Newborn hearing screening programs

Background and study aims  Adenoma detection rate (ADR) is validated for measuring quality of colonoscopy, however there is lack of colorectal cancer (CRC) screening program in South Asia. The purpose of this study is to analyze and review the polyp detection rate (PDR) and ADR and provide insight into the factors that influence them in Pakistan. Patients and methods  This retrospective, cross-sectional study was performed at the Aga Khan University Hospital, Karachi, Pakistan, on patients ≥ 18 years, who underwent colonoscopy between January 1, 2017 and June 30, 2018. Results  Of 1985 patients, 59 % were male and 41 % female, with mean age of 47.8 ± 16.2 years. The most common indication for colonoscopy was bleeding-per-rectum (28.0 %) and overall PDR and ADR were 17.9 % and 9.9 %, respectively. There was no significant difference between genders for either PDR ( P  = 0.378) or ADR ( P  = 0.574). Significantly higher PDR and ADR were found for patients ≥ 50 years ( P  < 0.001), ...

The incidence of bilateral congenital hearing loss is around 1.04-1.51 per 1000 newborns . The incidence of congenital hearing loss is much higher than that of congenital metabolic disorders, which are routinely screened in newborns . As half of the children with hearing loss have no identifiable risk factors [4], the universal hearing screening program was suggested to detect hearing impairments in the newborns.

Background: The present study is aimed at finding the referral rates in Transient Evoked Otoacoustic Emission (TEOAE) and Distortion Product Otoacoustic Emission (DPOAE) in well-born and high-risk infants, using two-step hearing screening protocol with TEOAE and DPOAE, and to compare and contrast the referral rates in the first screening. Subjects and Methods: A prospective study design was carried out on 404 neonates (808 ears) who were screened between June 2019 and February 2021 at Voluntary Health Services, Chennai. All subjects were randomly selected with inclusion and exclusion criteria. All newborns were screened with both TEOAE and DPOAE. 'Pass' and 'refer' were tabulated to calculate the referral rates and Chi-square test was done to find the significance between the groups. Results: Among 404 (100%) neonates screened, 364 (90.14%) were well-born and 40 (9.90%) were high-risk babies. The total referral rate for TEOAE was 88 (10.90%) among which 77 (21.15%) were well-born babies and 11 (27.50 %) were high-risk infants. Total referral rate in DPOAE was 91 (11.27%) among which 75 (20.06%) were well-born and 16 (40%) were high-risk infants. Statistical analysis revealed no significant difference between the groups (p=0.000). Conclusion: TEOAE is a rapid test with low referral rates and more acceptability. DPOAE, with greater sensitivity, frequency specificity and better SNR, is more accurately used for infants with high-risk registers. Both the OAEs can be used for all the infants as a screening procedure in a two-step protocol.

RESUMO Objetivo Pesquisar os potenciais exógenos em neonatos normo-ouvintes, nascidos a termo e pré-termo, correlacionando-os ao gênero e presença de Indicadores de Risco para Deficiência Auditiva (IRDA). Métodos A amostra inicial foi composta por 127 neonatos e, após análise de juízes, foram considerados 96. Destes, 66 eram nascidos a termo e 30 nascidos pré-termo, em um hospital público. Todos os neonatos apresentaram resultado “passa” na triagem auditiva neonatal. Os registros do exame foram feitos com os neonatos em sono natural, por meio de eletrodos assim posicionados: o ativo na fronte (Fz), o terra (Fpz) na fronte e os de referência na mastoide esquerda (M1) e direita (M2). Foram apresentados estímulos verbais, binauralmente, sendo /ba/ o estímulo frequente e /ga/ o estímulo raro, em intensidade de 70 dBNA, por meio de fones de inserção. Respeitou-se o paradigma oddball. Foi analisada a presença ou ausência dos potenciais exógenos. Para análise dos dados foram utilizados os ...

Objetivo: verificar se houve diminuição da taxa de evasão no reteste da Triagem Auditiva Neonatal, após implementação de um procedimento de assinatura de um termo de responsabilidade. Metodologia: foram avaliados 90 prontuários de neonatos com necessidade de reteste, pois falharam na Triagem Auditiva Neonatal, em um Hospital Universitário. Os prontuários foram divididos em grupo estudo (49), os quais os responsáveis assinaram o termo de responsabilidade, assim se comprometiam com o retorno para conclusão diagnóstica e grupo controle (41) sem a assinatura do referido termo. Analisou-se a taxa de evasão nos dois grupos, considerando a presença no reteste. Resultados: o grupo estudo apresentou uma taxa de evasão de 29% no reteste, já o grupo controle evidenciou taxa de 42%, mostrando diferença estatisticamente significativa entre os grupos. Conclusão: Foi encontrada diminuição da taxa da evasão dos bebês no reteste da Triagem Auditiva Neonatal, após implementação do procedimento de ass...

Background and study aims  Adenoma detection rate (ADR) is validated for measuring quality of colonoscopy, however there is lack of colorectal cancer (CRC) screening program in South Asia. The purpose of this study is to analyze and review the polyp detection rate (PDR) and ADR and provide insight into the factors that influence them in Pakistan. Patients and methods  This retrospective, cross-sectional study was performed at the Aga Khan University Hospital, Karachi, Pakistan, on patients ≥ 18 years, who underwent colonoscopy between January 1, 2017 and June 30, 2018. Results  Of 1985 patients, 59 % were male and 41 % female, with mean age of 47.8 ± 16.2 years. The most common indication for colonoscopy was bleeding-per-rectum (28.0 %) and overall PDR and ADR were 17.9 % and 9.9 %, respectively. There was no significant difference between genders for either PDR ( P  = 0.378) or ADR ( P  = 0.574). Significantly higher PDR and ADR were found for patients ≥ 50 years ( P  < 0.001), ...

