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Hearing loss is the third leading cause of years lived with disability. Approximately 1.4 billion people have hearing loss, of which 80% reside in low- and middle-income countries with limited audiology and otolaryngology care available to them. The objective of this study was to estimate period prevalence of hearing loss and audiogram patterns of patients attending an otolaryngology clinic in North Central Nigeria. A 10-year retrospective cohort study was carried out analyzing 1507 patient records of pure tone audiograms of patients at the otolaryngology clinic at Jos University Teaching Hospital, Plateau State, Nigeria. Prevalence of hearing loss of moderate or higher grade increased significantly and steadily after age 60. Compared to other studies, there was a higher prevalence of overall sensorineural hearing loss (24-28% in our study compared to 1.7-8.4% globally) and higher proportions of the flat audiogram configuration among the younger age patients (40% in younger patients compared to 20% in patients older than 60 years). The higher prevalence of the flat audiogram configuration compared to other parts of the world may be suggestive of an etiology specific to this region, such as the endemic Lassa Fever and Lassa virus infection in addition to cytomegalovirus or other viral infections associated with hearing loss.
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OBJECTIVE: To identify populations of authors who post about cochlear implants (CIs) on Instagram and TikTok, to illustrate the content of these posts, and to elucidate factors that might help surgeons better educate CI patients. STUDY DESIGN: Qualitative study. SETTING: Instagram and TikTok social media platforms. PATIENTS: All public social media posts identified with the search terms below. Posts were excluded if unrelated to CIs or if written in a non-English language. INTERVENTION: Instagram and TikTok were searched for posts from March 2021 through September 2021 with the search terms #cochlearimplant, #cochlearimplants, #cochlearimplantkids, #cochlearkids, and #cochlearfamily. MAIN OUTCOME MEASURES: Posts were subclassified and analyzed for content including topics of posts, authorship, timeframe of posts, depiction of CIs, and popularity. RESULTS: Of 1,942 posts included in the final analysis, 1,400 were found on Instagram and 542 on TikTok. Authors were mostly patients (n = 771, 39.7%), companies (n = 568, 29.2%), and patients' family members (n = 482, 24.8%). Only 21 posts were made by physicians (1.1%). Out of 379 total educational posts examined, patients themselves were the most common authors (n = 219, 57.8%) followed by patients' family members (n = 139, 36.7%). Physicians authored only a small fraction of all educational posts (n = 19, 5.0%). CONCLUSIONS: This study showed minimal physician involvement in the CI social media spheres of Instagram and TikTok. In addition, there were few educational posts on either platform, revealing ample opportunity for physicians to become more involved with CI social media.
Assuntos
Mídias Sociais , Cirurgiões , HumanosRESUMO
Combined large cell neuroendocrine carcinoma (LCNEC) and squamous cell carcinoma (SCC) of the H&N are exceptionally rare. We present the case of combined p16 negative SCC and LCNEC of the oropharynx treated with combination chemotherapy. This is the third reported case of combined neuroendocrine carcinoma and SCC of the oropharynx.
RESUMO
Low-vision rehabilitation (LVR) has significant benefit in improving the quality of life of visually impaired patients. However, these services are highly underutilized in ophthalmology practices. A quality improvement study was performed to investigate barriers to LVR services for patients at the University of Texas Medical Branch (UTMB) between 2010 and 2020. Low vision was defined as the best corrected visual acuity of 20/70 or worse in the better-seeing eye or a visual field less than 20 degrees. Potential subjects were screened (n = 577) from the electronic medical record using International Classification of Disease (ICD) codes for legal blindness, impaired vision, and low vision. Chart review identified 190 subjects who met criteria for low-vision analysis. Patients who received LVR referrals to attend at least one LVR service visit from the eligible subjects were contacted for participation in phone interviews regarding their LVR experience. Practicing eye care providers (ECPs) at UTMB completed a questionnaire to capture their referral patterns. Of the eligible subjects, 64% were referred to LVR services by ECPs. Reported patient barriers included mental health issues (76%), denial of need for low-vision aid (71%), poor physical health (67%), lack of transportation (57.1%), and lack of referrals (36%). EPCs reported patient's overall health (67%), older age (44%), lack of social support (44%), poor cognitive function (44%), and low likelihood of follow-up (44%) as barriers to referring patients to LVR. This study identified several modifiable barriers that can be addressed to access LVR services for low-vision patients. Changing referral patterns, eliminating variations in referral criteria, and increasing patient awareness and knowledge of LVR resources may tremendously improve the quality of life of low-vision patients.
