May 17, 2020

Tinnitus discovery leads to hope for drug treatment

tinnitus
drug treatment
Discovery
cellular mechanism
Admin
4 min
Hopes for a drug treatment for tinnitus have been renewed
Millions of tinnitus sufferers have been given renewed hope that a drug treatment for the condition is a possibility. It is all thanks to a discovery t...

Millions of tinnitus sufferers have been given renewed hope that a drug treatment for the condition is a possibility.

It is all thanks to a discovery that has been made by a group of research scientists from the University of Leicester in the UK.

They have identified a cellular mechanism that could underlie the development of tinnitus following exposure to loud noises.

It is this discovery that could lead to novel tinnitus treatments, and investigations into potential drugs to prevent tinnitus are already underway.

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Tinnitus is thought to affect 10 percent of the population, and in the UK alone it is estimated there are five million sufferers.

It refers to the sensation of phantom sounds, usually a ringing or buzzing in the ears, which the sufferer hears even when there is no external noise.

Commonly it is caused from exposure to loud noises, although there have been suggestions that it can also be caused from damage to nerve cells connected to the ears.

There are currently no treatments available for tinnitus, nor is there anything to prevent or ease the symptoms.

Commenting on the research team’s findings, Dr Martine Hamann, the leader of the study, said: “We need to know the implications of acoustic over exposure, not only in terms of hearing loss but also what's happening in the brain and central nervous system.

“It's believed that tinnitus results from changes in excitability in cells in the brain - cells become more reactive, in this case more reactive to an unknown sound.”

To carry out the investigation, Dr Hamann and her team looked at cells in the dorsal cochlear nucleus part of the brain, which carries signals from nerve cells into the ear to the parts of the brain that decode and make sense of sounds.

Following exposure to loud noises, some of the nerve cells (neurons) in the dorsal cochlear nucleus start to fire erratically, and this uncontrolled activity eventually leads to tinnitus.

“We showed that exposure to loud sound triggers hearing loss a few days after the exposure to the sound,” explained Dr Hamann.

“It also triggers this uncontrolled activity in the neurons of the dorsal cochlear nucleus.

“This is all happening very quickly, in a matter of days.”

In another key breakthrough, the team also identified the specific cellular mechanism that leads to the neurons' over-activity.

Malfunctions in specific potassium channels that help regulate the nerve cell's electrical activity mean the neurons cannot return to an equilibrium resting state.

Ordinarily, these cells only fire regularly and therefore regularly return to a rest state.

However, if the potassium channels are not working properly, the cells cannot return to a rest state and instead fire continuously in random bursts, creating the sensation of constant noise when none exists.

Dr Hamann continued: "In normal conditions the channel helps to drag down the cellular electrical activity to its resting state and this allows the cell to function with a regular pattern.

“After exposure to loud sound, the channel is functioning less and therefore the cell is constantly active, being unable to reach its resting state and displaying those irregular bursts.”

Although many researchers have investigated the mechanisms underlying tinnitus, this is the first time that cellular bursting activity has been characterised and linked to specific potassium channels.

Identifying the potassium channels involved in the early stages of tinnitus opens up new possibilities for preventing tinnitus with early drug treatments.

Dr Hamann's team is currently investigating potential drugs that could regulate the damaged cells, preventing their erratic firing and returning them to a resting state.

If suitable drug compounds are discovered, they could be given to patients who have been exposed to loud noises to protect them against the onset of tinnitus.

However, these investigations are still in the preliminary stages, and any drug treatment would still be years away.

The research was funded by a Research Councils UK fellowship to Dr Hamann, a grant from the Wellcome Trust and a PhD studentship from GlaxoSmithKline, with follow-up investigations funded by a three-month grant from Deafness Research UK.

Also commenting on the research, Vivienne Michael, Chief Executive of Deafness Research UK, said: “We're pleased to hear about this progress in such a debilitating hearing impairment.

“The charity continues to fund research into better treatments for tinnitus, with the ultimate aim of a cure.

“Our free information leaflets offer immediate help to sufferers and our national helpline provides additional support. Regularly tinnitus generates the most requests for help.”

Further pharmaceutical research will be carried out by the University of Leicester in collaboration with Autifony Therapeutics Ltd via a Medical Research Council Case studentship, which is due to start in October 2012.

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Jul 22, 2021

COVID-19 "causing mass trauma among world’s nurses"

COVID19
Hospitals
nurses
burnout
5 min
COVID-19 "causing mass trauma among world’s nurses"
Two nurses tell us about COVID-19, nurse burnout, and how to address it

Healthcare providers are facing ongoing nursing shortages, and hospitals are reporting high rates of staff turnover and burnout as a result of the COVID-19 pandemic. In June a report found that levels of burnout among staff in England had reached "emergency" levels

Registered nurses Molly Rindt and Erika Haywood are nurse mentors on US recruitment platform Incredible Health. In this joint Q&A they tell Healthcare Global about their own experiences of burnout and what can be done to tackle it. 

