Hearing tests can fail to diagnose hearing loss: study

April 21, 2017

Washington, Apr 21: A team of US researchers has revealed that the traditional clinical hearing tests often fail to diagnose patients with a common form of inner ear damage, which otherwise might be detected by some behavioural tests.

HearingAccording to researchers, the reason why some forms of hearing loss may go un-recognised in the clinic is that hearing involves a complex partnership between the ear and the brain and the central auditory system can compensate for significant damage to the inner ear by turning up its volume control, partially overcoming the deficiency.

This type of "hidden hearing loss" paradoxically presents itself as essentially normal hearing in the clinic, where audiograms -- the gold-standard for measuring hearing thresholds -- are typically conducted in a quiet room.

"You can have tremendous damage to inner hair cells in the ear that transmit information to the brain and still have a normal audiogram," said lead study author Richard Salvi from University at Buffalo.

"But people with this type of damage have difficulty in hearing in certain situations, like hearing speech in a noisy room. Their thresholds appears normal," Salvi added. About 95 percent of sound input to the brain comes from the ear's inner hair cells.

"Ear damage reduces the signal that goes the brain and it results trouble in hearing, but that's not what's happening here, because the brain "has a central gain control, like a radio, the listener can turn up the volume control to better hear a distant station." Salvi stated.

The sound is converted to neural activity by the inner hair cells in the auditory part of the ear, called the cochlea.

Sound-evoked neural activity then travels from the cochlea to the auditory nerve and into the central auditory pathway of the brain. For people with inner hair cell loss, sound is less faithfully converted to neural activity in the cochlea.

It is not clear how many people might have this type of hearing loss, but Salvi noted in the journal Frontiers in Neuroscience that it is a common complaint to have difficulty hearing in noisy environments as people get older.

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Agencies
June 11,2020

The World Health Organisation (WHO) Director-General Tedros Adhanom Ghebreyesus said that more research needs to be done to better understand the extent to which COVID-19 is being spread by people who don't show symptoms.

"Since early February, we have said that asymptomatic people can transmit COVID-19, but that we need more research to establish the extent of asymptomatic transmission," the WHO chief said at a virtual press conference from Geneva on Wednesday, Xinhua news agency reported.

"That research is ongoing, and we're seeing more and more research being done," he added.

Saying that the world has been achieving a lot in knowing the new virus, the WHO chief told reporters that "there's still a lot we don't

"WHO's advice will continue to evolve as new information becomes available," he said.

Tedros stressed that the most critical way to stop transmission is to find, isolate and test people with symptoms, and trace and quarantine their contacts.

"Many countries have succeeded in suppressing transmission and controlling the virus doing exactly this," Tedros said.

Meanwhile, Michael Ryan, executive director of WHO Health Emergencies Program, said Wednesday that the COVID-19 pandemic is still evolving.

"If we look at the numbers... this pandemic is still evolving. It is growing in many parts of the world," he said. "We have deep concerns that health systems of some countries are struggling, under a huge strain and require our support, our help and our solidarity."

He said "each and every country has a different combination of risks and opportunities, and it's really down to national authorities to carefully consider where they are in the pandemic."

In Europe, the risk issue now are about travels and the opening of the schools, around risk management, mass gathering, surveillance and contact tracing, said the WHO official.

In Southeast Asian countries, where to a great extent transmissions have been under control, governments are more concerned about the re-emergence of clusters, while in South America, the issue of PPE for health workers has not gone away, said Ryan.

As regards Africa, Ryan said the death rates have been very low in the past week, but the health system can be overwhelmed, as it would have to cope with other diseases such as malaria.

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Agencies
June 21,2020

Lower neighbourhood socioeconomic status and greater household crowding increase the risk of becoming infected with SARS-CoV-2, the virus that causes COVID-19, warn researchers.

"Our study shows that neighbourhood socioeconomic status and household crowding are strongly associated with risk of infection," said study lead author Alexander Melamed from Columbia University in the US.

"This may explain why Black and Hispanic people living in these neighbourhoods are disproportionately at risk for contracting the virus," Melamed added.

For the findings, published in the journal JAMA, the researchers examined the relationships between COVID-19 infection and neighbourhood characteristics in 396 women who gave birth during the peak of the Covid-19 outbreak in New York City. Since March 22, all women admitted to the hospitals for delivery have been tested for the virus, which gave the researchers the opportunity to detect all infections -- including infections with no symptoms -- in a defined population

The strongest predictor of COVID-19 infection among these women was residence in a neighbourhood where households with many people are common.The findings showed that women who lived in a neighbourhood with high household membership were three times more likely to be infected with the virus. Neighbourhood poverty also appeared to be a factor, the researchers said.Women were twice as likely to get COVID-19 if they lived in neighbourhoods with a high poverty rate, although that relationship was not statistically significant due to the small sample size.

The study revealed that there was no association between infection and population density.

"New York City has the highest population density of any city in the US, but our study found that the risks are related more to density in people's domestic environments rather than density in the city or within neighbourhoods," says co-author Cynthia Gyamfi-Bannerman."

The knowledge that SARS-CoV-2 infection rates are higher in disadvantaged neighbourhoods and among people who live in crowded households could help public health officials target preventive measures," the authors wrote.

Recently, another study published in the Journal of the American Planning Association, showed that dense areas were associated with lower COVID-19 death rates.

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