The objective of this report is to describe the development of an extension project focused on the orientations of mothers in the joint accommodation of a maternity to the realization of OAE test on an outpatient basis. Visits were made to the rooming of a philanthropic hospital, where pregnant women were addressed individually by two Speech Therapy students to receive guidance on the OAE test. There was done the explanation about the test as well as aspects related to maternal and child hearing health. 1128 mothers were addressed in the period August 2013 to June 2014. 35, 9% of pregnant women and mothers were after the test in the hospital this study.The data showed that the information made were not enough to cause great impact on the demand for the test on an outpatient basis, confirming the findings of the literature. However, the population guidelines were valid due to the promotion of children's hearing health. It was concluded that the instructions given in the format de...

Nationally newborn screening programs use 17-hydroxyprogesterone (17-OHP) as the biomarker to detect the rare but potentially fatal inherited disease, congenital adrenal hyperplasia (CAH). However, this biomarker is highly variable with a high false positive rate of detection, particularly in neonates born preterm. Several studies have examined various clinical and genetic factors to explain the variability of 17-OHP in preterm infants. The purpose of this study was to replicate previous clinical and genetic associations with 17-OHP in a well-characterized cohort of 762 preterm infants. We replicated previous findings that respiratory distress syndrome (P = 2×10 −3) is associated with higher 17-OHP. Higher 17-OHP and false positives were significantly associated with lower gestational age and birth weight, as previously reported. Incorporating gestational age and birth weight together decreases the false positive rate.

In this study, the authors report the results of a three-stage newborn hearing screening (NHS) program for well babies at the Gazi University Hospital (GUH) in Ankara between 2003 and 2013. GUH-NHS was performed by automated transient evoked otoacoustic emission (a-TEOAE) at the first and second steps and by automated brainstem audiometry (a-ABR) at the third step. The data were analysed to assess not only rate of congenital permanent hearing loss (CPHL), but also the effectiveness of the program during the years. A total of 18,470 well babies were tested. The data showed that coverage ratio for the GUH-born babies was increased and more outside-born babies (OBB) were admitted by time (means 84.31 and 11.28 %, respectively). Mean CPHL was found to be 0.26 %. Mean referral rate was decreased to 0.81 % by a-ABR from 2.16 % by a-TEOAE. Mean of missed cases in any stage of GUH-NHS was 4.88 %. It was seen that neither CPHL nor referral rate, but only ratio of missed ones presented increase in parallel to increment in OBB. This paper first presents that clinically acceptable screening procedures developed in GUH by time, and secondly higher rate of CPHL in Turkey than in the Western countries, and benefits of third stage screening by a-ABR because it prevented referral of 251 children (1.29 %) to the clinical tests. We think that this number is reasonably important regarding not only economical point of view, but also waiting lists in the audiology departments in a developing country, in which audiological service is still limited.

The early detection of idiopathic scoliosis has been advocated since the 1950s and '60s, concurrent with the development in the modern era of ambulatory spinal orthoses to treat scoliosis in adolescents. This led to the development of screening programs for specific populations, as evidenced by school screening programs in the United States and public health systems in Europe and Asia. Over time, the value of population screening in terms of optimal health care and economics has been debated in the popular press, by the U.S. Preventive Services Task Force, and by professional societies. Recent studies on the effectiveness of bracing to prevent the progression of scoliosis, improved delineation of "at-risk populations," and refined orthotic management programs with emphasis on the use of compliance monitors have influenced the American Academy of Orthopaedic Surgeons (AAOS), the Scoliosis Research Society (SRS), the Pediatric Orthopaedic Society of North America (POSNA), and the American Academy of Pediatrics (AAP) to update their position on screening for scoliosis and has led to a joint position statement on the topic. AAOS, SRS, POSNA, and AAP Position Statement Screening for the Early Detection of Idiopathic Scoliosis in Adolescents This Statement was developed as an educational tool based on the opinion of the authors. It is not a product of a systematic review. Readers are encouraged to consider the information presented and reach their own conclusions. The AAOS, SRS, POSNA, and AAP believe that there has been additional useful research in the early detection and management of adolescent idiopathic scoliosis (AIS) since the review performed by the U.S. Preventive Services Task Force (USPSTF) in 2004. This information should be available for use by patients, treating health care providers, and policy makers in assessing the relative risks and benefits of the early identification and management of AIS. The AAOS, SRS, POSNA, and AAP believe that there are documented benefits of earlier detection and non-operative management of AIS, earlier identification of severe deformities that are surgically treated, and incorporation of screening of children for AIS by knowledgeable health care providers as a part of their care.

RESUMO Objetivo Verificar a ocorrência de alterações nos exames de potencial evocado (PEA) auditivo em adultos fumantes normo-ouvintes. Estratégia de pesquisa Revisão sistemática da literatura de acordo com recomendações do PRISMA, buscando responder à pergunta: “Há alterações nos resultados do exame de PEA em adultos fumantes?”, estratégia PECOS. Pesquisa realizada nas bases de dados PubMed, Embase, CINAHL, LIVIVO, Scopus, Web of Science, LILACS e Scielo. Busca adicional da literatura cinzenta: Google Scholar e ProQuest e busca manual das referências dos estudos incluídos. Critérios de seleção Foram selecionados estudos com delineamento transversal, sem restrição do ano de publicação e idioma. Análise dos dados Primeiramente foram analisados os títulos e resumos de todos os estudos encontrados, seguido da leitura na íntegra dos estudos elegíveis. Resultados Foram obtidos 898 artigos, que após remoção dos duplicados e análise cega por três pesquisadores, foram selecionados oito trab...

