Avoidant/Restrictive Food Intake Disorder in an 11-Year Old South American Boy: Medical and Cultural Challenges.

Avoidant/Restrictive Food Intake Disorder (ARFID) is new in the DSM-5, replacing the DSM-IV-TR diagnosis of Feeding Disorder of Infancy or Early Childhood. ARFID has no age criterion, and therefore addresses eating disturbances across the lifespan. This report illustrates the case of an 11-year-old boy of Colombian ancestry with ARFID and explores the role of culture in the diagnosis of ARFID. To date, literature describing this disorder is limited. ARFID is often seen in the child and adolescent population and can have significant medical consequences, including weight loss, hemodynamic instability, and growth retardation. Studies examining the potential cultural challenges of diagnosing and treating ARFID would benefit patients, as well as health professionals working in primary care, pediatrics, and psychiatry. This paper is intended to inform the reader about this multifaceted disorder, and to generate interest for future research.

Le trouble d'alimentation sélective et/ou d'évitement (TASE) est nouveau dans le DSM-5, et remplace le diagnostic du trouble de l'alimentation de la première ou de la deuxième enfance du DSM-IV-TR. Le TASE n'a pas de critères d'âge et englobe donc les troubles d'alimentation de durée de vie. Cet article illustre le cas d'un garçon de 11 ans d'origine colombienne souffrant du TASE et explore le rôle de la culture dans le diagnostic du TASE. À ce jour, la littérature décrivant ce trouble est limitée. Le TASE est fréquent dans la population des enfants et des adolescents et peut avoir des conséquences médicales significatives, notamment la perte de poids, l'instabilité hémodynamique, et un retard de croissance. Des études qui examineraient les problèmes culturels potentiels du diagnostic et du traitement du TASE seraient bénéfiques pour les parents et pour les professionnels de la santé des soins de première ligne, de la pédiatrie et de la psychiatrie. Cet article vise à éclairer le lecteur sur ce trouble multi dimensionnel, et à susciter un intérêt pour une future recherche.

Eye color as a risk factor for acquired sensorineural hearing loss: a review.

Eye color may be an indicator of inner ear melanin content and has been associated with hearing loss. There is controversy as to whether eye color has an effect on acquired causes of sensorineural hearing loss. This review was conducted to analyze the literature evaluating the relationship between eye color and causes of sensorineural hearing loss. Six databases were searched to identify eligible studies. Included articles were independently assessed for quality by two authors. Eighteen articles were eligible for review. Eye color was not found to have an effect in the non-exposed population or in presbycusis. In noise-induced sensorineural hearing loss, light-eyed patients had more significant loss following noise exposure, although the variability reported due to eye color was modest (r(2) = 0.01-0.14). Two out of three studies reported that dark eye color is associated with cisplatin ototoxicity. In one study, green-eyed patients were found to be at higher risk of radiation-induced hearing loss. Eye color does not appear to play a role in hearing loss in non-exposed individuals or presbycusis. It is possible that dark-eyed individuals, with greater inner ear melanin content, are better protected against noise-induced hearing loss. Evidence suggests that melanin can be protective against radiation-induced sensorineural hearing loss, but may predispose individuals to cisplatin ototoxicity. Future studies are required to support these conclusions.

Assessment of ototoxicity of intratympanic administration of Auralgan in a chinchilla animal model.

OBJECTIVES/HYPOTHESIS: Auralgan (benzocaine and antipyrine) is an over-the-counter otic drug commonly used for otalgia. Nevertheless, there is limited evidence about the effects of the drug on hearing function and cochlear morphology in the presence of a tympanic membrane perforation. The aim of the present study was to assess the cytotoxicity of Auralgan using cultured auditory cells (HEI-OC1) and to examine its effects on hearing function and cochlear morphology after intratympanic administration in a chinchilla model. STUDY DESIGN: Animal experiment. METHODS: Cell viability and DNA labeling assays were conducted to investigate the cytotoxic effect of the drug on cultured auditory cells (HEI-OC1). To examine the possible drug ototoxic effect in vivo, chinchillas received intratympanic injection of Auralgan in one ear, whereas the contralateral control ear received saline. Outcome measures included auditory brainstem response and postmortem cochlear morphology. RESULTS: A dose-dependent toxic effect of Auralgan was noted on cultured cells. Animal experiments showed an inflammatory reaction in the experimental ears and facial paralysis in 80% of the animals on the side receiving transtympanic injection of Auralgan (P < .05). Auditory brainstem response testing demonstrated a 30- to 50-dB hearing threshold shift across all frequencies tested (P < .05). Control ears showed no inflammation or significant threshold shift. Microscopy showed damage to the hair cells and stria vascularis with bleeding in the perilymphatic space in the experimental ears and damage to the hair cells. CONCLUSIONS: Auralgan was cytotoxic to cultured auditory cells. It promoted an inflammatory reaction and seemed to be ototoxic when given via transtympanic injection in an animal model. LEVEL OF EVIDENCE: NA