Covid-19 pandemic and hearing loss in children

Pandemija COVID-19 je izazvala ogromne promene u pružanju zdravstvenih usluga na svim nivoima zdravstvene zaštite. Posledično velike su šanse za neblago- vremeno dijagnostikovanje i lečenje pojedinih bolesti. Cilj ovog rada je bio da se, na osnovu dostupne literature, utvrdi kakav je uticaj pandemije COVID-19 na skrining sluha i ranu audiološku procenu, kao i na dostupne načine lečenja oštećenja sluha kod dece. Problemi tokom pandemije su nastali na nivou sprovođenja skrininga sluha, u vidu smanjenog broja dece koja su prošla skirining ili koja su upućena na lečenje dijagnostikovanog oštećenja sluha. Pandemija je izazvala ukidanje ili odlaganje elektivnog operativnog programa, što je doprinelo obustavljanju programa kohlearne implantacije na određene vremenske periode. Problemi sa kojima su se sretali pacijenti i članovi njihovih porodica posle implantacije su bili vezani za same zdravstvene ustanove gde se programi kohlearne implantacije sprovode, za održavanje uređaja i nabavku rezervnih ili zamenskih delova za od- loženo uključivanje ili programiranje uređaja i za propuštanje tretmana re/ habilitacije i za rad kod kuće. Sigurno je da će postojeći zastoji u pružanju na- vedenih zadravstvenih usluga imati dalekosežne posledice za generacije koje je pogodila COVID-19 pandemija. Dalja istraživanja će biti potrebna da se u potpunosti proceni njihov obim i veličina potencijalne štete.The COVID-19 pandemic has caused huge changes in the provision of health services at all levels of health care. As a result, chanses were increased for untimely diagnosis and maltreatment of certain diseases. The aim of this study was to determine, based on the available literature, the impact of the COVID-19 pandemic on hearing screening and early audiological assessment, as well as on available treatments for hearing impairment in children. During the pandemic, reduced number of children underwent screening and were referred for treatment of diagnosed hearing impairments. The pandemic caused the cancellation or postponement of the elective operative program, which contributed to the suspension of the cochlear implantation program for certain periods of time. The problems encountered by patients and their family members after implantation were related to the health facilities where cochlear implantation programs are conducted, to device maintenance or getting replacement parts, delayed programing or switch on appointments and missing Rehabilitation Session. It is certain that the existing delays in the providing these health services will have far-reaching consequences for the generations affected by the COVID-19 pandemic. Further research will be needed to fully assess their extent and magnitude of potential damage

The impact of covid-19 pandemic on hearing loss and tinnitus

Od decembra 2019. godine korona virusna bolest (COVID-19) izazvana novim, do sada nepoznatim, koronavirusom nazvanim SARS-CoV2, ubrzo je postala pandemija koja je promenila svet i ceo zdravstveni sistem. O efektima i dugotrajnim sek- velama COVID-19 infekcije na senzorne organe a posebno na unutrašnje uvo, nema dovoljno podataka jer je primarni cilj lečenja spašavanje života pacijenata sa teškim simptomima. Poznato je da su virusi etiološki faktori različi- tih vrsta oštećenja sluha i pojave tinitusa pa su tako započeta itraživnja negativnog uticaja novog SARS-CoV2 virusa na audio-vestibularne simptome. Mogući patofiziološki mehanizmi oštećenja sluha i tinitusa su: direktna infekcija auditivnog puta i kohlearnog nerva, udaljeni efekti sistemske infekcije sa infekcijom kohlee, vaskularno oštećenje, autoimuni odgovor pro- tiv tkiva unutrašnjeg uva, a moguće je da se neki od ovih mehanizama prepliću. Cilj ovoga rada je bio da se pregledom dostupne literature sagledaju učesta- lost i patofiziološki mehanizmi oštećenja sluha i pojave tinitusa kod pacijenata sa COVID-19 infekcijom.Since December 2019, coronavirus disease (COVID-19) caused by a new hitherto unknown coronavirus called SARS-CoV-2, soon became a pandemic that changed the world and the entire health system. There are insufficient data on the effect and long-term sequelae of COVID-19 infection on sensory organs and especially on the inner ear, because the primary goal of treatment is to save the lives of patients with severe symptoms. It is known that viruses are etiological factors of various types of hearing impairment and the appearance of tinnitus, so the research for the negative impact of the new SARS- CoV2-2 virus on audio-vestibular symptoms has begun. Possible pathophysiological mechanisms of hearing loss and tinnitus are: direct infection on the auditory pathway and cochlear nerve, long term effect of systemic infection with cochlear infection, vascular damage, autoimmune sesponse against inner ear tissue, and some of these meschanisms may intertwine. The aim of this study was to study the frequency and pathophysiological mechanisms of hearing impairment and tinnitus in patients with COVID-19 infection by reviewing the available literature

