La prima infezione urinaria febbrile in bambini di età compresa tra 2 mesi e 3 anni

2020 ◽  
Vol 39 (8) ◽  
pp. 505-511
Author(s):  
Agnese Feresin ◽  
Martina Bevacqua ◽  
Giulia Del Piero ◽  
Paola Staffa ◽  
Egidio Barbi ◽  
...  

Conductive, mild-moderate hearing impairment in children is a very frequent condition after newborn hearing screening that easily leads to misdiagnosis. Conductive hearing impairment needs an accurate differential diagnosis to avoid inadequate treatments. The paper reports a case of bilateral, sensorineural hearing impairment of moderate degree in a 5-month male infant that was diagnosed after the failure of newborn hearing screening and because of a family history of hearing loss. His parents asked for an advice about the need of hearing aids at the Audiological and Otolaryngology Department. The diagnostic and audiological assessment recognised a conductive, moderate hearing loss associated with tympanic effusion and velar-tube dysfunction. After two months, in the follow-up, the child’s hearing threshold was normal. The case underlines the importance of early identification of hearing impairment and of a complete evaluation programme before indicating any treatment.

2012 ◽  
Vol 27 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Marieflor Cristy M. Garcia ◽  
Charlotte M. Chiong ◽  
Generoso T. Abes ◽  
Ryner Jose C. Carrillo

Objective: To determine the prevalence of hearing loss among infants six months old and below sent for newborn hearing screening in our institution, and to measure the accuracy, sensitivity, specificity and positive predictive values of reflexive behavioral (“Baah”) test in detecting hearing loss in infants.Methods:     Design: Cross-sectional study     Setting: Ear Unit of a tertiary government hospital     Participants: Infants less than Six months old sent for newborn hearing screening at the Ear Unit of a tertiary government hospital from April to September, 2011 were recruited. All participants were tested with OAE for hearing screening. OAE was also used as the standard for evaluating hearing impairment. The reflexive behavioral (“Baah”) test was then done using the human voice as a loud sound stimulus, and the response recorded were auropalpebral, startle and blinking response to the sound. Thesensitivity, specificity, accuracy, positive and negative predictive value of the test was then measured.Results: From April to September 2011, a total of 101 patients were tested, with a male to female ratio of 1.1:1 (53 males, 48 females). The prevalence of hearing impairment in this study population was 6.9% (7 out of 101). The reflexive behavioral (“Baah”) test was found to have sensitivity of 71.4%, specificity of 95.7%, accuracy rate of 94%, positive predictive value of 55.6% and negative predictive value of 97.8%.Conclusion: The reflexive behavioral (“Baah”) test shows potential as an accurate, acceptable and cost-effective screening tool to identify infants that may be at higher risk for hearing impairment. This test may aid the health care providers, in areas without OAEs, in identifying infants who are in need further hearing diagnostic evaluation, with OAEs or other hearing tests. It is recommended that the “Baah” test be implemented in the community to test its reproducibility in a larger population and outside the hospital setting.Keywords: reflexive behavioral test, “Baah” test, otoacoustic emission, hearing screening


2009 ◽  
Vol 20 (01) ◽  
pp. 049-057 ◽  
Author(s):  
Yvonne S. Sininger ◽  
Amy Martinez ◽  
Laurie Eisenberg ◽  
Elizabeth Christensen ◽  
Alison Grimes ◽  
...  

Background: Newborn Hearing Screening (NHS) programs aim to reduce the age of identification and intervention of infants with hearing loss. It is generally accepted that NHS programs achieve that outcome, but few studies have compared children who were screened to those not screened in the same study and during the same time period. This study takes advantage of the emerging screening programs in California to compare children based on screening status on age at intervention milestones. Purpose: The purpose of this study was to compare the outcomes of cohorts of children with hearing loss, some screened for hearing loss at birth and others not screened. Specifically, the measures compared are the benchmarks suggested by the Joint Committee on Infant hearing for determining the quality of screening programs. Study Sample: Records from 64 children with bilateral permanent hearing loss who were enrolled in a study of communication outcomes served as data for this study. Of these children, 47 were screened with 39 failing and 8 passing, and 17 were not screened. Intervention: This study was observational and involved no planned intervention. Data Collection and Analysis: Outcome benchmarks included age at diagnosis of hearing loss, age at fitting of amplification, and age at enrollment in early intervention. Delays between diagnosis and fitting or enrollment were also calculated. Hearing screening status of the children included screened with fail outcome, screened with pass outcome, and not screened. Analysis included simple descriptive statistics, and t-tests were used to compare outcomes by groups: screened/not screened, screened pass/screened failed, and passed/not screened. Results: Children with hearing loss who had been screened as newborns were diagnosed with hearing loss 24.62 months earlier, fitted with hearing aids 23.51 months earlier, and enrolled in early intervention 19.98 months earlier than those infants who were not screened. Screening status did not influence delays in fitting of amplification or enrollment in intervention following diagnosis. Eight of the infants with hearing loss (12.5%) passed the NHS, and the ages at benchmarks of those children were slightly but not significantly earlier than infants who had not been screened. Conclusions: The age at achievement of benchmarks such as diagnosis, fitting of amplification, and enrollment in early intervention in children who were screened for hearing loss is on target with stated goals provided by the Academy of Pediatrics and the Joint Committee on Infant Hearing. In addition, children who are not screened for hearing loss continue to show dramatic delays in achievement of benchmarks by as much as 24 months. Evaluating achievement of benchmarks during the start-up period of NHS programs allowed a direct evaluation of ability of these screening programs to meet stated goals. This demonstrates, unequivocally, that the NHS process itself is responsible for improvements in age at diagnosis, hearing aid fitting, and enrollment in intervention.


