Tag Archives: Harvard Health

Hearing Aids: Over-The-Counter vs Prescription

Hearing aids are not one-size-fits all. “While OTC devices may help many people with mild or moderate hearing loss, they might not be appropriate for all types of hearing loss,” says Dr. Naples.

Harvard Health Publishing – A change in FDA regulations has cleared the way for over-the-counter (OTC) hearing aids. What does this mean for you if you’re among the approximately 48 million Americans with some degree of hearing loss? We asked Dr. James Naples, assistant professor of otolaryngology/head and neck surgery at Harvard-affiliated Beth Israel Deaconess Medical Center, to help explain potential pros and cons.

The basics: Hearing aids versus amplification products

There are various types of hearing aids that largely work in the same way. Whether the style is behind the ear or in the ear canal, they amplify sounds to make them louder. They also help filter out certain types of noise. “All hearing aids use a combination of signal processing and directional microphones to filter out some unwanted noise and to improve our ability to hear sounds,” says Dr. Naples.

Don’t confuse prescription or OTC hearing aids with personal sound amplification products (PSAPs) sold at most drug stores. Such products merely amplify nearby sounds. They’re not tailored to an individual’s hearing loss, and aren’t regulated by the FDA or intended to treat hearing loss.

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COMMENTARY:

Humans and their mammalian cousins have lost the ability to regenerate the hair cells in the inner ear. In preindustrial society(how could they know?) people apparently didn’t lose hearing as they aged. However, in the Industrial Age, the prevalence of noise has been increasing along with our power consumption,  and loss of hearing consequently occurs along with Aging.

High frequency loss is the most prominent, and this leads to inability to hear consonants, and have more difficulty with the voices of children and women which tend to be of a higher frequency. The ability of young people to hear high frequencies better than older people has led to various ringtones and songs favoring high frequencies, which the children can hear and older people cannot.

There are a number of things that can add to this hearing loss, such as chronic exposure to loud sounds (such as rock concerts), exposure to drugs that damage hearing, such as certain antibiotics and even aspirin. Otosclerosis and repeated middle ear infections can also accentuate the problem by interfering with sound conduction.

Ringing in the ears, tinnitus, is also associated with accelerated hearing loss.

I have had tinnitus for a long time, and at the age of 90, I have definite hearing loss. Even a couple of decades ago my high frequency loss was quite demonstrable by audiogram. I am resisting the temptation to get it corrected, since the louder sounds from the device would probably gradually reduce my baseline hearing ability. Also  I am now forced to pay strict attention when listening to people. This may slow down the tendency of older people to have a greater difficulty in “decoding” the  spoken word, due to decreased brain processing.

With the passage of a new law permitting people to access hearing aids without a prescription, the price of hearing aids is bound to go down, another reason for waiting.

If you are considering getting a hearing aid, an audiologist would prepare one that is tuned to your specific hearing loss.

The best is none too good.

—Dr. C.

Vitamin D: Lower Levels Increase Dementia Risks

Low vitamin D levels were linked with an increased risk of both dementia and stroke over the following 11 years. Based on this observational study, people with low vitamin D levels were found to have a 54% greater chance of developing dementia compared with people whose levels were normal.

A study published online April 22, 2022, by The American Journal of Clinical Nutrition suggests vitamin D deficiency may raise risk for dementia and stroke.

The study analyzed more than 294,000 people (most of them women over 60) living in the United Kingdom. Using blood tests on all participants and neuroimaging tools on about 34,000, researchers looked for associations between vitamin D levels and risks of dementia and stroke. A normal blood vitamin D level was defined as at least 50 nanomoles per liter (nmol/L); a deficiency was defined as less than 25 nmol/L.

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Heart Disease: The Best Ways To Lower High LDL Cholesterol Levels

November 1, 2022

What is a healthy target for LDL cholesterol?

Target LDL depends on many factors, including your age, family history, and personal history of cardiovascular disease. For people at intermediate risk, LDL should be lowered by 30% to 50%. For those who have already had a heart attack, target LDL is no more than 70 mg/dl (note: automatic download).

Which non-statin therapies are recommended first?

Five non-statin therapies described in this post aim to help people achieve target LDL goals while minimizing side effects. They may be combined with a statin or given instead of statins.