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Otorhinolaryngology emergency department hospitalizations in a secondary medical center

Introduction/Objective. The overall number of emergency department visits, including otorhinolaryngology, has increased. Due to population growth, industry and traffic expansion, workload of the otorhinolaryngology emergency department is steadily on the rise. The objective of this study was to determine most common indications for an emergency hospitalization in the otorhinolaryngology department in a secondary medical center. Also, we examined the course of diagnostics and treatment upon admittance, the outcome of hospitalization, and possible referral to a tertiary medical center. Methods. This retrospective study included patients who were urgently hospitalized at the Department of Otorhinolaryngology and Maxillofacial Surgery of the Djordje Joanovic General Hospital in Zrenjanin, Serbia, during a two-year period. The data were obtained by processing the patients? medical charts. Results. The study included 428 patients who were urgently hospitalized at the department of otorhinolaryngology of a secondary medical center during a two-year period. Of the total number, 245 (57.2%) were male and 183 (42.8%) were female, with the average age of 48.5 years. The patients were most frequently hospitalized due to tonsillopharyngitis and its complications, followed by head and neck trauma. Most of the patients were treated conservatively, with medication therapy (72%), and 28% underwent surgical or other invasive intervention. Twenty-seven (6.3%) patients were referred to a tertiary medical center, which correlated significantly with the number of comorbidities and consultative exams. Conclusion. Otorhinolaryngology inflammatory/infectious diseases are the most frequent indication for urgent hospital admission to a secondary medical center. Most of the patients were treated conservatively. Referral to a tertiary medical center significantly correlated with the number of comorbidities and consultative exams.</jats:p

Rational use of antibiotics during the COVID-19 pandemic

Introduction/Aim: The global COVID-19 pandemic has long been considered an emergency, with the number of cases growing exponentially, despite constant efforts to control the infection. Although the disease is caused by the SARS-CoV-2 virus, most patients are treated with antibiotic therapy. The long-term effects of such broad antibiotics use on antimicrobial resistance are still unknown and are a matter for concern. The aim of this paper is: to determine, based on the available literature, the impact of the COVID-19 pandemic on the use of antibiotics; to determine the global situation regarding antimicrobial resistance; to identify key areas where urgent changes are needed. Methods: A systematic review of the current literature on the use of antibiotics in COVID-19 treatment was conducted. The PubMed and MEDLINE databases were searched for papers published between March 2020 and September 2021. Results: Between 76.8% and 87.8% of patients with COVID-19 were treated with antibiotics. Antibiotics were less frequently prescribed to children, as compared to adults (38.5%, compared to 83.4%). The most commonly administered antibiotics were fluoroquinolones (20.0%), macrolides (18.9%), b-lactam antibiotics (15.0%), and cephalosporins (15.0%). Self-medication with antibiotics to prevent and treat COVID-19 has been identified as one of the important factors contributing to antimicrobial resistance. Conclusion: The impact of COVID-19 on global antimicrobial resistance is still unknown and is likely to be unevenly distributed in the general population. Although various antibiotics have been used to treat patients with COVID-19, their role and the need for their application in the treatment of this infection remains to be determined. For now, there are no reliable data as to whether the use of antibiotics in COVID-19 cases without associated bacterial infections has any effect on the course of the disease and mortality.</jats:p

Pain Management After Surgical Tonsillectomy: Is There a Favorable Analgesic?

