Article's topics: Future "Cure" for Hearing Loss
An Israeli discovery on the function of tiny molecules called microRNAs (miRNAs) in the inner ears of mice could lead to the cure of human deafness in adults caused by aging, disease, drugs and noise, or genetic disease in children.
Inner ears with normal mouse hair cells and withoutPhoto: Courtesy Amiel Dror
The research, carried out over three years by world-renowned geneticist Prof. Karen Avraham of Tel Aviv University's Sackler School of Medicine and Dr. Lilach Friedman and other post-doctoral researchers in her lab, has just been released for publication in the prestigious journal PNAS (Proceedings of the National Academy of Sciences of the United States of America).
About one out of every two elderly people suffers from some degree of hearing disability, while one in 1,000 infants is born deaf due to mutant genes. Healthy babies are born with 15,000 sensory hair cells in each ear that allow them to hear. These hair cells are responsible for translating sounds to electrical pulses that the brain can interpret.
When these cells die off in a process called apoptosis, it results in hearing disability, and when the hair cells are all gone, profound deafness follows. Finding the mechanism in which apoptosis occurs might make it possible to prevent it.
MicroRNAs, first described by US labs in 1993 and named in 2001, are single-stranded RNA molecules that regulate gene expression and decide whether proteins will be produced.
They are known to be responsible for the normal functioning of cells in plants and animals. More recently, it was discovered that microRNAs are involved in diseases, including some types of cancer and liver and cardiovascular disorders.
MicroRNAs are involved in every part of a cell and can already be used to predict what kind of cancer a person has. Great effort is being made to develop strategies for inserting these tiny molecules into cells and using them as new drugs and potential cures.
The TAU team - working with cooperation from the Weizmann Institute of Science molecular genetics department and biologists at Indiana's Purdue University - has discovered for the first time that these molecules are vital to the development and survival of hair cells in the inner ear and for normal hearing. This important discovery opens an entirely new window for possible treatments and a cure for all types of deafness, whether age-related or genetic.
"The internal ears of mice and humans are very similar," Avraham told The Jerusalem Post on Monday.
Prof. Donna Fekete of Purdue helped Avraham and her post-doctoral students by working on the common black-and-white-striped aquarium-dwellers whose inner ears are very similar in structure and function to those of mammals and are translucent so their development can be easily viewed. "Donna 'knocked down' [blocked the functioning of] a specific miRNA in them," explained Avraham, who recently received the Prof. Michael Bruno Award from Yad Hanadiv/The Rothschild Foundation.
Her team blocked the functioning of the microRNA molecules in the inner ears of mice, preventing a protein from being made, causing them to degenerate and thus preventing hearing. As mice are born deaf and remain so for two weeks, when they were supposed to show the development of this sense, "the mice were found at one month to be completely deaf, with evidence that they had never heard. This suggested that a lack of normal microRNAs could also lead to progressive hearing loss in people born with normal hearing, said Avraham. "This understanding of miRNAs is a new phenomenon in genetic knowledge and gene regulation."
The study investigated both mice and zebrafish, but the model holds true for all vertebrates - including humans, she said. It's a whole new level of looking at our genome," said the TAU geneticist, who is originally from New Jersey. "We hope that both diagnostic and therapeutic applications for hearing loss will follow in the near future," Avraham added.
The Israelis made a "catalogue of all microRNAs they thought were important to the inner ear of the mouse. There probably are about 600 different ones, and each one is responsible for turning off and on as many as 200 genes. We 'knocked out' an enzyme called Dicer, causing the tiny hair cells in the inner ear to disappear, unlike in a normal inner ear where they are very numerous. Until now science knew only that mutations in protein-coding genes caused deafness. We went a layer deeper and discovered that the loss of microRNAs leads to deafness as well," she said.
She believes that further work could lead to treating and even curing deafness.
"We are continuing to work on this," said Avraham, who previously discovered four deafness genes and novel mutations in 10 deafness genes, among 46 known ones. Avraham, who collaborates with Palestinian researchers to help them understand and fight the high rate of genetic deafness in the offspring of Arabs who marry first cousins, concludes that if scientists can figure out how microRNAs regulate hair cells, they could be used to rescue the cells that are dying.
"During the past five years, genomics has shown that disease is a combination of events, not one mutation causing one disease but an enormous domino effect, a cascade that makes things fall apart," Avraham explained. "It is very complex."
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Tuesday, April 14, 2009
Sunday, April 12, 2009
Driving Safely with Hearing Loss
Driving Safely with Hearing Loss
By: Neil Bauman, PH.D.
