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Tarnovsky YC, Taiber S, Nissan Y, Boonman A, Assaf Y, Wilkinson GS, Avraham KB, Yovel Y. Bats experience age-related hearing loss (presbycusis). Life Sci Alliance 2023; 6:e202201847. [PMID: 36997281 PMCID: PMC10067528 DOI: 10.26508/lsa.202201847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 04/01/2023] Open
Abstract
Hearing loss is a hallmark of aging, typically initially affecting the higher frequencies. In echolocating bats, the ability to discern high frequencies is essential. However, nothing is known about age-related hearing loss in bats, and they are often assumed to be immune to it. We tested the hearing of 47 wild Egyptian fruit bats by recording their auditory brainstem response and cochlear microphonics, and we also assessed the cochlear histology in four of these bats. We used the bats' DNA methylation profile to evaluate their age and found that bats exhibit age-related hearing loss, with more prominent deterioration at the higher frequencies. The rate of the deterioration was ∼1 dB per year, comparable to the hearing loss observed in humans. Assessing the noise in the fruit bat roost revealed that these bats are exposed to continuous immense noise-mostly of social vocalizations-supporting the assumption that bats might be partially resistant to loud noise. Thus, in contrast to previous assumptions, our results suggest that bats constitute a model animal for the study of age-related hearing loss.
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Affiliation(s)
- Yifat Chaya Tarnovsky
- School of Neurobiology, Biochemistry, and Biophysics, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
- School of Zoology, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Shahar Taiber
- School of Neurobiology, Biochemistry, and Biophysics, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
- Department of Human Molecular Genetics and Biochemistry, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yomiran Nissan
- School of Zoology, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Arjan Boonman
- School of Zoology, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Yaniv Assaf
- School of Neurobiology, Biochemistry, and Biophysics, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | | | - Karen B Avraham
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Human Molecular Genetics and Biochemistry, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yossi Yovel
- School of Zoology, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- School of Mechanical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
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Urfali S, Urfali B, Sarac ET, Koyuncu O. Safety and Complications of Sedation Anesthesia during Pediatric Auditory Brainstem Response Testing. ORL J Otorhinolaryngol Relat Spec 2021; 84:188-192. [PMID: 34252904 DOI: 10.1159/000517156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/10/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The auditory brainstem response (ABR) test has been widely used in childhood. Although it is a painless procedure, sedation can be needed in pediatric patients. Thus, this study aimed to evaluate safety and complications of sedation anesthesia applied in pediatric patients during ABR testing. METHODS Medical records of 75 children who underwent ABR testing between 2018 and 2020 were evaluated retrospectively in terms of applicability, safety, and complications of sedation anesthesia. RESULTS The ages ranged from 3 to 9 (mean 6.2) years. Comorbidity was detected in 20% (n = 15); 3 had multiple comorbidities, and the most common comorbidity was Down syndrome (4%). The drugs used in sedation anesthesia were midazolam in 81.3% (n = 61), a combination of propofol and ketamine in 14.7% (n = 11), and only propofol in 4% (n = 3) of the patients. An additional drug use was needed in 44% (n = 33). The mean procedure time was 40 (range 30-55) min. The mean anesthesia duration was 45 (range 35-60) min. The mean recovery time was 10 (range 5-15) min. Complications related to anesthesia developed in 4 (5.33%) of the patients; respiratory distress, agitation, cough, and nausea-vomiting were seen in one of the patients, respectively. Complications like bradycardia and respiratory or cardiac arrest were not seen at all. CONCLUSIONS The complication rate of sedation anesthesia performed during ABR testing of pediatric patients is quite low. It may be more beneficial to use combinations of sedation drugs instead of using a single sedation drug. Although sedation anesthesia appears to be safe in general, the potentially life-threatening complications of sedative agents should be remembered, especially in children who have comorbidities.
