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Sample records for chronic tinnitus patients

  1. Catastrophizing and fear of tinnitus predict quality of life in patients with chronic tinnitus

    OpenAIRE

    Cima, Rilana FF; Crombez, Geert; Vlaeyen, Johan WS

    2011-01-01

    Objectives: It is well established that catastrophic misinterpretations and fear are involved in the suffering and disability of patients with chronic pain. This study investigated whether similar processes explain suffering and disability in patients with chronic tinnitus. We hypothesized that patients who catastrophically (mis)interpret their tinnitus would be more fearful of tinnitus, more vigilant toward their tinnitus, and report less quality of life. Moreover, tinnitus-related fear was ...

  2. The influence of tinnitus acceptance on the quality of life and psychological distress in patients with chronic tinnitus

    OpenAIRE

    David Riedl; Gerhard Rumpold; Annette Schmidt; Zorowka, Patrick G.; Bliem, Harald R.; Roland Moschen

    2015-01-01

    Recent findings show the importance of acceptance in the treatment of chronic tinnitus. So far, very limited research investigating the different levels of tinnitus acceptance has been conducted. The aim of this study was to investigate the quality of life (QoL) and psychological distress in patients with chronic tinnitus who reported different levels of tinnitus acceptance. The sample consisted of outpatients taking part in a tinnitus coping group (n = 97). Correlations between tinnitus acce...

  3. Altered Interhemispheric Functional Coordination in Chronic Tinnitus Patients

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    Yu-Chen Chen

    2015-01-01

    Full Text Available Purpose. Recent studies suggest that tinnitus may be due in part to aberrant callosal structure and interhemispheric interaction. To explore this hypothesis we use a novel method, voxel-mirrored homotopic connectivity (VMHC, to examine the resting-state interhemispheric functional connectivity and its relationships with clinical characteristics in chronic tinnitus patients. Materials and Methods. Twenty-eight chronic tinnitus patients with normal hearing thresholds and 30 age-, sex-, education-, and hearing threshold-matched healthy controls were included in this study and underwent the resting-state fMRI scanning. We computed the VMHC to analyze the interhemispheric functional coordination between homotopic points of the brain in both groups. Results. Compared to the controls, tinnitus patients showed significantly increased VMHC in the middle temporal gyrus, middle frontal gyrus, and superior occipital gyrus. In tinnitus patients, a positive correlation was found between tinnitus duration and VMHC of the uncus. Moreover, correlations between VMHC changes and tinnitus distress were observed in the transverse temporal gyrus, superior temporal pole, precentral gyrus, and calcarine cortex. Conclusions. These results show altered interhemispheric functional connectivity linked with specific tinnitus characteristics in chronic tinnitus patients, which may be implicated in the neuropathophysiology of tinnitus.

  4. The influence of tinnitus acceptance on the quality of life and psychological distress in patients with chronic tinnitus

    Directory of Open Access Journals (Sweden)

    David Riedl

    2015-01-01

    Full Text Available Recent findings show the importance of acceptance in the treatment of chronic tinnitus. So far, very limited research investigating the different levels of tinnitus acceptance has been conducted. The aim of this study was to investigate the quality of life (QoL and psychological distress in patients with chronic tinnitus who reported different levels of tinnitus acceptance. The sample consisted of outpatients taking part in a tinnitus coping group (n = 97. Correlations between tinnitus acceptance, psychological distress, and QoL were calculated. Receiver operating characteristic (ROC curves were used to calculate a cutoff score for the German "Tinnitus Acceptance Questionnaire" (CTAQ-G and to evaluate the screening abilities of the CTAQ-G. Independent sample t-tests were conducted to compare QoL and psychological distress in patients with low tinnitus acceptance and high tinnitus acceptance. A cutoff point for CTAQ-G of 62.5 was defined, differentiating between patients with "low-to-mild tinnitus acceptance" and "moderate-to-high tinnitus acceptance." Patients with higher levels of tinnitus acceptance reported a significantly higher QoL and lower psychological distress. Tinnitus acceptance plays an important role for patients with chronic tinnitus. Increased levels of acceptance are related to better QoL and less psychological distress.

  5. Disrupted Brain Functional Network Architecture in Chronic Tinnitus Patients

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    Chen, Yu-Chen; Feng, Yuan; Xu, Jin-Jing; Mao, Cun-Nan; Xia, Wenqing; Ren, Jun; Yin, Xindao

    2016-01-01

    Purpose: Resting-state functional magnetic resonance imaging (fMRI) studies have demonstrated the disruptions of multiple brain networks in tinnitus patients. Nonetheless, several studies found no differences in network processing between tinnitus patients and healthy controls (HCs). Its neural bases are poorly understood. To identify aberrant brain network architecture involved in chronic tinnitus, we compared the resting-state fMRI (rs-fMRI) patterns of tinnitus patients and HCs. Materials and Methods: Chronic tinnitus patients (n = 24) with normal hearing thresholds and age-, sex-, education- and hearing threshold-matched HCs (n = 22) participated in the current study and underwent the rs-fMRI scanning. We used degree centrality (DC) to investigate functional connectivity (FC) strength of the whole-brain network and Granger causality to analyze effective connectivity in order to explore directional aspects involved in tinnitus. Results: Compared to HCs, we found significantly increased network centrality in bilateral superior frontal gyrus (SFG). Unidirectionally, the left SFG revealed increased effective connectivity to the left middle orbitofrontal cortex (OFC), left posterior lobe of cerebellum (PLC), left postcentral gyrus, and right middle occipital gyrus (MOG) while the right SFG exhibited enhanced effective connectivity to the right supplementary motor area (SMA). In addition, the effective connectivity from the bilateral SFG to the OFC and SMA showed positive correlations with tinnitus distress. Conclusions: Rs-fMRI provides a new and novel method for identifying aberrant brain network architecture. Chronic tinnitus patients have disrupted FC strength and causal connectivity mostly in non-auditory regions, especially the prefrontal cortex (PFC). The current findings will provide a new perspective for understanding the neuropathophysiological mechanisms in chronic tinnitus. PMID:27458377

  6. Impairments of thalamic resting-state functional connectivity in patients with chronic tinnitus

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    Zhang, Jian [Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing (China); Chen, Yu-Chen [Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing (China); Center for Hearing and Deafness, University at Buffalo, State University of New York, Buffalo, NY (United States); Feng, Xu [Department of Otolaryngology, Zhongda Hospital, Medical School, Southeast University, Nanjing (China); Yang, Ming; Liu, Bin; Qian, Cheng [Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing (China); Wang, Jian [Department of Physiology, Southeast University, Nanjing (China); School of Human Communication Disorders, Dalhousie University, Halifax, NS (Canada); Salvi, Richard [Center for Hearing and Deafness, University at Buffalo, State University of New York, Buffalo, NY (United States); Teng, Gao-Jun, E-mail: gjteng@vip.sina.com [Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing (China)

    2015-07-15

    Highlights: • Tinnitus patients have aberrant thalamic connectivity to many brain regions. • Decreased thalamic connectivity is linked with tinnitus characteristics. • Thalamocortical connectivity disturbances can reflect tinnitus-related networks. - Abstract: Purpose: The phantom sound of tinnitus is believed to arise from abnormal functional coupling between the thalamus and cerebral cortex. To explore this hypothesis, we used resting-state functional magnetic resonance imaging (fMRI) to compare the degree of thalamocortical functional connectivity in chronic tinnitus patients and controls. Materials and methods: Resting-state fMRI scans were obtained from 31 chronic tinnitus patients and 33 well-matched healthy controls. Thalamocortical functional connectivity was characterized using a seed-based whole-brain correlation method. The resulting thalamic functional connectivity measures were correlated with other clinical data. Results: We found decreased functional connectivity between the seed region in left thalamus and right middle temporal gyrus (MTG), right middle orbitofrontal cortex, left middle frontal gyrus, right precentral gyrus, and bilateral calcarine cortex. Decreased functional connectivity was detected between the seed in the right thalamus and the left superior temporal gyrus (STG), left amygdala, right superior frontal gyrus, left precentral gyrus, and left middle occipital gyrus. Tinnitus distress correlated negatively with thalamic functional connectivity in right MTG; tinnitus duration correlated negatively with thalamic functional connectivity in left STG. Increased functional connectivity between the bilateral thalamus and a set of regions were also observed. Conclusions: Chronic tinnitus patients have disrupted thalamocortical functional connectivity to selected brain regions which is associated with specific tinnitus characteristics. Resting-state thalamic functional connectivity disturbances may play an important role in

  7. Acoustic Coordinated Reset Neuromodulation in a Real Life Patient Population with Chronic Tonal Tinnitus

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    Christian Hauptmann

    2015-01-01

    Full Text Available Purpose. Primary tinnitus has a severe negative influence on the quality of life of a significant portion of the general population. Acoustic coordinated reset neuromodulation is designed to induce a long-lasting reduction of tinnitus symptoms. To test acoustic coordinated reset neuromodulation as a treatment for chronic, tonal tinnitus under real life conditions, an outpatient study “RESET Real Life” was commissioned by ANM GmbH. Herein we present the results of this study. Methods. In a prospective, open-label, nonrandomized, noncontrolled multicenter clinical study with 200 chronic tinnitus patients, tinnitus questionnaire TBF-12 and Global Clinical Improvement-Impression Scale (CGI-I7 are used to study the safety and efficacy of acoustic coordinated reset neuromodulation. 189 patients completed the last 12-month visit, 11 patients dropped out (8 because of nontreatment related reasons; 2 because tinnitus did not change; and 1 because tinnitus got louder. Results. Acoustic coordinated reset neuromodulation caused a statistically and clinically significant decrease in TBF-12 scores as well as in CGI-I7 after 12 months of therapy under real life conditions. There were no persistent adverse events reported that were related to the therapy. Conclusion. The field study “RESET Real Life” provides evidence for safety and efficacy of acoustic coordinated reset neuromodulation in a prospective, open-label, real life setting.

  8. Therapeutic role of Vitamin B12 in patients of chronic tinnitus: A pilot study

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    Charu Singh

    2016-01-01

    Full Text Available True tinnitus is a phantom auditory perception arising from a source or trigger in the cochlea, brainstem, or at higher centers and has no detectable acoustic generator. The most accepted is the famous neurophysiologic model of Jastreboff, which stresses that tinnitus, is a subcortical perception and results from the processing of weak neural activity in the periphery. The aim of this study is to determine the role of Vitamin B12 in treatment of chronic tinnitus. In this randomized, double-blind pilot study, total 40 patients were enrolled, of which 20 in Group A (cases received intramuscular therapy of 1 ml Vitamin B12 (2500 mcg weekly for a period of 6 weeks and Group B (20 patients received placebo isotonic saline 01 ml intramuscular. The patients were subjected to Vitamin B12 assay and audiometry pre- and post-therapy. Of the total patients of tinnitus, 17 were Vitamin B12 deficient that is 42.5% showed deficiency when the normal levels were considered to be 250 pg/ml. A paired t-test showed that in Group A, patients with Vitamin B12 deficiency showed significant improvement in mean tinnitus severity index score and visual analog scale (VAS after Vitamin B12 therapy. This pilot study highlights the significant prevalence of Vitamin B12 deficiency in North Indian population and improvement in tinnitus severity scores and VAS in cobalamin-deficient patients receiving intramuscular Vitamin B12 weekly for 6 weeks further provides a link between cobalamin deficiency and tinnitus thereby suggestive of a therapeutic role of B12 in cobalamin-deficient patients of tinnitus.

  9. Multimodal therapy for chronic tinnitus.

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    Hahn, Ales; Radkova, Lenka; Achiemere, Gabriela; Klement, Vladislav; Alpini, Dario; Strouhal, Jaroslav

    2008-01-01

    From 2001 to 2006, we performed a retrospective study of patients suffering from chronic unilateral or bilateral tinnitus that was previously ineffectively treated by oral drugs [betahistine (Betaserc), extract of Ginkgo biloba (EGb 761), tanakan (Tebokan), and cinnarizine-dimenhydrinate (Arlevert), singly or in combination]. We divided 150 tinnitus patients (80 men, 70 women) into seven treatment groups. Treatments consisted of application of intravenous pentoxifylline, lidocaine, or vinpocetine (Cavinton) and combination of these agents with physiotherapy and soft laser. Mean duration (+/- standard deviation) of tinnitus in these patients was 7.4 +/- 6.0 years; their mean age was 55.6 +/- 12.5 years. The aim of our study was to compare treatment modalities and define their effectiveness for tinnitus relief. The most effective treatment was defined as a combination of Cavinton and physiotherapy. We evaluated pure lidocaine infusion therapy as ineffective. None of the treatment modalities had an objective correlate of improvement, though improvement was reported by a visual analog scale. PMID:18616089

  10. Psychophysiological Associations between Chronic Tinnitus and Sleep: A Cross Validation of Tinnitus and Insomnia Questionnaires

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    Martin Schecklmann

    2015-01-01

    Full Text Available Background. The aim of the present study was to assess the prevalence of insomnia in chronic tinnitus and the association of tinnitus distress and sleep disturbance. Methods. We retrospectively analysed data of 182 patients with chronic tinnitus who completed the Tinnitus Questionnaire (TQ and the Regensburg Insomnia Scale (RIS. Descriptive comparisons with the validation sample of the RIS including exclusively patients with primary/psychophysiological insomnia, correlation analyses of the RIS with TQ scales, and principal component analyses (PCA in the tinnitus sample were performed. TQ total score was corrected for the TQ sleep items. Results. Prevalence of insomnia was high in tinnitus patients (76% and tinnitus distress correlated with sleep disturbance (r=0.558. TQ sleep subscore correlated with the RIS sum score (r=0.690. PCA with all TQ and RIS items showed one sleep factor consisting of all RIS and the TQ sleep items. PCA with only TQ sleep and RIS items showed sleep- and tinnitus-specific factors. The sleep factors (only RIS items were sleep depth and fearful focusing. The TQ sleep items represented tinnitus-related sleep problems. Discussion. Chronic tinnitus and primary insomnia are highly related and might share similar psychological and neurophysiological mechanisms leading to impaired sleep quality.

  11. Sleep Quality of Patients with Tinnitus

    OpenAIRE

    Özler, Gül Soylu; Arlı, Cengiz; Çevik, Cengiz; Ercan AKBAY; Yengil, Erhan

    2014-01-01

    Objective: The aim of this study is to assess the sleep quality of tinnitus sufferers and to confirm the relationship between age, gender, tinnitus duration and tinnitus severity and sleep disturbances.Materials and methods: Sixty tinnitus patients and 60 control subjects without tinnitus were included in this study. Age, gender, duration of tinnitus were listed on a chart. Tinnitus severity was measured by Tinnitus Handicap Inventory (THI) (for tinnitus group). Pittsburgh Sleep Quality Index...

  12. Long-term evaluation of treatment of chronic, therapeutically refractory tinnitus by neurostimulation

    NARCIS (Netherlands)

    Staal, M. J.; Holm, A. F.; Mooij, J. J. A.; Albers, F. W. J.; Bartels, H.

    2007-01-01

    Objective: Long-term evaluation of treatment of chronic, therapeutically refractory tinnitus by means of chronic electrical stimulation of the vestibulocochlear nerve. Patients: Inclusion criteria were severe, chronic, therapeutically refractory, unilateral tinnitus and severe hearing loss at the ip

  13. Tinnitus

    OpenAIRE

    Savage, Julian; Waddell, Angus

    2012-01-01

    Up to 18% of people in industrialised societies are mildly affected by chronic tinnitus, and 0.5% report tinnitus having a severe effect on their daily life. Tinnitus can be associated with hearing loss, acoustic neuromas, drug toxicity, ear diseases, or depression.Tinnitus can last for many years, and can interfere with sleep and concentration.

  14. Tinnitus

    OpenAIRE

    Savage, Julian; Cook, Stephanie; Waddell, Angus

    2009-01-01

    Up to 18% of people in industrialised societies are mildly affected by chronic tinnitus, and 0.5% report tinnitus having a severe effect on their daily life. Tinnitus can be associated with hearing loss, acoustic neuromas, drug toxicity, ear diseases, or depression.Tinnitus can last for many years, and can interfere with sleep and concentration.

  15. Long-term effects of the “Heidelberg Model of Music Therapy” in patients with chronic tinnitus

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    Argstatter, Heike; Grapp, Miriam; Hutter, Elisabeth; Plinkert, Peter; Bolay, Hans Volker

    2012-01-01

    Objective The “Heidelberg Model of Music Therapy for Chronic Tinnitus” is a manualized short term treatment (nine 50-minutes sessions of individualized therapy on five consecutive days). It has proven to be efficient in reducing tinnitus symptoms in the short run. Now the long-term impact of the treatment after up to 5.4 years should be explored. Materials and methods 206 patients who had attended the neuro-music therapy were addressed in a structured follow-up questionnaire survey. 107 complete questionnaires entered analysis. Follow-up time was 2.65 (SD 1.1) years. Results 76% of the patients achieved a reliable reduction in their tinnitus scores, the overall tinnitus distress as measured by the Mini-TQ diminished from 11.9 (SD = 4.9) to 7.4 (SD = 5.2) points, 87% of the patients were satisfied by the way they were treated during therapy, and 71% of the patients did not undergo any further treatment after. Evaluation of therapeutic elements displays, that only music therapy specific interventions were rated helpful by the patients. Tinnitus related factors (such as tinnitus pitch or loudness, time since onset) did not influence therapy outcome but female gender, positive therapeutic relationship, and higher initial Mini-TQ scores became apparent as factors predicting better chances for greater therapy success. Discussion The “Heidelberg Model of Music Therapy for Chronic Tinnitus” seems to be effective in the long run. The outcome effect size of d’ = 0.89, can be accounted for as “large” effect and falls into the upper range value compared to established treatments. PMID:22993646

  16. Medium-Level Laser in Chronic Tinnitus Treatment

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    K. Dejakum

    2013-01-01

    Full Text Available The purpose of this study was to evaluate the effect of medium-level laser therapy in chronic tinnitus treatment. In a prospective double-blind placebo-controlled trial, either active laser (450 mW, 830 nm combined Ga-Al-As diode laser or placebo irradiation was applied through the external acoustic meatus of the affected ear towards the cochlea. Fourty-eight patients with chronic tinnitus were studied. The main outcome was measured using the Goebel tinnitus questionnaire, visual analogue scales measuring the perceived loudness of tinnitus, the annoyance associated with tinnitus, and the degree of attention paid to tinnitus as well as psycho-acoustical matches of tinnitus pitch and loudness. The results did show only very moderate temporary improvement of tinnitus. Moreover, no statistically relevant differences between laser and placebo group could be found. We conclude that medium-level laser therapy cannot be regarded as an effective treatment of chronic tinnitus in our therapy regime considering the limited number of patients included in our study.

  17. Abnormal resting-state cortical coupling in chronic tinnitus

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    Langguth Berthold

    2009-02-01

    Full Text Available Abstract Background Subjective tinnitus is characterized by an auditory phantom perception in the absence of any physical sound source. Consequently, in a quiet environment, tinnitus patients differ from control participants because they constantly perceive a sound whereas controls do not. We hypothesized that this difference is expressed by differential activation of distributed cortical networks. Results The analysis was based on a sample of 41 participants: 21 patients with chronic tinnitus and 20 healthy control participants. To investigate the architecture of these networks, we used phase locking analysis in the 1–90 Hz frequency range of a minute of resting-state MEG recording. We found: 1 For tinnitus patients: A significant decrease of inter-areal coupling in the alpha (9–12 Hz band and an increase of inter-areal coupling in the 48–54 Hz gamma frequency range relative to the control group. 2 For both groups: an inverse relationship (r = -.71 of the alpha and gamma network coupling. 3 A discrimination of 83% between the patient and the control group based on the alpha and gamma networks. 4 An effect of manifestation on the distribution of the gamma network: In patients with a tinnitus history of less than 4 years, the left temporal cortex was predominant in the gamma network whereas in patients with tinnitus duration of more than 4 years, the gamma network was more widely distributed including more frontal and parietal regions. Conclusion In the here presented data set we found strong support for an alteration of long-range coupling in tinnitus. Long-range coupling in the alpha frequency band was decreased for tinnitus patients while long-range gamma coupling was increased. These changes discriminate well between tinnitus and control participants. We propose a tinnitus model that integrates this finding in the current knowledge about tinnitus. Furthermore we discuss the impact of this finding to tinnitus therapies using Transcranial

  18. Medium-Level Laser in Chronic Tinnitus Treatment

    OpenAIRE

    K. Dejakum; Piegger, J.; C. Plewka; A. Gunkel; Thumfart, W.; S. Kudaibergenova; Goebel, G.; Kral, F.; Freysinger, W

    2013-01-01

    The purpose of this study was to evaluate the effect of medium-level laser therapy in chronic tinnitus treatment. In a prospective double-blind placebo-controlled trial, either active laser (450 mW, 830 nm combined Ga-Al-As diode laser) or placebo irradiation was applied through the external acoustic meatus of the affected ear towards the cochlea. Fourty-eight patients with chronic tinnitus were studied. The main outcome was measured using the Goebel tinnitus questionnaire, visual analogue sc...

  19. Illness representations as mediators of the relationship between dispositional optimism and depression in patients with chronic tinnitus: A cross-sectional study.

    NARCIS (Netherlands)

    Vollmann, Manja; Scharloo, Margreet; Langguth, Berthold; Kalkouskaya, Natallia; Salewski, Christel

    2014-01-01

    Objective: Both dispositional optimism and illness representations are related to psychological health in chronic patients. In a group of chronic tinnitus sufferers, the interplay between these two variables was examined. Specifically, it was tested to what extent the relationship between dispositio

  20. Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar

    OpenAIRE

    Bechter, Karl; Wieland, Martin; Hamann, Gerhard F

    2016-01-01

    Introduction Cervicogenic tinnitus is not a generally accepted pathogenetic subtype, which might be subsumed under the concept of somatosensory tinnitus. After the personal experience of therapy-resistant tinnitus in context with a cervical pain syndrome (CPS) and successful add-on treatment with cervical collar (CC), the idea was pursued in several individual treatments in patients. Patients and methods Reporting one particular case with chronic tinnitus, considered untreatable, t...

  1. Tinnitus

    NARCIS (Netherlands)

    Hoekstra, Carlijn; Venekamp, Roderick; van Zanten, Bert

    2015-01-01

    In this article, a number of common questions about the diagnosis and treatment of tinnitus are discussed, based on the first author’s PhD thesis. It is hoped that this will help general practitioners when deciding whether to refer a patient with tinnitus to an otorhinolaryngologist or an audiologic

  2. Brainstem auditory evoked response characteristics in normal-hearing subjects with chronic tinnitus and in non-tinnitus group

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    Shadman Nemati

    2014-06-01

    Full Text Available Background and Aim: While most of the people with tinnitus have some degrees of hearing impairment, a small percent of patients admitted to ear, nose and throat clinics or hearing evaluation centers are those who complain of tinnitus despite having normal hearing thresholds. This study was performed to better understanding of the reasons of probable causes of tinnitus and to investigate possible changes in the auditory brainstem function in normal-hearing patients with chronic tinnitus.Methods: In this comparative cross-sectional, descriptive and analytic study, 52 ears (26 with and 26 without tinnitus were examined. Components of the auditory brainstem response (ABR including wave latencies and wave amplitudes were determined in the two groups and analyzed using appropriate statistical methods.Results: The mean differences between the absolute latencies of waves I, III and V was less than 0.1 ms between the two groups that was not statistically significant. Also, the interpeak latency values of waves I-III, III-V and I-V in both groups had no significant difference. Only, the V/I amplitude ratio in the tinnitus group was significantly higher (p=0.04.Conclusion: The changes observed in amplitude of waves, especially in the latter ones, can be considered as an indication of plastic changes in neuronal activity and its possible role in generation of tinnitus in normal-hearing patients.

  3. Neuromagnetic indicators of tinnitus and tinnitus masking in patients with and without hearing loss

    OpenAIRE

    Adjamian, Peyman; Sereda, Magdalena; Zobay, Oliver; Hall, Deborah A; Palmer, Alan R

    2012-01-01

    Tinnitus is an auditory phenomenon characterised by the perception of a sound in the absence of an external auditory stimulus. Chronic subjective tinnitus is almost certainly maintained via central mechanisms, and this is consistent with observed measures of altered spontaneous brain activity. A number of putative central auditory mechanisms for tinnitus have been proposed. The influential thalamocortical dysrhythmia model suggests that tinnitus can be attributed to the disruption of coherent...

  4. Spontaneous Otoacoustic Emissions in Tinnitus Patients

    Institute of Scientific and Technical Information of China (English)

    SHI Yongbing; William Martin

    2006-01-01

    Otoacoustic emissions (OAEs) are believed to be the products of active cochlear mechanics. They are generally associated with relatively intact outer hair cell function. OAEs usually decrease or become undetectable when hearing loss of cochlear origin exceeds 40-50 dB HL. Subjective tinnitus is a perception of sound without detectable corresponding source. It is most often seen in patients with hearing loss. It is also frequently seen in patients with head injuries. Studies have suggested that the prevalence of spontaneous otoacoustic emissions(SOAEs) is lower in patients with hearing loss and tinnitus than in normal population. There have also been reports on association between tinnitus and SOAEs of unusually high amplitudes, which can be controlled by aspirin administration. The current paper is a preliminary review of clinical data collected from a group oftinnitus patients in an attempt to elucidate on the relationship between SOAEs and tinnitus from a clinical point of view. Audiometric, tinnitus and SOAE data from 59 patients seen at the Oregon Health & Science University Tinnitus Clinic were retrospectively studied. Fifty-four of these 59 patients showed sensorineural hearing loss of various degrees at the time of evaluation, mostly affecting high frequencies. SOAEs were detected in 26 ears (22%) of 1 8 patients(30.5%). There was no difference in SOAE prevalence between male and female patients. SOAEs were recorded in four of the five patients whose pure tone thresholds were within normal limits up to 8000 Hz. SOAEs appeared to be recorded at a higher rate in patients whose tinnitus started following motor vehicle accidents or head injuries(5/10) than in other patients.Time course of tinnitus did not appear to affect SOAE detection rate. There were no correlations between SOAE frequency and matched tinnitus pitch or frequency of maximum hearing loss. Significance of these findings is discussed.

  5. Tinnitus

    Science.gov (United States)

    Tinnitus is often described as a ringing in the ears. It also can sound like roaring, clicking, ... one or both ears. Millions of Americans have tinnitus. People with severe tinnitus may have trouble hearing, ...

  6. Real-time fMRI feedback training may improve chronic tinnitus

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    Haller, Sven [University Hospital Basel, Institute of Radiology, Department of Neuroradiology, Basel (Switzerland); Department of Imaging and Medical Informatics, Geneva University Hospital, Institute of Neuroradiology, Geneva (Switzerland); Birbaumer, Niels [University of Tuebingen, Institute of Medical Psychology and Behavioral Neurobiology, Tuebingen (Germany); Instituto di Ricovero e Cura a Carattere Scientifico, Ospedale San Camillo, Venezia (Italy); Veit, Ralf [University of Tuebingen, Institute of Medical Psychology and Behavioral Neurobiology, Tuebingen (Germany)

    2010-03-15

    Tinnitus consists of a more or less constant aversive tone or noise and is associated with excess auditory activation. Transient distortion of this activation (repetitive transcranial magnetic stimulation, rTMS) may improve tinnitus. Recently proposed operant training in real-time functional magnetic resonance imaging (rtfMRI) neurofeedback allows voluntary modification of specific circumscribed neuronal activations. Combining these observations, we investigated whether patients suffering from tinnitus can (1) learn to voluntarily reduce activation of the auditory system by rtfMRI neurofeedback and whether (2) successful learning improves tinnitus symptoms. Six participants with chronic tinnitus were included. First, location of the individual auditory cortex was determined in a standard fMRI auditory block-design localizer. Then, participants were trained to voluntarily reduce the auditory activation (rtfMRI) with visual biofeedback of the current auditory activation. Auditory activation significantly decreased after rtfMRI neurofeedback. This reduced the subjective tinnitus in two of six participants. These preliminary results suggest that tinnitus patients learn to voluntarily reduce spatially specific auditory activations by rtfMRI neurofeedback and that this may reduce tinnitus symptoms. Optimized training protocols (frequency, duration, etc.) may further improve the results. (orig.)

  7. Real-time fMRI feedback training may improve chronic tinnitus

    International Nuclear Information System (INIS)

    Tinnitus consists of a more or less constant aversive tone or noise and is associated with excess auditory activation. Transient distortion of this activation (repetitive transcranial magnetic stimulation, rTMS) may improve tinnitus. Recently proposed operant training in real-time functional magnetic resonance imaging (rtfMRI) neurofeedback allows voluntary modification of specific circumscribed neuronal activations. Combining these observations, we investigated whether patients suffering from tinnitus can (1) learn to voluntarily reduce activation of the auditory system by rtfMRI neurofeedback and whether (2) successful learning improves tinnitus symptoms. Six participants with chronic tinnitus were included. First, location of the individual auditory cortex was determined in a standard fMRI auditory block-design localizer. Then, participants were trained to voluntarily reduce the auditory activation (rtfMRI) with visual biofeedback of the current auditory activation. Auditory activation significantly decreased after rtfMRI neurofeedback. This reduced the subjective tinnitus in two of six participants. These preliminary results suggest that tinnitus patients learn to voluntarily reduce spatially specific auditory activations by rtfMRI neurofeedback and that this may reduce tinnitus symptoms. Optimized training protocols (frequency, duration, etc.) may further improve the results. (orig.)

  8. From Signal Space to Source Space : does Source Space Projection Improve the Neurofeedback Therapy in Chronic Tinnitus Patients?

    OpenAIRE

    Lorenz, Isabel

    2007-01-01

    Tinnitus, the subjective perception of a sound in the absence of any external stimulus, is an auditory phantom phenomenon, which affects millions of people worldwide. The neurophysiological mechanisms of tinnitus are still poorly understood. Although multiple treatments have been developed, to date there is no validated cure of tinnitus.Based on findings of abnormal oscillatory cortical activity regarding a reduction of temporal alpha power (8 - 12 Hz) and an enhancement of temporal delta pow...

  9. Correlation between Hearing Threshold Tinnitus Pitch and Loundness with Quality Of Life of Tinnitus Patients in Makassar

    OpenAIRE

    Savitri, Eka

    2014-01-01

    Introduction: Tinnitus is an unwanted auditory perception, with many causes, subjectively and affects the quality of life. It is important to evaluating the quality of life of tinnitus patients and related factors in treatment of tinnitus. The measurements of tinnitus psychoacoustic include pitch, loudness, minimum masking levels and residual inhibition. Aim: To analyze the correlation between hearing threshold, tinnitus pitch and loudness with quality of life of tinnitus patients in Makassar...

  10. Frequency-Specific Alternations in the Amplitude of Low-Frequency Fluctuations in Chronic Tinnitus

    Directory of Open Access Journals (Sweden)

    Yu-Chen eChen

    2015-10-01

    Full Text Available Tinnitus, a phantom ringing, buzzing or hissing sensation with potentially debilitating consequences, is thought to arise from aberrant spontaneous neural activity at one or more sites within the central nervous system; however, the location and specific features of these oscillations are poorly understood with respect to specific tinnitus features. Recent resting-state functional magnetic resonance imaging (fMRI studies suggest that aberrant fluctuations in spontaneous low-frequency oscillations (LFO of the blood oxygen level-dependent (BOLD signal may be an important factor in chronic tinnitus; however, the role that frequency-specific components of LFO play in subjective tinnitus remains unclear. A total of 39 chronic tinnitus patients and 41 well-matched healthy controls participated in the resting-state fMRI scans. The LFO amplitudes were investigated using the amplitude of low-frequency fluctuation (ALFF and fractional ALFF (fALFF in two different frequency bands (slow-4: 0.027-0.073 Hz and slow-5: 0.01-0.027 Hz. We observed significant differences between tinnitus patients and normal controls in ALFF/fALFF in the two bands (slow-4 and slow-5 in several brain regions including the superior frontal gyrus (SFG, inferior frontal gyrus, middle temporal gyrus, angular gyrus, supramarginal gyrus, and middle occipital gyrus. Across the entire subject pool, significant differences in ALFF/fALFF between the two bands were found in the midbrain, basal ganglia, hippocampus and cerebellum (Slow 4>Slow 5, and in the middle frontal gyrus, supramarginal gyrus, posterior cingulate cortex, and precuneus (Slow 5>Slow 4. We also observed significant interaction between frequency bands and patient groups in the orbitofrontal gyrus. Furthermore, tinnitus distress was positively correlated with the magnitude of ALFF in right SFG and the magnitude of fALFF slow-4 band in left SFG, whereas tinnitus duration was positively correlated with the magnitude of ALFF in

  11. Relationship between Audiometric slope and tinnitus pitch in tinnitus patients: insights into the mechanisms of tinnitus generation.

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    Martin Schecklmann

    Full Text Available BACKGROUND: Different mechanisms have been proposed to be involved in tinnitus generation, among them reduced lateral inhibition and homeostatic plasticity. On a perceptual level these different mechanisms should be reflected by the relationship between the individual audiometric slope and the perceived tinnitus pitch. Whereas some studies found the tinnitus pitch corresponding to the maximum hearing loss, others stressed the relevance of the edge frequency. This study investigates the relationship between tinnitus pitch and audiometric slope in a large sample. METHODOLOGY: This retrospective observational study analyzed 286 patients. The matched tinnitus pitch was compared to the frequency of maximum hearing loss and the edge of the audiogram (steepest hearing loss by t-tests and correlation coefficients. These analyses were performed for the whole group and for sub-groups (uni- vs. bilateral (117 vs. 338 ears, pure-tone vs. narrow-band (340 vs. 115 ears, and low and high audiometric slope (114 vs. 113 ears. FINDINGS: For the right ear, tinnitus pitch was in the same range and correlated significantly with the frequency of maximum hearing loss, but differed from and did not correlate with the edge frequency. For the left ear, similar results were found but the correlation between tinnitus pitch and maximum hearing loss did not reach significance. Sub-group analyses (bi- and unilateral, tinnitus character, slope steepness revealed identical results except for the sub-group with high audiometric slope which revealed a higher frequency of maximum hearing loss as compared to the tinnitus pitch. CONCLUSION: The study-results confirm a relationship between tinnitus pitch and maximum hearing loss but not to the edge frequency, suggesting that tinnitus is rather a fill-in-phenomenon resulting from homeostatic mechanisms, than the result of deficient lateral inhibition. Sub-group analyses suggest that audiometric steepness and the side of affected ear

  12. Investigation of Tinnitus Characteristics in 36 Patients with Subjective Tinnitus with Unknown Etiology

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    Mahdi Bakhshaee

    2006-06-01

    Full Text Available Background and Aim: Tinnitus represents the perception of sound without an external stimulus. The prevalence of tinnitus ranges from 3% to 30%. In most cases its etiology is unknown. Tinnitus can be classified as pulsatile or nonpulsatile. Nonpulsatile form is the most common form and almost exclusively subjective in nature. There is a range of condition attributed to nonpulsatile high frequency tinnitus (acoustic neuroma, Meniere’s disease, ototoxic agents, and noise exposure, etc. There are many studies about form, site, loudness, and frequency of tinnitus and how it can affect the quality of patient life. Materials and methods: This was a descriptive and analytic study. Thirty-six patients (23 men and 13 women with mean age 53.1 year old with subjective tinnitus evaluated in Pezhvak audiometric clinic in Mashhad.The data consisting of age sex, loudness, frequency form and site of tinnitus. Evaluation of effects of tinnitus on the quality of life and habits was performed with a tinnitus questionnaire (TQ. Results: Tinnitus was unilateral in 64% of cases. The right site was more common. Mean pitch was 7.03 kHz and average loudness was 3.8 dB SPL. SDS was in normal range in all of patients. There was a high frequency sensory neural hearing loss (above the 4 kHz in most of the patients. The greatest score (60.3% of TQ related to intrusiveness aspect. Sleep disorder has the lowest score (39/3%. Global score was 52.4%. Conclusion: Nonpulsatile subjective tinnitus has a broad range of etiology with unknown mechanism in most cases and without any history of underlying disease in a large group of patients. This symptom mostly involves the patients` lifestyle that is intrusiveness aspect in comparison with the other aspects including sleep, hearing and somatic complaints. There is no cure for most patient and more studies are needed in the future.

  13. 声治疗结合心理咨询治疗慢性耳鸣%A Clinical Study of Sound Therapy and Psychological Counseling for Chronic Tinnitus Patients

    Institute of Scientific and Technical Information of China (English)

    许轶; 王铭歆; 任飞; 周慧芳

    2015-01-01

    目的:分析声治疗结合心理咨询对慢性耳鸣的疗效。方法通过声治疗结合心理咨询治疗232例慢性耳鸣患者,其中,重度耳鸣178例(76.72%,178/232),轻度耳鸣54例(29.28%,54/232),疗程为12个月,于治疗前、治疗3、6、12个月后分别填写耳鸣评价量表,评估治疗效果。结果治疗后患者耳鸣症状明显改善,疗程结束后重度耳鸣患者为36例(15.52%,36/232),较治疗前的例数明显减少(P <0.01);治疗6个月后,总有效率为79.31%(184/232),治疗12个月后总有效率为86.21%(200/232)。结论声治疗结合心理咨询是治疗慢性耳鸣的有效方法,疗效稳定持久。%Objective To investigate the clinical effects of sound therapy and psychological counseling on chronic tinnitus .Methods Two hundred and thirty - two cases of chronic tinnitus patients were treated with sound therapy and psychological counseling in this study .The time course of treatment was 12 months .Tinnitus Evalua‐tion Questionnaire(TEQ) was filled out before sound therapy ,3 ,6 and 12 months after the therapy to evaluate the effects .Results After the therapy ,the patients had a significant improvement in tinnitus symptoms .Before the therapy ,178 patients had severe tinnitus ,while after the therapy ,this number decreased obviously .In the end of treatment there were only 36 cases ,with severe tinnitus(15 .52% ) .After the 6 months treatment ,the effective rate was 79 .31% ,after 12 months the effective rate was 86 .21% .Conclusion Sound therapy and psychological counse‐ling are effective treatments for chronic tinnitus ,and the effects are stable and durable .

  14. Repetitive transcranial magnetic stimulation induces oscillatory power changes in chronic tinnitus

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    Martin eSchecklmann

    2015-10-01

    Full Text Available Chronic tinnitus is associated with neuroplastic changes in auditory and non-auditory cortical areas. About ten years ago, repetitive transcranial magnetic stimulation (rTMS of auditory and prefrontal cortex was introduced as potential treatment for tinnitus. The resulting changes in tinnitus loudness are interpreted in the context of rTMS induced activity changes (neuroplasticity. Here, we investigate the effect of single rTMS sessions on oscillatory power to probe the capacity of rTMS to interfere with tinnitus-specific cortical plasticity. We measured 20 patients with bilateral chronic tinnitus and 20 healthy controls comparable for age, sex, handedness, and hearing level with a 63-channel EEG system. Educational level, intelligence, depressivity and hyperacusis were controlled for by analysis of covariance. Different rTMS protocols were tested: Left and right temporal and left and right prefrontal cortices were each stimulated with 200 pulses at 1Hz and with an intensity of 60% stimulator output. Stimulation of central parietal cortex with 6-fold reduced intensity (inverted passive-cooled coil served as sham condition. Before and after each rTMS protocol five minutes of resting state EEG were recorded. The order of rTMS protocols was randomized over two sessions with one week interval in between.Analyses on electrode level showed that people with and without tinnitus differed in their response to left temporal and right frontal stimulation. In tinnitus patients left temporal rTMS decreased frontal theta and delta and increased beta2 power, whereas right frontal rTMS decreased right temporal beta3 and gamma power. No changes or increases were observed in the control group. Only non-systematic changes in tinnitus loudness were induced by single sessions of rTMS.This is the first study to show tinnitus-related alterations of neuroplasticity that were specific to stimulation site and oscillatory frequency. The observed effects can be interpreted

  15. Tinnitus

    Science.gov (United States)

    ... and causes, some people develop tinnitus for no obvious reason. Most of the time, tinnitus isn’t a sign of a serious health problem, although if it’s loud or doesn’t go away, it can cause fatigue, depression, anxiety, and problems with memory and concentration. For ...

  16. Tinnitus

    Science.gov (United States)

    ... case. There is no need for radiologic testing (X-rays, CT scans or MRI scans) unless your tinnitus ... MP3 devices and nearly all hand-held electronic games are equipped with ear buds. It is difficult ...

  17. Neuronal correlates of maladaptive coping: an EEG-study in tinnitus patients.

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    Sven Vanneste

    Full Text Available Here we aimed to investigate the neuronal correlates of different coping styles in patients suffering from chronic tinnitus. Adaptive and maladaptive coping styles were determined in 85 tinnitus patients. Based on resting state EEG recordings, coping related differences in brain activity and connectivity were found. Maladaptive coping behavior was related to increases in subjective tinnitus loudness and distress, higher tinnitus severity and higher depression scores. EEG recordings demonstrated increased alpha activity over the left dorsolateral prefrontal cortex (DLPFC and subgenual anterior cingulate cortex (sgACC as well as increased connectivity in the default (i.e. resting state network in tinnitus patients with a maladaptive coping style. Correlation analysis revealed that the changes in the DLPFC correlate primarily with maladaptive coping behavior, whereas the changes in the sgACC correlate with tinnitus severity and depression. Our findings are in line with previous research in the field of depression that during resting state a alpha band hyperconnectivity exists within the default network for patients who use a maladaptive coping style, with the sgACC as the dysfunctional node and that the strength of the connectivity is related to focusing on negative mood and catastrophizing about the consequences of tinnitus.

  18. Learning tinnitus

    Science.gov (United States)

    van Hemmen, J. Leo

    Tinnitus, implying the perception of sound without the presence of any acoustical stimulus, is a chronic and serious problem for about 2% of the human population. In many cases, tinnitus is a pitch-like sensation associated with a hearing loss that confines the tinnitus frequency to an interval of the tonotopic axis. Even in patients with a normal audiogram the presence of tinnitus may be associated with damage of hair-cell function in this interval. It has been suggested that homeostatic regulation and, hence, increase of activity leads to the emergence of tinnitus. For patients with hearing loss, we present spike-timing-dependent Hebbian plasticity (STDP) in conjunction with homeostasis as a mechanism for ``learning'' tinnitus in a realistic neuronal network with tonotopically arranged synaptic excitation and inhibition. In so doing we use both dynamical scaling of the synaptic strengths and altering the resting potential of the cells. The corresponding simulations are robust to parameter changes. Understanding the mechanisms of tinnitus induction, such as here, may help improving therapy. Work done in collaboration with Julie Goulet and Michael Schneider. JLvH has been supported partially by BCCN - Munich.

  19. Paraoxonase Activity and Oxidative Status in Patients with Tinnitus

    Science.gov (United States)

    Akyüz, Servet; Somuk, Battal Tahsin; Soyalic, Harun; Yılmaz, Beyhan; Taskin, Abdullah; Bilinc, Hasan; Aksoy, Nurten

    2016-01-01

    Background and Objectives The aim of this study was to investigate serum paraoxanase-1 (PON) activity, total oxidant status (TOS), total antioxidant status (TAS), and the oxidative stress index (OSI) in tinnitus; and to compare the results with data from healthy subjects. Subjects and Methods A total of 114 subjects-54 patients with tinnitus and 60 healthy controls were enrolled in this study. Serum PON activity, TOS, TAS, and OSI levels were measured. Results In the tinnitus group, TAS, and PON were significantly lower than in the control group (p<0.001). However, the TOS, and OSI levels were significantly higher in the tinnitus group than in the control group (p<0.001). Conclusions According to the data obtained from the present study, patients with tinnitus were exposed to potent oxidative stress. Oxidative stress may be the key contributing factor to the pathogenesis of tinnitus. PMID:27144229

  20. Personality Traits in Patients with Subjective Idiopathic Tinnitus

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    Mahboobeh Adami Dehkordi

    2015-09-01

    Full Text Available Introduction: Tinnitus is a common complaint in patients referred to otorhinolaryngology clinics and is a condition where one hears a sound without any distinguishable external acoustic source or electrical stimulus. About 3-30% of adults experience different degrees of tinnitus during their life. This study aims to ascertain and compare personality traits between patients with tinnitus and a control group.   Materials and Methods: In a case control study, 66 participants were assessed. The case group consisted of 33 patients who suffered from tinnitus for at least two months, in addition to 33 healthy volunteers who were selected among their family (preferably of the same age and sex. A standard demographic questionnaire and an Eyzenck personality questionnaire were filled for both groups. A tinnitus severity index (TSI questionnaire was only filled for the case group. Data from each group was compared by Mann-Whitney U and Chi-Square tests. SPSS V.18 was the selected software.   Results: Statistical analysis showed a meaningful difference in neuroticism (P=0.001 and extraversion (P=0.001 between the patients and the controls; however, there was no statistical difference between these groups regarding psychotism.   Conclusion:  Tinnitus can be associated with personality characteristics. This study showed that in patients with tinnitus, neuroticism increases and extraversion decreases. Considering the personality and psychotic traits observed in the patients with tinnitus, psychiatric consultation is recommended.

  1. Cortical activity in tinnitus patients and its modification by phonostimulation

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    Katarzyna Pawlak-Osińska

    2013-04-01

    Full Text Available OBJECTIVE: The goal of this study was to observe spontaneous cortical activity and cortical activity modulated by tinnitus-matched sound in tinnitus patients and healthy subjects with no otoneurologic symptoms. METHOD: Data were prospectively collected from 50 tinnitus patients and 25 healthy subjects. Cortical activity was recorded in all subjects with eyes closed and open and during photostimulation, hyperventilation and acoustic stimulation using 19-channel quantitative electroencephalography. The sound applied in the tinnitus patients was individually matched with the ability to mask or equal the tinnitus. The maximal and mean amplitude of the delta, theta, alpha and beta waves and the type and amount of the pathologic EEG patterns were noted during each recording. Differences in cortical localization and the influence of sound stimuli on spontaneous cortical activity were evaluated between the groups. RESULTS: The tinnitus group exhibited decreased delta activity and increased alpha and beta activity. Hyperventilation increased the intensity of the differences. The tinnitus patients had more sharp-slow waves and increased slow wave amplitude. Sound stimuli modified the EEG recordings; the delta and beta wave amplitudes were increased, whereas the alpha-1 wave amplitude was decreased. Acoustic stimulation only slightly affected the temporal region. CONCLUSION: Cortical activity in the tinnitus patients clearly differed from that in healthy subjects, i.e., tinnitus is not a “phantom” sign. The changes in cortical activity included decreased delta wave amplitudes, increased alpha-1, beta-1 and beta-h wave amplitudes and pathologic patterns. Cortical activity modifications occurred predominantly in the temporal region. Acoustic stimulation affected spontaneous cortical activity only in tinnitus patients, and although the applied sound was individually matched, the pathologic changes were only slightly improved.

  2. Tinnitus: patients do not have to 'just live with it'.

    Science.gov (United States)

    Newman, Craig W; Sandridge, Sharon A; Bea, Scott M; Cherian, Kay; Cherian, Neil; Kahn, Karyn M; Kaltenbach, James

    2011-05-01

    Tinnitus is distressing and affects the quality of life for many patients. Because primary care physicians may be the entry point for patients seeking help for tinnitus, we urge them to acknowledge this symptom and its potential negative impact on the patient's health and quality of life. Physicians should actively listen to the patient and provide hope and encouragement, but also provide realistic expectations about the course of treatment. The patient must also understand that there may be no singular "cure" for tinnitus and that management may involve multidisciplinary assessment and treatment.

  3. SUPPRESSION OF TINNITUS IN PATIENTS UNDERGOING COCHLEAR IMPLANTATION

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    M. T. Khorsandi

    1999-07-01

    Full Text Available 7 'innitus is a frequent complaint in patients with sensorineural deafness. Different reports suggest that electrical stimulation caused by cochlear implant devices "upn"ises tinnitus to a considerable degree. In a longitudinal -.mdv we have evaluated the severity and duration of tinnitus in both ears of J 7 cochlear implant patients before and after operation. Severity of tinnitus was reduced in both implanted and not implanted ears after the implantation (P=0.003 and p - 0.00-1 respectively. Duration of tinnitus, however, was not affected significantly. No significant difference in tinnitus suppression was observed between the implanted and not implanted ears. This might be attributed to both the electrical stimulation caused by the device and the psychogenic stability provided by return to the world of sound.

  4. Cortico-limbic morphology separates tinnitus from tinnitus distress

    OpenAIRE

    Leaver, Amber M.; Anna eSeydell-Greenwald; Ted eTuresky; Susan eMorgan; Kim, Hung J.; Josef P Rauschecker

    2012-01-01

    Tinnitus is a common auditory disorder characterized by a chronic ringing or buzzing “in the ear.”Despite the auditory-perceptual nature of this disorder, a growing number of studies have reported neuroanatomical differences in tinnitus patients outside the auditory-perceptual system. Some have used this evidence to characterize chronic tinnitus as dysregulation of the auditory system, either resulting from inefficient inhibitory control or through the formation of aversive associations with ...

  5. Incidental findings on magnetic resonance imaging in patients with tinnitus

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    Parmod Kalsotra

    2015-01-01

    Full Text Available Introduction: Tinnitus is "a sound in one ear or both ears, such as buzzing, ringing, or whistling, occurring without an external stimulus." Magnetic resonance imaging (MRI is a well-established, cost-effective investigation for the patients with tinnitus. Aim: The purpose of the study was to define the frequency of incidental findings on MRI scans, of patients with a history of tinnitus but with normal clinical examination, audiometry and otoacoustic emissions. Materials and Methods: A total of 62 patients were enrolled for the present study with a history of gradually increasing tinnitus and normal clinical ENT examination. All these patients underwent MRI scan to find out any lesion that would cause tinnitus. Results and Conclusion: In the present study, evaluation of MRI scans of 62 patients with gradually increasing tinnitus was done, with ipsilateral vestibular schwannoma and neurofibromatosis II being diagnosed in 1 patient (1.61% each. Incidental findings were demonstrated in 26 cases (41.93%; with 8 cases (12.90% of white matter lesions, 5 cases (8.66% of vascular anomalies, 3 cases (4.83% of arachnoid cyst, 2 cases (3.22% of empty sella, 4 cases (6.45% of sinus involvement, 2 cases (3.22% of cerebral atrophy and 2 cases (3.22% of vascular infarcts, though none of these findings were serious and neither warranted an urgent surgical intervention but a few cases required assessment by other specialties and were referred accordingly.

  6. The Comparison of Ginkgo biloba and Cinnarizine effectiveness in tinnitus intensity of patients with subjective tinnitus

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    Hamidreza Khazraei

    2015-01-01

    Conclusion: It was found that after two months of treatment with Ginkgo biloba (120-140 mg daily tinnitus severity and the adverse changes on quality of life significantly decreased in the patients, whereas Cinnarizine did not reduce the latter significantly. However, no significant difference was observed between the two groups (Cinnarizine & Ginko biloba.

  7. Consensus for tinnitus patient assessment and treatment outcome measurement : Tinnitus Research Initiative meeting, Regensburg, July 2006

    NARCIS (Netherlands)

    Langguth, B.; Goodey, R.; Azevedo, A.; Bjorne, A.; Cacace, A.; Crocetti, A.; Del Bo, L.; De Ridder, D.; Diges, I.; Elbert, T.; Flor, H.; Herraiz, C.; Ganz Sanchez, T.; Eichhammer, P.; Figueiredo, R.; Hajak, G.; Kleinjung, T.; Landgrebe, M.; Londero, A.; Lainez, M. J. A.; Mazzoli, M.; Meikle, M. B.; Melcher, J.; Rauschecker, J. P.; Sand, P. G.; Struve, M.; Van de Heyning, P.; Van Dijk, P.; Vergara, R.; Langguth, B; Hajak, G; Kleinjung, T; Cacace, A; Moller, AR

    2007-01-01

    There is widespread recognition that consistency between research centres in the ways that patients with tinnitus are assessed and outcomes following interventions are measured would facilitate more effective co-operation and more meaningful evaluations and comparisons of outcomes. At the first Tinn

  8. PSYCHOLOGICAL MORBIDITY IN PATIENTS WITH TINNITUS : A HOSPITAL BASED CROSS SECTIONAL STUDY

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    Arti

    2015-08-01

    Full Text Available INTRODUCTION: Tinnitus is not a disease but a symptom of hearing sound when no external sound is present. Studies have shown that some people, the sound causes anxiety or interferes with concentration, incr eased awareness of depression and personality disorders. To this purpose we evaluated the prevalence of psychiatric morbidity in chronic tinnitus using MINI interview. METHODS: A sample of 53 male and female patients with tinnitus between the age of 13 and 50 years participated in the study. Patients with ear infections , disease of th e heart or blood vessels , Meniere's disease , brain tumors , exposure to certain medications, a previous head injury and earwax were excluded. The subjects so chosen, were explained the nature of the study. Da ta was collected from outpatient ENT Clinics regarding demographic and clinical profiles from these patients. Each subject was then administered Mini International Neuropsychaitric Interview (M.I.N.I RESULTS: More numbers of females were there than males and majority were in between 30 - 39 years. Both married and unmarried people were equally affected. Middle class and upper lower classes were most affected. The prevalence of psychiatric co morbidity in these tinnitus patients follows in descending order: M ajor depressive disorder>>Social Phobia > Suicide > Panic - disorder > Obsessive – compulsive – disorder > Agarophobia = Dysthymic - disorder=Generalized - anxiety. CONCLUSION : We observed that the prevalence of psychiatric morbidity in chronic tinnitus patients were as follows in descending order Major - depressive - disorder >> Social - Phobia > Suicide > Pani c - disorder > Obsessive - compulsive – disorder > Agarophobia = Dysthymic disorder=Generalized - anxiety . Treatment of this psychiatric morbidity with medications and psychotherapy may likely reduce the severity of tinnitus in many of these patients.

  9. Efficacy and safety of bilateral continuous theta burst stimulation (cTBS for the treatment of chronic tinnitus: design of a three-armed randomized controlled trial

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    Plontke Stefan K

    2009-08-01

    Full Text Available Abstract Background Tinnitus, the perception of sound and noise in absence of an auditory stimulus, has been shown to be associated with maladaptive neuronal reorganization and increased activity of the temporoparietal cortex. Transient modulation of tinnitus by repetitive transcranial magnetic stimulation (rTMS indicated that these areas are critically involved in the pathophysiology of tinnitus and suggested new treatment strategies. However, the therapeutic efficacy of rTMS in tinnitus is still unclear, individual response is variable, and the optimal stimulation area disputable. Recently, continuous theta burst stimulation (cTBS has been put forward as an effective rTMS protocol for the reduction of pathologically enhanced cortical excitability. Methods 48 patients with chronic subjective tinnitus will be included in this randomized, placebo controlled, three-arm trial. The treatment consists of two trains of cTBS applied bilaterally to the secondary auditory cortex, the temporoparietal associaction cortex, or to the lower occiput (sham condition every working day for four weeks. Primary outcome measure is the change of tinnitus distress as quantified by the Tinnitus Questionnaire (TQ. Secondary outcome measures are tinnitus loudness and annoyance as well as tinnitus change during and after treatment. Audiologic and speech audiometric measurements will be performed to assess potential side effects. The aim of the present trail is to investigate effectiveness and safety of a four weeks cTBS treatment on chronic tinnitus and to compare two areas of stimulation. The results will contribute to clarify the therapeutic capacity of rTMS in tinnitus. Trial registration The trial was registered with the clinical trials register of http://www.clinicaltrials.gov (NCT00518024.

  10. The impact of Type D personality on health-related quality of life in tinnitus patients is mainly mediated by anxiety and depression

    DEFF Research Database (Denmark)

    Bartels, Hilke; Pedersen, Susanne S.; van der Laan, Bernard F A M;

    2010-01-01

    To evaluate the impact of Type D personality on health-related quality of life (HRQoL) and self-reported tinnitus-related distress in chronic tinnitus patients and whether this relationship is mediated by indicators of psychological distress (i.e., vital exhaustion, anxiety, and depression)....

  11. The Impact of Type D Personality on Health-Related Quality of Life in Tinnitus Patients Is Mainly Mediated by Anxiety and Depression

    NARCIS (Netherlands)

    Bartels, H.; Pedersen, S.S.; van der Laan, B.F.A.M.; Staal, M.J.; Albers, F.W.J.; Middel, B.

    2010-01-01

    Objective: To evaluate the impact of Type D personality on health-related quality of life (HRQoL) and self-reported tinnitus-related distress in chronic tinnitus patients and whether this relationship is mediated by indicators of psychological distress (i.e., vital exhaustion, anxiety, and depressio

  12. Auditory hallucinations in tinnitus patients: Emotional relationships and depression

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    Santos, Rosa Maria Rodrigues dos

    2012-01-01

    Full Text Available Introduction: Over the last few years, our Tinnitus Research Group has identified an increasing number of patients with tinnitus who also complained of repeated perception of complex sounds, such as music and voices. Such hallucinatory phenomena motivated us to study their possible relation to the patients' psyches. Aims: To assess whether hallucinatory phenomena were related to the patients' psychosis and/or depression, and clarify their content and function in the patients' psyches. Method: Ten subjects (8 women; mean age = 65.7 years were selected by otolaryngologists and evaluated by the same psychologists through semi-structured interviews, the Hamilton Depression Rating Scale, and psychoanalysis interviews. Results: We found no association between auditory hallucinations and psychosis; instead, this phenomenon was associated with depressive aspects. The patients' discourse revealed that hallucinatory phenomena played unconscious roles in their emotional life. In all cases, there was a remarkable and strong tendency to recall/repeat unpleasant facts/situations, which tended to exacerbate the distress caused by the tinnitus and hallucinatory phenomena and worsen depressive aspects. Conclusions: There is an important relationship between tinnitus, hallucinatory phenomena, and depression based on persistent recall of facts/situations leading to psychic distress. The knowledge of such findings represents a further step towards the need to adapt the treatment of this particular subgroup of tinnitus patients through interdisciplinary teamwork. Prospective.

  13. The Relevance of Interoception in Chronic Tinnitus: Analyzing Interoceptive Sensibility and Accuracy

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    Pia Lau

    2015-01-01

    Full Text Available In order to better understand tinnitus and distress associated with tinnitus, psychological variables such as emotional and cognitive processing are a central element in theoretical models of this debilitating condition. Interoception, that is, the perception of internal processes, may be such a psychological factor relevant to tinnitus. Against this background, 20 participants suffering from chronic tinnitus and 20 matched healthy controls were tested with questionnaires, assessing interoceptive sensibility, and participated in two tasks, assessing interoceptive accuracy: the Schandry task, a heartbeat estimation assignment, and a skin conductance fluctuations perception task assessing the participants’ ability to perceive phasic increases in sympathetic activation were used. To test stress reactivity, a construct tightly connected to tinnitus onset, we also included a stress induction. No differences between the groups were found for interoceptive accuracy and sensibility. However, the tinnitus group tended to overestimate the occurrence of phasic activation. Loudness of the tinnitus was associated with reduced interoceptive performance under stress. Our results indicate that interoceptive sensibility and accuracy do not play a significant role in tinnitus. However, tinnitus might be associated with a tendency to overestimate physical changes.

  14. Investigation of Tinnitus Patients in Italy: Clinical and Audiological Characteristics

    OpenAIRE

    Francesco Martines; Daniela Bentivegna; Fabiola Di Piazza; Enrico Martines; Vincenzo Sciacca; Gioacchino Martinciglio

    2010-01-01

    Objective. 312 tinnitus sufferers were studied in order to analyze: the clinical characteristics of tinnitus; the presence of tinnitus-age correlation and tinnitus-hearing loss correlation; the impact of tinnitus on subjects' life and where possible the etiological/predisposing factors of tinnitus. Results. There is a slight predominance of males. The highest percentage of tinnitus results in the decades 61–70. Of the tinnitus sufferers, 197 (63.14%) have a hearing deficit (light hearing loss...

  15. Cognitive Mechanisms in Chronic Tinnitus: Psychological Markers of a Failure to Switch Attention

    Science.gov (United States)

    Trevis, Krysta J.; McLachlan, Neil M.; Wilson, Sarah J.

    2016-01-01

    The cognitive mechanisms underpinning chronic tinnitus (CT; phantom auditory perceptions) are underexplored but may reflect a failure to switch attention away from a tinnitus sound. Here, we investigated a range of components that influence the ability to switch attention, including cognitive control, inhibition, working memory and mood, on the presence and severity of CT. Our participants with tinnitus showed significant impairments in cognitive control and inhibition as well as lower levels of emotional well-being, compared to healthy-hearing participants. Moreover, the subjective cognitive complaints of tinnitus participants correlated with their emotional well-being whereas complaints in healthy participants correlated with objective cognitive functioning. Combined, cognitive control and depressive symptoms correctly classified 67% of participants. These results demonstrate the core role of cognition in CT. They also provide the foundations for a neurocognitive account of the maintenance of tinnitus, involving impaired interactions between the neurocognitive networks underpinning attention-switching and mood. PMID:27605920

  16. Cognitive Mechanisms in Chronic Tinnitus: Psychological Markers of a Failure to Switch Attention.

    Science.gov (United States)

    Trevis, Krysta J; McLachlan, Neil M; Wilson, Sarah J

    2016-01-01

    The cognitive mechanisms underpinning chronic tinnitus (CT; phantom auditory perceptions) are underexplored but may reflect a failure to switch attention away from a tinnitus sound. Here, we investigated a range of components that influence the ability to switch attention, including cognitive control, inhibition, working memory and mood, on the presence and severity of CT. Our participants with tinnitus showed significant impairments in cognitive control and inhibition as well as lower levels of emotional well-being, compared to healthy-hearing participants. Moreover, the subjective cognitive complaints of tinnitus participants correlated with their emotional well-being whereas complaints in healthy participants correlated with objective cognitive functioning. Combined, cognitive control and depressive symptoms correctly classified 67% of participants. These results demonstrate the core role of cognition in CT. They also provide the foundations for a neurocognitive account of the maintenance of tinnitus, involving impaired interactions between the neurocognitive networks underpinning attention-switching and mood. PMID:27605920

  17. Mindfulness-and body-psychotherapy-based group treatment of chronic tinnitus: a randomized controlled pilot study

    Directory of Open Access Journals (Sweden)

    Kreuzer Peter M

    2012-11-01

    Full Text Available Abstract Background Tinnitus, the perception of sound in absence of an external acoustic source, impairs the quality of life in 2% of the population. Since in most cases causal treatment is not possible, the majority of therapeutic attempts aim at developing and strengthening individual coping and habituation strategies. Therapeutic interventions that incorporate training in mindfulness meditation have become increasingly popular in the treatment of stress-related disorders. Here we conducted a randomized, controlled clinical study to investigate the efficacy of a specific mindfulness- and body-psychotherapy based program in patients suffering from chronic tinnitus. Methods Thirty-six patients were enrolled in this pilot study. The treatment was specifically developed for tinnitus patients and is based on mindfulness and body psychotherapy. Treatment was performed as group therapy at two training weekends that were separated by an interval of 7 weeks (eleven hours/weekend and in four further two-hour sessions (week 2, 9, 18 and 22. Patients were randomized to receive treatment either immediately or after waiting time, which served as a control condition. The primary study outcome was the change in tinnitus complaints as measured by the German Version of the Tinnitus Questionnaire (TQ. Results ANOVA testing for the primary outcome showed a significant interaction effect time by group (F = 7.4; df = 1,33; p = 0.010. Post hoc t-tests indicated an amelioration of TQ scores from baseline to week 9 in both groups (intervention group: t = 6.2; df = 17; p  Conclusions Our results suggest that this mindfulness- and body-psychotherapy-based approach is feasible in the treatment of tinnitus and merits further evaluation in clinical studies with larger sample sizes. The study is registered with clinicaltrials.gov (NCT01540357.

  18. Relationship Between Chronic Tinnitus and Glial Cell Line-Derived Neurotrophic Factor Gene rs3812047, rs1110149, and rs884344 Polymorphisms in a Turkish Population.

    Science.gov (United States)

    Orenay-Boyacioglu, Seda; Coskunoglu, Aysun; Caki, Zerrin; Cam, Fethi Sirri

    2016-08-01

    Glial cell line-derived neurotrophic factor (GDNF) plays a key role in early development of central auditory pathway and the inner ear. However, the auditory pathway studies of GDNF gene polymorphisms are scarce in the literature, and the studies especially associated with tinnitus are limited. Our study aimed to identify whether GDNF gene polymorphisms play any roles in the pathophysiology of tinnitus by investigating the relationship between tinnitus and GDNF polymorphisms. A total of 52 patients with chronic tinnitus and ages ranging from 18 to 55 were admitted to the Ear-Nose-Throat outpatient clinic of Celal Bayar University Medical Faculty Hospital of Manisa, Turkey and constituted the study group. Another 42 patients of the same age range, without tinnitus symptoms and lacking any systemic disease, were also admitted to the clinic and formed the control group. The tympanometric, audiological, and psychoacoustic assessments of the subjects were performed. Deoxyribonucleic acid samples obtained using venous blood taken for routine inspections were used to investigate GDNF gene polymorphisms (rs884344, rs3812047, and rs1110149) by polymerase chain reaction-based restriction fragment length polymorphism method. No correlation could be detected between GDNF rs884344 and rs3812047 polymorphisms and subjects with tinnitus (p > 0.05). Heterozygosity was significantly lower for GDNF rs1110149 polymorphism in tinnitus subjects compared to the controls (p tinnitus and control groups (p > 0.05). Failure to detect correlations between tinnitus and GDNF gene polymorphisms suggests this may be due to the fact that the GDNF gene has a variable expression pattern in different tissues and pathologies. Therefore, the study should be improved and its scope should be expanded by including a larger group of patients and different tissues to investigate the expression pattern of GDNF. PMID:27180191

  19. Tinnitus and psychological comorbidities

    OpenAIRE

    Zirke, Nina

    2014-01-01

    To explain pathogenetic reasons for tinnitus cochlear, acustic or neurophysiological reasons are discussed. Regardless of the origin of tinnitus, psychological factors are attributed to the chronification of tinnitus. Psychological comorbidities seem to decrease the opportunity of tinnitus habituation. Studies have demonstrated that patients with high tinnitus related distress are frequently accompanied by psychological comorbidities. We examined the prevalence of psychological disorders ...

  20. Tinnitus and Headache

    OpenAIRE

    Berthold Langguth; Verena Hund; Volker Busch; Jürgens, Tim P; Jose-Miguel Lainez; Michael Landgrebe; Martin Schecklmann

    2015-01-01

    Background. Tinnitus and headache are frequent disorders. Here, we aimed to investigate whether the occurrence of headache among tinnitus patients is purely coincidental or whether tinnitus and headache are pathophysiologically linked. We investigated a large sample of patients with tinnitus and headache to estimate prevalence rates of different headache forms, to determine the relationship between tinnitus laterality and headache laterality, and to explore the relationship between tinnitus a...

  1. Resequencing of the auxiliary GABAB receptor subunit gene KCTD12 in chronic tinnitus

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    Philipp G Sand

    2012-05-01

    Full Text Available Tinnitus is a common and often incapacitating hearing disorder marked by the perception of phantom sounds. Susceptibility factors remain largely unknown but GABAB receptor signalling has long been implicated in the response to treatment and, putatively, in the etiology of the disorder. We hypothesized that variation in KCTD12, the gene encoding an auxiliary subunit of GABAB receptors, could help to predict the risk of developing tinnitus. 95 Caucasian outpatients with a diagnosis of chronic tinnitus were systematically screened for mutations in the KCTD12 open reading frame and the adjacent 3' untranslated region by Sanger sequencing. Allele frequencies were determined for 14 known variants of which three (rs73237446, rs34544607 and rs41287030 were polymorphic. When allele frequencies were compared to data from a large reference population of European ancestry, rs34544607 was associated with tinnitus (p=.04. However, KCTD12 genotype did not predict tinnitus severity (p=.52 and the association with rs34544607 was weakened after screening 50 additional cases (p=.07. Pending replication in a larger cohort, KCTD12 may act as a risk modifier in chronic tinnitus. Issues that are yet to be addressed include the effects of neighbouring variants, e.g. in the KCTD12 gene regulatory region, plus interactions with variants of GABAB1 and GABAB2.

  2. Clinical signs and symptoms of tinnitus in temporomandibular joint disorders: A pilot study comparing patients and non-patients

    Directory of Open Access Journals (Sweden)

    Amisha Kanji

    2013-12-01

    Full Text Available Background: Tinnitus is one of the otologic symptoms commonly reported to be associated with temporomandibular disorder (TMD, and questions regarding its nature and cause continue to plague the clinical and research community.Objectives: The current pilot study aimed to investigate the clinical signs and symptoms of presenting tinnitus in a group of individuals with TMD (group A, and compare them with a group with tinnitus but without TMD (group B. Twenty participants were included in the study, 10 from each group.Methods: All participants underwent basic audiological as well as ear, nose and throat (ENT evaluations to establish group A and group B. For tinnitus assessment, all participants completed a tinnitus survey questionnaire, and their tinnitus was evaluated using tinnitus matching procedures.Results: Findings revealed clinically relevant differences in attributes of tinnitus in patients with and without TMD. Most of the participants in group A matched their tinnitus to a 6 000 Hz tone or noise, at lower intensity levels than participants in group B, although these results were not statistically significant. Participants in group A associated their tinnitus with a single sound whereas some participants in group B associated it with more than one sound. More participants in group B reported the duration of their tinnitus as constant.Conclusions: Tinnitus may occur in patients with TMD, and be of high frequency. This highlights the importance of thorough assessment for patients with tinnitus as this might have implications for diagnosis and management.

