High-frequency audiometry using precision earphones: reliability under laboratory and field conditions

New circumaural earphones were tested in the frequency range from 100 Hz to 20 kHz and compared to commonly used supra-aural earphones. The circumaural earphone HD 230 (Sennheiser) generates test stimuli at up to 20 kHz with almost constant sound pressure levels when its pos ed on an artificial ear. The reproducibility of hearing threshold mea ed with a new microprocessor-controlled Békésy audiometer using the ne was nearly as good as under free-field conditions. The practicabil diagnostic value of high-frequency audiometry have been demonstrated er field conditions. For this application, the good sound attenuation these earphones (30 dB above 1 kHz) are important. High-frequency he ds of healthy pupils and of pupils with a history of otitis media are kHz, the hearing threshold level difference between both groups reached 20 dB.     

Chronic Cortisol Increases in the First Half of the Night Caused by Road Traffic Noise

56 children age 7 - 10 had a medical check-up and they and their mothers completed questionnaires. Additionally the children's excretion of free cortisol was measured by HPLC in two urine samples collected at 1 p.m. and in the morning. The children lived either at a busy road with 24 h lorry traffic or in quiet areas. At the side of the road the noise level was registered during five nights. In the bedrooms representative measurements of the short-term maximal sound level (L(Amax) and L(Cmax)) and of the frequency spectrum were taken. During the night on average every 2 minutes a lorry with L(max) > 80 dB(A) passed by the houses. The indoor levels of the higher exposed half of the children were L(max) = 33-52 dB(A) resp. 55-78dB(C)). The frequency spectrum had its maximum below 100 Hz. 74% of the higher exposed never opened their windows as compared to 25% in the lower exposed half group. The excretion of free cortisol and its metabolites in the first half of the night was significantly correlated to L(Cmax) (co-variables: age, sex, and the day of the week) as well as to impaired sleep, memory and ability to concentrate. The cortisol excretion in the second half of the night was not correlated to the noise level. Disturbances of the normal circadian rhythm of cortisol can be quantified by the quotient of the cortisol excretion in the first half of the night in relation to that in the second half. Children under long-term road traffic noise exposure during the night had an increased risk of chronic stress hormone regulation disturbances. These disturbances were significantly correlated to L(Cmax) and findings of allergy and/or asthma bronchial. Long-term low frequency noise exposure with Lmax < 55 dB(A) during the night resulted in chronic increases of children's excretion of free cortisol in the first half of the night and in serious disturbances of the circadian rhythm of cortisol. Indications of increased risks of asthma bronchial and allergies in noise exposed children with stress hormone regulation disturbances need further clarification     

Treatment of depression with the CRH-1-receptor antagonist R121919: endocrine changes and side effects

A dysregulation of the hypothalamus-pituitary-adrenocortical (HPA) system has been hypothesized to account for a myriad of cardinal symptoms of affective disorders. Specifically, increased CRH signalling via CRH type 1 receptors is thought to be an important factor in the pathogenesis of major depression and anxiety disorders. Consequently, a number of drugs have been developed in order to target the postulated increase in CRH/CRH 1 receptor signalling. One of these compounds, R121919, binds with high affinity to CRH1 receptors antagonising the action of CRH. R121919 was recently tested in an open-label study conceptualized as a safety and tolerability study. As part of this study, a thorough endocrine evaluation and detailed clinical laboratory analysis were assessed several times during 30 days of treatment with two different dose regimens of R121919 (5–40 mg vs. 40–80 mg) in 24 patients with a major depressive episode. During treatment with the experimental drug no serious side effects were noted. In particular, there were no adverse effects or impairment of the hypothalamic–pituitary–gonadal system, the hypothalamic–pituitary–thyroid axis, the renin–angiotensin system, prolactin or vasopressin secretion. Furthermore, no changes in the serum corticotropin and cortisol concentrations and in the responsivity of corticotropin and cortisol following a CRH stimulation test were noted. No effects of R121919 on clinical laboratory parameters including liver enzymes, EEG and ECG were observed. These results encourage the development of other CRH-1-R antagonists as a novel class of antidepressive drugs.     

A global response to a global problem: the epidemic of overnutrition

It is estimated that by 2020 two-thirds of the global burden of disease will be attributable to chronic noncommunicable diseases, most of them strongly associated with diet. The nutrition transition towards refined foods, foods of animal origin, and increased fats plays a major role in the current global epidemics of obesity, diabetes and cardiovascular diseases, among other noncommunicable conditions. Sedentary lifestyles and the use of tobacco are also significant risk factors. The epidemics cannot be ended simply by encouraging people to reduce their risk factors and adopt healthier lifestyles, although such encouragement is undoubtedly beneficial if the targeted people can respond. Unfortunately, increasingly obesogenic environments, reinforced by many of the cultural changes associated with globalization, make even the adoption of healthy lifestyles, especially by children and adolescents, more and more difficult. The present paper examines some possible mechanisms for, and WHO's role in, the development of a coordinated global strategy on diet, physical activity and health. The situation presents many countries with unmanageable costs. At the same time there are often continuing problems of undernutrition. A concerted multisectoral approach, involving the use of policy, education and trade mechanisms, is necessary to address these matters.     

Factors that support women's successful transition to the community following jail/prison

The purpose of this study was to describe factors that support women's successful transition to the community following incarceration. The design is qualitative, utilizing open-ended data generating interview questions of women who participate in Welcome Home Ministries (WHM), a new community faith-based program for women released from jail/prison. A multitude of factors are necessary to support women's successful transition to the community following incarceration. Although no questions were asked about religion or spirituality, the rank-ordered dominant factors were a spiritual belief and practice and freedom from addiction. The role of support groups and their "sisters" in WHM, the nurse-chaplain's jail visit and support, and the role of supportive friends (not former drug using friends) were additional key factors. The study findings may be used to support the design of new interventions based upon women's needs and capacities to empower them to create their own and their children's healthy future.     

Light- and electron microscopic investigations of pulmonary tissue after high-frequency positive-pressure ventilation (HFPPV).

Narcotisized dogs were artificially ventilated for periods of two to five hours with HFPPV. During this time the blood gases, pH and bases were controlled. In spite of sufficient oxygenation and CO2-elimination, a metabolic acidosis developed which could not be fully compensated by the addition of buffer solutions. In light and electron microscopy these lungs did not differ significantly from control lungs. Haemorrhages or atelectases were never observed. Type I cells as well as Type II cells in the alveoli are unchanged, i.e. the Type II cells were not depleted but contained numerous typical lamellar bodies with a diameter of 0.4-1 mu. The blood gas barrier was not widened and was ca. 3000 A wide. The alveolar surface was coated by an often fragmented electron-dense film (monolayer of the surfactant).