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There is a need for better understanding of various characteristics in hyperacusis in the general population. The objectives of the present study were to investigate individuals in the general population with hyperacusis regarding demographics, lifestyle, perceived general health and hearing ability, hyperacusis-specific characteristics and behavior, and comorbidity. Using data from a large-scale population-based questionnaire study, we investigated individuals with physician-diagnosed (n = 66) and self-reported (n = 313) hyperacusis in comparison to individuals without hyperacusis (n = 2995). High age, female sex, and high education were associated with hyperacusis, and that trying to avoid sound sources, being able to affect the sound environment, and having sough medical attention were common reactions and behaviors. Posttraumatic stress disorder, chronic fatigue syndrome, generalized anxiety disorder, depression, exhaustion, fibromyalgia, irritable bowel syndrome, migraine, hearing impairment, tinnitus, and back/joint/muscle disorders were comorbid with hyperacusis. The results provide ground for future study of these characteristic features being risk factors for development of hyperacusis and/or consequences of hyperacusis.

Hyperacusis is a condition that is characterized by hypersensitivity to normal everyday sounds or reduced sound tolerance and can affect patients in distressing ways. Sound therapy is a treatment intervention that is used to desensitize patients. However, as yet, there is a lack of understanding on how it is used in clinical practice, the different types of devices, or how to use them. The aim of this scoping review was to establish the current use of sound therapy in adults with hyperacusis and identify any factors that may influence treatment. Methodology: An established methodological framework was used to formulate the research question and guide the search strategy and reporting. The inclusion criteria were studies reporting adult (>18 years) populations with hyperacusis and sound therapy treatments which were published in any language. Searches of electronic databases (CINAHL, Cochrane Library, Medline (EBSCO), Scopus, PsycINFO) identified 31 studies that met the inclusion criteria (completed in April 2024). Data from included records were collated and summarized descriptively.

Hyperacusis is defined as a reduction in tolerance to ordinary environmental sounds. Hyperacusis can occur in individuals of all age groups, making daily life difficult for the sufferers. Although there is no objective test to accurately diagnose hyperacusis, questionnaires are useful for the assessment of hyperacusis. The aim of this study was to explore the reduced sound tolerance in university students using a hyperacusis questionnaire (HQ). A total of 536 university students (300 females and 236 males) aged between 18 and 25 years, with a mean age of 21.34 ± 1.87 years, were assessed using an HQ developed by Khalfa. The mean total score of all the participants was 16.34 ± 7.91, and 5.78% of the participants had total scores indicating hyperacusis, where a majority of them were females. Females had significantly higher scores than men in terms of both the total and the attentional and emotional dimensions. The scores of the participants who reported noise exposure or a decrease in their tolerance to noise were significantly higher than those of the other participants. Even among young adults, there was a group of participants suffering from some problems related to decreased tolerance to everyday sounds. Although the Turkish translation of the HQ seems to be a reliable tool for evaluating hyperacusis in young adults, further work with various populations of different age groups is required to establish validity and to assess the psychometric qualities of the Turkish form.

Syncope, or fainting, affects approximately 6.2% of the population, and is associated with significant comorbidity. Many syncopal events occur secondary to excessive venous pooling and capillary filtration in the lower limbs when upright. As such, a common approach to the management of syncope is the use of compression stockings. However, research confirming their efficacy is lacking. We aimed to investigate the effect of graded calf compression stockings on orthostatic tolerance. We evaluated orthostatic tolerance (OT) and haemodynamic control in 15 healthy volunteers wearing graded calf compression stockings compared to two placebo stockings in a randomized, cross-over, double-blind fashion. OT (time to presyncope, min) was determined using combined head-upright tilting and lower body negative pressure applied until presyncope. Throughout testing we continuously monitored beat-to-beat blood pressures, heart rate, stroke volume and cardiac output (finger plethysmography), cerebral and forearm blood flow velocities (Doppler ultrasound) and breath-by-breath end tidal gases. There were no significant differences in OT between compression stocking (26.0±2.3 min) and calf (29.3±2.4 min) or ankle (27.6±3.1 min) placebo conditions. Cardiovascular, cerebral and respiratory responses were similar in all conditions. The efficacy of compression stockings was related to anthropometric parameters, and could be predicted by a model based on the subject's calf circumference and shoe size (r = 0.780, p = 0.004). These data question the use of calf compression stockings for orthostatic intolerance and highlight the need for individualised therapy accounting for anthropometric variables when considering treatment with compression stockings.