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Affiliation(s)
- Senem Urfali
- Department of Anesthesiology and Reanimation, Tayfur Ata Sökmen Faculty of Medicine, Hatay Mustafa Kemal University, Antakya, Turkey
| | - Boran Urfali
- Department of Neurosurgery, Tayfur Ata Sökmen Faculty of Medicine, Hatay Mustafa Kemal University, Antakya, Turkey
| | - Elif Tugba Sarac
- Department of Audiology, Tayfur Ata Sökmen Faculty of Medicine, Hatay Mustafa Kemal University, Antakya, Turkey
| | - Onur Koyuncu
- Department of Anesthesiology and Reanimation, Tayfur Ata Sökmen Faculty of Medicine, Hatay Mustafa Kemal University, Antakya, Turkey
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Levit Y, Mandel D, Matot I. Frequency-specific auditory brainstem response testing with age-appropriate sedation. Int J Pediatr Otorhinolaryngol 2018; 108:73-79. [PMID: 29605369 DOI: 10.1016/j.ijporl.2018.02.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 02/13/2018] [Accepted: 02/14/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Auditory brainstem response (ABR) testing is the gold-standard procedure for hearing evaluation in pediatric patients who cannot complete a behavioral hearing test. The amount of audiological information obtained depends on the quality of the patient's sleep during the test. In this retrospective database review, we aimed to assess the amount and the characteristics of the audiological information obtained in ABR testing in pediatric patients with age-appropriate sedation. METHODS A retrospective chart review was conducted on 501 consecutive ABR sedation sessions performed between January 2014 and June 2016 at the Tel Aviv Medical Center. Oral triclofos was used for the sedation of younger patients (3-24 months) and intravenous propofol for older patients (>24 months). The dataset included 370 triclofos sessions (in 337 patients) and 131 propofol sessions (in 126 patients). RESULTS None of the children developed complications, and all were discharged on the same day of the evaluation. Among the hearing-impaired children, a mean of 10 (1.8 SD) ABR threshold measurements was obtained from propofol-sedated patients and 9.4 (2.8 SD) measurements from those sedated with triclofos (P = 0.039). The major characteristics of the hearing loss, including its degree, type, and configuration, were obtained from all propofol-sedated patients and from 95% of those sedated with triclofos. CONCLUSIONS A comprehensive evaluation of hearing status can be obtained in ABR testing with age-appropriate sedation. An average number of ∼10 threshold measurements were obtained during ABR testing with age-appropriate sedation, thus allowing for the evaluation of the degree, type and configuration of the hearing loss.
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Affiliation(s)
- Yael Levit
- Hearing Clinic, Ear, Nose and Throat Department, Tel Aviv Medical Center, Tel Aviv, Israel.
| | - Dror Mandel
- Neonatology, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Idit Matot
- Anesthesia, Pain and Intensive Care Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Casteil L, Viquesnel A, Favier V, Guignard N, Blanchet C, Mondain M. Study of the efficacy of melatonin for auditory brainstem response (ABR) testing in children. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:373-375. [DOI: 10.1016/j.anorl.2017.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Stephen MCS, Mathew J, Varghese AM, Kurien M, Mathew GA. A Randomized Controlled Trial Comparing Intranasal Midazolam and Chloral Hydrate for Procedural Sedation in Children. Otolaryngol Head Neck Surg 2015; 153:1042-50. [DOI: 10.1177/0194599815599381] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 07/16/2015] [Indexed: 11/17/2022]
Abstract
Objectives To evaluate the efficacy and safety of intranasal midazolam and chloral hydrate syrup for procedural sedation in children. Study Design Prospective randomized placebo-controlled trial (double blind, double dummy). Setting Tertiary care hospital over 18 months. Subjects and Methods Eighty-two children, 1 to 6 years old, undergoing auditory brainstem response testing were randomized to receive either intranasal midazolam with oral placebo or chloral hydrate syrup with placebo nasal spray. Intranasal midazolam was delivered at 0.5 mg/kg (100 mcg per spray) and oral syrup at 50 mg/kg. Children not sedated at 30 minutes had a second dose at half the initial dose. The primary outcomes measured were safety and efficacy. Secondary outcomes were time to onset of sedation, parental separation, nature of parental separation, parental satisfaction, audiologist’s satisfaction, time to recovery, and number of attempts. Results Forty-one children were in each group, and no major adverse events were noted. The chloral hydrate group showed earlier onset of sedation (66%) compared with the intranasal midazolam group (33%). Significant difference in time to recovery was noted in the chloral hydrate group (78 minutes) versus the intranasal midazolam group (108 minutes). The parents’ and audiologist’s satisfaction was higher for chloral hydrate (95% and 75%) than for intranasal midazolam (49% and 29%, respectively). Overall, sedation was 95% with chloral hydrate versus 51% with intranasal midazolam. Both drugs maintained sedation. Conclusions Intranasal midazolam and chloral hydrate are both safe and efficacious for pediatric procedural sedation. Chloral hydrate was superior to intranasal midazolam, with an earlier time to onset of sedation, a faster recovery, better satisfaction among parents and the audiologist, and successful sedation.
