How to remove earwax at home

Earwax is the body's natural way of protecting the eardrum and inner ear from damage. However, if the body produces too much earwax, a person may experience a blockage. This can lead to hearing loss and pain. In this article, learn how to remove an earwax blockage safely at home, as well as when to see a doctor.

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How to remove earwax at home

Earwax is the body's natural way of protecting the eardrum and inner ear from damage. However, if the body produces too much earwax, a person may experience a blockage. This can lead to hearing loss and pain. In this article, learn how to remove an earwax blockage safely at home, as well as when to see a doctor.

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Sodium Thiosulfate Can Lower the Risk of Cisplatin-Induced Hearing Loss

Adding sodium thiosulfate after cisplatin chemotherapy can lower the incidence of cisplatin-induced hearing loss among children with liver cancer without jeopardizing survival, a new study found (N Engl J Med 2018;378[25]:2376). A total of 109 pediatric patients between 1 month and 18 years old were randomly assigned to receive cisplatin plus sodium thiosulfate, which was administered at a dose of 20 g per square meter intravenously over a 15-minute period and six hours after the discontinuation of cisplatin, or cisplatin alone, and their absolute hearing thresholds were measured through pure tone audiometry. Hearing loss of Brock grade 1 or higher occurred in 33 percent of the children in the cisplatin and sodium thiosulfate group, compared with 63 percent in the cisplatin-alone group, indicating a 48 percent lower incidence of hearing loss in the cisplatin and sodium thiosulfate group. At a median of 52 months of follow-up, the three-year rates of event-free survival were 82 percent in the cisplatin and sodium thiosulfate group and 79 percent in the cisplatin-alone group, and the three-year rates of overall survival were 98 percent and 92 percent, respectively.

​The administration of sodium thiosulfate was associated with a trend toward reduced ototoxicity in all the Brock grades, said the study authors in an interview with MedPage Today. "Children with hearing of grade 0 may not have completely normal hearing but can manage life with little or no additional help," they said. "The otoprotective dose of sodium thiosulfate was associated with a high sodium load, which is a factor to consider in planning treatment. Sodium thiosulfate was emetogenic despite the use of prophylactic antiemetic agents, with nausea and vomiting being common adverse events."

Published: 6/23/2018 9:34:00 AM

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Sodium Thiosulfate Can Lower the Risk of Cisplatin-Induced Hearing Loss

Adding sodium thiosulfate after cisplatin chemotherapy can lower the incidence of cisplatin-induced hearing loss among children with liver cancer without jeopardizing survival, a new study found (N Engl J Med 2018;378[25]:2376). A total of 109 pediatric patients between 1 month and 18 years old were randomly assigned to receive cisplatin plus sodium thiosulfate, which was administered at a dose of 20 g per square meter intravenously over a 15-minute period and six hours after the discontinuation of cisplatin, or cisplatin alone, and their absolute hearing thresholds were measured through pure tone audiometry. Hearing loss of Brock grade 1 or higher occurred in 33 percent of the children in the cisplatin and sodium thiosulfate group, compared with 63 percent in the cisplatin-alone group, indicating a 48 percent lower incidence of hearing loss in the cisplatin and sodium thiosulfate group. At a median of 52 months of follow-up, the three-year rates of event-free survival were 82 percent in the cisplatin and sodium thiosulfate group and 79 percent in the cisplatin-alone group, and the three-year rates of overall survival were 98 percent and 92 percent, respectively.

​The administration of sodium thiosulfate was associated with a trend toward reduced ototoxicity in all the Brock grades, said the study authors in an interview with MedPage Today. "Children with hearing of grade 0 may not have completely normal hearing but can manage life with little or no additional help," they said. "The otoprotective dose of sodium thiosulfate was associated with a high sodium load, which is a factor to consider in planning treatment. Sodium thiosulfate was emetogenic despite the use of prophylactic antiemetic agents, with nausea and vomiting being common adverse events."

Published: 6/23/2018 9:34:00 AM

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The effect of transverse prosthetic alignment changes on socket reaction moments during gait in individuals with transtibial amputation

