Biomedical subjects

N Laird

Publications and source records attributed to N Laird.

26 records · Page 2Linked to original sources

PubMed1983

Viral and epidemiologic studies of idiopathic sudden hearing loss.

The relationship between viral seroconversions and idiopathic sudden hearing loss (ISHL) is studied. Compared with our control group, the incidence of viral seroconversions is greater among ISHL patients, both for single and multiple viral infections. There was a significantly greater number of patients with seroconversions to mumps, rubeola, varicella-zoster, cytomegalovirus, and influenza B. We were unable to find a relationship between viral seroconversion and type or degree of hearing loss, vertigo, or chance for recovery. The incidences of viral conversion and sudden hearing loss track one another closely, suggesting that viral infection is a major cause of ISHL. During this 3-year study in Boston, ISHL was most prevalent in the spring.

Adolescent↗

PubMed1982

The relationship of idiopathic sudden hearing loss to diabetes mellitus.

A diabetic subgroup identified from a base population who have experienced idiopathic sudden hearing loss (ISHL) has been studied. In order to assess the relationship between diabetes and ISHL, two non-diabetic control groups were formed, and a comparison of the audiological data between the diabetic and non-diabetic ISHL patient was made. Mean degree of hearing loss and recovery, as well as the mean hearing level of the contralateral ear were analyzed. No statistically significant differences were noted in the audiological pattern of ISHL in diabetics and controls. A similar incidence of recovery was noted for the two groups throughout the mid frequencies; however, diabetic ISHL patients fail to recover as well as in the high frequencies. Preliminary data, while not statistically significant, suggest an increased hearing loss in both the affected and unaffected ear of the older diabetic patient.

Adult↗

PubMed1980

The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study.

Double-blind studies were conducted for the treatment of idiopathic sudden hearing loss (ISHL) with oral steroids. The condition was defined as not less than a 30-dB loss over three contiguous frequencies in three days or less. Follow-up audiograms were obtained four weeks and three months later. Specific audiologic guidelines for the assessment of hearing recovery were used to ensure objectivity. Steroids had a statistically significant effect on the recovery of hearing in patients with moderate hearing losses. The nature of the hearing loss and its susceptibility to improvement with steroid therapy lend support to the hypothesis that viral cochlitis is the primary cause of ISHL.

Adult↗

PubMedDate not supplied

Electronystagmographic findings in idiopathic sudden hearing loss.

The electronystagmographic findings for 116 patients with unilateral idiopathic sudden hearing loss (ISHL) were analyzed. For the purpose of the study, three groups were formed: patients with normal electronystagmographic (ENG) findings; patients with mild to moderate vestibular injuries consisting of spontaneous horizontal nystagmus or directional preponderance; and patients with severe vestibular injuries indicated by reduced vestibular responses, including paresis of the semicircular canal or lack of response to caloric testing. Clinical and audiologic findings were compared. High correlations were found between both subjective vertigo and abnormal ENG findings and the presence of profound hearing loss at the onset of ISHL. There was an inverse relationship between recovery from ISHL and the ENG findings, namely, as the severity of the vestibular injury increased, the percentage of patients who achieved recovery decreased. Patients with abnormal ENGs had a greater mean hearing loss at onset of ISHL and less mean recovery of hearing than did patients who had normal ENG findings. In addition, patients who had abnormal ENG findings recovered less fully from hearing loss in the high frequencies than from those in the low frequencies owing to the proximity of the basilar turn of the cochlea to the vestibular sense organ.

Adolescent↗

PubMedDate not supplied

Predicting recovery from idiopathic sudden hearing loss.

The probability of recovery from idiopathic sudden hearing loss depends on many factors, including patient age, presence of vertigo, audiogram type at diagnosis, and electronystagmographic test results. The authors present a model for calculating the probability of patient recovery based on the combined effects of risk factors determined for these variables. Data collected from 123 patients with "profound" or "moderate" sudden hearing losses are used to illustrate the model. Interrelationships among the prognostic factors and their relative importances in predicting hearing recovery are discussed.

Adolescent↗

PubMedDate not supplied

Efficacy of an H1 antagonist, astemizole, for chronic allergic rhinitis.

Astemizole, a new histamine H1 receptor antagonist, was tested in a double-blind cross-over comparison study with chlorpheniramine maleate, a very effective conventional H1 antagonist, in patients with chronic allergic rhinitis. Astemizole was found to be equally effective, yet there was a significant decrease in the side effects of sleepiness (P less than .01) and dry mouth (P less than .05). Astemizole has a completely different structure and binding curves from terfenadine. It is approved for clinical use in the United Kingdom, Canada, and many European countries.

Astemizole↗

PubMedDate not supplied

A unified approach to adjusting association tests for population admixture with arbitrary pedigree structure and arbitrary missing marker information.

A general approach to family-based examinations of association between marker alleles and traits is proposed. The approach is based on computing p values by comparing test statistics for association to their conditional distributions given the minimal sufficient statistic under the null hypothesis for the genetic model, sampling plan and population admixture. The approach can be applied with any test statistic, so any kind of phenotype and multi-allelic markers may be examined, and covariates may be included in analyses. By virtue of the conditioning, the approach results in correct type I error probabilities regardless of population admixture, the true genetic model and the sampling strategy. An algorithm for computing the conditional distributions is described, and the results of the algorithm for configurations of nuclear families are presented. The algorithm is applicable with all pedigree structures and all patterns of missing marker allele information.

Algorithms↗

PubMedDate not supplied

The costs of adverse drug events in hospitalized patients. Adverse Drug Events Prevention Study Group.

OBJECTIVE: To assess the additional resource utilization associated with an adverse drug event (ADE). DESIGN: Nested case-control study within a prospective cohort study. PARTICIPANTS: The cohort included 4108 admissions to a stratified random sample of 11 medical and surgical units in 2 tertiary-care hospitals over a 6-month period. Cases were patients with an ADE, and the control for each case was the patient on the same unit as the case with the most similar pre-event length of stay. MAIN OUTCOME MEASURES: Postevent length of stay and total costs. METHODS: Incidents were detected by self-report stimulated by nurses and pharmacists and by daily chart review, and were classified as to whether they represented ADEs. Information on length of stay and charges was obtained from billing data, and costs were estimated by multiplying components of charges times hospital-specific ratios of costs to charges. RESULTS: During the study period, there were 247 ADEs among 207 admissions. After outliers and multiple episodes were excluded, there were 190 ADEs, of which 60 were preventable. In paired regression analyses adjusting for multiple factors, including severity, comorbidity, and case mix, the additional length of stay associated with an ADE was 2.2 days (P=.04), and the increase in cost associated with an ADE was $3244 (P=.04). For preventable ADEs, the increases were 4.6 days in length of stay (P=.03) and $5857 in total cost (P=.07). After adjusting for our sampling strategy, the estimated postevent costs attributable to an ADE were $2595 for all ADEs and $4685 for preventable ADEs. Based on these costs and data about the incidence of ADEs, we estimate that the annual costs attributable to all ADEs and preventable ADEs for a 700-bed teaching hospital are $5.6 million and $2.8 million, respectively. CONCLUSIONS: The substantial costs of ADEs to hospitals justify investment in efforts to prevent these events. Moreover, these estimates are conservative because they do not include the costs of injuries to patients or malpractice costs.

Boston↗