Well, That Backfired

5 Dec

I went to bed later then normal, and of course my neighbors blasted music and shoited from 3:30AM to 4:20AM.  Drugs or just inconsiderate?  Hard to tell.  They were louder then the fan we use to mask noise though.  I can’t wait until I can pay more for a place and weed out some of these losers.  Unfortunately, now I can’t actual-sleep, but have no focus due to tiredness.  I thought maybe if I wrote some study things here it would engage my brain and focus more.

flashcards 002

Educational Audiology:

-still ID, dx, help with amplification & ALD, and refers.  (Clin. AuD dx balance issues as well, mng meds, & aud rehab)

—educationally relevant eval

—describe audiogram to school, parents, P

—refer other med conditions, comm issues, & educational concerns to appropriate prof.

—eval classroom/enviro acoustics & makes rec. for improvements

—ensure fit & funct. device & ALDs

—advocates for P; ensure services

—teach about impact HL & HL prevention

—make sure prof. std met & support staff properly trained

—educational accomodatios

—eval comm

—empower P; ensure daily living needs met

->assist is classroom/program placement

->facilitate programs for device & rehab

->calibrate & maint equip.

->assess CAPD

Cocktail Effect

Psycho-Social Considerations:

-early dx allows parents to go through grief stages (shock, denile, negotiation, depression, acceptance) faster

-children w/disabilities tend to be spoiled/indulged (decreased self worth/entitled)

-parental depression–>more stressed household, worse performance; P @ risk for cognitive, emotional, & comm impairments = lang dev promoted w/parental attention/sensitivity & emotional attachments

-good parental coping–>improved cognitive flaxibility, better prob solving skills, better social adjustment, less impulsive behavior, _______)

-kids w/HL tend to be:  more aggressive, complainy, social issues (isolated, depressed, low social acceptance/teasing); less social confidence to express feelings & present arguments

*peer rejection is associated w/worse academic performance & vice versa

Tinnitus Stats:

-30 to 60 million (10-20) US have it

-15 mil have clin. sig. (5%)

-1.5 mil (less than 1%) have debilitating

-75% of AuDs practice might see P w/some degree

-40% of P w/tinnitus also have hyperacusis

-of patients with hyperacusis, 90% have tinnitus

-10-30% kids have tinnitus

-30-60% HL kids have tinnitus

fractal 218

Causes of Tinnitus:

1]  otologic-noise induced, presbycusis, OM

Meiner’s DZ, cerumen impaction, hair against TM

2]  cardiac (pulsitile)-anything that causes tubulent blood flow (hypertention, shunt,________)

3]  somatic-TMJ, whiplash

—-head trauma, MS, migrane , stapedius/tensor tympani muscle/tendons

4]  chronic = central aud. prob

—-neural plasticity (reduced inhibition unmasks hyper-excited resp)

—-infectious (lymes, syphilis, MENNINGITIS)

—-diabetes, allergies, anemia, T4

5]  ototoxic

Mom's camera 083

POSSIBLE FUTURE RESEARCH QUESTION:

-BPPV is the #1 cause for vertigo.  BUT w/in 6 wks the calcium carbonate crystals (otoconia) that are causing the disturbance by bumping into cupula w/in the S.C.C. spontaneously resolve.  1]  why do they resolve?  I’m thinking it has everything to do with chemistry here.  2]  do they resolve under specific conditions?  And what are those circumstances.  3]  how do you replicate that condition in people that don’t naturally have it (where labyrinthectomy might be req)?

A]  http://www.library.nhs.uk/booksandjournals/details.aspx?t=Calcium+Carbonate%2Fanalysis&stfo=True&sc=bnj.ovi.amed,bnj.ovi.bnia,bnj.ebs.cinahl,bnj.ovi.emez,bnj.ebs.heh,bnj.ovi.hmic,bnj.pub.MED,bnj.ovi.psyh&p=5&sf=srt.publicationdate&sfld=fld.title&sr=bnj.ebs&did=2002115137&pc=13&id=80

We present a theoretical discussion on the biochemistry of Benign Paroxysmal Positional Vertigo (BPPV) based on the knowledge that the otoconia are calcium carbonate crystals and that their migration into the posterior semicircular canal is responsible for BPPV. Our principal focus has been on the factors that could affect the solubility of the calcium carbonate crystals in endolymphatic fluid and hence their dissolution. We suggest two factors that could affect the dissolution of the otoconia: the concentrations of carbon dioxide and calcium ions in the endolymphatic fluid. Calcium carbonate is insoluble in water or in an aqueous medium at pH 7.4, but it can be solubilized by its conversion to calcium bicarbonate in the presence of an excess of carbon dioxide in the form of carbonic acid. The role of carbon dioxide in body metabolism is discussed, including its function in calcium transport and in the primary buffer system controlling blood pH. The second obvious factor influencing dissolution of the otoconia in the endolymphatic fluid is the concentration of calcium ions in the fluid. The role of calcium in body metabolism is discussed briefly including four factors that affect its concentration in the peripheral circulation. First, the parathyroid glands control the level of calcium ions in the peripheral circulation and respond to low levels by causing release of calcium from the bone structure into the circulation. Other factors are diets high in calcium and vitamin D and soluble calcium supplements such as calcium citrate combined with vitamin D. Finally, the effects of diuretics that cause loss of fluid with consequential loss of calcium from the peripheral circulation are mentioned. In view of these considerations, one can speculate that the dissolution of the otoconia debris in the posterior semicircular canal would be favored by a high concentration of carbon dioxide or carbonic acid and a low concentration of calcium ion in the endolymphatic fluid of the posterior semicircular canal. Hypothetically, one also can speculate that if these conditions could be made to prevail, then the occurrence or reoccurrence of benign paroxysmal positional vertigo or BPPV could be prevented.

B]  http://www.jbc.org/content/285/28/21724.full

Otoconia are subjected to morphological and compositional changes by diverse environmental and genetic factors. Prolonged exposure to medications such as streptomycin results in formation of abnormal giant otoconia (1314). Age-related otoconia degeneration is highly abundant and increases the risk for free floating particles (15). Dislocation of otoconia or their broken particles outside their native position can lead to severe vestibular dysfunction in humans. Benign paroxysmal positional vertigo (BPPV) patients suffer from severe dizziness. This clinical condition affects up to 9% of the population older than 65 years of age (16). The phenotype manifests itself when otoconia migrate to one of the cristae (cupulolithiasis) or the semicircular canals (canalithiasis) and hinders its mechanical sensory properties (17). BPPV is one of the major clinical conditions attributed to dislocated otoconia.

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