Prevalence of tinnitus and hyperacusis in children and adolescents: a systematic review

Objectives: To systematically review studies of the epidemiology of tinnitus and hyperacusis in children and young people, in order to determine the methodological differences implicated in the variability of prevalence estimates and the influence of population characteristics on childhood tinnitus and hyperacusis. Data sources: Articles were retrieved from PubMed, EMBASE and Scopus databases and from the relevant reference lists using the methods described in the study protocol, which has previously been published. Reporting Items for Systematic Review (PRISMA) guidelines were followed. Eligibility criteria: Studies addressing childhood prevalence, for example, children and young people aged 5-19 years. Data selection: 2 reviewers independently assessed the studies for eligibility, extracted data and assessed study consistency. Owing to the heterogeneity in the methodologies among the reported studies, only narrative synthesis of the results was carried out. Results: Having identified 1032 publications, 131 articles were selected and 25 articles met the inclusion criteria and had sufficient methodological consistency to be included. Prevalence estimates of tinnitus range from 4.7% to 46% in the general paediatric population and among children with normal hearing, and from 23.5% to 62.2% of population of children with hearing loss. Reported prevalence ranged from 6% to 41.9% when children with hearing loss and normal hearing were both included. The prevalence of hyperacusis varied from 3.2% to 17.1%. Conclusions: Data on prevalence vary considerably according to the study design, study population and the research question posed. The age range of children studied was varied and a marked degree of variation between definitions (tinnitus, hyperacusis) and measures (severity, perception, annoyance) was observed. The lack of consistency among studies indicates the necessity of examining the epidemiology of tinnitus and hyperacusis in children and adolescents with a set of standardised criteria

Prevalence of tinnitus and hyperacusis in children and adolescents: a systematic review

Objectives: To systematically review studies of the epidemiology of tinnitus and hyperacusis in children and young people, in order to determine the methodological differences implicated in the variability of prevalence estimates and the influence of population characteristics on childhood tinnitus and hyperacusis. Data sources: Articles were retrieved from PubMed, EMBASE and Scopus databases and from the relevant reference lists using the methods described in the study protocol, which has previously been published. Reporting Items for Systematic Review (PRISMA) guidelines were followed. Eligibility criteria: Studies addressing childhood prevalence, for example, children and young people aged 5-19 years. Data selection: 2 reviewers independently assessed the studies for eligibility, extracted data and assessed study consistency. Owing to the heterogeneity in the methodologies among the reported studies, only narrative synthesis of the results was carried out. Results: Having identified 1032 publications, 131 articles were selected and 25 articles met the inclusion criteria and had sufficient methodological consistency to be included. Prevalence estimates of tinnitus range from 4.7% to 46% in the general paediatric population and among children with normal hearing, and from 23.5% to 62.2% of population of children with hearing loss. Reported prevalence ranged from 6% to 41.9% when children with hearing loss and normal hearing were both included. The prevalence of hyperacusis varied from 3.2% to 17.1%. Conclusions: Data on prevalence vary considerably according to the study design, study population and the research question posed. The age range of children studied was varied and a marked degree of variation between definitions (tinnitus, hyperacusis) and measures (severity, perception, annoyance) was observed. The lack of consistency among studies indicates the necessity of examining the epidemiology of tinnitus and hyperacusis in children and adolescents with a set of standardised criteria

Resistance to activated protein C and impaired TFPI activity in women with previous hormone-induced venous thromboembolism

Introduction: Hormonal contraception is a well-known risk factor for venous thromboembolism (VTE). APC resistance and impaired functions of protein S and TFPI are thought to play an important role in the pathogenesis of hormone-related VTE. It is unknown, whether women, who develop VTE during hormonal contraception possess a vulnerability in these pathways, making them susceptible to thrombosis. Materials and methods: Plasma samples were obtained from 57 premenopausal women in average 15.3 years after hormone-associated VTE and from 31 healthy controls. Thrombin generation at high tissue factor (TF) in the absence and in the presence of activated protein C (APC) and at low TF without and with inhibiting anti-protein S- and anti-TFPI-antibodies was measured via calibrated automated thrombography. Results: Women with previous hormone-related thrombosis had higher thrombin generation at low TF, higher APC resistance, protein S- and TFPI ratios, differences: 219.9 nM IIa.min (95%CI:90.4 to 349.3); 1.88 (95% CI:0.71 to 3.05); 0.13 (95%CI:0.01 to 0.26) and 0.19 (95%CI:0.08 to 0.30), respectively. Thrombin generation at high TF without APC did not differ between the groups. Smoking decreased thrombin generation at low TF by -222.6 nM IIa.min (95%CI: -381.1 to -64.1), the APC sensitivity ratio by -2.20 (95%CI: -3.63 to -0.77) and the TFPI ratio by -0.16 (95%CI: -0.29 to -0.03), but did not influence thrombin generation at high TF. Discussion: We demonstrated impairment of the protein S/TFPI system and increased APC resistance in women with previous hormone-induced VTE. Smoking decreased thrombin generation at assay conditions, dependent on the function of the TFPI system

