Hearing Disorders

听力障碍
  • 文章类型: Journal Article
    在他们的工作中,教师可能会受到导致不同健康问题的条件。这项研究调查了858名教师(528名女性;年龄44.0±9.67岁)的代表性样本中的职业健康失调,分为三组具有特定职业要求的教师:专业体育教师(专业PETs),课堂教师,和专业教师。使用慢性健康障碍问卷记录过去12个月的健康障碍数量。不同类型教师之间的差异,控制性别和年龄,采用二元逻辑回归分析。结果显示,89%的教师患感冒是最常见的健康问题,其次是58%的下背部问题,57%的头痛,51%为声音嘶哑,43%的脖子问题。二元逻辑回归显示,专业PETs是健康风险最高的组。他们患肌肉骨骼或听力障碍的可能性是其他两组教师的两倍。他们也更有可能患有声音嘶哑。了解这些不同的健康挑战对于开发有针对性的干预措施和强大的支持系统至关重要。这些干预措施应包括旨在提高对健康风险因素的认识的举措,实施损伤干预措施和声带卫生计划,进行人体工程学调整,和促进自我保健意识(精神和身体)。鉴于目前教师职业正在努力应对劳动力老化和教师短缺的问题,解决这些挑战对教学专业人员的持续福祉至关重要。
    During the course of their work, teachers may be subjected to conditions that cause different health problems. This study examines occupational health disorders in a representative sample of 858 teachers (528 female; age 44.0 ± 9.67 years) divided into three groups of teachers with specific occupational requirements: specialist physical education teachers (specialist PETs), classroom teachers, and specialist teachers. The number of health disorders in the last 12 months was recorded using the Chronic Health Disorders Questionnaire. The differences between the different types of teachers, controlled for sex and age, were analyzed using binary logistic regression. The results showed that 89% of teachers experienced colds as the most frequently reported health problem, followed by 58% for lower back problems, 57% for headaches, 51% for hoarseness, and 43% for neck problems. A binary logistic regression showed that specialist PETs were the group with the highest health risk. They were about twice as likely to have musculoskeletal or hearing disorders than the other two groups of teachers. They were also significantly more likely to suffer from hoarseness. Understanding these different health challenges is critical to developing targeted interventions and robust support systems. These interventions should include initiatives aimed at raising awareness of health risk factors, implementing injury interventions and vocal cord hygiene programs, making ergonomic adjustments, and promoting awareness of self-care (both mental and physical). Given that the teaching profession is currently struggling with an aging workforce and a shortage of teachers, addressing these challenges is critical to the continued well-being of the teaching professionals.
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  • 文章类型: Journal Article
    医生经常会遇到报告耳鸣的患者。耳鸣是一种症状,其中在没有外部声源的情况下在耳朵或头部中感知到声音或声音。大多数经历耳鸣的人对感知会有中性反应,但是在一小部分患者中,耳鸣可能是一种使人衰弱的症状。当它造成负担时,患者可能会在生活的多个不同方面受到影响,包括睡眠障碍,听力认知以及心理和精神健康,往往导致高医疗保健利用率和社会成本。因此,慢性,致残性耳鸣是一种复杂的疾病,具有多种因素和多种持续的生物心理社会因素。尽管努力增加对其病理生理学的了解和对治疗的研究,对现实世界的临床实践影响不大。目前尚无经证实有效的药物治疗或专门用于慢性、禁用耳鸣。尽管如此,有一个作用是通过多学科的方法来治疗这种情况,特别是针对共同的活动性精神病,在适当的临床环境中使用助听器,例如与确认的听力损失相关的助听器,对报告令人烦恼的耳鸣患者进行专门的认知行为治疗。在这方面,认知行为疗法仍然是最有价值的循证干预措施。这篇叙述性综述试图总结目前在病理生理学方面的理解,对可能遇到致残患者的内科医生耳鸣的评估和治疗,慢性耳鸣.
