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table option to treat children with CAA for the given indication, without the drawbacks of nonsurgical devices that use pressure for retention of the audio processor or the costs and possible complications involved with a surgical alternative.
This 12-month trial of the nonsurgical adhesive BCD in CAA patients showed sufficient and reliable audiological and subjective outcomes, long wearing time, and high acceptance. The ADHEAR can be considered a suitable option to treat children with CAA for the given indication, without the drawbacks of nonsurgical devices that use pressure for retention of the audio processor or the costs and possible complications involved with a surgical alternative.
The aim of the study was to investigate into the risk factors for failure in the first-time screening test among high-risk neonates in neonatal intensive care unit (NICU) in order to further clarify the etiology of neonatal hearing impairment, thus providing insights into early prevention and intervention.
We performed automated auditory brainstem response (AABR), distortion product otoacoustic emission (DPOAE), and acoustic immittance (AI) on 2,194 high-risk neonates admitted into the NICU of Shanghai Children's Medical Center from January 2015 to December 2019, and the risk factors, including premature birth, hyperbilirubinemia, and infant respiratory distress syndrome, were analyzed retrospectively by the univariate χ2 test and multivariate stepwise logistic regression analysis.
The pass rates of AABR, DPOAE, and AI were 70.21, 78.44, and 93.12%, respectively, in 2,194 cases of high-risk neonates screened, which are significantly lower than those of healthy controls. The most common diagnoses includeich the rate of AABR was significantly lower than that of DPOAE. NRDS, NHB, LBW, revised AMA, CHD, C-section, and artificial feeding are potential risk factors of hearing impairment. The combination of different hearing screening tests is necessary for accurate diagnosis of congenital hearing disorders.
The hearing screening pass rates of high-risk neonates in the NICU were lower than those of normal neonates, among which the rate of AABR was significantly lower than that of DPOAE. NRDS, NHB, LBW, revised AMA, CHD, C-section, and artificial feeding are potential risk factors of hearing impairment. The combination of different hearing screening tests is necessary for accurate diagnosis of congenital hearing disorders.
The minor stroke concept has not been analyzed in intracerebral hemorrhage (ICH) patients. Our purpose was to determine the optimal cut point on the NIH Stroke Scale (NIHSS) for defining a minor ICH (mICH) in patients with primary ICH.
An ICH was considered minor if associated with a favorable 3-month outcome (modified Rankin Scale score ≤2). For supratentorial ICH, the discovery cohort consisted of 478 patients prospectively admitted at University Hospital del Mar. Association between NIHSS at admission and 3-month outcome was evaluated with area under the curve-receiver operating characteristics (AUC-ROC) and Youden's index to identify the optimal NIHSS cutoff point to define mICH. External validation was performed in a cohort of 242 supratentorial ICH patients from University Hospital Sant Pau. For infratentorial location, patients from both hospitals (n = 85) were analyzed together.
The best -NIHSS cutoff point defining supratentorial-mICH was 6 (AUC-ROC = 0.815 [0.774-0.857] in the discovery cohort and AUC-ROC = 0.819 [0.756-0.882] in the external validation cohort). For infratentorial ICH, the best cutoff point was 4 (AUC-ROC = 0.771 [0.664-0.877]). Using these cutoff points, 40.5% of all primary ICH cases were mICH. Of these, 70.2% were living independently at 3-month follow-up (72% for supratentorial ICH and 56.1% for infratentorial ICH) and 6.5% had died (5.3% for supratentorial ICH, and 14.6% for infratentorial ICH). For patients identified as non-mICH, good 3-month outcome was observed in 11.3% of cases; mortality was 51%.
The definition of mICH using the NIHSS cutoff point of 6 for supratentorial ICH and 4 for infratentorial ICH is useful to identify good outcome in ICH patients.
The definition of mICH using the NIHSS cutoff point of 6 for supratentorial ICH and 4 for infratentorial ICH is useful to identify good outcome in ICH patients.
Antiplatelet agents are usually discontinued to reduce hemorrhagic tendency during the acute phase of intracerebral hemorrhage (ICH). Crenolanib chemical structure However, their use after ICH remains controversial.
This study investigated the effect of antiplatelet agents in ICH survivors. We used the National Health Insurance Service-National Sample Cohort 2002-2013 database for retrospective cohort modeling, estimating the effects of antiplatelet therapy on clinical events. Subgroup analyses assessed antiplatelet medication administered before ICH.
The prescription rate of antiplatelets after ICH was also examined. Of 1,007 ICH-surviving patients, 303 subsequent clinical events were recorded, 41 recurrences of nonfatal ICH recurrence, 26 incidents of nonfatal ischemic stroke, 6 nonfatal myocardial infarctions, and 230 incidents of all-cause mortality. The use of antiplatelet therapy significantly decreased the risk of primary outcomes (adjusted hazard ratio [AHR] = 0.743, 95% confidence interval [CI] = 0.578-0.956) and all-cause mortality (AHR = 0.740, 95% CI = 0.552-0.991), especially in patients without a history of antiplatelet treatment. The use of antiplatelet medication after ICH did not significantly increase the recurrence of ICH. The prescription rate of antiplatelet therapy within 1 year was 16.6%. Among 220 patients with a history of using antiplatelet medication, the resumption rate was 0.5% at discharge, 5% after a month, 12.7% after 3 months, and 29.1% after a year.
Using antiplatelet treatment after ICH does not increase chances of recurrence, but lowers the occurrence of subsequent clinical events, especially mortality. However, the prescription and resumption rate of antiplatelet therapy after ICH remains low in South Korea.
Using antiplatelet treatment after ICH does not increase chances of recurrence, but lowers the occurrence of subsequent clinical events, especially mortality. However, the prescription and resumption rate of antiplatelet therapy after ICH remains low in South Korea.
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