“How do you drive if you can’t hear?” is a question I get a lot. And I normally answer, “I use my eyes when I drive. What do you use?” A deaf friend responded to this same question by saying, “I use my hands. My ears aren’t able to reach the steering wheel.”
Indeed, when my wife noticed she was losing her hearing, one of her first worries was, “Will I still be able to drive?” Apparently, many people think you need to be able to hear in order to drive. I think a better criterion is being able to see!
In fact, people with long-standing, severe hearing loss are some of the safest drivers around. One of the reasons for this is that we have to rely almost entirely on our eyes. After all, driving is a visual activity much more than it is an aural experience. Sure, there’s the issue of hearing horns honking, but when a person is visually alert, she will have already seen the problem looming before another driver lays on his horn. Besides, much of the horn-honking these days is just impatient drivers sounding off and not genuine traffic warnings, so we aren’t really missing much in this respect.
Shocking as it may seem to hearing people, some people with hearing loss even choose not to wear hearing aids while driving. One woman explains, “I would rather drive without my hearing aids because there is no noise distraction. And I’ve never had an accident.”If you have recently lost much of your hearing, you need to retrain yourself to rely on your eyes, not your ears. Always be aware of what is going on in front and behind you – and not just the immediate car in front of or behind you either, but as far as you can see in both directions – and know what is going on in the lanes on both sides of you. Use your mirrors – all three of them. When you consistently do this, you will seldom have problems in your everyday driving due to a lack of hearing. However, there are a few situations where a lack of hearing can get us into trouble if we don’t learn how to properly deal with them. One of these is not hearing emergency vehicle sirens. It’s surprising, though, how many hearing people don’t hear sirens either. This is because modern cars are reasonably soundproof. Also, many people have their car radios blasting, or are busy talking on their cell phones, so they don’t hear sirens until the emergency vehicle is right on top of them. I know this because I used to drive fire trucks and ambulances.
Furthermore, studies have shown that it is very difficult to hear sirens coming up behind you if you are barreling down the interstate. That’s just how the laws of physics apply in such situations.The trick to driving safely without hearing sirens is to be especially alert for any flashing lights. Emergency vehicles must have their emergency lights on if they are sounding their sirens. That’s the law. And it is the rare emergency vehicle that can get close to me without my seeing its flashing lights. Often, I am the first vehicle to pull over, well before the hearing drivers are aware an emergency vehicle is approaching.The most difficult siren situation for me is at downtown intersections where buildings extend right out to the sidewalks, blocking the lateral view, and an emergency vehicle is approaching from the left or right, out of my line of sight.How do I avoid being hit in such situations? I have several tricks I use.
First, I always watch for flashing reflections, typically in the windows of the buildings on the opposite side of the intersection from me, or from any reflective surface in my line of sight. At night it is particularly easy to see these red flashes on glass surfaces as an emergency vehicle approaches the intersection from the left or right.
Second, I watch the traffic around me – especially when the vehicle in front of me suddenly brakes, refuses to move when a light is green or pulls to the side for no apparent reason. I do the same. I resist the temptation to swerve around until I know the reason for the seemingly strange behavior. This has served me well a number of times.
Third, I am aware that emergency vehicles often travel in packs. Thus, if a fire truck goes whizzing past, I watch out for other fire trucks, police cars and ambulances. And I have learned that not all the emergency vehicles will be coming from the same direction as the first fire truck. Some may, but others may be converging and coming from several directions, so I remain especially vigilant until I am well away from the area.
You know that feeling you get when you realize a police officer is pulling you over? This is a stressful situation for anyone, but especially challenging for a person with hearing loss. As we can’t hear the siren, the police may have to pursue us just a little longer than usual and that isn’t likely to put the officer in the best of moods. Then there’s understanding what the officer says when he approaches the vehicle. This is especially problematic at night when we can’t see his or her face to speech read. For example, did the officer just order us to get out of the vehicle or stay in it? We don’t have a clue, and doing the wrong thing could create a lot of unpleasant confusion.Fortunately, there is a simple solution for this situation: visor cards that let the officers know we are not responding to their commands because we are deaf or hard of hearing and thus can’t hear them. Download your own free visor cards (there is a deaf version and a hard of hearing version) and the instructions on how to properly use them at http://www.hearinglosshelp.com/articles/visorcards.htm Thousands of people are already using these visor cards with excellent results.
