ABSTRACT
BACKGROUND: Ototoxicity is a side effect of drugs and medications that usually leads to bilateral and symmetric sensorineural hearing loss that commonly affects the high-frequency range initially, with or preceded by tinnitus. Possible ototoxic side effects of calcineurin inhibitor immunosuppressants have been suggested, but this remains unclear. Therefore, this study aims to evaluate audiological changes in patients undergoing transplantation receiving immunosuppressive treatment with calcineurin inhibitors. METHODS: Prospective cohort study. Adult patients undergoing liver or kidney transplantation treated with calcineurin inhibitors were included. Pure-tone audiometry, distortion product otoacoustic emissions, and the Tinnitus Handicap Inventory questionnaire were completed at baseline, one, three, and six months after transplantation. Hearing thresholds were compared and correlated with plasma concentrations of calcineurin inhibitors. RESULTS: Seventeen patients were included, 59% males, with a median age of 54.7 years (29-68 years). Twelve patients underwent liver transplantation, four underwent kidney transplantation, and one patient underwent both. The medianfollow-up was 5.8 months (4-8 months). Significant pure-tone average shifts were observed in two patients. Both cases presented fluctuations in their hearing levels, which were not bilateral or symmetrical and affected the higher frequencies. All patients received tacrolimus within the therapeutic range during the follow-up period. Three different patients exceeded the expected range once; however, they were rapidly corrected and did not correlate with any changes in hearing. CONCLUSIONS: It appears that tacrolimus does not cause hearing loss when levels are within the therapeutic range for a follow-up period of six months post-transplantation.
Subject(s)
Audiometry, Pure-Tone , Calcineurin Inhibitors , Immunosuppressive Agents , Kidney Transplantation , Liver Transplantation , Ototoxicity , Humans , Male , Middle Aged , Female , Adult , Calcineurin Inhibitors/adverse effects , Immunosuppressive Agents/adverse effects , Prospective Studies , Aged , Follow-Up Studies , Tacrolimus/adverse effects , Hearing Loss, Sensorineural/chemically induced , Time FactorsABSTRACT
OBJECTIVES/HYPOTHESIS: To determine the prevalence and associated risk factors of voice disorders in healthcare workers of high-risk hospital care units during the 2019 coronavirus disease (COVID-19) pandemic. STUDY DESIGN: Cross-sectional study. METHODS: Questionnaire survey to healthcare personnel of COVID-19 high-risk hospital units was conducted, regarding demographic data, clinical activity, the pattern of usage of personal protective equipment, medical and vocal history, vocal symptoms, and Spanish validated Voice Handicap Index (VHI)-10 questionnaire. RESULTS: A total of 221 healthcare workers answered the survey. Nearly 33% of them reported having trouble with their voice during the last month, and 26.24% had an abnormal score in the Spanish validated VHI-10 questionnaire. The mean VHI-10 score was 7.92 (95% confidence interval 6.98-8.85). The number of working hours, the number of hours of mask daily use, simultaneous surgical and self-filtering mask use, and working in intermediate or intensive care units were independent variables significantly associated with a higher VHI-10 score. CONCLUSIONS: Healthcare workers of high-risk hospital care units during the universal masking COVID-19 pandemic are at risk of voice disorders. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E1227-E1233, 2021.
Subject(s)
COVID-19/prevention & control , Health Personnel/statistics & numerical data , Occupational Diseases/epidemiology , Voice Disorders/diagnosis , Voice Disorders/epidemiology , Adult , COVID-19/epidemiology , COVID-19/transmission , Cross-Sectional Studies , Female , Humans , Male , Personal Protective Equipment , Prevalence , Risk Factors , Surveys and QuestionnairesABSTRACT
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