    Physicians will frequently encounter patients who report tinnitus. Tinnitus is a symptom whereby there is the perception of sound or sounds in the ear or head in the absence of an external source of sound. Most individuals experiencing tinnitus will have a neutral reaction to the percept, but in a small proportion of patients, tinnitus can be a debilitating symptom. When it causes burden, patients can be affected in multiple different facets of life, including impairment in sleep, hearing cognition and psychological and psychiatric well-being, often resulting in high healthcare utilisation and societal costs. Hence, chronic, disabling tinnitus is a complex condition with multifactorial causes and multiple perpetuating biopsychosocial factors. Despite efforts to increase knowledge about its pathophysiology and research into treatments, little impact on real-world clinical practice has been seen. There are no proven effective pharmacological treatments or complementary medicines specifically for chronic, disabling tinnitus. Despite this, there is a role for treating this condition through a multidisciplinary approach specifically targeting comorbid active psychiatric conditions, using hearing aids in appropriate clinical settings such as in those with a coassociated confirmed hearing loss, and specialised cognitive behavioural therapy for patients reporting bothersome tinnitus. Cognitive behavioural therapy remains the most valuable evidence-based intervention in this regard. This narrative review attempts to summarise the current understanding in terms of pathophysiology, assessment and treatment of tinnitus for the internal physician who may encounter patients with disabling, chronic tinnitus.
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  • 文章类型: Journal Article
    背景:新生儿听力问题的早期发现和干预对于他们的听觉和言语发育至关重要,需要新生儿听力筛查。本研究旨在调查分娩方式的影响,特别是自然分娩和剖宫产,新生儿听力筛查结果。
    方法:对2020年1月至2023年1月在邵阳大学附属第一医院分娩的600名新生儿的数据进行了回顾性分析。最初的听力筛查使用AccuScreen耳声发射仪器。该研究检查了分娩方式对新生儿出生后48小时及以后的首次听力筛查通过率的影响。
    结果:初次听力筛查的通过率,在出生后48小时内和之后进行,自然分娩组明显高于剖宫产组(P<0.05)。此外,多变量分析确定分娩方法是影响新生儿首次听力筛查通过率的重要因素。
    结论:分娩方式似乎会影响新生儿初次听力筛查的结果,尽管需要进一步的研究来验证这些发现。
    BACKGROUND: Early detection and intervention of hearing issues in newborns are crucial for their auditory and speech development, necessitating newborn hearing screenings. This study aimed to investigate the impact of delivery methods, specifically natural delivery and cesarean section, on newborn hearing screening outcomes.
    METHODS: A retrospective analysis was conducted on data from 600 newborns delivered at The First Affiliated Hospital of Shaoyang University between January 2020 and January 2023. The initial hearing screenings used the AccuScreen otoacoustic emission instrument. The study examined the influence of delivery method on the pass rates of newborns\' first hearing screenings within and beyond 48 h postbirth.
    RESULTS: The pass rates for the initial hearing screenings, conducted within and after 48 h of birth, were significantly higher in the natural delivery group compared to the cesarean section group (P < 0.05). Furthermore, multivariate analysis identified the delivery method as a significant factor influencing the pass rates of newborns\' first hearing screenings.
    CONCLUSIONS: The mode of delivery appears to affect the results of the initial hearing screenings of newborns, though further research is needed to validate these findings.
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  • 文章类型: Journal Article
    背景:NF2相关神经鞘瘤病(NF2-SWN,以前称为神经纤维瘤病2型)是一种肿瘤易感性综合征,表现为多发性前庭神经鞘瘤,非前庭神经鞘瘤,脑膜瘤,和室管膜瘤.这种情况无情地进展,没有批准的疗法。根据Brigatinib(多种酪氨酸激酶抑制剂)在NF2驱动的非前庭神经鞘瘤和脑膜瘤中的临床前活性,对于患有多种类型的进展性NF2-SWN肿瘤的患者,需要使用布格替尼的数据.
    方法:在带有篮子设计的第2阶段平台试验中,12岁或以上的NF2-SWN患者和进展性肿瘤患者接受每日180mg口服布格替尼治疗.中央审查委员会评估了每位患者的一个目标肿瘤和最多五个非目标肿瘤。主要结果是靶肿瘤的影像学反应。关键次要结果是安全性,所有肿瘤的反应率,听力反应,和患者报告的结果。
    结果:共有40名患者(中位年龄,26年)进行性靶肿瘤(10例前庭神经鞘瘤,8个非前庭神经鞘瘤,20个脑膜瘤,和2个室管膜瘤)接受布格替尼治疗。在中位随访10.4个月后,有影像学反应的肿瘤百分比为10%(95%置信区间[CI],目标肿瘤为3至24),所有肿瘤为23%(95%CI,16至30);脑膜瘤和非前庭神经鞘瘤的益处最大。治疗期间,所有肿瘤类型的年化增长率均降低。35%(95%CI,20至53)的合格耳朵听力改善。探索性分析表明,治疗期间自我报告的疼痛严重程度降低(每月-0.013单位;95%CI,-0.002至-0.029),评分从0(无疼痛)到3(严重疼痛)。未报告4级或5级治疗相关不良事件。
    结论:Brigatinib治疗导致多种肿瘤类型的影像学反应,并在NF2-SWN患者的大量预处理队列中获得临床益处。(由儿童肿瘤基金会等资助;INTUITT-NF2ClinicalTrials.gov编号,NCT04374305。).