Different teams, same conclusions? A systematic review of existing clinical guidelines for the assessment and treatment of tinnitus in adults

Background: Though clinical guidelines for assessment and treatment of chronic subjective tinnitus do exist, a comprehensive review of those guidelines has not been performed. The objective of this review was to identify current clinical guidelines, and compare their recommendations for the assessment and treatment of subjective tinnitus in adults. Method: We systematically searched a range of sources for clinical guidelines (as defined by the Institute of Medicine, United States) for the assessment and/or treatment of subjective tinnitus in adults. No restrictions on language or year of publication were applied to guidelines. Results: Clinical guidelines from Denmark, Germany, Sweden, The Netherlands, and the United States were included in the review. There was a high level of consistency across the guidelines with regard to recommendations for audiometric assessment, physical examination, use of a validated questionnaire(s) to assess tinnitus related distress, and referral to a psychologist when required. Cognitive behavioral treatment for tinnitus related distress, use of hearing aids in instances of hearing loss and recommendations against the use of medicines were consistent across the included guidelines. Differences between the guidelines centered on the use of imaging in assessment procedures and sound therapy as a form of treatment for tinnitus distress respectively. Conclusion: Given the level of commonality across tinnitus guidelines from different countries the development of a European guideline for the assessment and treatment of subjective tinnitus in adults seems feasible. This guideline would have the potential to benefit the large number of clinicians in countries where clinical guidelines do not yet exist, and would support standardization of treatment for patients across Europe. © 2017 Fuller, Haider, Kikidis, Lapira, Mazurek, Norena, Rabau, Lardinois, Cederroth, Edvall, Brueggemann, Rosing, Kapandais, Lungaard, Hoare and Cima

Polar bears ( Ursus maritimus

Polar bears are seasonal breeders and typically mate from late March to early May. Implantation is, however, delayed until autumn, which can allow plasticity in the date of mating. As for other seasonal breeders, a rapid return to estrus after the loss of dependent offspring can be expected, even into the summer. A few earlier observations and dissections of dead animals suggest that polar bears are able to mate in summer. We report on a mating incident on 29 June 2014, the first documented mating this late in the season among wild polar bears. The female had lost her dependent cub during the period prior to the mating event. We speculate that she lost this cub late in the mating season, entered estrus and successfully mated in late June

Astrobiology and the possibility of life on Earth and elsewhere…

Astrobiology is an interdisciplinary scientific field not only focused on the search of extraterrestrial life, but also on deciphering the key environmental parameters that have enabled the emergence of life on Earth. Understanding these physical and chemical parameters is fundamental knowledge necessary not only for discovering life or signs of life on other planets, but also for understanding our own terrestrial environment. Therefore, astrobiology pushes us to combine different perspectives such as the conditions on the primitive Earth, the physicochemical limits of life, exploration of habitable environments in the Solar System, and the search for signatures of life in exoplanets. Chemists, biologists, geologists, planetologists and astrophysicists are contributing extensively to this interdisciplinary research field. From 2011 to 2014, the European Space Agency (ESA) had the initiative to gather a Topical Team of interdisciplinary scientists focused on astrobiology to review the profound transformations in the field that have occurred since the beginning of the new century. The present paper is an interdisciplinary review of current research in astrobiology, covering the major advances and main outlooks in the field. The following subjects will be reviewed and most recent discoveries will be highlighted: the new understanding of planetary system formation including the specificity of the Earth among the diversity of planets, the origin of water on Earth and its unique combined properties among solvents for the emergence of life, the idea that the Earth could have been habitable during the Hadean Era, the inventory of endogenous and exogenous sources of organic matter and new concepts about how chemistry could evolve towards biological molecules and biological systems. In addition, many new findings show the remarkable potential life has for adaptation and survival in extreme environments. All those results from different fields of science are guiding our perspectives and strategies to look for life in other Solar System objects as well as beyond, in extrasolar worlds