RESUMO Objetivo Avaliar os achados audiológicos de recém-nascidos expostos à sífilis materna, tratada adequadamente na gestação. Métodos Estudo de coorte única não concorrente, realizado em um hospital público. Fizeram parte da amostra recém-nascidos filhos de mães que apresentaram sorologia positiva para sífilis e que realizaram o tratamento adequado durante a gestação, compondo o grupo estudo, e recém-nascidos sem indicadores de risco para deficiência auditiva, grupo comparação. Resultados Participaram do estudo 90 recém-nascidos, sendo 41 do grupo estudo e 49 do grupo comparação. No exame de emissões otoacústicas por estímulo transiente, todos apresentaram presença de resposta bilateralmente e, na comparação das amplitudes de respostas nas bandas de frequências de 3,0 kHz, 3,5 kHz e 4,0 kHz observou-se menor amplitude de resposta no grupo exposto, com diferença estatisticamente significativa para a frequência de 4 kHz à direita. Na análise das respostas do exame de potencial evoc...

RESUMO Objetivo Avaliar os achados audiológicos de recém-nascidos expostos à sífilis materna, tratada adequadamente na gestação. Métodos Estudo de coorte única não concorrente, realizado em um hospital público. Fizeram parte da amostra recém-nascidos filhos de mães que apresentaram sorologia positiva para sífilis e que realizaram o tratamento adequado durante a gestação, compondo o grupo estudo, e recém-nascidos sem indicadores de risco para deficiência auditiva, grupo comparação. Resultados Participaram do estudo 90 recém-nascidos, sendo 41 do grupo estudo e 49 do grupo comparação. No exame de emissões otoacústicas por estímulo transiente, todos apresentaram presença de resposta bilateralmente e, na comparação das amplitudes de respostas nas bandas de frequências de 3,0 kHz, 3,5 kHz e 4,0 kHz observou-se menor amplitude de resposta no grupo exposto, com diferença estatisticamente significativa para a frequência de 4 kHz à direita. Na análise das respostas do exame de potencial evoc...

Öz. Durum çalışması olarak desenlenen bu araştırmanın amacı, bir ileri tanı merkezinde yenidoğan işitme taramasından eğitime yönlendirmeye kadar olan süreci incelemek ve bu sürece ilişkin sağlık çalışanları ile birlikte ailelerin deneyimlerini irdelemektir. Bu araştırmaya, ileri tanı merkezinden dört odyometrist, bir uzman odyolog, bir kulak burun boğaz hekimi ve çocuğu bu ileri tanı merkezinde tanılanan yedi aile katılmıştır. Bu araştırmanın verileri; aile ve sağlık çalışanları ile yapılan görüşmelerle, merkezde yapılan gözlemlerle, belgelerle, süreç ürünleriyle ve araştırmacı günlüğü yoluyla toplanmıştır. Toplanan veriler, tümevarımsal olarak analiz edilmiştir. Analizden elde edilen, bulgular, dört tema çerçevesince raporlaştırılmıştır. Araştırma sonucunda, ileri tanı merkezlerinin ve işitme kayıplı çocuklar için eğitim veren devlet kurumlarının arttırılmasına ihtiyaç duyulduğu belirlenmiştir. Ailelerin ise süreçte psikolojik ve ekonomik olarak desteklenmeye ihtiyaç duyduğu ortaya çıkmıştır. Sürecin daha etkin bir şekilde işlemesi için, sağlık çalışanlarına geri bildirim veren bir takip sistemine ve işitme kayıplı çocukların eğitimi alanında çalışanların sağlık çalışanları ile işbirliğinin arttırılmasına ihtiyaç duyulmaktadır.

A Triagem Auditiva Neonatal tem se efetivado mundialmente como meio para detecção precoce da surdez. Na Unicamp, desde 2002, os recém-nascidos na maternidade do Centro de Atenção Integral à Saúde da Mulher são agendados para a triagem auditiva no Centro de Estudos e Pesquisas em Reabilitação "Prof. Dr. Gabriel Porto". No entanto, nem todos vêm para a triagem e alguns abandonam o processo de avaliação antes do diagnóstico. O objetivo desta pesquisa foi caracterizar as taxas de adesão de lactentes ao Programa de Triagem Auditiva Neonatal. Tratou-se de pesquisa que utilizou dados contidos nos prontuários dos lactentes que efetuaram a triagem no período de fevereiro a novembro de 2007. Permaneceram no alojamento conjunto do CAISM 2107 lactentes e vieram para a triagem 1310. Dentre aqueles que não passaram na triagem (92 lactentes), realizaram o exame de PEATE-A 73 lactentes. A adesão na primeira etapa da triagem foi de 62,17%, e na segunda, 79,34%. As taxas de adesão são infer...