Increase in allergenicity towards cow’s milk, lactose intolerance, the prevalence of hypercholesterolemia, and flexitarian choice of food consumption have increased the market for cow’s milk alternatives. Non-dairy plant-based beverages are useful alternatives because of the presence of bioactive components with health-promoting properties, which attract health-conscious consumers. However, the reduced nutritional value and sensory acceptability of the plant-based beverages (such as flavor, taste, and solubility) compared to cow’s milk pose a big threat to its place in the market. Thermal treatments are commonly used to ensure the quality of plant-based beverages during storage. However, the application of high temperatures can promote the degradation of thermolabile compounds and some detrimental reactions, thus reducing protein digestibility and amino acid availability of non-dairy plant-based beverages substitutes. New and advanced food processing technologies, such as high-pressure processing, high-pressure homogenization, pulsed electric fields, and ultrasound, are being researched for addressing the issues related to shelf life increase, emulsion stability, preservation of nutritional content and sensorial acceptability of the final product. However, the literature available on the application of non-thermal processing technologies on the physicochemical and nutritional properties of plant-based beverages is scarce. Concerted research efforts are required in the coming years in the functional plant-based beverages sector to prepare newer, tailor-made products which are palatable as well as nutritionally adequate.

Although stress significantly impacts on various metabolic syndromes, including diabetes mellitus, most stress management techniques are based on psychological and subjective approaches. This study examined how the presence or absence of the inaudible high-frequency component (HFC) of sounds, which activates deep-brain structures, affects glucose tolerance in healthy participants using the oral glucose tolerance test (OGTT). Sounds containing HFC suppressed the increase in glucose levels measured by incremental area under the curve in the OGTT compared with the otherwise same sounds without HFC. The suppression effect of HFC was more prominent in the older age group and the group with high HbA1c. This suggests that sounds with HFC are more effective in improving glucose tolerance in individuals at a higher risk of glucose intolerance.

Sarcoidosis is a chronic disease which may involve muscular system subclinically at the onset of the disease. Sarcopenia is a musculoskeletal condition that may be associated with nonspecific symptoms in patients with sarcoidosis such as general weakness, arthralgia, reduced exercise capacity, and fatigue. This study aimed to determine the association between the functionality and the quadriceps femoris muscle (QFM) thickness measured using sonography in patients with sarcoidosis. Thirty-one women with sarcoidosis and 27 controls were evaluated for the following outcomes: (i) handgrip strength, (ii) QFM thickness measured using ultrasound (US), and (iii) sonographic thigh adjustment ratio (STAR). The sarcoidosis group was also evaluated using the 30-second chair stand test (30s-CST) and fatigue severity scale (FSS). The QFM thickness and STAR values of the sarcoidosis group were significantly lower than those of the control group (p=0.0001). However, no statistically significant difference was observed between the handgrip strengths of the groups (p=0.581). There was no statistically significant correlation between the STAR values and handgrip strength in the sarcoidosis group (p>0.05); however, there was a statistically significant positive correlation between the STAR values and 30s-CST (r=0.467, p=0.008). Probable sarcopenia is one of the musculoskeletal conditions in patients with sarcoidosis that may be associated with nonspecific symptoms, such as general weakness, exercise intolerance, and fatigue. Although the handgrip test is a frequently used test, it may not show prominent findings in the early stages of the disease. Ultrasound appears to be an innovative tool for preventing sarcopenia as it helps detect changes in muscle mass and muscle quality at an early stage. [1]Fayad F, Lioté F, Berenbaum F, Orcel P, Bardin T. Muscle involvement in sarcoidosis: a retrospective and followup studies. J Rheumatol 2006; 33:98–103. [2]Gea J, Casadevall C, Pascual S, Orozco-Levi M, Barreiro E (2012) Respiratory diseases and muscle dysfunction. Expert Rev Resp Med. 6:75–90 NIL. None Declared.

Recent focus has been given on the effects of high-intensity infrasound (HII) exposure, and whether it induces changes in pancreatic morphology and glucose metabolism is still unknown. As such, we have studied the impact of HII exposure on glucose tolerance, insulin sensitivity, pancreatic islet morphology, muscle GLUT4 and plasma insulin and corticosterone levels. Normal and glucose intolerant wild-type Wistar rats were randomly divided in two groups: one group not exposed to HII and the other continuously exposed to HII. Animals were sacrificed at three timepoints of exposure (1, 6 or 12 weeks). An intraperitoneal glucose tolerance test was performed, blood samples were collected and the pancreas and the quadriceps femoris muscle were excised. Circulating insulin and corticosterone levels were determined and pancreatic and muscular tissue were routinely processed for histochemistry and immunohistochemistry with an anti-GLUT4 antibody. Animals exposed to HII had higher corticosterone levels than animals not exposed. No differences were found on insulin concerning HII exposure or glucose intolerance. Glucose intolerant animals had pancreatic islet fibrosis and no differences were found in GLUT4 ratio concerning HII exposure. In conclusion, we found that continuous exposure to HII increases stress hormone levels without inducing glucose intolerance in rats.