    BACKGROUND: NF2-related schwannomatosis (NF2-SWN, formerly called neurofibromatosis type 2) is a tumor predisposition syndrome that is manifested by multiple vestibular schwannomas, nonvestibular schwannomas, meningiomas, and ependymomas. The condition is relentlessly progressive with no approved therapies. On the basis of preclinical activity of brigatinib (an inhibitor of multiple tyrosine kinases) in NF2-driven nonvestibular schwannoma and meningioma, data were needed on the use of brigatinib in patients with multiple types of progressive NF2-SWN tumors.
    METHODS: In this phase 2 platform trial with a basket design, patients who were 12 years of age or older with NF2-SWN and progressive tumors were treated with oral brigatinib at a dose of 180 mg daily. A central review committee evaluated one target tumor and up to five nontarget tumors in each patient. The primary outcome was radiographic response in target tumors. Key secondary outcomes were safety, response rate in all tumors, hearing response, and patient-reported outcomes.
    RESULTS: A total of 40 patients (median age, 26 years) with progressive target tumors (10 vestibular schwannomas, 8 nonvestibular schwannomas, 20 meningiomas, and 2 ependymomas) received treatment with brigatinib. After a median follow-up of 10.4 months, the percentage of tumors with a radiographic response was 10% (95% confidence interval [CI], 3 to 24) for target tumors and 23% (95% CI, 16 to 30) for all tumors; meningiomas and nonvestibular schwannomas had the greatest benefit. Annualized growth rates decreased for all tumor types during treatment. Hearing improvement occurred in 35% (95% CI, 20 to 53) of eligible ears. Exploratory analyses suggested a decrease in self-reported pain severity during treatment (-0.013 units per month; 95% CI, -0.002 to -0.029) on a scale from 0 (no pain) to 3 (severe pain). No grade 4 or 5 treatment-related adverse events were reported.
    CONCLUSIONS: Brigatinib treatment resulted in radiographic responses in multiple tumor types and clinical benefit in a heavily pretreated cohort of patients with NF2-SWN. (Funded by the Children\'s Tumor Foundation and others; INTUITT-NF2 ClinicalTrials.gov number, NCT04374305.).
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    本文探讨了老年听觉障碍的创新研究方向,强调了随着中国人口老龄化,老年听力损失成为重大公共卫生问题。文章探讨了建立我国自己的老年听觉障碍流行病学数据和预警体系的必要性,提出临床特征分型诊断、年龄相关听力损失大动物模型、规范化治疗方案、心理治疗和言语康复技术以及数字化诊疗体系等需要迫切解决的关键科学问题。旨在通过梳理相关技术创新,提高老年听力障碍的诊断、治疗和康复效果,减轻家庭和社会负担。.
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  • 文章类型: Journal Article
    Chronic tinnitus is a common symptom of the auditory system. A causal therapy does not yet exist. The recommended treatment includes expert counseling, psychotherapeutic interventions, particularly cognitive behavioral therapy, and measures to improve hearing. The treatment modules are multimodal and can be combined individually. Depending on the severity of the different disease dimensions (tinnitus and comorbidities), a rehabilitative approach may be useful for maintaining health and occupational ability. In addition to a thorough and well-founded diagnosis and counseling, specific cognitive behavioral therapy and non-specific psychotherapeutic interventions (mindfulness/relaxation) on an individual or group basis, physiotherapy, and exercise, as well as auditory rehabilitation measures (hearing aids, auditory therapy) in the context of multimodal therapy approaches are necessary.
