Speech recognition with hearing aids for 10 standard audiograms : English version.

BACKGROUND: Improvement of speech perception in quiet is an important goal of hearing aid provision. In practice, results are highly variable. The aim of this study was to investigate the relationship between type and extent of hearing loss (audiogram type), maximum word recognition score, and aided speech perception. MATERIALS AND METHODS: Pure tone and speech audiometric data of 740 ears in 370 patients were reviewed. All subjects visited our hearing center for hearing aid evaluation between 2012 and 2017. The maximum word recognition score (WRSmax) and the monosyllabic speech recognition score with hearing aids, WRS65(HA) were analyzed for 10 different standard audiogram types. RESULTS: The WRS65(HA) with hearing aids for different degrees of hearing loss is, within error boundaries, comparable to previous investigations and shows a difference of 10-20 percentage points to the WRSmax. This difference tends to be larger for flat and moderately sloping audiograms compared to steep-sloping audiograms. The ratio WRS65(HA)/WRSmax can be interpreted as an efficiency factor for hearing aid provision, since it relates speech recognition with hearing aids to the maximally achievable information carrying capacity of the hearing impaired. CONCLUSION: The expectation regarding hearing aid provision has to be adjusted according to maximum word recognition score, the derived quality measures, degree of hearing loss, and audiogram type.

[Speech recognition with hearing aids for 10 standard audiograms]. / Sprachverstehen mit Hörgeräten für 10 Standardaudiogramme.

BACKGROUND: Improvement of speech perception in quiet is an important goal of hearing aid provision. In practice, results are highly variable. The aim of this study was to investigate the relationship between type and extent of hearing loss (audiogram type), maximum word recognition score, and aided speech perception. MATERIALS AND METHODS: Pure tone and speech audiometric data of 740 ears in 370 patients were reviewed. All subjects visited our hearing center for hearing aid evaluation between 2012 and 2017. The maximum word recognition score (WRSmax) and the monosyllabic speech recognition score with hearing aids, WRS65(HA) were analyzed for 10 different standard audiogram types. RESULTS: The WRS65(HA) with hearing aids for different degrees of hearing loss is, within error boundaries, comparable to previous investigations and shows a difference of 10-20 percentage points to the WRSmax. This difference tends to be larger for flat and moderately sloping audiograms compared to steep-sloping audiograms. The ratio WRS65(HA)/WRSmax can be interpreted as an efficiency factor for hearing aid provision, since it relates speech recognition with hearing aids to the maximally achievable information carrying capacity of the hearing impaired. CONCLUSION: The expectation regarding hearing aid provision has to be adjusted according to maximum word recognition score, the derived quality measures, degree of hearing loss, and audiogram type.

Tacrolimus Aggravated Tube Feeding Syndrome with Acute Renal Failure in a Pediatric Liver Transplant Recipient.

Acute renal failure can be caused by calcineurin inhibitors (CNIs), due to arteriolopathy and altered tubular function. Within this context, we present the case of a 14-month-old liver transplant recipient who suffered an acute polyuric renal failure during a short episode of hypercaloric feeding. In our case, CNI-induced distal RTA led to nephrocalcinosis and therefore to secondary nephrogenic diabetes insipidus. The diet with high renal solute load consequently resulted in an acute polyuric renal failure with severe hypernatremic dehydration. In conclusion, a hypercaloric diet in children with potentially impaired renal function due to therapy with CNIs requires precise calculation of the potential renal solute load and the associated fluid requirements.

Cardiovascular autonomic function in poststroke patients.

BACKGROUND: Autonomic dysregulation is frequent in acute ischemic stroke. Several studies concluded that imbalance between sympathetic and parasympathetic cardiovascular function predisposes to malignant cardiac arrhythmia. However, there are few data on cardiovascular autonomic function in post-acute stroke patients. OBJECTIVE: To study cardiovascular autonomic function 18 to 43 months after lacunar stroke. PATIENTS AND METHODS: We continuously monitored R-R intervals (RR(int)), mean blood pressure (BP(mean)), and respiration in 15 patients (8 women, aged 43 to 73 years) after right-sided stroke, in 13 patients (7 women, aged 50 to 75 years) after left-sided stroke, and in 21 age- and sex-matched controls at rest. We used autoregressive spectral analysis to assess sympathetic and parasympathetic modulation as powers of RR(int) and BP(mean) oscillations in the low-frequency (LF: 0.04 to 0.15 Hz) and high-frequency bands (HF: 0.15 to 0.5 Hz). RESULTS: Mean values of RR(int), BP(mean), and respiratory frequency did not differ between patients after right- or left-sided stroke and controls (p > 0.05). Patients after right-sided stroke showed a trend toward elevated LF power of RR(int) as compared with patients after left-sided stroke and controls (p < 0.10). HF powers of RR(int) were reduced in patients after right- and left-sided stroke as compared with controls (p < 0.05). LF/HF ratio of RR(int) was elevated in patients after right-sided stroke as compared with patients after left-sided stroke and controls (p < 0.05). CONCLUSION: Irrespective of the side of the ischemia, post-acute stroke patients showed a parasympathetic cardiac deficit. Additionally, sympathetic cardiovascular modulation was increased in patients after right-sided stroke. Post-acute stroke patients might be at an increased risk for cardiac arrhythmia after unopposed sympathetic stimulation.