Early activation of the implant did not impact the healing process of the incision site, suggesting that one-day activation of the implant is feasible for some patients when medically possible. The evolution of the impedance and stimulation levels were consistent with that reported in previous studies, which indicates that early activation did not interfere with the physiological changes taking place after implantation.

This study revealed a substantial impact of physical, cognitive, and psychological disabilities on HRQOL of nursing home residents in Jordan.

The results presented in this article demonstrated that early activation for this sample did not seem to interfere with wound healing or with the fitting parameters suggesting that early activation should be considered as viable option to better serve CI patients' individual needs.

ECochG has long been shown to complement the diagnosis of MD, primarily through measurement of the SP/AP amplitude ratio. While reported in the literature to be highly specific to this disorder, ECochG's sensitivity in the general MD population remains relatively low (ranging from 20-65%). The current study assessed the sensitivity and specificity of the ECochG protocol we employ for suspected MD patients, which includes measuring both the amplitudes and areas of the SP and AP to clicks (to derive the SP/AP amplitude and area ratios), and the SP amplitudes to 1000 and 2000 Hz tone bursts. A retrospective chart review was conducted to compare ECochG results from 178 suspected MD patients with their eventual diagnoses. Measurements of highest sensitivity and specificity (determined using a logistic regression analysis) included: SP amplitude, SP area, SP/AP area ratio, and total SP-AP area. Sensitivity and specificity values associated with these measures were 92% and 84%, respectively. The sensitivity value is considerably higher than previously reported, and is attributable to the inclusion of area measurements in our protocol.

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PurposeThe aim of this study was to investigate the effects of physical, mental, and cognitive disabilities on gait and balance deficits among nursing home residents with different diseases in Jordan and also to find the risk of fall associated with or without these diseases.MethodsA sample of 221 nursing home residents aged 18–100 years in Jordan was recruited for this study. All participants were assessed using the Arabic versions of the Tinetti assessment battery (TAB) for gait and balance, mini–mental state examination, and disability of arm, shoulder, and hand assessment test.ResultsA total of 221 nursing home residents were included in this study. Different chronic diseases were medically reported in this study. Psychiatric disorders (45.7%) were shown to be the most prevalent disease seen among the participants, followed by hypertension and diabetes mellitus affecting 33.5% and 23.5% of the participants, respectively. However, the least prevalent diseases were stroke (17.2%), joint inflammation (17.2%), and arthritis (9.0%). Based on TAB scores, the participants were classified into three groups: high risk of falls (≤18; n=116), moderate risk of falls (19–23; n=25), and low risk of falls (≥24; n=80). The correlation between physical activity and mental health problems with risks of falls was reported in all participants. The data showed that participants with over 50% upper extremity disability, stroke, heart disease, arthritis, joint diseases, diabetes, and hypertension recorded higher risks of falls as measured by TAB test compared to those with low and moderate TAB scores. Also, impairment in cognitive abilities and psychiatric disorders was shown to be associated with gait and balance problems, with a higher risk of falls in 47.5% and 46.1% of the residents, respectively.ConclusionThis study revealed a significant impact of upper limb disability, stroke, heart disease, arthritis, joint diseases, diabetes, and hypertension as well as psychiatric disorders and cognitive disabilities on gait and balance deficits among home-resident older adults.

BACKGROUND: Hearing loss is an underestimated comorbid condition in type 2 diabetes. OBJECTIVES: Investigate hearing loss as a comorbidity associated with type 2 diabetes mellitus and evaluate the factors associated with hearing loss. DESIGN: Cross-sectional. SETTING: Tertiary care center, diabetes clinic. PATIENTS AND METHODS: Patients with type 2 diabetes, aged 30 to 60 years, were randomly selected to participate. All patients underwent clinical ear examinations and were referred for full audiological evaluation. Otoacoustic emission was used to assess inner function, tympanometry to assess middle-ear function, and pure tone air/bone audiometry to assess hearing sensitivity. Risk factors for hearing loss were assessed by multivariate logistic regression. MAIN OUTCOME MEASURE: Frequency, severity and risk factors for hearing loss. SAMPLE SIZE: 157 RESULTS: Of the 157 patients, 77 had hearing loss in both ears (49.0%), 13 in the right ear only (8.3%), 14 in the left ear only (8.9%), and 53 (33.8%) had normal hearing. In the 181 ears with sensorineural hearing loss, 90 had mild loss (49.7%), 69 moderate loss (38.2%), 16 severe loss (8.8%) and 6 had profound loss (3.3%). Disabling hearing loss was observed in 46 (29%) patients. A higher frequency of hearing loss was present in patients with glycated hemoglobin levels ≥8%. In the multivariate logistic regression analysis, the most important factors associated with hearing loss were longer diabetes duration, poor glycemic control and the presence of hypertension. CONCLUSIONS: Hearing loss is an underestimated comorbid condition in type 2 diabetes that warrants frequent hearing assessments and management. Strict glycemic and hypertension control is essential for the minimization of the effects of diabetes on hearing sensitivity. LIMITATIONS: Small sample size, limited age window (30-60 years), which was chosen to eliminate the natural aging effect on hearing. Cross-sectional nature was not ideal for the assessment of causality. CONFLICT OF INTEREST: None.

BACKGROUNDOtosclerosis is a common cause of progressive hearing impairment that causes fixation of the stapes. Surgical intervention is the preferred treatment approach to ameliorate the conductive hearing loss associated with stapedial otosclerosis. However, given that it is a difficult and delicate procedure, the surgery may fail for a number of reasons. Therefore, it is very important to evaluate the success rate of the surgical approach used in each regional center.OBJECTIVETo examine the effectiveness of stapedotomy in improving hearing sensitivity for otosclerotic patients at King Abdul Aziz University Hospital in Riyadh.DESIGNRetrospective chart review with an analysis of pre- and postoperative surgical treatment.SETTINGTertiary referral otolaryngology clinic.PATIENTS AND METHODSAll cases who underwent stapedotomy between 1997 and 2009 were retrospectively reviewed. Preoperative and postoperative audiometric assessments were conducted using conventional pure tone audiometry. Differences were analyzed by two-way repeated measures ANOVA.MAIN OUTCOME MEASURE(S)Pre- and postoperative pure tone thresholds for air and bone conduction.RESULTFifty-three patients underwent stapedotomy. Stapedotomy yielded significant improvements in mean (SD) postoperative air-conduction thresholds of about 18.7 (11.7) dB (P<.0001) and mean (SD) postoperative bone-conduction thresholds of about 2 (7.2) dB (P<.05). Additionally, a significant correlation was found between improvement in air-conduction thresholds and the size of preoperatve air-bone gap (P<.01) About 70%of patients achieved an air-bone gap of 20 dB or better. None of the cases examined in this study exhibited sensorineural hearing loss or adverse complications following stapedotomy.CONCLUSIONSStapedotomy is a safe and effective treatment option for patients with otosclerosis. Given that the majority of participants in this study exhibited mixed hearing loss preoperatively, the results further suggest that stapedotomy can also be effective in improving thresholds for these patients.LIMITATIONSThe sample size was relatively small.