Author(s):  
Philippa Horn ◽  
Carlie Driscoll ◽  
Jane Fitzgibbons ◽  
Rachael Beswick

Purpose The current Joint Committee on Infant Hearing guidelines recommend that infants with syndromes or craniofacial abnormalities (CFAs) who pass the universal newborn hearing screening (UNHS) undergo audiological assessment by 9 months of age. However, emerging research suggests that children with these risk factors are at increased risk of early hearing loss despite passing UNHS. To establish whether earlier diagnostic audiological assessment is warranted for all infants with a syndrome or CFA, regardless of screening outcome, this study compared audiological outcomes of those who passed UNHS and those who referred. Method A retrospective analysis was performed on infants with a syndrome or CFA born between July 1, 2012, and June 30, 2017 who participated in Queensland, Australia's state-wide UNHS program. Results Permanent childhood hearing loss (PCHL) yield was higher among infants who referred on newborn hearing screening (51.20%) than in those who passed. Nonetheless, 27.47% of infants who passed were subsequently diagnosed with hearing loss (4.45% PCHL, 23.02% transient conductive), but PCHL was generally milder in this cohort. After microtia/atresia, the most common PCHL etiologies were Trisomy 21, other syndromes, and cleft palate. Of the other syndromes, Pierre Robin sequence featured prominently among infants who passed the hearing screen and were subsequently diagnosed with PCHL, whereas there was a broader mix of other syndromes that caused PCHL in infants who referred on screening. Conclusion Children identified with a syndrome or CFA benefit from early diagnostic audiological assessment, regardless of their newborn hearing screening outcome.


2021 ◽  
Vol 15 (6) ◽  
pp. 2067-2071
Author(s):  
Gholam-Ali Dashti Khavidaki ◽  
Reza Gharibi

Introduction: Hearing loss is one of the most common congenital disorders. The prevalence of this disorder in different communities has been reported between 3.5 to 9 percent, which can have adverse effects on language learning, communication, and education of children. Also, early diagnosis of this disorder in newborns is not possible without the use of hearing screening. Therefore, the aim of this study was to evaluate the effectiveness of newborn hearing screening programs in Zahedan. Method: In this cross-sectional observational study, all babies born in the maternity hospitals of Zahedan city (maternity hospitals of Nabi Akram, Imam Ali, and Social Security hospitals) in 2020, were examined. In order to conduct the study, TEOAE was initially performed for all neonates. Then, based on the results obtained in the ODA test and in case of unsatisfactory response, cases were referred for re-evaluation. Infants who were rejected again in the second stage were immediately subjected to the AABR test and if they failed in this test, they were also subjected to a diagnostic ABR test. Results: Based on our results, 7700 infants were first evaluated with the OAE test. Of these, 580 (8%) had no OAE response. Out of 580 infants rejected in the first stage, 76 infants were also rejected in the second stage; Among them, 8 infants were re-diagnosed with hearing impairments. Finally, out of 3 infants who were diagnosed with hearing loss, 1 (33%) had conductive hearing loss and 2 (67%) had sensorineural hearing loss. Conclusion: Based on the findings of the present study, the implementation of a comprehensive neonatal hearing screening program is necessary for the timely and early diagnosis and treatment of hearing loss. Also, screening can improve the health of children and their personal, social, and educational development in the future. Keywords: Hearing screening, hearing loss, newborns, OAE, AABR


2005 ◽  
Vol 48 (2) ◽  
pp. 135-141 ◽  
Author(s):  
Shoichiro Fukuda ◽  
Naomi Toida ◽  
Kunihiro Fukushima ◽  
Yuko Kataoka ◽  
Kazunori Nishizaki

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Doncarli ◽  
H Tillaut ◽  
V Goulet

Abstract Background The French newborn hearing screening programme set up in 2014 aims to identify affected children as early as possible to allow appropriate care. Our goal was to evaluate the implementation of this programme at the national level. Methods The programme consist in a screening using a test (T1) and a retest (T2) in the maternity hospital in all newborns. In some region, a delayed test (T3) is performed afterwards in children for whom it was not possible to confirm normal hearing. Children suspected of deafness subsequently enter the diagnosis phase. We defined evaluation indicators after stakeholders consultation. We developed a web application to collect aggregated data on live births. We estimated the rate of coverage, refusal, children suspected of hearing loss at the end of the screening phase and the prevalence of bilateral deafness. Results In 2015, one year after the initiation of the programme, the coverage rate was already very high (88%) and even more so in 2016 (96%). Parental acceptance was very good (refusal: 0.1%). By the end of 2016, 19 out 27 regions had added a T3. The rate of suspicion of bilateral hearing loss was decreased by using a T3 (1.4% vs 0.9%). Bilateral deafness rate, estimated after a 2-years follow up, was 1.3‰ although it was estimated only on 51.5% of suspected children for whom diagnosis data had been transmitted. Conclusions The objective of a 90% coverage set by the French ministry of health has been met after 2 years of operation of the program. T3 appears useful in relieving diagnostic structures from false positives. Our estimated prevalence of bilateral deafness could be more accurate if data collection was improved but is consistent with prevalence reported in North America. Key messages The universal newborn hearing screening program has been successfully set up in France in terms of coverage. Future work should focus on improving the collection of follow up data to better characterise diagnosed children.


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