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12 pages, 894 KiB  
Review
Review: Piglets’ (Re)Feeding Patterns, Mineral Metabolism, and Their Twisty Tail
by Theo van Kempen and Eugeni Roura
Metabolites 2025, 15(7), 480; https://doi.org/10.3390/metabo15070480 - 16 Jul 2025
Viewed by 469
Abstract
The appearance rate of nutrients into systemic circulation affects hormones like insulin and through that efficiency of growth. This also affects mineral requirements critical for metabolism, notably phosphate (P), magnesium (Mg), and potassium (K). Fasting animals have a downregulated metabolism, upon which P, [...] Read more.
The appearance rate of nutrients into systemic circulation affects hormones like insulin and through that efficiency of growth. This also affects mineral requirements critical for metabolism, notably phosphate (P), magnesium (Mg), and potassium (K). Fasting animals have a downregulated metabolism, upon which P, Mg, and K are exported from their cells into the blood and are subsequently excreted in their urine. Abrupt resumption of feed intake, especially of highly glycemic feeds, creates an acute need for these minerals, which can result in deficiency symptoms, particularly with P deficiency. In human medicine, this is called refeeding syndrome: a large meal after a period of fasting can prove fatal. Young animals seem to be especially sensitive, likely driven by their ability to grow rapidly and thus to drastically upregulate their metabolism in response to insulin. Symptoms of P deficiency are fairly a-specific and, consequently, not often recognized. They include edema, which makes it appear as if piglets are growing well, explaining the high gain/feed rate typically seen immediately after weaning, even when piglets are eating at or below the maintenance requirements. Phosphate deficiency can also result in hypoxia and hypercarbia, which may trigger ear necrosis, Streptococcus suis infections, or even death. Hypophosphatemia can also trigger rhabdomyolysis, which may contribute to tail-biting, but this requires further study. Arguably, when fasting cannot be avoided, diets for newly weaned piglets should be formulated to avoid these problems by lowering their glycemic load and by formulating diets according to the piglets’ actual requirements inspired by their genuine intake and health and not simply by extrapolating from older animals. Full article
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19 pages, 2433 KiB  
Review
The Physiological Mechanisms and Hurdles of Efficient Water–Nitrogen Utilization in Maize Production: A Review
by Xichao Sun, Qian Zhao, Jia Gao and Zheng Liu
Plants 2025, 14(13), 1899; https://doi.org/10.3390/plants14131899 - 20 Jun 2025
Viewed by 428
Abstract
Maize (Zea mays L.) is one of the most important staple food crops globally. One-third of global maize production is located in areas with high or extreme water scarcity and concurrently faces the challenge of low nitrogen use efficiency. Therefore, achieving synergistically [...] Read more.
Maize (Zea mays L.) is one of the most important staple food crops globally. One-third of global maize production is located in areas with high or extreme water scarcity and concurrently faces the challenge of low nitrogen use efficiency. Therefore, achieving synergistically high-efficiency water and nitrogen utilization in maize production is of great significance for agricultural sustainable development and global food security. In recent years, more articles have focused on the physiological mechanisms and management practices of efficient water and nitrogen utilization in maize. Unfortunately, there is a relative scarcity of research on the interactive effects between water and nitrogen on the development of young ears, which plays a crucial role in maize productivity. By compiling the most pertinent publications, this review endeavors to consolidate the existing knowledge on the interactive effects between water and nitrogen on maize production. Moreover, it advances potential physiological mechanisms and strategies for high-efficiency water and nitrogen utilization in terms of root system functioning, phytohormones, metabolism, and organ development. The changes in the availability of water and nitrogen have a significant impact on the development of young ears during the critical period, which in turn directly determines the grain number per ear and grain weight. Full article
(This article belongs to the Section Crop Physiology and Crop Production)
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12 pages, 367 KiB  
Article
Comparative Analysis of Mustardé, Fascioperichondrial Flap, and Combined Otoplasty Techniques: Clinical Outcomes and Recurrence Rates in 365 Patients
by Ahmet Hamdi Kepekçi
Healthcare 2025, 13(11), 1325; https://doi.org/10.3390/healthcare13111325 - 3 Jun 2025
Viewed by 371
Abstract
Background/Objectives: Prominent ear deformity is one of the most common congenital anomalies and may lead to substantial aesthetic and psychosocial distress, particularly in children and young adults. This study evaluated the clinical outcomes of three frequently used otoplasty techniques, Mustardé sutures, fascioperichondrial flap, [...] Read more.