  3. Relation of distortion product otoacoustic emission and tinnitus in normal hearing patients: A pilot study

    Directory of Open Access Journals (Sweden)

    Datt Modh

    2014-01-01

    Full Text Available Introduction: Tinnitus, the perception of the sound in the absence of an external acoustic source, disrupts the daily life 1 out of every 200 adults, yet its physiological basis remains largely a mystery. The generation of tinnitus is commonly linked with the impaired functioning of the outer hair cells (OHC inside the cochlea. Otoacoustic emissions are the objective test used to assess their activity. Objective: The objective of the investigation was to study the features of Distortion product OtoAcoustic emissions (DPOAE in a group of tinnitus patients with normal hearing and to find out whether there is any difference in DPOAE findings in the tinnitus patients with normal hearing and in persons with normal hearing with no complaint of tinnitus. Materials and Methods: The participants consisted of two groups. The subject group consisted of 16 ears of patients, in which 6 subjects were having tinnitus in both ears while 4 subjects were having tinnitus only in one ear. All subjects were aged between 20 to 60 years with complaint of tinnitus with audiometrically normal hearing. Control group was comprised of 16 audiometrically normal hearing ears of persons who were age and gender matched with the subject groups and had no complaint of tinnitus. Both the subject group as well as control group was subjected for DPOAE test. Findings of both the groups were compared using the unpaired t test. Result and conclusion: It was observed that the amplitudes of DPOAE were significantly lower in tinnitus patients than that of persons without complaint of tinnitus, at a frequency of 1281-1560, 5120-6250, 7243-8837 Hz, which imply that decrease of DPOAEs amplitudes may be related to the presence of tinnitus. It can be concluded that there is association between tinnitus and reduced OHC activity which indicate the OHC of cochlea are involved in the generation of tinnitus.

  4. The effect of tympanoplasty on tinnitus and analysis of possible influencing factors in patients with chronic otitis media%慢性中耳炎患者鼓室成形术后耳鸣变化及影响因素

    Institute of Scientific and Technical Information of China (English)

    郭平; 王武庆

    2014-01-01

    目的:了解慢性中耳炎患者鼓室成形术后耳鸣改变情况,分析慢性中耳炎患者术后听力提高程度、中耳炎分型与术后耳鸣改变的关系。方法记录106例慢性中耳炎病人术前及术后6个月的耳鸣严重程度的变化及听力改变情况,分析耳鸣改变与中耳炎分型以及听力提高的关系。使用配对t检验、独立样本t检验、卡方检验和确切概率法进行统计分析。结果慢性中耳炎患者的耳鸣发生率为46%。术前伴有耳鸣的40例病人,术后有15例病人的耳鸣治愈;18例病人耳鸣治疗有效;7例耳鸣治疗无效,鼓室成形术对耳鸣治疗有效率为82%;术后有1例新发耳鸣。术后耳鸣改善明显组的气导听力提高较耳鸣改善不良组的明显(p0.05)。结论对慢性中耳炎伴耳鸣的患者,手术可使多数患者耳鸣缓解。其中低频气导听力的提高对其耳鸣的缓解作用较显著,鼓室成形术诱发新的耳鸣不常见。%Objective The purpose of this paper is to investigate the effect of tympanoplasty on tinnitus in patients with chronic otitis media(COM), and to determine the effect of audiologic outcome, different types of chronic otitis media influenc-ing on tinnitus changes. Methods Our study consisted of 106 patients who were operated between March 2012 and January 2013. Audiologic evaluation by pure tone audiometry and assessment of tinnitus scores were conducted 3 months before and after surgery. We analysed the data with Paired t test, Student’s t test and Fisher's exact test by stata software. Results The pre-operative incidence of tinnitus in patients with chronic otitis media was 46%. After tympanoplasty, tinnitus reduced in 82%of patients. There was a very significant difference between audiological gain and reduced tinnitus scores (p0.05). There was one patient having new tinnitus after surgery. Conclusions Following tympanoplasty, most patients experienced a reduction in

  5. Evaluation of a compact tinnitus therapy by electrophysiological tinnitus decompensation measures.

    Science.gov (United States)

    Low, Yin Fen; Argstatter, Heike; Bolay, Hans Volker; Strauss, Daniel J

    2008-01-01

    Large-scale neural correlates of the tinnitus decompensation have been identified by using wavelet phase stability criteria of single sweep sequences of auditory late responses (ALRs). Our previous work showed that the synchronization stability in ALR sequences might be used for objective quantification of the tinnitus decompensation and attention which link to Jastreboff tinnitus model. In this study, we intend to provide an objective evaluation for quantifying the effect of music therapy in tinnitus patients. We examined neural correlates of the attentional mechanism in single sweep sequences of ALRs in chronic tinnitus patients who underwent compact therapy course by using the maximum entropy auditory paradigm. Results by our measure showed that the extent of differentiation between attended and unattended conditions improved significantly after the therapy. It is concluded that the wavelet phase synchronization stability of ALRs single sweeps can be used for the objective evaluation of tinnitus therapies, in this case the compact tinnitus music therapy. PMID:19163872

  6. Retraining therapy for chronic tinnitus. A critical analysis of its status.

    Science.gov (United States)

    Kroener-Herwig, B; Biesinger, E; Gerhards, F; Goebel, G; Verena Greimel, K; Hiller, W

    2000-01-01

    Tinnitus retraining therapy (TRT), as conceived of mainly by PJ Jastreboff, has recently received increasing attention in the media, as well as in seminars and congresses on treatment methods for chronic tinnitus. It is often claimed, though not explicitly in scientific publications, that TRT is currently the most efficacious therapy for tinnitus, obtaining improvement rates exceeding 80%. This assertion is highly significant in light of the most likely increasing prevalence of chronic tinnitus and ensuing urgent demand for effective therapies. Before examining the evidence regarding the effectiveness of TRT, Jastreboff's theoretical idea of tinnitus as a neurophysiological disorder is examined and evaluated. This idea is plausible and is supported by some evidence. The interaction between neuroacoustic and emotional processes emphasized by Jastreboff is, however, neither new nor sufficiently elaborated with respect to the underlying psychological factors. The TRT intervention technique and its main components 'directive counselling' and use of 'noise generators' are found to be theoretically well grounded. The lack of detailed information concerning TRT implementation and the potential consequence that differing interventions may be labelled TRT are criticized. Jastreboff's obvious opposition to psychologists' participation in TRT, despite the increase in efficacy they could affect through utilization of cognitive restructuring techniques and behaviour modification interventions, is also criticized. Finally, studies regarding the efficacy of TRT are reviewed and severe methodological shortcomings (e.g. lack of controlled randomized group studies) in TRT research are noted. Taking the current state of evidence into account, we conclude that there is no convincing empirical support for the assumption that TRT is superior to other treatments, since no comparative studies have been conducted. It is contended that there is more substantial empirical support for the

  7. Plasma brain-derived neurotrophic factor levels are increased in patients with tinnitus and correlated with therapeutic effects.

    Science.gov (United States)

    Xiong, Hao; Yang, Haidi; Liang, Maojin; Ou, Yongkang; Huang, Xiayin; Cai, Yuexin; Lai, Lan; Pang, Jiaqi; Zheng, Yiqing

    2016-05-27

    Tinnitus is the perception of sound without an external source and is known to be associated with altered neuronal excitability in the auditory system. Tinnitus severity can be assessed by various psychometric instruments and there is no objective measures developed to evaluate tinnitus severity and therapeutic effects so far. Brain-derived nerve growth factor (BDNF) is believed in playing a key role in regulating neuronal excitability in the brain. To determine whether BDNF correlates with tinnitus induction and severity, we described plasma BDNF levels in patients with tinnitus and healthy controls and evaluated the correlation between plasma BDNF levels and tinnitus severity measured by Tinnitus Handicap Inventory (THI) and Visual Analog Scale (VAS). Moreover, alteration of plasma BDNF levels before and after tinnitus retraining therapy (TRT) in patients with severe tinnitus was also analyzed. We found plasma BDNF levels were elevated in patients with tinnitus compared with healthy controls. In addition, plasma BDNF levels in patients with severe tinnitus were decreased significantly after effective TRT. However, plasma BDNF levels were not correlated with tinnitus loudness and tinnitus severity measured by THI and VAS. These findings support plasma BDNF as a marker for activity changes in the auditory system and could possibly evaluate therapeutic effects in patients with tinnitus. PMID:27095590

  8. Acoustic startle reflex and pre-pulse inhibition in tinnitus patients

    Institute of Scientific and Technical Information of China (English)

    Kelly Shadwick; Wei Sun

    2014-01-01

    Gap induced pre-pulse inhibition (Gap-PPI) of acoustic startle reflex has been used as a measurement of tinnitus in animal models. However, whether this test is sensitive to detect tinnitus in humans is still unclear. Based on the testing procedure used in animal studies, a human subject testing method was formulated and conducted to investigate if a similar result could be found in tinnitus patients. Audiologic and tinnitus assessments and acoustic startle reflex measurements were performed on seven tinnitus subjects and nine age matched subjects without tinnitus. There was no significant difference found between the control and tinnitus group on the Gap-PPI across the frequencies evaluated. The amplitude of the startle response in the tinnitus group with normal hearing thresholds was significantly higher than the control group and those with tinnitus and hearing loss. This preliminary result suggests that hyperexcitability in the central auditory system may be involved in tinnitus. There was no correlation between hearing thresholds and the increased amplitude of startle response.

  9. Objective pulsatile tinnitus

    OpenAIRE

    Yacovino, Dario A.; Casas, Pablo

    2015-01-01

    Key Clinical Message Tinnitus is the usually unwanted perception of sound, in most cases there is no genuine physical source of sound. Less than 10% of tinnitus patients suffer from pulsatile tinnitus. Objective Pulsatile tinnitus can also be the first indication of dural arteriovenous fistula, so examination for such vascular origin must be performed.

  10. Anticonvulsants for tinnitus (Review)

    NARCIS (Netherlands)

    Hoekstra, C.E.; Rynja, S.P.; Zanten, G.A.; Rovers, M.M.

    2011-01-01

    BACKGROUND: Tinnitus is the perception of sound or noise in the absence of an external or internal acoustic stimulation. It is a common and potentially distressing symptom for which no adequate therapy exists. OBJECTIVES: To assess the effectiveness of anticonvulsants in patients with chronic tinnit

  11. Systematic Screening of the Serotonin Receptor 1A (5-HT1A) Gene in Chronic Tinnitus

    Institute of Scientific and Technical Information of China (English)

    Kleinjung T; Langguth B; Fischer B; Hajak G; Eichhammer P; Sand PG

    2006-01-01

    Objective Chronic tinnitus is a highly prevalent condition and has been hypothesized to result from an innate disturbance in central nervous serotonergic transmission. Given the frequent comorbidity with major depression and anxiety, we argue that candidate genes for these disorders are likely to overlap. The present study addresses the gene encoding for the 5-HT1A receptor as a putative risk factor for tinnitus. Methods In 88 subjects with a diagnosis of chronic subjective tinnitus who underwent a detailed neurootological examination, the entire 5-HT1A gene was amplified using overlapping PCR products. Amplicons were custom sequenced bidirectionally and were screened for variants in multiple alignments against the human genome reference. Results We identified a synonymous C > T exchange at residue 184 (Pro) in 7/88 subjects, but detected no missense variants in the population under study. Specifically, the following residues were fully conserved: 16 (Pro), 22 (Gly), 28 (Ile), 98 (Val), 220(Arg), 267 (Val), 273 (Gly), and 418 (Asn). Discussion The present data count against the causation of chronic tinnitus by a change in the 5-HT1A receptor's amino acid sequence. However, the allele frequency for the 184Pro minor allele (0.04) reached twice the frequency reported in control cohorts from the same ethnicity.Additional investigations are invited to clarify the role of the 5-HT1A polymorphism in larger samples, and to control for comorbid affective disorders.

  12. Asymmetry in primary auditory cortex activity in tinnitus patients and controls

    NARCIS (Netherlands)

    Geven, L. I.; de Kleine, E.; Willemsen, A. T. M.; van Dijk, P.

    2014-01-01

    Tinnitus is a bothersome phantom sound percept and its neural correlates are not yet disentangled. Previously published papers, using [(18)F]-fluoro-deoxyglucose positron emission tomography (FDG-PET), have suggested an increased metabolism in the left primary auditory cortex in tinnitus patients. T

  13. Transcranial Direct Current Stimulation in Tinnitus Patients: A Systemic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Jae-Jin Song

    2012-01-01

    Full Text Available Although transcranial direct current stimulation (tDCS has already been used to manage tinnitus patients, paucity of reports and variations in protocols preclude a comprehensive understanding. Hence, we conducted a meta-analysis based on systemic review to assess effectiveness of tDCS in tinnitus management and to compare stimulation parameters. PubMed was searched for tDCS studies in tinnitus. For randomized controlled trials (RCTs, a meta-analysis was performed. A total of 17 studies were identified and 6 of them were included in the systemic review and 2 RCTs were included in the meta-analysis. Overall 39.5% responded to active tDCS with a mean tinnitus intensity reduction of 13.5%. Additionally, left temporal area (LTA and bifrontal tDCS indicated comparable results. Active tDCS was found to be more effective than sham tDCS for tinnitus intensity reduction (Hedges' g=.77, 95% confidence interval 0.23–1.31. The efficacy of tDCS in tinnitus could not be fully confirmed by the current study because of the limited number of studies, but all studies included in the current systemic review and meta-analysis demonstrated significant tinnitus intensity improvement. Therefore, tDCS may be a promising tool for tinnitus management. Future RCTs in a large series regarding the efficacy as well as the comparison between LTA- and bifrontal tDCS are recommended.

  14. New Trends in Tinnitus Management

    OpenAIRE

    Fioretti, Alessandra; Eibenstein, Alberto; Fusetti, Marco

    2011-01-01

    Tinnitus is a perception of sound in absence of sound stimulation. Tinnitus in many cases cannot be eliminated by conventional medical treatment with drugs or surgery. Some people who begin to notice tinnitus, whether spontaneous or induced by noise, trauma or other insult, will experience spontaneous resolution, but many patients will have persistent tinnitus. For some of them, tinnitus sensation will be joined by tinnitus suffering, with many adverse effects like anxiety, depression and sle...

  15. Characterization of tinnitus in different age groups: A retrospective review

    Directory of Open Access Journals (Sweden)

    Jamil Al-Swiahb

    2016-01-01

    Full Text Available Objectives: The aim of this study was to characterize tinnitus in affected patients. Methods: A retrospective review of medical records from 470 consecutive patients who visited a tertiary care hospital for evaluation of chronic subjective tinnitus between January 2009 and June 2010 was performed. Patients were divided into three subgroups based on age. Clinical, audiological, and psychological characteristics of each subgroup were analyzed. Results: Of the 470 patients evaluated, 85 were less than 40, 217 between 40 and 60, and 168 above 60 years of age. Most patients were men and complained of unilateral, acute high-pitched tinnitus. Most patients above the age of 40 years complained of loud and annoying tinnitus and had worse stress and severity scores. Conclusions: Chronic tinnitus in older adults is subjectively louder, more annoying, and more distressing than that found in younger patients. We recommend considering age in the patient management plan.

  16. Evaluation of a tinnitus patient%耳鸣患者的检查与评估

    Institute of Scientific and Technical Information of China (English)

    石勇兵; 赵立东; 王秋菊

    2016-01-01

    Tinnitus is a common otologic complaint and can severely affect quality of life in some patients. Appropri-ate diagnosis and evaluation of tinnitus can impact treatment outcomes. Tinnitus diagnosis involves determination of etiolo-gy, tinnitus testing, evaluation of tinnitus severity and identifying other factors that may contribute to tinnitus. Identification of the cause of tinnitus is first step. Comprehensive tinnitus evaluation includes a thorough history and physical examina-tion, timely hearing and tinnitus tests, appropriate laboratory and imaging studies, and use of tinnitus evaluation and other questionnaires when indicated. In addition to tinnitus and the auditory system, identifying systemic disorders that may con-tribute to tinnitus and consulting relevant specialists are also important steps in tinnitus evaluation.%耳鸣是耳科常见主诉,可以严重影响少数病人的生活。耳鸣的诊断与评估直接影响对耳鸣患者的治疗效果。耳鸣诊断包括寻找病因、测量耳鸣、评价耳鸣对患者影响的严重程度,以及确定有无影响患者耳鸣感受的其他因素,其中寻找和排除可能导致耳鸣的重要病因是第一位的。全面的耳鸣诊断应包括详尽和有针对性的病史采集和身体检查,及时的听力和耳鸣测试,合理的实验室以及影像学检查,以及必要的耳鸣问卷和其他辅助问卷的使用。除耳鸣本身和听觉系统疾患外,排除可能导致耳鸣的全身性疾病和及时寻求相关专科专家会诊也是耳鸣诊断的重要部分。

  17. Intratympanic injection of dexamethasone for treatment of tinnitus in patients with sudden sensorineural hearing loss

    Directory of Open Access Journals (Sweden)

    Tadao Yoshida

    2012-01-01

    Full Text Available The purpose of this study is to test the effectiveness of intratympanic dexamethasone injections as a treatment for severe tinnitus in idiopathic sudden sensorineural hearing loss (SNHL. We studied 37 patients who received intratympanic dexamethasone injections and 14 control patients who did not receive it, with severe tinnitus after onset of unilateral sudden SNHL. Hearing level did not change during this study in any patient. The relationship between the duration of tinnitus and effectiveness of treatment was investigated in sudden SNHL. We used a visual analogue scale to evaluate 51 patients with severe tinnitus at the stage of stable hearing level after idiopathic sudden sensorineural hearing loss. Forty-one per cent of patients showed significant improvement after treatment. The average period between onset of sudden sensorineural hearing loss and initiation of intratympanic dexamethasone injection was significantly shorter (207 days in the improved group than in the unchanged group (482 days (P<0.001. In control group, one of 14 patients presented significant improvement spontaneously. Intratympanic dexamethasone treatment may be effective in treatment of severe tinnitus after sudden SNHL at the stage of stable hearing level, and the shorter the period from onset of sudden deafness to the start of intratympanic dexamethasone treatment, the greater the improvement in tinnitus that can be expected.

  18. Tinnitus-Related Distress and the Personality Characteristic Resilience

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    Elisabeth Wallhäusser-Franke

    2014-01-01

    Full Text Available It has been suggested that personality traits may be prognostic for the severity of suffering from tinnitus. Resilience as measured with the Wagnild and Young resilience scale represents a positive personality characteristic that promotes adaptation to adverse life conditions including chronic health conditions. Aim of the study was to explore the relation between resilience and tinnitus severity. In a cross-sectional study with a self-report questionnaire, information on tinnitus-related distress and subjective tinnitus loudness was recorded together with the personality characteristic resilience and emotional health, a measure generated from depression, anxiety, and somatic symptom severity scales. Data from 4705 individuals with tinnitus indicate that tinnitus-related distress and to a lesser extent the experienced loudness of the tinnitus show an inverse correlation with resilience. A mediation analysis revealed that the relationship between resilience and tinnitus-related distress is mediated by emotional health. This indirect effect indicates that high resilience is associated with better emotional health or less depression, anxiety, and somatic symptom severity, which in turn is associated with a less distressing tinnitus. Validity of resilience as a predictor for tinnitus-related distress is supported but needs to be explored further in longitudinal studies including acute tinnitus patients.

  19. Animal models of tinnitus.

    Science.gov (United States)

    Brozoski, Thomas J; Bauer, Carol A

    2016-08-01

    Presented is a thematic review of animal tinnitus models from a functional perspective. Chronic tinnitus is a persistent subjective sound sensation, emergent typically after hearing loss. Although the sensation is experientially simple, it appears to have central a nervous system substrate of unexpected complexity that includes areas outside of those classically defined as auditory. Over the past 27 years animal models have significantly contributed to understanding tinnitus' complex neurophysiology. In that time, a diversity of models have been developed, each with its own strengths and limitations. None has clearly become a standard. Animal models trace their origin to the 1988 experiments of Jastreboff and colleagues. All subsequent models derive some of their features from those experiments. Common features include behavior-dependent psychophysical determination, acoustic conditions that contrast objective sound and silence, and inclusion of at least one normal-hearing control group. In the present review, animal models have been categorized as either interrogative or reflexive. Interrogative models use emitted behavior under voluntary control to indicate hearing. An example would be pressing a lever to obtain food in the presence of a particular sound. In this type of model animals are interrogated about their auditory sensations, analogous to asking a patient, "What do you hear?" These models require at least some training and motivation management, and reflect the perception of tinnitus. Reflexive models, in contrast, employ acoustic modulation of an auditory reflex, such as the acoustic startle response. An unexpected loud sound will elicit a reflexive motor response from many species, including humans. Although involuntary, acoustic startle can be modified by a lower-level preceding event, including a silent sound gap. Sound-gap modulation of acoustic startle appears to discriminate tinnitus in animals as well as humans, and requires no training or

  20. Tonic tensor tympani syndrome in tinnitus and hyperacusis patients: A multi-clinic prevalence study

    Directory of Open Access Journals (Sweden)

    Myriam Westcott

    2013-01-01

    Full Text Available Tonic tensor tympani syndrome (TTTS is an involuntary, anxiety-based condition where the reflex threshold for tensor tympani muscle activity is reduced, causing a frequent spasm. This can trigger aural symptoms from tympanic membrane tension, middle ear ventilation alterations and trigeminal nerve irritability. TTTS is considered to cause the distinctive symptoms of acoustic shock (AS, which can develop after exposure to an unexpected loud sound perceived as highly threatening. Hyperacusis is a dominant AS symptom. Aural pain/blockage without underlying pathology has been noted in tinnitus and hyperacusis patients, without wide acknowledgment. This multiclinic study investigated the prevalence of TTTS symptoms and AS in tinnitus and hyperacusis patients. This study included consecutive patients with tinnitus and/or hyperacusis seen in multiple clinics. Data collected: Symptoms consistent with TTTS (pain/numbness/burning in and around the ear; aural "blockage"; mild vertigo/nausea; "muffled" hearing; tympanic flutter; headache; onset or exacerbation from exposure to loud/intolerable sounds; tinnitus/hyperacusis severity. All patients were medically cleared of underlying pathology, which could cause these symptoms. 60.0% of the total sample (345 patients, 40.6% of tinnitus only patients, 81.1% of hyperacusis patients had ≥1 symptoms (P < 0.001. 68% of severe tinnitus patients, 91.3% of severe hyperacusis patients had ≥1 symptoms (P < 0.001. 19.7% (68/345 of patients in the total sample had AS. 83.8% of AS patients had hyperacusis, 41.2% of non-AS patients had hyperacusis (P < 0.001. The high prevalence of TTTS symptoms suggests they readily develop in tinnitus patients, more particularly with hyperacusis. Along with AS, they should be routinely investigated in history-taking.

  1. Regional homogeneity on resting state fMRI in patients with tinnitus

    Institute of Scientific and Technical Information of China (English)

    Haidi Yang; Yiqing Zheng; Yongkang Ou; Xiayin Huang

    2014-01-01

    Objective:To study central functional network connections and their alterations in tinnitus patients using fMRI. Methods: Regional homogeneity (ReHo) values on fMRI were obtained from 18 tinnitus patients and 20 age and gender-matched control subjects. ReHo values were compared between tinnitus patients and control subjects to evaluate functional network connection differences. Results:Tinnitus patients showed increased ReHo values in gyrus frontalis inferior and decreased ReHo values in the anterior lobe of cerebellum in comparison with the controls. Analysis of functional network connection from the gyrus frontalis interior shows stronger connections to the middle brain (FWE, P<0.001) and right ventral striatum (FEW, P<0.05, small volume correction). Conclusions: The fMRI results indicate that both auditory and non-auditory centers play important roles in tinnitus. Functional connections among the auditory cortex, thalamus, medial temporal gyrus, parahippocampal gyrus and insula may be an underlying cause for the development of tinnitus.

  2. Impact of Multiple Factors on the Degree of Tinnitus Distress

    Science.gov (United States)

    Brüggemann, Petra; Szczepek, Agnieszka J.; Rose, Matthias; McKenna, Laurence; Olze, Heidi; Mazurek, Birgit

    2016-01-01

    Objective: The primary cause of subjective tinnitus is a dysfunction of the auditory system; however, the degree of distress tinnitus causes depends largely on the psychological status of the patient. Our goal was to attempt to associate the grade of tinnitus-related distress with the psychological distress, physical, or psychological discomfort patients experienced, as well as potentially relevant social parameters, through a simultaneous analysis of these factors. Methods: We determined the level of tinnitus-related distress in 531 tinnitus patients using the German version of the tinnitus questionnaire (TQ). In addition, we used the Perceived Stress Questionnaire (PSQ); General Depression Scale Allgemeine Depression Skala (ADS), Berlin Mood Questionnaire (BSF); somatic symptoms inventory (BI), and SF-8 health survey as well as general information collected through a medical history. Results: The TQ score significantly correlated with a score obtained using PSQ, ADS, BSF, BI, and SF-8 alongside psychosocial factors such as age, gender, and marital status. The level of hearing loss and the auditory properties of the specific tinnitus combined with perceived stress and the degree of depressive mood and somatic discomfort of a patient were identified as medium-strong predictors of chronic tinnitus. Social factors such as gender, age, or marital status also had an impact on the degree of tinnitus distress. The results that were obtained were implemented in a specific cortical distress network model. Conclusions: Using a large representative sample of patients with chronic tinnitus permitted a simultaneous statistical measurement of psychometric and audiological parameters in predicting tinnitus distress. We demonstrate that single factors can be distinguished in a manner that explains their causative association and influence on the induction of tinnitus-related distress. PMID:27445776

  3. Chronic tinnitus:a grading management mode study%慢性耳鸣分级治疗模式的初步探讨

    Institute of Scientific and Technical Information of China (English)

    曾祥丽; 龚树生; 李鹏; 李源

    2009-01-01

    目的 探讨针对不同程度慢性耳鸣患者的分级治疗模式,提高耳鸣治疗的成本一效益比.方法 根据患者对耳鸣的烦恼程度和治疗需求,对587例慢性耳鸣患者,进行分级治疗:一级,耳鸣的初步评估、咨询及治疗,筛选出需要临床干预者;二级,提供耳鸣相关知识的宣教;三级,对经过一、二级治疗后仍有治疗需求者,进行深入的听功能诊断、耳鸣评估,根据评估结果 制定并实施个体化的长期治疗方案.结果 75%(441/587)的患者仅需要通过咨询及耳鸣知识的宣教解除其对耳鸣的神秘感、恐惧感而实现耳鸣代偿,25%(146/587)需要长期综合的临床干预.结论 通过有效的分级诊疗可快速而准确地掌握患者耳鸣的程度及治疗需求,为不同患者提供从耳鸣知识的咨询到个体化的长期干预等不同层次的治疗,提高了耳鸣治疗的成本一效益比.%Objective To probe into grading management mode for chronic tinnitns victims, so as to improve the cost-effectiveness rate of tinnitus treatment. Methods According to the severity of patient's own feeling and the therapy demand, the authors managed 587 of chronic tinnitus victims using a progressive methods: Level 1 was primary evaluation, counseling and treatment for tinnitus victims, then determined if the victim require further clinical intervention . Level 2 was educational counseling about the knowledge of tinnitus. Level 3 was further evaluation for hearing function and the severity of tinnitus. Than the authors made and put in practice an individual integrative treatment project for every victim according to the assessment results. Results 75% (441/587) of the chronic tinnitus victims needed only educational counseling which can free them from the mystification and dread of tinnitus, the counseling helped them get habituation of tinnitus; the rest 25% ( 146/587 ) needed long-term integrative clinical treatment. Conclusion Effective grading

  4. SUBJECTIVE TINNITUS AS FIRST PRESENTATION IN A PATIENT WITH METASTATIC LUNG CANCER IN TEMPORAL BONE-A CASE REPORT

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jing; WANG Hongtian; JIA Jingjie; XIAO Yueyong; SHI Huaiyin; YANG Weiyan

    2013-01-01

    Metastasis of lung cancer to the temporal bone is a very rare disease and subjective tinnitus as the present-ing symptom in these patients is even rarer. Here we report a case in which a 42-year-old male presented with subjective tinnitus of three months, with no pulmonary disease symptoms. Pure tone audiometry indi-cated moderate conductive deafness in left ear with an air-bone gap of 21.3 dB. HRCT temporal bone scan-ning indicated high-density shadows in the left epitympanic cavity, sinus tympani and mastoid cavity. Chron-ic otitis media with cholesteatoma was suspected and surgical treatment recommended. However, preopera-tive chest x-ray revealed high-density millet lesions scattered widely in both lungs. HRCT lung scanning confirmed the lungs lesions and indicated lung cancer. In order to determine correlations between the tempo-ral bone and pulmonary lesions, a CT-guided trans-mastoid aspiration biopsy and immunohistochemical study were conducted, which confirmed that the temporal bone lesion was metastatic from the lungs. The pa-tient was given a series of chemotherapy immediately and his tinnitus significantly improved after three months of treatment, with full recovery of his hearing and complete resolution of shadows in the mastoid cavity. Unfortunately, he subsequently developed multiple bone metastases in the 9th month and cerebral metastasis in the 18th month. Multiple organ failure resulted in death in 2.5 years.

  5. Acceptance of Tinnitus : Validation of the Tinnitus Acceptance Questionnaire

    OpenAIRE

    Weise, Cornelia; Kleinstäuber, Maria; Hesser, Hugo; Westin, Vendela; Andersson, Gerhard

    2013-01-01

    The concept of acceptance has recently received growing attention within tinnitus research due to the fact that tinnitus acceptance is one of the major targets of psychotherapeutic treatments. Accordingly, acceptance-based treatments will most likely be increasingly offered to tinnitus patients and assessments of acceptance-related behaviours will thus be needed. The current study investigated the factorial structure of the Tinnitus Acceptance Questionnaire (TAQ) and the role of tinnitus acce...

  6. Complementary Therapies for Significant Dysfunction from Tinnitus: Treatment Review and Potential for Integrative Medicine

    Directory of Open Access Journals (Sweden)

    Ruth Q. Wolever

    2015-01-01

    Full Text Available Tinnitus is a prevalent and costly chronic condition; no universally effective treatment exists. Only 20% of patients who report tinnitus actually seek treatment, and when treated, most patients commonly receive sound-based and educational (SBE therapy. Additional treatment options are necessary, however, for nonauditory aspects of tinnitus (e.g., anxiety, depression, and significant interference with daily life and when SBE therapy is inefficacious or inappropriate. This paper provides a comprehensive review of (1 conventional tinnitus treatments and (2 promising complementary therapies that have demonstrated some benefit for severe dysfunction from tinnitus. While there has been no systematic study of the benefits of an Integrative Medicine approach for severe tinnitus, the current paper reviews emerging evidence suggesting that synergistic combinations of complementary therapies provided within a whole-person framework may augment SBE therapy and empower patients to exert control over their tinnitus symptoms without the use of medications, expensive devices, or extended programs.

  7. Lateralization of functional magnetic resonance imaging (fMRI) activation in the auditory pathway of patients with lateralized tinnitus

    Energy Technology Data Exchange (ETDEWEB)

    Smits, Marion [Erasmus MC - University Medical Center Rotterdam, Department of Radiology, Hs 224, Rotterdam (Netherlands); Kovacs, Silvia; Peeters, Ronald R.; Hecke, Paul van; Sunaert, Stefan [University Hospitals of the Catholic University Leuven, Department of Radiology, Leuven (Belgium); Ridder, Dirk de [University of Antwerp, Department of Neurosurgery, Edegem (Belgium)

    2007-08-15

    Tinnitus is hypothesized to be an auditory phantom phenomenon resulting from spontaneous neuronal activity somewhere along the auditory pathway. We performed fMRI of the entire auditory pathway, including the inferior colliculus (IC), the medial geniculate body (MGB) and the auditory cortex (AC), in 42 patients with tinnitus and 10 healthy volunteers to assess lateralization of fMRI activation. Subjects were scanned on a 3T MRI scanner. A T2*-weighted EPI silent gap sequence was used during the stimulation paradigm, which consisted of a blocked design of 12 epochs in which music presented binaurally through headphones, which was switched on and off for periods of 50 s. Using SPM2 software, single subject and group statistical parametric maps were calculated. Lateralization of activation was assessed qualitatively and quantitatively. Tinnitus was lateralized in 35 patients (83%, 13 right-sided and 22 left-sided). Significant signal change (P{sub corrected} < 0.05) was found bilaterally in the primary and secondary AC, the IC and the MGB. Signal change was symmetrical in patients with bilateral tinnitus. In patients with lateralized tinnitus, fMRI activation was lateralized towards the side of perceived tinnitus in the primary AC and IC in patients with right-sided tinnitus, and in the MGB in patients with left-sided tinnitus. In healthy volunteers, activation in the primary AC was left-lateralized. Our paradigm adequately visualized the auditory pathways in tinnitus patients. In lateralized tinnitus fMRI activation was also lateralized, supporting the hypothesis that tinnitus is an auditory phantom phenomenon. (orig.)

  8. Suppression of Tinnitus in a Patient with Unilateral Sudden Hearing Loss: A Case Report

    Directory of Open Access Journals (Sweden)

    Alessandra Fioretti

    2012-01-01

    Full Text Available We describe a case of a 67-year-old woman with severe disabling right-sided tinnitus, mild hyperacusis, and headache. The tinnitus was associated with sudden right hearing loss and vertigo, which occurred about 18 months before. Magnetic resonance imaging (MRI resulted in normal anatomical structures of the cochlea and of the cranial nerves showing a partial empty sella syndrome with suprasellar cistern hernia. Angio-MR revealed a bilateral contact between the anterior-inferior cerebellar artery (AICA and the acoustic-facial nerve with a potential neurovascular conflict. Surgery was considered unnecessary after further evaluations. The right ear was successfully treated with a combination device (hearing aid plus sound generator. Shortly after a standard fitting procedure, the patient reported a reduction of tinnitus, hyperacusis, and headache which completely disappeared at the follow-up evaluation after 3, 6, and 12 months. This paper demonstrates that the combination device resulted in a complete tinnitus and hyperacusis suppression in a patient with unilateral sensorineural sudden hearing loss. Our paper further supports the restoration of peripheral sensory input for the treatment of tinnitus associated with hearing loss in selected patients.

  9. Cochlear and brainstem audiologic findings in normal hearing tinnitus subjects in comparison with non-tinnitus control group.

    Directory of Open Access Journals (Sweden)

    Shadman Nemati

    2014-11-01

    Full Text Available While most tinnitus cases have some degree of hearing impairment, a small percent of the patients admitted to Ear, Nose and Throat Clinics or Hearing Evaluation Centers are those who complain of tinnitus despite having normal hearing thresholds. Present study was performed in order to better understanding of the probable causes of tinnitus and to investigate possible changes in the cochlear and auditory brainstem function in normal hearing patients with chronic tinnitus. Altogether, 63 ears (31 ears with tinnitus and 32 ears without tinnitus were examined. The prevalence of transient evoked otoacoustic emissions and characteristics of the auditory brainstem response components including wave latencies and wave amplitudes was determined in the two groups and analyzed with appropriate statistical methods. There was no difference between the prevalence of transient evoked emissions in the two groups. The mean difference between absolute latencies of waves I, III and V was less than 0.1 ms between the two groups that were not statistically significant. Also, the interpeak latency values of I-III, III-V and I-V in both groups had no significant difference. Only the V/I amplitude ratio in the tinnitus group was significantly larger than the other group (p =0.04. The changes observed in amplitude of waves, especially in the later ones, can be considered as an Audiologic finding in normal hearing tinnitus subjects and its possible role in generation of tinnitus in these patients must be investigated.

  10. 耳鸣患者听力分析%The Analysis of Hearing of Tinnitus Patients

    Institute of Scientific and Technical Information of China (English)

    林春招; 隆琰; 黄秋平; 白俊志; 江远仕

    2011-01-01

    目的 探讨以耳鸣为首发症状的患者用纯音电测听进行听力检查的必要性.方法 对218例耳鸣患者的纯音电测听结果进行分析.结果 218例耳鸣患者中,共有123例听力不正常,95例听力正常的患者中,有50例除耳鸣外,无其他病因.结论 听力正常的耳鸣患者中,如果未查出明确病因,需进一步行脑干电反应测听、耳声发射等听力检测及其他必要检查,以明确耳鸣的原因或听觉系统发生异常的部位,对耳鸣的早期诊断及治疗有重要意义,但纯音电测听应作为耳鸣患者首次就诊时的常规检查项目.%Objective To investigate the necessity to test the hearing of patients whose initial symptom is tinnitus with pure tone audiometer. Methods To analyze the results of pure tone audiometer of 218 tinnitus patients.Results Among 218 cases of tinnitus patients,a total of 123 patients with abnormal hearing,among 95 cases of patients with normal hearing, except for 50 cases of tinnitus, no other cause of disease. Conclusion Among the normal hearing tinnitus patients, we should do further hearing test for them if they are not identified a clear cause of disease,such as auditory brainstem response,otoacoustic emission and other necessary checks to clear the reasons for tinnitus or the position of the unusual auditory system. It is important for early diagnosis and treatment of tinnitus. But the pure-tone audiometer should be a routine examination when tinnitus patients come for the first visit.

  11. A critical evaluation of Web sites offering patient information on tinnitus.

    LENUS (Irish Health Repository)

    Kieran, Stephen M

    2012-02-01

    The Internet is a vast information resource for both patients and healthcare professionals. However, the quality and content often lack formal scrutiny, so we examined the quality of patient information regarding tinnitus on the Internet. Using the three most popular search engines (google.com, yahoo.com, and msn.com), we found pertinent Web sites using the search term tinnitus. Web sites\\' accountability and authorship were evaluated using previously published criteria. The quality of patient information about tinnitus was assessed using a new 10-point scale, the Tinnitus Information Value (TIV). Statistical analysis was performed using the independent sample t-test (p Tinnitus information available on the Internet is indeed variable, and care should be taken in recommending tinnitus Web sites to patients.

  12. The use of fractal tones in tinnitus patient management

    Directory of Open Access Journals (Sweden)

    Robert W Sweetow

    2013-01-01

    Full Text Available A variety of noises have been employed for decades in an effort to facilitate habituation, mask, or suppress tinnitus. Many of these sounds have reportedly provided benefit, but success has not been universal. More recently, musical stimuli have been added as a sound therapy component. The potential advantages of using such stimuli, in particular fractal tones, in combination with amplification are discussed in this paper.

  13. Radiologic diagnostic and therapeutic options in patients with pulsatile tinnitus; Radiologische Diagnostik des Ohrgeraeuschs und therapeutische Optionen

    Energy Technology Data Exchange (ETDEWEB)

    Wanke, Isabel [Klinik Hirslanden, Zuerich (Switzerland). Abt. fuer Neuroradiologie; Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Forsting, Michael [Universitaetsklinikum Essen (Germany). Inst. fuer Radiologie und Neuroradiolgoie

    2010-03-15

    A pulse synchronous tinnitus is characterized by a rhythmic sound that is in sync with the patient heartbeat or respiration and can be perceived by the patient as a bruit. Different from the more common classic and continuous ear sound, with pulse synchronous tinnitus one may often discover a pathological neovascular condition that can be diagnosed with medical imaging. This review covers the different conditions leading to pulse synchronous tinnitus and provides indications requiring preventive and active treatment to avoid potential but serious sequela for the patient. (orig.)

  14. When Your Child Has Tinnitus

    Science.gov (United States)

    ... an ENT Doctor Near You When Your Child Has Tinnitus When Your Child Has Tinnitus Patient Health Information News media interested in ... be continuous or sporadic. This often debilitating condition has been linked to ear injuries, circulatory system problems, ...

  15. Cortical reorganization in recent-onset tinnitus patients by the Heidelberg Model of Music Therapy

    Directory of Open Access Journals (Sweden)

    Christoph Maria Krick

    2015-02-01

    Full Text Available Pathophysiology and treatment of tinnitus still are fields of intensive research. The neuroscientifically motivated Heidelberg Model of Music Therapy, previously developed by the German Center for Music Therapy Research, Heidelberg, Germany, was applied to explore its effects on individual distress and on brain structures. This therapy is a compact and fast application of nine consecutive 50-minutes sessions of individualized therapy implemented over one week. Clinical improvement and long-term effects over several years have previously been published. However the underlying neural basis of the therapy’s success has not yet been explored. In the current study, the therapy was applied to acute tinnitus patients (TG and healthy active controls (AC. Non-treated patients were also included as passive controls (PTC. As predicted, the therapeutic intervention led to a significant decrease of tinnitus-related distress in TG compared to PTC. Before and after the study week, high-resolution MRT scans were obtained for each subject. Assessment by repeated measures design for several groups (two-way ANOVA revealed structural gray matter (GM increase in TG compared to PTC, comprising clusters in precuneus, medial superior frontal areas, and in the auditory cortex. This pattern was further applied as mask for general GM changes as induced by the therapy week. The therapy-like procedure in AC also elicited similar GM increases in precuneus and frontal regions. Comparison between structural effects in TG versus AC was calculated within the mask for general GM changes to obtain specific effects in tinnitus patients, yielding GM increase in right Heschl's gyrus, right Rolandic operculum, and medial superior frontal regions. In line with recent findings on the crucial role of the auditory cortex in maintaining tinnitus-related distress, a causative relation between the therapy-related GM alterations in auditory areas and the long-lasting therapy effects can be

  16. Multisensory attention training for treatment of tinnitus

    OpenAIRE

    Spiegel D. P.; Linford T.; Thompson B; Petoe M. A.; Kobayashi K; Stinear C. M.; Searchfield G. D.

    2015-01-01

    Tinnitus is the conscious perception of sound with no physical sound source. Some models of tinnitus pathophysiology suggest that networks associated with attention, memory, distress and multisensory experience are involved in tinnitus perception. The aim of this study was to evaluate whether a multisensory attention training paradigm which used audio, visual, and somatosensory stimulation would reduce tinnitus. Eighteen participants with predominantly unilateral chronic tinnitus were randomi...

  17. Temporary Suppression of Tinnitus by Modulated Sounds

    OpenAIRE

    Reavis, Kelly M.; Rothholtz, Vanessa S.; Tang, Qing; Carroll, Jeff A.; Djalilian, Hamid; Zeng, Fan-Gang

    2012-01-01

    Despite high prevalence of tinnitus and its impact on quality life, there is no cure for tinnitus at present. Here, we report an effective means to temporarily suppress tinnitus by amplitude- and frequency-modulated tones. We systematically explored the interaction between subjective tinnitus and 17 external sounds in 20 chronic tinnitus sufferers. The external sounds included traditionally used unmodulated stimuli such as pure tones and white noise and dynamically modulated stimuli known to ...

  18. Tinnitus guidelines and treatment

    DEFF Research Database (Denmark)

    Larsen, Dalia Gustaityté; Ovesen, Therese

    2014-01-01

    In this study literature search was performed on tinnitus guidelines and treatment. Tinnitus can be described as the perception of sound in the absence of external acoustic stimulation, and validated questionnaires, oto-neurological examination, audiometry tests, MRI and angiography are necessary...... as diagnostic tools. Antidepressants, melatonin and cognitive behavioural therapy have no effect on tinnitus, whereas sound generators, hearing aids and tinnitus retraining therapy show some but limited improvement. National recommendations are required to ensure a homogenous and optimum offer for all patients....

  19. The radiologic evaluation of tinnitus

    Energy Technology Data Exchange (ETDEWEB)

    Branstetter, Barton F. [University of Pittsburgh Medical Center, Departments of Radiology and Otolaryngology, Pittsburgh, PA (United States); Weissman, Jane L. [Oregon Health Sciences University, Departments of Radiology, Ophthalmology, and Otolaryngology, Portland, OR (United States)

    2006-12-15

    Tinnitus (''ringing in the ears'') is a prevalent symptom in the general population, and often brings patients to medical attention. Many causes of tinnitus are evident radiographically. The most frequently-encountered causes of tinnitus are discussed, and imaging recommendations are provided. (orig.)

  20. Prefrontal Cortex Based Sex Differences in Tinnitus Perception: Same Tinnitus Intensity, Same Tinnitus Distress, Different Mood

    OpenAIRE

    Sven Vanneste; Kathleen Joos; Dirk De Ridder

    2012-01-01

    BACKGROUND: Tinnitus refers to auditory phantom sensation. It is estimated that for 2% of the population this auditory phantom percept severely affects the quality of life, due to tinnitus related distress. Although the overall distress levels do not differ between sexes in tinnitus, females are more influenced by distress than males. Typically, pain, sleep, and depression are perceived as significantly more severe by female tinnitus patients. Studies on gender differences in emotional regula...

  1. Acupuncture Treatment of Tinnitus

    Institute of Scientific and Technical Information of China (English)

    胡金生

    2004-01-01

    @@ Case History Mr. Bakir Hossain, a 49-year-old engineer of a company in Decca, the capital of the People's Republic of Bangladesh, paid his first visit on May8, 2002, with the chief complaint of tinnitus for more than a year. The patient stated that the tinnitus appeared a year before, accompanied with hypoacusis,which disturbed his work and sleep.

  2. Phenotypic Characteristics of Hyperacusis in Tinnitus

    OpenAIRE

    Martin Schecklmann; Michael Landgrebe; Berthold Langguth

    2014-01-01

    BACKGROUND: Many people with tinnitus also suffer from hyperacusis. Both clinical and basic scientific data indicate an overlap in pathophysiologic mechanisms. In order to further elucidate the interplay between tinnitus and hyperacusis we compared clinical and demographic characteristics of tinnitus patients with and without hyperacusis by analyzing a large sample from an international tinnitus patient database. MATERIALS: The default dataset import [November 1(st), 2012] from the Tinnitus R...

  3. A case of tinnitus induced by chlorpromazine in a pediatric patient

    OpenAIRE

    Carla Carnovale; Paolo Pellegrino; Silvia Beretta; Gian Vincenzo Zuccotti; Valentina Perrone; Stefania Antoniazzi; Marco Pozzi; Emilio Clementi; Sonia Radice

    2014-01-01

    Chlorpromazine is a well-known antipsychotic agent that binds with a variety of receptors in the central nervous system. To date, chlorpromazine has never been associated with onset of hearing disorders and tinnitus. We report on an unexpected suspect adverse reaction to chlorpromazine that occurred in a 12-year-old boy, affected by severe generalized anxiety disorder. After treatment with chlorpromazine, the patient experienced an enhanced sensitivity to sounds accompanied by perception of n...

  4. Prefrontal cortex based sex differences in tinnitus perception: same tinnitus intensity, same tinnitus distress, different mood.

    Directory of Open Access Journals (Sweden)

    Sven Vanneste

    Full Text Available BACKGROUND: Tinnitus refers to auditory phantom sensation. It is estimated that for 2% of the population this auditory phantom percept severely affects the quality of life, due to tinnitus related distress. Although the overall distress levels do not differ between sexes in tinnitus, females are more influenced by distress than males. Typically, pain, sleep, and depression are perceived as significantly more severe by female tinnitus patients. Studies on gender differences in emotional regulation indicate that females with high depressive symptoms show greater attention to emotion, and use less anti-rumination emotional repair strategies than males. METHODOLOGY: The objective of this study was to verify whether the activity and connectivity of the resting brain is different for male and female tinnitus patients using resting-state EEG. CONCLUSIONS: Females had a higher mean score than male tinnitus patients on the BDI-II. Female tinnitus patients differ from male tinnitus patients in the orbitofrontal cortex (OFC extending to the frontopolar cortex in beta1 and beta2. The OFC is important for emotional processing of sounds. Increased functional alpha connectivity is found between the OFC, insula, subgenual anterior cingulate (sgACC, parahippocampal (PHC areas and the auditory cortex in females. Our data suggest increased functional connectivity that binds tinnitus-related auditory cortex activity to auditory emotion-related areas via the PHC-sgACC connections resulting in a more depressive state even though the tinnitus intensity and tinnitus-related distress are not different from men. Comparing male tinnitus patients to a control group of males significant differences could be found for beta3 in the posterior cingulate cortex (PCC. The PCC might be related to cognitive and memory-related aspects of the tinnitus percept. Our results propose that sex influences in tinnitus research cannot be ignored and should be taken into account in functional

  5. The cerebellum as a novel tinnitus generator.

    Science.gov (United States)

    Bauer, Carol A; Kurt, Wisner; Sybert, Lauren T; Brozoski, Thomas J

    2013-01-01

    The role of the cerebellum in auditory processing is largely unknown. Recently it was shown that rats with psychophysical evidence of tinnitus had significantly elevated neural activity in the paraflocculus of the cerebellum (PFL), as indicated by functional imaging. It was further shown that PFL activity was not elevated in normal rats listening to a tinnitus-like sound. This suggests that plastic changes in the PFL may underpin chronic tinnitus, i.e., it may serve as a tinnitus generator. Using a rat model of acoustic trauma-induced tinnitus, the role of the cerebellum was further examined in a series of experiments:The PFL was surgically ablated in animals with established tinnitus; the PFL was surgically ablated in animals before induction of tinnitus; the PFL was reversibly inactivated by chronic lidocaine infusion into the subarcuate fossa of animals with established tinnitus. It was found that PFL ablation eliminated established tinnitus without altering auditory discrimination. Similar to the ablation results, PFL inactivation with lidocaine reversibly eliminated existing tinnitus. In contrast however, PFL ablation before tinnitus induction attenuated, but did not completely eliminate, tinnitus. In a rat model of noise-induced chronic tinnitus, the cerebellar PFL may serve as a sufficient but non-obligatory generator of tinnitus. PMID:23418634

  6. Polarity Specific Suppression Effects of Transcranial Direct Current Stimulation for Tinnitus

    Directory of Open Access Journals (Sweden)

    Kathleen Joos

    2014-01-01

    Full Text Available Tinnitus is the perception of a sound in the absence of an external auditory stimulus and affects 10–15% of the Western population. Previous studies have demonstrated the therapeutic effect of anodal transcranial direct current stimulation (tDCS over the left auditory cortex on tinnitus loudness, but the effect of this presumed excitatory stimulation contradicts with the underlying pathophysiological model of tinnitus. Therefore, we included 175 patients with chronic tinnitus to study polarity specific effects of a single tDCS session over the auditory cortex (39 anodal, 136 cathodal. To assess the effect of treatment, we used the numeric rating scale for tinnitus loudness and annoyance. Statistical analysis demonstrated a significant main effect for tinnitus loudness and annoyance, but for tinnitus annoyance anodal stimulation has a significantly more pronounced effect than cathodal stimulation. We hypothesize that the suppressive effect of tDCS on tinnitus loudness may be attributed to a disrupting effect of ongoing neural hyperactivity, independent of the inhibitory or excitatory effects and that the reduction of annoyance may be induced by influencing adjacent or functionally connected brain areas involved in the tinnitus related distress network. Further research is required to explain why only anodal stimulation has a suppressive effect on tinnitus annoyance.

  7. Deep Brain Stimulation——A new treatment for tinnitus

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Intractable tinnitus can lead to serious consequences. Study evidence indicates that the central nervous system is involved in generation and maintenance of chronic tinnitus and that tinnitus and other neurologic symptoms such as chronic pain may share similar mechanisms. Brain ablation and stimulation are used to treat chronic pain with success. Recent studies showed that ablation and stimulation in non-auditory areas resulted in tinnitus improvement. Deep brain stimulation (DBS) may be an alternative treatment for intractable tinnitus and deserves further study.

  8. Tinnitus: Distinguishing between Subjectively Perceived Loudness and Tinnitus-Related Distress

    OpenAIRE

    Elisabeth Wallhäusser-Franke; Joachim Brade; Tobias Balkenhol; Roberto D'Amelio; Andrea Seegmüller; Wolfgang Delb

    2012-01-01

    OBJECTIVES: Overall success of current tinnitus therapies is low, which may be due to the heterogeneity of tinnitus patients. Therefore, subclassification of tinnitus patients is expected to improve therapeutic allocation, which, in turn, is hoped to improve therapeutic success for the individual patient. The present study aims to define factors that differentially influence subjectively perceived tinnitus loudness and tinnitus-related distress. METHODS: In a questionnaire-based cross-section...

  9. Influence of tinnitus percentage index of speech recognition in patients with normal hearing

    Directory of Open Access Journals (Sweden)

    Urnau, Daila

    2010-12-01

    Full Text Available Introduction: The understanding of speech is one of the most important measurable aspects of human auditory function. Tinnitus affects the quality of life, impairing communication. Objective: To investigate possible changes in the Percentage Index of Speech Recognition (SDT in individuals with tinnitus have normal hearing and examining the relationship between tinnitus, gender and age. Methods:A retrospective study by analyzing the records of 82 individuals of both genders, aged 21-70 years, totaling 128 ears with normal hearing. The ears were analyzed separately, and divided into control group, no complaints of tinnitus and group study, with complaints of tinnitus. The variables gender and age groups and examined the influence of tinnitus in the SDT. It was considered normal, the percentage of 100% correct and changed, and the value between 88-96%. These criteria were adopted, since the percentage below 88% correct is found in individuals with sensorineural hearing loss. Results:There was no statistically significant difference between the variables age and tinnitus, and tinnitus SDT, only gender and tinnitus. The prevalence of tinnitus in females (56%, higher incidence of tinnitus in the age group 31-40 years (41.67% and fewer from 41 to 50 years (18.75% and on the SDT there was a greater percentage change in individuals with tinnitus (61.11%. Conclusion: The buzz does not interfere with SDT and there is no relationship between tinnitus and age, only between tinnitus and gender.

  10. The characteristic and changes of the event-related potentials (ERP and brain topographic maps before and after treatment with rTMS in subjective tinnitus patients.

    Directory of Open Access Journals (Sweden)

    Haidi Yang

    Full Text Available OBJECTIVES: To compare the event-related potentials (ERPs and brain topographic maps characteristic and change in normal controls and subjective tinnitus patients before and after repetitive transcranial magnetic stimulation (rTMS treatment. METHODS AND PARTICIPANTS: The ERPs and brain topographic maps elicited by target stimulus were compared before and after 1-week treatment with rTMS in 20 subjective tinnitus patients and 16 healthy controls. RESULTS: Before rTMS, target stimulus elicited a larger N1 component than the standard stimuli (repeating soundsin control group but not in tinnitus patients. Instead, the tinnitus group pre-treatment exhibited larger amplitude of N1 in response to standard stimuli than to deviant stimuli. Furthermore tinnitus patients had smaller mismatch negativity (MMN and late discriminative negativity (LDNcomponent at Fz compared with the control group. After rTMS treatment, tinnitus patients showed increased N1 response to deviant stimuli and larger MMN and LDN compared with pre-treatment. The topographic maps for the tinnitus group before rTMS -treatment demonstrated global asymmetry between the left and right cerebral hemispheres with more negative activities in left side and more positive activities in right side. In contrast, the brain topographic maps for patients after rTMS-treatment and controls seem roughly symmetrical. The ERP amplitudes and brain topographic maps in post-treatment patient group showed no significant difference with those in controls. CONCLUSIONS: The characterical changes in ERP and brain topographic maps in tinnitus patients maybe related with the electrophysiological mechanism of tinnitus induction and development. It can be used as an objective biomarker for the evaluation of auditory central in subjective tinnitus patients. These findings support the notion that rTMS treatment in tinnitus patients may exert a beneficial effect.

  11. Frequency-Dependent Neural Activity in Patients with Unilateral Vascular Pulsatile Tinnitus

    OpenAIRE

    Lv, Han; Zhao, Pengfei; Liu, Zhaohui; Wang, Guopeng; Zeng, Rong; Yan, Fei; Dong, Cheng; Zhang, Ling; Li, Rui; Wang, Peng; Li, Ting; Gong, Shusheng; Wang, Zhenchang

    2016-01-01

    Previous resting-state functional magnetic resonance imaging (rs-fMRI) studies have shown that neurological changes are important findings in vascular pulsatile tinnitus (PT) patients. Here, we utilized rs-fMRI to measure the amplitude of low-frequency fluctuations (ALFF) in forty patients with unilateral PT and forty age-, gender-, and education-matched normal control subjects. Two different frequency bands (slow-4, 0.027–0.073 Hz, and slow-5, 0.010–0.027 Hz, which are more sensitive to subc...

  12. Frequency-Dependent Neural Activity in Patients with Unilateral Vascular Pulsatile Tinnitus

    Directory of Open Access Journals (Sweden)

    Han Lv

    2016-01-01

    Full Text Available Previous resting-state functional magnetic resonance imaging (rs-fMRI studies have shown that neurological changes are important findings in vascular pulsatile tinnitus (PT patients. Here, we utilized rs-fMRI to measure the amplitude of low-frequency fluctuations (ALFF in forty patients with unilateral PT and forty age-, gender-, and education-matched normal control subjects. Two different frequency bands (slow-4, 0.027–0.073 Hz, and slow-5, 0.010–0.027 Hz, which are more sensitive to subcortical and cortical neurological signal changes, resp. were analyzed to examine the intrinsic brain activity in detail. Compared to controls, PT patients had increased ALFF values mainly in the PCu, bilateral IPL (inferior parietal lobule, left IFG (inferior frontal gyrus, and right IFG/anterior insula and decreased ALFF values in the multiple occipital areas including bilateral middle-inferior occipital lobe. For the differences of the two frequency bands, widespread ALFF differences were observed. The ALFF abnormalities in aMPFC/ACC, PCu, right IPL, and some regions of occipital and parietal cortices were greater in the slow-5 band compared to the slow-4 band. Additionally, the THI score of PT patients was positively correlated with changes in slow-5 and slow-4 band in PCu. Pulsatile tinnitus is a disease affecting the neurological activities of multiple brain regions. Slow-5 band is more sensitive in detecting the alternations. Our results also indicated the importance of pathophysiological investigations in patients with pulsatile tinnitus in the future.

  13. Frequency-Dependent Neural Activity in Patients with Unilateral Vascular Pulsatile Tinnitus.

    Science.gov (United States)

    Lv, Han; Zhao, Pengfei; Liu, Zhaohui; Wang, Guopeng; Zeng, Rong; Yan, Fei; Dong, Cheng; Zhang, Ling; Li, Rui; Wang, Peng; Li, Ting; Gong, Shusheng; Wang, Zhenchang

    2016-01-01

    Previous resting-state functional magnetic resonance imaging (rs-fMRI) studies have shown that neurological changes are important findings in vascular pulsatile tinnitus (PT) patients. Here, we utilized rs-fMRI to measure the amplitude of low-frequency fluctuations (ALFF) in forty patients with unilateral PT and forty age-, gender-, and education-matched normal control subjects. Two different frequency bands (slow-4, 0.027-0.073 Hz, and slow-5, 0.010-0.027 Hz, which are more sensitive to subcortical and cortical neurological signal changes, resp.) were analyzed to examine the intrinsic brain activity in detail. Compared to controls, PT patients had increased ALFF values mainly in the PCu, bilateral IPL (inferior parietal lobule), left IFG (inferior frontal gyrus), and right IFG/anterior insula and decreased ALFF values in the multiple occipital areas including bilateral middle-inferior occipital lobe. For the differences of the two frequency bands, widespread ALFF differences were observed. The ALFF abnormalities in aMPFC/ACC, PCu, right IPL, and some regions of occipital and parietal cortices were greater in the slow-5 band compared to the slow-4 band. Additionally, the THI score of PT patients was positively correlated with changes in slow-5 and slow-4 band in PCu. Pulsatile tinnitus is a disease affecting the neurological activities of multiple brain regions. Slow-5 band is more sensitive in detecting the alternations. Our results also indicated the importance of pathophysiological investigations in patients with pulsatile tinnitus in the future. PMID:27413554

  14. Frequency-Dependent Neural Activity in Patients with Unilateral Vascular Pulsatile Tinnitus

    Science.gov (United States)

    Lv, Han; Zhao, Pengfei; Liu, Zhaohui; Wang, Guopeng; Zeng, Rong; Yan, Fei; Dong, Cheng; Zhang, Ling; Li, Rui; Wang, Peng; Li, Ting

    2016-01-01

    Previous resting-state functional magnetic resonance imaging (rs-fMRI) studies have shown that neurological changes are important findings in vascular pulsatile tinnitus (PT) patients. Here, we utilized rs-fMRI to measure the amplitude of low-frequency fluctuations (ALFF) in forty patients with unilateral PT and forty age-, gender-, and education-matched normal control subjects. Two different frequency bands (slow-4, 0.027–0.073 Hz, and slow-5, 0.010–0.027 Hz, which are more sensitive to subcortical and cortical neurological signal changes, resp.) were analyzed to examine the intrinsic brain activity in detail. Compared to controls, PT patients had increased ALFF values mainly in the PCu, bilateral IPL (inferior parietal lobule), left IFG (inferior frontal gyrus), and right IFG/anterior insula and decreased ALFF values in the multiple occipital areas including bilateral middle-inferior occipital lobe. For the differences of the two frequency bands, widespread ALFF differences were observed. The ALFF abnormalities in aMPFC/ACC, PCu, right IPL, and some regions of occipital and parietal cortices were greater in the slow-5 band compared to the slow-4 band. Additionally, the THI score of PT patients was positively correlated with changes in slow-5 and slow-4 band in PCu. Pulsatile tinnitus is a disease affecting the neurological activities of multiple brain regions. Slow-5 band is more sensitive in detecting the alternations. Our results also indicated the importance of pathophysiological investigations in patients with pulsatile tinnitus in the future. PMID:27413554

  15. A central nervous system approach to tinnitus

    NARCIS (Netherlands)

    Hoekstra, C.E.L

    2013-01-01

    Chronic tinnitus is a phantom auditory perception of meaningless sound. It is a highly prevalent symptom with potential severe morbidity. In this thesis diagnostic and therapeutic aspects of tinnitus are assessed, based on the notion that tinnitus most probably arises from hyperactivity in the centr

  16. The Cerebellum as a Novel Tinnitus Generator

    OpenAIRE

    Bauer, Carol A.; Wisner, Kurt; Sybert, Lauren T.; Brozoski, Thomas J.

    2013-01-01

    The role of the cerebellum in auditory processing is largely unknown. Recently it was shown that rats with psychophysical evidence of tinnitus had significantly elevated neural activity in the paraflocculus of the cerebellum (PFL), as indicated by functional imaging. It was further shown that PFL activity was not elevated in normal rats listening to a tinnitus-like sound. This suggests that plastic changes in the PFL may underpin chronic tinnitus, i.e., it may serve as a tinnitus generator. U...

  17. Auditory Cortex tACS and tRNS for Tinnitus: Single versus Multiple Sessions

    Directory of Open Access Journals (Sweden)

    Laura Claes

    2014-01-01

    Full Text Available Tinnitus is the perception of a sound in the absence of an external acoustic source, which often exerts a significant impact on the quality of life. Currently there is evidence that neuroplastic changes in both neural pathways are involved in the generation and maintaining of tinnitus. Neuromodulation has been suggested to interfere with these neuroplastic alterations. In this study we aimed to compare the effect of two upcoming forms of transcranial electrical neuromodulation: alternating current stimulation (tACS and random noise stimulation (tRNS, both applied on the auditory cortex. A database with 228 patients with chronic tinnitus who underwent noninvasive neuromodulation was retrospectively analyzed. The results of this study show that a single session of tRNS induces a significant suppressive effect on tinnitus loudness and distress, in contrast to tACS. Multiple sessions of tRNS augment the suppressive effect on tinnitus loudness but have no effect on tinnitus distress. In conclusion this preliminary study shows a possibly beneficial effect of tRNS on tinnitus and can be a motivation for future randomized placebo-controlled clinical studies with auditory tRNS for tinnitus. Auditory alpha-modulated tACS does not seem to be contributing to the treatment of tinnitus.

  18. A case of tinnitus induced by chlorpromazine in a pediatric patient

    Science.gov (United States)

    Carnovale, Carla; Pellegrino, Paolo; Beretta, Silvia; Zuccotti, Gian Vincenzo; Perrone, Valentina; Antoniazzi, Stefania; Pozzi, Marco; Clementi, Emilio; Radice, Sonia

    2014-01-01

    Chlorpromazine is a well-known antipsychotic agent that binds with a variety of receptors in the central nervous system. To date, chlorpromazine has never been associated with onset of hearing disorders and tinnitus. We report on an unexpected suspect adverse reaction to chlorpromazine that occurred in a 12-year-old boy, affected by severe generalized anxiety disorder. After treatment with chlorpromazine, the patient experienced an enhanced sensitivity to sounds accompanied by perception of noises of the buzzing or ringing type. This clinical case is of great clinical interest as chlorpromazine is not currently included among potentially ototoxic drugs. PMID:24799822

  19. A case of tinnitus induced by chlorpromazine in a pediatric patient

    Directory of Open Access Journals (Sweden)

    Carla Carnovale

    2014-01-01

    Full Text Available Chlorpromazine is a well-known antipsychotic agent that binds with a variety of receptors in the central nervous system. To date, chlorpromazine has never been associated with onset of hearing disorders and tinnitus. We report on an unexpected suspect adverse reaction to chlorpromazine that occurred in a 12-year-old boy, affected by severe generalized anxiety disorder. After treatment with chlorpromazine, the patient experienced an enhanced sensitivity to sounds accompanied by perception of noises of the buzzing or ringing type. This clinical case is of great clinical interest as chlorpromazine is not currently included among potentially ototoxic drugs.

  20. Differential auditory-oculomotor interactions in patients with right versus left sided subjective tinnitus: A saccade study

    Directory of Open Access Journals (Sweden)

    Alexandre eLang

    2013-02-01

    Full Text Available Subjective tinnitus (ST is a frequent but poorly understood medical condition. Recent studies demonstrated abnormalities in several types of eye movements (smooth pursuit, optokinetic nystagmus, fixation and vergence in ST patients. The present study investigates horizontal and vertical saccades in patients with tinnitus lateralized predominantly to the left or to the right side. Compared to left sided ST, tinnitus perceived on the right side impaired almost all the parameters of saccades (latency, amplitude, velocity, etc. and noticeably the upward saccades. Relative to controls, saccades from both groups were more dysmetric and were characterized by increased saccade disconjugacy (i.e. poor binocular coordination. Although the precise mechanisms linking ST and saccadic control remain unexplained, these data suggest that ST can lead to detrimental auditory, visuomotor and perhaps vestibular interactions.

  1. Clinical feature analysis on 217 patients with subjective tinnitus%217例主观性耳鸣的临床特征分析

    Institute of Scientific and Technical Information of China (English)

    陈玲; 杨海弟; 区永康

    2011-01-01

    目的 研究分析耳鸣患者的临床特征及听力学特点,比较不同类型耳鸣的掩蔽试验效果,探索耳鸣的个性化治疗.方法 对我科门诊及住院的主观性耳鸣患者217例,常规病史调查,同时行纯音测听、耳声发射、耳鸣检测及掩蔽,分析耳鸣患者的临床特征,评估各类耳鸣掩蔽试验的情况.结果 耳鸣在人群高发年龄段为36~ 55岁,占24%.男女比例分别为48%及52%,耳鸣发生侧别以左侧最常见(42%),双侧耳鸣次之(30%),右侧耳鸣最少(28%).城市人口及脑力劳动者居多,分别占77%和68%.病程中以慢性耳鸣患者(病程>1年)最多(占46%).耳鸣高频及低频耳鸣患者掩蔽最为有效,有效率分别为71.6%及73.6%,而中频耳鸣掩蔽有效率仅有52.2%,夫特曼曲线类型与掩蔽试验阳性率明显相关,由Ⅰ型掩蔽阳性率为89%降至Ⅴ型掩蔽阳性率为11.7%.结论 耳鸣患者各项特征与掩蔽试验、耳鸣频率等有较大相关性,可作为耳鸣治疗效果的预测指标.Feldman曲线类型在耳鸣诊断和治疗方面有很大应用价值及指导意义,是预测耳鸣掩蔽是否有效的一个重要指标,也是选择耳鸣个体化治疗的一个重要参考依据.%Objective To analysis the clinical feature and audiology feature of patients with subjective tinnitus,compare masking,screening effectiveness of various kinds tinnitus,and search for the individual treatment ways for subjective tinnitus.Methods 217 patients in our hospistor were performed pure tone test,DPOAE,tinnitus determination,and tinnitus masking including pitch matching,intensity matching,Feldmann masking curve,and residual inhibition test with TinniTestTM.Results The prevalence rate is higher in female (52%).Tinnitts occur to the left side more common (42%),followed by bilateral ears (30%) and the right side (28%).The urban population ( 77% ) and mental worker ( 68% ) were primary in patients.The patients

  2. Treating tinnitus distress via the Internet: A mixed methods approach of what makes patients seek help and stay motivated during Internet-based cognitive behavior therapy

    Directory of Open Access Journals (Sweden)

    Sarah Heinrich

    2016-05-01

    Conclusion: There are several motivational factors that tinnitus patients consider relevant for beginning and continuing ICBT. Particularly, focusing on specific targets that do not involve the tinnitus itself, and encouraging participants to take an active role in treatment may increase treatment effectiveness. However, further hypothesis-guided research is necessary to confirm our explorative results.

  3. Imaging in pulsatile tinnitus

    Energy Technology Data Exchange (ETDEWEB)

    Madani, G. [Radiology Department, St Mary' s Hospital, London (United Kingdom)], E-mail: gittamadani@yahoo.com; Connor, S.E.J. [Neuroradiology Department, King' s College Hospital, London (United Kingdom)

    2009-03-15

    Tinnitus may be continuous or pulsatile. Vascular lesions are the most frequent radiologically demonstrable cause of pulsatile tinnitus. These include congenital vascular anomalies (which may be arterial or venous), vascular tumours, and a variety of acquired vasculopathies. The choice of imaging depends on the clinical findings. If a mass is present at otoscopy, thin-section computed tomography (CT) is indicated. In the otoscopically normal patient, there is a range of possible imaging approaches. However, combined CT angiography and venography is particularly useful.

  4. Transdermal electrical stimulation in sensorineural tinnitus

    OpenAIRE

    S Maini; Deoganonkar, S. C.

    1999-01-01

    In 73 patients, comprising of 84 ears, with persistent decompensated tinnitus and sensorineu-ral deafness, tinnitus suppression was attempted with low frequency, low ampere transdermal electrical stimula-tion (TDES). The causes of tinnitus were presbyacusis, unknown aetiology, noise exposure, otosclerosis, ototoxic drugs, endolymphatic hydrops, labyrinthitis and post head injury. Reduction of tinnitus was achieved in 38 of 84 ears. Results i.e. improvement were achieved in patients in the fol...

  5. Long-term reductions in tinnitus severity

    OpenAIRE

    Folmer Robert L

    2002-01-01

    Abstract Background This study was undertaken to assess long-term changes in tinnitus severity exhibited by patients who completed a comprehensive tinnitus management program; to identify factors that contributed to changes in tinnitus severity within this population; to contribute to the development and refinement of effective assessment and management procedures for tinnitus. Methods Detailed questionnaires were mailed to 300 consecutive patients prior to their initial appointment at the Or...

  6. Long-term reductions in tinnitus severity

    OpenAIRE

    Folmer, Robert L.