What does it mean to be suffering from burnout? 
Some of the most common reasons for nurse burnout include long work hours, sleep deprivation, a high-stress work environment, lack of support, and emotional strain from patient care. 

While every profession has its stressors, the nursing industry has some of the highest burnout rates. The massive influence on patients’ lives, the long hours, and many other factors put nurses at risk of severe burnout. And with the rise of COVID-19, many healthcare professionals feel the strain more than ever.

Burnout in nurses affects everyone — individual nurses suffer, patients are impacted, and employers struggle with enormous turnover. This is why it’s crucial for healthcare systems and management to watch for signs of nurse burnout and take steps to provide a healthier workplace. Employers should be careful to watch for burnout symptoms in their healthcare staff — and not ignore them. 

Symptoms include constant tiredness, constant anxiety related to work, emotional detachment and unexplained sickness. 

How widespread is this problem?     
Unfortunately, burnout affects approximately 38% of nurses per year and even the WHO recently labelled burnout as an official medical diagnosis. To put this statistic into perspective, nearly 4 out of 10 nurses will drive to work dreading their shift. Burnout is a reason nurses leave their positions. 

Other top reasons for leaving included a stressful work environment, lack of good management or leadership, inadequate staffing, and finding better pay or benefits elsewhere.

Even before the pandemic, demanding workloads and aspects of the work environment such as poor staffing ratios, lack of communication between physicians and nurses, and lack of organisational leadership were known to be associated with burnout in nurses. 

Have either of you experienced burnout? 
Rindt: I have experienced burnout as an RN. I was constantly fatigued,  never felt like I was off work, and would frequently dream I was still at work taking care of patients. In my particular situation, I needed to take a step back and restructure my work schedule to allow for more time off. After doing this, I was able to reduce burnout by deciding to work two shifts back-to-back and then have 2-3 days off.

Haywood: I definitely experienced constant anxiety related to work - so much so it would impact the days I wasn’t at work. At one point, I was even on medication to help combat the anxiety and stress I was facing on the job. 

I had heart palpitations, chest pain, and wouldn’t be able to sleep before working the next day, which slowly started to impact other aspects of my life. I knew I couldn’t continue to live this way, it wasn’t sustainable. Because of this, I began to focus on my needs and prioritising self-care, especially during the beginning of the pandemic. Putting my needs first and not feeling guilty were necessary for me to overcome burnout.

What impact is COVID-19 having on nurses' wellbeing? 
Some nurses have suffered devastating health consequences. Many nurses have dealt with excessive on-the-job stress, fears of becoming infected, and grief over seeing patients succumb to COVID-19 while isolated from their families.

New evidence gathered by the International Council of Nurses (ICN) suggests COVID-19 is causing mass trauma among the world’s nurses. The number of confirmed nurse deaths now exceeds 2,200, and with high levels of infections in the nursing workforce continuing, overstretched staff are experiencing increasing psychological distress in the face of ever-increasing workloads, continued abuse and protests by anti-vaccinators. 

However, other small silver linings that came from the pandemic include increased professional autonomy, leadership opportunities and career growth potential.

How much of the cause of burnout is due to the hospitals or healthcare providers, and what can they do to address it?

Nurse fatigue poses serious problems for healthcare organisations, and a recent survey from Kronos found 63% of nurses say their job has caused burnout. The survey also found that more than 4 out of 5 nurses think hospitals today are losing good staff because other employers offer a better work/life balance.

Nurse burnout  not only contributes to staff turnover, but it can impact the facility’s quality of care, patient satisfaction, and even medical outcomes. 

Strategies to address burnout include training improving  nurse-to-patient ratios, include nurses in policy discussions, and prioritise fostering a healthy work culture in hospitals. 

What does your role mentoring nurses on the Incredible Health platform involve?
Rindt: My role can vary based on the needs of the nurses. The nurses love knowing they have someone in their corner who can give interview preparation advice or provide suggestions on how to improve their resume. Knowing that there is someone who is well-versed in the job process and can help set expectations on what to anticipate, really helps to remove a layer of uncertainty.

Haywood: When screening nurses, it is customised to what their individual RN or nurse practitioner needs, and at a time that is most convenient for them. Nurses are busy and often aren’t thought of first. Being able to provide support from the very beginning of their career advancement journey helps tremendously.  We also provide resources such as resume templates and tips that can help nurses be successful and feel supported.

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