淮北市听力筛查异常婴幼儿耳聋易感基因筛查特点分析

目的 分析淮北市听力筛查异常婴幼儿耳聋易感基因的特点,为婴幼儿耳聋防治工作的开展提供参考。方法选取2018年4月~2023年1月在淮北市妇幼保健院进行听力筛查的新生儿为研究对象,采用自动听性脑干诱发电位反应(AABR)和诊断性畸变产物耳声发射(DPOAE)进行复筛,对未通过AABR与DPOAE的婴幼儿进行遗传性聋相关基因检测(高通量测序法),包括GJB2、GJB3、SLC26A4和粒体12S rRNA,分析淮北市婴幼儿耳聋易感基因筛查特点。结果 共有67 150例婴幼儿进行听力筛查,初筛阳性率为12%,复筛阳性率为13.65%,未通过复筛者实施耳聋相关基因筛查,有84例检出常见遗传性聋基因突变位点,检出率为6.13%(84/1 100)。耳聋易感基因突变携带者听力损失发生率高于未携带者,差异有统计学意义(P<0.05)。4个常见遗传性聋基因中,以杂合突变最为常见。GJB2基因突变44例,以c.235delC位点突变为主;SLC26A4基因突变27例,以c.IVS7-2A>G位点突变为主;GJB3基因突变2例;线粒体12S rRNA 11例。GJB2基因与SLC26A4基因突变频率比较,GJB3基因与线粒体12S rRNA突变频率比较,差异均无统计学意义(P>0.05),GJB2基因和SLC26A4基因突变频率均高于GJB3基因突变和线粒体12S rRNA突变频率,差异有统计学意义(P<0.05)。结论 淮北市耳聋易感基因突变携带频率以GJB2基因c.235delC位点和SLC26A4基因c.IVS7-2A>G位点杂合突变最为常见,本地区耳聋基因筛查及遗传咨询工作开展过程中应着重注意GJB2基因与SLC26A4基因突变。

Hypothyroidism in Childhood and Adolescence

Juvenile hypothyroidism is an unfrequent form of hypothyroidism that affects children. If not diagnosed and treated properly, it may cause severe neurological disorders during growth. The most frequent difficulties are found in school performance, difficulties in concentration, hyperactivity or fatigue and damage on the onset of puberty. Starting levothyroxine as a drug of choice is essential, and it should be made according to the age and weight of the child. Laboratory tests for control should be requested periodically, along with a strict control of the child’s development and growth. The family-doctor relationship, along with a clear guidance on the importance of treatment, is critical to achieve a successful treatment. This article is a review about the main clinical features of hypothyroidism in childhood, especially in developing countries, providing key aspects of adherence and characteristics of its follow-up.

Evaluation of SON’OR^(█),a Medical Device for Provoked Otoacoustic Emissions and Brainstem Evoked Response Audiometry Made in Cameroon

Background: There is a huge gap in the audiological care in Africa by comparison with Western countries. Its main reason is the prohibitive cost of the medical devices used to screen or diagnose patients. A Cameroonian team tackled this problem by developing a medical device (SON’OR&copy;) which integrates a new instrumentation amplifier structure dedicated to perform otoacoustic emissions (OAE) and brainstem evoked response audiometry (BERA). The major technical challenges to perform OAE and BERA are the synchronization and the amplification of signals of very low amplitude. In this work, we emphasize on the general criteria necessary and indispensable to achieve an optimal amplification. The application of a novel instrumentation amplifier structure characterized by its optimized noise factor in the case of BERA and OEA emissions provides simulations and experimental results fully in line with forecasts. The design of SON’OR&copy;is based on general techniques of electronic instrumentation to which we associated the new instrumentation amplifier structure. Objective: To report the clinical evaluation of SON’OR&copy;as a screening and diagnostic tool. Methods: We conducted a cross sectional comparative study in Centre Hospitalier d’Essos in Yaoundé. We tested SON’OR&copy;on two sets of subjects, one for OAE with OTODYNAMICS Echoport ILO 292-II as gold standard and the other for BERA with NEUROSOFT NEURO AUDIO&copy;as gold standard. Each patient was tested with both devices and then we studied the inter device differences and calculated the sensitivity, specificity, positive predictive value and negative predictive value for each test. Results: We got 52 subjects for OEA and 51 for BERA testing. Sex ratio was 1 woman for 2 men in both groups. Mean age was 24.86(SD = 10.53) and 26.33 (10.55) for OAE and BERA groups respectively. SON’OR&copy;had good performances, showing sensitivity of 92.85%/95%, specificity of 96.77%/90.47%, positive predictive value of 95.21%/93.44% and negative predictive value of 95.23%/92.68% for OAE/ BERA respectively. Conclusion: SON’OR&copy;has good characteristics as a medical diagnostic tool. Furthermore its stability and performances in poor electrical conditions make it a robust device really suited for resource limited settings.