AMAÇ: Afyonkarahisar bölgesinde yapılan yenidoğan işitme tarama sonuçlarını değerlendirmek ve güncel literatür eşliğinde tartışmak amaçlanmıştır.GEREÇ VE YÖNTEM: Çalışmamızda Ocak 2014 - Aralık 2019 tarihleri arasında Afyonkarahisar Bölgesinde (Afyonkarahisar Sağlık Bilimleri Üniversitesi Hastanesi, Afyonkarahisar, Şuhut, Çay, Emirdağ, Dinar, Sandıklı, Bolvadin Devlet Hastanesi, Özel Fuar Hastanesi ve Özel Park Hastanesinde) işitme taraması yapılan 66.967 yenidoğanın işitme tarama sonuçları retrospektif olarak değerlendirildi. İlk teste gelen tüm yenidoğanlar uyarılmış otoakustik emisyonlar (TEOAE) ile değerlendirildi. İlk taramadan kalan yenidoğanlar risk faktörleri yönünden sorgulandı. Risk faktörü olan yenidoğanlar işitsel beyin sapı yanıt (ABR) ile, risk faktörü olmayanlar TEOAE ile değerlendirildi. İkinci tarama testinden kalan tüm yenidoğanlar ABR ile değerlendirildi. TEOAE ve ABR tarama testleriyle tek veya iki taraflı işitme kayıpları olan yeni doğanlar izlemlerinin yapılmas...

Assessment of speech perception in noise in children with hearing aids: Preliminary results* Objective: Noisy environments are a part of the daily life of children, just like adults. Children with hearing loss who wear hearing aids are more susceptible to the negative effects of noise than their normal-hearing peers. This study aims to evaluate the speech recognition in noise performance of hearing aid users and compare them with their normal-hearing peers. Material and Method: Five children aged 6-12 years with bilateral moderate to severe symmetrical sensorineural hearing loss and using bilateral behind-the-ear hearing aids were included in the study. 4 different conditions of the Turkish HINT-C were applied, and a speech recognition threshold (SRT) is determined for each condition. Results: Regardless of their age, the SRT needed by children with hearing aids to achieve equal performance with their normal-hearing peers was found to be higher for all test conditions. As seen in ch...

Newborn hearing screening (NHS) was implemented in Albania in four maternity hospitals in 2018 and 2019. Implementation outcome, screening outcome, and screening quality measures were evaluated. Infants were first screened by midwives and nurses before discharge from the maternity hospital and returned for follow-up screening. Acceptability, appropriateness, feasibility, adoption, fidelity, coverage, attendance, and stepwise and final-referral rates were assessed by onsite observations, interviews, questionnaires, and a screening database. A post hoc analysis was performed to identify reasons for loss to follow up (LTFU) in a multivariate logistic regression. In total, 22,818 infants were born, of which 96.6% were screened. For the second screening step, 33.6% of infants were LTFU, 40.4% for the third, and 35.8% for diagnostic assessment. Twenty-two (0.1%) were diagnosed with hearing loss of ≥40 dB, six unilateral. NHS was appropriate and feasible: most infants are born in maternity...

OBJETIVO: descrever a população de neonatos encaminhada para um programa de triagem auditiva seletiva, caracterizando e comparando o grupo de lactentes que compareceram à triagem (grupo I) com o grupo de lactentes que não compareceu (grupo II). MÉTODO: a amostra foi constituída por 55 lactentes, provenientes de uma maternidade de São Paulo. A metodologia incluiu a análise de prontuários e entrevistas com as mães. Foram variáveis do estudo: idade da alta hospitalar, resultado da triagem auditiva, resultado do diagnóstico, o tempo entre a alta hospitalar e a triagem, o tempo entre a alta hospitalar e o diagnóstico e, por fim, o tempo entre triagem e diagnóstico. Além destes aspectos, as características socioeconômicas e culturais dos grupos e os indicadores de risco foram analisados. RESULTADOS: foram encaminhados 55 lactentes e o comparecimento à triagem auditiva foi de 76% (42). A média de idade da alta hospitalar foi de 38 dias, da triagem auditiva foi de 42 dias e do diagnóstico f...

In this study, the authors report the results of a three-stage newborn hearing screening (NHS) program for well babies at the Gazi University Hospital (GUH) in Ankara between 2003 and 2013. GUH-NHS was performed by automated transient evoked otoacoustic emission (a-TEOAE) at the first and second steps and by automated brainstem audiometry (a-ABR) at the third step. The data were analysed to assess not only rate of congenital permanent hearing loss (CPHL), but also the effectiveness of the program during the years. A total of 18,470 well babies were tested. The data showed that coverage ratio for the GUH-born babies was increased and more outside-born babies (OBB) were admitted by time (means 84.31 and 11.28 %, respectively). Mean CPHL was found to be 0.26 %. Mean referral rate was decreased to 0.81 % by a-ABR from 2.16 % by a-TEOAE. Mean of missed cases in any stage of GUH-NHS was 4.88 %. It was seen that neither CPHL nor referral rate, but only ratio of missed ones presented increase in parallel to increment in OBB. This paper first presents that clinically acceptable screening procedures developed in GUH by time, and secondly higher rate of CPHL in Turkey than in the Western countries, and benefits of third stage screening by a-ABR because it prevented referral of 251 children (1.29 %) to the clinical tests. We think that this number is reasonably important regarding not only economical point of view, but also waiting lists in the audiology departments in a developing country, in which audiological service is still limited.