    2002-01-01

    Background This study was undertaken to assess long-term changes in tinnitus severity exhibited by patients who completed a comprehensive tinnitus management program; to identify factors that contributed to changes in tinnitus severity within this population; to contribute to the development and refinement of effective assessment and management procedures for tinnitus. Methods Detailed questionnaires were mailed to 300 consecutive patients prior to their initial appointment at the Oregon Heal...

  7. Tinnitus and arterial hypertension: a systematic review.

    Science.gov (United States)

    Figueiredo, Ricardo Rodrigues; de Azevedo, Andréia Aparecida; Penido, Norma de Oliveira

    2015-11-01

    Tinnitus is considered a multi-factorial symptom. Arterial hypertension has been cited as a tinnitus etiological factor. To assess the scientific evidence on the associations between arterial hypertension and tinnitus. A systematic review was performed using PubMed, ISI Web, Lilacs and SciELO scientific databases. This review included articles published in Portuguese, Spanish, French and English correlating tinnitus with hypertension. Letters to editors and case reports were excluded. A total of 424 articles were identified, of which only 20 met the inclusion criteria. Studies that analyzed the incidence of hypertension in tinnitus patients tended to show an association, while those that evaluated the incidence of tinnitus in hypertensive patients did not. There is evidence of an association between tinnitus and hypertension, although a cause and effect relationship is uncertain. Changes in the cochlear microcirculation, resulting in hearing loss, may be an adjuvant factor in tinnitus pathophysiology.

  8. Studying the Difference in the Effect of Noise and Pure Tone on the Residual Inhibition in Patients Suffering Tinnitus

    OpenAIRE

    Majid Norouzi; Abdollah Mousavi; Masoumeh Rouzbehani

    1998-01-01

    Objectives: we were aimed at studying the difference in the effect of noise and pure tone on the residual inhibition in patients suffering tinnitus. "nMethod: patients were selected among whom referred to audiology clinic in Ran faculty of rehabilitation sciences and aged between 20-70 years old. Our method in studying patients was experimental- masking with pure tone was performed in patients who had experienced partial residual inhibition with noise. Results; the differences between the mas...

  9. Autonomic Conditions in Tinnitus and Implications for Korean Medicine

    OpenAIRE

    Eun Ji Choi; Younghee Yun; Seungyeon Yoo; Kyu Seok Kim; Jeong-Su Park; Inhwa Choi

    2013-01-01

    Tinnitus patients suffer from not only auditory sensations but also physical, mental, and social difficulties. Even though tinnitus is believed to be associated with the autonomic nervous system, changes in autonomic conditions in tinnitus patients are not receiving much research attention. The aims of this study were to investigate the autonomic condition of tinnitus patients and to consider Korean medicine in the treatment of tinnitus with an evidence-based approach. We performed a retrospe...

  10. Does a single session of theta-burst transcranial magnetic stimulation of inferior temporal cortex affect tinnitus perception?

    Directory of Open Access Journals (Sweden)

    Moser Tobias

    2009-05-01

    Full Text Available Abstract Background Cortical excitability changes as well as imbalances in excitatory and inhibitory circuits play a distinct pathophysiological role in chronic tinnitus. Repetitive transcranial magnetic stimulation (rTMS over the temporoparietal cortex was recently introduced to modulate tinnitus perception. In the current study, the effect of theta-burst stimulation (TBS, a novel rTMS paradigm was investigated in chronic tinnitus. Twenty patients with chronic tinnitus completed the study. Tinnitus severity and loudness were monitored using a tinnitus questionnaire (TQ and a visual analogue scale (VAS before each session. Patients received 600 pulses of continuous TBS (cTBS, intermittent TBS (iTBS and intermediate TBS (imTBS over left inferior temporal cortex with an intensity of 80% of the individual active or resting motor threshold. Changes in subjective tinnitus perception were measured with a numerical rating scale (NRS. Results TBS applied to inferior temporal cortex appeared to be safe. Although half of the patients reported a slight attenuation of tinnitus perception, group analysis resulted in no significant difference when comparing the three specific types of TBS. Converting the NRS into the VAS allowed us to compare the time-course of aftereffects. Only cTBS resulted in a significant short-lasting improvement of the symptoms. In addition there was no significant difference when comparing the responder and non-responder groups regarding their anamnestic and audiological data. The TQ score correlated significantly with the VAS, lower loudness indicating less tinnitus distress. Conclusion TBS does not offer a promising outcome for patients with tinnitus in the presented study.

  11. Temporomandibular joint disorder complaints in tinnitus: further hints for a putative tinnitus subtype.

    Directory of Open Access Journals (Sweden)

    Veronika Vielsmeier

    Full Text Available OBJECTIVE: Tinnitus is considered to be highly heterogeneous with respect to its etiology, its comorbidities and the response to specific interventions. Subtyping is recommended, but it remains to be determined which criteria are useful, since it has not yet been clearly demonstrated whether and to which extent etiologic factors, comorbid states and interventional response are related to each other and are thus applicable for subtyping tinnitus. Analyzing the Tinnitus Research Initiative Database we differentiated patients according to presence or absence of comorbid temporomandibular joint (TMJ disorder complaints and compared the two groups with respect to etiologic factors. METHODS: 1204 Tinnitus patients from the Tinnitus Research Initiative (TRI Database with and without subjective TMJ complaints were compared with respect to demographic, tinnitus and audiological characteristics, questionnaires, and numeric ratings. Data were analysed according to a predefined statistical analysis plan. RESULTS: Tinnitus patients with TMJ complaints (22% of the whole group were significantly younger, had a lower age at tinnitus onset, and were more frequently female. They could modulate or mask their tinnitus more frequently by somatic maneuvers and by music or sound stimulation. Groups did not significantly differ for tinnitus duration, type of onset (gradual/abrupt, onset related events (whiplash etc., character (pulsatile or not, hyperacusis, hearing impairment, tinnitus distress, depression, quality of life and subjective ratings (loudness etc.. CONCLUSION: Replicating previous work in tinnitus patients with TMJ complaints, classical risk factors for tinnitus like older age and male gender are less relevant in tinnitus patients with TMJ complaints. By demonstrating group differences for modulation of tinnitus by movements and sounds our data further support the notion that tinnitus with TMJ complaints represents a subgroup of tinnitus with clinical

  12. Analysis of the Clinical Features of Senile Tinnitus Patients%老年耳鸣患者的临床特征分析

    Institute of Scientific and Technical Information of China (English)

    王栋武

    2015-01-01

    ObjectiveTo analyze the clinical features in elderly patients with tinnitus. Methods The patients with tinnitus questionnaire and symptom self-assessment scale (SCL-90), the characteristics of patients with tinnitus and psychology health statistics and analysis.Results The patients with sudden onset and slow onset in patients with different grade of tinnitus loudness differences and somatization, depression, anxiety and so on seven factor score with the domestic norm differences were statistically significant, (P<0.05).Conclusion Patients with sudden onset of tinnitus loudness is given priority to with 2~4, more patients with slow onset of tinnitus degree, Tinnitus is less than tinnitus prone to depression, anxiety, hostility, terror, paranoia and other psychological problems.%目的:探析老年耳鸣患者的临床特征。方法向患者发放耳鸣调查表和症状自评量表(SCL-90),对患者耳鸣特征和心理学健康状况进行统计、分析。结果患者突然发病和缓慢发病在不同耳鸣响度分级的差异以及患者躯体化、抑郁、焦虑等七个因子的评分与国内常模的差异均具有统计学意义,P<0.05。结论突然发病患者耳鸣响度多以2~4级为主,耳鸣程度较缓慢发病患者重;耳鸣者较非耳鸣者易发抑郁、焦虑、敌对、恐怖、偏执等心理问题。

  13. Análise da correlação entre a escala visual-análoga e o Tinnitus Handicap Inventory na avaliação de pacientes com zumbido Correlation analysis of the visual-analogue scale and the Tinnitus Handicap Inventory in tinnitus patients

    Directory of Open Access Journals (Sweden)

    Ricardo Rodrigues Figueiredo

    2009-02-01

    Full Text Available Um dos tópicos mais questionado nos estudos clínicos sobre zumbido é o método de mensuração do mesmo. As Escalas Visual-Análogas (EVAs e o Tinnitus Handicap Inventory (THI são freqüentemente utilizados para este fim. OBJETIVO: Verificar a correlação entre os escores da EVA e do THI em pacientes com zumbido neurossensorial através de um estudo prospectivo. MATERIAL E MÉTODO: 43 pacientes com zumbido neurossensorial quantificaram o zumbido pelos dois métodos, sendo os escores comparados através do Coeficiente de Relação de Spearman. RESULTADOS: Foi observada correlação entre os escores da EVA e do THI. CONCLUSÃO: Em pacientes com zumbido neurossensorial existe correlação entre os escores da EVA e do THI.One of the most challenging topics in tinnitus clinical studies is the measuring method used. Visual Analogue Scales (VAS and Tinnitus Handicap Inventory (THI are frequently used in tinnitus. AIM: To verify the relationship between VAS and THI scores in tinnitus patients in a prospective study. MATERIALS AND METHODS: 43 patients classified their tinnitus according to VAS and THI, and both scores were compared through the Spearman's correlation coefficient test. RESULTS: There was a correlation between the VAS and THI scores. CONCLUSION: There is correlation between VAS and THI scores in patients with sensorineural tinnitus.

  14. 梅尼埃病患者耳鸣疗效分析%The Treatment Outcome of Tinnitus in Patients with Ménière's Disease

    Institute of Scientific and Technical Information of China (English)

    陈晓鸿; 吴子明; 张素珍; 刘兴健; 隆琰; 林春招; 黄秋平

    2012-01-01

    目的 分析梅尼埃病患者药物治疗前后耳鸣疗效与梅尼埃病分期、耳鸣病程分期、眩晕疗效及听力疗效等的相关性.方法 24例(29耳)梅尼埃病患者给予药物治疗膜迷路积水,并进行为期6个月的随访.29耳均行纯音测听,了解患者治疗前后6个月最差听力损失情况,以分析梅尼埃病临床分期、耳鸣病程分期、眩晕疗效、听力疗效与耳鸣疗效的关系.结果 入选的24例(共29耳)患者中,梅尼埃病早期10耳,中期19耳,晚期0耳.耳鸣分期:急性7耳,亚急性3耳,慢性19耳.耳鸣疗效:痊愈9耳,显效7耳,有效6耳,无效7耳.眩晕疗效:完全控制9耳,基本控制14耳,部分控制3耳,未控制0耳,加重3耳.听力疗效:显效3耳,有效4耳,无效14耳,恶化8耳.结论 通过药物可控制梅尼埃病眩晕发作,但该药物治疗耳鸣的疗效与梅尼埃病分期、耳鸣病程分期、眩晕疗效及听力疗效之间无相关性.%Objective To analyze the effects of medication on the tinnitus of patients with Ménière's disease and the correlation between treatment outcome and the stage of Ménière's disease, the duration of tinnitus and the treatment outcome of vertigo and hearing loss. Methods The medical treatment was performed in 24 patients (29 ears) with Ménière's disease and the follow-up duration was 6 months. The pure-tone audiometry was carried out in all patients to evaluate the worst level of hearing loss before the treatment and during the follow-up period respectively. Results Of the 29 ears with Ménière's disease, there were 10 ears at the early stage, 19 ears at the mid-stage and no ear at the late stage. There were 7 ears with acute tinnitus, 3 ears with subacute tinnitus and 19 ears with chronic tinnitus. As for the tinnitus treatment outcome, 9 ears were cured, 7 ears markedly effective, 6 ears effective and 7 ears ineffective. As for the treatment outcome of vertigo, 9 ears were completely controlled, 14 ears generally

  15. Cognitive Behavioral Therapy for Tinnitus: Evidence and Efficacy

    OpenAIRE

    Jun, Hyung Jin; Park, Moo Kyun

    2013-01-01

    Tinnitus is defined as auditory perception without external sound. There is currently no cure for tinnitus. Cognitive behavioral therapy (CBT) is a tinnitus treatment that addresses the affected individual's reaction to tinnitus. It aims not to eliminate auditory perception as sound but to reduce or correct one's negative response to tinnitus. CBT identifies negative automatic thought and then evaluates its validity with the patient. It also aims to change negative automatic thought to more p...

  16. Titus's tinnitus.

    OpenAIRE

    Dan, Bernard

    2005-01-01

    Historical approaches to tinnitus have depended highly on cultural factors. While ancient Oriental mysticism regarded it as sensitivity to the divine, Roman medicine associated it with depressive and seizure disorders on the basis of presumed common pathophysiology shared by the three conditions. In the Babylonian Talmud, tinnitus appears as Titus's curse: a gnat buzzing in the brain, responding to sound therapy, and then habituating. Various sources show varied emphases with common attention...

  17. Prevalence and characteristics of tinnitus after leisure noise exposure in young adults

    OpenAIRE

    Sofie Degeest; Paul Corthals; Bart Vinck; Hannah Keppler

    2014-01-01

    The main goal of this study was to assess the prevalence and characteristics of tinnitus among students after exposure to leisure noise. In addition, the effects of tinnitus on otoacoustic emissions (OAEs) in participants suffering from chronic tinnitus were evaluated. The study consisted of two parts. First, a questionnaire regarding leisure noise exposure and tinnitus was completed. Second, the hearing status of the subjects suffering from chronic tinnitus was evaluated and compared with a ...

  18. 耳鸣掩蔽对耳鸣患者脑干听觉诱发电位波幅的影响%Effect of tinnitus masking on auditory brainstem response wave amplitude in patients with tinnitus

    Institute of Scientific and Technical Information of China (English)

    刘淑芳; 祝威; 闻雨婷

    2006-01-01

    背景:研究发现耳鸣患者常伴有脑干听觉诱发电位波幅大Ⅲ小Ⅴ波的变化,耳鸣掩蔽是耳鸣治疗中的一种方法,在耳鸣掩蔽的治疗过程中耳鸣患者脑干听觉诱发电位将会如何变化?目的:观察耳鸣患者的脑干听觉诱发电位变化特点,以及耳鸣掩蔽后脑干听觉诱发电位变化规律.设计:病例-对照及自身前后对照.单位:吉林大学第一医院耳鼻咽喉-头颈外科.对象:持续性耳鸣组:63例(68耳),为1999-03/2001-10吉林大学第一医院门诊收治;对照组:听力正常的青年人(20~23岁)10例(20耳).所有受试者自愿接受检测及治疗.方法:耳鸣患者首先进行脑干听觉诱发电位检查(采用额部乳突部引导方法记录),然后进行耳鸣检查及耳鸣掩蔽试验(掩蔽5 min),随后立刻做脑干听觉诱发电位检查,并与对照组进行对比观察.主要观察指标:①耳鸣患者脑干听觉诱发电位的特点.②耳鸣掩蔽后对脑干听觉诱发电位波幅的影响,分为后效抑制试验阳性和阴性2组进行分析.结果:83例全部进入结果分析.①听力正常青年人的脑干听觉诱发电位波幅为小Ⅲ波大Ⅴ波,而63例(68耳)中有22耳(312%)脑干听觉诱发电位为大Ⅲ波小Ⅴ波,其中17耳后效抑制试验阳性,5耳阴性.②后效抑制试验阳性17耳经耳鸣掩蔽治疗后10耳由大Ⅲ波小Ⅴ波转为小Ⅲ波大Ⅴ波,3耳Ⅲ波幅度减小;阴性5耳经耳鸣掩蔽治疗后有2耳转为小Ⅲ波大Ⅴ波,其余3耳无改变.结论:耳鸣掩蔽能使耳鸣患者异常的脑干听觉诱发电位波幅恢复至正常,此结果有望作为后效抑制阳性判定的客观指标.%BACKGROUND: Research shows that the auditory brainstem response (ABR) wave amplitude of tinnitus patients often act as big Ⅲ small Ⅴ.Tinnitus masking is a therapy of tinnitus, then how dose the ABR change in the process of tinnitus masking?OBJECTIVE: To observe the changing characteristics of ABR in patients

  19. Can Magnetic Coil Ease Tinnitus?

    Science.gov (United States)

    ... often recommend are cognitive behavior therapy, mindfulness, self-hypnosis, and relaxation therapy. These approaches can help patients ... a certain percentage do experience discomfort or even pain. See, for example, this 2009 review study . Tinnitus ...

  20. Transient reduction of tinnitus intensity is marked by concomitant reductions of delta band power

    Directory of Open Access Journals (Sweden)

    Weisz Nathan

    2008-01-01

    Full Text Available Abstract Background Tinnitus is an auditory phantom phenomenon characterized by the sensation of sounds without objectively identifiable sound sources. To date, its causes are not well understood. Previous research found altered patterns of spontaneous brain activity in chronic tinnitus sufferers compared to healthy controls, yet it is unknown whether these abnormal oscillatory patterns are causally related to the tinnitus sensation. Partial support for this notion comes from a neurofeedback approach developed by our group, in which significant reductions in tinnitus loudness could be achieved in patients who successfully normalized their patterns of spontaneous brain activity. The current work attempts to complement these studies by scrutinizing how modulations of tinnitus intensity alter ongoing oscillatory activity. Results In the present study the relation between tinnitus sensation and spontaneous brain activity was investigated using residual inhibition (RI to reduce tinnitus intensity and source-space projected magnetencephalographic (MEG data to index brain activity. RI is the sustained reduction (criteria: 50% for at least 30 s in tinnitus loudness after cessation of a tonal tinnitus masker. A pilot study (n = 38 identified 10 patients who showed RI. A significant reduction of power in the delta (1.3–4.0 Hz frequency band was observed in temporal regions during RI (p ≤ 0.001. Conclusion The current results suggest that changes of tinnitus intensity induced by RI are mediated by alterations in the pathological patterns of spontaneous brain activity, specifically a reduction of delta activity. Delta activity is a characteristic oscillatory activity generated by deafferented/deprived neuronal networks. This implies that RI effects might reflect the transient reestablishment of balance between excitatory and inhibitory neuronal assemblies, via reafferentation, that have been perturbed (in most tinnitus individuals by hearing damage. As

  1. Efeito da timpanoplastia no zumbido de pacientes com hipoacusia condutiva: seguimento de seis meses The effect of timpanoplasty on tinnitus in patients with conductive hearing loss: a six month follow-up

    Directory of Open Access Journals (Sweden)

    Adriana da Silva Lima

    2007-06-01

    Full Text Available O timpanoplastia tem como objetivos erradicar a doença da orelha média e restaurar os mecanismos de condução sonora. Contudo, alguns pacientes apresentam incômodo com o zumbido e muitas vezes questionam o médico sobre os resultados da cirurgia em relação ao zumbido. OBJETIVO: Avaliar a evolução do zumbido em pacientes com hipoacusia condutiva após timpanoplastia. Forma de Estudo: Coorte prospectiva. CASUÍSTICA E MÉTODO: Foram avaliados 23 pacientes com queixa de zumbido e diagnóstico de otite média crônica simples com indicação cirúrgica. Os pacientes foram submetidos a um protocolo de investigação médica e audiológica do zumbido antes, 30 e 180 dias após a timpanoplastia. RESULTADOS: 82,6% dos pacientes apresentaram melhora ou abolição do zumbido. Melhora significante do incômodo do zumbido no pré-operatório (5,26 em relação ao pós-operatório (1,91 com 30 e 180 dias, assim como entre o incômodo da perda auditiva pré-operatória (6,56 e pós-operatória (3,65 e 2,91. A audiometria revelou melhora do limiar tonal em todas as freqüências, com exceção de 8KHz, havendo fechamento ou gap máximo de 10dB NA em 61% dos casos. Pega total do enxerto em 78% dos casos. CONCLUSÃO: Além da melhora da perda auditiva, a timpanoplastia também proporciona bons resultados sobre o controle do zumbido.Tympanoplasty is done to eradicate ear pathology and to restore the conductive hearing mechanism (eardrum and ossicles. Some patients, however, do not tolerate tinnitus and question physicians about the results of surgery when tinnitus persists. AIM: to evaluate the progression of tinnitus in patients with conductive hearing loss after tympanoplasty. STUDY DESIGN: a prospective cohort study. Material and Methods: 23 consecutive patients with tinnitus due to chronic otitis media underwent tympanoplasty. The patients underwent a medical and audiological protocol for tinnitus before and after tympanoplasty. RESULTS: 82.6% of

  2. 重复经颅磁刺激(rTMS)治疗慢性主观性耳鸣的短期疗效分析%The Short-term Effect Analysis of Repetitive Transcranial Magnetic Stimulation (rTMS) in Chronic Tinnitus

    Institute of Scientific and Technical Information of China (English)

    杨海弟; 郑亿庆; 区永康; 黄夏茵

    2015-01-01

    Objective Evaluate the therapeutic effect of 1-Hz repetitive transcranial magnetic stimulation (rTMS) on tinnitus. Methods 46 chronic tinnitus patients were treated with repetitive transcranial magnetic stimulation for two weeks and the therapeutic effects were assessed afterward. Results rTMS treatment could improve tinnitus obviously. The overall effec⁃tive rate is 63.1%in subjective tinnitus, The effective rate is higher in decompensated tinnitus(THI≥40) than compensatory tinnitus (THI<40) (77%vs 45%;P<0.001), The THI score of tinnitus patients before and after treatment were r 51.8 ± 23.5 and 37 ± 18.8;espectively (t=5.94, p<0.001), VAS were 6.3 ± 2.4 and 4.9 ± 1.8;(t=5.27, p<0.01.) The difference of the changes of THI between decompensated tinnitus and compensated tinnitus group after rTMS treatment was 19.4 ± 8.5 (df=42, T=4.95, P<0.001). Conclusions rTMS could improve tinnitus, especially for decompensated tinnitus patients.%目的:采取1Hz低频重复经颅磁刺激(rTMS)治疗慢性主观性耳鸣并评价其治疗效果。方法对慢性主观性耳鸣患者46例行1Hz低频rTMS连续治疗2周,治疗前后分别行耳鸣残疾量表评分(THI)评分及主观疗效评估。结果 rTMS对耳鸣治疗有明显效果,对主观耳鸣症状总体有效率为63.1%,其中失代偿性耳鸣(THI≥40)的有效率明显高于代偿性耳鸣(THI<40)(77%vs 45%;P<0.001),耳鸣患者治疗前后THI为(51.8±23.5 vs 37.0±18.8;t=5.94,p<0.001), VAS为(6.3±2.4 vs 4.9±1.8;t=5.27,p<0.01),治疗前后有统计学差异。失代偿组与代偿组耳鸣rTMS治疗后THI变化存在显著差异,两组差值为19.4±8.5(df=42,T=4.95,P<0.001)。结论 rTMS治疗耳鸣有效,可明显降低THI得分,改善耳鸣症状,特别在失代偿性耳鸣效果更明显。

  3. Sensorineural Tinnitus: Its Pathology and Probable Therapies

    Directory of Open Access Journals (Sweden)

    Aage R. Møller

    2016-01-01

    Full Text Available Tinnitus is not a single disease but a group of different diseases with different pathologies and therefore different treatments. Regarding tinnitus as a single disease is hampering progress in understanding of the pathophysiology of tinnitus and perhaps, more importantly, it is a serious obstacle in development of effective treatments for tinnitus. Subjective tinnitus is a phantom sound that takes many different forms and has similarities with chronic neuropathic pain. The pathology may be in the cochlea, in the auditory nerve, or, most commonly, in the brain. Like chronic neuropathic pain tinnitus is not life threatening but influences many normal functions such as sleep and the ability to concentrate on work. Some forms of chronic tinnitus have two components, a (phantom sound and a component that may best be described as suffering or distress. The pathology of these two components may be different and the treatment that is most effective may be different for these two components. The most common form of treatment of tinnitus is pharmacological agents and behavioral treatment combined with sound therapy. Less common treatments are hypnosis and acupuncture. Various forms of neuromodulation are becoming in use in an attempt to reverse maladaptive plastic changes in the brain.

  4. Sensorineural Tinnitus: Its Pathology and Probable Therapies.

    Science.gov (United States)

    Møller, Aage R

    2016-01-01

    Tinnitus is not a single disease but a group of different diseases with different pathologies and therefore different treatments. Regarding tinnitus as a single disease is hampering progress in understanding of the pathophysiology of tinnitus and perhaps, more importantly, it is a serious obstacle in development of effective treatments for tinnitus. Subjective tinnitus is a phantom sound that takes many different forms and has similarities with chronic neuropathic pain. The pathology may be in the cochlea, in the auditory nerve, or, most commonly, in the brain. Like chronic neuropathic pain tinnitus is not life threatening but influences many normal functions such as sleep and the ability to concentrate on work. Some forms of chronic tinnitus have two components, a (phantom) sound and a component that may best be described as suffering or distress. The pathology of these two components may be different and the treatment that is most effective may be different for these two components. The most common form of treatment of tinnitus is pharmacological agents and behavioral treatment combined with sound therapy. Less common treatments are hypnosis and acupuncture. Various forms of neuromodulation are becoming in use in an attempt to reverse maladaptive plastic changes in the brain. PMID:26977153

  5. Physical therapy treatment in patients suffering from cervicogenic somatic tinnitus: study protocol for a randomized controlled trial

    OpenAIRE

    Michiels, Sarah; De Hertogh, Willem; Truijen, Steven; van de Heyning, Paul

    2014-01-01

    Background Tinnitus occurs in a large part of the general population with prevalences ranging from 10% to 15% in an adult population. One subtype is cervicogenic somatic tinnitus, arising from cervical spine dysfunctions, justifying cervical spine assessment and treatment. This study aims to investigate the effect of a standardized physical therapy treatment, directed to the cervical spine, on tinnitus. Additionally, a second aim is to identify a subgroup within the tinnitus population that b...

  6. Assessment of distress associated with tinnitus.

    OpenAIRE

    Veen, E.D. van; Jacobs, J. B.; Bensing, J M

    1998-01-01

    This paper focuses upon the quality of the Dutch translation of the STSS (Subjective Tinnitus Severity Scale), a scale which assesses the severity of tinnitus and the related distress. Research has been done on the psychometric qualities of this scale, its relationship with loudness-matching procedures and several psychological variables. Data presented on 104 tinnitus patients demonstrated the reliability of the STSS with a coefficient alpha of 0.71. Factor analysis revealed four factors: em...

  7. Intrinsic network activity in tinnitus investigated using functional MRI.

    Science.gov (United States)

    Leaver, Amber M; Turesky, Ted K; Seydell-Greenwald, Anna; Morgan, Susan; Kim, Hung J; Rauschecker, Josef P

    2016-08-01

    Tinnitus is an increasingly common disorder in which patients experience phantom auditory sensations, usually ringing or buzzing in the ear. Tinnitus pathophysiology has been repeatedly shown to involve both auditory and non-auditory brain structures, making network-level studies of tinnitus critical. In this magnetic resonance imaging (MRI) study, two resting-state functional connectivity (RSFC) approaches were used to better understand functional network disturbances in tinnitus. First, we demonstrated tinnitus-related reductions in RSFC between specific brain regions and resting-state networks (RSNs), defined by independent components analysis (ICA) and chosen for their overlap with structures known to be affected in tinnitus. Then, we restricted ICA to data from tinnitus patients, and identified one RSN not apparent in control data. This tinnitus RSN included auditory-sensory regions like inferior colliculus and medial Heschl's gyrus, as well as classically non-auditory regions like the mediodorsal nucleus of the thalamus, striatum, lateral prefrontal, and orbitofrontal cortex. Notably, patients' reported tinnitus loudness was positively correlated with RSFC between the mediodorsal nucleus and the tinnitus RSN, indicating that this network may underlie the auditory-sensory experience of tinnitus. These data support the idea that tinnitus involves network dysfunction, and further stress the importance of communication between auditory-sensory and fronto-striatal circuits in tinnitus pathophysiology. Hum Brain Mapp 37:2717-2735, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. PMID:27091485

  8. Investigation of Electrophysiological Patterns and Multiple Treatments in Tinnitus

    OpenAIRE

    Cartocci, Giulia

    2014-01-01

    Tinnitus is the most common auditory desorder, it is defined as a sound sensation in the absence of any external sound source. Sleep disturbances and depression are symptoms very often present in tinnitus patients. Starting from this observation, in the present thesis two electrophysiological approaches to tinnitus study are described: the former concerns sleep architecture pattern investigation in tinnitus patients, and the second concerns an index of serotonin activity in the auditory corte...

  9. The effect of cochlear implantation on tinnitus in patients with bilateral hearing loss : A systematic review

    NARCIS (Netherlands)

    Ramakers, Geerte G J; van Zon, Alice; Stegeman, Inge; Grolman, Wilko

    2015-01-01

    OBJECTIVES: To present an overview of the effect of cochlear implantation on tinnitus in adults with bilateral sensorineural hearing loss. DATA SOURCES: PubMed, Cochrane Library, CINAHL, and Embase databases were searched for articles from database inception up to January 13, 2015. METHODS: A system

  10. Wavelet analysis demonstrates no abnormality in contralateral suppression of otoacoustic emissions in tinnitus patients

    NARCIS (Netherlands)

    Geven, Leontien I.; Wit, Hero P.; de Kleine, Emile; van Dijk, Pim

    2012-01-01

    The efferent auditory system is thought to play a role in the origin of tinnitus. Part of this system can be tested in humans with contralateral suppression of otoacoustic emissions. Stimulation of the medial olivocochlear efferent system is responsible for this reduction of otoacoustic emissions af

  11. EEG driven tDCS versus bifrontal tDCS for tinnitus

    Directory of Open Access Journals (Sweden)

    Dirk eDe Ridder

    2012-09-01

    Full Text Available Tinnitus is the perception of a sound in the absence of any objective physical sound source. Transcranial Direct Current Stimulation (tDCS induces shifts in membrane resting potentials depending on the polarity of the stimulation: under the anode gamma band activity increases, whereas under the cathode the opposite occurs. Both single and multiple sessions of tDCS over the DLPFC (anode over right DLPFC yield a transient improvement in tinnitus intensity and tinnitus distress. The question arises whether optimalization of the tDCS protocol can be obtained by using EEG driven decisions on where to place anode and cathode. Using gamma band functional connectivity could be superior to gamma band activity as functional connectivity determines the tinnitus network in many aspects of chronic tinnitus. 675 patients were included in the study: 265 patients received tDCS with cathodal electrode placed over the left DLPFC and the anode placed overlying the right DLPFC, 380 patients received tDCS based on EEG connectivity, and 65 perceived no tDCS (i.e. waiting list control group. Repeated measures ANOVA revealed a significant main effect for pre versus post measurement. Bifrontal tDCS in comparison to EEG driven tDCS had a larger reduction for both tinnitus distress and tinnitus intensity. Whereas the results of the bifrontal tDCS seem to confirm previous studies, the use of gamma band functional connectivity seems not bring any advantage to tDCS for tinnitus suppression. Using other potential biomarkers, such as gamma band activity, or theta functional connectivity could theoretically be of use. Further studies will have to elucidate whether brain state based tDCS has any advantages over ‘blind’ stimulation.

  12. Comparison of the Clinical Characteristics of Tinnitus in Patients with Different Frequency%不同耳鸣频率患者的临床特征比较

    Institute of Scientific and Technical Information of China (English)

    王涂路; 李颖雯; 李松键

    2011-01-01

    Objective:To observe the clinical characteristics of patients with tinnitus in different frequency. Methods: A total of 70 patients with tinnitus were enrolled in this study. All the patients were received matching test. Tinnitus handicap inventory (THI) and visual-analogue scale (VAS) questionnaires were investigated. Results: There was no significant correlation between the side, pitch, tinnitus loudness and the hearing in tinnitus patients with different frequency;However, there was correlation between THI and VAS scores. Conclusions: Combined with the tinnitus matching test, it can be used in clinical evaluating of the tinnitus patients.%目的:探讨不同耳鸣频率患者的临床特征及其严重程度.方法:70例以主观性耳鸣为主诉的耳鸣患者,按其耳鸣频率的高低分为3组:高音调(4 000~8 000 Hz)组42例,中音调(1 000~3 000 Hz)组16例,低音调(125~750 Hz)组12例.所有入选患者均行纯音听阈测定、耳鸣匹配检查,同时由患者填写耳鸣残疾评估量表(tinnitus handicap inventory,THI)及视觉模拟量表(visual-analogue scale,VAS).结果:不同耳鸣频率患者的耳鸣部位、耳鸣音调、响度及听力状况构成比较无显著差异;不同耳鸣频率患者其THI评分及VAS评分关系密切.结论:不同耳鸣频率患者耳鸣匹配结果及其自我评分关系密切,临床上可以相互结合运用于临床耳鸣严重程度的评价.

  13. Arteriovenøs fistel med objektiv tinnitus efter fødsel

    DEFF Research Database (Denmark)

    Fisker, Jacob; Katholm, Morten; Cortsen, Marie;

    2011-01-01

    This case-report describes an otherwise healthy younger woman with post partum onset of objective pulsatile tinnitus. Neuroradiological examination revealed a dural fistula that was later closed using endovascular coiling technique, after which the patient's tinnitus disappeared. At 6-month follow......-up the patient was symptom-free. This case report emphasises the importance of examining for objective tinnitus in patients complaining of tinnitus, as the causes of objective pulsatile tinnitus can frequently be treated successfully....

  14. Anxiety and Depression in Tinnitus Patients: 5-Year Follow-Up Assessment after Completion of Habituation Therapy

    Directory of Open Access Journals (Sweden)

    Eva-Signe Falkenberg

    2012-01-01

    Full Text Available Treatment programs based on a neurophysiological model have shown a positive effect on anxiety and depression in tinnitus patients. The aim of this paper was to assess the long-term effect of tinnitus habituation therapy. Sixty-eight individuals were treated with a comprehensive therapy program. The degree of anxiety and depression was assessed before, after, and five years after intervention using the Hospital Anxiety and Depression Scale. The positive and significant changes achieved after habituation therapy (pre = 1.10, post = 0.92 for anxiety and pre = 0.77, post = 0.62 for depression were maintained five years after treatment ended (0.87 for anxiety and 0.52 for depression. A regression analysis revealed that individual evaluation of the treatment lectures, self-reported health condition, individual experiences of hyperacusis, and hearing loss could explain 44.3% of the variation in anxiety and 30.5% of the variation in depression posttreatment. Five years after, individual evaluation of the treatment lectures and self-reported health condition explained 22.2% of the variation in anxiety. These factors and individual experiences of hyperacusis could further explain 34.9% of the variation in depression. The effect of a neurophysiologic-based management treatment was maintained five years after treatment ended, indicating that the patients continued the improvement process without becoming dependent on professionals.

  15. Sucesso no tratamento do zumbido com terapia em grupo Group therapy for patients with tinnitus at the University of Brasilia Medical School

    Directory of Open Access Journals (Sweden)

    Lisiane Holdefer

    2010-02-01

    Full Text Available Embora os tratamentos em grupos para o zumbido sejam uma área bem documentada na literatura internacional, até onde sabemos nunca foram realizados no Brasil. Este estudo apresenta uma experiência bem-sucedida de um tratamento em grupo para zumbido baseado na terapia de retreinamento do zumbido aliada com as técnicas cognitivo-comportamentais. O objetivo deste estudo é avaliar pacientes com zumbido antes e depois do tratamento em grupo estruturado baseado da terapia de retreinamento do zumbido e na terapia cognitivo comportamental. MATERIAL E MÉTODO: Estudo coorte prospectivo: 27 sujeitos aplicaram-se para a pesquisa. Responderam ao inventário do Handicap do Zumbido (THI e à escala da Ansiedade e Depressão Hospitalar (HAD,antes e depois do tratamento. Foram realizadas 6 sessões estruturadas segundo os princípios da terapia de retreinamento do zumbido associada com técnicas cognitivo-comportamentais. RESULTADOS: 27 pacientes iniciaram e 19 terminaram o tratamento (8 excluídos. 47,4% homens, média das idades 47.6. O resultado do THI antes e depois do tratamento foi respectivamente: funcionais, 29 e 14; emocional, 24 e 10; e catastrófico, 12 e 5; a escala HAD: ansiedade, 12 e 9 e depressão, 10 e 6. CONCLUSÃO: O tratamento descrito é efetivo na melhora do zumbido.Although group therapy for tinnitus is a well documented field in the international literature, as far as we know it has never been held in Brazil. This study represents a successful experience of a group therapy for tinnitus based on the tinnitus retraining therapy associated with behavioral cognitive techniques. The goal of the present study is to assess patients with tinnitus before and after the group therapy based on the tinnitus retraining therapy and the behavioral cognitive therapy. MATERIALS AND METHODS: Prospective cohort study: 27 subjects signed in for the study, and answered the Tinnitus Handicap Inventory (THI and the Hospital Depression and Anxiety Scale (HAD

  16. A Survey of the Elderly and Young Elderly Tinnitus Patients with Tinnitus Handicap Inventory%老年及老年前期耳鸣患者耳鸣残疾度量化表问卷评估

    Institute of Scientific and Technical Information of China (English)

    赵素萍; 刘新颖; 赵阳; 冀飞; 周其友

    2011-01-01

    目的 研究老年前期及老年期患者的耳鸣对其情绪的影响,评估耳鸣残疾度,试图发现老年患者群中耳鸣的临床特征.方法 主诉耳鸣患者60例,其中男性37例,女性23例,平均年龄65.1±11.3岁.根据年龄将患者分为两组:老年组(60岁以上组)35例,男22例,女13例;老年前期组(49~59岁组)25例,男14例,女11例.使用问卷对患者进行病史调查和耳鸣残疾度量化评估.结果 在受调查患者中,78.3%(47/60)自觉有听力损失,2例使用助听器,8.3%(5/60)自诉有耳病史,38.3%(23/60)有噪声接触史,63.3%(38/60)伴发其他疾病,老年组伴发其他疾病的比例较高.60例患者中.耳鸣残疾1级38例,占63.3%,2级12例,占20%,3级5例,占8.3%,4级2例,占3.3%,5级3例,占5%.两组患者各自的分级构成无统计学差异(P=0.604).两组之间3类问题功能性(P=0.164)、情绪性(P=0.21 3)、灾难性(P=0.111)无统计学差异.结论 耳鸣所造成的主观影响在老年人群中很明显.对于老年及老年前期患者,加强针对耳鸣的心理和情绪性调节非常重要.%objective To study the influence of tinnitus on the emotions of the elderly and young elderly patients and to find out the clinical characteristics of tinnitus in elderly patients.Methods 60 patients with tinnitus were involved in the survey (37 males and 23 females). The mean age was 65.1 ± 11.3 years old. The patients were divided into two groups: the elderly group (older than 60 years old) including 35 patients (22 males and 13 females) and the young elderly group (49 to 59 years old) including 25 patients (14 males and 11 females). The medical histories of the patients were surveyed and the Tinnitus Handicap Inventory was used to measure the degree of tinnitus. Results Among the patients investigated, 78.3% of cases (47/60) complained of hearing loss and 2 cases worn hearing aids, 8.3%(5/60)reported ear disease history, 38.3% (23/60) reported a history of exposure to noise, and 63.3

  17. Priliminary investigation of psychologic factors in 76 tinnitus patients%76例耳鸣患者的心理因素初步分析

    Institute of Scientific and Technical Information of China (English)

    毛坤华; 江文; 冯永

    2011-01-01

    Objective: To study the psychological aspects of tinnitus patients , to analyze the distribution of psychologic obstacle in tinnitus patients, and then to provide information for diagnosing and treating tinnitus clini-cally. Method: All patients were detected their frequency and loundness of tinnitus. Then they were evaluated by symptom checklist 9CKSCL-90), life satisfaction scale, Pittsburgh sleep quality index(PSQI) and tinnitus handicap inventory(THI). All data were analyzed with statistical software SPSS11. 0. Result:①There was no straight line correlation beween frequency, loundness of tinnitus and the patient's scores from SCL-90,life satisfaction rating scale(LSR),life satisfaction index A(LSIA) ,LSIB,PSQ1,THI. ②To 76 tinnitus patients .some factors of SCL-90 were higher than internal nom. Compared with internal nom, tinitus patients' score of LSR, LSIA and LSIB were all lower than it. Many of tinnitus patients had sleep disorder, the ratio was higher than internal nom. ③Grouping these patients, based on the score of THI. To THI four grade group and THI five grade group, their satisfaction of lives were lower, some factors of SCL-90 were higher than internal nom. To THI five grade group, the ratio a-bout sleep disorder was higher than internal nom. Conclusion: There is no straight line correlation beween frequen-cy, loundness of tinnitus and the patient's scores from SCL-90,LSR,LSIA,LSIB.PSQI,THI. Grouping based on the score of THI, the groups of THI four grade and THI five grade are approved that they have psychologic obsta-cle obviously, they should be paid close attention.%目的:了解耳鸣患者的心理状态,并分析心理障碍在耳鸣患者中的分布,为临床上诊疗耳鸣提供参考.方法:所有患者均进行耳鸣的频率和响度测试,并使用90项症状清单(SCL-90)、生活满意度量表、匹兹堡睡眠质量指数量表(PSQI)、耳鸣残疾量化表(THI)对患者进行相关的评估.将所取得的数据采用SPSS11.0

  18. Tinnitus-Related Distress and the Personality Characteristic Resilience

    OpenAIRE

    Elisabeth Wallhäusser-Franke; Wolfgang Delb; Tobias Balkenhol; Wolfgang Hiller; Karl Hörmann

    2014-01-01

    It has been suggested that personality traits may be prognostic for the severity of suffering from tinnitus. Resilience as measured with the Wagnild and Young resilience scale represents a positive personality characteristic that promotes adaptation to adverse life conditions including chronic health conditions. Aim of the study was to explore the relation between resilience and tinnitus severity. In a cross-sectional study with a self-report questionnaire, information on tinnitus-related dis...

  19. American Tinnitus Association

    Science.gov (United States)

    American Tinnitus Association Donate Become A Member Member Login Find A Provider Search form Search Menu Close Understanding The Facts Managing Your Tinnitus Research Toward A Cure About Us Initiatives News & ...

  20. Tinnitus: probable association with the elderly's cervical alterations

    Directory of Open Access Journals (Sweden)

    Moreira, Michelle Damasceno

    2011-07-01

    Full Text Available Introduction: Tinnitus is a prevailing symptom that highly jeopardizes the elderly patient's quality of life. Neck pain and cervical column alterations are frequent in patients complaining about tinnitus. Objective: Evaluate the prevalence of both tinnitus and neck pain on an elderly group, and verify the likely association between tinnitus, neck pain and the constraint to make wide cervical movements. Methods: Retrospective transversal study, evaluating both the width of cervical movement by way of a goniometry and the tinnitus and neck pain by requesting a standard questionnaire to be filled out. Results: Sample was comprised of 147 individuals aged between 69.22, 61.90% of whom were female. Among these individuals, 42.85% showed a buzz complaint and 51% of these individuals claimed to have a neck pain. Neither was association found between tinnitus and neck pain nor it was between tinnitus and the width constraint of cervical movements. Conclusion: Despite not finding an association between tinnitus and neck pain or between tinnitus and the width constraint of cervical movements, there was a significant prevalence of tinnitus, neck pain and a reduction in the width of cervical movements on the elderly people. The results hereof, by finding this important prevalence of tinnitus in all the individuals of this study, will be the basis to integrate health professionals engaged in such alterations.

  1. Differences between a single session and repeated sessions of 1 Hz TMS by double-cone coil prefrontal stimulation for the improvement of tinnitus.

    Science.gov (United States)

    Vanneste, Sven; De Ridder, Dirk

    2013-03-01

    Tinnitus related distress is associated with increased activity in the anterior cingulate cortex (ACC). In a recent study, it was demonstrated that a single session of low frequency prefrontal TMS using a double-cone coil (DCC) modulating the ACC (AC/DC TMS, anterior cingulate cortex targeted modulation by Double-Cone coil) yields a transient improvement in subjects with chronic tinnitus. An increasing number of studies demonstrated that repeated sessions of low frequency TMS to the temporoparietal area can significantly improve tinnitus complaints. Our aim is to determine the extent to which repeated sessions of AC/DC TMS can modulate tinnitus in comparison to a single session. Seventy-three tinnitus patients received a single (N = 46) or repetitive (N = 27) session(s) of TMS using a DCC placed over the prefrontal cortex. Our results indicate that both single sessions as well as multiple sessions (i.e. 8 sessions) of AC/DC TMS suppress both tinnitus distress (respectively 7.60% vs. 26.19%) and tinnitus intensity (respectively 7.12% vs. 19.60%) transiently. It was further shown that multiple sessions of AC/DC TMS generate a higher suppression effect in comparison to a single session of AC/DC TMS and that more patients responded to repeated sessions of 1 Hz stimulation in comparison to a single session. Our findings give further support to the fact that non-auditory areas are involved in tinnitus intensity and tinnitus distress and that more patients respond to repeated sessions with a higher suppression effect in comparison to patients who received a single session, suggesting that the approach of daily TMS sessions is relevant.

  2. 突发性聋伴耳鸣患者治疗前耳鸣性状分析%Analysis of Tinnitus Characteristics in the Idiopathic Sudden Sensorineural Hearing Loss Patients

    Institute of Scientific and Technical Information of China (English)

    张帅; 周莲; 冯宁宇; 郑虹

    2011-01-01

    Objective To evaluate the distribution and characteristics of tinnitus in idiopathic sudden sensorineural hearing loss(ISSHL) patients , the relationship with hearing loss, and to explore appropriate evaluating method of tinnitus to the ISSHL patients. Methods 56 patients(56 ears) were diagnosed as idiopathic sudden sensorineural hearing loss accompanied with tinnitus and the data were analyzed accordingly. Results ①The frequencies of tinnitus match focus in the hearing loss frequencies and tinnitus mostly matched was narrow band noise. The tinnitus loudness spread wildly. ②The tinnitus subjective distress scales have no obvious correlation with the tinnitus types,loudness of tinnitus, or hearing loss. The tinnitus type match has no obvious relationship with hearing loss. Conclusion Every patient has different tolerance capacity to tinnitus, tinnitus match combine with subjective scale evaluation are more appropriate method.%目的 分析突发性聋伴耳鸣患者的耳鸣性状及其与听力损失之间的关系,探讨耳鸣对患者影响的评估方法.方法 对56例(56耳)突发性聋伴耳鸣患者行听力检测和耳鸣主观分级(评估)及耳鸣匹配检查.结果 ①耳鸣匹配的频率集中于听力损失的频率范围,耳鸣匹配的类型主要为窄带噪声,匹配响度分布较为广泛;②耳鸣主观分级与匹配类型,响度、听力损失程度之间无明显关系;听力损失程度与耳鸣匹配类型无明显关系.结论 突发性聋伴耳鸣患者耳鸣主观分级具有个体差异,与耳鸣匹配共同评估更能反映出耳鸣对患者的影响.

  3. A randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy and safety of neramexane in patients with moderate to severe subjective tinnitus

    Directory of Open Access Journals (Sweden)

    Jastreboff Pawel J

    2011-01-01

    Full Text Available Abstract Background Neramexane is a new substance that exhibits antagonistic properties at α9α10 cholinergic nicotinic receptors and N-methyl-D-aspartate receptors, suggesting potential efficacy in the treatment of tinnitus. Methods A total of 431 outpatients with moderate to severe subjective tinnitus (onset 3-18 months before screening were assigned randomly to receive either placebo or neramexane mesylate (25 mg/day, 50 mg/day and 75 mg/day for 16 weeks, with assessment at 4-week intervals. The primary (intention-to-treat efficacy analysis was based on the change from baseline in Week 16 in the total score of the adapted German short version of the validated Tinnitus Handicap Inventory questionnaire (THI-12. Results Compared with placebo, the largest improvement was achieved in the 50 mg/d neramexane group, followed by the 75 mg/d neramexane group. This treatment difference did not reach statistical significance at the pre-defined endpoint in Week 16 (p = 0.098 for 50 mg/d; p = 0.289 for 75 mg/d neramexane, but consistent numerical superiority of both neramexane groups compared with placebo was observed. Four weeks after the end of treatment, THI-12 scores in the 50 mg/d group were significantly better than those of the controls. Secondary efficacy variables supported this trend, with p values of Conclusions This study demonstrated the safety and tolerability of neramexane treatment in patients with moderate to severe tinnitus. The primary efficacy variable showed a trend towards improvement of tinnitus suffering in the medium- and high-dose neramexane groups. This finding is in line with consistent beneficial effects observed in secondary assessment variables. These results allow appropriate dose selection for further studies. Trial Registration ClinicalTrials.gov NCT00405886

  4. 梅尼埃病的耳鸣特征与影响因素分析%Characteristics and contributing factors of tinnitus in patients with Meniere's disease

    Institute of Scientific and Technical Information of China (English)

    张祎; 李云; 刘博; 刘冬鑫; 贾若

    2016-01-01

    目的:分析与探讨梅尼埃病患者耳鸣的临床特征与影响因素。方法90例梅尼埃病患者,收集纯音听阈、耳鸣匹配结果,记录耳鸣侧别、时间、睡眠质量,使用耳鸣残障量表(Tinnitus Handicap Inventory,THI)进行评价。结果①患者平均年龄48.08±10.28岁,男女比例为1.09:1;耳鸣主调频率匹配为低频和言语频率耳鸣者65例(72.2%);响度匹配为响度<10dB SL者(51例,56.7%),≥10dBSL者(39例,43.3%),其中以5-9dB SL最多,为30例(33.3%);≥15dB SL者最少,为15例(16.7%);持续性耳鸣患者77例(85.6%);单侧耳鸣患者68例(75.6%);有睡眠障碍者28例(31.1%)。②耳鸣响度较大(F=3.203,P=0.027)、睡眠质量较差(t=2.813,P=0.006)和持续性耳鸣(t=3.018,P=0.003)的患者其THI评分高于耳鸣响度较小、睡眠质量较好和间断性耳鸣的患者。双侧耳鸣患者THI评分高于单侧耳鸣患者,但差异无统计学意义(t=1.892,P=0.062)。不同性别、听力损失水平和耳鸣频率的患者THI评分间无明显差异(P>0.05)。③耳鸣影响因素有序多分类Logistic回归分析:耳鸣严重程度与耳鸣响度[P=0.011,95%可信区间(confidence interval,CI)1.019~1.151,优势比(odds ratio,OR)=1.083]、睡眠质量(P=0.011,95%CI1.288~6.931,OR=2.986)和耳鸣持续时间(P=0.007,95%CI1.559~16.265,OR=5.033)有关。结论梅尼埃病患者的耳鸣常常为低频、持续性的。耳鸣的严重程度与耳鸣的响度、睡眠质量和耳鸣的持续有关。%Objective To report clinical characteristics and contributing factors of tinnitus in patients with Meniere's disease. Methods Detailed medical histories were collected in 90 patients with Meniere's disease. Routine physical examina-tion, pure tone test and pitch matching were recorded. The affected sides, tinnitus duration and quality of sleep were in-quired. All the patients

  5. Can the tinnitus spectrum identify tinnitus subgroups?

    NARCIS (Netherlands)

    Heijneman, Karin M.; de Kleine, Emile; Wiersinga-Post, Esther; van Dijk, Pim

    2013-01-01

    The tinnitus spectrum is a psycho-acoustic metric of tinnitus. Previous work found a tight relation between the spectrum and the tone audiogram. This suggests that the spectrum and the audiogram provide essentially the same information, and the added value of the spectrum is limited. In order to tes

  6. Memory networks in tinnitus: a functional brain image study.

    Directory of Open Access Journals (Sweden)

    Maura Regina Laureano

    Full Text Available Tinnitus is characterized by the perception of sound in the absence of an external auditory stimulus. The network connectivity of auditory and non-auditory brain structures associated with emotion, memory and attention are functionally altered in debilitating tinnitus. Current studies suggest that tinnitus results from neuroplastic changes in the frontal and limbic temporal regions. The objective of this study was to use Single-Photon Emission Computed Tomography (SPECT to evaluate changes in the cerebral blood flow in tinnitus patients with normal hearing compared with healthy controls.Twenty tinnitus patients with normal hearing and 17 healthy controls, matched for sex, age and years of education, were subjected to Single Photon Emission Computed Tomography using the radiotracer ethylenedicysteine diethyl ester, labeled with Technetium 99 m (99 mTc-ECD SPECT. The severity of tinnitus was assessed using the "Tinnitus Handicap Inventory" (THI. The images were processed and analyzed using "Statistical Parametric Mapping" (SPM8.A significant increase in cerebral perfusion in the left parahippocampal gyrus (pFWE <0.05 was observed in patients with tinnitus compared with healthy controls. The average total THI score was 50.8+18.24, classified as moderate tinnitus.It was possible to identify significant changes in the limbic system of the brain perfusion in tinnitus patients with normal hearing, suggesting that central mechanisms, not specific to the auditory pathway, are involved in the pathophysiology of symptoms, even in the absence of clinically diagnosed peripheral changes.

  7. Central crosstalk for somatic tinnitus: abnormal vergence eye movements.

    Directory of Open Access Journals (Sweden)

    Qing Yang

    Full Text Available BACKGROUND: Frequent oulomotricity problems with orthoptic testing were reported in patients with tinnitus. This study examines with objective recordings vergence eye movements in patients with somatic tinnitus patients with ability to modify their subjective tinnitus percept by various movements, such as jaw, neck, eye movements or skin pressure. METHODS: Vergence eye movements were recorded with the Eyelink II video system in 15 (23-63 years control adults and 19 (36-62 years subjects with somatic tinnitus. FINDINGS: 1 Accuracy of divergence but not of convergence was lower in subjects with somatic tinnitus than in control subjects. 2 Vergence duration was longer and peak velocity was lower in subjects with somatic tinnitus than in control subjects. 3 The number of embedded saccades and the amplitude of saccades coinciding with the peak velocity of vergence were higher for tinnitus subjects. Yet, saccades did not increase peak velocity of vergence for tinnitus subjects, but they did so for controls. 4 In contrast, there was no significant difference of vergence latency between these two groups. INTERPRETATION: The results suggest dysfunction of vergence areas involving cortical-brainstem-cerebellar circuits. We hypothesize that central auditory dysfunction related to tinnitus percept could trigger mild cerebellar-brainstem dysfunction or that tinnitus and vergence dysfunction could both be manifestations of mild cortical-brainstem-cerebellar syndrome reflecting abnormal cross-modality interactions between vergence eye movements and auditory signals.

  8. 突发性耳聋患者耳鸣状况的危险因素研究%Risk factors of tinnitus in patients with sudden deafness

    Institute of Scientific and Technical Information of China (English)

    闫波

    2014-01-01

    目的:探讨突发性耳聋患者耳鸣状况的危险因素。方法收集2006年1月-2012年12月该院收治的507例突发性耳聋患者完整的病历资料,对其听力损失的程度、听力曲线的类型及治疗效果进行评定,对耳鸣响度进行分级。分析不同耳鸣程度的相关影响因素。结果507例突发性耳聋伴耳鸣患者的耳鸣程度以3级所占的比例最大,为32.94%(167/507);所占比例最低的为1级,为13.02%(66/507);2、4级分别各占27.02%(137/507)。不同耳鸣程度的患者在年龄、性别、耳侧、不同听力损害程度及不同听力曲线类型等方面的分布情况相比,均无统计学差异(P>0.05)。结论患者在年龄、性别、耳侧等方面的不同分布情况、不同听力损害程度及不同听力曲线类型等不同的突发性耳聋的听力学特征及治疗效果与耳鸣的严重程度并不存在相关性,并非造成突发性耳聋患者伴发不同严重程度耳鸣的独立的危险因素。%Objective To investigate risk factors of tinnitus in patients with sudden deafness.Methods Complete medical records of 507 cases of sudden deafness treated at The Hospital Affiliated to Panzhihua University from January 2006 to December 2012 were col-lected.Their degree of hearing loss,hearing curve type and treatment were evaluated for tinnitus loudness graded.Analysis of different degrees of tinnitus related factors was made.Results Of 507 cases of sudden deafness combined with tinnitus patients’tinnitus degree at level three accounted for the largest proportion (32.94%,167/507),that at level one accounted for the lowest proportion (13.02%, 66/507),and those at level two and four accounted for 27.02%,respectively,(137/507).There were no statistically significant differ-ences among patients with different degrees of tinnitus in age,gender,location of tinnitus,different degree of hearing loss,different types of hearing and other

  9. Eficácia da desativação dos pontos-gatilho miofasciais para o controle do zumbido Efficacy of myofascial trigger point deactivation for tinnitus control

    Directory of Open Access Journals (Sweden)

    Carina Bezerra Rocha

    2012-12-01

    Full Text Available Dor crônica nas imediações do ouvido pode influenciar o zumbido. OBJETIVO: Investigar a eficácia da desativação de pontos-gatilho miofasciais na melhora do zumbido. MÉTODO: Ensaio clínico randomizado com 71 pacientes com zumbido e síndrome dolorosa miofascial. O Grupo Experimental (n = 37 foi submetido a 10 sessões de desativação dos pontos-gatilho miofasciais e o Grupo Controle (n = 34, a 10 sessões de desativação placebo. RESULTADOS: O tratamento do Grupo Experimental foi eficaz para o controle do zumbido (p Chronic pain in areas surrounding the ear may influence tinnitus. OBJECTIVE: To investigate the efficacy of myofascial trigger point deactivation for the relief of tinnitus. METHOD: A double-blind randomized clinical trial enrolled 71 patients with tinnitus and myofascial pain syndrome. The experimental group (n = 37 underwent 10 sessions of myofascial trigger point deactivation and the control group (n = 34, 10 sessions with sham deactivation. RESULTS: Treatment of the experimental group was effective for tinnitus relief (p < 0.001. Pain and tinnitus relieves were associated (p = 0.013, so were the ear with worst tinnitus and the side of the body with more pain (p < 0.001. The presence of temporary tinnitus modulation (increase or decrease upon initial muscle palpation was frequent in both groups, but its temporary decrease was related to the persistent relief at the end of treatment (p = 0.002. CONCLUSION: Besides medical and audiological investigation, patients with tinnitus should also be checked for: 1 presence of myofascial pain surrounding the ear; 2 laterality between both symptoms; 3 initial decrease of tinnitus during muscle palpation. Treating this specific subgroup of tinnitus patients with myofascial trigger point release may provide better results than others described so far.

  10. Playing and Listening to Tailor-Made Notched Music: Cortical Plasticity Induced by Unimodal and Multimodal Training in Tinnitus Patients

    OpenAIRE

    Janna Pape; Evangelos Paraskevopoulos; Maximilian Bruchmann; Andreas Wollbrink; Claudia Rudack; Christo Pantev

    2014-01-01

    Background. The generation and maintenance of tinnitus are assumed to be based on maladaptive functional cortical reorganization. Listening to modified music, which contains no energy in the range of the individual tinnitus frequency, can inhibit the corresponding neuronal activity in the auditory cortex. Music making has been shown to be a powerful stimulator for brain plasticity, inducing changes in multiple sensory systems. Using magnetoencephalographic (MEG) and behavioral measurements we...

  11. 突发性聋伴耳鸣患者耳鸣特征%Characteristics of tinnitus in patients with idiopathic sudden sensorineural hearing loss

    Institute of Scientific and Technical Information of China (English)

    钟晓声; 杨海弟; 郑亿庆

    2015-01-01

    损失程度无相关性r=0.087,P=0.287>0.05。VAS得分与听力损失程度无相关性r=0.002,P=0.982>0.05。THI得分与耳鸣频率对数无相关性,相关系数r=-0.056,P=0.402>0.05。VAS 得分与耳鸣频率对数无相关性,相关系数 r=-0.003,P=0.970>0.05。THI得分与耳鸣响度无相关性,相关系数r=0.039,P=0.563>0.05。VAS得分与耳鸣响度无相关性,相关系数r=0.136,P=0.110>0.05。结论①突发性聋伴耳鸣患者中高频耳鸣最常见;②耳鸣频率与听力损失类型显著相关,低中频下降型以低频耳鸣多见,而中高频下降型及全聋型以高频耳鸣多见;③听力损失最大的频率与耳鸣的频率有较高的一致性;④突发性聋伴耳鸣患者急性期的耳鸣致残程度以3~4级为多;⑤THI及VAS得分与听力损失的程度、耳鸣的频率、耳鸣的响度均无相关性。%Objective To analyze the characteristics of tinnitus,correlation between tinnitus and hearing loss,effects of tinnitus,and mechanism of tinnitus in patients with sudden sensorineural hearing loss.Methods Clinical data of 23 1 tinnitus patients with idiopathic sudden sensorineural hearing loss were retrospectively reviewed.Results of Tinnitus Handicap Inventory (THI),visual analogue scale (VAS),pure tone audiometry,acoustic emission,tinnitus test and masking test were analyzed.Results ①Characteristics of hearing loss:Low-intermediate frequency hearing loss (rise type)was 8.7%,high-frequency hearing loss (fall type)was 26%,flat-type was 19%,total-deafness type was 34.2%,irregular type was 12.1%.②Frequency of tinnitus:Low-frequency (2 000 Hz)tinnitus was 52.8%,unmatched tinnitus was 2.6%.Of hearing loss with low-intermediate frequency,low,medium and high frequency tinnitus was 75%,15% and 10% respectively.Of hearing loss with medium-high frequency,low,medium and high frequency tinnitus was 13.3%, 26.7%and60.0%respectively

  12. TSG助听器用于耳鸣患者的临床结果%The Effect of TSG Hearing Aids on the Treatment of Tinnitus Patients

    Institute of Scientific and Technical Information of China (English)

    刘海红; 张峰; 张华; 冯定香

    2011-01-01

    目的 评估TSG助听器(GN Resound Live 9 TS)改善患者耳鸣的效果,从而检验该技术用于治疗单纯性耳鸣和耳鸣伴有听力障碍患者的可行性和疗效.方法 采用耳鸣残疾评估量表(TinnitusHandicap Inventory,THI)作为评估素材,分别对9名受试者在TSG助听器配戴前后的耳鸣残疾程度进行评估.结果 ①全部受试者配戴GN Resound Live 9 TS助听器前后THI总分和各条目得分均有显著性差异(P<0.0001) ; ②GN Resound Live 9 TS助听器配戴前后受试者THI的功能性、情感性及严重性得分均得到显著性改善(P<0.0001).结论 GN Resound Live 9 TS助听器对单纯耳鸣受试者或耳鸣伴有轻中度感音神经性听力损失者均显示出明显的改善作用.%Objective To evaluate the effectiveness and feasibility of Tinnitus Sound Generator (TSG) hearing aid (GN Resound Live 9 TS) in the treatment of tinnitus. Methods The Tinnitus Handicap Inventory (THI) was used to assess the degree of tinnitus in 9 subjects before and after wearing TSG hearing aids. Results The THI scores after 8 weeks of trial were significantly lower than the baseline scores(P<0.0001). The significant improvements were found in the functional, emotional and catastrophic THI scores after wearing the TSG hearing aids(P<0.0001).Conclusion Based on the assessment results, the GN Resound Live 9 TS hearing aid is an effective instrument to treat tinnitus patients with mild-to-moderate sensorineural hearing losses or with normal hearing even after a short period of use.

  13. Therapy of unspecific tinnitus without organic cause

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    Seiler, Gerda

    2006-08-01

    Full Text Available Introduction: There is a variety of medical and non-medical therapies in practice, which were not evaluated regarding its effectiveness by any systematic evidence oriented investigation. A number of therapies of medical and non-medical type try to treat the different types of tinnitus. The evidence in the scientific literature also had to be cleared in the field of diagnosis and classification as well as medical/psychiatric/psychological procedures of existing medical therapy. Question: The HTA report had to investigate the following questions: * Which evidence do diagnostic methods in recognition of tinnitus have? * Which types of therapy show medical effectiveness at the acute or chronic tinnitus without an organic cause? * Which consequences (need for further research, future procedures can be drawn? Methodology: In the following databases "tinnitus" was searched according to the search string:HTA97; INAHTA; CDAR94; CDSR93; CCTR93; ME66; ME0A; HT83; SM78; CA66; CB85; BA70; BA93; EM74; IS74; ET80; EB94; IA70; AZ72; CV72; GE79; EU93; HN69; ED93; EA08 Result: 1932 studies, unsorted after assessment in accordance with EBM criterions, selection: 409 studies. Due to the completely heterogeneous representation modes of the therapeutic approaches at the treatment of the chronic tinnitus no quantitative synthesis method could be performed. Therefore the methodology of a qualitative overview has been carried out. Results: The diagnostic confirmation of the non-specific tinnitus without organic cause meets with the problem of the assurance of the diagnosis tinnitus. According to the current opinion the stepwise diagnostics is carried out also in the case of the so called subjective tinnitus. Nothing can be said about the evidence of these procedures since no publication was found about that. A study concerning the evidence of the diagnostic questionnaires from Goebel and Hiller [1] comes to the end that the tinnitus questionnaire frequently used (TF [2

  14. Betahistine in the treatment of tinnitus in patients with vestibular disorders Betaistina no tratamento do zumbido em pacientes com distúrbios vestibulares

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    Maurício Malavasi Ganança

    2011-08-01

    Full Text Available Betahistine is a medicine used to treat vestibular disorders that has also been used to treat tinnitus. AIM: To assess the effects of betahistine on tinnitus in patients with vestibular disorders. MATERIAL AND METHOD: Retrospective data were collected from patient records for individuals presenting with vestibular dysfunction and tinnitus. Patients included had received betahistine 48 mg/day and clinical outcomes were compared with a control group comprising individuals who were unable to receive betahistine due to gastritis, ulcers, pregnancy, asthma or hypersensitivity to the drug. Patients underwent control of any aggravating factors and also standard vestibular exercises as a basis for treatment. The intensity, frequency and duration of tinnitus were assessed on the first day of dosing and after 120 days of treatment. Clinical improvement was defined as a total or partial reduction of tinnitus after treatment. RESULTS: Clinical improvement was observed in 80/262 (30. 5% of patients treated with betahistine and 43/252 (17. 1% of control patients. Betahistine significantly (pA betaistina é um medicamento utilizado no tratamento de distúrbios da função vestibular, que também tem sido utilizado para tratar o zumbido. OBJETIVO: Avaliar o efeito da betaistina sobre o zumbido de pacientes com distúrbios vestibulares. MATERIAL E MÉTODO: Foram coletados dados retrospectivos de pacientes com vestibulopatia e zumbido. Os pacientes incluídos receberam 48 mg/dia de betaistina ao dia e os resultados clínicos foram comparados com os de um grupo controle, que incluiu indivíduos impossibilitados de receber betaistina devido à gastrite, úlceras, gravidez, asma ou hipersensibilidade ao medicamento. Os pacientes realizaram controle de fatores agravantes e exercícios de reabilitação vestibular, como tratamento de base para a vestibulopatia. A intensidade, frequência e duração do zumbido foram avaliadas no primeiro dia e após 120 dias de

  15. Treatment options for subjective tinnitus: Self reports from a sample of general practitioners and ENT physicians within Europe and the USA

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    Hall Deborah A

    2011-11-01

    Full Text Available Abstract Background Tinnitus affects about 10-15% of the general population and risks for developing tinnitus are rising through increased exposure to leisure noise through listening to personal music players at high volume. The disorder has a considerable heterogeneity and so no single mechanism is likely to explain the presence of tinnitus in all those affected. As such there is no standardized management pathway nor singly effective treatment for the condition. Choice of clinical intervention is a multi-factorial decision based on many factors, including assessment of patient needs and the healthcare context. The present research surveyed clinicians working in six Westernized countries with the aims: a to establish the range of referral pathways, b to evaluate the typical treatment options for categories of subjective tinnitus defined as acute or chronic, and c to seek clinical opinion about levels of satisfaction with current standards of practice. Methods A structured online questionnaire was conducted with 712 physicians who reported seeing at least one tinnitus patients in the previous three months. They were 370 general practitioners (GPs and 365 ear-nose-throat specialists (ENTs from the US, Germany, UK, France, Italy and Spain. Results Our international comparison of health systems for tinnitus revealed that although the characteristics of tinnitus appeared broadly similar across countries, the patient's experience of clinical services differed widely. GPs and ENTs were always involved in referral and management to some degree, but multi-disciplinary teams engaged either neurology (Germany, Italy and Spain or audiology (UK and US professionals. For acute subjective tinnitus, pharmacological prescriptions were common, while audiological and psychological approaches were more typical for chronic subjective tinnitus; with several specific treatment options being highly country specific. All therapy options were associated with low levels

  16. 200例主观性耳鸣患者听力损失临床分析%Study of hearing loss in 200 patients with subjective tinnitus

    Institute of Scientific and Technical Information of China (English)

    唐建辉; 吉彬; 刘立中

    2011-01-01

    目的:对耳鸣患者的听力损失进行分析,为进一步探讨耳鸣的发病原因、检查方法提供临床依据.方法:对以主观性耳鸣为主诉的200例患者进行耳科专科检查、声导抗检测、常频纯音听阈测听和高频扩展听阈测听检查.结果:200例耳鸣患者中,单侧耳鸣123例(61.5%),双侧耳鸣77例(38.5%);46例(23.0%)听力正常.单侧耳鸣中,患侧与对侧听阈比较0.125~8 kHz差异有统计学意义(P0.05).常频听力正常组与听力异常组比较各频率阈值差异均具有统计学意义(均P 10 kHz), the difference between two groups was not statistically significant (P > 0.05). There was significant difference in hearing threshold between tinnitus patients with normal and abnormal hearing in normal frequency(P<0. 05) ,meantime the detection rate in abnormal hearing group was lower than the normal group. Conclusion:Tinnitus can occur in people with normal hearing. Early in tinnitus,further study need be undertaken on whether the audiometry extended high frequency can offer the early evidence of hearing loss for tin-nitus patients or not.

  17. Disentangling Tinnitus Distress and Tinnitus Presence by Means of EEG Power Analysis

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    Martin Meyer

    2014-01-01

    Full Text Available The present study investigated 24 individuals suffering from chronic tinnitus (TI and 24 nonaffected controls (CO. We recorded resting-state EEG and collected psychometric data to obtain information about how chronic tinnitus experience affects the cognitive and emotional state of TI. The study was meant to disentangle TI with high distress from those who suffer less from persistent tinnitus based on both neurophysiological and behavioral data. A principal component analysis of psychometric data uncovers two distinct independent dimensions characterizing the individual tinnitus experience. These independent states are distress and presence, the latter is described as the perceived intensity of sound experience that increases with tinnitus duration devoid of any considerable emotional burden. Neuroplastic changes correlate with the two independent components. TI with high distress display increased EEG activity in the oscillatory range around 25 Hz (upper β-band that agglomerates over frontal recording sites. TI with high presence show enhanced EEG signal strength in the δ-, α-, and lower γ-bands (30–40 Hz over bilateral temporal and left perisylvian electrodes. Based on these differential patterns we suggest that the two dimensions, namely, distress and presence, should be considered as independent dimensions of chronic subjective tinnitus.