Background/Objectives: Prominent ear deformity is one of the most common congenital anomalies and may lead to substantial aesthetic and psychosocial distress, particularly in children and young adults. This study evaluated the clinical outcomes of three frequently used otoplasty techniques, Mustardé sutures, fascioperichondrial flap, and their combination, concerning recurrence rates, complications, and patient satisfaction. Methods: This retrospective analysis included data from 365 patients who underwent otoplasty between 2017 and 2023 at a single institution, with all procedures performed by the same surgeon. Patients were categorized into three groups based on the surgical technique employed: Mustardé (n = 71), fascioperichondrial flap (n = 232), and a combined technique (n = 62). The primary outcome was the recurrence rate, while secondary outcomes included the type of suture material, complication rates, and aesthetic satisfaction. Results: The lowest recurrence rate was observed in the fascioperichondrial flap group (6.5%), followed by the combined group (8.5%) and the Mustardé group (29.6%). Logistic regression analysis revealed that the flap technique was associated with a 3.79-fold reduction in recurrence risk compared with the Mustardé method (p = 0.033). Overall complication rates were low across all groups. Hematoma occurred only in the flap group (1.3%), while suture extrusion and granuloma formation were exclusive to the Mustardé group. The highest aesthetic satisfaction was reported in the combined technique group. Conclusion: The fascioperichondrial flap method demonstrated statistically superior outcomes in minimizing recurrence and complications in prominent ear surgery. While the Mustardé technique demands careful patient selection due to its higher recurrence risk, the combined approach appears particularly beneficial for complex auricular deformities. The robust sample size and surgical standardization in this study provide valuable insights for surgical decision making in otoplasty. To our knowledge, this is one of the largest single-surgeon case series evaluating recurrence and complication outcomes in otoplasty. Full article
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16 pages, 480 KiB  
Article
Oropharyngeal Manifestations in Patients with HIV from Northeastern Romania
by Amelia Elena Surdu, Isabela Ioana Loghin, Victor Daniel Dorobăţ, Vlad Hârtie, Șerban Alin Rusu, Ion Cecan, Amelia Andreea Mihăescu, Otilia Eva and Carmen Mihaela Dorobăț
Medicina 2025, 61(5), 855; https://doi.org/10.3390/medicina61050855 - 6 May 2025
Viewed by 657
Abstract
Backgrounds and objective: Disorders in the stomatognathic system and otorhinolaryngologic manifestations are frequently observed in individuals living with HIV. Ear, neck, and throat (ENT) signs and symptoms often serve as critical markers of treatment failure, particularly in the advanced stages of HIV [...] Read more.
Backgrounds and objective: Disorders in the stomatognathic system and otorhinolaryngologic manifestations are frequently observed in individuals living with HIV. Ear, neck, and throat (ENT) signs and symptoms often serve as critical markers of treatment failure, particularly in the advanced stages of HIV infection. This article aims to evaluate and consolidate recent developments in the treatment and management of otorhinolaryngological manifestations in HIV-positive patients. Materials and methods: We carried out a retrospective clinical investigation of patients admitted with HIV/AIDS in the northeastern region of Romania, hospitalized in the “St. Parascheva” Clinical Hospital of Infectious Diseases in Iasi. We followed the viro-immunological status correlated with patients’ otolaryngology and dental symptomatology, aiming to emphasize the comorbidities of HIV/AIDS cases. The study period spanned from 1 January 2020 to 30 November 2024. Results: There were a total of 552 recorded cases of oropharyngeal manifestations in patients with HIV. They were more frequent in men (358 cases, 64.85%) than women (194 cases, 35.15%). The majority of cases were young adults, aged 30 to 39 years, comprising 255 patients (46.19%), and most cases (36.85%) had CD4+ T-lymphocyte values between 200 and 499 cells/μL. The most frequent diagnosis was oral candidiasis, recorded in 335 male and 174 female cases (509, 92.21% total). Other notable conditions included gingivitis/periodontitis, sinusitis/rhinosinusitis, mastoiditis, and dental abscesses, albeit at lower frequencies. Notably, antifungal therapy with fluconazole was the most frequently employed treatment, followed by aminopenicillins and fluoroquinolones. With respect to the antiretroviral treatment, 83.69% of cases were prescribed a single-pill regimen. Conclusions: The key to the management of HIV-positive patients is a multidisciplinary approach, including an ENT specialist and access to antiretroviral therapy. Full article
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19 pages, 2925 KiB  
Article
Impact of Pesticide Exposure on High-Frequency Auditory Thresholds and Cochlear Function in Young People Residing near Agricultural Areas
by Felipe Munoz, Cristian Aedo-Sanchez, Felipe Paredes-Aravena, Enzo Aguilar-Vidal, Pedro Jilberto-Vergara and Gonzalo Terreros
Toxics 2025, 13(5), 375; https://doi.org/10.3390/toxics13050375 - 6 May 2025
Viewed by 789
Abstract
Pesticide exposure poses a significant health risk, with emerging evidence suggesting its impact on auditory function. This study investigated the effects of pesticide exposure on hearing in young rural residents living near agricultural areas in Chile’s O’Higgins Region. We evaluated 51 participants (31 [...] Read more.