Dr. Meliha HAMURCU, Dr. Belit Merve ŞENER, Dr. Ahmet ATAŞ, Dr. Raziye Banu ATALAY, Dr. Fatih BORA, Dr. Özgür YİĞİT İstanbul Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Kliniği, İstanbul, Türkiye İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Odyoloji Bölümü, İstanbul, Türkiye Kartal Eğitim Araştırma Hastanesi, Kulak Burun Boğaz Kliniği, İstanbul, Türkiye Kafkas Üniversitesi, Kulak Burun Boğaz, Kars, Türkiye

The early detection of idiopathic scoliosis has been advocated since the 1950s and '60s, concurrent with the development in the modern era of ambulatory spinal orthoses to treat scoliosis in adolescents. This led to the development of screening programs for specific populations, as evidenced by school screening programs in the United States and public health systems in Europe and Asia. Over time, the value of population screening in terms of optimal health care and economics has been debated in the popular press, by the U.S. Preventive Services Task Force, and by professional societies. Recent studies on the effectiveness of bracing to prevent the progression of scoliosis, improved delineation of "at-risk populations," and refined orthotic management programs with emphasis on the use of compliance monitors have influenced the American Academy of Orthopaedic Surgeons (AAOS), the Scoliosis Research Society (SRS), the Pediatric Orthopaedic Society of North America (POSNA), and the American Academy of Pediatrics (AAP) to update their position on screening for scoliosis and has led to a joint position statement on the topic. AAOS, SRS, POSNA, and AAP Position Statement Screening for the Early Detection of Idiopathic Scoliosis in Adolescents This Statement was developed as an educational tool based on the opinion of the authors. It is not a product of a systematic review. Readers are encouraged to consider the information presented and reach their own conclusions. The AAOS, SRS, POSNA, and AAP believe that there has been additional useful research in the early detection and management of adolescent idiopathic scoliosis (AIS) since the review performed by the U.S. Preventive Services Task Force (USPSTF) in 2004. This information should be available for use by patients, treating health care providers, and policy makers in assessing the relative risks and benefits of the early identification and management of AIS. The AAOS, SRS, POSNA, and AAP believe that there are documented benefits of earlier detection and non-operative management of AIS, earlier identification of severe deformities that are surgically treated, and incorporation of screening of children for AIS by knowledgeable health care providers as a part of their care.

RESUMO Objetivo Mensurar os potenciais exógenos do potencial evocado auditivo cortical (PEAC) em neonatos nascidos a termo e pré-termo, além de compará-los, considerando as variáveis latência e amplitude dos componentes. Método Estudo transversal, prospectivo, contemporâneo e comparativo. Foram avaliados 127 neonatos; destes, foram considerados 96, após análise dos exames por três juízes, distribuídos em dois grupos: Grupo Termo: 66 neonatos e Grupo Pré-termo: 30 neonatos. Os registros do PEAC foram feitos com os neonatos posicionados no colo da mãe e/ou responsável, em sono natural, por meio de eletrodos de superfície. Foram apresentados estímulos verbais binauralmente, sendo /ba/ o estímulo frequente e /ga/ o estímulo raro, na intensidade de 70 dBNA, por meio de fones de inserção. Foi analisada a presença ou ausência dos componentes exógenos em ambos os grupos, bem como, latência e amplitude de P1 e N1. Para análise dos dados, utilizaram-se os testes pertinentes. Resultados A latê...

Objective: Universal newborn hearing screening programs have been successfully implemented in many countries, and result in early intervention and therapy. However, there are also a significant number of schoolchildren who have hearing problems. This study presents the results of a program of hearing screening in schoolchildren, implemented in Poland and subsequently followed up in other countries in support of the European Consensus on school-age hearing screening. The aim was to compare the frequency of positive outcomes of hearing screening between the countries.

Simple Summary The survival of colorectal cancer patients largely relies on the stage at diagnosis. The identification of early and non-invasive biomarkers to be used in screening programs for the diagnosis of the disease at the premalignant stage is mandatory. The aim of this study is to validate in plasma-derived extracellular vesicles secreted by malignant cells the diagnostic potential of well-known tumor-associated genes, ΔNp73, TAp73, and Δ133p53, in healthy subjects (n = 29), individuals with premalignant lesions (n = 49), and colorectal cancer patients (n = 42). Our data support ΔNp73 levels contained in extracellular vesicles as such a non-invasive and premature biomarker for the early diagnosis of colorectal cancer. Abstract The early diagnosis of colorectal cancer is a key factor in the overall survival of the patients. The actual screening programs include different approaches with significant limitations such as unspecificity, high invasiveness, and detection at late st...

Giriş: İşitme kaybı olan (İK) çocukların dil gelişimini anlama çabasına son yıllarda bilişsel gelişimi anlama çalışmaları da eklenmiştir. Bu araştırmada temel bilişsel süreçlerden biri olan yürütücü işlevlere odaklanmış araştırmaları derleyerek İK çocuklarda yürütücü işlevlerin diğer bilişsel süreçlerle/becerilerle ilişkisi ve bu çocukların yürütücü işlevler performansı üzerine genel bir bakış açısı ortaya koymak amaçlanmıştır. Yöntem: Sistematik derleme metodolojisi ile belirlenen dâhil etme ve dışlama ölçütleri doğrultusunda 15 araştırma derleme kapsamına alınmıştır.

The incidence of bilateral congenital hearing loss is around 1.04-1.51 per 1000 newborns [1,2]. The incidence of congenital hearing loss is much higher than that of congenital metabolic disorders, which are routinely screened in newborns [3]. As half of the children with hearing loss have no identifiable risk factors [4], the universal hearing screening program was suggested to detect hearing impairments in the newborns.

