The characteristics of Audioscan and DPOAE measures in tinnitus patients with normal hearing thresholds.

OBJECTIVES: To investigate auditory dysfunction in patients with tinnitus and normal hearing thresholds using two sensitive audiological measures. DESIGN: The study was designed to investigate the characteristics of Audioscan and DPOAE tests in tinnitus patients with normal hearing thresholds. Audioscan and DPOAE notches were analysed and compared. All tests were performed in a sound-treated chamber or in a sound-treated room. STUDY SAMPLE: Forty-five tinnitus patients with normal hearing thresholds were examined following a written clinical protocol. RESULTS: The averaged hearing levels obtained from tinnitus participants were significantly worse at high frequencies than those derived from the normative data. There was a significantly higher prevalence of Audioscan and DPOAE notches, whose central frequencies matched tinnitus frequencies in the mid-frequency regions, but not in the low- and high-frequency regions. A significant correlation was found between the centre frequencies of the Audioscan notches and the DPOAE notches from 500 to 4000 Hz. CONCLUSION: Tinnitus in different frequency regions may be associated with different underlying mechanisms of tinnitus generation. Some negative results on the Audioscan and DPOAE notches matching tinnitus pitches may be due to a limited set of discrete frequencies used for the tinnitus pitch matching test.

The relationship between patients' perception of the effects of neurofibromatosis type 2 and the domains of the Short Form-36.

OBJECTIVES: To investigate the relationship between those issues concerning quality of life in patients with neurofibromatosis type 2 (NF2) as identified by the closed set NF2 questionnaire and the eight norm-based measures and the physical component summary (PCS) and mental component summary (MCS) scores of the Short Form-36 (SF-36) Questionnaire. DESIGN: Postal questionnaire study. SETTING: Questionnaires sent to subjects' home addresses. PARTICIPANTS: Eighty-seven adult subjects under the care of the Manchester Multidisciplinary NF2 Clinic were invited to participate. MAIN OUTCOME MEASURES: Sixty-two (71%) completed sets of closed set NF2 questionnaires and SF-36 questionnaires were returned. RESULTS: Subjects with NF2 scored less than the norm of 50 on both the physical component summary and mental component summary scores and the eight individual norm-based measures of the Short Form-36 questionnaire. Correlations (using Kendall's tau) were examined between patients' perceptions of their severity of difficulty with the following activities and the eight norm-based measures and the physical component summary and mental component summary scores of the Short Form-36 questionnaire: Communicating with spouse/significant other (N = 61). The correlation coefficients were significant at the 0.01 level for the mental component summary score, together with three of the norm-based scores [vitality (VT), social functioning and role emotional]. Social communication (N = 62). All 10 correlations were significant at the 0.01 or 0.001 level. Balance (N = 59). All 10 correlations were highly significant at the P < 0.001 level. Hearing difficulties (N = 61). All correlations were significant at either the 0.01 level or less apart from the mental component summary score and three of the norm-based scores (role physical, VT and mental health). Mood change (N = 61). All correlations were significant at the 0.01 level or less, apart from one norm-based score (role physical). CONCLUSIONS: The Short Form-36 questionnaire has allowed us to relate patients' perceptions of their difficulties, as identified by the closed set NF2 questionnaire, to the physical and mental domains measured by this validated and widely used scale, and has provided further insight into areas of functioning affected by NF2.

Vestibular disorder and emotional distress.

A standardised test of psychopathology (CCEI) was administered to tinnitus sufferers some of whom also complained of dizziness. It was predicted that the complaint of dizziness would be associated with higher scores on the anxiety scales of the CCEI and this was confirmed. Subjects complaining of dizziness obtained much higher scores on 'phobic' and 'somatic' anxiety scales in particular. However, the complaint of dizziness was completely uncorrelated with objective assessments of balance and there was no effect of balance, objectively assessed, in moderating the association between the complaint of dizziness and 'anxiety'. The results highlight the complex relationship between vestibular dysfunction and complaint behaviour.

The desynchrony between complaints and signs of vestibular disorders.