  18. Persistent Primitive Trigeminal Artery: An Unusual Cause of Vascular Tinnitus

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    Ananya Panda

    2013-01-01

    Full Text Available Pulsatile tinnitus is generally of vascular origin and can be due to arterial, venous, or systemic causes. While certain congenital anatomical variants and arterial vascular loops have been commonly found in symptomatic patients undergoing imaging, persistent primitive trigeminal artery in association with isolated tinnitus is unusual. Thus we report a patient with unilateral isolated pulsatile tinnitus who was evaluated with magnetic resonance angiography and was found to have a persistent primitive trigeminal artery. We also briefly discuss vascular tinnitus as well as the embryology, imaging, and classification of persistent primitive trigeminal artery with the clinical implications.

  19. Persistent Primitive Trigeminal Artery: An Unusual Cause of Vascular Tinnitus

    Science.gov (United States)

    Arora, Arundeep; Jana, Manisha

    2013-01-01

    Pulsatile tinnitus is generally of vascular origin and can be due to arterial, venous, or systemic causes. While certain congenital anatomical variants and arterial vascular loops have been commonly found in symptomatic patients undergoing imaging, persistent primitive trigeminal artery in association with isolated tinnitus is unusual. Thus we report a patient with unilateral isolated pulsatile tinnitus who was evaluated with magnetic resonance angiography and was found to have a persistent primitive trigeminal artery. We also briefly discuss vascular tinnitus as well as the embryology, imaging, and classification of persistent primitive trigeminal artery with the clinical implications. PMID:24459596

  20. Persistent primitive trigeminal artery: an unusual cause of vascular tinnitus.

    Science.gov (United States)

    Panda, Ananya; Arora, Arundeep; Jana, Manisha

    2013-01-01

    Pulsatile tinnitus is generally of vascular origin and can be due to arterial, venous, or systemic causes. While certain congenital anatomical variants and arterial vascular loops have been commonly found in symptomatic patients undergoing imaging, persistent primitive trigeminal artery in association with isolated tinnitus is unusual. Thus we report a patient with unilateral isolated pulsatile tinnitus who was evaluated with magnetic resonance angiography and was found to have a persistent primitive trigeminal artery. We also briefly discuss vascular tinnitus as well as the embryology, imaging, and classification of persistent primitive trigeminal artery with the clinical implications. PMID:24459596

  1. Neuro-Music Therapy for Recent-Onset Tinnitus

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    Miriam Grapp

    2013-05-01

    Full Text Available The aim of this pilot study was the evaluation of the neuro-music therapy approach as a new treatment option for patients with recent-onset tinnitus whose tinnitus symptoms were enduring after initial pharmacological treatment. In all, 15 patients with recent-onset tinnitus took part in our manualized short-term music-therapeutic treatment. Tinnitus severity and individual tinnitus distress were assessed by the German version of the tinnitus questionnaire (TQ and the Attention and Performance Self-Assessment Scale (APSA at three different measurement times: baseline (T0, start of treatment (T1, and end of treatment (T2. Score changes in TQ and APSA from start to end of treatment indicated significant improvements in tinnitus-related distress. According to the Jacobson and Truax reliable change index (RC, 73.3% of the patients showed a reliable reduction in individual TQ-score. The neuro-music therapy for recent-onset tinnitus according to the “Heidelberg Model” introduced in this pilot study seems to provide an effective treatment option for patients with recent-onset tinnitus.

  2. Tinnitus and cell phones: the role of electromagnetic radiofrequency radiation

    OpenAIRE

    Luisa Nascimento Medeiros; Tanit Ganz Sanchez

    2016-01-01

    ABSTRACT INTRODUCTION: Tinnitus is a multifactorial condition and its prevalence has increased on the past decades. The worldwide progressive increase of the use of cell phones has exposed the peripheral auditory pathways to a higher dose of electromagnetic radiofrequency radiation (EMRFR). Some tinnitus patients report that the abusive use of mobiles, especially when repeated in the same ear, might worsen ipsilateral tinnitus. OBJECTIVE: The aim of this study was to evaluate the availabl...

  3. The Distressed (Type D) Personality Is Independently Associated With Tinnitus : A Case-Control Study

    NARCIS (Netherlands)

    Bartels, Hilke; Middel, Berrie; Pedersen, Susanne S.; Staal, Michiel J.; Albers, Frans W. J.

    2010-01-01

    Background: Tinnitus is a common and disturbing condition, reported by 10% to 20% of the general population. Objective: The authors sought to determine personality characteristics associated with tinnitus patients versus a control group of ear-nose-throat (ENT) patients without tinnitus. Method: Adu

  4. Tinnitus and its radiological diagnosis and therpy

    Energy Technology Data Exchange (ETDEWEB)

    Nadjmi, M.; Hofmann, E.; Ratzka, M.; Schuknecht, B.

    1987-03-01

    Tinnitus is a familiar symptom in diseases of the central nervous system. Its aetiology being of a varied nature, the type of tinnitus is a pointer to the pathoanatomic findings that are responsible for the disease. The causes of tinnitus are often found in the borderline areas between various neighbouring disciplines, such as otology, neurology and neurosurgery, whereas the final identification of the real causes is mainly within the scope of radiological diagnosis, in which computed tomography and superselective angiography play an essential role. In addition to arteriovenous fistulas near the petrous bone and glomus tumours, which are well known, there are a few other aetiologies of pulse-synchronous tinnitus that are being discussed in this paper. In recent years there has been substantial therapeutical progress owing to the introduction of new techniques and the development of improved materials for embolisation in international neuroradiology. Their application is discussed in connection with various patient groups.

  5. The Results of Nurotron Cochlear Implant on Tinnitus Patients%诺尔康人工耳蜗植入对耳鸣的影响研究

    Institute of Scientific and Technical Information of China (English)

    王倩; 李佳楠; 焦青山; 孙丽; 李思阳; 刘日渊; 于丽玫; 杨仕明

    2015-01-01

    Objective To study the changes of tinnitus after Nurotron cochlear implantation and to evaluate the therapeutic evolution on tinnitus patients.Methods 26 Nurotron® Venus™ cochlear implant recipients received the Tinnitus Handicap Inventory investigation before and after wearing the cochlear implant device.Results 20 patients (76.9%) got the THI score decreased more than 20 points after the implantation. Three patients had tinnitus intensity unchanged and one patient felt worsen. Furthermore, one patient without tinnitus had it occurred post-operation. The average THI score of pre-operation was 56.5±20.6, and post-operation score was 20.2±20.9. Statistical analysis showed a significant difference of the THI total and subscale scores (P=0.000<0.05).Conclusion As an electrical stimulation treatment method, cochlear implant has the inhibitory effect on tinnitus. In order to avoid the bad risk, we need to do more in-depth research on it.%目的:研究诺尔康人工耳蜗对耳鸣的治疗效果。方法对26例语后聋患者植入诺尔康人工耳蜗前后进行耳鸣问卷评估,评估材料采用耳鸣残疾评估量表(Tinnitus Handicap Inventory,THI)。结果21例(80.8%)患者自觉耳鸣消失或减弱,其中20例(76.9%)患者耳鸣治疗有效,THI得分与植入人工耳蜗前相比下降≥20分;3例患者自觉耳鸣无改善;1例患者自述耳鸣加重;1例患者术前无耳鸣,术后出现中度耳鸣。26例患者人工耳蜗植入术前THI总分平均分56.5±20.6,术后THI总分平均分20.2±20.9。经过配对t检验分析,配戴人工耳蜗前后的总分及功能性、情感性、严重性3个维度的得分具有显著差异(P=0.000<0.05)。结论人工耳蜗植入对耳鸣有一定程度的改善作用,但仍存在一定风险。

  6. 影响突发性聋患者耳鸣疗效的相关因素分析%Analysis of Related Factors on Tinnitus Curative Effect in Sudden Sensorineural Hearing Loss Patients

    Institute of Scientific and Technical Information of China (English)

    陈平; 周津徽

    2013-01-01

    Objective To provide the theoretic basis for clinical diagnosis, treatment and prognosis of sudden deafness patients, we investigated the related factors which might influence treatment effects on tinnitus of sudden deafness patients. Methods A prospective analysis was used to compare the relationship among the treatment effects of tinnitus for 70 patients with sudden deafness, such as genders, ears, ages, degrees of hearing lose, degrees of tinnitus and audiometric configurations. Results Tinnitus was detected in 87. 18% in 70 patients with sudden deaf ness, and the total effective rate of sudden deafness and tinnitus was 66. 22 % and 74. 32 %, respectively. The statis tical analysis has shown that the treatment effects of tinnitus were not related to genders, ears, ages, and degrees of tinnitus (P>0. 05). Comparing the tinnitus patients with various degrees of hearing lose and various audiometric curves, the total therapeutical rate was less in profound deafness and complete deafness patients with tinnitus(P< 0. 01). The total treatment effects of tinnitus in refractory sudden deafness patients was less than the patients who had recovery, remarkable therapeutic effects and therapeutic effects(P<0. 01). Conclusion The treatment effects on tinnitus in sudden deafness patients were more noticeable than that of sudden deafness. The treatment effects of tinnitus were not related to genders, ears, ages, and degrees of tinnitus. It was worse in the patients suffering pro found deafness, complete deafness and refractory sudden deafness.%目的 探讨影响突发性聋患者耳鸣疗效的相关因素,为突发性聋伴耳鸣患者的临床诊治及预后判断提供依据.方法 前瞻性分析比较117例突发性聋患者中符合入组条件的70例(74耳)突发性聋伴耳鸣患者的耳鸣疗效与性别、耳别、年龄、听力损失程度、听力曲线类型、耳鸣严重程度、听力损失疗效的关系.结果 本组117例突发性聋患者中102

  7. Development of a progressive audiologic tinnitus management program for Veterans with tinnitus

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    Paula J. Myers, PhD

    2014-07-01

    Full Text Available Tinnitus is the most prevalent service-connected disability awarded to Veterans. However, clinical protocols for management of tinnitus have been inconsistent across Department of Veterans Affairs (VA medical centers. A study was funded to develop and pilot test a protocol to provide tinnitus services consistently across VA audiology clinics. Drawing on a series of prior VA and external research projects, a clinical model was formulated, supporting materials in multimedia were developed, and a pilot study was conducted. Five hierarchical levels of care were defined and labeled the Progressive Audiologic Tinnitus Management (PATM model. The model facilitates access to medical services for tinnitus and includes detailed protocols for evaluation, education, and counseling of patients. Patients at each level of care have the option to "progress" to the next level of PATM if further services are required. Clinical procedures were defined for each level and materials were produced for audiologists and patients. The PATM model was then piloted with clinical patients at the James A. Haley Veterans’ Hospital (JAHVH in Tampa, Florida. Throughout the pilot study, feedback from patients and clinicians was carefully noted. Training materials for audiologists, incorporation of the protocol into clinic activities, and patient outcomes were evaluated. The model was implemented within the JAHVH Audiology Clinic and to assist Veterans with tinnitus management. The most notable finding was how little tinnitus-specific intervention was required for the majority of patients. This finding supports a clinical model that offers stepped-care ("progressive" levels of care until tinnitus management is achieved by the patient.

  8. Tinnitus: a large VBM-EEG correlational study.

    Science.gov (United States)

    Vanneste, Sven; Van De Heyning, Paul; De Ridder, Dirk

    2015-01-01

    A surprising fact in voxel-based morphometry (VBM) studies performed in tinnitus is that not one single region is replicated in studies of different centers. The question then rises whether this is related to the low sample size of these studies, the selection of non-representative patient subgroups, or the absence of stratification according to clinical characteristics. Another possibility is that VBM is not a good tool to study functional pathologies such as tinnitus, in contrast to pathologies like Alzheimer's disease where it is known the pathology is related to cell loss. In a large sample of 154 tinnitus patients VBM and QEEG (Quantitative Electroencephalography) was performed and evaluated by a regression analysis. Correlation analyses are performed between VBM and QEEG data. Uncorrected data demonstrated structural differences in grey matter in hippocampal and cerebellar areas related to tinnitus related distress and tinnitus duration. After control for multiple comparisons, only cerebellar VBM changes remain significantly altered. Electrophysiological differences are related to distress, tinnitus intensity, and tinnitus duration in the subgenual anterior cingulate cortex, dorsal anterior cingulate cortex, hippocampus, and parahippocampus, which confirms previous results. The absence of QEEG-VBM correlations suggest functional changes are not reflected by co-occurring structural changes in tinnitus, and the absence of VBM changes (except for the cerebellum) that survive correct statistical analysis in a large study population suggests that VBM might not be very sensitive for studying tinnitus. PMID:25781934

  9. Tinnitus: a large VBM-EEG correlational study.

    Directory of Open Access Journals (Sweden)

    Sven Vanneste

    Full Text Available A surprising fact in voxel-based morphometry (VBM studies performed in tinnitus is that not one single region is replicated in studies of different centers. The question then rises whether this is related to the low sample size of these studies, the selection of non-representative patient subgroups, or the absence of stratification according to clinical characteristics. Another possibility is that VBM is not a good tool to study functional pathologies such as tinnitus, in contrast to pathologies like Alzheimer's disease where it is known the pathology is related to cell loss. In a large sample of 154 tinnitus patients VBM and QEEG (Quantitative Electroencephalography was performed and evaluated by a regression analysis. Correlation analyses are performed between VBM and QEEG data. Uncorrected data demonstrated structural differences in grey matter in hippocampal and cerebellar areas related to tinnitus related distress and tinnitus duration. After control for multiple comparisons, only cerebellar VBM changes remain significantly altered. Electrophysiological differences are related to distress, tinnitus intensity, and tinnitus duration in the subgenual anterior cingulate cortex, dorsal anterior cingulate cortex, hippocampus, and parahippocampus, which confirms previous results. The absence of QEEG-VBM correlations suggest functional changes are not reflected by co-occurring structural changes in tinnitus, and the absence of VBM changes (except for the cerebellum that survive correct statistical analysis in a large study population suggests that VBM might not be very sensitive for studying tinnitus.

  10. Tinnitus: from cortex to cochlea

    NARCIS (Netherlands)

    Geven, Leontien

    2014-01-01

    Het medische woord voor oorsuizen is tinnitus. Tinnitus is het waarnemen van geluid, waar geen bron voor is. Het kan dus alleen worden waargenomen door de persoon zelf en niet door anderen. De meeste volwassenen hebben wel eens last gehad van tijdelijke tinnitus. Tinnitus kan echter ook blijvend zij

  11. Pilot study to develop telehealth tinnitus management for persons with and without traumatic brain injury

    OpenAIRE

    James A. Henry, PhD; Tara L. Zaugg, AuD; Paula J. Myers, PhD; Caroline J. Schmidt, PhD; Susan Griest, MPH; Marcia W. Legro, PhD; Christine Kaelin, MBA; Emily J. Thielman, MS; Daniel M. Storzbach, PhD; Garnett P. McMillan, PhD;; Kathleen F. Carlson, PhD

    2012-01-01

    Tinnitus, or “ringing in the ears,” affects 10%-15% of adults; cases can be problematic and require lifelong management. Many people who have experienced traumatic brain injury (TBI) also experience tinnitus. We developed Progressive Tinnitus Management (PTM), which uses education and counseling to help patients learn how to self-manage their reactions to tinnitus. We adapted PTM by delivering the intervention via telephone and by adding cognitive-behavioral therapy. A pilot study was conduct...

  12. The Gap Detection Test : Can It Be Used to Diagnose Tinnitus?

    NARCIS (Netherlands)

    Boyen, Kris; Başkent, Deniz; van Dijk, Pim

    2015-01-01

    Objectives: Animals with induced tinnitus showed difficulties in detecting silent gaps in sounds, suggesting that the tinnitus percept may be filling the gap. The main purpose of this study was to evaluate the applicability of this approach to detect tinnitus in human patients. The authors first hyp

  13. 300例大学生主观性耳鸣患者临床表现分析%Clinical study of 300 patients with subjective tinnitus from collegians

    Institute of Scientific and Technical Information of China (English)

    孙麦青; 叶放蕾; 丁虹

    2012-01-01

    Objective:To explore the clinical and psychoaeoustic characteristics of tinnitus patients from university students. Melhod:The study included 300 tinnitus patients. All patients were interviewed by the same investigator and using the same questionnaire. Data were collected and analyzed. Result: Hearing loss was seen in 54. 3% of the patients. There was no correlation between tinnitus severity and tinnitus loudness(PX). 05). There was a significant relationship between high-pitched tinnitus and high-frequency SNHL(P<0. 01). In 86.0% of these patients, tinnitus had produced an adverse effect on their psychology and daily life. Conclusion:There is a significant relationship between high-pitched tinnitus and high-frequency SNHL. Tinnitus has an impact on the life of patients from the university students.%目的:探讨大学生主观性耳鸣患者的临床表现及心理声学特点.方法:以问卷调查的方法,收集300例大学生主观性耳鸣患者的基本信息,并进行纯音测听及耳鸣匹配检查,分析耳鸣的基本特征及其与各相关因素之间的关系.结果:耳鸣伴听力下降163例(54.3%),耳鸣匹配频率与听力下降频率有密切关系(P<0.01),耳鸣响度与严重度无明显相关性(P>0.05).耳鸣对86.0%的患者的心理及学习生活产生较明显影响.结论:耳鸣与听力损失最大的音频近似;耳鸣响度与严重程度无相关性.耳鸣对患者心理及学习生活产生了较大的影响,在临床工作中应特别注重心理和社会因素对其的影响.

  14. 突发性聋患者耳鸣程度的相关因素分析%Related factor analysis of the degree of tinnitus in sudden sensorineural hearing loss patients

    Institute of Scientific and Technical Information of China (English)

    陈平; 周津徽

    2013-01-01

    Objective: To provide the theory basis for clinical diagnosis, treatment and prognosis of sudden deafness patients, we detected the relative factors of degree of tinnitus of the patients with sudden deafness. Method: Prospective analysis was used to compare degree of tinnitus with sex, ears, age, degree of hearing lose, hearing curve type and curative effect of tinnitus and sudden deafness. Result: Tinnitus was detected in 87. 2% in the 70 patients who with sudden deafness, and the most and least degree of tinnitus patients was the degree 3(32. 9%) and the degree 5 and 6(0). The total effective rate of sudden deafness and tinnitus was 66. 2% and 71. 3%, respectively. The statistical analysis shown the degree of tinnitus was not related to sex. ears, age, degree of hear-ing lose, auditory curve type and curative effect of tinnitus and sudden deafness (P>0. 05). Conclusion: There was a high rate of tinnitus occurrence in sudden deafness patients, and the moderate degree predominated. The curative effect of tinnitus was better than sudden deafness. There was no relationship between the degree of tinnitus and sex, ears, age, degree of hearing lose, auditory curve type and curative effect of tinnitus and sudden deafness.%目的:探讨影响突发性聋患者耳鸣程度的相关因素,为突发性聋患者耳鸣的临床诊治及预后判断提供依据.方法:前瞻性分析比较70例(74耳)突发性聋伴耳鸣患者的耳鸣程度与性别、耳侧、年龄、听力损失程度、听力曲线类型、耳鸣疗效、突发性聋疗效的关系.结果:突发性聋患者耳鸣的发生率为87.2%,其中耳鸣响度为3级者最多(32.9%),5、6级最少(0).突发性聋的总有效率为66.2%,耳鸣的总有效率为74.3%.耳鸣程度与性别、耳侧、年龄、听力损失程度、听力曲线类型、耳鸣疗效、突发性聋疗效的关系均差异无统计学意义(均P>0.05).结论:突发性聋患者的耳鸣发生率较高,耳鸣以中等程度为

  15. Tinnitus and insomnia: is hyperarousal the common denominator?

    Science.gov (United States)

    Wallhäusser-Franke, Elisabeth; Schredl, Michael; Delb, Wolfgang

    2013-02-01

    Tinnitus is an auditory sensation that is generated by aberrant activation within the auditory system. Sleep disturbances are a frequent problem in the tinnitus population. They are known to worsen the distress caused by the tinnitus which in turn worsens sleep quality. Beyond that, disturbed sleep is a risk factor for mental health problems and distressing tinnitus is often associated with enhanced depressivity, anxiety, and somatic symptom severity. Moreover there is evidence that therapies which alleviate tinnitus-related distress have a positive influence on sleep quality and help interrupt this vicious cycle. This suggests that distressing tinnitus and insomnia may both be promoted by similar physiological mechanisms. One candidate mechanism is hyperarousal caused by enhanced activation of the sympathetic nervous system. There is increasing evidence for hyperarousal in insomnia patients, and animal models of tinnitus and insomnia show conspicuous similarities in the activation pattern of limbic and autonomous brain regions. In this article we review the evidence for this hypothesis which may have implications for therapeutic intervention in tinnitus patients with comorbid insomnia. PMID:22750224

  16. Bilateral dorsal cochlear nucleus lesions prevent acoustic-trauma induced tinnitus in an animal model.

    Science.gov (United States)

    Brozoski, Thomas Jeffrey; Wisner, Kurt W; Sybert, Lauren T; Bauer, Carol A

    2012-02-01

    Animal experiments suggest that chronic tinnitus ("ringing in the ears") may result from processes that overcompensate for lost afferent input. Abnormally elevated spontaneous neural activity has been found in the dorsal cochlear nucleus (DCN) of animals with psychophysical evidence of tinnitus. However, it has also been reported that DCN ablation fails to reduce established tinnitus. Since other auditory areas have been implicated in tinnitus, the role of the DCN is unresolved. The apparently conflicting electrophysiological and lesion data can be reconciled if the DCN serves as a necessary trigger zone rather than a chronic generator of tinnitus. The present experiment used lesion procedures identical to those that failed to decrease pre-existing tinnitus. The exception was that lesions were done prior to tinnitus induction. Young adult rats were trained and tested using a psychophysical procedure shown to detect tinnitus. Tinnitus was induced by a single unilateral high-level noise exposure. Consistent with the trigger hypothesis, bilateral dorsal DCN lesions made before high-level noise exposure prevented the development of tinnitus. A protective effect stemming from disruption of the afferent pathway could not explain the outcome because unilateral lesions ipsilateral to the noise exposure did not prevent tinnitus and unilateral lesions contralateral to the noise exposure actually exacerbated the tinnitus. The DCN trigger mechanism may involve plastic circuits that, through loss of inhibition, or upregulation of excitation, increase spontaneous neural output to rostral areas such as the inferior colliculus. The increased drive could produce persistent pathological changes in the rostral areas, such as high-frequency bursting and decreased interspike variance, that comprise the chronic tinnitus signal. PMID:21969021

  17. Neural substrates predicting short-term improvement of tinnitus loudness and distress after modified tinnitus retraining therapy.

    Science.gov (United States)

    Kim, Shin Hye; Jang, Ji Hye; Lee, Sang-Yeon; Han, Jae Joon; Koo, Ja-Won; Vanneste, Sven; De Ridder, Dirk; Song, Jae-Jin

    2016-01-01

    Although tinnitus retraining therapy (TRT) is efficacious in most patients, the exact mechanism is unclear and no predictor of improvement is available. We correlated the extent of improvement with pre-TRT quantitative electroencephalography (qEEG) findings to identify neural predictors of improvement after TRT. Thirty-two patients with debilitating tinnitus were prospectively enrolled, and qEEG data were recorded before their initial TRT sessions. Three months later, these qEEG findings were correlated with the percentage improvements in the Tinnitus Handicap Inventory (THI) scores, and numeric rating scale (NRS) scores of tinnitus loudness and tinnitus perception. The THI score improvement was positively correlated with the pre-treatment activities of the left insula and the left rostral and pregenual anterior cingulate cortices (rACC/pgACC), which control parasympathetic activity. Additionally, the activities of the right auditory cortices and the parahippocampus, areas that generate tinnitus, negatively correlated with improvements in loudness. Improvements in the NRS scores of tinnitus perception correlated positively with the pre-TRT activities of the bilateral rACC/pgACC, areas suggested to form the core of the noise-canceling system. The current study supports both the classical neurophysiological and integrative models of tinnitus; our results serve as a milestone in the development of precision medicine in the context of TRT. PMID:27381994

  18. Conversations with chronic schizophrenic patients.

    Science.gov (United States)

    Morgan, R

    1979-02-01

    An account is given of some of the topics discussed during a small informal weekly open group meeting of chronic schizophrenic patients, based on occasional notes compiled over eleven years. The main feature of the patients' condition as displayed was poverty--clinical, social, behavioural, material and financial--and certain features suggested an organic aetiology. Reasons are given for considering that the patients' condition was predominantly caused by schizophrenia rather than by institutionalism.

  19. Efeito da acupuntura sobre as emissões otoacústicas de pacientes com zumbido Impact of acupuncture on otoacoustic emissions in patients with tinnitus

    Directory of Open Access Journals (Sweden)

    Renata Frasson de Azevedo

    2007-10-01

    Full Text Available O tratamento do zumbido continua a ser um desafio da atualidade. Na medicina tradicional chinesa, a acupuntura é recomendada para o alívio do zumbido, apesar de faltarem provas cientificas nesta área. OBJETIVO: Verificar o efeito da acupuntura sobre a função coclear de indivíduos com zumbido através do uso das emissões otoacústicas. CASUÍSTICA E MÉTODO: Foi realizado um estudo clínico-prospectivo, no qual foram avaliados 38 pacientes do ambulatório de zumbido. Os pacientes foram avaliados por meio de emissões otoacústicas transitórias e pela medida da supressão das emissões otoacústicas transitórias. Essa avaliação foi realizada antes e após a aplicação de acupuntura em um ponto na região têmporo-parietal, correspondente à área cócleo-vestibular (no grupo intervenção 1 n=19 e em um ponto 3cm acima dessa região (para o grupo intervenção 2 n=19. RESULTADOS: Os resultados mostraram uma diferença estatisticamente significante na amplitude das emissões otoacústicas antes e após a aplicação da acupuntura para o grupo intervenção 1. Não foram observadas diferenças para o grupo intervenção 2. CONCLUSÃO: Os resultados sugerem que houve um efeito da acupuntura sobre as emissões otoacústicas dos pacientes com zumbido.The treatment of tinnitus is still a challenge. Acupuncture is recommended for the relief of tinnitus in traditional Chinese Medicine, although scientific evidence is lacking. AIM: The aim of this study was to assess the effect of acupuncture on the cochlear function in patients with tinnitus by analyzing otoacoustic emissions. METHODS: Thirty eight patients with tinnitus were included in the prospective clinical study. Measures of transitory otoacoustic emissions and suppression of otoacoustic emissions were obtained from all subjects before and after acupuncture. Patients were assigned to one of two groups: intervention group 1 (n=19, in which needle acupuncture was applied at the

  20. Tinnitus intensity dependent gamma oscillations of the contralateral auditory cortex.

    Directory of Open Access Journals (Sweden)

    Elsa van der Loo

    Full Text Available BACKGROUND: Non-pulsatile tinnitus is considered a subjective auditory phantom phenomenon present in 10 to 15% of the population. Tinnitus as a phantom phenomenon is related to hyperactivity and reorganization of the auditory cortex. Magnetoencephalography studies demonstrate a correlation between gamma band activity in the contralateral auditory cortex and the presence of tinnitus. The present study aims to investigate the relation between objective gamma-band activity in the contralateral auditory cortex and subjective tinnitus loudness scores. METHODS AND FINDINGS: In unilateral tinnitus patients (N = 15; 10 right, 5 left source analysis of resting state electroencephalographic gamma band oscillations shows a strong positive correlation with Visual Analogue Scale loudness scores in the contralateral auditory cortex (max r = 0.73, p<0.05. CONCLUSION: Auditory phantom percepts thus show similar sound level dependent activation of the contralateral auditory cortex as observed in normal audition. In view of recent consciousness models and tinnitus network models these results suggest tinnitus loudness is coded by gamma band activity in the contralateral auditory cortex but might not, by itself, be responsible for tinnitus perception.

  1. Fibromyalgia syndrome in chronic urticaria patients

    OpenAIRE

    Aylin Gözübüyükoğulları; Duru Tabanlıoğlu Onan; Nuran Allı

    2014-01-01

    Background and Design: The aim of our study was to determine the frequency of fibromyalgia syndrome in chronic urticaria patients. Materials and Methods: The study was carried out with the participation of 100 chronic urticaria patients and 61 control group patients. Chronic urticaria patients were investigated for the etiology of urticaria and the autologous serum skin test was performed in those patients. Both the chronic urticaria patients and the controls were evaluated for fibromyalgi...

  2. Characteristics and Spontaneous Recovery of Tinnitus Related to Idiopathic Sudden Sensorineural Hearing Loss

    Science.gov (United States)

    Mühlmeier, Guido; Baguley, David; Cox, Tony; Suckfüll, Markus; Meyer, Thomas

    2016-01-01

    Objective: To evaluate the characteristics and spontaneous recovery of tinnitus related to idiopathic sudden sensorineural hearing loss (ISSNHL). Study Design: Retrospective analysis from two randomized placebo-controlled clinical trials for treatment of ISSNHL within 48 hours from onset (Study A), or of tinnitus related to ISSNHL within 3 months from onset (Study B). Setting: Forty-eight European sites (academic tertiary referral centers, private ENT practices). Patients: One hundred thirteen adult patients of which 65 with hearing loss ≥30 dB (Study A) and 48 with persistent acute tinnitus (Study B) at baseline. Interventions: Intratympanic (i.t.) injection of placebo gel in single dose or in triple dose during 3 consecutive days. Main Outcome Measures: Frequency of tinnitus, subjective tinnitus loudness, rates of complete tinnitus remission, and complete hearing recovery during 3 months follow-up. Results: In acute ISSNHL, tinnitus loudness decreased rapidly in cases of mild-moderate hearing loss, and tinnitus had completely resolved in two-thirds of patients after 3 months. Hearing recovery preceded tinnitus resolution. When associated with severe-profound hearing loss, tinnitus improved significantly less. Complete hearing recovery and full tinnitus remission were both about three times more frequent in mild-moderate hearing loss patients than in severe-profound cases. Improvement in tinnitus loudness over time can be approximated by a negative exponential function. Conclusions: Prognosis for ISSNHL-related tinnitus is relatively poor in case of severe-profound hearing loss and the longer it has persisted. Alleviation or management of tinnitus should be a key therapeutic objective especially in pronounced ISSNHL cases. PMID:27228021

  3. Resting-state functional connectivity density mapping of etiology confirmed unilateral pulsatile tinnitus patients: Altered functional hubs in the early stage of disease.

    Science.gov (United States)

    Han, L; Pengfei, Z; Zhaohui, L; Fei, Y; Ting, L; Cheng, D; Zhenchang, W

    2015-12-01

    Functional magnetic resonance imaging (fMRI) has been widely used to identify altered intrinsic local neural activities and global networks of tinnitus patients. In this study, functional connectivity density (FCD) mapping, a newly developed voxelwise data-driven method based on fMRI, was applied for the first time to measure the functional reorganization pattern in thirty-two unilateral pulsatile tinnitus (PT) patients in the early stage of disease (less than 48 months). FCD analysis was employed to compute short-range and long-range FCD values. A correlation analysis with clinical variables was also performed. Compared with normal controls, PT patients showed significantly increased short-range FCD, mainly in the precuneus (PCu), bilateral inferior frontal gyrus (IFG) and middle occipital gyrus (MOG), and increased long-range FCD in the PCu, posterior cingulate cortex (PCC), and bilateral middle frontal gyrus (MFG). In addition, correlation analysis showed positive correlations between PT duration and short-range FCD values in the right MOG. Positive correlations were also found between the disease duration and the long-range FCD value in the PCC. The increased short-/long-range FCD in bilateral dorsal visual areas indicated that the enhanced pathway between the auditory cortex and bilateral dorsal visual areas may have activated the "auditory occipital activations" (AOAs) pathway. The bilaterally altered FCD values in the dorsal visual areas reflected the cooperation of different brain areas. This study is a foundation of the connectivity research in PT patients. Our work may advance the understanding of the disrupted neural network of patients with PT. PMID:26384961

  4. Differential pathologies resulting from sound exposure: Tinnitus vs hearing loss

    Science.gov (United States)

    Longenecker, Ryan James

    The first step in identifying the mechanism(s) responsible for tinnitus development would be to discover a neural correlate that is differentially expressed in tinnitus-positive compared to tinnitus negative animals. Previous research has identified several neural correlates of tinnitus in animals that have tested positive for tinnitus. However it is unknown whether all or some of these correlates are linked to tinnitus or if they are a byproduct of hearing loss, a common outcome of tinnitus induction. Abnormally high spontaneous activity has frequently been linked to tinnitus. However, while some studies demonstrate that hyperactivity positively correlates with behavioral evidence of tinnitus, others show that when all animals develop hyperactivity to sound exposure, not all exposed animals show evidence of tinnitus. My working hypothesis is that certain aspects of hyperactivity are linked to tinnitus while other aspects are linked to hearing loss. The first specific aim utilized the gap induced prepulse inhibition of the acoustic startle reflex (GIPAS) to monitor the development of tinnitus in CBA/CaJ mice during one year following sound exposure. Immediately after sound exposure, GIPAS testing revealed widespread gap detection deficits across all frequencies, which was likely due to temporary threshold shifts. However, three months after sound exposure these deficits were limited to a narrow frequency band and were consistently detected up to one year after exposure. This suggests the development of chronic tinnitus is a long lasting and highly dynamic process. The second specific aim assessed hearing loss in sound exposed mice using several techniques. Acoustic brainstem responses recorded initially after sound exposure reveal large magnitude deficits in all exposed mice. However, at the three month period, thresholds return to control levels in all mice suggesting that ABRs are not a reliable tool for assessing permanent hearing loss. Input/output functions of

  5. Structural neuroanatomy of tinnitus and hyperacusis in semantic dementia

    OpenAIRE

    C.J. Mahoney; Rohrer, J.D.; Goll, J. C.; Fox, N C.; Rossor, M.N.; Warren, J D.

    2011-01-01

    Introduction Tinnitus and hyperacusis are common symptoms of excessive auditory perception in the general population; however, their anatomical substrates and disease associations continue to be defined. Patients with semantic dementia (SemD) frequently report tinnitus and hyperacusis but the significance and basis for these symptoms have not been elucidated. Methods 43 patients with a diagnosis of SemD attending a specialist cognitive disorders clinic were retrospectively studied. 14 patient...

  6. 伴感音神经性聋的耳鸣患者临床表现及心理声学特点%Clinical and psychoacoustic characteristics of tinnitus patients with sensorineural hearing loss

    Institute of Scientific and Technical Information of China (English)

    陈秀兰; 秦兆冰

    2011-01-01

    OBJECTIVE To investigate the clinical and psychoacoustic characteristics of tinnitus patients with sensorineural hearing loss, the characteristics of tinnitus were identified in order to facilitate their further management.METHODS One hundred and fifty seven tinnitus sufferers were studied. All the patients were interviewed by the same investigator, using the same questionnaire. Data were collected and analyzed. RESULTS There was a slight predominance of males. The hearing impairment results were limited to the high frequencies in 53.50% of the patients, pitchmatching was limited to high frequencies in 70.70% of the patients with sensorineural hearing loss (SNHL), while 94.05%of the patients with high-frequency SNHL had a high-pitched tinnitus. CONCLUSION There is a significant relationship between high-pitched tinnitus and high-frequency SNHL.There is no significant correlation between tinnitus severity and tinnitus loudness.%目的 通过对157例伴感音神经性聋的主观性耳鸣患者分析,了解耳鸣的临床表现和心理声学特点,为耳鸣诊治提供科学依据.方法 采集157例伴感音神经性聋的主观性耳鸣患者的基本信息、既往史、临床表现、听力学及耳鸣检测结果资料,分析耳鸣的临床特点及各因素与耳鸣之间的关系.结果 157例患者男女比为1.6:1,听力下降以高频为主(53.50%),耳鸣大多数是高调蝉鸣样声音,耳鸣匹配的频率与纯音听阈升高最大的频率关系密切.结论 伴感音神经性聋的耳鸣患者中,以高调耳鸣为主,耳鸣匹配声音类型以纯音居多,耳鸣与听力损失最大的音频近似;耳鸣的响度与耳鸣的严重程度无相关性.

  7. Pre-Treatment Objective Diagnosis and Post-Treatment Outcome Evaluation in Patients with Vascular Pulsatile Tinnitus Using Transcanal Recording and Spectro-Temporal Analysis

    Science.gov (United States)

    Choi, Inyong; Koo, Ja-Won; Lee, Kyogu

    2016-01-01

    Objective Although vascular pulsatile tinnitus (VPT) has been classified as “objective”, VPT is not easily recognizable or documentable in most cases. In response to this, we have developed transcanal sound recording (TSR) and spectro-temporal analysis (STA) for the objective diagnosis of VPT. By refining our initial method, we were able to apply TSR/STA to post-treatment outcome evaluation, as well as pre-treatment objective diagnosis. Methods TSR was performed on seven VPT patients and five normal controls before and after surgical or interventional treatment. VPT was recorded using an inserted microphone with the subjects placed in both upright and supine positions with 1) a neutral head position, 2) head rotated to the tinnitus side, 3) head rotated to the non-tinnitus side, and 4) a neutral position with ipsi-lesional manual cervical compression. The recorded signals were analyzed in both time and time-frequency domains by performing a short-time Fourier transformation. Results The pre-treatment ear canal signals of all VPT patients demonstrated pulse-synchronous periodic structures and acoustic characteristics that were representative of their presumptive vascular pathologies, whereas those the controls exhibited smaller peaks and weak periodicities. Compared with the pre-treatment signals, the post-treatment signals exhibited significantly reduced peak- and root mean square amplitudes upon time domain analysis. Additionally, further sub-band analysis confirmed that the pulse-synchronous signal of all subjects was not identifiable after treatment and, in particular, that the signal decrement was statistically significant at low frequencies. Moreover, the post-treatment signals of the VPT subjects revealed no significant differences when compared to those of the control group. Conclusion We reconfirmed that the TSR/STA method is an effective modality to objectify VPT. In addition, the potential role of the TSR/STA method in the objective evaluation of

  8. Tinnitus is associated with reduced sound level tolerance in adolescents with normal audiograms and otoacoustic emissions

    Science.gov (United States)

    Sanchez, Tanit Ganz; Moraes, Fernanda; Casseb, Juliana; Cota, Jaci; Freire, Katya; Roberts, Larry E.

    2016-01-01

    Recent neuroscience research suggests that tinnitus may reflect synaptic loss in the cochlea that does not express in the audiogram but leads to neural changes in auditory pathways that reduce sound level tolerance (SLT). Adolescents (N = 170) completed a questionnaire addressing their prior experience with tinnitus, potentially risky listening habits, and sensitivity to ordinary sounds, followed by psychoacoustic measurements in a sound booth. Among all adolescents 54.7% reported by questionnaire that they had previously experienced tinnitus, while 28.8% heard tinnitus in the booth. Psychoacoustic properties of tinnitus measured in the sound booth corresponded with those of chronic adult tinnitus sufferers. Neither hearing thresholds (≤15 dB HL to 16 kHz) nor otoacoustic emissions discriminated between adolescents reporting or not reporting tinnitus in the sound booth, but loudness discomfort levels (a psychoacoustic measure of SLT) did so, averaging 11.3 dB lower in adolescents experiencing tinnitus in the acoustic chamber. Although risky listening habits were near universal, the teenagers experiencing tinnitus and reduced SLT tended to be more protective of their hearing. Tinnitus and reduced SLT could be early indications of a vulnerability to hidden synaptic injury that is prevalent among adolescents and expressed following exposure to high level environmental sounds. PMID:27265722

  9. Análise da correlação entre limiares auditivos, questionários validados e medidas psicoacústicas em pacientes com zumbido Correlation analysis of hearing thresholds, validated questionnaires and psychoacoustic measurements in tinnitus patients

    Directory of Open Access Journals (Sweden)

    Ricardo Rodrigues Figueiredo

    2010-08-01

    Full Text Available Uma das principais dificuldades nos estudos clínicos sobre zumbido reside na falta de consenso sobre os métodos de mensuração. OBJETIVO: Avaliar a correlação entre os limiares audiométricos, pitch matching (PM, minimum masking level (MML, Tinnitus Handicap Inventory (THI e o Inventário de Depressão de Beck (BDI em pacientes com zumbido. MODELO DE ESTUDO: Prospectivo, coorte transversal. MATERIAL E MÉTODO: 48 pacientes com zumbido como queixa principal foram submetidos aos testes audiométricos e questionários acima descritos. Os dados foram comparados estatisticamente para as correlações entre os métodos. RESULTADOS: Não houve correlação estatisticamente significativa entre o THI e MML, tanto em pacientes com BDI acima e abaixo de 14 pontos, bem como entre a frequência de pior limiar auditivo e o Pitch matching e entre a frequência de "cut-off" e o PM nos pacientes com curvas descendentes em rampa. CONCLUSÕES: Não existe correlação estatisticamente significativa entre as medidas psicoacústicas do zumbido, os limiares audiométricos e os questionários de avaliação. O zumbido é um sintoma muito complexo e avaliações isoladas pelos métodos acima não são satisfatórias.One of the most criticized points in tinnitus clinical studies arise from the lack of consensus about measurement methods. AIM: To evaluate the correlation between audiometric thresholds, pitch matching (PM, minimum masking level (MML, Tinnitus Handicap Inventory (THI and the Beck Depression Inventory (BDI in tinnitus patients. STUDY DESIGN: Prospective, cross-sectional. MATERIALS AND METHODS: Subjects were submitted to tonal audiometry, PM and MML for tinnitus. They also filled out the THI and BDI. Data was statistically compared for correlation purposes between audiometric thresholds, psycho-acoustic measures and questionnaires. RESULTS: There was no statistically significant correlation between THI and MML, both in patients with BDI scores under and

  10. Therapeutic impact of repetitive transcranial magnetic stimulation (rTMS) on tinnitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Soleimani, Robabeh; Jalali, Mir Mohammad; Hasandokht, Tolou

    2016-07-01

    In this study, we conducted a systematic literature review and meta-analysis on the effect of repetitive transcranial magnetic stimulation (rTMS) compared with sham in chronic tinnitus patients. We searched databases, from their onset up to August 2014, for randomized controlled trials (RCT) in English that assessed the effectiveness of rTMS for chronic tinnitus. RCTs were selected according to inclusion/exclusion criteria before data were extracted. For the meta-analysis weighted mean differences (and standard deviations) of Tinnitus Questionnaire (TQ) and Tinnitus Handicap Inventory (THI) scores were determined. Therapeutic success was defined as difference of at least 7 points in the THI score between baseline and the follow-up assessment after treatment. The odds ratio (OR) for this variable was assessed. Results from 15 RCTs were analyzed. The mean difference for TQ score at 1 week after intervention was 3.42. For THI, the data of mean difference score in two groups, 1 and 6 month after intervention, was 6.71 and 12.89, respectively. The all comparisons indicated a significant medium to large effect size in follow-up which is in favor of the rTMS. The pooled OR of therapeutic success of the studies which used THI at 1 month after intervention was 15.75. These data underscore the clinical effect of rTMS in the treatment of tinnitus. However, there is high variability of studies design and reported outcomes. Replication of data in multicenter trials with a large number of patients and long-term follow-up is needed before further conclusions can be drawn. PMID:25968009

  11. The study of cochlear outer hair cells function in normally hearing patients with tinnitus%听力正常的耳鸣患者的耳蜗外毛细胞功能研究

    Institute of Scientific and Technical Information of China (English)

    刁明芳; 孙建军; 田芳洁; 贾仲红; 刘阳; 陈东兰

    2012-01-01

    目的 用畸变产物耳声发射(distortion product evoked oto-acoustic emissions,DPOAE)检测听力正常耳鸣患者的耳蜗外毛细胞(outer hair cell,OHC)功能.方法 选取门诊50例听力正常(250~8000Hz)伴有耳鸣的患者,对照组选取年龄性别匹配的听力正常无耳鸣的志愿者.比较两组受试者的DPOAE幅值.结果 与对照组相比,耳鸣组DPOAE幅值降低,在高频(4~8kHz)的幅值差异有显著性(P<0.05).结论 DPOAE幅值下降与听力正常患者的耳鸣产生有关,耳蜗OHC功能受损可能是耳鸣的来源.%Objective To compare cochlear outer hair cells functionin normally hearing patients with and without tinnitus based on distortion product otoacoustic emission(DPOAE). Methods Fifty tinnitus patients with normal hearing in the frequency range between 250 to 8000 Hz were selected as a study group. The control group consisted of 50 otologically normal subjects who have normal hearing threshold levels without tinnitus and were selected to match the study group by age and gender. DPOAE-grams of tinnitus group were compared with theose of control group. Results Tinnitus ears exhibited relatively decrease amplitudes of DPOAE when compared with the group of healthy ears .Statistically significant (P< 0.05) decrease mean values of DPOAE amplitudes were observed at a frequency of 4-8kHz. Conclusions There is an association between tinnitus and reduced distortion product otoacoustic emission amplitudes. The reduced cochlear outer hair cells function may be the source of tinnitus.

  12. Tinnitus and cell phones: the role of electromagnetic radiofrequency radiation

    Directory of Open Access Journals (Sweden)

    Luisa Nascimento Medeiros

    2016-02-01

    Full Text Available ABSTRACT INTRODUCTION: Tinnitus is a multifactorial condition and its prevalence has increased on the past decades. The worldwide progressive increase of the use of cell phones has exposed the peripheral auditory pathways to a higher dose of electromagnetic radiofrequency radiation (EMRFR. Some tinnitus patients report that the abusive use of mobiles, especially when repeated in the same ear, might worsen ipsilateral tinnitus. OBJECTIVE: The aim of this study was to evaluate the available evidence about the possible causal association between tinnitus and exposure to electromagnetic waves. METHODS: A literature review was performed searching for the following keywords: tinnitus, electromagnetic field, mobile phones, radio frequency, and electromagnetic hypersensitivity. We selected 165 articles that were considered clinically relevant in at least one of the subjects. RESULTS: EMRFR can penetrate exposed tissues and safety exposure levels have been established. These waves provoke proved thermogenic effects and potential biological and genotoxic effects. Some individuals are more sensitive to electromagnetic exposure (electrosensitivity, and thus, present earlier symptoms. There may be a common pathophysiology between this electrosensitivity and tinnitus. CONCLUSION: There are already reasonable evidences to suggest caution for using mobile phones to prevent auditory damage and the onset or worsening of tinnitus.

  13. 耳鸣对患者日常影响调查及耳鸣活动问卷的信度检验%Investigation of the influence of tinnitus to patients in their daily life and the reliability test of tinnitus activity questionnaire

    Institute of Scientific and Technical Information of China (English)

    潘滔; Richard Tyler; 宋昱; 王宇; 柯嘉; 马芙蓉

    2011-01-01

    OBJECTIVE To investigate the influence of tinnitus on daily life activities and to provide reference for individualized tinnitus counseling. To determine the reliability of Tinnitus Activity Questionnaire (TAQ) .METHODS 195 tinnitus patients who were seen in our ENT clinics from 2008 to 2010 and whose tinnitus lasted longer than 3 months were administered the TAQ. Factor analysis was used to explore the relationship among questions on the TAQ. RESULTS The average scores for the four subscales of the TAQ were: emotion 47, attention 27, hearing 28, and sleeping 32. Thus, the largest complaints was on emotion. Factors analysis found 4 factors which explained the percentage of variance 47.2%, 11.9%, 6.3%, 5.2% respectively. The accumulation of the total variance was 70.5%. The results of factor analysis were close to the original subscales of the questionnaire, but not perfect. CONCLUSION The influence of tinnitus to daily life included attention, sleeping, hearing and emotion. Emotional problem was the largest concern. The tinnitus counseling should focus on this area. Factor analysis showed that the reliability of the TAQ was good.%目的 调查耳鸣对患者日常影响,为耳鸣咨询提供参考和依据.检验耳鸣活动问卷(tinnitus activity questionnaire,TAQ)的可信度(reliability),为TAQ的应用提供依据.方法 我院2008~2010年门诊耳鸣患者,耳鸣持续时间长于3个月者195例接受TAQ调查,以了解耳鸣对患者日常生活的影响.对195例耳鸣患者的耳鸣活动问卷进行因子分析(factor analysis).结果 耳鸣对患者的影响包括:TAQ得分:情绪状况47,注意力27,听力28,睡眠32.情绪状态是耳鸣对患者影响的最主要方面.对TAQ问卷因子分析的结果得出4个因子:分别解释的变异百分比为47.2%、11.9%、6.3%、5.2%,累计解释总体变异70.5%.因子分析的结果比较接近问卷设计的注意力、睡眠、听力、情绪4个方面,但是符合性并不完善.结论

  14. 利多卡因-氯硝西泮联合治疗耳鸣13例分析%Clinical Analysis of Lidocaine Combined with Clonazepam in Treating 13 Patients with Tinnitus

    Institute of Scientific and Technical Information of China (English)

    吴天宇

    2015-01-01

    Objective To analyze and explore the lidocaine- clonazepam joint clinical treatment methods and treatment ef ect for the treatment of tinnitus. Methods 13 patients randomly selected in from January 2014 to December 2014 in our hospital for patients with tinnitus treatment, wil be randomly divided into two groups,Control group were treated by conventional methods tinnitus treatment in the form of the experimental group patients in the conventional treatment for the patients on the basis of intravenous lidocaine-input glucose injection, oral clonazepam treatment. Results:the patients' hearing recovery, tinnitus symptoms improve conditions are bet er than the control group, control group patients with tinnitus recovery is more than the experimental group. Conclusion lidocaine-clonazepam joint is ef ective in the treatment of tinnitus and treatment ef ect is good, is worth popularizing in each big hospital in clinical practice.%目的:分析与探究利多卡因-氯硝西泮联合治疗耳鸣的临床治疗方法与治疗效果。方法随机选出13例于2014年1月~12月在我:进行耳鸣治疗的患者,将其随机分为两组。对照组患者采用常规方式方式进行耳鸣治疗,实验组患者在常规方式治疗的基础上为患者进行静脉输入利多卡因-葡萄糖注射液,口服氯硝西泮进行治疗。结果实验组患者听力恢复情况、耳鸣症状改善情况均好于对照组,对照组患者耳鸣恢复用时多于实验组。结论利多卡因-氯硝西泮联合能有效治疗耳鸣且治疗效果较好,值得在各大医:的临床实践中推广。

  15. The relationship between tinnitus pitch and the audiogram.

    Science.gov (United States)

    Pan, Tao; Tyler, Richard S; Ji, Haihong; Coelho, Claudia; Gehringer, Anne K; Gogel, Stephanie A

    2009-05-01

    We studied the relationship between tinnitus pitch and the audiogram in 195 patients. Patients with tone-like tinnitus reported a higher pitch (mean = 5385 Hz) compared to those with a noise-like quality (mean = 3266 Hz). Those with a flat audiogram were more likely to report: a noise-like tinnitus, a unilateral tinnitus, and have a pitch or=8000 Hz. We failed to find a relationship between the pitch and the edge of a high frequency hearing loss. Some individuals did exhibit a pitch at the low frequency edge of a hearing loss, but we could find no similar characteristics among these subjects. It is possible that a relationship between pitch and audiogram is present only in certain subgroups. PMID:19842803

  16. Permanent Sensorineural Deafness in a Patient with Chronic Myelogenous Leukemia Secondary to Intracranial Hemorrhage

    Directory of Open Access Journals (Sweden)

    Sakshi Kapur

    2013-01-01

    Full Text Available A 52-year-old male presented with tinnitus and fullness in left ear for one day. Workup revealed a white blood cell count of 685×103/μL with marked increase in granulocyte series and myeloid precursors on peripheral smear. The initial impression was chronic myelogenous leukemia with hyperleukocytosis, and patient was started on hydration, hydroxyurea, and allopurinol. Patient tolerated bone marrow biopsy well but continued to bleed excessively from the biopsy site. Results confirmed Philadelphia chromosome positive chronic myelogenous leukemia (chronic phase. On day three of hospitalization, patient developed sudden slurred speech along with shaking movements involving extremities. Magnetic resonance imaging revealed multiple hemorrhages throughout the brain. Hydroxyurea was continued until insurance coverage for nilotinib was getting approved. On day nine of hospitalization, patient developed sudden bilateral sensorineural deafness. Repeat magnetic resonance imaging revealed multiple new hemorrhages throughout the brain. Computer tomography of the temporal bones showed inflammatory changes in right and left mastoid cells. Nilotinib was started on day eleven of hospitalization. Patient’s white blood cell count continued to decrease, but there was no improvement in hearing. Four months later, patient was treated with bilateral transmastoid cochlear implants. This case highlights permanent deafness as a hemorrhagic complication secondary to chronic myelogenous leukemia.

  17. Is the effect of tinnitus on auditory steady-state response amplitude mediated by attention?

    Directory of Open Access Journals (Sweden)

    Eugen eDiesch

    2012-05-01

    Full Text Available Objectives: The amplitude of the auditory steady-state response (ASSR is enhanced in tinnitus. As ASSR ampli¬tude is also enhanced by attention, the effect of tinnitus on ASSR amplitude could be interpreted as an effect of attention mediated by tinnitus. As attention effects on the N1 are signi¬fi¬cantly larger than those on the ASSR, if the effect of tinnitus on ASSR amplitude were due to attention, there should be similar amplitude enhancement effects in tinnitus for the N1 component of the auditory evoked response. Methods: MEG recordings of auditory evoked responses which were previously examined for the ASSR (Diesch et al. 2010 were analysed with respect to the N1m component. Like the ASSR previously, the N1m was analysed in the source domain (source space projection. Stimuli were amplitude-modulated tones with one of three carrier fre¬quen¬cies matching the tinnitus frequency or a surrogate frequency 1½ octaves above the audio¬metric edge frequency in con¬trols, the audiometric edge frequency, and a frequency below the audio¬metric edgeResults: In the earlier ASSR study (Diesch et al., 2010, the ASSR amplitude in tinnitus patients, but not in controls, was significantly larger in the (surrogate tinnitus condition than in the edge condition. In the present study, both tinnitus patients and healthy controls show an N1m-amplitude profile identical to the one of ASSR amplitudes in healthy controls. N1m amplitudes elicited by tonal frequencies located at the audiometric edge and at the (surrogate tinnitus frequency are smaller than N1m amplitudes elicited by sub-edge tones and do not differ among each other.Conclusions: There is no N1-amplitude enhancement effect in tinnitus. The enhancement effect of tinnitus on ASSR amplitude cannot be accounted for in terms of attention induced by tinnitus.

  18. An Adaptation Level Theory of Tinnitus Audibility

    OpenAIRE

    Grant eSearchfield; Kei eKobayashi; Michael eSanders

    2012-01-01

    Models of tinnitus suggest roles for auditory, attention, and emotional networks in tinnitus perception. A model of tinnitus audibility based on Helson’s (1964) adaptation level theory (ALT) is hypothesized to explain the relationship between tinnitus audibility, personality, memory, and attention. This theory attempts to describe how tinnitus audibility or detectability might change with experience and context. The basis of ALT and potential role of auditory scene analysis in tinnitus percep...

  19. 新疆维吾尔族耳鸣掩蔽曲线与掩蔽治疗效果的观察%Observation of Tinnitus Masking Curves and Effect of Masking Treatment in Uygur' s Patients

    Institute of Scientific and Technical Information of China (English)

    张伦; 丁伟; 余勐

    2011-01-01

    目的 观察维吾尔族耳鸣患者听力图及掩蔽曲线,探讨治疗效果及其相关性.方法 对105例(118耳)耳鸣为主诉的维吾尔族患者进行纯音测试,根据听力图分为正常听力(32耳)、轻度听力损失(24耳)、中度听力损失( 39耳)、重度听力损失(17耳)、极重度听力损失(6耳)5组.纳入对象均为维吾尔族耳鸣患者.按照弗德曼掩蔽曲线不同分别进行耳鸣测试及掩蔽治疗.结果105例(118耳)患者中,正常听力、轻度、中度听力损失组中耳鸣掩蔽曲线以重叠型为主;重度听力损失中耳鸣掩蔽曲线以间距为主.在所有病例中以重叠型和汇聚型居多.残余抑制试验在轻、中度听力损失组中均以重叠型阳性率高,与其他类型比较差异有统计学意义(P<0.05).结论 在耳鸣患者中存在心理焦虑的较多.因此心理暗示治疗和习服治疗尤为关键.耳鸣曲线的掩蔽不同所得到的后效抑制结果和耳鸣掩蔽治疗结果也不同.%Objective To analyze the audiogram and masking audiogram curve Uygur' s patients with tinnitus, and to evaluate the effect of masking treatment. Methods The pure tone test were performed in 105 Uygur patients(118 ears) with tinnitus. Based on the audiogram,all patients were divided into five groups:normal hearing(32 ears) ,mild hearing loss(24 ears) .moderate hearing loss(39 ears) .severe hearing Ioss( 17 ears) and extreme hearing loss(6 ears). The tinnitus test or masking treatment was chose according to Feldmann masking curves. Results In normal hearing,mild,moderate hearing loss group,overlapping tinnitus masking curve was the major part. In severe hearing loss group,the spacing tinnitus masking curve was the major part. In all cases, the overlapping and convergent was the major part. By taking residual inhibition test, the positive rate of overlapping tinnitus masking curve in mild and moderate hearing loss group was high,and the difference was

  20. Chronic constipation in hemiplegic patients

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To assess the prevalence of bowel dysfunction in hemiplegic patients, and its relationship with the site of neurological lesion, physical immobilization and pharmacotherapy.METHODS: Ninety consecutive hemiplegic patients and 81 consecutive orthopedic patients were investigated during physical motor rehabilitation in the same period, in the same center and on the same diet. All subjects were interviewed ≥ 3 mo after injury using a questionnaire inquiring about bowel habits before injury and at the time of the interview. Patients' mobility was evaluated by the Adapted Patient Evaluation Conference System. Drugs considered for the analysis were nitrates, angiogenic converting enzyme (ACE) inhibitors,calcium antagonists, anticoagulants, antithrombotics,antidepressants, anti-epileptics.RESULTS: Mobility scores were similar in the two groups. De novo constipation (OR = 5.36) was a frequent outcome of the neurological accident.Hemiplegics showed an increased risk of straining at stool (OR: 4.33), reduced call to evacuate (OR: 4.13),sensation of incomplete evacuation (OR: 3.69), use of laxatives (OR: 3.75). Logistic regression model showed that constipation was significantly and independently associated with hemiplegia. A positive association was found between constipation and use of nitrates and antithrombotics in both groups. Constipation was not related to the site of brain injury.CONCLUSION: Chronic constipation is a possible outcome of cerebrovascular accidents occurring in 30% of neurologically stabilized hemiplegic patients.Its onset after a cerebrovascular accident appears to be independent from the injured brain hemisphere,and unrelated to physical inactivity. Pharmacological treatment with nitrates and antithrombotics may represent an independent risk factor for developing chronic constipation.

  1. Tinnitus: A Large VBM-EEG Correlational Study

    OpenAIRE

    Vanneste, Sven; Van De Heyning, Paul; De Ridder, Dirk

    2015-01-01

    A surprising fact in voxel-based morphometry (VBM) studies performed in tinnitus is that not one single region is replicated in studies of different centers. The question then rises whether this is related to the low sample size of these studies, the selection of non-representative patient subgroups, or the absence of stratification according to clinical characteristics. Another possibility is that VBM is not a good tool to study functional pathologies such as tinnitus, in contrast to patholo...

  2. Theoretical Tinnitus Framework: A Neurofunctional Model

    Science.gov (United States)

    Ghodratitoostani, Iman; Zana, Yossi; Delbem, Alexandre C. B.; Sani, Siamak S.; Ekhtiari, Hamed; Sanchez, Tanit G.

    2016-01-01

    Subjective tinnitus is the conscious (attended) awareness perception of sound in the absence of an external source and can be classified as an auditory phantom perception. Earlier literature establishes three distinct states of conscious perception as unattended, attended, and attended awareness conscious perception. The current tinnitus development models depend on the role of external events congruently paired with the causal physical events that precipitate the phantom perception. We propose a novel Neurofunctional Tinnitus Model to indicate that the conscious (attended) awareness perception of phantom sound is essential in activating the cognitive-emotional value. The cognitive-emotional value plays a crucial role in governing attention allocation as well as developing annoyance within tinnitus clinical distress. Structurally, the Neurofunctional Tinnitus Model includes the peripheral auditory system, the thalamus, the limbic system, brainstem, basal ganglia, striatum, and the auditory along with prefrontal cortices. Functionally, we assume the model includes presence of continuous or intermittent abnormal signals at the peripheral auditory system or midbrain auditory paths. Depending on the availability of attentional resources, the signals may or may not be perceived. The cognitive valuation process strengthens the lateral-inhibition and noise canceling mechanisms in the mid-brain, which leads to the cessation of sound perception and renders the signal evaluation irrelevant. However, the “sourceless” sound is eventually perceived and can be cognitively interpreted as suspicious or an indication of a disease in which the cortical top-down processes weaken the noise canceling effects. This results in an increase in cognitive and emotional negative reactions such as depression and anxiety. The negative or positive cognitive-emotional feedbacks within the top-down approach may have no relation to the previous experience of the patients. They can also be

  3. Theoretical Tinnitus Framework: A Neurofunctional Model.

    Science.gov (United States)

    Ghodratitoostani, Iman; Zana, Yossi; Delbem, Alexandre C B; Sani, Siamak S; Ekhtiari, Hamed; Sanchez, Tanit G

    2016-01-01

    Subjective tinnitus is the conscious (attended) awareness perception of sound in the absence of an external source and can be classified as an auditory phantom perception. Earlier literature establishes three distinct states of conscious perception as unattended, attended, and attended awareness conscious perception. The current tinnitus development models depend on the role of external events congruently paired with the causal physical events that precipitate the phantom perception. We propose a novel Neurofunctional Tinnitus Model to indicate that the conscious (attended) awareness perception of phantom sound is essential in activating the cognitive-emotional value. The cognitive-emotional value plays a crucial role in governing attention allocation as well as developing annoyance within tinnitus clinical distress. Structurally, the Neurofunctional Tinnitus Model includes the peripheral auditory system, the thalamus, the limbic system, brainstem, basal ganglia, striatum, and the auditory along with prefrontal cortices. Functionally, we assume the model includes presence of continuous or intermittent abnormal signals at the peripheral auditory system or midbrain auditory paths. Depending on the availability of attentional resources, the signals may or may not be perceived. The cognitive valuation process strengthens the lateral-inhibition and noise canceling mechanisms in the mid-brain, which leads to the cessation of sound perception and renders the signal evaluation irrelevant. However, the "sourceless" sound is eventually perceived and can be cognitively interpreted as suspicious or an indication of a disease in which the cortical top-down processes weaken the noise canceling effects. This results in an increase in cognitive and emotional negative reactions such as depression and anxiety. The negative or positive cognitive-emotional feedbacks within the top-down approach may have no relation to the previous experience of the patients. They can also be

  4. Theoretical Tinnitus framework: A Neurofunctional Model

    Directory of Open Access Journals (Sweden)

    Iman Ghodratitoostani

    2016-08-01

    Full Text Available Subjective tinnitus is the conscious (attended awareness perception of sound in the absence of an external source and can be classified as an auditory phantom perception. The current tinnitus development models depend on the role of external events congruently paired with the causal physical events that precipitate the phantom perception. We propose a novel Neurofunctional tinnitus model to indicate that the conscious perception of phantom sound is essential in activating the cognitive-emotional value. The cognitive-emotional value plays a crucial role in governing attention allocation as well as developing annoyance within tinnitus clinical distress. Structurally, the Neurofunctional tinnitus model includes the peripheral auditory system, the thalamus, the limbic system, brain stem, basal ganglia, striatum and the auditory along with prefrontal cortices. Functionally, we assume the model includes presence of continuous or intermittent abnormal signals at the peripheral auditory system or midbrain auditory paths. Depending on the availability of attentional resources, the signals may or may not be perceived. The cognitive valuation process strengthens the lateral-inhibition and noise canceling mechanisms in the mid-brain, which leads to the cessation of sound perception and renders the signal evaluation irrelevant. However, the sourceless sound is eventually perceived and can be cognitively interpreted as suspicious or an indication of a disease in which the cortical top-down processes weaken the noise canceling effects. This results in an increase in cognitive and emotional negative reactions such as depression and anxiety. The negative or positive cognitive-emotional feedbacks within the top-down approach may have no relation to the previous experience of the patients. They can also be associated with aversive stimuli similar to abnormal neural activity in generating the phantom sound. Cognitive and emotional reactions depend on general

  5. Theoretical Tinnitus Framework: A Neurofunctional Model.

    Science.gov (United States)

    Ghodratitoostani, Iman; Zana, Yossi; Delbem, Alexandre C B; Sani, Siamak S; Ekhtiari, Hamed; Sanchez, Tanit G

    2016-01-01

    Subjective tinnitus is the conscious (attended) awareness perception of sound in the absence of an external source and can be classified as an auditory phantom perception. Earlier literature establishes three distinct states of conscious perception as unattended, attended, and attended awareness conscious perception. The current tinnitus development models depend on the role of external events congruently paired with the causal physical events that precipitate the phantom perception. We propose a novel Neurofunctional Tinnitus Model to indicate that the conscious (attended) awareness perception of phantom sound is essential in activating the cognitive-emotional value. The cognitive-emotional value plays a crucial role in governing attention allocation as well as developing annoyance within tinnitus clinical distress. Structurally, the Neurofunctional Tinnitus Model includes the peripheral auditory system, the thalamus, the limbic system, brainstem, basal ganglia, striatum, and the auditory along with prefrontal cortices. Functionally, we assume the model includes presence of continuous or intermittent abnormal signals at the peripheral auditory system or midbrain auditory paths. Depending on the availability of attentional resources, the signals may or may not be perceived. The cognitive valuation process strengthens the lateral-inhibition and noise canceling mechanisms in the mid-brain, which leads to the cessation of sound perception and renders the signal evaluation irrelevant. However, the "sourceless" sound is eventually perceived and can be cognitively interpreted as suspicious or an indication of a disease in which the cortical top-down processes weaken the noise canceling effects. This results in an increase in cognitive and emotional negative reactions such as depression and anxiety. The negative or positive cognitive-emotional feedbacks within the top-down approach may have no relation to the previous experience of the patients. They can also be

  6. Hypacusis and Tinnitus Associated to Otosyphilis

    Directory of Open Access Journals (Sweden)

    Oliveira, Neide Fátima Cordeiro Diniz

    2009-12-01

    Full Text Available Introduction: Both congenital and acquired syphilis may cause cochleovestibular dysfunction. In the literature, the neurosensorial hearing loss, tinnitus and unbalance have been described in the secondary and tertiary syphilis. Objective: The objective of this work was to emphasize the need for etiologic identification for treatment and control of individuals with cochleovestibular symptoms. Case Report: We described the case of a patient, aged 64 years, black, with complaints of slow and progressive diminishing of auditory accuracy since about 12 years ago, associated with tinnitus and occasional unbalances. In the laboratorial and audiometric evaluation, after exclusion of other related causes, we came to the additional diagnosis of otosyphilis. Final Comments: Syphilis must always be taken into account in patients with cochleovestibular complications, irrespectively of the age range, whether or not belonging to risk groups, and the number of partners of each patient. The etiological diagnosis is very important for the control and treatment of such patients.

  7. Contralateral parahippocampal gamma-band activity determines noise-like tinnitus laterality: a region of interest analysis.

    Science.gov (United States)

    Vanneste, S; Heyning, P Van de; Ridder, D De

    2011-12-29

    Tinnitus is described as an auditory perception in the absence of any external sound source. Tinnitus loudness has been correlated to sustained high frequency gamma-band activity in auditory cortex. It remains unknown whether unilateral tinnitus is always generated in the left auditory cortex, irrespective of the side on which the tinnitus is perceived, or in the contralateral auditory cortex. In order to solve this enigma source localized electroencephalographic (EEG) recordings of a homogenous group of unilateral left and right-sided tinnitus patients presenting with noise-like tinnitus was analyzed. Based on a region of interest analysis, the most important result of this study is that tinnitus lateralization depended on the gamma-band activity of the contralateral parahippocampal area. As for the auditory cortex no differences were found between left-sided and right-sided tinnitus patients. However, in comparison to a control group both left and right-sided tinnitus patients had an increased gamma-band activity in both the left and right primary and secondary auditory cortex. Thus whereas in tinnitus the primary and secondary auditory cortices of both sides are characterized by increased gamma-band activity, the side on which the tinnitus is perceived relates to gamma-band activity in the contralateral parahippocampal area. PMID:21920411

  8. 特发性耳鸣心理声学及临床特征的多因素分析%Multivariate Analysis of Psychoacoustic and Clinical Characteristics in Patients with Idiopathic Tinnitus

    Institute of Scientific and Technical Information of China (English)

    李昕琚; 梁勇; 赵靖; 刘友利; 李衍菲; 虞幼军; 赵远新

    2013-01-01

    Objective To study the psychoacoustic and clinical characteristics of idiopathic tinnitus and their correla-tions in order to improve clinic therapy for tinnitus. Method Systematic otorhinolaryngologic examination, audiometric test-ing, tinnitus evaluation were performed on 128 patients (159 ears) with idiopathic tinnitus. Tinnitus evaluation included tin-nitus pitch and loudness assessments and the Tinnitus Handicap Inventory (THI). Variables including gender, age, side of tinnitus, tinnitus duration and persistency, hearing loss, audiometric configuration, tinnitus pitch, loudness, Feldmann mask-ing curves, residual inhibition and THI score were quantified and their correlations analyzed by logistic regression models. Result Of the 159 ears, tinnitus was of high pitch in 102 ears (64.15%) and of mid or low pitch in 57 ears (35.85%), and its loudness was high in 53 ears (33.33%), moderate in 67 ears (42.14%) and soft in 39 ears (24.53%). Feldmann masking curves were dominated by convergent (32 ears, 20.13%), congruent (46 ears, 28.93%) and separate (62 ears, 38.99%) types. Residual inhibition was positive in 47 ears (33.57%), partially positive in 59 ears (42.14%) and negative in 34 ears (24.29%). THI scores indicated slight (67 ears, 42.14%) or mild (56 ears, 35.22%) tinnitus severity in most patients. Logis-tic regression showed correlation between tinnitus pitch and gender (χ2=12.588, P<0.001) and tinnitus persistency (χ2=3.866, P=0.049). Tinnitus loudness was correlated to hearing loss (χ2=50.006, P<0.001), audiometric configuration (χ2=63.187, P<0.001) and tinnitus pitch (χ2=14.757,P=0.001). Feldmann masking curve was chiefly influenced by audiomet-ric configuration (χ2=21.798, P=0.001). Theχ2 test showed that residual inhibition was correlated to THI scores (χ2=16.284, P=0.012), but not to the rest 10 items. Conclusion Certain psychoacoustic and clinical characteristics in idiopathic tinnitus appear to be correlated to each other. This information

  9. ANIMAL BEHAVIORAL MODELS OF TINNITUS

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chao; WANG Qiuju; SUN Wei

    2014-01-01

    The pathophysiology of tinnitus is poorly understood and treatments are often unsuccessful. A number of animal models have been developed in order to gain a better understanding of tinnitus. A great deal has been learned from these models re-garding the electrophysiological and neuroanatomical correlates of tinnitus following exposure to noise or ototoxic drugs. Re-liable behavioral data is important for determining whether such electrophysiological or neuroanatomical changes are indeed related to tinnitus. Of the many documented tinnitus animal behavioral paradigms, the acoustic startle reflex had been pro-posed as a simple method to identify the presence or absence of tinnitus. Several behavioral models based on conditioned re-sponse suppression paradigms have also been developed. In addition to determining the presence or absence of tinnitus, some of the behavioral paradigms have provided signs of the onset, frequency, and intensity of tinnitus in animals. Although none of these behavioral models have been proved to be a perfect model, these studies provide useful information on understanding the neural mechanisms underlying tinnitus.