Pesticide exposure poses a significant health risk, with emerging evidence suggesting its impact on auditory function. This study investigated the effects of pesticide exposure on hearing in young rural residents living near agricultural areas in Chile’s O’Higgins Region. We evaluated 51 participants (31 exposed, 20 unexposed) aged 18–35 years, using comprehensive audiological assessments including high-frequency audiometry, distortion product otoacoustic emissions (DPOAEs), and auditory brainstem responses (ABR). Participants were classified based on residential proximity to agricultural areas, with exposed individuals living around 400 m or less from monoculture fields. Results revealed significant differences in high-frequency hearing thresholds (14 and 16 kHz) in exposed individuals. The exposed group showed a higher number of absent DPOAEs and reduced ABR wave V amplitude in the right ear compared to the unexposed group. Additionally, the wave V/I ratio was significantly lower in exposed individuals. These findings suggest that pesticide exposure, even without direct occupational contact, may induce measurable changes in auditory function, particularly affecting high-frequency hearing and neural responses. These results emphasize the need for enhanced monitoring and protective measures for populations residing near agricultural areas where pesticides are extensively used. Full article
(This article belongs to the Section Neurotoxicity)
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12 pages, 1008 KiB  
Article
Long-Term Follow-Up of Vestibular Function in Cochlear-Implanted Teenagers and Young Adults
by Niki Karpeta, Eva Karltorp, Luca Verrecchia and Maoli Duan
Audiol. Res. 2025, 15(2), 42; https://doi.org/10.3390/audiolres15020042 - 13 Apr 2025
Cited by 1 | Viewed by 661
Abstract
Background: Vestibular function implements head position regulation and body spatial navigation. It matures during childhood and adolescence and integrates with the completion of an individual’s motor development. Nevertheless, vestibular impairment is associated with profound paediatric hearing loss and has a negative impact on [...] Read more.