Each helps lower LDL cholesterol when diet and statins are not sufficient, such as when there is a family history of high cholesterol (familial hypercholesterolemia). But so far, only two options are proven to reduce cardiovascular risk — the risk for heart attack, stroke, heart failure, and other issues affecting the heart and blood vessels.

Ezetimibe (Zetia)

What it does: Lowers LDL and cardiovascular risk by reducing cholesterol absorption.

How it’s given: A daily pill

Relatively inexpensive and often given with statins.

PCSK9 inhibitors, alirocumab (Praluent) and evolocumab (Repatha)

What it does: A protein called PCSK9 controls the number of LDL receptors on cells. These medicines are monoclonal antibodies against PCSK9 that increase LDL receptors on the liver, helping to clear circulating LDL from the bloodstream.

How it’s given: A shot every two to four weeks

Highly effective for lowering LDL, but expensive and may not be covered by insurance.

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Glaucoma: The Risks Of Ocular Hypertension

Often described as the silent thief of sight, glaucoma is the most common cause of irreversible blindness in the world. High pressure in the eye damages the optic nerve, first stealing peripheral vision (what you see at the corners of your eyes) and later harming central vision (what you see when looking straight ahead). Usually, people notice no symptoms until vision loss occurs.

Close up photo of a brown eye; black pupil in the center, irish is many shades of brown, white of eye shows tiny veins

Lowering high eye pressure is the only known treatment to prevent or interrupt glaucoma. But does everyone with higher-than-normal eye pressure need to be treated? A major long-term study provides some clues, though not yet a complete answer.

Does everyone with high eye pressure develop glaucoma?

In the US, glaucoma affects an estimated three million people, half of whom do not know that they have it. An ophthalmologist can perform a comprehensive eye exam to determine if someone has glaucoma, or is at risk for developing it in the future due to high eye pressure (ocular hypertension). Research from the long-running Ocular Hypertension Treatment Study (OHTS) shows that some people with high eye pressure may never develop glaucoma, while others will.

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Diet: Consuming Olive Oil Daily Lowers Heart Risks

Consuming just a half-tablespoon or more of olive oil a day is linked to a lower risk of dying from heart disease and other chronic health conditions, new research suggests.

photo of a hand holding a bottle of olive oil and drizzling it on a dish of quinoa

The study included more than 92,000 women and men from the Nurses’ Health Study and the Health Professionals Follow-up Study, who filled out diet questionnaires every four years for 28 years. Olive oil intake was calculated from how much they reported using in salad dressings, on bread and other food, and in baking or frying.

Compared with participants who rarely or never consumed olive oil, those who consumed the most (about a half-tablespoon or more daily) had a 19% lower risk of dying from heart disease during the study. Researchers also noted lower death rates over all among people who substituted olive oil for a similar amount of margarine, butter, mayonnaise, or dairy fat. The findings, published Jan.18, 2022, in the Journal of the American College of Cardiology, lend further support for choosing olive oil — a key component of the heart-friendly Mediterranean diet.

Read more at Harvard Health

Stroke: Long Periods Of Sitting Increases Risks

The study involved 7,607 adults who wore a hip-mounted accelerometer (a device that records how fast you move) for a week. Their average age was 63. During a follow-up period averaging 7.4 years, 246 of the participants experienced a stroke.

People who sat for 13 or more hours per day during the initial week of motion tracking were 44% more likely to have a stroke compared with those who’d spent less than 11 hours per day sitting still. In addition, longer bouts of sitting (more than 17 minutes at a time) were linked to a higher risk than shorter bouts (less than eight minutes).

Inflammation: Treating Ulcerative Colitis (UC)

Since ulcerative colitis (UC), a condition that causes inflammation in the colon and rectum, is never medically cured, certain lifestyle behaviors can help you manage symptoms and better cope with your condition. In addition to managing stress, paying attention to what you eat can have a big impact on your quality of life.

A notepad with "ulcerative colitis" printed on it and a stethoscope laying next to it.

You should eat a well-balanced, healthy diet rich in fresh fruits and vegetables, such as a Mediterranean style diet. Avoid preservatives and emulsifiers, such as carrageenan, carboxymethylcellulose, and polysorbate-80.