Konya ilinde bulunan özel eğitim ve rehabilitasyon merkezlerinde işitsel rehabilitasyon hizmeti alan işitme kayıplı çocukların ebeveynlerinin verdikleri bilgiler doğrultusunda çocukların demografik, doğum ve sağlık, işitme kaybı, müdahale ve aile profilini ortaya çıkarmak ve ebeveynlerin yasal olarak verilen haklar/hizmetler konularında düşüncelerini almaktır. Gereç ve Yöntemler: Çalışmanın evrenini Konya ilinde yaşayan işitme cihazı ve/veya işitsel implant kullanıcısı işitme kayıplı çocukların ebeveynleri oluşturmuştur. Çevrim içi sorucevap formu 135 ebeveyn tarafından yanıtlanmıştır. Araştırma verileri, 60 sorudan oluşan çevrim içi soru-cevap formu aracılığıyla toplanmıştır. Soru-cevap formundaki sorular demografik bilgiler, doğum ve sağlık, işitme kaybı, yasal haklar, aile profili ve müdahale başlıklarında yer almıştır. Bulgular: İşitme kayıplı çocukla en çok annenin ilgilendiği, ebeveynlerin yaklaşık yarısının çocuklarının işitme kaybını kabullenemedikleri ve bazı ebeveynlerin rehberlik ve araştırma merkezlerinde yeterli hizmet alamadığına ilişkin sorunlar yaşadığı belirlenmiştir. Ebeveynlerin çocuklarının rutin odyolojik değerlendirmelerini 1 yıl üzeri aralıklarla yaptırdıkları bulunmuştur. İşitme kaybının fark edilmesi en yüksek oranda 0-6 aylar arasında gerçekleşirken, teşhis yaşının daha geç olduğu belirlenmiştir. İşitme kayıplı çocukların 2/3'ü yenidoğan işitme taramasından kalmıştır. Yüksek oranlarda olmasa da gebelikte ilaç kullanımı, erken doğum, düşük doğum ağırlığı, yenidoğan yoğun bakımda kalma, ek problemlerin varlığının işitme kaybı için risk faktörü olduğu belirlenmiştir. Ayrıca, edinilmiş işitme kaybında yüksek risk faktörü olarak çocukluk çağı hastalıklarının yer alabileceği düşünülmüştür. Sonuç: İşitme kayıplı çocuğa sahip ebeveynlerden alınan bilgiler doğrultusunda işitme kayıplı çocukların profili çıkarılmıştır. Ebeveynlere sağlanan doğum ve sağlık, işitme kaybı, yasal haklar, aile eğitimi ve müdahaleye ilişkin hizmetlerin bütün olarak sunulması ve bu hizmetlerin daha nitelikli verilmesi gerektiği düşünülmektedir. Anah tar Ke li me ler: Pediatri; işitme kaybı; işitme cihazları; koklear implantlar; ebeveynler ABS TRACT Objective: To reveal the demographic, birth and health, hearing loss, intervention and family profile of the children in line with the information given by the parents of the children with hearing loss who receive auditory rehabilitation services in the special education and rehabilitation centers in Konya, and to get their opinions on the legal rights/services of the parents. Material and Methods: The population of the study consisted of the parents of children with hearing loss who use hearing aids and/or auditory implants living in Konya. Online question-answer form was answered by 135 parents. Research data were collected through an online question-answer form consisting of 60 questions. The questions in the question-answer form were included in the main titles of demographic information, birth and health, hearing loss, legal rights, family profile and intervention. Results: It has been determined that the mother is the most concerned with the child with hearing loss, nearly half of the parents cannot accept the hearing loss of their children, and some parents have problems related to the lack of adequate service in the guidance and research centers. It was found that parents made their children's routine audiological evaluations at intervals of more than one year. Hearing loss was noticed at the highest rate between 0-6 months, while the age of diagnosis was found to be later. Two-thirds of children with hearing loss fail newborn hearing screening. Although not at high rates, it has been determined that drug use during pregnancy, preterm birth, low birth weight, staying in neonatal intensive care unit, and the presence of additional problems are risk factors for hearing loss. In addition, it has been thought that childhood diseases may take place as a high risk factor in acquired hearing loss. Conclusion: In line with the information received from parents of children with hearing loss, the profile of children with hearing loss was created. It is thought that the services provided to parents regarding birth and health, hearing loss, legal rights, family education and intervention should be provided as a whole and these services should be provided more qualified.

Bu makalede, CODA (Children of Deaf Adults) olarak tanımlanan işitme engelli ebeveynlerin işiten çocuklarının aile ve iletişim deneyimleri neticesinde edindikleri CODA Kimliğinin gelişiminin incelenmesi ve analiz edilmesi amaçlanmıştır. Bu amaçla 4 kadın ve 7 erkek CODA ile yarı yapılandırılmış görüşmeler gerçekleştirilmiştir. Görüşmelerde elde edilen bulgular; "CODA Kimliği" teması ile CODA Kimliği gelişimini şekillendiren deneyimlerini içeren "Sosyal Farklılaşma ve Çift Kültürlülük", "İşaret Dili" ve "Ebeveyn Sorumluluğu ve * Bu çalışma Furkan Erdoğdu'nun Dr. Öğr. Üys. Ela Arı ve Dr. Öğr. Üys. Firdevs Melis Cin'in danışmanlığında İstanbul Ticaret Üniversitesi Sosyal Bilimler Enstitüsü bünyesinde yazmış olduğu "İki Dünya Arasında: İşitme Engelli Ebeveynlerin İşiten Çocuklarının (CODA'ların) Aile ve İletişim Deneyimleri" adlı yüksek lisans tezi ve bulgularından yola çıkılarak hazırlanmıştır.

The aim of this study was to examine the relationships between reasoning, working memory, and language in children with cochlear implants. A battery of tests of language, working memory, reasoning tasks, and speech perception tests was administered to each child. The participants were twenty-five children with deaf who had cochlear implant surgery before the age of 3. Parallel mediation analysis was conducted. The cause of reasoning is the working memory, however this effect is shown with the indirect effects of receptive and expressive language skills. As a result, activities to improve verbal working memory and receptive and expressive language skills might improve reasoning skills of children with cochlear implants.