Background: Vestibular function implements head position regulation and body spatial navigation. It matures during childhood and adolescence and integrates with the completion of an individual’s motor development. Nevertheless, vestibular impairment is associated with profound paediatric hearing loss and has a negative impact on the child’s motor proficiency. Cochlear implantation (CI) is the treatment of choice for severe hearing loss, where conservative treatment plans are not appropriate or fail. The Teenager and Young Adults Cochlear Implant (TAYACI) study investigates the long-term outcomes of early implantation with respect to the hearing, speech, psychological, and balance development among CI users. Methods: This study focuses on the vestibular function and the appropriate methods for vestibular assessment. The results of two established vestibular test methods are explored: the video head impulse test (vHIT) and cervical/ocular vestibular-evoked myogenic potentials (cVEMP, oVEMP) with air and bone conduction vibration stimulation. The results of vHIT, cVEMP, and oVEMP, per implanted ear and the relation to the aetiology of hearing loss are reported. An additional dynamic visual acuity (DVA) test was included to assess clinical oscillopsia. Results: Overall abnormal lateral canal testing was detected in 35/76 (46.1%) of the implanted ears. Bone-conducted cVEMP (BC cVEMP) was pathological in 33/76 (43.3%) and BC oVEMP in 42/76 (55.3%). Lateral canal impairment was associated with the background diagnosis of the hearing loss. Oscillopsia was related to bilateral canal impairment (sensitivity 73% specificity 100%). Conclusions: Lateral canal testing together with BC VEMPs were the most reproducible modules for vestibular testing The above tests were related to each other and complemented the overall vestibular assessment. DVA is a helpful tool to screen dynamic oscillopsia in patients with bilateral vestibular impairment. Full article
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19 pages, 1200 KiB  
Article
Lowland Sedge Meadows as a Potential Source of Macro and Micronutrient Supplementation
by Magdalena Janyszek-Sołtysiak, Maciej Murawski, Leszek Majchrzak and Bogusława Waliszewska
Agronomy 2025, 15(3), 539; https://doi.org/10.3390/agronomy15030539 - 23 Feb 2025
Viewed by 474
Abstract
From the point of view of farming utilization, investigations on the recognition of the mineral composition of sedges appears important, appropriate and useful. Sedges are often found in many meadow and pasture communities. It is therefore worth paying attention to the mineral content [...] Read more.
From the point of view of farming utilization, investigations on the recognition of the mineral composition of sedges appears important, appropriate and useful. Sedges are often found in many meadow and pasture communities. It is therefore worth paying attention to the mineral content of their tissues and their possible impact on the organisms of farm animals such as pigs. The basic objective of this study was to determine the concentration of selected macro and microelements: phosphorus (P), potassium (K), calcium (Ca), magnesium (Mg), sodium (Na), iron (Fe), silicon (Si), copper (Cu), zinc (Zn), chrome (Cr) and nickel (Ni) in the biomass of seven sedge species, potentially used as fodder, commonly occurring in natural sites in Central Europe. The material was collected twice during one growing season in the Krześniczka (N 52°37′14′ E 14°46′06′)—lubuskie voivodeship. The first harvest was carried out at the beginning of May, during the shooting and earring phase. The collected plant material included stems and leaves. The second harvest—the end of June—was collected at a time when the seedlings were developing flowers and young fruits, and their vegetative organs were developing dynamically. In June, the collected material represented organs in all possible development phases. The collected material was dried at a temperature of 65 °C, ground, and analyzed. The obtained results showed a difference in the content of microelements between the May and June harvest dates in the dry matter of all analyzed sedge species, which differed statistically significantly only in relation to copper. The harvest date had a statistically significant impact on the change in the content of macroelements in the dry matter of all analyzed sedge species and was associated with a decrease in the content of phosphorus, magnesium and calcium, while in the case of silicon, the delay in mowing resulted in an increase in the content of this element. Full article
(This article belongs to the Section Grassland and Pasture Science)
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17 pages, 2604 KiB  
Article
A Novel SLPI Splice Variant Confers Susceptibility to Otitis Media in Humans
by Christina L. Elling, Allen F. Ryan, Talitha Karisse L. Yarza, Amama Ghaffar, Erasmo Gonzalo d. V. Llanes, Jennifer M. Kofonow, Maria Rina T. Reyes-Quintos, Saima Riazuddin, Charles E. Robertson, Ma. Leah C. Tantoco, Zubair M. Ahmed, Abner L. Chan, Daniel N. Frank, Charlotte M. Chiong and Regie Lyn P. Santos-Cortez
Int. J. Mol. Sci. 2025, 26(4), 1411; https://doi.org/10.3390/ijms26041411 - 7 Feb 2025
Viewed by 992
Abstract
Otitis media is the most frequently diagnosed disease and a leading cause of hearing loss in young children. However, genetic contributors to susceptibility and pathogen–host–environment interactions in otitis media remain to be identified. Such knowledge would help identify at-risk individuals and effectively monitor, [...] Read more.
