Has your baby been screened for hearing impairment?

October 25, 2010 by  
Filed under HEARING

Hearing impairment is something that is not easily discernible in adults, much more in babies and little children. Studies have shown that even the slightest hearing impairment can translate to behavioural and learning difficulties in children. Those who suffer from more serious hearing problems can face a lifetime of speech and language deficits, poor academic performance and social and psychological problems. This is because even though the child can hear, he or she is missing some details of what is going on the environment, but cannot understand what is going on. It is thus important that children be screened early in life for hearing problems.

Hearing impairments may be congenital or acquired. Thus, screening for hearing loss should start early, in fact, right after the delivery of the baby. This means that a baby is screened before it leaves the hospital or the maternity clinic.

The two most commonly used hearing screening procedures for babies are (source: American Speech-Language Hearing Association (ASLHA):

The initial result of the screening is “pass” or “fail”. Those who pass are considered free from hearing impairment till the next screening. Those who fail require an intensive evaluation by an expert such as an audiologist or an ear specialist. They will be closely monitored for progression of the impairment plus other auditory-related effects.

In the clinical report of the American Academy of Pediatrics (AAP) entitle “Hearing Assessment in Infants and Children: Recommendations Beyond Neonatal Screening”:

“… researchers have developed an algorithm to assist pediatricians determine the course of treatment when a hearing screening indicates hearing loss in children from infants to 18 years of age. Confirmed abnormal hearing test results require ongoing evaluation and intervention by a team of specialists including an audiologist, otolaryngologist, speech-language pathologists and teachers. At least one-third of children with hearing loss will also have a coexisting condition, so they should continue to be monitored for developmental and behavioral disorders and referred for additional evaluation when necessary.”

Hangover: drink color does matter

January 19, 2010 by  
Filed under ADDICTION

Alcoholic drinks weren’t created equal. They come in different sizes, strengths, tastes, and yes – colors. You’d think that the last one is the least important when it comes to the after effects. But actually color does matter, according to researchers at Brown University.

The study looked at 95 young adults aged 21 to 33 who were healthy and were partial to alcoholic drinks. The participant were given caffeine-free cola mixed with bourbon, vodka or tonic water to drink until the alcohol drinkers reached the level of being “legally drunk”, i.e. their breath alcohol concentrations were on average 0.11. The intoxicated participants were then allowed to sleep it off. During sleep, the participants were hooked up to sleep monitors which also recorded brain activity. The following day, the participants were awakened and were asked to report on the severity of their hangovers without the aid of coffee or aspirin. Here are some of the findings:

  • Dark drinks such as bourbon resulted in more severe hangovers compared to those reported by the vodka drinkers. Hangover symptoms reported include headache, nausea, loss of appetite and thirst.
  • The alcohol drinkers’ sleep quality was greatly diminished regardless of the color of the drink.
  • The alcohol drinker’s capacity to perform safety-sensitive tasks was also diminished, even up to the following morning. The type of alcohol has not type in their performance.
  • Expectedly, those who imbibed tonic water fare better in terms of sleep and task performance the next day. It was also no surprise that they didn’t report any hangover symptoms.

According to Brown researcher Damaris Rohsenow

“People did feel sicker the morning after bourbon than after vodka, but they still feel plenty sick after drinking all that vodka.”

The differences in the severity of hangovers may be due to natural chemicals generated during the distillation process. According to Rohsenow, bourbon contains 37 times more toxic compounds than vodka does, including nasty organic molecules such as acetone, acetaldehyde, tannins and furfural. Thus, the clearer the liquor, the less of these substances it contains, and the less severe are the hangover symptoms.

However, the lack of hangover symptoms does not mean the drinker is fit enough to perform certain tasks. All alcoholic drinks are created equal when it comes to postdrinking impairment.

Heart over head: cognitive problems in patients with chronic heart failure

February 17, 2009 by  
Filed under HEART AND STROKE

Heart failure and cognitive decline – is there a link? This is the question that researchers from the University of California Davis Medical Center wanted to answer.

It may not be evident but heart health and brain health are closely linked. The UC Davis  study was conducted by comparing 50 heart failure patients with 50 controls (participants without heart failure). The demographics of the two groups (age, gender and estimated intelligence quotient) were very similar. The total of 100 participants were then assessed using 19 neurophysiological tests that asses the following:

  • orientation
  • attention
  • memory
  • executive function
  • motor speed
  • reaction times

The tests have been showed to be effective in measuring specific cognitive functions. The results of the assessments show that heart failure patients performed poorly compared to the control group in the majority of the tests. Other key results are:

The severity of these cognitive deficits in this sample of HF patients was associated with several factors, namely depressed learning and previous heart attacks but not to the left ventricular ejection fraction (LVEF), depression, anxiety, or physical functioning, duration or the classification heart failure according to the New York Heart Association( NYHA) classification system.

Data on the link between heart functioning and brain function are very limited and the effects of chronic heart failure on cognitive functions are not fully understood. This study adds valuable data to this rather “underrecognized and underappreciated” issue. The results have some wide-encompassing clinical implications. According to lead author Dr Mary Jane Sauvé

What it means in clinical practice is that when you give these patients verbal instructions, you also need to provide written materials because of patient difficulties with information requiring attention, learning, and memory functions; that you include the family in the discussion whenever possible; and that patients and families need to have a direct line to call if they are getting into trouble or become confused about the instructions. There is nothing more frustrating than a phone tree, even for people without [cognitive impairment].”

It is a fact that although screening for depression in cardiac patients is highly recommended, screening for cognitive deficits is not routine performed. However, cognitive problems can lead to non-compliance with therapy and medication regimen. Thus, this review paper recommends that

“…future research needs to focus on identifying a simple screening tool that nurses can use to screen for subtle changes in cognition including forgetfulness and delayed recall. Early identification of subtle cognitive changes has the potential to guide healthcare providers to formulate feasible strategies to understand and/or prevent a low cardiac output state before major cognitive impairment becomes evident.”

 

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.