Introduction: Hearing loss is one of the most common congenital disorders. The prevalence of this disorder in different communities has been reported between 3.5 to 9 percent, which can have adverse effects on language learning, communication, and education of children. Also, early diagnosis of this disorder in newborns is not possible without the use of hearing screening. Therefore, the aim of this study was to evaluate the effectiveness of newborn hearing screening programs in Zahedan. Method: In this cross-sectional observational study, all babies born in the maternity hospitals of Zahedan city (maternity hospitals of Nabi Akram, Imam Ali, and Social Security hospitals) in 2020, were examined. In order to conduct the study, TEOAE was initially performed for all neonates. Then, based on the results obtained in the ODA test and in case of unsatisfactory response, cases were referred for re-evaluation. Infants who were rejected again in the second stage were immediately subjected to the AABR test and if they failed in this test, they were also subjected to a diagnostic ABR test. Results: Based on our results, 7700 infants were first evaluated with the OAE test. Of these, 580 (8%) had no OAE response. Out of 580 infants rejected in the first stage, 76 infants were also rejected in the second stage; Among them, 8 infants were re-diagnosed with hearing impairments. Finally, out of 3 infants who were diagnosed with hearing loss, 1 (33%) had conductive hearing loss and 2 (67%) had sensorineural hearing loss. Conclusion: Based on the findings of the present study, the implementation of a comprehensive neonatal hearing screening program is necessary for the timely and early diagnosis and treatment of hearing loss. Also, screening can improve the health of children and their personal, social, and educational development in the future.

El potencial de disparidad o mismatch negativity (MMN) corresponde a la respuesta eléctrica extraída del electroencefalograma que se produce frente a diversos cambios de las características del estímulo acústico. Se obtiene presentando al sujeto una secuencia de estímulos repetitivos de características acústicas similares (estímulo estándar) alternado en forma aleatoria con estímulos acústicos discrepantes que difieren del primero en alguno de sus atributos (estímulo discrepante). El MMN se originaría en la corteza auditiva primaria y se ha logrado registrar desde el nacimiento. No requiere la atención del sujeto, permitiendo evaluar en forma objetiva la discriminación de tonos y fonemas. En clínica se ha utilizado en evaluación del procesamiento auditivo central, pacientes con dislexia o trastorno específico del lenguaje, autismo, individuos con implante coclear e incluso en pacientes en coma. En el presente artículo se revisan las principales características, origen anatómico y utilidad clínica del MMN. Palabras clave: Mismatch negativity, potencial de disparidad, procesamiento auditivo central, corteza auditiva, memoria auditiva, potenciales relacionados a evento.

İşitme kaybı yaklaşık 1000 bebekte 1-3 oranı ile en sık görülen konjenital anomalilerden biridir. Erken tanı ve müdahale ağır dil, eğitim ve psikososyal problemlerin gelişimi engelleyecektir. 6. aydan önce müdahale etmek işitme kaybı olan çocuğun normal konuşma ve dil gelişimini sağlamaktadır. Bu çalışmanın amacı yenidoğanlarda işitme kaybının insidensini araştırmak ve işitme kaybı olan çocuklarda ortalama müdahale zamanını belirlemektir.

Bu makalede, CODA (Children of Deaf Adults) olarak tanımlanan işitme engelli ebeveynlerin işiten çocuklarının aile ve iletişim deneyimleri neticesinde edindikleri CODA Kimliğinin gelişiminin incelenmesi ve analiz edilmesi amaçlanmıştır. Bu amaçla 4 kadın ve 7 erkek CODA ile yarı yapılandırılmış görüşmeler gerçekleştirilmiştir. Görüşmelerde elde edilen bulgular; "CODA Kimliği" teması ile CODA Kimliği gelişimini şekillendiren deneyimlerini içeren "Sosyal Farklılaşma ve Çift Kültürlülük", "İşaret Dili" ve "Ebeveyn Sorumluluğu ve * Bu çalışma Furkan Erdoğdu'nun Dr. Öğr. Üys. Ela Arı ve Dr. Öğr. Üys. Firdevs Melis Cin'in danışmanlığında İstanbul Ticaret Üniversitesi Sosyal Bilimler Enstitüsü bünyesinde yazmış olduğu "İki Dünya Arasında: İşitme Engelli Ebeveynlerin İşiten Çocuklarının (CODA'ların) Aile ve İletişim Deneyimleri" adlı yüksek lisans tezi ve bulgularından yola çıkılarak hazırlanmıştır.

In this study, the authors report the results of a three-stage newborn hearing screening (NHS) program for well babies at the Gazi University Hospital (GUH) in Ankara between 2003 and 2013. GUH-NHS was performed by automated transient evoked otoacoustic emission (a-TEOAE) at the first and second steps and by automated brainstem audiometry (a-ABR) at the third step. The data were analysed to assess not only rate of congenital permanent hearing loss (CPHL), but also the effectiveness of the program during the years. A total of 18,470 well babies were tested. The data showed that coverage ratio for the GUH-born babies was increased and more outside-born babies (OBB) were admitted by time (means 84.31 and 11.28 %, respectively). Mean CPHL was found to be 0.26 %. Mean referral rate was decreased to 0.81 % by a-ABR from 2.16 % by a-TEOAE. Mean of missed cases in any stage of GUH-NHS was 4.88 %. It was seen that neither CPHL nor referral rate, but only ratio of missed ones presented increase in parallel to increment in OBB. This paper first presents that clinically acceptable screening procedures developed in GUH by time, and secondly higher rate of CPHL in Turkey than in the Western countries, and benefits of third stage screening by a-ABR because it prevented referral of 251 children (1.29 %) to the clinical tests. We think that this number is reasonably important regarding not only economical point of view, but also waiting lists in the audiology departments in a developing country, in which audiological service is still limited.