Another hearing-related problem is that we can’t hear our turn signals clicking, and if they fail to cancel when we change lanes, for example, we may be driving down the road with our turn signals flashing, and risk getting flipped off, or worse, ticketed, as a result. Unfortunately for tall people like me, the turn signal indicator lights are typically hidden by the steering wheel. I have to duck my head to see if they are flashing or not. As a result, I have to consciously check that my turn signals have cancelled whenever I use them to avoid this.Sometimes our lack of hearing can cause us problems even before we hit the road. For example, I may be in a parking lot and think my motor didn’t start, so I try again, and the suddenly swiveled heads of those near my car let me know that I ground the starter gears – again! To prevent this, I now look at my tachometer before trying to restart my motor. If the tach doesn’t read zero, I keep my hands off the key.
We also run into problems when we can’t hear the warning sounds our cars make – warnings to put our seat belts on, that a door isn’t closed properly, that we left our keys in the ignition and so on. In fact, for a long time, I didn’t even know my car made any warning sounds at all! Those inaudible (to us) warnings are useless when we realize we just locked our keys in the car. To solve this problem, I always carry a spare key in my pocket.Furthermore, because there are no visual warnings, I have gotten out of my car and left the headlights on, and never heard my car warning me of this fact. I usually look back at my car as I walk away to be sure the lights are out and the locks are down, though a dead battery serves as a good reminder should I ever need one. Car manufacturers need to address this issue and build adequate visual warnings for every audible warning in their cars. No matter how much or little you hear, one of the main keys to safe and problem-free driving is staying visually alert and “seeing” the sounds you can’t hear. When we drive, let’s “hear” with our eyes.
Above Article from Hearing Health Magazine and the Center for Hearing Loss Help, Neil Bauman, Ph.D.49 Piston Court Stewartstown, PA 17363-8322 USA
By: Neil Bauman, PH.D.
“How do you drive if you can’t hear?” is a question I get a lot. And I normally answer, “I use my eyes when I drive. What do you use?” A deaf friend responded to this same question by saying, “I use my hands. My ears aren’t able to reach the steering wheel.”
Indeed, when my wife noticed she was losing her hearing, one of her first worries was, “Will I still be able to drive?” Apparently, many people think you need to be able to hear in order to drive. I think a better criterion is being able to see!
In fact, people with long-standing, severe hearing loss are some of the safest drivers around. One of the reasons for this is that we have to rely almost entirely on our eyes. After all, driving is a visual activity much more than it is an aural experience. Sure, there’s the issue of hearing horns honking, but when a person is visually alert, she will have already seen the problem looming before another driver lays on his horn. Besides, much of the horn-honking these days is just impatient drivers sounding off and not genuine traffic warnings, so we aren’t really missing much in this respect.
Shocking as it may seem to hearing people, some people with hearing loss even choose not to wear hearing aids while driving. One woman explains, “I would rather drive without my hearing aids because there is no noise distraction. And I’ve never had an accident.”If you have recently lost much of your hearing, you need to retrain yourself to rely on your eyes, not your ears. Always be aware of what is going on in front and behind you – and not just the immediate car in front of or behind you either, but as far as you can see in both directions – and know what is going on in the lanes on both sides of you. Use your mirrors – all three of them. When you consistently do this, you will seldom have problems in your everyday driving due to a lack of hearing. However, there are a few situations where a lack of hearing can get us into trouble if we don’t learn how to properly deal with them. One of these is not hearing emergency vehicle sirens. It’s surprising, though, how many hearing people don’t hear sirens either. This is because modern cars are reasonably soundproof. Also, many people have their car radios blasting, or are busy talking on their cell phones, so they don’t hear sirens until the emergency vehicle is right on top of them. I know this because I used to drive fire trucks and ambulances.
Furthermore, studies have shown that it is very difficult to hear sirens coming up behind you if you are barreling down the interstate. That’s just how the laws of physics apply in such situations.The trick to driving safely without hearing sirens is to be especially alert for any flashing lights. Emergency vehicles must have their emergency lights on if they are sounding their sirens. That’s the law. And it is the rare emergency vehicle that can get close to me without my seeing its flashing lights. Often, I am the first vehicle to pull over, well before the hearing drivers are aware an emergency vehicle is approaching.The most difficult siren situation for me is at downtown intersections where buildings extend right out to the sidewalks, blocking the lateral view, and an emergency vehicle is approaching from the left or right, out of my line of sight.How do I avoid being hit in such situations? I have several tricks I use.