    UNASSIGNED: Chronischer Tinnitus ist ein häufig auftretendes Symptom des auditorischen Systems. Eine kausale Therapie gibt es noch nicht. Die empfohlene Behandlung umfasst neben einer fachkundigen Beratung (Counselling) psychotherapeutische Interventionen, insbesondere kognitive Verhaltenstherapie, und Maßnahmen zur Verbesserung des Hörvermögens. Je nach Ausprägung der verschiedenen Störungsdimensionen (Tinnitus und Komorbiditäten) kann ein ambulanter oder stationär-rehabilitativer Ansatz für die Aufrechterhaltung von Gesundheit und Arbeitsfähigkeit sinnvoll sein. Neben einer gründlichen und fundierten Diagnostik und Beratung sind bei einer rehabilitativen Behandlung Tinnitus-Counselling, spezifische kognitive Verhaltenstherapie und unspezifische psychotherapeutische Interventionen (Achtsamkeit/Entspannung) auf Einzel- oder Gruppenbasis, Physiotherapie und Bewegung sowie hörtherapeutische Maßnahmen (Hörgeräte, Hörtherapie) im Kontext multimodaler Therapieansätze notwendig.
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  • 文章类型: Journal Article
    背景:老年人的感觉障碍与认知功能下降有关,抑郁症状升高,和低水平的生活满意度。然而,这些关系通常是分开和成对的。这项研究全面检查了这些关系,第一次。
    方法:分析包括来自中国健康与退休纵向研究的5,658名社区居住的老年人(年龄在50至108岁之间,52.1%的男性)完成了Jorm线人问卷的老年人认知下降和流行病学研究中心-抑郁症-简表。问卷被用来收集听力信息,视觉状态,和生活满意度。结构方程模型用于检查这些变量之间的直接和间接关系。
    结果:自我报告的听力和视力问题与认知能力下降和抑郁症状升高直接相关。此外,听力和视力问题通过升高的抑郁症状与认知能力下降间接相关。尽管听力和视力问题对生活满意度没有直接影响,它们通过认知功能下降和抑郁症状与生活满意度间接相关.
    结论:这项研究为听力和视力问题之间的全面关系提供了第一个流行病学证据。认知能力下降,抑郁症状,和生活满意度。当老年人报告听力和/或视力问题时,临床医生和护理人员应该意识到认知下降的并发,抑郁症状升高,并补偿生活满意度。未来的研究应该检查因果关系和这些关系的潜在机制。
    BACKGROUND: Sensory impairment in older adults is associated with cognitive decline, elevated depressive symptoms, and low levels of life satisfaction. However, these relationships are usually investigated separately and in pairs. This study examined these relationships comprehensively, for the first time.
    METHODS: The analysis included 5,658 community-dwelling older adults from the China Health and Retirement Longitudinal Study (aged 50 to 108 years, 52.1% male) who completed the Jorm Informant Questionnaire Cognitive Decline in the Elderly and the Center for Epidemiological Studies-Depression-short form. A questionnaire was used to collect information on hearing, visual status, and life satisfaction. Structural equation modelling was used to examine the direct and indirect relationships between these variables.
    RESULTS: Self-reported hearing and vision problems are directly associated with cognitive decline and elevated depressive symptoms. In addition, hearing and vision problems are indirectly related to cognitive decline through elevated depressive symptoms. Although hearing and vision problems had no direct effect on life satisfaction, they were indirectly associated with life satisfaction through cognitive decline and depressive symptoms.
    CONCLUSIONS: This study provides the first epidemiological evidence of the comprehensive relationships between hearing and vision problems, cognitive decline, depressive symptoms, and life satisfaction. When older adults report hearing and/or vision problems, clinicians and caregivers should be aware of the concurrence of declined cognition, elevated depressive symptoms, and compensated life satisfaction. Future studies should examine the causal relationships and potential mechanisms of these relationships.
