Mining and analysis of audiology data to find significant factors associated with tinnitus masker

Objectives: The objective of this research is to find the factors associated with tinnitus masker from the literature, and by using the large amount of audiology data available from a large NHS (National Health Services, UK) hearing aid clinic. The factors evaluated were hearing impairment, age, gender, hearing aid type, mould and clinical comments. Design: The research includes literature survey for factors associated with tinnitus masker, and performs the analysis of audiology data using statistical and data mining techniques. Setting: This research uses a large audiology data but it also faced the problem of limited data for tinnitus. Participants: It uses 1,316 records for tinnitus and other diagnoses, and 10,437 records of clinical comments from a hearing aid clinic. Primary and secondary outcome measures: The research is looking for variables associated with tinnitus masker, and in future, these variables can be combined into a single model to develop a decision support system to predict about tinnitus masker for a patient. Results: The results demonstrated that tinnitus maskers are more likely to be fit to individuals with milder forms of hearing loss, and the factors age, gender, type of hearing aid and mould were all found significantly associated with tinnitus masker. In particular, those patients having Age<=55 years were more likely to wear a tinnitus masker, as well as those with milder forms of hearing loss. ITE (in the ear) hearing aids were also found associated with tinnitus masker. A feedback on the results of association of mould with tinnitus masker from a professional audiologist of a large NHS (National Health Services, UK) was also taken to better understand them. The results were obtained with different accuracy for different techniques. For example, the chi-squared test results were obtained with 95% accuracy, for Support and Confidence only those results were retained which had more than 1% Support and 80% Confidence. Conclusions: The variables audiograms, age, gender, hearing aid type and mould were found associated with the choice of tinnitus masker in the literature and by using statistical and data mining techniques. The further work in this research would lead to the development of a decision support system for tinnitus masker with an explanation that how that decision was obtained

Read-through Activation of Transcription in a Cellular Genomic Context

Read-through transcription from the adjacent E1a gene region is required for wild-type (wt) activity of the downstream adenovirus E1b promoter early after infection (read-through activation). However, whether a cellular chromosomal template can support read-through activation is not known. To address this issue, read-through activation was evaluated in the context of stably expressed templates in transfected cells. Inhibition of read-through transcription by insertion of a transcription termination sequence between the E1a and E1b promoters reduced downstream gene expression from stably integrated templates. The results indicate that the mechanism of read-through activation does not depend on the structure of early adenovirus nucleoprotein complexes, a structure that is likely to be different from that of cellular chromatin. Accordingly, this regulatory interaction could participate in the coordinated control of the expression of closely linked cellular genes

Evaluation of vardenafil for the treatment of subjective tinnitus: a controlled pilot study

<p>Abstract</p> <p>Background</p> <p>Vardenafil (Levitra^®) represents a potent and highly selective phosphodiesterase type 5 (PDE5) inhibitor, which is established for treatment of various diseases. There are several unpublished reports from patients stating that vardenafil has a considerable therapeutic effect on their concomitant tinnitus. This pilot study was conducted to specifically assess the effect of vardenafil in patients with chronic tinnitus.</p> <p>Methods</p> <p>This trial was based on a prospective, randomized, double-blind, placebo-controlled, parallel group design. Fourty-two consecutive subjects with mon- or binaural chronic tinnitus received 10 mg vardenafil (N = 21) or matching placebo tablets (N = 21) administered orally twice a day over a period of 12 weeks. Clinical examination and data acquisition took place at each visit: at baseline, after 4 weeks, after 12 weeks (end of treatment with study medication), and at non-medicated follow-up after 16 weeks. Assessment of clinical effectiveness was based on a standardized tinnitus questionnaire (TQ), the Short Form 36 health survey (SF-36), audiometric measurements (mode, pitch and loudness of tinnitus; auditory thresholds) and biomarkers of oxidative stress in patients' blood (malondialdehyde, protein carbonyl, homocysteine and total antioxidative status). Therapeutic efficacy was evaluated by comparison of subjective and objective parameters with baseline data between both treatment groups (ANCOVA).</p> <p>Results</p> <p>Vardenafil had no superior efficacy over placebo in the treatment of chronic tinnitus during this study. The primary efficacy criterion 'TQ total score' failed to demonstrate significant improvement compared to placebo. Subjective reports of TQ subscales and general quality of life areas (SF-36), objective audiometric examinations as well as investigated biomarkers for oxidative stress did not reveal any significant treatment effects. The safety profile was favorable and consistent with that in other vardenafil studies.</p> <p>Conclusion</p> <p>Although hypoxia and ischemia play a special role in the pathogenesis of tinnitus, the PDE5-inhibitor-induced increase of nitric oxide-mediated vasodilatation exerted no specific influence on tinnitus symptomatology. Considering the unclear risk of rarely associated hearing impairment, systemic application of vardenafil or other PDE5 inhibitors prove to be not appropriate for therapy of chronic tinnitus.</p

Contribuição da reabilitação vestibular na melhora do zumbido: um resultado inesperado Contribution of vestibular rehabilitation in tinnitus recovery: a surprising result

INTRODUÇÃO: A tontura e o zumbido são sintomas comuns na prática clínica que podem ocorrer simultânea ou independentemente. Ambos podem ter etiologia indefinida ou múltipla, ser agravados por fatores emocionais e limitar as atividades rotineiras do indivíduo. OBJETIVO: avaliar os resultados da reabilitação vestibular (RV) enfocando a melhora dos acúfenos. FORMA DE ESTUDO: Coorte longitudinal. MÉTODO: após a observação clínica da melhora (não intencional) do zumbido com a RV realizamos o levantamento dos prontuários dos pacientes submetidos à terapia. RESULTADOS: Após a RV 100% dos sujeitos relataram melhora da tontura, 58% tiveram redução do zumbido e 75% relataram melhora da hipersensibilidade auditiva. A comparação da diferença entre os valores pós e pré-tratamento dos índices da escala análogo visual (0 a 5) de cada paciente evidenciou melhora da tontura (2,42), do zumbido (1,17) e da hipersensibilidade auditiva (1,00). CONCLUSÕES: A RV pode interferir positivamente no zumbido em alguns casos. Tais resultados abrem discussões a respeito das correlações e interferências entre os dois sintomas.<br>INTRODUCTION: Dizziness and tinnitus are common symptoms on clinical practice that can occur simultaneous or independently. Both can have multiple or unknown etiology, and can be worsen by emotional factors and limit day-by-day activities. AIM: evaluate the results of vestibular rehabilitation (VR) focusing on tinnitus recovery. STUDY DESIGN: Longitudinal cohorte. METHOD: after the clinical observation of the non-intentional tinnitus recovery with the VR we studied the patients' files with dizziness and tinnitus that underwent the therapy. RESULTS: After VR 100% of the subjects recovered from dizziness, 58% had tinnitus reduction and 75% had reduction on hypersensitivity to sound. The comparison of the difference between post and pre treatment values of the analog visual scale (0 a 5) of each patient showed the following: 2,42 for dizziness 1,17 for tinnitus and 1,00 for hypersensitivity to sound. CONCLUSION: The VR may have a positive interference on tinnitus