Short-Latency Evoked Potentials of the Human Auditory System

Auditory Brainstem Responses (ABR) are short-latency electric potentials from the auditory nervous system that can be evoked by presenting transient acoustic stimuli to the ear. Sources of the ABR are the auditory nerve and brainstem auditory nuclei. Clinical application of ABRs includes identification of the site of lesion in retrocochlear hearing loss, establishing functional integrity of the auditory nerve, and objective audiometry. Recording of ABR requires a measurement setup with a high-quality amplifier with adequate filtering and low skin-electrode impedance to reduce non-physiological interference. Furthermore, signal averaging and artifact rejection are essential tools for obtaining a good signal-to-noise ratio. Comparing latencies for different peaks at different stimulus intensities allows the determination of hearing threshold, location of the site of lesion, and establishment of neural integrity. Audiological assessment of infants who are referred after failing hearing screening relies on accurate estimation of hearing thresholds. Frequency-specific ABR using tone-burst stimuli is a clinically feasible method for this. Appropriate correction factors should be applied to estimate the hearing threshold from the ABR threshold. Whenever possible, obtained thresholds should be confirmed with behavioral testing. The Binaural Interaction Component of the ABR provides important information regarding binaural processing in the brainstem

A study on prevalence and determinants of ototoxicity during treatment of childhood cancer (SOUND): protocol for a prospective study

Background: Some children with central nervous system (CNS) and solid tumors are at risk to develop ototoxicity during treatment. Up to now, several risk factors have been identified that may contribute to ototoxicity, such as platinum derivates, cranial irradiation, and brain surgery. Comedication, like antibiotics and diuretics, is known to enhance ototoxicity, but their independent influence has not been investigated in childhood cancer patients. Recommendations for hearing loss screening are missing or vary highly across treatment protocols. Additionally, adherence to existing screening guidelines is not always optimal. Currently, knowledge is lacking on the prevalence of ototoxicity. Objective: The aim of the Study on Prevalence and Determinants of Ototoxicity During Treatment of Childhood Cancer (SOUND) is to determine the feasibility of audiological testing and to determine the prevalence and determinants of ototoxicity during treatment for childhood cancer in a national cohort of patients with solid and CNS tumors.Methods: The SOUND study is a prospective cohort study in the national childhood cancer center in the Netherlands. The study aims to include all children aged 0 to 19 years with a newly diagnosed CNS or solid tumor. Part of these patients will get audiological examination as part of their standard of care (stratum 1). Patients in which audiological examination is not the standard of care will be invited for inclusion in stratum 2. Age-dependent audiological assessments will be pursued before the start of treatment and within 3 months after the end of treatment. Apart from hearing loss, we will investigate the feasibility to screen patients for tinnitus and vertigo prevalence after cancer treatment. This study will also determine the independent contribution of antibiotics and diuretics on ototoxicity. Results: This study was approved by the Medical Research Ethics Committee Utrecht (Identifier 20-417/M). Currently, we are in the process of recruitment for this study. Conclusions: The SOUND study will raise awareness about the presence of ototoxicity during the treatment of children with CNS or solid tumors. It will give insight into the prevalence and independent clinical and cotreatment-related determinants of ototoxicity. This is important for the identification of future high-risk patients. Thereby, the study will provide a basis for the selection of patients who will benefit from innovative otoprotective intervention trials during childhood cancer treatment that are currently being prepared.Analysis and Stochastic