  10. Chronic diseases among older cancer patients.

    NARCIS (Netherlands)

    Deckx, L.D.; Akker, M.A. van der; Metsemakers, J.M.; Knottnerus, A.K.; Schellevis, F.G.; Buntinx, F.B.

    2011-01-01

    Introduction: With the growing number of older cancer patients, the burden of chronic diseases among older cancer patients will become increasingly important. Chronic diseases often interfere with treatment decisions and prognosis for cancer patients. However, little is known about the occurrence of

  11. Diagnosing Patients with Age-Related Hearing Loss and Tinnitus: Supporting GP Clinical Engagement through Innovation and Pathway Redesign in Audiology Services

    Directory of Open Access Journals (Sweden)

    Adrian Davis

    2012-01-01

    Full Text Available The public health challenge of hearing impairment is growing, as age is the major determinant of hearing loss. Almost one in four (22.6% over 75-year olds reports moderate or severe worry because of hearing problems. There is a 40% comorbidity of tinnitus and balance disorders. Good outcomes depend on early presentation and appropriate referral. This paper describes how the NHS Improvement Programme in England used service improvement methodologies to identify referral pathways and tools which were most likely to make significant improvements in diagnosing hearing loss, effective referrals and better patient outcomes. An audiometric screening device was used in GP surgeries to enable thresholds for effective referrals to be measured in the surgery. Revised referral criteria, the use of this device, new “assess and fit” technology in the audiology clinic, and direct access pathways can transform audiology service delivery so that patient outcomes are measurably better. This, in turn, changes the experience of GPs, so they are more likely to refer patients who can benefit from treatment. At the end of 2011, 51 GP practices in one of the audiology pilot areas had bought HearCheck screeners, a substantial development from the 4 practices who first engaged with the pilot.

  12. Increased intensity discrimination thresholds in tinnitus subjects with a normal audiogram

    DEFF Research Database (Denmark)

    Epp, Bastian; Hots, J.; Verhey, J. L.;

    2012-01-01

    Recent auditory brain stem response measurements in tinnitus subjects with normal audiograms indicate the presence of hidden hearing loss that manifests as reduced neural output from the cochlea at high sound intensities, and results from mice suggest a link to deafferentation of auditory nerve...... fibers. As deafferentation would lead to deficits in hearing performance, the present study investigates whether tinnitus patients with normal hearing thresholds show impairment in intensity discrimination compared to an audiometrically matched control group. Intensity discrimination thresholds were...... significantly increased in the tinnitus frequency range, consistent with the hypothesis that auditory nerve fiber deafferentation is associated with tinnitus....

  13. Application of distort product otoacoustic emission(DPOAE)in the tinnitus patients with normal hearing capability%畸变产物耳声发射在听力正常的耳鸣患者中的应用

    Institute of Scientific and Technical Information of China (English)

    邵渊; 安燕; 张少强

    2013-01-01

    Objective To explore the clinical characteristics of the distort product otoacoustic emission( DPOAE )in the tinnitus patients with normal hearing capability and its applied value. Methods DPOAE test was held in 160 tinnitus patients with the normal hearing capability and 120 healthy controls with the normal hearing capability and no tinnitus symptoms. The results were compared between two groups. The tinnitus patients were given nerve-nourishing medicine and vasodilator medicine for consecutive 3 weeks and then DPOAE test was performed again. The results before and after treatment were compared. Results In tinnitus group, the incidence of DPOAE in each frequency was significantly lower than that in healthy controls( P <0. 05 ). After the treatment, the DPOAE reacting amplitudes in high frequency were obviously improved in the tinnitus patients( P < 0. 05 ). Conclusion The occurrence of the tinnitus may be relevant to the cochlear outer hair cell early injury-induced high frequency hearing loss, and DPOAE test can reflect the early stage cochlear injury and act as an objective method for detecting the tinnitus.%目的 探讨听力正常的耳鸣患者畸变产物耳声发射(DPOAE)的临床特点,了解畸变产物耳声发射在耳鸣患者中的应用价值.方法 对160例听力正常伴耳鸣的患者设定为耳鸣组,进行DPOAE测试,同时对120例听力正常且无耳鸣健康者设定为对照组,进行DPOAE测试,对比两组检测结果.对耳鸣患者给予营养神经药物和改善内耳血液循环药物联合治疗3周后再次进行DPOAE测试,对比治疗前后结果.结果 耳鸣组中,DPOAE测试在各频率点的检出率均显著低于健康对照组(P<0.05).耳鸣组经过治疗后,耳声发射在高频段的反应幅值明显提高,与治疗前相比,差异具有统计学意义(P<0.05).结论 耳鸣的产生可能与耳蜗外毛细胞早期损伤导致的高频听力损失相关,DPOAE的检测可反映早期耳蜗病变并可作为耳

  14. Tinnitus referral pathways within the National Health Service in England: a survey of their perceived effectiveness among audiology staff

    OpenAIRE

    Collins Luke; Hoare Derek J; Gander Phillip E; Smith Sandra; Hall Deborah A

    2011-01-01

    Abstract Background In the UK, audiology services deliver the majority of tinnitus patient care, but not all patients experience the same level of service. In 2009, the Department of Health released a Good Practice Guide to inform commissioners about key aspects of a quality tinnitus service in order to promote equity of tinnitus patient care in UK primary care, audiology, and in specialist multi-disciplinary centres. The purpose of the present research was to evaluate utilisation and opinion...

  15. Association of tinnitus and electromagnetic hypersensitivity: hints for a shared pathophysiology?

    Directory of Open Access Journals (Sweden)

    Michael Landgrebe

    Full Text Available BACKGROUND: Tinnitus is a frequent condition with high morbidity and impairment in quality of life. The pathophysiology is still incompletely understood. Electromagnetic fields are discussed to be involved in the multi-factorial pathogenesis of tinnitus, but data proofing this relationship are very limited. Potential health hazards of electromagnetic fields (EMF have been under discussion for long. Especially, individuals claiming themselves to be electromagnetic hypersensitive suffer from a variety of unspecific symptoms, which they attribute to EMF-exposure. The aim of the study was to elucidate the relationship between EMF-exposure, electromagnetic hypersensitivity and tinnitus using a case-control design. METHODOLOGY: Tinnitus occurrence and tinnitus severity were assessed by questionnaires in 89 electromagnetic hypersensitive patients and 107 controls matched for age-, gender, living surroundings and workplace. Using a logistic regression approach, potential risk factors for the development of tinnitus were evaluated. FINDINGS: Tinnitus was significantly more frequent in the electromagnetic hypersensitive group (50.72% vs. 17.5% whereas tinnitus duration and severity did not differ between groups. Electromagnetic hypersensitivity and tinnitus were independent risk factors for sleep disturbances. However, measures of individual EMF-exposure like e.g. cell phone use did not show any association with tinnitus. CONCLUSIONS: Our data indicate that tinnitus is associated with subjective electromagnetic hypersensitivity. An individual vulnerability probably due to an over activated cortical distress network seems to be responsible for, both, electromagnetic hypersensitivity and tinnitus. Hence, therapeutic efforts should focus on treatment strategies (e.g. cognitive behavioral therapy aiming at normalizing this dysfunctional distress network.

  16. Tinnitus pitch and acoustic trauma

    Energy Technology Data Exchange (ETDEWEB)

    Cahani, M.; Paul, G.; Shahar, A.

    1983-01-01

    Fifty-six subjects complaining of tinnitus underwent an audiometric test and a test for identifying the analogous pitch of their tinnitus. All of the subjects reported that they had been exposed to noise in the past. The subjects were divided into two groups on the basis of their audiometric test results. Group P was composed of subjects who showed a sensorineural hearing loss typical of acoustic trauma. Group N was composed of subjects whose hearing was within normal limits. The pitch of the tinnitus in group P was concentrated in the high-frequency range, whereas in group N tinnitus pitch values were distributed over the low and mid-audiometric frequency spectrum. It was deduced that different processes are involved in the generation of tinnitus in the two groups.

  17. The effect of tinnitus volume on the ascending speed of auditory threshold%从耳鸣响度看听阈提高的速度

    Institute of Scientific and Technical Information of China (English)

    高福秀; 王斌全; 王建明

    2001-01-01

    Objective To study the reaction between tinnitus volume and the ascending speed of auditory threshold in chronic nervous tinnitus patients.Methods The tinnitus volmue and auditory threshold in 50 nervous tinnitus patients (76 ears) with raising auditory threshold were detected by pure tone audiometer.Results There was a significant difference between the 24 ears with tinnitus volume ≤10 dB HL and the 52 ears with tinnitus volume >10 dB HL (P<0.01),especially in above 3 kHz frequency field.Conclusion There are relations between tinnitus volume and the ascending speed of auditory threshold,clinical doctors should slow down the ascending speed of auditory threshold by treating tinnitus.%目的了解神经性渐进性耳鸣、耳聋患者的耳鸣响度与听阈提高速度的关系。方法对50例(76耳)神经性耳鸣并伴听阈提高的患者作纯音听阈及耳鸣响度的测试,并根据病程时间计算听阈提高速度。对25耳耳鸣响度在≤10 dB听力级(HL)的患者与52耳耳鸣响度在>10 dB HL的患者之提高速度进行比较,并进行统计学分析。结果耳鸣响度≤10 dB的24耳与>10 dB的52耳听阈之提高速度在3 kHz以上高频区差异有显著性(P<0.01)。结论耳鸣响度大小与听阈提高速度有关联。听阈的提高速度随着耳鸣响度的加大而增快。

  18. Self-Administered Domiciliary tDCS Treatment for Tinnitus: A Double-Blind Sham-Controlled Study.

    Directory of Open Access Journals (Sweden)

    Petteri Hyvärinen

    Full Text Available Transcranial direct current stimulation (tDCS has shown potential for providing tinnitus relief, although positive effects have usually been observed only during a short time period after treatment. In recent studies the focus has turned from one-session experiments towards multi-session treatment studies investigating long-term outcomes with double-blinded and sham-controlled study designs. Traditionally, tDCS has been administered in a clinical setting by a healthcare professional but in studies involving multiple treatment sessions, often a trade-off has to be made between sample size and the amount of labor needed to run the trial. Also, as the number of required visits to the clinic increases, the dropout rate is likely to rise proportionally.The aim of the current study was to find out if tDCS treatment for tinnitus could be patient-administered in a domiciliary setting and whether the results would be comparable to those from in-hospital treatment studies. Forty-three patients with chronic (> 6 months tinnitus were involved in the study, and data on 35 out of these patients were included in final analysis. Patients received 20 minutes of left temporal area anodal (LTA or bifrontal tDCS stimulation (2 mA or sham stimulation (0.3 mA for ten consecutive days. An overall reduction in the main outcome measure, Tinnitus Handicap Inventory (THI, was found (mean change -5.0 points, p < 0.05, but there was no significant difference between active and sham treatment outcomes. Patients found the tDCS treatment easy to administer and they all tolerated it well. In conclusion, self-administered domiciliary tDCS treatment for tinnitus was found safe and feasible and gave outcome results similar to recent randomized controlled long-term treatment trials. The results suggest better overall treatment response-as measured by THI-with domiciliary treatment than with in-hospital treatment, but this advantage is not related to the tDCS variant. The study

  19. [Some aspects of pharmacotherapy of tinnitus. Compound therapy with Xylocaine and directive counseling--long-term results].

    Science.gov (United States)

    Rogowski, Marek; Sieśkiewicz, Andrzej; Rózańska-Kudelska, Małgorzata; Walenczak, Izabela

    2004-01-01

    29 out of 49 patients, who were treated in 1996-1998 with Xylocaine and directive counselling for their tinitus, were reevaluated. Non of the patients used any other pharmacological treatment of the tinnitus or underwent full tinnitus retraining therapy (TRT) since 10-days treatment with Xylocaine had been completed. Initially 65.3% of patients declared improvement in their tinnitus. After over 5 years of observation success rate decreased to only 41.3%. Since the positive effect of 10-days treatment with Xylocaine and directive counselling was not stable we concluded that tinnitus patients should receive full TRT.

  20. 慢性肾脏病患者耳鸣耳聋患病率及临床特点调查%The Research of Morbidity of Tinnitus and Deafness of CKD Patient and Clinical Characteristics

    Institute of Scientific and Technical Information of China (English)

    梁莹; 屈欢欢; 全春梅; 杨丛旭; 余仁欢

    2012-01-01

    Objective: Probe into the morbidity of tinnitus and deafness of CKD patient and clinical characteristics. Methods :Cross - sectional survey research methods is used, collecting CKD patientS information anf the properties and degree of tinnitus and deafness, to analyze the morbidity of tinnitus and deafness of CKD patient and clinical characteristics. ResultS:( 1 )CKD patients, tinnitus morbidity is 51. 6% , deafness prevalence is 44. 8% . Tinnitus frequency is mainly high - frequency, and deafness with mild hearing damage sensorineural neuropathic deafness accounts for a large number. ( 2 Jdeafness for increases with age, the prevalence of deafness is significantly rising trend. ( 3 Jsecondary kidney patients morbidity of deafness is higher than primary glomerular disease patients. (4 )ln the different clinical diagnosis, diabetic nephropathy and hypertensive renal disease are the main influence factors in the deafness morbidity of CKD patients.( 5 Jlncreasing with CKD stage, the morbidity of CKD patients with deafness is significantly rising trend. That improves the morbidity of CKD patients with deafness is closely related to the renal function state and glomerular filtration rate. Conclusion:( 1 )CKD patients, Tinnitus frequency is mainly high -frequency, and deafness with mild hearing damage sensorineural neuropathic deafness accounts for a large number. ( 2 Jlncreasing with the age or decreasing with the renal function state and glomerular filtration rate, the morbidity of CKD patients with deafness is significantly rising trend. ( 3 Jsecondary kidney disease patients morbidity of deafness is higher than primary glomerular disease patients. In Secondary kidney diseases, diabetic nephropathy and hypertensive renal disease are the main influence factors.%目的:探讨慢性肾脏病(CKD)患者耳鸣耳聋的患病率及其相关临床特点.方法:采用横断面的调查方法,收集CKD患者相关信息和耳鸣耳聋的性质及程度,对肾脏病患者耳

  1. The Correlation of the Tinnitus Handicap Inventory with Depression and Anxiety in Veterans with Tinnitus

    OpenAIRE

    Jinwei Hu; Jane Xu; Matthew Streelman; Helen Xu; O’neil Guthrie

    2015-01-01

    Objective. The mechanisms of tinnitus are known to alter neuronal circuits in the brainstem and cortex, which are common to several comorbid conditions. This study examines the relationship between tinnitus and anxiety/depression. Subjects and Methods. Ninety-one male veterans with subjective tinnitus were enrolled in a Veterans Affairs Tinnitus Clinic. The Tinnitus Handicap Inventory (THI) was used to assess tinnitus severity. ICD-9 codes for anxiety/depression were used to determine their p...

  2. Salicylate induced tinnitus: behavioral measures and neural activity in auditory cortex of awake rats.

    Science.gov (United States)

    Yang, Guang; Lobarinas, Edward; Zhang, Liyan; Turner, Jeremy; Stolzberg, Daniel; Salvi, Richard; Sun, Wei

    2007-04-01

    Neurophysiological studies of salicylate-induced tinnitus have generally been carried out under anesthesia, a condition that abolishes the perception of tinnitus and depresses neural activity. To overcome these limitations, measurement of salicylate induced tinnitus were obtained from rats using schedule induced polydipsia avoidance conditioning (SIPAC) and gap pre-pulse inhibition of acoustic startle (GPIAS). Both behavioral measures indicated that tinnitus was present after treatment with 150 and 250 mg/kg of salicylate; measurements with GPIAS indicated that the pitch of the tinnitus was near 16 kHz. Chronically implanted microwire electrode arrays were used to monitor the local field potentials and spontaneous discharge rate from multiunit clusters in the auditory cortex of awake rats before and after treatment with 150 mg/kg of salicylate. The amplitude of the local field potential elicited with 60 dB SPL tone bursts increased significantly 2h after salicylate treatment particularly at 16-20 kHz; frequencies associated with the tinnitus pitch. Field potential amplitudes had largely recovered 1-2 days post-salicylate when behavioral results showed that tinnitus was absent. The mean spontaneous spike recorded from the same multiunit cluster pre- and post-salicylate decreased from 22 spikes/s before treatment to 14 spikes/s 2h post-salicylate and recovered 1 day post-treatment. These preliminary physiology data suggest that salicylate induced tinnitus is associated with sound evoked hyperactivity in auditory cortex and spontaneous hypoactivity.

  3. Neurostimulation as a new treatment for severe tinnitus : A pilot study

    NARCIS (Netherlands)

    Holm, AF; Staal, TJ; Mooij, TJA; Albers, FWJ

    2005-01-01

    Background: Tinnitus is an uncomfortable symptom for the patient and an embarrassing one for the consulted physician. So far, there is no treatment that can be considered well established in terms of providing long-term reduction of tinnitus in excess of placebo effects. There is considerable eviden

  4. The efficacy of Arlevert therapy for vertigo and tinnitus.

    Science.gov (United States)

    Novotný, M; Kostrica, R; Círek, Z

    1999-01-01

    We were interested in determining the efficacy of Arlevert therapy in vertigo and tinnitus patients, especially as it compared to the efficacy of the drug's two component agents, dimenhydrinate and cinnarizine. We conducted a comparative, randomized, double blind, multicenter, parallel group study involving a group of patients (n = 122) with vertigo and tinnitus of peripheral or central origin. The three test groups, nearly equal in size, were administered three times daily for 4 weeks one of the three agents being evaluated. To evaluate therapeutic success, we studied patients' vertigo symptoms, concomitant vegetative symptoms, CCG parameters, and electronystagmographic and audiometric parameters. We also obtained subjective assessments of outcomes from the test patients. Our results led us to conclude that Arlevert is more effective than either of its component drugs alone in treating vertigo and tinnitus. The drug also was well tolerated. PMID:10753423

  5. Objective Tinnitus and the Tensor Tympani Muscle.

    Science.gov (United States)

    Rock

    1995-01-01

    Objective tinnitus (OT) may be caused by contraction of the tensor tympani muscle (TTM). The more forcefully the TTM contracts, the greater the intensity of the OT heard. Forceful closure of both eyelids can reflexively cause OT by contracting the TTM. The Forceful Eyelid Closure Syndrome (FECS) was reported at the Proceedings of the Second International Tinnitus Seminar in 1983.(1) FECS consists of several factors: (1) Objective tinnitus (2) An associated waning of hearing primarily of the lower frequencies, as much as 45 dB at 125 Hz, 30 to 40 dB at 250 Hz ascending to the patient's norm at 2000 Hz and approximately a 5 to 10 dB at 4000 Hz and 5 to 20 dB at 8000 Hz (3) Retraction of the manubrium and posterior mid-third of the tympanic membrane (TM) at the malleus-umbo area as seen under the otomicroscope (OM) in 25% (108) of 432 ears examined (4) These same ears were 75% (324) positive for increased impedance at maximum compliance with FEC. Of the patients studied, 25% had no response under the otomicroscope or by impedance audiometry.

  6. Mental health and quality of life in patients with chronic otitis media.

    Science.gov (United States)

    Bakir, Salih; Kinis, Vefa; Bez, Yasin; Gun, Ramazan; Yorgancilar, Ediz; Ozbay, Musa; Aguloglu, Bülent; Meric, Faruk

    2013-02-01

    The present study focused on the comparison of mental health and quality of life (QoL) between chronic otitis media (COM) patients and the hearing population. The patients with chronic otitis media and healthy control group were enrolled in the study. The duration and severity of the auditory impairment were recorded. In addition to hearing loss (HL), the findings of each patient's other ear disorders (ear discharge and tinnitus) were also recorded. In both the groups, psychological symptom profile and health-related QoL were evaluated and compared using a sociodemographic questionnaire, the Symptom Check List 90-Revised Form (SCL-90-R), and the Short Form-36 (SF-36). According to SCL-90-R, somatization (p depression (p social functioning (p < 0.001), and mental health (p < 0.017) than those of control subjects. Our results indicated that COM patients with mild or moderate HL have poorer life quality and higher psychological problems. Psychological well being should be also considered in assessment of COM patients in addition to the clinical evaluation and audiological tests. PMID:22566178

  7. An Adaptation Level Theory of tinnitus audibility

    Directory of Open Access Journals (Sweden)

    Grant eSearchfield

    2012-06-01

    Full Text Available Models of tinnitus suggest roles for auditory, attention and emotional networks in tinnitus perception. A model of tinnitus audibility based on Helson’s (1964 Adaptation Level Theory (ALT is hypothesized to explain the relationship between tinnitus audibility, personality, memory and attention. This theory attempts to describe how tinnitus audibility or detectability might change with experience and context. The basis of ALT and potential role of Auditory Scene Analysis in tinnitus perception are discussed. The proposed psychoacoustic model lends itself to incorporation into existing neurophysiological models of tinnitus perception. It is hoped that the ALT hypothesis will allow for greater empirical investigation of factors influencing tinnitus perception, such as attention and tinnitus sound therapies.

  8. Lower Gastrointestinal Bleeding in Chronic Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Fahad Saeed

    2011-01-01

    Full Text Available Gastrointestinal (GI bleeding is more common in patients with chronic kidney disease and is associated with higher mortality than in the general population. Blood losses in this patient population can be quite severe at times and it is important to differentiate anemia of chronic diseases from anemia due to GI bleeding. We review the literature on common causes of lower gastrointestinal bleeding (LGI in chronic kidney disease (CKD and end-stage renal disease (ESRD patients. We suggest an approach to diagnosis and management of this problem.

  9. Does Attempt at Hearing Preservation Microsurgery of Vestibular Schwannoma Affect Postoperative Tinnitus?

    Directory of Open Access Journals (Sweden)

    Martin Chovanec

    2015-01-01

    Full Text Available Background. The aim of this study was to analyze the effect of vestibular schwannoma microsurgery via the retrosigmoid-transmeatal approach with special reference to the postoperative tinnitus outcome. Material and Methods. A prospective study was performed in 89 consecutive patients with unilateral vestibular schwannoma indicated for microsurgery. Patient and tumor related parameters, pre- and postoperative hearing level, intraoperative findings, and hearing and tinnitus handicap inventory scores were analyzed. Results. Cochlear nerve integrity was achieved in 44% corresponding to preservation of preoperatively serviceable hearing in 47% and useful hearing in 21%. Main prognostic factors of hearing preservation were grade/size of tumor, preoperative hearing level, intraoperative neuromonitoring, tumor consistency, and adhesion to neurovascular structures. Microsurgery led to elimination of tinnitus in 66% but also new-onset of the symptom in 14% of cases. Preservation of useful hearing and neurectomy of the eighth cranial nerve were main prognostic factors of tinnitus elimination. Preservation of cochlear nerve but loss of preoperative hearing emerged as the main factor for tinnitus persistence and new onset tinnitus. Decrease of THI scores was observed postoperatively. Conclusions. Our results underscore the importance of proper pre- and intraoperative decision making about attempt at hearing preservation versus potential for tinnitus elimination/risk of new onset of tinnitus.

  10. Muscle strength in patients with chronic pain

    NARCIS (Netherlands)

    van Wilgen, C.P.; Akkerman, L.; Wieringa, J.; Dijkstra, P.U.

    2003-01-01

    Objective: To analyse the influence of chronic pain on muscle strength. Design: Muscle strength of patients with unilateral nonspecific chronic pain, in an upper or lower limb, were measured according to a standardized protocol using a hand-held dynamometer. Before and after muscle strength measurem

  11. The Application of Biofeedback in Subjective Tinnitus Patients%全参数生物反馈指标在主观性耳鸣患者中的应用

    Institute of Scientific and Technical Information of China (English)

    黄夏茵; 杨海弟; 熊浩; 郑亿庆

    2014-01-01

    目的:研究全参数生物反馈在治疗主观性耳鸣患者中的效果。方法对20例主观性耳鸣患者行全参数生物反馈治疗10次,观察治疗前后耳鸣残疾评估量表(Tinnitus Handicap Inventory,THI)得分及全参数生物反馈指标的变化。结果耳鸣患者治疗前后THI总分分别为44.9±22.3和28.0±14.8,差异达到极显著性水平(P<0.01);治疗前后生物反馈指标肌电分别为6.7±1.6和5.1±1.2,差异达到显著性水平(P<0.05)、治疗前后α波分别为13.3±6.4和16.4±6.2,差异极显著(P<0.01)、治疗前后SMR波分别为5.4±1.6和6.2±2.2,差异显著(P<0.05)。结论主观性耳鸣患者进行生物反馈治疗有效,可明显降低THI总分,改善耳鸣症状,随着耳鸣患者症状减轻,其对应生物反馈指标也发生相应改变。%Objective To study the effectiveness of whole parameter biofeedback in the treatment of patients with subjective tinnitus.Methods 20 patients with subjective tinnitus patients were treated with biofeedback therapy 10 times. The THI scores and biofeedback indexes were observed and compared before and after the treatment.Results The total THI scores of the tinnitus patients were 44.9 ± 22.3 and 28.0 ± 14.8 before and after the treatment, showing a significant difference. There were significant differences in electromyography (EMG) (6.7 ± 1.6 vs 5.1 ± 1.2;P<0.05),αwave (13.3 ± 6.4 vs 16.4 ± 6.2;P<0.01) and SMR wave (5.4 ± 1.6 vs 6.2 ± 2.2;P<0.05) before and after the treatment.Conclusion Biofeedback therapy can significantly reduce the THI scores, improve the symptoms of tinnitus patients, reduce the EMG and increase theα wave and SMR wave, so it is effective in treating patients with subjective tinnitus.

  12. Salicylate toxicity model of tinnitus

    OpenAIRE

    Daniel Stolzberg

    2012-01-01

    Salicylate, the active component of the common drug aspirin, has mild analgesic, antipyretic, and anti-inflammatory effects at moderate doses. At higher doses, however, salicylate temporarily induces moderate hearing loss and the perception of a high-pitch ringing in humans and animals. This phantom perception of sound known as tinnitus is qualitatively similar to the persistent subjective tinnitus induced by high-level noise exposure, ototoxic drugs or aging which affects ~14% of the gener...

  13. Urea synthesis in patients with chronic pancreatitis

    DEFF Research Database (Denmark)

    Hamberg, Ole; Sonne, J; Larsen, S;

    2001-01-01

    Up-regulation of urea synthesis by amino acids and dietary protein intake may be impaired in patients with chronic pancreatitis (CP) due to the reduced glucagon secretion. Conversely, urea synthesis may be increased as a result of the chronic inflammation. The aims of the study were to determine...... urea synthesis kinetics in CP patients in relation to glucagon secretion (study I) and during an increase in protein intake (study II)....

  14. Hearing loss and tinnitus in rock musicians: A Norwegian survey.

    Science.gov (United States)

    Størmer, Carl Christian Lein; Laukli, Einar; Høydal, Erik Harry; Stenklev, Niels Christian

    2015-01-01

    Our focus in this study was to assess hearing thresholds and the prevalence and characteristics of tinnitus in a large group of rock musicians based in Norway. A further objective was to assess related factors such as exposure, instrument category, and the preventive effect of hearing protection. The study was a cross-sectional survey of rock musicians selected at random from a defined cohort of musicians. A random control group was included for comparison. We recruited 111 active musicians from the Oslo region, and a control group of 40 nonmusicians from the student population at the University of TromsØ. The subjects were investigated using clinical examination, pure tone audiometry, tympanometry, and a questionnaire. We observed a hearing loss in 37.8% of the rock musicians. Significantly poorer hearing thresholds were seen at most pure-tone frequencies in musicians than controls, with the most pronounced threshold shift at 6 kHz. The use of hearing protection, in particular custom-fitted earplugs, has a preventive effect but a minority of rock musicians apply them consistently. The degree of musical performance exposure was inversely related to the degree of hearing loss in our sample. Bass and guitar players had higher hearing thresholds than vocalists. We observed a 20% prevalence of chronic tinnitus but none of the affected musicians had severe tinnitus symptomatology. There was no statistical association between permanent tinnitus and hearing loss in our sample. We observed an increased prevalence of hearing loss and tinnitus in our sample of Norwegian rock musicians but the causal relationship between musical exposure and hearing loss or tinnitus is ambiguous. We recommend the use of hearing protection in rock musicians. PMID:26572701

  15. Hearing loss and tinnitus in rock musicians: A Norwegian survey

    Directory of Open Access Journals (Sweden)

    Carl Christian Lein Størmer

    2015-01-01

    Full Text Available Our focus in this study was to assess hearing thresholds and the prevalence and characteristics of tinnitus in a large group of rock musicians based in Norway. A further objective was to assess related factors such as exposure, instrument category, and the preventive effect of hearing protection. The study was a cross-sectional survey of rock musicians selected at random from a defined cohort of musicians. A random control group was included for comparison. We recruited 111 active musicians from the Oslo region, and a control group of 40 nonmusicians from the student population at the University of TromsØ. The subjects were investigated using clinical examination, pure tone audiometry, tympanometry, and a questionnaire. We observed a hearing loss in 37.8% of the rock musicians. Significantly poorer hearing thresholds were seen at most pure-tone frequencies in musicians than controls, with the most pronounced threshold shift at 6 kHz. The use of hearing protection, in particular custom-fitted earplugs, has a preventive effect but a minority of rock musicians apply them consistently. The degree of musical performance exposure was inversely related to the degree of hearing loss in our sample. Bass and guitar players had higher hearing thresholds than vocalists. We observed a 20% prevalence of chronic tinnitus but none of the affected musicians had severe tinnitus symptomatology. There was no statistical association between permanent tinnitus and hearing loss in our sample. We observed an increased prevalence of hearing loss and tinnitus in our sample of Norwegian rock musicians but the causal relationship between musical exposure and hearing loss or tinnitus is ambiguous. We recommend the use of hearing protection in rock musicians.

  16. Assessment of patients with chronic pain.

    Science.gov (United States)

    Dansie, E J; Turk, D C

    2013-07-01

    Chronic pain is a public health concern affecting 20-30% of the population of Western countries. Although there have been many scientific advances in the understanding of the neurophysiology of pain, precisely assessing and diagnosing a patient's chronic pain problem is not straightforward or well-defined. How chronic pain is conceptualized influences how pain is evaluated and the factors considered when making a chronic pain diagnosis. There is no one-to-one relationship between the amount or type of organic pathology and pain intensity, but instead, the chronic pain experience is shaped by a myriad of biomedical, psychosocial (e.g. patients' beliefs, expectations, and mood), and behavioural factors (e.g. context, responses by significant others). Assessing each of these three domains through a comprehensive evaluation of the person with chronic pain is essential for treatment decisions and to facilitate optimal outcomes. This evaluation should include a thorough patient history and medical evaluation and a brief screening interview where the patient's behaviour can be observed. Further assessment to address questions identified during the initial evaluation will guide decisions as to what additional assessments, if any, may be appropriate. Standardized self-reported instruments to evaluate the patient's pain intensity, functional abilities, beliefs and expectations, and emotional distress are available, and can be administered by the physician, or a referral for in depth evaluation can be made to assist in treatment planning.

  17. The 'Love Hormone' May Quiet Tinnitus

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_161110.html The 'Love Hormone' May Quiet Tinnitus Small, preliminary study suggests oxytocin ... tinnitus -- may find some relief by spraying the hormone oxytocin in their nose, a small initial study ...

  18. Psychoacoustic Assessment to Improve Tinnitus Diagnosis

    Science.gov (United States)

    Hutchins, Sean; Hébert, Sylvie

    2013-01-01

    The diagnosis of tinnitus relies on self-report. Psychoacoustic measurements of tinnitus pitch and loudness are essential for assessing claims and discriminating true from false ones. For this reason, the quantification of tinnitus remains a challenging research goal. We aimed to: (1) assess the precision of a new tinnitus likeness rating procedure with a continuous-pitch presentation method, controlling for music training, and (2) test whether tinnitus psychoacoustic measurements have the sensitivity and specificity required to detect people faking tinnitus. Musicians and non-musicians with tinnitus, as well as simulated malingerers without tinnitus, were tested. Most were retested several weeks later. Tinnitus pitch matching was first assessed using the likeness rating method: pure tones from 0.25 to 16 kHz were presented randomly to participants, who had to rate the likeness of each tone to their tinnitus, and to adjust its level from 0 to 100 dB SPL. Tinnitus pitch matching was then assessed with a continuous-pitch method: participants had to match the pitch of their tinnitus to an external tone by moving their finger across a touch-sensitive strip, which generated a continuous pure tone from 0.5 to 20 kHz in 1-Hz steps. The predominant tinnitus pitch was consistent across both methods for both musicians and non-musicians, although musicians displayed better external tone pitch matching abilities. Simulated malingerers rated loudness much higher than did the other groups with a high degree of specificity (94.4%) and were unreliable in loudness (not pitch) matching from one session to the other. Retest data showed similar pitch matching responses for both methods for all participants. In conclusion, tinnitus pitch and loudness reliably correspond to the tinnitus percept, and psychoacoustic loudness matches are sensitive and specific to the presence of tinnitus. PMID:24349414

  19. Clinical value of distortion product otoacoustic emission in tinnitus patients with normal hearing%畸变产物耳声发射测试在听力正常的耳鸣者中的应用价值

    Institute of Scientific and Technical Information of China (English)

    朱小平; 张香玉

    2011-01-01

    Objective To investigate the clinical value of distortion product otoacoustic emission (DPOAE) application in normal hearing patients with tinnitus. Methods A total of 82 healthy volunteers (164 ears) without tinnitus or hearing loss were enrolled as control group and tested with DPOAE. Meanwhile, 84 normal hearing patients (109 ears) with tinnitus were tested with DPOAE before and after 20-days treatment including circulation improvement and supplemental nutrition for inner ear. Results At the frequency of 0.5, 0.75, 1.00, 1.50, 2.00, 3.00, 4.00, 6.00 and 8.00 kHz, the detection rate of DPOAE in tinnitus group was significantly lower than that in control group (all P0.05); the wave height in every frequency was increased after treatment, especially in high frequency (3.00. 4.00, 6.00 and 8.00 kHz, all P< 0.05). Conclusion Tinnitus with normal hearing is likely to be related to hearing loss of super high frequency caused by early impairment of outer hair cells in cochlea. DPOAE examination can be used as an objective assessment for early change of cochlea and periphery tinnitus.%目的 探讨畸变产物耳声发射( DPOAE)测试在听力正常的耳鸣患者中的临床应用价值.方法 对82名(164耳)听力正常且无耳鸣的健康者(对照组)进行DPOAE测试.同时对84例(109耳)听力正常的耳鸣患者(耳鸣组)进行DPOAE测试,并给予改善内耳循环、补充营养等治疗20 d后再次进行DPOAE测试.结果 耳鸣组中,DPOAE测试在0.50、0.75、1.00、1.50、2.00、3.00、4.00、6.00、8.00 kHz各频率点的检出率均显著低于对照组(P值均<0.05).耳鸣组治疗后DPOAE的检出率为43.1%,与治疗前(56.9%)的差异无统计学意义(P>0.05),治疗后在各频率点的DPOAE反应幅值呈提高趋势,尤其在高频(3.00、4.00、6.00、8.00 kHz)的差异有统计学意义(P值均<0.05).结论 听力正常的耳鸣发生可能与耳蜗外毛细胞的早期损伤导致的超高频听力损失有关,DPOAE检测可以

  20. Tinnitus assessment by means of standardized self-report questionnaires: Psychometric properties of the Tinnitus Questionnaire (TQ), the Tinnitus Handicap Inventory (THI), and their short versions in an international and multi-lingual sample

    OpenAIRE

    Zeman Florian; Koller Michael; Schecklmann Martin; Langguth Berthold; Landgrebe Michael

    2012-01-01

    Abstract Background Tinnitus research in an international context requires standardized and validated questionnaires in different languages. The aim of the present set of analyses was the reassessment of basic psychometric properties according to classical test theory of self-report instruments that are being used within the multicentre Tinnitus Research Initiative (TRI) database project. Methods 1318 patients of the TRI Database were eligible for the analyses. The basic psychometric properti...

  1. Effectiveness of Low Level Laser Irradiation on Tinnitus and Parameters of Electrocochleography and Distortion Product Otoacoustic Emissions

    Directory of Open Access Journals (Sweden)

    Saeed Mahmoudian

    2008-06-01

    Full Text Available Background and Aim: Tinnitus is the consciousness of sound that arises in the ear or head without any external sound origin. The efficacies of transmeatal low-level laser irradiation for tinnitus treatment were reported before. The aim of this study was to evaluate the effectiveness of low level laser therapy on tinnitus and ECochG and DPOAEs parameters. Materials and Methods: The study design was prospective, quasi experimental. This investigation conducted on 16 ears (10 patients with disabling tinnitus. All patients underwent ENT examination, complete audiological evaluation, tinnitus study, ECochG and DPOAEs, and finally completing tinnitus data sheet. The results were compared before and after irradiation. Results: Means of tinnitus loudness (LMT and CAP amplitudes were significant different before and after irradiation (p<0.005. There was no any other significant difference before and after low level laser irradiation in subjective loudness, pitch matching annoyance grade of tinnitus and DPOAEs and other ECochG parameters.Conclusion: Transmeatal low-power laser irradiation with 200 mW seems not to be effective for treatment of tinnitus. This paper is the research brief report. In clinical point of view, this study should be repeated with a greater sample size although our results were statistically important.

  2. Condition of hearing sense and tinnitus before and after the treatment of otosclerosis

    Directory of Open Access Journals (Sweden)

    Terzić Negra

    2010-01-01

    Full Text Available Introduction. Otosclerosis is an osteodystrophy disease of the bony labyrinth of the ear which leads to stapes fixation and to bradyecoia of a conductive type. The microsurgical treatment by the use of a stapes prosthesis provides hearing improvement and a reduction or disappearing of tinnitus. The aim of our study was to determine the hearing condition and tinnitus before and after the treatment of otosclerosis. Material and methods. A hundred patients with otosclerosis, aged 20 to 70, were surgically treated at the Otorhinolaryngology Clinic and the Functional Diagnostics, Military Medical Academy, Belgrade. After the treatment, the audiometric examinations were performed in order to assess the hearing condition and tinnitus was assessed by a questionnaire. The subjective assessment of tinnitus was ranged as present, reduced or absent. Results. Before the treatment, hearing impairment was present in all the patients, while tinnitus was found in 91% of them. One year following the surgical treatment hearing improvement was found in 96% of the patients, and tinnitus cessation in 89% of them. Conclusion. The surgical treatment can result in hearing improvement and cessation or reduction of tinnitus.

  3. MALONDIALDEHYDE LEVELS IN PATIENTS WITH CHRONIC PERIODONTITIS

    Directory of Open Access Journals (Sweden)

    Madhur

    2013-06-01

    Full Text Available ABSTRACT: Periodontitis is a chronic condition leading to the destruction of the periodontium. A case control study was carried out in 30 subjects with chronic periodontitis aged 30 - 65 ye ars (group II and age matched with 30 control subjects (group I. Salivary and serum malondialdehyde, which is a marker of lipid peroxidation, was estimated in the cases and controls. Salivary MDA was elevated (p<0.001 in patients with chronic periodonti tis there was no change in serum MDA levels when compared with normal controls. Increased levels in MDA may be closely associated with periodontal disease and salivary estimation may provide advantage in pathogenesis of the periodontal disease. .

  4. An evaluation of the content and quality of tinnitus information on websites preferred by General Practitioners

    Directory of Open Access Journals (Sweden)

    Fackrell Kathryn

    2012-07-01

    Full Text Available Abstract Background Tinnitus is a prevalent and complex medical complaint often co-morbid with stress, anxiety, insomnia, depression, and cognitive or communication difficulties. Its chronicity places a major burden on primary and secondary healthcare services. In our recent national survey of General Practitioners (GPs from across England, many reported that their awareness of tinnitus was limited and as a result were dissatisfied with the service they currently provide. GPs identified 10 online sources of information they currently use in clinical practice, but welcomed further concise and accurate information on tinnitus assessment and management. The purpose of this study was to assess the content, reliability, and quality of the information related to primary care tinnitus assessment and management on these 10 websites. Methods Tinnitus related content on each website was assessed using a summative content analysis approach. Reliability and quality of the information was assessed using the DISCERN questionnaire. Results Quality of information was rated using the validated DISCERN questionnaire. Significant inter-rater reliability was confirmed by Kendall’s coefficient of concordance (Wt which ranged from 0.48 to 0.92 across websites. The website Map of Medicine achieved the highest overall DISCERN score. However, for information on treatment choice, the British Tinnitus Association was rated best. Content analysis revealed that all websites lacked a number of details relating to either tinnitus assessment or management options. Conclusions No single website provides comprehensive information for GPs on tinnitus assessment and management and so GPs may need to refer to more than one if they want to maximise their coverage of the topic. From those preferred by GPs we recommend several specific websites as the current ‘best’ sources. Our findings should guide healthcare website providers to improve the quality and inclusiveness of the

  5. Acoustic trauma-induced auditory cortex enhancement and tinnitus

    Institute of Scientific and Technical Information of China (English)

    Erin Laundrie; Wei Sun

    2014-01-01

    There is growing evidence suggests that noise-induced cochlear damage may lead to hyperexcitability in the central auditory system (CAS) which may give rise to tinnitus. However, the correlation between the onset of the neurophysiological changes in the CAS and the onset of tinnitus has not been well studied. To investigate this relationship, chronic electrodes were implanted into the auditory cortex (AC) and sound evoked activities were measured from awake rats before and after noise exposure. The auditory brainstem response (ABR) was used to assess the degree of noise-induced hearing loss. Tinnitus was evaluated by measuring gap-induced prepulse inhibition (gap-PPI). Rats were exposed monaurally to a high-intensity narrowband noise centered at 12 kHz at a level of 120 dB SPL for 1 h. After the noise exposure, all the rats developed either permanent (>2 weeks) or temporary (<3 days) hearing loss in the exposed ear(s). The AC amplitudes increased significantly 4 h after the noise exposure. Most of the exposed rats also showed decreased gap-PPI. The post-exposure AC enhancement showed a positive correlation with the amount of hearing loss. The onset of tinnitus-like behavior was happened after the onset of AC enhancement.

  6. Diagnosing Patients with Age-Related Hearing Loss and Tinnitus: Supporting GP Clinical Engagement through Innovation and Pathway Redesign in Audiology Services

    OpenAIRE

    Adrian Davis; Smith, Pauline A.; Michelle Booth; Margaret Martin

    2012-01-01

    The public health challenge of hearing impairment is growing, as age is the major determinant of hearing loss. Almost one in four (22.6%) over 75-year olds reports moderate or severe worry because of hearing problems. There is a 40% comorbidity of tinnitus and balance disorders. Good outcomes depend on early presentation and appropriate referral. This paper describes how the NHS Improvement Programme in England used service improvement methodologies to identify referral pathways and tools whi...

  7. Effect of unilateral and simultaneous bilateral cochlear implantation on tinnitus : A randomized controlled trial

    NARCIS (Netherlands)

    van Zon, Alice; Smulders, Yvette E; Ramakers, Geerte G J; Stegeman, Inge; Smit, Adriana L; Van Zanten, Gijsbert A; Stokroos, Robert J; Hendrice, Nadia; Free, Rolien H; Maat, Bert; Frijns, Johan H M; Mylanus, Emmanuel A M; Huinck, Wendy J; Topsakal, Vedat; Tange, Rinze A; Grolman, Wilko

    2015-01-01

    OBJECTIVES/HYPOTHESIS: To determine the effect of cochlear implantation on tinnitus perception in patients with severe bilateral postlingual sensorineural hearing loss and to demonstrate possible differences between unilateral and bilateral cochlear implantation. STUDY DESIGN: Prospective study. MET

  8. Discrimination task reveals differences in neural bases of tinnitus and hearing impairment.

    Directory of Open Access Journals (Sweden)

    Fatima T Husain

    Full Text Available We investigated auditory perception and cognitive processing in individuals with chronic tinnitus or hearing loss using functional magnetic resonance imaging (fMRI. Our participants belonged to one of three groups: bilateral hearing loss and tinnitus (TIN, bilateral hearing loss without tinnitus (HL, and normal hearing without tinnitus (NH. We employed pure tones and frequency-modulated sweeps as stimuli in two tasks: passive listening and active discrimination. All subjects had normal hearing through 2 kHz and all stimuli were low-pass filtered at 2 kHz so that all participants could hear them equally well. Performance was similar among all three groups for the discrimination task. In all participants, a distributed set of brain regions including the primary and non-primary auditory cortices showed greater response for both tasks compared to rest. Comparing the groups directly, we found decreased activation in the parietal and frontal lobes in the participants with tinnitus compared to the HL group and decreased response in the frontal lobes relative to the NH group. Additionally, the HL subjects exhibited increased response in the anterior cingulate relative to the NH group. Our results suggest that a differential engagement of a putative auditory attention and short-term memory network, comprising regions in the frontal, parietal and temporal cortices and the anterior cingulate, may represent a key difference in the neural bases of chronic tinnitus accompanied by hearing loss relative to hearing loss alone.

  9. Multitarget surgical neuromodulation: Combined C2 and auditory cortex implantation for tinnitus.

    Science.gov (United States)

    De Ridder, Dirk; Vanneste, Sven

    2015-03-30

    Tinnitus, as a phantom sound can express itself as a pure tone and as a noise-like sound. It is notoriously difficult to treat, and in medically, psychologically and audiologically intractable tinnitus patients sometimes intracranial electrodes overlying the auditory cortex are implanted. In this case report, we describe a patient who had a complete resolution of the pure tone component of his tinnitus by an auditory cortex implant, without any beneficial effect on the noise-like aspect of his tinnitus, even after changing the stimulation design to burst stimulation, which is known to treat noise-like tinnitus better than tonic stimulation. After an initial successful treatment of his noise-like component with transcutaneus electrical nerve stimulation, a wire electrode is inserted subcutaneously and connected to his internal pulse generator. With the dual stimulation his pure tone tinnitus remains abolished after 5 years of stimulation and his noise-like tinnitus is improved by 50%, from 8/10 to 4/10. This case report suggests that multi-target stimulation might be better than single target implantation in selected cases. PMID:25703225

  10. Salicylate toxicity model of tinnitus

    Directory of Open Access Journals (Sweden)

    Daniel eStolzberg

    2012-04-01

    Full Text Available Salicylate, the active component of the common drug aspirin, has mild analgesic, antipyretic, and anti-inflammatory effects at moderate doses. At higher doses, however, salicylate temporarily induces moderate hearing loss and the perception of a high-pitch ringing in humans and animals. This phantom perception of sound known as tinnitus is qualitatively similar to the persistent subjective tinnitus induced by high-level noise exposure, ototoxic drugs or aging which affects ~14% of the general population. For over a quarter century, auditory scientists have used the salicylate toxicity model to investigate candidate biochemical and neurophysiological mechanisms underlying phantom sound perception. In this review, we summarize some of the intriguing biochemical and physiological effects associated with salicylate-induced tinnitus, some of which occur in the periphery and others in the central nervous system. The relevance and general utility of the salicylate toxicity model in understanding phantom sound perception in general are discussed.

  11. 自觉听力正常耳鸣患者纯音听力及畸变产物耳声发射临床分析%Audiometry and distortion product otoacoustic emissions in tinnitus patients without hearing complaints

    Institute of Scientific and Technical Information of China (English)

    王晓晖; 肖玉丽

    2011-01-01

    Objective To study pure tone audiometry and distortion product otoacoustic emissions (DPOAE) features in tinnitus patients who do not perceive hearing loss. Methods Pure tone threshold, hearing loss, SNR of DPOAE were performed in 114 (190 ears) adults with tinnitus cases with never perceived hearing loss, investigate the relationship between every risk factor and tinnitus. Results Audiometry showed high frequency hearing loss in 46.31% (88/ 190), low frequency hearing loss in 14.73% (28/190), normal hearing in 23.15% (44/190), and other types of audio-grams in 15.78%(30/190) of the patients. Risk factors included noise exposure, fatigue, stress, and pre-existing diseases. There was a negative correlation between DPOAE amplitude and pure tone threshold. DPOAE response frequencies were closely related to frequency distribution of pure tone thresholds. Conclusion A significant number of patients with tinnitus but no hearing complaints may still have abnormal hearing, especially in the high frequency range. A negative correlation exists between DPOAE amplitude and pure tone threshold. DPOAEs may serve as an objective indicator of the level of hearing loss in tinnitus patients with no hearing complaints, which may be of value in the clinic.%目的 分析自觉听力正常耳鸣患者的纯音听力特征,并探讨自觉听力正常耳鸣患者畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)测定值与纯音听阈值之间的相关性及其意义.方法 2010-2011年在我科就诊的以耳鸣为第一主诉但无明显自觉听力障碍患者114例(190耳),对所有入组患者进行纯音测听及DPOAE检测.分析DPOAE测定值与纯音听阈值之间的相关性,并结合其发病的可能危险因素进行相关分析.结果 自觉听力正常的耳鸣患者中,听力异常可达76.84% (146/190).纯音测听表现为:高频下降型46.31% (88/190);低频下降型14.73% (28/190);正常23.15% (44/190);其它类型15.78% (30/190).

  12. Attitudes toward patient expertise in chronic illness.

    Science.gov (United States)

    Thorne, S E; Ternulf Nyhlin, K; Paterson, B L

    2000-08-01

    Although it has become an accepted standard to acknowledge the patient as a full partner in health care decisions, replacing traditional authoritative relationships with those based on an emancipatory model, the experiences of persons living with chronic illness confirm that this paradigm shift is not yet apparent in many health care relationships. In this paper, the authors present a qualitative secondary analysis of combined data sets from their research into chronic illness experience with two quite different chronic diseases - Type I Diabetes (a socially legitimized chronic disease) and Environmental Sensitivities (a disease which is currently treated with considerable scepticism). Comparing the experiences of individuals with diseases that are quite differently socially constructed, it becomes possible to detect common underlying health professional values and attitudes that powerfully influence the experience of living with and negotiating health care for a chronic illness. In the discussion of findings from this study, the authors examine the implications of the spiral of behaviors that fuels mutual alienation in chronic illness care relationships if professionals are unable to value patient expertise.

  13. Malnutrition in patients with chronic renal failure

    OpenAIRE

    Qureshi, Abdul Rashid Tony

    2000-01-01

    Protein-energy malnutrition is common in patients with chronic renal failure (CRF) and may contribute to a poor clinical outcome. However, the role of nutrition in this regard has not been clearly defined. Malnutrition in patients with CRF may have many causes, including disturbances in protein and energy metabolism, hormonal derangements, as well as low food intake because of anorexia, caused by uremic toxicity, various superimposed illnesses and psychosocial problems. Alth...

  14. Patient concerns regarding chronic hepatitis C infections.

    Science.gov (United States)

    Minuk, G Y; Gutkin, A; Wong, S G; Kaita, K D E

    2005-01-01

    Counselling of patients with chronic hepatitis C infections is often limited to discussions regarding how the virus is transmitted and what can be done to decrease the risk of transmission to others. The purpose of the present study was to document the principal concerns of newly diagnosed and follow-up patients with chronic hepatitis C, and thereby enhance counselling strategies and content. Seventy newly diagnosed and 115 follow-up patients with chronic hepatitis C virus (HCV) infection were initially asked in an open-ended manner (volunteered concerns) and then to prioritize from a prepared list of seven potential concerns (prioritized concerns), to identify those concerns that were of utmost importance to them. The most common volunteered concerns of newly diagnosed patients in decreasing order were: disease progression (27%), premature death (19%), infecting family members (13%), side-effects of treatment (11%) and miscellaneous others. In decreasing order, prioritized concerns included: infecting family members, development of liver cancer, infecting others, development of cirrhosis, social stigma of having liver disease, need for liver transplant and loss of employment. The principal volunteered and prioritized concerns of follow-up patients were similar to those of newly diagnosed patients. Volunteered and prioritized concerns were relatively consistent across the different genders, age groups, ethnic backgrounds, education level, marital status, employment, modes of viral acquisition and in the case of follow-up patients, duration of follow-up. These results indicate that health care providers who focus counselling efforts exclusively on viral transmission are unlikely to address other important concerns of newly diagnosed and follow-up patients with chronic HCV infection. PMID:15655048

  15. Theta, alpha and beta burst transcranial magnetic stimulation: brain modulation in tinnitus

    Directory of Open Access Journals (Sweden)

    Dirk De Ridder, Elsa van der Loo, Karolien Van der Kelen, Tomas Menovsky, Paul van de Heyning, Aage Moller

    2007-01-01

    Full Text Available Introduction: Some forms of tinnitus are considered to be auditory phantom phenomena related to reorganization and hyperactivity of the auditory central nervous system. Repetitive transcranial magnetic stimulation (rTMS is a non-invasive tool capable of modulating human brain activity, using single pulse or burst stimuli. Burst rTMS has only been performed in the theta range, and has not been used clinically. The authors analyze whether burst TMS at theta (5 Hz, alpha (10 Hz and beta (20 Hz frequencies can temporarily suppress narrow band noise/white noise tinnitus, which has been demonstrated to be intractable to tonic stimulation. Methods: rTMS is performed both in tonic and burst mode in 46 patients contralateral to the tinnitus side, at 5, 10 and 20 Hz. Fourteen placebo negative rTMS responders are further analyzed. Results: In 5 patients, maximal tinnitus suppression is obtained with theta, in 2 with alpha and in 7 with beta burst stimulation. Burst rTMS suppresses narrow band/white tinnitus much better than tonic rTMS t(13=6.4, p<.000. Women experience greater suppression of their tinnitus with burst stimulation than men, t(12=2.9, p<.05. Furthermore left sided tinnitus is perceived as more distressing on the TQ than right sided tinnitus, t(12=3.2, p<.01. The lower the tinnitus pitch the more effectively rTMS suppresses tinnitus(r=-0.65, p<0.05. Discussion: Burst rTMS can be used clinically, not only theta burst, but also alpha and beta burst. Burst rTMS is capable of suppressing narrow band/white noise tinnitus very much better than tonic rTMS. This could be due the simple fact that burst neuromodulation is more powerful than tonic neuromodulation or to a differential effect of burst and tonic stimulation on the lemniscal and extralemniscal auditory system. In some patients only alpha or beta burst rTMS is capable of suppressing tinnitus, and theta burst not. Therefore in future rTMS studies it could be worthwhile not to limit burst

  16. Behandlung des chronischen Tinnitus mit repetitiver transkranieller Magnetstimulation

    OpenAIRE

    Kleinjung, T

    2012-01-01

    Tinnitus ist eine Funktionsstörung des Hörsystems, die von verschiedenen Strukturen und Ebenen ausgehen kann. Tinnitus geht mit neuroplastischen Veränderungen im zentralen auditorischen System einher. Existenz eines „Tinnitus-Netzwerkes“.

  17. Does the location of a vascular loop in the cerebellopontine angle explain pulsatile and non-pulsatile tinnitus?

    Energy Technology Data Exchange (ETDEWEB)

    Nowe, V.; Wang, X.L.; Gielen, J.; Goethem, J.Van; Oezsarlak, Oe.; De Schepper, A.M.; Parizel, P.M. [University of Antwerp, Department of Radiology, Edegem (Belgium); Ridder, D. De [University of Antwerp, Department of Neurosurgery, Edegem (Belgium); Heyning, P.H.Van de [University of Antwerp, Department of Otorhinolaryngology, Edegem (Belgium)

    2004-12-01

    The purpose was to investigate patients with unexplained pulsatile and non-pulsatile tinnitus by means of MR imaging of the cerebellopontine angle (CPA) and to correlate the clinical subtype of tinnitus with the location of a blood vessel (in the internal auditory canal or at the cisternal part of the VIIIth cranial nerve). Clinical presentation of tinnitus and perceptive hearing loss were correlated. In 47 patients with unexplained tinnitus, an MR examination of the CPA was performed. Virtual endoscopy reconstructions were obtained using a 3D axial thin-section high-resolution heavily T2-weighted gradient echo constructive interference in steady state (CISS) data-set. High-resolution T2-weighted CISS images showed a significantly higher number of vascular loops in the internal auditory canal in patients with arterial pulsatile tinnitus compared to patients with non-pulsatile tinnitus (P<0.00001). Virtual endoscopy images were used to investigate vascular contacts at the cisternal part of the VIIIth cranial nerve in patients with low pitch and high pitch non-pulsatile tinnitus. A significantly different distribution of the vascular contacts (P=0.0320) was found. Furthermore, a correlation between the clinical presentation of non-pulsatile tinnitus (high pitch and low pitch) and the perceptive hearing loss was found (P=0.0235). High-resolution heavily T2-weighted CISS images and virtual endoscopy of the CPA can be used to evaluate whether a vascular contact is present in the internal auditory canal or at the cisternal part of the VIIIth cranial nerve and whether the location of the vascular contact correlates with the clinical subtype of tinnitus. Our findings suggest that there is a tonotopical structure of the cisternal part of the VIIIth cranial nerve. A correlation between the clinical presentation of tinnitus and hearing loss was found. (orig.)

  18. Psychosocial interventions for patients with chronic disease

    Directory of Open Access Journals (Sweden)

    Deter Hans-Christian

    2012-01-01

    Full Text Available Abstract Treatment of patients with chronic diseases will be one of the main challenges of medicine in the future. This paper presents an overview of different origins, mechanism, and symptoms necessary for understanding new and different interventions that include a psychosomatic view. In a psychosomatic therapeutic intervention there are very different targets, such as psychological symptoms, personality traits, attitudes toward disease and life, risk behaviour, and social isolation and as biological targets the change of autonomic imbalance and of the effects of the psycho-endocrinological or psycho-immunological stress responses. And there are also different psychosomatic measures that influence the individual biological, psychological and sociological targets. There is a need to give different answer to different questions in the field of psychosomatic and behavioral medicine. Comparative effectiveness research is an important strategy for solving some methodological issues. What is the target of treatment for different diseases: Symptom reduction, healing, or limiting progression to the worst case - the death of patients. We know that, the patient-physician relationship is important for every medical/therapeutic action for patients with chronic diseases. This volume of BioPsychoSocial Medicine will present four different psychosomatic treatment studies from the clinical field in the sense of phase 2 studies: Reports of patients with obesity, anorexia nervosa, chronic somatoform pain and coronary artery disease were presented

  19. [Anticoagulation in patients with chronic renal failure].

    Science.gov (United States)

    Niksic, L; Saudan, P; Boehlen, F

    2006-03-01

    Anticoagulation may be difficult to implement in patients suffering from chronic renal failure on account of platelet disorders and impaired clearance of some anticoagulant drugs. Although no adjustment of heparin and coumarin dosage is necessary, more frequent testing of coagulation pathways may be required when these drugs are used in patients with renal failure. Long-term use of LMWH should be implemented cautiously with regular testing of anti-factor Xa activity and a half-dose may be advocated in patients with a creatinine clearance heparin-induced thrombocytopenia with regular monitoring of coagulation tests. PMID:16562602

  20. Acinarcellcarcinomaofthepancreasina young patient with chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Fatima-Zahra Kebir; Ahlem Lahmar; Nafaa Arfa; Saber Manai; Mohamed Ali El Ouaer; Saadia Bouraoui; Carole Gouttalier; Sabah Mezabi-Regaya

    2010-01-01

    BACKGROUND: Acinar cell carcinoma (ACC) is a rare malignancy of the pancreas arising from acinar cells. Unlike ductal adenocarcinoma, this tumor rarely presents with pancreatitis. METHODS: We present a case of ACC associated with chronic calcifying pancreatitis, and a review of the literature focusing on diagnosis and management. RESULTS: A 43-year-old man was proposed for Wirsungo-jejunal derivation for chronic pancreatitis. Histopathological examination of the tissue extracted revealed an ACC. Duodenopancreatectomy was performed. Six months post-operatively, the patient developed hepatic metastasis and was treated with gemcitabine as palliative chemotherapy. CONCLUSIONS: The clinical presentation of ACC of the pancreas is not speciifc and the tumor can be under-diagnosed when associated with chronic pancreatitis. Data regarding course, treatment, and prognosis of this tumor are generally lacking.

  1. The Comparison of the Average Thresholds of Auditory Steady-State Response in Adult Subjective Idiopathic Tinnitus and Normal Subjects

    Directory of Open Access Journals (Sweden)

    Zahra Ghasem Ahmad

    2009-12-01

    Full Text Available Background and Aim: Tinnitus is a common symptom among lots of people but little is known about its origins. This study was aimed at comparing the Auditory Steady-State Response (ASSR thresholds in normal cases and patients with subjective idiopathic tinnitus (SIT in order to diagnose its real origins.Materials and Methods: This case-control study was conducted on 19 patients with tinnitus and 24 normal cases aged 18-40 yr.The patients underwent broad medical tests to roll out any background reason for their tinnitus. ASSR thresholds were estimated in both groups at 20 and 40 amplitude modulation. The patients were selected from tinnitus patients in Research Center in Hazrat Rasoul Hospital, Tehran, Iran.Results: The mean ASSR thresholds at 40HZ modulation were worse in tinnitus patients compared to normal ones (p<0.05 but no significant statistical differences was detected at 20HZ. These results were found in both situations in which we averaged both ears thresholds and when we estimated the thresholds of the ears separately.Conclusion: It seems that the origin of the responses of the modulation of 40Hz, primary auditory cortex, midbrain regions and subcortical areas, in these patients is involved or the origin of their tinnitus is related to some kind of problems in these areas, although more investigation is needed about 20Hz.

  2. Frequency of anemia in chronic psychiatry patients

    Directory of Open Access Journals (Sweden)

    Korkmaz S

    2015-10-01

    Full Text Available Sevda Korkmaz,1 Sevler Yildiz,1 Tuba Korucu,1 Burcu Gundogan,1 Zehra Emine Sunbul,1 Hasan Korkmaz,2 Murad Atmaca1 1Department of Psychiatry, 2Department of Cardiology, Faculty of Medicine, Firat University, Elazig, Turkey Purpose: Anemia could cause psychiatric symptoms such as cognitive function disorders and depression or could deteriorate an existing psychiatric condition when it is untreated. The objective of this study is to scrutinize the frequency of anemia in chronic psychiatric patients and the clinical and sociodemographic factors that could affect this frequency.Methods: All inpatients in our clinic who satisfied the study criteria and received treatment between April 2014 and April 2015 were included in this cross-sectional study. Sociodemographic data for 378 patients included in the study and hemoglobin (Hb and hematocrit values observed during their admission to the hospital were recorded in the forms. Male patients with an Hb level of <13 g/dL and nonpregnant female patients with an Hb level of <12 g/dL were considered as anemic.Findings: Axis 1 diagnoses demonstrated that 172 patients had depressive disorder, 51 patients had bipolar disorder, 54 patients had psychotic disorder, 33 patients had conversion disorder, 19 patients had obsessive-compulsive disorder, 25 patients had generalized anxiety disorder, and 24 patients had other psychiatric conditions. It was also determined that 25.4% of the patients suffered from anemia. Thirty-five percent of females and 10% of males were considered as anemic. The frequency of anemia was the highest among psychotic disorder patients (35%, followed by generalized anxiety disorder patients (32%, and obsessive-compulsive disorder patients (26%. Anemia was diagnosed in 22% of depressive disorder patients, 25% of bipolar disorder patients, and 24% of conversion disorder patients.Results: The prevalence of anemia among chronic psychiatry patients is more frequent than the general population

  3. 分析护理干预对老年性聋伴耳鸣患者心理状态及疗效的影响%To Analyze the Effect of Nursing Intervention on Mental State and Curative Effect of Elderly Patients With Hearing Loss and Tinnitus

    Institute of Scientific and Technical Information of China (English)

    梁亚琴

    2016-01-01

    Objective To analyze the effect of nursing intervention on mental state and curative effect of elderly patients with deafness and tinnitus. Methods 120 cases of elderly patients with deafness were randomly divided into observation group and control group. The observation group of 60 cases, including 51 cases of tinnitus, 60 cases of the control group, including 46 cases of tinnitus. The two groups received the same treatment, the observation group on the basis of drug treatment, the implementation of nursing intervention therapy. Results Compared with the control group, there were signiifcant differences in anxiety and depression state and tinnitus symptoms (P<0.05). Conclusion Nursing intervention has a good effect on the psychological state and treatment of elderly patients with tinnitus.%目的分析护理干预对老年性聋伴耳鸣患者心理状态及疗效的影响。方法选择老年性聋患者120例,随即分为观察组和对照组。其中观察组60例患者,其中耳鸣51例;对照组60例患者,其中耳鸣46例。两组均接受相同的治疗;观察组在药物治疗基础上实施护理干预疗法。结果治疗组与对照组焦虑抑郁状态差异均有统计学意义(P<0.05)。结论护理干预对老年性聋伴耳鸣患者心理状态及治疗有较好辅助作用。

  4. Tinnitus Suppression by Intracochlear Electrical Stimulation in Single Sided Deafness – A Prospective Clinical Trial: Follow-Up

    Science.gov (United States)

    Arts, Remo A. G. J.; George, Erwin L. J.; Janssen, Miranda; Griessner, Andreas; Zierhofer, Clemens; Stokroos, Robert J.

    2016-01-01

    Introduction Earlier studies show that a Cochlear Implant (CI), capable of providing intracochlear electrical stimulation independent of environmental sounds, appears to suppress tinnitus at least for minutes. The current main objective is to compare the long-term suppressive effects of looped (i.e. repeated) electrical stimulation (without environmental sound perception) with the standard stimulation pattern of a CI (with environmental sound perception). This could open new possibilities for the development of a “Tinnitus Implant” (TI), an intracochlear pulse generator for the suppression of tinnitus. Materials and Methods Ten patients with single sided deafness suffering from unilateral tinnitus in the deaf ear are fitted with a CI (MED-EL Corporation, Innsbruck, Austria). Stimulation patterns are optimized for each individual patient, after which they are compared using a randomized crossover design, with a follow-up of six months, followed by a 3 month period using the modality of patient’s choice. Results Results show that tinnitus can be suppressed with intracochlear electrical stimulation independent of environmental sounds, even long term. No significant difference in tinnitus suppression was found between the standard clinical CI and the TI. Conclusion It can be concluded that coding of environmental sounds is no requirement for tinnitus suppression with intracochlear electrical stimulation. It is therefore plausible that tinnitus suppression by CI is not solely caused by an attention shift from the tinnitus to environmental sounds. Both the standard clinical CI and the experimental TI are potential treatment options for tinnitus. These findings offer perspectives for a successful clinical application of the TI, possibly even in patients with significant residual hearing. Trial Registration TrialRegister.nl NTR3374 PMID:27111333

  5. HBV Vaccination in Chronic Renal Failure Patients

    Directory of Open Access Journals (Sweden)

    Mir-davood Omrani

    2006-12-01

    Full Text Available HBV infection in chronic renal failure (CRF becomes chronic in 30 to 60% compared with less than 10% in nonuremic patients. Immunological dysfunction in patients on hemodialysis may be related to imbalanced cytokine systems, such as tumor necrosis factor (TNF-|α| and interleukin (IL 6,1 by retention of renal metabolite in uremia and chronic inflammation and have a poor immunological reaction to T-cell-dependent antigens, like hepatitis B vaccination. Immunocompromised patients who are unresponsive to hepatitis B vaccination seem to be unable to enhance IL-10 synthesis for control of monokine overproduction. Moreover, human leukocyte antigen (HLA genes, which play a major role in the antigen presentation to immunocompetent cells, have also been shown to modulate this immune response. Unfortunately, seroconversion to anti-HBS has been reported to occur in only 40 to 50% of the vaccine, a significantly lower rate than that observed in healthy adults. Various methods including adjutants such as zinc, gamma interferon, thymopentine, GM-CSF and Levamisol for improving immune responses have been advised. Experience with Pres1/s2, third-generation vaccines is limited and they have not been proven more effective than intradermally (ID administered second-generation S antigen vaccines. Both intramuscular (IM and intradermal (ID vaccinations against hepatitis B have variable efficiency in hemodialysis and non-responders should be retreated by ID route.

