, or pitch, of the words first in the right hemisphere before the left side of the brain processes the semantics, or meaning, of the information.
The results show that language processing is more complex than previously thought, and it gives clues to why people who use auditory prosthetic devices have difficulty understanding Mandarin. The study appears in this week’s online early edition of the Proceedings of the National Academy of Sciences. In the English language, Zeng says, changes in pitch dictate the difference between a spoken statement and question, or in mood, but the meaning of the words does not change. This is different in Mandarin, in which changes in pitch affect the meaning of words.
"Most cochlear implant devices lack the ability to register large tonal ranges, which is why these device users have difficulty enjoying music ’ or understanding a tonal language," says Zeng, a professor of otolaryngology, biomedical engineering, cognitive sciences, and anatomy and neurobiology.
In his hearing and speech lab at UCI, Zeng has made advances in cochlear implant development, discovering that enhancing the detection of frequency modulation (FM) significantly boosts the performance of many hearing aids devices by increasing tonal recognition, which is essential to hearing music and understanding certain spoken languages like Mandarin.
Lin Chen, Hao Luo, Jing–Tian Ni, Zhi–Ou Li and Da–Ren Zhang of the University of Science and Technology of China, Hefei, are study co–authors. The National Natural Science Foundation of China and the National Basic Research Program of China provided support.
About the University of California, Irvine: The University of California, Irvine is a top–ranked university dedicated to research, scholarship and community service. Founded in 1965, UCI is among the fastest–growing University of California campuses, with more than 25,000 undergraduate and graduate students and about 1,400 faculty members. The second–largest employer in dynamic Orange County, UCI contributes an annual economic impact of $3.7 billion.
Contact: Tom Vasich
University of California – Irvine
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December 29: The vaccine to prevent every strain of flu, Daily Mail
by FIONA MacRAE
British scientists are on the verge of producing a revolutionary flu vaccine that works against all major types of the disease.
Described as the ‘holy grail’ of flu vaccines, it would protect against all strains of influenza A – the virus behind both bird flu and the nastiest outbreaks of winter flu.
Just a couple of injections could give long–lasting immunity – unlike the current vaccine which has to be given every year.
The brainchild of scientists at Cambridge biotech firm Acambis, working with Belgian researchers, the vaccine will be tested on humans for the first time in the next few months.
A similar universal flu vaccine, being developed by Swiss vaccine firm Cytos Biotechnology, could also be tested on people in 2007 – and the vaccines on the market in around five years.
Importantly, the vaccines would also be quicker and easier to make than the traditional jabs, meaning vast quantities could be stockpiled against a global outbreak of bird flu.
Martin Bachmann, of Cytos, said: "You could really stockpile it. In the case of a pandemic, that would be a huge advantage."
"If you were to start making a traditional vaccine at the start of a pandemic, there is no way there would be enough."
The Government believes a bird flu pandemic is inevitable, killing 50,000 people in Britain alone.
However, it acknowledges that the bug could be much more lethal – infecting one in two people and claiming more than 700,000 lives.
Normal winter flu can also kill, claiming up to 12,000 lives a year in the UK.
Although a vaccine exists, constant changes in the virus’s appearance have until now made it impossible to create just one flu vaccine. Instead a new vaccine is put together each year to protect against the particular strains circulating at that time.
In addition, the virus used in the jab is grown in hen’s eggs – a time–consuming process that yields just one shot of vaccine per egg.
The new jabs would be grown in huge vats of bacterial ‘soup’, with just two pints of liquid providing 10,000 doses of vaccine.
Current flu vaccines focus on two proteins on the surface of the virus. However, these constantly mutate in a bid to fool the immune system, making it impossible for vaccine manufacturers to keep up with the creation of each new strain.
The universal vaccines focus on a different protein called M2, which has barely changed during the last 100 years.
The protein is found in all types of Influenza A, including the current bird flu and the virus that caused the 1918 Spanish flu pandemic which killed up to 50 million across the globe.
Normally, such vaccines would have to go through at least five years of human tests before going on the market. However, if a bird flu pandemic occurs before that, they could be made more quickly available.
Zurich’based Cytos, which is also developing anti–smoking and obesity vaccines, has showed that its version of the jab stops mice dying from a dose of flu strong enough to kill them four–times over.
The vaccinated animals were also spared the fever that normally goes along with flu.
Although it is too early to say what the effect would be in humans, an initial course of two or three shots could provide long–lasting immunity, topped up with booster shots given every five to ten years.
Dr Ashley Birkett, of Acambis, said: "It wouldn’t be that one shot protects for life but you would need fewer doses over your lifetime."
In addition, the jabs could be produced in vast quantities and stockpiled ahead of a flu pandemic – or even given to people in advance.
In contrast, a traditionally–produced vaccine, matched to the specific strain of flu, would not be available until around six months after the start of the pandemic.
The new vaccines only protect against influenza A – the version of the bug responsible for pandemic flu and the most severe cases of winter flu.
However, it may also be possible to create a similar jab against influenza B, which causes a milder form of winter flu.
Professor John Oxford, Britain's leading flu expert, said the development of a universal vaccine was the "holy grail" of flu research.
He added: "If you get a M2 vaccine which protects against the whole caboodle in the same vaccine, the possibilities are huge."
But, others cautioned that there is no guarantee that the jabs would be as effective in humans as it has been in animals.
Virologist Professor Ian Jones, of the University of Reading, said: "It is an encouraging technique which may have a role to play but it is too soon to assume that it will translate into a universal vaccine in the human population."
Dr Jim Robertson, a vaccine expert from the government–funded National Institute for Biological Standards and Control, said the main advantage of a universal jab would be lasting immunity.
"If it works, it will be lovely," he said. "The best result would be that it would last for a long, long time."
Dr Ron Cutler, an infectious diseases expert from the University of East London, said: "Continual protection would be a tremendous advantage against flu."
He cautioned however, that there is no guarantee that the M2 protein will not mutate in the future – meaning the jab will have to be regularly reformulated.
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