Damir Katušić

Hearing levels and age in cleft palate patients

Tonal audiometry was used to compare hearing levels in patients with bilateral cleft lip and palate (BCLP) (57 patients). unilateral cleft lip and palate (UCLP) (124 patients) and isolated cleft palate (ICP) (62 patients), and according to age groups. Patients with isolated cleft palate showed greater improvement in hearing level with age than patients with UCLP and BCLP; as adults they showed the lowest frequency of ears with hearing level of less than 40 dB, and the highest frequency of ears with hearing levels of 11-20 dB. Patients with BCLP had a higher frequency of ears with a hearing level of 21-40 dB during early childhood and adult age than patients with ICP. Patients with UCLP and BCLP showed a slower decrease with age in the frequency of ears with hearing loss than patients with ICP; the hearing level in patients with UCLP and BCLP improved only in groups with hearing levels of 21-40 dB, while those with hearing levels above 40 dB showed no significant improvement with age.

Azithromycin vs doxycycline in the treatment of inclusion conjunctivitis.

PURPOSE The aim of the study was to compare the efficacy and safety of azithromycin and doxycycline in the treatment of chlamydial conjunctivitis in adults. DESIGN An open, randomized clinical trial. METHODS Seventy-eight adult patients with incluson conjunctivitis were enrolled in this multicenter clinical study. Patients with chlamydial conjunctivitis as indicated by a positive direct fluorescent antibody (DFA) test or cell culture were randomized to receive a single 1-g dose of azithromycin or doxycycline, 100 mg twice daily for 10 days. A conjuctival swab for cell culture was obtained from all patients immediately before the treatment for subsequent confirmation of the presence of chlamydial infection in the central laboratory. Control examinations were performed 10 to 12 days and 4 to 6 weeks after the treatment initiation. Clinical and bacteriological responses to the treatment were evaluated at the last visit. The occurrence and frequency of adverse events were analyzed as well. RESULTS Of 78 patients enrolled, 51 completed the study and were evaluated for efficacy. The main reasons for withdrawal were lack of confirmation of the presence of chlamydial infection by the central laboratory and failure to attend the follow-up visit. Eradication of C. trachomatis was achieved in 23 of 25 (92%) patients treated with azithromycin and in 25 of 26 (96%) patients treated with doxycycline. Clinical cure was observed in 15 (60%) and 18 (69%) patients treated with azithromycin and doxycycline, respectively. Both drugs were equally well tolerated. CONCLUSIONS A single 1-g azithromycin therapy was as effective as standard 10-day treatment with doxycycline (100 mg twice daily) in the treatment of adult inclusion conjunctivitis.

Pierre Robin syndrome : characteristics of hearing loss, effect of age on hearing level and possibilities in therapy planning

Hearing loss was studied in 22 patients with Pierre Robin syndrome (PRS) aged three to 12 years (median 5.0 years). The results were compared to those obtained in 62 patients with isolated cleft palate (ICP) aged one to 27 years (median 5.5 years). Hearing loss was more frequently found in PRS (73.3 per cent) than in ICP (58.1 per cent) patients (p = 0.02). PRS patients had more ears with moderate (21-40 dB) and severe (> 40 dB) hearing loss, disturbing their social contact, with no tendency to normalization with age (Spearman r = 0.065). In contrast to PRS, ICP patients showed a significant tendency to hearing level normalization with ageing (Spearman r = -0.453; p = 0.001). Planigraphs of temporal bones showed inadequately developed pneumatization of the mastoid bone in all PRS patients and in most ICP patients. No malformation of the inner or middle ear was found in either group. PRS patients have a significantly higher risk of conductive hearing loss than those with ICP. Use of tympanostomy (ventilation) tubes is therapy of choice in patients with Pierre Robin syndrome, and it should be introduced as early as possible, even at the same time as palatoplasty.

CHANGES OF DRUSEN NUMBER AND CENTRAL RETINAL THICKNESS IN AGE-RELATED MACULAR DEGENERATION PATIENTS OVER TWO YEARS

Age-related macular degeneration (ARMD) is the leading cause of blindness in developed world but there are still much unknown facts about the disease itself. Age, genetic factors and smoking are the three main risk factors for the development of ARMD, but the exact pathophysiological mechanism of the disease remains unknown. Current high resolution optical coherence tomography devices provide ample new information on retinal layers, drusen characteristics and their interaction. In this study, we analyzed 44 eyes with drusiform dry ARMD using high resolution optical coherence tomography over a 2-year period. Our results showed a statistically significant increase in drusen number in both females and males in the 2-year period. On average, increment by 4 and 5 drusen per eye during the 2-year period was recorded in female and male patients with drusiform dry ARMD, respectively. Also, statistical analysis of the central retinal thickness showed that women with drusiform dry ARMD had a statistically significantly thinner macula than their male counterparts.