Deep Brain Stimulation—A new treatment for tinnitus

AbstractIntractable tinnitus can lead to serious consequences. Study evidence indicates that the central nervous system is involved in generation and maintenance of chronic tinnitus and that tinnitus and other neurologic symptoms such as chronic pain may share similar mechanisms. Brain ablation and stimulation are used to treat chronic pain with success. Recent studies showed that ablation and stimulation in non-auditory areas resulted in tinnitus improvement. Deep brain stimulation (DBS) may be an alternative treatment for intractable tinnitus and deserves further study

Noise Induced Hearing Loss in Children: Preventing the Silent Epidemic

Noise-induced hearing loss and related tinnitus are often unrecognized problems, especially in non-occupational settings. Research indicates that increasing numbers of children and adolescents have or are acquiring noise induced hearing losses. Noise induced hearing loss can almost completely be prevented with simple precautionary measures. Educational programs rarely exist outside of those mandated in occupational settings. Health Communication theory can be applied to hearing health for developing effective loss prevention programs. Dangerous Decibels is one example of an effective multi-disciplinary effort to develop and disseminated prevention strategies

Hearing-Related Health Among Adult American Indians From a Pacific Northwest Tribe

INTRODUCTION: Hearing loss and tinnitus are common in most populations, although few data have addressed hearing-related health among tribal members and the need for public health interventions. METHODS: This cross-sectional study examined prevalence and risk factors for hearing loss and tinnitus among 217 adults in a Pacific Northwest tribe. Frequency measures were conducted for difficulty hearing certain sounds and hearing aid use. In 2006, risk factors were examined for two outcomes-hearing loss and tinnitus-with analysis conducted in the same year. RESULTS: Although self-reported hearing loss was more common in men (24%) than women (13%), a larger percentage of women compared with men reported difficulty hearing certain sounds. Only 8% of study participants reported hearing aid use. After age adjustment, significant noise exposure was associated with hearing loss (OR=8.30, 95% CI=1.84, 37.52). The overall prevalence of tinnitus was 33% (similar in men and women). After adjusting for age, the odds of tinnitus in individuals with more than four ear infections was 4.77 (95% CI=1.89, 12.02) times the odds in those who never had an ear infection. Tinnitus was also associated with significant noise exposure (OR=2.24, 95% CI=1.28, 6.73) even after age adjustment. CONCLUSIONS: Increasing age and significant noise exposure were associated with hearing loss in this tribe. Tinnitus was associated with significant noise exposure and history of otitis media, even after age adjustment. Public health efforts are needed to improve hearing-related health in this tribe through messages about noise exposure and use of hearing protection

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline