Efficacy of Sound Therapy for Tinnitus Using an Enriched Acoustic Environment with Hearing-Loss Matched Broadband Noise

Background: Tinnitus is a rather heterogeneous chronic condition/disorder which is difficult to treat. Some tinnitus treatments combine sound therapy with counselling. The main goal of this study is to report the efficacy of a customized sound therapy combined with counselling on a cohort of 83 tinnitus patients. Methods: 119 tinnitus subjects, recruited between January 2018 and June 2021, were subjected to a treatment consisting of a combination of an initial counselling session and four-month sound therapy. The sound stimulus was a personalized broadband noise colored by the audiometry of the subjects. These stimuli were given to the patients in mp3 format to be heard 1 h per day over 4 months. The tinnitus severity of the patients was evaluated monthly through the validated Spanish version of the Tinnitus Handicap Inventory. Results: Of the patients, 30% (36 of 119) withdrew from the treatment before finishing, and 96% (80 of 83) of the subjects completing the therapy attained some relief after 4 months. The overall average THI decrease of these 80 participants was 23. However, when the THI was analyzed by severity scales, it was found that patients with initial mild, moderate, severe and catastrophic handicap had an average THI decrease of 14, 20, 31 and 42 points, respectively. Thus, the average THI decrease depended on the baseline severity scale of patients. Conclusions: Consequently, the proposed treatment was demonstrated to be effective in providing clinically relevant relief in tinnitus distress patients in just 4 months.

Incidence, progression and risk factors of age-related macular degeneration in 35–95-year-old individuals from three jointly designed German cohort studies

ObjectiveTo estimate age-related macular degeneration (AMD) incidence/progression across a wide age range.Methods and analysisAMD at baseline and follow-up (colour fundus imaging, Three Continent AMD Consortium Severity Scale, 3CACSS, clinical classification, CC) was assessed for 1513 individuals aged 35–95 years at baseline from three jointly designed population-based cohorts in Germany: Kooperative Gesundheitsforschung in der Region Augsburg (KORA-Fit, KORA-FF4) and Altersbezogene Untersuchungen zur Gesundheit der Universität Regensburg (AugUR) with 18-year, 14-year or 3-year follow-up, respectively. Baseline assessment included lifestyle, metabolic and genetic markers. We derived cumulative estimates, rates and risk factor association for: (1) incident early AMD, (2) incident late AMD among no AMD at baseline (definition 1), (3) incident late AMD among no/early AMD at baseline (definition 2), (4) progression from early to late AMD.ResultsIncidence/progression increased by age, except progression in 70+-year old. We observed 35–55-year-old with 3CACSS-based early AMD who progressed to late AMD. Predominant risk factor for incident late AMD definition 2 was early AMD followed by genetics and smoking. When separating incident late AMD definition 1 from progression (instead of combined as incident late AMD definition 2), estimates help judge an individual’s risk based on age and (3CACSS) early AMD status: for example, for a 65-year old, 3-year late AMD risk with no or early AMD is 0.5% or 7%, 3-year early AMD risk is 3%; for an 85-year old, these numbers are 0.5%, 21%, 12%, respectively. For CC-based ‘early/intermediate’ AMD, incidence was higher, but progression was lower.ConclusionWe provide a practical guide for AMD risk for ophthalmology practice and healthcare management and document a late AMD risk for individuals aged <55 years.

Relaksasi Benson Dengan Masalah Kelelahan Pada Pasien Gagal Jantung di Rumah Sakit Islam Jakarta Cempaka Putih Jakarta Pusat Tahun 2020

Relaksasi benson merupakan pengembangan metode respon relaksasi dengan melibatkan faktor keyakinan pasien, yang dapat menciptakan suatu lingkungan internal sehingga dapat membantu pasien mencapai kondisi kesehatan dan kesejahteraan lebih tinggi. Subyek intervensi pada pasien dengan gagal jantung dilakukan intervensi relaksasi benson selama 3 hari sebanyak 2 kali pada Pagi dan Sore hari. Evaluasi dilakukan dengan pre dan post perlakuan dengan cara menjawab pertanyaan langsung di kuisioner fatique severity scale (FSS) yang bersisi 9 pertanyaan/pernyataan. Jumlah total responden 60 pasien terdiri dari kelompok intervensi sebanyak 30 responden dan kelompok kontrol 30 responden Hasil penerapan ini menggambarkan bahwa sesudah dilakukan relaksasi benson dapat mempengaruhi penurunan tingkat kelelahan pada pasien gagal jantung dengan nilai p value (nilai p 0,000) dan pada kelompok kontrol tidak mengalami perubahan dengan nilai p value (nilai p = 0,073) Kata Kunci: relaksasi benson, kelelahan

Diabetic Retinopathy Improved Detection Using Deep Learning

Diabetes is a disease that occurs when the body presents an uncontrolled level of glucose that is capable of damaging the retina, leading to permanent damage of the eyes or vision loss. When diabetes affects the eyes, it is known as diabetic retinopathy, which became a global medical problem among elderly people. The fundus oculi technique involves observing the eyeball to diagnose or check the pathology evolution. In this work, we implement a convolutional neural network model to process a fundus oculi image to recognize the eyeball structure and determine the presence of diabetic retinopathy. The model’s parameters are optimized using the transfer-learning methodology for mapping an image with the corresponding label. The model training and testing are performed with a dataset of medical fundus oculi images and a pathology severity scale present in the eyeball as labels. The severity scale separates the images into five classes, from a healthy eyeball to a proliferative diabetic retinopathy presence. The latter is probably a blind patient. Our proposal presented an accuracy of 97.78%, allowing for the confident prediction of diabetic retinopathy in fundus oculi images.

A Systematic Review and Meta-Analysis of the Effects of Herbal Medicine Buyang Huanwu Tang in Patients with Poststroke Fatigue

Poststroke fatigue (PSF) is reported to occur in 30%–72% of all patients with stroke. PSF not only is a symptom of stroke but has also been reported to adversely affect the prognosis of patients with stroke. However, no treatment has had a significant effect on PSF. In East Asian countries, several herbal medicines have been used to treat stroke, with Buyang Huanwu Tang (BHT) being the most common. This review aimed to evaluate the efficacy and safety of BHT for PSF. A literature search was conducted on MEDLINE, CENTRAL, Scopus, CiNii, CNKI, OASIS, NDSL, and KTKP databases for randomized controlled trials that evaluated the effects and safety of BHT on PSF. Six studies (n = 427) were included. The overall methodological quality of these studies was relatively low. In the adjunctive BHT group, the meta-analysis indicated statistically significant improvements in the Fatigue Severity Scale score (mean difference −1.49, 95% CI [−2.25, −0.73]) and total clinical efficacy rate (risk ratio 0.11, 95% CI [0.03, 0.41]) compared to those in the nonherbal group. Adverse events were only reported in one study, and no serious adverse events occurred. BHT administration might be effective in the treatment of PSF. We were unable to draw definitive conclusions owing to the limitations of the included studies. The trial is registered with CRD42019130178 in PROSPERO.

The effects ofcombined diamond microdermabrasion and a mixture of cosmetic acids on the condition of acne prone skin: a case report

Background: Exfoliating treatments are widely used in cosmetology and dermatology forthe treatment of skin lesions and, above all, toreduce the number of skin eruptions that occur with acne vulgaris. An effective treatment that can be offered to people suffering from this disease is diamond microdermabrasion. The addition of acid peeling to this treatment may lead to even better results than in the case of monotherapy. Aim of the study: To assess the effectiveness of a combination of microdermabrasion and acid peeling on a 21-year-old woman suffering from acne vulgaris. Case report: The patient suffered from acne vulgaris, too high a level of sebum on the entire surface of the face, and, over the course of the disease, developed open and closed blackheads and inflammatory pustules. The sebum level was measured with a DermaUnitSCC3 device and the number of skin eruptions was determined using the global acne severity scale (GAGS). Conclusion: The series of cosmetological treatments led to a reduction in the sebum on the surface of the epidermis and the number of skin eruptions.

Convalescent plasma for outpatients with early COVID-19

BackgroundConvalescent plasma (CP) for hospitalized patients with COVID-19 has not demonstrated clear benefits. However, data on outpatients with early symptoms are scarce. We aimed to assess whether treatment with CP administered during the first 7 days of symptoms reduced the disease progression or risk of hospitalization of outpatients.MethodsTwo double-blind randomized trials (NCT04621123, NCT04589949) were merged with data pooling starting when <20% of their predefined sample size had been recruited. A Bayesian adaptive individual patient data meta-analysis was implemented. Analyses were done with Bayesian proportional odds and logistic models, where odds ratios (OR)<1.0 indicate a favorable outcome for CP. Fourteen study sites across the Netherlands and Catalonia in Spain participated in the trial. The two studies included outpatients aged ≥50 years and diagnosed with COVID-19 and symptomatic for ≤7days. The intervention consisted of one unit (200-300mL) of CP with a predefined minimum level of antibodies. The two primary endpoints were (a) a 5-point disease severity scale (fully recovered by day 7 or not, hospital or ICU admission and death) and (b) a composite of hospitalization or death.ResultsOf 797 patients included, 390 received CP and 392 placebo. At baseline, they had a median age of 58 years, 1 comorbidity, symptoms for 5 days and 93% tested negative for SARS-CoV-2 S-protein IgG antibodies. Seventy-four patients were hospitalized, 6 required mechanical ventilation and 3 died. The OR of CP for an improved disease severity scale was 0.936 (credible interval (CI) 0.667-1.311). The OR for hospitalization or death was 0.919 (CI 0.592-1.416). The effect of CP on hospital admission or death was largest in patients with ≤5 days of symptoms (OR 0.658, 95% CI 0.394-1.085). CP did not decrease the time to full symptom resolution (p=0.62).ConclusionTreatment with CP of outpatients in the first 7 days of symptoms did not improve the outcome of COVID-19. The possible beneficial effect in patients with ≤5 days of symptoms requires further study.RegistrationNCT04621123 and NCT04589949 on https://www.clinicaltrials.govFunding sourceZONMW, the Netherlands, grant number 10430062010001.SUPPORT-E, grant number 101015756YoMeCorono, www.tomecorono.comThe Fight AIDS and Infectious Diseases Foundation with funding from the pharmaceutical company Grifols S.A