Long-term audiometric follow-up of click-evoked auditory brainstem response in hearing-impaired infants.

Conventional pure-tone thresholds were collected as determined at ages between 4 and 8 years from a group of 163 infants, tested by auditory brainstem response (ABR) in the age range between 1 and 3 years old for objective hearing assessment. The subjects suffered from a variety of degrees and types of sensorineural hearing impairment. The prognostic value of the ABR peak V thresholds in response to 0.1 ms clicks with respect to the behavioural thresholds at octave frequencies from 125 to 8,000 Hz obtained later is evaluated. Correlation between ABR and behavioural thresholds is largest in the 1,000- to 8,000-Hz frequency range. Predicted pure-tone audiograms (mean and SD) were determined for each 10-dB class of ABR thresholds. SDs are in the order of 15 to 18 dB in the 500- to 4,000-Hz range and slightly higher at adjacent frequencies (i.e., somewhat larger than in comparable adult studies). Mean pure-tone thresholds in the 1,000- to 8,000-Hz frequency range are up to 20 dB worse than ABR thresholds, which is opposite to findings in normally-hearing subjects. Thus, with an increasing degree of sensorineural hearing impairment, pure-tone thresholds increase at a significantly higher rate than ABR thresholds. The observation is explained in terms of reduced temporal integration in cochlear hearing loss. ABR thresholds worse than 80 dB nHL are demonstrated to have very limited predictive value with respect to the amount of residual hearing, not only in the low- but also in the high-frequency range. The presence of otitis media during ABR testing is shown to make estimation errors increase to more than 25 dB (SD).

Efficient synthesis of 3-aminodigoxigenin and 3-aminodigitoxigenin probes.

Oxidation of digoxigenin and digitoxigenin to the 3-ketones followed by reductive amination produced a mixture of amine epimers. The inability to separate the epimeric mixtures of chemiluminescent digoxigenin probes derived by conjugation to the acridinium label prompted us to develop an HPLC method to separate the amines. Labeling of the pure amines resulted in good yields of the isomerically pure probes.

[Physical diagnostic procedures: whispered speech and tuning fork test]. / Fysische diagnostiek--fluisterspraak en stemvorkproeven.

Hearing impairment occurs in 10% of the Dutch population and may lead to major communication problems and even social isolation. A good method to detect hearing loss in a general practice is the screening audiometer. The treating physician may further use the whispered speech test and tuning fork tests which together give a good impression of the severity and the nature of the hearing loss if any. The whispered speech test is best performed in the standardized form according to the guideline 'Slechthorendheid' [hardness of hearing] of the Dutch College of General Practitioners (NHG), in which certain combinations of letters are recommended. The tuning fork tests according to Rinne and Weber indicate a difference in perception and conduction deafness, and are decisive for any hearing asymmetry. Use of the whispered speech test and of the tuning fork tests is recommended for adults and children from the age of 7.

A barbiturate screening assay for the Abbott AxSYM analyzer.

A fluorescence polarization immunoassay for barbiturates on the Abbott AxSYM analyzer is described. The assay displayed dilution linearity up to 1200 ng/mL; coefficients of variation varied from 5.96 to 8.61%; recovery varied from 94.9 to 105.3%; and sensitivity was less than 40 ng/mL. Good correlation between the standard six- and factory two-point calibration methods was observed. The Immunoassay demonstrated good cross-reactivity to several commonly prescribed barbiturates; low cross-reactivity with structurally similar compounds; low interference from endogenous substances, dyes, preservatives, and several commonly available adulterants; and good correlation with the TDx Barbiturate Urine assay.