Measles was found to be responsible for 46.1% of acquired sensorineural hearing loss in children in a study conducted in the western area of Sierra Leone between 1975 to 1985. 125 children with acquired sensorineural hearing loss were seen and investigated in this study, which was conducted to determine the impact of the Expanded Programme on Immunisation and measles-induced hearing loss. 17 children had sensorineural hearing loss consequent to an attack of measles. A progressive drop in the number of cases seen from 6 in 1986 to 0 in 1989 was observed. During the same period the measles immunisation coverage in Sierra Leone increased from 21% in 1986 to 75% in 1990. Given that measles and some other causes of sensorineural hearing loss were preventable, it was hypothesised that lower incidence of these diseases would result in lower rates of acquired sensorineural hearing loss. This study demonstrated an inverse relationship between the incidence of measles induced sensorineural hearing loss and the increased immunisation coverage when Universal Child Immunisation (UCI) was attained in 1990.

Adolescent↗

PubMedDate not supplied

Identification of a high-risk clinically localized prostate cancer subgroup receiving maximum benefit from whole-pelvic irradiation.

PURPOSE: We recently identified a progression-free survival advantage for clinically localized high-risk prostate cancer patients receiving whole-pelvic irradiation. We now seek to identify a subgroup most likely to benefit from whole-pelvic irradiation. METHODS: Between October 1987 and December 1995, 506 clinically localized prostate cancer patients were treated with definitive radiotherapy consisting of whole-pelvic irradiation followed by a prostate-only boost, or prostate-only treatment (median follow-up, 35 months vs 30 months). Prostate-specific antigen (PSA) failure was defined as (1) a PSA value > or = 1 ng/mL or (2) a PSA value that rose > or = 0.5 ng/mL in < or = 1 year posttreatment on two consecutive measurements, with the first rise defined as the time of failure. The calculated risk of lymph node positivity (%rLN+) was defined as 2/3 (initial PSA) + 10(Gleason score - 6), with intermediate risk defined as 15% < or = %rLN+ < 35% and highest risk defined as %rLN+ > or = 35%. Univariate and multivariate analyses were performed. RESULTS: Intermediate-risk patients receiving whole-pelvic irradiation had significantly improved freedom from PSA failure compared with those receiving prostatic irradiation only (median progression-free survival 39.5 months vs 22.5 months; P < 0.0001); highest-risk patients did not (median progression-free survival 27.2 months vs 20.8 months, P = NS). Multivariate analysis revealed type of radiation treatment to be the most significant independent predictor of outcome (P < 0.0001). DISCUSSIONS: Whole-pelvic radiotherapy most significantly improves the PSA failure-free survival in patients with an intermediate calculated risk of lymph node positivity, suggesting that highest-risk patients may present with distant micrometastases.

Chi-Square Distribution↗