Otitis media is the most frequently diagnosed disease and a leading cause of hearing loss in young children. However, genetic contributors to susceptibility and pathogen–host–environment interactions in otitis media remain to be identified. Such knowledge would help identify at-risk individuals and effectively monitor, diagnose, and treat patients with otitis media. Through exome and Sanger sequencing, we identified a rare, deleterious splice variant SLPI c.394+1G>T co-segregating with otitis media in a large pedigree, with a genome-wide significant maximum LOD score of 4.59. Alternative splicing of SLPI was observed in saliva RNA of variant carriers. In bulk mRNA-seq data from an independent cohort of children with otitis media, SLPI was co-expressed with genes involved in infection, immune response, inflammation, and epithelial cell organization. After inoculation of non-typeable Haemophilus influenzae, Slpi was upregulated in polymorphonuclear leukocytes and epithelial cells of mouse middle ears. Furthermore, in the human middle ear, Haemophilus was significantly enriched in non-carriers, whereas Family-XI-Incertae-Sedis and Dialister were significantly enriched in variant carriers. Given the role of SLPI in immune modulation and host defense in mucosal epithelia, our findings support the SLPI variant as modulating susceptibility to otitis media. Full article
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14 pages, 2830 KiB  
Article
Lack of Amino Acid Alterations Within the Cochlear Nucleus and the Auditory Cortex in Acoustic Trauma-Induced Tinnitus Rats Using In Vivo Microdialysis
by Shanshan Yuan, Huey Tieng Tan, Paul F. Smith and Yiwen Zheng
Audiol. Res. 2024, 14(6), 1000-1013; https://doi.org/10.3390/audiolres14060083 - 17 Nov 2024
Viewed by 1285
Abstract
Background/Objectives: Tinnitus is a debilitating auditory disorder commonly described as a ringing in the ears in the absence of an external sound source. Sound trauma is considered a primary cause. Neuronal hyperactivity is one potential mechanism for the genesis of tinnitus and has [...] Read more.
Background/Objectives: Tinnitus is a debilitating auditory disorder commonly described as a ringing in the ears in the absence of an external sound source. Sound trauma is considered a primary cause. Neuronal hyperactivity is one potential mechanism for the genesis of tinnitus and has been identified in the cochlear nucleus (CN) and the auditory cortex (AC), where there may be an imbalance of excitatory and inhibitory neurotransmissions. However, no study has directly correlated tinnitus with the extracellular levels of amino acids in the CN and the AC using microdialysis, which reflects the functions of these neurochemicals. In the present study, rats were exposed to acoustic trauma and then subjected to behavioural confirmation of tinnitus after one month, followed by microdialysis. Methods: Rats were divided into sham (aged, n = 6; young, n = 6); tinnitus-positive (aged, n = 7; young, n = 7); and tinnitus-negative (aged, n = 3; young, n = 3) groups. In vivo microdialysis was utilized to collect samples from the CN and the AC, simultaneously, in the same rat. Extracellular levels of amino acids were quantified using high-performance liquid chromatography (HPLC) coupled with an electrochemical detector (ECD). The effects of sound stimulation and age on neurochemical changes associated with tinnitus were also examined. Results: There were no significant differences in either the basal levels or the sound stimulation-evoked changes of any of the amino acids examined in the CN and the AC between the sham and tinnitus animals. However, the basal levels of serine and threonine exhibited age-related alterations in the AC, and significant differences in threonine and glycine levels were observed in the responses to 4 kHz and 16 kHz stimuli in the CN. Conclusions: These results demonstrate the lack of a direct link between extracellular levels of amino acids in the CN and the AC and tinnitus perception in a rat model of tinnitus. Full article
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9 pages, 934 KiB  
Article
Auditory Development of Young Children with Profound Hearing Loss, Cochlear Implants, and Congenital CMV Infection
by Piotr H. Skarzynski, Anita Obrycka, Aleksandra Kolodziejak, Artur Lorens, Elzbieta Gos, Rita Zdanowicz and Henryk Skarzynski
J. Clin. Med. 2024, 13(22), 6734; https://doi.org/10.3390/jcm13226734 - 8 Nov 2024
Cited by 1 | Viewed by 1201
Abstract
Background/Objectives: The aim of this study was to assess auditory development in young children with profound hearing loss, cochlear implants (CIs), and congenital cytomegalovirus (cCMV) infection and to determine the effect of comorbidities on their development. Methods: The study group (cCMV group) consisted [...] Read more.