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Affiliation(s)
| | - John Mathew
- Department of Otolaryngology, Speech, and Hearing, Christian Medical College, Vellore, India
| | - Ajoy Mathew Varghese
- Department of Otolaryngology, Speech, and Hearing, Christian Medical College, Vellore, India
| | - Mary Kurien
- Department of Otolaryngology, Speech, and Hearing, Christian Medical College, Vellore, India
| | - George Ani Mathew
- Department of Otolaryngology, Speech, and Hearing, Christian Medical College, Vellore, India
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Soleimanpour H, Mahmoodpoor A, Eftekhari Milani F, Shahsavari Nia K, Mehdizadeh Esfanjani R, Safari S. Effectiveness of oral ketamine, midazolam, and atropine cocktail versus oral diphenhydramine for pediatric sedation in the emergency department. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e21366. [PMID: 25593736 PMCID: PMC4270670 DOI: 10.5812/ircmj.21366] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 08/06/2014] [Accepted: 08/18/2014] [Indexed: 11/16/2022]
Abstract
Background: Sedation is a condition of reduced level of consciousness (LOC) for a patient that is created to decrease irritability, anxiety, and restlessness. Objectives: In this study, we compared the sedative effect of oral administration of ketamine, midazolam, and atropine cocktail with diphenhydramine in the referent children to the emergency department. Patients and Methods: Based on the double-blind randomized clinical trial in this investigation, 80 children, who needed to repair their wounds with suture were randomly divided into two groups: group 1 and group 2, who have received oral diphenhydramine and oral ketamine, midazolam, and atropine cocktail, respectively. Behavioral changes were collected and recorded before, during intervention and two weeks after intervention. Statistical data were analyzed by SPSS-16 software and chi-square and Mann-Whitney U tests were employed to study the relations among variables. P < 0.05 was considered statistically significant. Results: There was no significant difference between two groups in terms of drug acceptance and anxiety degree in children before intervention. Group 2 had achieved better and deeper sedation than group 1 during 45-minute post-medication (P < 0.05, P = 0.01). Regarding pediatric general behavior such as crying or interruptive moves, there was also a significant statistical difference between group 2 and group 1 (P = 0.009) based on Houpt Classification. The mean recovery times in groups 1 and 2 were 34.37 ± 14.23 min and 27.25 ± 5.14 min, respectively (P = 0.003). In terms of behavioral changes, the rate of cumulative frequency was computed for behavioral changes two weeks after the discharge from emergency department in which there were less behavioral changes in group 2 than in group 1 (P = 0.04). Conclusions: Oral administration of ketamine, midazolam, and atropine cocktail induces better sedation than diphenhydramine with respect to its limited mood changes in children, who need a medical procedure at emergency department.
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Affiliation(s)
- Hassan Soleimanpour
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Ata Mahmoodpoor
- Anesthesiology Research Team, Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | | | - Kavous Shahsavari Nia
- Emergency Medicine Department, Tabriz University of Medical Sciences, Daneshgah Street, Tabriz, IR Iran
| | | | - Saeid Safari
- Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Saeid Safari, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2166509059, Fax: +98-2166515758, E-mail:
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