As part of an early intervention study on the acceptability of auditory rehabilitative intervention, we examined patient complaints and clinical findings of balance disorders. Hallam et al. have discussed desynchrony between such findings in hospital patient populations, and the aim of the present study was to investigate these relationships in a general population. The study was conducted in two industrial villages in Wales in which questionnaires were circulated to all individuals in the 50-65 age group. A marked desynchrony between semeions and clinical findings was found. This has been related to the desynchrony between auditory impairment, disability and handicap in this population. Subjects reporting giddiness or vertigo were more disabled but not more impaired in respect of auditory measures than those not reporting such balance problems. Those with abnormal balance test results showed no auditory differences from those with normal results.

Compositional and toxicological evaluation of the diazotrophic cyanobacterium, Cyanothece sp. strain ATCC 51142.

Compositional analyses of Cyanothece sp. strain ATCC 51142 showed high protein (50-60%) and low fat (0.4-1%) content, and the ability to synthesize vitamin B12. The amino acid profile indicated that Cyanothece sp. was a balanced protein source. Fatty acids of the 18:3n-3 type were also present. Mineral analyses indicated that the cellular biomass may be a good source of Fe, Zn and Na. Caloric content was 4.5 to 5.1 kcal g dry weight-1 and the carbon content was approximately 40% on a dry weight basis. Nitrogen content was 8 to 9% on a dry weight basis and total nucleic acids were 1.3% on a dry weight basis. Short-term feeding studies in rats followed by histopathology found no toxicity or dietary incompatibility problems. The level of uric acid and allantoin in urine and tissues was low, suggesting no excess of nucleic acids, as sometimes reported in the past for a cyanobacteria-containing diet. The current work discusses the potential implications of these results for human nutrition applications.

Storage stability of screwpress-extracted oils and residual meals from CELSS candidate oilseed crops.

The efficacy of using screwpress extraction for oil was studied with three Controlled Ecological Life-Support System (CELSS) candidate oilseed crops (soybean, peanut, and canola), since use of volatile organic solvents for oil extraction likely would be impractical in a closed system. Low oil yields from initial work indicated that a modification of the process is necessary to increase extraction efficiency. The extracted oil from each crop was tested for stability and sensory characteristics. When stored at 23 degrees C, canola oil and meal were least stable to oxidative rancidity, whereas peanut oil and meal were least stable to hydrolytic rancidity. When stored at 65 degrees C, soybean oil and canola meal were least stable to oxidative rancidity, whereas peanut oil and meal were least stable to hydrolytic rancidity. Sensory evaluation of the extracted oils used in bread and salad dressing indicated that flavor, odor intensity, acceptability, and overall preference may be of concern for screwpress-extracted canola oil when it is used in an unrefined form. Overall results with screwpress-extracted crude oils indicated that soybean oil may be more stable and acceptable than canola or peanut under typical storage conditions.

St Cadoc and the healing of the deaf.

This manuscript traces the traditions of the healing of the deaf associated with St Cadoc. While Saint Cadoc was Welsh, the traditions associated with him are found in Brittany. It seems likely that they originated there as pre-Christian healing traditions which were subsequently incorporated into those associated with the Church. The centre of these traditions was (and is) St Cado in the South of Brittany, near Carnac.

David Edward Hughes and his audiometer.

A brief biography of David Edward Hughes is outlined. His Audiometer and its presentation are described. The response of clinicians to the device is discussed.

Personality tests in Ménière's disorder.

The personality of patients with Ménière's disorder has been evaluated using the Eysenck Personality Inventory and the Middlesex Hospital Questionnaire. The most notable finding was an elevated obsessionality score in the patients with Ménière's disorder as compared with other groups. There was no significant difference between the personality of subgroups of patients complying with rigid definitions of Ménière's disorder and those complying with a more liberal definition. The results of most scales decreased with increasing severity of the disorder, although the obsessionality scores do not follow this tendency.

An approach to the audit of tinnitus management.

This study examines the advantages and internal consistency of an open-ended questionnaire (Benefit-problem questionnaire), over the Tinnitus questionnaire used by Jakes et al. (1985) in the auditing of a stress management programme. The Tinnitus questionnaire showed very little difference pre- and post-treatment, while the Benefit/problem questionnaire showed good improvement over a number of variables. This included some of the more traditional orthogonal values of tinnitus complaint. The clinical assessment made blindly and over a different time scale to the Benefit/problem questionnaire matched these positive results quite closely.

