Therapeutic approaches to early intervention in audiology: A systematic review

Babies born with a congenital sensorineural hearing impairment or acquire early-onset permanent bilateral hearing impairment are at risk for delayed speech and language development and poor scholastic outcomes. Auditory Verbal Therapy (AVT) has become the primary intervention approach for developing spoken language in children with hearing impairment, and South Africa also has adopted this approach. The outcomes of AVT within the South African context have not been thoroughly investigated. As part of a larger study, the objective of this systematic review was to describe the speech, language and scholastic outcomes of hearing-impaired children enrolled in AVT as a therapeutic approach to early intervention. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Electronic databases searched included Google Scholar, Science Direct and PubMed. Selected studies were published in English and focused on the outcomes of early intervention for children with hearing impairment. The selected date range of the included articles ensured that the latest research was reviewed. Due to the limited evidence base, the review cannot conclude definitively that AVT yields positive speech, language, and scholastic outcomes in children with hearing impairment. Of the reviewed articles, only one study compares the outcomes of therapeutic intervention approaches, an important consideration, particularly in Low- and Middle-Income countries (LMICs). Current findings provide a strong rationale for the larger study by highlighting that further research comparing AVT to standard speech-language habilitation is required. Research in contexts with linguistic and cultural diversity in countries such as South Africa is required.

Perspective on Living With a Skin Condition and its Psychological Impact: A Survey

Background:

Chronic skin conditions can have a profound impact on people’s lives, both physically and psychologically, and may predispose to mental health disorders. Providing sufferers with appropriate psychological support is important.

Objective:

In this study, we captured the views of people suffering from a chronic skin condition who were attending the “Skin Matters” conference, held on 20 May 2017, in London. Methods: Delegates were provided with a 5-point questionnaire to complete. Questions related to the impact of their chronic skin condition on their life, the nature of any psychological support they had found helpful and whether they felt they could benefit from greater support in managing their condition.

Results:

59% of the delegates completed the questionnaire. The survey results showed that skin conditions can have an impact of many areas of daily living as well as on mental well-being. The most popular source of psychological support was the Internet. The majority of survey participants felt they would benefit from increased psychological support in managing their condition.

Conclusions:

In the United Kingdom, there is a need to improve the availability of resources for people/patients with skin conditions in order to provide better support.

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

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.

Clinical adrenal insufficiency in patients receiving megestrol therapy

OBJECTIVE

To describe the clinical and biochemical features of patients in whom adrenal insufficiency developed during megestrol acetate therapy for advanced breast cancer.

PATIENTS AND METHODS

Thirteen patients with advanced breast cancer treated with oral megestrol acetate, 160 mg/d.

RESULTS

Fatigue and weakness were observed in all 13 patients. Hypotension was observed in 8. Anorexia, nausea, vomiting, and diarrhea were observed in 3. Mean basal cortisol level at the time of symptoms was 41.4 nmol/L (range, 27.6-110.4 nmol/L). After corticotropin stimulation, mean cortisol level at 30 minutes was 239.2 nmol/L (range, 93.8-447.0 nmol/L); at 60 minutes, 228.2 nmol/L (range, 88.3-474.5 nmol/L).

CONCLUSION

Megestrol therapy was associated with the development of clinical adrenal insufficiency in our patients, as proved by rapid corticotropin test.