Sudden hearing loss as an early detector of multiple sclerosis: a systematic review

To evaluate whether Sudden Sensorineural Hearing Loss (S-SNHL) may be an early symptom of Multiple Sclerosis (MS). A systematic review was conducted using the following keywords: "Multiple sclerosis, hearing loss, sudden hearing loss, vertigo, tinnitus, magnetic resonance imaging, otoacoustic emission, auditory brainstem responses, white matter lesions, sensorineural hearing loss, symptoms of MS and otolaryngology, nerve disease and MS". Only the articles that included results of at least one auditory test and MRI were considered. We evaluated the prevalence of SNHL in patients with MS, the presence of different forms of SNHL (S-SNHL and Progressive SNHL (P-SNHL)) and their correlation with the stage of MS, the results of electrophysiological tests, and the location (if any) of MS lesions as detected by white matter hyperintensities in the MRI. We reviewed a total of 47 articles, which included 29 case reports, 6 prospective studies, 6 cohort studies, 4 case-control studies, and 2 retrospective studies. 25% of patients suffered from SNHL. S-SNHL typically occurred in the early stage of the disease (92% of patients) and was the only presenting symptom in 43% of female subjects. Instead, P-SNHL occurred in the late stage of MS (88% of patients). Auditory Brainstem Responses (ABR) were abnormal in all MS patients with S-SNHL. When S-SNHL appeared during the early stage of the disease, MS lesions were found in the brain in 60% of patients and in the Internal Auditory Canal in 40% of patients. ABR remained abnormal after recovery. S-SNHL can be an early manifestation of MS and should always be considered in the differential diagnosis of this condition, especially in women. The pathophysiology can be explained by the involvement of microglia attacking the central and/or peripheral auditory pathways as indicated by WMHs

E-ABR in patients with cochlear implant: A comparison between patients with malformed cochlea and normal cochlea

OBJECTIVES: This study aims to compare the electrical auditory brainstem response (EABR) following cochlear implant (CI) surgery in pediatric subjects with cochlear malformation and a normal cochlea, in order to assess the sensitivity of EABR and to evaluate the surgery outcome. MATERIALS and METHODS: A total of 26 pediatric subjects who were deaf and scheduled for CI surgery were enrolled into this case control study. Group A (n=20) included subjects with a normo-conformed cochlea. Group B (n=6) included subjects with cochlear malformation. Subjects were evaluated with EABR immediately (T0) and 6 months (T1) post-CI surgery. The EABR Waves III and V average amplitude and latency were compared across time, separately for each group, and across groups, separately for each time. RESULTS: Auditory brainstem response (ABR) could only be recorded in Group A. We were able to record EABR from all subjects at T0 and T1, and waves III and V were present in all the recorded signals. There were no statistically significant differences between T0 and T1 in EABR Waves III and V in terms of average amplitude and latency in neither group. When comparing Groups A and B, the only statistically significant difference was the average amplitude of wave V, both at T0 and T1. CONCLUSION: EABR is a valid tool to measure the auditory nerve integrity after CI surgery in patients with a normal and malformed cochlea, as shown by its ability to measure waves III and V when ABR is absent. The EABR testing should be performed before and after CI surgery, and EABR should be used as a measure of outcome, especially in patients with a malformed cochlea

Acute Caffeine Supplementation in Regular Caffeine Consumers Minimally Affects Strength in Knee Flexors

Please refer to the pdf version of the abstract located adjacent to the title

“How do we get to them?” Insights on Preconception and Interconception Health for Women in Rural Northwest Ohio

Background: Rural women in the United States are at increased risk for poor preconception and interconception health. In a previous study, women living in Hardin County, a Primary Care Health Professional Shortage Area and maternity care desert in rural northwest Ohio expressed their concerns and their need for more resources to improve their health. As a follow-up study, key informants of Hardin County were interviewed to provide further insight on current resources for preconception and women’s health available to community members, barriers and challenges community members face, and interventions could be implemented in the county to improve health and pregnancy outcomes. Methods: A purposive sample of 14 key informants from community assets in Hardin County were recruited and individually interviewed with semistructured questions from 2 domains: perceived needs and barriers to care. Interview recordings were transcribed, precoded, and thematically analyzed. Participants received a $20 gift card as a token of appreciation. Results: Three themes were characterized from the data: current resources available, community observations, and suggested intervention strategies. Key informants identified the federally-qualified health center and YMCA, among others, as potentially underutilized resources for reproductive-age women. The small-town culture was described as both an advantage and disadvantage when trying to raise awareness about preconception/interconception health. Interventions built on partnerships and utilizing various outlets were suggested. Childcare, intergenerational knowledge transfer, and trust were issues crossing multiple themes. Conclusion: Key informants gave direction on available resources for reproductive-age women and potential approaches to provide education and outreach regarding preconception/interconception health and care