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  • 文章类型: Review
    听力损失影响着全球16亿人,尤其影响着低收入和中等收入国家的人。尽管在很大程度上是可以预防或治疗的,耳朵和听力条件导致严重的和终身的发病率,如延迟的语言发展,教育程度降低,减少社会福祉。有必要加强预防,早期识别,治疗,以及这些条件的康复。扩大了听力筛查的机会,听力健康劳动力的增长,耳朵和听力护理系统的创新是需要的变化之一。为此,世界卫生组织已将耳部和听力保健列为全民健康覆盖的优先事项,和最近的出版物提出了耳朵和听力护理的优先事项。世界各地的国家一级正在努力,赞比亚和尼日利亚等国已将耳部和听力保健纳入国家卫生战略。虽然在改善获取方面取得了重大进展,仍然迫切需要更多的研究,倡导,和干预,以确保没有人在实现普遍获得耳朵和听力保健的目标上落在后面。
    Hearing loss affects 1.6 billion people worldwide and disproportionately affects those in low- and middle-income countries. Despite being largely preventable or treatable, ear and hearing conditions result in significant and lifelong morbidity such as delayed language development, reduced educational attainment, and diminished social well-being. There is a need to augment prevention, early identification, treatment, and rehabilitation for these conditions. Expanded access to hearing screening, growth of the hearing health workforce, and innovations in ear and hearing care delivery systems are among the changes that are needed. To that end, the World Health Organization has prioritized ear and hearing care as a component of Universal Health Coverage, and recent publications have advanced the priority for ear and hearing care. Efforts are underway at the national levels around the world, as evidenced by countries like Zambia and Nigeria that have integrated ear and hearing care within national health strategies. While significant strides have been made in improving access, a critical need remains for additional research, advocacy, and intervention to ensure that no one is left behind in the goal to achieve universal access to ear and hearing care.
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  • 文章类型: Journal Article
    目的:混音是一种精神病,其特征是对听觉刺激有强烈的情绪和/或行为反应,导致痛苦和功能障碍。尽管以前尝试过定义和分类这种情况,目前,《精神疾病诊断和统计手册》或《国际疾病分类》中没有混音。缺乏正式的诊断共识对旨在评估和治疗这种临床表现的研究提出了挑战。
    方法:本研究在迄今为止最大的寻求治疗的样本中,呈现了青年(N=47)患有鼻音的临床特征。我们检查了样本的人口统计学特征,合并症的频率,特定错音症状的频率(即,触发器,情绪和行为反应,和损伤),和照顾者-儿童症状协议。使用包括临床医生在内的多模式评估来评估混音症状,青春,和护理人员关于凭经验确定的不发音措施的报告,并评估了措施之间的一致性。
    结果:寻求治疗的青少年出现明显的错音症状和一系列合并症。青年和护理人员确定了各种问音症状的触发因素(例如,咀嚼的声音,呼吸声),以及广泛的情感(例如,愤怒,烦恼,厌恶)和行为(例如,侵略,避免)对触发器的响应。青年和护理人员对错音触发因素的共识很高,但对症状严重程度和相关损害的共识较低。与年龄较小的儿童(8-13岁)相比,年龄较大的儿童(14岁以上)似乎更可靠地报告症状严重程度和相关损伤.
    结论:混音是一种异质性和损害性的临床疾病,值得未来的研究和循证治疗发展。
    OBJECTIVE: Misophonia is a psychiatric condition characterized by strong emotional and/or behavioral responses to auditory stimuli, leading to distress and functional impairment. Despite previous attempts to define and categorize this condition, misophonia is not currently included in the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases. The lack of formal diagnostic consensus presents challenges for research aimed at assessing and treating this clinical presentation.
    METHODS: The current study presents clinical characteristics of youth (N = 47) with misophonia in the largest treatment-seeking sample to date. We examined demographic characteristics of the sample, frequency of comorbid disorders, frequency of specific misophonia symptoms (i.e., triggers, emotional and behavioral responses, and impairments), and caregiver-child symptom agreement. Misophonia symptoms were evaluated using a multimodal assessment including clinician, youth, and caregiver reports on empirically established misophonia measures, and concordance among measures was assessed.
    RESULTS: Youth seeking treatment for misophonia presented with marked misophonia symptoms and an array of comorbid conditions. Youth and caregivers identified various triggers of misophonia symptoms (e.g., chewing sounds, breathing sounds), as well as a wide range of emotional (e.g., anger, annoyance, disgust) and behavioral (e.g., aggression, avoidance) responses to triggers. Youth and caregivers exhibited high agreement on misophonia triggers but lower agreement on symptom severity and associated impairment. Compared to younger children (aged 8-13), older children (aged 14+) appeared to report symptom severity and associated impairment more reliably.
    CONCLUSIONS: Misophonia is a heterogenous and impairing clinical condition that warrants future investigation and evidence-based treatment development.
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