Background/Objectives: The aim of this study was to assess auditory development in young children with profound hearing loss, cochlear implants (CIs), and congenital cytomegalovirus (cCMV) infection and to determine the effect of comorbidities on their development. Methods: The study group (cCMV group) consisted of 47 CI children—18 girls and 29 boys—who had been diagnosed as having prelingual hearing loss due to cCMV infection (with or without comorbidities); the mean age at CI activation was 15.2 months (range: 9.7–23.8; SD = 3.5). The reference group (no cCMV) consisted of 117 similar children (57 girls and 60 boys) who had profound sensorineural hearing loss not caused by cCMV infection; they had no comorbidities. The mean age at CI activation in the second group was 14.3 months (range: 7.9–23.5; SD = 4.0). Auditory development in all children was assessed with the LittlEARS Auditory Questionnaire (LEAQ) at CI activation and at about 1, 5, 9, 14, and 24 months of CI use. Results: The mean LEAQ total score increased over a similar time frame from 9.8 pts to 28.9 pts in the cCMV group without comorbidities, from 4.5 pts to 18.5 pts in the cCMV group with comorbidities, and from 9.2 to 31.6 pts in the reference group with no cCMV infection. Conclusions: Early cochlear implantation in children with sensorineural hearing loss due to congenital CMV infection and no comorbidities promotes their early auditory development in a similar way to children without cCMV infection. Full article
(This article belongs to the Special Issue Clinical Advances in Hearing Rehabilitation and Cochlear Implantation)
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12 pages, 474 KiB  
Article
Communication Skills in Toddlers Exposed to Maternal SARS-CoV-2 during Pregnancy
by Enrico Apa, Nicole Carrie Tegmeyer, Concetta D’Adamo, Eleonora Lovati, Chiara Cocchi, Paola Allegra, Francesco Ostello, Daniele Monzani, Elisabetta Genovese and Silvia Palma
Life 2024, 14(10), 1237; https://doi.org/10.3390/life14101237 - 27 Sep 2024
Viewed by 1343
Abstract
Studies about the effects of SARS-CoV-2 on pregnant women and children born to positive women are controversial with regard to possible inner ear-related damage but most of them do not detect the involvement of this virus in auditory function. However, only a few [...] Read more.
Studies about the effects of SARS-CoV-2 on pregnant women and children born to positive women are controversial with regard to possible inner ear-related damage but most of them do not detect the involvement of this virus in auditory function. However, only a few studies on long-term effects on language development are currently available because of the recent onset of the pandemic. The aim of this study was to investigate the impact of SARS-CoV-2 infection on perceptual and expressive abilities and the emerging development of communication in young children. To this purpose, the MacArthur–Bates Communicative Development Inventory—Words and Gestures form (CDI-WG), was administered to parents. In total, 115 children whose mother was infected by SARS-CoV-2 during pregnancy were enrolled in the study and evaluated at the Audiology Service of the Modena University Hospital. All children underwent Otoacoustic Emissions (OAE) at birth: 114/115 had a “pass” result bilaterally, while 1 case had a unilateral “refer” result. Overall, 110/115 newborns (95.65%) underwent audiological evaluation between 10–18 months of age. In 5/110 patients (3.6%), the Pure Tone Average (PTA) result was equal to 35 dB; one case had a hearing threshold of around 50 dB due to a bilateral effusive otitis media. A notable finding was the percentage of children with tubal dysfunction in both evaluations, within 2 months of age and around 12 months of age. Most children revealed normal hearing. The CDI-WG was completed by 56/115 families. The rate of children below the fifth percentile was 8.9% for sentences understood, 12.5% for words understood, and 5.4% for words produced. Concerning CDI-Gestures, only 2 children (3.6%) were below the fifth percentile. A structured audiological follow-up in association with the evaluation of communication skills of children appears fundamental, particularly in the years of maximum neuroplasticity. Long-term studies are still necessary to evaluate the possible consequences of the pandemic. Full article
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10 pages, 820 KiB  
Article
Incidence and Characteristics of Pediatric Patients with Acute Otitis Hospitalized in a Romanian Infectious Diseases Hospital
by Vlad Ștefan Pleșca, Anca Streinu-Cercel, Oana Săndulescu, Anca Cristina Drăgănescu, Răzvan Hainăroșie and Anca Doina Pleșca
Children 2024, 11(7), 832; https://doi.org/10.3390/children11070832 - 8 Jul 2024
Cited by 2 | Viewed by 1580
Abstract
Background: Otic involvement is common in children during acute infectious diseases, and is an important cause of morbidity and health service utilization. Methods: We performed a retrospective analysis of pediatric cases hospitalized in the largest infectious disease hospital in Romania between 2018 and [...] Read more.
