Impact of treatment with inhaled corticosteroids on bone mineral density of patients with asthma: related with age.

UNLABELLED: The effect of inhaled corticosteroid on bone mineral density (BMD) was investigated in 44 asthmatic patients after median treatment duration of 6.5 years. Compared with controls, BMD decreased only in patients aged <50 years in both the spine (11.3 %, p = 0.013) and hip (8.8 %, p = 0.044), whereas in patients ≥50 years BMD did not decrease significantly. INTRODUCTION: The results of studies which addressed the impact of inhaled corticosteroid (ICS) therapy on BMD of patients with asthma are conflicting. This case-control study aimed to compare BMD status in ICS user with asthma with healthy controls according to age. METHODS: BMD at the lumbar spine (LS), femoral neck (FN) was measured by dual energy X-ray absorptiometry (DEXA). Patients and controls were compared according to BMD gr/cm(2), BMD T-score, BMD Z-score, frequency of osteoporosis (defined as BMD T-score ≤-2.5), and frequency of patients with BMD Z-score <-1 at LS and FN with regard to age <50 and ≥50 years old. RESULTS: Forty-four ICS user patients (females 63.6 %) with median treatment duration of 6.5 years and 50 controls (females, 69.4 %) with respective mean age of 49.2 ± 9.5 and 47.4 ± 10.5 years (p = 0.38 and p = 0.35) entered the study. Overall LS-BMD and FN-BMD gr/cm2 in total patients were lower than in controls by 6 % (p = 0.065) and 5.9 % (p = 0.09), respectively. In patients <50 years, mean LS-BMD gr/cm(2) was lower than controls by 11.3 % (p = 0.013) and FN-BMD by 8.8 % (p = 0.044). Mean BMD T-score and BMD Z-score in both measurement sites were also lower than controls (p = 0.013 and 0.01, respectively. Frequency of osteoporosis did not differ but frequency of patients with BMD Z-score <-1 was significantly higher in patients (odds ratio (OR) = 6.57 95 % CI, 1.8-23.9, p = 0.004). In age group ≥50 years old, reduction of BMD in both measurement sites did not reach to a significant level. CONCLUSION: This study indicates that BMD reduction in ICS user with asthma is dependent on age and appears that younger patients are at greater risk of BMD loss. These findings suggest preventive measures particularly in patients <50 years.

Auditory screening in infants for early detection of permanent hearing loss in northern iran.

BACKGROUND: Undiagnosed hearing loss can cause disorders in speech and language and delay in social and emotional development. AIM: This study aimed to screen for hearing loss in all newborns born in Babol city during 2009-2011. SUBJECTS AND METHODS: Fifteen thousand one hundred and sixty-five newborns (49% [7430/15165] male and 51% [7735/15165] female) born during a 30-month period in Babol, underwent hearing screening by the otoacoustic emission (OAE) test at the age of 15 days. In infants referred at this stage, an auditory brainstem response (ABR) test was the next investigation. Data analyzed using Statistical Package for the Social Sciences software Version 16 (Chicago, IL, USA, 16) through descriptive statistic method. RESULTS: In the first screening stage, 10.8% (1648/15165) cases were referred to the second stage for further investigation. 9.4% (154/1648) were lost to follow-up from among the referred cases despite continuous contact and education about the importance of the problem. Among the participants in the second stage, 6.2% (92/1494) were referred to the third stage and underwent ABR and OAE testing. 14.1% (13/92) were lost at this stage. Of the remaining participants, 34.2% (27/79) were diagnosed with a hearing loss. Therefore, the incidence of hearing loss in this study was 1.8/1,000 newborns. CONCLUSION: Given the prevalence of hearing loss in this study, implementation of a universal newborn hearing screening program is recommended.