Emerging pharmacotherapy of tinnitus

Tinnitus, the perception of sound in the absence of an auditory stimulus, is perceived by about 1 in 10 adults, and for at least 1 in 100, tinnitus severely affects their quality of life. Because tinnitus is frequently associated with irritability, agitation, stress, insomnia, anxiety and depression, the social and economic burdens of tinnitus can be enormous. No curative treatments are available. However, tinnitus symptoms can be alleviated to some extent. The most widespread management therapies consist of auditory stimulation and cognitive behavioral treatment, aiming at improving habituation and coping strategies. Available clinical trials vary in methodological rigor and have been performed for a considerable number of different drugs. None of the investigated drugs have demonstrated providing replicable long-term reduction of tinnitus impact in the majority of patients in excess of placebo effects. Accordingly, there are no FDA or European Medicines Agency approved drugs for the treatment of tinnitus. However, in spite of the lack of evidence, a large variety of different compounds are prescribed off-label. Therefore, more effective pharmacotherapies for this huge and still growing market are desperately needed and even a drug that produces only a small but significant effect would have an enormous therapeutic impact. This review describes current and emerging pharmacotherapies with current difficulties and limitations. In addition, it provides an estimate of the tinnitus market. Finally, it describes recent advances in the tinnitus field which may help overcome obstacles faced in the pharmacological treatment of tinnitus. These include incomplete knowledge of tinnitus pathophysiology, lack of well-established animal models, heterogeneity of different forms of tinnitus, difficulties in tinnitus assessment and outcome measurement and variability in clinical trial methodology. © 2009 Informa UK Ltd.Fil: Langguth, Berthold. Universitat Regensburg; AlemaniaFil: Salvi, Richard. State University of New York; Estados UnidosFil: Elgoyhen, Ana Belen. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; Argentin

The R-process Alliance: The Peculiar Chemical Abundance Pattern of RAVE J183013.5-455510

© 2020. The American Astronomical Society. All rights reserved. We report on the spectroscopic analysis of RAVE J183013.5-455510, an extremely metal-poor star, highly enhanced in CNO, and with discernible contributions from the rapid neutron-capture process. There is no evidence of binarity for this object. At =-3.57, this star has one of the lowest metallicities currently observed, with 18 measured abundances of neutron-capture elements. The presence of Ba, La, and Ce abundances above the solar system r-process predictions suggests that there must have been a non-standard source of r-process elements operating at such low metallicities. One plausible explanation is that this enhancement originates from material ejected at unusually high velocities in a neutron star merger event. We also explore the possibility that the neutron-capture elements were produced during the evolution and explosion of a rotating massive star. In addition, based on comparisons with yields from zero-metallicity faint supernova, we speculate that RAVE J1830-4555 was formed from a gas cloud pre-enriched by both progenitor types. From analysis based on Gaia DR2 measurements, we show that this star has orbital properties similar to the Galactic metal-weak thick-disk stellar population