  6. Ginkgo biloba extract in the treatment of tinnitus: a systematic review

    Directory of Open Access Journals (Sweden)

    von Boetticher A

    2011-07-01

    Full Text Available Alexander von BoetticherEar, Nose and Throat Surgery, Lueneburg, GermanyAbstract: Tinnitus is a symptom frequently encountered by ear, nose, and throat practitioners. A causal treatment is rarely possible, and drug and nondrug treatment options are limited. One of the frequently prescribed treatments is Ginkgo biloba extract. Therefore, randomized, placebo-controlled clinical trials of Ginkgo biloba extract preparations were searched for and reviewed systematically. There is evidence of efficacy for the standardized extract, EGb 761® (Dr Willmar Schwabe GmbH & Co KG Pharmaceuticals, Karlsruhe, Germany, in the treatment of tinnitus from three trials in patients in whom tinnitus was the primary complaint. Supportive evidence comes from a further five trials in patients with age-associated cognitive impairment or dementia in whom tinnitus was present as a concomitant symptom. As yet, the efficacy of other ginkgo preparations has not been proven, which does not necessarily indicate ineffectiveness, but may be due to flawed clinical trials. In conclusion, EGb 761®, a standardized Ginkgo biloba extract, is an evidence-based treatment option in tinnitus.Keywords: tinnitus, Ginkgo biloba, EGb 761®, systematic review

  7. The Effectiveness of Hypnotherapy in Treating Depression, Anxiety and Sleep Disturbance Caused by Subjective Tinnitus

    Directory of Open Access Journals (Sweden)

    Seyed Mahmoud Mirzamani

    2012-09-01

    Full Text Available Background: Patients with tinnitus encounter many problems, including depression, anxiety, insomnia, increased sensitivity to sound, and negativity. The aim of this study was to evaluate the efficacy of hypnotherapy on the depression, anxiety, and insomnia caused by tinnitus. Materials and Methods: This study was a pilot research with a pretest-posttest and control design. The statistical population included individuals who suffered from tinnitus and its associated symptoms. Twenty patients with tinnitus were selected through available sampling. The subjects were divided randomly into two experimental and control groups. Both groups completed the Beck Depression Inventory, Spielberger's State-Trait Anxiety Inventory, and the Pittsburgh Sleep Quality Index in both pretest and post-test phases. Only the experimental group received 10 sessions of hypnotherapy. In this study, independent and dependent t-tests were used to obtain the data.Results: The two groups were similar in terms of tinnitus severity and age range. The results of independent and dependent t-tests at p=0.05 level in all three variables of depression, anxiety, and insomnia showed a significant difference between the scores of pretest and post-test as well as the post-test scores of control and experimental groups.Conclusion: The results indicated the effectiveness and usefulness of hypnotherapy in the reduction and treatment of the depression, anxiety, and insomnia caused by tinnitus in the experimental group.

  8. Acupuncture for the treatment of tinnitus: a systematic review of randomized clinical trials

    Directory of Open Access Journals (Sweden)

    Kim Jong-In

    2012-07-01

    Full Text Available Abstract Background Complementary and alternative medicine (CAM has frequently been used to treat tinnitus, and acupuncture is a particularly popular option. The objective of this review was to assess the evidence concerning the effectiveness of acupuncture as a treatment for tinnitus. Methods Fourteen databases were searched from the dates of their creation to July 4th, 2012. Randomized clinical trials (RCTs were included if acupuncture was used as the sole treatment. The Cochrane risk of bias tool was used to assess the risk of bias. Results A total of 9 RCTs met all the inclusion criteria. Their methodological quality was mostly poor. Five RCTs compared the effectiveness of acupuncture or electroacupuncture with sham acupuncture for treating tinnitus. The results failed to show statistically significant improvements. Two RCTs compared a short one-time scalp acupuncture treatment with the use of penetrating sham acupuncture at non-acupoints in achieving subjective symptom relief on a visual analog scale; these RCTs demonstrated significant positive effects with scalp acupuncture. Two RCTs compared acupuncture with conventional drug treatments. One of these RCTs demonstrated that acupuncture had statistically significant effects on the response rate in patients with nervous tinnitus, but the other RCT did not demonstrate significant effects in patients with senile tinnitus. Conclusions The number, size and quality of the RCTs on the effectiveness of acupuncture for the treatment of tinnitus are not sufficient for drawing definitive conclusions. Further rigorous RCTs that overcome the many limitations of the current evidence are warranted.

  9. [Clinical integration in the chronic patient].

    Science.gov (United States)

    Carretero-Alcántara, Luis; Comes-Górriz, Natividad; Borrás-López, Agustina; Rodríguez-Balo, Alberto; Seara-Aguilar, Germán

    2014-01-01

    Castilla-La Mancha Health Service is developing the integration of care levels due to the challenge of an aging population in the region. Aging is associated with chronic diseases and an increasing number of concomitant diseases. This poses a major care challenge care, with more fragile patients and new needs. This also requires a sustainable approach: the concurrence of several chronic diseases affects the cost of care, which is especially acute in times of severe economic crisis. One of the pillars of the strategy for dealing with chronic diseases in our region is care integration, in an effort to adapt the organization to the new needs. The Balanced Scorecard or Integrated Scorecard of the integration process was introduced as it has been designed. The integration of primary and hospital care at an organizational level has already been completed, and the development of integrated care processes has also been performed in order to achieve real integration at care level. To help finance this, a prospective capitation system is gradually being implemented, achieving a convergence of per capita costs in the different health areas integrated. Nurses has a key role in this process, their skills as educators and trainers in self-care, in the role of case managers of patients with particularly complex conditions, and the role of professional liaison to improve the transition between care areas and units. PMID:24468496

  10. Spiritual Needs of Patients with Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Harold G. Koenig

    2010-11-01

    Full Text Available For many patients confronted with chronic diseases, spirituality/religiosity is an important resource for coping. Patients often report unmet spiritual and existential needs, and spiritual support is also associated with better quality of life. Caring for spiritual, existential and psychosocial needs is not only relevant to patients at the end of their life but also to those suffering from long-term chronic illnesses. Spiritual needs may not always be associated with life satisfaction, but sometimes with anxiety, and can be interpreted as the patients’ longing for spiritual well-being. The needs for peace, health and social support are universal human needs and are of special importance to patients with long lasting courses of disease. The factor, Actively Giving, may be of particular importance because it can be interpreted as patients’ intention to leave the role of a `passive sufferer´ to become an active, self-actualizing, giving individual. One can identify four core dimensions of spiritual needs, i.e., Connection, Peace, Meaning/Purpose, and Transcendence, which can be attributed to underlying psychosocial, emotional, existential, and religious needs. The proposed model can provide a conceptual framework for further research and clinical practice. In fact, health care that addresses patients’ physical, emotional, social, existential and spiritual needs (referring to a bio-psychosocial-spiritual model of health care will contribute to patients’ improvement and recovery. Nevertheless, there are several barriers in the health care system that makes it difficult to adequately address these needs.

  11. The Effectiveness of Hearing Aids in the Treatment for Tinnitus Patients with Sensorineural Hearing Loss%配戴助听器治疗伴有感音神经性听力减退的耳鸣患者的临床初探

    Institute of Scientific and Technical Information of China (English)

    徐万红; 向阳红; 邓安春; 刘庆顺

    2013-01-01

      目的探讨配戴助听器治疗伴有感音神经性听力减退的耳鸣患者的临床疗效.方法根据入组时的听力图类型将56名伴有感音神经性听力减退的耳鸣患者分为平坦型、上升型、下降型和切迹型4组,采用耳鸣残疾评估量表评估其配戴助听器前后耳鸣的变化程度,了解配戴助听器治疗伴有感音神经性听力减退的耳鸣患者的疗效.结果配戴助听器半年后,耳鸣情况得到改善,无论从THI总体得分,还是分别从功能性、情感性、严重性三个方面的评分来看,配戴助听器后均有明显改善(P0.05).结论配戴助听器对部分伴有感音神经性听力减退的耳鸣患者有效.%Objective To study the efficacy of the application of hearing aids to the treatment of tinnitus patients with sensorineural hearing loss. Methods The tinnitus patients were divided into 4 groups according to the audiometric curve types: flat, ascending, descending and notched. The Tinnitus Handicap Inventory (THI) was used to assess the tinnitus degrees of the patients. Results Half a year after wearing hearing aids, the tinnitus of the patients was significantly reduced according to the total THI scores or functional, emotional and catastrophic scores(P0.05). Conclusion Appropriate hearing aids are effective in the treatment for some tinnitus patients with sensorineural hearing loss.

  12. [Telemedicine for patients with chronic intestinal failure].

    Science.gov (United States)

    Nauta, Sjoukje; Feibig, Doreen; Wanten, Geert

    2014-01-01

    Telemedicine is a valuable extension of the ways in which patients with chronic diseases can be contacted. Patients can easily contact their caregivers within the safe environment of the digital waiting room. Telemedicine especially offers an advantage for those forms of care where the visual aspect is important. Care should be taken with respect to its implementation into the disease management process with careful synchronisation between all involved parties, e.g. patient, caregiver, and organisation. The effectiveness of telemedicine and the savings that can be achieved should be properly established in order to justify the funding of a telemedicine project. Rather than focusing on the possible drawbacks of telemedicine, e.g. safety concerns and the user-friendliness of the system, we should highlight the possibilities that information technology offers. PMID:25515390

  13. Risk of chronic anxiety in implantable defibrillator patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; den Broek, Krista C van; Theuns, Dominic A M J;

    2011-01-01

    Little is known about the prevalence of chronic anxiety in patients with an implantable cardioverter defibrillator (ICD). In a multi-center, prospective study, we examined 1) the prevalence of chronic anxiety (i.e., patients anxious at implantation and 12 months), and 2) predictors of chronic...... anxiety....

  14. Pilot study to develop telehealth tinnitus management for persons with and without traumatic brain injury

    Directory of Open Access Journals (Sweden)

    James A. Henry, PhD

    2012-10-01

    Full Text Available Tinnitus, or “ringing in the ears,” affects 10%-15% of adults; cases can be problematic and require lifelong management. Many people who have experienced traumatic brain injury (TBI also experience tinnitus. We developed Progressive Tinnitus Management (PTM, which uses education and counseling to help patients learn how to self-manage their reactions to tinnitus. We adapted PTM by delivering the intervention via telephone and by adding cognitive-behavioral therapy. A pilot study was conducted to evaluate the feasibility and potential efficacy of this approach for individuals with and without TBI. Participants with clinically significant tinnitus were recruited into three groups: probable symptomatic mild TBI (n = 15, moderate to severe TBI (n = 9, and no symptomatic TBI (n = 12. Participants received telephone counseling (six sessions over 6 months by an audiologist and a psychologist. Questionnaires were completed at baseline, 12 weeks, and 24 weeks. All groups showed trends reflecting improvement in self-perceived functional limitations due to tinnitus. A follow-up randomized clinical study is underway.

  15. Psychometric properties of the Persian version of the Tinnitus Handicap Inventory (THI-P

    Directory of Open Access Journals (Sweden)

    Mir Mohammad Jalali

    2015-03-01

    Full Text Available Introduction: Tinnitus can have a significant effect on an individual’s quality of life, and is very difficult quantify. One of the most popular questionnaires used in this area is the Tinnitus Handicap Inventory (THI. The aim of this study was to determine the reliability and validity of a Persian translation of the Tinnitus Handicap Inventory (THI-P.   Materials and Methods: This prospective clinical study was performed in the Otolaryngology Department of Guilan University of Medical Sciences, Iran. A total of 102 patients aged 23–80 years with tinnitus completed the (THI-P. The patients were instructed to complete the Beck Depression Inventory (BDI and the State-Trait Anxiety Inventory (STAI. Audiometry was performed. Eight-five patients were asked to complete the THI-P for a second time 7–10 days after the initial interview. We assessed test–retest reliability and internal reliability of the THI-P. Validity was assessed by analyzing the THI-P of patients according to their age, tinnitus duration and psychological distress (BDI and STAI. A factor analysis was computed to verify if three subscales (functional, emotional, and catastrophic represented three distinct variables.   Results: Test–retest correlation coefficient scores were highly significant. The THI-P and its subscales showed good internal consistency reliability (α = 0.80 to 0.96. High-to-moderate correlations were observed between THI-P and psychological distress and tinnitus symptom ratings. A confirmatory factor analysis failed to validate the three subscales of THI, and high inter-correlations found between the subscales question whether they represent three distinct factors. Conclusion:  The results suggest that the THI-P is a reliable and valid tool which can be used in a clinical setting to quantify the impact of tinnitus on the quality of life of Iranian patients.

  16. Assessment of distress associated with tinnitus.

    NARCIS (Netherlands)

    Veen, E.D. van; Jacobs, J.B.; Bensing, J.M.

    1998-01-01

    This paper focuses upon the quality of the Dutch translation of the STSS (Subjective Tinnitus Severity Scale), a scale which assesses the severity of tinnitus and the related distress. Research has been done on the psychometric qualities of this scale, its relationship with loudness-matching procedu

  17. A fatal encephalopathy in chronic haemodialysis patients.

    Science.gov (United States)

    Burks, J S; Alfrey, A C; Huddlestone, J; Norenberg, M D; Lewin, E

    1976-04-10

    A distinct neurological syndrome in twelve chronic haemodialysis patients is described. This syndrome is currently the leading cause of death in one Denver dialysis unit. The hallmarks of this syndrome are progressive speech difficulties, mental changes, and a markedly abnormal electroencephalogram which may be present months before the clinical signs appear. Additional clinical features including seizures, myoclonus, asterixis, apraxia, focal neurological signs, and psychiatric symptoms may also be observed. Neuropathological changes are slight and non-specific. The aetiology of this syndrome is unknown but the clinical and pathological features suggest a toxic/metabolic disorder. To date, this disorder has been refractory to several therapeutic measures.

  18. Dynamic Adaptive Remote Health Monitoring for Patients with Chronic Disease

    OpenAIRE

    Suh, Myung-kyung

    2012-01-01

    Chronic diseases are the leading causes of death and disability in the United States. More than 70% of deaths among Americans are caused by chronic diseases and more than 133 million Americans have at least one chronic disease. Due to the prevalence of chronic disease-related issues, it is prudent to seek out methodologies that would facilitate the prevention, monitoring, and feedback for patients with chronic diseases.This dissertation describes WANDA (Weight and Activity with Other Vital Si...

  19. High-quality chronic care delivery improves experiences of chronically ill patients receiving care

    NARCIS (Netherlands)

    J.M. Cramm (Jane); A.P. Nieboer (Anna)

    2013-01-01

    markdownabstract__Abstract__ Objective. Investigate whether high-quality chronic care delivery improved the experiences of patients. Design. This study had a longitudinal design. Setting and Participants. We surveyed professionals and patients in 17 disease management programs targeting patients wi

  20. [Treatment of patients with chronic lymphocytic leukemia].

    Science.gov (United States)

    Mucsi, Orsolya

    2016-06-01

    Chronic lymphocytic leukemia (CLL) is the most common leukemia in the Western countries. The abnormal B lymphocytes progress into the blood and infiltrate the bone marrow, liver, spleen and lymph nodes. CLL is a disease of the adults and older individuals who often have coexisting conditions. It usually progresses slowly, but in patients who need treatment, CLL eventually returns. For relapsed, refractory patients treatment options are limited. The only curative treatment is bone marrow transplantation. However, the new, alternative therapeutics show superior efficacy in CLL than standard regimens. The aim of this review is to summarize the most important therapeutic aspects of CLL and to give an insight into the novel treatment options. PMID:27275639

  1. Does Tinnitus Distress Depend on Age of Onset?

    OpenAIRE

    Winfried Schlee; Tobias Kleinjung; Wolfgang Hiller; Gerhard Goebel; Iris-Tatjana Kolassa; Berthold Langguth

    2011-01-01

    Objectives: Tinnitus is the perception of a sound in the absence of any physical source of it. About 5–15% of the population report hearing such a tinnitus and about 1–2% suffer from their tinnitus leading to anxiety, sleep disorders or depression. It is currently not completely understood why some people feel distressed by their tinnitus, while others don’t. Several studiesindicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depre...

  2. Does tinnitus distress depend on age of onset?

    OpenAIRE

    Schlee, Winfried; Kleinjung, Tobias; Hiller, Wolfgang; Goebel, Gerhard; Kolassa, Iris-Tatjana; Langguth, Berthold

    2012-01-01

    Objectives: Tinnitus is the perception of a sound in the absence of any physical source of it. About 5 - 15% of the population report hearing such a tinnitus and about 1 - 2% suffer from their tinnitus leading to anxiety, sleep disorders or depression. It is currently not completely understood why some people feel distressed by their tinnitus, while others don’t. Several studies indicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid ...

  3. Tinnitus before and 6 Months after Cochlear Implantation

    OpenAIRE

    Kompis, M; Pelizzone, M.; Dillier, N; J. Allum; Demin, N; Senn, P.

    2012-01-01

    In this prospective multicenter study, tinnitus loudness and tinnitus-related distress were investigated in 174 cochlear implant (CI) candidates who underwent CI surgery at a Swiss cochlear implant center. All subjects participated in two session, one preoperatively and one 6 months after device activation. In both sessions, tinnitus loudness was assessed using a visual analogue scale and tinnitus distress using a standardized tinnitus questionnaire. The data were compared with unaided pre- a...

  4. Abnormal cross-frequency coupling in the tinnitus network

    OpenAIRE

    Adamchic, Ilya; Langguth, Berthold; Hauptmann, Christian; Peter A Tass

    2014-01-01

    Neuroimaging studies have identified networks of brain areas and oscillations associated with tinnitus perception. However, how these regions relate to perceptual characteristics of tinnitus, and how oscillations in various frequency bands are associated with communications within the tinnitus network is still incompletely understood. Recent evidence suggests that apart from changes of the tinnitus severity the changes of tinnitus dominant pitch also have modulating effect on the underlying n...

  5. The role of “on demand” therapist guidance vs. no support in the treatment of tinnitus via the internet: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Julia Rheker

    2015-05-01

    Conclusions: The iCBT self-help program is a good treatment option for tinnitus sufferers whether or not support-on-demand is provided. Furthermore, our results show the importance of outcome expectations to the efficacy of iCBT in tinnitus patients. Future research should focus on discovering further predictors of treatment outcome.

  6. Invasive Aspergillus infections in hospitalized patients with chronic lung disease

    Directory of Open Access Journals (Sweden)

    Wessolossky M

    2013-05-01

    Full Text Available Mireya Wessolossky,1 Verna L Welch,2 Ajanta Sen,1 Tara M Babu,1 David R Luke21Division of Infectious Diseases, University of Massachusetts Medical School, Worcester, MA, USA; 2Medical Affairs, Pfizer Inc, Collegeville, PA, USABackground: Although invasive pulmonary aspergillosis (IPA is more prevalent in immunocompromised patients, critical care clinicians need to be aware of the occurrence of IPA in the nontraditional host, such as a patient with chronic lung disease. The purpose of this study was to describe the IPA patient with chronic lung disease and compare the data with that of immunocompromised patients.Methods: The records of 351 patients with Aspergillus were evaluated in this single-center, retrospective study for evidence and outcomes of IPA. The outcomes of 57 patients with chronic lung disease and 56 immunocompromised patients were compared. Patients with chronic lung disease were defined by one of the following descriptive terms: emphysema, asthma, idiopathic lung disease, bronchitis, bronchiectasis, sarcoid, or pulmonary leukostasis.Results: Baseline demographics were similar between the two groups. Patients with chronic lung disease were primarily defined by emphysema (61% and asthma (18%, and immunocompromised patients primarily had malignancies (27% and bone marrow transplants (14%. A higher proportion of patients with chronic lung disease had a diagnosis of IPA by bronchoalveolar lavage versus the immunocompromised group (P < 0.03. The major risk factors for IPA were found to be steroid use in the chronic lung disease group and neutropenia and prior surgical procedures in the immunocompromised group. Overall, 53% and 69% of chronic lung disease and immunocompromised patients were cured (P = 0.14; 55% of chronic lung patients and 47% of immunocompromised patients survived one month (P = 0.75.Conclusion: Nontraditional patients with IPA, such as those with chronic lung disease, have outcomes and mortality similar to that in the

  7. Effect of social support intervention on the anxiety and depression status of patients with tinnitus%社会支持干预对耳鸣患者焦虑及抑郁状况的影响

    Institute of Scientific and Technical Information of China (English)

    金伟; 侯军华; 程雪; 郭莹

    2009-01-01

    Objective To study the effect of social support intervention on anxiety and depression of patients with tinnitus, in order to provide a theoretical basis for the clinical nursing for the patients. Methods A questionnaire was performed using serf-rating anxiety scale (SAS), self-rating depression scale (SDS) and social support rating scale (SSRS) in 60 tinnitus cases. These cases were randomly divided into a control group and an intervention group. The effective intervention of social support was given to the intervention group. The influence of social support on the anxiety and depression status was compared. Results For patients with tinnitus, the score of depression was negatively correlated with the score of total social support and the availabihty of social support (P<0.05). Compared with the control group, the scores of anxiety and depression were reduced after an effective social support intervention was given to the intervention group (P<0. 05). Conclusions The social support of the tinnitas patients obtained from the society is closely related to the depression state. And the effective social support has a positive effect in reducing the negative emotions of anxiety and depression.%目的 探讨社会支持干预对耳鸣患者焦虑及抑郁状况的影响,为护理耳鸣患者提供理论依据.方法 对60例耳鸣住院患者采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSRS)进行问卷调查,并随机分为对照组和干预组各30例,对干预组患者的焦虑、抑郁状况进行有效的社会支持,比较社会支持对患者焦虑、抑郁状况的影响.结果 耳鸣患者抑郁得分与社会支持总分、社会支持利用度呈负相关(P<0.05);干预组给予有效的社会支持后焦虑、抑郁得分降低,与对照组比较差异有统计学意义(P<0.05).结论 耳鸣患者获得社会支持与抑郁状况关系密切,有效的社会支持对减少焦虑、抑郁负面情绪有积极的作用.

  8. Effect of low level laser (LLL) on cochlear and vestibular inner ear including tinnitus

    Science.gov (United States)

    Rhee, Chung-Ku; Lim, Eun-Seok; Kim, Young-Saeng; Chung, Yong-Won; Jung, Jae-Yun; Chung, Phil-Sang

    2006-02-01

    Objectives: 1. To investigate preventive effect of LLL on gentamicin-induced vestibular ototoxicity. 2. To evaluate the effectiveness of lower level laser (LLL) in the treatment of tinnitus. Methods: 1. Twenty guinea pigs were divided into control and laser groups. Vestibular ototoxicity was induced by intratympanic injection of gentamicin into left ear. LLL was irradiated into left ear canal of animals in laser group. Vestibular function of the animals was evaluated with vertical and off-vertical axis rotation testing. 2. Forty patients with tinnitus were treated with ginkgo biloba orally and randomly divided into control and laser groups. The 20 patients of laser group received 80.4 J/cm2 of 830 nm laser, 3 times per week for 4 weeks, via transmeatal irradiation. Tinnitus was evaluated by visual analogue scale (VAS) and tinnitus handicap inventory (THI). Results: 1. Preventive effect of LLL to gentamicin induced vestibular ototoxicity was demonstrated by preventing reduction of gain in slow harmonic acceleration test and modulation in the off-vertical axis rotation test. 2. Eleven of 20 laser group patients have shown significant improvement in VAS and THI compared to those of the control group. Conclusions: 1. LLL therapy may have preventive effect to vestibular ototoxicity. 2. LLL therapy in combination with ginkgo biloba seems to be worth trying on patients with tinnitus.

  9. Intradialytic Hypoxemia in Chronic Hemodialysis Patients.

    Science.gov (United States)

    Campos, Israel; Chan, Lili; Zhang, Hanjie; Deziel, Sheila; Vaughn, Cheryl; Meyring-Wösten, Anna; Kotanko, Peter

    2016-01-01

    When kidney failure occurs, patients are at risk for fluid overload states, which can cause pulmonary edema, pleural effusions, and upper airway obstruction. Kidney disease is also associated with impaired respiratory function, as in central sleep apnea or chronic obstructive pulmonary disease. Hence, respiratory and renal diseases are frequently coexisting. Hypoxemia is the terminal pathway of a multitude of respiratory pathologies. The measurement of oxygen saturation (SO2) is a basic and commonly used tool in clinical practice. Both arterial oxygen saturation (SaO2) and central venous oxygen saturation (ScvO2) can be easily obtained in hemodialysis (HD) patients, SaO2 from an arteriovenous access and ScvO2 from a central catheter. Here, we give a brief overview of the anatomy and physiology of the respiratory system, and the different technologies that are currently available to measure oxygen status in dialysis patients. We then focus on literature regarding intradialytic SaO2 and ScvO2. Lastly, we present clinical vignettes of intradialytic drops in SaO2 and ScvO2 in association with different symptoms and clinical scenarios with an emphasis on the pathophysiology of these cases. Given the fact that in the general population hypoxemia is associated with adverse outcomes, including increased mortality, cardiac arrhythmias and cardiovascular events, we posit that intradialytic SO2 may serve as a potential marker to identify HD patients at increased risk for morbidity and mortality. PMID:26765143

  10. Complement defects in patients with chronic rhinosinusitis.

    Directory of Open Access Journals (Sweden)

    Maria Q Gaunsbaek

    Full Text Available The complement system is an important part of our immune system, and complement defects lead generally to increased susceptibility to infections and autoimmune diseases. We have studied the role of complement activity in relation with chronic rhinosinusitis (CRS, and more specifically studied whether complement defects collectively predispose individuals for CRS or affect CRS severity. The participants comprised 87 CRS patients randomly selected from the general population, and a control group of 150 healthy blood donors. The CRS patients were diagnosed according to the European Position Paper on Rhinosinusitis and nasal Polyps criteria, and severity was evaluated by the Sino-nasal Outcome Test-22. Serum samples were analysed by ELISA for activity of the respective pathways of complement, and subsequently for serum levels of relevant components. We found that the frequency of complement defects was significantly higher among CRS patients than among healthy control subjects. A majority of Mannan-binding lectin deficient CRS patients was observed. The presence of complement defects had no influence on the severity of subjective symptoms. Our studies show that defects in the complement system collectively may play an immunological role related to the development of CRS. However, an association between severity of symptoms and presence of complement defects could not be demonstrated.

  11. Emotion dynamics and tinnitus: Daily life data from the "TrackYourTinnitus" application.

    Science.gov (United States)

    Probst, Thomas; Pryss, Rüdiger; Langguth, Berthold; Schlee, Winfried

    2016-01-01

    It is well established that emotions influence tinnitus, but the role of emotion dynamics remains unclear. The present study investigated emotion dynamics in N = 306 users of the "TrackYourTinnitus" application who completed the Mini-Tinnitus Questionnaire (Mini-TQ) at one assessment point and provided complete data on at least five assessment points for the following state variables: tinnitus loudness, tinnitus distress, arousal, valence. The repeated arousal and valence ratings were used for two operationalizations of emotion dynamics: intra-individual variability of affect intensity (pulse) as well as intra-individual variability of affect quality (spin). Pearson correlation coefficients showed that the Mini-TQ was positively correlated with pulse (r = 0.19; p emotion dynamics might be a potential target in the prevention and treatment of tinnitus. PMID:27488227

  12. Audiological and psychological characteristics of a group of tinnitus sufferers, prior to tinnitus management training.

    Science.gov (United States)

    Dineen, R; Doyle, J; Bench, J

    1997-02-01

    A profile of audiological and psychological characteristics, obtained before starting tinnitus management training, is presented for 96 subjects with tinnitus. Variability was marked in all measures. A history of headaches, neck or back pain, or balance problems was not related to the ability to cope with tinnitus. The coping strategies used to manage tinnitus were influenced by the beliefs held about tinnitus, but the coping strategies chosen were not necessarily effective. No gender differences were found in coping ability or overall stress levels, although there were gender differences on some psychological measures and stress influences. Subjects who had previously sought assistance differed from those who had not in the complexity of the tinnitus sounds, the level of emotional reaction and the use of coping behaviours. PMID:9056041

  13. Chronic Rhinosinusitis in Patients with Cystic Fibrosis.

    Science.gov (United States)

    Hamilos, Daniel L

    2016-01-01

    Chronic rhinosinusitis (CRS) is highly prevalent in patients with cystic fibrosis (CF) and accounts for significant morbidity and contribution to CF lung disease. Mutations of the cystic fibrosis transmembrane regulator gene occur with increased prevalence in patients with CRS without CF, suggesting some contribution to CRS pathophysiology. Nasal polyps (NPs) occur with increased prevalence in patients with CF of all ages and have a more neutrophilic appearance with fewer eosinophils and increased submucosal glandular elements in comparison to NPs from patients without CF. Mainstays of medical treatment include isotonic saline irrigations and topical intranasal glucocorticoids, with some evidence that topical intranasal glucocorticoids reduce NP size. Although inhaled hypertonic saline (7%) has been widely studied as a mucolytic agent for CF lung disease, there are no reports of its use in CF CRS. Mucolytics have also not been studied as a treatment for CRS in CF, and most evidence does not support their use for CF lung disease. Nasally nebulized dornase alfa (recombinant human deoxyribonuclease) following sinus surgery shows promise for treatment. Other unproven therapies include addition of baby shampoo to isotonic saline to potentially thin mucus and help prevent biofilm formation. There are no data to support the use of low-dose oral macrolide antibiotics or the use of prophylactic oral antibiotics for CRS in patients with CF. However, there is some support for the use of topical antibiotics, including colistimethate sodium or tobramycin, administered as a sinus irrigation or antral lavage in patients following sinus surgery when susceptible bacteria are cultured. Key components of CF sinus surgical management include extensive surgery to ensure that the maxillary, frontal, sphenoid, and ethmoid sinuses are all widely opened with smoothing of bony overhangs to prevent mucus retention and bacterial recolonization, postoperative meticulous daily nasal irrigations

  14. Tinnitus: Network pathophysiology-network pharmacology

    Directory of Open Access Journals (Sweden)

    Ana Belen eElgoyhen

    2012-01-01

    Full Text Available Tinnitus, the phantom perception of sound, is a prevalent disorder. One in 10 adults has clinically significant subjective tinnitus, and for 1 in 100, tinnitus severely affects their quality of life. Despite the significant unmet clinical need for a safe and effective drug targeting tinnitus relief, there is currently not a single FDA-approved drug on the market. The search for drugs that target tinnitus is hampered by the lack of a deep knowledge of the underlying neural substrates of this pathology. Recent studies are increasingly demonstrating that, as described for other central nervous system disorders, tinnitus is a pathology of brain networks. The application of graph theoretical analysis to brain networks has recently provided new information concerning their topology, their robustness and their vulnerability to attacks. Moreover, the philosophy behind drug design and pharmacotherapy in central nervous system pathologies is changing from that of magic bullets that target individual chemoreceptors or disease-causing genes into that of magic shotguns, promiscuous or dirty drugs that target disease-causing networks, also known as network pharmacology. In the present work we provide some insight into how this knowledge could be applied to tinnitus pathophysiology and pharmacotherapy.

  15. Chronic aseptic meningitis in a patient with systemic lupus erythematosus.

    Science.gov (United States)

    Lancman, M E; Mesropian, H; Granillo, R J

    1989-08-01

    Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus. It may occur early in the course of the disease and sometimes may be the initial symptom. We report a patient with chronic aseptic meningitis associated with systemic lupus erythematosus. Magnetic resonance imaging showed several ischemic lesions and an appearance which was compatible with chronic inflammation of the ependyma of the lateral ventricles.

  16. Temporomandibular joint disorder complaints in tinnitus: Further hints for a putative tinnitus subtype

    OpenAIRE

    Vielsmeier, V; Strutz, J; Kleinjung, T; Schecklmann, M; Kreuzer, P M; Landgrebe, M; Langguth, B

    2012-01-01

    OBJECTIVE: Tinnitus is considered to be highly heterogeneous with respect to its etiology, its comorbidities and the response to specific interventions. Subtyping is recommended, but it remains to be determined which criteria are useful, since it has not yet been clearly demonstrated whether and to which extent etiologic factors, comorbid states and interventional response are related to each other and are thus applicable for subtyping tinnitus. Analyzing the Tinnitus Research Initiative Data...

  17. A Scientific Cognitive-Behavioral Model of Tinnitus: Novel Conceptualizations of Tinnitus Distress

    OpenAIRE

    McKenna, Laurence; Handscomb, Lucy; Hoare, Derek J; Hall, Deborah A

    2014-01-01

    The importance of psychological factors in tinnitus distress has been formally recognized for almost three decades. The psychological understanding of why tinnitus can be a distressing condition posits that it becomes problematic when it acquires an emotive significance through cognitive processes. Principle therapeutic efforts are directed at reducing or removing the cognitive (and behavioral) obstacles to habituation. Here, the evidence relevant to a new psychological model of tinnitus is c...

  18. Changes in Tinnitus after Cochlear Implantation and Its Relation with Psychological Functioning

    NARCIS (Netherlands)

    Kloostra, Francka J. J.; Arnold, Rosemarie; Hofman, Rutger; Van Dijk, Pim

    2015-01-01

    This study retrospectively assessed the prevalence of tinnitus in cochlear implant patients and the changes after implantation in 212 patients implanted between 2000 and 2009. Patients were included at least 6 months after implantation and received 2 sets of questionnaires, one about the situation b

  19. [Cerebral arachnoiditis in patients with chronic rhinosinusitis].

    Science.gov (United States)

    Gushchin, A N

    1994-01-01

    The examination and treatment of 66 patients with rhinosinusogenic cerebral arachnoiditis (RCA) were performed using otorhinolaryngological and neurological tests with special emphasis on pneumoencephalography to provide objective assessment of the brain layers and ventricles. It is shown that RCA occurs most frequently in subjects suffering from chronic purulent axillary sinusitis or recurrent polysinusitis. RCA manifestations depend on the duration of rhinosinusitis and its recurrence rate. RCA onset is usually not acute and takes place at the time of rhinosinusitis exacerbation. There are also mild frontal headaches, pathological changes in the coats of the anterior cranial fossa. The above abnormalities were most pronounced at the side of rhinosinusitis or most affected sinus. The treatment should be first of all oriented on elimination of maxillary infection in line with pathogenetic treatment of RCA. An individual approach to treatment policy is advocated.

  20. Clinical significance of changes of serum gastrin levels in patients with chronic eczema or chronic urticaria

    International Nuclear Information System (INIS)

    Objective: To study the clinical significance of changes of serum levels of gastrin in patients with chronic eczema or chronic urticaria. Methods: Serum gastrin levels were, 37 patients with chromic urticaria and 43 controls. Results: Serum gastrin levels in patients with chronic exzema (102.95 ± 27.33 ng/L) and patients with chronic urticaria (109.87 ± 33.64 ng/L) were both significantly higher than those in controls (61.72 ± 20.38 ng/L, both P<0.01). Difference between the levels in the two patients groups was not significant. Conclusion: The high gastrin levels in those patients might reflect the presence of helicobacter pylori infections; eradication of which might be helpful for treatment of these chronic dermatologic disorders. (authors)

  1. Gastric emptying in patients with chronic liver diseases

    Energy Technology Data Exchange (ETDEWEB)

    Ishizu, Hirotaka; Shiomi, Susumu; Kawamura, Etsushi; Iwata, Yoshinori; Nishiguchi, Shuhei; Kawabe, Joji; Ochi, Hironobu [Osaka City Univ. (Japan). Graduate School of Medicine

    2002-05-01

    There have been a number of reports of gastric emptying in cirrhosis, all with unconfirmed results. Moreover, the mechanism for delayed emptying in cirrhotic patients in unclear. We evaluated gastric emptying in patients with chronic hepatitis and cirrhosis by means of gastric emptying scintigraphy. The subjects were 18 normal controls and 75 patients with chronic viral hepatitis (50 patients had chronic hepatitis and 25 patients had cirrhosis). Tc-99m diethyltriamine pentaacetic acid labeled solid meals were used to evaluate gastric emptying; the half-time (T 1/2) of which was calculated. Digestive symptom scores were determined at the time of gastric emptying tests. Fourteen (28%) of 50 patients with chronic hepatitis and 16 (64%) of 25 patients with cirrhosis had delayed gastric emptying. T 1/2 in patients with cirrhosis was significantly higher than that in normal controls and patients with chronic hepatitis (p=0.0001 and 0.0003, respectively). The difference between T 1/2 in patients with chronic hepatitis and that in normal controls was not significant. On regression analysis, two indices, the serum albumin level and platelet count, were found to be significantly related to delayed gastric emptying. Gastric emptying was more delayed in cirrhotic patients than in those with chronic hepatitis and normal controls. Delayed gastric emptying may be related to liver function and portal hypertension. (author)

  2. Hearing Loss and Tinnitus in Military Personnel with Deployment-Related Mild Traumatic Brain Injury.

    Science.gov (United States)

    Karch, Stephanie J; Capó-Aponte, José E; McIlwain, D Scott; Lo, Michael; Krishnamurti, Sridhar; Staton, Roger N; Jorgensen-Wagers, Kendra

    2016-01-01

    The objective of this study was to analyze differences in incidence and epidemiologic risk factors for significant threshold shift (STS) and tinnitus in deployed military personnel diagnosed with mild traumatic brain injury (mTBI) due to either a blast exposure or nonblast head injury. A retrospective longitudinal cohort study of electronic health records of 500 military personnel (456 met inclusion criteria) diagnosed with deployment-related mTBI was completed. Chi-square tests and STS incidence rates were calculated to assess differences between blast-exposed and nonblast groups; relative risks and adjusted odds ratios of developing STS or tinnitus were calculated for risk factors. Risk factors included such characteristics as mechanism of injury, age, race, military occupational specialty, concurrent diagnosis of posttraumatic stress disorder (PTSD), and nicotine use. Among blast-exposed and nonblast patients, 67% and 58%, respectively, developed STS, (P=.06); 59% and 40%, respectively, developed tinnitus (Pnoise exposure was associated with both STS and tinnitus. This study highlights potential risk factors for STS and tinnitus among blast-exposed and nonblast mTBI patient groups. PMID:27613210

  3. Alexithymia and anxiety in female chronic pain patients

    OpenAIRE

    Saatcioglu Omer; Celikel Feryal

    2006-01-01

    Abstract Objectives Alexithymia is highly prevalent among chronic pain patients. Pain is a remarkable cause for high levels of chronic anxiety. The purpose of this study was to investigate the prevalence of alexithymia and to determine anxiety levels among DSM-IV somatoform pain disorder (chronic pain) female patients and to examine the relationship between alexithymia and the self-reporting of pain. Methods Thirty adult females (mean age: 34,63 ± 10,62 years), who applied to the outpatient p...

  4. Physical Activity Recommendations in Patients with Chronic Obstructive Pulmonary Disease

    NARCIS (Netherlands)

    Hartman, Jorine E.; Boezen, H. Marike; Zuidema, Menno J.; de Greef, Mathieu H. G.; ten Hacken, Nick H. T.; Boezen, Hendrika

    2014-01-01

    Background: Physical activity recommendations are hardly studied in patients with chronic obstructive pulmonary disease (COPD), and specifically recommendations that are individualized to a patient's aerobic fitness level are not studied. Objectives: To compare individualized (relative) and nonindiv

  5. Patients with chronic pancreatitis are at increased risk for osteoporosis.

    LENUS (Irish Health Repository)

    Duggan, SN

    2012-10-01

    Patients with chronic pancreatitis may be at an increased risk of low bone density because of malabsorption of vitamin D and calcium, poor diet, pain, alcoholism, and smoking. We investigated the rates of osteoporosis in patients with chronic pancreatitis compared to matched controls.

  6. Burnout in Patients with Chronic Whiplash-Associated Disorders

    Science.gov (United States)

    Clementz, Gunilla; Borsbo, Bjorn; Norrbrink, Cecilia

    2012-01-01

    This study sought to assess burnout and its relation to pain, disability, mood and health-related quality of life in a group of patients with chronic whiplash-associated disorders (WAD). Forty-five patients with chronic WAD ([greater than or equal to] 3 months) referred to a multidisciplinary rehabilitation centre were included. A questionnaire…

  7. Cognitive function in patients with chronic pain treated with opioids

    DEFF Research Database (Denmark)

    Kurita, G P; de Mattos Pimenta, C A; Braga, P E;

    2012-01-01

    The paucity of studies regarding cognitive function in patients with chronic pain, and growing evidence regarding the cognitive effects of pain and opioids on cognitive function prompted us to assess cognition via neuropsychological measurement in patients with chronic non-cancer pain treated...... with opioids....

  8. Review article: hepatitis vaccination in patients with chronic liver disease.

    Science.gov (United States)

    Reiss, G; Keeffe, E B

    2004-04-01

    Evidence regarding the outcomes of viral super-infection in patients with chronic liver disease and practical strategies for hepatitis A and B vaccination of these individuals are reviewed. Patients with acute hepatitis A and chronic hepatitis B have a more severe clinical course and a higher death rate compared with otherwise healthy individuals with hepatitis A, and these differences are most pronounced in older patients and those with histological evidence of chronic hepatitis or cirrhosis, rather than in asymptomatic hepatitis B carriers. Patients with acute hepatitis A super-infection and chronic hepatitis C have an increased risk of fulminant hepatitis and death. In addition, patients with other chronic liver diseases also appear to be at increased risk for more severe disease with superimposed hepatitis A. Patients with chronic hepatitis B and hepatitis C virus co-infection have more severe laboratory abnormalities, more severe histological disease, a greater frequency of cirrhosis and complications of cirrhosis, and a higher incidence of hepatocellular carcinoma. Vaccines for both hepatitis A and B are safe and effective if used early in the course of chronic liver disease. Hepatitis A and B vaccination should be part of the routine management of patients with chronic liver disease, preferably as early as possible in the natural course of their disease.

  9. Addiction to opioids in chronic pain patients: a literature review

    DEFF Research Database (Denmark)

    Højsted, Jette; Sjøgren, Per

    2007-01-01

    Opioids have proven very useful for treatment of acute pain and cancer pain, and in the developed countries opioids are increasingly used for treatment of chronic non-malignant pain patients as well. This literature review aims at giving an overview of definitions, mechanisms, diagnostic criteria......, incidence and prevalence of addiction in opioid treated pain patients, screening tools for assessing opioid addiction in chronic pain patients and recommendations regarding addiction problems in national and international guidelines for opioid treatment in cancer patients and chronic non-malignant pain...... patients. The review indicates that the prevalence of addiction varied from 0% up to 50% in chronic non-malignant pain patients, and from 0% to 7.7% in cancer patients depending of the subpopulation studied and the criteria used. The risk of addiction has to be considered when initiating long-term opioid...

  10. Influence of chronic kidney disease on the outcome of patients with chronic total occlusion

    OpenAIRE

    Zhang, Qing-Bin; Chen, Li-Ming; Min LI; Cui, Yu-Qi; Zhao, Chuan-Yan; Cui, Lian-Qun

    2016-01-01

    Objective: Chronic kidney disease (CKD) predicted a poor prognosis in patients with coronary artery disease. There is a paucity of data on outcomes after revascularization in patients with chronic total occlusion (CTO) and CKD. This study aims to investigate the impact of CKD on the revascularization of CTO. Methods: This study enrolled 1,092 CTO patients received treatments in our hospital between February 2009 and January 2014. Major adverse cardiac and cerebrovascular events (MACCE) and al...

  11. Transvascular lipoprotein transport in patients with chronic renal disease

    DEFF Research Database (Denmark)

    Jensen, Trine Krogsgaard; Nordestgaard, Børge Grønne; Feldt-Rasmussen, Bo;

    2004-01-01

    , determines the degree of atherosclerosis among patients with chronic renal disease. METHODS: We used an in vivo method for measurement of transvascular transport of low-density lipoprotein (LDL) in 21 patients with chronic renal disease and in 42 healthy control patients. Autologous 131-iodinated LDL...... was reinjected intravenously, and the 1-hour fractional escape rate was taken as index of transvascular transport. RESULTS: Transvascular LDL transport tended to be lower in patients with chronic renal disease than in healthy control patients [3.3 (95% CI 2.4-4.2) vs. 4.2 (3.7-4.2)%/hour; NS]. However...... with chronic renal disease, and healthy control patients [5.0 (3.2-7.8) vs. 3.0 (2.2-3.8) vs. 4.2 (3.6-4.8) %/hour; P

  12. Suppression and facilitation of auditory neurons through coordinated acoustic and midbrain stimulation: investigating a deep brain stimulator for tinnitus

    Science.gov (United States)

    Offutt, Sarah J.; Ryan, Kellie J.; Konop, Alexander E.; Lim, Hubert H.

    2014-12-01

    Objective. The inferior colliculus (IC) is the primary processing center of auditory information in the midbrain and is one site of tinnitus-related activity. One potential option for suppressing the tinnitus percept is through deep brain stimulation via the auditory midbrain implant (AMI), which is designed for hearing restoration and is already being implanted in deaf patients who also have tinnitus. However, to assess the feasibility of AMI stimulation for tinnitus treatment we first need to characterize the functional connectivity within the IC. Previous studies have suggested modulatory projections from the dorsal cortex of the IC (ICD) to the central nucleus of the IC (ICC), though the functional properties of these projections need to be determined. Approach. In this study, we investigated the effects of electrical stimulation of the ICD on acoustic-driven activity within the ICC in ketamine-anesthetized guinea pigs. Main Results. We observed ICD stimulation induces both suppressive and facilitatory changes across ICC that can occur immediately during stimulation and remain after stimulation. Additionally, ICD stimulation paired with broadband noise stimulation at a specific delay can induce greater suppressive than facilitatory effects, especially when stimulating in more rostral and medial ICD locations. Significance. These findings demonstrate that ICD stimulation can induce specific types of plastic changes in ICC activity, which may be relevant for treating tinnitus. By using the AMI with electrode sites positioned with the ICD and the ICC, the modulatory effects of ICD stimulation can be tested directly in tinnitus patients.

  13. Decreased Speech-In-Noise Understanding in Young Adults with Tinnitus

    Science.gov (United States)

    Gilles, Annick; Schlee, Winny; Rabau, Sarah; Wouters, Kristien; Fransen, Erik; Van de Heyning, Paul

    2016-01-01

    differ regarding audiometry, OAE, and ABR.However, tinnitus patients showed decreased speech-in-noise reception. The results are discussed in the light of previous findings suggestion NIT may occur in the absence of measurable peripheral damage as reflected in speech-in-noise deficits in tinnitus subjects. PMID:27445661

  14. The distressed (Type D) personality is independently associated with tinnitus

    DEFF Research Database (Denmark)

    Bartels, Hilke; Middel, Berrie; Pedersen, Susanne S.;

    2010-01-01

    Tinnitus is a common and disturbing condition, reported by 10% to 20% of the general population.......Tinnitus is a common and disturbing condition, reported by 10% to 20% of the general population....

  15. [The physician-patient relationship in chronic disease management].

    Science.gov (United States)

    Ginies, P

    2008-07-01

    The relationship between patients and clinicians is a key element in the management of chronic diseases. With the objective of a more efficient communication, the clinician should know his own personality but also the patient personality. The organisation of the consultation, of the waiting room and of the secretary has to facilitate this relationship. The amelioration of this relationship is usefulness only for the clinician in particularly complicated cases but also for the patients suffering from chronic diseases.

  16. Osteoporosis in chronic obstructive pulmonary disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Niklas Rye; Schwarz, Peter

    2008-01-01

    The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.......The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence....

  17. Rationale for the tinnitus retraining therapy trial

    Directory of Open Access Journals (Sweden)

    Craig Formby

    2013-01-01

    Full Text Available The Tinnitus Retraining Therapy Trial (TRTT is a National Institutes of Health-sponsored, multi-centered, placebo-controlled, randomized trial evaluating the efficacy of tinnitus retraining therapy (TRT and its component parts, directive counseling and sound therapy, as treatments for subjective debilitating tinnitus in the military. The TRTT will enroll 228 individuals at an allocation ratio of 1:1:1 to: (1 directive counseling and sound therapy using conventional sound generators; (2 directive counseling and placebo sound generators; or (3 standard of care as administered in the military. Study centers include a Study Chair′s Office, a Data Coordinating Center, and six Military Clinical Centers with treatment and data collection standardized across all clinics. The primary outcome is change in Tinnitus Questionnaire (TQ score assessed longitudinally at 3, 6, 12, and 18-month follow-up visits. Secondary outcomes include: Change in TQ sub-scales, Tinnitus Handicap Inventory, Tinnitus Functional Index, and TRT interview visual analog scale; audiometric and psychoacoustic measures; and change in quality of life. The TRTT will evaluate TRT efficacy by comparing TRT (directive counseling and conventional sound generators with standard of care; directive counseling by comparing directive counseling plus placebo sound generators versus standard of care; and sound therapy by comparing conventional versus placebo sound generators. We hypothesize that full TRT will be more efficacious than standard of care, directive counseling and placebo sound generators more efficacious than standard of care, and conventional more efficacious than placebo sound generators in habituating the tinnitus awareness, annoyance, and impact on the study participant′s life.

  18. Ovarian carcinoma in two patients with chronic liver disease

    Institute of Scientific and Technical Information of China (English)

    Mehlika Isildak; Gulay Sain Guven; Murat Kekilli; Yavuz Beyazit; Mustafa Erman

    2005-01-01

    Ascites is a common and debilitating complication of cirrhosis. However, patients with chronic liver disease are not spared from other causes of ascites and physicians should be careful not to miss an underlying malignancy.Ovarian cancer is an insidious disease, which is difficult to diagnose and it ranks first in mortality among all gynecological cancers. Here, we present two cases of patients with chronic liver disease that developed ascites not simply because of cirrhosis but as a manifestation of ovarian cancer. We would like to emphasize that the causes of ascites, other than the liver itself, should not be overlooked in patients with chronic liver disease.

  19. Assessing and Managing Sleep Disturbance in Patients with Chronic Pain.

    Science.gov (United States)

    Cheatle, Martin D; Foster, Simmie; Pinkett, Aaron; Lesneski, Matthew; Qu, David; Dhingra, Lara

    2016-06-01

    Chronic pain is associated with symptoms that may impair a patient's quality of life, including emotional distress, fatigue, and sleep disturbance. There is a high prevalence of concomitant pain and sleep disturbance. Studies support the hypothesis that sleep and pain have a bidirectional and reciprocal relationship. Clinicians who manage patients with chronic pain often focus on interventions that relieve pain, and assessing and treating sleep disturbance are secondary or not addressed. This article reviews the literature on pain and co-occurring sleep disturbance, describes the assessment of sleep disturbance, and outlines nonpharmacologic and pharmacologic treatment strategies to improve sleep in patients with chronic pain. PMID:27208716

  20. Assessing and Managing Sleep Disturbance in Patients with Chronic Pain.

    Science.gov (United States)

    Cheatle, Martin D; Foster, Simmie; Pinkett, Aaron; Lesneski, Matthew; Qu, David; Dhingra, Lara

    2016-06-01

    Chronic pain is associated with symptoms that may impair a patient's quality of life, including emotional distress, fatigue, and sleep disturbance. There is a high prevalence of concomitant pain and sleep disturbance. Studies support the hypothesis that sleep and pain have a bidirectional and reciprocal relationship. Clinicians who manage patients with chronic pain often focus on interventions that relieve pain, and assessing and treating sleep disturbance are secondary or not addressed. This article reviews the literature on pain and co-occurring sleep disturbance, describes the assessment of sleep disturbance, and outlines nonpharmacologic and pharmacologic treatment strategies to improve sleep in patients with chronic pain.

  1. [A new method for treating patients with chronic prostatitis].

    Science.gov (United States)

    Boĭko, M I

    1995-01-01

    A new preparation is reported for treatment of chronic inflammation of the prostate, which substantially lowers rates of patients' complaints and depresses the secretion leucocyte reaction. Prostatilen was shown to be capable of normalization of immunity status of the chronic prostatitis patients thus lowering the microbial index of the cultured prostate secretion microorganisms. The following new nonantibacterial strategy of treatment of chronic prostatitis patients is proposed: prostatilen given as a single agent or in combination with immunomodulators and physiotherapeutic methods. Antibacterial therapy is to be instituted on a short-term basis only during the period of exacerbation of the inflammatory process.

  2. Mitochondrial DNA deletions in patients with chronic suppurative otitis media.

    Science.gov (United States)

    Tatar, Arzu; Tasdemir, Sener; Sahin, Ibrahim; Bozoglu, Ceyda; Erdem, Haktan Bagis; Yoruk, Ozgur; Tatar, Abdulgani

    2016-09-01

    The aim of this study was to investigate the 4977 and 7400 bp deletions of mitochondrial DNA in patients with chronic suppurative otitis media and to indicate the possible association of mitochondrial DNA deletions with chronic suppurative otitis media. Thirty-six patients with chronic suppurative otitis media were randomly selected to assess the mitochondrial DNA deletions. Tympanomastoidectomy was applied for the treatment of chronic suppurative otitis media, and the curettage materials including middle ear tissues were collected. The 4977 and 7400 bp deletion regions and two control regions of mitochondrial DNA were assessed by using the four pair primers. DNA was extracted from middle ear tissues and peripheral blood samples of the patients, and then polymerase chain reactions (PCRs) were performed. PCR products were separated in 2 % agarose gel. Seventeen of 36 patients had the heterozygote 4977 bp deletion in the middle ear tissue but not in peripheral blood. There wasn't any patient who had the 7400 bp deletion in mtDNA of their middle ear tissue or peripheral blood tissue. The patients with the 4977 bp deletion had a longer duration of chronic suppurative otitis media and a higher level of hearing loss than the others (p media and the reactive oxygen species can cause the mitochondrial DNA deletions and this may be a predisposing factor to sensorineural hearing loss in chronic suppurative otitis media. An antioxidant drug as a scavenger agent may be used in long-term chronic suppurative otitis media.

  3. Analysis of electrocardiogram in chronic obstructive pulmonary disease patients

    Directory of Open Access Journals (Sweden)

    Lazović Biljana

    2013-01-01

    Full Text Available Introduction. Chronic obstructive pulmonary disease is the fourth leading cause of mortality worldwide. It is defined as a persistent airflow limitation usually progressive and not fully reversible to treatment. The diagnosis of chronic obstructive pulmonary disease and severity of disease is confirmed by spirometry. Chronic obstructive pulmonary disease produces electrical changes in the heart which shows characteristic electrocardiogram pattern. The aim of this study was to observe and evaluate diagnostic values of electrocardiogram changes in chronic obstructive pulmonary disease patients with no other comorbidity. Material and Methods. We analyzed 110 electrocardiogram findings in clinically stable chronic obstructive pulmonary disease patients and evaluated the forced expiratory volume in the first second, ratio of forces expiratory volume in the first second to the fixed vital capacity, chest radiographs and electrocardiogram changes such as p wave height, QRS axis and voltage, right bundle branch block, left bundle branch block, right ventricular hypertrophy, T wave inversion in leads V1-V3, S1S2S3 syndrome, transition zone in praecordial lead and QT interval. Results. We found electrocardiogram changes in 64% patients, while 36% had normal electrocardiogram. The most frequent electrocardiogram changes observed were transition zone (76.36% low QRS (50% and p pulmonale (14.54%. Left axis deviation was observed in 27.27% patients. Conclusion. Diagnostic values of electrocardiogram in patients with chronic obstructive pulmonary disease suggest that chronic obstructive pulmonary disease patients should be screened electrocardiographically in addition to other clinical investigations.

  4. Audiological, psychological and cognitive characteristics of tinnitus sufferers

    Directory of Open Access Journals (Sweden)

    Noorain Alam

    2012-01-01

    Full Text Available Objective: Tinnitus is widespread amongst clients attending hearing clinics and has been associated with a range of physical and emotional disorders. This study was undertaken with the assumption that tinnitus has a negative impact on psychological well-being as well as on mental concentration of the person. Materials and Methods: Three groups were selected, comprising 10 participants each. Two groups consisted of subjects with tinnitus complaints. The first group had no hearing loss (Tinnitus group (TIG, the second group had mild hearing loss (PTA >25, <40 dBHL (Tinnitus group with hearing impairment (TWHIG, and the third group had no tinnitus or hearing loss (Normal control group (NCG. After an audiological assessment, the following questionnaires were administered: 1 nature of tinnitus questionnaire, 2 tinnitus reaction questionnaire, 3 the symptom checklist (SCL-90-R, and 4 cognitive failure questionnaire (CFQ. Out of these, four were administered to all tinnitus groups while only the last two were administered on NCG. The results of these tests were compared using a t- test. Results: Participants with tinnitus reported significantly more psychological distress symptoms and everyday cognitive failures than the control group. Conclusion: Our assumption about the potential negative impact of tinnitus on psychological well-being as well as on mental concentration is supported by our study results. Implication: The present study indicates that there is a greater need for providing counseling as well as psychological intervention to reduce stress and assistance in coping with the cognitive failures for persons with tinnitus.

  5. Functional imaging of unilateral tinnitus using fMRI

    NARCIS (Netherlands)

    Lanting, C. P.; De Kleine, E.; Van Dijk, P.; Bartels, H.

    2008-01-01

    Conclusions. This article shows that the inferior colliculus plays a key role in unilateral subjective tinnitus. Objectives. The major aim of this study was to determine tinnitus-related neural activity in the central auditory system of unilateral tinnitus subjects and compare this to control subjec

  6. Bile acid malabsorption in patients with chronic diarrhoea

    DEFF Research Database (Denmark)

    Wildt, S; Nørby Rasmussen, S; Lysgård Madsen, Jan;

    2003-01-01

    Bile acid malabsorption (BAM), a cause of chronic diarrhoea, can be diagnosed by the SeHCAT test. The purpose of this study was to evaluate the usefulness of SeHCAT testing by assessing the extent of BAM and describing the clinical characteristics in a group of patients with chronic diarrhoea...

  7. Ribavirin for Chronic Hepatitis Prevention among Patients with Hematologic Malignancies

    OpenAIRE

    Tavitian, Suzanne; Peron, Jean-Marie; Huguet, Françoise; Kamar, Nassim; Abravanel, Florence; Beyne-Rauzy, Odile; Oberic, Lucie; Faguer, Stanislas; Alric, Laurent; Roussel, Murielle; Gaudin, Clément; Ysebaert, Loïc; Huynh, Anne; Recher, Christian

    2015-01-01

    Findings among a cohort of 26 patients who had hematologic malignancies and hepatitis E virus (HEV) infection support that HEV can induce chronic hepatitis. However, a 3-month course of ribavirin can induce a rapid viral clearance, reducing the risk for chronic hepatitis and enabling continuation of cytotoxic treatments for underlying malignancies.

  8. Comparison of Auditory Brainstem Response in Noise Induced Tinnitus and Non-Tinnitus Control Subjects

    Directory of Open Access Journals (Sweden)

    Ghassem Mohammadkhani

    2009-12-01

    Full Text Available Background and Aim: Tinnitus is an unpleasant sound which can cause some behavioral disorders. According to evidence the origin of tinnitus is not only in peripheral but also in central auditory system. So evaluation of central auditory system function is necessary. In this study Auditory brainstem responses (ABR were compared in noise induced tinnitus and non-tinnitus control subjects.Materials and Methods: This cross-sectional, descriptive and analytic study is conducted in 60 cases in two groups including of 30 noise induced tinnitus and 30 non-tinnitus control subjects. ABRs were recorded ipsilateraly and contralateraly and their latencies and amplitudes were analyzed.Results: Mean interpeak latencies of III-V (p= 0.022, I-V (p=0.033 in ipsilatral electrode array and mean absolute latencies of IV (p=0.015 and V (p=0.048 in contralatral electrode array were significantly increased in noise induced tinnitus group relative to control group. Conclusion: It can be concluded from that there are some decrease in neural transmission time in brainstem and there are some sign of involvement of medial nuclei in olivery complex in addition to lateral lemniscus.

  9. Chronic urticaria. Clinical and pathogenetic studies in 141 patients

    NARCIS (Netherlands)

    Doeglas, Hendrik Maarten George

    1975-01-01

    This study describes a combined clinical, laboratory and experimental approach of the problems of 141 patients with chronic urticaria, collected over a three-year period in a Dermatology department. ... Zie: Summary

  10. SRSF2 mutation in patients with chronic myelomonocytic leukemia

    Institute of Scientific and Technical Information of China (English)

    杨向绸

    2014-01-01

    Objective To investigate SRSF2 mutations in patients with chronic myelomonocytic leukemia(CMML)and the clinical characteristics of patients with SRSF2mutants.Methods In this study,the frequency of SRSF2mutation in a cohort of 20 patients with CMML was detected by polymerase chain reaction(PCR)followed by direct

  11. Ovarian carcinoma in two patients with chronic liver disease

    OpenAIRE

    Isildak, Mehlika; Guven, Gulay Sain; Kekilli, Murat; Beyazit, Yavuz; Erman, Mustafa

    2005-01-01

    Ascites is a common and debilitating complication of cirrhosis. However, patients with chronic liver disease are not spared from other causes of ascites and physicians should be careful not to miss an underlying malignancy. Ovarian cancer is an insidious disease, which is difficult to diagnose and it ranks first in mortality among all gynecological cancers. Here, we present two cases of patients with chronic liver disease that developed ascites not simply because of cirrhosis but as a manifes...

  12. Phenotypes selected during chronic lung infection in cystic fibrosis patients

    DEFF Research Database (Denmark)

    Ciofu, Oana; Mandsberg, Lotte F; Wang, Hengzhuang;

    2012-01-01

    During chronic lung infection of patients with cystic fibrosis, Pseudomonas aeruginosa can survive for long periods of time under the challenging selective pressure imposed by the immune system and antibiotic treatment as a result of its biofilm mode of growth and adaptive evolution mediated...... the importance of biofilm prevention strategies by early aggressive antibiotic prophylaxis or therapy before phenotypic diversification during chronic lung infection of patients with cystic fibrosis....

  13. Cardiovascular disease in patients with chronic kidney disease

    OpenAIRE

    Julian Wright; Alastair Hutchison

    2009-01-01

    Julian Wright, Alastair HutchisonManchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester, UKAbstract: Patients with chronic kidney disease have a high burden of cardiovascular morbidity and mortality. The vast majority of patients with chronic kidney disease do not progress to end stage renal failure, but do have a significantly higher incidence of all cardiovascular co-morbidities. Traditional cardiovascular risk factors only partially account for this ...

  14. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2011-03-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome.

  15. Impaired vascular reactivity in patients with chronic kidney disease

    DEFF Research Database (Denmark)

    Tetzner, Fabian; Scholze, Alexandra; Wittstock, Antje;

    2008-01-01

    Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics.......Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics....

  16. Disability and borderline personality disorder in chronic pain patients

    OpenAIRE

    Sansone, Randy A.; J David Sinclair; Wiederman, Michael W.

    2010-01-01

    BACKGROUND AND OBJECTIVE: Few studies have examined the relationship between disability and borderline personality symptomatology, and, among those that have, findings have been inconsistent. In the present study, the relationship between medical disability and borderline personality symptomatology was examined in a sample of chronic pain patients.METHODS: In a consecutive insured sample of male and female chronic pain patients (n=117), who were being initially evaluated by an outpatient pain...

  17. Quality of life in patients with chronic kidney disease

    OpenAIRE

    Maria Carolina Cruz; Carolina Andrade; Milton Urrutia; Sergio Draibe; Luiz Antônio Nogueira-Martins; Ricardo de Castro Cintra Sesso

    2011-01-01

    AIM: To compare the dimensions of quality of life in the stages of chronic kidney disease and the influence of sociodemographic, clinical and laboratory data. INTRODUCTION: The information available on the quality of life of patients on conservative treatment and the relationship between the quality of life and glomerular filtration rate is limited. METHODS: 155 patients in stages 1-5 of chronic kidney disease and 36 in hemodialysis were studied. Quality of life was rated by the Medical Outco...

  18. Health Related Quality of Life of Chronic Liver Patients: A Dutch Population-Based Study

    NARCIS (Netherlands)

    S.M. van der Plas (Simone)

    2004-01-01

    markdownabstract__Abstract__ Chronic illnesses form a spectrum of diseases. Some chronic illnesses are poorly understood and unpredictable, some are understood and manageable, some are progressively disabling and some are life threatening. Nevertheless, for all chronic patients chronic illnesses ha

  19. Quality of life in chronic disease patients

    Directory of Open Access Journals (Sweden)

    Kalliopi Megari

    2013-09-01

    Full Text Available During the past decades there was an increasing predominance of chronic disorders, with a large number of people living with chronic diseases that can adversely affect their quality of life. The aim of the present paper is to study quality of life and especially Health-related quality of life (HRQoL in chronic diseases. HRQOL is a multidimensional construct that consists of at least three broad domains − physical, psychological, and social functioning − that are affected by one’s disease and/or treatment. HRQoL is usually measured in chronic conditions and is frequently impaired to a great extent. In addition, factors that are associated with good and poor HRQoL, as well as HRQoL assessment will be discussed. The estimation of the relative impact of chronic diseases on HRQoL is necessary in order to better plan and distribute health care resources aiming at a better HRQoL.[«All the people perceive the concept of living good or being well, that is the same as being happy». (Aristotle. 384-322 BC. Ethica Nichomachea

  20. Classification and identification of opioid addiction in chronic pain patients

    DEFF Research Database (Denmark)

    Højsted, Jette; Nielsen, Per Rotbøll; Guldstrand, Sally Kendall;

    2010-01-01

    Addiction is a feared consequence of long-term opioid treatment of chronic pain patients. The ICD-10 and DSM-IV diagnostic addiction criteria may not be appropriate in these patients. Therefore Portenoy's criteria (PC) were launched. The aim was to estimate the prevalence of addiction, to investi......Addiction is a feared consequence of long-term opioid treatment of chronic pain patients. The ICD-10 and DSM-IV diagnostic addiction criteria may not be appropriate in these patients. Therefore Portenoy's criteria (PC) were launched. The aim was to estimate the prevalence of addiction...

  1. Stereoselective pharmacokinetics of methadone in chronic pain patients

    DEFF Research Database (Denmark)

    Kristensen, K; Blemmer, T; Angelo, H R;

    1996-01-01

    Ten patients with chronic pain were randomized to an open, balanced, crossover study. Each patients received two different preparations of racemic methadone, i.e., tablets and intravenous infusion. The pharmacokinetic parameters of the R- and S-enantiomers of the racemate are reported. The analge......Ten patients with chronic pain were randomized to an open, balanced, crossover study. Each patients received two different preparations of racemic methadone, i.e., tablets and intravenous infusion. The pharmacokinetic parameters of the R- and S-enantiomers of the racemate are reported...

  2. Patient-Staff Interactions and Mental Health in Chronic Dialysis Patients

    Science.gov (United States)

    Swartz, Richard D.; Perry, Erica; Brown, Stephanie; Swartz, June; Vinokur, Amiram

    2008-01-01

    Chronic dialysis imposes ongoing stress on patients and staff and engenders recurring contact and long-term relationships. Thus, chronic dialysis units are opportune settings in which to investigate the impact of patients' relationships with staff on patient well-being. The authors designed the present study to examine the degree to which…

  3. Chronic coinfections in patients diagnosed with chronic Lyme disease: a systematic literature review

    Science.gov (United States)

    Lantos, Paul M.; Wormser, Gary P.

    2014-01-01

    Purpose The controversial diagnosis of chronic Lyme disease is often given to patients with prolonged, medically unexplained physical symptoms. Many such patients are also treated for chronic co-infections with Babesia, Anaplasma, or Bartonella in the absence of typical presentations, objective clinical findings, or laboratory confirmation of active infection. We have undertaken a systematic review of the literature to evaluate several aspects of this practice. Methods Five systematic literature searches were performed using Boolean operators and the PubMed search engine. Results The literature searches did not demonstrate convincing evidence of 1) chronic anaplasmosis infection, 2) treatment responsive symptomatic chronic babesiosis in immunocompetent persons in the absence of fever, laboratory abnormalities and detectable parasitemia, 3) either geographically widespread or treatment responsive symptomatic chronic infection with Babesia duncani in the absence of fever, laboratory abnormalities and detectable parasitemia, 4) tick-borne transmission of Bartonella species, or 5) simultaneous Lyme disease and Bartonella infection. Conclusions The medical literature does not support the diagnosis of chronic, atypical tick-borne coinfections in patients with chronic, nonspecific illnesses. PMID:24929022

  4. Patients suffering benign chronic pain becoming acute: ER approach

    Directory of Open Access Journals (Sweden)

    Giovanni Nervetti

    2006-06-01

    Full Text Available Due to prescribing errors, to wrong therapeutic choice, to inadequate patient education, to errors in patients adherence to therapy, to social problems, to well known comorbidity between chronic pain and depression, a high number of patients, affected by chronic pain becoming acute, is in charge of the Emergency Department. But the Emergency Department is often the wrong place where to take care of such a complex condition. We present the results of a study conducted in our Emergency Department with the contribute of the Mental Health Department, concerning the evaluation of the diagnostic and therapeutic iter, the evolution of the symptoms, the customer satisfaction and the depression comorbidity, among the patients afferent to the Emergency Department because of a chronic non malignant pain becoming acute. The results of the study suggest the necessity of a more specific diagnostic and therapeutic approach to these patients, in both Emergency Hospital Department and outpatients settings.

  5. Evaluation of role of Candida in patients with chronic paronychia

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar Bahunuthula

    2015-01-01

    Full Text Available Background: Chronic paronychia, earlier considered to be an infection due to Candida, is currently being considered as a dermatitis of the nail fold. Irritant, allergic and protein contact dermatitis are the suggested major pathogenic mechanisms. Hypersensitivity to Candida is more likely to be the etiology, rather than the infection itself. Aims: To assess the clinico-etiological profiles of patients with chronic paronychia and to determine the role of contact sensitization and hypersensitivity to Candida. Methods: All consecutive patients of chronic paronychia attending the dermatology outpatient department (OPD were assessed for risk factors, number of nails affected, clinical presentation and presence of fungus, patch tested for contact allergy and prick tested for hypersensitivity to Candida allergen. Results: A total of 80 patients of chronic paronychia were recruited into our study. There was female preponderance (66 patients, 82.5%, with the most common group affected being housewives (47 patients, 58.8%. Frequent washing of hands (64 patients, 80% was the most common risk factor. Fungal culture was positive in 56.1% (41 patients, the predominant species cultured was Candida albicans (15 patients, 36.5%. Patch testing with Indian standard series was positive in 27.1% patients (19 out of 70 patients tested, with nickel being the most common allergen. Prick test with Candida allergen was positive in 47.6% patients (31 out of 65 patients tested. Limitations: Prick test and patch test provide indirect evidence of hypersensitivity, with inherent limitations. Conclusion: Our study shows that chronic paronychia is probably a form of hand dermatitis associated with prolonged wet work, and that there is a higher incidence of contact sensitization and Candida hypersensitivity in these patients.