A Triagem Auditiva Neonatal (TAN) é a estratégia recomendada para detectar precocemente a deficiência auditiva. A identificação de um caso potencial exige um re-teste realizado em consulta de retorno. O objetivo deste estudo foi identificar fatores que influenciam a não adesão ao retorno da TAN. Trata-se de estudo transversal, exploratório, com abordagem quantitativa e qualitativa. Todas as díades mãe-lactente, atendidas entre 2007 e 2009 em um hospital universitário de Salvador, Bahia, que foram solicitadas a retornar (N=102), constituíram a população do estudo. Aquelas que não retornaram foram elegíveis para investigação qualitativa. Das 102, 41,2% não compareceram para o re-teste. O não retorno foi 35% maior quando as mães tinham menor escolaridade, 37% menor quando tinham mais de um filho, e 41% maior quando os lactentes não apresentavam indicador de risco para deficiência auditiva, comparando-se aos grupos referentes. No discurso das mães, foram também identificados fatores que...

We describe a 6-day-old male who developed cardiac arrest due to hyperkalemia secondary to congenital adrenal hyperplasia and was successfully resuscitated. This case illustrates the importance of considering congenital adrenal hyperplasia as one of the causes of sudden cardiac arrest in a neonate. A literature review revealed only one similar case in a 3-month-old with a fatal outcome.

Congenital adrenal hyperplasia (CAH) comprises a group of rare autosomal recessively inherited disorders of cortisol biosynthesis in the adrenal cortex. More than 95% are based on a defect in the CYP21A2 gene causing 21-hydroxylase deficiency. Newborn screening (NBS) for CAH by means of 17-hydroxy-progesterone (17-OHP) determination in dried whole blood on filter paper has been introduced as part of the NBS in many countries worldwide. The goals of CAH screening are early detection of the severe, salt-wasting form, therefore prevention of adrenal crisis or death, early detection of the simple virilizing form, and prevention or shortening of the period of incorrect gender assignment in females. Methodological problems of false-positive samples, especially in pre-term infants, can be corrected by adapting the cutoff values for 17-OHP to birth weight, gestational age and age at the time of collection and by performing a second tier screening. Despite a positive voting for newborn CAH screening by the European Society for Pediatric Endocrinology and the Lawson Wilkins Pediatric Endocrine Society, it is obvious that the acceptance of CAH screening varies worldwide.

RESUMO Introdução Os potenciais evocados auditivos são respostas elétricas que ocorrem nas vias auditivas centrais, resultantes de estimulação acústica. O uso de estímulos de fala para eliciar a resposta desses potenciais possibilita a compreensão de informações sobre codificação e decodificação da fala no sistema nervoso central. Objetivo Comparar o resultado do potencial evocado auditivo de latência longa com dois diferentes estímulos de fala. Métodos Participaram do estudo 30 escolares saudáveis, de ambos os sexos, com idade entre 8 e 12 anos. Para os potenciais evocados auditivos, foram utilizados dois diferentes estímulos de fala para a discriminação auditiva: Teste 1 /ba/ x /da/ e Teste 2 /pa/ x /da/. Os estímulos foram aleatoriamente apresentados, sendo 20% raros e 80% frequentes. Os escolares participaram de uma tarefa auditiva ativa e disseram [da] para identificar os estímulos raros. A normalidade dos dados foi determinada utilizando o teste de Shapiro-Wilk. Para comparar ...

Introduction: The middle-latency auditory evoked potential is used to evaluate any abnormality that might impair the central auditory pathways, which are situated between the brain stem and the primary auditory cortex. Objective: To analyse the middle-latency auditory evoked potentials in children. Methods: This is a descriptive and cross-sectional study. Pure-tone audiometry was performed, and if no change was detected, Biologic’s portable Evoked Potential System (EP) was used to measure auditory evoked potentials. The identification of the responses was performed using electrodes positioned at C3 and C4 (left and right hemispheres) in reference to ears A1 and A2 (left and right earlobe). These were ipsilaterally and contralaterally paired and landed at Fpz (forehead), in two steps, with alternating stimulation of the right and left ears. Results: In this study, there was 100% detectability of the Na, Pa, and Nb components and interamplitude Na–Pa. This study compared different ele...

Purpose: to analyze the socioeconomic and demographic aspects of the mothers attended to a newborn hearing screening program. Methods: the data came from a database of newborn hearing screening program. Participated in this study, 2476 mothers, whose neonates and infants were seen in this program, from an university hospital, during the years of 2007, 2008, and 2009. Results: among the analyzed variable, it was observed that 65,1% of the mothers aged between 20 and 34 years-old, and 67,5% were married. From de socioeconomic variables, it is observed that 36,2% mothers did not finished the medium grade, 56,4% were housekeepers and 96,7% had their babies in public maternities. Conclusion: from these results, it can be seen that there is some socioeconomic and demographic characteristics considered unfavorable to good health, especially if one talks about newborns and infants. Those conditions can lead to risk indicators for hearing loss, and should be taken in account when implementin...

Globally, unidentified hearing loss is the largest and most significant childhood disability impacting on development. Of the babies born annually with hearing loss, 90% come from developing countries. Less than 2.5% of these babies will get hearing aids and less than 10% will ever have access to early intervention. With the dearth of services available to this largely marginalized paediatric community, the EHDI pathway has been established with significant buy in from the World Bank, WHO and UNESCO. This paper will explore the EHDI pathway and how it is currently being implemented in the developing world.