Background: Otic involvement is common in children during acute infectious diseases, and is an important cause of morbidity and health service utilization. Methods: We performed a retrospective analysis of pediatric cases hospitalized in the largest infectious disease hospital in Romania between 2018 and 2023, with the aim of quantifying the incidence and impact of acute otitis (AO) according to pediatric age subgroups. Results: A total of 1118 cases diagnosed with AO were eligible and included in the analysis. Acute congestive otitis media was the most common subtype, identified in 53.3% of cases, followed by acute purulent otitis media (APOM) in 26.7% of children. The majority of AO cases (69.9%) were diagnosed in the pre-pandemic period (2018–2019), and infants (10.6%), toddlers (49.4%), and preschoolers (29.2%) were the most affected age groups. A viral infection associated with the AO episode was documented in 49.6% of cases. Influenza viruses were most commonly reported (20.5%), followed by SARS-CoV-2 (5.8%), and adenovirus (4.9%). A total of 38 cases of AO were identified in children with measles. In 15.9% of APOM cases, Streptococcus pneumoniae was isolated by culture from otic secretions. The duration of hospitalization was longer in children with APOM and acute otitis externa compared to the other subtypes of AO (p < 0.001). Conclusions: Our study highlights the importance of ENT (ear, nose, and throat) monitoring in children hospitalized for acute infectious diseases, as the majority of AO cases occur in the context of a viral infection. These findings emphasize the necessity for tailored assessment and intervention in suspected cases of AO, especially in young children under 5 years of age. Full article
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9 pages, 724 KiB  
Case Report
Hamman’s Syndrome after Vaginal Delivery: A Case of Postpartum Spontaneous Pneumomediastinum with Subcutaneous Emphysema and Review of the Literature
by Kristina Olafsen-Bårnes, Marte Mari Kaland, Karol Kajo, Lars Jakob Rydsaa, Jozef Visnovsky and Pavol Zubor
Healthcare 2024, 12(13), 1332; https://doi.org/10.3390/healthcare12131332 - 3 Jul 2024
Cited by 3 | Viewed by 2199
Abstract
Hamman’s syndrome is a rare condition that mostly affects young males, often with a predisposition to asthma. It includes the presence of free air in the mediastinum and subcutaneous emphysema with no other underlying cause such as trauma, infection, or administration of any [...] Read more.
Hamman’s syndrome is a rare condition that mostly affects young males, often with a predisposition to asthma. It includes the presence of free air in the mediastinum and subcutaneous emphysema with no other underlying cause such as trauma, infection, or administration of any sort of mask support with hyperpressure. It occurs spontaneously and often in association with a prolonged Valsalva maneuver. This might explain why there are some cases of Hamman’s syndrome among young females giving birth. Here, we present a case report of a 24-year-old non-smoker primigravida with Hamman’s syndrome. She presented with symptoms a few hours after an uncomplicated vaginal delivery at 40 + 1 weeks of pregnancy where the active phase of labor lasted for three hours with normal progress. The second stage lasted for 30 min, with no signs of distress on CTG. The symptoms (pain in the right ear, swelling and pain in the neck, chest tightness, shortness of breath, dysphagia, odynophagia, and pain in the upper thorax on the right side) and objective findings as subcutaneous crepitations in the neck, parasternal region, right axillary fossa, clavicle and over the chest resolved spontaneously after a few days of observation and conservative management. We also give a systemic review of reported cases since 2000 to provide an overview of the pathomechanism, symptoms, diagnostics, treatment, and management of this condition. Hamman’s syndrome is a rare, usually benign, but potentially serious complication that can occur during the second stage of labor. Diagnostics include inquiring about typical symptoms, clinical examination, and chest x-ray or CT scan. Treatment is usually conservative with oxygen, bronchodilators, and pain relief. The recurrence rate is low and there is no contraindication to vaginal delivery in future pregnancies. However, it is suggested that physicians and midwives be cautious and consider a low threshold for instrumental delivery or cesarean section to avoid excessive Valsalva maneuvers. Full article
(This article belongs to the Special Issue 2nd Edition: Pregnancy and Perinatal Health)
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13 pages, 6649 KiB  
Article
Critical Steps and Common Mistakes during Temporal Bone Dissection: A Survey among Residents and a Step-by-Step Guide Analysis
by Giovanni Motta, Eva Aurora Massimilla, Salvatore Allosso, Massimo Mesolella, Pietro De Luca, Domenico Testa and Gaetano Motta
J. Pers. Med. 2024, 14(4), 349; https://doi.org/10.3390/jpm14040349 - 27 Mar 2024
Cited by 1 | Viewed by 2394
Abstract
Background: Given that the temporal bone is one of the most complex regions of the human body, cadaveric dissection of this anatomical area represents the first necessary step for the learning and training of the young oto-surgeon in order to perform middle ear [...] Read more.