  6. 240 Mold Sensitization in Chronic Rhinosinusitis Patients

    Science.gov (United States)

    Gawlik, Radoslaw; Czecior, Eugeniusz

    2012-01-01

    Background It is estimated that about 10% of the population have IgE antibodies to common inhalant molds. Exposure to fungal allergens could be linked to the presence and persistence of asthma, rhinitis and atopic dermatitis. Mold sensitization is a risk factor for development and deterioration of upper airway allergy, especially chronic rhinosinusitis. We addressed the incidence of mold allergy measured as specific IgE to molds and skin prick tests in chronic sinusitis patients. We assessed prevalence of allergic reactions to mould among surgery treated chronic sinusitis patients. Methods A group of 28 chronic sinusitis patients after surgery were included into the study. Routine medical examination, skin prick tests with common inhaled allergens and extended mold panel (Alternaria alternate, Cladosporium herbarium, Aspergilus fumigatus, Candida albicans, Mucor mucedo, Botrytis cinerea, Rhisopus nigricans, Penicilliumi notatum, Fusarum moniliforme Pullularia pullulans (Allergopharma, Germany), tIgE, asIgE measurement were performed (Phadia, Sweden). All investigated patients were consulted by laryngologist and mycological examination was performed. Results We found that sensitization to at least one allergen was present in 43.8(14/32) of sinusitis patients. The most prevalent was sensitization to house dust mite Dermatophagoides pt., found in 21.8 % (7/32) patients. Positive results of skin prick tests with Candida albicans we observed in 18.8% (6/32), with Alternaria alternate in 15,6% (5/32), Cladosporium herbarium in 6,3% (2/32), Aspergilus fumigatus in 3,13 % (1/32). None of investigated patients presented sensitization to other mold allergens. Microbiological methods demonstrated fungal infection only in 2 patients. Conclusions Almost half of chronic sinusitis patients presented sensitization to at least one allergen. Fungal allergy is relatively rare in chronic sinusitis patients.

  7. Psychological interactions in chronic disease education – Nursing interventions in chronically patients

    Directory of Open Access Journals (Sweden)

    Paraskevi Gourni

    2008-01-01

    Full Text Available Most of the diseases that the modern person faces in developed countries are chronic. These illnesses in their majority are not cured finally, but constitute situations that we try to control. The use of pharmaceutical medicines and the changes in the life of an individual allow henceforth in the chronically patients to live for along time duration an almost "physiologic" life, even if the chronic disease continues accompanying them. It is already known in all the interdisciplinary health care team that the chronically suffering patients present an enormous variety and differentiation of behaviours and experience abundance biological, psychological and social problems.This ascertainment led the researchers to develop a wide spectrum of theoretical approaches and clinical applications, with basic protractor of their efforts the maintenance of life’s quality as much patients who bear from chronic diseases as their familial environment.Aim of the present literature review was to investigate all the factors that interact in the psychology of an individual at the event of chronic disease, to report all the ways of adaptation in the new situation, and to assign all the nursing interventions that contribute positively in the acceptance of chronic illness.The education of patients with chronic diseases constitutes the corner stone of right therapeutic confrontation. The acceptance by the patient of changes that is required in his way of life is easier provided that when he has completely comprehended the nature of his illness, the gravity of his situation and role that plays the right collaboration with the health care providers.

  8. Intravenous immunoglobulin treatment in patients with chronic inflammatory demyelinating polyneuropathy.

    OpenAIRE

    van Doorn, P. A.

    1994-01-01

    Intravenous immunoglobulin (IVIg) treatment is shown to be effective in a selected group of patients with a chronic inflammatory demyelinating polyneuropathy (CIDP). The proportion of patients that improve after IVIg treatment varies between studies. Because 40% of a group of IVIg treated CIDP patients needed intermittent IVIg infusions to maintain their improved clinical condition, it is expected that IVIg is effective, at least in this subgroup of patients. However, the proportion of patien...

  9. Enhanced emotional reactions in chronic head trauma patients.

    OpenAIRE

    Fordyce, D J; Roueche, J R; Prigatano, G P

    1983-01-01

    The emotional characteristics of head injury patients referred for neuropsychological testing were examined as a function of the time since injury. Patients referred more than 6 months from injury were more emotionally distressed on the MMPI and Katz Adjustment Scale (relatives form) compared to those tested 6 months or earlier. The more chronic head trauma patients were more anxious and depressed, more confused in their thinking, and more socially withdrawn compared to the acute patient grou...

  10. Glucose intolerance in Chinese patients with chronic hepatitis C

    Institute of Scientific and Technical Information of China (English)

    Liang-Kung Chen; Shinn-Jang Hwang; Shih-Tzer Tsai; Jiing-Chyuan Luo; Shou-Dong Lee; Full-Young Chang

    2003-01-01

    AIM: To investigate the prevalence and the risk factors of glucose intolerance in Chinese patients with chronic hepatitis C and to evaluate the relationship between interferon (IFN)treatment and glucose intolerance in these patients.METHODS: Prospective cross-sectional study was done to evaluate the prevalence of glucose intolerance in Chinese patients with chronic hepatitis C virus (HCV) infection from the outpatient clinic of Department of Family Medicine, Taipei Veterans General Hospital. Chronic hepatitis C was defined as persistent presence of anti-HCV and persistent elevation of liver transaminase for at least 1.5 folds for at least 6 months. Moreover, patients were further categorized into normal fasting glucose and glucose intolerance (diabetes mellitus (DM) and impaired fasting glucose) according to the diagnostic criteria of American Diabetic Association. RESULTS: Totally, 359 Chinese patients with chronic hepatitis C were enrolled (212 males and 147 females, mean age=58.1±13.0 years). One hundred and twenty-three patients (34.3 %) had various forms of IFN treatment. One hundred and twenty-five patients (34.6 %)had glucose intolerance, including 99 patients (27.6 %) with DM and 26 patients (7.0 %) with impaired fasting glucose.Tn comparison with those with normal fasting glucose levels,patients with chronic hepatitis C with glucose intolerance were significantly older, had a significantly higher body mass index, and they were more likely to suffer from obesity, to have family history of diabetes and to have had previous IFN treatment. Stepwise multivariate logistic regression revealed significantly that age ≥ 57 years, obesity,previous history of IFN treatment and the presence of family history of diabetes were independent risk factors associated with the presence of glucose intolerance in chronic hepatitis C patients.CONCLUSION: In conclusion, 34.6 % of Chinese patients with chronic hepatitis C had glucose intolerance. Chronic hepatitis C patients who

  11. Importance of Social Relationships in Patients with Chronic Respiratory Diseases.

    Science.gov (United States)

    Kurpas, Donata; Szwamel, Katarzyna; Mroczek, Bozena

    2016-01-01

    The literature lacks reports on the role of the social relationships domain (SRD) of quality of life (QoL) in shaping care for patients with chronic respiratory diseases in primary care. In this study we examined a group of 582 patients with chronic respiratory diseases and chronic non-respiratory diseases recruited from 199 primary care centers. In the patients with chronic respiratory diseases, higher SRD correlated with more frequent patient visits due to medical issue, fewer district nurse interventions over the past 12 months, less frequent hospitalizations over the past 3 years, and fewer chronic diseases. In these patients, a high SRD was most effectively created by high QoL in the Psychological, Environmental, and Physical domains, and the satisfaction with QoL. Programs for preventing a decline in SRD should include patients with low scores in the Psychological, Environmental, and Physical domains, those who show no improvement in mental or somatic well-being in the past 12 months, those with a low level of positive mental attitudes, unhealthy eating habits, and with low levels of met needs. Such programs should include older widows and widowers without permanent relationships, with only primary education, living far from a primary care center, and those whose visits were not due to a medical issue.

  12. Whole scalp resting state EEG of oscillatory brain activity shows no parametric relationship with psychoacoustic and psychosocial assessment of tinnitus: A repeated measures study.

    Science.gov (United States)

    Pierzycki, Robert H; McNamara, Adam J; Hoare, Derek J; Hall, Deborah A

    2016-01-01

    Tinnitus is a perception of sound that can occur in the absence of an external stimulus. A brief review of electroencephalography (EEG) and magnetoencephalography (MEG) literature demonstrates that there is no clear relationship between tinnitus presence and frequency band power in whole scalp or source oscillatory activity. Yet a preconception persists that such a relationship exists and that resting state EEG could be utilised as an outcome measure for clinical trials of tinnitus interventions, e.g. as a neurophysiological marker of therapeutic benefit. To address this issue, we first examined the test-retest correlation of EEG band power measures in tinnitus patients (n = 42). Second we examined the evidence for a parametric relationship between numerous commonly used tinnitus variables (psychoacoustic and psychosocial) and whole scalp EEG power spectra, directly and after applying factor reduction techniques. Test-retest correlation for both EEG band power measures and tinnitus variables were high. Yet we found no relationship between whole scalp EEG band powers and psychoacoustic or psychosocial variables. We conclude from these data that resting state whole scalp EEG should not be used as a biomarker for tinnitus and that greater caution should be exercised in regard to reporting of findings to avoid confirmation bias. The data was collected during a randomised controlled trial registered at ClinicalTrials.gov (Identifier: NCT01541969).

  13. Chronic patient care at North West Province clinics

    Directory of Open Access Journals (Sweden)

    Claire van Deventer

    2009-04-01

    Full Text Available Background: Chronic illnesses are a significant burden to the health services in South Africa. There is a specific national health plan whereby chronically ill patients who are acceptably controlled should be managed at clinic level. The perception has emerged that the management of primary care has not been optimal in the Southern District of the North West Province. This provided the motivation to initiate this research, namely consideration of chronic patient care at clinics in the North West Province of South Africa.Method: A cross-sectional descriptive study was carried out at four randomly selected clinics covering four sub-districts in the Southern District (North West Province. This was done using charts and registers at the clinics. Inclusion criteria were patients older than 18, and presenting with the following chronic illnesses: asthma/chronic obstructive airways disease (COAD, hypertension, diabetes and epilepsy. The major focus areas were the regular assessment of the patients, the level of control of the illness and the use of the Essential Drugs List and Standard Treatment Guidelines (EDL/STG.Results: In the cases of all the chronic illnesses it was found that regular assessments were poorly done, with asthma (peak flow measurements being the most poorly done. Control was generally less than 50% for all the illnesses, although the EDL was followed fairly well by the personnel at the clinics.Conclusion: In the light of the burden of chronic illness the results give cause for great concern about the quality of care for chronically ill patients, and reasons were sought for some of the poor results. A subsequent decision was taken to carry out comprehensive quality improvement projects on each of the illnesses over the following five years.

  14. Patient-Centered Medical Home in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ortiz G

    2011-10-01

    Full Text Available Gabriel Ortiz1, Len Fromer21Pediatric Pulmonary Services, El Paso, TX; 2Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USAAbstract: Chronic obstructive pulmonary disease (COPD is a progressive and debilitating but preventable and treatable disease characterized by cough, phlegm, dyspnea, and fixed or incompletely reversible airway obstruction. Most patients with COPD rely on primary care practices for COPD management. Unfortunately, only about 55% of US outpatients with COPD receive all guideline-recommended care. Proactive and consistent primary care for COPD, as for many other chronic diseases, can reduce hospitalizations. Optimal chronic disease management requires focusing on maintenance rather than merely acute rescue. The Patient-Centered Medical Home (PCMH, which implements the chronic care model, is a promising framework for primary care transformation. This review presents core PCMH concepts and proposes multidisciplinary team-based PCMH care strategies for COPD.Keywords: Patient-Centered Medical Home, chronic care model, chronic obstructive pulmonary disease, patient education, physician assistants, nurse practitioners

  15. [Surgical management of trigeminal neuralgia, hemifacial spasm, paroxysmal tinnitus and nystagmus by neurovascular decompression].

    Science.gov (United States)

    Isu, T; Abe, H; Nakagawa, Y; Aida, T; Tsuru, M; Ito, T; Murai, H

    1983-11-01

    Trigeminal neuralgia, facial spasm, tinnitus, vertigo, and glossopharyngeal neuralgia are believed to be the symptoms complex of hyperactive dysfunction of the cranial nerve caused by vascular cross compression at the root entry (exit) zone of the appropriate nerve. Posterior cranial fossa approach for the neurovascular decompression was enhanced by Jannetta et al (1975). From their experiences of surgery, they emphasized that these symptoms were relieved by surgery. In this report, we will discuss the etiology of the disease, the neurotological examination, the angiographic findings, the operative findings and results in a series of 10 patients who have undergone neurovascular decompression. The series consisted of 4 cases with trigeminal neuralgia, 5 cases with facial spasm, and 1 case with paroxysmal tinnitus accompanied by facial spasm. The postoperative progress in these all patients was excellent and relieved of the symptoms. There was neither mortality nor any significant complication. We stress that the neurovascular decompression surgery is now well justified as the definite treatment for the trigeminal neuralgia and facial spasm, because the surgery can be performed easily and safely by the neurosurgeons. The indication of the neurovascular decompression for the acoustic nerve and glossopharyngeal nerve is still controversial. In our own case, tinnitus was paroxysmal and complicated with facial spasm, not synchronous with facial spasm, but with nystagmus. This selective synchronism between tinnitus and nystagmus is a particular feature of our clinical instance. This particular clinical experience may provide some highly significant suggestions in considering the applicability of neurovascular decompression to the acoustic nerve. PMID:6671636

  16. Role of Myeloperoxidase in Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Bojana Kisic

    2016-01-01

    Full Text Available Chronic kidney disease (CKD is a worldwide public health problem. Patients with CKD have a number of disorders in the organism, and the presence of oxidative stress and systemic inflammation in these patients is the subject of numerous studies. Chronic inflammation joined with oxidative stress contributes to the development of numerous complications: accelerated atherosclerosis process and cardiovascular disease, emergence of Type 2 diabetes mellitus, development of malnutrition, anaemia, hyperparathyroidism, and so forth, affecting the prognosis and quality of life of patients with CKD. In this review we presented the potential role of the myeloperoxidase enzyme in the production of reactive/chlorinating intermediates and their role in oxidative damage to biomolecules in the body of patients with chronic kidney disease and end-stage renal disease. In addition, we discussed the role of modified lipoprotein particles under the influence of prooxidant MPO intermediates in the development of endothelial changes and cardiovascular complications in renal failure.

  17. Sarcopenia and Physical Inactivity in Patients With Chronic Kidney Disease.

    Science.gov (United States)

    Hirai, Keiji; Ookawara, Susumu; Morishita, Yoshiyuki

    2016-05-01

    Sarcopenia and physical inactivity synergistically progress in patients with chronic kidney disease (CKD) and are strong predictors of mortality in this population. Exercise training and essential amino acids and vitamin D supplements may contribute to improving sarcopenia and physical inactivity in CKD patients. PMID:27570755

  18. Research on stage of chronic kidney disease in elderly patients

    Institute of Scientific and Technical Information of China (English)

    陈莹

    2013-01-01

    Objective To explore the clinical value of glomerular filtration rate (GFR) 45 ml·min-1·1.73 m-2for the stage assessment in the elderly patients with chronic kidney disease (CKD) .Methods From June 2009 to December 2011,2258 patients were recruited and divided

  19. Herbal medicine use among Turkish patients with chronic diseases

    Directory of Open Access Journals (Sweden)

    Munevver Tulunay

    2015-09-01

    Conclusions: In this study herbal medicine use was found to be higher among patients who had been diagnosed with chronic diseases. Therefore physicians should be aware of herbal medicine usage of their patients and inform them about the effectivity and side effects of herbal medicines. [J Intercult Ethnopharmacol 2015; 4(3.000: 217-220

  20. Chronic obstructive pulmonary disease in patients admitted with heart failure

    DEFF Research Database (Denmark)

    Iversen, K K; Kjaergaard, J; Akkan, D;

    2008-01-01

    OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in patients with heart failure (HF). The primary aims were to determine the prevalence of COPD and to test the accuracy of self-reported COPD in patients admitted with HF. Secondary aims were to study a...

  1. Therapy chronic trichomoniasis at patients with associated urogenital chlamydial infection

    Directory of Open Access Journals (Sweden)

    A. L. Poznyak

    2009-01-01

    Full Text Available Present material of problem question therapy chronic trichomoniasis. Study clinical and bacteriological effectiveness basic etiotropic preparation and their combination, used in treatment patients trichomoniasis. Found that the combined application antiprotozoal drugs have a more pronounced effect on kills T. vaginalis and shortens the rehabilitation of the patient.

  2. Psychological assessment and intervention of tinnitus%耳鸣的心理评估及干预

    Institute of Scientific and Technical Information of China (English)

    刘桂荣

    2014-01-01

    耳鸣指无外界声源刺激,而耳内或头部主观上有声音感觉的一种症状。耳鸣会使患者产生焦躁、抑郁的心理,影响患者正常的工作与生活。对患者进行相应的评估并及时进行心理干预对治疗耳鸣有着重要意义。%tinnitus refers to an external sound source stimulation, and the ear or head subjectively have the symptoms of a sound perception. tinnitus may make the patient to produce anxiety, depression in patients with psychological, affect the normal work and life. The assessment of patients and timely psychological intervention has important significance on the treatment of tinnitus.

  3. MEMBRANOUS INTESTINAL DIGESTION CHARACTERISTICS IN PATIENTS WITH CHRONIC PANCREATITIS

    Directory of Open Access Journals (Sweden)

    О.А. Stгокоva

    2009-03-01

    Full Text Available The study of enzymes activity of membranous intestinal digestion has been carried out. The condition of ultrastructure of mucous membrane of a small bowel in patients with chronic pancreatitis taking into account duration of disease is presented. It is shown, that signs of lesion of a small bowel in case of chronic pancreatitis are caused by disturbances in the first stage of membranous intestinal digestion, observed at early stages of disease and begin to progress with the disease duration.

  4. Tinnitus and neural plasticity of the brain

    NARCIS (Netherlands)

    Bartels, Hilke; Staal, Michiel J.; Albers, Frans W. J.

    2007-01-01

    Objective: To describe the current ideas about the manifestations of neural plasticity in generating tinnitus. Data Sources: Recently published source articles were identified using MEDLINE, PubMed, and Cochrane Library according to the key words mentioned below. Study Selection: Review articles and

  5. Neurodegenerative properties of chronic pain: cognitive decline in patients with chronic pancreatitis.

    Directory of Open Access Journals (Sweden)

    Marijtje L A Jongsma

    Full Text Available Chronic pain has been associated with impaired cognitive function. We examined cognitive performance in patients with severe chronic pancreatitis pain. We explored the following factors for their contribution to observed cognitive deficits: pain duration, comorbidity (depression, sleep disturbance, use of opioids, and premorbid alcohol abuse. The cognitive profiles of 16 patients with severe pain due to chronic pancreatitis were determined using an extensive neuropsychological test battery. Data from three cognitive domains (psychomotor performance, memory, executive functions were compared to data from healthy controls matched for age, gender and education. Multivariate multilevel analysis of the data showed decreased test scores in patients with chronic pancreatitis pain in different cognitive domains. Psychomotor performance and executive functions showed the most prominent decline. Interestingly, pain duration appeared to be the strongest predictor for observed cognitive decline. Depressive symptoms, sleep disturbance, opioid use and history of alcohol abuse provided additional explanations for the observed cognitive decline in some of the tests, but to a lesser extent than pain duration. The negative effect of pain duration on cognitive performance is compatible with the theory of neurodegenerative properties of chronic pain. Therefore, early and effective therapeutic interventions might reduce or prevent decline in cognitive performance, thereby improving outcomes and quality of life in these patients.

  6. Complement defects in patients with chronic rhinosinusitis

    DEFF Research Database (Denmark)

    Gaunsbaek, Maria Quisgaard; Lange, Bibi; Kjeldsen, Anette D;

    2012-01-01

    whether complement defects collectively predispose individuals for CRS or affect CRS severity. The participants comprised 87 CRS patients randomly selected from the general population, and a control group of 150 healthy blood donors. The CRS patients were diagnosed according to the European Position Paper...... was significantly higher among CRS patients than among healthy control subjects. A majority of Mannan-binding lectin deficient CRS patients was observed. The presence of complement defects had no influence on the severity of subjective symptoms. Our studies show that defects in the complement system collectively...

  7. Online Patient Education for Chronic Disease Management: Consumer Perspectives.

    Science.gov (United States)

    Win, Khin Than; Hassan, Naffisah Mohd; Oinas-Kukkonen, Harri; Probst, Yasmine

    2016-04-01

    Patient education plays an important role in chronic disease management. The aim of this study is to identify patients' preferences in regard to the design features of effective online patient education (OPE) and the benefits. A review of the existing literature was conducted in order to identify the benefits of OPE and its essential design features. These design features were empirically tested by conducting survey with patients and caregivers. Reliability analysis, construct validity and regression analysis were performed for data analysis. The results identified patient-tailored information, interactivity, content credibility, clear presentation of content, use of multimedia and interpretability as the essential design features of online patient education websites for chronic disease management.

  8. Online Patient Education for Chronic Disease Management: Consumer Perspectives.

    Science.gov (United States)

    Win, Khin Than; Hassan, Naffisah Mohd; Oinas-Kukkonen, Harri; Probst, Yasmine

    2016-04-01

    Patient education plays an important role in chronic disease management. The aim of this study is to identify patients' preferences in regard to the design features of effective online patient education (OPE) and the benefits. A review of the existing literature was conducted in order to identify the benefits of OPE and its essential design features. These design features were empirically tested by conducting survey with patients and caregivers. Reliability analysis, construct validity and regression analysis were performed for data analysis. The results identified patient-tailored information, interactivity, content credibility, clear presentation of content, use of multimedia and interpretability as the essential design features of online patient education websites for chronic disease management. PMID:26846749

  9. Management of insomnia in patients with chronic pain conditions.

    Science.gov (United States)

    Stiefel, Frederic; Stagno, Daniele

    2004-01-01

    The management of insomnia in patients experiencing chronic pain requires careful evaluation, good diagnostic skills, familiarity with cognitive-behavioural interventions and a sound knowledge of pharmacological treatments. Sleep disorders are characterised by a circular interrelationship with chronic pain such that pain leads to sleep disorders and sleep disorders increase the perception of pain. Sleep disorders in individuals with chronic pain remain under-reported, under-diagnosed and under-treated, which may lead--together with the individual's emotional, cognitive and behavioural maladaptive responses--to the frequent development of chronic sleep disorders. The moderately positive relationship between pain severity and sleep complaints, and the specificity of pain-related arousal and mediating variables such as depression, illustrate that insomnia in relation to chronic pain is multifaceted and poorly understood. This may explain the limited success of the available treatments. This article discusses the evaluation of patients with chronic pain and insomnia and the available pharmacological and nonpharmacological interventions to manage the sleep disorder. Non-pharmacological interventions should not be considered as single interventions, but in association with one another. Some non-pharmacological interventions especially the cognitive and behavioural approaches, can be easily implemented in general practice (e.g. stimulus control, sleep restriction, imagery training and progressive muscle relaxation). Hypnotics are routinely prescribed in the medically ill, regardless of their adverse effects; however, their long-term efficacy is not supported by robust evidence. Antidepressants provide an interesting alternative to hypnotics, since they can improve pain perception as well as sleep disorders in selected patients. Sedative antipsychotics can be considered for sleep disturbances in those patients exhibiting psychotic features, or for those with

  10. Peripheral blood lymphocytes DNA in patients with chronic liver diseases

    Institute of Scientific and Technical Information of China (English)

    Vasiliy I Reshetnyak; Tatyana I Sharafanova; Ludmila U Ilchenko; Elena V Golovanova; Gennadiy G Poroshenko

    2001-01-01

    BACKGROUND Viral replication in blood cells with nucleuses may lead to the damage of lymphocytes genetic apparatus and the beginning of immunopathological reactions.AIM Of this investigation is to reveal the damage to peripheral blood lymphocytes (PBL)DNA in the patients with chronic liver diseases.MATERIALS AND METHODS Sixteen-ninepatients with chronic liver diseases (37 patients with chronic viral hepatitis, 2 patients with liver cirrhosis of mixed etiology (alcohol + virus G),30 women with primary biliary cirrhosis-PBC)were examined. The condition of DNA structure of PBL-was measured by the fluorescenceanalysis of DNA unwinding (FADU) technique with modification. Changes of fluorescence (in %) reflected the DNA distractions degree (thepresence of DNA single-stranded breaks and alkalinelabile sights).RESULTS AND CONCLUSION . The quantity of DNA single-stranded breaks and alkalinelabile sightsin DNA in all patients with chronic viral hepatitis .didnt differ from the control group,excluding the patients with chronic hepatitis (CH) C + G. Patients with HGV and TTV monoinfection had demonstrated the increase of the DNA single-stranded breaks PBL quantity.This fact may be connected with hypothesisabout the viruses replication in white blood cells discussed in the literature. Tendency to increase quantity of DNA PBL damages in the patients with primary biliary cirrhosis (PBC) accordingly to the alkaline phosphatase activity increase was revealed. Significant decrease of the DNA single-stranded breaks and alkalinelabile sights in the PBC patients that were treated with prednison was demonstrated. Probably, the tendency to increase the quantity of DNA singlestranded breaks and alkalinelabile sights in lymphocytes of the PBC patients was depended on the surplus of the blood bile acid content.

  11. Anxiety and depression in patients suffering from chronic low backache

    International Nuclear Information System (INIS)

    To determine the frequency of anxiety and depression in patients with chronic low backache and to document other co-morbidities among these patients presenting at rheumatology clinic of a tertiary care hospital in Islamabad. Study Design: Cross sectional study. Place and Duration of Study: Study was conducted at Pakistan Institute of Medical Sciences from July 2012 to April 2013. Methodology: A total of 170 chronic low backache patients were administered urdu translated Zung Self-Rating Depression Scale and Zung Self-Rating Anxiety Scales. Scoring was done on Likert-type scale of 1-4 (based on these replies: a little of the time, some of the time, good part of the time, most of the time) with overall assessment by cumulative score ranging from 20 to 80, where 20-44 was normal range, 45-59 mildly depressed/anxious, 60-69 moderately depressed / anxious and 70 and above severely depressed / anxious. Results: Out of 170 patients, 157 patients above 18 years of age with male to female ratio 2:3 completed the study. Among study sample 72.2% had mild depression, 21.6% had mild anxiety, 32% had mixed mild anxiety and depression, 0.8% had severe depression, 1.6% had severe anxiety while 2.4% suffered from severe mixed symptoms. Overall, 125 (79.6%) patients were suffering from mild to severe form of depression and anxiety both alone or mixed. Obesity was present in 34 (21.66%) of patients with chronic backache and out of these 29 (85.3%) had psychological co-morbidity. Conclusion: Two thirds of the chronic backache patients reporting at rheumatology clinic of a tertiary care hospital were suffering from mild to severe degree of depression and anxiety. This worrying situation calls for thorough systematic evaluation of all chronic backache patient arriving at rheumatology clinic for mood disorders and psychological ailment. (author)

  12. Aureobasidium pullulans infection in a patient with chronic lymphocytic leukemia

    OpenAIRE

    Leonardo Rodrigues de Oliveira; Helio Moraes-Souza; Andre Luiz Maltos; Keila Cristina dos Santos; Rodrigo Juliano Molina; Cristina Hueb Barata

    2013-01-01

    Saprophytic fungi are being increasingly recognized as etiologic agents of mycoses in immunosuppressed patients. We report a case of subcutaneous infiltration by Aureobasidium pullulans, likely due to traumatic inoculation, in a neutropenic patient during chemotherapy for chronic lymphocytic leukemia. The patient was treated with amphotericin B deoxycholate but was subsequently switched to itraconazole, which improved the lesion. This case highlights the importance of considering unusual fung...

  13. Development of Tinnitus at a Low Dose of Sertraline: Clinical Course and Proposed Mechanisms

    Directory of Open Access Journals (Sweden)

    Christopher W. T. Miller

    2016-01-01

    Full Text Available Introduction. Serotonin is involved in filtering of auditory stimuli. Cochlear input is processed through complex interactions between serotonergic, glutamatergic, and GABAergic neurotransmitter systems. Options for treatment of tinnitus include selective serotonin reuptake inhibitors (SSRIs; however in rare instances this symptom may occur as a side effect of this class of medications. Case Presentation. A 50-year-old woman developed bilateral tinnitus after several weeks of being treated with sertraline 50 mg. She had been on a long-standing daily dose of aspirin 325 mg which had been discontinued shortly before starting sertraline. Medical work-up was negative for her symptom. Shortly after discontinuation of the medication, her tinnitus subsided completely. Discussion. Tinnitus is a rare side effect of sertraline and may be related to particular distribution of serotonin receptor subtypes within the auditory system, and serotonergic agents may reinforce or desensitize the activity of different receptors. Also, there may be a priming effect of salicylate agents on the auditory system, predisposing particular patients to be more sensitive to how auditory stimuli are processed.

  14. Revascularization options in patients with chronic kidney disease.

    Science.gov (United States)

    Ashrith, Guha; Elayda, MacArthur A; Wilson, James M

    2010-01-01

    Cardiovascular disease is the leading cause of death in patients who have chronic kidney disease or end-stage renal disease and are undergoing hemodialysis. Chronic kidney disease is a recognized risk factor for premature atherosclerosis. Unfortunately, most major randomized clinical trials that form the basis for evidence-based use of revascularization procedures exclude patients who have renal insufficiency. Retrospective, observational studies suggest that patients with end-stage renal disease and severe coronary occlusive disease have a lower risk of death if they undergo coronary revascularization rather than medical therapy alone. Due to a lack of prospective studies, however, the relative merits of percutaneous versus surgical revascularization are merely a matter of opinion. Several small, retrospective studies have shown that coronary artery bypass grafting is associated with higher procedural death but better long-term survival than is percutaneous coronary intervention. This difference appears to result from poor long-term results of percutaneous coronary intervention in patients who have chronic kidney disease or end-stage renal disease.Because randomized trials comparing percutaneous coronary intervention and coronary artery bypass grafting have included patients undergoing balloon angioplasty and placement of bare-metal stents, their conclusions are suspect in the era of drug-eluting stents. In this review, we discuss different revascularization options for patients with chronic kidney disease, the outcomes of revascularization procedures, and the risk factors for adverse outcomes.

  15. Chronic Inflammatory Periodontal Disease in Patients with Human Immunodeficiency Virus.

    Directory of Open Access Journals (Sweden)

    Vania López Rodríguez

    2009-07-01

    Full Text Available Background: The Chronic Inflammatory Periodontal Disease is related with multiple risk factors. Those patients with human immunodeficiency virus have higher risk of presenting this disease and it is usually more serious in these cases. Objective: To describe the prevalence of Chronic Inflammatory Periodontal Disease in patients with HIV. Methods: Descriptive, observational, cross-sectional study including patients with HIV in Sancti Spiritus province. The occurrence of the disease was determined after the Periodontics Cuban Standards, and oral hygiene was assessed through the simplified oral hygiene index. Other variables were measured, such as smoking habits, T CD4+ lymphocyte counting and virus load. The independent association of each risk factor with the disease was determined through a logistic regression model. Results: The 56, 5 % of the 154 patients presented Chronic Inflammatory Periodontal Disease; 60 (39.0% gingivitis and 27 (17,5% periodontitis. Gingivitis was associated with poor oral hygiene (OR: 3,71 and periodontitis with smoking habit (OR: 5,20. The severe forms of periodontitis occurred mainly in patients with lymphocyte counting lower than 500 cells/mm3 . Conclusions: The prevalence of Chronic Inflammatory Periodontal Disease in patients with HIV in Sancti Spiritus province is linked to known risk factors such as smoking habits and oral hygiene.

  16. Chronic pain and quality of life in schizophrenic patients

    Directory of Open Access Journals (Sweden)

    Jouce Gabriela de Almeida

    2013-03-01

    Full Text Available OBJECTIVE: To identify the prevalence and characteristics of chronic pain in schizophrenic patients and to compare the quality of life in patients with and without chronic pain. METHODS: Crossover design with a probablistic sample of 205 adult schizophrenic outpatients (80% paranoid schizophrenia. Socio-demographic, psychiatric disorder, pain and quality of life (WHOQOL- brief data were collected between June and September 2008. RESULTS: Mean age was 37 years, 65% were men, and the mean time spent in school was 9 years; 87% were single, 65% lived with parents and 25% had a job. Among patients with chronic pain, 70% did not receive treatment for pain. Regarding quality of life, patients with pain had more physical disabilities compared to those without pain (p < .001. There were no differences in other domains. Comparisons between patients with and without pain did not show any differences in how much they felt their mental health problems disabled them. Conclusion: Chronic pain was common in schizophrenic patients (similar to the general population of a similar age and decreased their quality of life. It is necessary to pay more attention to this co-morbidity.

  17. A single microvascular decompression surgery cures a patient with trigeminal neuralgia, hemifacial spasm, tinnitus, hypertension, and paroxysmal supraventricular tachycardia caused by the compression of a vertebral artery.

    Science.gov (United States)

    Jia, Yin; Wenhua, Wang; Quanbin, Zhang

    2013-01-01

    This report presents a 72-year-old woman with posterior cranial fossa neurovascular compression syndrome that included paroxysmal supraventricular tachycardia. The patient underwent surgical exploration of the posterior cranial fossa, and a gross left vertebral artery was identified as the offending vessel. The neurovascular conflicts were associated with the cranial nerves V, VII, VIII, IX, and X. The patient experienced significant postoperative relief. Probably this is the first report of a single microvascular decompression, having cured such a high number of syndromes, including paroxysmal supraventricular tachycardia.

  18. The impact of tinnitus on daily activities in adult tinnitus sufferers: A pilot study

    Directory of Open Access Journals (Sweden)

    Nomfundo F. Moroe

    2014-06-01

    Full Text Available Background: Few South African studies have been published on the impact of tinnitus on quality of life of tinnitus sufferers, although evidence suggests that a large portion of the general population suffers from tinnitus.Objectives: The current study aimed at describing the effects of tinnitus on the quality of life of the participants as measured by the Tinnitus Handicap Inventory (THI.Method: In a cross-sectional descriptive study design, 27 participants took part in the study by completing a self-administered THI questionnaire and participating in a semi-structured interview. Descriptive and inferential statistics were used to analyse the data. Descriptively, content analysis was used to organise and convey results from the interviews.Results: Participants reported a wide range of perceived disability on the THI. Results ranged from mild to catastrophic, with functional disability being most prominent in all participants, although there were differences when results were analysed according to gender. There was an association between gender and the type of perceived disability, although this was statistically non-significant (p > 0.05. Only 26% of the participants reported no effect on occupational performance and quality of life, with the remainder of the participants reporting a significant effect. Limited effective management strategies were reported to have been implemented – a significant implication for the audiologists.Conclusion: The results have implications for audiologists as they suggest that audiologists should take a detailed case history to determine the extent to which tinnitus affects the individual. Furthermore, audiologists should administer a scale such as the THI in the management of tinnitus.

  19. Anagrelide treatment in 52 patients with chronic myeloproliferative diseases

    DEFF Research Database (Denmark)

    Penninga, E; Jensen, B A; Hansen, P B;

    2004-01-01

    In this retrospective multi-centre study, we report our experience with anagrelide in the treatment of thrombocytosis in patients with chronic myeloproliferative diseases. Our study included 52 patients (age 20-78 years). The initial anagrelide dose was, in general, 0.5 mg once daily and mean...... anaemia (50%). Two patients experienced erectile dysfunction which has been described only once previously in association with anagrelide treatment. One patient progressed to acute leukaemia. However, this patient had been pre-treated with two potentially leukaemogenic drugs and had only been in short...... of the drug....

  20. Alexithymia and Early Maladaptive Schemas in chronic pain patients.

    Science.gov (United States)

    Saariaho, Anita S; Saariaho, Tom H; Mattila, Aino K; Karukivi, Max; Joukamaa, Matti I

    2015-08-01

    Psychological factors have an impact on subjective pain experience. The aim of this study was to explore the occurrence of alexithymia and Early Maladaptive Schemas in a sample of 271 first visit chronic pain patients of six pain clinics. The patients completed the study questionnaire consisting of the Toronto Alexithymia Scale-20, the Finnish version of the Young Schema Questionnaire short form-extended, the Beck Depression Inventory-II, and pain variables. Alexithymic patients scored higher on Early Maladaptive Schemas and had more pain intensity, pain disability and depression than nonalexithymic patients. Both alexithymia and depression correlated significantly with most Early Maladaptive Schemas. The co-occurrence of alexithymia, Early Maladaptive Schemas and depression seems to worsen the pain experience. Screening of alexithymia, depression and Early Maladaptive Schemas may help to plan psychological treatment interventions for chronic pain patients. PMID:26040835

  1. Addiction to opioids in chronic pain patients: a literature review

    DEFF Research Database (Denmark)

    Højsted, Jette; Sjøgren, Per

    2007-01-01

    Opioids have proven very useful for treatment of acute pain and cancer pain, and in the developed countries opioids are increasingly used for treatment of chronic non-malignant pain patients as well. This literature review aims at giving an overview of definitions, mechanisms, diagnostic criteria...... patients. The review indicates that the prevalence of addiction varied from 0% up to 50% in chronic non-malignant pain patients, and from 0% to 7.7% in cancer patients depending of the subpopulation studied and the criteria used. The risk of addiction has to be considered when initiating long-term opioid...... are concerned with the fact that pain may be under treated because of fear of addiction, and the guidelines in management of non-malignant pain patients include warnings of addiction. According to the literature, it seems appropriate and necessary to be aware of the problems associated with addiction during...

  2. Computerized spectral analyses of EEG in chronic schizophrenic patients

    International Nuclear Information System (INIS)

    This study was aimed at clarifying the EEG difference between chronic schizophrenic patients and normal controls by using the EEG method of spectral analyses. Twelve comparatively homogenous chronic schizophrenic patients and the 10 healthy controls were subjected to EEG investigations. 1) The EEG of schizophrenic patients had a slowing tendency of the frequency in the frontal pole, anterior temporal and central regions of the scalp compared with control subjects. 2) There was a decrease of mutual relation among the five electrodes' peak frequency in the schizophrenic patients. 3) The EEG of schizophrenic patients had more fast waves of β1 and β2 band than that of control subjects. 4) A slowing tendency of the frequency in the first half regions of the scalp was not found in 3 chronic schizophrenic patients which showed defective functions in the frontal area by positron emission tomography. 5) When mental arithmetic was given, the schizophrenic patients showed an increase of fast wave in the central, posterior temporal and occipital regions of the scalp. 6) When they opened their eyes, attenuation in the α band was not so marked in the schizophrenic patients. (author)

  3. Skin changes in patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Olarenwaju Falodun

    2011-01-01

    Full Text Available Management of patients with renal failure remains a major problem in poor-resource nations. Cutaneous manifestations in this group of patients are varied and remain helpful in differentiating acute from chronic renal failure (CRF. We studied the prevalence and pattern of skin disorders in patients with CRF at The University College Hospital, Ibadan, Nigeria, during the period between May 2006 and February 2007. Relevant information was collected with the aid of a questionnaire. The patients were then examined for skin disorders. One hundred and twenty patients who met the inclusion criteria were recruited into the study. The mean age of the CRF patients was 43.12 ± 15.38 years, while that of the control subjects was 43.13 ± 15.38 years. Seventy-six of the 120 patients (63.3% were on chronic hemodialysis while 44 (36.5% were on conservative management. A total of 107 patients (89.1% had at least one skin problem. The skin disorders seen include xerosis in 72 (60%, pruritus in 32 (26.7%, hyper-pigmentation, icthyosis and pityriasis versicolor in nine patients each (7.5%, either singly or in combination. Pallor of the skin was seen in three of the patients (2.5%, while uremic frost was seen in one (0.8%. Nail changes were seen in 48 patients (40%. We conclude that xerosis, pruritus, pigmentary and nail changes were the most common skin disorders in patients with CRF in our environment.

  4. Lung lobar volume in patients with chronic interstitial pneumonia

    International Nuclear Information System (INIS)

    We measured lung lobar volume by using helical computed tomography (HCT) in 23 patients with idiopathic interstitial pneumonia (IIP), 7 patients with chronic interstitial pneumonia associated with collagen vascular disease (CVD-IP), and 5 healthy volunteers HCT scanning was done at the maximal inspiratory level and the resting end-expiratory level. To measure lung lobar volume, we traced the lobar margin on HCT images with a digitizer and calculated the lobar volume with a personal computer. The lower lobar volume and several factors influencing it in chronic interstitial pneumonia were studied. At the maximal inspiratory level, the lower lobar volume as a percent of the whole lung volume was 46.8±4.13% (mean ± SD) in the volunteers, 39.5±6.19% in the patients with IIP, and 27.7±7. 86% in the patients with CVD-IP. The lower lobar volumes in the patients were significantly lower than in the volunteers. Patients with IIP in whom autoantibody tests were positive had lower lobar volumes that were very low and were similar to those of patients with CVD-IP. These data suggest that collagen vascular disease may develop in patients with interstitial pneumonia. The patients with IIP who had emphysematous changes on the CT scans had smaller decreases in total lung capacity and lower ratios of forced expiratory volume in one second to forced vital capacity than did those who had no emphysematous changes, those two groups did not differ in the ratio of lower lobar volume to whole lung volume. This suggests that emphysematous change is not factor influencing lower lobar volume in patients with chronic interstitial pneumonia. We conclude that chronic interstitial pneumonia together with very low values for lower lobar volume may be a pulmonary manifestation of collagen vascular disease. (author)

  5. Chronic Lyme disease: misconceptions and challenges for patient management

    Directory of Open Access Journals (Sweden)

    Halperin JJ

    2015-05-01

    Full Text Available John J HalperinDepartment of Neurosciences, Overlook Medical Center, Summit, NJ, USAAbstract: Lyme disease, infection with the tick-borne spirochete Borrelia burgdorferi, causes both specific and nonspecific symptoms. In untreated chronic infection, specific manifestations such as a relapsing large-joint oligoarthritis can persist for years, yet subside with appropriate antimicrobial therapy. Nervous system involvement occurs in 10%–15% of untreated patients and typically involves lymphocytic meningitis, cranial neuritis, and/or mononeuritis multiplex; in some rare cases, patients have parenchymal inflammation in the brain or spinal cord. Nervous system infection is similarly highly responsive to antimicrobial therapy, including oral doxycycline. Nonspecific symptoms such as fatigue, perceived cognitive slowing, headache, and others occur in patients with Lyme disease and are indistinguishable from comparable symptoms occurring in innumerable other inflammatory states. There is no evidence that these nonspecific symptoms reflect nervous system infection or damage, or that they are in any way specific to or diagnostic of this or other tick-borne infections. When these symptoms occur in patients with Lyme disease, they typically also subside after antimicrobial treatment, although this may take time. Chronic fatigue states have been reported to occur following any number of infections, including Lyme disease. The mechanism underlying this association is unclear, although there is no evidence in any of these infections that these chronic posttreatment symptoms are attributable to ongoing infection with B. burgdorferi or any other identified organism. Available appropriately controlled studies indicate that additional or prolonged courses of antimicrobial therapy do not benefit patients with a chronic fatigue-like state after appropriately treated Lyme disease. Keywords: Lyme disease, Borrelia burgdorferi, chronic, diagnosis, treatment, chronic

  6. Chronic Lyme disease: misconceptions and challenges for patient management.

    Science.gov (United States)

    Halperin, John J

    2015-01-01

    Lyme disease, infection with the tick-borne spirochete Borrelia burgdorferi, causes both specific and nonspecific symptoms. In untreated chronic infection, specific manifestations such as a relapsing large-joint oligoarthritis can persist for years, yet subside with appropriate antimicrobial therapy. Nervous system involvement occurs in 10%-15% of untreated patients and typically involves lymphocytic meningitis, cranial neuritis, and/or mononeuritis multiplex; in some rare cases, patients have parenchymal inflammation in the brain or spinal cord. Nervous system infection is similarly highly responsive to antimicrobial therapy, including oral doxycycline. Nonspecific symptoms such as fatigue, perceived cognitive slowing, headache, and others occur in patients with Lyme disease and are indistinguishable from comparable symptoms occurring in innumerable other inflammatory states. There is no evidence that these nonspecific symptoms reflect nervous system infection or damage, or that they are in any way specific to or diagnostic of this or other tick-borne infections. When these symptoms occur in patients with Lyme disease, they typically also subside after antimicrobial treatment, although this may take time. Chronic fatigue states have been reported to occur following any number of infections, including Lyme disease. The mechanism underlying this association is unclear, although there is no evidence in any of these infections that these chronic posttreatment symptoms are attributable to ongoing infection with B. burgdorferi or any other identified organism. Available appropriately controlled studies indicate that additional or prolonged courses of antimicrobial therapy do not benefit patients with a chronic fatigue-like state after appropriately treated Lyme disease.

  7. Quality of Life in Chronic Hepatitis B and C Patients

    Directory of Open Access Journals (Sweden)

    Abitin Heidarzadeh

    2007-08-01

    Full Text Available Background and Aims: Chronic hepatitis B and C are prevalent diseases, especially in developing countries. In many of the patients they cause limitations in physical and mental functions and finally cause reduction in their life quality. We wanted to assess the quality of life in these patients.Methods: This research was done on 74 chronic hepatitis B and C patients of Rasht which their diseases were confirmed by serologic and histologic methods and their hepatic enzymes including AST & ALT was two times more than normal range for at least 6 months. Cross-sectional questionnaire survey performed in October 2003 till Jully 2004 in Gastrointestinal & Liver Diseases Research Center of Rasht (north city of Iran, Razi hospital. The questionnaires consisted of 29 questions that were given to the patients and they were let free to complete it. Results: The individuals under survey consisted of 15 (20.27% chronic hepatitis B patients and 59 (79.72% chronic hepatitis C patients. 54 (72.79% ones were male and 20 (27.02% were female. Total adjusted score (up to 100 points of life quality was 54.4 ± 22.5. No meaningful difference was seen between two sexes based on total score of life quality. Also, in different fields of life quality no significant difference was seen between two genders, except the systemic signs that the average of adjusted score of females (43 ± 28 was less than males (63 ± 27 that means meaningful statistical difference (P < 0.007.Conclusions: Generally, it seems that chronic hepatitis B and C have untoward life qualities which could result from concern of decrease of social support or fear of society or decrease in patronage of the family or friends and it is mandate to be concerned when furnishing services to these patients.

  8. Tinnitus and stress – from bedside to bench and back

    OpenAIRE

    Heidi Olze; Szczepek, Agnieszka J

    2012-01-01

    The aim of this review is to focus the attention of clinicians and basic researchers on the association between emotional stress and tinnitus. Although tinnitus is an auditory symptom, its onset and progression often associates with emotional strain. Recent epidemiological studies have provided evidence for a direct relationship between the emotional status of subjects and tinnitus. In addition, studies of function, morphology, and gene and protein expression in the auditory system of animals...

  9. Remote patient monitoring in chronic heart failure.

    Science.gov (United States)

    Palaniswamy, Chandrasekar; Mishkin, Aaron; Aronow, Wilbert S; Kalra, Ankur; Frishman, William H

    2013-01-01

    Heart failure (HF) poses a significant economic burden on our health-care resources with very high readmission rates. Remote monitoring has a substantial potential to improve the management and outcome of patients with HF. Readmission for decompensated HF is often preceded by a stage of subclinical hemodynamic decompensation, where therapeutic interventions would prevent subsequent clinical decompensation and hospitalization. Various methods of remote patient monitoring include structured telephone support, advanced telemonitoring technologies, remote monitoring of patients with implanted cardiac devices such as pacemakers and defibrillators, and implantable hemodynamic monitors. Current data examining the efficacy of remote monitoring technologies in improving outcomes have shown inconsistent results. Various medicolegal and financial issues need to be addressed before widespread implementation of this exciting technology can take place. PMID:23018667

  10. Chronic diarrhoea in HIV patients: Prevalence of coccidian parasites

    Directory of Open Access Journals (Sweden)

    Gupta S

    2008-01-01

    Full Text Available The purpose of this study was to determine the prevalence of intestinal parasites in HIV patients with or without diarrhoea and to see an association between diarrhoea and the coccidian parasites in our setting. Stool samples from 113 HIV patients, 34 chronic diarrhoea and 79 without any history of diarrhoea were collected and examined for enteric parasites by microscopy. One hundred and thirteen control samples from HIV negative patients complaining of prolonged diarrhoea were also collected and analysed. Prevalence of coccidian parasites in HIV and non-HIV patients; with and without diarrhoea was compared using chi-square tests. Enteric parasites were detected in 55.8% HIV patients with diarrhoea compared to 16.4% in patients without diarrhoea ( P < 0.001. Isospora belli was found in 41.1% (14/34 of chronic diarrhoea and 6.3% (5/79 in non-diarrhoeal cases ( P < 0.001. Cryptosporidium was detected in 20.6% (7/34 of chronic diarrhoea and 2.5% (2/79 in non-diarrhoeal cases ( P < 0.01. Cyclospora cayetanensis associated diarrhoea was detected in only one case of chronic diarrhoea (2.9%. CD4+ T-cell count was lower (180 cells/μl0 in diarrhoeal HIV patients as compared to non-diarrhoeal patients. Coccidian parasites were seen at a mean CD4+ T-cell count of 186.3 cells/μL. This study concluded that Isospora belli was the predominant parasite followed by Cryptosporidium spp. and both were strongly associated with diarrhoea among HIV patients.

  11. Classification and identification of opioid addiction in chronic pain patients

    DEFF Research Database (Denmark)

    Højsted, Jette; Nielsen, Per Rotbøll; Guldstrand, Sally Kendall;

    2010-01-01

    Addiction is a feared consequence of long-term opioid treatment of chronic pain patients. The ICD-10 and DSM-IV diagnostic addiction criteria may not be appropriate in these patients. Therefore Portenoy's criteria (PC) were launched. The aim was to estimate the prevalence of addiction, to investi......Addiction is a feared consequence of long-term opioid treatment of chronic pain patients. The ICD-10 and DSM-IV diagnostic addiction criteria may not be appropriate in these patients. Therefore Portenoy's criteria (PC) were launched. The aim was to estimate the prevalence of addiction......, to investigate whether PC were applicable and to compare these criteria with the ICD-10 criteria. The study was cross-sectional and included 253 patients with chronic pain at a tertiary pain centre. Patients were screened for addiction by a physician and a nurse. The addiction prevalence was 14.4% according...... treated pain patients and seems to be more sensitive and specific than ICD-10 criteria....

  12. Questionnaire survey of chronic cough in asthmatic patients

    Institute of Scientific and Technical Information of China (English)

    魏为利; 邱忠民; 吕寒静; 杨忠民; 洪光朝; 王岚; 刘兴元; 郑桂芬

    2004-01-01

    @@ Wheezing is a common symptom of asthma and a main reason for most patients to seek medical care. Although wheezing has long been considered the essential symptom of asthma, clinical observations have shown that chronic cough is also an important symptom of asthma, even the sole presenting manifestation in cough variant asthma.1 As a special form of asthma, cough variant asthma probably represents the milder end of the spectrum of asthma or the forerunner of asthma, and may develop into typical asthma when the state of the illness progresses.2 Therefore, there may be a natural course from chronic cough to wheezing in the pathogenesis of asthma. However, there is currently no data to show how many patients with asthma present chronic cough before the first onset of wheezing. To investigate this question, we performed this questionnaire survey.

  13. Tinnitus prevalence in the city of São Paulo

    OpenAIRE

    Jeanne Oiticica; Roseli Saraiva Moreira Bittar

    2015-01-01

    INTRODUCTION: The public and private health care in the city of São Paulo has no data on tinnitus prevalence.OBJECTIVE: Determine tinnitus prevalence in São Paulo city.STUDY DESIGN: Series study.METHODS: Cross-sectional study by field questionnaire with 1960 interviews. Predictor variables included gender, age, tinnitus.RESULTS: The prevalence of tinnitus was 22%. It affects more women (26%) than men (17%) and increases with advancing age. Approximately one third of cases (32%) assert that th...

  14. Alexithymia and anxiety in female chronic pain patients

    Directory of Open Access Journals (Sweden)

    Saatcioglu Omer

    2006-08-01

    Full Text Available Abstract Objectives Alexithymia is highly prevalent among chronic pain patients. Pain is a remarkable cause for high levels of chronic anxiety. The purpose of this study was to investigate the prevalence of alexithymia and to determine anxiety levels among DSM-IV somatoform pain disorder (chronic pain female patients and to examine the relationship between alexithymia and the self-reporting of pain. Methods Thirty adult females (mean age: 34,63 ± 10,62 years, who applied to the outpatient psychiatry clinic at a public hospital with the diagnosis of chronic pain disorder (DSM-IV, were included in the study. Thirty seven healthy females (mean age: 34,46 ± 7,43 years, who matched for sociodemographic features with the patient group, consisted the control group. A sociodemographic data form, 26-item Toronto Alexithymia Scale (TAS-26, Spielberger Trait Anxiety Inventory (STAI were administered to each subject and information was obtained on several aspects of the patients' pain, including intensity (measured by VAS, and duration. Results Chronic pain patients were found significantly more alexithymic than controls. There was a positive correlation between TAS-26 scores and the duration of pain. The alexithymic and nonalexithymic group did not differ in their perception of pain. Neither positive correlation nor significant difference was found between alexithymia and trait anxiety in pain patients. Discussion Alexithymia may be important in addressing the diversity of subjective factors involved in pain. The conceptualization of alexithymia as a personality trait as well as a secondary state reaction is underlined by our data.

  15. Oral Tori in Chronic Peritoneal Dialysis Patients.

    Directory of Open Access Journals (Sweden)

    Chia-Lin Hsu

    Full Text Available The pathogenesis of oral tori has long been debated and is thought to be the product of both genetic and environmental factors, including occlusal forces. Another proposed mechanism for oral tori is the combination of biomechanical forces, particularly in the oral cavity, combined with cortical bone loss and trabecular expansion, as one might see in the early stages of primary hyperparathyroidism. This study investigated the epidemiology of torus palatinus (TP and torus mandibularis (TM in peritoneal dialysis patients, and analyzed the influences of hyperparathyroidism on the formation of oral tori.In total, 134 peritoneal dialysis patients were recruited between July 1 and December 31, 2015 for dental examinations for this study. Patients were categorized into two subgroups based on the presence or absence of oral tori. Demographic, hematological, biochemical, and dialysis-related data were obtained for analysis.The prevalence of oral tori in our sample group was high at 42.5% (57 of 134, and most patients with oral tori were female (61.4%. The most common location of tori was TP (80.7%, followed by TP and TM (14.0%, then TM (5.3%. All 54 TP cases were at the midline, and most were <2 cm (59.3%, flat (53.7%, and located in the premolar region (40.7%. Of the 11 TM cases, all were bilateral and symmetric, mostly <2 cm (81.9%, lobular (45.4%, and located at premolar region (63.6%. Interestingly, patients with oral tori had slightly lower serum levels of intact parathyroid hormones than those without oral tori, but the difference was not statistically significant (317.3±292.0 versus 430.1±492.6 pg/mL, P = 0.126. In addition, patients with oral tori did not differ from patients without tori in inflammatory variables such as serum high sensitivity C-reactive protein levels (6.6±8.2 versus 10.3±20.2 mg/L, P = 0.147 or nutritional variables such as serum albumin levels (3.79±0.38 versus 3.77±0.45 g/dL, P = 0.790. Furthermore, there were no

  16. [Anesthetic Management of Three Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy].

    Science.gov (United States)

    Maruyama, Naoko; Wakimoto, Mayuko; Inamori, Noriko; Nishimura, Shinya; Mori, Takahiko

    2015-08-01

    Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronically progressing or relapsing disease caused by immune-mediated peripheral neuropathy. We report the anesthetic management of three CIDP patients who underwent elective orthopedic surgeries. Owing to the risk of neuraxial anesthetics triggering demyelination, general anesthesia was selected to avoid epidural or spinal anesthesia or other neuraxial blockade. It was also judged prudent to avoid prolonged perioperative immobilization, which might compress vulnerable peripheral nerves. For Patient 1, general anesthesia was induced with propofol, remifentanil, and sevoflurane, and was maintained with sevoflurane and remifentanil. For Patients 2 and 3, general anesthesia was induced and maintained with propofol and remifentanil. For tracheal intubation, under careful monitoring with peripheral nerve stimulators, minimal doses of rocuronium (0.6-0.7 mg x kg(-1)) were administered. When sugammadex was administered to reverse the effect of rocuronium, all patients rapidly regained muscular strength. Postoperative courses were satisfactory without sequelae.

  17. Ibrutinib-induced lymphocytosis in patients with chronic lymphocytic leukemia

    DEFF Research Database (Denmark)

    Herman, S E M; Niemann, C U; Farooqui, M;

    2014-01-01

    Ibrutinib and other targeted inhibitors of B-cell receptor signaling achieve impressive clinical results for patients with chronic lymphocytic leukemia (CLL). A treatment-induced rise in absolute lymphocyte count (ALC) has emerged as a class effect of kinase inhibitors in CLL and warrants further...

  18. [Health maintenance, relaxation and hypnosis for chronic pain patients].

    Science.gov (United States)

    Boiron, Clare

    2014-10-01

    The treatment of chronic pain patients integrates more and more complementary therapies such as relaxation and hypnosis, implemented by specially trained nurses. These techniques are offered on the basis of nurses' diagnoses carried out in the framework of a clinical approach. PMID:25518140

  19. Invasive fungal infections in patients with chronic granulomatous disease

    NARCIS (Netherlands)

    Henriet, S.S.V.; Verweij, P.E.; Holland, S.M.; Warris, A.

    2013-01-01

    Invasive fungal infections are a major threat for chronic granulomatous disease (CGD) patients. The present study provides a comprehensive overview of published invasive fungal infections in the CGD host through an extensive review of epidemiological, clinical, diagnostic and therapeutic data. In ad

  20. Bone marrow dysfunction in chronic heart failure patients

    NARCIS (Netherlands)

    Westenbrink, B. Daan; Voors, Adriaan A.; de Boer, Rudolf A.; Schuringa, Jan J.; Klinkenberg, Theo; van der Harst, Pim; Vellenga, Edo; van Veldhuisen, Dirk J.; van Gilst, Wiek H.

    2010-01-01

    To investigate whether chronic heart failure (CHF) is associated with a general dysfunction of the haematopoietic compartment. Bone marrow was obtained during coronary artery bypass graft surgery from 20 patients with CHF (age 67 +/- 6 years, 75% NYHA class >= III, LVEF 32 +/- 6%), and 20 age- and g

  1. Dutch transmural nurse clinics for chronic patients: a descriptive study.

    NARCIS (Netherlands)

    Temmink, D.; Francke, A.L.; Kerkstra, A.; Huyer Abu-Saad, H.

    2000-01-01

    'Transmural care' can be defined as patient-tailored care provided on the basis of close collaboration and joint responsibility between hospitals and home care organizations. One form of transmural care is transmural nurse clinics for chronically ill. This study describes 62 transmural nurse clinics

  2. Chronic Melioidosis in a Patient with Cystic Fibrosis

    OpenAIRE

    Schülin, Tanja; Steinmetz, Ivo

    2001-01-01

    Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in Southeast Asia and northern Australia, where it can be found in soil and surface water. We report a case of chronic pulmonary melioidosis in a patient with cystic fibrosis who had traveled to an area where B. pseudomallei is endemic.

  3. Aureobasidium pullulans infection in a patient with chronic lymphocytic leukemia

    Directory of Open Access Journals (Sweden)

    Leonardo Rodrigues de Oliveira

    2013-09-01

    Full Text Available Saprophytic fungi are being increasingly recognized as etiologic agents of mycoses in immunosuppressed patients. We report a case of subcutaneous infiltration by Aureobasidium pullulans, likely due to traumatic inoculation, in a neutropenic patient during chemotherapy for chronic lymphocytic leukemia. The patient was treated with amphotericin B deoxycholate but was subsequently switched to itraconazole, which improved the lesion. This case highlights the importance of considering unusual fungal infections in critically ill patients such as those who are immunosuppressed due to chemotherapy. Diagnostic techniques and effective antifungal therapy have improved the prognosis of these cases.

  4. Increased Circulating Cathepsin K in Patients with Chronic Heart Failure

    OpenAIRE

    Guangxian Zhao; Yuzi Li; Lan Cui; Xiang Li; Zhenyi Jin; Xiongyi Han; Ennan Fang; Yihua Gao; Dongmei Zhou; Haiying Jiang; Xueying Jin; Guanghao Piao; Xiangshan Li; Guang Yang; Jiyong Jin

    2015-01-01

    Cysteinyl cathepsin K (CatK) is one of the most potent mammalian collagenases involved in cardiovascular disease. Here, we investigated the clinical predictive value of serum CatK levels in patients with chronic heart failure (CHF). We examined 134 patients with CHF, measuring their serum CatK, troponin I, high-sensitive C-reactive protein, and pre-operative N-terminal pro-brain natriuretic peptide levels. The patients were divided into two groups: the 44 patients who showed a left ventricula...

  5. Vitamin B status in patients with chronic fatigue syndrome.

    OpenAIRE

    Heap, L C; Peters, T. J.; Wessely, S

    1999-01-01

    Some patients with chronic fatigue syndrome say they benefit from taking vitamin supplements. We assessed functional status for the B vitamins pyridoxine, riboflavin and thiamine in 12 vitamin-untreated CFS patients and in 18 healthy controls matched for age and sex. Vitamin-dependent activities--aspartate aminotransferase (AST) for pyridoxine, glutathione reductase (GTR) for riboflavin, transketolase (TK) for thiamine--were measured in erythrocyte haemolysates before and after in-vitro addit...

  6. Phosphate diabetes in patients with chronic fatigue syndrome.

    OpenAIRE

    Lorenzo, F.; Hargreaves, J.; Kakkar, V V

    1998-01-01

    Phosphate depletion is associated with neuromuscular dysfunction due to changes in mitochondrial respiration that result in a defect of intracellular oxidative metabolism. Phosphate diabetes causes phosphate depletion due to abnormal renal re-absorption of phosphate be the proximal renal tubule. Most of the symptoms presented by patients with phosphate diabetes such as myalgia, fatigue and mild depression, are also common in patients with chronic fatigue syndrome, but this differential diagno...

  7. Influenza Vaccination Reduces Dementia Risk in Chronic Kidney Disease Patients

    OpenAIRE

    Liu, Ju-Chi; Hsu, Yi-Ping; Kao, Pai-Feng; Hao, Wen-Rui; Liu, Shing-Hwa; Lin, Chao-Feng; Sung, Li-Chin; Wu, Szu-Yuan

    2016-01-01

    Abstract Taiwan has the highest prevalence of chronic kidney disease (CKD) worldwide. CKD, a manifestation of vascular diseases, is associated with a high risk of dementia. Here, we estimated the association between influenza vaccination and dementia risk in patients with CKD. Data from the National Health Insurance Research Database of Taiwan were used in this study. The study cohort included all patients diagnosed with CKD (according to International Classification of Disease, Ninth Revisio...

  8. Experiences of air travel in patients with chronic heart failure

    OpenAIRE

    Ingle, Lee; Hobkirk, James; Damy, Thibaud; Nabb, Samantha; Clark, Andrew L.; Cleland, John G F

    2012-01-01

    Aim To conduct a survey in a representative cohort of ambulatory patients with stable, well managed chronic heart failure (CHF) to discover their experiences of air travel. Methods An expert panel including a cardiologist, an exercise scientist, and a psychologist developed a series of survey questions designed to elicit CHF patients' experiences of air travel (Appendix 1). The survey questions, information sheets and consent forms were posted out in a self-addressed envelope to 1293 CHF pati...

  9. The Expert Patient and Chronic Respiratory Diseases

    Directory of Open Access Journals (Sweden)

    Louis-Philippe Boulet

    2016-01-01

    Full Text Available The concept of “expert patient” has been developed in the last two decades to define a patient who has a significant knowledge of his/her disease and treatment in addition to self-management skills. However, this concept has evolved over the last years, and these patients are now considered, not only to be more efficient in the management of their own condition and communicating effectively with health professionals, but to also act as educators for other patients and as resources for the last, provide feedback on care delivery, and be involved in the production and implementation of practice guidelines, as well as in the development and conduct of research initiatives. There are some barriers, however, to the integration of this new contributor to the health care team, and specific requirements need to be considered for an individual to be considered as an expert. This new player has, however, a potentially important role to improve current care, particularly in respiratory health.

  10. Patient-Specific Airway Wall Remodeling in Chronic Lung Disease.

    Science.gov (United States)

    Eskandari, Mona; Kuschner, Ware G; Kuhl, Ellen

    2015-10-01

    Chronic lung disease affects more than a quarter of the adult population; yet, the mechanics of the airways are poorly understood. The pathophysiology of chronic lung disease is commonly characterized by mucosal growth and smooth muscle contraction of the airways, which initiate an inward folding of the mucosal layer and progressive airflow obstruction. Since the degree of obstruction is closely correlated with the number of folds, mucosal folding has been extensively studied in idealized circular cross sections. However, airflow obstruction has never been studied in real airway geometries; the behavior of imperfect, non-cylindrical, continuously branching airways remains unknown. Here we model the effects of chronic lung disease using the nonlinear field theories of mechanics supplemented by the theory of finite growth. We perform finite element analysis of patient-specific Y-branch segments created from magnetic resonance images. We demonstrate that the mucosal folding pattern is insensitive to the specific airway geometry, but that it critically depends on the mucosal and submucosal stiffness, thickness, and loading mechanism. Our results suggests that patient-specific airway models with inherent geometric imperfections are more sensitive to obstruction than idealized circular models. Our models help to explain the pathophysiology of airway obstruction in chronic lung disease and hold promise to improve the diagnostics and treatment of asthma, bronchitis, chronic obstructive pulmonary disease, and respiratory failure. PMID:25821112

  11. Patient-reported treatment burden of chronic immune thrombocytopenia therapies

    Directory of Open Access Journals (Sweden)

    Brown T

    2012-03-01

    Full Text Available Abstract Background Chronic immune thrombocytopenia (ITP is a debilitating autoimmune disorder that causes a reduction in blood platelets and increased risk of bleeding. ITP is currently managed with various pharmacologic therapies and splenectomy. This study was conducted to assess patient perceived and reported treatment side effects, as well as the perceived burden or bother, and need to reduce or stop treatment, associated with these side effects among adult patients with chronic ITP. Methods A Web-enabled survey was administered to members of a US-based ITP patient support group. Patients reported demographic and clinical characteristics, ITP treatments' side effects for treatments received since diagnosed, level of bother (or distress, and need to reduce or stop treatment, associated with side effects. Current and past exposure was assessed for five specific treatment types: corticosteroids (CS, intravenous immunoglobulin (IVIg, anti-D immunoglobulin (anti-D, rituximab (RT, and splenectomy (SPL, as well as for other patient-referenced therapies (captured as "other". Results The survey was completed by 589 patients; 78% female, 89% white, mean age 48 years (SD = 14.71, and 68% reported a typical low platelet count of P P P P Conclusions Current ITP treatments, particularly corticosteroids, are associated with multiple bothersome side effects that may lead to patients stopping or reducing therapy. Open, informed and complete communication between clinician and patient regarding both the benefits and the side effects of ITP treatment may better prepare patients for their prescribed regimens.

  12. Early diagnosis saves lives: focus on patients with chronic kidney disease

    OpenAIRE

    Ecder, Tevfik

    2013-01-01

    Chronic kidney disease is a global public health problem. Patients with chronic kidney disease have an increased risk of developing end-stage kidney disease and its complications. Early identification and management of patients with chronic kidney disease is important in order to decrease the morbidity and mortality. Early detection of chronic kidney disease is possible with screening programs targeting high-risk patients, such as patients with diabetes mellitus, hypertension, elderly patient...

  13. Hepatocellular Carcinoma in Patients with Chronic Hepatitis C

    Directory of Open Access Journals (Sweden)

    Dmitry Konstantinov

    2016-09-01

    Full Text Available The purpose of the study was to examine the clinical and epidemiological data in patients with chronic hepatitis C (CHC and hepatocellular carcinoma (HCC before they sought specialized medical care. The study included 92 patients with CHC. All patients were divided into 2 groups: Group 1 consisted of CHC patients with HCC (n=45, and Group 2 (n=47 consisted of CHC patients without HCC. With the development of HCC in CHC patients, clinical manifestations were absent only in 2.2% of patients. Determining factors in HCC development are male sex, mature age, the maintained HCV replication, moderate and severe fibrosis, disease duration of more than 10 years, and the lack of effect of antiviral treatment.

  14. The impact of chronic heamodialysis on the personality of patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Evgenia Vlachu D.

    2009-07-01

    Full Text Available People with chronic diseases, deal with permanent changes in their everyday life. At the same time these patients appear to have different pathological behavior and personality disturbances as aresult of the disorders of their biological functions.AIM: The aim of this study is the examination of the psychological behavior of patients with chronic renal failure who submit themselves to recurrent heamodialysis (CRH.MATERIAL METHODS:The research was based on the completion of a questionnaire which has been used on foreigners and Greek patients who complained about chronic diseases. This questionnaire guarantees the highest reliability of all so that it will be possible to specify the negative influence of their disease upon the different sides of their life. Emphasis should be given on the fact that the personality questionnaire of Eysenck has been intensively evaluated on the Greek population as very trustworthy for secure conclusions. It included 84 questions in four different disorders (psychotism, neurotism, ex/introversion and check inversion for inaccuracies. The questionnaire has been proved very useful for the evaluation of the influence of the different interventions upon the quality of life of patients under heamodialysis. It appeared also that it was more reliable in comparison with the Sickness Impact Profile and with a test, whhb ic was aout the exercise under stress conditions. RESULTS: It has been discovered that all the three scales of control of the personality disturbances have systematically been influenced according to the control group of 138 persons from different age and sex groups. Furthermore, it has been found that the men patients underthe CRH were in lower region of the scale of neurotism while women patients appeared to be lower in the scale of psychotism. The T‐test shows that there is no important statistic difference between the two sexes according to the quality of their job. There is also no important difference

  15. 77 FR 59929 - Guidance for Industry on Acute Bacterial Exacerbations of Chronic Bronchitis in Patients With...

    Science.gov (United States)

    2012-10-01

    ... August 22, 2008 (73 FR 49684), which in turn revised the draft guidance for industry entitled ``Acute... ``Acute Bacterial Exacerbations of Chronic Bronchitis in Patients With Chronic Obstructive Pulmonary... treatment of acute bacterial exacerbations of chronic bronchitis in patients with chronic...

  16. Occurrence of chronic lymphocytic leukemia in patients with chronic myelogenous leukemia

    Directory of Open Access Journals (Sweden)

    Pritish K Bhattacharyya

    2013-01-01

    Full Text Available Chronic lymphocytic leukemia (CLL is the most common leukemia of adults in the western world and constitutes about 33% of all leukemia′s. The incidence of CLL increases with age and are more common in older population. Chronic myeloid leukemia (CML on the contrary occurs in both young adults and elderly and is a chronic myeloproliferative disease that originates from abnormal pluripotent stem cells and results in involvement of multiple hematopoietic lineages, but predominantly myeloid and less commonly lymphoid. Association between CLL and myeloid malignancies (CML, acute myeloid leukemia and MDS, myelodysplastic syndrome is rare. In literature documenting CLL and CML in same patients, occur either simultaneously or CML is preceded by CLL.