Cisplatin Ototoxicity in Children

Cisplatin is a highly effective chemotherapy medicine used in the treatment of many childhood cancers. Like all medications, cisplatin has many side effects and as always the treatment of cancer in children is a balance between the risks of the medications used and their potential benefits. While many side effects of cisplatin chemotherapy are reversible, one major side effect is permanent and irreversible hearing loss (ototoxicity) in both ears which may worsen with time. The severity of cisplatin-related ototoxicity is associated with age and the cumulative dose received: the younger the child and the higher the total dose, the more severe the hearing loss may be. The spectrum of hearing loss varies from mild to moderate high tone hearing loss, to profound loss across the hearing range and permanent deafness. In addition to hearing loss, some children, especially adolescents, also experience tinnitus and vertigo. Cisplatin ototoxicity is one of most important of the many long-term effects experienced by children who are cured of their cancer. The burden of this toxicity may be compounded by other long-term health issues that emerge with time. This chapter will focus on cisplatin-induced hearing loss, its mechanisms, its health impact on the young person and ways to mitigate or reduce the severity of ototoxicity. This chapter has been written by a multi-disciplinary team including paediatric oncologists, audiologists, a psychologist, a health scientist and a parent of a child growing up with high frequency hearing loss

TCERG1L allelic variation is associated with cisplatin-induced hearing loss in childhood cancer, a PanCareLIFE study.

In children with cancer, the heterogeneity in ototoxicity occurrence after similar treatment suggests a role for genetic susceptibility. Using a genome-wide association study (GWAS) approach, we identified a genetic variant in TCERG1L (rs893507) to be associated with hearing loss in 390 non-cranial irradiated, cisplatin-treated children with cancer. These results were replicated in two independent, similarly treated cohorts (n = 192 and 188, respectively) (combined cohort: P = 5.3 × 10-10, OR 3.11, 95% CI 2.2-4.5). Modulating TCERG1L expression in cultured human cells revealed significantly altered cellular responses to cisplatin-induced cytokine secretion and toxicity. These results contribute to insights into the genetic and pathophysiological basis of cisplatin-induced ototoxicity

Surviving Maria from Dominica: Memory, Displacement and Bittersweet Beginnings

This paper refracts questions of human 'resilience' through the prism of social relations. Herein, it asks how Caribbean people utilize interpersonal networks, patterns of sociality and kinship relations to mitigate the exigencies of increasingly violent hurricanes. The essay draws on the individual narratives of three Dominicans: a librarian who recollects moments of familial support during hurricane David of 1979; the post-Maria journey of dislocation of a young woman as she ventures through an extended kin network, finding herself adrift in East London, far from loved ones; and a teacher and mother, who finally gets her 'papers' for America - reunited with her husband after years of waiting, yet, forced to leave her mother, father, and siblings at home. These narratives chart the social debris of Maria, while illustrating the ambivalent routes people take to reassemble their lives. In turn, they present kinship togetherness amidst chaos, an uprooted life in waiting, and the sudden acceleration of a long-awaited familial migration. Hence,'resilience' is revealed as something that is ethnographically fraught with contradiction; ever incomplete and bittersweet. More broadly, the paper complicates questions of 'resilience' by offering an interpersonal ethnographic perspective that compliments the large-scale focus of most disaster scholarship

'We moeten het de kiezers allemaal beter uitleggen'

Contains fulltext : 43733.pdf (publisher's version ) (Open Access)Rudy Andeweg Binnenhof van binnenuit. Tweede Kamerleden over het functioneren van de Nederlandse democratie Den Haag:ROB ,2007 978-90-5991-029-4 Sanderijn Cels Dat hoort u mij niet zeggen. Hoe politici u de werkelijkheid voorspiegelen Amsterdam:Bakker ,2007 978-90-351-3112-

Juliana & Bernhard. Biografie van een huwelijk en een hofhouding

Contains fulltext : 79121.pdf (publisher's version ) (Open Access)Cees Fasseur Juliana en Bernhard. Het verhaal van een huwelijk 1936-1956 Amsterdam:Balans ,2008 978905018955

Het Jongelingeffect

Contains fulltext : 78994.pdf (publisher's version ) (Open Access)Herman Veenhof Zonder twijfel : Pieter Jongeling (1909-1985), journalist, politicus en Prins Barneveld:Vuurbaak ,2009 978-90-5560-421-

Over lijken. Ontoelaatbaar taalgebruik in de Tweede Kamer

Contains fulltext : 43075.pdf (publisher's version ) (Open Access)222 p