Purpose The study of dynamic cerebral autoregulation (CA), which adapts cerebral blood flow to arterial blood pressure (ABP) fluctuations, has been limited in orthostatic intolerance syndromes, mainly due to its stationary prerequisites hardly to meet during maneuvers to provoke syncope itself. New techniques of continuous estimates of CA could overcome this pitfall. We aimed to evaluate CA during head-up tilt test in common conditions causing syncope. Methods We compared three groups: eight controls; eight patients with autonomic failure due to familial amyloidotic polyneuropathy; eight patients with vasovagal syncope (VVS). ABP and cerebral blood flow velocity (CBFV) were measured with Finometer ® and transcranial Doppler. We calculated cerebrovascular resistance index (CVRi), critical closing pressure (CrCP) and resistance area product (RAP), and derived CA continuously from autoregulation index [ARI( t )]. Results With HUTT, AF subjects showed a pronounced decrease in CBFV (−36 ± 17 versus −7 ± 6%, p  < 0.0001), ABP (−29 ± 27 versus 7 ± 12%, p  < 0.0001) and RAP (−17 ± 23 versus 3 ± 18%, p  < 0.0001) but not CVRi ( p  = 0.110). VVS subjects showed progressive cerebral vasoconstriction prior to syncope, (reduced CBFV 19 ± 15 versus 1 ± 6, p  < 0.000; increased RAP 12 ± 18 versus 2 ± 3%, p  = 0.024 and CVRi 12 ± 18 versus 2 ± 3%, p  = 0.005). ARI( t ) increased significantly in AF patients (5.7 ± 1.2 versus 6.9 ± 1.2, p  = 0.040) and VVS (5.8 ± 1.2 versus 7.3 ± 1.2, p  = 0.015) in response to ABP fall during syncope. Conclusions Our data suggest that dynamic cerebral autoregulatory response to orthostatic challenge is neither affected by autonomic dysfunction nor in neutrally mediated syncope. This study also emphasizes that RAP + CrCP model is more informative than CVRi, mainly during cerebral vasodilatory response to orthostatic hypotension.

Visceral adipose tissue measured by CT or MRI is strongly associated with an adverse metabolic risk profile. We assessed whether similar associations can be found with ultrasonography, by quantifying the strength of the relationship between different measures of obesity and indices of glucose metabolism in a population at high risk of type 2 diabetes. A cross-sectional analysis of 1342 participants of the ADDITION-PRO study. We measured visceral adipose tissue and subcutaneous adipose tissue with ultrasonography, anthropometrics and body fat percentage by bioelectrical impedance. Indices of glucose metabolism were derived from a three point oral glucose tolerance test. Linear regression of obesity measures on indices of glucose metabolism was performed. Mean age was 66.2 years, BMI 26.9kg/m2, subcutaneous adipose tissue 2.5cm and visceral adipose tissue 8.0cm. All measures of obesity were positively associated with indicators of glycaemia and inversely associated with indicators of insulin sensitivity. Associations were of equivalent magnitude except for subcutaneous adipose tissue and the visceral/subcutaneous adipose tissue ratio, which showed weaker associations. One standard deviation difference in BMI, visceral adipose tissue, waist circumference, waist/height ratio and body fat percentage corresponded approximately to 0.2mmol/l higher fasting glucose, 0.7mmol/l higher 2-hr glucose, 0.06-0.1% higher HbA1c, 30 % lower HOMA index of insulin sensitivity, 20% lower Gutt's index of insulin sensitivity, and 100 unit higher Stumvoll's index of beta-cell function. After adjustment for waist circumference visceral adipose tissue was still significantly associated with glucose intolerance and insulin resistance, whereas there was a trend towards inverse or no associations with subcutaneous adipose tissue. After adjustment, a 1cm increase in visceral adipose tissue was associated with ~5% lower insulin sensitivity (p≤0.0004) and ~0.18mmol/l higher 2-hr glucose (p≤0.001). Visceral and subcutaneous adipose tissue assessed by ultrasonography are significantly associated with glucose metabolism, even after adjustment for other measures of obesity.