[Dependency of APHAB score in the ECu subscale on age, gender and subjective hearing loss : Hearing aid fitting in two subjective hearing loss groups]. / Abhängigkeit des APHAB-Werts in der ECu-Skala von Alter, Geschlecht und objektivem Hörverlust : Hörgeräteerstversorgung in 2 subjektiven Hörverlustgruppen.

OBJECTIVE: The Abbreviated Profile of Hearing Aid Benefit (APHAB) determines subjective impairment by hearing loss in four situations before and after hearing aid fitting. The first part (APHABu) of the questionnaire can be used independently of hearing aid fitting. Previous research has demonstrated that the answers in the ECu subscale for hearing under easy conditions are concentrated in two groups: one with subjectively better, one with subjectively worse hearing. This study aimed to investigate in a large collective whether there are differences between these two groups in terms of age, gender, and individual hearing loss. PATIENTS AND METHODS: The data of 1755 patients were analyzed, whose APHAB answers and pure-tone thresholds had been collected during hearing aid fitting. Group 1 had an average ECu score ≤37.5%; in group 2 it was ≥67.5%. The individual hearing losses was determined. Statistical analysis was performed using Mann-Whitney U, χ2, Spearman, and Pearson tests. RESULTS: The 616 members of group 1 were significantly younger (68.7 vs. 73.0 years) and comprised more females (53.9 vs. 46.1%) than the 1139 members of group 2. Hearing was frequency specific in group 1, and hearing loss as classified using standard audiograms and according to the three-frequency table was significantly lower in group 1 than in group 2, CONCLUSION: The distribution with two maximums in the ECu subscale can be explained by individual differences in terms of age and hearing loss, in part also by gender. The lower absolute number of patients in group 1 could be explained by the still relatively late fitting of hearing aids in general.

Immunogenicity of different brands of human insulin and rapid-acting insulin analogs in insulin-naïve children with type 1 diabetes.

AIMS: To determine (i) whether insulin preparations produced by three companies induce the same immune responses in insulin-naïve children with type 1 diabetes (T1DM); (ii) if switching from human insulin to rapid-acting insulin analogs influences this immune response; and (iii) if different insulin brands produce different clinical results during the first 2 yr after T1DM diagnosis. METHODS: Insulin antibodies (IA) were measured for 140 patients aged 1.4-17.6 yr. Regular human insulin, neutral protamine Hagedorn (NPH) human insulin, and rapid-acting insulin analogs (lispro or aspart) taken by the patients were produced by one of three companies: Bioton, Poland (A), Eli Lilly, USA (B) and NovoNordisk, Denmark (C). RESULTS: Positive IA levels were found in 112 patients (80.0%) at baseline and in 137 (97.9%) at 6 and at 24 months after T1DM diagnosis. There was no difference in IA levels among patients taking insulin preparations produced by different companies at 6 months (mean ± SD, A 27.8 ± 15.7%; B 25.3 ± 15.4%; C 24.5 ± 14.2; p = 0.54) or at 24 months (A 25.6 ± 17.8%; B29.6 ± 17.0%; C 26.2 ± 17.0%; p = 0.52); HbA(1c) and daily insulin dose did not differ significantly either. After 24 months, IA levels were similar for those who had used human insulin (mean ± SD, 25.7 ± 17.2%) and for those that had added rapid-acting analogs (28.1 ± 17.3%, p = 0.41). CONCLUSIONS: Three brands of insulin preparations did not differ with respect to immunogenicity. Rapid-acting analogs did not increase IA levels in patients previously treated with human insulin only. Patients using insulin preparations of different brands did not differ with respect to daily insulin dose or HbA(1c) .

Auditory brainstem responses with optimized chirp signals compensating basilar-membrane dispersion.

This study examines auditory brainstem responses (ABR) elicited by rising frequency chirps. The time course of frequency change for the chirp theoretically produces simultaneous displacement maxima by compensating for travel-time differences along the cochlear partition. This broadband chirp was derived on the basis of a linear cochlea model [de Boer, "Auditory physics. Physical principles in hearing theory I," Phys. Rep. 62, 87-174 (1980)]. Responses elicited by the broadband chirp show a larger wave-V amplitude than do click-evoked responses for most stimulation levels tested. This result is in contrast to the general hypothesis that the ABR is an electrophysiological event most effectively evoked by the onset or offset of an acoustic stimulus, and unaffected by further stimulation. The use of this rising frequency chirp enables the inclusion of activity from lower frequency regions, whereas with a click, synchrony is decreased in accordance with decreasing traveling velocity in the apical region. The use of a temporally reversed (falling) chirp leads to a further decrease in synchrony as reflected in ABR responses that are smaller than those from a click. These results are compatible with earlier experimental results from recordings of compound action potentials (CAP) [Shore and Nuttall, "High synchrony compound action potentials evoked by rising frequency-swept tonebursts," J. Acoust. Soc. Am. 78, 1286-1295 (1985)] reflecting activity at the level of the auditory nerve. Since the ABR components considered here presumably reflect neural response from the brainstem, the effect of an optimized synchronization at the peripheral level can also be observed at the brainstem level. The rising chirp may therefore be of clinical use in assessing the integrity of the entire peripheral organ and not just its basal end.