First, I always watch for flashing reflections, typically in the windows of the buildings on the opposite side of the intersection from me, or from any reflective surface in my line of sight. At night it is particularly easy to see these red flashes on glass surfaces as an emergency vehicle approaches the intersection from the left or right.
Second, I watch the traffic around me – especially when the vehicle in front of me suddenly brakes, refuses to move when a light is green or pulls to the side for no apparent reason. I do the same. I resist the temptation to swerve around until I know the reason for the seemingly strange behavior. This has served me well a number of times.
Third, I am aware that emergency vehicles often travel in packs. Thus, if a fire truck goes whizzing past, I watch out for other fire trucks, police cars and ambulances. And I have learned that not all the emergency vehicles will be coming from the same direction as the first fire truck. Some may, but others may be converging and coming from several directions, so I remain especially vigilant until I am well away from the area.
You know that feeling you get when you realize a police officer is pulling you over? This is a stressful situation for anyone, but especially challenging for a person with hearing loss. As we can’t hear the siren, the police may have to pursue us just a little longer than usual and that isn’t likely to put the officer in the best of moods. Then there’s understanding what the officer says when he approaches the vehicle. This is especially problematic at night when we can’t see his or her face to speech read. For example, did the officer just order us to get out of the vehicle or stay in it? We don’t have a clue, and doing the wrong thing could create a lot of unpleasant confusion.Fortunately, there is a simple solution for this situation: visor cards that let the officers know we are not responding to their commands because we are deaf or hard of hearing and thus can’t hear them. Download your own free visor cards (there is a deaf version and a hard of hearing version) and the instructions on how to properly use them at http://www.hearinglosshelp.com/articles/visorcards.htm Thousands of people are already using these visor cards with excellent results.
Another hearing-related problem is that we can’t hear our turn signals clicking, and if they fail to cancel when we change lanes, for example, we may be driving down the road with our turn signals flashing, and risk getting flipped off, or worse, ticketed, as a result. Unfortunately for tall people like me, the turn signal indicator lights are typically hidden by the steering wheel. I have to duck my head to see if they are flashing or not. As a result, I have to consciously check that my turn signals have cancelled whenever I use them to avoid this.Sometimes our lack of hearing can cause us problems even before we hit the road. For example, I may be in a parking lot and think my motor didn’t start, so I try again, and the suddenly swiveled heads of those near my car let me know that I ground the starter gears – again! To prevent this, I now look at my tachometer before trying to restart my motor. If the tach doesn’t read zero, I keep my hands off the key.
We also run into problems when we can’t hear the warning sounds our cars make – warnings to put our seat belts on, that a door isn’t closed properly, that we left our keys in the ignition and so on. In fact, for a long time, I didn’t even know my car made any warning sounds at all! Those inaudible (to us) warnings are useless when we realize we just locked our keys in the car. To solve this problem, I always carry a spare key in my pocket.Furthermore, because there are no visual warnings, I have gotten out of my car and left the headlights on, and never heard my car warning me of this fact. I usually look back at my car as I walk away to be sure the lights are out and the locks are down, though a dead battery serves as a good reminder should I ever need one. Car manufacturers need to address this issue and build adequate visual warnings for every audible warning in their cars. No matter how much or little you hear, one of the main keys to safe and problem-free driving is staying visually alert and “seeing” the sounds you can’t hear. When we drive, let’s “hear” with our eyes.
Above Article from Hearing Health Magazine and the Center for Hearing Loss Help, Neil Bauman, Ph.D.49 Piston Court Stewartstown, PA 17363-8322 USA
Thursday, April 9, 2009
HOW TO MANAGE YOUR HOSPITAL STAY
Your hospital stay will be a less stressful experience if you do some advance preparation and inform the hospital about your hearing loss. Communicating your needs and limitations, and the services you require, will ensure that you and the hospital are prepared.
Teach / show people who tend to you the correct way to insert battery into processor before any scheduled procedure; and how your headpiece attaches to internal magnet (see picture Below).
Your hospital stay will be a less stressful experience if you do some advance preparation and inform the hospital about your hearing loss. Communicating your needs and limitations, and the services you require, will ensure that you and the hospital are prepared.
How will hospital personnel be notified about your hearing loss?
All staff including nurses, doctors, anesthesiologists and recovery room staff should be aware that you have a hearing loss and how you communicate. You may have difficulty hearing when emerging from anesthesia. Hospital personnel may think you appear non-responsive or are not responding appropriately if they are not notified about your hearing loss Can a sign (or picture- see below) noting your hearing loss be posted above your bed?
