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At least 307 records · Page 17Linked to original sources
PubMed2000

Bilateral sensorineural hearing disorders in children: etiology of deafness and evaluation of hearing tests.

OBJECTIVE: The purpose of this study was to determine the etiology of bilateral sensorineural hearing disorders in children and to evaluate the performed hearing tests by comparison of the results of the objective and subjective tests. METHODS: The medical history and the hearing tests (behavioral observation audiometry, acoustic evoked potentials and pure tone audiometry) of 106 bilaterally hearing impaired children were analyzed in a retrospective follow-up study. RESULTS: The total group included 52 males and 54 females. The ages at first diagnosis ranged from 4 months to 11 years with a mean age of 42 months and a median of 33 months. The degree of hearing loss for the better hearing ear was mild in one child, moderate in 28 children, severe in 29 children, profound in 32 children and total in 16 children. The delay between the first examination and diagnosis ranged from 0 to 597 days with a mean of 83 days and a median of 28 days. In 47 children (44%) no cause of hearing impairment could be determined. Nineteen children (18%) had a history of familial hearing loss, 40 (38%) suffered from acquired hearing loss (seven children had prenatal causes, 21 perinatal and 12 postnatal). A comparison between behavioral observation audiometry and brainstem evoked response audiometry revealed a statistically good agreement. Twenty-nine children (32%) showed progressive hearing loss, which was defined as a threshold shift of +10 dB or more in the pure tone average in at least one ear. CONCLUSIONS: In a significant number of children with early hearing impairments the etiology still remains uncertain. Further research in the field of genetic disorders will diminish this number. Evaluation of hearing tests showed that behavioral observation audiometry still is an excellent tool in the hands of an experienced examiner. The age at identification of hearing disorders in industrialized countries still is unacceptably high. To obtain ideal care of hearing impaired children, universal neonatal hearing screening programs are mandatory.

Age Distribution↗
PubMed1992

Reporting alcohol-impaired drivers: results from a national survey of emergency physicians.

STUDY OBJECTIVE: The purpose of this exploratory study was to learn of physicians' opinions on mandatory reporting of alcohol-impaired drivers they encounter in the course of their clinical work to the police or authorities from the Division of Motor Vehicles. DESIGN AND PARTICIPANTS: Two thousand four hundred sixty-four physicians randomly selected from the American College of Emergency Physicians were sent an anonymous, one-time only, self-administered questionnaire seeking demographic information and assessing attitudes toward mandatory reporting and alcohol treatment. MEASUREMENTS AND MAIN RESULTS: One thousand fifty-five physicians returned the survey. Seventy-eight percent of respondents agreed with mandatory reporting. More than half expressed strong agreement. Through canonical discriminant analysis we are able to identify the complex factors influencing attitude toward mandatory reporting. CONCLUSION: Although our preliminary results must be interpreted with caution, it appears that with the appropriate legal safeguards, physicians are supportive of mandatory reporting of the alcohol-impaired driver encountered in the course of clinical work.

Adult↗
PubMed2002

Vaccination policies in the military: an insight on influenza.

Influenza, despite its generally benign clinical course, is accompanied by absenteeism from work, acute suffering and even mortality, mainly in the elderly and in subjects who have high-risk medical conditions. Its prevention consists of strain specific vaccination, which must be repeated annually due to the high antigenic variability of the influenza virus. Influenza may represent an important obstacle to military readiness, particularly when considering its infectivity within closed communities. Despite such epidemiological situations, influenza vaccination is seldom included in the compulsory vaccination programme of the military on a global level. This may be due to several reasons, namely, a lack of confidence in the vaccine's effectiveness, the need for annual administrations (with expansion of economic and organisational efforts), false assumption that influenza is a disease with a minor impact, contradictory results of cost-effectiveness analyses (examples of which have yet to be made specifically for the military environment). The availability of more effective, economic and easy to administer vaccines, together with detailed and tailored cost-effectiveness analyses, may have a beneficial effect on the role the military plays in the fight against influenza across the globe.

Cost-Benefit Analysis↗