  17. Tinnitus: development of a neurophysiologic correlate

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    Sasaki, C.T.; Babitz, L.; Kauer, J.S.

    1981-12-01

    Although tinnitus severely afflicts 7.2 million Americans, the pathophysiology of this problem remains obscure because there presently exists no good animal model in which to study the phenomenon. We have examined changes in activity in the guinea pig auditory pathway using an autoradiographic method of functional brain mapping after short-term and long-term cochlear ablations which can, in humans, initiate the occurrence of tinnitus. With this method we have observed a reduction in activity in various nuclei in the auditory pathway between 4 hrs and 10 days after unilateral cochlear ablation. In contrast to these findings we have found a return of activity in these same nuclei if they are observed from 12 to 48 days following the lesion. These preliminary data suggest that this return of activity in the absence of sensory input may be a valid experimental analogue for tinnitus in humans. Such evidence for auditory plasticity may represent a significant first step toward understanding this common and profound otologic symptom.

  18. Myofascial Pain Syndrome in Chronic Back Pain Patients

    Science.gov (United States)

    Nizar, Abd Jalil

    2011-01-01

    Background Myofascial pain syndrome (MPS) is a regional musculoskeletal pain disorder that is caused by myofascial trigger points. The objective of this study was to determine the prevalence of MPS among chronic back pain patients, as well as to identify risk factors and the outcome of this disorder. Methods This was a prospective observational study involving 126 patients who attended the Pain Management Unit for chronic back pain between 1st January 2009 and 31st December 2009. Data examined included demographic features of patients, duration of back pain, muscle(s) involved, primary diagnosis, treatment modality and response to treatment. Results The prevalence of MPS among chronic back pain patients was 63.5% (n = 80). Secondary MPS was more common than primary MPS, making up 81.3% of the total MPS. There was an association between female gender and risk of developing MPS (χ2 = 5.38, P = 0.02, O.R. = 2.4). Occupation, body mass index and duration of back pain were not significantly associated with MPS occurrence. Repeated measures analysis showed significant changes (P pain patients was significantly high, with female gender being a significant risk factor. With proper diagnosis and expert management, MPS has a favourable outcome. PMID:21716607

  19. Neurocognitive performance in first-episode and chronic schizophrenic patients.

    Science.gov (United States)

    Moritz, Steffen; Andresen, Burghard; Perro, Christian; Schickel, Marc; Krausz, Micheal; Naber, Dieter

    2002-02-01

    Previous research on neuropsychological disturbances in first-episode and chronic schizophrenic patients has provided mixed results which can be partially attributed to methodological inconsistencies. For the present study, 70 schizophrenic patients (40 with chronic and 30 with first-episode schizophrenia) were compared to 30 healthy controls on a large battery of neuropsychological tests. Special attention was paid to potential confounds such as differences in psychopathology, age and educational level between the schizophrenic sub-samples. Healthy controls performed better than both first-episode and chronic patients in almost all cognitive domains (P < 0.01), while the patient samples did not differ in any of the tasks. Results were confirmed in a second series of analyses in which patient subgroups were equated for sociodemographic background variables. The present results confirm recent data collected in longitudinal studies, thus, lending further support for a neurodevelopmental model of schizophrenia. It is suggested that neuropsychological disturbances occur early in schizophrenia and do not worsen in the course beyond age-related decrement. Possible reasons why previous research has produced contradictory findings are discussed. PMID:12056580

  20. Small intestinal bacterial overgrowth in patients with chronic hepatitis C

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    K. V. Zhdanov

    2011-01-01

    Full Text Available In order to estimate the frequency of detection of bacterial overgrowth syndrome in patients with chronic hepatitis C, find a possible relationship between development dysbiotic changes in the small intestine and over chronic hepatitis C were examined 80 patients (68 males and 12 females. In addition to standard laboratory tests for all patients was performed hydrogen breath test with a load of lactulose and fibrogastroduodenoscopy and hepatic biopsy with subsequent histological examination of biopsy. It was found that bacterial overgrowth syndrome, according to the hydrogen breath test detected 40% of patients with chronic hepatitis C, and the severity of it increases with the progression of the pathological process in the liver tissue. urthermore, in patients with endoscopic signs of catarrhal duodenitis according fibrogastroduodenoscopy, the level of molecular hydrogen when the hydrogen breath test at the appropriate stages of measurement was significantly lower, which may be due to the lack of saccharolytic and / or the predominance of proteolytic flora in the development of bacterial overgrowth syndrome.

  1. Anticoagulation in chronic kidney disease patients-the practical aspects.

    Science.gov (United States)

    Hughes, Stephen; Szeki, Iren; Nash, Michael J; Thachil, Jecko

    2014-10-01

    There is an increasing awareness about the risks of arterial and venous thromboembolism (TE) in hospital patients and general public which has led to consideration of thrombosis prevention measures in earnest. Early recognition of the symptoms of TE disease has led to timely administration of antiplatelet and anticoagulant drugs, translating to better outcome in many of these patients. In this respect, patients with chronic kidney disease (CKD) represent a special group. They indeed represent a high-risk group for thrombosis both in the cardiovascular territory and also in the venous circulation. At the same time, abnormalities in the platelet membranes put them at risk of bleeding which is significantly more than other patients with chronic diseases. Anticoagulation may be ideal to prevent the former, but the co-existing bleeding risk and also that the commonly used drugs for inhibiting coagulation are eliminated by renal pathways pose additional problems. In this review, we try to explain the complex thrombotic-haemorrhagic state of chronic kidney disease patients, and practical considerations for the management of anticoagulation in them with a focus on heparins. PMID:25878775

  2. LIPID METABOLISM DISORDERS IN PATIENTS WITH CHRONIC HEPATITIS C

    Directory of Open Access Journals (Sweden)

    L. I. Tkachenko

    2015-01-01

    Full Text Available Purpose of the study. To study lipid metabolism in chronic hepatitis C and to assess its impact on the formation of insulin resistance, steatosis and progression of liver fibrosis.Materials and methods. The study included 205 patients with chronic hepatitis C (CHC. Conducts research, depending on the genotype C, viral load and body mass index (BMI of the patients.Results. CHC patients revealed a combined hyperlipoproteinemia on the background of op-pression synthesis of apolipoproteins A1 and B. Formation of hepatic steatosis was associated with HCV genotype 3 virus-induced viral load at ≥ 6 log10 IU/ml and metabolic in VL < 6 log10 IU/ml. In patients with chronic hepatitis C genotype 1, high viral load leads to inhibition of protein synthesis conveyor ApoA1 and increased synthesis of cholesterol, accompanied by abdominal obesity and the formation of insulin resistance. CHC patients with BMI < 25 kg/m2 viral load ≥ 6 log10 ME/ml was associated with dyslipidemia IV type on D. Fredriskson (1970, hyperglycemia, insulin resistance and diabetes. The advanced stage of liver fi brosis (F ≥ 3 on a scale METAVIR and non-response to treatment were associated with a decrease in HDL cholesterol below normal. With an increase in viral load > 5 log10 ME/ml signifi cantly increased the risk of lipid and carbohydrate metabolism.

  3. Quality of life in patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Petrović Lada

    2006-01-01

    Full Text Available Introduction. Hemodialysis and transplantation are performed not only to replace renal function, but also to improve patients' quality of life. The aim of our investigation was to compare the quality of life in patients with chronic renal failure (CRF before and after the introduction of active therapy. Material and methods. We tested 76 patients (pts: 20 pts on conservative therapy (CT, 21 pts on chronic hemodialysis and 35 pts with renal transplantation. A questionnaire (combining two questionnaires was used to investigate the physical, emotional and social aspects of health. Results. In regard to physical health of transplantation patients (TP it was established that work capacity and activities were less damaged, whereas physical activity was highest in pts on CT. Social activity was limited in a higher percentage in TP (40% than in hemodialysis patients (HD (19%, while family relationships were most damaged in pts on HD (28.57%. Discomforts were most common in pts on HD. The highest percentage of pts estimated their health status as good or average, but their health status improved after transplantation in 82.86% that is in 57.14% after HD. It was similar with the quality of life: 28.57% of kidney transplant patients rated their quality of life as very good, and 54.28% rated it as good; 38.09% of HD patients rated their quality of life as very good, whereas only 5% of CT patients rated it as very good, and 20% as good. .

  4. Herbal Product Use in Patients with Chronic Kidney Disease

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    Cem BİÇEN

    2012-05-01

    Full Text Available OBJECTIVE: Recently, despite the developments in diagnosis and treatment of diseases, herbal product use in patients with chronic diseases has become more frequent. The aim of our study was to investigate the frequency of herbal medicine use in patients with chronic kidney disease (CKD, used products, source of information, whether they were giving information to their clinicians about this subject and cost of used products. MATERIAL and METHODS: The investigation has been performed with 100 CKD patients. A questionnaire form has been used in collecting data about the patients. RESULTS: The herbal use rate in our study was 37%. The most used herbal products were ready products and stinging nettle. There was no relation between herbal product use and age, gender, educatin level, marital status (p>0.05. 87% of the patients indicated that monthly cost of the product was lower than 50 Turkish Liras. 78.4% of the patients defined that they didn't give information to their clinicians about the herbal product they used. CONCLUSION: A significant part of the patients with CKD use herbal products and do not give information to the clinicians about this subject. The physicians following the patients with CKD should examine the use of herbal products.

  5. Hyperhidrosis and sympathetic skin response in chronic alcoholic patients.

    Science.gov (United States)

    Tugnoli, V; Eleopra, R; De Grandis, D

    1999-02-01

    Palmoplantar hyperhidrosis is frequently observed in patients with a clinical history of chronic abnormal alcoholic intake. It can be related to peripheral or central mechanisms such as abnormal spontaneous activity in peripheral damaged fibres; receptor hypersensitivity; compensatory incremented activity in segmentary anhidrosis; or impairment of central sweat control. With the aim of quantifying this phenomenon and of identifying its possible origin, sympathetic skin response (SSR) analysis was performed in 20 chronic alcoholic patients with clinical diffuse acral hyperhidrosis, compared with 30 normal subjects and 2 patients affected by primary palmoplantar hyperhidrosis (PPH). SSRs were recorded by disc electrodes place on the hands and feet, simultaneously. At the hand level two recording sites were selected: palm-dorsum proximally and ventral-dorsal tip of the third finger distally. Attention was paid to the number of SSR after a single endogenous or exogenous stimulus. The alcoholic patients were divided into two groups, with and without mild polyneuropathy. Both patient groups showed synchronous SSR at recording sites, with the same pattern and the normal delay between upper and lower arms. In the control group one response was generally related to a single stimulus; if more responses were elicited an evident adaptation was shown; in the two groups of patients an increase of the waves was observed in all the recording sites without any adaptation. The SSR profile described in alcoholic patients was observed also in PPH. The pattern of SSR waves in alcoholic patients seems to suggest a possible central origin of this type of hyperhidrosis. PMID:10212744

  6. Skin autofluorescence predicts cardiovascular mortality in patients on chronic hemodialysis.

    Science.gov (United States)

    Kimura, Hiroshi; Tanaka, Kenichi; Kanno, Makoto; Watanabe, Kimio; Hayashi, Yoshimitsu; Asahi, Koichi; Suzuki, Hodaka; Sato, Keiji; Sakaue, Michiaki; Terawaki, Hiroyuki; Nakayama, Masaaki; Miyata, Toshio; Watanabe, Tsuyoshi

    2014-10-01

    Tissue accumulation of advanced glycation end products (AGE) is thought to contribute to the progression of cardiovascular disease (CVD). Skin autofluorescence, a non-invasive measure of AGE accumulation using autofluorescence of the skin under ultraviolet light, has been reported to be an independent predictor of mortality associated with CVD in Caucasian patients on chronic hemodialysis. The aim of this study was to assess the predictive value of skin autofluorescence on all-cause and cardiovascular mortality in non-Caucasian (Japanese) patients on chronic hemodialysis. Baseline skin autofluorescence was measured with an autofluorescence reader in 128 non-Caucasian (Japanese) patients on chronic hemodialysis. All-cause and cardiovascular mortality was monitored prospectively during a period of 6 years. During the follow-up period, 42 of the 128 patients died; 19 of those patients died of CVD. Skin autofluorescence did not have a significant effect on all-cause mortality. However, age, carotid artery intima-media thickness (IMT), serum albumin, high-sensitivity C-reactive protein (hsCRP), skin autofluorescence and pre-existing CVD were significantly correlated with cardiovascular mortality. Multivariate Cox regression analysis showed skin autofluorescence (adjusted hazard ratio [HR] 3.97; 95% confidence interval [CI]1.67-9.43), serum albumin (adjusted HR 0.05; 95% CI 0.01-0.32), and hsCRP (adjusted HR 1.55; 95% CI 1.18-2.05) to be independent predictors of cardiovascular mortality. The present study suggests that skin autofluorescence is an independent predictor of cardiovascular mortality in non-Caucasian (Japanese) patients on chronic hemodialysis.

  7. Skin autofluorescence predicts cardiovascular mortality in patients on chronic hemodialysis.

    Science.gov (United States)

    Kimura, Hiroshi; Tanaka, Kenichi; Kanno, Makoto; Watanabe, Kimio; Hayashi, Yoshimitsu; Asahi, Koichi; Suzuki, Hodaka; Sato, Keiji; Sakaue, Michiaki; Terawaki, Hiroyuki; Nakayama, Masaaki; Miyata, Toshio; Watanabe, Tsuyoshi

    2014-10-01

    Tissue accumulation of advanced glycation end products (AGE) is thought to contribute to the progression of cardiovascular disease (CVD). Skin autofluorescence, a non-invasive measure of AGE accumulation using autofluorescence of the skin under ultraviolet light, has been reported to be an independent predictor of mortality associated with CVD in Caucasian patients on chronic hemodialysis. The aim of this study was to assess the predictive value of skin autofluorescence on all-cause and cardiovascular mortality in non-Caucasian (Japanese) patients on chronic hemodialysis. Baseline skin autofluorescence was measured with an autofluorescence reader in 128 non-Caucasian (Japanese) patients on chronic hemodialysis. All-cause and cardiovascular mortality was monitored prospectively during a period of 6 years. During the follow-up period, 42 of the 128 patients died; 19 of those patients died of CVD. Skin autofluorescence did not have a significant effect on all-cause mortality. However, age, carotid artery intima-media thickness (IMT), serum albumin, high-sensitivity C-reactive protein (hsCRP), skin autofluorescence and pre-existing CVD were significantly correlated with cardiovascular mortality. Multivariate Cox regression analysis showed skin autofluorescence (adjusted hazard ratio [HR] 3.97; 95% confidence interval [CI]1.67-9.43), serum albumin (adjusted HR 0.05; 95% CI 0.01-0.32), and hsCRP (adjusted HR 1.55; 95% CI 1.18-2.05) to be independent predictors of cardiovascular mortality. The present study suggests that skin autofluorescence is an independent predictor of cardiovascular mortality in non-Caucasian (Japanese) patients on chronic hemodialysis. PMID:24456287

  8. Questionnaire survey on the clinical characteristics of 2 408 outpatients with tinnitus%门诊耳鸣患者2408例问卷调查

    Institute of Scientific and Technical Information of China (English)

    韩朝; 田亮; 丛宁; 黄一波; 杨娟梅

    2013-01-01

    Objective To explore the clinical characteristics of tinnitus in otolaryngological outpatients. Methods Tinnitus questionnaire survey was performed in 2 408 otolaryngological outpatients treated from Dec. 2009 to Jul. 2010. The data obtained were analyzed by statistical software. Results All outpatients were aged from 6 to 95 years, averagely (47.02 ± 17. 05) years. There were 996 cases with tinnitus(41. 36% ) , including 388(38. 96% ) male cases and 608(61. 04% )female cases. The difference of tinnitus incidence between male and female was significant(P = 0.001 9). Except for 4 cases aged less than 12 years, the remaining 992 tinnitus patients were divided into four groups according to the effect of tinnitus on life: no affection(149 cases, 15. 02%) , mild affection(480 cases, 48. 39%) , moderate affection(329 cases,33.16% ) ,severe affection(34 cases,3.43% ). The relationship between the degree of the different affection to life and doctors' office visiting was significantly correlated(P 2个月者,有效8例、无效6例.结论 耳鸣的发生率在耳鼻喉科门诊患者中所占比例极高,其中尤以女性多见.双侧耳鸣持续时间更长.随着治疗时间的延长,有效率有增加趋势.

  9. The Relation between Perception and Brain Activity in Gaze-Evoked Tinnitus

    NARCIS (Netherlands)

    van Gendt, Margriet J.; Boyen, Kris; de Kleine, Emile; Langers, Dave R. M.; van Dijk, Pim

    2012-01-01

    Tinnitus is a phantom sound percept that can be severely disabling. Its pathophysiology is poorly understood, partly due to the inability to objectively measure neural correlates of tinnitus. Gaze-evoked tinnitus (GET) is a rare form of tinnitus that may arise after vestibular schwannoma removal. Su

  10. Improvement of herpetic stomatitis therapy in patients with chronic tonsillitis

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    Lepilin А.V.

    2011-12-01

    Full Text Available The research goal is to determine the clinical and pathogenetic efficacy of Cycloferon liniment in the combined therapy in patients with herpetic stomatitis accompanied by chronic tonsillitis. Materials and methods: Medical examination and treatment of 60 patients have been carried out. The marker of endogenous intoxication, infectious severity and immunity has been investigated. Results. It has been established that use of Cycloferon liniment in the combined therapy in patients with herpetic stomatitis accompanied by chronic tonsillitis has allowed to decrease infectious severity in par-odontal recess and evidence of local inflammation, to normalize immunity indices and reduce the level of endogenous intoxication that has been liable for acceleration of recuperation processes and lowering of frequency of stomatitis recurrences. Conclusion. The clinical efficacy of Cycloferon liniment in the therapy in patients with herpetic stomatitis accompanied by chronic tonsillitis conditioned by the decreasing of activity of local inflammatory process according to the reducing of level pro-inflammatory cytokines, infectious burden of the mouth cavity, endogenous intoxication

  11. Iron metabolism in chronic hepatitis C patients on antiviral treatment

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    K. V. Zhdanov

    2009-01-01

    Full Text Available Purpose of the present research studying dynamics of the parameters describing a metabolism of iron at chronic hepatitis С patients on a combined antiviral therapy peg-interferon-2а and ribavirin. Has served 50 patients chronic hepatitis C (anti-HCV “+”, РНК HCV “+”, 1b genotype in the age from 18 till 59 years, on the average 33±1,5years, at various stages of disease and stages of monitoring antiviral treatments. To patients the parameters describing a metabolism of iron (serum iron, transferrin, ferritin, haptoglobin, ceruplasmin, total iron binding capacity, transferrin saturation by iron were defined. The sustain virology response (SVR was estimated - definition RNA HCV in half a year after end of treatment (72 week. It was carried out liver biopsy with the subsequent estimation of a degree of inflammatory activity and fibrosis on system METAVIR. Therapy peg-interferon-2а and ribavirin was accompanied by decrease serum iron, transferrin, ferritin, ceruplasmin, haptoglobin, transferrin saturation by iron irrespective of the answer to treatment. Thus, SVR directly correlated with higher level of iron and ceruplasmin of blood before therapy, on its background and during supervision. Normalization of biochemical activity chronic hepatitis C and positive morphological dynamics correspond with the parameters describing changes in a metabolism of iron at its patients, possibly, were compensatory-adaptive and to some extent endogen antiviral reaction of an organism of the person on HCV - infection. 

  12. Characterization of Chronic Kidney Disease Patients Undergoing Hemodialysis

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    Niovis Sosa Barberena

    2016-08-01

    Full Text Available Background: Cienfuegos has a high prevalence of chronic kidney disease, which is a health problem of great social and economic impact. Objective: to characterize patients with chronic kidney disease receiving hemodialysis. Methods: a cross-sectional study was conducted in 80 patients treated at the Specialized Outpatient Center of Cienfuegos in 2013. General variables such as age, sex, and place of origin were analyzed, in addition to the causes of the disease, length of time on hemodialysis, type of vascular access, and prevalence of hepatitis C. Absolute frequencies, percentages, and rates were calculated. Results: the 45 to 54 age group was the most affected by the condition. Males accounted for 63.7%. Cienfuegos municipality showed the highest prevalence with 27.6 per 100 000 inhabitants. The most common cause of chronic kidney disease was nephroangiosclerosis (33.3%. Seventy three percent of patients started hemodialysis as an emergency therapy. The time on hemodialysis was less than one year and one to two years in more than half of patients. An arteriovenous fistula was used in 81.3% of cases. Hepatitis C showed a high prevalence. Conclusion: renal disease is more common in men of working age in Cienfuegos municipality. The major causes of this disease are associated with hypertension and diabetes mellitus.

  13. Serum Hepcidin Evaluation in Patients with Chronic Dialysis

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    V. Manolov

    2015-06-01

    Full Text Available The aim of our study was to quantify serum hepcidin levels in Bulgarian patients with chronic kidney disease (CKD. Expected high values of peptide hormones might provide a new therapeutic choice for anemia of chronic disease. We looked for correlation between serum hepcidin levels and some iron metabolism parameters in CKD patients. Results: The sandwich ELISA is highly specific for hepcidin-25. We found statistically significant differences in serum hepcidin levels in patients of the control group, with CKD stages II to IV and CKD stage V (on chronic dialysis: 12.7±8.7μg/L, 90.74±21.1μg/L, and 282.49±81.1μg/L, respectively. Significant correlation between serum hepcidin and transferrin saturation (r=0.340, P<0.05 was found in the group of patients with CKD stage V. Conclusion: The use of 2 monoclonal antibodies in a sandwich ELISA format provides a reliable, reproducible, and inexpensive method for measuring serum concentrations of the bioactive form of hepcidin in Bulgarian laboratory practice.

  14. Managing a chronic pain patient in the perioperative period.

    Science.gov (United States)

    Kopf, Andreas

    2013-12-01

    The chronic pain patient with and without chronic opioid medication is at risk for under- and overtreatment perioperatively. Careful planning of the perioperative period by the anesthesiologist, the pain service and the surgeon is crucial. Epidural analgesia requires reduction of preoperative opioid doses to a maximum of 50% to avoid withdrawal as well as continuous postanesthesia care unit-monitoring for the first 24 hours. Brief cognitive behavioral interventions pre- and postoperatively contribute to successful pain management. The perioperative period may be used to re-evaluate the patient's opioid requirements. A follow-up by an experienced pain management service should be available after discharge of the chronic pain patient. Individualized assessment by a pain management team is necessary for this increasing group of patients. This report is adapted from paineurope 2013; Issue 2, ©Haymarket Medical Publications Ltd., and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International, LTD. and is distributed free of charge to healthcare professionals in Europe. Archival issues can be accessed via the website: http://www.paineurope.com at which European health professionals can register online to receive copies of the quarterly publication. PMID:24303836

  15. Understanding tinnitus distress: introducing the concepts of moderators and mediators.

    Science.gov (United States)

    Andersson, Gerhard; Westin, Vendela

    2008-11-01

    We focus this theoretical paper on a neglected distinction in tinnitus research between moderators and mediators of tinnitus distress. A moderator variable is one that influences the strength of a relationship between two other variables. In the paper we propose that several variables might act as moderators of tinnitus distress. Degree of hearing loss, arousal, insomnia, characteristics of tinnitus, noise sensitivity, and a range of psychological factors such as personality and perceived control are discussed as potential moderators. We then move on to mediator variables. A mediator variable is one that explains the relationship between the two other variables, and must by definition be caused by a predictor, and then mediate between the predictor and the dependent variable. We propose that stress levels (caused by tinnitus), classical conditioning, selective attention towards tinnitus, and psychological acceptance of tinnitus (versus experiential avoidance) might be mediators of distress. We encourage more research on moderators and mediators of tinnitus distress, as these will help illuminate treatment protocols and how they might work.

  16. Maladaptive plasticity in tinnitus--triggers, mechanisms and treatment.

    Science.gov (United States)

    Shore, Susan E; Roberts, Larry E; Langguth, Berthold

    2016-03-01

    Tinnitus is a phantom auditory sensation that reduces quality of life for millions of people worldwide, and for which there is no medical cure. Most cases of tinnitus are associated with hearing loss caused by ageing or noise exposure. Exposure to loud recreational sound is common among the young, and this group are at increasing risk of developing tinnitus. Head or neck injuries can also trigger the development of tinnitus, as altered somatosensory input can affect auditory pathways and lead to tinnitus or modulate its intensity. Emotional and attentional state could be involved in the development and maintenance of tinnitus via top-down mechanisms. Thus, military personnel in combat are particularly at risk owing to combined risk factors (hearing loss, somatosensory system disturbances and emotional stress). Animal model studies have identified tinnitus-associated neural changes that commence at the cochlear nucleus and extend to the auditory cortex and other brain regions. Maladaptive neural plasticity seems to underlie these changes: it results in increased spontaneous firing rates and synchrony among neurons in central auditory structures, possibly generating the phantom percept. This Review highlights the links between animal and human studies, and discusses several therapeutic approaches that have been developed to target the neuroplastic changes underlying tinnitus. PMID:26868680

  17. Neural correlates of human somatosensory integration in tinnitus

    NARCIS (Netherlands)

    Lanting, C. P.; de Kleine, E.; Eppinga, R. N.; van Dijk, P.

    2010-01-01

    Possible neural correlates of somatosensory modulation of tinnitus were assessed. Functional magnetic resonance imaging (fMRI) was used to investigate differences in neural activity between subjects that can modulate their tinnitus by jaw protrusion and normal hearing controls. We measured responses

  18. The Role of Central Nervous System Plasticity in Tinnitus

    Science.gov (United States)

    Saunders, James C.

    2007-01-01

    Tinnitus is a vexing disorder of hearing characterized by sound sensations originating in the head without any external stimulation. The specific etiology of these sensations is uncertain but frequently associated with hearing loss. The "neurophysiogical" model of tinnitus has enhanced appreciation of central nervous system (CNS) contributions.…

  19. Middle ear myoclonus: a new technique for suppression of spontaneous clicking tinnitus.

    Science.gov (United States)

    Chan, Chung; Palaniappan, Rudrapathy

    2010-01-01

    Middle ear myoclonus is one of the causes of clicking tinnitus and can be psychologically distressing. Current management of intractable clicking includes medication or tenotomy. Two cases with spontaneous intrusive irregular clicking are presented where relief and a sense of control were obtained using non-invasive self - administered zygomatic pressure. This technique may be useful in selected patients before resorting to medication or tenotomy. PMID:21609914

  20. The research on electrical promontory stimulation in treating severe disabling tinnitus: 12 case reports%鼓岬电刺激治疗重度耳鸣的研究(附12例报告)

    Institute of Scientific and Technical Information of China (English)

    王艺; 李明; 张剑宁

    2012-01-01

    To evaluate the the efficacy and feasibility of electrical promontory stimulation in treating severe disabling tinnitus. Method;Treated 12 cases of severe disabling tinnitus with EPS, and evaluated the alterations of tinnitus severity scale before and after the treatment. Result:The effect on tinnitus was assessed during and immediately after the stimulation by tinnitus severity scores. Immediately after EPS. 5 patients reported complete suppression,the duration of persistence time were 10 s~20 h,and 5 reported attenuation of tinnitus, the lasting time were 2~24 h. 2 patients said it was unchanged. After 3 days, the tinnitus severity scores remained unchanged in all these patients. Conclusion: In our opinion EPS could be a effective method for suppressing and alleviating tinnitus , but poor results in patients with longterm effects and compliance. It is not suggested that EPS could be a routine method of treatment for tinnitus.%目的:评价鼓岬电刺激(EPS)治疗重度耳鸣的可行性及疗效.方法:对12例重度耳鸣患者进行EPS治疗,比较EPS治疗前后耳鸣严重程度量表评分的变化情况.结果:12例患者EPS治疗后,5例耳鸣消失,消失持续时间10 s~20 h;5例患者仅耳鸣响度减轻,减轻持续时间2~24 h;2例耳鸣无改变.3d后再次评价耳鸣严重程度,同治疗前相比,无明显改变.结论:EPS能有效抑制和消除耳鸣,但远期疗效及患者依从性不佳,不推荐在临床上常规采用.

  1. ISCHEMIA in chronic kidney disease: improving the representation of patients with chronic kidney disease in cardiovascular trials.

    Science.gov (United States)

    Wyatt, Christina M; Shineski, Matthew; Chertow, Glenn M; Bangalore, Sripal

    2016-06-01

    Despite the high cardiovascular risk associated with chronic kidney disease, a recent systematic review confirmed that patients with kidney disease remain underrepresented in cardiovascular trials. Two ongoing trials are assessing the risk:benefit of aggressive evaluation and intervention for ischemic heart disease in patients with advanced chronic kidney disease.

  2. Recent technological advances in sound-based approaches to tinnitus treatment: A review of efficacy considered against putative physiological mechanisms

    Directory of Open Access Journals (Sweden)

    Derek J Hoare

    2013-01-01

    Full Text Available The past decade has seen an escalating enthusiasm to comprehend chronic tinnitus from the perspective of both scientific understanding and clinical management. At the same time, there is a significant interest and commercial investment in providing targeted and individualized approaches to care, which incorporate novel sound-based technologies, with standard audiological and psychological strategies. Commercially produced sound-based devices for the tinnitus market include Co-ordinated Reset Neuromodulation ® , Neuromonics © , Serenade ® , and Widex ® Zen. Additionally, experimental interventions such as those based on frequency-discrimination training are of current interest. Many of these interventions overtly claim to target the underlying neurological causes of tinnitus. Here, we briefly summarize current perspectives on the pathophysiology of tinnitus and evaluate claims made by the device supporters from a critical point of view. We provide an opinion on how future research in the field of individualized sound-based interventions might best provide a reliable evidence-base in this growing area of translational medicine.

  3. Recent technological advances in sound-based approaches to tinnitus treatment: a review of efficacy considered against putative physiological mechanisms.

    Science.gov (United States)

    Hoare, Derek J; Adjamian, Peyman; Sereda, Magdalena; Hall, Deborah A

    2013-01-01

    The past decade has seen an escalating enthusiasm to comprehend chronic tinnitus from the perspective of both scientific understanding and clinical management. At the same time, there is a significant interest and commercial investment in providing targeted and individualized approaches to care, which incorporate novel sound-based technologies, with standard audiological and psychological strategies. Commercially produced sound-based devices for the tinnitus market include Co-ordinated Reset Neuromodulation ® , Neuromonics © , Serenade ® , and Widex ® Zen. Additionally, experimental interventions such as those based on frequency-discrimination training are of current interest. Many of these interventions overtly claim to target the underlying neurological causes of tinnitus. Here, we briefly summarize current perspectives on the pathophysiology of tinnitus and evaluate claims made by the device supporters from a critical point of view. We provide an opinion on how future research in the field of individualized sound-based interventions might best provide a reliable evidence-base in this growing area of translational medicine. PMID:23571301

  4. Recent technological advances in sound-based approaches to tinnitus treatment: a review of efficacy considered against putative physiological mechanisms.

    Science.gov (United States)

    Hoare, Derek J; Adjamian, Peyman; Sereda, Magdalena; Hall, Deborah A

    2013-01-01

    The past decade has seen an escalating enthusiasm to comprehend chronic tinnitus from the perspective of both scientific understanding and clinical management. At the same time, there is a significant interest and commercial investment in providing targeted and individualized approaches to care, which incorporate novel sound-based technologies, with standard audiological and psychological strategies. Commercially produced sound-based devices for the tinnitus market include Co-ordinated Reset Neuromodulation ® , Neuromonics © , Serenade ® , and Widex ® Zen. Additionally, experimental interventions such as those based on frequency-discrimination training are of current interest. Many of these interventions overtly claim to target the underlying neurological causes of tinnitus. Here, we briefly summarize current perspectives on the pathophysiology of tinnitus and evaluate claims made by the device supporters from a critical point of view. We provide an opinion on how future research in the field of individualized sound-based interventions might best provide a reliable evidence-base in this growing area of translational medicine.

  5. Prevalence of anemia in predialysis chronic kidney disease patients

    Directory of Open Access Journals (Sweden)

    FAM Shaheen

    2011-01-01

    Full Text Available To evaluate the prevalence of anemia in a large cohort that comprises patients in different stages of chronic kidney disease (CKD in the kingdom of Saudi Arabia (KSA, we conducted a multi-center cross-sectional study of a cohort of CKD patients who have not started dialysis. The study patients were recruited from the nephrology clinics in 11 different medical centers distributed all over the regions of the KSA. For the estimated glomerular filtration rate (GFR, we used the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI equation. There were 250 study patients who fulfilled the criteria for the study. The patients were stratified according to their GFR as follows: stage 1: 19 patients, stage 2: 35 patients, stage 3: 67 patients, stage 4: 68 patients, and stage 5: 61 patients. The composite of proteinuria and abnormal imaging in stages 1 and 2 was satisfied in 100% of the cases. The prevalence of anemia was elevated for the hemoglobin levels below 12 g/dL (the level at which the evaluation of anemia in CKD should be initiated in the different stages of CKD, that is, 42%, 33%, 48%, 71%, and 82% in the stages from 1 to 5, respectively. The prevalence was also elevated for the hemoglobin levels below 11 g/dL (the minimum hemoglobin level at which therapy should be initiated with erythropoietin, that is, 21%, 17%, 31%, 49%, and 72%, respectively for stages from 1 to 5. In conclusion, we found a large prevalence of anemia among the CKD population in Saudi Arabia, and the burden of patients who require treatment with erythropoietin is considerably large. However, the response to therapy will not require large doses according to the availability of long-acting erythropoiesis stimulating agents, which will render the therapy more convenient and less expensive.

  6. HEARING ASSESSMENT IN CHRONIC RENAL FAILURE PATIENTS UNDERGOING HEMODIALYSIS

    Directory of Open Access Journals (Sweden)

    Arjun Singh

    2014-01-01

    Full Text Available The auditory sensitivity of 63 patient of chronic renal failure on hemodialysis was assessed in order to know the effect of dialysis on hearing threshold. All selected patient were non diabetic with normal tympanic membrane and with no history of ototoxic drug and any hereditary hearing problems. Pure tone audiometry was done before and after dialys is and all cases were followed for 3 month. A high incidence of high frequency sensorineural hearing loss was obtained which could not be attributed to age , noise exposure and ottotoxicity. An association between high frequency sensorineural hearing loss a nd hemodialysis is thus suggested KEYWORDS: Hemodialysis ; Pure tone audiometry ; High frequency sensorineural hearing loss ; Duration of disease ; Chronic renal failure

  7. Antiviral treatment for chronic hepatitis B in renaltransplant patients

    Institute of Scientific and Technical Information of China (English)

    Ezequiel Ridruejo

    2015-01-01

    Chronic hepatitis B infection is frequent in renaltransplant patients. It negatively impacts long termoutcomes reducing graft and patient survival. Currentguidelines clearly define who needs treatment, whento start, what is the first line therapy, how to monitortreatment response, when to stop, and how patientsmust be controlled for its safety. There is some datashowing a favorable safety and efficacy profile ofnucleos(t)ide analogue (NUC) treatment in the renaltransplant setting. Entecavir, a drug without majorsigns of nephrotoxicity, appears to be the first optionfor NUC na?ve patients and tenofovir remains thepreferred choice for patients with previous resistanceto lamivudine or any other NUC. Renal transplantrecipients under antiHBV therapy should be monitoredfor its efficacy against HBV but also for its safety witha close renal monitoring. Studies including a largenumber of patients with long term treatment and followup are still needed to better demonstrate the safetyand efficacy of newer NUCs in this population.

  8. Urinary Peptide Levels in Patients with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Mungli Prakash

    2010-10-01

    Full Text Available Introduction: Peptide levels in urine are found to be decreased in renal failure. In the current study urinary peptide levels were determined in chronic renal failure (CRF patients. Method: 86 CRF patients and 80 healthy controls were selected for the study. Urinary proteins and peptide levels were determined by spectrophotometer based Lowry and Bradford methods. Urinary creatinine levels were determined by clinical chemistry analyzer. Results: There was significant decrease in urinary peptide levels in CRF patients and Urinary % peptides were significantly decreased in CRF patients as compared to healthy controls. Urinary % peptides correlated negatively with proteinuria. Conclusion: we have found decrease in urinary peptides and % urinary peptides in CRF patients and possibly measurement of % urinary peptides may possibly serve as better indicator in early detection of impairment in renal function.

  9. Endotoxins in the prostatic secretions of chronic prostatitis patients

    Institute of Scientific and Technical Information of China (English)

    Yu-Ping Dai; Xiang-Zhou Sun; Ke-Li Zheng

    2005-01-01

    Aim: To evaluate the clinical significance of the quantitative determinations of endotoxins in the expressed prostatic secretions (EPS) of chronic prostatitis (CP) patients. Methods: The EPS of 45 patients with CP and 15 normal volunteers were obtained for microscopic examination, bacterial culture and endotoxin determination. The level of endotoxins was determined by the Limulus-amebocyte-lysate test with chromogenic substrate. Results: Patients (P>0.05), type Ⅱ/type Ⅲa vs. Normal controls P < 0.05)]. Conclusion: CP patients have elevated levels of endotoxins in the EPS, which suggests that inflammation is a feature of this disease. EPS endotoxin determination is not only helpful in diagnostic confirmation, but also in evaluating the response to treatment in CP patients.

  10. Valvular and perivalvular involvement in patients with chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    Neelavathi Senkottaiyan; Saad Hafidh; Farrin A. Manian; Martin A. Alpert

    2005-01-01

    Abstract Mitral annular calcification (MAC) and aortic valve alcification (AVC) are the most common valvular and perivalvular bnormalities in patients with chronic kidney disease (CKD). Both MAC and AVC occur at a younger age in CKD patients than in the general population. AVC progresses to aortic stenosis and mild aortic stenosis progresses to severe aortic stenosis at a more rapid rate in patients with CKD than in the general population. The use of calcium-free phosphate binders in such patients may reduce the calcium burden in valvular and perivalvular tructures and retard the rate of progression of aortic stenosis. Despite high rates of morbidity and mortality, the prognosis associated with valve surgery in patients with CKD is better than without valve surgery. Infective endocarditis remains an important complication of CKD, particularly in those treated with hemodialysis.

  11. The Prevalence of Allergic Rhinitis in Patients with Chronic Rhinosinusitis

    Directory of Open Access Journals (Sweden)

    Mehdi Bakhshaee

    2014-10-01

    Full Text Available Introduction: Chronic rhinosinusitis (CRS is a multifactorial disease. Allergies are considered a predisposing factor to CRS; however, this remains controversial. The objective of this research was to investigate the prevalence of co-morbidities and allergic reaction, and to specify the most common allergens in patients with confirmed CRS.   Materials and Methods: One hundred patients with signs and symptoms of CRS who met the diagnostic endoscopic and radiologic criteria of chronic rhinosinusitis were selected. They filled out a questionnaire and underwent a skin prick test for the common inhalant allergens. Allergic rhinitis was diagnosed according to the history and positive skin prick tests.   Results: The mean age of patients was 34. Males were slightly more involved (54%. The prevalence of polypoid and none-polypoid rhinosinusitis was 54% and 46% respectively. The patients’ most common symptoms were nasal discharge (95%, blockage (94%, smell disorders (63%, cough (45%, halitosis (41%, lethargy (37%, and aural fullness (36%. Allergy to at least one allergen was noted in 64% of the CRS patients which is higher than general population in Mashhad, Iran with allergic rhinitis (22.4%. Salsola was the most common allergen. There was no significant difference in allergic reactions between polypoid and non-polypoid CRS patients.   Conclusion:  Allergic reactions was found in Iranian CRS patients with or without polyposis to be much higher than general population in Mashhad with allergic rhinitis alone.

  12. Oral disorders in patients with chronic renal failure. Narrative review.

    Directory of Open Access Journals (Sweden)

    Carolina Hernández

    2016-02-01

    Full Text Available Chronic renal failure (CRF is one of the best known renal diseases. It is characterized by a deterioration in the overall renal function and is associated with other conditions such as hypertension, diabetes mellitus, uropathy, chronic glomerulonephritis and autoimmune diseases. Patients with CRF show alterations of the masticatory system that are specific to the disease and other type of disorders as a result of treatment. Oral health in dialysis and transplant patients tends to be poor, which makes them more likely to develop pathological conditions in the oral cavity, potentially increasing morbidity, mortality and affecting the quality of life of patients. Among the lesions we can find dysgeusia, periodontitis, candidiasis, gingival bleeding, petechiae, and joint alterations. Gingivitis and xerostomia associated to long-term use medications can cause oral lesions. Children with CRF show two oral conditions of interest: high incidence of dental anomalies and low caries activity. In patients receiving a kidney transplant, previous dental treatment is critical because the immune status of the patient will be affected not only by the toxemia, but by the immunosuppressive drugs used to prevent organ rejection. Therefore, the dentist plays an important role in training parents and/or guardians, doctors and paramedics on the treatment of oral lesions in these patients.

  13. Oral disorders in patients with chronic renal failure. Narrative review

    Directory of Open Access Journals (Sweden)

    Carolina Hernández

    2016-02-01

    Full Text Available Chronic renal failure (CRF is one of the best known renal diseases. It is characterized by a deterioration in the overall renal function and is associated with other conditions such as hypertension, diabetes mellitus, uropathy, chronic glomerulonephritis and autoimmune diseases. Patients with CRF show alterations of the masticatory system that are specific to the disease and other type of disorders as a result of treatment. Oral health in dialysis and transplant patients tends to be poor, which makes them more likely to develop pathological conditions in the oral cavity, potentially increasing morbidity, mortality and affecting the quality of life of patients. Among the lesions we can find dysgeusia, periodontitis, candidiasis, gingival bleeding, petechiae, and joint alterations. Gingivitis and xerostomia associated to long-term use medications can cause oral lesions. Children with CRF show two oral conditions of interest: high incidence of dental anomalies and low caries activity. In patients receiving a kidney transplant, previous dental treatment is critical because the immune status of the patient will be affected not only by the toxemia, but by the immunosuppressive drugs used to prevent transplant rejection. Therefore, the dentist plays an important role in training parents and/or guardians, doctors and paramedics on the treatment of oral lesions in these patients

  14. Tinnitus en arbeid. Een onderzoek naar de invloed van stressoren op tinnitus en de mogelijkheid tot werken

    NARCIS (Netherlands)

    Nienke Riemersma, [No Value

    2010-01-01

    Het al dan niet kunnen werken heeft te maken met stressoren die de tinnitus en/of de mogelijkheid tot werken negatief beïnvloeden. Welke stressoren van invloed zijn is in opdracht van de commissie Tinnitus en Hyperacusis van de Nederlandse Vereniging Voor Slechthorenden (NVVS) door de Wetenschapswin

  15. Intervention treatments for chronic pain syndrome in cancer patients

    OpenAIRE

    V. V. Bryuzgin

    2010-01-01

    Noninvasive treatments for chronic pain syndrome benefit in 80-90% of cancer patients. Invasive, intervention procedures for analgesia should be used in other cases. These include neuroablative and neuromodulatory measures. Neuroablation is defined as the physical suspension of painful impulse transmission pathways by a surgical, chemical, or thermal method and comprises lytic and other blocks. Neuromodulation is the dynamic and functional suppression of pain impulse pathways by the intraspin...

  16. Core strength training for patients with chronic low back pain

    OpenAIRE

    Chang, Wen-Dien; Lin, Hung-Yu; Lai, Ping-Tung

    2015-01-01

    [Purpose] Through core strength training, patients with chronic low back pain can strengthen their deep trunk muscles. However, independent training remains challenging, despite the existence of numerous core strength training strategies. Currently, no standardized system has been established analyzing and comparing the results of core strength training and typical resistance training. Therefore, we conducted a systematic review of the results of previous studies to explore the effectiveness ...

  17. Angiotensin II vaccine promising for patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    CHEN Yang-xin; YAO You-jie; NIE Ru-qiong; ZHOU Shu-xian; WANG Jing-feng

    2009-01-01

    @@ Chronic heart failure (CHF), as the end-stage presentation of all kinds of heart diseases, is a major public health problem as well as a pressing public policy issue. There are more than 5 million patients diagnosed with CHF in USA alone and approximately 550 000 new cases appear per year. About 0.4%-2% of the European population is affected by symptomatic heart failure. Hence heart failure is the leading cause of hospitalization especially in older people around the world.

  18. Disparities in Periodontitis Prevalence among Chronic Kidney Disease Patients

    OpenAIRE

    Ioannidou, E; Swede, H.

    2011-01-01

    Because of adverse effects of uremia in the innate and adaptive immune systems, we hypothesized that chronic kidney disease (CKD) patients would have higher prevalence of moderate periodontitis compared with individuals without CKD. We examined this hypothesis using the NHANES III dataset, including 12,081 adults stratified by Race-Ethnicity. We followed the American Academy of Periodontology/Centers for Disease Control and Prevention definition for moderate periodontitis. Estimated glomerula...

  19. Intimate Partner Aggression Perpetration in Primary Care Chronic Pain Patients

    OpenAIRE

    Taft, Casey; Schwartz, Sonia; Liebschutz, Jane M.

    2010-01-01

    This study examined the prevalence and correlates of partner aggression perpetration in 597 primary care chronic pain patients. Approximately 30% of participants reported perpetrating low-level aggression, 12% reported injuring their partner, and 5% reported engaging in sexual coercion. Women reported more low-level aggression perpetration than men, and men reported more engagement in sexual coercion than women. Substance use disorders (SUD) were associated with all outcomes, and both aggress...

  20. Subclinical microbial infection in patients with chronic plaque psoriasis.

    Science.gov (United States)

    Bartenjev, I; Rogl Butina, M; Potocnik, M

    2000-01-01

    Epidemiological evidence implicates bacterial infection as a common triggering stimulus for psoriasis. Recent studies suggest that continuing, subclinical streptococcal and staphylococcal infections might be responsible not only for relapse of acute guttate psoriasis but also for a new episode of chronic plaque psoriasis. In this study 195 patients suffering from a severe form of chronic plaque psoriasis hospitalized between 1996 and 1998 were examined. The presence of subclinical microbial infection of the upper respiratory tract was studied by the cultivation of pathogens from this area. Patients with other provoking factors, such as a positive history of taking any drugs that may exacerbate psoriasis, endocrine and metabolic factors, alcohol abuse, trauma, dental focus and clinically evident bacterial infection, were excluded. Subclinical streptococcal and/or staphylococcal infections were detected in 68% of tested patients and in only 11% of the control group. The results of this study indicate that subclinical bacterial infections of the upper respiratory tract may be an important factor in provoking a new relapse of chronic plaque psoriasis. Searching for, and eliminating, microbial infections could be of importance in the treatment of psoriasis.

  1. Development of Tinnitus in CBA/CaJ Mice Following Sound Exposure

    OpenAIRE

    Longenecker, Ryan J.; Galazyuk, Alexander V.

    2011-01-01

    Tinnitus, the perception of a sound without an external acoustic source, is a complex perceptual phenomenon affecting the quality of life in 17% of the adult population. Despite its ubiquity and morbidity, the pathophysiology of tinnitus is a work in progress, and there is no generally accepted cure or treatment. Development of a reliable common animal model is crucial for tinnitus research and may advance this field. The goal of this study was to develop a tinnitus mouse model. Tinnitus was ...

  2. Tinnitus Severity Is Reduced with Reduction of Depressive Mood – a Prospective Population Study in Sweden

    OpenAIRE

    Sylvie Hébert; Barbara Canlon; Dan Hasson; Linda L. Magnusson Hanson; Hugo Westerlund; Töres Theorell

    2012-01-01

    Tinnitus, the perception of sound without external source, is a highly prevalent public health problem with about 8% of the population having frequently occurring tinnitus, and about 1-2% experiencing significant distress from it. Population studies, as well as studies on self-selected samples, have reported poor psychological well-being in individuals with tinnitus. However, no study has examined the long-term co-variation between mood and tinnitus prevalence or tinnitus severity. In this st...

  3. Hvordan kan mindfulness-basert behandling hjelpe for pasienter med tinnitus?

    OpenAIRE

    Valle, Linda

    2014-01-01

    Tinnitus is a common and severe disorder presenting big health issues for the many people affected. The fact that not all people are affected by their tinnitus, have been a puzzle for scientists. This has led to an expanded psychological view of tinnitus over time. Tinnitus as a functional disorder, is first of all a medical disorder, and treatment has been oriented from an audiological perspective. Studies and neurophysiology has shown tinnitus to be a transdiagnostic disorder, which mean th...

  4. Basophil Activation Test with Food Additives in Chronic Urticaria Patients

    OpenAIRE

    Kang, Min-Gyu; Song, Woo-Jung; Park, Han-Ki; Lim, Kyung-Hwan; Kim, Su-Jung; Lee, Suh-Young; Kim, Sae-Hoon; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

    2014-01-01

    The role of food additives in chronic urticaria (CU) is still under investigation. In this study, we aimed to explore the association between food additives and CU by using the basophil activation test (BAT). The BAT using 15 common food additives was performed for 15 patients with CU who had a history of recurrent urticarial aggravation following intake of various foods without a definite food-specific IgE. Of the 15 patients studied, two (13.3%) showed positive BAT results for one of the te...

  5. Asymptomatic patients of chronic obstructive pulmonary disease in China

    Institute of Scientific and Technical Information of China (English)

    LU Ming; WANG Chang-zheng; NI Dian-tao; WANG Xiao-ping; WANG Da-li; LIU Sheng-ming; L(U) Jia-chun; SHEN Ning; DING Yan-ling; RAN Pi-xin; YAO Wan-zhen; ZHONG Nan-shan; ZHOU Yu-min; WANG Chen; CHEN Ping; KANG Jian; HUANG Shao-guang; CHEN Bao-yuan

    2010-01-01

    Background Chronic obstructive pulmonary disease (COPD) has a variable natural history and not all individuals follow the same course. This study aimed to identify the prevalence and characteristics of asymptomatic COPD patients from a population-based survey in China.Methods A multistage cluster sampling strategy was used in a population from seven different provinces/cities. All residents (over 40 years old) were interviewed with a standardized questionnaire and spirometry.Post-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of less than 70% was defined as the diagnostic criterion of COPD. All COPD patients screened were divided into symptomatic group and asymptomatic group according to the presence or absence of chronic respiratory symptoms. Socio-demographic,personal and exposure variables were collected and analyzed.Results Among the 1668 patients who were diagnosed with COPD from the 25 627 sampling subjects, 589 (35.3%)were asymptomatic. The age, sex, body mass index (BMI),rural and urban distributions, smoking habit and education levels were similar in the two groups. A total of 64.7% of the asymptomatic patients had no comorbidities. Cardiovascular diseases and lung cancer were more common among symptomatic COPD patients than asymptomatic group.Asymptomatic COPD group were less likely to present with poor ventilation in the kitchen, a family history of respiratory disease and recurrent childhood cough. Asymptomatic COPD patients had significantly higher FEV1 (73.1% vs. 61.0%), FVC (91.9% vs. 82.0%), and a higher ratio of FEV1/FVC (62.9% vs.58.7%) (all P <0.001) than symptomatic group. More asymptomatic patients were underdiagnosed (91.9% vs.54.3%, P<0.001) than symptomatic patients.Conclusions This large population-based survey confirmed a high prevalence of asymptomatic COPD patients in China. More use of spirometry screening test may be important to the early detection of COPD.

  6. [Concept analysis of medication adherence in patients with chronic disease].

    Science.gov (United States)

    Huang, Jen-Ying; Chen, Hsing-Mei

    2014-06-01

    Pharmacotherapy plays an important role in the management of chronic diseases. However, many patients with chronic disease do not adhere to their medication regimen. This results in worsening symptoms and frequent re-hospitalizations. As a result, healthcare providers may view these patients as bad. Medication adherence is a complex concept. Analyzing this concept may assist nurses to improve patient-centered care. This paper uses Walker & Avant's method to conduct a concept analysis of medication adherence. Results show the defining attributes of medication adherence as: (1) knowing and agreeing to the medication; (2) communicating and negotiating the regimen; and (3) active, continuous involvement in and appraisal of the treatment effect. Identified antecedents of medication adherence included the patient having: (1) a prescribed medication regimen; (2) cognitive and action abilities in her / his role as a patient; and (3) level of preparation for medication treatment. Identified consequences of medication adherence include: (1) improving symptom control; (2) decreasing re-hospitalizations and mortality; (3) reducing medical care costs; (4) restoring self-esteem; and (5) diminishing depression. It is hoped that this concept analysis provides a reference for nurses to achieve a better understanding of medication adherence and further improve nursing practice. PMID:24899565

  7. Skin cancer in patients with chronic radiation dermatitis

    Energy Technology Data Exchange (ETDEWEB)

    Davis, M.M.; Hanke, C.W.; Zollinger, T.W.; Montebello, J.F.; Hornback, N.B.; Norins, A.L.

    1989-04-01

    The cases of 76 patients with chronic radiation dermatitis resulting from low-dose ionizing radiation for benign disease were reviewed retrospectively for risk factors leading to the development of neoplasia. The patients were studied with respect to original hair color, eye color, sun reactive skin type, benign disease treated, area treated, age at treatment, and age at development of first skin cancer. Analysis of data showed 37% of patients had sun-reactive skin type I, 27% had type II, and 36% had type III. Types IV through VI were not represented. There appeared to be an overrepresentation of types I and II. Increased melanin pigmentation may therefore be either directly or indirectly protective against the development of skin cancers in patients who have received low-dose superficial ionizing radiation for benign disease. The sun-reactive skin type of patients with chronic radiation dermatitis may be used as a predictor of skin cancer risk when the total dose of ionizing radiation is not known.

  8. Longitudinal study of leptin levels in chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Averbukh Zhan

    2011-06-01

    Full Text Available Abstract Background The influence of serum leptin levels on nutritional status and survival in chronic hemodialysis patients remained to be elucidated. We conducted a prospective longitudinal study of leptin levels and nutritional parameters to determine whether changes of serum leptin levels modify nutritional status and survival in a cohort of prevalent hemodialysis patients. Methods Leptin, dietary energy and protein intake, biochemical markers of nutrition and body composition (anthropometry and bioimpedance analysis were measured at baseline and at 6, 12, 18 and 24 months following enrollment, in 101 prevalent hemodialysis patients (37% women with a mean age of 64.6 ± 11.5 years. Observation of this cohort was continued over 2 additional years. Changes in repeated measures were evaluated, with adjustment for baseline differences in demographic and clinical parameters. Results Significant reduction of leptin levels with time were observed (linear estimate: -2.5010 ± 0.57 ng/ml/2y; p Conclusions Thus leptin levels reflect fat mass depots, rather than independently contributing to uremic anorexia or modifying nutritional status and/or survival in chronic hemodialysis patients. The importance of such information is high if leptin is contemplated as a potential therapeutic target in hemodialysis patients.

  9. Cryoglobulinemia in elderly patients with HCV-related chronic hepatitis

    Institute of Scientific and Technical Information of China (English)

    Francesco; Giuseppe; Foschi; Anna; Chiara; Dall’Aglio; Arianna; Lanzi; Giorgio; Marano; Sara; Savini; Pietro; Andreone; Mauro; Bernardi; Giuseppe; Francesco; Stefanini

    2010-01-01

    Hepatitis C virus(HCV) infection affects about 3% of the world’s population and often leads to chronic liver disease.In some industrialized countries,HCV prevalence increases with age,but the optimal management of older patients has not been accurately defined.HCV infection can also lead to lymphoproliferative disorders,the most common being mixed cryoglobulinemia(MC),and also for this condition that frequently affects elderly patients,the optimal therapeutic strategy is still debated.We report the case of a 77-year-old Caucasian woman with HCV-related chronic hepatitis and cutaneous manifestations consisting of urticaria and pruritus related to MC resistant to antihistamines.The patient underwent a treatment with interferon and ribavirin.Such a treatment led to early biochemical and virological response associated with the resolution of cryoglobulinemia and cutaneous symptoms.After the end of treatment,HCV replication relapsed,but cryoglobulinemia and cutaneous symptoms did not recur.In the absence of definite treatment guidelines in this particular context,our experience suggests that the presence of symptoms related to HCV-infection that deeply affect patient quality of life warrants antiviral therapy even beyond the age limits that currently exclude patients from treatment.

  10. Enteral nutrition in the chronic obstructive pulmonary disease (COPD) patient.

    Science.gov (United States)

    DeBellis, Heather F; Fetterman, James W

    2012-12-01

    Chronic obstructive pulmonary disease (COPD) is a progressive, chronic disease, in which malnutrition can have an undesirable effect. Therefore, the patient's nutritional status is critical for optimizing outcomes in COPD. The initial nutrition assessment is focused on identifying calorically compromised COPD patients in order to provide them with appropriate nutrition. Nutritional intervention consists of oral supplementation and enteral nutrition to prevent weight loss and muscle mass depletion. Evaluation of nutritional status should include past medical history (medications, lung function, and exercise tolerance) and dietary history (patient's dietary habits, food choices, meal patterns, food allergy information, and malabsorption issues), in addition to physiological stress, visceral proteins, weight, fat-free mass, and body mass index. The current medical literature conflicts regarding the appropriate type of formulation to select for nutritional intervention, especially regarding the amount of calories from fat to provide COPD patients. This review article focuses on the enteral product formulations currently available, and how they are most appropriately utilized in patients with COPD.

  11. Quinapril therapy in patients with chronic mitral regurgitation.

    Science.gov (United States)

    Schön, H R; Schröter, G; Barthel, P; Schömig, A

    1994-05-01

    Pre- and afterload reduction is known to have beneficial effects in patients with chronic mitral regurgitation. To date, no controlled study has been reported analyzing the long term influence of angiotensin-converting enzyme inhibitor treatment on patients with chronic mitral regurgitation. Therefore the aim of this study was to assess the effects of one year angiotensin-converting enzyme inhibition with quinapril on myocardial performance in patients with chronic mitral regurgitation. Twelve patients with moderate to severe isolated chronic mitral regurgitation and no coronary disease on coronary angiography were studied under control conditions and followed up until one year of quinapril therapy (10-20mg/day) using echocardiography and simultaneous right heart catheterization, and radionuclide ventriculography at rest and exercise. As the result of a significant pre- and afterload reduction after one year quinapril treatment regurgitant fraction fell from 0.43 +/- 0.10 at control before therapy to 0.25 +/- 0.08 (p = 0.0001), left ventricular end-diastolic volume was reduced from 146 +/- 26 to 109 +/- 24 ml/m2 (p = 0.0001) and end-systolic volume decreased from 63 +/- 43 to 47 +/- 29 ml/m2 (p = 0.02). Left ventricular ejection fraction at control averaged 0.59 +/- 0.20 at rest, increased to 0.65 +/- 0.21 with maximum exercise and was unchanged after one year quinapril therapy. After one year treatment left ventricular mass was reduced by 15% (p = 0.0004) and septal wall thickness decreased from 11.8 +/- 0.7 to 10.8 +/- 0.8 mm (p = 0.0006). Moreover, there was significant functional improvement of nearly one NYHA class after one year quinapril therapy. In conclusion, in patients with chronic mitral regurgitation long term angiotensin-converting enzyme inhibition with quinapril reduces regurgitation and decreases left ventricular size and mass thereby demonstrating functional improvement. In addition, these data suggest that angiotensin-converting enzyme inhibition

  12. Platelet and other hemostatic characteristics in patients with chronic urticaria.

    Science.gov (United States)

    Isiksacan, Nilgun; Koser, Murat; Cemsitoglu, Ferhan; Kucuksezer, Umut C; Gurdol, Figen

    2015-04-01

    Several publications have pointed out the importance of coagulation and fibrinolysis in the occurrence of chronic urticaria (CU), but only a few indicated the direct role of platelets. We assessed platelet aggregation and evaluated parameters of coagulation and fibrinolysis in patients with CU. Patients (n = 34) diagnosed as having CU and 36 healthy controls were enrolled. Platelet aggregation was assayed using an impedance aggregometer and adenosine diphosphate, arachidonic acid, thrombin receptor-activating peptide (TRAP), and ristocetin as agonists. In patients with CU, significantly decreased platelet aggregation to some agonists (ristocetin and TRAP) was observed. The D-dimer levels were elevated, mean platelet volume was decreased, but no alteration was observed in other coagulation assays. Elevated D-dimer levels indicated that coagulation and fibrinolysis are activated in the patients with CU. Evaluation of platelet function may contribute to identify the role of these cells in the pathogenesis of CU.

  13. Early hospital readmission in the perspective of chronically ill patients

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    Elen Ferraz Teston

    2016-01-01

    Full Text Available Objective : learn, from the perspective of chronically ill patients, the reasons for rehospitalization. Methods : qualitative study with 19 patients in a general hospital. Data were collected through semi-structured interviews, submitted to content analysis and grouped into two categories. Results : the first category revealed that patients attributed the occurrence of rehospitalization to the living conditions and social determinants. The second category showed that patients believed that, by following medical advice and taking the prescribed medicines they could prevent rehospitalizations, but they did not associate these actions with other actions of self-care. Conclusion : the discharge planning is an opportunity to add new self-care actions that must be based on the real needs of individual, in order to avoid further rehospitalizations.

  14. Dysregulation of male sex hormones in chronic hepatitis C patients.

    Science.gov (United States)

    El-Serafi, A T; Osama, S; El-Zalat, H; EL-Deen, I M

    2016-02-01

    Chronic hepatitis C (HCV) infection is a serious problem all over the world and has a special importance in Egypt, where the prevalence of infection is 14.7% of population. In males, HCV is associated with sexual dysfunction and changes in the semen parameters. This study aimed at estimation of a panel of the most important related hormones in the serum of patients and illustration of their correlation to the routine laboratory investigations. The four studied hormones showed alteration in the patients in comparison with the controls. While androstenedione, prolactin and testosterone were significantly increased in patients, dehydroepiandrosterone sulphate was decreased. These changes in the hormones were not related to the liver functions, pathological grade or even viral load. We hypothesised a model of how HCV can induce these hormonal changes and recommended to add these hormones to the follow-up panel of male patients with HCV.

  15. Activation of the hedgehog pathway in chronic myelogeneous leukemia patients

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    Long Bing

    2011-01-01

    Full Text Available Abstract Background Hedgehog (Hh signaling pathway is involved in regulation of many tissues development and oncogenesis. Recently, Hh signaling has been identified as a required functional pathway for leukemia stem cells(LSCs, and loss of this pathway impairs leukemia progression. Objectives The aim of this study was to determine the expression of Hedgehog signaling molecules in Chronic Myelogeneous Leukemia (CML patients and normal people by semiquantitative polymerase chain reaction (PCR and to correlate mRNA expression to patients' clinical data. Results Here, we showed that Sonic hedgehog (Shh, Smoothened (Smo, and Gli1 genes of Hh signaling were significantly upregulated in CML patients when compared with normal people (P 0.05. Conclusions These findings suggested that activation of the Hh pathway maybe associated with CML progression. Treatment of CML with imatinib, a selective inhibitor of the BCR-ABL tyrosine kinase inhibitor, has no significant influence on the inhibition of Hh pathway of CML-CP patients.

  16. Facial Canal Dehiscence in Patients with Chronic Otitis Surgery

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    Ahmet Uluat

    2016-04-01

    Full Text Available Aim: To examine facial canal status in patients with chronic otitis media (COM surgery and to detect the relation between facial canals dehiscence (FCD with middle ear pathology in these patients. Material and Method: The surgery data of patients who were subjected to tympanoplasty with or without mastoidectomy and radical mastoidectomy due to COM were analyzed retrospectively from January 2006 to December 2012. In addition to demonstrative data of the patients, status of facial canal and preoperative diagnoses of patients, type of the operation performed, status of middle ear, number of surgeries, existence of cholesteatoma, existence of ossicular chain defect, lateral canal defect and dura defect were assessed and the relation thereof with facial canal dehiscence (FCD was analyzed statistically. Results: Seven hundred ninety six patients were included in the study. FCD was detected in 10.05% of the patients. FCD was most frequently observed in the tympanic segment. It was found out that there was a statistically significant relationship of middle ear pathology, cholesteatoma, revision surgery, lateral semicircular canal and ossicular chain defect with FCD. Discussion: COM diagnosed patients may have defect in facial canal according to their preoperative diagnoses, middle ear pathologies, number of operations and ossicular chain defects. These patients should be applied a more careful surgery and closely followed up in postoperative periods.

  17. Limbal and corneal calcification in patients with chronic renal failure.

    Science.gov (United States)

    Klaassen-Broekema, N; van Bijsterveld, O P

    1993-09-01

    In patients with chronic renal failure on regular dialysis treatment, limboconjunctival degenerations and calcifications are commonly observed. In this study three groups of patients were followed over a period of 6 years. The first group consisted of 47 patients with renal failure, the second group of 17 patients with renal failure and hyperparathyroidism not controlled by drugs, and the third group seven patients with primary hyperparathyroidism without renal failure. The aim of this study was to determine the progression of the limboconjunctival changes over time. The hypothesis that an increase in serum calcium and phosphorus concentrations, as a result of tertiary hyperparathyroidism, could possibly add a corneal component to the limbal calcification was also tested. All patients with renal failure (in as much as the degenerative limbal features were not obscured by deposits of lime salts), had a type II white limbus girdle of Vogt. This limbal degeneration was observed in only 45% of controls. In all 47 patients with renal failure conjunctival calcification was observed; 26 of them also had limbal calcification. After 6 years 41 patients had developed limbal calcification. This progression was statistically significant. In 15 out of 17 patients with tertiary hyperparathyroidism a band-shaped keratopathy developed in addition to the limboconjunctival calcification.

  18. Prevalence of Actinomyces spp. in patients with chronic periodontitis.

    Science.gov (United States)

    Vielkind, Paul; Jentsch, Holger; Eschrich, Klaus; Rodloff, Arne C; Stingu, Catalina-Suzana

    2015-10-01

    This study investigated the prevalence of Actinomyces spp. in shallow, deep and very deep pockets of patients with chronic periodontitis compared to healthy controls and correlated the results with clinical status. Twenty patients with chronic periodontitis and 15 healthy subjects were enrolled in this study. Clinical indices were recorded in a six-point measurement per tooth. From each patient samples of supra and subgingival plaque were taken separately from teeth with shallow, deep and very deep pockets. Samples of supragingival plaque and sulcular microflora were collected from the healthy subjects. All the samples were cultivated on different media at 37̊C in an anaerobic atmosphere for 7 days. All the suspect colonies were identified using a rapid ID 32 A system (bioMèrieux) and MALDI-TOF-MS analysis using an Autoflex II Instrument (Bruker Daltonics) together with in house developed identification software and a reference spectra database. A total of 977 strains were identified as Actinomyces. Actinomyces naeslundii/oris/johnsonii (430 isolates) was the most prevalent species and was found in all patients and in almost all of the healthy subjects. Significant differences (p=0.003) between the groups were found for Actinomyces odontolyticus/meyeri and Actinomyces israelii which were associated with periodontitis patients. Actinomyces dentalis was found in higher percentage (p=0.015) in the periodontitis group. Actinomyces gerencseriae and Actinomyces massiliensis were significantly more often found supragingivally than subgingivally (p=0.004, p=0.022, respectively) in the periodontitis group. Whether some Actinomyces species, definitely important plaque formers, are actively involved in the pathogenicity of chronic periodontitis needs further investigation. PMID:26324012

  19. Skeletal muscle dysfunction in patients with chronic obstructive pulmonary disease

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    Ho Cheol Kim

    2009-01-01

    Full Text Available Ho Cheol Kim1, Mahroo Mofarrahi2, Sabah NA Hussain21Department of Internal Medicine, College of Medicine, Gyeongsang National University, Gyeongsang University Hospital, Jinju, Korea; 2Critical Care and Respiratory Divisions, Royal Victoria Hospital, McGill University Health Centre, Montreal, Quebec, CanadaAbstract: Chronic obstructive pulmonary disease (COPD is a debilitating disease characterized by inflammation-induced airflow limitation and parenchymal destruction. In addition to pulmonary manifestations, patients with COPD develop systemic problems, including skeletal muscle and other organ-specific dysfunctions, nutritional abnormalities, weight loss, and adverse psychological responses. Patients with COPD often complain of dyspnea on exertion, reduced exercise capacity, and develop a progressive decline in lung function with increasing age. These symptoms have been attributed to increases in the work of breathing and in impairments in gas exchange that result from airflow limitation and dynamic hyperinflation. However, there is mounting evidence to suggest that skeletal muscle dysfunction, independent of lung function, contributes significantly to reduced exercise capacity and poor quality of life in these patients. Limb and ventilatory skeletal muscle dysfunction in COPD patients has been attributed to a myriad of factors, including the presence of low grade systemic inflammatory processes, nutritional depletion, corticosteroid medications, chronic inactivity, age, hypoxemia, smoking, oxidative and nitrosative stresses, protein degradation and changes in vascular density. This review briefly summarizes the contribution of these factors to overall skeletal muscle dysfunction in patients with COPD, with particular attention paid to the latest advances in the field.Keywords: skeletal muscles, chronic obstructive pulmonary disease, diaphragm, quadriceps, fatigue, disuse, atrophy, smoking, exercise

  20. 耳鸣习服治疗进展%The research progress of tinnitus retraining therapy

    Institute of Scientific and Technical Information of China (English)

    余斌

    2016-01-01

    One of tinnitus is a common disease and frequently encountered disease in otology, the serious influence the patient's quality of life, to the patient's psychological and mental caused problems. Many clinical treatment, the tinnitus acclimatization therapy is a simple, safe, effective and without side effects. In this paper the mechanism oftinnitus retraining therapy and clinical application were reviewed, aimed at making tinnitus acclimatization therapy in clinical application of further promotion.%耳鸣是耳科的常见病、多发病之一,严重影响患者的生活质量,给患者的心理和精神上造成困扰。临床上治疗方法很多,其中耳鸣的习服疗法是一种简便、安全、有效并无副作用的有效治疗方法。本文对耳鸣习服疗法的机制及临床应用等进行了综述,旨在提高耳鸣习服疗法在临床上的应用得到进一步的推广。