All staff including nurses, doctors, anesthesiologists and recovery room staff should be aware that you have a hearing loss and how you communicate. You may have difficulty hearing when emerging from anesthesia. Hospital personnel may think you appear non-responsive or are not responding appropriately if they are not notified about your hearing loss Can a sign (or picture- see below) noting your hearing loss be posted above your bed?
MikeG
This is especially important at night when your hearing aid or CI is removed and the night staff may be unaware of your hearing loss. Some hospitals may be reluctant to offer this without your requesting it because of patient privacy rights. The benefits outweigh the privacy issues. Health care providers tend to speak before checking your chart so the sign is important even if your chart is noted with your hearing loss. Use the general symbol for people with hearing loss.
This symbol does not communicate what you need or how you communicate. It is, unfortunately, the only universal symbol that is available. Are the nurses aware that yo
u may not be able to hear over the intercom? Can the hospital place a sticker on the intercom at the nurse's station indicating that you are hard of hearing and use a cochlear implant?
This will alert the staff not to use the intercom if you are unable to hear it. The staff will need to come into your room rather than speak over the intercom so the hospital may want to place you in a room near the nurses' station.
Did you pack a pad and pen for your hospital room?
A pad and pen will allow you and the staff to write down critical information and medical terms to ensure you hear them properly. Can staff wear clear surgical masks or remove them when they speak with you?
Let everyone know prior to entering the operating room if you rely on lip reading and therefore need to see people's faces. Wearing clear surgical masks or removing them when they speak with you allows you to see their lips.
This symbol does not communicate what you need or how you communicate. It is, unfortunately, the only universal symbol that is available. Are the nurses aware that yo
u may not be able to hear over the intercom? Can the hospital place a sticker on the intercom at the nurse's station indicating that you are hard of hearing and use a cochlear implant?This will alert the staff not to use the intercom if you are unable to hear it. The staff will need to come into your room rather than speak over the intercom so the hospital may want to place you in a room near the nurses' station.
Did you pack a pad and pen for your hospital room?
A pad and pen will allow you and the staff to write down critical information and medical terms to ensure you hear them properly. Can staff wear clear surgical masks or remove them when they speak with you?
Let everyone know prior to entering the operating room if you rely on lip reading and therefore need to see people's faces. Wearing clear surgical masks or removing them when they speak with you allows you to see their lips.
Did you bring your batteries, storage device, charger?
Bring all of your rechargeable batteries with you for your planned stay in the hospital. And don’t forget your charger. Inform staff about the charging procedure. If an emergency sends you to the hospital, does anyone know where you keep your charger at home, will they bring it (and any spare batteries) to you? And don’t forget to bring some sort of storage kit to place your device into
Bring all of your rechargeable batteries with you for your planned stay in the hospital. And don’t forget your charger. Inform staff about the charging procedure. If an emergency sends you to the hospital, does anyone know where you keep your charger at home, will they bring it (and any spare batteries) to you? And don’t forget to bring some sort of storage kit to place your device into
What visual alerts does the hospital offer for emergencies & to alert you if one is at the door? Do you have access to a TTY or CapTel? Is your TV captions on?
There are a variety of devices that can alert individuals with hearing loss to emergencies, to the phone ringing and/or to someone knocking at the door. Find out what the hospital has available and what is recommended based on your procedure.
There are a variety of devices that can alert individuals with hearing loss to emergencies, to the phone ringing and/or to someone knocking at the door. Find out what the hospital has available and what is recommended based on your procedure.
What about inserting battery into processor? or how to charge your batteries?
Teach / show people who tend to you the correct way to insert battery into processor before any scheduled procedure; and how your headpiece attaches to internal magnet (see picture Below).
Scheduled for an MRI?
Beware of warnings about MRIs. Make sure your surgeon and/or hospital staff know that you have an internal magnet, and discuss what the options may be.
Any other advise for CI / HA users in hospital?
Some suggestions I've come up with:
1. Make sure hospital personal face you when conversing
2. Have nurses and orderlies close enough to you to make lip reading easier, and make sure they do not stand in front of window where you may need to"squint" to see
3. Please keep "chit-chat" to a minimum (I'll have enough trouble just keeping up with what's important for my care)
4. I may need help installing battery, placing CI/HA in correct position, and in storing unit when I am resting or sleeping
5. Keep background sound to a minumum / and a small light on in room at all times so I can see if I need to
6. ANY finally; what other advice does anyone have to add to this list?
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