Pharmacists’ Provision of Contraception: Established and Emerging Roles

Pharmacists’ roles in provision of family planning products is expanding in the United States (U.S.). This article details established as well as emerging roles for U.S. pharmacists in the provision of contraception. These include helping patients develop reproductive life plans; dispensing prescription contraceptive products and counseling patients; assisting and educating patients with non-prescription contraceptive products, including emergency contraception; participating in collaborative practice agreements; administering contraception products; and making referrals and developing partnerships. The provision of contraception in the U.S. is dynamic, and pharmacists should continue to be aware of changes that will impact them professionally. As approximately 45% of pregnancies in the U.S. are unintended, through these roles pharmacists can impact an important public health priority. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties   Type: Idea Pape

Four Days of Caffeine Withdrawal in Caffeine Consumers Lowers Strength in Knee Flexors and Extensors

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An Elective Course in Women's Health Issues

Purpose: To develop, implement, and evaluate an elective course for the Doctor of Pharmacy (PharmD) curriculum that provides students with a comprehensive overview of women's health across the lifespan and exposes them to social and economic issues that impact women's health. Case Study: At the time of this writing, the class has been delivered 3 times to a total of 56 students. Students read and discussed (both in-class and online) timely articles in women's health issues on topics including sex-based biology; women in clinical trials; maternal and child health; women's health coverage and access to care in the United States; gender and health communication; abuse and the role of healthcare professionals; and international issues in women's health and women's rights. Students completed a pre- and post-test; developed seminar presentations regarding women's health issues; wrote reflective essays about the course; and designed and implemented health promotion projects for National Women's Health Week (NWHW). At the end of the course, the number of correct answers on the post-test significantly improved from the pre-test (p<0.001). Through anonymous course evaluations, students indicated that the assignments fulfilled the learning objectives (mean 4.68 on a 5-point Likert scale) and the exercises were useful in helping their understanding of the material (mean 4.66 on a 5-point Likert scale). Over 500 women from the campus and community participated in the NWHW projects. Implications: An elective course was designed to educate pharmacy students regarding women's health issues and to provide students with an opportunity to perform community outreach.   Type: Case Stud

An Elective Course in Women's Health Issues

Purpose: To develop, implement, and evaluate an elective course for the Doctor of Pharmacy (PharmD) curriculum that provides students with a comprehensive overview of women's health across the lifespan and exposes them to social and economic issues that impact women's health. Case Study: At the time of this writing, the class has been delivered 3 times to a total of 56 students. Students read and discussed (both in-class and online) timely articles in women's health issues on topics including sex-based biology; women in clinical trials; maternal and child health; women's health coverage and access to care in the United States; gender and health communication; abuse and the role of healthcare professionals; and international issues in women's health and women's rights. Students completed a pre- and post-test; developed seminar presentations regarding women's health issues; wrote reflective essays about the course; and designed and implemented health promotion projects for National Women's Health Week (NWHW). At the end of the course, the number of correct answers on the post-test significantly improved from the pre-test (p<0.001). Through anonymous course evaluations, students indicated that the assignments fulfilled the learning objectives (mean 4.68 on a 5-point Likert scale) and the exercises were useful in helping their understanding of the material (mean 4.66 on a 5-point Likert scale). Over 500 women from the campus and community participated in the NWHW projects. Implications: An elective course was designed to educate pharmacy students regarding women's health issues and to provide students with an opportunity to perform community outreach.   Type: Case Stud

The role of prenatal maternal stress in child development

ABSTRACT-The notion that a woman's psychological state during pregnancy affects the fetus is a persistent cultural belief in many parts of the world. Recent results indicate that prenatal maternal distress in rodents and nonhuman primates negatively influences long-term learning, motor development, and behavior in their offspring. The applicability of these findings to human pregnancy and child development is considered in this article. Potential mechanisms through which maternal psychological functioning may alter development of the fetal nervous system are being identified by current research, but it is premature to conclude that maternal prenatal stress has negative consequences for child development. Mild stress may be a necessary condition for optimal development