The aim of this study was to examine how ibuprofen and paracetamol prevent pain after cold-steel extracapsular tonsillectomy in children. Also, we examined the relation between age, gender, nausea, postoperative bleeding, antibiotic use, type of diet, and postoperative pain intensity and the type of administered analgesic. A prospective study was conducted on 147 children (95 males and 52 females, aged 7-17 years) who underwent tonsillectomy in the Clinical-Hospital Center “Dragiša Mišović” from January 1 to June 30, 2016. The degree of pain was measured using a visual analog scale (VAS). We did not observe any significant differences in postoperative nausea, hospitalization rate postoperative bleeding, and antibiotic use between the paracetamol and ibuprofen groups. A test of within-patient effects showed that VAS scores changed significantly during the postoperative follow-up period ( P = .00), but there were no significant differences between the groups ( P = .778). After 12 hours, 29.3% of the patients on paracetamol and 21.8% on ibuprofen were transferred to a soft diet; after 24 hours, 84.8% of the paracetamol group and 85.5% of the ibuprofen group were on a soft diet (χ2test, P &lt; .05). There was a statistically significant correlation between VAS scores measured 4 hours after the surgery and the time of transference to the soft diet (Spearman ρ test, P &lt; .001). The transfer to soft and normal diets was not significantly different between the 2 groups as assessed by the VAS scores (Pearson χ2test, P = .565).There is still no consensus on the most effective postoperative pain-control regiment after tonsillectomy. This study showed that satisfactory pain management was achieved equally with both paracetamol and ibuprofen.</jats:p

Symptoms of depression, anxiety and stress in patients with chronic otitis media

Purpose Persistent symptoms of chronic otitis media cause limitations in daily routine and social interactions, influencing significantly patients’ quality of life and mental health. The purpose of the study was to assess the intensity depression, anxiety and stress symptoms in patients with chronic otitis media and to examine if patient demographic data, characteristics and reported symptoms of otitis influence reported depression, anxiety and stress symptoms. Material and methods The study included 316 adult patients diagnosed with unilateral or bilateral chronic otitis media with or without cholesteatoma. Patients underwent a complete otological, audiological and radiological assessment. Chronic otitis media questionnaire 12 (COMQ-12) was used to assess the impact of COM and Depression Anxiety Stress Scale 21 (DASS-21) was used for depression, anxiety and stress assessment. Results Some level of anxiety and stress were detected in 70.57% 49.37% of the patients, respectively. 13.29% of the patients had scores indicating depression disorder. The mean value of the COMQ-12 questionnaire for this group of patients was 26.24 (SD±11.47) More intense symptoms of COM were significantly associated (p&lt;0.05) with higher scores on DASS-21 subscales. Multivariate logistic regression analysis indicated that significant positive predictors of higher anxiety scores were pure tone average (PTA) on better and worse hearing ear (p&lt;0.05). Drainage from the ear, hearing problems at home and tinnitus were significant positive predictors of a higher DASS-depression score. (p&lt;0.05) Conclusion The study confirmed positive correlation between reported level of anxiety, depression and stress, severity of COM symptoms and quality of life. Level of hearing on the better and worse hearing ear were significant positive predictors of anxiety and stress in patients with COM. </jats:sec

Immune Cell and Biochemical Biomarkers in Advanced Laryngeal Cancer

Objective The aim of this study was to evaluate cell and biochemical biomarkers and establish their prognostic value in patients with advanced laryngeal cancer. Material and Methods A prospective study included 52 patients with advanced laryngeal carcinoma surgically treated at the tertiary referral center. Tumor tissue was immunohistochemically stained for T-cell markers (CD4 and CD8), and levels of cytokines (IL-6 and IL-8) and C-reactive protein were analyzed from blood samples. Results Overall 3-year survival (OS) of patients included in the study was 69.2% and the disease specific survival (DSS) 72.5%. Higher expression of CD4 + and CD8 + were significant prognostic factors with positive impact on both OS and DSS in univariate analysis, but not in multivariate analysis. Levels of IL-8 were a significant predictor of 3-year OS and DSS survival in patients with advanced laryngeal cancer but not levels of IL-6 and CRP values. Conclusion Though high expression of CD4 and CD8 were demonstrated in the tumor tissue, but their prognostic role was not established. Higher values of IL-8 proved to be significant negative predictor of DSS. This could further collaborate the inclusion of combination of biomarkers in assessment of favorable treatment choice in patients with advanced laryngeal carcinoma