Publication date: Available online 23 June 2018
Source:Gait & Posture
Author(s): Hiroshi Hashimto, Toshiki Kobayashi, Fan Gao, Masataka Kataoka, Michael S. Orendurff, Kuniharu Okuda
BackgroundAlignment affects gait of individuals with transtibial prostheses. Sagittal and coronal alignment changes of the transtibial prostheses were demonstrated to affect socket reaction moments. However, the effects of transverse alignment changes on the socket reaction moments are not known.Research questionThe aim of this study was to investigate the effects of transverse alignment changes on the socket reaction moments and temporal-spatial parameters of gait in transtibial prostheses.MethodsThe effects of transverse prosthetic alignment changes (i.e. 10 degrees and 5 degrees of internal and external rotations: toe-in and toe-out of the foot relative to the socket from a baseline alignment) on the sagittal and coronal socket reaction moments and temporal-spatial parameters (gait speed, cadence and step width) while walking in 9 individuals with transtibial amputation were investigated using an instrumented prosthetic pyramid adaptor and 3D motion capture system.ResultsThe transverse alignment changes demonstrated significant effects on the socket reaction moments in the coronal plane at 5% (P =  0.04), 20% (P =  0.04) and 75% (P =  0.0001) of stance phase. No significant effects were found in the socket reaction moments in the sagittal plane and the temporal-spatial parameters. The internal and external rotations of the prosthetic feet may have opposite effect in early and mid- to late-stance potentially due to changes in the spatial position of the heel (rear foot) and toe (forefoot) of the prosthetic foot relative to the socket.SignificanceTransverse alignment of the transtibial prostheses should be tuned not only considering the symmetry in toe-out angles of the feet, but also considering the potential effects of transverse alignment changes that may affect the coronal socket reaction moments.



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The effect of transverse prosthetic alignment changes on socket reaction moments during gait in individuals with transtibial amputation

Publication date: Available online 23 June 2018
Source:Gait & Posture
Author(s): Hiroshi Hashimto, Toshiki Kobayashi, Fan Gao, Masataka Kataoka, Michael S. Orendurff, Kuniharu Okuda
BackgroundAlignment affects gait of individuals with transtibial prostheses. Sagittal and coronal alignment changes of the transtibial prostheses were demonstrated to affect socket reaction moments. However, the effects of transverse alignment changes on the socket reaction moments are not known.Research questionThe aim of this study was to investigate the effects of transverse alignment changes on the socket reaction moments and temporal-spatial parameters of gait in transtibial prostheses.MethodsThe effects of transverse prosthetic alignment changes (i.e. 10 degrees and 5 degrees of internal and external rotations: toe-in and toe-out of the foot relative to the socket from a baseline alignment) on the sagittal and coronal socket reaction moments and temporal-spatial parameters (gait speed, cadence and step width) while walking in 9 individuals with transtibial amputation were investigated using an instrumented prosthetic pyramid adaptor and 3D motion capture system.ResultsThe transverse alignment changes demonstrated significant effects on the socket reaction moments in the coronal plane at 5% (P =  0.04), 20% (P =  0.04) and 75% (P =  0.0001) of stance phase. No significant effects were found in the socket reaction moments in the sagittal plane and the temporal-spatial parameters. The internal and external rotations of the prosthetic feet may have opposite effect in early and mid- to late-stance potentially due to changes in the spatial position of the heel (rear foot) and toe (forefoot) of the prosthetic foot relative to the socket.SignificanceTransverse alignment of the transtibial prostheses should be tuned not only considering the symmetry in toe-out angles of the feet, but also considering the potential effects of transverse alignment changes that may affect the coronal socket reaction moments.



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Do Personality Factors Assessed Before Cochlear Implantation Predict Hearing-Related Quality Of Life After Cochlear Implantation in Postlingually Deafened Adults?

Background: Studies have shown that cochlear implants improve deaf patients’ hearing-related quality of life (hrQoL), but the degree of improvement varies considerably between patients. This study investigated whether personality factors contribute to hrQoL outcome after cochlear implantation. Method: Fifty adult patients with postlingual hearing loss who received a unilateral cochlear implant were administered the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI; a personality inventory) and the Nijmegen Cochlear Implant Questionnaire (NCIQ; a hrQoL questionnaire). The NEO-FFI was administered only before implantation; the NCIQ was administered before implantation and 12 months after implant activation. A linear regression analysis was computed to detect whether NCIQ scores at 12 months were predicted by the NEO-FFI personality factors (i.e., Extraversion, Neuroticism, Openness to Experience, Agreeableness, and Conscientiousness) assessed before implantation. Results: HrQoL scores had significantly improved 12 months after cochlear implantation in all subdomains of the NCIQ. Of the five personality factors, solely Neuroticism was negatively associated to the NCIQ subdomain self-esteem (β = −0.34; p = 0.013) at 12 months after cochlear implantation. Conclusions: While significant improvement of hrQoL was seen 12 months after implant activation, this improvement was barely predicted by the Big-Five personality traits measured before implantation. Only Neuroticism was found to moderately influence postimplantation hrQoL in our patients, in the way that higher degrees of Neuroticism tend to go along with lower degrees of self-esteem (as conceptualized by the NCIQ). The failure to detect personality effects on hrQoL could partly be due to the low levels of Extraversion and Openness to Experience observed in our sample of patients with hearing loss. Received April 10, 2017; accepted May 4, 2018. ACKNOWLEDGMENTS: The authors would like to thank Dr. Anke Hirschfelder, Berlin, for providing a German version of the Nijmegen Cochlear Implant Questionnaire. The authors have no conflicts of interest to disclose. Address for correspondence: Franz Muigg, Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria. E-mail: franz.muigg@tirol-kliniken.at Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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