Personality measures in E.N.T. outpatients.

Middlesex Hospital Questionnaires were given to 170 new adult outpatients at Lymington Hospital, the Royal South Hants Hospital, Southampton, and the Royal Northern Hospital, London. The examiners were asked to give their comments on the patients personality and a tentative clinical diagnosis. The significantly older population of Lymington Hospital was found to have lower hysteria and phobic anxiety scores. High hysteria and anxiety scores were found in a group of patients with rhinitis. As a whole there seemed to be little relation between the examiner's impression of the patient and their personality scores.

Prescription of hearing aids for the elderly: the views of general practitioners.

A questionnaire survey was carried out to examine the views of general practitioners in one Northern city regarding whether or not they thought that hearing aids should be prescribed from general practice, who they thought should prescribe them and whether or not additional resources and training would be needed if the responsibility for hearing aid prescription for the elderly was placed upon general practitioners. The survey indicated that whereas many general practitioners would be in favour of prescribing hearing aids from Health Centres, many would need extra training and resources to enable them to do so.

Acceptability of binaural hearing aids: a cross-over study.

Using screening questionnaires we were able to detect individuals aged 50-65 years with hearing disability in a general practice population. Those who had better ear hearing levels of 30 dB or worse were invited to take place in a cross-over study comparing the acceptability of a monaural or binaural hearing-aid fitting. Fifty-five per cent ultimately opted for a binaural fitting and had greater hearing disability and worse mean hearing levels than those who opted for a monaural fitting. They made their choice for acoustical reasons, particularly on the basis of improved localization ability.

Hearing disability in people aged 50-65: effectiveness and acceptability of rehabilitative intervention.

OBJECTIVE: To determine the best means of detecting hearing disability in subjects aged 50-65 and whether rehabilitative intervention is acceptable in this age group. DESIGN: Questionnaire survey of patients on general practice age-sex registers. Two types of questionnaire were used, one being based on the closed set approach of the Institute of Hearing Research questionnaire, which had been used in a pilot study, and the other being a simplified version of this questionnaire developed by the Welsh Hearing Institute and based on open set questions. Questionnaires were sent up to three times, and any patients who had not responded two months after the last posting were personally contacted. SETTING: Two general practices in Glyncorrwg and Blaengwynfi in the Afan valley, West Glamorgan. PATIENTS: 271 Patients in Glyncorrwg (136 men, 135 women) and 333 patients in Blaengwynfi (173 men, 160 women) aged 50-65. INTERVENTIONS: All patients indicating hearing disability in answering the questionnaires were invited to attend for a evaluative session in their village. After audiometric testing advice and arrangements for fitting a hearing aid were offered as appropriate. MAIN OUTCOME MEASURES: Response rates and prevalence of hearing disability before intervention and of possession of hearing aids before and after intervention. RESULTS: After three postings and personal contact the response rate was 98% (266/271) in Glyncorrwg, where the complex questionnaire was used, and 97% (322/333) in Blaengwynfi. The prevalence of hearing disability was respectively 53% (141/266) and 46% (148/322) and the prevalence of owning a hearing aid 7% (19/266) and 8% (24/322). After intervention the possession of hearing aids rose to 24% (64/266) in Glyncorrwg and 22% (71/322) in Blaengwynfi; six months later the aids were being used regularly. A direct comparison of the two questionnaires in 69 subjects from Blaengwynfi showed no significant differences in the amount of disability detected by each one. The first posting of questionnaires detected 65% (189/289) of the hearing disability in the two villages or 78% (72/92) of those prepared to accept hearing aids for the first time; 96% (88/92) of those who accepted hearing aids were detected by two postings. CONCLUSIONS: Simple questionnaires are effective in detecting hearing disabilities in people aged 50-65, and intervention was acceptable in many of those who reported having difficulties in hearing. The response rates from successive postings suggest that two postings are sufficient in terms of the return in detecting those who will accept intervention.