Neonatal hearing screening in high-risk patients with otoacoustic emissions: evaluation of results

Resumen Objetivo: evaluar la efectividad del programa de tamizaje auditivo del Homic en pacientes de alto riesgo de hipoacusia neurosensorial, el cual está basado en la realización de otoemisiones acústicas Diseño: estudio de cohorte retrospectiva, en el que se incluirán a los pacientes mayores de 12 meses de edad nacidos en el Hospital Militar central (HMC) entre enero de 2009 y diciembre de 2012; a quienes por condiciones de alto riesgo de hipoacusia neurosensorial se les realizó antes de los 6 meses de edad otoemisiones acústicas como prueba de tamizaje auditivo. A esta población, se le realizara diagnostico auditivo por medio del método diagnostico Gold Standart el cual es el “cross cheking”. Resultados: Se estudiaron los factores de riesgo para hipoacusia neurosensorial encontrando que el peso al nacer ≤1500 gr. Se relacionó con hipoacusia en un 16%. El 5.6% tiene antecedente familiar de hipoacusia neurosensorial en primer y segundo grado de consanguinidad. La infección congénita (TORCHS: toxoplasmosis, sífilis, rubéola, citomegalovirus, o herpes) como factor de riesgo se presentó en el 2.4% únicamente con la presencia de Toxoplasmosis, de los cuales 2 oídos presentaron cofosis. Conclusiones: La sensibilidad de las Otoemisiones acusticas para sospechar hipoacusia neurosensorial fue del 82.5%. La especificidad estimada en nuestro estudio fue de 90.9%Hospital Militar CentralObjective: To evaluate the effectiveness of auditory screening program Central Military Hospital in patients at high risk of sensorineural hearing loss, which is based on the realization of otoacoustic emissions. Design: Retrospective cohort study, in which over 12 months of age born patients in the Central Military Hospital (HOMIC) between January 2009 and December 2012 were included; who by conditions of high risk of sensorineural hearing loss was performed before 6 months of age otoacoustic emissions and hearing screening test. Total population was 125 patients. We evaluated each ear separately for a total of 250 measurements, this population was conducted auditory diagnosis through cross cheking diagnosis method were analyzed. Results: Risk factors for sensorineural hearing loss were studied. We found that birth weight ≤1500 g. It was associated with hearing loss by 16%. 5.6% have a family history of sensorineural hearing loss in first and second degree of consanguinity. Congenital infection (TORCHS: toxoplasmosis, syphilis, rubella, cytomegalovirus, or herpes) as a risk factor occurred in 2.4% only in the presence of Toxoplasmosis, of which 2 ears presented deafness. Conclusions: The otoacoustic emissions are effective as hearing screening test in Military Central Hospital in patients at high risk of Sensorineural hearing loss. The sensitivity of otoacoustic emissions to suspect sensorineural hearing loss was 82.5%. The estimated specificity in our study was 90.9

Global Impact of COVID-19 on Stroke Care and IV Thrombolysis

Objective To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. Methods. We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results. There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] −11.7 to −11.3, p \u3c 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI −13.8 to −12.7, p \u3c 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI −13.7 to −10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2–9.8, p \u3c 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions. The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months