If you have inflammatory bowel disease and also irritable bowel syndrome (IBS), a low-FODMAP diet may be helpful. FODMAP stands for the short-chain carbohydrates known as fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Some people who eat high-FODMAP foods have an increased risk of problems like diarrhea, bloating, abdominal pain, and flatulence. FODMAPs include the following:

  • disaccharides, such as lactose (in milk and other dairy products)
  • monosaccharides, such as fructose (for example, in apples and honey)
  • oligosaccharides, such as fructans (in wheat, onions, and garlic, for example) and galactans (commonly found in beans, lentils, and soybeans)
  • polyols, such as sorbitol and mannitol (in some fruits, vegetables, and artificial sweeteners).

A low-FODMAP diet can help reduce abdominal pain, bloating, and diarrhea and improve stool consistency in people with IBS who also have well-controlled IBD. Consult with your doctor and a nutritionist about how FODMAP reduction may fit into your dietary plan.

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Low Back Pain: Top New Approaches To Treatment

How big is this problem, and what did this study find?

Worldwide, low back pain is a leading cause of disability and affects more than 560 million people. In the US, four in 10 people surveyed in 2019 had experienced low back pain within the past three months, according to the Centers for Disease Control and Prevention.

Protect yourself from the damage of chronic inflammation.

Science has proven that chronic, low-grade inflammation can turn into a silent killer that contributes to cardiovas­cular disease, cancer, type 2 diabetes and other conditions. Get simple tips to fight inflammation and stay healthy — from Harvard Medical School experts.

Smart Watches: New Heart Surgery Remote Monitors

Smartwatches just keep getting smarter: the latest versions can estimate your blood oxygen level and record an ECG (a measurement of your heart’s electrical activity). A new study suggests these sophisticated devices may provide a safe, accurate way to monitor people at home after they undergo a minimally invasive heart valve replacement procedure.

The study included 100 people who had a transcatheter aortic valve replacement, most of whom went home within a day or two after the procedure. All received a smartwatch that recorded their heart rate, steps, pulse, oxygen saturation, and an ECG measurement. During next 30 days, the smartwatch detected 29 of 38 heart-related problems — mostly heart rhythm abnormalities — among 34 participants.

The findings suggest that smartwatches could be an effective way to remotely monitor patients from home, say the authors, whose study was published March 29, 2022, in the Journal of the American Heart Association.

Eye Health: Why Corneal Transplants Are Rising

At one time, replacement parts for the eyes must have seemed unimaginable. Nowadays, if the inner lens of the eye becomes clouded by a cataract, a routine surgery to swap it out with a new artificial lens restores vision.

But what happens if the outer lens of the eye (the cornea) becomes damaged or diseased? You can have that replaced, too. “It’s not as common as cataract surgery, but many people get corneal diseases after age 50 and may need a corneal transplant,” says Dr. Nandini Venkateswaran, a corneal and cataract surgeon at Harvard-affiliated Massachusetts Eye and Ear.

More than 49,000 corneal transplants occurred in 2021 in the US, according to the Eye Bank Association of America.

What is the cornea?

The cornea is a dome of clear tissue at the front of each eye, covering the iris and pupil, that acts as a windshield that protects the delicate eye apparatus behind it, and focuses light onto the retina, which sends signals that the brain turns into images (your vision).

You need this combo of windshield and camera lens to focus and see clearly. But many things can go wrong within the five layers of tissue that make up the cornea. That can make it hard to see and rob you of the ability to read, drive, work, and get through other activities in your day.

How does damage to the cornea occur?

It may stem from a number of causes:

  • Injuries, such as a fall. “Falls are a big reason for people to come in with acute eye trauma. The cornea can be damaged easily if something pokes it,” Dr. Venkateswaran says.
  • Previous eye surgeries. “Especially for adults who’ve had several eye surgeries — such as cataract and glaucoma surgeries — the inner layers of the cornea can become damaged and weakened with age,” she adds.
  • Illness. Problems like severe corneal infections, or genetic conditions such as Fuchs’ endothelial dystrophy, can cause vision loss.

What are the options for treating corneal damage?

Cornea treatment depends on the type of problem you have and the extent of the damage. “It’s a stepwise approach. Sometimes wearing a specialty contact lens or using medications can decrease swelling or scarring in the cornea,” Dr. Venkateswaran says.