Background: Given that the temporal bone is one of the most complex regions of the human body, cadaveric dissection of this anatomical area represents the first necessary step for the learning and training of the young oto-surgeon in order to perform middle ear surgery, which includes the management of inflammatory pathology, hearing rehabilitation, and also cognitive decline prevention surgery. The primary objective of this study was to identify common mistakes and critical passages during the initial steps of temporal bone dissection, specifically cortical mastoidectomy and posterior tympanotomy. Methods: A survey among 100 ENT residents was conducted, gathering insights into the most prevalent errors encountered during their training to uncover the most challenging aspects faced by novice surgeons during these procedures. Results: The most common mistakes included opening the dura of the middle cranial fossa (MCF), injury of the sigmoid sinus (SS), chorda tympani (CT), and facial nerve (FN) injury while performing the posterior tympanotomy. The most important critical steps to prevent mistakes are related to the absence of wide exposure during cortical mastoidectomy and the consequent impossibility of identifying the landmarks of the facial recess before performing posterior tympanotomy. Injury of these structures was more common in younger surgeons and in the ones who performed less than five temporal bone dissection courses. Conclusions: Numerous temporal bone dissections on cadavers are mandatory for ENT residents looking forward to performing middle ear surgery. Full article
(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)
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16 pages, 3459 KiB  
Article
Cochlear Ribbon Synapses in Aged Gerbils
by Sonny Bovee, Georg M. Klump, Sonja J. Pyott, Charlotte Sielaff and Christine Köppl
Int. J. Mol. Sci. 2024, 25(5), 2738; https://doi.org/10.3390/ijms25052738 - 27 Feb 2024
Cited by 5 | Viewed by 1727
Abstract
In mammalian hearing, type-I afferent auditory nerve fibers comprise the basis of the afferent auditory pathway. They are connected to inner hair cells of the cochlea via specialized ribbon synapses. Auditory nerve fibers of different physiological types differ subtly in their synaptic location [...] Read more.
In mammalian hearing, type-I afferent auditory nerve fibers comprise the basis of the afferent auditory pathway. They are connected to inner hair cells of the cochlea via specialized ribbon synapses. Auditory nerve fibers of different physiological types differ subtly in their synaptic location and morphology. Low-spontaneous-rate auditory nerve fibers typically connect on the modiolar side of the inner hair cell, while high-spontaneous-rate fibers are typically found on the pillar side. In aging and noise-damaged ears, this fine-tuned balance between auditory nerve fiber populations can be disrupted and the functional consequences are currently unclear. Here, using immunofluorescent labeling of presynaptic ribbons and postsynaptic glutamate receptor patches, we investigated changes in synaptic morphology at three different tonotopic locations along the cochlea of aging gerbils compared to those of young adults. Quiet-aged gerbils showed about 20% loss of afferent ribbon synapses. While the loss was random at apical, low-frequency cochlear locations, at the basal, high-frequency location it almost exclusively affected the modiolar-located synapses. The subtle differences in volumes of pre- and postsynaptic elements located on the inner hair cell’s modiolar versus pillar side were unaffected by age. This is consistent with known physiology and suggests a predominant, age-related loss in the low-spontaneous-rate auditory nerve population in the cochlear base, but not the apex. Full article
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